After Duphaston, no periods: when they start, 10 days and no periods, what to do

When the absence of menstruation is associated with a lack of progesterone, then drugs containing this hormone in their chemical composition can help restore the cycle. Duphaston is one of these drugs. Often women note that after Duphaston there are no periods or they start earlier than expected. Why is this happening? Do these phenomena relate to pathology? What should you do when faced with such violations? This article will help answer all your questions.

Why is menstruation delayed?

Time “X” has arrived, but menstruation has not begun; there are many reasons for the absence of menstruation:

Pregnancy

If there is a delay, or even absence of menstruation for more than 10 days, the first step is to exclude pregnancy. As they say, an unloaded gun fires once a year. That is, despite the protective measures taken, there is still a chance of getting pregnant (see Duphaston during pregnancy).

Postpartum period

Menstruation should not wait at least 4 (or better yet, weeks after childbirth, despite the fact that the woman adheres to artificial feeding. In the first 6 to 8 weeks after birth, the wound surface of the uterus (at the place where the placenta is located) should heal and grow a new functional layer of the endometrium, ready for desquamation. And if a woman is breastfeeding, then she has increased prolactin in her blood, which inhibits the production of FSH and LH in the pituitary gland, which, accordingly, block the secretion of estrogen and progesterone and changes in the endometrium (transformation and secretion) necessary for its rejection - menstruation.

Puberty

During puberty, an irregular menstrual cycle is considered normal for two years after menarche, which indicates unsteady hormonal levels and constant “jumps” of hormones. There is a shortening or lengthening of the cycle, which is accompanied by either a delay in menstruation or its unexpected onset. If after the specified time the cycle has not been regulated, you should undergo an examination and exclude other causes of delayed menstruation.

Anovulation

Lack of ovulation can occur in a healthy woman in 2–3 menstrual cycles throughout the year (see ovulation test). The corpus luteum does not form due to anovulation, and the proliferative phase does not give way to the secretory phase, that is, the functional layer of the endometrium does not grow and there is nothing to be rejected. Such anovulatory cycles occur due to short-term disruptions in the hypothalamic-pituitary-ovarian system under the influence of various but short-term factors (climate change, stress, physical overload).

Poor nutrition

Poor and insufficient nutrition, including strict diets for weight loss, affect the menstrual cycle. The level of estrogen, which is synthesized not only in the ovaries, but also in adipose tissue, decreases with a sharp weight loss, which leads to hormonal disorders up to the development of amenorrhea.

Overweight

Excess body weight can also cause persistent delays in menstruation, oligomenorrhea and amenorrhea. Estrogens, synthesized in large quantities by adipose tissue, are converted into androgens, which causes hyperandrogenism, cycle disruption and changes in appearance (acne, stretch marks, hirsutism and others).

Artificial or spontaneous termination of pregnancy

Both medical abortion and miscarriage are stressful for the body; sudden changes in hormonal levels after an interrupted pregnancy cause malfunctions in the hypothalamic-pituitary-ovarian system and lead to cycle disruption (short and scanty menstruation, their delay).

Gynecological hormonal diseases

Polycystic ovary syndrome, endometriosis, ovarian tumors and uterine cancer can be accompanied by prolonged delays in menstruation with subsequent bleeding.

Taking hormonal drugs

Preventing pregnancy with hormonal drugs (see oral contraceptives pros and cons) or treating endocrine pathology also affects the regularity of the menstrual cycle and provokes delayed menstruation.

Premenopause

With age, the production of hormones in the ovaries decreases, which is often accompanied by hormonal fluctuations and menstrual irregularities (the body prepares for menopause).

Infectious diseases of the uterus and appendages

Useful video

To learn why periods disappear, watch this video:

How does duphaston work?

