Pills with female hormones for beauty. Types of hormonal drugs for women

Depending on a person’s gender, certain hormones dominate in his body, thanks to which secondary sexual characteristics are formed. In a woman’s body, this function is performed by estrogens - steroid hormones, the action of which allows a woman to remain a woman. They are produced by the ovaries and adrenal cortex, and during pregnancy they are produced by the placenta.

What functions do estrogens perform in the female body, why is it important to maintain their normal level, and what drugs help achieve the desired goal?

Translated from ancient Greek, the word “estrogen” means “kind”, “liveness” and “brightness”. That is why, with the normal production of these hormones, a woman performs her reproductive function and flourishes. A lack of these substances leads to infertility and deterioration of appearance. However, their excess is no less dangerous, causing the formation of hormone-dependent tumors.

With the onset of a certain age, the production of estrogen in girls’ bodies is activated, which causes puberty to occur. Under the influence of these hormones, changes occur in the tissues of the genital organs. In addition, estrogens contribute to the manifestation of secondary sexual characteristics in the form of breast growth, roundness of body shape, and they also influence the development of interest in the opposite sex.

In combination with other hormones, estrogens influence metabolic processes in tissue cells. With normal concentrations of these hormones in women, the appearance of hair and skin improves.

Preparations with estrogens are prescribed for the following conditions:

ovarian failure, characterized by a decrease or complete cessation of hormone production;
to relieve symptoms accompanied by women during menopause;
in the absence of the production of one’s own hormones in the case of removal of the uterus and appendages;
conditions caused by excess male hormones, including androgenetic alopecia and acne;
underdevelopment of the genital organs;
contraception, which can be used not only tablets, but also gel.

Insufficient estrogen production leads to menstrual irregularities and infertility. Restoration of reproductive function is possible with the use of hormone replacement therapy, as well as vaginal products that restore tissue of the vagina and cervix. One of these products is vaginal gel.

Types of estrogen-containing drugs

All medications containing estrogen are divided into two groups.

Therapeutic. This group may include any medications used to correct hormone levels in endocrine diseases.
Contraceptive. This group of drugs is prescribed for the purpose of contraception.

In medical practice, drugs that can stabilize a woman’s hormonal levels have long been used. All of them have not only certain advantages, but also disadvantages, causing harm to the body. Pharmacologists are constantly working to develop new drugs that have less pronounced side effects. However, it is recommended to take them only if there are certain indications.

There are several types of estrogen-containing drugs.

Natural steroids containing estrogens, isolated from biological organisms, usually from animal urine, which is the cause of the frequent development of allergic reactions in humans.
Synthetic analogues are obtained in laboratories through chemical transformations. These drugs are highly effective and are used to treat many hormone-dependent diseases.
Natural steroid compounds are phytoestrogens obtained from plant materials through synthesis. They are used when there is no natural production of hormones by the body, for example, during menopause.

Medicines in tablets

drugs containing exclusively estrogens;
combination preparations containing estrogens and gestagens.

All hormonal drugs for women are divided according to the direction of action:

oral contraceptives;
means of hormone replacement therapy.

Products used to replenish the body's lack of hormones, which are estrogen in tablets, are used to treat menstrual irregularities and restore reproductive function in women. Such drugs effectively relieve menopause symptoms and stabilize hormonal levels in pregnant women. The estrogen contained in such tablets is most often estradiol. And the most popular among them are the following pharmaceutical products:

Estradiol. This medicine is most often prescribed to women during menopause to restore hormonal levels.
Premarin is used for menstrual irregularities, as well as for uterine bleeding.
Extrofeminal is prescribed in case of infertility. It helps stabilize hormone levels in women of reproductive age.
Hormoplex is a broad-spectrum drug. It can be used by women regardless of age and the reasons for the lack of hormones.
Proginova. This drug, like the previous one, can be used for any manifestations of hormonal deficiency (from 138 rubles).
Ovestin. The active ingredient in this drug is estriol. Indications for its use are symptoms of menopause, infertility and concomitant conditions after undergoing operations to remove reproductive organs (from 763 rubles).
Triquilar is a combined estrogen-progestogen drug containing high doses of hormones (from 469 rubles).
Microgynon. This drug, like the previous one, belongs to the group of combined estrogen-progestogen drugs (from 261 rubles).

The most popular contraceptives are the following birth control pills:

Aktivel;
Janine (from RUB 817);
Lindinet (from 358 rub.);
Femoden (from 526 rub.);
Yarina (from 878 rub.).

All of these birth control pills are monophasic contraceptives with low estrogen content. Their operating principle is based on the fact that synthetic estrogen, once in the body, promotes the production of natural hormones, as a result of which ovulation does not occur.

