7a. Women's Health - Intro Flashcards
What is the axis that maintains hormonal balance within the female reproductive system?
Hypothalamic-pituitary-ovarian (HPO) axis
Which hormones are released by the stimulation of the anterior pituitary by GnRH?
LH
FSH
What do LH and FSH do?
Support follicle development
Ovulation
Corpus luteum maintenance
Production of progesterone and oestrogen
Raised levels of which hormones exert negative feedback over LH and FSH?
Oestrogen
Testosterone
What is pregnenolone?
Hormone synthesised by cholesterol
Precursor of DHEA, testosterone, DHT, oestradiol, progesterone and cortisol
Anti-inflammatory
What are low levels of pregnenolone caused by?
Advancing age (30+)
Statins
What are the symptoms of low level pregnenolone?
Poor memory
Declining concentration/attention
Fatigue
Dry skin
Joint/muscle pain
Decreased libido
How to support healthy pregnenolone levels
Healthy fats - avocado, flax, chia, OO
B vits
Vit K
Vit D3
Manage stress
Improve sleep
What is the pregnenolone steal theory?
High stress means more pregnenolone is used to make cortisol
Reduces the amount available for the production of sex hormones
How does stress influence the sex hormones?
Downregulates LH and FSH
(meaning decreased ovulation)
When is progesterone produced?
After ovulation
Where is progesterone produced?
Corpus luteum
Which hormone is lacking if ovulation doesn’t happen?
Progesterone
What are the functions of progesterone?
Maintains endothelium for implantation and pregnancy
Increases cervical mucus (producing a barrier)
Helps relax smooth muscle (potentiates inhibitory actions of GABA)
Supports bone health and mammary development
Causes of low progesterone
Chronic stress
Synthetic progesterones
Xenoestrogens
Signs and symptoms of low progesterone
Irritability
Mood swings
Insomnia
How to balance progesterone
Support oestrogen detoxification
Increase fibre
Balanced meals
No snacking
Avoid alcohol until balanced
Mg, Vit C, B6, Zn
Agnus castus
What are the different types of oestrogen?
Oestrone (E1)
Oestradiol (E2)
Oestriol (E3)
How are oestrogens made?
Conversion of androgens via aromatase
(in ovaries, breast, adipose tissue, bone)
Which is the most physiologically active oestrogen during reproductive years?
Oestradiol (E2)
What are the functions of oestrogen?
Reproductive tract development
Menstrual cycle
Cell proliferation
Glucose homeostasis
Bone health
CV health
What can cause oestrogen dominance?
Elevated oestrogen relative to progesterone
Poor detoxification/elimination
Overexpression of ER-a and ER-b
Which conditions are associated with oestrogen dominance?
Fibroids
Endometriosis
PMS
Infertility
Miscarriages
Perimenopause
Breast/ovarian/endometrial cancers
Insulin resistance
Thyroid dysfunction
What are the causes of oestrogen dominance?
Synthetic HRT (synthetic progestin acts like testosterone)
OCP (negative feedback, prevention of ovulation)
Xenoestrogens
Heavy metals
Obesity (increased aromatisation of testosterone to oestrogen)
Poor liver detoxification/methylation
Constipation
Intestinal dysbiosis
Chronic stress (downregulates LH and FSH)
What happens during phase 1 oestrogen metabolism?
Liver breaks oestrogen down into smaller units
Which metabolites does oestrone (E1) convert to during phase 1 metabolism?
2-OH-E1
4-OH-E1
16-OH-E1
Which enzyme converts oestrone (E1) to 2-OH-E1?
CYP1A1
Which enzyme converts oestrone (E1) to 4-OH-E1?
CYP1B1
Which enzyme converts oestrone (E1) to 16-OH-E1?
CYP3A4
Describe 2-OH-E1
Weakest, protective form
Deactivated by COMT to 2-Methoxy-E1
Describe 4-OH-E1
Neutralised by COMT to 4-Methoyx-E1
Pro-carcinogenic if goes down the 4-Quinone-E1 route
Describe 16-OH-E1
High binding affinity
Associated with higher risk of oestrogen dependent conditions - heavy periods, clots, tender breasts, endometriosis, fibroids, breast cancer
How to support Phase 1 oestrogen metabolism
I3C (broccoli sprouts), cruciferous, AOs, glutathione, turmeric, berries, rooibos tea, celery
Support healthy microbiome
Avoid paracetamol, PCBs, grapefruit, smoking
What happens during Phase 2 oestrogen metabolism?
Broken down fat-loving, oestrogen metabolites have a water molecule added to them to enable elimination
Metabolites change from OH to Methoxy