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Survey Questionnaire- Natural progesterone in Secondary Amenorrhea and Immunomodulation

Doctor's details
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  1. In your clinical practice, how often do you encounter patients with secondary amenorrhea each month? *

  2. What is the most common underlying cause of secondary amenorrhea you observe in your patients? (Select all that apply) *

  3. What age group do your patients most commonly present with secondary amenorrhea? *

  4. How do you typically diagnose secondary amenorrhea? (Select all that apply) *

  5. In your practice, which of the following do you prefer for the treatment for secondary amenorrhea? *

  6. What is your preferred formulation of natural progesterone for treating secondary amenorrhea? *

  7. Do you use Oral NMP SR in your clinical practice? If Yes, what dosage regimen of oral NMP-SR do you prefer in your practice? *

  8. What percentage of patients present with first trimester spotting/ bleeding and pain abdomen in your clinical practice? *

  9. How often do you use exogenous natural progesterone for the prevention of pregnancy complications such as recurrent pregnancy loss or preterm birth? *

  10. Do you believe that the use of exogenous natural progesterone helps to regulate inflammatory markers during pregnancy? *

  11. Which dosage regimen and route of administration of natural micronized progesterone (NMP) is preferred in your clinical practice for immunomodulation in recurrent pregnancy loss? *
  12. In your clinical practice, do you believe there is an association between elevated pro- inflammatory cytokines and recurrent pregnancy loss? *

  13. In your experience, which of the following cytokines do you believe play a significant role in the pathophysiology of recurrent pregnancy loss? *

  14. Which cytokine or inflammatory marker do you believe is most predictive of pregnancy loss in women with recurrent pregnancy loss? *

  15. In your practice, which will be your preferred progestogen of choice for immunomodulatory properties in Threatened Abortion? *

  16. Are there any biomarkers or clinical signs that you monitor when prescribing exogenous natural progesterone to evaluate its immunomodulatory effects? If Yes, Please specify *

  17. In your practice, do you use different dose and route of NMP for acute and maintenance phase of Threatened abortion (TA)? If yes, please specify doses
    18. Dose & Route for Acute Phase of TA
    Dose & Route for Maintenance Phase of TA
  18. In your opinion what is the role of Progesterone inducing blocking factor (PIBF) in pregnancy maintenance and successful pregnancy outcome? *
  19. In your opinion, which is the most crucial role of NMP impacting pregnancy maintenance. *

  20. Is there any other immunomodulatory role of natural progesterone crucial to prevent spontaneous pregnancy loss? *
  21. Please rate immunomodulatory property of different progestogens (1: Least immunomodulatory effect, 5: Most immunomodulatory effect) *
    22. NMP
    Dydrogesterone
    17-Hydroxyprogesterone Caproate
  22. In your opinion, is IL-6 pro-inflammatory (unfavorable) or anti-inflammatory (favorable) for successful pregnancy outcomes? *

  23. How confident are you in the current evidence supporting the immunomodulatory effects of natural progesterone? *

  24. How important do you believe exogenous natural progesterone’s immunomodulatory property in its overall therapeutic effect? *

  25. Do you believe there is adequate clinical research evidences on progesterone’s immunomodulatory properties? *

  26. In your opinion, how well established is the role of natural progesterone in the modulation of the immune system? *

  27. Would you like to see more clinical trials specifically focusing on immunomodulatory effects of natural progesterone? *

  28. In your clinical practice, what has been the most difficult aspect or challenges with use of various formulations of Natural Progesterone. *
  29. Do you have any additional comments on the role of progesterone its immunomodulatory effects? *
  30. Are there any additional formulations dosage of natural progesterone you would like to see introduced? *
  31. How would you rate the level of awareness about secondary amenorrhea among your patients? *

  32. What is the most common misconception patients have about secondary amenorrhea? *
  33. What barriers do you face in educating patients about the role of natural progesterone in reproductive health? *
  34. Which factor do you think is the most important for improving natural progesterone formulations? *

  35. What improvements would you suggest in the currently available natural progesterone formulations? *
  36. Have you encountered patient non-compliance due to formulation-related issues? *

  37. How do you perceive the positioning of natural progesterone compared to synthetic progestins in the market? *

  38. What marketing or educational strategies could increase the adoption of natural progesterone in clinical practice? *
  39. What is the most influential factor in your decision to prescribe natural progesterone? *

  40. How do you think patients perceive the affordability of natural progesterone? *

  41. In which patient demographic do you see the highest need for natural progesterone therapy? *
  42. Have you noticed any geographical or socio-economic trends in the prescription of natural progesterone? *
  43. What is the most common reason for discontinuation of natural progesterone therapy among your patients? *

  44. What strategies do you use to improve patient adherence to progesterone therapy? *
  45. What other medications do you commonly prescribe alongside natural progesterone for managing secondary amenorrhea? *

  46. Do you recommend any lifestyle or dietary modifications when prescribing natural progesterone? *

  47. Have you faced any challenges regarding insurance coverage or affordability of natural progesterone for your patients? *
  48. What pricing strategy do you believe would enhance access to natural progesterone for more patients? *