Menopause and Hormone Replacement Therapy Lecture – Flashcards

Scientists and doctor's view of the benefits and risks from this has changed rapidly, and women have been advised to take and avoid HRT, much like being in a game of ping pong

book that promised taking estrogen would ease symptoms of menopause and fend women off from chronic diseases recommendations was that women over 50 would begin using estrogen therapy (premarin) sales shot up

Then doctors and scientists realized that taking estrogen alone increased the chances of developing endometrial cancer.

correlative studies between women taking estrogen and low heart attack rates, doctors began to recommend estrogen plus progesterone therapy. But correlations do not prove causation. For example, is it that estrogen plus progesterone reduces heart attacks or is it that women who take hormones are health conscious and also stay more fit

(six times higher than breast cancer). Based on correlative studies, researchers hypothesized that HRT would reduce the incidence of heart disease in women who used it

Researchers could not tell whether taking hormone replacement therapy made women healthy or whether healthy women were more likely to take hormones. Because this was only a correlation, researchers wanted to determine if the cause of the lowered risk of heart disease could be attributed to the HRT b/c women who took HRT may have more financial resources and better health care than women that didn't use HST

has helped shed light on hormone replacement therapy and its affects on women WHI conducted a study of thousands of women and examined effects of HRT in a two group experimental design (women taking HRT or placebo) results-2002, HRT increased risk of heart attacks, stroke, and blood clots HRT (estrogen + progesterone) increased risk of breast cancer

spread via the lymphatic and circulatory systems to important organs in the body. Cancer kills by interfering with important organ functions

lymphatic vessels are responsible for returning body fluids from tissues throughout the body to the bloodstream. The lymphatic vessels are spread throughout the body and can, therefore, carry cancer cells far from their point of origin

blood vessels, like the lymphatic vessels, are spread throughout the body and can, therefore, carry cancer cells far from their point of origin

Estrogen may be good for women in their 50's. By good, it helps reduce the symptoms of menopause. It should be taken with progesterone unless the woman has had a hysterectomy, a surgical procedure that removes the uterus. But if used, it should be used in a small dose and for a short amount of time new research suggests estrogen may be good for women in 50s but not older age may be imp

1. do use estrogen if needed for hot flashes, night sweats and other symptoms 2. Don't take it to prevent heart disease, osteoporosis, or other chronic conditions. 3. Do use estrogen in the smallest dose possible for the least amount of time. 4. Do take it with progesterone unless you have had a hysterectomy

hormone therapy experts treat symptoms with lowest effect dose for the shortest time possible and do NOT use it to prevent disease

follicle of ovary oviduct uterus vagina

site of gamete formation (egg or ovum) and hormone production. Within the ovary are thousands of follicles. Follicles are "nests" of ovary cells that surround an immature egg and produce estrogen. Each month from puberty until menopause, one follicle will respond to reproductive hormones (explained later) and grow to produce a mature egg which will be ovulated into the Oviduct

tube which travels from the ovary to the uterus; site of egg fertilization by sperm cell

muscular organ where implantation of the blastocyst (pre-embryo) and development of the fetus occurs. Inner layer of uterus is called the endometrium

layer of the uterus which becomes highly vascular in preparation for implantation of embryo. This layer is shed each month when pregnancy does not occur.

"neck" of the uterus which extends into the vaginal canal. Sperm must swim through the cervix to enter the uterus and a baby much exit through the cervix. The cervix is a common site of cancer in the female reproductive system. Pap smears are used to detect cancer of the cervix.

muscular tube that receives the penis during intercourse; site of sperm deposition. The vagina also serves as the birth canal.

is controlled by the hormones of the female reproductive system and is closely tied to the ovarian cycle cyclic buildup and breakdown f the endometrium as the uterus prepares monthly for an embryo (fertilized egg)

1840s: 17 1960: 13 2017: not unusual at 10

Glandular tissue in one of the endocrine organs of the body produce hormones which travel through the bloodstream to other body parts (target tissues) where they elicit a response.

1. At puberty the hypothalamus in the brain begins producing "releasing hormones" (GnRH) which controls the activity of the pituitary gland. 2. The pituitary responds to the releasing hormones by producing it's own hormones; LH and FSH. 3. FSH and LH travel through the bloodstream to the ovary where they cause changes to occur in the ovary. 4. In response to FSH, the cells around one early stage ovum (called a follicle) begin to grow and produce estrogen which causes female sex characteristics and causes the endometrium of the uterus to prepare for a pregnancy. 5. In response to LH, the follicle (with the developing egg inside) ruptures and the 27 egg is released. 6. After ovulation, the "old" follicle produces progesterone which causes the endometrium of the uterus to be maintained in case of pregnancy.

the principle way the body maintains homeostasis (a relatively constant internal environment). When estrogen and progesterone levels rise, they have a negative effect on the hypothalamus and pituitary which slows their production of GnRH, FSH and LH. Once estrogen and progesterone levels drop low enough, this will cause the hypothalamus and pituitary to begin production again. Negative feedback will keep these sex hormones in balance from puberty until menopause.

