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Questions and Answers
What is a common adverse effect associated with testosterone treatments?
What is a common adverse effect associated with testosterone treatments?
Which medication is used to stimulate ovulation in females?
Which medication is used to stimulate ovulation in females?
Which of the following is NOT a contraindication for testosterone therapy?
Which of the following is NOT a contraindication for testosterone therapy?
What is a primary use of Yutopar in obstetrics?
What is a primary use of Yutopar in obstetrics?
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What percentage of men became azoospermic from the male contraception trials mentioned?
What percentage of men became azoospermic from the male contraception trials mentioned?
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What is one primary adverse effect of prolonged oral contraceptive use?
What is one primary adverse effect of prolonged oral contraceptive use?
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Which hormone is primarily released by the ovary as an estrogen?
Which hormone is primarily released by the ovary as an estrogen?
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For which condition are progestogens NOT typically indicated?
For which condition are progestogens NOT typically indicated?
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How do combination oral contraceptive pills primarily prevent pregnancy?
How do combination oral contraceptive pills primarily prevent pregnancy?
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Which of the following is a characteristic of progestogen-only pills?
Which of the following is a characteristic of progestogen-only pills?
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What adverse effect can occur due to oral contraceptive use?
What adverse effect can occur due to oral contraceptive use?
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Which of the following is NOT an absolute contraindication for oral contraceptive use?
Which of the following is NOT an absolute contraindication for oral contraceptive use?
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What effect do progestogens have on menstruation?
What effect do progestogens have on menstruation?
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What hormone surge is primarily responsible for triggering ovulation in females?
What hormone surge is primarily responsible for triggering ovulation in females?
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What is the primary function of Aromatase inhibitors?
What is the primary function of Aromatase inhibitors?
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In males, which cells are primarily responsible for producing testosterone?
In males, which cells are primarily responsible for producing testosterone?
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What is the role of selective estrogen receptor modulators (SERMs) in various tissues?
What is the role of selective estrogen receptor modulators (SERMs) in various tissues?
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Which hormone stimulates the anterior pituitary gland to release LH and FSH?
Which hormone stimulates the anterior pituitary gland to release LH and FSH?
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What is a potential serious side effect of Aromatase inhibitors?
What is a potential serious side effect of Aromatase inhibitors?
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Which medication is known as a partial agonist in the endometrium and bone?
Which medication is known as a partial agonist in the endometrium and bone?
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What effect does an increase in estrogen generally have on the female reproductive system?
What effect does an increase in estrogen generally have on the female reproductive system?
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What is the role of Mifepristone (RU-486) in reproductive health?
What is the role of Mifepristone (RU-486) in reproductive health?
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Which drug is classified as an androgen receptor antagonist used for treating prostate cancer?
Which drug is classified as an androgen receptor antagonist used for treating prostate cancer?
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What is the primary combination used in oral contraceptives to suppress GnRH, LH, and FSH secretion?
What is the primary combination used in oral contraceptives to suppress GnRH, LH, and FSH secretion?
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What effect does estrogen have when used in oral contraceptives?
What effect does estrogen have when used in oral contraceptives?
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Which of the following delivery systems is NOT mentioned as an available method for oral contraceptives?
Which of the following delivery systems is NOT mentioned as an available method for oral contraceptives?
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Which progestin is associated with higher androgenic activity?
Which progestin is associated with higher androgenic activity?
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What is the mechanism by which Clomifene and Tamoxifen promote fertility?
What is the mechanism by which Clomifene and Tamoxifen promote fertility?
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What is the primary action of the emergency contraceptive, levonorgestrel?
What is the primary action of the emergency contraceptive, levonorgestrel?
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What is a possible side effect of excessive androgen secretion in women?
What is a possible side effect of excessive androgen secretion in women?
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What is a major adverse effect experienced by 20-30% of women using combination oral contraceptives?
What is a major adverse effect experienced by 20-30% of women using combination oral contraceptives?
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How do progesterone effects in oral contraceptives primarily work?
How do progesterone effects in oral contraceptives primarily work?
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What is the main adverse effect associated with mifepristone when used for therapeutic termination of pregnancy?
What is the main adverse effect associated with mifepristone when used for therapeutic termination of pregnancy?
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In the treatment of infertility, what is typically administered after daily injections of menotrophin or urofollitropin?
In the treatment of infertility, what is typically administered after daily injections of menotrophin or urofollitropin?
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How long can emergency contraception, specifically levonorgestrel, be effective after unprotected intercourse?
How long can emergency contraception, specifically levonorgestrel, be effective after unprotected intercourse?
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What is a common outcome when treating men with hypogonadotrophic hypogonadism?
What is a common outcome when treating men with hypogonadotrophic hypogonadism?
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Which progestin is known to have the least androgenic activity?
Which progestin is known to have the least androgenic activity?
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Study Notes
Endocrine Medications 2: Sex Hormones
- Aromatase Inhibitors: Used to inhibit estrogen-dependent tumors, metastatic breast cancer. Serious side effects include increased risk of osteoporosis. Examples include anastrozole, letrozole, exemestane, and formestane.
