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Questions and Answers
Which condition is treated with estrogen replacement therapy until around age 50?
Which condition is treated with estrogen replacement therapy until around age 50?
What is one of the increased risks associated with estrogen therapy?
What is one of the increased risks associated with estrogen therapy?
What side effect is commonly associated with Clomiphene?
What side effect is commonly associated with Clomiphene?
Which drug is recognized for blocking central estrogen receptors in the hypothalamus?
Which drug is recognized for blocking central estrogen receptors in the hypothalamus?
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What class of drugs includes Tamoxifen and Raloxifene?
What class of drugs includes Tamoxifen and Raloxifene?
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What notable risk is associated with Raloxifene treatment?
What notable risk is associated with Raloxifene treatment?
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Which condition is usually treated with Tamoxifen?
Which condition is usually treated with Tamoxifen?
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What is a common effect of Raloxifene on bone health?
What is a common effect of Raloxifene on bone health?
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What effect does progesterone have on the hypothalamus and pituitary gland during the menstrual cycle?
What effect does progesterone have on the hypothalamus and pituitary gland during the menstrual cycle?
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What is the primary effect of estrogen on bone health at menopause?
What is the primary effect of estrogen on bone health at menopause?
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What happens if implantation of the ovum does not occur?
What happens if implantation of the ovum does not occur?
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What is a potential risk associated with postmenopausal hormone therapy (HT)?
What is a potential risk associated with postmenopausal hormone therapy (HT)?
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Which metabolic effect is associated with estrogen deficiency after menopause?
Which metabolic effect is associated with estrogen deficiency after menopause?
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What is a primary treatment for women experiencing urogenital symptoms post-menopause?
What is a primary treatment for women experiencing urogenital symptoms post-menopause?
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Which factor increases the risk of stroke associated with estrogen?
Which factor increases the risk of stroke associated with estrogen?
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What role does progesterone play in contraception?
What role does progesterone play in contraception?
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What is one advantage of synthetic estrogen analogues compared to natural estrogens?
What is one advantage of synthetic estrogen analogues compared to natural estrogens?
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What effect does drospirenone have on serum potassium levels?
What effect does drospirenone have on serum potassium levels?
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Which mechanism is NOT associated with progestin's effect on the reproductive system?
Which mechanism is NOT associated with progestin's effect on the reproductive system?
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How does mifepristone function in medical procedures related to pregnancy?
How does mifepristone function in medical procedures related to pregnancy?
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What is the primary method of administering contraceptives to mitigate first-pass metabolism?
What is the primary method of administering contraceptives to mitigate first-pass metabolism?
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What is a potential consequence of administering mifepristone during early pregnancy?
What is a potential consequence of administering mifepristone during early pregnancy?
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What is the primary role of estrogen in the menstrual cycle?
What is the primary role of estrogen in the menstrual cycle?
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Which contraceptive method involves taking a pill for 21 days followed by a withdrawal period?
Which contraceptive method involves taking a pill for 21 days followed by a withdrawal period?
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Which hormones are primarily responsible for the production of progesterone?
Which hormones are primarily responsible for the production of progesterone?
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What effect does progesterone have on cervical secretion?
What effect does progesterone have on cervical secretion?
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What is the main reason progesterone prevents ovulation?
What is the main reason progesterone prevents ovulation?
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Which of the following statements is true regarding progestins used in contraception?
Which of the following statements is true regarding progestins used in contraception?
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What is a common side effect associated with synthetic progestins?
What is a common side effect associated with synthetic progestins?
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Which statement correctly distinguishes between the hormonal roles of estrogen and progesterone?
Which statement correctly distinguishes between the hormonal roles of estrogen and progesterone?
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Which of the following is NOT a contraindication for progestin use?
Which of the following is NOT a contraindication for progestin use?
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What type of hormonal change does progesterone induce following ovulation?
What type of hormonal change does progesterone induce following ovulation?
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What is the primary active ligand in muscle and liver tissues?
What is the primary active ligand in muscle and liver tissues?
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Which of the following treatments is primarily used for managing infertility due to deficiency in gonadotropins?
Which of the following treatments is primarily used for managing infertility due to deficiency in gonadotropins?
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What are anabolic steroids typically characterized by?
What are anabolic steroids typically characterized by?
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What is a potential side effect of excessive testosterone doses in older males?
What is a potential side effect of excessive testosterone doses in older males?
