Women's Health

Question 1

Why is women’s health important?

Answer 1

UK has the 12th largest female health gap globally

Obesity rate is higher for women (29%)

Women are more likely to have medical conditions that contribute
to weight gain and difficulty losing weight

Health-related impairments occur at lower BMIs in women

Women experience hormonal fluctuations across the month and lifespan that impact health/management

Question 2

Describe PCOS:

• aetiology
• prevalence
• symtoms
• diagnosis

Answer 2

PCOS - polycystic ovarian syndrome

Aetiology:
- exact cause unknown
- thought to be a combination of environmental and genetic factors

Prevalence:
- most common endocrine disorder in women.
- affects up to 10% women (up to 26% in deprived areas)

Symptoms:
- hirtuism (excess hair)
- hair loss/thinning on head
- difficulty getting pregnant
- irregular or no periods
- oily skin/acne

Diagnosis:
(rotterdam criteria) 2/3 of the following:
- irreg or no periods
- cysts on ovaries (ultrasound)
- high androgens levels (LH or T)

Question 3

Describe how PCOS can be treated and managed:

• diet/lifestyle
• pharmacological

Answer 3

NICE guidelines:
‘Encourage healthy lifestyle’

Commonly used dietary approaches:
* Low Glycaemic Index (GI)
* Reduced Carbohydrate
* Mediterranean Diet

Pharmacological:
metformin (can also improve fertility)

Question 4

Describe the treatment and management of endometriosis:

• medical
• diet/lifestyle

Answer 4

Medical:

• analgesics
• hormone: contraceptive to reduce levels of oestrogen
• surgery

Diet/lifestyle:

Anti-inflammatory diet
* Antioxidants (F&V)
* Omega 3 (Oily fish, nuts, seeds)
* Avoid/reduce alcohol, caffeine, trans fats

First line IBS management
* Food triggers
* Mindful approaches

Gluten:
Evidence to date has been observational so insufficient evidence to advice gluten-free diet.

Question 5

Describe how hormonal fluctuations in menopause affects nutritional status

Answer 5

Oestrogen:
- mood
- bone health
- heart health

Oestrogen regulates lipid metabolism
in the liver:
Reduced oestrogen levels –> higher LDL and triglycerides

Oestrogen is involved in bone
metabolism
* Reduced oestrogen levels –> reduced bone density
5-7 years following the
menopause, women can lose up to one-fifth of their bone density.

Question 6

Describe the treatment and management of menopause:

• medical
• diet/lifestyle

Answer 6

Medical:

Hormone replacement therapy (HRT)
Restores oestrogen levels
Usually combined with progesterone to protect womb lining
Helps counteract accumulation of abdominal fat

Diet/lifestyle:

• Bone Health:
  Calcium and Vit D supplementation
• Heart Health – Fibre, Unsat Fats, F&V (general healthy eating advice)
• Plant Oestrogens (Phytoestrogens):
  Similar to human oestrogen if eaten regularly, and in sufficient quantities
• soy beans
• tofu
• tempeh
• soy beverages
  Can take two to three months for benefits to be seen
  Consuming several times a day most effective.