One of the most current problems is the problem of miscarriage. The causes of miscarriage are numerous and varied, but the most common cause is insufficient production of progesterone by the corpus luteum.

Duphaston: application

Currently in Russian Federation To treat the threat of termination and maintain pregnancy, medications such as micronized progesterone Utrozhestan and dydrogesterone - Duphaston, an analogue of natural progesterone of plant origin, are used.

The prescribed drug Duphaston during pregnancy is safe for both the fetus and the mother. The safety of Duphaston has been proven not only in clinical studies, but also in real medical practice, where it has been widely used for many years.

Duphaston

The role of progesterone during pregnancy

Progesterone - (lat. pro- For, gestation– pregnancy) a key steroid hormone necessary to prepare for pregnancy, both to maintain the menstrual cycle and to maintain the pregnancy itself. Relative or absolute deficiency of progesterone leads to disruption of reproductive function or the menstrual cycle. Progesterone deficiency can be corrected with the help of exogenous progestogens. Currently, they are used to treat various gynecological pathologies, for example, infertility, threatened miscarriage or recurrent miscarriage.

During pregnancy, progesterone protects the fetus, which is foreign to the mother's body, from immunological rejection, suppresses the contractile activity of the myometrium by reducing the sensitivity of the myometrium to stimulation by oxytocin, and also prepares the endometrium for implantation.

Duphaston: indications for use

Progesterone deficiency (progesterone deficiency) can lead to serious consequences:

• before pregnancy– infertility due to the fact that the endometrium of the uterus is not ready for the attachment of a fertilized egg, endometriosis, dysmenorrhea (pain during menstruation), irregular menstruation;
• during pregnancy– spontaneous termination of pregnancy – threatened abortion, habitual miscarriage (pregnancy loss 2-3 or more times), associated with established progesterone deficiency.

Luteal phase deficiency- one of the main causes of miscarriage and menstrual irregularities. Insufficiency of the luteal phase is caused not so much by hormone deficiency as by a decrease in the sensitivity of the endometrial receptor apparatus to the effects of progesterone. A decrease in sensitivity may be associated with damage to the endometrium and mechanical removal of endometrial cells (and, therefore, along with progesterone receptor cells) during any intrauterine interventions (diagnostic curettage, abortion, frozen pregnancy), infections, etc.

How to take Duphaston during pregnancy

Duphaston is available in tablet form. The tablets are used orally. The dosage regimen is selected individually depending on the nature and severity of the disease.

Infertility due to luteal phase deficiency: 10 mg per day from the 14th to the 25th day of the cycle. Treatment should be carried out continuously for at least six consecutive cycles. In the first months of pregnancy, it is recommended to continue treatment according to the regimen described for recurrent miscarriage (10 mg 2 times a day).

Threatened abortion: 40 mg once, then 10 mg every 8 hours until symptoms disappear.

Habitual miscarriage: 10 mg 2 times a day until the 20th week of pregnancy, with a gradual reduction in dose.

During pregnancy, Duphaston is taken only as prescribed by the attending physician. The dosage and duration of the drug is determined strictly individually in each specific case.

Until what time should Duphaston be taken during pregnancy?

In order to prevent miscarriage due to a lack of endogenous progesterone, doctors recommend taking Duphaston until the 16-20th week of pregnancy with gradual withdrawal of the drug. The duration of use of the drug is determined by the doctor and depends on the severity of the woman’s pathology and on the level of the hormone progesterone, which must be regularly monitored. After the sixteenth to twentieth pregnancy, the placenta synthesizes sufficient levels of progesterone to maintain pregnancy.

Reducing the dose of Duphaston. It is necessary to start discontinuing Duphaston during pregnancy gradually, slightly reducing the dosage of the drug. The number of tablets is reduced by ½-1 every five to seven days.

An approximate scheme for withdrawing Duphaston: if you took 1 tablet. 2 times a day, then with gradual withdrawal:

• 1/2 t. 3 times a day - 5 days;
• 1/2 t. 2 times a day - 5 days;
• 1/2 t. 1 time per day for 5 days.

The duration of drug withdrawal and dose should be adjusted by the doctor taking into account the condition of the pregnant woman.

Contraindications

• Individual intolerance to dydrogesterone and other components that make up Duphaston (lactose, hypromellose, corn starch, colloidal silicon dioxide, magnesium stearate).
• Bleeding from the vagina of unknown origin.
• Liver dysfunction caused by acute or chronic diseases.
• Galactose intolerance, lactase deficiency.
• Age up to 18 years, due to the lack of data on effectiveness and safety in adolescent girls under 18 years of age.

Carefully Duphaston should be used for conditions that previously appeared or worsened during a previous pregnancy or previous use of hormones: herpes during pregnancy, severe skin itching.

Side effect

Most common: headache, nausea, breast tenderness/sensitivity.

May cause mild drowsiness and/or dizziness, especially in the first hours of use, so caution should be exercised when driving, but is generally well tolerated by women.

Safety of the drug Duphaston during pregnancy

Duphaston does NOT have androgenic or estrogenic properties. Unlike a number of other gestagens, it does not cause masculinization of the genital organs of a female fetus and feminization of the genital organs of a male fetus. That is, the fear that when using Duphaston, a female fetus will develop primary and secondary sexual characteristics of a male and vice versa, is groundless.

Duphaston extremely rarely leads to weight gain, does not lead to seborrhea, deepening of the voice, the appearance of pimples (acne) and hirsutism (excessive hair growth on the body and face) in women, and does not significantly affect blood clotting.

