Archive for the ‘Nurtura Health Blog’ Category

Women’s Health – Perimenopause… Menopause… Postmenopause

Perimenopause means “around menopause”.  This refers to the 2-12 year period prior to menopause occurring.  This is a time of fluctuating oestrogen levels, where your period begins to change.   It is not uncommon for many women to experience a wide range of symptoms and mental disturbances during this time including hot flushes, sleep disruption and night sweats.  The normal age range for menopause is between 45 to 55 years of age, with the average age being 50 years.  You have officially entered menopause when you have not had a period for one year.  After this time, you are in postmenopause.

Is it getting hot in here or is it just me?  Despite popular belief, if a woman is experiencing a hot flush, she is not actually hotter than an unaffected woman, it is simply the brain perceiving itself to be hotter and is performing a cooling response.

The hypothalamus sets a temperature range that allows variations in temperature without executing a shiver or cooling response to warm or cool the body, known as the thermoneutral zone.  In menopause, there is a narrowing of this zone.  This means that a slight variation in temperature may induce a flushing response, as the hypothalamus perceives the body to be too hot.  This narrowing is partially due to the decline of oestrogen.

Cognitive function is a well-recognised part of ageing, and it is seen to differing degrees in postmenopausal women.  This decline in function is thought to be driven by the decrease in sex hormone levels after menopause, as oestrogen has been shown to have neuroprotective effects.  Changes in thyroid function have also been associated with a decline in cognitive function.  At Nurtura Health, our dedicated Naturopaths will perform a comprehensive assessment for each individual person to assess any underlying causes along with the presenting symptoms.

There are numerous studies showing an association between thyroid function and an increased risk of bone fractures, depression, cardiovascular disease and earlier mortality.  The link between menopause and thyroid function is not one directional.  Menopause has been associated with coexistingchanges in thyroid function, particularly a higher incidence of autoimmune-related thyroid disease.  Postmenopausal women actually have the highest rate of thyroid disease, including hypothyroidism, nodular goitre and cancer.  Our Naturopaths will monitor and support your thyroid function during and after menopause.

Other factors to consider during menopause include the impact on gut microbiome, cardiometabolic health, weight loss to reduce hot flushes, and oestrogen lifting herbs.  Low oestrogen states such as those during menopause, may have an impact on the gut microbiome and this may potentially be the cause of negative health outcomes such as increased weight gain, insulin resistance, type 2 diabetes, increased inflammatory states, autoimmunity, and reduced bone density.  Hormonal and metabolic changes that occur in women as they age may easily lead to weight gain.  Many women find it harder to lose weight as they get older.  The increased weight gain in menopausal women also increases their risk for cardiovascular disease, along with the accumulation of abdominal fat linking to the above mentioned conditions.  Recent studies have found that women with higher body fat tend to experience more hot flushes than lean women.  In addition, gaining fat during the menopause transition is linked to an exacerbating of flushing.  Women who lost weight experienced a greater reduction in flushes than those who didn’t lose weight.  Although weight loss results in a reduction of oestrogen, it also improves the other factor that influences the thermoneutral zone – the sympathetic drive.

In order to assist women through the menopausal transition, we need to do more than simply raise oestrogen levels.  For best clinical results, we need to consider intracrinology, Hypothalamic-Pituitary-Adrenal (HPA) function, along with the role of the nervous system in the narrowed thermoneutral zone.  At Nurtura Health, we will assess you as a whole and take into consideration your diet and other lifestyle factors.  Stress reduction techniques, exercise and fat loss may all play a role in managing menopausal symptoms.

 

Watch this space for future posts on Women’s Health including Fertility.

Disclaimer:  The advice on this website is of a general nature only and Nurtura Health expressly disclaims all liability arising out of the improper use of the information provided.  Nurtura Health actively discourages any self-diagnosis or self-medication.  Please consult your health practitioner regarding these important health issues.  All rights reserved.
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Women’s Health – Leiomyomas (Uterine Fibroids)

Uterine leiomyomas (fibroids) are benign smooth muscle tumours of the uterus that appear during the reproductive years.  In addition to smooth muscle cells they are composed of variable amounts of fibrous tissue and collagen.  They are usually spherical, well-circumscribed, white, firm lesions and range in size from a pinhead to 20cm across (the average size is 2 cm).  Fibroids arise in the middle layer of the uterine wall and are either pedunculated within or outside the uterus, or develop within the uterine wall. 

