Women's Hormones Part 2

Question 1

Hot flashes alternative tx

Answer 1

Acupuncture,

Question 2

Hot flashes botanicals

Answer 2

•
Black cohosh
•
Siberian rhubarb
•
Red clover
•
Non GMO Soy
•
Sage - dopaminergic effect

Question 3

Take home message regarding adrenals and hot flashes

Answer 3

Estrogen set the rheostats, adrenaline triggers hot flash

Do not always correlate with estrogen levels, treat stress/sleep

Question 4

Phyto SERMS/ isoflavones

effects
safe with

Answer 4

Soy, red clover
Attached to ER beta only, avoiding Cell proliferative affects of ER alpha
Help with bONEs, decreased breast cancer risk, help with depression and cognition, favorable for CV risk, safe in breast cancer.

Question 5

Supplement for sleep with hot flashes

Answer 5

Phosphatidyl serine
5HTP
Passion flower
melatonin

Question 6

Progesterone supplementation for hot flashes/ irregular bleeding

Answer 6

Chasteberry 1000mg daily or
Progesterone 100-300mg orally or
P 25-50 mg topically day 14 28 of cycle, [2 weeks on/2 off] if premenopausal or
day 8 28 if perimenopausal/menopausal

Question 7

fibroids/endometriosis causes

Answer 7

think autoimmune
dysbiosis
LPS leads to low P
toxins
e dom

Question 8

fibroids/endometriosis tx -
diet
supp
detox

Answer 8

gf diet
detox:
Methylated B’s
catechins
Milk thistle and other liver herbs
Fiber
sweating
Exercise

Question 9

Testosterone for low libido in women

Answer 9

Don’t GIVE can increase estrogen vis-à-vis aromatase and decreasing SHBG

Question 10

Testosterone for low libido in women

Answer 10

Don’t GIVE can increase estrogen vis-à-vis aromatase and decreasing SHBG
CAN INCREASE BREAST CANCER
is a marker for low adrenal function

Question 11

Fibroid fun facts

Answer 11

They make their own estrogen from circulating androgen

Inflammatory cytokines stimulate aromatase in fibroids

Question 12

Vitamin for fibroids

Answer 12

vit d

Question 13

Phyto SERMS/ isoflavones

Answer 13

Soy, red clover***
MELATONIN
Attached to ER beta only, avoiding Cell proliferative affects of ER alpha
Help with bONEs, decreased breast cancer risk, help with depression and cognition, favorable for CV risk, safe in breast cancer.

Question 14

aromatase inhib

Answer 14

Fiber,
soy, 
resveratrol, 
grapeseed extract, 
chrysin (passion flower tea, honey, propolis) 
white button mushrooms

Question 15

detox foods

Answer 15

artichoke
Pomegranate,
watercress,
Green tea

Question 16

cannabinoids

Answer 16

for cramps and libido

Question 17

hormonal treatment for fibroids/endometriosis

Answer 17

25 50mg topically, 100 200mg orally day 12/14 28 of cycle

Question 18

vit for breast cancer reduction

Answer 18

13.
Vitamin D
14.
Iodine
15.
Melatonin
16.
Essential oils frankincense, myrrh
17.
Mushrooms turkeytail
18.
Cannabinoids

Question 19

Reduces SHBG

Answer 19

Obesity, insulin, testosterone, red meat

Question 20

SEEMS botanicals

Answer 20

Resveratrol
Genistein
Enterolactones
Lignans
Catechins
Isoflavones
Quercetin

Question 21

SEEMS and SERMS do what to SHBG

Answer 21

increase

Question 22

ER Alpha

Answer 22

Stimulatory

Question 23

er beta

Answer 23

= break

ER β inhibits ER α transcriptional activity at subsaturating
hormone levels.
•
ER β decreases overall cellular sensitivity to estradiol

Question 24

Tissues with er alpha

Answer 24

is expressed primarily in the uterus, liver, kidney, and heart.

Question 25

Tissues with both ER alpha and beta

Answer 25

bone
brain
breast 
thyroid
thymocytes
adrenal
epididymis

Question 26

16α-Hydroxy-estrone

Answer 26

HIGH affinity, carcinogenic, neutralized by reductase

Question 27

2-Hydroxy-estrone

Answer 27

Minimal estrogenic effect

neutralized by COMT to become methoxy- protective

Question 28

4-Hydroxy-estrone

Answer 28

(neutralized by COMT or) converted to quinones which are carcinogenic –> neutralized by glutathione

Question 29

High levels of 16 α hydroxyestrone or a decreased 2:16 ratio

Answer 29

have been associated with an increased risk of hormone

dependent cancers

Question 30

2-Hydroxy-estrone

Answer 30

Minimal estrogenic effect

neutralized by COMT to become methoxy- protective

Question 31

low 2:16 ratio

Answer 31

= high Estradiol

higher risk of osteoporosis

Question 32

Possible causes of low 2/16:

Answer 32

Obesity Increased net estrogen activity
Alcohol consumption
Autoimmune diseases : RA, SLE
Pesticide exposure
Low fiber diet
Meds : oral contraceptives
PCOS

Question 33

DIM effect

Answer 33

more 2-Hydroxy-estrone and metabolites

Question 34

Phase 1 Interventions to

Lower Estrogen Effect

Answer 34

Increase 2OH estrogens/decrease 16OH estrogens

Indole 3 carbinol, DIM
Flax lignans (seeds, not oil)
Soy and soy isoflavones
Physical activity
Omega 3 fatty acids: anti inflammatory
Resveratrol
Avoid alcohol
Increased Brassica vegetables

Question 35

COMT and breast cancer

Answer 35

COMT catalyzes Methylation (SAMe and Mg
•
Decreased COMT activity associated with increased breast
cancer risk through accumulation of genotoxic metabolites

Question 36

MOST IMPORTANT Phase 2:

Interventions to lower estrogen effect

Answer 36

Sulfation - Glucosamine sulfate, MSM, NaSO4
Methylation - Folate (activated), vitamins B6 and B12, methionine, betaine (trimethylglycine), SAMe, MSM
Glucuronidation - Beta glucuronidase —-> calcium d glucarate, normalize gut flora, fiber from ground organic flax seed

Question 37

FOLIC ACID CYCLE AND METHYLATION support

Answer 37

Important nutrients to Rx: 
Betaine(TMG), 
SAMe, 
B12, 
5MTHF, 
B6, 
B2,
Mg

Ideal HCY level 8 or less,
B12 > 600

Question 38

Beta glucuronidase

Answer 38

dysbiosis leads to high levels which reconjugate estrogen and help it recirculate

Question 39

RX for Enterohepatic Circulation

of Estrogens

Answer 39

•
Calcium D Glucarate 500 1000mg bid
•
Fiber, Flax seed (organic and freshly
•
Avoid alcohol inhibition of liver metabolism
•
Treat GI yeast overgrowth : Mycoestrogens and ETOH from

Question 40

Interventions to lower estrogen effect and improve excretion phase 3 detox

Answer 40

Flax lignans kill two birds with one stone
EPA regular bowel function (and anti inflammatory)
Magnesium to bowel tolerance
Probiotics
5R program when needed
Carminative herbs and spices for bile production
Cardamom, coriander, peppermint, chamomile, fennel, cumin

Question 41

seems meds

Answer 41

MELATONIN

PROGESTINS