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Which medication is used to decrease prostate size in benign prostatic hyperplasia (BPH)?
Which medication is used to decrease prostate size in benign prostatic hyperplasia (BPH)?
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What is a common application of cyproterone acetate when combined with ethinylestradiol?
What is a common application of cyproterone acetate when combined with ethinylestradiol?
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What impact does finasteride have on DHT levels?
What impact does finasteride have on DHT levels?
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What effect does high doses of testosterone have on gonadotropin secretion?
What effect does high doses of testosterone have on gonadotropin secretion?
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What is the primary mechanism of action for the non-medicated intrauterine device (IUD)?
What is the primary mechanism of action for the non-medicated intrauterine device (IUD)?
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Which type of contraceptive is indicated for emergency contraception within 5 days of unprotected intercourse?
Which type of contraceptive is indicated for emergency contraception within 5 days of unprotected intercourse?
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What are the potential side effects of using hormonal contraception?
What are the potential side effects of using hormonal contraception?
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What is a contraindication for the use of estrogen-based contraceptives?
What is a contraindication for the use of estrogen-based contraceptives?
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For how long can a medicated intrauterine device (IUD) typically prevent implantation?
For how long can a medicated intrauterine device (IUD) typically prevent implantation?
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What is a common metabolic side effect observed with hormonal contraception?
What is a common metabolic side effect observed with hormonal contraception?
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Which combination of hormones is specifically noted for emergency contraception using the ‘morning-after pill’?
Which combination of hormones is specifically noted for emergency contraception using the ‘morning-after pill’?
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What does a low dose of progesterone released by the medicated IUD primarily achieve?
What does a low dose of progesterone released by the medicated IUD primarily achieve?
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Study Notes
Gonadal Hormones
- Gonadal hormones are necessary for conception, embryonic maturation, and development of primary and secondary sexual characteristics at puberty.
- The hypothalamus secretes gonadotropin-releasing hormone (GnRH/gonadorelin), which stimulates the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary.
- These hormones regulate the function of the gonads and stimulate the secretion of sex hormones.
Overview of Gonadal Hormones
- Estrogens: Estradiol, Estrone, Ethinyl estradiol, Mestranol. Used in various combinations. Selective Estrogen Receptor Modulators (SERMs): Clomiphene, Raloxifene, Tamoxifen
- Progestogens: Desogestrel, Drospirenone(used in combination with ethinyl estradiol), Levonorgestrel, Medroxyprogesterone. Used alone or in combinations
- Androgens: Danazol, Fluoxymesterone, Oxandrolone, Testosterone (Androderm, Androgel, Striant, Testim, Testopel), Testosterone enanthate
- Antiandrogens: Bicalutamide, Dutasteride, Finasteride, Flutamide, Nilutamide
- Antiprogestin: Mifepristone
Female Hormones
- At puberty, the ovaries begin a 30-40 year period of cyclic function called the menstrual cycle.
- The cycle involves regular episodes of bleeding.
- Cessation of cycle bleeding is called menopause.
Menstrual Cycle
- Cycle begins with menstruation (3-6 days), shedding the superficial layer of the uterine endometrium.
- Under FSH influence, follicles develop; one becomes the Graafian follicle producing estrogen (follicular phase).
- Estrogen is responsible for endometrial proliferation, increasing thickness and vascularity (from days 5-6 to midcycle).
- At the peak of estrogen secretion, cervical mucus secretion increases, promoting sperm entry.
- Ruptured follicle becomes the corpus luteum, secreting progesterone (secretory phase), making the endometrium suitable for implantation.
- Progesterone maintains pregnancy or triggers menstruation if implantation fails.
Estrogens - Therapeutic Uses
- Development of 1ry & 2ry female sex characteristics: Estrogen's role in developing female organs and characteristics.
- Endometrial proliferation: Estrogen promotes growth and proliferation of the endometrium.
- Watery cervical secretions: Estrogen stimulates the production of watery cervical secretions.
- Bone health effects: Estrogen antagonizes PTH and reduces bone resorption (bone loss occurs aftermenopause).
- Metabolic effects: Estrogen influences glucose tolerance, Na+/H2O retention, and HDL/LDL cholesterol levels.
- Blood effects: May affect blood coagulation by influencing clotting factors.
- Pituitary effects: Negative feedback on FSH secretion.
