Progesterone Dosing for Uterine Protection

Evidence-Based Minimum Dosing

• The Endocrine Society recommends 2.5 mg medroxyprogesterone acetate (MPA) daily as the minimum effective dose for continuous combined regimens in postmenopausal women receiving estrogen therapy, achieving endometrial protection 1
• The Endocrine Society also suggests 10 mg medroxyprogesterone acetate daily for 12-14 days per month as an alternative minimum for sequential regimens in postmenopausal women receiving estrogen therapy, providing endometrial protection 1
• 200 mg vaginal micronized progesterone daily provides equivalent endometrial protection to oral administration and may be used as an alternative route, as recommended by the Endocrine Society 1

Clinical Context: Preterm Birth Prevention

• The American College of Obstetricians and Gynecologists recommends 90 mg vaginal progesterone gel or 200 mg suppository daily for singleton pregnancies with short cervical length ≤20 mm, to prevent preterm birth 2, 3
• The American College of Obstetricians and Gynecologists also recommends 250 mg 17-hydroxyprogesterone caproate (17P) IM weekly for singleton pregnancies with prior spontaneous preterm birth, to prevent preterm birth 2, 3