By Christiane Northrup, M.D.

“Deliberately pursue Pleasure”

Listen Closely. I want to let you in on a big and very well kept health secret. Ready? Here it is. The active and deliberate pursuit of pleasure—and the ability to receive it—are essential ingredients in creating and maintaining optimal health. Please read that again. And take a moment to remember the last time you really soaked in something pleasurable.

I know, I know. You think you’re too busy to experience pleasure. Or maybe the thought of pursuing pleasure as an important goal makes you feel guilty. (The term guilty pleasure comes to mind immediately, right?) Here’s the deal: Most of us were brought up to believe the “no pain, no gain” theory of health. Me, too. It’s ingrained in our culture. Last year I went to a Blue Angels air show at the Brunswick Naval Air Station. A Marine walked by me with the following message emblazoned on his T-shirt: “Pain is weakness leaving the body.” The subtext of this sentiment is that anything pleasurable is suspect and probably won’t get you anywhere. The “no pain, no gain” approach has its place. We are all capable of far more than we think we are. And there’s nothing like a crisis to bring out the best in human nature. We all remember the teacher who refused to accept less than our best and therefore helped bring it out of us.

“Maintain a balance”

But there has to be a balance. Too much “no pain, no gain” without the much-needed presence of pleasure is a setup for disease and addiction—pure and simple. Here’s why: We are pleasure-seeking creatures by Divine design. Just watch a bunch of little kids playing and you’ll see the truth of this. Our organs work better when we’re happily pursuing pleasurable activities—or thinking pleasurable thoughts. Pleasure is not only associated with better blood flow throughout the body, it’s also associated with higher levels of the neurotransmitter beta-endorphin—a naturally occurring morphine-like substance that dulls pain and induces a feeling of euphoria. Prolactin is another neurotransmitter that is also associated with pleasure. Like beta-endorphin, this natural substance is enhanced during pleasurable social interactions, while breastfeeding, and also during lovemaking.

“Include regular doses of pleasure in your day-to-day life”

When we follow a stressful lifestyle that’s devoid of regular pleasure, blood flow gets restricted throughout the brain and body—and our beta-endorphin and other neurotransmitter levels plummet. We’re left feeling depressed, sad, angry, or irritable as a result. So what do we do to get those levels back up fast? We reach for the quick fix of sugar, alcohol, coffee, cigarettes, or drugs. (And we justify this behavior by telling ourselves we “deserve” that hot fudge sundae because we’ve worked so hard.) Imbibing the sugar, or alcohol, or nicotine does make us feel better for a short time by balancing our brain chemistry. The problem is that over time, the body requires more and more of these substances to give us the same “high.” And that’s how addiction and disease begins. The bottom line is this: You cannot create the healthy sustainable beta-endorphin and blood flow levels that are associated with optimal health solely by taking mood-altering substances. The only way to achieve a feeling of optimal well-being within your body is by including regular doses of pleasure in your day-to-day life!

Here’s my step-by-step program to enhance your health through pleasure:

Step One: Make a commitment to your pleasure

Understand that all sustainable pleasure requires discipline, courage, and practice. Why? Because we live in a pleasure-starved culture that worships pain and suffering. Some people even believe that suffering is holy. And nearly every one of us has been led to believe that suffering and martyrdom actually buys us something—that somehow it makes us better people. No one leaves our planet without some pain and suffering. That’s for sure. But making pain and suffering a way of life—and being proud of it—does nothing but cause more pain and suffering. This has been called indulging in “negative pleasure.” Here’s an example: Have you ever worked in a job where everyone brags about how much work they have to do or how busy they are? Have you ever found yourself trying to “up” the ante of suffering by saying something like “You think you’ve got it bad? Listen to what happened to me. Last week my car broke down, I had to walk to work, and I still put in 12 hours?” If you want more happiness and enjoyment in your life, you have to catch yourself indulging in “negative pleasure” and stop.

Step Two: Name your bliss and follow it

To know sustainable pleasure, you must know what you desire—what lights you up! And you must also learn to trust those desires. I believe that our souls speak to us through our desires, and that we discover our unique gifts and talents only by allowing ourselves to follow our bliss. After all, desire is what created our bodies in the first place. We were conceived with an orgasm—the entire universe started with a big bang.
Articulating your specific desires and then manifesting them uplifts the entire planet. Get as specific as possible. Make a list. Do you like sexy, red underwear? Then go get some. And wear it regularly. Do you like to begin your morning quietly with a cup of coffee and a little inspirational reading? Then get up five minutes earlier to indulge in this pleasure. Do you love massage? Make sure you get a massage at least once a month. And if you can’t afford it, exchange a back rub or foot rub with your spouse or a good friend on a regular basis. To add more pleasure to your life, write down a list of your desires. Have fun thinking about everything you like.

In his wonderful book The Power of Pleasure (Hay House, 2007), Dr. Douglas Weiss points out that everyone has a unique pleasure blueprint—a specific way in which they experience pleasure. For some, pleasure comes through thrill seeking. They adore fast cars and extreme sports. Life just isn’t fun without indulging this pleasure zone regularly. For others, gardening and digging in dirt is a primary pleasure zone. Others experience pleasure through service.

One of my primary pleasure zones is taking a hot bath each evening. Whenever I travel, I insist on staying in a place that has a tub. I also love going to movies in theaters where I can get lost in the experience (and I’m not distracted by the phone or the lure of “multi-tasking,” which happens when I watch movies at home).

Step Three: Schedule pleasure into your life with the same regularity as you would brushing your teeth

Married couples who hire a babysitter and have regular “dates” each week, for example, find far more joy and pleasure in their relationship than couples who don’t take the time to enjoy the pleasure of each other’s company.

Step Four: Pleasure begins with your thoughts. Pay attention to them

Change the ones that aren’t pleasurable the minute you notice them. (Remember, this is a discipline that takes practice.) Here’s why this is so important. Thought plus emotion equals belief. Your beliefs are what create your reality and your state of health. Beliefs, which are felt primarily in the heart, transmute the invisible realm of spirit into the particles that make up matter.

