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Phytoestrogens: Hormone Balance With Food

Phytoestrogens, or plant-based estrogens, are compounds found in our food that can bind to our estrogen receptors.  While a lot of confusion exists on the impact this has on our hormone health, I’m going to help you understand the amazing balancing effects of phytoestrogens, and tell you why you should consider having more of them in your diet.

Why Phytoestrogens are Important

In our bodies we have three sources for estrogen: the estrogen we make (also known as endogenous estrogen), the estrogen we eat (phytoestrogens) and the estrogen-like compounds we are exposed to in our environment (xenoestrogens).

Each of these estrogens can bind to an estrogen receptor and cause an estrogen-like effect.  The chemical estrogens, or xenoestrogens, from the pesticides, herbicides, personal care products and other chemicals in our body have a much stronger impact than that of our own home-made estrogen.  And the plant estrogens have a much weaker effect.

The Balancing Effects of Estrogen

With many women suffering from conditions of excess estrogen – like fibroids, PCOS, obesity and estrogen dominance as well as estrogen sensitive conditions like endometriosis, fibrocystic breasts and breast cancer – lowering their body burden of estrogen is important.  For women with high estrogen, consuming more very mildly estrogenic phytoestrogens can prevent the negative impact of exposure to their body’s own estrogens as well as the chemical estrogens from the environment.  When you have lots of plant estrogens in your body they occupy the estrogen receptor, causing a very small estrogen-like impact, but most importantly, they prevent other stronger estrogens from binding to that receptor.  This results in an overall lower estrogen state in the body.

Following along so far?  It gets better!

When women are suffering from low estrogen – due to hysterectomy or menopause, phytoestrogens can also be helpful.  When women is no longer producing her own estrogen in optimal amounts, the small amount of an estrogen effect from a phytoestrogen can help to boost her estrogen levels and diminish symptoms of low estrogen like hot flashes, night sweats, insomnia and mood swings.

Food Sources of Phytoestrogens

More than 300 different plants contain phytoestrogens. There are several subclasses of phytoestrogens, some of which are listed below.

Lignans – Vegetables, fruits, nuts, cereals, spices, seeds; especially flax seeds

Isoflavones – Spinach, fruits, clovers, peas, beans; especially soy

Flavones – Beans, green vegetables, fruits, nuts

Chalcones – Licorice root

Diterpenoids – Coffee

Triterpenoids – Licorice root, hops

Coumarins – Cabbage, peas, spinach, licorice, clover

To increase dietary sources of phytoestrogens, consider the following foods:

Flax seeds – the highest food source of phytoestrogens is flax seed and oils. The phytoestrogens in flax seeds are lignans. Lignans have antitumour, antioxidant, and weakly estrogenic and antiestrogenic characteristics. They have been found in studies to decrease vaginal dryness, hot flashes or night sweats in women with low estrogen symptoms.

Soy, edamame, tofu, tempeh – the best known phytoestrogen, soy, when consumed in the diet, is safe for women with symptoms of both high and low estrogen.  For hot flashes and night sweats, women who consume soy tend to have less symptoms than women who do not.  Other research suggests that increasing soy foods in the diet stabilizes bone density, decreases cholesterol levels and has a favourable effect on cardiovascular risk profiles in menopausal women

Beans: soybeans, tempeh, black beans, white beans, kidney beans, lentils, mung beans, coffee

Grains: wheat berry, oats, barley, rice, alfalfa, wheat germ

Seeds and nuts: flaxseed, sesame seeds, fenugreek

Vegetablesyams, carrots

Fruits: apples, pomegranates

Herbs and spices: Mint, licorice root, ginseng, hops, fennel, anise, red clover

Harmonizing Your Hormones

If you are interested in exploring more ways to balance your hormones naturally, book a free 15 minute meet and greet appointment with me to discuss how you can bring harmony to your hormones and fire up your health!

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

 

The Empowered Woman’s Guide to UTIs

This month I’m sharing some of my best advice on how to support and maintain a healthy lady garden. And no discussion on lady garden health would be complete without a mention of those miserable, burning, peeing-a-million-times-a-day UTIs.

Urinary Tract Infections

While men get UTIs as well, women are much more prone to getting urinary tract infections. This is due to a couple of unique things about the lady garden anatomy – the urethra is very close to two bacteria-filled environments, the vagina and the anus, and the urethra in women is much shorter, allowing a fast-track for bacteria to get into the urinary bladder.

Sex can also increase the incidence of UTIs in women because of, well, friction. If the bacteria in the vaginal tract are not healthily balanced those bad bacteria can be pushed into the urethra and lead to a UTI (this is why we are told to pee after sex ladies!)

Symptoms of UTIs

Most women are pretty fast to identify a UTI. There is no mistaking that burning sensation when you pee, as well as that urgent and frequent need to urinate – even when very little comes out each time. Other symptoms to pay attention to are: cloudy urine, pain in the lower back or lower abdomen, or fatigue, fever and chills. If you pain, fever or fatigue – get to your doctor – the infection may have moved into your kidneys which needs immediate attention.

