Womens health Flashcards
What are the 3 main oestrogen’s?
Oestradiol, oestrone, oestriol
What is oestrogen’s main role?
increases growth of cells in place where there are many oestrogen receptors
What is aromatase for?
peripheral conversion of androgens to oestrone via aromatase
How is oestradiol transported?
sex hormone binding globulin (SHBG) in blood stream
What is progesterones role?
down regulate oestrogen receptors, inhibit oestrogen transcription, affect cellular adhesion, affect local oestrogen conversion, affect sulphating
How can we reduce oestrogen metabolites?
normal bowel flora prevents deconjugation of excreted oestrogen’s, use the 5R program, ensure liver detox is optimal, adequate fibre binds to conjugated oestrogens
What is a hormone disruptor?
exogenous agent interferes with production, release, transport, metabolism, binding, action or elimination
What food is high in oestrogen’s?
Dairy - processed milk
What should be avoided with any hormonal imbalance?
diary
What is diindolymethane (DIM)?
cruciferous indole that inhibits the conversion of oestrogen to 16-hydroxyestrone (a metabolite of oestrogen which has been linked to breast cancer)
What are phytoeostrogens?
plant-derived compounds similar in structure to oestradiol (E2) causing pro/anti-oestrogenic effects
What are some sources of phytoestrogens?
isoflavones (soya based food/legumes), prenylfavanoids - hops and beer, coumestans (split peas, pinto beans, lima beans) and lignans (flaxseeds, whole grains, fruit or vege, sesame seeds and legumes)
What is genistein?
phytoestrogen competes with oestrogen’s for occupancy of oestrogen receptors
How can hormones be balanced naturally?
increased fibre to clear metabolites, increase phytoestrogens, ensure adequate protein (metabolises oestrogen), increase brassica family (cruciferous vege, cancer protective), increases methylation abilities, increases probiotic food, avoid alcohol (interferes with liver detox which increases oestrogen levels)
What are some hormone disruptors that can be removed from diet?
clingfilm, soft plastic water bottles, diary, hormonal contraceptive use, soft plastic food containers, non-organic sources of meat, home chemicals
What nutrients reduce oestrogen metabolites?
vit B6 reduce oestrogen levels, zn and mg are cofactors for hormone production, DIM increases oestrogen clearance
What are the symptoms of PCOS?
amenorrhoa, hirsuitism, acne on face, obesity, infertility, acanthuses nigricans on the neck
What is PCOS?
abnormalities in metabolism of androgens and oestrogen’s; abnormal function of HPO axis
What investigation should be done for PCOS?
raise testosterone and androgens, LH high levels, low oestradiol, ovarian ultrasound (pearl necklace of cysts around ovary), increased prolactin, increase cholesterol, glucose and insulin levels
What are 5 possible causes of PCOS?
ovarian dysfunction (decreased oestradiol and androgens but increases oestrone), excess weight gain (fatty tissue causes increased conversion of androgens to oestrone), insulin resistance (causes increased androgens, TG and decreased HDL cholesterol), adrenal dysfunction (increases androgens), HPA axis dysfunction (abnormal GnRH causes increased LH and decreased FSH), genetic predisposition, leptin
What is PCOS orthodox treatment?
metformin (insulin resistance), cyproterone acetate, OCP and spironolactone (acne and hirsutism), progesterone (trigger withdrawal bleeding)
What are some nutritional aims for PCOS?
decrease obesity, decrease insulin resistance, promote liver clearance, lower circulating androgens, normalise cortisol levels
What are the naturopathic protocol?
exercise (1 hr, 4 time a week), increase fibre, reduce trans/saturated fats, decrease sugar, increase protein, GL diet for weight loss
How can we promote oestrogen clearance?
evaluate bowel function, increase brassica family, support phase II liver detox and reduce endocrine disruptors
What can be given to women with PCOS to support insulin sensitivity?
