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PHAR300 > L15 Female Contraception > Flashcards

L15 Female Contraception Flashcards

1
Q

World population growth projection trends are generally…

A

Decreasing

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2
Q

Name modern methods of contraception (8) and traditional or natural methods of contraception (3)

A

Modern: sterilization, oral hormonal pills, IUD, condoms, injectables, implants, vaginal barrier methods, emergency contraception

Traditional: rhythm (abstinence), withdrawal, lactations amenorrhea method (LAM)

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3
Q

Which family planning methods are permanent?

A

Sterilization (female and male)

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4
Q

What are the major components of the endocrine system

A

Hypothalamus (GnRH), anterior pituitary (LH, FSH), Testis/ovary (gametogenesis, gonadal hormone production)

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5
Q

What hormones do LH and FSH trigger in the testes and ovaries?

A

Testeosterone in testis
Estrogen in ovaries

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6
Q

What change allows puberty to are course

A

Hypothalamus and pituitary sensitivity to negative feedback decreases

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7
Q

What are the two steroid hormones produced by the ovary?

A

Estrogen and progesterone

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8
Q

TF: estrogen and progesterone send negative feedback signals to both the anterior pituitary and the hypothalamus

A

True

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9
Q

Pulsatile FSH and LH released by _ stimulate _ and _

A

Anterior pituitary
Maturation of ovarian follicles
Steroid synthesis

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10
Q

Which cells does LH act on in the ovary? What does it do

A

Theca cells
Increase steroid synthesis and FSH receptors

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11
Q

What are the effects of FSH on the ovary?

A

Q. Regulate follicle growth and maturation
2. Increases the activities of cholesterol side chain cleavage (progesterone synthesis by CYP11A1) and conversion of T to estradiol in granulosa cells by aromatase (FSH)

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12
Q

How do nuclear steroid hormone receptors work

A

Nuclear steroid hormone receptor has ligand binding domain and DNA binding domain
They will act to turn on transcription inside nucleus

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13
Q

Name the steroid receptors for progesterone and estrogen

A

Progesterone: hPR
Estrogen: hERalpha hERbeta

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14
Q

Describe the two paths for progesterone action. Which one is faster

A
  1. Nuclear receptors: activated genes (genomic) trigger biological function
  2. Membrane receptors (faster): secondary messengers (non genomic) trigger biological function
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15
Q

TF: estrogen has nuclear receptors

A

True

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16
Q

What can estrogens and progestins as drugs be used for

A

Fertility control: contraception and ovulation induction
Hormone replacement therapy
Cancer chemotherapy
Other

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17
Q

What are the relative levels of LH, FSH, progesterone and estrogen during menses

A

FSH>LH>estradiol>progesterone

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18
Q

What causes follicular rupture

A

LH and FSH surge (caused by estradiol surge)

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19
Q

When are progesterone levels highest?

A

When the corpus outermost is developing (peak when corpus outermost is mature)

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20
Q

TF: there is more progesterone during follicular phase than during luteal phase

A

False

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21
Q

TF: progesterone is secreted by corpus luteum

A

True

22
Q

Describe the positive feedback regulation of ovulation

A

Estradiol surge triggers increase GnRH release, causing increase LH and FSH release

23
Q

TF: both FSH and LH increase at similar levels when estradiol increases

A

False, there is a higher LH surge than FSH (although FSH levels do increase)

24
Q

Describe the negative feedback involved in ovulation and the menstrual cycle?

A

Increase in estradiol and progesterone cause decreased levels of LH and FSH released from the pituitary (also negative feedback on GnRH release)

25
Q

TF: progesterone acts to thicken the uterine endometrium

A

True

26
Q

During which phase are women most fertile

A

Follicular phase

Days leading up to ovulation + ovulation = most fertile

27
Q

TF: basal body temperature can indicate fertility

A

True, higher temperatures are detected during luteal phase

28
Q

Why are analogs of estrogen and progestin (progesterone analog) used for oral contraceptives

A

They are less rapidly inactivated by enzymes

29
Q

Oral contraceptives were approved by the FDA for what reasons?

A

To treat infertility and menstrual irregularities

30
Q

What was the trend for pill dosage?

A

Decreasing

31
Q

TF: oral contraceptive pills keep LH, FSH, Estrogen and Progesterone levels constant

A

True

32
Q

What is the mechanism of action of contraceptive pills

A

LH and FSH release are inhibited (as well as GnRH and higher brain centres)
Ovulation is inhibited - no ripe follicle

33
Q

What are the 3 functions of oral contraceptive pills

A
  1. Prevent ovary from releasing an egg
  2. Thicken cervical mucus to deter sperm from reaching egg
  3. Thin the lining of the uterus entering implantation of zygote
34
Q

For what reason is the typical use failure rate greater than the perfect use failure rate

A

Poor compliance (missing pills)

35
Q

Examples of P450s and antibiotics that can interact with oral contraceptives

A

P450s: barbiturates, phenytoin, rifampicin
Antibiotics: ampicillin, tetracycline, neomycin

36
Q

Are oral contraceptives still effective after taking P450 inducers? What about antibiotics?

A

Inducing P450s cause increased drug metabolism while antibiotics may decrease enterohepatic circulation

37
Q

What are the advantages of oral contraceptive pills (7)

A

Regular periods, women over 40 can use, decrease cramps and bleeding (and anemia), decrease risk of ovarian/endometrial/colorectal cancer, decrease breast tenderness and acne, increase bone density, does not interfere with sex

38
Q

What are the disadvantages of oral contraceptive pills (2)

A

Increase risk of venous thromboembolism, slight increase in risk of breast cancer (increased in smokers)

39
Q

The use of oral contraceptives in BRCA1/2 carriers appears to _

A

Decrease risk of ovarian cancer with no increase in breast cancer

40
Q

TF: oral contraceptives thicken the blood

A

True

41
Q

What do contraceptive patches release?

A

Norelgestromin (NGMN)
Ethinyl estradiol (EE)

42
Q

TF: contraceptive patches are more efficient than oral contraceptives

A

After 6 cycles, chances of getting pregnant are half that of oral contraceptive users
Patch compliance better than OC: unaffected by age (though lower in younger subjects)
*compliance is if the subject is using it correctly and regularly

Less efficacious in overweight women

43
Q

What steroids are usually found in implants

A

Levonorgestrel (progesterone analog)

44
Q

TF: implants of progesterone analogs work by decreasing the LH surge

A

True

45
Q

What are the two kinds of IUD (intra-uterine devices) and their differences?

A

Hormonal (levonorgestrel) and copper

Copper IUD lasts 10 years while hormonal IUD last 3-5 years

46
Q

What hormones does the plan b pill release

A

Levonorgesterol (progesterone analog)
There is also: Selective progesterone receptor modulator (uliprostal acetate)

47
Q

How does plan B work?

A

Temporarily blocks ovulation and fertilization

48
Q

TF: plan B can induce withdrawal bleed

A

True

49
Q

TF: plan B can be taken up to 7 days after unprotected sex

A

False, it is 5 days

50
Q

What is used for medical termination of pregnancy

A

Mifepristone (progesterone receptor antagonist) + misoprostal (prostaglandin analog)

51
Q

What does misoprostal do?

A

It is used in combination with mifepristone for medical termination of pregnancy, it dilates the cervix and induces uterine contractions

PHAR300 (13 decks)

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