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How to Select a Naturopathic Doctor

I believe that women need the medicine that Naturopathic Doctors offer.  I believe that giving women the knowledge they need to make healthy decisions for their health, and the health of their families, is one of the most powerful ways we can empower women. This is the entire reason my website exists – to share knowledge and empower women.

But I can’t be everywhere.  And I can’t treat everyone.  As a Naturopathic Doctor I am a regulated health care professional and can only practice in jurisdictions where I am licensed (Ontario, Canada).  Every week I receive emails from people across Canada and around the world who want to find someone like me.  The great news is that there are many wonderful Naturopathic Doctors out there who are making huge impacts on the health of their community.  And you can find one in your area.

How to Select a Naturopathic Doctor

The Basics

1. Do they have a degree in Naturopathic Medicine?

In North America there are only seven accredited schools where a Naturopathic Doctor can obtain a degree.  Only two of these are in Canada.  You can check the schools on the website for the Council for Naturopathic Medical Education (CNME).

2. Are they licensed to practice in the province or state where you live?

Naturopathic Medicine is not regulated the same in every province or state.  In fact, only 5 provinces (Ontario, British Columbia, Alberta, Saskatchewan and Manitoba) currently regulate Naturopathic Doctors.  Many states in the USA also regulate Naturopathic Medicine, while others are still seeking regulation.  (Click here to check if your state is regulated).

Regulation is important to ensure the safety of the public – if you are in a regulated area only see a Naturopathic Doctor who is licensed to practice in that area.  If you are not, consider finding a Naturopathic Doctor who is licensed to practice in a regulated area.

The Right Fit

3. Do they have a practice focus? 

Naturopathic Doctors are primary care physicians – trained to support a wide variety of health care conditions and concerns.  However, many Naturopaths choose to focus their practice on treating a specific concern or population.  Ask your potential ND if they have a practice focus and see if it is inline with the concerns you are seeking care for.  You don’t want to see a cancer-focused Naturopathic Doctor if you are seeking care for PCOS.

4. Do they have any additional certifications or training?

The education of Naturopathic Doctors should not end when they graduate from naturopathic medical school.  There are additional certifications and associations that Naturopathic Doctors can obtain that can enhance the services they offer.  Examples include bio-identical hormone prescribing, IV micronutrient therapy, perinatal, cancer, or pediatric associations.

The Best Practices

5. What types of assessments or testing do they offer in their practice?

One of the core tenets of Naturopathic Medicine is to treat the root cause.  How is your Naturopathic Doctor going to help to uncover the root cause of your symptoms?  Do they offer the highest level of functional tests in addition to standard blood tests? Do they do mostly energetic testing?  Will they review lab tests from your Medical Doctor? How do they decide what tests may be necessary for you?

6. Do they incorporate evidence based information and research into their treatment plans? 

The body of research on naturopathic medicine is growing every single day.  How does your Naturopathic Doctor stay up to date on research in their practice?  Do they incorporate both modern research and traditional knowledge into their treatment plans?  Patients are often surprised by the amount of research we can provide on the treatments we are suggesting for their care!

7. Will they work integratively together with your current health care team?

Integrative Medicine is choosing the best of all forms of medicine with the sole purpose of improving patient outcomes.  ~ Dr. Lisa

I think the medicine of the future will be more patient-centered, with all different types of health care providers working together to improve the health of individuals and their families.  I love working with Medical Doctors, physiotherapists, psychotherapists, nurse practitioners, chiropractors, osteopaths, massage therapists, and many other health professionals.  I truly believe this approach benefits everyone, most importantly my patients.

8. What types of therapies do they use in their practice?

Naturopathic Doctors are trained in a number of different therapies, from acupuncture to herbal medicine, nutritional supplementation and homeopathy.  What therapies does your Naturopath use, and why?  Personally I don’t use a lot of homeopathy in my practice because there isn’t a vast body of research supporting its use.  I focus on the research based treatments of nutritional and botanical medicines.  Discuss what your Naturopath is using and see if it resonates with what you’re looking for.

