Estrogen Therapy Flashcards
What is the main estrogen produced by the ovary
Estradiol-17B
Name 2 weak natural estrogens
- Estriol
2. Estrone
Tell me again how estradiol-17B is made?
Aromatization reaction of testosterone or androstenedione. Catalyzed by aromatase enzyme (CYP19)
Where do you find aromatase?
- Granulosa cells of the ovary
- Sertoli and leydig cells
- Adipose stroma
- Bone
- Brain (interesting)
In a premenopausal woman, where does most of the circulating estrogen come from?
The ovaries
What type of estrogen does the liver make?
Estriol and estrone. Catalyzed by type II hydroxysteroid dehydrogenase.
In a postmenopausal woman, where does most of the circulating estrogen come from?
Estrone produced by adipose tissue
What are the effects of estrogen in utero?
Formation of the:
- Vagina
- Uterus
- Fallopian tubes
What are the effects of estrogen when girls go through puberty, the best time of your life
- Pubic and axillary hair growth
- Distribution of body fat
- Ductal and stromal development of breast
- Endometrial development
- Long bone development and eventual epiphyseal plate closure
What are some of the metabolic effects of estrogen?
- increased bone mass (cause we ladies gots the strongest bones)
- Increased triglycerides (cause you ladies are fat) and reduces serum cholesterol
What modification is needed to make estrogen preparations orally action
17alpha
17a ethinyl estradiol is the pharm prep of estrogen that we need to know
What kind of disease would you consider using estrogen therapy for? (a bit intuitive)
- Hypogonadism: being replacement therapy between 11-13 yo and then switch to a 12a ethinyl estoradiol/progesterione OCP
- Menopausal hormone therapy
We know that estrogen helps treat the symptoms of menopause. What specifically is estrogen helping with?
- Decreasing bone fractures
- Hot flashes (vasomotor sx)
- Vaginal dryness
- Urogenital atrophy
- Memory problems
What are the consequences of hormone replacement therapy
Increased risk for MI and endometrial carcinoma
What is norethindrone acetate. Do we still use this drug?
Its a estrogen progesterone combined hormone replacement therapy. No, the study was halted in 2002 because of increased risks of MI, stroke, blood clots and breast cancer