Gynalven (Progesterone, Micronised)

Gynalven is used in hormone therapy where supplemental progesterone is required.

• Support of the luteal phase in assisted reproductive technology cycles.
• Management of progesterone deficiency in women with amenorrhea.
• Adjunct therapy in estrogen‑based hormone replacement regimens to reduce endometrial proliferation.
• Treatment of certain menstrual disorders such as irregular bleeding.
• Prevention of preterm birth in selected high‑risk pregnancies (off‑label in some regions).
• Preparation for endometrial priming before embryo transfer in in‑vitro fertilization protocols.

Side effects reported with oral micronised progesterone vary in frequency and severity. While most patients experience mild symptoms, clinicians monitor for less frequent but more serious events.

Common

• Nausea, abdominal discomfort, or mild gastrointestinal upset.
• Drowsiness, fatigue, or a feeling of reduced alertness.
• Breast tenderness, swelling, or a sensation of fullness.
• Headache, often mild and transient.
• Transient dizziness or light‑headedness, especially when standing quickly.

Serious

• Allergic reactions such as rash, itching, swelling of the face, lips, or tongue.
• Signs of venous thromboembolism, including unexplained leg pain, swelling, or shortness of breath.
• Severe mood changes, depression, or thoughts of self‑harm.

Before prescribing Gynalven, healthcare providers consider several precautionary factors to ensure safe use.

• Assess for a history of thromboembolic disorders or clotting disorders.
• Evaluate liver function, as progesterone metabolism occurs hepatically.
• Review any personal or family history of hormone‑sensitive cancers.
• Consider potential effects on mood; screen for depression.
• Use caution in patients with uncontrolled hypertension.
• Avoid in women who are pregnant unless specifically indicated.
• Check for known hypersensitivity to progesterone or excipients.

Oral micronised progesterone can interact with other medicines, affecting efficacy or safety.

Avoid

• Combined use with strong CYP3A4 inducers (e.g., rifampin, carbamazepine) may reduce progesterone levels.
• Concurrent anticoagulant therapy (warfarin, direct oral anticoagulants) may increase bleeding risk.

Use with caution

• Antifungal agents such as ketoconazole can raise progesterone concentrations.
• Certain antiepileptic drugs (phenytoin, phenobarbital) may alter hormone metabolism.
• Hormonal contraceptives containing estrogen may enhance progesterone‑related side effects.
• Herbal supplements like St. John’s wort may affect progesterone metabolism and should be discussed with the prescriber.