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Duphaston (dydrogesterone) is a synthetic version of the naturally-occurring hormone progesterone. The overwhelming majority of its use is by women, but it does occasionally see use in men.

Progesterone plays an important role in menstruation and pregnancy. In simple terms, levels of progesterone increase each month, which prepares the womb for an implanted egg. If pregnancy does not occur, levels of progesterone drop and menstruation occurs. If pregnancy does occur, levels stay relatively high until near birth.

Medications like Duphaston artificially replace progesterone, providing the same benefit when natural progesterone levels are low, due to age, injury, medications, or anything else.

Note that women who have had their uterus removed do not need Duphaston or any other progesterone replacement; it will not provide benefit.

Duphaston Uses

Duphaston has a range of uses, from enabling estrogen use in post-menopausal hormone replacement therapy (HRT) to promoting regular menstruation to promoting fertility.

In HRT:

• Estrogen supplementation is what alleviates menopause symptoms. However, women with a uterus need to also supplement progesterone to prevent uterine cancer.

In treating menstrual issues Duphaston is effective in a number of conditions:

• Irregular periods
• Amenorrhea (absent periods)
• Dysmenorrhea (painful periods)
• Abnormal uterine bleeding

And in promoting fertility or aiding with pregnancy:

• Duphaston helps prepare the womb for a fertilized egg.
• During pregnancy, Duphaston can help prevent miscarriage in those with low progesterone levels.

Treatment of the above can be quite variable depending on intent; dosage and duration of treatment will need to be individualized according to the condition being treated, hormone levels, age, weight, and numerous other personal variables.

Both men and women sometimes use Duphaston to inhibit powerful sexual urges, particularly when those urges deviate from social norms. The medication suppresses such urges, but will not cure them---they'll likely return when treatment ends.

Taking Duphaston

As mentioned above, Duphaston use will likely be customized to an individual's condition and other variables. That said, standard treatment guidelines are as follows:

• To treat irregular or heavy periods - 10 mg once per day on the 11th to 25th days of the menstrual cycle.
• To treat amenorrhea (absent periods) - 10 mg once per day on the 11th to 25th days of the menstrual cycle.
• To treat dysmenorrhea (painful periods) - 10 to 20 mg per day on the 5th to 25th days of the menstrual cycle.
• To help prepare the womb for a fertilized egg - a doctor will determine based on progesterone levels.
• To prevent miscarriage - 10 mg per day until the 20th week of pregnancy.
• To enable estrogen use in menopause - a doctor will determine based on the amount of estrogen being taken.

If doctor instructions deviate from the guidelines above, doctor instructions should always be followed.

Use of this product during pregnancy is somewhat controversial. Some studies show that too-high levels of progesterone can produce negative effects on unborn babies, particularly female babies, producing masculine attributes like facial hair. Other studies show there is no negative effect from using Duphaston (or similar medications) throughout pregnancy. We are not taking a side, simply presenting information. Ultimately it is a personal choice.

Precautions & Side Effects

Duphaston is well-studied and quite well tolerated, with the majority of patients experiencing no or very mild symptoms. Certain individuals are more likely to have serious adverse reactions, however, and Duphaston use should be avoided in those who have:

• Blood clots or history of blood clots
• Vaginal bleeding of unknown cause
• Progesterone-dependent cancer
• Depression or other mental disorders
• Kidney or liver impairment
• Porphyria

Likewise the medication should not be used with certain other medications. Of greatest concern are:

• Epilepsy medications, such as carbamazepine or phenobarbital
• HIV medications, such as ritanavir or saquinavir
• Potent over-the-counter herbs, such as St. John's wort or ginkgo biloba

Most patients have only mild side effects, including:

• Headache
• Dizziness
• Tender, swollen breasts
• Nausea
• Mild fatigue

Duphaston can cause liver damage. Symptoms to be alert for include abdominal pain that radiates to the back, loss of appetite, and jaundice.