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Acupuncture for IVF and IUI Cycles

The use of acupuncture as a supportive treatment for couples undergoing assisted reproductive therapies, including in vitro fertilization (IVF) and intrauterine insemination (IUI) is gaining in popularity, likely due to promising results in countless studies in the past 20 years.

Understanding how acupuncture can improve outcomes in IVF and IUI cycles can help you to decide if this treatment may be right for you.

A brief understanding of IVF and IUI

In vitro fertilization, or IVF is the process where a woman’s follicles are stimulated through medications to mature many follicles simultaneously. Once the majority of follicles are mature (17-20mm) they are retrieved and fertilized in a lab. These embryos grow for 3-5 days and are then transferred into the woman’s uterus (usually 1-2 at a time).

Intrauterine insemination will often also use medications to stimulate follicle growth, but the number of follicles is far fewer. The follicles develop within the woman’s ovaries and at ovulation the semen is inserted directly into the uterus and fertilization occurs within the body.

The success rates of IVF and IUI are variable. IVF alone is around 25-30% and IUI alone is around 13-20%. With acupuncture support, success rates can increase up to 40-60%.

How acupuncture benefits IVF and IUI cycles

Acupuncture has many benefits for improving outcomes (pregnancy rates and delivery rates) in IVF and IUI cycles. A 2002 study by Paulus and colleagues in Germany was one of the first to demonstrate an improvement in pregnancy rates with acupuncture in IVF cycles. The women receiving acupuncture had a 42.5% success rate, compared to 26.3% for those who did not receive acupuncture. Many more studies have since confirmed these findings, with impressive improvements in pregnancy and delivery rates.

Acupuncture is a very safe therapy, with relatively low costs and has no negative interactions with medications. Below I highlight some of the benefits acupuncture has on IVF and IUI cycles.

  1. Improved ovarian response

Acupuncture is based on traditional Eastern philosophies of meridians and acupuncture points. However, we now know that significant hormonal changes occur when we administer acupuncture to specific points in the body. Acupuncture impacts beta-endorphin levels, which in turn impact our production of reproductive hormones (notably GnRH, FSH, LH, estrogen and progesterone). Acupuncture can thus improve response of the ovaries to these hormones and optimize follicle development.

  1. Improved hormone balance

As mentioned above, acupuncture has a significant impact on hormone production and response. In IVF cycles where hormone-modulating medications are used, acupuncture can help the body to respond appropriately to medications, and minimize side effects.

  1. Improved egg (follicle) quality and quantity

Clinically acupuncture has been shown to positively influence the number and integrity of eggs released during IVF and IUI cycles – this may be due to increasing the blood supply to the developing follicles or by increasing the nutritional supply to the egg via the fluids that surround and nourish it.

  1. Improved blood flow to the uterus and increased rate of implantation

One of the most unique actions of acupuncture, increasing blood flow to the uterus can improve implantation rates and decrease rates of miscarriage. No medication currently exists that can enhance blood flow to the uterus the way acupuncture has been demonstrated to.

  1. Optimal endometrial thickness

In women with thin endometrial linings IVF can have higher rates of failure. Acupuncture can help to thicken the endometrial lining (through the enhancement of blood flow) and improve rates of implantation.

  1. Decrease rates of miscarriage

Acupuncture used during IVF results in higher rates of viable pregnancy. Additionally, acupuncture was found in a 2004 study by the American Society for Reproductive Medicine to lower miscarriage, reduce tubal pregnancy and increase live birth rate.

  1. Reduce stress

Stress is a major factor impacting most couples undergoing fertility treatments. Acupuncture treatments have been shown to decrease sympathetic nervous system activity (our fight-or-flight response), decrease stress hormone levels and increase opioid production – all resulting in a sense of calm and decreased stress.

Acupuncture treatments for IUI and IVF

Acupuncture treatments should be individualized to your IVF or IUI cycle, your personal medical history and current health state. For women undergoing IVF or IUI it is recommended in clinical studies to start having acupuncture 8-12 weeks (2-3 months) prior to your IUI or IVF procedure.

In my Toronto practices, I use acupuncture points selected based on clinically proven protocols (Paulus protocol, Stener-Victorin protocol, Westergaard protocol, Smith protocol), as well as points based on Traditional Chinese Medicine diagnoses and indications.

