Sex Hormone Flashcards
what type of activities does TIBOLONE has
oestrogenic, progestogenic and weak androgenic
examples of NATURAL estrogens
estradiol, estrone, estriol
examples of SYNTHETIC estrogens
ethinylestradiol, mestranol
how is TIBOLONE take
continously without cyclical progestogen
MHRA advises HRT should ONLY be used for…
post-menapausal symptoms adversely affecting quality of life
which type of HRT has the highest risk of breast cancer
combined continuous oestrogen-progestogen HRT more than oestrogen-only HRT
is the risk of breast cancer determined by the type of oestrogen/progestogen or the duration of use?
no and yes
how should HRT be stopped and why
gradually to minimise recurrence of menopausal symptoms
choice of HRT for women with uterus
oestrogen and cyclical/continuous progestogen (to reduce the risk of cystic hyperplasia) for last 12-14 days of cycle
what is the purpose of adding progestogen to oestrogen HRT
to reduce the risk of endometrial cancer
vasomotor symptoms (VMS) of menapause
hot flushes and night sweats
vasomotor symptoms (VMS) treatment
systemic oestrogen OR clonidine
which two options are not suitable for menopause women or within 12m of last period
continuous combined HRT or tibolone
HRT option for women without a uterus
oestrogen alone
for how long in advance should HRT be stopped before major surgery, and when should restart
4-6 weeks, restart after full mobilisation
which drug should be used for unplanned surgery for pt on HRT
LMWH or compression hosiery
what are the indications of ethinylestradiol
short term oestrogen deficiency, osteoporosis prophylaxis if others failed, hereditary haemorrhagic telagiectasia (abnormal connections, called arteriovenous malformations (AVMs), to develop between arteries and vein) palliative trt of prostate cancer
what does raloxifene treat and not treat
prevent postmenopausal osteoporosis, not reduce menopausal vasomotor symp
two main groups of progestogen
progesterone and testosterone
what are the newer progestogens
desogestrel, norgestimate, gestodene
where are newer progestogens derived from
from norgestrel (testosterone)
norgestrel has an active isomer that has twice its potency which is
levonorgestrel
what treatments are used in menorrhagia and dysmenorrhoea, which is more effective
progestogen and tranexamic acid (more effective), mefenamic acid (if dys)
are progestogens recommended for miscarriage prevention?
NO
MOA of ulipristal
progesterone rec modulator with partial progesterone antagonist effect
what are the three treatment options for endometriosis
- para +NSAID
- COC/ progestogen
- surgery (excision/ablation/hysterectomy- remove womb)
treatment options for menorrhagia
usually levonorgestrel-releasing-uterine system then tranexamic acid, NSAID, COC or cyclical PO progestogen
what is clomifene, what is the indication
anti-oestrogen, used to treat infertility due to ovulatory dysfunction
name a anti-androgen
cyproterone acetate
what is cyproterone used for
severe hypersexuality and sexual deviation in male (acne, hirsutism)
