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The Truth About Perimenopausal Weight Gain

womentowomen on August 11, 2014

by Marcelle Pick, OB/GYN NP

As women, we spend so much of our lives comparing ourselves to other women – whether it’s our friends, our co-workers, our sisters, or the many women who stare back at us from the pages of magazines or TV and film screens. We use them as models of what is good and beautiful, and what is not. Many of us struggle to accept that our nose or our thighs are just never going to look like Gisele’s.

Finally we make peace with our bodies and learn to love them as they are and then BAM! Perimenopause shows up with all its challenges, from hot flashes to headaches to the dreaded weight gain. Suddenly we find ourselves looking in the mirror wishing we could have our old bodies back. Perimenopausal weight gain is very common; it’s our bodies’ way of adapting to our new hormone levels and supporting us during the changes that nature intended to occur as we leave our reproductive years behind.

But just because it’s common doesn’t mean its mandatory. We all have a metabolic set point, and that set point can change, but it does not need to change after menopause. Weight gain is another symptom of imbalance in your body and with some effort and care, you can maintain — or restore — your ideal weight in perimenopause and menopause and beyond.

Let’s look at what is going on that is encouraging your body to store more fat and what we can do to help our bodies to let it go.

Causes of Menopausal Weight Gain

While we are all unique and we each face our own weight challenges, there are some common causes of menopausal weight gain that many women struggle with. Our hormones and our fat cells are part of a complex and comprehensive network responsible for metabolism, appetite, digestion, heat regulation, and detoxification. Any breakdown in communication will result in symptoms like hot flashes, food cravings, and yes, weight gain.

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In order to prevent weight gain, we need to ensure that the network is communicating regularly and effectively so that there are no breakdowns. There are many connections and links between hormones and fat and we are still learning about all of them. But one absolutely critical link is the connection between insulin, metabolism and body fat.

Insulin Resistance

Our bodies have three primary hormones: insulin, adrenaline, and cortisol. Adrenaline and cortisol manage our stress response while insulin controls our blood sugar levels. In other words, food and stress directly affect our hormones! Insulin is driven by the food we eat and when we eat too much sugar, white flour and processed foods, insulin levels will rise. When we are exposed to high or chronic stress, adrenaline and cortisol will increase.

Whenever our body is out of alignment and struggling with a primary hormone, it does not have the resources or the ability to produce optimal levels of secondary hormones such as estrogen and progesterone. Many of us eat too much white sugar and white flour, too many processed foods and carbohydrates and not enough healthy fats.

Whether your weakness is bread, pasta, sugared coffee drinks, alcohol or dessert, if your blood glucose levels are high and you are approaching insulin resistance, or have insulin sensitivity, your body will convert every calorie it can into fat. That’s because even though you may be gaining weight, your cells are actually starving for the healthy nutrients they need!

In addition, whether you have been diagnosed with diabetes or insulin resistance or not, many of us have insulin sensitivity and have glucose levels that are higher than they should be. Heading into perimenopause, this is a recipe for weight gain. Your body will store fat to ensure it has what it needs, and your hormonal imbalance and sugar consumption may lead to cravings that are hard to resist. If you do choose a high sugar option, be sure to add some protein to help stabilize your blood sugar levels.

For more information, read our numerous articles about this topic in our Insulin Resistance category in our Health Library.

On a side note, I just want to say that the answer to sugar cravings is not artificial sweeteners. These sweeteners such as aspartame (NutraSweet and Equal), sucralose (Splenda), and saccharin (Sweet ’n Low or Sugar Twin) have toxic effects on the body that can bring a host of side effects including headaches and digestive problems and can also exacerbate your underlying hormonal imbalance issues. For more information on this topic, read our article, “Sugar Substitutes And The Potential Danger Of Splenda“.

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Sweet Poison – Kicking Your Sugar Addiction

womentowomen on June 25, 2014

by Marcelle Pick, OB/GYN NP

When I started my practice years ago, I truly didn’t understand the power of food, but now I know more than ever that sugar can be a game-changer for people today. The epidemic of obesity is largely driven by the fact that sugar is an additive in many foods today – hidden in condiments, in almost every processed foods – including ones you’ve heard are healthy for you – like Greek-style yogurt with fruit! Many popular brands do indeed have additional protein but also contain many grams of sugar. Sugar increases insulin resistance, contributes to hormonal imbalance, fatigue and mood swings – and can cause weight gain, particularly around your middle.

The Seductress

She’s sexy and seductive. She’s sweet and rich and eminently satisfying. She brings us joy and comfort and pleasure. She’s our reward, our indulgence, and our gift to ourselves. She hides in plain sight and try as we might, we cannot let her go. We do our best to stay away. We set the intention to resist her. We focus our mind on other things, but like an irresistible temptress, she calls us back and makes us want her again. She is ubiquitous, unavoidable and compulsively compelling. She is … sugar.

These days so many of my patients are struggling with sugar addictions. Sugar is everywhere, hidden in so many foods and available in so many different forms, it’s hard to avoid. It goes by many different names including glucose, fructose, high fructose corn syrup, corn syrup, malt syrup, dextrose, and evaporated cane juice to name a few. And it hides in plain sight: oh how it hides!

While we expect to find sugar in candy bars and cookies, sugar is a common ingredient in fruit drinks, coffee drinks, cereals, salad dressing, ketchup, pizza and spaghetti sauce, and yogurt. Many people don’t realize that a small yogurt with fruit or fruit flavoring can often have as much sugar as a can of soda! While clearly yogurt is a better choice, the sugar levels in many processed and prepared foods can be much higher than you would ever imagine.

Especially vulnerable to high sugar content are low-fat foods. To make up for the diminished flavor resulting from the fat reduction, manufacturers often add sugars to improve the taste. (Just try looking for a low-fat salad dressing without sugar!) We know now that fat is not the enemy: actually, it is sugar. But knowing that is only part of the solution: what do we do about it?

Because most processed foods contain added sugars, our sugar thresholds are constantly increasing, making us want more and more. Even healthier forms of sweetness such as maple syrup or raw honey still provide higher levels of simple carbohydrates these days than our bodies require or desire. Sugar impacts a variety of biological functions in the body and can be compared to heroin in it’s addictability. Let’s look at the impact sugar has on our bodies and how we can reduce our sugar cravings and end our sugar addictions for good.

The Impact of Sugar on our Bodies and Emotions

Most of us grew up associating sweets with a special occasion such as a birthday or a holiday celebration. Many of us still associate a treat with celebration and reward.

We may have gotten to help mom or grandmother lick a bowl of brownie batter or cookie dough or been rewarded with the first cookie out of the oven. We hold special meanings in our hearts for those events and for the people who loved us and shared that special treat with us.

