Womens Health And Fertility

Front 1

How long is the female reproductive cycle?

Back 1

28 days

Front 2

What 3 phases is the female reproductive cycle split into?

Back 2

Menstruation phase
Proliferative phase
Secretory phase

Front 3

What days to each phase happen on?

Back 3

Menstruation phase = 1 - 7
Proliferative phase = 7 - 14
Secretory phase = 21

Front 4

What day ranges does ovulation occur?

Back 4

13-15

Front 5

What two hormones in the reproductive cycle does the anterior pituitary release?

Back 5

FSH and LH

Front 6

What two hormones in the reproductive cycle does the ovaries release?

Back 6

Estradiol and progesterone

Front 7

Name two things FSH does?

Back 7

inhibits LH
Causes the release of estrogen

Front 8

What does LH do?
What happens to LH when in the menstrual cycle?

Back 8

Causes the follicule to become the corpus luteum
LH levels rise rapidly around two weeks into the menstrual cycle triggering ovulation

Front 9

What does estradiol do?
What produces it?

Back 9

Estradiol along with progesterone prepares the endometrium for implantation
The growing follicules

Front 10

What is the role of progesterone in the menstrual cycle?

Back 10

It keeps the endometrium thick

Front 11

Name 2 places that produce estrogen?

Back 11

Ovary and adrenal glands

Front 12

What is the active form of estrogen called?
What is the weak form excreted in high amounts during pregnancy?

Back 12

Oestradiol

Oestriol

Front 13

What is oestrogens main role?

Back 13

To increase the growth of cells in places where there are estrogen receptors

Front 14

What moves around estrogen and testosterone in the body?
What is this made?

Back 14

Sex hormone binding globulin (SHBG)

Made in the liver

Front 15

Name two things that happen after the period?

Back 15

The ovaries secrete oestradiol
FSH develops the follicules

Front 16

When do ovarian estrogen reach a peak?

Back 16

Just before ovulation then stay stable until a drop prior to menstruation

Front 17

Name another way estrogen is created?

What then happens?

Back 17

Converstion of androgens to estrone via aromatase (a CYP 450 enzyme)

Enzymes convert estrgen toe 2-hydroxy estrogen, 4 hydroxyestrone or 16 hydroxyestrone

Front 18

What has been related to a higher risk of breast cancer and why?

Back 18

An elevated amount of 4-16 hydroyestrone due to its toxicity and reactivity

Front 19

What enzymes convert oestrogen?

Back 19

CYP 450 enzymes

Front 20

Which conjugation pathways can be involved?

Back 20

Sulfation, methylation or glucoronidation

Front 21

What does methylation and sulfation do to estrogen when conjugating it?

Back 21

Sulfation adds to the circulating estrogen pool

Methylation has a protective quality.

Front 22

What can check for methylation activity?

Back 22

Checking homocysteine levels

Front 23

What happens to estrogen if it goes down the glucoronidation pathyway?

Back 23

In the presence of imbalanced bowel flora the metabolites become deconjugated and reabsorbed

Front 24

What happens to all remaining circulating estrogen?

Back 24

It is excreted in the kidneys

Front 25

3 places progesterone is produced and in what quantities?

Back 25

Adrenals - small amounts
Corpus luteum - large amounts
Placenta - massive amounts

Front 26

Progesterone has a high ifinity to what?
Therefore?

Back 26

Mineral cortiticoid receptors therefre it is an antagonist to cortisol

Front 27

What estrogen metabolite encourages tumor development and which inhibits cancer growth?

Back 27

Inhibits = 2 hydroxyestrone
Encourages = 16 hydroxyestrone

Front 28

Name a dietary way to reduce estrogen metabolites?

Back 28

Adequate fibre

Front 29

Name 3 ways to reduce estrogen metabolites?

Back 29

Fibre
Normal bowel flora
Liver detox pathways - methylation b vits, glucoronidation - calcium d glucarate

Front 30

When reducing estrogen metabolites by supporting liver detox pathways... how may you do this?

Back 30

Methylation = B vits
Glucoronidation = Calcium d glucarate

Front 31

In any hormone balance or fertility program, what is prudent?

