04.1 Sex Steroids Flashcards
What are some synthetic derivatives of oestrogens?
Ethunyloestradiol
What are some synthetic derivatives of progesterone?
Medroxyprogesterone
Dyprogesterone
What is an example of emergency contraception?
Levonegestrel
What are some anti oestrogens?
Tamoxifen
Clomiphene
What is the primary mechanism of the COCP?
Inhibiting FHS/LH and hence ovulation
What are the three regimens of the COCP?
Monophasic - oestrogen + progesterone for 21 days
Triphasics - 3 different doses of hormones across 21 days
Every day - 21 days of hormones + 7 days of placebo
What are some ADRs of the COCP?
Weight gain
DVT
Hypertension
Name some drugs that can reduce the efficacy of the COCP?
CYP inducers such as:
Rifampicin, Carbamezepine, St John’s Wort
Broad spectrum antibiotics can reduce efficacy due to loss of intestinal flora, prevents demethylation of some COCOPs and prevent reentrance
What is the primary action of the progesterone only pill?
Primary action is thickening (and acidifying) cervical mucus
What are the indications for HRT?
Hot flushes/sweats
Vaginal dryness causing dyspareunia
Osteoporosis
What is not an indication for HRT?
Heart disease protection
What are some ADRs of HRT?
Increased risk of breast, endometrial and some ovarian cancers
Increased risk of stroke
Increased risk of DVT
How does clomiphene work?
Oestrogen antagonist at the pituitary
Induces ovulation
How does tamoxifen work?
Oestrogen receptor antagonist at breast tissue
