Open main menu
Home
Random
Recent changes
Special pages
Community portal
Preferences
About Wikipedia
Disclaimers
Incubator escapee wiki
Search
User menu
Talk
Dark mode
Contributions
Create account
Log in
Editing
Progestogen (medication)
(section)
Warning:
You are not logged in. Your IP address will be publicly visible if you make any edits. If you
log in
or
create an account
, your edits will be attributed to your username, along with other benefits.
Anti-spam check. Do
not
fill this in!
==Medical uses== ===Available forms=== {| class="wikitable floatright plainrowheaders" style="font-size:small; margin-left: auto; margin-right: auto; border: none;" |+ class="nowrap" | Progestogens marketed for clinical or veterinary use |- ! scope="col" style="width:100px;" | Generic name ! scope="col" style="width:50px;" | Class{{efn|group=progmarA1|1=Classes: P = [[progesterone]] derivative, T = [[testosterone]] derivative}} ! scope="col" style="width:80px;" | Brand name ! scope="col" style="width:50px;" | Route{{efn|group=progmarA1|1=Routes: IUD = [[intrauterine device]], PO = [[Oral administration|by mouth]], SC = [[Subcutaneous injection|subcutaneous injection or implant]], SL = [[sublingual|under the tongue]], TD = [[transdermal]], V = [[Vaginal administration|vaginal]]}} ! scope="col" style="width:50px;" | {{abbr|Intr.|Introduced in}} |- ! scope="row" style="background: #f8f9fa; | [[Acetomepregenol]] | P{{efn-lr|group=progmarA2|name=17a|[[17Ξ±-Hydroxyprogesterone|17Ξ±-hydroxy]]}}{{efn-lr|group=progmarA2|name=ester|Ester}} || Diamol || {{abbrlink|PO|Oral administration}} || 1981 |- ! scope="row" style="background: #f8f9fa; | [[Algestone acetophenide]] | P{{efn-lr|group=progmarA2|name=17a}}{{efn-lr|group=progmarA2|name=cyke|Cyclic ketal}} || Deladroxate{{efn|group=progmarA1|name=others|Also marketed under other brand names.}} || {{abbrlink|IM|Intramuscular injection}} || 1964 |- ! scope="row" style="background: #f8f9fa; | [[Allylestrenol]] | T{{efn-lr|group=progmarA2|name=19nt|[[19-Nortestosterone|19-nor]]}}{{efn-lr|group=progmarA2|name=estrane|estrane}} || Gestanin{{efn|group=progmarA1|name=others}} || PO || 1961 |- ! scope="row" style="background: #f8f9fa; | [[Altrenogest]]{{efn|group=progmarA1|name=vet|Veterinary use only.}} | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=estrane}} || Regumate{{efn|group=progmarA1|name=others}} || PO || 1980s |- ! scope="row" style="background: #f8f9fa; | [[Chlormadinone acetate]] | P{{efn-lr|group=progmarA2|name=17a}}{{efn-lr|group=progmarA2|name=ester}} || Belara{{efn|group=progmarA1|name=others}} || PO || 1965 |- ! scope="row" style="background: #f8f9fa; | [[Cyproterone acetate]] | P{{efn-lr|group=progmarA2|name=17a}}{{efn-lr|group=progmarA2|name=ester}} || Androcur{{efn|group=progmarA1|name=others}} || PO, IM || 1973 |- ! scope="row" style="background: #f8f9fa; | [[Danazol]] | T{{efn-lr|group=progmarA2|name=estrane}} || Danocrine || PO || 1971 |- ! scope="row" style="background: #f8f9fa; | [[Delmadinone acetate]]{{efn|group=progmarA1|name=vet}} | P{{efn-lr|group=progmarA2|name=17a}}{{efn-lr|group=progmarA2|name=ester}} || Tardak || PO || 1972 |- ! scope="row" style="background: #f8f9fa; | [[Desogestrel]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=gonane|Gonane}} || Cerazette{{efn|group=progmarA1|name=others}} || PO || 1981 |- ! scope="row" style="background: #f8f9fa; | [[Dienogest]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=estrane}} || Natazia{{efn|group=progmarA1|name=others}} || PO || 1995 |- ! scope="row" style="background: #f8f9fa; | [[Drospirenone]] | S{{efn-lr|group=progmarA2|name=spiro|Spironolactone}} || Angeliq{{efn|group=progmarA1|name=others}} || PO || 2000 |- ! scope="row" style="background: #f8f9fa; | [[Dydrogesterone]] | {{abbrlink|RP|retroprogesterone}} || Duphaston || PO || 1961 |- ! scope="row" style="background: #f8f9fa; | [[Etonogestrel]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=gonane}} || Implanon (SC), NuvaRing (V) || [[Subcutaneous injection|{{abbr|SC|Subcutaneous injection or implant}}]], {{abbrlink|V|Vaginal administration}} || 1998 |- ! scope="row" style="background: #f8f9fa; | [[Etynodiol diacetate]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=estrane}}{{efn-lr|group=progmarA2|name=ester}} || Demulen{{efn|group=progmarA1|name=others}} || PO || 1965 |- ! scope="row" style="background: #f8f9fa; | [[Flugestone acetate]]{{efn|group=progmarA1|name=vet}} | P{{efn-lr|group=progmarA2|name=17a}}{{efn-lr|group=progmarA2|name=ester}} || Chronogest || PO || 1960s |- ! scope="row" style="background: #f8f9fa; | [[Gestodene]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=gonane}} || Femodene{{efn|group=progmarA1|name=others}} || PO || 1987 |- ! scope="row" style="background: #f8f9fa; | [[Gestonorone caproate]] | P{{efn-lr|group=progmarA2|name=17a}}{{efn-lr|group=progmar2|name=19np|[[19-norprogesterone|19-nor]]}}{{efn-lr|group=progmarA2|name=ester}} || Depostat{{efn|group=progmarA1|name=others}} || IM || 1968 |- ! scope="row" style="background: #f8f9fa; | [[Gestrinone]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=gonane}} || Dimetriose{{efn|group=progmarA1|name=others}} || PO || 1986 |- ! scope="row" style="background: #f8f9fa; | [[Hydroxyprogesterone caproate]] | P{{efn-lr|group=progmarA2|name=17a}}{{efn-lr|group=progmarA2|name=ester}} || Makena{{efn|group=progmarA1|name=others}} || IM || 1954 |- ! scope="row" style="background: #f8f9fa; | [[Levonorgestrel]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=gonane}} || Plan B{{efn|group=progmarA1|name=others}} || PO, {{abbrlink|TD|Transdermal}},<br />{{abbr|IUD|intrauterine device}}, SC || 1970 |- ! scope="row" style="background: #f8f9fa; | [[Lynestrenol]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=estrane}} || Exluton{{efn|group=progmarA1|name=others}} || PO || 1961 |- ! scope="row" style="background: #f8f9fa; | [[Medrogestone]] | P{{efn-lr|group=progmarA2|name=17m|[[17Ξ±-Methylprogesterone|17Ξ±-methyl]]}} || Colprone || PO || 1966 |- ! scope="row" style="background: #f8f9fa; | [[Medroxyprogesterone acetate]] | P{{efn-lr|group=progmarA2|name=17a}}{{efn-lr|group=progmarA2|name=ester}} || Provera{{efn|group=progmarA1|name=others}} || PO, IM, SC || 1958 |- ! scope="row" style="background: #f8f9fa; | [[Megestrol acetate]] | P{{efn-lr|group=progmarA2|name=17a}}{{efn-lr|group=progmarA2|name=ester}} || Megace || PO, IM || 1963 |- ! scope="row" style="background: #f8f9fa; | [[Melengestrol acetate]]{{efn|group=progmarA1|name=vet}} | P{{efn-lr|group=progmarA2|name=17a}}{{efn-lr|group=progmarA2|name=ester}} || Heifermax{{efn|group=progmarA1|name=others}} || IM || 1960s |- ! scope="row" style="background: #f8f9fa; | [[Nomegestrol acetate]] | P{{efn-lr|group=progmarA2|name=19np}}{{efn-lr|group=progmarA2|name=ester}} || Lutenyl{{efn|group=progmarA1|name=others}} || PO || 1986 |- ! scope="row" style="background: #f8f9fa; | [[Norelgestromin]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=gonane}} || Evra{{efn|group=progmarA1|name=others}} || TD patch || 2002 |- ! scope="row" style="background: #f8f9fa; | [[Norethisterone]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=estrane}} || Aygestin{{efn|group=progmarA1|name=others}} || PO || 1957 |- ! scope="row" style="background: #f8f9fa; | [[Norethisterone acetate]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=estrane}}{{efn-lr|group=progmarA2|name=ester}} || Primolut-Nor || PO, TD patch || 1964 |- ! scope="row" style="background: #f8f9fa; | [[Norethisterone enanthate]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=estrane}}{{efn-lr|group=progmarA2|name=ester}} || Noristerat{{efn|group=progmarA1|name=others}} || IM || 1957 |- ! scope="row" style="background: #f8f9fa; | [[Norgestimate]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=gonane}}{{efn-lr|group=progmarA2|name=ester}} || Ortho-Cyclen{{efn|group=progmarA1|name=others}} || PO || 1986 |- ! scope="row" style="background: #f8f9fa; | [[Norgestomet]]{{efn|group=progmarA1|name=vet}} | P{{efn-lr|group=progmarA2|name=19np}}{{efn-lr|group=progmarA2|name=ester}} || Syncro-Mate B || PO || 1970s |- ! scope="row" style="background: #f8f9fa; | [[Norgestrel]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=gonane}} || Ovral || PO || 1966 |- ! scope="row" style="background: #f8f9fa; | [[Normethandrone]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=estrane}} || Metalutin || PO || 1957 |- ! scope="row" style="background: #f8f9fa; | [[Osaterone acetate]]{{efn|group=progmarA1|name=vet}} | P{{efn-lr|group=progmarA2|name=17a}}{{efn-lr|group=progmarA2|name=ester}} || Ypozane || PO || 2007 |- ! scope="row" style="background: #f8f9fa; | [[Oxendolone]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=estrane}} || Prostetin{{efn|group=progmarA1|name=others}} || IM || 1981 |- ! scope="row" style="background: #f8f9fa; | [[Progesterone (medication)|Progesterone]] | {{abbr|BI|bio-identical}} || Prometrium{{efn|group=progmarA1|name=others}} || PO, V, IM || 1934 |- ! scope="row" style="background: #f8f9fa; | [[Proligestone]]{{efn|group=progmarA1|name=vet}} | P{{efn-lr|group=progmarA2|name=17a}}{{efn-lr|group=progmarA2|name=cyke}} || Corvinan{{efn|group=progmarA1|name=others}} || PO || 1975 |- ! scope="row" style="background: #f8f9fa; | [[Promegestone]] | P{{efn-lr|group=progmarA2|name=19np}} || Surgestone || PO || 1983 |- ! scope="row" style="background: #f8f9fa; | [[Segesterone acetate]] | P{{efn-lr|group=progmarA2|name=17a}}{{efn-lr|group=progmarA2|name=ester}} || Elcometrine{{efn|group=progmarA1|name=others}} || SC, V || 2000 |- ! scope="row" style="background: #f8f9fa; | [[Tibolone]] | T{{efn-lr|group=progmarA2|name=19nt}}{{efn-lr|group=progmarA2|name=estrane}} || Livial{{efn|group=progmarA1|name=others}} || PO || 1988 |- ! scope="row" style="background: #f8f9fa; | [[Trimegestone]] | P{{efn-lr|group=progmarA2|name=19np}} || Lovelle{{efn|group=progmarA1|name=others}} || PO || 2001 |- class="sortbottom" | colspan="6" style="width: 1px; background-color:#eaecf0; text-align: center;" |{{hidden|header=Legend for class of molecule|content={{notelist-lr|group=progmarA2}}}} |- | colspan="6" style="width: 1px; background-color:#eaecf0; text-align: center;" |{{notelist|group=progmarA1}} |} Progestogens are available in many different [[pharmaceutical form|form]]s for use by many different [[routes of administration]]. These include [[oral administration|oral]] [[tablet (pharmacy)|tablet]]s and [[capsule (pharmacy)|capsule]]s, [[oil]] and [[aqueous solution]]s and [[suspension (chemistry)|suspension]]s for [[intramuscular injection|intramuscular]] or [[subcutaneous injection]], and various others (e.g., [[transdermal patch]]es, [[vaginal ring]]s, [[intrauterine device]]s, [[subcutaneous implant]]s). Dozens of different progestogens have been marketed for [[clinical medicine|clinical]] and/or [[veterinary medicine|veterinary]] use. ===Birth control=== Progestogens are used in a variety of different forms of [[hormonal contraception|hormonal birth control]] for females, including [[combined hormonal contraception|combined estrogen and progestogen forms]] like [[combined oral contraceptive pill]]s, [[contraceptive patch|combined contraceptive patch]]es, [[contraceptive vaginal ring|combined contraceptive vaginal ring]]s, and [[combined injectable birth control|combined injectable contraceptive]]s; and [[progestogen-only contraception|progestogen-only form]]s like [[progestogen-only pill|progestogen-only contraceptive pill]]s ("mini-pills"), [[emergency contraception|progestogen-only emergency contraceptive pill]]s ("day-after pills"), [[contraceptive implant|progestogen-only contraceptive implant]]s, [[intrauterine device|progestogen-only intrauterine device]]s, [[contraceptive vaginal ring|progestogen-only contraceptive vaginal ring]]s, and [[progestogen-only injectable contraceptive]]s.