Duphaston

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What Is Duphaston?

Duphaston is a branded generic of dydrogesterone, a stereoisomer of natural progesterone. Its molecular structure gives it highly selective progesterone receptor activity — without the androgenic, estrogenic, anti-mineralocorticoid, or glucocorticoid effects of other progestins. It is orally bioavailable (unlike micronized progesterone, which requires a special formulation) and has a 16–18 hour half-life. Manufactured by Abbott.

Clinical Uses

• HRT progestin opposition: 10 mg daily (continuous-combined) or 10 mg for 14 days/cycle (sequential).
• Threatened miscarriage: 40 mg loading then 10 mg twice daily until bleeding stops (PRISM trial subgroups).
• Recurrent miscarriage: 10 mg twice daily from ovulation through week 12–20 (LOTUS I and II trials show improved pregnancy rates in IVF).
• Secondary amenorrhoea: 10 mg twice daily for 10 days with estradiol.
• Dysfunctional uterine bleeding: 10 mg twice daily for 5–7 days to stop bleeding, cyclic thereafter.
• Endometriosis: 10 mg 2–3 times daily from day 5 to day 25 of cycle.
• IVF luteal phase support: 10 mg three times daily starting at embryo transfer.
• PMS / PMDD: 10 mg twice daily from day 12 to day 26 of cycle.

How to Take

1. Swallow tablet whole with water, with or without food.
2. Dose and timing depend on indication — follow the prescribing clinician’s schedule carefully.
3. For HRT, dydrogesterone is the oral progestin of choice for women who dislike the sedation of micronized progesterone.
4. For pregnancy support, continue until week 12–20 per fertility specialist; do not stop abruptly during active use.

Dydrogesterone vs Other Progestins

Side Effects

Common: headache, migraine, nausea, breast tenderness, breakthrough bleeding, spotting.

Less common: depression, allergic skin reaction, weight change.

Rare: cholestasis, jaundice, VTE (much less than estrogens or combined OCPs).

Who Should Not Take Duphaston

• Known or suspected pregnancy (unless used as pregnancy support under clinical guidance)
• Undiagnosed vaginal bleeding
• History of breast cancer
• Active liver disease
• Active thromboembolic disorder
• Known hypersensitivity

Storage

Store at room temperature (below 30 °C). Keep in original blister. Keep out of reach of children.

Συχνές Ερωτήσεις

How does dydrogesterone differ from natural progesterone?

Dydrogesterone is a stereoisomer — the molecules have the same atoms but a flipped 3D shape. The flip gives selective progesterone-receptor binding (no androgenic/estrogenic/mineralocorticoid effects) and eliminates the sedative property of natural progesterone.

Is duphaston safe in pregnancy?

Widely used for threatened miscarriage and IVF support. The LOTUS and PRISM trials support its safety and efficacy in these indications. Generally considered safe in pregnancy under clinician guidance.

Can I use duphaston for PMS?

Yes — cyclic dydrogesterone (day 12–26) is traditionally used for luteal phase support in PMS. Modern evidence favours SSRIs for severe PMS/PMDD, but dydrogesterone remains an option particularly when SSRIs are not tolerated.

Will duphaston make me gain weight?

Small weight fluctuations reported; generally considered weight-neutral in trials.

Is dydrogesterone safer than medroxyprogesterone?

Observational data (E3N cohort) suggest dydrogesterone and micronized progesterone have a more favourable breast-cancer profile than synthetic progestins like medroxyprogesterone when used for HRT.

Can I take duphaston while breastfeeding?

Small amounts pass into breast milk. Generally considered compatible with breastfeeding for short courses; discuss with clinician.

What if I miss a dose?

Take as soon as you remember unless nearly time for the next dose. Do not double-dose.

Can I use duphaston for endometriosis?

Yes — 10 mg 2–3 times daily cyclically (day 5–25). Modern alternatives (combined OCPs, Mirena IUD, GnRH agonists) are often preferred, but dydrogesterone remains useful in specific cases.

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