Ovarian Aging and Menopause Flashcards
First appearance of primordial germ cells in yolk sac occurs during which week?
week 4
By week ____, germ cells arrive at the genital ridge.
week 6
T/F the rate of follicular atresia is not fixed and becomes more rapid approximately 10-15 years prior to menopause.
T
clinical correlates of more rapid loss of follicles
reduced odds of pregnancy, fewer follicles grow per cycle, menstrual cycle irregularity
Menopause
the point in time when permanent cessation of menstruation occurs following loss of ovarian activity –> retrospective diagnosis/natural or surgical
Perimenopause/menopausal transition
menstrual irregularity duration of approx 4 years
Biochemical characteristics of menopause
elevated fsh/lh, low estrogen
Factors related to age of onset of menopause
smoking, family, possible dietary habits, alcohol consumption,
Total and LDL cholesterol levels are higher/lower in premenopausal women than in men
lower –> levels rise with age and after menopause
____ syndrome increases during perimenopause and postmenopause
metabolic syndrome
T/F menopause onset is related to accelerated bone loss and osteoporosis
T
Women typically experience ___ years of hot flashes if not treated after onset of menopause.
5 years
Tx of symptoms of menopause
hormone replacement, ssri, antihypertensive, behavioral
premature ovarian insufficiency
cessation of ovarian function < age 40 –> elevated lh/fsh on two occasions one month apart with low estradiol
prevalence of premature ovarian insufficiency
1%
why do you need low estradiol to determine premature ovarian insuffiency?
because if both fsh/estradiol are high, person might be about to ovulate vs having lost regulation of gonadotropins due to poi
An abnormality in or absence of one x chromosome resulting in ovarian failure is called ____
turner’s syndrome –> 45x or mosaic with 46xx/45x
Clinical features of turner’s
premature ovarian failure, delayed puberty, renal anomolies, cardiovascular and associated autoimmune disorders
MOA turner’s syndrome on premature ovarian failure
excessive rapid atresia of oocytes occurs starting in utero and streak gonads depleted of follicles develop
T/F both x chromosomes are active in ovary to ensure normal development (exception to lyonization)
T
gonads depleted of oocytes and gonads are colloquially known as ____
streak gonads
Older/younger exposure to chemotherapy/radiation has the greatest impact on early menopause
older –> fewer follicles on reserve
Why are alkylating agents especially damaging?
not specific to any particular stage of cycle
Risks of hormone replacement tx
dvt
Benefits of hormone replacement tx
quality of life, osteoporosis and cardiovascular disease prevention
