Women's Hormones Part 1 Flashcards
Estrogen dominance drivers
Obesity, BMI, WHR, Inflammation, Aromatase Activity, Endocrine Disruptors, POPs, Caffeine, Alcohol, Gut Dysbiosis
Luteal phase dysfunction definition
↓Progesterone, shorter luteal
phase <11 days, or <5 ng/mL
maximum serum progesterone
pms drivers
Sx usually from estrogen dominance, progesterone deficiency or stress,
Dysmenorrhea often overlaps w
Overlaps with IBS
PCOS eval and treatment
AMH three times higher in PCOS
PCOS 7 times higher rate of MI
Severe PCOS with higher cortisol and melatonin
high insulin messes up the HPA access which increases LH, leading to androgen secretion, and ovulation, unopposed E, high insulin also leads to lower SHBG and high T
PCOS equals higher zonulin
amenorrhea herbals
Chasteberry, fennel
infertility supp
PCOS give myoinositol 2g b.i.d.
Menorrhagia CAUSES
Hormonal Imbalance common in adolescence & perimenopause DM MET SYN Fibroids, POLYPS • High BMI • Use of anticoagulants • Problems with IUD • Adenomyosis/endometriosis • PID (Pelvic Inflammatory Disease) • Blood clotting disorder such as Von Willebrand’s • Vitamin A Deficiency • Uterine, Ovarian or Cervical Cancer
How does thyroid hormone help with progesterone production?
Thyroid hormones stimulate granulosa cells to produce progesterone (via FSH mediated LH/hCG receptors)
Luteal phase dysfunction treatment
Optimize insulin, can give P cream, lower TSH, weight loss
How to increase SHbG for women
• Vegetarian, low fat diet • Treat hypothyroidism • Treat obesity
How to decrease SHbG for women
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Testosterone therapy
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Exercise GH
Hormones to test on day 3
Estrogens, , fsh, testosterone, dhea shbg*
Hormones to test on day 21 to 24
P, testosterone, dhea shbg*
low Fat vegetarian diet
increase in shbg … less free E
low fat diet dec E
Fiber helps with with E metabolism
Lower the helps with fibroids, PMS, endometriosis
pms supp
B complex - especially vitamin B6 50-100mg • Vitamin C 1 gm • Magnesium citrate 300 600 mg at night • Progesterone cream 25 mg/day, days 14 28 of cycle chaste berry (vitex) 20-40 mg daily curcumin light therapy ginko crocus GINGER NOT st. John's wart or evening Primrose oil
chaste berry VITEX caution with
In patients with fibroids, endometriosis, breast cancer (or high breast cancer risk)
But it’s great for PMS and menstrual
irregularities
Menorrhagia treatments
METHYL B VITAMINS b6, FISH OIL, VITAMIN A, VITAMIN K, IRON, vit c
Can add progesterone on days 12 to 14
Tissues that have ER a and b receptors
Breast, ovary, bone, uterus, heart, blood vessels, CNS.
Others have B only
OCP bad effects
- Increased CVD, AI disease in certain patients.
- Increased risk for depression + anti-depressant use
- Increases thyroglobulin →decreases free thyroid hormone
- Increases SHBG →Decreases free testosterone →Decreased libido
- Potential liver toxicity
- Nutrient depletions - vit b12 , 6, folate, mag zinc selenium
pcos tx
NAC - equiv with metformin
MyoInositol - improves insulin sensitivity of ovary
cinnamon, fenugreek, aloe vera, black cohosh, chaste Berry
P supplementation in luteal phase
vit deficiency that can cause PMS
Calcium/vitamin D deficiency
How to improve PMS bloating
decreased fats decreases water retention
cytokines higher with dysmenorrhea
Higher levels of some prostaglandins, vasopressin, TNF alpha, il6, veg F, CRP
Herbs for dysmenorrhea
Cinnamon, Ginger
vit for luteal phase dysfunction
Vitamins: C, E, B6, black cohosh
p supplementation
Menorrhagia days 12 to 14
Luteal phase dysfunction post peak
