These studies generally reported oral progesterone to be only very weakly active. Oral non-micronized progesterone was introduced as a pharmaceutical medication around 1953, for instance as Cyclogesterin (1 mg estrogenic substances and 30 mg progesterone tablets) for menstrual disturbances by Upjohn, though it saw limited use. Another preparation, which contained progesterone alone, was Synderone (trademark registered by Chemical Specialties in 1952).Sublingual progesterone in women was first studied in 1944 by Robert Greenblatt. Buccal progesterone tablets were marketed by Schering under the brand name Proluton Buccal Tablets by 1949. Sublingual progesterone tablets were marketed under the brand names Progesterone Lingusorbs and Progesterone Membrettes by 1951. A sublingual tablet formulation of progesterone has been approved under the brand name Luteina in Poland and Ukraine and remains marketed today.Progesterone was the first progestogen that was found to inhibit ovulation, both in animals and in women. Injections of progesterone were first shown to inhibit ovulation in animals between 1937 and 1939. Inhibition of fertilization by administration of progesterone during the luteal phase was also demonstrated in animals between 1947 and 1949. Ovulation inhibition by progesterone in animals was subsequently re-confirmed and expanded on by Gregory Pincus and colleagues in 1953 and 1954. Findings on inhibition of ovulation by progesterone in women were first presented at the Fifth International Conference on Planned Parenthood in Tokyo, Japan in October 1955. Three different research groups presented their findings on this topic at the conference.
In 2019, it was the 188th most commonly prescribed medication in the United States, with more than 3 million prescriptions. Medical uses
Hormone therapy
Menopause
Progesterone is used in combination with an estrogen as a component of menopausal hormone therapy for the treatment of menopausal symptoms in peri- and postmenopausal women. It is used specifically to provide endometrial protection against unopposed estrogen-induced endometrial hyperplasia and cancer in women with intact uteruses. A 2016 systematic review of endometrial protection with progesterone recommended 100 mg/day continuous oral progesterone, 200 mg/day cyclic oral progesterone, 45 to 100 mg/day cyclic vaginal progesterone, and 100 mg alternate-day vaginal progesterone. Twice-weekly 100 mg vaginal progesterone was also recommended, but more research is needed on this dose and endometrial monitoring may be advised. Transdermal progesterone was not recommended for endometrial protection.The REPLENISH trial was the first adequately powered study to show that continuous 100 mg/day oral progesterone with food provides adequate endometrial protection. Cyclic 200 mg/day oral progesterone has also been found to be effective in the prevention of endometrial hyperplasia, for instance in the Postmenopausal Estrogen/Progestin Interventions (PEPI) trial. However, the PEPI trial was not adequately powered to fully quantify endometrial hyperplasia or cancer risk. No adequately powered studies have assessed endometrial protection with vaginal progesterone. In any case, the Early versus Late Intervention Trial with Estradiol (ELITE) found that cyclic 45 mg/day vaginal progesterone gel showed no significant difference from placebo in endometrial cancer rates. Due to the vaginal first-pass effect, low doses of vaginal progesterone may allow for adequate endometrial protection.