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Clin Med 2 > Male and Female Hormones > Flashcards

Male and Female Hormones Flashcards

1
Q

What is the role of male and female hormones?

A

To control reproductive function and secondary sex characteristics in respective gender groups

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2
Q

What are sex hormones classified as?

A

steroids

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3
Q

Where are sex hormones produced?

A

primarily by the gonads, with a small amount in the adrenal cortex (insignificant amount to produce physiological effects)

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4
Q

What are the male and female sex hormones?

A

Male=androgens

Female=estrogens (estradiol) and progestins (progesterone)

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5
Q

What is the control loop for testosterone?

A
  1. Gonadotropin releasing hormone (GnRH) is released from the hypothalamus, which causes
  2. Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are released from the anterior pituitary, which causes
  3. Testosterone to be released from the testes
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6
Q

What is the feedback loop for testosterone?

A

Increased testosterone in circulation inhibits production of these hormones (LH, FSH, GnRH) from the hypothalamus

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7
Q

What are the levels for testosterone in circulation?

A

Fairly constant until aging, where there is decreased production

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8
Q

What are the results (pros/cons) of testosterone replacement therapy?

A

Benefits on body composition, strength, bone mineralization, glucose metabolism, mood, and libido

May be an increased risk of prostate cancer

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9
Q

What are the reasons to administer androgens?

A
  1. Protein loss, muscle catabolism, effects of HIV (rarely first choice of physicians, mixed success)
  2. Delayed puberty-androgens may be used on a short term basis to kick start puberty, as long as no underlying pathology exists
  3. Limited use in hormone sensitive tumors
  4. Anemia-since testosterone is a potent stimulator of EPO, but more direct drugs are preferable
  5. Hereditary angioedema (defect in clotting factors)-may use androgens prophylactically due to action on liver to restore clotting factors
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10
Q

What are the adverse effects of androgens in women?

A

Hirsutism, deepening voice, enlarged external genitalia

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11
Q

What are the adverse effects of androgens in men?

A

Bladder irritation, breast swelling and soreness, frequent or prolonged erections, increased risk of prostate cancer

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12
Q

What are the adverse effects of androgens in children?

A

Accelerated sexual maturation and premature closure of the epiphyseal plates

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13
Q

What are the adverse effects of long term use of androgens?

A

Liver damage/carcinoma, HTN, fluid retention

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14
Q

What is the function of antiandrogens?

A

inhibit the synthesis or the effects of androgen production

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15
Q

When might antiandrogens be used?

A

In the tx of prostate cancer or benign prostatic hypertrophy

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16
Q

What are the antiandrogens?

A

Finasteride (Propecia, Proscar), dutasteride (Avodart)

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17
Q

Why might someone abuse androgen?

A

anabolic steroids are used to enhance athletic performance and increase muscle size and strength

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18
Q

How might someone take androgens to increase their effects?

A

Taking them in a stacking dosage

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19
Q

Review table 30-2 for common drugs

A

Review

20
Q

How might an athlete take steroids to avoid detection?

A

By using a certain steroid dosing cycle

21
Q

What are the potential benefits of androgen abuse?

A

Athletic performance, lean body mass, and muscle strength are improved-undetermined by how much

22
Q

What other things might athletes use to enhance performance?

A

Blood doping and growth hormones

23
Q

What are the adverse effects of androgen abuse?

A
  • *can be severe/fatal**
    1. mood “roid rage”
    2. liver damage
    3. hepatic tumors
    4. cardiomyopathy
    5. arrhythmia
    6. decreased HDL lipids
    7. changes in reproductive function
24
Q

What are the functions of estrogen?

A

Initiated in puberty:

  1. Maturation of sexual organs
  2. Subcutaneous fat stores
  3. Closure of epiphyseal plates
  4. Widening of pelvic girdle
25
Q

What is the function of progesterone?

A

Less important in sexual maturation-more involved with facilitating and maintaining pregnancy

26
Q

When is FSH released and what does it do?

