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Endocrinology > Sex hormones > Flashcards

Sex hormones Flashcards

1
Q

Tanner staging for girls?

A

Breast development = Thelarche

Pubic hair development staging

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2
Q

What do the following mean?

  • Gonadarche
  • Thelarche
  • Menarche
  • Spermarche
  • Adrenarche
  • Pubarche
A
  • Activation of gonads by HPG axis
  • Breast development
  • Menstrual cycles
  • Spermarche
  • Adrenarche
  • Adrenal Androgen Production
  • Pubic hair
  • in girls if you lack adrenarche it can affect pubarche
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3
Q

Secondary sexual characteristcs due to Oestradoil?

A 
-Breast Development
Hair Growth - 
      Pubic, Axillary
-Sweat Gland Composition -
      Skin oiliness / Acne
-Changes to external genitalia
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4
Q

Secondary male sexual characteristics

A 
Deepening of Voice
Hair Growth - 
      Pubic then Axillary, facial
Sweat Gland Composition -
      Skin oiliness / Acne
Changes to external genitalia
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5
Q

What is the sequence of events of puberty in girls?

A

Thelarche

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6
Q

How does the hormonal Axis change through early life?

A

Neonatal - GnRH is secreted ( mini-puberty )

Low during childhood

Increases through puberty ( pulsatility increases nocturnally )

During adult life normal pulsatile GnRH secretion

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7
Q

What is precocious or delayed puberty?

A

Early puberty before 8 ( common in girls )

After 14 ( common in boys )

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8
Q

What is precocious or delayed puberty?

A

Early puberty before 8 ( common in girls )

After 14 ( common in boys )

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9
Q

What are the characteristics of Menarche during puberty?

A

2.3 years after thelarche

Soon after peak height velocity (PHV)

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10
Q

What is Primary Amenorrhoea?

A

Not starting periods

Later than 16 years is abnormal

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11
Q

What is secondary Amenorrhoea?

A

no periods for 3-6 months or up to 3 a year

Periods can be irregular

Periods can start but then stop

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12
Q

Oligo-menorrhoea?

A

Few periods

Irregular or infrequent
4-9 cycles a year

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13
Q

1 - Follicular phase of menstrual cycle?

A

FSH increases ( FSH window )

2-3 follicles start to grow ( dominant Graafian follicle with grow )

Estradiol E2 and inhibin B are produced

So FSH then decreases

  • Smaller follicles which did not grow = death of the follicles and undergo atresia
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14
Q

What happens as Dominant Graafian follicle grows

A

Causes an increase of Oestradiol by positive feedback of high E2

This induces LH increase on day 14 = Ovulation

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15
Q

What does ovulation cause?

A

… corpus leteum?

Starts Luteal phase of progesterone increase for implantation and Oestradiol increase

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16
Q

What can we measure as evidence of ovulation taking place?

A

Midluteal D21 Progesterone

17
Q

How to describe the cycle as Endometrium Uterine cycle?

A

Menstrual phase

Proliferative phase ( Oestradiol ) : Endometrial Lining regrows:
Growth of new epithelial cells Gland proliferation
Increase in stroma / arterioles

Secretory phase ( progesterone ): Transformation to be Receptive for Implantation:
Increased volume of stromal cells&raquo_space;> thick spongy lining
Cork-screw shaped glands secreting glycogen
Coiling and lengthening of spiral arteries

18
Q

What does Beta HCG do?

A

Once embryo implanted, released HCG

Receptors in corpus luteum, which then keeps releasing progesterone

19
Q

What is the issue with continous non-pulsatile GnRH?

A

Decreased LH and FSH secretion

Pulsatility is relvent to menstrual cycle?

20
Q

What is Hypogonadism?

A

Decreased Oestrogen in a Woman /

Decreased Testosterone in a Man

21
Q

Characteristics of primary hypogonadism?

A

Problem with testes or ovaries

Reduced negative feedback

Causes in men : infection in testes, trauma, cancers

causes in women : menopause

22
Q

Characteristics of secondary hypogonadism?

A

Pituitary tumour
Prolactinoma

  • if LH/FSH was low and GnRH high it is also secondary
23
Q

What is menopause?

Symptoms?

A

Lack of negative feedback = rise of LH/FSH
Low E2
Low Inhibin

Symptoms linked to lack of E2

-Skin Dryness / Hair Thinning
-Hot Flushes / Sweating / Sleep Disturbance
-Mood Disturbance
-Osteoporosis - Decr Bone Mineral Density (BMD)
(E2 stimulates osteoblasts)
-Sexual Dysfunction - Vaginal Dryness, Decreased Libido
-Weight gain
-Amenorrhoea – Peri- within 1yr of LMP, Post- after 1yr
Cessation of fertility
-Climacteric - Irregular periods in years close to Menopause

24
Q

Menopause treatment?

A

-Oestrogen Replacement
HRT (Hormone Replacement Therapy)

-Oestrogen stimulates the endometrium
Add Progesterone - if Endometrium is intact to prevent risk of Endometrial Hyperplasia / Cancer

25
Q

What is the Ovarian reserve?

What to test to predict?

A

Number of eggs in ovaries

Anti-Mullerian Hormone - Peaks in Early Adult life
Made in granulosa cells

26
Q

What is Premature Ovarian Insufficiency (POI)

A

Same Symptoms as per Menopause
Previously called ‘Premature Ovarian Failure’ POF
Conception can happen in 20%.
Diagnosis High FSH >25 iU/L (x2 at least 4wks apart)

Causes
Autoimmune
Genetic eg Fragile X Syndrome / Turner’s Syndrome
Cancer therapy Radio- / Chemo-therapy in the past

27
Q

Andropause?

late hypogonad…

A

Total Testosterone does not change but SHBG increases with age and so free testosterone is reduced

28
Q

What is Free testosterone?

A

2% is free and active which manifests

38% Binds to Albumin - bioavailable

60% SHBG bound testosterone making it unavailable

29
Q

What rhythm does testosterone have?

A

Diurnal Rhythm

Higher in morning so measure before 11am

Lowers with sugar

30
Q

Symptoms of testoesterone deficiency?

A

Sexual Dysfunction - Reduced Libido (sexual desire)
Erectile Dysfunction&raquo_space; loss of Early Morning erections
Hair Growth - Frequency of Shaving?
Energy levels - General Well-being, Fatigue.
Mood Disturbance
Body Composition - Increased Fat / reduced Muscle Mass Gynaecomastia (breast enlargement in man)
Spermatogenesis - High levels of Intratesticular testosterone needed
Bone health - (Via conversion to oestrogen)

31
Q

What does 5 alpha reductase do?

A

Converts testosterone to Di-Hydro Testosterone as a really strong androgen. Binds to receptors and can cause baldness

Can use a inhibitor for enzyme e.g. Finasteride to tackle prostate cancer

32
Q

What does Aromatase do?

A

Convertes Testosterone to Oestrogens

Age, Obesity, Gonadotrphins, Alcohol increases Aromatase. So can reverse actions, can give Aromatase inhibitor e.g. breast cancer

Endocrinology (22 decks)

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