Puberty And Menopause

Question 1

Define thelarche

Answer 1

Development of breasts

Question 2

Define pubarche

Answer 2

Development of pubic and axillary hair

Question 3

Define menarche

Answer 3

First menstrual period

Question 4

Define adrenarche

Answer 4

Onset of an increase in the secretion of androgens

Question 5

Define puberty

Answer 5

Stage of development when sexual maturation and growth are complete and result in the ability to reproduce

Question 6

What are the events of puberty?

Answer 6

Accelerate somatic growth
Maturation of primary sexual characteristics
Appearance of secondary sexual characteristics
Menstruation/spermatogenesis begins

Question 7

What is the difference in the growth spurt between the sexes?

Answer 7

Females = starts earlier but is shorter
Males = starts later but is longer and faster

Question 8

What marks the end of growth spurt?

Answer 8

Closure of epiphyseal growth plates in bones

Question 9

What is the critical weight that it is unlikely puberty will start before?

Answer 9

47 kg

Question 10

Describe what happens to the HPG axis in puberty

Answer 10

Gradual activation of GnRH
Increased frequency and amplitude of LH pulses
Gonadtropins stimulate sex steroid secretion
Extragonadal hormone changes

Question 11

Which area in brain signals puberty?

Answer 11

Arcuate area

Releases kiss peptide

Question 12

Give some effects of increased GH secretion

Answer 12

Increases TSH 
Increases metabolic rate 
Promotes tissue growth 
Increases androgens 
Growth spurt

Question 13

What are the first phenotypic changes in males and females?

Answer 13

Breast development (females)
Testicular enlargement (males)

Question 14

At what age in males does LH and FSH start to rise?

Answer 14

~10 years

Question 15

What is the approximate age range of puberty in girls?

Answer 15

9 - 13 years

Question 16

What is the approximate age range of puberty in boys?

Answer 16

10 - 14 years

Question 17

What is the average age of start of puberty in boys and girls?

Answer 17

Boys = 12.5
Girls = 11.5

Question 18

What is the average duration of puberty in boys and girls?

Answer 18

Boys = 3.2 years
Girls = 2.4 years

Question 19

What is precocious puberty?

Answer 19

Occurring younger, more common occurrence in girls
Girls < 8 years
Boys < 9 years
Majority have unknown cause

Question 20

Give some known causes of precocious puberty

Answer 20

Gonadotropin dependent: Hormone secreting tumours, CNS trauma, congenital disorders
Gonadotropin independent: pineal tumours, meningitis, congenital adrenal hyperplasia, testotoxicosis

Question 21

What is delayed puberty?

Answer 21

Initial physical changes are not present by age 13 in girls or age 14 in boys

Question 22

Give some causes of delayed puberty

Answer 22

Gonadal failure - Turner’s, post-chemo, autoimmune

Gonadal insufficiency - congenital, hypothalamic/pituitary lesions

Question 23

Describe Turner syndrome

Answer 23

Karyotype 45, X
Short stature, gonadal dysgenesis, skeletal abnormalities, cardiac and kidney malformation
No mental defect
Give growth hormone and sex hormone substitutions

Question 24

What are the 7 common problems with menopause?

Answer 24

Itchy 
Twitch 
Sweaty 
Sleepy 
Bloated 
Moody 
Forgetful

Question 25

Describe pre-menopause

Answer 25

Typically from age 40 years Follicular phase shortens Ovulation is early or absent - less oestrogen, more LH and FSH Reduced fertility

Question 26

Describe menopause

Answer 26

``` Cessation of menstrual cycle Absent for 12 months = into menopause Average age 49-50 years No more follicles to develop - oestrogen levels fall dramatically FSH and LH rise No inhibin ```

Question 27

What are the effects of menopause?

Answer 27

Hot flushes - vascular changes - often at night Transient rises in skin temp and flushing Relieved by oestrogen treatment

Question 28

What are the effects of menopause on bone?

Answer 28

Bone mass reduces by 2.5% per year Reduced oestrogen - enhanced osteoclasts therefore more bone resorption Type 1 osteoporosis

Question 29

How does hormone replacement therapy work?

Answer 29

Relives Sx of menopause and can improve well being Orally or topically Give slowly decreasing doses Can limit osteoporosis