Intro to women's health Flashcards
vestibular glands
Skene and bartholin glands secretions are responsible for sexually stimulated vaginal lubrication
female differentiation dependent on
genetics (46xx), proteins, hormones (estrogens, androgens), ovaries
gonad development
early gonadal ridge differentiates into ovaries (influence of germ cells) germ cells migrate to ovaries and differentiate into oocytes
paramesonephric duct (mullerian)
contact of bilateral tubules with urogenital sinus causes differentiation ducts. lower ends fuse and become uterus, cervix, upper vagina. upper ends stay separated as fallopian tubes. mesonephric/wollfian regresses in females
external genitalia development
urogenital sinus, when contact mullerian ducts develops into lower vagina.
menarche
first menstrual cycle, first bleeding average age 12
follicular phase of menstrual cycle
begins with onset of menses and ends on the day of LH surge/ovulation. average is 14 days. FSH increases (follicular growth of oocytes, emergence of dominant follicle) estradiol maintains endometrium and starts low, increases near end to critical level
ovulation
positive feedback from estradiol causes LH surge which triggers ovulation. oocyte released from ovary. follicle becomes corpus luteum.
luteal phase
predominance of progesterone (corpus luteum) estradiol secretion. suppresses FSH and LH from pituitary.
fertilization
implanted zygote releases human chorionic gonadotropin (hCG) which sustains corpus luteum until 9-10 weeks gestation (then placenta takes over)
no fertilization
corpus luteum involutes after 9-10 days. withdrawal of progesterone results in increase in FSH to begin a new cycle
menstruation
first few days of follicular phase. duration 3-7 days. blood and desquamated superficial endometrial tissue. prostaglandins from secretory endometrium produce contractions of uterine vasculature and musculature, endometrial ischemia and uterine cramping. caused by involution of corpus luteum and decrease in progesterone and estrogen
oogenesis
increase in FSH stimulates oogenesis. several primary oocytes begin to grow. unequal division produces secondary oocytes. primary follicle develops several layers of granulosa cells around oocyte and becomes secondary follicle. develops into corpus luteum.
endometrium
follicular phase=proliferative phase.
rise in estrogen stimulates endometrial cell growth, glands become elongated. ovulation: endometrium at maximum thickness. luteal phase=secretory phase. progesterone converts endometrium into loose and edematous stroma and tortuous blood vessels and glands. menstruation: withdrawal of progesterone, endometrium sloughs off
primary vs secondary amenorrhea
primary: no menstruation by age 13 without secondary sexual development. by age 15 with secondary sexual development.
secondary: absence of menstruation for 3-6 months in a menstruating female.
metorrhagia
irregular menstrual bleeding, usually between cycles
menorrhagia
excessive menstrual bleeding at regular intervals
anovulation
failure to ovulate. can cause abnormal uterine bleeding, oligomenorrhea, amenorrhea. constant (noncyclic) estrogen levels stimulate growth of endometrium . irregular bleeding, unpredictable amounts as endometrium outgrows its blood supply and sloughs off.
hirsutism
male pattern hair growth caused by excess androgens and treated with OCPs (combination) or antiandrogens.
turners syndrome causes
45XO genetics.
symptoms of turners syndrome
few ovarian follicles, gonadal dysgenesis, no gonadal sex hormone production, primary amenorrhea, delayed puberty, small stature, webbed neck, coarctation of aorta, poor breast dev, widely spaced nipples, wide carrying of the arms, multiple pigmented nevi, renal anomalies, liver dysfunction, ocular and auditory deficiencies.
treatment turners syndrome
growth hormone early to max height. estrogen at puberty to optimize peak bone mass, genital tract maturation, menstruation, breast dev. progestins later to protect endometrium
