The use of steroidal substances in endometriosis.

Methods of administration side effects and pharmacology of 4 proges tins employed in treating endometriosis were presented. 17-alpha-hydrox yprogesterone caproate (Delalutin) 17-alpha-ethinyl-17-hydroxy-5-10-est ren-3-one (norethynodrel) with 1.5% ethinyl estradiol-3-methyl ether (Enovid) 6-alpha-methyl-17-alpha hydroxyprogesterone acetate (medroxyprogesterone) (Provera) and 17-alpha-ethinyl-19-nortestosterone (norethindrone) (Norlutin) were considered in detail. They are administered in combination with small amounts of estrogen in gradually increasing dosage. A constancy of absorption is an advantage of a parenteral administration of Delalutin with estradiol valerate since nausea is diminished and its androgenic potential is low. Norethynodrel had given an 80-85% improvement rate in less than 100 treated patients. Its side effects can be combatted by lowering the estrogen content. Of 8 cases with extensive endometriosis treated with Provera all results were excellent. Norlutin a potent oral progestin has the disadvantage of causing hirsutism acne or breakthrough bleeding in some patients. A decidual response was produced in the endometrium and in all areas of endometriosis with all 4 progestins. Improvement rates of 75-85% were noted.