Repro Session 3 Flashcards
Disadvantages of HRT in post-menopausal women?
The use of estrogen therapy, without progesterone is associated with an increase in risk of uterine cancer (endometrial cancer, cancer of the lining of the uterus).
Treatment with progesterone along with estrogen substantially reduces the risk of uterine cancer (endometrial cancer) so that the risk of developing this cancer is equivalent to that of women not taking estrogen.
Users of oral hormone therapy (HT) (in the doses of the Women’s Health Initiative) for more than five years are at slightly increased risk of breast cancer risk, heart disease-MIs, and stroke than are nonusers.
Increased risk of DVT and PE- oestrogens increase clotting factors
abnornal vaginal bleeding
minor SEs- headaches, nausea, breast pain
why is oestrogen given along with progesterone in those PM women on HRT who haven’t had a hysterectomy?
Uterus still present, and oestrogen given alone increases risk of endometrial cancer
what happens to hormones during the menopause?
loss of follicular units decreases oestrogens and progesterone, which normally act by -ve feedback to inhibit the release of GnRH, FSH and LH, hence the decline causes an increase in gonadotropins, especially FSH (no inhibition by inhibin) over a period of yrs.
early changes in women during the menopause?
areas of skin hyperpigmentation (melasma), hot flashes., night sweats, reduced vaginal secretions and urogenital atrophy- particularly of vaginal epithelium and ovaries
later changes in women during menopause?
net decrease in bone mineral density and increase in cholesterol, increasing risk of OP and bone fractures
1st investigation for secondary amenorrhoea?
pregnancy (hCG test)
result of disruption to hypothalamic-pituitary-portal system?
high circulating levels of prolactin, low FSH and LH and ovarian atrophy
what is the fixed sequence of events occurring in girls at puberty, between 8 and 13 yrs of age?
breast bud (thelarche)
pubic hair growth (adrenarche)
growth spurt
onset of menstrual cycles (menarche)
stages of breast development in the female?
1: prepubertal, only papilla elevated
2: breast bud, breast and papilla elevated, areola diameter enlarged
3: juvenile contour, further enlargement of breast and areola
4: areola and papilla project above breast
5: mature stage, projection only of papilla
fixed sequence of events occurring in boys at puberty, between 9 and 14yrs?
genital development begins
pubic hair growth
spermatogenesis begins
growth spurt
stages of genital development in boys?
1: preadolescent, everything same size and proportion as in early childhood
2: scrotum and testes enlarged, growth in length of penis, texture of scrotal skin changed
3: penis grown primarily in length, and circumference
4: penis further enlarged, glans penis develops, darkening of scrotal skin
5: genitalia adult size and shape
stages of pubic hair development in male and female?
1: no pubic hair
2: sparse, pigmented, long, straight, mainly along labia and base of penis
3: dark, coarser, curlier
4: filling out towards adult distribution
5: adult in quantity and type, spreading to medial thighs in male
why are men generally taller than women?
growth spurt in boys is longer and slightly faster than in girls, and boys enter puberty later so have a longer period of pre-pubertal growth
how is growth spurt ended in both sexes?
fusion of epiphyses
what controls pubic and axillary hair growth in the female?
androgens released from adrenals- zona reticularis
what hormone is breast development during puberty dependent on?
oestrogens
why can some breast devlopment occur in males during puberty?
testosterone produced by leydig cells of testes can be converted to oestrogen in the tissues, and oestrogen stimulates breast development
problem for young girls with abnormally high oestrogen levels?
early puberty, with oestrogen closing the epiphyses earlier than normal, so girl may be very small as no further growth in length of bones can occur once epiphyses fused
what does the growth spurt depend on?
GH and steroids in both sexes
oestrogen closes epiphyses earlier in girls
what is the most important factor in the timing of puberty?
body weight
critical weight in girls for menarche?
47kg
how can body size be signalled to the hypothalamus?
via leptins- concentration related to amount of fat we have in body
* involved in appetite control- stimulate inhibitory neurone, and inhibit excitatory neurone to suppress appetite
rising leptin levels inhibit NPY, which then releases GnRH from its prepubertal inhibition
how is the body weight necessary for puberty to begin affected by how big we are gentically programmed to be?
those programmed to be smaller will have a lower body weight needed to be reached for puberty to begin
what structure in the middle of the brain detects the amount of light in our environement?
pineal gland
which hormone secretion is affected by the amount of light we are exposed to?
melatonin- secreted by pineal gland in dark
why might having more artificial light nowadays contribute to puberty occurring at an earlier age?
effect on secretion of melatonin from the pineal gland, which influences the hypothalamus and hence puberty onset
what name is given to puberty that occurs too early?
precocious: signs of puberty before age of 8
how can pineal tumours cause precocious puberty?
affect secretion of melatonin, giving impression that there is more light than there actually is