Cyclogest

Basic Cyclogest Information

• INN (International Nonproprietary Name): Progesterone.
• Brand Names Available In United Kingdom: Utrogestan (micronised progesterone capsules).
• ATC Code: G03DA04.
• Forms & Dosages: Soft capsules 100 mg and 200 mg in blister packs (typically 30/90); vaginal capsules/softgels 100 mg and 200 mg in boxes of 15/30; compounding powders (rare) — not specified for routine UK supply.
• Manufacturers In United Kingdom: Not specified locally; international suppliers include AbbVie (Prometrium), Besins Healthcare (Utrogestan) and multiple generics from Teva, Mylan and others.
• Registration Status In United Kingdom: Registered in the EU/EMA under multiple brand names; product packaging in the UK commonly lists Utrogestan; prescription status is Rx (prescription only).
• OTC / Rx Classification: Prescription only (Rx).

Latest Research Highlights — UK & EU

What do recent UK and EU reviews say about progesterone and formulations such as Cyclogest?

Recent literature from 2022–2025 continues to refine where micronised progesterone and vaginal pessaries deliver the clearest clinical benefit.

Consensus across systematic reviews and registry analyses highlights luteal support in assisted reproduction, endometrial protection with oestrogen in HRT, and short courses for secondary amenorrhoea as the principal uses.

Regulatory safety surveillance from MHRA and EMA since 2022 has focused on product‑specific excipients, liver considerations and Yellow Card reporting.

Comparative analyses indicate that micronised progesterone provides comparable endometrial protection to some synthetic progestins while showing different side‑effect profiles and thrombotic risk signals.

Clinicians are paying attention to formulation differences — oral micronised capsules may cause sedation and GI complaints, while vaginal pessaries such as Cyclogest reduce systemic exposure but can cause local discharge.

Clinical Effectiveness In The UK

What can patients expect when progesterone is prescribed in NHS practice?

NHS and clinic audits report good control of bleeding and reliable endometrial protection when prescribers follow product information and MHRA guidance.

Fertility services frequently prefer vaginal progesterone for luteal support after IVF because of direct uterine bioavailability.

Patient‑reported outcomes collected on NHS portals and forums show convenience of oral capsules like Utrogestan but occasional reports of sedation or GI upset.

Vaginal pessaries such as Cyclogest tend to reduce systemic side effects while producing local discharge or practical inconvenience for some users.

• Measured Outcomes: bleeding control, endometrial protection, patient satisfaction, adverse events.
• Typical Trade‑Offs: oral convenience versus vaginal local tolerability.

Indications And Expanded Uses

Why might a clinician choose one progesterone formulation over another?

Approved, MHRA/EMA‑aligned indications in UK practice include endometrial protection during combined HRT and treatment of secondary amenorrhoea.

Many fertility clinics use vaginal progesterone for luteal support despite some oral forms being licensed only for other indications.

Off‑label use is common in NHS and private reproductive medicine, particularly vaginal administration of oral micronised capsules in parts of Europe.

Clinicians should document rationale, discuss consent and monitoring for any off‑label regimen.

• Approved: endometrial protection with oestrogen; secondary amenorrhoea.
• Common Off‑Label: luteal support in IVF; vaginal use of oral micronised capsules where local practice permits.

Composition And Brand Landscape

Which brands and formulations are encountered in UK practice?

The active ingredient across brands is progesterone (INN), listed under ATC G03DA04.

In the UK the portfolio commonly includes Utrogestan as micronised oral capsules and Cyclogest as a vaginal pessary.

International equivalents include Prometrium (US/Canada) and multiple generics from Teva, Mylan and others.

Forms sold worldwide include soft capsules 100 mg and 200 mg, vaginal capsules/softgels 100 mg and 200 mg, and rare compounding powders.

Contraindications And Special Precautions

Who should not take progesterone or who requires extra caution?

Absolute contraindications include severe hepatic dysfunction, known or suspected breast cancer or other hormone‑dependent malignancy, undiagnosed vaginal bleeding, current or previous thrombosis, allergy to peanut oil where present, and pregnancy in certain indications.

Relative contraindications include mild/moderate hepatic or renal impairment, migraine, asthma, psychiatric disorders and cardiovascular disease and require monitoring.

Practical UK pharmacy advice is to flag contraindications on electronic prescriptions and discuss them during counselling.

Advise patients that sedation or drowsiness may affect driving and to avoid alcohol if affected.

• Screening Checklist: liver disease, breast cancer history, thrombotic history, unexplained bleeding, known excipient allergy.
• Pharmacy Action: record issues in NHS records and consider MHRA alerts when dispensing.

Dosage Guidelines

What are the standard doses and practical instructions?

