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The HPG (Sex Hormone) Axis
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Hypothalamic Pituitary Gonadal (HPG) Axis
Dr. Dawn-Elise Snipes
Objectives
~ Overview of the HPG Axis-What is it—What does it do
~ Hormones in the HPG-Axis: Estrogen, Progesterone, Testosterone, (DHEA): Their function and impact on Neurotransmitters
~ Insulin and the HPG-Axis
~ Insulin and stress
~ Impact of stress and interaction of the HPA-Axis with the HPG-Axis
Intro
~ Gonadal hormones impact mood and cognition and mood and cognition impact gonadal hormone balances
~ Think of the Hypothalamus and the Pituitary like the CEO and COO the adrenals, thyroid and gonads are VPs of various departments which must work together to keep the factory working.

The HPG Axis and Mental Health
~ The HPG-Axis has been implicated in the development of psychiatric conditions, such as mood, anxiety, and cognitive disorders.
~ The HPG axis controls reproduction, development, and aging but also impacts and is impacted by the HPA-Axis
~ Alterations in the HPG axis during important reproductive health events, such as pregnancy and menopause, and aging alter the sensitivity of neurotransmitter systems
~ Gonadal hormones affect reproductive organs and also influence several other bodily functions by interacting with major neuroendocrine systems including thyroid hormones, stress hormones, and the autonomic nervous system.
~ The HPA (hypothalamic-pituitary-adrenal) axis is affected by similar factors as the HPG axis
~ Interestingly, alterations in maternal care can produce significant effects on both HPG and HPA physiology, as well as behavior in the offspring at adulthood (ACEs)

Functions of Estrogen
~ Increases muscle mass
~ Regulates fat distribution
~ Anti-inflammatory
~ Mediate formation of secondary sex characteristics
~ Regulates energy expenditure
~ Maintains bone density
~ Improves coagulation
~ Helps maintain healthy cholesterol levels
~ Assists with fluid balance
~ Promotes lung function
~ Sexual behavior
~ Increasing serotonin and serotonin receptors in the brain
~ Estrogen modulates higher order cognitive processes driven by dopamine such as learning, reward processing, working memory, and impulse control

Functions of Testosterone
~ Regulate sex drive (libido)
~ Fat distribution
~ Bone and muscle mass
~ Improves insulin response
~ Anti-inflammatory
~ Strength
~ Production of red blood cells
~ Production of sperm
~ Converted to estrogen (small amounts)
~ Enhances cognition
~ Increases dopamine, serotonin, GABA
~ Decreased by adrenaline/epinephrine

Functions of Progesterone
~ Increases in response to stress and cortisol (remember estrogen and testosterone decrease)
~ Under chronic stress and reduced levels of cortisol and progesterone, estrogen becomes dominant.
~ Estrogen Dominance: Mood swings, increased anxiety, weight gain, hair loss, sleep disruption, memory/cognitive disruption
~ Progesterone is the precursor to cortisol and is released in response to stress. Low progesterone can cause low cortisol. Progesterone has anxiolytic properties thought to modulate the stress response

Functions of DHEA
~ DHEA is actually a steroid hormone produced in the adrenal glands
~ It assists in the biosynthesis of the androgen and estrogen sex steroids both in the gonads and in various other tissues
~ DHEA is inversely related to cortisol
~ DHEA elevation by itself can exaggerate glucocorticoid dysfunction

Interventions (Reduce Stress)
~ Physical
~ Sleep
~ Nutrition Improvement
~ Stimulant reduction
~ Pain
~ Hormone balance (Thyroid/gonadal)
~ Promote feelings of physical relaxation: Yoga, Tai Chi
~ Affective
~ Reduce dysphoric emotions
~ Promote feelings of physical and emotional relaxation: Mindfulness, Meditation
~ Laughter

Interventions (Reduce Stress)
~ Cognitive
~ Distress tolerance
~ Increase awareness of cognitive distortions and biases
~ Increase positive attitude and appraisals
~ Improve problem solving skills
~ Environmental
~ Safety (Sights, sounds, smells)
~ Aromatherapy: Bergamot, lavender, rose, rose geranium (may increase estrogen)
~ Weighted blankets or vests
~ Relational
~ Improve supportive relationships
~ Enhance interpersonal skills
~ Develop self-esteem

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#Integrativehealth #testosterone #Mentalhealth

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