Prism Blog

Featured on RiverstoneChiropractic.com: Acupuncture and Post-Surgical Care

Hi everyone! I’m so excited to share my newest article, which was featured on riverstonechiropractic.com (my favorite—and LGBTQ-focused!—chiropractor). Click to read more.

“In Chinese medicine, surgery is considered to block the flow of the meridians (similar to nerve and blood vessel damage in Western medicine). Improperly healed scars and old scar tissue can have the same effect, potentially causing pain, sensation loss, decreased circulation, and even impaired internal organ function depending on the depth of the scar tissue. Acupuncture as soon as possible after surgery helps to promote healing, reduce pain, swelling, and bruising, and prevent scar tissue from forming. Once the bandages are removed, scars can be worked on directly to prevent adhesions and reduce the appearance of scars. Cupping massage is also used to treat surgical scarring and adhesions to underlying tissues, and moxa can be used for post-surgical pain as well as reducing scars…

Surgical scars that are at least two weeks old can be worked on with acupuncture. Such treatments not only reduce scar pain, but also help to break up scar tissue and adhesions, increase local circulation, and aid healing. This leads to less noticeable scars and a reduction in keloiding. Scars may not only be cosmetically undesirable, but may also have an impact on health…”

Click to read more.


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


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Acupuncture, Endometriosis, Fertility and Pregnancy, For Providers, Menopause and Beyond, Prism Blog, Surgical Recovery, Transgender Wellness

Treating Post-Surgical Constipation

photo credit: Practical Cures on flickr CC

Constipation is extremely common post-surgery, especially in combination with constipating pain killers, less physical activity, and irregular fluid and food intake. Often a bowel movement is required before a hospital will let a patient go home, so encouraging this process is especially beneficial to get you home sooner.

Acupuncture

Acupuncture is extremely useful for alleviating postoperative constipation. Studies have shown that patients receiving regular acupuncture post-surgery actually perform better (have more frequent, easier,  less painful, more complete bowel movements) than those taking laxatives or stool softeners.

Points on your arms, legs, and abdomen are most frequently chosen for this purpose, especially points on either side of your navel and points on the stomach and large intestine ‘meridians’ (lines along the body in Chinese Medicine, sort of like dermatomes).

Acupressure

Several of these points can also be used at home as acupressure points for constipation. Press each point lightly (no more than an inch deep for abdominal points, about the pressure of holding hands for arm and leg points) for about 30 seconds at a time:

Massage

Belly massage is also helpful. You can find a Chi-Nei-Tsang practitioner near you, or watch this video demo to perform a similar belly massage yourself. You can also refer to the illustrated steps available here. There are many methods of breathing exercises for constipation as well that massage your belly from the inside!

Herbs

Acupuncture can be complemented with some herbs that stimulate bowel motility like:

Nutrition

Hydration is key. Drink plenty of water and incorporate more warm foods and beverages to wake up your digestive system gently. Try ginger tea, hot water with lemon, and bone broth. If you urinate more frequently than every 2 hours you may be drinking too much or too fast. If you urinate less frequently than every 5 hours you are dehydrated!

Eat warm, easy-to-digest foods like rice porridge, oatmeal, and mashed sweet potato or yams. When you’re ready, try lamb or vegetable and mushroom soup. Give your family and friends recipes to make for you during your recovery, such as: Magical Mineral Broth, Congee, and Almond flour ginger cookies.


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

For more herbal estrogens, ideas, and resources see my previous posts: Feminizing Herbs and “The Basics.”


Further study:

  Acupuncture at ST25 and BL25   Acupuncture at LI11 and ST37   Acupuncture at ST25, BL25, LI11 and ST37   Medicine:oral use of mosapride citrate: 4-week oral use, 5mg, three times daily 0.5 hour before meal   Total
SBMs [1]
[units: times per week]
Mean (Standard Deviation)
  2.7  (1.9)   2.5  (1.7)   2.9  (2.0)   2.9  (2.8)   2.8  (2.1)
Bristol scale [2]
[units: units on a scale]
Mean (Standard Deviation)
  2.8  (1.3)   2.9  (1.4)   3.0  (1.5)   2.7  (1.4)   2.9  (1.8)
Degree of straining during defecation [3]
[units: participants]
0   5   8   9   5   27
1   63   60   68   59   250
2   68   69   58   72   267
3   30   35   28   31   124
no defecation   2   0   2   3   7

 

Prism Blog, Transgender Wellness

Herbal Trio for Breast Development

Trans women can use herbal estrogens and progesterones with a medical provider to:

  • if you don’t want to use hormones or undergo surgery, but still want to create physical changes in your body.
  • after being on synthetic hormones for many years to maintain the changes that you have made without the side effects of continued synthetic hormone use.
  • to compliment your synthetic hormone regimen.

