FEMALE SEX HORMONES
ESTROGEN
l
Produced
in ovaries, adrenal gland and testes
l
Regulated
by FSH
l
Stimulates
growth & development of sexual organs
l
Stops
growth - closes epiphyseal plate
l
Menstrual
Cycle - growth of endometrium and blood supply
ESTROGEN METABOLIC EFFECTS
l
Retention of sodium and water
l
Alter glucose tolerance
l
Prevent negative calcium balance
l
Carcinogenic
• Uterine
• DES babies with cervical cancer
• Breast ???
ESTROGEN THERAPEUTIC USE
l
Oral contraception with a
progesterone
l
Menopausal symptoms
l
Increase bone density
l
Atrophic vaginitis
l
Dysmenorrhea
l
Cancer - prostate
ESTROGEN SIDE EFFECTS
l
Nausea - tolerance develops
l
Mid cycle bleeding
l
Breast tenderness
l
Increased blood clotting
• avoid in smokers
• avoid BCP over age of 45
SPECIFIC ESTROGEN RECEPTOR MODULATOR
l
Non-estrogen that stimulates
estrogen receptor
l
Indicated for increased bone
density for those that cannot tolerate estrogens
l
example: Raloxifene (Evista®)
PROGESTERONE
l
Produced in corpus luteum after
ovulation
l
Regulated by LH
l
Corpus luteum regresses after 14
days if ovum is not fertilized
l
Prepares endometrium for
implantation
l
Increases basal body temp 1°C
PROGESTERONE THERAPEUTIC USE
l
Uterine Bleed due to ovulatory
failure
l
Dysmenorrhea
l
Contraception with or without
estrogens
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Protect uterus from estrogen
induced cancer
l
Endometrial cancer
ORAL CONTRACEPTIVES
l
99% effective
l
Stops Ovulation
l
Cervical gland produces mucous so
sperm cannot pass
l
Progesterone alone administered
daily
l
Progesterone with an estrogen
administered for 21 days
GENERAL INFORMATION
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Not effective during the first
month of therapy
l
If one dose is missed then double
the next dose, if two doses is missed then double for two days
l
Discontinue for three months prior
to pregnancy
Side Effects
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Nausea/vomiting
l
Headache
l
Weight gain
• Tolerance develops to all above
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Acne
• Lower incidence with tri-phasic birth control pills
l
Chloasma
LONG TERM RISKS
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Decreased fertility
l
Thromboembolism
l
Cancer ??