Women's Gynecological Health Issues Articles & Resources

Cervical Dysplasia

Cervical dysplasia is abnormal cervical cells diagnosed by a Pap smear. Risk factors include sexual activity, a viral infection, smoking, and low intake of fruit and vegetables. Doctors classify dysplasia as either low-grade (mildly abnormal cells) or high-grade (precancerous cells). Most of the time, symptoms are nonexistent. And most cases of mild dysplasia go away on their own. However, without treatment some strains may progress to cervical cancer in 10 to 15 years, says naturopath Hudson. If you're diagnosed with cervical dysplasia, discuss the following treatments with your doctor:

Include Healing Foods. Sometimes inflammation causes cells to appear abnormal on a Pap smear. You can help calm inflamed cells by eating healthy foods, says Tracy Gaudet, ., gynecologist and director of the Duke Center for Integrative Medicine in Durham, . A healthy diet includes foods rich in omega-3 fatty acids, which reduce inflammation. Eat five 3-ounce servings a week of coldwater fish like herring, salmon, or sardines. Or sprinkle 2 tablespoons of ground flaxseeds on salads or vegetable dishes daily. And consume at least three servings a day of vibrantly colored fruit and vegetables--eat dark leafy greens like kale and spinach, or grapefruit and oranges. These foods are rich in beta carotene, folic acid, and vitamin C. Research has linked low levels of these nutrients to an increased incidence of cervical dysplasia.

Exercise to Boost Immunity. Moderate exercise, which bolsters immunity, helps your body heal inflamed cells, says Gaudet. She recommends walking 30 minutes a day three or four times a week.

Get Examined to Stay Healthy. Having frequent Pap smears is the best way to monitor whether your dysplasia is healing or growing worse. Ask your doctor how often you should get one; most doctors recommend having two to four a year if you have low-grade dysplasia.

Reverse Abnormalities with an Herbal Therapy. If you have high-grade dysplasia, speak to a naturopathic or holistic physician about possibly undergoing escharotic treatments, a procedure in which a doctor applies enzymes and herbal solutions to your cervix twice weekly for five weeks. Escharotic treatments can remove abnormal cells and reverse your condition without the scarring of healthy cells associated with conventional surgical treatments. (Escharotic means producing a dry scab.) Escharotic treatments cured two advanced cases of dysplasia, according to a study in the Journal of Naturopathic Medicine in 1993. (To locate a naturopathic or holistic physician to administer this treatment, see "Find the Right Doctor," page 68.)

Endometriosis

Endometriosis occurs when cells from the lining of your uterus migrate to other parts of your body, like your stomach, liver, intestines, bladder, kidneys, or abdominal muscles, and start growing there. Symptoms include painful intercourse, painful periods, pelvic pain, pelvic irritation, and even infertility. Because uterine cells respond to hormones no matter where they are, many endometriosis symptoms come and go with your menstrual cycle. Scientists aren't sure what causes endometriosis, which makes it difficult to cure. However, you can safely and effectively reduce symptoms with natural methods.

Help Your Uterus with Food. To ease pelvic pain and menstrual cramps, gynecologist Gaudet recommends increasing your intake of foods rich in omega-3 fatty acids, which can reduce the inflammatory response that exacerbates symptoms. Eat five 3-ounce servings a week of cold-water fish like herring, salmon, or sardines. Or sprinkle 2 tablespoons of ground flaxseeds on meals each day.

Use Tried-and-True Cramp Treatments. The same remedies that work for menstrual cramps also lessen the pain of endometriosis. Niacin, or vitamin B3, dilates uterine arteries to increase circulation, which relieves cramping. Take 100 mg of niacin every two or three hours while you have pain. It should begin to work within a few hours, says Hudson. (Niacin can cause a feeling of blood rushing to your face, often called a niacin flush. It's safe for most people, but talk to your doctor if you take prescription drugs like heart medications, which can interact with niacin. If your flush bothers you, stop taking niacin.) Instead of niacin, you could try cramp bark (Viburnum opulus), which relaxes uterine muscles and stops spasms. Take 1/2 teaspoon of liquid extract every two to three hours while you have pain. If you have chronic pelvic pain, combining niacin and cramp bark can help. Twice a day, take 100 mg of niacin and 1/2 teaspoon of cramp bark liquid extract. You can take these indefinitely.

