Bleeding in early pregnancy

About 20% of pregnant women will experience bleeding in early pregnancy. Although women are often very worried about this, it is not always the sign of a serious problem. However, with bleeding there is a higher chance of miscarriage. About one in three women with bleeding will go on to miscarry.

What is progesterone?

Progesterone is a natural hormone that is very important during pregnancy. It helps the lining of the womb to grow and to accept the growing baby. Two recent studies have shown that in certain women with vaginal bleeding, progesterone can prevent miscarriage.

Who benefits from taking progesterone?

Studies have shown that women, who are bleeding and have had more than one miscarriage may benefit from taking progesterone.

  • PROMISE study: studied 836 women with unexplained recurrent miscarriages at 45 hospitals in the UK and the Netherlands and found a 3% higher live birth rate with progesterone.
  • PRISM studied 4,153 women with early pregnancy bleeding at 48 hospitals in the UK and found there was a 5% increase in the number of babies born to those who were given progesterone who had previously had one or more miscarriages, compared to those given a placebo.

What is the treatment?

Progesterone (drug name Cyclogest or Utrogestan) is taken as vaginal pessaries, 400mg twice daily from when you have a scan showing a normally sited pregnancy until 16 weeks of pregnancy.

The initial prescription will be given to you in the early pregnancy unit. Future prescriptions should be obtained from your GP.

Are there any side effects or risks?

The large studies mentioned, found no increase in problems in babies of women taking progesterone compared to women who did not take progesterone.

Common side effects of progesterone treatment include:

  • abdominal bloating and pain
  • constipation
  • breast pain
  • tiredness.

Some women may prefer to take the drug rectally (inside your bottom) if it causes vaginal discomfort.