Every thought you think creates a specific biochemical reaction in your body and also attracts specific events into your life. And guess what? When human DNA (that’s been isolated) is in the presence of positive emotions it begins to relax and unwind. Then it begins to create another molecule that is, itself, conceived in pleasure, appreciation, and love.

Try out this thought: “I am a highly desirable, sexy woman.”

How does that thought feel in your body? Good, right?

Now contrast how that feels with this thought: “I am a middle-aged woman whose best years are behind her. It’s too late for me to feel sexy or happy.”

Which thought is associated with better blood flow and more “feel good” chemicals? I’m sure you know it’s the first.

Your power to live a pleasurable, prosperous life lies in your willingness to focus your attention on thoughts, people, places, and events that are joyful, fun, sexy, and uplifting.

Step Five: Expect resistance.

The minute you decide to bring more pleasure and joy into your life, resistance will show up. Expect this. It’s a good sign!

When grief or sadness shows up, feel them for a bit and then do something pleasurable. Call a friend, watch a good movie, or get out and take a walk. You want to do something to move energy, something that feels better.

To create more pleasure in your life, you actually have to feel pleasure of some kind. Stop right now. Caress your hand with your other hand in a way that feels pleasurable. There. You’ve done it. You’ve created pleasure. Now do your feet. If you want to take it higher, put on some great music and dance around the room. That automatically increases pleasure—and also helps prevent cardiovascular disease and can burn fat!
Grieve your losses and let go regularly. You have to feel it to heal it. Every loss that isn’t grieved fully stays with us. Time doesn’t heal these losses. They wait for us to feel them and release them. We don’t get over them until we really grieve.

Anger is often a cover-up for loss and grief. It’s easier to be angry with someone or at someone than to feel sadness.

When we really grieve, forgive, and let go, we begin to recover who we really are. And then the miracle happens: more light comes into our lives than we could ever have imagined before. And we’re able to feel even more pleasure.

Step Six: Spread pleasure around and you’ll receive even more.

One of the most meaningful and Divinely pleasurable things I’ve done in the past year is both teach at and participate in Mama Gena’s School of Womanly Arts in New York City. My daughters have joined me in this transformational work, which my sister-in-law calls “personal growth on steroids for women.” Mama Gena (aka Regena Thomashauer) has created a curriculum that teaches women how to use pleasure to transform the world. We all know the old adage, “If Mama ain’t happy, ain’t nobody happy.” Well, the opposite is also true. When women are happy, everyone is uplifted and happy!

One of the core concepts of the School of Womanly Arts is the amazing power of women to uplift and approve of each other. (You won’t find any backbiting or jealous put-downs there.) As a result of my experiences at Mama Gena’s, I now realize the incredible value of openly appreciating another woman (or man). So when I see something about a woman (or man) that is pleasing to me—I tell them! If I see a woman waiting in line or walking down the street and her dress or her hair or her jewelry is pleasing to me, I let her know. I make every effort to reward beauty and pleasure wherever I see it, because I know what I pay attention to expands. The same goes for men and children. The more pleasure you spread around, the more you feel yourself.

Here’s my final advice on pleasure: You were issued one body when you were conceived. It’s your duty to attend to this particular portion of living matter in a way that uplifts, celebrates, and comforts it. But it’s not your job to figure out how to do this for anyone except yourself. What a relief! Now can’t you just feel your beta-endorphin levels rising—and your blood flow increasing just from that thought alone?

When you take care of yourself with pleasure, your influence creates a standing wave of joy and pleasure that goes out from you and affects all living things on this planet. The world is depending upon your happiness, your joy, your pleasure. You have nothing to lose by following your bliss except your suffering. And when your own suffering decreases, the suffering of the whole world lessens. You’ll probably lose a few extra pounds, too!

This information is not intended to treat, diagnose, cure, or prevent any disease. 
All material in this article is provided for educational purposes only. Always seek the advice of your physician or other qualified health care provider with any questions you have regarding a medical condition, and before undertaking any diet, exercise, or other health program.

© Christiane Northrup, Inc. All rights reserved. Reproduction in whole or in part without permission is prohibited.

Please visit Dr Christiane Northrup’s website http://www.drnorthrup.com/

By Christiane Northrup, M.D

The newest version of the groundbreaking classic Women’s Bodies, Women’s Wisdom by Christiane Northrup, M.D., is now available in bookstores across the United States. I share in my good friend, Dr. Northrup’s joy and excitement when I tell you that Women’s Bodies, Women’s Wisdom is now an essential guide for how to truly flourish in a female body, not merely avoid disease. In fact, the new Women’s Bodies, Women’s Wisdom is an owner’s manual designed to teach you everything that can go right with your body.

The first edition of Women’s Bodies, Women’s Wisdom was published in 1994 and was based on Dr. Northrup’s many years as an OB/GYN physician. She had seen up close and personal everything that could go wrong with the female body. As a matter of fact, her medical training was based on the concept that the female body is a minefield and everyday occurrences, like the menstrual cycle, pregnancy, and menopause, can only be spoken of in the language of pathology and discomfort.

It’s now 16 years later. Since its initial release, Women’s Bodies, Women’s Wisdom, an international bestseller, has become and remained the veritable bible of women’s health. Now, in this revised and updated edition, world-renowned and much-beloved women’s health expert Dr. Christiane Northrup shares the latest developments and advances that will maximize your potential for living well in your body today.

Inside you will discover:

• New material on sexuality—and how to have a more fulfilling sex life.
• The spiritual and scientific principles behind healing from terminal illnesses, and how you can utilize these principles for your own health and the health of others.
• Vital information about how to truly dissolve PMS and ease menstrual cramps.
• Extraordinary facts on Vitamin D—and why it is crucial for breast, cardiovascular, and immune system health.
• The importance of the preconception diet and how to greatly decrease your risk of birth defects.
• How to birth naturally, despite the current induction and C-section epidemic.
• All you need to know about thyroid function, including proper blood tests.
• Life-saving facts about cellular inflammation—the root cause of all chronic degenerative diseases—and how to prevent this condition.
• The essentials on the “fountain of youth molecule”—and how to enhance your levels of it for vibrant health.

