3 - Women's Health Flashcards
In addition to reproduction, progestogens affect _____ and _____
Bone mineralization
Lipid metabolism
The first half of the menstrual cycle is called ______ and the second half is called ______
Follicular Phase
Luteal Phase
During the follicular phase, estrogens are synthesized by ______
ovarian follicles
During the luteal phase, estrogens are synthesized by ______
the corpus luteum (unfertilized ovum)
During pregnancy, large quantities of which hormone are produced by the placenta?
Estrogen
Bearing in mind that estrogen is a steroid, where in the cell does it exert its effects?
in the cell nucleus, not the cell surface
Falling levels of which hormone cause menstruation?
Progesterone
Why are postmenopausal women at a higher risk of heart disease?
Estrogen receptors in the endothelium produce NO and estrogens lower levels of LDLs
Why are pregnant women so prone to clotting?
Estrogen increases levels of Coagulation factors and decreases the levels of antithrombin
They also increase fibrinolysis, which should keep things balanced
BUT if there’s any genetic oddities in the patient’s coagulation cascade or some precipitating factor, it’s easy for things to become unbalanced
What are the five metabolic functions effected by estrogen?
- Bone maintenance
- CV effects
- Coagulation
- Neuroprotection
- Glucose homeostasis
What are five therapeutic uses for Estrogens?
- Menopausal therapy
- female hypogonadism
- Acne
- Cancer palliation
- Transgender
Which patients should not receive estrogen?
- Abnormal vaginal bleeding with unknown cause
- estrogen dependent cancer
- DVT/PE Hx
- Thromboembolic event in the last year
- Abnormal liver fx
- Pregnancy
Which foods are best taken with estrogen?
Nausea is common early on and gets better with time
dry foods and raw fruits and veggies are less likely to produce nausea
What therapy regimen should women receiving hormone therapy for menopause take?
Estrogen AND progestin
Taking just estrogen can lead to endometrial carcinoma
A surge of which two hormones makes ovulation possible?
FSH
LH
What separates the follicular phase from the luteal phase?
The release of FSH and LH, resulting in ovulation
Which drugs can interfere with birth control?
What is the corpus luteum?
A cyst in the ovary formed from the ruptured ovum complex that secretes progesterone
What causes the endometrium to slough during menstruation?
When progesterone levels fall, the spiral arteries formed spasm and rupture, depriving the stratum functionalis of blood
The S. Functionalis becomes ischemic and sheds
What are the three types of estrogen?
Estrone (E1)
Estradiol (E2)
Estriol (E3)
What estrogen is produced by the ovaries?
E2 Estradiol
SELECTIVE ESTROGEN RECEPTORS MODULATORS
MOA & DRUG LIST
Tamoxifen, Raloxifene, Duavee
Block estrogen receptors in some tissues and activate them in others
Helpful for producing the beneficial effects of estrogen without the risks of exogenous estrogen
What’s the biggest difference between Tamoxifen and Raloxifene?
Tamoxifen carries a risk of endometrial cancer, and Raloxifene does not
Both of them protect against breast cancer
For the first 7 weeks of pregnancy, where is progesterone coming from?
From the Corpus Luteum
The developing trophoblast secretes hCG to trigger the corpus luteum to keep forming progesterone
