Does duphaston relieve uterine tone during pregnancy?

Increased uterine tone is a dangerous condition that often occurs during pregnancy. It poses a threat to the normal bearing of a child, namely the possibility of termination of pregnancy at different stages, that is, miscarriage, miscarriage or premature birth. In order to prevent such negative phenomena, patients are prescribed Duphaston.

Many women are prejudiced against doctor's recommendations to take any medications. The alarming questions are about how great the need for the use of drugs is, whether they can be used in an interesting position and whether this will harm the child.

Answers to these exciting questions can be obtained by reading the materials of the article.

Composition of the drug

The use of this drug is explained by the need to normalize the condition of the reproductive organ and thereby prevent the negative consequences of its deviation from the norm. That is, reduce the tone of the uterus and relax its muscles.

Most often, pathological conditions of this kind are provoked by an insufficient amount of the sex hormone - progesterone. Therefore, to normalize hormonal levels, Duphaston is widely used, the main component of which is progestogen - an analogue of the necessary natural hormone.

Properties of progesterone

Progesterone is a substance necessary for many processes in the body of the expectant mother. This:

• participation in the process of conception;
• attachment of the egg to the wall of the uterus;
• preparing the mammary glands for lactation.

Its special role is that it relieves the tone of the uterus, suppressing the activity of its muscles and thereby preventing the possibility of miscarriage. The greatest effectiveness of the drug is observed in the early stages of pregnancy.

Why is duphaston prescribed during pregnancy?

Duphaston tablets contain a progesterone analogue - dydrogesterone. Therefore, let's first look at the importance of progesterone for a woman's body.

The role of progesterone

The hormone is produced by the corpus luteum of the ovary and adrenal glands and affects a woman’s menstrual cycle, conception and fetal development. It is also called the “pregnancy hormone”.

Under its influence:

• the endometrium matures - after ovulation, the corpus luteum is formed, which begins to synthesize progesterone. Thanks to the hormone, the endometrium thickens and becomes loose, which is necessary for successful implantation. Also, in the wall of the uterus, under the influence of progesterone, a network of vessels is formed, which in the future will fully provide the fetus with nutrition;
• during implantation of the embryo, the activity of the immune system is reduced so that rejection does not occur;
• The tone of the uterine muscles decreases during pregnancy, they relax, spasms and contractions go away;
• The mammary glands develop, their secretory tissue grows, and the number of lobules increases.

Hormone deficiency leads to disruption of all of the above processes: the possibility of conception, gestation and embryonic development. We are interested in the period when pregnancy has already occurred. The goals of therapy with duphaston tablets vary and depend on the duration.

Early indications

Taking duphaston during pregnancy is indicated for the following conditions characteristic of early pregnancy:

• the risk of interruption when, due to progesterone deficiency, the tone of the uterus increases. In this case, the drug relaxes the muscles of the uterus. In medicine, this condition is called “threatened labor”, while the cervix is ​​not dilated and there are no contractions. The woman will be bothered by nagging pain in the lower abdomen, as during menstruation;
• history of recurrent miscarriage, when early miscarriages have already occurred;
• history of bleeding outside the cycle;
• history of infertility, which was treated with hormonal drugs. Then the hormone is prescribed if progesterone is reduced in the tests - in order to normalize hormonal levels and maturation of the endometrium. And after conception - to prevent miscarriage. Prescribing duphaston during pregnancy allows you to maintain a stable hormonal status;
• bleeding that begins after conception - when the fertilized egg or placenta is detached, there will be bloody discharge, which, if the cause is not eliminated, intensifies and leads to miscarriage;
• endometriosis, confirmed instrumentally;
• pregnancy resulting from an IVF procedure. In this case, Duphaston tablets are prescribed to a woman at the stage of preparation for the artificial insemination procedure to increase the likelihood of successful implantation. After embryo transfer and confirmation of pregnancy, the hormone contributes to the preservation and normal development of the fetus.

Late indications

In the 2nd and 3rd trimesters, duphaston tablets are prescribed for increased uterine tone. It feels like heaviness in the lower abdomen, cramps. If hypertension is not eliminated, water may break and premature labor may begin.

How to take the drug?

Duphaston can be used during pregnancy only on the basis of a doctor’s prescription. In this case, a prerequisite is a preliminary determination of progesterone levels.

The dosage is selected individually for each woman, taking into account the condition and degree of hormonal disorders.

If there is a threat of miscarriage, the drug is prescribed no earlier than 5-6 weeks of pregnancy. The treatment regimen is as follows:

• the first day - a single dose of Duphaston in the amount of 40 ml;
• then - 10 ml three times during the day with an 8-hour break;
• The duration of the course depends on the patient’s condition.