It is necessary to take any estrogen-containing drugs, including contraceptives, together with a progestin drug.

Vaginal preparations

Estrogen cream and gel are inserted into the vagina using an applicator. The hormone in this form has a beneficial effect on vaginal tissue and the urinary system. The cream is intended to relieve the symptoms of menopause and helps prevent changes caused by a lack of hormones. Vaginal estrogen tablets and suppositories have a similar effect.

The most popular vaginal medications include the following:

Ogen – cream;
Estrace – cream;
Estraderm - cream;
Estrogel - gel (from 584 rub.);
Ovestin - tablets and suppositories (from 763 rubles).

Phytoestrogens in tablets

Currently, the following phytoestrogens are used in the manufacture of medicines based on plant analogues of hormones:

lignans;
isoflavones;
salonins – steroidal and triterpenoid;
kumestans;
acid resorcylic lactones;
phytosterols.

However, phytoestrogens are contained in negligible quantities in foods and herbs. Therefore, to increase efficiency in the production of tablets, plant extracts are used.

Phytoestrogens contain the following drugs:

Inoklim - made on the basis of estrogens isolated from soybeans. In addition to being highly effective, this drug has virtually no side effects.
Feminal - made from red clover extract. This drug eliminates the symptoms of menopause, improves the functioning of the heart and blood vessels, and also strengthens bone tissue. The cost of this drug starts from 814 rubles.
Qi-Klim, Estrovel, Klimadinon. These preparations contain natural phytoestrogens obtained from the cimifuta plant. Their composition is also supplemented with a vitamin and mineral complex. Therefore, taking them significantly improves the appearance of women. You can buy these drugs at prices ranging from 220 rubles, 446 rubles. and 332 rub. respectively.
Klimafem contains natural phytoestrogens isolated from red clover and hops. This product effectively eliminates the symptoms of menopause and improves skin condition.

Side effects

Side effects may occur when taking estrogen tablets:

increase in the size of the mammary glands;
swelling of the limbs;
weight gain;
convulsions;
decreased appetite and bloating;

nausea and vomiting caused by problems with the gallbladder and liver;
bleeding from the vagina;
yellowing of eyes and skin;
shortness of breath and dizziness;
diarrhea;
headache;
increased libido.

To avoid side effects, you can buy medicines with natural estrogens of plant origin, as well as vaginal suppositories, cream or ointment, gel and tablets that have a targeted effect. They will restore reduced hormone levels without affecting internal organs.

The drugs are used to treat many diseases of the female reproductive system. In order for the use of these drugs to be safe, it is necessary to know their characteristics, indications and contraindications.

- These are the female steroid sex hormones estrone, estriol and estradiol. The ability to become pregnant, the phase of the menstrual cycle, as well as the general well-being of a woman depend on their content in the blood.

Therefore, estrogen preparations are used for therapeutic purposes, in replacement therapy and for contraception.

Indications for use

The doctor may prescribe for the following indications:

genitals during menopause;
hypofunction of the ovaries associated with various diseases of these organs, after radiation, chemotherapy and their partial removal;
post-castration syndrome, which develops after removal of the ovaries for one reason or another;
osteoporosis associated with menopause;
hypogonadism – underdevelopment of the gonads associated with chromosomal abnormalities;
hair loss and other pathological conditions that develop with an increase in the level of male sex hormones in a woman’s blood (hyperandrogenism);
severe acne that cannot be treated locally;
contraception for medical reasons or at the request of the patient. Typically, estrogen-containing drugs are prescribed to women after undergoing uterine surgery or abortion;
endocrine infertility;
before performing in vitro fertilization using a donor egg. The use of hormonal drugs is necessary in order to synchronize the menstrual cycle of the recipient and the donor;
some types of pregnancy pathology, for example, weakness of labor, postmaturity, etc.

Important! The use of hormonal drugs without indications can lead to the development of severe complications. To prevent this, it is recommended to consult a doctor before starting treatment and undergo all required diagnostic procedures.

List of estrogen-containing drugs and preparations

They can be prescribed in various forms. The only difference will be in the speed of their absorption and entry into the body. Your attending physician should determine what you need.

What tablets does it contain?

Hormonal drugs in the form of tablets are the main dosage form used for replacement therapy. This is due to its high digestibility and effect on the body as a whole.

The doctor may prescribe if any of the above indications are present. The most commonly used are estradiol or estriol. The duration of administration and dosage are selected individually depending on the level.

There is a separate group of hormonal drugs for contraception. It includes funds:

Diana-35;
Yarina;
Janine et al.

