Estrogen and Progesterone

Question 1

What estrogen has the most estrogenic action?

Answer 1

Estradiol (E2)

Question 2

What does LH target in females?

Answer 2

LH acts on Theca cells to synthesize androgen which is aromatized to E1 and E2 in Granulosa cells from FSH action

Question 3

What does LH target in males?

Answer 3

LH stimulates testosterone production in the Leydig cells

Question 4

What is the function of inhibins?

Answer 4

Inhibit FSH release

Question 5

What is the function of activins?

Answer 5

Stimulate release of FSH

Question 6

What is the function of aromatase?

Answer 6

Converts androgens to estrogen

Question 7

What type of cervical mucus is secreted under estrogen control?

Answer 7

Thin mucus

Question 8

What type of mucus is secreted under progesterone control?

Answer 8

Thick mucus

Question 9

What is the effect of E2 on HDL and LDL?

Answer 9

Increases HDL

Decreases LDL

Question 10

What are the main clinical uses of estrogens?

Answer 10

• Oral contraceptive
• HRT
• Acne

Question 11

What is the main SE of estrogen?

Answer 11

Endometrial hyperplasia and increased risk of endometrial carcinoma

Question 12

Estrogen Contraindications

Answer 12

• Breast and endometrial cancer
• Pregnancy
• Thrombotic disorders

Question 13

What are SERMs?

Answer 13

Selective Estrogen Receptor Modulators

Question 14

What are the actions of SERMs?

Answer 14

They bind estrogen receptors throughout the body and can act as an agonist OR antagonist depending on the tissue

Question 15

Tamoxifen Indications

Answer 15

Use to treat and prevent breast cancer

Question 16

Tamoxifen MOA

Answer 16

Estrogen receptor antagonist in breast tissue as a partial agonist in endometrium and bone

Question 17

Tamoxifen SE

Answer 17

• Neoplasm of endometrium
• Hot flashes
• Abnormal menstruation

Question 18

Tamoxifen Contraindications

Answer 18

• DVT

- Pregnancy

Question 19

Clomiphene MOA

Answer 19

Estrogen receptor antagonist in the hypothalamus and pituitary and partial agonist in the ovaries which disinhibits the release of GnRH and increases FSH and LH

Question 20

Clomiphene Indications

Answer 20

Female infertility from an ovulatory disorder

Question 21

Clomiphene SE

Answer 21

• Thromboembolism
• Ovarian cysts and hypertrophy
• Abdominal discomfort

Question 22

Raloxifene Indications

Answer 22

Osteoporosis prevention and treatment

Question 23

Raloxifene MOA

Answer 23

Estrogen receptor agonist in bone and antagonist in the uterus and breast

Question 24

Fulvestrant Indications

Answer 24

Treat estrogen receptor positive metastatic breast cancer in post-menopausal women

Question 25

Fulvestrant MOA

Answer 25

Competitively inhibit estrogen binding to receptor and blocks the action of estrogen on its target tissues - pure antagonist

Question 26

Fulvestrant Contraindication

Answer 26

Pregnancy

Question 27

What are examples of aromatase inhibitors?

Answer 27

- Anastrozole - Letrozole - Exemestane - Formestane

Question 28

Anastrozole/Letrozole Indications

Answer 28

Treatment and prevention of estrogen receptor positive early stage, locally advanced metastatic breast cancer

Question 29

Exemestane/Formestane Indications

Answer 29

Treatment and prevention of estrogen receptor positive early stage, locally advanced metastatic breast cancer

Question 30

Anastrozole/Letrozole MOA

Answer 30

Competitive inhibition of aromatase

Question 31

Exemestane/Formestane MOA

Answer 31

Irreversible inhibition of aromatase

Question 32

What is the main SE of all aromatase inhibitors?

Answer 32

Osteoporosis and fractures

Question 33

Norgestrel MOA

Answer 33

Alter GnRH pulsing and responsiveness of the anterior pituitary gland to GnRH

Question 34

Norgestrel Indications

Answer 34

Contraception

Question 35

Mifepristone MOA

Answer 35

Inhibits progesterone binding to receptor

Question 36

Mifepristone Indications

Answer 36

Abortion - up to day 49

Question 37

What is the idea of the combination of progestin with estrogen for HRT?

Answer 37

It is thought that progestin can protect the endometrium from the bad effects of estrogen

Question 38

Is the effectiveness of the combination OCPs greater than progestin alone?

Answer 38

Still inconclusive