By Dr. Chantell Groenewald (M. Tech Hom UJ).

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Estrogen dominance refers to an imbalance in the ratio of the female hormones estrogen versus progesterone. This ratio is crucial considering estrogen acts as an 'on switch' while progesterone acts as the 'off switch' for many processes in our body. An imbalance in this ratio is responsible for chronic diseases including, but not limited to endometriosis, uterine fibroids, endometrial and breast cancer as well as fibrocystic breast disease.

Estrogen dominance can be caused by three mechanisms:
Excessive production of estrogen in the body,
Activation of estrogen receptors from exogenous estrogen such as xenoestrogen, and
Lower than normal levels of progesterone. 

Estrogen dominance can be determined by a serum estrogen and progesterone blood test, however these results are not always accurate and a diagnosis can be made based on the clinical picture.

Here are 10 signs of estrogen dominance
Weight gain and difficulty loosing weight
Difficulty conceiving (especially in the presence of low progesterone)
Headaches and migraines
Excessive PMS symptoms
Bloating of the stomach
Hair loss
Anxiety and depression
Decreased libido and sex drive
Fatigue and decreased energy
Insomnia

Here are 5 diet and lifestyle changes to implement to help reduce estrogen dominance:
Eat at last 5 - 7 servings of vegetables each day. Include raw and cooked vegetables and plenty of cruciferous and allium vegetables. Vegetables help rewire your biochemical pathways and assists in estrogen metabolism.

Avoid plastic containers. This includes water containers and food packaged in plastic.
Plastic is a rich source of xenoestrogens.

Eat organic produce and free range reared live stock. This helps reduce exposure to growth hormones and pesticides that contribute to estrogen dominance. 

Include plenty of fiber including insoluble fiber in your diet. Fiber helps facilitate healthy metabolism of estrogen. 
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Use organic skin care products. What you put in your body is just as important as what you put on your body. Non organic skin care products contain products that become xenoestrogens when absorbed through the skin.

By Dr. Chantell Groenewald M. Tech Hom (UJ)
 
What is infertility.
Infertility is defined as not conceiving or carrying an infant full term after having regular unprotected sex for at least 12 months. According to Parent24, an estimated 15-20% of couples in South Africa struggle with infertility.
 
Causes of infertility in women:

1. Age: A women’s peak fertility years is in her 20’s, thereafter fertility decreases proportionately with an estimated third of women struggling with infertility by their 30’s;
2. Hormonal dysregulation: This includes female health issues such as polycystic ovarian syndrome (PCOS) and endometriosis;
3. Structural issues: An inverted uterus, uterine fibroids (myomas), fibrotic adhesions following pelvic inflammatory disease or endometriosis and blocked fallopian tubes;
4. Chronic disorders: Including eating disorders, sexually transmitted diseases, hyper-or hypo-functioning of the thyroid gland, tumours, candida overgrowth, certain auto immune conditions such as lupus and celiac’s disease, diabetes and hyperprolactinemia (over production of the hormone prolactin which stimulates breastmilk production);
5. Primary ovarian insufficiency: Commonly referred to as early menopause, when a woman stops ovulating and menstruating before the age of 40;
6. Diet and lifestyle factors: Smoking, being underweight, overweight or obese and alcohol use.

Many of the above-mentioned conditions are as a result of inflammation, hormonal dysregulation and a dysregulation of our body’s natural physiology. This can be as a result of diet and lifestyle, genetics and environmental factors to name a few. We all have a genetic makeup that predisposes us to certain health issues, whether these issues can take root depends on the soil in which it is planted. A healthy neighbourhood is less conducive to chronic illness.
 
Factors that play a crucial role in creating a neighbourhood conducive to conceiving include:

