Queen of Hearts NaPro Technology- Natural Treatments for Women

Queen of Hearts NaPro Technology- Natural Treatments for WomenQueen of Hearts NaPro Technology- Natural Treatments for WomenQueen of Hearts NaPro Technology- Natural Treatments for Women
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Queen of Hearts NaPro Technology- Natural Treatments for Women

Queen of Hearts NaPro Technology- Natural Treatments for WomenQueen of Hearts NaPro Technology- Natural Treatments for WomenQueen of Hearts NaPro Technology- Natural Treatments for Women
Home
Infertility
PCOS
endo
PMS
menopause
Patient Handouts
Progesterone & Pregnancy
FHA
Mental Health
Thyroid Problems
Vitamin D
Chronic Pelvic Pain
Abnormal Uterine Bleeding
Osteoporosis
Education
Semen Analysis
Laparoscopy
NaPro Symposiums
CrMS
FCP webpage
Nutritionists
My favorite Prayers
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NaPro TECHNOLOGY & Premenstrual Syndrome (PMS)

Premenstrual syndrome (PMS) is characterized by the presence of both physical and behavioral symptoms that occur monthly prior to your menstrual period. Symptoms that occur for only one to two days are considered somewhat “normal” and most likely reflect the normal fluctuations in hormones.  However, symptoms that last for three or more days are considered a “medical condition” for which NaPro providers can offer you an exceptionally efficacious treatment.   

What are symptoms of PMS?

Some of the most common symptoms recognized by women are:  

  •  Irritability 
  • Bloating 
  • Crying easily 
  • Fatigue 
  • Depression 
  • Anxiety
  • Anger
  • Food/sweat cravings 
  • Breast tenderness 
  • Weight gain 
  • Headache 
  • Insomnia 

What will the NaPro appointment be like?

Your appointments at MyCatholicDoctor with me will be one FULL HOUR in length. Generally speaking, NaPro appts will follow a typical protocol as outlined below. However, every individual is different and your situation may warrant a more expeditious process. Please know, the Creighton Model System (CrMS) is very important. Your CrMS chart will help direct me to what diagnostic tests and imaging tests should be done and what treatment plan would be most appropriate. 

First Appt: I will take a comprehensive medical history and provide you with education about normal healthy reproduction and oftentimes about a condition I suspect you may have after we have talked a while. 


I will order a pelvic ultrasound which I will ask you to schedule on day 5 of your next menstrual cycle. I will order a series of laboratory tests. Click the "laboratory tests" button below to learn more. 


You will be asked to begin charting your menstrual cycles using the Creighton Model System (CrMS). Please choose a Fertility Care Practitioner (FCP)  by clicking the "Fertility Care Practitioners webpage" button below to learn more about scheduling an Introductory Session to get started. 


Please consider joining me as I pray for you here.

Fertility Care Practitioners webpage

Second Appt:  You will be asked to return to the office in 2 mos for a follow-up appointment to review the results of your imaging and laboratory tests. Together we will also review your Creighton Model System (CrMS ) chart to look for specific biomarkers which will help me make a diagnosis. 


Please upload an image of your CrMS chart two days prior to all follow up visits and send to me via the portal. 


Please add the length of your post-peak phase and your mucus cycle score (MCS) to the R-hand margin of the chart. Your Fertility Care Practitioner (FCP) will calculate your MCS for you. 


During this appointment, you may be asked to begin some supplements and/or medications. We will also discuss drawing a full set of hormone panels. We will make a decision if you should have a peri-ovulatory estradiol panel, a post-Peak estradiol & progesterone panel, or both panels. 


 Hormone Panels: 

  • Peri ovulatory estradiol panel: start on CD8, go to the lab EOD for an estradiol draw, until you have one draw post-peak. 
  • post-Peak estradiol and progesterone panel: P+3, 5, 7, 9, and 11. See Handout #3 on the the Patient Handout webpage.
  • Hormone panels require 2 mos of CrMS charting AND the patient must be able to confidently identify her Peak day.


Many patients will be asked to consider working with a dietitian or a nutritionist to help optimize your reproductive health. Oftentimes I may also recommend a mental health appointment to help with anxiety, depression and/or disordered eating habits. 

recommended Dietitians and Nutritionists
Primary Care-Mental health Appointments

Third Appt:You will return to the office in 2 mos to review the results of your hormone panels as well as the biomarkers on your CrMS chart. Most often at this time I will have made one or more more diagnoses to identify the root cause of your symptoms. Together we will discuss a treatment plan, which will be implemented. 


