WOMEN'S HEALTH
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  • 1. What are the differences between dydrogesterone and micronized progesterone? 

    Progesterone has poor absorption after oral intake1 and even in micronized form, shows a wide variation of absorption and bioavailability in the individual person.2

    Dydrogesterone however is a retroprogesterone, a stereoisomer of progesterone, with an additional double bond between carbon 6 and 7. The progesterone molecule is almost “flat” while dydrogesterone is bent. With its cis-orientation, dydrogesterone appears to be highly selective for the progesterone receptor.2 Comparing oral dydrogesterone to oral micronized progesterone, dydrogesterone has over 5.6 times better oral bioavailability and requires a 10–20 times lower oral dose, regarding endometrial transformation.2-4

  • 2. Is dydrogesterone safe during pregnancy? 

    Dydrogesterone has a long history of use in early pregnancy.5 Dydrogesterone does not inhibit the formation of progesterone in the human placenta in early pregnancy, in contrast to progesterone and some other progestogens.6 It is estimated that the cumulative exposure for all indications since 1960 is more than 113 million patients. Of those, more than 20 million pregnancies were exposed to dydrogesterone in utero.7
  • 3. Why is dydrogesterone a good choice for treating dysfunctional uterine bleeding (DUB)? 

    Dysfunctional uterine bleeding (DUB), which is not due to pelvic or systemic diseases, is most frequently associated with the absence of ovulation. In these cases, irregular cycles are the result of prolonged endometrial growth stimulated by estrogen without endometrial transformation and withdrawal bleeding.The rationale for using dydrogesterone during the second half of the menstrual cycle (day 11 to day 25) is to induce endometrial transformation and trigger menstrual bleeding on withdrawal.9

    Treatment with dydrogesterone has been shown in numerous clinical studies to restore the regularity of menstrual cycles, reduced menstrual blood loss and duration of bleeding, and reduced pain and anxiety levels during menstruation in women with irregular menstrual cycles.10-12

  • 4. Why is dydrogesterone treatment effective in reducing the risk of threatened and recurrent miscarriage although it does not increase the progesterone level in blood samples? 

    Dydrogesterone administration does not increase progesterone levels; dydrogesterone works because it binds to the same receptors as progesterone and it does so with greater selectivity.2 There are no commercially available assays to measure dydrogesterone levels in the blood. However, the reported clinical outcomes with dydrogesterone support its effectiveness in reducing the risk of threatened and recurrent miscarriage.13-16

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