June 2015

Why I am Backing Sweetening the Pill, the Documentary

Published on June 29, 2015

3280 views

There are just three days left for the Kickstarter campaign launched by Ricki Lake and Abby Epstein to raise the $100,000 needed to make their next documentary. Inspired by the provocative 2013 book Sweetening the Pill: Or How We Got Hooked on Hormonal Birth Control by Holly Grigg-Spall, Sweetening the Pill, the documentary, aims to fairly critique hormonal birth control and raise awareness of non-hormonal alternatives. Lake and Epstein hope to do for birth control what their acclaimed documentary The Business of Being Born did for birth, get us thinking beyond a one-size-fits-all approach. Currently for contraception, that one-size approach is all about synthetic hormones packaged as—what are now being called—modern contraceptive methods.

Will this film ever get made? I bloody well hope so, and so should the thousands upon thousands of women who have experienced side effects associated with hormonal contraception, from those considered a mere nuisance, to adverse experiences that impair quality of life, to those that threaten a woman’s life itself.

I am not an alarmist, although I do believe that young women dying, however rarely, because they are using hormonal contraception is an unacceptable outcome, especially when safer hormonal and non-hormonal alternatives are available. Women’s health and safety absolutely matter to me, but I want this film to be made so that issues I have been advocating about for 30 years will finally get an accessible, comprehensive public airing.

With that said, here are five take-aways for viewers that I am expecting from the documentary Sweetening the Pill:

1) Hormonal birth control does not, has never, and will never regulate or normalize periods.

There is a false belief held by girls and women of all ages that problem periods are regulated or fixed by taking the Pill. Periods on the Pill are shorter and lighter because they are not real periods. Lara Briden, ND, author of Period Repair Manual: Natural Treatment for Better Hormones and Better Periods, sets the record straight in this June 3rd piece for Hormones Matter: Pill Bleeds are not Periods.

2) Contrary to what women are constantly being told, there are health benefits to consistent ovulatory menstrual cycles. By suppressing ovulation and normal menstrual cycle function we are, over time, depriving ourselves of these benefits.

You won’t get this information from your gynecologist, but you will from endocrinologist Dr. Jerilynn C. Prior, scientific director of The Centre for Menstrual Cycle Research at the University of British Columbia. Prior has over 40 years experience researching the very thing that all hormonal contraception disrupts: ovulation and normal menstrual cycle function. She has written a series of papers on the Preventive Powers of Ovulation and Progesterone that explain the impact of ovulation on our bone, breast and heart health. It is not “incessant menstruation” that’s bad for women’s health, as many OBGYNs would have us believe, but ovulatory disturbances. As I wrote once in a letter to Ms. Magazine challenging the assertion that suppressing ovulation and menstruation is good for our health: “Ask not what those cycle-stopping pills will do to you, but what a healthy ovulatory menstrual cycle can do for you.”

3) The pill should NOT be the standard-of-care treatment for being a girl.

In the foreword I wrote for Grigg-Spall’s book, I noted that: “Prescribing the pill, or other forms of hormonal contraception, has become, in the minds of most health-care providers, the ‘standard of care’ for being a girl.” It’s being used to treat every manner of menstrual cycle problem—irregularity, heavy bleeding, painful periods—associated with the maturation process of an adolescent’s reproductive system. The only sure thing these drugs will do is interrupt this maturation process. Alternative treatments for these problems can be found in the adolescence section on the CeMCOR website. On June 11, 2015, Twitter menstrual cycle advocate Kylie Matthews (@AuntFlo_28) Tweeted me this: “would you believe my 11 year old’s pediatrician already ‘recommended’ I put her on the pill? Of course I know better!” I expect the STP documentary to make sure all mothers know better.

4) Fertility Awareness Methods (FAM) of birth control, taught by skilled educators and enhanced with new technology, qualify as modern contraception.

The mainstream sexual and reproductive health community’s dismissiveness of fertility awareness based methods of birth control and its frustration with women who use or want to use them, must stop. In a previous Hormones Matter piece, I said that women who can’t, won’t, or don’t want to use drug- and devise-based birth control, have the same right to information, support and services as women who are willing and able to use hormonal birth control. Failure of the SRH community to adequately meet the needs of these women is contributing to unplanned pregnancies. But they aren’t the only show in town anymore, and women are seeking out alternative health-care providers, fertility awareness educators, and technological FAM support in droves. The roster of Justisse-trained Holistic Reproductive Health Practitioners is growing world-wide; women can readily access the services of HRHPs like Amy Sedgwick at redtentsisters.com and Ashley Ross at Conscious Birth Control. Tech companies like Kindara and Ovatemp are introducing thousands of women to the scientific principles that underpin fertility awareness methods that are as effective as the Pill at preventing pregnancy. I expect Lake and Epstein’s documentary to leave viewers fully informed as to how women can access the resources and experts they need to learn and use FAM effectively and confidently. If FAM is hot, and it is, then it’s modern contraception.

5) Body literacy, understanding how our bodies work and how hormonal contraception works, must precede birth control decision-making.

Girls deserve to grow up body literate. They must understand how their bodies work and how a normal menstrual cycle unfolds. They must be encouraged to develop a personal relationship with their bodies before they start making decisions, or have decisions made for them, on how to manage their cycles and their fertility. This is a tall order, but if the wave of 20- and 30-something women who are quickly acquiring this foundational knowledge is any indication, it just could be that the next generation of girls will grow up with the life skill of body literacy. They will understand how their sexual, reproductive and general health and well-being are connected to their menstrual cycles. Body literacy supports, if not compels, our fully informed participation in health-care decision making. This is the message I expect Sweetening the Pill to deliver.

So, back to the beginning. There are just three days left to become a backer of Sweetening the Pill, to support the making of a documentary that has the power to change the way we think about our bodies, our health and our birth control. There will always be a place for hormonal contraception, and that’s a good thing. But women need more and better options. We need to know that we don’t need to take it at all if that’s our preference, and that if we do, we don’t need to take it, and probably shouldn’t, for more than a few years of our reproductive lives.

Sweetening the Pill is about the future. Will you be a part of it? To echo my conclusion of the book’s foreword: This film will offer a new perspective on the Pill and its influence on our bodies and our lives, as well as evidence that affirms and confirms we make sacrifices—large and small—to live under its influence. It will remain for viewers to decide what to do about it.

