Flashcards in Repro 3.1 Puberty and Menopause Deck (44)
When does the growth spurt occur in boys?
12 months after genital development
How is the cause of delayed puberty in boys diagnosed?
Low testosterone indicates hypogonadism
Low FSH indicates hypothalamic/pituitary problem
How might you treat precocious puberty?
Treat underlying cause:
Drugs to inhibit pituitary gonadotrophin secretion eg medroxyprogesterone or LHRH analogues
Drugs to block androgen action e.g. cryproterone
What disorders of the adrenal gland might cause precocious puberty?
Congenital adrenal hyperplasia -> hyperfunction
Cushings syndrome from adrenocortical tumour
What is the menopause?
End of reproductive life
On average, at what age does menopause usually occur?
What causes menopause?
Depletion of follicles in the ovaries so gonadotropins are no longer able to stimulate follicular development - interaction between the hypothalamus, pituitary and gonads that usually maintains the reproductive cycle is broken
What physiological changes occur with the onset of the menopause?
vasomotor changes - hot flushes (approx 80%)
Regression of endo and myometrium
Thinning of cervix
Vaginal rugae lost
Involution of some breast tissue
Decreased bone mass 2.5% pre year -> osteoporosis
What changes occur in the menstrual cycle in pre-menopausal women?
More erratic menstrual cycle
Shortened follicular shortened - ovulation early or absent
Less oestrogen secreted
LH and FSH levels rise, FSH more (inhibin)
Reduced fertility but not absent
What changes in the menstrual cycle and relevant hormones occur in menopausal women?
Cessation of menstrual cycles
No more follicles to develop as the stock is used up
Oestrogen levels fall dramatically
FSH and LH levels rise (FSH more)
What is HRT?
Hormone replacement therapy
Relieves symptoms of the menopause
Can improve well-being
Oestrogen given orally or topically by patch of gel
Can limit osteoporosis but no longer recommended for first line treatment
No effect on cardio changes
When does the end of the male reproductive life occur?
Spermatogenesis continues throughout life but incidence of loss of libido, impotence and inability to reach orgasm increase with age
Testosterone levels may decrease but without rise in LH (or FSH) suggesting a change in feedback control mechanism
What are possible disadvantages of HRT?
Clots - thromboembolism
Endometrial or breast cancer