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LPD and Progesterone From: John Hellriegel (jhellrie@ubmedd.buffalo.edu) Fri Aug 30 00:09:56 1996 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: John Hellriegel: "Micronized Estradiol" Previous message: John Hellriegel: "Popular Remedies" LPD (luteal phase defect) and progesterone. I agree with Richard Chudacoff concerning the use of progesterone for LPD. I am not aware of any controlled studies which support this position. I too have had patients with recurrent spontaneous early first trimester abortions who met the criterion for a luteal phase defect in two cycles and who had successful pregnancies with progesterone supplementation. I have also treated such patients with Clomid and had successful pregnancies. I don’t think that progesterone, itself, has been associated with any fetal anomalies but the following is a statement associated with Provera - “patient info.” I think that it come form the FDA. “Progesterone or progesterone-like drugs have been used to prevent miscarriage in the first few months of pregnancy. No adequate evidence is available to show that they are effective for this purpose. Furthermore, most cases of early miscarriage are due to causes which could not be helped by these drugs. There is an increased risk of minor birth defects in children whose mothers take this drug during the first 4 months of pregnancy. Several reports suggest an association between mothers who take these drugs in the first trimester of pregnancy and genital abnormalities in male and female babies. The risk to the male baby is the possibility of being born with a condition in which the opening of the penis is on the underside rather than the tip of the penis (hypospadias). Hypospadias occurs in about 5 to 8 per 1,000 male births and is about doubled with exposure to these drugs. There is not enough information to quantify the risk to exposed female fetuses, but enlargement of the clitoris and fusion of the labia may occur, although rarely. Therefore, since drugs of this type may induce mild masculinization of the external genitalia of the female fetus, as well as hypospadias in the male fetus, it is wise to avoid using the drug during the first trimester of pregnancy.” If I recall my pharmacology and biochemistry correctly, I believe that the progestins associated with the anomalies described above were 19-nortestoserone derivatives or progestins that are metabolized to this type of compound. Neither Provera nor progesterone is one of these compounds. Never-the-less, the above statement scares a lot of people. -- John C. Hellriegel, MD, PhD Next message: John Hellriegel: "Micronized Estradiol" Previous message: John Hellriegel: "Popular Remedies"

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