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Hormone Harmony in PMS

Welcome to the first installment of the “Hormone Harmony” series. In this series I’ll be exploring some of the most common states of female hormone imbalance, how your hormones can explain your symptoms, and some simple hormone hacks to help bring your body back into a state of hormone harmony.

Premenstrual Syndrome (PMS)

While a definition of PMS may not be necessary if you are reading this (it’s likely you’ve had first hand experience), I will try to give one that encompasses exactly what PMS is.

PMS is a recurrent set of physical and/or behavioural symptoms that occurs 7-14 days before a period and negatively impacts some aspect of a woman’s life

There have been over 150 (seriously!) symptoms of PMS identified. Some of the most common include:

  • Low energy
  • Mood changes – anger, crying, irritability, anxiety, depression, bitchiness
  • Food cravings
  • Headache
  • Low sex drive
  • Breast tenderness
  • Digestive upset – constipation, bloating, diarrhea, gas
  • Difficulty sleeping

Unfortunately we don’t really know what causes some women to experience PMS more than other women. But hormone imbalances are a common proposed cause, and in my practice I see balancing hormones as the most important means of decreasing symptoms of PMS.

Hormone Imbalances in PMS

The relationship between estrogen and progesterone is one of the most important hormone balances in a woman’s body. Imbalance in estrogen and progesterone levels is thought to be the primary cause of PMS.

Estrogen is produced throughout the month by the ovaries, adrenal glands and fat cells. It main action is growth – growth of breast tissue in puberty, and growth of the endometrial lining in the uterus during menstrual cycles.

Progesterone is produced during the second half of the menstrual cycle – after ovulation – by the ovaries.  Progesterone helps to balance the effects of estrogen and prepare the uterus for a possible pregnancy.

A too high estrogen level, or a too low progesterone level is thought to be the most likely cause of PMS symptoms in most women. This state, commonly called “estrogen dominance” is the most common hormone imbalance in women between the ages of 15 and 50. Estrogen dominance is becoming more common in North America due to increasing exposure to xenoestrogens (chemicals in our environment that mimic estrogen), high rates of obesity, decreased ability of our livers to detoxify and overwhelming amounts of stress.

The important thing to remember with PMS and hormone balance is that it is the relationship and balance of estrogen and progesterone that leads to symptoms. You may have normal levels of estrogen, but if your progesterone is low you will still experience symptoms. Progesterone levels are low in women who do not ovulate, and in those with significant stress (your body will convert progesterone into cortisol, leaving you deficient in much-needed progesterone).

Hormone Hacks for PMS

If you are a woman experiencing PMS, taking charge of your hormones and getting them into balance can make a huge difference in your quality of life. Below are some simple Hormone Hacks to get you started.

  1. Follow the PMS diet

There have been some significant findings in the diets of women who suffer from significant PMS. Compared to women who do not have PMS they eat 275% more sugar, 79% more dairy and 62% more refined carbohydrates. Avoiding these foods – and instead choosing fruits, vegetables, whole grains and healthy proteins – can diminish PMS symptoms significantly and promote healthy hormone balance.

  1. Cut the caffeine

No one wants to hear it, but drinking caffeine-containing beverages increases the severity of PMS. And those effects are worsened if you add sugar to your tea or coffee. So cut back, or cut it out all together if you want to decrease your PMS.

  1. Exercise

Women who exercise regularly have less PMS. Multiple studies have found this to be true, and the more frequently you exercise the better the boost. Exercise is known to decrease estrogen levels – so get out there and get moving.

  1. Get your nutrients in

Deficiencies in many nutrients have been found in women with PMS. Some notable ones include magnesium, vitamin B6, and zinc. All of these nutrients can be found in nuts and seeds – also known to be excellent sources of vegan protein.

  1. Get tested

Understanding your hormone imbalances can be incredibly valuable to managing symptoms like PMS. Testing your hormone levels will give you a clear understanding of what is happening in your body during a specific phase of your menstrual period. For PMS we test hormone levels (estrogen, progesterone and prolactin) about 7 days before your expected period.

  1. Herbal hormone balancers

There are some phenomenal hormone balancers in the world of herbal medicine. Vitex agnus-castus (also known as chaste berry) can improve progesterone levels, helping to balance estrogen dominance. Phytoestrogens, like those found in black cohosh, soy and flaxseeds, can also help to normalize estrogen levels by decreasing the action of our body’s own estrogen in favour of the milder estrogen signal from plant estrogens.

  1. Bioidentical progesterone

When all else fails in hormone balancing for PMS, your naturopathic doctor can prescribe low dose bioidentical progesterone in a cream that you can apply during the final weeks of your menstrual cycle. This will be helpful if your progesterone levels are low, or if your estrogen levels are high. Be sure your ND is qualified to prescribe bioidentical hormones, as additional training is required.

Don’t suffer with hormone imbalances like PMS.  You can achieve hormone harmony, and working with a Naturopathic Doctor can get you there.  Book an appointment, or a meet and greet now to find your personal 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.           

Natural Treatments for Tinnitus

Tinnitus impacts nearly 400 000 Canadians and can severely impact the quality of life. Tinnitus is defined as the perception of sound without an external source. It may be described as a hissing, ringing, or whooshing noise.   Many individuals diagnosed with tinnitus are told that the condition is chronic, will never improve, and they will just have to learn to live with it.

While Naturopathic Medicine can not guarantee a successful treatment of tinnitus, there may be hope in some of the integrative treatments available.

Cause of Tinnitus

The exact underlying cause of tinnitus is not known. It can be associated with noise trauma (explosions, loud noises), physical trauma, post-inflammation, anxiety and other conditions. In many cases an underlying cause is not identified.

The symptoms of tinnitus may be processed by different parts of the brain than typical auditory pathways. The amygdala and limbic system – parts of the brain responsible for memory and emotions – seem to play a significant role in tinnitus.

