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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
Oestrogens bind to specific oestrogen receptors
ERa, ERB, GPER
26
Oestrogen functions:
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
oestrogen dominance = state of excess oestrogen activity e.g
High O:P ratio despite normal oestrogen High oestrogen due to poor detox/elimination Overexpression of ERa and ERB
28
Conditions of oestrogen dominance
Fibroids Endometriosis PMS Fibrocystic breasts dysmenorrhea infertility miscarriages peri menopause cancers = breast, ovarian, endometrial Hashimoto's brain fog anxiety and depression
29
Causes of oestrogen dominance
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
Oestrobolome
collection of microbes that metabolise oestrogens
31
Beta-Glucoronidase
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
Oestrobolome - healthy gut
produces the right amount of BG for oestrogen homeostasis
33
Oestrobolome - dysbiotic gut
if low fibre and poor bile flow increases chances of recirculation
34
GUT, STRESS, DETOXIFICATION
Look at all 3 in oestrogen metabolism
35
Imbalance of Beta-glucoronidase =
Hormonal cancers PCOS Endometriosis
36
Testosterone is produced in
ovaries and adrenal cortex
37
What is testosterone converted to
E2 via aromatase (most of it) and DHT
38
Testosterone functions
ovarian density, libido, bone strength, mood, cognition
39
Testosterone imbalances
PCOS - androgen dominance but driven by IR Perimenopause - low mood, libido, cognition especially if adrenal glands are shattered
40
Conversion of Testosterone to DHT via 5a-reductase
unregulated by insulin, inflammation, obesity down regulated by nettle, saw palmetto, lycopene, green tea, zinc, GLA, EPA
41
SHBG
Sex hormone binding globulin - sex hormones transported in blood bound to SHBG.
42
SHBG functions
Binds to oestrodial, testosterone, DHT - mops them up
43
Low levels SHBG associated with...
hyperinsulinemia, obesity, metabolic syndrome, T2DM, hypothyroidism, PCOS - higher circulating active levels of hormones
44
High levels SHBG associated with....
anorexia, pregnancy, androgen deficiency, hyperthyroidism, liver disease
45
Prolactin = a hormone controlled by...
oestrogen and dopamine
46
Prolactin functions
Lactation Breast maturation inhibits menstruation
47
Hyperprolactinemia
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
Endocrine disruptors
- 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
Xenoestrogens
structurally similar to oestrogen, bind to oestrogen receptors e. g pesticides, herbicides, dioxins, parabens, BPAs, preservatives, tap water
50
Xenoestrogen bioaccumulation is the
build up in the fat of meat/fish/dairy and human fat cells
51
Xenoestrogen exposure mainly by...
injecting via food and drink
52
Endocrine disruptors - DAIRY
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
Phytoestrogens - structurally similar to
E2 (estradiol)
54
Phytoestrogens
- weak anti-oestrogenic effect if circulating E2 - weak oestrogenic effect is low oestrogen - disrupts aromatase - favours 2-OH pathway - oestrogen modulators
55
Phytoestrogens naturally occur in plant foods such as
Flavonoids (the best) legumes, lentils, chickpeas Lignans Flavones Soybeans - miso, natta, tempeh - must be fermented
56
A healthy microbiome necessary for the fermentation of phytoestrogens, what can be used if variation of healthy gut microbiome?
Non-food forms e.g tinctures, teas, black cohosh (peri), Agnus cactus, red clover, dong quai
57
Sex hormone imbalance caused by:
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
Hormone balancing approach (see slide 34)
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
PMS put magnifying glass on your weakness, the liver can't cope, wants to get the hormones out
Non-physical and physical symptoms
60
PMS subtypes
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
Causes of PMS
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
PMS approach:
- 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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