The main indicator for stopping therapy is the absence of threatening symptoms of miscarriage. At the discretion of the doctor, a minimum dose of the drug may be prescribed to ensure the effectiveness of treatment.

The regimen can be changed by the gynecologist depending on the patient’s well-being.

Important rules for taking medication

In order not to harm your body and the development of the fetus, you must follow a number of rules:

1. Remember that Duphaston, like other medications, should not be taken without a doctor’s recommendation.
2. Follow dosage directions exactly.
3. Take the medicine at strictly specified hours.
4. Do not interrupt the course of treatment under any circumstances. This can negatively affect the condition of the child, since a sharp decrease in progesterone levels becomes a prerequisite for the possibility of spontaneous abortion.
5. If by chance the time for taking the medicine is missed, it should still be taken no later than 5 hours later. The dose cannot be increased.

The drug is also discontinued according to the regimen specified by the doctor. Most often, this is a gradual reduction in the dose of the drug and only if progesterone levels are normal.

Duphaston withdrawal regimen during pregnancy

Abrupt interruption of the dose is dangerous for the fetus. Due to Duphaston, a woman’s body receives the missing amount of progesterone, and its acute absence can lead to the fact that the uterus considers the fertilized egg foreign and simply pushes it out. This means that you should stop taking the drug gradually. And after withdrawal, you need to monitor the level of hormones in the body using tests.

Until what week should you take Duphaston during pregnancy? The withdrawal regimen is prescribed by the doctor, taking into account the reason why the drug was prescribed. The cancellation scheme could be like this:

If a woman initially took 4 tablets throughout the day, then when she becomes pregnant she should get tested, and only if the hormone is normal, reduce the dose:

• 4 tablets - 1st day;
• 3 tablets - 2nd;
• 2 tablets - 3rd;
• 1 tablet - 4th;
• do not take at all - 5th;

The withdrawal plan is individual for each woman. It is calculated based on the test results.

Contraindications

Despite the fact that Duphaston is a safe drug and is recommended for use during pregnancy, it has a number of contraindications. This is due to the possibility that the patient may have such pathologies as:

• liver failure;
• individual intolerance to components;
• vascular thrombosis;
• transferred Botkin's disease.

The patient is obliged to inform the gynecologist about all previous diseases in order to avoid unwanted consequences.

Possible side effects

Negative manifestations are rarely observed. Exposure to the drug may cause:

• digestive disorders;
• frequent urination;
• constipation;
• dizziness;
• migraine attacks.

These symptoms go away quickly, so it is not recommended to interrupt the therapeutic course.

However, the occurrence of intense pain in the liver area becomes an indication for discontinuation of the drug. In this case, the gynecologist selects a medication with a similar effect.

The use of Duphaston for conditions that can lead to miscarriage or premature delivery is recognized as effective and highly effective.

Following the doctor's instructions and strictly observing the rules for using the medicine is the key to successfully bearing a healthy child.

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Uterine hypertonicity is not a disease, but a symptom that means increased tension of the myometrium (smooth muscles of the uterus). Outside of pregnancy, the myometrium undergoes various phases of contractile activity every month, which depends on the menstrual cycle.

This process is regulated by many hormones and is ensured by the autonomic nervous system, which responds to their signals and “conducts” the activity of all internal organs, vascular and muscle tone.

But uterine hypertonicity during pregnancy is caused by other reasons, since the functions of the uterus are controlled by other hormones. The frequency and intensity of tension in the muscles of the uterus cause natural anxiety in pregnant women, as this can be a harbinger of serious problems for both the expectant mother and the child.

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Side effects and harm

The following side effects are possible:

1. Allergic reaction;
2. Impaired liver function with changes in biochemical parameters;
3. Inhibition of hematopoiesis with changes in the results of a general blood test;
4. Feeling unwell - headaches, nausea, vomiting, chest pain or discomfort, dizziness, swelling.

Dydrogesterone does not have side effects such as increased blood clotting and thrombus formation, impaired fat metabolism (obesity), arterial hypertension, increased male pattern hair, characteristic of drugs containing estrogen. It does not change the general hormonal levels.

There is no harm from duphaston during pregnancy if you follow the instructions and doctor’s recommendations. The drug does not have a negative effect on the fetus and its embryonic development, the course of labor and the postpartum period.

For any negative symptoms or complaints, urgent consultation with a doctor is required. The specialist will analyze the situation and possibly conduct a series of studies. Based on this information, he will decide whether it is advisable to continue treatment or to look for another option for correcting the condition.

