Gynecological Hormonal Drugs

Gynecological Hormonal Drugs

 Hormonal Drugs

Hormonal drugs are also known as endocrine drugs. Which medication influence the endocrine system & which regulates various physiological process through hormones.

Types of hormonal drugs

1.Hormone replacement therapy

2.Hormone modulators

3.Gonadotropin releasing hormone

4.Insulin

5.Cortico steroid

6.Anabolic steroids

1.Hormone replacement therapy

These drug replace hormones that the body is producing enough of such as estrogen for menopause or thyroid for hypothyroidism.

These drugs primarily involve estrogen, progesterone. This drugs use for manage, symptom of menopause & other condition related to hormonal imbalance.

Doses form of hormone replacement therapy

Tablets, Patches, Gel & Sprays

Generic/ Trades name of hormone replacement therapy

Generic Name

Estrogen

Progesterone

Trade Name

Estradot, oestrogel

Utrogestan

Side effect of hormone replacement therapy

Changes in periods

Headaches

Breast pain

Nausea

Mood change

Fatigue & Dizziness

Contra indication/ Risk for hormone replacement therapy

Breast cancer

Blood clots

Stroke

2.Hormone modulators

These drugs interfere the effects of hormones. Example include Anti estrogen drugs like tamoxifen which block the effects of estrogen & aromatase inhibitors, which reduce the production of estrogen.

Hormone modulators drugs like selective estrogen receptor modulators. After the way hormones interact with the body acting in both against & antagonists in different tissue. These drugs are used to treat various conditions, including breast cancer& osteoporosis.

Example of Hormone modulators drugs

Tamoxifen

Raloxifene

Clomiphene

Ospemifene

Aromatase inhibitors

Indication/ Uses of Hormone modulators drugs

Breast cancer treatment

Osteoporosis

Infertility

Menopause

Side effect of Hormone modulators drugs

Hot faces

Mood changes

Risk of blood clots & osteoporosis

Risk of heart attack, stroke

Muscle pain

Fatigue, nausea, vomiting

3.Gonadotropin releasing hormone (GnRh) Analogs.

These drugs can either stimulate OTC suppress the release of Gonadotropin which are important for reproductive function.

GnRh cell bodies are located in medical preoptic area & in the arcuate / infundibular Neucleus of the hypothalamus. It stimulates the pituitary glands to release FSH & LH. Which is important for function of ovaries & testes.

 4. Insulin

Insulin is an important hormone that produce by beta cell of the pancreatic islets.

Used to treat diabetes by regulating blood Glucose levels.

Function of Insulins

It moves glucose from our blood stream into the body’s cell to make energy.

If you don’t have enough insulin glucose builds up in your blood stream rather than getting into your cell to provide energy

Insulin types & example

1.Rapid Acting

Humalog

Novorapid

Apidra

2.Short Acting

Actrapid

Humulin R

Novolin R

3.Intermediate Acting

Humulin NPIT

Nonolin N

4.Long Acting

Lantus

Levemir

Tresiba

Premixed Insulin

This Insulin combination of short Acting and Intermediate Acting Insulin

Humolong Mix 50/50

Humalog Mix 75/25

Novomix 30

Penmix 30,40,50

Mixtand 30

5.Cortico steroid

A class of hormones e Anti- Inflammatory & immunosuppressive effects used for various condition like allergies, asthma etc.

Cortico steroids are a class of medications that act like the hormone cortisol which is naturally produced by adrenal glands

They are used to reduce inflammation and suppress the immune system, making them effective for a wide range of conditions. This medication can be administered in various ways, including orally, topically or trough injections.

Name of cortico steroid drugs

Cortisone

Prednisolone

Methylprednisolone

Dexamethasone

Betamethasone

Hydrocortisone

Side effects of corticosteroid

Osteoporosis (most common)

Cushinogoid feature

Increase risk of infection

Skin changes (thinning of skin)

Mood changes (insomnia)

Metabolic effect- increase appetite, weigh gain, hyperglycemia

 Gastrointestinal issues, stomach upset

Other- Swelling of legs, high blood pressure

6.Anabolic steroids

Used to increase muscle growth & treat contain medical condition but also have potential side effect.

Anabolic Steroids are medications that are manufactured forms of testosterone. The technical terms for these compounds is anabolic androgen steroids. Anabolic refers to tissue building (mainly muscle) and androgenic refers to group of sex hormone called androgen.

Testosterone is the main androgen. It stimulates is the development of male characteristics level of testosterone are naturally much higher in men then woman.

This drug used for low testosterone male hypogonadism. But they use it for other conditions as well, such as to stimulate muscle growth for people e cancer or AIDS.

Some other, body builders and other muscle these drugs are an attempt to enhance performance and improve their physical appearance.

Doses form of Anabolic Steroids

Pills,

Injection,

Cream & Topical gel

Skin patches

Implantable pellets

Name of Anabolic Steroids

Danazol

Fluoxy mestesone

Mestenolone

Methyltestostenone

Nandnolone phenpropionate

Oxandnolone

Oxymetholone

Testosterone capsule

Testosterone Injction

 Testosterone Nasal gel

Indication of Anabolic Steroids

Primary male hypogonadism

Hypogonadotropic hypogonadism

Delayed puberty in male children

Gonadotropin & Luteinizing hormone repleasing

Breast cancer

Endomatniasis

Osteoporosis

Details of Gynecological Hormonal Drugs

Gynecological Hormonal Drugs are the drugs managing various female reproductive health conditions. This Medication primarily regulate hormonal imbalance. Abnormal gynecological system and sometimes prevent disease progression.

