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Women's Health > Sex Hormones > Flashcards

Sex Hormones Flashcards

1
Q

What does HPO Axis stand for?

A

Hypothalamic-pituitary-ovarian

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2
Q

What does HPO axis do?

A

maintains hormonal balance within the female reproductive system

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3
Q

What does GnRH do?

A

stimulates the anterior pituitary to produce FSH and LH

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4
Q

inhibin

A

a hormone that inhibits FSH production

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5
Q

Pregnenolene

A

a hormone synthesised from CHOLESTEROL in adrenal glands, gonads and brain by CYP11A1

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6
Q

What is pregnenolene a precursor of?

A

DHEA
Testosterone
DHT
oestradiol
progesterone
cortisol

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7
Q

Benefits of pregnenolene

A

anti-inflammatory and neuroprotective

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8
Q

What are low levels of pregnenolene caused by?

A

Advancing age (>30) and statins

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9
Q

Symptoms of LOW pregnenolene

A

Poor memory and concentration
fatigue
dry skin
joint and muscle pain
low libido

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10
Q

DHEA is produced by ….

A

the adrenal glands, naturally declines with age

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11
Q

which hormone is made on demand and will be made in preference to progesterone?

A

Cortisol e.g if high stress periods can stop

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12
Q

to support healthy pregnenolone

A

Avocado
flax and chia
olive oil
walnuts
Vit B, K, D3

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13
Q

for DHEA balance

A

Maca
rhodiola
magnolia

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14
Q

Pregnenolone steal theory

A

high stress = more need for pregnenolone for cortisol production = less preg for sex hormone prod. but NO giant preg pool.

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15
Q

What majorly down regulates LH and FSH

A

STRESS! Can’t get pregnant when too stressed, will increase prolactin.

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16
Q

Progesterone is produced in the

A

corpus luteum AFTER ovulation
adrenal cortex and by the placenta during pregnancy
So LACK OF OVULATION = LACK OF PROGESTERONE

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17
Q

Progesterone functions

A

making body baby ready - PRO-GESTATION
maintains the endometrium for implantation
increases cervical mucus
increases GABA function
supports bone health and mammary development

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18
Q

Progesterone imbalances

A

Perimenopause
PCOS
infertility

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19
Q

Low progesterone =

A

oestrogen dominance

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20
Q

Low progesterone caused by

A

Chronic stress
Synthetic progesterones (OCP)
xenoestrogens

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21
Q

signs and symptoms of low progesterone

A

Irritability
mood swings
insomnia
risk of breast cancer in premenopausal women

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22
Q

To balance progesterone

A

Support OESTROGEN DETOXIFICATION:
fibre
3 meals a day
no snacking
Mg, Vit C, B6 (for serotonin), zinc
Agnus Castus
exercise/box breathing

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23
Q

Oestrogens - a group of steroid hormones

A

Oestrone (E1)
Oestradiol (E2)
Oestriol (E3)

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24
Q

Oestrogens are produced by…

A

conversion of androgens via AROMATASE (a CYP450 enzyme)
e.g in ovaries, bone, breast, adipose tissue
(anorexics no body fat = no menstruation because aromatose in adipose tissue)

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25
Q

Oestrogens bind to specific oestrogen receptors

A

ERa, ERB, GPER

26
Q

Oestrogen functions:

A

stimulate SEROTONIN receptors (lose oestrogen pre bleed so low mood, anxiety)
menstrual cycle
promotes cell proliferation (esp in breasts)
glucose homeostasis
immune robustness
bone and cardiovascular health

27
Q

oestrogen dominance = state of excess oestrogen activity e.g

A

High O:P ratio despite normal oestrogen
High oestrogen due to poor detox/elimination
Overexpression of ERa and ERB

28
Q

Conditions of oestrogen dominance

A

Fibroids
Endometriosis
PMS
Fibrocystic breasts
dysmenorrhea
infertility
miscarriages
peri menopause
cancers = breast, ovarian, endometrial
Hashimoto’s
brain fog
anxiety and depression

29
Q

Causes of oestrogen dominance

A

Synthetic HRT & OCP (synthetic prog doesn’t work the same in the body but oestrogen does)
Xenoestrogens - plastic, water, non-organic food
heavy metals - lead, mercury, aluminium, cadmium
Obesity - high aromatisation of testosterone to oestrogen
Poor liver detox and methylation
constipation - oestrogen recirculates
Genetic mutations - COMT SNP
Dysbiosis
Chronic stress - down regulates LH and FSH

30
Q

Oestrobolome

A

collection of microbes that metabolise oestrogens

31
Q

Beta-Glucoronidase

A

enzymes which reactivates oestrogen that were already conjugated for elimination (so not good) - can be reabsorbed via enterohepatic circulation therefore increasing oestrogen load in the body

32
Q

Oestrobolome - healthy gut

A

produces the right amount of BG for oestrogen homeostasis

33
Q

Oestrobolome - dysbiotic gut

A

if low fibre and poor bile flow increases chances of recirculation

34
Q

GUT, STRESS, DETOXIFICATION

A

Look at all 3 in oestrogen metabolism

35
Q

Imbalance of Beta-glucoronidase =

A

Hormonal cancers
PCOS
Endometriosis

36
Q

Testosterone is produced in

A

ovaries and adrenal cortex

37
Q

What is testosterone converted to

A

E2 via aromatase (most of it) and DHT

38
Q

Testosterone functions

A

ovarian density, libido, bone strength, mood, cognition

39
Q

Testosterone imbalances

A

PCOS - androgen dominance but driven by IR
Perimenopause - low mood, libido, cognition
especially if adrenal glands are shattered

40
Q

Conversion of Testosterone to DHT via 5a-reductase

A

unregulated by insulin, inflammation, obesity
down regulated by nettle, saw palmetto, lycopene, green tea, zinc, GLA, EPA

41
Q

SHBG

A

Sex hormone binding globulin - sex hormones transported in blood bound to SHBG.

