The Importance of Weight & Metabolic Balance in Female Reproductive Health

By Leigh Lewis NMD, L.Ac., FABORM, RYT

The role of weight in all aspects of female reproduction has been validated by science for several decades with both underweight and overweight body habitus causing problems.  Being underweight has been linked with a relative hormone deficiency what can lead to thin uterine lining and irregular ovulation and menses, therefore interfering with fertility.  Adipose tissue, most notably abdominal fat, has been linked to excess production of estrogen which can also lead to issues with ovulatory and cycle irregularity and decreased fertility.  Once pregnant, body weight should increase for most patients by 25-35 pounds, however, women who are underweight at the time of conception may need to gain more, with overweight women needing to gain less or sometimes, simply maintain their pre-pregnancy weight.  Pregnant women who are underweight are at a higher risk for having a miscarriage, an underweight baby or a preterm birth.  Being overweight confers an increased risk for miscarriage, gestational diabetes and hypertension, preeclampsia, C-section, and an overweight baby. There are also increased risks to the baby born to an overweight mother: diabetes and metabolic syndrome (high cholesterol, blood sugar imbalances, hypertension, overweight) in child- and adulthood. In a recent study, the CDC concluded that 50% of American women gain too much weight in pregnancy.  Oftentimes, excessive weight gain during pregnancy is difficult to lose in the post-partum and can be further compounded by subsequent pregnancies. Finally, many women gain weight during the months or years of hormonal fertility treatments…this weight can be the most difficult to lose.

In general, recommendations are for women to maintain a “normal body weight” as indicated by a body mass index between 18.5-25, although individual variability may dictate otherwise.  This would be a weight between 120-140 for a woman who is 5’6”. However, there are individual issues that might change this recommendation; for example, a female body builder will have a higher muscle to fat ration and since muscle weighs more than fat, she would likely have a higher healthy body weight. Your provider can help determine your ideal weight range.

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Diet and exercise are often the first recommendations made to women and while this is typically good advice, many women are frustrated because usually they have tried it all before.  An important and often neglected first step is to make sure there aren’t any underlying metabolic issues that might predispose one to having weight issues.  Lab analysis of Vitamin D, thyroid function, cholesterol, glucose and insulin can provide insight to underlying factors that could make weight loss or gain more difficult.  Radical diets may help one achieve initial goals, but are difficult to maintain for the long-term and may lead to nutritional deficiency.  In fact, most current research suggests that a sensible, whole-food, Mediterranean-style diet is the best for promoting and maintaining both a healthy weight as well as general health, including fertility and pregnancy.  Some individual variations may be necessary; women with PCOS for instance often fair better with a higher protein/lower carb diet.

In general, one does not have to even achieve a “normal” body weight to see improvement in ovulation, menses and fertility, including improving the success of in vitro fertilization treatments: improvement can be seen with as little as 5-10% weight change.  This is good news, but can seem daunting to many nonetheless, and getting assistance from a team of professionals at least initially may be the best course.  As many of us know, what to eat is only part of the issue for most…we all know less sugar and alcohol and more fruits and vegetables would be beneficial, portion size matters, exercise is important. You likely have heard it all before and could probably tell your best friend or daughter or mom the keys success. The issue isn’t so much how to eat better and exercise more, it is why can’t we implement what we already know we should be doing.  There are several studies that illustrate the positive impact individual or group therapy can have in changing lifestyle behaviors is a way that can have long-lasting health impacts.  In addition, while it may seem like a luxury to have a personal trainer, a series of 4 weekly sessions or joining small group trainings geared for women can set you up to have success with your workouts instead of just grinding out miles on the treadmill.  Some trainers can also help set up individual meal plans.  Finally, stress, both physical and mental can play havoc with the hormones that affect both weight and fertility, adding a mind/body practice to any regimen is a great place to start, whether it be as part of a group or as a home practice.

The bottom line is if you are concerned that your weight may be negatively impacting your reproductive health and fertility or you simply are trying to re-establish your pre-pregnancy weight for general health reasons, consider making an appointment to discuss your individual goals with one of the practitioners here at ilumina and please see resources below for other specialists offering programs to help you meet your goals.


