Menopause: Balancing Women's Hormones Naturally

Menopause. Ah, that lovely time in a woman's life when she finally stops having to deal with monthly cycles and can celebrate her freedom from Tampax, Always and Diva Cup. No more monthly mood swings, no more tender breasts, no more cramps, no more birth control. Life is good!


Well, for some women this is definitely true. For others, menopause means the ending of a list of complaints they may have gotten used to, only to be replaced by an entirely new group of symptoms. Or, for those women who spent their reproductive years relatively free of any associated complaints, menopause can bring on their first experience with a whole host of unpleasant concerns.


What is Menopause?
The term menopause is derived from the words meno (month) and pausis (cessation). Thus, menopause means the end of menstruation. Menopause is strictly defined as the time after 12 consecutive months of no menses, following your last monthly period.  Natural menopause occurs as a result of the decline of ovarian function, and is characterized by a number of symptoms, including: hot flashes, fatigue, mood swings, decreased sex drive, insomnia, vaginal dryness, increased susceptibility to urinary tract infections, a decrease in bone mineral density and an increase in the risk of coronary artery disease.

Natural menopause typically occurs in women between the ages of 40 and 58, with the average age in the U.S. being 51 years.  Three crucial factors affect the age of menopause: genetic factors involving the estrogen receptors, current smoking, and familial factors. The timing of menopause may also be influenced by: toxic chemical exposure, being overweight, history of no pregnancy, more than one pregnancy, epilepsy, treatment of childhood cancers with chemotherapy or radiation, and cognitive scores in childhood (the higher the score, the later the menopause).

Where Do Our Hormones Come From?
During the reproductive years, women's ovaries and adrenal glands are responsible for producing the majority of the hormones that control fertility, libido and the menstrual cycle, with the ovaries playing the largest role.  As women enter menopause, their ovarian function begins to decline, resulting in significantly lower production of estrogen, progesterone and testosterone.

Estrogen: 
During menopause, the adrenal glands begin to play a more significant role. Along with the production of cortisol, adrenaline, noradrenaline, and aldosterone, the adrenal glands also manufacture DHEA, testosterone and a hormone called androstenedione, which is converted to estrogen in body fat, as well as in the muscle and skin. For some women, this source of estrogen is enough to prevent some of the common side effects of menopause, giving them an easier transition. In others, the lack of estrogen may lead to a number of symptoms, including:

• Changes in menstrual bleeding and regularity
• Decreased fertility
• Decreased memory and concentration
• Mood changes
• Vaginal dryness and thinning with associated pain with intercourse and decreased libido
• Decreased sexual sensation
• Urinary problems, including incontinence, urination at night and recurring urinary tract infections
• Increased bone loss
• Increased risk of cardiovascular disease: elevated cholesterol, high LDL, low HDL, elevated blood pressure
• Hot flashes (although scientists are still unsure of the exact cause of hot flashes)
• Poor sleep
• Aging skin and wrinkles

Progesterone:

As ovarian function declines in menopause, the adrenal glands also become the crucial producers of progesterone. This is another reason why it is vital to maintain proper adrenal gland functioning through out the menopausal years.

Symptoms of low progesterone:

• Fatigue
• Anxiety
• Insomnia
• Decreased libido

Testosterone:
In our bodies, approximately 50% of testosterone comes from the ovaries and adrenal glands. The other 50% are made from other tissues in the body, including the skin, brain and liver.  The ovaries and adrenals make precursor hormones that these parts of the body use to produce testosterone.

Although it is a blessing that the adrenal glands are a source of hormonal support, they can only function maximally when the ovaries are also fully functioning. This means that in women who have had their ovaries removed, their adrenal glands will not be able produce up to their maximum potential.

Symptoms of low testosterone:

• Fatigue
• Low motivation
• Poor memory
• Depression
• Low libido
• Lack of sexual orgasm
• Decreased sexual sensation
• Elevated blood pressure
• Loss of muscle mass

Remedies for Menopausal Symptoms:
The naturopathic management of menopause includes a variety of approaches, including:

Dietary Suggestions:

• Recognize and eliminate food allergies
• Reduce intake of refined grains and flours, salt, and sugar
• Avoid trans fats
• Reduce intake of saturated fats
• Avoid dairy
• Increase intake of fruits (1-3 servings per day), vegetables (at least 6 servings per day), legumes (especially soy unless there is a high risk of or current status of breast cancer), flax, nuts and seeds, olive oil and cold-water fish. 
• Avoid alcohol and caffeine
• Avoid dehydration by drinking an adequate amount of water for your body weight
• Eat regularly (every 2-3 hours).