Eliminate Stress. Stress increases your body's output of hormones like adrenaline and cortisol, which can exacerbate pain, says Gaudet. So you'll benefit from practicing stress-reducing techniques. For two relaxation exercises, see "Erase Fatigue with Meditation or Yoga," Ask the Experts, page 35.

Try Acupuncture to Balance Hormones. Practitioners of traditional Chinese medicine report great success in using acupuncture to treat endometriosis, and some evidence supports those claims. A 1997 clinical observation study in Acupuncture and Electrotherapy Research found that electroacupuncture, a variation of traditional acupuncture in which pulses of electric current flow through the needles, may help regulate the release of certain hormones. Balancing hormones may help ease the cyclic problems associated with endometriosis and other gynecological conditions. Additionally, a 1996 Bulgarian study noted that traditional acupuncture effectively relieved menstrual cramps. To find an acupuncturist near you, contact the American Academy of Medical Acupuncture (323-937-5514; .org).

Fibrocystic Breasts

Most women have fibrocystic breast tissue, or dense connective tissue, and its presence may be more noticeable before menstruation. "Lumpy breasts are normal," says Adriane Fugh-Berman, ., medical advisor to the National Women's Health Network, a Washington, .-based consumer group. If you have fibrocystic tissue that causes painful pressure, try the tips that follow.

Whether your breasts are lumpy or not, you should know their topography so you can detect potentially cancerous changes. Do a self-exam a few days after every period. Although it can be difficult to distinguish between fibrocystic tissue and cancer, cancer is usually fixed and hard, whereas fibrocystic lumps are easy to move around and have a rubbery or softer texture, says Fugh-Berman. It is crucial to see your doctor for a yearly breast exam, since practitioners are trained to distinguish between benign and possibly cancerous lumps.

Control Pain with Diet. Naturopath Hudson has seen patients greatly reduce breast tenderness by eliminating caffeine, reducing dietary fat to 20 percent of calories, and increasing their fiber intake. Caffeinated drinks and foods like coffee and chocolate contain a chemical that overstimulates breast tissue in some women, causing pain. A high-fat diet raises your body's estrogen levels; too much estrogen can also overstimulate breast tissue. Fiber helps your body excrete extra estrogen. To get more fiber, Hudson suggests eating five to nine daily servings of fruit and vegetables and one to four daily servings of whole grains like amaranth, barley, brown rice, millet, oats, quinoa, and whole wheat.

Let Supplements Soothe Symptoms. Evening primrose oil (Oenothera biennis) has eased breast discomfort in studies. Hudson adds that it has relieved pain and even lumpiness for some of her patients. She recommends taking 3 to 4 g of evening primrose oil daily. You should feel relief within three months. Some women ease pain by taking 400 to 800 IU daily of natural vitamin E (d-alpha tocopherol), which may also reduce tenderness, although clinical evidence is conflicting. For cases that don't respond to evening primrose oil or vitamin E, Hudson prescribes aqueous iodine supplements, which can reduce breast sensitivity to estrogen and actually shrink the dense connective tissue, usually within three months. Supplemental iodine is only available by prescription; talk to your doctor.

Incontinence

Healthy pelvic floor muscles prevent urine flow when you're not urinating; weak muscles can result in urinary incontinence, the involuntary loss of urine. The most common form is stress incontinence, in which a few drops to about a tablespoon of urine leak out during coughing, sneezing, or physical exertion. Urge incontinence occurs when your bladder is full and you barely make it to the bathroom (or don't make it). Both forms of urinary incontinence respond well to self-care. (You should see a doctor first to rule out serious health problems like a nerve injury, stroke, or multiple sclerosis.)

