Women's Reproductive Roadmap

Of all the areas of well-being, women’s reproductive health is one of the most complex and fascinating. From the onset of menstruation to the journey through menopause, women experience an array of physical and emotional symptoms that range from bothersome to insufferable.

But women are finding new, natural, and effective ways to deal with their unique makeup. And experts agree that despite all the advances in research and treatment, what helps women enhance their reproductive health the most is taking care of their body, mind, and soul.

“In no way can you be reproductively healthy without being emotionally healthy,” says Dr. Jerilynn Prior, founder of Vancouver’s Centre for Menstrual Cycle and Ovulation Research.

Lorne Brown, founder of Acubalance Wellness Centre, a traditional Chinese medicine clinic that treats infertility, agrees that a woman’s overall well-being determines her reproductive health.

“The basic principle of Chinese medicine is to nourish the soil before you plant the seed,” Brown says.

Getting started

When it begins
Regardless of when the first signs of puberty appear, a girl’s period usually starts two to three years later.

In the United States the average age of breast development in girls in 1970 was 11.5 years, while in 2000 it had fallen to just under 10 for white girls and nine for black girls, with many developing breasts before age eight.

In Canada there was an eight-month decrease in the age at first menstruation (menarche) between the oldest and youngest age groups in a sample of more than 8,000 women surveyed for a 2008 Journal of Adolescent Health study.

What it means
Although not all girls will have problems as a result of early-onset puberty, some research shows that the sooner girls hit puberty, the more likely they are to suffer negative health consequences, such as polycystic ovarian syndrome and depression.

Furthermore, early puberty means longer lifetime exposure to estrogen, which is known to increase the risk of breast cancer. Menarche before age 12 raises the risk of breast cancer by 50 percent compared to that at age 16.

Although no one knows exactly why girls are starting puberty sooner, among the theories are obesity, premature birth, and environmental chemicals.

How it feels
Along with getting used to the initially very weird experience of bleeding down there, young girls can also be taken by surprise if they experience premenstrual syndrome (PMS).
Besides mood swings, they might resent the fact that boys don’t have to go through the same ordeal, though adolescent girls are often excited by the prospect of growing up.

When to take your daughter to the doctor

• She hasn’t had her period within three years of developing breasts
• She exercises excessively or has an eating disorder
• She has monthly cramps but no signs of blood

Period problems

PMS
One of the most common and recurring issues for women is PMS. Some of the symptoms include abdominal pain, bloating, and fatigue. See sidebar (below) for natural remedies.

Irregular periods
In adulthood irregular periods can be a concern for many women. These can be caused by excessive weight loss or gain, eating disorders, stress, overexercise, a break in routine, or anxiety about getting pregnant. Other possible causes include polycystic ovary syndrome and other hormone problems. Talk to your health practitioner to rule these out.

Heavy bleeding
Some women experience heavy bleeding. Possible causes include fibroids, hormonal abnormalities, pelvic-inflammatory disease or other infection, stress, weight loss or gain, travel, illness, polyps, or, in rare cases, endometrial cancer.

Increasing dietary or supplemental iron and drinking salty liquids (bouillon or vegetable juice) is a good idea to help replenish lowered blood count.

Painful periods
Painful periods are caused by high levels of prostaglandin, a hormone that increases the normal contraction of the muscle wall in the uterus. As with PMS, exercise can be a potent
tool in diminishing pain.

Natural ways to conquer PMS

• Calcium, magnesium, B₆, zinc, and vitamin E
• St. John’s wort
• Evening primrose and flaxseed oils, which are a source of essential fatty acids
• Regular aerobic exercise
• A healthy diet with small, frequent meals high in complex carbohydrates, which elevate serotonin levels in the brain

Period suppression

Whether they’re troubled by painful cramps or they simply can’t be bothered with the perceived inconvenience of menstruation, some women choose to suppress their periods.

Among the methods of suppressing menstruation are:

• Daily oral contraceptives: Seasonale, Seasonique, and Lybrel
• Injected hormonal contraception: Depo-Provera
• Intra-uterine device: Mirena

Although all of these approaches lead to fewer and lighter periods (about four a year), unexpected bleeding and spotting is far more frequent than with normal cycles.

Dr. Jerilynn Prior, who heads Vancouver’s Centre for Menstrual Cycle and Ovulation Research, has two concerns with the extended use of hormonal contraception:

1. the unknown health risks of higher doses of estrogen and progestin
2. the way the hype surrounding the drugs makes women feel as if menstruation is a problem

Many women, however, want to have regular periods because they rely on menstruation as a sign that their body is functioning normally.

Fertility

Age of conception
Women are most fertile between the ages of 20 and 24. However, since the mid 1970s, there has been a four-fold increase in the percentage of women having their first child after age 30.

According to the Human Fertilisation and Embryology Authority in the United Kingdom, women are half as fertile at 35 as they were at 25; by 40, they’re half as fertile as when they were 35.

What affects fertility
Factors affecting fertility include ovarian reserve (the number of functioning follicles left in the ovaries); the thinning of the endometrium, which results in the lining of the womb becoming less hospitable to a fertilized egg; and conditions such as endometriosis and chlamydia.

How to boost fertility

Exercise
According to Acubalance’s Brown, the first step is exercise, which releases endorphins, or, as he calls them, “Mother Nature’s antidepressants.” “Just a brisk walk for at least 30 minutes a day will get the feel-good hormones active and help with overall circulation,” he says.

Relax
The next step is deep relaxation, whether that’s having a massage, gardening, taking a bubble bath, or getting outside.

“Acupuncture can reduce stress by relaxing the sympathetic nervous system,” Brown adds.
Good-quality sleep is crucial too, as is connecting with family and friends.

Eat right
Brown has also devised a specific fertility diet. The whole foods, plant-based diet, which is high in antioxidants, includes “slow carbs” (meaning they’re slowly digested) such as beans, lentils, whole grains, and brightly coloured vegetables.

Registered holistic nutritionist Stephanie Hodges of Vitalis Nutrition Designs says diet plays a key role in reproductive health.

“Eat only whole unrefined fats, in moderation of course,” she says.

Cleanse your liver
Hodges also urges women to take care of their livers. “Three to six months before you plan to get pregnant, take a few weeks to cleanse your liver very gently. This can be done by adopting a simple vegetarian diet and cutting out caffeine, sugar, wheat, and dairy.”

Menopause

Before women hit menopause, they go through perimenopause, which is usually marked by irregular bleeding and can also include mood swings, night sweats, sleep disturbances, nausea, and migraine headaches.

The progression to menopause—defined by the cessation of menstruation for at least 12 months—usually takes anywhere from two to eight years. Menopause typically occurs between the ages of 40 and 55. Starting early is associated with lean body weight, low socioeconomic status, and smoking.

Popular culture tends to focus on the potential negative outcomes of menopause, such as depression and supposedly lower libido, but many women find the transition positive: no longer do they need to worry about feminine protection, birth control, or PMS.

There are physical effects of menopause, such as hot flushes, night sweats, breast tenderness, bloating, weight gain, and vaginal dryness. The last one has an easy solution: more sex. Regular sexual activity increases natural lubrication. Exercise can help with the other symptoms and also
boost energy.

Help for hot flushes

• Yoga
• Exercise
• Acupuncture
• Soy beverages
• Positive outlook

When to call your doctor

• You soak through a pad or tampon every hour for two to three hours
• Bleeding lasts longer than a week
• Severe pain
• Foul-smelling discharge