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Nutrition 2 (Semester I) > 7b. Women's Health - Pathologies > Flashcards

7b. Women's Health - Pathologies Flashcards

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1
Q

Non-physical signs/symptoms of PMS

A

Mood swings
Irritability
Anxiety
Poor concentration
Food cravings
Increased appetite

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2
Q

Physical signs/symptoms of PMS

A

Bloating
Breast tenderness
Headaches
Acne
GIT upset

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3
Q

Signs/symptoms and causes of PMS-A (anxiety)

A

Anxiety, irritability
High oestrogen:progesterone ratio

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4
Q

Signs/symptoms and causes of PMS-C (craving)

A

Sugar cravings, increased appetite
Blood glucose imbalance, low Mg

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5
Q

Signs/symptoms and causes of PMS-D (depression)

A

Depression, teary
Low oestrogen:progesterone ratio, low serotonin

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6
Q

Signs/symptoms and causes of PMS-H (hyperhydration)

A

Weight gain, breast tenderness, bloating
Increased water retention due to excess salt intake, excess oestrogen, stress, Mg def

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7
Q

Causes/triggers of PMS symptoms

A

Interactions between progesterone, oestrogen and neurotransmitters
Progesterone inhibits GABA receptors
Deficient serotonin functioning due to progesterone and oestrogen modifying serotonin availability (also poss nutrient def - tryptophan, gut dysbiosis)
Reduced cortisol awaking response
Smoking
Obesity
Alcohol (negative association with anxiety, mood changes, headaches during PMS)
High intake of dairy/refined sugars; low protein intake
High O6:O3 ratio increasing inflammation and aromatisation

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8
Q

Naturopathic approach to PMS

A

Avoid/minimise high GI foods, caffeine, alcohol, smoking, table salt, dairy, red/processed meats
Balance oestrogen:progesterone ratio - B vits, cruciferous, Mg, high fibre, increased phytoestrogens, remove endocrine disruptors
Optimise weight
Address stress
Balance blood glucose
Reduce inflammation
Balance neurotransmitters - tryptophan, tyrosine, B6, 9, 12, Zn, Mg, L-theanine, St John’s Wort
Reduce fluid retention - reduce Na/increase K-rich foods, B6 to help regulate aldosterone, seed cycling, diuretics - celery, dandelion, nettle

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9
Q

Why is B6 important for PMS?

A

Co-factor for GABA, serotonin, dopamine
Modulates oestrogen
Corpus luteum development
Oestrogen-progesterone imbalance can lead to B6 def - reduced dopamine = increased prolactin which affects breast tissue, promotes water retention
OCP can deplete B6

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10
Q

Why is Mg important for PMS?

A

GABA/serotonin synthesis

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11
Q

Why is Ca important for PMS?

A

Co-factor for tryptophan-serotonin conversion

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12
Q

Why is vit D important for PMS?

A

Neurotransmitter function

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13
Q

Why is Zn important for PMS?

A

Proper functioning of sex hormones
Controls prolactin

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14
Q

Why are EFAs important for PMS?

A

Women with PMS shown to have EFA/prostaglandin abnormalities e.g. low GLA
GLA is a precursor to PG1 which inhibits prolactin

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15
Q

Why is vitex agnus castus important for PMS?

A

Binds to dopamine receptors to reduce secretion of prolactin
Reduces mood changes, irritability, headaches and breast tenderness

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16
Q

Why is gingko biloba important for PMS?

A

Breast pain/tenderness

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17
Q

Why is rosemary important for PMS?

A

AO effects
Neutralises quinones by reducing 16-OH-E1 and increasing more 2-OH-E1

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18
Q

Why is ashwagandha important for PMS?

A

Adaptogen
Nervine
Thyroid support

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19
Q

Why is ginger tea good for PMS?

A

Improves blood circulation
Reduces cramping
Reduces bloating

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20
Q

Which herbal teas are good for PMS-A?

A

Chamomile
Passionflower

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21
Q

Why is green tea good for PMS?

A

L-theanine content to calm NS

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22
Q

Why is peppermint tea good for PMS?

A

Antispasmodic
Eases bloating

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23
Q

Why is St John’s Wort tea good for PMS?

A

Mood enhancer

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24
Q

What is PCOS?

