endo exam 3 reproduction n clinical concepts

Fetal T vs DHT developmental roles?

T → internal ducts; DHT → external male genitalia

What happens in complete AIS?

XY with nonfunctional AR, female-appearing external genitalia, no uterus

What happens in 5α-reductase deficiency?

Low DHT, underdeveloped external genitalia, male internal ducts present

Primary vs secondary male hypogonadism location?

Testes vs pituitary/hypothalamus

Mumps orchitis causes which form?

Primary hypogonadism

Meningitis or pituitary injury causes which form?

Secondary hypogonadism

Classic BPH symptom cluster?

Weak urinary stream, dribbling, nocturia, incomplete emptying

What promotes prostate growth in BPH?

DHT

Testosterone patch vs gel from D'Souza slides?

Patch slight fluctuations; gel minimal fluctuations

Depot testosterone drawback?

Peaks/troughs between doses

Two main types of androgen action?

Androgenic sexual changes; anabolic muscle/bone/RBC changes

Effect of testosterone on RBC production?

Increases erythropoiesis

Why doesn't taking extra T enhance sperm production?

Negative feedback suppresses LH/FSH and intratesticular T

Age-related T decline before TRT: main assessment?

Check symptoms, contraindications and prostate health

Menstrual cycle early phase dominant hormone?

Estrogen in follicular/proliferative phase

Luteal phase dominant hormone?

Progesterone

What triggers ovulation?

LH surge

Which hormone maintains corpus luteum early pregnancy?

hCG

What triggers normal menstruation without pregnancy?

Corpus luteum regresses → E/P fall

Estrogen action on cervical mucus?

Thinner, watery

Progesterone action on cervical mucus?

Thicker, sticky

Estrogen effect on endometrium?

Promotes proliferation

Progesterone effect on endometrium?

Supports secretory maintenance; opposes estrogen growth

Progesterone effect on uterine contractility?

Reduces uterine contractions

Why can estrogen without progestin raise endometrial cancer risk?

Unopposed endometrial proliferation

Which estrogen is most potent in lecture?

Estradiol

What is a progestin?

Synthetic drug with progesterone-like actions

Monophasic COC definition?

Same hormone dose in each active tablet

Multiphasic COC definition?

Active hormone dose changes during pack

Traditional mini-pill ovulation suppression?

Not consistent (lecture ~60–80% of cycles)

Main mini-pill pregnancy-prevention backup mechanism?

Cervical mucus thickening

Most important adverse effect in mini-pill lecture?

Irregular menstrual bleeding

Difference between gender identity and sexual orientation?

Internal gender sense vs whom a person is attracted to

What is gender dysphoria?

Distress some experience from gender/assigned-sex incongruence

Are hormones necessary for every transgender person?

No; goals and interventions are individualized

Nonpharmacologic gender-affirming options?

Binding, tucking, packing, hair removal, voice training

Typical feminizing therapy medications?

Estradiol; sometimes spironolactone/GnRH agonist

Typical masculinizing therapy medication?

Testosterone

Permanent masculinizing effect emphasized?

Voice deepening

Estrogen effects in feminizing therapy?

Breast growth, fat redistribution, reduced muscle mass

Testosterone effects in masculinizing therapy?

More muscle/hair, voice deepening, menses suppression

What should be discussed before gender-affirming hormones?

Fertility/family planning

What organ-based screenings are important?

Screen based on organs present (cervix, breasts, prostate)

Examples of healthcare access barriers in lecture?

Insurance/record mismatches, discrimination, limited trained clinicians