Classification and pharmacology of progestins

Adolf E Schindler; Carlo Campagnoli; René Druckmann; Johannes Huber; Jorge R Pasqualini; Karl W Schweppe; Jos H H Thijssen

doi:10.1016/j.maturitas.2003.09.014

Therapeutics Hormonal Agents

Classification and pharmacology of progestins

Schindler AE, Campagnoli C, Druckmann R, Huber J, Pasqualini JR, Schweppe KW, Thijssen JH

Published December 10, 2003 Maturitas, 46 Suppl 1, S7-S16

DOI 10.1016/j.maturitas.2003.09.014 PMID 14670641

RRM Academy Synopsis

Progestins form several classes, and each drug has its own effects

A 2003 Maturitas article by seven authors sorts synthetic progestins into classes. All progestins share one hormone effect, and their other biological effects differ from one progestin to another. Several of these drugs are changed by the body before they work.

Key Findings

The article sets natural progesterone beside synthetic classes: retroprogesterone, progesterone derivatives, 17alpha-hydroxyprogesterone derivatives, 19-norprogesterone derivatives, 19-nortestosterone derivatives and spironolactone derivatives.
In the abstract's examples, dydrogesterone is a retroprogesterone, drospirenone is a spironolactone derivative, and levonorgestrel and dienogest are 19-nortestosterone derivatives.
Some synthetic progestins are prodrugs, meaning the body has to metabolize them before they turn into the active compound.
All progestins share a progestogenic effect, and the abstract adds that many other effects vary from one progestin to another.

Interpretation

The source here is the published abstract of a classification article, so this summary reflects only what the abstract reports. The authors state that the varying effects of each progestin matter when medical treatment is under consideration. The abstract reports no patient data, outcomes or measurements.

RRM Context

Natural progesterone and the synthetic progestins belong to separate categories, and the abstract treats them that way. Restorative reproductive medicine works with the body's own function. A clear classification helps a reader judge studies that group very different drugs under one name.

Our editorial summary of this paper, not the article's abstract.

Abstract

Besides the natural progestin, progesterone, there are different classes of progestins, such as retroprogesterone (i.e. dydrogesterone), progesterone derivatives (i.e. medrogestone) 17alpha-hydroxyprogesterone derivatives (i.e. chlormadinone acetate, cyproterone acetate, medroxyprogesterone acetate, megestrol acetate), 19-norprogesterone derivatives (i.e. nomegestrol, promegestone, trimegestone, nesterone), 19-nortestosterone derivatives norethisterone (NET), lynestrenol, levonorgestrel, desogestrel, gestodene, norgestimate, dienogest) and spironolactone derivatives (i.e. drospirenone). Some of the synthetic progestins are prodrugs, which need to be metabolized to become active compounds. Besides the progestogenic effect, which is in common for all progestins, there is a wide range of biological effects, which are different for the various progestins and have to be taken into account, when medical treatment is considered.

Topics

Therapeutics › Hormonal Agents › Progesterone and Progestins · Reproductive Endocrinology › Ovarian Hormones › Progesterone

Adolf E Schindler, Carlo Campagnoli, René Druckmann, Johannes Huber, Jorge R Pasqualini, Karl W Schweppe, Jos H H Thijssen

A Schindler, C Campagnoli, R Druckmann, J Huber, J Pasqualini, K Schweppe, J Thijssen

PMID 14670641 14670641 DOI 10.1016/j.maturitas.2003.09.014 10.1016/j.maturitas.2003.09.014 Schindler et al. 2003, Schindler 2003

Classification and pharmacology of progestins

Progestins form several classes, and each drug has its own effects

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

Myoinositol as a Safe and Alternative Approach in the Treatment of Infertile PCOS Women: A German Observational Study

Peritoneal defects and the development of endometriosis in relation to the timing of endoscopic surgery during the menstrual cycle

Endometriosis: a clinically malignant disease

Related research

Uses of progesterone in clinical practice

Oral micronized progesterone

Impact of progestins on estrogen-induced neuroprotection: synergy by progesterone and 19-norprogesterone and antagonism by medroxyprogesterone acetate

Pharmacokinetics of progesterone administered by the oral and parenteral routes