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Gyn Hormones

Gynecology

QuestionAnswer
Primary estrogen in PG Estriol (E3); produced in placenta
Before menopause, primary circulating estrogen = Estradiol (E2); serum estradiol levels 30-200 pg/mL
After menopause, primary circulating estrogen = Estrone (E1); secreted by ovary; mean serum estradiol levels < 15 ng/mL
Induces glandular secretion in endometrium: Progesterone
Main role of testosterone in women estrogen precursor
Decreased testosterone levels in females cause: decline in libido, mood changes
Progesterone produced where? in corpus luteum after ovulation; by placenta in PG
Progesterone levels rise rapidly after: ovulation
FSH fn: binds to granulosa cells and stimulates estradiol secretion
In a state of estrogen deficiency, more ____ is secreted FSH
During luteal (secretory) phase, ______ are suppressed to low levels FSH and LH
Plasma LH surge precedes ovulation by 24-36 hrs
Estrogen pattern during menstrual cycle Secretion peaks just before midcycle, drops sharply with ovulation, rises again to plateau, then decreases again before menstruation
During luteal (secretory) phase, predominant hormone changes from: estradiol to progesterone
Adequate progesterone production is necessary to facilitate: implantation and sustain early pregnancy
Progesterone MOA Acts primarily on endometrium, initiates secretory phase
Results of hyperprolactinemia Loss of libido; Galactorrhea; Oligomenorrhea/ amenorrhea; Infertility; Decreased muscle mass; Osteoporosis
Decreased _____ levels in females cause decline in libido, mood changes testosterone
Hormone levels in PG: FSH/LH low; progesterone high
Primary test of menopause: FSH
GnRH Low: hypothalamic hypogonadism, dopamine, opiates
GnRH high: primary hypopituitary hypogonadism, epinephrine
GnRH testing: avoid: steroids, ACTH, gonadotropin or estrogen medications for ≥48hrs
FSH low: secondary gonadal failure, stress, malnutrition/anorexia, severe illness, hyperprolactinemia, PG
FSH high: primary gonadal failure, castration, alcoholism
LH low pit or hypothalamic failure, severe stress, anorexia, malnutrition, severe illness, PG, hemochromatosis, sickle cell anemia, hyperprolactinemia
LH high gonadal failure, precocious puberty, pituitary adenoma, menopause, PCOS
LH: Best time to obtain single specimen between 11am and 3pm
Progesterone low preeclampsia, threatened abortion, placental failure, fetal demise, ovarian neoplasm, amenorrhea, ovarian hypofunction, PCOS
Progesterone High: ovulation, PG, hyperadrenocorticalism, adrenocortical hyperplasia, luteal cysts, molar pregnancy, choriocarcinoma
Induces glandular secretion in endometrium: Progesterone
Physiologically most important estrogen Estradiol (E2); produced in ovary; peaks in ovulatory phase; FB to inc LH & decrease FSH
Major circulating estrogen after menopause estrone (E1); secreted by ovary
part of maternal serum quad test Estriol (tests looking for trisomy/Down syndrome)
main role of testosterone in women estrogen precursor
Decreased testosterone levels in females cause: decline in libido, mood changes
FSH assays done to dx: menopause, menstrual irregularities, gonadal failure, predicting ovulation, evaluating infertility, pituitary disorders
Progesterone produced where? in corpus luteum after ovulation; by placenta in PG
Progesterone levels rise rapidly after: ovulation
Estrogen: high precocious puberty, ovarian tumor, adrenal tumor, gonadal tumor, normal pregnancy, cirrhosis, liver necrosis, hyperthyroidism
Estrogen: Low failing PG, Turner syndrome, hypopituitarism, hypogonadism, Stein-Leventhal syndrome, menopause, anorexia, PCOS
Major estrogen in PG Estriol (E3); produced in placenta
Max testosterone values when: around 7am and 8pm
testosterone high: ovarian tumors, adrenal tumor, congenital adrenocortical hyperplasia, trophoblastic tumor, PCOS, idiopathic hirsutism, drugs
testosterone low: primary/ secondary ovarian failure, drugs
FSH fn: binds to granulosa cells and stimulates estradiol secretion
In a state of estrogen deficiency, more ____ is secreted FSH
During luteal phase, ______ are suppressed to low levels FSH and LH
Plasma LH surge precedes ovulation by 24-36 hrs
Estrogen during menstrual cycle Secretion peaks just before midcycle, drops sharply with ovulation, rises again to plateau, then decreases again before menstruation
During luteal phase, predominant hormone changes from: estradiol to progesterone
Adequate progesterone prodn necessary to facilitate: implantation and sustain early pregnancy
Progesterone MOA Acts primarily on endometrium, initiates secretory phase
Progesterone w/drawal test evaluates: H-P-gonadal axis
Progesterone withdrawal test: in normal cycle, progesterone surge: inhibits FSH/LH and leads to withdrawal bleeding
Progesterone withdrawal test: probs causing failure of bleeding: Estrogen production inadequate; Hypothalamic dysfunction; Uterus abnormal
Prolactin high pit adenoma, 2d amenorrhea, galactorrhea, hypothyroid, hypoglycemia, PCOS, anorexia, paraneoplastic syndromes, dz of hypothalamus /pituitary stalk, renal fail, drugs lowering dopamine, high estrogen
Prolactin low Sheehan syndrome, pituitary destruction by tumor
Prolactin levels should be collected: 3-4hrs after waking
Prolactin level: to dx: pituitary adenoma, amenorrhea, galactorrhea, hypothalamic pituitary disorders
Results of hyperprolactinemia Loss of libido; Galactorrhea; Oligomenorrhea/ amenorrhea; Infertility; Decreased muscle mass; Osteoporosis
Current hCG test is what type test: monoclonal Ab
Urine hCG tests may be negative when: serum test is positive
hCG high: PG, ectopic, molar pregnancy, choriocarcinoma, germ cell tumors, hepatomas, lymphoma
hCG low: threatened or incomplete abortion, fetal demise
Half life of hCG: 3-7 days
Decreased _____ levels in females cause decline in libido, mood changes testosterone
PCOS: lab values LH, testosterone, prolactin high; progesterone, estrogen low
Created by: Abarnard