These tumours have been identified by ultrasound in 4% of women aged 20–30 years, in 11-18% of women aged 30-40 years, and in 33% of women aged 40-60 years.  They grow under the influence of oestrogen and tend to shrink as oestrogen levels fall after menopause.  Although they rarely become malignant, uterine fibroids may become clinically significant if they grow to a size that causes pressure on adjacent organs.  Fibroids are generally asymptomatic but may be associated with the following:

  • Excessive or prolonged bleeding which is experienced by approximately 30% of women with fibroids.
  • Anaemia, as a result of the above.
  • Very large tumours may result in pelvic pressure, urinary symptoms and constipation.
  • Painful intercourse.
  • A lump or swelling in the lower abdomen.
  • Infertility (by interrupting endometrial implantation of the fertilised egg).
  • Poor pregnancy outcomes such as miscarriage, premature birth, placental abruption, uterine inertia or obstruction of the birth canal. They may also reduce blood flow to the placenta or compete with the developing foetus for space.

Fibroids are the leading reason for hysterectomies in women of reproductive age.

Risk factors for developing fibroids include:

  • Family history of fibroids
  • Early menarche (2-3 times increased risk)
  • Obesity with high insulin
  • Inactivity (sedentary lifestyle with obesity/insulin resistance)
  • Uterine irritation and/or infection
  • Oestrogen dominance and/or decreased 2:16-hydroxy oestrogen ratio.

Fibroid tumours are extremely sensitive to oestrogen and have a significantly increased number of receptors for oestrogen, making them far more likely to grow in a state of oestrogen dominance.    This is a potent growth promoter in fibroid development.  Environmental xeno-oestrogens are also suspected to play a role in fibroid growth.  Xeno-estrogens are chemical substances which mimic hormones.  They can be found in industrial plastics, pesticides and insecticides, chlorine etc and are “hormone disruptors”. 

The Naturopaths at Nurtura Health have access to many herbal and nutritional remedies which are indicated to support normal menstruation.  As this condition is normally an “oestrogen dominant” condition, having healthy liver detoxification is of paramount importance to restore hormone balance and excretion.  It is important to have a healthy oestrogen levels.  In addition consideration would be given to reducing inflammation and swelling; reduction in pain; ensuring iron levels are adequate; and reviewing diet and lifestyle. 

In all cases of hormonal imbalance and in particular with uterine fibroids, the Naturopaths would be happy to work collaboratively with the GP to ensure there are no underlying pathologies which would need referral to a Gynaecologist.  However, many women have gained much relief with the additional use of natural and herbal medicines in these conditions. 

 

Watch this space for future posts on other conditions in more detail!

Disclaimer:  The advice on this website is of a general nature only and Nurtura Health expressly disclaims all liability arising out of the improper use of the information provided.  Nurtura Health actively discourages any self-diagnosis or self-medication.  Please consult your health practitioner regarding these important health issues.  All rights reserved.
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Women’s Health – Endometriosis

Endometriosis affects approximately 10% of reproductive aged women, and is found in 20-50% of women with infertility or chronic pelvic pain.  This painful female reproductive condition is characterised by the presence of endometrial tissue which normally lines the uterus, outside the uterus.  Occurring most commonly in the pelvic region, endometrial implants may be found on the ovaries, fallopian tubes, vagina, cervix, Pouch of Douglas, uterosacral ligaments or in the rectovaginal septum.  Endometriosis may also occur in distant sites, such as the pleura, lungs, diaphragm, kidney, spleen, gallbladder, nasal mucosa, spinal canal, stomach, and breast.  This condition is most often associated with pelvic pain and infertility but may also be found in fertile and asymptomatic women.

The common symptoms of endometriosis include the following:

  • Premenstrual syndrome and/or painful periods (the most common symptom)
  • Pelvic pain – especially painful sexual intercourse, pain on urination, pain on passing bowel motions
  • Joint and muscle aches
  • Fatigue and lethargy
  • Depression
  • Infertility

Endometriosis is strongly associated with infertility.  It is considered that up to 50% of infertile women have endometriosis, and 30-40% of endometriosis sufferers are infertile.  The condition may contribute to reproductive failure in various ways, including:

  • Poor egg development, as endometrial lesions on the ovaries may interfere with ovulation
  • Scar tissue and adhesions may block the fallopian tubes or interfere with movement of the egg into uterus
  • Immune signalling – there is an association between endometriosis and autoimmune diseases and recurrent immune-mediated miscarriage

