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Progesterone is available in various forms synthetic progestins, natural progesterone and micronized natural progesterone. Natural progesterone being similar to the steroid produced by the corpus luteum has minimal side effects. Micronization of the progesterone molecule results in a chemically identical substance to the naturally produced progesterone in humans with better absorption and bioavailability. It has significantly lesser metabolic and vascular side effects as compared to the synthetic progestins. Micronized natural progesterone can be given orally as well as vaginally. The vaginal route avoids ﬁrst-pass hepatic metabolism and achieves a higher concentration locally.
Micronized natural progesterone is used in various conditions which require progesterone supplementation or replacement. In pregnancy it has been used for various indications requiring progesterone supplementation. It improves the pregnancy rate in luteal phase deficiency. It has also been used in preterm labour and recurrent miscarriage with variable results. Micronized natural progesterone has been used for hormonal replacement therapy along with oestrogen and in the treatment of dysfunctional uterine bleeding. Counselling of these patients for cardiovascular and thromboembolic disease and breast or ovarian cancer should be done. It has also been shown to be effective for treatment of hot flushes, night sweats and even depression in healthy women early in postmenopause period.
Keywords: Synthetic progestins; Micronization; Luteal phase deficiency; Preterm labour; Recurrent miscarriage