An Empowered Approach to Treating UTIs

While most women are given an antibiotic for UTIs – a treatment which is absolutely necessary in some cases – many women can manage their UTIs quickly and easily with a more natural and empowered approach. There is much more to the treatment of UTIs than just killing off bacteria (those antibiotics will kill off both good and bad bacteria) – we also need to support the health of the lady garden and the immune system.

Lifestyle and Prevention

If you have ever had a UTI it is likely you have been given this advice, but it is so important that it is worth mentioning again. Follow these simple tips to prevent UTIs:

  1. Pee after having sex (to flush the urethra of any bacteria that may have gotten in there)
  2. Drink lots of water
  3. Pee often – don’t hold it in!
  4. Wipe from front to back
  5. Don’t use scented products on your lady garden
  6. Wear cotton underwear and loose fitting clothes

Diet to Prevent Bladder Irritation

Some foods can promote a bladder environment that makes it more likely for you to develop UTIs – and can make it harder to effective treat infections, leading to an increased likelihood of chronic or recurrent urinary tract infections (no thank you!)

Limit caffeine, refined sugar, white flour, alcohol, and food allergies to support the health of your bladder and reduce irritation. If you are a smoker, you should quit as well.

Get Hydrated

Another piece of obvious advice, the importance of hydration can NOT be underemphasized in the treatment of UTIs. I recommend drinking water like it is your day job when actively treating a UTI. But for prevention you should still drink at least 2 litres of water per day. Avoid fluids that contain caffeine and sugar, and stick instead with just plain water – or water with lemon if you’d like.

Keep Your pH Balanced

We talked a lot about the importance of pH balance in the lady garden in the BV and yeast infection articles, and pH balance is just as important for urinary tract infections. Our urine should be slightly acidic (like our lady garden!) which creates an environment that is inhospitable to those UTI-causing bacteria, like e. coli.

Vitamin C is one of the easiest and most effective ways to support the proper pH of the urine. During acute UTIs you can take higher doses of vitamin C (discuss your dose with your Naturopath), and for maintenance take 1-2g per day in divided doses (morning and evening).

Promote Healthy Bacteria

UTIs are caused by the presence of nasty bacteria – most often e. coli, in the urinary tract. Promoting healthy levels of beneficial bacteria, especially lactobacillus, will prevent there from being large colonies of e. coli in the vaginal tract, urinary tract and digestive tract. A daily probiotic supplement is absolutely recommended, and I will often recommend a topical probiotic to be applied to the lady garden during acute infection.

Clear Out the Urethra

We’ve all heard of using cranberry to treat UTIs, and there is evidence that this treatment will help. Cranberry contains a compound called proanthocyanidin that prevents bacteria from adhering to the walls of the urinary tract. This allows you to clear the bacteria much faster. For an acute infection you need to use unsweetened 100% cranberry juice and drink a good amount per day – up to 16 ounces, diluted in water.

Banish Bad Bacteria

There are some excellent natural plant-based treatments for killing off the bacteria that cause UTIs. I never recommend these in isolation – they need to be taken as part of an empowered treatment plan. Destroying bacteria alone will not adequately treat a UTI.

Uva ursi is a powerful antimicrobial that can be highly effective in eradicating bacteria, including e. coli. It is not for use in pregnancy, breastfeeding, children or for more than one week at a time.

Goldenseal is another excellent antimicrobial that is effective against e. coli. It can be used as a supplement, in a tea, or as a lady garden rinse after sexual activity.

Boost Immune Function

To support your immune system, be sure you are maintaining healthy vitamin D levels. Vitamin D is necessary for the production of antimicrobial peptides – our body’s own antibiotics. Supplementation with vitamin D has been found to be associated with a decreased incidence of UTIs. And since just about every Canadian is deficient from October to May, a daily supplement is necessary for most everyone.

Empowered and UTI-Free!

I hope you can now see all the many factors that go into treating and preventing UTIs.  Working with a Naturopathic Doctor can help you to individualize your plan – to be sure that you are taking all the necessary steps to be empowered in the care of your lady garden.  If you’d like to talk – drop me a line!  You can book a 15 minute meet and greet session, join me on Facebook or Instagram.  I’m thrilled to a part of your empowered journey.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

The PATH To Treating Bacterial Vaginosis

BV, or Bacterial Vaginosis is the most common vaginal infection in women worldwide. With few symptoms, aside from an unpleasant odour, many women are experiencing recurrent BV infections without receiving appropriate treatment.

But no more. Today I will take you on the PATH to treating BV, so that you don’t have to struggle with BV any longer.

Understanding BV

Bacterial vaginosis occurs when the healthy bacteria balance in the vagina is disrupted. With trillions of bacteria colonizing the vaginal tract, when those populations are out of balance the delicate pH of the vagina changes and symptoms can occur.

Unlike yeast infections, bacterial vaginosis typically has fewer symptoms. Not usually associated with pain, itching, irritation or pain with intercourse, bacterial vaginosis has just two main symptoms:

  • a thin whitish discharge
  • a foul “fishy” odour

These symptoms are often worse after a menstrual period or exposure to semen in the vagina – these can alter the pH balance and support the growth of less-than-desirable bacteria in the lady garden.