Farrah Hauke, PsyD – offering individual therapy and a 4-week workshop series on psychological strategies to lose weight & keep it off. 480.659.5107; www.arizonapsych.com

Lindsey Cusey & McKenzie Smalley - Personal Trainers/Nutrition Consultants *offers a discount to ilumina patients; www.fithappygirl.com

Donation-based Yoga + Mindfulness classes for women @ Kinfolk Chiropractic, Tuesdays 6:30pm, to RSVP email leighklewis1@gmail.com

Lets Talk About Vaginal Tissue Health

By Leigh Lewis, ND, L.Ac.

Many women experience changes to their libido and sexual function due to changes in hormones that occur throughout life. Post-partum and perimenopause are frequent times when hormones plummet and this can causes lower desire and changes to the vaginal tissue that can cause discomfort with intercourse.  Other hormonal, like thyroid, or nutritional, like iron, deficiencies can contribute to this issue as well and should be screened for.

Medications can be a cause of sexual function issues, notably birth control and antidepressants, and there may be alternatives that have less impact. Alcohol and marijuana use can have negative impacts as well. Finally, it is important to consider relationship factors that may be playing a role; a couple of sessions with a qualified therapist can greatly help investigate & address this area. If discomfort is deep in the pelvic area, a specialized physical therapist may be able to assist you.

There are several ways you can address these issues on your own before consulting a physician:
For vaginal dryness or pain with intercourse: RepHresh or Replens, both available OTC at many pharmacies. These products are not lubricants, but actually restore vaginal tissue health without hormones. Try for twice a week for one month and see if the improvements decrease your symptoms.
For low libido: Maca (Femenessence) is a Peruvian herb that has been used traditionally to improve libido. Try 1000mg per day for a month to see if you notice an effect.

If these do not help, consider making an appointment here at ilumina to discuss pharmaceutical options. After ruling out any contributing factors, we can discuss possible hormonal therapies like bio-identical estrogen, testosterone or DHEA. These hormones have all been shown to be helpful for improving libido, orgasm and/or decreasing vaginal discomfort by improving tissue integrity. There are topical and oral forms available and some options are covered by insurance.  If vaginal tissue atrophy is the main concern, I have been very successful using both hormonal & non-hormonal compounded combinations.  Finally, a brief word about safety: most low dose topical hormone formulations used to treat local vaginal issues are not absorbed systemically and therefore are not considered to carry the same risks as menopausal hormone replacement therapy, even for breast cancer survivors.

Another pharmaceutical option is Addyi (flibanserin), a daily medication that has been shown to improve sexual desire. The side effects are generally minimal and it should not be taken with alcohol, but it may be good options for those women for whom none of the above has been helpful.

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Most importantly, seek help:

though this is a sensitive topic, we are here to help you with all facets of your health and that includes sexual health & wellbeing.

 

 

Why (not) Meditate?

By Dr. Leigh Lewis

This is a question I have been personally struggling with for years, nay, decades. I have long been aware of the research supporting the practice as pertains to health benefits, both mental & physical, and yet there was this wall blocking me from doing it. As a former endurance athlete, I’d spend hours each week running, biking, swimming and lifting, sometimes in the pouring rain and freezing temperatures, but never had the time to meditate for 15 minutes.

Then, when I relocated from Oregon to Arizona, by design, I found myself with more time. Coincidentally, I also found myself struggling with some health issues that required me to slow down. A quick web search and chat with my colleague, Dana Price, who is a strong advocate of meditation, I was able to connect with a local resource, the Phoenix branch of the international Tergar organization, which has a number of on-line and in-person meditation training opportunities and resources, offering both secular and Buddhist-based tracks.

It has been one year since I have embarked on my quest for a daily meditation practice. I haven’t been perfect, but have meditated formally more days than not and have been able to integrate mindfulness into my daily activities. What I have found is not earth-shattering, but, like many others will attest, this practice has helped me feel more calm, increase my tolerance to inevitable stressors, approach my dealings with others in a more compassionate way. Again, I am not perfect, I may still curse others in traffic and get irritated when placed on hold for more than 10 minutes, but I am more likely to see how these reactions are not beneficial and may, in some cases, be harmful. Many sources will describe how our thoughts can re-wire our brain and affect the levels of hormones and neurotransmitters produced thereby having specific physical actions. Physically, I have slept better, experienced less migraines, and have less distress from hormonal fluctuations.

