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Bio regulatory systems 2 > Sex hormones > Flashcards

Sex hormones Flashcards

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1
Q

What is the definition of puberty?

A

Maturation of the reproductive organs Production of sex steroids Develop secondary sexual characteristics Attain capability to reproduce

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2
Q

What is Tanner staging?

A

the overall name for the stages of puberty

-Stages go from 1-5 where 1 is pre pubertal and 5 is adult

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3
Q

What is the indication of tanner staging in boys and girls

A

Girls: -Telarche(breast development

Boys: Genitilia(testicular volume) Both: Pubarche(pubic hair development)

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4
Q

How can you measure testicular volume?

A

Orcidometer

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5
Q

Use tanner staging to describe Breast development?

A

1-Elevation of PAPILLA

2-Breast bud with elevation of the breast and the papilla and enlargekment of the areolas

3-Further enlargement of breast and papilla with no seperation of their contours

4-Projection of the areola and the papilla to form a secondary mound

5-Mature breast projection of the papilla only as the areola conforms to the breast contour

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6
Q

Use tanner staging to describe Genetilia development in boys?

A

1-Testes and penis and scrotum same size

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7
Q

What does the suffix ‘-arches’ mean?

A

Onset of

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8
Q

What so these terms mean?

  • Gonadarche
  • Thelarche
  • Menarche
  • Spermarche
  • Adrenarche
  • Pubarche
A

Onset of :

Gonadarche-Activation of the Gonads by HPG Axis

Thelarche-Breast Development

Menarche-Menstrual Cycles

Spermarche-Spermatogenesis

Adrenarche-Adrenal Androgen Production(starts 2 years before Gonardarche and controibutes to pubic hair)

Pubarche-Pubic Hair

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9
Q

What are the secondary sexual characteristics in girls?

A

Oestradiol causes:

  • Breast Development
  • Hair Growth-pubic, axillary
  • Sweat Gland Composition
  • skin oiliness/acne
  • Changes to external genetilia
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10
Q

Waht are the secondary sexual characteristics in boys?

A

Caused by testosterone:

  • Deepening of the voice
  • Hair growth-pubic then axillay, facila Sweat Gland Composition
  • skin oiliness/acne
  • Changes to the exteral genetilia
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11
Q

What is the age of the onset of puberty in girls and boys?

A

Girls:8-13

Boys:9-14

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12
Q

What are the stages of puberty in girls in order?

A

1-Breast bud(2):10.5 years old

2-Onset Pubic Hair(2):age 11

3-Peak height velocity(growth spurt)

4-Menarche:age 12.8

5-Adult breast(5): age 14,6

6-Adult pubic Hair(5): Age 13.7 numbers in bracket indicate the stage of the tanner line at which this occurs

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13
Q

What are the stages of puberty in boys in order?

A

1-Testicular volume >2ml(2): age 11.4

2-Onset Pubic Hair(2): age 12

3-Onset Penis Growth: 12.2

4-Peak height velocity:14.2

5-Adult Genitals(5):age 14.9

6-Adult pubic hair(5):age 15.2

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14
Q

When does Adrenarche occur in boys and girls?

A

Girls:6-9

Boys:7-10

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15
Q

What is DHEA?

A

An andrenal androgen released during Adrenarche and contributing to pubarche

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16
Q

As you go through the Genetilia Tanner stages what increase?

A

-FSH and LH levels -Testosterone increases in guys -Oestrodial increases in girls

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17
Q

Describe the HPG axis in females and draw?

A

Hypothalamic Pituitary Gonadal axis: 1-Hypothalamus makes Pulsitile GnRH(Gonadotroph releasing hormone) 2-GnRH stimulates the anterior pituitary gland in particular the GONADOTROPH CELLS which make LH and FSH (gonadotrophins ) -LH and FSH 3-FSH stimulates the GRANULOSA cells in the ovaries which produce inhibin which NEGATIVELY FEEDBACKS onto the anterior pituitary gland telling it to stop making FSH and LH, oestorgen is also made 4- LH stimulates the THECA cells in the ovaries causing Progesterone and Oestorgen to be made which can negatively and positively feeback onto the anterior pituitary and hypothalamus

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18
Q

Describe the HPG axis in males and draw?

A

1-Hpothalamus secretes GnRH onto he anterior pituitary gland 2-This then secretes LH and FSH 3-FSH acts on the SERTOLI CELLS in the testes causing them to secrete INHIBIN 4-Inhibin NEGATIVELY feedbacks onton the anterior pituitary gland to stop FSH and LH production 5-LH acts on the LEYDIG cells in the testes causing the secretion of TESTOSTERONE which NEGATIVELY feedbacks onto the anterior pituitary and the Hypothalamus

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19
Q

What is the mini puberty?

