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woman sleeping without using medication

5 Unexpected Tips to Sleep Like a Baby (Without Drugs)

By | Blogroll

So many people struggle to get a good night’s sleep.  In fact, according to the American Academy of Sleep Medicine about 30% of Americans have problems sleeping! 

Sleeping pills are available from your doctor, but they have side effects.  You can develop dependence on the medication, and sometimes sleeping pills can cause complex behaviors like sleep-walking, sleep-driving and sleep-eating. Even though they may help you get to sleep (and some sleep is better than no sleep), the pills don’t give you a “normal” sleep – you don’t go through the various stages of REM sleep the way you would if you were sleeping naturally.

The vast majority of over-the-counter sleep aids typically contain an antihistamine, called diphenhydramine, which is the same ingredient found in Benadryl.  Occasional use is ok, but regular use can actually predispose you to dementia!

Other side effects from over the counter sleeping pills include:

  • Dry mouth
  • Drowsiness
  • Dizziness
  • Trouble peeing (or not being able to pee)
  • Blurred vision
  • Confusion (in older adults)

So you can see that relying on medicines to help you to sleep isn’t the greatest longterm answer.

So what can you do????

 

Woman with insomnia because of perimenopause

 

5  tips to help you sleep like a baby 

  1. Melatonin – This is a hormone that naturally signals the body to sleep.  When you are exposed to light at night, your natural melatonin production is suppressed.  It is ok to try melatonin (0.5-3mg) at bedtime to see if this helps your sleep.  It is especially food for shift workers who have unusual sleep schedules and also for  jet lag.
  2. Blue blocker sunglasses – Blue light waves at night are especially prone to shutting off melatonin.  You are exposed from light bulbs, electric clocks, computer screens, the TV and your cell phone.  You can turn on the  “night shift” setting on your phone and computer to help reduce the blue light they give off.  And please do your best to stay off screens in the evening.  In addition, you can wear blue-blocker sunglasses, which filter our the blue light waves.  Just wear them around your house after the sun goes down, and you’ll likely find that it is easier to fall asleep and you’ll get a better quality of sleep.  (Fun fact:  campfires, fireplaces and candles don’t give off much blue light)
  3. Light therapy.  In addition to avoiding blue light at night, another great idea is to get natural sunlight in the morning!  This helps your brain know that it is daytime, so you can be more alert, and also helps set your natural day/night circadian rhythm (which gets pretty mixed up in our modern world).  In the winter, when morning sunshine is harder to come by, you can use a light box in the morning for 10-15 minutes while you drink your coffee.  This type of lamp gives off full spectrum light (like the sun) to help reset your circadian rhythm (and help you sleep at night).  Another helpful side effect, is that the lamp can help prevent seasonal affective disorder.
  4. Weighted Blanket – This type of blanket is filled with glass or plastic beads, so it feels heavy and provides gentle pressure, like being held.  It helps to cut down on tossing and turning, and many people report having better quality sleep (although we don’t have much research on this just yet).  The weight of the blanket should be about 10% of your body weight, so if you weight 150lbs, you should choose a 15 pound blaket.  This is not recommended for small children due to concern about suffocation.
  5. Cooling mattress pad – This one could save marriages!  In my house, my husband likes arctic temperatures, but I’m freezing and miserable.    You can get a mattress pad that is temperature controlled (it can warm OR cool). It’s possible to cool one side of the bed, and leave the other alone.  Yay! No more fights over the thermostat!  While this is a great idea, it is expensive (there are different brands available, and they are typically hundreds of dollars).  But cheaper than a divorce ;-)

Sleep is important!

Your brain heals at night, and lack of sleep is a major promoter of weight gain and chronic disease.  Getting a good sleep is very important to your health!  A couple of other quick tips:

Hormone problems commonly cause sleep problems.  Thyroid issues, perimenopausal and menopausal hormone changes,  and cortisol problems can all prevent you from sleeping soundly.   Balancing your hormones can be an important way to get back to sleep.  

Keep electronics (especially those with WIFI) out of your bedroom.  Mounting evidence suggest that electromagnetic frequencies from these devices may interfere with sleep in some people.  You can turn off your router, put your phone on airplane mode overnight, or just keep them out of your room altogether.

If you have sleep apnea, none of these suggestions will be completely successful.  It is very important to get a diagnosis and the proper treatment.  If your spouse tells you that you snore or stop breathing periodically in the night (or if you have any suspicion at all) please get tested.

 

 

Hope these tips were helpful!

Sleep tight!

Dr Deb

Overweight woman with hormone problems

Could this common hormone problem (PCOS) be causing your weight gain?

By | Blogroll

September is PCOS awareness month!

PCOS (polycystic ovarian syndrome) is the most common female hormone disorder, and affects about 1 in 10 women.

If you have PCOS, you’re in good company!  So do:

Fitness expert Jillian Michaels, from The Biggest Loser

Actress and singer, Lea Michele from Glee

Spice Girl and fashionista, Victoria Beckham

But many women who suffer with symptoms of PCOS have no idea!  (Many women have never even heard of it!)

Here are the five most common symptoms of PCOS

Acne – Many teenagers struggle with acne, but in PCOS it doesn’t go away just because you’re grown up.

Excess hair growth in places you don’t want it! (Like on the face and chest).  For some women this is because of their ethnicity, but sometimes PCOS is the cause.

Loss of scalp hair – While breaking out in pimples and having to wax a mustache may start young (in the teens or 20s) the hair loss becomes more noticeable later – in the 30s and 40s.  Hair loss is on the crown and temples, like in male pattern baldness.

Weight gain – not everyone with PCOS is overweight, but about 70% are.  Women with PCOS have a harder time losing weight and keeping it off.

Irregular periods – PCOS can cause infrequent periods (or no periods at all!) or you can get your period more often (even every couple of weeks).  Periods can be light and short or heavy and last a week or longer.  But predictable, “normal” periods are elusive for most women with PCOS.

