Can Dydrogesterone Prevent Pregnancy? A Look at Its Role in Reproductive Health

October 7, 2025 •

4 min read

Unlike many hormonal birth control methods, dydrogesterone is a synthetic progestin that does not inhibit ovulation and therefore cannot prevent pregnancy. This is a crucial distinction, as the medication is prescribed to treat conditions associated with a progesterone deficiency and support fertility.

Quick Summary

Dydrogesterone is a progestin that does not stop ovulation and is not a contraceptive, a key fact distinguishing it from birth control. Its purpose is to aid fertility and support pregnancy in women by acting on the uterine lining.

Key Points

Dydrogesterone is not a contraceptive: It does not prevent pregnancy by inhibiting ovulation.
It is used to support pregnancy: It is prescribed to help maintain pregnancies, particularly in cases of threatened or recurrent miscarriage.
Ovulation is not suppressed: Women can and often do ovulate normally while taking therapeutic doses of dydrogesterone.
Mechanism is pro-fertility: The drug works by supporting the uterine lining (endometrium) to make it more receptive to embryo implantation.
Use separate contraception: If pregnancy is not desired, an alternative, proven birth control method must be used.
Distinct from other progestins: Unlike many progestin-only contraceptives, dydrogesterone lacks the antigonadotropic effect that suppresses ovulation.

What is Dydrogesterone?

Dydrogesterone is a synthetic progestin, which is a type of medication that mimics the effects of the naturally occurring female hormone progesterone. It is often prescribed to treat conditions related to a deficiency of this hormone. The drug is structurally and pharmacologically similar to endogenous progesterone but is effective when taken orally, unlike natural progesterone which has low oral bioavailability. Dydrogesterone is a potent agonist of the progesterone receptor, meaning it binds to these receptors and triggers a biological response. However, its mechanism of action is distinct from hormonal contraceptives, and it is a common misconception that it can be used for pregnancy prevention.

How Dydrogesterone Works vs. Contraceptives

Dydrogesterone's Mechanism: Supporting Pregnancy

Dydrogesterone works directly on the uterus to prepare the endometrium (the lining of the uterus) for a potential pregnancy. When a woman's body is progesterone-deficient, the endometrium may not be adequately prepared to receive an embryo. By supplementing progesterone levels, dydrogesterone helps create a complete, secretory endometrium that is more receptive to implantation. In cases of threatened or recurrent miscarriage, it helps maintain the uterine lining to support the ongoing pregnancy. Crucially, at therapeutic doses, dydrogesterone does not interfere with the hypothalamic-pituitary-ovarian axis, meaning it does not prevent the release of the luteinizing hormone (LH) or follicle-stimulating hormone (FSH) that triggers ovulation. Women taking the medication can and do ovulate regularly, which is why conception can still occur.

How Hormonal Contraceptives Prevent Pregnancy

In contrast, hormonal contraceptives, such as combination pills, mini-pills, and injections, primarily work by preventing ovulation. They contain synthetic progestins (and often estrogen) that work systemically to suppress the hormonal signals from the brain that lead to the release of an egg. These methods also cause other changes that prevent pregnancy, such as:

Thickening cervical mucus: This creates a barrier that makes it difficult for sperm to pass through the cervix and reach an egg.
Thinning the uterine lining: This makes the endometrium less hospitable to implantation if an egg were to be fertilized.

Unlike dydrogesterone, which is often used in fertility treatments to improve the chances of pregnancy, hormonal contraceptives are specifically designed to be antifertility agents. Their entire mechanism is geared towards preventing conception through one or more of these pathways.

Key Indications for Dydrogesterone

Rather than preventing pregnancy, dydrogesterone is prescribed for a range of progesterone-related gynecological issues. These include:

Threatened and recurrent miscarriage: It is used to support pregnancy in women with a history of recurrent loss or signs of a threatened miscarriage.
Infertility due to luteal phase defect: For women struggling with infertility, it is used to support the luteal phase and enhance endometrial receptivity for embryo implantation.
Endometriosis: It helps relieve pain and symptoms of endometriosis by inhibiting the growth of ectopic endometrial tissue, often without inhibiting ovulation.
Menstrual disorders: It can regulate irregular menstrual cycles and treat conditions like premenstrual syndrome (PMS) and amenorrhea.
Hormone Replacement Therapy (HRT): When combined with estrogen, it protects the uterine lining against the risk of endometrial hyperplasia and cancer in postmenopausal women with an intact uterus.