A

When you are feotus GnRH secretion rises and when you are an infant causing the HPG axis to be active GnRH decreases rapidly in childhood but then increases again in puberty and maintained in adulthood

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20
Q

Why do we have a mini puberty?

A

Needed for maturation of the organs early on

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21
Q

What happens if you don’t go through a mini puberty

A

They have KALLMANN syndrome -where they lack GnRH This leads to: -undescended testes -Micropenis

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22
Q

What is classed as delayed puberty?

A

Dont hit puberty till 14(in boys) and 13(in girls)-more common in boys then girls

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23
Q

What is Precocious puberty?

A

When puberty starts early (before 8 in girls and 9 in boys) More common in girls

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24
Q

When does Menarche occur?

A

2.3 years after Thelarche/soon after Peak height velocity is achieved

Average age =12.7 years (range 10.7-16.1 years)

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25
Q

What is the name for if menarche happens after 16 years?

A

Primary Amenorrhoea

26
Q

What is secondary amenorrhoea?

A

Periods start but then stop for at least 3-6 months (common for periods to be irregular for the first 18 months)

27
Q

What is Oligomenorrheoa?

A

irregular or infrequent periods-so cylces are more than 35 days long resulting in 4-9 cycles a year

28
Q

Describe the Follicular phase of the menstrual cycle?

A

1- FSH rises stimulating 2-3 follicles to start grow

2- The follicles start to produce OESTODIAL(E2) and INHIBIN B

3-both of which have a negative feedback effect on the hypothalamus and pituitary gland to reduce FSH

4-FSH levels decrease

5- Lack of FSH causes lots of the smaller follicles die of (atresia) but the larger follicles are less FSH dependent so survive and continue to grow this negative feedback which causes the decrease in FSH restricts the FSH WINDOW(period where FSH increases)

6- Larger dominant GRAAFIAN follicles continue to grow and produce OESTRODIOL

7- At low levels oestrodial has a negative feedback effect but as levels of it rises it switches to have a POSITIVE feeback effect

8- so increases LH and FSH instead of decreasing it and this induces the LH surge which hapopens at day 14

9-LH surge causes OVULATION(release of the egg from the follicle)

29
Q

What happens after ovulation phase of menstrual cycle?

A

1-egg released from the follicle can then go down the fallopian tube and potentially be fertilised to form a zygote 2-The remenants of the follicle forms the Corpus Luteum 3-Corpus Luteum secretes Progesterone and Oestrodial(important for the development of the endometrium) Steos 2 and 3 are part of the LUTEAL phase

30
Q

How can we test if ovulation has occurred?

A

Test progesterone levels at day 21 of the menstrual cycle and if this is HIGH it suggests ovulation has occured If no it suggests infertility

31
Q

What are the phases of the menstrual cycle in terms of the endometrium?

A

MENSTRUAL phase: Day 1-5 -This is the phase of menstrual bleeding

PROLIFERATIVE PHASE: DAY 5-14 - Oestodiol increases leading to proliferation and thickening of the endometrium

SECRETORY PHASE:14-28 - the endometrium is full of blood vessels and its starts to secrete and become receptive to the embryo

32
Q

What happens if the embryo attaches to the endometrium during the Luteal phase?

A

Embryo starts making Beta-hCG Can activate LH receptors on the Corpus Luteum- this is good because the Corpus Luteum needs LH stimulation to survive and if pregnancy takes place the hCG does this In turn this means there will be continuous production of progesterone (as the corpus luteum produces progesterone) and this supports the pregnancy

33
Q

What happens if a pregnancy doesn’t happen?

A

There isnt hCG = corpus ;uteum dies=progesterone levels fall= start of the next menstrual cycle

34
Q

What would happen if GnRH was secreted in a non pulsitile manner?

A

Instead of stimulating the pituitary gland it would inhibit it= decreased LH and FSH =decreased Testosterone and Oestrogen Used to treat prostate cancer where we want to reduce testosterone and Oestrogen

35
Q

Describe GnRH pulsitility during the menstrual cycle?

A

Follicular phase- ever 90-120 minutes have and pulse of GnRH secretion Luteal phase-slowing of GnRH pulsing (every 180-240 mins) due to increase in Progesterone which inhibits the HPG Axis

36
Q

What is Hypogonadism?

A

Reduced function of the gonads(testes/ovaries) -This results in low Oestrogen in a woman and Low testosterone in a man

37
Q

What can cause Hypogonadism?

A

something directly damaging the gonads e.g infection, menopause

-Something effecting the hyptothalamus or pituitary gland= reduced GnRH/LH/FSH = low oestorgen/testosterone

38
Q

What is primary Hypogonadism?

A

problem with the gland that secretes the hormone in question-so in this case problem with either the ovaries or testes -

less oestrogen and testosteron= REDUCED negative feedback on the Hypothalamus and Pituitary =INCREASED LH and FSH

39
Q

What is an indicator of Primary Hypogonadism?