We may even look at our parents and grandparents and think, “They grew up indulging in homemade baked goods and they were fine. What’s the big deal about a little sugar?” Back then, however, it really was a treat; it wasn’t an everyday occasion. And mom and grandma were cooking mostly from scratch, making their own meals, and controlling their own ingredients.

Today we are so busy that most of us are cooking out of bags and boxes and the prepared processed food we consume is very different than what our parents grew up eating. It’s full of artificial ingredients and loaded with sugars. So, if it were just the occasional brownie or cookie, as it was in our youth, it might be just fine. But today, it’s the treat at the end of the day on top of all of the other sugars we are consuming that causes concern.

There have always been sweets in our diets: raw honey, maple sap, fruits and berries, and dates have long been used to add some sweetness in countries around the world. In generations past, we might, for example, indulge in a tablespoon of honey, burning off those 60 calories with our physically active lifestyle. Today, our average sugar consumption is a cup of sugar a day. At 774 calories and given our more sedentary lifestyles, that’s a huge caloric shift.

But it’s not just the calories that cause concern. Sugar has been shown to feed cancer cells and has been connected to breast, ovary, prostate, rectum, lung, gallbladder and stomach cancers. Sugar can interfere with the absorption of protein, cause gastrointestinal concerns such as increased risk of Crohn’s disease, ulcerative colitis, indigestion, acidic digestive tracts, and can cause food allergies. Sugar has also been connected to kidney disease, high blood pressure, asthma, arthritis, inflammation, diabetes and insulin resistance and heart disease. In fact, one cardiologist even declared that virtually all of his patients who suffered heart attacks also had above normal blood glucose levels.

Sugar raises your fasting glucose levels, which can lead to hypoglycemia. And we all know what happens when your blood sugar levels crash after a sugar spike! More aggressive behavior and a reduced immune system are also impacts of sugar, especially for children. Research has connected children’s behavior to their level of sugar consumption. When your body experiences the sugar crash post consumption, blood sugars fall and the brain is affected since glucose is its primary fuel.

So we have a soda, blood sugar goes up, the body releases insulin in response and the insulin increase causes the blood sugar to drop. As the ups and downs continue, the stress on the body causes a fight or flight response that results in a release of adrenaline. Aggressive behavior, anxiety, attention struggles and hyperactivity can occur not surprisingly.

It’s hard enough to manage your children’s sugar intake at home, but harder still at school. Even if you pack a healthy lunch, there is a plenitude of treats accessible. More than 80% of schools have contracts with soda companies, so whether it’s a soda or a fruit juice, an “energy” drink, or even flavored milk, high sugar options abound in schools.

There are some success stories, however. One Georgia elementary school adopted a sugar-free policy in 2005 making every parent and child sign an “Achieving Excellence Through Nutrition” contract. Sugary foods are prohibited and are taken from the children if they show up at school. School menus were changed; a good night’s rest and a healthy breakfast were expected.

The results included a 28% drop in bad behavior referrals by teachers, a 30% decrease in visits to the school nurse, and higher test scores. These measures may be extreme, but so are the results!

Sugar also wreaks havoc on our mineral absorption. Minerals play a critical role in digestion, maintaining our pH balance and nerve impulse transmission. When our mineral balance is out of alignment, we can experience trouble sleeping, anxiety, asthma, tooth decay, and weaker bones. Minerals function in a proper balance and when one mineral is out of proportion, the others typically follow suit.

Studies have shown that sugar causes the body to release calcium and magnesium, throwing the calcium and phosphorous ratio out of balance. In an attempt to rebalance the ratio, the body will pull calcium from teeth and bones. But because the alignment of calcium, magnesium and phosphorous remains unbalanced, the calcium isn’t fully or properly utilized and it will likely be excreted through the urine or land as a kidney or gallstone. So teeth and bones pay the price for the excess sugar, but the problem still isn’t solved.

The Sugar Addiction

We know that addiction to sugar is real, as withdrawal symptoms have been documented including low energy, mood swings, headaches and the relapse desire to consume more. Sugar increases pleasure-yielding opiates in the brain, similar to morphine and heroin, resulting in strong cravings that we cannot ignore. Mood enhancing neurotransmitters such as serotonin and endorphins are released when we eat sugar, making us feel relaxed or energized. We become addicted to the energy surge or the false sense of calm that they provide and return to them for that feeling over and over again.

At the same time, if you are consuming sugar in combination with poor sleep, stress, or adrenal fatigue, the likelihood of intense sugar cravings can increase as the sugar perpetuates a cycle of more sugar cravings that repeats over and over again. Excessive sugar actually re-wires the brain creating a biochemical dependency that will be very hard to ignore.

Even artificial sweeteners without calories trick our brain into wanting that sweet flavor and they come with a host of other side effects. For more information, see our article, “Sugar Substitutes and the Danger of Splenda“. But suffice to say, aspartame (NutraSweet or Equal), saccharin (Sweet ‘n Low or Sugar Twin) sucralose (Splenda) are not good substitutes and should always be avoided.

So many women tell me that they’ve tried to cut back but they can’t seem to stop. Either they feel the withdrawal symptoms of headache, shakiness, fatigue, nausea, or depression or they are overcome by stress and the struggles of work life balance and our busy schedules. Sugar can be a sweet release, a little self-love, an antidote to the absence of pleasure and joy in our lives.

But there are things you can do to begin to wean yourself off sugar and break the cycle of addiction. Let’s look at some small steps you can take forward in the right direction.

How to Beat a Sugar Addiction

If you love sugar, or have a sugar addiction, going cold turkey is not the best strategy. As we discussed, withdrawal symptoms will wreak havoc on your body and your willpower. So it’s best to put a plan in place to slowly decrease the amount of sugar you are consuming gradually over time.

1. Choose naturally sweet foods

Try to indulge your sugar cravings naturally by choosing fruits, berries, dates, raisins and other sweet whole foods. While these foods still have high sugar content, they also contain nutrients and fiber and can help to satisfy a sweet tooth when a candy bar is calling your name. If you want to use additional sweetness try Stevia. It is a more natural substitute, although we are still not sure if it primes some of the receptors in a similar way as does sugar. Stay tuned for more information on that.

2. Read labels

There’s no way around it if you want to beat a sugar craving. So many foods have hidden sugars you don’t even realize are there. Save your sugar intake for the things you really enjoy and remove the excess from the foods you don’t even realize have added sugar. 4 grams of sugar equals about 1 teaspoon so when you read the label and see 28 grams in a yogurt, ask yourself if 7 teaspoons of sugar is a good choice for you.

