Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Progesterone and progestins are commonly used in the treatment of endometriosis, and their use is strongly supported by scientific evidence. Endometriosis is an estrogen-dependent condition characterized by the presence of endometrial tissue outside the uterus. Progesterone counteracts the proliferative effects of estrogen on endometrial tissue and induces decidualization and atrophy of endometriotic implants. Multiple randomized controlled trials and systematic reviews have demonstrated that progesterone and various synthetic progestins (such as medroxyprogesterone acetate, norethindrone acetate, and dienogest) effectively reduce pelvic pain and other symptoms associated with endometriosis. These agents are included as first-line medical therapies in international guidelines (e.g., ESHRE, ACOG, NICE).

Mechanistically, progesterone suppresses gonadotropin secretion, leading to decreased ovarian estrogen production. It also exerts direct anti-proliferative effects on endometrial tissue. Clinical studies have shown significant symptom relief and lesion size reduction in many patients, although recurrence is common after discontinuation. Side effects such as irregular bleeding and mood changes can limit tolerability for some individuals. Nonetheless, the use of progesterone and progestins is a well-established, scientifically validated approach to managing endometriosis symptoms.

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