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You’ve just been (or about to be) diagnosed with PCOS for your irregular periods, now what?

Why is lab work important in understanding the progression and underlying causes of PCOS and its symptoms?

Treating symptoms alone is a band-aid solution to correcting a problem. Treating symptoms without the necessary investigation is like blindly applying a band-aid to a boo-boo and hoping you get it in the right spot. Why would you do that?

Likewise, why blindly put a band-aid on your health? I see a lot of women in my practice who either have a PCOS diagnosis or symptoms of PCOS, with very basic or little to no investigative lab work. These ladies have irregular cycles, intense carb cravings, a mighty hard time to lose weight, hair loss, and acne, and a whole lot of feeling pretty low about their appearance, health, and self-esteem.

Though these signs can be a flaming red sign pointing to PCOS, there are other root causes worth exploring. Why? PCOS is more than just irregular periods; insulin, thyroid hormones, and inflammation all contribute to the pattern of symptoms present.

As a naturopathic doctor, I encourage the awesome ladies I treat in my practice to consider a COMPLETE hormone investigation. This takes out the guesswork in piecing together which hormones are triggering your PCOS symptoms (i.e.: is it adrenal or insulin triggered?) while also giving us a baseline to build their specific treatment plans on.

Here is a snippet of the hormone-related labs I like to run in my patients.

  1. HbA1C: Marker for measuring how your blood sugar has been in the past 3 months. HbA1C value between 6.0%-6.4% indicates pre-diabetes. How well your body is at processing blood sugar reveals the risk of developing/already having insulin resistance; a key player in the worsening of PCOS symptoms, weight gain, and inflammation.
  2. SHGB: Sex Hormone Binding Globulin (try saying that 10 times fast!) Produced in the liver, SHBG has a high binding affinity for DHT (the hormone that causes male-type symptoms) and Testosterone. SHBG is like a sponge soaking up all that excess testosterone, keeping it from floating around in the blood.
  3. Androstenedione: Produced by the ovaries and adrenal glands, this steroid hormone marker is overproduced by the ovaries in PCOS.
  4. DHT: Dihydrotestosterone is produced by the conversion of testosterone by 5-a-reductase (an enzyme). DHT binds much strongly to testosterone receptors, and high levels have been attributed to male pattern balding in men and women.
  5. Ferritin: The storage form of iron. Some symptoms of low iron include fatigue, low mood, feeling cold, weakness, and hair loss*.
  6. TSH: Thyroid Stimulating Hormone acts on the thyroid gland to tell it to produce thyroid hormones (T3 and T4). We Measure TSH, T3 and T4 to rule out thyroid issues that may be contributing to irregular periods, hair loss, weight gain (i.e. hypothyroidism can present with hair loss, weight gain, irregular menstrual cycles, coldness, fatigue).

Notice how many PCOS symptoms are also present in other conditions or are affected by several hormones? Testing estrogen, LH, and FSH aren’t enough to help us understand the full hormonal picture. Yes, the symptoms look a heck of a lot like PCOS and you may even have a polycystic ovarian syndrome diagnosis, but until we understand the root cause and other hormonal and organ involvements, management and treatments are just a shot in the dark or conventional birth control pills.

 

Think you have PCOS and want to know how your specific hormonal pattern is affecting your periods? Connect with me here and let’s talk about finally improving your hormones so you can finally have a happy period!


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Hair loss.

Pain points

  1. Losing hair. Shedding a lot
  2. Can see bald spots
  3. No one is taking hair loss seriously
  4. Bad hair days. Low self-esteem

Causes:

  1. PCOS: androgenic alopecia. 
  2. Autoimmune: alopecia areata
  3. Hypothyroid
  4. Nutrient-related
  5. Tension alopecia traction alopecia  
  6. Telogen effluvium 
  7. Side effects of medications like the pill 

Conventional therapies

  1. Rogaine/minoxidil 
  2. Transplant
  3. PRP
  4. Drugs
  5. Birth Control

Other therapies (that are currently being explored)

  1. Acupuncture 
  2. Essential oils like rosemary (find research if it helps)
  3. Topical melatonin
  4. Correcting nutritional deficiencies!
  5. Herbs that correct the imbalance of hormones
  6. Scalp massage: to improve blood flow and decrease inflammation

Hair loss is a distressing symptom of a deeper imbalance in the body and is one of the symptoms that present in women with PCOS.

Hormonal dysregulation in PCOS presents with an increased amount of testosterone and androgens in the blood Which clinically manifests as acne, hirsutism (the growth of darker, more coarse hair on the chin, neck, and maybe cheeks), and alopecia.