Dydrogesterone vs. Hormonal Contraceptives: A Comparison


Feature	Dydrogesterone	Hormonal Contraceptives
Primary Purpose	To support fertility and pregnancy, and treat progesterone deficiency.	To prevent pregnancy.
Ovulation Inhibition	No, does not inhibit ovulation at therapeutic levels.	Yes, typically inhibits ovulation as a primary mechanism.
Mechanism of Action	Supports the uterine lining (endometrium) to make it receptive for implantation.	Suppresses hormonal cycles, thickens cervical mucus, and thins the uterine lining.
Effect on Fertility	Promotes fertility and is used in IVF and other treatments.	Inhibits fertility as its primary function.
Pregnancy Risk	Yes, pregnancy is still possible and is the intended outcome in many cases.	No, when used correctly, the risk of pregnancy is very low.

Why the Confusion?

The confusion around whether dydrogesterone can prevent pregnancy often stems from a misunderstanding of how different hormonal medications work. Since both dydrogesterone and hormonal contraceptives are synthetic hormones, people may incorrectly assume they have the same effect. The key difference lies in their mechanism of action and intended purpose. Dydrogesterone's role is to act as a friendly and welcoming signal to the uterus, preparing it for implantation and nourishing a developing embryo. In contrast, contraception sends signals that create a hostile environment for conception. It is essential for patients to clarify with their doctor whether a medication is for fertility support or birth control to ensure they are using the correct method for their needs.

Conclusion

Dydrogesterone is definitively not a method for pregnancy prevention. Its role in medicine is to support fertility and pregnancy, regulate menstrual cycles, and treat specific hormonal deficiencies and conditions like endometriosis. Because it does not inhibit ovulation, women can still become pregnant while using it, and for many, that is the desired outcome. For those who wish to avoid pregnancy, a separate and reliable form of contraception must be used alongside dydrogesterone, as it offers no protective effect. A clear understanding of the medication's purpose is vital for effective and safe reproductive health management. For more in-depth information on its uses and pharmacological profile, an authoritative source is the NIH website, which provides comprehensive details.

Frequently Asked Questions

Yes, you can get pregnant while taking dydrogesterone because it does not stop ovulation. In fact, it is often prescribed to women to support fertility and increase the chances of a successful pregnancy.

The primary function of dydrogesterone is to mimic the effects of natural progesterone by acting on the uterus. It is used to treat conditions caused by a progesterone deficiency, such as infertility, menstrual irregularities, and recurrent miscarriage.

Dydrogesterone differs from hormonal birth control because it does not suppress ovulation. Hormonal contraceptives prevent pregnancy primarily by stopping ovulation, whereas dydrogesterone works to support and maintain the uterine lining for potential implantation.

Yes, dydrogesterone is commonly used in fertility treatments, particularly for luteal phase support in procedures like in vitro fertilization (IVF). It is also used to treat luteal phase defects, which can hinder a woman's ability to conceive.

Dydrogesterone is sometimes given during early pregnancy to women with a history of recurrent miscarriage or threatened miscarriage. By supporting the uterine lining, it helps create a stable environment for the embryo to implant and grow.

No, at therapeutic levels, dydrogesterone does not inhibit or interfere with ovulation. This is one of its key features, distinguishing it from most other synthetic progestogens used for contraception.

If you wish to prevent pregnancy while taking dydrogesterone, you must use a separate, reliable form of contraception. Since dydrogesterone offers no contraceptive effect, another method, such as condoms or birth control pills, is necessary.

Like other medications, dydrogesterone can cause side effects, though they are often mild. These can include headache, nausea, breast tenderness, and menstrual irregularities. However, it is non-androgenic, meaning it does not cause side effects like weight gain or acne that are common with some other progestins.