Estrogens, Progestins, and Birth Control

These flashcards cover key concepts related to estrogens, progestins, hormone therapy, contraception, and relevant risks and benefits.

What are the main therapeutic uses of estrogens?

Menopausal Hormone Therapy, Cancer Hormone Therapy, Management of Acne

What are the available administration routes for estrogens?

Oral (PO), Transdermal, Intravaginal, Parenteral

What major concern is associated with estrogen administration?

Risk of endometrial cancer, mitigated by concurrent progestin administration.

What can induce CYP450 metabolism affect estrogen effectiveness?

It can lead to decreased estrogen effectiveness and potential drug interactions.

What is Raloxifene used for?

Postmenopausal osteoporosis prevention and prevention of estrogen receptor positive breast cancer.

What are the benefits of Raloxifene compared to regular estrogens?

Increases bone mineral density with less adverse effects regarding cancer risk.

What is the major clinical use of progestins in menopausal hormone therapy?

To reduce endometrial cancer risk associated with estrogen.

What are common adverse effects of progestins?

Increased risk of breast cancer, higher risk of thromboembolic events, abdominal discomfort, breast tenderness, and menstrual irregularities.

What significant findings emerged from the WHI and HERS-II studies regarding menopausal hormone therapy?

They found increased risk of cardiovascular events and breast cancer associated with estrogen and progestin.

What are the approved indications for menopausal hormone therapy?

Management of vasomotor symptoms, atrophy of vulva and vaginal wall, and prevention of osteoporosis.

What alternatives exist to manage vasomotor symptoms without MHT?

Consider paroxetine (a selective serotonin reuptake inhibitor).

What is the theoretical effectiveness of combination oral contraceptives?

99.7% effective; actual effectiveness is around 92% due to user error.

What is the mechanism of action for combination oral contraceptives?

They maintain steady high hormone levels to inhibit ovulation.

What are common contraindications for oral contraceptives?

Thromboembolic disorders, cerebral vascular disease, previous coronary occlusions, abnormal liver function.

How does progestin-only contraception work?

It stimulates cervical glands to produce thick mucus that acts as a barrier to sperm penetration.

What is the main purpose of cervical ripening agents?

To prepare the cervix for labor induction, reducing injury risk during delivery.

What is oxytocin used for in labor induction?

To enhance the strength and frequency of uterine contractions during labor.

What is the typical follow-up care after a medication abortion?

To ensure the abortion was effective and overall health is good.