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Q: Does Acupuncture balance hormones?

A: Acupuncture is a great option for balancing hormones. It's noninvasive, has little to no side effects, and is often described as providing a “sense of euphoria” by patients. Some research has shown that acupuncture has some modulating effects on the neuro-endocrine-immune network which has been determined to be the body's inherent regulatory system. These three systems are the biological basis of how the body maintains homeostasis. So when you hear an Acupuncturist refer to your bodybeing 'out of balance' they are essentially referring to a dysregulation of these systems.

 

Since we are talking about hormones, let's get into the effect of acupuncture on the endocrine system specifically. Some of you may be right here with me while others might be wondering 'what the heck IS the endocrine system?'. Totally fair question. Think back to health class, all I remember is my teacher putting a condom on a banana as we all squirmed in our chairs with both glee and terror. and many other things. Safe to say it's pretty important and we want it working like a well-oiled machine. Any introduction to sexual physiology whizzed over my head. The endocrine system is a crew of glands that produce hormones that regulate metabolism, growth and development, sexual function, reproduction, sleep, mood

 

There have been many recent studies on acupuncture's effect on the Hypothalamus-Pituitary-Adrenal (HPA) axis, Hypothalamus-Pituitary-Gonadal (HPG) axis and the Hypothalamus-Pituitary-Thyroid (HPT) axis (All important parts of the endocrine system). These studies have shown that acupuncture can reduce stress hormone levels, regulate levels of estrogen, follicular stimulating hormone (FSH), luteinizing hormone (LH) and hypothalamic gonadotropin releasing hormone restoring the balance of the Hypothalamus-Pituitary-Ovary (HPO) axis.

 

The stimulation of acupuncture points transmits a signal to the peripheral nerves (the ones farther from your brain) and body fluid thus starting a game of telephone up to the hypothalamus. These signals then tell the hypothalamus what glands or hormones need more regulation, with the ultimate goal of bringing your body 'back into balance'.

 

Although the acupuncture field has come a long way in terms of research there is still a lot of unknowns, and therefore not many resources explaining how it works. Here are a few places that you can get more information.

 

Resources:

  • The Treatment of Infertility with Chinese Medicine by Jane Lyttleton

  • The Infertility Cure: Ancient Chinese Wellness Program for Getting Pregnant and Having Babies by Randine Lewis

 

 

Q:What causes hormonal imbalances at a young age?

A: Hormonal imbalances of different types can occur at any age for a number of reasons. If we’re talking sex hormones (estrogen, progesterone, testosterone, etc.), the two expected periods of time in a female’s life where there will be imbalances are during puberty and the onset of menopause. A third potential time is during pregnancy. Those times aside, there are a number of health conditions that exists that can cause imbalances in female sex hormones, such as in PCOS (which is characterized by higher-than-normal levels of androgens, a sex hormone type that includes testosterone).

 

Sex hormone imbalances can include too low or high estrogen, testosterone, or progesterone. Hormone balance is connected to a number of things, including how your body is handling and reacting to stress, exercise, the food you eat, medication use, and the toxins in your environment. How this impacts our hormones happens in different ways. For example, stress leads to an increase in the stress hormone cortisol, which causes a lag in the creation of our other hormones (especially progesterone). Another example is the use of hormonal birth control, which halts the production of your sex hormones, an effect that lead to hormonal imbalances even after discontinuing use.

 

Estrogen dominance (aka high levels of estrogen compared to its hormone “partner” progesterone) is a popular topic these days. The connection between exogenous (aka environmental) hormones and their potential effects on human hormones is currently being explored in research, and chemicals and food/plant compounds that can mimic or act like estrogens in our body are key players in these studies.

 

Phytoestrogens, named because of their similarity to estrogen, for example, occur naturally in plants such as soy, alfalfa, and red clover. These phytoestrogens are functionally similar to estrogen, and research is being conducted in their potential role in issues such as: relief of menopausal symptoms, exacerbation of estrogen dominance symptoms, early puberty, and a protective effect on breast tissue and bones, to name a few.