Follow Up Appts: You will return to the office every 2 months. During this time, I will conduct a comprehensive medical interview to ensure your symptoms have resolved, and to ensure you are responding well and not having any negative responses to the management plan. Depending on the individual patient and your individual diagnosis, I may need to monitor your progress with serial laboratory tests and/or serial imaging. 


At any point in time, if a diagnosis has been made, treatment initiated, and/or you are satisfied with the medical management we have implemented, you can schedule annual or biannual visits, per your choice. 

BLEEDING KEY: How do I Measure Period Flow on my CrMS Chart?

I will be asking you to tell me very specifically how much you are bleeding. An example of a "detailed flow" is: M, M, H, L, L, VL/B


TAMPON or PADS: 

  • Very Heavy (VH): changing a full pad/tampon every 1-2 hours
  • Heavy (H): changing a full pad/tampon every 3-4 hours 
  • Moderate (M): changing a full pad/tampon every 5-7 hours
  • Light (L): changing a full pad/tampon every  8-12 hours
  • Very Light (VL): changing pad/tampon less than every 12 hours.


MENSTRUAL CUP MEASUREMENTS

  • Very Heavy (VH): 60 cc in a 24 hours
  • Heavy (H): 40 cc in 24 hours
  • Moderate (M): 20 cc in 24 hours
  • Light (L): 10 cc in 24 hours
  • Very Light (VL):  5 cc in 24 hours


**The Diva Cup comes in 20, 30 and 32 ml cups 32 being the largest but other cups may vary. 1 ml = roughly 1 cc 


Other important information about your flow: 

  • Tail End Brown Bleeding (TEBB): brown bleeding at tail end of period. 
  • Premenstrual bleeding: pink spotting or brown spotting at the prior to a full period starting. 
  • Intermenstrual bleeding: bleeding between periods. 

What type of laboratory tests may be done?

Urinary LH-monitor (ClearBlue)- Why I would not recommend use

What type of laboratory tests may be done?

laboratory tests

What type of imaging tests may be done?

Urinary LH-monitor (ClearBlue)- Why I would not recommend use

What type of laboratory tests may be done?

Imaging Tests

Urinary LH-monitor (ClearBlue)- Why I would not recommend use

Urinary LH-monitor (ClearBlue)- Why I would not recommend use

Urinary LH-monitor (ClearBlue)- Why I would not recommend use

No LH-monitors - Yes P+3 progesterone!

Why NOT the Birth Control Pill?

Mainstream ObGyn doctors will almost always recommend the birth control pill as first line treatment. The birth control pill will suppress your normal menstrual cycle and simply provides a band-aide for the underlying problem(s). 


Please know NaPro Providers to not prescribe the birth control pill (mentioned briefly towards the end of this video). 


To the contrary, we believe the birth control pill is harmful to women physically, emotionally, and spiritually. We pride ourselves on taking our patients OFF hormonal contraception, finding the root cause of their symptoms, making a proper diagnosis and providing superior treatments for all of the conditions we treat. 


For more information about the spiritual harm brought  into the relationship via contraception, visit my  CrMS page, scroll to the bottom and read about SPICE. 

Bio-identical Progesterone for Treatment of PMS

***** Do not take unless under medical supervision *****


Micronized Progesterone which is a bioidentical hormones. Dr. Lara Briden has an excellent podast where she discusses indications for, safety and efficacy of these supplements. Micronized” progesterone is biochemically identical to the progesterone your ovaries naturally make; it is very different from the synthetic progesterone which is found in many types of contraception pills and devices. 


Your CrMS charting is of the utmost importance. If you are prescribed progesterone hormone replacement therapy, this must be timed accurately and specifically to your menstrual cycle. Taking this medication too early or too late can cause more bleeding problems and increase your risk infertility. Whereas, taking this medication timed correctly will resolve these two problems. I will offer you two options for dosing .   


  • Oral capsules taken at bedtime once daily on P+3 through P+12  
  • Oral capsules inserted per vagina twice daily on P+3 through P+12 

More Information about Bioidentical Progesterone:

Again, only bioidentical hormones supplementation is offered. I commonly prescribe prometrium capsules, which are taken orally. The generic brand is just as good and ot costs much less. Prometrium (micronized progesterone) is truly a  bioidendical hormone formulation which can be purchased through a regular retail pharmacy. This medication is generally well-tolerated. Some common side effects are quite pleasant, eg: you may feel more relaxed or sleepy and your might find your mood may improves. Some more unpleasant side effects may be: next-day fatigue, nausea, headaches, or dizziness. Most often the unpleasant side effects can be easily managed by taking the medication right before you lay your head down on the pillow and/or changing to a compounded formulation. Please know prometrium and generic progesterone capsules contain peanut oil, so you CANNOT take this if you have a peanut allergy.


