Hormones and Menopause

Dear CE,

One of the most frequently discussed topics in healthcare today is menopause. The common perception of the "change of life" is that it is a disease, which could not be any further from the truth. Menopause is defined as 'the end of menses" and is merely a change that occurs in the female reproductive system, as it naturally transitions from the child birthing process of life.

The body no longer requires as many reproductive hormones and begins reducing their production. As a result, a woman's body changes, sort of re-wires" itself to adjust to the changes. Importantly, these years just prior, during and after menopause are the most crucial years in the health of the women and should be looked after carefully.

As the "mothering" stage of a woman's life ends and the body begins to program the hormonal changes, symptoms of hormonal imbalance may occur. These symptoms can occur years before a woman experience menopause, during what is commonly known as pre- or peri-menopause. Potentially, a woman can experience problems lasting several years, including hot flashes, "night sweats", muscle aches, sleeplessness and anxiety. Some of these symptoms have been known to last throughout the transition. That's the bad news.

The good news is that woman addressing their health and wellness can reduce, relieve and eliminate these symptoms. An entire field of medicine has been developed to address these concerns, as well as try to help prevent diseases that are of an increased risk during these times, such as hormone-related cancers, heart disease and osteoporosis. This field of medicine, known as hormone replacement therapy, provides many approaches to menopausal health, with varying levels of success in treatment.

One thing is clear; a woman (perhaps for the first time) needs to take a long look at their health. She will need to be aware of her family's predisposition to diseases related to the menopausal change, such as heart disease and breast cancer. She will need to discuss her health and any potential therapies with her physician.

Hopefully, she will also look at how her lifestyle choices can affect her desired goal of health and wellness in post-reproductive years. Indeed, the good news is that we now know that attention to diet, exercise and weight management can naturally reduce any problems associated with hormonal transitions and (indeed) build up the body to insure a longer, healthier and happier life.

Hormonal Balance

The body uses a delicate balancing system to properly utilize its hormones. Menopause can cause a "tweak" in this balance as reproductive hormonal production occurs. When the imbalance occurs, it usually is related to a deficiency of either estrogen or progesterone, a competition for these hormones created where they are received, (at the hormone receptor site) or problems in elimination of the hormones.

As ovarian hormone production ends, other places in the body continue to produce these hormones for bodily functions not related to reproduction. Estrogen, for example, is important for the maintenance of the skeletal structure and muscles. Our bodies are stronger when hormones are available to keep our muscles denser, which also keeps our supportive bones stronger. Osteoporosis is a deterioration of skeletal tissue, but has its roots in muscle and hormone imbalance. It is important that we are healthy and that our stress levels are low, so that our body can continue in this process of bone and muscle strength and much depends on hormone balance and proper use of vitamins and minerals to keep the body strong.

Since the heart is the most important muscle, it can be directly affected by hormone imbalances. But once again, knowing how to properly treat our heart can help to offset any concerns from menopause. Exercising the heart becomes a much more important NECESSITY as we age and studies already show that exercise is the single most effective way of reducing menopausal symptoms. Further, the relationship between healthy eating and heart health is well known. Providing the body with adequate vitamins and minerals is as important as exercise in maintaining energetic muscle and health tissue.

Hormone Replacement Therapy

Medications have been developed that can offset this imbalance, a field of medicine known as hormone replacement therapy. Both synthetic and natural approaches to this therapy do exist, but both have created controversy. A recent large clinical trial of certain hormone replacement medications was stopped when the results showed it to be too dangerous to continue the trial. Many women taking the medication have since consulted with their physicians and pharmacists to discuss options to their current regimen.

The therapy is designed to help balance the hormones and, in doing so, alleviating the symptoms and maintaining strength. Although certain women are strongly recommended to consider hormone replacement therapy, it is not a necessity for all women. Studies would suggest that there are elevated dangers related to hormone replacement therapy and both the woman and their physician should consider this.

Physicians are taking a closer look at bio-individual hormone replacement therapy, in which prescriptions are created based on your physician's tests for hormone imbalances. This is perhaps a more targeted approach to balancing hormones. Often progesterone creams are employed to aid in negating the competition at the receptor site, reducing excess estrogen activity and aiding with many symptoms. In a woman's body the majority of progesterone is secreted by the corpus luteum, which forms in the ovary following ovulation. During the second half of each monthly cycle, from ovulation until menses, progesterone is designed to be the dominant hormone. Not all women produce sufficient amounts of progesterone during the second half of their cycle.

Prior to menopause, as ovarian function wanes, cycles frequently occur where a woman does not ovulate (known as an anovulatory cycle). This period leading up to menopause is referred to as "perimenopause."

Anovulatory cycles that begin in perimenopause can lead to hormone changes that may result in hot flashes, changes in bleeding patterns, PMS-type symptoms, as well as many other menopausal symptoms. While progesterone levels fall close to zero due to anovulatory cycles at menopause, estrogen levels may only decline to about 40-60% of pre-menopausal levels.

Progesterone has a number of important roles relative to menopause. It is the natural balancer to estrogen, as well as being necessary for optimum estrogen utilization. Research over the years has also revealed other vital roles of progesterone on the heart, blood vessels, nerves and brain. Many women find that supplementing with progesterone allows them to achieve a balance once again. It is important to consider that the least invasive strategy of hormone replacement it the safest manner to approach the transition.