Despite the name, you don’t have to have a history of ovarian cysts to have PCOS.  But often on an ovarian ultrasound, your gynecologist will see small cysts in your ovaries.  Sometimes you can develop a large cyst that ruptures and is very painful (you may think you have appendicitis, and you may even go to the emergency room because of the pain).  But many women with PCOS never have this experience.

What causes PCOS?

PCOS is a condition caused by hormone imbalances.  There is a genetic component (if you mom had PCOS, you have a greater chance of developing it as well).

The main underlying problems are

  1. Too much testosterone – your ovaries produce too much testosterone (and related “androgen” hormones, like DHEA) that result in the acne, hair growth, and male pattern hair loss.
  2. Insulin resistance – insulin is the hormone that regulates your blood sugar.  In PCOS, your cells don’t use insulin properly, so you have to make more in order to get your blood sugar controlled.  Excess insulin is a problem because it is the “fat storing” hormone – hence the weight gain.  Women with PCOS have a significant risk of developing full blown diabetes in the future.  More insulin also triggers more testosterone production
  3. Ovarian dysfunction – a major problem in PCOS is that you don’t predictably ovulate.  The ovaries don’t release an egg every cycle.  If the egg isn’t released, that can result in a cyst forming.  Lack of ovulation also leads to the irregular periods (often no periods at all for long stretches, even years!).  Because you aren’t ovulating regularly, it can be more difficult to get pregnant, and you may need some help (we’ll talk more about this coming up).

This is a complex hormonal situation. Too much insulin causes you to make more testosterone.   Too much testosterone triggers you to make more insulin, and inhibits ovulation.  When you gain weight, because of the insulin, your body fat cells release inflammation compounds that make you more insulin resistant (so you have to make MORE insulin).  It’s a vicious cycle! 

Other possible complications of PCOS…

Women with PCOS have increased risks for other health conditions.

Gestational diabetes

Miscarriages

Metabolic syndrome (high cholesterol, high triglycerides, high blood pressure, high blood sugar and obesity)

Sleep apnea

Type 2 diabetes

Fatigue

Anxiety and depression

What can be done for PCOS?

The first step is to see your doctor to confirm the diagnosis.  There are blood tests that can be done to look at your hormone levels, and sometimes an ovarian ultrasound may be done to look for cysts.

Traditionally, women with PCOS end up on a lot of prescription medicines.

Birth control pills can regulate your periods and (since the block some of your testosterone) they also decrease acne.

Metformin is a diabetes medicine that helps control blood sugar.  It can help you to reduce the amount of insulin you produce, which may help stabilize your weight. 

Spironolactone is a blood pressure medicine that also acts as a testosterone blocker.  It can help reduce acne and facial hair growth.    

Clomiphene (Clomid) can help trigger ovulation, when you are ready to start your family.

The problem that I see with these prescription medicines, is that they are all trying to minimize your symptoms (which is great!) but they aren’t really fixing the underlying problem.

Many women have irregular periods as teens, and get started on birth control pills to regulate their period.  They stay on the pill for years, until they are ready to start their family, only to find that they don’t get their period (or at least not regularly) and they have a hard time conceiving. 

Are there any natural options?

Healthy lifestyle habits can help balance your hormones!

Exercise – regular exercise is very helpful for everyone, but especially for women with PCOS.  Studies have shown that women with PCOS who exercise regularly have more regular ovulation.  Exercise helps your cells use insulin more effectively (so you don’t have to make as much).  As your insulin level goes down, there will be less stimulation of testosterone production.  And of course exercise can help you lose weight!

Reduce stress – when you have stress, your body will make more cortisol (your main stress hormone) to help you cope.  Cortisol causes more problems with insulin.  It also causes you to gain more weight (especially on your belly, and belly fat is especially prone to releasing the inflammatory compounds that make insulin resistance worse) – so even more weight gain!

Healthy diet – we all know we should eat healthy.  For women with PCOS, healthy foods can be a game changer.  Because of the blood sugar problems, a low carb diet is especially helpful.  Avoid starches, like bread, pasta, rice, and potatoes, and instead focus on non-starchy veggies, fruit in moderation, healthy fats (like avocado, olive oil and nuts), and healthy protein, like fish.  Because PCOS is a permanent problem, going on a short term weight loss program isn’t going to permanently fix the problem.  Being too strict with your nutrition is unsustainable.  You don’t have to be perfect.  But watching the sugar and junk food in your diet, and eating a diet lower in carbs is really important to help you feel your best.

Lose weight – losing weight is harder for women with PCOS because your hormone pattern wants to cause weight gain.  But its not impossible!  And the good news is that even just losing 5% of your body weight can lead to very significant improvements in your hormone balance and in your symptoms!

Avoid toxins – we are all exposed to toxins on a daily basis.  Our liver helps us to flush the  chemicals from our system.  It appears that women with PCOS are “poor detoxifies”, meaning that your liver and other detox pathways don’t work as well.  Toxins can accumulate in your body and cause you to have problems, where your next door neighbor may be exposed to the exact same toxins and seem completely fine.  Many of these toxins are hormone disrupters (meaning that they interfere with how your hormones work, and since your’s weren’t doing their best in the first place, this can cause big problems. 

Do your best to avoid exposure to unnecessary chemicals by trying to use “green” cleaning supplies, look for healthier options for personal care products (especially avoid products containing parabens), and try to avoid the use of plastic (for example use glass or stainless steel water bottles instead). 

Nutritional supplements for PCOS

Myo-inositol is a nutrient that has been shown in medical studies to help improve blood sugar and increase ovulation

Berberine is an herbal supplement that helps regulate blood sugar and cholesterol (as well as helping to balance the healthy bacteria in your gut)

There is hope!

