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.”

Prism Blog, Transgender Wellness

The Feminizing Diet

This is a follow-up post to my post, “Nutritional Guidelines for Transgender Patients.” See the original post here. This article is an excerpt from my research paper, “Nutritional Guidelines for Transgender Patients,” which was written for practitioners of TCM to create holistic diets tailored to clients’ constitutions. It is not intended to function as medical advice. There are a few jewels tucked into this article for practitioners, if you don’t have an understanding of TCM theory you can skip over the italicized parts.


To start, proper general nutrition is important, including plenty of healthy fats, avoiding animal products raised with hormones and processed or refined foods, and adding more fresh fruits, vegetables, and high quality protein.

As long as there are not contraindications or food allergies, an estrogen and progesterone supportive diet (i.e. does not actually produce/mimic estrogen and progesterone but can help to support those hormones in your body) should be focused on ancient grains and cooked dark vegetables, and include cooked berries, eggs, dark legumes, micro-algaes, nuts and seeds, garlic, shiitake, and reishi.

This diet along with herbs and acupuncture can cause a slight elevation in estrogen levels and breast enlargement in some people. However, please understand that these diets alone will not have a significant effect. Since each individual has different goals, this diet can be adapted based on changes that each person wishes to make and any underlying conditions.

Estrogen & Progesterone Supportive Diet Suggestions

  1. Increase starchy vegetables, millet, barley, seaweed, micro-algaes, dark legumes, beets, kudzu, persimmon, cooked berries, bananas, watermelon, mollusks (limit mollusks when taking progesterone), pickled and fermented foods, eggs, and coconut milk.
  2. Grass-fed hormone-free organic milk and fermented/cultured dairy products are also a great addition.
  3. Limit meat to small amounts of duck, beef, pork, goose, rabbit, and organ meats.
  4. If not taking hormones, add raw dark fruits (blackberries, purple plums, blueberries, etc.), raw dark greens, raw bell peppers, and small amounts of real black licorice (avoid with high blood pressure, when taking spironolactone, or with hot flash or night sweat symptoms).
  5. If taking estrogen, add garlic, lemons and limes (avoid if taking progesterone), shiitake, and reishi. AVOID eating grapefruit or taking GSE with estrogen.
  6. If taking spironolactone, AVOID buchu, cleavers, dandelion, gravel root, horsetail, juniper, uva ursi, molasses, and radishes.

Yin:

Many, though by no means all, trans women taking estrogen and spironolactone have some degree of yin deficiency, and this diet can help to counteract this issue while still supporting transition goals. This is a generally mild and healthy diet safe for most people, however care should be taken in following this diet exclusively long term if yin deficiency is not present. Always talk to your healthcare provider when making dietary changes.

A yin nourishing diet should be based on millet, barley, teff, quinoa, amaranth, and other ancient grains (Pitchford, p. 65). Other appropriate yin foods that could be added to the diet include seaweed, micro-algaes, black beans, kidney beans, mung beans, sprouts, beets, string beans, kudzu (not with damp signs), persimmon, grapes, cooked berries, bananas, watermelon, dairy, eggs, clams, abalone, oysters (avoid mollusks when taking progesterone and with damp signs), and sardines (Pitchford, p. 65). Reduce meat -which is a more yang tonifying food- except for small amounts of yin and blood nourishing duck, beef, pork, goose, rabbit, and kidney (Pitchford, p. 65). Sour foods are beneficial because they tonify yin and move the blood (Caruso-Radin), which could be helpful to prevent blood clots, a common side effect of estrogen use,. Spices should mainly include milder white pepper, cilantro, and marjoram, which are yin spices (Pitchford, p. 62), rather than stronger yang spices like cayenne. When these foods are made into soups, stews, and congees they become even more yin tonifying.

Supporting Estrogen:

In designing a feminizing diet, it is necessary to think about not only the energetic and hormonal properties of foods, but also their safety for long term use. For example, eating mainly carbohydrates, starches, coffee, and soy can raise estrogen levels and lower testosterone levels (Duvall), but this can also potentially cause diabetes, hormone dependent cancers, heart palpitations, and other serious health consequences.

