Exam 4: Wed 3.23. hormones, being preggers, and organ systems Flashcards Preview

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Flashcards in Exam 4: Wed 3.23. hormones, being preggers, and organ systems Deck (69)
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Purpose of male and female hormones

Control reproductive function and secondary sexual characteristics in respective gender groups


How are homones technically classified?

as steroids


Where are male and female hormones produced? 

  • Primarily produced by the gonads
  • A small amount in the adrenal cortex (insignificant amounts to produce physiologic effects)


What are male and female hormones called?

Male hormones 

called androgens

Female hormones 

  1. Estrogens (primarily estradiol, usually referred to as estrogen)
  2. Progestins (progesterone)


Endocrine feedback loop of testosterone (3) 


  • Testosterone made in testes, regulated by anterior pituitary luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
  • LH and FSH regulated by gonadotropin-releasing hormone (GnRH) from the hypothalamus
  • ↑testosterone in circulation inhibits production of these hormones (negative feedback) – levels are fairly constant at all times, until aging process ↓production


How does replacement therapy of male hormones affect the body? (8) G-LiMB2S

Reported benefits:

  • Glucose metabolism
  • Libido
  • Mood (can be negative too) 
  • Body composition
  • Bone mineralization (reduces risk of osteoporosis)
  • Strength


  • Concern that there may be ↑ risk of prostate cancer
  • small balls


Medical Reasons Androgens may be prescribed by Doc (5)

  1. Can be administered medically for protein loss,  muscle catabolism, effects of HIV, rarely the treatment of choice by physicians – and mixed success
  2. Delayed puberty – androgens may be used on short-term basis to “kick start” puberty, as long as no underlying pathology exists
  3. Limited use in hormone-sensitive tumors
  4. Anemia – testosterone is potent stimulator of EPO, but other more direct drugs are preferable
  5. Hereditary angioedema (defect in clotting factors) – androgens may be used prophylactically due to their action on liver to restore clotting factors


Adverse effects of Androgen supplementation for women (4) 

  • masculinizing effects
  • hirsutism (abnormal growth of face and body hair)
  • deepening voice
  • enlarged external genitalia



Adverse effects of Androgen supplementation for men (5) B2ErPS

  • Bladder irritation
  • Breast swelling and soreness
  • Frequent or prolonged Erections
  • Increased risk of Prostate cancer
  • Small balls (if you haven't seen it, it is a strange sight) 



Adverse effects of Androgen supplementation for children (2)

  • accelerated sexual maturation
  • premature closure of epiphyseal plates


Long term effects of Androgen supplementation (3)

  • liver damage/carcinoma
  • hypertension
  • fluid retention



Antiandrogens- what do they do and what are they used for? 

  • Inhibit synthesis or effects of androgen production
  • May be used in treatment of prostate cancer or benign prostatic hypertrophy
    • Names: Finasteride (Propecia, Proscar), dutasteride (Avodart)


Points about androgen abuse and athletics- use, prevelance, ect.. (6)

  1. Anabolic steroids used to enhance athletic performance,↑ muscle size and strength
  2. Increasingly seen in younger athletes – at least 6% of high school athletes admit to use
  3. Usually obtained illegally, taken in “stacking” dosage to ↑ effects
  4. Use a steroid dosing cycle – athletes have a variety of ways to avoid detection during sports drug testing
  5. No question athletic performance is improved, as is lean body mass and muscle strength  - but how much is undetermined
  6. Athletes also use other performance-enhancing techniques such as blood doping, growth hormones


Adverse effects of androgen abuse outlined with the athletics powerpoints (7) MR LASH2

  • Mood (“roid rage”)
  • Changes in Reproductive function
  • Liver damage
  • Cardiomyopathy Arrhythmias
  • Effects can be Severe and fatal
  • Hepatic tumors
  • HDL lipids


When asking athlete about possible steroid abuse, what are a couple of approaches? 

  • Ask about any additional meds or supplementation (more non-threatning word choice)
  • Can ask if they take any supplements in a cycle if they respond with saying they take a variety of things
  • How do the supplements help you?
  • Important to prevent pt. for getting defensive. 


