Use of progestational compounds in gynaecology and obstetrics
Shah, P.N.
Journal of Obstetrics and Gynaecology of India 20(3): 298-315
1970
ISSN/ISBN: 0971-9202 PMID: 12275252 Document Number: 23069
The development of the synthesis of potent orally active 19-norsteroids and the beginning of the use of steroid hormones for contraception via ovulation suppression is reviewed. Chemical structures are shown for 19-nortestosterone progestogens: removal of the methyl group from position 19 increased the potency and additional potency was obtained by addition of an acetate group at positions 3 and 17 or of cyclopentylenol ether at position 3. 19-nortestosterone derivatives are partly metaboloized to estrogens; therefore they are called estrogenic testosterone. However they have no detectable estrogenic action. Chlomadinone is the most potent substituted progestogen and ethynodiol acetate is the most effective 19-norsteroid. Clinical applications are: 1)proved indications--dysfunctional uterine bleeding, menorrhagia, hypomenorrhea, amenorrhea, primary dysmenorrhea, endometriosis, metastatic endometrial carcinonma, and contraception; 2)proposed indications--precocious puberty, increase in linear growth in girls; timing of menstruation hirsutism of ovarian origin, idiopathic infertility and inadequate luteal phase, habitual abortion, and metastatic breast carcinoma.