Estrogens

Question 0

What is the most common estrogen produced by the ovaries?

Answer 0

E2- estradiol

Question 1

What are E1, E2 and E3?

Answer 1

E1- estrone
E2- estradiol
E3- estriol

Question 2

What is the purpose of estrogen?

Answer 2

Development of female reproductive organs, secondary sexual characteristics, and the menstrual cycle.

Question 3

Where and how are E1 and E3 produced? (2 ways)

Answer 3

In the liver via E2.

Adrenal cortex from androstenedione. (Or other androgens).

Question 4

Which form of estrogen is most common in post menopausal women?

Answer 4

Estrone (E1)- from the adrenal Cortex

Question 5

E2 is produced by…

Answer 5

Follicular cells and progesterone by the corpus luteum.

Question 6

What is SHBG?

Answer 6

Sex hormone binding globulin.

Question 7

Which estrogen binds the strongest to SHBG?

Answer 7

E2

E1 and E3 have weak affinity for ER (estrogen receptor)

Question 8

How does the liver effect estrogen?

Answer 8

1st pass effect and entero-hepatic recycling.

Question 9

Pharmacodynamics of estrogen.

Answer 9

ER has nuclear localization. ER dimer binds ERE in the promoter regions of estrogen-responsive genes.

Question 10

3 synthetic estrogen mimicking steroids:

Answer 10

Ethinyl estradiol

Mestranol

Quinostrol

Question 11

3 synthetic non-steroidal estrogen mimicking agents:

Answer 11

Diethylstilbestrol

Chlorotrianisene

Methallenestril

Question 12

Estrogen mimicking phytochemicals

Answer 12

Flavonones: genistein(soy) and resveratrol(red wine)

Question 13

Estrogen mimicking pesticides

Answer 13

Kepone, bisphenol, hexachlorophene

Question 14

What is hypogonadism and how do you treat it in women?

Answer 14

Lack of maturation and development of secondary sexual characteristics.

Estrogen

Question 15

Endometrial development and shedding during menstrual cycle is regulated by:

Answer 15

Estrogen

Question 16

Excessive exposure to estrogen can cause:

Answer 16

Endometrial hyperplasia and abnormal bleeding.

Question 17

How can lack of estrogen lead to osteoporosis?

Answer 17

Estrogen INHIBITS osteoclasts cells thus preventing bone reabsorption.

Question 18

Estrogen accelerates or decelerates bone growth and epiphyseal closure?

Answer 18

Accelerates

Question 19

Why is estrogen protective against atherosclerosis?

Answer 19

Increases hdl and lowers LDL.

Question 20

Estrogen increases what liver proteins?

Answer 20

CBG, SHBG, TBG, transferrin, renin substrate, fibrinogen.

Question 21

How does estrogen increase risk of stroke and cardiovascular disease?

Answer 21

Decreases anti thrombin 3 activity which increases coagulation. (Mostly in hrt)

Question 22

What post menopausal symptoms does estrogen help with?

Answer 22

Vasomotor symptoms (hot flashes)

Question 23

What is HRT and who is it used for?

Answer 23

Hormone replacement therapy

Post menopausal women and those with radical hysterectomy

Question 24

3 benefits of HRT.

Answer 24

Prevents osteoporosis Reduces vasomotor symptoms/genital atrophy Protective anti Alzheimer's effects

Question 25

Risks of HRT (4).

Answer 25

Breast cancer, endometrial carcinoma, coagulation and stroke.

Question 26

What can you take to reduce osteoporosis risk?

Answer 26

Calcium + D (and weight bearing exercise)

Question 27

Adding progestins to estrogen does what in terms of cancer?

Answer 27

Increases risk of BC but lowers risk of. Endometrial carcinoma.

Question 28

When giving estrogen and progestin as ERT how would split up the days?

Answer 28

Estrogen as the first 25 days and progestin during the last 10-14 days.

Question 29

What is the name for combined estrogen-progestin?

Answer 29

Medroxyprogesterone

Question 30

Medroxyprogesterone can cause...

Answer 30

Amenorrhea

Question 31

Estrogen-progestin combos can be used to treat... (2)

Answer 31

dysmenorrhea or amenorrhea + hirsuitism due to excess androgens

Question 32

AEs of estrogen treatment

Answer 32

postmenopausal uterine bleeding--possible b/c of edometrial hyperplasia/carcinoma (dec risk with progesterone) Breast cancer (dec with tamoxifen)

Question 33

Which form of estrogen is teratogenic, can give daughters of using mothers vaginal adenomas, and must be avoided during pregnancy?

Answer 33

Diethystilbestrol (DES)

Question 34

When is estrogen CI'ed?

Answer 34

estrogen dependant cancers (endometrial/BC/family hx) undiagnosed vaginal bleeding liver disease thromboembolic disorders heavy smoker over 40!