Diagnosis of Tinnitus

Diagnosis of tinnitus is generally clinical – the presence of a reported noise with no external source. An audiologist assessment should also be performed. A contrast MRI is also a useful tool and can identify possible underlying causes of tinnitus. Blood work for autoimmune antibodies, vitamin B12, inflammatory markers (ESR), cholesterol levels, blood sugar levels, thyroid-stimulating hormone and comprehensive hormone testing can also provide useful information in identifying metabolic, hormonal, or autoimmune cases of tinnitus. Questionnaires can also be valuable in tracking progress with integrative treatment options.

Conventional Treatment Options

There are several different treatment options offered by qualified audiologists. Many involve sound therapy, masking, hearing aids or tinnitus retraining devices. A referral to an experienced audiologist is necessary for these treatments.

Correcting underlying causes of tinnitus will be helpful in a patient-by-patient basis. If the tinnitus is caused by a hormonal imbalance, such as thyroid disease, correcting the thyroid dysfunction can lead to resolution of symptoms. Antidepressants (impacting serotonin and/or dopamine) and GABA-enhancing medications have also been used in some individuals with success.

Naturopathic Treatment Options

While no guarantee of success exists in the treatment of tinnitus, the lack of conventional treatment options leads many people to seek out natural and integrative therapies. The majority of these options are safe and may provide some degree of relief to people suffering with tinnitus. Working with a knowledgeable Naturopathic Doctor is advised as these treatments may have side effects or interactions with other medications.

Ginkgo biloba

One of the most commonly sold botanical medicines worldwide, ginkgo is used to increase blood flow to the head and treat symptoms of Alzheimer’s disease, dementia and vascular tinnitus. ginkgo has antioxidant, neuroprotective and platelet-inhibiting effects. Studies suggest that ginkgo may have a positive impact on patients with tinnitus, by increasing blood flow to the ear and may be especially useful in the elderly. The use of ginkgo may be limited by its interactions with medications, especially blood thinners, aspirin and seizure medications.

Zinc

Zinc is an essential mineral with significant actions in the central nervous system, including the hearing pathway, as well as in hormone production, enzyme function, and synthesis of DNA and RNA. Studies have suggested that zinc deficiency impacts between 2-69% of individuals with tinnitus. Giving zinc to individuals with tinnitus is a low risk intervention, and measuring serum zinc levels may identify those in greatest need for supplementation.

Melatonin

Melatonin, a hormone produced by the pineal gland during the night, regulates sleep/ wake cycles and acts as an antioxidant. Some studies have found that supplementing melatonin may improve tinnitus, especially in individuals with sleep disturbances. Melatonin may also help in individuals with stress by balancing cortisol production, another hormone often involved in tinnitus.

Vitamin B12

An important nutrient, and common deficiency, there have been studies showing a relationship between vitamin B12 deficiency and abnormal function of the hearing pathway. For every individual experiencing tinnitus, vitamin B12 levels should be assessed and optimal levels should be achieved through dietary and supplemental means.

Garlic

The flavourful garlic bulb is useful for many cardiovascular conditions. It has cholesterol-lowering effects, lowers blood pressure and can decrease blood clot formation. It may be useful for tinnitus by improving blood flow to the inner ear. There are no current studies on the use of garlic for tinnitus, but the possible benefits are evident.

Pycnogenol

Preliminary research suggests that the antioxidant, pycnogenol (pine bark extract) can decrease symptoms of tinnitus after one month of use. It is suspected that it’s influence on inflammation and the cardiovascular system may lead to improvements in tinnitus.

Hormone Modulation

Hormonal imbalances have been identified in many individuals experiencing tinnitus, with imbalance in the hypothalamus-pituitary-adrenal (HPA) axis being most common. This HPA axis is involved in the stress response, with abnormal cortisol production being a common feature. One study found that individuals with tinnitus had a blunted cortisol response after stressful events. Identifying and correcting underlying hormonal imbalance can improve tinnitus in some people, especially those with stress.

Acupuncture

Several studies have demonstrated improvement in tinnitus symptoms with acupuncture treatment. Improvements with acupuncture have not been found in all studies, and improvements may be short lived (average of 100 hours in one study). Acupuncture is a very safe treatment, with limited side effects and no interactions with medications. Administered by a qualified naturopathic doctor or acupuncturist, it may be a valuable option for the treatment of tinnitus.

Taking an integrative approach, managing stress and balancing your hormones may help to improve the symptoms of tinnitus, and also improve the quality of life of people suffering with tinnitus. To learn more, speak to a qualified Naturopathic Doctor.

References:

The sound of stress: blunted cortisol reactivity to psychosocial stress in tinnitus sufferers. Hébert S, Lupien SJ. Neurosci. Lett. – January 10, 2007; 411 (2); 138-42

Diagnostic value and clinical significance of stress hormones in patients with tinnitus. Kim DK, Chung DY, Bae SC, Park KH, Yeo SW, Park SN. Eur Arch Otorhinolaryngol – November 1, 2014; 271 (11); 2915-21

Hormones and the auditory system: A review of physiology and pathophysiology Neuroscience, 2008-06-02, Volume 153, Issue 4, Pages 881-900, Copyright © 2008

Complementary and Integrative Treatments for tinnitus Gregory S. Smith MD, Massi Romanelli-Gobbi BM, Elizabeth Gray-Karagrigoriou Au.D and Gregory J. Artz MD  Otolaryngologic Clinics of North America, The, 2013-06-01, Volume 46, Issue 3, Pages 389-408

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 Options for PUPPPS

 

PUPPPS may sound like a cute acronym, but ask any pregnant woman who has experienced it and you will soon realize this condition is anything but cute.

PUPPPS stands for pruritic urticarial papules and plaques of pregnancy.  This translates to “itchy, allergy-like rash during pregnancy”.  PUPPPS is a hive-like rash that occurs in around 1 in 200 women during pregnancy.  The rash is itchy and most commonly starts on the abdomen and may spread to the legs, feet, arms, chest and neck but usually does not occur on the face.

We don’t know why some women develop PUPPPS during pregnancy but it most often begins in stretch marks and is more common in women with significant skin stretching. Women with large fundal measurements and those who are carrying large babies or twins and triplets are at greater risk.

