Progestagen

[proh-jes-tuh-juhn]

Progestagens (also spelled progestogens or gestagens) are hormones that produce effects similar to those of progesterone, the only natural progestagen. All other progestogens are synthetic and are often referred to as progestins.

All progestagens have antiestrogenic (counteracting the effects of estrogens on the body) and antigonadotropic (inhibiting the production of sex steroids by gonads) properties.

Progestogens differ in their potency (affinity for progesterone receptors) and side-effects. Such side-effects may be androgenic (medroxyprogesterone and most C19 progestagens), antiandrogenic (cyproterone acetate), estrogenic, glucocorticoid (some C21 progestogens), or antimineralocorticoid (progesterone).

Uses

Birth control

Progestogens are used alone in progestogen only pills, or with an estrogen in combined oral contraceptive pills, a contraceptive patch, and a contraceptive vaginal ring.
Medroxyprogesterone acetate (Depo-Provera) and norethindrone enantate (Noristerat) are used by depot injection.
Etonogestrol is released by subcutaneous implants (Implanon). Norplant and Jadelle implants release levonorgestrel.
Levonorgestrel is released by the intrauterine system IUS (Mirena).

Antiandrogen

Progestinic compounds decrease luteinizing hormone (LH) levels and as such, will have antiandrogenic properties in trans-women and cisgender males alike, due to decreased LH stimulation of the testes. Cyproterone is a common example of a progestinic medication, and is an effective antiandrogen, which has the added benefit of blocking androgen receptors in addition to the progestinic feedback to decrease LH levels.

Progestogen withdrawal bleeding

In a normal menstrual cycle, a sudden drop in progesterone levels triggers menstruation. Norethindrone acetate (brand name Aygestin) and medroxyprogesterone acetate (brand name Provera) may be used to artificially induce progestogen withdrawal bleeding.