Female Reproductivr Disorders Flashcards
Oligomenorrhea
Periods occur infrequently
More than 35 days without a period
Primary amenorrhea
Absent / delayed puberty
No period by 15/16
Or within 3y of breasts developing
Causes of anovulation
PCOS
premature ovarian insufficiency
Menopause
Hyperprolactinaemia
Functional hypothalamic amenorrhea
Hypothalamus /pituitary gland dysfunction
Hyperprolactinaemia
High prolactin normal after pregnancy
Inhibits GnRH induced gonadotrophin ->lactational amenorrhea
PCOS
Commonest cause of anovulation
Abnormal follicle development,LH AND FSH ratio altered
Mid Antral follicles ‘cysts’ accumulate ->androgen excess
Ovulating follicle dev. Arrested
Prématuré ovation insufficiency
Loss of ovation follicle reserve resulting in low levels of gonadal hormones and high levels of gonadotropins
Symptoms of premature ovarian insufficnecy
Hot flushes
Reduced libido
Periods stopping/ infrequent
Endometriosis
Endometrium like tissue growing under ovation hormone control in pelvic cavity outside uterus
Treatment for endometriosis
Pain killers
Hormonal medications
Surgery to remove endometriotic foci
Uterine fibroids
Benign tumours in muscle layer of uterus
Tend to shrink after menopause due to low oestrogen
May be aymptomatic or cause painful periods, pelvic fullness
Treatment for uterine fibroids
Mild - NSAIDS
moderate/severe- ulipristal acetate reduces fibroid size by i hi toom of cell proliferation and inducing apoptosis
debilitating - surgery
causes of Damaged/ blocked fallopians tubes
Infection
Pelvic inflammatory disease
Endometriosis
Surgery in pelvic region
Sterilization
Difference between primary and secondary infertility
Primary - inability to conceive after one year or more of unprotected sex
Secondary - not being able to conceive after giving birth
How do gonadotropins serve as fertility drug
Directly stimulate ovaries to produce eggs
Drug has low success rate
clomiphene citrate
Stimulate ovulation in women w irregular ovulation or other reasons
40% success rate in acheiving pregnancy
Letrozale as a fertility drug
For PCOS
Works in similar way to clomid w fewer side effects
Success rate of 28%
Metformin as a fertility drug
Used for women w PCOS , improves insulin resistance and increases chances of ovulation
Success rate of 10-15%
Mechanism of how gonadotropins work as fertility drug
GnRH agonists stimulate FSH AND LH
exogenous FSH-> boosts foll dev
More large follicles
LH- final maturation of follicles
High doses for inducing multiple foll dev
Mechanism of clomiphene citrate in fertility
Reduce oestrogen -ve feedback
Increased GNRH secretion
Stimulates more FSH and LH from pituitary gland
More follicular recruitment and maturation
Treatment for PCOS
COC pill
Diet modification
Insulin sensitising drugs
Clomiphene
Anti androgens
Mechanism of letrozole
Fertility drug
Inhibition of aromatise enzyme
Pituitary gland releases more FSH due to reduced oestrogen
Promotes follicular development
Mechanism of metformin as a fertility drug
Improves blood sugar levels
Reduces androgen levels in PCOS
Helps promote follicle maturation and ovulation
