8) Sex Steroid

Question 1

What major effects does Oestradiol have ?

Answer 1

> Stimulates Growth of the endometrium
Stimulates Growth of breast
Stimulates production of Progesterone `

Question 2

What major effects does Progesterone have ?

Answer 2

> Stimulates Growth of the Endometrium and Breast
Maintains Pregnancy
Inhibits Production of Oestrogen

Question 3

What major effects does Testosterone have ?

Answer 3

> Stimulate Male Characteristics

• Deep voice
• Hairy Body
• Anabolism
• Aggression

Question 4

What effect does COCP have ?`

Answer 4

Made up of Oestrogen and Progesterone
> Causes Negative FB Loop on LH and FSH preventing follicle maturation and ovulation
> Prevents Endometrium Proliferation
> Prevents Cervical Mucus Thickening

Question 5

What effect does Progesterone Only Pill have ?

Answer 5

High dose or Low dose
High Dose => Affects Feedback Mechanisms of LH and FSH
Low Dose => Thickens Cervical Mucus

Question 6

Why must Oestrogen must supplied when using Progestin ?

Answer 6

B/c Progesterone Receptors are only present due to oestrogen action.

Question 7

What side effects are present with the Combined Pill ?

Answer 7

> Thromboembolic disease
Hypertension
Decreased Glucose Tolerance
Mood Swings

Question 8

What are some Pharmacokinetics points of Oestrogen
> Absorption
> Metabolism
> Excretion

Answer 8

> Natural and synthetic Oestrogens are well absorbed in the GI tract, Skin and Mucous Membranes
Metabolised in the Liver
Excreted in the urine as Glucuronides and Sulfates

Question 9

What are some Pharmacokinetics points of Progesterone ?

Answer 9

> Injected progesterone is bound to albumin with some stored in adipose tissue
Metabolised in Liver
Excreted in the urine conjugated to Glucuronic Acid

Question 10

Why may Oral Contraceptive efficacy be reduced ?

Answer 10

Metabolised by CYP450 enzymes in the liver therefore other drugs.which are also metabolised via the same route will affect efficacy.
E.g.
Anti Epileptic => Carbamazepine
ABx => Rifampicin

Question 11

What food product can enhance oestrogen absorption ?

Answer 11

Soya Protein

Question 12

Why may HRT be given ?

Answer 12

Help with symptoms of Menopause or Oesteoporosis

Question 13

What are risks of HRT ?

Answer 13

> Unopposed Oestrogen => Developing Endometrial and Ovarian Cancers
Opposed Oestrogen => Breast Cancer
Increased risk of venous Thromboembolism
CVS disease
Increased risk of stroke

Question 14

What effects do SERMs ( Selective Oestrogen Receptor Modulators ) have ?

Answer 14

Increase benefits of oestrogen

but has no proliferative effects on endometrium and breast

Question 15

Give examples of SERMs

Answer 15

Clomiphene => Induces ovulation as it prevents oestrogen binding to its receptor on AP so prevents the negative FB giving FSH and LH

Tamoxifen => Reduces breast cancer in ER positive cases, as it binds to ER receptors but acts like oestrogen in Endometrium

Question 16

What effect does Ulipristal Acetate have ?

Answer 16

Selective Progesterone Receptor Modulator

> Emergency contraception

Question 17

What are the actions and Side effects of Oestrogen ?

Answer 17

Actions:
> Mild Anabolic
> Na + Water Retention 
> Raises HDL, Lowers LDL 
> Decreases Bone Resorption 
> Impair Glucose Tolerance 
> Increase Blood Coagulability 

Side Effects:
> Endometrial Hyperplasia / Cancer 
> Ovarian Metaplasia / Cancer 
> Breast Hyperplasia / Cancer 
> Thromboembolism 
> Breast Tenderness 
> Water Retention 
> N+V 
>

Question 18

What are the actions and side effects of progesterone ?

Answer 18

Actions: 
> Secretory Endometrium 
> Anabolic
> Increase bone mineral density 
> Fluid Retention 
> Mood Changes 
> Maintains Pregnancy 

Side Effects:
> Weight Gain 
> Acne 
> N+V
> Irritability

Question 19

What are the actions and side effects of Testosterone ?

Answer 19

Actions:
> Male Secondary Sex Characteristics
> Anabolic
> Acne

Side effects:
> Affect HDL : LDL ratio therefore increased atherosclerotic disease