Gestagens are a group of steroid hormones that act similarly to progesterone. Gestagens are not only responsible for the development and maintenance of pregnancy, they are also used in contraception. In addition, they often support women in the menopausal period. What do you need to know about gestagens?

Gestagensare steroid hormones, which, apart from androgens and estrogens, belong to the hormones acting on the reproductive system. Endogenous gestagen is progesterone responsible for the monthly effect on the uterine mucosa, thus preparing the woman's body for pregnancy, and then maintaining it.

In the 1950s, it became possible to synthesize this compound chemically. Preparations whose main ingredients are synthetic derivatives of progesterone compounds are called gestagens.

Gestagens - functions

Gestagens are commonly used:

  • in gynecology and obstetrics in the treatment of menstrual bleeding disorders
  • primary or secondary amenorrhea
  • in the treatment of infertility
  • in postmenopausal disorders
  • in preventing premature births
  • in endometriosis
  • in the treatment of endometrial tumors or breast cancer
  • as a contraceptive

Gestageny and pregnancy

Endogenous gestagen produced during pregnancy is progesterone. It works in such a way as to keep a developing embryo in a woman's body.

At the beginning, it facilitates its implantation in the uterine wall. Progesterone causes the muscle to relax, the uterus is adequately supplied with blood and is prepared to sustain the pregnancy.

This gestagen stimulates the growth of the placenta, thanks to which the exchange of gases, metabolites and energy products takes place.

Gestagens - division according to the scope of application

Due to the range of applications, gestagens can be divided into:

  • gestagens with a wide range of applications:
    • medroxyprogesterone
    • noretisteron
    • linestrenol
  • gestagens with a narrow scope of application, among which the following gestagens can be distinguished:
    • as contraceptives (gestodene, desogestrel, drospirenone)
    • in habitual miscarriage (hydroxyprogesterone)
    • in the treatment of cancerendometrium or breast cancer (megestrol)
    • in menstrual disorders (dydrogesterone, nomegestrol)
    • in the treatment of infertility (dydrogesterone, nomegestrol)

Gestagens - chemical breakdown

Due to the chemical structure, we distinguish:

  • progesterone derivatives -pregnany , in addition to the progesterone effect, may have an androgenic and estrogen-specific effect
  • 19-nortestosterone derivatives -estrany , which usually have androgenic effects in addition to progestagen
  • compounds with a structure similar to norgestrel -gonanywith strong gestagenic and weak androgenic effects

Usually androgenic gestagens inhibit ovulation and secretion of pituitary gonadotrophins, while gestagens lacking androgenic and estrogenic effects have a stronger effect on the uterine mucosa and do not affect ovulation and gonadotropin secretion.

Compounds with estrogenic and androgenic effects may show indirect effects. The appropriate gestagen should be selected depending on the disease state.

Gestagens as contraceptives

Due to the way of application, the following means are distinguished:

  • oral (tablets) - they differ in the dose of hormones, both estrogens and gestagens, and the administration schedule, tablets should be taken daily for 21, 24 or 28 days
  • patches - hormones in this form are applied once a week
  • subcutaneous implants - long-acting methods of contraception, the drug is implanted in the area of ​​the forearm.

Contraindications:

  • pregnancy, breastfeeding
  • phlebitis, previous or ongoing thrombosis
  • hormone-dependent tumors
  • severe liver dysfunction
  • diabetes with vascular changes

Natural gestagen - progesterone

The natural gestagen found in a woman's organism is progesterone, which is used to prepare the body for pregnancy and then to maintain it. Progesterone is metabolized in the liver and mainly excreted in the urine. Progesterone is a hormone produced in:

  • ovaries, testicles
  • adrenal cortex
  • placenta (from 3rd month of pregnancy)

Progesterone works by:

  • inducing changes in the endometrium in preparation for pregnancy
  • facilitating ovulation
  • enabling the development of the endometrium, enabling the implantation of the embryo
  • inhibition of excessive endometrial growth under the influence of estrogens
  • reducedperistalsis of the fallopian tubes
  • influencing the mucus which becomes thick and impervious to sperm
  • stimulating the mammary gland.
About the authorNatalia MłyńskaStudent of medicine at the Medical University of Lodz. Medicine is her greatest passion. He also loves sports, mainly running and dancing. She would like to treat her future patients in such a way as to see them as a human being, not only a disease.

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