Utrozhestan quickly relieves nagging pain in the lower abdomen and reduces anxiety levels

Utrozhestan during pregnancy: indications and contraindications

Often women face hormonal problems that interfere with conceiving or bearing a child. The most common cause of miscarriage in the first trimester is a lack of progesterone, which is called the pregnancy hormone. It is produced by the corpus luteum. Utrozhestan during pregnancy is in most cases used specifically for the treatment of this pathology.

Utrozhestan is also prescribed to normalize the cycle, treat some benign diseases of the reproductive system, and support the second phase of the cycle. In this case, women are naturally interested in the question of what is the likelihood of pregnancy while taking Utrozhestan or its analogue, Duphaston, and what further actions should be taken if pregnancy does occur.

To understand this, special attention should be paid to the mechanism of operation of the drug, indications and contraindications, as well as methods of administration and its withdrawal.

Composition and mechanism of action

The active ingredient is natural progesterone, the chemical formula of which has been improved to facilitate absorption from the gastrointestinal tract or vagina. It belongs to the group of gestagenic agents. Progestogen (synonymous with progesterone) is a hormone that produces the corpus luteum, which forms after ovulation at the site of egg maturation. Read more about the yellow body→

The hormone prepares the endometrium (inner covering) of the uterus for the introduction of a fertilized egg into it, reduces the contractile activity of the uterus, thereby helping to maintain pregnancy. It also has an effect on the mammary glands, stimulating preparation for lactation.

Absorption of the drug occurs quickly both from the gastrointestinal tract and from the vagina. The main difference is that with intravaginal administration, progesterone quickly accumulates in the uterus and the local effect is more pronounced. If the administration of the drug exceeds 200 mg per day, then the concentration of the hormone in the blood corresponds to the first trimester of pregnancy.

Utrozhestan during pregnancy and other periods is prescribed only if there is a deficiency of progesterone in the body. There are differences in indications for taking the drug orally and vaginally.

Utrozhestan is used orally for:

infertility due to insufficiency of the second phase of the cycle;
cycle disruption due to lack of ovulation;
mastopathy;
severe premenstrual syndrome (PMS);
premenopause;
replacement therapy in women after menopause.

Utrozhestan as vaginal suppositories is prescribed for:

replacement therapy and “support” therapy in in vitro fertilization (IVF) protocols;
early onset of menopause;
infertility due to insufficiency of the second phase of the cycle;
prevention of spontaneous abortions and premature births in women at risk;
threat of miscarriage;
habitual abortion due to low progesterone levels.

Please note that Utrozhestan can only be used intravaginally during pregnancy. The drug cannot be used during breastfeeding, because it passes into breast milk and will affect the baby's hormonal levels.

The drug is available in special gelatin capsules containing 100 or 200 mg of natural micronized progesterone. Auxiliary elements are vegetable oil and soy lecithin. Capsules can be used for oral and vaginal administration depending on the indications. Packages usually contain 7, 14 or 30 capsules, depending on the manufacturer and dosage.

An analogue of Utrozhestan, Duphaston, is available in tablets for oral administration; unlike Utrozhestan, it contains a synthetic analogue of gestagen.

Causes of pain

Threat of miscarriage

Aching and nagging pain syndrome radiating to the lumbar region. Quite often it is accompanied by bloody spotting. After some time and without proper medical treatment, bleeding increases, contractions occur, the cervix shortens significantly, and premature labor/spontaneous abortion occurs.

This condition can be provoked by developmental pathologies of the unborn child, severe stress, intense physical activity, etc.

Ectopic pregnancy

Pain in the lower abdomen can occur when the fetus implants outside the main uterine cavity. Most often, the fertilized egg is localized in the tube and the resulting miscarriage makes itself felt with sharp pain and strong contractions on one side, while slight bleeding is observed.

At a later stage, an ectopic pregnancy can lead to rupture of the tube - cramping pain is replaced by severe pain with irradiation into the pelvic region, ribs, loss of consciousness, and intra-abdominal bleeding.

Premature placental abruption

This negative condition can develop both in the 2nd–3rd trimester of pregnancy and during childbirth. Increase the risk of preeclampsia, labor anomalies, abdominal trauma, short umbilical cord, and arterial hypertension.

In this situation, there is practically no discharge, but severe pain occurs in the lower abdomen, the doctor detects signs of hypoxia/internal bleeding in the fetus. The uterus is in constant tone, the placental hematoma is gradually increasing.

