C19 - Effects of Ageing on Reproduction Flashcards
What is senescence?
Deterioration of the human body.
How do hormone levels change as women age?
Secretion of oestrogen decrease
Secretion of FSH increases
Secretion of LH increases
What is an ovarian reserve?
The ability for an ovary to produce oocytes that can be fertilised.
What occurs to the ovarian reserve as women age?
The number of oocytes which can be successfully fertilised decreases, decreasing the woman’s fertility level.
What is AMH?
Anti-Mullerian hormone secreted by ovarian follicles.
Concentrations of AMH in the bloodstream indicate a woman’s ovarian reserve.
What is menopause?
The last time the menstrual cycle occurs due to lack of ovarian follicles.
This is complete once a woman has not had a period for over a year.
What does HRT mean?
Hormone replacement therapy
What is hormone replacement therapy?
A treatment for relieving the symptoms of menopause.
It replaces female hormones (oestrogen and progesterone) which are at lower levels as menopause approaches and progresses.
What are the 2 forms of HRT given?
Unopposed oestrogen
Combined HRT
What is unopposed oestrogen? (HRT)
When the woman is provided with oestrogen only.
What is combined HRT?
Oestrogen and progestin are given.
Progestin is a synthetic molecule with similar effects to progesterone however it reduces the risk of uterine cancer (which is promoted by oestrogen)
How can HRT be administered?
Continuously – the same hormone is taken through each month and doesn’t cause any withdrawal bleeds.
Cyclic regime – oestrogen and progestin taken for 3 weeks then stopped for the fourth, causing the woman to experience withdrawal bleeding.
How is HRT administered?
Tablets – taken orally
Skin patches
Implants inserted under skin of the stomach, buttock or thigh.
Vaginal rings
Oestrogen gel applied to skin
Advantages and disadvantages of taking HRT:
Advantages:
Prevention of hot flushes
Reduced risk of developing osteoporosis
Prevention of vaginal dryness
Protection against loss of connective tissue
Potential improvement in sleep and reduced muscle ache
Reduced mood swings and depressive symptoms
Disadvantages:
Greater risk of venous thromboembolism (VTE)
Greater risk of a stroke
Greater risk of breast cancer
Greater risk of endometrial (uterine) cancer
Oestrogen has side effects such as fluid retention, bloating, breast tenderness, nausea, leg cramps etc.
Progestin has side effects such as pelvic pain, backache, acne, depression, mood swings etc.
What are alternatives to HRT?
Phytoestrogens, chemicals found in plants, which have a similar molecular structure to oestrogen or are converted into oestrogen-like compounds in the gut are prescribed e.g.
Isoflavones – found in soya beans and alfalfa
Lignans – found in cereal grains, fruit and veg
Flavones – found in cereals, celery and herbs
Coumestans – found in split peas and alfalfa.
They have antifungal and antibacterial properties which can reduce the effects of viral infections.
Some also use relaxation therapies e.g. yoga to reduce symptoms.
What changes can be made to a woman’s lifestyle to reduce menopausal symptoms?
Do regular exercise
Stay cool at night
Reduce caffeine, alcohol and spicy food intake
Reduce stress levels
Give up smoking
What change occurs in the testes as males age?
There’s a decrease in the mass of testicular tissue. There many also be a slight decrease in the level of testosterone.
What change occurs with erectile function as males age?
Erectile dysfunction may occur where males cannot get or maintain an erection for intercourse.
What changes occur in fertility as males age?
The testes continue to produce sperm but at a slower rate.
The prostate gland, epididymis and seminal vesicles lose some of their surface cells despite continuing to produce semen.
Sclerosis can occur in the epididymis which causes the tissue to become less elastic.
Decline in testosterone production can also reduce libido.
How does urinary function change as males age?
Some of the prostate tissue can be replaced with scar tissue, causing the prostate gland to enlarge (known as BPH benign prostatic hypertrophy).
This can lead to issues with ejaculation and urination.
What is BPH?
Benign prostatic hypertrophy involves hyperplasia (increase in number of cells) rather than hypertrophy (increase in size of individual cells).
It causes the formation of large nodules that can compress the urethra, restricting the flow of urine from the bladder.
How is BPH (benign prostatic hypertrophy) diagnosed?
By rectal examination.
Blood tests for a specific antigen (PSA) are carried out to exclude prostate cancer.
Ultrasonography can also be used.
Describe the changes which occur during and after menopause and explain how changes in hormone levels are associated with these changes:
Changes during:
- irregular periods
- hot flushes
- fatigue
- mood changes / irritability / anxiety
- loss of libido
Changes after: - ovulation stops - menstruation stops - reproductive organs become smaller - vaginal, dryness / discharge - calcium loss from bone / reduction in bone mass (leading to osteoporosis) - increase in % body fat ;
Hormonal changes:
- lower concentrations of oestrogen and
progesterone
- higher concentrations of FSH
Suggest an active ingredient which may be found in a herbal remedy for menopausal symptoms:
Phytoestrogens
OR
Antioxidants
Isoflavones
