This week we had the pleasure of welcoming Dr. Jennifer Roelands, an integrative medicine trained, board-certified Ob-Gyn and the creator and head of Well Woman MD, an integrative women’s health practice.
Dr. Roelands covered three main questions in the workshop: hormone balancing, early detection/prevention of breast cancer, and the integrative medicine aspect of birth control.
How can we, as students, balance out hormones naturally?
There are over 85 different symptoms of hormone imbalance. Some symptoms mentioned by Dr. Roelands include vaginal dryness, bloating, brain fog, allergies, irritation, acne, hair loss, etc.
To understand the imbalance of hormones and their effects, Dr. Roelands discussed the basics of the menstrual cycle; such as 2 weeks before ovulation, estrogen is more prominent, while 2 weeks after ovulation, progesterone is more prominent. And this is important to understand because the symptoms of hormone imbalance may be dependent on what hormone level is high at that particular time in their cycle.
Usually, the blood test is the most prominent test done. While it does look at all the sex hormones, it is only “one” moment in time. And it is only relevant in female hormones if we know what time it is in their menstrual cycle. Other tests include the saliva test, which checks for most hormones, except for thyroid. An advantage to this is that it can be done at different times, so hormone levels can be monitored throughout the day. This is best for measuring cortisol levels. Finally, there is a urine test (DUTCH test), which looks at the production and what happens to hormones as they are broken down and used.
As an integrative gynecologist, Dr. Roelands first considers what exactly the patient wants and what treatment options they are comfortable with. Then looking at all pillars of integrative medicine (nutrition, movement, relationship, stress, sleep, and environment), Dr. Roelands formulates a treatment plan. In regards to nutrition, Dr. Roelands described the emergence of culinary medicine, which focuses on nutrition and its ability to prevent or treat diseases. Culinary medicine also focuses on Magnesium, Fiber, Vitamin D, Vitamin B9, and Omega 3.
What does early detection/prevention of breast cancer look like?
In terms of early detection, mammograms are available starting at ages 40-44. And at 50, every woman is recommended to have it every year.
In terms of the prevention of breast cancer, Dr. Roelands stated that a plant-forward diet can reduce breast cancer risk by 36% and that exercising 3 hours a week can reduce the risk by 26%. Good nutrition and exercise are vital in making sure that hormones are used up and gotten rid of efficiently. More recent research shows that vitamin D is also helpful in facilitating a good cycle.
What is an integrative medicine perspective of birth control? What are birth control’s safety aspects and effects, and are there any alternatives?
There are various birth control choices available, including some well-known ones such as the pill, patch, ring, nexplanon, IUD, and Depo. However, there are also some less-mainstream options such as paraguard, diaphragm, spermicide, etc. It is also important to note that some of the less-mainstream options, may utilize non-hormonal treatment, however, some may be less effective as well. When meeting with a patient, in regards to birth control, Dr. Roelands first considers what works for that patient, and what are they comfortable with, before formulating the best treatment plan.
Another option that can be utilized is natural family planning. Natural family planning, as stated by Dr. Roelands, looks at the basal body temperature and the cervical mucus every morning. There will usually be a difference in these two facts between the pre-ovulation, ovulation, and post-ovulation time frame. From this, one can figure out when ovulation is occurring and avoid having sex during that time.
Dr. Roelands also briefly went over complications that may occur. Complications for birth control are rare (around 1.2 per 10,000 in regards to stroke and blood clots), but serious. Usually, genetic predisposition plays a prominent role in whether complications may occur.
Finally, Dr. Roelands mentioned that birth control can cause vitamin deficiencies, disrupt the gut microbiome, and can act as a way to cover up other diseases. For example, low vitamin B can cause a higher chance of depression, which is a possible side effect of birth control. Another example includes the fact that PCOS may be present, but can be “covered up” with birth control regulating the menstrual cycle.
If you want to learn more about Dr. Roelands and her work, be sure to check out Dr. Roelands's website at https://wellwomanmd.com/.
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