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Aygestin

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Aygestin (Norethisterone Acetate) is a potent progestin hormone used to treat endometriosis, uterine bleeding, and secondary amenorrhea. It works by mimicking the effects of natural progesterone to regulate the growth and shedding of the uterine lining. Aygestin helps restore hormonal balance and manage menstrual irregularities effectively.


Availability
In Stock
Delivery Time
Airmail (14-21 days) | EMS trackable (5-9 days)
Product is shipped in a fully discreet envelope with no content disclosure, including all required documentation inside

Product Sheet

Active Ingredient(s)
Norethisterone Acetate
Reference Brand
Utovlan
Manufacturer
Pfizer Ltd
Product Form
Tablet
Regulatory Classification
Rx
Primary Category
Hormone Therapy
Product Category
Genito-urinary system, Sex hormones, Progestogens
Pharmacological Class
Pregnen derivatives
Manufacturer Description
A hormone treatment used for menstrual disorders and to delay periods.
Mechanism of Action
Norethisterone is a synthetic progestogen that mimics the natural hormone progesterone. It helps regulate the growth and shedding of the womb lining, stabilizing menstrual cycles and managing abnormal bleeding.
Route of Administration
Oral
Onset Time
1-2 days (to effect)
Duration
Duration of course
Contraindications
Pregnancy, Unexplained vaginal bleeding, History of blood clots, Severe liver disease
Severe Adverse Events
Deep vein thrombosis, Pulmonary embolism, Stroke, Sudden loss of vision
Common Side Effects
Nausea
Uncommon Side Effects
Headache, Breast tenderness, Weight gain, Dizziness
Drug Interactions
Rifampicin, St John's Wort, Antiepileptics
Pregnancy Safety Warnings
Contraindicated; do not use if pregnant.
Age Restrictions
Not typically used before puberty.
Storage Guidelines
Store at room temperature in a dry place.
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Aygestin FAQ

Can I travel internationally with Aygestin tablets?

Yes, Aygestin tablets are legal to carry for personal use within the UK and most other countries, provided you have a valid prescription. Keep the medication in its original packaging and carry a copy of the prescription to avoid customs delays.

What does the imprint on an Aygestin tablet look like?

Aygestin 5 mg tablets are typically round, white, film-coated, and bear the imprint “5 MG AYG.” The specific code may vary by manufacturer batch, so verify the imprint against the packaging information.

Are there any inactive ingredients I should be aware of?

The tablet contains lactose, maize starch, and magnesium stearate as excipients. Patients with severe lactose intolerance or maize allergy should discuss alternatives with their prescriber.

How does Aygestin compare with medroxyprogesterone acetate?

Both are synthetic progestogens, but norethisterone acetate (Aygestin) has a slightly higher androgenic activity, which can affect skin oiliness and hair growth. Medroxyprogesterone acetate is often used in contraception and hormone replacement, whereas Aygestin is primarily prescribed for menstrual disorders and endometriosis.

Is Aygestin detectable in standard drug tests for athletes?

Progestogens are not part of the typical screening panel for workplace or sports drug tests. However, therapeutic use exemptions (TUEs) may be required for competitive athletes subject to WADA regulations.

What is the history behind the development of Aygestin?

Norethisterone acetate was first synthesized in the 1950s as part of the early generation of oral progestins. Aygestin received marketing approval in the UK during the 1970s for the management of menstrual disorders and has since become a standard therapy for endometriosis.

Can I split or crush an Aygestin tablet?

No. The tablet is film-coated to ensure proper absorption and to protect the active ingredient. Splitting or crushing can alter the dose and reduce efficacy.

Are there any special considerations for storage during a heatwave?

If ambient temperatures exceed 30 °C, move the tablets to a cooler, dry place such as a refrigerator (do not freeze). Ensure the medication is sealed tightly to prevent moisture ingress.

How does the cost of Aygestin compare with generic norethisterone acetate?

Aygestin is a branded product; generic norethisterone acetate tablets are typically lower in price due to reduced manufacturing and marketing costs. NHS prescribing policies often favour the generic where clinically appropriate.

What should I do if I miss a dose while on a 10-day course?

