Skip to main content

The Empowered Woman’s Guide to Yeast Infections

If you have been reading my blog (yay you!), then you know my core mission is to empower women to demand more from their health. No more accepting mediocrity in our bodies and our wellness. You CAN feel better.

And the one condition I am constantly amazed that women are living with, without successful treatment, are yeast infections.

Ladies! You don’t have to live like this. If this is your first yeast infection, congratulations. You are going to learn how to deal with this right, the first time. If this is your third, or fourth, or fortieth – I am so glad you are here. Because we are going to get into some serious action-oriented information that you need to learn.

So let’s do this.

 

What is a Yeast Infection

A yeast infection is an overgrowth of yeast, usually Candida albicans that causes irritation to the vagina and vulva. Also known as VVC (vulvovaginal candidiasis), candida is most often self diagnosed and treated with over the counter creams and capsules.

While most women think of a yeast infection when they experience a thick, whitish discharge, only 20% of cases actually have this symptom.   The more common symptoms of a yeast infection are itching, swelling of the vulva and pain on urination (especially after peeing).

What is NOT a Yeast Infection

While most women self diagnose yeast infections, there are a number of imbalances that can occur in the lady garden that look like yeast infections, but aren’t.

Vaginitis – an infection of the vagina with inflammation. A yeast infection is a type of vaginitis, but this can also be caused by other infections, like trichomoniasis.

Vaginosis – the overgrowth of vaginal bacteria without inflammation. Most commonly caused by Gardnerella, BV (bacterial vaginosis) is incredibly common – even more so than yeast infections. But that is the subject of another article (coming very soon!)

Other conditions that are not yeast infections – contact irritation, allergic reactions, atrophic vaginitis, menopausal dryness, cytolytic vaginosis (Write this article too) and sexually transmitted illnesses like Chlamydia and gonorrhea.

What Your Doctor Isn’t Telling You About Yeast Infections

Yeast infections don’t need to be difficult to treat. They don’t need to be recurrent. The problem is that doctors aren’t offering complete solutions to women with yeast infections.

When you talk to your MD about yeast infections, most often you are told to take an over-the-counter antifungal medication that will kill the yeast. Sounds ok right? Well, no… not right.

Killing the yeast is important, there is no doubt about that. But killing the yeast does nothing to change the environment that the yeast was growing in. And since yeast is everywhere (yeast spores are airborne – you are going to be exposed to them both in your environment and from your digestive tract every day of your life) if you don’t change the environment, you’ll like just get another yeast infection.

The Empowered Approach to Yeast Infection Treatment

I’m going to present you with my empowered approach to fighting yeast infections. It takes a bit longer than the typical over-the-counter remedies – but it works a lot better. So if you’re ready to conquer candida, for once and for all, read on.

  1. Pay attention to pH

The healthy normal pH of the vaginal tract is around a 3.8-4.5. When you have candida (or BV), that pH can be increased above a 4.5. This occurs due to a change in the healthy bacteria, Lactobacillus, that should be the main bacteria in the vagina.

If you want to resolve your yeast infection, you need to pay attention to pH. If you optimize the normal, acidic pH of the vaginal tract, the yeast and nasty bacteria can’t thrive and the lactobacillus species can.

The best way to do this is with boric acid suppositories. Boric acid sounds scary – but remember, the vaginal tract is meant to be acidic. Using boric acid will restore the optimal pH and support the healthy bacteria populations. Made by a local compounding pharmacist, boric acid is simple to use and very effective.

  1. Eradicate the yeast

Ok. Yes, we do need to eradicate the yeast. But as I mentioned above, it can’t be the ONLY step in a successful yeast treatment. Most often I recommend using nature’s favourite antifungal – garlic – often combined with some caprylic acid (from coconut). Taken orally, or sometimes vaginally, these two are a powerhouse of antifungal activity.

But we don’t stop there. We also look at your diet. Yeast thrives in a high sugar environment, so I suggest avoiding all sugar (including dairy and bread products), alcohol and some fruits for at least a month while treating your yeast infection.

  1. Restore beneficial bacteria

yeast infection, candida, candidiasisWho hasn’t heard of the amazing benefits of probiotics? Those 300 trillion lovely little bugs that live in and on our body are a huge part of what makes us healthy (or not.)

In our lady garden, our boss bacteria is Lactobacillus. And imbalances in healthy levels of Lactobacillus are associated with BV and yeast infections.

The main source of bacteria for the vagina is from the “proximity exposure” to the exit of our digestive tract. So taking probiotics by mouth can be really effective for supporting healthy bacteria levels. Using vaginal probiotics is also highly recommended for yeast treatments, especially when using boric acid.

  1. Prevent recurrence

Eradicate yeast? Check.

Promote healthy pH? Check.

Lots of Lactobacillus? Check.

Now how do we stop this from happening again? Avoiding triggers that can lead to yeast infections – like a diet high in sugar, dairy and wheat, diabetes and unstable blood sugar, tight clothing and artificial fiber underwear (cotton ladies, cotton) is imperative. You can discuss with your ND whether you should embark on a longer “Candida Diet” – this isn’t necessary for everyone, but can make all the difference for some.