Acute surgical pathologies

Pancreatitis, appendicitis, intestinal obstruction and other pathological conditions can cause pain in the lower abdomen. At the same time, diagnosing the above diseases and problems is often difficult, especially in the later stages of pregnancy. In the vast majority of cases, in addition to pain, there are accompanying symptoms in the form of weakness, malaise, fever and dyspeptic disorders.

Problems with the gastrointestinal tract

Against the background of hormonal changes, poor nutrition, low mobility and other negative factors, problems with the gastrointestinal tract may arise. Constipation, bloating, dysbiosis and other problems often provoke pain in the lower abdomen.

Sprain of abdominal ligaments/muscles and pelvic bones

In the first trimester, aching pain in the lower abdomen without contractions can occur due to rapid physiological changes in the body, in particular due to softening of the tissue structures of the uterus and related organs. Their localization is not entirely clear, but, as a rule, they are diagnosed on both sides of the midline.

As the fetus grows, the uterus also changes in size, increasing additional stress on the pelvic ligaments. Along with the displacement of individual organs, the abdominal press experiences strong pressure. Most often, such a painful, aching syndrome with tingling occurs towards the end of the second trimester of pregnancy and can continue until childbirth. This symptom manifests itself especially strongly during multiple pregnancies or a very large child. Often, it may be accompanied by an umbilical hernia.

In the later stages of pregnancy, in the process of preparing the unborn baby for childbirth, the pelvic bones begin to diverge slightly, which in turn provokes the appearance of pain of moderate intensity.

The above types of problems are related to physiological causes and do not require special drug treatment.

Use of the drug during pregnancy

Utrozhestan can be prescribed by an obstetrician-gynecologist to prevent miscarriage if a woman is at risk of miscarriage or has a low level of her own progesterone according to the results of a blood test. The drug can be urgently prescribed if there is a threat of miscarriage in order to prevent it.

Women are at risk if:

in the past there were spontaneous abortions in the first trimester of pregnancy associated with a lack of gestagen;
an in vitro fertilization procedure was performed;
there was infertility due to luteal phase deficiency;
the woman was taking Duphaston or Utrozhestan at the time of conception;
there has been a previous premature birth in the second trimester of pregnancy;
there is shortening of the cervix in the present.

But each pregnancy is individual, so the question of prescribing the drug should be decided by the attending gynecologist, taking into account the woman’s medical history, concomitant diseases, age and other important factors.

Cancellation of Utrozhestan during pregnancy is a long process; you should not suddenly stop taking the drug, since a drop in progesterone levels can provoke a spontaneous miscarriage. Dosage reduction usually lasts 1-1.5 months. Only a doctor can determine the time when you need to start reducing the dose.

During the withdrawal period, the patient should monitor her well-being - note the amount and nature of discharge while taking Utrozhestan during pregnancy, the presence of pain or a feeling of petrification in the lower abdomen, nagging pain in the lower back or sacrum. If bloody discharge occurs, as well as brown or black color, pain, then you need to urgently go to the hospital.

The advantages of the drug are obvious - it helps to carry a pregnancy, the disadvantages are side effects (and they are quite common) and the need for gradual withdrawal.

Often women find themselves in a situation where a hormone is prescribed to support the second phase of the cycle. While taking it, pregnancy occurs, but the woman does not yet know about it and cancels the drug in order to induce another menstruation. This can cause a miscarriage or frozen pregnancy, which is a disadvantage of the drug.

About 50% of early miscarriages occur due to genetic disorders and infectious diseases. In these cases, Utrozhestan or Duphaston will not help maintain the pregnancy, but will only delay the onset of miscarriage. Therefore, the prescription of the drug is justified only in case of proven progesterone deficiency in the current pregnancy or multiple miscarriages due to progesterone deficiency in the past.

Instructions for use of Utrozhestan during pregnancy

— dosage

The therapeutic course is determined by the doctor, who analyzes the characteristics of the course of pregnancy, studies the severity of progesterone deficiency and prescribes a method of application.

If the choice is made in favor of oral administration of capsules, the daily dose varies between 200-300 ml during the day. As a rule, 100 ml is taken in the morning, the rest before bed.

For preventive purposes, when there is a threat of premature birth, the drug is used according to a certain scheme:

400 ml every 7-8 hours until the condition stabilizes;

- contraindications

Contraindications to taking the drug are:

Varicose veins;
Thrombophlebitis and thrombosis;
Serious liver pathologies;
Porphyria;
Neoplasia of the genitals or mammary glands;
Undiagnosed bleeding.