3. Don’t eat out of habit.

This may seem obvious and simple, but it’s actually neither. We often get into habits such as a 3pm snack for example, or a piece of chocolate after dinner. Try not to eat foods automatically or because that’s what you’ve always done. Instead, choose your sweet indulgences carefully, make them treats to savor, and if you don’t really desire it, skip it that day. Try working down to every other day, then every three days. I’m not saying never have your favorite treats again! But try to limit them to special occasions rather than every day and when you do partake, eat them slowly and savor each and every bite. Also try to eat them combined with healthy fats such as butter, eggs, cream, nuts or avocado to slow the sugar absorption.

4. Examine your emotions

Many of us grab sweet treats when we are tired, stressed, frustrated, angry, or depressed. We tell ourselves we deserve to feel better or we simply reach for it automatically, knowing the calmness or energy surge it provides will help us cope. If you’re feeling an urge for chocolate or ice cream, ask yourself if you really desire that or if what you really need is a hug or someone to listen. For more on this, read our article, “Emotional Eating.”

5. Prep in advance

Have healthy options around so when you are hungry or stressed there is something else available nearby. Chop up some carrots and celery, keep a few hard-boiled eggs in your fridge, make unsweetened ice tea and keep a pitcher handy. You know what your temptations are, so find the antidote -the healthier version, and keep it plentiful so you always have another choice available in any stressful moment.

6. Add fermented foods to your diet

In addition to being nutritional powerhouses, many people find that when added to their diets, the fermented foods seem to help diminish sugar cravings. And if eaten at the same time as something sugary, the beneficial microflora will minimize the negative effects of the sugar as the fermented foods and drinks will use the sugar as its food.

Every culture has its own form of fermented delicacies including miso, tempeh, kimchi, kombucha, kefir, fermented pickles and sauerkraut, fermented condiments such as chutneys and even fermented yogurt and a homemade version of a fermented ginger ale. Adding more fermented foods to your diet will make the sugar you eat less damaging and will help to reduce your cravings for it over time.

7. Eat foods with all six flavors

Ayurveda has been around for thousands of years and teaches us that there are six main flavors to food: sweet, sour, salty, bitter, pungent and astringent. When the body gets all six it is more balanced, digestion is improved and cravings are diminished. Many recipes or meals can easily contain all six, as can one simple side dish like a fruit and spice chutney, which can be fermented to add even more health (and sugar craving reducing) benefits.

Just as all six flavors bring the body back into balance, you can listen to your body and monitor how you feel after eating and use this information to bring yourself back into alignment. Your energy should be consistent and stable after a meal, not high then crashing low. Using healthy fats such as butter, olive oil, nuts and avocado can also help you to feel full, eat less and reduce cravings for something sweet.

8. Eat a healthy balanced diet

Avoiding packaged and processed foods rich in sugar and white flour in favor of fresh organic produce and grass fed meats will help your body restore its own natural balance and make sugar less of a seductress and more of an innocent bystander in your life. Supplementing with a high quality multivitamin (click here to learn about the one formulated by Women to Women) can also help support your body’s balance and eliminate nutritional gaps that could lead to cravings.

9. Try Chromium Picolinate

Chromium supplementation has been shown to help normalize blood sugar levels, improve blood sugar utilization, metabolize fats and decrease insulin requirements in patients with glucose intolerance and insulin resistance. One study tested blood sugar levels after a meal of white bread and found that a single (400 microgram) dose of chromium reduced blood sugar after the meal by 23%.

Chromium has also been shown in studies to reduce carb cravings and stabilize blood sugars, with the best results experienced by the participants with the greatest carbohydrate cravings. Chromium has been shown to reduce triglycerides by as much as 32% and while we don’t know exactly how yet, chromium plays a role in insulin signaling and has been shown to improve glucose disposal rates. If you struggle with cravings or blood sugar issues, consider chromium supplementation. Women to Women has a high quality chromium formulation, click here to find out more.

Sugar is one of the most powerful seductive foods that we can eat. When you stop using it, your life can be changed in the most powerful of ways.

For more information on the topic of sugar, read our article, “Insulin Resistance – Our Love Affair With Sugar.”

Detox and Women’s Health

womentowomen on June 13, 2014

by Frank Lipman, MD

A note from Marcelle: There’s a lot of buzz about detox right now, and we’re glad of it. Detox should be part of every woman’s effort to take control of her health. To help you learn how, we’ve asked Dr. Frank Lipman to share his perspective. Frank specializes in detoxification; he’s the author of a wonderful book on detox, Total Renewal, and his approach is identical to our practice here at Women to Women.

Here are the sections you’ll find in this article:

Why effective detox is a necessity
Environmental toxins
What is detoxification?
Assessing the burden on your detox system
Symptoms of toxicity
How to detox your body naturally

In more than 25 years of clinical experience, I’ve had the great pleasure of working with thousands of patients from all walks of life. Over time, I’ve seen how few of us are able to stay healthy and feel really well as we get older. Many of us have come to accept developing a degenerative disease or simply feeling incrementally worse each year as part of the aging process.

It’s not. There is so much we can do to take control of our health and support our bodies happily and healthily our entire lives. And it begins with understanding what kind of “burden” your body is under right now, today, both physical and emotional, and lessening it.

Think of yourself as a ship floating in water. You will ride high or sink low depending on the burden you carry. The more burdens you unload, the better you will feel. I strongly believe that detoxification is an effective way to unload these burdens and is an essential — and often overlooked — aspect of total healthcare.

In my book, Total Renewal, I go into detail about the seven steps I recommend to detoxify your body, rebalance your biochemistry, and build resiliency for a new lease on your health. I’d like to take this time to introduce the basic ideas behind this concept and the importance of detoxification. These steps reflect the same ideals and integrative approach I share with the practitioners at Women to Women, and I welcome the opportunity to bring them to you. So let’s begin.

Effective detoxification is a necessity

I came to realize the importance of detoxification after studying Chinese medicine and being in practice for a number of years. I learned from Chinese medicine that we (humans) are all microcosms of the macrocosm (the universe), that we are part of it and intricately connected to it. Therefore what is happening to the environment will and does affect all the species in it, including man.

Environmental pollution is not only changing the ozone layer, plant species and animals, but humans as well. But only after seeing more and more young women with breast cancer and infertility problems; patients with chronic fatigue and chemical sensitivities; and more and more patients complaining of aches and pains and degenerative problems, did I suspect something was not right.

It was at that time — about 15 years ago — that I realized that most of these problems were not “normal” aging problems, but rather malfunctioning detoxification systems. I was shocked to discover vast amounts of literature on where these toxins are coming from and what they are doing not only to the environment, but to our health and especially our children’s health.

I began to identify one common link to many of the health concerns I witnessed in my patients: an inability to cope with their toxicity load. It was then that I realized that detoxification is an absolute necessity.

