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PA10315 > Hormones of pregnancy, menopause and contraception. > Flashcards

Hormones of pregnancy, menopause and contraception. Flashcards

1
Q

What is the precursor for progesterone?

A

Cholesterol.

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2
Q

What is progesterone?

A

Female sex hormone, but also the precursor for androgens.

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3
Q

What are androgens?

A

Precursors for male and female hormones - testosterone and androstenedione.

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4
Q

What is misleading about the idea of male and female sex hormones?

A

They are present in everyone, it is just receptors in the body that change the responses of male and female bodies.

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5
Q

What type of receptors do sex hormones act through?

A

Nuclear receptors.

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6
Q

What are common properties of sex hormone nuclear receptors?

A

They have ligand-binding and DNA-binding domains. They translocate to the nucleus once the hormone is bound and bind to hormone-response elements (recognition elements) in specific gene sequences. DImerization is important for their function.

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7
Q

What hormones use nuclear receptors?

A

Androgens, oestrogen and progesterone.

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8
Q

What happens when oestrogen binds to its receptor?

A

The receptor changes conformation due to dissociation of heat shock proteins after oestrogen binds.

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9
Q

What happens after the conformation of the oestrogen receptor has changed?

A

It undergoes dimerization.

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10
Q

Why does the oestrogen receptor undergo dimerization?

A

To increase affinity for DNA.

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11
Q

What are specific DNA sites called where oestrogen-receptor complexes bind?

A

Oestrogen response/recognition elements (EREs).

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12
Q

What do nuclear receptors regulate?

A

Gene transcription.

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13
Q

What is the gene that endcodes the progesterone receptor?

A

PR.

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14
Q

What are the two isoforms of the PR receptor?

A

PR-A and PR-B.

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15
Q

What does PR-B do?

A

It mediates the stimulatory effects of progesterone.

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16
Q

What is the effect oestrogens on the ovaries?

A

They stimulate the endometrium, the thickening of the vaginal mucosa and thinning of the cervical mucus so it is easier for sperm to enter.

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17
Q

What is the effect of oestrogens on the hypothalamus?

A

There is increased gonadotrophin-releasing hormone (GnRH).

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18
Q

What is the effect of oestrogens on the pituitary?

A

Increased luteinizing hormone release (LH).

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19
Q

What does LH do?

A

Causes development of the corpus luteum and triggers ovulation.

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20
Q

What is the effect of oestrogen on metabolism?

A

Protein anabolism, bone growth and decreased circulating cholesterol.

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21
Q

What is the effect of oestrogen on female sexual characteristics?

A

There is secondary sex characteristics and development of the breast ductal system.

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22
Q

What is the effect of progesterone on GNRH?

A

Causes a decrease.

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23
Q

What does GnRH do?

A

Stimulates secretion of gonadotrophin, FSH and LH.

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24
Q

What is gonadotrophin?

A

Hormone that stimulate activity of the gonads - ovaries and testes.

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25
Q

What effect does progesterone have on the endometrium?

A

It inducts secretory activity.

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26
Q

What is the endometrium?

A

Mucous membrane lining the uterus which thickens during the menstrual cycle.

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27
Q

What effect does progesterone have on cervical mucus?

A

It increases the viscosity - harder for sperm to swim.

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28
Q

What is the effect of progesterone on breast development?

A

It promotes glandular breast development.

29
Q

What effect does progesterone have on the basal body temperature?

A

It increases it.

30
Q

What are the natural oestrogens?

A

Oestradiol/oestrone and oestriol.

31
Q

What are some synthetic oestrogens?

A

Mestranol, ethinylestradiol and diethylstibestrol.

32
Q

What does SERMs stand for?

A

Selective estrogen receptor modulators.

33
Q

Why is selectivity in oestrogen receptors possible?

A

alpha and beta oestrogen receptors show differential tissue expression, conformation-dependent binding to DNA and transcription factors, tissue dependent responses ranging between pro-oestrogenic, partially oestrogenic and anti-oestrogenic effects.

34
Q

What are natural progestogens?

A

Hydroxyprogesterone, medroxyprogesterone and dydrogesterone.

35
Q

What are some testosterone derivatives?

A

Norgestrel, desogestrl and ethynodiol.

