Reproductive health - menarche + puberty Flashcards
What is hormonal regulation?
- The reproductive cycle is controlled by hormones released from the hypothalamus, anterior pituitary gland, and ovaries
What hormones are involved in hormonal regulation?
- Hypothalamus produces and secretes gonadotrophin releasing hormone (GnRH) that acts on the gonadotroph cells in the anterior pituitary gland to stimulate their release of follicle-stimulating hormone (FSH) and luteinising hormone (LH).
- FSH and LH enter the blood and act on the ovary where they influence follicle growth and secretion of ovarian sex hormones.
What is the role of the hypothalamus and anterior pituitary?
- FSH as per its name, stimulates ovarian follicle growth.
- A growing follicle accumulates more follicular fluid in its antrum.
- Both FSH and LH stimulate the secretion of oestrogen by the ovarian follicle.
What is the role of LH?
- LH stimulates the theca cells of an ovarian follicle to produce androgens.
- Under the influence of FSH, the androgen are then taken up by the nearby granulosa cells of the follicle and converted into oestrogens
- LH also triggers ovulation mid-cycle. It stimulates the corpus luteum (remaining follicular structure after ovulation) to maintain production of oestrogens, progesterone, relaxin and inhibin.
What is the role of oestrogen?
OESTROGENS: produced by ovarian follicles have several important functions.
* Development and maintenance of female reproductive structures and secondary sex characteristics e.g. adipose (fat) tissue distribution, voice pitch, broad pelvis and female pattern of hair growth
* Building and maintaining bone density for strong bones
* Maintaining lower blood cholesterol
What is the role of progesterone?
PROGESTERONE
* Progesterone (for pregnancy) is mainly secreted by cells of the corpus luteum after ovulation.
* Works synergistically with oestrogen to prepare the endometrium for implantation of a fertilised ovum.
* Progesterone also prepares the mammary glands for milk secretion.
What is the role of relaxin?
RELAXIN
* The corpus luteum produces a small quantity of relaxin which relaxes the myometrium (muscle layer) of the uterus.
* It is believed to support implantation of an embryo.
* Relaxin is produced in much larger quantities during pregnancy by the placenta.
What is the role of inhibin?
INHIBIN
* The granulosa cells in a growing follicle and the corpus luteum both secrete inhibin.
* Vital part pf the negative feedback cycle that allows homeostasis of reproductive hormones.
What is the reproductive timeline for male and females according to TCM?
- According to CM, the reproductive timeline occurs in seven-year cycles for females and eight-year cycles for males.
- Several factors contribute to gynaecological imbalances between yin and yang, qi and blood.
- Overwork, increased financial stress, inappropriate diet, lack of exercise environmental pathogens and emotions all contribute.
What is the 7 year cycle for women?
WOMEN
7 YEARS
* Child > Abundant Kidney essence > Baby teeth fall out
14 YEARS
* Teenager > Tian Gui arrives, conception vessel qi flows, penetrating vessel qi abundant, puberty > menarche occurs
21 YEARS
* Adult > kidney essence at highest level > ideal reproductive phase
28 YEARS
* Kidney essence remain high > ideal reproductive phase
35 YEARS
* Stomach Qi + Blood weakens > reproductivity declines
42 YEARS
* Yang vessel weakens > hair begins to fall out and turn grey
49 YEARS
* CV and PV depleted, Tian Gui exhausted > menopause
56 YEARS
* Older adult
What is the 8 year cycle for men?
MEN
8 YEARS
* Child > abundant kidney essence > baby teeth fall out
16 YEARS
* Teenager > puberty
24 YEARS
* Ideal reproductive phase
32 YEARS
* Ideal reproductive phase
40 YEARS
* Declining fertility
48 YEARS
* Hair falls out and turns grey
56 YEARS
* Fertility declines
64 YEARS
* Older adult
What are the 6 evils?
6 external pathogens
Wind, Cold, Heat, Damp, Dry, Summer Heat
How does wind influence the body?
- Injures the body especially if it is weak.
- Said to be the spearhead of 1000 diseases meaning it can pick up any of the other pathogens (cold, heat, damp, dry, summer heat) and drive it into the body
- Women are vulnerable to pathogenic wind attacks at times of weakness, especially during menstruation or pregnancy. Wind pathogen may also manifest as post-natal seizures or fevers.
How does cold influence the body?
- Cold in a Yin factor and depresses the Yang of the body
- Cold naturally contracts and thus constricts the blood vessels. It can be lodged in many places like the muscles, channels and internal organs.
- Invasion of cold in the Stomach, intestines and uterus might present like sharp stabbing pains in the stomach.
- Cold in the uterus might present with conditions like dysmenorrhoea, painful periods, stabbing pain, scanty menstruation, amenorrhoea, endometriosis and fibroids. Cold pathogen can often lead to infertility.
How does heat influence the body?
- Heat can arise from exposure to extreme heat
- Infectious disease when they cause a fever are a sign of heat as well as inflammations
- Extreme heat may lead to dryness in various forms
- Heat pathogens may injure the penetrating vessel and conception vessel, lead to early menstruation, menstrual headaches, epistaxis, vaginal infections, and post-partum disorders such as mastitis.
