Women's Health Medicine Cabinet - By Dr. Chelsea Cole, ND

A Naturopathic Medicine Cabinet….

Medicine cabinets call to mind bathroom mirrors hiding shelves lined with toothpaste, lip balm, and an assortment of over the counter or prescribed medications.

While all of these items are necessary, I don’t feel particularly inspired by this vision of a medicine cabinet. Instead, I like my medicine cabinet to be found in my kitchen cupboards, and on a shelf laden with botanicals for everything from a cold to a sleepless night.

While there are many folk remedies to be found in books and online, I do like to go a step further and research the evidence behind nature’s remedies. In this way, I feel confident in what I am choosing to keep on hand.

While it is important to see a health care provider if a particular symptom is getting worse despite your best efforts, I think it can be empowering to keep evidence-based natural remedies in your medicine cabinet to use as needed.

In this particular article, I want to highlight some of my favourite items to help with menstrual and genitourinary health concerns.  

Ginger

This spicy botanical can help with everything from nausea to menstrual cramps. The use of a standardized extract of ginger to help with menstrual cramps is supported by clinical studies[1],[2], and has been found to be as effective as ibuprofen and mefanamic acid.[3] Side effects, like heartburn and headaches, are infrequent, making ginger a safe choice.[4] Most studies explore primary dysmenorrhea, which is menstrual pain unrelated to any identifiable disorder, usually beginning around the time of a person’s first menstrual cycle. Secondary dysmenorrhea is menstrual pain secondary to an identifiable disorder, like endometriosis, and usually starts some time after the first menstrual cycle. It is important to have new onset menstrual cramps evaluated by a health care provider, to determine whether they are a symptom of an underlying problem. Ginger may still be a useful pain relief, but other approaches will also be needed.  

Vaginal probiotics

It is important to have new onset vaginal discomfort or discharge evaluated by a health care provider before self-treating. If a vaginal yeast infection (vulvovaginal candidiasis – VVC) or bacterial vaginosis (BV) have been diagnosed, and you are aware of the signs and symptoms, you could consider using vaginal probiotics during an active infection, and to prevent future infections from occurring. The vagina is normally inhabited by Lactobacillus bacterial species, which help to maintain a slightly acidic vaginal pH, thereby preventing the growth of some harmful microbes. When BV or VVC occur, it means that the delicate balance of the vaginal microbiome was disrupted. Therefore, it makes sense that supplementing with lactobacilli species could help bring vaginal health back into balance. In fact, research demonstrates that lactobacillus supplementation can help with both BV and VVC.[5],[6],[7],[8],[9],[10] Keep in mind, conventional medication is advised if the infection is not resolving, is severe, or if you are pregnant.  

Cranberry

The use of cranberries for urinary tract infections (UTI) is fairly well known, and has certainly received some attention in research. Research primarily focuses on uncomplicated UTI’s in women. Complicated UTI’s are those that are associated with other disorders (ex. diabetes), anatomic abnormalities, or are caused by an unusual pathogen (ex. yeast). Uncomplicated UTI’s are very common, and are usually caused by E. coli bacteria. Studies show that a compound found in cranberries can prevent E. coli from adhering to the bladder wall, thereby preventing infection.[11] The research on the use of cranberry for UTI’s is conflicting, party due to a wide variety of cranberry preparations used (ex. juice, capsules).[12] One review study found that cranberry might be effective in reducing the risk of UTI recurrence in women.[13] Another study found that daily consumption of cranberry juice lowered the number of UTI’s experience by women.[14] Based on the research, regular cranberry intake might be worth trying if you are prone to UTI’s. It is important to visit a health care provider to insure that urinary symptoms are in fact caused by a UTI before self-treating. If UTI’s are recurring, then you should seek further evaluation to determine why they recur. If symptoms worsen, or do not get better within 24 hours of self-treating, seek the advice of a healthcare provider.

