Drugs Used in Disorders of the Reproductive System



Drugs Used in Disorders of the Reproductive System



Overview


Sex hormones include androgens, progestins, and estrogens. They are produced by the gonads and the adrenal glands and are necessary for conception, embryonic maturation, and development of primary and secondary sexual characteristics during puberty. These hormones are used therapeutically as contraceptives, as therapy for postmenopausal complications and breast cancer, and as replacement therapy in hypogonadism.


Combination oral contraceptives (COCs) are effective in blocking ovulation in approximately 98% of patients and come in many different formulations. Ethinyl estradiol and mestranol are the commonly used estrogens; desogestrel and norgestimate are commonly used progestins. Also used for contraception are progestin-only formulations to inhibit or delay ovulation and emergency preparations such as mifepristone (RU-486), given along with misoprostol, for medical termination of intrauterine pregnancy. Although COCs do have adverse effects, they are associated with benefits unrelated to contraception, such as a reduced risk of ovarian cysts, and can also ameliorate other menstrual and reproductive system abnormalities, acne, and hirsutism. Their ability to induce neoplasms is controversial.


The doses of estrogen used in hormone replacement therapy (HRT) for treatment of postmenopausal symptoms including vasomotor manifestations, genitourinary atrophy, and osteoporosis are substantially less than those used in oral contraceptives (OCs). The risks and benefits of estrogen in postmenopausal women with regard to cardioprotection, neuroprotection, and carcinogenicity have been a subject of much debate and are the focus of considerable research efforts.


Certain hormonelike drugs whose estrogenic activities are tissue selective (the selective estrogen receptor modulators, or SERMs) have different therapeutic uses, including prevention and treatment of breast cancer (tamoxifen) and osteoporosis (raloxifene).


Infertility associated with anovulatory menstrual cycles can be treated by use of antiestrogens such as clomiphene.


In female patients with failure of ovarian development, therapy with estrogen, usually in combination with progestin, replicates most of the events of puberty. Testosterone replacement therapy is used for male patients with hypogonadism.








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Jun 21, 2016 | Posted by in PHARMACY | Comments Off on Drugs Used in Disorders of the Reproductive System

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