Professional Documents
Culture Documents
5 Gonadal Hormones
5 Gonadal Hormones
5 Gonadal Hormones
.
Hormonogenesis
Testosterone: predominant hormone secreted
by the testes
Controlled by pituitary hormones:
Follicle-stimulating hormone (FSH)
acts primarily on germinal stem cells
Luteinizing hormone (LH)
acts primarily on the Leydig cells
l o c at e d in the testicular insterstitium
synthesize testosterone
Hormonal Control of Testicular
Function
Prenatal Development
The primitive gonads b e c o m e distinguishable at about the seventh
week of embryonic stage.
Both chorionic gonadotropins a n d fetal LH stimulate
production of testosterone by the fetal Leydig cells.
Exposure of testosterone to the Wolffian duct leads to
differentiation of the various components of the male genital tract.
Sertoli cells produce müllerian regression factor, which aids
in regression of the female primordial genital tract. The scrotal
skin is rich in 5-reductase, which converts testosterone to DHT.
Fetal exposure to drugs that block this hormone leads to
feminization of the male fetus.
Cellular Mechanism of
Testosterone Action
Postnatal Development
Development of secondary sex hair (face, chest, axilla, an d pubis),
enhanced linear skeletal growth, development of internal a n d
external genitalia, increased upper body musculature, a n d
development of larynx an d vocal cords with deepening of the
voice.
Possible m o o d changes an d aggression are undesired effects that
may occur during puberty.
The linear growth effects of testosterone are finite, with epiphysial
closure when genetically determined height is achieved.
Hypogonadism during puberty leads to imprecise
closure of growth plates, leading to excessive height, long
limbs, a n d disproportionate upper an d lower body
segments.
Cellular Mechanism of
Testosterone Action
Prolactin elevation
Drug-induced
Prolactin-producing tumors of the
pituitary
Age
Secondary disease
destruction of the pituitary
FSH and/or LH levels
inappropriately normal or low
Primary disease
Pituitary MRI should b e done
destruction of the testes
in young individuals
FSH and/or LH levels
are elevated
Diagnosis of Hypogonadism
Older individuals
Secondary or tertiary (hypothalamic)
dysfunction
Reduced hypothalamic pulse generator
frequency
Resulting in low or inappropriately normal FSH and/or LH
levels
TANNER STAGING OF GENITAL
AND PUBIC HAIR DEVELOPMENT IN
MALES
STAGES OF GENITAL
DEVELOPMENT
1 Prepubertal
2 Enlargement of scrotum
and testes
3 Increased length of penis,
further enlargement of testes
4 Enlargement of testes,
scrotum, and penis with
growth of glans; darkening of
scrotal skin
5 Mature genitalia
TANNER STAGING OF GENITAL
AND PUBIC HAIR DEVELOPMENT IN
MALES
Parenteral testosterone
Transdermal testosterone therapy
Testosterone gel
Buccal testosterone
Complications of testosterone replacement
polycythemia
prostate enlargement
possible growth-promoting effect on undiagnosed prostate cancer
worsening of obstructive sleep a p n e a
peripheral e d e m a
gynecomastia
Hormonal Production by the
Ovaries
Activin
enhances FSH secretion an d induces
steroidogenesis
Folliculostatin, relaxin, follicle
regulatory protein, oocyte maturation
factor, and meiosis-inducing substance
important yet not clearly
characterized functions
The Menstrual Cycle
Anovulation an d amenorrhea
Injury to the hypothalamus
Presence of either psychosocial or
physical stressors
Changes in hormonal cues
TANNER STAGING OF BREAST
AND PUBIC HAIR DEVELOPMENT IN
FEMALES
STAGES OF BREAST
DEVELOPMENT
1 Prepubertal
2 Elevation of
breast b u d a n d
papilla, areolar
enlargement
3 Elevation of breast
tissue an d papilla
4 Elevation of areola a n d
papilla in secondary mound
a b ov e the level of the
breast
5 Mature stage: recession of
areola into the breast with
projection of papilla only
TANNER STAGING OF BREAST
AND PUBIC HAIR DEVELOPMENT IN
FEMALES
Abnormalities
Am enorrhea
O lig om enorrhea
M enorrha g ia
Amenorrhea
Absence of menses
Primary amenorrhea
Has never menstruated
Secondary amenorrhea
A t least one menstrual cycle followed by
absences of menses for a minimum of 3–
6 months
Oligomenorrhe
a
↑ incidence of
invasive ↓ bone loss
breast cancer
↓ colon
↑ venous polyp
clot formation
formation
↓
no benefit in menopausal
cognitive decline symptoms
or coronary artery
hot flashes
disease
Vaginal
dryness
MISCELLANEOU
S ENDOCRINE
GLANDS
KIDNEYS
PANCREA
S GASTROINTESTINAL
TRACT
PLACENT
A
KIDNEY
S
RENI
N
ERYTHRO PO IE
TIN 1,25-DIHYDROXY
VITAMIN D3
SECRETI
N
CHOLECYSTOKINI
N
SECRETI
N