Back 31

Avoid dairy

Front 32

Name a supplement to stop the conversion of estrogen to 16- hydroxyestrone?
Dose?

Back 32

DIM

100-400mg day

Front 33

Name a good vegetable to take if you're wanting to reduce estrogen emtabolites and why?

Back 33

Broccoli because it creates indole 3 carbinol

Front 34

What competes with estrogen as an antagonist for receptors?

Back 34

Genistein

Front 35

Five ways to balance hormones naturally (learn!)

Back 35

Increase dietary fibre, increase lignans, adequate protein intake (low GL), phytoestrogens, bassica

Front 36

How does fibre help balance hormones?
How do increased lignans help balance hormones?
How does adequare protein help hormones?
How do brassicas help hormones?

Back 36

Balances estrogen metabolites
Physotestrogen and high fibre
Needed for estrogen metabolism in the liver
Contains indoles

Front 37

How do indoles help reduce estrogen?

Back 37

Prevents the conversion of estrogen into 16 hydroxyestrone

Front 38

3 sources of brassica?

Back 38

Cabbage, brocolli, brussels sprouts

Front 39

Name two dietary ways to increase methylation conjugation power?

Back 39

Folic acid, B2, B6, b12

Front 40

We've already covered this but, more simply, name 3 ways to reduce estrogen metabolites?

Back 40

Indole 3 carbinol or dim = increase estrogen clearance
Calcium d glucarate = increase glucoronidation pathway
B6 = reduce elevated estrogen levels

Front 41

Two things that characterise PCOS?

Back 41

Multiple cysts on the ovaries and excess androgen production.

Front 42

Two symptoms of PCOS

Back 42

Hirsutism, lines on neck

Front 43

Two investigations into PCOS?

Back 43

Estradiol normal, estrone raised
Testosterone, DHEA, androstenidone raised

Front 44

Name 4 possible causes of PCOS?

Back 44

Insulin resistance
Ovarian dysfunction
Imbalanced HPA Axis
Adrenal dysfunction

Front 45

How may insulin resistance cause PCOS?
How many imbalanced HPA axis cause PCOS?

Back 45

Elevated insulin levels = raised ovarian androgens
Inappropriete GnRH leads to raised LH and lowred FSH

Front 46

Name 3 recommended naturopathic tests for PCOS?

Back 46

Salivary adrenal stress index
Female hormone panel
Glucose tollerence test

Front 47

Name four typical hormone disturbances with PCOS?

Back 47

LH elevated, FSH low 2:1
Progesterone low
SHBG low
Tesotsterone and DHEA high

Front 48

Diet for PCOS?

Back 48

Low GL

Front 49

Name 4 naturopathic treatment aims for PCOS?

Back 49

Decrease central obesity
Increase insulin sensitivity
Promote estrone clearance by supporting phase 2
Lower circulating androgens

Front 50

Name 4 ways of promoting estrone clearance?

Back 50

Improve bowel flora
Increase the brassica family
Support phase 2
Reduce endocrine disrupters

Front 51

What nutrient may help insulin resistance in PCOS?
3 sources?

Back 51

Inositol
Fruits, beans, grains

Front 52

What do people taking metformin have?
What should they take to reduce this?

Back 52

High homocysteine
B vitamins and folic acid

Front 53

Name 4 supplements that may help PCOS?

Back 53

EFAs, ALA, chromium, spearmint tea

Front 54

What does spearmint tea do for PCOS?

Back 54

Increases LH, FSH, estradiol, decrease testosterone

Front 55

How is ALA used in PCOS?
Dose?

Back 55

Used to reduce insulin resistance and increase glucose metabolism.
100-600mg day

Front 56

Name two ways EFA's help PCOS?

Back 56

Competes with AA to reduce inflamation and decreases cell inflexibility found in ovaries and cysts.

Front 57

3 nutritional aims for uterine fibroids?

Back 57

Regulate bleeding
Reduce free oestrogens- especially 16 hydroxyestrone form
Reduce inflamatino

Front 58

2 ways to reduce bleeding?

Back 58

Iron (if deficient)
Yarrow tea

Front 59

2 ways to reduce estrogens?