Squeeze to Stop Stress Incontinence. Kegel exercises, in which you strengthen your pelvic floor muscles by contracting them, are the best treatment for stress incontinence, says Hudson, a naturopath. First, learn how to isolate your pelvic floor muscles. You can do this by inserting one finger into your vagina and contracting around it. Or you can buy vaginal cones (weighted plastic devices shaped like tampons); when you insert a cone, if you are not properly contracting your pelvic floor muscles, it will fall out. You can order vaginal cones at Home Delivery of Incontinence Supplies (800-269-4663; .com). Once you have learned to isolate those muscles, perform Kegel exercises (contracting the muscles) in five sets of 10 per day to strengthen them. Done daily, Kegels can stop or drastically reduce stress incontinence in two to three months, says Hudson.

Tame the Urge with Biofeedback. Women who have urge incontinence often contract their abdominal muscles when trying to avoid urination. But this puts pressure on their bladders and worsens the problem. To treat urge incontinence, you need to train yourself to relax your abdominal muscles while contracting your pelvic floor muscles. Biofeedback can help you learn this skill. This therapy uses sensors hooked to a computer to measure muscle movements in your body; watching the readouts on a computer screen helps you become aware of, and ultimately control, the appropriate muscles. Biofeedback can work after a single session, but you may need to take multiple sessions to reinforce your skills. (To locate a biofeedback practitioner, check with your local hospital or clinic, or contact the Biofeedback Certification Institute of America at 303-420-2902.)

Amend Your Drinking Habits. You can improve stress and urge incontinence by not drinking excessive amounts. Most people need to drink only about a quart, or four 8-ounce glasses of fluids, a day, says Hudson. Drinks like coffee or soda commonly trigger incontinence. If you notice a specific beverage causes a problem for you, Hudson suggests eliminating or drinking less of it. If you have urge incontinence, don't wait until your bladder fills to urinate. Set a small alarm to remind yourself to use the bathroom every few hours. Also, if you tend to wake in the middle of the night to urinate, don't drink anything after 7 .

Infertility

Several factors can hamper fertility in women, including an imbalance of reproductive hormones, pelvic infections, and endometriosis. In about 1 in 10 cases, medical tests cannot determine the cause. No single treatment will be successful for everyone, but research has shown that the following simple, inexpensive treatments can help women conceive. Work with your doctor as you try them.

Do Away with Certain Substances. You can significantly increase fertility, according to several clinical studies, by eliminating caffeine, alcohol, and cigarettes, which may interfere with reproduction. Also stop taking herbs, in supplement form or as teas, and over-the-counter and prescription medications, except under a doctor's supervision, because they may hamper fertility, says Alice D. Domar, ., psychologist and director of the Mind/Body Center for Women's Health at Boston IVF and author of Conquering Infertility (Viking, 2002).

Check Your Weight. Weighing too little or too much can disrupt your reproductive system, because body fat affects hormone production. To find out if your weight is healthy, calculate your body mass index (BMI) by multiplying your weight in pounds by 703 and then dividing that number by your height in inches squared. The ideal BMI for a woman trying to conceive is 20 to 27. If you are on either side of that range, talk to your doctor about adjusting your eating or exercise habits.

Slow Your Pace. For some women, intense exercise suppresses fertility, says Domar, although experts aren't sure why. If you're not trying to lose a significant amount of weight, exercise at a moderate to easy pace two to three times a week and keep your heart rate under 110 beats per minute. Good forms of moderate exercise include yoga or walking for about two miles. Moderate exercise also encourages relaxation and reduces stress, which may increase fertility.