Interestingly there is a higher rate of PUPPPS in women carrying boys. Statistics have shown that bw-pregnant-window70% of women with PUPPPS deliver boys. Researchers think this may be due to male DNA interacting with the mother’s body, leading to irritation.

The good news is that PUPPPS, aside from causing itching and irritation, has no long term negative effects on either the mother or the baby and tends to resolve on its own within a week of delivery.

Most treatments for PUPPPS involve hydrating the skin and keeping the mother comfortable.  Certain antihistamines may also be tried.  From a Naturopathic perspective, we focus on decreasing the allergic response of the immune system, supporting the detoxification properties of the liver, decreasing inflammation and helping to clear and possible underlying causes.

6 Natural Treatment Options for PUPPPS

  1. Increase vegetable consumption and vegetable juice consumption

To optimize liver function by supplying healthy antioxidants and cholagogues (plant based compounds that support optimal liver function). Ideal vegetables are dark green leafy vegetables, beets, carrots, broccoli, cauliflower, bok choy, brussels sprouts, kale and kohlrabi

Also increase consumption of canned tomatoes for the lycopene content, an excellent antioxidant and member of the beta carotene family – but be sure to choose organic canned tomatoes to decrease exposure to BPA. Glass containers are even better.

  1. High quality omega 3 rich oils

TomatoesOmega 3 fatty acids, such as those found in flax seeds, chia seeds, salmon and fish oil supplements help to improve the fluidity of skin membranes, decreasing the potential for stretch marks. Omega 3 fatty acids are also anti-inflammatory and can help to decrease the production of inflammatory mediators, decreasing redness and itching in skin rashes.

Consume omega-3 rich foods such as ground flax seeds and chia seeds daily. Consume omega 3 rich fish (those that are safe in pregnancy include salmon, tilapia, cod and Pollock) at least two to three times per week. An omega 3 rich fish oil supplement may also be recommended by your Naturopathic Doctor.

  1. Moisturize the skin with a soothing moisturizer

    Coconut oil is a safe choice for pregnancy and is highly moisturizing. Chickweed ointment is another stellar choice as chickweed is a natural antihistamine and can greatly reduce itching sensations.

  1. Dandelion Root (Taraxacum officinalis)

    allergy_dandelion medicineAnother highly effective treatment for PUPPPS. Dandelion acts as a hepatic and cholagogue – it enhances the function of the liver and gallbladder, clearing inflammation and congestion through that system. It is highly indicated for chronic skin eruptions, especially those that are hot, red or itchy.

    Dandelion is available as a tea (which will have diuretic effects) or as a capsule. For PUPPPS I usually recommend starting with a tea and introducing a supplement if needed.

  1. Milk thistle (Silybum marianum)

    Mike thistle is a liver supportive treatment that can be used to enhance the actions of dandelion root or on it’s own. It is effective in increasing the secretion and flow of bile from the liver and gall bladder. Milk thistle also promotes milk secretion and is encouraged for breast-feeding mothers.

  1. Avoid food sensitivities

    There is some research suggesting a correlation between food sensitivity (especially dairy) and PUPPPS. Consider food sensitivity testing or elimination diets to address symptoms.

PUPPPS can be a difficult condition to life with, and with the support of naturopathic medicine you may not need to!  Gentle and safe natural treatments are available.  Speak with your Naturopathic Doctor today to put together a plan.

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.

10 Tips to Treat PMS Naturally

PMS (premenstrual syndrome) sucks.  That’s not medical jargon, that’s just the way it is.  Once a month, up to three-quarters of women experience physical or emotional discomfort or pain which can last up to 14 days (two weeks!!).  Over 150 symptoms of PMS have been identified but the most common symptoms are:

Naturopathic treatment of PMS
There are over 150 symptoms associated with PMS
  • Decreased energy
  • Irritability, nervousness, anxiety and anger
  • Food cravings
  • Depression
  • Headache
  • Altered sex drive
  • Breast pain
  • Muscle aches and low back pain
  • Bloating
  • Diarrhea and/ or constipation
  • Swelling of the hands and feet
  • Trouble concentrating
  • Difficulty sleeping

What causes PMS?

Honestly, we don’t exactly know what causes PMS.   It’s most likely a combination of imbalances in our hormones, neurotransmitters and environment that leads to symptoms of PMS.

Balancing these diverse systems gives most women relief from their PMS symptoms.  It sometimes takes time to determine which treatment is right for you.  An experienced Naturopathic Doctor will be able to tailor an individualized plan to give you the best chance for success.

10 Tips to Treat PMS Naturally

1. Exercise

Exercise is important for your overall health, but it can also decrease symptoms of PMS.  Studies have shown again and again that women who engage in regular exercise have fewer PMS symptoms than women who do not.  And the exercise doesn’t need to be intense – it just needs to happen regularly (at least 3 times per week throughout the month).

Exercise is thought to reduce PMS symptoms by reducing estrogen levels, improving glucose tolerance and raising endorphin levels.  Aerobic exercise (swimming, cycling, running, etc), yoga or tai chi are all beneficial.

2.    Cut out sugar

Women who experience PMS have been reported to eat whopping 275% more refined sugar than women who do not get PMS symptoms.  Refined sugars deplete our magnesium levels, increase sodium and water retention and create imbalances in our insulin levels.  All of these processes have been linked to the development of PMS symptoms.

Eliminating refined sugar and limiting simple carbohydrates in favour of high fiber complex carbohydrates lowers blood levels of estrogen, improves magnesium levels and can significantly improve symptoms of PMS.   So cut out the cookies, cakes, bagels and breads in favour of oatmeal, popcorn, quinoa, brown rice and other fiber rich foods.

 3.    Eliminate caffeine

Caffeine consumption is associated with more and worse PMS symptoms.  Caffeine is linked especially to breast tenderness,anxiety, irritability and difficulty sleeping during PMS.  The impact is even worse when combined with sugar (pay attention all you Frappuccino drinkers!).  Eliminating caffeine, or limiting it during the premenstrual phase can improve PMS symptoms for a lot of women.