  1. Don’t accept mediocrity from your lady garden

I’ve said it before – and I’ll say it once more – yeast infections are not normal. And you don’t have to live with them. Now that you know better, I hope you will want better for yourself. And go out there and do it. You have been empowered – and I’m cheering you on.

Want a personalized treatment plan to get over your yeast infections?  Book in and let’s talk.  I’m ready when you are.

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

 

Your Guide to Pain Free Periods

Painful periods and menstrual cramps

This is the one article series a lot of women have been asking for – what to do about painful periods and period cramps. Half of women experience pain during their menstrual cycles (and around 90% of teen girls) and 1 in 10 women have periods that are so painful they are unable to work or function for up to a week each month.

So what are we going to do about it ladies? I’m not one to just take things as they are – and I don’t want you to either! Let’s learn a bit more about why some of us get such significant pain during our periods, and then we’ll talk about what we can DO to lessen our pain, and live our amazing lives, every damn day of the month.

Dysmenorrhea

The medical term for painful periods is dysmenorrhea. And it encompasses anything from cramps in the lower abdomen to low back pain, pain/pulling sensation in the inner thighs, diarrhea, nausea, vomiting, dizziness, headache and fatigue. Dysmenorrhea is basically anything miserable during a period that interferes with our ability to function.

There are two different types of dysmenorrhea: primary and secondary.

Primary dysmenorrhea – no underlying cause, just the result of our body’s natural physiology

Secondary dysmenorrhea – occurs as a result of something else – an underlying condition that can lead to pain during periods – endometriosis, ovarian cysts, pelvic inflammatory disease, uterine fibroids, a narrow cervical opening, etc.

Ultimately we need to understand if there is a secondary cause for the painful periods – and treat that. If your periods started being painful right from your first period in your teens, then it’s most likely primary dysmenorrhea. If you had years of pain-free periods, then a full workup for secondary dysmenorrhea is highly recommended. In either case read on and learn more about what you can do to help yourself manage your period pain.

Why Are My Periods Painful?

A couple of specific physiological changes occur at the start of our periods that contribute to pain during periods.

Just before the start of our period flow the blood supply, and thus oxygen delivery, to the uterus is significantly restricted. In order for the lining of the uterus to be shed there is also an increase in the production and release of inflammatory compounds (called prostaglandins) that stimulate uterine contractions. This combination of low oxygen delivery (called ischemia), inflammatory prostaglandins, and contractions causes the pain associated with our periods.

But Dr. Lisa, not every woman experiences painful periods (lucky b*tches)

Yes, dear reader, this is absolutely true! Some factors need to be considered in those of us who do have painful periods.

Women who have painful periods produce on average 8-13 times more prostaglandins than women who do not experience painful menstrual cramps (more on this in the treatment section). Women who do not ovulate during their menstrual cycle also do not have painful periods – the drop in progesterone is what triggers the inflammatory prostaglandin production and painful uterine contractions. As we get older and make less progesterone, we also can experience much less painful periods.

And lifestyle makes a difference for some women too. Women who already have poor oxygen delivery to the uterus – smokers, women who are overweight, women who are sedentary – they tend to have cramping that is either more intense, or lasts longer, or both.

Treatment of Painful Periods and Menstrual Cramps

There is a LOT that we can do to manage our menstrual cramps. Many of the lifestyle and natural treatments are very effective for reducing pain during our periods and can give women back their vitality every day of the month. Ultimately it can be a trial and error to determine what will be the most effective for you, and working with a Naturopathic Doctor can accelerate your progress.

Below I’ve given you my top ten lifestyle modifications for managing period cramps.  Once you’ve made those changes, check out my article on Natural Treatments for a Pain Free Period. And then when you’re empowered with all that knowledge, book an appointment so we can put together the very best plan for you.

Lifestyle for Pain Free Periods

Studies have found a number of factors that can contribute to painful periods – women who eat more sugar, junk food, fast food and saturated fats tend to have more painful periods. Women who exercise regularly (not just during their periods) tend to have less menstrual cramps. Using tampons can make menstrual cramps worse, as can constipation or food sensitivities.

Below you’ll find my top ten lifestyle tips for reducing period pain

  1. Cut the sugar

Not really a newsflash, but sugar makes just about everything worse – including period cramps. Sugar interferes with the body’s ability to absorb and use B vitamins and minerals, both of which can worsen muscle tension and increase the force of uterus cramps. So quit it – you already knew you should.

  1. Ditch dairy

Prostaglandins, those inflammatory molecules produced by our uterus that cause pain, are made in our body from arachidonic acid. Arachidonic acid comes mostly from our diet, in particular dairy products (although poultry is also a high source of arachidonic acid). Reducing or eliminating dairy is a great idea for women who get period pain – and it has been suggested that eliminating dairy may provide a significant benefit (with no other treatments) for up to one-third of women with painful periods!