Natural Approaches to Supporting the Menopausal Transition

Many physicians and pharmacists are also looking at what is termed natural hormone replacement therapy, in which certain botanical products are showing positive results in balancing hormone levels as well as aiding with the symptoms of the transition. It has been shown that certain "phyto-hormones", such as soy isoflavones and botanical agents can be effective in reducing the symptoms without resorting to traditional hormone therapy. Many women reason that trying these products first and finding relief can keep them from a more invasive hormone replacement therapy.

Other products are also available without a prescription to address symptoms, such as black cohosh, wild yam and Indole-3-carbinol, perhaps one of the best products on the market to help balance and eliminate dangerous estrogens.

As I mentioned, the least invasive strategy for addressing hormonal balance is the best strategy. I always recommend that women consider addressing their health issues while looking at products that will address symptoms of menopause prior to considering hormone replacement therapy. Studies already show that cardiovascular exercise is the best way to help quell symptoms of imbalance. We also provide a diet plan to our patients that will help. For more information about our diet plan, e-mail me for an appointment here.)

We carry a wide array of products to help address the symptoms of imbalance related to menopause. We address the problem of protein balance, which can be an issue at this stage of life. We provide products that will help to quell symptoms of night sweats, hot flashes, and mood. I recommend your consider these products prior to considering the influence of hormones. We provide products that will help to balance your hormones, with the use of phyto-estrogens and progesterone.

It may be important for you to call us first, so that we can help you decide which products fit your symptoms, your family background and your state of health. We conduct consultations on an ongoing basis and are happy to help you approach your menopausal years with good health, a calm, clear mind and healthy attitude. Call us at 504-888-3077.

1.Heart disease is rare in pre-menopausal women
2.Heart disease (including hypertension and stroke) is the most frequent cause of death in women over the age of fifty.
3.Heart attack, though usually occurring later in life, is twice as deadly in women as men.
4.One in two women will eventually die of coronary artery disease or stroke.

Cardiovascular disease has emerged as the number one killer of women past menopause. Women are at an increased risk for heart attack during and after the change occurs. Studies banter back and forth regarding the safety of the heart in relation to hormone replacement therapy, suggesting in some that estrogen replacement protects the heart and in others that areas of the cardiovascular system may be at added risk with hormone replacement. While other benefits are touted, hormone replacement therapy is not without risk, including hormone-related cancers, such as breast and uterine. One thing remains clear: it is important to protect the heart from the onset of menopause and thereafter. Recent studies (HERS and ERA) indicate that hormone replacement does not decrease the incidence of heart attack in women who already have heart disease and in fact may actually increase the risk for a while. For this reason alone, it should be considered prudent that all women take added measures to protect their cardiovascular system.

Free radical activity seems to increase with the onset of menopause. The added dangers of pollution, past or present smoking activity, sun exposure, and diets high in trans-fatty acids all contribute to a free radical load that exceeds the antioxidant defense systems in place within the body. Antioxidant supplementation is, therefore, not only essential for the cells that make up the major organs, such as the skin, but also in particular for the protection of the heart. Warning signs, such as heart palpitations, are clear indicators of added stress burden on the heart and, although they are considered hormonal in nature, the heart begins to suffer as a result.

The truth is that women at menopausal age are simply at greater risk for heart related conditions. A women's increased risk is associated with family history, lifestyle factors such as smoking and lack of exercise and predisposing factors such as high LDL cholesterol and triglycerides. Further, adjunct menopausal problems such as stress, anxiety and depression contribute to a weakening of the heart and circulatory system. Women with periodontal disease and diabetes are at a higher risk, as are those with poor diets and sedentary lifestyle.

Cholesterol and Menopause

It was once considered conventional wisdom that estrogen and hormone replacement therapy would lower LDL cholesterol levels and raise HDL levels, providing added protection from the cholesterol role in cardiovascular disease. No research to date has proven this theory, of it had not only would women be on estrogen, but all men over 40 would be candidates for the drug as well. In fact, estrogen in the body is only one factor that improves blood lipids associated with heart disease. Lack of exercise, lifestyle and diet are considered more important factors in maintaining proper cholesterol ratios and reducing cardiovascular risk.

For all the above reasons, it makes sense to supplement any diet less than perfect, with nutritional programs designed to benefit the heart.

Homocysteine levels are a strong risk factor. Nutritional supplements are now considered mainstream methods of reducing the amino acid levels that can contribute to heart attacks. Vitamin B6, B12 and folic acid all play a supportive role in this process (and no medication has been found, to date, to provide more protection).

Antioxidants will provide added protection to the heart, above and beyond anything the diet offers. Recent studies indicated that several antioxidants, found in fresh foods, were found in significantly less levels than previously thought, forcing the American Heart Association to reconsider its strategy on antioxidant nutritional supplements.

Calcium plays an important role in the heart. Adequate calcium levels will help keep blood pressure normal and works in tandem with magnesium to support the muscles and bones.

Magnesium, not for so many functions related to menopause, plays an important role in heart health. It stabilizes electrical conduction in the cardiac muscle, important for those suffering from palpitations and neuromuscular excitability. Magnesium also helps to relax smooth muscle tissue in blood vessels. Magnesium has the side benefit of aiding in the sleep cycle and maintaining muscle mass, which is a contributing factor in bone strength.

CoEnzyme Q10 affects all cells, but is found in higher levels in the heart tissue; ten times that of other tissues. Any condition that affects the heart leaves it open to greater free radical damage and this is the best reason to supplement this nutrient. High doses of the nutrient have been shown to reverse several cardiac dilemmas, including cardiomyopathy. It provides added energy and is a powerful antioxidant. It improves the heart muscle's ability to pump blood and is also important for breast health. CoQ10 is depleted in women that take statin drugs to improve cholesterol levels. Studies show that almost half the patients with hypertension are deficient in CoQ10 stores.

