Duphaston contains dydrogesterone 10 mg, a progestogen. It is prescribed for irregular, absent, heavy or painful periods, endometriosis, as part of hormone replacement therapy, and in some pregnancy-related situations. It is not a contraceptive, and it does not prevent pregnancy.
What is Duphaston?
Duphaston is registered in South Africa as Schedule 4 — prescription-only:
| Product | Contains |
|---|---|
| Duphaston 10 mg | Dydrogesterone 10 mg tablet |
Dydrogesterone is a progestogen — a synthetic version of progesterone, the hormone dominating the second half of the menstrual cycle.
Understanding progesterone’s natural role explains most of what Duphaston does. After ovulation, progesterone stabilises the endometrium (the womb lining), holding it in a settled, secretory state. When progesterone falls at the end of a cycle, the lining sheds — that is a period.
Duphaston reproduces that:
- Taken for set days then stopped, the withdrawal triggers a period. This is how it regulates an erratic cycle or brings on a delayed one.
- Taken continuously, it keeps the lining stable, reducing heavy or irregular bleeding.
- Added to oestrogen in HRT, it protects the womb lining. This is not optional — oestrogen alone thickens the endometrium and raises the risk of endometrial cancer.
What distinguishes dydrogesterone from other progestogens is that it is structurally very close to natural progesterone and highly selective for progesterone receptors. It has little androgenic activity — so acne, unwanted hair growth and adverse effects on cholesterol are less of an issue than with some older progestogens such as medroxyprogesterone.
It also does not suppress ovulation at usual doses. That is the reason it is not a contraceptive — and it is a genuine point of confusion, because many hormonal medicines are. If you need contraception, use a separate method.
That same property is why dydrogesterone is one of the few progestogens used in early pregnancy in some settings.
What is Duphaston commonly used for?
- Irregular or absent periods (amenorrhoea), to regulate the cycle or induce a withdrawal bleed.
- Heavy or prolonged menstrual bleeding.
- Painful periods (dysmenorrhoea).
- Abnormal uterine bleeding, once serious causes have been excluded.
- Endometriosis, to suppress the tissue causing pain.
- Premenstrual syndrome, in some cases.
- As the progestogen part of HRT, alongside oestrogen.
- Luteal phase support in fertility treatment.
- Threatened or recurrent miscarriage, in some settings and under specialist care. This use is debated internationally, with differing guidance between countries — it is a decision for your doctor, based on your specific circumstances.
- Infertility due to luteal insufficiency.
It treats the hormonal pattern, not always the cause. Irregular bleeding has many possible causes — polycystic ovary syndrome, thyroid disease, fibroids, polyps, pregnancy and, importantly, endometrial cancer. Persistent abnormal bleeding, especially after menopause, needs investigation before it is simply treated.
How Duphaston fits into this medicine category
| Group | Examples | Role |
|---|---|---|
| Progestogens | Dydrogesterone (Duphaston), norethisterone, medroxyprogesterone | Cycle control, heavy bleeding, HRT |
| Injectable progestogen | Depo-Provera | Long-acting contraception |
| Combined hormonal contraceptives | Oestrogen + progestogen pills | Contraception, cycle control |
| HRT | Oestrogen with a progestogen | Menopausal symptoms |
| Hormonal IUD | Levonorgestrel IUS | Heavy bleeding and contraception together |
| NSAIDs | Mefenamic acid, naproxen | Period pain and heavy bleeding, non-hormonally |
For heavy periods where contraception is also wanted, a hormonal IUD is often more effective than tablets and worth asking about. See the general medicines hub and the HP553 guide.
What to check before using Duphaston
Take it exactly as prescribed, on the specific days you were told. With cyclical use the timing is what produces the intended effect — taking it irregularly generally produces irregular bleeding.
Do not rely on it for contraception. Use another method if you need one.
Tell your doctor or pharmacist if you:
- Are or might be pregnant. Dydrogesterone is used in pregnancy in some circumstances, but only under medical direction — do not take leftover tablets on your own.
- Are breastfeeding.
- Have had a blood clot — deep vein thrombosis or pulmonary embolism — or a clotting disorder or family history of clots.
- Have breast cancer, another hormone-sensitive cancer, or a history of one.
- Have liver disease, or have had jaundice or severe itching in pregnancy.
- Have undiagnosed vaginal bleeding. This needs investigating first — treating bleeding without knowing its cause can delay a diagnosis.
- Have migraine, particularly with aura.
- Have diabetes, high blood pressure, epilepsy, asthma or depression.
- Smoke, especially over 35.
- Take rifampicin, carbamazepine, phenytoin or St John’s wort, which reduce its effect.
Expect follow-up, particularly on long-term use or as part of HRT.
Possible cautions and when to ask a pharmacist or doctor
Common effects are headache, breast tenderness, nausea, abdominal pain, irregular bleeding or spotting, mood changes and tiredness. Dydrogesterone is generally well tolerated, and spotting is common in the first months.
Seek medical attention urgently if you develop:
- Pain, swelling, warmth or redness in a leg — possible deep vein thrombosis.
- Sudden breathlessness, chest pain or coughing blood — possible pulmonary embolism. Call emergency services.
- Sudden severe headache, visual disturbance, weakness or numbness on one side, or difficulty speaking — possible stroke.
- Yellowing of the eyes or skin, or severe abdominal pain.
- A new breast lump.
- New or worsening depression, or thoughts of self-harm.
- Severe migraine, or migraine with aura for the first time.
- Swelling of the face, lips or tongue, or a severe rash.
See a doctor rather than continuing if:
- Bleeding is heavy, prolonged or unpredictable despite treatment.
- You have bleeding after menopause, or bleeding after sex — these always need investigation.
- You have pelvic pain that is new or worsening.
- Periods do not return as expected after stopping.
- You might be pregnant.
- You are using it long term without review.
Bleeding is a symptom, not a diagnosis. Where Duphaston is prescribed for abnormal bleeding, it should follow an assessment rather than replace one.
Related medicine guides
Frequently asked questions
What is Duphaston 10 mg used for? Irregular, absent, heavy or painful periods, abnormal uterine bleeding, endometriosis, as the progestogen part of HRT, and in some pregnancy-related situations. It contains dydrogesterone.
Is Duphaston a contraceptive? No. It does not suppress ovulation at usual doses and does not prevent pregnancy. Use a separate method if you need contraception.
Will it bring on my period? Taken for a set number of days and then stopped, the withdrawal usually triggers a bleed within a few days. Your doctor sets the schedule.
Can I take it in pregnancy? It is used in pregnancy in some settings under specialist care, though the evidence is debated internationally. Only take it if a doctor has specifically prescribed it for you.
Is it a fertility treatment? It is sometimes used as luteal phase support in fertility treatment, but it does not itself cause ovulation.
How is it different from Provera? Both are progestogens. Dydrogesterone is closer in structure to natural progesterone, has little androgenic activity, and does not suppress ovulation.
Does it cause weight gain? Weight change is less commonly reported with dydrogesterone than with some older progestogens, but mention it to your doctor if it occurs.
Why is it given with oestrogen in HRT? Oestrogen alone thickens the womb lining and raises the risk of endometrial cancer. A progestogen protects against that.