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93 Cards in this Set
- Front
- Back
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what is required to convert testosterone into estrogen
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aromatase
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what kind of Rc is the estrogen Rc
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nuclear
has alpha and beta type |
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what is estrogens effect on osteoblast
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increase IGF1, TGF B, osteoprotegrin, bone morphogenic protein 6
ALL OF THESE ARE PRO BONE MASS |
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what is estrogens effect on osteoclast
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estrogen decreases the number and activity of osteoclast therefore decreases bone resorption
estrogen also recruits co-repressors and decreases IL1, IL6, TNF alpha (cytokines which activate osteoclast) |
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what does estrogen do to lipid levels
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increases HDL
decreases LDL |
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what does estrogen do to the bile composition and what is the effect
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estrogen alters the bile composition by increasing the amount of cholesterol and decreasing the bile acids in bile this results in the cholesterol precipitating and forming crystals which lead to the formation of gall stones therefore WOMEN ON HORMONE THERAPY AT GREATER RISK OF GALL STONES
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before menopause are women more or less likely to have a heart attack than men
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less likely
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after menopause are women more or less likely to have a heart attack than men
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more likely due to the lack of estrogen
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how can estrogen help prevent cardiovascular disease
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estrogen upregulates nitric oxide (vasodilator) this is good for lowering BP as we build plaque
estrogen suppresses inflammation associated w/ plaque |
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what were the lab results that proved the women's initiative study to be faulty
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women develop plaque before menopause due to high fat diet in america
estrogen can be given to a women just as she goes into menopause and have give her cardiovascular benefit but if estrogen is given to a women 10 years after menopause there is no benefit because plaque has already accumulated and therefore she is at more risk of heart attack |
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what does estrogen increase and what is its effect on clots
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factor 7, 12, 2 all of which increase clot formation
fibrinolysis which breaks clots down |
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what does estrogen decrease and what is its effect on clots
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estrogen decreases protein C, S, antithrombin 3 this leads to more clot formation
estrogen decreases plasminogen activating factor inhibit 1 this leads to more clot break down |
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what is the effect does menopause have on the bone
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osteoporosis can occur due to the lack of estrogen
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what are the ways Polycystic Ovary Syndrome can occur
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due to a defficiency in 21 B OH or due to obesity
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what happens when a woman has a defeciency in 21 B OH
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PCOS WILL OCCUR BUT
this is genetic and occurs because they are dysfunctional in that gene. this will lead to accumulation of androgenic progestins and she might have hirsutism, amenorrhea, and acne |
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how does obesity lead to PCOS
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with obesity the abdominal fat that accumulates has been shown to push the womans reproductive system into a state of PCOS. this is not entirely due to obesity alone and there is most likely a mild genetic disposition already but it won't manifest until obesity develops.
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why is PCOS caused by abdominal adiposity considered an inflammatory condition
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this is due to the types of cells that end up in the fat and the cytokines produced
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what does obesity lead to
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insulin resistance > hyperglycemia
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what is seen in both causes of PCOS
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increased circulating androgens (mild hirsuitism may occur)
hyperinsulinemia |
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what is insulins role in PCOS when there is obesity
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works in synergy with LH to increase androgen synthesis
works in synergy with LH to promote development of more follicles binds IGF1 Rc driving follicle growth and increasing follicle volume |
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what are the adipokines role in PCOS when there is obesity
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leptin directly suppresses ovulation
TNF alpha increases steroidogenesis in ovary IL 6 increases adrenal androgen synthesis |
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how does metformin increase fertility in obese women w/ PCOS
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metformin works through AMP Kinase and would therefore sensitize our muscles allowing insulin independent uptake of glucose and as our tissues become insulin sensitive we can decrease insulin content and therefore decrease androgen and increase LH/FSH
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what treatment for PCOS in obese women can be used to increase fertility and decrease symptoms
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lower blood glucose
-done by using metformin diet and exercise needed as well or TZD (which have bad side effects) decrease obesity -done by using ORLISTAT (alli) which inhibits lipase in the gut so we have trouble absorbing fat in both cases once you lose weight you will start ovulating |
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what treatment for PCOS in obese women will only releave the symptoms and not increase fertility
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Sironolactone
Oral Contraceptives Finasteride Androgen Antagonists (flutamide) Chronic GnRH |
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how do Sironolactones relieve PCOS symptoms
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its an aldosterone and androgen Rc antagonist
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how do Oral Contraceptives relieve symptoms of PCOS
