womentowomen – Page 14 – Marcelle Pick Site

Nutritional Relief For Hot Flashes

womentowomen on December 8, 2013

by Marcelle Pick, OB-GYN, NP

Foods to ward off hot flashes for simple, natural relief

Protein — the foundation for hot flash relief
Healthy fats — how they help
High-fiber phytonutrients — fewer flashes
Balanced nutrition for hormonal equilibrium

I’m thrilled to say that it’s been a while since I have had to think about hot flashes, but I remember those days well. However, I am always reminded and quickly remember when my patients tell me their stories. One of my patients shared with me what happened to one of her friends. She was dining out at a Mexican restaurant with her daughter and baby granddaughter. The combination of the spicy food, sangria, and the stress of the irritable baby and the scene of her daughter trying to nurse in a crowded noisy space was enough to give any woman a hot flash. The experience left her having intense hot flashes, so she left the restaurant without even saying a word to her daughter, ran out to her car and turned the A/C on full blast!

This story reminded me that just as a nursing baby is affected by what it’s mother eats because it is passed to the baby through their mother’s milk, we too are affected by the foods and drinks that we put into our bodies. There is a wealth of great advice about how to deal with the symptoms of menopause, but you don’t hear much about how food can be our greatest ally in combating many of our menopausal symptoms. Certain foods can calm us or make us more irritable, or simply push us off-balance. Through working with thousands of women, we’ve observed that certain foods and drinks do seem to bring on hot flashes and night sweats, while others work well to subdue them.

You might be asking yourself, “What is the best way to eat when you’re dealing with hot flashes?” Let’s take a closer look at how foods affect the continual balancing act that occurs between your major and minor hormones, so that you can minimize the intensity and frequency of your hot flashes — and enjoy nourishing, delicious meals in peace.

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Most importantly — get your protein

Our bodies involve complicated balance of hormones that are greatly affected by our environment and the foods that we ingest. Healthy hormonal and emotional balance can be achieved by ingesting healthy foods. These nutritious foods can provide not only good information for our bodies—it supplies all the raw materials your neuroendocrine (nerve–hormone). Protein is one of the raw materials required to make and balance hormones, so it is wise to include some with each meal and snack that you eat. I explain why protein is so important in my book Is It Me or My Hormones?

Hot flash snack foods and beverages

We’ve assembled some ideas to help you get started on resetting your hormonal balance.

Roasted soy nuts — look for non-GMO, with sea salt or other natural seasonings
Raw broccoli, cauliflower, and celery sticks dipped in Creamy Tofu-Garlic Dip (see recipe below)
A bowl of old-fashioned oatmeal, topped with 3 tablespoons freshly ground flax seeds and soy milk
Broccoli sprouts, generously sprinkled atop a salad or tucked inside a whole grain wrap or omelet
Icy soy smoothie, blended with your choice of deeply-pigmented berries
Soothing chamomile tea, iced or freshly steeped

“Humans need a steady source of protein for the constant rebuilding that goes on within the body, including hormone production. Without protein the body ceases to regenerate, and hormone production declines and/or becomes imbalanced.”

A simple and easy way to increase your protein intake is it to add whole, non-GMO soy foods to your diet. You will also reap the sizeable benefits soy isoflavones have to offer menopausal women. We understand here, though, that soy is not for everyone, but when it comes to quelling vasomotor symptoms, we’ve seen such favorable results that we regard soy as a menopausal superfood. We regard it so highly that we often suggest a smoothie for breakfast that includes a soy shake. See our articles on soy for menopause symptoms to learn how genistein, daidzein, and glycitein — soy isoflavone “active ingredients” — work.

Some other wonderful sources of plant-based protein include freshly crushed flax seeds, nuts and nut butters (like almond butter or cashew butter), lentils, and other legumes. These foods offer protein, healthy fats, and fiber, as well as additional phytochemicals that your body needs to synthesize, properly metabolize, and keep hormones in balance. Wild-harvested seafood and organic/grass-fed meats, eggs, and yogurt are great examples of quality sources of animal proteins and healthy fats.

Creamy Tofu-Garlic Dip

1 14-oz tub of soft or silken tofu
2 tsp toasted sesame oil
1 Tbsp cider vinegar
½ tsp dry mustard
½ tsp iodized sea salt
1 tsp tamari or soy sauce
2 cloves of garlic

Whip all of the above ingredients in a blender or food processor, transfer to a covered glass refrigerator dish, and chill.

Use as a dip for your favorite raw or steamed veggies, chips, or pita.

Yes — you need fat!

Believe it or not, women need fat to support hormonal balance in menopause! I want to give you comfort in know that eating healthy fat won’t make you fat. Cholesterol is an important type of fat that comes in different forms — not all of which are “bad.” Read our articles about estrogen imbalance for an illustration of the hormone-generation process called steroidogenesis. It reveals that cholesterol serves as the mother molecule to all our steroid hormones — both sex hormones and stress hormones.

We also can’t live without the essential fatty acids (EFA’s), because essential fatty acids are healthy hormone-balancing fats. Olive oil, nuts, fatty fish like salmon, and avocado are all examples of foods that are rich in these EFAs. In order to prevent symptoms like hot flashes, we must have balance between all our hormones. New research suggests that omega-3’s in particular can help diminish the frequency of a woman’s hot flashes. For more information and to learn more about the truth about fat and cholesterol and omega-3 fatty acids, refer to our articles on this topic.

