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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 (seriously.  14 days.)  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.  Researchers, clinicians, and people all over the internet debate this constantly.  We do know that it’s most likely a combination of imbalances in our hormones, neurotransmitters, lifestyle factors and our environment that leads to symptoms of PMS.

Balancing these diverse systems gives most women relief from their PMS symptoms. But it can take some time to determine what will work for you!  Don’t try to do this alone – an experienced naturopath or functional medicine doctor can guide you and give you the best chance for bidding farewell to your PMS.

Below you will find my TOP TEN natural treatments for PMS.  Start here.  Empower yourself with knowledge.  Then find the support you need.

10 Tips to Treat PMS Naturally

1. Exercise

Come on.  We know exercise is important, but did you know it can decrease your PMS symptoms?  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 can reducing estrogen levels, improve blood sugar levels and raise your feel-good endorphins!  And really, any exercise will do.  So run, dance, swim, cycle, hula hoop, yoga or pilates – it doesn’t matter.  Just do it!

2.    Cut the sugar

Women who experience PMS have been reported to eat whopping 275% more refined sugar than women who do not get PMS symptoms.  DAMN.

Refined sugars zap our magnesium levels, increase salt and water retention and create imbalances in our insulin levels.  All of these concerns have been linked to PMS symptoms.

Eliminating refined sugar and limiting simple carbohydrates (grains, pasta, baked goods) in favour of high fiber complex carbohydrates (fruits and vegetables, whole grains) lowers 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

I hate to be the bearer of bad news, but 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!  Those little buggers living in our intestines are working hard 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 healthy bacteria levels in your gut 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.    Consider Cal-Mag

1k-7649 spinachEstrogen and calcium are BFFs in our bodies.  Estrogen is involved in the absorption, metabolism and utilization of calcium in our bodies (this is why we are more prone to osteoporosis as we age – we’re learning so much today!)  And studies have found that both mood and physical symptoms of PMS are improved with daily calcium supplementation

Magnesium deficiency is a serious concern and most women with PMS are deficient in magnesium!  I’m going to say that again – MOST women with PMS are deficient in magnesium.   Magnesium deficiency causes fatigue, irritability, mental confusion, menstrual cramps, insomnia, muscle aches or 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.  Take to your ND about a Cal-Mag supplement, and take it in the evening away from other medications and supplements.

6.    Bring the B vitamins

It is hard to keep track of the hundreds of different things B vitamins do!  One of the most important is the detoxification of hormones through our liver.  If you don’t have enough B vitamins, your body is going to be dealing with those hormones a lot longer than you want to be.

Vitamin B6 is also a superstar when it comes to treating PMS.  Necessary for the production of two neurotransmitters – serotonin and dopamine (read all about them in my article on hormones for happiness!), vitamin B6 can seriously ease symptoms of PMS such as 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 women’s hormones.  It has been used for menopause, painful menstruation, no menstruation and as a uterine tonic.  Dong quai has phytoestrogenic properties and I recommend it 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

The SINGLE most important herb in the treatment of PMS, chaste tree (Vitex agnus castus) has been a life-changer for many women in my practice.

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 production 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 – one of the most powerful we use.  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

Obviously I think this is 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 cortisol, 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.  And of course, you can contact me if you’d like us to work together.

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 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.

 

PCOS and Hair Loss

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

PCOS: Hormone Havoc

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

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

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

Testosterone and Hair Loss

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

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

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

Treating PCOS Hair Loss

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

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

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

Disclaimer

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

DUTCH test, hormone testing,hormone test, women's hormones, hormone health

DUTCH: Gold Standard in Hormone Testing

In my work with women’s health and hormones, one of the biggest areas of debate is hormone testing. Women are confused about when and how to test their hormones, and if I’m honest, a lot of doctors are confused as well. Which is leaving women under-diagnosed and under-treated for their very real (and very annoying) hormone imbalances.

But no more. Science has come a long way and right now we have the ability to test for hormones in ways that we never have been able to before. And women everywhere can benefit. So if you’ve ever wondered, “Do I have a hormone imbalance?”, now we can easily answer that question.

The DUTCH Test

Hormone testing with the DUTCH testDUTCH is an acronym that stands for Dried Urine Test for Comprehensive Hormones. It is a simple, but sophisticated test that looks not just at your hormones, but how your body processes and metabolizes them.

The DUTCH test looks not just at your reproductive hormones (although it does look at those quite thoroughly), but it also looks at your stress hormones, your androgens (male pattern hormones), your melatonin and the new DUTCH test also looks at organic acids – markers for mood and nutritional balance in the body.

