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7 Cards in this Set

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CONTRACEPTIVES
1. Estrogen/Progestin Combination (Oral, ring, patch)
2. Progestin (Oral, Implantable, Injectable)
3. Postcoital Contraception (Plan B)
Estrogen/Progestin Combination Therapy
No LH/FSH surge- prevent ovulation, change endometrium to prevent implantation, thicken cervical mucus to prevent sperm passage

1. Oral- 3 types (monophasic- on for 28 days off 7, biphasic, triphasic- progestins have 3 doses to mimic real menstruation)
2. Nuva Ring
3. Ortha Evra patch- less effective in women who weigh over 198lbs *3X higher clot risk due to higher estrogen content

Estrogens= ethinyl estradiol and mestranol (50mg ie low dose)
Side Effects- Nausea and Vomiting, Cramping, Fluid Retention, Headache, Breast Discomfort, Thrombosis, Gallbladder disease, HTN, Impaired glucose tolerance, Cervical and Breast Cancer

Progesterones= norgestrel, norethindrone, levonorgestrel, desogestrel, norgestimate, gestodene, and drosperinone
Side Effects: Spotting and breakthrough bleeding, Weight Gain, Acne, Hirsutism, Reduction in HDL:LDL ratio, Impaired glucose tolerance
Progestin Therapy
only some prevent ovulation, change endometrium to prevent implantation, thicken cervical mucus to prevent sperm passage

1. ORAL: “Minipill” taken continuously
2. Injectable: “Depot Provera” intramuscular injection that lasts for 3 months *increase risk of osteoporosis if used for more than 2 years
3. Implantable: “Implanton” is an implantable rod just under the skin of the medial aspect of the upper arm that lasts for 3 years
4. Postcoital Contraception (Plan B)- given in very high doses (750 Ìg levonorgestrel) to block ovulation and endometrial changes- 2 dose must be within 72hrs of sex
HORMONE REPLACMENT THERAPY
Estrogens (If there is an intact uterus progestins are used to reduce risk of uterine cancers)
*doses are lower than contraceptive use (5-10Ìg)
Benefits: reduction of vasomotor symptoms (hot flashes) and reduced osteoporosis
Risks: increased risk of pulmonary embolus, breast cancer, stroke, and endometrial cancer
CONTRAGESTATION (Abortion pill)
Anti-Progestin- Mifepristone
antagonist of progesterone and glucocorticoid receptors- causes endometrial shedding. * given with a prostaglandin to induce contraction of the uterus
**must be given within 49 days of the last menstrual period
FERTILITY DRUGS
Anti-estrogen- Clomophene
an antagonist of the estrogen receptor in the pituitary and hypothalamus increasing the surge of LH due to inhibition of negative feedback effects of high estrogen levels
*induces ovulation and increases the risk of multiple births
SELECTIVE ESTROGEN RECEPTOR MODULATORS (SERMs)
able to selectively target specific tissues with no effect on other tissues with estrogen receptors

ex- Tamoxifen (Nolvadex- an estrogen antagonist in breast tissue to inhibit proliferation of breast cancer tissue without any agonist side effects in the rest of the body
ex. Raloxifene (Evista)- an estrogen antagonist in the breast and uterus, and agonist in the bone- prevents breast cancer, uterine cancer, and osteoporosis