Can Long-Term Use of Progesterone Affect Fertility and Menstrual Cycle?

Can progesterone be taken long-term for ovarian cysts?

Hello, I would like to ask about my situation.
I had a chocolate cyst removed last year and took medication for three months.
After that, my CA-125 level was 8.
However, after six months, although the ultrasound showed no issues, my CA-125 level rose to the 40s.
Since I might not get married for another two to three years, I am very concerned about infertility.
Is it possible to take medication like Yao Ru or progesterone long-term until I get married? Will there be any side effects or will my menstrual cycle stop? Thank you.

cc, 30~39 year old female. Ask Date: 2017/05/06

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if the ultrasound examination shows no issues, observation is sufficient.
Wishing you good health.

Reply Date: 2017/05/06

More Info

Long-term use of progesterone, particularly in the form of medications like Utrogestan, can have various effects on fertility and menstrual cycles. Progesterone is a hormone that plays a crucial role in regulating the menstrual cycle and maintaining pregnancy. It is often prescribed to women who have hormonal imbalances, such as those with polycystic ovary syndrome (PCOS), endometriosis, or those who have undergone surgery for conditions like chocolate cysts (endometriomas).

When considering the long-term use of progesterone, it is essential to understand its potential impacts on fertility and menstrual health. Here are some key points to consider:
1. Impact on Menstrual Cycle: Progesterone is responsible for preparing the uterine lining for a potential pregnancy after ovulation. If you are taking progesterone continuously or for extended periods, it may lead to changes in your menstrual cycle. Some women may experience irregular periods or even amenorrhea (the absence of menstruation). This is because the body may become accustomed to the external supply of progesterone, which can suppress natural hormone production.

2. Fertility Considerations: While progesterone is vital for maintaining a pregnancy, its long-term use can sometimes mask underlying fertility issues. If you are planning to conceive in the future, it is crucial to discuss with your healthcare provider how long-term progesterone therapy might affect your fertility. In some cases, stopping progesterone may lead to a return of normal ovulatory cycles, while in others, it may take time for the body to readjust.

3. Potential Side Effects: Long-term use of progesterone can lead to side effects, including mood changes, weight gain, breast tenderness, and bloating. Some women may also experience headaches or changes in libido. It is essential to monitor these side effects and communicate with your healthcare provider about any concerns.

4. CA-125 Levels: Your concern about elevated CA-125 levels is valid, especially after having undergone surgery for a chocolate cyst. CA-125 is a tumor marker often elevated in conditions like endometriosis and ovarian cancer. While a CA-125 level of 40 is above the normal range, it is not definitive for cancer and can be influenced by various factors, including hormonal changes. Regular monitoring and follow-up with your healthcare provider are essential to interpret these results accurately.

5. Consultation with Healthcare Provider: Given your history and concerns about fertility, it is crucial to have an open dialogue with your healthcare provider. They can help you weigh the benefits and risks of continuing progesterone therapy until your marriage and potential conception. They may also suggest alternative treatments or monitoring strategies to ensure your reproductive health is maintained.

In summary, while long-term use of progesterone can help manage certain hormonal imbalances and conditions, it is essential to consider its effects on your menstrual cycle and fertility. Regular consultations with your healthcare provider will help you make informed decisions about your treatment plan and ensure that your reproductive health is prioritized as you approach your future family planning.

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