Search for tag: "natural remedies"

Dr. Jones: You or someone in your house has painful menstrual cramps. What can you do without going to the drugstore or seeing a professional? This is Dr. Kirtly Jones from Obstetrics and Gynecology at University of Utah Health and this is The Scope.

Announcer: Covering all aspects of women's health, this is the Seven Domains of Women's Health with Dr. Kirtly Jones on The Scope.

Dr. Jones: Menstrual cramps seem to be a uniquely human problem, well female human problem. Of course, part of that is because only primates have a menstrual cycle. Other animals have other biology and don't have nearly as many cycles and even other primates, chimpanzees and gorillas, don't seem to bleed as much or suffer cramps as much as we do.

About two weeks after ovulation if we don't become pregnant, the hormones from the ovary that would have supported an early pregnancy, progesterone or pregnancy, starts to fall and the uterus makes another local hormone called prostaglandins that causes the uterus to cramp, the blood vessels to constrict, and push out the old uterine lining to make way for the new with a bunch of blood that doesn't really seem necessary.

So what can you do right now? A hot but not too hot water bottle on your lower abdomen can be soothing or on your back if you primarily feel the cramps in your back. This was used by our mothers and probably their mothers. It doesn't really heat up your uterus but thermally stimulating the skin can distract other nerve pathways involving pain. Using this principle, a new take on an old device called a transcutaneous nerve stimulator that's been used for chronic back pain, might be useful for period cramps. But we're talking about right here and right now in a hot water bottle or a hot towel and a plastic bag is available to everyone but remember not too hot. Many women get in a hot bath tub and find this is helpful.

Well, what else right now? Well, believe it or not, exercise helps period cramps. Get out and move. A vigorous walk or ride or jog actually decreases the perception of menstrual pain for many women. Of course, if you never do these things, doing them now could be more painful but it will distract you from your cramps. Women who exercise regularly have less perception of menstrual pain, so for right now get up and move and if that doesn't work for you, go get that hot water bottle.

For women who have menstrual periods regularly, there are some habits that may decrease your pain. Some studies have found that decreasing fat in the diet significantly decreasing fat and particularly animal fat can lead to less painful periods. It won't work for you today, but it could be helpful for your next period.

Now personally and scientifically, I wouldn't say that supplements, substances you get in a pill at the health food store, are natural, but some studies found that fish oil decreased the intensity of menstrual cramps. It takes a lot of fish oil, about five pills a day.

A Danish study found that fish oil in combination with vitamin B12 worked better than other oils or placebo. Interestingly the women in the study were women who were chosen because they had bad period cramps. These women had low levels of omega-3 fatty acids in their diet compared to other Danish women. So all of the recommendation for decreasing period cramps is to decrease that in the diet, it may be all about the kinds of fat, less omega-6 from animal and dairy fats, which are associated with inflammation and prostaglandins and more omega-3s from nuts, fish, and seeds, which are anti-inflammatory.

Taking supplements may feel natural to some women but what's in the supplement may not be natural at all and they may contaminant, so be careful. The best choice may come down to dietary choices of low sugar and fat diets with seeds, nuts, and beans as the carbs and healthy oils and fish for the fat.

Of course the category of over-the-counter medicines called NSAIDs, non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen, all work to stop the production of prostaglandins, which cause the cramps. But we're talking about home remedies today.

Remember aspirin was originally isolated from willow bark and teas made from the bark of trees in the willow family have been used by many indigenous peoples to treat pain. Some herbal teas that claim to help period cramps may have some of these substances in them.

So these are some of things you try at home and a few options from the health food store and from the pharmacy section of your grocery store. But two things to consider, if your periods never used to be painful when you were younger and now are increasingly painful or heavy, it's important to see your clinician. Some diseases in the pelvis like endometriosis or fibroids in the uterus can grow and lead to increasingly painful periods.

In medicine we divide painful periods into two categories -- primary painful dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea refers to the menstrual cramps that started in early teen hood, the periods were always painful. The good news about primary dysmenorrhea is it gets better as women get older or maybe we just cope with it better.

Secondary dysmenorrhea means you didn't use to have cramps when you were younger and now you do. Secondary dysmenorrhea if it interferes with your daily activity, warrants a visit to your gynecologist.

Lastly if your painful periods interfere with your life and your home remedies and over the counter remedies aren't working, we as gynecologists have some options that are very helpful. Give us a call and thanks for joining us on The Scope.

Announcer: Want The Scope delivered straight to your inbox? Enter your email address at thescoperadio.com and click sign me up for updates of our latest episodes. The Scope Radio is a production of University of Utah Health Sciences.

Dr. Jones: So you're having trouble getting pregnant. It's been six months and you really want to have a baby, but you know that fertility therapy can be very expensive and involved. Is there another way? And what's the difference between taking different kinds of ways to getting your baby? This is Dr. Kirtly Jones from Obstetrics and Gynecology at University of Utah Health Care, and this is "Making Babies" on The Scope.

