On women, hormones, and other things that go bump in the night

Warning: Ultimately, this will probably turn out to be more a book than a blog, but let’s open that box and let the Pandora in us live again.

As I write this warning note, it occurs to me how many times I’ve referred to Pandora’s box without truly thinking about the story of Pandora. According to Greek mythology, Pandora was the first woman on earth. She was endowed with many attributes, including beauty, music, and persuasion; in fact, her name means, “all-gifted.” Prominent among those gifts, of course, was curiosity; thus the opening of the container she had been warned not to open, and the unleashing of multitudes of evil upon the earth. Clearly, recovering our personal Pandora is a valiant pursuit.

But, I learned something new during my recent revisiting of this ancient tale: after the evils departed, something was left in the box. And that something was hope. Evils may surround us, but hope abides.

What — you may well ask — has all of this got to do with my hormones? I believe that maintaining good health requires women (and men, too, but we’ll come back to men in a future posting) to rely on our gift of curiosity. We must educate ourselves on how best to stay healthy through the sometimes seismic effects of raging hormones and aging systems. And, often, it means facing potential evil while maintaining hope. I want to help you discover and understand the hope nestled inside your box, waiting to be discovered.

Let’s start with hormones. As we age, our hormones inevitably shift. A multiplicity of factors contribute to this shift, so let’s examine those areas we can influence. In this first installment, I’d like to focus on diet. (OK, yes, it’s another proverbial box. But, open it I shall.)

First, virtually everyone who talks food and diet agrees on a few things. Vegetables good, white flour and sugar bad. Water? Yes. Soda? No. Meat? Grass-fed only, no hormones, please. Carbs? Depends. OK. Which carbs? Low glycemic index. So far, so good.

But now, it gets more complicated. Many of us are eating too much, not often enough, and too fast. This leads to chronic adrenal stress. We’re poorly nourished and stressed, so we’re tired. We try to deal with our fatigue — and thereby close the vicious circle — through more inappropriate eating. Our adrenals get the message that we need more juju, and bursts of cortisol — our natural stress-response drug — come screaming down the pike.

Producing cortisol requires a chemical known as pregnenolone, and producing so much of it drains our pregnenolone supplies. But, guess what? Making hormones requires the same stuff. The adrenals get first dibs. Leaving little or none for production of progesterone, estrogen, or testosterone. Are you beginning to see a pattern? Is it surprising that women — especially those age 38 and above — are tired and that sex has plummeted to the bottom of their priority lists? What to do? Stay tuned…

Yes, I Do That

Even after twenty years of practice, I regularly get surprised. Sometimes these surprises come in the form of helpful reminders or provocative questions. And sometimes the questions serve as reminders. One patient recently — and kindly — reminded me that part of my job is letting you know how I can help you. And this website and blog help me meet that challenge.

I was treating the patient — who had come to me often, for a variety of complaints — when she casually asked, “Do you do jaws?” Now, you may well wonder what “doing” a jaw entails. But don’t be alarmed, it’s just shorthand for “treat and fix.”

And, yes, I do jaws. Lots of them. That’s because — it may be your turn to be surprised— lots of people suffer from jaw problems. And many of them are completely unaware of the source of their discomfort.

The culprit is a condition called temporomandibular joint dysfunction, or TMJ for short. It manifests itself as a clicking, cracking, popping hinge; in discomfort when chewing…or yawning…or even talking; and it sometimes causes headache and stiff neck and…well, a long list of maladies.

What is that pesky temporomandibular joint? Well, the temporal bone is actually a part of your skull, while the mandible is a part of your jaw. So, once again we’re dealing with a joint and, of course, with the supporting structure of muscles, tendons, and ligaments.

And what goes wrong? Often, TMJ results from tight muscles that prevent the joint from moving properly. If you’re keeping score at home, these muscles include the buccinators, the temporalis, and the pterygoids, and they’re located both inside and outside of the mouth. Sometimes, the neck muscles, especially the anterior ones, are connected to an ongoing jaw problem. And even the shoulder and pectoral muscles can be culprits, as well.

That means a successful TMJ treatment must address not only the jaw itself, but also the surrounding structures. (Hello! Once again, we’re reminded that the body is an interconnected system.) The good news is that TMJ usually responds favorably to simple, short-term treatment. Especially if you don’t wait — and suffer — twenty-or-so years before seeking help.

So, yes, I do jaws. And feet. And hands and heads and so on.

All of this serves as another reminder to me: that my patients have always been, and will continue to be, my best teachers. If I haven’t thanked you who are reading this for the privilege of being your doctor, let me use this opportunity to do so. I’ve been blessed with a diverse and stimulating group of wonderful people who join me in pursuit of a higher level of wellness — Total Wellness, in fact — and who constantly challenge me to learn and grow. For all of this and more, I thank you.