6.4.1.2. Progestogens
Prescribing Notes:
Mirena is the preferred levonorgestrel intra-uterine system for prevention of endometrial hyperplasia during oestrogen replacement therapy.
Prescribe by brand name. Intra-uterine device which releases levonorgestrel (52mg). It is licensed for use for up to 4 years for this indication; please also see Royal College of Obstetricians & Gynaecologists (RCOG) guidance.
For other indications, see section 7.3.2.3.
Prescribing Notes:
The use of medroxyprogesterone tablets for postponing menstruation is off-label, and only for use in patients at higher risk of VTE or where norethisterone is unsuitable. Further guidance is available from the Specialist Pharmacy Service.
Prescribing Notes:
Norethisterone should be avoided in patients at risk of venous thromboembolism.
Prescribing Notes:
As an adjunctive use with oestrogen in post-menopausal women with an intact uterus, as hormone replacement therapy (HRT).
Restrictions:
Use of Lubion® injection is restricted to women who are unable to use or tolerate vaginal preparations.
Prescribing Notes:
Use for luteal support as part of an assisted reproductive technology (ART) treatment program for infertile women is restricted to specialist use only in line with national guidance.
Restrictions:
Restricted to specialist initiation for the prevention of miscarriage in women presenting with bleeding in the first trimester of pregnancy and have a history of recurrent miscarriages.