Susten Gel

Susten gel is a vaginal gel which contains progesterone.

The hormones are secretions conveyed by a ductless system of transport i.e. via blood to the target areas all over the body. The most fundamental functions of the body are regulated by way of hormones.

The hormones secreted by the ovaries for the progression of growth and differentiation of the female sex and accessory sexual characteristics. Apart from that they also maintain the normal female monthly cycle essential for fertility and reproduction. These in addition play a pivotal role in the maintenance of pregnancy as well as in parturition.

The two most important female hormones are estrogen and progesterone. Progesterone is the chief hormone belonging to the class of hormones that has several names i.e. progestins, progestagens, gestagens etc. all substances which maintain pregnancy. Progesterone is secreted throughout the ovarian or menstrual cycle.

Progesterone has a variety of functions:

• Effect on Breast development: After being primed up by estrogen, progesterone acts to stimulate the formation of the alveolobular structure and the overall ductal system of the mammary gland. During pregnancy, this effect becomes even greater.
• Effect on Uterus: Progesterone acts on uterus and promotes the proliferation of the secretory epithelium, necessary to sustain nutrition to the developing fetus which will implant itself to the uterine walls. The myometrium shows transient hypertrophy and decreases the oxytocin receptors to help maintain the pregnancy.
• Effect on vagina: The cells lining the vagina become rounded and filled with mucus.
• Effect on mating behavior: Progesterone greatly augments the action of estrogen on female mating behavior.
• Effect on metabolism: Progesterone increases the mobilization and catabolism of the maternal tissue during pregnancy.
• Effect on Respiration: It stimulates breathing.

The lack of progesterone production by the ovaries in the 2nd half of the pregnancy is called Luteal phase defect. Women suffering from this disorder have difficulty in getting pregnant and are more prone to having miscarriages.

The gel is applied using an applicator containing a prescribed amount of gel. This may be done once or twice every day till pregnancy is achieved. If pregnancy occurs the treatment may be continued or discontinued as advised by the physician. The precautions to be remembered are:

• Anyone allergic to progesterone must not use it.
• Women with history of abnormal vaginal bleeding must not use it.
• Females suffering from epilepsy or migraine should avoid it.
• Females with asthma should also avoid it.
• Women with renal or kidney disease must avoid the drug usage.

The adverse effects that may be seen in progesterone therapy are change in the pattern of weight and appetite, edema, acne, skin rash, headache, fever, breast changes, hirsutism altered menstrual cycles or irregular bleeding.