Women's Health

Menopause

The menopausal transition, characterised by fluctuating hormone levels, irregular menstrual periods and, oftentimes, hot flashes and night sweats, is a normal life stage that all women go through. Menopause is reached when the menses have ceased for a whole year and most often occurs around 50 years old.

Although menopause is normal, the symptoms that accompany it can be bothersome for some women. The drop in estrogen and progesterone can result in a multitude of symptoms ranging from hot flashes, to vaginal dryness, and weight gain.

Dr. Hartman has received extensive training in the safe use of bioidentical hormone replacement therapy to help smooth out the symptoms of menopause via hormone balancing. For those ineligible for hormone replacement either due to a personal or family history of hormone sensitive cancer, or due to personal preference, symptom relief can also be achieved via the use of herbs, homeopathics, acupuncture, and pharmaceutical medications.

Hormone Testing in Menopause

Dr. Hartman uses the Dried Urine Hormone Panel to assess for hormone imbalances during peri-menopause and menopause in order to effectively prescribe bioidentical hormones or herbs to achieve balance. This panel also investigates estrogen metabolism pathways to ensure proper hormone detoxification which is beneficial for decreasing cancer risk in those with a family history.

Suboptimal Fertility

Whether you and your partner are just starting your fertility journey, or you have been attempting conception for some time, I am able to meet you where you’re at to help you achieve a healthy, successful pregnancy.

Mind Body Soul Integrative Clinic is in the same building as Kelowna Regional Fertility Centre and we share many of the same patients. I am able to work with you as you undergo fertility treatments such as providing supportive acupuncture as well as providing treatments to improve egg and semen quality.

For those couples not yet at the point of undergoing fertility treatments, I am able to help you investigate for causes of diminished fertility including hormone imbalances, ovulatory disorders, poor semen quality, and low egg supply.

Treating Infertility

The treatments for infertility are as diverse as the causes. I utilize a range of medical nutrition, acupuncture, herbal medicine and pharmaceuticals to provide evidence-based, effective interventions. For those undergoing IVF, I am able to work with your fertility clinic to optimize your health to improve embryo health and increase the likelihood of proper implantation.

Pregnancy Care

Congratulations, Mama! Pregnancy is an exciting time for both mom and dad but doesn’t always go as smoothly as we hope. Working with a Naturopathic Doctor during your pregnancy can give you all of the research-backed information you need to have as natural and healthy of a pregnancy as possible.

The needs of both mama and baby vary with each trimester. Dr. Hartman is able to provide you with individualized health plans to help you feel your best in each trimester whether that means addressing nausea in your first trimester (and beyond!) to helping you prepare your body for labour as you near your due date.

Managing Early Pregnancy Symptoms

The first trimester is exciting! From the first high of a positive pregnancy test to the first time you see your little bean on an ultrasound, there is no shortage of thrilling moments in the first few months of pregnancy. However, this trimester is often the worst one for many mamas. From nausea to exhaustion, there can be a lot to battle through.

The good news is that there are many safe, natural ways to deal with most pregnancy concerns. Dr. Hartman uses strategic supplementation with herbs and nutrients, and tools like acupuncture and lifestyle medicine to improve how you feel. Hang in there mama – the second trimester is usually a lot better!

Managing Pregnancy Complications

There are a number of more serious complications that can arise during pregnancy such as pre-eclampsia and and gestational diabetes that may require conventional medical treatment provided by your midwife or obstetrician. Dr. Hartman is able to support you by providing appropriate recommendations that are safe to combine with your other treatments, and to improve birth outcomes.

Dr. Hartman also treats breech presenting babies to encourage them to flip via the use of moxabustion and acupuncture. This research-backed method has been proven to be a safe and effective therapy for breech presentation to be used during weeks 33-35.

Preparing Your Body For Labour

As you are nearing your due date, you may be wondering if there is anything you can do to help you have a natural labour and reduce the risk complications. Dr. Hartman uses a mixture of pre-birth acupuncture and herbs to help prepare the body for labour and delivery as well as prevent post-date labour and medical induction.

Someone to Answer Your Questions

It’s important that you feel empowered during your pregnancy and informed to make educated decisions surrounding your pregnancy and delivery. A Naturopathic Doctor is able to answer all your questions about pregnancy and delivery including what to eat in pregnancy and what natural health products are safe.

Polycystic Ovarian Syndrome (PCOS)

Polycystic ovarian syndrome (PCOS) is a common hormonal disorder in women of reproductive age and is characterised by infrequent or irregular periods, high androgen levels, and numerous follicles in the ovary that fail to release eggs during ovulation.

Diagnosis of PCOS

In 2003, a new set of guidelines was released indicating the diagnostic criteria needed to reach the diagnosis of PCOS called The Rotterdam Criteria. In order to be diagnosed with PCOS, two out of the following three features needs to be present:

Types of PCOS

PCOS can be divided into two main types based on the presence of insulin resistance. This is important to know as the treatment does change depending on whether insulin resistance is present. However, some people do break down the condition into 5 separate categories based on the presence of insulin resistance as well as androgen levels.

