3rd yr med student seminar, cases in reproductive endocrinology. To follow REI part I

1. Variations on a Theme Hormones In Real Life

2. 7 year old with breast budding & leukorrhea AGE Normal or abnormal ? SEQUENCE of puberty? TIME frame? HORMONE culprit? TREATMENT options?

3. 16 year old with amenorrhea Age- Normal or abnormal? Sequence? Time Frame? Hormone issues? Treatment Options?

4. 20 year old with PMS PROGESTERONE Made by the corpus luteum Bloating/ constipation Headache Mood changes Acne Fatigue PROSTAGLANDINS Made by the endometrium Cramps Nausea/ diarrhea

5. 31 y/o desiring pregnancy Basics: Eggs Sperm Must get together Progesterone Tests? Treatments?

6. 37 y/o with irregular periods Frequency? Duration? Total Volume? Causes? Form (anatomy) Function (hormonal) Tests? Treatment Options? www.asrm.org

7. 42 y/o with increased facial hair Pattern? Hormonal cause? Sources? Tests? Treatments?

8. 45 y/o G4 P3 with decreased libido “Female sexual desire is highly contextual & discontinuous throughout a woman’s lifetime. Desire and response ebb & flow & are dependent on current contextual & relationship variables, as well as historical, biographical, & hormonal factors. In contrast, male sexual desire generally remains fairly constant.”

9. 52 y/o with ostepenia Urogenital tissues Vagina (pH) Bladder Sexual fctn Bone loss Risk factors Treatment Hot flashes

12. What to DO???

13. Assessment and Plan for MOM Risk factors: Female age>50 menopausal smoker low BMI Family history ethnicity corticosteroids vitaminD EtOH (>3/d) Prev osteoporotic fracture RhemArth Screening: What? When? Lifestyle recommendations: ________________________________ ________________________________ Prevention/ Treatment: Estrogen yes no why? _______________________ SERM yes no why? _________________________ Bisphosphonate yes no why?___________________ Follow-up:_____________

14. Thanks !