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Nutrition 2 (Semester I) > 7b. Women's Health - Pathologies > Flashcards

7b. Women's Health - Pathologies Flashcards

1
Q

Non-physical signs/symptoms of PMS

A

Mood swings
Irritability
Anxiety
Poor concentration
Food cravings
Increased appetite

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2
Q

Physical signs/symptoms of PMS

A

Bloating
Breast tenderness
Headaches
Acne
GIT upset

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3
Q

Signs/symptoms and causes of PMS-A (anxiety)

A

Anxiety, irritability
High oestrogen:progesterone ratio

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4
Q

Signs/symptoms and causes of PMS-C (craving)

A

Sugar cravings, increased appetite
Blood glucose imbalance, low Mg

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5
Q

Signs/symptoms and causes of PMS-D (depression)

A

Depression, teary
Low oestrogen:progesterone ratio, low serotonin

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6
Q

Signs/symptoms and causes of PMS-H (hyperhydration)

A

Weight gain, breast tenderness, bloating
Increased water retention due to excess salt intake, excess oestrogen, stress, Mg def

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7
Q

Causes/triggers of PMS symptoms

A

Interactions between progesterone, oestrogen and neurotransmitters
Progesterone inhibits GABA receptors
Deficient serotonin functioning due to progesterone and oestrogen modifying serotonin availability (also poss nutrient def - tryptophan, gut dysbiosis)
Reduced cortisol awaking response
Smoking
Obesity
Alcohol (negative association with anxiety, mood changes, headaches during PMS)
High intake of dairy/refined sugars; low protein intake
High O6:O3 ratio increasing inflammation and aromatisation

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8
Q

Naturopathic approach to PMS

A

Avoid/minimise high GI foods, caffeine, alcohol, smoking, table salt, dairy, red/processed meats
Balance oestrogen:progesterone ratio - B vits, cruciferous, Mg, high fibre, increased phytoestrogens, remove endocrine disruptors
Optimise weight
Address stress
Balance blood glucose
Reduce inflammation
Balance neurotransmitters - tryptophan, tyrosine, B6, 9, 12, Zn, Mg, L-theanine, St John’s Wort
Reduce fluid retention - reduce Na/increase K-rich foods, B6 to help regulate aldosterone, seed cycling, diuretics - celery, dandelion, nettle

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9
Q

Why is B6 important for PMS?

A

Co-factor for GABA, serotonin, dopamine
Modulates oestrogen
Corpus luteum development
Oestrogen-progesterone imbalance can lead to B6 def - reduced dopamine = increased prolactin which affects breast tissue, promotes water retention
OCP can deplete B6

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10
Q

Why is Mg important for PMS?

A

GABA/serotonin synthesis

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11
Q

Why is Ca important for PMS?

A

Co-factor for tryptophan-serotonin conversion

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12
Q

Why is vit D important for PMS?

A

Neurotransmitter function

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13
Q

Why is Zn important for PMS?

A

Proper functioning of sex hormones
Controls prolactin

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14
Q

Why are EFAs important for PMS?

A

Women with PMS shown to have EFA/prostaglandin abnormalities e.g. low GLA
GLA is a precursor to PG1 which inhibits prolactin

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15
Q

Why is vitex agnus castus important for PMS?

A

Binds to dopamine receptors to reduce secretion of prolactin
Reduces mood changes, irritability, headaches and breast tenderness

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16
Q

Why is gingko biloba important for PMS?

A

Breast pain/tenderness

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17
Q

Why is rosemary important for PMS?

A

AO effects
Neutralises quinones by reducing 16-OH-E1 and increasing more 2-OH-E1

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18
Q

Why is ashwagandha important for PMS?

A

Adaptogen
Nervine
Thyroid support

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19
Q

Why is ginger tea good for PMS?

A

Improves blood circulation
Reduces cramping
Reduces bloating

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20
Q

Which herbal teas are good for PMS-A?

A

Chamomile
Passionflower

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21
Q

Why is green tea good for PMS?

