The Metabolic Influence of Progestins

Abstract

Information concerning the general metabolic, or what might be termed the systemic, effects of progesterone and synthetic progestins is reviewed. Included in the review, are sections on: 1) electrolyte metabolism, 2) protein metabolism, 3) growth hormone secretion, 4) carbohydrate metabolism, 5) fat metabolism, 6) respiratory effects, 7) the influence of synthetic progestins on electrolyte metabolism, and 8) the effect of synthetic progestins on electrolyte metabolism, and 8) the effect of synthetic progestins on protein metabolism. It appears that aldosterone and progesterone are the dominate endocrine factors regulating salt excretion during pregnancy. As 1 of the sex hormones, progesterone has a distinct growth-promoting influence on selected tissues of the accessory sex apparatus. Progesterone induces protein wasting which can be compensated for by the comsumption of added calories. It appears that progesterone is partially responsible for maintaining the positive energy balance in pregnant women, the appetite stimulus arising from the catabolic process which it initiates. Recent interest in the influence of progesterone and synthetic progestins on pituitary growth hormone secretion has come about both as a by-product of studies done on the effects of progestins on protein and carbohydrate metabolism and because of the known effects of other sex steroids on the output of this hormone. Progestins whether derived from testosterone or 17-alpha-hydroxyprogesterone when employed in the usual antiovulatory doses, and progesterone in amounts comparable to the levels achieved in the first half of pregnancy have no adverse effect on carbohydrate metabolism in normal men or women. However, in diabetics and perhaps in potential or prediabetics, 17-alpha-hydroxyprogesterone derivatives may cause slight deterioration in glucose tolerance. Circumstantial evidence has provided much support for the idea that some relationship exists between sex hormones and serum lipid content. A great number of synthetic and few natural derivatives of testosterone have ben evaluated with the purpose of developing a pharmacologically effective steroid with the full general protein anabolic activity of the male hormone but with minimal androgenic or virilizing potential.