Puberty and Menopause

Question 1

What does Thelarche mean?

Answer 1

Breast Development

Question 2

What does Puberache mean?

Answer 2

Development of Axillary and Pubic Hair

Question 3

What does Menarche mean?

Answer 3

The First Menstrual Period

Question 4

What does Adrenarche mean?

Answer 4

The Increase in Androgen Secretion from the Adrenal Glands

Question 5

How do you define Puberty?

Answer 5

A stage of human development when sexual maturation occurs , results in the ability to reproduce

Question 6

When are Primary Sexual Characteristics established?

Answer 6

Before Birth

Question 7

How is Puberty initiated?

Answer 7

By an increase in the number of GnRH pulses, which increases LH and FSH secretion

Question 8

What is Precocious Puberty?

Answer 8

The Early Onset of Puberty

In females this could mean secondary characteristics before the age of 8, or menarche before the age of 10

In males it means earlier than 9

Question 9

What is a growth spurt?
When does it occur?
why does it end earlier in girls?

Answer 9

A sudden increase in growth
It occurs at at around 10-15 (12 peaks) for Girls and 12-17 (14 peak) for Boys
It ends earlier as Oestrogen fuses the epiphyseal plates earlier

Question 10

What is the Critical Weight (Puberty)?

Answer 10

Critical Weight is the minimum weight a female has to be for menarche
It is about 47kg
It shows Leptins may be involved in signalling for puberty

Question 11

What are some environmental influences on puberty?

Answer 11

Changes in Day Length

Involves Pineal Gland and Melatonin Secretion

Question 12

What are the hormone changes in puberty?

Answer 12

Increase in GnRH secretion
Increases LH and FSH, which leads to steroid production = Sexual Maturation

Increase in Growth Hormone and TSH

Question 13

What is the first phenotypical change in puberty in fe/males?

Answer 13

Breast Development
Testicular Enlargement
Due to Nocturnal LH secretion

Question 14

At what age does puberty occur?

Answer 14

Between 8 and 13 for Girls

Between 9 and 14 for Boys

Question 15

At what age does Menarche occur?

Answer 15

95% of girls between 11-15

Normally before 16 years

Question 16

What does the increase in LH and FSH do? (Puberty)
In Males?
In Females?

Answer 16

Male: Stimulates Spermatogenesis and Androgen Secretion

Androgens lead to the growth of sex accessory structures (prostate…); secondary characteristics and mineral retention (bone/muscle) growth

Females: Increases Oestrogen Production
Androgens from Adrenal Glands increase

Oestrogen and Androgens induces secondary characteristics

Question 17

Why does TSH rise in puberty?

Answer 17

Increases Metabolic Rate

Promotes Tissue Growth

Question 18

What are the Secondary Characteristics of Females?

Answer 18

Growth of the Pelvis
Deposition of Subcutaneous Fat
Growth of Internal Repro. Organs
Growth of External Genetalia
(All stimulated by Oestrogen)

Pubic Hair Growth
Lowering Voice
Bone Growth
Increased Secretion from Sebaceous Glands
(Androgens from Adrenal)

Question 19

What are the Secondary Characteristics of Males?

Answer 19

Facial Hair
Growth of the Larynx
Increase Genital Volume and Size
Pubic Hair
Growth Spurt

Question 20

What is the Tanner Standard?

Answer 20

The Classification of pubertal development

Stages each Secondary Characteristic

Question 21

What initiates the 1st ovarian cycle?

Answer 21

The surge of LH release
Doesn’t usually have ovulation in 1st cycle
Follicle growth stimulates Oestrogen increase

Question 22

What can cause Precocious Puberty?

Answer 22

Hormones Secreting Tumours (Dependent of Gonadotrophs)

Early Stimulation of Central Maturation, increase in hormones, not related to the HPG axis

Question 23

What can cause early independent stimulation of maturation?

Answer 23

Congenital Adrenal Hyperplasia
Tumours
Testotoxicosis
Exogenous Oestrogen/Androgen Exposure

Question 24

What is Delayed Puberty?

Answer 24

When the physical changes of puberty aren’t present by 13 or 14
Or there is primary amenorrhoea at 16

Question 25

What can delay puberty?

Answer 25

Gonadal Failure | Gonadal Deficiency

Question 26

What can cause Gonadal Failure?

Answer 26

Turner's Syndrome Post-Malignancy Chemo/Radiotherapy/Surgery Polyglandular Autoimmune Syndromes

Question 27

What can cause Gonadal Deficiency?

Answer 27

Congenital Hypogonadotrophic Hypogonadism Hypothalmic/Pitruitary Lesions Gene Mutations Inactivating FSH/LH or their receptors

Question 28

What is the Climacteric?

Answer 28

``` The end of the reproductive cycle for females Has 3 Parts: Pre Menopause Menopause Post Menopause ```

Question 29

Describe Pre-Menopause

Answer 29

``` Around 40 years Follicular phase shortens No/Early ovulation Less Oestrogen and Inhibin produced Increase in LH and FHS Reduced fertility ```

Question 30

Describe Menopause

Answer 30

The complete cessation of the menstrual cycle No follicles left to develop Vascular changes = hot flushes (due to decrease in Oestrogen) Endometrium regresses Myometrium shrinks Cervix thins Vaginal rugae are lost Breast tissue involution Skin changes Bladder changes Bones = Osteoporosis

Question 31

Describe HRT

Answer 31

Hormone Replacement Therapy Aims to reduce/prevent symptoms of the menopause Topical or Oral

Question 32

What are the main risk factors about HRT?

Answer 32

Increase risk of breast malignancy | Endometrium thickens in Oestrogen only preperations so don't give unless Hysterectomy

Question 33

How is the end of the male reporductive life signalled?

Answer 33

There is no defined end Number/Quality of Sperm can decrease as go on Testosterone levels can lower