A

High LH/FSH

Low E2/TESTOSERONE

40
Q

What is secondary Hypogonadism?

A

Something effecting the pituitary or Hypothalamus e.g Pituitary tumour, High prolactin

41
Q

What is an indication of Secondary Hypogonadism?

A

LH or FSH has decreased or not increased in the presence of low E2/ testosterone as this should have a negative feedback response to increase the LH and FSH indicating problem with pituitary or hypothalamus

42
Q

What is an indication of menopause?

A

Menopause causes Primary Hypogonadism =decresed E2=negative feedback on pituitary and hypothalamus =HIGH LH/FSH (in an attempt to increase E2 levels

43
Q

What are the symptoms of menopause?

A
  • skin dryness
  • Hair thinning
  • Hot flushes
  • sweating
  • sleep disturbance Mood disturbance
  • OSTEOPOROSIS as decreased oestrodial = less stimulation of Osteoblasts (make bone)= decreased bone mineral density
  • Sexual Dysfunction
  • Vaginal dryness, decreased libido
  • Weight Gain
  • Amenorrheoa- infertility Climacteric
  • irregular periods leading up to menopause
44
Q

How can you treat menopause? What are the potential risks and how can we prevent them?

A

Most symptoms due to oestrogen deficiency so can give Oestrogen replacement -Hormone replacement therapy(HRT)

This can stimulate THICKENING of the endometrium which could lead to cancer ADD PROGESTERONE this prevents the thickening and reduced risk of ENDOMETRIAL HYPERPLASIA/CANCER

45
Q

What is the Ovarian reserve?

A

The idea that you start with all your eggs and these gradually run out as you reach menopause

46
Q

How can we assess the ovarian reserve?

A

Using markers such as AMH which secreted for the SERTOLI cells in the ovaries as it peaks in early adult life and become very low towards menopause

47
Q

What is the average age for menopause?

A

Average -51

Range: 45-55

48
Q

What is premature Ovarian Insufficiency?

A

Menopause before the age of 40

49
Q

What is the chance of pregancy if you have Premature Ovarinan insufficiency ?

A

20%

50
Q

How do you diagnose Premature Ovarian Insufficiency?

A

High FSH (do at least 2 times with a month apart)

51
Q

What are the causes of Premature Ovarian Insufficiency?

A
  • Autoimmune conditions
  • Genetic Syndromes
  • Fragile X/Turners Syndrome
  • Cancer therapy
  • can damage ovaries
52
Q

What is late onset Hypogonadism?

A

When the decrease in free testosterone levels as age increases leads to symptoms

53
Q

What is free testosterone?

A

60% of testosterone is strongly binded to SHBG and therefore is inactive as it cant be released into the tissues

38% is bound to ALBUMIN less strongly so has potential to be released(BIOAVAILABLE) into tissue to have effect

2% free testosterone and therefore active

54
Q

What causes late onset Hypogonadism?

A

lncreased age=increased SHBG=decreased free testosterone= leads to the symptoms of late onset hypogonadism

(overall the testosterone levels stay the same)

55
Q

When are testosterone levels measured?

A

Higher in the morning so measured before 11

Measured fasting- as glucose can cause a decrease in testosterone levels

56
Q

What are the symptoms of testosterone deficiency?

A

Sexual dysfunction-Reduced Libido, erectile dysfunction(loss of early morning erections)

Less hair growth-You can ask patient about the frequency of shaving

Mood disturbance

Energy Levels-Fatigue Body composition-Increase in fat / reduced muscle mass/Gynaecomastia(breast enlargement in man)

Spermatogenesis reduced-High levels of intratesticular testosterone needed

Bone health decrease- as low testosterone=low oestrodiol

57
Q

What is the difference between Testosterone and di-hydro-testosterone ?

A

5 alpha reductase (in testes, prostate, liver, scalp) converts testosterone into Di-hydro testosterone(DHT) -DHT is much stronger than normal testosterone=important for prostate growth and male baldness

58
Q

What does aromatase do?

A

converts testosterone to oestrogen

In adiposes tissues, adrenal glands, ovaries(granulosa cells), Testes(sertoli cells), brain, bone, skin

59
Q

What things can stimulate aromatase?

A
  • weight gain
  • obesity
  • insulin
  • gonadotrophs
  • alcohol
60
Q

How can weight loss treat low testosterone?

A

decrease weight=decreased stimulation of aromatose=less conversion of testosterone to oestrogen

61
Q

How can we help treat/prevent breast cancer?

A

Give AROMATASE INHIBITOR =decrease Oestrodiol levels

62
Q

How can we treat prostate cancer?

A

Reduce DHT levels by giving a 5-alpha reductase inhibitor to prevent the conversion of testosterone to DHT

Bio regulatory systems 2 (15 decks)

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