You may be wondering why your doctor is having you take progesterone tablets in pregnancy. Having stable progesterone levels is an important part of the reproductive cycle from your periods being regular to building up your uterus for possible pregnancy.
Your ovaries are in charge of producing, releasing, and keeping progesterone levels where they need to be. In the first weeks of pregnancy, the ovaries produce needed progesterone until the placenta begins to produce it on its own in the second trimester. Sometimes, this doesn't always work right. This article will explain the reasons for needing extra progesterone, how it works, and any safety concerns.
Is It Necessary to Take Progesterone Tablets During Pregnancy?
In the beginning of your pregnancy, you need enough of the hormone progesterone helps keep it going until the placenta develops and takes over. Your ovaries secrete this hormone in response to the embryo implanting in your uterine wall. This goes on for the first 9 weeks of your pregnancy.
If you have had miscarriages in the past or got pregnant via in vitro fertilization, your doctor may choose to put you on progesterone tablets. This will help give you the extra progesterone you need to maintain the pregnancy.
Studies show that progesterone given in early pregnancy is safe.
When do You Need Progesterone Tablets During Pregnancy?
History of miscarriage (3 or more) - Progesterone tablets are usually given soon after a positive pregnancy test if you have a history of 3 or more miscarriages in the past.- Low progesterone levels and cramping or spotting - Progesterone may also be prescribed anytime up to 12 weeks if you have low progesterone levels with cramping or spotting.
- During egg retrieval with in vitro fertilization - If you have in vitro fertilization, your doctor may prescribe progesterone tablets right after egg retrieval to mimic the body’s natural responses after ovulation. This will help prepare your uterine lining for the implantation procedure.
In any situation, you will take these tablets until you are 12 weeks pregnant.
What do Progesterone Tablets Do?
Progesterone tablets during pregnancy mimic your body’s own progesterone that is produced by your ovaries. It has some very important roles:
- Relaxes your uterus to prevent contractions that may expel the baby
- Relaxes the ligaments in the hips and pelvis to get them ready to expand
- It keeps your immune system from "fighting" off the baby’s DNA
- Keeps the uterine lining thick and nourished until the placenta takes over
- Prevents your progesterone levels from dropping too low, which could signal your body to "shed" the lining and expel the pregnancy
The tablets are made in a lab and all of the above are the very same things your natural progesterone would do.
Note: One thing that progesterone tablets do not do is prevent an impending miscarriage if the process has already started and the doctor cannot find a fetal heartbeat.
Side-Effects of Progesterone Tablets
The side-effects of progesterone are pretty much the same as normal pregnancy symptoms; however they may be a little more intense depending on how much progesterone you are taking. The side-effects are as follows:
1. Headaches
The headaches you get in pregnancy are caused by increased progesterone levels. Part of this is due to more relaxed blood vessels to help improve your blood flow. The blood vessels leading to your head and brain also relax and the increased blood flow to your head causes almost intolerable headaches at times. Migraine sufferers may notice more migraines while taking progesterone.
2. Constipation
This isn’t a very comfortable side-effect, but it does have a good reason. Progesterone slows down your intestines by relaxing the muscle walls. This prevents strong bowel contractions from triggering contractions in your uterus. The benefit to you and your baby is the food stays in longer so your body can extract every bit of nutrition from the food that you eat.
3. Fatigue
This inevitable sign in early pregnancy can be heightened if you take progesterone tablets during pregnancy. Progesterone naturally relaxes your central nervous system and can make you feel sleepy. The good news is, if you suffer from anxiety or are tense you may feel much more relaxed.
4. Sore Breasts
You can thank progesterone for breast soreness in early pregnancy. Taking progesterone tablets may cause increased breast soreness. Find a good sports bra because your nipples may be very tender too.
5. Moodiness
It is pretty normal to have mood swings early in pregnancy. When you take progesterone tablets during pregnancy, these may be a bit more intense than they normally would. You may experience increased depression, bouts of anger, and even intense happiness at times.
6. Stuffed Up Nose
Your nose has smooth muscles that help move mucus through and out of your body. When you take progesterone, these muscles relax and have a harder time doing their job. This can lead to an increase in nose stuffiness.
7. Other Uncommon Side Effects
Rarely, you may also experience the following:
- Dizzy spells
- Abdominal pain
- Increased nausea and vomiting
- More frequent colds
- Brain fog
- Blood clots
- Swollen ankles
It is important to talk to your doctor about side-effects, what is normal, and what you need to call the office and report.
Are There Any Risks or Precautions to Take?
While the FDA (Food and Drug Administration) has neither approved or disapproved the use of progesterone tablets during pregnancy, it has been found safe for use. There were no adverse effects reported on mother or fetus when studied in animals. Since being used in women, there have been no reports of adverse effects to mother and baby. Your doctor will decide if the benefits are more than the risk when prescribing you this medication.
There was only one birth defect reported during progesterone use in pregnancy. This baby was born with a cleft palate, which can happen in any situation even without progesterone. Very rarely, there have been pregnancy losses in women using progesterone and the cause was never pinpointed. Make sure you are only using progesterone as directed by your doctor.