Does Gestrinone Work for Endometriosis? What It Does to Your Labs

Gestrinone is an old endometriosis drug that now gets used for other things. In Brazil it became the "chip da beleza", the beauty chip: a small hormone pellet slipped under the skin of the hip or buttock and sold for a leaner body, more energy, higher libido and no periods. Clips of influencers getting it inserted spread well beyond Brazil, and now the question turns up in Australian and UK clinics too. Does it actually treat endometriosis, and what is it doing to the rest of you?

The short version is that gestrinone is not a gentle hormone. It comes from the same chemical family as nandrolone and trenbolone, and the designer steroid THG was made from it. This article covers what endometriosis is, what the gestrinone trials found, what the drug does to your bloodwork, and how to decide whether an implant should come out.

What is endometriosis?

Endometriosis is tissue similar to the lining of the uterus growing outside it: on the ovaries, the lining of the pelvis, the bowel, the bladder and the ligaments around the uterus. That tissue responds to your hormones, bleeds and inflames, and over time it can cause scarring and adhesions that stick organs together (Zondervan et al., 2020).

Doctors describe three main types:

• Superficial peritoneal disease: small lesions on the lining of the pelvis. The most common form.
• Ovarian endometriomas: cysts filled with old blood, often called "chocolate cysts".
• Deep infiltrating endometriosis: lesions that grow into the bowel, bladder or the tissue behind the uterus. This form causes the worst pain.

It is common. Roughly 1 in 10 women of reproductive age has it (Shafrir et al., 2018), which the World Health Organization puts at about 190 million women of reproductive age worldwide.

The biology that matters here: endometriosis feeds on estrogen and resists the calming effect of progesterone. Almost every drug that treats it works by cutting estrogen, overriding progesterone signalling, or both. Gestrinone does both, with an androgen attached.

Common symptoms of endometriosis

The two symptoms that matter most are pain and trouble getting pregnant (Becker et al., 2022). In practice it looks like this:

• Painful periods (dysmenorrhoea) that are worse than "normal cramps", get worse over the years, and stop you from working or training
• Pelvic pain outside your period, sometimes constant
• Pain during or after sex (dyspareunia), especially deep penetration
• Painful bowel movements or urination, especially around your period
• Heavy menstrual bleeding, with fatigue from the iron loss that follows
• Bloating that swells through the cycle, often called "endo belly"
• Difficulty conceiving, which is sometimes the first sign
• No symptoms at all in some women, whose disease is found during surgery for something else

Lesion size and symptom severity do not line up well. Small superficial lesions can hurt badly while large cysts sometimes cause little pain.

Why diagnosis takes so long

In a study of 1,418 women across 10 countries, the average delay from first symptoms to a surgical diagnosis was 6.7 years. It was 8.3 years in mostly state-funded health systems (Nnoaham et al., 2011). In Austria and Germany the median was 10.4 years, and 74% of women had been given at least one wrong diagnosis along the way (Hudelist et al., 2012). The usual story is that period pain gets written off as normal.

The European guideline (ESHRE 2022) no longer treats laparoscopy as the only way to confirm it. A skilled transvaginal ultrasound or an MRI can be enough to diagnose endometriomas and deep disease and start treatment (Becker et al., 2022).

Can a blood test diagnose endometriosis?

No. A Cochrane review of 122 blood biomarkers across 141 studies found none accurate enough to replace surgery or imaging (Nisenblat et al., 2016). The best known one, CA-125, catches only 40% to 73% of cases depending on the cut-off:

A normal CA-125 does not rule endometriosis out. The bloodwork that actually helps an endometriosis patient is more mundane: ferritin and haemoglobin if your periods are heavy, and AMH before any surgery on an ovarian cyst, since removing endometriomas can cut your egg reserve. For more on CA-125 and where the next generation of treatments is heading, see When will ENDO-205 be available?.

Where gestrinone sits in treatment

Today's first-line treatments are painkillers, the combined pill, progestin-only drugs such as dienogest, and GnRH-based drugs. Relugolix combination therapy, for example, cut period pain (dysmenorrhoea) for 75% of women against 27% to 30% on placebo in two phase 3 trials (Giudice et al., 2022). Surgery is used for cysts, deep disease and infertility.

Gestrinone is an older drug from the 1980s and 1990s, from the same era as danazol. It has never been tested head to head against dienogest (Jacobsen, 2026), and it is hard to find as a licensed product in most countries.

What is gestrinone?

