Progestins in the Medical Management of Active Acromegaly1

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Abstract
Ideal medical management of active acromegaly is wanting. Therapy directed at injuring tumor tissue is not without complications and may be unsuccessful in arresting the disease process. The administration of progesterone to normal individuals has resulted in poor growth hormone response to provocative stimuli such as arginine infusion. The oral progestin, medroxyprogesterone acetate, was also found to suppress growth hormone response to arginine infusion, an observation previously reported by Simon et al. Oral medroxyprogesterone acetate therapy resulted in striking reduction in growth hormone levels in 10 of 12 acromegalics and growth hormone response to arginine infusion was negligible or absent in 9 volunteers and 11 of 12 acromegalics during this form of therapy. Improvement in glucose tolerance and cosmetic appearance has been observed in initial active acromegalic patients chosen for chronic treatment with this oral progestin.

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