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ESA4 > 6 - Repro - Puberty + Menstruation Abnormalities > Flashcards

6 - Repro - Puberty + Menstruation Abnormalities Flashcards

1
Q

Define puberty:

A

A stage of human development when sexual maturation and growth are completed, resulting in the ability to reproduce.

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2
Q

What is the age range for the normal start of puberty?

A

Females: 8-13 yrs
Males: 9-14 yrs

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3
Q

What initiates puberty?

A

KISS neuropeptides in brain secrete KISS:

= Initiates GnRH secretion

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4
Q

What is the main determining factor of the initiation of puberty?

A

Body weight

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5
Q

What is the normal body weight that girls must reach to initiate the growth spurt in puberty?

A

~ 30 kg

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6
Q

What is the normal body weight that girls must reach to initiate menarche?

A

~ 47 kg

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7
Q

What is the normal body weight that boys must reach to initiate the growth spurt in puberty?

A

~ 55 kg

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8
Q

Approx. how fast do girls grow during the growth spurt in puberty?

A

~ 9 cm/year

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9
Q

Approx. how fast do boys grow during the growth spurt in puberty?

A

~ 10 cm/year

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10
Q

Approx how long does puberty last?

A

~ 5 yrs

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11
Q

Which hormones causes the growth of the pelvis in girls during puberty?

A

Oestrogens

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12
Q

Define thelarche:

A

Onset of female breast development

~ 10.5 - 13.5 yrs

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13
Q

Menarche has usually occurred by what age in girls?

A

< 13 yrs

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14
Q

What are the first signs of puberty?

A 
Females = breast development
Males = Testicular volume ~ 4ml
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15
Q

Define precocious puberty:

A

Onset younger than 2 SD before average age:
Females = < 8 yrs
Males = < 9 yrs

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16
Q

List some causes of precocious puberty:

A
  • CNS tumours
  • CNS trauma
  • Congenital disorders ie hydrocephalus, testotoxicosis, adrenal hyperplasia
  • hCG-secreting tumours
  • Choriocarcinomas
  • Adrenal tumours
  • Exogenous oestrogen or androgen exposure
17
Q

Define delayed puberty:

A

Initial physical changes of puberty not present by:
Females = 13 yrs (or no menarche by 15/16yrs)
Males = 14 yrs

18
Q

List some causes of delayed puberty:

A
  • Malnutrition ie AN, CF
  • Chronic disease ie Crohn’s
  • Excessive exercise ie athletes
  • Steroids
  • Hypothyroidism
  • Post-malignancy chemo/radiotherapy
  • Turners syndrome
  • CNS tumours
  • Congenital hypogonadotrophic hypogonadism
19
Q

List some symptoms of the menopause:

A
  • Itchy
  • Sweaty
  • Twitchy
  • Sleepy
  • Bloated
  • Moody
  • Forgetful
20
Q

What is the average age range of menopause onset?

A

~ 49-51 yrs

21
Q

What is the hormonal change which results in hot flushes during the menopause?

A

Drop in both progesterone and oestrogen results in vascular changes

22
Q

What is the hormonal change which increases the risk of urinary incontinence after the menopause?

A

Drop in oestrogen = decreases pelvic tone

23
Q

Which hormones change during the menopause?

A
  • Oestrogen drops
  • Progesterone drops
  • LH increases
  • FSH increases
24
Q

What is HRT and what are some ways of taking it?

A

Hormone Replacement Therapy, usually Oestrogen + Progesterone:

  • Tablets
  • Creams
  • Skin patches
  • Pessaries
  • Rings
25
Q

What are the main risks associated with HRT?

A
  • Blood clots –> Stroke/thromboembolism
  • Breast cancer
  • Bladder disease
26
Q

Define menorrhagia:

A

Abnormally heavy or prolonged bleeding

27
Q

What are some causes of menorrhagia?

A
  • Intrauterine contraceptive device (IUCD)
  • Hormone imbalance ie the pill
  • Uterine/ovarian/cervical cancer
  • Inherited blood coagulation disorders
  • Uterine fibroids
28
Q

What drugs can be used to treat menorrhagia?

A
  • NSAIDs
  • Iron
  • Tranexamic acid
  • Oral contraceptives
29
Q

What are some causes for irregular menstrual bleeding?

A
  • Common in 1st 3 months of hormonal contraception
  • Missed pill
  • PCOS
  • St. Johns Wort while on pill/ring/implant
30
Q

Define secondary amenorrhoea:

A

Cessation of normal menstrual periods for > 6 months

ESA4 (36 decks)

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