Gestrinone (development code R2323, also called ethylnorgestrienone, once sold as Dimetriose) is a synthetic steroid built on 19-nortestosterone. That is the nandrolone backbone. In endometrial tissue it binds progesterone, androgen and estrogen receptors (Tamaya et al., 1986), and in women it behaves as an antiestrogen, an androgen and an antiprogestogen at the same time (Venturini et al., 1989).

What that means in practice:

• Lesions shrink. Endometrial tissue loses its estrogen and progesterone signals and stops growing.
• Periods often stop. Amenorrhoea was reported in 41% of cases across the safety literature (Fagundes et al., 2025).
• Androgen effects follow: oily skin, acne, extra body hair, weight gain and sometimes a lower voice.

A recent pharmacology review describes its defining feature as an "androgenic-metabolic signature" and notes that its androgenic effects "are not consistently milder than those of danazol" (Jacobsen, 2026). If you've read that gestrinone is the gentle alternative to danazol, the data don't support it.

Is gestrinone the same as THG?

No, but they are close relatives. THG (tetrahydrogestrinone) was found in a spent syringe from an athlete in 2003. It had been made by hydrogenating gestrinone, so it would slip past urine tests of the time (Catlin et al., 2004). Its structure is "closely related to gestrinone" and resembles trenbolone, and in lab assays it is a very potent androgen and progestin (Death et al., 2004). It binds the androgen receptor about as tightly as DHT (Jasuja et al., 2005).

Gestrinone itself is on the WADA prohibited list as an anabolic agent, banned in and out of competition. THG data doesn't tell you what gestrinone does to muscle in a woman, and nobody has measured that. It does tell you which family you're dealing with.

Does gestrinone work for endometriosis?

Here are the controlled trials. They are old and small.

The 2026 Cochrane review pooled what exists and reached a cautious verdict. Gestrinone "may be less effective than leuprorelin in treating dysmenorrhoea, but it may improve dyspareunia", and against danazol "we are uncertain". All of the evidence was rated low to very low certainty (Grammatis et al., 2026). The earlier version found hirsutism was more than twice as likely on gestrinone than on danazol (odds ratio 2.63) (Fu et al., 2017).

A 2023 meta-analysis of 16 studies and 1,286 women was more upbeat about pain relief but rated its own evidence "very low or unclear" (de Souza Pinto et al., 2023). Several of its authors are affiliated with a hormone-implant company, which is worth knowing when you read it.

So gestrinone does reduce endometriosis pain, and in the small trials it performed roughly in line with danazol and leuprorelin. Cochrane rates that evidence low to very low certainty and suggests it may be weaker than leuprorelin for period pain. Nobody has shown it is better than modern first-line options, and its side effects are a big part of why it fell out of use.

What about the 85 mg implant?

The only properly designed implant trial is GLADE, a Brazilian study that enrolled 100 women with deep endometriosis to an 85 mg bioabsorbable gestrinone pellet or a placebo pellet, both on top of a hormonal IUD (Malavasi et al., 2025). Its main outcome is safety, not pain, and it tracks hair growth, clitoral size, acne, hair thinning and voice recordings at 3 and 6 months. It finished in October 2025, and no results had been posted on ClinicalTrials.gov as of its June 2026 update. The trial is funded by the company that makes the pellet.

Until GLADE publishes, there is no controlled evidence on gestrinone implants for endometriosis.

Gestrinone side effects by the numbers

A 2025 systematic review pooled 32 papers on gestrinone safety (Fagundes et al., 2025). It reported:

The review mixes cases, reports and patients, so treat these as rough rates rather than precise risks. Its own conclusion is that the evidence is insufficient to judge the risks of today's unregulated use. A 1992 review of ways to stop periods in servicewomen noted that in one study, all 20 gestrinone patients developed acne and oily skin (Hipkin, 1992).

Are the androgenic changes permanent?

Small studies say most resolved after stopping. In 30 Mexican women, weight gain, voice change and hirsutism had gone by the one-year follow-up (Cervantes Villarreal et al., 1995), and in a high-dose fibroid study acne, oily skin, hoarseness and mild hirsutism "promptly reversed" (Coutinho, 1990).

I wouldn't lean on that. Those were oral courses of 6 months to a year that could be stopped the day a problem appeared. A deeper voice or an enlarged clitoris from any androgen can be permanent, and an implant keeps releasing drug after you notice the first hoarseness. If your voice changes, treat it as a stop signal, not something to watch.

What gestrinone does to your bloodwork

This is where most of the gestrinone literature is solid, because the 1980s and 1990s trials measured lipids and hormones carefully. Every number below comes from oral gestrinone in women with endometriosis. There is no published lab data from implant users.

