Women's Health And Reproductive Endocrinology

Front 1

Describe the 2 phases that the menstrual cycle is split into?

Back 1

1. Follicular phase (proliferative phase) - development of primary ovarian follicle which produces oestrogen - proliferation of endometrium
Spike in LH - stimulates ovulation, separates ovum from follicle
2. Luteal phase (secretory phase) - remnants of primary ovarian follicle develop into corpus luteum which secretes progesterone to maintain the integrity of the endometrial lining
Degeneration of the corpus luteum - endometrial lining sloughs off
Falling levels of oestrogen and progesterone due to absence of fertilised ovum --> rise in FSH starts cycle again

Front 2

Describe the function of LH and FSH

Back 2

LH stimulates theca interna cells to produce androgens + corpus luteum formation
GSH stimulates granulosa cells to cause follicle maturation and conversion of androgens to oestrogens

Front 3

Describe how once fertilisation occurs the endometrial lining is maintained

Back 3

Fertilisation --> trophoblast which produced hCG which maintains the corpus luteum --> continues to produce oestrogen and progesterone --> maintainance of endometrial lining

Front 4

What is the average cycle length of a menstrual cycle

Back 4

28 days (26-30)

Front 5

What is the average days of menstrual flow

Back 5

4-6

Front 6

Average blood loss during a period

Back 6

25-60mls

Front 7

Describe the changes in endometrial glands across the proliferative and secretory phase

Back 7

Proliferative
tubular, straight and narrow, with low columnar epithelium
Secretory
Tortuous glands with prominent secretory activity

Front 8

Are spinal arterioles a feature of proliferative or secreoty phase

Back 8

secretory

Front 9

What stimulates menstruation

Back 9

progesterone withdrawal

Front 10

List the common causes of infertility in females

Back 10

Tubal factors (20-30%)
PID, adehsions (endometriosis, previous surgery, peritonitis), ligation
Ovulatory dysfunction (15-20%)
Hypothalamic, pituitary, PCOS, stress, poor nutrition, excessive exercise
Fibroids
Often multiple factors (30%)
Unknown factors (10-15%)

Front 11

What is the most common cause of male fertility

Back 11

Testicular problems
Idiopathic, genetic, undescended testis, mumps
Accounts for > 90% of male infertility

Front 12

How long does it take the average female 24-25 to fall pregnant?

Back 12

5.3 months

Front 13

How long does it take the average female 35-36 to fall pregnant

Back 13

8.9 months

Front 14

What investigations can be done to investigate male infertility

Back 14

semen analysis
sperm antibody testing
sperm DNA fragmentation
endocrine profile: FSH, LH, TSH, prolactin
GEnetic tests
Testicular biopsy (Azospermia)

Front 15

How do you diagnose PCOS

Back 15

2 of 3
Oligomenorrhea/irregular menses for 6 months
clinical of lab evidence of hyperandrogenism
polycystic ovaries on US (at least 1 ovary with 12 + follicles 2-9mm and/or ovarian volume > 10mls)