Lifestyle Management:

• Increase exercise
• Stop smoking
• Decrease stress
• Avoid being overweight or underweight

Supplements:
Below is a list of some of the most common menopausal concerns, followed by the most commonly used supplements for treatment. How each of these supplements work is a wonderful question for your naturopathic doctor. Be sure to ask in order to keep us on our toes!

Nutritional Supplementation:

• For Hot Flashes: Vitamin C, vitamin E, soy isoflavones, fish oil
• For Bone Health: Calcium, vitamin B6, Vitamin C, vitamin D3, vitamin K2, boron, magnesium, manganese, zinc, copper, folic acid
• For Mood Health/Insomnia: Vitamin B6, 5-HTP, niacinamide, inositol, calcium, magnesium
• For Vaginal Dryness: Topical vitamin E, oral fish oil, flax seeds, evening primrose oil
• For Heart Health: B vitamins (especially folic acid, B6 and B12), vitamin C, vitamin E, calcium, co-q-10,  fish oil, magnesium, niacin, potassium, L-arginine, L-carnitine 

Herbal Supplements:

• For Hot Flashes: Black cohosh, dong quai, chaste tree, red clover, fennel, flax, licorice, curcumin
• For Mood Health/Insomnia: St. john's wort, passionflower, valarian, skull cap, melatonin, kava
• For Adrenal Support: Rhodiola, Withania, Eleutherococus, Licorice
• For Heart Health: Dandelion, hawthorne, red yeast rice, ginkgo, curcumin, plant sterols

Bio-identical Hormone Replacement:

• Estrogen, progesterone, testosterone and DHEA may be used in more extreme cases where diet, lifestyle and supplements do not provide adequate relief. 
• Estriol cream for vaginal symptoms

Non-Hormonal Prescription Medications:

The following may be prescribed if diet, lifestyle and supplements do not provide substantial relief:

• Thyroid medication
• Antidepressants
• Anti anxiety medication
• Blood pressure medication

As you can see, there are a number of remedies available to help you through menopause, and this blog is certainly not all inclusive! In addition to this list, there are also a variety of homeopathic treatments available, as well as a full-body approach, including treatment of the liver and other organs that your naturopathic doctor can discuss with you.

With a little bit of education, the right guidance, and some patience, you can make menopause into a comfortable, enjoyable transition! We look forward to working with you!




References:
www.mayoclinic.com
Menopause: Dr. Lorilee Schoenbeck, ND
Nutritional Medicine: Dr. Alan Gaby, MD
The Complete Guide to Women's Health: Dr. Sat. Dharam Kaur, ND
Women's Encyclopedia of Natural Medicine: Dr. Tori Hudson, ND














   

Conquering a Stomach Bug Naturally

It's called "GII.4 Sydney" and it is a new strain of norovirus that is reeking havoc this year all over the world.

According to the CDC, each year, greater than 21 million people in the U.S. become infected with norovirus and develop acute gastroenteritis (inflammation of the stomach and intestines). Contrary to it's mistaken identity as a stomach "flu", norovirus has nothing in common with the flu, other than also being caused by a virus.  The flu is actually a respiratory illness caused by the influenza virus.

Although typically more of an uncomfortable inconvenience than a life-threatening illness, norovirus can have serious consequences in young children, the elderly and anyone immunocompromised, so management should be taken seriously.  Furthermore, symptoms can lead to dehydration in even the healthiest of individuals, which results in prolonged recovery time and decreased resistance to other infections. In fact, the CDC estimates that each year, 70,000 people are hospitalized and 800 people die from norovirus infection. As a result, it is important to maintain a strong immune system year-round and to be able to recognize the signs and symptoms quickly if you or someone you know is infected so you can begin treatment as soon as possible.

Signs and Symptoms of Norovirus:
Common symptoms of norovirus include stomach cramping, diarrhea, nausea and vomiting.  Less common symptoms may include headache, low-grade fever, chills, muscle aches and fatigue.

