Duphaston in the prevention and treatment of recurrent miscarriage. International Conference of the Club of Specialists on the Problem of Miscarriage Per Speculum uMEDp

control of fertilization;
growth of the corpus luteum;
preparing the mammary glands for feeding function;
preparing the lining of the uterus for pregnancy;
maintenance for carrying a child until birth.

The popularity of this hormonal substitute is quite high, as evidenced by the reviews of those who have used it.
In most cases, women positively characterize his assistance in pregnancy. Many people, with the help of this medicine, were able to save their baby when there was a threat of miscarriage. Some managed to get rid of endometrial tumors. It is used for confirmed progesterone deficiency to treat:

infertility;
endometriosis (benign tumor in the lining of the uterus);
habitual miscarriage or its threat;
menstrual irregularities;
painful periods (dysmenorrhea).

It is also used as a progesterone substitute during removal of the ovaries or during menopause. Moreover, it is constantly consumed in combination with estrogens to artificially form the second phase of the cycle.

What kind of substance is Duphaston

Duphaston is a popular drug prescribed for the treatment of diseases of the female reproductive system. Duphaston is the trade name of a drug whose main active component is dihydrogesterone. The manufacturer is the Dutch pharmaceutical company Abbott.

What is this substance, is it a hormonal drug or not? Will it cause you to grow a mustache and start gaining weight? Let's figure it out.

Attention! This article is about a medical drug. It is intended for informational purposes only. Remember that a doctor must prescribe and stop medications. The appointment is made individually in each case, taking into account the test results and clinical picture. It is unacceptable to prescribe and stop medications on your own; this can lead to irreparable consequences for your health!

Hormonal or not?

Dihydrogesterone is a chemical compound that is an artificially synthesized analogue of the human hormone progesterone.

Duphaston refers to synthetic hormonal drugs, namely synthetic progestins. It is a synthesized analogue of the endogenous steroid hormone of the female reproductive glands - progesterone, which performs a wide range of functions in the female body. It shapes a woman’s appearance, regulates the menstrual cycle and ensures the onset of pregnancy, while controlling its progress. This hormone also largely regulates metabolism, affects the blood clotting system, as well as many other functions of the body. Therefore, this drug is a hormonal drug and is widely used in hormone replacement therapy (HRT).

Duphaston for anovulatory cycle

Every healthy woman has 1-2 cycles during the year in which there is no ovulation. This condition is often characterized by a long delay. Anovulatory cycles can reach a duration of 40-50 days. This causes discomfort to the patient, especially when planning pregnancy. The same drug that replaces natural progesterone will help speed up the completion of such a cycle.

Duphaston for anovulation is prescribed from the 11th day of the cycle. You can determine that an egg is not expected to be released using an ultrasound. During the examination, the ultrasound specialist discovers that there are no dominant follicles in the ovary, and the endometrium is completely unprepared for conception. In this case, it is impossible to say when the next menstruation will begin. Taking Duphaston will create the illusion of the second phase for the body. As soon as a woman stops taking the medication, which is usually recommended on day 25 of the cycle, menstruation will soon begin. In the absence of ovulation, the medicine is taken 2 tablets per day - morning and evening.

With frequent anovulatory cycles, gynecologists prescribe hormonal therapy to patients planning pregnancy. It involves stimulating the growth of follicles in the first phase and maintaining the functioning of the corpus luteum in the second. Often this method helps in getting pregnant.

What functions does progesterone perform in the female body?

Duphaston is prescribed when a woman has a decrease in her own progesterone levels. With this diagnosis, disturbances in all body functions for which progesterone is responsible may occur, as well as disruptions in the levels of other sex hormones. Symptoms of progesterone deficiency can range from mild to very serious:

Disruptions in the menstrual cycle
In the most severe cases – absence of menstruation
Problems when trying to get pregnant
Miscarriage, early miscarriages
Severity of premenstrual syndrome manifestations
Endometriosis
Uterine neoplasms
Increased risk of developing breast cancer

With such symptoms, tests are prescribed that should confirm or refute the lack of progesterone in the woman’s body. The fastest and most effective treatment in case of a real deficiency is to compensate for the deficiency of progesterone, that is, hormone replacement therapy. It is for this purpose that experts prescribe artificially synthesized analogs of progesterone - progestins, which include the drug Duphaston.