They are used depending on the day of the menstrual cycle, at the end of which they take a break of 7 days. The dosage is selected by the attending physician based on research data, depending on the type of contraceptive drug.

Names of patches

Transdermal hormonal drugs are a modern dosage form that allows you to achieve an effect on a woman’s body throughout the day.

Thanks to this, the level of hormones in the blood remains approximately at the same level, there are no sudden jumps, which reduces the likelihood of developing complications.

Representatives of this group of drugs are Klimara, Extratherm, Evra. They can be used as a contraceptive, during menopause, and menstrual irregularities.

The duration of use is determined individually depending on the purpose of use and the severity of symptoms.

Vaginal suppositories and ointments

Usually used for the treatment of menopausal syndrome. They have a pronounced local effect, effectively reducing vaginal discomfort and other symptoms. Representatives of this group of drugs are Ovipol Clio, Ovestin, Estrocad, Revitaxa, etc.

Synthetic estrogen preparations in the form of ointments or gels are also used for local therapy. The principle of their action and indications do not differ from vaginal suppositories.

How to increase with herbal remedies?

Sometimes, with a slight deviation, it is wiser not to use hormonal drugs, but to take advantage of the gifts of nature. But this must be done strictly in consultation with a doctor and never self-medicate.

Flax seeds

This product is considered the most effective herbal remedy indicated for reducing estrogen levels.

Flax seeds not only increase the content of these hormones in the blood, but also help cleanse the body and have an antitumor effect.

In pharmacies you can find an extract of flaxseeds, which can also be used when signs of menopause appear.

Hog queen

This phytotherapeutic agent is also quite effective in reducing the level of estrogen in the blood. Doctors often prescribe it to patients with infertility.

Important! Products based on boron uterus are not recommended for use together with synthetic hormonal drugs. This is due to the high likelihood of developing complications when using medications simultaneously.

Before starting treatment, you should consult with a specialist, and during the course of therapy you should undergo periodic tests. The duration of treatment should not exceed three months.

Are there non-hormonal ones?

These drugs are usually prescribed to neutralize the unpleasant effects of menopause. Be sure to consult your doctor.

In ampoules

To neutralize the manifestations of menopausal syndrome, doctors often prescribe drugs that affect the nervous system.

For example, a remedy such as Atarax reduces the severity of anxiety, excitability, sleep disturbances, and normalizes cardiac activity. It is available in 2 ml ampoules; intramuscular administration at night is recommended.

Drugs from the company "Evalar"

For non-hormonal therapy during menopause, you can use Qi-Clim from the Evalar company. It is based on an extract of the black cohosh plant, which contains phytoestrogens.

The use of Qi-Clim helps relieve a woman from such manifestations of menopausal syndrome as:

mood disturbance;
irritability;
sleep disorders;
sweating

The effect of using the drug occurs gradually, the peak is observed two to four weeks after the start of treatment.

The difference between synthetic and natural

First of all, it should be noted that natural remedies that increase the level of estrogen in the blood are not complete medicines.

These are dietary supplements that have less, and often unproven, effectiveness, but are much less likely to cause the development of undesirable effects when used. Therefore, they are used as an adjunct to primary therapy.

Contraindications

Contraindicated for use in the following cases:

the presence of benign neoplasms of the reproductive system and mammary glands;
mastopathy;
malignant neoplasms of any location, not only organs that belong to the reproductive system;
increased levels of estrogen in a woman’s blood during menopause;
endometritis;
diseases associated with excessive growth of the endometrium, for example, endometriosis.

To exclude the presence of contraindications for use, you must first undergo a full examination. In addition, after starting treatment, the doctor should regularly monitor the patient’s condition and laboratory test results. Thanks to this approach, it is possible to promptly identify a developing complication and change the treatment regimen.

Overdose during treatment with estrogen

nausea, vomiting;
vaginal bleeding;
significant swelling;
impairment of consciousness due to blood loss.

Important! If you suspect the development of this condition, you should consult a doctor as soon as possible. The patient is hospitalized in a hospital, where she must be under the supervision of specialists.

First aid

There are no specific measures aimed at eliminating hyperestrogenism due to an overdose of hormones. To remove the remaining medication from the body, gastric lavage is performed. After this, maintenance therapy is prescribed, which includes diuretics, vitamins, etc.

Side effects

There is a high probability of developing undesirable effects associated with blood clotting disorders, target organ damage and changes in metabolism.