The birth of a child and even conception itself do not always depend only on nature. In more than 50% of cases, she needs help. One way to do this is Duphaston during pregnancy. The drug is often prescribed at the planning stage. And when pregnancy occurs, it helps eliminate many of the risks associated with it.

Read in this article

What is Duphaston and why take it before conception?

This drug is an artificially created hormone progesterone, called dydrogesterone. In the female body, a similar substance is produced mainly in the second phase of the menstrual cycle. At this stage, progesterone is needed to prepare the cavity to receive a fertilized egg. The ovaries and adrenal glands are responsible for its production, but not all women perform their functions efficiently. Therefore, difficulties arise with the regularity of the menstrual cycle, and therefore with conception. In such cases, Duphaston is indispensable when planning pregnancy. Especially when age does not allow you to wait for the natural balance of hormones.

In addition to infertility, which is caused by progesterone deficiency, the drug is prescribed for endometriosis. This is another reason for infertility, because the lining of the uterus during the disease is not developed enough to receive an egg. Over the 6 months during which Duphaston is prescribed to stimulate conception, it is possible to restore the required amount of progesterone and the endometrium. The drug is taken from the beginning of the luteal phase of the cycle, 10 mg 2 times a day. But depending on the specific situation, the dosage may be increased.

Taking duphaston during pregnancy

The long-awaited two lines on the test do not mean complete achievement of the goal. This is rather an intermediate stage where there is still a lot of work to be done. During pregnancy, as well as during conception, you cannot always rely only on your own body. Lack of progesterone observed before conception can create many obstacles on the way to your goal and beyond.

The question of whether to drink Duphaston during pregnancy should be decided by a specialist. There may be several reasons for this.

Threat of interruption: can Duphaston remove it?

The fertilized egg is firmly attached to the uterus. But only subject to the required amount of progesterone. After fertilization, the body normally begins to intensively produce it for:

• Decreased contractility of the uterus. If her smooth muscles are too active, she will try to push the embryo out. Duphaston on early stages pregnancy prevents this.
• Formation of the mucous membrane of the organ. It must have a certain number of vessels for the formation of fetal tissue and placenta, which protect and nourish the embryo. If there is insufficient blood supply to these organs, there is a danger of oxygen starvation of the fetus, which prevents its normal development.

If there is a deficiency of natural progesterone, you can drink Duphaston during pregnancy and it is even necessary to do this in order to eliminate factors dangerous to the fetus and provide it with opportunities for development.

With chronic endometritis, when the uterine mucosa is inflamed, the likelihood of abortion increases due to the fact that the body perceives the fetus as something foreign that needs to be gotten rid of. In this case, Duphaston blocks this reaction during early pregnancy immune system mother, keeping it intact.

Pregnancy due to gynecological diseases and Duphaston

One of the most common gynecological diseases significantly complicates the course of pregnancy and is also dangerous with the possibility of miscarriage.

A benign tumor is characterized by frequent bleeding, which is very undesirable in this condition. During early pregnancy, Duphaston in a dosage carefully selected by a specialist can reduce the size of fibroids, as well as its effect on the body. It prevents bleeding, eliminating the fetal failure characteristic of this disease.

If there is an established increased risk of fetal failure, combined with a small amount of progesterone, the drug can reduce it by improving blood supply to tissues. And although the reasons for a non-developing pregnancy are not precisely determined, it is obvious that creating optimal conditions for the embryo will reduce its likelihood.

The opportunity to maintain a pregnancy with Duphaston should also be used by those who in the past have had the sad experience of miscarriage or premature birth, as well as the birth of children with developmental defects caused by progesterone deficiency.

How pregnancy manifests itself when using Duphaston

Pregnancy on Duphaston may show symptoms more actively before the delay than without taking the drug. Many women note that:

• increases to the point that the feeling of hunger becomes almost constant;
• there is a feeling of an enlarged abdomen, although there are no external manifestations of this;
• Pain in the chest occurs, and the feeling of fullness in the mammary glands also intensifies.

And although while taking Duphaston they are often pronounced, it is worth doing or conducting an analysis for hCG to be completely sure. The fact is that the drug can cause an adverse reaction in the body, which is similar to the symptoms of the first trimester. And hCG is synthesized by the body regardless of additional hormone therapy.

In the future, women describe the signs of pregnancy against the background of Duphaston as follows:

• Delayed menstruation. Here, you still shouldn’t delude yourself, since it also happens with hormonal imbalance. And the anxiety associated with waiting is itself a stress factor that can delay menstruation;
• Breast augmentation. If previously only increased sensitivity and pain were observed, now the size of the mammary glands has changed;
• More, caused by swelling of the tissues of the uterus and appendages characteristic of pregnancy;
• Quick tiredness, feeling of lack of sleep in normal mode. Pregnancy on Duphaston shows signs of this kind due to a direct dependence on the increase in progesterone levels. This can be compared to the sensations of premenstrual syndrome;
• Lifting basal temperature. Problematic conception forces a woman to control it, so it is easy to see from the chart that the indicator has increased to 37 degrees. This is exactly the temperature that is necessary for the development of the fertilized egg at this stage;
• Nausea and aversion to smells. In the morning, a woman experiences vomiting and dizziness. It is possible that new food preferences will emerge when the nausea subsides.

When taking Duphaston, signs of pregnancy can be especially pronounced, due to the approaching balance of hormones to normal. But the appearance of bloody discharge and mild abdominal pain is possible. These symptoms are evidence of too low a dosage of the drug. It is necessary to consult a doctor and have it corrected or replaced with an analogue.

Signs of pregnancy after Duphaston may be smoother than without taking the drug. This is due to the alignment hormonal levels, which improves your well-being. Of all the available initial symptoms of pregnancy, toxicosis is the least likely to occur. Some women, when taking duphaston, feel a “wolfish” appetite and an unprecedented elation. All other signs will appear one way or another.

