General Overview of the Reproductive Axis Flashcards
Reasons why hypothalamic-pituitary axis is unique (5)
- Male/female
- Age-related
- 2 pituitary hormones
- 3 end-organ hormones
- Also alternate hormone sources
Hormone profile in females: progestins, androgens, estrogens
- Progestins
- 10-6g/L
- 10-4 g/L if pregnant (excess from placenta)
- Androgens
- DHEA: 10-8 g/L (from adrenal source)
- DHEAS: 10-5 g/L
- DHT: 0 (doesn’t circulate)
- Testosterone: 10-9 g/L (50% ovary, 50% adrenal)
- Estrogens
- Estrone (E1): not measured, from fat, same in males and females
- Estradiol (E2): 10-9 g/L, 10-6 g/L if pregnant
Hormone profile in males: progestins, androgens, estrogens
- Progestins
- 10-8 g/L
- Androgens
- DHEA: 10-8 g/L (from adrenal source)
- DHEAS: 10-5g/L
- DHT: 0 (doesn’t circulate)
- Testosterone: 10-8 g/L (95% from testes)
- Estrogens:
- Estrone (E1): not measured, from fat, same in males and females
- Estradiol (E2): 10-9 g/L
Cholesterol molecule - recognize structure and correctly number carbon atoms in steroid nucleus
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Molecules synthesized from cholesterol (6)
- Bile salts
- Membranes
- Vitamin D
- Glucocorticoids –> cortisol
- Mineralocorticoids –> aldosterone
- Sex steroids
Categories (3) and examples of sex steroids
- Progestins
- 21 carbons
- Progesterone, 17-hydroxyprogesterone
- Androgens
- 19 carbons
- Testosterone, DHEA, DHEA-S, adrostenedione, DHT
- Estrogens
- Estrone (E1)
- Estradiol (E2)
- Estriol (E3)
Key features in biosynthesis of sex steroids
- Relies on coordinated system involving 2 cell types
- Involves progressive reduction in number of carbon atoms
- Various sex steroids produced in extra-gonadal tissues
- Placenta, dermis, adrenal glands, adipose tissue
Rate-limiting step of sex steroid synthesis
- Conversion of cholesterol (27 carbons) to pregnenolone (21 carbons)
- Catalyzed by **20,22-desmolase **(rate-limiting step)
- Pregnenolone - goes on to be converted into all other sex steroids
3 categories of sex steroids
- Progestins
- Androgens
- Estrogens
Progestins
- 21-carbon sex steroids
- Pregnenolone
- 17-a-hydroxypregnenolone
- Progesterone
- 17a-hydroxyprogesterone (17-OH-P)
Androgens
- 19-carbon sex steroids
- Testosterone
- Dehydroepiandrosterone (DHEA)
- Dehydroepiandrosterone-sulfate (DHEA-S)
- Dihydrotestosterone (DHT)
- Adrostenedione
- 5a-reductase: converts testosterone to dihydrotestosterone in target cells (prostate and skin)
- Biologic activity of DHT 30-50x higher than testosterone
Estrogens
- 18-carbon sex steroids
- Estrone (E1)
- Estradiol (E2)
- Estriol (E3)
- Aromatase: converts androgens into estrogens
- Present in gonads & various peripheral tissues (adipose tissue, liver, CNS)
Hormones involved in hypothalamic-pituitary-gonadal axis (7)
- Gonadotropin releasing hormone (GnRH)
- Follicle stimulating hormone (FSH)
- Luteinizing hormone (LH)
- Androgens
- Progestins
- Estrogens
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GnRH
- Released in hypothalamus in pulsatile fashion into portal circulation, travels to anterior pituitary
- MOA: GnRH binds to receptor on gondadotroph cell surface and stimulates FSH and LH secretion from AP
FSH and LH
- Released by AP following stimulation by GnRH
- Primary regulators of gonadal function in both sexes
- Patterns of FSH/LH secretion change over the life cycle
- Ovulatory women: levels of FSH and LH vary throughout menstrual cycle - reach peaks shortly before ovulation
- Once secreted: both stimulate production of sex steroids and inhibin
- LH stimulates rate-limiting conversion of cholesterol into pregnenolone in two ways:
- Increasing amount of desmolase
- Enhancing affinity of desmolase for cholesterol
Androgens
- Secreted by Leydig cells in males, theca cells in females following LH stimulation
- Males:
- Resulting testosterone acts on Sertoli cell to support spermatogenesis and synthesis inhibin
- Provides negative feedback at levels of AP (decrease FSH/LH) and hypothalamus (decrease GnRH)
