{"id":6644,"date":"2024-11-18T20:51:33","date_gmt":"2024-11-18T20:51:33","guid":{"rendered":"https:\/\/workhouse.sweetdishy.com\/?p=6644"},"modified":"2024-11-18T20:51:33","modified_gmt":"2024-11-18T20:51:33","slug":"female-sex-hormones-and-hormonal-contraception","status":"publish","type":"post","link":"https:\/\/workhouse.sweetdishy.com\/index.php\/2024\/11\/18\/female-sex-hormones-and-hormonal-contraception\/","title":{"rendered":"Female Sex Hormones and Hormonal Contraception"},"content":{"rendered":"\n

Oestrogens
These drugs can be classified into three groups.<\/p>\n\n\n\n

    \n
  1. Natural \u2013 estradiol, esterone, estriol<\/li>\n\n\n\n
  2. Semisynthetic \u2013 Ethnylestradiol<\/li>\n\n\n\n
  3. Synthetic: Diethylstibosterol
    Natural
    Estradiol: Estradiol is most potent, major secretory product of ovary.It is oxidized into esterone
    by liver; estrone is hydrated to estriol and synthesized by ovarian follicle, adrenal cortex,
    fetoplacental unit, and testis. Androgen and testestrone are precursor for estrogen. Certain
    tissue can make estrone from androgen.
    Semisynthetic<\/strong>
    Ethylestadiol: Highly potent, effective orally
    Absorption and Fate: It is absorbed from GI and skin and rapidly metabolized in the liver
    Physiologic actions:
    Genital system
    Ovary: estrogen affects the ovary through indirectly influencing the secretion of gonadotrophin

