Women’s Health Flashcards
What is the job of the hypothalamic pitutiary ovarian axis? (HPO axis)
To maintain hormonal balance within the female reproductive system
What is pregnenolone?
A hormone synthesized from cholesterol in steroidogenic tissues such as the gonads and adrenal glands
What does pregnenolone do?
It is a precursor to many hormones such as oestradiol, progesterone, testosterone and cortisol
What are low levels of pregnenolone caused by?
Advancing age (30+) & statin use
Symptoms of low pregnenolone
Poor memory
Dry skin
Low libido
Joint and muscle pain
Support pregnenolone levels with:
Avocado, flax, chia, walnuts
Vits B, D & K
(all for sleep and stress)
Maca & rhodiola
(DHEA balance)
Pregnenolone steal theory
High stresses increases the use of pregnenolone for cortisol production, reducing the amount of it available for sex hormone production
How does stress affect sex hormones?
It downregulates FH & LSH which reduces ovulation
Where is progesterone produced?
In the corpus luteum after ovulation, in the adrenal cortex and by the placenta during pregnancy
(So a lack of ovulation means less progesterone)
What is the function of progesterone?
- It maintains the endometrium for implantation for pregnancy
- Increases cervical mucus (producing a barrier)
- Increases GABA production (which relaxes smooth muscle)
- Supports bone health and mammary development
What is progesterone imbalance linked to?
PCOS, infertility, perimenopause
Low progesterone can lead to oestrogen dominance what are the causes and symptoms
Stress, synthetic progsterone, xenoestrogens
Irritability, mood swings, insomnia and breast cancer in premenopausal women
Low progesterone can lead to oestrogen dominance what are the causes and symptoms
Stress, synthetic progsterone, xenoestrogens
Irritability, mood swings, insomnia and breast cancer in premenopausal women
How to balance progesterone
- Support oestrogen detox
- Increase fibre
- Eat 3 balanced, unprocessed meals a day
- Avoid alcohol
- B6, zinc, vitex agnus castus, She oak, exercise and box breathing
What is oestrogen?
A group of steroid hormones including oestrone (E1), oestradiol (E2) and oestri ol (E3)
How is oestrogen produced?
By conversion of androgens via aromatase
Oestrogen functions
Menstrual cycle
Reproductive tract development
Immune robustness
Cardio & bone health
Oestrogen dominance is associated with
Fibroids
Endometriosis
Infertility
Miscarriages
Thyroid dysfunction
Anxiety
Breast/ovarian/endometrial cancers
Oestrogen dominance aetiology
HRT & OCP
Xenoestrogens
Heavy metals
Obesity
Poor liver detox
Constipation
Dysbiosis
Stress
Oestrogen dominance aetiology
HRT & OCP
Xenoestrogens
Heavy metals
Obesity
Poor liver detox
Constipation
Dysbiosis
Stress
Where is testosterone produced
In the ovaries and adrenal cortex
Testosterone functions
Libido
Bone strength
Mood
Cognition
How do testosterone imbalances present?
Androgen dominance in PCOS: hirsuitism, acne & anovulation
Low testosterone: low mood, low libido, cognitive dysfunction
Testosterone can be converted to a more potent form - DHT. What upregulates or downregulates this?
Upregulates: insulin, inflammation, obesity
Downregulated by: green tea, zinc, turmeric
What are xenoestrogens?
They are structurally similar to oestrogen and can bind to oestrogen receptors with potentially hazardous outcomes
Give some examples of xenoestrogens
BPA, pesticides, tap water, preservatives
How do you accumulate xenoestrogens?
Mainly by ingesting via food and drink
Meat, fish, dairy products
Commercial milk is usually obtained from pregnant cows with high hormonal concentrations which can disrupt our own hormones
What are phytoestrogens?
Naturally occuring plant compounds structurally similar to estradiol
How do phytoestrogens work?
They have an anti-oestrogenic effect by reducing circulating oestrogen
Have an oestrogenic effect where there is low oestrogen
What are the health benefits of phytoestrogens?
Lowers menopausal symptoms
Obesity
Breast cancer
Phytoestrogen sources
Flavonoids: legumes, lentils and chickpeas
Lignans: cereals, linseeds, fruit and veg
Flavones: parsley, thyme, celery and chamomile tea
Phytoestrogen herbs
Black cohosh, dong quai, agnus castus
(Can be more useful when someone doesn’t have a healthy microbiome
to process phytoestrogenic foods)
What does hormone imbalance stem from?
