SynthesisBMC women's health2025
The impact of progestogens on RAAS - a systematic review.
Synthesis in BMC women's health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
5 citing papers in PubMed.
- Maternal kidney adaptation and function in pregnancy: review and perspectives.Function (Oxford, England) · 2026Review
- Review
- Blood Volume and Haemoglobin Mass in Relation to Fat-Free Mass and Aerobic Capacity in Elite Junior Rowers.Sports (Basel, Switzerland) · 2026Article
- Menstrual Cycle and Hormonal Contraceptives in Female Athletes: Should Symptoms and Nutrition Matter More than Cycle Phase? A Narrative Review.Nutrients · 2026Review
- Progesterone signaling in cardio-renal physiology and pathophysiology.Frontiers in endocrinology · 2026Review
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProgestogens, synthetic analogues of progesterone, are widely used in clinical practice for contraception, hormone replacement therapy, and the management of gynecological disorders. Understanding the specific impacts of different progestogens on the renin-angiotensin-aldosterone system (RAAS) is crucial due to their potential effects on cardiovascular and renal outcomes.
objectiveThis systematic review aims to synthesize existing research on the effects of various progestogens on the RAAS and associated clinical outcomes.
methodsWe conducted a comprehensive search of databases up to the search date, including randomized controlled trials (RCTs), cohort studies, case-control studies, cross-sectional studies, and qualitative studies. The NIH Study Quality Assessment Tool for Controlled Intervention Studies was used to evaluate the quality of the included studies. Data extraction and quality assessment were performed independently by two reviewers, with discrepancies resolved through discussion.
resultsForty-two studies on drospirenone (DRSP) were the most extensively investigated, showing either decreased or unchanged blood pressure (BP), mostly unchanged serum sodium, and an increased risk of hyperkalemia only in patients with mild renal impairment. Sixteen studies on norethindrone (NET/NETA) presented conflicting results on BP and a higher risk of hyperkalemia. Other progestogens, such as levonorgestrel (LNG) and medroxyprogesterone acetate (MPA), showed varied effects on RAAS parameters. Notably, changes in plasma renin activity (PRA), serum aldosterone, and angiotensin II levels were inconsistent across different progestogens and study designs.
conclusionThe effects of progestogens on the RAAS are complex and varied, influenced by the type of progestogen, dosage, and combination with estrogen. While some progestogens like DRSP may offer benefits in BP management with minimal electrolyte disturbances, others like NET/NETA might require more careful monitoring due to their associated risks. These findings highlight the importance of personalized medicine approaches in the use of progestogens, tailored to individual patient characteristics and specific hormonal profiles. Further research with standardized methodologies is needed to clarify these effects and guide clinical practice.
trial registrationThis review was prospectively registered with PROSPERO.
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