Aygestin: Progesterone Therapy for Endometriosis and Abnormal Uterine Bleeding
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Synonyms | |||
Aygestin (norethindrone) is a prescription progestin medication used to treat a range of gynecological conditions by mimicking the effects of the natural hormone progesterone. It is primarily indicated for the management of abnormal uterine bleeding, amenorrhea, and endometriosis. By regulating or suppressing endometrial growth, Aygestin helps restore hormonal balance, alleviate painful symptoms, and prevent the complications associated with uncontrolled endometrial proliferation. Its well-established efficacy and predictable pharmacokinetic profile make it a cornerstone in hormonal therapy protocols.
Features
- Active ingredient: Norethindrone (a synthetic progestin)
- Available in 5 mg oral tablet formulation
- Bioidentical activity to endogenous progesterone
- Standardized hormonal potency per dose
- Prescription-only medication requiring clinical oversight
- Manufactured under strict pharmaceutical quality controls
Benefits
- Effectively manages and reduces abnormal uterine bleeding episodes.
- Provides symptomatic relief from endometriosis-associated pain.
- Helps restore regular menstrual cycles in patients with amenorrhea.
- Reduces risk of endometrial hyperplasia in high-estrogen states.
- Offers a non-surgical hormonal management option for certain gynecological conditions.
- Well-characterized safety profile with decades of clinical use.
Common use
Aygestin is commonly prescribed for the treatment of secondary amenorrhea, abnormal uterine bleeding due to hormonal imbalance without organic pathology, and endometriosis. It is also used as a component of hormone replacement therapy (HRT) in postmenopausal women with an intact uterus to counteract estrogen-induced endometrial proliferation. Off-label uses may include management of premenstrual dysphoric disorder (PMDD) and contraception in specific populations, though other progestins are typically preferred for contraceptive purposes.
Dosage and direction
Dosage varies significantly based on indication and patient response. For abnormal uterine bleeding: 5 mg daily for 5-10 days during the second half of the menstrual cycle. For endometriosis: 5 mg daily for 14 days per cycle, may be increased gradually. For amenorrhea: 5-10 mg daily for 5-10 days. Always take at the same time each day with or without food. Do not crush or chew tablets. Follow the specific dosing regimen prescribed by your healthcare provider, as duration and dosage require individualization based on clinical response and tolerability.
Precautions
Use with caution in patients with history of depression, asthma, diabetes, migraine, epilepsy, hypertension, cardiac dysfunction, or renal impairment. May cause fluid retention; use carefully in patients with conditions that might be aggravated by fluid retention. Monitor patients with history of psychic depression; discontinue if depression recurs to significant degree. Long-term use may decrease glucose tolerance. May mask onset of climacteric. Not indicated for use before menarche. Use with caution in adolescents until bone growth is complete.
Contraindications
Known hypersensitivity to norethindrone or any component of the formulation; known or suspected pregnancy; undiagnosed abnormal genital bleeding; history of or current thrombophlebitis or thromboembolic disorders; cerebral vascular disease; coronary artery disease; known or suspected breast carcinoma; estrogen-dependent neoplasia; benign or malignant liver tumors; active liver disease; history of idiopathic jaundice of pregnancy; severe pruritus of pregnancy; herpes gestationis; otosclerosis with deterioration during pregnancy.
Possible side effect
Common: nausea, vomiting, headache, dizziness, breast tenderness, changes in weight, edema, acne, hirsutism, alopecia, changes in libido, fatigue, insomnia, depression, mood swings. Less common: cholestatic jaundice, anaphylaxis, anaphylactoid reaction, hypertension, thrombophlebitis, pulmonary embolism, retinal thrombosis, optic neuritis. Rare: neoplasms including hepatic adenomas and breast cancer. Most side effects are dose-dependent and may diminish with continued use or dosage adjustment.
Drug interaction
Strong CYP3A4 inducers (carbamazepine, phenytoin, rifampin) may decrease norethindrone levels. Strong CYP3A4 inhibitors (ketoconazole, itraconazole) may increase norethindrone levels. May decrease effectiveness of bromocriptine. May alter insulin requirements in diabetic patients. May reduce lamotrigine levels potentially increasing seizure risk. Concurrent use with other hepatotoxic drugs may increase risk of liver damage. May interfere with laboratory tests including thyroid function, coagulation parameters, and metyrapone test.
Missed dose
If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not double doses. If vomiting occurs within 3-4 hours of taking a dose, consider it a missed dose. For specific dosing regimens (particularly for bleeding control), contact your healthcare provider for instructions, as timing is critical for therapeutic effect.
Overdose
No serious adverse effects have been reported with acute overdose. Possible effects may include nausea, vomiting, drowsiness, and withdrawal bleeding in females. There is no specific antidote. Treatment should be symptomatic and supportive. Gastric lavage may be considered if ingestion was recent. Monitor vital signs and provide appropriate supportive care based on symptoms presented.
Storage
Store at controlled room temperature (20-25°C or 68-77°F). Excursions permitted to 15-30°C (59-86°F). Keep container tightly closed. Protect from light and moisture. Keep out of reach of children and pets. Do not use after expiration date printed on packaging. Properly dispose of unused medication through take-back programs or according to FDA guidelines.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting, changing, or stopping any medication. The complete prescribing information should be reviewed before initiating therapy. Individual results may vary based on patient-specific factors. Not all possible uses, precautions, side effects, or interactions are listed here.
Reviews
Clinical studies demonstrate Aygestin’s efficacy in controlling abnormal uterine bleeding in approximately 85-90% of cases when used appropriately. For endometriosis management, studies show significant pain reduction in 70-80% of patients after 3-6 months of therapy. Patient satisfaction surveys indicate generally favorable tolerability profile, though individual responses vary considerably. Long-term safety data supports its use for extended periods when medically indicated with appropriate monitoring. Many clinicians consider it a first-line option for hormonal management of certain gynecological conditions due to its predictable effect and extensive clinical experience.