title: Selective progesterone receptor modulators.
abstract: OBJECTIVE
  Review of recent data from clinical trials and descriptions of endometrial morphology with administration of selective progesterone receptor modulators (SPRMs).
  
  
  RESULTS
  Recent reports concerning administration of SPRMs, specifically the efficacy of ulipristal acetate in reducing fibroid size and rapid control of menstrual blood loss, have renewed clinical interest in this class of compound. Histological data from studies with SPRMs report that this class of drugs is associated with progesterone receptor modulator-associated endometrial changes. Data on mechanisms of action are lacking. The antagonistic progesterone effect of SPRMs has shown promising results in animal studies with endometriosis. Sex steroid receptor effects of PRMs outside the reproductive tract raise the potential for use in neurology and oncology, and although there are several randomized trials in these areas, there are limited small studies published to date.
  
  
  CONCLUSIONS
  The SPRM ulipristal acetate is an effective treatment for preoperative treatment of fibroids and a reliable emergency contraceptive. This class of compounds holds the potential for long-term effective medical management of fibroids and may have utility in the management of other sex steroid-dependent conditions.
authors.affiliation: MRC Centre for Reproductive Health, The University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, UK.
authors.forename: Lucy H R
authors.initials: LH
authors.lastname: Whitaker
authors.forename: Alistair R W
authors.initials: AR
authors.lastname: Williams
authors.forename: Hilary O D
authors.initials: HO
authors.lastname: Critchley
mesh_terms: D001943:Breast Neoplasms / Q000139:chemically induced* / Q000473:pathology; D003281:Contraceptives, Postcoital / Q000627:therapeutic use; D004715:Endometriosis / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy* / Q000473:pathology; D008595:Menorrhagia / Q000188:drug therapy* / Q000473:pathology; D009649:Norpregnadienes / Q000627:therapeutic use*; D011788:Quality of Life; D011980:Receptors, Progesterone / Q000627:therapeutic use*; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D003281:Contraceptives, Postcoital; D006727:Hormone Antagonists; D009649:Norpregnadienes; D011980:Receptors, Progesterone; C555622:ulipristal acetate