Cyclogest

Cyclogest is a medication which contains micronised progesterone which is chemically identical to the female sex hormone Progesterone naturally produced by females in the ovaries. It is packaged in the form of a pessary which contains either 200mg or 400mg of micronised Progesterone in a off-white colour with the pessaries made in a torpedo shape.

It is normally used in fertility treatments such as in vitro fertilisation (IVF), frozen-embryo transfer (FET) and such to help support pregnancy in the early stages. The exogenous progesterone provides the uterus with a progesterone-rich environment which helps to maintain the lining of the uterus known as an endometrium. This creates a stable environment for the implantation of the embryo and supports its development through the early stages of pregnancy.

Cyclogest is designed to bypass first-pass liver metabolism hence is inserted either vaginally or via the rectum which localises its absorption and reduces any systemic side effects compared to medications taken orally.

The purpose of the following article is to describe and explain the purpose of Cyclogest and how it works in detail below. It will also include information on how to buy Cyclogest pessaries and discuss the prices.

What Is Cyclogest Used For?

Cyclogest is recommended as a treatment for the following conditions:

Treatment of premenstrual syndrome which includes premenstrual tension and depression:

• Pre-menstrual syndrome affects women around 7-10 days before the start of their menstrual cycle also known as the luteal phase.
• These symptoms include the feelings of low mood, depression, headaches, weight gain, irritability, body acne, fatigue, bloating, tenderness in breasts and so on

Treatment of post-natal depression (puerperal depression) or also known as post-partum depression:

• A mood disorder commonly affecting women during pregnancy or within the first year after giving birth.

• It can lead to feelings of restlessness, irritability, hopelessness, low-self esteem, low self-confidence, loss of pleasure in everyday things
• If not treated in time, it can lead to hostile behaviours and may also lead to suicidal thoughts and tendencies causing harm to oneself and others.

Treatment for women undergoing an Assisted Reproductive Technology (ART) treatment:

• These include treatments such as in vitro fertilisation (IVF) and intrauterine insemination (IUI) to combat fertility issues and help couples conceive children.

Cyclogest Dosage & Strengths

Cyclogest pessaries come in two different strengths as outlined below and the doses vary and depend on the type of condition being treated:

• Cyclogest 200mg pessary

• Cyclogest 400mg pessary

Cyclogest pessaries are used according to the condition that needs to be treated and these are detailed below:

For women who are commencing an Assisted Reproductive Technology (ART) programme:

1. The dose required for this programme is 400mg TWICE a day therefore It is recommended to use TWO Cyclogest pessaries (200mg) or ONE Cyclogest pessary (400mg) TWICE a day into the vagina.
2. It is recommended to start with the Cyclogest 400mg dose on the day of the egg retrieval.
3. Once pregnancy is confirmed, Cyclogest treatment should then be continued for 38 days.

For women who are being treated for premenstrual syndrome which includes premenstrual tension and/or post-natal depression.

1. The recommended dose is ONE 200mg Cyclogest pessary ONCE a day or ONE 400mg Cyclogest pessary TWICE a day by either vaginal or rectal insertion.
2. For premenstrual tension, it is recommended to start Cyclogest treatment on Day 12 or Day 14 of the menstrual cycle. Please make sure to mark your calendar accordingly.

How Cyclogest Works

Progesterone is a naturally occurring steroid hormone which is produced by the ovaries in females. It is also secreted by the placenta during pregnancy and also the adrenal gland. When Estrogen levels in the body are adequate, the endometrium undergoes a transformation which changes from its normal proliferative state to a secretory state due to Progesterone.

This is especially important because in the secretory state, high levels of Progesterone ensure the lining of the endometrium is stable for implantation by an embryo. Once the implantation process is completed, Progesterone is needed to maintain the pregnancy to ensure the endometrium remains stable for the embryo.

The cyclogest tablet therefore works to increase the levels of Progesterone in the body to meet the above conditions for a successful implantation to occur. It is inserted via the vagina or the rectum which avoids first pass metabolism by the liver. This reduces any systemic side effects common in oral medications hence is a safer method for the female and the fetus.

Furthermore, Progesterone is also useful to manage pre-menstrual syndrome such as low mood, irritability, breast tenderness and so on which occur in the luteal phase before a female’s menstrual cycle. This helps to regulate the neuro-hormonal changes therefore Cyclogest pessaries are also used for this purpose.

How to Use Cyclogest Correctly

Before using this medication, please ensure you follow the instructions provided by your doctor. Ensure that you do not swallow the pessaries under any circumstances. If you are unsure, contact a doctor or pharmacist for clarification.

The pessary can be inserted in two ways: via vaginal or rectal (back passage) insertion as a suppository however, this depends on certain conditions therefore read the following to see which method suits your needs:

You should insert Cyclogest into the vagina:

• If you have Colitis which is inflammation in your large intestine (colon) which causes issues such as violent diarrhoea with visible mucous and blood in stools.
• If you suffer from faecal incontinence (problems with controlling your bowel movements)

You should insert Cyclogest tablets into the rectum:

• If you have a current vaginal infection (thrush, bacterial vaginosis)

• If you have recently given birth.
• If you are planning on using a physical barrier form of contraception such as a condom, cap or diaphragm which may become ineffective from the hard fat from the pessary
• If you suffer from cystitis which involves burning pain when you urinate.

