{"paper_id":"47bda4a7-fe59-42d9-9b0f-945ae27db5f8","body_text":"Abstract\nSince the 1970s the main thrust of drug research and development in endometriosis has been with danazol and latterly the LHRH analogues. The role of these drugs is explored in detail elsewhere in this book and there is no doubt about their efficacy. However, these developments have tended to overshadow the use of progestagens and anti-gestagens in treatment of the disease and yet both these types of compounds are also effective. They undoubtedly have an important therapeutic role both as first- and second- line drugs. The purpose of this chapter is to describe the place of these drugs in the treatment of endometriosis. We shall begin by describing gestagens, then move on to anti-gestagens as exemplified by the new compound, gestrinone (Roussel - UCLAF, Paris).\nPreview\nUnable to display preview. Download preview PDF.\nSimilar content being viewed by others\nReferences\nKistner, R.W. (1958). The use of newer progestins in the treatment of endometriosis. Am. J. Obstet Gynecol., 75, 264–278\nKistner, R.W. (1965). Current status of the hormonal treatment of endometriosis. Clin. Obstet. Gynecol., 9, 271–292\nKistner, R.W. (1959). Treatment of endometriosis by inducing pseudo-pregnancy with ovarian hormones. Fertil. Steril., 10, 539–554\nAndrews, M.C., Andrews, W.C. and Strauss, M.D. (1959). Effects of progestin-induced pseudopregnancy on endometriosis: Clinical and microscopic studies. Am. J. Obstet. Gynecol., 78, 776–785\nThomassen, H. and Berthelsen, H.G. (1966). Treatment of endometriosis with progestogens. Dan. Med. Bull., 13, 33–35\nChalmers, J.A. (1962). Treatment of endometriosis with Anovlar. J. Obstet. Gynaecol Br. Commonw., 69, 801–803\nOstergaard, E. (1965). The oral progestational and anti-ovulatory properties of megestrol acetate and its therapeutic use in gynaecological disorders. J. Obstet. Gynaecol Br. Commonw., 72, 45–58\nKourides, I.A. and Kistner, R.W. (1968). Three new synthetic progestins in the treatment of endometriosis. Obstet. Gynecol., 31, 821–828\nThomas, H.H. (1960). Conservative treatment of endometriosis. Use of long-acting ovarian steroid hormones. Obstet. Gynecol., 15, 498–503\nNoble, A.D. and Letchworth, A.T. (1979). Medical treatment of endometriosis: a comparative trial. Postgrad. Med. J., 55 (suppl. 5), 37–39\nNoble, A.D. and Letchworth, A.T. (1980). Treatment of endometriosis: A study of medical management. Br. J. Obstet. Gynaecol., 87, 726–729\nKistner, R.W. (1965). The effects of new synthetic progestogens on endometriosis in the human female. Fertil. Steril., 16, 61–80\nRiva, H.L., Wilson, J.H. and Kawaski, D.M. (1961). Effect of norethynodrel on endometriosis. Am. J. Obstet. Gynecol., 81, 109–118\nLebherz, T.B. and Fobes, CD. (1961). Management of endometriosis with nor-progesterone. Am. J. Obstet. Gynecol., 83, 102–110\nDito, W.R. and Batsakis, J.G. (1961). Norethynodrel-treated endometriosis: A morphologic and histochemical study. Obstet. Gynecol., 18, 1–12\nRiva, H.L., Kawaski, D.M. and Messinger, A.J. (1962). Further experience with norethynodrel in treatment of endometriosis. Obstet. Gynecol., 19, 111–117\nWilliams, B.P.F. (1962). Conservative treatment of endometriosis with progestin therapy. Am. J. Obstet. Gynecol., 83, 715–719\nWilliams, B.F.P. (1967). Conservative management of endometriosis: Follow-up observations of progestin therapy. Obstet. Gynecol., 30, 76-S2\nSoiva, K. and Castren, O. (1963). The conservative treatment of endometriosis with lynestrenol. Ann. Chir. Gynaecol. Venn., 52, 376–382\nSoiva, K. and Castren, O. (1964). Clinical observations on the effect of lynestrenol on endometriosis and ovarian function. Int. J. Fertil., 9, 253–255\nTimonen, S. and Johansson, C.