9. How much experience does the Naturopathic Doctor have?

There are many more important considerations than the number of years a doctor has been in practice, but it is something to discuss when meeting a Naturopath for the first time.  You don’t necessarily want to be someone’s first patient with your health concern.

10. Do you trust them, feel listened to, and comfortable with them?

In my mind, this is one of the most important considerations.  Ideally you are building a long term relationship with your Naturopathic Doctor.  Consider the so-called “soft traits” like personality, approachability, empathy and trust when deciding on your Naturopath.  This can be the make or break factor in selecting your ND, and I encourage you to trust your gut.

To make things easy for you, I’ve made a pdf with all these suggestions.  Bring it along when meeting your Naturopathic Doctor for the first time.  Most NDs offer a free 10-15 minute meet and greet appointment – I highly recommend taking them up on this.  Take the time to choose the best ND for you, and you will benefit immensely from the investment!

How to Select an ND

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.

 

 

Hormone Harmony during Breastfeeding

Going through my pregnancies with my two sons, and supporting hundreds of women in my practice through their pregnancies and beyond, I am always interested in the information that is given to pregnant women and what that says about what our society deems important.

Women going through pregnancy know a lot – they know what to eat, what to avoid, when their baby develops eyelashes (32 weeks) and what position to sleep in. They know how to track contractions, how often to breastfeed and the best positions for breastfeeding.

What women know very little about is what is happening in their own bodies. What the hormonal changes that occur during pregnancy, breastfeeding and the postnatal stage mean for their own energy, emotions and health.

This article is here to close that gap – to help women understand the hormonal changes that occur during breastfeeding and when that hormone balance is normal, and when to seek support when it is not.

Breastfeeding Hormones

Breastfeeding is associated with production of two specific hormones: prolactin and oxytocin. These two hormones allow for peak production of breastmilk as well as bonding with your new babe. Let’s look at each one in more detail.

Prolactin

Prolactin, or “pro-lactation hormone” is produced during breastfeeding to increase breast milk supply. Levels rise for almost an hour after the baby begins to feed, encouraging the alveoli in the breasts to make milk.

But that is not all prolactin does. In fact, not just breastfeeding parents produce it – all parents produce it. Prolactin is a calming and relaxing hormone that decreases progesterone and testosterone production in both parents. It can cause mothers to feel deep relaxation (and sometimes deep fatigue) during breastfeeding and for some time after.

Interestingly, prolactin is also released during sexual intimacy, counteracting the effects of dopamine (which is associated with sexual arousal) and resulting in a sensation of gratification and calm. With high circulating levels of prolactin during the breastfeeding stage, there is often less sex drive – your body feels like it’s already in the afterglow, and your libido is no where to be seen.

Oxytocin

Mostly commonly referred to as the “love hormone”, oxytocin is released to encourage let down during breastfeeding. Oxytocin increases bonding and is produced in both parents during cuddling and intimate contact – with both the baby and with each other. Oxytocin levels are highest during new relationships, such as with your brand new baby, and while baby is breastfeeding.

Most of the time we respond to oxytocin in positive ways – it feels good to be awash in these bonding hormones. But it isn’t this way for all women. Some women are very sensitive to such high levels of oxytocin and feel more anxious, irritable or overwhelmed while breastfeeding.

Women’s Hormones in Breastfeeding

It is no surprise that women’s hormones fluctuate a lot in the time after pregnancy – after all, those hormones that helped to sustain the pregnancy are now dropping off (quickly!) to pre-pregnancy levels. How a woman feels in the months, and years, after her baby is born has a lot to do with the balance of her hormones.

Estrogen

Estrogen levels can hit menopausal levels for the months after giving birth – and for some women they stay low throughout the time she is breastfeeding. Low estrogen levels can cause mood swings, irritability, hot flashes and night sweats as well as vaginal dryness, tenderness and discomfort during sexual intercourse. Low estrogen can also zap your desire for sexual intimacy (let alone how dry your lady garden is…) Using a water-based lubricant, and engaging in foreplay can help to overcome some of these low estrogen issues, but if the concern persists, talk to your ND about a low dose topical estriol cream.

Low estrogen can also contribute to an increased incidence of yeast infections, especially in women who are prone to them. If this happens, talk to your Naturopathic Doctor about treatments that are safe during breastfeeding.