Androgenic alopecia or female pattern hair loss (FPHL) is often experienced by women who have PCOS, but also by women who have a genetic sensitivity to testosterone and DHT (the more potent product of testosterone metabolism).

Understanding Hair loss Causes

  1. Female pattern: alopecia in women is seen as the loss of occipital hair and thinning on the vertex/crown area of the head. Often the thicker terminal hairs fall out and are replaced by thinner, lighter, and sparser vellus hairs. Unlike men who suffer from androgenic alopecia, women retain their frontal hairline. A current understanding of the mechanism of action for this pattern of hair loss, especially in men, is that the circulating testosterone gets converted to DHT by an enzyme called 5-a-reductase; DHT then acts on the hair follicles to minimize them. Research now suggests this is only part of the problem, as there is inflammation in the scalp about the follicles that also contributes to miniaturization.
  1. Alopecia Areata: present in both sexes, this type of hair loss presents as patchy spots of loss over the scalp. It is often worsened or triggered by stress, and some of my patients have also reported a tingling feeling in the scalp right before they notice the hair fall. This is an autoimmune type of hair loss.
  2. Hypothyroid hair loss: diffuse hair loss or hair that is dry, brittle, and breaks easily is a common symptom in those who also have an underactive thyroid.
  3. Nutrient deficiencies: Iron-deficiency (more common in menstruating women), presents with diffuse hair loss and low energy. Low levels of zinc, vitamin B1, biotin have also been linked to hair fall, while vitamin A toxicity can also contribute to alopecia.
  4. Tension or Traction alopecia: Tight ponytails, buns or updos pull on the root of the hair and subsequently lead to hair fall. This type of hair loss is usually noticed in the frontal hairline (where ever the hair is pulled the tightest).
  5. Telogen Effluvium: A non-inflammatory (and non-scarring) form of hair loss that occurs after an event (usually due to medications). This alopecia alters the growth cycle of hair, where the hair remains in the resting phase for longer periods of time. Hair shedding is noticed after medications like chemotherapy and generally begins to grow back after 2 months.
  6. Side effects of medications: Specifically, the birth control pills. Some BCPs are made with progestins (synthetic, almost-progesterone, which binds to progesterone receptors), that are more androgenic. Progestins such as Methyltestosterone, Gestodene, Levonorgestrel, -Norgestrel, and Desogestrel, contribute to the worsening of androgenic activity like hair loss, hirsutism, and acne.

Conventional Therapies

Medications are used to treat the underlying root cause of hair loss. In patients suffering from hypothyroidism, treatments involve medications such as levothyroxine to replace thyroid hormones not produced by the gland. Hair transplants are available for moderate to severe hair loss patients.

Topical conventional treatments include Rogaine (minoxidil), that can be purchased at the pharmacy and applied to the scalp twice a day. A reported side effect is increased hair growth on the face.

Women with androgenic alopecia (with or without PCOS), are often prescribed a mix of birth control pills (with the least androgenic activity) along with spironolactone. Drugs that block the activity of 5-a-reductase are used to decrease the conversion of testosterone to its more potent form, DHT. Commitment to conventional medications is often life-long, once stopped, the hair fall returns.

Other therapies like PRP, protein-rich plasma, are cosmetic procedures that aim to stop hair shedding by decreasing inflammation in the scalp and stimulating new hair growth.

Alternative Therapies

  1. Acupuncture: Done locally in the scalp, acupuncture causes a micro-trauma which stimulates blood flow to the area. Increased blood flow brings nutrients for the follicles, and may stimulate new hair growth while also decreasing local inflammation.
  2. Topical essential oils: Rosemary essential oil also may support new hair growth by improving circulation to the scalp.
  3. Topical Melatonin: Research suggests that a 0.1% melatonin solution applied nightly to the scalp improves hair growth in the occipital area of the scalp. It is suggested that melatonin may also act as an anti-inflammatory in the area. The same research finds that applying melatonin to the scalp did not affect blood concentration levels.
  4. Correcting nutritional deficiencies: while low levels of biotin are typically seen in rare genetic conditions, it is also present in patients taking medications for epilepsy, in those who consume large amounts of alcohol (also causes vitamin B1 deficiency), and smokers. Iron deficiency is common amongst menstruating women; while the range for “normal” ferritin levels is great, as a naturopathic doctor I like to see serum ferritin greater than 70 ng/mL.
  5. Herbs that may improve hair growth include those that support the elimination of excess testosterone and DHT from the body and others that block the conversion of testosterone to DHT. These include reishi, saw palmetto, nettle, licorice. Other herbs that support the production of estrogen and progesterone, like vitex and white peony may also help correct the hormonal imbalance in some women.
  6. Scalp massage stimulates blood flow to the hair follicles. Massage may also decrease inflammation. While more research needs to be conducted into the exact techniques, when and how often, massaging one’s scalp can relax the mind and decrease stress – win!

