Where are the following hormones synthesized and what are th

Where are the following hormones synthesized and what are their target tissues (male and female): LH, FSH, testosterone, estrogen, and progesterone?

In the conditions listed below, what are the hormone(s) involved, symptoms observed, lab assays used to diagnose, and expected results of those assays (abnormal - disease and normal)?

a. Primary and secondary testicular hypofunction
b. Primary and secondary testicular hyperfunction
c. Primary and secondary ovarian hypofunction
d. Primary and secondary ovarian hyperfunction
e. Hirutism
f. Virilization
g. Menopause
h. Andropause
i. Male infertility
j. Female infertility

Solution

Hormones

Synthesized in

Target tissue

In males

In females

LH

Secreted from cells in the anterior pituitary called gonadotrophs

In the testes, LH binds to receptors on Leydig cells, stimulating synthesis and secretion of testosterone.

Theca cells in the ovary respond to LH stimulation by secretion of testosterone, which is converted into estrogen by adjacent granulosa cells.

ovulation of mature follicles on the ovary is induced by a large burst of LH secretion known as the preovulatory LH surge.

FSH

Secreted from cells in the anterior pituitary called gonadotrophs

FSH is also critical for sperm production. It supports the function of Sertoli cells, which in turn support many aspects of sperm cell maturation.

FSH stimulates the maturation of ovarian follicles

Testosterone

Leydig cells

Male sexual characteristics: testosterone promotes the development of the male sexual organs as well as secondary sexual characteristics

Hyperandrogenism in women causes hirsutism, which is the excessive growth of body hair in areas associated with male-pattern growth such as the chin and upper lip.

Estrogen

Glandular estrogen synthesis: occurs in the granulosa and theca cells of the ovaries, as well as the corpus luteum

Men with liver disease who have an excess of estrogen because of the inability of their liver to metabolize it develop gynecomastia, palmar erythema, and spider angiomas

Estrogen expression is responsible for female primary and secondary sexual characteristics. Estradiol promotes epithelial cell proliferation in the uterine endometrium and mammary glands of the breasts.

Progesterone

Progesterone is secreted by ovarian follicular cells prior to ovulation; it is also secreted in larger amounts by the corpus luteum, which forms from follicular granulosa cells following ovulation.

The role of progesterone in males is less clear, but it is believed to play a role in activating sperm in the female reproductive tract. It has also been implicated as a modulator of male sexual response and behaviour.

Progesterone plays several important actions in the normal female reproductive cycle:

Prepares the uterus for pregnancy by shifting the endometrium from proliferation to secretion.

Withdrawal of progesterone in the absence of pregnancy leads to organized shedding (menstruation).

Helps mediate sexual response in the brain.

·        After fertilization, progesterone:

Organizes the vasculature of the endometrium to prepare for implantation

Primary and secondary testicular hypo function:

Testicular hypofunction occurs when the testicles produce less than normal amounts of testosterone. Hypofunction may be caused by a problem that is related to the testes themselves (primary hypofunction) or by low production of luteinizing hormone (LH) by the pituitary gland (secondary hypofunction). LH is released into the blood stream and signals the testes to make testosterone.

Symptoms:

Symptoms depend on when testicular hypofunction started. If it starts before puberty, boys may have abnormal development of genitalia and male sex characteristics.

Onset after puberty may cause decreased sexual drive and infertility.

The vein from the testicle will usually swell when you are suffering from this disorder.

Lab assay to diagnose:

Testosterone:

Although a testosterone determination is the threshold test in the evaluation of suspected male hypogonadism, the total testosterone concentration may be within the normal range in men with primary testicular disorders such as Klinefelter’s syndrome. Low production of testosterone and increased estradiol stimulate production of SHBG by the liver. The increased level of SHBG results in higher circulating total testosterone than would otherwise be present with low circulating free testosterone. An increased SHBG level may also be associated with hyperthyroidism, liver disease, severe androgen deficiency, or estrogen excess. SHBG levels increase about 1% per year as men age. Male patients with hypogonadism often have high SHBG levels because of low serum testosterone levels and enhanced production of estradiol from increases in intratesticular aromatization.