Insulin-Resistant PCOS

Insulin-resistant PCOS is by far the most common presentation of this condition. The women with type I PCOS can present with all of the classic symptoms of PCOS such as irregular periods, excessive hair growth (hirsutism), acne, weight gain, and hair loss. Due to the presence of insulin resistance, these women are also at an increased risk of one day developing type II diabetes.

The key to treating this type of PCOS is treating the insulin resistance which is often the culprit behind all of the symptoms. If excess weight is part of the symptom picture, even a 10% loss of body weight can restore ovulation in some women with PCOS. Sometimes doctors will prescribe medications such as metformin to lower blood sugar and help restore insulin sensitivity.

Non-Insulin Resistant PCOS

Some women fulfill the diagnostic criteria for PCOS but do not have the classic insulin resistance associated with the condition. This presentation is referred to as type II PCOS, or non-insulin resistant PCOS.

In these women, weight loss and blood sugar lowering medications or supplements will have no effect on their symptoms or their fertility. For women with type II PCOS, the cause of their condition tends to be a bit more complicated. For instance, disorders of the thyroid or adrenal gland may be to blame as well as nutrient deficiencies such has iodine, vitamin D, and zinc. In some women, environmental hormone disrupting toxins such as BPA, phthalates, and dioxins may be at the root of their symptoms. This results in a type of PCOS which is sometimes called inflammatory PCOS. These women often have other signs of inflammation such as headaches, acne, joint pain, autoimmune disease or elevated CRP levels on blood testing.

Testing for PCOS

The following tests are used not only for helping diagnose PCOS, but also can be used to investigate the potential root causes of the condition to determine the most optimal treatment plan for your particular presentation.

Endometriosis

Endometriosis is a painful female reproductive disorder in which endometrial tissue that normally lines the uterus will start growing outside of the uterus, such as in the fallopian tubes, ovaries, pelvis, and other parts of the body.

This displaced endometrial tissue will behave the same way as in the uterus with growth and thickening followed by breakdown and bleeding with each menstrual cycle. The released blood has no way to escape the body and can cause cyst formation within the ovaries, scar tissue from inflammation, and adhesions that cause the pelvic organs to stick together.

It is thought that endometriosis is caused by a combination of backflow of blood into the pelvic cavity during a menstrual period combined with a genetic predisposition and immune dysregulation.

Hormonal Factors in Endometriosis

Estrogen metabolism in the endometrium is known to be affected in women with endometriosis. In particular, an enzyme known as aromatase that converts androgens into estrogens has been found in the endometrial tissue of women with endometriosis. Further, an enzyme that converts estradiol (a strong estrogen) into estrone (a weaker estrogen) is not fully functional. These two factors work to increase the local amount of estradiol (the strong estrogen) in the endometrial tissue which causes growth and a local hormone imbalance.

The Naturopathic Approach to Endometriosis

In integrative medicine, there are several effective, research-backed treatments for endometriosis. The goals of treatment are to rebalance hormone levels by reducing the production of harmful estrogens and increasing progesterone in order to limit growth of endometrial tissue. Dr. Hartman also aims to reduce inflammation and enhance circulation to reduce pain and the formation of new adhesions and scars. This is done via the use of carefully selected botanicals, nutrients, and medications in conjunction with dietary modification.

Vaginal Infections

Vaginiits is inflammation of the vagina that often results in discharge, itching and irritation. It is usually caused by an imbalance in the vaginal flora or by an infection.

The most common causes of vaginitis include:

Diagnosis and Treatment

The key to effective treatment of vaginitis is proper diagnosis of the condition. Luckily, these three conditions can be differentiated with an easy vaginal swab that can be sent to a lab for culture.

Not only does Dr. Hartman address the infection by providing effective treatments with either antimicrobial herbs and/or antibiotics as needed, but she works with you on a deeper level by addressing any contributing factors, and works towards prevention of further occurrences by altering the vaginal ecology and the health of the body.

Premenstrual Syndrome (PMS)

Premenstrual syndrome (PMS) is characterized by significant mood, behhavioural and physical changes that occur during the luteal phase of the menstrual cycle (up to 2 weeks before the period is due). It is thought that up to 30% of all women experience some degree of PMS that interferes with their daily functioning.

Premenstrual Dysphoric Disorder (PMDD) is the most severe type of PMS and is characterised by significant mood changes, including depression and anger, fatigue, and difficulty concentrating. PMDD significantly interferes with the quality of life and is often treated with antidepressants within the conventional medical system.

Naturopathic Treatment of PMS

Dr. Hartman’s primary goal in treating women suffering from PMS is to reduce or eliminate symptoms via correcting hormonal and/or neurotransmitter imbalances that may be present in the luteal phase of the cycle. This may involve detoxifying excess estrogen out of the body, improving progesterone levels, and neurotransmitter balancing via medical nutrition, acupuncture, botanicals and prescription medications.