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Women's Health > General > Flashcards

General Flashcards

1
Q

What is the HPO axis and what does it do?

A

Hypothalamus-Pituitary-Ovarian Axis. Maintains hormonal balance within the reproductive system

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2
Q

What stimulates the anterior pituitary gland to produce LH and FSH?

A

GnRH

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3
Q

Raised oestogen and testosterone exert _______ feedback over FSH and LH secretion

A

negative

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4
Q

What hormone is synthesised from cholesterol in steriodogenic tissues such as the adrenal glands, gonads, and brain by mitochondrial enzymes CYP11A1?

A

Pregnenolone

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5
Q

Pregnenolone is synthesised from …?

A

Cholesterol

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6
Q

What enzyme synthesises pregnenolone?

A

CYP11A1

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7
Q

Where is pregnenolone synthesised?

A

Gonads,
Adrenal glands
Brain
By the mitochondrial enzyme CYP11A1

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8
Q

Pregnenolone is a precursor of… ?

A 
DHEA
Testosterone
Oestrogen
Progesterone
Cortisol
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9
Q

Name 2 benefits of pregnenolone?

A

Anti-inflammatory

Neuroprotective

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10
Q

Low levels of pregnenolone are caused by…?

A

Age (>30)

Statins

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11
Q

Name some symptoms of low pregnenolone…?

A 
Poor memory
Declining concerntration and attention
Fatigue
Dry skin
Joint and muscle pain
Decreased libido
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12
Q

What does DHT stand for?

A

Dihydrotestosterone

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13
Q

What does DHEA stand for?

A

Dehydroepiandrosterone

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14
Q

What can support healthy pregnenolone levels?

A 
Sleep quality
Stress management
Healthyfats - avocado, flaz, chia, olive oil, walnuts
B vitamins
Vitamin K
D3
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15
Q

What can help balance DHEA

A 
Maca
Rhodiola
Magnolia
Perilla oil
Tribulus
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16
Q

High stress increases the use of pregnenolone for cortisol production, reducing the total amount of pregnenolone available for sex homrone production, what is this called?

A

Pregnenolone steal theory

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17
Q

What is the pregnenolone steal theory?

A

High stress = Increases pregnenolone to cortisol conversion = reduced pregenolone for sex homrones

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18
Q

Where is progesterone produced?

A

corpus luteum after ovulation
Adrenal cortex
Placenta during pregnancy

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19
Q

Name the functions of progesterone

A

Maintains the endometirum for implantion and pregnancy
Increases cervical mucus
Relaxes smooth muscle
Supports bone and mammary development

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20
Q

What conditions can see an imbalance in progesterone?

A

Perimenopause
PCOS
infertility

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21
Q

Low progesterone leads to what?

A

Oestrogen dominance

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22
Q

What are the causes of low progesterone?

A

Chronic stress
Synthetic progesterones
xenoestrogens

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23
Q

What are the sings and symptoms of low progesterone?

A

Irritability
mood swings
insomnia

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24
Q

Low progesterone can increase the risk of what condition?

A

breast cancer in perimenopausal women

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25
Q

Name ways in which progesterone can be balanced?

A 
Supporting oestrogen detoxification
Increase fibre
3 balanced meals a day
No snacking
avoid alcohol
Mg
Vitamin C
B6
Zn
Vitex Angus castus
Exercise
Box breathing
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26
Q

Name the 3 types of oestrogen

A

E1 - Oestrone
E2 - Oestrodoil
E3 - Oestriol

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27
Q

How are oestogens produced?

A

Conversion of androgens via aromatase

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28
Q

Which oestrogen is ost active during the reproductive years?

A

E2 - oestrodiol

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29
Q

What are the functions of oestrogen?

A 
Reproductive tract development
Menstural cycle
Promotes cell proliferation
Glucose homeostasis
Immune robustness
Bone and cardiovascular health
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30
Q

Name 3 oestrogen receptors that oestrogen binds to…

A

Er(alpha)
ER(beta)
GPER

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31
Q

What does GPER stand for?

A

G-protein coupled oestrogen receptor

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32
Q

What is aromatase?

A

CYP450 enzyme

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33
Q

What is oestrogen dominace?

A

A state of excess oestrogenix activity encompassing some or all of;
elevated oestrogen relative to progesterone (HIGH O:P despite normal oestrogen)
Elevated specifc types of oestrogen or metabolites due to poor detoxificatin and elimination
Exceess oestrogen induces overexpression of ERa and ERb

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34
Q

Oestrogen dominance is assocaited with;

A 
firboids
endometriosis
PMS
firbocystic breasts
dysmenorrhea
infertility
miscarrigaes
perimenopause
breast/ovarian/endo cancers
insulin resistance
thyroid dysfunction
brain fog
anxiety
depression
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35
Q

What can cause/affect oestrogen dominance?

