oral contraceptives, menopause, HRT Flashcards
what are the forms of oestrogen contraceptives/HRT?
- oestrone sulphate
- oestriol
- ethinyl oestradiol (ethinyl groups protects from first pass metabolism)
what is the issue with oestradiol?
- well absorbed but LOW bioavaliability
- extensive first pass metabolism
what does a lack of oestrogen result in?
inc. chance of osteoporosis and fracture
what does oestrogen contribute to?
- breast growth
- CVS problems
describe the absoprtion and metabolism of progesterone
- poorly absorbed
- rapidly metabolized in liver
what is the combined oral contraceptive?
- combination of an oestrogen and a progestogen
- synthetic combo supresses ovulation
what are the mechanisms that it supresses ovulation by?
- feedback of oestrogen and progestogens on hypothalamus and piuitary
- progestogens thicken cervical mucus
- oestrogen counteracts androgenic effects of synthetic progestogens
what are some side effects of oestrogens?
- nausea
- headache
- inc. weight
- CVS problems
- breast (oestrogen-dependant cancers)
- endometrium (proliferative effects)
when are progesterone only contraceptives used?
when oestrogens are not a good idea i.e.. CVS problems, history of thrombosis
what are the 3 forms of emergency contraception?
- levonorgestrel (2 doses 12 hours apart being within 72 hours of intercourse)
- copper IUD
- ulipristal (up to 120 hours after intercourse)
- levonorgestrel (2 doses 12 hours apart being within 72 hours of intercourse)
what is menopause?
permanent cessation of menstruation resulting resulting from loss of ovarian follicular activity
what is climacteric?
period of transition from predictable ovarian function through the postmenopausal years
what is premature ovarian failure?
menopause occuring before age of 40
may be autoimmune, secondary to surgery, chemotherapy or radiation
compare the GnRH, LH/FSH and oestradiol levels in normal women and in menopause
Normal women: GnRH - high LH/FSH - high oestradiol - high Menopause: GnRH - high LH/FSH - high oestradiol - low
what are the symptoms of menopause?
- hot flushes
- sleep disturbance
- depression
- urogential atrophy
- dec. libido
- joint pain