Features of taking Duphaston

Despite the fact that the drug replaces a natural substance, it cannot be used arbitrarily; there is a risk of further disrupting hormonal levels. Taking Duphaston in the early stages of pregnancy may not be limited to this time and last up to 20 weeks. But more often it ends at 4 months, since the further formed placenta is able to produce the hormone itself.

How to drink Duphaston during early pregnancy is determined by the gynecologist in a specific case. It depends on the

• Degree of progesterone deficiency;
• Circumstances preceding pregnancy (abortion, premature birth, miscarriages);
• Age;
• The body's reactions to the components of the drug.

Factors currently observed are also taken into account. The most significant of these is the threat of interruption. If it persists for a long time, Duphaston is taken in the same amount in the early stages of pregnancy, but the dosage can be up to 40 mg per day. This is 4 tablets for the same number of doses.

When maintaining pregnancy using the drug, it is necessary to regularly monitor hormone levels. It becomes known from analyzes. Based on the results, the specialist may change his opinion about how to drink Duphaston in the early stages of pregnancy. It is important to maintain a normal level of progesterone, and not accumulate it “in reserve,” so the dosage can be reduced.

How to safely stop taking the drug

Some try to do this as soon as they find two stripes on the test, considering the drug’s task completed. But abruptly interrupting the intake can negate all the efforts made so far. A sudden cessation of the hormone entering the body is a stress that can cause heavy bleeding and terminate the pregnancy.

How to stop Duphaston during pregnancy is decided by the doctor. In any case, this will be a gradual reduction in the dose so that the reproductive system adapts painlessly. If you take half a tablet less every day than the previous day, there will be no negative reaction.

But this cancellation scheme cannot be considered universal, since the individual characteristics of a particular woman can interfere with its implementation. Therefore, it is necessary to discontinue Duphaston at the end of early pregnancy under the supervision of a specialist, as well as to take it all this time.

Can Duphaston cause harm?

When they fear harm from using the drug, they primarily mean the side effects of Duphaston during pregnancy. You should not expect any other negative effects from its use. The drug is safe for the fetal endocrine system; it begins to form later. The use of the product by many women has revealed that it may be accompanied by:

• Migraine-type headaches;
• Allergic manifestations;
• Malfunction of the liver, manifested by abdominal pain, jaundice, general malaise;
• Decreased hemoglobin;
• Excessive breast sensitivity, especially in the nipple area;
• Itchy rashes on the skin.

There are also factors that do not allow you to take Duphaston; the instructions for pregnancy include the following:

• Severe liver damage and of cardio-vascular system;
• Insulin-dependent diabetes mellitus;
• Epilepsy.

What women who took it say about duphaston

Duphaston in the early stages of pregnancy receives favorable reviews from most women. Many have had a child, and more than one, only thanks to taking this drug, since problems with female hormones are common. Comparing Duphaston with a drug with a similar action, Utrozhestan, many argue that the first is more effective and has fewer side effects.

Most women who took the drug did so when there was a threat of miscarriage. Others got rid of placental insufficiency and oxygen starvation of the fetus.

Some are sure that the pimples and excess weight that appeared on the skin were caused by taking the product. But long-term observations demonstrate that this is sometimes characteristic of the “interesting situation” itself, and is not associated with the drug.

Duphaston during pregnancy in the early stages should not be considered a panacea for any complex cases. But according to statistics, the drug increases the chances of normal pregnancy by 2 times.

It is important to strictly control the intake and withdrawal of Duphaston, without neglecting other necessary conditions for a healthy pregnancy.

Before taking any medications, you should consult a specialist doctor. There are contraindications.

If a woman is planning to conceive, then the coveted two lines on the test make her the happiest. However, this is just the beginning long way, since at any moment various problems with bearing a baby may arise. If they are associated with a lack of progesterone, a very important pregnancy hormone, then doctors often prescribe the drug Duphaston. How effective is it? How to take the product correctly?

Duphaston as a medical product

The active drug of Duphaston is dydrogesterone (10 mg per tablet). This is a synthetic analogue of the natural hormone progesterone (their molecular structure is almost identical). It is synthesized by the female body in the second phase of the menstrual cycle, as well as throughout the entire period of pregnancy. When ingested, the chemical begins to actively act, exhibiting chemical and pharmacological properties similar to a natural hormone.
Dydrogesterone has a similar molecular structure to the natural hormone

Duphaston is available in tablet form. They are biconvex round shape with beveled edges, white and covered with a shell.
Duphaston is available only in tablet form

The drug contains auxiliary components:

• corn starch;
• lactose monohydrate;
• hypromellose;
• magnesium stearate;
• colloidal silicon dioxide.

The hormonal drug is taken orally and is quickly absorbed from the gastrointestinal tract. The highest concentration of the active substance in the blood is observed after two hours; it binds to blood proteins by 97%. The drug is excreted from the body primarily by the kidneys; this process takes approximately 72 hours.

Video: the importance of the hormone progesterone during pregnancy (explained by an obstetrician-gynecologist)

The feasibility of using Duphaston in the early and late stages of gestation

Progesterone is extremely important when carrying a child; it is not without reason that it is also called the “pregnancy hormone”. At the initial stage, it helps the embryo to securely attach itself, since it reduces the contractile movements of the uterus. In the future, due to its property of relaxing muscles, the hormone maintains pregnancy. It is also important for the formation of a full-fledged uterine mucosa: it must have enough vessels that nourish the unborn baby.

