Menopause Flashcards
(27 cards)
What are the Anterior pituitary gland functions
- controls activity of other endocrine glands
- stimulates production of oestrogen and progesterone
- ovulation and pregnancy in females
- testosterone production and spermatogenesis in males
Which Hormones are produced in the pituitary gland?
FSH - follicle-stimulating hormone
LH - luteinizing hormone
PRL - prolactin
What are the 4 Phases of the menstrual cycle?
1) menstrual phase
2) follicular phases
3) ovulation phases
4) luteal phase
Which is the most potent type oestrogen?
17 B oestradiol
What is the Genomic effect?
Which receptors are used?
ER a B nuclear receptors
Regulation of gene expression through the action of transcription factors
What is the Non-genomic effect?
Which receptors are used?
Membrane G coupled receptors
Rapid action through the cascade of kinases
- eg: skeletal homeostasis
Lipid and carbohydrates metabolism
CVS
Electrolyte homeostasis
What does oestrogen regulate?
Growth
# cellular division
# differentiation
# cellular and tissue functions in the body
They play a role in the maintenance and regulation of the female and male reproductive systems.
What are the effects of oestrogens ?
Rapid effects of oestrogens don’t depend on a long process of mRNA and protein synthesis.
It relies on phosphorylation of the kinases (MAPK, ERK).
This can provide a rapid cellular response or indirectly regulate other genes expression
What are Roles of oestrogens?
+ At puberty stimulates the growth of organs important for reproduction
+ stimulates cellular proliferation of glandular tissue and epithelial ciliated linings of fallopian tubes
+ stimulates bone growth
+ slightly increases whole body metabolic rates
+ increased fat deposition in the subcutaneous tissues
+ cause softening and better vascularisation off the skin
+ has an effect on sodium and water retention
What is Perimenopause?
What age does it usually start?
It’s the time before the full cessation of the menstrual cycle
A natural transition towards the menopause
Oestrogen levels start to decrease ( from 300 msg per day to almost O )
Starts around 40 years and can last from a few months to a few years
Women can experience typical signs and symptoms of the menopause
What are the Symptoms of perimenopause?
~ period changes
~ hot flushes and night sweats
~ mood changes
~ vaginal dryness
~ sleep problems
~ weight Changs
Menopause definition
Menopause occurs when the women is not menstruating for 12 months - in most cases around the age of 50
It can be triggered by surgery such as hysterectomy or oophroectomy
What is Primary ovarian insufficiency or premature ovarian failure (ROI)?
The loss of ovarian function in younger women
It’s not related to menopause but can cause similar symptoms
Including:
- irregular bleeding
- hot flushes
1 in 1000 under 30
1 per 100 under 40
What are some Causes of POI?
• Surgical removal of ovaries
• cancer treatment
• autoimmune disease leg:m (DM type 1, Addisons)
• genetic ( eg related to X chromosome - turner syndrome or genetic predisposition).
• infections (mumps, TB)
• Environmental toxins leading to follicle depletion
Menopause facts
The end of female reproduction activity
Starts with irregular often non- ovulatory menstrual cycles
Follicle supply is exhausted
Production of oestrogens decreases and no negative feedback occurs
Lack of oestrogens triggers physical changes
Where can Oestrogen still be produced?
In low levels by the adrenal glands
What are Changes to the ovaries after the menopause?
Architectural changes to the structure
Which Changs happen to the uterus after the menopause?
Decrease in size of the uterus
The endometrium thins
How does the Corpus - cervix ratio change after menopause?
Decreases
Part of the sonography post-menopausal assessment
What are some of he Vaginal changes that occur after menopause?
The mucosal layer undergoes atrophy causing dryness and loss of elasticity
What changes does the Menopause cause to bone?
The increased activity of osteoclasts (bone reabsorption) and very low activity of osteoblasts (bone production)
This leads to weaker bones and a risk of osteoporosis
Increased risk of vertebral, femur and hip fractures
What are the Cardiovascular - vasomotor symptoms during the menopause?
Patient modulate the vasomotor tone of the blood vessels through its action on adrenaline and noradrenaline and release of nitric oxide (NO).
This process is unstable in menopause - increased adrenaline and noradrenaline release
The unstable flow of blood into the skin blood vessels leads to “hot flushes” , night sweats , cluster and tension headaches
Lack of oestrogen causes vasoconstriction of blood vessels. Combined with increases LDL levels there is a increased risk of cardiovascular disease
What Metabolic changes occur related to menopause?
Lower BMR and ability to burn , increased LDL, lower HDL ( dyslipidemia) and increase deposition of central visceral fat leads to an increased risk of CVD and T2D as well as other metabolic disorders
What Emotional Changes are related to the menopause?
• Insomnia leading to irritability and mood swings; feeling low
• feeling sadness and anxiety can lead to depression
• lack of motivation and difficulty concentrating
• fatigue
• brain fog
