Signed in as:
filler@godaddy.com
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
- Food/sweat cravings
- Breast tenderness
- Weight gain
- Headache
- Insomnia
What will the NaPro appointment be like?
Your appointments at Natural Women's Health 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 Charting 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: During your first appt with me, I will take a comprehensive medical history, order a baseline ultrasound and check blood levels for FSH/LH and estrogen, which must be timed to day 3-5 of your next menstrual cycle. You will be asked to begin charting your menstrual cycles using the Creighton Model System. Please choose a Fertility Care Practitioner by clicking the button below and begin to chart your cycle.
You will also be asked to record your PMS symptoms using the NaPro PMS Symptom Tracker. You may print out the pdf file or document your symptoms using an electronic EXCEL form. The EXCEL format is preferred by me because I can easily transfer data into the patient note in your chart.
Second Appt: You will be asked to return to Natural Women's Health for a follow-up appointment with me after you have charted two full menstrual cycles or two months, whichever is shorter. Together we will review your Creighton Model Chart and your PMS Symptom Tracker, a GYN physical examination will be preformed, and additional laboratory tests and/or imaging may be ordered, which will be specifically timed to your Creighton model chart. We will look for certain "biomarkers" in your menstrual cycle to help guide your medical management.
Third Appt: You will return to the office two weeks later to review the results of your laboratory and imaging studies. Depending on your results, you may be asked to undergo additional testing, start medications and/or make an appointment with a specialist such as a dietician, a sleep specialist, or a counselor.
Follow Up Appts: You will return to the office every two months to monitor and/or make adjustments to your medications and treatment plan.
What types of laboratory tests may be done?
Comprehensive Hormone Panel:
- FSH/LH and estradiol (on day 3-5 of your menstrual cycle)
- Progesterone and estrogen levels will be specifically timed to your Creighton Model chart.
- Prolactin (fasting)
- 17OH progesterone timed at 8AM.
- Sex Hormone Binding Globulin (SHBG)
- AMH-Anti-Müllerian Hormone Test to check for ovarian reserve.
Comprehensive Thyroid Panel:
- TSH, total T4, FT4
- Total T3, rT3, T3:r3 ratio
- anti-TPO and anti-Thyroglobulin antibodies
Health Labs:
- Vitamin D level
NaPro Treatments for of PMS
As mentioned, your NaPro provider can offer you exceptionally efficacious treatment for your PMS. Some examples are:
Micronized Progesterone: micronized progesterone is a bioidentical hormone which will be specifically timed to cooperate with your individual menstrual cycle. “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. The timing of your dosing is very specific to your individual menstrual cycle and will be based off your Creighton Model Chart.
- 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
Human Chorionic Gonadotropin (HCG): HCG will stimulate your ovaries to increase your own production of progesterone and estrogen. Timing of administration will be based on your Creighton Model Chart. HCG is given via injection only; it more costly and may be a bit more difficulty to obtain.
- HCG 2000 IU given either intramuscularly or subcutaneously on P+3, P+5, P+7 and P+9.
Naltrexone:
- NaPro Protocols recommends full dose naltrexone (50 mg) for PMS.
- Naltrexone is commonly used to help people with additions avoid alcohol use and or opioid use.
- This medication is an opioid-receptor antagonist (blocks opioid receptors).
- Many NaPro providers have had wonderful success using naltrexone to treat PMS.
We would start at a very low dose and slowly titrate up as follows:
- 0.25 mg 4 x daily for 10 days
- 0.50 mg 4x daily x 10 days
- 1 mg 4x daily x 10 days
- 2 mg 4x daily x 10 days
- 4 mg 4x daily x 10 days
- 8 mg 4x daily x 10 days
- 50 mg, one tab daily, thereafter
Two Compounding Pharmacies are recommended:
1. Kubat's Compound Pharmacy in Omaha, NE commonly prescribes for NaPro patients. Website: https://www.kubathealthcare.com/
2. Empower Pharmacy in Houston, TX commonly prescribes for NaPro patients. Website: https://www.empowerpharmacy.com/
How can I make an appointment?
You can schedule an appointment to see Sharon at Natural Women's Health by calling the office at: 215-939-4251. If you would just like to chat to find our more information, please email stbest8@gmail.com and a phone appointment can can easily be scheduled.