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In my clinical practice, I am frequently working with patients who are reporting physical symptoms that are at least partially due to or exacerbated by stress. Many have been told they need to decrease stress to see improvement in these symptoms. However, there is no anti-stress pill or quick fix to achieve this and stress is, unfortunately, a very prevalent fact of our modern lives. Unlike many other medical treatments, meditation is not only effective, but is free, has no side effects, is easily accessible, and can be done by anyone. Research supports the application of meditation for a wide variety of health issues such as anxiety, depression, high blood pressure,  perinatal mood issues, chronic pain, insomnia, infertility, disordered eating, and decreased immune function.

So knowing that stress is a fact of life and has negative impacts on our health and well-being, where does one start? First, it is important to realize there is no “right way” to meditate. Like with exercise, it is important to find a technique that resonates with you for long-term success. Listed below are a variety of apps, books, websites and local resources that can help you find a path that will work best for you. I suggest starting with one of the books that do a great job providing the foundation of why meditation can be so helpful and how to go about starting a practice. If you are more technologically-minded, the apps may provide a great resource for guided meditations and ways to track your time. As always, contact me if you have any questions or would like to discuss this topic further

Books:

Joy of Living: Unlocking the Secret & Science of Happiness; Yongey Mingyur Rinpoche

Why Meditate: Working With Thoughts and Emotions; Matthieu Ricard

Peace is Every Step: The Path of Mindfulness in Everyday Life; Tich Nacht Hahn

Apps

Headspace www.headspace.com

Insight Timer www.insighttimer.com (free)

Online Resources:

https://learning.tergar.org Joy of Living and Path of Liberation training resources.

https://palousemindfulness.com/MBSR/gettingstarted.html 8- week free MBSR training

Local Resources:

http://www.iluminahealing.com/meditation/ Led by Dana Price

https://tergar.org/communities-and-practice-groups/find-a-center-or-group/phoenix/

http://www.solutionmindfulness.com/about MBSR group training & resources

 

 

Skin Cancer Awareness

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We in AZ are probably more attuned to issues related to sun damage and skin cancer than our friends in Northern climes, but I am frequently amazed how few people use a daily SPF and reapply as recommended to truly prevent pre-cancerous changes.  People usually are good about applying and reapplying when on vacation at the beach or the lake, but it the daily ultraviolet exposure driving to work, walking the dog or working in the garden that adds up over time and causes skin cell damage that can cause discoloration, wrinkles and skin cancer. Over 5 million new cases of skin cancer are diagnosed each year in America, with nearly 90,000 of those attributed to melanoma, which is the cause of almost 10,000 deaths.  

Skin cancer can be present anywhere on the body and with little to no signs or symptoms, however, most can be caught through the simple process of monthly self-check and annual dermatologist skin exams. Early detection, like in all health concerns, is key, and knowing your body’s specific moles and freckles and other marks is the best way to notice a new lesion or change in a previously existing one.

The “ABCDE Rule” of skin cancer detection is simple to follow when conducting monthly self-check skin exams and should be a sign to see a dermatologist:

ASYMMETRY: if one half is different from the other half of a lesion
BORDER: irregular edges to a mole
COLOR: any multicolored lesion or growth that contains blue, pink, white, red or black shades
DIAMETER: a growth that is larger than ¼ inch across or increases in size
EVOLUTION: any changes to a pre-existing mole

In terms of prevention, The American Cancer Society recommends people “SLIP on a shirt, SLOP on sunscreen, SLAP on a hat, and WRAP on sunglasses” to prevent the negative effects of UVA and UVB radiation from the sun.  Understandable, people worry about the chemicals found in sunscreens, but there are ways to find which sunscreens are the safest by researching the Environmental Working Groups website and/or app http://www.ewg.org/sunscreen/

Even with this information, many are confused by the array of sunscreens on the market.  Physical sunscreen formulations are made up of minerals like titanium and zinc oxide that create a barrier on the skin, blocking & reflecting both UVA rays (cause wrinkles & cancer) and UVB rays (responsible for sunburn). Mineral sunscreens are effective once applied, unlike chemical sunscreens which require approximately 30 minutes to become effective.  In addition, chemical sunscreens not only are less effective than physical forms, but have been found to accumulate in the body and have even been linked hormonal disruption and breast cancer. Chemical sunscreens may also oxidize in the sun, causing potential free radial formation which could increase the risk for premature aging and skin cancer.  Some companies have added minerals to their chemical sunscreens as a marketing tool, but the risks of the chemicals stay the same.

