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Nutrition 2 (Semester I) > 7a. Women's Health - Intro > Flashcards

7a. Women's Health - Intro Flashcards

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1
Q

What is the axis that maintains hormonal balance within the female reproductive system?

A

Hypothalamic-pituitary-ovarian (HPO) axis

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2
Q

Which hormones are released by the stimulation of the anterior pituitary by GnRH?

A

LH
FSH

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3
Q

What do LH and FSH do?

A

Support follicle development
Ovulation
Corpus luteum maintenance
Production of progesterone and oestrogen

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4
Q

Raised levels of which hormones exert negative feedback over LH and FSH?

A

Oestrogen
Testosterone

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5
Q

What is pregnenolone?

A

Hormone synthesised by cholesterol
Precursor of DHEA, testosterone, DHT, oestradiol, progesterone and cortisol
Anti-inflammatory

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6
Q

What are low levels of pregnenolone caused by?

A

Advancing age (30+)
Statins

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7
Q

What are the symptoms of low level pregnenolone?

A

Poor memory
Declining concentration/attention
Fatigue
Dry skin
Joint/muscle pain
Decreased libido

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8
Q

How to support healthy pregnenolone levels

A

Healthy fats - avocado, flax, chia, OO
B vits
Vit K
Vit D3
Manage stress
Improve sleep

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9
Q

What is the pregnenolone steal theory?

A

High stress means more pregnenolone is used to make cortisol
Reduces the amount available for the production of sex hormones

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10
Q

How does stress influence the sex hormones?

A

Downregulates LH and FSH
(meaning decreased ovulation)

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11
Q

When is progesterone produced?

A

After ovulation

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12
Q

Where is progesterone produced?

A

Corpus luteum

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13
Q

Which hormone is lacking if ovulation doesn’t happen?

A

Progesterone

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14
Q

What are the functions of progesterone?

A

Maintains endothelium for implantation and pregnancy
Increases cervical mucus (producing a barrier)
Helps relax smooth muscle (potentiates inhibitory actions of GABA)
Supports bone health and mammary development

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15
Q

Causes of low progesterone

A

Chronic stress
Synthetic progesterones
Xenoestrogens

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16
Q

Signs and symptoms of low progesterone

A

Irritability
Mood swings
Insomnia

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17
Q

How to balance progesterone

A

Support oestrogen detoxification
Increase fibre
Balanced meals
No snacking
Avoid alcohol until balanced
Mg, Vit C, B6, Zn
Agnus castus

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18
Q

What are the different types of oestrogen?

A

Oestrone (E1)
Oestradiol (E2)
Oestriol (E3)

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19
Q

How are oestrogens made?

A

Conversion of androgens via aromatase
(in ovaries, breast, adipose tissue, bone)

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20
Q

Which is the most physiologically active oestrogen during reproductive years?

A

Oestradiol (E2)

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21
Q

What are the functions of oestrogen?

A

Reproductive tract development
Menstrual cycle
Cell proliferation
Glucose homeostasis
Bone health
CV health

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22
Q

What can cause oestrogen dominance?

A

Elevated oestrogen relative to progesterone
Poor detoxification/elimination
Overexpression of ER-a and ER-b

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23
Q

Which conditions are associated with oestrogen dominance?

A

Fibroids
Endometriosis
PMS
Infertility
Miscarriages
Perimenopause
Breast/ovarian/endometrial cancers
Insulin resistance
Thyroid dysfunction

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24
Q

What are the causes of oestrogen dominance?

A

Synthetic HRT (synthetic progestin acts like testosterone)
OCP (negative feedback, prevention of ovulation)
Xenoestrogens
Heavy metals
Obesity (increased aromatisation of testosterone to oestrogen)
Poor liver detoxification/methylation
Constipation
Intestinal dysbiosis
Chronic stress (downregulates LH and FSH)