1. Diet: ‘Let food be they medicine, and medicine be they food’ Hippocrates. We are what we eat, and if you are net getting in essential nutrients through your diet to promote and maintain a healthy body, then you will not have the necessary building blocks to create an environment conducive to conceiving and carrying a pregnancy full term. If you have known nutritional deficiencies, then a supplement may be beneficial granted your body is able to assimilate and absorb these nutrients.
2. Heal your gut: An unhealthy gut is a preventable source of inflammation. This is probably the single most important factor to address in the treatment of infertility in the absence of any structural or functional causes for not being able to conceive. Inflammation is associated with and promotes chronic disease and does not create a favourable neighbourhood for fertility.
3. Support the liver: Our liver is responsible for metabolizing our oestrogen. A liver that is struggling with phase I and II detoxification of the liver will lead to unhealthy forms of oestrogen being reabsorbed and causing an oestrogen dominance which will hinder fertility.
4. B-vitamin’s and folate to support methylation: Methylation is a chemical reaction that happens in each of our cells and impacts how a protein functions in our bodies. A study conducted in the USA found that up to 60% of adults had a gene mutation that negatively affected their methylation. B vitamin’s as well as methylated folate plays a crucial role in the methylation process which is important for oestrogen metabolism.
5. Adrenal Health. The adrenal glands secrete a hormone called cortisol which plays a crucial role in regulation many functions in our bodies, including hormone production. During periods of high stress cortisol supresses hormone production to favour the fight or flight response. When stress becomes chronic and a state of adrenal fatigue ensues then our body uses DHAE to favour the production of cortisol rather than oestrogen and progesterone which negatively impacts female health and wellness.

Infertility is becoming a growing problem which some researchers attribute to our poor quality of life, high stress levels and poor nutrition. Healing your gut, managing inflammation as well as stress and incorporating enough nutrition rich food into your diet plays a key role in promoting healthy hormone levels and conceiving
 
“Parenting begins the moment you make any conscious effort to care for your own health in preparation for enhancing your child’s conception.” Carista Luminare-Rosen

By: Dr. Chantell Groenewald (M.Tech Hom UJ)
 
What is inflammation?
Inflammation is our body’s immune reaction following damage to tissue, to localize and eliminate the injury or infection. Acute inflammation has many triggers including:

• Viruses and bacteria
• Physical or chemical injuries
• Chronic allergies and
• Autoimmune reactions

This acute response is crucial to life, however when inflammation become chronic then it negatively impacts our health. Chronic inflammation happens when the triggering substance is not entirely eliminated, this can include but is not limited to:

• Repeated acute inflammatory reactions
• Obesity
• Auto-immune diseases
• Smoking
• Alcohol use
• Leaky gut
• Poor diet and lifestyle
• Chronic stress and
• Long term exposure to certain irritants

 
Chronic inflammation damages healthy tissue. Most adults have chronic inflammation that goes undetected by physicians, fuelling disease. Research suggest that chronic inflammation either promotes or is the direct cause of many diseases including:

• Cancer
• Rheumatoid arthritis
• Diabetes
• Heart disease
• Cognitive decline
• Female hormonal issues including endometriosis
• Hypertension
• Osteoporosis
• Alzheimer’s disease and
• Parkinson’s disease, to name a few.

 
What role do our genes play in inflammation?
Interleukin-6 (IL-6), Tumour necrosis factor alpha (TNFA) and Interleukin-1 (IL-1) play a key role in the regulation of inflammation. Some individuals have variations in their nucleotide base pairs that favours the expression of IL-6, IL-1 and TNFA which in turn promotes inflammation. While most underlying causes of inflammation can be addressed, we cannot change our genes, so these individuals need to take special care in terms of diet and lifestyle interventions to combat inflammation.
 
What are the special investigations to identify inflammation?

1. DNA Analysis. Optimizing health based on genetics. Our DNA is made up of only 4 building blocks, adenine, guanine, cytosine and thymine. These nucleotides form base pairs. Human DNA consists of more than 3 billion nucleotide base pairs, 99% of which are identical in each human (which is what makes us human). Single nucleotide polymorphisms (SNP) are variations in a single nucleotide that make up the remaining 1% of our DNA. DNA analysis gives us insight into these SNP’s which effects the functioning of our genes that can have profound effects on our health. Understanding SNP variations can allow us to tailor a diet and lifestyle program to each individual’s needs to compensate for the gene variations and to promote health.
2. Blood tests include C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR). CRP is an inflammatory marker that can be increased in several diseases including infections, inflammatory diseases and heart disease. Moderately elevated levels of ESR is a good predictor of inflammation. These blood tests can give you insight into the state of inflammation within the body.