Sometimes the Prometrium or generic micronized progesterone that is  purchased will include a package insert which will "warn" of possible birth defects. However, this warning refers to progesterone substitutes that are often prescribed in oral contraception pills, not the bioidentical progesterone we are prescribing.  NaPro providers, who were trained at the St. Paul VI Institute, have been safely prescribing micronized progesterone to many, many women to support pregnancies for over 35 yrs and they have not encountered problems. 


If the oral medication is not strong enough or if the side effects are bothersome, we can try a vaginal suppository. This will be prescribed for you by a specialty pharmacy called a "compounding pharmacy". You can see a list of compounding pharmacies by viewing Handout #21 here.


Sometimes we will have to use progesterone injections. I will ask you to watch this instructional video and choose someone such as your spouse or a close relative who is willing to administer the injections to you. I would also recommend injections be administered in the upper-outer quadrant of the buttocks (shown in the video) and that you alternate sides. Common side effects of the injections are: soreness, itching and/or mild bruising at the injection site, especially if the injection is done too quickly.        

Discussion about Low Dose Naltrexone (LDN)"

***** Do not take unless under medical supervision *****


Naltrexone (off-label use):  

  • NaPro Protocols recommend full dose naltrexone (50 mg) for PMS. 
  • Naltrexone is commonly used to help people with addictions avoid alcohol use and or opioid use.  
  • This medication is an opioid-receptor antagonist (blocks opioid receptors).  
  • Thus, we call this an "off-label" use of this medication, which is somewhat common to do in mainstream medicine. 
  • Many NaPro patients report wonderful success using naltrexone to treat PMS. 


I do occasionally use the full 50 mg dose of naltrexone in very severe cases. Most often I will recommend "Low-Dose Naltrexone" (LDN) for you namely b/c  there has been some discussion among the medical community that if a patient has been on full dose naltrexone for many years, this may present a conundrum if the patient needs opioid medications to control severe pain, such as after a surgery or after a significant injury has been sustained. The concern is twofold: 

  1. If the pt is left on the 50 mg of naltrexone, it may be very difficult to manage his/her pain, because the naltrexone is blocking the pain receptors. 
  2. Whereas, if the patient is taken off the naltrexone and given an opioid medication to control his/her pain, a regular dose of the opioid (eg; Percocet) may be too much, and the patient may be at a higher risk of respiratory depression (breathing stops) due to a normal dose of an opioid medication now being too potent, because the patient's opioid receptors have undergone a process called down-regulation, which occurs after long term opioid use. 


My recommended treatment for most cases: 

We would start at a very low dose and slowly titrate up to 8 mg and see how you feel. The 8 mg dose may be enough for most women. Again, in rare cases, we may continue uptitration to the full 50 mg dose, but I would prefer to use this short term. 


There are some studies that have emerged indicating patients who have been on 50 mg of naltrexone, for long periods of time, may present a conundrum if they need short term opioids to control pain, such as in the setting of a serious injury or if an emergency surgery is needed. Acute care medical providers are faced with a dilemma, ie: stop the naltrexone (which is filing 'mu-opioid" receptors) or continue the naltrexone and try to control pain. If naltrexone is abruptly stopped, their is a risk that the opioid dose will be too high for the patient, which can cause respiratory depression (breathing slows or even stops), OR if the provider chooses to continue with the naltrexone, it may harder to achieve adequate pain control for the patient. 


I prefer to prescribe naltrexone capsules from a compounding pharmacy.  You can view a list of  compounding pharmacies that I frequently work with here. 


*** If we agree on using the full dose, I will document you have been educated to the risks as noted above, and you would like to take this risk. Also, we would plan to use the full dose for only 4-6 mos. 

Naltrexone - OPEN Access Research

Low dose naltrexone- Effects on medication in rheumatoid and seropositive arthritis. A nationwide register-based controlled quasi-experimental before-after study (pdf)

Download

Low dose naltrexone in multiple sclerosis- Effects on medication use. A quasiexperimental study (pdf)

Download

Cochrane Review- Low dose naltrexone for induction of remission in Crohn's disease (pdf)

Download

Safety and efficacy of low dose naltrexone in a long covid cohort; an interventional pre-post study (pdf)

Download

Copyright © 2025 Queen of Hearts Fertility Care  & Napro Technology - All Rights Reserved---Ocean Video image courtesy of Sitthijate Poonboon. 

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