Transcript 3533 Tutorial MT 2

Sex Hormones

Endocrine glands
 Secrete hormones internally (Bloodstream)
 Hormone
○ Complex chemical
○ Specific actions for specific organs

Exocrine glands
 Secrete externally (aweat glands)
Sex Hormones

Hypothalamus
 Controls pituitary
 Dual function
○ As a gland
 Reacts to hormonal levels in the bloodstream
○ As a part of the CNS
 Reacts to higher brain functions (perceptions,
thoughts, feelings, moods)
Testosterone

Bound and free

Men
 95% bound, not active for sexual desire
 5% free

Women
 97-99% bound
 1-3% free
Testosterone

Amount needed varies in individuals of
both sexes. Women more sensitive.

More testosterone does not produce
more sexual desire
Testosterone

Additional testosterone has adverse effects

Men

Women
 Hair loss
 Facial and body hair
 Salt and fluid retention
 Muscle mass
 Possible testicular cancer
 Smaller breasts
 Acne
 Larger clitoris
 Digestive problems
 Voice deeper
 Irritability and aggression
Gestational Development of
Genitals

First seven weeks
 Undifferentiated
 2 gonads
 2 sets of ducts (Mullerian and Wolffian)

7th week
 Y chromosome turns gonad into testicle
Gestational Development of
Genitals

10th-11th week
 Absence of Y chromosome = ovaries develop.
 Both types of gonads start producing their respective
hormones.
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Female:
 Absence of testosterone causes degeneration of
Wolffian ducts
 Mullerian ducts form internal sex organs
Gestational Development of
Genitals

Male
 Testes produce anti-Mullerian hormone, so
they disappear
 Wolffian ducts become internal sex organs
Gestational Development of
Genitals

Tubercle, folds and swelling develop into
external genitals for each sex
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The default model is female
 In the absence of any step to go to the male
model, the child will be female
MENSTRUATION

Onset
 Menarche
○ Mean age: 12.6

1900
 Mean age 16
 Diet changes increases in body fat

20-36 days is normal range

Lasts until Age 45-55
MENSTRUATION
MENSTRUATION
MENSTRUATION
MENSTRUATION
MENSTRUATION
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Changes in cervical mucus during cycle:
 Regular functions of mucus:
○ Lubrication
○ Bacteriostatic
○ pH regulation
 It is cloudy, whitish, thick
MENSTRUATION

Ovulatory cervical mucus:
 Days 12-16 of cycle
 Transparent
 Very stretchy, like raw egg white
 Functions:
○ To help sperm
○ Regulating pH (normal to alkaline)
○ Sugars
○ Conveyor
MENSTRUATION

Toxic Shock Syndrome
 Presence of staphilococcus aureus (ubiquitous)
 Particularly when using tampons
 Can be fatal
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Dioxin
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Bleaching chemicals
Used in “sanitary” products
Powerful carcinogen
Can affect hormones
Immunosuppressant
Endometriosis
MENSTRUATION

Anovulatory cycles
 Adolescents and menopause (climacteric)
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Amenorrhea
 The absence of a menstrual period in a
woman of reproductive age
 After menopause
MENSTRUATION

Dysmenorrhea
 Painful menstruation
 Prostaglandins
○ Hormone-like
○ Secreted by uterus
○ Cause uterine contractions
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Endometriosis
 Endometrium grows outside uterus
 Dysmenorrhea is a symptom
MENSTRUATION
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PMS
Negative expectations
 Unhealthy diet
 No exercise
 Smoking
 Endometriosis
Anxiety
Physical symptoms
Pregnancy
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Prenatal period
 Nine months
 Three trimesters
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Perinatal period
 From beginning of labour to 72 hrs.
postpartum
Conception

Requires the following
 Adequate sperm count
 Changes in vaginal mucus
 Open Fallopian tubes
 Normal ovulation
 Normal hormonal levels
Infertility

Most common reason for infertility:
 STDs in both men and women
 Lead to infertility
 Blocked Fallopian tubes or vas deferens
Pregnancy

