Blame It On Menopause
Recently, one of our female patients who is around menopause started to develop excruciating pain around the bladder and surrounding tissues. Lab work showed lots of inflammation, but no infection. The pain got too severe at one point to be able to walk, and total helplessness rushed in like a threatening storm.
Her diet was extremely clean. Lots of vegetables, with a good mix of anti-inflammatory fruits-many of these being organic, meats were grass fed locally grown, starches were few and organic, with a good mix of nuts and beans.
The burning seemed more linked to airborne toxins and supporting their clearing helped ease the pain. But the burning came back. Bladder infection products helped, but new labs still showed no infection, AND THE PAIN STILL DID NOT GO AWAY!
Very Little Research
Looking into the research on such symptoms we found a term called Interstitial Cystitis meaning pain and inflammation around the bladder and surrounding tissues. This condition is more common in premenopausal and post-menopausal women, but the research cannot explain why these women have this problem.
Welcome to my world, trying to find answers to common questions that the mainstream of research and literature has not fully been able to clearly explain. It’s at times like these that we have to dig through volumes of studies to try to find some logical answers as to why this is going on.
IT’S JUST A PART OF MENOPAUSE IS NOT AN ACCEPTABLE ANSWER – WE NEED TO KNOW WHY – WHAT IS CAUSING THIS!
So after spending hours back in Guyton’s Physiology Text Book, and more hours mining through the research, we have some answers. And the woman’s life is returning back to normal.
So what is the issue that causes all of this? The bottom line is that it is as simple as it is complex.
Our hormones affect everything in our bodies. Our sexual hormones-the ones that make us men and women-are at the top of the list of hormones that affect everything. As we age, these hormones change. We have less of them.
But that is not the entire story.
The Hormone Saga
We all make hormones inside of us. Not always how we think that they are made and not always healthy hormones.
Take estrogen for example. Both men and women make estrogens. There are three primary estrogens: estradiol which is most common in cycling women; estrone which is most common in menopausal women; estriol associated mostly with pregnancy.
Estradiol is mostly made from cholesterol in the ovary, where estrone and estriol are mostly made in the peripheral tissues from an adrenal hormone called DHEA. But these three hormones can easily convert back and forth into one of the other estrogens.
And there is a hormone in fat tissue called aromatase that converts your estrogens into toxic estrogens and testosterone.
Then there are these things called xenoestrogens-meaning foreign estrogens. These come from outside of our bodies, and are usually toxic. Plastics, herbicides, and pesticides are filled with xenoestrogens, but the worst offender is receipt paper. You absorb them through your skin when you handle receipt paper, and that absorption increased many times when your hands are wet.
Then there are phytoestrogens. These are from plants. They help modulate your estrogen function by helping to regulate your estrogen receptors on your cells.
Then there are different detoxification pathways that estrogen has to go through to be excreted from our bodies. Only one of these pathways is healthy, the others make your estrogens more toxic.
Now we can see that the management of hormones mandates that we favor healthy hormones, and try to stay away from the toxic ones. To do this, we will need to be careful of what we eat, or put in our mouth, and touch (receipt paper) to avoid xenoestrogens. And we will need to adjust our lifestyles to favor proper estrogen excretion.
From this perspective, we can look at a simple common experience called hot flashes. To men it’s just a word; to women it’s a nightmare. Women are told that hot flashes are caused by a decrease in estrogen and are then sometimes directed to ingest xenoestrogens. We have been finding something different.
If too little estrogen is the cause for hot flashes, then why don’t young girls have them before they reach puberty? I would love to hear a really good explanation on this.
For the same matter, we should ask this question of all the symptoms that plague women in menopause. If a decrease in estrogen is truly the cause for whatever menopause symptom I’m having, then why didn’t I have that symptom in my childhood?
These questions bring us back to what else can cause hot flashes. Thyroid hormones control your metabolism, blood pressure, energy, menstrual cycles, pregnancy, as well as oppose estrogen when it’s not balanced. Adrenal hormones can create “fires” in us that will cause heat, especially when were chronically stressed. Blood sugar fluctuations can cause hot flashes, and so can some digestive disorders.
So there is much more to look at than just the types of estrogens and their toxicity. Healthy estrogens tend to promote healthy responses in our bodies, while toxic estrogens tend to promote unhealthy responses. The cause of young girls starting puberty at the young ages of 6 to 8 years old seem to be the same reason that post-menopausal women are being plagued with so many different symptoms; these all appear to be linked to unhealthy estrogens, and unhealthy ways of metabolizing estrogens.
The adrenal glands make the precursor hormones of DHEA and Pregnenolone that convert into estrogens and progesterone. Blood sugar regulation, in part, helps to determine how healthy our estrogens will be. Stress pushes the DHEA and Pregnenolone into other pathways to make stress hormones. Thyroid hormones will oppose estrogens when the two are not properly balanced. And the gut is the first site of hormone production directing the body to get ready for whatever changes need to occur from the foods that we just ate.
Say for example, that the woman is having digestive issues that she does not know about. Eventually the gut will get inflamed and start to leak. The leaking gut will overwhelm the liver with too much toxins to be able to clear. The extra toxins will overload the adrenals as they try to stop the toxic inflammation. The adrenals will slow down their production of DHEA and Pregnenalone to make cortisol. The cortisol will raise the blood sugars, with insulin rising to keep the blood sugars in check.
Insulin and cortisol turn on a hormone in your fat tissue that converts your estrogens into toxic forms. All of this will overload the thyroid and its hormones, affecting metabolism and upsetting the balance of estrogen and thyroid hormones.
So which of these started the problem that led to the hot flash? This is why just throwing things at the symptoms doesn’t work.
You have to address what started the whole problem in the first place to get everything to calm down. In our example the problem started in the woman’s gut, so most likely the solution must start there also.
Back to the Beginning
So now back to the bladder pain that we started this article with. Declining estrogens change the urinary tract. Research shows that the kidneys enlarge as estrogen declines. The bladder thins as the urethra loses diameter as its surrounding tissues begin to shrink.
If toxins are added to all of these urinary tract changes, we have all of the elements to start a fire-an inflammatory fire. And all fires burn.
So what started the burning in her bladder? It was a combination of almost everything we have discussed above. Chronic stress, with situational disruption of eating patterns bringing about changes in blood sugar, and gut function. This increased internal production of toxins, while she was in places where she could not avoid external toxins.
All of this coupled with declining estrogens brought about her interstitial cystitis or simply bladder pain. Estrogenic foods coupled with a changed eating schedule, gut healing and some detox have made this bladder issue quite manageable.
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