At any age, for anyone, weight gain, unwanted wait loss, inability to build muscle or simply the inability to maintain a healthy weight, can be an issue. I have found that when hormones are off-kilter, weight is too. I am not a weight loss expert, a point I often emphasize when I start working with patients, but I do see that people are able to maintain a healthy weight when we work on key things the body needs to “work” well. I love seeing the joy that many women feel when their weight feels "right." I will share more on body image, society's obsession with ideal body size available to hardly anyone and what excessive weight gain may mean to the body later. For now, know that as you work on a strong foundation and supportive hormonal landscape, things often fall into place.

Well, well, well, HRT, you are certainly having a moment!  Not a week goes by that i dont  overhear conversations at parties, at the grocery store and on the sidelines of my kids’ soccer games–and social media is fanning the flames. What is hormone replacement therapy (aka HRT)? It’s replacing the hormones your body is losing or lacking when we move from reproductive age into post-reproductive age–ya know, the golden years! Then there’s bio-identical hormone replacement therapy (aka Bio-HRT) which is using a chemical structure identical to what the body makes, instead of a synthetic one. It’s confusing, layered and fraught with misinformation. Rest assured, we will go deeper on this topic in the most honest, thoughtful, science based, open-minded, integrative and comprehensive way I know how. For the record, I use Bio-HRT in my own body and with my patients. Having used all available options as a clinician, I found Bio-HRT to contain the most trusted ingredients, and to be the safest and best tolerated with the lowest risk. I am so thankful we are openly talking about this subject, but there is so much more to it, so much more we can do to support women in this time. Replacing or replenishing hormones during perimenopause and menopause can be life affirming for many women. That said, it’s not for everyone, and not everyone can use it. But it is something that all women should know about and be able to choose how they wish to approach it.

Sleep: it’s so important, and the science is clear on that. If you can't sleep, you know first hand the debilitating effects of lack of sleep. Sleep is not just about getting into bed. Your sleep quality is a reflection of the body as a whole. The 24 hour cycle of waking and sleeping is influenced by stress hormones, sex hormones (PMS and perimenopause, I’m looking at you!), food and movement, to name just a few. Unfortunately, modern life does a number on all of those things. Young or old, good quality sleep can be elusive and frustrating. I approach sleep like I do everything else: what does the body need, and what can the body do without, so the body can do what it so desperately wants to do? Sleep.

PMS and PMDD are horrible conditions, not just women being difficult or moody. Periods are hard and no joke but the lead up to it should not be traumatic. PMS, aka premenstrual syndrome, and PMDD, premenstrual dysphoric disorder, are syndromes where women experience physical, mental and emotional symptoms that are related to the menstrual cycle, typically in the luteal or 2nd half of the cycle. PMS can be mild to moderate and PMDD is severe. Both can be life altering and should be approached from a holistic, whole body perspective. Women with these conditions need more attention than just birth control pills or antidepressants; they deserve a deep dive into the underlying causes in order to understand the ‘why’ behind the debilitating symptoms.

When menstrual symptoms are more than just a mild blip, it is a sign that something is wrong, a check engine sign, if you will. Symptoms like dramatic change in mood, pronounced fatigue, extreme bloating, abdominal pain, difficulty sleeping in the 2nd half of your menstrual cycle or even around ovulation, tell us something is not right. In order to understand the ‘why’ behind the symptoms we need to look at how we regulate stress and sex hormones, how the gut is functioning, whether our liver is able to meet the demands of life and how to support our genetics, to name just a few. PMS/PMDD should not be masked with birth control pills or anti-anxiety medications, but treated with the same detailed, science based approach that helps the body work for us, not against us.

Anxiety and depression are often discussed, but rarely are they approached with the sensitivity and curiosity they deserve. Mood disorders are on the rise–in all age groups, in all humans. Modern living has much to do with that, but there are things we can do to support our sensitive human selves in the modern world. In fact, all the things we do to establish a supportive, functioning foundation helps to regulate mood. I approach mood challenges with a nod to a few key things, like our nervous system and our gastrointestinal system. Working on those areas helps to make our nutrients replete, our hormones balanced and our neurotransmitters plentiful. The body is complex. No one thing does it all, but small things can really add up!