Sautéed, steamed, or raw: pile the vegetables on!

For women with hot flashes, it is very important to include fruits and vegetables into their everyday diet. If we take a closer look as to why, we see that the fiber they contain is completely indispensable to a woman’s digestion, healthy weight, and yes, hormonal balance. Fiber not only “keeps things moving,” it’s the preferred food of your GI flora. Feed them well and they’ll help you properly absorb nutrients and metabolize your sex hormones. Fiber also prevents you from having sharp spikes of insulin. Insulin is one of the body’s major hormones, so once it is in check, it makes balancing all of your other hormones, especially in menopause, that much easier.

“Phytochemicals” are a component of many fruits and vegetables that are essential to women in perimenopause and menopause. These wonderful, helpful phytochemicals are just a part of fruits and vegetables. The most important for women are those that contain phytoestrogens. These are the plant kingdom’s version of a woman’s estradiol, but they are not estrogen molecules. They also don’t increase a woman’s own estrogen, but instead gently work with your body to recalibrate balance at the cellular level. We explain and illustrate this adaptogenic, protective mechanism in our articles on phytotherapy for hormonal balance.

The types of phytoestrogens best known for their potential to reduce menopause symptoms and reduce disease risk include isoflavones, lignans, and coumestans. As noted above, soybeans are a classic example of an isoflavone rich food. The menopausal super food most abundant in lignans is flax seeds. We recommend 1–3 tablespoons a day, always freshly ground, stirred into soups, salads, smoothies, or porridges. To enjoy the benefits of coumestans, brew up some red clover tea in the evenings. This also helps you to sleep. You can also enjoy them on top of your salads with alfalfa sprouts. Phytoestrogens are also found in members of the parsley family, such as fennel and celery, as well as garlic, onions, and all sorts of seeds, nuts and legumes.

Broccoli for hormonal balance?

The antioxidant compound known as sulforaphanes is especially potent in young broccoli sprouts. It is theorized that by activating phase II detoxification enzymes, sulforaphanes help balance the hormonal estrogen scales There are present studies looking at how the body metabolizes estrogen, and linking this to breast cancer, not the estrogen levels themselves.

Another important family of vegetables is the cruciferous: greens such as watercress, collards and kale, plus cabbages, broccoli, brussel sprouts, cauliflower, radishes, and their relatives. All the cruciferous are ultra-rich in the phytochemicals plant scientists call glucosinolates. These sulfur-containing compounds get converted in the body — because of your digestive enzymes and friendly intestinal microflora — into potent detoxifying molecules called isothiocyanates.

You don’t need to understand the chemistry to reap the benefits, though. Simply take in a big helping of greens daily. Three-day-old broccoli sprouts top out the charts, so throw them into your salads and enjoy. By supporting your phase II detoxification pathways at the molecular level, this modest step helps balance hormones and reduces hot flashes.

Every season brings a myriad of new shapes, colors, texture, and tastes to savor at every meal. The seemingly endless variety of plant based foods is wonderful, so enjoy the abundance.

For the time being, leave these things on the shelf

Eating a diet high in white sugar, white bread, pasta, or any foods that are highly refined and/or processed, will induce more hot flashes. I also warn women to also stay away from such things like caffeinated drinks, chocolate, red wine, aged cheeses, and dishes that are deep-fried or overly spicy are other typical hot flash triggers for many women. To create better health and hormonal balance and reduce hot flashes I strongly suggest tapping into the endless variety of plant based foods that you can pick up at your local farmers market or natural food store.

Because there is never one size fits all, the problem is that foods that affect other women may be completely different from the foods that affect you. That’s why I would suggest keeping a food journal of what and when you eat and drink, and how you feel afterward. You can pick up one at the store, or you can keep one digitally on your computer. If you notice a connection between certain foods you love and your hot flashes or another unpleasant symptom, save it for a special occasion. You can also try it at a later date, after you’ve been symptom-free for a while, to see if you’re better able to tolerate it then. Our bodies are changing every day, and as we care for ourselves as time goes by, the better we will begin to feel. You may even see your devotion begin to shift away from certain foods and habits and more toward yourself!

Balanced nutrition, balanced body

Our Nutritional and Lifestyle Guidelines can provide you with further specifics on eating for hormonal balance.

Your body needs its stores of vital nutrients replenished daily. This is especially important during hormonal transitions like menopause. A balanced diet of quality protein, healthy fats, and phytonutrient-rich fruits and vegetables, together with regular exercise, adequate sleep and stress reduction, are all that’s needed to regulate healthy hormonal and neurotransmitter balance in most women. You can also take a top-quality multivitamin-mineral complex and omega-3 supplement, not only to ensure that your nutritional bases are covered for today and tomorrow, but that the inevitable swings of hormonal change are less dramatic and unpleasant. You may also benefit from a variety of delicious recipes for hormonal balance featured in my book, Is It Me or My Hormones?

