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Reproductive and Endocrine > Menstrual Cycle > Flashcards

Menstrual Cycle Flashcards

1
Q

What are the three phases that the endometrium goes through in the uterine cycle?

A

Menstrual phase = stratum functionale is shed
Proliferative phase = oestrogen stimulates the proliferation of the stratified squamous epithelium to regrow the stratum functionale
Secretory phase = progesterone stimulates the development of uterine glands and spiral arteries to make the endometrium ready for implantation

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2
Q

Why is menstruation required?

A

Female reproduction needs to be cyclical so the body can switch between supporting gametogenesis and fertilisation, to supporting pregnancy.

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3
Q

What are the three types of oestrogen produced by the ovaries?

A

Oestradiol - produced when not pregnant (by granulosa cells in follicle)
Oestrone - produced when pregnant
Oestriol

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4
Q

What produces progesterone?

A

The corpus luteum

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5
Q

What are the effects of oestrogen?

A

Regulates release of LH (low oestrogen inhibits, high oestrogen stimulates)
Regulates release of FSH (high oestrogen inhibits)
Regulates body temperature
Stimulates endometrial proliferation
Improves memory
Decreases cholesterol synthesis in the liver, decreases plaque build up in coronary arteries
Maintains thick and lubricated vaginal lining
Causes breast development in puberty
Maintains bone density

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6
Q

What are the side effects caused by oestrogen in contraception?

A

Fluid retention
Oedema
Risk of venous thromboembolism

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7
Q

What are the side effects of progesterone in contraception?

A 
Irregular menstruation
Hirsuitism
Acne
Weight gain
Irritability
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8
Q

What is puberty?

A

The state of becoming capable of procreation.

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9
Q

What is adrenarche?

A

Adrenal development towards puberty

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10
Q

What is thelarche?

A

Breast development as part of puberty

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11
Q

What is pubarche?

A

Pubic hair development as part of puberty

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12
Q

What is menarche?

A

Time of first period

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13
Q

What is menopause?

A

Last menstrual period

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14
Q

What is climacteric?

A

Period of life leading up to last menstrual bleed

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15
Q

What is perimenopause?

A

12 months before and after last menstrual period - gradually stabilising towards postmenopause

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16
Q

What is postmenopause?

A

More stability after the menopause

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17
Q

What is preadolescence?

A

When you have an immature hypothalamus (this means the hypothalamus releases only slow irregular pulses of GnRH, and FSH and LH levels are minimal).

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18
Q

What is the critical weight for onset of menarche?

A

46kg

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19
Q

Why is the age of menarche decreasing?

A

Better nutrition, so people are reaching a higher weight at a younger age.

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20
Q

What is the other factor that affects menarche besides weight?

A

Latitude - lower latitudes get more light, more stimulation to hypothalamus, younger menarche

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21
Q

What is it called when menarche is younger than 9 years, and what can cause this?

A

Precocious puberty - can be caused by obesity, cerebral tumours, congenital adrenal hyperplasia, ovarian tumours, drugs

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22
Q

What is delayed puberty?

A

Menarche at age above 16 years. Can be caused by athlete training, congenital abnormalities in uterus development, chromosomal abnormalities

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23
Q

What are the criteria for having a menstrual cycle?

A 
Women who are:
Post-pubertic age
Pre-menopause
Not severely overweight or underweight
Not pregnant or breastfeeding
Don't have premature ovarian failure
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24
Q

What are the three types of molecules involved in the regulation of the menstrual cycle?

A

Neuropeptides (GnRH)
Glycoproteins (FSH, LH)
Steroids (Progestagens 21C, Androgens 19C, Oestragens 18C)

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25
Q

What do all the glycoproteins have in common?

A

They are all heterodimers (made up of an alpha and a beta subunit), and all the glycoproteins have the same alpha chain but their beta chains differ.

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26
Q

Where is the first rate limiting step in the metabolism of cholesterol to produce progestagens, androgens and oestrogens?

A

In the mitochondria, where cholesterol is converted to pregnenolone.

27
Q

Which enzyme converts testosterone to oestrogen?

A

Androgen aromatase

28
Q

Which enzyme converts testosterone to dihydrotestosterone?

A

5a-reductase

29
Q

What two factors are most important in the regulation of the menstrual cycle?

A

The abundance of the hormone, the expression of the hormone receptor by the cells

30
Q

In what way does the hypothalamus release GnRH after puberty?

A

Regular pulses

31
Q

Name the degeneration of ovarian follicles that do not ovulate in the ovary.

A

Atresia

32
Q

What does folliculogenesis start with?

A

Starts with a Primordial Follicle, which is a primary oocyte surrounded by a layer of granulosa cells

33
Q

What happens when a primordial follicle develops into a primary follicle?

A

A Primary Follicle is produced when the primary oocyte grows in diameter and secretes an avascular layer of glycoproteins - the Zona Pellucida - which separates the primary oocyte from the granulosa cells. The granules cells have divided to become several layers thick.

34
Q

When is a preantral follicle produced?

A

When there are several layers of granulosa cells, and the outer layer differentiates into theca cells which begin to express receptors.

35
Q

When does a preantral follicle become an antral follicle?