Complications of Norovirus:
Typically, norovirus infection is not serious and most people get better in 1-2 days.  However, norovirus can be serious in people who are immunocompromised and in young children and the elderly.  In these cases, it can lead to severe dehydration, hospitilization, and sometimes death.


Who Can Catch It?
Anyone can catch norovirus, and because there are different strains of it, you can get it more than once in your life.  Furthermore, norovirus is highly contagious and spreads easily from person to person if good hygiene is not maintained.  Norovirus is located in the vomit and stool of an infected person. Therefore, it is spread by coming into contact with vomit and/or stool from an infected individual. This sounds like a difficult process, but unfortunately it spreads easily when infected people do not practice adequate hygiene and ultimately contaminate areas around them. Norovirus can also be spread through contaminated food or water. Therefore, do not share meals or drinks with someone who is currently ill or until after they are no longer contagious.


How Do I Prevent Norovirus Infection?
The best way to prevent getting a norovirus infection is to keep your immune system healthy.  People come into contact with viruses all the time, but not everyone gets sick.  Therefore, be sure to educate yourself on how to maintain proper function of your immune system.

Secondly, avoid contact with people who currently have the infection. Since this is nearly impossible, especially for those who work in contact with others, be sure to keep your hands out of your mouth, don't chew on pens, and wash your hands frequently throughout the day.

How Do I Prevent The Spread of Norovirus?
People infected with norovirus are contagious from the moment they start feeling ill to at least 3 days after their symptoms have resolved.  Therefore, people should not prepare food for others until at least 3 days post norovirus infection.  Infected persons must wash their hands thoroughly after using the bathroom, and any surfaces that come into contact with stool or vomit must be cleaned and disinfected.  In addition, all linens that come into contact with vomit or stool must also be thoroughly cleaned and disinfected. Be sure to wash your hands thoroughly after handling any soiled linens or articles of clothing.


Treatment Options:
Currently, there are no conventional treatment options available to either treat or prevent norovirus, though hospitalization is an option if consequences become serious. Thankfully, there are a variety of naturopathic options for both the prevention and management of norovirus.

Prevention:
Diet and Lifestyle Modification: Maintaining a healthy diet and lifestyle is one of your best defenses against getting sick in the first place.  Some short and sweet tips include:

• Eliminating inflammatory foods from your diet: Be aware of any dietary sensitivities you may have and be sure to avoid them as much as possible. If you become ill, refrain from dairy consumption until 7 days after the onset of your symptoms to allow your gut to recover.  
• Avoid excess sugar: Sugar consumption depletes immune function and is one of the worst things you can consume when trying to prevent illness or the progression of illness.
• Get adequate rest: Some studies have shown that people who sleep between 6.5 and 7.5 hours a night live the longest.  Although the verdict may still be out, most experts will agree that sleeping less than 6 hours per night is not good for your overall health. Therefore, make sure to sleep around 7 hours per night on a regular basis and when recovering from illness, I suggest sleeping as much as your body requires.  
• Avoid alcohol, recreational drugs, and smoking: All of these deplete immune system function.
• Avoid strenuous exercise if feeling run down: Studies have shown that it is actually better to rest when starting to feel run-down, rather than go to the gym to get your energy back up. This is because exercising when depleted actually depresses your immune system more and can make you sicker! Furthermore, gyms are great breeding grounds for germs, and if you are feeling really low on energy, chances are your ability to fight off infection is also decreased, so my advice is to skip the work out and get a good night's rest instead.

Supplements: There are a variety of supplements that people can take to boost their immune system function.

• Vitamin D: One of the best ways of fighting infection is to maintain adequate vitamin D levels. If you have low vitamin D, be sure to use supplements to get it up to where it should be.  
• Herbs: Echinacea, astragalus, andrographis and others. 
• Vitamins and Minerals: Vitamin C, vitamin A, vitamin E, and zinc are all essential to maintaining proper immune system function. Thankfully, these can be obtained through diet, but I suggest supplementing with them to give your immune system an extra boost when necessary.

Treatment: 

Unfortunately, once symptoms begin, it is clear that you have become infected, and in my opinion,  the best option of reducing signs and symptoms at this point is through the use of homeopathics. You can purchase the remedies at 30C potency and must take them frequently until symptoms resolve.  This means taking 2-3 pellets every 15 minutes. Typically, symptoms will begin to improve within an hour.  These are safe in people of all ages, which make them wonderful treatment options. 

