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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. 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.
NaPro providers offer many types of pharmacological treatments, which are oftentimes inexpensive and/or able to be purchased without a prescription, such as:
TO HELP WITH PAINFUL PERIODS:
OTHER SUPPLEMENTS & MEDICATIONS THAT MAY BE RECOMMENDED:
.
WHAT DO WE FIND IN THE RESEARCH ABOUT ASPIRIN?
BENEFITS:
The EAGeR trial was a randomized control study, which included 1228 women. The study was initially published in 2014, and indicated daily aspirin did NOT improve pregnancy outcomes in women with a history of RPL. However, the data was recently re-analyzed by the authors, who took a closer look at the compliance of the women during the trial in taking their aspirin. The data indicated that among study participants who were compliant in taking their aspirin for 4-7 days per week, there was a significant improvement in the live birth rate of 15 births per 100 women. You can read more here.
RISKS:
Many years ago, it was agreed upon among medical professionals that women should avoid aspirin and NSAIDS (eg: ibuprofen, naproxen, Aleve, etc...) during pregnancy. The biggest concerns were congenital anomalies, abnormal kidney development, which leads to low amniotic fluid, gastroschisis, and/or congenital heart malformations. You can read about this here, More recently, a number of studies have been published suggesting low dose aspirin does not put the baby at any increased risk of harm. Please see here and here. However, a meta-analysis, which looked at 22 publications, agreed aspirin did not increase the incidence of congenital anomalies, but the authors did feel the data indicated babies were at a significantly higher risk of developing gastroschisis, which you can read here.
Another meta-analysis published in 2023, looked at 21 published trials which included 373,926 women. The authors concluded that daily low dose aspirin increased the risk of bleeding during and/or right after delivery, which you can read about here . Another large Swedish study, which included 313,624 was published in 2020 demonstrated the same increased risk of bleeding and postpartum hemorrhage to mothers, and they also reported that babies were at an increased risk of brain hemorrhage, which you can read here.
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.
Naltrexone (off-label use):
I do occasionally use the full 50 mg dose of naltrexone only 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:
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. Naltrexone can only be purchased with a prescription. The Low doses capsules (4 mg to 8 mg) are only available through a compounding pharmacy. You can view a list of
compounding pharmacies that I frequently work with here.
A typical treatment titration regimen would be:
Rx# 1: naltrexone 4 mg:
#30 pills total for Rx # 1.
Rx#2: naltrexone 8 mg:
#60 pills total for Rx #2.
Rx#3: naltrexone 50 mg (available at either retail pharmacy or compounded)
#30 pills total for Rx #3.
*** 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.
Low dose naltrexone- Effects on medication in rheumatoid and seropositive arthritis. A nationwide register-based controlled quasi-experimental before-after study (pdf)
DownloadLow dose naltrexone in multiple sclerosis- Effects on medication use. A quasiexperimental study (pdf)
DownloadCochrane Review- Low dose naltrexone for induction of remission in Crohn's disease (pdf)
DownloadSafety and efficacy of low dose naltrexone in a long covid cohort; an interventional pre-post study (pdf)
DownloadUPMC Divine Mercy Womens Health
225 Grandview Avenue, St 302, Camp Hill, PA 17011
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The course includes 8 sections covered in 3 hrs.
Click the image to the left to be directed to:
https://www.rrmacademy.org/challenge-page/masterclass-in-endometriosis-and-surgery
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