Women's Health Exam 3 Flashcards
physiological role of estrogen
- female maturation
- menstruation (builds the endometrium for the first 14 days)
- CV protection
- increased blood clotting
physiological role of progestin
- secretory phase that develops the lining of the endometrium
- important for maintenance of the baby
- increase fat production
- increase basal insulin levels and insulin responsivity to glucose
- can increase sodium reabsorption
- increase body temp
- increase sensitivity to pCO2
- precursor for estrogen, androgen, and adrenocortical hormones
pharmacological uses for estrogen
- contraception
- hypogonadism
- hormone replacement post menopause
ADE of estrogen
- uterine bleeding
- cancer risks
- nausea
- breast tenderness
- migraines / headaches
- gallbladder problems
- HTN
pharmacological uses for progestin
- HRT post Mpause
- contraception
- delay premature labor
- test estrogen secretion
How does progestin delay premature labor?
helps stabilize uterus and endometrium and delays labor
How does progestin test estrogen secretion ?
the drop in progesterone levels (if they have enough estrogen in the body) should lead to mestruation (estrogen secretion); concerned if they do not menstruate -> there is no lining there to peel off; causes a suspicion that the estrogen levels are too low
ADE of progestin
- increase BP
- lower HDL
- edema due to sodium retention
combined estrogen and progestin as hormonal contraception
- allows lower doses of both hormones
- inhibits ovulation (if does not inhibit, then that means it FAILED)
- increase viscosity of cervical mucus
- decrease secretory ability of endometrial lining
- inhibit flow through Ftubes
progestin only as hormonal contraception
- usually continuous dosage
- dosage forms: oral, injectable, subcutaneous
- inhibits ovulation (not always)
- increase viscosity of cervical mucus
- decrease secretory ability of endometrial lining
- inhibit flow through Ftubes
ADE of contraceptives
- hypertension
- clots (MI, stroke)
- possible cancer risk
- fluid retention
- increase LDL, decrease HDL
- glucose
- acne / hirsutism
- migraines / headaches
- nausea
- breakthrough bleeding
- mood effects
- weight gain
corpus luteum
- corpus luteum will continue to supplement progesterone (and estrogen) for about 10 weeks
- corpus luteum is kept healthy by hCG
- placenta takes over production and secretion of progesterone to maintain pregnancy
MOA of emergency contraception
- inhibits ovulation
- could prevent implantation
- there are progestin only and combination pills
MOA of ulipristal acetate (Ella)
- selective progesterone receptor modulator
- partial agonist at PG receptors
- weak antagonist at glucocorticoid recepetors
- progesterone withdrawal can cause bleeding
MOA of mifepristone (RU486)
- progesterone receptor antagonist
- use with prostaglandin to induce abortion