Progesterone

Progesterone – “pro-gestation hormone” is at sky-high levels during pregnancy and it can feel like a rollercoaster free fall when you return to pre-pregnancy baselines in the weeks after delivery. Prolactin production suppresses ovulation, especially during the first six months after delivery, and with no ovulation progesterone production is incredibly low.

Symptoms of low progesterone can include anxiety, depression, mood swings, low libido, and insomnia. Many clinicians believe that low progesterone is a contributing factor to the development of post-partum depression in some women. There are many available treatments for post-partum depression, if you are concerned that you may have PPD, talk to your Naturopathic Doctor right away.

Testosterone

Produced mainly by the ovaries, but also in the adrenal glands, testosterone levels are also low in breastfeeding women. Testosterone can contribute to sexual desire, as well as sexual response. Low levels can impact mood, focus and libido.

Beyond Hormones

The months after giving birth are a challenging time for everyone. My take home message here is that while lack of sleep, and an exhausting schedule are huge factors in the way women feel during the months and years of breastfeeding, there are also hormonal influences at play that need to be considered.

If you have been feeling off, feeling exhausted, or have mood swings or low moods don’t just attribute it to the busy-ness of having a baby – talk to someone about how you can support your hormones and restore your hormone harmony throughout breastfeeding.

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 HSV

Oh herpes. No one wants you. But with 2/3 of people under age 50 having some form of herpes, a lot of women are dealing with this unwanted guest in their lady garden. And herpes isn’t going anywhere – once you have the herpes virus, you always have the herpes virus. Herpes is one of the types of virus that is able to remain in a hidden state in our bodies (called “latent” infection) and pop out when we least want it to.

Types of Herpes

There are two types of herpes simplex virus – HSV-1 and HSV-2. HSV-1 is the virus associated with most cold sores. HSV-2 is the one associated with genital herpes. However their location doesn’t really matter – you can have HSV-1 on your genitals, and while relatively rare, you can also have HSV-2 around your mouth.

How to Get Herpes

Now no one wants to get herpes, but honestly it is hard to avoid. HSV-1 and -2 are transmitted by physical contact, kissing or sexual intimacy. As one of the most common sexually transmitted infections, exposure rates are very high. To avoid exposure to HSV use condoms or dental dams when having sexual contact, and avoid direct contact during known outbreaks in a partner.

While HSV-2 is commonly transmitted sexually, it can infect the mouth as well through oral sex. Most cases of HSV-1 are contracted during childhood, but can also occur sexually. HSV-1 and -2 can both also be passed along to infants during childbirth.

Symptoms of HSV

Many people recognize the symptoms of cold sores – a watery blister near the lip (or sometimes the nose) or in the mucous membranes of the mouth. As the blister heals it forms a characteristic scab.

But herpes can also be completely silent – many people have HSV infections and never know it. This contributes to the high rates of exposure to HSV – it can be passed on even if no active blisters or sores are present.

Symptoms of an outbreak can also cause some symptoms such as tingling, burning or flu-like symptoms before the blisters appear. It is important to avoid direct contact with a partner during these times (use a condom or dental dam).

The first contact with the virus will cause the primary outbreak – usually with symptoms showing up between 2-21 days after contact. Typically this outbreak is more severe and can last longer than subsequent outbreaks.

Triggering Future Outbreaks

Any number of different triggers can lead to the resurgence of the herpes virus. Things that compromise your immune function – like lack of sleep, stress, poor diet and alcohol consumption are common triggers. Other triggers may be sun exposure, excessive heat, skin irritation or other local infections.

Diagnosing HSV

The best test is a simple swab, done in your doctor’s office soon after the onset of the blisters. It can take up to a week for results to come back, so treatment is often started if the symptoms and appearance are consistent with a herpes infection.

There are blood tests available as well that can be used if HSV is suspected.

An Empowered Approach to Treating HSV

My first step in treating HSV in women is to offer assurance. You are practically a unicorn if you have never had HSV – most people in Canada do have it (and remember, once you’ve had it you always have it). It is a virus like any other and we need to let go of some of the negative connotations around contracting HSV.