 

When it comes to potentially negative effects on hormones, the big debate currently revolves around environmental causes. This includes, for example, the hormone interfering effect (coined endocrine disruptors) of BPA or Bisphenol A, which is used to make soft, flexible plastics. Studies have shown BPA to interact with estrogen receptors, and this influence on hormones has led to it’s connection in pathologies such as: affecting fertility of both males and females, early puberty and menarche in females, a promoting effect on hormone-dependent cancers such as breast and prostate, and metabolic disorders such as PCOS and diabetes.

 

Other areas of life where endocrine disruptors may potentially be found are cleaning products, personal care products (like makeup, perfume, face wash, etc.), water, and food sprayed with pesticides and herbicides. Hormone exposure is also possible through ingesting animal products from animals exposed to hormonal drugs, of which we currently have a limited understanding on how these drugs and active metabolites affect us. However, research does appear to show an influence on our hormones. For example, studies on the consumption of foods containing high amounts of estrogen (like milk and cheese) and a connection between increased development of hormone-dependent cancers. As research goes on, we’ll continue to learn more and more.


 

References:

  • Walters, K. A. (2016). Androgens in polycystic ovary syndrome: lessons from experimental models. Current Opinion in Endocrinology, Diabetes and Obesity, 23(3), 257-263.

  • Sirotkin, A. V., & Harrath, A. H. (2014). Phytoestrogens and their effects. European journal of pharmacology, 741, 230-236.

  • Konieczna, A., Rutkowska, A., & Rachon, D. (2015). Health risk of exposure to Bisphenol A (BPA). Roczniki Państwowego Zakładu Higieny, 66(1).

  • Horan, T. S., Pulcastro, H., Lawson, C., Gerona, R., Martin, S., Gieske, M. C., ... & Hunt, P. A. (2018). Replacement bisphenols adversely affect mouse gametogenesis with consequences for subsequent generations. Current Biology, 28(18), 2948-2954.

  • Fenichel, P., Chevalier, N., & Brucker-Davis, F. (2013, July). Bisphenol A: an endocrine and metabolic disruptor. In Annales d'endocrinologie (Vol. 74, No. 3, pp. 211-220). Elsevier Masson.

  • Jargin, S. V. (2014). Soy and phytoestrogens: possible side effects. GMS German Medical Science, 12.

  • Fortes, É. M., Malerba, M. I., Luchini, P. D., Sugawara, E. K., Sumodjo, L., Ribeiro Neto, L. M., & Verreschi, I. T. (2007). High intake of phytoestrogens and precocious thelarche: case report with a possible correlation. Arquivos Brasileiros de Endocrinologia & Metabologia, 51(3), 500-503.

  • Zung, A., Glaser, T., Kerem, Z., & Zadik, Z. (2008). Breast development in the first 2 years of life: an association with soy-based infant formulas. Journal of pediatric gastroenterology and nutrition, 46(2), 191-195.

  • Gasnier, C., Dumont, C., Benachour, N., Clair, E., Chagnon, M. C., & Séralini, G. E. (2009). Glyphosate-based herbicides are toxic and endocrine disruptors in human cell lines. Toxicology, 262(3), 184-191.

  • Nachman, K. E., & Smith, T. J. (2015). Hormone use in food animal production: assessing potential dietary exposures and breast cancer risk. Current environmental health reports, 2(1), 1-14.

Q: What is the deal with Bacterial Vaginosis (BV)?

6 weeks ago I was diagnosed with BV by my OBGYN. Since then I have tried antibiotics, probiotics, and tea tree suppositories. The itching has lessened, however the other symptoms have not. Based off of what I’ve read I do not fit most of the risk factors for having  BV (douching, IUD, multiple sex partners, pregnancy). I feel like I've hit an info dead end with this subject. Any ideas about where BV comes from and how to get rid of it when its been lingering for ages? 

A: What you’re describing, surprisingly, isn’t too uncommon! About 30% of patients treated for a BV infection, who were considered to have responded well to the treatment, have a recurrence of symptoms within 3 months. A recurrence within 1 year of the initial infection occurs a shocking 50% of the time. But if you took the prescriptions, used the suppositories, did all the recommended things, why is this happening to you, just like it does to so many others?! 

