5.2) Reproductive Health Flashcards

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1
Q

What are the sex steroid hormones?

A

Oestrogen progesterone and androgens

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2
Q

What are the sex steroid hormones derived from?

A

Cholesterol

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3
Q

What type of receptor are the steroid hormone receptors?
How do they exert their effect?

A

Nuclear receptors
Exert effects through gene transcription and subsequent production of proteins

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4
Q

What are the actions of oestrogen?

A
  • endometrial proliferation
  • sodium and water retention
  • raises HDL, lowers LDL
  • decreases bone resorption (reduces osteoclast activity)
  • impaired glucose tolerance
  • increases blood coagulability
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5
Q

What are the side effects of oestrogen?

A
  • breast tenderness
  • nausea/vomiting
  • water retention
  • thromboembolism
  • impaired glucose intolerance
  • endometrial hyperplasia and cancer
  • ovarian metaplasia and cancer
  • breast hyperplasia and cancer
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6
Q

What are the actions of progesterone?

A
  • secretory endometrium (dominant in secretory phase of cycle)
  • anabolic
  • increases bone mineral density
  • fluid retention
  • mood changes
  • maintains pregnancy
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7
Q

What are the side effects of progesterone?

A
  • weight gain
  • fluid retention
  • acne
  • nausea/vomiting
  • irritability, depression, PMS
  • lack of concentration
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8
Q

What are the actions of testosterone?

A
  • androgenic- male secondary sex characteristics (voice changes, body hair, aggression)
  • anabolic- growth, increased muscle mass
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9
Q

What are the side effects of testosterone?

A
  • acne
  • voice changes
  • increases aggression
  • increased body hair/male pattern baldness
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10
Q

What are the different types of hormonal contraceptives?

A

Short or long-acting reversible contraception

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11
Q

What are the actions of hormonal contraceptives?

A

Preventing ovulation, fertilisation or implantation

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12
Q

What are the pharmacokinetic properties of oestrogen? (Absorption/metabolism/excretion)

A

Natural and synthetic oestrogens well absorbed in the GI tract.
Readily absorbed from skin and mucous membranes.
Metabolism- liver
Excretion- in urine as glucuronides and sulfates

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13
Q

What are the pharmacokinetic properties of progesterone? (Administered?, metabolism, excretion)

A

Injected progesterone is bound to albumin with some stored in adipose tissue (can last ~3months)
Oral bioavailability is low (oral= low dose/injected= high dose)
Metabolised by liver
Metabolites excreted in the urine conjugated to glucuronic acid

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14
Q

What is the relationship between COCP and POP contraceptives and CYP 450 enzymes?

A

Metabolised by CYP enzymes in the liver.
Efficacy is thus reduced by CYP enzyme inducing drugs ie carbamazepine or phenytoin

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15
Q

What is the action of COCP?

A

Prevents ovulation
Secondary actions- reduces endometrial receptivity to implantation, thickens cervical mucus

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16
Q

What are some adverse effects of COCP?

A
  • increased risk of VTE
  • increased risk of stroke
  • increased risk of breast cancer and cervical cancer
17
Q

What are some of the contraindications of COCP prescription?

A
  • smoker> 35 years (generic RF for stroke/VTE)
  • previous VTE
  • high BMI
  • HTN
  • IHD/stroke
  • migraine with aura (increased risk stroke)
  • breast cancer
  • cirrhosis (metabolised by liver- could effect clearance)
18
Q

What is the POP? What is the action of this therapy?

A

Progesterone only pill
Low dose progesterone (does not effect HPG axis)
Thickens cervical mucus
Secondary actions- reduced cilia activity in fallopian tubes (if pregnancy was to occur, more likely to be ectopic)

19
Q

What is the mode of administration of POP?

A

Taken orally ODS
No breaks

20
Q

What are the advantages of POP treatment?

A
  • reliable if used correctly (up to 99%)
  • can be used if COCP contraindicated
21
Q

What are the disadvantages of POP therapy?

A
  • no STI protection
  • strict timing, so effectiveness is user dependent
  • can cause menstrual irregularities
  • increased risk of ectopic pregnancy
  • progesterone related side effects— acne, changes to mood etc