Gonadotropins: If a low testosterone level has been established, further laboratory testing is used to determine whether the hypogonadism is related to a primary testicular disorder (hypergonadotropic hypogonadism) or to pituitary disease (hypogonadotropic hypogonadism). The primary feature of hypogonadotropic hypogonadism is the failure of a reciprocal increase in gonadotropins in the setting of a substantially decreased testosterone level. In patients with signs and symptoms indicative of hypogonadism, determining luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels together with the initial testosterone level is usually most efficient.

Additional studies, such as gonadotropinreleasing hormone (GnRH) testing, by an endocrinologist may help in the further assessment of these patients.

Primary and secondary hypofunction

Ovarian Hypofunction is reduced production of female sex hormones due to decrease in ovarian function: Ovarian Hypofunction is sometimes known as ‘Premature Menopause’ or ‘Early Menopause’. There is a decreased chance of getting pregnant and increased chance of osteoporosis for women with this condition

symptoms of menopause such as hot flashes, mood swings, irregular periods, night sweats, and vaginal dryness

Hirsutism (HUR-soot-iz-um) is a condition of unwanted, male-pattern hair growth in women. Hirsutism results in excessive amounts of dark, course hair on body areas where men typically grow hair — face, chest and back.

DIagonitic assay:

Testosterone: The most important assay is the level of serum testosterone, the major circulating androgen. If the total serum testosterone level is normal, measure the free serum level because hyperandrogenism (and insulin resistance, if present) decreases sex steroid-binding globulin, such that the unbound, biologically active testosterone moiety may be elevated even if the total level is unremarkable. Extremely high testosterone levels are likely to be associated with adrenal or ovarian tumors, whereas idiopathic and benign etiologies result in very mild elevations. Indeed, in idiopathic hirsutism, the results from testing androgen levels are often normal. In some of these women, hirsutism is thought to be caused by increased skin sensitivity to androgen or by increased skin 5-alpha-reductase activity.

Dehydroepiandrosterone sulfate (DHEAS): Elevations in both testosterone and DHEAS suggest an adrenal origin, whereas an isolated testosterone elevation indicates an ovarian source.

Virilization: It is a condition in which women develop male-pattern hair growth and other masculine physical traits. Women with virilization often have an imbalance in sex hormones, such as estrogen and male sex hormones, or androgens, like testosterone.

Symptoms include excess facial and body hair, baldness, acne, deepening of the voice, increased muscularity, and an increased sex drive.

Diagnosis

The combination of body changes makes virilization relatively easy for doctors to recognize. A test can determine the level of androgens in the blood. If the level is very high, a dexamethasone suppression test can help determine if the problem is coming from the adrenal glands and whether the problem is an adenoma or adrenal hyperplasia. If the problem is adrenal hyperplasia, dexamethasone prevents the adrenal glands from producing androgens. If the problem is an adenoma or cancer, dexamethasonereduces androgen production only partially or not at all. Doctors may do computed tomography (CT) or magnetic resonance imaging (MRI) to obtain a view of the adrenal glands.

Menopause marks the time in a woman\'s life when her menstruation stops, and she is no longer fertile (able to become pregnant).

The menopause is a normal part of life; it is not a disease or a condition.

Even though it is the time of the woman\'s last period, symptoms may begin many years earlier. Also, some women may experience symptoms for months or years afterward.

Symptoms of menopause

Experts say that technically, menopause is confirmed when a woman has not had a menstrual period for 1 year. However, the symptoms and signs of menopause generally appear well before that 1-year period is over. Irregular periods, hot flashes

Diagnosis:

measure levels of FSH (follicle-stimulating hormone), there is no definitive test to diagnose menopause or perimenopause. FSH blood levels rise when a woman is going through menopause. However, as FSH levels tend to fluctuate a lot during the menopause and perimenopause, the test is not that helpful for a diagnosis.

