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Gynecological Pharmacology

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Copper IUD

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Uses: Long-term contraception, emergency contraception. Mechanism: Copper toxicity to sperm and ova, inflammatory response. Side effects: Heavy menstrual bleeding, cramps, possible expulsion.

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Clomiphene Citrate

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Uses: Induce ovulation in anovulatory infertility. Mechanism: Blocks estrogen receptors, increasing FSH and LH release. Side effects: Hot flashes, ovarian enlargement, multiple births.

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Raloxifene

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Uses: Prevention of osteoporosis in postmenopausal women. Mechanism: Selective estrogen receptor modulator; estrogenic on bone, antiestrogenic on breast and uterus. Side effects: Hot flashes, leg cramps, increased risk of venous thromboembolism.

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Tinidazole

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Uses: Treatment of trichomoniasis, bacterial vaginosis. Mechanism: Disrupts DNA synthesis in protozoa and anaerobic bacteria. Side effects: Metallic taste, nausea, disulfiram-like reaction with alcohol.

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Levonorgestrel IUD

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Uses: Long-term contraception, heavy menstrual bleeding. Mechanism: Releases levonorgestrel to thicken cervical mucus and thin the endometrium. Side effects: Ovarian cysts, acne, amenorrhea.

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Gonadotropins

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Uses: Induce ovulation, assist with IVF. Mechanism: Directly stimulate ovaries with FSH and LH. Side effects: Ovarian hyperstimulation syndrome, multiple births, headache.

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Mifepristone

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Uses: Medical termination of pregnancy. Mechanism: Progesterone receptor antagonist, leads to endometrial breakdown. Side effects: Heavy bleeding, nausea, cramping.

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Doxycycline

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Uses: Treatment of sexually transmitted infections. Mechanism: Inhibit protein synthesis in bacteria. Side effects: Photosensitivity, gastrointestinal upset, tooth discoloration.

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Azithromycin

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Uses: Treatment of sexually transmitted infections, pelvic inflammatory disease. Mechanism: Inhibit bacterial protein synthesis. Side effects: Gastrointestinal upset, liver enzyme abnormalities, QT prolongation.

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Progesterone-only Pills

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Uses: Prevent pregnancy, suitable for breastfeeding women. Mechanism: Thickens cervical mucus, thin the endometrium. Side effects: Menstrual irregularities, headache, breast tenderness.

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Metformin

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Uses: Manage insulin resistance in PCOS. Mechanism: Decreases hepatic glucose production, increases insulin sensitivity. Side effects: Gastrointestinal upset, lactic acidosis, vitamin B12 deficiency.

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Human Papillomavirus Vaccine

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Uses: Prevent HPV infection and related cervical, vulvar, vaginal, and anal cancers. Mechanism: Induces an immune response against HPV types most commonly associated with cancers. Side effects: Injection site reactions, fainting, headache.

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Terbutaline

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Uses: Delay preterm labor. Mechanism: Beta-agonist, relaxes uterine smooth muscle. Side effects: Tachycardia, palpitations, hyperglycemia.

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Combined Oral Contraceptives

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Uses: Prevent pregnancy, regulate menstrual cycles. Mechanism: Suppress ovulation via negative feedback on pituitary, thicken cervical mucus. Side effects: Nausea, headache, increased risk of thromboembolism.

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Misoprostol

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Uses: Medical management of miscarriage, cervical ripening. Mechanism: Prostaglandin E1 analog, softens cervix, increases uterine contractions. Side effects: Diarrhea, abdominal pain, miscarriage or preterm labor.

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Spironolactone

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Uses: Treat hirsutism in PCOS. Mechanism: Androgen receptor antagonist, decreases testosterone synthesis. Side effects: Electrolyte imbalances, menstrual irregularities, breast tenderness.

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Medroxyprogesterone Acetate

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Uses: Contraception, endometriosis, menopausal symptoms. Mechanism: Progestin that suppresses ovulation and endometrial growth. Side effects: Weight gain, depression, loss of bone mineral density.

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Letrozole

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Uses: Induce ovulation in infertility, especially PCOS. Mechanism: Aromatase inhibitor, decreases estrogen production. Side effects: Hot flashes, fatigue, joint pain.

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