Why is uterine hypertonicity dangerous?

Hypertonicity of the uterus in the first trimester (up to the 13th week) can lead to the death of the embryo and miscarriage.

Hypertonicity of the uterus in the second trimester (up to the 26th week) is a real threat of late spontaneous abortion. In addition, at such times, a frequent increase in the tone of the uterine muscles can cause persistent fetal hypoxia, which negatively affects its development. And uterine hypertonicity in the third trimester is fraught with premature onset of labor and the birth of a non-viable or premature baby. Or it can lead to the so-called isthmic-cervical insufficiency - the inability of the cervix to keep its cavity closed as the size of the fetus increases.

When frequently recurring spontaneous local hypertonicity of the uterus is observed, the threat of premature separation (detachment) of the placenta from the uterine mucosa increases manifold (since the placenta does not contract when the uterus contracts). And if a third of the placenta detaches, the fetus may die. However, it should be borne in mind that short-term spontaneous local hypertonicity of the uterus often occurs only when examining a pregnant woman or performing an ultrasound.

Symptoms of uterine hypertonicity

The increase in tone varies in degree: uterine hypertonicity of the 1st degree and uterine hypertonicity of the 2nd degree.

In the first case, doctors mean partial hypertonicity of the anterior wall of the uterus or hypertonicity of the posterior wall of the uterus, and in the second, the tense state of the myametrium of the entire uterus.

In most pregnant women, hypertonicity of the posterior wall of the uterus does not manifest itself in any way: doctors detect thickening of muscle fibers on ultrasound. Although, towards the end of pregnancy, painful sensations appear in the lumbar region, as well as nagging pain in the sacral area.

The main symptoms of uterine hypertonicity, which affects its anterior wall, are the tension felt by the woman in the abdominal area (the abdomen hardens); The symptom goes away quite quickly in a lying position and with calm, deep breathing. There may be nagging pain in the lower abdomen, involving the perineum, as well as more frequent urination, rectal tension (similar to the urge to defecate).

The listed symptoms of uterine hypertonicity may vary in intensity, but most often resemble the condition before and during menstruation. The appearance of any vaginal discharge, especially bloody discharge, should cause particular concern and immediate consultation with a doctor.

Hypertonicity of the lower segment of the uterus, that is, the cervix, is practically not observed during pregnancy (before the physiological due date). Unless the cervix was injured in a previous birth, or there is significant deformation.

As a rule, the opposite happens: with the onset of pregnancy, the lower segment of the uterus becomes shorter and its muscles become softer. But during childbirth, with cervical rigidity, hypertonicity of the lower segment of the uterus is quite possible.

Instructions for use

Only a doctor can prescribe the drug. Self-medication is unacceptable. Before starting therapy, the woman is examined and the level of progesterone in the blood is determined. Only when its quantity is reduced and clinical manifestations of deficiency does the doctor prescribe treatment. It is also prohibited to change the dose of the drug on your own or stop it, even if you feel very well and nothing bothers you.

Taking duphaston during pregnancy should be carried out strictly according to the instructions: although the drug is an analogue of a natural hormone, if the dosage is exceeded, it can lead to negative consequences.

Duphaston tablets should be taken orally. Eating does not affect the absorption of the drug.

The dosage is as follows:

• if there is a risk of interruption - 4 tablets at a time. Then take 1 tablet every 8 hours until the signs of the threat disappear - pain in the lower abdomen, radiating to the perineum, lower back, legs, spotting, hypertonicity of the uterus. When all symptoms disappear, treatment is continued for 1 week, after which the dose begins to be reduced;
• with increased uterine tone without discharge and habitual abortion, the use of tablets according to the scheme of 1 tablet every 12 hours is indicated;
• for IVF, 1 tablet is prescribed 3 times a day until the 10th week.

Treatment of uterine hypertonicity

Symptomatic treatment of uterine hypertonicity during pregnancy consists of its removal using appropriate pharmacological drugs. Therapy is also carried out taking into account the etiology of this symptom complex.

How to treat uterine hypertonicity with identified endogenous progesterone deficiency? Drug treatment of uterine hypertonicity in early pregnancy is carried out using drugs containing hormones. Duphaston for uterine hypertonicity is prescribed in this case by almost all domestic gynecologists. This drug (another trade name is Dydrogesterone) is a synthetic analogue of the female sex hormone progesterone and helps maintain pregnancy in case of recurrent miscarriage. The standard dosage is 20 mg per day (in two doses, according to the schedule prescribed by the doctor), the maximum is 60 mg. However, it must be borne in mind that Duphaston has side effects such as headache, weakness, abdominal pain, and breakthrough uterine bleeding.