-J. (1968). Endometriosis treated with lynestrenol. Ann. Chir. Gynaecol. Fenn., 57, 144–147\nMettler, L. (1987). Vergleich der medikamentösen Behandlung der Endometriosis genitalis externa mit Gestrinon, Lynestrenol und Danazol in Rahmen-Stufen-Behandlung. Fertilitat, 3, 133–139\nMettler, L. and Semm, K. (1984). 3-Step therapy of genital endometriosis in cases of human infertility with lynestrenol, danazol or gestrinone administration with the 2nd step. In Raynaud, J.P., Ojasso, T. and Martini, L. (eds.) Medical Management of Endometriosis, pp. 233–247. (New York: Raven Press)\nGunning, J.E. and Moyer, D. (1967). The effect of medroxyprogesterone acetate on endometriosis in the human female. Fertil. Steril., 18, 759–774\nMoghissi, K.S. and Boyce, C.R. (1976). Management of endometriosis with oral medroxyprogesterone acetate. Obstet. Gynecol., 47, 265–267\nRoland, M., Leisten, D. and Kane, R. (1976). Endometriosis therapy with medroxyprogesterone acetate. J. Reprod. Med., 17, 249–252\nLuciano, A.A., Turksoy, R.N. and Carleo, J. (1988). Evaluation of oral medroxyprogsterone acetate in the treatment of endometriosis. Obstet. Gynecol., 72, 323–327\nAmerican Fertility Society. (1985). Revised American Fertility Society classification for endometriosis. Fertil. Steril., 43, 351–352\nTelimmaa, S., Puolakka, J., Ronnberg, L. and Kauppila, A. (1987). Placebo-controlled comparison of danazol and high-dose medroxyprogesterone acetate in the treatment of endometriosis. Gynecol. Endocrinol., 1, 13–23\nAydar, C.K. and Greenblatt, R.B. (1964). 6-Dehydro-retroprogesterone (Duphaston) an interesting progesterone-like compound. Int. J. Fertil., 9, 585–95\nBacker, M.H. (1962). Isopregnenone (Duphaston): A new progestational agent. Obstet. Gynecol., 19, 724–729\nJohnston, W.I.H. (1976). Dydrogesterone and endometriosis. Br. J. Obstet. Gynaecol., 83, 77–80\nGrant, A. (1961). The non-surgical treatment of endometriosis by progestagens. Med. J. Amt., 48, 936–938\nGrant, A. (1963). An evaluation of the conservative treatment of endometriosis. Aust. N.Z. Obstet. Gynaecol., 3, 162–167\nEvers, J. (1987). The second look laparoscopy for the evaluation of the results of medical treatment of endometriosis should not be performed during ovarian suppression. Fertil. Steril., 47, 502–504\nScott, R.B. and Wharton, L.R. (1957). The effect of estrone and progesterone on the growth of experimental endometriosis in rhesus monkey. Am. J. Obstet. Gynecol., 74, 852–863\nTeichmann, A.T., Cremer, P., Wieland, H., Kuhn, W. and Seidel, D. (1988). Lipid metabolic changes during hormonal treatment of endometriosis. Maturitas, 10, 27–33\nSakiz, E. and Azadian-Boulanger, G. (1970). R-2323 — An original contraceptive compound. In Hormonal Steroids. Proceedings of the Third International Congress. Excerpta Medical International Congress Series, No. 219, pp. 865–871\nAzadian-Boulanger, G., Secchi, J. and Sakiz, E. (1971). Biological study of the anti-progesterone effect