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Repro > Week 3.0 - Puberty and menopause > Flashcards

Week 3.0 - Puberty and menopause Flashcards

(53 cards)

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1
Q

Define Puberache

A

-Development of axillary and pubic hair

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2
Q

Define menarche

A

-First menstrual period

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3
Q

Define adrenache

A

-onset of increased androgen secretion

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4
Q

What is puberty?

A

-Stage of human development when sexual maturation and growth are completed and results in the ability to reproduce

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5
Q

Who begins puberty first girls or boys?

A

-Girls

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6
Q

Define thelarche

A

-Development of breast

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7
Q

Describe the main features of puberty

A
  • Accelerated somatic growth
  • maturation of gonads and genitals
  • Development of secondary sexual characteristics
  • Menstruation and spermatogenesis begins (reproductive system inactive before this)
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8
Q

With what hormonal changes is the onset of puberty associated with?

A
  • Gradual activation of GnRH causing steady rise in FSH and LH
  • Increased secretion of oestrogens and androgens
  • Extragonadal hormonal changes -> elevation of adrenal steroids and IGF-1
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9
Q

Which hormones is the growth spurt dependent upon?

A
  • Growth Hormone

- Sex steroid hormones

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10
Q

What is the difference between the growth spurt in girls and boys?

A

-Earlier and shorter in girls

men are larger because growth spurt longer and slightly faster

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11
Q

What signifies the end of the growth spurt?

A

-Epiphyseal fusion

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12
Q

What causes the growth spurt to be shorter in girls?

A

-Oestrogen closes the epiphyseal plates earlier

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13
Q

What controls the rate of genital development in boys?

A

-Testosterone

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14
Q

When does puberty typically begin in girls?

A

-8-13 years (mean 11.5 years)

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15
Q

When does puberty typically begin in boys?

A

-10-14 years (mean 12.5 years)

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16
Q

What is the critical weight for menarche?

A

-47kg

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17
Q

What is the relationship between weight and menstruation?

A
  • If weight falls below ~47kgs then reproductive cycle will cease
  • Overweight tend to start period early
  • Obesity can also interfere with normal menstruation
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18
Q

Name one environmental factor thought to influence puberty?

A
  • Light/dark exposure ie day length

- Altitude

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19
Q

What happens to the LH pulses on lead upto puberty?

A

-Pulses are negligible and then increase in amplitude and frequency

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20
Q

What is the first phenotypic change in girls?

A

-Breast development

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21
Q

What is the first phenotypic change in boys?

A

-Testicular enlargement

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22
Q

What is the relationship between sleep and LH?

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A

-LH secretion is associated with REM sleep and begins as nocturnal pulsatility which causes a noturnal increase in sex steroid secretion

23
Q

What initiates gonadal development in puberty?

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A

-high levels of FSH and LH secretion

24
Q

What happens after the gonads have started to develop in males?

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A
  • Spermatogenesis and androgen secretion begins

- Androgens initiate growth of sex accessory structures (eg prostate) and secondary sex characteristics

25
The adrenal glands secrete androgens, why does this not initiate puberty?
-Level too low
26
What is the relationship between TSH and puberty?
-As puberty starts TSH secretion from pituitary increases leading to increased metabolic rate and promotes tissue growth
27
What effects do androgens have on growth?
-Cause retention of mineral to support bone and muscle growth
28
Which sex steroid do sertoli cells secrete?
-Oestrogen
29
Which secondary sex characteristics are driven by androgens in females?
- Pubic hair growth - Bone growth - Sebaceous gland secretion
30
Where are androgens released from in women?
-Adrenals
31
State the order of pubertal changes in girls
- Thelarche - Pubuc hair growth - Growth spurt - Menarche - Breast development and pubic hair development complete
32
State the order of pubertal changes in males
- Genital deveopment - Pubic hair growth - Spermatogenesis - Growth spurt - Genital development and pubic hair development complete
33
What is tanner staging? explain it
-A method of staging pubertal development -Different in girls and boys -Each individual change has 5 stages eg girls: Breast 1-5, Pubic hair 1-5, Axillary hair 1-5, menarche boys: Testicular vol >4ml, Penis enlargment 1-5, pubic hair 1-5, axillary hair 1-5, spermache
34
What initiates the 1st ovarian cycle?
-1st LH surge
35
Define precocious puberty
- Onset of puberty before the average age | - Before 8 in girls and 9 in boys
36
How common is precocious puberty?
-1/5000-10,000 | much more common in females
37
What is the most common cause of precocious puberty?
-Idiopathic
38
Besides idiopathic, what are the two types of causes of precocious puberty?
- Gonadotrophin dependant | - Gonadotrophin independent
39
Give an example of gonadotrophin dependant cause of precocious puberty
- Tumour eg hcg secreting tumour - Trauma - Nutritional status ie obesity
40
Give an example of gonadotrophin independent cause of precocious puberty
- Choriocarcinoma of gonads/pineal gland - Meningitis - Congenital adrenal hyperplasia
41
What is precocious pseudopuberty?
- Development of secondary sex characteristics without activation of the reproductive system - Caused by an alternative source of androgen or oestrogen, independent of FSH/LH/GnRH
42
What is testotoxicosis?
- Familial male precocious puberty - Autosomal dominant condition where there is rapid skeletal growth, skeletal maturation and sexually aggressive behaviour in the first 2/3 years of life
43
Define delayed puberty
Either: -Initial physical changes of puberty are not present by age 13 in girls (or primary amenorrhea by 15.5/16) or 14 in males or -Pubertal development is inappropriate ie interval between first signs of puberty and menarche.complete genital growth is >5years
44
What are the 2 major causes of delayed puberty?
- Gonadal failure (hypergonadotrophic hypogonadism) | - Gonadal deficiency
45
Give some causes of gonadal failure
- Turners syndrome - Post-malignancy treatment - polyglandular autoimmune syndrome
46
Give some causes of gonadal deficiency
- Congenital hypogonadotrophic hypogonadism - Hypothalamic/pituitary lesions - Rare genetic mutations inactivating LH/FSH receptors
47
Describe pre-menopause
- typically from age 40 - Follicular phase shortens - Ovulation becomes early/absent as primary follicles begin to run out-> reduced fertility - less oestrogen secreted
48
Describe menopause
- Cessation of menstrual cycle for at least 12months - Average age 49-50 - No more follicles - Oestrogen levels fall dramatically thus FSH/LH rise dramatically (no inhibin)
49
Describe the effects of the menopause on oestrogen sensitive tissues
- Thinning of cervix - Regression of endometrium/myometrium of uterus - Vaginal rugae lost reducing vaginal tone - Involution of breast tissue - Urinary incontinence
50
Describe the effects of the menopause on bone
- Bone mass reduces by 2.5%/year for several years - Enhanced osteoclast ability to absorb bone and attentuated osteoblastic activity - Osteoporosis
51
Describe the purpose of HRT
-Relieve symptoms of menopause and improve well-being -Can limit osteoporosis (-given orally or topically)
52
Why might precocious puberty be stimulated by meningitis?
-Increased pressure due to swollen meninges causing activation of HPG axis
53
Would you expect a female to be taller or shorter with precocious puberty? why?
-Shorter due to early closure of epiphyseal growth plates

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