The most common bacteria involved in BV is Gardnerella vaginalis, but some other bacteria have been implicated as well – including Mycoplasma hominis, Ureaplasma urealyticum and Prevotella bivia…along with many others.

The metabolic activity of these bacteria causes the discharge and the characteristic odour of BV.

While BV may have few symptoms on its own, it can lead to urinary tract infections (UTIs), pelvic inflammatory disease, infertility, candida infections and an increased risk for sexually transmitted infections (STIs).

Diagnosing BV

BV is pretty straightforward to diagnose – and most women can tell you without a doubt if they are experiencing it. To diagnose BV your doctor will use what is called the Amsel Criteria. This can easily be done in office.

The PATH To BV Treatment

Understanding that BV is caused by an imbalance in healthy bacteria is the most important step in treating BV. When I am treating BV, I encourage all women to follow the PATH – four essential steps in treating BV so that it doesn’t keep coming back.

            PROMOTE Healthy Vaginal Flora

The bacteria that live in our lady garden are essential for maintaining a healthy vaginal environment. Their health often depends on our behaviours – so we need to do what we can to support them.

A diet high in sugar can promote the growth of undesirable bacteria. As can a diet low in fiber from plant foods. A lack of fermented foods in the diet can lead to low populations of healthy bacteria as well.

The most important thing we can do to promote healthy vaginal flora is to take a probiotic supplement. Both oral and vaginal probiotics (suppositories and creams) can support and promote a healthy balance of bacteria levels in the vaginal tract. Selecting appropriate strains is important – make sure that any probiotic you choose has adequate amounts of Lactobacillus – at least 10-12 billion per day for at least 6 months is what is recommended.

            AVOID Triggers of Vaginal Infection

Just as we need to promote healthy bacteria levels, we also have to avoid those things that promote infection.

Bacteria imbalances are more common in women using the birth control pill – both due to the high doses of estrogen and the less frequent condom use in women on the pill. Antibiotic use will also alter bacteria balance and increase the incidence of BV.

Douching and wearing non-cotton based underwear will also increase the risk for BV and should be avoided, especially during active treatment for BV.

            TREAT Overgrowth of Bacteria and Normalize pH

The normal pH of the lady garden is somewhere between 3.8-4.5 – a nice acidic environment.   The pH is maintained in this range by the healthy bacteria – mostly Lactobacillus that colonize the vaginal tract. In BV the pH is elevated above 4.5 – sometimes as high as 7.0! Restoring the healthy pH is essential for resolving the symptoms of BV and preventing recurrence.

The best way to normalize the pH is with the use of boric acid suppositories. Having a similar pH to the healthy vaginal tract, boric acid can restore the pH and, when combined with healthy bacteria supplementation, treat BV very effectively.

Your ND will help you to understand the protocol for use of boric acid suppositories and you can have a local compounding pharmacist make the capsules just for you.

HEAL Inflamed or Irritated Tissues

For the majority of women bacterial vaginosis is not associated with significant irritation or inflammation. If you have redness or swelling of your vulva, discuss with your Naturopath whether you may also have a candida (yeast) infection.

For women using the boric acid suppositories to restore healthy pH balance, there is a small chance of irritation. If this occurs a topical vitamin E gel is highly effective for decreasing irritation and healing the tissues.

Taking the PATH

Now that you have a roadmap to treating BV, I hope you will always consider the PATH when you are managing your BV. This approach has helped countless women in my practice overcome their bacterial vaginosis, and I hope it will help you too. If you’d like to work together and allow me to be a guide on your PATH, don’t hesitate to book an appointment today!

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Select Resources

Cribby S, Taylor M, Reid G. Vaginal Microbiota and the Use of Probiotics. Interdiscip Perspect Infect Dis. 2008 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2662373/

 

Estrogen Dominance

Estrogen dominance – it’s the most common hormone imbalance for women in their 40s and has symptoms that will sound familiar to many of you – but many women don’t realize this imbalance even exists. So let’s shed some light on this imbalance so that no woman has to suffer in silence anymore.

Women’s Hormones 101

To understand estrogen dominance, first we have to start with a quick refresher on our two primary female hormones – estrogen and progesterone.

Estrogen is the main hormone in the first half of our menstrual cycle and causes the lining of the uterus to thicken. Estrogen is produced by the ovaries, but also by fat cells. Estrogen levels can also be raised by exposure to xenoestrogens – compounds in our environment that look like estrogen and are able to bind to estrogen receptors.

Progesterone is the main hormone in the second half of our cycle, and supports implantation and pregnancy. Increases in progesterone signal the body to stop making so much estrogen. Progesterone is made almost completely by the ovaries, but small amounts can be made in the adrenal glands as well.

WTF is Estrogen Dominance?

Women are born with all their eggs – so the eggs we ovulate each month have been along for the entire ride of our lives. As our eggs age their quality decreases – this has two major impacts that set us up for estrogen dominance.

