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	[[Category:Pharmacology]]		[[Category:Pharmacology]]
	[[Category:Medicinal chemistry]]		[[Category:Medicinal chemistry]]
			<gallery>
			File:Chlormadinone acetate.svg\|Chlormadinone acetate
			File:Chlormadinone acetate molecule ball.png\|Chlormadinone acetate molecule ball
			File:Testosterone levels with 50 mg per day allylestrenol or 50 mg per day chlormadinone acetate over 12 weeks in men with benign prostatic hyperplasia.png\|Testosterone levels with 50 mg per day chlormadinone acetate
			File:Chlormadinone acetate availability.png\|Chlormadinone acetate availability
			</gallery>

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'''Chlormadinone acetate''' ('''CMA'''), also known as '''17α-acetoxy-6-chloro-6-dehydroprogesterone''', is a synthetic [[steroid]]al [[progestin]] with additional [[antiandrogen]] and [[glucocorticoid]] properties. It is used primarily in [[hormone therapy]] for [[menopause]] and [[endometriosis]], in [[oral contraceptives]], and in the treatment of [[androgen-dependent conditions]] like [[acne]], [[seborrhea]], [[hirsutism]], and [[prostate cancer]].

==Medical Uses==
Chlormadinone acetate is employed in various clinical settings. It is a component of some [[combined oral contraceptive pill]]s, where it serves to prevent [[ovulation]] and thereby prevent [[pregnancy]]. Additionally, it is used in the management of [[endometriosis]], a condition characterized by the presence of endometrial tissue outside the uterus, causing pain and infertility. CMA is also utilized in hormone therapy for menopausal symptoms, such as hot flashes and vaginal atrophy, by counteracting the effects of estrogen deficiency. Furthermore, due to its antiandrogen properties, it is effective in treating androgen-dependent conditions, including acne, seborrhea, and hirsutism.

==Pharmacology==
===Mechanism of Action===
Chlormadinone acetate acts primarily as a potent progestogen, binding to and activating the [[progesterone receptor]] (PR) in target tissues. This activation mimics the effects of natural progesterone, leading to the suppression of [[gonadotropin]] secretion, inhibition of ovulation, and alterations in the endometrial lining, making it unsuitable for [[implantation]]. Additionally, CMA possesses antiandrogenic effects by blocking the [[androgen receptor]] (AR), reducing the action of androgens in target tissues. Its glucocorticoid activity, though weaker, involves interaction with the [[glucocorticoid receptor]] (GR), influencing inflammation and immune responses.

===Pharmacokinetics===
After oral administration, chlormadinone acetate is well absorbed from the gastrointestinal tract. It undergoes extensive [[metabolism]] in the liver, with its metabolites being excreted primarily through the kidneys. The elimination half-life of CMA allows for once-daily dosing in most therapeutic applications.

==Adverse Effects==
The use of chlormadinone acetate can lead to several side effects, similar to those of other progestins. These may include [[nausea]], [[headache]], [[breast tenderness]], and mood changes. Due to its antiandrogenic properties, it may also cause decreased libido and fatigue. Long-term use requires monitoring, as it may increase the risk of [[venous thromboembolism]] (VTE), [[breast cancer]], and [[liver disease]].

==Contraindications==
Chlormadinone acetate is contraindicated in individuals with a history of [[venous thromboembolism]], severe [[liver disease]], known or suspected [[breast cancer]], and in those who are pregnant or breastfeeding. Caution is advised in patients with a history of depression, diabetes, and conditions predisposed to thrombosis.

==Interactions==
CMA may interact with other medications, altering their effects. It can affect the metabolism of drugs processed by [[cytochrome P450]] enzymes, potentially leading to increased plasma levels of certain drugs. Concurrent use with other hormonal therapies should be approached with caution to avoid additive effects or increased side effects.

==See Also==
* [[Progestin]]
* [[Combined oral contraceptive pill]]
* [[Endometriosis]]
* [[Menopause]]
* [[Androgen-dependent condition]]

[[Category:Progestogens]]
[[Category:Antiandrogens]]
[[Category:Oral contraceptives]]
[[Category:Endometriosis]]
[[Category:Menopause]]
[[Category:Pharmacology]]
[[Category:Medicinal chemistry]]

Chlormadinone acetate - Revision history

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