الفهرس 
Progesterone OverviewOnly 14 pages are availabe for public view
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Abstract
•Progesterone plays a key role in the development, differentiation and maintenance of female reproductive tissue. • Progestins used in contraception in many type, doses and routs. As regard progestin only pills, no firm conclusion that they are as effective as combined oral contraceptives. • Administration of progestin alone orally, intramuscularly, or subcutaneously may be considered as first-line therapy but medical treatment of minimal and mild endometriosis does not enhance fertility in subfertile women and should not be offered. • Progestogenic agents alone or in combination with estrogen may not be effective and surgery still the main method of diagnosing and managing adenomiosis. • Systemic or local progestin therapy for endometrial hyperplasia is an unproven but commonly used alternative to hysterectomy, which may be appropriate for women who are poor surgical candidates or who desire to retain fertility. • There is no evidence to support the use of adjuvant progestagen therapy in the primary treatment of endometrial cancer and insufficient evidence that hormonal treatment in any form, dose or as part of combination therapy improves the survival of patients with advanced or recurrent endometrial cancer. • Oral progestogens given during the luteal phase only should not be used for the treatment of heavy menstrual bleeding, while levonorgestrel-releasing intrauterine system or norethisterone (15 mg) daily from days 5 to 26 of the menstrual cycle, or injected long acting progestogens can be used. • No evidence to support the effectiveness of progestogens on uterine fibroids. There is some evidence of benefit of the progestogen-releasing intrauterine system in premenopausal women with uterine fibroids • When treating women with premenstrual syndrome, treatment with the lowest possible dose of progestogen is recommended to minimize adverse effects and there is insufficient evidence to recommend the routine use of progesterone or progestogens for women with PMS. • Continuous combined hormonal replacement therapy including tibolone is effective in treating hot flushes, urogenital symptoms and endometrial cancer and protective effect of progestogen is dose- and duration-dependent. • The effects of the oral contraceptive pill in the treatment of functional ovarian cysts concluded that there was no earlier resolution in the treatment group compared to the control group. • Progesterone and progestins can have a proliferative, antiproliferative, or neutral effect on breast tissue, depending on the type, timing, and dose of progestin used. The use of depot medroxyprogesterone acetate does not increase the risk of breast cancer in the general population, and further research into progestin-only contraception in the breast cancer survivor is needed. • There is a significant effect in favor of progesterone for luteal phase support, favoring synthetic progesterone over micronized progesterone, but no evidence favoring a specific route or duration of administration of progesterone. • No evidence to support the routine use of progestogen to prevent miscarriage in early to mid-pregnancy, and the finding of a significantly reduced miscarriage rate in women with a history of recurrent miscarriage deserves further study. • The use of progesterone is associated with benefits in women considered to be at increased risk of preterm birth due either to a prior preterm birth or where a short cervix has been identified on ultrasound examination, But further trials are required to assess the optimal timing, mode of administration and dose of administration of progesterone therapy when given to women considered to be at increased risk of early birth. • There is insufficient evidence to recommend progesterone for prevention of pre-eclampsia and its complications.