Hormone Optimizing Warrior M.D.

Many women who develop uterine polyps have no idea they have this condition, yet these abnormal growths are very common. They develop on the endometrium and can be the size of a sesame seed—or they can develop to be the size of a golf ball. While this condition is often asymptomatic, you could also experience heavy bleeding, bleeding between periods, and infertility.

So, what's the difference between fibroids and uterine polyps? Fibroids grow from fibromuscular tissue, whereas polyps grow inside the uterine cavity from the endometrium. Fibroids are hard, whereas polyps are soft. Polyps are often benign, whereas fibroids are almost always benign. However, both conditions share a common risk factor: high estrogen levels.

An ultrasound is usually the first step for diagnosis. You may also undergo a hysteroscopy, a procedure in which a tiny camera visually examines the uterus and performs an endometrial biopsy. This is an in-office procedure, so it helps you avoid something more invasive, as well as a hospital visit.

Asymptomatic polyps may not require any treatment, especially for women who have already gone through menopause. For women experiencing symptoms, including those struggling with infertility, they may want to have them removed. Addressing excess estrogen is the best way to address the underlying cause of polyps.

Progesterone can stabilize the uterine lining and stop it from growing further, thereby limiting the influence of excess estrogen. If you have abnormal bleeding, like especially long periods, short periods, very heavy flow, or very light flow, talk to your healthcare provider and find out if uterine polyps are affecting you.

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Uterine fibroids are benign tumors, and they are a very common uterine disease. Fibroids may also be called nodules or cysts, and may vary in size and appearance. However, they are always solid because they are made of fibromuscular tissue, and they can cause a host of symptoms.

Fibroids can develop inside the uterus or even outside the uterus into the abdomen. So what makes fibroids develop in the first place? While there is no decisive answer, there are specific factors that contribute to the formation of fibroids including: race, obesity, and estrogen levels. Women with a higher body mass, as well as women with estrogen dominance, are more likely to develop fibroids.

Sometimes fibroids are big enough to feel simply by floating on your lower belly. They can be painless, even when they're quite large. But most of the time, they create pelvic pressure and other potential issues, for example pressure on your bladder leading to feelings of urgency.

You can have fibroids removed surgically, but you will have to give birth by C-section if you have children. This solution also doesn't take into account the underlying issue, so the fibroids could come back. But, primarily, the treatment for fibroids addresses the symptoms such as pain and bleeding using over-the-counter medications and birth control.

If you have fibroids, you should know your options for treatments. One is a uterine artery embolization, a procedure that can significantly reduce symptoms as well as fibroid size. Other treatments include a laparoscopic radiofrequency ablation or a high intensity focused ultrasound (HIFU), both of which are minimally invasive.

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Do you have painful, heavy periods? Adenomyosis and uterine fibroids are common uterine conditions, yet so many women go through their reproductive years not knowing that they have such a condition. Listen to this episode to learn the signs and symptoms to look out for, as well as the solutions that are available.

Many women will write off occasional uterine pain as a weird cycle, however this can delay diagnosis and treatment of a possibly serious medical condition. The female reproductive system is intricately designed, and the uterus plays a significant role. The uterus is a muscular organ and has a mucosal lining called endometrium.

Some of the issues that can affect the uterus include adenomyosis (endometriosis of the uterus), uterine fibroids, uterine tumors, endometrial polyps, and uterine prolapse. It's estimated that 25-35% of women of reproductive age suffer with endometriosis, which can be very painful.

Chronic pelvic pain that increases during menstruation, as well as bloating and bowel dysfunction, are signs of adenomyosis. A diagnosis is made through a gynecological exam and imaging, like MRIs or ultrasounds. Hormonal therapies can be effective in controlling the symptoms.

If medical treatment fails, surgery is an option. You can get a procedure that destroys the lining of the uterus. This procedure can delay the need for a hysterectomy. There is recent research being done to explore new procedures to help with this condition too. Menopause can be challenging for women with this condition, so they should be well informed of their options and solutions.

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Hormone replacement therapy can promote vaginal bleeding after menopause. So, is progesterone necessary as a part of HRT? It is essential to take progesterone to balance levels of estrogen, much like the way our bodies naturally would. So how often and how long is progesterone required?