Sweetening the Pill, the Documentary

About the author: Laura Wershler, B.Sc., is a veteran pro-choice sexual and reproductive health advocate and women’s health critic who has worked for or volunteered with Planned-Parenthood-affiliated organizations in Canada since 1986. Laura graduated with a Certificate in Journalism from Mount Royal University in 2011. She has contributed columns on women’s health to Troymedia.com and blogs regularly for re:Cycling, the blog of the Society for Menstrual Cycle Research. Follow her on Twitter @laurawershler.

Participate in Research about Oral Contraceptives

Hormones Matter is conducting an ongoing, online survey of oral contraceptive side effects. If you have ever used oral contraceptives, you are eligible to participate. The survey takes 10-15 minutes and is anonymous. Take the oral contraceptives survey today.

Hormones Matter conducts other crowdsourced surveys on medication reactions. To take one of our other surveys, click here.

If you’d like to share your health story contact us here.

Real Risk Study: Birth Control and Blood Clots

Lucine Health Sciences and Hormones Matter are conducting research to investigate the relationship between hormonal birth control and blood clots. If you or a loved one have suffered from a blood clot while using hormonal birth control, please consider participating. We are also looking for participants who have been using hormonal birth control for at least one year and have NOT had a blood clot, as well as women who have NEVER used hormonal birth control. For more information or to participate, click here.

In Search of the Female Orgasm

by Lisbeth Prifogle, MFA

Published on June 25, 2015

4255 views

My family does not talk about sex. In fact, I can only pray that my mother doesn’t happen to get on Facebook, see a status with a link to this article and read this; I blush at the mere thought. I like sex (now I’m really blushing), but in respect to how a lady should act when discussing, or rather not discussing it, I’d say that Bree Van de Kamp from Desperate Housewives is the best way to describe how I was taught to act. You can only imagine my surprise when I recently discovered that there are entire careers and movement dedicated to sex, outside of sex workers, for OUR pleasures.

Intimacy Coaches

Recently, I read an article on how yoga helps intimacy (a lady is not supposed to talk about it, that does not mean she can’t read about it!). I already find yoga challenging, so trying to incorporate some of the poses into sex just left me in awe of the writer. As I read through her bio, she mentioned that she was an “intimacy coach.” I’ve met wellness coaches, career coaches, life coaches, and more, but I have never met an intimacy coach. When I read the bio, I was instantly intrigued by this ‘unprofessional’ (as Bree would see it) profession.

Intimacy coaching, and intimacy, is more encompassing than just sex, but I find it ironic that we live in a society that is constantly bombarded with erotic imagery and yet require intimacy coaches. Turn on the television or open a magazine and there are flashy images of Victoria’s Secret models who are nearly nude. Family television shows have evolved from Leave it to Beaver to pregnant teenagers, scandalous affairs and intimateless relationships, and the commercial breaks air Viagra and other sexual dysfunction ads (try explaining this one to an inquisitive child!). We are a culture that appears to be obsessed with sex, but, judging by commercials, one that doesn’t sexually function properly at all. Intimacy coaching is probably a lucrative business or at least should be.

I looked up “intimacy coach” and a variety of sites popped up. Some practitioners have an MA (I’m assuming in psychology?) others were just listed as “coaches.” I’m assuming someone decided to jump on the “coaching” bandwagon and open a school to certify people as intimacy coaches, but I couldn’t find too much information that wasn’t an ad or blog for an a actual coach. Have you ever sought treatment with or know an intimacy or sex coach?

Slow Sex Movement

While researching intimacy coaching I came across the Slow Sex Movement. Nicole Daedone, the founder of One Taste and the origins of the Slow Sex Movement, describes her company as “a business dedicated to researching and teaching the practices of Orgasmic Meditation and Slow Sex. Though it embraces certain tenets based in eastern philosophy, One Taste’s central focus is female orgasm and sexuality.” An entire sexual movement dedicated to the female orgasm from a cultural perspective not medical – it’s about damn time!

The slow sex movement practices “OMing” or orgasmic meditation. Similar to regular meditation, it is a mindfulness exercise in which the object of meditation is finger to genital contact on the woman with the focus of both partners developing connective resonance between them. There are group classes, private lessons, coaching opportunities and more (including retreats where participants live in the facility and practice daily OMing). I find it interesting that the focus of this movement is on the woman’s body and pleasure, but does not require love, romance or flirtation according to a NYTimes article. Is the belief that for women sex and orgasms are more emotionally driven than men, false?

Here is an introductory video to OMing, but it is graphic so watch it in private and without children present: One Taste Intro Video

Orgasm, Inc.

Why are women so embarrassed to talk about our sexuality? Why is it taboo to talk about our clitoris and the fact that it has more sensory nerves than any other part of our bodies including our hands and, sorry men, the penis? I’ll admit, I’m stepping way outside of my comfort zone to publicly write about this subject, but why is that? If we can’t talk about it, how are we to address problems like female sexual dysfunction. A problem that has created a multi-billion dollar solution in the form of pharmaceuticals.

Filmmaker Liz Canner, recently made a documentary examining the mainstream and less-mainstream practices that women are seeking out in order to deal with sexual dysfunction, called Orgasm, Inc. I watched this documentary when it popped up on my Netflix account. It’s a very interesting look at a very quiet, but very booming industry. One statistic that is repeated over and over when researching this topic is from the Journal of American Medical Association (JAMA) and states that “43% of women in the US suffer from sexual dysfunction.” As you can see in the preview, Oprah called it a “secret epidemic.”

The various salesmen, medical professions and others throughout the documentary talk about female orgasm as if it were as legendary as a leprachaun riding a unicorn through fields of gold plated daisies. Perhaps these women just need to practice OMing more?

Vagina Monologues

If you have never read or seen this play I am commanding that you do it today. Right now. It will make you laugh, cry and love being a woman even more. Eve Ensler wrote the monologues after interviewing over 200 women on their sex, relationships and violence against women. She asked questions like, “If your vagina could talk what would it say? SLOW DOWN.” She talked about first periods, smells, and everything that is not proper to talk about. After seeing a photograph and magazine article about girls who had survived a rape camp in former Yugoslavia, Eve went there and interviewed Bosnian women refugees in camps and centers.

Eve started a nonprofit, V-Day, a global movement of grassroots activists dedicated to generating broader attention and funds to stop violence against women and girls, including rape, battery, incest, female genital mutilation (FGM) and sex slavery. Theaters, schools, individuals all around the world perform the Vagina Monologues, raise money and awareness to break the silence of violence against women.