I personally have been very impressed with TiZo, a mineral sunscreen that is free of oils, parabens, fragrances and dyes and unlike the pallor imparted by many similar products in the past, these blend well and are very comfortable to wear.  Since these products are only available through licensed professionals, mention it to your ilumina practitioner and we can get some ordered for you.

Parabens: It is important to know what they are.

Our skin is the largest organ in the body, and what we put on our skin is important to our health.  Everyday we use products such as; sun screen, body lotions, shampoo, body wash, deodorant, and so on. These body products have ingredients that can cause harm to our immune and endocrine system.

A commonly used synthetic ingredient to help preserve body products, food, and pharmaceuticals is paraben. The parabens most commonly used in cosmetics are methylparaben, propylparaben, butylparaben, and ethylparaben. It’s important to check your products for these parabens, and buy products that are paraben free.

Parabens acts like estrogen, which may increase the risk of women developing estrogen-positive breast cancer. Researchers conducted tests on 20 different samples of human breast tumors, which revealed parabens to be present in each sample.

Parabens also affects men’s endocrine system; findings from several studies have reported low sperm counts as well as decreased levels of testosterone in men. It was concluded that these results were related to the absorption of parabens in commercial products.

It is important to check the labels of your cosmetics, and buy paraben free products. Many companies are realizing the dangers of paraben products, and switching their formulas to paraben-free. Keep healthy this summer and check your body products and sunscreens for these hidden ingredients.  Make informed choices in regards to what you put on your skin.  If you aren't sure, ask one of us at ilumina and we can help make recommendations.

 

 

Author Highlight: Christiane Northrup

At ilumina we want to be an educationalresource for our patients and with that we have a lending library were we make available some of our trusted teachers and authors.  

Christiane Northrup started with a medical degree from Dartmouth Medical School and completed her residency at Tufts New England Medical Center in Boston. She is an obstetrician and gynecologist and an advocate for woman’s health and wellbeing. She has written several books including Women's Bodies, Women's Wisdom; The Wisdom of Menopause; Mother-Daughter Wisdom; The Secret Pleasures of Menopause; and Goddesses Never Age: The Secret Prescription for Radiance, Vitality, and Wellbeing. Dr. Northrup is a crusader for woman’s health, and is helping woman change their ideas around aging in our society.

As a Chinese Medicine practitioner her views on women’s health align with the ancient Chinese beliefs in treating the root of the problem verse the patients symptoms. At ilumina we treat the origin of the ailment, and help woman to restore health and balance in their lives. Chinese Medicine has a deep history in treating Women’s Health and is being used to treat a variety of conditions to help reestablish health in the body.

In Women's Bodies, Women's Wisdom, she covers the treatment of many health concerns PMS, menstrual cramps, breast cysts, fibroids, cervical dysplasia, endometriosis, infertility, depression, and cystitis. She takes her time explaining how many of these physical problems have roots in emotional upsets or lifestyle choices. This book helps woman to have an educated and healthy outlook on there bodies.
    
Women have trusted Dr. Northrup’s approach for decades. In 2013, Reader’s Digest named her one of “The 100 Most Trusted People in America.” And, in 2016, she was named one of Oprah Winfrey’s Super Soul 100, a group of leaders using their voices and talent to help and heal humanity.

Christiane Northrup has many hobbies including Argentina tango, culinary arts, travel, and watching movies. Dr. Northrup’s work has been featured on The Oprah Winfrey Show, the Today Show, NBC Nightly News, The View, Rachael Ray, Good Morning America, 20/20, and The Dr. Oz Show. 


“True health is only possible when we understand the unity of our minds, emotions, spirits and physical bodies.”
-Christiane Northrup

 

 

Why is water so important to the body?

