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Sex Hormones During Life Flashcards

(67 cards)

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1
Q

Puberty

A

Maturations of the reproductive organs
Production of sex steroids - oestradiol and testosterone
Develop secondary sexual characteristics
Attain capability to reproduce

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2
Q

What is the main measure of puberty in girls

A

Thelarche ( breast development)

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3
Q

What is the main measurement of male puberty

A

Genitalia ( testicular volume in boys)

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4
Q

What is used to measure the puberty in both males and females

A

Pubarche

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5
Q

Gonadarche

A

Activation of gonads by HPG axis

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6
Q

Thelarche

A

Breast development

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7
Q

Menarche

A

Menstrual cycles

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8
Q

Spermaeche

A

Spermatogenesis

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9
Q

Adrenarche

A

Adrenal androgen production

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10
Q

Pubarche

A

Pubic hair

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11
Q

Secondary sexual characteristic in girls

A 
Oestradiol : 
Breast development 
Hair growth ( pubic, axillary) 
Sweat gland composition - skin oiliness / acne
Changes to external genitalia
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12
Q

Secondary sexual characteristic in men

A 
Testosterone 
- deepening of voice 
Hair growth - Pubic, axillary  , facial 
Sweat gland composition - skin oiliness / acne
Changes to external genitalia
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13
Q

Onset of puberty in girls

A

8-13 yrs

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14
Q

Onset of puberty in boys

A

9-14 yrs

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15
Q

Look at the puberty sequence of events slide

A

Puberty sequence of pubertal events diagram

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16
Q

First thing that occurs for puberty to take place

A

Activation of the GnRH axis

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17
Q

Gonadarche

A

In foetus there is a mini puberty so especially in boys what happens is that there is testicular descent, pencils length , Sertoli cell maturation and behavioural effects

Then quiescence of HPG axis

Then increased nocturnal GnRH pulsatility

The normal pulsating GnRH secretion

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18
Q

Who does delayed puberty occur more often in

A

Boys than girls

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19
Q

Who does precocious puberty occur more often in

A

Girls

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20
Q

Sequence of puberty in girls

A

Thelarche
Growth spurt
Pubarche
Menarche

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21
Q

Sequence of events in boys

A

Genitalia
Pubarche
Growth spurt
Spermarche

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22
Q

Primary ammenorrhea

A

When periods start later than 16 years or do not occur

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23
Q

Secondary amenorrhea

A

Common for periods to be irregular/ involuntary for the first 18 months
Periods start and then stop for at least 3-6 months

