Although oral medroxyprogesterone acetate has been used in various gynecologic conditions in women, literature is scant on its use in adolescents. Hence, this article reviews the clinical indications of oral medroxyprogesterone in these young women.
MEDROXYPROGESTERONE ACETATE ; PROGESTINS

Endometriosis is a common, benign, and chronic gynecologic disorder. It is an Estrogen dependent disease that can cause pelvic pain, dysmenorrhea, and infertility. GnRH agonists, Danazol, progestogens, and oral contraceptives have been conventionally used for the medical treatment of endometriosis. Increasing knowledge about endometriosis has introduced more new targeted agents for endometriosis. Further study might be required to evaluate effectiveness and safety of new agents.
Contraceptives, Oral ; Danazol ; Dysmenorrhea ; Endometriosis ; Estrogens ; Female ; Gonadotropin-Releasing Hormone ; Infertility ; Pelvic Pain ; Progestins

Endometrial cancer is increasing in South Korea. In young women, endometrial cancer can be treated by progestins for preserving fertility. We experienced a successful case of twin pregnancy after conservative therapy of endometrial cancer with Megestrol acetate. Ovulation induction and intrauterine insemination was done. A brief review of related literature was done.
Endometrial Neoplasms* ; Female ; Fertility ; Humans ; Insemination ; Korea ; Megestrol Acetate ; Ovulation Induction ; Pregnancy ; Pregnancy, Twin* ; Progestins ; Twins*

OBJECTIVE: The aim of this study is to investigate the effectiveness of high dose progestins in young patients with early stage of endometrial cancer. METHODS: Between April 1998 and December 2005, 10 women with early stage of endometrial carcinoma were treated with high dose progestins as primary therapy for the purpose of saving fertility. RESULTS: They took 80~160 mg of megestrol acetate or 500~1,000 mg of medroxyprogesterone acetate per day, and then followed up with the endometrial curettages. Seven patients (70.0%) responded to the treatment. Three patients didn't respond and so underwent hysterectomy as definite treatment. Four patients were able to become pregnant after completing treatment. No patients died of their disease. CONCLUSION: The majority of patients with well-differentiated endometrial adenocarcinoma who underwent conservative treatment with a progestational agent responded to the treatment. High-dose progestin therapy can be used as primary therapy in selected young women with early stage of endometrial carcinoma.
Adenocarcinoma ; Curettage ; Endometrial Neoplasms* ; Female ; Fertility ; Humans ; Hysterectomy ; Medroxyprogesterone Acetate ; Megestrol Acetate ; Progestins ; Treatment Outcome*

Endometrial carcinoma has been the most common female pelvic malignancy in the U.S.A. Approximately one-fourth of patient treated for early endometrial cancer will develop reccure-nt disease. Kelly and Baker first descibed that the use of progestational agents for treatment of met- astatic endometrial cancer in 1961. Response of progesterone therapy in metastatic endometrial cancer is related to several factors. Higher response rates are observed in well differentiated tumors, longer disease free interval and tumors that positive for estrogen and progesterone re- ceptors. We experienced a case of complete response in recurrent endometrial cancer to metastasis to lung treated by tamoxifen and progesterone, we present this case with a brief review of lite- rature.
Endometrial Neoplasms* ; Estrogens ; Female ; Humans ; Lung* ; Neoplasm Metastasis* ; Progesterone* ; Progestins ; Tamoxifen*

Endometrial cancer is the most common gynecologic malignancy in the United States, with over 40,000 cases diagnosed each year. While a majority of cases are diagnosed in post-menopausal women, up to 14% of cases will be in pre-menopausal women, including 4% diagnosed in women less than 40 years of age. While hysterectomy with bilateral salpingo-oophorectomy with assessment of the retroperitoneal lymph nodes is standard initial treatment for endometrial cancer, younger women may desire fertility sparing options. The decision to proceed with conservative management in this younger patient population is associated with multiple complexities, including the inherent oncologic risks of an inadequately staged and treated endometrial cancer, the risk of a synchronous or meta-synchronous cancer, the increased risk of an inherited genetic predisposition to malignancy and the lack of uniformity in the medical management and surveillance. In this review we will discuss the conservative management of endometrial cancer, specifically the role of progestin hormonal therapy, including the risks associated with non-standard care, appropriate candidate selection and work up, expected outcomes, various progestin agents and recommended follow-up.
Endometrial Neoplasms ; Female ; Fertility ; Fertility Preservation ; Genetic Predisposition to Disease ; Humans ; Hysterectomy ; Lymph Nodes ; Progestins ; United States