  1. Older eggs take longer to mature – an older egg may be slower to reach maturity – this causes the brain to produce higher levels of FSH (follicle stimulating hormone) to attempt to mature the egg. The higher the FSH, the more follicles that are stimulated and the higher the estrogen production.

While many women believe estrogen levels decline in our 40s, the opposite is in fact true. Estrogen levels only significantly decline at menopause.

  1. Older eggs produce less progesterone – one of the main reasons our fertility drops off with age is that our older eggs make less progesterone. This drop in progesterone production can impact much more than our fertility – it is also the reason that PMS is more intense in our 40s and sets the stage for estrogen dominance.

Estrogen dominance is the state where estrogen levels are not balanced by progesterone levels – too high estrogen and too low progesterone. And this is where the chaos begins…

Symptoms of Estrogen Dominance

Not sure yet if you are dealing with estrogen dominance? Read these symptoms and see if they ring true for you.

  • Anxiety
  • Depression
  • Mood swings
  • Irritability
  • Insomnia
  • Bloating
  • Carbohydrate and sugar cravings
  • Difficulty concentrating
  • Brain fog
  • Weight gain or difficulty losing weight
  • Frequent yeast infections
  • Joint pain or inflammation
  • Heavy or irregular periods (longer or shorter cycles)
  • More PMS
  • Headaches and migraines premenstrually
  • Swelling and water retention
  • Lack of sex drive/ low libido
  • Breast tenderness or swelling
  • Uterine fibroids

Why Haven’t I Heard of Estrogen Dominance?

Unfortunately a woman who presents to her doctor with the symptoms listed above will often be dismissed (It’s just stress! You’re getting older – it happens), be given an antidepressant, be put on the birth control pill (to “regulate” hormones) or told to relax, lose weight, or get counseling. Very rarely will a doctor delve into the hormonal fluctuations with hormone testing, or even discuss the likely imbalances that occur in our 40s.

Testing for Estrogen Dominance

For some women the symptoms are so clear that testing may not be necessary. But for most women, hormone testing is recommended to get a clear picture of what her individual hormone balance is, and to develop a plan that will help to restore her personal hormone harmony.

DUTCH test, hormone testing,hormone test, women's hormones, hormone healthHormone testing can be done via blood tests, saliva tests or the DUTCH urine test. I go into greater detail on hormone testing in this article: Hormone Testing Options

For any hormone test that is done, the most important thing to look for is balance. Many women are dismissed as “normal” when their hormone values are all within the normal limits. But more important than the actual value of the hormones, is the balance between the hormones. If estrogen is normal but progesterone is very low, estrogen dominance occurs. If estrogen is high but progesterone is normal, estrogen dominance occurs. You need to ensure that whoever is interpreting your tests with you has a great deal of knowledge on hormone balance.

It’s Not Just About Your Periods

As you can see from the list of symptoms above, estrogen dominance impacts a lot more than just our periods and our PMS. All our hormones function in harmony with each other – and when one hormone is imbalanced, there can be significant ripple effects on the other hormones. Below are just a few:

Estrogen dominance worsens hypothyroid – high levels of estrogen lead to an increased clearance of our energizing thyroid hormones – this can lead to symptoms of hypothyroidism (fatigue, brain fog, weight gain, hair loss) or worsen symptoms in women who have this condition

Estrogen dominance is worsened by stress – increased production of cortisol, as occurs during times of stress, lowers progesterone levels. Cortisol also competes with progesterone for receptors – which can cause symptoms of estrogen dominance even when progesterone levels are adequate. This can worsen symptoms of stress like irritability, decreased coping, fatigue and overwhelm.

Treatment of Estrogen Dominance

When we are treating estrogen dominance we have two main goals in mind – lower the estrogen and increase the progesterone.

Lowering Estrogen

  1. Decrease exposure to xenoestrogens – Commonly found in plastics, personal care products and household cleaners, avoiding exposure to the synthetic estrogens that are abundant in our environment is an essential first step.
  2. Support estrogen detoxification – B vitamins, probiotics, brassica vegetables, DIM and 13C are all essential for allowing your body to clear the estrogen and restore balance to your body. Your Naturopathic Doctor will help you to determine what the best choices are for you – but starting with a B complex supplement, a probiotic and choosing more foods in the cabbage family (broccoli, cauliflower, kale, cabbage, Brussels sprouts) is recommended.

Increasing Progesterone

  1. Make sure you can make it – essential nutrients for the production of progesterone include B vitamins (especially vitamin B6), and magnesium. So ensuring you have an abundance of these in your diet, or in supplement form, is important for overcoming estrogen dominance.
  2. Bioidentical progesterone cream – sometimes the only way to overcome estrogen dominance is to add back some of what we need – progesterone. Available in Canada as a prescription from your Naturopath, bioidentical progesterone provides your body with the progesterone you no longer make as easily. It can be a life changing treatment for many women in their 40s.