 

Female pattern hair loss (FPHL)/androgenic alopecia is a distressing symptom of hormonal imbalance and PCOS. FPHL may even trigger psychological symptoms of low mood and depression. In fact, hair shedding is often overlooked by many professionals as a reaction to stress or a short-term change in diet and lifestyle habits. Some women may not even notice that hair loss has occurred until at least 25% has fallen/not grown back. In my practice I focus on uncovering the root cause of hair fall, be it thyroid-related, hormonal, or even autoimmune; no one-size-fits-all approach is going to stimulate every patient’s hair growth. This process may take longer for some, but treating the appropriate root cause is worth it.

 

Note from Dr. Usman, ND

Please share this article! I personally know just how hard it is to find the right (and relevant) information out there. A lot of androgenic alopecia studies are conducted in men, and there isn’t enough evidence to support female hormonal balance and hair growth – yet. The more we talk about hair loss and natural therapies in women, the more we can support those experiencing female pattern hair loss.


If you’d like to book in with me to discuss hair shedding solutions, please click here.

 

 


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Irregular menstrual cycles are frustrating!

A young woman recounts her experience with irregular periods:

“The hardest part was knowing when it [her period] would come and understanding where the heck my emotions were at. I was tired in school and didn’t have much focus [around menstruation]; the emotional instability really rocked me..”.


Irregular, out-of-whack menstrual cycles are common in PCOS. This could look anything like periods that show up twice in a month, or once every month and a half; some periods just change it up each cycle to keep you on your toes. So much for tracking your cycles and planning out safe days to wear white jeans because the irregularity makes Aunty Flow’s next visit unpredictable.

Nearly 20% of women of reproductive age have PCOS and almost 70% of women with symptoms of PCOS remain undiagnosed in Canada. That’s a lot of women living with the discomfort and mental stigma of irregular periods, acne/hair growth, infertility. This article focuses on irregular cycles and how unpredictable menstruation affects the lives of SO MANY WOMEN.

Uncovering the cause of irregular periods

  1. PCOS: Polycystic ovarian syndrome is the amalgam of an imbalance of hormones, also known as an endocrinopathy (fancy word for, an issue with the endocrine – hormone – system). We know that PCOS presents with irregular periods and increases the risk of developing type 2 diabetes, metabolic syndrome, and cardiovascular issues. The natural cycle of hormones stimulates ovulation which contributes to the balance of estrogen and progesterone with which (if no fertilization) brings about a period. In PCOS, this delicate cycle is thrown off contributing to the lack of regular menstruation.
  2. Stress is another factor that affects the cycle of hormones (mentioned above). If your body is under extreme or chronic stress, it wants to survive first. The body uses any and all of its resources to make sure you’re safe and sound. I.e. the body takes resources away from your digestion and reproductive organs, ultimately affecting your cycles.
  3. Thyroid dysfunction causes a variety of menstrual-related problems as abnormal levels of thyroid hormones affect the release and amount of sex hormones available to bind and act on the body.
  4. Weight: Extreme weight changes disrupt the balance of hormones. Crash diets, malnutrition, anorexia can all lead to irregular periods or amenorrhea (no period). Obese women also demonstrate abnormal hormone profiles; in obese women with PCOS (or at risk of PCOS) tend to carry extra fat around the waist and abdomen rather than the hips.

Do I have PCOS?

While irregular cycles (short: less than 21 days or longer: more than 35 days between periods) are one symptom of PCOS, menstrual irregularities are also present in thyroid dysfunction, periods of stress, and extreme changes in weight or diet. Speak to your doctor/naturopathic doctor about further testing to confirm a diagnosis of PCOS.

 

Management

Treatment for regulating periods always start with diet and lifestyle interventions. If PCOS is the likely cause, cutting out sugar and increasing exercise (more HIIT training!) are my favourite places to start. The less sugar a woman is consuming, the less her insulin levels will spike and the less fat she will store on her body. This is especially important for obese women. If I suspect an underlying thyroid dysfunction, after a thorough investigation, I’ll recommend specific herbs and supplements to help support natural thyroid hormone balance.

 

Some of my favourite herbs for treating irregular periods:

Vitex: Also known as Chasteberry, acts on the hypothalamus-pituitary system by slightly elevating LH and decreasing FSH in favour of producing more progesterone.

Black Cohosh: Traditionally used for treating menopause symptoms and painful periods, this herb is estrogenic and helps balance hormones to support menstrual regularity.