4.    Take a probiotic

Probiotics are not just for digestive health!  Having good bacteria in our intestines has wide ranging benefits for our health.  Healthy bacteria can decrease symptoms of PMS by increasing beta-glucuronidase enzyme activity and promoting estrogen excretion.

The best way to establish a healthy bacteria flora in your intestinal tract is to take a probiotic supplement.  Try for one with both Lactobacillus acidophilus and Bifidobacterium bifidum.  Taken with food, probiotics are extremely safe and have no negative side effects (you can experience bloating if you take too much – 1 to 10 billion is usually a safe amount).

 5.    Take a calcium and magnesium supplement

1k-7649 spinachThere is a direct relationship between calcium and estrogen.  Estrogen is involved in the absorption, metabolism and utilization of calcium in our bodies.  Clinical trials have found that both mood and physical symptoms of PMS are improved with daily calcium supplementation

Magnesium deficiency is a major concern and is seen in a majority of women with PMS.  Magnesium deficiency causes fatigue, irritability, mental confusion, menstrual cramps, insomnia, muscle aches and pains and heart beat irregularities.

Dietary sources of calcium include dark green leafy vegetables, dairy (cheese, yogurt, milk), tofu, and almonds.  Dietary sources of magnesium are similar and include green leafy vegetables, tofu, legumes, nuts, seeds and whole grains.  Calcium and magnesium supplements should be taken in the evening, away from iron supplements and thyroid medications.

6.    Take B vitamins

B vitamins are involved in hundreds of different processes in our bodies.  The liver uses various B vitamins to detoxify estrogen and allow our bodies to eliminate it.

Additionally, pyridoxine (vitamin B6) can ease symptoms of PMS by increasing production of the neurotransmitters serotonin and dopamine.  Low levels of these neurotransmitters have been suggested as a cause of many PMS symptoms including low energy, irritability and mood swings.

As if that wasn’t enough, B6 is also involved in transfer of magnesium into cells – without B6 magnesium wouldn’t be able to enter cells.  This is another reason why B vitamins, and especially B6 are so important in the relief of PMS symptoms.

7.    Dong Quai

Dong Quai (Angelica sinensis) is a traditional Chinese herb with thousands of years of use for imbalances in the female reproductive system.  It has been used for menopause, painful menstruation, no menstruation and as a uterine tonic.  Dong quai has phytoestrogenic properties and is best used for women who experience PMS symptoms in addition to painful menstruation.

 Dong quai is usually used from ovulation (day 14) until menstruation begins.  If you are also experiencing painful periods, continue it until your period stops.

 8.    Chaste tree

While best known as a treatment for menopause, chaste tree (Vitex agnus castus) is probably the single most important herb in the treatment of PMS.

The effects of chaste tree appear to be due to the impact it has on the hypothalamus and pituitary – the starting point for hormone production in the body.  As a result, chaste tree is able to normalize the secretion of many hormones, for instance, reducing prolactin levels and normalizing the estrogen to progesterone ratio.

Chaste tree is best taken daily throughout the menstrual cycle.  Studies have found it to be useful for almost all symptoms associated with PMS including irritability, mood swings, anger, anxiety, headache, and breast tenderness.

9.    Licorice

Licorice (Glycyrrhiza glabra) is an amazing herb!  It has been used in both Western and Eastern herbal medicine for thousands of years for a wide variety of ailments.  It also has impressive modern scientific research to back up its historical uses.

 Licorice is useful in the treatment of premenstrual syndrome because it lowers estrogen levels while simultaneously raising progesterone levels.  Licorice also blocks the hormone aldosterone, decreasing water retention.

 Licorice is usually taken from ovulation (day 14) until your period starts.  It should not be used if you have a history of kidney disease or high blood pressure.  You should be under the care of a Naturopathic Doctor while taking licorice.

10. See a Naturopathic Doctor

This is probably the best thing you can do to help manage your PMS symptoms.  Naturopathic Doctors are experts in correcting the underlying imbalances that lead to PMS symptoms.  Your unique set of symptoms will give an experienced ND a lot of information that can be used to individualize a treatment plan just for you.  NDs also can order comprehensive hormone panels that will identify imbalances in prolactin, estrogen, progesterone or testosterone that may be contributing to your symptoms.  You can find a licensed Naturopathic Doctor in your area by visiting the national association websites – CAND in Canada and AANP in the United States.

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.

Photo credits:

Creative Commons License Mislav Marohnić via Compfight

Creative Commons License Ed Yourdon via Compfight

Tim Hamilton via Compfight

Natural Treatments for Thin Endometrial Lining

The uterus is made up of three layers: an outer protective layer, a muscular layer, and an inner lining (endometrium) which develops each month to support and nourish a fertilized egg. If a woman does not conceive, this lining is lost during the menstrual period.

Endometrial thickness is an important factor in improving pregnancy outcomes. An ideal thickness is between 9-10 mm at ovulation. If your endometrial lining is thin it may not allow for optimal implantation and successful pregnancy.

A thin endometrial lining can be identified on ultrasound done at or near ovulation, or can be suspected in women who have very light menstrual periods.

Women with long term use of birth control pills (10 years or longer) are more likely to experience thin endometrial lining. Use of the fertility drug Clomid (Clomiphene citrate) is also associated with thin endometrial lining, especially when used for multiple cycles in a row.

Below are some suggestions for ways to naturally increase the thickness of your endometrial lining and improve your chances for a healthy pregnancy.

Red Raspberry Leaf Tea

An herbal medicine with a very long history of use, red raspberry leaf (Rubus idaeus) is a uterine tonic that may help to optimize development of the uterine lining. It is also a rich source of nutrients to support a healthy endometrium, including iron and vitamin C. Drink three cups of the tea per day from the first day of your period until ovulation.