Environmental toxins

Although technology and industry have helped us to live more comfortably and have generally enhanced our way of life, we are paying a heavy price. The air we breathe, water we drink, and food we eat are no longer clean. Our environment is contaminated and polluted. Since the 1940’s there has been an explosion of synthetic products. We are the first generation of humans to be exposed to so many synthetic chemicals.

In the past 60 years, these processes have been significantly altered:

How food is grown and packaged
How homes are built, furnished, and cleaned
How lawns and gardens are maintained
What cosmetic products we use

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Polycystic Ovarian Syndrome (PCOS)

womentowomen on June 13, 2014

by Marcelle Pick, OB/GYN NP

It’s amazing how often we see women at our medical clinic with health issues that can be traced back to insulin resistance. Polycystic Ovarian Syndrome, or PCOS, is one such condition that we see with increasing frequency. PCOS affects about 10% of women worldwide and can occur at any age before menopause. It can often go undiagnosed for months, because its symptoms overlap with so many other women’s health concerns. PCOS itself is not a disease and no one is sure yet what causes it in the first place.

Women with PCOS have ovaries that create an abundance of follicles each month without producing an egg. PCOS can contribute to irregular periods, depression, excessive weight gain (despite diet and exercise efforts), acne, and excess facial hair. It is also a common cause of infertility (for more information, read our article, “PCOS And Fertility – Answers To Your Questions.”

PCOS is often temporary. We see it in girls going through puberty (when their ovaries are trying to set a regular menstrual pattern) and during the transition years of perimenopause. It usually goes hand-in-hand with insulin resistance. We find that PCOS responds well to a program of natural support that restores hormonal balance, especially the dietary changes we recommend for women with insulin resistance.

What is PCOS?

Understanding PCOS is easier if one tries to picture what goes on inside our ovaries every month. For more about women’s monthly cycles, please refer to our article on menstruation.

Each month our ovaries begin to ripen a number of follicles. You may be surprised to hear that normal follicles are cysts – in that they are pockets of tissue filled with benign fluid and hormones, mostly estrogen. The amount of immature follicles changes with each cycle— but during normal times, one or two follicles grow stronger than the others and produce an egg. When we ovulate, the egg in the dominant follicle pops out and flows into the fallopian tube on its way to the uterus. This event triggers a host of hormonal secretions, one of which is progesterone, that will plump up the uterus to support a pregnancy if the egg is fertilized or a normal monthly period if it is not.

Polycystic ovaries

When ovaries become polycystic, they create a lot of follicles that form like a pearl necklace on the ovaries. No one follicle becomes dominant and ovulation can’t occur. For the most part, these multiple ovarian cysts are not dangerous in themselves—unlike larger ovarian cysts that cause pain and can rupture. But they do bring with them a range of uncomfortable side effects. Because a woman with PCOS doesn’t ovulate, her natural sequence of hormonal events gets interrupted, her levels of estrogen and androgens (testosterone and DHEA) remain high, and her body reacts with symptoms.

What are the symptoms of PCOS?

The most common symptoms of PCOS are an irregular period, infertility, increased hair growth and unusual weight gain, even with dieting or increased exercise. Women with PCOS will often go for months without a period and then start bleeding heavily for days. This occurs when the uterine lining has gotten too thick and the body must naturally shed it. Because PCOS disrupts ovulation, it can be very difficult to become pregnant.

Other signs of PCOS include acne, high blood pressure, obesity, and abnormal facial and body hair growth (due to too much testosterone). One of the less recognizable symptoms of PCOS is depression, which can be misread as a bipolar illness. While depression stems from many factors, we think it is always a good idea to consider PCOS if patients have other symptoms. In some medical practices antidepressants are prescribed, which do not alleviate the underlying issues, and therefore are not very helpful.

PCOS and insulin resistance

Another telltale symptom of PCOS is steady, significant weight gain — even with reduced caloric intake. Some women report that they’re gaining weight no matter what they do. It’s not unusual for patients with PCOS to tell me they’ve recently gained 60 or more pounds in less than a year despite dieting all the time and exercise. This weight usually accumulates around their middle. Why do women with PCOS gain weight at such alarming rates? The research is showing that PCOS is strongly linked with insulin resistance.

Insulin resistance — a condition some people get by eating too many carbohydrates — leads to sustained high levels of insulin in the bloodstream. It is possible that this extra insulin hitches into the receptors lining the ovary and stimulates cyst production. This is an issue that should be monitored because women with insulin resistance have a much higher risk of developing other serious health problems, like diabetes. On the bright side, women with insulin resistance and PCOS respond very well to modifications in their diet, adding nutritional supplements (Women to Women has formulated high-quality, pharmaceutical-grade supplements to enhance your health), and beginning an exercise program. We’ve found that our patients often get normal periods as their insulin levels normalize.

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Should I see a doctor if I think I have PCOS?

If any of these symptoms describe what you’ve been feeling, it’s important to see your healthcare practitioner. If I suspect PCOS in a woman, I will do a complete evaluation, including checking for insulin resistance. This work-up includes a physical examination, a fasting lipid profile, a glucose test, hormone levels, and an insulin test (before and two hours after a high-carbohydrate meal). A blood sample is very informative for testing elevated thyroid and prolactin levels. If these tests come up positive, I also look for an altered FSH to LH ratio and increased levels of androgens. Occasionally I will suggest a pelvic ultrasound. It can be possible to see the pearl-necklace pattern of cysts on some women’s ovaries.

If there is any abdominal pain or pressure around the ovaries, an evaluation is certainly necessary. In most cases a woman will be monitored on a regular basis to make sure her cysts are not at risk for rupture.

If a patient has been trying to get pregnant for more than a year, I usually refer her to a fertility specialist, especially if she is over the age of 35. Ovulation stimulants, like Clomid, can be helpful for many would-be moms who have PCOS. When a non-menopausal woman skips a period for more than four months, pregnancy should be considered. Having regular menstrual periods is important to prevent osteoporosis and maintain the protective effects of estrogen.

Occasionally a woman with PCOS will simply not get her period. If she is not pregnant, I advise stimulating a period after four months with the use of Provera, Aygestin or micronized progesterone (a bioidentical hormone). This protects the lining of the uterus from becoming too thick or unusual.

What is the treatment of Polycystic Ovarian Syndrome?

Traditionally, doctors have overlooked PCOS unless it was diagnosed relative to infertility or irregular bleeding. If diagnosed, it was and often still is commonly treated with birth control pills. The Pill lessens the symptoms of PCOS by short-circuiting ovulation and giving the ovaries a rest from follicle production. This is always an option for women looking to avoid pregnancy. Testosterone levels will go down on the Pill and it is good for regulating cycles but it won’t address the basic issue of insulin resistance.