For those of you who continue to experience hot flashes and night sweats, a well-formulated phytotherapeutic supplement can make all the difference. Isoflavone-rich, non-GMO soy foods can provide additional gentle endocrine support to moderate sex hormone fluctuations. A majority of women seeking natural relief from menopause symptoms find their hot flashes are reduced remarkably well with this combination approach. All through our life our bodies engage in a constantly shifting, dynamic balancing act — which means that whether or not we’re passing through a major transition like menopause, the path to better health and balance is always within reach.

Thankfully, there are many natural ways to quiet the unwelcome symptoms of hormonal imbalance – hot flashes, night sweats, and the anxiety, irritability, fatigue, and sleeplessness that can sometimes accompany them. Nourishing yourself well with each new day is simply the easiest place to begin.

Endometrial Ablation – The Pros and Cons

womentowomen on December 8, 2013

by Marcelle Pick, OB/GYN NP

There are times that medical terms can be a little intimidating to people who aren’t familiar with what they mean. Some of you might know what something means in a general way, but it’s always best to know, for your own well-being and peace of mind, specifically what something means. This will better help you know what’s going on with your body and also help you make the best decision about what’s right for you.

The procedure called endometrial ablation might be a great option for you to consider rather than having a hysterectomy, after you have tried other less invasive measures. For example, if you are seeking an option that would allow you to keep your uterus, especially if you have tried hormonal management and it did not work, then ablation may well be a good choice.

Here is more information about this procedure. Ablation means “to remove by erosion, melting, evaporation, or vaporization.” Endometrial ablation is done with a hysteroscope, along with a device that heats, freezes, or lasers your endometrial lining. This destroys a layer of your endometrial lining, and usually your monthly menstrual period will stop completely—at least for a while—and usually you will not be able to become pregnant following uterine ablation. However, it’s a good idea to remember that there are women who do get pregnant after this procedure, so it’s very important that birth control or sterilization be reviewed, as post-ablation pregnancies can be risky. Some insurance companies require that a woman be sterilized before they’ll pay for the ablation procedure.

Some types of this procedure can be performed by a trained gynecologist (GYN) in the office. It can be done fairly quickly and easily. This can be useful to treat selected areas of the endometrial lining. In other circumstances, it needs to be done under anesthesia after a hysteroscopically–guided dilatation and curettage (D&C) sampling. This may be an ideal way to exclude pathology, rather than assuming that an endometrial biopsy is adequate.

At Women to Women we don’t recommend this course of action as a first line intervention for several reasons. For one, we always try to suggest the most minimally invasive procedures and recommend medical management when possible. In addition, we generally obtain a good outcome with medical management of our patients who have heavy bleeding. Although endometrial ablation does work well for some women, the long-term results for treating heavy bleeding with endometrial ablation are not always predictable, and there is a relatively high rate of recurrence. Our nurses have heard from women who have had an ablation that it had failed and that their heavy periods returned after a year or two. Another issue is that there is a risk that endometrial ablation might mask endometrial cancer later in life, because it removes any endometrial spotting that would signal to you that something abnormal is happening in your body.

Now that you know more about this process, you can do what you think and feel is best for your healthy lifestyle. To sum it up, endometrial ablation has its limits. With time we can look forward to medical technology that will bring us more advanced treatment alternatives to hysterectomy. But until then, ablation techniques do offer women and their healthcare practitioners some options that can be useful in certain circumstances.

Stroke And Heart Attack Symptoms In Women

womentowomen on December 8, 2013

by Marcelle Pick, OB/GYN NP

You may be surprised to learn that when it comes to women and heart attacks, it is extremely easy to overlook or miss the signs and symptoms of a heart attack because they show up in different ways in women than they do in men. It is important for women to understand that the signs and symptoms of a heart attack are different for them.

It is very important that if any of the below listed warning signs start to appear that you should seek immediate medical attention. It could mean life or death, which is why I feel that it is vitally important for all women to be aware of the warning signs of a heart attack.

Symptoms of heart attacks in women

In women, almost all heart attacks start slowly with mild pain or discomfort. Below are common symptoms of a heart attack in women:

Shortness of breath may occur with or without chest discomfort
Nausea and light-headedness
Flu-like symptoms, including chills and cold sweats
Heart palpitations
Chest discomfort (angina): pain, tightness or pressure in the center of the chest that lasts more than a few minutes, or that goes away and comes back, this is seen less often in women than men
Discomfort in other areas, including pain or discomfort in: one or both arms (especially the left arm), the back, between the shoulder blades, neck, jaw or stomach – this is the most common set of symptoms we see
Heartburn or indigestion
Extreme fatigue

Strokes are as well-known as heart attacks, but tend to come on unexpectedly. Allow me to share some of the signs and symptoms that a stroke may be occurring:

Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
Sudden confusion, trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance or coordination
Sudden, severe headache with no known cause

I feel that is worth noting that in certain women, symptoms such as palpitations, chills, or faintness could actually be symptoms of perimenopause. If you happen to be experiencing any of these symptoms, please see your doctor immediately to rule out a heart attack. It could save your life.

Symptoms of inflammation

Heart disease often occurs together with inflammation. Monitoring any inflammation indicators you might have is a helpful way to assess your risk of heart attack or stroke.