More than simply an update, the newest version of Women’s Bodies, Women’s Wisdom is an entire rewrite! You can purchase Dr. Northrup’s beloved classic everywhere books are sold. Purchase at your favorite local bookseller or online in paperback from Amazon.com, Barnes & Noble, and Borders and in hardcover from Amazon.com, Barnes & Noble, and Borders. To read an excerpt, go to www.drnorthrup.com.

Dr. Northrup’s New PBS Show

During the first week of June, the PBS special Women’s Bodies, Women’s Wisdom will begin airing across the United States. The new show, Dr. Northrup’s seventh special for PBS, represents the distilled essence of 30 years of exploration on the front lines of women’s health and wellness. This groundbreaking program focuses on four key areas uppermost in the minds of women 50+. They are: heart health, hormone therapy, diet, and sexuality. Dr. Northrup also presents a five-step program that guarantees weight loss if adhered to as directed.

Watch as Dr. Northrup invites midlife women to embrace their inner wisdom and transform the second half of their lives. Click here to see a trailer for PBS special Women’s Bodies, Women’s Wisdom. To find show times in your area, go to your local Public Broadcasting Station’s Web site or www.PBS.org.

Every 13 minutes someone dies from breast cancer. But did you know that almost 100 percent of all government and private funding supports ways to fight breast cancer rather than prevent it?
That’s right. After 30 years of research and billions of dollars spent, we still don’t know the cause of this deadly disease. And while an abundance of funding is pouring in to advance mechanical forms of fighting breast cancer such as chemotherapy and radiation, there is basically no research being administered that looks at the cause of breast cancer.

“You deserve better than this”

Don’t you think you deserve better than this? So does Dr. Northrup as she continues to devote her life work to changing these discouraging facts and teaching women about the emotional anatomy of breast cancer.

“I’ve seen women heal from everything—including breast cancer that had spread to their bones!” Dr. Northrup affirms. “In most cases, these women had the courage to release the grip of the past, feel their pain, and then chose to walk into the light of peace and joy.”

“Promote healthy breast tissue”

In her newly revised edition of The Wisdom of Menopause, Dr. Northrup includes the latest research on breast cancer as well as a detailed program to promote healthy breast tissue. “Like all diseases, cancer has an emotional component as well as a physical one,” she says. “There are now many scientific studies confirming the idea that our emotional style may influence both the incidence of breast cancer and our ability to recover from it.”

In The Wisdom of Menopause, Dr. Northrup also cites a study where, interestingly, the way in which a woman dealt with adversity was also a significant factor in whether she developed cancer. “Those who had allowed themselves to experience their grief fully when they confronted devastating losses were three times less likely to suffer from breast cancer than those who hid their emotions behind a brave face or submerged their grief in various forms of activity.”1

“Making a difference”

The good news is that there are many advocates like Dr. Northrup daring to change the statistics on breast cancer. One such group making a difference by shifting breast cancer research toward integrative medicine and preventative study is the Heal Breast Cancer Foundation (HBCF). This revolutionary foundation recently honored Dr. Northrup and five other inspirational teachers and leading advocates of this groundbreaking research.

At a gala benefit hosted in February by HBCF, Dr. Northrup was lauded for her innovative approach to women’s health and wellness. She was joined by colleagues and fellow proponents to prevent breast cancer—renowned spiritual guru Eckhart Tolle, alternative medicine trailblazer Dr. Dean Ornish, What the Bleep Do We Know? producer and screenwriter William Arntz, renowned psychosocial oncologist Dr. Carl Simonton, and inspirational writer and actress Meg Ryan’s mom Susan Ryan Jordan.

The Heal Breast Cancer Foundation, which was established in 2004, is dedicated to uncovering the many breast cancer myths, raising both public awareness and the funds necessary to research the cause and healing mechanism of cancer, and helping shift the focus in healthcare to holistic prevention, pre-tumor detection, and biopsychosocial intervention. This innovative foundation, we’re proud to report, is currently supporting and conducting research in several pioneering projects, including the organ-brain connection and brain diagnostics, traumatic life events and breast cancer, and pre-tumor breast cancer prevention.

“Though the most important part of creating daily breast health is achieved through the energetic influence of self-nurturance, releasing resentments, and mutually reinforcing relationships, the health of our breasts, like that of every bodily organ, is also affected by what we eat and by other lifestyle choices.”
And as new research efforts inch closer to integrative approaches and an exploration of the mind, body, spirit, and environmental connection, a cure for breast cancer may be closer than we think. “Remember, we always have the power to create and maintain healthy breasts,” Dr. Northrup confirms.

References
1.Chen, C. C., et al. (1995). Adverse life events and breast cancer: Case-control study. British Medical J, 311, 1527-1530.
Last updated: August 21, 2009

Please visit Dr Christiane Northrup’s website http://www.drnorthrup.com/

Hormones are a Godsend for some women and just aren’t appropriate for others.

By Christiane Northrup, M.D.

The topic of hormone replacement therapy (HRT), especially with bioidentical hormones, seems to raise more questions than answers. Given the amount of misinformation and confusion that exists, I have prepared the following primer. It covers the ABCs of HRT and addresses some of the most commonly asked questions.

Who Needs Hormone Support?

Healthy women who go through perimenopause—the five to twelve year process leading up to the final menstrual period—may not require any additional hormone support. Menopause is, after all, a natural process, not a medical event requiring medication. In fact, some women make all the hormones they need from their own adrenals and ovaries, and they sail through the process. Others enter midlife exhausted from chronic sleep deprivation, nutritional deficiencies, difficult marriages, or a lifestyle of over-giving to parents or children. Hence, these women are running on empty and their bodies lack the raw materials to produce adequate hormones. Women who’ve had hysterectomies with or without ovary removal frequently require additional hormone support because surgery interferes with the blood flow to the ovaries. The end result is low hormone levels. And, in the case of ovary removal, instant menopause.
Note: Menopause refers to the final menstrual period. When we use the term “menopausal” we really mean that someone is going through the process of perimenopause. This process ends a year or so after the final menstrual period. The final menstrual period is a retrospective diagnosis. You don’t know you’re done until one year has passed. During that year you could still get pregnant, so use birth control! You may require hormonal support both during and after perimenopause.

