Hormon Wanita

DPMA
 OBJEKT
IF
1. Memberi definisi hormon wanita.
2. Menyatakan tujuan/ indikasi ubat.
3. Menyatakan dos dan contoh ubat.
4. Menyatakan kaedah pemberian
ubat.
1. Menyatakan tindakan ubat.
2. Menerangkan kesan sampingan
dan kontraindikasi ubat.
3. Memberikan nasihat spesifik
dalam pengambilan ubat.
 Female hormones

• Play a vital role because they

• Aid in development and
maintenance of secondary sex
characteristics.
• Are necessary for human
reproduction.
• Terdapat dua jenis hormon
wanita:
• Estrogens
• Progestrone
Estrogen
 Estrogens
• Hormon ini dirembeskan
oleh ‘ovarian follicle’ dan
‘adrenal cortex’ (small
amount).
• Penghasilan hormon ini
dipengaruhi oleh ‘anterior
pituitary’.
 Tindakan

• Perkembangan & penyeleng
garaan sistem pembiakan
wanita.
• Primary sex characteristics:
• Pertumbuhan organ
pembiakan wanita.
• Secondary sex
characteristics:
• Perubahan suara, payudara & 
pembesaran pelvis.
• Apabila cukup umur:
• Menggalakkan
tumbesaran & perkembangan 
vagina, uterus, tiub fallopio & .
• Penipisan mukus pangkal
rahim
• Memudahkan ovulasi
• meransang pengecutan
tiub falopio:
• Bagi pergerakan ovum
• Kembalikan endometrium selepas 
haid
• Memulihara kalsium dan fosforus
• Mempengaruhi pengeluaran gonad
otropins pituitari
 General Indication

• Terapi penggantian
hormon di kalangan
wanita menopaus..
• Melegakan gejala-
gejala menopaus.
• Female hypogonadism.
• Osteoporosis in
postmenopausal women.
• selepas pembuangan ovari b
agi wanita pra-menopaus.
• Primary ovarian failure.
• Rawatan paliatif untuk kanser 
prostat yang teruk.
• Rawatan paliatif untuk kanser
payudara..
 Contoh ubat

• Estrogen conjugated
(Premarin tab)
• Estrogen conjugated
(Premarin vaginal cream)
• Estradiol (Estrace)
1. Estrogen conjugated
0.625mg tablet
(Premarin tab)
Category: A
 Indication
• Gejala yang dikaitkan
dengan monopous
• Female
hypogonadism(ovari tidak
keluarkan hormon)
• Wanita yang mandul
• Primary ovarian failure
• Osteoporosis
• Palliative treatment of
prostatic & breast cancer
 Dose
• Menopausal symptom:
• 0.625mg/d PO
• (If no menses for 2 months –
can start therapy at any
time)
• If got menses – start therapy
on day 5 of bleeding)
• Female hypogonadism:
• 0.3-0.625mg/d PO for 20
days & 10 days rest

• Female castration, primary

ovarian failure:
• 1.25mg/d PO for 20 days &
10 days rest
• Osteoporosis:
• 0.625mg/d PO for 25 days &
5 days rest
• Breast cancer:
• 10mg tid PO for at least 3
months
• Prostate cancer:
• 1.25-2.5mg tid PO
 2. Estrogen conjugated
(Premarin vaginal cream)
Category: A

Indication
• Atropik vulvae vaginitis & k
raurosis yang dikaitkan den
gan menopause
 Dose

• Intravaginally or topically: 1-
2g/d depending on severity
of condition
• Do not exceed > 4g
 3. Estradiol (Estrace)
Category: A

Indication
• Symptoms associated with
menopause
• Female hypogonadism
• Female castration(buang
satu ovari)
• Primary ovarian failure
• Osteoporosis
• Palliative treatment of
prostatic & breast cancer
 Dose
• Menopausal symptom,
female hypogonadism,
castration & primary
ovarian failure:
• 1-2mg/d PO
• Osteoporosis:
• 0.5mg/d PO for 25 days & 5
days rest
• Breast cancer:
• 10mg tid PO for at least 3
months
• Prostate cancer:
• 1.25-2.5mg tid PO
 Kesan sampingan

• CNS:
• Headache
• Migraine
• Dizziness
• Mental depression
• Dermatologic:
• Chloasma (pigmentation of the
skin)
• Melasma (discoloration of the
skin)

• GIT:
• Nausea
• Vomiting
• Abdominal cramp
• Genitourinary:
• Bleeding
• Spotting
• Change in menstrual flow
• Dysmenorrhea
• Vaginal candidiasis
• Ophthalmic:
• Steepening of corneal
curvature
• Intolerance to contact lenses
• Others:
• Edema
• Changes in libido
• Breast tenderness & pain
• Pulmonary embolism
• Venous thromboembolism
 Contraindication