Progesterone also plays a role in awakening expectant mother maternal instinct. It is he who makes a woman (even a non-pregnant one) move at the sight of babies, programs her to take care of the child.

In the second half of the menstrual cycle, progesterone begins to produce the corpus luteum, which is formed after ovulation. Once a pregnancy has taken place, it continues its work until the placenta is formed. Further, the synthesis of progesterone already depends on it.
The corpus luteum begins to produce progesterone, which is necessary for the consolidation of the embryo and the further maintenance of pregnancy.

If a pregnant woman's body produces an insufficient amount progesterone, it becomes difficult for the fetus to develop normally.

The uterus, with its contractile movements, can simply push it out - in this case, a miscarriage will occur. If there is insufficient blood supply to the uterus, there is a risk of oxygen starvation of the baby (possibly partial detachment of the fertilized egg), which can lead to the fading of the pregnancy.

Hypertonicity of the uterus manifests itself in the form of nagging and aching pain below the navel, a feeling of tension in the groin (this condition is diagnosed using ultrasound). However, if a woman simply feels a tingling sensation on her sides, then this may be a natural stretching of the uterus, which is adapting to bearing a fetus. A clear symptom of an incipient miscarriage is bloody vaginal discharge (even a small amount may indicate a hormonal imbalance).

Basically, Duphaston is prescribed in the early stages to maintain pregnancy.

By the 16th week, the placenta is fully formed, which usually copes with the production of progesterone. However, in some cases Duphaston is taken for more later with an increase in the tone of the muscles of the uterus: this helps to avoid premature birth.
For longer periods of time, Duphaston can be prescribed for increased uterine tone

As for the potential negative effect of Duphaston on the fetus, the opinion of doctors is ambiguous. Some believe that the hormonal drug is completely safe in this regard. Other doctors are not so optimistic.

Many Western doctors are shocked by the amount of synthetic progesterone consumed by Russian pregnant women. In the 70s in the USA it was often prescribed to expectant mothers in the early stages. But subsequently, research evidence emerged that it causes minor developmental defects in the fetus, especially those affecting the genitals. And the Federal Drug Administration (FDA) introduced a ban on the use of artificial hormone in the first trimester (the corresponding contraindication appeared in the instructions for the drug; by the way, it is sold in the USA only by prescription).

European doctors also conducted their own research: as a result, in a number of countries, artificial progesterone was even banned from sale. Some domestic doctors, for example, gynecologist Elena Berezovskaya, also do not approve of “preserving” progesterone therapy.

In fact, there are not many women with insufficiency of the luteal (second) phase of the cycle, and in our country doctors often misdiagnose it. Even at the planning stage, they analyze the progesterone content traditionally on the 21st day of the cycle, while the maximum level of the hormone is observed 7 days after ovulation (and in different women it can happen in different days). Thus, Duphaston is mistakenly prescribed, the use of which continues even during pregnancy. In addition, the woman becomes psychologically dependent on the drug - she is sure that without the artificial hormone her pregnancy is doomed.

Indications for use for expectant mothers

The main indications for taking Duphaston during pregnancy (according to the instructions) are the following:

1. The risk of spontaneous abortion (threatening or habitual) against the background of established progesterone deficiency. In general, if a woman is planning a child and cannot get pregnant for some time (or has an early miscarriage), then a fertility specialist must check her hormonal status. If the problem is precisely the lack of progesterone, then Duphaston is prescribed in the second phase of the cycle. If pregnancy occurs, the drug continues to be taken until the period determined by doctors.
2. Pregnancy due to endometriosis.

However, in practice, the drug is also used in pregnant women with chronic endometritis and uterine fibroids. In the first case, the embryo most often fails to implant, but if this happens, the affected uterus begins to actively contract, trying to get rid of it. Artificial progesterone suppresses muscle activity, which increases the chances of a successful pregnancy. With uterine fibroids, Duphaston helps stop the growth of a benign tumor, prevents bleeding, which often occurs with this condition, thereby helping to maintain pregnancy.

In many cases, Duphaston is able to stop the growth of fibroids, which gives pregnancy the opportunity to develop

Duphaston is also traditionally used as maintenance therapy during IVF pregnancy. After embryo transfer, it helps the endometrium prepare for their implantation and reduces the likelihood of miscarriage.

Of course Duphaston is enough effective means: in many cases it is able to stop a miscarriage that has already begun. However, if termination of pregnancy occurs not due to progesterone deficiency, but for some other reason (for example, the embryo has pathologies incompatible with life, and the female body rejects it), then the hormonal drug will no longer help. Another important point: Duphaston should be taken only as prescribed by your doctor, but not just in case (on the advice of your mother or friend). Although the drug is not a prescription drug, it is freely available in Russian pharmacies.

Duphaston is prescribed only by a doctor if the problem has been identified.

Contraindications and side effects

Duphaston has virtually no contraindications. The following cases are exceptions:

• hypersensitivity to the components of the drug (the hormonal drug is prescribed with caution to expectant mothers who suffered from itching during a previous pregnancy);
• serious liver pathologies (Dubin-Johnson syndrome, Rotor syndrome).

Being a hormonal drug, Duphaston can cause unwanted side effects:

• changes in the gastrointestinal tract: nausea, diarrhea or constipation;
• slight disruption of the liver, which may manifest itself as weakness, abdominal pain;
• discomfort in the mammary glands;
• skin itching and rash, extremely rarely - Quincke's edema;
• headache, dizziness;
• hemolytic anemia (isolated cases).

Drug interactions

In principle, Duphaston is compatible with various drugs, but its effect is reduced with the simultaneous use of inducers of microsomal liver enzymes (Phenobarbital, Rifampicin) due to accelerated metabolism.