The pain of endometriosis is induced by recurrent, cyclic micro-bleeding of extra-uterine endometrial tissue.  This cyclic activation of tissue is oestrogen-dependent and inflammatory, leading to the development of lesions and cysts which form, filling with blood.  These are known as “chocolate cysts”.  These cysts may rupture and cause severe pain at any time during the month.  The severity of pain is related to an inflammatory process, rather than the size, location and extent of endometrial implants – explaining why some women with few microscopic lesions experience debilitating pain, whilst others with widespread endometrial implants may be asymptomatic.  Chronic inflammation also contributes to the formation of scar tissue and adhesions between lesions and organs causing restrictive pain.  Most commonly, pelvic pain is experienced at the onset of menstruation, although it may occur at ovulation, after menstruation or throughout the month.

Fundamentally, endometriosis is an oestrogen-dependent, immune-mediated, inflammatory condition that is believed to start with refluxed endometrium entering the pelvic cavity, as a result of retrograde menstruation.  It is estimated that retrograde menstruation occurs in up to 90% of all women, although only about 10-15% of these women will develop endometriosis.  The question then, is why do some women develop endometriosis while others do not?

It appears all of the alterations in inflammatory and immune processes play an important role in the persistence and progression of endometriosis and contribute to the development of infertility and pelvic pain.

From a Naturopathic perspective there are a number of functions which need support in a female who is suffering from endometriosis.  There is involvement of the immune system, heavy and painful periods, possible issues with liver detoxification and hormone balance, inflammation, muscle spasm and cramping, and diet.  All of these aspects would be considered by our Naturopaths at Nurtura Health in supporting you in your mission to regain and restore healthy endometrial tissue and relief from symptoms. 

 

 

Watch this space for future posts on other conditions in more detail!

Disclaimer:  The advice on this website is of a general nature only and Nurtura Health expressly disclaims all liability arising out of the improper use of the information provided.  Nurtura Health actively discourages any self-diagnosis or self-medication.  Please consult your health practitioner regarding these important health issues.  All rights reserved.

Women’s Health – Polycystic Ovarian Syndrome (PCOS)

PCOS  affects  4 – 7% OF WOMEN.  It is characterised by ovaries containing multiple cysts (polycystic ovaries, signs of excess body hair; male pattern baldness; abnormal, irregular or scanty periods and metabolic syndrome (high insulin, obesity and hypertension)).  Polycystic ovaries can be 2-5 times the normal size, as follicles fail to ovulate and develop into cysts with a thickened white capsule. 

PCOS is the most common cause of infertility from lack of ovulation in women of reproductive age.  Other signs and symptoms associated with PCOS include:

  • Symptoms of hyperandrogenism such as a deepening of the voice and male-pattern baldness
  • Infertility due to failure to ovulate
  • Obesity with related metabolic syndrome, non-insulin dependent diabetes, hypertension and/or dyslipidaemia
  • Sleep apnoea
  • Acanthosis nigrans (i.e. diffuse velvety thickening and hyperpigmentation of the skin on skin folds, nape of the neck)
  • Acne, oily skin, seborrhoea
  • Prolonged periods of PMS-like symptoms
  • Chronic pelvic pain
  • Hypothyroidism

These symptoms are a result of the biochemical and endocrine changes that occur in a woman with PCOS.  In PCOS, the woman’s pituitary function favours synthesis of luteinising hormone (LH) over follicle stimulating hormone (FSH).  In the ovaries, increased LH stimulation causes the theca cells to increase androgen production (typically male sex hormones e.g. testosterone and androstenedione).  At the same time, low FSH fails to stimulate the ovarian cells to convert androgens to oestrogen.  This leads to a failure of follicular maturation, low ovarian oestrogen production and a failure to ovulate, often resulting in absent, infrequent or scanty menstruation.  The increased androgens, in turn, influence the development of masculine characteristics, such as excess hair or male pattern baldness, and contribute to the development of metabolic syndrome.

Obesity is present in nearly half of all women with PCOS due to increased peripheral insulin resistance and high insulin production.  Obesity amplifies the hormonal abnormalities of both PCOS and metabolic syndrome causing increased insulin resistance.  Elevated insulin levels then further increase LH effects on ovarian function, exacerbating symptoms.  This becomes a vicious cycle!