• Arsencium album: This homeopathic is the main remedy for food poisoning and gastroenteritis, making it a wonderful treatment for norovirus. I have seen this remedy decrease episodes of vomiting significantly in patients that have used this, versus those that haven't, as well as significantly reduce stomach cramping and diarrhea.
• Aloe: This remedy is used for diarrhea, unstoppable bowel movements and involuntary stool when passing gas or urine. Therefore, it may also be useful at eliminating the diarrhea from norovirus as well.
• Podophyllum: This remedy is for offensive, explosive liquidy diarrhea (no I am not joking!)  that occurs with or without cramping so may also be essential in the treatment of norovirus. 
• Nux vomica: This remedy is one of our best for the treatment of nausea and vomiting. I have seen it settle the stomachs of people with norovirus, as well as those with nausea due to chemotherapy.
• Ipecac: This remedy is for those who have persistent nausea and vomiting with no relief and is therefore very useful in the treatment of those with norovirus, as well as nausea and vomiting in cancer patients. 
• Mag phos: This remedy is for cramping pains and spasms and may help to reduce the painful intestinal cramps associated with norovirus. 

Maintenance:

• Ginger Tea/Extract: This wonderful herb can be used to soothe nausea, although it will not rid you of the virus.
• Water Intake: It is crucial to drink water during this virus to replenish fluid lost through vomiting or diarrhea. Even if it comes out one or both ends, be sure to continue drinking it!
• Rice Water: I learned this trick while afflicted with terrible food poisoning in a developing country. Prepare yourself to cook brown rice (or have someone else do this for you if you can't do it yourself), but add twice as much water. Cook the rice as you normally would, and after about 40 minutes, take the excess water off of the top and drink it down. This helps to constipate the system and will provide some nourishment. 
• Bland Diet: Once symptoms begin to resolve, be exceptionally careful about what foods you introduce into your diet. Anyone who has had the norovirus stomach and intestinal cramps will tell you that eating the wrong thing can send your abdomen into a crisis again. The best foods are bland foods: Plain rice, plain bread, bananas, broths, plain chicken, etc. Avoid spices, dairy and sauces until 24 hours post symptom resolution or until all stomach and intestinal pain has resolved.
• Supplements: Once the symptoms have resolved, it is essential to begin taking a strong probiotic. Probiotics repopulate the good bacteria lost during illness and will help prevent the growth of the virus. Other supplements include anti-microbial herbs to kill off any remaining viral particles, and glutamine to decrease inflammation in the gut and repair any damage that has been done. Since your immune system will undoubtedly be depleted after experiencing this virus, you may also want to get on a good immune-boosting supplement regimen for awhile to prevent catching any other illnesses. 
• IV Therapy: Rehydration IVs may be necessary for some people after having this virus, H2O2 IVs may help your immune system fight it off better if used early enough and can be tolerated, and immune-boosting IVs post-virus would be a great way to speed the recovery process and prevent any other illnesses from occurring. 

Caution: 

As mentioned above, although norovirus does not tend to be serious in most people, it can become life-threatening in some. Therefore, be sure to recognize the signs of dehydration in immunocompromised individuals, as well as the children and elderly and bring them to an appropriate facility to receive the care they need. 

Good luck! 

Sources:

http://www.cdc.gov/Features/Norovirus/

http://www.time.com/time/health/article/0,8599,1812420,00.html
Naturopathic Clinical Boards Study Manual, 2011; Piscopo and  Yarnell. 

Why You Should See a Naturopathic Doctor If You Have Breast Cancer

Naturopathic Doctors (NDs) are quickly becoming recognized as vitally important in the treatment of cancer.  Cancer Treatment Centers of America now employs NDs as part of their cancer treatment team and praises their remarkable results. 

Oncology is one of the few areas in which NDs are becoming board certified. Naturopathic oncologists work in both hospital oncology settings and in private practices.  One of the most common questions I receive when telling people of my profession is this: "As a naturopathic doctor, what is your role in the treatment of breast cancer?"  Hopefully I can answer that here.

Based on current research, the best medical approach for patients with cancer is to utilize both standard medical care from your oncologist and medicine that supports your body’s natural defenses and recovery systems, otherwise known as naturopathic medicine.  Although surgery, radiation and chemotherapy are our only known cures for cancer, they can have certain side effects that naturopathic medicine can successfully manage. In addition, once conventional therapy is over, naturopathic medicine can be utilized to help prevent a recurrence.

