Puberty and Menopause Flashcards
State 2 physiological events in puberty and what influences it
Gonadarche- HPO axis
Adrenarche- Adrenal glands
Describe what happens during gonadarche x4
Release of GnRH by hypothalamus> ant pituitary gland> FSH and LH release > gametogenesis and steroidogenesis in gonads
State the function of estradiol in puberty x2
Breast development
Skeletal growth
Which hormone causes cessation of linear growth and how
Estradiol by fusion of growth plates
Which part of the adrenal glands produces DHEA
Zona reticularis
Purpose of adrenarche x2
Induce pubic and axillary hair growth
Apocrine sweat gland maturation
What is the sequence of pubertal maturation x5
Growth spurt
Thelarche
Pubarche
Peak growth velocity
Menarche
Hormones that influence growth spurt x4
Estradiol
Progesterone
Growth hormone
Insulin like growth factor
What is thelarche and what hormone causes it
Appearance of breast tissues
Due to estradiol
Hormones responsible for pubarche x2
DHEA- dehydroepindrosterone
Androsterone
Two parts of the secondary mound of the breast
Areola and papilla
Why is menarche an anovulatory cycle
There is HPO immaturity, the small amounts of FSH and LH produced are not sufficient for follicle development but can influence endometrial cycle
Factors influencing puberty x3
Genetics
Social environment
General health and nutrition
What is classified as delayed or interrupted pregnancy x3
- Failure to develop secondary sex characteristics by age 13
- No menarche by age of 15
- Not attained menarche 5+ years since onset of puberty
Causes of delayed or interrupted puberty x3
Anatomical abnormalities
Hypergonadotropic hypogonadism
Hypogonadotropic hypogonadism
What causes the high levels of FSH in hypergonadotropic hypogonadism
Lack of suppression of ant pituitary gland by negative feedback from ovaries
What is asynchronous puberty and its cause
Puberty that deviates from the normal pattern of puberty
Androgen insensitivity syndrome
What is androgen insensitivity syndrome
X linked recessive disease with absence of androgen receptors > failure of normal masculinization
Classification of precocious puberty x3
Central
Peripheral
Benign or non progressive pubertal variants
What is benign pubertal variants and what causes it
Isolated thelarche or pubarche
Caused by early activation of hypothalamic pituitary adrenal axis
Causes of precocious puberty x5
Ovarian cyst
Ovarian tumor
CNS lesions
Genetics
Exogenous sex androgens
Management of precocious puberty
GnRH agonists eg leuprolide, triptorelin
Define climacteric period
When a woman passes from reproductive to non reproductive stage.
From peri,meno, to post lasting 5 to 10 years
What causes high FSH/LH in menopause x4
Depletion of oocytes > decreased estrogen and inhibin b > decreased negative feedback on pituitary > increase in FHS
Diagnostic criteria of menopause x4
Cessation of menses for 12 months
Appearance of menopausal symptoms
Low serum estradiol
High serum FSH & LH
Management of menopause x3
Non hormonal- lifestyle modification
Tibolone- reduces bone resorption
Selective estrogen receptors modulators - treats osteoporosis
Contraindications of hormonal therapy in menopause x5
CHD
Active liver disease
Previous thromboembolic event
Active endometrial cancer
Hx of breast cancer
3 types of estrogen and when they are produced
E1 estron- produced by aromatisation i peripheral fat
E2 estradiol- produced in ovary
E3 estriol produced during pregnancy
MOA of tibolone in post menopausal women x3
Reduces osteoclastic activity and prevents bone resorption
Also reduces vasomotor symptoms eg hot flushes
Contraindications for hormonal therapy in post menopausal women x5
Hx of
CHD
Breast cancer
Endometrial Ca
Thromboembolic event
Acute liver disease