Below are some of the symptoms to take into consideration (for more information read our articles on inflammation):

Elevated levels of CRP, homocysteine, LDL or triglycerides
High blood pressure
Insulin resistance or diabetes
Joint pain or arthritis
Headaches
GI distress, bloating, constipation/diarrhea
Ulcers/heartburn
Food and other allergies/sensitivities
Chronic respiratory difficulties, asthma, or bronchitis
Dry, itchy skin, rash, psoriasis or eczema
Weight gain/obesity
Fever or chronic infection
Other autoimmune diseases
Achiness all over
Digestive issues, bloating, gas, chronic abdominal discomfort

To learn more about the underlying causes of heart disease, see our articles about risk factors for heart disease.

Sarah’s Story: Relief From GI Pain

womentowomen on December 8, 2013

by Marcelle Pick, OB/GYN NP

One woman’s amazing story of gastrointestinal relief

When Sarah first came to see me, she was a 45 year old woman who suffered for more than five years with gastrointestinal pain as well as discomfort. This included her body alternating between constant diarrhea and constipation, sensitivity to particular foods, persistent bloating, extreme flatulence, and probably environmental allergic reactions, uncommon exhaustion, as well as upper respiratory issues.

Sarah was a married woman, who more than likely was married to an alcoholic. Not only that, but Sarah also lived in a home that her husband purchased before they were married and she resided in this home with her husband and his mother. His mother happened to have furnished the entire home before Sarah moved in. Years before Sarah came to see me she already started doing internal healing work. She was curious to examine how she could create boundaries for herself in her current home, as well as if this was the best home for her to live in.

Sarah requested a food allergy and food intolerance panel performed. I spoke with Sarah, and we discussed performing a CDSA along with a CP x2 with a purge. The testing suggested that she suffered with Candida (yeast), which is an overgrowth of the bacteria’s unbalanced intestinal flora plus she had several food sensitivities. Immediately, I opted to put Sarah on numerous dietary supplements including probiotics. I also asked that she avoid the food allergens that her test revealed and she was quickly placed on a yeast-free diet. None of this is easy to do, but the results are life changing for many.

She quickly began to feel healthier than she ever had in her life. Sarah was not suffering from constipation, diarrhea, abdominal bloating or discomfort any longer. She told me that her energy levels were better than she could ever remember. Not only that, but Sarah shared with me that she felt at least 20 years younger!

Sarah is now able to create the boundaries she desires in her life. She made the changes in her relationship that she wanted to make. She also made the changes in her home life she felt were necessary for her to continue moving in a positive direction. As Sarah demonstrates, when you feel better, it is easier to take the steps needed to improve your life.

During her last visit, Sarah told me that she finally feels as though she has reached a sense of balance in her life. She truly understands now that she has accomplished her internal balance emotionally by looking at her issues that kept her feeling “stuck.” She also completed the outer pieces that she needed to do which included getting her physical problems in order. Sarah explained how she felt that her inner life and biological issues were finally aligned and balanced. I predict that Sarah will no longer have problems in her future with dysbiosis.

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Fibroids and Myomectomy

womentowomen on December 5, 2013

by Marcelle Pick, OB/GYN NP

Myomectomy for problematic fibroids

Myomectomy involves uterine resection which is the removal of a fibroid and a small portion of the uterus where the fibroid is attached. Myomectomy requires a highly skilled GYN surgeon, to obtain success.

Damage to the uterine tissue as well as the surrounding organs can happen with other techniques so the main goal of myomectomy is to minimize these complications. Myomectomy can be performed via open incision, or via laparoscope or hysteroscope. Each process has its advantages and limitations, but laparoscopic myomectomy and hysteroscopy myomectomy are less invasive than open surgery and require far less recovery time.

Not all fibroid cases make good candidates for this method. Many women do have good success with myomectomy, but women with larger or multiple fibroids, we have seen the fibroids return over time, depending on the size and position of the original fibroids, as well as the expertise of the surgeon.

Talk to your surgeon before you decide, ask questions, and you can also obtain more information here at Women to Women with our articles concerning the causes and the natural treatments for fibroids.

Many women have great success with this method of removal and were thrilled to not have such an invasive procedure such as a complete hysterectomy.

For more information about myomectomy for removal of uterine fibroids, visit www.ob/gyn.net.

Acid Alkaline Food Chart

womentowomen on December 5, 2013

by Marcelle Pick, OB/GYN NP

pH balancing foods

Combined with our articles about pH balance and digestion, this chart of acid/alkaline forming foods will help you gain a better understanding of the effect that individual foods have in terms of digestive pH.

There are a lot of such lists out there, a few more definitive and reliable than others, and contradictions among them do show up, however the basics are fairly consistent. This list is just a sampling an overview of which foods fall on either side of the pH scale. From this basic understanding you could start to assess how pH may be playing a part in your personal health and diet picture.

All humans have this in common: when the body is under threat or not functioning well, it communicates that fact by way of physical symptoms. And the one irritating symptom that is most common is stubborn weight gain—weight that just won’t budge, no matter what you do. In fact, weight gain as a symptom of a body out of core balance is so ubiquitous that I’ve coined my own term for it: toxic weight. You gain toxic weight when your body and mind are overburdened, and you won’t ever lose it permanently until you unburden yourself.