Conclusion

Why? Why is it so taboo to talk about women and sex, be it pleasure, violent, medical or just casual? I used to babysit for old neighbors – a boy and girl (ages 10 and 7 respectively). One time the little girl fell and as she stood up, she announced, “Ouch, I hurt my vagina.” I remember being uncomfortable (much like our current legislators), and then feeling uncomfortable with myself that it had made me uncomfortable. It always starts with our children and teaching them the proper anatomical words rather than making our sex organs taboo. Is the Western world’s inability to address female sexuality the reason so many women are considered “sexually dysfunctional” or is there a biological component? What do you think?

This article was published previously in Hormones Matter in June 2012.

Pressure on the Perineum – A Woman’s Bicycle Story

by Elena Perez

Published on June 24, 2015

6161 views

Sometime ago I read an article in the New York Times about the impact of cycling on one’s nether region. Though the article noted discomfort in the genital area of women, scientists mainly focused on erectile dysfunction. The study cited was even titled “Cutting Off the Nose to Save the Penis,” clearly concentrating on men’s health.

Even so, I began to wonder how pressure on the perineum could impact my own sexual health as a woman, especially when I began to feel numbness and tingling in my genital area. This sensation worried me; like most women, issues regarding my genital sensation and sexual health concern me.

I tried to figure out what had changed that may have increased the pressure on my perineum. It didn’t take long before I determined the culprit for my sore punani: my purse.

It was the same tote bag I had been using to transport my wallet, glasses, and dictionary; but over time it amassed everything I decided I couldn’t do without: Issues of the New Yorker, books, notebooks, iodine (for injuries), occasionally my computer, and more.

I decided that the added burden was probably pushing down on my crotch, causing pressure on the perineum and potentially affecting my sexual health, so it had to go.

After removing the unnecessary weight from my bag, the perineal pressure was significantly reduced, and I noticed the difference right away. I was able to enjoy a comfortable bicycle commute again, without worrying whether the ride was detrimental to my vaginal health.

I have since learned cycling can negatively impact a woman’s sexual health. The New York Times recently posted an article about the impact of cycling on a woman’s sexual health, and reported scientific findings that point to genital desensitization due to frequent bicycle riding.

Female cyclists do not, however, have to stop cycling in order to protect their genital sensitivity. We just have to understand what causes genital desensitization and what we can do to avoid it.

Preventing Pressure on the Perineum

The main reason female cyclists experience vaginal distress is because we are putting too much pressure on the perineum, a part of the body that is not designed to bear weight, and this perineal pressure cuts blood circulation in the genital area.

There are various ways women cyclists can reduce pressure on the perineum and improve their sexual well-being. Women’s bodies and needs vary, so determine what suits your needs best.

Noseless saddle.While I have yet to purchase a noseless saddle, it is next on my to-do list. The noseless saddle is a type of bicycle seat that forces cyclists to carry weight in their sit bones, as opposed to their perineum. We often press our perineum against the “nose” of our bicycle saddle, but with no seat nose, there’s no way to put pressure on the perineum.
Adjust your handlebars. Many cyclists lean forward to reach their low-positioned handlebars, often flattening their backs, so they can ride in an aerodynamic position. Unfortunately, this position causes added pressure on the perineum, which scientists have found can decrease vaginal sensitivity. Luckily, this perineal predicament can be fixed by raising your handlebars.
Adjust your bicycle and your riding position. On a similar note, it is important that your bicycle is adjusted to fit your body size and needs. Your saddle is not designed to take on all of your body’s weight. Instead, your weight should be distributed to various parts of your bike in order to minimize pressure in any one place, like the perineum. For instance, pedaling with the balls of your feet enables your legs to bear the weight of your body better.
Give your perineum a break. If you bike for long distances, your body is bound to get tired and weigh more heavily on your bicycle seat – stifling your perineal area. Stand-up-saddle riding, where you stand up while cycling, completely relieves the pressure from your groin and permits blood flow in your vaginal region.
Reduce the weight. I’ve learned from personal experience that added weight just bears down on the perineal area. In order to minimize the weight you carry on your body, consider saddle bags, or baskets, which place the weight on your bicycle instead. You can also just clear out the clutter in your purse.

Spinning and Pressure on the Perineum

I haven’t taken a spin class, but I’ve been informed that it entails the same perineal pressure, with few adjustments that can be made to the stationary bike to improve comfort. In this situation, women may want to consider padded bicycle shorts to minimize pressure on the perineum.

This story was published previously on Hormones Matter in 2012.

What Causes Ovarian Cancer?

by Karen Ingalls, RN, MA

Published on June 22, 2015

6677 views

Ovarian cancer is the most difficult to diagnose of all the gynecologic cancers, which are uterine, fallopian, vulva, and cervical. The symptoms of bloating, back or pelvic pain, digestive issues, changes in bowels, urinary frequency, and fatigue are the most commonly reported. Other symptoms include vaginal bleeding or unusual discharge, change in weight, painful intercourse, and menstrual changes. Any one of these can be symptomatic of other diseases or disorders such as Irritable Bowel Syndrome, Gastritis, Back Strain, or Menopause to name a few.

Risk Factors for Ovarian Cancer

Scientists do not know what exactly causes ovarian cancer, but according to the American Cancer Society, there are “some factors that make a woman more likely to develop epithelial ovarian cancer,” which is the most common form of ovarian cancer. The three most prominently researched factors include:

Estrogen exposure – synthetic and endogenous
Genetics
Family history

Ovarian Cancer and the Estrogens

Estradiol is a female hormone that plays an important role in normal sexual and reproductive development. It is one of many estrogenic hormones produced by the ovaries. The ovaries produce most of the estrogenic hormones, though a far lesser amount comes from the adrenal glands. After menopause, the adrenal glands produce the majority of estrogens.

Estradiol and the other endogenous estrogens affect skin, hair, mucus membranes, pelvic muscles, breasts, bones, urinary tract, heart and blood vessels, and the brain. Perhaps more importantly, the estrogens affect mitochondrial energy metabolism in the heart, but also in the brain, and everywhere else as well. In light of that, it is understandable that synthetic estrogens might influence these same systems.