<ref name="JamesonGroot2015">{{cite book|author1=J. Larry Jameson|author2=Leslie J. De Groot|title=Endocrinology: Adult and Pediatric E-Book|url=https://books.google.com/books?id=xmLeBgAAQBAJ&pg=PA2304|date=25 February 2015|publisher=Elsevier Health Sciences|isbn=978-0-323-32195-2|pages=2304β}}</ref><ref name="ClarkHarvey2011">{{cite book | author1 = Michelle A. Clark | author2 = Richard A. Harvey | author3 = Richard Finkel |author4=Jose A. Rey |author5=Karen Whalen | title = Pharmacology | url = https://books.google.com/books?id=Y558dgp_PjoC&pg=PA322 | date = 15 December 2011 | publisher = Lippincott Williams & Wilkins | isbn = 978-1-4511-1314-3 | page = 322}}</ref><ref name="Bhattacharya2003">{{cite book | author = Bhattacharya | title = Pharmacology, 2/e | url = https://books.google.com/books?id=X3cCZQCrrjcC&pg=PA378 | date = 1 January 2003 | publisher = Elsevier India | isbn = 978-81-8147-009-6 | page = 378}}</ref><ref name="KellermanBope2017">{{cite book|author1=Rick D. Kellerman|author2=Edward T. Bope|title=Conn's Current Therapy 2018 E-Book|url=https://books.google.com/books?id=3xNBDwAAQBAJ&pg=PT1124|date=10 November 2017|publisher=Elsevier Health Sciences|isbn=978-0-323-52961-7|pages=1124β}}</ref> Progestogens mediate their contraceptive effects by multiple mechanisms, including prevention of [[ovulation]] via their [[antigonadotropic]] effects; thickening of [[cervical mucus]], making the [[cervix]] largely impenetrable to [[sperm]]; preventing [[capacitation]] of [[sperm]] due to changes in cervical fluid, thereby making sperm unable to penetrate the [[ovum]]; and [[atrophy|atrophic]] changes in the [[endometrium]], making the endometrium unsuitable for [[implantation (human embryo)|implantation]].<ref name="VarneyKriebs2004">{{cite book|author1=Helen Varney|author2=Jan M. Kriebs|author3=Carolyn L. Gegor|title=Varney's Midwifery|url=https://archive.org/details/varneysmidwifery0000varn|url-access=registration|year=2004|publisher=Jones & Bartlett Learning|isbn=978-0-7637-1856-5|pages=[https://archive.org/details/varneysmidwifery0000varn/page/513 513]β}}</ref><ref name="Golan2008" /><ref name="MilesRayburn2012">{{cite book|author1=Pamela S. Miles|author2=William F. Rayburn|author3=J.Christopher Carey|title=Obstetrics and Gynecology|url=https://books.google.com/books?id=tKigBwAAQBAJ&pg=PA109|date=6 December 2012|publisher=Springer Science & Business Media|isbn=978-1-4684-0220-9|pages=109β}}</ref><ref name="pmid15715527">{{cite journal | vauthors = Erkkola R, Landgren BM | title = Role of progestins in contraception | journal = Acta Obstet Gynecol Scand | volume = 84 | issue = 3 | pages = 207β16 | date = March 2005 | pmid = 15715527 | doi = 10.1111/j.0001-6349.2005.00759.x | s2cid = 6887415| doi-access = free }}</ref> They may also decrease [[tubule|tubal]] [[motility]] and [[cilia]]ry action.<ref name="pmid15715527" /> ===Hormone therapy=== ====Menopause and hypogonadism==== Progestogens are used in combination with [[estrogen (medication)|estrogen]]s in [[menopausal hormone therapy]] in women. They are also used in combination with estrogens in hormone therapy for [[hypogonadism]] and [[delayed puberty]] in girls and women. They are used mainly to prevent [[endometrial hyperplasia]] and increased risk of [[endometrial cancer]] from unopposed estrogen therapy. ====Transgender hormone therapy==== Progestogens are used as a component of [[transgender hormone therapy|hormone therapy]] for [[transgender women]] and [[transgender men]]. They are used in transgender women in combination with estrogens to help suppress and block [[testosterone]]. Progestogens might