- Blood glucose dysreg
- High/low body fat
- Chronic inflammation
- Poor digestion, microbiome, elimination or detox
- Thyroid/adrenal dysfunction
- Toxic load
- Stress
- Nutrient deficiences - mag, b vits, zinc etc
How to reduce inflammation? (Hormone imbalance)
Reduce inflammatory food - sugar, fried, processed, dairy
Increase colourful antioxidant rich foods such as oily fish, nuts, seeds and anti inflammatory phytonutrient quercetin
How to support digestion and elimination (Hormone imbalance)
Dietary fibre and hydration
How to support the microbiome (Hormone imbalance)
- Prebiotic rich foods (onion, garlic)
- Probiotic rich foods ( kefir, sauerkratut, kimchi)
- A 5R approach
How to
manage stress and sleep (Hormone imbalance)
- Reduce caffeine
- Improve relaxation (deep breathing, journalling
- Encourage a good sleep- wake cycle e.g reduce blue light
What is PMS?
Symptoms that affect women a week or two before their period and can last a few days into menses
PMS prevalence
- Affects up to 80% of women
- Peaks in 30s and 40s
- Often worse after childbirth and worsens after each child
What is PMDD? (Pre menstrual dysphoric disorder)
A severe variant of PMS affecting up to 10% of women that includes anger and irritability in the second half of the cycle
PMS symptoms
Physical: headaches, weight gain, acne, GIT upset
Non-physical: Anxiety, low mood, mood swings, poor concentration, cravings
What is PMS-A?
Anxiety
Possibly related to high progesterone:oestrogen
Symptoms: irritability and anxiety
What is PMS-C?
Cravings
Blood glucose imbalance and low magnesium
Increased appetite and sugar cravings
What is PMS-D
Depression
Low oestrogen:progesterone ratio & neurotransmitter imbalances e.g serotonin
What is PMS-H?
Hyperhydration
Water retention due to high salt intake, excess oestrogen, stress, magnesium deficiency
Weight gain, breast tenderness, bloating
PMS causes
Alcohol
Sugar
Dairy
Low protein
Obesity
High omega 6:3 ratio
Stress
Smoking
Natural approach to PMS
Minimise alcohol, caffeine, sugar, sat foods
Balance oestrogen/progesterone ratio
Balance blood glucose
Reduce inflammation
Optimise key nutrients
Balance neurotransmitters
Reduce fluid retention
How to balance oestrogen/progesterone ratio
(PMS)
Support oestrogen detox: B vits, mag, high fibre, cruciferous veg
Increase phytoestrogens inc 2 cups of red clover tea per day
Low sat fat diet reduces circulating oestrogen
Remove endocrine disruptors, excess weight & stress
Include herbs such as agnus castus
How to balance blood glucose (PMS)
Complex carbs
Low GI foods
Plant based foods
Cinnamon, chromium, mag, b vits
Reduce inflammation (PMS)
Reduce dairy & sugar
Increase omega 3
Increase good quality protein
How to optimise nutrients for PMS
B vits esp b6
Mag
Zinc
D
Omega 3
Calcium
How to balance neurotransmitters for PMS
L-Tryptophan (serotonin precursor)
5HTP
L-theanine
St John’s Wort
Alcohol, sleep, exercise
Reduce fluid retention in PMS
B6
Nettle and dandelion twa
Reduce sodium and potassium rich foods
B6 in PMS function
- Cofactor for GABA, serotonin and dopamine
- Required for corpus luteum development
- Supports healthy progesterone levels and modulates oestrogen
- Oestrogen/progesterone imbalance lead to less B6
- Typically low when taking OCP
Magnesium in PMS function
Gaba and serotonin synthesis
Calcium function PMS
Cofactor for tryptophan which is important for serotonin conversion
Vit D function in PMS
Helps with sex hormone fluctuations
Zinc function in PMS
Particularly important for prolactin control
EFA function PMS
Women with PMS have been shown to exhibit EFA abnormalities
Vitex Agnus Castus function in PMS
- Reduces mood changes, irritability, headache and breast tenderness
- Binds to dopamine receptors to reduce prolactin secretion
(Hyperprolactemia can lead to long/irregular cycles and low progesterone)
Gingko Bilboa in PMS
Decreases overall severity
Breast pain/tenderness
PMS herbal teas
Ginger root - reduces bloating, congestion/cramping
Chamomile/passionflower, green tea - PMS-A, calming
Peppermint - bloating, cramps
St John’s Wort - mood
What is endometriosis?
