LECTURE- Female Endocrinology Testing Flashcards
average menstrual cycle length
28 (+/- 2d)
- more variation near menarche, menopause
what hormones do the ovaries produce?
estrogen
progesterone
testosterone
three distinct phases in the menstrual cycle =
follicular = vaariable
ovulation
luteal = same
test results regarding female endocrinology dependent on time in cycle
- important to know LMP when interpreting results
- cycle day one = first day of full flow of period
describe the follicular phase
- variable duration; 10-18 days
- development of egg/follicle; FSH key hormone
- estradiol is the most important estrogen
> increasing estrogen UNTIL ovulation (neg feedback) - proliferative pattern of endometrium
ovulation phase
- LH surge = early pregnancy, endocrine marker (15 U/L)
- starts 28-32 hrs before ovulation; coincidentally increased temp
- peaks 10-12 hrs pre-ovulation
to have an LH surge, need these at day 14:
- large enough follicle (ultrasound) = peak FSH
- sufficient estrogen levels (serum estradiol)
- fertility monitoring uses both
luteal phase
- constant length of menstrual cycle; 14 days from ovulation
- progesterone is the key hormone
> peaks 7 days post ovulation
> maintains endometrium - LH maintains progesterone production
> corpus luteum - endometrium = secretory changes
this is the phase we test
follicular phase
the inability to conceive after 12 months
- affects 10% of couples = look at tubal function, semen
- anovulation affects 20% = most have irregular periods
critical lab test in infertility
serum progesterone
- peak value 7 days before menses
- day 21 in typical 28 day cycle
what constitutes are oligomenorrhea
- fewer than 9 periods a year
- due to anovulation or irregular ovulation
- the commonest cause is polycystic ovary syndrome (6-10% of women)
-associated w high ovarian androgens = high testosterone, both total and free - abnormal LH/FSH ratio (>2/1)
> high H, with normal FSH
PCOS = polycystic ovarian syndrome
- anovulation, irregular menses, infertility
- hirsutism, acne
- insulin resistance is common
- weight loss = first line of treatment in obese patients
> NOT the answer, but may aid in conception
> metformin = insulin sensitizer - treat symptoms that bother patient *
menopause
- amenorrhea with high gonadotrophins; FSH >20U/L
- low estradiol levels
- day 3 FSH (if peiods still)
- random FSH if no periods
- mean age 51 yrs = Canada (.1/3 of ife)
symptoms of menopause
hot flashes, mood swings, vaginal changes
