Repro - Physiology (Estrogen, Progesterone, Tanner Stages of Development, & Menstrual cycle)

Question 1

What are the sources of estrogen? What form(s) of estrogen does each source make?

Answer 1

(1) Ovary (17Beta-estradiol) (2) Placenta (estriol) (3) Adipose (estrone via aromatization)

Question 2

List the forms of estrogen in order of decreasing potency.

Answer 2

Potency: estradiol > estrone > estriol

Question 3

What 4 sets of functions does estrogen serve?

Answer 3

(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

Question 4

What function does estrogen serve with regards to physical development?

Answer 4

Development of genitalia and breast, female fat distribution

Question 5

Aside from its impact on hormones, what function does estrogen serve as it relates to the uterus and/or menstruation?

Answer 5

Growth of follicle, endometrial proliferation, and increased myometrial excitability

Question 6

What function does estrogen serve as it relates to hormone levels and/or activity?

Answer 6

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)

Question 7

What effects does estrogen have on prolactin, and in what contexts?

Answer 7

Stimulation of prolactin secretion (but blocks its action at breast)

Question 8

What substances does estrogen affect, other than hormones? In what ways are these substances affected?

Answer 8

Increase transport proteins, SHBG; Increase HDL; Decrease LDL

Question 9

How do different forms of estrogen change during pregnancy? Which is an indicator of fetal well-being?

Answer 9

Pregnancy: 50-fold increase in estradiol and estrone; 1000-fold increase in estriol (indicator of fetal well-being)

Question 10

Where are estrogen receptors expressed? What occurs once ligand binds them?

Answer 10

Estrogen receptors expressed in the cytoplasm; Translocate to nucleus when bound by ligand

Question 11

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.

Answer 11

See p. 567 in First Aid 2014 or Pg. 520 in First Aid 2013 for diagram

Question 12

What are the sources of progesterone?

Answer 12

(1) Corpus luteum (2) Placenta (3) Adrenal cortex (4) Testes

Question 13

What does elevation of progesterone indicate?

Answer 13

Elevation of progesterone is indicative of ovulation; Think: “Progesterone = pro-gestation”

Question 14

What 9 functions does progesterone serve?

Answer 14

(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

Question 15

What effect does fall in progesterone after delivery cause, and why?

Answer 15

Fall in progesterone after delivery disinhibits prolactin –> lactation

Question 16

What function does progesterone serve with regard to vasculature development?

Answer 16

Stimulation of … spiral artery development

Question 17

What 5 functions does progesterone serve as it relates directly to the uterus?

Answer 17

(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

Question 18

What function does progesterone serve that involves the cervix, and what effect does this have?

Answer 18

Production of thick cervical mucus, which inhibits sperm entry into uterus

Question 19

What effect does progesterone have on body temperature?

Answer 19

Increases body temperature

Question 20

What are examples of gonadotropins? What effect does progesterone have on these?

Answer 20

FSH, LH; Inhibits gonadotropins

Question 21

What effect does progesterone have on estrogen levels and/or activity?

Answer 21

Decreased estrogen receptor expressivity

Question 22

Which characteristics are independently assigned their own Tanner stage?

Answer 22

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)

Question 23

What are the Tanner stages of sexual development?

Answer 23

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

Question 24

What is the typical length of the follicular phase? What is the typical length of the luteal phase?

Answer 24

Follicular phase can vary in length; Luteal phase is usually a constant 14 days

Question 25

In terms of timing, what/when is menstruation?

Answer 25

Ovulation day + 14 days = menstruation

Question 26

When is follicular growth the fastest?

Answer 26

Follicular growth is fastest during 2nd week of proliferative phase

Question 27

What stimulates endometrial proliferation?

Answer 27

Estrogen stimulates endometrial proliferation

Question 28

What maintains the endometrium, and why?

Answer 28

Progesterone maintains endometrium to support implantation

Question 29

What effect does progesterone have on fertility?

Answer 29

Decreased progesterone –> Decreased fertility

Question 30

Define the following terms: (1) Oligomenorrhea (2) Polymenorrhea (3) Metorrhagia (4) Menorrhagia (5) Menometorrhagia.

Answer 30

(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

Question 31

Fill in the blanks [ ] regarding the menstrual cycle: Increased estrogen –> [1 ] –> Ovulation –> [2] (from [3]) –> [4] –> Menstruation (via [5])

Answer 31

(1) LH surge (2) Progesterone (3) Corpus luteum (4) Progesterone levels fall (5) Apoptosis of endometrial cells

Question 32

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.

Answer 32

See p. 568 in First Aid 2014 or Pg. 521 in First Aid 2013 for visual on bottom.

Question 33

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).

Answer 33

See p. 568 in First Aid 2014 or Pg. 521 in First Aid 2013 for visual on top.