reproductive online modules Flashcards
what 5 things should you ask about in a gynae history?
menstrual cycle cervical smear sexual history any treatment/surgery obstetric history
oligomenorrhoea and hyperandrogenism are key features of what?
polycystic ovaries
differential for infertility?
polycystic ovaries pelvic inflammatory disease premature ovarian failure hyperprolactaemia pregancy
most common cause of female infertility?
polycystic ovaries
to be diagnosed with PCOS you must have 2 out of what 3 things?
oligomenorrhoea/amenorrhoea
hyperandrogenism (acne, hairy )
polycystic ovaries on ultrasound
what is menarche
when you start your period
what triggers menarche?
GnRH which is released by hypothalamus
what does an ovarian follicle consist of?
an oocyte surrounded by granulosa cells and theca cells
what do theca cells produce?
androgens (which are then converted to oestrogens by granulosa cells via acromatase enzyme)
when is ovulation day?
12-14
what does LH cause theca cells to do?
produce androgens
what does FSH cause granulosa cells to do?
covert androgens to oestrogens
what does too much oestrogen inhibit?
FSH
what triggers ovulation
surge in LH
2 phases of menstrual cycle?
follicular phase
luteal phase
what does the remaining follicle turn into in the luteal phase?
corpus luteum
what hormone does the corpus luteum release?
progesterone
what happens to endometrium in the luteal phase?
thickness increases
what does high levels of progesterone do?
inhibit FSH and LH
if no fertilisation what happens to corpus luteum?
degenerate which eventually leads to bleeding (period time!)
why does increase in androgens make you hairy?
because increase in androgens =increase testosterone which gives you more hair (esp on your face)
most appropriate investigation for PCOS?
transvaginal ultrasounnd
is PCOS usually unilateral or bilateral?
bilateral
how can you manage hyperandrogenism?
contraceptive pill alone or in combination with an anit androgen