HPO & Estogen-like Compounds

1. HPO & Estogen-like Compounds

2. Hormone Review Hypothalamus ==> GnRH Anterior Pituitary ==> FSH, LH Ovary ==> Estradiol, Progesterone Is that it?

3. Vitex agnus-castus

4. Hormones and the Menstrual Cycle

5. Types of estrogens & their receptors: Estrone Estradiol Estriol -Estrogen receptors -Estrogen receptors

6. Functions of LH & FSH LH - Stimulates the granulosa cells of the ovary to produce estradiol. Ovulation Tester kit measures LH in the urine. When levels spike, ovulation will occur, and fertilization is a possibility within the next 24-48 hours. FSH - Stimulates the follicle to become a corpus luteum and begin producing progesterone. When FSH spikes, the ovum is released from the follicle.

7. Functions of Estradiol & Progesterone Estradiol acts as a growth hormone for all tissues of the female reproductive tract, as well as bone, blood vessels, liver, and brain. Estradiol binds to both ER and ER receptors. During pregnancy, estradiol increases due to placental production. Progesterone causes thickening of the endometrium to prepare for implantation and thickening of the cervical mucus to block the cervical os. It also stimulates other tissues with progesterone receptors including breast, intestines, brain, gall bladder, and oral mucosa. Progesterone is also produced by the adrenal glands and the placenta during pregnancy.

8. Herbs Used to affect Estrogen & Progesterone Vitex: increases progesterone (LH agonist)and decreases estradiol (FSH antagonist) *Application: Restores balance in cases of low progesterone (cause of majority of PMS, miscarriage, dysmenorrhea, metorrhagia, and hormonal acne) Phytoestrogens: Medicago sativa (formononetin), Trifolium pratense (formononetin), Glycyrrhiza glabra (saponins & phyto sterols), Actea racemosa (formononetin & triterpenoid glycosides) Phytoprogesterones: Trigonella foenum-graecum (diosgenin), Dioscorea villosa (diosgenin), Chamaelerium luteum (diosgenin)

9. Estrogen-related Tumors & Phytoestrogens • GOOD - given to adolescent females • GOOD - given to postmenopausal women • GOOD - given to premenopausal women with family history of BRCA • NOT GOOD - given to women taking tamoxifen • Understand how phytoestrogens work, and this should make sense.

10. Trifolium pratense vs. Medicago sativa

11. Trifolium vs. Medicago • BOTH are in the Fabaceae family and fix nitrogen • BOTH are found in open fields and disturbed soils • BOTH contain formononetin & biochanin A • which convert to diadzein (equol) and genestein in the body, respectively • BOTH are very nutritive and alterative • very high in minerals, protein, and vitamins • BOTH contain saponins, coumarins, and flavonoids

12. Hemoglobin vs. Chlorophyll

13. Canavanine Sandwich?

14. (Trigonella foenum-graecum) Family: Fabaceae Part used: seeds No known toxicity “Urine and sweat will smell like maple syrup” Contains Diosgenin

15. (Trigonella foenum-graecum) THIS HERB WILL BE REVISITED WHEN YOU STUDY DIABETES!!!

16. Dioscorea villosa

17. Dioscorea villosa Family: Dioscoreaceae Part used: root No known toxicity Beware of widespread misuse of the common name “Mexican Wild Yam” X X X

18. Dioscorea villosa Family: Dioscoreaceae Part used: root No known toxicity Beware of widespread misuse of the common name “Mexican Wild Yam” X X X

19. Dioscorea villosa • Active constituents: • High amounts of Diosgenin (steroidal saponin) • Hormone precursor used in the production of most all steroid ‘natural’ hormones, especially progesterone • Increases estradiol binding • Relaxes gall bladder and digestive smooth muscle • Russell Earl Marker • Also contains starch and tannins

20. Dioscorea villosa Actions: Antioxidant, inflammation modulating, estrogenic, antispasmodic, cholagogue, increases body secretions Dosing: Crude: 2-4g encapsulated, or by decoction, TID FE: (1:1) @ 45%, 2-4 ml TID Tincture: (1:5) @45%, 2-10 ml TID Safety: Non toxic, however contraindicated in estrogen-sensitive conditions.