Of the synthetic progestins, Duphaston is the latest generation drug with the least number of unwanted effects. The structure of the active substance molecule (dydrogesterone) is similar to the structure of the human progesterone molecule, therefore it binds to progesterone receptors, selectively binding only to uterine receptors. Due to its selectivity, the drug does not affect the functioning of other organs and does not affect the production of other hormones, affecting only the reproductive system, which significantly reduces the number of side effects.

Is it possible to combine Duphaston and alcohol?

In the instructions for the drugs, manufacturers do not always write about the categorical prohibition of drinking alcohol during the course of therapy.
One of these drugs is Duphaston, which is prescribed for hormonal imbalances, problems with conceiving and bearing a child.

The instructions do not contain specific prohibiting information about whether it is possible to combine alcohol and Duphaston, and what consequences such a combination can lead to for the body.

If Duphaston is prescribed to pregnant women or women planning pregnancy, this question automatically disappears. Any sane woman will not drink alcohol while pregnant or planning pregnancy.

But if we are talking about normalizing hormonal levels, alleviating menstrual or menopausal syndrome, then this issue becomes important for some women, despite the fact that the course of treatment with the drug is only 10 days.

In order to understand whether Duphaston is compatible with alcohol, you should know how it works, what it affects and how it is eliminated.

Duphaston is a hormonal drug. The active substance is dydrogesterone. Once in the body, the drug is broken down by liver enzymes and sent to the problem area. When drinking alcohol together with Duphaston, a number of side effects may occur due to increased load on the liver.

All side effects can be divided into several groups, depending on the organ and body system that is affected by the combination of alcohol and medication.

Side effects when using Duphaston and alcohol:

From the side of the liver.
From the gastrointestinal tract.
From the circulatory system.

Now let’s take a closer look at these consequences and try once again to think about whether a small party is worth such a reckoning.

Circulatory system reaction

A completely negative reaction can follow from the circulatory system. Alcohol dilates blood vessels and increases blood circulation. Against this background, as a result of simultaneous use of Duphaston and alcohol, uterine bleeding may occur. And as a result of increased blood circulation, the drug will be eliminated from the body faster, which will significantly reduce its effectiveness.

The side effects listed above will not lead to death, but the unpleasant consequences that will arise if you combine alcohol during the next party and treatment with Duphaston are unlikely to bring many positive emotions.

Another advantage in favor of giving up alcohol during treatment is that Duphaston is used to treat diseases that are associated with increased production of estrogen.

Thus, all treatment with Duphaston is reduced to zero - why suppress the production of estrogen with the help of medication and at the same time deliberately increase the amount of this hormone in the body.

Excretion from the body

The drug Duphaston is completely eliminated from the body within 72 hours, so you should not drink alcohol immediately after completing the course of treatment. You will have to wait another three days to avoid possible unpleasant consequences.

No matter how conscientiously a woman approaches her treatment, there are situations when drinking alcohol is inevitable (for example, an important business dinner on which a career or the financial well-being of a company depends).

In this case, the woman will not have to make excuses and come up with reasons for giving up alcohol.

As a conclusion

Drinking alcohol against the background of hormonal diseases further aggravates the health condition. The combination of alcoholic beverages along with Duphaston therapy is contrary to logic and common sense. Of course, this will not lead to death, but the effectiveness of treatment will decrease.

If we are talking about planning a pregnancy or maintaining it, then this question should not arise for the expectant mother at all. Any amount of alcohol is extremely dangerous for the baby's health.

