Reproductive Cycle

Question 1

3 fns of male reproductive system

Answer 1

• spermatogenesis
• sex act
• regulation of male reproduction function

Question 2

spermatogenesis

Answer 2

• the sertoli cells in the seminiferous tubule are where differentiation and meiosis of sperm cells occurs
• requires FSH and E
• LH required to push sperm into lumen
• T and E required for maturation of sperm

Question 3

FSH source, target, and action

Answer 3

• pituitary
• sertoli cells
• spermatogenesis

Question 4

LH source, target, and action

Answer 4

• pituitary
• Leydig cells
• androgen release

Question 5

GH source, target, and action

Answer 5

• pituitary
• many
• background metabolism

-if you have a GH deficiency, it may cause a decrease in sperm count

Question 6

Androgens source, target, and action

Answer 6

• testes
• many
• masculinization

Question 7

Androgenic effect

Answer 7

• hair pattern
• muscle distribution
• fat distribution

Question 8

T, Androsterone, Stanozolol

Answer 8

• T anabolic:androgenic = 1:1
• Andro anabolic:androgenic = 1:6
• Stanozolol anabolic:androgenic = 3-6:1
• if you want to bulk up, you want an anabolic effect –> stanozolol!

Question 9

male sex act

Answer 9

• arousal
• spinal reflexes
• parasympathetic (sacrospinal) control of erection, sympathetic (thoracolumbar) control of ejaculation

Question 10

Female follicles

Answer 10

• primary follicle –> forms due to FSH and LH
• once the primary follicle develops, the others go through programmed cell death called atresia
• roughly 20 follicles are lost per month
• secondary follicle (antrum forming) –> has external wall (stratum granulosum)

Question 11

ovarian phase

Answer 11

• follicular

- luteal (dominated by corpus luteum)

Question 12

what causes the release of FSH and LH from the hypothalamus?

Answer 12

• environmental influences

- psychological influences from higher brain

Question 13

Uterine phase

Answer 13

• proliferative (controlled by hormones, i.e. estrogen)

- secretory (i.e. progesterone)

Question 14

FSH effect on ovaries

Answer 14

• development of follicle

- production of estrogen

Question 15

LH effect on ovaries

Answer 15

• ovulation
• development of corpus luteum
• production of progesterone

Question 16

Lukron

Answer 16

-horrible drug used to induce menopause –> inhibits GNRH

Question 17

How does menstruation occur

Answer 17

-at the end of the cycle, abrupt drop in P

Question 18

how long do sperm survive?

Answer 18

• 1st part of cycle, sperm can live for about 5 days

- end of cycle, cervix is dryer and sperm only live for a couple days

Question 19

Stability of follicular phase vs. luteal phase

Answer 19

• follicular phase not as stable –> susceptible to lack of sleep, stress, travel, etc.
• luteal phase much more stable

Question 20

how can you get pregnant if you only missed one pill

Answer 20

• stop having estrogen and progesterone so your body doesn’t have negative feedback
• progesterone maintains the uterine lining and causes most of the side effects of BC

Question 21

reasons why you cant get pregnant

Answer 21

• due to male
• because female luteal phase may only be 8-10 days (on average, its 12-14 days), developing embryo needs time to make own nutrients

Question 22

body temperature during ovulation

Answer 22

• cortisol causes body temperature to rise during the day so you must measure at the same time each day
• PROGESTERONE makes the body temp increase!
• when you ovulate, corpus luteum makes progesterone which causes temp to spike!!

Question 23

erectile dysfunction

Answer 23

• are you attracted to your partner
• if problem is at gonads, T will be low but GNRH, LH, and FSH will be high
• multiple causes including psychogenic, neurogenic, hormonal, vascular, drug related, penile related

Question 24

Hypogonadism

Answer 24

• decreased androgen levels (primary = gonad issue, secondary = pituitary issue)
• presents with decreased libido, depression, fatigue
• measure free T –> most is bound to androgen binding proteins
• cause could hyperprolactinemia (inhibits GnRH centrally)
• MCC related to vascular changes d/t smoking, lipids, DM, HTN, etc.

Question 25

hypergonadotrophic hypogonadism

Answer 25

-decreased T, increased FSH

Question 26

hypogonadotrophic hypogonadism

Answer 26

-decreased T, decreased FSH

Question 27

endometriosis

Answer 27

- growth of endometrial tissue outside uterus - increase in western countries (10-15%) - risk factors = early menarche (more cycling time), short cycles (more cycles in same amnt of time), long periods, heavy flow, increased pain, primary relatives - MC with postponed childbirth (fewer kids) -possible mechanisms: retrograde menstruation (when woman menstruates, some goes out of tubes and into body cavity), or hematogenous spread (travels in blood and lymph)

Question 28

amenorrhea

Answer 28

- absence of menstruation - failure to develop follicle to point of maturation/ovulation - MCC = PREGNANCY - common after menarche and during perimenopause (both times, the ovaries are not fully functional)

Question 29

hypomenorrhea

Answer 29

scanty menstruation

Question 30

oligomenorrhea

Answer 30

infrequent menstruation (>35d)

Question 31

polymenorrhea

Answer 31

frequent menstruation (<27d)

Question 32

menorrhagia

Answer 32

excessive menstruation

Question 33

metrorrhagia

Answer 33

bleeding between periods

Question 34

causes of dysfunctional menstrual cycles

Answer 34

- alteration of hormones supporting normal cycles - estrogen = bricks, progesterone = mortar - causes are complex (relative or actual reduced E, sudden drop of P, NOT absence of P) - dysfunctional menstrual cycles are often the result of E and P problems, not pituitary hormones

Question 35

Primary amenorrhea

Answer 35

- failure to menstruate by 16yo or 14yo if absence of secondary characteristics - causes: gonadal dysgenesis (not developing), gongenital mullerian agenesis, testicular feminization, HPO axis defect

Question 36

Secondary amenorrhea

Answer 36

- cessation of menstruation for 6 mos in woman with normal cycles - normal for woman to miss a period every once in a while - ovaria, pituitary or hypothalamic dysfunction, Asherman's syndrome, infection, pituitary tumor, anorexia nervosa, strenuous exercise

Question 37

workup for amenorrhea

Answer 37

-Lab testing: FSH:LH, prolactin (prolactinoma), testosterone (too much testosterone may be indicative of a birth defect), pregnancy, pituitary imaging

Question 38

tx for amenorrhea

Answer 38

- give progesterone challenge - 10d with expected period after withdrawal - combo BCP for period can help regulate cycles - correct underlying causes

Question 39

premenstrual syndrome

Answer 39

- cluster of physical and psychological symptoms limited to the luteal phase, typically relieved by menses --> IT IS NOT PMS IF IT IS NOT LUTEAL PHASE - multiple hormonal theories include prolactin, estrogen, progesterone, aldosterone - PMDD is a DSM4 diagnosis for severe, debilitating PMS with a significant emotional component, treated with SSRI

Question 40

Galactorrhea

Answer 40

- breast milk secretion from non-lactating breast - causes: nipple stimulation, exogenous hormones, hormone imbalance, local infection or trauma, pituitary tumor (prolactinoma) - usually benign, can be observed