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Frequently Asked Questions
What is dydrogesterone?
Dydrogesterone is a retroprogesterone — a stereoisomer of progesterone — used outside the US for endometrial protection in combined HRT and for threatened or recurrent miscarriage support. It is highly selective for the progesterone receptor with minimal androgenic, estrogenic, or glucocorticoid activity.
Is dydrogesterone available in the US?
No. Dydrogesterone is not FDA-approved and is not commercially available in the United States. It is widely approved across Europe, the UK, and Asia (Duphaston, Femoston).
How does it compare to micronized progesterone?
Both have a more favorable breast cancer signal than older synthetic progestins in observational cohorts (E3N). Dydrogesterone has lower sedative effect than micronized progesterone (which has neuroactive allopregnanolone metabolites) and is often preferred by women who experience excessive drowsiness with oral progesterone.
What are the main risks?
Observational data suggest a neutral-to-favorable breast cancer signal compared with synthetic progestins. As with all progestogens added to estrogen, monitoring for breast and endometrial changes remains important.
How is dydrogesterone dosed in HRT?
Typical doses are 5–10 mg daily in continuous combined HRT or 10 mg for 12–14 days per month in sequential regimens. Dosing follows the prescribing physician's protocol.
What are common side effects?
Headache, breast tenderness, nausea, and breakthrough bleeding can occur. Sedation is less common than with oral micronized progesterone.
Can I get dydrogesterone without a prescription?
No. Dydrogesterone is a prescription medication in countries where it is approved. It is not legally available in the US.
How do I find a doctor who prescribes dydrogesterone?
Within the US, dydrogesterone is not available. Patients abroad should consult a local menopause or reproductive medicine specialist. TruthTides lists clinicians experienced with menopausal HRT alternatives.
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