In PCOS the Syndrome exacerbates obesity, and the insulin-resistant obesity further exacerbates PCOS.  In support of a return to hormone balance it is important to address the menstrual irregularities; health and function of the reproductive system; support to re-establish and maintain blood glucose levels; support for appetite control and review of dietary patterns; ensure cholesterol is within normal limits; and support healthy liver detoxification which further assists in balancing hormones.  The most beneficial support for PCOS includes individual assessment by one of our dedicated Naturopaths.  Although PCOS has a “name” there are many layers and each woman has her own unique set of underlying drivers, whether it be hypofunctioning thyroid, insulin resistance/blood sugar irregularities, inability to metabolise and detoxify fats, or dietary and appetite challenges.  Call Nurtura Health for an appointment and we can support you to regain healthy ovulation.   

 

 

Watch this space for future posts on other conditions in more detail!

Disclaimer:  The advice on this website is of a general nature only and Nurtura Health expressly disclaims all liability arising out of the improper use of the information provided.  Nurtura Health actively discourages any self-diagnosis or self-medication.  Please consult your health practitioner regarding these important health issues.  All rights reserved.
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Women’s Health – Luteal Phase Defects

A luteal phase defect is a menstrual cycle abnormality where low progesterone levels in the luteal phase of the menstrual cycle result in delayed development of the endometrium.  This deficiency of progesterone in the luteal phase is more often termed “oestrogen dominance”.  Oestrogen dominance is thought to affect 3-5% of infertile women and up to 5% of women with a history of repeated miscarriage, and yet may be present in as many as 30% of all women.

Symptoms of a luteal phase defect include a short or irregular menstrual cycle, PMS, menorrhagia, infertility and/or menstrual spotting.  Blood serum progesterone level of lower than 10ng/mL one week prior to the start of menstruation and/or one week after the mid-cycle Luteinising Hormone surge is generally accepted as a diagnosis of luteal phase defect.

As the menstrual cycle is under the synchronised control of all the reproductive hormones, a simple lack of progesterone in the luteal phase is unlikely to be an isolated event.  It is more likely due to a defect in the follicular phase with subsequent poor follicular development.  This results in the inability of the corpus luteum to produce adequate progesterone in the second half of the woman’s menstrual cycle.

In a healthy menstrual cycle, high levels of Follicle Stimulating Hormone in the follicular phase ensure follicular development and the Lutenising Hormone and oestrogen surge mid-cycle mediates ovulation.  This in turn allows the corpus luteum to form and progesterone production to occur as it should in the luteal phase.  In the luteal phase, the endometrial lining proliferates under the influence of oestrogen and progesterone.

Progesterone, in particular, gives the endometrial lining structure and integrity, and prepares the endometrium for implantation of a fertilised egg.  Without adequate progesterone production by the corpus luteum, the endometrium fails to develop properly and pregnancy cannot occur as the embryo cannot attach to the uterine wall.  This is why luteal phase defects are associated so strongly with menstrual abnormalities and infertility.

To maintain balance, hormones such as oestrogen need to be excreted via healthy detoxification.  This process occurs primarily in the gut and liver.  It is also important to support healthy hormone balance both in the follicular phase and the luteal phase.   Specific herbal combinations and nutritional remedies may be prescribed by our caring Naturopaths to support a return to a balanced and healthy cycle. 

 

 

Watch this space for future posts on other conditions in more detail!

Disclaimer:  The advice on this website is of a general nature only and Nurtura Health expressly disclaims all liability arising out of the improper use of the information provided.  Nurtura Health actively discourages any self-diagnosis or self-medication.  Please consult your health practitioner regarding these important health issues.  All rights reserved.

Women’s Health – Menorrhagia (Heavy periods)

Menorrhagia is the term for excessive (greater than 80ml blood loss) and/or prolonged (no longer than nine days) menstrual bleeding.  Menorrhagia due to hormonal factors is most common in the first years of menarche, and approaching menopause due to hormonal influences, and may be exacerbated by other pathology, most commonly, uterine fibroids.

Excessive menstrual flow may contain blood clots, as blood loss exceeds normal fibrinolytic mechanisms in the uterus and begins to clot.  The most important complication of ongoing menorrhagia is an increased risk of anaemia that may, in turn, lead to heavier bleeding.  Other causes of menorrhagia include:

  • Annovulation (failure to ovulate)
  • Uterine fibroids
  • Cervical and/uterine polyps
  • Adenomyosis (i.e. endometrial thickening with the uterine wall)
  • Intra-uterine contraceptive devices
  • Abnormal blood clotting
  • Miscarriage
  • Uterine, cervical or vaginal cancer
  • Pelvic inflammatory disease
  • Excessive oestrogen and/or unopposed oestrogen

Anovulatory cycles commonly lead to menorrhagia in both early menstrual development and during peri-menopause.  During these times there is no trigger for ovulation.  Due to lack of the Luteinising Hormone surge mid-cycle, ovulation fails to occur with a subsequent lack of progesterone secretion.   Progesterone strengthens and stabilises the endometrium.  Without progesterone, the endometrium proliferates excessively under the influence of unopposed oestrogen which may then lead to the prolonged heavy bleeding.

