This article appears in the May issue of online magazine Live, Love and Eat. For more great information to support your healthiest and happiest life, get your copy at http://www.liveloveandeatmagazine.com/
Here’s a look at 3 common health conditions that can negatively impact women’s fertility and 3 foundations for reproductive health that can help heal them.
1. Polycystic Ovarian Syndrome (PCOS)
What is it?: A complex hormone imbalance syndrome characterized by inflammation and insulin resistance and an overproduction of male (or androgenic) hormones. It’s estimated up to 10% of women have PCOS and it’s one of the leading causes of infertility in women.
Common symptoms: irregular or no periods, miscarriages, weight gain and insulin resistance, elevated levels of androgenic hormones causing acne, hair loss, pigmentation of the skin, oily scalp, increased facial hair growth
How it impacts fertility: Lack of ovulation or irregular timing of ovulation
Medical Treatment: PCOS is typically diagnosed when a woman has a combination of the following conditions: 1. Irregular or no periods; 2. Tests showing high androgens or symptoms of high androgens 3. enlarged ovaries containing multiple small follicles (polycystic ovaries).
Metformin, a drug used to treat Type 2 diabetes, is often prescribed to help control the amount of glucose in the blood. Hormonal medications like the birth control pill may be used to help create a regular menstrual cycle, but this doesn’t solve the root problem and also prevents pregnancy. Clomid is commonly used to hyperstimulate the ovaries to ovulate.
Natural Treatment: A low glycemic, anti-inflammatory diet, and consistent exercise plan are essential to controlling PCOS insulin resistance and inflammation. Effective supplements that are used include combination myo-inositol and D-chiro-inositol, berberine, fish oil, N-Acetyl cysteine, Vitamin D, magnesium
What is it?: A chronic inflammatory disease in which tissue similar to that of the lining of the uterus implants and grows outside of the uterus. Endometriosis tissue can attach to the ovaries, fallopian tubes, bowel, bladder, lining of the pelvic cavity, ligaments or other areas. These lesions are sensitive to estrogen, so they swell and bleed with every menstrual cycle, causing internal bleeding and extremely painful inflammation. Adhesions and scar tissue can form and cause organs to stick to each other and parts of the pelvic cavity. Endometriosis affects an estimated 1 in 10 women in their reproductive years – approximately 176 million women in the world. It’s estimated that endometriosis accounts for 25 to 50% of fertility issues in women.
Common symptoms: There are 4 diagnostic stages of endometriosis, based on the amount of growth, location and depth of the disease, and it can only be definitively diagnosed visually via a laparoscopic surgery. Symptoms include severe pain with periods, or general pelvic pain, heavy periods, long or abnormal cycles, swollen abdomen, ovarian cysts, pain with bowel movements, bladder pain, pain with sex, low back pain, infertility
How it impacts fertility: Women with endometriosis have an increased risk of miscarriage and ectopic pregnancy. Excess tissues growing create inflammation and may block an embryo from implanting. Internal damage to the fallopian tubes from scar tissue can block the tubes, and ovulatory function can also be affected. Changes in the hormonal environment can decrease the quantity and quality of eggs. An auto-immune reaction to the misplaced tissue may attack the uterine lining and cause miscarriages.
Medical Treatment: The gold standard treatment for endometriosis is excision surgery, where the tissue and adhesions are removed. Hormone suppressing medications are often prescribed to stop the menstrual cycle, and prevent further growth of the lesions. Interestingly, the same Metformin used in PCOS therapy is also being studied as a new therapy for endometriosis to help with inflammation and estrogen suppression.
Natural Treatment: Since many experts believe there may be an auto-immune component to the disease, it’s important to heal the digestive tract by identifying individual food intolerances, and eating an anti-inflammatory diet as well as balancing blood sugar.
Due to the estrogen sensitivity, assisting the body to clear excess estrogen with nutrition and reducing exposure to xenoestrogens (estrogen mimicking chemicals) are also key approaches.
