Meta Information
ID:progesterone
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
major
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
0
Description:
Progesterone's primary metabolite, allopregnanolone, has potent sedative effects. Taking the dose at bedtime utilizes this effect to improve sleep quality and avoids significant daytime drowsiness.
Actionable advice:
Take your progesterone dose within 2 hours of bedtime to aid sleep and avoid daytime impairment.
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
major
Interaction type:
requirement
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Taking oral micronized progesterone with food, particularly a meal containing fat, can more than double its absorption from the gut, leading to more effective and consistent blood levels.
Actionable advice:
Always take oral progesterone with a meal, ideally your evening meal, for consistent absorption.
Target id:
/class/cyp3a4-strong-inhibitors
Target name:
Strong CYP3A4 Inhibitors (e.g., Ketoconazole, Grapefruit)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
These substances block the primary enzyme (CYP3A4) that breaks down progesterone, leading to significantly higher levels in the body and an increased risk of side effects like drowsiness and dizziness.
Actionable advice:
Avoid using strong CYP3A4 inhibitors with progesterone; consult a clinician for alternatives.
Target id:
/class/broad-spectrum-inducers
Target name:
Metabolic Enzyme Inducers (e.g., Rifampin, Carbamazepine)
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
These medications speed up the liver enzymes (like CYP3A4) that metabolize progesterone, causing it to be cleared from the body too quickly and severely reducing its effectiveness.
Actionable advice:
Avoid co-administration as progesterone efficacy will be severely compromised.
Target id:
/intervention/saint-johns-wort
Target name:
Saint John's Wort
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
St. John's Wort is a potent inducer of the CYP3A4 enzyme, which significantly accelerates the breakdown of progesterone, rendering it much less effective.
Actionable advice:
Do not take St. John's Wort while using progesterone.
Target id:
/condition/hepatic-impairment
Target name:
Hepatic Impairment
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The liver is the primary site of progesterone metabolism; severe liver disease impairs its clearance, leading to dangerously high levels and is a contraindication for use.
Actionable advice:
Do not use progesterone if you have severe liver disease.
Target id:
/condition/hormone-sensitive-cancer
Target name:
History of Hormone-Sensitive Cancer (e.g., Breast Cancer)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Progesterone can potentially stimulate the growth of certain hormone-sensitive cancers. Its use is contraindicated in individuals with a personal history of these conditions.
Actionable advice:
Progesterone is contraindicated if you have a history of breast cancer or other hormone-sensitive malignancies.
Target id:
/condition/thromboembolic-disorder
Target name:
History of Thromboembolic Disorders (Blood Clots)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Hormonal therapies can influence blood clotting factors. Progesterone is contraindicated in individuals with an active or past history of blood clots (DVT, PE), stroke, or heart attack.
Actionable advice:
Do not use progesterone if you have a history of blood clots, stroke, or heart attack.
Target id:
/condition/undiagnosed-vaginal-bleeding
Target name:
Undiagnosed Abnormal Vaginal Bleeding
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Abnormal vaginal bleeding must be investigated to rule out serious underlying conditions, such as cancer, before initiating progesterone therapy.
Actionable advice:
Progesterone is contraindicated until the cause of any abnormal vaginal bleeding has been diagnosed.
Target id:
/class/estrogens
Target name:
Estrogen Therapy (in women with a uterus)
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
In women with an intact uterus, unopposed estrogen therapy increases the risk of endometrial hyperplasia and cancer. Progesterone is required to oppose this effect and protect the uterine lining.
Actionable advice:
Progesterone must be co-administered with estrogen if you have a uterus to prevent endometrial cancer.
Target id:
/class/cns-depressants
Target name:
CNS Depressants (e.g., Alcohol, Benzodiazepines, Opioids)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Progesterone can cause drowsiness and dizziness; combining it with other substances that depress the central nervous system can lead to excessive sedation and impaired coordination.
Actionable advice:
Use extreme caution and avoid combining progesterone with alcohol or other sedative medications.
Target id:
/class/antidiabetic-medications
Target name:
Diabetes Medications
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Progesterone may slightly decrease glucose tolerance and increase insulin resistance in some individuals, potentially reducing the effectiveness of diabetes medications.
Actionable advice:
Monitor blood glucose levels closely when starting or changing the dose of progesterone.
Target id:
/condition/depression
Target name:
Major Depressive Disorder
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Progesterone and its metabolites can influence mood and neurotransmitter systems, potentially exacerbating symptoms in individuals with a history of depression.
Actionable advice:
Monitor mood closely and report any worsening of depressive symptoms to your clinician.
Target id:
/class/cyp2c19-inhibitors
Target name:
CYP2C19 Inhibitors (e.g., Omeprazole, Fluconazole)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
These drugs can inhibit a secondary enzyme (CYP2C19) involved in progesterone breakdown, potentially increasing its levels and the risk of side effects.
Actionable advice:
Use with caution and monitor for increased side effects like drowsiness if taking with a CYP2C19 inhibitor.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Progesterone is excreted in breast milk, and its effects on a nursing infant are not fully established. Caution is advised.
Actionable advice:
Consult with your healthcare provider before using progesterone while breastfeeding.
Target id:
/biomarker/thyroid-panel
Target name:
Thyroid Function Tests
Severity:
minor
Interaction type:
assay_interference
Nature:
absolute
Temporal spacing:
null
Description:
Progesterone can increase levels of thyroid-binding globulin (TBG), which may lead to an increase in total T4 and T3 measurements, though free hormone levels and TSH usually remain normal.
Actionable advice:
Inform your clinician you are taking progesterone when interpreting thyroid tests; focus on Free T4, Free T3, and TSH.
Target id:
/biomarker/lipid-panel
Target name:
Lipid Panel
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Progesterone can have variable effects on lipid profiles, sometimes slightly increasing LDL and decreasing HDL cholesterol in some individuals.
Actionable advice:
Periodically monitor your lipid panel when on long-term progesterone therapy.