Check out my interview with Dr. Briana Lutz where we talk about everything from fertility to hormones.
Since my stillbirth and my miscarriage, I’ve become incredibly passionate and invested in the female body and everything that comes along with it. Think menstrual cycle and its four phases, hormones, fertility and more. And I know I’m not alone. I know a lot of you have gone through a similar path and are therefore curious about the same things as I am. That’s why I’ve decided to bring in a naturopathic doctor and ask her as many questions in regards to women’s reproductive health. Yes, Google has a lot of information at the tip of our fingers, but getting answers straight from a medical professional is priceless.
Everyone, please meet Dr. Briana Lutz.
Q: Can you tell me a little bit about yourself? How long have you been a naturopathic doctor, what led you to become one and what are your specialties?
Ever since a young age I wanted to be a doctor, but it wasn’t until my second year of university that I found naturopathic medicine. I didn’t realize until then that the physician I always imagined myself being was a naturopathic doctor. Once I knew this profession existed, everything clicked. I graduated from Boucher Institute of Naturopathic medicine in 2017, and began practicing shortly after. I have always had an interest in women’s health, especially seeing how women’s conditions are often palliated, dismissed, or ignored entirely. I want better for my patients. This passion continues, and fertility is now a large component of this special interest.
Q: It’s no secret that infertility is on the rise in the Western world. Why do you think that is?
There are many factors I believe that are contributing to the rise in infertility. I tend to frame it that infertility is a symptom, not a diagnosis. Issues with fertility are the expression of a deeper underlying cause. Firstly, our environment plays a large part in hormonal expression. Hormone disrupting chemicals (and their increase in prevalence) can wreak havoc with our hormone signalling needed to coordinate egg development, ovulation, fertilization, and uterine environment for implantation and maintenance of a pregnancy. This may also include the birth control pill that many women are on since their teens, for either contraceptive purposes or symptom management. While it can be a useful tool, the birth control pill doesn’t fix the underlying hormonal condition or imbalance that she went on the pill for in the first place, and will likely still be present when she comes off to get pregnant.
Additionally, what we call oxidative stress, can interfere with the quality of our eggs. This is problematic as this can decrease implantation or be a risk factor for miscarriage. Oxidative stress can come from lack of nutrient density, poor blood sugar regulation, lack of quality sleep, more environment exposures… again, infertility is the symptom of something else. The same oxidative stressors can also decrease the quality and quantity of sperm, something that has drastically dropped from even our parents’ generation.
I also see a lack of knowledge around the menstrual cycle in general. In our health classes, we’re taught how to avoid pregnancy and STIs, but not a lot of our education is geared towards understanding our cycle and our fertile window.
Q: Is there anything that can be done to decrease the possibility of infertility?
Optimizing your menstrual cycle is an important place to start. Menstrual symptoms, although common, aren’t “normal”. These symptoms are suggestive of an underlying hormonal imbalance that can make getting pregnant more difficult when you’re ready to start trying. This also involves learning more about how the menstrual cycle works, and when/if you’re ovulating. Ovulation is a vital component for the health of a woman, regardless if she’s trying to conceive or not. While apps are useful tracking tools where you can input data about your cycles, most apps can only mathematically predict a possible fertile window. Just because your app says, it doesn’t necessarily guarantee when or if you’ve ovulated.
Q: Many women suffer from irregular periods. What are some potential causes besides PCOS? And what can they do to regulate their periods?
PCOS is one of the most common causes of irregular periods, but not all with PCOS have irregular cycles from the same cause. Understanding which PCOS “type” will change the treatment intervention. For some women with PCOS, it’s about blood sugar and insulin regulation, for others it’s about supporting estrogen levels to be able to trigger regular ovulation. Others with PCOS, and even without PCOS, have HPA-axis dysfunction, or cortisol/stress issues that can cause both PCOS symptoms, or irregular cycles.Another cause of irregular cycles can be related to thyroid dysfunction. Hormones are chatty, so if one hormonal system is affected (thyroid) it can affect other hormonal systems (ovaries).
So to regulate your period, it’s about figuring out the cause of the cycle irregularity. Track your cycle so your healthcare provider has good insight as to where you may be deviating from the norm. Blood work may also be a useful tool to verify, or investigate the cause of the irregularity.
Q: Women are constantly told that their biological clock is ticking and that they should get pregnant young. But how much does age really factor in?
The reason women are told this is for a couple of reasons, the first being that the quantity of your eggs decreases over time. But when it comes to fertility, it’s quality over quantity. The second reason women are told this is theoretically, quality will decrease over time. This is largely based on the accumulation of negative impacts on egg quality– so the longer a woman experiences oxidative stress such as smoking for example, the poorer the quality of the egg as she increases in age. But, there is a huge difference in chronological age versus physiological age. If there is a conscious effort to avoid these possible causes of oxidative stress and hormone disrupting chemicals for instance, then that has a better impact on fertility.Additionally, this is changeable. Our eggs, until triggered to develop, will remain in a quiescent, or frozen in time, stage. It will then take three months for the egg to fully develop until it is ready to ovulate. During this window, we can improve egg quality. That’s why it’s ideal for a “preconception phase” we have at least 3-6 months to correct hormonal imbalance, and improve egg quality for conception.
Q: How does a woman balance her hormones (preferably naturally) after losses (e.g. miscarriage, stillbirth, TFMR).
After a pregnancy loss, to help bring hormones back into balance we’ll need to support our systems that help to eliminate these elevated hormones. Eliminating hormones is largely done through the bowels (digestive system) and the liver. Having regular, healthy bowel movements with both insoluble and soluble fiber, hydration and daily movement, as well as supporting liver function with leafy greens, cruciferous vegetables, and citrus could be of benefit. Estrogen balancing foods, such as flax seed may be an option as well, however I recommend women seek advice about individual recommendations nutritionally, not only from the food you eat, but possible nutrient supplements, or botanical medicine and acupuncture that can help. Many women feel alone or isolated with pregnancy loss, especially early pregnancy loss because they may not have shared that they are pregnant. I encourage women to seek emotional support for this loss, not only for mental health, but this may also have an impact on returning hormones to balance. You are never alone.
Q: What is one thing (or a few things) women in general should be doing on a regular basis?
In discussing oxidative stress, I recommend consuming antioxidant, nutrient dense foods on the daily. A nutritional “hack” is to look for color, and a variety of it. Dark leafy greens, carrots, purple cabbage, blueberries, bell peppers, colorful spices like turmeric or paprika… be playful and creative and enjoy food as much as nourishing your body. Daily movement, especially activity you love, promotes blood circulation that is essential for delivering nutrients to your reproductive organs. Focus on your sleep and stress. Create time for rest, play, and connection. Don’t “should” all over yourself. Struggles with fertility can feel like you’re at war with your body, when it can be the opportunity to become more aligned with it.
If there’s anything else you’d love to ask Dr. Briana Lutz, please leave it in the comments section below.