Harmonizing Hormones

Our 40s as women can be a tumultuous time – raising children, achieving career success, supporting spouses, aging parents – any number of significant life events. But our hormones don’t need to be tumultuous. We can support our bodies and our minds by focusing on achieving our individual hormone harmony. If you want to discuss more about your hormone health, book a free meet and greet or an appointment today.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

WTF Is Happening: Hormones in Your 40s

This event is for all those women who are wondering WTF is happening with my hormones?

As we move through our 40s our hormones enter into a “second puberty” – a time of significant upheaval in our previously balanced state.  And if you thought puberty was bad – try having kids and partners and jobs on top of it!

If you are curious if your hormones are contributing to your:

  • Mood changes, anxiety, depression, PMS or what we affectionately call “werewolfing”
  • Low libido (or high libido!  It happens!)
  • Acne, hair growth, or hair loss
  • Irregular periods, no periods, heavy periods, sometimes all of these, sometimes none of them
  • Breast changes
  • Insomnia or sleep changes
  • Or so many, many other issues

Then please join me at Oma Chiropractic on Thursday, May 31st as we drop some truth bombs on what REALLY IS HAPPENING during our 40s.

You can find more information on the Facebook Event page here:  https://www.facebook.com/events/161921597814032/ 

Hope to see you there!

PCOS and Mental Health

Polycystic ovarian syndrome is the most common hormone imbalance in women and yet very few people are talking about how significantly this imbalance is impacting women’s lives.

PCOS can impact any woman, at any age – from puberty to perimenopause, and in addition to the typical symptoms of irregular or absent periods, acne, facial hair growth and scalp hair loss, there can also be an increased incidence of mental health concerns.

PCOS and Depression

It has been my experience in practice that women with PCOS often have signs of depression – many of them due to the effects the symptoms of PCOS have on their body image. Researchers have found that nearly ¼ of women with PCOS have depression and they too suggest it may be linked to the “emotionally distressing” symptoms associated with PCOS, rather than the underlying hormone imbalance itself.

PCOS and Anxiety

Rates of anxiety are also higher in women with PCOS, with 11.5% of women in one study having both diagnoses (compared to an average 9% in the general female population).

Anxiety may be associated both with the physical symptoms of PCOS, but potentially may also stem from the hormone imbalances, such as low progesterone, that are common in PCOS. Progesterone is an anxiety-lowering hormone and low levels of progesterone occur when there is no ovulation – such as in PCOS.

PCOS and ADHD

Another interesting finding from the 2018 study on PCOS and mental health – women who have PCOS have an increased risk of having children who are diagnosed with ADHD (attention deficit hyperactivity disorder) or an autism spectrum disorder. The researchers suggest that it may be due to higher circulating androgens during development.

Support for PCOS and Mental Health

Focusing on whole body health, rather than just the visible symptoms of PCOS is important for all women with PCOS. While most women will want to focus on clearing acne and decreasing body weight, we must look at women as a complex entity of interlacing systems – ladies, we are all unicorns – we need to be treated individually and with attention to our specific wants and needs. Our mental and physical health are one and the same, and we should seek care from health care providers who recognize that.

Your Naturopathic Doctor can help you to put together a plan that focuses on your diet, lifestyle, obstacles to health, hormonal imbalances and mental and spiritual health.  Looking at your life and health as a whole, rather than individual symptoms to be managed, your ND works with you to achieve optimal health – in all areas of your life.

Select References

Thomas R Berni Christopher L Morgan Ellen R Berni D Aled Rees.  Polycystic ovary syndrome is associated with adverse mental health and neurodevelopment outcomes.  The Journal of Clinical Endocrinology & Metabolism, jc.2017-02667

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

 

PCOS and Hair Loss

My personal experience with hair loss in my early 20s has given me a keen passion to support women with hair loss of any cause. In other articles I’ve discussed the Root Causes of Female Hair Loss and Alopecia Areata but in this article I’m discussing the hormonal hair loss associated with PCOS.

PCOS: Hormone Havoc

In polycystic ovarian syndrome (PCOS) the ovaries do not respond appropriately to hormonal cues from the brain (the pituitary gland to be precise), resulting in the formation of cysts in the ovaries.

These cysts are actually unsuccessfully ovulated follicles – in normal ovulation the follicle ruptures and releases an egg. But in PCOS the follicle continues to grow and becomes a cyst.

Because the follicle does not release the egg, and continues to grow, it also continues to release hormones – mostly estrogen and testosterone. And it is this hormonal havoc that can lead to hair loss.

Testosterone and Hair Loss

High levels of testosterone are known to contribute to hair loss, and women with PCOS often have elevated levels of testosterone and other androgens (including dihydrotestosterone – a super powerful form of testosterone).

The testosterone can bind to receptors in the scalp hair follicles, stimulating hair loss in a male pattern – typically hair is lost at the front of the hair line, and at the very top of the head. It’s usually in a diffuse pattern – meaning the hair falls out all over rather than in patches.

The low progesterone that occurs in PCOS (progesterone is only produced after ovulation – no ovulation, no progesterone) also binds to those same hormone receptors in the hair follicle – preventing hair loss from occurring. So the balance of high (or even normal) testosterone and little to no progesterone causes the hair loss we see in PCOS.

