Part of “CHAPTER 98 – ENDOMETRIOSIS“

Many synthetic progestins are effective in the treatment of pelvic pain caused by endometriosis. High-dose progestin treatment produces an acyclic, hypoestrogenic environment by suppressing gonadotropin secretion. In addition, synthetic progestins have direct antiestrogenic effects on endometriosis lesions by binding to intracellular progesterone and androgen receptors. Synthetic progestins can be divided into two broad classes, the C-21 progestins, such as medroxyprogesterone acetate (MPA), and the C-19 progestins, such as gestrinone. In general, the C-19 progestins have more androgenic activity than the C-21 progestins.