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Can the birth control pill fix my period?

October 29, 2018
birth control fix period, naturopathic doctor toronto, toronto naturopath

Short answer: No. 

You can’t fix your period with birth control because birth control doesn’t ‘improve’ your hormones. The birth control pill actually shuts off your period. 

How does the pill work?

The pill stops your natural menstrual cycle. More specifically, it prevents follicle stimulating hormone (FSH) and lutenizing hormone (LH) from being produced. This prevents follicles from maturing and releasing estrogen, and it prevents ovulation from happening, which produces progesterone. Because LH is not being produced, this causes cervical mucus to thicken affecting sperm movement and endometrial development (this is the lining that’s shed during your period). 

The birth control pill does have its own hormones: estrogen and progestin. These are not the same hormones that our body produces, but mimic them. 

If you are using a 28-day packet, 21 pills will contain the synthetic hormones and 7 will be placebo. When you take placebos, your body will experience a withdrawal bleed (often mistaken as a period). 

6 ways that these hormones are different

1. They enter your body differently

The hormones from the pill enter your bloodstream through your GI tract and portal vein (an important vein in your liver). Your ovarian hormones enter your circulation through veins in the ovary and the inferior vena cava. 

2. They have different concentrations

When you take the pill everyday, the hormones enter your body in a single, large dose. Your body’s hormones are always being produced based on where you’re at in your cycle. 

3. They have constant levels

Once you take the pill, those hormone levels don’t change. Your body’s hormones levels may change based on what’s going on with your hypothalamic-pituitary-gonadal axis. 

4. They stay in your body longer

Because the pill’s hormones are synthetic, they are designed to be more resistant to metabolism (aka. they don’t break down as easily). Therefore, they stay active in the body longer than your body’s natural hormones. It’s been thought that they can remain inside your body for at least 6 months after discontinuation. 

5. Progestin is not progesterone

Progestin is similar to progesterone, but they’re not the same molecule. Some progestins like levonorgestrel may cause hair loss because they are testosterone-like (and have a high androgen index). Progestins may also cause acne, as they suppress sebum production. 

Some progestins may have a low androgen index, and while may not cause hair loss while on the pill, they may cause hair loss after the pill is stopped because the body’s androgen levels increase. 

6. They have different actions

The hormones from the pill have a different action on hormonal receptors inside the body, compared to our hormones. This is because the structure, type, and concentration of pill hormones are different than your actual hormones. 

Then why use the pill?

The pill is the first line treatment option for many common conditions like PMS, PCOS and endometriosis. And it’s often given with the reasoning that it will regulate your period and stop the problem. But when you stop taking the pill, your problems will likely come back. 

There are times when the pill should be considered. For example, women taking accutane (which is a category X drug) should not be conceiving while on the drug. Or for women who have endometriosis, taking the pill may make the biggest difference for their pain and quality of life. 

How do I fix my period?

Ultimately, it’s important that you understand your symptoms so you can support your body. Especially if you’re using the pill to ‘fix’ the problems. You may want to figure out why these symptoms are happening, and see which dietary and lifestyle changes you can implement to support your longterm health. 

How do I start?

  • Review my articles about PMS, PCOS, and endometriosis

  • Track your symptoms, diet and your period

  • Get some blood work done (if applicable)

  • Find a Naturopathic Doctor to work with (feel free to contact me to find someone in your area)

  • Implement key dietary and lifestyle changes

  • Give your body time to adjust to your treatment plan

When I work with period problems, I figure out why they’re happening. I use information that you give me (diet/symptom/period trackers, blood work, your personal story) to determine the root cause and create a plan from that info. 

It’s not always a quick fix, but change takes time!

If you found this information helpful, check out my handy chart of the nutritional deficiencies caused by the pill!

References

Sims, S. and Heather, A. (2018). Myths and Methodologies: Reducing scientific design ambiguity in studies comparing sexes and/or menstrual cycle phases. Experimental Physiology, 103(10), pp.1309-1317.

Why do my boobs hurt during my period?

November 5, 2018
cyclic breast pain, toronto naturopath, naturopathic doctor toronto

Do you experience tender breasts a few days before your period? But then it’s gone once your period starts?

