Repro - Physiology (Estrogen, Progesterone, Tanner Stages of Development, & Menstrual cycle) Flashcards
Pg. 520-521 in First Aid 2013 Pg. 567-568 in First Aid 2014 Sections include: -Estrogen -Progesterone -Tanner stages of sexual development -Menstrual cycle
What are the sources of estrogen? What form(s) of estrogen does each source make?
(1) Ovary (17Beta-estradiol) (2) Placenta (estriol) (3) Adipose (estrone via aromatization)
List the forms of estrogen in order of decreasing potency.
Potency: estradiol > estrone > estriol
What 4 sets of functions does estrogen serve?
(1) Development of genitalia and breast, female fat distribution (2) Growth of follicle, endometrial proliferation, and increase myomerial excitability (3) Upregulation of estrogen, LH, and progesterone receptors; feedback inhibition of FSH and LH, then LH surge; Stimulation of prolactin secretion (4) Increase transport proteins, SHBG; increase HDL; decrease LDL
What function does estrogen serve with regards to physical development?
Development of genitalia and breast, female fat distribution
Aside from its impact on hormones, what function does estrogen serve as it relates to the uterus and/or menstruation?
Growth of follicle, endometrial proliferation, and increased myometrial excitability
What function does estrogen serve as it relates to hormone levels and/or activity?
Upregulation of estrogen, LH, and progesterone receptors; Feedback inhibition of FSH and LH, then LH surge; Stimulation of prolactin secretion (but blocks its action at breast)
What effects does estrogen have on prolactin, and in what contexts?
Stimulation of prolactin secretion (but blocks its action at breast)
What substances does estrogen affect, other than hormones? In what ways are these substances affected?
Increase transport proteins, SHBG; Increase HDL; Decrease LDL
How do different forms of estrogen change during pregnancy? Which is an indicator of fetal well-being?
Pregnancy: 50-fold increase in estradiol and estrone; 1000-fold increase in estriol (indicator of fetal well-being)
Where are estrogen receptors expressed? What occurs once ligand binds them?
Estrogen receptors expressed in the cytoplasm; Translocate to nucleus when bound by ligand
Create a diagram depicting the involvement of granulosa and theca cells in estrogen formation. More specifically, diagram the following: (1) Aromatase (2) Androstenedione (may be depicted twice) (3) Cholesterol (4) Desmolase (5) FSH (6) Granulosa cell (7) Estrogen (8) Estrogens (9) Theca cell (10) Pusatile GnRH (11) LH.
See p. 567 in First Aid 2014 or Pg. 520 in First Aid 2013 for diagram
What are the sources of progesterone?
(1) Corpus luteum (2) Placenta (3) Adrenal cortex (4) Testes
What does elevation of progesterone indicate?
Elevation of progesterone is indicative of ovulation; Think: “Progesterone = pro-gestation”
What 9 functions does progesterone serve?
(1) Stimulation of endometrial glandular secretions and spiral artery development (2) Maintenance of pregnancy (3) Decreased myometrial excitability (4) Production of thick cervical mucus, which inhibits sperm entry into the uterus (5) Increased body temperature (6) Inhibition of gonadotropins (LH, FSH) (7) Uterine smooth muscle relaxation (preventing contractions) (8) Decreased estrogen receptor expressivity (9) Prevents endometrial hyperplasia
What effect does fall in progesterone after delivery cause, and why?
Fall in progesterone after delivery disinhibits prolactin –> lactation
What function does progesterone serve with regard to vasculature development?
Stimulation of … spiral artery development
What 5 functions does progesterone serve as it relates directly to the uterus?
(1) Stimulation of endometrial glandular secretions; (2) Maintenance of pregnancy; (3) Decreased myometrial excitability; (4) Uterine smooth muscle relaxation (preventing contractions); (5) Prevents endometrial hyperplasia
What function does progesterone serve that involves the cervix, and what effect does this have?
Production of thick cervical mucus, which inhibits sperm entry into uterus
What effect does progesterone have on body temperature?
Increases body temperature
What are examples of gonadotropins? What effect does progesterone have on these?
FSH, LH; Inhibits gonadotropins
What effect does progesterone have on estrogen levels and/or activity?
Decreased estrogen receptor expressivity
Which characteristics are independently assigned their own Tanner stage?
A Tanner stage is assigned independently to genitalia, pubic hair, and breast (e.g., a person can have Tanner stage 2 genitalia, Tanner stage 3 pubic hair)
What are the Tanner stages of sexual development?
I. Childhood (prepubertal), II. Pubic hair (pubarche); breast buds form (thelarche), III. Pubic hair darkens and becomes curly; penis size/length increases; breasts enlarge, IV: Penis width increases, darker scrotal skin, development of glans; raised areolae, V. Adult; areolae are no longer raised
What is the typical length of the follicular phase? What is the typical length of the luteal phase?
Follicular phase can vary in length; Luteal phase is usually a constant 14 days
In terms of timing, what/when is menstruation?
Ovulation day + 14 days = menstruation
When is follicular growth the fastest?
Follicular growth is fastest during 2nd week of proliferative phase
What stimulates endometrial proliferation?
Estrogen stimulates endometrial proliferation
What maintains the endometrium, and why?
Progesterone maintains endometrium to support implantation
What effect does progesterone have on fertility?
Decreased progesterone –> Decreased fertility
Define the following terms: (1) Oligomenorrhea (2) Polymenorrhea (3) Metorrhagia (4) Menorrhagia (5) Menometorrhagia.
(1) > 35-day cycle (2) < 21-day cycle (3) Intermenstrual bleeding: Frequent but irregular menstruation (4) Heavy menstrual bleeding: > 80 mL blood loss or > 7 days of menses (5) Heavy, irregular menstruation at irregular intervals
Fill in the blanks [ ] regarding the menstrual cycle: Increased estrogen –> [1 ] –> Ovulation –> [2] (from [3]) –> [4] –> Menstruation (via [5])
(1) LH surge (2) Progesterone (3) Corpus luteum (4) Progesterone levels fall (5) Apoptosis of endometrial cells
Draw a diagram of the following blood hormone levels across an x-axis of days (mark 0, 7, 14, 21, and 28): (1) FSH (2) Estrogen (3) LH (4) Progesterone. Also, label where ovulation occurs on this diagram.
See p. 568 in First Aid 2014 or Pg. 521 in First Aid 2013 for visual on bottom.
Create a visual to depict changes in the endometrium, labeling the following: (1) Endometrium (2) Maturing graafian follicle (3) Corpus luteum (4) Menstruation (5) Regressing corpus luteum (6) Ovulation (7) Secretory phase (luteal) (8) Proliferative phase (follicular).
See p. 568 in First Aid 2014 or Pg. 521 in First Aid 2013 for visual on top.