Oral contraceptives. According to the Center for Disease Control and Prevention, “there is no known way to prevent ovarian cancer.” However those who used birth control pills “has consistently been found to be associated with a reduced risk of ovarian cancer….Oral contraceptive formulations with high levels of progestin were associated with a lower risk ….” Various studies have shown a 10-12% decrease after just one year of use and as much as a 50% decrease after five years.

Some research suggests that total duration of exposure to estrogenic hormones, whether endogenously produced or synthetic (and there is some debate about this), decreases a woman’s risk for ovarian cancer. With this line of reasoning, some researchers have argued that the use of oral contraceptives may reduce the risk of ovarian cancer because contraceptives prevent ovulation. The theory is that each time she ovulates the woman is exposed to more hormones. According to researchers at Johns Hopkins “It is hypothesized that the longer a woman is exposed to estrogen, the higher her risk of ovarian cancer…. The longer the woman menstruates, the higher her risk.” This may not be the case for all women, however.

For those who carry the BRCA1 and BRCA2 mutations, oral contraceptives may or may not reduce the risk for ovarian cancer, but pregnancy does. A study published in 2001 stated that “We believe that it is premature to prescribe oral contraceptives for the chemoprevention of ovarian cancer in carriers of a BRCA1 or BRCA2 mutation, particularly in the light of the report of a possible increased risk of breast cancer in such women.” In contrast, a study in May of 2014 the Journal of the National Cancer Institute wrote, “Although we were not able to undertake meta-analyses of the existing data, it is likely that oral contraceptives are associated with ovarian cancer risk reduction. For those who carry the BRCA1 or BRCA2 mutations, oral contraceptives did reduce the risk for ovarian cancer.” More research is required to fully determine if or how oral contraceptives affect the occurrence of ovarian cancer, for those women with or without BRCA1 or BRCA2 mutations.

Other researchers speculate that it is not the estrogens but exposure to androgens that increases risk. Regardless of the mechanisms by which oral contraceptives may or may not confer protection against ovarian cancer, they are not without other risks. When a woman takes birth control pills she is also increasing her risk for breast, cervical, and liver cancer. Therefore, it is imperative that she understand and discuss with her physician these risk factors, as well as her personal and family history.

Since the introduction of oral contraception in the 1960’s there have been many studies on its relationship to various cancers. The studies have been on birth control pills of estrogen only, estrogen-progesterone, and those with androgenic properties (testosterone effects). How much a factor estrogen alone is in causing ovarian cancer requires more research.

I chose to not take birth control pills because I did not believe it was healthy to control when a woman was to have or not have a period. In other words, control her hormones and menstrual cycle. I am the mother of three healthy sons. If I had taken the birth control pills between pregnancies, would I now have ovarian cancer? No one knows for sure. I made my decision many years ago believing it was best for my health so I do not have any regrets.

Hormone Replacement Therapy. For many years women have used Hormone Replacement Therapy (HRT) to help relieve the hot flashes, mood swings, and other symptoms due to menopause. According to a study published in the Lancet in February, 2015, a study of 21,488 postmenopausal women with ovarian cancer, concluded an increase risk from the use of both estrogen-only and progesterone and estrogen combinations of Hormone Replacement Therapy. “Women who had taken HRT for at least 5 years were still at increased risk of ovarian cancer 10 years later.”

An interesting article about HRT and its affects on ovarian and breast cancers, a historical review of HRT, and post oophorectomies written by Chandler Marrs raises the question if HRT is “largely or wholly causal in ovarian cancer.” More research is needed to answer the questions raised by Dr. Marrs.

There are additional factors for the woman and her physician to take into consideration if HRT is right for her. Has she had a hysterectomy? What are her menopausal side effects, and how severely are they affecting her quality of life? Has she had breast cancer, or have a family history? “Based on the WHI (Women’s Health Initiative) study, taking EPT is linked to a higher risk of breast cancer.” It is recommended that a woman be on as low a dose and for as short a period of time as possible to reduce her risk of ovarian cancer. There are also over-the-counter herbs and supplements that might help reduce or eliminate the menopausal side effects.

Once again I chose not to take any HRT for three reasons: one, I did not want to manipulate my hormones; two, I had a family history of breast cancer from one aunt; and three, menopausal symptoms of hot flashes and insomnia were not severe enough for me to take any HRT. I used over the counter meds for the insomnia.

Another theory suggests that tubal ligation or hysterectomies might lower the risk of ovarian cancer. This is based on “some cancer-causing substances may enter the body through the vagina and pass through the uterus and fallopian tubes to the ovaries.” This theory also requires more research.

Finally, there appears to be a link between polycystic ovarian syndrome (PCOS), an imbalance of the female hormones, and ovarian and endometrial cancers. Any personal or familial breast cancer history also puts women at higher risk. More research is required for this complex and familial disease.

Ovarian Cancer and Genetic Risk Factors

Is ovarian cancer caused by some defect in our DNA or genes? Our DNA carries instructions for each cell in our body. Any defect in our genes can cause or lead to any type of cancer. What causes the genes to be defective is not completely known. Most often the body is able to correct any damage to a gene, but due to not fully understood factors sometimes the mutated gene is not reversed. “Usually, it takes multiple mutations over a lifetime to cause cancer” which is why aging is a high risk factor for ovarian cancer.

Lynch Syndrome, an inherited cancer of the digestive tract causes a 12% risk increase for ovarian cancer because of the mutation in DNA repair genes.
BRCA1 and BRCA2 are inherited genes that produce tumor suppressor proteins. If these genes are mutated they increase the risk of developing breast and ovarian cancers. Unfortunately women of Eastern Jewish descent (Ashkenazi) are at greatest risk. Norwegian, Dutch and Icelandic peoples also have a higher incidence of these mutations. BRCA1 and BRCA2 mutations account for about 15% of ovarian cancers overall. BRCA1 and 2 carriers also have a higher concentration of female hormones. Research is examining how estrogen affects the Fallopian tubes where most ovarian cancers begin. Many women with BRCA1 and 2 gene mutations choose to have their breasts and ovaries removed, which is a drastic and difficult decision.

“Most DNA mutations related to ovarian cancer are not inherited but instead occur during a woman’s life….So far, studies haven’t been able to specifically link any single chemical in the environment or in our diets to mutations that cause ovarian cancer. The cause of most acquired mutations remains unknown.”

Genetic testing is recommended. The process will include your family health history and environmental factors as well as the gene test. The information can be valuable for the patient, family members, and future generations. If tested positive, family members have the opportunity to make prophylactic decisions as to their health care options.

