Progesterone Receptor Modulators: Current Applications and Perspectives

Selective progesterone receptor modulators (PRMs) are steroid progesterone receptor ligands able to induce agonistic or antagonistic activities. Mifepristone, the class leader, was primarily used for pregnancy termination from the 1980s. Emergency contraception with extended activity was the second major development 30 years later, using mifepristone in some countries and ulipristal acetate worldwide. Finally, more recently Ulipristal acetate was released for the treatment of myoma-related uterine bleeding. In addition to a very rapid cessation of bleeding, PRMs allow decrease in myoma volume. Estradiol secretion is not blunted by PRMs. This offers new alternatives for myoma treatment, especially in women close to menopause.