Interestingly, at the planning stage, Duphaston can be prescribed in combination with other drugs that directly affect hormones (for example, with Clostilbegit and Proginova when stimulating ovulation).

The combination of Duphaston with alcohol is strictly prohibited(naturally, a sane pregnant woman would not drink alcohol anyway, especially if she has any problems with pregnancy).

The nuances of using synthetic progesterone during pregnancy

To maintain pregnancy in the early stages, the specific dose of Duphaston is selected exclusively by the attending physician, based on the woman’s hormone analysis.

1. However, you can familiarize yourself with the general regimen for taking the drug, which is indicated in the instructions:
2. In case of habitual miscarriage, you should take one tablet twice a day until the 20th week, after which the dose is gradually reduced. In this case, it is advisable to take the hormone at regular intervals - every 12 hours: this will allow it to maintain the same level in the body.

In case of threatened spontaneous abortion, you need to take 40 mg once (4 tablets), and then one tablet every 8 hours until the dangerous symptoms disappear.

It is very important to correctly discontinue progesterone therapy. After all, if you do this abruptly, then vaginal bleeding and even a miscarriage may well occur. The doctor usually recommends starting to gradually reduce the dose from the 16th week - it is at this period that the situation, as a rule, stabilizes, and the threat of miscarriage (overt and hidden) disappears. In some difficult cases, the drug is taken in full dosage until the 20th week. Eco-pregnancy is supported by Duphaston until the 16th week (if there is a threat of miscarriage - until the 20th).

Standard tactics include gradually reducing the daily volume of the drug by ½ tablet every week: thus, the dose can be reduced to zero in three weeks (again, only the gynecologist prescribes a specific withdrawal regimen). If a pregnant woman’s daily dose is four tablets, then in a week she reduces the volume of the hormone by a whole tablet (cancellation also occurs in three weeks).

However, during the week after the first dose reduction, the condition of the expectant mother and baby is closely monitored: if the pregnancy develops normally, then the dose can be further reduced.

The standard withdrawal regimen is to reduce the daily dose by half a tablet every week

You can take Duphaston before or after meals - it does not matter.

Duphaston analogues allowed during pregnancy

Of course, Duphaston is not the cheapest drug, especially since a pregnant woman often has to take it for a long time (the approximate cost of a package is 500–600 rubles). Therefore, the question quite naturally arises about the existence of analogues of the drug.

Table: characteristics of some popular analogues of Duphaston

Name	Active substance	Release form	Contraindications	Significant differences
Natural micronized progesterone synthesized in humans and animals (100 or 200 mg)	Capsules	Severe liver dysfunction; vaginal bleeding of unknown origin; incomplete/failed abortion; cerebral hemorrhage; thromboembolic disorders; thrombophlebia; neoplasia of the genital organs/mammary glands (confirmed or suspected); porphyria; hypersensitivity to any of the substances contained in the capsules.	Highly effective, but has many more contraindications. Both oral (inside) and intravaginal (the capsule is placed in the vagina like a suppository) is possible. It has a sedative effect on the body. The approximate cost is 350–400 rubles.
Protesterone	Progesterone (in 1 ml of solution - 10 or 25 mg of hormone)	Injection	Liver diseases, liver dysfunction, hepatitis, liver and kidney failure; cholestatic jaundice during pregnancy (history), benign hyperbilirubinemia; neoplasms of the breast and genital organs; tachycardia; tendency to thrombosis, active venous or arterial thromboembolism, severe thrombophlebitis or a history of these conditions; nervous disorders with the phenomenon of depression; porphyria; II-III period of pregnancy, history of ectopic pregnancy or frozen pregnancy; vaginal bleeding of unknown origin, condition after abortion; hypersensitivity to the components of the drug.	The drug is available only in the form of an injection solution. This makes it difficult to use at home - it is mainly used in hospitals. The medicine has a faster therapeutic effect (compared to Duphaston), and is therefore suitable for severe forms of spontaneous abortion. There are also quite a few contraindications. The approximate cost of packaging is 300–350 rubles.
Progesterone (100 or 200 mg per tablet, 80 g per 1 g gel)	Tablets, vaginal gel, oil solution	Deep vein thrombosis, thrombophlebitis; thromboembolic disorders (pulmonary embolism, myocardial infarction, stroke), intracranial hemorrhage or a history of these conditions/diseases; bleeding from the vagina of unknown origin; incomplete abortion; porphyria; established or suspected malignant neoplasms of the mammary glands and genital organs; age under 18 years (efficacy and safety have not been established); lactation period (breastfeeding); hypersensitivity to progesterone or any of the auxiliary components of the drug. For oral use (optional): severe liver diseases (including cholestatic jaundice, hepatitis, Dubin-Johnson syndrome, Rotor syndrome, malignant liver tumors) currently or in history; the drug should be used with caution in diseases of the cardiovascular system, arterial hypertension, chronic renal failure, diabetes mellitus, bronchial asthma, epilepsy, migraine, depression, in the second trimester of pregnancy.	There are more contraindications compared to Duphaston. The approximate cost of tablets is 25–3000 rubles.

Photo gallery: the most common analogues of Duphaston

Prajisan differs from Duphaston in the auxiliary components Progesterone is produced in the form of ampoules with a solution, which makes it difficult to use at home
Utrozhestan has more contraindications than Duphaston, for example, vaginal bleeding

There is also a complete analogue of Duphaston - Dydrogesterone. It contains a minimum number of additional components. However, the drug is extremely rare in pharmacies.

It is unacceptable for a pregnant woman to independently replace Duphaston with its analogue - mandatory approval from the attending physician is necessary.

