Kimzey, L. M., Gumowski, J., Merriam, G. R., Grimes, G. J., Jr., & Nelson, L. M. (1991). Absorption of micronized progesterone from a nonliquefying vaginal cream. Fertility and Sterility, 56(5), 995-996. https://doi.org/10.1016/s0015-0282(16)54680-9
Kimzey LM, Gumowski J, Merriam GR, Grimes GJ Jr, Nelson LM. Absorption of micronized progesterone from a nonliquefying vaginal cream. Fertil Steril. 1991;56(5):995-996. doi:10.1016/s0015-0282(16)54680-9
Kimzey, Lorene M., et al. "Absorption of micronized progesterone from a nonliquefying vaginal cream." Fertility and Sterility, vol. 56, no. 5, 1991, pp. 995-996.
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RRM Academy Synopsis
Vaginal progesterone cream sustained blood levels longer than capsules
Vaginal progesterone cream kept blood levels higher at 24 hours than oral capsules in a single-dose study of eight healthy women at the National Institutes of Health. Peaks came later after the cream and appeared to differ less between women.
Key Findings
Peak progesterone came at 19.2 ± 3.2 hours (mean ± SEM) after the vaginal cream and at 3.6 ± 0.8 hours after oral capsules (P < 0.01).
At 24 hours, serum progesterone remained higher after the vaginal cream than after oral capsules (P < 0.01).
Between-woman variation in peak levels, the coefficient of variation, was 20% after the cream and 120% after the capsules.
After capsules, one woman developed marked drowsiness with flushing, nausea and moderate headache, and two others reported mild to moderate headache.
After the cream, one woman had a mild headache and none reported drowsiness. Three women described vaginal discharge as minimal and two as moderate.
Interpretation
This single-dose pharmacokinetic study tracked progesterone levels over 24 hours in healthy women with regular menses, studied in the follicular phase, the first half of the cycle. Five women took capsules, five used the cream, and two tried both in separate cycles. The authors concluded that the cream holds promise as a convenient delivery method. The findings support larger studies of vaginal progesterone delivery.
RRM Context
This study tested progesterone itself, the hormone the ovary makes after ovulation, as distinct from synthetic progestins. RRM supports the ovulatory cycle, so how well a route sustains levels is a practical question. NaProTechnology protocols use cycle-timed progesterone support guided by charting.
Our editorial summary of this paper, not the article's abstract.
Abstract
An improved delivery method to achieve sustained physiological P levels would be useful. Based on this single-dose pharmacokinetic study, micronized P prepared in a nonliquefying vaginal cream holds promise as a convenient method to achieve this goal with a single daily application.