These are my top three favorite herbs focusing on breast tissue development. They can be taken all together or individually, following the instructions of your healthcare provider and directions for dosage on the bottle.

You can expect it to take at least a month to notice any changes, which will likely start with breast tenderness, swelling under the nipple, or slight areola growth. Understand that changes will not increase as fast or dramatically as with synthetic hormones, but nonetheless herbal estrogens and progesterones are a desirable alternative for many people.

If you are taking synthetic estrogens, eliminate the hops from this regimen as it can increase systemic estrogen levels.This trio of herbs may also be used to maintain breast growth created by synthetic hormones if you want to stop taking hormones, though you should always get your hormone levels checked regularly by your healthcare provider to make sure you are maintaining your desired levels.

Herbal Trio for Breast Development:

  • Hops
    • Hops have 0.2-20% the potency of estradiol and can increase estrogen levels in the body.
    • It is commonly used to increase lactation as it acts on the milk ducts of the breast. It may have a side effect of lactation in some people.
  • Maca
    • Maca is known for its effects of creating curves, and is fairly inexpensive.
    • It is known for its aphrodisiac effects, and can increase erectile capacity, stamina, and sperm counts -which may either be viewed as extra benefits or side effects depending on your goals.
    • It also boosts the immune system and helps combat osteoporosis.
  • Fenugreek
    • Fenugreek/Hu Lu Ba (Trigonella foenum-graecum) seeds contain a compound (diosgenin) that’s estrogenic and promotes breast tissue growth.
    • Sprouted seeds contain much more diosgenin than the unsprouted seeds, so breast enlargement is more noticeable if you sprout the seeds first.

Taking your herbs:

  • Be cautious of interactions with other herbs, supplements, and medications you’re taking! Herbs are safe when used correctly, but can have dangerous interactions if you use them carelessly.
  • You can take these herbs all at once if that is easier for you to remember.
    • However, because maca increases energy and hops have a mild sedative effect, you might try taking maca in the morning and hops before bed.
  • Where you get your herbs has a major influence on their effectiveness. Some herb companies have much higher quality standards and produce a stronger product with less additives. Any of these brands are good options to look into further:
    • Gaia and Herb Pharm both have great quality herbs in a variety of options: Hops, Maca, and Fenugreek.
    • My Evanesce has several herbal blends, most of which have many unnecessary added ingredients, but their Feminol product has a more useful blend of dong quai, black cohosh, chaste tree, white kwao krua, fennel, fenugreek, licorice, kudzu, sarsaparilla, boron, plus b6, d3, and b12. They recommend taking all of their formulations at once which is not only completely unnecessary as they mostly contain the same ingredients but also could lead to dangerous dosages of the herbs. Do not do this and do your own research!
    • If you take synthetic hormones (or other medications), you could take your fenugreek as part of their liver cleanse combo to support your liver.

All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

For more herbal estrogens, ideas, and resources see my previous posts: Feminizing Herbs and “The Basics.”

Endometriosis, Fertility and Pregnancy, Menopause and Beyond, PCOS, Prism Blog, Transgender Wellness

The Soy Controversy

“Women consuming the equivalent of two cups of soy milk per day provides the estrogenic equivalent of one birth control pill… men who consumed the equivalent of one cup of soy milk per day had a 50% lower sperm count than men who didn’t eat soy. –Chris Kresser’s Paleo Code

Soy is often touted as a natural source of estrogen, but is it safe to use either for this purpose or as a food?

“About two ounces of soy products per day may be sufficient to ward off hot flashes and other symptoms” of menopause (Wright & Morgenthaler, Natural Hormone Replacement for Women over 45). However, as an estrogen source, it may not be the safest food option.

Soy is present in nearly every packaged and processed food in the U.S, in fact, the average American gets up to 9% of our calories from soybean oil alone. Compare this to about 2 teaspoons per day in China and 9 teaspoons per day in Japan, most of which is fermented soy, which neutralizes the toxins (like trypsin inhibitors that inhibit protein digestion and affect pancreatic function, and phytic acid, which reduces absorption of minerals like calcium, magnesium, copper, iron and zinc) that are present in most of the soy we consume in the U.S. (Chris Kresser’s Paleo Code)

Unfermented soy also increases our requirement for vitamin D and B12 (the opposite of fermented soy which provides these vitamins!), and disrupts endocrine function (potentially causing breast cancer and thyroid problems). Processed unfermented soy often actually contains carcinogens as well. (Chris Kresser’s Paleo Code)

It is not fully known how soy consumption may impact synthetic hormones, and it’s nearly impossible to avoid all soy since it’s in most of the food we consume, but it would be wise for most people to avoid eating the major processed soy foods like tofu, soy milk, and soy protein isolate. Fermented soy still contains estrogens, but is not as disruptive (or potentially carcinogenic) to our natural hormones, and is probably a safe food for most people.