8 Reasons the DUTCH Test is the Gold Standard for Hormone Testing

  1. Simple collection

Nothing is easier than peeing on a piece of filter paper. (Ok… some people might get a little pee on themselves, but still… is that the worst thing that can happen to you today?)

  1. In depth hormone levels

If you have a question about your hormones, the answer is likely to be found in the DUTCH test. While your Naturopathic Doctor may still recommend blood testing for hormones like thyroid hormone, FSH or LH, just about every other hormone is covered in the DUTCH test.

  1. Metabolism matters

Hands down, the reason the DUTCH test is the best, is that it measures metabolites. The absolute level of your hormones matter – but what can matter more is what your body does with those hormones. This is metabolism – does your body turn testosterone into nasty acne-promoting 5a-DHT?? Does your body turn estradiol into DNA damaging 4-OH estrone? Are you healthfully metabolizing and eliminating estrogen from your body? The DUTCH test can tell you.

  1. It’s all about those curves

Not every hormone has stable levels over the entire day. In particular, our primary stress hormone, cortisol, and its metabolite cortisone, have a curve that changes over the course of the day. Blood tests only give us a single snapshot of your cortisol levels, but the dried urine test gives us not only the total levels of cortisol and cortisone, but also the curve – how those levels change over the day. This is some VALUABLE information for people who are struggling with stress, fatigue, anxiety, decreased libido, trouble sleeping and insomnia.

  1. Balanced estrogen

Estrogen is one of the most important hormones in our bodies, and it has so many benefits for our health, but it can also have negative impacts if it is not in balance.

Typical hormone testing for estrogen looks just at estradiol, the dominant estrogen in the body. But that only tells us such a small bit of information. If we want to balance our estrogen, and prevent complications of estrogen dominance, then we want to understand how our body copes with our burden of estrogen. What metabolism pathways does our body use? Are those the best pathways?

If you are considering bioidentical hormones (BHRT) for perimenopause, or menopause symptoms, then the DUTCH test is highly recommended at the initial visit to understand how you will metabolize the hormones.

  1. Androgens and acne and hair health

In my work with women, no one condition is more loathed or baffling than acne. WTF, am I right ladies? How did we reach our 30s and still have to deal with acne?? Often it’s an issue of androgen metabolism. But typical hormone testing just looks at the amount of testosterone being made, and not what your body is doing with it. If your body is sending more testosterone towards the DHT metabolites, you will have more acne and possibly hair loss (and chin/ upper lip hair growth!) The DUTCH test will tell you if this is happening – and then we can talk about what to do about it!

  1. Melatonin

If you are having difficulty sleeping, knowing your melatonin levels is amazing information to have. But not only those with insomnia or sleep challenges should know their melatonin levels. Melatonin is also a powerful antioxidant in our bodies, and optimal levels of melatonin have been found to reduce the incidence of hormonal cancers (including breast cancer). No other hormone test looks at melatonin, but the DUTCH test does.

  1. Organic acids

Natural treatments and testing for depression and anxietyA new addition in 2018 to the DUTCH test is the 6 OAT (organic acid tests). I’m so excited for this new information!

Three new markers for neurotransmitters – to help us understand your mood. If you struggle with depression, anxiety or insomnia, this information can be very significant. If you have tried antidepressants without benefit, your organic acid markers for specific neurotransmitters, like serotonin, may tell you why.

Additionally there are three new markers for nutritional levels – looking at your B6 and B12 metabolism as well as your glutathione status. If you are concerned about weight gain or inflammation as part of your hormone imbalance, now we may be able to identify why.

The 1 Reason I don’t love DUTCH Testing

  1. The test results are ugly

I know. Such an aesthetic issue. But the test results are ugly – seriously. The results are clear. The information is valuable. But the results look a lot like a airplane dashboard, and some patients find this overwhelming. So take the time to talk through the results with your ND to understand what they mean for you.

Toronto, naturopath, doctor, naturopathic doctor, holistic, functional doctor

Next Steps

If you are interested in DUTCH testing, I suggest booking a 15 minute complimentary meet and greet to discuss the details. It is an amazing, useful, sophisticated test. But it’s not the right test for everyone. So let’s talk and see if it is the right test for you.

Dr. Lisa

Further Reading

https://dutchtest.com

https://articles.mercola.com/sites/articles/archive/2016/05/08/dutch-hormone-test.aspx

 

Natural Treatments for Pain-Free Periods

Natural treatment options for period cramps

Ok ladies. In the last article we talked about why your periods can be painful – conditions l

ike endometriosis, fibroids or pelvic inflammatory disease, and lifestyle factors. We also talked my top ten lifestyle tips for pain-free periods. (If you haven’t read that article, pop over and read it now, then come on back and join me here. I’ll wait.)

