Sex Steroid pharmacology - Drugs and uses
Hypothalamic estrogen receptor antagonist (e.g. clomifene)
Ovulatory failure: ^ GnRH > ^ LH/FSH > hyper-stimulated ovary > multiple
follicles
BHCG
- Ovulatory failure: LH analogue > stimulate ovulation
- Undescended non-functioning testis: LH analogue > stimulate testosterone
- Male infertility: LH analogue > stimulate sperm production (use with FSH
analogue)
GnRH agonists (e.g. naferilin, goserilin)
- General: ^LH/FSH (initially), vLH/FSH (due to down regulation)
- Endometriosis: v LH/FSH > v estrogen, progesterone > reduce
proliferation ectopic endometrial tissue
- Precocious puberty: v LH/FSH > v estrogen, progesterone > v secondary
sex characteristics
- Female hirsuitism: v LH > v ovarian androgens > v secondary male
characteristics
Aromatase inhibitor [anti-estrogen] e.g. tamoxifen, anastrozole
- General: v androgen to estrogen conversion
- Gynaecomastia: v estrogen > breast tissue stimulation
- Premature puberty: v estrogen > v bone epiphyseal closure
- Breast cancer: v estrogen > v estrogen sensitive breast cancer growth
5-alpha reductase inhibitor [anti-androgen] e.g. finasteride
- General: v testosterone to dihydrotesterone (DHA) conversion
- BPH: v DHA > v prostate hyperplasia
- Male alopecia: v DHA > v androgenic hair loss
- Female hirsuitism: v DHA > v secondary male characteristics
Estrogen-Progestin
- General: v GnRH > v FSH/LH
- Contraception: v FSH > v follicular maturation, v LH > prevent
ovulation; Endometrial atrophy, progesterone > ^ cervical mucus
- Female hirsuitism/hyperandrogenism: v LH > v ovarian androgen production
> v ACTH > v adrenal adrenal production > v secondary male characteristics
- Anovulatory bleeding
- Excessive ovulatory bleeding (menorrhagia):
- Painful ovulatory bleeding (dysmenorrhea)
- Endometriosis: v LH/FSH > v estrogen, progesterone > reduce
proliferation ectopic endometrial tissue
- Polycystic ovarian syndrome: v FSH > v follicular maturation, v LH > v
ovarian androgen production > v ACTH > v adrenal adrenal production > v
secondary male characteristics
Glucocorticoids
- Female hirsuitism: v ACTH > v adrenal adrenal production > v secondary
male characteristics
Androgen (e.g. Danazol)
- General: v GnRH > v LH/FSH
- Endometriosis: v LH/FSH > v estrogen, progesterone > reduce
proliferation ectopic endometrial tissue
- Polycystic ovarian syndrome: v FSH > v follicular maturation
- Testosterone
- Delayed male puberty
- Male hypogonadism