The active ingredient of Duphaston is dydrogesterone. One tablet contains 10 mg. A feature of dydrogesterone is its similarity in structure, chemical and pharmacological effects with natural progesterone. Since dydrogesterone is not a derivative of testosterone, it does not cause the side effects inherent in most synthetic progestogens derived from androgens (excessive hair growth or deepening of the voice).

Also, the drug does not have anabolic activity (does not increase protein synthesis and muscle mass), does not affect the production and metabolism of glucocorticoids and temperature, including basal temperature (for example, when taking COCs, there is no point in measuring basal temperature). Dydrogesterone supports the beneficial effects of estrogens on blood lipids, but differs in that it does not affect blood clotting. Also, dydrogesterone does not have a negative effect on carbohydrate metabolism and liver function.

Dydrogesterone replenishes the deficiency of its own progesterone in the body, that is, it promotes the “unfolding” of the second phase of the cycle - it loosens the endometrium, preparing it either for implantation of the egg or for rejection (menstruation). Thus, duphaston reduces the increased risk of endometrial hyperplasia or cancer due to excess estrogen, which is observed with long and regular delays in menstruation.

General information

As mentioned above, progesterone is a female sex hormone produced by the ovaries. When there is a lack of it in the body, the endometrium of the uterus suffers greatly, which leads to the development of uterine fibroids, endometriosis, etc.

A deficiency of this hormone also affects the process of conceiving a child - pregnancy either does not occur at all, or frequent miscarriages occur. This happens because progesterone:

Thickens the endometrium of the uterus and makes it loose, making it much easier for a fertilized egg to attach to its walls.
It has a relaxing and antispasmodic effect on the muscles of the uterus when pregnancy occurs.
Strengthens the maternal instinct in women.
The mammary glands are prepared for the upcoming lactation.

Not only the processes described above, but also the woman’s mood depend on the level of this hormone in the body, since it also affects the production of serotonin (the hormone of happiness). Therefore, with progesterone deficiency, a woman becomes irritable and prone to depression.

In addition, this hormone is responsible for the formation of the figure. When its concentration drops, body hair growth increases, facial features become coarser, etc. In other words, the figure begins to change from a feminine type to a masculine one.

Indications for use and dosage

The drug, in addition to inducing menstruation, is also used for other indications (in case of progesterone deficiency):

endometriosis - duphaston is prescribed from days 5 to 25 of the cycle, 1 tablet twice a day;
insufficiency of the second phase (luteal) and treatment of infertility caused by it - from 14 to 25 days of the cycle, 1 tablet;
premenstrual syndrome - from days 11 to 25, one tablet twice a day;
irregular menstruation - from 11 to 25 days, take a tablet twice a day;
amenorrhea - in combination with estrogens (from days 1 to 25, once a day), duphaston must be taken one tablet twice a day from days 11 to 25 of the cycle.

If the endometrial response to the drug according to ultrasound is not sufficient (the thickness of the endometrium in the second phase does not reach 10 mm), the dose of duphaston is increased to 20 mg.

How to induce menstruation with duphaston?

If there is a long delay in menstruation, you should see a doctor, who will first rule out pregnancy. If there is no pregnancy, then after carefully collecting anamnesis and complaints, the doctor determines the possible cause of the delay in menstruation.

In the case of the influence of external factors (stress, climate change, etc.), menstruation begins on its own after their effect is eliminated.
But in case of a continued delay of up to 10 days or more, it is recommended to take a blood test for hormones, and then begin drug treatment.
Duphaston to induce menstruation is prescribed in a dosage of 10 mg (1 tablet) twice a day for 5 days.
Menstruation begins after stopping the drug, or slightly before the end of the course.
A delayed effect is also possible, when menstruation “comes” 3 to 7 days after stopping duphaston.

If the patient complains of an irregular menstrual cycle and constant delays in menstruation, then she is prescribed a 3-6 month course of treatment with duphaston from the 11th to the 25th day of the cycle. As a rule, after such a course of treatment, the cycle is restored.

Side effect

Taking duphaston may be accompanied by a number of side effects.

