5: Menstruation, Puberty, Development Flashcards
H’s from anterior vs posterior pituityar
- anterior: FSH, LH, TSH, prolactin, GH, ACTH
2. posterior: oxytocin, ADH
five hormones from the hypothalamus that affect the reproductive cycle
GNRH, Thyrotropin-releasing H, somatostatin, CRF, PIF
where does the majority of progesterone come from during follicular development
peripheral conversion of adrenal pregnenolone
two zones of the endometrium + what their arteries are called
- functional: spiral arteries
2. basalis: basal arteries
median age of menarche
12.43 years
when does thelarche occur compared to menarche
thelarche -> 2 or 3 yrs -> menarche
primary amenorrhea
no menstruation by 13 years without secondary sex characteristics OR by 15 with secondary sex characteristics
mean blood loss per menstrual period
30ccs
what amount of blood loss during menses is associated with anemia?
80cc+
invariant weight necessary to start menarche
106 lbs
what years is the HPO axis suppressed in females?
btween 4-10yrs of age
two things that keep low levels of gonadotropins and sex steroids during prepubertal phase
- gonadostat sensitivity to negative feedback of low esradiol
- CNS inhibition of GNRH secretion
what is the initial endocrine change associated with puberty?
adrenal androgen production
four stages of normal pubertal development
- thelarche (breast devel)
- pubarche & andrenarche (pubic and axillary hair)
- maximal growth / peak height velocity
- menarche
unilateral breast development
not uncommon for first 6 months of puberty
four things that qualify as delayed puberty
- no secondary sex characteristics by 13
- no thelarche by 14
- no menarche by 15
- no menses 5 years after onset of thelarche
OPC function in PCOS
suppresses LH an FSH, allowing regression of overproduction of T
what does clomiphene citrate do?
induce ovulation
what does spironolactone do in PCOS?
competes for T-binding sites -> anti-andogen effects at target organ
why does hirsutism occur?
hair follicles exposed to an excess of androgen
virilization
masculinization of a female due to marked increase in T -> clitoromegaly, temporal balding, deep voice, decreased breast size, hirsutism
scoring system for hirsutism
Ferimma-Galloway
polymenorrhea
abnormally frequent menses, cycle less than 21 days
metrorrhagia
irreg bleeding episodes
menometrorrhagia
heavy and irregular uterine bleeding
oligomenorrhea
menstrual cycles more than 35 days long, but less than 6 months
DUB: dysfunctional uterine bleeding
AUB that cant be attributed to meds, blood dyscrasias, systemic disease, trauma, or organic conditions (pregnancy, fibroids, CA) - usually due to changes in HPO axis
massive AUB: treatment
hospitalizations, transfusions, IV conjugated estrogens then OCPs/Mirena
moderate AUB treatment
OPCs or mirena
AUB unresponsive to meds - Tx
d&c, polypectomy, myomectomy, endometrial ablation, hysterectomy