Vitamin E helps to keep blood platelets slippery, which lowers the risk of blood clots and, by extension, the risk of death from coronary artery disease. Studies patients taking vitamin E exhibited a lower rate of heart attack than those not taking the supplement, and another study showed a 77percent reduction in cardiovascular disease over a year's time for those taking 400 ius of the nutrient. Vitamin E is the "Heart Smart" nutrient.

Vitamin C protects the endothelial lining of the blood vessels and has also been found to aid in the absorption of calcium and magnesium. A gram a day has been shown to reduce diastolic blood pressure in menopausal women.

Carnitine is an amino acid that plays a significant role in heart health, protecting the hat, reducing fatty deposits and helping to regulate blood pressure.

Other nutrients that play a role in cardio health include selenium, alpha-lipoic acid, proanthocyadinins, B vitamins, and potassium. Sodium-induced hypertension may be relieved by taking a potassium supplement and positively offset the ratio of sodium to potassium, responsible for water retention, both a risk factor for heart disease and an uncomfortable part of menses health.

For more information about cholesterol, as it relates to overall health and cardiovascular function, click here to go to our article in the heart section of this site.

Questions about Health?
Ask "Mike"
For Consultation with Jerry "Michael" Casso R.Ph.
Phone: (504) 888-3077



Dear Mike,

My husband and I are trying to conceive, but have not had much luck. I understand you know a bit about fertility and nutrition. I wondered if you had any information about the nutritional approaches to conception. We would like to make sure we are fortified nutritionally prior to seeking fertility help.

JM, Mandeville

Dear JM,

I sure appreciated your letter and it is a great thing to see people taking responsibility or their health and the health of their as yet unborn child. I am happy to share with you and will include some great information about the birthing process as well.

Nutritional influence on the process of reproduction is complex, in that each participant in the process must have optimal levels of nutrients. Many physiological factors in conception require proper nutrition, which in turn influences hormones, sperm, eggs, and organs important in the growth and maturation of the fetus.

In spite of the millions of dollars invested in fertility studies and treatment programs, infertility problems remain a mystery. The lack of results from treatments further elevates the problem by creating a situation of stress, which could in turn serve as yet another damaging element. The combination of nutritional, hormonal, physiological, mental, and psychosocial contribution to the process must be properly addressed in each of the partners, to eliminate problems and allow for full concentration of problems not yet qualified. The process of stimulating the reproductive system through nutrition should be considered first protocol, before consideration to high tech solutions is given.

It is clear that nutrition plays one of the key roles in a comprehensive fertility program. By definition, infertility is a lack of conception after one year or more time in attempts at conception. Before anyone considers them selves candidates for fertility treatment, they should know what types of foods might help in conception, as well as any non-invasive treatments are available.

Figures suggest that 20% of adults in childbearing years have conception problems. Each gender has specific nutritional needs. The causes of infertility may be classified into four major categories; (1) the female factor, (2) the male factor, (3) combined factors, (4) unexplained infertility. While it is difficult to assign exact percentages to each category, it is generally reported that the female factor accounts for 35% of cases and 30% attributed to male factors. In 20% of cases, abnormalities are reported in both partners, and in 15% of cases no diagnosis can be made after complete investigation.


Male Nutrition and Fertility

Micronutritional considerations for women are more complex than male counterparts because so many uses of both nutrients and precursive nutrients are necessary in hormonal production and regulation. Further consideration to nutrients that may have become depleted or displaced in the course of hormonal therapy should be considered. Men facing the possibility of infertility must consume the proper nutrients for sperm production. Lower sperm counts may only be a part of the puzzle, as well as the age of the potential mother. Another problem may well be the state of the modern lifestyle and the evolving body.


Antioxidants are Important for Male Fertility

The majority of research conducted in the area of nutrition and male infertility is in nutrient classification of antioxidants. The effect of oxidative damage on sperm function and fertility has been of interest to specialists. Free radical damage is associated in semen of men sustaining subfertility.

These observations have led to a search for the vital nutrients targeted to protect against oxidation. Vitamin E has been found to be an effective antioxidant in improving sperm-oocyte fusion in vitro. Studies also indicate the use of selenium (200mg) with vitamin E (400iu) in synergy increased sperm motility, increase percentage of live sperm and increased percentage of active spermatozoa.

CoQ10 levels are also a critical nutrient in the fertility process. There is a significant correlation, by several studies, between CoQ10 levels and sperm motility. Co-enzyme Q10 is a component of cellular energy and plays a role in the body's entire energy metabolism. Coenzyme Q10 could play an essential role in the motile activity of the sperm. It also has an antioxidant capability, which could help protect the sperm cell membranes from oxidative insult.

Vitamin C has long been associated with fertility. Vitamin C may benefit fertility through its ability to promote collagen synthesis, its role in hormone production and its ability protect cells from free radicals. Vitamin C accumulates in tissues of the ovary and testis. Vitamin C may prevent these cells from free radical damage during production and fertilization.

Zinc deficiency leads to problems. Zinc deficiency can result in a depletion of testosterone and inhibition of spermatogenesis in males. Glutathione is another antioxidant that may play an important role in the process of fertilization.

Other nutrients are mentioned in studies related to fertility. Chromium, niacin, and magnesium are all considered important nutrients and lower levels of these nutrients have been reported in males studied for infertile situation. Male impotence due to medication influence or prostatic function should also be addressed.