I would generally recommend that people transitioning towards the masculine side of the spectrum avoid soy foods, and for those looking for natural sources of estrogen, there are many safer feminizing herbs and foods out there. For example, “flax contains substances called lignans, which have been shown to have estrogen-like qualities” (Wright & Morgenthaler). A few foods have small amounts of identical-to-human hormones [about 1-2% potency of human hormones] (Wright & Morgenthaler), including:
Rice, apples, date palm, pomegranate (estrone)
French bean seedlings (estradiol)
rice, licorice (estriol)


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

Prism Blog, Transgender Wellness

Herbs for Transitioning: Masculinizing Herbs

This is a follow-up post to “The Basics.” Also see the feminizing herbs post here.

Hormones and surgery can be expensive or not accessible. Herbs can also be used if you don’t want to use hormones or undergo surgery, but still want to create physical changes in your body, or after being on synthetic hormones for many years to maintain the changes that you have made without the side effects of continued synthetic hormone use. Note: Most are unlikely to have a significant effect without any other transition methods.

Vitex: The Regulating Herb

Vitex is a hormone normalizer that works with the pituitary gland to keep progesterone stable and prevent  it from converting to estrogen or testosterone. This helps to hold secondary sex characteristics that have developed with synthetic hormones. Technically, it increases LH and reduces FSH, which increases progesterone and reduces estrogen and testosterone. This helps it regulate emotions, prevent acne, hormonal edema and bloating, and it can help you transition onto and off of synthetic hormones, as well as stabilize fluctuations in hormones while taking hormones.

These herbs can be used instead of synthetic hormones:

(Ex. to create small changes if hormones are not desired, or after years of taking hormones to maintain changes.)

  • Example combination: pine pollen, ashwaganda, Lu Rong
  • ashwaganda- steroidal precursor to T… and an adaptogen that helps build your immune system!
  • Yohimbe– promotes and supports testosterone levels
  • ginseng/Ren Shen- “yang tonic” in TCM, yang is both the masculine energy in TCM (ex. Ren Shen is sometimes used for impotence), and the energy needed to create change (ex. transition). DO NOT take while on testosterone.
  • sassafrass
  • pine nuts & pine pollen- closest approximation to human androgens
  • wild oats
  • Lu Rong/young deer antler- contains deer testosterone
  • blue cohosh- to stop periods, often taken with black cohosh. ONLY take this herb under supervision of a professional herbalist, it can be dangerous or cause opposite of desired effects if used incorrectly.
  • Blends:
  • Foods:

These herbs can help support synthetic hormones:

(DO NOT combine these with your medications without discussing with a healthcare provider.)

  • buplerum/Chai Hu- for emotional stability
  • stinging nettle– decreases “bound” testosterone and increases “free” or usable testosterone. also provides lymphatic and immune support.
  • white button mushroom- prevents testosterone conversion to estrogen
  • prickly ash- smoothes and eases voice transformation

For side effects of synthetic herbs:

(DO NOT combine these with your medications without discussing with a healthcare provider.)

  • He Shou Wu- for hair growth, prevents male-pattern baldness
  • saw palmetto- prevents male-pattern baldness, especially when combined with 10-30mg zinc daily
  • B5- to prevent acne
  • marshmallow- for constipation
  • motherwort/Yi Mu Cao
  • kavakava, california poppy, skullcap/Huang Qin, lemon balm, aralia or damiana- for emotional imbalances
  • bitters- for digestive symptoms
  • echinacea
  • yarrow
  • turmeric/Jiang Huang
  • nettle
  • dandelion/Pu Gong Ying, milk thistle/Shui Fei Ji-for liver damage
  • garlic/Da Suan- for high cholesterol & blood pressure
  • red root, cleavers, and ocotillo- for lymphatic drainage – to prevent reproductive cancers
  • hawthorne berry/Shan Zha can help prevent cardiovascular problems (which can occur with long-term T use), but can react with pharmaceutical heart medicines and shouldn’t be combined with them.