Black Cohosh

Another herbal medicine, black cohosh (Actaea racemosa) is a rich source of phytoestrogens that can provide further estrogen stimulation to the uterus and support a thick endometrial lining. Studies have been done combining black cohosh with clomid and found improved endometrial thickness and more successful pregnancy rates. Dosage ranges from 80-120mg per day from the first day of your period until cycle day 12. Best taken under the supervision of a naturopathic doctor who can monitor liver function for optimal safety.

Red Clover

Red clover (Trifolium pratense) is another isoflavone rich phytoestrogen, similar to black cohosh. It is used to increase blood flow to the uterus and support estrogen balance in the body. It is used daily from cycle day 1 to 12 at a dose of 40-80mg of standardized isoflavones.

Bioidentical Estrogen

red poppyEstrogen is necessary for the development of a healthy endometrium. If estrogen levels are low (which occurs as we get older) then the lining of the uterus will not develop optimally before ovulation. A blood or saliva test for estradiol can identify low estrogen levels and a bioidentical estrogen cream can be used safely to increase estrogen levels in the first half of the cycle, prior to ovulation. Your Naturopathic Doctor can prescribe bioidentical estrogen at a dose that is individualized to your needs.

Iron

Iron deficiency is the most common nutrient deficiency in women. Necessary for the health of red blood cells, low levels of iron may lead to an inadequate development of the uterine lining. If you are a vegan or vegetarian or have a history of having a thin uterine lining, ask your Naturopath or Medical Doctor to test your iron (ferritin) and hemoglobin levels.

Exercise

Inadequate blood flow to the uterus can be a significant cause of a thin uterine lining. This can be caused by a sedentary lifestyle, chronic stress or uterine fibroids. Exercise and acupuncture are two of the most effective ways of improving blood flow to the uterus. Swimming, walking, jogging, dancing, yoga or hula hooping are all excellent ways of getting the blood flowing to the uterus. Try engaging in some form of physical activity every day, especially in the two weeks leading up to ovulation.

red tulipsVitamin E and L-Arginine

Researchers have found that the use of these two nutrients can increase the blood flow to the uterus through the uterine radial artery. Published in the journal Fertility and Sterility in 2010, it was found that vitamin E increased blood flow in 72% of patients and increased the endometrial thickness in over half of patients. L-Arginine increased blood flow in 89% of patients and increased endometrial thickness in two-thirds of patients. Dosage of vitamin E in the study was 600mg per day and the dosage of L-arginine was 6g per day.

Acupuncture

Acupuncture is one of my favourite ways of addressing the issue of a thin endometrial lining. Acupuncture has many benefits for women’s hormonal health. It decreases stress, supports hormone balance, and regulates and increases blood flow to the reproductive organs. Clinical studies have demonstrated an improvement in the thickness of the endometrial lining with regular acupuncture treatments. Points that are often considered include: CV4, CV6, LI10, KI3, SP6, SP10 and ST36. Moxibustion, a warming technique, can also be used in combination with the acupuncture.

Working with a Naturopathic Doctor can help you to develop an individualized plan that will improve your chances of a healthy pregnancy. Additionally, if you difficulty conceiving be sure to have your thyroid thoroughly assessed because low thyroid function is also associated with failure of implantation.   Be sure to work with a Naturopathic Doctor who is experienced in supporting fertility and can help you achieve your goals, naturally.

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.

Select references:

Takasaki A, Tamura H, et al. Endometrial growth and uterine blood flow: a pilot study for improving endometrial thickness in the patients with a thin endometrium. Fertil Steril. 2010;93(6):1851-8.

Yu W, Horn B, et al. A pilot study evaluating the combination of acupuncture with sildenafil on endometrial thickness. Fertil Steril. 2007;87(3):S23

Botanical Medicines to Avoid in Epilepsy

This past weekend I presented at the Toronto Epilepsy annual conference.  I was happy to be invited to speak on the topic of Integrative and Naturopathic Medicine in the Management of Seizures.

One of the things I was most interested to share with this audience was the fact that while nearly half of people with epilepsy use some form of complementary or alternative treatments, up to 75% of those people don’t discuss the use with their medical doctor or neurologist.

This situation has to change.  Natural treatments may be effective, but they are not always safe.  Especially for people who take medications, like anticonvulsants, that may be altered by the use of natural products.

Botanical Medicines and Anti-Convulsants

There are three primary ways that botanical (plant based) medicines can negatively impact a seizure disorder

  1. Decrease the seizure threshold – making a person more likely to experience a seizure
  2. Has pro-convulsant effects – this plant has been found to cause convulsions or seizures
  3. Interfere with the absorption or metabolism of anticonvulsants – changing the way the drugs act in the body and potentially decreasing their effectiveness

Not all botanical medicines have these effects.  Most botanical medicines can be used safely in people with seizures.  It is important to know which ones can, and can not be used. And this is the role of the Naturopathic Doctor in integrative care.  We are experts in safe prescribing of botanical medicines and can see if your medication will interact with a herbal medicine in a negative way.

Botanical Medicines to Avoid

This list is a general list of botanicals that have been found to have potential negative effects on epilepsy.  This list is not exhaustive, new research is being done all the time.  You should not take any of these plant medicines without a consultation with your Naturopathic Doctor.  And be sure to discuss the use with your medical doctor and neurologist.

Botanical Medicines that May Decrease the Seizure Threshold

  • Goldenseal (Hydrastis Canadensis)
    Goldenseal (Hydrastis Canadensis)

    Borage (Borago officinalis)

  • Damiana (Turnera diffusa)
  • Evening primrose oil (Oenothera biennis)
  • Ginkgo (Ginkgo biloba)
  • Ginseng (Panax ginseng)
  • Goldenseal (Hydrastis Canadensis)
  • Green tea (Camellia sinensis)
  • Guarana (Paullinia cupana)
  • Wormwood (Artemesia absinthium)
  • Yohimbe (Pausinystalia yohimbe)

Botanical Medicines that Have Pro-Convulsant Effects

  • St. John's Wort (Hypericum perforatum)
    St. John’s Wort (Hypericum perforatum)

    Bearberry (Arctostaphylus uva ursi)

  • Clove (Syzygium aromaticum)
  • Coffee (Coffea spp.)
  • Ephedra/ Ma Huang (Ephedra sinica)
  • Ergot (Claviceps spp.)
  • Eucalyptus (Myrtacea spp.)
  • Juniper (Juniperus communis)
  • Kava (Piper methysticum)
  • Monkshood (Aconite napellus)
  • Oleander (Nerium oleander)
  • Pennyroyal (Mentha pelugium)
  • Sage (Salvia officinalis)
  • St. John’s Wort (Hypericum perforatum)
  • Thuja (Thuja occidentalis)
  • Yohimbe (Pausinystalia yohimbe)

Botanical Medicines that Interfere with Anti-Convulsants

  • Echinacea (Echinacea spp.)
    Echinacea (Echinacea spp.)

