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B > Sex Hormones During Life > Flashcards

Sex Hormones During Life Flashcards

1
Q

Puberty

A

Maturations of the reproductive organs
Production of sex steroids - oestradiol and testosterone
Develop secondary sexual characteristics
Attain capability to reproduce

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2
Q

What is the main measure of puberty in girls

A

Thelarche ( breast development)

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3
Q

What is the main measurement of male puberty

A

Genitalia ( testicular volume in boys)

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4
Q

What is used to measure the puberty in both males and females

A

Pubarche

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5
Q

Gonadarche

A

Activation of gonads by HPG axis

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6
Q

Thelarche

A

Breast development

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7
Q

Menarche

A

Menstrual cycles

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8
Q

Spermaeche

A

Spermatogenesis

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9
Q

Adrenarche

A

Adrenal androgen production

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10
Q

Pubarche

A

Pubic hair

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11
Q

Secondary sexual characteristic in girls

A 
Oestradiol : 
Breast development 
Hair growth ( pubic, axillary) 
Sweat gland composition - skin oiliness / acne
Changes to external genitalia
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12
Q

Secondary sexual characteristic in men

A 
Testosterone 
- deepening of voice 
Hair growth - Pubic, axillary  , facial 
Sweat gland composition - skin oiliness / acne
Changes to external genitalia
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13
Q

Onset of puberty in girls

A

8-13 yrs

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14
Q

Onset of puberty in boys

A

9-14 yrs

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15
Q

Look at the puberty sequence of events slide

A

Puberty sequence of pubertal events diagram

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16
Q

First thing that occurs for puberty to take place

A

Activation of the GnRH axis

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17
Q

Gonadarche

A

In foetus there is a mini puberty so especially in boys what happens is that there is testicular descent, pencils length , Sertoli cell maturation and behavioural effects

Then quiescence of HPG axis

Then increased nocturnal GnRH pulsatility

The normal pulsating GnRH secretion

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18
Q

Who does delayed puberty occur more often in

A

Boys than girls

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19
Q

Who does precocious puberty occur more often in

A

Girls

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20
Q

Sequence of puberty in girls

A

Thelarche
Growth spurt
Pubarche
Menarche

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21
Q

Sequence of events in boys

A

Genitalia
Pubarche
Growth spurt
Spermarche

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22
Q

Primary ammenorrhea

A

When periods start later than 16 years or do not occur

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23
Q

Secondary amenorrhea

A

Common for periods to be irregular/ involuntary for the first 18 months
Periods start and then stop for at least 3-6 months

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24
Q

What is the most commonest physiological cause of secondary amenorrhea in women

A

Pregnancy

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25
Q

Amenorrhea

A

Absence of periods

  • no periods for at least 3-6 months
    Or up to 3 periods per year
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26
Q

Oligomenorrhea - few periods

A

Irregular or infrequent periods which are more than 35 day cycles
4-9 cycles per year

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27
Q

1st stage of follicular phase

A

FSH ( follicular stimulating hormone ) rises which causes 2-3 follicles to grow

28
Q

Second phase of menstrual cycle

A

2-3 follicles start to grow

29
Q

Third phase of menstrual cycle

A

Follicles produce estradiol and inhibin B
Inhibin B causes negative feedback on pituitary gland , estradiol at low levels can cause negative feedback on the HPG axis - these all act to decrease the HPG axis and decrease FSH back down

30
Q

What is the 4 th step of menstrual cycle

A

FSH is reduces by E2 and inhibin B by negative feedback

31
Q

What is the 5th step of the menstrual cycle

A

The FSH window is restricted and the non dominant follicles undergo atresia
However the largest follicle typically needs less FSH to grow as it grows larger and therefore this then develops into the dominant grafian follicle

32
Q

Step 7 of menstrual cycle

A

The levels of oestradiol increase as the dominant graffiti follicle continues to secrete more oestradiol

33
Q

Step 8 of menstrual cycle

A

The oestradiol switches to positive feedback on pituitary gland

34
Q

Step 9 of the menstrual cycle

A

LH surge is induced by high E2 and positive feedback and this causes high LH

35
Q

Step 10 of ovulation

A

Ovulation is caused

36
Q

Literal phase

A

Corpus leuteum produces progesterone and oestradiol acts on endometrium to make it better for pregnancy

37
Q

Endometrium ; uterine cycle

A

1) menstrual phase

2) proliferative phase / oestradiol - endometrium lining regrows which causes the growth of new epithelial cells
Gland proliferation
Increase in stromatolites / arteriolar