More often noted:

the development of thrombosis or thromboembolism due to increased blood clotting. The likelihood of this complication is especially high if a woman is diagnosed with varicose veins, in the presence of hematological diseases;
mood instability, depression;
regular migraine-like headaches;
the occurrence of edema of the lower extremities associated with changes in mineral metabolism, fluid retention in the body;
liver failure, cholecystitis, cholangitis. These complications are associated with changes in cholesterol metabolism, changes in the composition of bile;
indigestion, which can be manifested by diarrhea, constipation, nausea, lack of appetite and other symptoms.

If any of the listed undesirable effects are observed during use, the treatment regimen should be changed. Sometimes changing the medication is enough, but often it is necessary to completely stop taking hormones.

Important! With long-term use of estrogen drugs, the likelihood of developing tumors of the breast and other organs, and endometrial cancer increases. Therefore, during treatment it is necessary to undergo regular examinations by a gynecologist.

Is it possible to enlarge breasts and glands?

Breast size depends on two factors: the level of female sex hormones in the blood and genetic characteristics. If a woman has previously experienced hypoestrogenism, that is, a decrease in estrogen concentration, then when taking hormonal drugs, some enlargement of the mammary glands is possible.

Estrogen is usually classified as a type of steroidal female sex hormones produced by the follicular apparatus of the ovaries. However, some of it can be synthesized in the male body (in the testicles). In addition, it is produced in small quantities in the adrenal glands of both women and the stronger half of humanity.

Estrogens are biologically active substances that ensure the normal functioning of various organs and systems of the body.

They are synthesized from androgens through an enzymatic reaction.

The hormone can be produced by:

follicular apparatus of the ovaries;
adrenal cortex;
placenta;
male testicles;

To date, 3 types of steroid hormones have been identified.

Therefore, it is often called in the plural – estrogens.

Among them:

Estradiol is the most active steroid hormone that is produced in the female body in the ovaries, and in the male body through the conversion of testosterone.
Estrone– the second most important hormone after estradiol. It is synthesized from androstenedione, the main androgen produced by the female ovaries.
Estriol- a minor and inactive hormone. However, during pregnancy it plays the most important role, as it helps improve blood flow through the vessels of the uterus and is involved in the development of the mammary glands.

Together with the movement of blood through the vessels, estrogens can be transferred to any corner of the human body.

Most often they are found:

in the mammary glands;
in the organs of the genitourinary system;
liver;
pituitary gland;
hypothalamus;

Estrogen can be synthesized not only in the human body. It also occurs naturally.

It can be found in the following products:

in milk;
legumes;
soy products;
some vegetables and fruits;
in various types of fish and meat;
coffee;

It is no coincidence that estrogens are classified as female hormones. They have a feminizing effect on the body.

With the direct participation of this hormone, the development of the organs of the reproductive system occurs, as well as the formation of secondary sexual characteristics of the female type, which include:

Appearance of hair on the pubis and armpits.
Enlargement of the mammary glands.
Formation characteristic shape of the pelvis.

The amount of hormone present in the female body increases during puberty and decreases significantly after menopause.

A decrease in estrogen levels often causes:

Sleep disturbance.
The appearance of osteoporosis.
Rush of blood to the skin of the face.
Reduction of the organs of the genitourinary system.
The occurrence of diseases of the cardiovascular system.

Role

The main function of estrogens– regulation of the normal functioning of the female reproductive organs. They provide support to the body during pregnancy.

The main functions of the presented steroid hormone for the female body:

Security normal and regular menstrual cycle.
Stimulation secretion of vaginal mucus, creating a favorable environment for the survival of sperm and further fertilization of the egg.
Reducing cholesterol and low density lipoproteins.
Improvement brain activity.
Maintenance normal blood pressure.
Harmonious distribution of fat deposits, which creates soft and feminine contours of the figure.
Preparation female body to motherhood.
Prevention development of atherosclerosis.
Regulation water-salt balance.
Participation in the process of natural hydration skin surface.
Regulation normal functioning of the sebaceous glands.
Maintenance bone strength.
Stimulation formation of new bone tissue.

Estrogens directly affect a woman’s psyche. A decrease in the amount of steroid hormone contributes to the occurrence of frequent mood swings, depressed and irritable states (PMS).

Estrogens are also synthesized in the male body, just like testosterone in the female body.

On average, their amount is 50–130 pmol/l.

For men, the presented steroid hormone performs the following functions:

Regulation of work cardiovascular system.
Influence on brain activity.
Improve e memory.
Formation libido.
Maintenance normal amount of cholesterol.
Participation during the process of muscle growth.

Estrogen is often used to prevent the development of prostate cancer in men. However, an excess of the hormone present can contribute to male infertility, breast formation and feminine body contours.

Indications and contraindications

A large or insufficient amount of estrogen negatively affects the functioning of the entire body.