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24
Q

What is the most commonest physiological cause of secondary amenorrhea in women

A

Pregnancy

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25
Amenorrhea
Absence of periods - no periods for at least 3-6 months Or up to 3 periods per year
26
Oligomenorrhea - few periods
Irregular or infrequent periods which are more than 35 day cycles 4-9 cycles per year
27
1st stage of follicular phase
FSH ( follicular stimulating hormone ) rises which causes 2-3 follicles to grow
28
Second phase of menstrual cycle
2-3 follicles start to grow
29
Third phase of menstrual cycle
Follicles produce estradiol and inhibin B Inhibin B causes negative feedback on pituitary gland , estradiol at low levels can cause negative feedback on the HPG axis - these all act to decrease the HPG axis and decrease FSH back down
30
What is the 4 th step of menstrual cycle
FSH is reduces by E2 and inhibin B by negative feedback
31
What is the 5th step of the menstrual cycle
The FSH window is restricted and the non dominant follicles undergo atresia However the largest follicle typically needs less FSH to grow as it grows larger and therefore this then develops into the dominant grafian follicle
32
Step 7 of menstrual cycle
The levels of oestradiol increase as the dominant graffiti follicle continues to secrete more oestradiol
33
Step 8 of menstrual cycle
The oestradiol switches to positive feedback on pituitary gland
34
Step 9 of the menstrual cycle
LH surge is induced by high E2 and positive feedback and this causes high LH
35
Step 10 of ovulation
Ovulation is caused
36
Literal phase
Corpus leuteum produces progesterone and oestradiol acts on endometrium to make it better for pregnancy
37
Endometrium ; uterine cycle
1) menstrual phase 2) proliferative phase / oestradiol - endometrium lining regrows which causes the growth of new epithelial cells Gland proliferation Increase in stromatolites / arteriolar 3) secretory phase ( progesterone ) - transformation of uterine layer to be receptive for implantation . Increased volume of stromatolites cells > thick spongy lining Cork screw shaped glands secreting glycogen Coiling and lengthening of spinal arteries
38
What hormone does the embryo produced and how does this cause on corpus leuteum
Secreted B-HCG which acts on LH receptors on corpus Lyceum and maintains the production of progesterone and oestradiol during pregnancy which maintains the endometrium lining If no embryo is implanted then no beta HCG is produced which means that the corpus luteum dies off and no progesterone and oestradiol is produced
39
When in non pulsation GnRH used ( normal GnRH secretion is pulsatile)
If nonpulsatile you get a decrease in GnRH and this decreases LH and FSH which can be used to treat prostate cancer for example as cancer cells need LH and FSH to divide
40
Hypogonadism
Decreased oestrogen in woman | Decreased testorone in. Man
41
Possible causes of hypogonadism
Problems affecting pituitary gland or the testes or ovaries or the hypothalamus
42
Primary hypogonadism
Problem with the testes or the ovaries | You have low E2 or Testosterone but have high LH/FSH
43
Examples of causes of primary hypogonadism in man
Infection - e.g. mumps / trauma/ cancer of testes
44
What is the commonest physiological cause of primary hypogonadism in women
Menopause. Low E2 , High LH/FSH Low inhibin
45
Secondary hypogonadism / hypogonadotropjic hypogonadism
Low or normal LH/FSH | Low E2/ Testosterone
46
Possible causes of secondary hypogonadism
Pituitary tumour / high prolactin- prolactinoma
47
Menopause symptoms
Due to lack of estradioj ``` Skin dryness/hair thinning Hot flushes / sweating / sleep disturbances Mood disturbance Osteoporosis Sexual dysfunction Weight gain Amenorrhea Cessation of fertility Climacteric ```
48
Peri menopausal
Within 1 year of LmP
49
Post menopausal
After 1 he of menopause
50
Treatment of menopause
Osteogenesis replacement ( HRt) Oestrogen stimulates the endometrium but to make sure that the endometrium doesn’t grow too much, you add progesterone which reduces risk of endometrial hyperplasia/ cancer
51
What is ovarian reserve
Number of eggs that you can have in the ovaries before you go to menopause
52
Blood test to find ovarian reserve
Blood test - measure level of anti mullerian hormone - peaks in early adult life
53
Early menopause is also called
Premature ovarian insufficiency
54
Symptoms of PoI
Same symptoms as per menopause but still producing a bit of oestrogen , conception may occur
55
Diagnosis of POI
High FSH > 25 iU/L on at least 2 occasions 4 weeks apart
56
Causes of POI
Autoimmune Genetic - fragile X syndrome / Turner syndrome Cancer therapy - radio / chemo therapy in the past
57
Is there an equivalent of menopause in men
Late onset hypogonadism
58
SHBG
Sex hormone binding globulin which binds to testosterone and makes it not available
59
Albumin
Binds to testosterone but weakly and so the testosterone is bioavailable
60
Free testosterone
With age there is a decrease in free testosterone and increase in SHBG
61
When and how is testosterone measured
In the morning at fasting as glucose can decrease testosterone levels
62
Symptoms of testosterone deficiency
Sexual dysfunction Erectile dysfunction Hair growth - decreased frequency of having Low energy levels Mood disturbance Body composition - increased fat/reduced muscle mass Gynaecomastia ( breast enlargement in man) Spermatogenesis - high levels of intra testicular testosterone needed Bone health - via conversion to oestrogen
63
5 alpha reductase
Converts testosterone to di hydro testosterone ( DHT) and stronger androgen than testosterone and more potent ligand for androgen receptor
64
Aromatase
Converts testosterone to Oestrogens
65
What can increase Oestrogens
``` Age Obesity Insulin Gonadotrophins Alcohol ```
66
Breast cancer
Can use aromatase inhibitor like anstfozole which decreases the testosterone to oestrogen
67
Prostate cancer
5 alpha reductase inhibitor | E.g. finasteride

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