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Progesterone (P4), sold under the brand name Prometrium among others, is a medication and naturally occurring steroid hormone. [20] It is a progestogen and is used in combination with estrogens mainly in hormone therapy for menopausal symptoms and low sex hormone levels in women.
Progesterone causes many changes to the genitourinary system. A pregnant woman may experience an increase in the size of the kidneys and ureter due to the increase blood volume and vasculature. Later in pregnancy, the woman might develop physiological hydronephrosis and hydroureter, which are normal. [ 33 ]
The secretion of sex hormones like estrogen and progesterone increases significantly during pregnancy, influencing the regulation of sleep in terms of both circadian rhythms and sleep need. [ 1 ] [ 16 ] Sleep disruption can also occur due to nighttime uterine contractions , which are a result of the nighttime surge in oxytocin levels.
In women, the most common adverse effects of MPA are acne, changes in menstrual flow, drowsiness, and can cause birth defects if taken by pregnant women. Other common side effects include breast tenderness , increased facial hair, decreased scalp hair, difficulty falling or remaining asleep, stomach pain, and weight loss or gain. [ 24 ]
Progesterone normalizes blood clotting and vascular tone, zinc and copper levels, cell oxygen levels, and use of fat stores for energy. Progesterone may affect gum health, increasing risk of gingivitis (gum inflammation). [99] Progesterone appears to prevent endometrial cancer (involving the uterine lining) by regulating the effects of estrogen.
Progesterone prepares the endometrium for implantation, as the level of progesterone increases, the capillaries grow. [10] These capillaries spread throughout the granulosa layer of cells which promotes vascularization and blood flow in the endometrium, ensuring an adequate blood supply to the developing placenta and fetus. [ 10 ]
At high doses, progestogens can cause low sex hormone levels and associated side effects like sexual dysfunction and an increased risk of bone fractures. [3] Progestogens are agonists of the progesterone receptors (PRs) and produce progestogenic, or progestational, effects. [1]
Many nonhuman studies can be used as both potential models for humans and to show the phylogenetic conservation of some endocrine signals. [1] Estrogen and progesterone released by ovaries during pregnancy make oxytocin receptors more sensitive in female rats [8] and is associated with the onset of maternal behaviors in other species as well.