Of course, whether to combine Duphaston with pregnancy planning or treatment is a personal matter for each woman.

The effect of Duphaston on the body

Let's now take a closer look at what positive effects progesterone therapy should have on the female body:

Normalization of the menstrual cycle. Prescription for hormonal imbalance

Since progesterone directly regulates the menstrual cycle, fluctuations in its level cannot but affect its course. Taking Duphaston according to a certain scheme helps normalize the cycle, restoring its regularity. A pleasant bonus is the smoothing out of PMS phenomena.

Increased fertility

Progesterone is the main hormone regulating the second phase of the menstrual cycle. After ovulation, an increase in progesterone levels puts the endometrium of the uterus in a state of readiness for implantation of a fertilized egg. Progesterone also reduces the maternal immune response to avoid fetal rejection and reduces the contractility of the smooth muscles of the uterus, which together contributes to the successful occurrence of pregnancy after fertilization.

Therefore, a lack of your own progesterone often causes the impossibility of pregnancy and miscarriages in the early stages. Maintaining the required level of the hormone with the help of the drug neutralizes these negative factors, as a result of which the fertilized egg is successfully implanted and normally survives the first weeks of pregnancy.

Maintaining early pregnancy

As you already understood from the previous paragraph, additional progesterone helps maintain pregnancy if it is threatening. Therefore, Duphaston is often recommended for women who experience bleeding and pain in the lower abdomen in the first weeks of pregnancy.

Preventing the consequences of hyperestrogenemia

Even if a woman does not have a goal to become pregnant, an imbalance of sex hormones can cause a lot of trouble. Progesterone and estrogen are the main female sex hormones. When one hormone is deficient, the effects of the second often begin to predominate. This is fraught with such unpleasant phenomena as endometriosis and the appearance of malignant tumors in the uterus. Duphaston, by increasing progesterone levels, thereby reduces the amount of estrogen. Diseases caused by excess estrogen, for which Duphaston therapy is indicated:

Endometriosis
Polycystic ovary syndrome
Dysfunctional uterine bleeding
Habitual abortions
As hormone replacement therapy to prevent proliferative changes in the muscular layer of the uterus, in case of taking estrogen in the treatment of disorders associated with menopause

However, it is customary to associate a large number of true and not so true horror stories and myths with the use of hormonal drugs. Let's figure out what the scary word “hormonal therapy” threatens a woman with.

Duphaston when planning pregnancy

After ovulation, Duphaston is prescribed when planning pregnancy. The medicine helps the under-functioning corpus luteum maintain its new condition. The medication also prepares the “soil” for embryo growth – it has a beneficial effect on the endometrium.

If conception has taken place, the drug maintains proper uterine tone, preventing the walls of the reproductive organ from contracting and rejecting the fertilized egg. After ovulation, your doctor may recommend drinking Duphaston immediately or only when problems arise. If there is a threat of miscarriage in the form of detachment of the ovum, hematoma, bleeding and hypertonicity of the uterus, then the medicine will help prevent miscarriage.

Will the mustache grow? Myths associated with taking hormonal drugs.

When taking hormonal drugs, many women are afraid of unpleasant side effects, which can often be read about in various sources. However, many of them are nothing more than myths.

If I start taking hormonal medications, I will gain excess weight. Many women are afraid that taking “hormones” will lead to weight gain. This is partly true, because many hormones directly affect metabolism, that is, the metabolism of fats, proteins and carbohydrates. Progesterone is a hormone involved in weight regulation. In general, progesterone is considered a weight loss hormone. However, one must understand that hormonal regulation is a complex thing and has not yet been fully studied, and in each specific case the results can be unpredictable. Post-clinical trials (and reviews of women who took it) show that in most cases, Duphaston does not lead to weight changes, either up or down.

