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Flashcards in Gynecological Disorders Deck (29)
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1

Gynecological Disorders

1) Hormone Imbalance Disorders
2) Menopause
3) Dysmenorrhea

2

Hormone Imbalance
aka

aka: estrogen dominance, hyperestrogenism

3

Hormone imbalance
--may contribute to:

1) premenstrual syndrome
2) abnormal uterine bleeding
3) benign growths of breast, uterus, ovary
4) breast cancer risk
may be affected by nutrition or botanical agents

4

hormone imbalance
--possible causes

1) obesity:
2) hyperinsulinemia
--affects gonadal hormone metabolism
3) impaired hepatic estrogen metabolism
--estrogen is conjugated and excrete in bile
4) inappropriate reactivation & absorption of excreted conjugated estrogen from the gut
--requires beconjugation by certain intestinal flora

5

phytochemical effects on estrogen

1)Plant fiber
--enhance excretion of conjugated estrogen
--influence flora balance to reduce estrogen beconjugation
2) Phytoestrogens from soy, flax, herbs
--may block estrogen r/c
--may (+) estrogen catabolism
3) Cruciferous veggies
--stim estrogen catabolism

6

Other influences on estrogen

1) alcohol may increase estrogen levels
2) B-Vitamins
--needed for hepatic estrogen catabolism
--actived B6 can block hormone r/c
3) Exercise may lower estrogen levels

7

premenstrual syndrome definition

--defined by symptoms and their timing
--when more severe and disabling = premenstrual dysphoric disorder
--Timing: onset 7-10days before menses, ending when menses starts
*estrogen dominance appears to play a role

8

PMS treatment

1) estrogen-balancing approaches
--vegetarian, high-fiber, low-fat diet
--Vit B6 100mg/day

9

PMS botanical therapy

1) Vitex Agnus (Chasteberry)
--may affect progesterone & prolactin levels
2) several tested european products
*Best choice = Femaprin by nature's way 20mg/day

10

PMS combo products

PMS-specific multis
--B-complex w. extra B6
--Calcium & Mg
--Vit E
--Vitex agnus
--phytoestrogens

11

Fibrocystic breast disease

a benign but painful condition
--painful cysts are present throughout monthly cycle
*associated with estrogen dominance
--soy protein, flaxseed, isoflavone supplement
--may be associated with methylxanthine
*eliminate caffeine, theobromine, theophylline

12

Fibrocystic breast disease
*best supplement =

--red clover isoflavones, 40mg/day
--reduced pain by 44%

13

soy & hot flashes

--mixed results...may be placebo effect
--best results = 50% reduction w. 50mg/day
--not effective in breast cancer survivors

--other benefits = lover LDL, BP, arterial stiffness, osteoporosis prevention

14

menopausal symptoms

--hot flashes, skin & vaginal dryness, reduced libido. easy bruising
--recent warnings against HRT
--aerobic exercise & plant based diet
--phytoestrogens may be pro-estrogenic rather than anti-estrogenic in perimenopausal women

15

menopausal symptoms & hot flashes

--50% reduction in freq & severity = 50mg/day isoflavones, soy , or pills
*not effective in breast cancer survivors
--other benefits = lower LDL, blood pressure, decreased arterial stiffness, osteoporosis prevention

16

menopausal symptoms
& flaxseed

--40g/day was effective as HRT
--contains phytoestrogenic lignans
--effectiveness may require optimum colon flora for conversion of phytoestrogens to more effective forms
--only about half the population make adequate conversion

17

menopausal symptoms & red clover

80mg/day reduced 44% of hot flashes
twice day =best bcuz fast half life

18

menopausal symptoms
& black cohosh

aka: cimicifuga racemosa

19

dysmnorrhea

--pelvic & low back pain occurring during menses
--r/o 2ndary causes
--associated w/ eicosanoid imbalances: congested circulation & ischemia, smooth m irritability & increase pain sensitivity
--relationship to hormone imbalances is unclear
--exercise, healthy diet, and stress reduction = effective

20

Prostaglandin modification & dysmorrhea

--omega 3
--vegetarian diet
--neptune krill oil
--ginger root powder
--pycnogenol (pine bark extract)

21

dysmorrhea & smooth muscle relaxation

Calcium & magnesium

22

dysmorrhea & unclear mechanisms

--low fat or vegetarian diet
--vit E

23

PCOS
clinical pic = 1/3

--hirsutism 50%
--obesity 40%
--infertility 20%
--amenorrhea 50%
--AUB 30%

24

PCOS
--supplements

--increase SHBG: soy, flax, mettles, green tea
--decrease androgens: saw palmetto, green tea extract
--improve insulin resistance: vit C, chromium, diet

25

PCOS
--botanicals

--increase ovulation: vital (chaste tree), rhodiola, tribulus
--decrease T or conversion to DHT
--reishi (ganoderma lucid)
--licorice
--white peony
--green tea
--spearmint

26

reishi (ganoderma lucidum)

inhibits T --> DHT decreasing acne & balding

27

licorice

phytoestrogen effects and inhibits T decreasing hirsutism

28

green tea

also reduced risk of DM2 & CA

29

spearmint

--decreases fT helping to reduce hirsutism
--tea 2 cups qd