Success in acupuncture depends on more than just the frequency and timing of visits. It also requires a knowledgeable practitioner who can guide you through the process and help you achieve the benefits you desire. If you’d like to learn more, book a free meet and greet consultation or initial intake today.

References

Betts D. The Essential Guide to Acupuncture in Pregnancy and Childbirth. 2006.

Change, R, Chung P, Rosenwaks Z. Role of acupuncture in the treatment of female infertility. Fertil Steril. 2002 Dec:78(6)

Dieterle, S., et al. Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study. Fertil Steril. 2006 May;85(5):1347- 51.

Gurfinkel E, et al. “Effects of acupuncture and moxa treatment in patients with semen abnormalities.” Asian J Androl. 2003 Dec;5(4):345-8.

Johnson D. “Acupuncture prior to and at embryo transfer in an assisted conception unit – a case series.” Acupunct Med. 2006:24(1):23-28.

Paulus WE, Zhang M, Strehler E, El-Danasouri I, Sterzik K. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertil Steril 2002;77(4):721-4.

Stener-Victorin E, et al. “Use of acupuncture in female infertility and a summary of recent acupuncture studies related to embryo transfer. Acupunct Med. 2006 Dec;24(4):157-63. Review.

Westergaard. LG, et al. “Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial.” Fertil Steril. 2006 May;85(5):1341-6.

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.

 

 

 

Are Menstrual Clots Normal?

One of the “joys” of womanhood, our monthly menstrual flow, can sometimes come with some surprises. One of those occurrences for many women is menstrual blood clots. Most women want to know if this is normal – and why it is happening.

Your Period

During your monthly cycle the lining of your uterus (endometrium) grows thick and increases the blood supply to support a potential pregnancy. When a pregnancy does not occur the drop in hormones (especially progesterone) leads to a release of the innermost lining of the uterus and we experience a period. In an average period women lose 30-40ml (6-8 tsp) of blood, with women experiencing heavy periods losing more than 60ml (12 tsp).

Blood Clots During Your Period

In a typical menstrual flow, the blood is not clotted due to the release of anticoagulants. The contraction of the uterus also stops further bleeding from the remaining blood supply to the uterus, and helps to expel the menstrual blood. After 3 to 4 days of bleeding, most of the inner lining of the endometrium (the “stratum functionalis”) has been released and blood loss slows considerably.

Blood clots are often a consequence of heavy menstrual flow. When the blood loss is too much, or too fast, the anticoagulants produced are not adequate to breakdown the lining of the uterus and prevent further clotting. Most women who experience clotting do so on the heaviest days of their menstrual period.

Possible Underlying Causes of Menstrual Blood Clots

  1. Miscarriage

Sometimes clots are actually a very early stage miscarriage. These clots may be found along with small gray clumps of tissue. If you experience other signs or symptoms of pregnancy along with clots, you may consider having your beta HCG levels tested to determine if it was, indeed, an early miscarriage.

  1. Uterine Fibroids (Leiomyomas)

Uterine fibroids are benign (non-cancerous) growths that occur in the muscular layer of the uterus. Some women with fibroids experience no symptoms at all, but for many women with fibroids they experience heavy periods (and blood clots) as a result. Fibroids are more likely to occur as we get older, especially after having children. Fibroids are also more common in women of African descent, those who are overweight and those with a family history of fibroids.

  1. Adenomyosis

Adenomyosis occurs when the endometrium breaks through into the muscular layer of the uterus (the myometrium). This can cause cramping, bloating, heavier menstrual periods and the presence of blood clots. Adenomyosis is also more common with age, in women who have had children, and in those who have had uterine surgery (such as a Caesarean section).

  1. Iron deficiency

In one of the great injustices in women’s health one major consequence of heavy periods, iron deficiency, can also lead to heavy periods. If you are experiencing heavy periods it is vitally important to test your hemoglobin, hematocrit and ferritin (iron) levels and build up your iron levels if needed.

  1. Hormonal imbalances

Imbalances between the two main female hormones, estrogen and progesterone, can lead to increased thickening of the uterine lining, resulting in heavy menstrual periods and blood clots. Imbalances in these hormones can occur at any stage of the reproductive life span, but are most common during adolescence and through the 40s and perimenopausal years.

