Sex Steroids

Question 1

What are the main sex steroid hormones?

Answer 1

Oestrogen
Progesterone
Testosterone

Question 2

What are sex steroids synthesised from?

Answer 2

Cholesterol

Question 3

What are the effects of oestrogen?

Answer 3

Growth of breast + endomeytrium

Stimulates production of PR

Question 4

What are the actions of oestrogen?

Answer 4

Sodium + water retention 
Raises HDL, lowers LDL
Decrease bone resorption 
Impair glucose tolerance 
Increase coagubility

Question 5

What are the side effects of oestrogen?

Answer 5

Breast tenderness
Water retention
Endometrial, ovarian, breast cancer

Question 6

What are the effects of progesterone?

Answer 6

Growth of endometrium + breast
Maintains pregnancy
Inhibits production of ER

Question 7

What are the actions of progesterone?

Answer 7

Increases bone mineral density
Fluid retention
Mood changes
Maintains pregnancy

Question 8

What are the side effects of progesterone?

Answer 8

Weight gain
Fluid retention
Acne
Mood changes

Question 9

What are the effects of testosterone?

Answer 9

Stimulate male characteristics

• deep voice
• hairy body
• aggression

Question 10

What are the actions of testosterone?

Answer 10

Male secondary sexual characteristics

Question 11

What are the side effects of testosterone?

Answer 11

Acne
Voice changes
Increases aggression

Question 12

Why is HRT given in menopause?

Answer 12

Relieves the symptoms

Protects against osteoporosis

Question 13

What are risks of HRT?

Answer 13

Not preventative against heart disease
Increase VTE risk
Increased stroke risk

Question 14

What hormones are used in HRT?

Answer 14

Oestrogen

Progesterone

Question 15

What are the routes of administration of HRT?

Answer 15

Oral 
Transdermal 
Implant
Transvaginal 
Nasal

Question 16

What is the risk of unopposed oestrogen?

Answer 16

Increased risk of

• endometrial cancer
• ovarian cancer

Question 17

What is the risk of opposed oestrogen?

Answer 17

Increased risk of breast cancer

Question 18

What is an example of a progesterone receptor antagonist?

Answer 18

Mifepristone

Question 19

What is the indication of mifepristone?

Answer 19

Medical pregnancy termination

Question 20

What is the route of administration of mifepristone?

Answer 20

Oral

Question 21

What is the mechanism of mifepristone?

Answer 21

Anti-progesterone

Sensitises the myometrium to prostaglandin induced contractions

Question 22

What are the side effects of mifepristone?

Answer 22

Abdo cramps
Diarrhoea
PID

Question 23

What is a SERM?

Answer 23

Selective oestrogen receptor modulator

Question 24

What is an example of a SERM?

Answer 24

Tamoxifen

Question 25

What are the indications for tamoxifen?

Answer 25

Oestrogen-receptor-positive breast cancer

Anovulatory infertility

Question 26

What is the route of administration of tamoxifen?

Answer 26

Oral

Question 27

What is the mechanism of tamoxifen?

Answer 27

Reduces DNA polymerase activity
Impaired thymidine utilisation
Blocks oestradiol uptake
Decreased oestrogen response

Question 28

What are the side effects of tamoxifen?

Answer 28

Breast cancer
Alopecia
Constipation
D+V

Question 29

What is an example of an anti-oestrogen?

Answer 29

Clomiphene

Question 30

What is the indication of clomiphene?

Answer 30

Anovulation

Question 31

What is the route of administration for clomiphene?

Answer 31

Oral

Question 32

What is the mechanism of clomiphene?

Answer 32

Competes with oestrogen

Induces ovulation - increased production of anterior pituitary hormones

Question 33

What are the side effects of clomiphene?

Answer 33

Anxiety
Depression
Alopecia
Hot flushes