Duphaston (dydrogesterone) vs other progesterone options - detailed comparison

Duphaston (dydrogesterone) vs other progesterone options - detailed comparison
Olly Steele Oct, 17 2025

Progesterone Option Comparison Tool

Choose your priorities

Select the factors that matter most for your situation to see which progesterone options are best suited for you.

Your recommended options

Selected criteria:

  • Medical need:
  • Preferred route:
  • Top side effect concern:
  • Budget preference:

Key Takeaways

  • Duphaston contains dydrogesterone, a synthetic progestogen with high oral bioavailability.
  • Micronized progesterone, medroxyprogesterone acetate, norethisterone and vaginal progesterone gel are the most common alternatives.
  • Side‑effect profiles differ: Duphaston tends to cause fewer androgenic symptoms than norethisterone, while vaginal gel avoids first‑pass metabolism.
  • Cost varies widely - generic dydrogesterone is usually cheaper than branded micronized progesterone products.
  • Choosing the right option depends on the indication (e.g., luteal‑phase support, HRT, menstrual disorders) and patient preferences.

What is Duphaston?

Duphaston is a brand‑name tablet that contains dydrogesterone, a synthetic progestogen designed to mimic natural progesterone activity while offering better oral stability. It was first launched in the 1960s and has become a staple in many hormonal‑therapy protocols, especially in Europe and Australia.

How does dydrogesterone work?

Dydrogesterone binds to progesterone receptors in the uterine lining, preparing it for implantation and maintaining a pregnancy‑friendly environment. Unlike some synthetic progestins, it has minimal affinity for androgen or mineralocorticoid receptors, which translates into fewer side effects like acne or water retention.

Typical uses of Duphaston

Doctors prescribe Duphaston for several reasons:

  • Luteal‑phase support in assisted reproductive technologies (IVF, IUI).
  • Treatment of irregular or heavy menstrual bleeding.
  • Hormone replacement therapy (HRT) for post‑menopausal women when combined with estrogen.
  • Management of endometriosis‑related pain.
Group of moe characters each displaying a different progesterone form.

Common alternatives to Duphaston

When Duphaston isn’t available or a patient has specific preferences, clinicians often turn to one of these options:

  • Micronized progesterone - the closest to natural progesterone, usually taken orally or vaginally.
  • Medroxyprogesterone acetate (brand name Provera) - a potent synthetic progestin taken orally.
  • Norethisterone - another oral progestin with notable androgenic activity.
  • Vaginal progesterone gel (e.g., Crinone) - delivers progesterone directly to the uterus, bypassing the liver.

Side‑effect snapshot

Below is a quick glance at how the most frequent adverse effects line up. The intensity often hinges on the dose and the route of administration.

  • Duphaston (dydrogesterone): mild nausea, breast tenderness, occasional headache.
  • Micronized progesterone: drowsiness, bloating, rare mood swings.
  • Medroxyprogesterone acetate: weight gain, mood changes, rare breakthrough bleeding.
  • Norethisterone: acne, oily skin, increased appetite.
  • Vaginal progesterone gel: local irritation, discharge, minimal systemic side effects.

Cost considerations (2025 market snapshot)

Cost is a practical driver, especially for long‑term HRT. Prices shown are average Australian retail rates for a typical 30‑day supply.

  • Duphaston (brand): AUD55-70 per pack of 30×10mg tablets.
  • Generic dydrogesterone: AUD30-45 for the same strength.
  • Micronized progesterone (capsules): AUD65-80 for 30×200mg.
  • Medroxyprogesterone acetate: AUD20-35 for 30×10mg.
  • Norethisterone: AUD15-25 for 30×5mg.
  • Vaginal progesterone gel (single‑use applicators): AUD85-110 for a 30‑day course.
Anime doctor and patient discussing progesterone options with icons.

Side‑by‑side comparison table

Comparison of Duphaston (dydrogesterone) and common alternatives
Attribute Duphaston (dydrogesterone) Micronized progesterone Medroxyprogesterone acetate Norethisterone Vaginal progesterone gel
Route Oral tablets Oral capsules or vaginal capsules Oral tablets Oral tablets Vaginal gel
Typical dose (HRT) 10mg daily 200mg nightly 10mg daily 5mg daily 90mg nightly (one applicator)
Oral bioavailability ≈95% ≈12% (first‑pass) ≈80% ≈65% - (bypasses gut)
Androgenic activity Low None Low Moderate None
Key side effects Nausea, breast tenderness Drowsiness, bloating Weight gain, mood swings Acne, oily skin Local irritation
Cost (30‑day) AUD55-70 (brand) / AUD30-45 (generic) AUD65-80 AUD20-35 AUD15-25 AUD85-110
Best for Luteal support, HRT where oral stability matters Patients preferring natural progesterone profile Short‑term contraception, endometrial protection When strong progestogenic effect needed quickly Infertility cycles requiring high uterine concentrations

Pros and cons in practice

Going beyond the table, here’s how clinicians weigh each option in real‑world settings.

