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Module 1: The Physiology of Women's Hormones & Reproductive Health > Common Hormone Imbalances and Underlying Factors > Flashcards

Common Hormone Imbalances and Underlying Factors Flashcards

1
Q

What do hormones play a role in?

A

Brain health, heart health, bone health, mood regulation, blood sugar regulation, mineral balance, metabolic function, and more.

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2
Q

Do hormones themselves cause issues with clients?

A

No, the imbalance of hormones do.

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3
Q

When it comes to the menstrual cycle

What is estrogen responsible for?

A
  • Facilitating the menstrual cycle
  • Supporting antral ovarian follicle growth
  • proliferating the endometrium
  • stimulating the production of fertile-quality cervical mucus
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4
Q

What else does estrogen do besides facilitate the menstrual cycle?

A
  • It has anti-inflammatory properties, esp with the brain
  • Support the health & function of the brain
  • In this way, plays an important role in regulating a woman’s mood, mental clarity, and focus.
  • Promotes quality sleep and circadian rhythm balance
  • Increases insulin sensitivity
  • Supports bone health & density by enhancing calcium absorption
  • Promotes skin health
  • Contribute’s to desire to seek out sexual encounters
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5
Q

When is estrogen the highest?

A

During the follicular-ovulatory phases, which is when the female is most fertile

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6
Q

What contributes to a woman’s plumper physique and clear “glowing skin” and during what phase is this common?

A

Rising estrogen levels during the follicular phase

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7
Q

During what phase does progesterone dominate?

A

During the luteal phase. In a healthy cycle, you can find it in a higher concentration than estrogen during this time.

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8
Q

What is one of progesterone’s primary roles within the menstrual cycle?

A

To oppose estrogen, which helps to protect the endometerial lining within the uterus by inhibiting excessive estrogen action.

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9
Q

What can excess estrogen potentially lead to?

A

Endometrial Hyperplasia which can increase one’s risk for developing endometerial cancer.

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10
Q

By inhibiting estrogenic action, what else does progesterone do?

A
  • Supports breast health, as excessive growth can factor into the onset & proliferation of breast cancer cells
  • Supports brain health by promoting the growth & repair of myelin sheaths
  • Helps improve the brain’s neuroplasticity which can improve cognitive function, learning & memory
  • Production of GABA, which plays an important role in modulating stress, improving sleep, and maintaining mood regulation.
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11
Q

Can the actionof progesterone metabolism and GABA production have an adverse effect?

A

Yes, it can lead to extreme physical and psychological disturbances that are common in women with PMDD

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12
Q

How does progesterone work with the thyroid and thyroid hormones?

A
  • In the luteal phase, progesterone’s thermogenic effect stimulates thyroid hormone production, resulting in an increase in basal body temperature during this time.
  • This increase in thyroid hormone helps to improve cholestrol clearance and estrogen metabolism within the liver.
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13
Q

Women produce how much testostrone compared to males?

A

1/10TH THE AMOUNT

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14
Q

What does testosterone do?

A
  • Helps boost one’s mood, energy levels, self-confidence, and sexual arousal
  • Within the menstrual cycle, it pairs up with estrogen in the pre-ovulatory phases to stimulate ovarian follicle development and a healthy libido
  • Facilitates the development and maintenance of muscle mass and promote’s one’s endurance and stamina
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15
Q

Estrogen is produced from what?

A

The conversion of androgens such as testosterone, so low levels of testosterone may have a downstream effect on estrogen and progresterone production

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16
Q

Do synthetic hormones found within hormonal birth control have the same beneficial effects as natural hormones?

A
  • No, HBC suppresses the menstrual cycle and along with it these hormones and their benefits.
  • Hormone replacement therapy may have some positive or similiar effects as natural hormones, but it doesn’t compare to the real deal
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17
Q

What are Xenoestrogens?

A

Synthetic estrogen-mimicking compounds

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18
Q

What is excess estrogen?