The lipid trap

Gestrinone's lipid pattern can fool a quick glance at your results. In the Japanese study, total cholesterol fell 20%, triglycerides fell 36% and VLDL triglycerides fell 52%. That looks like an improvement. But HDL fell 41% and ApoA-I fell 31%, so the LDL to HDL ratio rose 92% (Fukuda et al., 1989). In a 56-woman Chinese study, HDL and ApoA-I fell while LDL and ApoB rose significantly (Zheng et al., 2005).

That's the classic androgen fingerprint, the same one we see with oxandrolone in women (Anavar bloodwork for women) and with most steroids in men (cholesterol on steroids). Don't read the total cholesterol line. Read HDL, ApoB and the ratio.

The one bright spot is Lp(a), which fell about 40% in the Italian trial. Some anabolic steroids also lower Lp(a), but that single trial is the only gestrinone evidence, and nothing shows it offsets a 25% to 40% drop in HDL.

Why your testosterone result looks wrong

SHBG carries testosterone in the blood. Gestrinone flattens it: in one study it fell from 56.4 nmol/L to 28.1 after a week and to 7.1 after four weeks, roughly an 87% drop (Dowsett et al., 1986). Total testosterone falls with it, which can look reassuring. Free testosterone, the fraction that actually acts on your skin, hair follicles and vocal cords, holds steady or rises.

If you're on gestrinone, total testosterone tells you almost nothing. Ask for SHBG and free testosterone, or calculate free T from total T, SHBG and albumin.

What about the liver?

The safety review counted raised liver enzymes in 15.1% of reports (Fagundes et al., 2025). On the other hand, ALT and AST stayed normal in 24 women taking double doses for fibroids (Coutinho, 1990). Gestrinone isn't a 17-alpha-alkylated oral, but it's worth a baseline and a 6-week check. The GLADE trial treats ALT or AST above 3 times the upper limit as a safety signal. For how to read liver enzymes in general, see liver enzymes on steroids.

What isn't known

No published gestrinone study reports haematocrit, haemoglobin, platelets, fasting glucose or insulin sensitivity. The bone data conflict. Bone density rose slightly on gestrinone while it fell 3% on leuprorelin in the Italian trial, but in one small study spine bone rose 7.1% on 2.5 mg and fell 7.1% on 1.25 mg, and neither change had fully reversed six months after stopping (Dawood et al., 1997).

Androgens can raise haemoglobin and haematocrit in women as well as men, so check a full blood count even though no gestrinone study has reported it.

The chip da beleza: gestrinone implants in Brazil

Brazilian compounding pharmacies sold gestrinone as subdermal pellets, often combined with testosterone or oxandrolone, for body composition, libido, cellulite, lipedema and stopping periods. Brazil's regulator, Anvisa, lists gestrinone, testosterone and oxandrolone as the main hormones in these implants. Its warnings name raised cholesterol and triglycerides, high blood pressure, stroke, arrhythmia, excess hair growth, hair loss, acne, voice changes, insomnia and agitation (Anvisa, 2024).

What the evidence says about the cosmetic uses:

• Lipedema: a 2025 systematic review found no studies of any kind on gestrinone for lipedema, and no trials under way (Amato et al., 2025).
• Weight loss: there is no trial. In the safety review, about 40% of studies reported weight gain, of 0.9 to 8 kg per patient.
• Body composition: nobody has measured lean mass or fat mass in women on gestrinone.

How regulation has tightened in Brazil:

• December 2021: Anvisa banned advertising gestrinone to the public, whether made by industry or compounded.
• Gestrinone is on Brazil's controlled anabolic list (C5), alongside testosterone and oxandrolone.
• October 2024: Anvisa suspended the manufacture and sale of compounded hormone implants in all compounding pharmacies. Registered implant products were not covered.
• October 2025: Anvisa suspended the compounded medicines and hormone implants of Elmeco, a large implant compounder, over irregular compounding (Anvisa, 2025).

A compounded pellet is not the same as the 85 mg pharmaceutical pellet in the GLADE trial. Nobody has published an assay of how much gestrinone compounded pellets actually contain or release, so the dose you got is unknown.

What if my HDL reads 0.6 on a gestrinone implant?