 

Well, the culprit could fall into two categories: reinfection (unlikely), or this recurrence phenomenon we’re talking about. According to research, recurrence would be occurring because, with whatever treatments were attempted, either not all of the targeted bacteria were finished off as planned (so their numbers were left to creep up again), OR the much-needed protective vaginal flora population wasn’t re-established to the number needed to fend off any “opportunistic” bacteria trying to sneak in and set up shop. The latter of the two brings up the idea of setting up the right environment for the RIGHT flora to thrive. Think of it this way: even if you put down the seeds for a plant to grow, you still need the right soil for it to actually happen. So, while taking a probiotic is definitely on the right track, for that good flora to be able to set up shop in a permanent way, the environment needs to be to their liking. This is a factor that you can dive into more with your holistic practitioner. 

 

Another factor is that it is much more difficult to fully get rid of bacteria that have set up biofilms. Biofilms are this sort of protective substance that attaches a cell to their chosen surface, and makes it much harder to get to the bacteria itself. Think of it as like a slimy forcefield. Not only that, but it appears this biofilm, once set up, functions as kind of like a scaffolding for other unwanted species to come hang out. Basically, they can be a huge pain, and require a long-term treatment targeted at also breaking up the biofilm. 

 

As an aside, in 2015 the CDC reclassified Bacterial Vaginosis as a sexually transmitted infection. However there is no research supporting the treatment of male sexual partners for the reduction in recurrence of infection. What is significant is that the presence of other STI’s can increase your risk of BV, so always be sure to check that another infection isn’t lurking! And while this doesn’t apply to your case specifically, for all the other gals out there, there’s also an increased risk of developing BV if your partner is uncircumcised, so something to keep in mind. Other additives to BV’s occurrence can be lifestyle, such as douching like you mentioned, but also smoking cigarettes. When in doubt, it’s never a bad idea to take a break from anything that has the potential of adding to the problem and see if it has an effect. 

 

References:

  • Kimberlin, D. W. (2004). Neonatal herpes simplex infection. Clinical Microbiology Reviews, 17(1), 1-13.

  • Stephenson-Famy, A., & Gardella, C. (2014). Herpes simplex virus infection during pregnancy. Obstetrics and Gynecology Clinics, 41(4), 601-614.

  • Kimberlin, D. W. (2007, February). Herpes simplex virus infections of the newborn. In Seminars in perinatology (Vol. 31, No. 1, pp. 19-25). WB Saunders.

  • Corey, L., & Wald, A. (2009). Maternal and neonatal herpes simplex virus infections. New England Journal of Medicine, 361(14), 1376-1385.

 

 

Q: Does oral herpes affect unborn babies? 

A: The biggest risk of contraction of HSV from mom to baby (or, really, anyone to anyone else) is skin contact, which is why a baby being exposed through the actual birthing process by passing by the active virus on their mother is the biggest risk of exposure for a baby. To be clear, Herpes Simplex CAN be transmitted from mom to fetus “transplacentally” aka through the placenta.

 

But before you start getting nervous, here are the stats: there are only 3 documented ways that neonatal HSV can occur. 85% of cases occur “perinatally,” meaning during the birthing process. This means that, whether the mother is having a genital herpes outbreak or not, if the virus is present in the genital tract as the baby is passing through, they have a risk of contracting the virus through this contact. The second most common instance, occurring in 10% of cases, is “postnatal,” or after birth. This occurs if the newborn's caretaker has an active HSV infection, and the newborn infant comes in contact with it. The last and most rare cause is the one in question: “intrauterine,” or while the baby is in the uterus. While possible, this only occurs in 1 in 250,000 delivered babies. This comes out to be a whopping 0.0004%.

 

Why do these instances even happen then? According to the research, intrauterine infections seem to occur if, while a mother is pregnant, she experiences her first (aka “primary”) episode resulting from exposure to the HSV virus, and there is a detectable presence of the virus within mom’s blood.  As this is the first EVER exposure to the virus that mom is experiencing, her body doesn’t yet have an immune defense set up to help counter it, so it’s a bit of an intense exposure. This would explain why it has the increased capability of affecting a fetus hanging out in mom’s uterus. 

