3.5.2 Treatment of Female Reproductive Disorders Flashcards
What are the characteristics of premature puberty?
Puberty or thelarche before the age of 7 (causasian) or 6 (African American)
After age 6 or 7 if: Rapid progression of puberty. CNS findings or progression impacting emotional health of girl or family
What are some genetic mutations that could cause premature ovarian failure?
What are the characteristics of Hypergonadotropic Amenorrhea?
Elevated FSH
Premature ovarian failure
Fill in this chart
Is precocious puberty more common in girls or boys?
Girls
How can hormonal therapy be used to treat sexual dysfunction?
How would you treat a patient with central precocious puberty?
Use of depot GnRH agonist will result in regression or cessation of pubertal development
Early initiation will preserve growth
Many recommend cessation of treatment around age 11
What is important about androgen therapy for HSDD?
Describe the increase in sexual inactivity with age
What Tanner stage corresponds with the onset of menses?
Tanner stage 3
What are some treatment options for sexual pain disorders?
Pelvic floor physical therapy
Botox to overdevelop pelvic floor muscles
Dilator therapy
Lube
What is primary amenorrhea?
No menses with or without the appearance of other features of puberty
What is progressing precocoious puberty?
Progression between tanner stages w/in 3-6 months
Accelerated growth velocity
Advanced bone age
Falling off growth curve
What are some possible etiologies of Sexual arounsal disorder?
Menopause, surg, diaabeeeetus, neurologic disease, psychological, vascular
What is hypogonadotropic?
Hypothalamic (or pituitary) amenorrhea
Can be related to Anorexia, stress or exercise
What are some possible CNS findings in a patient with a pubertal disorder?
Fill in this chart
What is Sexual Arousal Disorder (FSAD)?
Persistent or recurring inability to attain or maintain sufficient sexual excitement - decreased lubrication or labial sensation
What is female sexual dysfunction?
The various ways in which an individual is unable to participate in a sexual relationship as she would wish
What are some of the possible etiology of sexual pain disorders?
How would you go about treating a patient with Sexual arousal disorder?
Sometimes a sex therapist needs to be consulted
In an evaluation for a patient with a pubertal disorder what are some things you are looking at?
What are the characteristics of puberty?
Puberty is the development of secondary sexual characteristics and menstruation in girls
Puberty requires the reactivation of the HPO axis and adrenal axis
Age of puberty has declined related to weight and nutrition
Early age of adrenarche may be a sign of?
PCOS
Describe the variability of the Menstrual cycle in adolescent females.
Primary amenorrhea with significant adrenarche?
PCOS
What occurs to initiate puberty?
GnRH regulates FSH and LH release - Pulsatility increases prior to puberty. Initially GnRH pulses occur during sleep
FSH is first to appear
LH pulsatility begins to mirror GnRH - maturation allows for the positive feedback by E2. Allowing the LH surge necessary for ovulation
What is the average age of breast, pubic hair and menarche in puberty for US women?
What is the prevalance of female sexual dysfunction?
43% of women
What are some possibilities of problems that could cause peripheral precocious puberty?
Describe androgen insufficiency in women
What are some of the characteristics of the people and how they were affected according to the National Health and Social Life Survey?
Describe the stages of reproductive aging?
Describe the prevalence of Male and Female sexual complaints?
Describe normal pubertal development in adolescent girls.
What is hypoactive sexual desire disorder?
Persistent or recurring deficiency of sexual fantasies/thoughts and/ or receptivity to sexual activity
Etiology - Menopause, aging, endocrine abnormality or Medications
What is a good benefit for pelvic pain disorder?
Physical therapy
How does testosterone relate to female sexual function?
Data from younger oophorectomized women support role of testosterone in sexual desire and orgasm.
What are some sexual pain disorders?
Dyspareunia - recurrent or persistent genital pain associated with sexual intercourse
Vaginismus - Recurrent or persistent involuntary spasms of the musculature of the outer third of the vagina that interferes with vaginal penetration
What are the characteristics of primary amenorrhea?
Absence of menses by:
Age of 13 in the ansence of any secondary sexual characterisitics
Age 16 otherwise
What are the 4 general categories of Female Sexual Dysfunction?
Libido
Arousal
Orgasm
Sexual Pain
What are the WHO classifications of Amenorrhea?
What groups of people are at risk for androgen deprivation?
Premature ovarian failure
Oophorectomy
Hypopituitarism
Addisons
Corticosteroid
Oral estrogen therapy
What determines the age of menopause?
It is related to follicle deposition in ovary which is detemined prenatally
What is androgen deprivation and what is important about it?
Androgen levels start to decline before age 30. At menopause - levels are half of that of a 30-40 year old. Abrupt change in androgen levels is not common with natural menopause but can be a prolen with surgical menopause
