Progestins

Synthetic Natural
progestins Progestins

Synthetic
Progesterone
and 19-Nortestosterone derivatives
progesterone (19-Nor compound)
deriv.
19-Demethylated and 17-Ethinylated
(Pregnane
21C)

Gonane
Estranes
(13-Ethylated)

2nd 3rd
1st Generation Generation Generation
19- 19- 19-
nortestosterone nortestostero nortestostero
ne ne
 Synthetic
progestins

Synthetic Progesterone 19-Nortestosterone derivatives

and progesterone (19-Nor compound)
deriv. 19-Demethylated and 17-
(Pregnane 21C) Ethinylated

megestrol,
medroxyprogesterone, Gonane
hydroxyprogesterone, Estranes
dyhrogesterone
(13-Ethylated)

1st Generation
2nd Generation 3rd Generation
19- 19-nortestosterone 19-nortestosterone
nortestosterone

High Progestational High Progestational High Progestational

Activity w/ high Activity w/ remained Activity w/o androgenic
androgenic activity high androgenic activity activity
 The first-generation agents
the pregnanes
(medroxyprogesterone acetate, megestrol acetate, 17-acetoxy progesterone)
the androstanes
(ethisterone, dimethisterone)
the 19-norandrostanes : estrane
(norethynodrel, norethindrone, norethindrone acetate, ethynodiol acetate)
The second-generation agents
19-norandrostanes : gonane
Norgestrel and levonorgestrel
The third-generation agents
19-norandrostanes : gonane (norgestrel derivatives)
desogestrel, gestodene, norgestimate
The fourth-generation agents
nonethynylated 19-norandrostane
Dienogest
spironolactone derivative,
drospirenone
Cyproterone