L12 and L13 Estrogens

Question 1

Describe the levels of Estrogen & Progesterone during the Follicular Phase of the menstrual cycle

Answer 1

High estrogen
Low progesterone

Question 2

Describe the levels of Estrogen & Progesterone during the Luteal Phase of the menstrual cycle

Answer 2

High estrogen
High progesterone

Question 3

List the broad physiological effects of estrogens

Answer 3

Female maturation
Endometrial effects

Question 4

List the female maturation physiological effects of estrogens

Answer 4

• Development of the vagina, uterus, and uterine tubes
• Stromal development and ductal growth in the breast
• Accelerated growth phase and the epiphyseal closure
• Growth of axillary and pubic hair
• Alteration in the distribution of body fat to produce female body contours
• Pigmentation in the skin (nipples, areolae, and genital region)

Question 5

List the endometrial physiological effects of estrogens

Answer 5

• Development of endometrial lining during menstrual cycles
• Prolonged exposure leads to hyperplasia of the endometrium and abnormal bleeding

Question 6

List the broad clinical uses of estrogens

Answer 6

• Hormone replacement therapy (postmenopausal women)
• Osteoporosis
• Replacement therapy in patients with primary hypogonadism
• Castration (oophorectomy)

Question 7

List the clinical effects of estrogens when used for HRT for postmenopausal women

Answer 7

• Relief of CNS disturbances – hot flashes, sweating, flushing
• Relief of symptoms resulting from urogenital atrophy - vaginal dryness, increased risk of infections
• Relief of psychological effects – mood swings, insomnia, depression, nervousness

Question 8

List the clinical effects of estrogens when used for osteoporosis

Answer 8

Estrogens decrease the rate of bone resorption

**for postmenopausal osteoporosis only

Question 9

Identify the broad adverse effects of estrogens

Answer 9

• Uterine bleeding
  Estrogen therapy is a major cause of postmenopausal uterine bleeding, should be given cyclically
• Endometrial carcinoma
• Breast cancer
• Nausea, headache, fluid retention, weight gain

Question 10

What adverse effects of estrogens can be prevented / reduced risk with the use of a progestin?

Answer 10

uterine bleeding and endometrial carcinoma

Question 11

What adverse effects of estrogens CANNOT be prevented / reduced risk with the use of a progestin?

Answer 11

breast cancer

Question 12

List the pharmacological uses of aromatase inhibitors

Answer 12

• Block the biosynthesis of estrogens
• Effective in some patients whose breast cancer has become resistant to tamoxifen
• Ovulation induction (off-label use)
• Gynecomastia