Under certain circumstances, a doctor may order a blood test to determine the level of estradiol (estrogen). As hypothyroidism (underactive thyroid) can cause menopause-like symptoms, a blood test to determine the woman\'s level of thyroid-stimulating hormone might be recommended.

Andropause: Andropause is a condition that is associated with the decrease in the male hormone testosterone.

this problem retated to androgen (testosterone) decline in the aging male -- or what some people call low testosterone. Men do experience a decline in the production of the male hormone testosterone with aging, but this also occurs with conditions such as diabetes.

Along with the decline in testosterone, some men experience symptoms that include:

Diagnosis: IF symptoms match those of people with low testosterone. Then, a blood test is performed to check the level of testosterone in the blood.

Male infertility: A man’s fertility generally relies on the quantity and quality of his sperm. If the number of sperm a man ejaculates is low or if the sperm are of a poor quality, it will be difficult, and sometimes impossible, for him to cause a pregnancy.

What are the symptoms of male infertility?

In most cases, there are no obvious signs of infertility. Intercourse, erections and ejaculation will usually happen without difficulty. The quantity and appearance of the ejaculated semen generally appears normal to the naked eye.

Diagnosis: physical examination along with a semen analysis to check the number, shape and movement of sperm in the ejaculate.

Blood tests may also be done to check the levels of hormones that control sperm production. Genetic investigations and testicular biopsies are sometimes done.

Female infertility:

An infertility diagnosis is given to a couple that has been unsuccessful in efforts to conceive over the course of one full year. When the cause of infertility exists within the female partner, it is referred to as female infertility.

Diagnosis:

Hormones	Synthesized in	Target tissue
		In males	In females
LH	Secreted from cells in the anterior pituitary called gonadotrophs	In the testes, LH binds to receptors on Leydig cells, stimulating synthesis and secretion of testosterone. Theca cells in the ovary respond to LH stimulation by secretion of testosterone, which is converted into estrogen by adjacent granulosa cells.	ovulation of mature follicles on the ovary is induced by a large burst of LH secretion known as the preovulatory LH surge.
FSH	Secreted from cells in the anterior pituitary called gonadotrophs	FSH is also critical for sperm production. It supports the function of Sertoli cells, which in turn support many aspects of sperm cell maturation.	FSH stimulates the maturation of ovarian follicles
Testosterone	Leydig cells	Male sexual characteristics: testosterone promotes the development of the male sexual organs as well as secondary sexual characteristics	Hyperandrogenism in women causes hirsutism, which is the excessive growth of body hair in areas associated with male-pattern growth such as the chin and upper lip.
Estrogen	Glandular estrogen synthesis: occurs in the granulosa and theca cells of the ovaries, as well as the corpus luteum	Men with liver disease who have an excess of estrogen because of the inability of their liver to metabolize it develop gynecomastia, palmar erythema, and spider angiomas	Estrogen expression is responsible for female primary and secondary sexual characteristics. Estradiol promotes epithelial cell proliferation in the uterine endometrium and mammary glands of the breasts.
Progesterone	Progesterone is secreted by ovarian follicular cells prior to ovulation; it is also secreted in larger amounts by the corpus luteum, which forms from follicular granulosa cells following ovulation.	The role of progesterone in males is less clear, but it is believed to play a role in activating sperm in the female reproductive tract. It has also been implicated as a modulator of male sexual response and behaviour.	Progesterone plays several important actions in the normal female reproductive cycle: Prepares the uterus for pregnancy by shifting the endometrium from proliferation to secretion. Withdrawal of progesterone in the absence of pregnancy leads to organized shedding (menstruation). Helps mediate sexual response in the brain. ·        After fertilization, progesterone: Organizes the vasculature of the endometrium to prepare for implantation