Gynecological Hormonal Drugs are

1.Combined oral contraceptives (COCs)

This pills combine synthetic estrogen and progestin to prevent ovulation, regulation menstrual cycle and reduce menstrual bleeding. They are also effective in treating conditions like polycystic ovary syndrome endometriosis and acne. How over they may not reduce the size of uterine fibroid.

2.progesterone only pills & Devices

Progesterone oral or vaginal: Used for luteal phase support in Assisted reproductive technology (ART) cycles and to prepare the endometrium for implantation in infertility therapy.

Levonorgestrel releasing intra uterine:  System (LNG-IUS) –Effective in treating menorrhagia (heavy menstrual bleeding) and also used in the management of adenomyosis.

3.GnRh Agonist & Antagonist

GnRh agonist (eg. Leuprolide): suppress ovarian estrogen production leading to a temporary fibroids and manoge endometriosis symptoms.

 GnRh Antagonist: offer a quicker onset of action & are used in combination with add back therapy to reduce side effects.

4.Danazol- Synthetic androgen that suppress ovarian function and reduce estrogen production. It is used in the treatment of endomentriosis but may have androgenic side effects such as weight gain. Acne and voice changes.

5.Gastrinone: An anti-progestin and anti estrogen agent used in the treatment of endometriosis and uterine fibroids. It has fewus androgenic side effects compared to danazol.

6.Spirinoloctone– An anti-androgenic medication used to treat hirsutism in woman e pcos. It can cause menstrual irregulation and is often used in combination with oral contraceptives.

7.Hormone replacement therapy (HRT)-Used to prevent menopausal symptoms such as hot fuses and vaginal dryness by supplementing estrogen and in some cases progesterone. Doses form of Hormonal replacement therapy –oral, transdermal or vaginal preparation.

Some common disease & its hormonal treatment

 1.Endometriosis– Endometriosis is characterized by the growth of endometrial tissue outside the uterus, leading to pain and infertility. Hormonal therapies aim to suppress estrogen production, reducing the growth of endometrial tissue. CnRh analogs, progestine and aromatase inhibitors are common by used. Aromatase inhibitors block estrogen production and when used shown benefits in pain control and quality of life.

2.Polycystic ovary syndrome (PCOS)- PCOS is a common hormonal disorder affecting woman of reproductive age characterized by irregular periods, Acne hirsutism and infertility treatment focuses are managing symptoms & reducing the long term complications. Hormonal contraceptives regulate menstrual cycles and lower androgen levels, while anti androgens like spironolactone adrens symptoms and reducing the risk of long term complications. Hormonal contracptive regulates menstrual cycles and lower androgen levels, while anti androgens like spironolactone adrens symptoms such as acne and exceess haite growth. Metformin may be used to improve insulin sensitivity.

Causes of PCOS– Hormonal imbalance genetics, Insulin resistance.

Symptoms- Irregular periods, excess hair growth. Acne, infertility, weigh gain.

Treatment—1) Lifestyle changes (Diet, exercise)

                       2) Hormonal birth control

                        3) Metformin for Insulin Resistance

                       4) Fertility treatments if pregnencency desired.

3.Uterine fibroids-

 Causes– Benign tumor in the uterus exact causes unknown.

 Symptoms– Heavy menstrual bleeding pelvic pressure, pain                                             during intercourse.

Treatment-Medication to shrank fibroids

                   Non- invasive procedures

                  Surgical options (Myomectomy or hystenectory)

4.Pelvic Inflammatory Disease-

Causes– Bacterial infection, other from sexually transmitted infection (STIs)

Symptoms- Lower abdominal pain, fever, unused discharge, painful intercourse.

Treatment-

Antibiotics

Hospitalization for severe cases

Treatment of sexual pastness

5.Ovarian cyst–

Causes- Fluid filled sacs on the ovary often related to the menstrual cycle.

Symptoms- Often a symptomatic but may include pain, bloating.

Treatment-

Monitoring (Most cysts resolve on their own)

Birth control pills

Surgery if cysts are large or persistant

6.Cervical-

Causes- Primarily caused by HPV (Human papilloma virus) infection.

Symptoms- Abnormal bleeding, pelvic pain, vaginal discharge.

Treatment-

Surgery (Hysterectomy)

Radiation therapy

Chemotherapy

HPV vaccination for prevention

Hormonal Drugs- For PCOS

1. Combined oral contractives (cocs)
2.  Progestines
3. Anti androgens (eg- Spironolactone)
4. Metformin

For Endometriosis-

1. GnRh agonists (Eg- Leaprolide)
2. Progestins (eg- Nore ethidrone, Medroxyprogestesone)
3. Combine oral contraceptiues

For uterine fibroids

1. GnRh agonists
2. Progestins
3. Tronaxamic acid

For PID

1. Combined oral contraceptive pills eg- Ethinylestradiol = Levonorgeshol Ethinyestradiol + Drospirenone
2. Progestneo only pills or therapy eg. Norethisterone
3. Levonorgestrol Rebeasing Intra-uterine Device (IUD)