Back 59

DIM or cruciferous indoles
Nutrients to support phase 2

Front 60

2 ways to reduce inflamation?

Back 60

EPA 2000mg
Turmeric

Front 61

How long can menopause last?

Back 61

7 years

Front 62

Ages of perimenopause? What happens?
Ages of menopause? What happens?
Post menopause age?

Back 62

45-50. Symptoms start
50-52. Periods stop
55 onwards.

Front 63

Main symptom of menopausse?
Theory?

Back 63

Hot flushes
Low estrogen or fluctuations in estrogen levels

Front 64

Explain simply the hormonal changes in menopause?

Back 64

Progesterone and estrogen gradually decrease, 2-3 years later ovulation stops.

Front 65

Name three naturopathic considertions when treating someoen in menopause?

Back 65

THe adrenals take over to produce sex hormones therefore support adrenals
Check thyroid function
Preventative measures against CVD

Front 66

Name one way to reduce CVD in menopause

Back 66

Vitamin C reduces CRP

Front 67

Name two ways to decrease risk of osteoporosis in monospause?

Back 67

Weight bearing exercise, give up smoking

Front 68

Name 4 nutrients/vitamins for menopause and what they do?

Back 68

Calcium and vitamin D for bone densityy
Lignans for insulin sensitivity
Vitamin E for vasomotor function of hot flushes
Red clover isoflavones for hot flushes

Front 69

Name on important dietary advice to give a menopausal woman?

Back 69

Eat phytoestrogen rich foods

Front 70

Name 3 phytoestrogen rich foods?

Back 70

Soy milk
Tofu
Legumes

Front 71

Simple home remedy for hot flushes?

Back 71

Chop 6 fresh sage leaves and soak overnight in fresh lemon juice. Strain and drink the lemon juice in water before food.

Front 72

Name one theory of endometriosis?

Back 72

Retrograde flow

Front 73

Pregnancy and endometriosis?

Back 73

Once pregnant, women usualy get better due to high levels of female hormones

Front 74

What does PCB stand for? Where are they found?

Back 74

Polychlorinated biphenyls found in platics

Front 75

Explain PCB's and endometriosis.

Back 75

Women with high levels of PCB's have a higher risk of endometriosis

Front 76

What can green tea catechins do for endometriosis?

Back 76

They have anti angiogenic properties

Front 77

What does exercise do for endometriosis?

Back 77

40-80% risk reduction

Front 78

Basic diet to reduce risk of endometriosis? (6)

Back 78

B6, ACE, probiotic, fish oil

Front 79

How does fish oil help endometriosis?

Back 79

Reduces the proliferation of endometrial tissue

Front 80

4 naturopathic treatment aims for endometriosis?
2 tests?

Back 80

1. Normalise immune response 2. Optimize liver function to conjugate and metabolise hormones 3. Eliminate metabolic wastes 4. Reduce exposure to hormone disrupters

Check adrenal and thyroid function

Front 81

What causes PMS?

Back 81

Changes in estrogen and progesterone causes changes in brain neurotransmitters

Front 82

Name 3 ways B6 helps PMS?

Back 82

Helps prduce prostaglandin E1
Reduces estrogen and increases progesterone

Front 83

What is an important factor to consider in PMS?
What can decrease this?

Back 83

High prolactin levels
Vitex agnus cactus

Front 84

Name 3 herbs, two vitamins and one mineral to help PMS?

Back 84

St Johns wort, agnus cactus, chasteberry, vitamin B6, Vitamin E, magnesium.

Front 85

Name 5 PMS subgroups?

Back 85

PMT-Pain
PMT- Anxiety
PMT- Depression
PMT- Craving
PMT- Hyperhydration

Front 86

What does PMT P respond well to? (2)
What causes PMT A and what does it respond well to? (4)

Back 86

Mg and EPO supplementation
High estrogen to progesterone ratio.
5 HTP, L theanine, high fibre

Front 87

What does PMT C respond well to?

What does PMT D respond well to and is caused by? (3)

Back 87

Blood sugar control

Low estrogen to progesterone level. Responds well to 5HTP, St Johns Wort.

Front 88

What does PMT H respond well to?

Back 88

Reduced sodium, increased potatssium