DON’T combine synthetic hormones with St. John’s wort/Guan Ye Lian Qiao, it stresses the liver. It also encourages bleeding, so avoid before SURGERY too!

References include:
http://www.sfherbalist.com/holistic-health-for-transgender-gender-variant-folks/
http://midnightapothecary.blogspot.com/


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

Prism Blog, Transgender Wellness

Androgel: Info for Trans Men

Androgel can be used to initiate or maintain the development of male secondary sex characteristics, as well as virilization (clitoral enlargement) and cessation of menstrual periods.

Though testosterone levels return to baseline 48-72 hours after last dose, most changes (such as cessation of the menstrual period and muscle/fat redistribution) reverse if Androgel treatment is stopped; however, voice changes, facial and body hair, genital growth, and male-pattern baldness persist.

Showering 2-6 hours post-dose decreases testosterone by 13%; using lotion on the application site 1 hour after increases testosterone 14%.

Excess testosterone is converted to DHT (which causes male pattern baldness) and estradiol (a form of estrogen), and can therefore cause adverse effects. This makes finding the appropriate dose and getting hormones checked regularly very important.

It is important to apply gel only to the area of your shoulders that can be covered by a t-shirt, since skin-to-skin contact within 2 hours of application can significantly increase testosterone levels in others (research shows a 280% increase in cis women with skin-to-skin contact vs. only 6% if covered with a t-shirt). Also, remember to wash your hands right away afterwards to prevent transmission as well!

You may experience an increase in urinary disorders or other side effects. It is important to continue to perform regular self chest exams to check for lumps if you still have breast tissue (including tissue near the armpits which often is not removed during top surgery). You should also get your blood pressure, red blood cell counts (to monitor for blood clots), cholesterol and T4 levels checked regularly to monitor for these side effects.


Full Review of Research Follows:

Continue reading

Prism Blog, Transgender Wellness

Estrogen and Blood Clot Risk in Trans Women

Estrogen produced by the body lowers blood concentrations of several clotting factors and speeds the rate at which clots dissolve. Estrogen also suppresses production of a factor which is involved in enlarging the size of a clot, and is also beneficial to cholesterol levels. (This may be why cisgender men are about 18% more likely to develop DVT than cisgender women.)

Administered estrogen, however, actually increases plasma fibrinogen, the activity of coagulation factors, and platelet activity. This explains why estrogen medications increase blood clots (in both transgender women and cisgender women taking birth control or hormone replacement therapy). Oral estrogen also significantly increases “bad” cholesterol in trans women, while decreasing the level of “good” cholesterol, which can lead to clogged arteries, increasing chances of clots.

Highest risk: Combining antiandrogens (like spironolactone) with oral ethinyl estradiol (birth control pills) carries a much higher risk of thrombosis than any other regimen. Trans women taking birth control pills are 20 times more likely to suffer from DVT than the general population. Premarin also carries a higher risk of DVT than injectable estrogen, though not as high as birth control. This is most often the case for hormones that are procured without a prescription. Prescribed HRT for trans women in the U.S. usually includes spironolactone and 17-beta estradiol (aka micronized estradiol), rather than ethinyl estradiol. This regimen is much less likely to produce clots.

Other risk factors: lack of exercise, long periods of immobility (such as long airline flights), genetic clotting risk, injuries (broken bones especially), liver stress (support liver while taking hormones!), high blood pressure, type 1 diabetes. Aspirin therapy is often recommended if over age 40 because of increased plasma concentrations of coagulation factors. Smoking increases factor XIII, thrombin, and fibrinogen, which increase clotting risk. Smokeless nicotine does not carry the same risk, and abstention from smoking for a period of only 2 weeks significantly decreases the rate of fibrinogen synthesis. Risk is highest within the first year of estrogen use, potentially because oral estrogen is more common than injectable estrogen during this time.

Recommendations:

  • Using injectable rather than oral estrogen of any kind (if using oral estrogen make sure it’s 17-B estradiol)
  • Taking baby aspirin for the first year of HRT if over age 40
  • Supporting your liver metabolism
  • Exercise regularly
  • Quit smoking (or switch to smokeless tobacco for at least the first year of HRT)
  • Test for genetic clotting risk
  • Check blood pressure regularly and maintain safe levels

Symptoms of DVT: inexplicably warm area on your lower leg which persists for more than an hour, localized swelling, redness, pain, shortness of breath, chest pain, symptoms of stroke. CALL 911!


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.


