Women's Bodies, Women's Wisdom (37 page)

Women with DUB who are in their forties and older are statistically at greater risk for endometrial hyperplasia, and most physicians will do an endometrial biopsy before they initiate hormonal treatment. Progestin hormone (synthetic progesterone such as Provera or A ygestin) is often the treatment of choice, both to clear up the hyperplasia if it is present and to stop the abnormal bleeding. I recommend natural progesterone for the same purpose (Crinone or Prochieve vaginal gel or Prometrium capsules). Over-the-counter 2 percent progesterone creams (one-quarter to one-half teaspoon applied to the skin daily) have also been shown to achieve adequate serum levels and help protect the endometrium.
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If a woman is skipping periods and wants to get pregnant, the fertility drug Clomid, which tricks the brain and ovaries into ovulation, will often be prescribed.
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DUB and Polycystic Ovary Syndrome (PCOS)

A subgroup of women with DUB don’t ovu late regularly. Many of these women are overweight, with body fat that produces too much estrogen. The estrogen overstimulates the uterine lining and can result in anovulation. These women sometimes have a condition known as poly cystic ovary syndrome, in which their ovaries develop a thickened outer wall, just under which many unreleased, partially stimulated eggs form cysts. On ultrasound examinations, the ovaries show up as being enlarged and having multiple small cysts in them. (Interestingly, medical intuitives report exactly the same appearance when they do readings on these women.) Studies have shown that the risk of menstrual irregularities is two to three times greater in obese women than in women of average body size.
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Dietary change to decrease excess body fat and stabilize blood sugar and insulin levels can help create hormonal balance as well as lower estrogen levels. These women also have elevated androgen levels, which contribute to their problems. Androgens are a group of hormones that include testosterone and are produced in the ovaries, the adrenal glands, and body fat. Not all women with PCOS are overweight, however.

As with PMS and menstrual cramps, unabated stress, a diet high in refined foods and low in nutrients that raises blood sugar and insulin, and a lack of exposure to natural light can
all
result in DUB. Many women with DUB and/or PCOS have been helped by lifestyle and dietary changes alone. Some make these changes in addition to hormonal treatment.

Alisa Vitti is a colleague of mine who is a certified holistic health counselor specializing in nutrigenomics (the study of using food to manipulate biochemistry). When she was a premed student at Johns Hopkins, she experienced a number of problems (overweight, anovulation, depression, and menstrual irregularity since menarche at age fourteen) that drove her to investigate her condition by combing through the ob-gyn literature. Suspecting that she had PCOS, she insisted that her gynecologist order an ultrasound, which confirmed the diagnosis. But then she discovered that conventional medicine has very little to offer women with menstrual cycle problems other than drugs and surgery. Inspired by the first edition of this book back in 1994, Alisa set out not only to heal herself naturally but also to help other young women to find and implement natural solutions to their hormonal problems, which led to a change in her career path. Here’s her story:

After my PCOS diagnosis, although I had repeatedly resisted going on the pill, I finally relented because my doctors could give me no other options. They believed that artificially regulating my hormone levels might be the key to alleviating my symptoms. But within two weeks, my worst fears proved true. I began suffering from ocular migraines, fluctuating body temperature, and heart arrhythmia. That’s when I finally realized that I not only had to go off the pill but also had to empower my own healing process. So I started looking at many different avenues— including those outside of Western medicine. Becoming an apprentice to a number of alternative health care practitioners, I studied and experimented with herbology, naturopathy, homeopathy, and acupressure, as well as various supplements and restriction diets—trying them all out to see if they’d work on me.

I discovered that these approaches were unable to correct the deeper imbalances in my body that were contributing to my condition. I turned to the one thing that I (along with my doctors) hadn’t really explored— food. I began experimenting, and eventually I found that with the right combination of certain foods, I was able to drop sixty pounds from my two hundred–pound frame. In addition, I cleared up my acne and healed my depression. As a result, I’ve had regular menstrual periods for the last decade.

In the process, I shifted gears, changing my career plans to study integrative medicine and nutrition and become a certified holistic health counselor. Based on my research and studies, I designed a specific five-step healing protocol. I realized early on that because the underlying causes of hormonal imbalances are very similar, my protocol was effective for many gynecological conditions that doctors couldn’t easily treat. Although my healing journey had been focused on PCOS, I felt passionate about wanting to help women with these other issues as well. So in 2001, I founded Laughing Sage Wellness (now known as FLO Living) in New York City, focusing my practice exclusively on women in their twenties and thirties who have chronic hormonal imbalances.

Fast-forward to today: I have now worked with many hundreds of women in the United States and on four continents to help them heal naturally from PCOS, PMS, fibroids, cystic ovaries, thyroid issues, adrenal fatigue, irritable bowel syndrome, amenorrhea, dysmenorrhea, and HPV. I also help women preserve and enhance their fertility and libido. In addition, I hire and train other health counselors to deliver this protocol, and I educate ten thousand readers weekly through the FLO Living newsletter. My goal is to provide women all over the United States with a platform for education, support, and healing.

FLO Living (
www.floliving.com
) offers in-person, over-the-phone, and online programs to help women heal their period problems and hormonal issues naturally without drugs or surgery. Because of the success of the program, this approach is being rigorously studied, measuring before-and-after hormone levels, by a research physician from Columbia University Medical Center. Researchers expect to release preliminary results by the spring of 2010.

Women’s Stories

Deborah: Breaking Family Ties

Deborah was seventeen when she left her family to go to college. She described her family as “lower middle-class and not oriented to a college education.” In fact, Deborah was the first person from her family ever to leave home for any reason except to marry. Her family was not supportive of her living away from home, and they wanted her to visit every weekend.

