Sex Hormones Question And Answers

Sex Hormones

Question 1. Enumerate Important Medications, Contraindications, And Adverse Reactions Of Oral Contraceptives.
or
Give An Account Of Adverse Reactions Of Oral Contraceptives.
Answer:

Oral Contraceptives.

Oral Contraceptives Important Medications

• Combined pills: It contains estrogen and progesterone.
• Mini pill: Progesterone-only pill
• Postcoital pill: Emergency contraceptive.

Oral Contraceptives Contraindications

The oral contraceptives are contraindicated:

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• Moderate to severe hypertension.
• Acute liver disease.
• Suspected cancer of the breast or genitals.
• Diabetes.
• Migraine.
• Cardiovascular diseases: Thromboembolism, thrombophlebitis disease, congestive cardiac failure.

Oral Contraceptives Adverse Effects

The adverse effects are dose-dependent

• Non­-Serious Side Effects:
  • Nausea and vomiting: Similar to morning sickness of pregnancy.
  • Headache: Migraine may be precipitated.
  • Breast discomfort
  • Amenorrhea may occur.
• Moderate Side Effects:
  • Weight gain, acne, and increased body hair
  • Pigmentation of cheek, nose, and forehead.
• Serious Complications:
  • Leg vein and pulmonary thrombosis.
  • Coronary or cerebral thrombosis resulting in myocardial infarction
  • Rise in blood pressure
  • Genital carcinoma: Increased incidence of vaginal, cervical, and breast cancer.

Question 3. Describe The Usage Of Estrogen.
Answer:

The following are the oral contraceptives:

• Combined pill
• Mini pill
• Postcoital pill.

Estrogen Combined Pill

• It is the combination of estrogen and progestin preparations.
• Ethinyl estradiol (30 to 50 mg) is the estrogen used. Progestins such as desogestrel and norgestimate are used.
• The combined pill should be started on the 5th day of the menstrual cycle and is taken daily for 21 days with a gap of 7 days during which bleeding occurs. This is a monophasic regimen.
• Mechanism of action: Estrogen and progestin act synergistically on hypothalamopitutary axis through a negative feedback mechanism and stop the release of follicular stimulating hormone and luteinizing hormone which makes inhibition of ovulation.
  This leads to tubal and uterine contractions which interfere with fertilization. This makes endometrium less suitable for implantation. The thick cervical mucus secretion prevents the penetration
  of sperm.

Estrogen Mini Pill

• It is a progestin-only pill.
• This pill should be taken without any gaps.
• Estrogen and its adverse effects are removed by the pill.
• Its efficacy is low and the menstrual cycle can be irregular, so this pill is not popular in its use.
• There is also the risk of ectopic pregnancy associated with this pill.
• Mechanism of action: Minipill causes alteration of cervical mucus and interferes with implantation and also inhibits ovulation.

Estrogen Postcoital Pill

• It is an emergency contraceptive.
• Drugs used are levonorgestrel, ulipristal and mifepristone.
• Mechanism of action: This pill interferes with implantation and it has anti-ovulatory effects.
• This pill is started within 72 hours of coitus.
• This pill is used following rape, unprotected intercourse, and the breakage of a condom during coitus.

Question 4. Describe The Usage Of Estrogen.
Answer:

• Estrogen is a female sex hormone.
• Estrogens are synthesized by the ovary and also by the placenta.
• Synthetic estrogen is also available.

Estrogen Uses

• Postmenopausal hormone replacement therapy: Estrogen improves physical mental and sexual well-being.
• In combination with progesterone as oral contraceptives.
• Treatment of primary hypogonadism is used with progesterone.
• Senile vaginitis: Estrogen change vaginal cytology to the premenopausal pattern.
• Dysmenorrhea: Cyclic estrogen therapy with progesterone benefits by inhibiting ovulation and decreasing pH synthesis.
• Acne and hirsutism: Due to relatively higher androgen production. Estrogen suppresses ovarian androgen production.

Question 5. Write In Brief About Mini Pills And Its Uses.
Answer:

• Minipill is a progestin only pill.
• This pill should be taken without any gaps.
• Estrogen and its adverse effects are removed by the pill.
• Its efficacy is low and the menstrual cycle can be irregular, so this pill is not popular in its use.
• There is also the risk of ectopic pregnancy associated with this pill.

Mini Pills  Mechanism Of Action

The mini pill causes alteration of cervical mucus and interferes with implantation and also inhibits ovulation.

Uses

• They are used as contraceptives.
• They are used in hormone replacement therapy.
• They are used in dysfunctional uterine bleeding.
• It is used in premenstrual tension.
• They are used in endometrial carcinoma.
• They are used in habitual abortion.