Symposium on steroid hormones. 1. Synthetic progestational steroids. Their significance and use.

Synthetic progestational compounds are evaluated in terms of specifi c potencies and actions. The synthetic progestins have a wide spectrum of activity. Certain progestins might be preferred in 1 situation and others elsewhere. In reviewing the progestins, it was concluded that the management of habitual abortion might be most effective by administering 1 gm of progesterone or 40 mg of medroxyprogesterone daily by mouth. As an injectable, 17-hydroxyprogesterone caproate insures constancy of action and promotes a physiologic type of secretory endometrium. Medroxyprogesterone as an oral agent also appears favorable in this regard. The 19-norsteroids appear to have a hemostatic action. They have a definite role in the management of dysmenorrhea. Pregnancy has occurred with astonishing promptness in fertile women who have stopped the use of 19-norsteroids taken previously for contraceptive purposes. The 19-norsteroids and medroxyprogesterone are being used in the treatment of endometriosis. It was concluded that the concept of a synthetic progestin merely as a convenient substitute for progesterone is untenable and does not take advantage of the great potential of these new drugs.