Progesterone -Its classifications

Classifications of Progesterones:  Family of progestins Parent compounds

A)Progesterone

1) 17a acetoxyprogestreone – Pregnane  derivatives – Megestrol acetate , medroxyprogesterone acetate , Chlormadinone acetate cyproterone acetate

B) Testosterone – Derivatives – 19  nortestosterone

C)  – Estrane derivatives – Norethindrone , norethindrone acetate , Ethynodiol diacetate , Mefipristenone , norethynodrel , Tibolone

D)                        Gonane  derivatives

Norgestrel

Levonorgestrel

Desogestrel

Etonogestrel

Gestodene

Norgestimate

Norelgestromin

Spirolactone – 17a spironolactone – Drospirenonehe other way of classification of Progesterones: Besides the natural progestin, progesterone, there are different classes of progestins, such as 1) retroprogesterone (i.e. dydrogesterone) used for preg support/ Luteal support. And sometimes for withdraw bleed when ET is > 6 mm 2) , progesterone derivatives (i.e. medrogestone) 17α-hydroxyprogesterone derivative) chlormadinone acetate(not used nowadays ) , b) cyproterone acetate(questionable progesterone) , c) medroxyprogesterone acetate mostly used as cycle nebulizers ,d) megestrol acetate mainly as first gen COC ), e)19-nor progesterone derivatives (i.e. nomegestrol, promegestone, trimegestone, nesterone—these 4 are for sub dermal implants ), f) 19-nortestosterone derivatives most commonly used progesterone norethisterone (NET), lynestrenol, levonorgestrel, desogestrel, gestodene, norgestimate all these are primarily for COC . Dienogest also come under this group may be used for COC but dienogest-used mainly for endometriosis or. There is still another group called spironolactone derivatives (i.e. drospirenone).

Some of the synthetic progestins are prodrugs, which need to be metabolized to become active compounds. Besides the progestogenic effect, which is in common for all progestins, there is a wide range of biological effects, which are different for the various progestins and have to be taken into account, when medical treatment is considered.