Stages of uterine development
 Zygote:
○ 1-14 days
 Embryo:
○ 3-8 weeks
 Fetus:
○ 9-40 weeks
Reproductive Technologies

Artificial Insemination
 Introducing sperm into woman’s vagina or
uterus by artificial means

in vitro fertilization (IVF)
 Test tube or Petri dish used to mix gametes
 Once dividing, surgically implanted into
woman’s uterus
Prenatal Diagnosis
Tests for chromosomal abnormalities
and fetal infections
 Amniocentesis
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 11-14 weeks
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Chorionic villus sampling (CVS)
 6-8 weeks
Physical and Psychological
Changes During Pregnancy
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1st trimester:
 Enlarged, tender breasts
 Amenorrhea
 Nausea (⅓ severe,⅓ mild, ⅓ none)
 Sleepiness (⅔)
 Aversion to some foods, odors
 Increased urinary frequency (hormonal)
 Mixed emotions, ambivalence, anxiety and
exhilaration
Physical and Psychological
Changes During Pregnancy
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2nd trimester:
 Quickening
○ Initial motion of the fetus in the uterus
○ As it is perceived by the pregnant woman
 Increased girth and well-being
 Mostly positive outlook, energy
 Preparatory behaviors, prenatal classes
 Some who rejected pregnancy accept it
Physical and Psychological
Changes During Pregnancy
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3rd trimester:
 Large abdomen, awkward
○ Difficulty turning over in bed
 Lost sleep due to
○ Frequent urination (weight of uterus on
bladder)
○ Activity of fetus
 Anxiety increases (delivery, birth defects)
 Differences between fit and unfit women
Physical and Psychological
Changes During Pregnancy
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Possible pregnancy complications
 Edema
 Hypertension
 Gestational diabetes
○ Proteinuria
 Threatened early labor
Physical and Psychological
Changes During Pregnancy

Male
 Economic worries
 Feeling left out
 Couvade
○ Experiences some of the same symptoms and
behavior as the mother near the time of labor
○ Actual changes in hormonal levels
 Before birth, more prolactin and cortisol
 After birth, less testosterone
Teratogens
Teratogens
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Smoking
 CO
○ 200 times more affinity to Hgb than oxygen
 Oxygen supply compromised (5% less)
 Decreases sperm motility
○ Lower fertility
 Less progesterone
○ Miscarriages
 Placental problems
 Higher morbidity and mortality
○ From 9/1000 to 33/1000
 Higher rates of cleft palate and hare lip
Teratogens
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Alcohol
 FASD (fetal alcohol spectrum disorder)
○ Brain abnormalities
 learning difficulties
 ADDH
 Mental retardation, etc.
○ Possible damage to eyes, ears, immune
system, internal organs, joints, limbs
○ Low birth weight
○ Increased prematurity, miscarriage and
stillbirth risk
Teratogens
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Alcohol
 FASD (fetal alcohol spectrum disorder)
○ Growth retardation
○ Facial and cranial malformations
○ Dose and timing related
○ No safe dose
○ There is no cure for FASD
○ Leading cause of preventable mental
retardation
Teratogens
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Maternal Diseases
 Rubella
 Toxoplasmosis
 CMV
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Radiation
High temperature (hot bath)
Environmental Pollution
 Phthalates
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Drugs
 Prescription
○ Thalidomide
 Recreational
 Interactions
Teratogens
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Maternal stress
 Acute or chronic (worse)
 Adrenaline, corticosteroids
○ Compromise oxygen supply for infant
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After birth
 Digestive problems
 Low birth weight
 Irritability
Teratogens
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Maternal age
 No more obstetrical complications (if
healthy)
 Increased Down’s syndrome
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Other effects of these variables
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Affect maternal-infant interaction
Abuse
Neglect
Rejection
Maternal Nutrition
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First trimester
 Usually not an issue
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Second trimester
 Quality
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Third trimester
 Quality and quantity
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Folic acid
 Prevents neural tube defects (spina bifida)
Maternal Nutrition
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Infant Optimal Weight
 7½ - 8 lbs. (European stock)
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Low Birth Weight
 5½ lbs. or 2,500 g
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Montreal Diet Dispensary
 500 extra daily calories:
○ 1 qt. milk
○ 1 egg
○ 1 orange
Birth
LABOUR
 Fetal hormone signals mom’s
hypothalamus
 Produced when fetal lungs ready to
breathe
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Hypothalamus stimulates pituitary
 Pituitary secretes oxytocin
○ Oxytocin makes uterus contract
 Labour begins
Labour
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First stage:
 Early first stage
○ Longest (hours or days)
○ Mild contractions, relatively short
○ Relatively large intervals
 Late first stage
○ Shorter than early stage
○ Contractions longer and at much shorter intervals
 Transition
○ Shortest
○ Most intense
○ Random pattern of contractions.