 To relieve pain and heavy menstruation we consider formulas based on traditional Chinese herbal medicine.  Warming properties help to relieve menstrual pain by invigorating and moving stagnated blood in the abdomen and uterus.  Herbs may also assist in the management of painful menstruation via the regulation of blood circulation.  This reduces the stagnation of blood that may be associated with heavy, congested and painful periods.  Of course for every woman, menorrhagia has a very individual relevance and one of our dedicated Naturopaths would be happy to discuss this with you and look for a prescription or advice specifically to support your hormones back into a balanced state.   

 

 

Watch this space for future posts on other conditions in more detail!

Disclaimer:  The advice on this website is of a general nature only and Nurtura Health expressly disclaims all liability arising out of the improper use of the information provided.  Nurtura Health actively discourages any self-diagnosis or self-medication.  Please consult your health practitioner regarding these important health issues.  All rights reserved.
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Women’s Health – Amenorrhoea and Oligomenorrhoea

Amenorrhoea  is the absence of the menstrual cycle during a woman’s reproductive years, excluding pregnancy and lactation.  Primary amenorrhoea is the failure to start menstruation by the age of 16 years and is associated with developmental problems.  Secondary amenorrhoea is more common, where menstruation ceases for three months or more after normal menstruation, for reasons other than pregnancy and lactation.  Amenorrhoea, whether primary or secondary, is a symptom of some underlying cause, ranging from hormonal failure, physical obstruction, extreme stress (including over-exercise), metabolic dysfunction or hormonal imbalances.  Many causes may overlap to cause secondary amenorrhoea, most commonly polycystic ovarian syndrome (PCOS), low body fat or major stress.  Oligomenorrhoea on the other hand is characterised by infrequent or very scant menstruation.  The cycle is longer than 35 days, and may occur as little as four times per year. 

Amenorrhoea and oligomenorrhoea may be symptoms of:

  • Pregnancy or lactation (amenorrhoea)
  • Hormonal contraception; oral contraceptive pill use or progesterone therapy
  • Excessive stress
  • Low body fat mass (e.g. associated with eating disorders, excessive exercise or athleticism)
  • Polycystic ovarian syndrome (PCOS)
  • Pituitary tumours
  • Some medical therapies; for example, chemotherapy

Stress is by far the most common reason for amenorrhoea and/or oligomenorrhoea.  Excessive and/or chronic stress may suppress reproductive function.  Elevated stress hormones interfere with hormones which regulate ovulation and menstruation.  Subsequent low oestrogen and progesterone production may lead to anovulation and lack of menstruation.

Low levels of body fat may also contribute to amenorrhoea and/or oligomenorrhoea.  Body fat is critical to healthy oestrogen metabolism.  Low body fat may cause primary amenorrhoea, where menstruation fails to start, or secondary amenorrhoea, as a result of excessive exercise and/or dieting.

High levels of exercise may contribute to amenorrhoea and/or oligomenorrhoea as it both increases stress hormone production and reduces body fat levels.  It is estimated that up to 20% of female athletes experience exercise-induced amenorrhoea.  Due to the competitive nature of sport it may be difficult to separate this entirely from low body fat induced amenorrhoea, and the metabolic effects of stress, as both often occur together.  In women who exercise intensely, there may be a resultant drop in oestrogen and progesterone levels, causing anovulation and amenorrhoea.

Excessive exercise and low body fat induced amenorrhoea is characterised by oestrogen deficiency, similar to menopause, leading to increased risks of calcium loss and early osteoporosis.  Athletes with amenorrhoea are three times more likely to suffer from stress fractures, and are more likely to be infertile.  For this reason, persons with anorexia nervosa are also more susceptible to osteoporosis. 

At Nurtura Health, our dedicated Naturopaths utilise herbal and nutritional formulas specifically indicated for the support of healthy reproduction and ovarian function in women.  Herbs have a strong traditional use to support female reproductive function in women who have low oestrogen levels and annovular cycles and may assist in regulating menstruation, supporting female fertility and maintaining normal healthy sexual desire and function in women with low oestrogen levels.  This approach is particularly useful for female persons trying to conceive in their late 30’s/early 40’s.