Water is important to many functions of the body. We can survive three weeks without food, but only three days without water. There are some factors when figuring out how much water we should consume, like our activity level, age, and the consumption of water-rich veggies and fruit. On average we should consume 90oz of water on a daily basis. Increasing your water consumption can help with anxiety, constipation, and more.

1. Clearer Skin - Certain toxins in the body can cause inflammation to the skin, which results in clogged pores and acne. Water helps flush the system and reduce blemishes.

2. Fluid Balance - Roughly 60 percent of the body is made of water. Drinking enough H2O maintains the body’s fluid balance, which helps transport nutrients in the body, regulate body temperature and improves digestion.

3. Kidney Function - Our kidneys process 200 quarts of blood daily, sifting out waste and transporting urine to the bladder. Kidneys need hydration to clear away what we don’t need in the body.

4. Fatigue Fighter - Water can help fight the afternoon energy drops. One of the most common symptoms of dehydration is fatigue.


Bottoms Up!!

Begin by drinking a glass of water as soon as you wake up. Get in the habit of keeping a water bottle on hand at all times. If the taste begins to become a drag, shake it up with a squeeze of citrus, cucumbers or mint.

 

Massage Therapy and Breast Cancer: Myths and Facts

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Myth: Massage is a luxury.
Fact: There are many benefits to receiving regular massage, especially during times of stress or health crisis. Many people use massage a part of their regular preventative health maintenance program.
Some benefits of massage therapy include:
    -Massage is relaxing and rejuvenating
    -Calms the nervous system
    -Helps you cope with mental/emotional stress
    -Relief of physical pain and fatigue
    -Increase flexibility and range of motion
    -Speeds recovery from surgery
    -Improves circulation and immune system
    -Speeds the removal of metabolic waste from the body

Myth: Massage is NOT safe for someone newly diagnosed with cancer.
Fact: Initially, it is best to err on the side of caution and receive gentle massage techniques such as Swedish massage or Reiki energy healing to help calm the nervous system. Deep tissue work should be avoided as well as work directly on the tumor area.

Myth: Since massage stimulates the blood flow it can increase the risk of metastasis (spreading to other parts of the body).
Fact: Massage does stimulate the blood flow but so does walking, exercising, taking a shower or a bath, all of which are highly recommended during cancer treatment.
Recent studies show that massage induces the production of the hormone oxytocin which counter acts cortisol also known as the “stress hormone”. Cortisol is very useful when we need the fight or flight mechanism, but under constant stress excess production of cortisol can be harmful by decreasing the immune system response. A cancer diagnosis is very stressful and a person is susceptible to anxiety and depression. Since massage aids with the relaxation response and the release of Oxytocin it can be a major aid in strengthening the immune system and release of toxins and promote healing.
 

Myth: Women who had lymph nodes removed should never receive massage.
Fact: Extra caution is necessary in this case due to the risk of developing Lymphedema. Receive only light massage on the compromised quadrant of the torso (arm, chest and back) but a regular massage can be administered to the rest of the body. It is best to see a professional who is trained in oncology massage.
 

Is massage OK during chemotherapy and radiation?
Fact: Yes, however a waiting period of 4-7 days after chemotherapy treatment is recommended depending on the treatment and the individual. It is OK to receive bodywork during radiation, but massage and oils should not be administered to the radiated area.
 

How about massage after surgery?
Fact: After surgery it is recommended to wait 7 days and up to 6 weeks before receiving bodywork, depending on the type of surgery and reconstruction and healing progress. However, energy work and gentle massage to non affected areas can be administered as soon as the client feels up to it and the doctor approves it.
 

What about massaging around tumors?
Fact: Direct pressure to the area should be avoided. Once the tumor is removed and the wound is healed, massage is very helpful to prevent scar tissue adhesions. Avoid deep massage to the quadrant of the body where lymph nodes are compromised due to the risk of Lymphedema.
 If tumor is deep and cannot be removed massage should be administered with caution.
 

Body image issues
Some women are self conscious about their body, especially after a mastectomy. This is understandable and most practitioners use draping techniques which reassure the client’s privacy. If the client is not comfortable with work on the breast area, or prefer that area covered they should make sure the practitioner knows.