Resources:
http://www.atsjournals.org/doi/full/10.1513/pats.200407-038MS#.VIKVP8mJkTA
http://www.ncbi.nlm.nih.gov/pubmed/2960241
http://transascity.org/deep-vein-thrombosis-and-hormone-use/
http://www.pharmacologyweekly.com/custom/archived-content/pharmacotherapy/51
http://www.sciencedaily.com/releases/2013/09/130930162226.htm
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096855/
A Personal Story: bloodisthickerthanwaterr.wordpress.com/2015/01/13/my-blood-clot-story-2/

Acupuncture, For Providers, Prism Blog, Transgender Wellness

Yin and Yang; Masculine and Feminine

 

“Instead of saying that all gender is this or all gender is that, let’s recognize that the word gender has scores of meanings built into it. It’s an amalgamation of bodies, identities, and life experiences, subconscious urges, sensations, and behaviours, some of which develop organically, and others which are shaped by language and culture. Instead of saying that gender is any one single thing, let’s start describing it as a holistic experience.” –Kate Bornstein & S. Bear Bergman (Gender Outlaws)

Most diagnoses in Chinese medicine, represent the interaction between hot and cold, day and night, yin and yang, masculine and feminine. However, Chinese medicine’s outlook on these dualities is actually much more inclusive of LGBTQ identities when you look beyond this basic binary.

Yin and yang, though often associated with male and female, are more accurately represented by masculine and feminine. Masculinity and femininity are indeed seen as opposites, but they are also in a constant state of transformation from one into the other, and at each stage yang contains yin and yin contains yang.

Basic Principles of Yin & Yang/Masculinity and Femininity:

1. Masculinity and Femininity are opposites

2. Masculinity and Femininity are interdependent: There is always masculinity within Femininity and femininity within Masculinity

3. Masculinity and Femininity are mutually consuming and in a constant state of transformation of one into the other

In this way, masculinity and femininity cannot exist without both opposing each other and containing a piece of the other. Most people in discussing yin and yang theory today, and even most Chinese Medicine practitioners, only focus on the first principle, which alone can be used to reinforce our culture’s thinking of gender as binary. However, traditionally this medicine was much more inclusive of gender variations and spectrums!

Further Sources:
genderevolve.blogspot.com
acupuncturetoday.com


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

 

Prism Blog, Transgender Wellness

Herbs for Transitioning: The Basics

Herbs can be used for many aspects of transitioning: transitioning with herbs alone, switching from synthetic hormones to herbs to maintain secondary sex characteristics, and supporting the body with herbs and nutrition to counteract side effects of synthetic hormones.

The Basics:

It’s first important to take care of your body with proper nutrition so that you can handle the changes  and stress that will accompany transitioning. All hormones are made of fat, so it’s important to eat good fats (raw oils & omega 3s especially) to help your body form and transform those hormones, and also to coat your nerve cells (their myelin sheaths are also made of fat) to help you cope with stress and stay emotionally healthy. Fats form the boundaries of our cells–they keep out and let in what we want to–we need good fats in our bodies to have good boundaries physically and emotionally!

We ALL have the same hormones, just in different amounts and we USE different amounts of them too. Furthermore, we can change how our bodies use the hormones we already have. Every body makes progesterone from cholesterol, and that progesterone can turn into estrogen OR testosterone. The estrogen and testosterone in our bodies can also convert back and forth (estrogen to testosterone and vice versa). This is the reason you want to get your hormone dosages right: if you take too much, your body is just going to convert it into another hormone to maintain balance in your system. This could actually counter the desired effects of the hormone you are taking: too much estrogen in your system and your body will start converting it to testosterone, counteracting the changes you want to make.

Coming up with a plan for your body:

There are many different options for transitioning, even when just using synthetic hormones. Progesterone itself helps to build tissue and can often be useful for developing breasts (taken externally) or muscle tissue (taken internally). Aromatase is what turns testosterone into estrogen, so you can take extra aromatase instead of (or in addition to) taking estrogen. Likewise, you can take aromatase inhibitor to prevent that testosterone from turning into estrogen, instead of taking testosterone. There are many options for prescription hormones; it’s important to talk to your doctor about what will work best for your body.
For most people, herbs aren’t going to change your hormones drastically alone, so you might choose to start out taking synthetic hormones and, once you’ve achieved the effect you want, use herbs to lower your dose of synthetic hormones or switch to herbs entirely. Herbs can maintain the hormone levels and characteristics you’ve built up with synthetic hormones. This is a good alternative to the sometimes health damaging side effects of long-term synthetic hormone use.


Contact us to see if your insurance covers services at our office!


References include:
http://www.sfherbalist.com/holistic-health-for-transgender-gender-variant-folks/


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.