  1. Thyroid imbalances

The thyroid is a small, butterfly shaped gland in your neck that controls your metabolic rate and has significant impacts on your hormonal health. An underactive thyroid can cause many symptoms – fatigue, difficulty losing weight, hair loss, and heavy periods. And with these heavy periods may come menstrual blood clots.

Recommended Testing for Menstrual Clots

If you regularly experience blood clots during your period, having some laboratory and imaging studies done is a good idea. It can help you understand why you are experiencing blood clots and your Naturopathic or Medical Doctor can work with you to determine an appropriate treatment plan.

Complete blood cell count – including hemoglobin and hematocrit to look for healthy red blood cells

Ferritin – to assess for iron deficiency anemia

TSH and complete thyroid panel – to assess health of the thyroid

Female hormone panel – to compare levels of estrogen and progesterone, along with other reproductive hormones, to ensure balance

Transvaginal or pelvic ultrasound – to identify uterine fibroids or other abnormalities of the uterus and uterine lining

MRI – a further visual assessment of the uterus if ultrasound is not adequate

If you are experiencing heavy periods and menstrual clotting, speaking to your Medical or Naturopathic Doctor can help you understand why you are experiencing these symptoms and develop a treatment that is as unique to your body and your period.

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.

References:

Young, B. Wheater’s Functional Histology, 6th Edition, 2014.

Melmed, S. Williams Textbook of Endocrinology, 2016.

 

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 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

The PCOS Diet

A nutritious diet is the cornerstone of health – a foundation on which we can build healthy choices and behaviours. In no condition is this more true than polycystic ovarian syndrome. Choosing the right foods for PCOS and avoiding others can be enough for many women to balance their hormones and decrease symptoms of PCOS. And there are no harmful side effects – just the benefits of a healthy diet and vibrantly healthy lifestyle.

The PCOS Diet – What to Avoid

  1. Refined grains

Breads, bagels, muffins, crackers, pasta – all the many forms of refined grains that are common in the western diet, should be avoided in women with PCOS. These high glycemic-index foods quickly raise blood sugar levels and can lead to insulin resistance – a condition where your cells no longer respond to insulin. This is thought to be one of the underlying hormonal imbalances in PCOS.

  1. Refined sugars

Fighting Sugar AddictionSugars found in cookies, cakes, candies, sodas and sweetened beverages can wreak havoc on your hormones in a similar way to refined grains. Best to leave these foods out of your diet entirely and instead opt for naturally sweet fruits to nourish your sweet tooth.

  1. Alcohol

Alcohol is one of the most hormonally devastating things we can put in our body. Not only is it made of mostly sugar (and in PCOS we know what sugar can do to our insulin response!) it also prevents the liver from being able to effectively process and eliminate excess hormones. Women with PCOS also have an increased risk of non-alcoholic fatty liver disease. Limit alcohol consumption to red wine, have no more than one serving per day and don’t have it every day.

  1. Red meat

Red meats are high in saturated fats and contribute to inflammation. Saturated fats can also lead to increased estrogen levels. I recommend limiting red meat to lean cuts of grass-fed, hormone free meat and consuming it no more often than 1-2 times per week.

  1. Dairy

Dairy is a significant source of inflammation, unhealthy saturated fats and should be avoided by women with PCOS. Additionally, dairy increases the production of insulin-like growth factor (IGF) which is known to negatively impact ovulation in PCOS. Rather than reducing dairy, you should consider avoiding it all together to help manage your PCOS.

The PCOS Diet – What to Enjoy

  1. Vegetables and fruits

Eat food

The foundation of the PCOS diet is a plant-based diet. Vegetables, fruits, beans and legumes, nuts and seeds are provide the body with essential nutrients and fiber. Soluble fiber such as that found in apples, carrots, cabbage, whole grains such as oatmeal, and beans and legumes, can lower insulin production and support hormone balance in PCOS.

  1. Proteins

Healthy proteins are an absolute necessity for women with PCOS. While dairy and red meat are not recommended, plant based proteins like nuts, seeds, beans, lentils and legumes are encouraged. Other healthy proteins like turkey, chicken breast, eggs and fish should also be emphasized. For most women with PCOS, a daily intake of 60-80g of protein per day is recommended.

