Quiz 5 Hormone therapy

Question 1

Natural estrogens

Answer 1

steroid hormones—synthesized estrogens may be non-steroidal

They cross cell membranes and activate estrogen receptors inside cell—modulate expression of genes

Question 2

The menstrual cycle:

Answer 2

• Menstrual—menses
• Follicular- proliferative
• Luteal—secretory

Question 3

Natural estrogens

Answer 3

• Estrone (predominant during menopause)- E1
• Estradiol (predominant during productive years)—E2
• Estratriol (predominant during pregnancy)—E3

Question 4

Synthetic estrogens

Answer 4

• Steroidal: ethinyl estradiol

* Non-steroidal: diethylstilbesterol

Question 5

Physiological functions of estrogen

Answer 5

• Sexual maturity
• Increased CNS excitability (seizure inducing?)
• Increased endometrial and uterine growth
• Maintain skin elasticity
• Reduce bone adsorption
• Increase blood coagulability

Question 6

Estrogen Guidelines for use

Answer 6

• Always use the smallest dose for the shortest period of time possible
• Sometimes local creams are preferred to minimize exposure

Question 7

Progestins

Answer 7

• Made from cholesterol

* Present in males, but less than females

Question 8

Progesterone (natural)

Answer 8

a. most important progestin in human
• Precursor to estrogen, androgen and adrenalcortical steroids (e.g., cortisol)
• Also precursor to testosterone and estradiol

Question 9

Synthetic progestins

Answer 9

Short half life= 5min
Effects:
• Increase fat deposition
• Decrease CNS excitability (e.g., antiseizure—opposite of estrogen)
• Increase aldosterone—increase Na+ retention—increase BP—increase water retention and blood volume
• Increase body temperature

Question 10

Combination ( progesterone + estrogen)

Answer 10

• Decreases ovulation (approaching 100%)

* Decreases conception and implantation

Question 11

Progestin only

Answer 11

(less effective, ~80-90%)
• Decreases ovulation 50-80%
• Thickens mucus and reduces sperm penetration
• Impairs implantation

Question 12

DElivery modes

Answer 12

⎫ Monophasics- constant doses of both estrogen and progesterone
⎫ Biphasic- dosage of one or both change one time during cycle
⎫ Triphasic-dosages change 2 times

Question 13

Tamoxifen

Answer 13

blocks actions of estrogen in breast-used to treat breast cancers

Question 14

Mifepristone

Answer 14

morning after contraceptive: blocks progesterone and glucocorticoid receptors

Question 15

Danazol

Answer 15

suppresses ovarian function (has a masculinizing effect)

Question 16

Clomiphene (Clomid)

Answer 16

induces ovulation.

for promoting fertilization and pregnancy (increased risk of multiple births—e.g., twins)

Question 17

testosterone

Answer 17

• Converts to estradiol
• Replacement therapy for males
• Gynecological disorders—reduces breast size (gynecomastia)
• Has protein anabolic effects—helps replace muscle loss
• Growth stimulation—can prematurely close growth plates in growing adolescents
• Counter some age-related loss of muscle mass
• Adverse effects in women especially—masculinization
• Testosterone analogs abused for muscle and strength building—can cause acne, aggressiveness and “roid rage”, although this I controversial