Treating PCOS Hair Loss

The goal of treatment in hair loss associated with PCOS is to get you ovulating again. The balance of hormones in a healthy menstrual cycle should prevent hair loss from occurring. In the early stages of treatment we may also use treatments like saw palmetto, spearmint, berberine or inositol to decrease the testosterone levels.

As with all treatments for hair loss, the benefits take time to become apparent. The life cycle of the hair is three months – any hairs that have already been triggered by testosterone to fall out will do so for the first few months. So don’t give up on your treatment if you don’t see a benefit right away. The work you do now will benefit future you.

If you have any questions about your hair loss – whether it is associated with PCOS or any other condition, book a free 15 minute consultation so we can talk.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Diagnosing PCOS

Polycystic ovarian syndrome is one of the most common conditions that I treat in my hormone balancing practice. It affects 1 out of every 10 women and shows up in many different ways – hair loss, facial hair growth, acne, difficulty losing weight, irregular menstrual periods or infertility. Because of the many different symptoms of PCOS, an accurate diagnosis is important.

The Rotterdam Criteria

In 2003 the Society for Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM) came up with a specific criteria for making a diagnosis of PCOS – The Rotterdam Criteria.  Diagnosis of PCOS requires that a woman meets two of three criteria:

  1. Infrequent or no ovulation (resulting in irregular or absent menstrual periods)
  2. Signs and symptoms or laboratory tests that show high androgen (male hormone) levels – these include acne, hair loss, facial hair growth, darkening of the skin at skin folds
  3. Cysts on the ovaries on ultrasound

For a diagnosis of PCOS it is also important to rule out other causes of these symptoms, such as a pituitary, thyroid or adrenal disease.

Clinical Evaluation

taking-notesThe first step in diagnosis of PCOS is a thorough evaluation with your medical or naturopathic doctor. Your doctor will ask a lot of questions. Be sure to share if you experience any of the following:

  1. Irregular periods – menstrual cycles that are longer than 35 days, infrequent periods or no periods at all can all be associated with anovulation and PCOS.  (Keep in mind: 1 in 5 women with PCOS still have regular periods, so having a regular period does not rule out PCOS)
  1. Acne – facial, chest, or back acne can be a sign of elevated androgens
  2. Hirsutism – abnormal growth of coarse hair in a male pattern (lip, chin, torso)
  3. Hair loss – elevated androgens is a major cause of head hair loss in women
  4. Oily hair or skin
  5. lump-sugar-549096_640Sugar cravings – a sign of insulin imbalance, one of the major hormonal imbalances in PCOS. Other symptoms include dizziness, lightheadedness or irritability (or “hangry”) if a meal is missed.
  6. Recurrent yeast infections – a sign of elevated blood sugar levels. Other symptoms include excess thirst and frequent urination.
  7. Overweight or difficulty losing weight – often a cause, and consequence, of the hormone imbalances in PCOS
  8. Darkening of the skin – especially at the back of the neck or in the skin folds at the underarms, under the breasts and between the thighs. This darkened skin is called acanthosis nigricans and is associated with elevated testosterone.
  9. Infertility – difficulty getting pregnant is often the driving factor for a diagnosis for PCOS
  10. Family history of PCOS or diabetes

Laboratory Testing

Laboratory testing is the second criteria for a PCOS diagnosis. Many different lab tests can be used to confirm a suspected PCOS diagnosis, and these tests may highlight the underlying hormonal imbalances that cause PCOS. If you are taking the birth control pill to suppress your PCOS symptoms these tests will not provide accurate information.

Luteinizing hormone (LH) – high – produced by the pituitary gland to stimulate ovulation, levels are often elevated because ovulation is not occurring

Follicle stimulating hormone (FSH) – normal or low – typically assessed in relation to LH levels, some women with have a higher than normal LH:FSH ratio (greater than 1:1)

PCOS laboratory testingSerum testosterone (free and total testosterone) – high – 80% of women with PCOS have elevated levels of androgens. DHT levels may also be elevated

Progesterone – low – during the second half (luteal phase) of the menstrual cycle progesterone levels will be low due to the lack of ovulation

Estradiol – normal – typically in PCOS estrogen levels are normal or slightly elevated

Sex hormone binding globulin (SHBG ) – low – if tested, levels may be low

Fasting blood glucose – high – women with abnormal blood sugar levels typically have higher body weight, have higher androgen levels and are more insulin resistance

HbA1C – high – a long term (3 month) measure of blood sugar stability

Anti-Mullerian hormone (AMH) – high – levels of AMH are often elevated in PCOS due to the lack of regular ovulation

DHEAS – high – half of women with PCOS will have elevated adrenal production of DHEAS

Prolactin – normal – elevated prolactin can cause symptoms similar to PCOS; if your prolactin levels are high a pituitary tumour must be ruled out.

