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孕激素 C

Hydroxyprogesterone Caproate (OHPC)

Hydroxyprogesterone Caproate (OHPC)

Intramuscular Injection (IM)

Hydroxyprogesterone Caproate is a long-acting, injectable progestin. While it boasts a lengthy half-life, it is exceedingly rare in modern transgender HRT protocols. There is virtually zero clinical research regarding its safety or efficacy in transgender women. If you desire a progestogen, oral bioidentical micronized progesterone is infinitely preferred.

Extremely Limited Evidence

The use of OHPC in feminizing HRT lacks any high-quality clinical support. The data extrapolated below is entirely derived from OB/GYN literature concerning cisgender women experiencing recurrent miscarriages ^[1] . It holds an Evidence Level of C (Expert Opinion/Case Studies only).

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Pharmacology

Hydroxyprogesterone Caproate (OHPC) is a synthetic derivative of 17α-hydroxyprogesterone, categorizing it as a semi-synthetic progestin ^[1] .

Core characteristics:

• Administration: Mandatory Intramuscular (IM) injection. It cannot be taken orally.
• Half-Life: Once injected deep into the muscle, it creates a depot effect lasting roughly 7 to 8 days.
• Mechanism: It binds to the body’s progesterone receptors (PR), mimicking standard progestogenic activity.
• Metabolism: Broken down heavily by the liver and excreted through the kidneys.
• Global Branding: Previously famous as Makena (withdrawn from the US market in 2023) and Proluton (still accessible in gray markets and parts of Asia/EU).

The Difference from Bioidentical Progesterone

Tratis	Micronized Progesterone	Hydroxyprogesterone (OHPC)
Chemical Origin	Bioidentical to human P4	Semi-synthetic derivative
Delivery Route	Oral Softgel	Intramuscular Injection
Frequency	Daily	Every 1 to 2 Weeks
Sedative Effect	Yes (Heavy GABA-A interaction)	None
GAHT Data	Limited, but utilized broadly	Non-existent
Tolerability	High	High rate of injection site pain

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The Reality of OHPC in GAHT

OHPC is a ghost in mainstream transgender medicine. The Endocrine Society 2017 Guidelines ^[2] and WPATH SOC 8 ^[3] completely ignore OHPC regarding gender-affirming care regimens.

Why would anyone use it?

• A user suffers from extreme gastrointestinal intolerability to oral micronized progesterone.
• A user fiercely desires a weekly injection rather than swallowing daily pills.
• Deep gray market availability where bioidentical progesterone is geoblocked.

Theoretical Benefits

If utilized, OHPC functionally acts as a standard progestogen:

• It theoretically could assist in lobuloalveolar breast maturation (Tanner IV-V), though there is not a single clinical trial proving this in trans women.
• It indirectly assists in suppressing the HPG axis (lowering LH/FSH), gently aiding testosterone suppression.
• It does not possess the anti-anxiety or sedative (sleep aid) properties that make oral progesterone massively popular.

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Dosing Framework

Doses are Pure Conjecture

There are no established clinical doses for OHPC in transgender HRT. The following metrics are sourced entirely from historical OB/GYN data and the anecdotal logs of rogue DIY users ^[1] .

Protocol	Dosage	Administration	Notes
Standard OB/GYN Dose	250 mg / week	Intramuscular	Designed for cis women preventing miscarriage.
DIY Experimental Dose	125-250 mg / every 1-2 weeks	Intramuscular	Sourced from community self-reporting.

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Side Effects

• Severe Injection Site Reactions: OHPC is notoriously suspended in thick, painful carrier oils (like castor oil). Bruising, hard long-lasting lumps (indurations), and deep muscle aching are nearly guaranteed.
• Nausea and Vertigo
• Emotional Volatility: Like all progestogens, it can trigger severe, unprompted depressive episodes or PMS-like emotional crashes.
• Anaphylaxis: Allergic reactions to the thick carrier oils are reported.

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Global Access

• In the US: Functionally dead. The FDA ripped Makena (the premier OHPC brand) from the market in 2023 after investigations proved it did not actually help prevent preterm births.
• The Grey Market: Brands like Proluton are still heavily trafficked by global DIY pharmacies operating out of regions with lax pharmaceutical export laws, making it accessible but difficult to verify for purity.

Stick to Oral Progesterone

For 99% of transgender women, bioidentical oral progesterone (Prometrium / Utrogestan) is cheaper, safer, heavily documented, and painless. Unless you have a staggering medical reason to avoid oral pills, OHPC is an unnecessary complication to your HRT regimen.

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References

1. Kuhl H. Pharmacology of estrogens and progestogens: influence of different routes of administration. Climacteric 2005;8(Suppl 1):3-63. DOI:10.1080/13697130500148875
2. Hembree WC et al. Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons. J Clin Endocrinol Metab 2017;102(11):3869-3903. DOI:10.1210/jc.2017-01658
3. Coleman E et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J Transgend Health 2022;23(S1):S1-S259. DOI:10.1080/26895269.2022.2100644

品牌图鉴

🇩🇪德国

Proluton Depot

厂商

拜耳 (Bayer)

规格

250mg/mL × 1mL 安瓿

外观

油状溶液，玻璃安瓿

注射用己酸羟孕酮，每周一次

🇮🇳印度

Proluton Depot

厂商

Zydus (拜耳印度授权)

规格

250mg/mL / 500mg/mL

外观

油状溶液

印度产注射用己酸羟孕酮

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