Female Nutrition and Fertility

Hippocrates argued, "Let foods be thy medicine and let thy medicine be food." There are many conditions in which a dietary influence may affect a medicinal change in reproductive status in women. The female factors noted with infertility suggest that obesity is a key consideration. Maintaining proper body fat percentages should be considered a life long goal and not a short-term solution to a health condition. In many cases of infertility, even when weight management is the key issue, chronic negative eating patterns should be considered.

Recent research is showing the importance of eating certain foods to provide the neonate with the necessary nutrients for proper cognitive and endocrine development. Consideration to the proper dietary influences for weight management and optimal health will also accomplish the "smart foods" approach for the neonate. (See essay on Birthing Nutrition.)

Dieting during attempts at conception is not recommended. Diets concentrating on gradual and crash formulas for weight loss could cause infertility itself. Dieting can create a lowering of progesterone and slow down follicular growth, which inhibits the surge of luteinizing hormone (LH) and prevents ovulation. This could also be dangerous in fertile situations, as the reduction of corpus luteum could lead to miscarriage.

Women planning pregnancy should eat regular and healthful meals. A diet that is barely adequate for the women is sure to be inadequate for the developing fetus, which could lead to birth defects and inadequate birthweight. Therefore, it should be considered inappropriate to consider conception when engaged or recovering from amenorrhea.

Women with chronic PMS are also at risk of low levels of progesterone. Consideration to supplementation with vitamin B6 (50-200mg) to counter both the occurrence of PMS and give nutritional status to many functions important to the body, particularly to the immune system and the reproductive function. Many nutritionists suggest that B vitamins are an important part of the overall reproductive health of women, and a formula for these nutrients is should be considered in conception planning, particularly for those individuals previously on a birth control pills or hormone therapy. These medicinal regimens have been shown to reduce the levels of these important nutrients, including folic acid, a depletion of which has been proven to lead to neural tube defects.

Current guidelines now recommend that all women of childbearing age who are capable of becoming pregnant consume 0.4 mg of folic acid per day for the purpose of reducing their risk of having a pregnancy affected with neural tube defects. Patients who have had a fetus with a neural tube defect should be advised to take 4 mg of folic acid daily preferably starting 1 month before planning to become pregnant and continuing through the first 3 months of pregnancy.

Infertile couples should both consider a balanced and targeted nutritional supplement regimen during the conception period. This should include a good multivitamin, a mineral complex (for added iron, calcium, manganese, and chromium), an essential fatty acid supplement (heavy in omega-3 oils), and added B-vitamins (with the designated levels of B-6 and folic acid), deficiencies of which are related to infertility.

Attention to the gastrointestinal influence on reproduction should also be addressed. Women suffering from fungal or parasitic conditions may also have fertility problems and the need to have these conditions addressed should precede attempts at conception. Decreasing sugar intake, increasing essential fatty acids and protein, and supplementing with probiotic cultures should be a part of treatment for candida, and a synergistic protocol with nystatin or flagyl prescription.

The need for individualized nutritional counseling should be addressed during the preconception period. A well-balanced diet should be recommended. Vegetarians should be encouraged to increase their milk and egg intake and to use vitamin and mineral supplements. Iron-deficient women should be advised to build up their iron stores with iron supplementation in an effort to correct their anemia before conception. Caffeine intake before and during pregnancy is associated with an increased risk of fetal loss, supporting the US Food and Drug Administration's recommendation to pregnant women to reduce their caffeine intake. It is also considered, as is alcohol, with infertility concerns in men. The belief is that these substances leech zinc and associated minerals from the system, which could affect sperm count and function.


Foods to Consider for Fertility

Listed below is a partial listing of foods which may have a nutritional influence, based primarily on the micronutritional constituents of the food, in the process of reproduction:

* Consume foods high in vitamin B6. Although most foods contain some measure of this important nutrient, higher levels may be found in cauliflower, watercress, spinach, bananas, okra, onions, broccoli, squash, kale, Brussels sprouts, peas and salad greens.

* The recommendation for green vegetables is five to seven servings a day, for both men and women, not only to improve an infertile dysfunction, but also to protect the body against certain cancers, including ovarian, endometrial, and gastrointestinal cancers.

* Foods high in folate are obviously a wise choice. And a number of foods have good levels, including spinach, endive, asparagus, parsley, okra and cabbage. Since these foods are also high in zinc, they are good food choices for both genders.

* Protein sources prepared properly will increase essential fatty acids in the body and provide for optimal amino acid metabolism. These sources include cold water fish, including salmon, trout, and halibut. Venison and other lean wild game are also suggested. Soy sources of protein may also be considered. Soy is an excellent protein source for women, but caution should be considered if there is evidence of hormonal cancer history. Soy is estrogenic, containing healthful isoflavones, but creation of an estrogen-dominant situation may be deleterious to progesterone levels and ovulation.

* Certain amino acids have been linked to fertilization, including arginine, which had been linked in deficiency with poor sperm motility erectile dysfunction. The amino acid methionine has been suggested in cases of premature ejaculation. Foods high in arginine include sunflower seeds (unsalted, raw is optimal), carob, butternuts, sesame seeds, soybeans, fenugreek, mustard, almonds, and lentils. Carnitine is another amino acid found in concentration in healthy sperm. Carnitine is considered a nonessential amino acid, in that it is manufactured in the liver from other amino acids and does not need to be consumed through a food source. Carnitine has been used in supplemental form for other functions, including fat metabolism and cardiovascular health.

