Female Repro

Question 1

What are the two main functions of the ovaries? What is it regulated by?

Answer 1

Steroidogenesis(makes hormones) & Gametogenesis (makes eggs). Regulated by FSH and LH

Question 2

____________ responds to hormones secreted by ovaries to prepare an environment for fertilized ovum

Answer 2

uterus

Question 3

HPO Axis

Answer 3

hypothalamus secretes GnRH > GnRH stimulates anterior pituitary to release FSH or prolactin which influences the breasts > FSH and LH act on ovary to mature and release an egg > ovaries in this process release estrogen and progesterone which act on the uterus to prep the lining > negative feedback system

Question 4

What are the 3 types of estrogens and which one is the most clinically relevant?

Answer 4

estradiol, estrone, and estriol

(estradiol most relevant)

Question 5

What are the many roles of estrogen?

Answer 5

1. Development and maturation of female reproductive structures from embryo through puberty
2. Involved in ovulation, implantation, pregnancy maintenance, parturition(birth), and lactation
3. Decreases bone reabsorption
4. Increases HDL, lowers LDL
5. Increases clotting factors
6. Fluid and electrolyte balance

Question 6

What is progesterone secreted by?

Answer 6

corpus luteum (shell of the egg that stays in the ovary) after ovulation occurs

Question 7

What are the roles of progesterone?

Answer 7

1. Increases breast development
2. Increases glandular development of endometrium
3. Increases basal body temperature
4. Smooth muscle relaxer

Question 8

What are androgens secreted by?

Answer 8

stroma

Question 9

What is the major type of andorgen in females?

Answer 9

androstenedione

Question 10

What are androgens responsible for?

Answer 10

Hair growth
Involved in sexual function

Question 11

Ovarian cycle refers to the ___________ cycle

Answer 11

hormonal

Question 12

Menstrual cycle refers to the __________ response to hormones

Answer 12

uterine

Question 13

Menarche

Answer 13

This is the start of the hormonal and menstrual cycles.
May occur anywhere from age 10 to 15.

Question 14

Failure to reach menarche by age 16 and secondary sexual characteristics by 15
is considered _________________

Answer 14

primary amenorrhea.

Question 15

Females are born with 1 million +______________

Answer 15

primordial follicles (fetal follicles they stay until time of puberty and mature as a group and become primary follicles)

Question 16

__________ stimulates the ovary to mature primary folicles into secondary folicles

Answer 16

FSH

Question 17

Menstrual phase

Answer 17

(progesterone drops as corpus luteum recedes)
Endometrial lining is sloughed off
2 to 7 days

Question 18

Pre-ovulatory

Answer 18

(proliferative) phase (increasing levels of estrogen mature egg)
Increasing levels of estrogen begin to build up the endometrial lining
Variable length

Question 19

What triggers ovulation is

Answer 19

pituitary surging the luteinizing hormone (LH surge)

Question 20

Ovulation

Answer 20

(LH surge)

Question 21

Post-ovulatory

Answer 21

(luteal) phase (corpus luteum secretes progresterone)
Endometrial lining continues to thicken and prepares for implantation
Nearly always 14 days regardless of the length of the whole menstrual cycle.

Question 22

Menopause

Answer 22

Cessation of the hormonal cycle
Cessation of menstrual cycle for 12 consecutive months

Question 23

Menopause usually occurs between ages of ____________ and average age of onset is __________ mean age is between _________

Answer 23

48-53, 47.5, 51-52

Question 24

Premature menopause

Answer 24

<30 years old

Question 25

For menopause, Labs and EMB should be performed in any woman with regular cycles

Answer 25

> 55 years old

Question 26

Surgical Menopause can occur in women with ____________________

Answer 26

bilateral salpingo oopherectomy

Question 27

Menopause physiology

Answer 27

The ovaries stop functioning long before the anterior pituitary stops secreting FSH and LH. Since the ovaries do not response to elevating FSH levels there is no suppression of the FSH and levels continue to rise (above 30mIU/mL) No corpus luteum is created so there is not enough progesterone to build up the endometrial lining.

Question 28

How long does perimenopause range from?

Answer 28

1 to 10 years in length

Question 29

Peri-Menopause

Answer 29

Period of time from the onset of menstrual changes to the first year of menopause

Question 30

What is the average length of time for peri menopause?

Answer 30

4 years

Question 31

Irregular menses can be considered normal after the age of __________

Answer 31

40

Question 32

What are the vasomotor instability for perimenopause?

Answer 32

Hot flashes Night sweats

Question 33

What are some other symptoms that women can experience during peri-menopause?

Answer 33

Mood changes may occur in 1 in 4 women Insomnia Decline in libido and vaginal dryness. when estrogen decreases, dryness can occur and can cause painful intercourse

Question 34

Perimenopause is a time of great menstrual flux and can present as

Answer 34

menorrhagia and/or metrorrhagia oligomenorrhea hypomenorrhea (menses is very light/spotting)

Question 35

___________is frequent diagnosis during perimenopause

Answer 35

AUB

Question 36

S/S of menopause

Answer 36

1. Irregular menses progressing to amenorrhea x 12 consistent months 2. Breast tissue, body hair, skin elasticity and subQ fat decrease 3. Ovaries, uterus, cervix and vagina atrophy 4. Vasomotor instability can persist 5. Increased risk of osteoporosis, cardiovascular disease

Question 37

Hormonal cycle

Answer 37

FSH stimulates the ovary to mature primary multiple follicles into secondary follicles > granulosa cells release estrogen > dominant follicle emerges and lesser follicles regress > increasing estrogen stimulates anterior pituitary to release LH and decrease FSH production (with inhibin) > LH causes the dominant follicle to release an oocyte aka ovulation > ruptured follicle is now called the corpus luteum and begins secretion of progesterone > progesterone continues to increase for about a week > if pregnancy doesnt occur, the corpus luteum begins to degenerate and progesterone levels decrease > low progesterone stimulates the anterior pituitary to secrete FSH

Question 38

The menstrual cycle refers to the ___________ response to the ________ cycle. Average length is _____ days but may be anywhere from _______ to ______ days. Day one is the very first day a woman sees any _________

Answer 38

uterine, hormonal. 28, 21-45, bleeding