Duphaston for menopause

The drug Duphaston, which is part of the pharmacological group of hormonal drugs-gestagens, is prescribed for menopause both separately and as part of complex hormone replacement therapy, which consists of taking estrogen-containing drugs that help reduce the intensity of climacteric symptoms.

[ 1 ], [ 2 ], [ 3 ], [ 4 ]

Indications Duphaston for menopause

In the initial period of menopause - when the corpus luteum of the ovaries, which produces the hormone progesterone, ceases to form, and there are disruptions in the secretion of estrogen with short periods of increased levels - indications for the use of the drug Duphaston (Dydrogesterone, Duphaston, Dabroston, Duvaron, Gynorest, Terolut) include progesterone deficiency, endometrial hyperplasia (proliferation of tissues of the inner lining of the uterus), multiple follicular ovarian cysts (polycystic).

Duphaston for menopause and uterine myoma (fibromyoma) is prescribed only in cases where this benign formation is diagnosed against the background of such pathologies as endometriosis (heterotopic implantation of the endometrium, that is, its growth beyond the uterine cavity) or endometrial hyperplasia.

[ 5 ], [ 6 ]

Release form

Duphaston is available in the form of tablets of 5 and 10 mg for oral administration.

[ 7 ], [ 8 ], [ 9 ]

Pharmacodynamics

The active substance of the drug Duphaston dydrogesterone (6-dehydroretroprogesterone) is an analogue of the endogenous female sex hormone progesterone and is a non-acetylated derivative of pregnane of the retroprogestin class. The main effect of dydrogesterone is antiestrogenic, that is, neutralizing estrogen, which stimulates the mitotic activity of the cells of the tissues of the inner lining of the uterine cavity (which leads to endometrial hyperplasia).

Dydrogesterone selectively affects membrane and intracellular estrogen receptors (ER-A and ER-B) of the endometrium and reduces their sensitivity to this hormone, which leads to a decrease in cell mitosis. Also, the drug Duphaston during menopause interacts with progesterone receptors (PR-A and PR-B) of the uterine mucosa, as a result of which hormone-dependent processes in the tissues of the inner lining of the uterus are normalized.

In all cases of endogenous progesterone deficiency, the therapeutic effect of dydrogesterone is closely related to its physiological action on the neuroendocrine control of ovarian function and on the endometrium.

[ 10 ], [ 11 ]

Pharmacokinetics

After taking Duphaston orally, it is absorbed in the gastrointestinal tract and enters the blood, reaching maximum concentration in the serum within 0.5-2.5 hours; binding of dydrogesterone to blood albumins is up to 97%. Absolute bioavailability is 28%.

The active substance is broken down in the liver – by hydroxylation by cytochrome P450-dependent monooxygenases and binding to glucuronic acid.

Inactive metabolites are excreted from the body through the kidneys (with urine); the half-life is 14-17 hours.

[ 12 ], [ 13 ]

Dosing and administration

The appointment of Duphaston during menopause and determination of the dose is carried out only based on the results of the examination. During replacement therapy with estrogen drugs, Duphaston is taken daily - 10 or 20 mg (once a day).

Contraindications

It is contraindicated to use Duphaston during menopause if a woman has significant liver dysfunction. This drug is not prescribed for hepatitis; hereditary pigment hepatosis; blood clotting disorders (including deep vein thrombosis and thrombophlebitis of superficial vessels of the extremities); severe cardiovascular insufficiency; cerebral circulatory disorders; systemic lupus erythematosus; malignant neoplasms of the uterus or mammary glands.

Duphaston is not prescribed for menopause and uterine fibroids with an unchanged endometrium.

[ 14 ]

Side effects Duphaston for menopause

Side effects of Duphaston during menopause include urticaria and itching, as well as breakthrough bleeding from the uterus.

[ 15 ], [ 16 ]

Overdose

An overdose of the drug is not described in the official instructions, but it is noted that if the prescribed dose is exceeded, the stomach should be washed.

[ 17 ], [ 18 ]

Interactions with other drugs

The drug interaction of Duphaston is manifested in the fact that its effect may be reduced with simultaneous oral administration of drugs that activate liver enzymes. This concerns alcohol-containing tinctures, sleeping pills of the barbiturate group, benzodiazepine tranquilizers, antipsychotic drugs of the aminazine and phenothiazine group, and some NSAIDs.

[ 19 ], [ 20 ], [ 21 ]

Storage conditions

It is recommended to store Duphaston at normal room temperature, but in a dark place.

[ 22 ], [ 23 ]

Shelf life

The shelf life of the drug is 5 years.

Doctors' opinion

Doctors' opinions on the advisability of using Duphaston during menopause - as well as hormone replacement therapy itself at the beginning of menopause - differ. Firstly, some gynecologists attribute the use of hormones during their physiologically justified decrease to attempts to change the course of age-related processes in the reproductive system of women, laid down by nature itself. The hot flashes that accompany the onset of menopause can be waited out, but prolonged use of hormones can significantly increase the risk of thrombosis, stroke and the development of malignant processes in the mammary glands.

Some specialists recommend using Duphaston during menopause and uterine myoma if endometrial hyperplasia is diagnosed at the same time. Others hold the opposite point of view, bearing in mind the pathogenesis of this pathology, in which one of the key roles is played by the activation of progesterone receptors of uterine tissue.

So for now this issue is still under study.