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108 Cards in this Set
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- Back
- 3rd side (hint)
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Puberty
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Biological transformation that takes a person from being a sexually immature child to a sexually mature, reproductive fertile adult
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Pubescence
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State of the child between the onset of pubertal changes and the completion of sexual maturation
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Adolescence
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Socially defined period of youth between puberty and social adulthood
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Tanner Stages
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Classification of pubertal changes
Anatomical characteristics detected by physical exam that change in a predictable order |
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Female Pubertal Changes
Age: 9 |
Earliest pubertal changes
Growth spurt begins Accelerated height gain Increased fat deposition |
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Female Pubertal Changes
Age: 10 |
Pubic hair
breasts development growth and widening of the bony pelvis fat deposition in hips and breasts |
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Female Pubertal Changes
Age: 11 |
Ovaries and female sex accessory structures (oviducts, uterus, vagina) grow and mature
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Female Pubertal Changes
Age: 12 |
axillary hair (armpit)
menarche |
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Female Pubertal Changes
Age: 13 |
skeletal growth rate declines
sweat and sebaceous skin glands develop acne may develop |
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Average age for menarche in USA?
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12.3 years
13 in Northern Hemisphere |
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Female Pubertal Changes
Age: 14 |
female voice may deepen slightly
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Female Pubertal Changes
Age: 15 |
adult height reached due to high levels of estrogen secreted in puberty which halts bone growth
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Precocious puberty in females
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Breasts development or pubic hair growth occurs before age 7
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Delayed puberty in females
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No breasts development by age 14 or no skeletal growth spurt by age 15
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primary amenorrhea
+ what causes it? |
female who has not menstruated by age 16
low body fat content from extreme exercise, anorexia nervosa, or other forms of malnutrition |
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Male Pubertal Changes
Age: 9 |
Earliest pubertal changes
initial stages of spermatogenesis Leydig cells appear and begin to secrete androgens |
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Male Pubertal Changes
Age: 10 |
testes begin to enlarge
increased subcutaneous fat deposition |
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Male Pubertal Changes
Age: 11 |
skeletal growth spurt begins
increase in scrotum and penis size increased in spontaneous erections growth of seminal vesicles and prostate glands |
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Male Pubertal Changes
Age: 12 |
Pubic hair develops
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Male Pubertal Changes
Age: 13 |
Hair on axilla and on upper lip
voice deepens from larynx growth |
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Male Pubertal Changes
Age: 14 |
first fertile ejaculation
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Male Pubertal Changes
Age: 15 |
sweat and sebaceous glands to develop, including acne
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Male Pubertal Changes
Age: 16 |
accelerated muscle growth and strength
broadening of shoulders |
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Male Pubertal Changes
Age: 17 |
males reach adult stature
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Precocious puberty in males
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sexual development before age 9
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Delayed puberty in males
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No testicular growth has occurred by age 14
or no skeletal growth spurt has occurred by age 18 |
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Delayed puberty in males
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No testicular growth has occurred by age by age 14
or no skeletal growth spurt has occurred by age 18 |
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Testicular Development
Age: 9-10 |
Leydig cells again are visible
spermatogenesis begins in the the seminiferous tubules mature spermatozoa are not yet produced testis enlarge markedly by 10 years of age |
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Testicular Development
Age: 14-15 |
mature spermatozoa are produced
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Testicular Development Testicular Size
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1 year old: 0.7 ml
8 years old: 0.8 ml 10 years old: 3.0 ml Adult Male: 16.5 ml |
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In newborns, do seminiferous tubules of testes contain spermatogonia, Sertoli cells, and sperm?
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seminiferous tubules contain spermatogonia, Sertoli cells
but no sperm |
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When are Leydig cells not present?
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Leydig cells are not present from 6 month - 9 years of age
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Cryptochordism
and cryptochordism rate |
testes failed to descend into scrotum by birth
3-4% at birth 0.8% by 1 year 0.3% by 10 years when spermatogenesis should occur Prevents spermatogenesis and causes sterility because of temperature can develop into cancer can be treated early and then can be normal |
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How does thyroid hormone increase?
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With puberty and supports body growth and results in a rise in metabolic rate in both sexes
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How does LH pulse need to be in order for puberty to occur?
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LH pulse need to be 1-3 hours and need to be of large amplitude
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Where do pubertal estrogens arise in females?
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Estradiol is from growing follicles in ovary
Estrone is produced by body fat |
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How often in alcohol intake would result in an increased risk in breast cancer?