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Chart of alkalizing foods

Alkalizing vegetables
AlfalfaBarley grassBeets and beet greensBroccoli Cabbage Carrot Cauliflower Celery Cucumber Fermented veggies (Sauerkraut, kim chee) Garlic Green beans Green peas Kale	KohlrabiLettuceMushroomsNightshade veggies (Tomatoes, peppers, eggplant, etc.) Onions Peas Pumpkin Radishes Sea vegetables Spinach Sprouts Sweet potatoes Wild greens
Alkalizing fruits
AppleApricotAvocado Banana Berries Cantaloupe Cherries, sour Coconut, fresh Currants Dates, dried Figs, dried Grapes Grapefruit Honeydew melon Lemon	LimeMuskmelonsNectarine Orange Peach Pear Pineapple Raisins Raspberries Rhubarb Strawberries Tangerine Tropical fruits Watermelon
Alkalizing protein
AlmondsChestnutsMillet	Tempeh (fermented)Tofu (fermented)Whey protein powder
Other alkalizing foods
Apple cider vinegarBee pollenGreen juices Lecithin granules	Mineral waterMolasses, blackstrapProbiotic cultures Soured (cultured) dairy products

For more information, read our informative article, “The Truth About pH Balance“.

The Role Of Stress and PMS

womentowomen on December 5, 2013

by Marcelle Pick, OB/GYN NP

I’ll never forget it. I was 20 years old, having just graduated from college and home for the summer while preparing to take off for a long-awaited trip to Europe. My whole life lay ahead of me—and I wasn’t even able to get motivated to renew my passport. Despite all the wonderful things I had to look forward to, I was miserable. I felt bloated and weighed down, physically and emotionally.

I remember sitting in my mother’s car outside a pottery shop while she went inside. I was thinking about all the things I had to do: get my tickets, shop for new clothes, and call the close friend who would be traveling with me. This should have been an exciting time, so I couldn’t understand why I felt so numb. Only a few days earlier, I had felt thrilled to be going off to explore this new chapter of my life. But now I was filled with despair. What in the world had happened to me?

Looking back on that bewildered 20-year-old, I wish I could tell her what I know now. I wish I could say to her, “I know you feel overwhelmed and confused. But there is a simple explanation. You’re suffering from premenstrual syndrome (PMS) symptoms, and the good news is that help is readily available.”

My hormonal journey

I struggled with hormonal issues throughout my 20’s. Every month I wondered whether this one would be just difficult or a truly grueling ordeal. All too often, I felt like an alien had taken up residence inside me, bringing with it bloating, nausea, ravenous appetite, low energy, and terrible cramping. Usually I enjoyed life – but not when these symptoms flared. When I became a nurse-practitioner, I discovered that I was far from alone.

Many of my patients struggled with difficult PMS, painful periods, or challenging perimenopause – the transition into menopause that typically begins in the early or mid-40’s and continues until menopause finally takes over. My patients were also dealing with endometriosis, fibroids, polycystic ovarian syndrome (PCOS), and premature ovarian failure (POF), and other fertility issues. Many women felt, as I did, that hormonal issues were playing far too big a role in their lives. We all longed for a straightforward solution.

When I would ask women to tell me about their PMS symptoms and how PMS affects their lives, they would say, “I’m just not ME when I’m PMS-ing.” Or they say that they miss work each month from the headaches, cramps, or irritable bowels that come before their periods. But because so many of us suffer from the PMS symptoms, we may not search for answers to feel better because we think it’s normal to “feel hormonal” once a month.

Well, I am here to tell you – chronic symptoms of PMS are not normal. And they may even point to a hormonal imbalance that may affect how your body responds later to perimenopause and menopause.

After years of experience at my clinic, I can assure you that there is no reason for you to suffer every month. There are a variety of ways that you can help to reduce the hormonal fluctuations that cause your PMS symptoms. This will set the stage for a healthy, balanced future.

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What You Can Do To Reduce Or Even Eliminate PMS

womentowomen on December 4, 2013

by Marcelle Pick, OB/GYN NP

I will never forget it. I was 20 years old, having just graduated from college and home for the summer while preparing to take off for a long-awaited trip to Europe. My whole life lay ahead of me—and I wasn’t even able to get motivated to renew my passport. Despite all the wonderful things I had to look forward to, I was miserable. I felt bloated and weighed down, physically and emotionally.

My hormonal journey

I struggled with hormonal issues throughout my 20’s. Every month I wondered whether this one would be just difficult or a truly grueling ordeal. All too often, I felt like an alien had taken up residence inside me, bringing with it bloating, nausea, ravenous appetite, low energy, and terrible cramping. Usually I enjoyed life but not when this other entity paid its monthly visits.

When I became a nurse practitioner, I discovered that I was far from alone. Many of my patients struggled with difficult PMS, painful periods, or challenging perimenopause, the transition into menopause that typically begins in the early or mid-40’s and continues until menopause finally takes over. My patients were also dealing with endometriosis, fibroids, polycystic ovarian syndrome (PCOS), and premature ovarian failure (POF), and other fertility issues. Many women felt, as I did, that hormonal issues were playing far too big a role in their lives. We all longed for a straightforward solution.

You don’t have to live with chronic symptoms of PMS! After years of experience at my clinic, I can assure you that there is no reason for you to suffer every month. There are a variety of ways that you can help to reduce the hormonal fluctuations that cause your PMS symptoms.

