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Block 3 Week 8 > Female Physiology Before Pregnancy and Female Hormones > Flashcards

Female Physiology Before Pregnancy and Female Hormones Flashcards

1
Q

Period of sex determination predisposes offspring to many forms of adult (blank)

A

diseases

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2
Q

Having a morning erection is indicative of (blank)

A

cardiovascular health

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3
Q

What can cause ED?

A

Aging and heart problems

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4
Q

What does semen quality tell you?

A

general health

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5
Q

As females grow what happens to their follicles?

A

they start to deplete and atretic (dying follicles) increases

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6
Q

What are the five hormones needed for females?

A 
GnRH
FSH
LH
Estrogen
Progesterone
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7
Q

What does FSH do?

A
  • stimulates development of secondary follicles
  • stimulates granulosa cells to convert androgens to estrogen
  • stimulates synthesis of LH receptors on granulosa cells
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8
Q

What does LH do?

A

Triggers primary oocytes to complete meiosis I and enter meiosis II
Initiates ovulation
Affects transformation of granulosa and theca interna into luteal cells

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9
Q

What does Estrogen?

A 
maintains female reproductive
secondary sexual characteristics
rebuilding of uterus (proliferative phase)
Increases inhibition of FSH 
Induces surge in LH
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10
Q

Granulose cells secrete what three things?

what also secretes inhibin?

A

inhibin, follistatin, and activin

sertoli cells

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11
Q

What does progesterone do?

A

initiates conversion from proliferative uterus to secretory uterus for implantation
maintains uterus in secretory phase in pregnancy
inhibits LH production

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12
Q

What is the average menstrual cycle duration?

A

28 days (20-45 days)

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13
Q

What happens during every menstrual cycle?

A

one ovum is released monthly

uterine endometrium is prepared in advance for implantation

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14
Q

What is menarche?

A

first menstrual cycle

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15
Q

When does LH and FSH progressively start increasing?

A

age 9-12

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16
Q

When does the normal sexual cycle begin?

A

at puberty (11-15 years)

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17
Q

So during puberty what happens?

A

FSH and LH increase and you get follicular growth and 6-12 primordial follicles are recruited to undergo maturation

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18
Q

How do follicles mature?

A

primary follicles-> secondary follicles (pre antral)

-> antral follicles -> preovulatory (Graafian) follicles-> ovulation

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19
Q

What increases the amount of FSHR receptors on granulosa cells?

A

estrogen (E2)

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20
Q

What does FSH and estrogen do?

A

makes LH receptors on granulosa cells to allow for sitmulation of LH

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21
Q

What does FSH, LH, and estrogen together make happen?

A

rapid growth of follicles

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22
Q

How many follicles mature each month?

A

1, the rest undergo atresia

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23
Q

When LH receptors are peaking (6-10 fold increase 16 hours before ovulation) what happens to FSH levels?

A

they also increase (2-3 fold) but not enough to induce ovulation

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24
Q

How does the LH surge affect the granulosa and theca cells?

A

In lutenizes them and makes them secrete progesterone.

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25
Q

That day before ovulation what happens to estrogen and why?

A

it decreases due to exhaustion do to intense secretion to get LHR receptors onto follicular cells

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26
Q

Describe the environment prior to ovulation

A

rapid growth of follicles
diminished estrogen levels
onset of progesterone secretion

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27
Q

Describe the initiation of obulation

A

LH levels increase which makes granulosa cells secrete large amounts of progesterone. This initiates proteolytic enzymes from lyososmes of theca externa and destruction of stigma. Blood and plasma rushes into follicle wall and ruptures follicle

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28
Q

When do follicular cells become granulosa cells?

A

at multilaminar primary follicles

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29
Q

What part of the follicle makes releases the proteolytic enzymes from lysosomes?

A

the theca externa. So they function in ovulation by chewing through the stigma

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30
Q

When does the corpus albicans present?

A

12 days after ovulation (if not pregnant)

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31
Q

If you pregnancy occurs, how does the corpus luteum survive?

A

it survives 2-4 months under HCG

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32
Q

Explain the luteal phase of the ovarian cycle

A

the corpus leutum secretes progesterone and estrogenes which leads to decreased levels of FSH and LH and inhibin from sertoli cells. This will then lead to decreased levels of estrogen and progesterone triggering the next ovarian cycle with increase in FSH and LH

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33
Q

Where do we get estrogen?