Thyroid stimulating hormone – normal – should be measured to rule out other causes of menstrual irregularities

Cortisol – normal – should be measured to rule out Cushing’s syndrome

Additionally, a pelvic or transvaginal ultrasound may reveal multiple 2-6mm follicular (simple) cysts on the ovaries. Ovarian volume or area may also be increased.

Moving Beyond Diagnosis

PCOS DietAn appropriate diagnosis of PCOS is important for women seeking optimal hormone balance. But the diagnosis is only the beginning. Your naturopathic doctor can be your partner as you move beyond diagnosis towards understanding and hormone balance. Read the other articles in the PCOS Series by Dr. Lisa Watson: Understanding PCOS, The PCOS Diet (also available as an infographic), PCOS and Infertility, PCOS in Adolescence, PCOS and Pregnancy, Hormonal Balance in PCOS and Naturopathic Medicine for PCOS.

Dr. Watson is currently accepting new patients at both her Toronto clinics. Contact her for a complimentary meet and greet appointment, or book your initial consultation today. The best time to start balancing your hormones is now.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

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PCOS & Berberine

While your medical doctor may not have heard of it, the functional and naturopathic medicine community is raving about berberine for polycystic ovarian syndrome (PCOS). And if you haven’t heard about it – you are about to go to school on WHY berberine may be exactly the treatment you have been looking for.

What is Berberine?

Berberine is a compound (technically a quaternary ammonium salt – damn! science!) found in several plants – most notably barberry, Oregon grape and goldenseal.  It has been used as a medicine in Traditional Chinese Medicine for over 5000 years.

Berberine Improves Insulin Responsiveness

One of the key findings in many women with PCOS is a poor response to insulin. When the cells (including those of the ovaries) stop responding to insulin, energy goes down, weight gain goes up and many of the hormone imbalances associated with PCOS show up.

One of the most common prescription treatments for PCOS is metformin, a drug that improves insulin response. But studies have found that berberine is able to do this too – and maybe even a bit better than metformin!

Berberine stimulates cells to take up glucose, so blood sugar and insulin levels drop. This can result in ovulation for women with PCOS. One study also found that the women taking berberine lost more weight than the women on metformin. Win-win!

Berberine Lowers Testosterone

The elevated testosterone associated with PCOS is the one hormone imbalance most women want addressed quickly. Elevated testosterone leads to the acne, head hair loss, chin and upper lip hair growth that women despise. Studies have demonstrated that berberine can lower testosterone levels and speed the resolution of these symptoms.

Berberine Benefits Your Gut

Berberine is not just great for your ovaries, but it’s great for your gut too. Berberine has been used for generations to treat symptoms of gas, bloating, constipation and diarrhea. Now we understand that it does this by helping increase the production of short chain fatty acids and supporting the healthy bacteria (probiotics) in our guts. Healthy bacteria help us to eliminate estrogen – minimizing the potential for estrogen dominace – another common hormone imbalance in PCOS.

Berberine Loves Your Liver

Your liver is essential in hormone balance. Berberine has been found in studies to increase the production of sex hormone binding globulin (that’s a mouthful…) or SHBG that binds to testosterone and makes it unavailable for use in your body.

Berberine has also been found to lower liver enzymes in non-alcoholic fatty liver disease, a condition that is commonly found in women who are overweight and have PCOS.

Berberine Benefits Fertility

Whether you are trying to get pregnant or just balance your hormones, it is reassuring to know that berberine can improve ovulation and pregnancy rates in women with PCOS. In women with PCOS undergoing IVF procedures, those who took berberine (no matter whether they were normal weight or overweight) had higher pregnancy rates than women using metformin or a placebo.

Berberine Boosts Weight and Fat Loss

Not every woman with PCOS is overweight (I talk about that more in the PCOS Types article), but if you are even mildly overweight berberine can help you to shed some unwanted fat.

Berberine has been found in multiple studies to support weight loss and to help target fat loss from the midsection of the body. Berberine helps to lower the production of our hunger hormone, leptin – a hormone that stimulates our appetite. Women with PCOS and women who are overweight often have abnormal levels of leptin.

Building on Berberine

Berberine is an excellent option for many women with PCOS. It can be the cornerstone for PCOS treatment and help you to achieve your dreams of hormone harmony.

Discuss with your Naturopathic Doctor if berberine is the best bet for you.  It may be used in combination with other natural treatment options, diet and lifestyle changes to improve your health and hormones, naturally.

Select Resources

Toronto Naturopath, Dr. Lisa Watson discusses the use of berberine for PCOS - polycystic ovarian syndromeAn Y, Sun Z, Zhang Y, Liu B, Guan Y, Lu M. The use of berberine for women with polycystic ovary syndrome undergoing IVF treatment. Clin Endocrinol (Oxf). 2014 Mar;80(3):425-31

Wei W, Zhao H, Wang A, Sui M, Liang K, Deng H, Ma Y, Zhang Y, Zhang H, Guan Y. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. Eur J Endocrinol. 2012 Jan;166(1):99-105.

Wu X, Yao J, et al. Berberine improves insulin resistance in granulosa cells in similar way to metformin. Fertility and sterility.2006; supplement S459-S460.