Five Tips to combat inflammation:

1. Heal your gut: “Disease begins in the gut” Hippocrates. Our gut is a constant source of inflammation due to bacterial overgrowth, poor diet and nutrition as well leaky gut syndrome. A good gut cleanse or detox can help heal the gut lining and reduce inflammation.
2. Omega 3: Omega 3 is a potent anti-inflammatory substance that can down regulate inflammation. A Mediterranean style diet is the ideal source of omega 3, including foods such as avocado, oily fish, olive oil and olives to name a few. If your diet is deficient in omega 3 then you should consider a supplement.
3. Liver support. Increased inflammation causes increased stress on phase 1 detoxification of the liver. Your healthcare professional can recommend various supplements that can support the liver.
4. Eat a pound of vegetables every day. SNP’s impacts the genes in which they are found, which in turn affects our biochemical pathways. Eating enough vegetables packed with phytonutrients and antioxidants can help combat the gene variations and, in this way, rewire our biochemical pathways. Try to incorporate both raw and cooked veggies with each meal and make sure you include the entire colour spectrum of vegetables.
5. Weight management. Losing weight can combat inflammation. Fat cells in our abdomen, called visceral adipocytes, secrete pro-inflammatory markers which causes chronic low-level inflammation. We are all unique and lose weight in different ways, some people need a low-calorie diet or a high intensity training program to mobilise fat stores. Intermittent fasting, low carbohydrate eating plan or ketosis might be for you, or it may not. Find the program that works for you and do not be discouraged with slow and steady weight loss, some SNP genes are prone to difficulty losing weight and in these instances, slow and steady wins the race.

To find out more about DNA analysis, gut health, weight loss and inflammatory related chronic diseases, please do not hesitate to contact us.
 
Article by Dr. Chantell Groenewald M. Tech Hom (UJ)
Instagram: @the_female_health_homeopath

DR. Chantell Groenewald
M. Tech Hom (UJ)

 
What is PCOS?
 
Polycystic ovarian syndrome is the most common hormonal disorder affecting women of child bearing age. It is a chronic disease affecting the functioning of the ovaries causing excessive male hormones to be secreted and is characterized by:

• Increased androgens (male hormones) as mentioned,
• Insulin resistance (which further exacerbates the excess of male hormones),
• Infrequent or no menstrual cycle,
• Adult acne,
• Accumulation of multiple cysts on the ovaries,
• High cholesterol,
• Obesity and
• Infertility

 
 
What causes of PCOS?
 
The cause for PCOS is poorly understood, but genetic and environmental factors seem to play an important role. There is a hormonal dysregulation at play, which includes

• Higher than normal luthenizing hormone (LH). Produced by the anterior pituitary gland, the LH is required to stimulate the ovarian follicles to secrete oestradiol.  A surge in LH, causes the ovarian follicle to tear and release the ripe egg. Because the LH hormone is already higher than normal in patients with PCOS, there is no LH surge and ovulation does not take place.
• Decreased follicle stimulating hormone (FSH), Also released by the anterior pituitary gland, the FSH is responsible for the growth of the ovarian follicle, as well as secretion of oestrogen,
• Higher than normal levels of testosterone (hyperandrogenism). Testosterone is normally secreted in small amounts by the ovaries as well as the adrenal glands, but in patients with PCOS the ovaries secrete abnormally high levels of testosterone, and
• Elevated levels of insulin. Insulin regulates blood glucose levels, by signalling cells to absorb glucose from the blood stream to use as energy. Insulin is also involved in fat storage.

50-70% of females with PCOS suffer from insulin resistance which exacerbates excess secretion of male hormones by the ovaries. Insulin resistance contributes to obesity, which increases insulin resistance and further aggravates PCOS.
 
What are the diagnostic criteria for PCOS?
 
The current diagnostic criteria for PCOS is at least two of the three following characteristics:

• Infrequent periods (oligoanovulation)
• Increased male hormones (clinical hyperandrogenism)
• Polycystic ovaries on ultrasound (present in only 20-30% of woman with PCOS)

 
What are the signs and symptoms of PCOS?
 
The signs and symptoms of PCOS varies from one woman to the next. Here is a list of the most common symptoms:

• Infertility or difficulty conceiving
• Increased testosterone
• Oligomennorrhea (a woman who regularly goes 35+ days without having a period)
• Insulin resistance
• Gaining weight or difficulty losing weight
• Acne
• Thinning hair (male pattern balding)
• Acanthosis Nigricans (dark patches of skin)
• Hirsutism (abnormal hair growth pattern on a woman’s face or body)
• Hyperlipidemia (High cholesterol)
• Low sex drive (libido)
• Fatigue
• Obesity
• Anxiety and depression

 
What are the natural treatment protocols for PCOS?
 