  1. Avoid alcohol

Ladies, I get it. The urge to have a lovely glass of wine to dull the cramping and misery, and really, you just want it. But I’m a teller of truths – alcohol is a no-go for painful periods. Alcohol is well known to deplete B vitamins as well as muscle-relaxing minerals such as magnesium. Not only that – it interferes with the liver’s ability to metabolize hormones. All of these contribute to more cramping and heavier periods (which lead to more clots, which trigger more uterine spasms, which causes more pain…)

  1. Skip the salt

Salt is something many people think they are avoiding, but that stuff sneaks into everything. While I’m not opposed to a bit of sea salt on my edamame, the primary source of salt in the diet is processed or packaged foods. Salt can increase fluid retention, which can worsen bloating and discomfort as well as period pain. So skip the salt and season with spices instead.

  1. Load up on the legumes, nuts and seeds

Nuts and seeds are excellent sources of minerals like magnesium and calcium – both of which can lessen muscle tension and reduce the pain of menstrual cramps. Additionally, eating a diet higher in plant proteins and lower in animal proteins has been found to reduce the incidence of dysmenorrhea. So skip the chicken and have some chickpeas and cashews instead.

  1. Eat your veggies

Really, is there anything vegetables CAN’T do? They are the most important component of the human diet, and eating more of them cures just about everything – including period cramps. Women who eat more fruits and vegetables have the lowest rates of painful periods. Vegetables are excellent sources of minerals, like calcium and magnesium, as well as fiber to reduce bloating and discomfort.

  1. Understand your food sensitivities

Wait, what? Food sensitivities? What do those have to do with my period cramps?

It turns out, quite a lot!

Food sensitivities can damage the lining of the digestive tract, altering the absorption of B vitamins and minerals, resulting in more cramping. Additionally, food sensitivities can cause increased production of inflammatory molecules, leading to more inflammation (and more pain) when period time rolls around. Add to the mix the irregular bowel movements that can result from food sensitivities and you have the perfect storm for period pain. So if you’ve ever wondered if you have food sensitivities and you get painful periods, I’d considering having the food sensitivity test. It may be just what you need.

  1. Exercise regularly

Exercise improves blood flow to, and from, the uterus. Exercise also helps to alter the production of prostagandins, leading to less pain. And it’s not just exercise during your period that helps – most studies show that women who exercise regularly have less painful periods than those who don’t. There are also some specific exercises that have been found to help manage period pain – you can read more about those here.

  1. Toss the tampons

We are entering a new age of period empowerment. No longer are we having to choose between bulky pads and bleached cotton tampons. There are so many options now for women to comfortably accommodate their periods.

Pain free periods. Natural treatments for period cramps

From the Diva Cup to Thinx period panties, to all natural pads that are thin and comfortable. Women who use tampons have more painful periods than those who don’t, and most of those tampons are full of chemicals that can be absorbed across the mucosal barrier of the vaginal canal – not a good thing! So toss those tampons and join women in the age of period empowerment!

  1. Try a Natural Approach

While we may be tempted to manage our period pain with Midol and Advil and other pain killers, there are a number of natural supplements – nutrients and botanical (plant) medicines that can provide amazing relief. And without the side effects of those pain killers as well! Start by reading my article on Natural Treatments for Pain-Free Periods and then work with a Naturopathic Doctor to personalize a treatment plan that can give you relief from your menstrual cramps.

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!

When it’s NOT PCOS: Non-Classic Congenital Adrenal Hyperplasia

A woman, let’s call her Nicole, enters my office with a concern of acne. Acne in an adult woman is, unfortunately, not uncommon these days. After spending some time talking to Nicole we find that she also has hair loss from her scalp, and hair growth on her chin as well as irregular periods.

If you’re familiar with PCOS you may recognize these as the most common symptoms of PCOS – irregular (or absent periods), acne and hair growth on the face or hair loss from the scalp.

But it wasn’t PCOS for Nicole. It was something else.

Non-Classic Congenital Adrenal Hyperplasia

Non-classic congenital adrenal hyperplasia (NCAH) is a condition that usually develops around the age of puberty and can impact both boys and girls (this article is just about the girls – sorry guys!)

NCAH is an inherited condition where a person does not make enough of a specific enzyme, 21-hydroxylase, that converts the hormone progesterone into cortisol. When this enzyme doesn’t work more progesterone is shifted into testosterone and levels of testosterone and other androgens increase.

Why Does NCAH Look Like PCOS?

Both PCOS and NCAH have symptoms that are the result of high androgens – testosterone, androstenedione, and dihydrotestosterone. However, the source of the high androgens is different.

In PCOS the elevated androgens come from overstimulation of the ovaries by follicle stimulating hormone (FSH), without the corresponding ovulation – leading the ovaries to continue to produce large amounts of testosterone over time.

In NCAH, the testosterone comes from the conversion of progesterone (and 17-OH progesterone) into androstenedione and subsequently testosterone.

In either case, high testosterone in a woman leads to oily skin, acne, facial hair, and scalp hair loss. Not such a pretty picture.

So, is my PCOS actually NCAH??

There are some warning signs that your PCOS may actually be NCAH.

  • Did your puberty start early – before 10 years of age? Or was it significantly delayed – after 15 years of age?
  • Did you have premature development of pubic or underarm hair?
  • Are you shorter than average height for an adult?

