Chapter 27 Drugs That Affect the Reproductive System

Abnormal uterine bleeding

Irregular or excessive uterine bleeding from structural problems or hormonal imbalance.

Amenorrhea

Absence of normal menstruation.

Atrophic vaginitis

Postmenopausal thinning and dryness of vaginal epithelium related to decreased estrogen levels.

Dysmenorrhea

Difficult or painful menstruation.

Endometriosis

Presence of functioning endometrial tissue outside the uterus.

Hypogonadism

Inadequate production of sex hormones.

Hysterectomy

Surgical removal of the uterus.

Infertility

Inability to achieve pregnancy during 1 year or more of unprotected intercourse.

Menopause

Termination of menstrual cycles, marked by at least 1 full year without menstruation.

Menorrhagia

Excessive menstrual bleeding.

Pelvic inflammatory disease

Infection of the uterus, fallopian tubes, and pelvic structures unrelated to pregnancy.

Polycystic ovary disease

Condition characterized by enlarged ovaries containing fluid-filled cysts.

Premenstrual dysphoric disorder

Severe premenstrual condition characterized by depression, anxiety, hopelessness, and self-deprecation.

Premenstrual syndrome

Physical and emotional symptoms occurring before the start of the menstrual cycle.

Supraovulation

Simultaneous rupture of multiple mature follicles.

Toxic shock syndrome

Rare disorder caused by certain Staphylococcus aureus strains, often linked to tampon use.

Warning labels for Oral Contraceptives (Estrogen and Progestin Combinations)

May take with food. Take at same time daily. Avoid prolonged sun. Avoid smoking.

Dosing and replacement schedule for copper-releasing IUD (ParaGard)

Insert into uterine cavity; replace 10 years after insertion.

Special warning for nafarelin (Synarel) nasal spray

Do not use nasal decongestants for 30 minutes after using nafarelin spray.

Lifestyle factors causing infertility

Factors such as smoking or alcohol abuse.

Symptoms of premenstrual syndrome (PMS)

Headache, mood changes, fatigue, weight gain, and sleep changes.

Potential causes or indicators of amenorrhea

Weight loss, pregnancy, lactation, menopause, or reproductive system disease.

Pathogens causing sexually transmitted infections (STIs)

Communicable pathogens such as viruses, bacteria, fungi, and protozoa.

Purpose of condoms

To prevent pregnancy and transmission of STIs like gonorrhea, syphilis, and HIV.

Mechanism of hormonal contraceptives

Initiate negative feedback inhibition of FSH and LH secretion.

Diaphragm insertion and removal timing

Insert before intercourse; remain in vagina 6 to 8 hours after last ejaculation.

Mechanism of intrauterine devices (IUD)

Prompts endometrium to release leukocytes and prostaglandins, interfering with fertilization and implantation.

Unintended pregnancy rate of the pill

Estimated at between 0.1% and 3% if used correctly and consistently.

Emergency contraceptive pills timing window

Within 3 days for Plan B or 5 days for Ella after unprotected intercourse.

Risks identified by the 2002 WHI hormone replacement therapy study

Increased risk of breast cancer, heart attacks, strokes, and blood clots.

Indications for gonadotropin-releasing hormone (GnRH) analogs

Prostate cancer, endometriosis, advanced breast cancer, and endometrial thinning.

Treatments for infertility include

Antiestrogens, menotropins, human chorionic gonadotropin, recombinant human FSH

Treatment of endometriosis

GnRH agonists (ex Zoladex/goserelin), androgens (Danazol)