A

An endocrine metabolic condition

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25
What are the signs and symptoms of PCOS?
Irregular/absent periods Weight gain Hirsutism Thinning hair/hair loss Oily skin Acne Infertility
26
What are the complications of PCOS?
T2D Gestational diabetes Hypertension Dyslipidaemia NAFLD Metabolic syndrome Endometrial cancer AI Depression/anxiety
27
What is the pathophysiology of PCOS?
Increased LH = increased androgens Reduced FSH reduces aromatisation of androgens to oestrogen, leading to anovulation Suppressed SHBG = increased free circulating androgens/testosterone
28
What is the most common mediator in the majority of PCOS cases?
Insulin resistance
29
How does insulin resistance lead to PCOS?
Decreases SHBG synthesis = increased free circulating androgens/testosterone Increases ovarian androgen production Increases adrenal androgen secretion Leads to leptin resistance
30
What increases the risk of PCOS?
Obesity Chronic low-grade inflammation Gut dysbiosis Chronic stress Genetics Smoking Vit D def
31
Why can obesity lead to PCOS?
IR increases adipogenesis and decreases lipolysis IR increases androgen production IR sensitises thecal cells to LH and increases androgen production
32
Why can low-grade inflammation lead to PCOS?
Western diet Obesity Lack of exercise Metabolic endotoxaemia High levels of oxidative stress All adds to IR
33
Why can gut dysbiosis lead to PCOS?
Alters hormone secretions Alters gut-brain mediators Alters inflammatory pathways Alters islet b-cell proliferation
34
Why can chronic stress lead to PCOS?
Increased production of adrenaline/cortisol = increase in IR Stimulates production of DHEA which converts to testosterone in peripheral tissues
35
Why can genetics lead to PCOS?
Polymorphisms in CYP11/CYP17
36
Why can vit D deficiency lead to PCOS?
Reduces insulin sensitivity
37
Examples of hormones/markers elevated during PCOS?
Testosterone with DHT DHEA Androstenedione Oestrogen Prolactin LH Insulin HbA1c TNF
38
Examples of hormones/markers low during PCOS?
Progesterone FSH SHBG
39
What are the therapeutic aims for supporting PCOS?
Decrease insulin resistance Balance blood glucose Decrease central obesity Reduce inflammation and oxidative stress Reduce stress/cortisol levels Liver detoxification for oestrone clearance
40
Protocols for supporting blood glucose balance, insulin sensitivity and weight loss in PCOS
Low GI foods Low saturated fat No trans fats/processed foods Increase fibre Limit snacking Quality protein from vegs, eggs, fish Optimise O6:3 ratio Include chromium-rich foods - cinnamon, berberine, ALA, vit D, Mg, CoQ10 HIIT/interval training
41
Protocols for supporting hormone balance in PCOS
Seed cycling Liquorice Spearmint tea Nettle root Green tea Saw palmetto
42
Protocols for supporting HPA axis in PCOS
Ashwagandha Mg Chamomile, passionflower, lemon balm teas Limit caffeine Sleep hygiene Yoga
43
Protocols for supporting microbiome, detoxification and elimination in PCOS
Probiotics/prebiotics/fermented foods/increased fibre – for gut microbiome balance Cruciferous veg, B complex, Mg, NAC, silymarin – for detoxification/elimination
44
Why can myo-inositol be used to support PCOS?
Improves insulin sensitivity Positive effect on elevated androgens Decreases serum testosterone Helps regulate menstrual cycle
45
Typical dosage of myo-inositol for PCOS
1g/day
46
Food sources of myo-inositol
Whole grains Beans Nuts Fruit
47
What is endometriosis?
Presence of endometrial tissue outside uterus
48
Where can endometrial tissue end up outside of the uterus?
Ovaries Fallopian tubes Rectum
49
What is the pathophysiology of endometriosis?
Endometrial tissue follows the menstrual cycle causing it to grow, break down and bleed The blood has no outlet, leading to inflammation, pain, formation of scar tissue
50
Signs/symptoms of endometriosis
Dysmenorrhoea Heavy menstrual bleeding Dyspareunia Chronic pelvic pain Lower back pain Migraines Anxiety Depression
51
Complications of endometriosis
Infertility Bowel obstruction Ovarian cancer
52
Why is histamine implicated in endometriosis?
Oestradiol (E2) is needed for endometrial tissue growth Mast cells contain oestrogen and progesterone receptors Oestrogen triggers histamine degranulation Histamine induces ovarian E2 synthesis High histamine drives inflammation and angiogenesis = endometriosis proliferation While progesterone has an inhibitory effect on histamine, it is overridden by oestrogen
53
Causes/risk factors for endometriosis
Immune dysfunction - inability to recognise endometrial tissue outside uterus Surgical scar implantation Endometrial cell transport via lymphatics Prolonged oestrogen exposure (early period, OCP) Obesity Poor oestrogen detox/elimination Environmental toxin exposure Emotional trauma Microbial infections Consumption of fats, red meat, alcohol Diet low in fibre, O3, Se, vit D
54
How can microbial infections be a risk factor for endometriosis?
Virus e.g. EBV, E. coli or parasite Dysbiosis can lower DAO enzyme activity Compromised mucosal barrier - increase in LPS contributing to inflammation
