Natural Micronized Progesterone Sustained Release Tablets (Mogogest SR 300)

Natural Micronized Progesterone Sustained Release 300mg Tablets (Mogogest SR 300)

Introduction

Progesterone is an essential hormone which plays an important role in woman’s normal reproductive cycle. The name Progesterone is derived from ‘progestational steroid hormone’ since it helps to prepare and maintain the uterine bed for conception. Progesterone is secreted by ovaries, placenta and adrenal glands and is essential during luteal phase to sustain pregnancy. Also, it promotes shedding of endometrium due to its antiproliferative endometrial action and thereby helps in maintaining a regular menstrual cycle.

Exogenous progesterone supplementation is given for treatment of secondary amenorrhea, dysfunctional uterine bleeding, and endometriosis, for management of luteal phase deficiency, for preventing preterm delivery and also to prevent endometrial hyperplasia .

In such cases the role of Natural or Synthetic Progesterone is often highlighted.

Progesterone is available as Natural Progesterone and Synthetic Progestin. The Natural Progesterone is obtained from soybeans and Mexican yam roots and it shows the same chemical structure as that of physiological progesterone found in human body. Micronization of the Natural Progesterone increases the half-life of progesterone with the metabolites including Allopregnanolone showing indirect stimulatory effect on progesterone receptor.

Micronization decreases particle size and enhances the dissolution of progesterone . Absorption of micronized progesterone is enhanced twofold when the hormone is taken with food. Unlike synthetic progestins, micronized progesterone has not been shown to affect mood, decrease high-density lipoprotein (HDL) cholesterol levels or adversely affect pregnancy outcome.

The pharmacologic effects of synthetic progestins (e.g., Norethindrone, Norgestrel, Levonorgestrel, Medroxyprogesterone acetate, Norgestimate) are slightly different from those of natural progesterone. Some of the androgenic effects of synthetic progestins include fluid retention, reduction of HDL cholesterol levels, headaches and mood disturbance.

Dydrogesterone or retroprogesterone is a stereoisomer of progesterone that is a highly selective synthetic progestin binds almost exclusively to progesterone receptor due to its retrostructure .

Progesterone Actions: Hormonal Action of Progesterone helps in implantation of fertilized egg in the following ways: i) Stimulates the growth of uterus; ii) Maintains uterine quiescence by stabilizing lysosomal membranes & inhibiting PG synthesis; iii) Inhibits myometrial contractions; iv) Endometrial changes: Induces secretory transformation, increases vascularity of the endometrial lining, stabilizes endometrium . The nonhormonal actions include: i) Immunomodulatory or anti-inflammatory: Progesterone along with HCG and cortisol inhibits the tissue rejection and protect the conceptus. Progesterone blocks the chemokines – transcription factor, NF- kB leading to decreased PG synthesis & release while positively regulating PIBF (Progesterone Induced Blocking Factor), NK (Natural Killer cells), HOX-10, trophoblast HLA gene leading to favorable shift of Th1-Th2 balance towards Th2 type .

Uterine relaxant: Progesterone blocks the oxytocin effect of prostaglandin F2 α and α-adrenergic stimulation. Similarly it reduces intracellular calcium concentrations and reduces contractility along with lowering the amount of phosphorylated myosin and promote myometrial relaxation.

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