Endocrinology- sex hormones during life

Question 1

What is puberty?

Answer 1

maturation of reproductive organs

production of sex steriods

secondary sexual characterisitcs

capability to reproduce

Question 2

What is used to measure puberty in Tanner staging?

Answer 2

females - breasts

males- genitalia, i.e testes grow volume measured by orchidometer

pubic hair - curled long etc

Question 3

What are the onset of certain characteristics called? Terminology?

Answer 3

Gonadarche - Activation of gonads by HPG axis

Thelarche - Breast Development

Menarche - Menstrual Cycles

Spermarche - Spermatogenesis

Adrenarche - Adrenal Androgen Production

(starts ~2yrs before Gonadarche)

Pubarche - Pubic hair

Question 4

What causes sec characteristics

and what are they for each gender?

Answer 4

Question 5

What is the difference between girls and boys puberty?

Answer 5

Boys 1 year later

Question 6

Describe HPG axis?

Answer 6

Question 7

Which hormones intiates puberty? How does it change?

Answer 7

GnRH

function as when foetal for testiular descent, penile length, sertoli cells and behaviour effects

Question 8

When does menarche begin?

What are conditions when it goes wrong?

Answer 8

after peak heigh velocity 2 years Thelarche

Primary amenorrhoea - never have mentral cycle after 16 years

secondary amenorrhoea - period started but stopped for 3-6 months

Question 9

What is olgio-menorrhoea?

Answer 9

irregular periods longer than 35 days

Question 10

Describe hormonal changes (1) in follicular changes?

Answer 10

E2 is oestrogen

E2 and inhibin reduce FSH

dominant follicules can survive without FSH

small follicle die

Question 11

Second part of follicular phase?

Answer 11

High LH and FSH trigger ovulation

Question 12

What a 3 phases of uterus?

Answer 12

menstrual- breakdown of previous

proliferative - new epitherial cells, gland proliferation, increase in stroma

secretory - receptive for implantaion, increase volume of stromal cells, glands secreted glycogen , coiling of spinal arteries

Question 13

What happens when GnRH is non - pulsatile?

Answer 13

Decrease LH and FSH

needs to be pulsatile

Question 14

What are levels like in primary hypogonaldism?

Answer 14

High LH/FSH

low oestrogen/testoterone

causes

men - infection, cancer, truama

women - menopause

Question 15

What are levels like in secondary hypogonaldism?

Answer 15

high prolactin, pit tumour

Low everything

Question 16

What additionally does menpause has

Answer 16

low inhibin

high FSH and LH

low estorgen

Question 17

what are symptoms of menopause/lack of oestrogen?

Answer 17

ymptoms of Menopause

Skin dryness

Hair thinning

Hot flushes/sweating

Sleep disturbance

Mood disturbance

Osteoporosis; decrease in bone mineral density (BMD) - E2 stimulates osteoblasts

Weight gain

Sexual dysfunction; vaginal dryness; decreased libido

Amenorrhoea - no periods for 1yr/ cessation of fertility

Climacteric - irregular periods in the years approaching menopause

Question 18

treatment of menopause?

Answer 18

Oestrogen replacement - HRT

however oestrogen stimulaes endometrium,

add progesterone to prevent hyperlasia/cancer of endometrial

Question 19

What is a good indicator of ovary reserve

Answer 19

granulosa cells produce AMH

Question 20

What ages in menopause common?

Answer 20

median 51

Question 21

What is another name for early menopause?

Causes?

Answer 21

premature ovarian insufficnicy

diagnosis: high FSH
causes: autoimmnue, genetic, cancer therapy

Question 22

Does andropause exist?

Answer 22

Kind of,

means free testerone declines, becomes binded

strongly bound testosterone increasses SHBG

overall levels don’t change

Question 23

How do levels of tesosterone change in a day?

Answer 23

diural rhythm

can fall 20% with sugar so fasting

highest around 8

Question 24

Symptoms of tesosterone deficiency?

Answer 24

Question 25

How does testosterone have local tissue effects?

Answer 25

Can be:

converted to oestrogen by aromatase

converted by 5a-reductase to DHT

Question 26

function of DHT and oestrogen?

Answer 26

oestrogen- bone health

DHT - bind to Adrogen receptors on for development secondary sexual