A

In non pregnant: from ovary-> via granulosa cells
AND
From adrenal cortex
Pregnant: Placenta

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34
Q

What are the three types of estrogen and where do they come from?

A

Beta-estradiol-> ovaries
estrone-> peripheral tissues (adrenal and ovaries)
estriol-> weak estrogen comes from estradiol and estrone in liver

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35
Q

What is the most potent and least potent estrogen?

A

Beta-estradiol-> estrone-> estriol

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36
Q

Where do progestins come from?

A

Nonpregnant: corpus luteum, latter half of each ovarian cycle
Pregnant: placenta

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37
Q

What are the two types of progestins?

A

Progesterone (major)

17-1-hydroxyprogesterone (small amount but same effect)

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38
Q

How do you make progesterone and estrogen in the ovaries?

A

you use cholesterol

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39
Q

In the follicular phase what produces progesterone?

In the luteal phase and right before ovulation, what produces progesterone?

A

the theca interna cells

granulosa cells and theca lutein

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40
Q

In the follicular phase what is happening?

A

progesterone and androstenedione are made by theca interna cells which will send androstenedione to the granulosa cells where they will turn this into estrogen

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41
Q

Do the theca interna cells EVER directly make estrogen?

A

NO

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42
Q

What happens in the luteal phase?

A

the follicular lutein and thecal lutein cells produce progesterone

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43
Q

What are estrogens and progesterone bound to?

A

albumin and globulins

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44
Q

How is estrogen degraded?

A

In the liver,

convert to estriol and then conjugate to glucoronnides and sulfates-> excreted into bile (major) and urine (minor)

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45
Q

What happens if you have diminished liver function?

A

Increased estrogen-> hyperestrinism

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46
Q

How is progesterone degraded?

A

quickly in the liver into pregnanediol

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47
Q

What does estrogen increase the size of?

A

increases the size of:

ovaries, Fallopian tubes, uterus, vagina, fat deposition in mons pubis, labia majora, labia minor

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48
Q

What does estrogen do to the vaginal epithelium? Why is this important?

A

turns cuboidal cells of vagina into stratified cells

Makes it more resistant to trauma and infection

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49
Q

What does estrogen do to the uterus?

A

Increases its size and proliferates endometrial stroma and glands

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50
Q

What does estrogen do to the fallopian tubes?

A

Proliferates endometrium, increases ciliated epithelial cells, enhances cilia activity (beating)

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51
Q

What does estrogen do to the breast?

A

increases fat deposition, increase ducts, develops stroma.

Initiates growth of breasts and milk producing apparatus

52
Q

Does estrogen allow breasts to lactate all by itself?

A

no it needs progesterone and prolactin

53
Q

How do you get a lactating breast?

A

you build the breast with estrogen (ducts, fat and stroma) You make lobules and alveoli with progesterone (allows breast to secrete), and you actually secrete milk with prolactin

54
Q

What does estrogen do to the bone?

A

it increase bone growth and the uniting of epiphyses with bones.

55
Q

Why are girls shorter than boys?

A

since estrogen speeds up the uniting of the epiphyses with bones, girls bones will stop growing faster than boys (tesosterone has less of an effect on epiphyses than estrogen)

56
Q

How come older women get osteoporosis?

A

after menopause you have decreased levels of E2 which will increase osteoclast activity (remember estrogen inhibits osteoclast activity)
and decrease you bone matrix and densitiy (decreased calcium and phosphate)

57
Q

What does estrogen do to your metabolism?

A

increase protein deposition
increase metabolic rate
increase fat deposition

58
Q

What does estrogen do to your hair and skin?

A

changes hair distribution (adrenal gland)

Soft smooth vascular skin

59
Q

What does estrogen do to your electrolytes?

A

retains sodium and water in the kidney (mainly during pregnancy)

60
Q

What does progesterone do to the uterus?

A

promotes secretory changes in uterine endometrium (2nd half of cycle) to ready endometrium for implantation
decreases intensity and frequency of uterine contraction to prevent explusion of implanted ovum

61
Q

Why does progesterone decrease frequency and intensity of uterine contractions?