* Both partners need foods high in vitamin C. Among foods high in vitamin C are guava, peppers, citrus fruits, broccoli, cauliflower, spinach, melons, greens, and berries. The use of food sources high in

* Vitamin C has been directly influential on sperm. Studies conducted with supplemental vitamin C have been shown to be as effective as several fertility-enhancing drugs, in doses of 1000 mg. daily.

* Use antioxidant foods, rich in vitamin C and carotenes, including vegetable sources with color. Antioxidant deficiency is linked with sperm problems in men. Foods rich in zinc, a principal component of male reproductive function, should be considered if the fertility problem is a male factor. Good sources of zinc include spinach, potatoes, greens, sprouts, string beans, and asparagus. Consider snacking on pumpkin seeds for added zinc. The raw, unsalted seeds are the richest food source of zinc known.

* Foods and supplements that contain good sources of choline are recommended. Several studies have shown deficiencies of B vitamins and choline (a "distant cousin" to the B vitamins) is associated with infertility. Choline plays a valuable role in maintaining cellular energy and cognitive function. It is also associated with pre- and neo-natal health. Good food sources of choline are lecithin and fenugreek. Peas, mung beans, lentils are also good sources of this important nutrient.


Botanical Considerations for Fertility

The problem of infertility has been addressed throughout recorded history through the use of herbs. There are some studies to indicate a clinical acceptance, but many are strictly anecdotal. The list below makes no distinction, and should be viewed as an introduction of an herbal program, which may require additional investigation.

For Men:

* Ginger has been used for problems with fertility in many cultures for many centuries. Research has shown that ginger significantly increased sperm count and motility in animals. Animal studies in fertility should be considered, as mammalian reproductive systems are all quite similar. Ginger may be used in supplemental form, as well as food sources including ginger tea, ginger ale (natural source), and in baking and cooking with the herb.
* Panax ginseng is an herbal treatment for fertility that is standard protocol in Chinese medicine. This long-touted tonic for longevity and energy is also known as a male potency tonic, and animal studies suggest that ginseng does stimulate sexual activity. Concern over imported ginseng laced with contaminants is a constant challenge, so obtain a reputable standardized extract. Ginseng is also considered estrogenic.
* The Ayurvedic herb ashwaganda is this medical culture's form of ginseng, known for its historic use as a male tonic for libido and sexual function. The herb astragulus is also known for this function.
* The expression "sow your wild oats" has some validity. Wild oats (Avena Sativa) are well known as a sexual tonic for males and many herbalists believe oats are important for infertility as well. Oats are found cheaply in a natural foods supermarket, or in extracts and capsule form.
* Other stimulant herbs used in male potency include muira puama, sarsparilla, yohimbe, and tribulis terristris. These herbs work by increasing testosterone response, which may be a concern in males. It is not recommended to use these herbs, or any testosterone-enhancing supplements (or steroids) on an ongoing basis. It is also suggested that males with cardiovascular problems refrain from usage of yohimbe, which is known to raise blood pressure in certain individuals.
Products for male potency can be found by clicking here .

For Women

* Chaste tree berries (Vitex) have been throughout history as an aphrodisiac, and have since been approved by the German commission E report as a prescriptive for PMS and irregular menstruation. Vitex has valid method of action in increasing luteinizing hormone (LH) and inhibiting the release of follicle-stimulating hormone, which alters the estrogen/gestagen ratio in favor of ovulation. For this reason, the herb has been used to regulate the menses cycle. The diuretic ability of vitex is noted, as is its use in treating secondary amenorrhea, as well as its benefit as a lactogogue, in enhancing lactation.

* Dong quai (Chinese Angelica) is one of the most respected herbs in the world and could be considered the yang to Ginseng's yin. Dong quai is used in many parts of the world as an important part of menstrual treatments. It aids in estrogenic function, and has been used for circulatory aspects of fertility, aiding in pregnancy-related pain, and importantly, in amenorrhea. The herb has other actions to consider in fertility, including smooth muscle action, which aids against cramping, and uterine support action. There are a number of interaction considerations with medicines, and it is wise to consider current medicinal regimens with the use of herbs with circulatory and estrogenic effect. Heparin and coumarin anti-coagulants are contraindicated.

* False unicorn root is considered by many to be the safest and most efficacious uterine tonic available. The herb has diuretic ability and has been used in reproductive function in both genders. It is listed in the British Pharmacopoeia as a uterine tonic, and is used in amenorrhea, ovarian dysmenorrhea and for cases of threatened miscarriage. It is considered quite safe and well tolerated.

* Blessed thistle is an herb often found in reproductive herbal formulas. It is used primarily in treating painful menstruation and has been used in combination with red raspberry leaves to promote and enhance lactation. It is often used in combination with the above-mentioned herbs, for a couple of reasons. It aids in the digestibility of herbs, as well.

* Red Raspberry is an herb used primarily to calm uterine irritability, but has been used in a comprehensive naturopathic formula for infertility. Many animal breeders add the leaves of this herb to feed to stimulate fertility. It enhances the process of lactation and has also been suggested in use with men. It can be found in extract or tea form.

Other considerations

* There are many studies currently in progress that are questioning the influence that heavy exercise may have on amenorrhea and the ability to conceive. Despite concerns, an ongoing prospective study has been unable to detect an increased incidence of infertility in >200 women who continued regular, sustained, endurance types of recreational exercise throughout the peri-conceptional period. If the female factor is a consideration when an athlete is in question, it would be wise to examine these studies.

* Meditation and aromatherapy promote a holistic approach to the fertilization process. Both partners must maintain optimal stress levels and meditation (prayer) has been shown to aid in the reduction of stress and benefit concentration. Aromatherapy blends have been formulated for the fertilization process, and are specific to the gender in crisis, as well as aids in conception strategies.

