6 - Repro - Puberty + Menstruation Abnormalities Flashcards
Define puberty:
A stage of human development when sexual maturation and growth are completed, resulting in the ability to reproduce.
What is the age range for the normal start of puberty?
Females: 8-13 yrs
Males: 9-14 yrs
What initiates puberty?
KISS neuropeptides in brain secrete KISS:
= Initiates GnRH secretion
What is the main determining factor of the initiation of puberty?
Body weight
What is the normal body weight that girls must reach to initiate the growth spurt in puberty?
~ 30 kg
What is the normal body weight that girls must reach to initiate menarche?
~ 47 kg
What is the normal body weight that boys must reach to initiate the growth spurt in puberty?
~ 55 kg
Approx. how fast do girls grow during the growth spurt in puberty?
~ 9 cm/year
Approx. how fast do boys grow during the growth spurt in puberty?
~ 10 cm/year
Approx how long does puberty last?
~ 5 yrs
Which hormones causes the growth of the pelvis in girls during puberty?
Oestrogens
Define thelarche:
Onset of female breast development
~ 10.5 - 13.5 yrs
Menarche has usually occurred by what age in girls?
< 13 yrs
What are the first signs of puberty?
Females = breast development Males = Testicular volume ~ 4ml
Define precocious puberty:
Onset younger than 2 SD before average age:
Females = < 8 yrs
Males = < 9 yrs
List some causes of precocious puberty:
- CNS tumours
- CNS trauma
- Congenital disorders ie hydrocephalus, testotoxicosis, adrenal hyperplasia
- hCG-secreting tumours
- Choriocarcinomas
- Adrenal tumours
- Exogenous oestrogen or androgen exposure
Define delayed puberty:
Initial physical changes of puberty not present by:
Females = 13 yrs (or no menarche by 15/16yrs)
Males = 14 yrs
List some causes of delayed puberty:
- 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
List some symptoms of the menopause:
- Itchy
- Sweaty
- Twitchy
- Sleepy
- Bloated
- Moody
- Forgetful
What is the average age range of menopause onset?
~ 49-51 yrs
What is the hormonal change which results in hot flushes during the menopause?
Drop in both progesterone and oestrogen results in vascular changes
What is the hormonal change which increases the risk of urinary incontinence after the menopause?
Drop in oestrogen = decreases pelvic tone
Which hormones change during the menopause?
- Oestrogen drops
- Progesterone drops
- LH increases
- FSH increases
What is HRT and what are some ways of taking it?
Hormone Replacement Therapy, usually Oestrogen + Progesterone:
- Tablets
- Creams
- Skin patches
- Pessaries
- Rings
What are the main risks associated with HRT?
- Blood clots –> Stroke/thromboembolism
- Breast cancer
- Bladder disease
Define menorrhagia:
Abnormally heavy or prolonged bleeding
What are some causes of menorrhagia?
- Intrauterine contraceptive device (IUCD)
- Hormone imbalance ie the pill
- Uterine/ovarian/cervical cancer
- Inherited blood coagulation disorders
- Uterine fibroids
What drugs can be used to treat menorrhagia?
- NSAIDs
- Iron
- Tranexamic acid
- Oral contraceptives
What are some causes for irregular menstrual bleeding?
- Common in 1st 3 months of hormonal contraception
- Missed pill
- PCOS
- St. Johns Wort while on pill/ring/implant
Define secondary amenorrhoea:
Cessation of normal menstrual periods for > 6 months
