Which medications in the drug class Progestational Agents are used in the treatment of Endometriosis?

Updated: May 10, 2021
  • Author: G Willy Davila, MD; Chief Editor: Michel E Rivlin, MD  more...
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Progestational Agents

All progestational agents act by decidualization and atrophy of the endometrium. Use of this category of drugs relies on high-dose hormones to suppress the hypothalamus through negative feedback. This results in a hypoestrogenic state. Evidence for direct inhibition of endometrial implants by progestins also exists. These medications provide pain relief equivalent to the gonadotropin-releasing hormone (GnRH) analogues and seem to have a slightly lower recurrence rate.

Norethindrone acetate (Aygestin, Camila, Errin)

Norethindrone is a common progestin used in many of the oral (PO) contraceptive pills currently available; the dose administered for endometriosis is significantly higher.

Medroxyprogesterone (Provera, Depo-Provera)

Progestins stop endometrial cell proliferation, allowing organized sloughing of cells after withdrawal. These agents typically do not stop acute bleeding episode, but they produce normal bleeding episodes following withdrawal.

Medroxyprogesterone is a common progestin available in both an oral (PO) and an intramuscular (IM) depo form. The efficacy and adverse effects of this drug are similar to those of norethindrone.

Megestrol (Megace)

Megestrol produces results similar to those of medroxyprogesterone.

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