You’re not alone. Almost 35% of women experience swollen and tender breasts (aka. cyclic breast pain) before their period.

So why is this happening to you?

You might not be producing enough progesterone in the luteal phase. Remember, if you’re not ovulating, progesterone isn’t being made by the corpus luteum (tip: go back and read my ovulation article). When progesterone is ‘low,’ estrogen becomes the dominant hormone in the body. 

Or, you may have enough progesterone, but your breast tissues might be sensitive to estrogen. 

Estrogen dominance

Why is this happening?

  • Excess body fat, because fat makes estrogen

  • Stress 

  • Constipation

  • Not eating enough fibre

  • Liver isn’t detoxing well

  • Exogenous estrogens

  • Nutritional deficiencies

And because you’re probably thinking about the scary ‘C’ word, cyclic breast pain, does not usually happen because of cancer.

Supporting Breast Health

You can start supporting your breasts right now. Cyclic breast pain can be a thing of the past if you start including the following strategies:

Stop introducing estrogen into your body

The only estrogen that belongs in your body is your own. That means no estrogen from plastics, from food chemicals or anything else. 

If you’re putting your leftovers into plastic containers, swap them for glass. Same with your water bottles, choose glass or stainless steel instead. Get familiar with the Dirty Dozen. If you’re buying any products off that list, choose organic instead. If you wear lipstick everyday, choose a version that is green (not the colour, but all the power to you if you can rock a green lip). 

dirty dozen

Help your liver

Once you stop introducing unwanted ‘outside’ estrogen into your body, you gotta deal with the estrogen that’s already there (the estrogen that your body makes and the ones coming from plastic and all that junk). 

Let’s get something straight though, your body needs estrogen. But, when there’s too much circulating around, it’s not helping, it’s hurting. 

Your liver is your body’s most important detoxification organ. And it’s the organ that specifically gets ‘used’ estrogen out of your body. It’s always detoxing.

Think about a cashier at the grocery store on Saturday morning. You have 5 minutes to get out of the store. if you put down 10 items onto the belt, she can scan the items quickly and send you on your merry way. But what if you put 75 items on the belt and wanted to price match each one? It’s probably going to take her longer than 5 minutes. Now what if she didn’t know all the codes to your fruits and vegetables, and had to call out for every code? You’re not leaving in 5 minutes, that’s for sure. 

When your liver has a lot of toxins to get out, it’s harder for it to do its job. And, to be frank, if you don’t have the vitamins, minerals and amino acids that it needs to work effectively, then that’s going to affect it too.

Here’s where you can start:

  • Don’t introduce outside estrogens into your body (unless they’re phytoestrogens)

  • Introduce a B supplement for phase 1 support, and eat protein and your brassica vegetables for phase 2 support

  • Drink a turmeric latte, it’s better than the fake orange pumpkin spice

  • You can also take herbs that are specific for your liver. I like dandelion and milk thistle, but you’ll want to work with your ND for this part here.  

Make sure you poop

When your liver finally detoxifies that estrogen, it doesn’t magically disappear from your body, the products are sent to your large intestine (imagine estrogen with a little tag attached). Everything is going to hang out there until you have a bowel movement. Here’s the thing, if it’s there for too long, bacteria in your large intestine will snip that tag, letting the estrogen circulate back into your body. So all that work your liver did to detoxify it? Yes, it was for nothing. 

So we want to make sure that you:

  • Are having a bowel movement 1-2 times per day

  • Healthy balance of good bacteria 

You might have to:

  • Eat enough fibre – whether it be a combination of fruits and vegetables, and ground flax seeds (these really help with estrogen elimination)

  • Take a probiotic and/or eat more fermented foods like kimchi, kombucha, etc. 

  • Take a magnesium supplement because it promotes bowel movements (talk to your ND about best form and dose)

Other quick tips

  • Drink water instead of coffee or other caffeine-rich drinks (soda, energy drinks, etc.)