In some conditions, Utrozhestan should be used with extreme caution or may be contraindicated: we are talking about so-called relative contraindications. These are controversial situations when the doctor assesses the risks of taking the drug and pregnancy complications (threat of miscarriage, premature birth, lack of progesterone).

Such situations arise when:

Stable increase in blood pressure;
Epileptic seizures;
Bronchial asthma;
Diabetes mellitus;
Mastopathy;
Migraine;
Impaired kidney function;
Diseases of the cardiovascular system;
Lupus erythematosus;
Benign formations.

- side effects

Side effects from taking the drug are rare, however they can be:

Amenorrhea;
Mammalgia;
Bleeding from the birth canal;
Headaches and dizziness;
Drowsiness, apathy, depression;
Absent-mindedness;
Nausea and vomiting;
Stool disorders (diarrhea and constipation);
Itching, peeling of the skin, rashes;
Yellowness of the skin, chloasma.

Vaginal use of capsules may cause a local reaction: itching, burning, swelling.

Other negative reactions to the drug include blurred vision, blood clots, venous insufficiency, severe headaches, lack of sexual desire, weight gain or loss, thromboembolism, swelling, hirsutism, localized alopecia and anaphylactic shock.

But the appearance of yellowish oily discharge in moderate quantities after intravaginal administration of the drug is a variation of the norm.

- how to cancel

Since Utrozhestan is a hormonal drug, discontinuation should occur gradually. The most successful method of discontinuation of treatment and prevention is to reduce the dosage to 100 ml weekly or 50 ml every three days.

During gradual withdrawal of the drug, the woman should be constantly monitored by a doctor so that if bleeding begins, appropriate measures can be taken.

Method of use of the drug during pregnancy

During pregnancy, Utrozhestan is used intravaginally: the capsule is inserted deep into the vagina, after toileting the external genitalia.

Mode of application:

During a threatened abortion or for the prevention of habitual abortion, the dose of utrozhestan is from 200 to 400 mg per day. It is divided into 2 doses. Should be taken daily in the 1st and 2nd trimesters. By the end of the 2nd trimester, the drug is gradually discontinued.
With IVF, the dose is determined individually. Start taking it from the day of hCG injection and continue until the end of the 2nd trimester. The maximum dose is 600 mg, divided into 3 doses per day. This dose is achieved gradually according to an individual scheme, and the drug is also gradually discontinued.
Prophylactic use in women at risk of premature birth (shortened cervix, unfavorable medical history) - from the 22nd to the 34th week at a dose of 200 mg once a day at night.

In all cases, the doctor may change the dosage, because it depends on the level of hormones of a particular patient and the problems that exist. You should not skip doses of the drug or stop taking it yourself.

Treatment and advice

Any measures related to the treatment and elimination of the symptom of pain in the lower abdomen during pregnancy can be carried out only after a comprehensive comprehensive diagnosis and the correct diagnosis, as well as determining the true cause of the pain syndrome.

If there is a threat of miscarriage. Sedatives and antispasmodics are prescribed to relieve uterine tone, as well as restorative vitamin therapy. In addition, for hormonal factors, the doctor recommends undergoing therapy with a synthetic analogue of progesterone; in some cases, a special ring is placed on the cervix to prevent its premature dilation.
With an ectopic pregnancy. The only way to get rid of an ectopic pregnancy is through abortion in the early stages, removal of the fertilized egg, and in some cases, partial or complete removal of the tube. At the same time, modern methods and equipment make it possible to restore the reproductive function of the body.
With placental abruption. Depending on the extent and degree of complexity of the detachment, bed rest, antispasmodics (Drotaverine, Magnesia), hemostatic agents (Vikasol, ascorbic acid), iron supplements, as well as tocolytic therapy (Ginipral and other drugs that relax the tone of the uterus) are prescribed. In some cases, with rapid progression of the problem, a caesarean section is prescribed or the amniotic sac is punctured and the woman gives birth on her own.
For acute surgical pathologies. Appendicitis, pancreatitis, intestinal obstruction and other diseases/pathological conditions require special attention and care during pregnancy, because any surgical intervention can have a detrimental effect on the health of the mother and the unborn child. Decisions on the prescription of drug therapy, surgery and other actions are made by a special council of qualified doctors.
Physiological problems. Special diets, light but regular physical activity, and restoratives are recommended.

Contraindications and side effects

Side effects usually occur when taking the drug orally, and with intravaginal administration, only local allergic reactions to the components of the capsule are observed - burning, itching, oily vaginal discharge.