I chose to be genetically tested though I did not have any of the ethnic risk factors associated with BRCA1 and BRCA2. I wanted to be sure I had not passed on a mutated gene. I am glad to say that I tested negative.

Family History and Ovarian Cancer

How much of a factor is family history? Any family history of ovarian, breast, or colon cancers might raise a red flag to the physician. How close the relative is to the patient is a question to be considered.

My aunt on my mother’s side had breast cancer and we do not know if she had a mutated gene (other than BRCA) that got passed on to me. My great grandfather had colon cancer but it was decided that he was too far removed from me to be a factor. My mother died from stomach cancer and my uncle who was a habitual smoker died of throat cancer. To sciences present knowledge there is no connection with my ovarian cancer.

Do you know your family history? This knowledge may be important along with the presenting symptoms for your physician in determining a diagnosis. From a small, non-scientific, and anonymous questionnaire of gynecologic survivors, here are some unfortunate and interesting statistics:

Did your physician(s) ask about your family history? Yes from 35 out of 131MD’s
Did your physician(s) ask about your symptoms? Yes from 34 out of 131 MD’s

Only about 25% of the doctors discussed the family history or symptoms. The women mainly saw their family physician or gynecologist for an initial appointment with presenting symptoms. Here are the most common symptoms:

55%–Bloating
42%–Abdominal pain
28%–Digestive problems
28%–Fatigue
20%–Frequent urination
16% –Constipation
13%–Vaginal bleeding
11%–Weight change
11%–Back pain
8%–Painful intercourse
4%–Shortness of breathe
4%–Menstrual issues
2%–Temperature
2%–Overweight

Here are some comments from the women who completed the questionnaire:

“My family doctor only did testing because I demanded it after she sent me home the first time and I still didn’t feel better after 2 months later.” (Diagnosed Stage IIIC)

“Had I not demanded the ultrasound my diagnosis would have been missed….” (Diagnosed Stage IIIC)

“I look back and I do believe I did have subtle symptoms, but my male doctor ignored my complaints….with a family history I feel I should be been looked at more closely.” (Diagnosed IIC)

“I found that the best doctor is the one that listens.” (Diagnosed Stage IC)

The following patient had a hysterectomy 14 years prior to diagnosis, removing only her uterus. “…I was on Estrogen only for all those years.” (Diagnosed IIIC)

It is important to recognize that there are many possible risk factors that have not been substantiated in various case studies. Such factors are infertility drugs, talcum powder, smoking, aspirin and NSAIDS, and dietary considerations. According to the National Cancer Institute (May 15, 2015) more research is needed for these possible contributors.

Early Detection Is Key

In closing, early detection & diagnosis are a woman’s best opportunity to treat gynecologic cancers. From Johns Hopkins, “…the combination of bloating, increased abdominal size, and urinary problems was found in 43% of women with ovarian cancer…. Women presenting with non-specific symptoms, particularly if severe intensity or rapid onset, should be thoroughly evaluated for the possibility that the symptoms are due to an ovarian mass.”

When we experience any of the symptoms of ovarian cancer for two weeks without any relief despite medications, women need to seek out medical attention quickly. We must advocate for ourselves that the physician listen to our symptoms, discuss our family history, and insist that an abdominal ultrasound and CA125 be parts of the diagnostic tools.

About the author: Karen Ingalls is the author of the award-winning book, Outshine: An Ovarian Cancer Memoir, which discusses the symptoms, risk factors, and statistics of this lesser known disease; shares her journey; and how she used traditional medicine and complementary therapies together. She writes how “the beauty of the soul, the real me and the real you, outshines the effects of cancer, chemotherapy, and radiation.”

Corrections. On June 26, the word ‘increases’ was changed to ‘decreases’ in the following sentence: ‘…whether endogenously produced or synthetic (and there is some debate about this), decreases a woman’s risk for ovarian cancer.’ The 2014 study was added to the discussion of BRCA mutations and oral contraceptives.

Stop the Metformin Madness

by Chandler Marrs, PhD

Published on June 18, 2015

28931 views

I have never been a fan of Metformin. It seemed too good to be true. Many years ago I had a conversation with a researcher about all of its possible therapeutic indications. His lab was actively pursuing the anti-cancer angle. That should have been a clue that Metformin might be causing more damage than we recognized, but it wasn’t. At that point, I was still enamored with the wonders of pharmacology and hadn’t yet begun my path toward understanding medication adverse reactions. Indeed, it wasn’t until very recently, when a family member began suffering from one of these reactions, that I began my investigation in full. This is what I learned.

Type 2 Diabetes is Big Business

The global profits from Type 2 diabetes medications rested at a paltry 23 billion dollars in 2011 but are expected to grow to over $45 billion annually by 2020. The market growth is bolstered in large part by the ever-expanding demand for therapeutics like Metformin or Glucophage. Metformin is the first line of treatment and standard of care for insulin resistance across all populations of Type 2 diabetics with over 49 million Americans on Metformin in 2011-2012. It is particularly popular in women’s health with an increasing reliance on Metformin for the metabolic dysfunction observed in women with PCOS, PCOS-related infertility, and even gestational diabetes. Metformin is prescribed so frequently and considered so innocuous that it is sometimes euphemistically referred to as vitamin M.

If we quickly scan the safety research for metformin, there is little immediate evidence suggesting any side effects whatsoever. In fact, in addition to controlling blood sugar by blocking the hepatic glucose dump, this drug is suggested to promote weight loss, increase ovulation in women, (thereby helping achieve pregnancy), and prevent an array of pregnancy complications (everything from miscarriage to gestational diabetes, pre-eclampsia and preterm birth). Metformin is argued to prevent cancer and the neurocognitive declines associated with aging, even aging itself. By all accounts, Metformin is a wonder drug. Why isn’t everyone on Metformin prophylactically? Increasingly, we are.

With the increasing rates of obesity and associated metabolic disturbances, drugs that purportedly reduce those indicators are primed for growth. Like the push to expand statin prescription rates from 1 in 4 Americans to perhaps 1 in 3, millions have been spent increasing the therapeutic indications and reach for this medication. Amid all the excitement over this drug, one has to wonder if it isn’t too good to be true. In our exuberance to get something for nothing, to have cake, if you will, have we overlooked the very real risks and side effects associated with Metformin? I think we have.