Take the missed dose as soon as you remember, unless it is less than 12 hours before the next scheduled dose. In that case, skip the missed tablet and continue with the regular schedule; do not double the dose.

What is Aygestin?

Aygestin is a prescription pill that contains 5 mg of norethisterone acetate as its sole active ingredient. It belongs to the women’s health therapeutic class and is used to manage a range of menstrual-related conditions. In the United Kingdom, Aygestin is regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) and is available only with a prescription from a qualified prescriber, typically a GP or a gynaecologist. The medication is manufactured by Bayer plc and is supplied in film-coated tablets that are taken orally.

How Aygestin Works in the Body

Norethisterone acetate is a synthetic progestogen that mimics the activity of natural progesterone. After oral ingestion, the ester is rapidly hydrolysed to norethisterone, which then binds to progesterone receptors in the uterus and elsewhere. The key actions are:

  • Suppression of the hypothalamic-pituitary-ovarian axis - reducing the release of luteinising hormone (LH) and follicle-stimulating hormone (FSH) and thereby inhibiting ovulation in some dosing regimens.
  • Induction of a secretory endometrium - the lining of the uterus becomes thinner and less proliferative, which limits abnormal bleeding and the growth of endometrial implants.
  • Alteration of cervical mucus - making it less receptive to sperm, although Aygestin is not prescribed as a primary contraceptive.

These mechanisms together alleviate symptoms of conditions such as endometriosis and primary dysmenorrhea.

Approved Medical Uses

Aygestin is approved in the UK for the following indications:

  • Endometriosis - reduction of painful pelvic lesions through hormonal suppression.
  • Primary dysmenorrhea - relief of menstrual-related cramping when other analgesics are insufficient.
  • Menstrual disorders - treatment of irregular, heavy, or prolonged bleeding associated with hormonal imbalance.
  • Hormonal therapy for delayed menses - induction of withdrawal bleeding in cases of amenorrhoea where pregnancy has been excluded.

These uses are based on clinical studies that demonstrated improvement in pain scores, bleeding patterns, and quality-of-life measures for women receiving norethisterone acetate.

Investigational Uses

Research is ongoing into the potential role of norethisterone acetate for:

  • Adenomyosis - early-phase trials suggest that progestogenic therapy may shrink ectopic endometrial tissue within the uterine muscle.
  • Hormone-dependent migraines - some observational reports indicate a reduction in migraine frequency when menstrual pain is controlled.

These applications are not approved by the MHRA and would be considered off-label. Any use beyond the licensed indications should be undertaken only under specialist supervision, with a thorough risk-benefit assessment.

Who Should Use (or Avoid) Aygestin?

Absolute Contra-indications

  • Known or suspected pregnancy
  • History of thromboembolic disease (deep-vein thrombosis, pulmonary embolism)
  • Active or a history of breast cancer or other estrogen-dependent tumours
  • Severe, uncontrolled hypertension (> 160/100 mmHg)
  • Significant liver disease (e.g., cirrhosis, hepatic adenoma)
  • Undiagnosed abnormal vaginal bleeding
  • Hypersensitivity to norethisterone acetate or any tablet excipient

Relative Contra-indications

  • Smoking in women over 35 years
  • Migraine with aura or other vascular headaches
  • Diabetes mellitus with vascular complications
  • Moderate hepatic impairment (adjustment or careful monitoring)

Special Populations

  • Pregnancy: Contra-indicated; use can jeopardise fetal development.
  • Breastfeeding: Caution advised; limited data on excretion in milk.
  • Elderly women: Evaluate cardiovascular risk before initiating therapy.
  • Adolescents: Typically not prescribed unless a specialist determines clear benefit.

If any of these conditions apply, a healthcare professional must evaluate whether alternative therapies are more appropriate.

Safety Profile: Side Effects and Interactions

Common Side Effects

  • Nausea or mild gastrointestinal discomfort
  • Breast tenderness or enlargement
  • Headache, especially at treatment onset
  • Weight gain or fluid retention
  • Mood changes (irritability, mild depression)
  • Acne or oily skin
  • Spotting or breakthrough bleeding between periods

These effects are usually transient and improve with continued therapy or after dose adjustment.

