What is the duration of progesterone (progestin) treatment?

From the Guidelines

The duration of prolog treatment should be individualized based on the specific condition being treated, but typically ranges from 3-6 months for conditions like uterine fibroids, with the goal of reducing fibroid size before surgery, as recommended by the 2019 ASCO clinical practice guideline focused update 1. When using GnRH agonists like leuprolide acetate (Lupron) for endometriosis, a common regimen is 3.75 mg intramuscularly monthly or 11.25 mg every three months.

• For uterine fibroids, treatment often continues for 3-6 months to reduce fibroid size before surgery.
• Patients should begin treatment during menstruation to ensure they're not pregnant, as these medications can harm a developing fetus.
• Side effects may include hot flashes, mood changes, and temporary bone density reduction. The treatment works by initially stimulating gonadotropin release, followed by downregulation of receptors, ultimately suppressing estrogen production.
• This creates a temporary menopausal state that reduces endometriosis lesions, shrinks fibroids, or achieves other therapeutic goals.
• Regular monitoring during treatment is essential to assess response and manage side effects, as recommended by the 2019 ASCO clinical practice guideline focused update 1. In contrast, the 2021 Blood Reviews study on hormonal replacement therapy in adolescents and young women with chemo- or radio-induced premature ovarian insufficiency does not provide direct guidance on the duration of prolog treatment 1. However, it highlights the importance of individualized treatment and regular monitoring to minimize risks and maximize benefits.
• The study recommends that hormonal replacement therapy should be continued until the average age of spontaneous menopause (45-55 years), and then the decision to stop or continue treatment should be based on individual risks, family history, and personal preferences 1.

From the FDA Drug Label

The treatment groups were: Progesterone capsules at the dose of 200 mg per day for 12 days per 28-day cycle The results for the incidence of endometrial hyperplasia in women receiving up to 3 years of treatment are shown in Table 3 The times to diagnosis of endometrial hyperplasia over 36 months of treatment are shown in Figure 1.

The duration of progesterone treatment can be up to 36 months.

• The study evaluated the effects of progesterone capsules on the endometrium for up to 3 years.
• The treatment was given in a cyclical regimen, with progesterone capsules administered at a dose of 200 mg per day for 12 days per 28-day cycle 2.

From the Research

Duration of Prolog Treatment

• The duration of prolog treatment is not directly addressed in the provided studies, which focus on various medical topics such as Helicobacter pylori eradication, prostate cancer treatment, and the pharmacodynamics and safety of progesterone 3, 4, 5, 6, 7.
• However, the study on Helicobacter pylori eradication regimens provides insight into the optimal duration of treatment for certain medical conditions, suggesting that increased duration can lead to higher eradication rates 4.
• The study on prostate cancer treatment timing discusses the impact of treatment delay on outcomes, but does not provide information on the duration of prolog treatment specifically 5.
• The studies on progesterone focus on its pharmacodynamics, safety, and effects on mood, but do not address the duration of prolog treatment 6, 7.
• Overall, there is limited information available on the duration of prolog treatment, and further research is needed to determine the optimal treatment duration.