A

A hormone imbalance that is caused by there being too much estrogen in the system. Typically, the body does not produce too much estrogen on it’s own, rather it’s usually the result of poor estrogen elimination and/or exogenous xenoestrogen exposure.

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19
Q

What causes excess estrogen?

A
  • Can result from ecessive alcohol, drug, or toxin exposure, as these compounds can compete for elmination of estrogen, leading to a build-up of estrogen metabolites.
  • May also result from obsesity, excfess body fat and insulin resistance can inrease estrogen levels by stimulating aromatization in adipose tissue
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20
Q

What is aromatization?

A

An enzymatic process where the aromatase enzymes trigger an enzymatic process, which converts the androgens into estrogen within the Granulosa cells

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21
Q

What is estrogen dominance?

A

Too much estrogen in ratio to progesterone

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22
Q

Can estrogen dominance still be present even if estrogen is low?

A

Yes, when progesterone is even lower —simply because estrogen is higher than progesterone by ratio.

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23
Q

Which is more common: for a woman to experience both estrogen excess AND estrogen dominance or only one at a time?

A

Both. However, they could just be experiencing estrogen dominance and not necessarily excess because progesterone directly opposses estrogen, when there is too little of it, it can result in estrogen-excess-related symptoms, often in tandem with symptoms of low progesterone.

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24
Q

What are symptoms of estrogen excess/estrogen dominance?

A
  • Heavy periods
  • Painful periods
  • Breast tenderness
  • Bloating
  • Water-retention
  • Menstrual migraines
  • Ovulatory pain
  • PMS
  • Fibroids
  • Cysts
  • In some cases, endometriosis and adenomyosis
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25
Q

What is adenomyosis?

A

A condition where endometrial tissue grows within the muscular wall of the uterus causing painful cramping, heavybleeding, bleeding between periods, painful intercourse, tender abdomen, and pain with bowel movements

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26
Q

What is endometriosis?

A

A phenomena where tissue that is similar to the endometerial linig grows in areas outside of the uterus causing pelvis pain, scarring, and sometimes internal bledding

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27
Q

What kind of hormone is estrogen?

A

It’s a growth hormone, so the symptoms you’ll likely see as a result of estrogen excess or estrogen dominance are symptoms associated with excess growth

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28
Q

What is low progesterone?

A

A common hormone imbalance in women who experience ovulatory issues as progesterone is made via ovulation.

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29
Q

What should you do if someone is experiencing symptoms of low progrestone but they also experience sporadic or non-existent periods?

A

Take a look at their ovulatory health

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30
Q

When may low progesterone be found?

A
  • In tandem with excess estrogen
  • In low estrogenic states as one needs sufficient estrogen levels to properly grow their ovarian follicles, of which a corpus luteum will be formed.
31
Q

What is a corpus luteum?

A

A mass of cells that forms in an ovary. It is a temporary organ that appears every menstrual cycle and disappears if fertilization does not occur. It also produces the hormone progesterone during early pregnancy. The role of the corpus luteum depends on whether or not fertilization occurs. It is what produces the sex hormone, Progesterone.

32
Q

What other factors can lower progesterone?

A
  • HBC usage
  • Stress (cortisol can compete for the same cofactors as progesterone, so cortisol can take priority over progesterone)
  • Inflammation
33
Q

What are the symptoms of low progesterone?

A
  • Difficulty conceiving/staying pregnant
  • PMS
  • Short luteal phase (less than 10 days)
  • Premenstrual spotting
  • Menstrual mirgrains
  • Breast tenderness
  • Depression/anxiety
  • Fatigue
  • Brain fog
34
Q

What is low estrogen?

A

A hormone imbalance that can be experienced by women of many stages, not just menopause.

35
Q

What is the cause of low estrogen?

A

Usually stress, due to the same reasons as low progesterone, as well as HBC usage, disordered eating, and nutrient deficiencies. Can be common in those who consume a low fat and low cholesterol diet.

36
Q

What are the symptoms of low estrogen?

