Complete Body Health Methodology
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► High FSH
An estimated 5-10 percent of women in their childbearing years have PCOS. As obesity become more common,
PCOS is on the rise. Polycystic ovarian syndrome is an endocrine imbalance that affects multiple hormones. Most patients will have abnormal periods, weight gain, body hair and facial hair, and elevated hormones like testosterone, DHEA-S, and insulin. Many
women also have low sex hormone binding globulin (SHBG). In addition to infertility, women suffer from a constellation of problems including heart disease, breast cancer, uterine cancer, and are almost 10X more likely to develop Type II Diabetes. PCOS is
diagnosed with blood tests and a pelvic ultrasound. Sometimes a blood test is enough to diagnose PCOS. Oral contraceptives, spironolactone, and metformin are commonly used as treatments, but can have side effects.
Secondary Amenorrhea is the absence of menstrual periods for 6 months in a women who had previously been regular, or for 12 months in a woman who had irregular periods. Amenorrhea is seen in about 1% of women and can be caused by many factors. Some factors include thyroid disease, PCOS, low body fat, excessive exercise, stress, hormone imbalance, pituitary abnormalities, and perimenopausal changes. The most important part of correcting amenorrhea is finding the cause. Lab tests and clinical diagnosis are the best way to determine the reason for your amenorrhea. Milky discharge from the breasts indicate high prolactin levels. Women who lost a lot of blood during a previous pregnancy may have a pituitary problem. Weight gain, cold intolerance, fatigue, hair loss, and constipation may indicate a thyroid problem. Hot flashes, breast atrophy, and low libido may be signs of premature ovarian failure. Amenorrhea may follow a dilation and curettage due to intrauterine adhesions.
Very low or high BMI may be a sign that unhealthy body mass is causing amenorrhea. testing will include FSH, LH, estradiol, progesterone, TSH, prolactin, cortisol, free and total testosterone, DHEA-S, 17-hydroxyprogesterone, pregnenolone, CBC, ANA, RF, ESR, CRP, and thyroid antibodies. Sometimes, endometrial biopsy or progesterone challenge can used to obtain further information. If the progesterone challenge fails, the next step is to give estrogen followed by a progesterone challenge test. If this is successful, the problem is low estrogen.
The next step is to order and HSG (hysterosalpingography) to look for abnormalities in the uterus. If the progesterone challenge is successful and the HSG is normal, conventional doctors will use clomiphene to induce ovulation. If the thyroid is not functioning properly, Levothyroxine is used to increase thyroid hormone levels.
Your Naturopathic Doctor will work with you to correct the underlying problem using nutrition, supplements, and any other treatment that is necessary. Thyroid dysfunction is treated with nutrients and herbs that will support healthy thyroid hormone levels. High prolactin is treated with herbs that regulate the pituitary gland. PCOS is treated with weight loss and hormonal balance. Ovarian failure is treated with herbal medicine, nutritional supplements, and homeopathy. Treatments for amenorrhea are highly individualized because there so many factors that can cause it. To learn more about naturopathic modalities available, click here.
Endometriosis causes abnormal scarring of the reproductive organs. It causes cyclic pain, pain during intercourse, and infertility. There are many theories about why this happens. Some doctors believe that endometrial tissue flows backwards into the fallopian tubes. Others believe that endometrial tissue travels through lymphatic tissue and implants in abnormal places. Still others believe that the cause is an abnormal immune response. One thing that is clear is that many women have an imbalance of estrogen and progesterone and significant levels of inflammatory proteins called prostaglandins. Endometriosis can be diagnosed through laproscopy. Ultrasound may show “chocolate cysts”, or it may appear normal. Sometimes a HSG is used to see if the fallopian tubes are open. Treatments usually include oral contraceptive pills, lupron, and removal of the abnormal tissue through surgery. These treatments, particularly lupron, can have unpleasant side effects.
Naturopathic Medicine addresses abnormal hormonal levels and inflammation. In addition, their digestive function and liver function are addressed to help eliminate excess estrogen in the body. Treatment may include hormone balancing herbs, nutrients to lower inflammation, and homeopathic remedies.
High FSH is a sign that your ovaries are not functioning normally. FSH is a signal from the pituitary gland that your ovaries need to work harder. Your ovaries get the signal and make estrogen. FSH levels have to increase when the follicles that are not functioning optimally. FSH levels may increase if a woman has been exposed to environmental toxins that are damaging to the ovarian function. FSH levels may also increase in a woman whose endocrine system is not functioning optimally for other reasons. The ovaries may be unhealthy from environmental factors, dietary factors, or stress. All of these factors are addressed in a Naturopathic treatment.
Ovarian failure and low egg quality are known to be associated with autoimmune disease or Turner’s syndrome. Immune problems are present in nearly 40% of women who have premature ovarian failure. Often, these women are asymptomatic. In addition to these factors, there are other important considerations if you have ovarian failure or poor egg quality. If your body mass index is between 19 and 25, you are in the ideal range for becoming pregnant. If you are overweight or underweight, your egg quality can decline. Nutritional deficiencies can also lead to decline of egg quality. Other factors include environmental toxins, abnormal light cycle or sleep schedule, decreased blood flow to the uterus, smoking, extreme exercise, and less than optimal pH in the body. Sometimes nigh natural killer cell activity can damage eggs as well. This is discussed more in the autoimmune section.
