Naturogest (Progesterone 8%) Gel

Naturogest general information

What is Naturogest used for?

If you have suffered the heartbreak of not being able to conceive you will very likely have been investigated to find the reason, and you are perhaps undergoing in vitro fertilization (IVF) as part of an assisted reproductive technology programme.  One of the reasons you may be having difficulty conceiving is a condition called luteal phase defect, resulting in low levels of the hormone progesterone, which is essential to prepare the lining of the uterus, the endometrium, for a pregnancy.  Naturogest is a vaginal gel containing progesterone, and it is used to treat luteal phase defect by supplementing progesterone, to help improve your chances of becoming pregnant, while you undergo treatment for infertility problems. 

Menstrual cycle phases

The first phase of the menstrual cycle is the follicular phase when a single follicle in the ovary develops and ripens in preparation for releasing an egg.  This stage of the cycle is regulated by the hormone oestrogen, and when oestrogen levels peak ovulation takes place.  Oestrogen then levels out, and progesterone is gradually secreted by the corpus luteum, the structure remaining once the egg has been released.  This is the second half of the menstrual known as the luteal phase is, usually lasting two weeks.  A luteal phase that lasts for less than 10 days is referred to as a luteal phase defect because there is not enough progesterone produced to support a pregnancy and this is a common cause of infertility.

Importance of progesterone in pregnancy

A receptive endometrium is vital for a successful pregnancy.  This means that the endometrium must be fully developed for implantation, which is when the fertilized egg attaches and begins to develop into an embryo.  Oestrogen controls the first stage, which is the proliferative stage of endometrial development, by stimulating its proliferation and thickening.  Progesterone then stimulates the endometrium to develop into the secretory phase, which is when the blood supply increases and glands in the endometrium secrete nutrients that will nurture the embryo once a fertilized egg has implanted until the placenta develops.  This process is essential for maintaining and supporting the pregnancy in the early stages and without sufficient progesterone, chances of becoming pregnant are reduced; also staying pregnant is unlikely, if a fertilized egg does manage to implant, due to increased risk of an early miscarriage.

Naturogest vaginal gel 8% helps increase the chances of becoming pregnant and of maintaining the pregnancy.  It provides a source of progesterone for luteal phase support, to prepare the endometrium to receive a fertilised egg before in vitro fertilization, and to maintain the implanted embryo during the first few weeks of development.  This has been shown to improve the success of IVF. 

How does Naturogest work?

Naturogest vaginal gel 8% contains micronized progesterone, which is obtained from a plant-based source of progesterone that has the same chemical structure and same biological effects as naturally occurring progesterone produced by your body.  Micronization is the process of reducing progesterone to tiny particles so that it is better absorbed.  Naturogest vaginal gel 8% is used as an infertility treatment for the hormonal imbalance that occurs due to a luteal phase defect.

Naturogest gel is contained in a prefilled applicator, which is inserted into the vagina.  When discharged, the gel vagina coats the vagina and progesterone is gradually released from the gel and absorbed through the lining of the vagina into the bloodstream.  When administered as a gel directly into the vagina, more micronized progesterone reaches the endometrium than if taken by other routes such as orally or by injection. 

Naturogest vaginal gel 8% provides an effective progesterone supplement that increases low levels of progesterone to provide luteal phase support during IVF and increases the chance of becoming pregnant.  

What does Naturogest contain?

Naturogest gel 8% contains the active ingredient natural micronized progesterone.  Each application delivers 90 mg progesterone in 1.35g gel as an oil and water emulsion, in a pre-filled single-use vaginal applicator. 

What are the side effects of Naturogest?

Most medications have some side effects, but they are not experienced by everyone.  Some side effects are commonly experienced when taking Naturogest, but others are not so common, and you should discuss any problems or concerns with your primary care physician. 

Common side effects when taking Naturogest include headache, breast enlargement, tenderness and pain, abdominal pain, cramps, perineal pain (around the genitals and rectum), gastrointestinal upset (constipation, diarrhoea, nausea, vomiting), dyspareunia (painful sexual intercourse), depression, decreased libido, nervousness, and somnolence (sleepiness), nocturia (passing urine at night), vaginal discharge, itching and thrush, arthralgia (painful joints).

When should Naturogest not be used?

Have a talk with your primary healthcare physician before taking Naturogest so that you have a full understanding of what this medicine is for and how to use it.  There are some reasons for not taking a medication; these are called contraindications, and for Naturogest you should consider the following before using Naturogest:

• Have you ever had an unusual reaction or an allergy when taking Naturogest?
• Do you have liver disease?
• Have you had any abnormal vaginal bleeding of unknown cause?
• Have you had a recent or current missed abortion or miscarriage?
• Do you have a past or family history of carcinoma of the breast, endometrial carcinoma?
• Do you have a history of thrombosis (blood clots) or stroke?
• Do you have the blood disorder porphyria or do you have depression as Naturogest can make your condition worse?
• Are you taking other vaginal preparations?

How should Naturogest be used and for how long?

You should apply your Naturogest gel 8% by inserting the pre-filled applicator deep into your vagina, following the instructions provided, and squeeze to deliver the measured dose of progesterone gel.  You should use one applicator once or twice daily, at the same time each day, morning and evening, as recommended by your doctor, starting usually 2-4 days before your infertility treatment begins.  If you become pregnant, you should continue to apply your Naturogest gel for up to 12 weeks, or as long as recommended by your doctor. 

Missed dose of Naturogest

If you miss a dose of Naturogest take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Naturogest be stored?

You should store your Naturogest below 25°C in a cool, dry place.