    Uterus: it affects the \u2018proliferative phase\u2019 of the endometrium and also increases the growth and
    sensitivity of myometrium for oxytocin.
    Cervix: it makes cervical mucus thin and alkaline
    Vagina: Stratification, cornification and glycogen deposit is affected by estrogen.
    Breast
    Estrogen causes the growth of gland and duct system
    Anterior pitutary
    Estrogen inhibit release of gonadotrophins (FSH, LH)
    Metabolic action:<\/strong>
    a) Retention of salt and water
    b) Plasma lipid level: it increases the level of high density lipoprotein and
    triglycerides while decreases the level of low density lipoprotein and cholesterol.
    c) Increases Catt bone deposition
    d) It has a mild anabolic action
    Blood coagulation
    Enhance level of factor II, VII, IX, X so, increase the coagulability of blood and may predispose
    to thromboembolic condition
    Therapeutic use: contraceptive in combination with progestogens, Functional uterine bleeding,
    Dysmenorrhea, Alleviation of menopausal disorder, Osteoporosis, Replacement therapy in
    ovarian failure, Prevents senile and atrophic vaginitis
    Side effects: Thromboembolism, Sodium and water retention, Withdrawal bleeding, nausea,
    endometrial carcinoma
    Contraindication: History of thromboembolism condition, Undiagnosed uterine bleeding,
    endometrial Carcinoma, liver disease
    PROGESTOGENS<\/strong>
    Progestrone is natural occuring progestational hormone.it is synthesized by corpus luteum,
    placenta, adrenal cortex, testis. It is less effective orally due to complete metabolism by liver so
    it\u2019s given through intramuscular route.
    136
    Actions on genital organs:
    Ovary – Inhibition of ovulation
    Uterus – converts the endometrum for secretory phase and makes the myometrium less
    sensitive to oxytocin. It also causes relaxation of the uterus in late pregnancy.
    Metabolic actions:
    (a) Thermogenic action
    (b) Competes with aldosterone at renal tubule so inhibits sodium reabsorption.
    Synthetic \/Senisynthetic progestogens:
    Derivative of progestrone: Hydroxyprogesterone capriot\/medroxyprogestrone
    Derivative of testestrone: Dimethisterone
    Nortestrone: Norethisterone
    Therapeutic use: Hormonal contraception, functional uterine bleeding, dymennorrhea
    Ammenorrhea, Endometrial Carcinoma, Premenustral tension
    ORAL CONTRACEPTIVEs<\/strong>
    These are drugs taken orally to prevent conception. They are available in the following forms:<\/li>\n\n\n\n
  4. Combined regimen type<\/li>\n\n\n\n
  5. sequential regimen type<\/li>\n\n\n\n
  6. triphasic pill regimen
    Combined regimen: involves the administration of pills containing combination of Estrogen and
    Progestogen. They are administered starting 5th day of menustral cycle for 21 days.
    They can also be classified as fixed dose combination (monophasic), biphasic and triphasic
    pills. Fixed dose combination: the commonest procedure is to administer one pill containing both
    an estrogen and progestin daily at bed time for 21 days. In biphasic and triphasic pills: these are
    combined oral contraceptive pills containing varying proportion of an estrogen and a
    progesterone designed to stimulate the normal pattern of menustral cycle.
    Formulation:
    a) low estrogen, low progesterone(0.03mg ethinylestradiol+0.15 mg norgestril
    b) Low esterogen, high progestogen
    (0.03 mg ethinylestradiol + 1.5 mg norethindrone)
    137
    c) High estrogen, high progestrone
    (0.05 mg ethinylestradiol + 0.5 mg norgestril)
    Mechanism: includes inhibition of release of FSH and LH, increase viscosity of cervical mucus
    endometrial changes, interfere with contraction of cervix, uterus and fallopian tube
    Single Entity preparation<\/strong>
    A. Continuous progestrone
    i) Oral progestrone
    Norethindone (Norgestril)
    ii) Depot
    IM injection of long acting progestogen.
    e.g. Medroxyprogestrone acetate (Depoprovera\u00ae)
    iii) Subcutanous implant
    L \u2013 norgestril (Norplant\u00ae)
    Mechanism: It makes cervical mucus thick, though & hostile and also alter endometrial wall
    B. Post coital \u201cmorning after\u201d pill
    Oestrogen like Diethyl stilbosterol used within 72 hrs
    Combined oral contraceptive pills can also be used.
    Side effects of oral contraceptive: Thromboembolic complication, Weight gain & fluid retention,
    Menstrual disorder, Breast tenderness & fullness, Skin changes, Nausea & vomiting, Depressed
    mood, Reduced lactation
    Beneficial effects of estrogen \/progesterone oral contraceptive
    1) Reduced risk of endometrial Carcinoma, ovarian cyst
    2) regular Menses, No excessive blood loss
    3) Less premenustrual tension and dysmennorrhea
    4) Relief of endometriosis
    Contraindication:<\/strong> In patients withcardiovascular diseases (hypertension, coronary heart
    disease)
    Thromboemolic disease, breast Cancer, diabetes mellitus, liver disease, women > 35 years
    (esp. smokers and hypertensives)

    Drug interaction:<\/strong><\/li>\n\n\n\n
  7. Effect reduced when taken with enzyme inducers like Rifampicin, Phenytoin,
    Phenobarbitone etc. It may result in unexpected pregnancy and spotting.<\/li>\n\n\n\n
  8. Oral contraceptive antagonize the effect of Coumarin anticoagulant and some
    antihypertensives
    Ovulation inducing drug<\/strong>
    These are drugs used in the treatment of infertility due to ovulatory failure.
    Clomiphen
    It is antiestrogenic drug. It interferes with estrogen feedback inhibition at hypothalamus and
    anterior pitutary so enhance secretion of FSH, LH causing ovarian stimulation which finally
    leads to ovulation.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    OestrogensThese drugs can be classified into three groups.<\/p>\n","protected":false},"author":1,"featured_media":6510,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[683],"tags":[],"class_list":["post-6644","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-endocrine-drugs"],"jetpack_featured_media_url":"https:\/\/workhouse.sweetdishy.com\/wp-content\/uploads\/2024\/11\/18179857.png","_links":{"self":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts\/6644","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/comments?post=6644"}],"version-history":[{"count":1,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts\/6644\/revisions"}],"predecessor-version":[{"id":6645,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts\/6644\/revisions\/6645"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/media\/6510"}],"wp:attachment":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/media?parent=6644"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/categories?post=6644"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/tags?post=6644"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}