NSG 511 Exam 4
ovaries and estrogen/progesterone pathway - hypothalamus > GnRH > anterior pituitary > FSH/LSH > ovaries
- ovaries/follicles > Estrogen > uterus
- ovaries/corpus luteum > Progesterone/Estrogen > Uterus
- hormones are in bold
testes and testosterone pathway - hypothalamus > GnRH > anterior pituitary > FSH/LSH > testes/seminiferous
tubules/interstitial cells
- testes/interstitial cells > testosterone
- hormones are in bold
ovaries/estrogen feedback loops positive:
- GnRH stimulates pituitary
- FSH/LH stimulates ovaries
- estrogen inhibits hypothalamus and pituitary
female reproductive cycle if not pregnant - corpus luteum breaks down
- progesterone drops
- menstruation begins
- hypothal. releases GnRH; stimulates pituitary
- pituitary releases FSH and LH; stimulates ovaries
- ovaries release estrogen; stimulates ovulation
- uterine lining builds
- progesterone increases
- chance for pregnancy
female reproductive cycle if pregnant - egg is fertilized
- zygote forms
- HCG stimulates corpus luteum to release progesterone
- uterine lining is maintained
reproductive phases of ovaries follicular phase:
- follicle matures and ovum develops
- ovulation occurs on day 14
luteal phase:
- released ovum matures into corpus luteum
reproductive phases of endometrium - day 1-5; menses
- day 5-13; endometrium proliferates (proliferative phase)
- day 14 - 28; secretory phase
reproductive phases of ovarian hormones estrogen:
- initially low
- increases until ovulation (day 14)
- another smaller peak around day 25 as progesterone levels begin to decline
progesterone:
- begins to increase just before ovulation
- peaks around day 21
- drops off quickly
reproductive phases of pituitary gonadotropins FSH:
- low, plateau
- small spike at day 14
LH:
- low(er), plateau
- large spike at day 14
effect of ovarian estrogen on the follicle and follicle:
endometrium. - estrogen peaks as ovulation occurs
endometrium:
- Proliferation of uterine epithelium
- endocervical mucus production
, NSG 511 Exam 4
State the physiologic effects of estrogen - Sexual maturity: Female secondary sex characteristics
- Reproductive cycle: Follicular and luteal phases - Proliferation of uterine
epithelium and endocervical mucus production (among others)
- Bones: Block the actions of osteoclasts.
- Cholesterol: Favors HDL and nitric oxide - considered cardioprotective
- Coagulation: Complex, but clinically estrogen considered thrombogenic.
State the physiologic effects of progesterone. - Reproductive cycle: Luteal phase - secretory phase and hypertrophy of the
endometrium in preparation for implantation of zygote.
- If no pregnancy, corpus luteum breaks down, progesterone declines, and
endometrium sheds (menstruation).
pharmacological uses of estrogen and progesterone - Contraception
- Menopausal hormone therapy
- Gender affirmation and transgender health
- Cisgender: Male and female hypogonadism (deficient sex hormones)
what hormone is used in the implant rod (Nexplanon) - progesterone
and what is its general effectiveness? - "works really well"
- < 1:100 women become pregnant
what hormone is used in intrauterine device and what is - levonorgestrel (progesterone) OR copper (non-hormonal)
its general effectiveness? - "works really well"
- < 1:100 women become pregnant
what hormone is used in oral contraceptive pills, and - combined estradiol and progestin or progestin only
what is its general effectiveness? - "OK"
- 6-9:100 women become pregnant
what hormone is used in dermal patch, and what is its - estradiol and progestin
general effectiveness? - "OK"
- 6-9:100 women become pregnant
what hormone is used in vaginal ring, and what is its - estradiol and progestin
general effectiveness? - "OK"
- 6-9:100 women become pregnant
what hormone is used in long acting (depo) injection, and - medroxyprogesterone
what is its general effectiveness? - "OK"
- 6-9:100 women become pregnant
birth control mechanism of action Exogenous administration activates the negative feedback loop and turns off
pituitary secretion of follicle stimulating and luteinizing hormone
Side effects of Excess estrogen (r/t oral contraceptives): - nausea
- breast tenderness
- edema
side effects of Excess progestin (r/t oral contraceptives): - increased appetite
- fatigue
- depression
side effects of Deficit estrogen or progestin (r/t oral Menstrual irregularities
contraceptives):
progesterone only pill MOA and considerations - MOA: alter the cervical mucosa making it hostile to sperm and making the
endometrium less susceptible to implantation.
- The person still ovulates.
