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Gyn Hormones
Gynecology
| Question | Answer |
|---|---|
| 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
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