OBGYN Overview Flashcards
at the termination of the vagina
the “window” of the uterus
The Cervix
Made of squamous epithelium consistent with that of the vagina, and
columnar epithelium of the endocervix
Cervix
What two types of epithelium meet at the Transformation zone around the Os of the cervix?
squamous epithelium
columnar epithelium
Why is the squamocolumnar junction of the cervix so important?
Area in which >90% of cervical neoplasia originates
> 35 day cycle
Oligomenorrhea
<21 day cycle
Polymenorrhea
Frequent but irregular menstruation
Metrorrhagia
Heavy, irregular menstruation at irregular intervals
Menometrorrhagia
The follicle with the greatest number of granulosa cells, FSH receptors, and the highest estradiol production
The rest undergo atresia (degenerative process)
Dominant Follicle
White fibrous streak within the ovary that was once the corpus luteum
Corpus albicans
FSH and LH are released from where?
the anterior pituitary gland
Menstruation regulation: These hormones are involved in upregulation
Estrogen
LH
Progesterone
Menstruation regulation: These hormones are involved in inhibition
FSH
LH
LH surge
The follicle stimulating hormone (FSH) acts on which cells?
Acts on granulosa cells
The lutenizing hormone (LH) acts on which cells?
Acts on the theca cells (Produce androgens)
Which estrogen is the major estrogen of the reproductive years?
Estradiol
List the types of estrogen in order of most potent to least potent
Estradiol > estrone > estriol
What are the sources of estrogen?
Ovary
Placenta
Adipose tissue
Estrogen is dominant in which phase of the menstrual cycle?
Dominant in the follicular phase
Which estrogen is an indicator of fetal wellbeing in pregnancy?
estriol
What are the functions of estrogen?
Development of female breast and genitalia
Female fat distribution
Growth of follicle
Endometrial proliferation
Increase HDL
Lower LDL
Elevation of progesterone (LH surge) is indicative of what?
ovulation
What are the sources of progesterone?
Corpus luteum
Placenta
Adrenal cortex
testes
Progesterone is dominant in which phase of the menstrual cycle?
Dominant in the luteal phase (Luteinization)
What is the function of progesterone in pregnancy?
PRO- GESTATION
Maintenance of pregnancy
Uterine smooth muscle relaxation (preventing contractions)
Progesterone levels are maintained by hCG
What is the function of progesterone?
Stimulation of endometrial glandular secretions
Stimulation of spiral artery development
Production of thick cervical mucus which inhibits sperm entry into
the uterus
Increase basal body temperature
Inhibition of LH and FSH
Describe estrogen and progesterone’s hormonal changes and effects on the endometrium
Estrogen - Proliferation
Progesterone withdraw - Endometrium breaks down and is
sloughed off during menses
Progesterone - Differentiation of endometrial components (proliferative 🡪 secretory)
Describe estrogen and progesterone’s hormonal changes and effects on the endocervix
Estrogen - Glands secrete large quantities of thin, clear, watery mucus
Progesterone - Mucus production diminishes
Describe estrogen and progesterone’s hormonal changes and effects on the vagina
Estrogen - Promotes growth of epithelium, Maturation of the epithelial cells, Vaginal transudation and lubrication during intercourse
Progesterone - Epithelium retains thickness, secretions are markedly
diminished
Describe progesterone’s hormonal changes and effects on the breasts
Progesterone - Breast tenderness and fullness
Describe progesterone’s hormonal changes and effects on the hypothalamus
Progesterone - Basal body temperature increases by 0.5 to 1.0 degrees F
The proliferation stage of menstruation is which phase?
The follicular phase
The secretory stage of menstruation is which phase?
The luteal phase
The dominant hormone during the follicular phase is what?
Dominant hormone is estrogen
The dominant hormone during the luteal phase is what?
Dominant hormone is progesterone
Which phase is a constant (14 days) and which phase is variable during menses?
Follicular phase can vary in length
Luteal phase is constant (14 days)
Definition: permanent cessation of menses after significant decrease
in ovarian estrogen production due to aging or bilateral oophorectomy
12 consecutive months of no bleeding
End of reproduction
Menopause
Menopause before age 40 is called what?
premature ovarian failure
What fraction of a woman’s life is in menopause?
1/3 of woman’s life span
Undernourished women and smokers tend to have an earlier what?
menopause
Transition from the reproductive to the non-reproductive years during which ovarian estrogen production may fluctuate unpredictably
Can last 1-3 years
Perimenopause
The time period during which the changes of menopause occur
Climacteric
What stage is the permanent cessation of a period?
Post-menopause
What hormone is the major product of the post-menopausal ovary?
Testosterone
Which estrogen is the predominant endogenous estrogen post-menopause?
Estrone
What is the hallmark of menopause?
Hot flashes and vasomotor instability
What is the first physical manifestation of decreased estrogen?
flush (night sweats if happens at night)
One of the most common and debilitating effects of menopause
Sleep Disturbances
What induces change in a woman’s sleep cycle?
Decreased E2
This diagnosis should be suspected in a young woman with hot
flushes and other symptoms of hypoestrogen and secondary
amenorrhea
Premature Ovarian Failure
What is the diagnosis for Premature Ovarian Failure?
FSH levels >30 IU/mL
List some causes of premature ovarian failure
Genetic Factors
Autoimmune
Smoking
Chemotherapy
Hysterectomy
Women who smoke can undergo ovarian failure how many years earlier?
3-5 years
Hormone therapy should only be used SHORT TERM in menopause because why?
The administration of continuous unopposed estrogen can result in endometrial hyperplasia and cancer
What are the contraindications for estrogen use?
Undiagnosed bleeding
Cancer
Liver disease
History of DVT, stroke, MI
Known or suspected pregnancy
hypersensitivity
What are some benefits of estrogen therapy?
Osteoporosis prevention/reduction in hip fracture risk
Lipid improvement
May decrease the onset of diabetes
Reduces risk of colon cancer
Note: must take progesterone if patient still has a uterus
