Is Progesterone compatible with breastfeeding? Do we have alternatives for Progesterone?

Progesterone

January 10, 2015 (Very Low Risk)

Excreted into breast milk in a non-significant amount with no side-effects observed in breastfed infants of treated mothers. The plasma levels in those infants have been undetectable or very low.

During the first 6 weeks after birth, non-hormonal methods are of choice as contraceptives.

If associated to estrogens may inhibit lactation. It is recommended the use of contraceptive medication that does not contain estrogens, or, better if it contains progestogen alone.

Alternatives

We do not have alternatives for Progesterone since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Dioxipregnen
  • Pregnenedione
  • Progestin

References

  1. Berens P, Labbok M; Academy of Breastfeeding Medicine. ABM Clinical Protocol #13: Contraception During Breastfeeding, Revised 2015. Breastfeed Med. 2015Abstract Full text (link to original source) Full text (in our servers)
  2. RamaRao S, Clark H, Merkatz R, Sussman H, Sitruk-Ware R. Progesterone vaginal ring: introducing a contraceptive to meet the needs of breastfeeding women. Contraception. 2013Abstract
  3. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013Abstract Full text (link to original source) Full text (in our servers)
  4. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
  5. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011Abstract Full text (link to original source) Full text (in our servers)
  6. Massai R, Quinteros E, Reyes MV, Caviedes R, Zepeda A, Montero JC, Croxatto HB. Extended use of a progesterone-releasing vaginal ring in nursing women: a phase II clinical trial. Contraception. 2005Abstract
  7. Erkkola R, Landgren BM. Role of progestins in contraception. Acta Obstet Gynecol Scand. 2005Abstract
  8. Johansson ED, Sitruk-Ware R. New delivery systems in contraception: vaginal rings. Am J Obstet Gynecol. 2004Abstract
  9. Gjerdingen D. The effectiveness of various postpartum depression treatments and the impact of antidepressant drugs on nursing infants. J Am Board Fam Pract. 2003Abstract Full text (link to original source) Full text (in our servers)
  10. Halderman LD, Nelson AL. Impact of early postpartum administration of progestin-only hormonal contraceptives compared with nonhormonal contraceptives on short-term breast-feeding patterns. Am J Obstet Gynecol. 2002Abstract
  11. Baheiraei A, Ardsetani N, Ghazizadeh S. Effects of progestogen-only contraceptives on breast-feeding and infant growth. Int J Gynaecol Obstet. 2001Abstract
  12. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  13. Massai R, Miranda P, Valdés P, Lavín P, Zepeda A, Casado ME, Silva MA, Fetis G, Bravo C, Chandía O, Peralta O, Croxatto HB, Díaz S. Preregistration study on the safety and contraceptive efficacy of a progesterone-releasing vaginal ring in Chilean nursing women. Contraception. 1999Abstract
  14. Chen JH, Wu SC, Shao WQ, Zou MH, Hu J, Cong L, Miao L, Wang C, Dong J, Gao J, Xiao BL. The comparative trial of TCu 380A IUD and progesterone-releasing vaginal ring used by lactating women. Contraception. 1998Abstract
  15. Díaz S, Zepeda A, Maturana X, Reyes MV, Miranda P, Casado ME, Peralta O, Croxatto HB. Fertility regulation in nursing women. IX. Contraceptive performance, duration of lactation, infant growth, and bleeding patterns during use of progesterone vaginal rings, progestin-only pills, Norplant implants, and Copper T 380-A intrauterine devices. Contraception. 1997Abstract
  16. Sivin I, Díaz S, Croxatto HB, Miranda P, Shaaban M, Sayed EH, Xiao B, Wu SC, Du M, Alvarez F, Brache V, Basnayake S, McCarthy T, Lacarra M, Mishell DR Jr, Koetsawang S, Stern J, Jackanicz T. Contraceptives for lactating women: a comparative trial of a progesterone-releasing vaginal ring and the copper T 380A IUD. Contraception. 1997Abstract
  17. Kelsey JJ. Hormonal contraception and lactation. J Hum Lact. 1996Abstract
  18. [No authors listed] Progestogen-only contraceptives during lactation: II. Infant development. World Health Organization, Task Force for Epidemiological Research on Reproductive Health; Special Programme of Research, Development, and Research Training in Human Reproduction. Contraception. 1994Abstract
  19. Shaaban MM. Contraception with progestogens and progesterone during lactation. J Steroid Biochem Mol Biol. 1991Abstract