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The androgenicity of progestins.
Am J Med. 1995 Jan 16; 98(1A):104S-110S.AJ

Abstract

All steroid hormones are structurally similar, but relatively minor differences cause profound alterations in biochemical activity. The 21-carbon series (pregnane nucleus) includes the corticoids and the true progestins (e.g., medroxyprogesterone acetate). The 19-carbon series (androstane nucleus) includes all the androgens, among them the progestins used in most oral and parenteral contraceptives. The removal of carbon 19 from testosterone changes the major hormonal effect from androgenic to progestogenic, but these "19-nor" steroids retain varying degrees of androgenic activity. (They can also have limited estrogenic activity, but this is insignificant at the low doses used for contraception.) Some of the 19-nortestosterone progestins are metabolized to other compounds (e.g., norethynodrel, ethynodiol diacetate, and lynestrenol to norethindrone), and some (levonorgestrel, desogestrel) are active unchanged. The lingering androgenic effects of 19-nor progestins are dose-related, opposed by estrogen, and are manifested metabolically (e.g., glucose tolerance, lipoprotein synthesis) and symptomatically (e.g., acne, weight gain). The effect of 19-nortestosterones on lipoproteins prompted the development of less androgenic compounds, but the obvious benefit of the new progestins (desogestrel, gestodene, norgestimate) is a reduction in the symptoms associated with the androgenicity of the older compounds. Mitigation of androgenic effects on lipoprotein and carbohydrate metabolism could have long-term benefits, especially for women who are at risk of arteriosclerotic vascular disease; however, these effects remain to be epidemiologically demonstrated.

Authors+Show Affiliations

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

7825629

Citation

Darney, P D.. "The Androgenicity of Progestins." The American Journal of Medicine, vol. 98, no. 1A, 1995, 104S-110S.
Darney PD. The androgenicity of progestins. Am J Med. 1995;98(1A):104S-110S.
Darney, P. D. (1995). The androgenicity of progestins. The American Journal of Medicine, 98(1A), 104S-110S.
Darney PD. The Androgenicity of Progestins. Am J Med. 1995 Jan 16;98(1A):104S-110S. PubMed PMID: 7825629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The androgenicity of progestins. A1 - Darney,P D, PY - 1995/1/16/pubmed PY - 1995/1/16/medline PY - 1995/1/16/entrez KW - Biology KW - Carbohydrate Metabolic Effects KW - Contraception KW - Contraceptive Agents, Female--side effects KW - Contraceptive Agents, Progestin--side effects KW - Contraceptive Agents--side effects KW - Family Planning KW - Lipid Metabolic Effects KW - Lipids KW - Literature Review KW - Metabolic Effects KW - Physiology SP - 104S EP - 110S JF - The American journal of medicine JO - Am J Med VL - 98 IS - 1A N2 - All steroid hormones are structurally similar, but relatively minor differences cause profound alterations in biochemical activity. The 21-carbon series (pregnane nucleus) includes the corticoids and the true progestins (e.g., medroxyprogesterone acetate). The 19-carbon series (androstane nucleus) includes all the androgens, among them the progestins used in most oral and parenteral contraceptives. The removal of carbon 19 from testosterone changes the major hormonal effect from androgenic to progestogenic, but these "19-nor" steroids retain varying degrees of androgenic activity. (They can also have limited estrogenic activity, but this is insignificant at the low doses used for contraception.) Some of the 19-nortestosterone progestins are metabolized to other compounds (e.g., norethynodrel, ethynodiol diacetate, and lynestrenol to norethindrone), and some (levonorgestrel, desogestrel) are active unchanged. The lingering androgenic effects of 19-nor progestins are dose-related, opposed by estrogen, and are manifested metabolically (e.g., glucose tolerance, lipoprotein synthesis) and symptomatically (e.g., acne, weight gain). The effect of 19-nortestosterones on lipoproteins prompted the development of less androgenic compounds, but the obvious benefit of the new progestins (desogestrel, gestodene, norgestimate) is a reduction in the symptoms associated with the androgenicity of the older compounds. Mitigation of androgenic effects on lipoprotein and carbohydrate metabolism could have long-term benefits, especially for women who are at risk of arteriosclerotic vascular disease; however, these effects remain to be epidemiologically demonstrated. SN - 0002-9343 UR - https://www.unboundmedicine.com/medline/citation/7825629/The_androgenicity_of_progestins_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(99)80067-9 DB - PRIME DP - Unbound Medicine ER -
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