What is progesterone?

Progesterone is a hormone that is needed to maintain a pregnancy. It occurs naturally, but some people may need extra progesterone to help prevent their baby being born early (also referred to as preterm birth). Progesterone is available as a supplement.

When is it used?

You may need to use a progesterone
supplement if:

• you have had a preterm birth previously
• you have lost a previous baby between 16 and 24 weeks into your pregnancy
• you have had an ultrasound that shows you have a shortened cervix – we will give you information about this if you need it.

Your GP, doctor or midwife will tell you if you need to use progesterone and they will write you a prescription. You can fill this prescription at any pharmacy.

How is it used?

Usually, we will recommend a dose of 200mg of progesterone in the form of a pessary (see picture), or dissolving capsule. You will need to put this inside your vagina each evening. You may need to start this as early as 16 weeks into your pregnancy, continuing through to 36 weeks into your pregnancy.

If you have had recent surgery on your cervix do not insert the progesterone into your vagina. Please discuss this with your health professional.

How to use progesterone pessaries

Please refer to the instructions inside the packet.

The best time to put the pessary in is at night before going to bed.

1. Wash your hands thoroughly with soap and water.
2. Remove the pessary from the wrapper.
3. Squat or lie on your back or side. Put the pessary deep into your vagina. If it feels uncomfortable to put it in, you can use a water-based lubricant on the pessary like KY jelly© which can be purchased at a chemist or briefly dip it in plain water.
4. If you are squatting, please move to a lying position after the pessary has been inserted.
5. Remain lying down for around 30 minutes after putting the pessary in to assist with absorption.
6. Throw away the wrapper and wash your hands thoroughly again with soap and water.

You may choose to use a disposable (single use) glove to insert the pessary. You may also like to wear a pantyliner for any discharge which may happen while using progesterone pessaries.

Are there any side effects?

Vaginal progesterone is usually free from any side effects. Some people may have some skin irritation. Rare side effects may include headaches, nausea, vomiting or constipation or diarrhea. If you have any concerns, please speak to your healthcare provider.

Further reading

• https://www.pretermalliance.com.au
• https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/ijgo.13187
• https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797994
• https://www.miraclebabies.org.au/

Useful Contact Details

Centenary Hospital for Women and Children (CHWC) Fetal Medicine Unit (FMU)

Referral to the preterm birth prevention clinic in the FMU can be made by your GP or doctor or midwife.

Opening hours: Monday – Friday 9am to 4.30pm.
Ph: (02) 5124 7461

Centenary Hospital for Women and Children Birthing Suite

24-hour service for pregnancy concerns 12 weeks or more into your pregnancy.

Ph: (02) 5124 7444

Or your nearest hospital if this is not Centenary Hospital for Women and Children

Canberra Hospital Emergency Department

24-hour emergency service for pregnancy concerns up to 12 weeks into your pregnancy. Yamba Dr, Garran ACT 2605.

Email contact for non-urgent queries

CHS.PretermBirthPreventionClinic@act.gov.au

CHWC is part of the Australian Preterm Birth Prevention Alliance project called Every Week Counts. This project started in Western Australia. It involves a thorough approach to screening and educating women to prevent babies being born early.

This information is about a common medicine which can prevent preterm birth and helps pregnancy last the whole nine months.

Further details of the project are available at: www.thewholeninemonths.com.au

Centenary Hospital for Women and Children Hospital, Hospital Road, Garran, Canberra ACT 2605

Some information in this handout has been provided by the WA Preterm Birth Prevention Clinic and is used with their permission.