All of these findings are more common in NCAH than in PCOS.

But ultimately the diagnosis of NCAH requires a blood test.

17-OH Progesterone Testing

The first test for non-classic congenital adrenal hyperplasia is a 17-OH progesterone test. If your levels of this test are elevated, then you most likely have NCAH. While this test is routinely done in newborns, the non-classic variant can be missed until puberty.

If the 17-OH test is positive then a follow up test, known as the ACTH stimulation test, is done to confirm the diagnosis.

As NCAH is the most common autosomal recessive disorder in humans (you have to have two mutated copies of the gene to get this condition) – impacting around 1 in 100 people, this test is highly recommended if you have PCOS – especially if you don’t seem to fit the typical PCOS picture.

Moving Forward

NCAH, for some women, causes little to no difficulty. Other women have issues with abnormal hair growth/ hair loss or acne that can be difficult to treat. Other women have issues with infertility. It is a variable condition. Talk to your Naturopathic Doctor or Medical Doctor if you think your PCOS may actually be NCAH, and learn about your diagnosis and treatment options.

 

WTF is MTHFR?

The world of genetics is confusing AF.  But trust me, you will be hearing more and more about genetics in the coming years.  In 2003 researchers completed The Human Genome Project, a many year endeavour to sequence the human genome and understand what our genes can tell us about our health.  And one of the most important genes identified was MTHFR.

MTHFR

MTHFR is the acronym for the gene that makes methylenetetrahydrofolate reductase. This is an essential step in the methylation pathway – a complex pathway that results in the production of neurotransmitters (mental health), glutathione (liver, inflammation and antioxidant health), and processing of estrogen and testosterone (hormone health). Methylation has been considered by many to be the most important enzyme function in the human body.

MTHFR Polymorphisms

Somewhere between 30-50% (perhaps more) people carry a mutation (also called a single nucleotide polymorphism – or SNP) in the MTHFR gene, with an estimated 14-20% of people having a more severe mutation. First identified by the Human Genome Project, researchers noted that people with the MTHFR mutation were more likely to develop certain diseases, including ADHD, autism, Alzheimer’s, atherosclerosis and autoimmune disorders.

Autism Alzheimer’s ADHD Atherosclerosis Miscarriages Fibromyalgia
Deep vein thrombosis Neural tube defects Gluten intolerance Pernicious anemia Schizophrenia Chronic fatigue syndrome
Post-menopausal depression Chemical sensitivities Parkinson’s Irritable bowel syndrome Pre-eclampsia Stroke
Spina bifida Bipolar disorder Male infertility Vascular dementia Blood clots Congenital heart defects
Gastric cancer Migraines with aura Low HDL cholesterol Epilepsy Atherosclerosis Oral clefts
Type I Diabetes Cervical dysplasia Glaucoma Prostate cancer Multiple sclerosis Essential hypertension
Thyroid cancer Premature death Heart murmurs Placental abruption Myocardial infarction Tongue tie
Asthma Bladder cancer Low testosterone Heavy metal toxicity
Conditions Associated with MTHFR Polymorphisms

It is important to remember that just because you have inherited a gene (thanks mom and dad), does not mean you will develop one of these health conditions. There are many factors (diet, lifestyle, nutritional status, environment) that contribute to gene expression.

Your genes are not your destiny, but they are your tendency

MTHFR C667T and MTHFR A1298C

Two main MTHFR mutations have been identified and are the focus of most research.

Mutations are inherited from our parents, and as such we have two copies of each gene. A mutation on either of these genes can be heterozygous (+/-) – meaning only one copy is abnormal – or homozygous (+/+), meaning both inherited copies is mutated. Homozygous mutations are more likely to cause health problems. And having a homozygous mutation in both MTHFR C667T and MTHFR A1298C is considered to be the most problematic.

The Consequences of MTHFR Mutations

The importance of the methylation cycle, impacted by MTHFR mutations, can not be understated. Some of the consequences of altered MTHFR function include:

  • Decreased methylationMTHFR, naturopath, nutrigenomics
  • Increased heavy metal toxicity (iron, copper, lead, mercury)
  • Low iron (often secondary to elevated copper)
  • Increased homocysteine leading to vascular inflammation (cardiovascular disease, increased blood pressure, increased risk of vascular dementia)
  • Poor conversion of homocysteine to glutathione (increased stress, fatigue, toxin build up, cellular stress)
  • Poor conversion of homocysteine to methionine (increased atherosclerosis, non-alcoholic fatty liver disease, anemia, inflammation)
  • Decreased production of SAMe and decreased serotonin levels (depression)

Nutrigenomics for MTHFR

One of the main reasons I became interested in genetic medicine, is the ability of nutrients, diet and lifestyle to strongly influence the function of our genes.  This field of study is known as nutrigenomics. 

When we know what our genetic tendencies are, we can alter and optimize them through dietary and supplemental choices. It’s an empowering way to look at our bodies.