Rhodiola: A herb that helps the body deal with stress effectively.

Dong Quai, Alfalfa, Flaxseed, Licorice: which all help to balance hormones

 

Our young woman with the irregular cycles on her menstrual experiences after making dietary and lifestyle adjustments:

“Having regular periods helps me have regular emotions and I can plan out my outfits”


If these symptoms sound like you, or someone you know, book in an appointment with me to uncover the root cause of your irregular cycles and how naturopathic medicine can support your hormones and regulate your periods. Life is unpredictable, periods shouldn’t have to be!


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Improving pregnancy outcomes for expecting mothers

Pregnancy is a major life event for nearly all women. What a woman puts into her body before, or during this time can greatly impact both hers and the health of her fetus. Whether meticulously planned or otherwise, there is a ton of information out there for maternal health during pregnancy and sifting through all that information can easily become overwhelming and stressful.

 

Why is it important to prepare for pregnancy anyway?

Pregnancy, birth outcomes, and the future health of the child are all impacted by the mother’s mental/emotional and physical health both before and during gestation. If the expectant mother has underlying health conditions such as diabetes, thyroid disorders, or blood pressure issues, or even being older than 40 at the time of pregnancy, she may be monitored and treated as a high-risk pregnancy. High-risk pregnancies require more diligent care from health providers, physicians, and naturopathic doctors.

This post breaks down the prenatal vitamin and the purpose each nutrient serves for both baby and mama.


 

When to start taking a prenatal:

As soon as you find out your pregnant, but even starting a couple of months before you are planning to conceive all the way up to the postpartum period is encouraged. Ontario standards of practice for perinatal care advise women to take a folic acid supplement (or in their multi) prior to conception.

Vitamins:

Vitamin A

Required for the healthy development of vertebrae, spinal cord, limbs, heart, eyes, ears, and regulating the health of genes. Be careful though; vitamin A in doses of 10,000IU or more it can be toxic to the developing fetus (especially in the first trimester), causing malformations and defects in the heart and genitourinary systems. Better to stick with B-carotene.

 

Vitamin B

B6

Also known as pyridoxine, helps with nausea and vomiting experienced by the mother during the first trimester of pregnancy.

B12

This vitamin comes in a few forms, methylcobalamin, hydroxycobalamin, and cyanocobalamin. Methylcobalamin is used by individuals who have impaired methylation while cyanocobalamin breaks down to cyanide and cobalamin in the body. Naturopaths and health-care providers prefer the first two forms of vitamin B12 when supplementing their patients, which helps with nausea/vomiting and low energy.

 

Vitamin C

Ascorbic acid supplementation may help prevent the rupturing of membranes by stimulating collagen synthesis. Vitamin C is also associated with a lessened risk of pre-eclampsia (a disorder of pregnancy, associated with marked high blood pressure and increased protein in the urine).

 

Vitamin D3

Deficiency is associated with low birth weight and pre-term birth, as well as a higher risk of developing MS or diabetes later on in life. Vitamin D is important for the development of a healthy immune system and lungs in utero. When expectant mothers increased their intake of D3, a decreased risk of asthma in 40% of children between the ages of 3 and 5 was observed. Vitamin D3 is important for bones and teeth development. Recommended dose: 400-1000 IU daily.

 

Vitamin E

Vitamin E does thin the blood, so your naturopathic doctor or MD will note to monitor the dose. This vitamin helps with the formation of cells and is used as an antioxidant.

 

Vitamin K

Important for making the components that develop into blood clots.

 

Zinc

Decreases risk of low birth weight (especially in malnourished women). Zinc important for protein synthesis and nucleic acid metabolism, and RNA. This nutrient may prevent congenital malformations. Recommended dose: 10-25mg/day.

 

Iodine

Expecting mothers require more to meet the demands of fetal needs. Maternal thyroid hormone decreases slightly during the first trimester to meet the needs of the fetal thyroid hormone and to make up for the increased excretion. Too much or too little iodine may contribute to the development of congenital hypothyroidism.

 

Calcium

Important for the development of the skeleton, tissues, and hormones. Usually given up to 1000 mg daily.

 

Magnesium

Magnesium is required for building body tissues and preventing the uterus from contracting prematurely.  500 mg daily.

 

Iron

Iron is imperative for hemoglobin production and is sourced from our diets (red meats and plant sources such as dark green leafy vegetables. Hemoglobin carries oxygen in the blood for all of the tissues in the body throughout life. The growing fetus accumulates iron from their mother, who then experiences a decrease in her own iron stores. Iron-deficiency anemia is pretty common in pregnancy for this reason and these women may have a desire to chew on ice. Ferrous fumarate is a form of iron that is commonly used in over-the-counter prenatal vitamins however, it is not very well tolerated by the GI system. Some iron supplements like ferrous fumarate and succinate tend to also cause or worsen constipation. The most bio-available form of iron is iron glycinate.