What you can do to reduce – or even eliminate – PMS

It’s natural for your hormones to shift and fluctuate throughout the month, but when you experience uncomfortable symptoms, it’s time to listen to the message your body is sending – symptoms are your body’s way of letting you know that your hormones are not in balance. There are simple changes you can make to help regain that balance!

Eating well – lowering your carbohydrate intake and eating protein at every meal and snack will help keep your insulin levels stable, getting enough sleep, paying attention to your stress levels and moving your body every day are great ways to start.

For more than 30 years I have witnessed the women I’ve seen at the clinic make adjustments to their daily living, transforming them and the way they feel in the weeks before their menstrual cycles.

Herbal remedies support hormonal balance and prevent symptoms

Herbal remedies can offer targeted support for your body, so it can meet the demands being placed on it that lead to hormonal imbalance and PMS. This is especially true with blended herbal therapies that are “adaptogenic”—meaning that they allow your body to use only what it needs to create your own hormonal balance.

Do you have a PMS diet?

The typical North American daily diet is filled with processed food, sugar, and designer coffee that are all difficult to resist—until something goes wrong. One of the first signs that what you are eating is not meeting what you need is when you have PMS symptoms that grow worse.

It’s important to remember that if what you eat is high in simple carbohydrates and sugars, this diet can lead to insulin resistance and weight gain, so your first focus needs to be on decreasing your carbs. Because fat cells produce estrogen, the more fat you have, the higher your estrogen levels may become. This disrupts your natural hormonal balance and makes your PMS symptoms worse. A better way is to eat a balanced diet that is rich in whole foods, non-starchy vegetables, and healthy proteins and fats, which may prevent insulin resistance and weight gain.

I also want to suggest that you consider taking a high-quality multivitamin, omega-3 fish oil, B complex vitamins, calcium, magnesium, and vitamin D – these can all make a great difference in the way that you feel. And a final suggestion: be sure to eat regular meals and snacks throughout the day to support balanced blood sugar, which stabilizes your mood.

Exercise for PMS relief

Regular aerobic exercise will ease your premenstrual symptoms by increasing natural painkilling, euphoria-producing chemicals in your body. These chemicals, called endorphins and their levels tend to drop in the second half of your menstrual cycle.

In addition, exercise boosts your detoxification capabilities by increasing the cleansing action of your lymph system and helping to rid your body of toxins and excess hormones through sweat. An added benefit it that it increases your metabolic rate, and this encourages the body to burn fat for energy, thereby helping you to maintain a healthier hormonal balance.

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5 Multivitamin Myths, Part 1

womentowomen on December 4, 2013

by Marcelle Pick, OB/GYN NP

Do you need a multivitamin if you eat healthy food?
Are multivitamins a waste of money?
Are multivitamins unsafe?
Does your body benefit from multivitamins?

Essential vitamins

Let’s start by exploring these building blocks of healthy nutrition, called vitamins. Vitamins are the ever-busy worker ants of the metabolic process. They are numerous and their functions are on the verge of miraculous, from protecting eyesight to scrubbing cells to repairing deoxyribonucleic acid (DNA). Vitamins work hard with the help of enzymes to activate (catalyze) body functions. As coenzymes, vitamins regulate metabolism and help in myriad biochemical processes that release energy from food. Most are water-soluble, so any excess is excreted in urine. Those that are fat-soluble—vitamins A, D, E, and K—are stored in tissue and can become toxic at high levels. For this reason, I do not recommend self-prescribing high dosages of fat-soluble vitamins.

There are several subcategories of vitamins. Bioflavonoids, sometimes referred to as vitamin P, are not true vitamins, but are essential for the absorption of vitamin C. Carotenoids/ carotenes, a subclass of vitamin A, are antioxidants thought to help prevent cancer, much like vitamin D. Beta-carotene and lycopene are two of the most widely known carotenes; however, there are as many as 600 and still more to be discovered. Finally, Co-enzyme Q10 is a vitamin-like substance that resembles the structure of vitamin E; it’s a powerful antioxidant and mitochondrial helper.

Should you worry about your vitamins?

Let’s discuss an example that you may find similar to your own experience. One evening on her way home, Heather stopped with her children at the grocery store purchase a multivitamin for herself. The children were hungry, and they were disappointed that the race-car grocery cart they usually sat in wasn’t available. By the time Heather arrived at the vitamins, she picked up two brands, checking each for the quantity of vitamin D (she had read that it was important), then reached for a third brand to compare it to the others. While trying to compare the three bottles to see what she should purchase, she saw her daughter running away. After chasing her through the store and putting the vitamin selections down somewhere near the eggs, Heather gave up, bought a pre-cooked chicken, and went home. The next day Heather was thankful that she hadn’t bought one of the store vitamins because her health-care practitioner informed her that they were a waste of money because her body could not absorb them!

When I heard this story about Heather, I thought, Wow, we’ve got a lot of work to do. You have probably heard about reports that say that multivitamins and nutritional supplements are a waste of good money, a scam, or even hazardous. But if that’s the truth, then why do so many people take them?

If you’ve been confused or frustrated like Heather, this article is for you. Let’s take look at the most common myths about multivitamins. I want you to be able to make a knowledgeable decision about what’s best for you for your healthy balanced lifestyle.

