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.
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.
Side‑by‑side comparison table
| 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
- Identify the primary goal. Are you supporting a pregnancy, managing menopause, or treating menstrual irregularities?
- Consider the route you prefer. Oral tablets are convenient, but if you want to avoid first‑pass metabolism, vaginal gel might be better.
- Check for contraindications. History of thromboembolism, liver disease, or hormone‑sensitive cancers can narrow choices.
- Factor in cost and insurance coverage. In Australia, Medicare often subsidises medroxyprogesterone acetate more than branded Duphaston.
- Review side‑effect tolerance. If acne is a concern, avoid norethisterone; if drowsiness bothers you, steer clear of micronized progesterone.
- 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.
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.
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
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.