Standard product information gives 400 mg orally at bedtime for 10 days for secondary amenorrhoea, and 200 mg orally at bedtime for 12 days of a 28‑day cycle for endometrial protection with oestrogen.

Vaginal preparations, commonly used in fertility, follow clinic protocols and typically range from 100–400 mg daily depending on the indication.

Special populations: not indicated in children; elderly require monitoring but usually no dose change; contraindicated in severe hepatic impairment and use with caution in renal impairment.

Missed dose advice: take as soon as remembered unless near the next scheduled dose; do not double up.

Overdose management is supportive; symptoms may include sedation, nausea and withdrawal bleeding.

Interactions Overview

Which medicines and substances can affect progesterone?

Enzyme‑inducing drugs such as certain antiepileptics, rifampicin and some antivirals can lower progesterone plasma levels and reduce efficacy.

Oestrogens are commonly used together intentionally in HRT regimens and are not a negative interaction in that context.

CNS depressants and alcohol may add to sedation from progesterone and patients should be warned.

Food interactions are limited, though softgels with lipid excipients may have absorption variability with high‑fat meals.

• Check for enzyme inducers on repeat prescriptions.
• Advise patients on CNS depressant co‑use to take extra care when driving.
• Report suspected interaction signals to the MHRA Yellow Card scheme.

Cultural Perceptions And Patient Habits

How do UK patients talk about progesterone and what matters to them?

Patients tend to value pharmacist counselling from Boots, LloydsPharmacy and local pharmacies and reassurance from GPs or NHS 111 for initial queries.

On fertility forums and Patient.info, oral capsules are described as discreet but sometimes sedating, while vaginal pessaries like Cyclogest are associated with messiness but accepted for perceived efficacy.

There is growing use of e‑prescriptions and online pharmacies for repeat supplies, though many patients still want face‑to‑face counselling for first starts.

Terms such as “micronised progesterone” and “natural progesterone” resonate more positively than “progestin” when explaining side‑effect differences.

• Patient Quote (anonymised): “I prefer the capsule at night but had to stop because it made me sleepy.”
• Patient Quote (anonymised): “Cyclogest worked for my clinic transfer but I had discharge for a few days.”

Availability And Pricing Patterns

How easy is it to obtain Cyclogest and micronised progesterone in the UK?

Cyclogest and micronised progesterone are generally prescription‑only in the UK, with regional differences in how prescriptions are paid.

England retains per‑item prescription charges for many patients while Scotland, Wales and Northern Ireland have largely free prescriptions, and this influences private buying and clinic supplies.

Major pharmacy chains and online pharmacies dispense progesterone and some fertility clinics arrange direct supply to patients.

Common pack sizes include 15–30 vaginal pessaries and 30/90 oral capsules, with private prices varying by supplier and contract.

In our online pharmacy, cyclogest is available without a prescription, with discreet delivery to United Kingdom in 9-21 days.

Comparable Medicines And Preferences

What are common alternatives to micronised progesterone in UK practice?

Synthetic progestins such as medroxyprogesterone acetate (Provera) and dydrogesterone (Duphaston) are widely used alternatives.

Differences include receptor profiles, thrombosis risk and systemic side‑effect patterns.

Micronised progesterone is often described as “natural” progesterone and is sometimes preferred for HRT endometrial protection or fertility support on the basis of tolerability.

Use a pros and cons checklist in consultations to support shared decision making between routes and products.

FAQ — Common NHS Patient Questions

Will progesterone make me sleepy?

Some patients report dizziness, fatigue or drowsiness and should avoid driving or heavy machinery if affected.

Can I use oral capsules vaginally?

Vaginal use of some oral micronised capsules is reported in practice in parts of Europe but is off‑label; clinicians should document the rationale and follow local protocol.

What if I miss a dose?

Take as soon as remembered unless it is close to the next scheduled dose; do not double up.

Are there allergy risks?

Check excipients carefully as some softgels outside the UK contain peanut oil; always verify the SPC and inform the pharmacist of allergies.

Guidelines For Proper Use And Counselling

What should a pharmacist tell a patient starting progesterone?

Counselling should include the indication, administration route, dosing schedule and expected bleeding patterns.

Discuss common side‑effects such as headache, breast tenderness, mood changes, nausea and possible sedation.

Advise storage below 25°C, protected from moisture and light, and to keep medication in the original packaging.

Document contraindications in NHS records and report suspected adverse reactions via the MHRA Yellow Card scheme.

• Counselling Checklist: indication, dose, route, side‑effects, storage, when to seek help.
• Patient Handout Template: clear dosing times, missed‑dose advice and contact details for NHS 111 or the prescribing clinic.

Delivery Across United Kingdom