Susten Gel (Progesterone)

What is Susten Gel (Progesterone)?

Susten Gel is a vaginal gel formulation of natural micronized progesterone. It is primarily used in fertility treatments, luteal phase support, and hormone replacement therapy (HRT) in women. Progesterone is a natural hormone essential for regulating ovulation, preparing the uterus for implantation, and maintaining pregnancy.

• Generic Name: Progesterone

• Form: Vaginal gel

• Strength: Commonly available as 8% gel (90 mg of progesterone per 1.125 g of gel)

What are the Uses of Susten Gel?

Susten Gel is used for:

• Luteal phase support in assisted reproductive techniques (ART) like IVF

• Supporting early pregnancy in women with progesterone deficiency

• Part of HRT in women undergoing menopause (especially those with a uterus)

• Treatment of secondary amenorrhea

• Progesterone supplementation in infertility due to luteal phase defect

What are the Benefits of Susten Gel?

• Direct delivery of progesterone to the uterine tissue

• Avoids first-pass metabolism (unlike oral progesterone)

• Improved bioavailability for fertility and pregnancy support

• Reduces systemic side effects compared to oral forms

• Convenient and once-daily application

How Does Susten Gel Work?

Susten Gel delivers micronized progesterone via vaginal absorption. It mimics the body’s natural hormone, acting on progesterone receptors in the endometrium to:

• Promote endometrial maturation for embryo implantation

• Maintain a supportive environment for early pregnancy

• Counterbalance the effects of estrogen on the uterine lining in HRT

How to Use Susten Gel?

• Route: Vaginal

• Application: Use the applicator provided to insert the prescribed amount deep into the vagina, typically once or twice daily.

• Best Time: Preferably at bedtime to reduce leakage

• Instructions:

  • Wash hands before and after application

  • Lie down for a few minutes after inserting the gel

  • Avoid sexual activity or using other vaginal products immediately after application

Dosage of Susten Gel

Common dosage:

• 90 mg (1 applicatorful) once or twice daily

• In IVF protocols: Usually once daily starting post-ovulation or embryo transfer, continued until pregnancy is confirmed and possibly into the first trimester

Dosage may vary depending on individual response, indication, and doctor’s guidance.

Missed Dose and Overdose

Missed Dose:

• Apply as soon as remembered.

• If close to the next dose, skip the missed one.

• Do not double the dose.

Overdose:

• Rare with vaginal use.

• Symptoms may include drowsiness, nausea, or breast tenderness.

• Seek medical help if large amounts are ingested or if serious symptoms occur.

Available Strengths of Susten Gel

• Susten 8% vaginal gel (90 mg progesterone)

• Also available in other forms under the Susten brand, including:

  • Susten 100/200/300 mg capsules (oral/vaginal)

  • Susten injections (IM)

Side Effects of Susten Gel

Common Side Effects:

• Vaginal discharge or irritation

• Breast tenderness

• Abdominal cramps

• Headache

• Mood changes

• Fatigue or dizziness

Serious Side Effects (rare):

• Allergic reactions

• Vaginal bleeding

• Depression

• Risk of blood clots (especially with systemic exposure)

Seek immediate care for swelling, leg pain, chest pain, or difficulty breathing.

Interactions of Susten Gel

May interact with:

• Other hormone therapies

• Antiepileptic drugs (e.g., phenytoin, carbamazepine)

• Antibiotics or antifungals

• Herbal supplements like St. John’s Wort

Inform your doctor about all current medications and supplements.

Precautions of Susten Gel

• Avoid in cases of:

  • Known or suspected breast or genital cancer

  • Undiagnosed vaginal bleeding

  • Liver dysfunction

  • History of thromboembolic disorders

• Caution in women with:

  • Depression

  • Migraine

  • Hypertension

• Not recommend for use in pediatric or male patients

Storage Information

• Store at room temperature (15°C – 25°C or 59°F – 77°F)

• Keep away from heat and moisture

• Do not freeze

• Keep out of reach of children

Availability in the US and Australia

• Susten Gel is commonly available in India and select Asian markets.

• In the US, similar products include:

  • Crinone vaginal gel

  • Endometrin vaginal inserts

• In Australia, progesterone gels may be available through prescription or compounding pharmacies.

Frequently Asked Questions (FAQs)

Q1: Can Susten Gel help prevent miscarriage?

A: Yes, it supports the uterine lining during early pregnancy and is used in women with recurrent miscarriages due to progesterone deficiency.

Q2: How long can I use Susten Gel during pregnancy?

A: Typically used up to 10–12 weeks of gestation, or as prescribe by your fertility specialist.

Q3: Is vaginal progesterone better than oral?

A: Vaginal delivery provides localize uterine effect with fewer systemic side effects compared to oral progesterone.

Q4: Can I have intercourse while using Susten Gel?

A: Yes, but it’s best to avoid immediately after application to ensure proper absorption.

Q5: Can it cause spotting?

A: Mild spotting may occur and can be a side effect. Consult your doctor if bleeding is heavy or persistent.