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CSI- Winter > Hormonal Cycle > Flashcards

Hormonal Cycle Flashcards

1
Q

Ages of menarche and menopause

A

12.5

51

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2
Q

At birth females have 1 million primordial follicles. They oocytes are arrested in _______

A

prophase of the first meiotic division until menarche

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3
Q

The hypothalamus secretes ________ from the _________ in a ________ manner.

A

GnRH from the arcuate nucleus in a pulsatile manner (every 70-90 minutes)

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4
Q

GnRH stimulates the ________ to release ________

A

anterior pituitary to release FHS and LH (gonadotropins)

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5
Q

TSH acts at

A

thyroid gland

released from ant pit

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6
Q

ACTH acts at

A

adrenal cortex

released from ant pit

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7
Q

TSH and LH act at

A

testes and ovaries

released from ant pit

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8
Q

GH acts at

A

entire body

released from ant pit

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9
Q

PRL (prolactin) acts at

A

mammary glands

released from ant pit

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10
Q

endorphins act on

A

pain receptors in brain

released from ant pit

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11
Q

LH stimulates ______, which causes _________

A
  1. LH stimulates theca cells of ovary to produce androgens

2. Androgens to to granulosa cell of ovary and are converted to estrogen by aromatase

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12
Q

FSH stimulates _______ which causes ________

A
  1. FSH stimulates granulosa cells to convert androgens (coming from the thecal cells) to estrogen by aromatase during the follicular phase of the menstrual cycle
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13
Q

Estradiol (estrogen) has a negative feedback on ______ and a positive feedback on ______

A

negative fb on GnRH and FSH/LH most of the cycle, but a positive fb on GnRH/FSH/LH for days 12-14 (high estrogen levels during this time)

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14
Q

So basically granulosa cells of ovary produce ______ and theca cells produce _______

A

estradiol

androgen

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15
Q

Estrogen provides _________ to hypothalamus and anterior pituitary for most of the cycle, but ________ for days 12-14

A

negative fb for most

positive fb for days 12-14
the positive fb of estrogen is mostly acting on LH

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16
Q

In order for FSH and LH to be released, you need ________

A

a PULSATILE release of GnRH

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17
Q

LH acts on 2 places in the ovary (and why)

A
  1. growing follicle (for ovulation and to produce estrogen, this mid-cycle increase of estrogen will stimulate more LH secretion, positive FB)
  2. corpus luteum (which secretes progesterone and estrogen after ovulation to inhibit FSH and LH secretion)
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18
Q

Phases of menstrual cycle

A

follicular phase, ovulation, luteal phase

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19
Q

Day 1 of follicular phase:

A
  • First day of bleeding
  • progesterone withdrawal is happening (causes period bleeding)
  • Prostaglandins are released–> causes contractions of uterus
  • -> ischemic pain (cramping)
  • hormones are all at their LOWEST points on day 1
  • this causes at DECREASE in the negative feedback, resulting in FSH production
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20
Q

FSH production on day 1 of follicular phase causes

A
  • new follicles to mature
  • dominant follicle to be selected
  • granulosa cells increase and secrete estradiol
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21
Q

Follicular phase- Estradiol acts at the LH receptors on

A

theca cells, cause androgen secretion, which are converted to more estradiol by aromatase

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22
Q

Follicular phase- Rising estradiol causes an INCREASE in negative feedback at the hypothalamus, which will _______

A

decrease FSH and increase LH

23
Q

Determining Dominant Follicle- FSH binds to receptors on the granulosa cells, causing ______

A

proliferation of cells –> more binding of FSH –> more estradiol produced

24
Q

Determining Dominant Follicle- The follicle with the ________ becomes the dominant follicle, and then OVULATION HAPPENS!

A

greatest # of granolas cells

this is the best follicle- has the most estrogen production, greatest number of granulosa cells

25
Q

The ONLY FOLLICLE that ovulates is _________

A

the dominant follicle

26
Q

Ovulation- estradiol produced causes

A

a positive feedback at hypothalamus causing an increase in LH

27
Q

_________ happens around days 11-13 of cycle

A

LH Surge

28
Q

Ovulation starts ______ AFTER the LH surge

A

30-36 hours

-so ovulation happens around day 14 of cycle

29
Q

During ovulation what physically happen to oocyte?