How can I find a practitioner?
Since cancer diagnosis requires some modifications it is best to find someone who is experienced and has Oncology Massage training. However, if one already has an established relationship with a practitioner, trust and rapport are just as important as skills and knowledge. It won't be a bad idea to ask the practitioner if he/she is comfortable with educating him/herself before providing massage therapy during the cancer treatment. Audrey has recently completed a 24 hour National Certification Board for Therapeutic Massage and Bodywork approved Continuing Education class for Breast Cancer and Massage Therapy to better understand and treat her clients that are breast cancer survivors.

Reference:
Massage Therapy and Breast Cancer. Eeris Kallil, Lic. CMT. Boulder, CO. bodyworkwisdom.com

 

Massage Therapy for Breast Cancer Support


“Massage therapy has great potential to aid in the rehabilitation of the patient who has undergone treatment for breast cancer. We actually under utilize massage, and the early institution of that therapy might actually prevent some of the more long-term complications, such as retraction of the skin and lymphedema.”
-Oncologist Frank Senecal, M.D.

    Massage therapy can be beneficial for women recovering from mastectomy, lumpectomy and lymph node removal by alleviating pain, fatigue, and anxiety. Massage therapy can increase range of motion and reduce scar tissue adhesions after surgery and radiation. By gentling stretching tissues surrounding the surgery or radiation site, muscles and ares of tightness can be opened and soothed increasing circulation and improving skin tone.

    Gentle manual lymph drainage, decongestive techniques, and light effleurage help to relieve and prevent lymphedema. Lymphedema is a condition that is caused when a person’s lymphatic system is compromised due to fluid retention and swelling. This is a problem because tissues that have lymphedema are at risk of infection.  Also, as part of the diagnosis for breast cancer many women have a large number of the lymph nodes removed through surgery for diagnosis. The greater the number of lymph nodes that are removed the higher the chances are that woman will have swelling that is called lymphedema. Deep tissue massage is contraindicated in areas where lymph nodes have been comprised (removed or irradiated) even if the patient/client is not experiencing lymphedema.

    Other benefits of massage therapy for breast cancer patients include an increase in immune system function. Massage aids the patient’s ability to relax, thus reducing levels of cortisol, the stress hormone, and increasing levels of oxytocin, natural kill cells and lymphocytes.  According to one study, breast cancer patients have “improved immune and neuroendocrine functions” following massage therapy [study conducted by the Touch Research Institutes, Department of Pediatrics, Hematology/Oncology Clinics, Sylvester Comprehensive Cancer Center and Department of Medicine at the University of Miami School of Medicine].
 In the study, 34 women with either stage 1 or 2 breast cancer were randomly assigned to either a massage therapy group or a standard treatment control group. In the massage therapy group, the women received three 30-minute massages per week for five weeks, including stroking, squeezing and stretching on the head, arms, legs, feet and back. Urine tests showed that the massage group had increased serotonin, dopamine, and natural killer cells and lymphocytes. Questionnaires administered in the study showed reduced anxiety, depression, anger, and hostility in the massage therapy group.
  

The decision to receive massage therapy after breast cancer treatment is something to discuss with your doctor and/or surgeon.  He/she can help you decide if and when massage therapy will be of benefit during the treatment process. Post mastectomy massage generally takes place several weeks after surgery. It is important to choose a Massage Therapist who has additional training in treating oncology patients, and specifically treating breast cancer patients.

Resources:
“Breast Cancer: How Massage Aids Recovery”. Yvonne Meziere. Massage Magazine, April 2014.
Massage Therapy and Breast Cancer. Eeris Kallil, Lic. CMT

 

Is It Me or Is It Hot In Here: Symptoms Associated with Perimenopausal Hormal Changes

By Leigh Lewis ND, L.Ac.

There is a lot of confusion both among women and their health care practitioners regarding perimenopause. Literally, perimenopause is “around menopause”; menopause being defined as the spontaneous, permanent ending of menstruation, literally one day, typically the day that is one year after the last menstrual period, usually around age 50, but can be anywhere between age 40-60.  Clinically then, perimenopausal symptoms can be described as any symptom that happens around a woman’s last menstrual period. Unfortunately, menopause is not like a light switch, where one moment you are pre-menopausal and the next you are post-menopausal. It is in fact quite the opposite: erratic hormone production fluctuates from day to day and month to month causing changeable and varied symptoms.  