 

To get a little more technical: during the primary infection with a virus the immune system develops antibodies which act as the front line of defense during future outbreaks. The immune system’s initial response to a virus is weak because it doesn’t have the antibodies or troops ready to combat the virus. This is why primary outbreaks are usually the most intense. After the initial exposure to a virus, the immune system has created antibodies which will recognize and attach to viral particles during future outbreaks, reducing the intensity.  Research has found that mother’s with low antibody avidity (aka the ability to attach to the virus) at time of birth are more likely to transmit HSV to their babies, so that just goes to show how important this factor is. 

 

But could oral herpes be a risk in other ways, such as the environment of the birthing? There has been a proposal to explore if oral herpes could infect a fetus during a water birth, so maybe we’ll have a more clear picture of that soon!

 

Either way, what research seem to say is that fetal exposure to mama’s HSV virus seems to primarily be from an infection going on in the genital area during the birth OR, very rarely, if mom has her first HSV episode during pregnancy. 

 

References:

  • Hillier S, Holmes KK. Bacterial vaginosis. In: Sexually Transmitted Diseases, 2nd ed, Holmes KK, Mardh PA, Sparling PF, Wiesner PJ (Eds), McGraw-Hill, New York 1990. p.547.

  • Bradshaw, C. S., Morton, A. N., Hocking, J., Garland, S. M., Morris, M. B., Moss, L. M., ... & Fairley, C. K. (2006). High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. The Journal of infectious diseases, 193(11), 1478-1486.

  • Swidsinski, A., Mendling, W., Loening-Baucke, V., Swidsinski, S., Dörffel, Y., Scholze, J., ... & Verstraelen, H. (2008). An adherent Gardnerella vaginalis biofilm persists on the vaginal epithelium after standard therapy with oral metronidazole. American journal of obstetrics and gynecology, 198(1), 97-e1.

  • Swidsinski, A., Mendling, W., Loening-Baucke, V., Ladhoff, A., Swidsinski, S., Hale, L. P., & Lochs, H. (2005). Adherent biofilms in bacterial vaginosis. Obstetrics & Gynecology, 106(5), 1013-1023.

  • Swidsinski, A., Mendling, W., Loening-Baucke, V., Ladhoff, A., Swidsinski, S., Hale, L. P., & Lochs, H. (2005). Adherent biofilms in bacterial vaginosis. Obstetrics & Gynecology, 106(5), 1013-1023.

  • Fethers, K., Marks, C., Mindel, A., & Estcourt, C. S. (2000). Sexually transmitted infections and risk behaviours in women who have sex with women. Sexually Transmitted Infections, 76(5), 345-349.

  • Marrazzo, J. M., Antonio, M., Agnew, K., & Hillier, S. L. (2009). Distribution of genital Lactobacillus strains shared by female sex partners. The Journal of infectious diseases, 199(5), 680-683.

  • Bradshaw, C. S., Walker, S. M., Vodstrcil, L. A., Bilardi, J. E., Law, M., Hocking, J. S., ... & Chen, M. Y. (2013). The influence of behaviors and relationships on the vaginal microbiota of women and their female partners: the WOW Health Study. The Journal of infectious diseases, 209(10), 1562-1572.

  • Vodstrcil, L. A., Walker, S. M., Hocking, J. S., Law, M., Forcey, D. S., Fehler, G., ... & Bradshaw, C. S. (2014). Incident bacterial vaginosis (BV) in women who have sex with women is associated with behaviors that suggest sexual transmission of BV. Clinical Infectious Diseases, 60(7), 1042-1053.

  • Evans, A. L., Scally, A. J., Wellard, S. J., & Wilson, J. D. (2007). Prevalence of bacterial vaginosis in lesbians and heterosexual women in a community setting. Sexually transmitted infections, 83(6), 470-475.

  • https://www.cdc.gov/std/tg2015/bv.htm

 

 

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