A 
Syntehtic HRT
OCP
Xenoestrogens
Heavy metals
Obesity
Poor liver detoxification
Constipation
SNPs - COMT
Intestinal dysbiosis
Chronic srtress
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36
Q

Dicuss the phase 1 oestogen biotransformation…

A

CYP450 enzymes convert E1 into 1 of 3 metabolittes;
2-OH-E (CYP1A1)
4-OH-E (CYP1b1)
16a-OH-E (CYP3A4)

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37
Q

What is 2-OH-E and what CPY450 enzyme metabolises it?

A

CYP1A1
weakest form
Protective
COMT deactivates 1-OH-E1 to protective 2-MeOE1

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38
Q

What is 4-OH-E and what is the CYP450 enzyme that metabolises it?

A

CYP1B1
pro-carcinogenic
Neautralised by COMT into proetcitve 4-MeOE1 metabolites

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39
Q

What is 16a-OH-E and the CYP450 enzyme that metabolises it?

A

highest binding affinity for oestrogen receptors with high proliferative effects. High = higher risk of esteigen dependant conditions such as breast cancer, fibroids and endo

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40
Q

What are quinones?

A

Organix aromatic-derived compounds

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41
Q

Describe phase 1 oestrogen

A

Biotransfomration using CYP450 enzymes

42
Q

Describe phase 2 oestrogen metabolism

A

Uses sulphation, methylation and glucuronidation pathways

43
Q

Which pathway do 2-OH-E and 4-OH-E undergo during phase 2 of oestrogen metabolism?

A

Methylation via COMT

44
Q

Poor methylation increases conversion of 4-OH-E to WHAT which will increase oxidative damage to DNA?

A

quinones

45
Q

What increase in oranic aromatic-derives compound is assocaited with cancer when thinking about oestogen metabolism?

A

quinones

46
Q

16a-Oh-E metabolises E3 which undergos metabolism on which pathway?

A

Sulphation

47
Q

2-OH-E and 4-OH-E undergo which pathways?

A

Methylation
Sulphation
Glucoronidation

48
Q

What nutritional support can be given to phase 1 oestogen metabolism?

A 
I3C
cruciferious veg
antioxidants
glutathione
turmeric
resveratrol
berries
roobios tea
celery
49
Q

When supporting phase 1 oestrogen metabolism, what should be avoided?

A

CYP450 inducers; paracetamol
PCBs
smoking]
grapefruit

50
Q

How can phase 2 oestrogen metabolism be supported?

A

Conjugation pathway support - cruciferious veg, allium veg, Mg, antioxidants
Methylation support - folate, B12, B6 SAMe, choline

51
Q

What should be avoided when supoprting phase 2 oestogen metabolism?

A

OCP
high alcohol
high cortisol
mould exposure

52
Q

What is the oestrobolome?

A

collectio of microbes capable of metabilisng oestrogens

53
Q

the oestrobolome bacteria produce which enzyme?

A

Beta-glucuronidase

54
Q

What is beta-glucoronidase?

A

an enzyme which deconjugates (reactivates) oestrogen that were conjugated for elimation

55
Q

deconjugated oestrogens can be reabsorbed via the…

A

enterohepatic circulation

56
Q

What can increase chances of enterotoxigenic circulation of oestrogens?

A

Dysbiosis
low fibre
poor bile flow

57
Q

Imbalances in beta-glucuronidase can promote conditions such as;

A 
endo
breast cancer
ovarian cancer
PCOS
Endo cancer
Endometrial hyperplasia
58
Q

Discuss the obersvations seen with beta-glucuronidase in endo andPCOS;

A 
Endo = larger numbers of beta-glucuronidase (high circ. oestrogen - oestogen dominace)
PCOS = low beta-glucuronidase = reduced oestrogen and higher andrgoens
59
Q

How to maintain healthy beta-glucuronidase levels;
High levels =
Low levels =

A

High levels =
increase fibre
calcium D-glucarate
glucaric acid-rish foods such as mung bean sprouts, apples, crucierfous veg, milk thistle, Lactobacilli and bifidum bacertia

LOW =
probiotics and/or probiotic foods

60
Q

Where is testosterone produced in women?

A

Ovaries and adrenal cortex

61
Q

What is testosterone converted to?

A

E2 and DHT

62
Q

What are the functions of testosterone in women?

A

Ovarian density
Libido
Bpnoe strengthmood
cognition

63
Q

List 2 testosterone imbalances

A

Andrgoen dominace in PCOS

Low testosterone

64
Q

What is the more potent form of testosterone?

A

DHT

65
Q

converts testosterone to DHT?

A

5a-reductase

66
Q

List ways in which the testosterone to DHT pathway is upregulated;

A

insulin
Inflammation
obesity

67
Q

List ways in which the testosterone to DHT pathway is downregulated;

A 
Nettle
Saw palmetoo
Lycopene
Turmeric
Green tea
Zn
GLA and EPA
68
Q

How do sex hormones travel around the body?

A

in the blood bound to SHBG

69
Q

Where is SHBG produced?

A

Ine the liver

70
Q

What are the functions of SHBG?