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they suppress the gonadotropin production therefore no LH/FSH then no estrogen or androgen production from ovaries this stops the extra androgen production coming from the ovaries
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what does Finasteride/Duteriside due
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5 alpha reductase inhibitor
this prevents formation of dihydrotestosterone this is used to treat hirsuitisim in women, don't take is trying to get pregnant |
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how does flutamide relieve symptoms of PCOS
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antagonizes androgen Rc
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what is Clomiphene used for
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used to enhance and induce fertility
estrogen Rc antagonist in the hypothalamus therefore it relieves us from the normal feed back of estrogen therefore we produce GnRH/LH/FSH weak estrogen agonist in female sex organs (uterus, ovary, vagina, cervix) |
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what serms are used for osteoprososis
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tamoxifen and raloxifene
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what is tamoxifen used for
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estrogen Rc positive breast cancer
can also be used in osteoprosis |
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what is raloxifene used for
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prevent osteoprosis
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what are the properties of tamoxifen
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agonist in bone and uterus
estrogen Rc antagonist |
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what are the properties of raloxifene
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agonist in bone
antagonist in breast, uterus |
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what are the steroidal estrogen synthesis inhibitors
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formestane
exemestane these inhibit aromatase |
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what are the non steroidal estrogen synthesis inhibitors
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anastrozole
letrozole these inhibit aromatase |
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can you use estrogen synthesis inhibitors to treat estrogen Rc negative breast cancer
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no
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what can be used to treat hirsuitism in females
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finasteride
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what is finasteride used for in men
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to slow hair loss
dihydrotestosterone causes rapid hair growth and turnover which leads to hair gowing slower so finasteride inhibits the formation of this |
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what is danazol used for
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mainly used for endometriosis
has antiestrogen activity weakly androgenic some glucocorticoid activity |
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what are the serms
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raloxifene
tamoxifene clomiphene |
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what is endometriousis
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when the endometrium grows inappropriately up and around the ovaries and fallopian tubes leading to infertility
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what is responsible for endometrial growth
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estrogens
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what does danazol bind to
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SHBG and CBG
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what does enzyme does danazol inhibit
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P450 therefore we don't convert cholesterol into androgens/estrogen/progestins
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what does estrogen do for men w/ prostate cancer
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estrogen can act at the hypothalamus inhibiting GnRH therefore no LH/FSH produces therefore no sex steroids made
main goal is to suppress androgens |
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when are men put on estrogen for prostate cancer
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when they have receptor positive prostate cancer
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what are the side effects of estrogen use in men
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develope breast
decrease aggression softer skin |
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how can GnRH agonist be used to treat prostate cancer in men
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GnRH can be given chronically to desensitize the GnRH Rc on the gonadotrophs
GnRH is usually given w/ Flutamide (androgen Rc antagonist) |
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why is Flutamide given w/ GnRH to treat prostate cancer
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this is because initially when you give GnRH you will have a spike of testosterone so Flutamide is given to counteract that testosterone spike
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what is the side effect of suppression of sex steroids
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decreased libido
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what do progestins do
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control secretory phase
make endometrium unfavorable for implantation (due to lack of estrogen) inhibit fallopian peristalsis thicken cervical mucus (therefore sperm can't get into endometrium) suppress LH release |
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why won't a contraceptive w/ progestin alone not develope the rich endometrium
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the development of a rich endometrium is controlled by estrogen
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what is fallopian peristalsis
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this occurs when the sperm meets with the egg and must then be carried down the fallopian tube to the endometrium
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why must you be careful when giving women OC w/ progestins when they want to treat acne
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the more androgenic activity the progestin has the more likely it is to bind to androgen Rc and acne is due to a lot of androgenic activity
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what keeps the endometrium in place if we have a conception
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progesterone
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what are the therapeutic applications of progestins
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contraception, emergency contraception
HRT long term suppression of ovulation |
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why is progestin used in hormone replacement therapy
