[The significance of gestagens in treatment of mastopathy].

The term "mastopathy" has yet to receive a common accepted definition. 70% of all mastopathies do not demonstrate, morphologically speaking, a proliferation, where as less than 10% show an atypical proliferation that suggests an increased risk for cancer development. The indication for the treatment of a mastopathy without proliferative processes is the existence of pain. The concurrent development of Hyperprolactinemia, Hyperandrogenemia, or Hypothyreosis and the resulting metabolic disorders that accompany such should be treated in a causal manner. Progestins have proved to be effective in cases where a progesterone deficit and/or a relative hyperestrogenism exist. An evaluation of progestins as a prophylaxis for breast carcinoma development in women with an atypical proliferation, however, can first be completed when a deeper knowledge of the local hormone situation in the breast tissue exists. Suitable in this case, are the 17-Hydroxyprogesterone derivatives, because the 19-Nortestosterone derivatives produce a negative influence on the Lipid metabolism due to their partial androgenic effect and in addition, antagonise the hepatocellular estrogen effect (IGF1-reduction and SHBG-increase), which may indirectly offer protection for the breast.