also have other beneficial effects in transgender women, but these are controversial and unsupported at present. Examples of progestogens used in hormone therapy for transgender women include [[cyproterone acetate]], [[medroxyprogesterone acetate]], and [[progesterone (medication)|progesterone]]. Progestogens, such as medroxyprogesterone and [[lynestrenol]], are used in transgender men to help suppress [[menses]]. Progestogens have also been used to delay [[puberty]] in [[transgender youth|transgender boys and girls]]. ====Other uses==== Certain progestogens, including [[megestrol acetate]], medroxyprogesterone acetate, cyproterone acetate, and [[chlormadinone acetate]], have been used at high doses to reduce [[hot flash]]es in men undergoing [[androgen deprivation therapy]], for instance to treat [[prostate cancer]].<ref name="pmid18231613">{{cite journal | vauthors = Guise TA, Oefelein MG, Eastham JA, Cookson MS, Higano CS, Smith MR | title = Estrogenic side effects of androgen deprivation therapy | journal = Rev Urol | volume = 9 | issue = 4 | pages = 163β80 | year = 2007 | pmid = 18231613 | pmc = 2213888}}</ref><ref name="pmid19962840">{{cite journal | vauthors = Frisk J | title = Managing hot flushes in men after prostate cancer--a systematic review | journal = Maturitas | volume = 65 | issue = 1 | pages = 15β22 | year = 2010 | pmid = 19962840 | doi = 10.1016/j.maturitas.2009.10.017| doi-access = free }}</ref><ref name="pmid24223412">{{cite journal | vauthors = Koike H, Morikawa Y, Matsui H, Shibata Y, Ito K, Suzuki K | title = Chlormadinone acetate is effective for hot flush during androgen deprivation therapy | journal = Prostate Int | volume = 1 | issue = 3 | pages = 113β6 | year = 2013 | pmid = 24223412 | pmc = 3814123 | doi = 10.12954/PI.12010}}</ref> ===Gynecological disorders=== ====Menstrual disorders==== Progestogens are used to treat [[menstrual disorder]]s such as [[secondary amenorrhea]] and [[dysfunctional uterine bleeding]].<ref name="ClarkHarvey2011" /><ref name="Bhattacharya2003" /> In a normal [[menstrual cycle]], declining levels of progesterone trigger [[menstruation]]. Progestogens such as [[norethisterone acetate]] and [[medroxyprogesterone acetate]] may be used to artificially induce progesterone-associated [[breakthrough bleeding]].<ref name="pmid11041215">{{cite journal |vauthors=Hickey M, Fraser IS | title = A functional model for progestogen-induced breakthrough bleeding | journal = Hum. Reprod. | volume = 15 | issue = Suppl 3 | pages = 1β6 |date=August 2000 | pmid = 11041215 | doi = 10.1093/humrep/15.suppl_3.1| doi-access = free}}</ref> The [[progestogen challenge test]] or progestogen withdrawal test is used to diagnose [[amenorrhea]]. Due to the availability of assays to measure estrogen levels, it is now rarely used. ====Uterine disorders==== Progestogens are used in the prevention and treatment of [[uterine disorder]]s such as [[endometrial hyperplasia]], [[endometriosis]], [[uterine fibroids]], and [[uterine hypoplasia]]. ====Breast disorders==== Progestogens are used to treat [[benign tumor|benign]] [[breast disorder]]s.<ref name="pmid20383772">{{cite journal | vauthors = Schindler AE | title = Dydrogesterone and other progestins in benign breast disease: an overview | journal = Archives of Gynecology and Obstetrics | volume = 283 | issue = 2 | pages = 369β371 | date = February 2011 | pmid = 20383772 | doi = 10.1007/s00404-010-1456-7 | s2cid = 9125889 }}</ref><ref name="pmid12227885">{{cite journal | vauthors = Winkler UH, Schindler AE, Brinkmann US, Ebert C, Oberhoff C | title = Cyclic progestin therapy for the management of mastopathy and mastodynia | journal = Gynecological Endocrinology | volume = 15 | issue = Suppl 6 | pages = 37β43 | date = December 2001 | pmid = 12227885 | doi = 10.1080/gye.15.s6.37.43 | s2cid = 27589741 }}</ref> They are associated not only with a reduction in [[breast pain]], but also a decrease in [[breast]] [[cell proliferation]], a decrease in [[mammary gland|breast gland]] size, and a disappearance of breast [[nodule (medicine)|nodularity]].