A

A viscous fluid (comprised of secretions from the granulosa cells and a serum transudate) begins to accumulate between the granulosa cells which continue to proliferate.
The droplets coalesce to form a single follicular antrum.

36
Q

What is the name for the mass of granulosa cells surrounding the oocyte suspended in follicular fluid in the antral follicle?

A

Cumulus oophorus

37
Q

What are the two phases of the menstrual cycle?

A

Follicular phase - day 1 to 14

Luteal phase - day 14 to 28

38
Q

During the early follicular phase, what effect do LH and FSH have on the follicle, and what does this lead to?

A

LH binds to receptors on the theca interna, and causes the cells to produce androgens.
FSH causes the granulosa cells to produce androgen aromatase and so convert androgens to produce oestrogen.

39
Q

What effect do the androgens produced by the theca cells have on the follicle?

A

They stimulate the proliferation of the granulosa cells, so the follicle develops (rescued from atresia) and oestrogen levels rise.

40
Q

What are the two other hormones produced by granulosa cells in the follicular phase?

A

Inhibin B, to inhibit FSH release, and Anti-Mullerian Hormone. This stops more than one follicle being produced at the same time.

41
Q

What are the effects of the oestrogen surge produced by the granulosa cells?

A

Inhibit FSH release
Cause granulosa cells to start expressing LH receptors
Switch from negative feedback to positive feedback of LH
LH can then act of the granulosa cells to cause ovulation

42
Q

What are the effects of LH on the granulosa cells, when the granulosa cells express LH receptors in the oestrogen surge?

A

Cause ovulation

Reduce oestrogen production and increase progesterone production

43
Q

What is it called when the oocyte completes its first meiotic division just as ovulation occurs, and why does this happen?

A

Nuclear maturation, happens because the cells of the cumulus oophorus are derived from granulosa cells, so start expressing LH receptors for the LH spike.

44
Q

What two things are produced by nuclear maturation?

A

Secondary oocyte (which receives most of the cytoplasm), and a first polar body

45
Q

What is it called when the cytoplasm is reorganised during ovulation and the mitochondria and cortical granules migrate to the periphery?

A

Cytoplasmic maturation

46
Q

What occurs during the process of ovulation?

A

The outer wall of the ovary swells rapidly, a stigma forms and viscous fluid oozes.
The stigma ruptures and viscous fluid evaginates and carries the ovum and corona radiate (mass of granulosa cells) to the fimbriae

47
Q

What converts the granulosa and theca cells to produce progesterone instead of oestrogen after ovulation?

A

LH binding to the receptors they now express.

48
Q

What 3 things are produced by the luteal cells of the corpus luteum?

A

Inhibin A
Oestrogen
Progesterone

49
Q

What is the role of progesterone produced by the corpus luteum?

A

Inhibits release of GnRH, and is important for developing the endometrium ready for implantation.

50
Q

What is the role of inhibit A produced by the corpus luteum?

A

Inhibit release of FSH so more follicles don’t develop.

51
Q

What happens to the corpus luteum after 14 days if there is no fertilisation?

A

Luteolysis.

52
Q

What does FSH stimulate granulosa cells to produce in the early follicular phase?

A

Androgen aromatase, so they can produce oestrogens from the androgens produced by the theca cells.
Also, inhibin B, which inhibits FSH release so suppresses the development of other follicles so the follicle can become the dominant follicle.

53
Q

What are the two functions of androgens in folliculogenesis?

A

Stimulate proliferation of granulosa cells

Stimulate oestrogen synthesis

54
Q

When do the phases of the uterine cycle occur in relation to the phases of the ovarian cycle?

A

The proliferative phase occurs before ovulation (during the luteal phase) and is completed 4-7 days after the start of menstruation.
The secretory phase occurs after ovulation during the luteal phase.

55
Q

What are the effects of the hormones produced by the corpus luteum during the secretory phase of the uterine cycle?

A

Oestrogen decreases the cellular proliferation of the stratum functionale.
Progesterone causes the swelling and development of the endometrium (uterine glands and spiral arteries), so it is prepared for implantation.
Progesterone also supports secretions of the female reproductive tract ready for pregnancy.

56
Q

Why is it useful that home ovulation testing kits look for the LH surge that is 24 hours before ovulation?

A

The probability of getting pregnant is higher if the sperm have the opportunity to wait for the egg.

57
Q

What is the cumulative pregnancy rate/cumulative conception rate?

A

Your chance of getting pregnancy over 12 months (the highest probability for one month is 20%)

58
Q

What is the cumulative contraception rate for most couples in one year, and what is it reduced to by condoms?

A

100%, reduced to 12% by condoms.

59
Q

What is the term used to describe the number of egg cells left in the ovary?

A

Ovarian reserve

60
Q

What three things can reduce the cumulative conception rate?

A

Smoking, pathology, increased female age

61
Q

What is formed if there is no fertilisation and the corpus luteum undergoes luteolysis?

A

Corpus albicans

62
Q

If fertilisation does occur, which hormone causes the corpus luteum to be maintained and keep producing progesterone?

A

Human Chorionic Gonadotropin (hCG)

63
Q

What is Clomiphene citrate?

A

A Selective Estrogen Receptor Modulator (SERM) which can stimulate FSH secretion and ovulation.

Reproductive and Endocrine (11 decks)

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