{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:09:11Z","timestamp":1792116551856,"version":"4.4.0"},"reference-count":63,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T00:00:00Z","timestamp":1683676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Progestin is a term used to describe a synthetic progestogen. The activity and potency of synthetic progestins are mostly evaluated via parameters associated with their endometrial effects, which are related to their interactions with progesterone, estrogen, androgen, glucocorticoid, and mineralocorticoid receptors. The chemical structure of progestins is the key to understanding their interactions with these receptors and predicting the other effects associated with these drugs. Due to their endometrial effect, progestins are used for different gynecological conditions, such as endometriosis, contraception, hormonal replacement therapy, and artificial reproduction techniques. This review is focused on improving our knowledge of progestins (from their history and biochemical effects related to their chemical structures to clinical applications in gynecological conditions) in order to improve clinical practice.<\/jats:p>","DOI":"10.3390\/jcm12103388","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T01:37:24Z","timestamp":1683769044000},"page":"3388","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Understanding Progestins: From Basics to Clinical Applicability"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9216-0383","authenticated-orcid":false,"given":"Manuel","family":"Garc\u00eda-S\u00e1enz","sequence":"first","affiliation":[{"name":"Servicio de Endocrinolog\u00eda, Hospital de Especialidades del Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ra\u00fal","family":"Ibarra-Salce","sequence":"additional","affiliation":[{"name":"Departamento de Endocrinolog\u00eda, Facultad de Medicina, Universidad Aut\u00f3noma de Coahuila, Saltillo 25204, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Javier","family":"Pozos-Varela","sequence":"additional","affiliation":[{"name":"Hospital Star M\u00e9dica, Aguascalientes 20029, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania Sofia","family":"Mena-Ureta","sequence":"additional","affiliation":[{"name":"Hospital Star M\u00e9dica, Aguascalientes 20029, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Flores-Villag\u00f3mez","sequence":"additional","affiliation":[{"name":"Centro M\u00e9dico Campestre, Leon 37180, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Santana-Mata","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Interna, Hospital General de Zona N. 2, Saltillo 25296, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7511-1050","authenticated-orcid":false,"given":"Ram\u00f3n G.","family":"De Los Santos-Aguilar","sequence":"additional","affiliation":[{"name":"Departamento de Biolog\u00eda de la Reproducci\u00f3n Dr. Carlos Gual Castro, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Uribe-Cort\u00e9s","sequence":"additional","affiliation":[{"name":"Hospital \u00c1ngeles Clinica Londres Torre Frontera, Mexico City 06700, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5159-9856","authenticated-orcid":false,"given":"Aldo","family":"Ferreira-Hermosillo","sequence":"additional","affiliation":[{"name":"Unidad de Investigaci\u00f3n M\u00e9dica en Enfermedades Endocrinas, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1134\/S0026893315050155","article-title":"Molecular basis and tissue specificity of the progestins action","volume":"49","author":"Shchelkunova","year":"2015","journal-title":"Mol. Biol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1080\/13697137.2018.1463982","article-title":"Non-clinical studies of progesterone","volume":"21","year":"2018","journal-title":"Climacteric"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.neubiorev.2014.11.015","article-title":"The role of progesterone in memory: An overview of three decades","volume":"49","author":"Barros","year":"2015","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.neubiorev.2020.12.007","article-title":"Progress in progestin-based therapies for neurological disorders","volume":"122","author":"Bonsack","year":"2021","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0010-7824(01)00222-0","article-title":"Use of the name \u201cProgestin\u201d","volume":"64","author":"Stanczyk","year":"2001","journal-title":"Contraception"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.mce.2016.09.004","article-title":"Progestins used in endocrine therapy and the implications for the biosynthesis and metabolism of endogenous steroid hormones","volume":"441","author":"Storbeck","year":"2017","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"106157","DOI":"10.1016\/j.jsbmb.2022.106157","article-title":"Progesterone\u2014Historical perspective","volume":"223","author":"Mesiano","year":"2022","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1016\/j.ajog.2005.02.116","article-title":"Physiology of the corpus luteum. 