Women's health and wellness from a Board Certified Obstetrician and Gynecologist, topics from wellness, sex, to infertility, your periods and hormones, menstrual periods, uterine fibroids, bladder problems, endometriosis, healthy weight management
Do You Have Hormonal Signals to Lose Weight; Or Hormonal Signals To Gail Weight
We are designed to have internal signals that tell us we are hungry, and should eat, or we are full, and don't need to. Theoretically that system is in perfect balance and we have what is termed energy homeostasis, and we neither lose weight or gain weight. The regulation of this system is in our brain, and it takes in data from both the adipose tissue (our fat), as well as from our gut. Fat cells, called adipocytes produce many molecules that are released
into the blood stream and act as hormones. One of the most important hormones that is critical to the regulation of the energy we consume is made by the fat in our body called 'white fat' , and this hormone is leptin. Obesity, dieting, and lack
of exercise, aging, body fat percentages, and genetic tendencies alter the amount of the the leptin levels in our body.
Menopause is associated with weight changes, and now menopause has been found to alter leptin levels as well. Menopause is associated with lower estrogen, so it has been thought that perhaps the two hormones, leptin in fat and estrogen of menopause, are linked. Based mostly on animal data, women gain about 22% body fat from the withdrawal of estrogen at the time of menopause. There is also a subtle chronic raising of leptin that may be the ultimate case of the accumulation of body fat at this time of life. So far to scientists the regulation of leptin is mostly a mystery. In 1994 we discovered
that a ob gene mutation can make mice obese. The ob gene regulates the adipocyte production of
leptin. Leptin is one of those hormones that has to be in balance, too much or two little leads to obesity. Deficiency of
leptin can cause obesity. However sustained elevations of leptin do not produce ever thinner individuals. Confusingly sustained elevation in leptin can
cause obesity by producing diabetic and prediabetic metabolic changes, and make those individuals with chronic high leptin have
uncontrolled eating behavior (hyperphagia). The more fat we add the worse our leptin problem, and thus our weight. Obese individuals
conversely can have resistance to leptin itself that can aggravate
insulin resistance and compound obesity problems. Interestingly, both leptin and estrogen at the right level can reduce food intake, and help women become more lean. Much research is going into this area of medicine, and hopefully the answers to whether you have signals to lose or gain weight as these questions are answered.
Periods can be fairly easy, passing some tissue at a time, or off can come the whole lining in one piece called a decidual cast. Generally the lining of the uterus is only 6-8 mm thick at the time of the menstrual period, and it is shed gradually, a few cells at a time. The decidual cast is when the entire lining passes spontaneously. It's not uncommon, but it usually both uncomfortable, and alarming to some. But us women are designed to have some sort of periods Or Not? We have to pass tissue each month. Or Not? Are they good for us? Or Not? Do we want them? Or Not? Is this something that is individual? Or Not? It's a complex topic that I will be discussing a lot over my time in this blog. So lets start with basics: How much do we bleed and what are we loosing, and just what was this that the patient passed? And another basic: track your periods, and the Women's Health Practice site http://www.womenshealthpractice.com/media/pdf/menstrual_chart.pdf you can find one. Wom…
For women on an IUD sex drive changes are often reported. We have already discussed relationships between the levels of testosterone and a woman's sexual function in a prior post. Women on OCs (oral contraceptives, birth control pills) have a known decreased levels of male hormones due to suppression of their hormones naturally made by their ovaries. We take advantage of that fact, and it is a bonus non-contraceptive effect of the pill, that when using OCs to suppress ovarian male hormones this treatment therefore helps to control acne, PMS, heavy bleeding, menstrual cramps as well as other hormonal symptoms such as breast pains. But a disadvantage of this is that some studies have reported that the suppression of testosterone by OCs also suppress sexual function and desire. We know that even aging changes our male hormone levels, by your mid 40s you probably have about a 30% decrease in your male hormones due to decreased ovulation and decreased adrenal gland function. Add cont…
If you have had an endometrial ablation and have developed symptoms of pelvic pain you might have post endometrial ablation syndrome. What is post-endometrial ablation syndrome? It is a constellation of symptoms due to entrapped blood or tissue within a uterus that has previously undergone an endometrial ablation. We are able to diagnose this at Women's Health Practice but occasionally other conditions are causing similar symptoms. Other complications of endometrial ablation include pregnancy, risks from pre-existing conditions such as a polyp or fibroid, an infection of the uterus, or a pregnancy. If you have had a tubal ligation then it is possible that the condition could be post-ablation tubal sterilization syndrome. The ablation procedure is designed to destroy all lining tissue, but in fact there is no way to confirm the completeness of the ablation. It is thought that either residual or regrowth of the tissue is producing the symptoms of post-endometrial ablation syndrome.…