Speak to your naturopath about how much iron is right for you.

 

Omegas and Essential Fatty Acids

DHA (an essential fatty acid) is important for the development of the brain and nervous tissue which is most significant from the 3rd trimester to the first 3 months of breastfeeding and early childhood.

 

Working with the naturopath:

 

Pregnancy is an exciting and overwhelming time for most women so choosing the right prenatal vitamin shouldn’t be. While there are a lot of options out there, I focus on selecting vitamins that specifically provide therapeutic doses to best support the health of mama and baby throughout all stages of pregnancy. (Not all vitamins are created equal and it’s important to keep in mind that some may cause more harm than good).

As a naturopathic doctor, I always ensure that my patients are up to date and aware of which vitamins and supplements they should (or should not) be on, what lifestyle factors and other wellness habits can improve their health outcomes, and any other naturopathic modalities might best support them.

 

If you found this article informative chances are it’ll resonate with someone else too! So please share it with your friends and family, and comment below what other topics you’d love to learn more about!


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29/Aug/2019

PCOS stands for Polycystic Ovarian Syndrome and is a condition that affects the natural balance of female hormones. Nearly 10% of women have PCOS globally. Read more about the involvement of hormones here [https://thewellnesssuiteto.com/pcos-naturopathic-treatment-solutions/]. While cysts on the ovaries are only part of the diagnose, they aren’t always present in all cases. To diagnose PCOS a woman needs to exhibit at least 2 out of the 3 following symptoms: ovarian cysts, anovulatory cycles (not ovulating during her period/irregular cycles), and male-type characteristics such as increased facial hair and hair loss on the head.

The imbalance of hormones and menstrual irregularities aren’t the sole indicators of PCOS. In fact, this disease has similar symptoms to metabolic disorders like diabetes. The hormone insulin (the which is off balance in diabetes) also plays a significant role in how PCOS leads to obesity and fat gain around the waist. Insulin is the storage hormone; when we eat sugars the body releases insulin to signal the all the cells to take in the sugar. If the cells have had enough sugar they eventually stop responding to insulin, and since insulin is a storage hormone, the sugars get converted to fat and stored in fat.

Insulin also affects ovulation. When insulin is imbalanced ovulation may or may not occur. It is common to have blood sugar dysregulation, abdominal obesity, and diabetic-like symptoms with PCOS.

Other symptoms like coarse hair growth on the face and hair loss on the scalp are due to an imbalance between male and female hormones. The absence of ovulation may cause a relative increase in male hormones (ovulation = progesterone being produced). Some women may also experience estrogen dominance where due to the absence of ovulation, there is no progesterone being produced and the abundant estrogen causes symptoms of decreased sex drive, boating, hot flashes, and worsening of PMS symptoms. Imbalances of sex hormones produced by the adrenal glands also contribute to PCOS.

Treatment options vary on both the type of PCOS you have as well as the symptoms you are presenting with. Your doctor and/or naturopath will best be able to provide you with an individualized treatment protocol to support your hormonal health. Here are some commonly used options to encourage the rebalancing of hormones

1. Diet

The heavy influence of insulin on PCOS symptoms means that by actively eliminating excess or refined sugars from our diet will promote regular ovulation and menstrual cycles. Limiting the consumption of sugary treats, refined carbs like bread, pastas, cakes/cookies/muffins/bagels and any added sugars in foods (re: sugary drinks like soda and fruit juices, sugars added to sauces and salad dressings) has a profound effect on regulating periods while also improving blood sugar and other markers of diabetes. Increasing fibre in the diet also helps to bind to and remove any excess hormones.

2. Lifestyle

In addition to diet, lifestyle factors like proper sleep, adequate exercise, and stress management also help to maintain a healthy balance of hormones. Stress often makes any underlying condition or disease worse, so plan out time in your daily schedule for relaxation activities. Aim for 7-8 hours of quality, uninterrupted sleep every night.

3. Botanicals, Herbs, Supplements, and Vitamins

Vitex: Also known as chasteberry, helps to promote and support ovulation, improve mood, bloating, PMS symptoms, acne, and cravings. There is some evidence that vitex may not be for every woman with PCOS, especially those with increased LH.

Licorice: Supports stress management and cortisol production, decreases excess androgens in combination with white peony.