If you have PCOS, becoming informed and an active participant in your health is important.  A good resource is the book PCOS SOS, by Dr Felice Gersh, who is an Integrative Gynecologist (and has PCOS herself).   

We see women everyday who are struggling with their symptoms, but it is possible to overcome the challenges and thrive!  

Yours in health,

Dr Deb

Dealing with PMS

Feel Like the “Wicked Witch of the West” Each Month?

By | Blogroll

PMS causing problems?

 I hear ya sister.   Most of the month you’re nice.  You try to be kind, and be a good person (maybe you don’t ALWAYS succeed, but you try!)   And then once a month, something happens.   (Your hormones…and PMS!)

You get so aggravated with that lady in line in front of you at the grocery store who is taking FOREVER to find the coupon at the bottom of her purse.  Its hard to stop yourself from telling her what you REALLY think…..

You lose your mind over things that SEEM like a big deal in the moment, like the old man driving 40 in a 55mph zone.

You lose patience with those ungrateful beings who call you mom.  I mean, how many times should you have to ask a teenager to take out the trash before it is considered perfectly justifiable to damage his eardrums with your shrieking.  (As if he can hear you anyway with those darn earbuds in his ears….)

As you pick up dirty socks from the bedroom floor and find the empty milk carton in the fridge you wonder why in the world you ever picked this man to be your husband.

And some days you don’t even like being around yourself!

Then you start your period and go back to your normal self …

You feel like exercising!  You find yourself chopping vegetables to make healthy meals!  You are motivated to clean out your closets! 

The grocery store lady doesn’t bother you (after all, you have a big purse too, and you know what it feels like when you can’t find what you’re looking for…) 

You get stuck behind the slow driver and think “bless his heart”. 

You recognize that you have good kids!  You actually like your hubby! (After all, he is a good guy!  THAT’S why you married him!)

This is NOT normal!

If you have one bad PMS day a month, you’ll probably be able to deal with it.  But it becomes a real problem when hormone imbalances cause your PMS symptoms to stretch to a week or more, and to affect the people around you – like your family, friends and co-workers.

Hormones are pretty powerful!  They affect how you relate to other people, how you react to the world around you and who you are on the inside!  When your hormones are out of whack, it is NOT pretty!  And this is NOT normal!  The good news is that you don’t have to be held hostage by your hormones any more!

Simple tips to help!

Here are some simple tips to get your hormones back into balance and reduce PMS:

  1. Eat a healthy diet

    A whole food diet rich in fruits, veggies, and healthy fats (like avocados and olive oil), contains the nutrients you need for healthy hormone balance. On the other hand, processed foods, which have few nutrients and lots of additives, are a sure-fire way to throw your hormones out of whack.  Sugar is one of the worst offenders for creating hormone havoc.  The younger you are, the greater the chance that dietary changes will help you!  Once you’re over 40, diet is still important, but there may be other hormonal factors that need to be addressed as well to solve your PMS problems.healthy diet with fruits and vegetables

  2. Exercise regularly

    Exercise is a great way to help balance your hormones.  The good news is that you don’t have to run a marathon – regular moderate exercise goes a long way.  Even gentle exercise like yoga and walking can help.

  3. Reduce stress

    Stress is a huge cause of hormone problems and PMS in women!  (See – you knew it was your teenagers fault!)  When you are under stress, cortisol levels go up (this is the hormone that helps you cope with stress).  Cortisol regulates your other hormones, so when you have a problem with cortisol, it can create a whole bunch of other problems, including PMS.Woman meditating to reduce stress

  4. Add some natural progesterone

    Progesterone is an important hormone that helps regulate your menstrual cycles and prevent PMS.  It is a calming hormone, which helps you feel more relaxed and sleep more soundly.  If you aren’t naturally making enough progesterone the week before your period, you’ll have more mood symptoms.  You may feel more anxious, irritable, impatient, critical, easily frustrated..… (sound familiar?)

  5. Have your hormone levels tested!  

    Common hormone issues that lead to PMS can include too much estrogen, not enough progesterone, problems with cortisol, and thyroid problems.  Many doctors aren’t really interested in testing your hormones, and will just recommend an anti-depressant or birth control pills.  The problem is that the medications are just putting band-aids over your symptoms and aren’t really addressing the root cause of the problem.  You may need to find a Functional Medicine doctor to help you get the tests you need, and the solutions you’re looking for.

If any of this sounds like you, please don’t continue to suffer.  Trust me – your kids, spouse and co-workers WANT you find a solution! 

I’ve written a book to help you understand more about this,  called “This is NOT Normal, A Busy Woman’s Guide to Symptoms of Hormone Imbalance”.  It’s a quick read, with checklists and tips for what to do.  There is even info about how to find a doctor to help you. 

If you want to learn more you can find it on Amazon, or you can download the ebook for FREE at www.IsItYourHormones.com

Wishing you balanced hormones and optimal health!

 

Dr Deb

 

fish oil

Is taking fish oil a waste of time?

By | Blogroll

It can be hard to know what to do.  One week, you hear a report saying that taking fish oil is good for you.  The next week, there’s a report saying it doesn’t make a difference.  Occasionally, you may even hear a report saying people were worse off when they took fish oil!  So what are you supposed to think?

Let me help you understand more about omega 3s and the problems with how the research is done.

Why are Omega 3s important?

Fish oil contains omega 3 fatty acids which are important to the health of your cells.  These fats are naturally anti-inflammatory and are important for your brain, your immune system, your hormones, and more!

We know that omega 3s are important.  We know that when you eat more foods rich in omega 3s (like wild caught fish) you reduce your risk of chronic disease.  The question is, can you get the same benefits from taking a fish oil supplement.

Does the research support fish oil supplements?

Here’s where the problems come in.  Medical doctors don’t do a good job of researching nutrition and nutrients.  They treat nutritional supplements like drugs. 