Receptor Antagonists
- Selective Estrogen Receptor Modulators (SERMs): Are mixed agonists/antagonists, meaning they act as both estrogen agonists and antagonists depending on the tissue type. ERα (alpha) and ERβ (beta) types are tissue-specific.
SERMs: Specific Actions
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Tamoxifen: An estrogen antagonist in breast tissue, but a partial agonist in endometrial and bone tissue.
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Raloxifene: An estrogen agonist in bone, but an antagonist in breast and endometrial tissue.
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Clomiphene: Used to induce ovulation; an ER antagonist in the hypothalamus and anterior pituitary, but a partial agonist in the ovaries.
Androgen Receptor Antagonists
- Flutamide and spironolactone: Used to treat metastatic prostate cancer and benign prostatic hyperplasia (BPH).
Progesterone Receptor Antagonists
- Mifepristone (RU-486): Used to induce first-trimester abortion. Often administered with misoprostol. Inhibits endometrial and myometrial tissue growth. May treat endometriosis and uterine fibroids.
Adrenal Sex Hormones
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Androgens: Male hormones secreted by the adrenal cortex in both sexes, responsible for various physiological effects, including increasing protein synthesis (anabolism) which enhances muscle and bone mass/strength and the development of male secondary sex characteristics (increased hair growth). Excessive secretion in females may lead to masculine effects.
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Female Sex Hormones: Produce few effects. Excessive secretion may lead to feminine characteristics in males.
Drugs Affecting the Reproductive System
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Oral Contraceptives (OCPs): Composed of estrogen and progestin, used for contraception, but can result in adverse effects, including hypertension and high LDL cholesterol, dizziness, and breakthrough bleeding. Absolute contraindications: thromboplebitis, CVA, breast cancer, pregnancy, liver disease, CAD with patients over 35, and smokers.
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Combination Pills: Contain ethinylestradiol and a progestin (e.g., ethinylestradiol/norethindrone, ethinylestradiol/levonorgestrel). Taken for 21 days, then a period of 7 days without the pill to facilitate menstruation.
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Progestogen-only Pills: Contain a low dose of progestin (e.g., norethindrone, desogestrel). Taken continuously.
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Contraceptive Mechanisms: Various OCP types act through feedback inhibition on the hypothalamus to suppress GnRH and hence plasma gonadotropin (LH and FSH) secretion thus preventing the release of an ovum.
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Adverse Effects (OCP): Common side effects include menstrual irregularities (breakthrough bleeding), abdominal pain, chest pain, dizziness, numbness, high blood pressure, high blood sugar, impaired vision, leg pain, hirsutism, vaginal yeast infections, and depression. In rare cases, serious effects such as cholestatic jaundice and/or thromboembolic disease.
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Emergency Contraception: Single dose of levonorgestrel can be taken up to three days after unprotected sex, inhibiting the LH surge. Includes mifepristone, highly effective in early pregnancies (up to 63 days) combined with PG-cervical ripening agents.
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Male Contraception: Attempts to suppress sperm production but are generally unsuccessful. The most promising approaches include testosterone enanthate/oral levonorgestrel and/or injectable testosterone undecanoate combined with injectable medroxyprogesterone acetate. Variable results with adverse effects (azoospermia, acne, high blood cholesterol/count, and increased risk of weight gain).
Infertility Drugs (e.g., Clomid)
- Mechanism: Stimulates secretion of FSH and LH, aiding follicle maturation and ovulation. Often used in cases of inadequate ovulation and/or reduced sperm counts.
- Adverse Effects: Similar to OCPs, including increased incidence of early abortion, multiple births, and pelvic pain.
Oxytoxics (e.g., Pitocin)
- Mechanism: Enhances uterine muscle contractions.
- Uses: Post-partum hemorrhage.
- Adverse Effects: Uterine rupture, fetal hypoxia, and/or trauma.
Premature Labor Inhibitor (e.g., Yutopar)
- Mechanism: Selective β2 adrenergic receptor antagonist to prevent uterine muscle contractions.
- Uses: Preterm labor (if gestation > 20 weeks).
- Adverse Effects: Palpitations, tachycardia, hypotension.
Male Hormones (e.g., Testosterone)
- Secreted by the testes, it is essential for the development of male secondary sex characteristics.
- Uses: Treatment of low sperm counts, impotence, undescended testicles, and other conditions necessitating anabolic activity (e.g., osteoporosis, anemia).
- Adverse Effects: Edema, acne, hirsutism, voice deepening, polycythemia, increased LDL, depression.
- Contraindications: Pregnancy, prostate cancer, breast cancer.
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Description
Explore the different sex hormones and their related medications in this quiz. Learn about aromatase inhibitors, selective estrogen receptor modulators (SERMs), and androgen receptor antagonists. Test your understanding of their uses, mechanisms, and specific actions.
