Promestriene is a white to off-white solid with the chemical name 3-propoxy-17β-methoxyestra-1,3,5,(10)-trien. It was first introduced in France in 1974 and has been marketed in 34 countries worldwide. It is a synthetic estrogen analog used to relieve vaginal atrophy and its associated symptoms. The structure is shown in fig. 1.
Vaginal atrophy is a consequence of reduced estrogen in urogenital and pelvic tissue that results in a loss of vaginal elasticity, dryness, decreased lubrication, dyspareunia, and urinary symptoms. Vaginal atrophy affects a large number of postmenopausal women and the severity varies from person to person. One study surveyed 1858 women aged 45-90 with vaginal atrophy in the United States. The results showed that most respondents experienced or were experiencing hot flashes (82%), vaginal dryness (79%), vaginal itching or irritation (77%), or painful intercourse. The detailed results are shown in fig. 2.
Most cases of symptomatic vaginal atrophy require treatment. However, many women do not volunteer to discuss their symptoms because they feel embarrassed, or believe that nothing can be done, and only about 25% of symptomatic women seek medical help.
As a synthetic estrogen analog, promestriene has two important attributes.
In addition to treating vaginal atrophy and its associated symptoms, promestriene has many other applications. For example, promestriene has a good healing effect on women who undergo an episiotomy during childbirth; promestriene also promotes rapid regeneration of epithelial cells after CO2 laser treatment, with complete healing within 21 days in 60% of cases.
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