First of all, during treatment with this drug, breakthrough uterine bleeding may occur, which is eliminated by increasing the dose of the drug.
Changes in the hematopoietic system and the development of hemolytic anemia are also possible (rare).
A number of women note the appearance of headaches or migraines, and increased sensitivity of the mammary glands.
The occurrence of allergic reactions (skin itching and rash, urticaria and, in rare cases, Quincke's edema) cannot be ruled out.
Possible liver dysfunction (weakness or malaise, jaundice and pain in the right hypochondrium).
And extremely rarely, duphaston provokes the development of edema of the extremities.

Features of the drug

Duphaston is a medication used for hormone replacement therapy. This hormonal drug is not tied to a specific age category: both young women and ladies after forty take it. For young women, the drug helps stabilize hormone levels and normalize the monthly cycle. During menopause, the medicine eliminates hormonal imbalance and unpleasant symptoms of menopause, prevents bleeding in the middle of the cycle, reduces pain, and stabilizes metabolism.

In general, women tolerate the drug well, but the following side effects from Duphaston are possible:

headache;
allergy to Duphaston;
sometimes women gain weight;
your chest may hurt;
thrush appears;
daub after Duphaston;
skin rash.

One of the possible side effects is an allergy to Duphaston. In most cases, the drug component, dydrogesterone, acts as an allergen. Often allergic reactions manifest as a rash on the skin.

However, there are other manifestations of allergies to Duphaston:

skin itching;
nausea and vomiting;
bloating;
abdominal pain;
frequent sneezing;
overweight;
stuffy nose, difficulty breathing, copious nasal discharge;
increased lacrimation;
headaches and dizziness;
peripheral or angioedema;
suffocation;
sense of smell worsens;
taste sensations disappear;
Quincke's edema;
increase in body temperature.

If such symptoms appear, it is recommended to immediately consult a doctor, especially if the allergy to Duphaston is severe.

Is Duphaston a contraceptive? Any gynecologist should know the answer: no. If you drink Duphaston after a contraceptive, on the contrary, the chances of conception increase.

Instructions for use of Duphaston.

Duphaston analogs

There are a number of drugs whose mechanism of action is similar to duphaston. A distinctive feature of all of the listed duphaston analogues is their ability to cause lethargy and drowsiness and reduce concentration.

Utrozhestan

The active substance of this medicine is natural micronized progesterone, which is obtained from plant materials. Utrozhestan is available in gelatin capsules, which are taken either orally (orally) or administered intravaginally. One capsule contains 100 active substances. The dose for treatment is selected individually in each specific case and depends on the form of the disease and the severity of clinical symptoms. Utrozhestan, like Duphaston, can be taken during pregnancy. Price: 28 pcs 410 rub.

Iprozhin

The active ingredient of the drug is progesterone, obtained synthetically. Iprozhin is also available in capsules, which can be taken orally or administered intravaginally. One capsule contains 100 mg of progesterone. Price: 15 pieces 380 rub.

Crinon

Crinone is available in gel form. One applicator contains 1.125 g. artificially synthesized progesterone. The applicators are inserted into the vagina. Price: Crinon 2200-2700 rub.

Prajeesan

This drug also contains synthetic progesterone, 100 or 200 mg per capsule. Oral and intravaginal administration of prajisan is allowed. Price: 10 pcs. 270 rub.

Question answer

I had a long delay, the pregnancy test was negative. The doctor prescribed me to take duphaston. After finishing the treatment, a dark spotting discharge began, which lasted only 2 days. This is fine?

Yes, after the first course of taking the drug, periods do not last long and are quite scanty, which is explained by incomplete proliferation of the endometrium, that is, the uterine mucosa was not yet completely ready for rejection, since the functional layer of the endometrium had not reached the required thickness. After taking Duphaston for three months, hormonal levels and the menstrual cycle will level out and menstruation will become more intense and longer.