The role of estrogen in puberty (5) PEPS2


  • Puberty
  • Epiphyseal plates closure
  • Pelvic girdle widening 
  • Subcutaneous fat stores 
  • Sexual organs maturation 


Progesterone. What is it good for? 

(to be sung to the tune of 'War') 

  • Facilitates and maintains pregnency
    • Less important in sexual maturation


The female cycle and hormone activity (4)

  • FSH released by anterior pituitary in follicular phase, which matures into ovum
  • LH released by anterior pituitary at menstrual midpoint, with smaller burst of FSH, for ovulation – follicle releases ovum, then becomes infiltrated with lipids (corpus luteum)
  • Corpus luteum controls second half of menstrual cycle – continues to grow for ~1 week post ovulation, secreting estrogen and progesterone – thickens uterine lining, and progesterone stimulates mucus for potential implantation of a fertilized egg
  • If no fertilization, corpus luteum regresses and menstruation occurs


If the egg is fertilized in the uterus, then........(4)

  • human chorionic gonadotropin (HCG) is released, takes over the role of LH and prevents destruction of corpus luteum
  • Corpus luteum persists until 9-14th week of gestation, producing progesterone to facilitate uterine environment

  • Placenta produces estrogen and progesterone thereafter – also facilitates development of mammary glands for lactation

  • Estrogen may play a role in parturition (labor)


7 Pharmacological Uses of Estrogen and Progesterone


  1. Contraceptives - altering control between pituitary and ovarian hormones
  2. Carcinoma – metastatic breast cancer treated by estrogen
  3. Hypogonadism – low ovarian function, bleeding abnormalities
  4. Endometriosis – progesterone and estrogen/progesterone combos
  5. Failure of ovarian development
  6. Menstrual irregularities (amenorrhea, dysmenorrhea)
  7. Osteoporosis – estrogen replacement


Women who have multiple miscarriages may take _____ to help maintain pregnancy



Points about HRT (hormone replacement therapy)- the good and the bad (7) BP C3oST2

  • Improves Bone mineralization
  • Improves Plasma lipids
  • Controversial
  • Cardiovascular improvement- possibly
  • Several RCTs have shown↑ risk of Stroke, Thromboembolic disease
  • Timing may be important – start HRT when women are <60 y.o. and within 10 years of reaching menopause
  • Zero benefit in protecting Cognitive decline of Alzheimer’s, mixed results in other cognitive studies


Adverse effects of taking estrogen and/or progesterone (6) STAMP

  • Stroke
  • Thromboembolism
  • Abnormal blood clotting
  • Menstrual function may be altered with prolonged use
  • PE
  • Cannot use estrogen with estrogen-sensitive breast cancers – importance of screening for women on contraceptives


What do Selective Estrogen Receptor Modulators (SERMs) do? 

  • Bind to and activate estrogen receptors on certain tissues while blocking the effects on other tissues (Dr. T thinks this is really cool)
  • Can reduce carcinogenic effects of estrogen on breast and uterine tissue while producing favorable effects on bone mineralization and cardiovascular function


Name 2 Selective Estrogen Receptor Modulators (SERMs)

  1. Tamoxifen (Tamofen, Nolvadex)
  2. Raloxifene (Evista) 


Use and side effects of Raloxifene (Evista) 

  • primarily used to treat osteoporosis
  • may also give protection against breast cancer
  • side effects
    • hot flashes
    • bone/joint pain
    • GI effects
    • “flu-like” symptoms


True or False: Tamoxifen can increase fertility

True (happened to Dr. T's friend at age 41) 


What do Anti-estrogens (Clomiphene) do? (2)

  • treats infertility by promoting ovulation
  • Fulvestrant (Faslodex) – an antiestrogen used to treat estrogen-sensitive breast cancers


What muppet was MB most like?


What may Antiprogestins be used for? (3) 

  • termination of pregnancy (RU486)
  • treatment of uterine fibroids and endometriosis
  • Cushing syndrome (blocks cellular glucocorticoid receptors)