In order to optimize MTHFR function, there are some things that need to be avoided:

  1. Synthetic folic acid – further slows the MTHFR function
  2. Cyanocobalamin – a form of vitamin B12 that slows methylation
  3. Birth control pills – block the uptake of folate in the gut
  4. Methotrexate – another medication that blocks folate uptake
  5. Proton pump inhibitors – a medication for heartburn that alters stomach acid levels and decreases vitamin B12 absorption
  6. Processed grains – contain synthetic folic acid
  7. Mercury amalgams and heavy metals – can lead to greater heavy metal toxicity due to poor metal clearance

Individuals who have MTHFR polymorphisms will often thrive with appropriate nutritional support. Supplements that can help to improve methylation are the cornerstone of MTHFR therapy.

Supplemental Support for MTHFR

Folate – natural folate, from leafy green plants (foliage – that’s how folate got its name!) and natural supplements will help to improve methylation. Especially important during the months prior to pregnancy, women of reproductive age with MTHFR mutations should be taking folate regularly.

Vitamin B6 – an essential cofactor in the methylation pathway, vitamin B6 helps to ensure folate works properly.

Vitamin B12 – vitamin B12 is a methyl donor – it contributes a methyl group to the methylation pathway, allowing it to function at optimal capacity. B12 should be taken in the methylcobalamin or hydroxycobalamin form, and never in the cyanocobalamin form.

Treatments for MTHFRTMG (Trimethylglycine or Betaine) – another methyl donor, providing three methyl groups to the methylation cycle, this nutrient is commonly deficient in people with MTHFR. Stress, infections, inflammation and high levels of heavy metals will all increase the demand for THM. In a healthy body, plenty is made, but it is also available as a supplement and in foods such as broccoli, beets and other vegetables. TMG is especially useful for people with depressive symptoms as it increases the production of SAMe.

SAMe – a consequence of poor MTHFR function is low levels of SAMe. Essential for the production of serotonin, low SAMe can be associated strongly with depression. SAMe acts as a methyl donor in the body, and is made in the body through methylation processes. Supplementation is available although often levels improve with supplementation of methyl donors, B12 and folate.

NAC (N-Acetyl Cysteine) – a direct precursor to the production of glutathione. NAC can be used to support detoxification and decrease oxidative damage in people with MTHFR mutations.

Confused? 

You’re not alone!  The study of genetics, and the influence of our genes on our health, is some pretty deep, dark science stuff!  But it’s also incredibly informative, and empowering.  And if you’ve ever wondered how your genes are impacting your health, you should consider genetic testing and working with a Naturopathic Doctor,  Geneticist or Functional Medicine Doctor who can help you understand your genetic tendencies, and realize your optimal health potential.

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.

 

Pregnancy and Thyroid Health

Pregnancy is a time when we expect a lot of hormonal changes – but not every woman is aware of the changes that can occur in her thyroid function – and what that can mean for both her health, and the health of her baby.

A Brief Introduction to your Thyroid

Your thyroid is a hormone-producing gland, located at the front of the neck. It produces thyroid hormones (T4 and T3) that regulate our metabolic rate – our ability to make energy in our cells.

Thyroid Hormone Changes in Pregnancy

During pregnancy the body has a significant increase in metabolic activity – a lot of energy is required to make a baby! As such, the need for thyroid hormone increases. Women need approximately 40% more thyroid hormones during pregnancy to sustain the increases in energy needed for a healthy pregnancy.

Many women with thyroid disease are not immediately identified in pregnancy, as many of the symptoms of hypothyroidism (low thyroid function) are the same as symptoms of pregnancy. Weight gain, depression, fatigue, constipation and dry skin are all common in pregnancy and are also signs of an under-performing thyroid gland.

If you know prior to pregnancy that you have an underactive thyroid (half of people with hypothyroidism don’t know it), then increasing your thyroid medication soon after a positive pregnancy test is recommended. An increase in the medication dose of 25-40% is suggested for most women.

An underactive thyroid, challenged by the increased energy demands in pregnancy, may also be exacerbated by the increased clearance of iodide by the kidneys in pregnancy (all those increased trips to the bathroom have consequences as well!) Many prenatal supplements still do not contain adequate amounts of iodine to address this issue, worsening an already delicate hormone balance in pregnancy.

Consequences of Thyroid Disease in Pregnancy

Hypothyroidism in pregnancy is a serious health concern. Recurrent miscarriages have been found in women with even mild and asymptomatic thyroid disease. Increases in fetal death, birth defects, premature birth, low birth weights, placental abruption and intellectual disability have all been linked to hypothyroidism in pregnancy, especially in early pregnancy.

Hypothyroid is not the only thyroid concern that is problematic in pregnancy. The presence of autoimmune antibodies against the thyroid (TPO or anti-TG) can also increase the chances of miscarriage – in some studies doubling the risk of an early miscarriage.

Thyroid Testing in Pregnancy and Pre-Conception

Unfortunately, thyroid testing is not standard care for women who are trying to conceive, or who are pregnant. It is not even standard for women who have experienced an early miscarriage, in spite of the association of hypothyroidism and autoimmune thyroid antibodies and miscarriage.The demand for thyroid hormone in pregnancy increases most in the first half of pregnancy – especially in the first 6-12 weeks. This means we need to be testing women sooner – ideally before pregnancy, and certainly after a positive pregnancy test. Most experts believe that testing should be done before 9 weeks gestation – within the first month after a positive pregnancy test.