Myth 1: All multivitamins are created equal

In these difficult financial times, I know that many of us shop at discount stores. But please let me give you a bit of advice regarding purchasing your vitamins and your supplements from these stores. The makers of these supplements may not follow a good manufacturing process. These multivitamins are often poor quality, low on nutrients, and full of unnecessary additives.

If you purchase inexpensive multivitamins, you can probably find that they contain nutrients that are hard for the body to break down and utilize. However, if you choose to purchase professionally formulated brands that combine naturally sourced nutrients and chelated minerals, and then be assured that your body can digest and use those vitamins more readily. Some cheap multivitamins contain preservatives, sweeteners, fillers, and artificial colors or flavoring, while others leave these additives out.

I like to compare multivitamins to salads. Most of us would agree that salads are good for us. However a salad made of lettuce from a bag, which was sprayed with chemicals, and topped with salad dressing made with high-fructose corn syrup is very different from a salad made with organic spinach, topped with olive oil, lemon juice, and walnuts. Salads can be made with different quality ingredients, and multivitamins can be made with different quality ingredients. Be a smart consumer!

Myth 2: If you eat a healthy diet, you don’t need a multivitamin

How many times have you heard this myth? In a recent Huffington Post blog, my colleague and functional medicine pioneer Mark Hyman, MD, agreed that you don’t need to take a multivitamin—but, listen to what he says: “ONLY if you eat wild, fresh, whole, organic, local, non-genetically modified food grown in virgin mineral and nutrient soils, and not transported across vast distances and stored for months before eaten . . . work and live outside, breathe only fresh unpolluted air, drink only pure, clean water, sleep nine hours a night, move your body every day,and are free from chronic stressors and exposures to environmental toxins.”

We are exposed, whether by choice or happenstance, to a variety of factors that will make it hard to get everything that our body needs nutritionally—even if we eat a healthy diet. Studies show that most of us do not get the basic nutrition that is needed to prevent disease, let alone achieve the optimal health that we’re working toward.

Of course, taking a vitamin is not a replacement for eating healthy food! But there is evidence that some scarcer key nutrients are more reliably obtained from supplements. The current research suggests that vitamin K, for example, is absorbed better from tablets than from food. Iodine is another crucial micronutrient that many women lack. Vitamin D and omega–3’s are simply not found in sufficient quantity in the food we eat to fully guard us from degenerative disorders. A good multivitamin–mineral complex will cover these gaps. This is essential for women who have been under a lot of stress, or if they are on a special diet, or especially if they have food sensitivities.

See Part 2 for Myths 3-5.

What to look for in a multivitamin?

Be sure the multivitamin you choose has some or all of the following characteristics:

Pharmaceutical grade.
Contains the most bioavailable forms, including chelated minerals
Contains naturally-sourced nutrients
No preservatives, sugar, artificial flavorings, fillers, dyes, or colorings

In our experience, women cannot resolve the imbalances and symptoms we see most often without filling the gaps in their nutritional foundation. For further guidance, see our articles about choosing a multivitamin.

Electronics and multivitamins?

Did you know that exposure to even extremely low-frequency electromagnetic forces (EMF) through our abundant cell phone use, wireless technology, televisions, computers, and other electronics, is associated with oxidative stress, lowered immune defense, and DNA damage in our bodies?

We may not always be able to modify our environment, but we can help offset this everyday oxidative damage by taking a multivitamin enriched with antioxidant nutrients—putting a little more in our cellular health savings account!

Brilliant yellow urine—what’s that about?

When you take a “rich” multivitamin, you will notice that your urine fairly glows in the dark. Have you wondered if maybe those vitamins just simply went right through you? Women often ask us about this phenomenon, and we’re happy to explain. What makes your urine yellow is a fluorescent component of riboflavin (vitamin B2) called the flavin ring. As it passes along the body’s metabolic pathways, riboflavin plays many important roles and undergoes biochemical changes. Several of riboflavin’s molecular metabolites retain the fluorescent flavin ring that, when excreted, gives your urine that special glow!

Read our other articles about riboflavin metabolism for more information.