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1-2 drinks a day up to greater than 3 drinks a day
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put this on the end after catching up
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What percentage of Americans between 15-55 will acquire some form of STI?
How many Americans acquire STI each year? |
25% of Americans
15 millions Americans acquire STI each year |
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Where do STI typically require?
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Organisims causing STIs typically require moist membranes of transition zones
ex: vulva, vagina, urethra penis, urethra, mouth, oral cavity, throat, eyes, anus |
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How is the vaginal environment normally acidic?
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Under the influence of estrogen, cells of vaginal epithelium accumulate glycogen
these sugar rich cells are metabolized by bacteria that creates lactic acid retards yeast fungal overgrowth antibiotics kill these beneficial bacteria |
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What are some viral STI
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HPV
HIV Hep B virus Hep C virus Mulluscum contagiosum |
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What are some bacterial STI?
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syphilis
urethritis chancroid vaginitis and urethritis |
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What are some sexually transmitted infection types?
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Viral
Bacterial Fungal Lice Protozoan Scabies |
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Trichomonas vaginalis
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vaginitis with frothy, odorous discharge that develops 4-8 days post exposure
Vulva, cervix, urethra, and bladder may become inflammed Most men are asymptomatic, but may develop urethritis or cystitis Diagnosed by microscope and treated by metronidazole |
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Chlamydia
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bacterial STI
Incubation for 7-28 days 50% of men are asymptomatic 75% of infected women are asymptomatic Nearly half the cases in U.S. occur in 15-19 Urethritis in both men and women resulting in yellow discharge from the urethra Cervix is the main site of infectino in female Salpingitus - oviduct inflammation which leads to scarring and blockage of the oviducts which can cause infertility in women Pelvic inflammatory disease in women |
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Chlamydia's effect in newborns
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can be transferred to eyes of a newborn if present in vaginal canal
leads to conjunctivitis and pneumonia in the newborn infant newborn eyes are routinely treated with topical antibiotics like silver nitrate |
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Diagnosis of Chlamydia
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(first stream) urine is collected and PCR
Culture of purulent material |
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Treatment of Chlamydia
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Azithromycin by mouth
Doxycycline by mouth |
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Gonorrhea
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STI transfered through coitus
gram negative diplococcus bacteria that causes STI In U.S., most new cases 15-29 high in sexually active under 23 + men who have sex with men |
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Gonorrhea in men
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70-90% of men infected with gonorrhea develop symptoms
Purulent discharge form urethra redness of glans and penis |
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Gonorrhea in women
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75% are asymptomatic
Symptomatic females develop whitish yellowish, or greenish discharge from: vagina cervix urethra bladder (cystitis) |
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Endometritus
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Gonorrhea in females
uterine infection |
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Salpingitis
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Gonorrhea in females
inflammation and infection of oviducts which can cause scarring of tissue leading to infertility because of oviduct blockage |
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Pelvic inflammatory disease
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Gonorrhea in females
general infection of pelvic tissues |
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Diagnosis of Gonorrhea
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(first stream) urine is collected and PCR evaluation
Culture of purulent material swab of throat of rectum |
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Treatment of Gonorrhea
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Ceftriaxone injection
Doxycycline by mouth |
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Syphilis on rise in USA
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# of cases in US increased every year
5%-60% of newcases in Gay men from 1998-2006 |
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Syphilis: Primary Stages
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Chancre sore develops at site where syphilis enters the body
resolution of chancre, primary stage is over contagious during primary stages |
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Chancre sores
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symptoms of Syphilis primary stage
chancre are 0,5 - 1.0 inches in diameter with hard edge and soft center male chancre sores: glans, corona of penis females chancre sores: vulva, cervic, vaginal wall Chancres apprear 10-90 days after entrance of microbe and lasts for 1-5 weeks |
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Syphilis: Secondary stage
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2-6 weeks after the primary srage
rash develops on upper body, upper extremities Rash is painless and not itchy Hair loss, sore thorat, swollen lymph nodes, painful joints, poor appetite reoccurs over the next two yearss Contagious in secondary stage |
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Syphilis: Latent stage
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lasts for years, person will have few or no symptoms
half who enter latent phase never enter tertiary phase people in latent stage are not contagious, except for pregnant females who can transmit to fetus |
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Herpes simplex Type 2 virus
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Retention of the virus in nerve fibers for life
mainly infects genital area, but can occur within oral cavity from oral sex typically transmitted through person with active lesion, but can transmitted from a a person who has no obvious symptoms can survive on toilet seats for hours and are transmittable tiny blisters develop through genital, anal, oral contact that can change into painful round sores in 4 - 7 days and may progress into ulcers Males: prepuce, glans, urethra, shaft Females: labia, prepuce, urethral orifice Lesion usually resolve 1-2 weeks |
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Herpes 2 diagnosis
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PCR or culture of tissue
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Herpes 2 treatment
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Acyclovir by mouth can limit the frequency and length of outbreaks
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Congenital herpes simplex
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If mom has active genital lesions at time of delivery, the newborn can potentially acquire herpes simplex and this can result in death
These women are advised to have a C-section Newborn with herpes are treated with IV acyclovir |
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HIV transmission routes
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Blood inoculation
Perinatal: Across placenta During Birth Breastfeeding Sex: Sores on genital or anal area from anothe infection make it easier to be infected with HIV |
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Circumcision and HIV transmission
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circumcised men are 50% less likely to aquire HIV through sex
circumcised men are less likely to acquire other sexually transmitted diseases as well |
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HIV are also present in addition to sex?