21. Actaea racemosa

22. Actaea racemosa Family: Ranunculaceae Part used: root No known toxicity Overdosing will produce severe frontal headache. Menopause. 2008 Jul-Aug;15(4 Pt 1):628-38. United States Pharmacopeia review of the 30 black cohosh case reports of hepatotoxicity.

23. Chamaelirium luteum False Unicorn Root Family: Liliaceae Part Used: Root Endangered

24. Chamaelirium luteum • Uterine tonic • Regulates menses • Resolves ovarian cysts • Steroidal saponins • Sapogenin • Diosgenin

25. (Asparagus racemosus) Ayurvedic: Shatavari Great alternative to Chamaelirium X

26. Case 1 48 year old female with perimenopausal symptoms. She is experiencing hot flashes and night sweats. She is very anxious and has a bad relationship with her husband, but feels too weak and vulnerable to stand up for herself. She has palpitations, especially when stressed. She is emotional and weepy in the office, explaining that she feels like she is ‘losing her mind’. She is still cycling, mostly regular, but lighter and occasionally skips a cycle.

27. Case 1 List her symptoms and match them to specific herbs… Hot flashes: Night sweats: Anxiety and depression: Heart palpitations: Stress: Metorrhagia:

28. Case 1 List her symptoms and match them to specific herbs… Hot flashes: Actea racemosa, phytoestrogens Night sweats: Anxiety and depression: Heart palpitations: Stress: Metorrhagia:

29. Case 1 List her symptoms and match them to specific herbs… Hot flashes: Actea racemosa, phytoestrogens Night sweats: Actea racemosa, sedatives Anxiety and depression: Heart palpitations: Stress: Metorrhagia:

30. Case 1 List her symptoms and match them to specific herbs… Hot flashes: Actea racemosa, phytoestrogens Night sweats: Actea racemosa, sedatives Anxiety and depression: Withania somnifera, Hypericum perforatum, Melissa officinalis Heart palpitations: Stress: Metorrhagia:

31. Case 1 List her symptoms and match them to specific herbs… Hot flashes: Actea racemosa, phytoestrogens Night sweats: Actea racemosa, sedatives Anxiety and depression: Withania somnifera, Hypericum perforatum, Melissa officinalis Heart palpitations: Leonurus cardiaca, Medicago sativa, Avena sativa Stress: Metorrhagia:

32. Case 1 List her symptoms and match them to specific herbs… Hot flashes: Actea racemosa, phytoestrogens Night sweats: Actea racemosa, sedatives Anxiety and depression: Withania somnifera, Hypericum perforatum, Melissa officinalis Heart palpitations: Leonurus cardiaca, Medicago sativa, Avena sativa Stress: Glycyrrhiza glabra, Asparagus racemosus Metorrhagia:

33. Case 1 List her symptoms and match them to specific herbs… Hot flashes: Actea racemosa, phytoestrogens Night sweats: Actea racemosa, sedatives Anxiety and depression: Withania somnifera, Hypericum perforatum, Melissa officinalis Heart palpitations: Leonurus cardiaca, Medicago sativa, Avena sativa Stress: Glycyrrhiza glabra, Asparagus racemosus Metorrhagia: Vitex agnus-castus, Dioscorea villosa,phytoestrogens

34. Case 1 Her Formula Vitex agnus-castus 30 ml 25% Actaea racemosa 20 ml 17.5% Medicago sativa 20 ml 17.5% Leonurus cardiaca 10 ml 8% Dioscorea villosa 10 ml 8% Withania somnifera 10 ml 8% Glycyrrhiza glabra 10 ml 8% Panax quinquefolium 10 ml 8% Total 120 ml Sig. 3ml TID. Take 2ml Valeriana officinalis & Stachys betonica before bed.