B vitamins

There is some research that suggests supplementing with B vitamins may help alleviate some of the symptoms associated with premenstrual syndrome (PMS). PMS symptoms are variable, and can include: anxiety, depression, fatigue, irritability, cramps, breast tenderness, or headaches, among other symptoms. PMS is distinguishable from other health concerns because the symptoms only occur in the second half of the menstrual cycle (luteal phase), and resolve within a few days of bleeding. One study found that women who consumed higher levels of vitamin B1 and vitamin B2 were less likely to experience PMS.[15] Another study concluded that vitamin B6 was particularly helpful for mood-related PMS concerns.[16] With the exception of B12, which is primarily found in animal-based food, B vitamins can be found in a wide variety of vegetables, nuts, and seeds. B vitamins can also be found in supplement form. PMS is very common, but that doesn’t mean you have to feel terrible every month. Make sure to see a naturopathic doctor if PMS continues to be bothersome despite your best efforts.  

It is important to know that there are many options for helping with menstrual and genitourinary health concerns.

My hope is that you will feel inspired to seek help when you need it, but feel confident incorporating botanicals like ginger into tea to help with cramps, and leafy greens into meals to supply some B vitamins. If changes like these don’t do the trick, then it is time to see your naturopathic doctor. I spend a lot of time with you, so that I can tailor treatments to you and your specific needs and health concerns, and particularly enjoy helping people improve their experience of menstruation. 

To book an appointment with a Naturopath at Juniper Family Health please call 778-265-8340 or book online here.

References:

[1] Daily J. et al. Efficacy of ginger for alleviating the symptoms of primary dysmenorrhea: a systematic review and meta-analysis of randomized clinical trials. Pain Medicine 16(12):2243-2255, 2015.

[2] Rahnama P. Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in

primary dysmnehorrhea: a placebo randomized trial. BMC Complement Altern Med

12(92), 2012. 

[3] Ozgoli, G. et al. Comparison of effects of ginger, mefanamic acid, and ibuprofen on pain in women with primary dysmenorrhea. J Altern Complement Med 15(2):129-132, 2009.

[4] Chen X. et al. Efficacy of oral ginger (Zingiber officinale) for dysmenorrhea: a systematic review and meta-analysis. Evid based Complement Alternat Med. 2016, 2016.

[5] Anukam, K. et al. Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic lactobacillus rhamnosus GR-1 and lactobacillus reuteri RC-14: randomized, double-blind, placebo controlled trial. Microbes and Infection. 8:6, 2006.

[6] Ehrström, S. et al. Lactic acid bacteria colonization and clinical outcome after probiotic supplementation in conventionally treated bacterial vaginosis and vulvovaginal candidiasis. Microbes and Infection. 12:10, 2010.

[7] Falagas, M. E et al. Probiotics for the treatment of women with bacterial vaginosis. Clinical Microbiology and Infection. 13:7, 2007.

[8] Falagas, M. E. Probiotics for prevention of recurrent vulvovaginal candidiasis: a review. Journal of Antimicrobial Chemotherapy. 58:2, 2006.

[9] Vujic, G. et al. Efficacy of orally applied probiotic capsules for bacterial vaginosis and other vaginal infections: a double-blind, randomized, placebo-controlled study. European Journal of Obstetrics & Gynecology and Reproductive Biology. 168:1, 2013.

[10] Wang Y, et al. Efficacy of vaginal probiotic capsules for recurrent bacterial vaginosis: a double-blind, randomized, placebo-controlled study.  Amer J Obst/Gyn 2010:120.1-120.6

[11] Howell A. B. et al. Dosage effect on uropathogenic Escherichia coli anti-adhesion activity in urine following consumption of cranberry powder standardized for proanthocyanidin content: a multicentric randomized double blind study. BMC Infect Dis. 10:94, 2010.

[12] Jepson R.G. et al. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev 10: CD001321, 2012.

[13] Fu Z. et al. Cranberry reduces the risk of urinary tract infection recurrence in otherwise healthy women: a systematic review and meta-analysis. J Nutr 147(12): 2282-2288, 2017.

[14] Maki K.C. et al. Consumption of a cranberry juice beverage lowered the number of clinical urinary tract infection episodes in women with a recent history of urinary tract infection. Am J Clin Nutr. 103(6):1434-42, 2016.

[15] Chocano-Bedoya P. et al. Dietary B vitamin intake and incident premenstrual syndrome. The American Journal of Clinical Nutrition. 93(5): 1080-1086, 2011.

[16] Kashanian M. et al. Pyridoxine (vitamin B6) therapy for premenstrual syndrome. International Journal of Gynecology and Obstetrics. 2006.