In this article we’re going to go deeper into the science on period pain and discuss ten of most promising natural treatments for managing period cramps and painful periods.

But remember, these won’t work if you don’t have a healthy foundation in place, so start with the lifestyle changes, and then work with your Naturopathic Doctor to layer in some of these treatments to help you achieve your pain-free period!

Nutrients for Menstrual Cramps

B1 – Thiamine

Ah, thiamine, vitamin B1 – named so because it was the first B vitamin discovered! I’ve got a weak spot for B vitamins (and all vitamins really) because they are literally how our bodies get sh*t done! Thiamine is needed for your body to make energy from food – especially the grains that it is abundant in.

The mechanism by which this B vitamin can help period cramping stems from it’s action on the central nervous system and neuromuscular system – all coming down to it being effective for reducing spasmodic uterine pain (i.e. cramping). One study (link: https://www.ncbi.nlm.nih.gov/pubmed/8935744) found that taking vitamin B1 daily for 3 months completely alleviated period pain in 87% of study participants – damn! Worth a shot I think!

B6 – Pyridoxine

Vitamin B6 has fast become one of my favourite B vitamins (sorry B12!) due to it’s profound actions on female hormone balance. In addition to supporting energy production (just like all the B vitamins), vitamin B6 is needed to make progesterone, serotonin, norepinephrine and melatonin.

When used with its BFF, magnesium, vitamin B6 may be helpful in decreasing period cramps. When used for 10 days prior to the period, women have reported less painful periods (and less premenstrual acne!) when using a combination of B6 and magnesium. While it may not be enough on its own, it can be an important part of a treatment plan for period cramps.

Magnesium

Magnesium, known primarily for its ability to relax muscle (making it incredibly useful for blood pressure, muscle cramps and asthma), is unfortunately one of the most common nutrient deficiencies in North America. Found mostly in unprocessed foods (like leafy greens, nuts and seeds), magnesium deficiency can cause:

  • fatigue
  • irritability
  • weakness
  • muscle spasms
  • menstrual cramps
  • poor nail growth (I get asked about this issue all the time!)
  • insomnia
  • sugar cravings
  • anxiety

It has been suggested that the majority of women with PMS have a deficiency of magnesium – unfortunately magnesium is not easily tested for in laboratory tests, so deficiency often goes undiagnosed.

But the benefits of magnesium are not going unnoticed! A Cochrane study found that using magnesium for period cramps was effective for pain relief and resulted in women using less pain medication during their periods. Win! Magnesium: 1, period pain: 0.

Omega 3s

The last of our nutrients for period cramps, are our omega 3 fatty acids. These amazing compounds decrease inflammation (by altering prostaglandin production – remember this from the last article?) and taking relatively high doses (around 2 grams per day) has been found to reduce pain scores in women with period pain. And with all the side effects of omega 3s (healthy skin, less inflammation, improved mood, better heart health), it sure won’t hurt to give these a try.

Botanicals for Menstrual Cramps

While nutrients help our body to function optimally (that’s what they do!), botanicals, or plant medicines, act more like medications – changing or encouraging our bodies to function in specific ways. Most often I have my patients on a combination of nutrients (Woot! Optimal health!) and plant medicines to get the best outcomes.

Valerian

Best known for it’s sleep supporting actions, valerian (Valerian officinalis) can be very supportive for managing painful periods. With the ability to bind to GABA receptors in our brain (the same ones Valium uses), valerian can reduce pain, anxiety and insomnia. It has also been found to reduce spasmodic contractions – those same ones that lead to all the pain of period cramps. Valerian doesn’t need to be taken all month – just during your period to manage the discomfort and misery of painful periods.

Crampbark

Well doesn’t the name just say it all?? Crampbark (Viburnum opulus) has been used for generations for period cramps. Acting as a uterine relaxer and antispasmodic, crampbark is your best friend if your period cramps are accompanied by low back pain or pain that radiates into your thighs.   Taken in a similar manner as ibuprofen, one capsule of crampbark every 3-4 hours can help to reduce cramping and pain.

Ginger

I hate to play favourites (no, that’s not true. I totally love my favourites), but ginger is the BOMB when it comes to managing period pain.

With antispasmodic effects as well as the ability to inhibit the production of inflammatory and spasmodic prostaglandins (again with the prostaglandins!), ginger is a powerhouse of period pain management.

