Sex steroid hormones in contraception Flashcards
Progesterone
- Prepares endometrium for implantation
- promotes growth of mammary glands
- a feedback inhibitor for FSH and LH
what r the different sex steroid hormones?
Oestrogens, progestagens, androgens
what r the major effects of:
Oestradiol, Progesterone,Testosterone
what r sex steriod synthesised from?
cholesterol
Oestrogen action and side effects
Progesterone / progestin action and side effects
Testosterone
action and side effects
what r some Routes of Administration?
VINTO
- Oral
- Transdermal patch (Evra®) norelgestromin
- Implants
- Nasal
- Vaginal
how r sex hormones transported and metabolised?
bound to (SHBG: sex hormone binding globule) EXCEPT PROGESTERONE! & also bound to albumin
Liver metabolism: note progesterone almost totally metabolised in one passage through liver
why can liver metabolism of sex steroids be a problem sometimes?
bc can be affected by other drugs that work through the same enzyme that metabolise progesterones!
how r sex steroids stored? elimination rate? excreted?
Sex steroids easily stored in fatty tissue (adipocytes and brain) because they are lipophilic; they r embedded into the plasma membrane just like cholesterol.
SLOW
Metabolites excreted in faeces and urine (as glucuronides and sulphates, respectively)
what type of pills do oral contraceptives exist as?
Exist as 2 types
– Oestrogen + progestin* (COCP)
• Administered in 3 ways
– Progestin only (POP)
• Administered in lots of ways
what r the 3 ways combined (COCP) Oestrogen + progestin r administered?
u don’t need to know details of this
what r the Synthetic derivatives of estrogen?
ethinylestradiol, methoxy derivative (mestranol), valerate
mu ila u know this
what does NICE recommend in terms of dosage for the Combined Oral Contraceptive Pill ?
lowest dose possible)
Mode of Action of COCP (3 effects of oral contraceptives)
§ Suppression of ovulation: inhibits FSH, LH
§ cervical mucus – makes it more viscous
§ Adverse effect on the endometrium– endometerium doesnt grow as much>> prevent implantation
complications of oral contraceptives