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HIV present in blood,
semen, cervical and vaginal secretions, breast milk (cracked nipples), saliva, tears |
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HIV diagnosis
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Detection of HIV Ab in blood or saliva
seroconversion: nearly all persons infected with HIV have detectable Ab w/in 6 month of infection Viral RNA test can detect virus before Ab emerge |
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HIV prevention
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Condoms
Circumcised men have 50% reduction HIV positive women who are pregnant receive AZT (w/ their newborn) to reduce transmission rate Breast milk can be heated to a low temperature to eliminate the HIV |
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HIV treatment
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Nucleoside reverse transcriptase inhibitors (AZT)
Nonnucleoside reverse transcriptase inhibitors Protease inhibitors Fusion inhibitors |
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Contraceptive Mechanisms
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Preventing fertilization
Disrupt preembryo transport through oviduct Disrupt implantation of preembryo |
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Unintended pregnancies
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55% of birth by unmarried women were unintended pregnancies
30% of births by married women were unintended pregnancies |
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Contraception rates
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62% of women in their childbearing years use some form of contraception
Combination oral contraceptive is most common form for never-married women Female tube tied or male vasectomy is most common form for married couples |
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Popular contraceptives around the world
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Econ developed countries
Pill Condom Female tube tying Econ developing countries Female tube tying IUD Pill |
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Contraceptives using progesterone or progesterone-estrogen combination
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Mimicks the negative feedback on GnRH that progesterone and estrogen exhibit during the luteal phase
Inhibit follicular phase tertiary ovarian follicle growth which results in the prevention of: -estrogen peaks in late follicular phase -positive feedback of estrogen -surge of GnRH, LH, and FSH -ovulation |
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Contraceptive: transdermal hormone delivery
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patch delivers progesterone and estrogen across skin
once for three weeks, fourth week has no patch is applied Another method of administration is a plastic ring placed in the vagina that contain hormone that cross the vaginal epithelium to bloodstream |
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Contraceptive: injectable progestogen implants
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injectable progestogen (Depo-provera) is injected every 90 days
A combination progestogen-estrogen monthly shot is also available Efficacy is very high at 99.7% However, side effects (weight gain) is higher small progestogen implants (Norplants) were inserted under skin surface of inner, upper forearm and is gradually released for up to 5 years. Withdrawn from market because they were difficult to remove in addition to have significant side-effects in some women |
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Contraceptives: Intrauterine devises (IUD)
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Flexible T-shaped plastic devises that typically contain copper or progestogen and are inserted through the cervix into the uterus.