Take Fertility-Enhancing Vitamins. Studies have tied vitamin deficiencies to infertility, and nutrient deficiencies can harm a developing fetus. So Domar recommends taking a prenatal multivitamin (available from your physician) or a basic daily multivitamin that contains 400 mcg of folic acid. (If yours does not contain that much folic acid, take a separate folic acid supplement.) But don't exceed the daily value of any vitamin or mineral without the supervision of your doctor or nutritionist, says Domar. Some nutrients, like vitamin A, can build up to toxic levels in your body and can cause birth defects. To further protect against consuming too many nutrients, read the labels on fortified foods like cereals and energy bars. Some brands can contain up to 100 percent of the recommended daily value of some vitamins.

Ask About Supplements. Depending on the cause of your infertility, certain herbs may help you conceive. Ask your doctor about trying the following herb or about taking a combination supplement.

Chaste tree berry (Vitex agnus-castus; also called chasteberry or vitex) has been used for centuries in Europe and China to balance hormones. It treats infertility by normalizing levels of the hormones that help to stimulate ovulation. Chaste tree berry should begin to take effect after three to four months, according to Hudson. The usual dosage is 40 drops of a liquid extract or 175 mg of standardized capsules per day, but it's best to work with a practitioner if you want to take it.

A supplement that combines herbs and nutrients, called FertilityBlend, may also help speed conception, according to a double-blind, placebo-controlled study published earlier this year in the Journal of Women's Health and Gender-Based Medicine. In the study, researchers gave 29 women who were having trouble conceiving this supplement or a placebo. After three months, four of the 14 women taking the supplement became pregnant, compared to none of the women in the placebo group. FertilityBlend is available at pharmacies and natural food stores, or through the manufacturer (866,222-9862; .com). According to lead researcher Lynn Westphal, ., assistant professor in the department of gynecology and obstetrics at Stanford University in California, daily doses of FertilityBlend contain 400 mcg of folic acid, 6 mg of vitamin [.6], 12 meg of vitamin [.12], 225 IU of natural vitamin E (d-alpha tocopherol), 18 mg of iron, 400 mg of magnesium, 70 mcg of selenium, 15 mg of zinc, 80 mg of chaste tree berry, 200 mg of green tea (Camellia sinensis), and 800 mg of the amino acid L-arginine.

Address Depression. Recent studies show that women who are depressed are less likely to get pregnant, according to Domar. Depression may decrease the production of luteinizing hormone, making it less likely that you'll release an egg. If for the last two weeks or longer you have been feeling sad or hopeless or are not excited about the future, talk to your doctor and ask for a referral to a psychiatrist, psychologist, or another licensed mental health professional. Or visit the American Society for Reproductive Medicine's website at .org to find an infertility counselor.

Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) occurs when your ovaries don't release eggs. It is usually caused by an overproduction of androgens (hormones like testosterone). A complicated disorder, PCOS can cause one or more symptoms, including acne, amenorrhea (stopped periods), facial hair, thinning hair, elevated insulin levels, infertility, and weight gain. "Because not all women have a classic picture [acne, obesity, facial hair, and hair thinning], PCOS can be elusive," says naturopath Hudson. "It commonly goes undiagnosed."

If you have been diagnosed with PCOS or you think you might have it, seek out an . or naturopath who can address your total health. Women who have PCOS are at an increased risk for a wide range of conditions, including diabetes, heart disease, obesity, and uterine cancer, says gynecologist Gaudet. If you try the following treatments and your symptoms don't improve, contact a reproductive endocrinologist. To find this type of practitioner, visit the American Society for Reproductive Medicine's website at .org.

Relax to Lessen Symptoms. Since stress intensifies many PCOS symptoms, Gaudet suggests practicing anything you find extremely relaxing for at least 15 minutes a day, whether it's doing yoga, knitting, or reading a book. Relaxing can minimize your body's production of stress chemicals like adrenaline and cortisol, which exacerbate symptoms. If you practice relaxing daily, you may improve in two months, says Gaudet.