1. Losing weight
This is vital in controlling insulin sensitivity, reversing insulin resistance and metabolic syndrome (triad of elevated insulin, cholesterol and blood pressure) and will aid in controlling the production of excess androgens by the ovaries. A carefully selected diet may assist in weight loss. There are various options including low carbohydrate, intermittent fasting, anti-inflammatory and anti-allergic eating programs to choose from. The correct eating plan can reduce inflammation and help control insulin levels and manage dysregulation of hormones.
 
 
2. Controlling stress
Excess cortisol produced by the adrenal glands during periods of high stress has a profound effect on our hormones. Long term expose to higher than normal levels of cortisol translate into insulin resistance, weight gain and hormonal imbalances. Getting enough sleep is also vitally important in regulating cortisol levels.
 
3. Supplements
There are various supplements that can aid in controlling blood sugar, reducing excess androgen production and balancing female hormones. A qualified practitioner can prescribe the correct supplements to help manage each individual case. Some supplements that have been suggested to benefit cases of PCOS include:
I.Chaste Tree: May be beneficial in regulating erratic ovulation, acne, oligomennorrhoea and amenorrhoea, ovarian cysts and assist in sleep maintenance.
II.Inositol: specifically, myo-inositol, is a vitamin like substance found in many plants and produced in our bodies. There are various studies that illustrates the beneficial effects of myo-inositol in the treatment of PCOS.
III.Vitamin D: Vitamin D deficiency effects an estimated 60-70% of people. The only way to test if you are vitamin D deficient is by doing a blood test (supplementing without confirmed deficiency is dangerous and should be done under the supervision of a primary health care physician). Vit D plays an important role in maturation of eggs and ovulation.
IV.Folic acid, omega 3, calcium, magnesium, zinc, n-acetylcysteine and chromium are a group of supplements that may be beneficial in the treatment of PCOS.
 
4. Homeopathy
There are various case studies that demonstrates the beneficial effects of specific homeopathic remedies to aid in the treatment of PCOS. Following a consultation, a homeopath can prescribe a remedy that suites each individual case. 
 
 
5. Exercise
Moderate exercise assists in both stress management and weight loss, which aids in controlling cortisol as well as insulin levels.

PCOS is a silent disorder with an estimated 50% of woman being not being diagnosed correctly. The potential long-term health risks of PCOS include sleep apnoea, endometrial cancer, fatty liver disease, type 2 diabetes, cardiometabolic disease and more. There are several ways to naturally balance our hormones and reverse the effects of PCOS

By Dr. Chantell Groenewald (M. Tech Hom UJ)

What are Fibroids?
Fibroids, also known as uterine myomas or leiomyomas, are the most common benign (non-cancerous) tumours of the female reproductive system with an estimated 80% of women being affected by the age of 50. Fibroids are abnormal uterine growths composed of smooth muscle cells and fibrotic tissue that can range in size from pea size to the size of a grapefruit. These fibroids may be asymptomatic in some women while causing severe menstrual issues for others and the leading indication for a hysterectomy. 

There are different types of fibroids classified according to their location, these include: 
• Intramural fibroids: Situated within the muscular wall of the uterus,
• Subserosal fibroids: Located on the outside of the uterus called the serosa,
• Pedunculated fibroids: A subserosal tumour that develops a stem, 
• Submucosal fibroids: These fibroids grow in the middle muscular layer of the uterus called the myometrium, and 
• Cervical Fibroids: These fibroids take root at the cervix. 

What causes Fibroids?
The exact cause of fibroids is unknown; however, their growth is dependant on the steroid hormones Oestrogen and Progesterone and specific growth factors. 