There have been studies comparing ginger with ibuprofen and found no difference in the effectiveness of the two treatments for period pain – in fact, more women in the ginger group were completely pain free than in the ibuprofen group. BOOM!

Ginger is most effective starting a few days before your period, and continuing through the first days when cramping is most likely to occur.

Black Cohosh

One of the best researched botanical medicines in the world, black cohosh’s claim to fame is in managing symptoms of menopause. But that’s not all it is good for.

Black cohosh (Actaea racemosa) is another uterine relaxer that can be useful for period cramping. It’s best for women who also have significant water retention (think swollen ankles, bloating and tender breasts), irritability during PMS, and delayed or irregular menstrual periods.

Other Natural Supplements

A few other natural medicines can help you achieve your dream of a pain-free period. And I certainly couldn’t leave them out! These two treatments are best used under supervision or advisement of your Naturopathic Doctor – so have a talk with them about whether to include these in your plan for a Pain-Free Period!

Melatonin

Melatonin for period crampsMelatonin is most commonly thought of as our sleep hormone, produced by the pineal gland in our brain to support sleep-wake cycles. But it does so much more than that!

Melatonin levels are lower during the second half of our menstrual cycle (during our luteal phase), and this is thought to be a factor in the development of period pain.

When melatonin levels are high, it can decrease the contractile force of the uterus – decreasing painful cramps. As well melatonin is known to have analgesic properties – decreasing pain. Melatonin also inhibits the production of those pesky prostaglandins that lead to most period pain.

Safe for most women, melatonin should be used for a few days prior to the onset of the period and for the first few days of the period. Taken before bed, you’ll likely get some stellar sleep as well!

BHRT Progesterone

For women whose period pain does not improve, no matter how many things they try, bioidentical progesterone can be a game changer.

Progesterone is the hormone that dominates the second half of the menstrual cycle, and a drop in the level of progesterone leads to an increase in inflammatory arachidonic acid and prostaglandins from the uterus. Welcome to Pain City.

If we can lessen the severity of this drop, or delay it, then often we can reduce the pain and intensity of uterus contractions that come from a hard drop in progesterone.

Best indicated for women in their 30s and 40s, bioidentical progesterone should be prescribed by a knowledgeable practitioner. Used for somewhere between 3-12 days before the onset of the period, progesterone may be exactly what some women need.

Onwards in your Pain-Free Period Journey!

Ladies, you don’t have to suffer. There are SO many things you can do to manage your periods so that they do not negatively impact your life. If you want to learn more, browse through some of the other articles on this website, or book an appointment to get your periods back on track!

Problems with the Pill

There is no doubt that the birth control pill was a huge player in the feminist revolution. First released in 1960, the pill allowed women to delay pregnancy and focus on their career, transforming the lives of women and society. While the pill may be a political powerhouse, and be effective at preventing pregnancy, my belief is that it is being overprescribed, and women are under-educated on the impact that the pill can have on their health.

This article will share some of the concerns that I, as a naturopathic doctor and women’s health expert, have regarding the pill. The purpose is not to convince you to give up the pill, but to empower you with information so that you can make an informed choice as to whether this medication is the right choice for you.

Problems with the Pill

  1. The Pill Depletes Nutrients

One of the biggest problems with the pill is the nutrient deficiencies that result from use. From B vitamins to essential minerals, the pill changes the absorption, utilization and metabolism of a number of different nutrients. These nutrient depletions are the underlying cause of many of the negative side effects of the pill – things like weight gain, moodiness, fatigue and blood clots. You can read all about the nutritional problems with the pill in this article.

  1. Weight gain

The estrogen in birth control pills can cause an increased appetite and fluid retention, leading to weight gain, especially in the first few months on the pill. Long term weight gain on the pill is more likely due to the decreased levels of B vitamins, necessary for carbohydrate and fat metabolism (i.e. burning fat for energy).

  1. No glory for our guts

The pill is known to alter the balance of healthy bacteria in our guts. Estrogen affects gut permeability (a risk factor for autoimmune disease) and bacteria balance, a condition known as dysbiosis. Healthy bacteria are incredibly important for our overall health – especially our immune, mood and digestive health. The pill has been linked to symptoms of gas, bloating, IBS, and an increased risk of Crohn’s disease in women with a family history of the digestive condition.

The change in healthy bacteria balance, combined with the estrogen in the pill, also makes women more susceptible to vaginal and digestive yeast infections. If you get frequent or recurrent yeast infections, or significant gas or bloating symptoms, consider if your pill may be part of the problem.

