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77 Cards in this Set
- Front
- Back
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Age of Menopause
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Around age 50
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Andropause: hormonal changes
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Gradual decline in testosterone at a rate of 1% per year after age 40
Testes lose ability to respond to gonadotropins Blood supply to testes also reduce Seminiferous tubules show damage Blood levels of estrogen rise in older men |
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Andropause vs. Menopause duration
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Andropause symptoms occur gradually from late 40 - 70
Menopause lasts a duration of about a few months |
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Andropause signs and symptoms
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(more women like)
Erections require more foreplay + stimulation Voice pitch rise Facial hair rise scrotum, penis, and other accessory structures reduce in size (prostate can enlarge) Decrease muscle mass and strength Osteoporosis |
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Androgen replacement therapy
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Testosterone is given as a skin patch or gel
DHEA is used to replace Increase libido, muscle mass, bone mass |
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Menopause
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permanent end of menstrual cycling, loss of ovarian follicular activity
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Average of Menopause in world + US
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occurs 45-55
52 years old in USA |
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Clinical Diagnosis of Menopause
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Woman in this age range who has no menstrual cycles for at least one full year
Possible for women to ovulate for up to one year after menopause has occurred and can still have eggs going into menopause |
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Number of lifetime ovulation in relation with the age of menopause onset
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Few ovulations throughout life tends to delay the onset of menopause
More ovulations women have earlier menopause onset Women with multiple pregnancies tend to have later menopause Use of oral contraceptives (mimic pregnancy) have later menopause |
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Woman's behavior and menopause
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Women who breasts feed have later menopause
Women who smoke have earlier menopause |
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Premature Menopause
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Occurs before age 40
Occurs in 1 in 100 women |
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perimenopause
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stage preceding true menopause that lasts an average of 4 years where women experience premenopause symptoms (continues to ovulate)
Symptoms include: oligomenorrhea (infrequent mensturation), irregular periods, vaginal dryness, breast pain, hot flashes |
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Female infertility rates in USA
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5%: 20-29 years
10%: 30-34 years 20%: 35-40 years |
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Egg Aging
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Primary oocytes are arrested in prophase of the 1st meiotic division for as long as 50 years
As eggs age, they have more genetic problems |
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Problem in egg meiosis: polyploidy
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production of embryos that have more than two full sets of homologous chromosomes (3N, 4N)
Lost through spontaneous abortions Increases with age |
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Aneuploidy
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more common than polyploidy
one chromosome too few, or too many (monosomy, trisomy) increases with age |
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Preembryo
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the developing organism between fertilization (conception) and implantation at end of 2nd week post conception
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Embryo
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Stage of prenatal development between implantation (end of second week post conception) through the 8th week post conception
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Chromosomal Abnormalities
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Occurs as ovulated eggs get older
Accounts for about 1/2 of early miscarriages (aneuploidy mostly) Causes preembryos to fail to implant (31% of all conceptions, higher in older women) |
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Infertility under 40 years of age
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Mostly due to loss of preembryos or early implanted embryos due to chromosomal abnormalities
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Perimenopause and infertility (women over 40)
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Infertility rapidly increases due to a dramatic drop in ovarian function, ovulation, and ability to conceive
Simultaneously, women over 40, have rapid increasing percentage of their preembryos that have chromosomal abnormalities |
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Perimenopause and infertility
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After 42, women have less than a 10% chance of being pregnant
but numerous examples of women in their 50s being pregnant naturally |
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Maternal age & Chromosomal abnormalities for 45 year old women
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1/25 embryos with trisomy 21
1/18 embryos with any chromosomal abnormality |
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Menopause symptoms trends
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85% of women have symptoms before and after reaching menopause
Intensity varies between individuals and may last for months to as long a several years Symptoms caused directly or indirectly by drop in circulating estrogen |
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Hot flashes in menopause
How often each hot flash last? How long this lasts? |
most common symptom which is experienced by over 75% of menopausal women in the USA
sudden intense feeling of sweat that spreads to the face and chest 30 seconds - several minutes May occur as often as every 10 minutes for the duration of 30 seconds to several minutes Last for one to five or more years |