A
  • Cycle irregularities - polymenorrhea or oligiomenorrhea
  • Amenorrhea
  • Low sex drive
  • Vaginal dryness
  • Painful sex
  • Hot flahes
  • Joint pain
  • Dry skin/eyes
  • Cellulite formation, as low levels can cause decreased blood flow to connective tissue and loss of elasticity
  • Depression
  • Poor memory
37
Q

What are high androgens?

A

High levels of testosterone, and/or DHEA, and/or androstenedione, which can be caused by adrenal issues, high blood sugar, and high insulin levels, high cortisol due to excess stress, excess body fat, and certain conditions like PCOS and congenital adrenal hyperplasia

38
Q

What is congenital adrenal hyperplasia?

A

Causes the adrenals to produce too little cortisol, and excess androgens instead.

39
Q

Can women experience symptoms of high androgens while showing “normal” levels of androgens on their test results?

A

Yes.

40
Q

What is Idiopathic Hirsutism?

A

Also known as androgen hypersensitivity, it is a type of dysfunctional response caused at the receptor site of particular cells. Causes are not entirely clear.

41
Q

What are symptoms of high androgens?

A
  • Hirsutism
  • Blood sugar instability
  • Ovulatory dysfunction
  • Cycle irregularities
  • Acne/oily skin
  • Ovarian cysts
  • PCOS diagnosis
42
Q

What is PCOS?

A

It is an accumulation of symptoms rather than a standalone disease.

The common diagnosable symptoms are:
* Irregular cycles
* Polycystic ovaries on ultrasound
* Hyperandrogenism such as hirsutism, acne, male-pattern balding, and a deep hoarsening voice

43
Q

What is low androgen caused by?

A

Adrenal dysfunction, low ovarian function, ovarian removal, HBC, and nutrient deficiencies.

44
Q

What are symptoms of low androgens?

A
  • Low sex drive
  • Painful intercourse
  • Lack of lubrication
  • Lowered muscle mass
  • Lack of motivation and self confidene
45
Q

Can hormone imbalances overlap?

A

Yes. Hormones are not separate from each other. Typically when there is an imbalance in one, others tend to follow suit.

46
Q

What are cortisol imbalances?

A

High cortisol due to heightened stress & inflammation and low cortisol due to HPA-dysregulation or adrenal insufficiency, can lead to HPG axis dysfunction, as well as resulting in dampened GnRH and lowered LH & FSH.

47
Q

What can cortisol mimic?

A

Progesterone. It can then attach to progesterone receptors, leaving it unusable by cellular tissues.

48
Q

CAR Hypofunction

A

Excess cortisol may impair the melatonin-cortisol balance, resulting in higher levels of cortisol in the evening and lower levels in the morning, impacting sleep quality and waking ability.

49
Q

What is CAR (Cortisol Awakening Response) hyperfunction?

A

Excess cortisol due to heightened stress or cortisol dysfunction may contribute to even higher levels of cortisol in the morning, resulting in feelings of anxiety and hyperactiity upon waking. Can cause sensitivity to morning light.

50
Q

What can high and low cortisol state be signs of?

A

Cushing’s disease and Addison’s disease

51
Q

What is high prolactin?

A

Also known as Hyperprolactinemia can intefere with reproductive health in a number of ways. This can inhibt GnRH and decrease aromitization, leading to ovulatory issues and hormone imbalances.

52
Q

What causes high prolactin?

A
  • High stress
  • Blood sugar imbalances
  • Thyroid disorders
  • Estrogen excess
  • Traumatic brain injury
  • Pituitary tumors
  • Can be associated with autoimmune conditions
53
Q

Symptoms of high prolactin

A
  • Menstrual irregularities
  • Amenorrhea
  • Short luteal phase
  • Low libido
  • Painful sex
  • Glactorrhea (lactation outside of normal breastfeeding siutations)
54
Q

What is the primary function of prolactin?

A

Stimulate breast milk production, common/normal to have high prolactin in lactating women

55
Q

What happens if you don’t have enough thyroid hormone?

