Lecture 20: Reproductive Psychiatry Flashcards
What is the difference between sex and gender?
Results due to biology (like estrogen vs. testosterone) = sex
Results due to societal expectations only = gender
What is the ORGANIZATIONAL role of hormones?
Effects that occur early in development
Considered to be permanent
e.g. girl who got testosterone in utero that draws masculine pictures
What is the ACTIVATIONAL role of hormones?
Effects that occur later
In development
Transient
Superimposed upon organizational effects
What is an example of both organizational and activational role of hormones?
Giving women testosterone so that she has decreased ability to determine mental state via the eye exam (this is actually an example of BOTH organizational and activatonal because women who were exposed to MORE androgens in utero, i.e. more masculinized to begin with, had a GREATER impairment when exposed to additional testosterone because they were already primed for it)
The symptoms of girls with congenital adrenal hyperplasia is due to organizational or activational effects of hormones? Significance?
Organizational
-organizational because girl had been given testosterone in utero
What hormone is responsible for sexual differentiation?
Testosterone (androgens)
Degree of androgen exposure
What hormone is responsible for sexual differentiation into females?
LESS testosterone or androgen loll
-it is not estrogen
What disorders do women experience more due to sex bias?
MDD
- panic disorder
- generalized anxiety disorder
- PTSD
- borderline personality disorder
- seasonal affective disorder
What disorders do men experience more due to sex bias?
- autism
- schizophrenia
- alcoholism
- drug addiction
- antisocial behavior
What affects males in general?
Shit that occurs earlier in life
e.g. ADHD
What more likely affects females in general?
Affective disorders (shit that fucks with mood) Autoimmune disorders
What human disease do women get more due to sex bias?
-SLE
-Rheumatoid arthritis
-OA
-MS
-Grave’s
Alzheimer’s
Hashimoto’s
Itchy eyes, postmenopausal females
What human disease do men get more due to sex bias?
Hepatocellular Carcinoma Kidney disease Ankylosing spondylitis Heart Disease Parkinson’s Disease
Are there certain diseases that females are more predisposed to than males?
Yes
What are girls better at?
- Interpreting body language, vocal tone,
- facial expression
- attributing subtle mental states to an individual by looking at eyes
What are males better at?
Recognizing other males that are angry lmao
What is one way to remember that Men are more predisposed to autism?
Women are better at interpreting body language and expression
Autism is a disease of someone who can’t pick up social cues
-so it would make sense that men, who are predisposed to sucking more at picking up social cues, will develop autism
What is the 2D:4D ratio?
2nd digit:4th digit length ratio
If you have a greater ratio difference = less masculinized; less exposure to androgens
If you have a smaller ratio difference between 2nd and 4th digit = more masculinized; more exposure to androgens
What is the leading cause of disease for women?
Unipolar depression
What is PMS (premenstrual syndrome)?
physical OR mood symptom
- having a symptom that impair your daily activities
- increased risk for MDD
How do hormones of females and males change throughout life?
Females have menarche and menopause
-postmenopause is risk factor for MDD
Guys have decreased testosterone later in life
What is the association between serotonin and gender differences?
Serotonin functions in different ways for males and females
-implicated in differences in depression and anxiety
What is a synonym for serotonin? Where is it made?
5-hydroxytryptamine (5-HT)
Derived from tryptophan
Catalyzed into serotonin or 5-hydroxytryptamine by tryptophan hydroxylase (TPH)
What is the significance of estrogen? (TEST Question)
Pro-serotenergic (increases serotenergic function)
Estrogen increases tryptophan hydroxylase mRNA
-decreases rate of clearance of 5-HT by SERT, like SSRI
-estrogen INCREASES 5-HT 2A receptor density
-estrogen DECREASES MAO-A thereby decreasing 5-HT degradation
What is tryptophan hydroxylase (TPH)?
The enzyme that catalyzes the transformation of tryptophan to serotonin
What is the difference between dominant females and passive females in response to estrogen therapy?
Females that are stressed throughout life, do not have much of an effect when given more estrogen (because estrogen does not do as much for increasing serotonin activities)
Females who are dominant throughout life respond well to estrogen therapy however (greater serotonin activity)
Why are dendritic spines important?
Increases surface area for synaptic transmission
Estrogen improves dendritic spines
What are progesterone effects on GABA?
Progesterone modulates GABA through conversion through allopregnanolone
Allopregnenlone (progesterone product) will then act like a benzo and bind to GABA_
What is the function of pregnenolone?
Precursor to progesterone
What is the function of Allopregnanolone? Significance of MDD in women?
A metabolite of progesterone
A potent modulator of GABA_A receptors
Allopregnenolone = increase chloride channel and increase cortical INHIBITION
-is made during menstrual cycle and during pregnancy
-women should be resistant to these effects to allopregnanolone
BUT there is 5% of women who ARE affected by allopregnanolone
What is the point of oxytocin?
Uterine contraction Milk production Orgasm Relationship/love Happiness Antiglucocorticoid, minimizes stress Made in both men and women
What are the criteria for premenstrual dysphoric disorder?
Irritability, depressed mood, affective lability, anxiety or tension
- difficulty concentrating
- onset from menarche to menopause (3-5%)
- typically worsens with age
- onset can be triggered by obstetrical event
How do you treat PMDD?
With selective serotonin reuptake inhibitors
Administered during the luteal phase
What do we need to know about PMDD (premenstrual dysphoric disorder) about the test?
Patients with PMDD do not have different hormonal levels
It is instead their RESPONSE TO HORMONAL LEVELS
Have to look at CNS effects
-you CANT treat PMDD or PMS with progesterone/estrogen
Can you treat PMDD with estrogen or progesterone?
NO
Because PMDD is caused by women who have adverse reaction to normal levels of estrogen
What is an example of activational effects on behavior?
The onset of allopregnanolone during pregnancy for women, that then cause 5% of women to be depressed
How do Androgens play an important role in the development of the sexually dimorphic brain?
More androgens = males
Less androgens = females
What is an androgen?
Generic term for any natural or synthetic compound that stimulates or controls the development/maintenance of MALE characteristics in vertebrates
What role does hormone play in the body?
Mediates and modulates mood, COGNITION and behavior