A

L-theanine content to calm NS

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22
Q

Why is peppermint tea good for PMS?

A

Antispasmodic
Eases bloating

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23
Q

Why is St John’s Wort tea good for PMS?

A

Mood enhancer

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24
Q

What is PCOS?

A

An endocrine metabolic condition

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25
Q

What are the signs and symptoms of PCOS?

A

Irregular/absent periods
Weight gain
Hirsutism
Thinning hair/hair loss
Oily skin
Acne
Infertility

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26
Q

What are the complications of PCOS?

A

T2D
Gestational diabetes
Hypertension
Dyslipidaemia
NAFLD
Metabolic syndrome
Endometrial cancer
AI
Depression/anxiety

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27
Q

What is the pathophysiology of PCOS?

A

Increased LH = increased androgens
Reduced FSH reduces aromatisation of androgens to oestrogen, leading to anovulation
Suppressed SHBG = increased free circulating androgens/testosterone

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28
Q

What is the most common mediator in the majority of PCOS cases?

A

Insulin resistance

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29
Q

How does insulin resistance lead to PCOS?

A

Decreases SHBG synthesis = increased free circulating androgens/testosterone
Increases ovarian androgen production
Increases adrenal androgen secretion
Leads to leptin resistance

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30
Q

What increases the risk of PCOS?

A

Obesity
Chronic low-grade inflammation
Gut dysbiosis
Chronic stress
Genetics
Smoking
Vit D def

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31
Q

Why can obesity lead to PCOS?

A

IR increases adipogenesis and decreases lipolysis
IR increases androgen production
IR sensitises thecal cells to LH and increases androgen production

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32
Q

Why can low-grade inflammation lead to PCOS?

A

Western diet
Obesity
Lack of exercise
Metabolic endotoxaemia
High levels of oxidative stress
All adds to IR

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33
Q

Why can gut dysbiosis lead to PCOS?

A

Alters hormone secretions
Alters gut-brain mediators
Alters inflammatory pathways
Alters islet b-cell proliferation

34
Q

Why can chronic stress lead to PCOS?

A

Increased production of adrenaline/cortisol = increase in IR
Stimulates production of DHEA which converts to testosterone in peripheral tissues

35
Q

Why can genetics lead to PCOS?

A

Polymorphisms in CYP11/CYP17

36
Q

Why can vit D deficiency lead to PCOS?

A

Reduces insulin sensitivity

37
Q

Examples of hormones/markers elevated during PCOS?

A

Testosterone with DHT
DHEA
Androstenedione
Oestrogen
Prolactin
LH
Insulin
HbA1c
TNF

38
Q

Examples of hormones/markers low during PCOS?

A

Progesterone
FSH
SHBG

39
Q

What are the therapeutic aims for supporting PCOS?

A

Decrease insulin resistance
Balance blood glucose
Decrease central obesity
Reduce inflammation and oxidative stress
Reduce stress/cortisol levels
Liver detoxification for oestrone clearance

40
Q

Protocols for supporting blood glucose balance, insulin sensitivity and weight loss in PCOS

A

Low GI foods
Low saturated fat
No trans fats/processed foods
Increase fibre
Limit snacking
Quality protein from vegs, eggs, fish
Optimise O6:3 ratio
Include chromium-rich foods - cinnamon, berberine, ALA, vit D, Mg, CoQ10
HIIT/interval training

41
Q

Protocols for supporting hormone balance in PCOS

A

Seed cycling
Liquorice
Spearmint tea
Nettle root
Green tea
Saw palmetto

42
Q

Protocols for supporting HPA axis in PCOS

A

Ashwagandha
Mg
Chamomile, passionflower, lemon balm teas
Limit caffeine
Sleep hygiene
Yoga

43
Q

Protocols for supporting microbiome, detoxification and elimination in PCOS

A

Probiotics/prebiotics/fermented foods/increased fibre – for gut microbiome balance
Cruciferous veg, B complex, Mg, NAC, silymarin – for detoxification/elimination

44
Q

Why can myo-inositol be used to support PCOS?

