Flashcards in Week 3.0 - Puberty and menopause Deck (53)
State the order of pubertal changes in girls
-Pubuc hair growth
-Breast development and pubic hair development complete
State the order of pubertal changes in males
-Pubic hair growth
-Genital development and pubic hair development complete
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
What initiates the 1st ovarian cycle?
-1st LH surge
Define precocious puberty
-Onset of puberty before the average age
-Before 8 in girls and 9 in boys
How common is precocious puberty?
(much more common in females)
What is the most common cause of precocious puberty?
Besides idiopathic, what are the two types of causes of precocious puberty?
Give an example of gonadotrophin dependant cause of precocious puberty
-Tumour eg hcg secreting tumour
-Nutritional status ie obesity
Give an example of gonadotrophin independent cause of precocious puberty
-Choriocarcinoma of gonads/pineal gland
-Congenital adrenal hyperplasia
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
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
Define delayed puberty
-Initial physical changes of puberty are not present by age 13 in girls (or primary amenorrhea by 15.5/16) or 14 in males
-Pubertal development is inappropriate ie interval between first signs of puberty and menarche.complete genital growth is >5years
What are the 2 major causes of delayed puberty?
-Gonadal failure (hypergonadotrophic hypogonadism)
Give some causes of gonadal failure
-polyglandular autoimmune syndrome
Give some causes of gonadal deficiency
-Congenital hypogonadotrophic hypogonadism
-Rare genetic mutations inactivating LH/FSH receptors
-typically from age 40
-Follicular phase shortens
-Ovulation becomes early/absent as primary follicles begin to run out-> reduced fertility
-less oestrogen secreted
-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)
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
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
Describe the purpose of HRT
-Relieve symptoms of menopause and improve well-being
-Can limit osteoporosis
(-given orally or topically)
Why might precocious puberty be stimulated by meningitis?
-Increased pressure due to swollen meninges causing activation of HPG axis