Hormonal drugs are widely used in gynecological and obstetric practice. The lack of female sex hormones (estrogens and progesterone) is compensated with the help of natural or synthetic analogues.

This allows you to get rid of the manifestations of various gynecological diseases, including endometriosis, tumors, cervical ectopia, etc.

Duphaston during pregnancy

In addition, a significant share in the clinical use of hormonal drugs is their use to prevent pregnancy complications. Most often, the hormone progesterone and its synthetic analogues (dydrogesterone) are used for these drugs.

The original drug containing this substance is Duphaston. This remedy has found wide application in obstetric practice. What is Duphaston used for during pregnancy? How many weeks should you take the drug? What to do if you forgot to take your pill? We will try to answer these and other questions in this article.

Effect

Modern technologies of biochemical synthesis have made it possible to create a drug that has the positive effects of the natural hormone progesterone, while being devoid of most of the negative ones. Dydrogesterone, contained in the drug Duphaston, became such a drug.

The advantage of the effect of dydrogesterone is its selective effect on the endometrium (the inner lining of the uterine wall). Duphaston causes the following changes:

1. Promotes the onset of the secretion phase in the endometrium.
2. Increases the number of secreting glands on the inner surface of the uterine wall.
3. Increases the intensity of blood circulation in the organs of the reproductive system.
4. Increases the ability of the endometrium to implant a fertilized egg.
5. Reduces the excitability and ability to contract the muscle fibers of the uterus and fallopian tubes.
6. Eliminates deficiency of own progesterone.
7. Reduces the risk of endometrial hyperplasia and cancer with high levels of estrogen in the body.

Such a wide range of therapeutic activity of the drug ensures its widespread use in the treatment and prevention of obstetric complications.

Metabolism

How is Duphaston absorbed by the body? After oral administration, the drug is absorbed in the intestine. It enters the bloodstream, is captured by blood proteins, then distributed throughout the tissues and has a therapeutic effect.

Removal of the drug from the body begins in the liver. A series of biochemical reactions occur here that convert dydrogesterone into inactive substances. After this, the metabolites are filtered by the kidneys and excreted in the urine.

The time for complete removal of the drug from the body is three days after taking the drug.

Advantages over progesterone

A woman and a doctor often have a choice: to use natural progesterone or synthetic analogues. It is worth considering the specific properties of dydrogesterone, which distinguish it from the natural hormone:

• The drug, like progesterone, undergoes a number of metabolic changes in the liver, but the number of reactions, and therefore the effect on the organ, is less.
• The drug does not have a sedative effect, which is characteristic of progesterone. Duphaston can be taken while performing work that requires increased alertness, as well as while driving.
• Does not affect the function of adrenal hormones, does not change kidney function.
• The medicine does not affect the thermoregulation center; body temperature remains normal when used.
• Dydrogesterone does not have the property of causing feminization of women and masculinization of the fetus.
• In case of kidney failure, it is able to be excreted from the body without causing any additional toxic effect.

These properties of the drug allow it to combine the effectiveness of natural progesterone and get rid of many of the side effects of the hormone.

Indications

Why take Duphaston during pregnancy? Obstetricians prescribe the drug during the treatment and prevention of complications of pregnancy. This includes the following indications:

1. Endocrine infertility is the inability to get pregnant due to low levels of the body’s own hormone progesterone. Under influence various reasons During the secretory phase of the cycle, the corpus luteum of the ovary produces a small amount of the hormone, the endometrium is not able to accept the egg, and pregnancy does not occur. Duphaston not only affects the inner layer of the uterus, but also the epithelium of the vagina, creating all the conditions for fertilization and implantation of the fertilized egg.
2. Threatened miscarriage, habitual abortion. These conditions often develop against the background of a lack of progesterone in the body. Whether it is genetic predisposition, influence unfavorable factors external environment or stress, a woman’s body experiences a deficiency of the pregnancy hormone, which is why pregnancy is interrupted in the first trimester.
3. Menstrual irregularities in the form of absent, small or irregular menstruation. In this case, pregnancy cannot occur due to the inability of the reproductive system to fully ovulate and consistently change the phases of the cycle. Treatment of the pathology is achieved by simultaneous administration of dydrogesterone and estrogen preparations.
4. Dysmenorrhea is a pathological course of the menstrual cycle, in which on critical days there is severe pain in the lower abdomen. The pathology is often caused by hormonal problems, which are eliminated by taking Duphaston.
5. Endometriosis is the appearance of the endometrium (cells of the inner layer of the uterus) in various tissues and other organs. This hormonally determined pathology often leads to infertility and also increases the likelihood of miscarriage. Duphaston therapy is often used to eliminate endometriosis.

In addition to the listed obstetric conditions, Duphaston is also prescribed for many gynecological problems: uterine bleeding, premenstrual syndrome, and other hormonal-dependent diseases.

Contraindications

When using the drug, you should pay attention to contraindications to taking the drug. The following conditions are identified in which Duphaston during pregnancy is harmful to the body:

• Allergy to the components of the product. At the first manifestations (rash, itchy skin, headache, fever) hypersensitivity the drug should be discontinued.
• Dubin-Johnson syndrome is a hereditary liver disease, which is accompanied by liver failure, manifestations of jaundice and disruption of the gastrointestinal tract.
• Rotor syndrome is a mild form of the previous disease.

In addition to these contraindications, there are restrictions under which taking the drug is not recommended, as it can lead to deterioration in the function of the affected organ. Duphaston is harmful under the following conditions:

• Liver diseases.
• Diseases of the cardiovascular system.
• Diabetes.
• Neurological diseases – migraines, epilepsy.
• Breastfeeding should be avoided while taking the drug. breast-feeding, dydrogesterone and its metabolites pass into breast milk.

