TABLE 1.
Metabolites of progestins commonly used in contraception
| Progestin | Metabolites | Active compound | Reference(s) |
|---|---|---|---|
| MPA | 1β-hydroxy-MPA$; 2β-hydroxy-MPA$; 6β-hydroxy-MPA$; 6β, 21-dihydroxy-MPA$ | MPA | (Fukushima, et al., 1979; Helmreich & Huseby, 1962; Sturm, et al., 1991; Zhang, et al., 2008) |
| NET-EN | NET; EE | NET; EE | (Bayer Healthcare Pharmaceuticals Inc, 2011; Stanczyk & Roy, 1990) |
| NET | 5α-NET; 5β-NET; 3α,5α-NET; 3β,5α-NET; 3α,5β-NET; 3β,5β-NET; EE | 5α-NET; 3α,5α-NET; 3β,5α-NET; NET; EE | (Blom, et al., 2001; Chu, et al., 2007; Chwalisz, et al., 2012; Garcia-Becerra, et al., 2004; Kuhl, 2005; Kuhl & Wiegratz, 2007; Kuhnz, et al., 1997; Larrea, et al., 2001; Lemus, et al., 2009; Reed, et al., 1990; Schoonen, et al., 2000; Stanczyk, 2003; Stanczyk & Roy, 1990) |
| LNG | 5α-LNG; 5β-LNG; 3α,5α-LNG; 3β,5α-LNG; 3α,5β-LNG; 3β,5β-LNG; 2α-hydroxy-LNG; 16β-hydroxy-LNG; 16β-hydroxy-3α,5β-tetrahydro-LNG | 5α-LNG; 3α,5α-LNG; 3β,5α-LNG; LNG | (Garcia-Becerra, et al., 2002; Garcia-Becerra, et al., 2004; Larrea, et al., 2001; Schoonen, et al., 2000; Stanczyk, 2003; Stanczyk & Roy, 1990) |
| GES | 5α-GES; 3α,5α-GES; 3β,5α-GES; 1β-hydroxy-GES; 6α-hydroxy-GES; 11α-hydroxy-GES; 11β-hydroxy-GES | 5α-GES; 3α,5α-GES; 3β,5α-GES; GES | (Garcia-Becerra, et al., 2004; Larrea, et al., 2001; Lemus, et al., 2001; Stanczyk & Roy, 1990; Ward & Back, 1993) |
| NGM | Norelgestromin; Norgestrel (LNG) | Norelgestromin; LNG | (Juchem, et al., 1993; Madden, et al., 1990; McGuire, et al., 1990; Phillips, et al., 1990; Prifti, et al., 2004; Stanczyk, 2003) |
| ETG | 6β-hydroxy-11,22-epoxy-ETG*; 11,22-epoxy-ETG*; 10β-hydroxy-ETG*; 6β-hydroxy-ETG*; 14α-hydroxy-ETG* | ETG | (Baydoun, et al., 2016) |
| NES | 17α-deacetyl-NES#; 4,5-dihydro-17α-deacetyl-NES# | NES | (Kumar, et al., 2017; Prasad, et al., 2010) |
| DRSP | 4,5-dihydro-DRSP-3-sulfate; acid form of DRSP; 6β,7β,15β,16β-dimethylene-11α-hydroxy-3-oxo-l7α-pregn-4-en-21,17-carbolactone**; 6β,7β,15β,16β-dimethylene-11α-hydroxy-3-oxo-l7β-pregn-4-en-21,17-carbolactone**; 6β,7β,15β,16β-dimethylene-11β-hydroxy-3-oxo-l7α-pregn-4-en-21,17-carbolactone**; 6β,7β,15β,16β-dimethylene-2β-hydroxy-3-oxo-l7α-pregn-4-en-21,17-carbolactone** | DRSP | (Bachmann & Kopacz, 2009; Krattenmacher, 2000; Quintana, et al., 2013; Wiesinger, et al., 2015) |
| DNG | 6β-hydroxy-DNG$ | DNG | (Shin, et al., 2013) |
| CPA | 15β-hydroxy-CPA; 3α-hydroxy-CPA | 15β-hydroxy-CPA; CPA | (Bhargava, et al., 1977; Kerdar, et al., 1995; Schindler, et al., 2003) |
$
Activity of metabolites unknown.
*
ETG hydroxylation in fungi (Cunninghamella blakesleeana and C. echinulate). Presence and physiological relevance in humans not known.
#
NES metabolism in rats administered by subcutaneous injection. Presence and physiological relevance in humans not known.
**
DRSP is metabolised in fungal cells (Absidia corymbifera, BAFC 1072, A. coerulea and Syncephalastrum racemosum). Presence and physiological relevance in humans not known.