Didrogesterona

dydrogesterone is evaluated for the following indications with varying evidence strength: Endometrial protection during estrogen MHT (evidence tier A), Luteal phase support in ART (evidence tier A), Irritable bowel syndrome (evidence tier F). See the full indication matrix with dosing and citations above on this page.

Common side effects of dydrogesterone (≥ 1 in 100): Headache, Breast tenderness, Breakthrough bleeding, Nausea, Mood changes. See the Safety section for uncommon and serious reactions.

Use in the first and second trimesters for ART or recurrent loss indications is acceptable. Without specific indication, routine pregnancy use is unjustified.

Transfers into milk in minimal amounts. Compatible with breastfeeding.

dydrogesterone is contraindicated in: Hypersensitivity; Undiagnosed vaginal bleeding; Progestogen-dependent (or suspected) tumors; Severe hepatic disease. Full list in the Safety section.

in patients without recurrent loss, evidence is lacking. Cramping and spotting more often reflect physiological processes than embryonic chromosomal abnormality.

the laboratory diagnosis of «progesterone deficiency» does not exist in international gynecology. Progesterone levels vary throughout the day and menstrual cycle. Endocrine causes of anovulatory infertility are diagnosed with other approaches — follicle tracking, hormone panels by clinical picture, extended workup as indicated.

in anovulation, luteal-phase progesterone is physiologically low because no corpus luteum formed. A progestogen does not treat the cause of anovulation. Management requires identifying the cause (PCOS, hypothalamic dysfunction, hyperprolactinemia, thyroid dysfunction, etc.).