Hot Flashes and Night Sweats

Both hot flashes and night sweats are signs of hormone imbalance, often associated with a drop in estrogen that occurs at menopause.

But, did you know that:
1. Men can have hot flashes and night sweats too? These can accompany a drop in testosterone at andropause.
2. Women as early as their late 30’s can experience them? This is often a sign of an underfunctioning endocrine system as a whole. Supporting the components of the endocrine system (adrenal glands, ovaries, thyroid, pituitary etc) can help resolve these symptoms.
3. Stress can precipitate hot flashes?
4. Hot flashes can be a sign of hormone imbalances other than low estrogen? Low testosterone, low progesterone and low DHEAs can also cause hot flashes.
5. Certain medications can trigger hot flashes? Over the counter sinus and allergy remedies are an example of such medication triggers.
6. The most common time for night sweats is between 3 a.m. and 4 a.m.?

Whatever the cause of your hot flashes, natural medicine has many treatment options including diet changes, vitamins and minerals, herbs and acupuncture.

Hypothyroid and Autoimmunity

If you’ve been diagnosed with an underactive thyroid, you may also have been tested to determine if your thyroid is underactive because you have a condition called Hashimoto’s disease. Hashimoto’s is an autoimmune thyroid problem where your body is attacking your thyroid and destroying the tissue so that it can’t function normally. Firstly, it’s important to know if this is the type of hypothyroidism that you have. The blood tests for Hashimoto’s include: TSH, free T3, free T4, anti-TPO antibodies, anti-thyroglobulin antibodies and anti-microsomal antibodies.

If these tests are positive for Hashimoto’s, then there are six factors that need to be considered in order to reduce the antibodies and help you feel better, maybe even recovering normal thyroid function.

1. Stress
2. Adrenal gland function
3. Viruses or latent viral infections (such as herpes viruses)
4. Diet
5. Dysbiosis and Leaky gut
6. Toxin accumulation (including heavy metals)

If you have been diagnosed with an underactive thyroid, particularly if there is a family history of hypothyroidism and if you are not feeling significantly better on thyroid medication, you should pursue Hashimoto’s testing and if positive, address the above factors with the assistance of a licensed naturopathic doctor.

Fibroids and Estrogen

There are a couple of prevailing theories as to what causes fibroids. One, is that there is too much estrogen which is promoting proliferation of the uterine lining.

I saw an excellent example of this recently where we actually confirmed by blood test that the day 3 estrogen level was about 3 times the norm for that specific day of the cycle. The range for the follicular phase of the menstrual cycle (roughly day 1 to day 14) is 46-622 pmol/L. Because estrogen is at its lowest around day 1 of the period, and it increases to a peak at day 14, on day 3 you would expect estrogen to still be at the lower end of this range. The higher number would occur closer to day 12. This particular woman’s estrogen was already close to 500 on day 3. Ideally, estradiol measured on day 3 should be around 110 – 200 pmol/L. Random estradiol measurements that don’t take into account where exactly the person is in their cycle are fairly useless and will almost invariably be interpreted as “normal”.

What kind of symptoms would this cause?
1. Heavy menstrual bleeding. With this much estrogen so early in the cycle, there is a thick uterine lining being built, which means a lot of blood to discharge at her next period.
2. Painful periods. Excessive estrogen can promote inflammation and cramping.
3. Fibroids. Inflammation and estrogen are considered to be contributors to fibroids and with this much estrogen she’s got both going on.

The solution?
Provide specific nutrients that help the liver detoxify and eliminate excess estrogen. This particular person has already seen significant improvement in only 3 weeks of this type of treatment.

Hum Reprod Update. 2014 Sep 8. pii: dmu048. Ovarian steroids, stem cells and uterine leiomyoma: therapeutic implications. Moravek MB1, Yin P1, Ono M1, Coon V JS1, Dyson MT1, Navarro A1, Marsh EE1, Chakravarti D1, Kim JJ1, Wei JJ2, Bulun SE3.

Endometriosis and IBS

These two often seem to go hand in hand and it’s difficult to differentiate whether the gut issue is part of the endometriosis or a separate entity. In one study, 29% of endometriosis patients had either IBS or constipation.

Here are potential links between endometriosis and the gut:

1. Adhesions – abdominal tissue stuck together and not functioning normally due to endometriosis
2. Gluten sensitivity has been linked to both IBS and endometriosis
3. Endometriosis tissue adhering to the gut and causing gut irritation or inflammation
4. Ovarian hormones affect sensorimotor gastrointestinal function, modulate pain, and modulate susceptibility to stress. So the same imbalances that are causing or contributing to endometriosis can also be causing IBS symptoms.
5. Gut dysbiosis – overgrowth of unhealthy microorganisms in the gut can disrupt the ability to excrete excess estrogen and create more inflammation in the gut. An inflamed gut will increase endometriosis related abdominal pain.

