Progesterone Vaginal Suppositories

What Is It?

A compounded suppository that places progesterone directly in the vagina. Made by prescription for one patient.

How It Works

Vaginal progesterone reaches the uterus through a "uterine first-pass effect." It delivers about 10 times more progesterone to the uterus at roughly 7 times lower blood levels than an intramuscular shot.

Why the Vaginal Route?

Vaginally delivered hormones concentrate in the uterus and nearby tissue with low systemic exposure — progesterone goes straight to its target organ. Some patients also prefer it to injections.

Who Prescribes It?

OB/GYNs, reproductive endocrinology/fertility specialists, women's health NPs and PAs, and primary care. Uses are prescriber-directed, such as luteal support in fertility care or menopausal hormone regimens.

Is It FDA-Approved?

FDA-approved vaginal progesterone products exist (such as a vaginal insert and gel). This compounded suppository is not FDA-approved. Compounding is used when a prescriber wants a custom strength or form.

Key Safety Note

If progesterone is intended to protect the uterine lining, the dose must be adequate — that is the prescriber's determination. Any abnormal bleeding should be evaluated by a provider.

Quality

Because progesterone is a hormone (a hazardous drug), Mixwell compounds in a USP <800>-compliant HD negative-pressure lab, by prescription only. Non-sterile pharmacy; no injectables. Not FDA-reviewed. No result is promised, and this is not claimed to be better than commercial products.

References

1. Bulletti C, de Ziegler D, Flamigni C, et al. Targeted drug delivery in gynaecology: the first uterine pass effect. Hum Reprod. 1997;12(5):1073–1079.
2. Cicinelli E. Intravaginal oestrogen and progestin administration: advantages and disadvantages. Best Pract Res Clin Obstet Gynaecol. 2008;22(2):391–405.
3. American College of Obstetricians and Gynecologists. Compounded Bioidentical Menopausal Hormone Therapy. Clinical Consensus. Obstet Gynecol. 2023.