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

Depending on the gender of a person, certain hormones dominate in his body, due 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, their production is carried out 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 the ancient Greek language, 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. The 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 in the body of girls, the production of estrogen is activated, due to which puberty occurs. 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 growth of the mammary glands, roundness of body shapes, and they also affect the development of interest in the opposite sex.

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

Estrogen preparations are prescribed for the following conditions:

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

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

Varieties of estrogen-containing drugs

All medications containing estrogen are divided into two groups.

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

In medical practice, drugs that can stabilize the hormonal background of a woman have long been used. All of them have not only certain advantages, but also disadvantages, causing harm to the body. Pharmacologists are constantly working on the development of new drugs with less pronounced side effects. At the same time, it is recommended to take them only if there are certain indications.

There are several varieties of estrogen-containing drugs.

Natural steroids containing estrogens isolated from biological organisms, usually from the urine of animals, which is the reason for the frequent development of allergic reactions in humans.
Synthetic analogues are obtained in laboratories by chemical transformations. These drugs are highly effective and are used to treat many hormone-dependent diseases.
Compounds of natural steroids are phytoestrogens obtained from plant materials by synthesis. They are used in the absence of natural production of hormones by the body, for example, during menopause.

Preparations in tablets

preparations containing exclusively estrogens;
combined preparations containing estrogens and gestagens.

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

oral contraceptives;
means of replacement drug hormone therapy.

Means used to compensate for the lack of hormones in the body, which is estrogen in tablets, is used for menstrual irregularities and restoration of reproductive function in women. Such drugs effectively relieve the symptoms of menopause and stabilize the hormonal background in pregnant women. The most commonly used estrogen in these pills is estradiol. And the most popular among them are the following pharmacy 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 causes of hormone deficiency.
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 the symptoms of menopause, infertility and concomitant conditions after surgery to remove the reproductive organs (from 763 rubles).
Triquilar is a combined estrogen-gestagenic drug containing high doses of hormones (from 469 rubles).
Microgynon. This drug, like the previous one, belongs to the group of combined estrogen-gestagenic drugs (from 261 rubles).

The most popular contraceptives are the following birth control pills:

Activel;
Janine (from 817 rubles);
Lindinet (from 358 rubles);
Femoden (from 526 rubles);
Yarina (from 878 rubles).

All of these birth control pills are low-estrogen monophasic contraceptives. Their principle of action 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 progestogen drug.

Vaginal preparations

The estrogen cream and gel are inserted into the vagina using an applicator. The hormone in this form has a beneficial effect on the tissues of the vagina and the urinary system. The cream is designed 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 preparations include the following:

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

Phytoestrogens tablets

Currently, the following phytoestrogens are used in the manufacture of drugs based on plant analogs of hormones:

lignans;
isoflavones;
salonins - steroid and triterpenoid;
coumestans;
acidic resorcylic lactones;
phytosterols.

However, in foods and herbs, phytoestrogens are found in negligible amounts. Therefore, extracts from plants are used to increase efficiency in the production of tablets.

Phytoestrogens contain the following drugs:

Inoklim - made on the basis of estrogens isolated from soy. In addition to high efficiency, this drug has practically no side effects.
Feminal - made from red clover extract. This drug eliminates the manifestations 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. The composition of these preparations contains natural phytoestrogens obtained from the cymifuta plant. Their composition is also supplemented with a vitamin and mineral complex. Therefore, their reception significantly improves the appearance of women. You can buy these drugs at a price of 220 rubles, 446 rubles. and 332 rubles. respectively.
Klimafem contains natural phytoestrogens isolated from red clover and hops. This tool effectively eliminates the manifestations of menopause and improves skin condition.

Side effects

When taking estrogen tablets, side effects may occur:

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

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

To avoid side effects, you can buy medicines with natural plant estrogens, as well as vaginal suppositories, cream or ointment, gel and tablets that have a targeted effect. They will restore the low level of hormones without affecting the 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 features, indications and contraindications.

are the female steroid sex hormones estrone, estriol and estradiol. The possibility of getting pregnant, the phase of the menstrual cycle, as well as the general well-being of a woman depends 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:

genital with menopause;
hypofunction of the ovaries associated with various diseases of these organs, after radiation, chemotherapy and partial removal;
post-castration syndrome that develops after the 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 the blood of a woman (hyperandrogenism);
severe acne, which is not amenable to local treatment;
contraception for medical reasons or at the request of the patient. Usually, estrogen-containing drugs are prescribed to women after surgery on the uterus, abortions;
endocrine infertility;
before 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 pathology of pregnancy, for example, weakness of labor, overbearing, etc.

