What is oligomenorrhoea?
Menstrual cycles lasting longer than 35 days
What is amenorrhoea?
Amenorrhoea can be either ___ or ___.
Which abnormal event of the menstrual cycle can cause oligomenorrhoea or amenorrhoea?
GnRH is released from the hypothalamus in a pulsatile manner.
Which types of pulses cause the secretion of
a) FSH is secreted by low frequency GnRH pulses
b) LH is secreted by high frequency GnRH pulses
Which hormones cause thickening of the endometrium during the menstrual cycle?
basically all of them
Which organs secrete oestrogens?
Oestrogens cause the (thickening / thinning) of the cervical mucus.
Which process does high concentrations of oestrogen cause?
Which hormones are affected?
Negative feedback AND Positive feedback
FSH, Prolactin secretion inhibited
LH secretion stimulated
Secretion of which hormone is inhibited by progesterone?
seeing as LH surges to cause ovulation, and progesterone secretion marks the luteal phase and menstruation
What effect does progesterone have on body temperature?
Increases body temperature
Progesterone is a smooth muscle (relaxant / contractor).
smooth muscle relaxant
presumably to make menstruation easier
Regular menstrual cycles suggests that ___ is occuring as normal.
Irregular menstrual cycles indicate that which abnormal event is occuring?
___ disorders are a common cause of presumed infertility.
What are three causes of anovulation according to the World Health Organisation?
I - Hypothalamic-pituitary failure - hypogonadotrophic hypogonadism
II - Hypothalamic-pituitary dysfunction - PCOS, hyperprolactinaemia
III - Ovarian failure - menopause, premature
What is hypothalamic-pituitary failure, causing anovulation, also known as?
What are four important causes of hypogonadotrophic hypogonadism?
Low BMI (e.g anorexia nervosa)
Excessive exercise (often goes with the above, or eating disorders)
Kallmann syndrome (associated with anosmia)
What hormone abnormalities are seen in hypogonadotrophic hypogonadism?
Low FSH and LH
so low oestrogen
What is the main symptom of hypogonadotrophic hypogonadism?
How can hypogonadotrophic hypogonadism be diagnosed?
Progesterone challenge test
How is hypogonadotrophic hypogonadism treated?
Treat underlying causes (stress, sort BMI, hormone tests/USS for tumours)
IV FSH/LH injections
What are two ovulatory disorders which come under WHO II: Hypothalamic-pituitary dysfunction?
Polycystic ovary syndrome (PCOS)
What is PCOS?
Polycystic ovary syndrome
Causes hyperandrogenism (acne, hirsutism) and oligo- or amenorrhoea
What are the three diagnostic criteria for PCOS?
1. Oligo- or amenorrhoea
2. Evidence of polycystic ovaries on USS
3. Hyperandrogenism symptoms (acne, hirsutism)
What is an endocrine complication of PCOS?
What two effects does hyperinsulinaemia have on the HPO axis?
Reduces SHBG levels, leading to increased levels of free testosterone > hyperandrogenism
What BMI must patients be under before they are considered for any sort of infertility treatment?
< 35, <30 depending on some places
What supplement are all pregnant women given?
Helps to prevent birth defects
What general type of treatment is used for patients with PCOS?