  • Cut out alcohol for the time being

  • Skip sugar because it’s inflammatory, and you don’t need any more inflammation in your body right now

  • Consider how much red meat and dairy you’re eating, these contain outside estrogens and hormones that might not be doing your body any good

When to call a Naturopathic Doctor

You don’t need to live with tender breasts for a week every month. 

Use some of the tips I listed above to start you off. And if you need some extra support, give me a call (or for you millenials,  book an appointment online). I can help make sure your hormones are working for you, and not against you. I can also help you figure out the supplements that your body needs. (So you don’t leave a health food store with a bag of everything). And, if you like or are curious about acupuncture, we can do some of that too!

If you found this information helpful, please sign up for my monthly newsletter called The Flow for great and informative content like this!

Types of PCOS

September 10, 2018
types of PCOS, toronto naturopath, naturopathic doctor toronto

The previous post about PCOS was about the criteria involved in diagnosing someone with PCOS. Many clinicians follow the Rotterdam criteria, which require 2 out of 3 criteria to be met in order to be diagnosed with PCOS. 

They are: 
  1. Delayed ovulation or menstrual cycles (anovulation)

  2. High androgenic hormones like testosterone

  3. Polycystic ovaries on ultrasound

Because you need to meet 2 criteria, your PCOS presentation may be slightly different than someone else’s. This brings us to the four types of PCOS.

The 4 PCOS types

Type A

Classified by:

  • Hyperandrogenic

  • Anovulation

  • Polycystic ovaries

Known as the classic type of PCOS. Signs and symptoms include: high BMI, increased weight circumference, highest androgens values, increased LH/FSH, AMH, low progesterone, and menstrual irregularity. Insulin resistance is also a factor – leading to an increased risk of diabetes and heart disease. 

Type B

Classified by:

  • Hyperandrogenic

  • Anovulation

Another classic form of PCOS. Signs and symptoms include: increased BMI, weight around the waistline, menstrual irregularity, signs of high androgens (ie. hirsutism, acne, and hair loss). Insulin resistance is also a factor in this type. In addition, this type may include older women. 

Type C

Classified by:

  • Hyperandrogenic

  • Polycystic ovaries

Signs and symptoms include: Medium BMI score, weight around the waistline, high androgens (ie. testosterone), polycystic ovaries, and while periods may be regular – ovulation may not be occurring (therefore, be sure to get your progesterone checked around day 21)! 

Type D

Classified by:

  • Anovulation

  • Polycystic ovaries

Considered the ‘lean’ PCOS. Signs and symptoms include: menstrual irregularities, polycystic ovaries, androgen levels are optimal – no physical signs of androgen excess, normal BMI, normal waist circumference, may be signs of insulin resistance. 

Rule these conditions out

Before you jump aboard the PCOS train, you want to rule out certain conditions first, as they may be the cause of some of your symptoms:

  • High prolactin (found on blood work)

  • Hypothalamic amenorrhea

  • Hypothyroidism – this can occur with PCOS

  • Non-classical congenital adrenal hyperplasia

A note about insulin resistance

As you might have noticed, insulin resistance is predominant in many of the types of PCOS. So how do you measure for it?

  • Fasting insulin

  • Fasting glucose

  • Oral glucose tolerance test

You can use these first two values (which you can get assessed through blood work) to calculate your HOMA-IR score. Ideally your score should be less than 1.5. 

Too much insulin can lead to excess androgens being formed (in various ways) and it may also impair ovulation. 

Final Thoughts

If you’re thinking that you have some of these signs and/or symptoms, and have yet to get any of your blood work done – do it! Because there are different types of PCOS, you want to get solid evidence of which type you may be. This will ultimately help determine the best type of treatment for you!

Find out your PCOS type with this blood work:

  • Total testosterone

  • Free testosterone

  • DHEA

  • Androstenedione

  • DHT

  • Fasting insulin

  • Fasting glucose

  • TSH

  • Free T4

  • Free T3

Don’t forget that Naturopathic Doctors can also requisition blood work! Speak to your ND to determine if that’s the best option for you. 

Now that you have a solid plan, please sign up for my monthly newsletter called The Flow for more informative and useful content like this! I want to make sure that you have a good flow!