The image of a menopausal woman–red in the face, dripping with sweat, flustered–comes to mind. But hot flashes are not just an easy cultural trope. They are debilitating, sleep-depriving, mind-numbing daily events that affect women as early as late 30's and well into our 50's and 60's. They don’t just cause you to feel incredibly hot–they can cloud thinking, induce anxiety, impact cardiovascular health and disturb sleep.

Hot flashes are a part of the menopausal experience, for sure, over 75% of women suffer from them, but they do not have to be. Hot flashes, or vasomotor symptoms as they are called medically, do not have to be simply tolerated, they can be treated. There is not a daily number that is acceptable, as women tell me they are told by their medical providers. They do not have to be "bad enough" to be treated. They are not benign, they affect our quality of life and can be harbingers of other issues. There are many effective treatments including herbs, nutrients, movement, dietary changes, hormones and non-hormonal medications. But I always approach this from a whole body perspective, because hot flashes represent an opportunity to work on our whole body, not just the momentary flash.

Deep breath, this is such an important topic. It is not just a women's issue. I’s a human issue. The ability to create children when we want to and prevent pregnancy when we don't is key to: 

• Personal freedom

• Economic empowerment

• Educational opportunities

• Career development

• Health and well-being

• Family planning

• Life satisfaction

• Gender equality

• Societal progress

To name just a few!

Our fertility depends on the health of our bodies as a whole, and our world at large. It is not just about birth control pills, IUD's and freezing eggs, all of which are useful tools but we need more. The toxins in our water, the pesticides in our foods, the stress we bathe in–all impact our health and, in particular, fertility. The state of our planet is reflected in all of us. My goal is to help the body regulate hormones, improve nutrient status, improve gut function, mitigate stress and then allow the body to do what it wishes. And, if it doesn't, we support treatments for fertility that are the most effective and least damaging to the body.

Gut issues, gut health, GI, gastrointestinal issues: so many terms for this complex system that is the master regulator of healthy hormones, optimal digestion and good mood, to start! Bloating, reflux, constipation, and diarrhea are the most common complaints and obvious signs there is work to do. But anxiety, depression, PMS, and irregular periods are rarely considered when we think about gut health, and they should be. Unfortunately, we do so little to get to the bottom of the chaotic mess of symptoms we sometimes experience. Usually, we are offered medications to relieve the symptoms–I get it, no one wants to feel bloated and constipated, anxious and depressed. But if we ignore, or take medications for long periods of time, we may risk more damage. I work to understand what is impacting the gut, what is driving the symptoms and how to heal and restore gut function.

The timing of periods can be all over the place: every 2-3 weeks, every 2-3 months, 2 times a year, or never ending. And the bleeding–sometimes it's a crazy, heavy flow that causes anemia, stops you from doing what you want, ruins clothes and even causes you to go to the ER or doctor's office. Next up, the pain. For many, it’s not just a mild inconvenience; it’s intense and severe, requiring heavy doses of medication, time off from work and repeated medical and surgical interventions.

Periods are no joke, even when they are "regular" and "normal." But when they are irregular, painful and profuse, it can be devastating. We deserve better treatment options, more research, open conversations and support. I aim to do that both from a holistic and functional perspective, and also in collaboration with our conventional colleagues. One size does not fit all here, but it must include focusing on the foundation and digging deep to understand the why.

Brain fog is a condition characterized by confusion, forgetfulness, and a lack of focus and mental clarity. It is a lay term that has really taken hold in conversations among women, especially peri and menopausal women. But my younger patients are talking about it too. Why is our brain foggy all the time? What contributes to it? What can we do to support our brain health? I’m happy to say the science in this area is exploding. Some studies are finally starting to research the female brain and the risk of memory disorders. The stats for the female brain and memory loss are staggering  (e.g. women are 2x more likely to develop Alzheimer's disease). I believe improving our brain health starts with foundational building blocks like blood sugar control, hormonal support, nutrient dense diets and strength building.

Acne, simply stated, is awful. It’s painful, stigmatizing and also incredibly common. It can happen at any age, but tends to occur when there is a major shift in hormones. We’re most familiar with adolescent struggles, but the shift in hormones at any age can induce acne–from pregnancy and infertility treatments to post-partum and perimenopause. Complex and frustrating, it requires more than just an external, topical approach. I look to understand what the inside of our bodies are telling us.