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endocrinology obgyn diagnosis gynecology menstrualcycle ovariancycle pathophysiology causes differential algorithm amenorrhea androstenedione aromatase estradiol management secondary testosterone treatment uterinecycle 17bhydroxysteroid
ACTH LH Cholesterol cholesterol desmolase Pregnenolone 17a-hydroxylase 17 Hydroxyregnenolone 17,20-lyase 3B-hydroxysteroid dehydrogenase 3B-hydroxysteroid dehydrogenase 17a-hydroxylase #Progesterone 17-Hydroxyprogesterone 17,20-lyase 21ß-hydroxylase 21ß-hydroxylase 11-Deoxycorticosterone 11-Deoxycortisol 11ß-hydroxylase 11ß-hydroxylase #Cortisol #Dehydroepiandrosterone #DHEA 3ß-hydroxysteroid dehydrogenase 个 #Androstenedione #17B-hydroxysteroid #dehydrogenase #Testosterone #aromatase #FSH #Estradiol #5a reductase #Corticosterone aldosterone synthase #Aldosterone Angiotensin || #Dihydrotestosterone (DHT)
17a-hydroxylase #Progesterone
Menstrual Cycle Physiology: the Uterine Cycle The endometrium has receptors for ovarian hormones! Changes in structure and
Note: The drop in progesterone ... short course of progesterone ... days once the progesterone ... termination of progesterone ... days once the progesterone
Contraception and CKD Preferred Contraception in kidney disease: Intrauterine devices and progesterone only methods Avoid combined progesterone/estrogen pills #Contraception
Intrauterine devices and progesterone ... Avoid combined progesterone
Menstrual Cycle Physiology: Ovarian Cycle – Luteal Phase Explained • The LH surge can be thought
to run and make progesterone ... of estrogen and progesterone ... large amount of progesterone ... combination of high progesterone ... corpus luteum so progesterone
Menstrual Cycle Physiology: Correlating the Ovarian and Uterine Cycles Note: Some charts show different relative levels of
to estrogen and progesterone ... estrogen with progesterone ... which secretes progesterone ... sharp decline in progesterone ... hormones, mostly progesterone
Causes of Secondary Amenorrhea - Differential Diagnosis Algorithm Absence of menses for more than 3 cycles or
syndrome (positive progesterone ... Hypothalamic - Negative progesterone
Menstrual Cycle Physiology: Ovarian Cycle – Brief Overview LH and FSH are required for follicular development and
pregnancy occur -> Progesterone
Causes of Primary and Secondary Amenorrhea - Differential Diagnosis Algorithm Primary Amenorrhea - No onset of menarche
Hypothalamic - Negative progesterone
#LH #Cholesterol t cholesterol desmolase (#thecal cells) V 3ß-hydroxysteroid dehydrogenase Pregnenolone Progesterone 17a-hydroxylase 17-Hydroxypregnenolone 17,20-lyase Dehydroepiandrosterone 3ß-hydroxysteroid dehydrogenase #Androstenedione 17B-hydroxysteroid dehydrogenase FSH V #Testosterone Đ #aromatase (granulosa cells) V #Estradiol
Pregnenolone Progesterone
PCOS Treatment 1st line = weight loss • 5-10% weight loss can restore ovulatory cycles • Improvement
norethindrone • Progesterone
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