Fertility and Reproduction Flashcards
Types of Sex Hormones/Gonadal Steroids
- Estrogen
* Estradiol
* Estrone
* Estriol - Progestin/Progesterone
- Androgen
Essential for normal female reproductive development
Estrogens
Estrogens Hormonal Action
- Growth & development
- Secondary Sex Characteristics
- Affect mood & Emotions
- Distribution of body fat
- Enhance blood coagulation
- Prevent osteoporosis
- Cholesterol
Major ovarian estrogen in women; most potent estrogen produced & secreted by the ovary
Estradiol
Principle estrogen in the premenopausal womem
Primary circulating estrogen after menopause
Estrone
Present during pregnancy, the principal estrogen produce by placenta
Estriol
The major progestin in humans produced in response to luteinizing hormone (LH) by both females & males
Progesterone
Hormonal Actions of Progesterone
- Emotional State
- Cholesterol
- Increase basal body temp
- Has mineralocorticoid properties
Responsible for thickening of endometrium lining that can accommodate implantation of a newly forming embryo (gestational hormone)
Progesterone
Have anabolic &/or musculinizing effects in both males & females
Androgen
Menstrual Cycle
- Follicular Phase
Development of estrogen-secreting follicle develops
High Estrogen, Very low Progesterone
Surge of LH, triggers ovulation - Luteal Phase
* 14 Days
* From ovulation to start of period
* Follicle becomes corpus luteum - secretes both estrogen and progesterone
* Prepares uterus for implantation of fertilized egg
Pregnancy
- Placenta produces Human chorionic gonadotropin
- Placenta becomes prodominant source of progesterone
- Progesterone maintains pregnancu & prevent endometrial sloughing
Estrogens
1. Natural Estrogen
* Estradiol
* Estrone
* Estriol
2. Synthetic Estrogen
Steroidal: Ethinyl Estradiol
Non-Steoidal: DES (Diethylstilbestrol)
3. Premarin
MOA of Estrogen
Activation of estrogen receptors leads to changes in the rates of transcription of estrogen-regulated genes (gene –activation)
A prodrug that is converted to ethinyl estradiol, contained in some contraceptives
Mestranol
Conjugated equine estrogen
Premarin
Hydrolysis: Equilin + Estrone
Clinical Uses of Estrogen
- Hormone Replacement Therapy (Menopause)
- Treatment of acne & Dysmenorrhea
- Treat of heavy menstrual bleeding
- Oral Contraception
- Treatment of primary hypogonadism
A/Es of Estrogens
If given alone: Endometrial Hyperplaseia (Mx: + Progesterone)
N/V, Headache
Edema
HPN
Thromboembolism
Progestins
- Progesterone
- Norgestrel
- Hydoxyprogesterone caproate
- Medroxyprogesterone acetate (Provera®)
- Megestrol Acetate
Synthetic Progestins
* Norgestrel
* Norgestimate
* Drospirenone
MOA of Progestins
Activation of progesterone receptors leads to changes in the rates of transcription of progesterone-regulated genes
Clinical Uses of Progestins
- Treatment of Endometriosis
- Treatment of Uterine Bleeding and Dysmenorrhea
- Contraceptive
Breakthrough Bleeding - most common problem encountered in female patien
Primary natural progestin in mammals
Progesterone
Treatment of endometriosis
Medroxyprogesterone acetate (MPA)
* ORAL / IM
Androgens
Testosterone
Methyltestosterone
Danazol
Menotropins
Birth control pills that contain female sex hormones
Oral Contraceptive Pills
Combination Pill
- Estrogen (Ethinyl estradiol) + Progesterone
- Reminder Pill
- 21/28 tablets
Trandermal Patch
Ethinyl Estradiol + Progestin (Norelgestromin)
Progestin-only pills
Norethindrone Products
(Minipills)
Levonorgestrel
Emergency Contraceptives
Prevent pregnancy after unprotected sex
72 hours after intercourse
Vaginal Ring
Ethinyl Estradiol + Etonogestrel
Progestin Implants
Norplant
Progestin Intrauterine Device
Levorgestrel
Post-coital Pills (Morning after pills)
High dose of progesterone, within 36 hours
Injectable Contraceptives
Depo-provera® ( Methoxy progesterone acetate), q 3months
