WOMEN’S HEALTH PHARM – FNP CRAM SHEET
BIG TEST RULES
• Uterus present → must add progestin with estrogen
• No uterus → estrogen alone OK
• OCPs primarily suppress ovulation (LH surge)
• SERMs are tissue selective
ESTROGEN THERAPY
Uses: hot flashes, vulvovaginal atrophy, osteoporosis prevention
Major risks: VTE, stroke, breast cancer, gallbladder disease
Transdermal estrogen → lower VTE risk and avoids first-pass metabolism
PROGESTINS
Purpose: protect endometrium from estrogen stimulation
Common ADEs: breakthrough bleeding, mood changes, breast tenderness
COMBINED ORAL CONTRACEPTIVES
MOA: suppress FSH/LH → prevent ovulation (primary)
Benefits: cycle control, ↓ ovarian & endometrial cancer, improves acne
Major contraindications: VTE history, migraine with aura, smoker ≥35, severe HTN
PROGESTIN-ONLY METHODS
Preferred in: breastfeeding, VTE risk, smokers >35
Mini-pill must be taken at the same time daily
DMPA (DEPO-PROVERA)
Key risks: reversible bone mineral density loss, weight gain, delayed fertility
SERMs
Tamoxifen: breast antagonist, uterine agonist → ↑ endometrial cancer risk
Raloxifene: breast antagonist, bone agonist, NO uterine stimulation
EMERGENCY CONTRACEPTION
Options: levonorgestrel, ulipristal, copper IUD (most effective)
Mechanism: delays or inhibits ovulation (not abortifacient)
BIG TEST RULES
• Uterus present → must add progestin with estrogen
• No uterus → estrogen alone OK
• OCPs primarily suppress ovulation (LH surge)
• SERMs are tissue selective
ESTROGEN THERAPY
Uses: hot flashes, vulvovaginal atrophy, osteoporosis prevention
Major risks: VTE, stroke, breast cancer, gallbladder disease
Transdermal estrogen → lower VTE risk and avoids first-pass metabolism
PROGESTINS
Purpose: protect endometrium from estrogen stimulation
Common ADEs: breakthrough bleeding, mood changes, breast tenderness
COMBINED ORAL CONTRACEPTIVES
MOA: suppress FSH/LH → prevent ovulation (primary)
Benefits: cycle control, ↓ ovarian & endometrial cancer, improves acne
Major contraindications: VTE history, migraine with aura, smoker ≥35, severe HTN
PROGESTIN-ONLY METHODS
Preferred in: breastfeeding, VTE risk, smokers >35
Mini-pill must be taken at the same time daily
DMPA (DEPO-PROVERA)
Key risks: reversible bone mineral density loss, weight gain, delayed fertility
SERMs
Tamoxifen: breast antagonist, uterine agonist → ↑ endometrial cancer risk
Raloxifene: breast antagonist, bone agonist, NO uterine stimulation
EMERGENCY CONTRACEPTION
Options: levonorgestrel, ulipristal, copper IUD (most effective)
Mechanism: delays or inhibits ovulation (not abortifacient)