When we’re studying a drug, the same dose of drug is given to one group of people, and a placebo pill is given to a second group of similar people  Then we sit back and look at predetermined factors (like whether there was a difference in the number of heart attacks or deaths).

Nutrients work differently than drugs

When nutrients are deficient, they typically cause long-latency diseases, which means that it takes many years for the problems to develop.  So giving a supplement for the short term and looking for changes may not be helpful.   

Some people may not be deficient in the nutrient, so adding more of it may make no difference. 

Some people are very deficient, so taking one fish oil pill may not be nearly enough to make a difference – they’re now only slightly less deficient.   

I’m not even going to get started on the problem of knowing the quality of the fish oil capsules – poor quality fish oil obviously isn’t going to result in much benefit.

BUT if we design research studies like our nutritional science colleagues, we often see very different outcomes! 

Here is an example

This week I saw a study looking at omega 3s and heart failure. 

  • 73.1% of patients with heart failure had low omega 3 levels!
  • 22.4% had “marginally sufficient” levels
  • only 4.5% had levels in the heart healthy range 

They adjusted for all kinds of risk factors, like smoking, diabetes, etc and found that the lower the omega 3 levels, the higher the risk for heart failure.

According to the study authors,  the typical fish oil dose used in medical studies would only be expected to raise the omega 3 level from “insufficient” to “marginally sufficient”. 

In other words, the typical dose  used in medical research is not nearly enough to get to a protective level.  It’s not surprising that many studies don’t show much benefit!

So what SHOULD be done instead?

We should measure omega 3 levels, prescribe a dose to get the level in the optimal range and THEN see what the outcome is.  (Doesn’t this just make sense?)

Doctors should know better, but the reality is that we’re not taught nutrition (and certainly not taught how to evaluate research on nutrients). 

What do doctors think?

Many doctors are frustrated and jaded, because they are confused by the inconsistent research findings (just like you!).  For many, it is easier to just NOT recommend supplements, and stick with the drugs that they feel comfortable with.

As a patient, you are caught between the ads telling you to buy fish oil capsules, and the doctors who think that supplements generally don’t work.  Unfortunately, you’ll have to become educated and be your own advocate. 

fish oil capsules

How can you know what to think? 

Next time you hear a report about fish oil (or Vitamin D, or probiotics, or whatever) here are some points to consider.

If the study says the supplement had benefits,  we don’t have to be as suspicious (although we should still keep an open mind).  It’s easier to prove that something works than to prove something doesn’t work.

If the study says that the supplement had no benefit we need more information.

1.  Did everyone get the same dose?  Logically, the standard dose may be unnecessary for some people (who are already have enough of the nutrient) and not nearly enough for others, so even if some people DID get a benefit it won’t show in the statistics.

2.  Did they simply do a questionnaire, such as asking people “over the past 5 years have you been taking a fish oil supplement?”.  You can imagine that this is wildly inaccurate – What type of fish oil?  What was the quality of the supplement?  What dose?  How regularly was it taken?

3.  Did they measure blood levels of omega 3s (or Vitamin D, etc), give a personalized dose, then re-measure to make sure each person was in the therapeutic range and THEN see what the results were?  These are really the only studies that we should trust. 

You will almost never see this type of study done by medical doctors, because this is not how drug studies are done (since there aren’t any “normal” levels of drugs in our bodies).   

These studies ARE done routinely by human nutrition scientists, but they are published in nutrition journals (that medical doctors don’t read.)

Most doctors are not experts in nutritional supplements….

So now you understand why there is so much controversy over supplements.  Most of the problem starts with the lack of training that physicians receive.  They simply “don’t know what they don’t know.” (I am speaking from personal experience here!). 

Even though you’re always told to “ask your doctor” about supplements, please know that your doctor’s advice may not be any more accurate than the research they are basing their opinion on.

Here are some facts 

Omega 3 fatty acids are very important for hormone health, brain health (especially fetal brain development), heart health, eye health, skin health, immune system health, and more!  These facts are not in question.  So wouldn’t you prefer to have sufficient amounts in your body?

Omega 3s are hard to come by in our modern food supply.  This fact is also not in question.  You can get omega 3s in foods like wild caught (but not farm-raised) fish, ground flax seeds, and walnuts.  These are foods that the average America simply doesn’t get enough of. 

What can you do?

Get your blood level of omega 3s tested.  Your regular doctor may not agree to do this.  The test is available, but they aren’t trained on how to order the test or how to interpret the results.  You may need to find a Functional Medicine doctor to help you get the test done.

  • If your level is optimal, then continue to eat a healthy diet including foods containing omega 3s, like wild caught fish, walnuts and ground flax seeds. 
  • If your level is below optimal, then eat more omega 3-rich foods in your diet and consider adding a fish oil supplement.  Several months later, repeat your lab test to see if your level is now good. 
  • If you have an inflammatory health condition, like heart disease, arthritis, or an autoimmune disease, you may want to add a fish oil supplement even if your omega 3 level is good.  Omega 3s are naturally anti-inflammatory and may help reduce your symptoms, and possibly reduce your need for prescription medications.  This is the part that is still controversial.  At a minimum, if you have one of these conditions you want to make sure that you are aren’t deficient in omega 3s!

Many (most?) Americans have insufficient omega 3 levels.  This may be a topic of controversy among doctors, but let the doctors argue with each other about population statistics and simply get YOUR level tested.  Then you’ll know whether taking a fish oil supplement is worthwhile for YOU!

Yours in health,

Dr Deb

PS – If you’re one of our practice members and want your omega 3 level tested, we can help with that (just call or message us in the online portal)

frazzled perimenopausal woman pulling her hair

Are You In Peri-menopause?

By | Blogroll, Hormones, Women's Health

I often get asked, “How can I know if  I’m in peri-menopause?”  It seems like a simple question, but the answer is not so straightforward!

What exactly is peri-menopause anyway? 

