Progestogens: a look at the "other" hormone

Health care providers need a general understanding of progestogens to use them safely and effectively in practice. These hormone formulations are used extensively in combination oral contraceptives and in hormonal replacement therapy with estrogen or alone. Although considered relatively safe for most women, it is important to look closely at the actions of the various progestogens and associated impacts. Major concerns regarding the use of these preparations center on potential untoward lipoprotein changes, carbohydrate metabolism alterations, and breast cancer. Other concerns relate to coagulation effects, prostacyclin changes, sex hormone-binding globulin capacity, psychological disturbances, blood pressure alterations, breakthrough bleeding, headaches, and other side effects. Over the years progestogen preparations have evolved into safer formulations with fewer apparent risks.