What Hormones Do You Need?

Although there are a lot of jokes and stereotypes about midlife women needing estrogen, there are actually three hormones that can drop to low levels or become out of balance relative to one another. These hormones, sometimes referred to as the sex hormones, are estrogen, progesterone, and androgens such as testosterone. Because all three hormones are produced by the ovaries, when a woman approaches menopause and stops ovulating, these hormone levels typically change.

While some women might be perfectly comfortable with no supplemental hormones, some might need progesterone only and some might need all three. Another thing to keep in mind is, as you transition from perimenopause to post menopause, you might need to adjust which hormones you are taking. This can mean adding or subtracting a specific hormone, increasing or decreasing an amount, and even eliminating them altogether.

• During perimenopause, women begin to skip ovulations causing a decline in their primary source of progesterone. This results in irritability, sleeplessness, anxiety, and premenstrual migraines. Natural progesterone can calm these symptoms very effectively. Sometimes the only thing that is necessary is 1/4 tsp. –1/2 tsp. of 2% progesterone cream (about 30-60 mg), which is available over the counter. Research has shown that small amounts of transdermal progesterone are, indeed, absorbed into the blood stream.1
• Another common complaint of perimenopause is hot flashes. Hot flashes and night sweats are caused by fluctuating levels of estrogen, which is why estrogen therapy is the gold standard for relieving hot flashes. I always recommend using the lowest dose you need to feel better. Interestingly, natural progesterone cream can also relieve hot flashes in many women.
• Some women also experience midlife chest pain from coronary artery spasm. Natural progesterone has been shown to be very helpful in this regard—and at very low doses of only 30 mg (1/4 tsp. of 2% progesterone cream) applied as a cream to the skin.2
• Many women experience a waning sex drive during perimenopause. Most of the time, this is the result of unfinished business in a relationship, the need for more sleep, low vitamin D levels, or simply the need to reinvent oneself. (That’s why the number one predictor of good midlife libido is a new partner! I always tell people that they need to become that new partner, not necessarily ditch their husbands.) Often, a low sex drive is associated with low testosterone levels, so a little bit of testosterone (or its precursor, DHEA) supplementation may help.
• Vaginal dryness can play a part in loss of sex drive, too. For most women, a little estrogen applied vaginally is all that’s needed to restore sex drive and make intercourse more pleasurable. Some don’t even need that. A little KY Jelly or one of the other numerous lubricants on the market is fine.

For more information about perimenopausal symptoms and the common effects of lower hormone levels on your body and overall health, refer to The Wisdom of Menopause.
What About Thyroid Hormones?

When women start skipping ovulations, they may develop a condition known as “estrogen dominance”—too much estrogen relative to progesterone. In the face of excess stress hormones, this estrogen itself can be metabolized into substances that act like stress hormones. To compensate, the body will often lower levels of thyroid hormone so as not to overstimulate the heart beat, and so forth. The result is subclinical hypothyroidism. So it’s always a good idea to get your thyroid checked. Your TSH level should be no higher than 3, even though in many labs the range for normal is up to 4.5!

Up to 15 percent of women are iodine deficient, which can also cause subclinical hypothyroidism—as well as sore breasts! (Believe it or not, breasts require 3 mg of iodine per day to be healthy!) The safest way to increase your iodine level is through eating kelp tablets, seafood, and a couple eggs per week. Iodine supplements are available, of course, but it’s important to work with a healthcare practitioner who has experience with this.

What Are Bioidentical Hormones?

Simple. They’re hormones that match, exactly, the hormones found in your body. Their chemical structure and shape were designed by Mother Nature, not by a pharmaceutical company. The raw materials used to make bioidentical hormones are yams and soybeans. Pharmaceutical companies then create various hormones from these plant precursors. Some are bioidentical; some are not.

Bioidentical hormones cannot be patented because they occur naturally. Hence drug companies have had to make synthetic hormones with hormone-like effects in order to make a profit from hormones. This is also why the vast majority of hormone research has been done with synthetic hormones, including estrogens derived from horse urine.

However, it is possible to patent the delivery systems of bioidentical hormones, which is why we now have a wide variety of patches and vaginal gels that use bioidentical hormones! The availability of these preparations is largely the result of market pressure from those of us who want safer and more natural solutions. Not only are these available by prescription, they can be purchased in a typical pharmacy, including those that accept insurance.
Note: Don’t be fooled. The label “natural” or “plant based” is virtually meaningless. The only thing that’s important when it comes to a hormone is that it match exactly what’s normally occurring in the human body!

Are Progestins and Progesterone the Same?

Progestins are a class of hormones that include bioidentical progesterone. There is only one progesterone, but there are many synthetic progestins that have some progesterone-like actions in the body. Medroxyprogesterone acetate (MPA), brand name Provera (and also used in Prempro), is a good example. It’s often confused with natural progesterone because it’s referred to as a progestin. Similar sound, different substance entirely.

Because MPA isn’t found anywhere in nature, it has far more side effects that natural progesterone. It can cause PMS symptoms, headache, bloating, and even constriction of coronary arteries. Numerous studies show that natural progesterone typically relieves these cycle-related concerns and confers relief for women with angina.

But because MPA and other progestins are lumped in the category “progesterone” in the medical literature, many doctors think it’s the same thing as bioidentical progesterone. In addition to causing more side effects than natural progesterone, synthetic progestins aren’t metabolized by the body in the same way.

There are several “progestins” that have progesterone-like activity. In addition to MPA, norethindrone acetate and norgestryl are frequently used in synthetic HRT formulations. These three progestins are commonly found in birth control pills, too. The only “real” progesterone occurs naturally in the female body (or is made in the lab to match it exactly).

