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MD1 - Reproduction Block > 14. Sex hormones and disease > Flashcards

14. Sex hormones and disease Flashcards

1
Q

What is the regulation of sex hormones in females?

A
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2
Q

What is the regulation of sex hormones in males?

A
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3
Q

What is the pathway of sex hormone synthesis?

A
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4
Q

What are the uses of Oestrogen for children?

A

Hypogonadism

To develop secondary sex characteristics and accelerate growth

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5
Q

What are the uses of oestrogen for adults?

A
  • Primary amenorrhea + Progestin
  • Contraceptive + progestin
  • Menopause
    • Oestrogen (hormone) replacement
        • progesterone
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6
Q

What are the benefits of Oestrogen as postmenopausal hormone therapy?

A
  • Improved bone density
  • Relief from flushes, fatigue
  • Relief from vaginal dryness
  • Reverses atrophy of vulva, vagina urethra
  • Improve sleep
  • Reduce indicence of colorectal cancers
  • CVD
    • Reduced incidence of coronary heart disease
  • Delay Alzheimers
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7
Q

What are the risks of using Oestrogen for postmenopausal hormone therapy?

A
  • Increased risk of uterine/breast cancer
  • Increased thromboembolism/stroke
  • Breast tenderness, nausea & fluid retention
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8
Q

What are the mechanism of action of Oestrogen?

A
  • Cell membrane receptor = Rapid
  • GPCR
  • Heterodimer nuclear receptor
  • Homodimer nuclear receptor
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9
Q

How does Oestrogen and Progesterone cause breast cancer especially in post menopausal women?

A

One of the gene that Estrogen receptor switches on is the Progesterone receptor (which promotes growth and differentiation). Receptor levels of people who breast cancer have ER are PR +ve

Poat-menopausal the levels of ER & PR increase and increases your risk if you do estrogen therapy

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10
Q

What are some selective oestrogen receptor modulators?

A
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11
Q

What is the use of Tamoxifen?

A
  • Agonist at Uterus ++, Bone+, CV+
  • Antagonsit at Breast and CNS

Pallative treatment of metastatic breast cancer & adjuvant after lumpectomy

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12
Q

What are the side effects Tamoxifen?

A
  • Endometrial hyperplasia, polyps & cancer
  • Thromboembolic events
  • Thrombocytopenia
  • Ocular toxicity
  • Menopausal symtoms
    • Hot fushes, atrophic vaginitis
  • Resistance
    • Tumors may recur
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13
Q

What are Aromatase inhibitors?

A
  • Reduce all levels of Oestrogen
  • Improve disease free survival after tamoxifen
    • Reduced incidence of contralateral breast ancer
    • Reduced Thromboembolic events
    • Reduced incidence of endometrial cancer
  • Side effects
    • Bone loss, fracture risk
    • Arthalgia (damage around the joint)
    • Potential poorer lipid profile, hepatic steatosis & metabolic syndrome
    • Menopausal signs
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14
Q

Where are DHT active?

A
  • DHT active in prostate, seminal vesicles, epididymis, skin
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15
Q

Which of the male androgens provide the feedback signal?

A
  • Testosterone is the one that circulates in the blood so it is involved in negative feedback
    • GnRH release
    • Spermatogenesis
    • Sexual differentiation
    • Anabolic effects
  • It is not always converted into DHT
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16
Q

What are the therapeutic effects of Androgens?

A
  • Hypogonadism
  • Senile osteoporosis
  • Speed recovery from surgery & chronic debilitating disase
  • Promote skeletal growth in pituitary dwarfism
  • Endometriosis = Pain and Inflammation

Can also be used to increase lean body mass, muscle strength and aggressiveness

17
Q

What are the effects of andogen in children?

A

Premature closure of epiphyseal plates, abnormal sexual maturation

18
Q

What are the adverse effects of androgens in females?

A

Acne, facial hair, deepening of voice, male pattern baldness, excessive muscle development & menstrual irregulatities

19
Q

What are the adverse effects of androgens in males?

A

Priapism, impotence, decrease spermatogenesis & gynaecomastia

20
Q

What are the adverse effects of androgens in athletes?

A

Liver damage, increased aggression and psychotic episodes

21
Q

What do androgens do to HDL and LDL levels?

A

Increase LDL & decrease HDL

Increase risk of coronary heart disease

22
Q

What are the antiandrogens?

A
  • Cyproterone = Steroidal antagonist
  • Flutamide = Non-steroidal antagonist
  • Finasteride = 5a-reductase inhibitors
23
Q

What are the uses and side effects of Cypoterone (steroidal antagonist)?

A
  • Uses
    • Prostate cancer
    • Androgenisation in females
  • Adverse effects
    • Cognitive changes, fatigue, oedema
    • Reduced spermatogenesis
24
Q

What are the uses and side effects of Flutamide (Non-steroidal antagonsit)

A
  • Uses
    • Metastatic prostate cancer
  • Adverse effects
    • Diarrhoea, anemia, hepatic injury
    • Oedema dizziness, blurred vision
25
Q

What are the uses and side effects of 5a-reductase inhibitors/Finasteride?

A

Uses (selective for DHT)

  • Benign prostatic hypertrophy
  • Hair loss

Adverse effects

  • Impotence, decreased libido and ejaculation disorder
  • Breast enlargement, tenderness
  • Breast cancer
26
Q

Drugs affecting sex hormones

A

MD1 - Reproduction Block (15 decks)

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