Recommended supplements include turmeric or curcumin as an anti-inflammatory, selenium to modulate immune function and assist with the production of progesterone, zinc to help repair the gut and decrease inflammation, estrogen detoxing DIM and Calcium D-Glucarate, berberine, fish oil, N-Acetyl cysteine
3. Thyroid Disease
What is it?: The thyroid gland is a butterfly shaped gland at the base of the throat producing thyroid hormones (T4 and T3) which help regulate the body’s metabolic processes, including digestion, detoxification and ovulation. It can be affected by environmental toxins, genetics, stress, nutrient deficiencies, other hormone imbalances, or auto-immune dysfunction. It’s estimated now that 5 to 20% of women in their reproductive years have a thyroid condition, and that up to 90% of those with an underactive thyroid (hypothyroid) actually have Hashimoto’s Thyroiditis, an auto-immune disease. You can also have an hyperactive thyroid (Grave’s disease) but this is much less common.
Common symptoms: infertility, miscarriages, irregular periods or period pain, fatigue, brain fog, cold extremities, stubborn weight gain, dry or thinning hair, constipation, consistently low basal temperature (below 36.5C first thing in the morning)
How it impacts fertility: Good thyroid function is necessary for fertility, the ability to conceive and to maintain a pregnancy. An underactive thyroid can affect your fertility by causing luteal phase problems where a fertilized egg can’t implant securely, higher prolactin levels resulting in irregular ovulation or no ovulation, and contributing to excess estrogen levels, progesterone deficiency and lowered sex hormone binding globulin, all of which interfere with proper reproductive hormone balance.
Medical Treatment: Thyroid hormone medication to bring hormones into normal range.
Natural Treatment: If it’s determined you have Hashimoto’s, then following an autoimmune disease nutrition and lifestyle protocol is very important. Specific supplements that support underactive thyroid function include selenium, iodine, and l-tyrosine
What do these conditions have in common?
Women with endometriosis and PCOS commonly can also have thyroid disorder. Multiple hormone disruptions and inflammatory conditions often co-exist. There are common underlying factors, and addressing these are foundations for hormonal balance and improved fertility.
Clean Up and Calm Down – 3 Key Foundations for Reproductive Health
1. REDUCE INFLAMMATION
Dietary and environmental toxins may build up in the body, turning the immune system on and keeping it highly reactive. Inflammation can disrupt ovulation and impair progesterone production. Chemical messengers can block hormone receptors for your progesterone and thyroid hormone, and hyperstimulate estrogen receptors – all of which are going to contribute to endometriosis, PCOS and thyroid disease.
We can clean up our internal landscape by reducing exposure to inflammatory foods and chemical burden.
Top inflammatory foods to avoid include:
- vegetable oils – for the most part made from genetically modified crops but also are heavy in Omega 6 fatty acids which when over-consumed promote the production of inflammatory prostaglandins
- sugars – highly inflammatory and suppress the immune system
- conventional meats – may have considerable exposures to antibiotics and hormones which disrupt our own hormones
- pasteurized dairy – the A1 casein protein in dairy can stimulate an inflammatory response by the immune system in many people, and dairy products often contain disruptive hormones and other toxins.
- gluten – gluten protein promotes intestinal permeability and autoimmune disease and is a top food sensitivity for many.
An elimination diet is often used by holistic health practitioners to identify personal food sensitivities, which is any food that causes an inflammatory reaction. These can vary from person to person.
Foods that reduce inflammation:
Choosing mostly whole, nutrient dense, organic foods reduces exposure to toxic chemicals, pesticides and hormones, so go for
- free range, grass fed meats and wild-caught salmon
- coconut and other nut milks
- a wide variety and rainbow color of organic veggies
- fermented foods
- gluten free grains like quinoa, millet, buckwheat
- nuts and seeds
- organic berries and domestic fruits
- healthy fats from olive oil, coconut oil and avocados
Making sure you get fiber of up to 30 to 40 grams per day, drinking plenty of clean filtered water, and taking a daily probiotic will help your body clean up through improved digestion and elimination.
