Menstruation

Question 1

Sources and forms of estrogen?

Answer 1

Ovary: 17-B estradiol
Adipose tissue: Estrone via aromatization
Placenta: Estriol

Question 2

Potency of estrogens in decreasing order?

Answer 2

Estradiol, estrone, estriol

Question 3

What “growth” functions does estrogen have?

Answer 3

Development of genitalia and breast
Female fat distribution
Growth of follicle
Endometrial proliferation
Myometrial excitability

Question 4

What hormonal effects does estrogen have?

Answer 4

Upregulation of estrogen, LH and progesterone receptors
Inhibition of FSH and LH (then LH surge)
Stimulates prolactin secretion

Question 5

What is the effect of estrogen on transport proteins?

Answer 5

Increase TX proteins, SHBG, HDL.

Decreases LDL.

Question 6

Where are estrogen receptors located in the cell?

Answer 6

Expressed in cytoplasm, translocate to nucleus when bound by estrogen

Question 7

What changes occur in pregnancy to the levels of estradiol, estrone, and estriol?

Answer 7

50-fold increase in estradiol and estrone.

1000-fold increase in estriol –> indicator of fetal well-being.

Question 8

What stimulates FSH and LH release from anterior pituitary?

Answer 8

pulsatile GnrH

Question 9

What does LH stimulate?

Answer 9

Theca internal cell. Conversion of cholesterol to androgens via desmolase.

Question 10

What does FSH stimulate?

Answer 10

Granulosa cell. Conversion of androgens to estradiol by aromatase.

Question 11

Which cells are closet to egg?

Answer 11

granulosa (granny hugs the baby).

Question 12

What are the sources for progesterone?

Answer 12

Corpus luteum, placenta, adrenal cortex, testes

Question 13

What is the function of progesterone in the menstrual cycle?

Answer 13

Stimulation of endometrial glandular secretions and spiral artery development

Question 14

What is the effect of progesterone on pregnancy?

Answer 14

Maintenance - pro-gestation.

Question 15

What is the effect of progesterone on myometrium?

Answer 15

Decreases myometrial excitability, uterine smooth muscle relaxation, preventing contractions.

Question 16

What is the effect of progesterone on the cervix?

Answer 16

Production of thick cervical mucus, which inhibits sperm entry into the uterus

Question 17

What is the effect of progesterone on body temperature?

Answer 17

Increases

Question 18

What is the effect of progesterone on estrogen receptor expression?

Answer 18

Decreases - prevents endometrial hyperplasia.

Question 19

What is the effect of progesterone on gonadotropins?

Answer 19

Inhibits LH and FSH

Question 20

What does fall in progesterone after delivery do?

Answer 20

Disinhibits prolactin –> lactation.

Question 21

What happens during the follicular phase to the endometrium?

Answer 21

Proliferative phase - thickens.

Question 22

What happens to the follice during the follicular phase?

Answer 22

Matures. Follicular growth is fastest during second week of proliferative phase.

Question 23

What hormone predominates during the proliferative phase?

Answer 23

FSH and LH at beginning induce rising estrogen levels

Question 24

What does rising levels of estrogen lead to?

Answer 24

LH surge

Question 25

What does LH surge lead to?

Answer 25

Ovulation, followed by progesterone secretion from corpus luteum

Question 26

When does the luteal phase/secretory phase begin?

Answer 26

After ovulation.

Question 27

What is the role of progesterone in the luteal phase?

Answer 27

Maintains endometrium to support implantation.

Question 28

When does menstruation occur?

Answer 28

If corpus luteum not fertilized, regresses, and progesterone levels fall.
By 14 days after ovulation, menstruation will begin.

Question 29

How does menstruation occur?

Answer 29

Apoptosis of endometrial cells

Question 30

What is a normal cycle length?

Answer 30

21-35days.

Question 31

What is the cutoff for menorrhagia?

Answer 31

> 80mL blood bloss, >7 days of menses.