    Garlic (Allium sativum)

  • Echinacea (Echinacea spp.)
  • Pycnogenol (Pinus pinaster)
  • Milk thistle (Silybum marianum)
  • American hellebore (Veratrum viride)
  • Mugwort (Artemisia vulgaris)
  • Pipsissewa (Chimaphila umbellata)

Botanical medicines can be safely used by people with epilepsy.  Be informed, be safe and consult your Naturopathic Doctor for optimal results!

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.

 

Low Testosterone in Men: Supportive Supplements

Many otherwise healthy men are suffering with low testosterone levels.  Testosterone is an important hormone for male sexual health, but also mood, energy, muscle strength, bone density and many many other functions in the body.

Testosterone levels decline with age, and men of this generation are producing up to one-quarter less than their grandfathers.

Symptoms of low testosterone are variable but may include:

  • Low libido
  • Erectile dysfunction
  • Depression and low mood
  • Brain fog and reduced mental functioning
  • Osteoporosis
  • Reduced muscle mass
  • Infertility and low sperm count

Low testosterone levels can be identified on blood or salivary panels. If you think you may have low testosterone, ask your doctor for a test.

You can learn about lifestyle approaches to improving low testosterone levels here, or read on to learn how specific nutritional and botanical supplements can increase your testosterone and get you back to feeling vibrantly healthy.

Nutritional Supplements

Zinc

The most important nutrient for male health, even a slight deficiency in zinc can lead to lower testosterone levels and decrease sperm counts. It is estimated that 80% of men are not getting the daily recommended intake of zinc (11mg). Good food sources are nuts, pumpkin seeds and whole grains. Take supplements only under the care of a qualified naturopathic doctor – taking too much zinc can be toxic to sperm and result in infertility. Taking zinc with folic acid has also been shown to be more effective at balancing hormones and sperm production than either alone.

Astaxanthin

This carotenoid molecule (less well-known than it’s cousin beta carotene), is isolated from algae.  Astaxanthin has been found to increase testosterone levels and sperm health after three months of supplementation. It has stellar antioxidant properties and is safe for most men.

Botanical Supplements

Mucuna pruriens

A traditional Ayurvedic herb, mucuna is able to balance the entire cascade of male hormone balance from the production of GnRH in the hypothalamus all the way to testosterone production in the testes. Human and animal studies have shown increases in sperm count and increased testosterone. It also has been found to decrease reports of stress and decreased stress hormone (cortisol) production.

Tongkat Ali

Eurycoma longifolia Jack, or Tongkat Ali, is a traditional Malaysian botanical medicine. We don’t know exactly how it works, but studies have demonstrated increases in hormones, including testosterone as well as increased libido and sperm count.

Withania somnifera

Ashwaganda, an excellent adaptogenic botanical, has been found in studies to improve sperm counts, hormone balance and testosterone levels. This botanical is best indicated for men with stress in addition to low testosterone levels.

Tribulus terrestris

A botanical with a long history of use for improving male virility, muscle strength and sexual potency. Tribulus is thought to enhance production of lutenizing hormone, leading to an increase in testosterone production. Studies have found daily supplementation can improve hormone parameters after as little as one month.

As with all supplements, supervision by an experienced and qualified Naturopathic Doctor is recommended to ensure safe and effective use.  Natural remedies may be natural, but they are not without side effects and potential interactions.  Your ND will help you find your ideal 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.

 

Spearmint Tea for PCOS

Hormone imbalances are a characteristic feature of polycystic ovarian syndrome (PCOS) – you can read more about the many imbalances in my article Understanding PCOS. But research has shown that a simple treatment may help to balance one of the most common hormone imbalances in PCOS – elevated testosterone.

Researchers have found that drinking spearmint tea, two cups per day over a 30 day period decreased free and total testosterone levels compared to a group consuming a different placebo herbal tea. More importantly, the women in this study self-reported improvements in hirsutism (abnormal hair growth patterns).

This finding is remarkable for a number of reasons. First – improvements in testosterone levels can lead to more regular ovulation in women with PCOS and decrease symptoms associated with elevated testosterone (such as acne). Second – a decrease in hirsutism after just 30 days of study is a result many women with PCOS would be pleased to experience. A longer duration of spearmint tea use would likely result in more significant improvements in abnormal hair growth due to time needed to see changes in hair follicle response to androgen hormones.

Spearmint tea is also delicious, inexpensive and easy for most women to incorporate into their daily routines. Discuss with your Naturopathic Doctor whether spearmint tea might be a useful addition to your PCOS treatment plan!

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.

Reference:

Grant P. Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. A randomized controlled trial. Phytother Res. 2010 Feb;24(2):186-8.

 

 

Natural Labour Induction

As every pregnant woman approaches the last weeks of pregnancy they can’t help but start thinking of ways to bring on labour and get the chance to meet their baby sooner.

A pregnancy is considered full term at 37 weeks and the techniques discussed in this article should not be started until after this point.  Some women choose to wait until 40 weeks, or their due date to begin trying to naturally induce labour.

Below are suggestions for natural labour induction methods that can be attempted at home and also those that should only be administered by a qualified Naturopathic Doctor.

