Sex Hormones during life Flashcards
(57 cards)
What are the symptoms of menopause ?
Skin dryness/ hair thinning Hot flushes - go red; lasts for many years but treatable Mood disturbance Osteoporosis; E2 stimulate osteoblasts Sexual dysfunction Weight gain Amenorrhea Climacteric- irregular periods approaching menopause
What are the effects of testosterone?
Hair growth, sexual function, muscle mass and voice- deep
Sweat production; acne
When does adrenarche start in relation to gonadoarche
2 yrs BEFORE; adrenaline contribute to development of hair.
Why can’t men with prolactinoma cannot secrete milk?
Men don’t have oestrogen in breast area to prime the breast for secretion unlike females. Prolactin is dependent on oestrogen for milk secretion.
What must to do to accurately measure testosterone levels?
Measure before 11am
Measure with fasting
Describe the pre ovulatory follicular phase of the menstrual cycle
- Graffian follicle emerges
- E2 increases; switch to positive feedback by E2
- Induces LH surge
- Causes ovulation
What are the other hormonal changes during puberty?
Adrenarche
Gonadarche- activation of HPG axis
What is the significance of DHT?
More potent ligand for Androgen Receptor (AR)
What is used to measure testicular volume
Orchidometer
What is pre mature menopause and explain its prognosis
Menopause before 40 yr- 1% women have this.
Premature ovarian insufficiency
Conception can still happen(20%)
High FSH of more than 25iU/L
What are the congenital causes of secondary hypogonadism
Idiopathic hypogonadotrophic hypogonadism
Kallmann syndrome- LACK of smell with CHH
Describe the “Follicular” phase of the menstrual cycle?
- FSH rises
- Two or 3 follicles start to grow
- The follicles produce E2 and inhibin B
- They reduce FSH by negative feedback
- Restrict FSH window and non-dominant follicles underdo atresia
What might be the causes of primary hypogonadism in men and women
Man- infection/trauma/ cancer of testis
Woman- menopause
The sex glands are the ones affected
What are the markers of primary hypogonadism?
Low E2/testosterone
Hence high LH/FSH
What is secondary hypogonadism? What are the potential causes?
Low LH/FSH
Low E2/testosterone
Cause by pituitary tumour or high prolactin
What is the boys prepubertal and adult size testicular size
Prepubertal- lower than 4 mls
Adult size- higher than 15mls
What is common for secondary amenorrhea?
Irregular/anovulatory period for the 1st 18 months
What could be the cause of congenital primary hypogonadism?
Clinfekter syndrome- extra X chromosome
Cryptorchism- Testicles does not descend fro abdomen
What is the purpose of progesterone in the SECRETORY PHASE?
Maintains endometrium; angiogenesis
It inhibits HPG axis hence LH and FSH is low
What is primary amenorrhea?
No menarche after 16yrs; abnormal
What are the symptoms of testosterone deficiency?
Sexual dysfunction; loss of morning wood Decreased Hair growth- frequency of shaving Energy levels go down Mood disturbance Increased fat and low muscle mass Decreased bone health Breast enlargement Low spermatogenesis
What is androstenedione aromatised to?
Oestrone
Explain the late onset hypogonadism in MEN
Free testosterone levels in man go down with age
SHBG goes up; as testosterone blinded to SHBG is unavailable to tissues
Total testosterone levels is still the same
What is testosterone aromatised to?
17B-Oestradiol