10) Contraceptives, HRT, and SERMs Flashcards
Define menopause:
permanent cessation of menstruation
What will the levels of oestradiol & FSH/LH be like in menopause?
Low oestradiol
High FSH/LH
6 symptoms of menopause:
1) Hot flushes
2) Urogenital atrophy & dyspareunia
3) Sleep disturbance
4) Depression
5) Decreased libido
6) Joint pain
2 complications of menopause:
Osteoporosis
CVD
If menopause is debilitating for someone, how can they be treated?
HRT
- Oestrogen & progesterone
- if had a hystrectomy just oestrogen given
2 types of HRT drugs:
Ribolone
-oestrogen + progesterone + weakly androgenic
Raloxifene=SERM
- selective oestrogen receptor modulator
- oestrogenic affect on bone
- anti-oestrogenic in breast+uterus=reduced breast cancer
- doesn’t reduce vasomotor symptoms
What is tamoxifen?
used to treat oestrogen dependent breast cancers
Side effects of HRT:
Breast cancer + stroke + CHD + DVT
What are the effects of oestrogen + progesterone for under 50s?
Oestrogen=beneficial on lipid profile + endothelial function
Progesterone=negates beneficial effects of oestrogen (but progesterone alone isn’t harmful)
What is the effect of oestrogen for women over 60 with atherosclerosis?
Pro-inflammatory + pro-thrombotic
What is the condition that causes early menopause (<40)?
Premature ovarian insufficiency
4 causes of premature ovarian insufficiency?
Autoimmune
Idiopathic
Radiation
Surgery
2 types of contraceptive pills:
Combined oral
- oestrogen + progesterone cause loss of -ve feedback
- thickens cervical mucus so sperm can’t penetrate
Progesterone-when oestrogen is contraindicated (over 35/smoker)
3 types of emergency contraception?
Copper IUD (5-7 days after)
Levonorgesterel (72hrs)
Ulipristal (120hrs)
