Endocrine Control Female Reproduction 6 Flashcards

Differentiate the endocrine causes of female reproductive dysfunction.

1
Q

What are the major categories of endocrine disorders of the HPG axis?

A
  • Disruption of GnRH secretion
  • Damage of the pituitary gonadotropes
  • Damage to the ovary
  • Androgen excess
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2
Q

What is the most common cause of androgen excess?

A
  • Polycystic ovary syndrome (PCOS)
    • one of the most common endocrine disorders
    • affects 5-10% of reproductive-age women worldwide
    • originally described as a reproductive disorder
    • now recognized as a major metabolic disorder
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3
Q

What are the types of menstrual dysfunction?

A
  • “Physiologic”
    • pregnancy
    • lactation
    • menopause
  • Primary amenorrhea
    • no menarche by age 15-16 years
    • evaluation is appropriate if there are no secondary sex characteristics by age 13
  • Secondary amenorrhea
    • arbitrarily defined as no menses for 6 months
    • the longer the time period, the lower the rate of undiagnosed pregnancy
  • Oligomenorrhea
    • menses every 36 days to 6 months
  • Anovulation
    • diagnosed by appropriately-timed serum P level and/or urinary LH measurments
    • body temperature increased by ~0.5 degrees F secondary to P
    • lack of basal body temperature increase is indicative of anovulation
    • amenorrhea and anovulation usually though not necessarily synonymous
    • can have cyclic anovulatory menses and, conversely, ovulation without menses
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4
Q

What are the principles of evaluation of endocrine disorders of reproduction?

A
  • FSH is the most sensitive parameter of ovarian follicular reserve
  • Progestin challenge to assess estrogen secretion
    • if there has been stimulation of endometrial growth by estrogen, administration of progestin will usually result in menses
    • indirect assessment of residual estrogen production in women with amenorrhea
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