However, some women complain of drowsiness, dizziness and increased toxicosis. Despite unconfirmed data, you need to keep in mind such systemic side effects.

Contraindications:

intolerance to components;
thrombosis, thrombophlebitis, strokes, myocardial infarction in the present or past;
incomplete abortion;
breast or reproductive system cancer, as well as suspected cancer;
porphyria;
bleeding from the vagina with an unknown cause.

The drug should be taken with caution in case of renal and liver failure. Before prescribing, assess the magnitude of the risk and possible benefit. During admission, it is necessary to monitor the biochemical analysis of blood and urine.

Thus, Utrozhestan is an indispensable drug for miscarriage due to a lack of progesterone. Unfortunately, many doctors prescribe it without sufficient reason. If you have doubts about whether the drug has been prescribed correctly, it is recommended to see another doctor.

If the appointments are confirmed, then it will be necessary to take Utrozhestan daily for quite a long time, despite the high price of the drug. Fortunately, it very rarely causes side effects when administered intravaginally. The drug is considered safe for the fetus, although studies are still being conducted.

Author: Yulia Prokofieva, obstetrician-gynecologist, especially for Mama66.ru

Utrozhestan during pregnancy

Girls, tell me, maybe someone has had this happen. I am 10 weeks pregnant, yesterday I went to register (1 time). The doctor examined it (with a mirror), took swabs, and felt it. She said that there was brown discharge - she showed it to me (on the mirror). I would say that they are very light brown, and there are very few of them, because I didn’t notice anything before, the linen is clean. Otherwise, everything seems to be normal, there is no tone! I prescribed Folka, Vit *****, Magne-B6 and Utrozhestan (due to discharge). So I have a dilemma. I know that utrozhestan is now prescribed to almost all pregnant women - according to indications, and simply for prevention. It seems like they don’t write anything bad about him, on the contrary, you keep your guard up. But I still wouldn’t want to take anything extra. So I’m wondering if it’s necessary. After all, there is no tone, severe pain does not bother me (sometimes it tugs a little - but they said that it is the ligaments that are stretched), but this discharge. I don’t see them at all, and they are not dark brown, scarlet or bloody (then I would drink without question), but barely brown. But on the other hand, you read all sorts of things and it’s scary. I'm going for a scheduled ultrasound in 2 weeks. In general, I don’t know what to do.

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[2927680412] – November 9, 2011, 10:10 pm

Well, if there is discharge, I would take it. I had Utrozhestan in support from weeks 10 to 16 (due to the fact that progesterone was falling), inserted into the vagina, the dose was small - 200 mg (100 in the morning and 100 in the evening). I can’t write anything bad about this drug.

[3276509760] – November 9, 2011, 10:23 pm

I drank this stuff, then I had problems

[1772354437] – November 9, 2011, 10:23 pm

I had bleeding at 11 weeks, red blood, the doctor from the hospital emergency room simply sent me home, like if the pregnancy is normal, then there will be a pregnancy, but if not, then it’s not meant to be. I practically persuaded him to prescribe me at least something to calm me down, because... the fetus developed well and corresponded to the gestational age. Well, he prescribed me Utrozhestan 100 vaginally 3 times a day for 10 days (I think) and said so hopelessly like - well, if it helps you. as if there is no faith in this matter. When the bleeding stopped, my treating gynecologist said that the hormones didn’t help, it recovered on its own. and when before that I had brown discharge, they told me that this was normal, go home and rest, they didn’t even give me sick leave.

[1772354437] – November 9, 2011, 10:25 pm

I see that in Russia it is generally accepted to simply feed with hormones and pills during pregnancy.

[1226325139] – November 9, 2011, 10:34 pm

Utrozhestan is a hormonal drug. There is no threat to you, why drink it? Be patient until the ultrasound - let them look at the tone of the uterus and general condition. The doctor also prescribed me duphaston (the same hormone), explained that my cycle was not constant, which means my hormones were out of order. Didn't do any tests. I sent her to the kindergarten and changed the doctor. I didn’t take any hormones, I’m now 21 weeks.

[1772354437] – November 9, 2011, 11:07 pm

During my first pregnancy, I didn’t take any pills at all except vitamins, we don’t even have the concept of “tone,” they just send me home to rest and that’s it.

