Mifepristone (RU486), the first clinically available antiprogestin, has generated great interest since its discovery in the early 1980s. Today, it is recognized that mifepristone, along with other antiprogestins, has a potentially significant therapeutic role in human health and disease, with likely applicability to a variety of pregnancy-related conditions (e.g., management of labor) and to contraception, endometriosis, and cancer, among others. But because mifepristone has been studied and used most widely as a means of nonsurgical abortion, political issues have thus far limited research on the drug and prevented its introduction into the U.S. market. This book provides an unbiased evaluation of current knowledge about both the fundamental nature of antiprogestins as well as their possible use in treating numerous diseases and conditions, and it contains recommendations for future research.

The "contraceptive revolution" of the 1960s and 1970s introduced totally new contraceptive options and launched an era of research and product development. Yet by the late 1980s, conditions had changed and improvements in contraceptive products, while very important in relation to improved oral contraceptives, IUDs, implants, and injectables, had become primarily incremental. Is it time for a second contraceptive revolution and how might it happen? Contraceptive Research and Development explores the frontiers of science where the contraceptives of the future are likely to be found and lays out criteria for deciding where to make the next R&D investments. The book comprehensively examines today's contraceptive needs, identifies "niches" in those needs that seem most readily translatable into market terms, and scrutinizes issues that shape the market: method side effects and contraceptive failure, the challenge of HIV/AIDS and other sexually transmitted diseases, and the implications of the "women's agenda." Contraceptive Research and Development analyzes the response of the pharmaceutical industry to current dynamics in regulation, liability, public opinion, and the economics of the health sector and offers an integrated set of recommendations for public- and private-sector action to meet a whole new generation of demand.

Abortion is a legal medical procedure that has been provided to millions of American women. Since the Institute of Medicine first reviewed the health implications of national legalized abortion in 1975, there has been a plethora of related scientific research, including well-designed randomized clinical trials, systematic reviews, and epidemiological studies examining abortion care. This research has focused on examining the relative safety of abortion methods and the appropriateness of methods for different clinical circumstances. With this growing body of research, earlier abortion methods have been refined, discontinued, and new approaches have been developed. The Safety and Quality of Abortion Care in the United States offers a comprehensive review of the current state of the science related to the provision of safe, high-quality abortion services in the United States. This report considers 8 research questions and presents conclusions, including gaps in research.

Advances in basic biological research have proceeded rapidly in recent years. The fields of molecular genetics and immunology have experienced dramatic breakthroughs, capturing the imagination of both the scientific community and the general public. With less public notice, receptor biology has brought a cascade of new discoveries and insights. The entire science of pharmacology has been virtually rewritten in terms of receptor phenomenology. In particular, the discovery of specific receptors for steroid and protein hormones has been of seminal importance. With this new information, we have advanced our understanding of the mechanism and specifity of hormone action. We can now explain how hormones interact selectively with specific target cells and how hormones alter biochemical events within the target cells. These facts have already impacted on applied problems of clinical medicine, particularly in diagnosis and treatment of cancer and some metabolic diseases. Now, a new and important application of basic receptor biology and chemistry looms ahead. Within a few short years since the discovery of the progesterone receptor, chemists have synthesized molecules with a greater affinity for the receptor than progesterone itself and which, while occupying the receptor, fail to trigger the events which transform a target cell from the unstimulated to the stimulated state. This is the basis of the competitive inhibitory action of the anti-progestational agent, synthesized by the chemists at Roussel Uc1af, Paris, and designated RU 486.

Endometriosis is an oestrogen-dependent disease and is usually not encountered after menopause. Endometriosis-associated pain is treated with drugs that suppress oestrogen secretion in the ovaries. Hormonal products used to reduce pain also prevent pregnancy and are not recommended for infertility patients.Surgery relieves pain and may improve infertility.

This is the very first book to deal with sex and gender differences in drug therapy - an increasingly recognized medical need. It starts with an overview on S/G in clinical syndromes and a documentation of the medical and socioeconomic damage caused by gender specific adverse drug effects. Part I covers S/G differences in pharmacokinetics. Researchers will be satisfied by the detailed discussion of the mechanisms of S/G differences in drug effects that represents cutting edge science and includes interaction of drugs with sex hormones, genomic and epigenetic mechanisms. It also covers S/G in drug development, in animal models and clinical development and S/G in drug prescriptions. Part II targets S/G differences in drug effects in cardiovascular, pulmonary, CNS, neuromuscular, neuropsychiatric and metabolic diseases, in cancer, inflammation, and rheumatic diseases, in bacterial and retroviral infections, thrombosis, embolism. New drugs will be discussed.