Cycles of our Lives

1. Cycles of our Lives Devra Krassner, N.D. Integrative Health Center of Maine

2. Reclaiming Women’s Health • Self help health care- Our Bodies, Ourselves, • Sharing information gives us power • But tools are still allopathic!

3. Naturopathic Medicine • Our bodies have the ability to heal ourselves • The healing power of nature • Doctor as teacher • First of all, do no harm • Preventive medicine • Treat the whole person

4. Naturopathic Medicine and Self-Help philosophy: A WINNING COMBINATION

5. Hormonal Changes are Normal • The wisdom of our bodies dictates cycles from menarche (beginning menstruation) through menopause • Menopause across cultures- the medicalization of menopause • Women are more than our reproductive systems

6. Symptoms can be limiting • Sometimes hormonal cycles, though normal, can interfere with our lives • How do we treat ourselves without drugs?

7. Menarche • The beginning of menstruation • A time to celebrate! • Indigenous people have rites of passage • A time of self-renewal

8. BUT- What about…. • PMS- pre-menstrual syndrome • Dysmenorrhea- pain during menstruation • Hot flashes • Night sweats and insomnia • Mood swings

9. Nutrition • Avoid exogenous hormones. These are hormones that come from outside our bodies, such as in our food. • Eat organic and hormone-free! • Stimulants and hot foods may aggravate hot flashes. • Reduce the intake of sugar and refined carbohydrates, caffeine and alcohol, dairy and processed foods, which can be pro-inflammatory. • Avoid artificial sweeteners (Splenda/sucralose, aspartame/Nutrasweet), pesticides and other chemicals. • Increase fiber, water and whole foods.

10. What about soy? • Buy non-GMO (genetically modified) and organic, unrefined sources of soy, such as edamame, tofu and tempeh. • Soy isoflavones contain phytoestrogens (plant estrogens) such as genistein. These can help menopausal hot flashes, vaginal dryness, and other menopausal complaints. • Eat soy in moderation!

11. Exercise • Supports global hormonal health- thyroid, adrenals, and reproductive hormones • Light exercise can decrease hot flashes, but heavy exercise can sometimes make them worse. • Benefits to mood and energy • Regularity and diversity • Interval training for weight loss • Weight-bearing exercise

12. Optimize your lifestyle • Stress management techniques- meditation, Tai chi, yoga and many more • Stop smoking!

13. Hormonal adaptogens- to balance hormonal fluctuations • Chasteberry (also called Vitex and chaste tree) • Maca- Femmenessence- MacaPause, MacaLife and MacaHarmony • Adrenal adaptogens- Siberian ginseng, ashwagandha, rhodiola, holy basil and others

14. PMS- Supplements • Fish oils/omega 3s- 1,000 to 2,000 mg a day • Evening primrose oil- 1,000 mg twice a day • B-complex- 50-100 mg a day • B vitamins are also needed in higher amounts with oral contraceptives, which can deplete them • Calcium/Magnesium/Vitamin D3- common dosing is calcium 1,000 mg, magnesium 500 mg and vitamin D3 1,000 IU)

15. PMS- Herbs • Women’s Phase One- Vitanica-two capsules every day all month long, or two capsules twice a day for two weeks before the period • Red clover- a rich source of isoflavones (plant estrogens). • Liver supportive herbs- Burdock, yellow dock, dandelion, milk thistle which improve estrogen detoxification.

16. Menstrual pain- dysmenorrhea • Cylease cramp by BOIRON- homeopathic combination for cramp relief • Herbs for relief of pain from cramps, such as Moon Ease from Avena Botanicals, with herbs such as crampbark, ginger and wild yam root. • Valerian- anti-spasmodic and sedative

17. Peri-menopause • The time immediately before and after menopause. The length of peri-menopause varies greatly among women. • Symptoms can vary also. Women can have periods less or more often, bleeding which is heavier or lighter. Women may have other symptoms or none at all. • The average age of menopause is estimated to be between 50 and 52. The age that your mother or older sisters went through menopause my be similar to your own.