Note that around day 12 or 13, the levels of these hormones "surge". This surge in hormones will cause the developing follicle in the ovary to release an egg into the oviduct where it may be fertilized.

The FSH causes cells around the developing ovum (the follicle) to begin to grow. As the follicle grows, the cells of the follicle begin producing estrogen which is responsible for female sex characteristics. The surge of LH around day 13 causes the mature follicle to rupture and release the ovum into the oviduct where it may be fertilized by a sperm.

Estrogen which is responsible for female sex characteristics and the 28 thickening of the uterine lining is produced by the developing follicle in the ovary. As the follicle is growing during the first 14 days of the cycle, the estrogen levels begin to climb. Progesterone which is produced by the follicle after the egg has been ovulated is not produced in large quantities until after day 14 (ovulation). Progesterone maintains the uterine lining in case of pregnancy.

Note that when the levels of estrogen and progesterone are low, the endometrium breaks down and is sloughed off. When the levels of estrogen and progesterone rise, the endometrium thickens. In order for pregnancy to occur, the endometrium must be thick and filled with blood vessels. Note that it is after ovulation (when fertilization can occur) that the endometrium is thickest

In response to FSH from the pituitary gland, one follicle will begin to grow (each month). By day 14, the follicle is "mature" and is ready to release the egg. Ovulation is the rupturing of the mature follicle in response to the surge of LH from the pituitary gland. The egg is then available to be fertilized by a sperm. After ovulation, the follicle closes up and forms the corpus luteum that produces the hormone progesterone which regulates the uterine lining in case of pregnancy.

1. pituitary produces FSH and LH 2. FSH and LH cause follicle to develop and release egg 3. follicle produces estrogen and progesterone 4. estrogen and progesterone thick endometrium to prepare for implantation if fertilized egg and suppress production of FSH and LH 5. egg is either fertilized or not

1. implants in endometrium and begins to grow 2. developing embryo sends out hormonal message (HCG) to old follicle (corpus lute) to let know an embryo is presence and halt menstrual cycle to maintain endometrium for developing fetus throughout rest of pregnancy 3. HCG is produced by embryo (not mother) and presence in blood and urine indicates pregnant, old follicle produces estrogen and progesterone to maintain endomentrium

Once the egg is ovulated from the ovary it enters into the oviduct (fallopian tube). It is in the oviduct that the egg may be fertilized by a sperm. After fertilization, the cell is now called a zygote. The zygote undergoes cleavage division in which the DNA is copied and cleavage divides the cell into two identical cells. Cleavage is a special type of mitosis. During cleavage division, the cell mass does not enlarge, but rather the number of cells increases with each new cell being smaller than the original one.

Cleavage divisions continue until the cell mass takes on a hollow ball formation with an inner cell mass. This stage is called a blastocyst. The inner cell mass is made up of identical cells (called stem cells) that are undifferentiated. Stem cells will be a topic of later lectures. The blastocyst travels down the oviduct and into the uterus where it will implant into the endometrium and begin developing into an embryo.

the inner cell mass will develop into the embryo while the trophoblast (the rest of the blastocyst) will aid in implantation into the uterine wall and will contribute to part of the placenta

There is a long period of time when unprotected sex can result in pregnancy. The unsafe days last from the 10th day of the month to the 17th day of the month. Few women have regular cycles from month to month, so this is only an estimate of when women may become pregnant

Without the hormonal message coming from the developing embryo, the usual course of the menstrual cycle ensues. 1. unfertilized egg does not implant 2. no hormonal messages is sent to the old follicle and it stops production of estrogen and progesterone 3. without estrogen and progesterone, the endometrium breaks down and the menstrual flow occurs

the estrogen and progesterone levels in the blood decline, and the endometrium breaks down

combination of synthetic estrogen and progesterone hormones

use of the pill was extremely controversial in some areas of US society. During the 1960's, women usually had to be married to get it. There were laws in the US that prevented contraception being used and these laws were struck down by the Supreme Court in the 1960's 2010, 100 mil women use the pill

often begin in a woman's 40's and include symptoms which may last for several years. Menopause involves a halt in estrogen production and an end to menstrual cycles. The average age of menopause today is 51 -woman's 40s, estrogen production declines -preimenopause may last for 5 yrs -eventually pre stops and menopause b/w 45 to 55 yrs of age

hot flashes, dry skin, brittle hair, insomnia, vaginal dryness, mood swings, skipped periods

technically correct, there must be a distinction between these two stages. Perimenopause is the time period of hormonal fluctuation when a woman experiences the symptoms of "menopause". Actual menopause is after 12 consecutive months of no menstrual flow indicating that hormone production has ended -the uneven rising and falling of hormone levels during preimenopause may be responsible for menstrual irregularities and other problems associated with menopause

a bone thinning disease that sets the stage for serious fractures common during menopause rapid loss in menopause