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BRS 4: Endocrinology > 4.13: Sex hormones (part 1 of 2) > Flashcards

4.13: Sex hormones (part 1 of 2) Flashcards

1
Q

Definition of puberty

A

Maturation of reproductive organs

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2
Q

What 3 things occur during puberty

A

Production of sex steroids
Develop secondary sexual characteristics
Attain capability to reproduce

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3
Q

Classification of puberty

A

Tanner stages used to determine development during puberty

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4
Q

Tanner staging in girls

A

Thelarche - breast development

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5
Q

Tanner staging in boys

A

Genitalia - testicular volume

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6
Q

Tanner staging in both genders

A

Pubarche - pubic hair

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7
Q

-arche definition

A

Onset of

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8
Q

Gonadarche

A

Onset of Activation of gonads by HPG axis

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9
Q

Thelarche

A

Onset of Breast development

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10
Q

Menarche

A

Onset of menstrual cycles

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11
Q

What gender is adrenarche more important in

A

Girls as in boys testes are producing testosterone

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12
Q

Spermarche

A

Onset of spermatogenesis

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13
Q

Adrenarche

A

Onset of adrenal androgen production ( starts 2years before gonadarche)

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14
Q

Pubarche

A

Onset of pubic hair

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15
Q

Puberty hormone in girls

A

Oestradiol

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16
Q

4 secondary sexual characteristics in girls

A

Breast development
Hair growth- pubic, axillary
Sweat gland composition - skin oiliness, acne
Changes to external genitalia

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17
Q

Puberty hormone in boys

A

Testosterone

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18
Q

4 secondary sexual characteristics

A

Depending of voice
Hair growth - pubic, axillary then facial
Sweat gland composition
Changes to external genitalia

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19
Q

1st sign of puberty in girls

A

Thelarche

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20
Q

Late sign of puberty in girls

A

Menarche

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21
Q

Testicular size of prepubertal boys

A

<4mls

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22
Q

Adult male testicular size

A

> 15mls

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23
Q

Adrenarche

A

Activation of adrenal androgen production

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24
Q

Changes to gonadarche during puberty

A

Activation of HPG axis

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25
Menarche occurs
2.3yrs after Thelarche Soon after peak height velocity (PHV) Mean age 12.7yrs
26
Primary amenorrhoea is
Lack of period from birth
27
Commonest physiological cause of secondary amenorrhoea
Pregnancy
28
Secondary amenorrhoea is
Loss of periods after previously having them
29
Secondary amenorrhoea at the start of the menstrual cycle
Common for irregularities Periods start but then stop for at least 3-6montha
30
Menstrual cycles in adult women last
28 days Vary by +-2days each month
31
Amenorrhoea in adult women
No periods at least 3-6months Or up to 3periods per year
32
Oligo-menorrhoea in adult women
Irregular or infrequent periods > 35day cycles Or 4-9 cycles per year
33
Follicular phase of menstrual cycle (5)
1) FSH rises 2) 2-3 follicles start to grow 3) producing E2 (Oestradiol) and Inhibin B 4) these reduce FSH (-ve feedback) 5) restrict FSH window and non-dominant follicles undergo atresia
34
Follicular phase (pre-ovulatory phase)
6) dominant Graafian follicle emerges 7) E2 continues to increase 8) switch to +ve feedback by high E2 9) induces LH surge 10) causing ovulation
35
What two hormones does the Corpus luteum produce
Progesterone Oestradiol
36
How to measure if ovulation has occurred
Measure progesterone levels at day 21
37
3 stages of endometrium - uterine cycle
Menstrual phase, proliferative phase , secretory phase
38
In the Proliferative phase of menstrual cycle
Growth of new epithelial cells Gland proliferation Increase in stroma
39
Secretory phase of uterine cycle
Transform to be receptive for Implantation: Increased volume of stromal cells >> thick spongy lining Cross screw shaped glands secrete glycogen Coiling and lengthening of spiral arteries
40
GnRH secretion has to be ___ to stimulate the pituitary gland
Pulsation
41
What does the continuous non-pulsation administration of GnRH cause
Decreased LH/FSH secretion
42
Hypogonadism is
Decreased oestrogen in a woman Decreased testosterone in a man
43
In primary Hypogonadism
Direct damage to testes or ovaries High LH / FSH Low E2/ testosterone Reduced negative feedback
44
In Secondary Hypogonadism
Damage to hypothalamus or pituitary gland
45
Primary Hypogonadism in men can lead to
Infection Trauma Cancer of testes
46
Primary cause of Hypogonadism in women
Menopause
47
Examples of Secondary Hypogonadism
Pituitary tumour High prolactin Low or normal LH/FSH Low E2/testosterone
48
In menopause
Primary Hypogonadism- Low E2 High LH/FSH Low Inhibin : greater effect on FSH so more FSH affected
49
Menopausal symptoms are due to
Lack of estradiol
50
10 symptoms of menopause
Skin dryness / hair thinning Hot flushes Mood disturbances Osteoporosis - decreased BMD Joint pains Sexual dysfunction Genito-urinary disturbance Weight gain Amenorrhoea- peri- leading up to menopause, post- after 1 year Cessation of fertility
51
Treatment of menopausal symptoms
Menopausal hormone therapy (MHT) Oestrogen replacement (stimulates endometrium to proliferate) and progesterone if endometrium is intact to prevent risk of endometrial hyperplasia / cancer ( if bleeding post menopause)
52
At what age does menopause occur
Range : 45-55 years Only 1% menopause <40 years old
53
Ovarian reserve marker
AMH - anti-müllerian hormone
54
Early menopause is called (before age 40)
Premature ovarian insufficiency (POI)
55
Complications of POI
Previously known as POF (ovarian failure) Conception can happen in 20% Diagnosis high FSH > 25iU/L
56
Symptoms of POI
Same as menopause
57
Causes of POI
Autoimmune Genetic e.g fragile X syndrome Previous cancer therapy
58
Male hormonal changes at old age
Late onset Hypogonadism ( lower testosterone levels) no significant changes
59
Free hormone hypothesis - testosterone
2% active free testosterone 60% SHBG-bound testosterone - strongly binds ‘unavailable’ 28% albumin-bound testosterone , albumin weakly binds testosterone “bioavailable”
60
Testosterone changes with old age
Total testosterone unchanged by SHBG is increased, free testosterone reduced
61
What kind of rhythm does testosterone have
Diurnal rhythm High in morning (measured before 11am)
62
7 Symptoms of testosterone deficiency
Sexual dysfunction- reduced libido, erectile dysfunction Hair growth - frequency of shaving Energy levels - general well being, fatigue Mood disturbance Body composition- increased fat/ reduced muscle mass, gynaecomastia (breast enlargement) Spermatogenesis - high levels of intratesticular testosterone needed Bone health - via conversion to oestrogen
63
Why does testosterone have Local tissue effects
Enzymes within tissues convert testosterone to other things
64
Local tissue effects of testosterone in the scalp
5-alpha reductase converts testosterone into di-hydro-testosterone; leading to male pattern baldness DHT is a more potent ligand for androgen receptor (AR)
65
Local tissue effects of testosterone in adipose tissue
Aromatise present in adispose tissue converts testosterone to oestrogens Obesity related Hypogonadism
66
Using local tissue effects to reduce risk of breast cancer
Using an aroma taste inhibitor to prevent conversion of testosterone to oestrogen
67
Using local tissue effects to stop prostate cancer
5-alpha reductase inhibitor to prevent DHT being made

BRS 4: Endocrinology (10 decks)

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