Progesterone During Pregnancy & Breastfeeding
Can Pregnant Women Take Progesterone?
Manufacturers do not recommend the use of progesterone preparations (e.g. Prometrium) in pregnant women. Progesterone is often prescribed together with hormonal replacement therapy for postmenopausal women to prevent thickening of the uterine lining. It is also used to regulate menstrual cycle in women who have inadequate progesterone. However, progesterone is thought to be beneficial in women who are undergoing fertility treatments or those with history of miscarriages.
Because of reported cases of birth defects due to progesterone use during pregnancy, the U.S. Food and Drug Administration (FDA) required manufacturers of progesterone to include a warning that this medication should not be used by pregnant women. However, new studies and clinical experience suggest that progesterone does not increase the risk at all. On the contrary, it seems that progesterone preparations can help sustain pregnancy in women who have low progesterone levels. However, the FDA recommendation stays in place. So, don’t be surprised to find pregnancy warning in progesterone prescription labels.
Pregnancy Category B
Interestingly, despite being contraindicated in pregnant women, progesterone is classified by the FDA as a Pregnancy Category B medication. This means that the drug is usually considered quite safe for pregnant women. A Pregnancy Category B classification is given to medications that have not been adequately studied in humans but animal studies suggest it does not cause harm on the unborn child.
Many pregnant women are concerned because of the contrasting and inconclusive information about using progesterone pregnancy. Most resources would advise against the use of the medication in pregnant women while some healthcare providers recognize it as beneficial for pregnancy. There is also no “official” guideline as to the use of the medication in pregnant women; as such the recommended dose varies widely. It should also be noted that there are some healthcare providers who do not recommend progesterone during pregnancy.
If you plan to become pregnant or become pregnant while on progesterone treatment, be sure to discuss with your healthcare provider the potential benefits and risks of progesterone. Officially, progesterone should not be taken by pregnant women unless specifically instructed by a healthcare provider.
Can Breastfeeding Women Take Progesterone?
Small amounts of progesterone are excreted into the breast milk, however its effects on lactation and the nursing infant has not been well established. The manufacturer recommends that this medication be given to breastfeeding women only when clearly necessary.
However, studies suggest that progesterone preparations do not seem to affect lactation and do not cause harm on the nursing infant. In fact, some birth control pills intended for lactating women do contain progestin (synthetic progesterone-like medication).
You should discuss with your healthcare provider use of progestin during breastfeeding. Do not take this medication without your approval of your healthcare provider.