Techniques for Natural Labour Induction at Home

1.     Sexual intercourse

One of the simplest methods of inducing labour (if you’re up for it!)  The prostaglandins in semen can help with the dilating and effacing (thinning) of the cervix.  If you are able to achieve orgasm this can further open the cervix.  Additionally, sex can trigger the release of oxytocin, the ‘contraction’ hormone.  Sex, even this late in pregnancy, is perfectly safe for both the mother and baby.

2.     Nipple stimulation

Stimulating the nipples (manually or with a breast pump) can lead to increased frequency and strength of contractions.  Stimulating the nipples causes the release of oxytocin, the same hormone that is responsible for uterine contraction.  This technique is best done if you are already experiencing infrequent contractions, labour has stalled or you are several days past your due date.  There are several methods that are suggested:

i.   firm pressure of nipple with fingers for 2 minutes, rest for 3 minutes.  Repeat for 20 minutes.

ii.  15 minutes of firm nipple (including the areola) stimulation (alternating breasts midway through) each hour for several hours in a row.

3.     Exercise

Sometimes the best technique for inducing labour is encouraging the baby to assume the best position for labour and delivery.  Exercise, such as walking, swimming, belly dancing, or some yoga movements can help descend a baby into the pelvis and apply the necessary pressure on the cervix for dilation to occur.

4.     Pineapple

Fresh pineapple is a rich source of bromelain, an enzyme that some people think can encourage ripening of the cervix and bring on labour.  Eat fresh pineapple daily, juicing and canning pineapple destroys the bromelain.  Caution: large amounts of pineapple can contribute to heart burn or diarrhea in some people.

5.     Castor Oil

One of the oldest methods of bringing on labour, it is one that I don’t personally recommend unless you are past your due date.  Castor oil works by irritating the digestive tract and having purgative (vomiting) and laxative (diarrhea) effects.  This over-stimulation of the digestive tract also results in stimulation of the uterus and can be effective in bringing on labour.  However, many women would prefer not to be experiencing diarrhea or vomiting in their early labour.  If you choose to use castor oil start with smaller amounts (1-2 tablespoons) and mix with a nut butter (such as almond butter) to provide  some fat and protein to lessen the negative effects of the castor oil.

6.     Evening Primrose Oil

Evening primrose oil is a rich source of prostaglandins and can support the thinning and dilation of the cervix.  Gel caps are easily available in health food stores.  Insert 3 capsules as close to the cervix as possible each night at bedtime (wear a pad to bed in case there is a slight discharge.)

Techniques for Labour Induction Provided by a Naturopathic Doctor

7.     Red raspberry leaf tea

A botanical that is well known for it’s uterine tonifying properties.  It promotes stronger contractions of the uterus and is often used throughout the entire third trimester to ‘work out’ the uterus and get it ready for labour and delivery.  It is unlikely to induce labour on its own, but when used in combination with other methods it can speed up the progression of labour and promote strong, healthy contractions.

8.     Botanicals – blue cohosh and black cohosh

Blue cohosh (Caulophyllum thalictroides) and black cohosh (Cimicifuga racemosa) are uterine tonifying herbs.  They are known to cause contraction of the uterus and are thus contraindicated for use in early pregnancy.   They may be used in certain circumstances to stimulate labour and promote strong and regular contractions.  These herbs should never be taken without proper medical supervision from a qualified Naturopathic Doctor, midwife or obstetrician.

9.     Homeopathic Remedies

Homeopathic remedies are small doses of more potent substances and, as a result, are very safe for use during pregnancy, labour and delivery.  They are considered much safer than botanical remedies – no published studies exist showing any harm to the mother or fetus after use of homeopathics in pregnancy and labour.

The most common homeopathic remedies used to induce labour are pulsatilla, caulophyllum and cimicifuga.  Homeopathic remedies are taken by mouth at regular intervals to induce labour.  Dosages vary – contact your Naturopathic Doctor for an individualized plan.

10. Acupuncture

Acupuncture has been used for centuries to treat conditions associated with pregnancy (such as heart burn, nausea, and carpal tunnel syndrome) as well as for inducing labour.  Acupuncture to stimulate labour can be begun after 37 weeks gestation and is administered from once per week to once per day, depending on the desired outcome.  When performed after the due date, acupuncture has been shown in studies to have a success rate of up to 88% in starting labour.

Specific points are used to stimulate and strengthen uterine contractions, promote proper fetus positioning and encourage the downward movement of Qi (energy) which can bring on labour.

All published studies have shown acupuncture to be safe for both mother and fetus when applied by a qualified practitioner.  Be sure to find someone who is experienced in perinatal acupuncture protocols and techniques.

Your Naturopathic Doctor can also teach you proper acupressure techniques for you, or your birth partner, to administer to induce labour or manage pain during labour and delivery.

Remember, although most of these methods are safe and can be effective in encouraging labour in full-term pregnancies, it is important to make sure your primary health care provider (e.g. midwife or obstetrician) has given you the go-ahead for trying to induce labour.  There are some instances where waiting is the best approach for both mother and baby.

Also be sure any practitioners (Naturopathic Doctors, homeopaths, herbalists, acupuncturists, etc.) are fully qualified and knowledgable in pregnancy and labour.  Not all practitioners have the same level of experience – ask questions and only work with practitioners you have confidence in.

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.

Naturopathic Medicine and Endometriosis

Endometriosis is a chronic condition affecting millions of Canadian women. It can begin at any age between the teens and 40s and impacts between 10-15% of women in these age groups.

There is no cure for endometriosis, but Naturopathic Medicine can offer women with this condition hope for improved hormone balance, decreased pain and support for fertility.

Prior to reading this article, I suggest you check out Understanding Endometriosis to learn how to recognize the symptoms of endometriosis and the underlying imbalances that lead to this frustrating condition.

