Chapter 56_drugs female_reproductive_disorders_audio

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Drugs for female reproductive disorders :

Drugs for female reproductive disorders Chapter 56

Oral contraceptives:

Oral contraceptives Act by prevent conception Combination of estrogen/progesterone or progesterone only ‘ minipill ’

Estrogen/progesterone combinations:

Estrogen/progesterone combinations Prevent contraception by suppressing pituitary release of FSH and LH Make endometrium less hospitable Make cervical mucus more hostile to sperm Preparations vary according to amount of estrogen **Goal-prevent ovulation w/as few side effects as possible

3 types:

3 types Monophasic Fixed ration E to P throughout cycle Biphasics Amount E fixed P varies (less at first, more later) to mimic natural physiology Triphasics Amt of E or P varies throughout cycle Deliver low doses Prescribed for acne Ortho Try- cyclen


variations Seasonale (generic is Quasense ) Seasonique First extended-cycle BCP 91 day course 84 active, 7 placebo pills Reduces periods to 4/year Used for women w/ endometriosis, dysmenorrhea , PMS , ovarian cysts Always have a SUNDAY start

Progesterone Only:

Progesterone Only ‘mini pill’ Alters cervical mucus, endometrium Inhibits implantation May block LH release Less circulatory side effects Less effective If pill taken >3 hrs late , use back up contraception x48 hrs More break through bleeding

Nursing educational points:

Nursing educational points w/ combo pills, missing > 1 pill ->increasing pregnancy risk Ab interferes w/many BCPs Estrogen SE: N/V, breast tenderness, fluid retention, edema, cramps Progesterone SE: wt gain, dysmenorrhea , oily skin/acne,


Depo-Provera 1 IM injection every 3 months Suppresses ovulation, changes pH of vaginal mucosa May breast feed Wt gain, decreased libido, hair loss, depression Increases bone loss & breakthrough “spotting” an issue


Patch Ortho evra Weekly patch Once a week for 3 weeks Week off Prevents ovulation, fertilization, implantation Many physiologic advantages Decreased cancers, bleeding, premenstrual syndrome etc Skin reaction


NuvaRing Indwelling ring Releases E and P locally In 3 weeks, out 1 week Cardiovascular/clot risk similar to other hormonal contraceptives

IUDs (intrauterine devices):

IUDs (intrauterine devices) Best for women w/ low risk of STIs ParaGard T (10 yrs) causes inflammation of endometrium Heavy menstrual flow and painful cramping Mirena (5 yrs) thickens cervical mucus, changes endometrium Improves Menorrhagia , may stop periods

Hormone replacement therapy HRT:

Hormone replacement therapy HRT Tx of vasomotor symptoms, vaginal dryness Estrogen/progesterone Increased risk of breast ca, Thromboembolism , coronary heart disease, stroke Medroxyprogesterone ( Provera ) Patch, vaginal cream Estring - Releases hormones for 3 mos Femring Estrasorb cream

Herbal Treatments: Menopause:

Herbal Treatments: Menopause Black cohosh : symptoms of menopause, such as hot flashes, irritability, mood swings, and sleep disturbances. Soy products : reduce the frequency and severity of hot flashes