- Slightly less effective than combination pills
- None of the side effects associated with excess estrogen
- increased progesterone side effects PLUS spotting which declines with long
term use but is a common reason for discontinuation
ovaries and estrogen/progesterone pathway - hypothalamus > GnRH > anterior pituitary > FSH/LSH > ovaries
- ovaries/follicles > Estrogen > uterus
- ovaries/corpus luteum > Progesterone/Estrogen > Uterus
- hormones are in bold
testes and testosterone pathway - hypothalamus > GnRH > anterior pituitary > FSH/LSH > testes/seminiferous
tubules/interstitial cells
- testes/interstitial cells > testosterone
- hormones are in bold
ovaries/estrogen feedback loops positive:
- GnRH stimulates pituitary
- FSH/LH stimulates ovaries
- estrogen inhibits hypothalamus and pituitary
female reproductive cycle if not pregnant - corpus luteum breaks down
- progesterone drops
- menstruation begins
- hypothal. releases GnRH; stimulates pituitary
- pituitary releases FSH and LH; stimulates ovaries
- ovaries release estrogen; stimulates ovulation
- uterine lining builds
- progesterone increases
- chance for pregnancy
female reproductive cycle if pregnant - egg is fertilized
- zygote forms
- HCG stimulates corpus luteum to release progesterone
- uterine lining is maintained
reproductive phases of ovaries follicular phase:
- follicle matures and ovum develops
- ovulation occurs on day 14
luteal phase:
- released ovum matures into corpus luteum
reproductive phases of endometrium - day 1-5; menses
- day 5-13; endometrium proliferates (proliferative phase)
- day 14 - 28; secretory phase
reproductive phases of ovarian hormones estrogen:
- initially low
- increases until ovulation (day 14)
- another smaller peak around day 25 as progesterone levels begin to decline
progesterone:
- begins to increase just before ovulation
- peaks around day 21
- drops off quickly
reproductive phases of pituitary gonadotropins FSH:
- low, plateau
- small spike at day 14
LH:
- low(er), plateau
- large spike at day 14
effect of ovarian estrogen on the follicle and follicle:
endometrium. - estrogen peaks as ovulation occurs
endometrium:
- Proliferation of uterine epithelium
- endocervical mucus production
, NSG 511 Exam 4
State the physiologic effects of estrogen - Sexual maturity: Female secondary sex characteristics
- Reproductive cycle: Follicular and luteal phases - Proliferation of uterine
epithelium and endocervical mucus production (among others)
- Bones: Block the actions of osteoclasts.
- Cholesterol: Favors HDL and nitric oxide - considered cardioprotective
- Coagulation: Complex, but clinically estrogen considered thrombogenic.
State the physiologic effects of progesterone. - Reproductive cycle: Luteal phase - secretory phase and hypertrophy of the
endometrium in preparation for implantation of zygote.
- If no pregnancy, corpus luteum breaks down, progesterone declines, and
endometrium sheds (menstruation).
pharmacological uses of estrogen and progesterone - Contraception
- Menopausal hormone therapy
- Gender affirmation and transgender health
- Cisgender: Male and female hypogonadism (deficient sex hormones)
what hormone is used in the implant rod (Nexplanon) - progesterone
and what is its general effectiveness? - "works really well"
- < 1:100 women become pregnant
what hormone is used in intrauterine device and what is - levonorgestrel (progesterone) OR copper (non-hormonal)
its general effectiveness? - "works really well"
- < 1:100 women become pregnant
what hormone is used in oral contraceptive pills, and - combined estradiol and progestin or progestin only
what is its general effectiveness? - "OK"
- 6-9:100 women become pregnant
what hormone is used in dermal patch, and what is its - estradiol and progestin
general effectiveness? - "OK"
- 6-9:100 women become pregnant
what hormone is used in vaginal ring, and what is its - estradiol and progestin
general effectiveness? - "OK"
- 6-9:100 women become pregnant
what hormone is used in long acting (depo) injection, and - medroxyprogesterone
what is its general effectiveness? - "OK"
- 6-9:100 women become pregnant
birth control mechanism of action Exogenous administration activates the negative feedback loop and turns off
pituitary secretion of follicle stimulating and luteinizing hormone
Side effects of Excess estrogen (r/t oral contraceptives): - nausea
- breast tenderness
- edema
side effects of Excess progestin (r/t oral contraceptives): - increased appetite
- fatigue
- depression
side effects of Deficit estrogen or progestin (r/t oral Menstrual irregularities
contraceptives):
progesterone only pill MOA and considerations - MOA: alter the cervical mucosa making it hostile to sperm and making the
endometrium less susceptible to implantation.
- The person still ovulates.
- Slightly less effective than combination pills
- None of the side effects associated with excess estrogen
- increased progesterone side effects PLUS spotting which declines with long
term use but is a common reason for discontinuation