3) secretory phase ( progesterone ) - transformation of uterine layer to be receptive for implantation . Increased volume of stromatolites cells > thick spongy lining
Cork screw shaped glands secreting glycogen
Coiling and lengthening of spinal arteries

38
Q

What hormone does the embryo produced and how does this cause on corpus leuteum

A

Secreted B-HCG which acts on LH receptors on corpus Lyceum and maintains the production of progesterone and oestradiol during pregnancy which maintains the endometrium lining

If no embryo is implanted then no beta HCG is produced which means that the corpus luteum dies off and no progesterone and oestradiol is produced

39
Q

When in non pulsation GnRH used ( normal GnRH secretion is pulsatile)

A

If nonpulsatile you get a decrease in GnRH and this decreases LH and FSH which can be used to treat prostate cancer for example as cancer cells need LH and FSH to divide

40
Q

Hypogonadism

A

Decreased oestrogen in woman

Decreased testorone in. Man

41
Q

Possible causes of hypogonadism

A

Problems affecting pituitary gland or the testes or ovaries or the hypothalamus

42
Q

Primary hypogonadism

A

Problem with the testes or the ovaries

You have low E2 or Testosterone but have high LH/FSH

43
Q

Examples of causes of primary hypogonadism in man

A

Infection - e.g. mumps / trauma/ cancer of testes

44
Q

What is the commonest physiological cause of primary hypogonadism in women

A

Menopause.
Low E2 ,
High LH/FSH
Low inhibin

45
Q

Secondary hypogonadism / hypogonadotropjic hypogonadism

A

Low or normal LH/FSH

Low E2/ Testosterone

46
Q

Possible causes of secondary hypogonadism

A

Pituitary tumour / high prolactin- prolactinoma

47
Q

Menopause symptoms

A

Due to lack of estradioj

Skin dryness/hair thinning
Hot flushes / sweating / sleep disturbances
Mood disturbance 
Osteoporosis 
Sexual dysfunction 
Weight gain 
Amenorrhea
Cessation of fertility 
Climacteric
48
Q

Peri menopausal

A

Within 1 year of LmP

49
Q

Post menopausal

A

After 1 he of menopause

50
Q

Treatment of menopause

A

Osteogenesis replacement ( HRt)

Oestrogen stimulates the endometrium but to make sure that the endometrium doesn’t grow too much, you add progesterone which reduces risk of endometrial hyperplasia/ cancer

51
Q

What is ovarian reserve

A

Number of eggs that you can have in the ovaries before you go to menopause

52
Q

Blood test to find ovarian reserve

A

Blood test - measure level of anti mullerian hormone - peaks in early adult life

53
Q

Early menopause is also called

A

Premature ovarian insufficiency

54
Q

Symptoms of PoI

A

Same symptoms as per menopause but still producing a bit of oestrogen , conception may occur

55
Q

Diagnosis of POI

A

High FSH > 25 iU/L on at least 2 occasions 4 weeks apart

56
Q

Causes of POI

A

Autoimmune
Genetic - fragile X syndrome / Turner syndrome
Cancer therapy - radio / chemo therapy in the past

57
Q

Is there an equivalent of menopause in men

A

Late onset hypogonadism

58
Q

SHBG

A

Sex hormone binding globulin which binds to testosterone and makes it not available

59
Q

Albumin

A

Binds to testosterone but weakly and so the testosterone is bioavailable

60
Q

Free testosterone

A

With age there is a decrease in free testosterone and increase in SHBG

61
Q

When and how is testosterone measured

A

In the morning at fasting as glucose can decrease testosterone levels

62
Q

Symptoms of testosterone deficiency

A

Sexual dysfunction
Erectile dysfunction
Hair growth - decreased frequency of having
Low energy levels
Mood disturbance
Body composition - increased fat/reduced muscle mass
Gynaecomastia ( breast enlargement in man)
Spermatogenesis - high levels of intra testicular testosterone needed
Bone health - via conversion to oestrogen

63
Q

5 alpha reductase

A

Converts testosterone to di hydro testosterone ( DHT) and stronger androgen than testosterone and more potent ligand for androgen receptor

64
Q

Aromatase

A

Converts testosterone to Oestrogens

65
Q

What can increase Oestrogens

A 
Age
Obesity 
Insulin 
Gonadotrophins
Alcohol
66
Q

Breast cancer

A

Can use aromatase inhibitor like anstfozole which decreases the testosterone to oestrogen

67
Q

Prostate cancer

A

5 alpha reductase inhibitor

E.g. finasteride

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