18. Menopause- when does it start? • Menopause is reached when it has been twelve months since the last period. • Testing is rarely needed- the age, history and symptoms of a woman are usually all you need. • If testing is indicated, FSH (follicle stimulating hormone) can be measured. An FSH > 30 is an indication of menopause.

19. Menopause and Peri-Menopause- Supplements • Vitamin E- mixed tocopherols- 400-800 IU a day. Can help with hot flashes and vaginal dryness. • Calcium/Magnesium/Vitamin D3/trace nutrients including vitamin K2 (50mcg) and boron (2-3 mg). Vitamin D3 is best dosed individually based on serum blood test, but starting dose is 1,000 IU a day. Important for bone health and to prevent osteoporosis. • Comprehensive multi-vitamin without iron unless anemic. • Vitamin B6- 50-200 mg a day may be helpful if insomnia, depression and irritability are present. Best taken along with a B complex or multi-vitamin.

20. Menopause- Herbs • Vitanica- Women’s Phase II- a combination formula. • Black cohosh- standardized extract capsules (40 mg per cap). Start with 1 cap 2x a day. Helpful for insomnia and hot flashes. If depression or other mood changes are present, it can be combined with St. John’s wort. Note that black cohosh does not contain phyto-estrogens. • Red clover- a rich source of isoflavones (plant estrogens). Red clover can help with hot flashes and may slow bone loss. • Avena Botanicals Wise Woman Tonic (contains black cohosh, licorice and other herbs). If you have high blood pressure, consult with your health care provider before taking licorice. • Valerian- recent study showed improvement with 225 mg cap three times a day for 8 weeks. For information about the study go to drtorihudson.com. Dr. Hudson also formulated the Vitanica products.

21. Mood changes-Depression and anxiety • Depression- St. John’s wort is excellent for mild to moderate depression. Other helpful herbs are lemon balm, and rhodiola. Consult your practitioner about using 5-HTP and Sam-e. • Anxiety- Lavender in gel caps (such as Lavela, a product from Integrative Therapeutics) is particularly helpful in anxiety. Other helpful herbs are passionflower, skullcap, hops and chamomille. Kava is excellent for acute anxiety. • Fish oil- helpful for mild to moderate depression. Can also support heart, joint and skin health, cognition (memory and comprehension) and is anti-inflammatory.

22. Insomnia • Find the cause! There are many reasons for insomnia and treatment should be individualized. Consult your health care provider to determine the cause of your insomnia. • Nervine herbs such as valerian, skullcap, hops and chamomille can be helpful. Valerian may occasionally have side effects such as grogginess and nightmares. • Magnolia is indicated if the problem is elevated night-time cortisol. • Melatonin is helpful when the normal day-night cycle is disrupted. • 5-HTP may be useful, especially if depression is also present.

23. Menopause- What about hormones? • Bio-identical hormones- These are hormones that are biochemically identical to the corresponding human hormone and are derived from plants. • Transdermal (across the skin). These hormones bypass the liver, which may lower adverse effects. Patches, creams and other forms can deliver progesterone, estrogen and other hormones. Estriol vaginal cream can be used for vaginal dryness. • Compounded hormones- prescribed by your doctor and compounded by Apothecary by Design. !

24. Cautions about hormones • Progesterone must always be used along with estrogen in any form in women with an intact uterus. • Hormones (including herbs ) should be discontinued periodically to see if they are still needed. • CONSULT YOUR DOCTOR or other health care provider. Even natural hormones must be prescribed individually and monitored.

25. Selected resources • Hudson, Tori, Women’s Encyclopedia of Natural Medicine, Keats Publishing, Los Angeles, CA 1999. Also view her blogs, articles and links to studies at www.drtorihudson.com • Northrup, Christiane, The Wisdom of Menopause, Bantam Books, NY, NY, 2001. • Soule, Deb, The Roots of Healing, Citadel Press, NY,NY, 1995. Also go to her website at www.avenabotanicals.com and visit her beautiful gardens in Rockport, Maine. • The staff here at Apothecary By Design!