 

 

Watch this space for future posts on other conditions in more detail!

Disclaimer:  The advice on this website is of a general nature only and Nurtura Health expressly disclaims all liability arising out of the improper use of the information provided.  Nurtura Health actively discourages any self-diagnosis or self-medication.  Please consult your health practitioner regarding these important health issues.  All rights reserved.
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Women’s Health – Dysmenorrhoea (Painful Periods)

Dysmenorrhoea, or painful periods, is common.  Debilitating, painful, cramping periods are one of the leading causes of female school and work absenteeism.  Dysmenorrhoea literally means “difficult monthly flow” and the characteristic pain is most acutely felt at the onset of menstruation, lasting for 1 – 2 days.  Symptoms of dysmenorrhoea include:

  • Moderate to severe cramping and abdominal/pelvic pain beginning with onset of period and lasting 8–72 hours
  • Low back and upper leg pain
  • Headache
  • Diarrhoea
  • Nausea/vomiting

Primary dysmenorrhoea is menstrual pain that is not associated with other pathology; whilst secondary dysmenorrhoea refers to pelvic pain related to underlying pathology and exacerbated by menstruation, such as endometriosis, uterine fibroids, adenomyosis, bladder inflammation, irritable bowel syndrome or chronic pelvic inflammatory disease.  Secondary dysmenorrhoea may be associated with:

  • Infertility
  • Heavy menstrual flow or irregular bleeding
  • Dyspareunia (painful sexual intercourse)
  • Vaginal discharge
  • Lower abdominal or pelvic pain at other times in the cycle

Note:  It is vital in dysmenorrhoea to determine if there is an underlying pathological cause of pain before proceeding with natural treatment recommendations.

Excessive oestrogen exposure throughout the menstrual cycle is thought to be a primary driver of dysmenorrhoea, as oestrogen stimulates excessive production of certain prostaglandins (PGs).  PGs are inflammatory mediators which vasoconstrict endometrial vessels and contract smooth muscle causing cramping and pain. 

Increased levels of inflammatory mediators may also be involved in dysmenorrhoea and studies on women with dysmenorrhoea have found elevated levels of these in the menstrual discharge of 10-30% of women with dysmenorrhoea who failed to respond to some anti-inflammatory therapy.  This finding correlated to abnormally high levels of white blood cell counts found in the menstruum of these women, indicating high levels of inflammatory activity. 

Primary dysmenorrhoea is associated with early onset of menstruation, never having delivered a baby (nulliparity), heavy or prolonged menstrual flow and a positive family history of dysmenorrhoea.  Some of the key drivers are stress, smoking and obesity.  There may also be an association with sexual abuse or chronic mood disorders, such as depression. 

Combining Western herbal medicine with Activated B Vitamins may be used for the management of painful and heavy menstrual flow.  Using herbal remedies to encourage a normal, healthy balance of oestrogen and progesterone in women, as well as having scientifically proven anti-inflammatory actions, may give effective relief in dysmenorrhoea.  Periods are not optional but pain and heavy bleeding is.  Talk to one of the dedicated Naturopaths at Nurtura Health to ask how you may get support and relief from what is often a debilitating condition. 

 

 

 

Watch this space for future posts on other conditions in more detail!

Disclaimer:  The advice on this website is of a general nature only and Nurtura Health expressly disclaims all liability arising out of the improper use of the information provided.  Nurtura Health actively discourages any self-diagnosis or self-medication.  Please consult your health practitioner regarding these important health issues.  All rights reserved.
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Women’s Health – Premenstrual Syndrome (PMS)

The “dreaded” Premenstrual syndrome (PMS) affects up to 75% of women at some time in their lives.  PMS is described as a cluster of symptoms appearing during the 10 – 14 days before menstruation, that usually resolve with the onset of menstruation.  Symptoms are variable between women, and may include:

  • Mood swings and/or depression/weepiness
  • Irritability, anxiety, insomnia and/or nervous tension
  • Mental confusion, poor concentration and forgetfulness
  • Abdominal bloating and distension
  • Weight gain from fluid retention
  • Breast tenderness and swelling
  • Acne
  • Headaches/ brain fog
  • Altered appetite, especially cravings for sugar, alcohol and fatty foods
  • Physical fatigue and weakness
  • Changes in libido
  • Constipation and/or diarrhoea

Studies show that when compared to controls, women with PMS have lower levels of progesterone throughout the menstrual cycle, with elevated oestrogen levels during the premenstrual phase.  The progesterone metabolites interact with the central nervous system to positively affect mood and behaviour, improve the stress response and enhance cognitive function.  Lower levels of these metabolites may contribute to the mood disorders women experience in the premenstrual phase. 