* Stress reduction and blocking issues may play a role in the fertilization process. It is important for both parties to be committed to the process of procreation, and counseling in some form may be helpful in this process. Consider Reiki massage, hypnotherapy or energy work as complementary therapy in this process. Detoxification programs and cleansing rituals have also been touted by several cultures for fertility purposes, including the Hindu practice of Panchakarma.


Environmental Theories in Fertility

Over the past one hundred years, the human body has been forced to begin an evolutionary journey unprecedented in physiological history. Technology and medicine have expanded the borders of life since 1900, and the incredible rise in the average life span proves this. Some theories suggest that the rate of fertility may be adversely tied to the technological advancement.

This century, advancements in medicine, petrochemical usage, and the creation of new materials such as plastics have each brought the world a better expression of advancement than all the previous centuries combined. The use of chemical mediators in agriculture has slowed the flow of bacterial influenced illness in the developed world. New methods of growing produce, packaging and preparing foods for market, and the newly emerging field of genetically-engineered foods are all innovations of the past century. As a result, most people on the planet do not live in an environment similar to their ancestors of a hundred years ago.

It has been noted that pollutants and pesticides are estrogenic, meaning the chemical compound constituents may mimic the female sex hormone. If the lengthy exposure to estrogenic activity in males exists, a feminization may occur, and reduced sperm count could result. Shrinking male sex organs in animal studies focused on pesticides indicates that this may be true. While the debate continues, and the chemical industry backs studies to counter this argument, it is important to consider the effect of all pollutants on the population.

The introduction of building materials to the domicile brings a strong measure of comfort and many items not invented in 1900 are now taken for granted as a part of living. With these improvements in the home may potentially come dangers however. Reports of chemical sensitivities to carpet, findings related to asbestos poisoning and additional reports of air-borne allergies can all be considered illnesses of modern technology.

One of the aspects of modern living that may be most influential in the process of fertilization is diet. Studies examining the influence of diet over this century indicate that the shift away from diets rich in organic vegetables and fruits, replaced by diets high in simple sugar, preservatives and other elements of processing may be responsible for many illnesses, including the rate of fertility. Influence in the gastrointestinal tract is a marked example, with the association of cancer in the alimentary canal and a reduction of fiber in the typical diet. Many such studies are perhaps a sound basis of the "return to organics" movement.

Whether there is validity in the cultural argument toward the consumption of living foods opposed to refined and processed foods, it is important for potential parents to consider their diet. It should be considered both in terms of nutrients necessary for the process, but also for nutrients that may help in the natal growth and maturation function. The old adage, "eating for two," must be considered as a rallying cry for additional healthful foods, not a signal to add an extra scoop of ice cream or other craving to the daily intake.

According to several governmental reporting agencies, the increase in sugar and sugary foods is astounding. At the turn of the century, the average American consumed six pounds of sugar annually. The last report in this decade suggests that people are now on average, consuming sixty pounds of sugar. This influence on the gastrointestinal fermentation is considered by many nutritionists to be a most deleterious occurrence. Incidence of diabetes, immune problems, and cognitive/neurological dysfunction may all have roots in this shift in the diet.

The absorption of nutrients and lipids in the GI tract is crucial for the process of reproduction. Paying close attention to the health of the gastrointestinal tract and the amount of sugar (simple carbohydrates) in the diet can make a healthful difference in the process of reproduction. Paying close attention to the environment may also be an important part of the process. Certainly, paying close attention to all the aspects of fertility, and protecting the peri-natal process through proper nutrition may make a difference in the infertile or subfertile condition.

Prior to expensive therapy and fertilization procedure, consider a holistic approach to the process of fertilization. It will provide benefit, regardless of the outcome, and certainly will pay off as an important safeguard, should a high tech fertilization program be used. Perhaps the most crucial aspect of nutritional influence in this process is the preparation a mother needs for the best possible conception and neonatal health of the child, should the fertilization process be successful.

JM, I hope I have been helpful in offering you information that you can use. I might also recommend some nutritional products for several types of problems mentioned in the article, but would really like you to consider contacting me for a consultation prior to recommending anything. You can contact me on the website or give us a call at the Wellness Store. And good luck, I know you have a great attitude and that is so important, particularly as you approach becoming parents. You will need a good attitude from now on! Below is a continuation of this important subject, with information about the process of birthing.



A healthy, happy mother-to-be improves the baby's chances for great health!

We have learned a lot about the birthing process. We have learned that babies stand a much better chance if the mother thinks ahead, prior to trying to conceive. We have learned that proper attention to nutrition and exercise can not only help the mother-to-be produce a healthier child, but also help the mother after the birth in the nursing function. We have learned so much about the newborn child's cognitive development and know how to keep the mother healthy before, during and after the reproductive functions are complete. Our hope is that all mothers and mother's-to-be will use what we have learned. Take advantage of the information and provide your baby with the best of 21st century understanding.

Think ahead when planning for a "new arrival"

If you are considering having children (or more children), plan ahead. If you are taking an oral contraceptive, plan on discontinuing it 3-6 months prior to conceiving. Studies show that the medication can cause depletions of important vitamins. Deficiencies of some vitamins are tied to birth defects. The more time to prepare; the better potential for a healthy delivery of that "new arrival."

To give yourself the best possible pregnancy and birthing outcome, make sure you are in good shape before you conceive. If your diet is less than absolutely great, you will need to make changes. The greatest gift you can provide your expected child will be a healthy choice of foods…and you will feel better during pregnancy as well.