Its lack often leads to the following consequences:

Slowdown development of the reproductive system in adolescents.
Irregular menstrual cycle or its absence altogether.
Depressed mental state, sudden change of mood.
Painful periods.
Memory impairment.
Unreasonable weight gain.
High blood pressure.
Frequent constipation.
Decreased performance and the appearance of insomnia.
Deterioration of skin condition.

If you have at least three of the above symptoms, you should immediately contact an experienced gynecologist-endocrinologist. In this case, estrogen tablets are most often prescribed.

In addition, this drug is necessary in the following cases:

For the treatment of menopause.
IN as a contraceptive.
For normalization menstrual cycle.
For vaginal dryness and decreased sexual desire.
For the treatment of infertility and with weak labor activity.

For the production of medicines, the hormone is often obtained from soybeans or sweet wild potatoes. This process is carried out by purifying the plants and forming a molecule that is almost identical to the one produced by the ovaries.

Hormones are often produced synthetically. The resulting synthetic estrogen has a chemical structure that is somewhat different from the structure of its natural counterpart. However, such a hormone can have a stronger effect on the body.

The following symptoms may indicate this:

Cold extremities arms and legs.
Breast tumor and uterus.
Migraine and irritability.
Breast tenderness.
Hair loss and acne on the skin.
Bloating and swelling.

Excess hormone can lead to:

Mastopathy.
Breast cancer.
Heavy premenstrual syndrome.

In addition, taking estrogen drugs is contraindicated if:

hypertension;
thrombophlebitis;
cancerous tumors;
long-term smoking;

Advantages and Disadvantages

Advantages of estrogen tablets:

Maintaining normal balance hormone in the human body.
Positive Impact on the activity of the brain and cardiovascular system.
Formation of new bone tissue.
Normalization menstrual cycle.
Monitoring glucose levels.
Regulation metabolism.

The disadvantages are the presence of a number of side effects, as well as the high cost of the drug itself.

Side effects

Taking estrogen pills may cause the following:

Bloating and constant thirst.
Nausea and headache.
Soreness mammary glands.
Menorrhagia.
Sudden change of mood.
The appearance of irregular bleeding.
Increased blood pressure.
Fluid retention in the body.
Excess weight.

Review

There are 2 types of drugs containing estrogen:

Contraceptives.
Medicines treatment group necessary for the correction of diseases.

The most well-known and popular means of contraception include:

"Janine"

"Lindynet"

(20 tablets – from 410 RUR)

"Femoden"

To correct hormonal imbalances in women, replacement therapy and during menopause, tablets containing female sex hormones can be used. The main female sex hormones include estrogens and gestagens (progesterone), which are produced by the ovaries. Before prescribing any female sex hormone in tablets to correct the menstrual cycle, you need to know in which phase of the cycle it works and what functions it performs. Also, pills that contain female hormones are used as contraceptives. But birth control pills with female hormones can contain either estrogen or progesterone, or both hormones (combination contraceptives). In order to correctly choose the right female sex hormone for treatment, you need to know their functions in the body.

Estrogen and progesterone - functions

The main female sex hormones, estrogen and progesterone, are not only produced in different phases of the cycle, but also perform different roles in the body. Functions of hormones:

are produced by the ovaries in the first phase of the cycle and contribute to the destruction and subsequent proliferation of the endometrium. Additionally, estrogens affect the appearance of secondary sexual characteristics, increase the deposition of subcutaneous fat, normalize the condition of the skin and mucous membranes, cholesterol metabolism, and increase bone density.
Progesterone is produced by the ovaries from the beginning of the second phase and ensures ovulation and implantation of a fertilized egg, supports the maintenance of pregnancy, preventing the uterus from contracting and ensuring its growth, and prepares the mammary glands for milk production.

Female hormones in tablets - names and functions

Female sex hormones are produced in tablets: estrogens, progesterone and combination preparations containing both estrogens and gestagens. Less commonly used are herbal medicine tablets that increase female sex hormones in the body. Tablets containing estrogens (most often estradiol) are indicated for replacement therapy after removal of the ovaries and for complications of menopause, for some forms of breast cancer and for contraception. Contraindicated for uterine tumors and a tendency to thrombosis. Most often, these drugs are taken strictly by number on certain days of the cycle, since they contain a different dose of hormones for each phase. Among the most well-known, we can list such names of estrogens in tablets as Ovestin, Regulon, Premarin, Rigevidon, Miniziston.

