Endocrinology of menstrual cycle Flashcards

(36 cards)

1
Q

What are the 3 types of combined hormonal contraceptives?

A

Oral contraceptives, transdermal patch, vaginal ring

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2
Q

What does CHC do?

A

Inhibit ovulation

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3
Q

How is ovulation inhibited?

A

Oestrogen and progesterone components which act on hypothalami-pituitary axis to reduce LH and FSH production

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4
Q

What does oestrogen do?

A

Causes endometrium to proliferate and grow

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5
Q

What does progesterone do?

A

Prevents hyperplasia of endometrium by opposing proliferative effects of oestrogen

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6
Q

What does HPG stand for?

A

Hypothalamus-pituitary gonad axis

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7
Q

What does GnRH stand for?

A

Gonadotropin releasing hormone

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8
Q

What does FSH stand for?

A

Follicle stimulating hormone

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9
Q

What does LH stand for?

A

Luteinising hormone

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10
Q

What does GnRH do?

A

LH and FSH production

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11
Q

Where is GnRH released from?

A

Hypothalamus

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12
Q

What do LH and FSH do?

A

Act on ovarian follicles and corpus luteum

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13
Q

Where are oestrogen and progesterone produced?

A

Ovarian follicles and corpus luteum

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14
Q

Which tissue is responsible for menstrual flow?

A

Endometrium

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15
Q

Which structure controls luteal phase?

A

Corpus luteum

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16
Q

What are the three phases of the menstrual cycle?

A

Menstrual phase: flow occurs
Proliferative phase: cells proliferating
Secretory phase: lots of secretions occurring n endometrium, very thick, ready for fertilisation

17
Q

Lifecycle of primordial follicle

A

Primordial follicle (13-50 years)
Primary follicle (45 days)
Secondary follicle
Graafian follicle

18
Q

What happens in pre-ovulation follicular phase?

A
Hypothalamus makes GnRH
Ant. pituitary makes FSH and LH 
Acts on ovary to develop follicle
Inhibin and low levels of oestrogen 
Negative feedback effect on ant. pituitary
19
Q

How does hypothalamus decrease FSH concentration?

A

Hypothalamus stimulates pituitary to produce FSH and LH, stimulates oestrogen production. Not allowing production of other hormones. Action of oestrogen and inhibin increases oestrogen, decreases FSH

20
Q

What happens in late follicular phase?

A

Increased production of oestrogen
Graphian follicle
Hypothalamus - GnRH - ant. pituitary - FSH and LH - stimulates Graphian follicle
LH surge produces ovum from follicle
No FSH peak needed but inescapable
Inhibit acts on ant. pituitary = negative feedback
FSH smaller because of inhibin

21
Q

Where is most progesterone produced?

A

Corpus luteum

22
Q

when will follicle become CL?

A

After ovulation

23
Q

What happens in luteal phase?

A
Hypothalamus produces GnRH
LH and FSH from ant. pituitary 
Makes uterus favourable for egg
Progesterone high - low FSH and LH
CL formed 
CL makes progesterone and oestrogen - negative feedback on hypothalamus and pituitary
24
Q

How is fertilised egg maintained?

A

CL maintained by hCG released from chorion which maintains until placenta takes over

25
What are ovarian follicles?
Ovaries made of sacs called ovarian follicles. They contain oocyte and cells that produce oestrogen and progesterone
26
Flow chart of follicle changing to ovulation
Primordial follicle - primary follicle - secondary follicle - Graafian follicle - ovulation
27
How is anterior pituitary connected to hypothalamus?
Vascular
28
How is posterior pituitary connected to hypothalamus?
Neuronal
29
LH surge
Re-starts meiosis in oocyte | Follicle ruptures - ovulation - oestrogen production reduced
30
What happens when no fertilisation occurs?
No hCG so CL degenerates Progesterone and oestrogen lost Vasoconstriction - tissue death
31
Dysmenorrhea
Painful periods
32
Menorrhagia
Heavy/prolonged periods
33
Amenorrhea
Absence of periods
34
Oligomenorrhea
Light periods
35
Combined pill
Low oestrogen: no FSH - no follicles - nothing to ovulate | Progestogen: decreases LH, decreases GnRH
36
Progestogen-only pill
Cervical mucus inhospitable to sperm Hinders implantation Breakthrough bleeding/irregular periods