1929","volume":"193","author":"Corner","year":"2005","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.bpobgyn.2020.07.012","article-title":"Progesterone: History, facts, and artifacts","volume":"69","author":"Tosto","year":"2020","journal-title":"Best. Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1126\/science.82.2120.155.a","article-title":"Crystalline Progestin and Inhibition of Uterine Motility In Vivo","volume":"82","author":"Allen","year":"1935","journal-title":"Science"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1126\/science.82.2118.89","article-title":"The Isolation of Crystalline Progestin","volume":"82","author":"Allen","year":"1935","journal-title":"Science"},{"key":"ref_12","first-page":"1440","article-title":"Zur Isolierung und Characterisierung des Corpus-luteum-Hormons","volume":"67","year":"1934","journal-title":"Chem. Eur."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1002\/hlca.193401701111","article-title":"Ein krystallisiertes Hormon aus Corpus luteum. (Vorl\u00e4ufige Mitteilung)","volume":"17","author":"Hartmann","year":"1934","journal-title":"Helv. Chim. Acta"},{"key":"ref_14","first-page":"1270","article-title":"Reindarstellung der Hormone aus dem Corpus luteum. (Vorl\u00e4uf. Mitteil.)","volume":"67","author":"Slotta","year":"1934","journal-title":"Chem. Eur."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1126\/science.82.2120.153.b","article-title":"Nomenclature of Corpus Luteum Hormone","volume":"82","author":"Allen","year":"1935","journal-title":"Science"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"167","DOI":"10.18597\/rcog.604","article-title":"Pasado, presente y futuro de las progestinas","volume":"55","year":"2004","journal-title":"Rev. Colomb. Obstet. Ginecol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1080\/13697130500148875","article-title":"Pharmacology of estrogens and progestogens: Influence of different routes of administration","volume":"8","author":"Kuhl","year":"2005","journal-title":"Climacteric"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1186\/bcr450","article-title":"Expression and transcriptional activity of progesterone receptor A and progesterone receptor B in mammalian cells","volume":"4","author":"Graham","year":"2002","journal-title":"Breast Cancer Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.mce.2011.09.016","article-title":"Progesterone receptors, their isoforms and progesterone regulated transcription","volume":"357","author":"Jacobsen","year":"2012","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"T1","DOI":"10.1530\/JME-19-0212","article-title":"90 YEARS OF PROGESTERONE: New insights into progesterone receptor signaling in the endometrium required for embryo implantation","volume":"65","author":"DeMayo","year":"2020","journal-title":"J. Mol. Endocrinol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e009","DOI":"10.1621\/nrs.07009","article-title":"Progesterone action in human tissues: Regulation by progesterone receptor (PR) isoform expression, nuclear positioning and coregulator expression","volume":"7","author":"Scarpin","year":"2009","journal-title":"Nucl. Recept. Signal."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1210\/me.2005-0242","article-title":"Up-regulation of the progesterone receptor (PR)-C isoform in laboring myometrium by activation of nuclear factor-kappaB may contribute to the onset of labor through inhibition of PR function","volume":"20","author":"Condon","year":"2006","journal-title":"Mol. Endocrinol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1210\/mend-4-12-1833","article-title":"5\u2032-Heterogeneity in human progesterone receptor transcripts predicts a new amino-terminal truncated \u201cC\u201d-receptor and unique A-receptor messages","volume":"4","author":"Wei","year":"1990","journal-title":"Mol. Endocrinol."},{"key":"ref_24","first-page":"1379","article-title":"An amino-terminal truncated progesterone receptor isoform, PRc, enhances progestin-induced transcriptional activity","volume":"10","author":"Wei","year":"1996","journal-title":"Mol. Endocrinol."},{"key":"ref_25","first-page":"1256","article-title":"Antagonist-occupied human progesterone B-receptors activate transcription without binding to progesterone response elements and are dominantly inhibited by A-receptors","volume":"7","author":"Tung","year":"1993","journal-title":"Mol. Endocrinol."},{"key":"ref_26","first-page":"291","article-title":"The A and B isoforms of the human progesterone receptor: Two functionally different transcription factors encoded by a single gene","volume":"54","author":"Giangrande","year":"1999","journal-title":"Recent Prog. Horm. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"69","DOI":"10.3109\/13697137.2013.802556","article-title":"Progesterone and related progestins: Potential new health benefits","volume":"16","year":"2013","journal-title":"Climacteric"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.maturitas.2004.01.001","article-title":"Pharmacological profile of progestins","volume":"47","year":"2004","journal-title":"Maturitas"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1080\/13697137.2018.1462792","article-title":"The history of natural progesterone, the never-ending story","volume":"21","author":"Piette","year":"2018","journal-title":"Climacteric"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1111\/aogs.12771","article-title":"Physiology, production and action of progesterone","volume":"94","author":"Taraborrelli","year":"2015","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/j.tem.2017.05.006","article-title":"Progesterone-Mediated Non-Classical Signaling","volume":"28","author":"Garg","year":"2017","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/j.steroids.2003.08.003","article-title":"All progestins are not created equal","volume":"68","author":"Stanczyk","year":"2003","journal-title":"Steroids"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.tem.2004.06.006","article-title":"Progestogen therapies: Differences in clinical effects?","volume":"15","author":"Wiegratz","year":"2004","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1080\/13625180600772741","article-title":"Metabolic and clinical effects of progestogens","volume":"11","author":"Wiegratz","year":"2006","journal-title":"Eur. J. Contracept. Reprod. Health Care"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/j.coph.2008.10.002","article-title":"Progesterone and progestins: Neuroprotection and myelin repair","volume":"8","author":"Schumacher","year":"2008","journal-title":"Curr. Opin. Pharmacol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1037\/1064-1297.15.5.427","article-title":"Progesterone: Review of safety for clinical studies","volume":"15","author":"Goletiani","year":"2007","journal-title":"Exp. Clin. Psychopharmacol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Nagy, B., Szekeres-Bartho, J., Kovacs, G.L., Sulyok, E., Farkas, B., Varnagy, A., Vertes, V., Kovacs, K., and Bodis, J. (2021). Key to Life: Physiological Role and Clinical Implications of Progesterone. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms222011039"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/S0002-9378(98)70553-8","article-title":"Effects of hormone replacement therapy on the endometrium and lipid parameters: A review of randomized clinical trials, 1985 to 1995","volume":"178","author":"Pickar","year":"1998","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/S0140-6736(79)91504-6","article-title":"Prevention and treatment of endometrial disease in climacteric women receiving oestrogen therapy","volume":"2","author":"Thom","year":"1979","journal-title":"Lancet"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1080\/13697137.2018.1446932","article-title":"Progesterone, progestins and the endometrium in perimenopause and in menopausal hormone therapy","volume":"21","author":"Gompel","year":"2018","journal-title":"Climacteric"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/S0378-5122(02)00031-2","article-title":"Endometrial safety of hormone replacement therapy: Review of literature","volume":"42","author":"Neven","year":"2002","journal-title":"Maturitas"},{"key":"ref_42","first-page":"CD002122","article-title":"Progestagens and anti-progestagens for pain associated with endometriosis","volume":"2012","author":"Brown","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1016\/j.fertnstert.2016.10.022","article-title":"Estrogen-progestins and progestins for the management of endometriosis","volume":"106","author":"Vercellini","year":"2016","journal-title":"Fertil. Steril."},{"key":"ref_44","first-page":"643","article-title":"Progestin therapy in endometriosis","volume":"11","author":"Gezer","year":"2015","journal-title":"Womens Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1080\/17425255.2018.1461840","article-title":"Current understanding on pharmacokinetics, clinical efficacy and safety of progestins for treating pain associated to endometriosis","volume":"14","author":"Barra","year":"2018","journal-title":"Expert Opin. Drug Metab. Toxicol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"93","DOI":"10.17691\/stm2021.13.1.11","article-title":"Clinical Use of Progestins and Their Mechanisms of Action: Present and Future (Review)","volume":"13","author":"Fedotcheva","year":"2021","journal-title":"Sovrem. Tekhnologii Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1515\/hmbci-2020-0013","article-title":"A progestin isn\u2019t a progestin: Dienogest for endometriosis as a blueprint for future research\u2014Review as a contribution for discussion","volume":"42","author":"Oettel","year":"2020","journal-title":"Horm. Mol. Biol. Clin. Investig."