A gender reassignment program for male to female transsexuals normally includes the prescription of feminising hormones, oestrogen and progesterone which develop female secondary sexual characteristics. In addition this may be accompanied before surgery by anti-androgen treatment to reduce the effect of the patients own male sex hormones. There can be risks attached to hormone therapy in both men and women and therefore it is definitely inadvisable to take any form of hormone product unless it is medically prescribed.

Prometrium is usually taken orally, however it can also be used as a vaginal suppository. In the latter case, the capsule is inserted directly in the vagina.

Micronized progesterone is natural progesterone that has been broken down -- or micronized -- to enable your body to metabolize it more easily. Before this process was discovered, women couldn't take natural progesterone orally because it was absorbed badly and became inactive when swallowed. But now it's easily available, allowing you to get the benefits of natural progesterone in the ease of a pill.

Most often, you get micronized progesterone at a compounding pharmacy -- a pharmacy that formulates its own drugs according to a doctor's prescription. But in 1998, a micronized natural progesterone called Prometrium put out by the large pharmaceutical company Schering, became available, which is good news for women who found it difficult to find a compounding pharmacy in their area.

Typical dosage

Pre-op 100-400mg/day capsules in conjunction with estrogens.

Post-op 50-400mg/day capsules in conjunction with estrogens.

Pharmacology

Suspension of progesterone in oil. This is the same molecule as produced endogenously in females, not a progestin.

Delivery

Capsules or Vaginal cream or Suppositories.

Availability

Approved by U.S. FDA

Contraindications

Active or past blood clotting disorders. Liver dysfunction or disease.

Adverse reactions - Generally mild and transient.

Comments

Those allergic to peanuts, beware: Prometrium uses a peanut oil medium. Compounding pharmacies supplying non-branded progesterone may also use peanut oil; ask them if you need to know.

Some people call this drug progesterone USP/PharEu/BP (according to the local regulatory commission), to differentiate from progestins. In some countries the drug is simply referred to as progesterone.

The largest fraction progesterone taken orally is destroyed in the digestive tract, which, along with the very short half-life, accounts for the high dosage in comparison to synthetics, and may also account for some of the variability in efficacy.