A

to decrease expulsion of the ovum

62
Q

What does progesterone do to the fallopian tube?

A

Makes the peg cells secrete fructose for the ovum and sperm

63
Q

What is the effect of progesterone on breasts?

A

development of lobules and alveoli
increased alveolar cells
makes breasts in secretory status

64
Q

Can you get milk production w/out prolactin?

A

no

65
Q

Explain the proliferative phase

A

4-7 days after menstruation you get stromal and epithelial cells proliferation due to estrogen. Next 1.5 weeks stromal cells, glands, BVs increase in endometrium

66
Q

How thick does the endometrium get at the end of the proliferative phase

A

3-5 mm

67
Q

What is the proliferative phase under the influence of?

A

estrogen

68
Q

What is the secretory phase under the influence of?

A

progesterone and estrogen

69
Q

Explain the secretory phase

A

estrogen increases cellular proliferation
progesterone makes glands secretory and tortuous (glycogen filled)
blood supply increases
becomes thick

70
Q

How thick does the endometrium get?

A

gets 5-6 mm thick during the secretory phase

71
Q

Why is it so important for the secretory phase to have occured?

A

because it allows for the storage of nutrients for fertilized ovum

72
Q

How many days does it take for the ovum to enter the uterus?

how many days does it take for the ovum to implant?

A

3-4 days after ovulation

7-9 days after mplantation

73
Q

Once the ovum implants in the uterus, what happens?

A

trophoblast digest and absorb nutrients to provide for the early implanting embryo

74
Q

Explain menstruation

A

no fertilization-> loss of progesterone and estrogencorpus luteum degenerates
->release of prostaglandins->destruction of BVs->loss of blood (for 24-36h)->loss of functional layer ->uterine contractions to expel contents

75
Q

How much fluid is lost during a period?

A

40ml of blood

35 ml of serous fluid

76
Q

How long does it take for the necrotic outer layer (functionalis layer) to separate from the uterus ?

A

around 48 hours

77
Q

When the corpus luteum degenerates what happens to the endometrium and blood vessels?

A

rapid involution of endometrium

vasospasm of BV to release prostaglandins

78
Q

How is FSH and LH released?

A

by GnRH in a pulsatile rhythm every 90 minutes

79
Q

Where is GnRH released from?

A

the mediobasal hypothalamus, especially in the arcuate nuclei

80
Q

What signals GnRH release?

A

lots of factors

81
Q

What does estrogen inhibit?

A

FSH and LH

82
Q

What does progesterone inhibi?

A

not much by itself, it needs a partner

83
Q

What does progesterone inhibit when coupled with estrogen?

A

inhibits FSH and LH (strongly)

84
Q

What do progesterone and estrogen act on?

A

pituitary and hypothalamus

85
Q

What is inhibin secreted by and what does it do?

A

secreted by granulosa cells and inhibits FSH and LH

86
Q

When do you get the LH surge?

A

1-2 days before ovulation

get a small FSH surge too

87
Q

What happens if you have anovulatory cycle?

A

You wont have a luteal phase (no progesterone, no LH surge, no corpus luteum)
and you will have a short cycle

88
Q

What does progesterone control in the menstrual cycle?

A

the rhythm of the cycle not the cycle itself

89
Q

What days is menstruation during the menstrual cycle?
What days is proliferative during the menstrual cycle?
What days are secretory during the menstrual cycle?
What days are ischemic during the menstrual cycle?

A

1-5
5-14
14-27
27-28

90
Q

Do children release GnRH? Why?

A

no because they have suppressive factors in the brain

91
Q

Do pubertal aldolescents release GnRH?

A

gradual increases of gonadotropins

92
Q

Explain menopause

A

menstrual cycle stops,
female hormones diminish
very few follicles (i.e. not strong response to LH and FSH

93
Q

What is the hormone of menopause that causes “menopausal syndrome”
hot flushes
psychic sensation of dyspnea
irritability
fatigue
anxiety
decreased strength and calcification of bones

A

Loss of estrogen

94
Q

What are the symptoms of menopause?

A 
hot flushes
psychic sensation of dyspnea
irritability
fatigue 
anxiety
decreased strength and calcification of bones
95
Q

Before 45, how many follicles mature and are ovulated?

