OCPs, Estrogens and Progestins MCQs

Treatment of PCOD Weight loss of more than 5% of previous weight is important. Cigarette smoking should be avoided. Estrogen in combination with progesterone (lacking androgenic properties). Dexamethasone 0.5 mg at bedtime also reduces androgen production. Hirsutism is treated with cyproterone acetate or spironolactone. Infertility is treated with Clomiphene. Ovulation is induced in around 80% of patients and about 40% conceive. However, abortion rate of 25-40% is due to corpus luteal phase defect manifested by Clomiphene. In Clomiphene failed group, ovulation can be induced with FSH or GnRH analogues. Metformin treats the root cause of PCOS, rectifies endocrine and metabolic functions and improves fertility and is the drug of choice.

Tamoxifen is a SERM that acts as an antagonist at estrogen receptors in the breast. It decreases the risk of contralateral breast cancer and is Approved for primary prevention of breast cancer in women at high risk. Adverse effects of Tamoxifen include: Hot flashes Vaginal discharge or bleeding Menstrual irregularities Thromboembolic events (rare) Endometrial hyperplasia/Carcinoma Cataract Hepatotoxicity