Disorders of Sexual & Reproductive Function

made by naomi

What are the different causes of disorders in sexual function?

- hormone imbalance

- genetic/cogenital factors

- infections

- structural/physical issues

- lifestyle/environmental factors

What's the difference between primary and secondary hypogonadism?

primary is specific issues with the ovary/testicles whereas secondary is a problem with the pituitary

What are symptoms of male hypogonadism?

- subfertility (reduced ability to naturally conceive)

- poor libido (reduced sexual desire)

- impotence (unable to maintain a firm erection)

- loss of secondary sexual hair

What can cause male primary hypogonadism?

- congenital issues

- chemo/radiation

- renal failure

- alcohol/cirrhosis

What is the treatment for primary hypogonadism?

- If the patient wants children: there's no medical treatment so patient should go through IVF

- If patient doesn't want children: testosterone & esters will help with symptoms

What causes male hypopituitarism (secondary hypogonadism)?

- GnRH deficiency (LH + FSH)

- drugs

- hyperprolactinaemia

What is the treatment for hypopituitarism?

- if fertility is required= no treatment

- if fertility isn't required: gonadotrophins e.g menotrophin (LH + FSH), leutrotrophin (LH), follitrophin (FSH)

What is impotence?

failure to maintain a penile erection which can be cause by psychological, vascular, drugs

What is the treatment of impotence?

- identify underlying cause

- PDE-5 inhibitors as they increase penile blood flow e.g sildenafil

- alprostadil~ prostaglandin E1

What are symptoms of female hypogonadism?

- subefertility

- breast reduction

- poor libido

- dry vagina

- pain on intercourse

- amenorrhoea (lack of periods)

What can cause premature ovarian insufficiency (primary hypogonadism)?

- issues with ovaries before 40

- can be related to menopause

What cause hypopituitarism in females?

- GnRH deficiency

- hypoprolactanaemia

- polycystic ovary disease

- adrogen excess

- fallopian tube defects

Treatment for primary hypogonadism in females?

- IVF needed if they want children

- prescribed HRT to help with their symptoms

Treatment for hypopituitarism in women.

- gonadotrophins

- pulsatile GnRH; stimulates LH & FSH

- clomifene~ blockes oestrogen receptors and induces GnRH release interfering with feedback mechanism

What is polycystic ovary syndrome?

when small ovarian cysts occur and there's excess androgen production

Symptoms of polycystic ovary syndrome?

- hirsuitism~ excess hair

- menstrual ireegularities

- acne

- obesity

- subfertility

How to treat hirsuitism?

- COC e.g dianette

- cream e.g elfomithine which inhibits enzyme involved in hair growth and production

- mestrual disturbance: COCs & metformin (reduces insulin)

How to treat infertility in polycystic ovary syndrome?

- clomifene~ causes release of GnRH causing ovulation

- chorionic gonadotrophin

- gonadotrophins

What is endometriosis?

when functioning endometrial tissue is found in an abnormal location (outside the uterus)

Symptoms of endometriosis?

- chronic pelvic pain

- dysmenorrhoea

- depression

- menorrhagia

- infertility

- back pain

Why is endometriosis hard to diagnose?

- because symptoms vary from person to person

- location/amount of endometriosis makes it difficult

- difficult to diagnose as it can present as other things

What are the treatments for endometriosis?

- analgesia- NSAIDs, paracetamol

- progesterone

- COCs

- gonadotrophin analogues

- surgery (removal endometriosis or hysterectomy)

- danazol~ inhibits pituitary gonadotrophins causing weak androgenic activity

What drugs can cause infertility?

- cyclophosphamide

- chlorambucil

- methtroxate

- vinicristine

What drugs can cause hyperprolactinaemia?

- methyldopa

- metoclopramide

- cimetidine

What drugs can cause amenorrhoea?

- danazol

- spironalactone

- isoniazid

What drugs can cause erectile dysfunction?

- anti-androgens

- antidepressants

- beta-blockers

- thiazide diuretics