Flashcards in 3a physiology -Estrogen-Progesterone-Tanner stages of sexual development -Menstrual cycle Deck (45):
Name three places in the female body where estrogen can be produced.
The ovaries (17β-estradiol), the placenta (estriol), and adipose tissue (estrone via aromatization)
Rank the following three forms of estrogen in order of most to least potent: estradiol, estriol, and estrone.
Estradiol, estrone, and estriol
What major hormone is produced by the granulosa cells? By the theca cells?
Granulosa cells—estrogen via conversion of androgens by aromatase; theca cells—androgens via conversion of cholesterol by desmolase
A young female patient is ovulating and thus has increased luteinizing hormone (LH) levels. What is the effect of LH in theca cells?
LH promotes the conversion of cholesterol to androgens via the enzyme desmolase
What effects does estrogen have on the uterus and ovaries?
Estrogen stimulates follicle growth and endometrial proliferation and increases myometrial excitability
What is the role of estrogen on physical development during puberty?
Genital and breast development and creation of female fat distribution
What is the effect of estrogen on proteins and fats in the body?
Increased synthesis of sex hormone–binding globulin, transport proteins, and HDL, with decrease in LDL
What is the effect of estrogen on the plasma lipid profile?
Increased HDL and decreased LDL
How does estrogen affect follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels?
It provides negative feedback on FSH and LH secretion except near ovulation, when estrogen provides positive feedback for the LH surge
A pregnant woman has increased levels of estrogen. What is the effect of estrogen on prolactin secretion?
Estrogen increases prolactin secretion
Where are estrogen receptors located? What happens once estrogen binds?
Cytoplasm; receptors translocate to the nucleus once estrogen binds
An increase in ____ (estradiol/estriol) is an indicator of fetal well-being during pregnancy.
Estriol (increases 1000-fold typically)
A pregnant female notices various changes in her body. During pregnancy, what happens to the levels of endogenous estrogens?
There is a 50-fold increase in estradiol and estrone and a 1000-fold increase in estriol
Estrogen causes ____ (upregulation/downregulation) of estrogen, LH, and progesterone receptors.
A young female has constant GnRH secretion. Would you expect her to have normal FSH and LH levels?
No (pulsatile GnRH stimulation is needed to have normal FSH and LH secretion)
Name the four sources of progesterone.
Corpus luteum, placenta, adrenal cortex, and testes
Progesterone causes what changes in the endometrium?
Spiral artery development and increased endometrial glandular secretions; also prevents endometrial hyperplasia
A 21-year-old woman is worried about miscarriage. She has an adequate progesterone level. What effect does progesterone have on pregnancy?
Progesterone maintains the pregnancy (progesterone is pro-gestation)
Progesterone ____ (increases/decreases) myometrial excitability; estrogen ____ (increases/decreases) myometrial excitability.
What is the effect of progesterone on cervical mucus?
Progesterone thickens cervical mucus to prevent sperm entry into the uterus
Progesterone ____ (increases/decreases) uterine smooth muscle relaxation and therefore ____ (prevents/promotes) contractions.
What effects does progesterone have on follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estrogen?
Inhibits release of FSH and LH and decreases estrogen receptor expressivity
Progesterone levels are monitored daily during a female's menstrual cycle. What does the elevation in her progesterone level indicate?
Progesterone elevation indicates that ovulation has occurred
A woman was noted to have a drop in progesterone levels after delivery. What is the significance of this phenomenon?
A fall in progesterone levels disinhibits prolactin, which allows an increase in lactation (prolactin is prolactation)
Progesterone has what effect on body temperature?
Increases body temperature
Describe Tanner stage 1
A young girl is starting to notice the appearance of pubic hair and breast buds. Which Tanner stage is she in?
Tanner stage 2, which is defined by pubarche (pubic hair) and thelarche (breast budding)
A pubertal boy notices that his pubic hair is darker and curlier and his penis has increased in size and length. What Tanner stage is he in?
Tanner stage 3
A pubertal girl notices that her pubic hair is darker and curlier and her breasts are enlarged. What Tanner stage is she in?
Tanner stage 3
A pubertal boy notices that his penis is wider and scrotal skin darker. He also notes development of the glans. What Tanner stage is he in?
Tanner stage 4
A teenage girl is not sure if she has finished going through puberty. She is at least tanner stage IV. How can she know if she has finished?
In Tanner stage 4, the areolae are raised and the glans clitoris develops—in Tanner stage 5, the areolae are no longer raised
How does Tanner stage V differ from IV?
The main difference is that the areolae are no longer raised (Tanner stage 5 = adult)
What hormone stimulates endometrial proliferation during the menstrual cycle?
How long does the luteal phase of the menstrual cycle typically last? The follicular phase?
14 days (ovulation day + 14 days = menstruation); follicular phase can vary in length (accounts for differences in menstrual cycle lengths)
Estrogen levels peak ____ (after/before) ovulation, whereas progesterone levels peak ____ (after/before) ovulation.
Is the corpus luteum present during the follicular or luteal phase?
Luteal phase (the corpus luteum is formed from the ruptured follicle and produces progesterone)
Regression of the corpus luteum leads to what event?
Menstruation (when progesterone levels decrease, the endometrial lining sloughs off due to apoptosis of endometrial cells)
Place in order: progesterone from corpus luteum, LH surge, menstruation, ovulation, increase in estrogen release, progesterone levels fall
Increase in estrogen release, LH surge, ovulation, progesterone from corpus luteum, progesterone levels fall, menstruation
Oligomenorrhea is defined as a cycle lasting more than ____ days, whereas polymenorrhea is defined as a cycle lasting fewer than ____ days.
A 23-year-old woman has heavy and irregular menses and has to change her sanitary pad every 2 hours. What is this condition called?
A 32-year-old woman complains of spotting and frequent menstruation. She says that her periods are unpredictable. What is this condition?
Metrorrhagia (frequent or irregular menstruation), often called spotting or intermenstrual bleeding
A 23-year-old woman has heavy, regular menses that last for more than 7 days. What is this condition called?
Menorrhagia, defined as menses with greater than 80 mL blood loss or menses that last for more than 7 days.
A woman is at the beginning of her pregnancy. Which hormone is essential in maintaining the endometrium and supporting implantation?
Progesterone (decreased progesterone levels lead to decreased fertility)
Follicular growth is fastest during which period of the menstrual cycle?
Second week of proliferative phase