The effectiveness of progestogens in advanced and recurrent endometrial carcinoma has been widely accepted. But the use of progestogens in young women with early stage of endometrial carcinoma (Stage Ia) is controversial. Some authors reported that progestogens alone therapy improved or cured the endometrial pathology in young patients with early stage of endometrial carcinoma. The response to the progestogens has known to be better in cases of early stage, well-differentiated histologic type and narrow depth of invasion. We used the high-dose megestrol acetate (Megace(R)) as the primary treatment in four young women with early stage of endometrial carcinoma (Stage Ia) for the purpose of saving the fertility. We made the patients to have 320~400 mg of Megace(R) per day for 3 months, and then repeated the endometrial curettage for the purpose of finding changes of endometrial pathology. Three cases revealed no response to the Megace(R), so they were operated later. One case showed the resolution of endometrial pathology and delivered a baby following therapy. There have been no evidences of clinical recurrence in all cases. Even though the therapeutic efficacy is limited, high-dose therapy with megestrol acetate can be used as primary therapy in young women with early stage of endometrial carcinoma.
Curettage ; Endometrial Neoplasms* ; Female ; Fertility ; Humans ; Megestrol Acetate* ; Megestrol* ; Pathology ; Progestins ; Recurrence ; Treatment Outcome*

It has become more and more urgent to develop a safe, effective, recoverable and acceptable contraceptive for males. Decades of studies have made much progress on male hormonal contraception, one of the promising contraceptive methods. The principle is based on the suppression of pituitary gonadotropin and intratesticular testosterone, then the suppression of spermatogenesis, and the supplement of androgen to maintain the male characteristics and sexual function. There are many male hormonal contraceptive methods being studied include androgen, androgen combined with progesterone, GnRH antagonists combined with androgen, as well as immunological methods. To develop a safe and convenient androgen preparation with longer action and fewer side effects is also one of the key items of present research in this field.
Androgens ; Animals ; Contraception ; methods ; Contraceptive Agents, Male ; Contraceptives, Oral, Hormonal ; Humans ; Male ; Mice ; Progestins ; Rats ; Sheep

Endometrial Neoplasms ; drug therapy ; pathology ; Female ; Humans ; Precancerous Conditions ; drug therapy ; pathology ; Progestins ; therapeutic use

OBJECTIVE: To evaluate the usefulness of transvaginal sonographic measurement of endometrial thickness with Progestin-Induced Withdrawal as a screening method for endometrial pathology in postmenopausal women.

DESIGN: This study is an observational case control research design.

METHODOLOGY: One hundred forty three registered postmenopausal women at VMMC Out Patient Department were examined by TVS: 60 asymptomatic women (Group A) and 83 with uterine bleeding (Group B). Endometrial thickness of 5 mm was considered pathological. All women with abnormal endometrium from group A underwent PCT. All women from group A were positive for PCT and all women from group B underwent D&C. Histologic findings of hyperplasia w/ or w/o atypia, polyp and cancer were considered pathologic. Validity testing method was then used by measuring the sensitivity, specificity, positive predictive and negative predictive values of the data collected.

RESULTS: Eighteen women with a (+) PCT who underwent D&C revealed 6 benign histologic finding: Endometrial Polyp (2), Hyperplasia without atypia (4), 3 were premalignant and 1 case of Endometrial Cancer. All women with negative PCT had non-pathologic histologic findings. Validity testing showed that a Positive PCT in a asymptomatic patients with a sonographic endometrial thickness of 5mm, has a sensitivity of 100 percent, specificity of 46.66 percent,(+) predictive value of 55.55 percent and negative predictive value of 100 percent. Sixty two patients from Group B had abnormal sonographic and histologic findings: 13 benign (hyperplasia or polyp), 10 premalignant (hyperplasia w/ atypia) and 18 malignant (cancer). There was no cancer in cases w/ endometrial thickness 5 mm. The sensitivity, specificity, positive and negative predictive value of TVS for detecting endometrial pathology were 93.94 percent, 94.74 percent, 98.41 percent and 81.82 percent respectively if the cut-off limit of 5 mm was used.

CONCLUSION: TVS combined with PCT is a useful and reliable method for identifying endometrial pathology in postmenopausal women. (Author)

Human ; Female ; Progestins ; Hyperplasia ; Postmenopause ; Endometrial Hyperplasia ; Uterine Hemorrhage ; Endometrial Neoplasms ; Endometrium ; Polyps