Some doctors are now prescribing a diabetes drug, Glucophage, for blood sugar control, but in my experience, if a woman with PCOS doesn’t attend to some of her lifestyle choices — such as adhering to a PCOS diet — her ovaries become polycystic again when she goes off either pill. This is particularly irksome for women trying to get pregnant.

At our medical practice, we treat PCOS with a combination approach, whether it is a chronic or a temporary condition of perimenopause. We’ve helped countless women reduce their polycystic ovaries through nutritional supplements, progesterone cream, enriched nutrition and regular exercise. This combination approach is an effective way to start bringing the body back into hormonal balance.

Progesterone cream is an especially good way to bring on a regular monthly period. Applying the cream at Day 14 for two weeks introduces this essential hormone back into the body at the right time during a cycle. In a menstruating woman, ovaries produce progesterone after ovulation. Eventually the body catches on to this rhythm and begins to cycle on its own, thereby reducing the presence of cysts.

If you have PCOS or think you do, I hope that you will take heart in realizing there are many things you can do to alleviate your symptoms naturally, without drugs. Like any condition related to hormone imbalance, taking the right steps to improve your lifestyle and nutrition will do wonders to restore your well-deserved good health!

For more information, read our article, “Nutritional and Lifestyle Guidelines“.

Safe (and Enjoyable) Sex in Your Middle Years

womentowomen on June 2, 2014

by Marcelle Pick, OB/GYN NP

If you’ve been waiting in line at the supermarket or browsed a newsstand recently, you cannot help but notice the controversial and attention getting covers of today’s women’s magazines. If they are not sharing “the secret to losing weight overnight,” these magazines are offering up tips on how to have a better sex life or how to be and feel sexier.

They do this, of course, because sex sells – most of us wouldn’t mind feeling more sexy and having more enjoyable sex. If only it were as simple as a magazine checklist! So many women entering perimenopause or menopause have entered a new phase of their relationship lives – some may have been widowed while others may have ended a long-term relationship.

However they got there, more and more of my patients are finding themselves navigating the dating scene once again and they are discovering that it’s a different world today than when they were last single. In addition to the media images about what is sexy and the magazine stories offering us “quick-fix sex solutions,” there is the presence of social media and internet dating sites that have changed the way people meet and date. These tools have made it easier for newly single people to connect with more people, even if it’s not for a long-term relationship.

Despite the ease with which we can meet people today, I’m often surprised when women come in for their annual exams and share that they have had unprotected sex. Whether pregnancy is a concern or not, they may have forgotten or just not been aware that there are other health concerns that come from being intimate with someone, regardless of your age.

In other ways, though, I am not so surprised. After all, sex is a wonderful, pleasurable experience. And being touched, held, caressed, and cuddled feels incredible, especially if you have not had that experience in a long time. Some of my patients tell me that after years without physical contact or connection, they couldn’t resist and the moment just got away from them.

Talking about sex can be difficult. Inquiring about your partner’s dating history may make you feel like a prude and you may even have no idea how to bring it up. But the same media that brings us information about the weight loss secrets of the stars is telling us that the incidence of sexually transmitted diseases among the 45-64 year old group has tripled in recent years.

We know it can be hard or awkward to discuss sex and sexual health. At Women to Women, we believe it’s important to talk about sex — it’s benefits and it’s risks — so that you are informed and you can make the best choices for your long-term health and well-being.

Whether you are single, divorced, or still committed to a long-term relationship, let’s start the conversation so you can enjoy the healthy, safe sex you deserve in the second phase of your life.

Sex, STDs, and Menopause/Perimenopause

Many women don’t realize that just because their periods are slowing down and becoming less regular, they can still become pregnant during perimenopause. Until you have gone 12 months without menstrual bleeding, you still need to protect yourself from the possibility of pregnancy.

But while there are many forms of birth control that can help you avoid pregnancy, only a condom can protect you from sexually transmitted diseases, or STDs. If you have had sex without a condom and you have not been tested recently, even in a committed relationship, you really should consider getting tested for your own health and peace of mind.

That may seem extreme, and it surprises some of my patients, but there are several important reasons why I tell my patients this.

First, whether you have been using condoms faithfully or not, the reality is that many of us have already been exposed. It’s estimated that about 1/3 of us have had or will have a diagnosed STD in our lives. If you’ve already been diagnosed, there is nothing to ashamed of – 15 million Americans get diagnosed each year and 65 million people are living with an STD that is considered “incurable.” STDs are becoming increasingly common.

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Menopause Myths and The Answers You Need

womentowomen on May 16, 2014

by Marcelle Pick, OB/GYN NP

Menopause is a time of change and it can be so confusing! There is so much information out there (and so many stories) about what will happen to your body — and your life! Will you gain weight, lose your sex drive, suffer from hot flashes?

Will menopause feel as though it’s hitting you like a freight train? It may feel that way for some women – while for others, it sneaks up over time and catches them by surprise. Over the last 25 years, I’ve seen firsthand that it’s a different experience for every woman – but surprisingly, there are myths about menopause that many women still believe to be universally true.

I see it over and over again with our patients and our members. They come to us frustrated or upset about what they have been told will happen to them, even if they are not yet experiencing any symptoms!

So what’s your menopause IQ? Do you understand what is going on with your body and how best to navigate this transition? Without the right information, addressing your hormonal changes and finding the most effective solutions for your own unique symptoms and experiences will be more difficult than it needs to be.

Menopause is a transition that may not be simple, but that doesn’t have to mean that it must be hard. Whether you are trying to make sense of your symptoms and their impact on your body or you are just beginning to learn more about what may lie ahead for you, debunking the menopause myths will help you to make the decisions that are right for YOU.

Discover how much you know with our eye-opening menopause questions below and learn more about what to expect in menopause!

1. Does menopause typically begin at age 50?

The average age for women beginning menopause is age 52 but the truth is, premature menopause can start for you as early as your late 30’s and menopause can come as late as your 60’s, though this is less common. For most women, their menopause timeline lies more within the late forties to mid-50’s range.

Most people think that menopause is a long process, but menopause actually occurs once you have officially gone 12 months without any menstrual bleeding. After that, you are considered to be post-menopausal, though for many that does not mean your symptoms are over!

The period leading up to menopause is called perimenopause and it can be just a few months or as long as 13 years! During this time, you may be experiencing a variety of symptoms including hot flashes, irritability, fatigue, or weight gain. These symptoms can come as a surprise to many women who are still having their period, and may be (or may think they are!) years away from menopause.

Symptoms are often more common — or more severe — during this time leading up to menopause as your sex hormones, which include estrogen, testosterone, and progesterone, can fluctuate more dramatically than they do after menopause.

You can learn more about this time in our article, “Am I in Menopause?“.