Inositol
What supplements should be given to people with PCOS?
vitamin D and calcium - PCOS individual have poor bit D3, spearmint and peppermint (anti-androgen), LAL and mag (insulin resistance)
What is a side effect of metformin?
elevated homocysteine levels
What are uterine fibroids?
non-cancerous benign tumours in submucusally or intramurally
What are the symptoms of uterine fibroids?
heavy bleeding, heaviness in abdominal, abdominal enlargement, increased urinary freq, pain if ischaemic, infertility
What is the pathophysiology of uterine fibroids?
increases local oestradiol in fibroids causing growth
What are 5 risk factors of fibroids?
smoking, OCP, hypertension, obesity (increases oestrogen), pregnancy (post partum involution)
What treatment is there of fibroids?
surgery or GnRH agonists
What are 5 nutritional aims of fibroids?
increase oestrogen clearance, regulate excessive bleeding, improve progesterone and oestrogen balance, decrease inflammation, decrease aromatisation
How can we increase oestrogen clearance?
reduce xenoestrogen sources, increase DIM cruciferous indoles(inhibits conversion of oestrogen), address digestive dysfunction, increase phase 2 liver detox
What is important to consider with excessive bleeding?
anaemia and possibly increasing iron
What is endometriosis?
normal endometrial tissue is found in areas of the body other the uterine cavity
What are 5 symptoms of endometriosis?
dysmenorrhea, heavy bleeding, irregular bleeding, lower abdominal or back pain, bloating, nausea, vomiting
What is the link between endometriosis and fertility?
it can reduce fertility in serious cases but people with low endometriosis can still get pregnant. Pregnancy improves endometriosis because of high levels of progesterone
What is the orthodox treatment for endometriosis?
anti-inflammatory pain killers and hormone treatments, maybe surgery
What toxin is linked to endometriosis?
PCBs - electrical equip, hylauric fluid, carbonless carbon paper
Organochlorines(fish, cows milk, other meats) - mimic oestrogens
What are the naturopathic interventions?
regular exercise, supplement vit C and E (decrease oxidative stress), green tea (inhibits endometrial growth), increased of green and fresh fruit, fish oils, omega 3 fatty acids, vit D
What re some PMS symptoms?
ecreased energy, tension, irritability and sensitivity, depression, headache, altered sex drive, breast pain, backache, abdominal bloating, sugar/salt/carb cravings, and oedema of the fingers and ankle
What is aetiology of PMS?
cyclic changes causes changes in hormones which alters body function (including neurotransmitters), most thought neurotransmitter involved is serotonin, vitamin B deficiencies (excess oestrogen is due to lack of B vitamins not detoxifying the body),
What are some diet and lifestyle considerations for PMS?
Lower GI diet, decrease alcohol and smoking, vitex agnus castus fruit decreases prolactin which is associated with increase PMS symptoms, calcium, magnesium,
What are the 5 subgroups of PMS?
PMT-P (pain) - EPO and mg supplementation PMT - A (anxiety) PMT -C (craving) PMT-D (depression) PMT-H (hyperhydration)
What are 6 major guidelines of PMS?
reduce high GI food, remove alcohol, smoking, tobacco, reduce salt, restrict diary, normalise sleep, increase green leafy vege, mg, zn, B6
What is the difference between peri-menopause, menopause and post menopause?
-Peri-menopause: Starts around 45-50 when hormonal changes start to occur and cycle fluctuations and symptoms start to be experienced.
– Menopause: Around 50-55. Actual cessation of periods.
– Post-menopause: From 55 onwards. When no more periods occur and
generally the worst of the hormonal symptoms have passed.
What are some (5) symptoms of menopause?
hot flushes, lethargy, night sweats, lack of conc, increase urgency to urinate, decrease libido
How does menopause happen?
oss of ovarian sensitivity to gonadotropin stimulation, cessation of ovulation, menopause is when there is no visible eggs left, oestrogen and progesterone decline gradually
What are some treatment for menopause?
hormone replacement therapy (HTP), oestrogen only or oestrogen-progesterone
What nutrients are important for menopause
vitamin C, vit D and calcium, high lignin, vit E, phytoestrogens,
What is the naturopathic protocol for menopause?
Two pieces of fruit and five vegetables to increase antioxidant sources and fibre – Consume whole grains – Increase fibre – Proteins – Eat organic – Low GL diet – reduce caffeine, alcohol intake – Drink at least 2 litres of water a day exercise, eat phytoestrogen rich foods