• Allergic to drug
• Estrogen dependent
neoplasm (cancer)
• Pregnancy
• Thromboembolism
 Cautious

• Gallbladder disease
• Hypercalcemia
• Cardiovascular disease
• Liver impairment
 Interactions
• Oral Anticoagulants
– Kesan oral anticoagulants
berkurang
• Tricyclic antidepressants
– Meningkatkan risiko toksisiti
antidepressants
• Rifampicin
– Kurangkan paras serum
estrogen
• Cigarette (rokok)
– Meningkatkan risiko
komplikasi kardiovaskular
 Soalan
1. Beri definisi ubat estrogen?
2. Terangkan cara tindakan
ubat estrogen?
3. Senaraikan contoh ubat
estrogen?
4. Nyatakan kesan sampingan
dan kontraindikasi ubat
estrogen?
Progesterone
 Progesterone
• Hormon ini dirembeskan
oleh ‘corpus luteum’
‘placenta’ dan ‘adrenal
cortex’ (small amount).
• Penghasilan hormon ini
dipengaruhi oleh ‘anterior
pituitary’.
 Tindakan

• Transform proliferative
endometrium into secretory
endometrium.
• Development of placenta
• Inhibit pituitary
gonadotropins
• Prevent menstruation &
ovulation
 General Indication

• Amenorrhea
• Endometriosis
• Abnormal uterine bleeding
• Oral contraceptives
 Contoh ubat

• Hydroxyprogesterone
caproate (Proluton-Depot)
• Medroxyprogesterone
acetate (Provera)
1. Hydroxyprogesterone
caproate 250mg/ml Inj
(Proluton-Depot)

Category: A
 Indication

• Amenorrhea
• Abnormal uterine bleeding
• Habitual abortion or for the
production of secretory
endometrium
 Dose
• Habitual abortion:
• 250-500mg weekly IM
(during first half of
pregnancy)
• Others:
• 125-375mg/d IM
2(a). Medroxyprogesterone
acetate 5mg/ 10mg tablet
(Provera)

Category: B
 Indication
• Amenorrhea
• Abnormal uterine bleeding
 Dose
• Amenorrhea:
• 5-10mg/day (5-10 days)
• Abnormal uterine bleeding:
• 5-10mg/day (5-10 days) on
day 15-21 of menstrual
cycle
2(b). Medroxyprogesterone
acetate 100mg/ 500mg tablet
(Provera)

Category: A
 Indication
• Breast carcinoma
• Endometrial carcinoma
• Renal carcinoma

Dose
• 250-500mg/day
 Kesan sampingan

• Bleeding
• Spotting
• Changes in menstrual cycle
• Breast tenderness
• Edema
• Weight increase or decrease
• Acne
• Chloasma
• Melasma
• Mental depression
 Contraindication
• Allergic to drug
• Thromboembolism
• Cerebral hemorrhage
• Impaired liver function
• Cancer of breast & genital
organs
• Pregnancy
 Cautious
• Migraine
• Epilepsy
• Asthma
• Cardiac or renal impairment
 Interactions

• Anti-epileptics & rifampicin

– Kesan progesterone
berkurang
 Estrogen &
Progesterone
Combination
Estrogen & Progesterone
Combination

• Gabungan 2 hormon bagi

mengimbangkan semula
paras estrogen dan
progesterone dalam badan.
 General Indication

• Hormon replacement
therapy
• Amenorrhea
• Menstrual irregularities
 Contoh ubat

• Estrogen + Progesterone
(Progyluton tab)
• Estrogen conjugated +
Medroxyprogesterone
(Prempak tab)
1. Estrogen + Progesterone
(Progyluton tab)
Category: B
 Indication

• Hormon replacement
therapy
• Amenorrhea
• Menstrual irregularities
 Dose

• Start on 5th day of menses:

• 1 tab/d for 21 days, then

stop for 7 days.
2. Estrogen conjugated +
Medroxyprogesterone
(Prempak tab)
Category: A

Indication
• Hormon replacement therapy
 Dose

• Start on 5th day of menses:

• 1 tab/d for 21 days, then stop

for 7 days.
 Kesan sampingan

• Kesan bagi estrogen

dan progesterone
 Contraindication
• Sama seperti estrogen
dan progesterone

Cautious
• Sama seperti estrogen
dan progesterone
 Interactions

• Penicillin & Tetracycline

– Kesan kombinasi estrogen &
progesterone berkurang
• Interaksi lain sama seperti
estrogen & progesterone
 Soalan
1. Beri definisi ubat progesterone?
2. Terangkan cara tindakan ubat
progesterone?
3. Senaraikan contoh ubat
progesterone?
4. Nyatakan kesan sampingan dan
kontraindikasi ubat
progesterone?
5. Nyatakan indikasi gabungan
estrogen dan progesterone?
6. Senaraikan ubat estrogen,
progesterone & gabungan
estrogen & progesterone?