How to take Duphaston correctly to get pregnant

Does Duphaston help you get pregnant? The answer will be ambiguous. Duphaston is not prescribed to all women planning pregnancy. It is not always prescribed just because the woman has a history of early pregnancy termination; in these cases, Duphaston helps. The drug is prescribed in cases where a woman is diagnosed with:

• infertility - cause - insufficiency of the luteal phase during the menstrual cycle;
• endometriosis - can cause infertility;
• recurrent miscarriage;

Luteal phase deficiency is diagnosed as follows:

1. Measuring basal temperature (the fact that there is a lack of progesterone may be indicated by a temperature below normal - less than 37 degrees, in the second half of the menstrual cycle).
2. Test for progesterone (taken in the second half of the menstrual cycle), it will be below normal.
3. Ultrasound.

According to the instructions, Duphaston is taken according to the following scheme:

1. Diagnosed luteal insufficiency - take 10 mg per day from the 14th to 25th day of the menstrual cycle. Duphaston is taken for 6 months. It is worth noting that every woman’s body is individual. Therefore, the dosage can be adjusted by the doctor you are seeing. Very often, a hormonal drug is prescribed for 3 months, and if the woman does not become pregnant, she continues to take it for another 3 months. When pregnancy has occurred, Duphaston should be taken for several more months.
2. If you are diagnosed with “recurrent miscarriage,” take 10 mg 2 times a day, at the beginning of the day and at the end, in order to prepare for a future pregnancy.

Of course, like every drug, Duphaston has its side effects. Perhaps the most worrying of them is possible weight gain. Read a separate article about other side effects of Duphaston.

What should you not do if you have uterine hypertonicity?

If during pregnancy the tone of the uterus systematically increases, then in order to preserve the fetus, a pregnant woman should not: physically strain (including in terms of everyday household chores); lift something heavy; walking or standing for a long time; undertake car trips over long distances; fly by the plane; take a bath (or a too hot shower).

The concepts of sex and uterine hypertonicity are incompatible, so you will have to do without intimacy for some time: increased contraction of the uterus during sexual intercourse can cause premature termination of pregnancy.

About pathology

The uterus is a flat internally sloping, contractile organ consisting of muscles. During pregnancy, the baby increases in size significantly. During the entire period, the muscles of the uterus, despite the significant increase, should be at rest. This feature allows you to carry a child despite increasing pressure.

Also, normally, the organ may contract slightly; as a rule, contractions intensify as the period increases. This kind of phenomenon is called training contractions.

But sometimes the muscles of this organ are constantly toned, thereby increasing the pressure on the cavity. It is the constant tension of the organ and contractions that are commonly called increased tone during pregnancy.

This circumstance is pathological and needs to be eliminated quickly. As a rule, its main danger is the threat of spontaneous abortion or premature birth. If this condition develops in the third trimester, it can lead to premature birth.

Signs

Most often, this kind of feature occurs in women in the first trimester of pregnancy. There are quite a few signs of the development of this condition. The most important of them:

• Pain in the lower abdomen.
• Spasms.
• Pain in the lumbar region.

However, very often these kinds of signs do not appear, and upon diagnosis, increased tone is established.

In fact, during pregnancy, the reaction to the most seemingly insignificant changes in the body is specific. Therefore, if you notice any symptoms, you should immediately consult a doctor. The doctor will determine the cause of the increased tone and prescribe treatment.

If you experience bloody discharge in combination with the main symptoms, you should immediately consult a doctor. The appearance of this kind of discharge may indicate a possible miscarriage. It is also worth contacting a specialist if the frequency of cramping spasms becomes more frequent. In this case, the doctor may prescribe special treatment until the situation stabilizes.

Feel

Many women, while carrying a child, begin to experience new sensations that can easily be confused with symptoms of various diseases. With increased tone, the expectant mother may feel:

• Aching pain in the lower abdomen.
• Tension in the abdomen.
• Pain in the lumbar region.

This kind of sensation indicates the development of increased uterine tone. If pain of this nature appears or significantly intensifies, you should consult a specialist.

Reasons for development

As a rule, experts identify 2 different groups of factors that lead to the development of such a feature as increased uterine tension:

• Somatic. They are caused by the presence of problems of a biological or physiological nature.
• Psychosomatic. Their appearance is due to the influence of psychological factors. As a rule, these types of factors affect the nervous system.

Psychosomatic reasons may influence the development of this condition in the last weeks of pregnancy. Most often, the development of this feature is facilitated by:

• Stress.
• Excessive physical activity.
• Fear.

