Normethandrone (Orgasteron; Metalutin; Methalutin) is a progestin and androgen/anabolic steroid agent which is used in combination with an estrogen in the treatment of menstruation disorders in women. Normethandrone is a modified form of nandrolone. It differs by the addition of a methyl group at carbon 17-alpha to protect the hormone during oral administration. Normethandrone is aromatized by the body, and converts to a synthetic estrogen with a high level of biological activity (17alpha-methyl-estradiol). Orgasteron has been used as progestational agent and as an androgen. Normethandrone is available in combination with methylestradiol or estradiol valerate in a few countries, including Brazil, Indonesia, and Venezuela. This is a controlled substance (anabolic steroid): 21 CFR, 1308.13, as defined in 1300.01. Normethandrone was first described in 1954. Shortly after, it was developed into a medicine by Organon (now Merck/MSD), which introduced it under the Orgasterone brand name in Belgium and Switzerland, and as Orgasteron in the Netherlands. This steroid had also been sold by other manufacturers in various parts of Europe as Methalutin, Lutenin, and Matdonal. Although a simple oral methylated nandrolone, with strong properties as an anabolic steroid, Normethandrone exhibits such strong progestational activity that it was marketed as an oral progestin. Its anabolic effects were more looked at as secondary applications for the drug, and accounted for very little medical interest.

Demegestone, a norprogesterone derivative, is a progesterone receptor agonist that was previously used to treat luteal insufficiency. It was marketed in France as Lutionex, but has since been discontinued. Demegestone has also been studied in combination with estrogens as an oral contraceptive and treatment for infertility. Demegestone did not exercise androgenic activity. Demegestone is the potent inhibitor of estrone sulfatase activity.

Allylestrenol (INN) (brand names Gestanon, Gestanin, Orageston, Turinal, Gestin, others), or allyloestrenol (BAN), also known as 17α-allylestr-4-en-17β-ol or as 3-deketo-17α-allyl-19-nortestosterone, is a synthetic steroid with progestational activity, that is used to prevent threatened miscarriage, recurrent pregnancy loss, and premature labor. Allylestrenol has also been studied as a treatment for benign prostatic hyperplasia in men, with encouraging results. Although it is less potent as a progestogen relative to many other 19-nortestosterone derivatives, allylestrenol is said to be virtually devoid of androgenic, estrogenic, or glucocorticoid activity, and hence, unlike virtually all other 19-nortestosterone derivatives, appears to be a pure progestogen with similar effects to those of progesterone. Allylestrenol is widely marketed throughout Europe, including Russia and many other European countries, and is also available in Japan, Hong Kong, India, Bangladesh, Indonesia, and much of Southeast Asia, though notably not in the United States or Canada.

Lynestrenol is a progestogen structurally related to norethisterone; it is used singularly, or as the progestogenic component of oral contraceptives. It is also used in treatments for menstrual disorders. Lynestrenol is typically used as an oral contraceptive, but also for the treatment of menstrual disorders like: Oligo-menorrhea and hypo-menorrhea; Polymenorrhoea; Fibrocystic mastopathy; Endometriosis; Endometrial carcinoma and/or metastases etc. As a synthetic oral progestogen, Lynestrenol has similar effects as that of the natural progesterone hormone. It has a strong progestational effect on the uterine endometrium by transforming the proliferative endometrium into a secretory one. It also inhibits the secretion of gonadotropin, suppresses maturation of follicles in the ovaries and ovulation, and reduces menstrual bleeding. Lynestrenol has minimal estrogenic, androgenic and anabolic effects.

Norgestimate is a steroidal progestin of the 19-nortestosterone group that is used in combination with ethinylestradiol as an oral contraceptive and for treatment of acne. and in combination with estradiol in menopausal hormone replacement therapy. Norgestimate shows high selectivity for the progesterone receptor and low androgenic activity.

Levonorgestrel (LNG) is a synthetic progestational hormone with actions similar to those of progesterone and about twice as potent as its racemic or (+-)-isomer (norgestrel). It is used for contraception, control of menstrual disorders, and treatment of endometriosis. It is usually supplied in a racemic mixture (Norgestrel, 6533-00-2). Only the levonorgestrel isomer is active. Within an Intrauterine device (IUD), sold as Mirena among others, it is effective for long term prevention of pregnancy. The local mechanism by which continuously released LNG enhances contraceptive effectiveness of Mirena has not been conclusively demonstrated. Studies of Mirena and similar LNG IUS prototypes have suggested several mechanisms that prevent pregnancy: thickening of cervical mucus preventing passage of sperm into the uterus, inhibition of sperm capacitation or survival, and alteration of the endometrium. Mirena has mainly local progestogenic effects in the uterine cavity. The high local levels of levonorgestrel lead to morphological changes including stromal pseudodecidualization, glandular atrophy, a leukocytic infiltration and a decrease in glandular and stromal mitoses. Ovulation is inhibited in some women using Mirena. In a 1-year study, approximately 45% of menstrual cycles were ovulatory, and in another study after 4 years, 75% of cycles were ovulatory. There has been much debate regarding levonorgestrel emergency contraception's (LNG-EC's) method of action since 1999 when the Food and Drug Administration first approved its use. Proponents of LNG-EC have argued that they have moral certitude that LNG-EC works via a non-abortifacient mechanism of action, and claim that all the major scientific and medical data consistently support this hypothesis. However, newer medical data serve to undermine the consistency of the non-abortifacient hypothesis and instead support the hypothesis that preovulatory administration of LNG-EC has significant potential to work via abortion. The implications of the newer data have important ramifications for medical personnel, patients, and both Catholic and non-Catholic emergency room protocols. In the future, technology such as the use of early pregnancy factor may have the potential to quantify how frequently preovulatory LNG-EC works via abortion. The latest scientific and medical evidence now demonstrates that levonorgestrel emergency contraception theoretically works via abortion quite often. The implications of the newer data have important ramifications for medical personnel, patients, and both Catholic and non-Catholic emergency room rape protocols.

Nomegestrol acetate (NOMAC) is a 19-norprogesterone derivative with high biological activity at the progesterone receptor, a weak anti-androgenic effect, but with no binding to estrogen, glucocorticoid or mineralocorticoid receptors. Nomegestrol has been developed by the Monaco-based company Théramex SAM (a Teva subsidiary). Nomegestrol acetate has been used successfully for the treatment of some gynaecological disorders (menstrual disturbances, dysmenorrhoea, premenstrual syndrome) and as a component of hormone replacement therapy in combination with estradiol for the relief of menopausal symptoms; it has been approved in Europe as monotherapy for the treatment of the menopausal syndrome, uterine diseases and menorrhagia, and in combination with an estrogen for the treatment of menopausal symptoms. Nomegestrol acetate in combination with estradiol is used as an oral contraceptive.