<ref name="pmid20383772" /><ref name="pmid12227885" /><ref name="pmid25113944" /> Progestogens that have been used for such purposes include [[topical progesterone]], [[dydrogesterone]], [[promegestone]], [[lynestrenol]], [[medroxyprogesterone acetate]], [[dienogest]], and [[medrogestone]].<ref name="pmid20383772" /><ref name="pmid12227885" /><ref name="BiΕkowskaWoroΕ2015">{{cite journal | vauthors = BiΕkowska M, WoroΕ J | title = Progestogens in menopausal hormone therapy | journal = Przeglad Menopauzalny = Menopause Review | volume = 14 | issue = 2 | pages = 134β143 | date = June 2015 | pmid = 26327902 | pmc = 4498031 | doi = 10.5114/pm.2015.52154 }}</ref><ref name="pmid25113944">{{cite journal | vauthors = Ruan X, Mueck AO | title = Systemic progesterone therapy--oral, vaginal, injections and even transdermal? | journal = Maturitas | volume = 79 | issue = 3 | pages = 248β255 | date = November 2014 | pmid = 25113944 | doi = 10.1016/j.maturitas.2014.07.009 }}</ref> Progestogens are used in the treatment of [[breast hypoplasia]] and [[lactation insufficiency]]. This is because they induce [[lobuloalveolar]] [[breast development|development]] of the [[breast]]s, which is required for [[lactation]] and [[breastfeeding]]. ===Enlarged prostate=== Progestogens have been used at high doses to treat [[benign prostatic hyperplasia]] (BPH). They act by suppressing [[gonad]]al [[testosterone]] [[biosynthesis|production]] and hence circulating testosterone levels. Androgens like testosterone stimulate the growth of the [[prostate gland]]. ===Hormone-sensitive cancers=== ====Endometrial cancer==== Progestogens were first found to be effective at high doses in the treatment of [[endometrial hyperplasia]] and [[endometrial cancer]] in 1959.<ref name="pmid14409476">{{cite journal | vauthors = Kistner RW | title = Histological effects of progestins on hyperplasia and carcinoma in situ of the endometrium | journal = Cancer | volume = 12 | issue = 6| pages = 1106β22 | date = 1959 | pmid = 14409476 | doi = 10.1002/1097-0142(195911/12)12:6<1106::aid-cncr2820120607>3.0.co;2-m| doi-access = free}}</ref><ref name="AcademicPress2009">{{cite book|title=Regulatory Mechanisms in Transcriptional Signaling|url=https://books.google.com/books?id=yIESHM-P-ZIC&pg=PA62|date=25 July 2009|publisher=Academic Press|isbn=978-0-08-091198-4|pages=62β}}</ref><ref name="MD2011">{{cite book|author=Loren K. Mell, MD|title=Gynecologic Cancer|url=https://books.google.com/books?id=K0CaWNG4L6sC&pg=PA393|date=20 December 2011|publisher=Demos Medical Publishing|isbn=978-1-61705-095-4|pages=393β}}</ref> Subsequently, high-dose [[gestonorone caproate]], [[hydroxyprogesterone caproate]], [[medroxyprogesterone acetate]], and [[megestrol acetate]] were approved for the treatment of endometrial cancer.<ref name="McKinnell1998">{{cite book|author=Robert G. McKinnell|title=The Biological Basis of Cancer|url=https://books.google.com/books?id=7DPzBK27R_EC&pg=PA262|date=13 March 1998|publisher=Cambridge University Press|isbn=978-0-521-59695-4|pages=262β}}</ref><ref name="BurchumRosenthal2014">{{cite book|author1=Jacqueline Burchum|author2=Laura Rosenthal|title=Lehne's Pharmacology for Nursing Care - E-Book|url=https://books.google.com/books?id=C7_NBQAAQBAJ&pg=PA740|date=2 December 2014|publisher=Elsevier Health Sciences|isbn=978-0-323-34026-7|pages=740β}}</ref><ref name="SmithWilliams2005">{{cite book|author1=H. John Smith|author2=Hywel Williams|title=Smith and Williams' Introduction to the Principles of Drug Design and Action, Fourth Edition|url=https://books.google.com/books?id=P2W6B9FQRKsC&pg=PA493|date=10 October 2005|publisher=CRC Press|isbn=978-0-203-30415-0|pages=493β}}</ref> ====Breast cancer==== Progestogens, such as megestrol acetate and medroxyprogesterone acetate, are effective at high doses in the treatment of [[metastatic breast cancer|advanced]] [[menopause|postmenopausal]] [[breast cancer]].