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Menopause hot flash origins
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low estrogen during menopause is associated with a woman's sympathetic (pushing) nervous system becoming more active which causes blood vessels in the skin to become dilated and rise in temperature
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Menopause symptoms
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(more male like)
slight shrinking of external genitalia + uterus Vaginal dryness, reduced lubrication increased pH of vaginal fluid weight gain, voice deepening, hair development on chin + upper lip irritability, insomnia, and fatigue |
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Female climacteric in menopause
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all the psychological, emotional, hormonal, and physical changes of menopause
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Perimenopause
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Woman has increased number of cycles that are irregular (anovulatory)
Fewer quality eggs by 40, 50% of eggs are chromosomally abnormal by 42, 90% are chromosomally abnormal |
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Endocrine changes during perimenopause/menopause
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Depletion of ovarian follicles -> decrease in estrogen -> lack of negative feedback on GnRH -> increase in FSH and LH
Decline in release of inhibin (the one used in menopause), increased FSH as well ovaries cease to respond to FSH and LH (no estradiol production despite increase in FSH and LH, cause it breaks down) FSH is 10 times and LH is 4 times higher than in younger women Eventually, decrease in GnRH pulse frequency (after it goes haywire) |
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Evolution of menopause in humans
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African chimps and elephants go through menopause
Evolved menopause to limit fertilization of eggs with chromosomal abnormalities Grandparents to spend more time with grandchildren which has profound benefits |
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Menopause and Osteoporosis
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Dramatic reduction in estrogen -> reduction in stimulation of bone estrogen receptors, causing loss of calcium and phosphorus from bone
Bone become weak and prone to fracture results in 1.3 million fractures per year which lead to 30,000 deaths |
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Bone estrogen receptors
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activates genes in bone
lowers osteoporosis |
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Breast estrogen receptors
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activates genes in breasts
raises breasts cancer |
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Uterine estrogen receptors
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activates genes in uterus
raises uterine cancer |
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Osteoporosis
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present in 25% of USA women over 50 years
Blacks, Latinas, and Asians have lower rates than white women caused by natural menopause, "induced" menopause from surgical removal ovaries, or amenorrhea (lack of estrogen) |
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Risk factors for osteoporosis
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Amenorrhea from weight loss induced by excessive exercise (lack of estrogen from lack of ovulation of egg)
or anorexia nervosa contribute to the development of osteoporosis (not enough estrogen from adipose tissue) |
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Other risk factors for osteoporosis
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low calcium intake
low Vitamin D intake Smoking Fair complexion Nulliparous (no baby) Amenorrhea Menopause Family history Diet low in nuts, seeds, beans, and vegetables |
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Osteoporosis treatment
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Increased weight bearing exercise
Calcium supplements Drugs that inhibit bone breakdown Hormone replacement therapy (but may cause breast cancer) Foods rich in phytoestrogens |
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Postmenopausal disorders
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Osteoporosis
Cardiovascular disease Reproductive organ cancer Dementia including Alzheimer's |
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Treatment for menopause
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Hormone Replacement Therapy
either estrogen alone or in combination with progesterone |
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premarin
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original pharmaceutical estrogen for women
6 estrogen derived from pregnant mares' urine |
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Diosgenin
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molecule extracted from a species of yam that treats menopause
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Benefits of Hormone Replacement Therapy
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relieves hot flashes, night sweats, insomnia
relives vaginal and skin dryness reduces vaginal shrinking reduces osteoporosis reduces risk of colorectal cancer (when combined Estrogen and Progesterone) |
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Risks of Hormone Replacement Therapy
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Heart disease
Breast cancer Ovarian cancer Gallbladder disease Benign uterine fibroids Endometrial Cancer (w/o progestogen) |
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Exogenous Steroid Hormones
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Exogenous molecules that affect hormone receptors in the human body and can increase the risk of breast, uterine, and ovarian cancer
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Xenoestrogens
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human made chemicals (DDT, pesticides, plastics) with very strong estrogenic effects
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Analogs
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Exogenous Steroid Hormone
Molecule synthesized by chemists that are chemically similar to endogenous molecules (analogous) |
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Agonists
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Exogenous Steroid Hormone
Stimulate estrogen receptors |
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Antagonists
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Exogenous Steroid Hormone