Endometrial like tissue outside the uterus usually in pelvic regions such as ovaries, fallopian tubes, rectum
Tissue responds to natural hormonal cycle the blood has no outlet leading to pain, inflammation & adhesions
Signs and symptoms of endometriosis
- Dysmenorrhoea
- Heavy menstrual bleeding
- Dyspareunia
- Chronic pelvic/back pain
- Cyclical GI/urinary symptoms
Endometriosis complications
Infertility
Bowel obstruction
Ovarian cancer
Endometriosis causes
Prolonged oestrogen exposure
Obesity
Poor detox
Toxin exposure
Emotional trauma
High fats & alcohol
Low veg, fibre & nutrients
Infections
Dysbiosis
Natural approach to endometriosis
Reduce histamine
Normalise immune response
Optimise liver function
Support elimination
Optimise microflora
Reduce inflammation
Nutrients for endometriosis
Turmeric - inflammation
Pre/probiotics - microbiome
Folate, B12, B6, choline - methylation
B vits, mag, glutathione - liver
Quercetin - antihistamine
What are fibrocystic breasts?
Common benign condition - swelling and tender breasts
- Often in premenopausal women
Symptoms of fibrocystic breasts
Cyclical breast cysts
Breast pain, often bilateral and better post menses
Nipple discharge
Fibrocystic breasts causes
Oestrogen dominance
Obesity
Low fibre
HRT
Iodine def
Natural approach to fibrocystic breasts
Seed cycling
Evening primrose oil
Vitex agnus castus
Castor oil packs
What are uterine fibroids?
- benign tumours in myometrium and connective tissue
- affect 30% globally
- most common 35-49
Signs/symptoms of fibroids
50-80% asymptomatic
heavy/prolonged bleed
pelvic pain
bloating
frequent urination/constipation
Fibroid complication
Miscarriage
Iron def
Infertility
Postpartum haemmorhage
Foetal anomalies
Fibroid causes
Genetics
Poor oestrogen clearance
Chronic stress
Heavy metals
Vit D def
Diet/lifestyle - low fibre, low activity, high sat fat, caffeine & alcohol
How to balance oestrogen and detox (uterine fibroids)
- Eliminate caffeine and alcohol
- Address stress
- Increase phytoestrogens
- Fibre
- Green tea
- Vitex agnus castus
- Liver detox - cruciferous veg
- Chloretics ans cholagogues
How to regulate excessive bleeding
Iron levels - increased risk of heavy bleeding
Iron rich foods - spirulina, apricots, nettle leaf tea (plus vit c)
Astringent herbs to constrict blood vessels and control blood flow
How to reduce inflammation (uterine fibroids)
Eliminate pro inflammatory foods
Up anti- inflammatories - curcumin, EPA
Castor oil packs
Optimise weight and insulin resistance
Menopause stages
Less than 40: Premature menopause
Genetic or oophorectomy
40-45: Early menopause: ovarian function ceases without secondary cause
45-50: Perimenopause: Irregular menstural cycles until 1 year after final period
50-50: Menopause: After 12 months of no periods
55+: Post menopause: Periods cease and worst of hormonal symptoms subside
Factors affecting menopause transition
Obesity - exacerbates symptoms
Smoking - early onset, hypoestrogenic
Stress - menstrual irregularity
Gut microbiome - oestroblome
Lead exposure
Family history
Hypertension
Menopause symptoms
Hot flushes - spice, stress, obesity
Sleep disturbances - night sweats and mood
Genitourinary - dry/sore vagina, dysuria, dyspareunia
Mood - irritability, anger, anxiety, depression
Other - hair loss, joint pain, low libido, memory problems, headaches
Herbal meds for menopause
Liquorice root - mildly oestrogenic
St Johns wort - sleep, hot flashes, mood
Shatavari - vaginal dryness
Black cohosh - cooling - hot flashes
Maca - libido, sleep, mood, hot flushes
Natural approach to menopause
- Improve sleep - remove stimulants and use valerian and magnesium
- Manage stress/anxiety - b vits, l-theanine, bach flowers
- Optimise microbiome
- Increase phytoestrogens
- Sage leaves drink
- Blood glucose
- Avoid smoking, alcohol and caffeine
- Herbs