[186314782] – November 9, 2011, 11:41 pm

Girls, thanks to everyone who responded! I won’t drink for now either! Tomorrow I’ll take a blood test for progesterone - if it’s really low - then I’ll think about it, but for now I’ll wait until the ultrasound, watch myself so that the discharge doesn’t increase and there’s no pain. I’ll take Magne B6 and vitamins. Right before pregnancy, I was examined, took hormones and tracked ovulation using an ultrasound scan - so then I took progesterone, on the 23rd day of the cycle, and as it turned out later, it was 6 days after conception - progesterone was normal! like all other hormones. Actually, pregnancy happened)) As I read on the Internet, our doctors actually prescribe Utrozhestan and Duphaston for a long time in a row as a cure for all diseases!

[186314782] – November 9, 2011, 11:42 pm

Post 7 - it was me, the author))

[525767199] – November 9, 2011, 11:45 pm

Take it just in case to preserve it. I’m not pregnant, but I took it for almost 2 years from 16-25 days, nothing terrible, no side effects, and during pregnancy it’s a necessity if there is even the slightest suspicion of a miscarriage.

[525767199] – November 9, 2011, 11:47 pm

By the way, even if the hormone progesterone is normal, you still need to take it, as far as I’ve heard. Ask your doctor!

[366262984] – November 10, 2011, 10:51 am

Zlata - that’s it, I wouldn’t want to take anything “just in case” during pregnancy! Just in case, you can take some vitamins, but Utrozhestan is still a hormonal drug, no matter how you look at it. I understand that of course there should be no harm. but I would like to do without it. And for example, I heard about duphaston (an analogue) that it is already banned in some countries, and in some countries it is being discontinued due to lack of proven effectiveness. Although at the same time there are a lot of reviews from women that it was only because of him that the pregnancy was pulled out.

[3370272629] – November 10, 2011, 11:45

And tell me how much progesterone you had, I just tested it too, but mine seems low in value, it seems to me.

[3591728868] – November 10, 2011, 2:46 pm

Author, it’s up to you to decide in any case. But I would advise you to do an ultrasound scan right away and then decide. At 6 weeks I had a strong tone according to ultrasound, my stomach hurt, there was no discharge. I took utrozhestan (vaginally) 2 days from 6 to 11 weeks, it helped me very well, the tone went away and I was calm. There are high risks for such a short period of time.

[366262984] – November 10, 2011, 5:31 pm

Katyusha - progesterone was 64 nmol/l, at laboratory standards - follicular phase - 0-6.0 nmol/l, luteal phase - 10-89 mmol/l. I took it on the 23rd day of the cycle. At this time I was already pregnant for 6 days (but I didn’t know about it yet)).

[366262984] – November 10, 2011, 5:33 pm

Bead - I understand about the risks, but my first trimester is already ending. Moreover, the doctor did not tone it (during the examination). Now the discharge is already yellow. I read that this seems to be normal, it seems that the corpus luteum is slowly stopping working intensively, and this can happen. However, on Tuesday I’ll go to the doctor again to take smears, let him take a look.

[1772354437] – November 10, 2011, 10:12 pm

I had bleeding because a hematoma had formed inside the uterus. And hormones had nothing to do with it at all. it just passed.

[1298360813] – November 11, 2011, 5:22 pm

As I read on the Internet, our doctors actually prescribe Utrozhestan and Duphaston over and over again as a cure for all diseases!

Hello! I would still advise you to take this drug. You see, I myself am in the 5th week of pregnancy and have been taking utrozhestan from the very beginning of pregnancy. I think it played an important role in maintaining my pregnancy.

[770437719] – November 11, 2011, 7:04 pm

I gave birth to a girl in July 2011. So, starting from 8 weeks, there was a threat of starting to drink morningzhestan (prescribed) and I had shock doses. It won’t do anything bad, you just need to stop drinking it very carefully. Think about it, after all, utrogestan supports the corpus luteum, and it is pregnancy. Better drink it. do not organize amateur performances.

[3770703989] – November 12, 2011, 10:22 am

Hello! I took Utrozhestan from the 8th week to the 14th week, my lower abdomen constantly felt tight, Utrozhestan relieved the pain, and during the normal course of pregnancy the lower abdomen should not pull and hurt! I also think you should take it. Moreover, you say that your stomach hurts sometimes

[2754695109] – November 12, 2011, 3:40 pm

author, of course it’s up to you and your doctor to decide. from my experience: with my first pregnancy, I started smearing at about 5-6 weeks, I was prescribed Utrozhestan, then there was still a suspicion of a threat after a fall, and in the end I took it for more than 20 weeks. The pain and “spotting” went away with the baby too, thank God everything is fine, but, IMHO, they over-preserved it and eventually during labor they opened it manually and gave oxytocin. The neck did not want to open at all.