Naturopathic Treatments for Endometriosis

A Naturopathic treatment plan for endometriosis will be highly individualized to each person, addressing their unique lifestyle, dietary and symptom needs. The treatment goals vary person to person, but always include a combination of the following:

  • Normalize the function of the immune system
  • Balance hormones
  • Support liver detoxification of hormones
  • Reduce and block pro-inflammatory chemicals produced by the body
  • Support the large intestine and microbiome (healthy bacteria)
  • Decrease stress

Vitamin CBy addressing these underlying imbalances in endometriosis Naturopathic Doctors can improve the overall health of women with endometriosis, decrease or eliminate symptoms of endometriosis and address the underlying cause of endometriosis.

Normalize Immune Function

There are many nutrients involved in healthy immune function. One of the largest categories of immune supportive nutrients are the antioxidants. Nutrients like vitamin C, beta carotene, vitamin E and selenium all enhance immune function and can be used to support endometriosis treatment. Many of these nutrients also decrease inflammation and can improve pain associated with endometriosis.

Vitamin D, an incredibly important nutrient for Canadians, has profound impacts on endometriosis. Vitamin D regulates cell growth and differentiation in endometriosis, enhances macrophage action and decreases inflammation. Vitamin D supplementation has been found in studies to reduce the weight of endometriosis lesions as well.

Balance Hormones

hormone balanceEndometriosis is a hormonally responsive condition – the growth of the endometrial lesions occurs under the influence of estrogen – so balancing hormone levels is an important treatment goal for all women with endometriosis.

Phytoestrogens, such as lentils, flax seeds and soy, can bind to estrogen receptors and have a less potent effect than our body’s own estrogen. When these phytoestrogens are bound to receptors they displace our own estrogen resulting in a lower estrogen effect overall. These foods should be incorporated into our diet daily for optimal hormone balancing effects.

Indole-3-carbinole and DIM (di-indolylmethane) from brassica vegetables are also estrogen regulating supplements that act much like phytoestrogens by binding estrogen receptors and decreasing our body’s estrogen response. Your Naturopathic Doctor may recommend these supplements, or recommend increasing consumption of broccoli, cauliflower, cabbage and brussels sprouts for hormone balancing in endometriosis.

Reduce Inflammation

Grapes are a source of resveratrolMany of the most profoundly effective treatments for endometriosis work by reducing inflammation in the body. Pycnogenol, a pine bark extract, has anti-inflammatory, immune supportive and anti-growth properties. Studies have shown significant improvements in pain symptoms in women using pycnogenol.

Resveratrol, a substance found in the skin of grapes, is especially beneficial for women with endometriosis and infertility. Resveratrol can decrease inflammation, reduce proliferation of endometrial lesions and protect eggs from the effects of aging.

N-acetyl cysteine (NAC) is one of the most promising treatments for endometriosis. Studies have found immune function improvements (increases in T regulatory cells, decreases in TNF-alpha), significant decreases in inflammation (including increases in glutathione – a cellular anti-inflammatory) as well as reduces in the size of existing endometrial lesions.

Support Liver Detoxification

The liver is essential for hormone balance as it is where our body detoxifies estrogen and prepares it for elimination. B vitamins are necessary for this function, allowing the liver to more efficiently inactivate and process estrogen.

Nutrients known as lipotropics also promote liver function by promoting the flow of fat and bile (containing estrogen for elimination) out of the body through the large intestines. Choline, betaine, methionine and dandelion are all prime examples of lipotropics that can be used to enhance liver detoxification in endometriosis.

oatmealSupport Large Intestines and Healthy Bacteria

Our body eliminates estrogen by attaching it to a carrier molecule (glucuronic acid) and excreting it through the bile into the stool. Unfriendly bacteria in the large intestines can prevent our ability to eliminate estrogen by breaking this bond between estrogen and it’s carrier. This estrogen is then recycled back into our body, resulting in higher circulating levels of estrogen.

We can modify this action, and support healthy hormone levels, by following the Endometriosis Diet which emphasizes healthy fiber and avoidance of unhealthy fats. Probiotic supplements can also be used in some cases to encourage healthy bacteria balance.

Decrease Stress

Stress occurs frequently in our fast-paced society, but we know that unhealthy levels of stress, or poor adaptation to stress is linked to decreased immune function and may trigger the kind of biochemical imbalances that lead to endometriosis. Studies have demonstrated that endometriosis grows more rapidly, or recurs faster and in greater quantities, during times of extreme emotional stress.

Breathing exercises, physical exercise, yoga, meditation, mindfulness, good quality sleep and adaptogenic herbs and supplements can decrease your stress response and help you to manage your endometriosis, naturally.

Not All Nutrients Are Beneficial

Just because it’s natural, does not mean it’s safe. It is strongly recommended to consult with a Naturopathic Doctor to develop a safe and effective endometriosis plan that will address your concerns and give you the best chances for success.

Additionally, some nutrients may negatively impact endometriosis. L-carnitine, an amino acid, was shown in one study to induce a condition resembling endometriosis with accompanying infertility when give to young female mice. We are not sure of the impact this may have on humans, but a cautious approach is recommended.

Treating Endometriosis

Understanding EndometriosisTo take a fully empowered, knowledgeable approach to your endometriosis I recommend you read the other articles written by Dr. Lisa Watson, ND on endometriosis: Understanding Endometriosis, The Endometriosis Diet, Endometriosis and the Immune System, Acupuncture and Endometriosis and Endometriosis and Infertility.  If you are ready to take the next step, book a complimentary 15 minute meet-and-greet appointment with Dr. Watson, or book an initial consultation.  You can feel better! Get started now.

References

Hudson, Tori. Women’s Encyclopedia of Natural Medicine. New York: McGraw Hill, 2008.

Lauersen, Niels H and Bouchez, Collette. Getting Pregnant. New York: Fireside, 2000.

Lewis, Randine. The Infertility Cure. New York: Little, Brown and Company, 2004.

Kohama T, et al. Effect of French maritime pine bark extract on endometriosis as compared with leuprorelin acetate. Journal of Reproductive Medicine; 2007:52(8),703-8

Vassiliadis S, Athanassakis I. A “conditionally essential” nutrient, L-carnitine, as a primary suspect in endometriosis. Fertil Steril. 2011 Jun 30;95(8):2759-60.

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.