Side effects

If you follow your doctor's prescriptions and there are no contraindications, Duphaston rarely causes side effects. However, individual characteristics of a person’s metabolism can lead to the following phenomena:

1. Anemia associated with the destruction of red blood cells (hemolytic).
2. Allergic reactions.
3. Headache.
4. Impaired liver function, leading to jaundice, weakness, and abdominal pain.
5. Uterine bleeding.
6. Breast engorgement.
7. Skin rash, itching.
8. Swelling of the subcutaneous tissue.

The listed side effects occur extremely rarely, their occurrence should serve as a reason to discontinue the drug.

Release form

The original product containing synthetic dydrogesterone is the drug Duphaston. This medicine is currently available in only one form - film-coated tablets.

The package contains 20 doses of the drug, 10 mg each. The shell protects the drug from the effects of gastric juice. Excipients of the drug are:

• lactose;
• hypromellose;
• starch;
• silica;
• magnesium steaterate;
• polyethylene glycol;
• titanium dioxide.

In case of intolerance to the described components or lactase deficiency, the use of the medicine is contraindicated.

Instructions for use

Duphaston is drunk 2 times a day, the tablet is not chewed, it is correct to take the drug with a small amount of water. The amount of product (dosage) depends on pathological condition and is determined by the doctor. Self-administration of medication can lead to complications.

The doctor will prescribe the required amount of the drug based on the clinical examination, test results and the condition of the patient's body.

Scheme of use during pregnancy

Why should pregnant women take dydrogesterone? Most often, Duphaston should be taken in the early stages in case of a recurrent miscarriage or a history of frozen pregnancy. For these indications, the drug is prescribed even before pregnancy at a dose of 20 mg per day. Take 1 tablet 2 times a day.

If pregnancy occurs in the early stages of pregnancy, the dose is continued at the same dosage. In the first trimester, the product helps maintain pregnancy.

Many people are interested in the question of when to stop taking it. Cancellation of Duphaston during pregnancy most often occurs at 16–20 weeks of intrauterine development. At this time, the woman’s body adapted to the presence of a fetus in the uterus, and the necessary auxiliary organs, such as the placenta and membranes, were formed. It is for the formation of these structures that the drug is needed in the early stages. After 20 weeks, and especially in the third trimester, Duphaston is usually not prescribed.

You can stop taking the drug only after consulting a specialist who will correctly assess the risks and give an opinion on how many weeks you need to take dydrogesterone. The medication regimen is prescribed by the doctor individually.

If the drug has not previously been taken during pregnancy, it can be prescribed for use in the early stages, up to 16–20 weeks. This will allow you to maintain your pregnancy.

An obstetrician-gynecologist must decide whether or not to take Duphaston and what dose should be taken.

Features of use

There are some nuances when using the drug that allow you to use the product with minimal risks. Features of using Duphaston:

1. It is necessary to be careful when taking the drug together with estrogens. Most side effects occur when taking drugs simultaneously.
2. Breakthrough uterine bleeding that occurs due to taking Duphaston is eliminated by increasing the dose. This complication often needs to be treated in a hospital.
3. If there is evidence in the anamnesis of the presence of a progesterone-dependent neoplasm, the drug can be prescribed only after a thorough examination.
4. If the patient has lactase deficiency or galactose intolerance, as well as malabsorption syndrome (reduced absorption of food in the intestine), the drug should be discontinued.
5. The product should be stored in a dry place at a temperature below 30 degrees.
6. In case of overdose of the drug, it is necessary to perform gastric lavage. There is no specific antidote for dydrogesterone.

Always consult your doctor before prescribing a regimen, changing the dose, or stopping a drug. It is impossible to reduce the dose without the consent of a specialist. Stopping treatment without prior consultation means increasing the risk of miscarriage.

What to do if the patient forgot to drink Duphaston? It is necessary to take the drug according to the previous regimen. Dydrogesterone is excreted from the body within three days, so skipping a dose once is not a cause for concern. You cannot double the dose of the drug, even if the woman forgot to take the medicine several times.

Analogs

If the patient has an individual intolerance to the components of the drug, or she is not satisfied with the price of the drug, the question arises of selecting an analogue of Duphaston.

It is worth saying that today there are no other drugs containing only dydrogesterone. You can replace Duphaston only with natural progesterone, other synthetic gestagens or a combination medicine. Natural remedies containing progesterone include:

1. Utrozhestan.
2. Crinon.
3. Progestogel.
4. Iprozhin.

Synthetic gestagens, in addition to dydrogesterone, include:

• Cliogest.
• Orgametril.
• Klimonorm.
• Postinor.
• Charosetta.
• Medrogeston.
• Depo-Provera.

There is a combination drug Femoston, containing estrogens in addition to dydrogesterone. This combination is often useful in the treatment of gynecological pathologies.

It is impossible to select drug analogues, taking into account the pros and cons, without consulting an experienced specialist.

Duphaston is a hormonal drug that has a complex effect. With its help, problems in the female genital area are eliminated. This medicine has a positive effect on the process of bearing a child.

In contact with

Operating principle

Duphaston is an analogue of progesterone, which is often prescribed during pregnancy.

Thanks to this tool, the full process of bearing a child is ensured. the medicine is a progestin.

The medication has an effect that completely coincides with the natural compounds produced by the adrenal cortex and the corpus luteum of the ovary.

The drug is produced in the form of tablets, which makes it easy to use. Can be used not only in stationary, but also at home.

In most cases, duphaston is prescribed to maintain pregnancy, as it has an effect similar to progesterone.