A

400 follicles

96
Q

In women, what does hypogonadism cause?

A

causes irregular menses, amenorrhea (need estrogen for normal cycle)

97
Q

What happens if the ovaries are absent from birth or they become non-functional before puberty?

A

female enuchism

98
Q

What does female eunchism cause?

A

lack of 2nd sexual characteristics
sex organs remain infantile
prolonged growth of long bones (delayed epiphyses fusion with the shafts)

99
Q

What happens if the ovaries of a fully developed woman are removed?

A

sex organs regress (similiar to women after menopause)

100
Q

What should we suspect is the problem if we have hypersecretion by the ovaries?

A

rare, often associated with granulosa cell tumor (inhibin deficiency)

101
Q

The state of being a (blank) is the absence of the testes or failure of the gonads to develop or function, resulting in a lack of reproductive and sexual function and of development of secondary sex characteristics.

A

eunuch

102
Q

What is the stimulation needed to complete the female sexual act?

A

psychic and local stimulation

103
Q

Explain the female erection and lubrication

A

Parasympathetic innervation allows for penile erection and secretion from bartholins gland and vaginal epithelium

104
Q

Where are the bartholin glands located?

A

beneath the labia minora

105
Q

Explain the female orgasm

A
  • perineal muscle contraction
  • dilation of cervical canal
  • oxytocin secretion
106
Q

What does contracting the perineal muscle do?

A

it allows for increased motility in uterus and fallopian tube to help transport sperm to the ovum

107
Q

What does dilation of the cervical canal in the female erection allow for?

A

easy entrance of sperm

108
Q

What does oxytocin secretion in the female orgasm allow for?

A

allow for contraction of the uterus which facilitates sperm transport

109
Q

When does the fertile period of the sexual cycle occur?

A

within 24 hours after ovulation

110
Q

How long can sperm in the female tract survive?

A

up to 5 days

111
Q

When do sperm need to be in the female reproductive tract for fertilization?

A

either 4-5 days before ovulation and or a few hours after ovulation

112
Q

The interval from ovulation to menstruation is a (blank) day period.

A

13-15 day

113
Q

If an individual has a 28 day cycle, when will ovulation occur?

A

within 1 day of the 14th day cycle

114
Q

If an individual has a 40 day cycle, when will ovulation occur?

A

within 1 day of the 26th day of the cycle

115
Q

How can you practice the rhythm method of contraception?

A

have regular periods
know when you ovulate
avoid intercourse 4-5 days before ovulation and 3 days after

116
Q

How do contraceptive pills work?

A

Uses synthetic estrogen ad progesterone to maintain your estrogen and progesterone levels so that you wont have an LH surge and thus will not have ovulation

117
Q

If you dont have a perfect balance between estrogen and progesterone, what can result?

A

you can get abnormal bleeding

118
Q

Why is it important to use synthetics in place of real progesterone and estrogen for birth control?

A

because synthetics wont get degraded in liver

119
Q

What are causes for female infertility and what percent of married couples have this problem?

A

endocrine, structural and genetic

15% married and 50% are due to females

120
Q

What endocrine abnormality can cause female infertility?

A

anovulation due to hyposecretion of gonadotropins -> insufficient to induce ovulation

121
Q

What is the test for hyposecretion of gonadotropins?

A 
urine pregnanediol levels (no surge, no ovulation)
body temp (secretion of progesterone increases body temp)
122
Q

What are the treatments for hyposecretion of gonadotropins?

A

HCG (which can lead to multiple ovulations and births)

123
Q

What structural abnormalities result in female infertility?

A

Ovarian anatomic abnormalities
Endometriosis
Salpinitis
Abnormal secretion of mucus by the uterine cervix

124
Q

What is endometriosis?

A

it is when the endometrial tissue surrounds uterus, fallopian tubes, ovaries grows in pelvic cavity and even menstruates-> results in fibrosis throughout pelvis-> obstructs ovulation

125
Q

What is salpingitis?

A

inflammation of fallopian tubes

126
Q

What kind of genetic abnormalities cause infertility?

A

mutations in genes essential for follicular genesis

Block 3 Week 8 (8 decks)

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