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can't give estrogen alone if the woman has a uterus so progestins are given as well to oppose the growth stimulating activities of estrogen
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what are the side effects that long term suppression of ovulation via progestin is used to treat
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dysmenorrhea (crazy period cycle)
endometriosis bleeding disorders (progestins help b/c w/ them alone you won't make endometrium) |
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what do oral contraceptives do as far as pregnancy
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prevent pregnancy by suppressing secretion of gonadotropins (estrogen containing OC do this via feedback that inhibits GnRH secretion)
no FSH = no follicle no LH = no egg |
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what are one of the side effects of Oral Contraceptives
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increased risk of coagulation (higher risk if a smoker)
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how do oral contraceptives treat dysmenorrhea
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they give you a steady concentration of hormone instead of the peaks and troughs seen
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how do oral controceptives treat acne
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they suppress gonadotropins but OC upregulate SHBP so they are more likely to soak up androgens floating around freely in the blood stream therefore androgenic activity is reduced
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what does SHBP do
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binds androgens
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what is an emergency post coital contraceptive
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Plan B
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what is levonogestrel
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Plan B
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why is Plan B not considered the abortion drug
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inhibits the midcycle LH surge
changes consistancy of cervical mucus changes paristalsis of fallopian tube make uterus uninhabitable for fertilized egg IT DOESN'T ALLOW FOR THE FERTILIZED EGG TO GET IMPLANTED THEREFORE NOT ABORTION DRUG |
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what is the risk of pregnancy if plan b taken 24 hrs later
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.4%
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what is the risk of pregnancy if plan b is take 48 hrs later
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1.2%
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what is the risk of pregnancy is plan b is taken 72 hrs later
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2.7%
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what is Mifepristone also known as
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RU 486
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what are the properties of Mifepristone
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antagonizes both progesterone and glucocorticoid Rc
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when does Mifepristone work
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any time during pregnancy
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what are the weak androgens
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DHEA (dihydroepiandrosterone)
androstendione |
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how do androgens circulate
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bound to SHBG
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what do estrogens do to SHBG
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they increase the transcription/translation/secretion of SHBG
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what does an increase in SHBG do to androgen levels
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this decreases androgen activity due to less free androgen being available
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where are the types of 5 alpha reductase found
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type 1 found in skin, liver
type 2 found in genital skin or urogenetal tissue |
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why is Dihydrotestosterone considered more potent
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it is considered more potent because it binds the androgen Rc with even more affinity
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what happens if women have an androgen defeciency
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decrease in libido and muscle mass
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what happens if men have a defeciency in androgens
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cryptorchidism
incomplete development of primary sex characteristics |
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what are some possible causes for androgen deficiency
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defect of androgen Rc
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what are the androgen Rc antagonist
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tamides (flutamide etc)
spironolactone |
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what all can treat hirsutism
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flutamide, finasteride
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what kind of receptor is the androgen Rc
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nuclear
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what is the side effect seen by spironolactone and when is it seen
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spironolactone caused gynecomastia when used to treat hypertension
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what is a spironolactone derivative
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drosperinone
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what are 5 alpha reductase inhibitors used for
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used to treat prostate cancer
promote hair growth in men suppres hirsutism in women benign prostate hyperplasia |
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what type of 5 alpha reductase are finasteride/dutaseride antagonist for
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type 2
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what is the 5 alpha reductase inhibitor role in treating benign prostate hyperplasia
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decrease size of prostate therefore decreasing prostatic volume and increasing urine flow
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what is another name for finasteride
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proscar
propecia |
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what is another name for dutaseride
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avadart
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what happens in benign prostate hyperplasia
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when prostate gland grows and swells in its capsule and has no where to go out
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