  • Duphaston (dydrogesterone):
    • Pros - high oral bioavailability, predictable pharmacokinetics, low androgenic side effects.
    • Cons - brand price can be steep; not always covered by insurance.
  • Micronized progesterone:
    • Pros - closest mimic to endogenous progesterone, safe in pregnancy, useful for women worried about synthetic hormones.
    • Cons - poor oral absorption forces higher doses; may cause drowsiness.
  • Medroxyprogesterone acetate:
    • Pros - inexpensive, strong progestogenic effect, works well for endometrial protection in estrogen therapy.
    • Cons - higher risk of weight gain and mood changes; not ideal for long‑term HRT for some women.
  • Norethisterone:
    • Pros - rapid onset, useful for breakthrough bleeding control.
    • Cons - androgenic side effects can be uncomfortable; not the first choice for fertility cycles.
  • Vaginal progesterone gel:
    • Pros - delivers high uterine concentration without systemic exposure; excellent for IVF luteal support.
    • Cons - more expensive, requires applicator, may be messy for some patients.

How to choose the right option - a quick decision guide

  1. Identify the primary goal. Are you supporting a pregnancy, managing menopause, or treating menstrual irregularities?
  2. Consider the route you prefer. Oral tablets are convenient, but if you want to avoid first‑pass metabolism, vaginal gel might be better.
  3. Check for contraindications. History of thromboembolism, liver disease, or hormone‑sensitive cancers can narrow choices.
  4. Factor in cost and insurance coverage. In Australia, Medicare often subsidises medroxyprogesterone acetate more than branded Duphaston.
  5. Review side‑effect tolerance. If acne is a concern, avoid norethisterone; if drowsiness bothers you, steer clear of micronized progesterone.
  6. Consult your prescriber. A short conversation can reveal which formulation aligns with your lifestyle and health profile.

Following this checklist helps you compare Duphaston with the alternatives in a structured way, rather than guessing.

Frequently Asked Questions

Can I switch from Duphaston to micronized progesterone?

Yes, but you should do it under doctor supervision. The doses aren’t 1:1 because oral bioavailability differs, so your clinician will adjust the amount accordingly.

Is Duphaston safe during pregnancy?

Duphaston is frequently used as luteal‑phase support in IVF cycles and is considered safe when prescribed at the recommended dose. It does not cross the placenta in harmful amounts.

Why does vaginal progesterone gel feel messy?

The gel is a thick, muco‑adhesive formulation designed to stay in the vagina for several hours. Some users experience slight discharge, but it usually clears within a day. Using a clean applicator each time helps keep it tidy.

Which option has the lowest risk of weight gain?

Dydrogesterone (Duphaston) and micronized progesterone generally have a lower association with weight changes compared with medroxyprogesterone acetate, which is known for that side effect.

Do I need blood tests before starting any of these progestogens?

Baseline liver function and hormonal panels are advisable, especially if you have a history of liver disease or endocrine disorders. Your doctor will decide which tests are required based on your medical history.

14 Comments
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    Darryl Gates October 17, 2025 AT 16:37

    When weighing progesterone options, start with the patient’s primary goal – whether it’s luteal‑phase support, HRT, or managing irregular bleeding. Duphaston offers a predictable oral dose thanks to its high bioavailability, which can simplify adherence. If cost is a major concern, the generic dydrogesterone version often undercuts many micronized products. Keep an eye on side‑effects: mild nausea and breast tenderness are common, but they’re usually manageable. For patients worried about androgenic symptoms, Duphaston’s low activity gives it an edge over norethisterone.

