| 1. Title: Contragestion by antiprogestin RU 486: a novel approach to human fertility control. Author: Baulieu EE; Ulmann A; Philibert D Source: In: Fertility regulation today and tomorrow, [edited by] E. Diczfalusy and M. Bygdeman. New York, New York, Raven Press, 1987. :55-73. (Serono Symposia Publications from Raven Press, Volume 36) Abstract: The steroidal derivative RU 486 is the 1st potent antiprogestin useful medically. Acting reversibly at the molecular level of receptor binding, RU 486 interrupts progesterone action while allowing endocrine functions to return quickly to normal afterwards. However, target cells dynamics that depend upon a continuity of progesterone action will be irreversibly disrupted. In cycled women, RU 486 acts during the luteal phase in the endometrium, provoking bleeding, and via a decrease in luteinizing hormone resulting in a secondary luteolysis. In pregnant women, it affects mainly the decidualized mucosa, increases myometrial contractility and maturation of the cervix, leading to termination of pregnancy. Luteolysis, brought on by secondary alteration or detachment of the trophoblast, is secondary to the decrease in chorionic gonadotrophin. Clinical studies thus far indicate that RU 486 can be a very efficient and safe contragestive agent, especially for the medical termination of early pregnancy, as a postcoital menses inducer, or menstrual regulator. The failure observed when RU 486 is given alone may be overcome when efficient form(s) of RU 486 are administered and/or when uterotonics are used in combination with the RU 486. A small amount of prostaglandin, which by itself is inefficient, when given at the end of RU 486 treatment, yields highly satisfactory results up to 8 weeks of amenorrhea. The treatment with the antiprogestin RU 486 does not expose women to a hormonal drug continuously, and no significant systemic side-effects have been observed, including those which seemed possible because of the compound's antiglucocorticosteroid activity. Based upon physiological and molecular understanding of RU 486 actions, this antiprogestin may be a 2nd generation agent to achieve a safe and effective control of human fertility. (author's) Language: English Keywords: DEVELOPING COUNTRIES | DEVELOPED COUNTRIES | FERTILITY CONTROL, POSTCONCEPTION | ABORTION | FERTILITY CONTROL, POSTCOITAL | MENSTRUAL REGULATION | CONTRACEPTIVE AGENTS, POSTCOITAL | CONTRACEPTION RESEARCH | FEMALE CONTRACEPTION | RESEARCH AND DEVELOPMENT | RU-486 | EMERGENCY CONTRACEPTION | SIDE EFFECTS | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Technology | Economic Factors | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Treatment Document Number: 201602 Notification |
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