estrogens/progesterones Flashcards
which 2 cells are required for estradiol synthesis?
- theca
2. granulosa
steroidogenesis in the ovary is regualted by what?
the gonadotropins (LH & FSH)
which phase of menstrual cycle? high frequency, low amp LH secretion; estrogen rises; endometrial proliferation
follicular phase
which phase of menstrual cycle? estrogen induced gonadotropin surge
ovulation
which phase of menstrual cycle? rise in estrogen/progesterone; endometrial differentiation
luteal pahse
what induces the gonadotropin surge at day 14?
estrogen
which hormone is involved in decr uterine contractions?
progesterone
ethinyl estradiol, mestranol - synthetic or natural?
synthetic estrogen
what are the pharmacological uses of estrogen
- hypogonadism
- HRT
- Contraception
- acne
HRT has an ____risk of breast cancer
increased
contraceptives have a ______risk of ovarian and endometrial cancer
decreased
is estrogen administered by itself for bc?
NEVER
effect of progesterone on cervical glands?
increaase cervical mucous viscosity
breakthru bleeding is assc’d with?
progestin only bc
breakthru bleeding is ____ when assc’d with estrogen, and ______when assc’d with progestin
mild with estrogen, moderate with progestin
if a person has known h/o breast cancer, what sort of bc should you give them?
progestin only
antibiotics _____contraceptive effectiveness
lower
which estrogen is a natural water-soluble estrogen sulfates; need to be given in higher dose
Conjugated equine estrogens (Premarin)
side effects of 19 nor progestins?
acne
hirsuitism
which estrogens or progestins are 19-nortestosterone derivatives?
- Norethindrone
2. Norgestrel
which BC are only available in progestins only
implantable, IUD
what is the failure rate for combo emergency contraceptive?
25%
what is the failure rate for progestin only emergency contraceptive?
12%, must be taken within 72 hrs post sex
BC has drug interactions with which drugs?
- St. John’s Wort
- antiretrovirals
- anticonvulsants
- antibiotics
which drug is a partial agonist; block estrogen negative feedback & used for fertility?
clomiphene
when in the menstrual cycle to dose clomiphene?
follicular phase
in bone, SERMs act as _____ and suppress bone resorption
agonist
in endometrium, SERMS act as ______ and induce proliferation
partial agonist
in pituitary & breast, SERMS act as ______ and induce hotflashes and inhibit breast proliferation
antagonist
works against ER+ breast cancer, but can cause incr risk for endometrial cancer
tamoxifen
tx for carcinoma, postmenopausal bone loss, no adverse effects against endometrium
raloxifene
in comparison to estrogen, tamoxifen ____hot flashes
increases
in comparison to estrogen, tamoxifen ____risk of breast cancer
decr
MOA: Inhibit gonadal function (mild androgenic effects)- inhibition of estrogen
Danazol
MOA: Aromatase inhibitor (convert androgen to estrogen)- inhib estrogen synthesis
Anastrozole/ Letrozole
what is used as an abortifacient (progesterone antag)-induce delivery after fetal death or induce labor at end of 3rd trimester
Mifepristone
when should mifepristone be used?
less than 7 wks gestation for 1st dose
what do you f/u mifepristone dosing with/?
misoprostol to induce uterine contractions admin 48 hrs later
Longer acting emergency contraceptive that can be used up to 5 days after intercourse; partial agonist
ulipristal
which hormone is responsible for endometrial proliferation?
estrogen
which hormone is responsible for endometrial differentiation?
progesterone
what is the key regulator during the luteal phase?
progesterone