Tablets containing female hormones gestagens (progesterone and its synthetic analogues) - Progesterone, Utrozhestan. They are indicated for threatened miscarriage in the first trimester, premenstrual syndrome, fibrocystic mastopathy, endometriosis, menstrual irregularities, and for replacement therapy after removal of the ovaries. Progesterone tablets are contraindicated in the second half of pregnancy, renal and liver failure, high blood pressure, diabetes, bronchial asthma, thrombosis and thrombophlebitis, epilepsy, migraine, lactation and ectopic pregnancy.

Tablets containing both estrogens and gestagens - combined hormonal drugs, are used both for contraception and for the hormonal regulation of menstrual irregularities. They are divided into high, low and micro-dosed (50; 30-35 and 15-20 mcg EE/day), monophasic (same doses of hormones in all phases of the cycle) and triphasic (different doses of hormones in different phases).

Androgens are steroid hormones produced by the gonads and adrenal cortex, which have the property of causing androgenesis and the development of male secondary sexual characteristics in both sexes. In boys, under the influence of androgens in the prenatal period, internal genital organs are formed, and during puberty, an increase in muscle mass is stimulated, libido and potency are formed. In women, androgens in concentrations characteristic of men cause an increase in the size of the clitoris and labia and the rapprochement of the labia, partial atrophy of the mammary glands, uterus and ovaries, cessation of menstruation and ovulation, and infertility. Androgens also have a direct effect on the mental sphere, making a person aggressive, rude, hypersexual, and stimulate hematopoiesis, increasing the number of erythrocytes (red blood cells) and hemoglobin.

The main natural androgen is testosterone, but there are other androgens: dihydrotestosterone, androsterone, androstenedione, androstenediol.

Testosterone is synthesized in the body from cholesterol, but itself is biologically inactive and has a weak affinity for androgen receptors (it is actually a prohormone), however, under the action of the enzyme 5?-reductase it is converted into a biologically active form - dihydrotestosterone, which has a high affinity for androgen receptors and more active.

Mechanism of action

The action of androgens is due to interaction with specific intracellular receptors, which ultimately leads to activation of the expression of certain genes and the development of pharmacological effects.

Indications

Testosterone preparations are used in case of deficiency of this hormone due to primary or secondary hypogonadism in men as replacement therapy.

Adverse reactions

Androgens in high concentrations in the body suppress the secretion of LH (luteinizing hormone) and FSH (follicle-stimulating hormone), thereby inhibiting testicular function, which leads to a decrease in the ability to fertilize (fertility) and infertility.

Under the influence of the aromatase enzyme, testosterone can be converted into estrogens (female sex hormones) and cause gynecomastia.

Other undesirable reactions of androgens are: impaired liver function, an increase in the number of red blood cells, an increase in hemoglobin levels, the appearance of acne, hypertension, alopecia, etc.

Female sex hormones. Estrogens

Estrogens are steroid sex hormones produced primarily by the follicular apparatus of the ovaries in women, but estrogens are also produced in small quantities by the testes in men and the adrenal cortex in both sexes.

In humans, the main estrogens are estradiol, estriol and estrone, which are synthesized from androgens (estriol and estradiol from testosterone; estrone from androstenedione) under the action of the aromatase enzyme. There are also synthetic estrogens such as ethinyl estradiol, mestranol, etc.

Mechanism of action estrogen is caused by interaction with specific intracellular receptors, movement of the receptor complex into the nucleus, its interaction with estrogen-sensitive DNA elements, resulting in activation of gene transcription processes and acceleration of the synthesis of specific proteins, which determine the development of the pharmacological effects of estrogens.

Pharmacological effects

Estrogens in the female body ensure puberty and the development of female secondary sexual characteristics: vagina, uterus, fallopian tubes, and also activate the growth of mammary gland ducts and stroma; participate in the regulation of ovulation and prepare the genital organs for fertilization and implantation.

Estrogens increase bone mass, inhibit the removal of calcium from bones and thereby protect bones from the development of osteoporosis. Also, this group of hormones has an anti-atherosclerotic effect, as a result of which it prevents the occurrence of myocardial infarction and other cardiovascular disasters; increases blood clotting and retains fluid in the body.

The introduction of estrogens into the body, for example, as part of drugs, in the proliferative phase of the menstrual cycle according to the principle of negative feedback can lead to inhibition of the production of FSH by the pituitary gland and a slowdown in the growth and maturation of follicles in the ovaries.

Indications

Estrogens are used in clinical practice for conditions after removal of the ovaries and other pathological conditions as part of replacement therapy.

Adverse reactions

The use of estrogens may be associated with the risk of developing thrombosis and thromboembolism, endometrial cancer, breast cancer and other estrogen-dependent tumors, edema, weight gain, emotional lability and other complications.