Announcer: Covering all aspects of women's health, this is "The Seven Domains of Women's Health," with Dr. Kirtly Jones, on The Scope.

Dr. Jones: Most of us want children and we'd like to have children in a timely manner. But if you're not getting pregnant in the time that you want, we always have said, "Well, go to your doctor or your family doctor, and then if you're not getting pregnant, come to see a specialist." But are there ways that you can actually enhance your own fertility without intervening with medications or interventions, at least for the start?

Today on The Scope studio, we are talking with Dr. Joseph Stanford, professor in the Department of Family and Preventative Medicine. And Dr. Stanford has a special interest in natural, procreative technology. And we're going to be talking about that, how to make yourself as fertile as you can be using natural methods. Thank you for joining us, Joe.

Dr. Stanford: Thank you, it's a pleasure.

Dr. Jones: So can you tell me about what is natural restorative or reproductive medicine? I'm a reproductive endocrinologist and everything that I do is not very natural. I do some really big hormones, and we do some really big procedures, and we do help people get really pregnant. But maybe there's something on the way to coming to me that actually might be very successful. So go with it.

Dr. Stanford: So natural procreative technology actually has a spectrum of things. The entry level is for couples to understand their fertility better, to understand what factors improve it, what factors are detrimental. And make lifestyle changes and also understand when the best times are for having sex.

Dr. Jones: Okay. What things make it better? What makes your fertility better?

Dr. Stanford: Adequate sleep, good diet. These are things you probably tell patients just as much. Moderate amount of exercise and weight that is not too high or too low, especially for women but also for men.

Dr. Stanford: Okay. And what things make things worse? All those converses meaning, an unhealthy lifestyle, not getting enough sleep, alcohol, and cigarettes smoke and unhealthy weight for men and women?

Dr. Stanford: Right, other drugs, marijuana, all those things.

Dr. Jones: Right. And then not enough sex?

Dr. Stanford: Well, not appropriately timed sex. That's one of the myths, is that you have to have sex either every day or every other day. But for couples with infertility, it's often the case that the fertile window is narrower for the woman. It may be three days instead of five or seven. It may be one or two days, the days that are functionally most likely for conception to happen. Couples can learn to track that and know when those days are with fertility awareness or natural family planning as one component of the natural procreative of technology.

Dr. Jones: Okay. So, education about things which enhance your fertility in your own body and timing and appropriate frequency of intercourse. And then you mentioned that was one. So what's two?

Dr. Stanford: So number two for natural procreative technology is really very similar in some ways to a medical . . . We do a full medical history exam for the woman and the man. We're trying to identify underlying factors that may be inhibiting fertility. I think we could both agree that a healthy woman, healthy man, healthy couple that didn't have any health issues, part of their healthiness would be being able to reproduce when they're in their reproductive age range.

So if there is not fertility at a normal level, something organically, physically is wrong. And usually, in our research with looking at this with couples, there are usually multiple underlying contributing factors. So what we're trying to do is identify all of those contributing factors and make them better to the extent we can. Some of them are lifestyle issues, some of them are medical issues. It may be thyroid, it may be polycystic ovary syndrome, it may be an endometriosis it may be a varicocele. It may be other things affecting semen quality. So we were trying to identify all of those things and find whatever we know that we have in our toolkit currently to correct and restore the possibility of natural conception.

Dr. Jones: So let's take endometriosis for an example. In my world, if we think someone has endometriosis and maybe we can feel it. Maybe someone's had a look inside their tummy, and they saw it, we feel an abnormal ovarian cyst and we can tell on ultrasound it's endometriosis. In my world, we operate on that and say, "Now we've restored your pelvis, at least for a little while, to its better fertility so go for it."

Dr. Stanford: I would I would applaud that. I think that the only definitive treatment we currently have for endometriosis is good surgery. And when I say good surgery, I mean surgery that's not just removing it but also minimizing the risk of subsequent adhesions. So adhesion-free surgery. I don't personally do surgery, but I have a short list of surgeons that I trust to refer to for patients that need that. So I think surgery can be part of the restorative process. And in endometriosis, it's what we currently know we have for that. I hope down the road, we'll find some other ways to reverse endometriosis or prevent it without surgery, but we're a ways away from that.

Dr. Jones: So for guys, if we have a gentleman who comes to us at the Utah Center for Reproductive Medicine and he has maybe half the numbers of sperm that he should or less. He has less than 20 million sperm per CC, and they don't look right, we move right away to . . . maybe we'll look for a varicocele, but we might do inseminations or might move to IVF. What do you do for guys to enhance their fertility? Do you go back to the lifestyle and the health issues?