- Adverse effects (cancer risk): Increased risk of endometrial and breast cancer with continuous estrogen use. Use of progestogen along with estrogen can reduce endometrial cancer risk
- Therapeutic uses: Postmenopausal hormone therapy (HT), use in contraceptives, developing female sex organs in young women with primary hypogonadism, and in women with premature menopause.
Progesterone - Preparations and Uses
- Progesterone, produced by the corpus luteum, placenta, and adrenal cortex, is inactive orally due to liver metabolism.
- Two major groups of progestogens are natural and testosterone derivatives (used in injections and orally). Newer progestogens in contraception include desogestrel and gestodene
- Progesterone promotes thickening of the endometrium to support implantation, regulates uterine contractions, and maintains pregnancy. Progesterone inhibits LH release from the pituitary, therefore inhibits ovulation
- Uses: contraception; treating dysfunctional uterine bleeding (during perimenopause); treatment of dysmenorrhea and endometriosis.
- Adverse effects: Headaches, depression, weight gain, acne and hirsutism, and potential potassium increase (when combined with other drugs).
Antiprogestin - Mifepristone
- Blocks progesterone receptors and inhibits the relaxation effect of progesterone on the uterus.
- Administration to early pregnant females may interfere with the needed progesterone for pregnancy.
- Commonly combined with a prostaglandin analog to induce uterine contractions for pregnancy termination.
- Uses: a possible oral contraceptive and emergency contraceptive.
- Adverse effects: uterine bleeding, and risk for incomplete abortion.
Contraceptives - General
- Estrogen provides negative feedback on LH and FSH, suppressing ovulation.
- Progestin increases cervical mucus viscosity and suppresses LH release.
- Methods include oral (combined or progestin-only pills), transdermal patch, injectable, vaginal ring, implants and IUDs (copper or progestin-releasing).
- Emergency contraception (morning-after pill): High dose progestin or progestin/estrogen combination within 72 hours of unprotected sex can reduce risk of pregnancy.
Other Substances
- SERMs (Selective Estrogen Receptor Modulators): Tamoxifen, Raloxifene, and Clomiphene are estrogen-related compounds that are selective agonists or antagonists for estrogen receptors in different types of tissues. Clomiphene is used in treating anovulatory infertility and Tamoxifen/Raloxifene has uses for osteoporosis prevention/treatment.
- HMG (Human Menopausal Gonadotropins): A combination of FSH and LH hormones used for induction of conception in female infertility .
- HCG (Human Chorionic Gonadotropin): A hormone, primarily from the placenta, having LH activity. Used to measure endogenous levels to diagnose pregnancy.
Male Hormones (Testosterone)
- The primary male sex hormone is testosterone, produced by Leydig cells in the testes.
- Testosterone influences male secondary sex characteristics, sperm production, muscle protein synthesis, erythropoiesis, bone growth and resorption, and other effects
- Uses: replacement therapy in hypogonadism, delayed puberty, infertility, and certain anemias; anabolic agent to reverse/reduce protein loss in debilitated patients; treatment for senile osteoporosis.
Adverse Effects of Various Hormones
- Estrogens: Breast tenderness, depression, fluid retention, headache, nausea, thromboembolism, hypertension and cerebral/coronary thrombosis, abnormal glucose tolerance (weight gain).
- Progestogens: Headache, depression, weight gain , increase in libido, and acne/hirsutism. Increased potassium (combined use).
- Antiprogestins: Uterine bleeding, possible incomplete abortion
- Other Substances (e.g., SERMs and oral contraceptives): The variety of potential adverse effects can vary.
Antiandrogens
- Finasteride and Dutasteride: 5-alpha-reductase inhibitors to decrease DHT and reduce prostate size in benign prostatic hyperplasia (BPH). Also used to treat prostate cancer
- Flutamide and Bicalutamide: Competitive blockers of androgen receptors, most effective in treating prostate cancer.
- Cyproterone acetate: An androgen antagonist used to treat androgen-dependent conditions such as acne, excessive hair growth, early puberty, and prostate cancer. It also has progestin activity and is used in birth control. It can also be used to inhibit gonadotropin synthesis.
Gonadotropin-releasing Hormone (GnRH)
- A hormone secreted by the hypothalamus that stimulates the anterior pituitary to release FSH and LH.
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Description
This quiz covers the essential aspects of gonadal hormones, including their roles in conception, embryonic maturation, and sexual development. It also discusses various types of hormones such as estrogens, progestogens, and androgens, along with their specific functions and examples. Test your knowledge on this crucial topic in human biology and endocrinology.