The hormone prolactin naturally elevates during the premenstrual phase and may be further increased by oestrogen and stress.  Elevated serum prolactin levels are associated with cyclic breast tenderness, fluid retention and irritability.  Aldosterone also contributes to symptoms of fluid retention, contributing to weight gain and bloating.  Other neurological factors are thought to trigger food cravings, binge eating and fatigue.  Collectively these factors contribute to the wide variability of symptoms experienced by each woman during her cycle. 

Many of the emotional mood symptoms associated with PMS and stress may be linked to low neurotransmitter levels and function.  Combinations of herbs have been shown to act synergistically to assist in the management of hormonally-related mood disorders by having a calming effect and restoring feelings of happiness and well-being during the pre-menstrual period. 

Premenstrual dysphoric disorder (PMDD) is a very extreme form of PMS that can be quite challenging.  In a study of women with PMDD, subjects who took a specific herbal combination for six menstrual cycles revealed improvements were shown in all mood symptoms, including depression, anxiety and irritability. Some herbal combinations have been shown to have measurable phytoestrogen content.  It is suggested this may help to modulate the mental and emotional symptoms of PMS.

Other herbal and natural remedies may help in the management of premenstrual headaches, mood swings and nervous tension, sore breasts, bloating and fluid retention.  There is so much available to relieve the symptoms of this distressing syndrome.  Don’t despair.  Talk to one of our dedicated Naturopaths at Nurtura Health and let them support you to start enjoying life without this cyclic challenge. 

 

 

 

Watch this space for future posts on other conditions in more detail!

Disclaimer:  The advice on this website is of a general nature only and Nurtura Health expressly disclaims all liability arising out of the improper use of the information provided.  Nurtura Health actively discourages any self-diagnosis or self-medication.  Please consult your health practitioner regarding these important health issues.  All rights reserved.
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Women’s Health – Sex Hormones & the Reproductive Cycle

Women’s fertility is cyclic in nature and goes through constant change.  These changes occur, not only through the transition from childhood to menopause, but on a monthly and, indeed, daily, basis.  Hormones mediate these cyclical changes and balanced hormones are essential for female reproductive health.

After the onset of menstruation, the reproductive system takes 6-8 years to develop fully at around age 20. The implications here are that for girls put on the oral contraceptive pill (OCP) at a young age (for example due to heavy periods or dysmenorrhoea), proper signalling and feedback mechanisms may never fully develop, leaving them with a potential lifetime of hormone disturbances and menstrual difficulties.

The ‘menstrual cycle’ is the term used to describe the natural hormonal and physical changes that occur in order to prepare healthy eggs (ova) within the ovaries, and develop the lining of a woman’s uterus in preparation for pregnancy. 

The menstrual cycle is divided into three phases.

The Follicular Phase  – starts at day 1 (the first day of the period) and goes to day 14 (ovulation).  During this phase the follicles (sacs which contain an egg) develop in an oestrogen dominant environment, until the dominant follicle matures and the egg is released at around day 14. 

The oestrogen dominance in the follicular phase stimulates the lining of the uterus, the endometrium, to proliferate and become more vascular, thickening in preparation for possible embryo implantation. 

Ovulation occurs once the dominant follicle has reached maturity in the ovary, following which time the egg is released and enters the fallopian tube ready to travel to the uterus.

After ovulation, the follicle from which the egg was released changes state and becomes a progesterone-secreting gland: the corpus luteum. 

The Luteal Phase is the final stage of your cycle during which time the uterus lining becomes thicker in preparation for a fertilised egg.  Progesterone is produced in the corpus luteum in increasing quantities during the luteal phase, preparing the uterine environment for fertilisation and embryo implantation.  The progesterone release after ovulation also heats the body causing a rise in temperature of between 0.1 – 0.5oC.  A sustained temperature rise after day 14 confirms ovulation.

Finally, the corpus luteum survives for about 12–16 days, and if the egg is not fertilised, the egg dies and the corpus luteum breaks down.  When the corpus luteum breaks down, the drop in progesterone causes the endometrium to break down and shed as the menstruation.  It is important to note however that women can have a “period” without ovulating.   This phase occurs from days 16 – 28.  The cycle then begins again. 