2. Is it true that I won’t know I’m in menopause until my first hot flash hits?

When that first hot flash hits, it is a good indication that you are in perimenopause. However, many women experience other symptoms first. It’s not uncommon to experience weight gain, cravings, irregular periods, fuzzy thinking, lower libido, hair loss, irritability, mood swings, depression and/or anxiety, or fatigue long before you ever feel that first hot flash. (And some women survive their perimenopausal journey without ever having a hot flash!)

The list of symptoms is long and if you begin by experiencing depression or weight gain, for example, you may not immediately connect the dots to menopause.

Your symptoms may or may not include hot flashes so it’s good to know what to look for so that you can find relief. Our article, “Relief Tips for the Top Five Menopause Symptoms” can get you started.

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Adrenal Stress And Weight Gain – Are They Related?

womentowomen on March 20, 2014

by Marcelle Pick, OB/GYN NP

The stress response and how it causes us gain weight
Belly fat, one of the first symptoms of adrenal dysfunction
Changing your diet, the key ingredient for adrenal balance
Balancing your life, where to start?

The most important question so many of my patients ask me is “Why am I gaining weight? I’ve done nothing different.”

Times have changed greatly and our lives are busier than ever. Multi-tasking is now the norm. Between the stressors of our jobs, relationship turmoil, caring for aging or sick parents, and many other responsibilities, we are all very aware that life challenges are more difficult than ever before. Sometimes unconscious snacking can occur as it’s a quick fix solution to increased stress, and it does temporarily soothe the tension. BUT it is by far not the only reason for our weight gain as stress and the physical effects can be such a big factor.

Many physiological changes happen with high levels of stress and all of these predispose us to gain unwanted pounds – many times without changing our diets or eating habits!

The origin of these dramatic changes stem from hormones produced by our adrenal glands. These amazing glands govern many very important bodily functions and are crucial to helping us deal with the stress response. When the adrenals are completely out of balance, the fight-or-flight response occurs and the body prepares for the worst case scenario by storing calories for a rainy day. But the good news is that when supported properly and healthy function is regained – energy comes back, stamina returns, cravings for carbs and sugar disappear, and best of all – the unwanted pounds just fall off with little effort.

Our adrenal products help thousands of women. Learn more about all of the products included in our True Health Systems for Adrenal Health.

So how does stress really affect our weight? Let’s take a more in depth look at how this happens and what you need to do about it so you can feel more like your old self.

How stress really can makes us gain unwanted weight

As a culture, we most often think that “being stressed” is only related to our emotions, yet few of us understand the dramatic effect it has on us physically. The most frustrating way that it affects us is by storing any calories that are not absolutely necessary, and most often the storage occurs in the abdominal area and thighs.

Our ancient evolution has everything to do with why this happens this way. Many years ago, if you were being chased by a tiger, your adrenals quickly went into the fight-or-flight mode, releasing it’s stress hormones – adrenaline and cortisol. Those superhuman powers we have heard about in cases of stress come from adrenalin and cortisol, and their ability to quickly mobilize carbohydrates and fats to give us instant energy. When the threat is over, our body relaxes but our instincts cause us to refuel with carbohydrate dense foods that are most often stored as fat. When high levels of cortisol are streaming through the blood, we are much less sensitive to leptin, the hormone that gives the signal to the brain that we are full. Therefore, there may be a tendency to eat more than usual, as it feels like a need for survival.

The real problem here is that these physiological responses take place whether the threat is real or psychological. Because most of the everyday stressors we experience on a day to daybasis don’t require our fight or flee response we really don’t need the extra calories our body is so efficiently storing. The other significant change is that many of us are living in a constant state of stress which causes high levels of cortisol to be released on a regular basis for extended periods of time.

Belly fat: One of the key symptoms of adrenal fatigue

Women with adrenal dysfunction most often develop additional body fat around their middle, known for many as a “spare tire”. There are several reasons for this. In normal circumstances, if we have gone for long periods of time without food, our blood sugar drops and our brain sends chemical messages to the adrenals to release cortisol. This cortisol mobilizes glucose, amino acids and fat to prevent the blood sugar from going too low and keeps the body and brain fueled with the energy it requires when food is not available. Cortisol’s job is to maintain stable levels of glucose in the blood while insulin assists in the ushering of glucose into the cells.

After years and or months of long term stress, cortisol and insulin remain high in the blood and the extra glucose gets stored as that unwanted fat, mostly in the abdomen and thighs. Research is now showing us that fat cells have special receptors for the stress hormone cortisol, but most importantly these receptors are much more prevalent on the fat cells in the abdominal area.

Another extremely frustrating issue, is that this fat does not just sit there. Recent research shows that it actually works like an endocrine organ that reacts to the stress response which in turn creates even more abdominal fat and on and on it goes. The great news – and it is great news – is that you can stop the cycle by taking steps to heal that adrenal imbalance.

What can you do to change the pattern: Eat right!!

Many of you may have read my article on how to eat for adrenal health, and everything I talk about in my book, Is It Me or My Adrenals? and in this article applies here too. So what can you do?!

Regular meals and two snacks per day. To convince your body that it is not starving, and most importantly, that it is not in danger, you must eat on a regular basis. Keeping your blood sugar stable prevents large amounts of cortisol from being released and in the long run, decreases the burden on the adrenal glands. I recommend that you eat three balanced meals and two snacks per day, and these need to be spread out across the day to work with your bodies’ natural circadian rhythm. See our diagram of the cortisol cycle for the effects of meals and snacks on cortisol.

Eating at the right times does matter. Cortisol has a natural rhythm, which is highest in the morning, and decreases gradually as the day progresses, and is lowest at night so restful sleep can occur. Eating tends to increase cortisol, so eating the largest meal earlier in the day is the best option for optimal well-being.

Having your favorite foods readily available. So many of my patients use sugar, sugary snacks and caffeine because these give them quick energy and are fast and easy. But trust me, eating this way often leads to an even bigger drop in energy as the blood sugar plummets after the initial spike. If energy is needed, add protein and foods high in nutrients that support the adrenals, foods such as blueberries, broccoli, ginger, avocado and of course lean proteins.

Tip: Something extremely important to consider is adding a pharmaceutical grade multivitamin/mineral complex and adaptogenic herbs like the ones we offer in our True Health Systems. Adrenal expert Shawn Talbott, PhD, writes, “When it comes to dietary supplementation for stress adaptation and cortisol control, the first line of defense appears in the form of a comprehensive multivitamin/mineral supplement…”

Balancing your life to promote the healing of the adrenals

As I talked about in the beginning of this article, we live in a world that is non-stop. We as women multi-task and are often proud of all that we can accomplish in a day. We have cell phones, and most of us have smart phones, ipads, computers, do texting and Facebook, and we seldom take a peaceful break. Restoring the adrenals back to balance means having balance in your life which requires that you take time for yourself and find ways to slow down regularly. Many of us think that being on the go all the time will help with weight loss, but the opposite is actually true. But if you’re tired, wired, and overweight, it’s likely you will need to lower your stress level and heal your adrenals to stop the vicious weight-gain cycle.