How to use the pessary:

1. Before starting, ensure to wash your hands with soap and give yourself plenty of time and space with some privacy.
2. It is advised to empty your bladder or bowels before use for maximum comfort.
3. If you are inserting the pessary into the vagina, first find a comfortable position such as lying down or squatting and gently place the pessary.
4. For use via the rectum, gently push the pessary inside the rectum around an inch. When it is far enough, your anal muscles will hold the pessary in place. Ensure to squeeze your buttocks for a few seconds until the pessary stays in.
5. Wash your hands after using the pessary.
6. Cyclogest pessaries are only for vaginal or rectal use. They are not to be taken orally.
7. It is normal to expect some discharge in the upcoming days after use, this is normal and expected. Speak to your doctor if the discharge looks like blood or any abnormal colour that is not white/cream coloured.

The following details any further questions you may have in regards to using Cyclogest:

Side Effects & Safety Information

The following table outlines the various side effects to keep in mind before starting treatment with Cyclogest:

As with most medications, side effects are possible as each individual is different and is susceptible to different side effects.

However, if you notice any symptoms of an allergic reaction such as rashes, breathing difficulties, itching, struggling to swallow, tongue swelling up and so on, please discontinue medication and contact your nearest emergency department as soon as possible to avoid instances of an anaphylactic shock.

Safety and warnings:

Cyclogest is safe to take during pregnancy and is normally prescribed to help support early stages of pregnancy in women. Furthermore, it is normally delivered via a vaginal or rectal route of administration which avoids first pass metabolism by the liver. This reduces any systemic side effects common in oral medications hence is a safer method for the female and the fetus.

Cyclogest is not commonly known to interact with other medications however if you are taking medications for other conditions such as carbamazepine (epilepsy), rifampicin (for infections), other hormonal treatments or any over-the-counter medicated or herbal medications, ensure to contact your doctor and inform them before commencing treatment as treatment may become ineffective when used alongside certain medications.

Who Can Take Cyclogest?

Cyclogest UK is recommended for the treatment of the following conditions:

1. Treatment of premenstrual syndrome which includes premenstrual tension and depression
2. Treatment of post-natal depression (puerperal depression) which is a mood disorder commonly affecting women during pregnancy or within the first year after giving birth.
3. Women undergoing an Assisted reproductive Technology (ART) treatment such as in vitro fertilisation (IVF) and intrauterine insemination (IUI) to help combat fertility issues and conceive children.

Do not use cyclogest treatment if the following apply to you:

• Allergic to progesterone or any of the ingredients in Cyclogest pessaries (please see the patient information leaflet in the pack to find out more)
• Vaginal bleeding
• You have a known or a suspected tumour which is hormone sensitive
• Porphyria disorder which can affect the individual’s skin or nervous system
• Blood clots in the body in the past or currently
• Liver problems
• Previous miscarriage or suspected future miscarriages.
• You are under 18 years of age.

Ensure to inform your doctor, nurse or a pharmacist before starting Cyclogest if you experience any of the following symptoms during or after treatment:

• Pain in the legs (especially calves) or chest
• Sudden shortness of breath
• Coughing up blood
• Severe headaches, dizziness or fainting episodes
• Any changes in vision, or speech or weakness and numbness on one or both sides of the body
• Depressive symptoms worsening
• Jaundice (liver dysfunction)
• Epilepsy (seizures)
• Migraines
• Asthmatic attacks
• Cardiac (heart) or renal (kidney) problems
• Diabetes

Cyclogest during pregnancy:

Cyclogest is commonly prescribed during the first trimester in pregnancy for women who are undergoing treatments such as IVF or IUI who may require extra progesterone.

However, since the effects of exogenous progesterone during pregnancy have not been extensively studied yet, it is unknown whether exogenous progesterone can cause or increase risks of children developing congenital health issues while in the womb.

It is advised to consult your doctor before starting treatment with progesterone especially if you are planning a pregnancy or are already pregnant.

Cyclogest during breastfeeding:This medication should not be used if you are breastfeeding.

Buy Cyclogest Online & Price in the UK

Cyclogest pessaries are a prescription only medication (POM) therefore can only be prescribed by a doctor, and dispensed by a UK registered pharmacist. It can also be purchased via a private prescription although Cyclogest prices via a private prescription are determined by each individual pharmacy and do not follow the standard NHS charge guidelines.

The current prescription charges for medications on the NHS is £9.90 per item however, if the medication is used regularly then it is recommended to purchase a prescription pre-payment certificate (PPC) which covers the cost of all your NHS prescriptions over the course of 3 months (3 items) or 12 months (11 items) hence being the more cost effective option.

Cyclogest pessaries can be purchased online, however, you should ensure you’re purchasing from a reputable provider such as Meds for Less.