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Hormonal treatment of endometriosis: duphaston HORMONAL TREATMENT OF ENDOMETRIOSIS: DUPHASTON
Duphaston has been used to treat women with endometriosis in Australia for over 25 years. It has also been used to treat a variety of other conditions, including amenorrhea (absence of periods), dysmenorrhoea (painful periods), PMS (premenstrual syndrome) and abnormal uterine bleeding.
Duphaston is a progestogen (synthetic progesterone) which is very similar to the naturally occurring progesterone produced by the ovaries.
Duphaston is manufactured by Ethnor in the form of small, white tablets, each of which contain 10 milligrams of Duphaston. It is sometimes also known by its chemical name, dydrogesterone.
How Duphaston works
It is not known precisely how Duphaston eradicates endometrial implants because, unlike the other drugs used in the treatment of endometriosis, it does not stop menstruation and it does not usually stop ovulation at the dosages that are most commonly used. It is thought that Duphaston probably works by inhibiting the growth of the misplaced endometrial cells in some way, causing them to gradually waste away.
Dosages of Duphaston generally used
There are several approaches to the use of Duphaston for the treatment of endometriosis. The dosage recommended will depend largely on the practices of the gynecologist and, to a lesser degree, on the severity of the condition and the woman's response to the treatment.
The majority of gynecologists will recommend 10 to 30 milligrams of Duphaston daily (one to three tablets daily) for six to twelve months. A few gynecologists will recommend taking the tablets cyclically from the 5th to the 25th day of the menstrual cycle each month for six to twelve months.
At these relatively low dosages most women will continue to menstruate and many will continue to ovulate regardless of whether the Duphaston is taken daily or cyclically.
In contrast, some gynecologists will recommend significantly higher dosages of Duphaston because they believe that the treatment is more likely to be effective if menstruation is stopped. These gynaecologists will generally recommend 30 to 60 milligrams of Duphaston a day (three to six tablets a day) for six to twelve months. The dosage recommended will usually depend on the response to the drug, the final dosage usually being the minimum required to stop menstruation and ovulation.
Although the usual length of treatment with Duphaston is six to twelve months there is no evidence that prolonged or repeated courses cause long-term side effects.
You should make an appointment to visit your gynecologist about six to eight weeks after you start your course of Duphaston so that you can discuss how the treatment is progressing.
Thereafter, you should visit every two to three months for the remainder of your course of Duphaston.
Duphaston can only be supplied under the Pharmaceutical Benefits Scheme for endometriosis if you have been definitely diagnosed during a laparoscopy or laparotomy and if your doctor fills in a special prescription form known as an 'Authority'. If this is done one month's supply of Duphaston will only cost you the maximum cost of a script under the Pharmaceutical Benefits Scheme as opposed to its full cost.
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