Dr. Stanford: Definitely start there because that's kind of the foundation and it's a rare man that doesn't have some lifestyle issue, right? We definitely start there, but there are also some limited trials, some of the supplements that have been done for antioxidant and other types of supplements. And I think, in many cases, it's worth the trial of those with a follow-up semen analysis to see which way things are going, paying attention to the fact that semen analyses have a natural fluctuation as well.

Dr. Jones: So here's the problem that I face often here in Utah. And that is, and it can happen anywhere, and that is a young couple, they're 25. They've been trying six months. They haven't become pregnant. They want to be pregnant yesterday. And they want to immediately jump to my toolbox. And I don't even want to open . . . I don't even go looking for my tool box yet because they haven't tried long enough and hard enough for. . . And if I tell them I think they should try for another year using, actually, things that you're recommending, sometimes they walk out of my door and walk into my partner's door. So maybe if I send them to you, you'll keep them in your arms until you decide they need to come back to me?

Dr. Stanford: I would certainly do my best. And I think we have a reasonable track record. One of the things we find from studies of infertility treatment is that there's a high dropout rate from all types of fertility treatment. IUI, IVF, also the natural procreative technology, we all struggle with the keeping the couples engaged enough to say, "You really can succeed if you give it the full try." And couples often give up before we think they should, medically.

But, having said that, I do think that what I do is a lot different than just saying, "Okay. Try for another year," or, "Learn how to time it, and then try for another year." We're actively managing the cycle. What I mean by that is we track it with the woman's fertility tracking, charting biomarkers. We're looking at the mucus score. We quantitate the quality of the cervical fluid or cervical mucus production. We look at the bleeding pattern, including little bits of spotting making us nervous. We look at that. I usually just do a single [inaudible 00:08:21] hormone level seven days after ovulation.

So we're looking at these parameters and their timing of intercourse to look at 12 optimized cycles, not just trying for a year, but let's get 12 cycles where we can document that the cycle looks optimized for conception, based on the woman's charting, based on the timing of intercourse, based on the hormone levels.

Dr. Jones: So after that, what do you do if it's been 12 cycles and they haven't conceived, and you haven't either found a reason, or you found a reason, but they still haven't conceived. Where do they go from there? Do they get to decide about where the next steps are?

Dr. Stanford: They certainly always get to decide, but my recommendation to them at that point is, "We've done a full course of treatment, I can't promise you anything further. If you want to keep going, because that's what you want to do, I'll support that, but I'm not recommending that in the sense that we have done a full course of treatment. And you can look at other options, whether that's other fertility treatment or adoption or accepting your childlessness with saying you've done what you wanted to do." So those are always the couple's choices. So, for me, a full course of treatment is those 12 optimized cycles after having corrected all the underlying issues that we can.

Dr. Jones: Right. Well, I think most of us who do this want people to have the family that they want and we don't want any kind of therapy dragging on for too long because the clock is ticking, especially for women. But in the fertility business, I would say, I think it's important not to intervene with the big guns too soon, but not to avoid the big guns, meaning in-vitro fertilization, if it's something that's a choice for them.

And I think that what you've done, I've seen many of your patients over the years be pretty happy and successful with doing their own fertility once you've ruled out . . . you wouldn't . . . Somebody with no sperm, no eggs or no tubes, you would probably send them on pretty quickly.

Dr. Stanford: Right. If they don't have a possibility for natural conception because their both tubes are blocked, I'll certainly advise them of that upfront. This approach, I think, is a viable approach for the vast majority of sub-fertile or infertile couples, but there are a few that have absolute reasons that they can't conceive naturally.

Dr. Jones: Right. So I think both of us want the same thing in the end. I don't want to over-treat young couples that might get pregnant on their own with either specially adapted cycles to look at their own peak natural fertility or just time. And you probably don't want people jumping into high-tech fertility before it's time for them as well.

Dr. Stanford: Definitely, I agree with that. And I think that one of the things that are a little different about the restorative approach is we, ourselves, are also trying to take a longer view. Not just getting them pregnant, and I know that you would agree with this too, we want a healthy baby. We want a full-term life, ideally singleton baby. In other words, not twins when we can avoid that because of the risk. Not because we don't like twins, but because they just have more risks to the mom and babies. And we want that baby to grow up healthy, and we want the mother to be healthy later in her life. So I think the idea is to look at the overall health picture and not just, "Do you get pregnant next month?"

Dr. Jones: Great. Okay. Well, so for people who are attempting to get pregnant and are still young, of course, 45-year-olds might get a different approach, our goal is to do the right thing at the right time. And both of us are planning on doing that. And call us if you need us and thanks for joining us on The Scope.

Dr. Stanford: Thank you.

Announcer: Want The Scope delivered straight to your inbox? Enter your email address at thescoperadio.com and click "Sign me up" for updates of our latest episodes. The Scope Radio is a production of University of Utah Health Sciences.