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PHS 933 > Block 2 Lecture 1 -- Menstrual Cycle > Flashcards

Block 2 Lecture 1 -- Menstrual Cycle Flashcards

1
Q

How long does menses last?

A

3-5 days (2-7 is normal)

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2
Q

When is normal onset of menses?

A

12 yo

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3
Q

What is the other name for aromatase?

A

CYP19

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4
Q

What causes the LH surge?

A

estradiol ≥ 200 pg/mL x 48 hours

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5
Q

When does the LH surge occur relative to ovulation?

A

10-16 hours prior

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6
Q

What is the best predictor of ovulation?

A

LH surge

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7
Q

When is [progesterone] greater than [estrogen]?

A

ONLY during luteal phase of menstrual cycle

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8
Q

What is the time period over which the CL degenerates?

A

9-11 days if no fertilization

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9
Q

When is hCG detectable?

A

6-8 days post-fertilization

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10
Q

When does the luteal-placental shift occur?

A

12 weeks post-fertilization

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11
Q

What hormones are produced by the placenta?

A

progesterone and estriol

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12
Q

When is hCG produced?

A

immediately following blastocyst implantation in the endometrium

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13
Q

Describe the structures of FSH and LH.

A
    • 36kDa heteromeric glycoproteins
    • secreted by AP
    • common alpha, unique beta subunits
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14
Q

What is the half-life of FSH?

A

3-4 h

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15
Q

What is the half-life of LH?

A

20 minutes

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16
Q

What is the E# designation for estrone?

A

E1

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17
Q

What is the E# designation for estradiol?

A

E2

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18
Q

What is the E# designation for estriol?

A

E3

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19
Q

What is E1

A

estrone

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20
Q

What is E2

A

estradiol

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21
Q

What is E3

A

estriol

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22
Q

When is E1 most abundant?

A

estrone most abundant…

– post menopause

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23
Q

Where is E1 primarily produced

A

estrone produced …

– primarily from fat

24
Q

When is E2 most abundant?

A

estradiol most abundant…

– in repro women

25
Q

When is E3 most abundant?

A

estriol most abundant…

– during pregnancy (and only detectable during pregnancy)

26
Q

Where is E2 produced?

A

ovaries

27
Q

Where is E3 produced?

A

in placenta from E2 or E1, or from circulating DHEA

28
Q

What is the most abundant steroid in circulation?

A

DHEA

29
Q

What are the non-menstrual effects of estrogens?

A

1) secondary sex characteristics
2) increased bone formation
3) improved lipids
4) opposition of aldosterone
5) positive mood
6) neuroprotection
7) softer skin
8) increased liver protein synthesis

30
Q

What is the concentration of progesterone in the follicular phase?

A

less than 2 ng/mL

31
Q

What is the concentration of progesterone in the luteal phase?

A

5+ ng/mL (normally 10-15)

32
Q

What is the concentration of progesterone in pregnancy?

A

100-200 ng/mL

33
Q

What are the progestogens?

A

1) progesterone

2) 17-alpha-hydroxyprogesterone

34
Q

Where is progesterone formed?

A

corpus luteum

adrenals

35
Q

Where is 17-alpha-hydroxyprogesterone formed?

A

adrenals

36
Q

What is the principle circulating progestogen?

A

progesterone

37
Q

What is the concnetration of progesterone in the luteal phase?

A

10-15 ng/mL

38
Q

What is the concentration of 17-alpha-hydroxyprogesterone in the luteal phase? 3rd trimester?

A

1-5 mg/mL

30 ng/mL

39
Q

When is 17-alpha-hydroxyprogesterone concentration elevated?

A

pregnancy

CAH

40
Q

Describe the structure of inhibin

A

peptide dimer

41
Q

What is the function of hCG?

A

maintain CL

maintain progesterone production

42
Q

What are the functions of progesterone?

A

1) suppress uterine contractility, maternal immune response to fetus, inhibit lactation, promote preparation of lactation
2) sperm attractant via activating Ca channels
3) prepares endometrium for implant
4) forms thick cervical mucous to inhibit sperm movement
5) used by embryo to make glucocorticoids and sex steroids

43
Q

Where are the targets of progesterone?

A

1) uterus
2) breast
3) CNS – neuromodulator, neuroprotector

44
Q

What is the function of FSH?

A
    • stimulate granulosa cells to produce estrogen by upregulating aromatase
    • stimulate inhibin production
    • in males: spermatogenesis
45
Q

How long is menses?

A

21-40 days; (u=28)

46
Q

Which phase of the cycle is most likely to vary in length?

A

follicular, esp. after menarche and before menopause

47
Q

What is non-pharm tx for dysmenorrhea?

A
    • topical heat up to 12h
    • exercise
    • low-fat diet
48
Q

When is the usual onset of PMS?

A

1-2 weeks prior to menses

49
Q

What is non-pharm tx for PMS?

A

1) decrease caffeine, EtOH, sugar, salt
2) increase exercise
3) vitamin b6 (50-100 mg/day) + Calcium

50
Q

What is the incidence of PMS?

A

75%, most common between 25-35 yo

51
Q

What are the symptoms of dysmenorrhea?

A

– crampy pelvic pain 1-3 days before menses
+/- menorrhagia
+/- nausea/vomiting
+/- headache

52
Q

What percentage of women experience recurrent dysmenorrhea?

A

25%

53
Q

What are the causes of secondary dysmenorrhea? Most common?

A

most common = endometriosis

others: uterine polyps, pelvic infections, cervical stenosis

54
Q

What percentage of PMS patients develop PMDD?

A

3-8%

55
Q

What is the primary target of estrogens?

A

ER-alpha

– primarily ovary, uterus, breast

PHS 933 (14 decks)

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