Several studies have documented that symptoms may begin up to 17 years before cessation of menses and may last for several years after.  As such, if the average age of menopause is 50, some women may start to experience these symptoms as early as 33. Many factors may impact this transition, from genetics, to thyroid function to lifestyle habits and some women enter into menopause through surgery or medication and, for the latter population of women, the symptoms may be more severe and dramatic.

There are estrogen receptors throughout a woman’s body which helps to explain the varied symptoms a woman may have as estrogen levels start to decline as evidenced by this graphic:

Since hormone fluctuations can start in the 30’s for many women and others may experience unintended pregnancy in their 40’s, special consideration should be given to issues related to fertility. Some women may have difficulty achieving or maintaining pregnancy in the absence of these symptoms at any age, but age-related hormonal changes are a common cause. As such, contraception and/or fertility-preserving strategies should be a part of every woman’s assessment and plan during the perimenopausal transition.  Regardless of the cause, be it endometriosis, irregular menses or hormonal issues, acupuncture and select supplements and herbs may be helpful in improving fertility outcomes, either when used alone or in combination with conventional reproductive medicine.

When a woman suspects she is having perimenopausal-related symptoms, it is an excellent time to have a complete medical examination by a qualified health professional. The diagnosis of perimenopause can usually be made by reviewing a woman’s medical and menstrual history in addition to her specific set of symptoms and treatment recommendations can be made accordingly. Unfortunately for most women, hormone tests are usually not helpful in giving definitive information as to whether symptoms are related to perimenopause because levels change throughout the menstrual cycle. A single hormone level can be misleading since production does not fall at a steady rate, but varies greatly and therefore cannot predict or confirm menopause. Furthermore, normal hormone levels in the presence of hormone-related symptoms does not eliminate the likelihood that the women is perimenopausal. Some testing may be helpful with complaints of sexual dysfunction, fertility problems or when periods stop at an early age and some lab tests can identify other causes of symptoms that mimic or worsen the symptoms of perimenopause, such as thyroid disease or vitamin deficiencies, and diseases that can increase during perimenopause, such as cardiovascular disease and diabetes. Treatments should never be prescribed to “treat” hormone levels, but solely to alleviate symptoms and therefore hormone levels are unnecessary to determine or adjust dosing.

There are several treatment options available to women and there is no “one-size-fits-all” plan that will take care of all of the symptoms that may be associated with hormonal fluctuations. It is also important to remember that not all women will require treatment; perimenopause is not a disease and as such therapies should be directed at controlling symptoms. Therapies with less associated risk, like diet and lifestyle, should be tried first. There are several studies confirming the positive impact of diet, exercise, acupuncture, stress management and lifestyle changes for women with mild perimenopausal symptoms and should be first-line therapy. Vitamin and herbal supplements may be helpful in some women, but research is mixed and appropriate dosing and use of high-quality products is necessary to know if these may be effective. Finally, there are non-hormonal prescription medications that may do double-duty in decreasing perimenopausal symptoms while treating other conditions, such as depression and anxiety. The goal should be to help patient’s manage menopausal symptoms without needing a grocery bag full of medications or supplements by utilizing targeted therapies that are supported by research.

If hormones are being considered, a thorough assessment of a woman’s potential benefits vs. risks should be conducted. While risks are possible with any use of hormones, symptoms can negatively impact a woman’s day-to-day quality of life, affecting relationships with family and friends and performance at work and the degree to which this happens may outweigh these potential risks. Medical organizations devoted to the care of women agree that there is no question that hormone therapy has an important role in managing symptoms for many healthy women during the transition. There are several benefits to using hormones including decreasing the typical symptoms such as hot flashes, night sweats, insomnia, mood issues, “brain fog”, urinary symptoms, vaginal dryness and painful intercourse, preventing bone fractures later in life and lowering the risk of heart disease & diabetes if hormones are started early. However, despite some claims, there is no such thing as “risk-free” hormone treatment for menopause when used systemically to achieve these benefits. The potential risks include stroke, blood clots, and uterine and breast cancer. What we’ve learned so far about the benefits and risks comes from large groups of women, but each woman is unique. New studies are frequently published, so this topic is constantly in flux.

