Male Hypogonadism

Question 1

What cells produce oestrogen in the ovaries?

Answer 1

granulosa and theca cells as well as the corpus luteum

Question 2

What hormone stimulates the granulosa cells to produce pregnelone?

Answer 2

LH

Question 3

How is oestrogen produced from pregnelone?

Answer 3

pregnenolone diffuses out of granulosa cells to the theca cells which converts the pregenolone to androstenedione via DHEA; the androstenedione returns to granulose cells and is converted to oesterone by aromatase then oestradiol by 17beta-HSD

Question 4

What is the expression of the enzymes aromatase and 17beta-HSD controlled by?

Answer 4

FSH stimulation

Question 5

What enzyme converts pregenenolone to progesterone?

Answer 5

3beta-HSD

Question 6

What are the actions of progesterone synthesis primarily mediated by?

Answer 6

intracellular progesterone receptor

Question 7

What horomone controls the numbers of intracellular progesterone receptor

Answer 7

oesterogen

Question 8

What is the main ovarian product during follicular maturation?

Answer 8

oestradiol

Question 9

What is the main ovarian product in the luteal phase?

Answer 9

progesterone

Question 10

What is the definition of oligomenorrhoea?

Answer 10

reduction in frequency of periods to less than 9/year

Question 11

What is primary amenorrhea?

Answer 11

failure of menarche by the age of 16

Question 12

Waht is secondary amenorrhea?

Answer 12

cessation of periods for >6 months in an individual who has previously menstruated

Question 13

What are the causes of primary amenorrhea?

Answer 13

congenital problems - Turner’s; Kallmans

Question 14

What are causes of secondary amenorrhea?

Answer 14

PCOS; premature ovarian failure; uterine adhesions; hypothalamic dysfunction; pituitary- high PRL; hypopituitarism

Question 15

What are the symptoms of oestrogen deficiency?

Answer 15

flushing; decreased libido; dyspareunia

Question 16

What are features of PCOS/androgen excess?

Answer 16

hirsutism/acne

Question 17

What would anosmia point to?

Answer 17

Kallman’s

Question 18

What is female hypogonadism identified as?

Answer 18

low levels of oestrogen

Question 19

What is primary hypogonadism?

Answer 19

problem with the ovaries

Question 20

What are the levels of LH/FSH in primary hypogonadism?

Answer 20

high

Question 21

What is primary hypogonadism therefore also called?

Answer 21

hypergonadotrophic hypogonadism

Question 22

What is a cause of hypergonadotrophic hypogonadism?

Answer 22

premature ovarian failure

Question 23

What is secondary hypogonadism?

Answer 23

probelm with hypothalamus or pituitary

Question 24

What are the levels of LH and FSH in secondary hypogonadism?

Answer 24

low

Question 25

What is the otehr name for secondary hypogonadism?

Answer 25

hypogonadotrophic hypogonadism

Question 26

What are the causes of hypogonadotrophic hypogonadism?

Answer 26

high PRL; hypopituitarism

Question 27

What is POF?

Answer 27

amenorrhea; oestrogen deficiency and elevated gonadotrophins occuring ,40 yo as a result of loss of ovarian function

Question 28

What is POF defined as biochemically?

Answer 28

FSH>30 on 2 seperate occasions >1 month apart

Question 29

What are the causes of POF?

Answer 29

chromosomal abnormalities (Turner’s; fragile X); gene mutations (FSH or LH receptor); AI disease (associ. with Addison’s thyroid); iatrogenic- radio/chemotherapy

Question 30

What is secondary hypogonadism characterised by?

Answer 30

low oestradiol with low/ normal LH/FSH