Are Hormones Safe?

Bioidentical hormones are, theoretically, safer than estrogens made from horse urine or synthetic progestin. As a matter of fact, some studies show that natural progesterone is far safer than synthetic progestin. The large KRONOS study that is due out this year will answer a lot of our questions about this issue. The bottom line is that because of the confusion about which hormone preparations are bioidentical and which are not, most experts lump everything together and warn women of the well-defined risks that have been associated mostly with the synthetic compounds. That said, even bioidentical estrogen is a growth hormone in the body and may have adverse effects on uterine and breast tissue, especially if not balanced with progesterone.

The truth is that hormones are a Godsend for some women and just aren’t appropriate for others—one-size-fits-all is obsolete medicine. There’s no harm in trying a small amount of bioidentical hormone replacement to see if it’s right for you. You will know very quickly because your body will either say yes or no.

Are Pills or Creams Better?

The most physiologic way to take hormones is through the skin—either with a cream or a vaginal gel. That way the hormone goes right into the blood stream without having to be metabolized by the liver. All the patches work this way (transdermally). There are a number of estrogen gels available and a progesterone gel that is used vaginally. Because taking hormones in pill form forces the liver to first process the hormone, you have to use bigger doses to get the same effect. This is undesirable because it can cause the liver to produce increased clotting factors.

How Do Stress Hormones Affect Perimenopause?

The stress hormones cortisol and epinephrine, which are produced by the adrenal glands, can wreak havoc on normal hormone metabolism. For example, if you are skipping ovulations, have progesterone levels that are very low, but estrogen levels that are high (called estrogen dominance), your body will convert your estrogen into substances that act like additional stress hormones. That’s why so many women notice that their symptoms go away when they learn to meditate, get more sleep, or go on vacation. Their bodies, when relaxed, can metabolize excess stress hormones beautifully.

Hormone metabolism also gets messed up by following a diet that’s high in foods that elevate blood sugar such as white bread, white potatoes, and white sugar products.

Many experts believe that the key to quelling menopausal symptoms lies in getting stress hormone levels under control. Given that stress hormones are associated with everything from midlife weight gain to poor sleep, I certainly agree!

What Is a Compounding Pharmacy?

Compounding pharmacies, also called formulary pharmacies, specialize in creating hormone (and other) prescriptions tailored to individual needs. The bioidentical hormones used by compounding pharmacies are all FDA approved—and are the same hormones that drug companies also use in their pills, patches and vaginal gels.

How Do You Individualize Your Treatment?

A full range of bioidentical hormones—either singly or in combination—is available by prescription from formulary pharmacies. The dosages can be individually adjusted. Hormones can be prescribed based on a woman’s test results and symptoms so she is taking only what she needs to maintain the optimal levels of hormones in her body. (This approach is standard with thyroid hormone, but wasn’t applied to sex hormones until recently.) It’s also possible to create a bioidentical hormone replacement regimen using hormone preparations available in all conventional pharmacies. You just have to know which brands are bioidentical and which are not. Refer to The Wisdom of Menopause (Bantam, 2006), Chapter 5 for a list or ask your doctor.

One popular form of hormone replacement therapy is to have a prescription created especially for you using a combination of one or more of the bioidentical estrogens (estradiol, estrone, estriol) combined with bioidentical progesterone and an androgen in the form of DHEA or testosterone, if needed. These hormones are mixed into a lotion, cream, or other base and applied to the skin. Because the estrogen known as estradiol can be converted by the body into the other types of estrogen, I generally recommend just that one.

Is Hormone Testing Helpful?

Hormone testing is controversial because a hormone level measures only a point in time (like looking at the speedometer in our car only once during a road trip) and hormones fluctuate widely throughout the day. (This applies to blood, saliva or urine tests.) Results also depend upon what you eat, your activity level, the time of day, and your nutritional status. Still, a baseline blood test is a good starting point for monitoring therapy. At this point in time, the vast majority of experts agree that blood hormone values are the most reliable compared to saliva. These should be done by a lab that has a lot of experience in this area such as Genova Diagnostics. Their Hormonal Health profile is very comprehensive. Another good lab is My Med Lab, which doesn’t require a healthcare practitioner’s order.

How Can You Find a Healthcare Practitioner?

Fortunately, more and more healthcare providers are knowledgeable about bioidentical hormones. To find one, I recommend going to the Web site of the American Holistic Medical Association or the Institute for Functional Medicine. Nurse practitioners who specialize in women’s health are also very good at it, and so are many ob/gyns. Another way to find a practitioner is to contact the International Academy of Compounding Pharmacists to find a compounding pharmacy near you. They will usually be happy to provide you with the names of local practitioners who work with them.

Where Can You Go For More Information?

Remember that a one-size-fits-all approach to hormone replacement therapy (HRT) is not good medicine—every woman is different. If you’re approaching or in perimenopause, I encourage you to learn all you can about the different options so you can partner with your doctor effectively. Midlife and beyond can be the best years of your life! They don’t have to be laden with medical challenges.

My book The Wisdom of Menopause is a complete resource for health concerns at midlife, and Chapter 5 provides in-depth information in hormone therapy—it even lists the names of some of the bioidentical formulations available with a prescription at conventional pharmacies, such as Estragel (bioidentical 17 beta estradiol as a skin cream).

Learn More | Recommended Reading

• The Wisdom of Menopause, by Christiane Northrup, MD

References

1. 1.Burry, K., Patton, P., Hermsmeyer, K., 1999. Percutaneous absorption of progesterone in postmenopausal women treated with transdermal estrogen. American Journal of Obstetrics and Gynecology, June 180(6 Pt1):1504-11.
2. 2.Hermsmeyer, K., et. al, 2008. Cardiovascular effects of medroxyprogesterone acetate and progesterone: a case of mistaken identity? Nature Clinical Practice: Cardiovascular Medicine, Jul 5(7):387-95.

