Reproduction Flashcards
Where is glandular oestrogen synthesised?
Granulosa and theca cells of the ovaries
And the corpus luteum
What are granulosa cells stimulated by?
LH to produce pregnenolone
What is oligomenorrhea?
Reduction in frequency of periods to less than 9 per year
What is primary amenorrhea?
Failure of menarche by age 16
What is secondary amenorrhea?
Cessation of periods for >6 months
What congenital problems can cause amenorrhea?
Turner’s syndrome
Kallman’s syndrome
What should you measure in amenorrhea?
LH, FSH, Oestradiol
Thyroid function, prolactin
What defines female hypogonadism?
low levels of oestrogen
What can cause primary hypogonadism?
Ovary problems
High FH/FSH - Hyper H
e.g. premature ovarian failure
What can cause secondary hypogonadism?
Hypothalamus or pituitary problems
Low FH/FSH - hypo H
e.g. high PRL, hypopituitarism
What characterises hypogonadism?
Low oestradiol with low/normal LH/FSH
What rarer things can cause secondary hypogonadism?
Prader-willi
Haemachromatosis
What is idiopathic HH?
Delayed/absent sexual development with low gonadotrophin + sex hormones without anatomical/functional abnormalities of hypothalamic-pituitary gonadal axis
What is Kallman’s syndrome
Absence of olfactory bulbs
Genetic
What is Pituitary dysfunction?
Loss of FH/FSH stimulation due to non-functioning pituitary macroadenoma
Hyperprolactinemia
What can cause hyperprolactinanemia?
Prolactinomas Drugs e.g. anti-psychotics hypothyroidism Idiopathic Macroprolactin
What can high gonadotrophins be a sign of?
Ovarian failure
What is hirsutism?
Excess hair
What can cause hirsutism?
Androgen excess at the hair follicle by an adrenal or ovarian tumour, idiopathic, PCOS or familial
What is Congenital Adrenal Hyperplasia (CAH)
Inherited deficiency of the enzymes needed for cortisol synthesis
What are signs of an Androgen-secreting tumour?
Rapid onset of symptoms
Assoc. with virilisation
High testosterone (>5nmol/l)
MRI adrenal and ovaries will have tumour over 1cm
What is Turner’s syndrome?
Absence of an X chromosome
What are 4 main features of Turner’s?
Short stature
Webbed neck
Shield chest with widespread nipples
Cabitus valgus
What is a sign of Turner’s?
failure to progress through puberty
Infertility
Primary/secondary amenorrhea