I would generally recommend that for those looking for natural sources of estrogen, there are many safer options than soy. 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); and French bean seedlings (estradiol). Note that eating these foods alone will generally not be enough to noticeably increase estrogen levels.

For trans women not taking hormones, licorice could be added to the diet to increase estrogen, however it should not be taken with diuretics (such as spironolactone), by an individual with high blood pressure (Griffith, p. 345), or with symptoms of hot flashes and night sweats. The ipriflavone in soy, alfalfa, and propolis is additive when taken with estrogen (Gale Group), and should not be combined with estrogens (Gaby, p. 110), but may be useful for those not taking hormones, though only fermented soy such as tempeh should be consumed (to avoid the other detrimental effects of soy).

Supporting Progesterone:

Pregnenolone derived from diosgenin in wild yams is extracted in the body when combined with cholesterol heavy foods such as eggs, and is converted to either DHEA or progesterone (Bennett), which can balance high estrogen levels. This is known to cause breast enlargement in male assigned people (Griffith, p. 174-175), but because DHEA and progesterone can convert to either estrogen or testosterone in the body, they should not be used with synthetic hormones or without medical supervision.

Synthetic Estrogen and Food Interactions:

Trans women taking hormones should be aware that they can interact with nutrients in certain foods. Estrogen for example, has adverse interactions with the quercetin in grapefruit, which is also to a lesser extent in capers; onions; raw dark fruits like cranberries, black plums, blueberries, currants, and cherries; and raw kale, lettuce, asparagus, spinach, broccoli, and peppers (Kerns, 2014). These foods should be limited when taking estrogen and not eaten at the time of medication.

In addition to having adverse reactions with quercetin, synthetic estrogens deplete B6, which can be replaced by eating organ meats, brewer’s yeast, garlic, and whole potatoes (USDA). B6 smooths liver qi stagnation, clears heat, harmonizes wood and earth, and clears heat from the stomach and damp-heat from the gall bladder (Caruso-Radin), which can help ease negative effects of estrogen on the digestive system and emotional health.

Countering Estrogen Side Effects:

Estrogen can cause several side effects, such as circulation problems, blood clotting, and sometimes increased blood levels of cholesterol, all of which may be prevented with nutrition. Circulatory problems can be combated with the chlorophyll in dark leafy greens and micro-algaes (Balch, p.129). This can be further aided by the CoQ10 and B5 (converted to coenzyme-a, which works along with CoQ10) in organ meats, eggs, brewer’s yeast, avocado, and seeds, which together improve tissue oxygenation (Coffman). According to TCM, CoQ10 and coenzyme-a relieve liver qi stagnation, clear heat, and tonify the spleen (Caruso-Radin), perhaps allowing the spleen to create qi and the liver to move qi to prevent stagnation that could lead to blood clots and other circulatory problems.

Shiitake and reishi prevent hypertension, heart disease, and cholesterol problems (Midnight). The Vitamin C and other antioxidants in a diet full of fermented foods and a variety of fruits and vegetables prevents blood clotting (Midnight), and also clears heat, resolves toxins, and calms the shen (Caruso-Radin), potentially minimizing the toxicity of synthetic hormones and easing emotional imbalances caused by introducing new hormones to the system. Nuts and seeds, especially coconut milk, walnuts and sunflower seeds which contain both essential fatty acids and vitamin E (USDA), should also be consumed to help the body to manufacture hormones like estrogen (Balch, p. 454), and to replenish vitamin E that is depleted by synthetic estrogen (Pitchford, p. 397).

Anyone taking estrogen should include lemons or limes (avoid with progesterone), spinach, and other leafy greens to detox the liver (Duvall). Brussels sprouts and broccoli in particular also contain phyto-estrogens (Duvall), so are an especially good choice. Monitor your hormone levels with a doctor when doing a liver detox to ensure that you are maintaining the appropriate amounts for your body.

Countering Spironolactone Side Effects:

Spironolactone is the most commonly used androgen blocker in the United States. It was originally developed as a potassium sparing diuretic and therefore should not be combined with diuretic herbs like buchu, cleavers, dandelion, gravel root, horsetail, or juniper; or with foods with a lot of magnesium and potassium (Gaby, p. 243), like molasses, kelp, chocolate, bananas, or radishes (USDA), since those minerals are not excreted as easily with spironolactone use.