  1. Wild salmon

An excellent source of protein, wild salmon is also rich in omega-3 fatty acids. Omega 3s improve insulin response and blood sugar metabolism and studies have shown lower circulating testosterone levels in women who supplement with omega 3s. Choose wild caught salmon and other cold water fish two to three times per week and incorporate other healthy sources of omega 3s such as walnuts and flax seeds into your diet.

  1. Cinnamon

CinnamonSpices are an amazing way to increase antioxidants in your diet, and cinnamon is especially useful for women with PCOS because it can help to regulate blood sugar. Sprinkle it on apples, oats or quinoa in the morning, add it to teas and use it in flavourful stews or curries.

  1. Pumpkin seeds

    These zinc-rich seeds help to lower testosterone levels and are an easy, high protein snack to enjoy every day!

  2. Green tea

Studies have shown that green tea extract helps to improve the response of cells to insulin, as well as lower insulin levels. Consider drinking a few cups of green tea daily – or better yet, have some matcha to get a big nutritional benefit!

  1. Spearmint tea

Spearmint tea for PCOSAs little as two cups of spearmint tea per day for a month can lower testosterone levels and improve symptoms of abnormal hair growth (hirsutism) in women with PCOS. A must for all women with polycystic ovarian syndrome!

  1. Broccoli

Cabbage, cauliflower, bok choy, broccoli, kohl rabi, kale – these brassica vegetables are a source of indole-3-carbinole, a compound thought to support the detoxification and breakdown of hormones in the liver.

  1. Walnuts

Researchers have found that consuming 1/3 cup of walnuts per day for six weeks can reduce testosterone levels, improve insulin sensitivity, and improve fatty acid status in the body. Combine these with your pumpkin seeds for a satisfying afternoon snack!

  1. Leafy greens

Spinach, kale, arugula and all the amazing variety of leafy greens are good sources of vitamin B6 – a nutrient necessary for balancing prolactin levels – a hormone that is often elevated in PCOS. Greens are also high in calcium, a mineral necessary for healthy ovulation. One more great reason to get those greens!

I hope you will embrace the PCOS diet – you really can heal your body through food medicine. If you need more support or guidance, contact me to book a free 15 minute consultation and together we can find your vibrant 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.

Select References

Kaur, Sat Dharam. The complete natural medicine guide to women’s health. Toronto. Robert Rose Inc. 2005.

Hudson, Tori. Women’s encyclopedia of natural medicine. Los Angeles. Keats publishing. 2007.

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.

 

 

Understanding Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) affects up to 1 in 10 women. It truly is a multi-headed beast – each woman manifests the hormonal imbalances and symptoms of PCOS differently. Only through understanding the underlying imbalances unique to each woman can we hope to overcome polycystic ovarian syndrome and achieve balanced, vibrant health.

What is PCOS?

PCOS is a “syndrome” – in medical language that means it is a condition characterized by a group of symptoms, not all of which are necessary for diagnosis. To be diagnosed with PCOS you must have two of the following:

  1. Infrequent or no ovulation (irregular or long menstrual cycles or no menstrual periods)
  2. Signs or symptoms (or laboratory testing) showing high androgens (testosterone or dihydrotestosterone) – these include acne, abnormal hair growth, hair loss, darkening skin at skin folds
  3. Polycystic ovaries on ultrasound

As you see it is possible to have PCOS and not have polycystic ovaries! It is a syndrome that results from hormone imbalances in the body – hormones that directly impact the ovaries and ovulation.

Causes of Polycystic Ovarian Syndrome

What causes the hormone imbalance that leads to the symptoms associated with polycystic ovarian syndrome? We don’t have a clear answer to that for every woman. There are some risk factors associated with developing PCOS, but women with no risk factors can still develop this syndrome.

            ScaleRisk Factors for PCOS

  • Genetics
  • Family history of diabetes
  • Obesity
  • Insulin resistance
  • High blood sugar
  • Low blood sugar
  • Use of seizure medication (valproate)

Hormones and Polycystic Ovarian Syndrome

There are a vast number of hormonal imbalances that are intricately intertwined in PCOS. A brief summary is given below, for a more in depth exploration, please read the article Hormones and Polycystic Ovarian Syndrome.

hormone balanceTestosterone and dihydrotestosterone (DHT) – levels of free and total testosterone are often elevated. Production of androgens (male hormones) in the ovaries is increased in PCOS. The increased levels of testosterone and DHT lead to the characteristic acne associated with PCOS.

