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110 Cards in this Set

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  • Back
What is Menarche?
The onset of first menses
Immediately after menarche, how does the menses cycle appear in terms of regularity and predictability? Why?
It is usually irregular and unpredictable because hormone communication is erratic.
When we are talking about the menstrual cycle, how many days is the cycle based on?
28 days
What is uterine bleeding in direct response to in the body?
Cycling hormones
How many years does pre-menapouse typically last?
7-10 years
How can a girl get pregnant before she has had menarche?
If she has ovarian cycles, she can have ovulation and thus pregnancy.
What is menstrual blood composed of?
-Blood
-vaginal/cervical secretion
-bacteria
-mucus
-leukocytes
Which organ must mature in the body to initiate menarche?
When the brain, ovaries and adrenal glands are mature
What is the actual beginning of menopause?
No menstrual cycle for 12 months
Why (hormone wise) does menopause occur?
The ovaries no longer producing progesterone and estrogen
What is the name of the lining that sheds blood during menses?
Decidua
What kind of diagnosis is used to dx menopause?
Retrospective diagnosis.

-Must look back and have no menses for 12 months
In an ideal menstrual cycle, how many days after ovulation does menses occur?
about 14 days after ovulation.
What is the average age of menopause?
51-52 years old
Amenorrhea may occur if there is a low % of body _____?
fat
____ controls the development of the female secondary sex characteristics.
Estrogen
List the secondary female sex characteristics.
1. Breast development
2. Growth of body hair
3. widening of the hips
4. deposits of tissue (fat) in the buttocks and mons pubis.
Which hormone is responsible for inhibiting FSH production and stimulating LH production?
Estrogen
The hormone estrogen is responsible for increasing ____ feelings in humans and thus can help bring about intercourse and fertilization.
libidinal
Estrogens cause the uterus to increase in ____ and ______?
Size and weight
Which hormone assist in the maturation of the ovarian follicles and causes the endometrial mucosa to proliferate following menstruation?
Estrogen
What is the hormone of pregnancy?
Progesterone!
Progesterone _____ uterine motility and contractility caused by estrogens.
Decreases
This hormone is secreted by the corpus luteum and is found in greatest amounts during the Luteal phase of the menstrual cycle?
Progesterone
Glycogen, arterial blood, accessory glands, amino acids and water increase their supply in the endometrium through the expression of which hormone?
progesterone
What kind of change in temperature occurs at ovulation?
At ovulation, there is a temp rise of 0.5-1 degree F that persists through the secretory phase of menstrual cycle
What are prostaglandins?
Oxygenated fatty acids that are produced by the cells of the endometrium
What is the function of PGF?
It is a potent vasoconstrictor and increases the contractility of muscles and arteries
Which prostaglandin is known for relaxing smooth muscles and is a potent vasodilator?
PGE
Other than endogenous PGE, what is another way of increasing this product in the body?
Heterosexual Sex. It is present sperm
What is the definition of the menstrual cycle?
Periodic uterine bleeding that begins approximately 14 days after ovulation
What are the 3 concurrent cycles that take place with the menstrual cycle?
1. Hypothalamic-pituitary
2. Ovarian
3. Endometrial
Are PGEs and PGFs working against each other?
No
The cycle most responsible for providing negative feedback that ultimately stimulates the ovaries is the________?
Hypothalamic-pituitary cycle
The ____ cycle is responsible for the selection of a mature oocyte for ovulation.
Ovarian
Define the endometrial cycle
Cyclic proliferation and shedding of the functional layer of the endometrium
What are the 3 hormones involved in the hypothalamic-pituitary cycle?
1. GnRH
2. FSH
3. LH
What is the function of GnRH? Why is it released?
- Stimulates the anterior pituitary to release LH/FSH

-Released in response decreased estrogen and progesterone at the "end" of the menstrual cycle.
What hormone inhibits FSH?
Estrogen
which organ release FSH and LH?
anterior pituitary
Which hormone is released in a biphasic response to estrogen?
LH
The follicular phase and Luteal phase are part of which cycle?
The Ovarian cycle
Which days correspond to the follicular phase? Which cycle is this?
Days 1-14 of the ovarian cycle
The follicular phase of the ovarian cycle is dominated by which hormone?
Estrogen
Which phase in the ovarian cycle is variable?
Follicular phase
The surge of ____ serves to select the follicle for ovulation?
LH
Under the influence of FSH and estrogen, between _____ follicles mature in each ovary
1 and 30
Proliferation of the endometrial cycle occurs at the same time as which stage in the ovarian cycle?
Follicular
When exactly does ovulation occur in accordance to the ovarian cycle?
34-36 hours after the LH surge begins