More comprehensive thyroid testing should also be offered to women trying to conceive, or who are pregnant. A simple TSH is not enough to fully assess the thyroid – autoimmune antibodies, T3 and T4 levels should also be tested.

And please keep in mind, the lab ranges for “normal” on thyroid testing are not the same as those that are optimal for pregnancy. Even mild or asymptomatic hypothyroidism, or any elevation in thyroid antibodies, can increase risk for an unsuccessful pregnancy.

If your doctor is unwilling to run these tests for you, speak to your Naturopathic Doctor. They can advocate for you, or run the tests to ensure you are getting the optimal support you need both before, and during, pregnancy.

The risks of not identifying a thyroid condition in pregnancy are significant. Don’t let a lack of knowledge, a lack of testing, or a lack of an appropriate diagnosis impact your pregnancy. Speak up, get the testing, and have a healthy, happy pregnancy.

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

Alexander EK, Mandel SJ – Diagnosis and Treatment of Thyroid Disease During Pregnancy. Endocrinology: Adult and Pediatric 7th Ed, 2016. Chapter 84; 1478-1499.

 

 

 

PCOS Types

Syndrome of PCOS

Polycystic ovarian syndrome (PCOS) is condition impacting up to 1 in 10 women in North America. PCOS is a “syndrome” – a medical term for a condition that can have different symptoms in different people. In PCOS we can see a wide variety of presentations. Some women have many symptoms, while others have few. Some of the symptoms that can present in PCOS are:

  • Irregular periods
  • Long time between periods (prolonged cycles)
  • Infertility
  • Hair growth where you don’t want hair (chin, upper lip, neck, chest, back, breasts, buttocks)
  • Hair loss where you do want hair (scalp)
  • Weight gain
  • Oily skin
  • Acne

Diagnosis of PCOS

Ultimately the diagnosis of PCOS is based on the Rotterdam criteria – you must have 2 of the 3 criteria (irregular periods, cysts on your ovaries, signs or laboratory evidence of elevated androgens) to be diagnosed. To learn more about diagnosis, read this article by Dr. Lisa on PCOS Diagnosis.

As a Naturopathic Doctor I think we should move beyond mere diagnosis, and really get to the underlying causes of PCOS. And this is where the PCOS Types come into play.

Types of PCOS

Type 1: Insulin-Resistant PCOS

The classic presentation of PCOS – a woman experiencing weight gain, irregular or no periods, acne and facial hair – is represented by Type 1 PCOS, a condition associated with insulin resistance. The lack of response of the ovaries to insulin leads to a hormonal cascade that results in increased testosterone levels, the underlying cause of those unfortunate symptoms.

Women with insulin resistant PCOS have an increased risk of developing diabetes and depression – two other conditions associated with insulin resistance.

Treatment for insulin resistant PCOS involves improving the body’s response to insulin. Supplements such as inositol, chromium and cinnamon can be helpful. Spearmint tea can help to decrease testosterone levels and reduce facial hair growth and acne.

Weight optimization and following the PCOS Diet can also be part of this process. However, please keep in mind that not all women with insulin resistant PCOS are overweight. Slender women can also have insulin resistance as a result of their diet.

Type 2 PCOS: Non-Insulin Resistant PCOS

What once was a rare occurrence, I am now seeing many more women in my practice with non-insulin resistant PCOS. This can be caused by a number of different causes including:

  • Inflammation
  • Immune system challenges (including autoimmune diseases)
  • Vitamin D deficiency
  • Iodine deficiency
  • Thyroid hormone imbalance
  • Stress
  • Low dose chronic environmental exposures
  • Discontinuation of the birth control pill
  • A diet inconsistent with your body’s individual biochemistry

This type of PCOS requires more investigation and understanding that the classic insulin-resistant PCOS. Often I will run more extensive blood work than is typically offered to a woman with PCOS. Depending on the woman I may look at nutritional levels, hormone balance (prolactin, thyroid, LH, progesterone, cortisol, DHEA, testosterone), autoimmune antibodies, inflammatory markers, and food sensitivity testing.

The approach to managing non-insulin resistant PCOS is a personalized medical approach. It is essential that we uncover the root cause of the PCOS and address it directly with an approach that encourages balance and optimum function. Often women respond quickly once the cause has been identified and balance is restored.

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.

 

Hormones in Weight Loss

We believe we can get healthy by losing weight – but we need to be healthy to lose weight

Weight loss is a lot more than just watching what you eat and how much you exercise.  While diet and exercise are essential components of a weight loss program, if your hormones are not in balance you will always be fighting against your body to lose fat and improve your body composition and health.

In this article I discuss some of the most important hormones for weight loss – our hormone helpers, and our hormone haters.  For a more in depth look at your personal hormone balance, consider booking an appointment with a naturopathic doctor for individual testing and hormone assessment.

