Role of progestins in the premenopausal climacteric.

Both the prevention of diseases and therapy of symptoms in premenopausal women is a demanding task for the gynecologist. Present day knowledge allows a differentiated approach for the use of the various progestins in the premenopausal period. A women-specific medicine needs individual selection of the progestins, both for substitution and treatment. The various partial effects of the progestins, such as androgenic, antiandrogenic, estrogenic, antiestrogenic, glucocorticoid etc., have to be taken into account and should be applied according to the individuals' needs. The benefits of progestins can be obtained in various clinical conditions, including bleeding disorders; benign proliferative diseases (such as benign breast disease, endometrial hyperplasia and endometriosis); contraception; androgenization; and gynecological oncology.