Before you go through menopause, there is a period of time (up to 10 years!) where things start to change.  The changes can be subtle or not so subtle.  We call this phase of life “peri-menopause”, and it can be one of the most difficult transitions in a women’s life. Often women are told that they are too young to be in peri-menopause.  Sadly, some women are told to tough it out and that it will pass.

Addressing the hormonal symptoms of peri-menopause can dramatically improve quality of life for many women.  Let’s talk about what is going on.

Estrogen and progesterone levels are changing…

Estrogen levels usually start to decline around menopause (average age of menopause is 52), but progesterone levels start to decline much earlier!  In fact, progesterone can decline by as much as 80% during the decade of your thirties, so it is common to have relatively lower progesterone levels in your forties.

When progesterone levels start to decline because of age, and symptoms of hormone imbalance become noticeable, we call this “peri-menopause”.   Later, when estrogen levels also start to drop, symptoms can become even more problematic.

How will you feel when you’re in peri-menopause?

 Because progesterone levels naturally vary over the menstrual cycle, the symptoms vary as well.  

Typically the week after a period is the “good” week; you’re eating your broccoli, exercising regularly, and cleaning out your closets.  Then as you get closer to your period, symptoms get worse – including irritability, anxiety, and interrupted sleep. You may feel more negative, critical, impatient, and easily frustrated – and this can affect how you behave towards your family, friends and co-workers!

Progesterone is a natural anti-anxiety compound, helps with sleep and is calming – sort of like nature’s version of valium or a glass of red wine.  So if you don’t have enough, you may not feel like your best version of yourself during that time in your cycle.

This variation in symptoms is a big clue that hormones are the problem.  If your mood symptoms or insomnia are exactly the same every day in your cycle, it is less likely that hormones are the cause.

What symptoms can you expect in peri-menopause?

Here is a checklist of symptoms that you may experience if your progesterone levels are declining:

  • Insomnia (especially wakening in the night)
  • Night sweats
  • Anxiety
  • Irritability
  • Mood swings
  • Weight gain
  • Increased PMS
  • Pre-menstrual headaches
  • Heavier periods
  • Shorter cycles (periods coming less than 28 days apart)

Are there lab tests to tell if you’re peri-menopausal?

A blood test called FSH (follicle stimulating hormone) can be done.

When you’re pre-menopausal your FSH level will be quite low (often in the range of 2-10).  When your ovaries are no longer functioning their best, your FSH level will increase (typically women who are postmenopausal will have FSH levels above 25, and even over 100).  If your FSH level is starting to go up, you’ll know that you are peri-menopausal.

Your doctor may tell you that you’re “menopausal” if your FSH is over 25.  This causes so much confusion!  Technically, you are menopausal once you go for 12 months without a period.  Often FSH levels go up in the “menopausal” range several YEARS before you stop having a period. 

So if you are still having periods, you technically aren’t menopausal (even though your FSH is in the menopausal range), you are peri-menopausal.  Your FSH level doesn’t tell us exactly what is going on with your estrogen and progesterone levels,  just that ovarian function is changing.

What if you don’t have a period, but still have functioning ovaries?

Here’s where things get even more confusing.  Some circumstances where you may not have periods but still have functioning ovaries include:

  • You’ve had a partial hysterectomy (your uterus was removed, but you still have at least one ovary)
  • You’ve had an ablation (a uterine procedure that may stop you from having a period)
  • You have an IUD

If your ovaries are still producing estrogen, then you aren’t technically menopausal even though you haven’t had a period for at least 12 months – see how confusing this gets!  But you certainly could be peri-menopausal.  We’ll mostly need to go by symptoms to tell, and an FSH can be helpful.

Do you have to put up with the symptoms of peri-menopause?

No!   

If you are having symptoms and would like help, the first step is to have your hormones measured.  This is another thing that sounds easy, but turns out not to be so simple.

If you ask your primary care doctor or your gynecologist, they will typically be happy to order the FSH level, but do not typically order estrogen, progesterone or testosterone levels.  If you push, you may be able to convince them, but it’s very important that the hormone levels are checked at the right time of your menstrual cycle.  We want the levels done approximately day 19 of your cycle (day 1 is the first day of your period).  Since hormone levels fluctuate over your cycle, the timing of the test is very important. 

If you aren’t having a regular period, you can try to guess when your next cycle will be or just do the test anytime if things are completely unpredictable.  Your hormone levels will be very different if the test is done while you are on a period, the week after a period, or right at ovulation.  So you can see it’s not so simple, and the test results will need to be interpreted properly.

Another problem with having your primary care doctor or gynecologist order the test, is that they’re going to look at the “normal” range from the lab.  You are almost certainly going to land somewhere in the normal range, because the range is very wide, and mostly developed to identify things like tumors (which you almost certainly don’t have).  It can be very frustrated to work hard to have the test finally done, only to be told that everything is normal!  If it is normal, why do you feel so bad?

A Functional Medicine doctor can do a more comprehensive hormone panel to look at your sex hormones, and the other hormones that influence them, like thyroid and cortisol (your stress hormone).  Hormone levels can be measured in blood, urine, and saliva, and the best test for you depends on your personal history and circumstances.   

How can you get your hormones back into balance?

Depending on your test results, you may benefit from trying some natural progesterone.  Progesterone can help you sleep soundly, feel more relaxed and prevent PMS symptoms.  It can also help regulate your cycles, reduce night sweats, and helps reduce breast cysts and tenderness.

It’s important to use the natural, bio-identical progesterone (an exact match to  your body’s own progesterone).  There are many synthetic drug forms of progesterone (called progestins) that are used in things like birth control pills.  These are man made chemicals that are never naturally found in a woman’s body.  They can help prevent a pregnancy, and may help with things like menstrual problems, but there are health risks associated, like blood clots.

What are other natural treatments for peri-menopause?