We can clean up our external exposure to toxins by choosing natural ingredient household cleaners and personal products. (see The Environmental Working Group’s website at www.ewg.org).
2. BALANCE BLOOD SUGAR
Insulin is produced in the pancreas and is released to move glucose into the bloodstream to use as energy. If you’re eating a high sugar diet, over time your body becomes less sensitive to the effects of insulin and the pancreas has to keep producing more of it, with blood sugar levels rising. What happens hormonally with all this excess insulin?
- an inflammatory environment
- women with insulin resistance are 4 to 5 times more likely to have a miscarriage
- an increase in testosterone that can inhibit fertility and stop ovulation
- follicular development is impacted when estrogen and progesterone come out of balance and egg quality can become low
- difficulty for the embryo to attach properly to the uterus
- a thyroid condition causes more insulin resistance and makes PCOS worse, and if insulin resistance is higher it can make a thyroid condition worse.
An anti-inflammatory diet as described above will naturally improve insulin resistance. Avoid higher glycemic foods and personal food sensitivities. Though there are many grains such as buckwheat and barley, that are considered anti-inflammatory and are also high in antioxidants and other nutrients, women with PCOS may do better minimizing their intake of these also, at least for a period of time. Grains still turn to sugar in the body faster and are generally less nutrient dense than foods like vegetables.
Every meal should contain protein, fats, and carbs consisting mostly of vegetables. Protein at breakfast is especially important to set your body up for even blood sugar levels throughout the day. High fiber foods such as broccoli, dark leafy greens, and flaxseed are great ways to slow down the digestion of sugars in the body and also help process excess estrogens. Regular exercise is also key to battling insulin resistance.
3. MANAGE STRESS
And now comes the calm down part! Stress causes the body to release the hormone cortisol from the adrenal glands. Higher levels of cortisol inhibit the conversion of T4 to the active T3 hormone, slowing down thyroid activity. High cortisol increases insulin release in the body and can lead to insulin resistance over time. The adrenal glands will also steal progesterone to make more cortisol, which can contribute to estrogen imbalance. So you can see that the hormonal effects of stress are widespread!
Stressors can include poor nutrition, caffeine, over-activity, and lack of sleep. Be mindful of any changes you can make to your and your family’s schedule – it’s o.k to just say no! Make time to rest and have quiet reflective time each day. A meditative and/or deep breathing practice is extremely helpful to calm the nervous system and adrenal response. Gentle exercise can also help. This is not the time to be running marathons, which can tax the adrenals – instead choose activities like walking in nature, yoga, pilates, weights or swimming.
Make getting enough restful sleep a huge priority or it will undermine everything else you’re working on! Sleep helps stabilize your cortisol, improves your insulin sensitivity and regulates the release of hormones.
Your body is listening and reacting to your emotional state in a very real way, so appreciate and cultivate nurturing yourself, making time to do things that are fun and give you joy.
These are strong foundations to build upon on the road to a healthy reproductive system. Working with a health practitioner that specializes in these conditions will give you access to the right testing and getting a nutrition and lifestyle program tailored specifically for your needs. Many of the medications used can cause significant side effects and nutrient deficiencies and are only masking the symptoms. A good program will work on identifying and correcting individual root causes of infertility and consider and balance both traditional medical and natural options for optimal results.
Period Repair Manual, Natural Treatment for Better Hormones and Better Periods, Lara Briden, ND, 2015
Stop Endometriosis and Pelvic Pain, Andrew S. Cook, MD, FACOG, 2012
Dietary and Lifestyle Strategies for the Management of Endometriosis, in Today’s Dietician magazine, Danielle Cook, MS, RD, CDE, 2016
Androgen Excess and PCOS Society http://www.ae-society.org/