-10-12 hours after LH peak
Days 15-28 corresponds to which phase of the ovarian cycle?
Luteal phase
Following ovulation, the follicle has a transformation to the___?
corpus luteum
The luteal phase is dominated by which hormone?
Progesterone
Which hormone influences the creation of the corpus luteum from the follicle?
LH
What is the appearance of the corpus luteum within 2-3 days post ovulation?
Yellowy, sphere-like and increased in vascularity
Which hormone is released from the fertilized egg when it is implanted into the endometrium?
HcG
The degeneration of the corpus luteum following a lack of fertilization corresponds to what changes in hormones?
Drop in estrogen and progesterone and an increase in LH and FSH
How long does it take for the corpus luteum to degenerate post no fertilization?
within 1 week
List the phases of the endometrial cycle.
1. Menstrual phase
2. Proliferative phase
3. Secretory phase
4. Ischemic phase
Days 1-5 of the endometrial cycle are know as? what happens during these days?
the menstrual phase
-have shedding of the endometrium
What occurs in the arteries of the endometrium during the menstrual phase?
Spiral artery spasms
The levels of estrogen are _____ during the menstrual phase.
LOW
Define estrogen withdrawal in the menstrual phase
triggers the endometrial shedding that is the menstrual flow.
Which phase of the endometrial cycle occurs in days 6-14?
Proliferative phase
Rapid endometrial thickening and restoration of the endometrial surface is characteristic of which phase?
the proliferative phase of the endometrial cycle
In the ____ phase of the endometrial cycle, the levels of estrogen and progesterone fall rapidly.
Ischemic
What days are characteristic of the ischemic phase?
26-28
List the series of events that occur in the ischemic phase.
1. Spiral arteries vasoconstrict ans spasm
2. blood supply to the functional endometrium is blocked and necrosis develops
3. The functional layer separaties from the basal layer
4. Menstrual bleeding begins
In the secretory phase, the endometrium becomes ____ and ____?
edematous and vascular
What is glycogen's role in the secretory phase?
It is secreted to prepare for the fertilized egg.
What hormone increase significantly during the secretory phase?
Progesterone
What are the changes in basal body temperature pre and post ovulation?
Before ovulation there is a drop in temp
-at ovulation and after there is a rise in body temp
Define amenorrhea.
The absence or cessation of menstrual flow
List the characteristics for primary amenorrhea.
-absence of menarche and secondary sex characteristics by age 14

-absence of menarche regardless of secondary sex characteristics by age 16
A 6 month cessation of menses after a period of menstruation is known as?
Secondary amenorrhea
What are the possible causes of amenorrhea?
1. Pregnancy
2. Stress
3. Various diseases
4. Medications (steroids/the pill)
5.eating disorders
6. strenuous exercise
7. hormonal contraceptives
8. menopaure
What % of women and troubled with dysmenorrhea?
50-80%
What is painful menstruation known as?
Dysmenorrhea
Primary dysmenorrhea is associated with what cycles?
Ovulatory cycles
When does pain occur in primary dysmenorrhea?
At the onset of menses and lasting 8-48 hours
What prostaglandins are associated with primary dysmenorrhea?
PGFs
What are the symptoms associated with primary dysmenorrhea?
-backache
-weakness, dizziness, syncope
-sweating
-GI upsets, anorexia, diarrhea
-N/V
-headache
What are some Tx for primary dysmenorrhea?
NSAIDS or sex
What menstrual disorder is associated with the luteal phase of the menstrual cycle?
Premenstrual syndrome (PMS)
How can you differentiate PMS from depression?
In PMS, you have a symptom free time period
What are the symptoms of PMS?>
1. water retention
2. behavioral or emtional changes
3. premenstrual cravings
4. headache
5. Fatigue
6. Backache
Describe the management for PMS.
-Certain Birth controls
--exercise
-diet
-NSAIDS
-diuretics
-can also give SSRIs to manage mood swings
What dysmenorrhea is known to begin after the age of 25?
Secondary dysmenorrhea
Secondary dysmenorrhea is associated with what pathology?
Pelvic pathology
When does the pain of secondary dysmenorrhea occur?
A few days before menses but can be present @ ovulation and continues the first few days of menses

-It can also begin after menses has begun
What is the pain characterized in secondary dysmenorrhea?
Dull, lower abdominal, aching pain that radiates to the back or down the thighs.

-typically complain of bloating or pelvic fullness
What are the possible pelvic pathologies associated with secondary dysmenorrhea?
1. adenomyosis
2. endometriosis
3. PID
4. Polyps
5. Fibroids
What is endometriosis?
Growth of endometrial tissue outside the uterus
How does the pain range for women who suffer from endometriosis?
Non-existent --> mild --> incapacitated
What is a major symptom of endometriosis?
Pelvic pain
Endometriosis is characterized by?
1. Secondary amenorrhea
2. Dyspareunia (painful intercourse)
3. abnormal uterine bleeding
4. infertility
What are the management options for endometriosis?
-Hormonal therapy
-NSAIDS
-even hysterectomy (very rare)
What can occur in pain levels from one month to the next for a woman with endometriosis?
They can actually fluctuate

-one month may have nothing and the next is excruciating
What are tumor on stalks arising from the mucosa called?
Uterine polyps
What are the most common benign LESION of the cervix during the reproductive years?
Uterine polyps
What is the management for uterine polyps?
surgical removal

-send to pathology to check for malignancy
what is the most common benign TUMOR of the reproductive tract?
Fibroids
What group of women is most likely to be affected by fibroids?
> 50 years old
Which class of fibroid is the least common but most symptomatic?
Subserosal fibroid
What typically happens to fibroids during menopause?
they usually shrink
What can cause fibroids?
- ovarian hormones
- OCPs
- Pregnancy
- Hormone replacement therapy
What is the procedure called to remove fibroids?
myomectomy
What re the Tx options for fibroids?
1. NSAIDs
2. myomectomy
3. occasionally give OCPs (may control bleeding and increase comfort)
What are the reproductive years?
13-64
What is a symptom of fibroids?
bleeding and pain depending on the location of the growth
What are the possible locations of fibroids?
1. Intramural
2. Subserosal
3. Submucosal
4. Cervical
5. Pedunculated