Important things for you to Know!

Craving salt and being light headed, especially when getting up quickly, can be signs of adrenal dysfunction.

You can take our quick quiz to see if you have an adrenal dysfunction and get our unique recommendations for your unique situation. Learn more.

How do I start to balance my life?

Sleep. So many of my patients tell me they feel more energized at night especially after dinner or that night time is their best time. I also hear from them that they just can’t get to sleep or falling asleep is easy, but they always wake up and can’t get back to sleep. If your circadian rhythm is backwards and your cortisol is low in the morning and high at night you will feel tired in the morning and wired and awake at night. You can begin to change this pattern by eating your largest meal earlier in the day, and having a light dinner, stopping any screen time including the computers at 7pm and making an effort to be in bed by 10 pm, striving for at least 7-8 hours of sleep. If you are struggling with sleep, our Women to Women’s Sleep Support Formula can help naturally reset your sleep cycle.

Be mindful of exercise. If you are already in a pattern of getting regular exercise, and feel good after the exercise, then continue your regime. IF, on the other hand, you feel wiped out after exercise, try decreasing the exercise and try not to get your heart rate over 90 until the adrenal dysfunction is resolved. If you are just starting to exercise, try taking a walk (preferably outside) for 15 minutes to start and then increasing to 15 minutes two times per day. Exercise has been known to decrease stress and help endorphins, which help you feel better.

Play. As adults we seldom make time to play. Most of us have forgotten that fun and play are essential parts of life. Making some time in your life now for more fun is essential for your well-being. Many times in my practice I will actually write out a prescription for my patients to have fun and PLAY more. So now I want you to do just that!

Breathe. Breathing is crucial for slowing your heart rate and calming your entire body. Just three or four deep breaths can do wonders to accomplish just that. So find time to take those deep breaths throughout the day – especially when you are stressed. The good news is that it takes up very little of your time and you need to breathe anyway. Try to recognize those times when your body needs a break. Get some fresh air, take a few deep breaths, have a relaxing cup of tea and relax – even if this is for a short period of time. It will do wonders.

Allow your body to release the stress and relax

In seeing patients every day, I see over and over again the enormous sense of responsibility many women have today. For so many it can seem virtually impossible to take just a minute for themselves. But I know that unwanted weight gain and lack of get up and go are significant worries for many women. For so many of us our stress in intimately connected to our weight and lack of energy. Our amazing bodies are very wise and want to protect us with the fight-or-flight response, and hold onto those extra pounds.

Tired of those extra pounds? Clothes that just don’t fit? You don’t have to do this alone – start today with Women to Women. Click here to start!

Stroke And Heart Attack Symptoms In Women

womentowomen on March 5, 2014

by Marcelle Pick, OB/GYN NP

For so many women, it is easy to miss the signs of a heart attack, and that’s because the symptoms that women have are very different from men. They are often misdiagnosed, especially the top four symptoms, such as heartburn and digestive disorders. Understanding that immediate action is needed if a heart attack occurs, can mean the difference between whether a woman lives or dies, making it that much more compelling to be aware of the warning signs.

Symptoms of a heart attack in women

For most people the symptoms of a heart attack start slowly with mild discomfort or pain. Below are the symptoms women tend to experience when having a heart attack.

Shortness of breath. This may occur with or without chest discomfort.
Nausea and light-headedness.
Flu-like symptoms, including chills and cold sweats.
Heart palpitations or an irregular heart beat.
Chest discomfort ( also known as angina) – pain, tightness or pressure in the center of the chest that lasts more than just a few minutes, or that comes and goes.
Discomfort or a heaviness in other areas, including a pain or discomfort in one or both arms (especially the left arm), in the back, in the upper back between the shoulder blades, in the neck, and/or in the jaw or stomach.
Heartburn or indigestion.
Extreme fatigue, a sense of not being able to have the energy to do normal activities.

Symptoms of stroke in women

Strokes are not nearly as common as heart attacks, but they can – without any warning signs – occur very quickly. Following are some of the signs that a stroke may be occurring:

A very sudden numbness or weakness of the face, arms or legs, generally it is seen on one side of the body.
Sudden confusion, difficulty speaking or comprehending even simple conversation.
Sudden difficulty with sight in one or both eyes.
Sudden difficulty with walking, dizziness with movement, a severe loss of balance or coordination.
A very sudden, intense headache with no obvious reason.

One of the difficulties is that some of the symptoms of a heart attack or heart problems such as palpitations, dizziness, and feeling faint are also seen by some in perimenopause. It is important to understand that any symptoms that may be related to your heart health should be evaluated by your healthcare practitioner first.

Symptoms of inflammation

The most recent scientific information is showing that inflammation and heart disease go hand in hand. Closely monitoring any and all symptoms of inflammation is a very important preventive tool to help asses your risk and also help you prevent future issues with your heart. Here are some of the tests to look which indicate a risk in the future. For more information, read our multiple articles on inflammation.

Elevated levels of HS-CRP, homocysteine
High blood pressure
Insulin resistance diagnosed with an elevated fasting or 2hr pp insulin
Diabetes, diagnosed with elevated fasting blood sugars or elevated Hgb A1C
Joint pain or diagnosis of arthritis
Chronic headaches
GI distress, bloating, constipation/diarrhea, gas/ IBS, Chrohns or colitis, diverticulitis
Ulcers/heartburn
Food and other allergies/sensitivities
Chronic respiratory difficulties, asthma, or bronchitis
Dry skin, itchy skin, rashes, psoriasis or eczema
Weight gain/obesity as this is now known to increase inflammation
Fever or chronic infection
Other autoimmune diseases
Elevated fibrinogen
High ferritin levels
Elevated Lp(a)

Stress And Happiness

womentowomen on January 2, 2014

by Marcelle Pick, OB/GYN NP

Stress seems to be so prevalent in everyone’s life today – how many times do you hear it from your friends? How many times do you say it yourself?

We’ve learned that stress is a highly significant contributor to disease. The World Health Organization estimates that by the year 2020, stress related disorders will be the second leading cause of disabilities in the world. Everything we know about stress – either real or perceived – acute or chronic affects your health. Stress changes the way your neurotransmitters relay information and your hormonal pathways. It is never too late to do something about stress – once you can look at your stress and come up with a plan minimize and reduce it – you may see an improvement in your overall health.