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1080\/13625180400007736","article-title":"Clinical profile of contraceptive progestins","volume":"9","author":"Benagiano","year":"2004","journal-title":"Eur. J. Contracept. Reprod. Health Care"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1111\/ajo.12095","article-title":"Immediate post-partum initiation of intrauterine contraception and implants: A review of the safety and guidelines for use","volume":"53","author":"Mwalwanda","year":"2013","journal-title":"Aust. N. Z. J. Obstet. Gynaecol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1097\/GRF.0000000000000055","article-title":"Postpartum contraception","volume":"57","author":"Sober","year":"2014","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"S74","DOI":"10.1002\/jcph.1740","article-title":"Postmenopausal Hormone Therapy-Local and Systemic: A Pharmacologic Perspective","volume":"60","author":"Smith","year":"2020","journal-title":"J. Clin. Pharmacol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1080\/03630242.2020.1824956","article-title":"Micronized progesterone, progestins, and menopause hormone therapy","volume":"61","author":"Gompel","year":"2021","journal-title":"Women Health"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1080\/13697130902905757","article-title":"Different cardiovascular effects of progestins according to structure and activity","volume":"12","author":"Nath","year":"2009","journal-title":"Climacteric"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/S0378-5122(99)00076-6","article-title":"Estrogen with interrupted progestin HRT: A review of experimental and clinical studies","volume":"34","author":"Casper","year":"2000","journal-title":"Maturitas"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"S29","DOI":"10.1016\/j.maturitas.2009.09.012","article-title":"Luteal support: Progestogens for pregnancy protection","volume":"65","author":"Daya","year":"2009","journal-title":"Maturitas"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1515\/hmbci-2019-0067","article-title":"Progestogens in luteal support","volume":"42","author":"Carp","year":"2020","journal-title":"Horm. Mol. Biol. Clin. Investig."},{"key":"ref_57","first-page":"CD009154","article-title":"Luteal phase support for assisted reproduction cycles","volume":"2015","author":"Buckingham","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2152","DOI":"10.1093\/humrep\/dex266","article-title":"A Phase III randomized controlled trial comparing the efficacy, safety and tolerability of oral dydrogesterone versus micronized vaginal progesterone for luteal support in in vitro fertilization","volume":"32","author":"Tournaye","year":"2017","journal-title":"Hum. Reprod."},{"key":"ref_59","first-page":"2212","article-title":"Oral dydrogesterone versus intravaginal micronized progesterone gel for luteal phase support in IVF: A randomized clinical trial","volume":"33","author":"Griesinger","year":"2018","journal-title":"Hum. Reprod."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1093\/humrep\/17.2.357","article-title":"Progesterone supplementation during early gestations after IVF or ICSI has no effect on the delivery rates: A randomized controlled trial","volume":"17","author":"Schmidt","year":"2002","journal-title":"Hum. Reprod."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1093\/humrep\/den012","article-title":"Prospective randomized study comparing luteal phase support for ICSI patients up to the first ultrasound compared with an additional three weeks","volume":"23","author":"Aboulghar","year":"2008","journal-title":"Hum. Reprod."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"983","DOI":"10.3109\/09513590.2012.702875","article-title":"A systematic review of dydrogesterone for the treatment of threatened miscarriage","volume":"28","author":"Carp","year":"2012","journal-title":"Gynecol. Endocrinol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.fertnstert.2016.10.031","article-title":"Supplementation with progestogens in the first trimester of pregnancy to prevent miscarriage in women with unexplained recurrent miscarriage: A systematic review and meta-analysis of randomized, controlled trials","volume":"107","author":"Saccone","year":"2017","journal-title":"Fertil. Steril."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/10\/3388\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:32:05Z","timestamp":1760124725000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/10\/3388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,10]]},"references-count":63,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["jcm12103388"],"URL":"https:\/\/doi.org\/10.3390\/jcm12103388","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,10]]}}}