[Progesterone, progestagens in premenstrual syndrome, the perimenopause and the menopause]

Progesterone has been the first isolated gestagen. After a short review on the physiology of secretion of progesterone some pharmacologic actions are considered by the authors. Among gestagens, derivatives of pregnane are of special interest, particularly because of fewer, notably androgenic, side effects. After reviewing commercial French and Swiss products the authors focus on three applications: the premenstrual syndrome where progesterone is of interest for local and systemic administration the perimenopause in which several pathologies treatable by gestagens occur Finally the menopause in which progesterone is important in view of its physiologic role. Among the reasons to use progesterone combined with estrogens during menopause, prevention of endometrial cancer is the most important but other advantages are also noted. The authors discuss risk factors for breast cancer during treatment with gestagens in menopause. Finally the authors review compliance and underline the importance of new treatment schedules for the menopause: Continuous treatment, on-demand treatment or menstruation every 3 months.