Birth Control Methods

womentowomen on December 2, 2013

by Marcelle Pick, OB/GYN NP

Method	Reliability*	Protection against HIV/STDs?	Pros and Cons
Intrauterine Devices (IUD/IUS)
(All)	99%	No	Pros: Longevity/Low side effect profile/High initial cost, but low cost when averaged for the lifespan of device. Cons: Recommended principally for women in monogamous relationships. Can be expelled or become dislodged. Not recommended for women with fibroids.
ParaGard (Copper T) IUD			ParaGard can stay in place for up to 10 years. Fertility usually resumes immediately when removed. Can be accompanied by an increase in volume and duration of menstrual flow.
Mirena IUS			Mirena can remain in place for 5 years. Possible delay in return of fertility once Mirena IUS is removed. Releases levonorgestrel (LNg), a synthetic progestin, just in the uterus. Reduces menstrual volume eventually, but spotting can occur in initial 6–12 months.May cause benign ovarian cysts.Can rarely cause hormonal side effects similar to those seen with oral birth control pills, such as mood swings, breast tenderness, headaches, and acne.
Sterilization
(All)	Greater than 99%	No	Pros/Cons: Surgical risks. Permanent way to no longer become pregnant. Cost-effective over time.These methods can in some (few) cases be reversed, depending on the method and the individual.
Tubal ligation (female)			Tubal ligation immediately effective.
Vasectomy (male)			Vasectomy is not immediately effective; it may take months before full sterility is achieved. The man must follow up with the practitioner to be sure that the vasectomy was successful.
Hormonal Methods
Birth control pills (BCP) (Oral contraceptive pills —BCPs/OCPs) Options include: —20–35 mcg combined pills —Regular or extended-cycle use pills —Pills with shortened pill-free interval option —Progestin-only mini-pills	95–99%	No	Pros: High rate of efficacy. Relatively convenient. Multiple options available. Regulates menstrual cycle. Decreased risk of endometrial and ovarian cancer, endometriosis, pelvic inflammatory disease (PID). Cons: Undesirable risks and side effect profile in some women. Not affordable for all women. May have drug interactions.
Vaginal ring (NuvaRing)	About 99%	No	Pros/Cons: Same as w/BCPs, see above. Other advantages: Privacy.Use allows for more normal vaginal moisture and flora, reducing yeast infections for some women. Protection from pregnancy one month at a time. Other disadvantages: Contraindicated with certain pelvic conditions, for example, uterine prolapse, endometriosis, susceptibility to irritation, etc.
Transdermal birth control patch (Ortho Evra)	About 99% (less reliable for women who weigh more than198 pounds)	No	Pros/Cons: Similar to those of BCPs, see above, except exposure to synthetic estrogen is about 60% higher, with resultant higher risk profile for thromboembolic events.
Depo-Provera injection	99.7%	No	Pros/Cons: Same as w/BCPs, see above. Other advantages: Effective 24 hours after injection. Other disadvantages: Side effects can be significant and long-lasting, including reduction in bone density, depression, and weight gain.
Contraceptive implants	99%		Pros: Longevity: Different systems last from 3–5 years.Fertility returns relatively quickly. Cons: Can be difficult to remove. Potential for scarring. Side effects can in some cases be significant and long-lasting.
Barrier Methods
Male condom	87–98%	Yes, except for sexually transmitted infections (STI) contracted from genital areas not covered*	Pros: Convenience and availability.Multiple options.Inexpensive.Allows greater male partner participation. Cons: Reduced spontaneity. Reduced sensation. Some users experience allergies.
Female condom	79–95%	Yes; only abstinence provides better protection*	Pros: Can be placed up to 8 hours in advance. Good protection against STIs. Does not require fitting by health care practitioner. Cons: Only 1 style currently available. More costly than male condoms.
Female cervical cap	Varies: 68–91%	No	Pros: Can be inserted up to 6 hours in advance. Very few side effects. Several designs on the market. Cons: Relatively low efficacy, *especially in women who have given birth. Some types require fitting by health care practitioner; limited to 4 sizes. Not widely available.Some users experience allergies.
Spermicidal Methods
Today Sponge	89–91**	No	Pros: Immediate and continuous protection for 24-hour period. One size fits all and easy to insert. Cons: Cost. Removal can be tricky for some. Some users experience sensitivities/allergies to spermicide.
Diaphragm with contraceptive jelly or foam	80–94%	Some*	Pros: Few side effects. Can be inserted up to 6 hours in advance.Can be used for intercourse during menses to collect flow. Cons: May reduce spontaneity. Requires fitting/periodic refitting. Some users experience allergies. Some consider method to be “messy”.
Vaginal contraceptive film, foam, inserts	74–94%; efficacy maximal when used in conjunction with barrier method	No	Pros: Readily available. Relatively inexpensive.Lubrication. Cons: No protection from STI/HIV infection. Some users experience irritation and/or allergies. “Messiness” factor. Must be inserted within an hour before intercourse.
Fertility Awareness Methods (FAM):
Examples: Basal Body Temperature (BBT) Sympto-thermal Billings Ovulation “Rhythm”	88–98%	No	Pros: Zero health risks or side effects. Enhances body awareness and partner intimacy. Inexpensive. Cons: Requires significant partner education, cooperation, and daily attention. Relatively high failure rate. Not ideal in perimenopause years or for women with otherwise irregular cycles.

* Assumes perfect use, that is the method is used correctly each and every time. Actual effectiveness rates vary significantly. Statistics from Our Bodies, Ourselves (Boston Women’s Health Book Collective, 2005).

** McClure, D., & Edelman, D. (1985). Worldwide method effectiveness of the Today vaginal contraceptive sponge. Adv. Contracept. 1: 305–11.

Sex & fertility

Birth Control Method Comparison Chart

This comparison chart provides various methods of birth control, along with their reliability factors, pros and cons, and also advantages and disadvantages. This information will give you and your partner knowledge about a variety of conception methods, including intrauterine devices (IUD), hormonal methods (pills, ring, patch, injection, and implant), spermicidal methods, and family awareness methods (rhythm, body temperature, billings, and sympto-thermal).

While these mentioned methods are primarily female related, there are two methods that also include men. These are sterilization (tubal ligation for women and vasectomy for men) and barrier methods (male and female condoms). As a woman, or together as a couple, it is critical for you to be well informed about all available options. This chart is a compilation of currently available choices. It is wise to review the options with your health care practitioner from time to time to determine if the contraception method you are currently using is the best for your healthy lifestyle. I hope this knowledge will empower you.

Refer to our other articles about birth control for more information.