From the Guidelines
Dufastone (dydrogesterone) should be considered as a treatment option for abnormal uterine bleeding, but only after ruling out underlying gynecological problems, and with careful consideration of the patient's medical history and potential side effects, as recommended by the most recent guidelines 1. When treating abnormal uterine bleeding with Dufastone, the typical dosage is 10 mg twice daily from day 5 to day 25 of the menstrual cycle.
Key Considerations
- Before initiating treatment with Dufastone, it is essential to consider an underlying gynecological problem, such as interactions with other medications, an STD, pregnancy, or new pathologic uterine conditions (e.g., polyps or fibroids) 1.
- If an underlying gynecologic problem is found, treat the condition or refer for care.
- If an underlying gynecologic problem is not found and the woman wants treatment, the following treatment options during days of bleeding can be considered: NSAIDs for short-term treatment (5–7 days), hormonal treatment (if medically eligible) with low-dose COCs or estrogen for short-term treatment (10–20 days) 1.
- Dufastone works by stabilizing the endometrial lining and counteracting estrogen dominance, which helps regulate bleeding patterns.
- Side effects are generally mild and may include headaches, nausea, or breast tenderness.
- Unlike some other progestins, dydrogesterone has minimal androgenic effects and doesn't significantly impact metabolic parameters.
- It should be avoided in patients with liver disease, known or suspected hormone-dependent tumors, or a history of thromboembolic disorders.
Treatment Approach
- Regular follow-up is important to assess treatment response, typically after 2-3 months of therapy.
- If bleeding persists despite treatment, further investigation may be necessary to rule out structural abnormalities or malignancy.
- The patient's goals and preferences should be taken into account when deciding on a treatment approach, and alternative contraceptive methods should be discussed if necessary 1.
From the Research
Considerations for Using Dufastone in Treating Uterine Bleeding or Other Gynecological Issues
- The effectiveness of Dufastone (also known as Duphaston) in treating uterine bleeding or other gynecological issues is supported by several studies 2, 3.
- Dufastone is a progestin that has been shown to be effective in reducing menstrual blood loss and improving symptoms in women with endometriosis 2.
- In a study comparing different treatments for heavy menstrual bleeding, progestogens such as Dufastone were found to be effective in reducing menstrual blood loss, although the evidence was rated as low certainty 4.
- Dufastone has also been used in combination with other medications, such as human menopausal gonadotropin, in controlled ovarian hyperstimulation protocols for in vitro fertilization and intracytoplasmic sperm injection treatments 3.
- The management of abnormal uterine bleeding in women taking hormonal replacement therapy, including those taking Dufastone, requires careful evaluation to rule out organic causes such as endometrial cancer 5.
Potential Side Effects and Interactions
- The potential side effects of Dufastone, such as weight gain, breast tenderness, and mood changes, should be considered when evaluating its use in treating uterine bleeding or other gynecological issues.
- Interactions between Dufastone and other medications, such as blood thinners, should also be considered 5.
Comparison with Other Treatments
- The effectiveness of Dufastone in reducing menstrual blood loss and improving symptoms has been compared to other treatments, such as non-steroidal anti-inflammatory drugs, antifibrinolytics, and combined oral contraceptives 4.
- The choice of treatment will depend on individual patient characteristics, such as age, desire for future pregnancy, and presence of other symptoms 4.