Everyone knows about cranberry juice for Urinary tracy infections (UTI’s), but I have always had a problem with recommending it because the juice has too much sugar. Now the active ingredient in cranberries, mannose, comes as a supplement. It is still relatively unknown as a supplement, (especially in the conventional medical community), and I have found it to be extremely effective for many UTI’s. It is called D Mannose and there have been many research reports over the years demonstrating it’s safety and effectiveness against E. coli, the commonest bacteria causing UTI’s. It is 10-50 times stronger than cranberry juice and works usually within 24-48 hours. Unfortunately the large drug companies have no incentive to spend the millions of dollars it would take to do the large-scale controlled study which would be required for FDA approval, because it cannot be patented.

D-mannose does not kill the E Coli, rather it prevents it from sticking to the bladder wall and it dislodges bacteria that are already attached. The bacteria attach to the D-mannose molecules, and are flushed out with the normal urine flow.

Recommended dosage for infection:

The recommended dosage for an ongoing infection is one teaspoon of D-mannose dissolved in liquid every few hours, continued for three days. Most women with E Coli infections respond within 24 hours. If no change is noticed within 72 hours, you should consult your Physician. (as it may be that the infection is caused by a bacteria other than E. coli).

For those women who suffer from “honeymoon cystitis” (bladder infections linked to sexual intercourse), one teaspoon of D-mannose an hour before intercourse, and another immediately after, can help prevent infection.

And for those who suffer from recurring infections. The maintenance dose varies per person, but a good starting point is one teaspoon per day mixed with liquid.

Safe for diabetics, pregnant women and young children.:

As opposed to antibiotics, D-Mannose does not kill the good bacteria in your gut or, so it won’t make you more prone to a yeast infection. Even though it is a natural sugar, it does not affect sugar regulation as it is not metabolized and goes to the kidneys and then bladder, where it works. It is safe for diabetics, pregnant women and young children.

The questions surrounding supplements continue to grow and though knowledge and understanding have also grown, pharmaceutical companies continue to hamper this quest by spending more and more money on their own studies and funding lobbyists that try to hamper our pursuit of a more natural approach to health. There is no doubt that the drugs we have developed are saving lives but they could save many more lives if they were part of an integrative lifestyle combining a healthy balance of diet, exercise, necessary supplements, and when these fail, pharmaceutical medications.

In integrative medicine we speak about the “core” nutrients. These are the vitamins and minerals that we all require. I generally start people on a multivitamin and mineral complex first. There are many out there so selecting an appropriate combination is not that difficult. Some of the new age-targeted formulas combine most of a person’s needs into one formula for ease of use. So a women’s formula for women over forty will include more calcium, magnesium and trace minerals than a formula designed for younger women. This simplifies what a person needs and often taking fewer products increases compliance. The next core nutrient necessary is a good healthy source of essential fatty acids, also known as EFA’s. EFA’s are essential because we cannot make them. We need to ingest them so that our bodies can then use them as raw materials for other things we do make. These include cholesterol (much needed), hormones, prostaglandins (messengers that help us control all sorts of processes in the body, including inflammation). There are so many problems with the environment and this includes our water. Eating fish that is not contaminated has become a problem and there is nothing in the literature that leads me to believe that things will change any time soon. Keeping your “ toxic burden “ low is the only thing we can control in trying to prevent cancer and other autoimmune diseases that seem to be growing in numbers in spite of all the new “ scientific advances”. In order to get the omega 3’s that you can get from one or two capsules of oil a day, you would probably need to eat 4 to 6 servings of fish a week, and thereby risk exposure to elevated levels of mercury, arsenic, cadmium, and lead. If you ate farm raised fish, than you increase your risk of exposure to dioxins ( carcinogens ) and PCB’s ( also carcinogens ). The amount of fish oil a person should take also varies according to need.

The next core nutrient is a probiotic. This is what many people commonly refer to as “acidophilus” but in reality is a whole family of beneficial bacteria that is comprised of many different “friendly” bacteria that thrive throughout the gastrointestinal tract, starting in the mouth and ending in the rectum. For women without any serious or chronic gut issues, eating a good organic yogurt containing live cultures of friendly bacteria, on a regular basis, is adequate.

For women, the big question today is about calcium. While we have all become conscious of our need for calcium many people are unaware of the need for magnesium, adequate amounts of vitamin D and the need for other trace minerals that aid in absorption. The amount of minerals that are needed varies from person to person. Women after the age of forty should begin to get bone density studies done to assess their need for minerals. The average woman needs 1000mg of calcium a day, 400 to 800mg of magnesium a day, and at least 2000 units of vitamin D3 but we are finding more cases of severe deficiency and under medical guidance we use as much as 10,000 units a day. If the bone density test, also called a Dexa scan, shows osteopenia or the beginnings of osteoporosis than I increase the calcium to 1200 to 1500mgs a day and increase the magnesium accordingly. I often request that patients have their vitamin D levels measured because many people supplementing with calcium and magnesium are still showing signs of progression of their bone density issues. In our search for answers why, the question of the right amount of D has come to be a new insight into possible failures of other therapies. In osteopenia and osteoarthritis, weight resistance exercise is essential for stopping progression.

There are a million supplements on the market and I encourage all women to try and get as much of their nutrition from food and then target the remaining imbalances with the supplements that are necessary. I encourage all my patients to eat as organically as possible. We need to reduce our exposure to chemicals. As long term studies are limited, I assume that all chemicals are bad and try to reduce them every where possible. Animal protein like chicken, fish, beef, and pork, as well as all dairy carry a heavy burden of toxins with them. First they contain the herbicides and pesticides from the foods they are grown on, and second they are usually given hormones and antibiotics to maximize the yield. All of these are passed to us when we eat these things. I implore all people to buy as much of their foods organically but animal derived products especially. With ovarian and breast cancer on the rise, you have to question the “estrogen dominant “ nature of society due mostly from the consumption of xeno estrogens and phyto estrogens from the food supply. With vegetables and fruits I take an aggressive approach to washing them before I consume them.

Research from the Journal of the American Medical Association reports that after removing all menopausal women from a study who might have had osteoporosis, 7% had osteoporosis and 42% had osteopenia. Are Fosimax and some of the other drugs the answer? I think not.

