Week 3.0 - Puberty and menopause Flashcards Preview

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Flashcards in Week 3.0 - Puberty and menopause Deck (53):
1

Define Puberache

-Development of axillary and pubic hair

2

Define menarche

-First menstrual period

3

Define adrenache

-onset of increased androgen secretion

4

What is puberty?

-Stage of human development when sexual maturation and growth are completed and results in the ability to reproduce

5

Who begins puberty first girls or boys?

-Girls

6

Define thelarche

-Development of breast

7

Describe the main features of puberty

-Accelerated somatic growth
-maturation of gonads and genitals
-Development of secondary sexual characteristics
-Menstruation and spermatogenesis begins (reproductive system inactive before this)

8

With what hormonal changes is the onset of puberty associated with?

-Gradual activation of GnRH causing steady rise in FSH and LH
-Increased secretion of oestrogens and androgens
-Extragonadal hormonal changes -> elevation of adrenal steroids and IGF-1

9

Which hormones is the growth spurt dependent upon?

-Growth Hormone
-Sex steroid hormones

10

What is the difference between the growth spurt in girls and boys?

-Earlier and shorter in girls
(men are larger because growth spurt longer and slightly faster)

11

What signifies the end of the growth spurt?

-Epiphyseal fusion

12

What causes the growth spurt to be shorter in girls?

-Oestrogen closes the epiphyseal plates earlier

13

What controls the rate of genital development in boys?

-Testosterone

14

When does puberty typically begin in girls?

-8-13 years (mean 11.5 years)

15

When does puberty typically begin in boys?

-10-14 years (mean 12.5 years)

16

What is the critical weight for menarche?

-47kg

17

What is the relationship between weight and menstruation?

-If weight falls below ~47kgs then reproductive cycle will cease
-Overweight tend to start period early
-Obesity can also interfere with normal menstruation

18

Name one environmental factor thought to influence puberty?

-Light/dark exposure ie day length
-Altitude

19

What happens to the LH pulses on lead upto puberty?

-Pulses are negligible and then increase in amplitude and frequency

20

What is the first phenotypic change in girls?

-Breast development

21

What is the first phenotypic change in boys?

-Testicular enlargement

22

What is the relationship between sleep and LH?

-LH secretion is associated with REM sleep and begins as nocturnal pulsatility which causes a noturnal increase in sex steroid secretion

23

What initiates gonadal development in puberty?

-high levels of FSH and LH secretion

24

What happens after the gonads have started to develop in males?

-Spermatogenesis and androgen secretion begins
-Androgens initiate growth of sex accessory structures (eg prostate) and secondary sex characteristics

25

The adrenal glands secrete androgens, why does this not initiate puberty?

-Level too low

26

What is the relationship between TSH and puberty?

-As puberty starts TSH secretion from pituitary increases leading to increased metabolic rate and promotes tissue growth

27

What effects do androgens have on growth?

-Cause retention of mineral to support bone and muscle growth

28

Which sex steroid do sertoli cells secrete?

-Oestrogen

29

Which secondary sex characteristics are driven by androgens in females?

-Pubic hair growth
-Bone growth
-Sebaceous gland secretion

30

Where are androgens released from in women?

-Adrenals

31

State the order of pubertal changes in girls

-Thelarche
-Pubuc hair growth
-Growth spurt
-Menarche
-Breast development and pubic hair development complete

32

State the order of pubertal changes in males

-Genital deveopment
-Pubic hair growth
-Spermatogenesis
-Growth spurt
-Genital development and pubic hair development complete

33

What is tanner staging? explain it

-A method of staging pubertal development
-Different in girls and boys
-Each individual change has 5 stages
eg girls: Breast 1-5, Pubic hair 1-5, Axillary hair 1-5, menarche
boys: Testicular vol >4ml, Penis enlargment 1-5, pubic hair 1-5, axillary hair 1-5, spermache

34

What initiates the 1st ovarian cycle?

-1st LH surge

35

Define precocious puberty

-Onset of puberty before the average age
-Before 8 in girls and 9 in boys

36

How common is precocious puberty?

-1/5000-10,000
(much more common in females)

37

What is the most common cause of precocious puberty?

-Idiopathic

38

Besides idiopathic, what are the two types of causes of precocious puberty?

-Gonadotrophin dependant
-Gonadotrophin independent

39

Give an example of gonadotrophin dependant cause of precocious puberty

-Tumour eg hcg secreting tumour
-Trauma
-Nutritional status ie obesity

40

Give an example of gonadotrophin independent cause of precocious puberty

-Choriocarcinoma of gonads/pineal gland
-Meningitis
-Congenital adrenal hyperplasia

41

What is precocious pseudopuberty?

-Development of secondary sex characteristics without activation of the reproductive system
-Caused by an alternative source of androgen or oestrogen, independent of FSH/LH/GnRH

42

What is testotoxicosis?

-Familial male precocious puberty
-Autosomal dominant condition where there is rapid skeletal growth, skeletal maturation and sexually aggressive behaviour in the first 2/3 years of life

43

Define delayed puberty

Either:
-Initial physical changes of puberty are not present by age 13 in girls (or primary amenorrhea by 15.5/16) or 14 in males
or
-Pubertal development is inappropriate ie interval between first signs of puberty and menarche.complete genital growth is >5years

44

What are the 2 major causes of delayed puberty?

-Gonadal failure (hypergonadotrophic hypogonadism)
-Gonadal deficiency

45

Give some causes of gonadal failure

-Turners syndrome
-Post-malignancy treatment
-polyglandular autoimmune syndrome

46

Give some causes of gonadal deficiency

-Congenital hypogonadotrophic hypogonadism
-Hypothalamic/pituitary lesions
-Rare genetic mutations inactivating LH/FSH receptors

47

Describe pre-menopause

-typically from age 40
-Follicular phase shortens
-Ovulation becomes early/absent as primary follicles begin to run out-> reduced fertility
-less oestrogen secreted

48

Describe menopause

-Cessation of menstrual cycle for at least 12months
-Average age 49-50
-No more follicles
-Oestrogen levels fall dramatically thus FSH/LH rise dramatically (no inhibin)

49

Describe the effects of the menopause on oestrogen sensitive tissues

-Thinning of cervix
-Regression of endometrium/myometrium of uterus
-Vaginal rugae lost reducing vaginal tone
-Involution of breast tissue
-Urinary incontinence

50

Describe the effects of the menopause on bone

-Bone mass reduces by 2.5%/year for several years
-Enhanced osteoclast ability to absorb bone and attentuated osteoblastic activity
-Osteoporosis

51

Describe the purpose of HRT

-Relieve symptoms of menopause and improve well-being
-Can limit osteoporosis
(-given orally or topically)

52

Why might precocious puberty be stimulated by meningitis?

-Increased pressure due to swollen meninges causing activation of HPG axis

53

Would you expect a female to be taller or shorter with precocious puberty? why?

-Shorter due to early closure of epiphyseal growth plates