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

List of estrogen-containing drugs and preparations

They may be given in various forms. The difference will be only in the speed of the method of their assimilation and entry into the body. Your attending physician should determine what you need.

What tablets contain?

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

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

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

Diana-35;
Yarina;
Jeanine and others

Apply them 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 on the basis of research data, depending on the type of contraceptive drug.

Names of patches

Transdermal hormonal agents are a modern dosage form that allows you to achieve an effect on a woman's body during the day.

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

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

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

Vaginal suppositories and ointments

Usually used for the treatment of menopausal syndrome. They have a pronounced local effect, effectively reduce vaginal discomfort and other symptoms. Representatives of this group of drugs are Ovipol Clio, Ovestin, Estrocad, Revitax, 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 boost with herbal remedies?

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

Flax seeds

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

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

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

upland uterus

This phytotherapeutic agent also has a fairly high efficiency in reducing the level of estrogen in the blood. Doctors often prescribe it to patients with infertility.

Important! Means based on the boron uterus are not recommended for use together with synthetic hormonal preparations. This is due to the high likelihood of complications with the simultaneous use of drugs.

Before starting the reception, you need to consult with a specialist, and during the course of therapy, you should periodically take 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 ampoules of 2 ml, intramuscular administration at night is recommended.

Preparations of the company "Evalar"

For non-hormonal therapy during menopause, you can use the Tsiklim remedy from the Evalar company. It is based on the extract of the cimicifuga plant, which contains phytoestrogens.

The use of Tsiklim helps to save a woman from such manifestations of menopausal syndrome as:

mood disorder;
irritability;
sleep disorders;
sweating.

The effect of the use of 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 full-fledged medicines.

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

Contraindications

It is contraindicated to use in the following cases:

the presence of benign neoplasms of the reproductive system, mammary glands;
mastopathy;
malignant neoplasms of any localization, not only organs that belong to the reproductive system;
increased levels of estrogen in the blood of a woman 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 complete examination. In addition, after the start of treatment, the doctor should regularly monitor the patient's condition and laboratory tests. Thanks to this approach, it is possible to identify a developing complication in a timely manner and change the treatment regimen.

Overdose with estrogen treatment

nausea, vomiting;
vaginal bleeding;
significant swelling;
impaired 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 hormone preparations. To remove the remnants of the drug from the body, gastric lavage is performed. After that, supportive therapy is prescribed, which includes diuretics, vitamins, etc.

Side effects

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

More often noted:

development of thrombosis or thromboembolism due to increased blood clotting. The probability of this complication is especially high if a woman is diagnosed with varicose veins, in the presence of hematological diseases;
mood instability, depression;
regular headaches resembling a migraine;
the occurrence of edema of the lower extremities associated with a change 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 noted during use, the treatment regimen should be changed. Sometimes a change of medication is enough, but often it is required to completely stop taking hormones.

Important! With prolonged use of estrogen preparations, the likelihood of developing tumors of the breast and other organs, endometrial cancer increases. Therefore, during treatment, it is necessary to regularly undergo examination by a gynecologist.

Can breasts and glands be enlarged?

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

Estrogen is commonly referred to as a type of steroid female sex hormones produced by the ovarian follicular apparatus. However, some of its share is able to be synthesized in the male body (in the testicles). In addition, in small quantities it is produced in the adrenal glands both in women and in the strong half of humanity.

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

They are synthesized from androgens by an enzymatic reaction.

The hormone is capable of producing:

ovarian follicular apparatus;
adrenal cortex;
placenta;
male testicles;

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

Therefore, it is often referred to in the plural - estrogens.

Among them:

Estradiol- This is the most active steroid hormone that is produced in the female body in the ovaries, and in the male body - by converting 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 to 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 is also found in nature.

It can be found in the following products:

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

Estrogens are not accidentally referred to 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 is carried out, as well as the formation of secondary sexual characteristics of the female type, which include:

The appearance of hair on the forehead and in the 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.
occurrence of osteoporosis.
Congestion 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

Main function of estrogen- regulation of the normal functioning of the female reproductive organs. They provide support for 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 spermatozoa and further fertilization of the egg.
Reducing the amount of cholesterol and low density lipoproteins.
Improvement brain activity.
Maintenance normal blood pressure.
Harmonious distribution of fat deposits, which creates a soft and feminine outline of the figure.
Training 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 the psyche of a woman. A decrease in the amount of steroid hormone contributes to the occurrence of frequent mood swings, depression and irritability (PMS).

Estrogens are synthesized in the male body, as well as testosterone in the female.

On average, their number is 50-130 pmol / l.

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

Work regulation of cardio-vascular system.
Influence on brain activity.
Improvements e memory.
Formation libido.
maintenance normal amount of cholesterol.
Participation during muscle growth.