Important! During the period of use of the medicine, a decrease in the tone of the uterine walls is ensured, which leads to the elimination of the possibility of miscarriage.

The drug has a minimal number of contraindications, which allows it to be used for most patients. It does not have a negative effect on the fetus, which ensures the safety of its use during pregnancy. During the manufacture of the medicine, no application is carried out, which eliminates the possibility negative influence on women's and children's health.

What duphaston is used for and how it is taken can only be answered by a specialist, so it is recommended to consult a doctor.

Admission rules

Most patients are recommended to take duphaston during early pregnancy. This is explained by the fact that the symptoms manifest themselves more intensely, which makes it possible to determine this condition almost immediately after. Representatives of the fairer sex note an increase in appetite and a lack of feeling of satiety while eating. Patients also note the occurrence of pain in the chest. The mammary glands become engorged.

When the first signs of pregnancy appear while taking the medication, patients are recommended to undergo a pregnancy test. human chorionic gonadotropin. This is explained by the fact that while using the medicine, symptoms are observed that are similar to those of the first trimester of pregnancy.

If duphaston is used during pregnancy in the early stages, then later the symptoms appear in the form of:

1. Delayed periods. IN in this case You shouldn’t get your hopes up, as a delay may occur during a period of hormonal imbalance.
2. Enlarged mammary glands. If previously only breast enlargement was observed, then while taking the drug it changes in size.
3. Increased urination. The appearance of this symptom is explained by the fact that the tissues of the uterus and appendages swell.
4. Increases. In case of problematic conception, this indicator is always checked. If a temperature of 37 degrees is observed, this indicates the development of the fertilized egg.
5. Excessive fatigue. Ladies often complain of fatigue even when doing usual things.
6. Attacks of nausea. This symptom occurs in most cases due to intolerance to certain odors.

Before, how to take duphaston during pregnancy, it is necessary to determine the characteristics of the effect of its influence. This will ensure maximum effectiveness of the medicine.

Features of application

Despite the fact that duphaston is used as a progesterone substitute, its independent use is strictly prohibited.

This is explained by the possibility of hormonal imbalance. The use of the drug is recommended almost immediately after fertilization.

The length of time to take the medicine directly depends on the individual characteristics of the expectant mother.

In most cases, the medication is stopped when the baby reaches 4 months of gestation. During this period, the placenta is fully formed and begins to independently produce the hormone.

Important! The dosage of the medication is determined only by the doctor in accordance with the individual characteristics of the woman.

The degree of progesterone deficiency must be taken into account. The doctor also determines the circumstances that preceded the pregnancy.

In this case, must be taken into account such aspects, How:

• premature birth;
• miscarriages;

When prescribing the drug, the doctor must take into account the woman’s age. When prescribing a medication, the individual plays a rather important role. sensitivity to active ingredients. At the time of appointment, it is necessary to assess the current health status of the pregnant woman. If the patient is at risk of miscarriage, then I definitely recommend that she take this remedy.

While carrying a child, you are allowed to take up to 4 tablets of the drug. The break between the procedure should be approximately the same. During treatment, hormone levels are constantly monitored. That is why a woman must constantly get tested. According to the results, the doctor may change the dosage. Therapy should be carried out in such a way as to maintain progesterone levels, and not accumulate it in the body.

If a woman accidentally missed time of receipt medication, then she needs to wait until the next procedure and take the pill. Discontinuation of the course of treatment is recommended only after testing for human chorionic gonadotropin.

Treatment of pregnant women should be carried out under the strict supervision of a doctor, which will eliminate the possibility of developing unwanted complications.

Termination of use

Before stopping the medication, you need to read general rules carrying out this procedure.

If the hormone stops entering the body at one point, this can cause stress and other undesirable consequences that manifest themselves in bleeding and termination of pregnancy.

Only a doctor can decide to stop taking a medication.

The dosage is gradually reduced, which gives the reproductive system the opportunity to adapt painlessly. Women are recommended to reduce the dose by half a tablet daily. This will eliminate the possibility of developing undesirable consequences.

This cancellation scheme does not belong to the category of universal ones. During its development, the individual characteristics of the pregnant woman must be taken into account. Discontinuation of the drug at the stage of early pregnancy should be carried out under strict medical supervision, which will eliminate the possibility of developing undesirable consequences.

Complications

Only a doctor can tell you whether duphaston can be taken during pregnancy after a preliminary examination of the patient. Otherwise, side effects may occur. The drug does not negatively affect the endocrine system of the unborn child, since it is formed at a later stage. Improper use of the medication can lead to headaches. Some pregnant women experience migraines.

Undesirable consequences may manifest themselves in the form of allergic manifestations. In most cases, women experience skin rashes and itching.

Sometimes a decrease in hemoglobin levels in the blood is diagnosed. Irrational use of the drug may cause disturbances in liver function.

In this case, patients complain of abdominal pain and general malaise.

If this complication is not treated promptly, jaundice develops. Patients claim that after taking the medication, the sensitivity of the mammary glands increases significantly.

To eliminate the possibility of undesirable consequences, it is recommended to take into account contraindications before taking the drug;

• severe liver damage;
• diseases of the cardiovascular system;
• insulin-dependent diabetes mellitus;
• manifestations of epilepsy.

Useful video: why take duphaston during pregnancy

Conclusion

Duphaston is a synthetic hormone that has a significant effect on the body's reproductive system. With its help, restoration and renewal of the endometrium is ensured. When using the drug, the possibility of the occurrence of various neoplasms in the uterine area is excluded. During pregnancy, the medicine is taken to preserve it. Application should occur after a preliminary examination to exclude the possibility of complications.