A

oocyte is expelled from follicle into fallopian tube, and the follicle becomes the corpus luteum (follicle without egg in it anymore is corpus luteum)

30
Q

Luteal phase of menstrual cycle is ________ dominant

A

progesterone dominant (bc the progesterone is coming from the corpus luteum)

31
Q

Luteal phase- Maximum production of progesterone happens _________

A

3-4 days after ovulation (and lasts 11 days)

32
Q

Luteal phase- If there is NO implantation, _______

A

involution of the corpus lute occurs (takes 13-14 days), and there is a DECREASE in progesterone

(decrease in progesterone, no negative fb, this increases FSH and LH, start producing estradiol, get your period)

33
Q

Luteal phase- if there IS implantation, _________

A

hCG is secreted from corpus luteum, this maintains the CL and there is CONTINUED progesterone secretion

(progesterone prevents your period)

34
Q

During the Luteal phase, progesterone provides __________

A

a NEGATIVE feedback for FSH and LH

35
Q

Timeline if follicular phase

A

CAN VARY

overall cycle is about 28 days

36
Q

Timeline of luteal phase

A

ALWAYS 14 DAYS!!!

37
Q

What causes ovulation?

A

LH surge

38
Q

What causes follicle growth?

A

estradiol

39
Q

What causes estradiol to increase?

A

FSH

40
Q

Negative fb from estradiol causes

A

decline in FSH

41
Q

What forms during ovulation?

A

corpus luteum

42
Q

When progesterone stops being produced, what happens?

A

withdrawal phase- menses

43
Q

During menstruation, endometrium is __________

A

sloghed to basal level (bleeding happens bc progesterone withdrawal)

  • compact stroma cells
  • short, narrow endometrial glands
44
Q

During the follicular phase, what happens to endometrium?

A
  • Estrogen causes growth of the endometrium
  • stroma thickens
  • glands elongate and are straight/tubular
  • endometrium is proliferative and growing
45
Q

What progesterone is released during luteal phase, what happens to endometrium?

A
  • Differentiation
  • Stroma becomes loose and edematous
  • blood vessels twist and thicken (spiral arterioles)
  • glands become tortuous
  • it’s called a “secretory endometrium” and it’s getting ready to support a pregnancy
46
Q

How does Estradiol alter the endocervix and cervical mucus?

A
  • causes sperm capture, storage and transport
  • thin
  • clear
  • water
  • conducive to preparing for pregnancy
47
Q

How does Progesterone alter the endocervix and cervical mucus?

A
  • thick (prevents sperm)
  • opaque
  • tenacious
  • conducive to
48
Q

How does progesterone affect the breasts?

A
  • stimulates acinar glands
  • rounds them
  • increased tenderness
49
Q

How does progesterone affect body temperature?

A

increases body temp by

0.6-1 degree F

50
Q

Leuoprolide

A
  • acts at hypothalamus
  • hormonal control
  • takes 2 weeks to decrease FSH/LH
  • GnRH agonist
  • when continuous, decreases pulsate GnRH release
  • decrease initial surge of FSH/LH-can only use for 3-6 months, puts pt into “early menopause”
51
Q

Ganirelix

A
  • acts at hypothalamus
  • immediately decreases FSH/LH
  • GnRH antagonist
52
Q

Clomiphene citrate

A
  • acts at hypothalamus
  • Causes ovulation
  • can make someone ovulate, for someone with PCOS who is ovulating irregularly- can have multiple dominant follicles, twins/triplets
  • Antagonist of estrogen at hypothalamus
  • Increases LH/FSH release
53
Q

Combination oral contraceptives

A

*acts at ovary
-Progestin: suppression of LH secretion= no ovulation
-Thicken cervical mucus
and altered fallopian tube peristalsis

-Estrogen: suppression of FHS secretion= no dominant follicle (won’t be able to ovulate)

54
Q

Progestins

A
  • acts at ovary
  • Depo-Provera
  • Nexplanon
  • Thicken cervical mucus
  • Alters endometrial proliferation (“hostile” environment)
  • Some suppress ovulation (if high enough dose)

CSI- Winter (44 decks)

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