Medication Summary
The goals of pharmacotherapy are to reduce morbidity and prevent complications.
Estrogens
Class Summary
Used to achieve adequate estrogenization of vaginal epithelium in young women and to maintain bone density.
Estradiol transdermal system (Alora)
Increases synthesis of DNA, RNA, and many proteins in target tissues.
Conjugated equine estrogens (Premarin)
Contains a mixture of estrogens obtained exclusively from natural sources, occurring as the sodium salts of water-soluble estrogen sulfates blended to represent the average composition of material derived from pregnant mares' urine. Mixture of sodium estrone sulfate and sodium equilin sulfate. Contains as concomitant components, sodium sulfate conjugates, 17-alpha-dihydroequilenin, 17-alpha-estradiol, and 17-beta-dihydroequilenin.
Available in 0.3-mg, 0.625-mg, 0.9-mg, 1.25-mg, and 2.5-mg PO tablets.
Progestins
Class Summary
When administered orally in the recommended doses to women adequately exposed to exogenous or endogenous estrogen, they transform the proliferative endometrium into a secretory one.
Medroxyprogesterone acetate (Provera)
Derivative of progesterone. Androgenic and anabolic effects have been noted, but apparently is devoid of significant estrogenic activity. Parenterally administered dosage form inhibits gonadotropin production, which, in turn, prevents follicular maturation and ovulation. Available data indicate that this does not occur when the usually recommended PO dose is administered qd.
Progesterone (Prometrium)
Used to prevent endometrial hyperplasia in women with a uterus who are receiving estrogen therapy.
Androgens
Class Summary
Responsible for normal growth and the development and maintenance of secondary sex characteristics in males. In addition, androgens have exhibited metabolic activity and may cause retention of nitrogen, sodium, potassium, and phosphorus and decrease urinary excretion of calcium. In the presence of sufficient caloric and protein intake, they will improve nitrogen balance. Androgens also have been reported to stimulate production of RBCs through the enhancement of erythropoietin production. Also increase muscle mass, improve muscle strength, and increase libido.
Methyltestosterone (Android)
Synthetic testosterone derivative with significant androgen activity. Tablets are available in 5-mg, 10-mg, and 25-mg strengths.
Testosterone enanthate or cypionate
Derivative of the primary endogenous androgen testosterone. For IM administration. In active form, androgens have a 17-beta-hydroxy group. Esterification of 17-beta-hydroxy group increases duration of action. Hydrolysis to free testosterone occurs in vivo.
Each mL of sterile colorless-to-pale yellow solution provides 200 mg testosterone enanthate in sesame oil with 5 mg chlorobutanol (chloral derivative) as preservative.
Tables
Ovarian Clinical Situation |
Menses |
Gonadotropins |
Fertility |
Occult insufficiency |
Normal |
Normal |
Reduced |
Biochemical insufficiency |
Abnormal |
Elevated |
Reduced |
Overt insufficiency |
Abnormal |
Elevated |
Reduced |
Premature ovarian failure |
Absent |
Elevated |
Zero |
