Women's Hormones Part 1 Flashcards

1
Q

Estrogen dominance drivers

A
Obesity, BMI, WHR, 
Inflammation,
Aromatase Activity,
Endocrine Disruptors, 
POPs, 
Caffeine, Alcohol, 
Gut Dysbiosis
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2
Q

Luteal phase dysfunction definition

A

↓Progesterone, shorter luteal
phase <11 days, or <5 ng/mL
maximum serum progesterone

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3
Q

pms drivers

A

Sx usually from estrogen dominance, progesterone deficiency or stress,

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4
Q

Dysmenorrhea often overlaps w

A

Overlaps with IBS

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5
Q

PCOS eval and treatment

A

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

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6
Q

amenorrhea herbals

A

Chasteberry, fennel

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7
Q

infertility supp

A

PCOS give myoinositol 2g b.i.d.

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8
Q

Menorrhagia CAUSES

A
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
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9
Q

How does thyroid hormone help with progesterone production?

A

Thyroid hormones stimulate granulosa cells to produce progesterone (via FSH mediated LH/hCG receptors)

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10
Q

Luteal phase dysfunction treatment

A

Optimize insulin, can give P cream, lower TSH, weight loss

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11
Q

How to increase SHbG for women

A
•
Vegetarian, low fat diet
•
Treat hypothyroidism
•
Treat obesity
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12
Q

How to decrease SHbG for women

A


Testosterone therapy

Exercise GH

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13
Q

Hormones to test on day 3

A

Estrogens, , fsh, testosterone, dhea shbg*

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14
Q

Hormones to test on day 21 to 24

A

P, testosterone, dhea shbg*

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15
Q

low Fat vegetarian diet

A

increase in shbg … less free E
low fat diet dec E
Fiber helps with with E metabolism
Lower the helps with fibroids, PMS, endometriosis

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16
Q

pms supp

A
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
17
Q

chaste berry VITEX caution with

A
In patients with fibroids, endometriosis,
breast cancer (or high breast cancer risk)

But it’s great for PMS and menstrual
irregularities

18
Q

Menorrhagia treatments

A

METHYL B VITAMINS b6, FISH OIL, VITAMIN A, VITAMIN K, IRON, vit c
Can add progesterone on days 12 to 14

19
Q

Tissues that have ER a and b receptors

A

Breast, ovary, bone, uterus, heart, blood vessels, CNS.

Others have B only

20
Q

OCP bad effects

A
  1. Increased CVD, AI disease in certain patients.
  2. Increased risk for depression + anti-depressant use
  3. Increases thyroglobulin →decreases free thyroid hormone
  4. Increases SHBG →Decreases free testosterone →Decreased libido
  5. Potential liver toxicity
  6. Nutrient depletions - vit b12 , 6, folate, mag zinc selenium
21
Q

pcos tx

A

NAC - equiv with metformin
MyoInositol - improves insulin sensitivity of ovary
cinnamon, fenugreek, aloe vera, black cohosh, chaste Berry
P supplementation in luteal phase

22
Q

vit deficiency that can cause PMS

A

Calcium/vitamin D deficiency

23
Q

How to improve PMS bloating

A

decreased fats decreases water retention

24
Q

cytokines higher with dysmenorrhea

A

Higher levels of some prostaglandins, vasopressin, TNF alpha, il6, veg F, CRP

25
Q

Herbs for dysmenorrhea

A

Cinnamon, Ginger

26
Q

vit for luteal phase dysfunction

A

Vitamins: C, E, B6, black cohosh

27
Q

p supplementation

A

Menorrhagia days 12 to 14

Luteal phase dysfunction post peak