OR-486 is primarily used as a selective antagonist for the progesterone receptor, making it a valuable tool in reproductive health research and drug development. It has been investigated for its potential in terminating pregnancy due to its ability to block the activity of progesterone, a hormone essential for maintaining pregnancy. In clinical settings, it has been explored as a non-surgical option for early pregnancy termination, often in combination with prostaglandins to enhance efficacy.

Additionally, OR-486 is used in scientific studies to understand hormonal regulation, particularly in models of endometrial function, ovulation, and hormone-dependent cancers. Its antagonistic properties help researchers dissect the role of progesterone in various physiological and pathological processes. Due to its potency and selectivity, it is also considered in the development of emergency contraception and treatment of conditions like endometriosis or uterine fibroids where modulating progesterone signaling is beneficial.