Quiz 5 Hormone therapy Flashcards
(17 cards)
Natural estrogens
steroid hormones—synthesized estrogens may be non-steroidal
They cross cell membranes and activate estrogen receptors inside cell—modulate expression of genes
The menstrual cycle:
- Menstrual—menses
- Follicular- proliferative
- Luteal—secretory
Natural estrogens
- Estrone (predominant during menopause)- E1
- Estradiol (predominant during productive years)—E2
- Estratriol (predominant during pregnancy)—E3
Synthetic estrogens
- Steroidal: ethinyl estradiol
* Non-steroidal: diethylstilbesterol
Physiological functions of estrogen
- Sexual maturity
- Increased CNS excitability (seizure inducing?)
- Increased endometrial and uterine growth
- Maintain skin elasticity
- Reduce bone adsorption
- Increase blood coagulability
Estrogen Guidelines for use
- Always use the smallest dose for the shortest period of time possible
- Sometimes local creams are preferred to minimize exposure
Progestins
- Made from cholesterol
* Present in males, but less than females
Progesterone (natural)
a. most important progestin in human
• Precursor to estrogen, androgen and adrenalcortical steroids (e.g., cortisol)
• Also precursor to testosterone and estradiol
Synthetic progestins
Short half life= 5min
Effects:
• Increase fat deposition
• Decrease CNS excitability (e.g., antiseizure—opposite of estrogen)
• Increase aldosterone—increase Na+ retention—increase BP—increase water retention and blood volume
• Increase body temperature
Combination ( progesterone + estrogen)
- Decreases ovulation (approaching 100%)
* Decreases conception and implantation
Progestin only
(less effective, ~80-90%)
• Decreases ovulation 50-80%
• Thickens mucus and reduces sperm penetration
• Impairs implantation
DElivery modes
⎫ Monophasics- constant doses of both estrogen and progesterone
⎫ Biphasic- dosage of one or both change one time during cycle
⎫ Triphasic-dosages change 2 times
Tamoxifen
blocks actions of estrogen in breast-used to treat breast cancers
Mifepristone
morning after contraceptive: blocks progesterone and glucocorticoid receptors
Danazol
suppresses ovarian function (has a masculinizing effect)
Clomiphene (Clomid)
induces ovulation.
for promoting fertilization and pregnancy (increased risk of multiple births—e.g., twins)
testosterone
- Converts to estradiol
- Replacement therapy for males
- Gynecological disorders—reduces breast size (gynecomastia)
- Has protein anabolic effects—helps replace muscle loss
- Growth stimulation—can prematurely close growth plates in growing adolescents
- Counter some age-related loss of muscle mass
- Adverse effects in women especially—masculinization
- Testosterone analogs abused for muscle and strength building—can cause acne, aggressiveness and “roid rage”, although this I controversial
