Estrogens

Estrogen medications are used for a number primarily gynecologic conditions including contraception, menorrhagia, and hormone replacement.  Estrogens are hormones that cross cell membranes and bind to nuclear receptor proteins and promote the synthesis of RNA, which leads to the production of proteins that mediate estrogen's effects.  Estrogens are combined with progestins for use as oral contraceptives and work by suppressing LH and FSH levels. Reduction of LH and FSH levels eliminates ovulation.

Nausea, thromboembolism, promotion of breast and endometrial cancer, and increased risk of acute coronary syndrome are all potential side effects.  

Class Drugs

• Estradiol

• Estrone

• Ethinyl estradiol

• Mestranol

Class Mechanism of Action

Estrogens cross cell membrane by diffusion and bind to nuclear receptor proteins to stimulate synthesis of RNA and proteins to mediate effects

• Estradiol - produced by the ovary and most potent, primary premenopausal hormone

• Estrone - metabolite of estradiol and less than half as potent as estradiol, circulates after menopause

• Estriol - metabolite of estradiol and much less potent, circulates during pregnancy and is produced by the placenta

Class Applications

Hormone replacement

• Hypogonadism, premature menopause and surgical menopause

Postmenopausal hormone replacement

• Treatment of postmenopausal symptoms

• Use lowest effective dose due to side-effects

Contraception

Class Adverse Effects

Thromboembolism

Breast tenderness

NauseaBreast and endometrial cancer

• When combined with progesterone, risk is lessened

Increased risk of acute coronary syndromes

Drug Table

Drug Name	Application	Comments	Image
Estradiol			"Extra Dials"
Estrone			"Extra Scones"
Ethinyl Estradiol			"Ethanol" "Extra Dials"
Mestranol			"Messy Train"