Genito-urinary system

Question 1

Synthetic oestrogens eg. ethinyloestradiol

Answer 1

Used as HRT or in combination with progestogen as COCP.
ADRs: VTE, MI, HTN, decreased glucose tolerance, headaches, mood swings, cholestatic jaundice, gallstones, porphyria, stroke in women with focal migraines.Efficacy affected by CYP inducers.

Question 2

Synthetic progestogens eg. medroxyprogesterone, dydrogesterone, norethisterone, levonorgestrel, desogestrel

Answer 2

Used in HRT, as POP or in combination with oestrogens as COCP - thicken cervical mucus. can be given orally, as depot or implant
ADRs: menstrual irregularity, nausea, vomiting, headache, dizziness, breast discomfort, depression, skin disorders, appetite disturbance, changes in libido.

Question 3

Levonorgestrel

Answer 3

Emergency contraception up to 72 hours post coitus.
MOA: Thickens mucous and prevents ovulation.
ADRs: Menstrual irregularities, nausea, low abdominal pain, fatigue, headache, dizziness, breast tenderness, vomiting
Counsel: Should use barrier contraception until the next period, seek medical attention if they get abdominal pain (? ectopic pregnancy), return if menstrual bleed is not as expected

Question 4

Ulipristal acetate

Answer 4

Emergency contraception up to 120 hours post-coitus.
MOA: selective progesterone receptor modulator
ADRs: GI disturbance, dizziness, fatigue, headache, menstrual irregularity
Counsel: Should use barrier contraception until the next period, seek medical attention if they get abdominal pain (? ectopic pregnancy), return if menstrual bleed is not as expected