A

It’s difficult to produce sufficient amounts of sex hormones necessary for facilitating the menstrual cycle and maintaining reproductive health.

56
Q

What can hypothyroidism lead to?

A

Sluggish clearance, resulting in elevated levels of free cortisol and estrogen metabolites.

57
Q

What can hyperthyroidism lead to?

A
  • It can increase clearane, resulting in a lowered amount of estrogen and free cortisol, which can also be problematic.
  • It can further perpetuate low hormone levels dues to its influence on SHBG.
  • Stimualte an increase in TBG to lower the amount of free thryoid hormone and its metabolic effects.
58
Q

Why can hyperthyroidism be a root cause behind anovulatory or amenorrheic states?

A

Because when TBG rises, this indirectly causes a rise in SHBG as well, which may alter the bioavailability of free testosterone and free estradiol.

59
Q

What are the symptoms of hypothyroidism?

A
  • Chronic fatigue and brain fog
  • Hair loss/thinning
  • Loss of the lateral third of eyebrows
  • Sensitivity to cold
  • Weight gain
  • High cholesterol
  • Constipation
60
Q

What are the symptoms of hyperthyroidism?

A
  • Anxiety/nervousness
  • Rapid weight loss
  • Fast pulse rate
  • Flushing
  • Sensitivity to heat
  • Muscle weakness
  • Insomnia/sleep disorders
61
Q

What can insulin resistance cause?

A
  • Huge contributing factor behind PCOS
  • High LH levels, which can result in ovulatory failure
  • Lowers SHBG, which cna result in higher free testosterone levels
  • High levels of prolactin
62
Q

What are symptoms of insulin resistance?

A
  • Abnormally high blood sugar levels into pre-diabetic ranges
  • Stubborn weight gain
  • Sugar cravings
  • Fatigue
  • Brain fog
  • Dark patches in the armpits, neck, and groin areas
  • Increased thirst
  • Sleep issues
  • Ovulatory failure
  • PCOS diagnosis
  • Diarrhea/indigestion
63
Q

What are the biggest leading factors behind hormone imbalances?

A
  • Systemic inflammation
  • Liver Burden
  • Gut dysfunction
  • Endocrine Disrupting Chemicals
  • Parmaceuticals & NSAIDs
64
Q

Why is systemic inflammation one of the biggest leading factors behind hormone imbalances?

A

Pro-inflammatory cytokines can directly block hormone receptors, increase cortisol, and decrease sex hormone production

65
Q

What causes systemic inflammation?

A
  • Poor diet
  • Nutrient deficiencies
  • Unmanaged stress
  • Blood sugar instability
66
Q

What happens when the liver is overburdened?

A

This usually happens due to stress, inflammation & toxin exposure and if it’s overburdened, it can’t eliminate hormones properly, which can cause them to recirculate in the body and wreak havoc.

67
Q

What leads to an imbalance of gut bacteria?

A

Inflammation and dysfunction within the gut can lead to dysbiosis, which can have a direct effect on poor hormone elimination.

68
Q

What do endocrine disrupting chemicals do?

A

Environmental chemicals that can mimic hormones — namely estrogen, which increase toxic estrogens in the body, and block hormone receptors, resulting a host of issues as well as symptoms of estrogen excess.

69
Q

Why can pharmaceutical drug usage interfere/impair hormone production and metabolism?

A

Many of them compete for the same liver detoxification pathways as estrogen, so over usage can potentially lead to estrogen-excess-related issues.

70
Q

What do prostaglandins do?

A

They help regulate inflammation.

71
Q

What do the prostaglandins that are considered pro-inflammatory do?

A

Also known as PGE2, they are the prostaglandins that help facilitate ovulation and uterine contraction resulting in menstruation.

72
Q

What happens when these prostaglandins are in excess?

A

They can contribute to ovulation pain (Mittelschmerz), primary dysmenorrhea, and digestive issues.

73
Q
A

Module 1: The Physiology of Women's Hormones & Reproductive Health (4 decks)

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