Hormonal drugs cause women's voices to become rougher and a mustache to grow. This is only true if women, for some reason, need to take male sex hormones. Duphaston does not have the properties of androgens (male sex hormones), so taking this drug will not in any way affect the appearance of body hair, deepening of the voice, and the woman will not begin to acquire male characteristics in any way. On the contrary, normalizing progesterone levels to normal promotes a more “feminine” appearance.

The use of hormonal drugs is harmful to the cardiovascular system and can lead to atherosclerosis. The female hormone estrogen has a protective function for the cardiovascular system and helps maintain low cholesterol. Related to this is the fact that men aged 40-50 years are much more likely to suffer from cardiovascular diseases. And after age 50, when women typically reach menopause, the score becomes even. Since progesterone therapy reduces the level of estrogen associated with it in a woman's body, a logical question may arise - will this lead to an increased risk of cardiovascular disease?

The answer to this question is this: you need to understand that progesterone drugs are prescribed when there is a lack of progesterone and an excess of estrogen in a woman’s body. If you take Duphaston under the supervision of a doctor, then if estrogen decreases, it will only be to a physiologically normal level. Which is sufficient protection for the cardiovascular system.

Let's deal with progesterone

Progesterone is a steroid hormone and is produced in a woman’s body by the ovaries and adrenal glands. The role that progesterone plays in the functioning of the reproductive sphere is irreplaceable; the menstrual cycle, fertilization and further pregnancy depend on the level of this hormone.

As you know, the menstrual cycle is divided into 2 phases: follicular (proliferative) and luteal (secretory).

In the first half of the cycle, estrogens predominate, under the influence of which the dominant follicle matures. At the moment of ovulation (rupture of the main follicle), the content of progesterone reaches its peak, the “newly made” egg leaves the follicle and enters the fallopian tube. In place of the burst follicle, a corpus luteum is formed, which maintains (synthesizes) progesterone levels at the same levels. Under the influence of the described hormone, secretory changes occur in the functional layer of the uterine mucosa, it thickens, loosens, and the blood supply in it increases.

All the processes described are designed to create favorable conditions for the introduction or implantation of an egg that has been fertilized by that time. If conception has occurred, the corpus luteum continues to function as before, maintaining progesterone levels at a constant level. This is explained by the properties of the hormone:

It supports secretory changes in the endometrium, necessary for the further progression of pregnancy, Suppresses uterine contractions, thereby preventing the rejection of the fertilized egg. Progesterone affects the development of tissues, primarily the mammary glands, and prepares them for breastfeeding. The hormone also has some sedative effect, inhibits the activity and bright emotions of a woman and stimulates the growth and stretching of the uterus as the gestation period increases.

Due to the listed “abilities” of progesterone, it is called the pregnancy hormone. Indeed, if it is insufficient, neither fertilization nor further development of pregnancy is possible. A reduced level of progesterone in the blood indicates either insufficiency of the second phase of the cycle or reduced function of the corpus luteum or placenta.

Lack of the hormone can be manifested by intermenstrual bleeding (see discharge in the middle of the cycle), threat of miscarriage and retardation of intrauterine development of the fetus.

What effect do hormonal pills have on the fetus during pregnancy?

It is common for every mother, even expectant mothers, to worry more about her child than about herself. Questions creep into my head: will the child have hormonal disorders if the mother took hormones?

Duphaston has been on the market for just under 20 years, and during this time no significant developmental disorders have been recorded in children whose mothers took this drug during pregnancy. However, it is worth understanding that 20 years is not too long, and any drug should be prescribed only in the case “when the expected benefit exceeds the possible harm.” The thoughtless prescription of duphaston in the early stages of pregnancy “for prevention”, of course, can in no way be justified.

Duphaston helps to get pregnant and promotes the normal course of pregnancy only if the woman suffers from a lack of progesterone.

The decision on the need to use Duphaston during pregnancy is made exclusively by a gynecologist based on the patient’s medical history, examination and the results of biochemical screenings. Based on the data, if endogenous progesterone deficiency is established, the doctor chooses the dosage of the drug, the regimen and course of treatment with Duphaston, since it is progesterone that is responsible for preserving the fetus and the ability to conceive.

