repro 3.1- puberty and the menopause

Question 1

What are primary sexual characteristics?

Answer 1

internal and external genitalia, established before birth, but immature.

Question 2

when do secondary sexual characteristics develop?

Answer 2

The changes that occur during puberty

Question 3

Give examples of secondary sexual characterstics of the female

Answer 3

-thelarche (breast development)
-Menarche (first period)
-growth spurt
puberache- axillae and pubic hair

Question 4

When do girls experience puberty?

Answer 4

8-13

Question 5

Give examples of male secondary sexual characteristics.

Answer 5

testicular growth
growth spurt
deepening of voice
puberache

Question 6

When do boys experience puberty?

Answer 6

9-14 years

Question 7

What’s the first change to happen in females and males during puberty?

Answer 7

females- breast bud development

males- growth of the testicles

Question 8

Why do males grow taller than females?

Answer 8

Their growth spurt begins later and lasts longer (due to no oestrogen closing the epiphyseal growth plates early).

Question 9

What is required for puberty to happen?

Answer 9

Rise in GnRH levels, causing a rise in FSH and LH levels.

Question 10

What is thought to cause the rise in GnRH levels?

Answer 10

development and maturation of central mechanisms.

Removal of inhibition to the hypothalamus

a critical weight being achieved (47Kg)

Question 11

What does higher androgen levels cause?

Answer 11

-pubic and axillary hair growth

Question 12

What does the rise in oestrogen cause (characteristic wise)

Answer 12

breast development (breasts have oestrogen receptors, which is what allows for cell growth)

Question 13

What is the growth spurt caused by?

Answer 13

growth hormone, increased metabolic rate, increased androgens.

Question 14

What is the critical weight needed for puberty to occur?

Answer 14

47kg.

Question 15

Why might puberty be occuring earlier and earlier?

Answer 15

increased nutritional status, larger people,

Question 16

What is precocious puberty?

Answer 16

puberty that happens 2 SD below mean, so <8 years for girls, <9 years for boys.

Question 17

How can precocious puberty be classified?

Answer 17

true/complete- due to early maturation of the HPG axis.

False/incomplete- ovarian/testicular/arenal secretion of homrones.

Question 18

Give some causes of true precocious puberty

Answer 18

meningitis
pineal cysts
post-infectious encephalitis
primary hypothyroidism.

Question 19

How does primary hypothyroidism lead to precocious puberty

Answer 19

Hormonal mechanism not well understood, may be due to the low levels of thyroid hormones leading to an increase in TRH and GnRH, thus puberty gets started early.

Question 20

Give some caused of false precocious puberty

Answer 20

ovarian cysts
ovarian/testicular tumours
congenital adrenal hyperplasia

Question 21

How would you distinguish between true and false precocious puberty?

Answer 21

Blood tests to look at the GnRH, LH, FSH and androgen levels.

Question 22

What are some main consequences of precocious puberty?

Answer 22

early closure of the epiphyseal growth plates, leading to short stature.
Family/child distress, eg due to bullying
increased risk of sexual abuse.

Question 23

What’s the name given to the end of reproductive life for the female?

Answer 23

Climacteric.

Question 24

How can the climacteric be further subdivided?

Answer 24

pre-menopause
menopause
post-menopause

Question 25

When does the pre-menopause happen and what does it involve?

Answer 25

around 40 years old
Shortening of the follicular phase, sometimes menarche will happen without ovulation 
Falling oEstrogen levels
increasing FSH and LH levels. 
Reduced fertility

Question 26

Why do FSH and LH levels rise?

Answer 26

less oesotrogen is being produced, so there’s less negative feedback, so less inhibition of GnRH and therefore LH/FSH.

Question 27

which hormone rises faster, FSH/LH. Why?

Answer 27

FSH, along with less negative feedback due to less oestrogen, there is also less inhibin production so there is a 2 fold reduction in inhibition.

Question 28

When does the menopause happen?

Answer 28

Around age 50.

Question 29

What are some symptoms of the menopause?

Answer 29

itchy 
twitchy
sweaty
sleepy
bloated
moody
forgetful
hot flushes

Question 30

What happens in the menopause?

Answer 30

Complete cessation of menstrual periods, no more follicles left.
the uterus shrinks,
loss of vaginal rugae,
involution of breast tissue

Question 31

What happens to the bone in menopause?

Answer 31

decreased density by up to 2.5% per year, less oestrogen so less inhibition of osteoclast activity.

Question 32

What can be given to relieve the symptoms of the menopause?

Answer 32

Hormone replacement therapy, oestrogen and progesterone

Question 33

Why should most woen not take oestrogen only HRT?

Answer 33

if they have a uterus, oestrogen can act on receptors and cause excessive growth, which increases the risk of cancer.
Only women who have had a hysterectomy can take oesrogen on it’s own.

Question 34

How is HRT given?

Answer 34

Orally

topically

Question 35

what are the main associated risks of HRT?

Answer 35

increased risk of breast cancer (and womb cancer in those who have had a hysterectomy).