Hormone Contraception Flashcards
(36 cards)
Menotropins
human menopausal gonadotropin, or hMG
Follicle stimulating hormone (3)
Follitropin alfa (rFSH alfa), Follitropin beta (rFSH beta), Urofollitropin (uFSH)
Leuteinizing hormone
Lutropin alfa
Human choriogonadotropin hormone
Choriogonadotropin alfa (rhCG)
Gonadotropin-releasing hormone analogs (6)
- Leuprolide
* You have to grow up to ride loop-rollercoasters - Goserelin, Histrelin, Nafarelin, Triptorelin, Gonadorelin (synthetic human GnRH)
* Ellen was always very little
Gonadotropin-releasing hormone antagonists (3)
Cetrorelix, Degarelix, Ganirelix
Estrogens (4)
Conjugated estrogens (Premarin), Estradiol valerate, Ethinyl estradiol, Mestranol
Progestins (6)
Desogestrel/Etonogestrel, Drospinenone, Medroxyprogesterone, Norethindrone, Norgestimate, Norgestrel
Estrogen and Progesterone inhibitors and antagonists (4 classes)
- Mifepristone
- Selective estrogen receptor modulators (Raloxifene, Tamoxifen Toremifene)
- Aromatase inhibitors (Anastrazole, Exemestane, Letrozole)
Which estrogen is commonly found in oral and implantable contraceptives?
Ethinyl estradiol
Which has more variation in oral and implantable contraceptives, estrogen or progesterone?
Progesterone
Why is Ethinyl estradiol so common?
Very potent; resistant to hepatic metabolism –> can give very low dose
Estrogen adverse effects
Nausea, breast tenderness, hyperpigmentation, increased migraines, cholestasis, gallbladder disease, HTN, Breast/Endometrial cancer(?)
Estrogen contraindications
Estrogen-dependent neoplasm, genital bleeding, liver disease, blood disorder, heavy smoker, CV disease, migraine with aura
Progesterone adverse effects
Breakthrough bleeding, Breast cancer, androgenic effects (weight gain, acne, hirsutism, low HDL)
When to give progestin-only contraceptive
Migraines, 35yo+ and smoker or obese, blood disorder, CV disease, HTN, SLE, high cholesterol
Which progesterone is not androgenic?
Desogestrel, Norgestimate
Dropsirenone
Dees No Drops (your voice)
Acne treatment
Desogestrel, Norgestimate, Dropsirenone
Combination oral contraceptives MOA
Prevent ovulation (feedback inhibition)
- suppressed GnRH/LH/FSH
- absent LH surge
- low endogenous steroids
Progestin-only pills
Highly effective - thick cervical mucus, impaired implantation; only blocks 60% ovulations
Benefits of Combination oral contraceptives
Estrogen - osteoporosis prevention, reduced cholesterol
Combination - reduce ovarian & colon cancer, ectopic pregnancy, breast disease, dysfunctional uterine bleeding/dysmenorrhea; improve PMS, hirsutism, acne
Benefit of LARC
e. g. Mirena (Levonorgestrel)
- Rapid return to fertility after removal
Implantable contraceptive
Etonogestrel (progestin)
Depo-provera
Medroxyprogesterone acetate
- IM or SQ every 3 mos
- can take 6-12 mos for fertility to return