(Providers: Magnesium astringes yin, suppresses yang, and calms shen (Caruso-Radin), so the fact that spironolactone causes the body to retain magnesium may explain why spironolactone has a yin tonifying anti-androgenic effect. Potassium tonifies the spleen, drains damp, and clears heat (Caruso-Radin), accounting for the diuretic effects of spironolactone.)

Anyone taking spironolactone should supplement with organ meats, spinach, or asparagus which provides the folate that can be depleted from spironolactone use (Gaby, p. 243). Folate nourishes the blood, harmonizes the liver, and calms the shen (Caruso-Radin), which could potentially ease some of the emotional side effects of hormones.

Salt is also depleted and should be supplemented via cheese and pickled or fermented vegetables (UCSF). Salt tonifies the liver and kidney and astringes jing (Caruso-Radin), which can all be damaged by longer-term synthetic hormone use. A low-salt diet combined with spironolactone can cause low blood pressure. Blood pressure should be monitored frequently while taking spironolactone to ensure it is not too low, especially if you tend to experience low blood pressure.

Countering Progesterone Side Effects:

Progesterone, when taken internally, increases vitamin A. From a TCM standpoint, vitamin A tonifies the blood and jing and clears deficiency heat and stagnation, accounting for progesterone’s ability to nourish yin to counterbalance estrogen.

Progesterone also increases folate, zinc, and magnesium (Gaby), so these items should not be supplemented, however, this most likely does not apply to foods containing those nutrients. This does mean that the folate depleted by spironolactone would be balanced by progesterone and magnesium would be even more increased so should definitely not be supplemented when taking both of these medications.

Summary:

Overall, a diet for trans women could focus on ancient grains, especially millet and barley, and cooked Brussels sprouts, broccoli, and other dark greens. It should also include micro-algaes, dark legumes, cooked berries, eggs, coconut milk, grass-fed organic hormone-free dairy, walnuts, sunflower seeds, garlic, shiitake, and reishi.


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.


ix Taken as a supplement, cream, or suppository. Not usually used in food due to toxicity, though it may be found in Eden Food’s “Wild Yam Soba.”

Prism Blog, Transgender Wellness

Nutrition for Transitioning

This article is an excerpt from my research paper, “Nutritional Guidelines for Transgender Patients.” It is not intended to function as medical advice. Before beginning or changing your diet, always consult a healthcare provider.

Nutrition is an important part of Chinese Medicine that should not be overlooked especially when working with clients taking hormones and other medications, as those medications can have significant effects on a client’s digestive system and nutrient absorption.

For any client, it is most important to start with a basic healthy diet. Clients should try to avoid animal products raised with hormones, salty and fried foods, sugar, white flour, chocolate, processed or refined foods, soy, alcohol, and caffeine, and to add more fresh fruits and vegetables (Gladstar, p. 84-85). Clients should also try to avoid too much raw or cold food and drinking with meals; and focus on chewing thoroughly, eating slowly, and eating a variety of foods (Caruso-Radin). Eating plenty of healthy fats helps to support mental health since fats form the myelin sheaths that coat nerve and brain cells, allowing them to function more effectively (Midnight). Fats also support the body in making hormones, many of which are derived from cholesterol (Midnight). Starting with these guidelines, specific nutrients may be used to support synthetic hormones and create a new healthy balance based on the client’s goals. Nutrition is extremely important for anyone’s health, but is especially valuable in a transitioning process which can cause both bodily and mental stress. Creating a diet that fits a client’s goals can ensure more compliance as well as enhance the work being done with other modalities.

Read more here on masculinizing and feminizing specific diets!

References:

American Pregnancy Association. Folic Acid. June 2014. Retrieved from americanpregnancy.org/pregnancy-health/folic-acid/

Balch, Phyllis and Balch, James. Prescription for Nutritional Healing, 3rd edition. Avery, Penguin Putnam Inc, New York. 2000.

