Medication

  • 1 What might I need to know about drugs frequently used in gynaecology?
  • 2 How do hormone treatments work?
  • 3 In what situations may hormone treatments be indicated?
  • 4 What are the sources of hormone treatments?
  • 5 What determines the effect of a hormone treatment?
  • 6 When are hormones used in combination?
  • 7  Why do hormone treatments sometimes cause side effects?You may be interested to learn:
    • how these drugs are thought to work.
    • about the possible indications (uses).
    • how they may be administered (taken).
    • their possible side effects and risks.
    • the dose of the medication that you can take.

To answer these questions fully even for the more frequently used drugs in gynaecology would require a book dedicated to the subject. The objective of this chapter is to provide a brief explanation of some of the basic issues. It should be emphasised that when prescribing for women during their reproductive years, great care is taken to avoid medication that could have an adverse effect on a possible pregnancy.

The action of one hormone treatment may be altered by that of another:

  • a course of progestogen will not result in a withdrawal bleed in a patient with amenorrhoea and low oestrogen levels after the menopause. The same woman, however, would have a positive result if she were given oestrogen before the progestogen.

Thank you for choosing to visit us.

This is the personal website of David A Viniker MD FRCOG, retired Consultant Obstetrician and Gynaecologist – Specialist Interests – Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women’s health questions in the patient information and medical advice provided.

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Following his retirement, David Viniker, has continued with his interest in website design in Essex and on researching the Google algorithm – the program that determines the webpages that appear on the top page of Google. He has developed a top keyword difficulty tool to determine the keywords a website can target. To this end, he writes articles on subjects from the work of divorce solicitors in Hendon to the work of a life coach in Bedfordshire. He enjoys learning about home improvement such as loft conversions and house clearance in London. He has a special interest in the Google algorithm and PageRank. He offers SEO training courses for those SMEs who wish to to promote their own websites.

– Specialist Interests – Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women’s health questions in the patient information and medical advice provided.

 

A drug may act by blocking a receptor.

  • clomifene (clomiphene citrate) blocks the oestrogen feedback mechanism. Gonadotrophin releasing hormone agonists may initially have a positive action with a temporary increased output of the gonadotrophins FSH and LH (flare response) from the pituitary. They then block the receptor sites suppressing FSH and LH levels (down-regulation); this action is used in IVF regimens (24), as one possible treatment of endometriosis (endometriosis) and as pre-surgical preparation for removing fibroids (17).

Some drugs have actions on different receptor sites and these combined actions can be utilised therapeutically.

  • Tibolone (Livial) activates both oestrogen and progesterone receptors so that it has the benefits of providing hormone replacement therapy whilst conferring endometrial protection. It may also have some beneficial androgenic activity.
  • Tamoxifen has anti-oestrogenic activity, which enhances the treatment of patients with breast cancer. Its anti-oestrogenic action is also used in the treatment of anovulatory infertility (tamoxifen infertility). Tamoxifen also has some oestrogenic activity so that it may relieve some menopausal symptoms. Its oestrogenic activity may adversely affect the endometrium (uterine lining) leading to hyperplasia (thickening) and rarely malignancy.