All along, cervix dilating and effacing (thinning)
Labour

Second stage:
 Cervix fully dilated (10 cm)
 Baby moves down birth canal
 Crowning
 Duration
○ Primiparas
 About 1 hr.
○ Multiparas
 Faster
 Head first, rotation
Labour

Third stage:
 After 10-15 min interval
○ Expulsion of placenta
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During interval between stages 2 and 3:
 Lungs start to work gradually
 Cord delivers last of maternal blood to infant
 Heart valves close
 Cord must not be cut until white and not
pulsing
Labour
POSITIONS FOR LABOUR
 Lithotomy Position
 Weight of uterus and its content on
abdominal aorta
○ Can cause reduced blood flow to fetus
○ Slows down labour
○ Importance of gravity’s help
Labour

Better Positions
 Sitting up reclined
 Lying on her side
 On hands and knees

Unmedicated, undisturbed birth best
 90-95% births do not need intervention.
RISKS OF INDUCING LABOUR
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Induction of labour with pitocin
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Contractions too hard
 Lead to more analgesics and anesthetics
 Uterine rupture and to brain damage
(pressure on the skull)
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If lungs not ready, leads to respiratory
distress due to lack of surfactin
POSSIBLE COMPLICATIONS (5-10%)
Placenta previa
 abruptio placenta
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 Separation of the normally located placenta
Transverse or breech presentation
 Prolapsed cord
 Cord pinched or wrapped around neck
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POSSIBLE COMPLICATIONS
All
carry risk of hypoxia or anoxia
Hypoxia
 Reduced oxygen
Anoxia
 NO oxygen
Consequences
 Brain damage
 Detectable or subclinical
Common interventions
C-section
Major abdominal surgery
Possible lack of adrenaline/noradrenaline in baby
N. American C-sec rates too high
Pain
medication (analgesics and
anesthetics)
Can slow down labour and decrease oxygen
delivery to baby
EFFECTS OF ANESTHETICS AND ANALGESICS
Slow
down labour (leading to pitocin use)
Sluggish baby
Mother zonked, weak
Can interfere with bonding
Can interfere with lactation
Can interfere with rooming-in
HUMAN LACTATION

Mammals perfected milk for their young over
millions of years of evolution

Each species has the perfect milk for its own
young, for optimal adaptation to environmental
demands
 Chemical composition very varied

Production of both prolactin and oxytocin respond
to demand
 More sucking = more hormonal output.
Advantages for infant

Nutritional
 Smooth adaptation period from intra to
extra-uterine life
○ (Shortened gestation – 9 months instead of 12
as other primates)
 Species-specific
○ Each species has different developmental
needs
○ Right amounts of the right nutrients
Advantages for infant

Nutritional (Cont’d):
 Non-allergenic
 100% digestible, no waste
○ Bioavailability of nutrients
 Lower renal solute
 unlikely to overfeed due to changing
composition through a feed
○ Lower risk of later obesity
 Brain development
Immunological advantages

Fresh antibodies in each drop
 Infant has immature immune system
 Mammary gland makes antibodies in situ
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when a new pathogen appears in the
environment
Lactobacillus bifidus prevents gut colonization
by harmful bacteria
Lower morbidity and mortality
Benefits for lactating mother
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Uterus back to pre-pregnant state due to
oxytocin-induced contractions
Contraception**
Breast cancer protection
Skeletal calcium deposits (lower
osteoporosis risk)
Weight loss
Stress control (hormonal)
Bonding