Metformin and Vitamin B12 Deficiency

As we’ve reported previously, Metformin leaches vitamin B12 and to a lesser degree B9 (folate) from the body. One study found almost 30% of Metformin users are vitamin B12 deficient. For the US alone, that’s almost 15 million people who could be vitamin B12 deficient and likely do not know that they are deficient. What happens when one is vitamin B12 deficient?

Firstly, inflammation increases, along with homocysteine concentrations, which is a very strong and independent risk factor for heart disease (the very same disease Metformin is promoted to prevent). And that is the tip of the iceberg.

Vitamin B12 is involved with a staggering number of physiological functions including DNA, RNA, hormone, lipid, and protein synthesis. Deplete vitamin B12 and a whole host of problems emerge, mostly neurological.

Vitamin B12 is critical for the synthesis of the myelin sheaths around nerve fibers. There is a growing relationship between multiple sclerosis, which involves the disintegration of myelin and brain white matter, and vitamin B12 deficiency. Often the first signs of B12 deficiency are nervous system-related with cognitive disturbances and peripheral neuropathy among the most common.

Additionally, many women have dysregulated hormones connected to vitamin B12 deficiency. In light of the Metformin-mediated vitamin B12 deficiency, one has to wonder if some of the chronic health issues plaguing modern culture are not simply iatrogenic or medication-induced.

Metformin, Pregnancy and Maternal and Fetal Complications

Considering that half the population is female, many of whom are on Metformin and may become pregnant, we must consider the potential effects of Metformin-induced vitamin B12 deficiency during pregnancy. As troubling as the effects of B12 deficiency are on non-pregnant individuals, during pregnancy they can be devastating. Vitamin B12 deficiency during pregnancy leads to an increased incidence of neural tube defects and anencephaly (the neural tube fails to close during gestation). Once thought to be solely related to folate deficiency (vitamin B9) which Metformin also induces, researchers are now finding that B12 has a role in neural tube defects as well.

Scan the internet for Metformin and infertility and you’ll see long lists of fertility centers boasting the benefits of this drug. During pregnancy, the exuberance for vitamin M is palpable, although entirely misplaced. Early reports suggested Metformin would reduce an array of pregnancy complications including gestational diabetes. The data supporting these practices were mixed at best. At worst, however, they were downright incorrect. Metformin, it appears, may evoke the very conditions it was promoted to prevent during pregnancy and then some. Additionally, recent research suggests Metformin alters fetal development and induces long-term metabolic changes in the offspring, likely predisposing the children to Type 2 Diabetes, an epigenetic effect perhaps.

Metformin Inhibits Exercise-Induced Insulin Sensitivity

As if those side effects were not enough to question mass Metformin prescribing practices, it appears that Metformin reduces any gains in insulin sensitivity that normally would be achieved from exercise. I cannot help but wonder if Metformin impairs insulin signaling in general. Cancer research suggests that it might.

According to one study, physical exercise can increase insulin sensitivity by up to 54% in insulin-resistant individuals, unless of course, they are taking Metformin. Metformin abolishes any increased insulin sensitivity gained by exercise. Metformin also reduces peak aerobic capacity, reducing performance and making exercise more difficult. Moreover, despite claims to the contrary, Metformin does not appear to be an especially effective tool for weight loss, netting a reduction of only 5-10 pounds over 4-8 months. Regular exercise and a healthy diet net on average a loss of 5-10 pounds per month for most people and are significantly more effective at reducing diabetes and associated health complications without the potential side effects.

Metformin and Mitochondrial Damage

Perhaps most troubling amongst the Metformin side effects is its ability to severely impair mitochondrial functioning.

Recall from high school biology, the mitochondria are those bean-shaped organelles inside cells that are responsible for cellular respiration or energy production. Through a variety of pathways, the mitochondria provide fuel for cell survival. In addition to cellular energy production, mitochondria control cell apoptosis (death), calcium, copper, and iron homeostasis, and steroidogenesis. In essence, mitochondria perform the key tasks associated with cell survival, and indeed, human survival. Damage the mitochondria and cellular dysfunction or death will occur. Damage sufficient numbers of mitochondrion and chronic, multi-symptom illness arises.

As we have come to learn, many pharmaceuticals, environmental toxicants, and even dietary deficiencies can impair mitochondrial functioning and induce disease processes that are often difficult to diagnose and treat. Metformin is no different. Metformin impairs mitochondrial functioning quite significantly by several mechanisms and, in doing so, sets off a cascading sequence of ill effects.

At the center of metformin’s mitochondrial damage is its effect on the most basic of mitochondrial functions – ATP (cellular energy) production. Metformin reduces mitochondrial ATP production in skeletal muscle by as much as 48%. Sit with that one for a moment, a 48% reduction in cell fuel. Imagine functioning at only half capacity. This would make basic activities difficult at best and exercising to lose weight a very unlikely proposition. Imagine similar reductions in ATP production were observed in the brain or the heart or the GI tract (which, when on Metformin are likely), the types of disturbances we might see become quite clear: neurocognitive decline, psychiatric instability, neuropathy, heart rate, rhythm and blood pressure abnormalities, along with gastrointestinal distress to name but a few. Underlying all of these symptoms, and indeed, all mitochondrial dysfunction is an overwhelming sense of fatigue and malaise.

Metformin Alters Immune Reactivity via the Mitochondria

As I wrote in a previous post:

Some researchers argue that the mitochondria are the danger sensors for host organisms; having evolved over two billion years to identify and communicate signs of danger to the cells within which they reside. The signaling is simple and yet highly refined, involving a series of switches that control cellular energy, and thus, cellular life or death. When danger is present, energy resources are conserved and the immune system fighters are unleashed. When danger is resolved, normal functioning can resume.
If the danger is not resolved and the immune battles must rage on, the mitochondria begin the complicated process of reallocating resources until the battle is won or the decision is made to institute what can only be described as suicide – cell death. Cell death is a normal occurrence in the cell cycle of life. Cells are born and die for all manner of reasons. But when cell death occurs from mitochondrial injury, it is messy, and evokes even broader immune responses, setting a cascade in motion that is difficult to arrest.

Metformin alters this process, first by damaging the mitochondrial ATP factory and reducing energy production capacity and then by inhibiting the signaling cascades that would normally respond to the danger signals. The double hit fundamentally alters immune function and I would suspect predisposes those who take Metformin to more infections and an array of inflammation-based disease processes. More details on this in a subsequent post.