Bennett, Alan. How to Convert Cholesterol to Pregnenolone. Livestrong: Health. January 28, 2015. Retrieved from livestrong.com/article/72359-convert-cholesterol-pregnenolone

Caruso-Radin, David. Nutrition East and West. Course at AIMC Berkeley, Winter 2015.

Coffman, Melodie Anne. Which Foods are Rich in CoQ10? Livestrong. January 10, 2014. Retrieved from livestrong.com/article/256149-what-foods-are-rich-in-coq10/

Cole, B. and Luna Han, editors. Freeing Ourselves: A Guide to Health and Self Love for Brown Bois. 2011.

Earthangel, Reverend Doctor. The Importance of a Healthy Diet. The House of Sissify: The Herbal Encyclopedia. 2005. Retrieved from sissify.com/feminization-hormones/healthy-diet

Erickson-Schroth, Laura. Trans Bodies, Trans Selves: A Resource for the Transgender Community. Oxford University Press, New York, NY. 2014.

Gaby, Alan R. and The Healthnotes Medical Team, editors. A-Z Guide to Drug-Herb-Vitamin Interactions, 2nd edition. Three Rivers Press of Random House, NY. 2006.

The Gale Group. Ipriflavone. AltMD: Gale Cengage Learning. 2008. Retrieved from altmd.com/Articles/Ipriflavone–Encyclopedia-of-Alternative-Medicine

Gladstar, Rosemary. Herbal Healing for Women. Fireside of Simon & Schuster Inc, NY. 1993.

Griffith, H. Winter. Vitamins, Herbs, Minerals and Supplements: The Complete Guide, revised edition. New York, NY. 1988.

Kerns, Michelle. Foods with the Highest Content of Quercetin. Livestrong: Food and Drink. June 23, 2014. Retrieved from livestrong.com/article/301326-foods-with-the-highest-content- of-quercetin/

Kerns, Michelle. Foods Containing L-Carnitine. Livestrong: Food and Drink. August 25, 2015. Retrieved from livestrong.com/article/22647-foods-containing-l-carnitine

Marz, Russel B. Medical Nutrition from Marz, 2nd ed. mni-Press, U.S. 1999.

Midnight, Dori. Holistic Health for Transgender & Gender Variant Folks. Ohlone Herbal Center, Research Papers. December 28th, 2009. Retrieved from ohlonecenter.org/research- papers/holistic-health-for-transgender-gender-variant-folks/

Petersen, Julia, Johanna Dwyer, Herman Adlercreutz, Augustin Scalbert, Paul Jacques, and Marjorie McCullough. Dietary Lignans: Physiology and Potential for Cardiovascular Disease Risk Reduction. Nutrition Review, 68 (10), p. 571-603. October, 2010. Retrieved from ncbi.nlm.nih.gov/pmc/articles/PMC2951311

Pitchford, Paul. Healing with Whole Foods: Asian Traditions in Modern Nutrition 3rd edition. North Atlantic Books, Berkeley, CA. 2002.

The Prodragonist. More Queer Herbs (Masculine). July 24, 2013. Retrieved from belladonnaquixote.wordpress.com/2013/07/24/more-queer-herbs-masculine/comment- page-1

Renee, Janet. List of Foods that Contain Glutamine. Livestrong: Food and Drink. January 9, 2014. Retrieved from livestrong.com/article/249890-list-of-foods-that-contain-glutamine

Transgender Nutrition Considerations. February 27, 2013. Retrieved from transidentified.com/2013/02/27/transgender-nutrition-considerations

UCSF Medical Center. Guidelines for a Low Sodium Diet. University of California San Francisco. Retrieved from ucsfhealth.org/education/guidelines_for_a_low_sodium_diet

United States Department of Agriculture (USDA). National Nutrient Database for Standard Reference Release 27. Agicultural Research Service. Retrieved from ndb.nal.usda.gov/ndb/nutrients

ivCan include a variety of identities that do not fit into the categories of “man” and “woman.” Some terms are gender neutral, genderqueer, non-binary gender, gender non-conforming, and gender fluid, among others. Sometimes people with these identities also consider themselves trans and may or may not undergo medical transition.


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.

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!

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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.