- Females
- Androgens produced by theca cells (lack aromatase) diffuse to nearby granulosa cells where they are converted into estrogens
Progestins
- Secreted by theca cells and granulosa cells in women following stimulation by LH (theca cells) or FSH (granulosa cells)
- Regulates growth and development of tissues and organs related to ovulation, menses, pregnancy, and lactation
- Provides negative (or positive, depending on the situation) feedback on the AP (decrease FSH/LH) and the hypothalamus (decrease GnRH)
Estrogens
- Secreted by granulosa cells (theca cells lack aromatase) in response to FSH stimulation
- Regulates the functions of many tissues in the body, including those of the reproductive tract
- Provides negative feedback at levels of AP (decrease FSH/LH) and hypothalamus (decrease GnRH)
Inhibins
- Secreted by Sertoli cells in men and granulosa cells in women in response to FSH stimulation
- Provides negative feedback at level of AP (decrease FSH/LH)
Primary areas of hypothalamus responsible for production of GnRH and key features of GnRH secretion
- Originates in neurons of arcuate nucleus and preoptic area of hypothalamus
- Released into portal circulation in pulsatile fashion
- Pulsatility is key to physiologic stimulation of AP - Constant administration of GnRH actually suppresses pituitary response
- Adult males: 8-14 pulses/24 hour period
- Adult females: patterns of GnRH secretion vary throughout the menstrual cycle
- Pulsatility is key to physiologic stimulation of AP - Constant administration of GnRH actually suppresses pituitary response
Functions of testosterones
- Anabolic: growth in muscle and height
- Androgenic: development of male genitalia, spermatogenesis, secondary sex characteristics (hair, voice, acne), embryogenesis
Functions of female sex hormones
- Oogenesis and ovulation
- Puberty
- Embryogenesis
- Prepare for implantation
- Breast development and lactation
2-cell theory of sex steroid production
- In both sexes - gonadal sex steroid production & gametogenesis involve 2 distinct cell types working synergistically
- In testes: Leydig and Sertoli cells
- In ovary: theca and granulosa cells
- Both located at surface of ovary (ovarian cortex)
- Both cell types required to metabolize cholesterol into estradiol
- Male Leydig and female theca cells: interstitial cells with ability to make andorgens and inability to make estrogens due to absence of aromatase
- Male Sertoli and female granulosa cells: immediately adjacent to developing gametes with ability to make inhibin and ability to convert androgens into estrogens due to presence of aromatase
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Male sex steroid production
- In response to LH
- Leydig cells produce 95% of testosterone in males by:
- amount of desmolase and
- affinity of desmolase for cholesterol
Female sex steroid production
- In response to LH secretion, theca cells produce progesterone and androgens
- Theca cells lack aromatase (and therefore capacity to make estrogens)
- Adrostenedione from theca cells must therefore diffuse into nearby granulosa cells for estrogen to be produced
- Granulosa cells (do have aromatase) convert androstenedione into estradiol
- Lack enzyme which converts progesterone into androgens - progesterone from granulosa cells must diffuse to theca cells –> converted into androstenedione –> then diffuse back to granulosa cells to be converted into estradiol
Major extra-gonadal sources of various sex steroids
- Adrenal cortex
- Skin
- Adipose tissue
Menstrual cycle and hormone fluctuations
- Levels of FSH and LH vary throughout the menstrual cycle, reaching peaks shortly before ovulation
- Levels of circulating estradiol and progesterone produced in response to FSH/LH also fluctuate in cyclic pattern
- Endometrial cells which form uterine lining respond to fluctuations in predictable pattern –> culminates in menstrual blood flow
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