Serious Adverse Events

  • Venous thromboembolism (VTE): Deep-vein thrombosis, pulmonary embolism - requires immediate medical attention.
  • Severe hepatic dysfunction: Jaundice, hepatic pain, abnormal liver function tests.
  • Marked depression or suicidal ideation - rare but reported.
  • Gallbladder disease - cholelithiasis in predisposed individuals.

A black-box-type warning is included in the UK product information for VTE and severe liver disease.

Drug Interactions

  • Enzyme inducers (e.g., rifampicin, carbamazepine, phenytoin) can lower norethisterone levels, reducing efficacy.
  • CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, HIV protease inhibitors) may raise plasma concentrations, increasing the risk of side effects.
  • Anticoagulants (warfarin, direct oral anticoagulants) - monitor for any change in coagulation parameters, as hormonal therapy can affect clotting risk.

Patients should provide a full medication list, including over-the-counter drugs, herbal supplements, and vitamins.

Food and Lifestyle Interactions

  • No specific food restrictions, but taking the tablet with a glass of water improves absorption.
  • Moderate alcohol consumption does not markedly affect the drug, but excessive intake may exacerbate liver-related risks.
  • No known impact on driving or the use of machinery; however, severe headache or dizziness warrants caution.

How to Take Aygestin

  • Standard dosing: A typical regimen involves 5 mg taken once daily for a period of 5-10 days, usually beginning on the first day of menstrual flow or as directed by the prescriber. The exact duration depends on the condition being treated.
  • Administration: Swallow the tablet whole with water; it may be taken with or without food.
  • Missed dose: If a dose is remembered within 12 hours, take it immediately; otherwise skip and continue with the next scheduled dose. Do not double-dose.
  • Overdose: Symptoms may include severe nausea, vomiting, and heavy menstrual bleeding. Seek emergency medical care; treatment is supportive, focusing on symptom control and fluid replacement.
  • Discontinuation: For short-term courses, abrupt cessation is acceptable. For prolonged therapy, a prescriber may recommend a gradual taper to minimise breakthrough bleeding.

Dosing must always be individualized. The above schedule reflects the most common prescribing pattern but is not a substitute for professional guidance.

Monitoring and Follow-Up

  • Blood pressure should be checked at baseline and periodically, especially in women with pre-existing hypertension.
  • Liver function tests (LFTs) are advisable for long-term users or if hepatic disease is suspected.
  • Signs of VTE (leg swelling, chest pain, shortness of breath) require immediate evaluation.
  • Menstrual response is monitored to ensure the desired reduction in pain or bleeding; dose adjustments are made accordingly.

Regular follow-up appointments enable early detection of adverse events and optimisation of therapy.

Storage and Handling

  • Keep tablets in the original blister pack until use.
  • Store at room temperature (≤ 30 °C), away from direct sunlight and moisture.
  • Keep out of reach of children and pets.
  • Do not use tablets after the expiry date printed on the packaging.

If a tablet becomes discoloured or damaged, discard it according to local pharmacy disposal guidelines.

Medication-Specific Glossary

Progestogen
A synthetic hormone that imitates the actions of natural progesterone, influencing the menstrual cycle and uterine lining.
Endometrium
The inner lining of the uterus that thickens each month in preparation for possible implantation of an embryo.
Thromboembolism
Formation of a blood clot (thrombus) that can travel through the bloodstream and block a vessel elsewhere in the body.
CYP3A4
A liver enzyme responsible for metabolising many drugs; inhibitors can raise drug levels, while inducers can lower them.
Hormonal therapy
Treatment that uses hormones or hormone-like substances to modify physiological processes, often to correct menstrual abnormalities.

Medical Disclaimer

This article provides educational information about Aygestin and is not a substitute for professional medical advice. Treatment decisions, including use for unapproved indications, must be made under the guidance of a qualified healthcare provider. The content is intended for informational purposes and does not constitute medical recommendations. Always consult a physician before starting, stopping, or changing any medication regimen.

Information for Aygestin is sourced from established medical standards and updated frequently. It is provided for general guidance and should be confirmed with a healthcare professional before use.
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