Female sex hormones. Gestagens (progestins)

Progestins are steroid hormones produced mainly by the corpus luteum of the ovaries and partly by the adrenal cortex, as well as by the placenta of the fetus. The main progestin hormone in humans is progesterone. There are also synthetic analogues of gestagens on the market: medroxyprogesterone, megestrol, dydrogesterone, cyproterone, levonorgestrel, desogestrel, norethisterone, drospirenone, etc.

The main physiological role of gestagens in women is mainly to enable the onset and then to maintain pregnancy (gestation).

Mechanism of action is caused by interaction with gestagen receptors and subsequent activation of transcription of specific genes.

Pharmacological effects

Progestins suppress the secretion of luteinizing hormone (LH) from the pituitary gland according to the principle of negative feedback, prepare the endometrium for implantation and development of a fertilized egg, stimulate the growth, enlargement and maturation of the mammary glands, reduce the excitability and contractility of the muscles of the uterus and fallopian tubes, and increase the viscosity of cervical mucus.

Indications

Gestagens are widely used in clinical practice for the purpose of contraception, both as monocomponent drugs and in combination with estrogens. Also, this group of drugs can be effective in cases of miscarriage, hormone replacement therapy and some other hormone-dependent diseases.

Adverse reactions

The use of progestin drugs can lead to the development of insomnia, depression, menstrual irregularities, weight gain and other complications.

Hormonal contraceptives

Medicines containing female sex hormones can be divided into:

1. Combined contraceptives containing estrogen and progestogen components.

2. Monocomponent preparations (“mini-pills”) containing only gestagen.

3. Postcoital contraceptives used to prevent pregnancy in the first 72 hours after unprotected intercourse.

Combined contraceptives

In the composition of combined contraceptives, gestagenic effects significantly exceed estrogenic ones, therefore the contraceptive effect of the drugs is due primarily to the gestagenic component. The role of estrogens is to potentiate the inhibitory effect of gestagens on the secretion of gonadotropic hormones of the pituitary gland.

There are three main types of combined contraceptives depending on changes in the dose of gestagens (the dose of estrogen in the drug remains the same throughout the entire administration cycle): monophasic, biphasic and triphasic.

Monophasic combined contraceptives (Diane-35, Zhanin, Yarina, etc.) contain a constant dose of estrogen and gestagen throughout the entire cycle; V biphasic contraceptives (Anteovin, etc.) the estrogen content does not change, and the dose of gestagen is increased in the second phase of the cycle; V three-phase contraceptives (triquilar, tri-mercy, etc.) The estrogen content does not change, and the dose of gestagen increases stepwise.

Mechanism of contraceptive effect These drugs are associated with thickening of cervical secretions (difficulty in the penetration of sperm into the uterine cavity), suppression of ovulation, decreased peristalsis of the fallopian tubes, and changes in the structure of the endometrium (difficulty in implantation).

Indications Prescribing this group of drugs, in addition to contraception, in some cases may cause menstrual irregularities.

Adverse reactions

When using combined contraceptives, thrombosis of various locations may develop due to an increase in the concentration of coagulation factors caused by the action of estrogens. The risk of thrombosis increases with prolonged immobilization, in women who smoke or have obesity (BMI >30 kg/m?), arterial hypertension, heart valve disease or atrial fibrillation. Taking combined contraceptives can also cause swelling, increased blood pressure, weight gain, headaches, nausea, vomiting and other complications.

Progestin contraceptives

These drugs (exluton, charozetta, etc.) contain only gestagens and differ in their mechanism of action from combined estrogen-gestagen agents in that when they are used, ovulation is maintained.

Mechanism of action

Prevention of pregnancy when using minipills is associated with an increase in the viscosity of cervical mucus, disruption of coordinated contractions of the fallopian tubes and the implantation process.

Indications

Due to its pharmacodynamic characteristics, this group of drugs can be recommended for postpartum contraception in nursing women, since pure gestagens do not affect the quantity and quality of mother’s milk, as well as the duration of lactation. It is also possible to use monocomponent gestagen contraceptives in women of late reproductive age and in women who smoke.

Adverse reactions

Menstrual irregularities, metrorrhagia (irregular uterine bleeding), etc.

Postcoital contraceptives

Postcoital contraceptives are drugs that a woman can use to prevent pregnancy after unprotected sexual intercourse, however, due to the risk of severe complications, this type of contraception cannot be recommended as a method of permanent protection from pregnancy, even in the case of rare sexual intercourse. These drugs can be used only in emergency, exceptional cases, no more than once every six months, and only under the supervision of a doctor. Independent and regular use of drugs without medical supervision can lead to serious, including life-threatening complications.

Classification

For emergency hormonal contraception, use:

1. combined estrogen-gestagen drugs;

2. gestagens;

3. danazol;

4. mifepristone.

