Characterized by marked mood swings, depressed mood, disruptions of relationships, decreased work productivity, irritability, anxiety and physical symptoms (breast pain, HA, joint or muscle pain)
Premenstrual Dysphoric Disorder
What is the possible cause of PMS/PMDD
enhanced responsiveness to the normal changes in ovarian hormone levels that cause ovulation
alterations in the availability of serotonin
PMS Treatment (3)
Prevention of ovulation via oral contraceptives, estrogen patches
Antidepressants that contain serotonin repute inhibitors
Exercise and stress reduction
Nutrition supplements to help PMS symptoms (2)
1000 mg/day of calcium
50-100 mg/day of Vitamin B6 (involved with the synthesis of serotonin)
Herbal supplment for PMS
Chasteberry extracts
20 mg/d have been reported to decrease irritability, mood alterations, anger, HA
True/False: Chasteberry may not be safe for women who ma become or are pregnant, are taking oral contraceptive pills or have breast cancer
True
Obesity decreases or increases likelihood of reproductive health problems?
Increases
Insulin resistances and elevated insulin cause increased production of what?
Androgens (testosterone)
which leads to irregular menstrual cycles, delayed conception, anovolution
In men, insulin resistance is associated with what fertility problem?
reduced sperm quality
Elevated BG, insulin and free fatty acid levels increase the production of what?
reactive oxygen molecules which trigger oxidative stress and inflammation
How does oxidative stress affect fertility?
in damages sperm DNA leading to impaired function and motility
True/False: not all obese individuals are at risk for fertility problems
True
metabolically healthy obese ppl have a lower risk than obese individuals with elevated BP, lipid levels, glucose intolerance, increased markers of inflammation
People are more fertile after bariatric surgery because...
their hormone levels are improved and inflammation has decreased
True/False: you can safely get pregnant after bariatric surgery
FALSE
recommended to wait 12-18 months after because eating very little after surgery and may not be well nourished/can't get nutrition for mom and baby
also at risk for micronutrient deficiencies (iron, folate, calcium, thiamin, vitamin B12, vitamin D)
Cessation of menstruation related in hypothalamic signals that maintain secretion of hormones required for ovulation
Hypothalamic amenorrhea
3 or more months of no periods
amenorrhea
What causes hypothalamic amenorrhea?
deficits in energy
Suppressed activity of GnRH in hypothalamic amenorrhea causes
won't stimulate the release of LH and FSH and therefore no ovulation
Nutritional management of hypothalamic amenorrhea
weight gain by eating a healthy diet
gain of 6-11 lb typically restore fertility
Decreased estrogen production by fat cells and suppressed GnRH activity (decreasing FSH secretion which decreases ovarian estrogen secretion) is caused by
very low levels of body fat
Nutritional management of eating disorders
normalize body weight (AN) and eating behavior (BN) and multidisciplinary approach
High blood glucose level during the first 2 month of pregnancy are
teratogenic
What is associated with a 2-3 fold increase in congenital abnormalities in pelvic, CNS and heart in newborn and higher rate of miscarriages
diabetes mellitus prior to pregnancy
Nutrition management of DM
Consistent CHO intake
low fat
<2300 mg sodium
DRI for fiber
Weight loss
Exercise
Prevention of gestational diabetes (starts in week 24-28)
Priority to pregnancy:
weight loss (if needed)
exercise
high fiber diet
eating a healthy diet
cystic ovaries*** (eggs and follicles that start to form and can't)
hirsutism (growing hair in male-patterened form)
elevated androgens*** (increases testosterone)
Menstrual abnormalities***
Infertility
are all clinical signs of
Polycystic ovary syndrome
***need 2 of 3 for PCOS diagnosis
What is the leading cause of female infertility?
PCOS
infertility due to absence of ovulation
What is the cause of PCOS
unknown but insulin resistance appears to play a role
genetic component, tens to run in the family
Management of PCOS
Increase insulin sensitivity by weight loss (5-10% wt loss)
Exercise (>30 mins/day)
Insulin sensitizing drugs (metformin)
True/False: PKU affects fertility
False
If you have PKU in preconception period you need to take caution
elevated blood PHE due to lack of phenylalanine hydroxylase which concerts PHE to tyrosine
PKU
True/False: if mother has elevated serum levels of PHE during early pregnancy it can affect the baby
TRUE
impaired CNS development in fetus (severe mental retardation, low life expectancy)
PHE can cross the placenta
Nutrition management of PKU
Strict control of maternal PHE levels before conception and during pregnancy