Research on vitamin D demonstrates that optimizing vitamin D is as effective as commercial medications. Regular exercise, which is not optional for any of us, also helps keep bones strong and healthy.  An Israeli study echoes that giving just 500 mg of magnesium daily increased bone density.  Further, trace nutrients that we find in fresh whole foods, vitamin K, vitamin C, potassium, copper, manganese, zinc, silicon, boron, and fluorine all play a role in bone building. Stress causes bone loss by changing our internal pH; as we become more acidic, our body takes minerals out of our bone-bank-account to alkalize our cells and blood.

The Pearls:

• Get your vitamin 25-OHD (vitamin D) level checked by your doctor. Optimal levels are 45 or 50 and above. If less, take 2000 to 4000 IU of vitamin D daily, or even more with your doctor’s approval.

• Move your body- weight bearing exercise shows the greatest return, but any movement helps build your bones and keeps you happy too.

• Take a bone building supplement. Make sure that it has calcium, magnesium, vitamin D, manganese, vitamin C and other bone building nutrients. My favorite is Perque Bone Guard.

• Eat lots of fruits, vegetables, nuts, seeds, legumes, and organic meats and poultry. These will provide the trace nutrients that will keep your bones healthy and happy.

• Get some pH paper and check your first morning pH. Optimal is 6.5-7.5. If your pH is consistently lower, focus on eating more alkaline balancing foods like fruits, vegetables, lentils, yams, vegetable juices, greens and more.

• And finally, what’s good for your bones is also great for you!

Breast cancer prevention requires addressing the real issues surrounding the global increase in incidence of breast cancer. Public health education, corporate responsibility, and governmental regulation of toxic chemicals and poor quality modern foods must be included in addressing the factors contributing to today’s cancer epidemic. Environmental factors influence an array of molecular mechanisms and consequently influence disease risk and gene expression.

A growing number of studies show that a parent’s diet and environmental exposures can influence DNA expression and have an effect on health outcomes later in life. Genetic studies provide insights to further understand fetal origins of adult disease. Epigenetics holds that environmental factors from our diets, stress responses, and chemical exposures can affect our genetic fate by turning genes on and off and that information can be passed down to future generations. Evidence therefore is accumulating that toxic exposures during in utero, and childhood, leads to an increased risk of breast cancer.

Women in the United State face a greater lifetime risk of breast cancer than any previous generation, even though only about 5 percent have a known genetic link.

According to a report published last year, WHO, released it’s first ever country by country analysis of environmental health and disease. The International Agency for Research on Cancer reports that breast cancer is now the most common form of cancer in women worldwide, with the highest rates in industrialized nations. In the United States, a woman’s lifetime risk of breast cancer has tripled during the past 40 years, with estimates of one in six women having a diagnosis in their lifetime. Global research estimates that a women’s cumulative exposure to environmental estrogen compounds may be responsible for up to 50% percent of all breast cancers today.

To compound the problem of our toxic environment, we have refined away much of the nutritional value of our food supply and replaced it with artificial colorings, preservatives, flavorings, conditioners, etc. This poor quality diet-combined with extensive use of antibiotics in medicine and agriculture-may have predisposed many of us to experience a kind of  ‘internal’ pollution.

According to Dr. Walter Willet at the Harvard School of Public Health and the American Institute for Cancer Research, a recent study reviewing 4,500 scientific studies concluded in a 650 page report that 40% of Cancers are avoidable. “The bottom line: eat a plant based diet, maintain moderate weight throughout life, and get some exercise.”

Endocrine Disruptors

Of all the common pollutants we are exposed to, the most harmful are those potent substances known as hormone disruptors, estrogen mimickers, or xenoestrogens. These pervasive chemicals, common in our daily lives and contained in most of our personal care products, household cleaners, pesticides, and plastics, have the potential to disrupt our hormonal and endocrine balance and cause chaos to many systems including the immune system, increasing the risk of cancer and other diseases.

The Good News: What we can do

Increasingly, scientists are examining the role specific natural plant compounds play in increasing the body’s natural defense system .

Nutrigenomics is the study of the response of humans to the natural qualities in food and the phytochemicals in nature. The understandings of nutrigenomics encourages foods and plant based supplements that can be matched to individual human genotypes to benefit the health of those individuals and enhance normal physiological processes.Currently, in major cancer centers, researchers are studying the effect of concentrated nutrients on gene expression and cell signaling pathways. Nutrients including resveratrol, curcumin, sulforaphane, and Vitamin D3 have been researched for their use as both protective agents as well as for the chemotherapeutic role in the treatment of cancer, including breast cancer.

Summary of Protective Nutrients

Vitamin D3

Research estimates that as many as 50 percent of breast and colon cancer cases could be prevented by increasing intake of vitamin D, according to a study that backs continued calls for higher upper limits of this essential vitamin.

Published in the journal, Nutrition Reviews, researchers at the University of California, San Diego (UCSD) compiled data from observational studies showing an inverse link between serum 25-hydroxyvitamin D [25(OH)D] and these cancers. They took previous results one step further by looking into the dose-response gradient between serum 25 (OH)D and the risk of both cancers.

The findings confirm what some researchers have long been advocating: we does not consume enough vitamin D and that it needs to be made more available to consumers through public awareness as well as increasing recommended dosing. According to the study’s projections, in North America, a 50 percent reduction in colon cancer incidence would require universal intake of 2000 IU (International Units) per day of vitamin D3, and a 50 percent reduction in breast cancer would require 3500 IU per day.

Resveratrol

Resveratrol is classified as a polyphenol because of its chemical structure. Polyphenols make up a huge group of plant compounds that are further broken down into other classifications such as flavonoids, and proanthocyanidins. Naturally created by certain vines, pine trees, peanuts, grapes, and other plants, resveratrol also contains anti inflammatory, neuroprotective, and antiviral properties. Reservatrol is currently in trials at Anderson Cancer Center for use as a potential chemotherapeutic agent.