Estrogen is often used to prevent the development of prostate cancer in men. However, an excess of the presented hormone 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 whole organism.

Its lack often leads to the following consequences:

slowdown development of the organs of the reproductive system in adolescents.
Irregular menstrual cycle or even its absence.
Depressed mental state, abrupt change of mood.
Painful periods.
Memory deterioration.
Unreasonable weight gain.
Increased blood pressure.
Frequent constipation.
Decreased performance and the onset of insomnia.
Deterioration of the skin.

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 needed in the following cases:

For the treatment of menopause.
AT as a contraceptive.
For normalization menstrual cycle.
For vaginal dryness and decreased sex drive.
For the treatment of infertility and with weak labor activity.

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

Often, hormones are produced synthetically. The resulting synthetic estrogen has a chemical structure that is slightly different from that of its natural counterpart. However, such a hormone is able to have a stronger effect on the body.

The following symptoms may indicate this:

cold extremities hands and feet.
breast tumor and uterus.
Migraine and irritability.
Soreness of the chest.
Hair loss and acne on the skin.
Bloating and swelling.

An excess of the hormone can lead to:

Mastopathy.
breast cancer.
Heavy premenstrual syndrome.

In addition, taking estrogenic drugs is contraindicated in:

hypertension;
thrombophlebitis;
cancerous tumors;
prolonged smoking;

Advantages and disadvantages

Benefits of estrogen tablets:

Maintaining a normal balance hormone in the human body.
positive impact on the activity of the brain and the cardiovascular system.
The formation of new bone tissue.
Normalization menstrual cycle.
Glucose control.
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 tablets can cause the following:

Bloating and constant thirst.
Nausea and headache.
Soreness mammary glands.
Menorrhagia.
Sudden change of mood.
The appearance of irregular bleeding.
Increase in 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 famous and popular means of contraception include:

"Janine"

"Lindinet"

(20 tabs - from 410 r)

"Femoden"

To correct hormonal disorders in women, replacement therapy and menopause, tablets containing female sex hormones can be used. The main female sex hormones include estrogens and progestogens (progesterone), which are produced by the ovaries. Before prescribing any female sex hormone in tablets for correcting 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 (combined contraceptives). To 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, maintains pregnancy by preventing the uterus from contracting and ensuring its growth, and prepares the mammary glands for milk production.

Female hormones in tablets - names and functions

The tablets release female sex hormones: estrogens, progesterone and combined preparations containing both estrogens and gestagens. Less often, herbal medicine pills are used that increase female sex hormones in the body. Pills containing estrogen (most often estradiol) are indicated for replacement therapy after ovarian removal and for complications of menopause, for some forms of breast cancer and for contraception. Contraindicated in tumors of the uterus, a tendency to thrombosis. Most often, these drugs are taken strictly by numbering on certain days of the cycle, since they contain a different dose of hormones for each of the phases. Of the most famous, one can list such names of estrogens in tablets as Ovestin, Regulon, Premarin, Rigevidon, Minisiston.

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, for replacement therapy after removal of the ovaries. Progesterone tablets are contraindicated in the second half of pregnancy, renal and hepatic insufficiency, increased blood pressure, diabetes mellitus, bronchial asthma, thrombosis and thrombophlebitis, epilepsy, migraine, lactation and ectopic pregnancy.

Tablets containing both estrogens and gestagens - combined hormonal preparations, are used both for contraception and for hormonal regulation of menstrual irregularities. They are divided into high, low and microdosed (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 the adrenal cortex, which have the property of inducing androgenesis and the development of male secondary sexual characteristics in both sexes. In boys, under the action of androgens, internal genital organs are formed in the prenatal period, and during the puberty period, 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 convergence of the labia, partial atrophy of the mammary glands, uterus and ovaries, cessation of menstruation and ovulation, infertility. Androgens also have a direct effect on the mental sphere, making a person aggressive, rude, hypersexual, 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 in 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? and more active.

Mechanism of action

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

Indications

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

Adverse reactions

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

Under the action 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 (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 small amounts of estrogens are also produced by the testicles 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 due to interaction with specific intracellular receptors, the movement of the receptor complex into the nucleus, its interaction with estrogen-sensitive DNA elements, resulting in the activation of gene transcription 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 provide puberty and development of female secondary sexual characteristics: vagina, uterus, fallopian tubes, and also activate the growth of mammary ducts, stroma; participate in the regulation of ovulation and prepare the genital organs for fertilization and implantation.

Estrogens increase bone mass, inhibit the excretion 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 slowing down the growth and maturation of follicles in the ovaries.

