Female endocrinology Flashcards
During the follicular phase of menstruation, describe FSH, LH, oestrogen and progesterone levels.
FSH and LH low.
Progesterone low.
Oestrogen rising and peak just before day 14.
LH spike just before day 14.
What hormone maintains the corpus luteum if fertilisation occurs?
hCG - produced by foetus.
What hormone/s does inhibin inhibit?
FSH.
Describe the changes in the histology of the vagina in the ovarian cycle.
Early follicular phase - oestrogen low - vaginal epithelium is thin and pale.
Late follicular phase - oestrogen increases - squamous cells mature causing epithelial thickening.
Luteal phase - mature squamous cells shed as cellular debris.
Describe the changes in cervix and cervical mucus in the ovarian cycle.
Late follicular phase - increased cervical vascularity and watery mucus - allows sperm passage.
Luteal phase - progesterone thickens cervical mucus and reduces elasticity.
Apart from the ovaries, what other structure is an important source of androgens in females?
Adrenal gland (cortex).
Produces 90% DHEA and 100% DHEAs, and 50% of testosterone and androstenedione.
What is the most common cause of congenital adrenal hyperplasia? What is the affects of this?
21-hydroxylase deficiency.
No production of aldosterone, cortisol and corticosterone which shifts production to oestrogen and testosterone.
What are the clinical features of congenital adrenal hyperplasia?
Ambiguous genitalia, precocious puberty, anovulation, hirsutism.
What is the consequences of aromatase deficiency and aromatase excess on the appearance of genitalia?
Deficiency - ambiguous genitalia.
Excess - feminisation of male genitalia.
What does hormone hypersensitivity give rise to?
Hirsutism.
What is the clinical presentation of polycystic ovarian syndrome?
Infertility
- no ovulation and lack of menses.
Weight gain, acne and hirsutism.
What is the pathogenesis of polycystic ovarian syndrome?
No negative feedback therefore there is continuous oestrogen production and an elevated LH:FSH ratio.
Increased LH leads to androgen production causing an ovulation, amenorrhea, hirsutism, acne etc.