One of the most important aspects of my job is to develop a plan to optimize your immune system's functioning, as well as address certain aspects of your physiology and biochemistry that may have set up an environment for a cancer to develop.  In addition, I also ensure that the rest of your body is working optimally by supporting you in the following ways: pre and post biopsy and surgery to minimize side effects and boost recovery time, reducing the side effects and possibly increasing the efficacy of radiotherapy and chemotherapy, and helping you to better deal with the mental-emotional aspects of breast cancer.  This combination of naturopathic medicine and conventional treatment helps women fight cancer more effectively and increases their well-being. 

One question I am asked frequently is "can you work with my oncologist?" The answer is, "yes, I would love to!" When I first started working with cancer in 2009, many oncologists were still unsure about the role that naturopathic medicine could play in cancer care. These days, due to the vast amount of research currently available on naturopathic supportive therapies, many oncologists recognize the value of following a naturopathic supportive protocol while undergoing conventional therapy and are in full support of it. 

What does this mean for a woman diagnosed with breast cancer?

A diagnosis of breast cancer can be a very emotional time for a woman. Ultimately, I find myself in the role as a trusted advocate, and my patients know that I am looking out for them.  During this difficult time, it is always best to talk with an oncologist and see what they recommend for treatment. Generally, I will support the recommendations of the oncologist and help my patients make the most informed decisions. 

Although I do see patients who have decided to forgo conventional treatment for personal reasons, this is not something I recommend. In fact, despite what you may read on the internet, naturopathic medicine is not a treatment or a cure for cancer. I see, by far, the best outcomes when patients follow a conventional treatment protocol while seeing us for naturopathic support. To read more about this, please see our FAQs page on integrative cancer support on our website: http://walnutcreeknaturopathic.com/FAQ/.
If, after making sure the patient understands their conventional options, they still choose to only utilize naturopathic medicine, we will have them sign a waiver that states they understand that naturopathic medicine is not a treatment or a cure for cancer, and at that time I can support them with the best naturopathic care that I can.

It is never too soon after receiving a breast cancer diagnosis to begin a naturopathic supportive program.  In my practice, a breast cancer program starts with a basic dietary and lifestyle plan, along with a nutraceutical regimen that is based on the stage and type of breast cancer that a woman has, her particular biochemistry and physiology, as well as where she is in her standard cancer treatment. A physical exam may also be included in the consultation, and recent blood work, and other pertinent tests and information will also be required.  Due to my background in psychology, I also focus on addressing common mental-emotional issues associated with breast cancer, such as stress, anxiety, depression, and grief, as well as other important mental emotional factors that can have a major impact on survival rates as well as on a patient’s quality of life. 

Once a patient has begun her standard cancer treatment, I will adjust the program accordingly to help support the side effects of surgery, radiotherapy and chemotherapy.  The program will continue to be adjusted as necessary based on what is needed while we work together.

Here are some of the ways I work with women with breast cancer: 

• I can help explain in great detail the standard breast cancer treatment you will receive from your oncologist and treat the many side effects associated with it. 

• I prescribe therapies that research shows may improve the efficacy of the standard breast cancer treatment you are receiving from your oncologist.

• I create individualized programs that boost your immune system, as well as other crucial organs and systems in your body that are essential supporting your conventional therapy to help you overcome breast cancer.

  

• I design programs and prescribe therapies specifically formulated that may help reduce the risk of breast cancer spreading, including pre-post biopsy and surgery protocols.

• I prescribe nutraceuticals and therapies that may minimize the side effects of commonly prescribed hormonal drug therapies and other prescription drugs that you may be taking.

• I prescribe various forms of holistic “mind body medicine” to treat stress, depression, anxiety, grief and other challenges that accompany breast cancer treatment.  These are often overlooked or minimized by most medical doctors, despite the strong correlation between good mental health and higher survival rates.

In addition to providing supportive breast cancer treatment, I can also help you to reduce your chances of getting breast cancer in the first place. A Naturopathic Doctor’s greatest strength is in disease prevention!  For patients with significant risk factors for breast cancer, I prescribe treatment programs that can address and mitigate many of these factors.  

If you have any questions about breast cancer for yourself or a friend, you may contact our team at Walnut Creek Naturopathic at 925-939-0300.

Thank you and be well!

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