progestiny

Progestiny is a term that may be encountered to refer broadly to progestins—synthetic progesterone-like medications—or, in some contexts, to the natural hormone progesterone itself. In formal pharmacology, the term progestin is preferred for synthetic compounds, while progesterone denotes the endogenous hormone. Progestiny, when used, therefore often denotes the same receptor-driven actions on the progesterone receptor (PR) that underlie both natural and synthetic progestogens.

Pharmacology: Progestins bind to PR-A and PR-B, modulating transcription of target genes involved in the endometrium, cervical mucus, and ovulation suppression. They vary in effects beyond progesterone activity, including androgenic, glucocorticoid, and mineralocorticoid properties, depending on chemical structure. Metabolism occurs primarily in the liver, with elimination via urine and feces. Duration of action ranges from hours to days, enabling a variety of regimens in clinical use.

Medical uses: Progestins are used for contraception (oral, injectable, implants, vaginal rings), hormone replacement therapy for menopausal symptoms, management of abnormal uterine bleeding, treatment of endometriosis and other gynecologic conditions, and support of assisted reproduction protocols.

Safety and adverse effects: Common side effects include nausea, breast tenderness, headaches, mood changes, and breakthrough bleeding. Thromboembolic risk varies with formulation, particularly when used with estrogen-containing regimens. Long-term use can affect lipid profiles, blood pressure, glucose tolerance, and bone density; individual risk assessment is advised.

Availability and regulation: Progestins are formulated in many products with differing pharmacokinetics. Examples include norethindrone, levonorgestrel, desogestrel, gestodene, drospirenone, and medroxyprogesterone acetate. Choice depends on indication and patient factors; some progestins have antiandrogenic or antimineralocorticoid properties.