Selective progesterone receptor modulators and reproductive health

review OA: closed CC0 ⤵ 1 in-corpus citation
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AI-generated summary by gemini-2.5-flash-lite, 2026-06-08

Selective progesterone receptor modulators (SPRMs) like mifepristone and ulipristal acetate show promise for reproductive health but require further study due to potential liver function abnormalities with chronic use.

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Abstract

PURPOSE OF REVIEW: This review is intended to provide perspective on the history of selective progesterone receptor modulators (SPRMs) and progesterone antagonists, their current availability, therapeutic promise and safety concerns. RECENT FINDINGS: Despite keen interest in synthesis of these compounds, only a handful have had clinical test results allowing for commercialization. Mifepristone is well tolerated and effective for single dose first trimester at-home pregnancy termination and is available in much of the world. Ulipristal acetate, at single doses, is well tolerated and effective for emergency contraception, with less availability. Chronic use of these agents has been associated with abnormal liver enzymes, and rarely, with hepatic failure; causality is not understood. SUMMARY: SPRMs and progesterone antagonists have great therapeutic promise for use in other reproductive disorders, including breast cancer, endometriosis, adenomyosis, estrogen-free contraception and cervical ripening but require additional study. Alternative formulations, whether local (topical breast or intrauterine) or extended-release may reduce the incidence of liver function abnormalities and should be explored.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone Progesterone

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References (44)

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europepmc
last seen: 2026-08-26T06:08:41.316361+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-07-14T06:08:25.154024+00:00
unpaywall
last seen: 2026-08-26T06:23:03.089193+00:00
License: CC0 · commercial use OK