Optimal Dosage of Progesterone for Managing Menstrual Irregularities

Q: Optimal Dosage of Progesterone for Managing Menstrual Irregularities

Hello： Endometrial hyperplasia should first undergo a dilation and curettage (D&C) for pathological diagnosis to rule out the possibility of endometrial lesions. <br>If it is diagnosed as simple hyperplasia, it is recommended to use Provera at a dosage of 10 mg per day for 10-14

Dosage of progesterone?

I am 49 years old and for the past two and a half years, I have been experiencing endometrial hyperplasia, with menstruation lasting for several months whenever it starts.
I have undergone three dilation and curettage (D&C) procedures, and the biopsy results were normal.
I have been treated with progesterone (taking PROVERA 5 mg once daily for ten days each month).
Since starting the medication, my periods have been regular but very light.
However, about a year later, my menstrual cycle became irregular again, occurring once every one and a half months or sometimes every two months.
One doctor suggested increasing the dosage to twice daily for ten days, and after doing so, my menstrual flow increased and the cycle became regular again.
My original doctor advised that I could maintain the original dosage, but another doctor believes that the increased dosage is necessary.
What is the appropriate dosage of progesterone? Could taking too much or too little have negative effects or side effects? Thank you!

Wen Hui, 40~49 year old female. Ask Date: 2005/06/16

Dr. Li Guanghan reply Obstetrics and Gynecology

Hello: Endometrial hyperplasia should first undergo a dilation and curettage (D&C) for pathological diagnosis to rule out the possibility of endometrial lesions.
If it is diagnosed as simple hyperplasia, it is recommended to use Provera at a dosage of 10 mg per day for 10-14 days each cycle, for at least six months.
All medications have potential side effects.
Department of Obstetrics and Gynecology, Hsinchu Hospital.

Reply Date: 2005/06/16

More Info

When it comes to managing menstrual irregularities, particularly in the context of progesterone therapy, determining the optimal dosage can be quite complex and varies significantly from person to person. In your case, you have a history of endometrial hyperplasia and have undergone multiple dilation and curettage (D&C) procedures, which adds another layer of consideration to your treatment plan.

Progesterone, such as Provera (medroxyprogesterone acetate), is commonly prescribed to help regulate menstrual cycles, especially in women who experience irregularities due to hormonal imbalances. The typical dosage for managing menstrual irregularities can range from 5 mg to 10 mg daily for a duration of 10 to 14 days, depending on the individual's specific needs and the physician's judgment. In your situation, you initially took 5 mg once daily for ten days, which helped establish a regular cycle but resulted in lighter menstrual flow. After adjusting the dosage to 5 mg twice daily, you noted an improvement in both the volume of menstrual flow and the regularity of your cycle.

The variation in recommendations from different physicians regarding the dosage of progesterone is not uncommon. Some practitioners may prioritize maintaining a lower dose to minimize potential side effects, while others may advocate for a higher dose to achieve more effective regulation of the menstrual cycle. It is essential to consider that progesterone therapy can have side effects, including mood changes, breast tenderness, headaches, and gastrointestinal disturbances. In some cases, excessive doses may lead to more pronounced side effects or complications, such as increased risk of thromboembolic events.

In your case, the increase in dosage to twice daily appears to have yielded positive results, suggesting that your body may require a higher amount of progesterone to effectively regulate your menstrual cycle. However, it is crucial to monitor your response to the medication closely. If you experience any adverse effects or if your menstrual irregularities persist, it would be advisable to consult with your healthcare provider for further evaluation and potential adjustment of your treatment plan.

Furthermore, it is essential to consider the underlying causes of your menstrual irregularities. Given your history of endometrial hyperplasia, ongoing monitoring of your endometrial health is critical. Regular follow-ups with your gynecologist, including ultrasound examinations and possibly repeat endometrial biopsies, may be necessary to ensure that there are no further complications or developments.

In summary, the optimal dosage of progesterone for managing menstrual irregularities can vary widely based on individual circumstances. It is essential to work closely with your healthcare provider to find the right balance that effectively manages your symptoms while minimizing potential side effects. Regular monitoring and open communication with your physician will help ensure that your treatment remains safe and effective.

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