Luteinizing hormone (LH) – increased LH is characteristic of PCOS. The diagnosis of PCOS is often identified when the LH:FSH ratio is greater than 2:1.

Follicle stimulating hormone (FSH) – can be low or normal. The lack of ovulation that occurs in PCOS is partially due to the lack of follicle response to FSH.

Sex hormone binding globulin (SHBG) – levels are decreased. SHBG binds to testosterone and DHT, rendering them biologically unavailable. With low levels of SHBG, increased action of testosterone is seen in tissues (resulting in hair loss, abnormal hair growth, and acne).

Insulin – high levels of insulin, or resistance to insulin in the tissues, is thought to be a primary cause of PCOS. Many doctors think that insulin imbalances are the first step in the cascade of hormone imbalances that occur in PCOS.

Symptoms of PCOS

The symptoms of PCOS occur as a result of the hormonal imbalances at the root of this condition. Your symptoms can help guide an experienced clinician to identify the dominant imbalances resulting in your PCOS.

            Common symptoms of PCOS:

  • Obesity and weight management issues (only in 40-50% of PCOS sufferers)
  • Acne (typically along the chin and around the mouth)
  • Oily skin
  • Polycystic or enlarged ovaries (found on ultrasound)
  • Blood sugar imbalances (“hangry”, dizziness, lightheadedness)
  • Darkening of skin at skin folds (acanthosis nigricans)
  • Long or irregular menstrual cycles (due to lack of ovulation)

Naturopathic Management of PCOS

Naturopathic medicine has great potential in the treatment of polycystic ovarian syndrome because it focuses on individualized care. There is no “standard” protocol for PCOS, your ND will need to discuss your symptoms and recognize your state of hormonal imbalance to develop an effective treatment plan.

Organic VegetablesYour naturopath may order additional laboratory testing if the underlying hormonal imbalances are not clear. Testing may include salivary or blood tests, depending on which hormone is being assessed. You may be asked to keep a record of your Basal Body Temperature, a simple means of tracking the hormonal ebb and flow of your monthly cycle.

The cornerstone of treatment for PCOS is improving response of the body to insulin. This often involves exercise and consuming a whole foods diet that is low in refined and processed sugars. Botanical medicines and nutritional supplements may also be used to address specific hormone imbalances such as elevated testosterone or decreased sex hormone binding globulin. Please read the article Naturopathic Medicine for PCOS to learn about the many treatment options available.

Beyond Understanding

At this point you have an understanding of the symptoms and hormonal imbalances associated with PCOS. Continue your understanding by reading other articles in this series by Dr. Lisa Watson, ND including Hormonal Imbalances in PCOS, PCOS and Infertility, The PCOS Diet, PCOS in Adolescence and Naturopathic Medicine for PCOS.

If you are ready to start working on achieving your healthy balance, Dr. Watson is currently accepting new patients at both her Toronto clinics. Contact her for a complimentary meet and greet appointment, or book your initial appointment today.

 

 

Endometriosis in Adolescence

Endometriosis is one of the most common causes of menstrual pain in women in their 20s, 30s and 40s. Recently doctors and scientists have begun to recognize that symptoms of endometriosis can begin during adolescence and be a significant cause of menstrual pain in teens as well.

Unfortunately, endometriosis is often overlooked in teenaged girls – one study found that women with endometriosis symptoms starting before age 15 had to see a doctor an average of 4.2 times before it was correctly diagnosed. That was more than in any other age group!

This same study found that more than one-third of women with endometriosis had symptoms starting before 15 years of age.

Early diagnosis of endometriosis is important for teenagers. Only with proper diagnosis can these young women receive appropriate education on the future of their reproductive health and treatments that can minimize or eliminate their pain and preserve their future fertility.

How Do I Know if I Have Endometriosis?

6979261624_6407c5ac68The most common symptoms of endometriosis are:

  • Pain before and during your period
  • Pain with intercourse (only in sexually active teens)
  • Infertility

For many teen girls pain with intercourse and infertility are not issues that they experience, which makes diagnosis more difficult. Other signs of endometriosis include:

  • Bleeding prior to your period (spotting)
  • Back or abdominal pain during your period
  • Pain with bowel movements
  • Painful digestive upset

In teen girls one symptom to look for is painful periods that do not respond well to pain medications like aspirin, ibuprofen, Advil, Aleve or naproxen.