Metformin and the Statins: Beware

The mechanisms through which Metformin derails mitochondrial functioning are complex but likely related to depletion of coQ10, an enzyme involved in what is called the electron transport chain within the mitochondria. CoQ10 also referred to as ubiquinol and ubiquinone, is critical for mitochondrial functioning. Recall from a previous post, that statins, like Lipitor, Crestor and others also deplete coQ10 and from a pharmacological perspective these mechanisms are implicated in the development of atherosclerosis and heart failure.

“statins may be causative in coronary artery calcification and can function as mitochondrial toxins that impair muscle function in the heart and blood vessels through the depletion of coenzyme Q10 and ‘heme A’, and thereby ATP generation.”

CoQ10 depletion is also implicated in the more common statin-induced side effects like muscle pain and weakness and in severe cases, rhabdomyolysis. Since Metformin and statins are regularly co-prescribed, the potential for severely depleted mitochondria and significant side effects is very high. Consider muscle pain and weakness among the first signs of problems.

My Two Cents

When we contrast the reduction in glucose mediated by Metformin with the damage this medication does to the mitochondria and immune signaling, along with its ability to leach vitamin B12, block insulin sensitivity and reduce aerobic capacity, one cannot help but wonder if we are causing more harm than good. Admittedly, obesity and hyperglycemia are growing problems in Western cultures. As we are coming to learn, however, obesity itself is not linked to the diseases processes for which many drugs like statins and Metformin are promoted to protect against – the obesity paradox. Growing evidence suggests that obesity is indicative of mitochondrial dysfunction and chemical exposures which then may provoke impaired insulin sensitivity and hyperglycemia and continued fat storage versus metabolism. If this is true, simply reducing circulating glucose concentrations, in an effort to reduce obesity and the purported health problems associated with obesity, will do nothing to treat the underlying problem.

Insulin resistance and the associated hyperglycemia are environmental and lifestyle-mediated problems that should be reversible with environmental and lifestyle changes. Having said that, those lifestyle and dietary changes will fail unless we consider the underlying mitochondrial damage initiated by dietary choices, pharmaceuticals, and other environmental exposures. For that, we must dig deeper into mitochondrial functioning and correct what we can.

I believe obesity and hyperglycemia are symptoms of damaged and dysfunctional mitochondria, partly mediated by lifestyle, partly iatrogenic (pharmaceutically induced), and likely epigenetic. If we are to solve the ‘obesity’ problem and prevent the damage mediated by hyperglycemia, we have to address these variables. Failing to do so serves no one except those who profit from our continued ill-health.

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Lucine Research Featured in International Innovation

by Chandler Marrs, PhD

Published on June 15, 2015

2084 views

Lucine Health Sciences, the parent company of Hormones Matter^TM and Heal with Friends^TM, was featured in a recent piece on women’s health, in International Innovation. Entitled Data, Decisions and Discovery, the article is a first in a series of articles that will highlight our unique approach to research. From the article:

Medical science was, and still is to some degree, predicated upon physicians and researchers having a controlling view of patient health. Among scientists, there is a tendency to favour pristine and highly controlled experiments that address just one variable at a time. Yet while this may result in neat, publishable studies, it fails to take into account the complexities of life and human physiology. “When you isolate one variable at a time, you may obtain some interesting insights into the operation of that variable – but this does not address the complexity of the systems in human health and disease,” Marrs elucidates. “Science will only move forwards if we successfully capture the messiness of multiple variables and understand how they interact with each other within the context of health and disease.”
For modern research to be effective, it must take into account the patient’s knowledge about his or her health and move beyond the paradigm that equates health with simple linear equations. By putting the patient at the centre of the research equation and considering multiple variables, Lucine Health Sciences is well-placed to explore the efficacy of medications, as well as their potential side effects.

To read the full article: Data, Decisions and Discovery.

About Lucine Health Sciences

Lucine Health Sciences is a social-benefit company committed to improving healthcare by providing critical and credible health information to consumers, physicians and industry. We leverage the broad social media reach generated by Hormones Matter^TM to conduct large-scale and much needed research in the field of women’s health. Studies address the side effects associated with common medications, vaccines and surgical procedures used in women’s healthcare. Contract research services are available.

My Battle with Endometriosis: Hysterectomy at 23

by Samantha Bowick

Published on June 9, 2015

6954 views

At the young age of 19, I was diagnosed with an incurable disease: endometriosis. During my adolescent years, from the age of 13 on, I suffered with debilitating periods every month, and eventually I had ovary pain even when I was not on my menses. My first gynecologist first suggested that I try birth control pills to see if my pain would decrease. She made it seem like it was normal for women to be in so much pain during their period.

When that did not help, we decided that it was time to do a laparoscopic surgery to see if I had endometriosis, since it does run in my family. I was 19 years old. During that surgery, I was found to have endometriosis–she removed it all but a little bit that was on my ovary. I also had a cyst drained. A few months later, the pain was back. My doctor said there was nothing else she could do, so I was forced to find another gynecologist.

Repeated Surgeries, Medications, and Natural Methods with No Relief from Endometriosis

Since my first laparoscopy in 2010, I have had multiple other surgeries. I had laparoscopic surgery for endometriosis in 2012 and 2013. During my surgery in 2013 I also had my appendix removed to prevent disease from growing on it or having it rupture. The surgeon that performed this surgery is an endometriosis specialist. I had to leave pharmacy school twice because the pain was so unbearable.

I have tried almost every birth control pill there is on the market, Lupron, a gluten-free/dairy-free diet, physical therapy for pelvic floor spasms, heating pads, over the counter pain medications, and narcotics as well as Xanax, Cymbalta, Celebrex, Meloxicam, and Ponstel to see if any of these things would decrease my pain and the disease. I also had a colonoscopy done at 20 years old, a CT scan, an MRI, and was tested for interstitial cystitis, a bladder disease that is often found in patients with endometriosis. These procedures did not show anything out of the ordinary.

When I had laparoscopic surgery, I would be pain free for a few months, but then the pain would return, most likely because my body was estrogen dominant. My blood work always came back fine other than my Vitamin D levels were always low. Over the course of five years I went to at least sixteen different doctors trying to find something that would end my pain. However, many of the doctors I went to did not know what else to do because the disease is so complex. It was after I put my body through menopause twice with Lupron, that I decided it was time to have a hysterectomy.