Indications

Estrogens are used in clinical practice for conditions after ovarian removal 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)

Gestagens are steroid hormones produced mainly by the corpus luteum of the ovaries and partly by the adrenal cortex, as well as by the fetal placenta. The main progestogenic hormone in humans is progesterone. Synthetic analogs of gestagens are also on the market: medroxyprogesterone, megestrol, dydrogesterone, cyproterone, levonorgestrel, desogestrel, norethisterone, drospirenone, etc.

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

Mechanism of action due to interaction with progestogen receptors and subsequent activation of transcription of specific genes.

Pharmacological effects

Gestagens suppress the release 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, 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 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 progestogen in their composition.

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

Combined contraceptives

As part of combined contraceptives, gestagenic effects significantly exceed estrogenic ones, therefore, the contraceptive effect of drugs is due mainly to the gestagenic component. The role of estrogens is to potentiate the inhibitory effect of progestogens on the secretion of gonadotropic hormones from 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 cycle of administration): monophasic, biphasic and triphasic.

Monophasic combined contraceptives (Diane-35, Janine, Yarina, etc.) contain a constant dose of estrogen and progestogen throughout the cycle; in biphasic contraceptives (anteovin, etc.) the content of estrogen does not change, and the dose of progestogen is increased in the second phase of the cycle; in three-phase contraceptives (trikvilar, tri-merci, etc.) the content of estrogen does not change, and the dose of progestogen increases in steps.

The mechanism of the contraceptive effect These drugs are associated with a thickening of the cervical secret (difficulty in the penetration of spermatozoa into the uterine cavity), suppression of ovulation, a decrease in peristalsis of the fallopian tubes, a change in the structure of the endometrium (difficulty in implantation).

Testimony to the appointment of this group of drugs, in addition to contraception, in some cases, there may be menstrual irregularities.

Adverse reactions

When using combined contraceptives, the development of thrombosis of various localization is possible due to an increase in the concentration of coagulation factors caused by the action of estrogens. The risk of thrombus formation increases with prolonged immodilization, in women who smoke or who are obese (BMI >30 kg/m?), arterial hypertension, valvular heart disease, or atrial fibrillation. Taking combined contraceptives can also cause edema, increased blood pressure, weight gain, headaches, nausea, vomiting, and other complications.

Gestagen contraceptives

These drugs (exluton, charosetta, etc.) contain only gestagens and, according to the mechanism of action, differ from the combined estrogen-progestin drugs in that ovulation is preserved when they are used.

Mechanism of action

Prevention of pregnancy when using mini-pills is associated with an increase in the viscosity of cervical mucus, a violation of the coordinated contractions of the fallopian tubes and the implantation process.

Indications

This group of drugs, due to its pharmacodynamic characteristics, can be recommended for postpartum contraception in lactating 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 progestogen contraceptives in women in late reproductive age and in women who smoke.

Adverse reactions

Violation of the menstrual cycle, metrorrhagia (irregular uterine bleeding), etc.

Postcoital contraceptives

Postcoital contraceptives are drugs that a woman can use to prevent pregnancy after unprotected intercourse, however, due to the risk of developing severe complications, this type of contraception cannot be recommended as a method of permanent protection against 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 physician. Independent and regular use of drugs without medical supervision can lead to severe, including life-threatening complications.

Classification

For emergency hormonal contraception, use:

1. combined estrogen-gestagen preparations;

2. gestagens;

3. danazol;

4. mifepristone.

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

Adverse reactions

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

Antiandrogenic drugs

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

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

The mechanism of action of these drugs is associated with inhibition of the 5?-reductase enzyme in the prostate, which leads to a decrease in the formation of dihydrotestosterone and, as a result, a decrease in its stimulating effect on prostate cell division 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, ejaculation disorder, gynecomastia, allergic reactions, etc.

Androgen receptor blocking drugs include flutamide and bicalutamide, mechanism of action which is associated with androgen receptor antagonism, 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 the palliative treatment of prostate cancer and the differential diagnosis of hypogonadism in men.

Adverse reactions

Gynecomastia and / or soreness 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 the suppression of the secretion of gonadotropic pituitary hormones and reduces the effects of androgens in peripheral tissues.

Indications

In men, cyproterone is used to reduce hypersexuality, as well as in prostate cancer, and in women, with pronounced 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 antiestrogenic activity include estrogen receptor modulators. (clomiphene, tamoxifen, toremifene, raloxifene) and inhibitors of estrogen 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 due to 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.

Allocate steroid ( formestane, exemestane) and nonsteroidal ( anastrozole, letrozole) inhibitors of the synthesis of estrogen hormones.

Indications

Mammary cancer.

Adverse reactions

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

Antigestagens

Antiprogestogen 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 ovum.

Indications

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

Adverse reactions

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