Sexual Absorption of Vaginal Progesterone

NCT ID: NCT01959464

Last Updated: 2022-04-22

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-11-30

Study Completion Date

2010-09-30

Brief Summary

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The purpose of this study is to determine if sexual intercourse lowers serum progesterone in women using vaginal progesterone gel (Crinone®), and increases serum progesterone in their male sexual partners. We hypothesize, based on previous estrogen studies done by our group, that intercourse will interfere with absorption of vaginal progesterone.

Detailed Description

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The effects of intercourse on the absorption of vaginal progesterone for the female user and her sexual partner have not been studied. However, a previous study performed by our group found that intercourse lowered the absorption of vaginal estrogen cream in women, and men absorbed a small but statistically significant amount of estradiol during intercourse. Vaginal progesterone gel may be used by women for several clinical indications, and if intercourse alters the absorption and distribution of vaginal progesterone, clinical outcomes may be compromised. If intercourse lowers absorption, the efficacy of the treatment could be reduced. If intercourse enhances absorption, side effects may be increased. Also, if the male sexual partner absorbs vaginal progesterone, undesirable side effects may occur.

Conditions

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Infertility Pregnancy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Initial assignment randomized, then crossed over to the other treatment
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Crinone vaginal progesterone gel

Crinone is a bioadhesive vaginal gel containing micronized progesterone in an emulsion system containing a water swellable but insoluble polymer, polycarbophil. Crinone 8% is formulated to provide a long-acting vaginal retention, and is prescribed daily. Each applicator delivers 1.125 grams of Crinone gel containing 90 mg of progesterone. The reported time to maximum progesterone concentration is 6.8 +/- 3.3 hours with use of a single dose of Crinone 8%. Absorption half-life is approximately 25-50 hours and an elimination half-life of 5-20 minutes.

On the evening of day 3, the female will insert the applicator into the vagina, administer the gel, and have intercourse within 1 hour of insertion of the cream.

Group Type EXPERIMENTAL

Crinone vaginal progesterone gel

Intervention Type DRUG

Crinone vaginal progesterone gel is inserted in the female vaginal using the pre-filled applicator.

Placebo vaginal gel

The couple will be given a prefilled applicator containing either Crinone gel (progesterone) or placebo vaginal gel, data collection sheets and laboratory requisitions. On the evening of day 3, the female will insert the applicator into the vagina, administer the gel, and have intercourse within 1 hour of insertion of the cream.

Group Type PLACEBO_COMPARATOR

Placebo vaginal gel

Intervention Type DRUG

Placebo vaginal gel is inserted in the female vagina using the pre-filled applicator.

Interventions

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Crinone vaginal progesterone gel

Crinone vaginal progesterone gel is inserted in the female vaginal using the pre-filled applicator.

Intervention Type DRUG

Placebo vaginal gel

Placebo vaginal gel is inserted in the female vagina using the pre-filled applicator.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Sexually active 18-40 year old heterosexual couple
* Subject willing to take Mircette birth control pills for at least one cycle (one pack)
* Willing to have intercourse at the defined times (at least weekly within a 3 week interval, and draw blood within 10 hours of intercourse)
* IRB signed informed consent

Exclusion Criteria

* Undiagnosed vaginal bleeding
* Contraindication to oral contraceptives
* Liver dysfunction or disease
* Known sensitivity to Crinone
* Known or suspected malignancy of the breast or genital organs
* History of or active thrombophlebitis or thromboembolic disorders
* Use of condoms during intercourse
* Male erectile or ejaculatory dysfunction
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Carolinas Medical Center

OTHER

Sponsor Role collaborator

Wake Forest University Health Sciences

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Bradley S Hurst, MD

Role: PRINCIPAL_INVESTIGATOR

Carolinas Medical Center

Locations

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Carolinas Medical Center

Charlotte, North Carolina, United States

Site Status

Countries

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United States

References

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Daya S, Gunby J. Luteal phase support in assisted reproduction cycles. Cochrane Database Syst Rev. 2004;(3):CD004830. doi: 10.1002/14651858.CD004830.

Reference Type BACKGROUND
PMID: 15266541 (View on PubMed)

Yanushpolsky E, Hurwitz S, Greenberg L, Racowsky C, Hornstein M. Crinone vaginal gel is equally effective and better tolerated than intramuscular progesterone for luteal phase support in in vitro fertilization-embryo transfer cycles: a prospective randomized study. Fertil Steril. 2010 Dec;94(7):2596-9. doi: 10.1016/j.fertnstert.2010.02.033. Epub 2010 Mar 27.

