Reproductive Flashcards
They primary male androgen
testosterone
Androgens are used to treat
disorders in males and females.
Hypogonadism in males
Diseases such as cancer and HIV infection in both sexes
Andorgens formualations and drug names
Testosterone
Testosterone gel
Transdermal testosterone
Fluoxymesterone (injectable)
Methyltestosterone (injectable)
Anabolic steroids are
scheduled drugs
Anabolic steroids are contraindicated in
Male breast cancer or prostate cancer
Pregnancy (category X) and lactation
Transdermal drugs not used in women
Androgen ADR
Hepatitis, hepatic neoplasm, cholestatic hepatitis, jaundice, and hepatocellular carcinoma
Androgen Men ADR
gynecomastia, reduced sperm levels, decreased libido at high levels, depression
Androgen ADR women
menstrual irregularities, virilization
Biggest ADR for androgen (anobolic sterods)
liver issues
Androgen Monitoring
Serum testosterone levels, lipids, liver function, complete blood count
Men need prostate-specific antigen and digital prostate examinations
Androden prescribed for
Primary hypogonadal males
Hypogonadotropic hypogonadism
Male climacteric
For men who come in asking to be put on testosterone, what is done first
Lifestyle managment
Testosterone indictions that the increased risk
of prostate cancer with long-term replacement is not as great as thought (unless already present)
Statin therapy can decrease
testosterone on a statistically significant level, but clinically insignificant level
Androgen hormone inhibitors (anitiandrogen)
Also known as and example
5a-reductase inhibitors
Propecia, Proscar
Leuprolide acetate (Lupron) AKA
luteinizing hormone-releasing hormone antagonist
Direct antiandrogens
Inhibit
androgen uptake or nuclear binding of androgen at target tissues
Spironolactone (Aldactone) is a
An aldosterone antagonist and inhibitor of 5a-reductase
Big use for antiandrogens is
treatment of BPH
Fanastroide is used in smaller doses
for balding in men
Spironolactone is used in
PCOS for women when they are thought to have too high of a testosterone level
Estrogen examples
Conjugated equine estrogens (Premarin) Esterified estrogens Estradiol Ethinyl estradiol Phytoestrogens
Effects of estrogen in the body are
Increases bone density
Results in normal skin and blood vessel structure
Affects lipid levels
Reduces bowel motility
Enhances coagulability of blood
Causes edema because of its action on the renin–angiotension system
Maintains stability of the thermoregulatory center
blood clot risk associated with
estrogen
Estrogen-ONLY (unopposed estrogen) products are contraindicated
in women with an intact uterus.
must take estrogen with progestrone
Estrogen contraindicated in
Pregnancy (unless specialist directed low hormone level)
Breast cancer
Estrogen-dependent neoplasia
Do not give estrogen in these four situations
Active deep vein thrombosis or pulmonary embolism
History in past year of stroke or myocardial infarction
Liver dysfunction
Smokers
Smoking and estrogen can
raise risk for blood clots
Estrogen use
Contraception
Combination of estrogen and progestin
Estrogen use of per-postmenopausal stimptoms directions
Start on lowest dose.
Do not give unopposed estrogen to women with a uterus.
See Hormone Therapy chapter for full information.
relief of peri-and postmenopausaul give
lowest dose for shortest duration
Estrogen other use
Vaginal atrophy and dryness
Vaginal cream, tablets, or ring
Osteoporosis (not for primary treatment use)
Antiestrogens
Clomiphene
Danazl
Tamoxifen
Raloxifene
Clomiphene (clomid)
Used to initiate ovulation in normogonadotropic, normoprolactinemic, and anovulatory patients
Danazol (Danocrine)
Used to treat endometriosis
Tamoxifen (Nolvadex)
Selective estrogen receptor modulator
Adjuvant therapy for breast cancer in patients with estrogen receptor –positive tumors (helps reduce breast cancer risk and protects bone)
Raloxifene (Evista)
Selective estrogen receptor modulator (SERM) used for osteoporosis
Estrogen agonists/antagonists can be used to treat
dyspareunia (painful sex) medications have selective estrogen effects.
Estrogen agonists/antagonists can have a possible positive
impact on breast cancer risk and
Known uterine lining development, but much less than with estrogen
Estrogen agonists/antagonists are helpful for those who
cannot take progestins
Progesterones examples
Progesterone (Promethrium, Progesterone in Oil, Crinone, Prochieve) Medroxyprogesterone acetate (Provera, Depo-Provera) Norethindrone (Aygestin) Megestrol acetate (Megace)
Androgen-derived progestins examples
Norethindrone, norethindrone acetate, ethynodiol diacetate, norgestrel, desogestrel, levonorgestrel, and norgestimate
Drospirenone: a progestin developed as a derivative of spironolactone
Progesterone precautions and contraindications
Thromboembolic disease
Breast cancer
Impaired liver function
Depression
Disorders that worsen with fluid retention
Progesterone: Old pregnancy category D.
Norethindrone acetate: Old pregnancy category X.
Progesterones: Adverse Drug Reactions
Irregular bleeding Amenorrhea Acne Injectable and implanted progesterone Weight gain Irregular menstrual bleeding Osteoporosis risk with 2+ year use
Progesterone only comes with a lot of
a lot of fluid retention. Will see bloating.
progsterone is not recommended
in pregnancy. D or X
Postmenopausal hormone replacement
Combined with estrogen when
uterus is intact
Depo-preva (progestin only)
in young women use with caution and try to avoid (up to age 25) because it can cause risk of osteoporosis. It also comes with a 15 lbs weight gain
Progesterone use
Postmenopausal hormone replacement
Combined with estrogen when uterus is intact
Progestin-only contraception
Progestin-only pills (norethindrone)
Medroxyprogesterone acetate (Depo-Provera)
Progestin implanted intrauterine device (Mirena)
Progesterone monitoring
Depression
Increased risk of seizures
In diabetes, monitoring of blood glucose
