Journal / Preventive Care

Progesterone Therapy to Prevent Miscarriage For Some Women

Nancy L. Belcher

Medically reviewed by Nancy L. Belcher Ph.D, MPA

Written by Winona Editorial Team

Last updated November 25, 2021

Progesterone Therapy to Prevent Miscarriage For Some Women

Progesterone Therapy

Progesterone can play a powerful role in how to prevent miscarriage. Progestogens are sex hormones (like estrogens and testosterone), which have a job in both men’s and women’s sexual development at puberty and then their ongoing reproduction. 

Hormones are molecules produced by your glands that travel throughout your bloodstream, seeking specialized receptors on certain organs. The hormone progesterone targets and affects the uterus, vaginacervixbreasts, and testes, as well as the brain, blood vessels, and bones.1,2

Progesterone therapy is one of the ways to prevent miscarriage.1 For women who have had multiple miscarriages, treatment with progestogen may help prevent miscarriage—particularly in people who have had three or more pregnancy losses.1 Learning the importance of progesterone can help you to figure out how to avoid miscarriage and have a healthy pregnancy, or choose the best type of birth control. There is medicine to prevent miscarriage that is readily available. 

Progesterone prepares the endometrial lining in your uterus for a potential pregnancy after ovulation. Progesterone regulates how thick the lining is, and how prepared it is to accept a fertilized egg, and can also prohibit muscle contractions in the uterus that would cause the body to reject an implanted egg. While the body continues to produce high levels of progesterone, the body will not ovulate again and only one pregnancy will occur.1

If a woman does not become pregnant, progesterone levels will drop and menstruation will begin again. If conception does take place, progesterone will continue to maintain the thicker endometrium which will allow for the development of the growing fetus.1

Miscarriage

Low progesterone might be a cause for infertility or miscarriage.1 When women have low levels of progesterone, they can have abnormal menstrual cycles and may struggle to conceive. It’s because there is not enough progesterone to properly prepare their body for a conceived egg to grow. Women who can get pregnant but have low progesterone levels are at higher risk for miscarriage or pre-term delivery because the proper levels of progesterone are required to maintain the pregnancy.2,3,4

The miscarriage of a child can be traumatic and is often due to some medical issues that are beyond your control. If a pregnancy ends before 24 weeks, it is known as a miscarriage.1Miscarriages are common in the first three months of pregnancy with about one in six confirmed pregnancies ending in miscarriage.1Sometimes the mother only finds the baby has died when she goes in for an ultrasound. This can come as a painful surprise. This type of miscarriage is called a missed or silent miscarriage.1

Those miscarriages that occur before week 14 are often a result of developmental problems with the baby but there are other potential causes, such as hormonal problems. Later miscarriages can be caused by infection and problems with the placenta or cervix. 

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What does progesterone do to the body?

  • Stops the build-up of the endometrium caused by estrogen

  • Inhibits ovulation when at high levels esp. during pregnancy

  • Prepares the endometrium for the possible implantation of a fertilized egg

  • Supports early pregnancy and helps maintain a continued pregnancy

  • Develops the mammary glands during pregnancy in preparation for lactation

  • Decreases uterine contraction to prevent early labor1

  • Changes the cervical mucus to keep sperm from entering the uterus

What is Progestin?

It’s important not to confuse progestins with progesterone. Progestins are synthetic hormones created from progesterone or testosterone that have progesterone-like effects.1Progestins are used in hormonal contraception (alone or with estrogen).  Scientists made progestin because the progesterone they were making wasn’t well absorbed when taken as a pill. Today,  hormone replacement therapy (HRT) uses bioidentical progesterone that is micronized and well absorbed.

Unlike bioidentical progesterone, progestin’s chemical structure is different from the body’s progesterone, and they are not a perfect fit for progesterone receptors. This means that when you use birth control you may have a very different experience with hormones than you would with HRT. Progestins, because of their chemical structure differences, may attach to more than just progesterone receptors including receptors for testosterone and estrogen, causing the side effects associated with these hormones.1,2

For example, progestins (NOT HRT progesterone) can activate testosterone receptors which may lead to side effects like acne or hirsutism  (excess hair) in some people, especially when birth control has low or no estrogen.1 Not everyone’s response will be the same, but the formulation and type of progestin will matter, and again should not be confused with the bioidentical progesterone used in HRT.5-8

Progestin was previously used to treat menopause symptoms such as hot flashes  and vaginal dryness, but today for women who are perimenopausal or menopausal, healthcare providers may suggest an oral micronized bioidentical progesterone treatment as a preferred alternative.2,3

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Progesterone & Menopause

If you are looking to use progesterone treatment for menopause, treatment should be started at the beginning of menopause if at all possible. If a woman is over 60 years old or has been menopausal for longer than 10 years, it may be too late to start progesterone treatment. Ask your Winona experts if you could still be offered treatment.5-9

The most effective way to relieve menopause symptoms is to try natural menopause hormone treatments like HRT that include progesterone. If a woman doesn’t have a uterus, it is common to be prescribed just estrogen therapy alone. If a woman does have a uterus, they will be prescribed a combination of estrogen and progesterone to protect the uterus, and keep the uterine lining thin.

When estrogen and progesterone are taken together, it’s often in pill form or a cream. Progesterone on its own can also be in the form of a pill or a cream that contains micronized progesterone, which is easily used by the body at low doses.5-9

Summary:

For women who are struggling with miscarriages, the emotional toll of the struggle is painful. There can be many reasons, but it’s valuable to talk to your doctor about your progesterone levels and what types of medicine to prevent miscarriage there are.  Progesterone therapy can be one of the ways to prevent miscarriage.1 Reassuringly, most women who have had a miscarriage will have a successful pregnancy and birth in the future.9

Conversely, if you are looking at your progesterone levels because you are experiencing menopausal symptoms. You can embrace your evolving body by providing the nutrients your body needs like estrogen, progesterone, and testosterone. Bioidentical hormones as HRT can enable you to move through this sometimes precarious phase with grace and wellness.  Let the Winona women’s health care experts work with you to replace the missing ingredients to help you feel and stay young and healthy.

“This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.”

References:

  1. https://www.nidirect.gov.uk/articles/miscarriage-stillbirth-and-ectopic-pregnancy

  2. https://helloclue.com/articles/cycle-a-z/progesterone-101

  3. https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/progesterone#:~:text=Progesterone%20prepares%20the%20endometrium%20for,body%20to%20reject%20an%20egg

  4. https://www.rcog.org.uk/en/news/progesterone-could-prevent-8450-miscarriages-a-year-finds-new-research/

  5. https://www.healthline.com/health/progesterone-for-menopause#bottom-line

  6. https://www.medpagetoday.org/endocrinology/generalendocrinology/43123?vpass=1

  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245250/

  8. https://www.healthywomen.org/your-health/progesterone/facts-to-know

  9. https://www.hotzehwc.com/2018/04/anxiety-relief-with-bioidentical-progesterone/