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25
What happens during phase 1 oestrogen metabolism?
Liver breaks oestrogen down into smaller units
26
Which metabolites does oestrone (E1) convert to during phase 1 metabolism?
2-OH-E1 4-OH-E1 16-OH-E1
27
Which enzyme converts oestrone (E1) to 2-OH-E1?
CYP1A1
28
Which enzyme converts oestrone (E1) to 4-OH-E1?
CYP1B1
29
Which enzyme converts oestrone (E1) to 16-OH-E1?
CYP3A4
30
Describe 2-OH-E1
Weakest, protective form Deactivated by COMT to 2-Methoxy-E1
31
Describe 4-OH-E1
Neutralised by COMT to 4-Methoyx-E1 Pro-carcinogenic if goes down the 4-Quinone-E1 route
32
Describe 16-OH-E1
High binding affinity Associated with higher risk of oestrogen dependent conditions - heavy periods, clots, tender breasts, endometriosis, fibroids, breast cancer
33
How to support Phase 1 oestrogen metabolism
I3C (broccoli sprouts), cruciferous, AOs, glutathione, turmeric, berries, rooibos tea, celery Support healthy microbiome Avoid paracetamol, PCBs, grapefruit, smoking
34
What happens during Phase 2 oestrogen metabolism?
Broken down fat-loving, oestrogen metabolites have a water molecule added to them to enable elimination Metabolites change from OH to Methoxy
35
How are 2-OH-E1 and 4-OH-E1 metabolised during Phase 2?
Methylation via COMT Converts to 2-Methoxy-E1 and 4-Methoxy-E1
36
Why might 4-OH-E1 and 16-OH-E1 levels elevate?
If methylation is compromised
37
What does poor methylation of 4-OH-E1 mean?
Increased conversion to 4-Quinones-E1 (increased oxidative damage and cancer risk)
38
Which detoxification pathways are used to metabolise oestrogen?
Methylation Sulphation Glucuronidation
39
How can Phase 2 oestrogen metabolism be supported?
Cruciferous, alliums Mg, AO, B6, B9, B12 SAMe, choline Avoid OCP, high alcohol, high cortisol, mould exposure
40
What is the oestrobolome?
Collection of microbes capable of metabolising oestrogens
41
Examples of microbes that metabolise oestrogens
Beta-glucuronidase E. coli Clostridium perfringens Bacteroides fragilis/vulgatus
42
What is the role of beta-glucuronidase?
Reactivates oestrogens already conjugated for elimination
43
What effect can beta-glucuronidase have one conjugated oestrogens?
Deconjugate them and allow them to be reabsorbed into the bloodstream via enterohepatic circulation
44
What factors can contribute to an increased amount of beta-glucuronidase?
Dysbiosis Low fibre intake Poor bile flow
45
What conditions can higher levels of beta-glucuronidase lead to?
Endometriosis Breast/ovarian cancers (increased circulating oestrogen = oestrogen dominance)
46
What conditions can low levels of beta-glucuronidase lead to?
PCOS (increased androgen synthesis and reduced oestrogen levels)
47
Ways to maintain healthy beta-glucuronidase
Optimise the microbiome (pro/prebiotics) If high levels - increase fibre, Ca D-glucarate (BG inhibitor), apples, cruciferous veg, milk thistle, Lactobacilli If low levels - probiotics
48
Where is testosterone produced?
Ovaries Adrenal cortex
49
Which form of oestrogen does testosterone get converted to?
Estradiol (E2)
50
What converts testosterone to estradiol (E2)?
Aromatase
51
What are the functions of testosterone in women's health?
Ovarian density Libido Bone strength Mood Cognition
52
What can high levels of testosterone lead to?
PCOS Anovulation Hirsutism Acne vulgaris
53
What can low levels of testosterone lead to?
Low mood Low libido Cognitive dysfunction
54
What can testosterone convert to in addition to estradiol (E2)?
DHT
55
Which enzyme converts testosterone to DHT?
5a-reductase
56
What things can increase DHT levels?
Insulin Inflammation Obesity
57
What things can decrease DHT levels?
Nettle root Saw palmetto Lycopene Turmeric Green tea Zinc
58
What is SHBG?
Glycoprotein produced to transport fat-soluble sex hormones in the bloodstream to the correct places
59
Why do we need SHBG?