  1. Moodiness

Any woman can tell you that hormones can have a significant impact on your mood. The rises and dips in estrogen and progesterone that occur over a woman’s monthly cycle can lead to moods and behaviours that foster relationships, encourage sexual intimacy, and make women weepy, emotional and volatile. While some women on the pill notice very little difference in their mood states, other women find their normal emotional states become heightened in intensity and more difficult to manage. The reasons for this are very individual – some women don’t tolerate the high levels of estrogen and others find the high progesterone problematic. In either case, if the pill makes you moody switching to another pill is unlikely to help.

  1. Blood clots

Possibly the most well known side effect of the pill, the risk of blood clots is highest in women who are obese, are smokers or who have a family history of blood clots. The estrogen in the birth control pill is the most likely culprit, increasing the production of clotting factors and increasing a woman’s risk of blood clots by three-to-four fold. Deficiencies of key nutrients can also contribute to an increased risk of blood clots, most notably vitamin B6, vitamin E and magnesium – all of which are depleted by the pill.

  1. Thin endometrial lining

The endometrial (or uterine) lining is necessary for a successful implantation and pregnancy. In women wanting to have a family, long term use of oral birth control pills could thin the endometrial lining, leading to difficulty conceiving or maintaining a pregnancy. The underlying cause of this change is thought to be a down-regulation of estrogen receptors in the uterus, resulting from long term use of synthetic progesterone. The upside to this situation, is that this same mechanism is thought to be the reason why the pill reduces the risk of endometrial cancer.

  1. No sex drive

Never mind a thin endometrial lining if you can’t get up the urge to have sex at all. Many women report a low libido as a major issue they have with taking the pill. The pill lowers androgens and the lowered testosterone is likely responsible for the lack of sex drive. Around ovulation women typically experience a small, but significant, testosterone surge, causing them to seek out sex. On the pill you don’t experience this testosterone surge and your urge for sex can all but dry up. On a positive note – this decrease in testosterone is the reason why the pill can improve acne. But there are other ways to clear acne than giving up your lusty libido.

  1. Ignoring Mr. Right

Some of the most intriguing research on the pill surrounds a woman’s decision making around possible partners. Women who are on the pill tend to be attracted to more masculine, macho men with more ‘manly’ physical characteristics, and ignore men with softer, more ‘feminine’ features. Dr. Julie Holland, in her book Moody Bitches, refers to this as the “dad-or-cad” dilemma – women on the pill are more likely to be attracted to the bad-boy, rather than the more sensitive man who may be more acceptable as a long term partner and father to her children. Dr. Holland suggests it might be a good idea to get off the pill if you’re entering the dating pool, to prevent later regrets!

As if that wasn’t enough, another study found that women on the pill tend to seek out men with more genetic similarities to themselves, increasing their risk of miscarriage and genetic issues in their offspring. Women off the pill tend to choose men that are more genetically dissimilar – a pairing that tends to result in healthy pregnancies, happier relationships, more satisfying sex, and an increased likelihood of female orgasm.

  1. Masks symptoms

One of my biggest concerns with the pill is that it is used by conventional doctors as a band-aid for every female reproductive issue. Got PCOS? Take the pill! Got endometriosis? Take the pill! Got fibroids? Take the pill! PMS or menstrual cramps? Take the pill! Perimenopausal? You get the pill too! In no way does the pill address the underlying issues of these women’s health issues. The pill just provides a steady state of synthetic hormones, suppressing and masking the symptoms of the underlying imbalance. When you get off the pill you are no better than when you started – but you are older. And if you want to try and start a family you still have to address the underlying imbalance. The use of the pill as a way to suppress and deny the imbalances in women’s hormones is a disservice to women and I deplore it.

  1. The pill is a carcinogen

Ok. I get it, this sounds scary. But it’s true. The International Agency for Research on Cancer includes oral birth control pills as a carcinogen on its list of known human carcinogens. Studies have shown that birth control pills can increase the risk of breast cancer, cervical cancer and liver cancer. It can reduce your risk of ovarian and endometrial cancers, however. In general I’d suggest using the pill for as short a duration as possible and consider other forms of contraception for the majority of your reproductive years.

We have to keep in mind that the pill is not without problems. It contains synthetic hormones at levels much higher than our body produces on its own. Some of the side effects like acne, breast tenderness, or moodiness might be manageable, but I think women need to be empowered with knowledge to decide if the pill is the right choice for them.

If you have concerns about using the pill, want to balance your hormones naturally, or discuss natural forms of non-hormonal contraception, book an appointment now. Your hormones are in your hands – strive for hormone harmony!

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.