<ref name="Winchester2006">{{cite book|author=David J. Winchester|title=Breast Cancer|url=https://books.google.com/books?id=aHetwn61JigC&pg=PA333|year=2006|publisher=PMPH-USA|isbn=978-1-55009-272-1|pages=333β}}</ref><ref name="pmid10685337">{{cite journal | vauthors = Gadducci A, Genazzani AR | title = Endocrine therapy for gynecological cancer | journal = Gynecol. Endocrinol. | volume = 13 | issue = 6 | pages = 441β56 | date = December 1999 | pmid = 10685337 | doi = 10.3109/09513599909167590}}</ref> They have been extensively evaluated as a second-line therapy for this indication.<ref name="Winchester2006" /> However, they produce various [[side effect]]s, such as [[dyspnea]], [[weight gain]], [[vaginal bleeding]], [[nausea]], [[water retention (medicine)|fluid retention]], [[hypertension]], [[thrombophlebitis]], and [[thromboembolism|thromboembolic complication]]s.<ref name="Winchester2006" /><ref name="pmid10685337" /> In addition, megestrol acetate has been found to be significantly inferior to [[aromatase inhibitor]]s in the treatment of breast cancer, and in relation to this, progestogens have been moved down in the sequential therapy of the disease.<ref name="Winchester2006" /> Megestrol acetate is the only [[Food and Drug Administration]]-approved progestogen for breast cancer.<ref name="Winchester2006" /> The [[mechanism of action]] of progestogens in the treatment of breast cancer is unknown, but may be related to their functional [[antiestrogen]]ic and/or [[antigonadotropic]] effects.<ref name="Winchester2006" /> ====Prostate cancer==== Certain progestogens, particularly those with antiandrogenic properties, have been used at high doses in the treatment of [[prostate cancer]].<ref name="pmid16406864">{{cite journal | vauthors = Lam JS, Leppert JT, Vemulapalli SN, Shvarts O, Belldegrun AS | title = Secondary hormonal therapy for advanced prostate cancer | journal = J. Urol. | volume = 175 | issue = 1 | pages = 27β34 | date = January 2006 | pmid = 16406864 | doi = 10.1016/S0022-5347(05)00034-0}}</ref><ref name="pmid9712436">{{cite journal | vauthors = Fourcade RO, Chatelain C | title = Androgen deprivation for prostatic carcinoma: a rationale for choosing components | journal = Int. J. Urol. | volume = 5 | issue = 4 | pages = 303β11 | date = July 1998 | pmid = 9712436 | doi = 10.1111/j.1442-2042.1998.tb00356.x | s2cid = 25107178 | doi-access = free}}</ref> These include [[cyproterone acetate]], [[chlormadinone acetate]], and [[megestrol acetate]].<ref name="pmid16406864" /><ref name="pmid9712436" /> Other progestogens such as [[medroxyprogesterone acetate]], [[hydroxyprogesterone caproate]], and [[gestonorone caproate]] have also been studied, but have inadequate effectiveness. They act by suppressing [[gonad]]al [[testosterone]] [[biosynthesis|production]] and hence circulating testosterone levels. Androgens like testosterone stimulate the growth of prostate [[tumor]]s. ===Fertility and pregnancy=== Progestogens are used in [[fertility medicine]] for women. For example, progesterone (or sometimes [[dydrogesterone]] or [[hydroxyprogesterone caproate]]) is used for [[luteal support]] in [[in vitro fertilisation|''in-vitro'' fertilization]] protocols.<ref name="Loose 2006">{{cite book |author1=Loose, Davis S. |author2=Stancel, George M. |editor1=Brunton, Laurence L. |editor2=Lazo, John S. |editor3=Parker, Keith L. |year=2006 |chapter=Estrogens and Progestins |title=Goodman & Gilman's The Pharmacological Basis of Therapeutics |edition=11th |pages=1541β71 |location=New York |publisher=McGraw-Hill |isbn=978-0-07-142280-2}}</ref> Certain progestogens are used to support [[pregnancy]], including [[progesterone (medication)|progesterone]], [[hydroxyprogesterone caproate]], [[dydrogesterone]], and [[allylestrenol]]. They are used questionably for treatment of [[habitual abortion|recurrent pregnancy loss]] and for prevention of [[premature birth|preterm birth]] in pregnant women with a history of at least one spontaneous preterm birth.