The average menstrual cycle or a healthy menstrual cycle length should be 291/4 days in length; the same as the lunar cycle.  Long or short cycles are due to variations in the length of the follicular phase or luteal phase.

With the cyclical changes there is a change in the quality and quantity of the cervical mucus.  With the increase in oestrogen in the follicular phase, the mucus increases in quantity, becomes wetter and slipperier.  This mucus is designed to allow the sperm passage to the uterus.  Just prior to ovulation the mucus is profuse, wet and clear.  At this time, many women produce clear, stretchy mucus which resembles raw egg white.  As progesterone levels increase in the luteal phase, the mucus quantity decreases and it becomes drier, pastier and more acidic.  This, in effect, acts as both a barrier and a spermicide, as sperm cannot pass through the mucus and are immobilised in a lower pH.  These mucus changes are critical for fertility and though the mucus pattern alone won’t confirm ovulation, it can tell you the potentially fertile times in a woman’s cycle.  

Note: For more information on temperature and mucus patterns and cycle charting, please discuss this with one of our Naturopaths at Nurtura Health.  

SEX HORMONE PRODUCTION

The cyclical fluctuations in sex hormones during a woman’s monthly menstrual cycle are key to her reproductive health and the changes that occur during her menstrual cycle are mediated mostly be steroidal sex hormones (i.e. oestrogens and progesterone).  All steroid hormones are synthesised from the same precursor, cholesterol. 

Numerous organs and tissues have the capacity to synthesize steroid hormones, including the adrenals, ovaries, testes, brain, adipose tissue, skin and the placenta.  The adrenal gland is the most important steroidogenic tissue in the human body and is essential for survival.  An enzyme unique to the adrenal cortex is essential for the conversion of progesterone and 17-hydroxyprogesterone into the precursors for corticosterone and cortisol, respectively.  The importance of this will become more apparent when we look at the effects of stress on steroid hormone profiles. 

OESTROGEN METABOLISM

There are three primary forms of oestrogens produced in the human body: oestrone (E1), oestradiol (E2) and oestriol (E3).  These exist in different ratios and have differing potencies.  E3 is the least potent and should make up around 60-80% of our oestrogens, E2 and E1 are more potent and each should make up 10-20% of the oestrogen balance.  Increased levels of the most potent oestrogen E2 are associated with increased risk of many oestrogen-dependent pathologies (e.g. endometriosis, fibroids, breast cancer, etc), therefore ensuring the right balance of oestrogens is important for women’s health.  Interestingly, progesterone facilitates the conversion of E2 to the weaker E1, so the implications of adequate progesterone production extends to facilitating safer oestrogen metabolism.

All three forms of oestrogen are metabolised by liver enzymes.  This process converts E1 and E2 into a weaker, safer form of oestrogen.  In another chemical process an enzyme which is concentrated in local tissues like breast tissue, converts the oestrogens to a more potent oestrogen metabolite, 4-OH oestrogen.  This 4-OH oestrogen is strongly associated with breast cancer development.  A third metabolic pathway is also active where enzymes convert oestrogens to the strongly proliferative metabolite, 16-OH oestrogen.  This oestrogen metabolite is associated with increased risk of oestrogen-dependent cancer, and other oestrogen-dependent conditions, including fibroids, endometriosis, PMS and dysmenorrhoea.  

What does this mean?  It is of utmost importance to have healthy liver detoxification so the 2-OH, 4-OH and 16-OH oestrogens can go through a process of conversion and detoxification in the liver to be excreted through the bowels and urine. 

If there is impairment in these processes, highly reactive substances are produced which induce tumour formation largely through binding to DNA and causing breakages in the DNA strands.  These reactive substances are linked to the development of breast cancer and other types of human cancer.  Ensuring adequate enzyme, detoxification and anti-oxidant pathways effectively “mops up” these carcinogenic metabolites to render them safe and facilitate their excretion.

For optimal oestrogen metabolism and detoxification it is also important to have adequate levels of specific activated B group vitamins.

Assessing whether this is occurring in women can be easily achieved through functional pathology tests such as the Female Salivary Hormone Profile test and 2:16-OH Oestrogen Urinary Metabolite test.  For further details on these functional pathology tests, please contact one of our Naturopaths at Nurtura Health.

 

Watch this space for future posts of each condition in more detail!

Disclaimer:  The advice on this website is of a general nature only and Nurtura Health expressly disclaims all liability arising out of the improper use of the information provided.  Nurtura Health actively discourages any self-diagnosis or self-medication.  Please consult your health practitioner regarding these important health issues.  All rights reserved.
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