Yang J et al. Berberine improves insulin sensitivity by inhibiting fat store and adjusting adipokines profile in human preadipocytes and metabolic syndrome patients. Evid Based Complement Alternat Med. 2012

Zhao L et al. Berberine improves glucogenesis and lipid metabolism in nonalcoholic fatty liver disease. BMC Endocr Disord. 2017 Feb 28;17(1):13.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Natural Treatment of PCOS

PCOS is the most common hormone imbalance impacting women and teenage girls. Polycystic ovarian syndrome, meaning “multiple ovarian cysts” can start soon after puberty and can persist for years. For some women it starts later – but for all women and teenage girls, it can be an incredibly frustrating, and sometimes painful condition.

WTF is PCOS?

Ovarian cysts occur when ovulation doesn’t occur as it is supposed to. In every cycle each ovary stimulates a number of follicles to develop, one of which will release an egg at ovulation. In PCOS the follicles are stimulated to grow (totally normal), but they do not respond to the hormonal cue to release an egg at ovulation. Instead they continue to grow and form cysts within the ovary.

There are many reasons why you may not respond appropriately to the hormones and instead form ovarian cysts – you can learn more about the types of PCOS in this article.

How Do I Know If I Have PCOS?

I talk about the diagnosis of PCOS in this article, but these are the most common symptoms that may suggest a diagnosis of PCOS:

  • Irregular or absent periods
  • Infertility
  • Hair growth on the upper lip or chin
  • Hair loss from the head
  • Acne – especially on the body or on the “beard distribution” of the face
  • Weight gain or excess weight around the abdomen

If you have a family member with PCOS, you are more likely to develop it. So talk to your mom, sister, aunts and grandmothers to see if you have a family history.

If you suspect you may have PCOS, then discuss it with your MD or ND and get an appropriate diagnosis.

What Causes PCOS?

PCOS is the result of failed ovulations – so the cause can be anything that disrupts healthy ovulation. Hormone imbalances stemming from the pituitary gland, the thyroid, the adrenal glands or pancreas can all cause PCOS. Insulin resistance – when your cells no longer respond to the hormone insulin – is probably the most common hormone imbalance that leads to PCOS.

How is PCOS Treated?

In conventional care, PCOS is most often treated with the birth control pill. Other choices, like spironolactone or metformin, are also suggested if acne or insulin resistance are present. However, many women are successfully choosing a more empowered approach to treating their PCOS through diet, exercise and some health supporting supplements.

Diet and Lifestyle

While not every woman with PCOS is overweight, if you are, losing weight is an important goal. Losing as little as 5% of your body weight can reverse insulin resistance, promote ovulation and decrease testosterone (less acne and chin/lip hair!)

I go into great detail on the basics of the PCOS Diet in this article – also available as a fun infographic! Check it out for all the information you need.

Vitamins and Minerals

Many different supplements can be used for managing PCOS. These are best selected by working with your ND – knowing what your hormone imbalance is will allow you to choose those supplements most likely to work for you. Here are a few of the most helpful options:

Vitamin B6 – can help balance prolactin levels, a hormone often elevated in PCOS.

Chromium – essential for proper blood sugar regulation. Taking chromium (also known as insulin tolerance factor) increases the uptake of glucose into cells, decreasing insulin resistance.

Vitamin D – essential for healthy ovulation. Every Canadian is deficient during the winter months, and supplementation is often needed to correct that deficiency.

Herbal Medicines

Plant medicines can be incredibly powerful medicines, especially when it comes to supporting hormone balance. It depends on your type of PCOS what herbal medicines may be recommended.

Saw palmetto (Serenoa repens) – an incredibly effective hormone balancer, saw palmetto decreases the conversion of testosterone to its more powerful form, dihydrotestosterone (DHT). This makes saw palmetto an excellent choice in the treatment of acne, hair loss, and facial hair growth.

Chaste tree (Vitex agnus-castus) – one of the best known herbal medicines for PCOS, chaste tree lowers prolactin levels and raises progesterone levels. It can also restore regular ovulation, the main issue in PCOS!

Other Natural Supplements

A few honourable mentions are necessary in any discussion of PCOS – treatments that have excellent research and deserve to be considered in any woman seeking a more empowered approach to her PCOS.

Inositol – a B-like vitamin, inositol has many benefits for PCOS – it decreases insulin resistance, decreases testosterone levels and helps to promote regular ovulation. It is a super-star for PCOS treatment.

Berberine – compared in studies to metformin, berberine has powerful actions on blood sugar regulation and insulin resistance. It can reduce testosterone, and androgens. Women taking berberine also achieved greater weight loss in some studies.

Next Steps

Knowing that there are a great many different options for the treatment of PCOS, some women can feel overwhelmed by information. This is one of the many benefits of working with a Naturopathic Doctor. Your ND can help you understand your individual hormone imbalance and guide you to the treatments that will be most effective for you.

Remember, any hormone imbalance will take time to resolve. Start taking the steps now to achieve your healthy hormone balance.

Disclaimer

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.