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cofactor · 2
The neural tube closes 21–28 days after conception, before most people know they are pregnant. Cells in the embryo divide extremely fast in those weeks, and the building blocks of their DNA come from folate-dependent one-carbon metabolism, which is why folic acid needs to start before pregnancy.
←Zinc
Zinc deficiency lowers testosterone. But zinc only helps on the stretch from deficient to adequate; in someone who already gets enough, more zinc does not push testosterone any higher. Supplement ads usually tell only the first half.
regulates · 6
The reproductive system is governed by a hormone axis of hypothalamus, pituitary and gonads: the hypothalamus sends a signal, the pituitary releases gonadotropins, the ovaries or testes release estrogen or testosterone, and those hormones in turn hold back the upstream signals. Polycystic ovary syndrome (PCOS) is a classic case in which this axis, insulin resistance and excess androgens are tangled together.
Estrogen protects blood vessels: it promotes nitric oxide production, helps lower LDL cholesterol and keeps the vessel lining stable. After estrogen falls in perimenopause, women's cardiovascular risk begins to rise; women who reach menopause early or have their ovaries removed tend to develop cardiovascular disease earlier.
→Bone
Estrogen holds back bone breakdown and keeps bone removal and bone building in balance; when estrogen falls in perimenopause, bone is lost fastest. Low testosterone in men likewise speeds up osteoporosis, though it is often overlooked.
→Iron
Pregnancy raises blood volume and iron needs together; the US Recommended Dietary Allowance rises from 18 mg to 27 mg a day. How much iron the gut absorbs is regulated by the hormone hepcidin, and only a modest share of dietary iron is absorbed anyway, so the WHO antenatal care guideline recommends a daily iron supplement in pregnancy rather than relying on food alone.
Estrogen has been holding back osteoclasts, the cells that break bone down. After menopause estrogen falls sharply, the brake comes off, and bone calcium is lost faster than it is laid down; the loss is concentrated in the years around the final menstrual period and then settles into a slower, steady decline.
←GERD
Reflux in pregnancy is common, with about two thirds of pregnant women having heartburn, and it is not a matter of eating the wrong thing: progesterone relaxes the sphincter at the lower end of the esophagus while the growing uterus pushes up the pressure in the belly. Both act at once, which is why it is worst late in pregnancy.