WH Intro Flashcards
What components are necessary to cause differentiation of female sex system?
- genetics: 46XX
- proteins
- hormones
- ovaries
What is Turner Syndrome?
- 45 XO
- streak ovaries w/ few ovarian follicles
- gonadal dysgenesis
- no gonadal sex hormone production
What are some physical characteristics seen in Turner Syndrome?
- short stature
- webbed neck
- poor breast development
- wide carrying of the arms
- renal anomalies and liver dysfunction
- ocular and auditory deficiencies
Treatment of Turner Syndrome
- growth hormone
- estrogen
- progestins
What conditions might be caused by excess androgens?
- hirsutism
- virilization (masculinization of reproductive structures)
- polycystic ovary syndrome (PCOS)
- hormone secreting turmors
- adrenal: Cushings, congenital adrenal hyperplasia
What happens with an imperforate hymen?
- pt will menstruate but blood has nowhere to go
- present with pain and bloating
- easily fixed
What happens with transverse vaginal septum?
- no opening between upper and lower vagina
- amenorrhea, pelvic pain
What happens with agenesis of the lower vagina?
- no fusion of the upper with lower vagina
- must be reconstructed surgically
What happens with a bicornate uterus?
- poor fusion of Mullerian ducts = divided uterus
- would be difficult to maintain a pregnancy b/c of space restrictions (will cause an abortion)
When the hypothalamic-pituitary-ovarian axis gets activated at puberty, what happens physiologically?
- GnRH is released
- produce sex steroids from ovary
- secondary sexual maturation (breasts, female pattern hair growth)
- ovulation/menstruation
Hypothalamic-Pituitary-Ovarian Axis: What is released from each part?
- hypothalamus: gonadotropin releasing hormone
- pituitary: gonadotropins (LH and FSH)
- ovaries: sex steroid hormones (estrogen, progesterone)
During the reproductive cycle, when is estrogen at its highest level? When is progesterone at its highest level?
- estrogen peaks right before ovulation then drops dramatically when egg released
- progesterone peaks in days to week after egg is released (luteal phase)
What happens during the follicular phase of the reproductive cycle?
- onset of menses to the day of the LH surge
- 14 days
- FSH increases: follicular growth of oocytes
- estradiol: maintains endometrium
What happens during ovulation?
- estradiol feedback causes LH surge, which triggers ovulation
- oocyte released from ovary
- follicle becomes corpus luteum
What happens during the luteal phase of the reproductive cycle?
- predominance of progesterone
- suppress LH and FSH
- w/ fertilization: implanted zygote
- no fertilization: corpus luteum involutes and withdrawal of progesterone results in FSH release and start of new cycle
What happens during menstruation and what triggers the start of menstruation in the reproductive cycle?
- first days of follicular phase
- blood and desquamated superficial endometrial tissue
- prostaglandins cause uterine contractions and cramping
- menstruation caused by involution of corpus luteum and decrease in progesterone
What stimulates oogenesis?
-increase FSH stimulates oogenesis
Describe the changes of the endometrium throughout the reproductive cycle.
- follicular phase: endometrial cell growth
- ovulation: endometrium at maximum thickness
- luteal phase: endometrium converted to loose edematous tissue
- menstruation: endometrium sloughs off
Amenorrhea
absence of menstruation
Primary Amenorrhea
- no menstruation by age 13 with absence of secondary sex characteristics
- by age 15 w/ secondary sex development
Secondary Amenorrhea
-absence of menstruation for 3-6 months in a menstruating female
Possible Causes of Secondary Amenorrhea
- pregnancy
- HPO axis: poor nutrition, neoplasm, psychogenic, substance use
- ovarian: PCOS, ovarian failure, chromosome abnormality
- genital outflow obstruction
Metrorrhagia
-irregular menstrual bleeding, usually between cycles
Menorrhagia
-excessive menstrual bleeding at regular intervals
Menometrorrhagia
-frequent and excessive menstrual bleeding
Polymenorrhea
-frequent menstrual bleeding, usually regular
Possible Causes of Abnormal Uterine Bleeding
- pregnancy or pg complications
- GU: infx, fibroids, polyps, neoplasms
- HPO axis: abnormalities, medications, systemic dz
- dysfunctional uterine bleeding
Anovulation
- failure to ovulate
- cam cause abnormal uterine bleeding, oligomenorrhea, amenorrhea