Women all experience stress in different ways

As women, we tend to have a nurturing response that can tend to put us in positions where we are trying to care for everyone but ourselves. There is a belief with some scientists that during times of stress this response may actually strengthen. The reasoning behind this theory stems from the evolutionary instinct women have to protect themselves and their offspring during times of stress.

Short term stress is the kind of stress we feel when we have a deadline – or when driving in hazardous road conditions. Symptoms of short term stress may include an increased heart rate, sleep disturbances, increased blood pressure, irritability, headaches or muscle tension, decreased memory, fuzzy thinking and poor eating habits.

Chronic or long term stress is stress that stays with us for months – or even years. We know that psychological stress disrupts blood sugar metabolism which can be a key factor in diabetes. Chronic stress also affects our immune systems and increases the risk for lupus, rheumatoid arthritis, hypothyroidism and allergies. Studies conducted in 2006 showed a direct correlation between stress and cardiovascular disease. In a recent study conducted with 58 women – those under high levels of stress showed an increase in oxidative stress and cellular aging!

I always urge women to look at the sources of their stress. While some of these sources might be difficult to admit, they are easy to recognize. Sometimes stress comes from a job you love but has changed, other times from a relationship. Long term stress can develop from experiences in our childhoods. The ACE – Adverse Childhood Event – Study (1998) showed that children who experienced adverse childhood events were more apt to have adverse health conditions or disease as adults. Some of the adverse childhood events which were reported are:

Growing up with an alcoholic
Growing up with a drug user
Recurrent sexual, emotional or physical abuse
Living with someone who was mentally chronically depressed or who was treated violently
If a child in some way was separated from a parent – through death, divorce, illness or separation

Dealing with emotional stress is one piece of your happiness – but I know from years of practice that stress is a larger piece of our physical wellness than many people have considered.

Every woman has a different journey when getting to the root cause of her stress – and everyone resolves their stress differently. During this time its so important lessen the effects of stress on your body.

Here’s what I recommend to my patients:

Practice healthy eating! I suggest three meals and two snacks per day. The stress hormone cortisol is released when your blood sugar is low, so keep your body fueled well to lessen this stress. Choose good protein sources, lots of nutrient rich fruits and vegetables and high quality fats.

Create some relaxation practices. Whether you journal for fifteen minutes a day, walk for 30 or connect with a friend – find a time each day to relax. You may even want to try yoga, acupuncture or reiki. Whatever helps you quiet your parasympathetic nervous system is the right thing for you.

Consider taking a multivitamin. When you are under stress your body needs all the support you can give it! While we would like to think that we can get all our nutritional needs from the foods we eat, in this day and age its difficult. Close any gap you might have with a dietary supplement.

If you may want to explore uncovering deep seated emotional stress you may want to consider: psychotherapy, EFT (Emotional Freedom Technique) or a fantastic program offered by the Hoffman Institute known as the Quadrinity Process.

While we all may experience stress every day in our lives, we don’t have to let it overpower us or prevent us from living the lives we want.

I know from personal experience that taking the time to lessen stress and resolve stressors in your life isn’t always easy. I also know from my own experience and from talking with women every day that it is well worth it. Take the time for you!

Help For Insomnia

womentowomen on January 2, 2014

by Marcelle Pick, OB/GYN NP

Insomnia can be one of the reasons patients see a healthcare practitioner. Night after night of unplanned wakefulness can take its toll on women – and so many women are aware of the far reaching health effects that they are often looking for ‘anything’ that will help.

Conventional healthcare practitioners are most likely to turn to sleep aids – there are many available over the counter as well as by prescription.

I’ve always found it’s better to help a woman get to the root source of her insomnia. Sleep is so important to our natural biological rhythm that it’s worth the effort to help reset its natural flow.

We all have our own unique circadian rhythm which is linked to the sunrises and sunsets of our days. Deep inside our brain clusters of nerve cells work as our internal clock, signaling the time for cell regeneration and hormone production and regulation. They also release the hormone melatonin which makes you sleepy. Light exposure – either natural or artificial inhibits melatonin production. There are times in our lives when due to life circumstances, travel or illness when our circadian rhythm will reset itself – sleep aids can help get through the moment – but its not a good solution long term.

Many women who experience sleeplessness may have physiological imbalances which are responsible for disrupting their inner clock. Diet changes and stress can easily cause daytime fatigue and nighttime insomnia. Unfortunately for many women, these become routine, rather than exceptions. If you have trouble sleeping for more than a few weeks, you are considered to have chronic insomnia.

Chronic insomnia is broken down into two distinct categories – primary insomnia and secondary insomnia. Primary insomnia is usually brought on my conditions which interfere with sleep – caffeine intake, sleep environment and low level worry.

Secondary insomnia has many more potential root causes, and many times occurs or is a result of medical or psychological concerns. Many things might contribute to secondary insomnia including: hormone balance, chronic pain, arthritis, urinary incontinence, mineral deficiencies, insulin resistance and breathing problems.

We find that for many women, hormone imbalance can be a primary culprit. Shifting hormones can cause temperature disruptions – hot flashes and night sweats which affect many women. There is a theory that shifting estrogen levels affect melatonin production – without enough melatonin are brain doesn’t receive the signal to slow and quiet down.

I recommend my patients keep a sleep log for about a week to help us figure out what might be happening during the day which is impacting sleep. Items to track are: caffeine, nicotine and alcohol consumption, foods you eat and when you eat them, exercise habits, stress levels, and the kind of medications and supplements you take – when you take them and the amounts. Your bedtime and noise and light levels when you can’t sleep.

The first step in getting back to sleep and to find out what keeps you awake. When creating a plan to get you back to sleeping well we recommend:

Insuring that hormones are balanced! Aside from diet and lifestyle changes, you may want to consider nutritional supplements or even talking with your healthcare practitioner about hormone replacement therapy.

Create a good nighttime routine. Set the stage for a good night’s sleep. Try to go to bed at about the same time every day, turn of all electronics about an hour before bed and make sure your environment is comfortable.

When you are suffering from sleeplessness it’s more important than ever to support your body’s nutritional needs – during times of stress, our bodies may require more nutrients. One way to do this is take a high quality multivitamin/mineral supplement every day.

You also may want to consider one of nature’s own sleep aids – calming teas or even a supplement with herbs that assist with sleep. I always recommend working with a healthcare practitioner to help choose the right supplement for you.

If you try some of these steps and don’t see relief, you may want to consider looking into behavior modification techniques for insomnia. There are wonderful choices available – guided imagery, cognitive behavioral therapy, mediation – the list goes on.

I hope I’ve reassured you that insomnia is a highly treatable condition that doesn’t necessarily need pharmaceutical intervention.

When you listen to the messages that your body is sending, you can often provide just the support you need!