Sulfurophane

Three recently published scientific studies reinforce the protective power of sulforaphane, the naturally-occurring antioxidant in broccoli and broccoli sprouts by demonstrating three new aspects. Sulforaphane is the most characterized isothiocyanates (ITCs), which are identified in cruciferous vegetables. Sulforaphane is viewed as a promising agent in cancer prevention. Because of its ability to induce cancer cell apoptosis, it inhibits progression of benign tumors to malignant tumors and interrupts metastasis.

Green Tea Polyphenols

The polyphenols in green tea are catechins with multiple linked ring-like structures. Polyphenols are a form of bioflavonoids with several phenol groups. The dominant and most important catechin in green tea is (-) Epigallocatechin Gallate (EGCG), a potent antioxidant.

Curcumin

Curcumin research has been extensively published in peer-reviewed medical journals detail it’s ability to protect against cancer. In addition to its capacity to intervene in the initiation and growth of cancer cells and tumors—and to prevent their subsequent spread throughout the body by metastasis—curcumin also has been shown to increase cancer cells’ sensitivity to certain drugs commonly used to combat cancer, rendering chemotherapy more effective in some cases.

RESEARCH

Vitamin D and prevention of breast cancer: pooled analysis.
J Steroid Biochem Mol Biol. 2007 Mar;103(3-5):708-11
Garland CF, Gorham ED, Mohr SB, Grant WB, Giovannucci EL, Lipkin M, Newmark H, Holick MF, Garland FC.Department of Family and Preventive Medicine, University of California-San Diego,
Serum 25-hydroxyvitamin D and risk of post-menopausal breast cancer–results of a large case-control study

Carcinogenesis. 2008 Jan;29(1):93-9. Epub 2007 Oct 31. .Abbas S, Linseisen J, Slanger T, Kropp S, Mutschelknauss EJ, Flesch-Janys D, Chang-Claude J. Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.

The Role of Resveratrol in Cancer Therapy
Aggarwal BB, Bhardwaj A, Aggarwal RS, Seeram NP, Shishodia S, Takada Y. Cytokine Research Laboratory, Department of Bioimmunotherapy, The University of Texas M. D. Anderson Cancer Center. Sulforaphane Inhibits Human MCF-7 Mammary Cancer Cell Mitotic Progression and Tubulin Polymerization

The American Society for Nutritional Sciences J. Nutr. 134:2229-2236, Nutrition and Cancer Steven J. T. Jackson and Keith W. Singletary3 Department of Food Science and Human Nutrition, University of Illinois, Urbana, IL 61801

Epigallocatechin gallate (EGCG) stabilizes p27kip1 in estrogen- stimulated MCF-7 cells through downregulation of the Skp2 protein. Huang HC, Way TD, Lin CL, Lin JK. Endocrinology. 2008 Aug 21.
Green tea intake, MTHFR/TYMS genotype and breast cancer risk: the Singapore Chinese Health Study. Inoue M, Robien K, Wang R, Van Den Berg DJ, Koh WP, Yu MC. Carcinogenesis. 2008 Oct;29(10):1967-72.

Today I review a great book on yoga with beautiful illustrations. Finally, in One Invaluable New Resource, Everything a Woman Needs to Know about Her Body and Her Yoga.

Look around the studio of any yoga class and you’re likely to see more women than men, sometimes many, many more. Still, most women don’t know that a woman’s body and the cycles of a woman’s life require special adjustments in yoga postures.

Now one book gathers together everything a woman needs to know about the menstrual cycle and the cycles of a woman’s life. It’s The Woman’s Yoga Book: Asana and Pranayama for All Phases of the Menstrual Cycle, published by Rodmell Press.

Written and sumptuously illustrated by senior Iyengar Yoga teacher, Bobby Clennell, and drawing on her decades of experience in both teaching and practice, this comprehensive program of yoga supports menstrual health from menarche through to menopause. It also includes essential nutritional and lifestyle advice for those times off the mat.

This book empowers women to draw on the strength that comes from practicing women’s yoga. Bobby helps women to observe the monthly ebb and flow of recurring hormonal activity, so they can begin to understand the way the menstrual cycle plays out in their bodies and their emotions. With this awareness, a woman can fine-tune her yoga practice to coordinate with her own unique menstrual pattern.

This refined approach to yoga not only helps women avoid injury and fatigue. It also leads to vibrant good health, boosts fertility and leads women into a smooth transition into a trouble free menopause. The Woman’s Yoga Book is filled with treasures that you’ll use time and again. Among them are:

• Detailed, easy-to-follow yoga sequences for each phase of the menstrual cycle, from premenstrual (poses to stabilize), through menstruation itself (poses to restore), the post-menstrual time (poses to rebalance), and the return to ovulation, by which time a practice can be built back to its full strength and variety.
• Sequences to help ease and solve a variety of menstrual and premenstrual problems, including amenorrhea (failure to menstruate), menorrahgia (excessively heavy periods), and dysmenorrheal (painful periods).

Though solidly grounded in theory, this book is a practical, everyday guide–easy to read and easy to follow. It’s an invaluable resource for women, from beginning students to the most experienced.

Bobby’s background as a filmmaker and illustrator is evident in the drawings on nearly every page; they have a dynamic movement and rhythm of their own, illuminating the movements into and out of the various postures. More than 700 illustrations teach the yoga asanas (postures) alongside written directions.

For example, in the instructions for Salamba Sirsasana (Headstand Pose), Bobby’s illustrations clearly show exactly how to align the wrists, arms, shoulders, and head; how to draw the body up and onto the support of the wall; and how to achieve a graceful final posture.

Throughout The Woman’s Yoga Book Bobby invites women to join her in embracing the physical, emotional, mental, and spiritual well-being that comes with practicing yoga. With everything you need finally in one place, it’s time to begin the journey — now!

Bobby Clennell is a core faculty member of the Iyengar Yoga Institute of New York, where she teaches women’s and prenatal classes in addition to regular classes. She also teaches yoga workshops and retreats throughout the United States and abroad.

For more information, visit BobbyClennell.com