You also want to consider your nutritional status, stress levels, and lifestyle habits, as these affect your hormone balance.  Many common chemicals are hormone disruptors, so it is important to gently flush these toxins from your body so your hormones can do their job.  If your symptoms are mild, making some lifestyle changes may be all that you need to get back to feeling great!

Don’t be held hostage by your hormones for one more day!

If you think that you may be in peri-menopause, and are having symptoms that are interfering with your health or quality of life, please know that help is available.  You don’t have to suffer! Together we can get you back to feeling like the best version of you again, because you deserve to LOVE the way you feel!

Yours in Health!

Dr Deb

PS.  Here are some ways you can learn more:

  1.  You can find more information at our website www.signaturewellness.org
  2. You can read my book, This is NOT Normal, A Busy Woman’s Guide to Symptoms of Hormone Imbalance.  It’s available on Amazon.
  3. If you are in the Charlotte area you can come to one of our FREE informational dinner seminars.  Call the office for details about our next seminar and to RSVP 704-752-9346
  4. If you would like to learn about becoming a patient you can contact the office to talk to one of our patient care coordinators about how we may be able to help you.  Call at 704-752-9346,  email us at questions@signaturewellness.org, or contact us online here: https://local.demandforce.com/b/signaturewellnesscharlotte/schedule
Menopausal Lady with Fan

Scared That Estrogen Replacement Will Cause Breast Cancer? Lets Talk….

By | Blogroll

Worried about the risks of hormone replacement therapy?

You’ve probably heard that hormones cause breast cancer, which is pretty scary. The truth is estrogen  does NOT increase breast cancer, and for most women the benefits of estrogen replacement far outweigh the risks! 

Without hormone replacement, you are at risk for symptoms like hot flashes and vaginal dryness, but that is just the tip of the iceberg. There is a long list of other symptoms that you may not even connect with menopause, including fatigue, depressed mood, irritability, poor sleep, bad memory, changes in your hair, your skin, your sex life and the shape of your body!   These problems don’t just affect you – when you’re not at your best it can affect your relationships, your work performance and your quality of life! 

Many women put up with menopausal symptoms because they are afraid of the risks of hormone replacement. Sadly the risks of estrogen have been over-stated, mis-construed and mis-understood resulting in unnecessary suffering.

Did you know that consistently, across many studies, estrogen replacement has been shown to DECREASE the risk of breast cancer?  That is not a typo, I did mean to say decrease (as in lower, reduce, diminish…).  Estrogen has also been shown to reduce the risk of heart attacks and death!

But wait a minute, how many times have you heard that it increases risks?  How can this be?Lets go through the research and you’ll see for yourself.

The Women’s Health Initiative Trial (WHI) Started the controversy

The Women’s Health Initiative Trial (or WHI) was published in 2002.  Prior to this study there were many studies (done over many years) that showed many benefits of estrogen, including protecting your heart, brain and bones.The WHI found that women on hormones had an increase in the risk for breast cancer, and turned everything we knew about hormone replacement on its head.  Millions of women (and their doctors) suddenly saw hormones as dangerous and something to be avoided.  But was this interpretation accurate?

The WHI was a very large, expensive study in which women were given estrogen replacement. The estrogen they used was derived from the urine of pregnant horses, and was not bio-identical, meaning it wasn’t exactly the same as the estrogen that your ovaries make.Some women also got a synthetic form of progesterone (“progestin”).It turns out that the progestin was the real problem but for now, lets focus on estrogen, since that’s the hormone that got a bad rap.

Here is what we know

Estrogen is good for your bones (it helps reduce the risk of osteoporosis) and is the most effective therapy for hot flashes.  These facts are not in question.  But why are we so scared of estrogen?

Here is what the WHI results showed:

Women who started estrogen replacement (ERT) between age 50-59 had LESS Heart disease, LESS strokes, LESS breast cancer, and LESS risks of death.

Women who started ERT between age 60-69 had LESS heart disease and LESS breast cancer, but they had a slightly increased risk of blood clots and stroke.  There was no increase or decrease in overall deaths.

Women who started ERT between ages 70-79 had  increased blood clots, stroke and heart disease, and increased overall mortality, but STILL no increase in breast cancer. 

Did you catch that?  There was no increase in breast cancer (in fact for women under 70 there was LESS risk).   This data is from the same WHI study that trumpeted all over the news that hormones increase breast cancer!

So why does everyone “know” that hormone replacement causes breast cancer?

Here’s where that message came from…    

Women in the study were divided into 2 groups.One group of women had previously had a hysterectomy, and they received estrogen (ERT) with the results we saw above (no increase in breast cancer).

The other group of women still had their uterus, so they were give progesterone to protect their uterus from the effect of estrogen replacement. The pill they were given contained a synthetic version of progesterone (a “progestin”) which is not bio-identical (not the same as the progesterone their ovaries used to make) and this group of women had a slight increase in breast cancer rates. 

Sometimes  numbers can seem worse than they are….

The media proclaimed that the WHI found a 26% increase in breast cancer in women on hormone replacement (remember this was only true in the group of women taking synthetic progestins).While it sounds pretty scary, this doesn’t mean you have a 26% chance of getting breast cancer.In absolute numbers, for every 1,000 women taking estrogen/progestin there was 1 extra case of breast cancer (0.9 extra cases to be exact). I’m not recommending the use of synthetic progestin, but 1 extra case per 1000 women doesn’t sound like a huge increase in the risk.In fact the numbers were re-examined several years later and not found to be statistically significant (in other words, the slight increase in this group of women could have just been due to chance)

Other studies have shown that if estrogen is given with bio-identical progesterone (the same form of progesterone as your ovaries used to make) there is NO increase in the risk of breast cancer.

Hormone replacement has important benefits!

Lets look at some of the studies that showed the benefits of hormone replacement.

