Progestins, Estrogens & Androgens Flashcards

1
Q

Describe the hypothalamic-pituitary-ovarian axis.

A

hypothalamus releases GnRH; pituitary stimulated to release FSH & LH; ovary stimulated for follicular growth and ovulation and to produce estrogens & progesterone; placenta binds to LH receptors to stimulate progesterone & estrogen production

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2
Q

progesterone vs estrogen for feedback

A

progesterone is inhibitory to hypothalamus

estrogen is inhibitory early in menstrual cycle but stimulatory midway through the cycle

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3
Q

**What does the ovary use in steroid synthesis that is not present in adrenal steroid synthesis?

A

aromatase (CYP19A1)

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4
Q

**theca vs granulosa cells

A

in ovary; theca cells are outside of the follicle (convert cholesterol to androgens); granulosa cells convert androgens to estrogens

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5
Q

What is the main estrogen in humans?

A

estradiol-17beta

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6
Q

actions of estrogens

A

stimulate growth & development of the mammary gland; promote endometrial proliferation during follicular phase; promote proliferation of vaginal epithelium; block resorption of bone; increase HDL; increase thromboembolism risk; increase endometrial/breast CA; *increase progesterone receptors

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7
Q

What is the most important progestin in humans?

A

progesterone

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8
Q

progesterone actions

A

endometrial development during luteal phase; determinant of onset of menstruation; *decreases cervical mucus and increases viscosity; increases basal body temp; stimulates development of mammary gland during pregnancy; maintenance of pregnancy

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9
Q

Which estrogen is most commonly used in contraceptives?

A

ethinyl estradiol

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10
Q

What is bisphenol?

A

BPA; environmental contaminant with esetrogen-like effects

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11
Q

non-hormonal contraception

A

copper IUDs
copper has spermicidal effect
*in theory it can prevent implantation…but in order for this to happen fertilization would have to have occurred prior to insertion of IUD

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12
Q

types of progestin contraceptive agents

A

oral daily
IM injections
SQ implants
IUDs

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13
Q

mechanism of action of progestins

A
  • -prevent fertilization by decreasing the amt & increasing the viscosity of cervical mucus; prevent sperm from reaching uterus & fallopian tube
  • -prevent ovulation by inhibiting gonadotropin secretion
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14
Q

Which drugs are typically combined in progestin/estrogen contraceptives?

A

norethindrone & ethinyl estradiol–*monophasic, biphasic, & triphasic preparations
–**drospirenone & ethinyl estradiol combo is Yaz

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15
Q

mechanism of action of progestin/estrogen combos

A

prevent ovulation by **inhibiting the hypothalamus & the pituitary; increase amt & viscosity of mucus

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16
Q

combo contraceptive adverse effects

A

avoid in pts w/ migraines; thromboembolism; MI in smokers; decreased glucose tolerance; weight gain; hirsutism

17
Q

combo contraceptive health benefits

A

decreased ovarian cysts & benign fibrocystic breast disease; decreased endometrial & ovarian CA; increased HDL & decreased LDL levels

18
Q

Which antibiotic reduces the efficacy of combo-type contraceptives? **

A

rifampins

19
Q

mechanism of action of post-coital contraceptive

A

high dose of progestin; suppresses hypothalamic-pit-gonadal axis to inhibit ovulation

20
Q

adverse effects of post-coital contraceptive

A

N/V; HA; dizziness; breast tenderness; abdominal and leg cramps

21
Q

What is the hypothalamic-pituitary-testicular axis?

A

hypothalamus releases GnRH; signals pit to release LH & FSH; signals testes to release androgens (testosterone, dihydrotestosterone)

22
Q

Why is 5alpha-reductace (SRD5A2) important?

A

in males; converts testosterone to dihydrotestosterone which is a better androgen

23
Q

actions of androgens

A

virilization of urogenital tract during development; puberty; maintenance of secondary sex characteristics; spermatogenesis; anabolic reactions