Cyclogest is indicated for the:
- Treatment of premenstrual syndrome, including premenstrual tension and depression.
- Treatment of puerperal depression.
- Luteal phase support as part of an Assisted Reproductive Technology(ART) treatment for women.
What is Cyclogest used for?
- Premenstrual syndrome (PMS or PMT).
- Postnatal depression.
- Supporting pregnancy in women having assisted reproduction treatment such as IVF.
How does Cyclogest work?
- Cyclogest pessaries contain the active ingredient progesterone, which is a naturally occurring female sex hormone.
- Progesterone is essential for normal functioning of the reproductive system and its levels naturally fluctuate throughout the menstrual cycle. After ovulation, if an egg is not fertilised, the level of progesterone in the blood falls before a menstrual period starts. Some women find that using progesterone for 12 to 14 days before their period starts can relieve the symptoms of premenstrual syndrome.
However, it's not fully understood how this works, as PMS has not been scientifically shown to be caused by a lack of progesterone in the bloodstream.
Progesterone can also be used to treat depression following childbirth (postnatal depression). The placenta produces progesterone throughout the pregnancy, and a drop in progesterone levels after the birth may be partly responsible for postnatal depression.
Progesterone is also used to support early pregnancy in women having in vitro fertilisation (IVF). In this case the pessaries are started on the day of egg retrieval. The progesterone acts on the womb lining and causes it to thicken in preparation for a fertilised egg to implant. The progesterone is continued for 38 days if pregnancy is confirmed. This helps to maintain the pregnancy until the placenta develops fully, when it then takes over the production of progesterone to continue to support the pregnancy.
Cyclogest pessaries can be inserted either into the vagina or rectum (bottom). In both cases, the pessaries melt and the progesterone from the pessaries is absorbed into the bloodstream via the the rich supply of blood vessels in these areas.
How do I use Cyclogest?
- Always follow the instructions given by your doctor regarding when to use these pessaries, how often and for how long.
- If you are using Cyclogest for assisted reproduction you should always use the pessaries in your vagina.
- If you are using Cyclogest for PMS or postnatal depression you can use the pessaries in your vagina or rectum (like a suppository). This depends on your personal choice and whether any of the following apply to you:
- Cyclogest pessaries should be used in your rectum if you are using latex (rubber) condoms or diaphragms (caps) to prevent pregnancy or STIs. This is because Cyclogest pessaries may damage these barrier forms of contraception and so make them less effective.
- Cylogest pessaries should also be used rectally if you have a vaginal infection such as thrush, recurrent urine tract infections, eg cystitis, or have recently given birth.
- Cyclogest pessaries should be used vaginally if you suffer from bowel inflammation (colitis) or any problems controlling your bowel movements, such as faecal incontinence.
Who should not use Cyclogest pessaries?
- Women with abnormal vaginal bleeding where the cause has not been diagnosed.
- Women with rare hereditary blood disorders called porphyrias.
- Women with severe liver problems.
- Women with a known or suspected progesterone-sensitive tumour, eg breast cancer or cancer involving the genital tract.
- Women with inflammation of a vein caused by a superficial blood clot (thrombophlebitis).
- Women with a blood clot in a vein (venous thromboembolism), eg in the leg (deep vein thrombosis) or in the lungs (pulmonary embolism).
- Women who have had a heart attack or stroke.
- Women who have had a miscarriage but the tissue is still inside the womb (called a missed or silent miscarriage).
- Women with a pregnancy that is developing in one of the fallopian tubes (ectopic pregnancy).
- Women who are allergic to any ingredient of the pessaries.
Cyclogest pessaries should be used with caution in
- Women with an increased risk of getting a blood clot in a blood vessel.
- Women with high blood pressure (hypertension).
- Women with heart disease, such as angina or heart failure.
- Women with liver or kidney problems.
- Women with epilepsy.
- Women who suffer from asthma.
- Women who suffer from migraines.
- Women with a history of depression.
- Women with diabetes.
Can I use Cyclogest pessaries while pregnant or breastfeeding?
- Cyclogest pessaries shouldn't be used during pregnancy except for luteal support in assisted reproduction. Get medical advice from your doctor if you think you could be pregnant while using this medicine for any other reason. However, as progesterone is a naturally occurring hormone it is not expected to have any harmful effects.
- Progesterone is produced naturally during pregnancy. This medicine has the same effects as natural progesterone and has no harmful effects when used as luteal support during the first month of pregnancy.
- Progesterone passes into breast milk. The manufacturer states that Cyclogest pessaries are not recommended for women who are breastfeeding. Get advice from your doctor before using this medicine if you are breastfeeding.
What are the possible side effects of Cyclogest pessaries?
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with Cyclogest pessaries. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.
Common (affect between 1 in 10 and 1 in 100 people)
- Sleepiness.
- Abdominal pain or discomfort.
- Breast pain.
- Hot flushes (when used in assisted conception).
- Constipation (when used in assisted conception).
- Fatigue (when used in assisted conception).
- Unknown frequency
- Changes in menstrual cycle, such as earlier or delayed periods.
- Discharge of oily pessary base from the vagina or rectum. You might want to use a panty liner to avoid leakage onto your underwear.
- Soreness of the vagina or rectum.
- Diarrhoea and flatulence (with rectal use only).
Read the leaflet provided with the medicine or talk to your doctor, nurse or pharmacist if you want any more information about the possible side effects of Cyclogest pessaries.
Can I use Cyclogest pessaries with other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with Cyclogest. Similarly, check with your doctor or pharmacist before taking any new medicines while using Cyclogest pessaries, to make sure that the combination is safe.
It is recommended that other vaginal medicines should not be used in combination with Cyclogest.
The following medicines may increase the breakdown of progesterone by the liver and so could potentially make this medicine less effective:
- carbamazepine
- fosphenytoin
- oxcarbazepine
- phenobarbital
- phenytoin
- primidone
- rifampicin.
References:
https://www.drugs.com/uk/cyclogest-400mg-leaflet.html
https://www.netdoctor.co.uk/medicines/a8718/cyclogest-progesterone/
https://www.medicines.org.uk/emc/product/5569/smpc
https://www.rxwiki.com/cyclogest
http://www.mhra.gov.uk/home/groups/spcpil/documents/spcpil/con1526618757689.pdf
Health Reference: Female infertility
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