oral contraceptives, menopause, HRT Flashcards

1
Q

what are the forms of oestrogen contraceptives/HRT?

A
  • oestrone sulphate
  • oestriol
  • ethinyl oestradiol (ethinyl groups protects from first pass metabolism)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the issue with oestradiol?

A
  • well absorbed but LOW bioavaliability

- extensive first pass metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what does a lack of oestrogen result in?

A

inc. chance of osteoporosis and fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what does oestrogen contribute to?

A
  • breast growth

- CVS problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe the absoprtion and metabolism of progesterone

A
  • poorly absorbed

- rapidly metabolized in liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the combined oral contraceptive?

A
  • combination of an oestrogen and a progestogen

- synthetic combo supresses ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the mechanisms that it supresses ovulation by?

A
  • feedback of oestrogen and progestogens on hypothalamus and piuitary
  • progestogens thicken cervical mucus
  • oestrogen counteracts androgenic effects of synthetic progestogens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are some side effects of oestrogens?

A
  • nausea
  • headache
  • inc. weight
  • CVS problems
  • breast (oestrogen-dependant cancers)
  • endometrium (proliferative effects)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when are progesterone only contraceptives used?

A

when oestrogens are not a good idea i.e.. CVS problems, history of thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the 3 forms of emergency contraception?

A
    1. levonorgestrel (2 doses 12 hours apart being within 72 hours of intercourse)
      1. copper IUD
      2. ulipristal (up to 120 hours after intercourse)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is menopause?

A

permanent cessation of menstruation resulting resulting from loss of ovarian follicular activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is climacteric?

A

period of transition from predictable ovarian function through the postmenopausal years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is premature ovarian failure?

A

menopause occuring before age of 40

may be autoimmune, secondary to surgery, chemotherapy or radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

compare the GnRH, LH/FSH and oestradiol levels in normal women and in menopause

A
Normal women:
GnRH - high
LH/FSH - high
oestradiol - high
Menopause:
GnRH - high
LH/FSH - high
oestradiol - low
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the symptoms of menopause?

A
  • hot flushes
  • sleep disturbance
  • depression
  • urogential atrophy
  • dec. libido
  • joint pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the 2 complications of menopause?

A
  • osteoporosis

- CVD

17
Q

what is the treatment of menopause?

A
  • HRT
  • oestrogen and progestrone
  • prevent endometrial hyperplasia
  • reduces risk of cancer
18
Q

what does HRT inc. the risk of?

A
  • breast cancer
  • VTE
  • stroke
  • gall stones
  • HRT to older women has much more inc. risk than in younger postmenopausal women
19
Q

what is tibolone?

A
  • synthetic prohormone

- has oesteogenic, progestogenic and weal androgenic actions

20
Q

when is HRT-oestrogen only used?

A

only for women that have had hysterectomies

21
Q

what are SERMs? give 2 examples

A

Selective Oestrogen Receptor Modulators

e.g. Raloxifene, Tamoxifen

22
Q

describe raloxifene

A
  • tissue selective (oestrogenic in bone, anti-oestrogenic in breast/uterus)
  • used in treatment and prevention of postmenopausal osteoporosis
23
Q

what does raloxifene inc./ dec. risk of?

A

inc risk of fatal stroke, VTE

dec. risk of vertebral fractures and breast cancer

24
Q

describe tamoxifen

A
  • anti-cancer drug
  • anti-oestrogenic in breat tissue
  • used to treat oestrogen-dependant breast tumours and metastatic breast cancers