Estrogens and Progestins – Reproductive Pharmacology

by Pravin Shukle, MD

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    We’re going to start off with estrogens. This is a huge topic. And I'll go over in detail for you because it's going to be very relevant when you're out in practice. It's also going to be very relevant on the exams. With respect to the first of the estrogens, let's talk about estradiols. Now, these are available as a patch, let's talk about estradiols. Now, these are available as a patch, as a vaginal cream or as an oral agent. Cypionate is this long-acting version for intramuscular injection and we use this as depot injections, in some cases, for hormonal treatment and, in some cases, for anti-conception medication. Premarin is also used for hormone replacement therapy. Ethinyl estradiol is a high bioavailability oral contraceptive agent that is used quite frequently in oral contraceptive medications. Now, the biological effects of these drugs are quite wide and diverse. First of all, the obvious effect is going to be gonadal. So, it's going to have an effect on female tract development and secondary sexual characteristics. There are some central or neurological issues too. So, it does reduce secretion of gonadotropins from the pituitary gland. This is a normal feedback mechanism. This is a controversial area too in terms of lipids. We know that estradiols will increase your triglyceride levels. It may reduce your LDL levels and it may increase your HDL levels. And finally, there are issues surrounding coagulation. We know that estradiols will increase coagulability of most patients. So, that becomes problematic when you're giving estradiols to women who are at risk for stroke, for example. And so, sometimes, we actually withdraw estradiols from patients who are at risk for stroke for that very same reason. We also withdraw medications in patients who are hypertensive because we’re worried about risk of...

    About the Lecture

    The lecture Estrogens and Progestins – Reproductive Pharmacology by Pravin Shukle, MD is from the course Reproductive Pharmacology. It contains the following chapters:

    • Estrogens
    • Progestins

    Included Quiz Questions

    1. A 45 year old mother of two children with a history of DVT.
    2. A 25 year old man that is interested in transitioning to become female.
    3. A 14 year old woman who wants to use oral contraception to prevent pregnancy while having sex with her boyfriend.
    4. A 51 year old woman who is perimenopausal.
    5. A 35 year old woman who often has painful and heavy periods.
    1. Iatrogenic menopause
    2. Vaginal adenocarcinoma
    3. Ectopic pregnancy
    4. Infertility
    5. Increased risk of breast cancer
    1. Forces the uterus to contract to expel fertilized ovum.
    2. Prevents ovulation
    3. Alters cervical gland formation and function
    4. Reduce implantation receptivity in the fallopian tubes
    5. Decrease the chance of implanting in the uterine wall
    1. Increased risk of uterine and breast cancer
    2. Increased risk of developing colorblindness
    3. Increased risk of liver cancer
    4. Reduced risk of developing a hemangioma in the liver
    5. Increased risk of osteopenia
    1. Reduces risk of endometrial cancer
    2. Negates all negative side effects of estrogen
    3. Improves bioavailability of estrogen
    4. Improves absorption of estrogen
    5. Reduces risk of cardiovascular disease seen in estrogen only therapies

    Author of lecture Estrogens and Progestins – Reproductive Pharmacology

     Pravin Shukle, MD

    Pravin Shukle, MD

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