After stopping duphaston, my period did not start on the 5th or 7th day. The pregnancy test is questionable. What to do?

Of course, first of all, it is worth excluding/confirming pregnancy, donating blood for hCG and performing an ultrasound of the uterus. In 90% of cases, pregnancy is confirmed.

The doctor prescribed me duphaston for a long delay, but after stopping the drug, menstruation did not begin. What is this connected with?

If pregnancy is 100% excluded, then perhaps your estrogen level is too low, which did not cause proliferation of the endometrium in the first phase, and, accordingly, could not spur the second – secretory phase of the cycle. Thus, the endometrium turned out to be “immature” and not at all prepared for desquamation - menstruation. It is necessary to examine the level of estrogen in the first phase and the content of progesterone in the second and adjust the treatment of the disrupted menstrual cycle with estrogen and progesterone preparations.

Does taking duphaston increase weight?

The drug enhances metabolic processes, that is, it accelerates the absorption of nutrients, which can “stimulate” appetite and provoke weight gain. When treating with duphaston, physical inactivity should be avoided and appetite controlled, then the weight will remain at the same level. There may be some increase in body weight due to peripheral edema, but they disappear with the onset of menstruation on their own.

Is it possible to drink alcohol while being treated with duphaston?

Drinking alcoholic beverages is not advisable (but not prohibited) during treatment with duphaston. The drug is metabolized in the liver, and alcohol accelerates this process, so the therapeutic effect of duphaston may decrease due to alcohol consumption.

Is it possible to speed up periods with duphaston?

Yes, taking the drug from the 11th day of the cycle allows you to bring the onset of menstruation closer, but doctors categorically do not recommend doing this. All hormonal drugs affect the body’s hormonal levels, and an “innocent” desire to shift the cycle in one direction or another can lead to ovarian dysfunction and even infertility.

Treatment of endometrial hyperplasia, endometriosis and uterine fibroids

Duphaston for endometrial hyperplasia helps stabilize the balance of hormones in the female body. If endometrial hyperplasia is not treated, the pathology will progress. After taking the drug in premenopause, the menstrual cycle becomes regular, the increased abundance of blood discharge and the likelihood of bleeding in the middle of the cycle disappear. As for postmenopause, vaginal bleeding disappears completely.

Often during menopause, endometriosis disappears on its own - this is a completely physiological process. If the disease continues to develop, doctors prescribe progesterone medications. This drug reduces the production of estrogen, the endometrium stops growing and the disease will no longer progress. Thanks to this remedy, you can get rid of pain in the lower abdomen that occurs due to overgrown endometrial tissue.

During menopause, doctors prescribe taking Duphaston for uterine fibroids. However, it must be taken into account that taking the drug is possible only when fibroids are simultaneously diagnosed with endometrial hyperplasia or endometriosis. Combined with the mentioned diseases, myomatous nodes are of estrogen nature. Therefore, in order to slow down their growth, it is necessary to regulate the effect of estrogen, which is what this remedy does.

It happens that after taking it, brown discharge begins. Such discharge during treatment may indicate polyps in the uterus.

A similar pathology appears in women at any age, but the largest percentage of cases occur at the age of 40 years and older.

Expert opinion

Alexandra Yurievna

General practitioner, associate professor, teacher of obstetrics, work experience 11 years.

It is after 40 years that a hormonal imbalance occurs in the body, which is the main cause of the appearance of polyps. Basically, polyps are removed surgically, so we can say that the polyp and Duphaston are incompatible. Duphaston for polyps in the uterus is widely used to prevent the appearance of new formations.

Doctors have different opinions about the benefits of taking the drug. Most pharmaceutical companies write that the product stops the growth of the uterine mucosa and reduces the risk of its cells degenerating into cancerous ones.

However, Canadian studies and evidence-based medicine indicate a high risk of cancer when taking progesterone drugs. Draw your own conclusions and consult only competent and attentive specialists.