36
Q

When does the menopause normally occur?

A

45-55 years old.

37
Q

What happens in the menopause?

A

Menstruation becomes irregular and then ceases.

38
Q

What causes the menopause?

A

Ovarian failure - there are very few functional primordial follicles left in the ovaries.

39
Q

What are the three phases of the menopause?

A

Perimenopause, menopause and postmenopause.

40
Q

What happens in perimenopause?

A

Fluctuation in hormone levels. It can last 2-8 years.

41
Q

What happens in the menopause phase?

A

Oestrogen levels drop and it occurs 1 year after the ceasation of periods.

42
Q

What happens in postmenopause?

A

Oestrogen levels continue to drop and there are health concerns that begin.

43
Q

What are the symptoms of the menopause?

A

Hot flushes, night sweats, palpitations, increased irritability, mood change, vaginal atrophy (dryness) and development of osteoporosis.

44
Q

How is oestrogen involved with osteoporosis?

A

Oestrogen acts to maintain bone mineral density.

45
Q

What is Raloxifene?

A

A selective oestrogen receptor modulator that functions like oestrogen to maintain bone density.

46
Q

What is the problem with just using oestrogen in hormone replacement therapy?

A

It can lead to increased risk of breast cancer.

47
Q

What makes up hormone replacement therapy treatments?

A

Oestrogens and progesterones - the progesterones are used to prevent the negative effects of oestrogen (not increase breast cancer risk).

48
Q

What is hormone replacement therapy used for?

A

Balance oestrogen and progesterone around the menopause.

49
Q

What are the good effects associated with HRT?

A

Strengthened bones, lowered LDL cholesterol, raised HDL cholesterol and reduced menopausal symptoms.

50
Q

What are the bad effects associated with HRT?

A

Increased breast cancer risk, increased uterine cancer risk, increased blood clot risk.

51
Q

What are barrier methods of contraception?

A

Caps, diaphragms and condoms.

52
Q

What are examples of oral contraceptives?

A

Combined hormonal contraceptives, progestogen-only contraceptives and emergency contraception.

53
Q

What are COCs?

A

Combined oral contraception.

54
Q

What does the oestrogen do in COCs?

A

Suppresses ovulation by inhibiting LH/FSH release - mimicking the normal negative feedback effect of oestrogen at pituitary and hypothalamic level.

55
Q

What does progestogens do in COCs?

A

Induce thickening of cervical mucus and thins the endometrium.

56
Q

What are the side effects of COCs associated with oestrogen?

A

Nausea, vomiting, weight gain, mild hypertension and breast tenderness.

57
Q

What are the rare side effects of COCs?

A

Venous thromoembolism, cerebral haemorrage, increased risk of breast/cervical cancer and amenorrhoea following withdrawal that can last several months.

58
Q

What are POCs?

A

Progestogen-only contraceptives.

59
Q

What are effects of POCs?

A

The cervical mucus becomes thick and sticky (hostile to sperm), the endometrium changes making implantation less likely, there are weak negative feedback inhibition of LH release and ovulation and POCs in some women can completely suppress gonadotrophin secretion and ovulation resulting in amenorrhoea.

60
Q

What is postcoital oral contraception?

A

Morning after pill.

61
Q

What is dysmenorrhoea?

A

Painful periods and abdominal cramps.

62
Q

What is menorrhagia?

A

Heavy periods/excessive blood loss.

63
Q

What is PMS?

A

Physical, psychological and behavioural symptoms occurring before menstruation.

64
Q

What is endometriosis?

A

A long term condition where the cells that line the wall of the uterus are found outside the normal areas - undergo cyclic development throughout the body - pain and discomfort.

65
Q

What are antiprogestogens used for?

A

Medical abortions - an alternative to surgical termination of pregnancy.

66
Q

What can phospholipids be converted to?

A

Arachidonic acid which can then be converted to prostaglandins, thromoboxanes and leukotrienes.

67
Q

What effect do prostaglandins have?

A

They cause vascular effects but also contraction of the uterus wall.

68
Q

What does oxytocin and prostaglandins do?

A

Stimulate contractions and induce labour.

69
Q

What do beta2-adrenoceptor agonists do?

A

Inhibit contractions of the pregnant uterus.

PA10315 (47 decks)

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