Lecture 14- Menopause & External Structures

Question 1

What can cause precocious puberty? (Early puberty)

Answer 1

• Early activation of KiSS-peptin neurons (activation causes release GNRH)
• Usually a tumor, or possibly infection

Question 2

What was a sign of early puberty in ovary-having folks?

Answer 2

Stage 2 Breast development before age 7

Early puberty is 10X more likely in ovary-having folks.

Question 3

What was a sign of early puberty for testicle-having folks?

Answer 3

Genital stage 2 before age 9

Question 4

How to treat precocious puberty?

Answer 4

Give patient GNRH agonist, which means that you give them a constant amount of GNRH and since it’s not in pulsatile waves→ GNRH levels go down.

Question 5

What is puberty?

Answer 5

Onset of secondary sex characteristics

Question 6

In Klinefelter syndrome(XXY), what is causing delayed puberty?

Answer 6

Since they have XXY, they have more DAX-1 gene and DAX-1 inhibits testicle development. → hypogonadism→ low testosterone→ increased FSH and LH→ increased aromatase

Question 7

What is considered delayed puberty?

Answer 7

A 13 year old female or a 14 year old male do not show any signs of pubertal development is considered to have delayed puberty.

Question 8

When is the prime for females to have a child?

Answer 8

Early 20’s is the peak. Probability of conception decreases after early 20’s.

Question 9

Menopause:

Answer 9

NO menstrual cycle for 1 year. It is the decline in reproductive function.

Usually happens from 45-55 years old.

Question 10

As women age we see loss of oocyte quantity and oocyte_______.

Answer 10

quality. We see a loss of mitochondria, rates of aneuploidy rise, and microtubule issues.

Question 11

Why do women run out of good oocytes?

Answer 11

Follicles deteriorate = infertile

No more follicles = no more estrogen

No estrogen = no menstrual cycle, because stromal cells on the endometrium don’t receive the signal from estrogen to keep it thick.

Question 12

As women age, androgen levels drop BUT not as much as estrogen. So what are some results of seeing these levels of androgen?

Answer 12

• Some facial hair
• Deepening of voice (not that common)
• Increased deposition of fat on the abdomen

Question 13

As you run out of follicles and oocytes, production of inhibin decreases. Why?

Answer 13

Granulosa cells that secret inhibin, die. As a result, FSH and LH levels go up. Inhibin inhibits FSH and LH but since inhibin is gone, FSH and LH go up.

Question 14

Physicians can tell the reproductive age of a person based on these things:

Answer 14

• Menstrual cycle regulatory
• FSH levels
• Antral follicle count
• Inhibin levels

Question 15

Some women experience some uncomfortable effects after going through menopause. For example, hot flashes (body temp. increases). How can we treat these women?

Answer 15

Give them low doses of estrogen to get rid of :

• Hot flashes, insomnia
• Reduces colorectal cancer
• Reduces osteoporosis

Can’t give them too much estrogen or else we can give them increased risk of cancers and heart disease. (Breast, ovarian, and endometrial cancer)

Question 16

What’s another way to treat women experiencing discomfort because of menopause?

Answer 16

• Weight-bearing exercise for osteoporosis
• Calcium supplements for bone density

Question 17

Testosterone screted by leydig cells are converted into DHT.

What does DHT signal, and what is the outcome of that signal?

Answer 17

It signals the genital tubercle to become the penis.

No DHT→ No signal → genitalia become clitoris, labia, and vagina