Gonadosteroids PDF

Gonadosteriods Intro lo Conadosteriods hormones > - produced by testes or ovaries that stimulate reproductive organe germ ,...

Gonadosteriods Intro lo Conadosteriods hormones > - produced by testes or ovaries that stimulate reproductive organe germ , all maturation and the man characteristics secondary sex o Female sex normones : > - estradiol(major m estrogen hormone i ss i females involved in development + maintenate , in mu of characteristics secreted by ovaries) hmm , progesterone I secreted by corpus lateum & placenta min > - , imman cycle pregnancy · male sex hormones : > - testosterone (produced mainly by testes ↳ regulates gene expression ↳ development of primary secondary sex characteristics ↳ sperm maturation ↳ increase musch mass Therapeutic Indications Hormonal contraception > - in female Hormone transplant therapy > - Transgender hormonal therapy > - > - Breast canar treatment Prostate > - canar treatment Infertility > - > - Menstrual disorders > - Endometriosis > - Acne > - Anemia > - Anabolic agent  Hormonal Contraceptives > - mod suppress the release of gonadotropine = ↳ bit m gonadotropin-releasing hormon (GnRH) Lease um from hypothalamus in the brain ↳ this dea and In circulation resulting in Andicular maturation in the mes Imbited and ovulation ↳ of altered additionally , secretions endocervical gland are - to a thick fluid not optimal for sperm migration, ~ , endometrium underdeveloped ↳ > unsuitible for implantation of fertilized orum Types of Hormonal preparations : Oral Contraceptives ① Fixed combinations ↳ombesqnesterone ② Multiphasis progestin (increasing from usually finestrogen , n week to week ↳ traceptive e currently of o ↳ closely mimic normal ovarian cych ③ Continuous ~ Anousen-Astin preparations ↳ taken for 28 days each cycle , no dray free period , ④ Mini-pill eliminating menstruction ↳ doseprestin taken as long as needed - breakthrough bleeding often a problem , so patient acceptability Is less than with estrogen-progestin combo  Adverse Effect of Combination Oral Contraceptives > - Bloodcots ↳ of heart attack and stroke this also increases risk u u ↳ small risk of heart attack-risk 4 If patient is obese or smokes ↳ risk of strok is 4 35 is patient over yrs > - Hypertension ↳ believed to be caused by estrogen ↳ more prevalent if over 35 urs > - Cancer ↳ endometrial , ovarian , colorectal cancer risk ↓ ↳ for slight I rich developing breast and cervical canas Noncontraceptive Benifits > - reduced risk of ovarian cysts > - reduced risk of ovarian and endometrial canar > - reduced incedence of ectopic pregnancy (fetus develops outside oterus less (due reduced mestrual flow) deficiency > - iron anema to less and hirsutism (excessive hair body > - acre Other Hormonal Contraceptives > - Depo-provera : Injectable progestin /Intramuscularly every 3 month Transdermal contraceptive paten delived at rate for > - : constant 7 days > - Norplant : comprimised of silicone tubes filled w/ L-norgestrel (progestin) implanted under skin /released over surs-provides effective contraception during this time > - vaginal contraceptive riny I placed in vagina for 21 days of 28-day cycle Intranterine > - device (1UD) : effective for S yrs ↳ very effective , becoming contraceptive of choice for long term contraception  after sexual intercourse - Post-Coital Contraceptives · Estrogen an Zurs usually taken after ↳ his wit coitus > - have several mods : may ↳ follicular development interference ↳ s altered cervical mucus altering ↳ sperm migration ↳ Inhibition of fertilization ↳ adverse effect = naused num ↳ ex. preven plan B · Antiprogesting ↳ blocks effect of progesterone receptor in endometrium ↳ can be taken after missed period to on Any meation and i mate an embortion ↳ ex. mifegymiso ↳ combo of progesteron and prostaglandin Hormone Replacement Therapy · Hypogonadism ↳ mon o e r of mone secretion or other physiological activity of gonads (testes or ovaries) Female - when little or no estrogen is produced , delaying puberty ↳ treatment dose of estrogen  Emmays I-2) of cycle ↳ In females 11-13 gre old ↳ closes of when growth completed , t estrogene and progesting administered until menopause · males ↳ result timmar failure (primary) or from hmmmalamic pituitary disease (secondary - ↳ treatment urogen replacement (ie. testosterone u ↳ adverse effect , gynecomastia, sleep apped = acne , azoospermia (absence of viable sperm Postmenopausal Females Cessation of Ovarian function loss periods , sleep disturbance , > - menopause = of , flushing , headaches , Insomnia ↳ also resultsIn accelerated bone loss and lipid changes that may contribute to atherosclerotic Cardiovascular disease. hormone replacement therapy > - ↳ current clinical guidelines do not recommend this for this population ↳ need to consider for osteoporosis /low a and risk bone mas m discuse) ,muscular and endometrial disease Pr e canor , · Bone density : ↳ been estrogen replacement therapy has shown Entive decrease to be in netny mmmdensity that occurs during menopause · Cardiovascular Disease ↳ ↓ m estrogen causes Cholesterol and - LDL ↳ gen replacement has cial effect on these circulating lipids  more research needed · Cancer - ↳ ↑ many studies show risk of endometrial carcinoma concomitant in patients taking estrogene alone , however , use of rish a progestin prevents ↳ breast cancer incidence is not increased o short term estrogen therapy , but may w/ occur prolonged therapy ↳ not protective this progesterone in case Males Elderly > - androgen production decreases with age in males , and may contribute to ↓ in music mas strength and libido > - preliminary studies of androgen replacement suggest testosterone mmm increase kommmeral density andmuss defest uncertain if androgen replacement will benign prostatic hyperplasia > - num hmm or increase incidence of Precancer Transgender Individuals (identify of birth > - Transgender women as woman , man ↳ involves anti-androgens emmmgen and - health concerne : -coagulation disorder > venous - thromboembolism (blood clos in veins ↳ cerebrovascular disease up myocardial infarct ↳ to minimize thromboembolic events : hypercholesterolemia, hypertension and ↳ smoking use should be addressal ↳ decrease in sexual desire may be expirenced due to anti-androgens > - Transgender Men (identify as man but biologically woman - testosterom um is used ↳ (a red blood alls) appears to cause ehemia ↳ blood profile recommended monitoring  transgender and insulin > - women and men expirence I fasting glucose resistance , relating to 4 in type & diabetes therapy does not↑ > - transgender hormone cancer prevalence * overall data that hormone suggeste therapy is safe in transgender adults w/ close physician supervision for adverse effects ↳ but more research needed Hormone Therapy in Cancer Treatment > - Tamoxifen = Selective estrogen receptor modulator (tissue - Selective mu ↳ immetitive estrogen receptor blocker in bast and metrial tissues um ↳ treat breast estrogen-sensitive cancer ↳ s reduces of mu risk ing breast cancer in und breast by 35 % also hish > - used for prevention in females and in Alive of breast ment - cancer in menopausal female > - androgens have also been use for chemotherapy of breast tumours in premenopausal females treat prostate cancer antiandrogens to > - can be used Infertility Treatment iphene > - = anti-estrogen /estrogen antagonist in all tissues ↳ inhibits estrogen mediated negative feedback on hypothalamus ↳ Ineorulation , used for utility > - adverse effect = not flashes ↳ like in menopause