  • A Danish study of 1000 women found a 50% reduction in heart attacks, heart failure and death in women on hormone replacement.Women on estrogen only (the ones without a uterus) had a decrease in breast cancer, women on combined estrogen/progestin had no increase in breast cancer.In total, 26 women in the control group died, compared with 15 women on HRT = 42% reduction in the risk of death in the women on hormone replacement.

Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial.BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e6409

  • Researchers in Finland looked at the effect of estradiol (bio-identical estrogen) on longterm health in postmenopausal women.Almost half a million women were studied.The results were pretty convincing. Risk of all cause mortality (death from ANY cause) was reduced by 12-28%;  the longer the women used the hormones, the lower their risk of death.In absolute numbers, there were 19 fewer heart disease deaths and 7 fewer stroke deaths per 1000 women using hormone replacement for at least 10 years.

Menopause. 2015 Mar 23.

  • “Over-interpretation and misrepresentation of the WHI findings have damaged the health and well-being of menopausal women by convincing them and their health professionals that the risks of HT outweigh the benefits.”

Climacteric. 2014 Jun;17(3):215-22.

  • “For healthy women aged 50-59 years, estrogen therapy decreases coronary heart disease and all-cause mortality”

Climacteric. 2014 Oct;17(5):540-56.

  • “Breast cancer risk increased marginally with estrogen/progestogen therapy, related to duration of use, but with estrogen-alone therapy, breast cancer risk decreased significantly, as did mortality. For younger women receiving estrogen alone, there is great consistency between all randomized trials, including the WHI and observational data showing a coronary benefit and a decrease in all-cause mortality.”

Climacteric. 2014 Dec;17 Suppl 2:12-7.

  • “In this paper, we review data supporting the use of HT administered to postmenopausal women, showing it to have more benefit than risk for symptom control, prevention of bone mineral loss and fracture, and improvement of the metabolic profile in women who began HT when they were less than 60 years of age and had their last menstrual period less than ten years previous. In hysterectomized women treated with estrogen only, a reduction in breast cancer risk was noted in all age groups

J Steroid Biochem Mol Biol. 2014 Jul;142:4-11.

  • “Unlike oral estrogens, transdermal estradiol has been shown not to increase the risk of blood clot or stroke, and to confer a significantly lower risk for gallbladder disease. Unlike some progestogens, [bioidentical] progesterone is also not associated with an increased risk of blood clot, or with an increased risk of breast cancer.

Climacteric 2012;15(Suppl 1):3–10

And here is one more study…

This study shows just how much harm we have done by unnecessarily misinforming (and scaring) women and their doctors. It is pretty shocking….

  • A Yale study found that estrogen therapy was associated with a reduction in deaths from heart attacks and breast cancer in women aged 50-59 who had had a hysterectomy. The authors estimated that 90,000 women have died because they did NOT continue to take hormone replacement therapy after the WHI study was published.

The Mortality Toll of Estrogen Avoidance: An Analysis of Excess Deaths Among Hysterectomized Women Aged 50 to 59 Years. Sarrell et al American Journal of Public Health: September 2013, Vol. 103, No. 9, pp. 1583-1588.

The facts….

Hormone replacement has important benefits for women. There is no need to suffer with symptoms of hormone imbalance due to fear! Empower yourself with information, and you can feel like yourself again! 

If you have questions, please call to talk to a member of our team at 704-752-9346 or email us at questions@signaturewellness.org. You deserve to LOVE the way you feel!

Tired lady holding coffee cup

Feeling tired and sad? It might be the “Winter Blues” (Seasonal Affective Disorder)

By | Blogroll

The winter months bring shorter days, less sunlight and more gloomy weather.  Have you noticed that you feel tired or sad?  Are you craving carbs? Have you stopped doing activities you usually enjoy?  If so,  it could be Seasonal Affective Disorder, aka SAD.

What can you do about Seasonal Affective Disorder?

Actually there are many simple and inexpensive ways to feel better.

  1. Light therapy: Sitting in front of a full-spectrum light box for 30min a day in the morning can improve symptoms of SAD in as little as a few days. They emit light similar to the sun and can be easily purchased without a prescription.  Try typing in “full spectrum light” on Amazon and many options will pop up. Light therapy can boost your energy, perk up your mood and help you sleep better!
  2. Vitamin D: Also known as the ‘sunshine vitamin’, over 70% of the US population is estimated to be deficient in Vitamin D! You can get some from eating foods like eggs and salmon, but the majority of Vitamin D is made in your skin in response to sunshine.  Most people need to take an extra Vitamin D supplement of at least 2000IU, especially during the winter months.  Your doctor can measure your vitamin D level in a simple blood test so you can make sure you are getting enough.
  3. Exercise: Endorphins and serotonin are chemicals in the brain that make you feel happy.  They are released when you exercise, so going outside for a walk (weather permitting), dancing, or visiting the gym can decrease your SAD symptoms. In studies, exercise has the same or better effects when compared with an antidepressant!

If you are having problems that are not going away with these simple measures and would like more help, please let us know.  A Functional Medicine approach (addressing hormones, nutrition, gut health, detoxification and lifestyle habits) can help transform your mental health! 

 

romantic couple

5 Common Causes of Low Sex Drive in Women…

By | Blogroll

If chocolates, hearts and flowers aren’t enough to get you into the mood this Valentine’s Day, you aren’t alone.  It is estimated that nearly 1 in 3 women between 18 and 59 years of age complain of lack of desire.  Here are some common causes:

  1. Stress.   When you are under a lot of stress, cortisol levels go up (causing your sex drive to go down).
  2. Fatigue.  If you are always tired, it is hard to muster up enough energy to really enjoy intimacy.
  3. Medications.  Many different prescription medicines can cause sexual problems, including anti-depressants, blood pressure medications and birth control pills.  Even anti-histamines can contribute to vaginal dryness.
  4. Depression is a real downer for sex drive (and many anti-depressants make the problem worse).
  5. Hormonal problems are common in women.  Low testosterone can result in vaginal dryness, loss of interest in sex and lack of arousal.  Menopausal hormone changes can result in painful sex.  Hypothyroidism is often associated with sexual problems (but your doctor may not even be aware of the connection or think of checking for this.)