55
Naturopathic approach to endometriosis
Immune support Reduce histamine load Reduce exposure to hormone disruptors Optimise liver function for detox/elimination Optimise intestinal microflora Reduce inflammation
56
Nutrients to support endometriosis
Turmeric, ginger, ALA, resveratrol, O3 - inflammation Probiotics/prebiotics - microbiome support/bacterial contamination B6, B9, B12, choline - methylation B vits, Mg, glutathione, NAC - liver support Green tea, quercetin - histamine lowering Cruciferous veg, onions, garlic - aromatase inhibitors Vit D, vit C, Zn - immune support
57
What are uterine fibroids
Benign tumours that originate from the myometrium and connective tissue
58
Signs/symptoms of fibroids
50-80% are asymptomatic Heavy/prolonged menstrual bleeds Pelvic pain Abdominal bleeding Frequent urination Constipation
59
Complications of fibroids
Iron def anaemia Infertility Miscarriage Obstructed labour
60
Causes/risk factors of fibroids
Genetics - SNPs on CYP1A1 Hypertension - may cause smooth muscle cell injury Poor oestrogen metabolism Chronic stress Heavy metals - cadmium and lead active oestrogen receptors Diet/lifestyle - low fibre, high sat fats, refined carbs, caffeine, alcohol, low physical activity Vit D deficiency - needed to inhibit fibroid cell proliferation
61
Naturopathic approach to fibroids
Support oestrogen balance and detoxification Regulate excessive bleeding Reduce inflammation
62
Why is it important to reduce oestrogen levels in fibroids?
Fibroids are oestrogen dependent Oestrogen receptors are over-expressed in fibroid tissue Excess aromatisation also seen IGF and cytokines also promote fibroid growth
63
Protocols for supporting oestrogen balance and detoxification in fibroids
Eliminate caffeine and alcohol – for liver support Support liver detoxification – cruciferous veg, B-complex, Mg, NAC Choleretics/cholagogues - globe artichoke, turmeric Increase phytoestrogen foods – chickpeas, flaxseed – for oestrogen balance Increase fibre-rich wholefoods to improve oestrogen excretion Green tea – epicatechins shown to inhibit fibroid cell growth Sage – for oestrogen balance Red clover – for oestrogen balance Vitex Agnus castus – prolactin inhibitor Avoid endocrine disrupters/xenoestrogens Address stress – to reduce cortisol/inflammation
64
Protocols to regulate excessive bleeding in fibroids
Fe-rich foods - spirulina, apricots, nettle leaf tea Vit C - to enhance absorption Astringent herbs to control blood flow - yarrow, cranesbill Check Fe/ferritin levels
65
Protocols to reduce inflammation in fibroids
Eliminate all sources of arachidonic acid - refined sugars, red meat, eggs O3 Ginger Curcumin Bromelain Serrapeptase
66
What are the 5 stages of menopause (plus ages)?
Premature menopause (<40) Early menopause (40-45) Perimenopause (45-50) Menopause (50-55) Post-menopause (55+)
67
What are the hormonal changes during perimenopause?
FSH and LH levels rise due to reduced negative feedback O:P ratio fluctuates a lot
68
What are the hormonal changes during menopause?
Low oestrogen Persistently high FSH and LH
69
What are the hormonal changes post menopause?
Insufficient testosterone from adrenal glands to sustain libido (assess adrenal health)
70
What factors can affect the smooth transition through to menopause?
Obesity Smoking Chronic stress Gut microbiome changes Family history Lead exposure
71
Signs/symptoms of menopause
Hot flushes (spicy food, alcohol, stress, smoking, caffeine) Weight gain/obesity (genetic factors, hormonal) Sleep disturbance (night sweats) Mood disturbances (irritability, mood swings, anxiety, depression) Genitourinary (dry/sore vagina, dysuria) Joint/muscle pain Headaches Dry skin Low libido Poor memory/concentration
72
Natural approach to supporting menopause
Increase AO/fibre Include 1x phytoestrogen source day (flax, fermented soy, sage) Plant protein over animal Prebiotic/probiotic foods Drink at least 1.5 l water/day Low GI diet O3 Avoid food/beverages aggravating hot flushes - alcohol, caffeine, spicy food Lose weight Balancing blood glucose
73
Protocols for reducing fracture risk in menopause
Ca Vit C, D, K2 Mg Black cohosh Weight bearing exercise
74
Protocols for managing stress/anxiety in menopause
Mg L-theanine B vits Ashwagandha Bach flowers Yoga Acupuncture Breathing exercises
75
Protocols for improving sleep in menopause
Passionflower Valerian Mg
76
Why is black cohosh good for menopause?
Oestrogen modulating Energetically cooling Reduces hot flushes Supports bone density
77
Why is shatavari good for menopause?
Testosterone effects Adaptogen Relieves vaginal dryness
78
Which herbs are good for calming in menopause?
Chamomile Valerian root Passionflower
79
Why is St John's Wort good for menopause?
Reduces hot flashes Improves sleep Improves mood Relieves anxiety
80
Why is liquorice root good for menopause?
Mildly oestrogenic
81
Why is maca good for menopause?
Improves libido Improves sleep Improves hot flushes Improves mood Interferes with androgen receptors

Nutrition 2 (Semester I) (15 decks)

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