Hormones & reproduction

Hypothalamus GnRH Anterior pituitary LH, FSH Gonads (ovaries, testis)

Releasing of sex hormones Female Progesterone, Estrogen Male Testosterone Sex hormones are steroidal hormones which are synthesized from cholesterol

 Estrogens Important for the growth of genital structures & appearance of 2nd sexual characteristics. Clinical uses of estrogens Most frequent uses are for 1.contraception (with Progestins) 2.Primary Hypogonadism (failure of ovarian function) estrogen is used in combination with progestin to stimulate growth & development of 2nd sex characteristics

 Given with Progestin (to prevent endometrial CA) S/Es: Thromboembolism

Progestins
The endogenous hormone is progesterone which is orally inactive

Therapeutic uses: Contraception 1. With estrogen in combined OC pill 2. As progesterone only contraceptive pill 3. As injectable (e.g.: Norgestrel), progesterone only contraception
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S/Es: edema, weight gain,

III. Androgens Testosterone is the main natural androgens, it is synthesized in the testis & in smaller amount by adrenal cortex Testosterone is inactive orally / 1st pass effect Fluoxymesterone: is testosterone analog that is active orally

 Therapeutic uses 1. Androgenic insufficiency 2. Has anabolic effect it progression of osteoporosis it counteract the catabolic effect of externally administered cortical hormones 3. Growth: it is used in conjunction with other hormones to promote skeletal muscle growth in prepubertal boys with pituitary dwarfism

Drugs used for contraception The are 2 types of oral contraceptives. a. Combined pills They contain progestin & estrogen. MOA: 1. Estrogen inhibit FSH release & thus suppreses the development of the ovarian follicle. 2. Progestin inhibit LH secretion & thus prevent ovulation, it also makes the cervical mucus less suitable for the passage of sperm.

 It is taken for 21 consecutive days out of 28. start from the first day of the menstrual cycle to day 21,followed by 7pill-free days which causes withdrawal bleeding.

S/Es: nausea, vomiting, wt gain CV complication: deep venous thrombosis, pulmonary embolism, hypertension,MI.


1. 2. 3. 4. 5. 6. 7.

C/Is:
History of DVT,PE. CVA. Cardiovascular disease Heavy smoker &age >35. Pregnancy. Breast/endometrial cancer. Abnormal liver function.

b. The progestin- only pill ( mini pill) They are taken continuously (every day each time) They are less effective than combined pills. Irregular bleeding is common.

c. Injectable contraceptives: Medroxyprogesterone acetate injected/I.M./ 3months

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