Progestin



 

A progestin is a progesterone.

The two most frequent uses of progestins are for estrogen), and to prevent endometrial hyperplasia from unopposed estrogen in hormone replacement therapy. Progestins are also used to treat secondary amenorrhea, dysfunctional uterine bleeding and endometriosis, and as palliative treatment of endometrial cancer, renal cell carcinoma, breast cancer, and prostate cancer. High dose megestrol acetate is used to treat anorexia, cachexia and AIDS-related wasting. Progesterone (or sometimes the progestin 17α-hydroxyprogesterone caproate) is used for luteal support in IVF protocols, questionably for treatment of recurrent pregnancy loss, and for prevention of preterm birth in pregnant women with a history of at least one spontaneous preterm birth.[1]

History

The recognition of progesterone's ability to suppress ovulation during pregnancy spawned a search for a similar hormone that could bypass the problems associated with administering progesterone (low bioavailability when administered orally and local irritation and pain when continually administered parenterally) and, at the same time, serve the purpose of controlling ovulation. The many synthetic hormones that resulted are known as progestins.

The first orally active progestin, Schering in the U.S. in 1945 as Pranone[2][3][4][5][6]

A more potent orally active progestin, first oral contraceptives (Ortho-Novum, Norinyl, etc.) in the early 1960s.[3][3][4][5][6][7]

Searle in Skokie, Illinois and used as the progestin in Enovid, marketed in the U.S. in 1957 and approved as the first oral contraceptive in 1960.[3][4][5][6][8]

Examples

Some examples of progestins that have been used in hormonal contraceptives are desogestrel.

Methods of progestin-based contraception

It has been found that the most effective method of contraception was with a combination of estrogen and progestin. This can be done in a monophasic, biphasic, or in a triphasic manner. In the monophasic method, both an estrogen and a progestin are administered for 20 or 21 days and stopped for a 7 or 8 day period that includes the 5 day menstrual period. Sometimes, a 28 day regimen is used that includes 6 or 7 inert tablets. Newer biphasic and triphasic methods are now used to more closely simulate the normal menstrual cycle. Yet another method is to administer a small dose of progestin only (no estrogen) in order to decrease certain risks associated with administering estrogen, but a major side effect is irregular bleeding that is usually observed during the first 18 months of such therapy.

See also

List of steroid abbreviations

References

  1. ^ Loose, Davis S.; Stancel, George M. (2006). "Estrogens and Progestins", in Brunton, Laurence L.; Lazo, John S.; Parker, Keith L. (eds.): Goodman & Gilman's The Pharmacological Basis of Therapeutics, 11th ed., New York: McGraw-Hill, pp. 1541-71. ISBN 0-07-142280-3. 
  2. ^ Inhoffen HH, Logemann W, Hohlweg W, Serini A (May 4, 1938). "Untersuchungen in der Sexualhormon-Reihe (Investigations in the sex hormone series)". Ber Dtsch Chem Ges 71 (5): 1024-32.
  3. ^ a b c d Maisel, Albert Q. (1965). The Hormone Quest. New York: Random House. OCLC 543168. 
  4. ^ a b c Petrow V (1970). "The contraceptive progestagens". Chem Rev 70 (6): 713-26. PMID 4098492.
  5. ^ a b c Sneader, Walter (2005). "Hormone analogues", Drug discovery : a history. Hoboken, NJ: John Wiley & Sons, pp. 188-225. ISBN 0-471-89980-1. 
  6. ^ a b c Djerassi C (2006). "Chemical birth of the pill". Am J Obstet Gynecol 194 (1): 290-8. PMID 16389046.
  7. ^ Djerassi C, Miramontes L, Rosenkranz G, Sondheimer F (1954). "Steroids. LIV. Synthesis of 19-Nor-17α-ethynyltestosterone and 19-Nor-17α-methyltestosterone". J Am Chem Soc 76 (16): 4089-91.
  8. ^ Colton FB (1992). "Steroids and "the pill": early steroid research at Searle". Steroids 57 (12): 624-30. PMID 1481226.
 
This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Progestin". A list of authors is available in Wikipedia.