Eating foods with lots of fiber, lots of nutrients and lots of "good fats" will not only keep you happier during pregnancy, but will also set you newborn up to grow faster, stay healthier from birth and, potentially, develop more brain power!

Good diets can be difficult, but consider these tips:

* Fresh is BEST! Fresh foods contain more nutrients per ounce than processed foods. They also contain enzymes that help with their digestion. They are generally much higher in fiber than processed foods as well!
* Foods that contain more fiber will help you steer clear of a common problem associated with pregnancy, digestive and elimination problems. Generally speaking, the more fiber a food contains, the more nutrients it contains and the less preservatives are in it. Remember you are eating for two and good diet helps natal development.
* Choose healthy liquids to consume. There are a lot of herbal teas on the market that substitute for all the coffee you are used to drinking. It seems logical to avoid caffeine during pregnancy, but don't feel deprived. Instead, enjoy teas that are decaffeinated. Many herbal teas are touted by midwifes, who believe their usage make delivery easier. Ask an herbalist or midwife for more suggestions.
* Studies have already shown that certain essential fatty acids, notably DHA, are important for brain function in developing children. Babies that are low in DHA have associative problems, including potential development of Attention Deficit Disorder. Foods that contain DHA include nuts, avocado and cold-water fish, which is a great source of protein.
* Avoid cravings or make them healthy ones. Nuts, fruits, berries all contain healthful nutrients…so enjoy them! Fresh is best!
* Two months prior to delivery, I suggest you supplement your diet with a "probiotic" containing acidophilus, particularly if you have any signs of digestive problems, immune problems or yeast activity. You want to be your healthiest when you deliver and studies show this supplement can support your digestive and immune health.
* One month prior to delivery, I also recommend use of the B vitamin known as Pantethine. This nutrient is quite helpful in preparing the mother's body for lactation.


Exercise is so good for your body, your brain…and the baby!

Exercise should also be a daily activity. Building up your muscles prior to getting pregnant will help you so much during and after your pregnancy. You stand a better chance of carrying the extra weight without backaches, if you exercise the affected areas. You also want to make sure as much of that extra weight you gain is the baby, not you!

* Enjoy cardiovascular exercise, which will help keep unwanted pounds away and help you with your mood. Get your heart rate up every day if possible, for at least 30 minute. Walk, ride a bike, swim…there are so many ways. Look around the community for exercise classes that cater to expecting mothers.
* Breathing exercises will really come in handy, as they can be used even after the baby is born. Breathing helps our mind to remain calm and can enhance our mood at any time. Meditation exercises, visual imagery and, of course, prayer are all shown clinically to slow down our heart rate and blood pressure, as well as help control anger and stress.
* Don't confine yourself to exercise in your home. Get active in the community and continue to be a "social animal." There is no reason to hide your "growth." There truly is nothing more beautiful that a mother-to-be, so hold up your head and shoulders and strut your pregnant self all over town. The walk will do you good!

We recognize that these are simply common sense tips, but feel they are worth reading. It is the basics of good health that most dramatically prepares our bodies for the emotional, physical and loving moments in the birth of a new family member.

I am happy to provide you with a free initial counseling session on conceptual and pre-natal nutrition, to help you develop your program. Contact me or call the Wellness Store for an appointment. Have a great birthing experience by preparing yourself today. For products that will support the process of reproduction and birthing, click here.

Questions about Health?
Ask "Mike"
For Consultation with Jerry "Michael" Casso R.Ph.
Phone: (504) 888-3077


Midwifery and Home Birthing

Dear Mike,

I am considering a home birth and midwife service for my next child, and wondered if the herbal products used for birthing are safe. Can you offer any advice?

LK, New Orleans

Dear LK,

Debates rage on regarding the idea of home birthing and midwifery. Without knowing the circumstances of your health, previous births, or conditions that may signal the use of herbs, I can only offer some information that will, hopefully, keep your newborn and yourself safe!

Over the past twenty years there has been a strong movement to return to home birthing. Coincidently, there has also been quite the resurgence in the practice of midwifery. Midwifery is perhaps the oldest medical profession on the planet. Most cultures, including our own, have and continue to rely on the important services of these esteemed and caring people.

The practice remains strong in the United States and is supported by many professional disciplines and organizations. While many physicians that absolutely bark at the mention of midwifery, there are also many that support a woman's decision to have their children in the comfort of their home. A physician may be in attendance at the home birth, to support the efforts of the midwife. Conversely, many physicians employ the use of a midwife to support their efforts. Midwifes count many nurses among their ranks.

Midwifes and physicians team up to insure that a healthy pregnancy leads to a healthy birth. If your midwife suggests to you that a physician is not a necessary part of your birthing process, fire her and get another midwife. It is important to know what is expected of each participant in a birth. As the mother, you are expected to make sound decisions about your safety and the safety of your child. The physician will help you by performing the necessary tests, recommend the proper prenatal vitamins and keep you abreast of the internal status of your child, through visits and screenings.

A wise and ethical midwife will utilize the benefits of the physician in the process, and will help you to eat properly, exercise and make the proper lifestyle choices, preparing you for the birthing process.

It is crucial that you allow both practitioners to help you. It will take away any detectable dangers. Home birthing is usually recommended only for a healthy mother with a healthy pregnancy, but how will you know how healthy you are without help?

If you don't have the proper tests or you are counting on your intuition to lead you through the birthing process, you are not taking advantage of the 21st century knowledge, and that, I delicately suggest, is a dangerous approach.