Second, there are antiviral medications available that can help to lessen the severity of an outbreak and lower the chances of passing HSV to a partner. While I don’t advocate for on going use of these medications, they can be used judiciously in women who are looking for short term support.

Of course, as a naturopathic doctor, my focus is on empowering women to make choices for their health based on knowledge and informed by science. So I like to emphasize what we, as women, can do to help control HSV and prevent outbreaks.

St. John’s Wort – most commonly known as a treatment for depression, Hypericum perforatum (St. John’s Wort) also has powerful antiviral properties that are effective against herpes viruses. Typically taken at higher doses for 1-2 weeks, then decreasing to a lower or maintenance dose.

Lysine – one of the more well-known treatments for HSV, lysine is an amino acid that helps to stabilize the virus and prevent reactivation. It is most often taken daily to prevent outbreaks. Many doctors also suggest consuming more lysine in the diet, and avoiding arginine – this balance supports the immune system in it’s work. Below you’ll find a list of foods high in lysine (enjoy lots of these!) and foods high in arginine (limit these).

Lemon Balm – topical lemon balm is stellar at soothing and supporting the healing of cold sores and genital herpes. It is applied directly to the lesions once or twice per day during an outbreak.

Coriolus Mushrooms – mushrooms pack one hell of a punch when it comes to optimizing our immune system. Coriolus mushrooms in particular have been found to optimize immune function and support the immune system in it’s battle against viruses. I suggest taking mushrooms regularly to support your immune function.

Empowered Steps

If you are struggling with recurrent HSV outbreaks, or this is your first outbreak, I hope that you feel more knowledgeable after reading this article. As always, I suggest that you work with a qualified Naturopathic Doctor to put together a plan that approaches all aspects of your health, and the health of your lady garden. If you’d like to work with me, I am happily taking new patients in my women’s health focused practice in Toronto. You can book here.

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 Vaginal pH Testing

In teaching my patients to provide empowered care for their lady garden, I have emphasized the importance of a healthy vaginal pH. So how do you know if your pH is optimal? You test it of course!

The Importance of Balance

Your vaginal pH is one of the most important factors contributing to the health and comfort of your lady garden. The pH of the vaginal tract is maintained by the healthy bacteria that live there – mostly Lactobacillus species. When the pH is out of balance this can lead to bacterial vaginosis (BV), yeast infections, and urinary tract infections.

If you are experiencing symptoms of itching, burning, discomfort or an unpleasant odour from your lady garden, a pH test can help you to determine the cause. And once you know the cause, an empowered woman can find the appropriate solution!

How to Test Vaginal pH

Testing your vaginal pH couldn’t be simpler. You purchase a pH test kit – it has to have a pretty narrow range to accurately assess the pH of the vaginal tract. This one is the one I recommend most – you can purchase it easily on Amazon.

To test the pH simply part the outer labia then apply a piece of the pH paper to the vaginal walls for a few seconds. You can then compare the colour of the pH paper to the packaging to determine your pH balance.  Choose the colour that most closely resembles the colour of the paper – it doesn’t have to be a perfect match, just a close match.

What the Results Mean

The pH of a healthy vaginal tract is slightly acidic – typically between 3.8 and 4.5.

A higher number (above 4.5) suggests a more alkaline environment – and is one of the most accurate ways of diagnosing BV. If your pH is high, you should skip the yeast infection treatments and instead start on the PATH to treating BV.

Yeast infections don’t typically change the pH of the lady garden. So if your pH is normal and you still have itching or discomfort, then a yeast infection is more likely your issue. If you don’t have typical symptoms of a yeast infection, speak with your Naturopathic Doctor about whether it may be cytolytic vaginosis, a condition associated with an overgrowth of Lactobacillus that can sometimes mimic a yeast infection.

Monitoring with pH

One of the best things you can do when you are learning to expertly tend to your lady garden is test your pH. If you have had a history of bacterial vaginosis in the past, using pH to monitor your balance, or to assess the impact of treatments, can be incredibly empowering. I suggest you try testing your vaginal pH at different times through your cycle, I recommend weekly, to get a sense of your pH balance throughout your hormonal cycle.