If a woman manages to become pregnant while undergoing treatment with Duphaston, she should not abruptly stop taking the drug. Discontinuation of the drug should be carefully monitored by the attending physician. If you suddenly stop taking the drug, hormone levels can suddenly change, often leading to miscarriage and miscarriage. The withdrawal of the drug should be smooth and gradual, so that the body itself begins to produce endogenous hormones. In some cases, the drug is also taken during pregnancy to maintain it. Duphaston is also taken to relax the uterus, the stimulation of which can lead to miscarriage.

It must be borne in mind that in addition, the drug has a relaxing effect on the intestines and helps the mammary glands begin active preparation for lactation.

After the twentieth week, the placenta is already sufficiently developed to independently support the functioning of the fetus and produce its own hormones that help maintain pregnancy. Therefore, if there are no strict contraindications, the doctor prescribes a gradual reduction in the dosage of the drug, and gradually completely stop taking it.

Side effects of Duphaston

Duphaston, like any drug, has a number of side effects. Most of them do not require immediate discontinuation of the drug or any drug intervention. However, if side effects cause you significant discomfort, you should consult a doctor.

Side effects:

From the immune system: allergic reactions may occur
From the central nervous system: headache, development of migraine attacks.
From the liver: minor disturbances in the normal functioning of the liver, weakness, malaise, hepatic jaundice, pain in the stomach.
From the genital organs: sometimes breakthrough bleeding is possible, which is stopped by taking higher doses of the drug, increased, sometimes painful, sensitivity of the mammary glands.
From the skin: skin rash, itching, urticaria, swelling of the subcutaneous tissue.
From the hematopoietic system: very rarely, hemolytic anemia may occur.

Does Duphaston have contraceptive properties?

Is Duphaston a contraceptive?
Can the drug be considered as a birth control pill? You can give an affirmative answer - no. This medicine does not have a contraceptive effect. It is not capable of causing spontaneous abortion and does not threaten termination of pregnancy. On the contrary, it promotes pregnancy by maintaining normal progesterone levels. Women taking the drug to prevent pregnancy do not achieve their goal with dydrogesterone stimulation.

The drug is prescribed for infertility if there is progesterone deficiency. If pregnancy cannot occur within a year of regular sexual activity, the doctor may recommend taking Duphaston. A daily dose of 20 milligrams is divided into two doses at equal intervals from the 11th to the 25th day of menstruation. Therapy is continued for up to 6 months. If pregnancy is confirmed, there is no need to stop taking the drug. The doctor adjusts the dose based on examination and examination data. Usually, it corresponds to that prescribed for fetal loss.

In cases where recurrent miscarriage is observed, Duphaston can be effective in a daily dosage of 10-40 milligrams, taken according to the classical regimen. Taking the drug continues for up to 14-16 weeks continuously (daily). Do not suddenly stop taking the drug. Abrupt withdrawal of Duphaston can cause a miscarriage. The correct thing to do would be to consult a doctor and follow the proposed scheme for gradual withdrawal of the medication.

Is it possible to start drinking or stop taking Duphaston on your own?

No. Self-prescription of the drug is strictly contraindicated. The erroneous use of any hormonal drug can not only increase hormonal imbalance, but also cause new problems that did not exist before taking the drug. Before prescribing the drug, the doctor must conduct a series of laboratory tests that should reveal progesterone deficiency. And only after receiving the results, the doctor prescribes the drug and selects an individual dosage and treatment regimen, as well as the duration of the course.

Self-discontinuation of the drug is also contraindicated, since a sharp change in hormone levels can lead to a new hormonal imbalance, which can cancel all the positive effects achieved by taking the drug. Therefore, discontinuation of the drug should occur gradually, under the strict supervision of a doctor, who should monitor changes in hormonal levels.