Balance Hormones Naturally. PCOS contributes to menstrual irregularities by suppressing your body's production of progesterone. If you experience irregular periods or missed periods, ask your doctor about using natural progesterone to help regulate menstruation. Your doctor will determine the dose and whether you should use cream or pills. Progesterone may also improve acne, according to Hudson. (If your doctor is not familiar with natural progesterone, seek out a holistic or naturopathic physician. For contact information, see "Find the Right Doctor," page 68.)

High testosterone levels, common in PCOS, cause acne, facial hair, and thinning hair. Flaxseeds, green tea (Camellia sinensis), and saw palmetto (Serenoa repens) can help by increasing your body's levels of a molecule that binds excess testosterone. Sprinkle 2 tablespoons of ground flaxseeds daily on cereal, salads, and vegetable dishes. Also take 300 to 400 mg of green tea extract (standardized to contain 80 percent total polyphenols and 55 percent epigallocatechin gallate) and 200 mg of saw palmetto extract (standardized to contain 85 to 95 percent liposterols) each day.

Women with PCOS may have too much estrogen. Aim to limit your alcohol consumption to 6 ounces of wine, 12 ounces of beer, or 1 1/4 ounces of liquor per day (alcohol increases your body's production of estrogen). Allow at least three months to see improvement.

Consume Foods that Ease PCOS. Since many PCOS symptoms are estrogen-related, changing your diet to eliminate excess estrogen may reduce your symptoms. Countries like Japan, whose citizens generally include large amounts of healthy foods like vegetables and fish in their diets, have a significantly lower risk of estrogen-related cancers, according to research. So Gaudet suggests eating five to nine servings a day of fruit and vegetables. Replace unhealthy fats like saturated fats and partially hydrogenated oils with foods high in monounsaturated fat, like avocados and olive oil, and foods rich in essential fatty acids, like walnuts and salmon. Allow three months to see improvement from dietary changes.

Uterine Fibroids

Uterine fibroids are benign tumors in your uterus. Health care practitioners and researchers don't know why they occur. Fibroids occasionally cause heavy or irregular bleeding, menstrual cramps, frequent urination, or even miscarriage or infertility. But because the majority of fibroids don't cause symptoms, many women don't realize they have them until their gynecologists discover them during a pelvic exam. Fibroids can grow within the uterine wall, on the outside of the uterus, or inside the cavity of the uterus. Here's how to treat them. Talk to your physician if the following treatments don't offer relief after three months or if you're planning to become pregnant.

Wait for Improvement. Fibroids are sensitive to estrogen, which can spur fibroid growth. Because your levels of estrogen decrease after menopause, many women deal with fibroids by simply waiting to see if they'll go away after they reach menopause, says women's health advisor Fugh-Berman. (If you choose this route, be aware that both conventional and natural hormone replacement therapies supply enough estrogen to prevent fibroids from shrinking.) Fibroids may get bigger during pregnancy, but they should resume their pre-pregnancy size after your baby is born, adds Fugh-Berman.

Treat Bleeding. If fibroids cause heavy or painful periods, herbs and nutrients can help. To treat heavy bleeding, take 20 drops every two hours of each of the following liquid extracts: greater periwinkle (Vinca major), life root (Senecio aureus; also called ragwort), shepherd's purse (Capsella bursa-pastoris), and yarrow (Achillea millefolium), says Hudson, a naturopath. If your bleeding continues for more than one day, reduce your dosage to so drops of liquid extract of each herb once a day.

Comfort Painful Periods. Hudson also recommends taking the following nutrient and two herbs together to calm inflammation and muscle spasms. The bioflavonoid quercetin, ginger (Zingiber officinale), and cramp bark (Viburnum opulus) typically work within a few hours to a few days. Take 800 to 1,000 mg of quercetin a day, 1 to 2 g of ginger capsules a day, and 1/2 teaspoon of cramp bark liquid extract every two to three hours as needed. Additionally, supplementing with 400 mg of magnesium and 1,000 mg of calcium daily throughout the month can reduce chronic pain by increasing circulation to your uterus, says Hudson.

