03.1 Endocrinology - Puberty and Menopause

Question 1

Define Thelarche

Answer 1

The onset of breast development

Question 2

Define Adrenarche

Answer 2

The onset of pubic hair growth

Question 3

Define Menarche

Answer 3

The onset of menstruation

Question 4

What is the range of onset of puberty in boys and girls?

Answer 4

Girls 8-13

Boys 9-14

Question 5

Which hormones begin to rise at the beginning of puberty?

Answer 5

LH

FSH

Question 6

Which hormone closes the epiphysis after the growth spurt?

Answer 6

Oestrogen

Question 7

What weight is required for menarche?

Answer 7

48Kg

Question 8

Define precocious puberty

Answer 8

Signs of puberty before the age of 8

Question 9

What are some examples of gonadotrophin dependent causes of precocious puberty?

Answer 9

Tumours (gliomas, astrocytomas, pineal tumours, hamartomas)
CNS Trauma (infection, radiation, surgery)
Congenital Disorders (hydocephalus, arachnoid cyst)
Gonadotrophin secreting tumours (rare)

Question 10

What is the mechanism of gonadotrophin independent precocious puberty?

Answer 10

Pseudopuberty caused by increased production of male/female hormones independent of the HPG axis
LH/FSH suppressed

Question 11

Define pericious puberty?

Answer 11

Delayed puberty

Lack of initial physical changes at 13 in girls, 14 in boys

Question 12

What are the two main classes of causes of pericious puberty?

Answer 12

Gonadal failure (hypergonadotrophic hypogonadism)
Gonadal Deficiency

Question 13

What are some causes of gonadal failure?

Answer 13

Turner’s syndrome
Chemo/radio/surgery
Polyglandular autoimmune syndromes

Question 14

What are some causes of gonadal deficiency?

Answer 14

Congenital hypogonadotrophic hypogonadism
Hypothalmic/pituitary lesions
Rare gene mutations inactivating FSH/LH receptors

Question 15

When does premenopause occur?

Answer 15

40 years

Question 16

What happens in premenopause?

Answer 16

Follicular phase shortens
Ovulation is early/absent
Oestrogen and inhibin levels fall
FSH/LH levels rise

Question 17

When does menopause occur?

Answer 17

At roughly 50 years

Question 18

What happens in menopause?

Answer 18

No more follicles develop
Cessation of menstrual cycles
Oestrogen levels fall
FSH/LH levels rise

Question 19

What are some of the symptoms of menopause?

Answer 19

Hot flushes
Regression and shrinkage of endometrium/myometrium
Cervix thinning
Vaginal rugae lost
Involution of breasts
Skin changes
Bladder changes
Bone density decreases (osteoporosis)