Some risk factors for the development of uterine fibroids include:
• Genetics: a family history of fibroids
• Race: Woman of African descent are at a higher risk of developing fibroids
• Puberty: Fibroids have not been observed in girls before their first menses
• Age: Premenopausal woman are exposed to elevated levels of oestrogen for prolonged periods of time
• Consumption of alcohol
• High blood pressure
• Being overweight or obese

Symptoms of Fibroids?
Fibroids can often go unnoticed without symptoms. Symptoms vary depending on the size, number and location of the fibroid or fibroids and include:
• Heavy, prolonged menstrual bleeding, or bleeding between periods;
• Dysmenorrhea (painful periods);
• Pelvic and lower back pain;
• Painful intercourse;
• Difficulty conceiving;
• Urinary frequency; and
• Abdominal distention. 

How are Fibroids diagnosed?
Fibroids are usually diagnosed during a routine pelvic examination. A transvaginal ultrasound or a pelvic MRI is used to confirm the diagnosis. 

What are the natural treatment options for Fibroids? 
Until recently large or multiple fibroids were removed surgically via a myomectomy and in severe cases a hysterectomy is performed. There are also several minimally invasive treatment protocols which include forced ultrasound surgery which uses high frequency sound waves to ablate the fibroids, cryomyolisis, endometrial ablation and uterine artery embolization. These treatment protocols are effective in removing current fibroids, but it does not address the mechanism of the fibroid growth and often fibroids return. 

To naturally treat fibroids, it is important to address the mechanism of fibroid growth and this is focussed on addressing the elevated levels of oestrogen. 

5 Tips to treat fibroids naturally:

1. Eliminate environmental xenoestrogens 

Xenoestrogens are substances that have a hormone like action on the body which are used in but not limited to food production, pesticides, food packaging production and cosmetics. Here are some tips to reduce exposure to xenoestrogens:
• Choose cosmetics and toiletries that do not contain parabens
• Choose organic veggies that have not been exposed to pesticides
• Choose animal products that have been reared without any growth hormones or routine antibiotics
• Stay away from foods packaged in disposable plastic

High fat non-organic processed meat like hamburger patties containing unhealthy saturated and trans-fats should be avoided at all costs
• Rather use a glass water bottle than a plastic water bottle.


2. Losing weight

Fat cells can act as endocrine glands and secrete oestrogen. Although these levels might not be very high it is still significant enough to raise blood levels of oestrogen, especially in obese woman. Weight loss will also assist in not only decreasing insulin resistance which is important for optimal ovarian function but also in regulating blood pressure which is important in preventing uterine fibroids.  A few tips on an effective diet program to combat fibroids include:
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• Foods high in oestrogens such as soy and commercially raised animal products should be avoided
• Inflammatory foods should be eliminated from the diet, this includes foods such as diary, wheat, processed foods, sugar etc.
• Avoid fresh produce that was not organically grown seeing as pesticides, herbacides, synthetic fertilizers and food preservatives contain xenoestorgens that high jack oestrogen receptors in the body and further exacerbates oestrogen dominance. 

3. Detox the liver and heal the gut
The liver is responsible for metabolising oestrogen. If the liver is not functioning optimally, high levels of oestrogen will further exacerbate oestrogen dominance. There are various supplements including Chedlidonium, Taraxicum and Carduus Marianus, that may be beneficial in supporting liver function.

After oestrogen has been metabolised by the liver, it is excreted via the gut. Leaky gut syndrome causes an up regulation of an enzyme called B-glucuronidase which breaks up bound oestrogen to be excreted and allows these smaller particles to be re absorbed into the system. A gut cleanse diet is essential in the healthy functioning of our hormonal system.


4. Supplements & Herbal treatment

Supplements that may be recommended by a qualified physician include: 
• Chaste tree: Chaste tree may be beneficial in reducing oestrogen dominance by balancing out the oestrogen vs progesterone ratio of the menstrual cycle,
• Progesterone cream: Can be considered under the supervision of your health care practitioner,
• Omega 3 fatty acid: Due to its anti-inflammatory properties,
• B vitamins: To balance hormone levels,
• Liver support: A well formulated herbal mixture to help facilitate phase 1 and 2 detoxification of the liver and support the healthy functioning of the liver,
• Indole 3 carbinol is an antioxidant that helps eliminate excess oestrogen from the body.


5. Homeopathy

There are several homeopathic remedies indicated for the treatment of fibroids. The correct remedy is chosen based on each individual case. Studies suggest that a thorough case taking based on the symptom picture will lead to a similimum prescription to aid in shrinking uterine fibroids.