The question is whether it is the right choice for you. These decisions are nuanced and only after you and your doctor have a thorough discussion about your individual risks, benefits, and preferences can you make a decision that’s right for you.

The North American Menopause Society is an excellent resource for high quality information: http://www.menopause.org/for-women.

 

Ten Reasons to Meditate and Practice Mindfulness (and how to do it)

Ten Reasons to Meditate and practice Mindfulness (and how to do it)

1) Increases blood flow, lowers respiration rate, slows heart rate 2) Decreases heart rate 3) Reduces stress, anxiety and aggression 4) Enhances the immune system 5) Harmonizes the endocrine (hormonal) system 6) Relaxes the nervous system 7) Improves brain function and electrical activity 8) Reduces stress and balances hormones to stimulate ovulation 9) Improves learning ability and memory and increases productivity 10) Improves relationships with others

Mindfulness Meditation by Thich Nhat Hanh

This exercise is very simple, but the power, the result, can be very great. The exercise is simply to identify the in-breath as in-breath and the out-breath as the out-breath. When you breathe in, you know that this is your in-breath. When you breathe out, you are mindful that this is your out-breath. Just recognize: this is an in-breath, this is an out-breath. Very simple, very easy. In order to recognize your in-breath as in-breath, you have to bring your mind home to yourself. What is recognizing your in-breath is your mind, and the object of your mind—the object of your mindfulness—is the in-breath. Mindfulness is always mindful of something. When you drink your tea mindfully, it’s called mindfulness of drinking. When you walk mindfully, it’s called mindfulness of walking. And when you breathe mindfully, that is mindfulness of breathing. So the object of your mindfulness is your breath, and you just focus your attention on it. Breathing in, this is my in-breath. Breathing out, this is my out-breath. When you do that, the mental discourse will stop. You don’t think anymore. You don’t have to make an effort to stop your thinking; you bring your attention to your in-breath and the mental discourse just stops. That is the miracle of the practice. You don’t think of the past anymore. You don’t think of the future. You don’t think of your projects, because you are focusing your attention, your mindfulness, on your breath. It gets even better. You can enjoy your in-breath. The practice can be pleasant, joyful. Someone who is dead cannot take any more in-breaths. But you are alive. You are breathing in, and while breathing in, you know that you are alive. The in-breath can be a celebration of the fact that you are alive, so it can be very joyful. When you are joyful and happy, you don’t feel that you have to make any effort at all. I am alive; I am breathing in. To be still alive is a miracle. The greatest of all miracles is to be alive, and when you breathe in, you touch that miracle. Therefore, your breathing can be a celebration of life. An in-breath may take three, four, five seconds, it depends. That’s time to be alive, time to enjoy your breath. You don’t have to interfere with your breathing. If your in-breath is short, allow it to be short. If your out-breath is long, let it to be long. Don’t try to force it. The practice is simple recognition of the in-breath and the out-breath. That is good enough. It will have a powerful effect.

This meditation instruction excerpted from the Shambhala Sun website. http://www.shambhalasun.com/index.php?option=content&task=view&id=3490

Acupuncture: Another Option When Facing Depression

A recent study in the Canadian Journal of Psychiatry suggests that acupuncture, as a stand-alone therapy, may be quite effective for mild to moderate depression. This particular report was a compilation of several different studies looking at the effectiveness of acupuncture at relieving the symptoms of mild to moderate depression. Our practitioner, Catherine Travis, L.Ac. was part of the University of Arizona 's National Institute of Health's funded study "Acupuncture and the Treatment of Depression " and is quite familiar with the research on this subject.

Read the complete article.. http://www.dailyherald.com/article/20120903/entlife/709039967/

Aging and Longevity, Free Informational Evening

Join us at ilumina Healing Sanctuary on Monday, May 14th from 6 to 7 pm for a talk and demonstration on the many benefits of acupuncture in regards to our aging process.  It is all part of a natural progression and acupuncture can increase the quality of the process.  Catherine Travis, L.Ac will share with us the wisdom she has gained over 30 years as a practitioner.  Don't just live, THRIVE.