For some patients, they will need to take it every day—especially those with a medical reason to avoid getting their period. Studies have shown that it is safe to use daily. But in all other cases, it's best to mimic the way nature intended it, taking progesterone 12-14 days a month. However, doing it this way means you will get a period.

If you use progesterone without estrogen, you will not get a period. Estrogen is required to create the uterine lining. Are there cons to having a period after menopause? Having a regular period can be inconvenient and/or physically distressing, or even cause anemia.

There are also pros to having a period after menopause too. For one, it can promote heart health by helping to naturally thin out your blood. It also protects your lining by promoting shedding. You're also less likely to develop polyps or hyperplasia. Having a period is also useful data for your doctor, especially if you're on HRT.

Bleeding monthly can also help to prevent breakthrough bleeding. This can happen multiple times a year and always needs to be evaluated, which can be costly and uncomfortable. Ultimately, the decision to take it daily or not is a personal one, but knowing the pros and cons can help you make an informed decision.

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As you approach menopause, you may be considering hormone replacement therapy. Knowing what to expect can help you make the most informed decision possible. For example, if you are on HRT and are taking progesterone, you may experience vaginal bleeding.

Generally, there is a lack of options for exactly how you can take progesterone as a patient. If you go to a Naturopathic doctor, they may only give you the option to take progesterone therapy daily. However, you should be given the option to cycle your progesterone replacement to mimic how it would fluctuate during your cycle.

The standard of care in this area is lacking, despite how important it is to continue to balance progesterone as you approach and enter menopause. So, is it bad to bleed while you are taking progesterone?

Some women feel like having a cycle is inconvenient and annoying, whereas other women feel better physically and psychologically when they have a period. As a medical professional with over a decade of experience supporting progesterone HRT, I recommend cycling progesterone. Daily progesterone may feel easier, but it doesn't take into account the inner workings of hormonal balance.

Having an in-depth knowledge of the inner workings of a woman's delicate hormone balance is crucial to ensure her mental and physical health while on progesterone replacement. That's why it's so important to work with a doctor who is an expert in HRT. Using hormones with the most effective methods and the right doctor can help you avoid undesirable symptoms while still gaining positive outcomes.

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Why do doctors recommend birth control pills for hormonal imbalance in women? This is one of the many questions I hear from my female patients over and over again. To answer this question, it helps to understand why women bleed monthly. The answer comes down to estrogen and progesterone.

Estrogen promotes growth of the uterine lining. Then, around day 14, you ovulate, and progesterone fortifies this lining. Without estrogen, your period would be light. With a little bit of estrogen, you may have light but more frequent cycles. If you have erratic periods, it's a sign your hormones are not functioning properly.

Your cycle should be reliable and predictable. When it's not, many physicians will recommend birth control. Why? Because they believe the birth control pill is designed to help you regulate your period. But in reality, this can often act as nothing more than a band-aid. Using birth control to regulate your period masks your underlying issues without addressing them.

Birth control is not the answer for managing perimenopause symptoms, and it can actually worsen your mood, mental clarity, and metabolism. If you're looking for support during perimenopause, you should seek testing first with your physician. At that time, you could explore taking progesterone.

Balanced hormones are crucial for a normal period, and our bodies need to be healthy for this harmony to exist. Doctors tend to get fixated on the function of your organs, like the uterus and ovaries. Focusing on balancing hormones, even adrenal and thyroid hormones, may reveal the root of the problem.

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Our current healthcare system in America is leading to serious burnout among physicians. Why? Because demand is high and the pay is very little. Respect and satisfaction among doctors is low—even for those who perform crucial surgeries. As a patient, you will pay more to replace your car transmission than what your doctor gets paid for a bypass surgery.

This is an indicator of where the values in our society lie. Doctors spend years on their education and work grueling hours, racking up debt, but they are no longer compensated accordingly. Considering the sacrifice they have gone through, they are greatly underpaid.

For these reasons and many more, doctors are deciding to go with a concierge service, including charging membership and other associated fees. Before you pass judgement about doctors for going this route, you have to understand the reasons why so many physicians would choose to.