A

Released in follicular phase

Matures into ovum

27
Q

When is LH released and what does it do?

A

Released at menstrual midpoint with a smaller burst of FSH for ovulation
Causes the follicle to release the ovum, and become infiltrated with lipids, forming the corpus luteum

28
Q

What does the corpus luteum do during the second half of the menstrual cycle?

A

Continues to grow for around 1 week post-ovulation, secretes estrogen and progesterone, which thickens the uterine lining and progesterone stimulates mucus for potential implantation of a fertilized egg

29
Q

What happens if an egg is not fertilized?

A

The corpus luteum regresses and menstruation occurs

30
Q

What happens if an egg is not fertilized?

A

human chorionic gonadotropin (HCG) is released, takes over the role of LH and prevents the destruction of the corpus luteum

31
Q

How are estrogen and progesterone produced if an egg is fertilized?

A
  1. Corpus luteum persists until 9th-14th week of gestation, producing progesterone to facilitate uterine environment
  2. Placenta produces estrogen and progesterone thereafter-also facilitates development of mammary glands for lactation
32
Q

When may estrogen play a role during pregnancy?

A

In parturitionp

33
Q

What are the pharmacological uses for estrogen and progesterone?

A
  1. contraceptives-altering control between pituitary and ovarian hormones
  2. osteoporosis-estrogen replacement
  3. hypogonadism-low ovarian function, bleeding abnormalities
  4. Failure of ovarian development
  5. Menstrual irregularities-amenorrhea, dysmenorrhea
  6. Endometriosis-progesterone and estrogen/progesterone combos
  7. Carcinoma-metastatic breast cancer treated by estrogen
34
Q

What are the pros/cons of estrogen replacement therapy?

A

Definitely improves bone mineralization, may improve plasma lipids, possibly some CV benefit
May have increased risk of stroke and thromboembolic disease

35
Q

When may be the best timing for estrogen replacement therapy?

A

starting HRT when a woman is less than 60 years old and within 10 years of reaching menopause

36
Q

What is the role of HRT and cognitive disorders?

A

No benefit in protecting cognitive decline in of Alzheimer’s, mixed results in other cognitive studies

37
Q

Review for clinical used of estrogen/progesterone

A

30-4/30-5

38
Q

What are other adverse effects of taking estrogen and progesterone?

A

abnormal blood clotting, PE, thromboembolism, stroke

39
Q

How do Selective Estrogen Receptor Modulators work?

A

Bind to and activate estrogen receptors on certain tissues while blocking the effects on other tissues

Example: can reduce carcinogenic effects of estrogen on breast and uterine tissue while producing favorable effects on bone mineralization and cardiovascular function

40
Q

What are some examples of SERMs? What are some potential adverse effects?

A

Tamoxifen (Tamofen, Nolvadex), may increase fertility
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 sx

41
Q

What are some anti-estrogens?

A

Clomiphene=treats infertility by promoting ovulation

Fulvestrant (Faslodex)-an antiestrogen used to treat estrogen sensitive breast cancers

42
Q

What are the functions of anti-progestins?

A 
Used for termination of pregnancy (RU486)
Treatment of uterine fibroids and endometriosis
Cushing syndrome (block cellular glucocorticoid receptors)
43
Q

What are hormonal contraceptives? How do they work?

A

almost 100% effective when taken correctly
varying levels of estrogen/progesterone combos
LH and FSH are inhibited, so there is no ovulation

44
Q

What are some adverse effects of hormonal contraceptives?

A

Adverse effects have decreased with newer drugs-less estrogen, better forms of progestins

Still may have risk of thromboembolism, CV events-usually unassociated with risk factors of smoking, HTN, hyperlipidemia

45
Q

What are some potential beneficial effects of hormonal contraceptives?

A

May actually protect against endometrial and ovarian cancers; relationship to breast cancer is more complicated

Clin Med 2 (2 decks)

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