42
Q

SHBG functions

A

Binds to oestrodial, testosterone, DHT - mops them up

43
Q

Low levels SHBG associated with…

A

hyperinsulinemia, obesity, metabolic syndrome, T2DM, hypothyroidism, PCOS - higher circulating active levels of hormones

44
Q

High levels SHBG associated with….

A

anorexia, pregnancy, androgen deficiency, hyperthyroidism, liver disease

45
Q

Prolactin = a hormone controlled by…

A

oestrogen and dopamine

46
Q

Prolactin functions

A

Lactation
Breast maturation
inhibits menstruation

47
Q

Hyperprolactinemia

A

occurs naturally in pregnancy and lactation, can occur in non-pregnant women
Associated with infertility, low libido, osteopenia, breast pain, vaginal dryness
Increased by high cortisol, pituitary tumours, circadian disruption, renal failure, vit D def, drugs

48
Q

Endocrine disruptors

A
  • alter hormone receptor signalling and sex hormone production, secretion and metabolism
  • induce oxidative stress, mitochondrial damage, epigenetic alterations
  • PCOS, cancer, early puberty, infertility, obesity, cognitive deficits
49
Q

Xenoestrogens

A

structurally similar to oestrogen, bind to oestrogen receptors
e. g pesticides, herbicides, dioxins, parabens, BPAs, preservatives, tap water

50
Q

Xenoestrogen bioaccumulation is the

A

build up in the fat of meat/fish/dairy and human fat cells

51
Q

Xenoestrogen exposure mainly by…

A

injecting via food and drink

52
Q

Endocrine disruptors - DAIRY

A

commercial milk mostly from pregnant cows with high hormone concentration, E1,2,3 in all milks esp in whole milk. Organic milk makes little difference.
also contain hormones IGF, PCBs, dioxins, insecticides
amounts are deemed safe but they add to oestrogen overload os should be avoided in hormonal imbalances

53
Q

Phytoestrogens - structurally similar to

A

E2 (estradiol)

54
Q

Phytoestrogens

A
  • weak anti-oestrogenic effect if circulating E2
  • weak oestrogenic effect is low oestrogen
  • disrupts aromatase - favours 2-OH pathway
  • oestrogen modulators
55
Q

Phytoestrogens naturally occur in plant foods such as

A

Flavonoids (the best) legumes, lentils, chickpeas
Lignans
Flavones
Soybeans - miso, natta, tempeh - must be fermented

56
Q

A healthy microbiome necessary for the fermentation of phytoestrogens, what can be used if variation of healthy gut microbiome?

A

Non-food forms e.g tinctures, teas, black cohosh (peri), Agnus cactus, red clover, dong quai

57
Q

Sex hormone imbalance caused by:

A

Blood glucose dysregulation, obesity
inflammation
poor digestion, dysbiosis, detox, elimination
thyroid dysfunction
adrenal dysfunction
toxic load
chronic stress, poor sleep
nutrient deficiencies e.g B Vits, Mg, zinc

58
Q

Hormone balancing approach (see slide 34)

A

PAvoid processed etc
Effective digestion - chewing
Reduce pro-inflam foods
increase antioxidant rich foods, oily fish, nuts, seeds, quercetin (anti-inflammatory)
Fat digestion (bitters)
Build microbiome (prebiotic/probiotic rich foods
Support thyroid hormone synthesis and metabolism - selenium, iodine, zinc, tyrosine
High protein
Support detoxification
Reduce toxic load
Manage stress - relaxation techniques

59
Q

PMS put magnifying glass on your weakness, the liver can’t cope, wants to get the hormones out

A

Non-physical and physical symptoms

60
Q

PMS subtypes

A

PMS-A (anxiety) - high oestrogen:progesterone
PMS - C (craving) - blood glucose imbalance, low Mg
PMS - D (depression) - Low oest:prog ratio, low serotonin
PMS - H (hyperhydration) - high water retention, excess salt, excess oestrogen, stress, Mg deficiency - weight gain, swelling, bloating, breast tenderness - cooling foods, diuretics

61
Q

Causes of PMS

A

Interaction between oestrogen, progesterone and neurotransmitters:
- Progesterone inactivates GABA (synthetic progesterone in OCP not same as what your body naturally produces, block GABA receptors).
- Low serotonin - oest/prog modify availability, low tryptophan, gut dysbiosis
Reduced cortisol awakening response (CAR)
Smoking - declines HPA axis response, increases susceptibility to environment toxins.
Obesity
Alcohol - genetically low GABA more likely to drink, 1st drink mimics feeling of GABA
Dairy - chemicals and hormones
sugar - triggers adrenals
High 6:3 ratio - inflammatory and induce aromatisation

62
Q

PMS approach:

A
  • Hormone detoxification (phase 1 & 2)
    elimination and metabolism
  • adrenal support - address stress
  • minimise xenoestrogen exposure
  • nutrient def e.g B vits, zinc, Mg
  • blood glucose balance
  • reduce inflammation

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