of R2323. In Recent Investigations in Reproduction. Excerpta Medica International Congress Series, No. 278, pp. 129–133\nSakiz, E., Azadian-Boulanger, G. and Raynaud, J.P. (1972). Antiestrogens, antiprogesterones. In Proceedings of the Fourth International Congress of Endocrinology. Excerpta Medica International Congress Series, No. 273, pp. 988–994\nAzadian-Boulanger, G., Secchi, J., Laraque, F., Raynaud, J.P. and Sakiz, E. (1976). Action of the midcycle contraceptive (R 2323) on the human endometrium. Am. J. Obstet. Gynecol., 125, 1049–1056\nMoguilewsky, M. and Philibert, D. (1984). Dynamics of the receptor interactions of danazol and gestrinone in the rat: Correlation with biological activities. In Raynaud, J-P., Ojasoo, T. and Martini, L. (eds.) Medical Management of Endometriosis, pp. 163–181. (New York: Raven Press)\nProulx, L., Labrie, F., Veilleux, R. and Azadian-Boulanger, G. (1984). Actions of progestins and androgens at the hypothalamo-adenohypophyseal level in the female rat. In Raynaud, J-P., Ojasoo, T. and Martini, L. (eds.) Medical Management of Endometriosis, pp. 149–162. (New York: Raven Press)\nPugeat, M., Nicolas, B., Tournaire, J. and Forest, M.G. (1984). Interaction of gestrinone with human plasma steroid binding proteins. In Raynaud, J-P., Ojasoo, T. and Martini, L. (eds.) Medical Management of Endometriosis, pp. 183–192. (New York: Raven Press)\nKauppila, A., Isomaa, V., Ronnberg, L., Vierikko, P. and Vihko, R. (1985). Effect of gestrinone in endometriosis tissue and endometrium. Fertil. Steril., 44, 466–470\nThomas, E.J. and Cooke, I.D. (1987). The impact of gestrinone upon the course of asymptomatic endometriosis. Br. Med. J., 294, 272–274\nDowsett, M., Attree, S.L., Virdee, S.S. and Jeffcoate, S.L. (1985). Oestrogen-related changes in sex hormone binding globulin levels during normal and gonadotrophin stimulated menstrual cycles. Clin. Endocrinol., 23, 303–312\nDowsett, M., Forbes, K.L., Rose, G.L., Mudge, J.E. and Jeffcoate, S.L. (1986). A comparison of the effects of danazol and gestrinone on testosterone binding to sex hormone binding globulin in vitro and in vivo. Clin. Endocrinol, 24, 555–563\nBergquist, A., Landgren, B-M. and Diczfalusy, E. (1988). Clinical, pharmacokinetic and pharmacodynamic study of three progestagens in the treatment of endometriosis. New Trends Gynaecol. Obstet., 4, 65–84\nVenturini, P.L., Fasce, V., Bertolini, S. et al (1989). Endocrine metabolic and clinical effects of gestrinone in women with endometriosis. Fertil. Steril., 52, 589–599\nRobyn, C., Delogne-Desnoeck, J., Bourdoux, P. and Copinschi, G. (1984). Endocrine effects of gestrinone. In Raynaud, J-P., Ojasoo, T. and Martini, L. (eds.) Medical Management of Endometriosis, pp. 207–222. (New York: Raven Press)\nKitawaki, J., Yamamoto, T. and Okada, H. (1988). Induction of estradiol dehydrogenase activity in human uterine endometrium by synthetic steroids. J. Endocrinol Invest., 11, 351–354\nRose, G.L., White, J.O., Dowsett, M., Mudge, J.E. and Jeffcoate, S.L. (1988). The inhibitory effects of danazol, danazol metabolites, gestrinone and testosterone on the growth of human endometrial cells in vitro. Fertil. Steril., 49, 224–228\nBrosens, I.A., Verleyen, A. and Cornillie, F. (1987). The morphologic effect of short-term medical therapy of endometriosis. Am. J. Obstet. Gynecol., 157, 