Aygestin (Norethindrone) vs. Other Progestins - Full Comparison

Aygestin is a synthetic progestin (norethindrone) prescribed for menstrual disorders, endometriosis, and as part of hormonal contraception. It belongs to the class of progestins, which mimic the action of natural progesterone.

Why people look at Aygestin

Patients often turn to this medication when they need a low‑dose, oral progestin that can thin the uterine lining and reduce painful bleeding. In the UK, the NHS includes Aygestin in its formulary for moderate‑to‑severe endometriosis, offering a cheaper alternative to injectable options.

How Aygestin works

The active ingredient, norethindrone, binds to progesterone receptors in the endometrium, suppressing growth and stabilising the lining. This suppression cuts down on prostaglandin‑driven cramping and can also prevent ovulation when taken in a cyclic regimen.

Key attributes of Aygestin

• Formulation: 5mg oral tablet
• Typical dose for endometriosis: 5mg daily, often for 10‑day cycles repeated monthly
• FDA status: Approved prescription drug (ClassC pregnancy risk)
• Metabolism: Hepatic via CYP3A4; half‑life ≈7hours
• Common side‑effects: Weight gain, mood swings, breast tenderness

Popular alternatives

When clinicians compare progestins, they usually line up a handful of well‑known drugs. Each has a slightly different receptor profile, dosing schedule, and side‑effect fingerprint.

Medroxyprogesterone acetate (often known by the brand Depo‑Provera) is an injectable progestin given every 12weeks. It’s favoured for patients who dislike daily pills but can cause more pronounced bone‑density loss with long‑term use.

Levonorgestrel appears in many emergency‑contraception pills and intra‑uterine systems. Its high affinity for progesterone receptors makes it very effective at preventing ovulation, yet it carries a slightly higher risk of menstrual spotting.

Norethisterone acetate is another oral progestin, typically marketed as a 5mg tablet similar to Aygestin but with a slower release profile, which some patients find gentler on mood.

Dienogest is a newer, highly selective progestin often combined with estradiol for endometriosis. It’s praised for strong anti‑inflammatory effects but costs more than generic options.

Side‑effect snapshot

All progestins share a baseline of possible side‑effects, yet the intensity varies. Below is a quick visual guide.

When Aygestin is the right pick

If you need a low‑cost, once‑daily pill that can be tapered on and off, Aygestin often wins. It’s especially useful for:

• Women with mild‑to‑moderate endometriosis who want to avoid injections.
• Patients who need cycle‑specific therapy (e.g., 10‑day “pill‑off” regimens).
• Those on the NHS, where the 5mg tablet is fully reimbursed.

When to consider an alternative

Switching away from Aygestin makes sense if you experience:

• Severe mood instability that does not settle after 2‑3 cycles.
• Persistent weight gain (>5kg in 6months) despite lifestyle measures.
• A need for long‑acting contraception - in that case an IUD with levonorgestrel or a depot injection of medroxyprogesterone acetate may be more convenient.
• High‑risk breast‑cancer history; dienogest’s lower estrogenic impact could be preferable.

Cost and accessibility in the UK

The NHS lists Aygestin at a standard prescription charge of £9.35 (or free in certain exemptions). Medroxyprogesterone acetate injections are more expensive because they require a clinic visit. Levonorgestrel IUDs have a one‑off cost of about £150-£200, but last up to five years, making the per‑year price competitive.

Managing the switch

1. Consult your GP or specialist to review your symptom diary.
2. If moving to an injectable, schedule the first medroxyprogesterone acetate dose on day 1 of your next menstrual period.
3. For levonorgestrel IUD, a brief bridging with oral progestin (like Aygestin) may minimise bleeding spikes.
4. Monitor blood pressure, weight, and mood weekly for the first two months after any change.

Related concepts and guidelines

The National Health Service recommends reviewing progestin therapy every 12months, with particular attention to bone density for long‑term injectable users. The US FDA, meanwhile, mandates a black‑box warning for any ClassC progestin in pregnancy, reinforcing the need for reliable contraception if child‑bearing is not intended.

Understanding the broader category of hormonal contraception helps you weigh benefits beyond symptom control - such as reduced ovarian cyst formation and lower risk of certain cancers.

Quick take‑away

• Aygestin offers a cheap, daily oral option great for endometriosis and short‑term cycle control.
• Injectable medroxyprogesterone acetate provides long‑acting coverage but needs clinic visits.
• Levonorgestrel IUDs excel at high‑efficacy contraception with minimal daily maintenance.
• Norethisterone acetate is a close cousin of Aygestin with a smoother release curve.
• Dienogest shines in severe endometriosis but carries a higher price tag.

Frequently Asked Questions

Can I use Aygestin as a birth‑control method?

Aygestin can suppress ovulation when taken in a strict 10‑day regimen each month, but it is not as reliable as combined oral contraceptives or IUDs. Most clinicians reserve it for menstrual‑related issues rather than primary contraception.

What’s the biggest difference between Aygestin and medroxyprogesterone acetate?

The former is a daily oral tablet; the latter is an injection given every 12weeks. The injection provides continuous hormone levels but may affect bone density, while the tablet offers more flexibility and lower upfront cost.

Is there a risk of weight gain with Aygestin?

Weight gain is reported in up to 15% of users, usually modest (1‑3kg). Lifestyle modifications and regular monitoring can mitigate the effect.

How does Dienogest compare for endometriosis?

Dienogest has stronger anti‑inflammatory properties and often yields greater pain relief, but it costs roughly three times more than generic norethindrone tablets and may cause slight liver‑enzyme elevations.

Can I switch from Aygestin to a levonorgestrel IUD without a break?

Yes. Doctors often finish the current Aygestin cycle, then insert the IUD within a week. A short bridge with a combined pill can reduce spotting during the transition.