White Peony: When combined with licorice has been noted to reduce excess testosterone and improve fertility.

N-acytl-cystine/NAC: Decreases excess androgens and may improve insulin levels

Vitamin D: Promotes anti-inflammatory actions in the body.

Inositol: Improves ovulation and decreases insulin resistance.

*Safety note: Always speak to your trusted health professional before starting a new herb, vitamin, or supplement to make sure that it is the best option for you!

PCOS natural treatment

When to seek out the guidance of a naturopath or MD:

While lifestyle and dietary changes are the first place to start when implementing natural treatments for PCOS, a naturopath/functional medical doctor can better support your unique cluster of PCOS symptoms by first conducting specialized functional lab tests. These may include routine serum blood tests as well as dried urine hormone testing to measure just how your body is responding and using its hormones and metabolites. Prior to starting any treatment protocol, it is generally advisable to work with a professional so that they may monitor your symptoms, labs, and ensure that there are no interactions between herbs and supplements with any other medications you may be taking.

A diagnosis of PCOS or even just irregular, painful, uncomfortable periods doesn’t have to be a life sentence. Are you overwhelmed with a PCOS diagnosis or even just irregular, painful, uncomfortable periods? Book in a free 15-minute consultation with Dr. Anousha, and learn about alternate options today! There are solutions to improving your wellness, and we are here to help!


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01/Aug/2019

What is stress?

Picture yourself as a calm ancient human collecting berries about 50 meters away from your camp. The day is bright and warm and your basket of succulent ripe berries is half full. Ahh, peaceful.

Suddenly you see a FEROCIOUS BEAR coming towards you. You drop your basket, your heart races, breathing quickens, and with a surge of adrenalin you take off at full speed away from the bear.

Now at a safe distance, your heart rate and breathing normalize as you begin to relax from the above-mentioned frightening experience.

This is stress. An evolved response to a perceived threat to keep the body safe. Stress symptoms are biological (change in breathing and heart rate, sweating, an adrenalin surge) as well as psychological (fear, anxiety). Cortisol (the stress hormone) is responsible for the physiological changes we experience during these periods of agitation and threat. Cortisol and adrenaline quicken the heart rate ensuring that there is enough oxygenated blood being pumped to the brain (vital organ – necessary for survival from said bear) as well as the limbs which help you to escape.

Biology of stress – how it works

Stress can be broken down into 3 stages. (General Adaptation Syndrome by Hans Syele, MD).

  1. Alarm (becoming aware of the bear – experiencing the fight or flight response. ).
  2. Resistance (Where the recovery stage begins, your heart rate and breathing normalize, but your mind and body are still on high alert – what if the bear comes back?). In the resistance stage, the body is still releasing low levels of cortisol
  3. Exhaustion – from the chronic levels of cortisol being released, even your stress adrenal glands become exhausted. Some symptoms of the Exhaustion phase include, depression, burn out, fatigue, decreased stress tolerance.
stress symptoms

The brain has a system for responding to an unpleasant stimulus, known as the HPA Axis or, Hypothalamic-Pituitary- Adrenal Axis. The hypothalamus first receives a memo of a stressful trigger, which then causes it to release a chemical message to the pituitary gland. The pituitary responds by releasing another chemical that triggers the adrenal glands (tiny little glands that sit atop the kidneys) to release cortisol. Cortisol then acts on the body to prepare it for a fight or flight response. When the hypothalamus stops receiving any signal of threat, it halts the chemical message to the pituitary leading to downstream effects of decreased cortisol production. After this response the body returns to a state of rest and digest – where digestion is normalized and hormones rebalance. During rest and digest periods the body is able to have restful sleep, metabolize foods, experience a libido and other reproductive processes, and have enough energy stores for day to day living.

Now if the bear was constantly present nearby it’s safe to say that you would be anything but relaxed! Similarly, the presence of chronic stress (a bear or otherwise looming in the background) causes the body to feel on-edge in an unrestful state.

What are symptoms of stress that has become chronic?

  • Low energy
  • Fatigue
  • Difficulty sleeping, insomnia
  • Changes in digestion: constipation, diarrhea, bloating and gas
  • Decreased libido
  • Unintentional weight gain or loss
  • Changes in dietary habits, cravings for sugar
  • Decreased immune system, falling sick often
  • Difficulty concentrating, brain fog
  • Changes in mood, irritability, anxiety, depression
  • Hormonal changes in women such as changes in period length or flow

Sources of stress symptoms:

  • Career and jobs
  • Home life
  • Finances
  • Relationships
  • Our own health, and the health of loved ones

The true dangers lie in the long-term poor management of stress symptoms and experiences of triggering events. Chronically elevated cortisol eventually leads to exhaustion and burn out.

