Gyn & Reproductive Health

Question 1

what is the HPO axis?

Answer 1

hypothalamic - pituitary - ovarian axis which regulates female steroid hormone production through positive and negative feedback loops

Question 2

what does the hypothalamus release?

Answer 2

gonadotropin-releasing hormone (GnRH), in a pulsatile fashion

Question 3

what are the main gondatropins?

Answer 3

FSH and LH

Question 4

what does the anterior pituitary gland release?

Answer 4

FSH and LH, in response to GnRH

Question 5

what are the main steroid hormones? where are they produced?

Answer 5

estrogen, progesterone, androgens
in the ovaries
in response to FSH/LH

Question 6

how does the negative feedback loop work?

Answer 6

when E/P reach over a certain point, the hypothalamus decreases secretion of GnRH, thereby decreasing FSH/LH (same other way around if E/P are under a certain point)

Question 7

how does the positive feedback loop work?

Answer 7

when E reaches a peak right before ovulation, the hypothalamus increases GnRH secretion resulting in an LH (and FSH) surge and release of mature ovum from ovary

Question 8

how do we define delayed onset of puberty?

Answer 8

no breast growth by 14 or no growth spurt by 15

Question 9

how do we define precocious puberty?

Answer 9

breast or pubic hair development before age 7 in caucasian females, or 6 in african american females

Question 10

what are the 3 components of the ovarian cycle?

Answer 10

follicular phase
ovulation
luteal phase

Question 11

when does the follicular phase start?

Answer 11

day 1 of menses

Question 12

what are e and p levels like during the follicular phase?

Answer 12

start out low, then e increases because of follicle recruitment and production
once dominant follicle emerges, e drops as other follicles atrophy, but dominant begins to produce high levels of e
p low throughout

Question 13

what are FSH and LH levels like during the follicular phase?

Answer 13

bc of low e at the end of previous phase, GnRH stimulates ant pit to release FSH and LH
once follicles produce e, LH and FSH drop off
the drop in e once dominant follicle emerges causes high FSH and LH
LH surge begins

Question 14

when does ovulation occur, relative to the LH surge?

Answer 14

10-12 hours after peak of LH (32-44 hours after surge begins)

Question 15

how does ovulation occur?

Answer 15

dominant follicle ruptures and oocyte is released

Question 16

how long after release can the oocyte be fertilized?

Answer 16

12-24 hrs

Question 17

when does the luteal phase start?

Answer 17

after ovulation

Question 18

how long is the luteal phase?

Answer 18

14 days +/– 1-2

Question 19

what do p & e do during luteal phase?

Answer 19

produced by corpus luteum, peaks 7-8 days post ovulation, higher amount ofp rogesterone, moderate estrogen

Question 20

when does the luteal phase end?

Answer 20

with the onset of menses

Question 21

what are the 3 components of the uterine cycle?

Answer 21

proliferative phase
secretory phase
mensturation

Question 22

what hormone plays the bigger role in the proliferative phase?

Answer 22

estrogen! helps grow/thicken endometrium

Question 23

how long does the proliferative phase last?

Answer 23

10 ish days from menses to ovulation

Question 24

what hormone dominates the secretory phase?

Answer 24

progesterone

Question 25

how long does the secretory phase last?

Answer 25

12-16 days from ovulation to menses

Question 26

why does progesterone decline in the mesntruation phase?

Answer 26

bc the CL is toast once pregnancy doesn’t occur

Question 27

talk about cervical mucus changes

Answer 27

early follicular phase: scant, thick, cloudy, non elastic
late follicular phase: amoutn increases, thin, clear, more elastic
ovulation: abundant and highly elastic (think wiping)

Question 28

what is spinnbarkeit?

Answer 28

quality of mucus around ovulation, elastic, stretches between finer/thumb

Question 29

how does basal body temp change?

Answer 29

low in follicular phase
increases after ovulation bc of progesterone
stays elevated 2-4 days before menses

Question 30

how is infertility defined?

Answer 30

inability to conceive after 1 year of unproptected sex before age 35, after 6 months if AMA

Question 31

how long can a healthy sperm survive in the female reproductive tract?

Answer 31

3-5 days

Question 32

2 female etiologies of infertility?

Answer 32

ovulatory dysfunction

pelvic pathology

Question 33

4 male etiologies of infertility?

Answer 33

low sperm count
adhesions in vas deferens
anatomic abnormalities
ED

Question 34

what are 6 drugs that could effect contraceptive efficacy?

Answer 34

rifampin
rifapetntine
some anticonvulsants
some antiretrovirals
griseofulvin
st johns wort `1as