Naturopathically we can address all of these issues, improving gut health, hormone balance and endometriosis.

1. World J Gastroenterol. 2014 Jun 14;20(22):6725-43. doi: 10.3748/wjg.v20.i22.6725.
Gender-related differences in irritable bowel syndrome: potential mechanisms of sex hormones.
Meleine M, Matricon J.
2. Colorectal Dis. 2011 Jan;13(1):67-71. doi: 10.1111/j.1463-1318.2009.02055.x.
Irritable bowel syndrome and chronic constipation in patients with endometriosis.
Meurs-Szojda MM1, Mijatovic V, Felt-Bersma RJ, Hompes PG.

Polycystic Ovarian Syndrome Theories

Some of the prevailing theories as to what is going on with women with PCOS include:

1.  A defect in insulin action and secretion that leads to higher blood insulin levels and insulin resistance.
2.  A defect in the nervous and endocrine systems leading to an exaggerated LH (luteinizing hormone) pulse frequency and amplitude
3.  A defect of androgen (male hormone) production that results in enhanced ovarian testosterone, DHEAs and/or androstenedione production
4. An alteration in cortisol metabolism resulting in enhanced adrenal androgen production (Tasoula et al, Clin Endocrinol, 2004)
5. Intrinsic theca (ovarian) cell hypersensitivity to LH stimulation that results from defective inhibition by FSH that may involve inhibin-B signalling. (Hirshfeld-Cytron et al, J Clin Endocrinol Metab, 2009)

In any case, improvement is usually seen through measures that lower insulin such as low glycemic index, low glycemic load diet, stress reduction and daily exercise. Additional support from insulin sensitizing agents like inositol, NAC, zinc, and cinnamon is also helpful.

What is a Normal Testosterone Level for a Woman?

Testosterone helps build muscle mass, helps maintain healthy vaginal tissue, provides energy, drive and motivation and influences libido in women. Too much testosterone can contribute to hair loss, acne, irregular periods and excess facial hair. So you want some testosterone, just not too much.

According to our lab, less than 2.0 nmol/L is normal for an adult female. Many of the patients that we test for testosterone come back either too high or too low. Being close to either end of the normal range can cause problems. Ideally, a woman’s testosterone level should be around 1.0 – 1.6 nmol/L, neither to close to the low or the high end.

Getting to the Root Cause of Recurring Vaginal Yeast Infections

Here’s an excerpt from an article I wrote this week for Naturopathic Doctor News & Reviews:

Most women experience it at least once in their lifetime: that itching, burning, irritated and white chunky discharge that signifies a vaginal yeast infection. A one-off yeast infection is no big deal, you just head to the nearest pharmacy, grab some over the counter yeast infection treatment and Bob’s your uncle. But, there are many women for whom the OTC treatments just plain don’t work or they only work temporarily and the yeast infection recurs within a few weeks or months. If you are one of these unfortunate ones that yeast is driving batty, here are some ways to get at the root of the yeast problem for good:

First off, is it really yeast? If swabs came back clear then:

  • Repeat the swab. Lab tests aren’t fool proof, sometimes mistakes are made.
  • Itching, burning, irritation and discharge signify vaginal irritation, but not necessarily from yeast. Look for another possible cause such as bacterial overgrowth (bacterial vaginosis), food sensitivities, allergies to latex condoms or spermicides, vaginal dryness, hormone imbalances and even allergies to semen.

If vaginal swabs did show yeast and symptoms improved with yeast treatment but yeast came back. Then we have to ask, why is your system so receptive to yeast? Here are some possible avenues to explore with your naturopathic doctor:

  • Pregnancy
  • Birth control pills  and HRT
  • Antibiotics
  • Inadequate progesterone production
  • Disordered glucose metabolism and diabetes 
  • A weakened immune system
  • Use of vaginal hygiene products, such as douches and bubble bath that alter the vaginal pH
  • Iron Deficiency Anemia
  • Anti-fungal resistance
  • Changes in vaginal pH throughout the menstrual cycle.
  • Sexually transmitted reinfection

A naturopathic physician can help balance hormones, restore healthy vaginal and digestive tract flora, correct iron deficiency and improve immune function for lasting improvement from recurring yeast infections.