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GONADAL HORMONES & INHIBITORS WEEK 1 - DAY 1 CLASSROOM RULES LEARNING OUTCOME: 1. Clearly define the key gonadal hormones, including estrogens (estradiol, estrone, estriol), progesterone, and androgens (testosterone, dihydrotestosterone). 2. Describe common inhibitors of gonadal functio...

GONADAL HORMONES & INHIBITORS WEEK 1 - DAY 1 CLASSROOM RULES LEARNING OUTCOME: 1. Clearly define the key gonadal hormones, including estrogens (estradiol, estrone, estriol), progesterone, and androgens (testosterone, dihydrotestosterone). 2. Describe common inhibitors of gonadal function, such as GnRH analogs, anti-androgens, and estrogen receptor modulators. 3. Explain the role of estrogens and androgens in sexual differentiation and the development of primary and secondary sexual characteristics during puberty 4. Discuss how estrogens and progesterone regulate the menstrual cycle, ovulation, and pregnancy. Describe the role of androgens in spermatogenesis and male reproductive health. 5. Analyze the effects of gonadal hormones on bone health, cardiovascular function, and metabolic processes. Explain how hormonal imbalances can impact overall health. 6. Assess the efficacy and potential side effects of various hormonal treatments and inhibitors used in clinical practice 1. INTRODUCTION Gonadal hormones are a group of steroid hormones produced by the gonads (ovaries in females and testes in males). 2. Importance in human physiology 1. Reproductive System Regulation 2. Secondary Sexual Characteristics 3. Bone Health 4. Cardiovascular Health 5. Metabolism 6. Mood and Cognitive Function 7. Pregnancy and Lactation 8. Puberty 3. Gonadal Hormones ESTROGEN PROGESTERONE ANDROGENS ESTROGENS - is the most potent and predominant form of estrogen in humans, playing a crucial role in various physiological processes. ESTROGENS 1. Estradiol 2. Estrone 3. Estriol - Sexual development (female secondary sexual characteristics) - Reproductive function (menstrual cycle regulation) - Bone health - Cardiovascular protection PROGESTERONE Physiological Roles: Regulation of the menstrual cycle Maintenance of pregnancy Preparation of mammary glands for lactation ANDROGENS 1. TESTOSTERONE 2. DIHYDROTESTOSTERONE (DHT) PHYSIOLOGICAL ROLES: Sexual development (male secondary sexual characteristics) Sperm production Muscle mass and strength Libido Inhibitors of Gonadal Function Types of Inhibitors: 1. GnRH agonists and antagonists 2. Aromatase inhibitors 3. Selective Estrogen Receptor Modulators (SERMs) 4. Anti-androgens 5α-Reductase The enzyme that converts testosterone to dihydrotestosterone (DHT); it is inhibited by finasteride, a drug used to treat benign prostatic hyperplasia and prevent male-pattern hair loss in men Anabolic steroid Androgen receptor agonists used for anabolic effects (eg, weight gain, increased muscle mass) Breakthrough bleeding Vaginal bleeding that occurs outside of the period of regular menstrual bleeding Combined oral contraceptive (COC or just OC) Hormonal contraceptive administered orally that contains an estrogen and a progestin Hirsutism A male pattern of body hair growth (face, chest, abdomen) in females that results from hyperandrogenism HRT Hormone replacement therapy; refers to estrogen replacement for women who have lost ovarian function and nearly always involves combination therapy with estrogen and a progestin SERM Selective estrogen receptor modulator such as tamoxifen Mechanisms of Action GnRH Agonists and Antagonists: Inhibition of gonadotropin release Aromatase Inhibitors: Block conversion of androgens to estrogens SERMs: Modulate estrogen receptors Anti-androgens: Block androgen receptors or inhibit androgen production Physiological Roles in Sexual Development Estrogens: Development of female reproductive system Growth spurts and closure of epiphyses in long bones Androgens: Development of male reproductive system Voice deepening and facial hair growth Physiological Roles in Reproductive Function Estrogens and Progesterone: Regulation of menstrual cycle Preparation of uterus for implantation Support of early pregnancy Androgens: Spermatogenesis Libido Clinical Applications Hormone Replacement Therapy (HRT) For menopause symptoms Contraceptives Estrogen and progesterone combinations Cancer Treatment Use of inhibitors in breast and prostate cancer ENGAGING ACTIVITY 1 Case Study: Patient Sarah Sarah is a 48-year-old woman who has recently been experiencing a range of symptoms that have significantly impacted her quality of life. She reports frequent hot flashes, night sweats, mood swings, and a noticeable decrease in bone density leading to joint pains. She also mentions irregular menstrual cycles that have become progressively lighter over the past year. CONTINUATION Medical History: No significant past medical history. Non-smoker, occasional alcohol consumption. No history of hormone replacement therapy (HRT). Current Symptoms: Hot flashes and night sweats Mood swings and irritability Decreased bone density Joint pains Irregular menstrual cycles Lab Results: Blood test shows significantly lower levels of estradiol. Bone density scan indicates early signs of osteoporosis. DISCUSSION 1. Identify the Symptoms 2. Physiological Impact 3. Treatment Options 4. Lifestyle Modifications 5. Long-term Management

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