Reference Type BACKGROUND
PMID: 20347079 (View on PubMed)

Polyzos NP, Messini CI, Papanikolaou EG, Mauri D, Tzioras S, Badawy A, Messinis IE. Vaginal progesterone gel for luteal phase support in IVF/ICSI cycles: a meta-analysis. Fertil Steril. 2010 Nov;94(6):2083-7. doi: 10.1016/j.fertnstert.2009.12.058. Epub 2010 Feb 19.

Reference Type BACKGROUND
PMID: 20171629 (View on PubMed)

Miles RA, Paulson RJ, Lobo RA, Press MF, Dahmoush L, Sauer MV. Pharmacokinetics and endometrial tissue levels of progesterone after administration by intramuscular and vaginal routes: a comparative study. Fertil Steril. 1994 Sep;62(3):485-90. doi: 10.1016/s0015-0282(16)56935-0.

Reference Type BACKGROUND
PMID: 8062942 (View on PubMed)

De Ziegler D, Bulletti C, De Monstier B, Jaaskelainen AS. The first uterine pass effect. Ann N Y Acad Sci. 1997 Sep 26;828:291-9. doi: 10.1111/j.1749-6632.1997.tb48550.x.

Reference Type BACKGROUND
PMID: 9329850 (View on PubMed)

Fonseca EB, Celik E, Parra M, Singh M, Nicolaides KH; Fetal Medicine Foundation Second Trimester Screening Group. Progesterone and the risk of preterm birth among women with a short cervix. N Engl J Med. 2007 Aug 2;357(5):462-9. doi: 10.1056/NEJMoa067815.

Reference Type BACKGROUND
PMID: 17671254 (View on PubMed)

Cooper AJ. Progestogens in the treatment of male sex offenders: a review. Can J Psychiatry. 1986 Feb;31(1):73-9. doi: 10.1177/070674378603100116.

Reference Type BACKGROUND
PMID: 2936441 (View on PubMed)

Cooper AJ, Sandhu S, Losztyn S, Cernovsky Z. A double-blind placebo controlled trial of medroxyprogesterone acetate and cyproterone acetate with seven pedophiles. Can J Psychiatry. 1992 Dec;37(10):687-93. doi: 10.1177/070674379203701003.

Reference Type BACKGROUND
PMID: 1473073 (View on PubMed)

Money J. Treatment guidelines: antiandrogen and counseling of paraphilic sex offenders. J Sex Marital Ther. 1987 Fall;13(3):219-23. doi: 10.1080/00926238708403894.

Reference Type BACKGROUND
PMID: 2959790 (View on PubMed)

Hurst BS, Jones AI, Elliot M, Marshburn PB, Matthews ML. Absorption of vaginal estrogen cream during sexual intercourse: a prospective, randomized, controlled trial. J Reprod Med. 2008 Jan;53(1):29-32.

Reference Type BACKGROUND
PMID: 18251358 (View on PubMed)

Practice Committee of the American Society for Reproductive Medicine. Progesterone supplementation during the luteal phase and in early pregnancy in the treatment of infertility: an educational bulletin. Fertil Steril. 2008 Apr;89(4):789-92. doi: 10.1016/j.fertnstert.2008.02.012.

Reference Type BACKGROUND
PMID: 18406835 (View on PubMed)

Practice Committee of the American Society for Reproductive Medicine. The clinical relevance of luteal phase deficiency: a committee opinion. Fertil Steril. 2012 Nov;98(5):1112-7. doi: 10.1016/j.fertnstert.2012.06.050. Epub 2012 Jul 20.

Reference Type BACKGROUND
PMID: 22819186 (View on PubMed)

Watson Pharmaceuticals, Inc. Prescribing Information for Crinone. Available at: http://www.crinoneusa.com/professionals/Prescribing_Information.pdf. Retrieved April 22, 2011.

Reference Type BACKGROUND

Merriam KS, Leake KA, Elliot M, Matthews ML, Usadi RS, Hurst BS. Sexual absorption of vaginal progesterone: a randomized control trial. Int J Endocrinol. 2015;2015:685281. doi: 10.1155/2015/685281. Epub 2015 Feb 3.

Reference Type DERIVED
PMID: 25713585 (View on PubMed)

Other Identifiers

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SAVP2013

Identifier Type: -

Identifier Source: org_study_id

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