Endocrine-2 (Female Reproductive) Flashcards by Allyson Lenz

Therapeutics

GnRH (pulse generator)
↓
FSH & LH
↓
Ovary

How well did you know this?

Not at all

Perfectly

What does pulsatile release of GnRH from the hypothalamus stimulate?

Pituitary release in pulses of FSH/LH

How well did you know this?

Not at all

Perfectly

What does FSH stimulate?

Ovarian follicle development

How well did you know this?

Not at all

Perfectly

What do ovarian follicles release?

Estradiol

How well did you know this?

Not at all

Perfectly

What does estradiol stimulate?

Growth of endothelial lining (“positive” feedback)

How well did you know this?

Not at all

Perfectly

What do LH surges trigger?

Ovulation

How well did you know this?

Not at all

Perfectly

In increase in estradiol/progesterone levels maintains what?

Uterine lining

How well did you know this?

Not at all

Perfectly

Day 1 to ovulation is called the ________ phase.

follicular

How well did you know this?

Not at all

Perfectly

Ovulation to menstruation is called the __________ phase.

luteal

How well did you know this?

Not at all

Perfectly

Estrogen

Reproductive organs mature

How well did you know this?

Not at all

Perfectly

What does estrogen decrease?

Reabsorption of bone

How well did you know this?

Not at all

Perfectly

What does estrogen increase?

Coagulability of blood

How well did you know this?

Not at all

Perfectly

What does continuous/unopposed estrogen for long periods of time lead to?

Abnormal hyperplasia

How well did you know this?

Not at all

Perfectly

What does progesterone maintain?

Endometrial lining (in pregnancy)

How well did you know this?

Not at all

Perfectly

What is androstenedione?

A weak androgen

How well did you know this?

Not at all

Perfectly

What does testosterone have?

Significant androgen activity

How well did you know this?

Not at all

Perfectly

What is the brand name for a copper-IUD?

Paragard

How well did you know this?

Not at all

Perfectly

What is the duration of a copper-IUD’s use?

10 years

How well did you know this?

Not at all

Perfectly

What is the mechanism of action in a copper-IUD?

Non-hormonal
Continual release of Cu++ into uterus

How well did you know this?

Not at all

Perfectly

What are the side effects of a copper-IUD?

Heavier flow, abdominal cramps

How well did you know this?

Not at all

Perfectly

What is the duration of a levonorgestrel IUD?

3-5 years

How well did you know this?

Not at all

Perfectly

What is the mechanism of action in a levonorgestrel IUD?

Progestin ONLY
Local release of progestin into uterus

How well did you know this?

Not at all

Perfectly

What are the side effects of a levonorgestrel IUD?

Changes in bleeding patterns, amenorrhea

How well did you know this?

Not at all

Perfectly

What is the brand name for etonogestrel?

Nexplanon

How well did you know this?

Not at all

Perfectly

What is the duration of the etonogestrel implant?

3 years

What is the mechanism of action in the etonogestrel implant?

- Progestin ONLY - Controlled progestin release - Suppresses ovulation

What is a prominent side effect of the etonogestrel implant?

Unpredictable bleeding

What are some considerations when using long-acting reversible contraception?

- Return to fertility in 1-2 cycles - Effectiveness is NOT decreased with weight - Efficacy

What are combination hormonal contraceptives?

Continuous administration of estrogen + progestin

What do combination hormonal contraceptives suppress?

GnRH release from hypothalamus

What does the estrogen component of combination hormonal contraceptives do?

- Prevents ovulation - Provides cycle control - Prevents ADEs

What enzymes are part of the elimination component of combination hormonal contraceptives?

CYP450 3A4 enzymes

What doses do ethinyl estradiol come in?

50mcg, 35mcg, 30mcg, 20mcg, 10mcg

What is a good starting dose of ethinyl estradiol for women?

20mcg

What dose of ethinyl estradiol is good to use for women with adherence issues?

30mcg/35mcg

What does the progestin component of combination hormonal contraceptives do?

Provides most contraceptive effect

What does the progestin component of combination hormonal contraceptives suppress?

LH levels

What does the progestin component of combination hormonal contraceptives decrease?

Ovary response to FSH

What is drospirenone?

Analog of spironolactone, anti-aldosterone/mineralcorticoid

What are some risks of estrogen?

- Venous thromboembolism - CV disease - Hypertension - Breast cancer - Headaches

What E/P ratio do you use for monophasic cycles?

Equal E/P dose

What E/P ratio do you use for biphasic cycles?

Same E/ different P in 2 phases

What E/P ratio do you use for triphasic cycles?

Vary the E/ or P/ or both

What should you do if you miss 2 or more combination hormonal contraceptive pills?

Use a non-hormonal backup until hormonal pills have been taken for 7 days

What is an example of a progestin-only contraceptive?

Norethidrone (Micronor)

What is the mechanism of action in norethidrone?

Increases thickness of the cervical mucus

Are there placebo pills in norethindrone packs?

What dose of tablets do norethindrone come in?

0.35mg

What is an over the county progestin only pill?

Norgestrel

What strength do norgestrel pills come in?

0.075mg

What is the brand name of norgestrel?

Opill

What is the name for the depo-injection?

depo-MedroxyProgesterone Acetate (DMPA)

What is the mechanism of action of DMPA?

Suppresses FSH/LH (no ovulation)

What are the adverse effects of DMPA?

- Unpredictable bleeding - Weight gain - Decreased bone mineral density

What is a form of emergency contraception that comes in a prescription only?

Ulipristal acetate (Ella)

What is the dose that ulipristal acetate comes in?

30mg

What is the mechanism of action of ulipristal acetate?

Inhibits/delays ovulation

What does ulipristal acetate block?

Progesterone from binding to its receptor

When should ulipristal acetate be administered?

Up to 5 days after unprotected intercourse

What is a form of emergency contraceptive that is available over the counter?

Levonorgestrel (Plan B)

What dose does levonorgestrel come in?

1.5mg

What is the common directions for levonorgestrel?

Take as soon as possible after unprotected sex *The sooner you take it the better it will work*

What are some adverse effects of levonorgestrel?

Mild headache, fatigue, dizziness, breast tenderness

Menarche

1st period that occurs

Menopause

When a woman has had no cycles for 12 months or longer

What are characteristics of perimenopause?

- Irregular cycles - Unpredictable fertility - Increases FSH levels

How is perimenopause diagnosed?

- Bleeding changes - Increased FSH levels

What are examples of drug therapy for menopause symptoms?

- OTC vaginal moisturizers - Vaginally inserted estrogen (local effect)

What are some examples of vaginal estrogen products?

- Creams - Tablets - Rings

Is progestin needed in vaginal estrogen products?

What are examples of estrogen products for systemic symptoms/hormone therapy?

- Conjugated equine estrogens (Premarin) - Estradiol (Estrace)

What are examples of progestin products for systemic symptoms/hormone therapy?

- Medroxyprogesterone acetate (Provera) - Levonorgestrel IUD

For women with a uterus, do they need estrogen therapy alone or estrogen + progestin?

Estrogen + progestin

For women WITHOUT a uterus, do they need estrogen therapy alone or estrogen + progestin?

Estrogen therapy alone

For women with "okay" FSH/LH levels and something "wrong" with their hormonal balance, what can they use to induce ovulation?

Clomiphene citrate (Clomid)

Endocrine-2 (Female Reproductive) Flashcards

(75 cards)