Posted by: cb | 2008/08/19


i would like to find out how long after taking Duphaston should you start menstruating? Went to Gynae to find out why my cycle is so long this month 48 days. Did an internal sonar and there is a small cyst, but she says nothing to worry about, its very small. She gave me 5 tablets (Duphaston)to be taken, and still nothing. According to the ovulation detection kits, I did ovulate this month, day 22. I usually have cycles between 32-35 days. What could possibly be the problem?

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Dear CB

Duphaston is a very weak progesterone and in some cases may not be strong enough to induce a bleed. However I would still suggest that wait atleast another 4-5 days and should there be no change, contact your gynaecologist again. Your ovulation is certainly delayed and is suggestive of a very poor follicular phase development i.e. the phase of the build-up to ovulation and this may be indicative of poor egg quality or poor hormone production from the pituitary gland. I would recommend that ovulation be stimulated by means of fertility preparations, either tablets or injections and that careful follicle tracking be done simultaneously by means of ultrasound scanning so as to establish whether there is adequate response to the induction treatment. Furthermore, once ovulation has occurred I would suggest that some form of luteal support be introduced as well and in this case Duphaston or Cyclogest may be considered. The need for progesterone supplementation after ovulation is in order to promote implantation and to allow the lining of the womb to be more receptive.

Answered by: Dr M.I. Cassim

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