Unbound sex hormones are biologically active and could create problems if in high levels
60
What does low levels of SHBG lead to?
Higher levels of circulating, biologically active sex hormones Hyperinsulinemia Obesity Metabolic syndrome T2D Hypothyroidism PCOS
61
What does high levels of SHBG lead to?
Anorexia Pregnancy Androgen deficiency Hyperthyroidism Liver disease
62
What are the functions of prolactin?
Lactation Breast maturation Inhibits menstruation
63
Examples of endocrine disrupters
BPA (plastic bottles) Heavy metals Pesticides NSAIDs Tap water
64
What do endocrine disrupters do?
Alter hormone receptor signalling Alter hormone production, secretion and metabolism Induce oxidative stress, mitochondrial damager
65
What can endocrine disrupters increase the risk of?
Cancer PCOS Early puberty Infertility Obesity
66
What are xenoestrogens?
Endocrine disruptors that are structurally similar to oestrogen Bind to oestrogen receptor sites
67
Examples of xenoestrogens
Pesticides Parabens BPA Tap water
68
Why is dairy a endocrine disruptor?
Commercial milk derived from pregnant cows who have increased hormone production during third trimester E1, E2, E3 all found in milk IGF, PCBs, insecticides also found in milk
69
What are phytoestrogens?
Naturally occurring plant compounds similar to estradiol (E2)
70
How do phytoestrogens work?
Produce a weak anti-oestrogenic effect in the presence of high endogenous oestrogen Reduces circulating bioavailable E2 Produces a weak oestrogenic effect in the presence of low endogenous oestrogen Disrupts aromatase - favouring 2-OH-E1 pathway
71
What are the health benefits of phytoestrogens?
Lower risk of menopausal symptoms, CVD, metabolic syndrome, T2D, breast cancer
72
What types of foods do phytoestrogens occur naturally in?
Flavonoids - soybeans, legumes, lentils, chickpeas Lignans - linseed, fruit, veg Flavones - parsley, thyme, celery, chamomile tea
73
What are the better sources of soy to eat for their phytoestrogenic effect?
Fermented soy such as tempeh, miso (avoid soy isolates and other processed soy)
74
How can phytoestrogens ferment in the gut?
Microbiome
75
What things can contribute to a sex hormone imbalance?
Blood glucose dysregulation Excessively high or low body weight Chronic low grade inflammation Poor digestion Dysbiosis Poor detoxification/elimination Chronic stress Disrupted sleep Mg, B vits, Zn deficiencies
76
First step to balancing hormones
Avoid processed foods, refined sugar, table salt, cow's dairy Focus on fruit/veg, wholegrains, nuts, seeds, water, small amount of oily fish Encourage effective digestion
77
Second step to balancing hormones
Improve blood glucose Weight management Reduce inflammation - reduce inflammatory foods (dairy, alcohol, sugar, processed Increase AO rich foods, oily fish, nuts, seeds Support digestion and elimination - bitters, fibre, hydration Build microbiome - 5R, pre/probiotics Support thyroid hormone synthesis - Fe, I, Zn, Se etc Support detoxification Manage stress levels Improve sleep
78
Nutrients to promote 2-OH-E1 route over 4/16-OH-E1 routes
Cruciferous veg I3C O3
79
Nutrients to reduce oxidation of 2-OH and 4-OH
A, C, E ALA NAC Turmeric Green tea
80
Nutrients to promote methylation of 2-OH and 4-OH
B2, 6, 9, 12 Mg
81
Nutrients to increase circulating levels of SHBG
Fibre Flax Nettle root
82
Nutrients to inhibit aromatase
Flax Phytoestrogens Green tea Mg Zn
83
Nutrients to promote the detoxification of oestrogens by upregulating P1 and 2 enzyme activity
B2, 6, 12 Mg Protein
84
Nutrients to inhibit the activity of beta-glucuronidase
Fibre Probiotics Ca D-glucarate
85
Nutrients to inhibit 5a-reductase, reducing conversion to DHT
Lycopene Turmeric Green tea Saw palmetto
86
Nutrients to modify oestrogen receptor activity
Flax I3C Resveratrol

Nutrition 2 (Semester I) (15 decks)

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