Sexual Characteristics Flashcards
Causes of hirsutism
Familial Idiopathic ↑ androgens: Ovary: PCOS Adrenals: Cushing’s, adrenal Ca Drugs: steroids
PCOS features
2O oligo-/amenorrhoea → infertility Obesity Acene, hirsutism
PCOS USS
bilateral polycystic ovaries
PCOS hormones
↑ testosterone, ↓ SHBG, ↑LH:FSH ratio
Management of PCOS
Metformin COCP Clomifene for infertility
What is gynaecomastia
Abnormal amount of breast tissue in men May occur in normal puberty
Causes of gynaecomastia
Cirrhosis Hypogonadism Hyperthyroidism Oestrogen- or HCG-producing tumours: e.g. testicular Drugs: spiro, digoxin, oestrogen
Erectile dysfunction causes
Smoking EtOH DM Endo: hypogonadism, hyperthyroidism, ↑Prl Neuro: MS, autonomic neuropathy, cord lesion Pelvic surgery: bladder, prostate Penile abnormalities: Peyronie’s disease
What is androgen insensitivity syndrome
X-linked recessive condition due to end-organ resistance to testosterone causing genotypically male children (46XY) to have a female phenotype. Complete androgen insensitivity syndrome is the new term for testicular feminisation syndrome
Features of androgen insensitivity syndrome
‘primary amennorhoea’ undescended testes causing groin swellings breast development may occur as a result of conversion of testosterone to oestradiol
Diagnosis of androgen insensitivity syndrome
buccal smear or chromosomal analysis to reveal 46XY genotype
Management of androgen insensitivity syndrome
counselling - raise child as female bilateral orchidectomy (increased risk of testicular cancer due to undescended testes) oestrogen therapy
3 causes of CAH
21-hydroxylase deficiency 11-beta hydroxyls deficiency 17-hydroxylase deficiency
21-hydroxylase deficiency features
virilisation of female genitalia precocious puberty in males 60-70% of patients have a salt-losing crisis at 1-3 wks of age
11-beta hydroxylase deficiency features
virilisation of female genitalia precocious puberty in males hypertension hypokalaemia
Disorders of sex development
