Progesterone suppositories are a specialized form of medication designed to deliver the hormone progesterone directly into the body, typically through vaginal or sometimes rectal insertion. Unlike oral pills, the suppository is a cone-shaped or ovular base material that dissolves or melts, allowing the progesterone to be absorbed locally and into the bloodstream. This method bypasses the digestive system, which can break down the hormone, and delivers a stable dose primarily to the uterine lining. Progesterone supplementation is commonly prescribed to support reproductive health, such as during fertility treatments like in vitro fertilization (IVF), to prepare the endometrium for implantation or maintain an early pregnancy.
Step-by-Step Insertion Guide
Preparation for administering a progesterone suppository begins with hygiene; thoroughly wash your hands with soap and water and ensure the genital area is clean. Before unwrapping the suppository, check its firmness. If it is too soft, briefly chilling it in the refrigerator can help it firm up for easier handling. Clear your bladder and bowels before insertion, as straining afterward can potentially push the medication out.
A comfortable position is necessary for successful administration, and this often means lying on your back with your knees bent and feet flat, or standing with one foot elevated on a stool. Carefully unwrap the suppository and, if using an applicator, load it according to the package instructions. If inserting without an applicator, place the suppository on the tip of your index finger.
Gently insert the suppository into the vagina, guiding it upward and slightly backward, similar to inserting a tampon. Push the medication in as far as it can comfortably go, which is typically the length of your finger, to ensure it rests high in the vaginal canal. After the suppository is in place, you must remain still, typically lying down for at least 10 to 15 minutes, which allows the base material to melt and the hormone to begin absorbing before gravity causes leakage. After the required rest period, wash your hands again to remove any residue.
Managing Common Post-Insertion Issues
The most frequent consequence of using a progesterone suppository is leakage or discharge after the base material has dissolved. This discharge is typically whitish, sometimes gooey, and may have a watery or oily consistency. This is normal and does not mean the full dose was not absorbed. Most of the progesterone is absorbed by the vaginal tissue within 20 to 30 minutes, so the discharge is largely the residue of the inactive carrier ingredients.
Wearing a thin panty liner or sanitary pad after insertion is recommended to manage the wetness and protect clothing. Avoid using tampons, as they could absorb some of the medication and interfere with the hormone’s intended absorption into the body. Some users may experience mild local side effects like vaginal irritation, dryness, or an unpleasant discharge.
Although rare, signs of a severe reaction require immediate medical attention. These include symptoms of an allergic response like hives, difficulty breathing, or swelling of the face, lips, or tongue. Contact a healthcare provider if you notice unusual vaginal bleeding heavier than spotting, severe pain, sudden vision changes, or signs of a blood clot (such as pain, swelling, or warmth in the leg).
Storage and Missed Dose Protocols
Proper storage of progesterone suppositories is necessary to maintain their integrity, as they are sensitive to temperature changes. While some brands can be stored at room temperature, many compounded suppositories must be refrigerated to prevent premature melting. Always check the specific instructions provided by your pharmacist or the product packaging to determine if refrigeration is required. Store all medications securely out of the reach of children and pets.
Consistency is necessary for hormonal medications, but a specific protocol should be followed if a dose is missed. If you remember the missed dose soon after the scheduled time, take it immediately. If it is close to the time for your next scheduled dose, skip the missed one entirely. Never take a double dose to compensate for the one you missed, as this can lead to an excess hormone concentration.