Foil Fibroids with Food. The hormone estrogen causes fibroids to grow. Certain foods can lower estrogen levels in your body, says gynecologist Gaudet. She has seen fibroids shrink when patients increased their intake of whole foods and healthy fats. Researchers have found a significantly lower risk of estrogen-related cancers in countries like Japan, where citizens generally eat diets built on these healthy foods. Eat five to nine servings a day of fruit and vegetables and minimize your intake of refined foods like white flour and sugar. You should also replace unhealthy fats like saturated fats and partially hydrogenated oils with foods high in monounsaturated fat, like avocados and olive oil, and foods rich in essential fatty acids, like walnuts and salmon. Aim to limit your alcohol consumption to 6 ounces of wine, 12 ounces of beer, or 1 1/4 ounces of liquor per day (alcohol increases your body's production of estrogen). As with all lifestyle changes, you shouldn't expect a quick fix. Allow at least three months to see improvement.

Getting Started

Find the Right Doctor

Women's health problems respond well to a whole-body approach. If you have any of the ailments in this guide, consider seeking out a holistic . or an . (naturopathic physician) who will not just concentrate on your reproductive system.

To find a holistic ., contact the American Holistic Medical Association (505-292-7788; www .). To locate a naturopath, contact the American Association of Naturopathic Physicians (703-610-9037; www .).

Consider This

Your Risk by the Numbers

Here are your chances of getting the ailments featured in Natural Health's Annual Women's Health Guide. If you have any of these problems, the natural remedies on these pages can provide safe and effective relief.

Benign Ovarian Cysts

Who Gets Them: All women of childbearing age, but most cysts are too small for concern.

The Good News: Most cysts go away on their own or with natural remedies.

Cervical Dysplasia

Who Gets It: 1 in 28 women; most cases occur in women from 25 to 35.

The Good News: 60 to 80 percent of mild dysplasias will heal on their own; vitamins and exercise can help.

Endometriosis

Who Gets It: Up to 1 in 7 women of childbearing age.

The Good News: Few cases require treatment beyond pain relievers (including pain-relieving herbs).

Fibrocystic Breasts

Who Gets Them: 1 in 2 women of childbearing age.

The Good News: The right diet and supplements can ease breast pain and lumpiness.

Incontinence

Who Gets It: 1 in 5 women over 75; 1 in 2 women report occasional incontinence during their lifetime.

The Good News: Most cases can improve or be cured with simple exercises.

Infertility

Who Gets It: 1 in 10 women between 15 and 44,

The Good News: More than 95 percent of couples seeking treatment will not need advanced reproductive techniques like in vitro fertilization to conceive. Herbs show promise for reversing infertility.

Polycystic Ovary Syndrome

Who Gets It: Up to 1 in 15 women of childbearing age.

The Good News: A healthy diet, exercise, and stress reduction techniques can help manage this syndrome.

Uterine Fibroids

Who Gets Them: 4 in 10 women of childbearing age.

The Good News: 50 to 80 percent of cases don't cause symptoms and don't need to be treated. A diet rich in fruit, vegetables, and other healthy foods can help manage symptoms.

SOURCES: AMERICAN MEDICAL ASSOCIATION; ADRIANE FUGH-BERMAN, .; TRACY GAUDET, .; TORI HUDSON, .; NATIONAL INFERTILITY ASSOCIATION; NATIONAL LIBRARY OF MEDICINE/NATIONAL INSTITUTES OF HEALTH; NATIONAL WOMEN'S HEALTH RESOURCE CENTER; UNIVERSITY OF CALIFORNIA AT DAVIS MEDICAL CENTER.

Julia Tolliver Maranan is the assistant editor at Natural Health. Writing this piece has motivated her to continue her regular visits to a gynecologist.