Puberty and Menopause Flashcards
What does Thelarche mean?
Breast Development
What does Puberache mean?
Development of Axillary and Pubic Hair
What does Menarche mean?
The First Menstrual Period
What does Adrenarche mean?
The Increase in Androgen Secretion from the Adrenal Glands
How do you define Puberty?
A stage of human development when sexual maturation occurs , results in the ability to reproduce
When are Primary Sexual Characteristics established?
Before Birth
How is Puberty initiated?
By an increase in the number of GnRH pulses, which increases LH and FSH secretion
What is Precocious Puberty?
The Early Onset of Puberty
In females this could mean secondary characteristics before the age of 8, or menarche before the age of 10
In males it means earlier than 9
What is a growth spurt?
When does it occur?
why does it end earlier in girls?
A sudden increase in growth
It occurs at at around 10-15 (12 peaks) for Girls and 12-17 (14 peak) for Boys
It ends earlier as Oestrogen fuses the epiphyseal plates earlier
What is the Critical Weight (Puberty)?
Critical Weight is the minimum weight a female has to be for menarche
It is about 47kg
It shows Leptins may be involved in signalling for puberty
What are some environmental influences on puberty?
Changes in Day Length
Involves Pineal Gland and Melatonin Secretion
What are the hormone changes in puberty?
Increase in GnRH secretion
Increases LH and FSH, which leads to steroid production = Sexual Maturation
Increase in Growth Hormone and TSH
What is the first phenotypical change in puberty in fe/males?
Breast Development
Testicular Enlargement
Due to Nocturnal LH secretion
At what age does puberty occur?
Between 8 and 13 for Girls
Between 9 and 14 for Boys
At what age does Menarche occur?
95% of girls between 11-15
Normally before 16 years
What does the increase in LH and FSH do? (Puberty)
In Males?
In Females?
Male: Stimulates Spermatogenesis and Androgen Secretion
Androgens lead to the growth of sex accessory structures (prostate…); secondary characteristics and mineral retention (bone/muscle) growth
Females: Increases Oestrogen Production
Androgens from Adrenal Glands increase
Oestrogen and Androgens induces secondary characteristics
Why does TSH rise in puberty?
Increases Metabolic Rate
Promotes Tissue Growth
What are the Secondary Characteristics of Females?
Growth of the Pelvis Deposition of Subcutaneous Fat Growth of Internal Repro. Organs Growth of External Genetalia (All stimulated by Oestrogen)
Pubic Hair Growth Lowering Voice Bone Growth Increased Secretion from Sebaceous Glands (Androgens from Adrenal)
What are the Secondary Characteristics of Males?
Facial Hair Growth of the Larynx Increase Genital Volume and Size Pubic Hair Growth Spurt
What is the Tanner Standard?
The Classification of pubertal development
Stages each Secondary Characteristic
What initiates the 1st ovarian cycle?
The surge of LH release
Doesn’t usually have ovulation in 1st cycle
Follicle growth stimulates Oestrogen increase
What can cause Precocious Puberty?
Hormones Secreting Tumours (Dependent of Gonadotrophs)
Early Stimulation of Central Maturation, increase in hormones, not related to the HPG axis
What can cause early independent stimulation of maturation?
Congenital Adrenal Hyperplasia
Tumours
Testotoxicosis
Exogenous Oestrogen/Androgen Exposure
What is Delayed Puberty?
When the physical changes of puberty aren’t present by 13 or 14
Or there is primary amenorrhoea at 16
What can delay puberty?
Gonadal Failure
Gonadal Deficiency
What can cause Gonadal Failure?
Turner’s Syndrome
Post-Malignancy Chemo/Radiotherapy/Surgery
Polyglandular Autoimmune Syndromes
What can cause Gonadal Deficiency?
Congenital Hypogonadotrophic Hypogonadism
Hypothalmic/Pitruitary Lesions
Gene Mutations Inactivating FSH/LH or their receptors
What is the Climacteric?
The end of the reproductive cycle for females Has 3 Parts: Pre Menopause Menopause Post Menopause
Describe Pre-Menopause
Around 40 years Follicular phase shortens No/Early ovulation Less Oestrogen and Inhibin produced Increase in LH and FHS Reduced fertility
Describe Menopause
The complete cessation of the menstrual cycle
No follicles left to develop
Vascular changes = hot flushes (due to decrease in Oestrogen)
Endometrium regresses
Myometrium shrinks
Cervix thins
Vaginal rugae are lost
Breast tissue involution
Skin changes
Bladder changes
Bones = Osteoporosis
Describe HRT
Hormone Replacement Therapy
Aims to reduce/prevent symptoms of the menopause
Topical or Oral
What are the main risk factors about HRT?
Increase risk of breast malignancy
Endometrium thickens in Oestrogen only preperations so don’t give unless Hysterectomy
How is the end of the male reporductive life signalled?
There is no defined end
Number/Quality of Sperm can decrease as go on
Testosterone levels can lower