Mechanism of action postcoital contraceptives is associated with suppression or delay of ovulation, disruption of the processes of fertilization, transport and implantation of the egg. Moreover, the effectiveness of this method directly depends on the time that has passed from the moment of sexual intercourse to taking the drugs - post-coital contraceptives are advisable to use in the first 72 hours after sexual intercourse.

Adverse reactions

Nausea, vomiting, dizziness, breast tenderness, menorrhagia, menstrual irregularities, fainting, hypotension, lower abdominal pain, etc.

Antiandrogen drugs

Antiandrogen drugs are drugs that disrupt the formation of androgenic hormones or block their binding to specific receptors.

Drugs that interfere with androgen formation include finasteride, dutasteride, etc.

The mechanism of action of these drugs is associated with inhibition of the enzyme 5?-reductase in the prostate, which leads to a decrease in the formation of dihydrotestosterone and, as a consequence, a decrease in its stimulating effect on the division of prostate cells and a decrease in its size.

Indications

5β-reductase inhibitors are prescribed to men with benign prostatic hyperplasia for the purpose of symptomatic therapy.

Adverse reactions

Impotence, decreased libido, impaired ejaculation, gynecomastia, allergic reactions, etc.

Drugs that block androgen receptors include flutamide and bicalutamide, mechanism of action which is associated with antagonism of androgen receptors, which prevents the development of the biological effects of androgens in androgen-sensitive organs, such as the prostate gland in men.

Indications

These drugs are used for palliative treatment of prostate cancer and differential diagnosis of hypogonadism in men.

Adverse reactions

Gynecomastia and/or pain in the mammary glands, galactorrhea, fluid retention, decreased libido, impotence, nausea, vomiting, diarrhea or constipation, increased or lack of appetite, impaired liver and/or kidney function, etc.

Progestin also has antiandrogenic activity. cyproterone, mechanism of action which is associated with suppression of the secretion of gonadotropic hormones of the pituitary gland and reduces the effects of androgens in peripheral tissues.

Indications

In men, cyproterone is used to reduce hypersexuality, as well as for prostate cancer, and in women - for severe androgenization phenomena, such as severe hirsutism, androgen-dependent alopecia, severe forms of acne and seborrhea, etc.

Adverse reactions

Increased fatigue, dry skin, anxiety or depression, fatigue, decreased ability to concentrate, fluid retention in the body, changes in body weight, allergic reactions, etc.

Antiestrogenic drugs

Drugs with anti-estrogenic activity include estrogen receptor modulators (clomiphene, tamoxifen, toremifene, raloxifene) and inhibitors of estrogen hormone synthesis (formestane, exemestane, anastrozole, letrozole).

Mechanism of action estrogen receptor modulators is due to the fact that in some tissues, where these drugs have positive effects (bones, liver), they interact with estrogen receptors as agonists, and in others, where the growth-stimulating effect of estrogens is undesirable, for example, the mammary gland and endometrium, as antagonists.

Indications

Estrogen-sensitive tumors, breast and endometrial cancer.

Adverse reactions

Thrombophlebitis, thromboembolism, fatigue, depression, confusion, visual impairment, etc.

Mechanism of action inhibitors of the synthesis of estrogen hormones is caused by inhibition of the aromatase enzyme and an obstacle to the formation of estrone from androstenedione and estradiol from testosterone in peripheral tissues. Estrogen deficiency leads to suppression of the division of estrogen-dependent tissues.

There are steroids ( formestane, exemestane) and non-steroidal ( anastrozole, letrozole) inhibitors of estrogen hormone synthesis.

Indications

Breast cancer.

Adverse reactions

Anemia, hypertension, thrombophlebitis, thromboembolism, vaginal dryness, vaginal bleeding, myalgia, arthralgia, chest pain, back pain, decreased joint mobility, etc.

Antigestagens

Antigestagenic drugs include mifepristone(a derivative of 19-norethisterone), the mechanism of action of which is associated with competitive blocking of progesterone receptors, which leads to an increase in the contractile activity of the myometrium, stimulation of uterine contractions, desquamation of the decidua and expulsion of the fertilized egg.

Indications

Medical termination of intrauterine pregnancy in the early stages (up to 42 days of amenorrhea), confirmed by a pregnancy test; preparation and induction of labor during full-term pregnancy; emergency (postcoital) contraception within 72 hours after unprotected sexual intercourse; treatment of uterine leiomyoma.

Adverse reactions

Bloody discharge from the genital tract, menstrual irregularities, dyspepsia, insomnia, asthenia, leg pain, anxiety, anemia, etc.