My Hysterectomy at Age 23

One of the doctors I was seeing was supposed to do my hysterectomy, but changed her mind at the last minute because she decided she wanted me to have a uterine nerve ablation instead, which could cause my uterus to prolapse. I did not want to take the chance of that; I just wanted everything removed. She told me she would not do it without me seeing a therapist because I was so young. Once again, I had to find another doctor who would perform the surgery. I met with a new doctor and told him everything I had already been through, and he agreed I had tried everything and was old enough to make my own decisions, so we went through with the surgery.

Hysterectomy did not Cure Me

I was hoping after I had a hysterectomy that would be the end of my struggles, but it was not. A hysterectomy is not a cure and if the doctor does not remove all of the disease while he is operating, the disease can still grow. I had to have another surgery to remove endometriosis at the beginning of 2015, with a different endometriosis specialist than in 2013.

Right now, I am pain free. I am currently on bio-identical hormones to help me sleep and decrease my stress. In just a few months, I will be able to start my second quarter of pharmacy school and hopefully this time will be successful in finishing. I still struggle with my decision to have a hysterectomy because I have always wanted to have kids, but I know I can still have children; it will just be by a different route. I have decided to use what I have been through to help others, and I hope that by putting my story out there that we will be one step closer to finding a cure.

Pill Bleeds Are Not Periods

by Lara Briden, ND

Published on June 3, 2015

12030 views

The Pill is not just contraception anymore. It has become standard treatment for everything from acne to endometriosis to irregular periods. Yes, hormonal birth control can mask symptoms, but it cannot “regulate” hormones or periods in any meaningful way.

Hormonal birth control does not augment or regulate hormones. Instead, it suppresses ovarian function and shuts down hormones completely. It replaces endogenous hormones with synthetic steroids, and that’s not good enough for women’s health. Real hormones have many benefits for health that synthetic steroids simply cannot deliver.

Real Hormones versus Synthetic Hormones

Our real endogenous hormones are estradiol and progesterone. In contrast, synthetic steroids are ethinylestradiol, levonorgestrel, drospirenone, and many others. Real hormones and synthetic steroids are similar molecules, but they’re not identical and as a consequence, synthetic steroid have many different effects on the body, some of which we are only now beginning to understand.

For example, estradiol improves insulin sensitivity. Its synthetic counterpart ethinylestradiol impairs insulin sensitivity [1] (which is one of the ways the Pill causes weight gain). Progesterone is beneficial for hair, brain health, and bone density, but its synthetic analogues levonorgestrel, drospirenone, and medroxyprogesterone have quite different effects. They cause hair loss, depression [2], and reduced bone density. Moreover, the drospirenone progestin found in the Yaz, Yasmin and Ocella series of birth control pills, increases the risk of heart attack and stroke six fold. Its modified shape blocks what are called the mineralocorticoid receptors. These receptors are responsible for salt and water balance (think swelling) and blood pressure.

The only way that ethinylestradiol and progestins are similar to real hormones is that they induce a uterine bleed. They can even induce it monthly, but only if they’re dispensed that way.

Why Bleed?

Who really cares about a bleed for its own sake? If women can’t have real hormones, then why have a monthly bleed at all? It is merely to give the appearance of a period, and reassure women that they’ve had a period (when they haven’t). A bleed does prevent excess build-up of the uterine lining, but it does not have to be monthly. It can be quarterly or yearly or any time we withdraw from the synthetic steroids. Regardless of when we choose to bleed, the pill bleed is not the same as menstruation. Remember, the purpose of oral contraceptives is to block ovulation and prevent pregnancy. Without ovulation, our bodies do not produce endogenous hormones. Indeed, as any woman who has gone off of the pill after a long period of usage will tell you, it takes some time for ovulation and hormone production to begin again.

Normalizing our Periods: A Myth

Interestingly, the “regulation” of periods was the Pill’s earliest cover story. When the Pill was first developed, it could not be sold as contraception because contraception was not legal. Instead, the Pill was ostensibly prescribed to “normalize” periods. “Normalize” was a quaint euphemism which really just meant to be “not pregnant” (wink-wink).

Five decades later, and the Pill’s early cover story has now taken hold as a kind of weird counterfeit reality. Doctors readily prescribe oral contraceptives for all manner of female reproductive disorders, the most common of which is to ‘normalize’ the menstrual cycle. What they, and most women, fail to realize is that the monthly bleed precipitated by the withdrawal of synthetic steroids, is not a real period. It is simply a withdrawal bleed.

It’s time to end it. It’s time to bring back real periods.

There Is Another Way

As a naturopathic doctor working in women’s health for twenty years, I want my patients to have real periods. More precisely, I want them to have a follicular phase and make estradiol. I want them to ovulate, so they can then have a luteal phase and make progesterone. In short, I want my patients to make real hormones and to enjoy their many benefits.

There’s another reason I want my patients to have real periods. A healthy, regular period tells me that all is well with her underlying health. If a woman does not have healthy periods, then I keep working with her until she does. We use her period as a helpful, useful marker guiding her health decisions. We think of it as her monthly report card.

It’s not always easy to restore healthy periods, but it can be done. But with a little perseverance, natural treatments such as diet, supplement and herbs work well, and they give women what they deserve: A real period rather than a pharmaceutically induced bleed.

Real Risk Study: Birth Control and Blood Clots

Lucine Health Sciences and Hormones Matter are conducting research to investigate the relationship between hormonal birth control and blood clots. If you or a loved one have suffered from a blood clot while using hormonal birth control, please consider participating. We are also looking for participants who have been using hormonal birth control for at least one year and have NOT had a blood clot, as well as women who have NEVER used hormonal birth control. For more information or to participate, click here.

References

Kojima T et al. Insulin sensitivity is decreased in normal women by doses of ethinyl estradiol used in oral contraceptives. Am J Obstet Gynecol. 1993 Dec;169(6):1540-4. PMID: 8267059
Kulkarni J et al. Depression associated with combined oral contraceptives–a pilot study. Aust Fam Physician. 2005 Nov;34(11):990. PMID: 16299641

Participate in Research about Oral Contraceptives

Real Risk Study: Birth Control and Blood Clots

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My Two Cents

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Repeated Surgeries, Medications, and Natural Methods with No Relief from Endometriosis

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Hysterectomy did not Cure Me

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