Most teen girls with endometriosis will experience pain away from their periods; less than 10% had period pain alone and over 90% have pain both with their period and at other times during the month.

If you suspect you may have endometriosis your doctor will recommend an ultrasound and possibly a procedure called a laparoscopy. During a laparoscopy a small incision is made in the abdomen. A surgeon will be able to insert a camera into this incision and see if endometriosis is present – some endometriosis lesions can also be removed during this procedure.

Treatment for Endometriosis in Teen Girls

Naturopathic Medicine and EndometriosisThere are many available treatments for endometriosis. When started soon after diagnosis appropriate treatments can preserve a woman’s fertility and significantly decrease pain.

The most common mainstream treatment for endometriosis in adolescence is the birth control pill, used continuously or monthly, combined with pain medications to manage pain.

Naturopathic treatments focus on treating the underlying issues associated with endometriosis, normalizing hormone balance, decreasing pain and inflammation, optimizing immune function and supporting the body through the diet. You can read more about Understanding EndometriosisNaturopathic Medicine and Endometriosis, Acupuncture and Endometriosis and the Endometriosis Diet, all written by Naturopathic Doctor, Dr. Lisa Watson.

If you are a teen who wants to treat her endometriosis, book a consultation now to get started.  You can make a big impact on your future health if you act now.

References

Ballweg ML. Big picture of endometriosis helps provide guidance on approach to teens: comparative historical data show endo starting younger, is more severe. J Pediatr Adolesc Gynecol 2003;16(3 Suppl):S21–6.

Rowe T. Endometriosis: Diagnosis and Management. J Obstet Gynaecol Canada 2010;7(32)

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.

 

Endometriosis and Infertility

Endometriosis impacts around 1 in 10 women of menstruating age and one-third to one-half of those women will struggle with infertility – about twice the rate of infertility of the general population.

This article will help you understand the many ways endometriosis can impact your fertility. It is only through understanding that we can hope to find an end to the pain and suffering of endometriosis, and the pain and suffering of infertility.

Endometriosis and the Fallopian Tubes

Blausen_0349_EndometriosisEndometriosis is the presence of endometrial cells outside of the uterus. These cells migrate and implant themselves in other structures, sometimes creating significant blockages and scarring that can impact fertility.

The most common sites for endometriosis to occur are the ovaries, fallopian tubes, vaginal-rectal space, colon and bladder wall.

When endometriosis occurs in the fallopian tubes scar tissue can form and create an obstruction that interferes with the ability of sperm to reach the egg, or for a fertilized egg to travel to the uterus. This physical blockage significantly reduces fertility and can also explain the increased incidence of ectopic (outside the uterus) pregnancy in women with endometriosis.

Additionally, the production of prostaglandins (inflammatory particles) that are produced by endometriosis can cause spasms in the fallopian tubes. When this occurs a fertilized egg can be pushed to the uterus so quickly that the endometrium does not have enough time to prepare for a healthy implantation. This may result in no implantation, early miscarriage or possibly premature labour.

In one of the great injustices in the world, women with endometriosis have a risk of miscarriage that is 3 times greater than other women.

Endometriosis, Ovaries and Ovulation

Two out of three women with endometriosis will have endometriomas – endometriosis on the ovaries. These endometriomas lead to the formation of blood-filled “chocolate” cysts on the ovaries – so named because of their characteristic colour and texture.

When endometriosis impacts the ovaries the overall health of the ovary is affected, blood flow may be altered, inflammation and hormonal changes are common. The health of the ovary is not the only concern, but egg growth, development and release are also affected. Women with endometriosis have increased rates of luteinized unruptured follicle syndrome – a condition further exacerbated by the use of NSAID pain relievers for pain management in endometriosis.

Endometriosis and the Uterus

Endometriosis can also invade the muscular wall of the uterus, a condition known as adenomyosis. When this occurs scar tissue can develop within portions of the muscle wall and interfere with proper implantation. And if implantation does occur, it can keep your baby from growing properly within the uterus, resulting in a dramatically increased risk of very early miscarriage in women with endometriosis.