A typical premenopausal woman sits around 1.3 to 1.8 mmol/L. Say yours was 1.5 before the implant and reads 0.6 at week 8. That is a 60% drop, beyond anything reported in the oral trials (25% to 41%). Either the implant is releasing more than an oral dose, or something else is stacked with it. Here's what to do:

1. Check ApoB and LDL on the same panel. Low HDL with rising ApoB is the combination that matters for your arteries.
2. Check SHBG and free testosterone. A very low SHBG with high free T confirms a strong androgen effect.
3. Ask whether the implant contained anything else. Combined gestrinone and testosterone or oxandrolone pellets were common.
4. Recheck in 4 weeks. If HDL is still below about 0.8 mmol/L, or ApoB is climbing, take it to your doctor as a reason to remove the implant.

The HDL marker page covers the full interpretation.

Should you have your gestrinone implant removed?

Implants can't be dosed down. Removal is the only off switch. Work through these in order:

1. Has your voice changed, or has your clitoris enlarged? Yes: ask for removal now. These are the side effects most likely to be permanent, and waiting means more exposure.
2. Is ALT or AST above 3 times the upper limit? Yes: removal and a liver workup. This is the threshold the GLADE trial uses.
3. Has HDL fallen more than 40%, or has ApoB risen above your baseline range? Yes: this is beyond the oral trials. Discuss removal, especially if you have a family history of heart disease.
4. Is acne or hirsutism getting worse month on month? Yes: these were common in the trials and usually reversible, but a rising trend on an implant means the exposure isn't tapering.
5. Are you planning a pregnancy? Yes: it has to come out, and you need contraception until your cycle returns.
6. None of the above, and your pain is controlled? Keep testing every 3 months, and plan what you'll do when the implant runs out.

Removal only stops new drug entering your body. Gestrinone already in your bloodstream and tissue still has to clear, and the timing for that has not been published.

How long after removal do labs normalise?

There is no published data on implants. The closest evidence is from oral gestrinone. In the 56-woman Chinese study, lipids and hormones had returned to baseline six months after stopping, but bone density had not (Zheng et al., 2005). Bone changes were also incomplete at six months in the American two-dose study (Dawood et al., 1997).

A reasonable plan is a lipid panel, SHBG, free testosterone and liver enzymes at 3 and 6 months after removal. If HDL is still well below your pre-implant level at 6 months, ask your doctor whether anything else is going on, such as weight gain or a second compound.

Can you get gestrinone in Australia, the UK or the US?

• Australia: gestrinone is a Schedule 4 prescription medicine and listed in Appendix D as an anabolic and androgenic steroidal agent (Poisons Standard, 2025). I couldn't find a currently registered product: the old Dimetriose 2.5 mg capsule entry on the ARTG shows as cancelled. As a Schedule 4 anabolic steroid, it needs a prescription, and importing it without one is illegal.
• Ireland and the UK: Dimetriose was licensed in Ireland from 1990 until it was withdrawn in 1998. I couldn't find a current UK product.
• United States: gestrinone has never been approved by the FDA. THG, its hydrogenated derivative, is named as an anabolic steroid under US law.
• Sport: gestrinone is on the WADA prohibited list under S1 anabolic agents, banned at all times. An implant that lasts for months is a positive test waiting to happen.

"Gestrinone implant London" and similar searches turn up private clinics. Ask any clinic what is in the pellet, who made it, what dose it releases, and what bloodwork they'll run. If they can't answer, that is your answer.

The bloodwork schedule on gestrinone

Practical recommendations

• If you have endometriosis and haven't tried dienogest, the combined pill or a GnRH-based drug, ask about those first. They have far more evidence and fewer androgenic side effects.
• If you're considering gestrinone, the oral form at 2.5 mg twice a week is the studied dose and it can be stopped the day a problem appears. An implant can't.
• Treat any voice change as a stop signal.
• Read HDL, ApoB and free testosterone. Ignore total cholesterol and total testosterone on this drug.
• Use reliable contraception for the whole time you're exposed.
• If you're a competitive athlete, don't use it. It is a WADA-banned anabolic agent.

Key takeaways

• Endometriosis affects about 1 in 10 women. Diagnosis takes 7 to 10 years on average, and no blood test, including CA-125, can confirm it.
• Gestrinone eased endometriosis pain in small trials, with no clear difference from danazol or leuprorelin, and it may be weaker than leuprorelin for period pain. The 2026 Cochrane review rates the evidence low to very low certainty.
• It's a 19-nortestosterone derivative from the same family as nandrolone and trenbolone, and the parent compound of THG.
• HDL fell 25% to 41% across studies, LDL and ApoB rose in most, and SHBG fell about 87% within four weeks.
• Total cholesterol and total testosterone can look better while the real picture gets worse.
• There is no evidence for gestrinone in lipedema or weight loss, and no published lab data from implant users.
• Voice change or clitoral enlargement means the implant should come out now.

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