A

to oestadoil, testosterone, DHT

only unbound hormones are biologically active

71
Q

Only ____________ sexx ormones are bilogically active

A

unbound

72
Q

Low levels of SHBG are assciated with which conditions?

A 
Hypoinsulinemia
Metabolic syndrom
T2DM
hypothyroidism
PCOS
73
Q

High levels of SHBG are asscoaited with;

A 
anorexia
Pregnany
Androgen deficiency
hyperthyroidism
liver disease
74
Q

What is prolactin?

A

Key hormone controlled by oestrogen and dopamine

75
Q

what 2 hormones control prolactin?

A

oestrogen and dopamine

76
Q

What are the functions of prolactin?

A

lactation
breastmaturation
inhibitsmenstruation

77
Q

What is hyperprolactinaemia?

A

Occurs naturally in pregnancy and lactiation but can also occue in non-pregnant women

78
Q

What is hyperprolactinaemia asscoatied with?

A 
Pregnancy
Lactation
Infertility
Menstural irregularities
low libido

osteopenia
breast pain
vaginal dryness

79
Q

What increases Prolactin?

A 
High cortisol
Circadian rythmn disruption
Pituitary tumours
Renal failure
vitamin D deficiency
drugs - dopamine antagonists
80
Q

What are EDCs?

A

Endocrine disrupting Chemicals
Exogenous agents that interfere with the production, release, transport, metabolism, binding, action or elimination of bodily hormones

81
Q

List ways in which EDCs can affect hormones

A 
binding
metabolism
elimination
production
release
transportation
action
82
Q

List some EDCs

A 
BPAs
PCBs
Phthalats
heavy metals
pesticides
herbicides
fire retardants
dioxins
drugs
tap water
83
Q

What can alter homrone receptor signalling, production, secretion and metabolism of homrones and well as induce oxidative stress, mitochondrial damamge and epigentic alterations?

A

EDCs

84
Q

What adverse health effects are associated with EDCs?

A 
Cancer
PCOS
Early puberty
Gynaecomastia
infertility
cognitive defects
obesity
85
Q

What is the critical window of susceptibility of EDCs becoming an issue?

A

in utero
neonatally
childhood
puberty

86
Q

What are xenoestrogens?

A

sub-category of EDCs. Structually similar to oestoogen and can bind to oestrogen receptor sites

87
Q

Name some examples of xenoestrogens

A 
Pesticides
herbicides
dioxins
parabens
phthalates
BPAs
preservatives
tap water
88
Q

When can xenoestrogens build up?

A

Fat of meat, fish, dairy and human fat cells with age

89
Q

How can someone be exposed to xenoestrogens?

A

Ingesting via food and drink
inhaled
skin or mucus membranes

90
Q

Why is dairy considered an endocrine disruptor?

A

It contains E1,E2 and E3 steroid hormones

Includes IGF, PCBs, dioxins insecticides, bovine growth hormone

91
Q

What are phytoestogens?

A

NAturally occuring palnt compunds strcutually similar to 17beta oestradiol (E2)

Produce weak anti-oestoengic effect on high or low endogenous oestrogen
reduces circulating bioavailability of E2
Disrupts aromatase - favours 2-OH pathway
Oestrogen modulators

92
Q

List some benefits of phytoestrogens

A 
lower risk of;
menopausal symptoms
CVD
obesity
metabolic syndrome
T2DM
breast cancer
93
Q

List some naturally occuring phytoestrogens

A

flavinoids
lignans
flavones

94
Q

What phytoestrogen has been shown to inhibit breast cancer cell growth and is neuroprotective?

A

Apigenin

95
Q

List soybean products;

A

Tempeh
soy paste
miso
natto

96
Q

Is soy products are consumed they should be…

A

fermented

97
Q

Why is consumption of soyban in western societies deemed as unhealthy?

A

include soya oil
flour
GMOs

98
Q

What is necessary for fermentation of phytoestrogens?

A

a healthy microbiome

99
Q

List some herbs which are considered good forms of tea/tinctures which contain phytoestrogens;

A

black Cohosh
agnus castus
red clover
dong qui

100
Q

List ways in which hormone imbalance can be driven by;

A 
blood glucose dysregulation
high or low body weight/fat percentage
chronic low-grade inflammation
poor digestion
Microbiome health
detoxification and eliination
thyroid and adrenal health
High toxic load
Chronic stress
disrupted sleep
Nutritional deficincies - B vitamins, Mg, Zn
101
Q

List ways which can support hormone balancing from a Naturopathic perspective;

A 
avoid;
processed and microwaved foods
stimulants
refined sugars
table salt
artifical sweeteners
cow's dairy
Focus on;
local, seasonal, while, fresh and organic foods - vegetables, fruit, legumes, whole grains, nuts, seeds, water, herbal teas, oily fish and meat
Make sure food combining principles are followed
Consider energetics
Appropriate digestion - chew foods well, keep fluids away from meals, avoid snacking
102
Q

List ways to imrpove blood glucose and weight management;

A

avoid processed foods

Women's Health (2 decks)

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