Correcting the underlying problem is necessary if you want to get that spark back. 

Balanced hormones, including the use of bio-identical hormone replacement therapy where appropriate, is important.   Other tools, such as an OShot, can help restore sensitivity. 

If you are having problems and would like help, please let us know.  A Functional Medicine approach (addressing hormones, nutrition, gut health, detoxification and lifestyle habits) can help transform your sexual health!

Health benefits of dark chocolate

10 Reasons You Should Eat CHOCOLATE on Valentines Day!

By | Blogroll

The amazing health benefits of chocolate

Over $75 billion is spent worldwide every year on chocolate, and it is estimated that the average American consumes 12 pounds of chocolate every year.  The good news is that the cocoa beans (also called cacao beans) used to make chocolate are  a superfood – one of the healthiest foods around!

Top 10 reasons you should eat chocolate:

  1. One of the highest sources of antioxidants.  Cocoa beans have been found to have more antioxidants than blueberries, acai berries, red wine or green tea. 
  2. Great source of magnesium.  Magnesium is needed for over 300 processes in your body – for example, it is a natural muscle relaxer, helps with sleep, keeps your bowels regular, reduces anxiety, and prevents high blood pressure.
  3. Rich in polyphenols – which are natural mood boosting compounds.  They can help you feel more calm, so if you have chocolate cravings, indulging may actually make you feel better!
  4. Rich in soluble fiber, which helps maintain normal cholesterol levels and digestive health.
  5. Contains high amounts of trace minerals (such as manganese, copper, potassium, phosphorus, zinc,  and selenium)
  6. Contains nutrients called flavonols which help increase blood flow to your heart and brain, and can help lower blood pressure.  In fact, in one study, elderly men who ate chocolate regularly reduced their risk of death from heart disease by 50%!.   Flavonols also reduce the risk of blood clots and stroke. 
  7. Rich in healthy, anti-inflammatory omega 3 fats
  8. Helps stabilize blood sugar levels.
  9. Being evaluated for possible cancer prevention effects
  10. Helps increase HDL levels (“good” cholesterol)

What kind of chocolate should you eat?

In order to get these health benefits, you need to eat at least 70% dark chocolate.  The percentage refers to how much cocoa is in the chocolate; 70% dark means that 70% is cocoa and the other 30% is made up of other ingredients, such as sugar. 

If you are looking for healthy dark chocolate, read the ingredients!  It should list chocolate liquor, cocoa (or cacao), cocoa powder, or cocoa nibs as the first ingredient (any of these is ok).  The higher the percentage of cocoa,  the lower the sugar content and the more health benefits, but the chocolate also tastes more bitter. 

Is milk chocolate ok?

Milk chocolate has as little as 10% cocoa (the rest is milk, sugar and other ingredients).  This means you would have to eat MUCH more chocolate to get the same health benefits, but all the sugar and calories will erase the benefits of the cocoa.

What about white chocolate?

White chocolate is made from cocoa butter.  It has zero flavonols and does not have any health benefits. 

How much dark chocolate should you eat?

To get the health benefits of dark chocolate, eat 1 ounce at least twice a week, but eating 1 ounce daily is even better!  1 ounce is about 1 square.  Be aware that while dark chocolate is very healthy, it is not a low calorie food, so moderation is important.  

Add nuts or fruit!

Adding other healthy foods, such as coconut, almonds, or strawberries can add extra fiber, healthy fats and other nutrients, and can make dark chocolate even tastier!  Be sure to read the label and watch for hidden sugar.  

What if I don’t like dark chocolate?

Not everyone is a fan of dark chocolate, but you can develop a taste for it!  Start with 50% dark and work your way up to see if starts to grow on you.  If you really don’t like the dark stuff, you’ll have to pick other healthy foods instead.  Save milk chocolate only for a special treat, since this is just candy without any health benefits.

Enjoy!

Eating healthy can taste good and be fun.  And since dark chocolate is good for you,  you can indulge and don’t have to feel guilty!

Remember, eating well is the best medicine.   Take care of yourself, because you deserve to LOVE the way you feel!

Dr Deb

low libido in women

Have you lost that lovin’ feeling? Here’s how to get it back

By | Blogroll

Did you know that almost 50% of women report a low sex drive? 

If your sex life – regardless of your age – has taken a nosedive, either because it is painful or unexciting due to lack of arousal, or if you suffer from vaginal dryness or urinary dysfunction, there is a simple treatment that can bring desire back and so much more!

We are pleased to offer a revolutionary procedure called an O-Shot.

Image result for o'shot

What is an OShot?

The O-Shot uses growth factors from your own blood that rejuvenate nerves and blood vessels, enhancing sensitivity and arousal.

It begins with a simple blood draw.  The blood is prepared to separate out Platelet Rich Plasma (or PRP) which contains growth factors.  The PRP is injected into 2 areas that are important for sexual response:  near the clitoris and into the upper vagina.  These areas are numbed with a topical anesthetic cream before injection, so you can expect little to no discomfort. 

The PRP activates stem cells located in the vagina and clitoris, which get to work regenerating tissues, and stimulating growth of blood vessels and revitalizing nerves for better sensation and function.

Although each woman’s experience may differ in some ways, many patients report:

  • Greater arousal 
  • A tighter vaginal opening
  • Stronger orgasm
  • Increased sexual desire
  • Decreased pain for those with painful intercourse
  • Increased natural lubrication
  • Decreased or resolved urinary incontinence 

For more information about how we may be able to help YOU, please give us a call!

704-752-9346 or contact us via our website at www.signaturewellness.org.