Mechanisms of uterine specificity of vaginal progesterone
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Vaginal progesterone administration resulted in significantly higher endometrial concentrations compared to intramuscular administration, despite lower serum levels, suggesting a direct pathway for uterine specificity.
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Abstract
Endometrial transformations achieved by vaginal progesterone exceed those normally expected from the circulating concentrations obtained, this suggests some degree of direct vagina to uterus transport. We speculate on the different mechanisms involved in uterine specificity of vaginal progesterone and report data of a preliminary randomized study comparing progesterone concentrations in serum and endometrial tissue obtained from hysterectomy specimens after vaginal or i.m. administration. Eight post-menopausal women undergoing transabdominal hysterectomy were randomized to receive either vaginal progesterone gel, 90 mg, or i.m. progesterone formulation, 50 mg, at 08.00 and 20.00 on the day before surgery and at 06.00 on the day of surgery. Venous blood samples for progesterone measurement were drawn at 08.00 on the day before surgery and during the surgery. Endometrial progesterone concentrations were markedly higher in women who received vaginal progesterone (1.38+/-0.66 and 0.38+/-0.19 ng/mg protein, for vaginal and i.m. groups respectively) (P < 0.02) despite lower serum concentrations (4.17 < 0.56 and 32.32+/-11.06 ng/ml, for vaginal and i.m. groups respectively) (P < 0.001). The vaginal route induces endometrial progesterone concentrations that far exceed those expected from the serum progesterone concentrations achieved.
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Cites (1)
Cited by (4)
- Vaginal micronized progesterone versus intramuscular progesterone for luteal support in women undergoing in vitro fertilization–embryo transfer 2009
- Potential Therapeutic Options and Perspectives for Alleviation of Endometrial Estrogen Dominance and Progesterone Resistance in Endometriosis 2021
- Endometriosis - Recent Advances, New Perspectives and Treatments 2021
- Clinical effectiveness of therapeutic regimens of progesterone in IVF programs in women with tuboperitoneal factor of infertility 2016
References (13)
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Cited by (4)
- Potential Therapeutic Options and Perspectives for Alleviation of Endometrial Estrogen Dominance and Progesterone Resistance in Endometriosis 2021
- Endometriosis - Recent Advances, New Perspectives and Treatments 2021
- Clinical effectiveness of therapeutic regimens of progesterone in IVF programs in women with tuboperitoneal factor of infertility 2016
- Vaginal micronized progesterone versus intramuscular progesterone for luteal support in women undergoing in vitro fertilization–embryo transfer 2009
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