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The Reproductive System > Lecture 4.2: Puberty and the Menopause > Flashcards

Lecture 4.2: Puberty and the Menopause Flashcards

1
Q

What is Puberty? What occurs during it?

A
  • Development of reproductive maturity
  • Secondary sexual characteristics
  • Gamete production/maturation
  • Behavioural changes necessary for reproduction
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2
Q

Tanner Staging: Stage 1

A

Hormone release begins but no physical changes

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3
Q

Tanner Staging: Stage 2

A

First physical changes noticeable
* Girls: breast bud
* Boys: testes and scrotum enlargement

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4
Q

Tanner Staging: Stage 3

A

Growth spurts, physical changes progress
* Girls: fat deposits on hips in girls
* Boys: voice cracking and nocturnal ejaculation

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5
Q

Tanner Staging: Stage 4

A

Key functional events
* Girls: menarche
* Boys: spermatogenesis

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6
Q

Tanner Staging: Stage 5

A

Adult physical appearance and function
* Girls: regular periods and ovulation
* Boys: facial hair and musculature

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7
Q

Age of onset of puberty in girls

A

8-13

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8
Q

What is Adrenarche

A

Beginning of pubic hair growth

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9
Q

Breast Development: Stage 1

A

No glandular breast tissue palpable

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10
Q

Breast Development: Stage 2

A

Breast bud palpable under areola (1st pubertal sign in females)

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11
Q

Breast Development: Stage 3

A

Breast tissue palpable outside areola; no areolar development

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12
Q

Breast Development: Stage 4

A

Areola elevated above contour of the breast, forming “double scoop” appearance

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13
Q

Breast Development: Stage 5

A

Areolar mound recedes into single breast contour with areolar hyperpigmentation, papillae development and nipple protrusion

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14
Q

Age of onset of puberty in boys

A

9-14

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15
Q

Male Genital Development: Stage 1

A

Testicular volume < 4 ml or long axis < 2.5 cm

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16
Q

Male Genital Development: Stage 2

A

4 ml-8 ml (or 2.5-3.3 cm long), 1st pubertal sign in males

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17
Q

Male Genital Development: Stage 3

A

9 ml-12 ml (or 3.4-4.0 cm long)

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18
Q

Male Genital Development: Stage 4

A

15-20 ml (or 4.1-4.5 cm long)

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19
Q

Male Genital Development: Stage 5

A

> 20 ml (or > 4.5 cm long)

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20
Q

Pubic Hair Growth: Stage 1

A

No hair

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21
Q

Pubic Hair Growth: Stage 2

A

Downy hair

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22
Q

Pubic Hair Growth: Stage 3

A

Scant terminal hair

23
Q

Pubic Hair Growth: Stage 4

A

Terminal hair fills the entire triangle overlying pubic region

24
Q

Pubic Hair Growth: Stage 5

A

Terminal hair extends beyond the inguinal crease onto thighs

25
Q

What hormones increase to cause growth spurt in puberty? (2)

A

GH and IGF1

26
Q

How does a growth spurt occur (regarding bones)?

A
  • Due to proliferation of chondrocytes
  • Ends of the long bones
27
Q

How does the growth spurt end (regarding bones)?

A
  • Terminated by fusion of the epiphyseal plate
28
Q

What hormone controls the termination of the growth spurt via fusion of the epiphyseal plate?

A

Oestrogen

29
Q

Hypothalamic-Pituitary-Gonadal Axis

A
  • Hypothalamus (GnRH)
  • Anterior Pituitary (Gonadotrophins/FSH & LH)
  • Gonads (Gonadal Hormones/Testosterone/
    Progesterone/Oestrogen)
  • Reproductive Tract
30
Q

At puberty: GnRH Release is disinhibited, How?

