19 The effects of ageing on the reproductive system Flashcards
what is the definition of ageing?
the accumulation of physical and physiological changes within a person
give four examples of ageing
decreased basal metabolic rate
decreased cardiac output
changes in reproductive hormones
change in physiology of ovaries
what is the effect of ageing on oestrogen secretion?
decreased secretion
what is the effect of ageing on FSH secretion?
increased secretion, then decreases when menstruation finishes
what is the effect of ageing on LH secretion?
increased secretion, then decreases when menstruation finishes
what is the definition of senescence?
the deterioration of tissues and the loss of their biological function as a result of time, which increases the mortality of the organism
what effect does ageing have on the ovaries?
follicles become less sensitive to FSH ∴ rupture and disappear
when none left, menstruation stops
decreased oestrogen secretion
from what age does fertility in women begin to decrease?
35
what is the ovarian reserve?
the ability of an ovary to produce secondary oocytes that can be fertilised
the presence of which hormone in the blood plasma is used to indicate an ovarian reserve?
anti-mullerian hormone (AMH)
what is the menopause?
the last menstrual cycle in a woman
what is the normal age range for the onset of the menopause?
50-54
can be 35-59
what is the perimenopause?
occurs several years before the menopause
periods become irregular and infrequent
length of time between periods increases to cessation (menopause)
give examples of menopausal symptoms
irregular h.r.
night sweats
insomnia
loss of libido
depression
vaginal dryness
what are some causes of early-onset menopause
heavy smoking
medical treatment –> decreased oestrogen (e.g. chemotherapy/hysterectomy)
what is the purpose of hormone replacement therapy (HRT)?
replacement of hormones that are decreasing in concentration due to the menopause
what is unopposed oestrogen (HRT)? what are its strengths and weaknesses?
daily oestrogen
+ good for early menopause
- increased risk of uterine cancer
what is combined HRT? what are its strengths and weaknesses?
daily oestrogen and progestin
+ reduced risk of endometrial cancer
what is the cyclical regime of HRT? what are its strengths and weaknesses?
daily oestrogen and progestin for 3 weeks, followed by a 1 week bleed
+ lighter period
- still have periods
what is the continuous schedule of HRT? what are its strengths and weaknesses?
same hormones taken daily (usually oestrogen and progestin)
+ no withdrawal bleeds and fewer side effects
- patch requires replacing every 1-2 weeks
what are the delivery systems used to administer HRT?
oral tablets
skin patches
transdermal implants
vaginal rings
gel
what are some advantages of HRT?
prevention of hot flushes/vaginal dryness
reduced risk of osteoporosis
reduced muscle pain
reduced loss of connective tissues
reduced risk of Alzheimer’s
what are some disadvantages of HRT?
2x/3x increased risk of venous thromboembolism
increased risk of stroke
increased risk of breast cancer
increased risk of endometrial cancer
why are alternatives to HRT required?
history of breast/ovarian/endometrial cancer
history of blood clots
history of heart disease/hypertension
liver disease
what is the role of phytoestrogens?
naturally occurring; mimic oestrogen
converted to oestrogen-like compounds in the gut by hydrolysis
reduce effects of viral infections
e.g. isoflavones; lignans
how can lifestyle changes reduce symptoms of the menopause?
yoga/aromatherapy
regular exercise
reduce stress
reduce caffeine/alcohol
what is the effect of ageing on testicular tissue?
decrease in mass
decrease in testosterone secretion
what is the effect of ageing on sperm production?
rate of production decreases
loss of surface cells in prostate gland/epididymis/seminal vesicles
sclerosis in epididymis
what is the effect of ageing on erectile function?
erectile problem –> erectile dysfunction
loss of libido
what is benign prostate hypertrophy/hyperplasia (BPH)?
result of ageing in men, causing scarring of prostate tissue
hyperplasia = incr. in cell quantity hypertrophy = incr. in cell size
what is are the effects of BPH?
ejaculation/urination problems
decreased testosterone production
incontinence
decrease in dihydrotestosterone
how is BPH diagnosed?
rectal examination
blood tests for PSA to exclude prostate cancer
ultrasounds
how can BPH be treated?
lifestyle changes
medication to relax smooth muscle in prostate
surgery
