New Progestogens: A Review of Clinical Data
The past 5 years have witnessed important simultaneous developments in the understanding of the role of progesterone in the prevention and treatment of menopausal disorders, and in the evolution of a group of progestogens that may have fewer undesirable effects when used in postmenopausal women. The pharmacology and clinical applications of oral contraceptives based on the new progestins have been the subject of many publications, although applications among postmenopausal women have been reported less frequently. Each of these new progestins is related to the levonorgestrel (LNG) molecule, which differs by one methyl grouping from norethindrone (NET). The new compounds are desogestrel (DSG), gesto-dene (GSD), and norgestimate (NGM). The structural distinctions among this group of progestational steroids are relatively small, but these small differences allow for the possibility of distinguishable pharmacologic and clinical effects. Receptor and metabolic studies suggest that these different effects may favor the use of the new progestins. Clinical experience also suggests that efficacy and adverse affects (at least in relation to oral contraception) are similar in formulations based on the new progestogens, compared with compounds now in wide use.
KeywordsCholesterol Osteoporosis Progesterone Estradiol Thrombin
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