Medical Pharmacology Chapter 31:  Endocrine: Gonadal Hormones

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Gonadal Hormones and Inhibitors:  Table of Contents

Classification

Physiology/Endocrine Background

Estrogens

 

 

Testis

 

 

 

Steroid Hormone Classification

(partial listing)

 

Some structures of Interest

Puberty: Mechanism and ovarian function

Estrogens

Some Commonly Used Estrogens

Ethinyl estradiol

Micronized estradiol

Estradiol cypionate

Estradiol valerate

Estropipate

Mixed estrogenic agents

Eiethylstilbestrol

Quinestrol

Chlorotrianisene

Methallenestril

 

Estrogen Biosynthesis/Metabolism

 

Physiological Effects:Estrogens

Estrogens: Clinical Uses

 

Progestins

Some Progestational Compounds and their Biological Activities

Agent

Activities

Progesterone and derivatives

estrogenic

androgenic

anti-estrogenicccc

antiandrogenic

anabolic

progesterone

-

-

+

-

-

Hydroxyprogesterone capoate

-/+

-/+

-

-

-

Medroxyprogesterone acetate

-

+

+

-

-

Megestrol acetate

-

+

-

+

-

17 ethinyl -testosterone derivatives and testosterone drivatives

         

Dimethisterone

-

-

-/+

-

-

19-Nor-testosterone derivatives

         

Desogestrel

-

-

-

-

 

Norethynodrel

+

-

-

-

-

Norethindrone

-/+

+

+

-

+

Ethynodiol acetate

-/+

+

+

-

 

L-Norgestrel

-

+

+

-

+

 

 Progesterone effects: Metabolic

Stimulates lipoprotein lipase

Promotes fat deposition

Limited effect on protein metabolism

Significant effect on carbohydrate metabolism

Increases basal insulin levels

Increases insulin response to glucose

Promotes glycogen storage (liver)

Promotes ketogenesis

Progestins without androgenic activity include

Desogestrel

Gestodene

Norgestimate

 

 

Other Ovarian Hormones

Hormonal Contraception

 

 

Clinical Uses

 

Adverse Effects: Contraceptives

 

   Mild Adverse Effects: contraceptives

  Moderate Adverse Effects:

(these effects may require discontinuation of oral contraceptive use)

   Severe Adverse Effects:

Primary Reference: Goldfien, A., The Gonadal Hormones and Inhibitors, in Basic and Clinical Pharmacology, (Katzung, B. G., ed) Appleton-Lange, 1998, pp 653-680.

Carr, B. R. and Bradshaw, K.D, Disorders of the Ovary and Female Reproductive Tract , In Harrison's Principles of Internal Medicine 14th edition, (Isselbacher, K.J., Braunwald, E., Wilson, J.D., Martin, J.B., Fauci, A.S. and Kasper, D.L., eds) McGraw-Hill, Inc (Health Professions Division), 1998, pp 2097-2115.

Mitchell-Leef, D.E. Endometriosis in Medicine for the Practicing Physician, Fourth edition, (Hurst, J. Willis, editor in chief) Appleton and Lange, 1996, pp 751-755.

 
 
 
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