A

Improves insulin sensitivity
Positive effect on elevated androgens
Decreases serum testosterone
Helps regulate menstrual cycle

45
Q

Typical dosage of myo-inositol for PCOS

A

1g/day

46
Q

Food sources of myo-inositol

A

Whole grains
Beans
Nuts
Fruit

47
Q

What is endometriosis?

A

Presence of endometrial tissue outside uterus

48
Q

Where can endometrial tissue end up outside of the uterus?

A

Ovaries
Fallopian tubes
Rectum

49
Q

What is the pathophysiology of endometriosis?

A

Endometrial tissue follows the menstrual cycle causing it to grow, break down and bleed
The blood has no outlet, leading to inflammation, pain, formation of scar tissue

50
Q

Signs/symptoms of endometriosis

A

Dysmenorrhoea
Heavy menstrual bleeding
Dyspareunia
Chronic pelvic pain
Lower back pain
Migraines
Anxiety
Depression

51
Q

Complications of endometriosis

A

Infertility
Bowel obstruction
Ovarian cancer

52
Q

Why is histamine implicated in endometriosis?

A

Oestradiol (E2) is needed for endometrial tissue growth
Mast cells contain oestrogen and progesterone receptors
Oestrogen triggers histamine degranulation
Histamine induces ovarian E2 synthesis
High histamine drives inflammation and angiogenesis = endometriosis proliferation
While progesterone has an inhibitory effect on histamine, it is overridden by oestrogen

53
Q

Causes/risk factors for endometriosis

A

Immune dysfunction - inability to recognise endometrial tissue outside uterus
Surgical scar implantation
Endometrial cell transport via lymphatics
Prolonged oestrogen exposure (early period, OCP)
Obesity
Poor oestrogen detox/elimination
Environmental toxin exposure
Emotional trauma
Microbial infections
Consumption of fats, red meat, alcohol
Diet low in fibre, O3, Se, vit D

54
Q

How can microbial infections be a risk factor for endometriosis?

A

Virus e.g. EBV, E. coli or parasite
Dysbiosis can lower DAO enzyme activity
Compromised mucosal barrier - increase in LPS contributing to inflammation

55
Q

Naturopathic approach to endometriosis

A

Immune support
Reduce histamine load
Reduce exposure to hormone disruptors
Optimise liver function for detox/elimination
Optimise intestinal microflora
Reduce inflammation

56
Q

Nutrients to support endometriosis

A

Turmeric, ginger, ALA, resveratrol, O3 - inflammation
Probiotics/prebiotics - microbiome support/bacterial contamination
B6, B9, B12, choline - methylation
B vits, Mg, glutathione, NAC - liver support
Green tea, quercetin - histamine lowering
Cruciferous veg, onions, garlic - aromatase inhibitors
Vit D, vit C, Zn - immune support

57
Q

What are uterine fibroids

A

Benign tumours that originate from the myometrium and connective tissue

58
Q

Signs/symptoms of fibroids

A

50-80% are asymptomatic
Heavy/prolonged menstrual bleeds
Pelvic pain
Abdominal bleeding
Frequent urination
Constipation

59
Q

Complications of fibroids

A

Iron def anaemia
Infertility
Miscarriage
Obstructed labour

60
Q

Causes/risk factors of fibroids

A

Genetics - SNPs on CYP1A1
Hypertension - may cause smooth muscle cell injury
Poor oestrogen metabolism
Chronic stress
Heavy metals - cadmium and lead active oestrogen receptors
Diet/lifestyle - low fibre, high sat fats, refined carbs, caffeine, alcohol, low physical activity
Vit D deficiency - needed to inhibit fibroid cell proliferation

61
Q

Naturopathic approach to fibroids

A

Support oestrogen balance and detoxification
Regulate excessive bleeding
Reduce inflammation

62
Q

Why is it important to reduce oestrogen levels in fibroids?