<ref name="Loose 2006" /> ===Puberty suppression=== Progestogens have been used to treat [[precocious puberty]] in both boys and girls. They have also been used to delay puberty in [[transgender youth]]. ===Sexual deviance=== Certain progestogens, such as [[cyproterone acetate]] and [[medroxyprogesterone acetate]], are used as a form of [[chemical castration]] to treat [[sexual deviance]] in men, particularly [[sex offender]]s. They are specifically used to treat [[paraphilia]]s and [[hypersexuality]]. They work by suppressing [[gonad]]al [[testosterone]] [[biosynthesis|production]] and hence circulating testosterone levels. This results in decreased [[libido]] and interference with [[erectile function]] and ability to attain [[orgasm]]. ===Skin and hair conditions=== Progestogens are used to treat [[androgen-dependent condition|androgen-dependent]] [[skin condition|skin]] and [[hair condition]]s in women. These include [[oily skin]], [[acne]], [[seborrhea]], [[hirsutism]], [[scalp hair loss]], and [[hidradenitis suppurativa]]. They act by suppressing testosterone levels and, in the case of antiandrogenic progestogens, by directly blocking the actions of androgens. ===Androgen excess=== Progestogens are used to treat [[hyperandrogenism]], such as due to [[polycystic ovary syndrome]] and [[congenital adrenal hyperplasia]], in women. Examples include [[cyproterone acetate]] and [[chlormadinone acetate]]. ===Appetite stimulation=== Certain progestins can be used at very high doses to [[appetite stimulant|increase appetite]] in conditions like [[cachexia]], [[anorexia (symptom)|anorexia]], and [[wasting syndrome]]s. In general, they are used in combination with certain other steroid medications such as [[dexamethasone]]. Their effects take several weeks to become apparent, but are relatively long-lived when compared to those of [[corticosteroid]]s. Furthermore, they are recognized as being the only medications to increase [[lean body mass]]. [[Megestrol acetate]] is the lead drug of this class for the management of cachexia, and [[medroxyprogesterone acetate]] is also used.<ref name="pmid11332139">{{cite journal |vauthors=Maltoni M, Nanni O, Scarpi E, Rossi D, Serra P, Amadori D | title = High-dose progestins for the treatment of cancer anorexia-cachexia syndrome: a systematic review of randomised clinical trials | journal = Ann. Oncol. | volume = 12 | issue = 3 | pages = 289β300 |date=March 2001 | pmid = 11332139 | doi = 10.1023/a:1011156811739 | doi-access = free}}</ref><ref name="pmid12868546">{{cite journal |vauthors=Lelli G, Montanari M, Gilli G, Scapoli D, Antonietti C, Scapoli D | title = Treatment of the cancer anorexia-cachexia syndrome: a critical reappraisal | journal = J Chemother | volume = 15 | issue = 3 | pages = 220β5 |date=June 2003 | pmid = 12868546 | doi = 10.1179/joc.2003.15.3.220 | s2cid = 29442148}}</ref> The [[mechanism of action]] of the appetite-related effects of these two medications is unknown and may not be related to their progestogenic activity. Very high doses of other progestogens, like [[cyproterone acetate]], have minimal or no influence on appetite and weight.
Edit summary
(Briefly describe your changes)
By publishing changes, you agree to the
Terms of Use
, and you irrevocably agree to release your contribution under the
CC BY-SA 4.0 License
and the
GFDL
. You agree that a hyperlink or URL is sufficient attribution under the Creative Commons license.
Cancel
Editing help
(opens in new window)