Aygestin (Norethindrone) vs. Other Progestins - Full Comparison
24 September 2025
Progestin Choice Quiz
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.
| Drug | Formulation | Typical dose | FDA status | Key side‑effects |
|---|---|---|---|---|
| Aygestin (norethindrone) | 5mg oral tablet | 5mg daily (10‑day cycle) | Prescription (ClassC) | Weight gain, mood changes, breast tenderness |
| Medroxyprogesterone acetate | 150mg IM injection | Every 12weeks | Prescription (ClassC) | Bone loss, irregular bleeding, weight gain |
| Levonorgestrel | 1.5mg oral (LNG‑IUD 52mg) | Single dose (emergency) or 0.02mg/day (IUD) | Prescription/OTC (ClassC) | Spotting, headache, abdominal pain |
| Norethisterone acetate | 5mg oral tablet | 5mg daily | Prescription (ClassC) | Acne, nausea, mood swings |
| Dienogest | 2mg oral tablet (often combined) | 2mg daily | Prescription (ClassC) | Elevated liver enzymes, headache, weight loss |
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
- Consult your GP or specialist to review your symptom diary.
- If moving to an injectable, schedule the first medroxyprogesterone acetate dose on day 1 of your next menstrual period.
- For levonorgestrel IUD, a brief bridging with oral progestin (like Aygestin) may minimise bleeding spikes.
- 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.
Emily Torbert
September 24, 2025 AT 19:13Aygestin can be a solid starter if budget’s tight.
Rashi Shetty
September 29, 2025 AT 10:20While the table succinctly outlines side‑effects, it neglects the nuanced metabolic implications of norethindrone. A patient with pre‑existing insulin resistance may experience exacerbated glycemic variability, a fact seldom highlighted in generic summaries. Moreover, the discussion glosses over the ethical considerations of prescribing long‑acting injectables without thorough bone‑density assessment. 📚💊
Queen Flipcharts
October 4, 2025 AT 01:26In the grand theatre of hormonal modulation, each progestin assumes a role not merely as a chemical agent but as a philosopher of the endocrine realm. To reduce Aygestin to a simple cost‑effective tablet is to ignore its ontological significance in the cascade of progesterone signalling. One must ask whether the patient seeks merely symptom relief or an alignment with the deeper rhythm of her own physiology. The answer, dear reader, shapes the very choice of molecule, for chemistry is never divorced from the narrative of the self.
Yojana Geete
October 8, 2025 AT 16:33Ah, the noble scholar sounds lofty, yet the real drama unfolds in the clinic where a tired patient worries about weight and mood. Subtle as a whisper, the tablet’s side‑effects can crescendo into daily battles. Ignoring that theatre does a disservice to those who live the script day after day.
Jason Peart
October 13, 2025 AT 07:40Hey, totally get where you’re coming from! If you’re just starting out, a cheap oral like Aygestin can be a gentle way to test the waters without committing to big injections. Just keep an eye on any changes in mood or weight, and chat with your doc if anything feels off. You’ve got this!
Hanna Sundqvist
October 17, 2025 AT 22:46Ever notice how Pharma pushes the newer, pricier options while keeping the old cheap pills hidden behind a veil of “side‑effects”? It’s like they want us to believe that the cheaper generic is somehow inferior, when really it’s just about profit margins.
Jim Butler
October 22, 2025 AT 13:53Indeed, the market dynamics often eclipse patient‑centred care. By emphasizing novelty over necessity, manufacturers create a perception that only the most expensive options are “effective”. Yet clinical data repeatedly show that generic norethindrone is just as capable for many indications. Let’s keep the focus on evidence, not on marketing hype. 😊
Ian McKay
October 27, 2025 AT 05:00Correction: “Aygestin” is spelled with a capital “A” and the active ingredient is “norethindrone”, not “norethindrone”. Also, the table lists the half‑life as ≈7 hours; the correct notation is “≈ 7 h”. Please revise for accuracy.
Deborah Messick
October 31, 2025 AT 20:06While the insistence on orthographic perfection is commendable, it distracts from the substantive clinical discussion. A focus on minor typographical details does not compensate for the lack of patient‑centred context regarding long‑term bone health when choosing injectables. Let us not mistake pedantry for insight.
Jolanda Julyan
November 5, 2025 AT 11:13Reading through the exhaustive comparison reminded me of the first time I tried to pick a progestin for my own endometriosis struggles. I was overwhelmed by the sheer amount of data, from dosing schedules to side‑effect profiles, and the tables seemed like a wall of numbers. First, I noted the low cost of Aygestin, which was appealing because I was on a tight budget and needed daily relief without breaking the bank. Then I considered the convenience of the monthly injection, Medroxy, but the thought of frequent clinic visits made me uneasy. The levonorgestrel IUD looked promising for contraception, yet I was concerned about spotting and the invasive insertion process. I also read about norethisterone’s smoother release, which sounded like a possible compromise between efficacy and tolerability. The mention of dienogest’s strong anti‑inflammatory actions caught my eye, especially since my pain had become increasingly refractory. However, the price tag attached to dienogest made me pause, as insurance coverage was uncertain. While digesting this information, I kept returning to the side‑effect column, worrying about weight gain, mood swings, and bone density loss. Each progestin seemed to have a trade‑off, and the decision felt like a balancing act between benefits and risks. I also thought about the importance of flexibility; the ability to stop a daily pill if side‑effects emerged was reassuring compared to the long‑acting depot. Moreover, the practical aspect of obtaining the medication – whether I could get a prescription easily or needed a specialist – played a role in my final choice. Over several weeks, I jotted down my priorities, ranking cost, convenience, side‑effect profile, and hormonal potency. In the end, I chose Aygestin because it aligned best with my immediate need for pain control, affordability, and the freedom to discontinue if needed. Still, I remain open to switching later if my symptoms evolve or if I decide to pursue a more permanent contraceptive solution. This whole process underscored how personal the progestin decision truly is, and how essential it is to have clear, unbiased information to guide patients through the maze.