Sex Hormones Flashcards

Question

Follicle Stimulating Hormone (FSH)

Answer 1

* Women: develops ovarian follicles and supports estrogen synthesis * Men: stimulates spermatogenesis •Human menopausal gonadotropins (hMG) is FSH & LH (aka menotropins, Humegon®) -> used for FSH

Answer 2

``` •Stimulates ovulation •Stimulates luteinization of follicles •Steroid production: –Women: estrogen/progesterone synthesis –Men: testosterone synthesis ``` •human Chorionic Gonadotropin (hCG, Pregnyl®) – Used instead of LH, has same actions

Answer 3

• Reversing infertility • Men: Inducing spermatogenesis: – LH increases testosterone (for up to a year), FSH then induces spermatogenesis (take months) • Women: IVF (ART) • FSH (9-12 days) stimulates ovaries and estrogen production, single dose of LH given to induce ovulation

Answer 4

``` •Side effects –Uncomplicated ovarian enlargement –Ovarian hyperstimulation syndrome –Multiple births – 20% –Gynecomastia – Headache, depression, edema, precocious puberty ```

Answer 5

– Sex steroid-dependent cancers

Answer 6

* Produced by corpus luteum * Produced by fetal/placental unit in pregnant women • Nuclear receptor

Answer 7

•Uterus: converts endometrium to a secretory state – Maintains pregnancy – Suppresses contractility during pregnancy • Endocervical glands: regulates cervical mucus • Breasts: lobuloalveolar development at the end of the mammary ducts during pregnancy and puberty • Thermogenic action: increases body temperature

Answer 8

– Contraception – Prevent endometrial hyperplasia in HRT – Treatment of other problems when estrogens are contraindicated

Answer 9

– Possible increased blood pressure – High doses may reduce plasma HDL levels • 19-nortestosterones – Depression and drowsiness

Answer 10

– Progesterone/glucocorticoid receptor antagonist – Uses: •Terminate pregnancy (w/ prostaglandins) •Prevent implantation – Side effects: vomiting, diarrhea, abdominal or pelvic pain, and vaginal bleeding

Answer 11

``` •Common – Weight gain – Nausea – Edema – Depression •Breakthrough bleeding – Progestin alone or too little estrogen •Try different combinations •Cardiovascular problems – Clotting •Women over 35 •Smoking –Mild hypertension –Migraine –MI/Stroke • Cholestatic jaundice and gallbladder disease • Teratogenesis • Fertility – can be suppressed for 3+ months ```

Answer 12

• Effective contraception • Reduced risk for: – Ovarian & Endometrial cancer • 50% reduction, even after 2 years of treatment • Protection lasts 15 years after discontinuation – Ovarian cysts – Benign breast disease – Ectopic pregnancy – Iron deficiency, rheumatoid arthritis, PMS, etc. • Consensus: that it saves 1000s of lives, disease episodes & hospitalizations every year.

Answer 13

``` • ASCVD, thromboembolic phenomena, thrombophlebitis, cerebrovascular disorders • Estrogen-dependent cancers • Pregnancy • Smokers & >35 years old • Uncontrolled hypertension • Uncontrolled diabetes ```

Answer 14

``` • Liver disease • Children who have not yet completed epiphyseal closure • Migraine • Smoking • >35 years old ```

Answer 15

``` • P450 inducers reduce effectiveness – phenytoin, rifampin, carbamazepine, etc. • Antibiotics can reduce effectiveness – Stop enterohepatic circulation • Oral contraceptives decrease effectiveness of: – Anticoagulants – Anticonvulsants – Tricyclic antidepressants – Guanethidine – Oral hypoglycemics ```

Answer 16

``` – Endometrial cancer – progestins reduce – Breast cancer –small risk (1.25 fold) •8 cases per 10,000 women/year – Gallbladder disease (2.5 fold) – Cardiovascular ```

Answer 17

•Virilizing (androgenic) effects – Spermatogenesis – Sexual development • Anabolic effects – ↑ Bone density – ↑ Amino acid incorporation into muscle – ↑ Red blood cell mass – Antagonize catabolic effects of glucocorticoids • Puberty: development of secondary sexual characteristics in males

Answer 18

* Testicular deficiency * Female hypopituitarism (estrogens and androgens) * Hypoproteinemia of nephrosis * Negative nitrogen balance patients * Female-to-male gender-affirming hormonal treatment

Answer 19

``` • Men – Decreased spermatogenesis – May exacerbate prostate cancer • Women – Masculinization – Pseudohermaphroditism of fetus in pregnant women • Both Sexes – Baldness – Fluid retention, edema – Oily skin, acne – Decreased HDL, increased LDL – Psychological changes ```

Answer 20

Flutamide (Eulexin®) | Spironolactone (Aldactone®)

Answer 21

– Androgen receptor antagonist – Used in prostate cancer w/ long-acting GnRH agonist – Hepatotoxic – reversible

Answer 22

``` – Mineralocorticoid antagonist – High doses antiandrogen – Uses: •Hirsutism, PCOS, and PMS in women •Precocious puberty ```

Answer 23

``` – Inhibits 5α-reductase (no DHT) – Suppresses male sex accessory organs without affecting libido – Uses • Benign prostatic hyperplasia • Male pattern baldness – Can cause gynecomastia or impotence(ED) – Teratogenic ```