19 The effects of ageing on the reproductive system

Question 1

what is the definition of ageing?

Answer 1

the accumulation of physical and physiological changes within a person

Question 2

give four examples of ageing

Answer 2

decreased basal metabolic rate

decreased cardiac output

changes in reproductive hormones

change in physiology of ovaries

Question 3

what is the effect of ageing on oestrogen secretion?

Answer 3

decreased secretion

Question 4

what is the effect of ageing on FSH secretion?

Answer 4

increased secretion, then decreases when menstruation finishes

Question 5

what is the effect of ageing on LH secretion?

Answer 5

increased secretion, then decreases when menstruation finishes

Question 6

what is the definition of senescence?

Answer 6

the deterioration of tissues and the loss of their biological function as a result of time, which increases the mortality of the organism

Question 7

what effect does ageing have on the ovaries?

Answer 7

follicles become less sensitive to FSH ∴ rupture and disappear

when none left, menstruation stops

decreased oestrogen secretion

Question 8

from what age does fertility in women begin to decrease?

Answer 8

35

Question 9

what is the ovarian reserve?

Answer 9

the ability of an ovary to produce secondary oocytes that can be fertilised

Question 10

the presence of which hormone in the blood plasma is used to indicate an ovarian reserve?

Answer 10

anti-mullerian hormone (AMH)

Question 11

what is the menopause?

Answer 11

the last menstrual cycle in a woman

Question 12

what is the normal age range for the onset of the menopause?

Answer 12

50-54

can be 35-59

Question 13

what is the perimenopause?

Answer 13

occurs several years before the menopause

periods become irregular and infrequent

length of time between periods increases to cessation (menopause)

Question 14

give examples of menopausal symptoms

Answer 14

irregular h.r.

night sweats

insomnia

loss of libido

depression

vaginal dryness

Question 15

what are some causes of early-onset menopause

Answer 15

heavy smoking

medical treatment –> decreased oestrogen (e.g. chemotherapy/hysterectomy)

Question 16

what is the purpose of hormone replacement therapy (HRT)?

Answer 16

replacement of hormones that are decreasing in concentration due to the menopause

Question 17

what is unopposed oestrogen (HRT)? what are its strengths and weaknesses?

Answer 17

daily oestrogen

+ good for early menopause
- increased risk of uterine cancer

Question 18

what is combined HRT? what are its strengths and weaknesses?

Answer 18

daily oestrogen and progestin

+ reduced risk of endometrial cancer

Question 19

what is the cyclical regime of HRT? what are its strengths and weaknesses?

Answer 19

daily oestrogen and progestin for 3 weeks, followed by a 1 week bleed

+ lighter period
- still have periods

Question 20

what is the continuous schedule of HRT? what are its strengths and weaknesses?

Answer 20

same hormones taken daily (usually oestrogen and progestin)

+ no withdrawal bleeds and fewer side effects
- patch requires replacing every 1-2 weeks

Question 21

what are the delivery systems used to administer HRT?

Answer 21

oral tablets

skin patches

transdermal implants

vaginal rings

gel

Question 22

what are some advantages of HRT?

Answer 22

prevention of hot flushes/vaginal dryness

reduced risk of osteoporosis

reduced muscle pain

reduced loss of connective tissues

reduced risk of Alzheimer’s

Question 23

what are some disadvantages of HRT?

Answer 23

2x/3x increased risk of venous thromboembolism

increased risk of stroke

increased risk of breast cancer

increased risk of endometrial cancer

Question 24

why are alternatives to HRT required?

Answer 24

history of breast/ovarian/endometrial cancer

history of blood clots

history of heart disease/hypertension

liver disease

Question 25

what is the role of phytoestrogens?

Answer 25

naturally occurring; mimic oestrogen

converted to oestrogen-like compounds in the gut by hydrolysis

reduce effects of viral infections

e.g. isoflavones; lignans

Question 26

how can lifestyle changes reduce symptoms of the menopause?

Answer 26

yoga/aromatherapy

regular exercise

reduce stress

reduce caffeine/alcohol

Question 27

what is the effect of ageing on testicular tissue?

Answer 27

decrease in mass

decrease in testosterone secretion

Question 28

what is the effect of ageing on sperm production?

Answer 28

rate of production decreases

loss of surface cells in prostate gland/epididymis/seminal vesicles

sclerosis in epididymis

Question 29

what is the effect of ageing on erectile function?

Answer 29

erectile problem –> erectile dysfunction

loss of libido

Question 30

what is benign prostate hypertrophy/hyperplasia (BPH)?

Answer 30

result of ageing in men, causing scarring of prostate tissue

hyperplasia = incr. in cell quantity
hypertrophy = incr. in cell size

Question 31

what is are the effects of BPH?

Answer 31

ejaculation/urination problems

decreased testosterone production

incontinence

decrease in dihydrotestosterone

Question 32

how is BPH diagnosed?

Answer 32

rectal examination

blood tests for PSA to exclude prostate cancer

ultrasounds

Question 33

how can BPH be treated?

Answer 33

lifestyle changes

medication to relax smooth muscle in prostate

surgery