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S5.2 Sex Steroid Hormones Flashcards

(19 cards)

1
Q

What are the effects of oestrogen?

A

Stimulates growth of the endometrium and breast

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2
Q

What are the actions and ADRs of oestrogen?

A

Na and water retention, decrease bone resorption

ADRs: breast tenderness, nausea

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3
Q

What are the effects of progesterone?

A

Stimulates growth of the endometrium and breast; maintains pregnancy and prepares endometrium for implantation

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4
Q

What are the actions and ADRs of progesterone?

A

Increases bone density

ADRs: weight gain, acne

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5
Q

What are the effects of testosterone?

A

Stimulates male characteristics e.g pubes, deep voice

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6
Q

What are the ADRs of testosterone?

A

Acne, aggression

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7
Q

Describe the transport of sex steroid hormones

A

Transport bound to SHBG (sex hormone binding globule, production upregulated by oestrogen) and albumin

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8
Q

Describe the pharmacokinetics of sex steroid hormones

A

Liver metabolism: hormones metabolised in one passage through liver.
Stored in fatty tissue which increases half life

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9
Q

What is the mechanism of the OCP?

A
Oestrogen (ethinyloestradiol) + progesterone (levonorgestrel).
Prevents ovulation (inhibits FSH LH), thickening of cervical mucous
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10
Q

What are the ADRs of the OCP?

A

Venous thromboembolism, MI, Hypertension.
Metabolised by CP450, so there efficacy is reduced by enzyme inducing drugs;
Phenytoin, Carbamazapine, Rifampicin, Rifabutin (as all increase CP450)

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11
Q

Describe the features of the progesterone-only pill

A

E.g: levonorgestrel, norethisterone, medroxyprogesterone.
Thickens cervical mucus so impenetrable to sperm.
ADRs: menstrual problems common

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12
Q

What advice would you give to a woman who missed the pill on one day?

A

Take last pill immediately and continue others as normal. May need extra contraception for next 7 days.

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13
Q

What are the two forms of emergency contraception?

A

Levonorgestrel (72h after sex), ulipristal acetate (120h after sex).

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14
Q

Describe the two types of HRT

A
Unopposed oestrogen (E)RT - risk of endometrial or ovarian cancer. 
Opposed oestrogen (H)RT - risk of breast cancer.
Both reduce menopausal symptoms, and can increase HDL
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15
Q

What is the mechanism of clomiphene?

A

Ovulation induction: inhibits oestrogen to its receptor in the anterior pituitary, inhibits negative feedback, so results in increased FSH, LH expression

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16
Q

What is the mechanism of tamoxifen?

A

Reduces risk of breast cancer: Binds to oestrogen receptor in breast tissue and blocks oestrogen-stimulated myoepithelial cell division

17
Q

What is the mechanism of anti-progestins (mifepristone)?

A

Inhibits progesterone action.

Sensitises the uterus to prostaglandins, is used for termination of pregnancy and induction of labour

18
Q

What is the mechanism of anti-androgens (cyproterone)?

A

Partial agonist at progesterone receptor, that competes with DHT. Used to treat prostate cancer.

19
Q

What is the mechanism of the SERM raloxifene?

A

Protects against osteoporosis.

Reduced risk of invasive breast cancer in postmenopausal women with osteoporosis