By Dr. Thalia Farshchian
It can be both a beautiful and frustrating thing that the body is so interconnected. In some respects, it is fascinating and comforting and in other ways, it can feel so complicated. The more I study medicine, the more in awe I become of how it all works.
As a doctor, I focus on both digestion and hormones. It is really no coincidence as these are two areas I struggled with myself. I had a childhood history of stomach aches, but when I went to college both digestive and hormonal issues reared their ugly heads.
At that time, the hormonal issues with my menstrual period took precedence and drove me to my doctor. I had a full work-up with blood work and imaging all to find out, I was normal. It was disappointing to hear as I felt awful. When I asked my doctor what was next, her response was birth control. If my hormones were all “normal,” why would I take birth control? Her response was, “it is just what we do.” After my frustration, I started looking at other schools of thought and found a naturopathic doctor.
He spent time with me to learn more about my lifestyle, stress and current complaints followed by a battery of specialized tests. In short, I was a first year in college eating a poor diet, experimenting with alcohol and stressed by the big changes in life. My doctor’s assessment was that my liver was having a hard time detoxifying my hormones and in turn causing my symptoms. Within a month of cleaning up my diet and adding in some supplements, I felt back to normal without birth control. I got so excited by the process of understanding my body that I became a naturopathic doctor.
Now the purpose of this story is not to make you all quit your jobs and become naturopathic doctors, but it was the first light bulb to go off in my head that these two seemingly different systems of the body were in fact related.
Love your Liver
Let’s start by focusing on and paying homage to the all mighty liver. It is an incredibly resilient organ that puts up with the dirty world we live in.
The liver helps with the following functions:
- Metabolizing protein, fat and carbohydrates from our food
- Producing cholesterol to help make bile acids in the gall bladder and hormones in the ovaries/testes
- Producing proteins necessary for blood clotting and fluid balance
- Stores glycogen for energy expenditure
- Activating thyroid hormones
We have various ways of testing its health, but there are symptoms that also clue us in to look closer including:
- Skin Issues: Acne, Liver Spots
- Hay Fever or Chronic Environmental Allergies
- Emotional: Anger (traditionally thought in Chinese Medicine)
- Hormonal Issues: Fatigue, Irregular Cycles, Breast Tenderness
- Digestive Issues: Indigestion, Fatty Stools (Floating), Abdominal Discomfort
- Cardiovascular: High Cholesterol
On a daily basis, our liver is up against quite a bit including:
- Caffeine
- Alcohol
- Saturated Fats
- Pesticides
- Medications (prescribed, food based from hormone/antibiotic fed meat)
- Fumes via Paint/Exhaust, etc.
- Environmental Factors including pollen, dander, dust
- Hormones (our own, birth control, food based as mentioned above)
- Chemicals commonly from plastic and skincare products
- Bacterial toxins from digestive bacterial/flora imbalances
Among the list above are both things that are easily modified with proper awareness and those that are difficult to avoid or understand are an issue in the first place.
As I mentioned before the liver is arguably our most resilient organ system, which means we can support it with proper nutrition and lifestyle change. To enhance detoxification, incorporate the following:
- Exercise and break a sweat
- Stay hydrated
- Eat a diet high in fresh vegetables and fruits
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- Foods high in Vitamin C including citrus fruits and greens: kale, collard greens, Brussel sprouts, broccoli
- Foods high in Vitamin E including avocado, almonds and sunflower seeds
- Foods high in Zinc including oysters, ginger root and pumpkin seeds
- Foods high in Selenium including brazil nuts and garlic
- Foods high in Magnesium including kelp, avocado and good quality chocolate
- Foods high in B Vitamins including lean meat and liver
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- Be mindful of the quality of your meat products by sticking to grass fed, chemical free and wild
Microbiome Balance
Our microbiomes, the bacteria that make up our body, are becoming quite the hot topic in health and wellness. We are made up of one trillion bacteria, which could allow one to argue that we are more bug than we are human.
With modern stressors of food sources, environmental toxins, antibiotics, increased cleanliness, reduced time breast feeding and life stress, our bacterial balance becomes heavily affected. This in turns can cause digestive, immune and hormonal issues. This topic can easily go on forever, but we will stay focused on the hormones.
So we know that the livers aids in detoxifying hormones to allow us to expel them via our urine and feces. The large intestines which help with bulking and excreting feces plays a role in hormones as well.
When the bacterial balance is thrown off and we have bad bugs that cause dysfunction, there can be an enzyme that is created in excess called beta glucaronidase. Beta glucaronidase actually takes hormones, medications and other toxins in the large intestines that supposed to be expelled and loops them back to the liver. This in turns results in the liver working over time. For some, this recirculation can exacerbate any of the general symptoms that suggest liver stress including hormone imbalances and/or increased yeast infections.
Stool testing can confirm the presence of excess beta glucaronidase and help determine the make-up of the microbiome. This specialized testing can offer information on the digestive component of detoxification and aid appropriately supporting those affected by hormone imbalance.
If you suffer from pelvic pain your liver and hormones may play a role. To learn more, consult with a naturalpathic doctor in your area.
About the Author
Dr. Thalia Farshchian is a naturopathic doctor in San Francisco helping people to optimize their health to stay active. She specializes in digestive and hormone conditions using diet and natural remedies to support healing. With an expertise in both these areas, she has been able to assist people in achieving their optimal body, inside and out. To learn more about Dr. Farschian please visit her Website — www.drthalia.com.
FAQ
What are pelvic floor muscles?
The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.
What is pelvic floor physical therapy?
Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.
What happens at pelvic floor therapy?
During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.
What is pudendal neuralgia and how is it treated?
Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.
Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.
What is interstitial cystitis and how is it treated?
Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.
Who is the Pelvic Health and Rehabilitation Team?
The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.
How many years of experience do we have?
Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.
Why PHRC versus anyone else?
PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.
Do we treat men for pelvic floor therapy?
The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.
Do I need pelvic floor therapy forever?
The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.