Sex hormones

Question 1

What is the definition of puberty

Answer 1

Maturation of reproductive organs Production of sex steroids Development of secondary sexual characteristics Attain capability to reproduce

Question 2

What is thelarche

Answer 2

Breast development

Question 3

What is genitalia

Answer 3

Question 4

What is pubarche

Answer 4

Question 5

What are the different types of arche

Answer 5

Gonadarche - activation of gonads

Thelarche - breast development

Menarche - menstural cycles

Spermarche - spermatogensis

Adrenache - Adrenal Androgen Production

Pubarche - Pubic hair

Question 6

What are the secondary sexual characteristics in girls

Answer 6

Breast development

Hair growth - pubic, axillary

Sweat Gland Composition - skin oiliness/acne

Changes to external genitalia

Question 7

What are the secondary sexual characteristics in men

Answer 7

Deepening of voice

Hair growth - pubic then axillary, facial

Sweat Gland Composition - skin oiliness/acne

Changes to external genitalia

Question 8

Sequence of pubertal events in girls

Answer 8

Thelarche

Pubarche

Height

Menarche

Question 9

Sequence of pubertal events in guys

Answer 9

Gonadarche

Pubarche

Onset penis growth

Height

Question 10

Is normal Gonnadotrophin releasing hormone secretion pulsatile

Answer 10

Yes

Question 11

Hormonal Control of Puberty-Gonadarche

Answer 11

Question 12

What are the normal age of puberty

Answer 12

Girls 8-13yrs

Boys 9-14yrs

S.d. SD

Question 13

What are the features of menarche

Answer 13

Happens 2.3 years after thelarche

Primary amenorrhoae - later than 16 years is abnormal

Secondary amernorrhoea - periods can be irregular. Classified as stopping for 3 to 6 months

Question 14

What is a-menorrhoea

Answer 14

Absence of periods

3-6 months no periods

Question 15

What is oligo-menorrhoea

Answer 15

Few periods

Infrequent periods with >35 days

4-9 cycles per year

Question 16

What is the follicular phase of menstrual cycle

Answer 16

1. FSH rises
2. 2-3 follicles grow
3. Produces E2 and Inhibin B
4. Reduce FSH (negative feedback)
5. Restrict FSH window and non dominant follicles undergo atresia
6. Dominant graafian follicle is less FSH dependent
7. E2 continues to increase
8. Switches to +ve feedback
9. Induces LH surge
10. Ovulation

Question 17

What happens during the luteal phase of ovarian cycle

Answer 17

Corpus luteum forms

Progesterone and oestradiol

Question 18

What happens during the secretory phase - uterine cycle

Answer 18

Increased volume of stromal cells

Cork-screw shaped glands secreting glycogen

Coiling and lengthening of spinal arteries

Question 19

What happens during the proliferative pahse

Answer 19

Growth of new epithelial cells

Gland proliferation

Increase/ arterioles

Question 20

What happens when there is non-pusaltility of the HPG axis

Answer 20

Decreased LH/FSH secretion

Question 21

What is the difference in pulsatility in follicular compared to luteal

Answer 21

Follicular phase - every 90-120 minutes

Luteal phase - 180-240 minutes

Question 22

What is hypogonadism

Answer 22

Decrease Oestrogen in a woman

Decreased Testosterone in a man

Question 23

What happens in primary hypogonadism

Answer 23

Low E2/testo

High LH/FSH

Men - infection, trauma, cancer of tests

Women - menopause

Question 24

What happens in secondary hypogonadism

Answer 24

Pituitary Tumour

High Prolactin

Low LH/FSH

Low E2/Testo

Question 25

What are the symptoms of menopause

Answer 25

Skin dryness/ hair thinning hot flushes/ sweating/ sleep disturbance Mood disturbance Oestoporosis Sexual Dysfunction Weight gain Amenorrhoea - peri, within 1yr of LMP: post - after 1yr LMP Cessation of fertility Climateric - irregular periods

Question 26

What is the treatment of menopause

Answer 26

Oestrogen Replacemnt - HRT Oestrogen stimulates the endometrium Add progesterone if endometrium is intact to prevent endometrial hyperplasia/ cancer

Question 27

What does ovarian reserve refer to

Answer 27

Number of eggs in ovaries that you can have before menopause

Question 28

What hormone can you detect for ovarian reserve

Answer 28

Anti mullerian Hormone Produced by granulosa cells in ovaries

Question 29

What is the average age of menopause

Answer 29

45-55 51

Question 30

How to diagnosis someone with premature ovarian isuffiency

Answer 30

FSH \>25 iU/L on two occasions

Question 31

What are causes of premature ovarian insuffiency

Answer 31

Autoimmune Genetic - fragile X syndrome/ Turners syndrome Chemotherapy

Question 32

What is the percentage of testosterone in the blood

Answer 32

60% is bound to sex hormone binding globulin - extremely strong so unavaliable 38% Albumin - weakly binds, bioavaliable 2% active - free testosterone

Question 33

What is andropause

Answer 33

SHBG increase which decreases free testosterone Lat onset hypogonadism

Question 34

When is testosterone at its peak

Answer 34

Measure testosterone at its peak Diurnal rhythm

Question 35

How does sugar affect testosterone

Answer 35

Drop testosterone by 20% Measure it when fasting

Question 36

What are symptoms of testosterone deficiency

Answer 36

Sexual dysfunciton Decrease frequency of hair growth Energy level Mood disturbance Increase fat/ reduced muscle mass Gynaecomastia (breast enlargment) Decrease spermatogenesis Oestoperosis

Question 37

What converts testosterone to dihydrotesterone

Answer 37

Stronger androgen, more potent ligand for AR 5alpha - reductase Prostate, Skin, Liver, Testes

Question 38

What converts testosterone to oestrogens

Answer 38

Armotase Adipose tissue Adrenal glands Ovaries Testes Brain Bone Skin

Question 39

What increases aromatase

Answer 39

Age Obesity Insulin Gonadotrophins Alcohol

Question 40

What does aromatase convert

Answer 40

Androstenedione - oestrone Testosterone - 17B oestradiol

Question 41

How can you use enzymes therapeutically

Answer 41

Aromatase inihibtor - anastrozole for breast cancer 5 alpha reductase inhibitor - finasteride