In selecting a midwife, I recommend checking out the midwife association your practitioner utilizes. Ask your midwife is she is certified, and get all the referrals you can before deciding on the best person to place you and your newborn's care with.

Consult your library for more information about home birthing and ask your physician for information about it. The Internet is also a good resource for information about midwifery, home birthing and reputable associations in the practice, (mentioned at the end of the article). Your physician might also be helpful in this regard and may have worked with midwifes before.

Regardless of your decision to employ, please let your doctor know all you are planning, in order to help. Learn all you can, check your references and feel confident in your decision. Also consider how your family members will participate…and educate them.

Herbs in the Birthing Process

Your question referred to the use of herbs in midwife services. It is quite important that you do not use herbs unless you are thoroughly educated on their benefits and dangers. It would very prudent for you to find someone knowledgeable about these herbs, if your midwife is not.

There are a number of formulas and individual herbs that have been historically used to aid in delivery and nursing. My suggestion is that you don't take any herbal product without first learning of its uses – safety and benefits – prior to taking it. Know where the product is manufactured and if using raw herbs, where they were purchased. A couple of herbs a midwife may suggest are Chamomile and Red Raspberry Leaf.

Chamomile reaches across the centuries as a general relaxant for mothers-to-be and moms as well. It provides a general calming to the stressors that accompany any day in the life of pregnancy. Ask your midwife about its usage.

Red Raspberry leaf also has a long history of use by midwifes. This herb has been used for centuries to aid in relaxing the uterine lining prior to delivery, balancing the hormones relaxin and prolactin, and is also purported to aid in the process of lactation.

LK, this information should not, in any way, be used as a recommendation of herbal use for pregnancy. Each mother is different and can have successes…and problems… that are unique to their history and condition of pregnancy.

Finally, I would STRONGLY suggest that you consult with your physician and midwife, together if possible, and plan a safe and sound strategy for your home birth. Your stress will be lightened by having all the information you need, and your baby is in better hands, when there are a number of hands involved.

Resources for home birthing include the National Association of Childbearing Centers, the American College of Home Obstetrics and the Association for Childbirth at Home International. The American College of Nurse-Widwifes (ACNM) and the Midwifes' Alliance of North America (MANA) are also two excellent sources.

An excellent primer on home birthing is available from Dr. William Sears and Martha Sears, RN. It is (naturally) called The Birth Book and is published by Little, Brown. The Sears are well known in the birthing field and their books are great resources for the home.

Take advantage of education, information and good advice when making such an important decision as the birthplace of your child and who will help make it a healthy and happy experience. Whether your birth is at home or the hospital, your state of health is the most important consideration you can make. For products that will support the process of reproduction and birthing, click here.

Questions about Health?
Ask "Mike"
For Consultation with Jerry "Michael" Casso R.Ph.
Phone: (504) 888-3077


Oral Contraceptives

Dear Mike,

I have been taking an oral contraceptive for five years and am considering having children now. I saw a magazine article that stated I might have risks to consider. Do you have advice about this?

FR, Gretna

Dear FR,

You have asked a very good question, and I certainly can offer some suggestions about preparing your body for childbirth. I have also seen articles about the risks of contraceptives, and I always suggest that you consider talking to your physician about them.

The popular press is quite limited with healthcare advice. Due to space restrictions and lack of good data, many articles simply issue warnings and leave you high and dry about the next step. While the press is not always to blame for this, I believe getting good advice from a qualified healthcare professional about all drugs and their effect on health is important.

Preparation for conception and childbirth is perhaps one of the most important strategic elements in a woman's life. Supporting the body's reproductive functions through nourishment and lifestyle can certainly make a difference between a healthy baby and one with problems.

I always counsel women taking oral contraceptives to consider nutritional elements of their health prior to conceiving. I do this because many of my patients do not tell me when they are thinking about discontinuing their regimens. I hope all women consult their physicians prior to doing this, as there is important information about preparing your body for this important event. I will share some of this with you in the hope that is spurs you to get all the information you need.

Oral contraceptives have been shown to deplete certain vitamins from the body, and I find it interesting that these wasted nutrients may be responsible for some of the side effects of the drug. There are a number of reported depletions of vitamin C and B vitamins in patients taking "the Pill." Included in these depletions is folic acid.

Folic acid deficiency in women is the subject of several studies that has prompted the FDA to issue a warning about low levels of folic acid and the occurrence of neural tube defects.

Other B vitamins depleted by orals include vitamin B-2, B-12, B-5, and vitamin B-6. Let's consider how this may affect users. Vitamin B-6 depletions may cause symptoms of depression, anxiety, sleep disturbance and irritability. These are among the considered side effects of oral contraceptives. Vitamin B-2 losses may also show symptoms of headaches and dizziness. Vitamin B-12 depletions are linked to anemia, chronic fatigue, drowsiness and headaches. These problems also occur in patients with orals.

I always counsel women taking oral contraceptives to consider supplementing their diet with a B Complex formula. I have noticed many side effects diminishing or disappearing as a result of the advice. Other depletions that may occur with contraceptive use include calcium, zinc, magnesium, and manganese. I suggest that women consider a using a mineral supplement as well, to offset these depletions and safeguard against future problems with bone and muscle health.

Like the popular press, I hope I have prompted you to seek more information about your medications and how to support your body during conception and childbirth.

For more information, contact me or stop by the Wellness Store. And good luck with this most important event in your family's history.

Mike Casso, R.Ph.

Questions about Health?
Ask "Mike"
For Consultation with Jerry "Michael" Casso R.Ph.
Phone: (504) 888-3077