Recognizing and identifying the root causes of stress is integral to learning effective coping strategies for life long wellness.

How to relieve stress:

  1. Quick check-in: how do you feel right now in your body? Is your breathing deep and full or short and shallow? Do you notice any stiffness in your muscles or joints?
  2. Breathing: when there is abundant oxygen going to the brain, your body is reminded that it is notin danger. Deep, slow belly-breaths helps put the body back into rest and digest mode. Try this! Sweet 16 breathing: inhale through your nose for 4 seconds, pause for 4 seconds, exhale slowly through pursed lips for 4 seconds, pause for 4 seconds. Repeat.
  3. Spending time in nature: Unplug once a day and spend time going for walks in a nearby park.
  4. Exercise: health guidelines recommend about 30 min of moderate physical activity daily. Movement is a great way to let off steam!
  5. Seeking out support: reach out to loved ones, a compassionate friend, or a professional who can provide you with the tools to cope and decrease stress symptoms
  6. Limiting junk foods: sugar cravings are a common stress symptom and too much sugar treats can lead to downstream ill health effects. Avoid reliance on coffee, alcohol, and nicotine.
  7. Hobbies you enjoy: create and nurture areas of joy in your life daily!
  8. Boundaries: create space between yourself and the stressful trigger by taking breaks throughout your day, learning when to say no, and prioritizing your self-care routine
  9. Give thanks: an attitude of gratitude helps retrain the mind to focus on positive experiences and outcomes during your day. Positive affirmations help the brain to relieve stress and keep the mind form spiraling into stressful negative thought patterns.

Bonus!

Identify which habits work best for you. Keep a stress symptom journal to pinpoint:

  1. Source of stress
  2. How you reacted
  3. How it felt
  4. What you did to feel better

Monitor these over time as you test out the 9 different techniques to relieve stress.


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Hormones and other factors that impact libido 

Girl. Female. Low libido, hormone imbalance, decreased sex drive. Naturopathic medicine helps to naturally support hormones in order to regain sex driveFemale Sexual Dysfunction affects an overwhelming number of women globally. Some studies estimate about 41% of premenopausal women experience some form of sexual dysfunction (1).

Female Sexual Dysfunction or FSD is defined as persistent or chronic problems with sexual activity including arousal, orgasm, or pain experienced by women. The causes are multifactorial and include chronic stress, side effects of medications including antidepressants or birth control, hormonal imbalances and (natural decreases in estrogen) menopause, and other health conditions such as depression, diabetes, hypothyroidism. How unsexy – but it doesn’t have to be!

This article will focus on some of the common causes of low libido in women, hormone testing for women, and naturopathic approaches to improving sexual desire.

 

What is arousal?

A physiological state where there are changes in muscular tension, organ size, heart rate, breathing, that create conditions for copulation. Aspects of arousal are defined by physiological responses such as increases in blood pressure and rate of breathing and a decrease in the activity of the digestive system. While primary arousal is mainly governed by the sympathetic nervous system (aka fight-or-flight nervous system), responses of the parasympathetic nervous system (aka rest-and-digest nervous system) also contribute to the patterns of arousal. Physiologically, arousal patterns are not limited to sexual activity and sympathetic (fight-or-flight) reactions are also present in periods of stress and danger.

How sexual arousal works:

There are 4 stages of arousal: Desire, Arousal, Orgasm, and Resolution.

  1. Desire: General physiological characteristics of the first phase include increased muscular tension, a quickening heart rate and accelerated pattern of breathing. The skin may become flushed and the nipples are erect. Genital blood flow increases and vaginal lubrication begins. Women may also experience swelling of the breasts and vaginal walls, as well as hardening of the nipples.
  2. Arousal: Characteristics of this phase are similar and more intense than the previous stage. Muscle spasms may begin as well as an increase in sensitivity to the erogenous zones.
  3. Orgasm: This phase lasts anywhere between 1-50 seconds in women and consists of involuntary vaginal muscular contractions, and sudden release of tension. A flush may appear over the body.
  4. Resolution: The final phase of arousal where the body slowly returns to its normal level of functioning and swelling of the breasts and vaginal walls reduce to pre-arousal size and colour.

Stress and libido:

In the literature, chronic psychosocial stress is defined as either a “major life event that induces an extended period of stress such as a death in the family” (2) or “the accumulation of small stressors that are frequently present, such as on-going deadlines, traffic, financial troubles” (2).