Weight Loss: Hormone Helpers

Thyroid Hormone

Thyroid hormones are our metabolism masters – they control the rate of energy production (metabolism) throughout the body. When thyroid hormones are too low symptoms of fatigue and weight gain can occur. When thyroid hormones are too high symptoms of anxiety, jitteriness and weight loss are common.

The optimal range for TSH (a measure of thyroid function) for weight loss is 0.75-2.5.  Outside of this range can alter metabolism and make weight loss difficult.

Glucagon

Glucagon hormone works with insulin to balance blood sugar – insulin rises when blood sugar is high, glucagon rises when blood sugar is low. Improving glucagon levels helps us to keep our blood sugar stable and support weight loss.

Not surprisingly, activities that support stable blood sugar can improve glucagon levels. Specifically exercise and healthy protein consumption can increase glucagon levels while a diet high in sugar decreases glucagon.

Growth Hormone

Growth hormone is produced throughout our lifetime although it’s production is highest during our younger years. Growth hormone is necessary for tissue repair, muscle building and improving the density of bone.

The majority of growth hormone is produced overnight but it is also produced during exercise. Low levels of growth hormone (associated with poor sleep, eating too close to bed and lack of exercise) can lead to fatigue, depression, cholesterol imbalances, and abdominal weight gain.

Leptin

One of our weight-loss helpers, leptin is our appetite-suppressing, full-sensation hormone. It is released by fat cells and communicates with our brain that we have had enough to eat.

We can improve our leptin levels through our lifestyle. Sleep, regular exercise, sufficient calories from our food and weight loss all help to balance leptin and improve our body composition.

We can also sabotage our leptin balance through our lifestyle choices. A regular intake of excess saturated fat and sugar leads to “leptin resistance”. When this occurs the brain no longer respond to high circulating levels of leptin and allows you to keep eating despite not being hungry.

Weight Loss: Hormone Haters

Ghrelin

Ghrelin works very closely with leptin to maintain our body weight. Ghrelin is the hunger hormone, produced when your digestive tract is empty. If you stomach is growling, ghrelin is being produced.

Ghrelin tells our brain when we’re hungry, and leptin tells us when we’re full.

Cortisol

Cortisol is most commonly known as our “stress hormone”. It is produced in high levels during stress, but our bodies produce varying levels over the course of every day.

High levels of cortisol can influence our eating habits and our hormone balance. People with elevated cortisol often crave sugary and salty foods, leading to an increase in insulin levels and all the symptoms associated with that imbalance.

Cortisol also stimulates a process in the liver known as “gluconeogenesis” – our body makes sugar to provide us fuel to get away from our stress. If we don’t use this extra sugar (by exercising) it gets deposited as fat around our midsection.

Insulin

Insulin helps our cells get energy in the form of sugar. When we eat foods that contain sugar (fruits, vegetables, grains, processed foods) our body releases insulin as a way of controlling blood sugar levels – getting the sugar out of the blood stream and into our cells.

When insulin levels are too high our cells can become less sensitive to it’s effects – leading to ‘insulin resistance’. This then leads to cravings for more sugar to meet the needs of our cells. And more insulin is released, and a vicious cycle ensues.

High levels of circulating insulin are associated with weight gain (especially around the belly). When you have excess insulin you can not burn fat as energy – your body will just demand more sugar to bring the insulin levels down. This makes losing abdominal fat almost impossible.

Serotonin

Serotonin is one of our feel-good neurotransmitters (along with dopamine and norepinephrine). When serotonin is out of balance symptoms of anxiety and depression are common. These emotions contribute negatively to weight loss by altering our motivation, drive, commitment and self esteem.

The depression associated with low serotonin leads to increases in inflammation and cortisol levels – both of which make it harder for our body to burn fat as fuel and lose weight.

Low levels of serotonin also decrease mood and lead us to crave foods that are rich in carbohydrates – a source of tryptophan, which our body uses to create serotonin.

Estrogen

Estrogen is the most common female hormone (although men have it too!) It is produced mainly in the ovaries but fat cells also produce large quantities of estrogen. High levels of estrogen, or “estrogen dominance” is as great a risk factor for obesity as having a poor diet or not exercising.

Estrogen balance is greatly impacted by our lifestyle and environment. Exposure to chemical estrogen-mimicking compounds, alcohol consumption, a high fat diet, lack of exercise and sleep deprivation can all lead to abnormally high levels of estrogen.

Hormones are incredibly important for our overall health, energy and metabolism.  If you are struggling to lose weight, or are stuck at a weight loss plateau, perhaps hormones are your issue.  Book a free 15 minute consultation now to discuss your options, and get your hormones back in 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.

Bitch Redux

In my work in women’s health I see a lot of conditions impacting the lady garden, endometriosis, PCOS, fibroids, cervical dysplasia, yeast infections and UTIs. But the one issue a lot of the women in my practice complain about is bitchiness. It might not be a medical diagnosis, but it impacts up to 80% of women at some point during their monthly cycle.

Women’s Emotions

Women have evolved to have immense sensitivity, and their emotional variations allow them to be more responsive to the environment, people and connections important to them.

