Antiprogestins constitute a group of compounds, developed since the early 1980s,
that bind progesterone receptors (PR) with different affinities. The first clinical uses
for antiprogestins were in reproductive medicine: e.g. menstrual regulation, emergency
contraception, and termination of early pregnancies. These initial applications, however,
belied the capacity for these compounds to interfere with cell growth. Within the context
of gynaecological diseases, antiprogestins can block the growth of and kill
gynaecological-related cancer cells, such as those originating in the breast, ovary,
endometrium, and cervix. They also can interrupt the excessive growth of cells giving rise
to benign gynaecological diseases such as endometriosis and leiomyomata (uterine
fibroids). In this article, we present a review of the literature providing support for
the anti-growth activity antiprogestins command over cells from various gynaecological
diseases. We also provide a summary of the cellular and molecular mechanisms reported for
these compounds that lead to cell growth-inhibition and death. The preclinical knowledge
gained during the past few years provides robust evidence to encourage using
antiprogestins in order to alleviate the burden of gynaecological diseases, either as
monotherapies or as adjuvants of other therapies with the perspective of allowing for
long-term treatments with tolerable side effects. The key to the clinical success of
antiprogestins in this field, likely lies in selecting those patients who will benefit
from this therapy. This can be achieved by defining the genetic makeup
required—within each particular gynaecological disease—for attaining an
objective response to antiprogestin-driven growth-inhibition therapy.