When you’re struggling with fertility issues it can feel very isolating. It’s not something that is often spoken about – it’s not even something that is often written about as anyone who has tried Googling knows very well. I’ve been lucky to connect with amazing women via Fruitful, but it’s shocking that even close friends who have struggled with these issues aren’t necessarily open to discussing them. It’s such an emotional and physically exhausting time and, in my experience, traditional doctors are often jaded and don’t look for the root causes of issues. I’ve been to enough “top doctors” to know that “top” doesn’t always mean much of anything (and is often code for over-worked, prone to missing things, and not up-to-date on the latest advances). In meantime thousands and thousands of dollars are flying out the window. With that in mind I reached out to the medical director of Dr. Mark Hyman’s Ultrawellness Center, Dr. Elizabeth Boham. Dr. Hyman is a functional medicine pioneer and his center is at the cutting edge when it comes to treating chronic issues at their root – not covering them with a Ban-Aid. I still haven’t committed to going since it’s very expensive and outside of New York City, but anyone who is in this boat will likely find great inspiration in Dr. Boham’s words.
A typical case from so many women I’ve spoken with: get off the pill and after months, even a year, are still not ovulating. How does functional medicine work to treat the root cause of this issue?
We work to evaluate all of the systems in a person’s body. We evaluate all hormone levels. This includes thyroid levels, adrenal levels and sex hormone levels. We work to support natural detoxification. This is important for helping the body process and get rid of past hormones and toxins. We make sure they are having regular bowel movements, eating sufficient fiber, drinking enough water and sweating. This helps the body get rid of toxins and past hormones that may be impacting your health. Cruciferous vegetables (broccoli, cauliflower, cabbage and kale) help support detoxification as well. We make sure there is the right balance of good bacteria in the gut, since this can hinder detoxification of hormones. We also work on supporting the normal daily rhythms of life and the body. This means helping the person get on a good schedule. Making sure they are sleeping enough to support the adrenal glands and all hormones. Many people are not getting enough rest. So we make sure people are getting the 7-9 hours of recommended sleep and supporting their adrenals. Some people need thyroid support. This can include foods that support thyroid and sometimes hormones. Foods rich in iodine (seaweed), selenium (brazil nuts – just 1-2 daily) and iron all support the thyroid to function properly. We do testing to make sure people have sufficient nutrients in their body for their systems to work well. There are many toxins that impact our hormones. BPA, pthalates, parabens, pesticides to name a few. We work to help women eliminate these.
While there are clearly many cases of overweight/poor diet contributing to infertility have you seen the cause of infertility being someone over-exercising?
Yes absolutely! Balance is key. But often hard to achieve. A good general rule of thumb, is if you are getting more tired after exercise or the next day and are not bouncing back after your workout, then you may be working out too intensely or too hard. Working out 6-7 days per week may be ok, but make sure to mix it up (different types of exercise) and that 1-2 of those days are less intense, like going for a walk or going to a relaxing or moderate yoga class. Women need to be careful. Too much exercise can backfire. If our period stops, then this is a sign that we are exercising too much or not eating enough food to support our exercise routine. Also women don’t often continue to lose more weight with more exercise. Many studies have shown that women will stop loosing weight at some point with more and more exercise. This may be a protective mechanism that we have in our body’s for fertility and it also may be because we get more hungry. Exercise is a wonderful stress reliever and great for our health, but too much exercise can hurt our fertility and actually prevent weight loss in some women.
Can seemingly unrelated symptoms – like a chronic cough – be related to fertility? How does functional medicine take a holistic view in a way traditional medicine doesn’t?
Yes all systems in the body are inter related. Chronic cough for example could indicate that there is exposure to an allergen in foods or the environment. Inflammatory foods have been shown to trigger insulin resistance in some. There could be a connection there. Not necessarily related to the cough, we screen for nutritional levels and make sure the person does not have any nutritional deficiency. The body is less likely to get pregnant if there are nutritional deficiencies. That makes sense, since we don’t want to be bringing children into a world where there is not enough food. So we work with women to get them on the highest nutritional density diet possible. Many women think they are healthy, but because of some junk food sneaking in, or restrictions to help maintain weight, or because of our food supply, some women have nutritional deficiencies that are harming their fertility. We of course have to screen for celiac disease and other autoimmune conditions such as autoimmune thyroiditis. Celiac disease causes nutritional deficiencies because of malabsorption.