A

Fibroids are oestrogen dependent
Oestrogen receptors are over-expressed in fibroid tissue
Excess aromatisation also seen
IGF and cytokines also promote fibroid growth

63
Q

Protocols for supporting oestrogen balance and detoxification in fibroids

A

Eliminate caffeine and alcohol – for liver support
Support liver detoxification – cruciferous veg, B-complex, Mg, NAC
Choleretics/cholagogues - globe artichoke, turmeric
Increase phytoestrogen foods – chickpeas, flaxseed – for oestrogen balance
Increase fibre-rich wholefoods to improve oestrogen excretion
Green tea – epicatechins shown to inhibit fibroid cell growth Sage – for oestrogen balance
Red clover – for oestrogen balance
Vitex Agnus castus – prolactin inhibitor
Avoid endocrine disrupters/xenoestrogens
Address stress – to reduce cortisol/inflammation

64
Q

Protocols to regulate excessive bleeding in fibroids

A

Fe-rich foods - spirulina, apricots, nettle leaf tea
Vit C - to enhance absorption
Astringent herbs to control blood flow - yarrow, cranesbill
Check Fe/ferritin levels

65
Q

Protocols to reduce inflammation in fibroids

A

Eliminate all sources of arachidonic acid - refined sugars, red meat, eggs
O3
Ginger
Curcumin
Bromelain
Serrapeptase

66
Q

What are the 5 stages of menopause (plus ages)?

A

Premature menopause (<40)
Early menopause (40-45)
Perimenopause (45-50)
Menopause (50-55)
Post-menopause (55+)

67
Q

What are the hormonal changes during perimenopause?

A

FSH and LH levels rise due to reduced negative feedback
O:P ratio fluctuates a lot

68
Q

What are the hormonal changes during menopause?

A

Low oestrogen
Persistently high FSH and LH

69
Q

What are the hormonal changes post menopause?

A

Insufficient testosterone from adrenal glands to sustain libido
(assess adrenal health)

70
Q

What factors can affect the smooth transition through to menopause?

A

Obesity
Smoking
Chronic stress
Gut microbiome changes
Family history
Lead exposure

71
Q

Signs/symptoms of menopause

A

Hot flushes (spicy food, alcohol, stress, smoking, caffeine)
Weight gain/obesity (genetic factors, hormonal)
Sleep disturbance (night sweats)
Mood disturbances (irritability, mood swings, anxiety, depression)
Genitourinary (dry/sore vagina, dysuria)
Joint/muscle pain
Headaches
Dry skin
Low libido
Poor memory/concentration

72
Q

Natural approach to supporting menopause

A

Increase AO/fibre
Include 1x phytoestrogen source day (flax, fermented soy, sage)
Plant protein over animal
Prebiotic/probiotic foods
Drink at least 1.5 l water/day
Low GI diet
O3
Avoid food/beverages aggravating hot flushes - alcohol, caffeine, spicy food
Lose weight
Balancing blood glucose

73
Q

Protocols for reducing fracture risk in menopause

A

Ca
Vit C, D, K2
Mg
Black cohosh
Weight bearing exercise

74
Q

Protocols for managing stress/anxiety in menopause

A

Mg
L-theanine
B vits
Ashwagandha
Bach flowers
Yoga
Acupuncture
Breathing exercises

75
Q

Protocols for improving sleep in menopause

A

Passionflower
Valerian
Mg

76
Q

Why is black cohosh good for menopause?

A

Oestrogen modulating
Energetically cooling
Reduces hot flushes
Supports bone density

77
Q

Why is shatavari good for menopause?

A

Testosterone effects
Adaptogen
Relieves vaginal dryness

78
Q

Which herbs are good for calming in menopause?

A

Chamomile
Valerian root
Passionflower

79
Q

Why is St John’s Wort good for menopause?

A

Reduces hot flashes
Improves sleep
Improves mood
Relieves anxiety

80
Q

Why is liquorice root good for menopause?

A

Mildly oestrogenic

81
Q

Why is maca good for menopause?

A

Improves libido
Improves sleep
Improves hot flushes
Improves mood
Interferes with androgen receptors

Nutrition 2 (Semester I) (15 decks)

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