treatment options

Integrative options for women's health 

Herbs and Supplements 
For centuries herbs have been used to help manage women’s issues during hormonal changes and other gynecological concerns. I often prescribe herbs and supplements as therapy, depending on the severity of the issue at hand. Herbs and supplements can be especially useful for women who need support but do not want to take hormones. Many herbs can also act like a hormone, either progestenic, estrogenic or adaptogenic, without being true active hormones and thereby producing positive effects without the risk. Supplements and vitamins can be tailored to support optimal health for individual health issues.

Hormone Replacement Therapy / Bio-identical Hormones
Conventional medicine has long established that replacing the estrogen and progesterone that decline in menopause can relieve symptoms such as hot flashes, night sweats, insomnia, mood disturbances, vaginal dryness and painful sex. The aim of HRT is to restore female hormone levels, allowing the body to function  as it did prior to the shifts. Most clinicians choose from prescribed pharmaceutical hormones that are synthesized to mimic the hormones in a women’s body. 

Bio-identical hormone therapy is the process of restoring and maintaining hormone balance with hormones that are biologically identical to hormones produced by the human body. I have decided to use only bio-identical hormones and have worked with them for 25 years in treating a variety of women’s hormonal concerns. Bio-identical hormones are made, or synthesized, from yams and soy extracts. They include all three of the estrogens (estriol, estradiol, estrone), progesterone and testosterone which are the most commonly prescribed hormones for menopause.

Bio-identical hormones can be custom compounded by a compounding pharmacy to match each patient’s individual needs and body chemistry. This allows for more variation in dosing and strength as opposed to the ‘one size fits all’ approach of most prescribed pharmaceutical treatments.

Consultant - Educator - Advocate

RPa, mph, pc

Hormones: Perimenopause and Menopause
Hormonal concerns, such as PMS and menopause, are a source of confusion for many women today. This would not be quite so troubling if these same concerns did not also confuse many clinicians. Conflicting opinions, competing medical studies and a diverse array of questionable treatments can make the search for proper care both intimidating and frustrating. 

Hormonal fluctuations of both the menstrual and reproductive pathways influence many other systems within a woman’s body. Although these interconnections are not well researched or understood, their effects are widely observed by a great variety of women. Despite the need for more knowledge, there is a glaring lack of scientific or medical research due to the embedded sexism in modern medicine. We have created such fear and shame about hormonal conditions that medicine has neglected their health aspects and reinforced sexist attitudes towards women themselves. 

I believe that these hormonal shifts deserve further attention and that many women need assistance during these chaotic transitions. Women need to know what is changing in their bodies, how they can ease the changes they are going through and more comfortably adjust to new stages in their lives. I hope to be part of a larger tradition of helping women safely and smoothly rebalance hormones during major and minor shifts. My approach incorporates established remedies and therapies, including the use of bio-identical hormones as well as herbs and supplements, the practice of stress management and a variety of other healing modalities.

For many women, the initial upset of hormonal balance prior to medically recognized menopause can be the most confusing and bewildering time. After many years of living in, and being accustomed to, one’s body, even a gradual shift in how that body works can be startling. 

During the time of perimenopause, a woman’s menstrual cycle or flow, her moods, and her energy, all subtly change. Periods become irregular; emotions may be unpredictable. For some women, this time is marked by increased anxiety and disrupted sleep and hot flashes. For others, perimenopause can feel like prolonged PMS. When the established relationship with one’s own body is altered, it creates a sense of dissonance or internal upheaval. This change may be so stressful, so intimately tied up in one’s own sense of self, that it can become a source of shame or guilt for many women, especially when there is a lack of assistance in coping physically and emotionally. While still in the stages of “pre” menopause, women may have a more challenging time finding the help they need. This dismissal can worsen the sense of emotional, mental or physical burden. 

Menopause can also be a difficult time for women; stress hormones escalate  exponentially as sex hormones decrease. The effects of this hormonal battle can be exhausting. Daily life may become harder to manage as symptoms –mood swings, hot flashes, night sweats, trouble sleeping -- become more pronounced. The effects can leave one feeling physically depleted, resulting in adrenal fatigue and a sense of being overwhelmed. Menopause can be a time in a woman’s life when she may want to feel her power and wisdom, but can also sense the cultural aversion to older women. There is a persistent haze of shame that surrounds this physiological transition for women  which focuses on the instability and not the strengths of women. Many women do not suffer through menopause and for those who do, there is help and no shame in seeking it.