Most commonly used reversible contraceptive method in the world |
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IUD: mechanism of action
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reduce sperm motility and viability
interfere with ova development + maturation Cause inflammation and increase white blood cell in the uterus which interfere with implantation High efficacy rate, can be left for 10 years Copper IUD have 96-9% efficacy rate and can be left in for 5 years Progestogen IUD have a 94%-98% efficacy rate and can be left in for 5 years |
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IUD side effects
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Abdominal cramping
menstrual bleeding (especially copper IUD) Pelvic infection, especially with copper IUDs, result in less infection use of IUDs in the USA has declined over the past two decades because of the perceived risk of pelvic infection |
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Spermicides
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Inserted into vagina next to cervical os in form of foams, creams, jellies, or suppositories
Act as barriers to sperm transport and as sperm killing agents Nonoxynol-9 is main active ingredient and works as a suractant to disrupt the structure of the sperm Use of spermicide more than once a week can increase resk of urinary tract infection High failure rate More effective when used in combination with other contraceptives |
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Diaphram for women
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Shallow cup of thin rubber stretched over flexible wire ring and is placed in the upper vagina to block the external os of the cervix
Failure rate 3-18% |
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cervical cap for women
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small silicone cervical cap that fits over and blocks the cervix
Efficacy is enhanced when a spermicide is delivered into the vagina Can be difficult to insert and may irritate the cervix |
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Contraceptive: sponge for women
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Collagen sponge that contains a spermicide is placed against the uterus and it catches semen and prevents sperm penetration into the uterus
Possible association with toxic shock |
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Coitus Interruptus
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Withdraw of penis before ejaculation
Unintended pregnancy can result from the release of a small amount of pre-sperm |
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Coitus reservatus
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allows loss of erection without ejaculation while the penis is inserted
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Coitus obstructus
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pressure through squeezing is placed onthe base of the spongy urethra, causing retrograde ejaculation into the bladder instead of ejaculation of the distal penis
ineffective and causes bladder infection |
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Fertile period
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sperm are capable of fertilization for up to seven days after ejaculation
ovum can be fertilized for up to one day after ovulation therefore women are potentially fertile from 7 days prior to ovulation to one day after ovulation |
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Natural rhythm methods
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Contraceptive methods based on prediction of safe and fertile days in the mens. cycle
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Natural rhythm methods
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Calender method
Basal body temperature method cervical mucus method sympto-thermal method |
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Natural rhythm method: calender method
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cycles are recorded over one year period
Very High failure rate Safe to have sex three days after women has ovulated until her next menstruation estimated based on being 14 days before first day of next cycle |
end
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Pubertal androgens in females:
What kind? where produced? |
DHEA and androstenedione (weak androgens) are increased during puberty
produced by adrenal glands during adrenarche (maturation of adrenal glands, 1st pubertal change) |
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What do pubertal andtrogens in females cause?
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growth of pubic and axillary hair
lowering of voice sebaceous glands and acne development long bone growth increased sex drive arrive at certain tissue to create testosterone which makes certain tissues grow |
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When does the secretion of LH and FSH occur in males?
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around 10 years of age and correlates with onset of spermatogenesis
rise in testosterone secretion from testis |
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Pubertal androgens (testicular + adrenal) in males causes what?
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sex accessory + secondary sex structure growth
retention of N, Ca, P that support bone + muscle growth Penis touch enhancement Sex drive |
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Pubertal estrogen in males
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Blood estrogen levels rise slightly during and before puberty
Estrogen likely from Sertoli cells may make slight growth of mammary glands during puberty that gets resolved |
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Puberty onset and hypothalamus sensitivity
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sensitivity of hypothalamus to steroidal negative feedback on GnRH decreases as puberty approaches (less negative feedback after puberty)
positive feedback of estrogen is initiated in women |
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Puberty onset and GnRH pulse generator
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the GnRH pulse generator appears to be under inhibition from the brain during childhood
This inhibition is lifted during puberty |
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What causes the appearance of positive feedback of estrogen on GnRH in pubertal females?
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maturation of the hypothalamic GnRH surge center
and the ability of the pituitary to synthesize and store adequate amounts of gonadotropins |
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Gonadotropin Inhibiting Hormone (GnIH)
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Hormone that inhibits the release of gonadotropins
transduce information via changes in melatonin signal to influence the reproductive axis |
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Kisspeptin
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hormone produced by the neurons that stimulates release of GnRH with increased production of LH & FSH and steroidal hormones
Its signaling contributes to the onset of puberty |
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Kisspeptin in animals
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plays a role in coordinating seasonal reproduction in wide range of animal species (monoestrous, etc)
Connects environmental change to physiological change (fall, winter) |
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Age of menarche trend
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declining worldwide at a rate of 3 months per decade over the last century
improved nutrition and access to food less physical activity and more weight gain increased exposure to xenoestrogens (plasics) |
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Leptin
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protein produced by fat cells
increases before onset of puberty increases the rate of GnRH pulses overweight people have high leptin underweight people have low leptin Humans lacking leptin can fail to enter puberty |
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Light and menarche
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Light contributes to an earlier onset of menarche
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Stress and menarche
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Psychological stress during he first 5-7 years of life accelerates sexual maturation in females
menarche is reached 5 months earlier have children earlier |
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Genetics and menarche
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age of menarche for mother and daughter tends to be the same
Identical twins have it within 2 months of each other lower ratio of testosterone to estrogen result in earlier initiation of sexual development Black and Latina women tend to reach menarche faster due to a gene |
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