1215–1221\nCornillie, F.J., Brosens, I.A., Vasquez, G. and Riphagen, I. (1986). Histologic and ultrastructural changes in human endometriotic implants treated with the antiprogesterone steroid ethylgestrienone (Gestrinone) during 2 months. Int. J. Gynaecol. Pathol., 5, 95–109\nRaynaud, J-P., Salmon, J., Azadian-Boulanger, G., Bucourt, R. and Sakiz, E. (1973). Metabolic studies of R-2323, an original contraceptive compound. In Abstracts, Federation International Pharmac., Stockholm, p. 39\nSalmon, J., Cousty, C. and Mouren, M. (1984). Gestrinone pharmacokinetics and metabolism. In Raynaud, J-P., Ojasoo, T. and Martini, L. (eds.) Medical Management of Endometriosis, pp. 103–206. (New York: Raven Press)\nHornstein, M.D., Gleason, R.E. and Barbieri, R.L. (1990). A randomised double blind prospective trial of two doses of gestrinone in the treatment of endometriosis. Fertil. Steril., 53, 237–241\nCoutinho, E.M. (1982). Treatment of endometriosis with gestrinone (R-2323) a synthetic antiestrogen, antiprogesterone. Am. J. Obstet. Gynecol., 144, 895–898\nCoutinho, E.M., Husson, J.M. and Azadian-Boulanger, G. (1984). Treatment of endometriosis with gestrinone — five years experience. In Raynaud, J-P., Ojasoo, T. and Martini, L. (eds.) Medical Management of Endometriosis, pp. 249–261. (New York: Raven Press)\nCoutinho, E.M. and Azadian-Boulanger, G. (1988). Treatment of endometriosis by vaginal administration of gestrinone. Fertil. Steril., 49, 418–422\nSakiz, E., Azadian-Boulanger, G., Laraque, F. and Raynaud, J.P. (1974). A new approach to estrogen-free contraception based on progesterone receptor blockade by mid-cycle administration of ethyl norgestrienone. Contraception, 10, 467–474\nDavid, S.S., Huggins, G.R., Garcia, C-R. and Busacca, C. (1979). A synthetic steroid (R-2323) as a once a week contraceptive. Fertil. Steril., 31, 278–281\nDeltour, G., Azadian-Boulanger, G., Nelson, J. and Sakiz, E. (1984). Tolerance and contraceptive efficacy of gestrinone in 800 patients in the United States from 1974 to 1978. In Raynaud, J-P., Ojasoo, T. and Martini, L. (eds.) Medical Management of Endometriosis, pp. 223–232. (New York: Raven Press)\nCoutinho, E.M. and Goncalves, M.T. (1989). Long-term treatment of leiomyomas with gestrinone. Fertil. Steril., 51, 939–946\nAmerican Fertility Society (1979). Classification of endometriosis. Fertil. Steril., 32, 633\nFedele, L., Bianchi, S., Viezzoli, T., Arcaini, L. and Candiani, G.B. (1989). Gestrinone versus danazol in the treatment of endometriosis. Fertil. Steril., 51, 781–785\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 1991 Springer Science+Business Media Dordrecht\nAbout this chapter\nCite this chapter\nThomas, E.J., Mettler, L. (1991). Gestogens and anti-gestogens as treatment of endometriosis. In: Thomas, E.J., Rock, J.A. (eds) Modern Approaches to Endometriosis. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-3864-2_12\nDownload citation\nDOI: https://doi.org/10.1007/978-94-011-3864-2_12\nPublisher Name: Springer, Dordrecht\nPrint ISBN: 978-94-010-5719-6\nOnline ISBN: 978-94-011-3864-2\neBook Packages: Springer Book Archive\nKeywords\n- Medroxyprogesterone Acetate\n- LHRH Analogue\n- Breakthrough Bleeding\n- American Fertility Society\n- Plasma Testosterone Concentration\nThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.","source_license":"CC0","license_restricted":false}