estrogen/progesterone

Question 1

Describe Hypothalamic-Pituitary-Gonadal Axis

Answer 1

• Steroidogenesis is regulated by feedback regulation
• Estrogen and progesterone EXERT both NEGATIVE and POSTIVE feedback to regulate gonadotropin release
• POSITIVE FEEDBACK OCCURS MID-OVARIAN cycle which includeds ovulation

Question 2

describe the menstrual cycles

Answer 2

• Follicular phase
  
  • estrogen rises
  • endometrial proliferation
• Ovulation
  
  • estrogen induced gonadotropin surge
• Luteal phase
  
  • rise in estrogen and PROGESTERONE
  • endometrial differentiation under control of progesterone

Question 3

describe Estrogens effects

Answer 3

• HPG axis = feedback regulation for steroidogenesis and ovulation
• Endometrium = endometrial Proliferation
• metabolic effects
  
  • lipids –> decrease LDL, increase HDL, increase Triglycerides
  • Bone –> ANTIRESORPTIVE
  • liver –> increase plasma proteins
  • Blood –> increase expression of coagulation factors, decreased antithrombin
• Development –> ovaries, follopian tubes, uterus, vagina, breasts
• Menstrual cycle –> follicular phase

Question 4

Progesterone effects

Answer 4

• HPG axis = feedback regulation for steroidogenesis and ovulation
• Endometrium = endometrial DIFFERENTIATION, decrease UTERINE CONTRACTIONS
• Metabolic
  
  • lipids –> increase LDL, fat deposition
  • GLucse –> increase fasting glucose levels
• Development = ovaries, fallopian tubes, uterus, vagina, breasts
• Menstural cycle = LUTEAL PHASE
• uterus smooth muscle = decrease UTERINE contractions, decrease prostaglandin production
• Cervical glands = increase cervical mucous viscosity

Question 5

Risks of hormone replacement therapy

Answer 5

• increase coronary heart disease
• increase stroke
• increase pulmonary embolism
• increase invasive breast cancer

OKAY SHORT TERM, BAD LONG TERM

Question 6

adverse effects of hormone contraceptives

Answer 6

• Mild
  
  • nasuea, mastalgia (tender breasts), breakthrough bleeding due to estrogen, edema, headache, withdrawal bleed failure, serum protein changes
• moderate
  
  • breakthrough bleeding due to progestin, weight gain, acne, hirsutism, vaginal infection, Amenorrhea
• severe
  
  • thromboembolic disease, myocardial infarction, cerebrovascular disease, cholestasis, depression, CANCER

Question 7

what are some of the non-Contraceptive benefits of hormone birth control

Answer 7

• reduced risk of ovarian and endometrial cancer
• reduction in dysmenorrhea, endometriosis
• decreased incidence of ectopic pregnancy
• decreased incidence of benign breast disease
• increase hemoglobin conc
• suppress acne and hirsutism

Question 8

Contraindications of estrogen containing contraceptives

Answer 8

• known or suspect breast cancer or cancer of female reproductive tract
• Thromboembolic disorder
• liver disease
• history of cardiovascular disease
• smokers 35 years of age or older

Question 9

Drug interactions of birth control

Answer 9

• HIV agens, anticonvulsants, St. JOHNS WORT induce hormoen metabolism
• Antibiotics LOWER contraceptive effectiveness