During her first year in college, Deborah met many people who were interesting and exciting to her, and a whole new world of intellectual challenge and career possibilities began opening up for her. She was happier and felt more fulfilled than at any other time in her life. Unfortunately, her mother, fearing that she would lose Deborah, began to call her on the phone every evening, telling her that she was a failure and that she would never succeed at anything if she stayed in college. She threatened to call the dean of the college and have Deborah’s scholarships rescinded so that she would have no choice but to come home.

Deborah became depressed, and her periods became irregular for the first time since menarche. They came two or three times per month, or not at all for two or three months at a time. To feel better about herself, she began to run as a form of exercise. At first, this made her feel physically stronger, more independent, and more in control of her body—which seemed to be out of control for the first time in her life. But the exercise didn’t help her irregular periods. In fact, it contributed to long periods of amenorrhea (no periods at all). She saw a gynecologist, who told her that her pelvic exam was completely normal. The reason for her problem, he said, was that she was “fooling around with too many guys.” Since she was not involved with any men at this time, she was not helped by this physician and avoided gy necologists for the next eleven years.

Deborah did, however, consult with an acupuncturist, who pre scribed Chinese herbs for her in addition to acupuncture. These treatments helped regulate her periods within two months, but she discovered that her periods went right back to their abnormal pattern as soon as she stopped her acupuncture and herb treatments, and she found that she had to deal with the source of her depression, which returned when she had to stop running because of an injury. She came to see that her relationship with her mother was the source of her problems, and she eventually moved out of state to break her mother’s control over her life.

When I first saw Deborah, she was recovering from an addiction to exercise. She had begun psy chotherapy and was exploring her relationship to her mother. I recommended a mindfulness workshop to help Deborah learn how to be present with the sensations in her body without getting caught up in her mental story. I also recommended a whole-food diet, natural progesterone creams, and a calcium-magnesium supplement. Over the next six months, her periods became regular, every twenty-eight to twenty-nine days, and she was no longer depressed. She fin ished college and completed her Ph.D. She has broken the original family ties that were at the root of her problem, and her life is becoming balanced on all levels.

Donna: Dysfunctional Family and Dysfunctional Bleeding

Donna, a forty-two-year-old professor, came into my office with a six-month his tory of irregular periods—bleeding for two weeks, then nothing for six weeks, then a few days of spotting, and so on. She also had bouts of severe anxiety and depression that lasted for three weeks straight, at just about the time the irregularity started. An endometrial biopsy revealed cystic and adenomatous hyperplasia, an abnormality associated with anovulation (failure to ovulate).

Donna’s mother had also gone through abnormal periods and mood swings in her forties but had decided that it was all her hormones, and she was just going to have to live with it. Donna was quite sure that her mother had unresolved issues with her own father, since Donna remembers her grandfather as someone who was very scary to be around when she was a child.

Donna told me that she’d been having some dreams about and memories of sexual abuse by her uncles. “I’ve been terrified that if I tell anyone what happened or what I think happened, God will get me,” she told me. “Can I force myself to deal with this stuff any faster?” Like many women, she was under the impression that merely having the facts—who, what, where, and when—would help her deal with her dis comfort and get on with her life once and for all. But getting the facts satisfies only the intellect—which always wants more facts. The intellect is the part of us that keeps telling the same story over and over again—thus re-creating the biology of conflict. Healing happens in the body, not the intellect. We have to let healing work its way through us—gently, gradually, and respectfully.

Donna’s upbringing had led her to claim, “Everything in life is my fault. I keep thinking that I must be crazy and must be making this stuff up.” I reassured her that in this culture women have been labeled crazy for centuries for telling the truth and that what she was going through was quite normal, given her history. She decided to do some work with an incest survivors’ group to help her break through her own and her family’s denial. After several months of work, she had another endometrial biopsy—to check for abnormal cells—and it was perfectly normal, as were her pituitary hormones. Her periods had gradually become more regular.

Dealing with her emotional trauma was what actually cured Donna’s period problems. Her periods, through their irregularity, had communicated to her a bodily wisdom. Her menstrual blood turned her attention to the healing that was required in her relationship with her family, her bloodline.

Darlene: Irregular Periods Since Menarche

I first saw Darlene, a teacher, as a patient when she was thirty years old. She was married, had no children, and had a very long history of dysfunctional uterine bleeding since puberty. She experienced long stretches of time with no periods, followed by bleeding almost continuously for a month at a time, then spotting infrequently. Darlene had ongoing anxiety issues and had panic attacks if she had to leave the house for a long period of time. Her marriage was a source of unhappiness to her rather than comfort. She was generally anxious, had trouble sleeping, and had frequent headaches.

Darlene’s upbringing had been stressful. Her father and at least one grandfather were alcoholics—although, she said, there was a lot of family denial around this. Her mother, her maternal grandmother, and her cousin had had lifelong problems with irregular bleeding that led to hysterectomies. Her aunt and another cousin had uterine cancer and also had hysterectomies.

Darlene originally came to my office for a fertility workup. Because of her bleeding pattern, we did an endometrial biopsy, which showed endometrial hyperplasia. For treatment of this condition, she was placed on large doses of synthetic progestin. In contrast to most women on this therapy, however, her bleeding didn’t stop. A repeat biopsy after the progestin treatment again showed the abnormality of cystic and adenomatous hyperplasia. The next step would be a surgical dilation and curettage (D&C) to be certain that she didn’t have uterine cancer.

But Darlene was terrified of the procedure and begged me for an alternative. Because of her strong reaction, I compromised and recommended a low-glycemic-index diet to stabilize blood sugar plus castor oil packs on her lower abdomen three or four times a week to help restore her immune system. I knew this would give her a chance to reflect at least three times per week on her condition and any messages it might hold for her. We agreed that if this didn’t change her cells, we would go ahead with the D&C.