The inflammatory reaction that occurs with endometriosis can also cause the endometrial cells in the uterus to stop producing a key protein marker (beta-integrin-3) that is necessary to encourage fertilized eggs to implant in the uterus.

Endometriosis and the Immune System

The endometrial lesions found in women with endometriosis produce high levels of prostaglandins. These excess prostaglandins create inflammation and can cause your internal environment to become so biochemically hostile that sperm is destroyed before it can reach the egg for fertilization.

Another key finding in the immune function of women with endometriosis is a higher than normal number of macrophages, a specific type of immune cell that scavenges and consumes foreign cells such as viruses and bacteria. These same cells have been demonstrated to have the ability to kill sperm (a foreign cell) as it moves towards the egg or to destroy embryos as they travel to the uterus for implantation.

Moving Beyond Understandingempowerment

Understanding the ways endometriosis can cause infertility is the first step towards overcoming this diagnosis. In other articles we will discuss Understanding Endometriosis, the Immune System in Endometriosis, The Endometriosis Diet, Acupuncture for Endometriosis and Naturopathic Treatments for Endometriosis. Please read on or book an appointment with Dr. Lisa Watson, ND to discuss your options for managing your endometriosis. You don’t have to do this alone!

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.

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.

 

Getting Under Your Skin – Ten Natural Treatments for Psoriasis

Psoriasis is a common condition, affecting more than 50 000 people in Toronto alone.  Both men and women are equally impacted by psoriasis and more than one-third of people with psoriasis have a family member who also has it.

What is Psoriasis?

Psoriasis is a chronic, immune-mediated inflammatory condition that manifests as red, scaly skin rashes (known as “plaques”) that occur on the knees, elbows, scalp and other areas of the body.  The underlying issue that leads to psoriasis is immune activation of T-cells leading to release of inflammatory mediators and hyper-proliferation of keratinocytes.

Naturopathic Treatment of Psoriasis

Naturopathic treatment of psoriasis works to address the underlying causes of psoriasis – immune dysfunction and inflammation.  Correcting the imbalances that lead to psoriasis plaques and arthritis can significantly improve outcomes and promote optimal health.  Listed below are ten natural treatment options for psoriasis.

Ten Natural Treatment Options for Psoriasis

1. Anti-Inflammatory Diet

Food is a major source of inflammatory particles for our body.  Some foods promote inflammation, while other foods inhibit inflammation.  Foods that cause inflammation include: dairy, red meats, partially hydrogenated vegetable oils, safflower oil, canola oil and trans-fats.  These foods should be reduced or eliminated in the diet.

 Foods that reduce inflammation include the omega 3 fatty acids, many spices, and most fruits and vegetables.  A vegetarian diet, or diet rich in fruits and vegetables can decrease inflammation and symptoms of psoriasis.

 2. Identification and Elimination of Food Allergies and Sensitivities

In addition to foods that contain compounds known to lead to inflammation, individual food sensitivities or allergies can also cause inflammation.  Consuming foods that we have a sensitivity to leads to an immune response in our body, ultimately leading to inflammation.  Determining your food sensitivities and eliminating them can profoundly decrease the symptoms of psoriasis.  The most common food sensitivities found in people with psoriasis include gluten (wheat), eggs and dairy.

3. Healthy Weight LossBalance scale

People who are overweight tend to have worse symptoms of psoriasis, likely due to the increase in inflammation from insulin imbalance and the metabolic effects of being overweight.  Achieving and maintaining a healthy body weight is an important lifestyle goal for all people with psoriasis and something your Naturopathic Doctor can help you do in a healthy and long-lasting way.

 4. Manage Stress

Long term stress can deplete our body’s ability to produce cortisol, one of the most powerful natural anti-inflammatories in our body.  Psoriasis tends to worsen during times of stress – whether it is mental, emotional or physical stress.  Learning appropriate stress management skills, and using appropriate natural supplements to decrease the physical impacts of stress can be an effective way of managing psoriasis across your lifespan.

 5. Spice Up Your Life!

Literally! Many spices can be used to decrease inflammation and act as strong antioxidants, promoting healing of skin.  Specific spices that can decrease inflammation and help treat psoriasis include: turmeric, capsaicin (red pepper), cloves, ginger, cumin, anise, fennel, basil, rosemary and garlic.