Seeking Support

If you test your vaginal pH and it is out of balance, I suggest you work with a qualified Naturopathic Doctor to regain your balance. The health of your lady garden is a reflection of your hormonal and bacterial health, and I want your health to be vibrant and amazing!

Selected Resources

Hemalatha R, Ramalaxmi BA, Sweta E, Balakrisna N, Mastromarino P. Evaluation of vaginal pH for detection of bacterial vaginosis. Indian J Med Res. 2013; 138(3):354-359

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.

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.

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.

 

Ovarian Cysts: Simple and Complex

Ovarian cysts are small growths that form on or inside of the ovary. Many women are diagnosed with ovarian cysts on routine ultrasounds, and others are diagnosed when they experience changes in their menstrual cycles or painful periods. Often women are told they have cysts without really understanding what that means. This article will give you the knowledge you need to understand your diagnosis, and empower you to select the best treatment options for you and allow you to restore your optimal hormone health.

Simple Ovarian Cysts

Simple ovarian cysts are by far the most common type of ovarian cyst. A simple cyst forms when an egg fails to be released by the ovary at ovulation, or when the follicle the egg developed in continues to grow after ovulation. Simple ovarian cysts develop with exposure to estrogen, and are sometimes called ‘functional’ cysts.

Simple cysts often have no symptoms and will resolve on their own with time. Simple cysts are often found in a condition called Polycystic Ovarian Syndrome (PCOS) where many simple cysts develop and symptoms such as a lack of periods (amenorrhea), irregular periods, infertility, acne, hair loss or facial hair growth can occur.

Complex Ovarian Cysts

Complex cysts are much less common and are not formed during a typical menstrual cycle. There are three different types of complex ovarian cysts:

  • Cystadenomas – ovarian tissue filled with fluid or mucus
  • Dermoid cysts – composed of cells you have had since before you were born. Dermoid cysts contain cells that are used to produce dermal tissue, so they can contain skin, hair, fat, or teeth.
  • Endometriomas – a result of endometriosis. Endometriomas occur when cells from your uterine lining grow on or in the ovaries.

Complex ovarian cysts are most often benign, especially those that develop before menopause. Some ovarian cysts can be malignant so it is important to have them assessed fully.

Symptoms of Ovarian Cysts

Most simple ovarian cysts do not cause any symptoms at all. Some symptoms that may alert you to the possible presence of simplex or complex cysts include:

  • Bloating, pressure, or pain in the low abdomen
  • Frequent urination (if the cyst is large and pressing on the bladder)
  • Sudden severe pain (if the cyst ruptures)

If you have endometriomas – cysts associated with endometriosis, you may experience:

  • painful periods
  • pain during sex
  • pain during bowel movements
  • infertility

What Causes Cysts?

Simple cysts (like those in PCOS) are the result of hormonal and metabolic issues. You can read more about PCOS in these articles, Understanding PCOS, PCOS Types and Diagnosing PCOS.

Complex cysts can be present from birth and grow under hormone stimulation after puberty. Endometriomas, another complex cyst, occur when the lining of the uterus grows outside of the uterus, including on the ovaries. Cystadenomas can occur when ovarian cells mutate and grow (most often these are benign, but can be cancerous).

Diagnosis of Cysts

Most cysts are diagnosed with a transvaginal ultrasound. Some can also be detected with a simple pelvic exam. Often the type of cyst can be identified with an ultrasound, but occasionally a biopsy or blood test (such as CA-125) may also be used.

Treatment of Cysts

Simple cysts are easily treated with Naturopathic approaches – hormone balancing, blood sugar stabilization and improved ovarian response are common treatment goals.

Some complex cysts require no treatment, but some may need to be removed if they are large or causing significant symptoms. Most often the cyst is removed through a simple surgery caused laparoscopy.

Endometriomas are treated in the same manner as other types of endometriosis. If you have endometriosis, please read the Endometriosis series of articles written by Dr. Lisa on this website.

 

If you have any more questions about your ovarian cysts, don’t hesitate to get in touch!  You can send Dr. Lisa an email or book a free 15 minute meet and greet here.

 

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