Steroid Hormone Pathway – Increased production of cortisol leads in a decreased production of sex hormones

Researchers noted that it was these smaller stressors, “daily hassles,” that had a profound negative effect on health as compared to a severely traumatic or stressful life incident. Daily hassles like being in traffic or deadlines that never seem to reach completion are related to sexual difficulties amongst individuals. A survey found that women with higher levels of chronic daily stress experienced increased amounts of sexual dysfunction and lower levels of sexual satisfaction; this was represented in a study measuring levels of genital arousal in women who experienced chronic stress (2). In the same population, women who experienced daily stressors had higher levels of salivary cortisol (the stress hormone). Sex drive in females is affected negatively by the presence of daily chronic stressors.

 

Medication and libido:

Nearly 60% of individuals globally reported sexual dysfunction as a side effect of antidepressant use (3). SSRI’s (a commonly prescribed class of antidepressant) have been linked to significantly decreased libido, arousal, duration and intensity of orgasm (3)

On the other hand, the use of oral contraceptives has mixed side effects, where many experience a decrease in libido. There are some women who do experience an increase in sexual desire (4)

Other conditions and libido:

Sexual dysfunction also presents in a variety of conditions such as diabetes, heart disease, alcoholism, hormonal imbalances, thyroid disease, and as a symptom of depression; approximately 50% of women reported decreased sexual interest prior to treatment of depression (5).

The Naturopathic Approach

A naturopath will first conduct a thorough history and case taking in order to identify some lead causes that may be impacting a woman’s sex drive. Further investigation into hormone levels via blood, saliva, and urinary testing may be ordered when evaluating the root cause of sexual dysfunction. For instance, monitoring changes and imbalance in sex hormones (estradiol, testosterone, DHEA) and stress hormone (cortisol) illustrates that in the presence of chronically elevated cortisol, the sex hormones that are generally elevated during sexual stimulation/desire are lessened.

A naturopathic doctor will investigate all potential causes for low libido (hormonal, stress-related, side effect of a medication), and work with you to create an individualized treatment plan to gently stimulate your body’s natural arousal mechanisms.

Decreased or absent sex drives are frustrating and generally a symptom of a deeper problem.

Though every case is unique, it is important to note that there are no quick fixes and as with any health goal, lasting changes develop over time.

What can you do today to improve factors that negatively impact your libido?

  1. Start with stress! Kick your libido out of neutral and into drive! Practice a beginner’s breathing exercise. Our absolute favourite technique is 7-4-8 breathing. Start by sitting or lying comfortably without distraction and with your eyes closed. Inhale for 7 seconds through your nose. Pause for 4 seconds. Exhale through pursed lips for 8 seconds. Repeat.
  2. Create boundaries between yourself and daily stressors by not bringing them into the bedroom. This means, no work, no screens, no fighting – the bedroom is for sleep and sex only!
  3. Opt for whole foods that support the libido like maca, and limit heavily processed foods and sugars. Fun fact: Maca root consumption in postmenopausal women with sexual dysfunction caused by SSRI antidepressants, ALLEVIATED symptoms!
  4. Have a conversation with your naturopath, doctor, or pharmacist if you feel that your medications might be impacting your sex drive.

Interested in learning more?

Book in with our naturopath, Dr. Anousha Usman ND, at The Wellness Suite to rediscover your sexual wellness!

 

 

  1. Mccool, M. E., Zuelke, A., Theurich, M. A., Knuettel, H., Ricci, C., & Apfelbacher, C. (2016). Prevalence of Female Sexual Dysfunction Among Premenopausal Women: A Systematic Review and Meta-Analysis of Observational Studies. Sexual Medicine Reviews,4(3), 197-212.doi:10.1016/j.sxmr.2016.03.002
  2. Hamilton, L. D., & Meston, C. M. (2013). Chronic Stress and Sexual Function in Women. The Journal of Sexual Medicine,10(10), 2443-2454.doi:10.1111/jsm.12249
  3. Higgins, A. (2010). Antidepressant-associated sexual dysfunction: Impact, effects, and treatment. Drug, Healthcare and Patient Safety,doi:10.2147/dhps.s7634
  4. Higgins, J. A., & Smith, N. K. (2016). The Sexual Acceptability of Contraception: Reviewing the Literature and Building a New Concept. The Journal of Sex Research,53(4-5), 417-456.doi:10.1080/00224499.2015.1134425
  5. Kennedy, S. H., Eisfeld, B. S., Dickens, S. E., Bacchiochi, J. R., & Bagby, R. M. (2000). Antidepressant-Induced Sexual Dysfunction During Treatment With Moclobemide, Paroxetine, Sertraline, and Venlafaxine. The Journal of Clinical Psychiatry,61(4), 276-281.doi:10.4088/jcp.v61n0406

 


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