The major transition of menopause represents the end of a woman’s reproductive years, which can be a relief for some and a source of difficulty for others. There are such varied reactions to menopause from woman to woman. For some, it can feel like only a flush here and there, while for others it feels crushing. For still others, depression can settle in as everything in life suddenly seems to be in flux. Menopause is often a time of reckoning but in the wake of its aftermath, many women experience surges of creative energy, confident autonomy and empowering wisdom.

Regardless of the way an individual woman experiences menopause, it can be immensely helpful to have a clinician who is knowledgeable about these particular shifts and can act as a source of support during this time of women’s lives to positively reinforce optimal health and happiness. 

I use a variety of methods and theories in my approach to dealing with common hormonal fluctuations. A selection of these methods are further explained under treatment options.

Sex and Sexual Health
Another egregious omission in women’s medical care is the study of, and tending to, her sexuality. Historically, women’s sexual issues, especially those of older women, have been dismissed as psychological; women have been blamed for being ‘frigid’ or non-orgasmic. Astonishingly enough, these antiquated ideas still permeate modern medicine. Countless women worry about vaginal pain, orgasmic response, sexual communication skills or lowered libido, as well as many other sexual issues. Our culture’s homophobia has neglected the health needs  and sexual health of the LGBT community in precarious ways. Sadly, most clinicians tend to avoid the discussion of sexual health, leaving sexual concerns to go unacknowledged and women to become fearful of advocating for themselves in an unwelcoming environment. In my practice, I encourage open and honest conversation with the aim of educating and empowering my patients. All women have the right to better information in regards to their sexual pleasure, their sexual health and how their sex lives can impact their general wellbeing and happiness. I offer a selection of remedies that can relieve many symptoms, as well as counseling women towards vitality and taking control of their sex lives.

Reproductive Health
Among women in their reproductive years appears, there seems to be an idea that fertility is no longer be the norm and many women now expect difficulty in getting pregnant. This is a serious misconception as most women are fertile, but have little basic information about the timing of fertility and how both gynecological and men’s health can impact conception. I am dedicated to helping teach women non-invasive methods, including herbs, supplements and natural hormones to optimize fertility.

For unintended pregnancy there are few sources of support or counseling available for women. There is persistent shame and difficulty finding help for an unintended pregnancy. Many OB/GYN practices do not offer options or services for unexpected pregnancies or miscarriage.  Women want and deserve an opportunity to discuss their options and have counseling about their decisions but often can’t find a safe and supportive place for such direction and support. I have been an abortion counselor for over 30 years and have many referrals available for all outcomes of unintended pregnancies including abortion services, pregnancy care and adoption.

In addition I am an advocate of non-hormonal contraception and have designed a barrier method contraceptive called THE V CUP, which is a hybrid of the cervical cap and diaphragm. This can be an appropriate method for those women who don’t want to use hormonal contraception or the IUD or those who want a more natural contraceptive or those women expecting to get pregnant within months.

Integrative  Gynecology 
Modern gynecology offers surprisingly few options for the treatment and relief of symptoms outside the use of pharmaceuticals or surgery. In fact, there are many complaints for which standard medical practice offers no treatment options at all. Today many women are starting to seek alternative methods of dealing with hormonal shifts or gynecological symptoms, such as chronic vaginitis, menstrual irregularities, fibroids, breast pain and other conditions. I have a breadth of knowledge and years of experience with these issues and am able to recommend effective remedies, supplements and herbs as well as nutritional approaches towards healing these common gynecological complaints without the rush towards pharmaceutical intervention. 

Medical Decision Making and Empowerment 
Yet another failure of the contemporary medical system is a lack of patient advocacy. In my practice, I will offer consultations designed to help women with medical decision-making and fact-based empowerment. These consults are particularly helpful for women who have recently been diagnosed and thus labeled ‘patient’ by the medical system. The ‘patient’ label can reduce one’s sense of power and autonomy. I will also work with women facing surgical decisions and those in search of further information with regard to alternative treatment options. 

Using my clinical knowledge and experience, I can translate medical language to help patients navigate the often overwhelming medical maze. I also focus on helping a woman who is facing medical decisions to maintain a dynamic balance between the external and internal factors that govern her sense of optimal health. Combined with healing therapies and exercises in stress management, these sessions can reconcile fears and allow a woman to tell the story of her own body. By taking control of this narrative, a woman is able to move toward a place of healing and health, both emotional and physical, even in the face of uncertainty.Type your paragraph here.