Puberty And The Menopause

Question 0

At what age does puberty tend to start for girls?

Answer 0

8-13 years

Question 1

When are the primary sexual characteristics established?

Answer 1

Before birth

Question 2

What are the changes seen during puberty in a girl?

Answer 2

Breast bud (thelarche) appears
Pubic hair growth begins (adrenarche)
Growth spurt
Onset of menstrual cycle (menarche)
Pubic hair and breasts develop

Question 3

At what age does puberty happen for boys?

Answer 3

9-14

Question 4

What changes occur in boys in order?

Answer 4

Genital development begins
Pubic hair growth (adrenarche)
Spermatogenesis begins
Growth spurt - lasts longer and higher rate than girls
Genitalia and pubic hair develop until in full adult form

Question 5

What is female breast bud development dependent on?

Answer 5

Oestrogen

Question 6

What is genital development and pubic hair development dependent on in males?

Answer 6

Testosterone

Question 7

What ends the growth spurt?

Answer 7

Fusion of the epiphyses

Question 8

What initiates the growth spurt and closes the epiphyses in girls?

Answer 8

Oestrogen

Question 9

What is the onset of puberty due to?

Answer 9

Initiated by the brain
Get a rise in GnRH
Causes a steady rise in FSH and LH

Question 10

What is pubic and axillary hair development dependent on in both sexes?

Answer 10

Androgens

-produced by the adrenal glands in girls

Question 11

What is the growth spurt dependent on?

Answer 11

Growth hormone
Steroids
Oestrogen closes the epiphyses earlier in girls

Question 12

How is the start of puberty thought to be determined?

Answer 12

Reduction in sensitivity to negative feedback by steroids
More likely to be maturation of central mechanisms
Body weight

Question 13

What is the critical weight for menarche?

Answer 13

47kg

Question 14

Which hormone can cause the brain to switch puberty on and off?

Answer 14

Melatonin
Pineal gland detects light. More is secreted in the dark.
If the gland develops a tumour, can influence the onset of puberty

Question 15

When is it classed as precocious puberty?

Answer 15

If there are signs of puberty before 8

Question 16

What are some possible causes of precocious puberty?

Answer 16

Neurological

• early stimulation of central maturation caused by pineal tumours or meningitis
• uncontrolled gonadotrophin or steroid secretion by hormone secreting tumours

Question 17

What changes occur in the pre-menopause stage?

Answer 17

Follicular phase showered a 
Ovulation is early or absent 
Less oestrogen is secreted 
FSH and LH levels rise - FSH more so
Reduced feedback and reduced fertility

Question 18

What changes occur in the menopause?

Answer 18

Cessation of the menstrual cycle
No more follicles to develop so oestrogen levels drop
FSH and LH levels rise - FSH a lot
No inhibin

Question 19

What are some the vascular changes seen in the menopause?

Answer 19

Increased vasodilation due to a fall in progesterone and oestrogen
Hot flushes - transient rises in skin temperature

Question 20

What can hot flushes be relieved by?

Answer 20

Oestrogen treatment

Question 21

What changes occur to the reproductive organs in menopause?

Answer 21

Uterus - regression of endometrium and shrinkage of myometrium
Thinning of cervix
Vaginal rugae lost
Involution of some breast tissue

Question 22

What other changes occur in the menopause?

Answer 22

Changes in skin and bladder
Bone mass reduces by 2.5% per year for several years
-increased resorption compared to bone production leading to osteoporosis
-can be limited by oestrogen therapy

Question 23

Methods of taking HRT?

Answer 23

Orally

Topically by a patch/gel

Question 24

Why take HRT?

Answer 24

Relieves symptoms of menopause and improve well-being

Limit osteoporosis

Question 25

Risks of HRT?

Answer 25

Increased risk of breast cancer, DVT, PE