A
  • Kisspeptin, neurokinin B release from KND neurons in
    hypothalamus seemed to involved in switching on
    GnRH release
  • Kisspeptin neuropeptide signalling important
  • Glutamate signalling also probably involved
  • GABA downregulation
31
Q

Why has age of menarche decreased in the last c.150 years? (3)

A
  • Improved diets etc.
  • Improved health/reduced disease
  • Possible input of exogenous hormones e.g. in food
32
Q

Why is Leptin signalling important in puberty?

A
  • Leptin released by fat cells
  • Leptin can stimulate GnRH production via kisspeptin
33
Q

What is critical weight and fat percentage in women for menarche?

A
  • Critical weight of 47kg
  • 17% fat
34
Q

In many species breeding is seasonal- new ‘puberty’ each year, what us this triggered by? What gland and hormone is involved?

A
  • Triggered by changes in day length
  • Involvement of pineal gland, source of melatonin
35
Q

What kind of tumours can influence puberty? (think melatonin)

A

Pineal tumours

36
Q

Puberty – Hormonal Events: Females

A
  • Onset of puberty associated with a rise in pulsatile
    GnRH secretion
  • Initially at night
  • Followed by a steady rise in FSH & LH secretion
  • In girls FSH stimulates follicles, the theca produces
    oestrogen
37
Q

Puberty – Hormonal Events: Males

A
  • Onset of puberty associated with a rise in pulsatile
    GnRH secretion
  • Initially at night
  • Followed by a steady rise in FSH & LH secretion
  • In boys LH and FSH stimulate testicular enlargement
    and testosterone production
38
Q

What does Idiopathic mean?

A

Disease with an unknown cause or mechanism of apparent spontaneous origin

39
Q

What does Pathological mean?

A

Abnormal anatomical or physiological conditions and objective or subjective manifestations of disease, not classified as disease or syndrome

40
Q

What is Precocious Puberty?

A

Puberty in girls before 8 and boys before 9

41
Q

What is Delayed Puberty in Females?

A

No sign of breast development by age 13 or breasts present but no menarche by age 15

42
Q

What is Delayed Puberty in Males?

A

No sign of testicular development in boys at age 14 (volume <4ml)

43
Q

What is the Female Climacteric?

A

It is the period of life starting from the decline in ovarian activity until after the end of ovarian function

44
Q

What are the Stages in the Female Climacteric?

A
  • Pre-menopause
  • Menopause
  • Post menopause
45
Q

When does Pre-Menopause occur?

A

Typically from age c.40yrs

46
Q

What happens in Pre-Menopause? (4)

A
  • Follicular phase shortens, ovulation early or
    absent
  • Less oestrogen secreted
  • LH & FSH levels rise due to reduced feedback
  • Reduced fertility
47
Q

When does Menopause occur?

A

c. 45-55 years

48
Q

What happens in Menopause?

A

Cessation of menstrual cycles

49
Q

What happens to sex hormones in Menopause?

A
  • Oestrogen levels fall dramatically
  • FSH & LH levels rise, FSH dramatically
50
Q

Side Effects of Menopause (11)

A
  • Vascular changes i.e., ‘hot flushes’
  • Regression of endometrium
  • Shrinkage of myometrium
  • Thinning of cervix
  • Vaginal rugae lost
  • Vaginal dryness
  • Involution of some breast tissue
  • Changes in skin
  • Changes in bladder
  • Bone mass reduces by 2.5% per year for several years
  • Osteoporosis
51
Q

What happens in Post-Menopause?

A
  • No periods for 12 consecutive months
  • Fertility ends (low possibility up and until this stage)
52
Q

Benefits of Oestrogen for Post-Menopausal Women?

A
  • Relieves symptoms of the menopause
  • Can limit osteoporosis
53
Q

Cons of Oestrogen for Post-Menopausal Women?

A
  • Not advised for cardio-protection
  • Not advised/caution if VTE or stroke risk or breast/
    ovarian/endometrial cancer risk
54
Q

The end of reproductive life: Males

A
  • No obvious ‘event’ equivalent to menopause
  • But a gradual decline in semen volume, sperm motility,
    quantity and quality throughout adult life in males

The Reproductive System (19 decks)

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