The Female Genito-urinary System

Question 1

Estrogens

Answer 1

• Sexual maturation
• Ovulation - promote growth of follicles
• Develop/maintain female accessory organs
• maintaining skin & blood vessels
• ↓bone resorption
• ↓LDL
• ↑HDL
• ↑cholestrol
• moving fluid into tissue

Question 2

Progesterones

Answer 2

• Maintain pregnancy
• Breast development
• Maturation of endometrium cells
• ↑body temp
• Smooth muscle relaxation

Question 3

How are estrogen and progesterone levels controled in women?

Answer 3

via the Hypothalamic-pituary feedback control.

Hypothalamus

Anterior pituary

LH / FSH

Corpus leutum / Theca interna

Progesterone / Estrogen

Question 4

• ↑ estrogen (↓prgstrn) → GnRH, LH, FSH
• ↑ progesterone & estrgn → GnRH, LH, FSH (from albicans)
• LH → ovulation
• Inhibins → STOP LH, FSH
• FSH: repair end proliferatino of endometrium
• LH: prepare endo for fertilized ovum
• LH: menstruation

Answer 4

• GnRH sitmulates release of FSH/LH
• FSH stimulates:
  
  • Growing follicles
  • Inital development of ovarian follicles
  • Ovaries
  • Further development of ovarian follicles
  • Ovarian secretion of:
    
    • Estrogen
    • Inhibin
• LH stimulates:
  
  • Corpus luteum secretion:
    
    • Progesterone
    • Estrogens
    • Relaxin
    • Inhibin

Question 5

What are the roles of Estrogen?

Answer 5

• Promote development/maintain female:
  
  • reproductive structures
  • feminine 2ndry sex charact.
  • breasts
• ↑Protein
• ↓Blood cholestrol
• Moderate levels inhibit:
  
  • GnRH
  • FSH
  • LH

Question 6

What are the roles of Progesterone?

Answer 6

• Work with estrogen to prepare endometrium for implantation
• Prep. mammary for milk
• Inhibit:
  
  • GnHR
  • LH

Question 7

What are the roles of Relaxin?

Answer 7

• Inhibit contractions of uterine smooth muscle
• ↑ flexibility of pubic symphysis
• dilates uterine cervix

Question 8

What are the roles of Inhibin?

Answer 8

• Inhibits release of
  
  • FSH
  • LH (less extent)

Question 9

The Menetrual Cycle

Answer 9

Hypothalamus → GnRh → Anterior pituary → FSH+LH →

Ovarian follicles begin to mature = Follicular phase

Developing follicule produces estrogen → ↓FSH: Only the strongest follicles survive the drop in FSH

Follicles continue to make estorgen → stimulates LH release from ant.pit → release of egg → ovulation → follicle cells become corpus luteum → progesterone = Luteal phase

Progesterone preps body for preg → if no preg, corpus leutum dies → progesterone drop → GnHR to start new cucle

Question 10

What are some Mestrual disorders?

Answer 10

• Amenorrhea
• Dysmenorrhea
• Premenstrual syndrome
• Menopause & aging

Question 11

What is primary amenorrhea?

Answer 11

When menstruation never starts

Causes:

• congenital defects
• genetic (abno. sex chrom)
• CNS lesion
• trauma
• infection
• tumours
• abnormal/absent FSH/LH

Treatment:

• correction of disorders
• hormone replacement therapy

Question 12

What is secondary amenorrhea?

Answer 12

When menstruation starts but dissapears, never again

Causes:

• Pregancy/lactation
• menopause
• weight loss
• excess exercise
• stress
• oral contraceptives
• H-P gland hormone imbalance → estro/progestro imbalance
• structural abnormality of uterus
• removal of uterus
• anabolic steroids
• thus, no corpus lutemis not formed
  
  • no secretory phase

Symptoms:

• Lack of menstruation
• Infertility
• Vasomotor flushes
• Vaginal atrophy
• Acne
• Hirstituism

Treatment

• hormone replacement therapy
• corrective surgery

Question 13

What is primary dysmenorrhoea

Answer 13

Painfull periods

• ↑endometrial prostaglandin production/release
• ↑ uterine smooth muscle contractions
• Prostaglandins released ~48hrs
• prostaglandins released to circulation

Treatment:

• Prostaglandin inhibitors: ibruprofen
• OCP
• excercise
• heat massage

Question 14

What is secondary dysmenorrhea?

Answer 14

Pain caused by anither disorder

• PID
• Endomitosis
• Endomitosial polyps
• cervical disease

Treatment

• Prostaglandin inhibitors
• OCP
• treatment of underlying disorder

Question 15

What is Menopause or Climacteric

Answer 15

• Decreased ovary function
• ↓estrogen
  
  • osteoporosis
  • athersclerosis
• less inhiibition of pituary
  
  • ↑FSH/LH
  • Hot flashes

Question 16

Vaginal bacterial flora

Answer 16

• Many diff bacteria
• prod lactic acid
• pH 3.8-4.2

normal flora can be disrupted by:

• abnorm estrogen levels
• ↑glycogen avaliability
• antibiotics

Question 17

Cervical Epithelium

Answer 17

• Inside the cervix: columnar epihtelium
• Exposed to acid in vag → squamous epith
• Transforming cells more likely to become cancerous

Question 18

Cancers of the cervix & vagina

Answer 18

Cervical cancer

• related to HPV

Vaginal cancer

• related to prenatal exposure to diethylstilbestro
• cervical cancer
• HP
• chronic local irritation

Question 19

What are some endometrial disorders?

Answer 19

The endometrium is the inner membrane of the uterus

• Endometritis
• PID
• Endometriosis
• Adenometriosis
• Endometrial cancer
• Leiomyas

Question 20

Endometrial cancer

Answer 20

caused by admin of estrogen w/o progesterone

Question 21

Ovarian disorders

Answer 21

• Polycystic ovary syndrome
• Functioning tumours
  
  • Estrogen releasein
  • Androgen releasing

Question 22

Polycystic Ovary Syndrome

Answer 22

• Follicles develop
• do NOT ovulate
• ↑LH continue (not inhibited)
• ↑LH → androgen production
• ↑interfreance with ovulation
• ovaries contain UNOVULATED follicles

Question 23

What are some Benign tumors?

Answer 23

• Eothelial cells: cystadenomas
• Endometrioas “chocolate cysts”
• Fibromas
• Teratomas/dermoid cysts: dvlp from germ cells

Question 24

What are some Functioning ovarion tumours?

Answer 24

• Functioning tumours screte hormones
• Estrogen: alter menstrual cylce
• Androgens: masculine characteristics

Question 25

Ovarian cancer

Answer 25

• associated with family history of breas&ovarian cancers
• ~GI symptoms
• ~75% metastasized when discovered
• no good screening avaliable