SF: Chapter 28pt4

What is the onset age for female puberty

11-13

by what age is female puberty completed

16

menarche def.

first menstrual bleed

What organs enlarge with puberty

vagina, uterus, fallopian tubes, external genitalia

What type of tissue enlarges and deposits at the breasts and hips

adipose tissue

what else develops during puberty

sex drive and pubic/axillary hair

When does the cycle become regular and all cycles are ovulatory?

3rd year postmenarche

Menstrual cycle def.

cyclic changes in sexually mature nonpregnant females

Where are changes occurring during the menstrual cycle

uterus (hormones and ovaries too!)

What is the longest the menstrual cycle can last

40 days

What is the shortest the menstrual cycle can last

18 days

What is the average number of days the menstrual cycle lasts

28 days

What causes the fluctuation /variation between months in the number of days during menstrual cycles

nutrition, stress, level of activity

What are the 2 cycles in the overall menstrual cycle

ovarian cycle and uterine cycle

ovarian cycle: changes within the?

ovaries

uterine cycle: changes within the?

uterus

what is the ovarian cycle responsible for

egg maturation

what is the ovarian cycle day range

21-40 days

what percentage of women have a 28 day ovarian cycle?

10-15%

When does ovulation occur in the ovarian cycle

midcycle: day 14

What are the 2 phases within the ovarian cycle

follicular and luteal phase

Does the follicular phase remain constant or vary in regard to ovulation and length?

varies

Does the luteal phase remain constant or vary in regard to ovulation and length?

remains constant

When does the follicular phase occur (days)

1-14

When does ovulation occur during follicular phase

day 14

when does the luteal phase occur (days)

14-28

What is active during the luteal phase

corpus luteum

What are Graafian (vesicular) cells rescued from?

Atresia (programmed cell death)

How are Graafian (vesicular) cells rescued?

rising FSH levels by end of prior cycle

True or false: all graafian follicles are equally sensitive to FSH

false

When do FSH levels drop?

mid follicular phase

What happens to graafian follicles when FSH levels drop

Graafian follicles compete for FSH to survive atresia

What do graafian follicles become when they survive atresia

dominant follicles

What completes meiosis I

primary oocyte of dominant follicle

the completion of meiosis I leads to

secondary oocyte and 1st polar body

the presence of secondary oocyte and 1st polar body means?

ready for ovulation

ovulation def.

ovary wall ruptures and secondary oocyte is expelled into peritoneal cavity with corona radiata remaining intact

Mittelschmerz literal definition

German for "middle pain"

Mittelschmerz presents as

twinge in lower abdomen

What might cause Mittelschmerz

intense stretch of wall and irritation of peritoneum by blood released by ruptured follicle

What percentage of ovulations releases more than 1 oocyte

1-2%

Do the chances of releasing more than one oocyte increase or decrease with age?

increases

what does the release of more than one oocyte during ovulation result in

multiple births

identical twins def.

fertilization of single oocyte by a single sperm, separation of daughter cells

fraternal twins def.

different oocytes fertilized by different sperm

What is an interesting scenario that is possible with fraternal twins?

more than one baby daddy

Corpus hemorrhagicum def.

ruptured follicle collapses and antrum fills with clotted blood

Does the corpus hemorrhagicum become absorbed or does it pass out of the body?

eventually absorbed

What happens to the remaining granulosa cells during the luteal phase

enlarge and join internal Theca cells

What is corpus luteum composed of

internal theca cells + granulosa cells

What is the purpose of corpus luteum during the luteal phase

provides high levels of progesterone and estrogen

What happens during the luteal phase if NOT PREGNANT

corpus luteum degenerates in about 10 days and hormonal output ends

What is formed on the ovary during luteal phase when not pregnant

corpus albicans (white scar)

What happens during the luteal phase IF PREGNANT

corpus luteum persists producing progesterone until the placenta is ready to resume hormone-producing role

How long does it take the placenta to take on hormone-producing role upon becoming pregnant

by the end of the first trimester (within 3 months)

What are the 3 phases of the uterine cycle

menstrual, proliferative, secretory

menstrual phase of uterine cycle days

1-5

What is happening during the menstrual phase of uterine cycle

slough off endometrial lining becoming then endometrial repair

proliferative phase of uterine cycle days

5-14

What is happening during the proliferative phase of uterine cycle

endometrium of uterus regenerates and forms tubular spiral glands and arteries

During which of the 3 uterine cycle phases does ovulation occur

proliferative phase

What day does ovulation occur during the uterine cycle

day 14

What is most important about day 14 during proliferative phase of uterine cycle

LH peak = ovulation

secretory phase of uterine cycle days

14-28

What is happening during the secretory phase of uterine cycle

maturation and secretion by spiral glands, endometrium is thickening, spiral glands develop greater

When do menstrual cramps occur

before and during menstruation

What causes menstrual cramps

excess prostaglandin secretion

When is Prostaglandin secreted in excess during menstrual cycle

as endometrium lining sloughs off (menstrual phase)

How to alleviate menstrual cramps

NSAIDs (ASA and ibuprofen)

How do NSAIDs help with menstrual cramps

inhibit prostaglandin biosynthesis prior to onset of menstruation

What is female sex drive dependent on

hormones

During sexual excitement, what is happening to the clitoris and vaginal opening?

erectile tissue within both becomes engorged with blood

What other reproductive becomes erect with sexual excitement

nipples

During sexual excitement, what is happening to the mucous glands within the vestibule

secrete small amounts of mucus

During sexual excitement, where is the majority of mucus being secreted from

vaginal walls

What is the purpose of secretions during sexual excitement

allows for easy entry of penis into vagina and easy movement of penis during intercourse

tactile stimulation of genitalia and psychological stimuli triggers?

orgasm, maybe more than one

What is the age RANGE for menopause

40-50 y/o

menopause def.

cessation of menstrual cycles

what is the avg menopause

51

menopause presents as?

less regular menstrual cycles with inconsistent ovulation

perimenopausal def.

time from onset of irregular cycles to complete cessation

how long does perimenopause last

3-5 years

When do women become symptomatic for perimenopause

as progesterone and estrogen are reduced

symptoms of perimenopausal

hot flashes, fatigue, anxiety, temporary drop in sex drive, emotional lability, dryness

how to treat perimenopausal symptoms

hormone replacement therapy

What hormones are involved in HRT

estrogen or estrogen/progesterone

Does HRT treatment increase or decrease overtime?

decreases

What does HRT prevent and reduce the chances of? (in addition to perimenopausal symptoms)

osteoporosis, colorectal cancer

What could HRT treatments prolong?

symptoms of menopause

Side effects of HRT

increased risk of breast, ovarian, and uterine cancer

What does HRT NOT reduce the risk of?

heart disease for 1st few years of menopause

side effects of HRT: risk of??? is increased

MI, CVA, blood clots

What are potential causes for female infertility

dysfunctional fallopian tubes, less hormone secretion, interference with implantation

What can dysfunction of fallopian tubes look like?

PID which leads to adhesions

What could cause less hormone secretion leading to infertility?

hypothyroidism or tumors

What could lead to interference with implantation

uterine tumors

endometriosis def.

endometrial tissue deposits outside the uterus

endometriosis: theory of retrograde menses

endometrial cells become inflamed, sensitive to estrogen and progesterone

symptoms of endometriosis

dyspareunia, heavy bleeding, pain with BM or urinate, cramping, constipation, nausea, bloating