Women are naturally more empathic and intuitive than men (of course acknowledging the great diversity of individual personalities). Women have always been the caretakers, the gatherers, the life-givers. Women rely more on social relationships for their survival, and the survival of their children and communities. Women have great emotional intelligence, because they need to be able to intuit and empathize with those around them – their children’s needs, their community’s goals, their partner’s intentions.

Women’s Brains

Women’s brains develop different to men, hardwiring us to feel more deeply, be more attuned to the emotional states of others, and be more reactive to the needs of those around us. At 8 weeks gestation, the testes become functional and the resulting surge of testosterone kills neurons in the communication centre of the brain. The testosterone instead develops more neurons for action, aggression and sexual drive – ultimately taking up about 2.5 times the space in men’s brains than women’s.

In women’s brains more space is allotted for language, hearing and memory. The memory center, the hippocampus, is larger in women, allowing those early female gatherers to remember where to find the food. The insula, thought to be the seat of self awareness, empathy, and interpersonal relationships, is also noticeably larger in women. This may lead to an increased intuition, or gut feeling, in women.

Women’s Hormones

Women’s hormones DO make them more moody. For women being fixed and rigid doesn’t lend itself to survival. Our emotionality is our strength – we may not be as physically strong as men, we rely more on our emotional connections and strength of connections, community and family.

Unlike men, whose hormone production spikes at puberty and remains fairly stable across their lifetime, women’s hormones ebb and flow over a monthly cycle and wax and wane over their reproductive years.

At the beginning of our menstrual cycle, at the onset of our bleeding, estrogen levels climb to prepare an egg for ovulation at midcycle. Estrogen production is strongly linked to serotonin production – and as estrogen goes up, so too does serotonin.

As estrogen continues to climb to the midcycle peak, most women note a positive mood state. During this time our biology encourages us to be more social, to connect to our tribe, more confident, to meet people and more alluring, to try to find a mate to conceive a baby with.

Estrogen acts as a stress hormone, or an anti-stress hormone. Making us more likely to brush off things that at other points in our cycle may provoke a significant response.

At midcycle estrogen levels are at their highest, along with dopamine and oxytocin. This encourages pro-social, trusting behaviour, and we are more generous and connected to others in our social network. We also talk more and are more interested in intimacy than at any other time of the monthly cycle.

Immediately after ovulation, our estrogen levels start to decline, but the rise in progesterone catches us before our moods crash. Progesterone doesn’t increase serotonin levels like estrogen does, but it supports GABA production, leading to a sense of calm and low anxiety that persists for about 10 days while progesterone levels are high.

All hell breaks loose during the final 3-7 days of the menstrual cycle however, with estrogen levels at a low, and progesterone levels steeply declining. Women during this time are more depressive, more cautious – a way for nature to keep us from harm during a time when we may be pregnant without knowing it.

The low estrogen also makes us less resilient, experience more physical pain, more emotionally sensitivity, and makes us more likely to react or respond to triggers that we would ignore during our high estrogen first half of the cycle. It’s not that we have more stress – we’re just way more likely to call it what it is and not stand for any shit.

Estrogen is essentially the “whatever you want honey” hormone – you are so much more willing to give to others and sacrifice your own needs when estrogen levels are high. But when those levels drop we are more likely to react and share our opinions – good or bad. It is not that we are reacting to things that aren’t really there – we’re reacting to things that upset or anger us – we just might ignore them at other times. If you feel underappreciated, overworked, or overwhelmed, or that you’re not in balance with your partner – it’s probably all true.

Bitch Redux

I want to encourage women to recognize the power in our hormonal fluctuations – our mood changes are adaptive – they help us seek out relationships, build connections, and preserve our energy. The mood changes that occur during our premenstrual phase are normal, and temporary. I want women to reclaim our natural hormone and mood fluctations, and be empowered by our emotions, rather than struggling against them.

My recommendation is to learn your natural fluctations and use your bitchiness as a superpower. Track your cycle – using any number of excellent free apps – and plan your month accordingly. Plan for presentations, meetings, anything requiring verbal skills for your first half of the cycle (the closer to ovulation the better! Your personality is magnetic when you’re near ovulation!) Have a task that requires fine motor skills – an intricate art project or rewiring your house? Keep that to the first half of the month as well.

Leave the tasks best left for your OCD-self for the last month of the cycle. I think most women probably read The Life-Changing Magic of Tidying Up during the last week of their cycle. So put “clean out the kitchen cupboards” on your list for the premenstrual week (maybe stay out of your closet though – many women feel less appealing during their premenstrual week and this could be a disastrous task.) Your pain tolerance is also lowest during your premenstrual phase – so skip the dentist or your tattoo appointment and get a mani-pedi or skin care facial instead.

Think of your PMS as a time to spend in reflection and personal contemplation. Your intuition is at its peak in the week before your period, so take time to do a mental health inventory – are you doing what you want? Are you where you want to be? Pay attention to the things you are critical about during your premenstrual phase – these thoughts are probably a lot more valid than you might want them to be. Write down the things that upset you/ anger you/ send you into a whirling passion of emotions and act on them in the beginning of the next cycle when you’re feeling energized and empowered again. Harness your bitchiness, it could end up being your greatest power.

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.