Antigestogens: the holy grail of contraception

Progesterone is essential for the establishment and maintenance of pregnancy. The discovery of antagonists of progesterone offered the possibility of developing new methods of fertility regulation. It was very quickly demonstrated that antigestogens would induce bleeding in early pregnancy, and mifepristone in combination with a prostaglandin is used as a method of abortion in several countries. Mifepristone will also inhibit ovulation, prevent implantation and induce menstrual bleeding at the time of expected menses. However, the development of these contraceptive uses of antigestogens has been inhibited by political and ethical controversy surrounding abortion. Surely the time has come to dissociate the ongoing debate about the ethics of abortion from the method so that the full therapeutic potential of this class of drugs can be exploited fully.