Lecture 20: Reproductive Psychiatry

Question 1

What is the difference between sex and gender?

Answer 1

Results due to biology (like estrogen vs. testosterone) = sex
Results due to societal expectations only = gender

Question 2

What is the ORGANIZATIONAL role of hormones?

Answer 2

Effects that occur early in development
Considered to be permanent
e.g. girl who got testosterone in utero that draws masculine pictures

Question 3

What is the ACTIVATIONAL role of hormones?

Answer 3

Effects that occur later
In development
Transient
Superimposed upon organizational effects

Question 4

What is an example of both organizational and activational role of hormones?

Answer 4

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)

Question 5

The symptoms of girls with congenital adrenal hyperplasia is due to organizational or activational effects of hormones? Significance?

Answer 5

Organizational

-organizational because girl had been given testosterone in utero

Question 6

What hormone is responsible for sexual differentiation?

Answer 6

Testosterone (androgens)

Degree of androgen exposure

Question 7

What hormone is responsible for sexual differentiation into females?

Answer 7

LESS testosterone or androgen loll

-it is not estrogen

Question 8

What disorders do women experience more due to sex bias?

Answer 8

MDD

• panic disorder
• generalized anxiety disorder
• PTSD
• borderline personality disorder
• seasonal affective disorder

Question 9

What disorders do men experience more due to sex bias?

Answer 9

• autism
• schizophrenia
• alcoholism
• drug addiction
• antisocial behavior

Question 10

What affects males in general?

Answer 10

Shit that occurs earlier in life

e.g. ADHD

Question 11

What more likely affects females in general?

Answer 11

Affective disorders (shit that fucks with mood)
Autoimmune disorders

Question 12

What human disease do women get more due to sex bias?

Answer 12

-SLE
-Rheumatoid arthritis
-OA
-MS
-Grave’s
Alzheimer’s
Hashimoto’s
Itchy eyes, postmenopausal females

Question 13

What human disease do men get more due to sex bias?

Answer 13

Hepatocellular Carcinoma
Kidney disease
Ankylosing spondylitis
Heart Disease
Parkinson’s Disease

Question 14

Are there certain diseases that females are more predisposed to than males?

Answer 14

Yes

Question 15

What are girls better at?

Answer 15

1. Interpreting body language, vocal tone,
2. facial expression
3. attributing subtle mental states to an individual by looking at eyes

Question 16

What are males better at?

Answer 16

Recognizing other males that are angry lmao

Question 17

What is one way to remember that Men are more predisposed to autism?

Answer 17

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

Question 18

What is the 2D:4D ratio?

Answer 18

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

Question 19

What is the leading cause of disease for women?

Answer 19

Unipolar depression

Question 20

What is PMS (premenstrual syndrome)?

Answer 20

physical OR mood symptom

• having a symptom that impair your daily activities
• increased risk for MDD

Question 21

How do hormones of females and males change throughout life?

Answer 21

Females have menarche and menopause
-postmenopause is risk factor for MDD
Guys have decreased testosterone later in life

Question 22

What is the association between serotonin and gender differences?

Answer 22

Serotonin functions in different ways for males and females

-implicated in differences in depression and anxiety

Question 23

What is a synonym for serotonin? Where is it made?

Answer 23

5-hydroxytryptamine (5-HT)
Derived from tryptophan
Catalyzed into serotonin or 5-hydroxytryptamine by tryptophan hydroxylase (TPH)

Question 24

What is the significance of estrogen? (TEST Question)

Answer 24

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

Question 25

What is tryptophan hydroxylase (TPH)?

Answer 25

The enzyme that catalyzes the transformation of tryptophan to serotonin

Question 26

What is the difference between dominant females and passive females in response to estrogen therapy?

Answer 26

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)

Question 27

Why are dendritic spines important?

Answer 27

Increases surface area for synaptic transmission

Estrogen improves dendritic spines

Question 28

What are progesterone effects on GABA?

Answer 28

Progesterone modulates GABA through conversion through allopregnanolone
Allopregnenlone (progesterone product) will then act like a benzo and bind to GABA_

Question 29

What is the function of pregnenolone?

Answer 29

Precursor to progesterone

Question 30

What is the function of Allopregnanolone? Significance of MDD in women?

Answer 30

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

Question 31

What is the point of oxytocin?

Answer 31

Uterine contraction
Milk production
Orgasm
Relationship/love
Happiness
Antiglucocorticoid, minimizes stress
Made in both men and women

Question 32

What are the criteria for premenstrual dysphoric disorder?

Answer 32

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

Question 33

How do you treat PMDD?

Answer 33

With selective serotonin reuptake inhibitors

Administered during the luteal phase

Question 34

What do we need to know about PMDD (premenstrual dysphoric disorder) about the test?

Answer 34

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

Question 35

Can you treat PMDD with estrogen or progesterone?

Answer 35

NO

Because PMDD is caused by women who have adverse reaction to normal levels of estrogen

Question 36

What is an example of activational effects on behavior?

Answer 36

The onset of allopregnanolone during pregnancy for women, that then cause 5% of women to be depressed

Question 37

How do Androgens play an important role in the development of the sexually dimorphic brain?

Answer 37

More androgens = males

Less androgens = females

Question 38

What is an androgen?

Answer 38

Generic term for any natural or synthetic compound that stimulates or controls the development/maintenance of MALE characteristics in vertebrates

Question 39

What role does hormone play in the body?

Answer 39

Mediates and modulates mood, COGNITION and behavior