Block estrogen receptors |
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Estradiol activates:
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lowers osteoporosis
increases breast and uterine cancer |
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Tamoxifen
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Estrogen Derivative
activates bone and uterine receptors lowers osteoporosis increases only uterine cancer |
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Raloxifene
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Estrogen Derivative
activates only bone receptors lowers osteoporosis |
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Phytoestrogens
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weak estrogenic effects whch appear to be similar to raloxifene
reduce the risk of developing hormone-dependent cancer |
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Phytoestrogens in plant foods may:
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reduce: (menopausal and estrogenal effects)
cardiovascular disease breast cancer ovarian cancer prostate cancer menopausal symptoms osteoporosis |
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Phytoestrogens contain
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non-steroidal estrogen in foods that contain phenyl substitute like estradiol
have affinities for estrogen receptors |
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Isoflavone Phytoestrogens
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soybeans
native to China where it is consumed as whole bean, tofu, miso, soy sauce, flour increased follicular phase decreased FSH and LH levels delay in in peak progesterone levels Most potent known phytoestogrenic effects on humans |
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Lignin Phytoestrogens
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Flaxseed in Linaceae
forms foundation of plant cell wall |
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Coumestan Phytoestrogens
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sunflower seeds, legumes, and bean sprouts
binds to estrogen cytosol receptors |
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Genistein in Asian and American diet
+ Required amounts |
Asian diet contains 20-80 mg of genistein/day
American diet contains 1-3 mg genistein/day Daily consumption of 10-80 gms of soy protiens/day required to ingest 20-80 mg of genistein.day |
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What does the study on urinary phytoestrogens show between Japanese men and women vs. Western men and women
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Japanese men and women have 50-80 fold higer concentration of their phytoestrogens in their urine compared to people on Western diets
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Phytoestrogen and protein synthesis
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Stimulates protein synthesis to a lesser degree than endogenous estrogen
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How does phytoestrogen reduce risk of breast and other hormone dependent cancer?
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overall reduced exposure to estrogen
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Phytoestrogens and Lipids
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~10% drop in total cholesterol, LDL, and triglycerides
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Tea and osteoporosis
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regular consumption of tea is associated with lower rates of osteoporosis due phytoestrogen flavonoids in tea leaves
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Coronary Artery Disease Development and Tea
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Flavonoids (tea) is thought to cause an antioxidant effect as free-radical scavengers that act on enzymes that influence blood clot formation
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Antioxidants / Coronary Artery Disease
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pigments found in carotenoids found in tomato paste, watermelon, and grapefruit
reduce heart attacks |
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Diet and Blood Pressue
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Blood pressure can be substantially lowered with a diet rich in:
fruits, vegetables, low-fat dairy foods with reduced saturated and total fat |
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Environmental Triggers that Modulate Genetic Predisposition to Cardiovascular Disease
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Diet/Overall caloric intake
Obesity Level of physical activity Stress psychological/social |
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Plant Constituents
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Protein
Fat Carbohydrates Vitamins Minerals Phytochemicals/Secondary metabolite compounds |
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Fat
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oily or greasy components that contain glycerol esters
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Saturated fatty acids
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possess no double bonds and are solid at room temperature
OK to eat, but there are better fats |
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Trans fatty acids
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vegetable liquid oils are hydrogenated to become trans fatty acids which are solid at room temperature
Really bad for you |
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Unsaturated fatty acids
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possess one or more double or triple bonds and are liquid at room temperature
Generally healthy Monounsaturated (canola, olive, peanut, almond, sesame, acacado oils) Polyunsaturated (safflower, soy) |
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Essential fatty acids
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unsaturated fats from plants essential in human diet (cannot be made by humans)
Linoleic and Linolenic acid (rich in soybeans and other beans/seeds) |
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Omega-3-fatty acids
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flaxseed oil, walnut oil, salmon oil
polyunsaturated fatty acids |
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Daily recommendation to reduce risk of coronary heart disease
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reduce saturated fat in diet to <10% of calories
Total Fat: 40% of calories mainly from healthy plant based fats with the ratio of monunsaturated:polyunsaturated of 2:1 Protein: 15% of calories Complex Carbs: 45% (non-refined whole grains and fresh fruits and vegetables) |