6. Omega 3 Essential Fatty Acids

Essential Fatty AcidsOne of the most powerful treatments for all forms of inflammation, including psoriasis, is omega 3 fatty acids.  Omega 3s are essential fatty acids, our body can’t produce them and needs to get them from food.  Unfortunately our diets are rich in omega 6s (pro-inflammatory) and deficient in omega 3s (anti-inflammatory).

 Omega 3s have many impacts on the development of psoriasis.  They change the function of cell membranes, modify immune function decreasing overactivation, prevent blood supply from developing in psoriatic plaques and decrease inflammation throughout the body.

 Dietary sources of omega 3 fatty acids include cold water fish (mackerel, salmon, herring, sardines, albacore tuna), flaxseeds, walnuts, algae and hemp seeds.  Supplementing with higher doses of omega 3s is recommended for people with active psoriasis.

7. Vitamin D

People with psoriasis have lower levels of the active form of vitamin D in their blood streams.  At this point it’s not clear if this finding is a cause of psoriasis or a consequence.  It is known that psoriasis is much less common in areas of the world with higher vitamin D production – sunny and warm climates have a much lower incidence than cold climates.  UV phototherapy is another effective treatment for psoriasis that increases vitamin D levels but can have unwanted side effects.

 Supplementing with vitamin D, and using it topically is safe for most people with psoriasis.  A simple blood test is available that will tell you whether this treatment is right for you, talk to your Naturopathic Doctor about it today.

8. Bioactive Whey Protein

Emerging research has shown bioactive whey protein isolate to be a promising treatment for psoriasis.  Whey isolate has immune regulating effects due to the presence of growth factors, immunoglobulin’s and active peptides.  Taking this supplement twice daily showed significiant improvements in psoriasis skin plaques after just two months of use.

9. Curcumin Gel

While much of the healing for psoriasis depends on healing from the inside out, topical use of curcumin gel has been shown to be more effective than calcipotriol cream, one of the most common prescription medications for psoriasis.  After 2-6 weeks of daily use all patients had at least a 50% improvement in psoriasis plaques with half of patients having a 90% improvement.

aloe vera
Aloe vera gel

Curcumin gel works by reducing inflammation locally and in combination with other Naturopathic treatments can be an amazing treatment option for psoriasis.

10. Aloe Vera Gel

Another topical option for healing psoriasis, aloe vera gel is an incredibly gentle and safe treatment with good clinical results.  Not only is aloe vera calming to inflamed skin but it also promotes healthy regrowth of normal skin cells.  One study found an 82% improvement compared to placebo.

Psoriasis is a multi-faceted condition that stems from an imbalance in the immune system leading to inflammation and characteristic skin plaques.  Naturopathic Medicine offers treatment options that address the underlying imbalances and can result in profound improvements in overall health and lead to healthy, clear skin.

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.

Selected References

Calder PC. n-3 Polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr 2006;83:1505S-1519S.

Chalmers RJ, Kirby B. Gluten and psoriasis. Br J Dermatol 2000;142:5-7.

Heng MC, Song MK, Harker J, Heng MK. Drug- induced suppression of phosphorylase kinase activity correlates with resolution of psoriasis as assessed by clinical, histological and immunohistochemical parameters. Br J Dermatol 2000;143:937-949.

Perez A, Raab R, Chen TC, et al. Safety and efficacy of oral calcitriol (1,25-dihydroxyvitamin D3) for the treatment of psoriasis. Br J Dermatol 1996;134:1070- 1078.

Pizzorno JE, Murray MT. Textbook of Natural Medicine. 3rd ed. St. Louis, MO: Churchill Livingstone; 2006.

Poulin Y, Bissonnette R, Juneau C, et al. XP-828L in the treatment of mild to moderate psoriasis: randomized, double-blind, placebo-controlled study. J Cutan Med Surg 2006;10:241-248.

Syed TA, Ahmad SA, Holt AH, et al. Management of psoriasis with Aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study. Trop Med Int Health 1996;1:505-509.

Traub M, Marshall K. Psoriasis – Pathophysiology, Conventional and Alternative Approaches to Treatment. Alt Med Review. 2007;12(4).

Wolters M. Diet and psoriasis: experimental data and clinical evidence. Br J Dermatol 2005;153:706-714.