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Do I need progesterone during pregnancy?

Q: I am 45 years old and 14 weeks pregnant, I conceived naturally. The sonogram looked very good according to my doctor. I understand that progesterone is helpful for older women. I have been taking 100 mg since the first month as suppositories. My doctor says that the placenta has formed and has taken over the progesterone production. I believe him and am not worrying. However, I remember two women who were taking progesterone shots throughout the duration of their pregnancy. Considering my age, I wonder if I should not be monitored to see if my progesterone level is rising properly. I don't know why these women were taking shots. This pregnancy is a tremendous gift for me and I would like to do the best for it.

A:I am surprised that you are taking progesterone. There is no medical reason to take them. Well if you are 45 years old, you need some tests extra (over and above if you had been 25) but not take extra medicines. Even if you get serum progesterone levels done and progesterone levels are less than the normal range, there is no proof that giving progesterone as pessaries or injections will help the pregnancy. On the contrary these hormones are potentially harmful. You have conceived naturally and in all probability it is a normal pregnancy. Please let it progress naturally. Taking one or the other hormone will not help. These drugs are being marketed very vigorously for the last few years but there is no proof that it helps. In fact the royal college has issued a policy statement and warning to general population to avoid all irrational and scientifically unproven treatments in pregnancy (you can see it on the site www.rcog.org.uk ). Your desire to have a perfect baby is understandable but you must understand that the normality of the pregnancy and the baby does not depend on treatment. To give a hormone like progesterone because you are 45 years old and something must be done (i.e something must be given) is illogical. To take this hormone since it will do no harm is not acceptable and logical and has no place in modern scientific medicine. Please do not take this or any other hormone. At 45, you have a higher chance of having an abnormal baby in the form of downs syndrome and you need tests (amniocentesis) to exclude that. And if this test is normal, please leave the pregnancy alone and it will progress normally. I also have no answer to why your other friends were given progesterone throughout their pregnancy except by the logic that something must be done so give some hormone. Please read about these hormones on the net. This was common till about 20 years ago in the west when progesterone was supposed to be harmless but now that increasing complications with progesterone are known giving this hormone has no place in modern practice or rational evidence based medicine. This pregnancy is decidedly a gift (in your case as indeed in every case) but surely it does not mean that you need to take more hormones! which are useless and potentially harmful. Please take no medicines during pregnancy until you have life threatening conditions. Please have faith in nature and let it look after the pregnancy but either way remember that medicines especially hormones cannot help a growing baby and potentially can cause harm to the baby.

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