Naturopathic Medicine looks for the cause of the low egg quality and corrects any factors that may be lowering egg quality. Specialty labs can be used to look for reasons that the egg number or quality is not idea. You can be tested for heavy metals, solvents, specific nutrient levels, genetic polymorphisms, neurotransmitter imbalances, gastrointestinal infections, and hormone level variations throughout the month. ► Learn More About Our Specialty Labs
Egg quality and ovarian failure are addressed with diet, lifestyle, cleansing, herbs, nutrients, and homeopathy. Foods that are known to lower fertility are eliminated. Lifestyle factors that damage egg quality are changed. Environmental toxin exposure is avoided and unhealthy levels of metals and solvents are removed. Herbs that balance the endocrine system are used. Nutrients that are deficient are supplemented. Homeopathic remedies are used to calm anxiety and reduce depression. One or many of these methods are used based on the individual’s needs and case history.
The uterine lining is made up of endometrial tissue. In order to assess the uterine lining, an ultrasound can be used to look at the “endometrial stripe”. This shows the thickness of the endometrium. The endometrium is the tissue that is stimulated by estrogen during the menstrual cycle. This tissue contains the blood and nutrients needed for the implantation of a fertilized egg. If an egg does not implant, the tissue is sloughed off during menses. If estrogen levels are not ideal, the lining will be poor. A Luteal phase defect (LPD) is a hormonal imbalance that can lead to poor lining. If the endometrium is not responding to estrogen, this may also lead to poor lining. In some cases, high natural killer cell levels or abnormal neurotransmitter levels may cause poor uterine lining. Typically, the idea uterine lining measurement is 8-13 mm. Anything less ant 6mm could cause a problem for implantation. Lining may be poor due to scar tissue causing intrauterine adhesions. Naturopathic Medicine treats the cause of the thin lining. If the lining is thin due to low estrogen, phytoestrogenic plants are used to restore estrogen levels naturally. If the lining is thin due to an autoimmune response, the immune system is regulated with supplements. If intrauterine adhesions are a factor, abdominal massage techniques may be used.
Uterine fibroids are a common benign tumor of the uterus. Many are asymptomatic and will not interfere with fertility. Fibroids can interfere with implantation. Fibroids can be subserosal (on the outside of the uterus), intramural (in the muscle), or submucousal (in the cavity of the uterus). Submucousal fibroids interfere with fertility because they are found in the cavity. Symptoms may include pain and heavy bleeding during menses. Large fibroids may also lead to miscarriage due because they may steal blood supply from the baby. Fibroids are caused by an imbalance of estrogen and progesterone. A combination of high estrogen and low progesterone creates the condition for fibroids to grow. Medium sized fibroids, between 5 and 7 cm, are the fastest growing fibroids.
Fibroids that are less than 5 cm can be treated naturally with herbs and supplements. When treating fibroids naturopathically, the hormone levels are balanced. The liver function is supported to help conjugate and excrete estrogens. Digestive function is improved to increase elimination of excess estrogens though the stool. Women are also educated about how to limit daily exposure to exogenous estrogens.
Miscarriages may be a sign of nutritional deficiencies, abnormal uterine cavity, hormonal imbalance, infection, autoimmune problems, or genetic disorders. If you have had chronic miscarriages, it is a good idea to find out why this is occurring. The American College of Obstetricians and Gynecologists recommends blood karyotyping, cytogenetic analysis, ultrasound, screening for factor V Leiden, and testing for anti-phospholipid antibodies. There are many natural treatments that can help.
Naturopathic Medicine treats the cause of miscarriage, so there are many options for treatment based on the individual. Some herbs are used safely to prevent miscarriage. There are many homeopathic remedies available for people who have chronic miscarriages. Naturopathic Medicine can regulate the immune system in cases of abnormal activity.
Autoimmunity is perhaps one of the most important and increasing problems seen today in fertility medicine. There are many signs that you may have a dysfunctional immune response. Some of these signs include poor egg production, a history of blighted ovum, 3 miscarriages before age 35, endometriosis, preeclampsia, preterm labor, retarded fetal growth, or unexplained infertility. Common testing for immunological factors include tests for ANA, anti-phospholipid antibodies, and factor V leiden. More extensive testing may be necessary. It is important to understand that an abnormal immune response can show up in a variety of ways. Natural killer cells can attack the placenta. Blood clots can obstruct blood flow to the placenta. Antibodies can attack fetal tissue. Antibodies can attack sperm in the cervical mucous. Natural killer cells can even stimulate production of antibodies to hormones like progesterone and estrodiol.
For most women, the conventional treatment offered is 1 baby aspirin. Naturopathic Medicine focuses on regulating the immune system with natural supplements, homeopathy, diet, and stress relief.
In many cases, infertility cannot be explained with conventional medicine. If this is the situation, your case history will be carefully evaluated. There may be an explanation that no one has found yet. Many factors can lower fertility including low progesterone, Epstein barr virus, diabetes, cardiovascular disease, Chlamydia, Candida, chronic dental infections, environmental toxicity, nutritional deficiency, and stress. While some people diagree with the idea that stress can lead to infertility, the hormonal effects of stress are clear. A body undergoing chronic stress will begin to show abnormal levels of estrogen, testosterone, DHEA, and cortisol. This is because pregnenolone, a precursor these hormones, is being diverted to cortisol production. Cortisol is a “stress hormone”. When it is being preferentially made, the reproductive hormones suffer. Signs of high cortisol include anxiety, abdominal weight gain, insomnia, and fatigue.
In order to pinpoint specific imbalances, you may need further testing. Testing includes conventional lab work as well as specialty labs for heavy metals, solvents, hormone levels, nutrient levels, neurotransmitters, food sensitivities, gastrointestinal infections, and genetic polymorphisms. With unexplained infertility, as with any case, you will be given a variety of ways to improve your chances of conceiving. Treatments may include homeopathy, botanical medicine, dietary changes, weight loss, amino acids, or other dietary supplements.