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    Kevin Adams October 18, 2025 AT 14:50

    Dude you read the table and it’s like a saga of pills and gels you get to choose from and each has its own vibe and you’re stuck picking a hormone like it’s pizza toppings yeah

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    Katie Henry October 19, 2025 AT 13:03

    Esteemed readers, it is imperative to recognize that the pharmacokinetic profile of dydrogesterone distinguishes it from other progestogens. Its oral bioavailability approaches ninety‑five percent, thereby ensuring consistent plasma concentrations. Conversely, micronized progesterone suffers from considerable first‑pass metabolism, necessitating higher dosages. Moreover, the androgenic potential of norethisterone may precipitate dermatological concerns such as acne. In clinical practice, these nuances inform individualized therapeutic strategies.

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    Winston Bar October 20, 2025 AT 11:17

    Sure, because paying more always means better results.

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    genevieve gaudet October 21, 2025 AT 09:30

    i think its clear that teh choice between dyprogesterone and othrs is more than just money its about lifestyle and how u feel on each med i mean some ppl love the natural vibe of micronized while others prefer the steady oral dose of duphaston its all personal and definatly not one size fits all

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    Patricia Echegaray October 22, 2025 AT 07:43

    Wake up, folks! The pharma giants want you to believe the most expensive gel is the only safe route, but the truth is buried under glossy ads and nationalist rhetoric. Dudhaston’s generic form flicks the bird at the monopoly while still delivering low‑androgenic action. Don’t let the color‑coded marketing fool you-your body deserves transparency, not corporate propaganda.

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    Miriam Rahel October 23, 2025 AT 05:57

    From a pharmacological standpoint, medroxyprogesterone acetate presents a cost‑effective alternative, yet its metabolic side‑effects merit scrutiny. While the brand may appear appealing, the empirical data suggests that weight gain and mood fluctuations are not trivial concerns. Consequently, prescribers should balance fiscal considerations with patient quality of life.

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    Samantha Oldrid October 24, 2025 AT 04:10

    Oh great, another “cheaper is better” sermon-how original.

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    Malia Rivera October 25, 2025 AT 02:23

    Life is a series of choices, and the hormone you pick is a reflection of your values and your body’s whispers. If you cherish a natural feel, micronized progesterone whispers softly; if you crave predictability, Duphaston shouts confidence. Ultimately, the decision is yours, not the pharmaceutical treadmill.

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    lisa howard October 26, 2025 AT 00:37

    I have to admit, reading the exhaustive table felt like an odyssey through a hormone labyrinth. Each column promises a miracle, yet the reality is stitched together by chemistry and patient preference. Duphaston’s synthetic dydrogesterone shines with oral stability, delivering near‑complete absorption. This means fewer pills per cycle and a steadier plasma curve, something many patients appreciate. Micronized progesterone, though chemically closer to the body’s own hormone, suffers from a dismal oral bioavailability that forces clinicians to crank up the dose. The higher dose can translate into unwanted drowsiness, a side effect that some patients find intolerable. Medroxyprogesterone acetate, the stalwart of cheap oral progestins, carries a reputation for weight gain and mood swings, making it a less attractive long‑term option for many women. Norethisterone, with its moderate androgenic activity, can wreak havoc on the skin, leading to acne and oily complexion that many wish to avoid. Vaginal progesterone gel sidesteps first‑pass metabolism entirely, delivering the hormone directly to the uterus, which is a blessing in IVF cycles. However, the gel’s cost and the messiness of nightly applicators can be a deterrent for patients who value convenience. When you overlay cost, the picture becomes even more nuanced: generic dydrogesterone can be almost half the price of branded micronized capsules. Yet insurance formularies sometimes favor the older, cheaper medroxyprogesterone, leaving patients to navigate a financial maze. Side‑effect profiles also tip the scales; a patient prone to anxiety may shy away from medroxyprogesterone’s mood‑altering tendencies. Conversely, someone battling acne might avoid norethisterone like the plague. In the end, the “best” choice is a composite of efficacy, tolerability, cost, and personal lifestyle. So, before you pick a pill, sit down with your clinician, list your priorities, and let the data guide you rather than marketing hype.

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    Cindy Thomas October 26, 2025 AT 22:50

    I totally get the overwhelm – the table is a beast, but the key is to match the drug to what matters most to you 😊

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    Kate Marr October 27, 2025 AT 21:03

    Great summary! 👍 The bioavailability point really clears up a lot of confusion.

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    James Falcone October 28, 2025 AT 19:17

    Dude, stick with the home‑grown options – our own pharma can crank out solid pills without the overseas fluff.

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    Frank Diaz October 29, 2025 AT 17:30

    While your informal take captures the spirit, the nuance lies in pharmacodynamics, not in casual slang; a deeper dive reveals that receptor affinity dictates real‑world outcomes.

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