| Name | Compounded Progesterone (Micronized, Sustained-Release, or Oil-Based) & Branded Progesterone (Prometrium, Crinone, Endometrin, etc.). |
| Uses | Support hormonal balance, treat progesterone deficiency, luteal phase support, perimenopause/menopause therapy, and fertility protocols. |
| Route Of Administration | Oral, sublingual, vaginal, intramuscular (IM), or subcutaneous (SC). |
| Frequency Of Use | Determined by provider based on indication: typically daily or cyclic use (14 days/month for cycle support). |
| Concentration(s) | Oral: 100mg, 200mg capsules. Vaginal: 90mg gel, 100-200mg suppository. IM: 50mg/mL, 100mg/mL oil-based solutions. |
| Maximum Dosage (Day, Wk) | Oral: Max 300mg/day. Vaginal: Max 200mg/day. IM: Max 200mg/session, 600mg/week. |
| Contraindications | Active or history of thromboembolic disorders, liver dysfunction, undiagnosed abnormal vaginal bleeding, known or suspected malignancies (breast, uterine). |
| Possible Side Effects | Fatigue, dizziness, headache, nausea, breast tenderness, mood changes, fluid retention, breakthrough bleeding. |
| Compatibility With Other Treatments/Drugs | Avoid concurrent use with CYP3A4 inhibitors/inducers, anticoagulants, and strong sedatives (e.g., benzodiazepines). |
| Allergies | Check for hypersensitivity to progesterone, peanut oil (Prometrium), or other excipients. |
| Administration Time | Oral: Nighttime dosing preferred (due to sedation effect). Vaginal: Bedtime insertion. IM: Administer slowly over 30-60 sec. |
| Dosing/Settings | Oral: 100-200mg/day. Vaginal: 100-200mg/day. IM: 50-100mg per injection, typically every 2-3 days as needed. |
| Test Spot Requirement | IM: Not required unless prior reaction to compounded or oil-based formulations. |
| Pre-Treatment Guidelines | Confirm menstrual cycle phase, pregnancy status, and baseline progesterone levels if applicable. |
| Provider Clearance Guidelines | Ensure no contraindications, confirm progesterone deficiency via labs if clinically necessary, review medical history. |
| Pre-Treatment Screening Workflow | 1. Verify indication for use. 2. Assess contraindications. 3. Obtain informed consent. |
| What To Do If Adverse Reaction Occurs | 1. Assess severity. 2. If mild (dizziness, nausea), monitor and adjust dose. 3. If severe (anaphylaxis, thrombosis symptoms), initiate emergency response and refer to ER. |
| Clinic Implementation Guidelines | Confirm patient identity, document treatment parameters in EMR, verify prescription and dispense accordingly. |
| Photographic Documentation Protocol | Not required unless IM injection site reactions occur. |
| Post-Treatment Care | Monitor for breakthrough bleeding or mood changes, follow up after 2-4 weeks for dose adjustments if needed. |
| Additional Documentation Requirements | Signed informed consent, treatment logs, prescription details, and adverse event documentation if applicable. |
| Special Notes | Treatment is elective; safety considerations and patient education are critical. |