Progesterone pessaries in pregnancy

[mama2047]

Hi everyone, I’m currently 8 weeks pregnant after a loss in February. I have been have on and off spotting for the past few weeks so I went for an early scan and they said I have a subchorionic hematoma. Thankfully, the baby was healthy and there was a healthy heartbeat. The obstetrician offered me progesterone pessaries due to my previous loss. I’ve done some research and seen mixed reviews so I wanted some of your guys opinions and advice? I’ve got them but not as of yet taken them. Would appreciate any advice🫶🏼

If the obgyn wants you to take them, TAKE THEM!

I took them as part of an ivf pregnancy. I took them at least once, daily, until 12 weeks. They were fine, a little messy but ok. I didn’t have any side effects and my baby was born healthy and well. My second ivf pregnancy I took progesterone injections which were mildly painful but a lot less messy.

Curious about the mixed reviews? Like reviews from women who’ve taken them? Or did you mean mixed research results? In all the studies I’ve read which is about using them to prevent loss, the have been shown to be effective. I’ve finnnnallly been signed off of them yesterday at 36 weeks, prescribed since 16 weeks due to an extremely short cervix, they help calm the uterus and help prevent late loss/extremely preterm delivery. So positive experience here. Also took them for first 12 weeks due to ivf. As with all medicine, you balance the pros and cons. And progesterone prescribed for pregnancy is well studied. That’s not to say there’s zero risk, but there’s no known risks. The progesterone generally prescribed is a natural form of progesterone so the same as your body makes to maintain the pregnancy. Sometimes loss can be attributed to lower progesterone and so you’re effectively topping it up. I was told for ivf it’s given becuase the body’s own signals have been interrupted by medication, and the corpus luteum might not function like in a spontaneous pregnancy. It’s certainly a choice you have to make for yourself, but for me, I couldn’t face more loss and wanted to maintain the pregnancy more than feeling worried about side effects or possible risks (that are not yet known).

if you’re worried about how they affect you, in my own experience it was fine, though everyone is affected by hormones differently. And yes a little messy but that’s small fry in the face of more loss.

congrats on your pregnancy! I know how scary it is after loss, and having a sch. There’s a lot on your worry plate, but in my opinion taking progesterone doesn’t need to be on your list of worries.

I can’t sustain a pregnancy without them, I love progesterone! Personally I don’t get any ‘side effects’ but I think my body doesn’t produce much on its own. For less mess lie down for 30 minutes after inserting them. Anal is way less messy than vaginal

I’ve just been prescribed progesterone due to a previous loss and current bleeding. I’ve researched/googled and can’t see any negatives - it doesn’t guarantee a successful pregnancy but no evidence of harm or reasons that I can see not to take it. I’m interested in what you mean by mixed reviews?

I’m not sure how true it is but I’ve seen some people saying that there is some research suggesting taking progesterone pessaries causes autism in children later on? That’s the only negative take I’ve seen on it but it has made me a bit hesitant.

Would you mind linking the research here?

https://pmc.ncbi.nlm.nih.gov/articles/PMC6252360/

Thanks for sharing the link. I had a read but I have no skill in interpreting scientific data so I asked Copilot, including the link, and it said:

Short answer: there is currently no credible evidence that using progesterone pessaries in early pregnancy (e.g. up to 12 weeks) causes autism. The paper you were sent suggests a possible association in one dataset, but it has important limitations and does not establish causation—and its findings aren’t supported by broader clinical evidence or guidelines.

Below is a clear, plain‑English interpretation.

1. What that specific paper actually shows The article you were sent (Frontiers in Psychiatry, 2018) reports: A case–control study in one region of China (235 ASD cases out of ~37,800 children). [europepmc.org] It found a statistical association between ASD and: use of progestins (including for threatened miscarriage), contraceptive hormone exposure around conception, and even “progestin‑contaminated seafood.” [europepmc.org] The authors concluded prenatal progestin exposure“may be associated” with ASD. [europepmc.org] They also included animal experiments showing “autism‑like behaviours” in rodents exposed to hormones. [europepmc.org] ✅ Key point: This is hypothesis‑generating research, not proof of harm.
2. Why experts interpret this cautiously (major limitations) There are several reasons this study is not considered strong evidence: a) It shows association, not cause Case‑control studies are prone to confounding (other factors explaining the link). For example: progesterone is given when a pregnancy is at higher risk (bleeding, miscarriage risk)—those underlying factors themselves are linked with poorer outcomes. b) Different exposures are lumped together The study grouped: natural progesterone, synthetic progestins, contraceptives, environmental exposure (seafood). ➡️ These are biologically very different, so it’s unclear what, if anything, is responsible. [europepmc.org] c) Limited generalisability Single geographic population (Hainan province). Small number of ASD cases (235), increasing statistical uncertainty. d) Animal data ≠ human outcomes “Autism‑like behaviour” in rodents does not directly translate to human autism.
3. What the wider body of evidence says When you zoom out beyond this one paper: ✅ Autism is multifactorial ASD risk is influenced by genetics plus many prenatal factors (e.g. maternal health, prematurity, metabolic conditions). [pmc.ncbi.nlm.nih.gov] ✅ Hormones in pregnancy are complex—but not proven causal Research looks at the overall hormonal environment, not progesterone treatment alone. [pmc.ncbi.nlm.nih.gov] No consistent evidence shows that giving progesterone medication causes ASD. ✅ Studies of progesterone in pregnancy generally do NOT show clear harm Large clinical trials and IVF use (where progesterone is very common) have not identified autism as a signal. NHS/NICE‑based guidance continues to recommend progesterone in specific situations, noting no established safety concerns in available studies. [cuh.nhs.uk] ✅ Even newer research is mixed and not definitive A 2025 observational study suggested some differences in certain developmental scores, but: small sample, not autism diagnoses, still observational (cannot prove cause). [pmc.ncbi.nlm.nih.gov]
4. Crucially: risk–benefit matters Progesterone pessaries are commonly prescribed because they can: Reduce miscarriage risk in some women Support early pregnancy where hormonal support is needed NICE specifically recommends progesterone for women with bleeding and prior miscarriage. [cuh.nhs.uk] 👉 If a treatment helps maintain a pregnancy, that benefit is substantial, and withholding it based on weak or uncertain evidence would usually not be advised.
5. Bottom line (clinically realistic interpretation) The paper you were sent: suggests a possible association in one dataset but is not strong or causal evidence Broader medical evidence: does not support a causal link between progesterone use and autism considers progesterone generally safe when clinically indicated Autism risk: is complex and largely driven by genetic and broader prenatal factors, not a single medication

I'm sorry for your loss and congrats on this pregnancy.

I personally wouldn't be worried single research paper from an obscure 'research' company I've never heard of.

I too found using them vaginally very messy because even with a panty liner, the med dissolves and leaks out as paste! Rectally, I used a tiny speck of lube on the end to help insertion. Yes, it was uncomfortable for a few seconds, but no mess. When you go to the loo, you might see some of the pessary come out, but the active ingredient still gets absorbed (unless you poo straight after insertion). Wishing you the best of luck x

I'm on Progesterone currently after bleeding at 14 weeks and 2 previous early miscarriages. The way I see it is that it's literally the only thing that can be done to support the pregnancy at this point so worth a shot! If I didn't take it and lost the baby I'd feel like i hadn't done everything i could to prevent the miscarriage.

Also, I know a child with autism who's mother didn't take progesterone. I believe autism is mostly genetic.

🙄