Estrogen Therapy (lecture) Flashcards
What is the primary hormone responsible for endometrial proliferation?
Estrogen
What cells are the primary source of estrogen and what stimulates their production of estrogen?
Granulosa
FHS / LH
What is the primary hormone responsible for the growth of glandular endometrium and the major source of this hormone?
Progesterone
Corpus Luteum
What is the major form of estrogen?
estradiol 17-Beta
How does estrogen influence coagulation?
Decrease in antithrombin III, incr. clotting factors –> increase thrombis
What are the three forms of orally active estrogen?
Ethinyl estradiol, Mestanol, Equilenin
What are the three main side effects of estrogen therapy?
Thrombosis, Incr. risk of endometrial carcinoma, incr. in breast cancer
What are the first and second line categories of drugs used in postmenopausal treatment of osteoporosis?
Bisphosphonate (alendronate)
SERM (tamoxifen, raloxifene)
What is the MoA of Tamoxifen?
Estrogen antagonist in breast, agonist in endometrium
What SERM is primarily used in Breast Cancer?
Tamoxifen
What is the MoA of raloxifene?
Estrogen antagonist in breast, partial antagonist in endometrium
What SERM is primarily used in osteoporosis?
Raloxifene
Which SERM has fewer thrombosis and endometrial side effects?
Raloxifene
What is the only SERM that is an agonist on vaginal epithelium and used for dyspareunia?
Ospemifene
If “Ouch” use Os
What is the MoA of clomiphene citrate and its indication for use?
Estrogen antagonist in hypothalamus and pituitary gland –> lack of negative feedback –> FHS and LH release –> induced ovulation