We need our doctors, and we need to start acting like it. The way the healthcare system is designed doesn't protect doctors and their businesses. They support the insurance companies who fleece you, the patient, and your medical professionals.

Doctors want to help and heal people. Ideally not only those who can afford them. But at the same time, physicians have to put a value on the time they spend serving your needs outside of a face-to-face visit. Spending the minimum amount on your healthcare costs will get you the minimum amount of care. The business of medicine is the same as any other: You get what you pay for.

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We're continuing our conversation about the American healthcare system in this week's episode. It's important to recognize that the Affordable Healthcare Act advertised simplicity in our system, but in reality, the changes made fueled a huge rise in premium costs.

This act was intended to lower the number of uninsured Americans. Yet 10 years later, affordability has tanked for most people. So, what is the answer, and how do we address this? We have to trim the fat: Get rid of the bureaucracy that doesn't enhance the system in any way, shape, or form.

Private doctors are a dying breed, leaving room for only those associated with groups and corporations. This has made healthcare much less accessible overall. When you do seek care, you may also find yourself confronted with long wait times to see the doctor in person, but also with customer service over the phone.

If you find a skilled doctor who takes your insurance, hold on to them. It isn't likely that we'll see a change in this system anytime soon. We are facing a physician shortage. The Great Resignation is still impacting medical support personnel in clinics and hospitals, making it hard to find good candidates to fill these roles.

At the same time, the cost of overhead and labor has been weighing heavily on doctors, influencing many to decide to close their practice or retire from their practice early. Experienced, well-trained doctors want to be paid fairly–and rightly so. As a result, the people who need it the most are missing out on quality care.

The Congressional Joint Economic Committee created this flowchart to map Obamacare

Physician Suicide: A Call to Action

Will the doctor see you now? Maybe not amid the changing health care landscape in the US.

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Have you ever thought about how the healthcare system in the USA operates? The American healthcare system isn't designed to cover you or support you. At the end of the day, these healthcare entities are a business, and therefore they exist to be profitable, not to put your best interests first.

When you buy insurance, you're signing a contract that will only cover certain aspects of your care. Insurance plans can vary greatly, so don't be surprised when your doctors and other health professionals don't know what your plan covers. Being savvy and in-the-know about your insurance plan is really important and will pay off for you.

Your deductible is the amount you have to pay out of pocket before your plan will cover medical services. Some services are subject to deductibles while others are not. Deductible costs vary and could be as high as $10,000. If this is the case for you, you're more than likely paying for your care out of pocket.

Once you agree to a plan, you are also limited to medical services from the doctors you have access to and the services they provide. Waiting in line for an opening can delay your services, which is something you need to know upfront. A PPO plan is always preferable over an HMO or EPO plan.

When you sign up for a plan, the number one thing you need to know is your maximum out-of-pocket costs. When you have a serious medical condition that requires hospitalization, you may end up spending an astronomical amount in bills without being aware of or even prepared for it. If you don't know the details of your plan yet, be sure to check them out sooner rather than later.

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Having a great wellness provider matters, and that includes the medical team that works at the practice you choose. Recently on the podcast we've covered what to look for in a doctor, which includes a willingness to give you, the patient, a lot of time and patience while actively listening to your concerns. They should also have a great depth of knowledge that they also know how to apply.

Your doctor and their medical team should never see you or treat you like just another number. Access to prompt, quality medical care is important for patients to have—however, it is increasingly difficult to find. Doctors are overwhelmed, and the consequences fall on the patients.

Members of the medical team are usually the first point of contact with patients and will support quite a significant degree of your care. While their job is to support the doctor, each team member plays an important role in the outcome of your care.

Yet, the way most medical teams are set up is flawed. Doctors aren't necessarily trained on how to be effective leaders, but this is crucial if you want to create a strong team. The medical team is truly an extension of the physician, so they need to be exceptional in their interactions and their knowledge to provide the best quality care.

Doctors cannot run their office alone. A great physician will need a great team to work alongside them. In fact, they are the most valuable asset a doctor can have. Working well as a unit with minimal supervision and being able to handle difficult situations on their own allows the doctor to focus on what they do best.

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