Variations on a ThemeHormones In Real Life

7 year old with breast budding & leukorrhea

AGE Normal or abnormal ?

SEQUENCE of puberty?TIME frame?HORMONE culprit?TREATMENT options?

16 year old with amenorrhea

Age- Normal or abnormal?

Sequence?Time Frame?Hormone issues?Treatment Options?

20 year old with PMSPROGESTERONE

Made by the corpus luteum

Bloating/ constipation

HeadacheMood changesAcneFatigue

PROSTAGLANDINSMade by the

endometriumCrampsNausea/ diarrhea

31 y/o desiring pregnancyBasics:

EggsSpermMust get togetherProgesterone

Tests?Treatments?

37 y/o with irregular periodsFrequency?Duration?Total Volume?Causes?

Form (anatomy)Function (hormonal)

Tests?Treatment Options?www.asrm.org

42 y/o with increased facial hair

Pattern?Hormonal

cause?Sources?Tests?Treatments?

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.”

52 y/o with ostepeniaUrogenital tissues

Vagina (pH)BladderSexual fctn

Bone lossRisk factorsTreatment

Hot flashes

What to DO???

Assessment and Plan for MOMRisk factors:

Female age>50 menopausal smoker low BMIFamily history ethnicity corticosteroids vitaminD EtOH (>3/d) Prev osteoporotic fracture Rhem Arth

Screening:What? When?

Lifestyle recommendations:________________________________________________________________

Prevention/ Treatment:Estrogen yes no why? _______________________SERM yes no why? _________________________Bisphosphonate yes no why?___________________

Follow-up:_____________

Thanks !