Fertility, Contraception, Gonadal Hormones, and Inhibitors Flashcards
What are the effects of high concentrations of progesterone on the endometrium during pregnancy?
Progesterone hyperpolarizes uterine smooth muscle membranes makign muscle non-excitable and prevents release of arachidonic acid (so prostaglandins are low)
How does the levles of progesteron changes as parturition approaches?
Estrogen levels rise compared to progesterone causing an increase in prostaglandin release that increases the number of gap junctions that electrically excite myometrial cells
What are some oxytocics?
Oxytocin (Pitocin)
What are the uses of oxytocics?
These can be used to induc labor in case of premature rupture of membranes, fetal growth restriction, uteroplacental insufficiency, pre/eclampsia
these can also be used to control postpartum uterine hemorrhage, induction of uterine contraction after C-section or during uterine surgery, or for induction of therapeutic abortion
What is the use of tocolytics?
delay or prevent premature parturition for brief periods to allow time for additional therapeutic measures including glucocorticoid therapy to increase pulmonary surfactant levels
What are some estrogen therapy options?
- Ethinyl estradiol (Estinyl)
- Mestranol
- Estrogen esters (Delestrogen, Valergen, Depo-estradiol Cypionate)
What are some progestin therapy options?
- Norethindrone
- Norgestrel
- Levonorgestrel
What are some selective estrogen receptor modulators?
Tamoxifene and Raloxifene
What are some antiprogestins?
Mifepristone and Onapristone
What are some aromatase inhibitors?
Anastrozole and Letrozole
What are some testosterone analogs?
Testosterone (systemic or transdermal patches)
Methyltestosterone
Testosterone propionate/cypionate
Danazol
What are some androgen receptor antagonists?
Flutamide and Bicalutamide
What are some 5a-reductase inhibitors?
Finasteride
Commercial pregnancy diagnostic kits depend on what?
qualitative detection of CG in urine of pregnant women (based on the use of AB specific for the CG unique B subunit)
The exact time of ovulation can be predicted by what?
measuring urinary LH- ovulation occurs 36 hrs after onset of LH surge
How does estrogen act?
Estrogen acts through cytoplasmic receptors, ERa and ERb, that translocate to the nucleus to initiate DNA transcription
Where are ERa receptors located?
in the female reproductive tract (uterus, vagina, and ovary)
Where are ERb receptors located?
prostate and ovary
How does estrogen affect HDL levels? LDL? TAGs?
Increase HDL and TAG levels and lower LDL cholesterol
How does estrogen affect bone?
It is osteo-protective, hastens bone maturation, and quickens closure of epiphyseal plates in long bones more effectively than testosterone (thus women are shorter than men!)
How does estrogen affect the myometrium?
Increases muscle content (and causes prolfieration of the endometrium during the follicular phase of the menstrual cycle)
T or F. Estrogen increases the production of clotting factors
T. So oral contraceptives and post-menopausal estrogen promote a pro-thrombotic state
How do defective estrogen receptors affect bone in males?
These men suffer from osteoporosis, unfused epiphyses, and increased bone turnover and delayed bone age
How does progesterone affect cholesterol?
decreases HDL and stimulates LDL