If uterine tension increases in the second trimester, this may mean that its development is influenced by an incorrect lifestyle or severe psychological stress.

Inflammatory diseases can also influence the development of this feature. As well as women’s ailments such as fibroids and endometriosis. Previous abortions also have a significant impact. Infectious diseases can also leave their mark.

Muscle overstretching has a fairly significant influence on the occurrence of this feature. Most often, this phenomenon is observed when carrying several fetuses or with polyhydramnios.

What can a woman do?

In order to protect herself, a woman should visit a gynecologist throughout her pregnancy.

Also, most experts recommend avoiding stress and heavy physical activity during this period. In addition, in order to avoid the development of this pathology, a woman needs to balance her daily routine.

Doctor's recommendations

As a rule, treatment for increased tone of an organ such as the uterus is prescribed by a specialist, taking into account various factors. The success of elimination depends on how timely the woman sought help.

The specialist will explain in detail what needs to be done in order to avoid complications. And if such a pathology manifests itself in the first or third trimester, he will select drug treatment.

This condition is treated quite simply. First of all, for normalization it is necessary to eliminate the factor that provoked the increase in the level of tension. As a rule, the doctor prescribes bed rest.

Normalization occurs by balancing:

• Time for rest and sleep.
• Working hours.
• Power mode.
• Physical activity.

As a rule, a woman will have to give up sexual activity for the entire period of treatment.

Treatment with medications

Quite often, many women, in order to normalize the condition of the uterus, have to combine a special regimen and medications. Very often, specialists prescribe a course of sedatives. As a rule, initially these are remedies based on valerian and motherwort, however, if their use does not bring the desired result, other medications may be prescribed.

In order to reduce the tone and relax the muscles of the organ, special medications can be prescribed, which, thanks to their special composition, relax the muscles of the uterus.

Treatment with this drug is prescribed exclusively to eliminate such pathology in the early stages of pregnancy.

Can it be used with other drugs?

During pregnancy, Duphaston should not be taken together with certain antibiotics and antivirals, anticonvulsants, and herbal remedies. These groups of drugs reduce the effectiveness of the hormone, as they accelerate its elimination from the body, which is why it does not even have time to act.

Duphaston can be combined with other drugs that may be prescribed in an interesting situation - hormonal agents, vitamins during pregnancy and can be used without loss of beneficial qualities.

Features of taking Duphaston

The main active substance that characterizes the effect of the drug Duphaston is progestogen. This substance acts as an analogue of a natural hormone and does not affect metabolism.

In addition, Duphaston causes virtually no side effects. Its main feature is that it selectively affects the uterine receptors. It affects the level of muscle relaxation.

The drug is absorbed into the blood quite quickly. Its maximum concentration is observed after a few hours. The complete elimination period is 72 hours.

Indications

First of all, Duphaston is prescribed for hormone deficiency. As a rule, this condition is observed when:

• Endometriosis.
• Threatened abortion in the early stages of pregnancy.
• Dysmenorrhea.

Duphaston is also used for hormonal therapy. As a rule, it is used only on the recommendation of a specialist, after the exact reasons have been established.

Is it possible to replace Duphaston with Utrozhestan?

Utrozhestan or Duphaston during pregnancy (or planning), which is better? There are many reasons why women are interested in this issue. The main one may be an allergic reaction to the components of Duphaston.

Difference between Duphaston and Utrozhestan:

1. Duphaston contains synthetic progesterone. The composition of Utrozhestan is progesterone of plant origin. Its structure is similar to female progesterone.
2. Duphaston began to be used earlier than Utrozhestan; it underwent many clinical trials. Its action has been well studied.
3. Taking Utrozhestan may cause side effects: general weakness, malaise, drowsiness. Taking Duphaston practically does not cause such effects.
4. The release form of Duphaston is capsules, Utrozhestan is capsules, vaginal suppositories. Doctors say about this that it can be replaced. Everything is individual for each woman. It is important to pay attention to contraindications, which include certain diseases.

Utrozhestan has the same effect on the body as Duphaston if there is a risk of fetal loss:

• replenishes progesterone deficiency;
• removes increased tone of the uterine muscles;
• promotes pregnancy without complications;

It is often recommended to take Utrozhestan in the first half of pregnancy, but there are cases in which it can also be taken in the second half. While taking the drug, you should monitor the slightest changes in your health; if side effects occur, consult a doctor immediately.

You can also replace Utrozhestan on the contrary with Duphaston. But again, this is only after consulting a doctor. The doctor will select the correct regimen and dose to take.

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