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Pelvic Health

I recently gave a talk to a group of women about the Pelvic Floor: what is is, what affects it, who is affected, and what to do about it. This was the 2nd time I’ve given this talk (for a monthly series) because it was so well-received the 1st time.

The first talk was a huge success.  There were several people that came to the talk AGAIN the second time around.

The first talk was a huge success. There were several people that came to the talk AGAIN the second time around.

In my talk, we dive right into the hormonal aspects of pelvic floor health, the personal history contributions, and the physical/mechanical factors at play.

I have long taken for granted the fact that people do not know their internal anatomy. I fell in love, head-over-heels-passionate-sleepless-nights-in-love with human anatomy when I was 19. I am visual. I locked in on where every organ, muscle, bone and ligament lived in the human body. Now, I’m teaching people in their 40’s where their bladder is relative to their uterus (or prostate!) and their colon and rectum. it feels like I have always known.

It is now believed to be true that 70-80% of the general population has some degree of pelvic floor dysfunction serious enough to warrant a doctor’s visit. The median age for females is 41. Let that sink in. That is why we decided the time had come for us to do a pelvic floor talk. My bootcamp leader at Wy’east Sisterhood and I were involved in a discussion with women who had never been pregnant, talking about incontinence.

Hold the phone.

People that had never been pregnant had pelvic floor issues? That’s when a light came on for me. I had treated tons of people for pelvic floor issues, but most of them were postpartum. I even said, “Every body that has a pregnancy needs pelvic floor work afterward”.

I had bought into the misunderstanding. People who had not been pregnant would not come to see me for things like constipation, low back pain, prostatitis, erectile dysfunction, or recurrent UTIs because those things haven’t been connected to pelvic floor muscle dysfunction in the mainstream. They didn’t know to come, and I hadn’t told them.

Well, I am telling them (and you) now. We are at a time when the importance of the pelvic floor muscles and organs is being realized. It’s about more than Kegels.

Just a little touch.....

Hi my people!  I'm just back from New Zealand and have been bathed in a sea of green plants and an ocean of blue waters.  So lovely.  I read a TON about the effects of nature on our human bodies while I was there, and I wanted to leave a sweet little study here for you to read.  Tell me you're not going to go get a houseplant after that (at minimum) or at least make a pledge to get yourself in nature once a week (twice? three times?).  

Radiation protection, re-visited

It's been just over a year since the Nuclear meltdown in Japan.  We had a lot of concerns about radiation for a month or two, and then things sort of simmered down. However, I recently had a patient ask me what she could do to protect her young children from the effects of increased radiation in our atmosphere.  There's a lot out there on the web.  Weeding through all of it to determine an effective set of guidelines for families with little ones (or pregnant ones!) has been my pet project for the past few weeks.

Without further ado, I present "Dr. Roe's Radiation Protection Plan"

1. An apple a day.  Pectins (found in apples) are probably the most well-studied food source for radiation protection, even after exposure has occurred.  People in the Chernobyl radiation zone have been advised for years and years now to consume apples on a regular basis to help the body absorb and eliminate excess radiation.

2. Eat iodine-containing foods, and keep a source of iodine on hand for your family in the medicine cabinet.  There is no need to supplement Iodine on a regular basis, and this can, in fact, put people over the age of 40 at risk for thyroid cancer.

3. Add Spirulina to Smoothies or, even better, applesauce a few times per week.  Spirulina also shows the ability to bind radioactive isotopes so that the body can more readily eliminate them.

4. Find a reputable source for Kombucha tea, and drink it 3-6 times per week (8oz serving).  Besides, the hot-link there, I was able to easily find lots of evidence to show the anti-oxidant, free radical scavenging, radiation-busting effects of this ancient beverage.

5. Most of all, be healthy.  Eat whole foods.  Drink water.  Take a daily multivitamin (a good one!!!!)  Avoid sugar and processed foods to keep all of your organ systems intact and functioning properly.  Your body's ability to combat radiation exposure is only as strong as it is healthy.

So there you have it, the naturopathic doctor-approved, weeded-out version of Radiation Protection, 101.

Pap happy.

Guess what?  The guidelines have changed for Pap smears!  I know that coming in for your annual exam is about as fun as going to the dentist for a filling, but I am proud when you ladies come in and take care of business.  I like checking in with you each year.  However, the guidelines have changed, and it means we won't be seeing eachother quite as often. To summarize: Under Age 21: no pap smear, no HPV testing Age 21-29 Pap every 3 years Age 30-65 Pap + HPV every 5 years

Here's a nice article written by a colleague, Aviva Jill Romm, MD.  This is a great summarization of the new guidelines.

If you want more info from the U.S. Preventive Services Task Force, click here.

Vitamin D and you!

Winter in the Pacific NW generally means very little opportunity for sun exposure.  When you're talking about a nutrient that is made in the body when skin gets exposed to UV light, the lack of rays can be a problemo grande. I've been checking my patients' Vitamin D levels this winter with surprising results.  I have yet to get a normal result back.  The normal range isn't even all that high.  People still have symptoms of Vitamin D deficiency at the "normal" level.  Symptoms like: lethargy, decreased mood, body aches, soreness, headaches, decreased libido.  Any of this sound familiar?

When I was in medical school, a family member called me with what sounded like a classic case of fibromyalgia.  She was having difficulty sleeping, had lots of pain in her body, and was tired all the time.  One of my mentors at the time suggested Vitamin D.  She got her levels checked and they were extremely LOW.  She started taking 1000 IU/day.  Her levels have been in the optimum range now for years AND she doesn't feel like she has fibromyalgia.

Aside from feeling good in the winter, Vitamin D is important for long-term health issues.  Check out this article in the American Journal of Clinical Nutrition.  It talks about how Vitamin D appears to delay aging and diseases of aging by slowing the turnover rate of white blood cells.

Taking a high quality Vitamin D supplement daily is a good idea if you live somewhere gray.  It's also a good idea to get your nutrients from food sources whenever possible.  The best sources of Vitamin D are:

  • Herring, 85 g (3 ounces (oz)) provides 1383 IU
  • Catfish, 85 g (3 oz) provides 425 IU
  • Salmon, cooked, 100 g (3.5 oz]) provides 360 IU
  • Mackerel, cooked, 100 g (3.5 oz]), 345 IU
  • Sardines, canned in oil, drained, 50 g (1.75 oz), 250 IU
  • Tuna, canned in oil, 85 g (3 oz), 200 IU
  • Eel, cooked, 100 g (3.5 oz), 200 IU
  • One whole egg, provides 20 IU

images*amounts provided by Wikipedia.*

Women of childbearing age and children should not eat mackerel  or more than 6oz of tuna per week due to mercury content.

There are rare cases of people overdosing on Vitamin D.  You should always consult with your doctor before adding anything new to your daily intake of nutrients.  It is advisable to have your Vitamin D levels checked to assess the proper dosage for your body.

Beat the Blues, naturally.

It's that time of year when Seasonal Affective Disorder rears its ugly head here in the Pacific NW.  Fear not, this doesn't have to mean hopping on the Prozac train, the Zoloft bus, or the Wellbutrin boat.  There are a number of natural alternatives that are effective to help with mood during these months of cloudy weather.  Check out this article by Dr. Mercola for some ideas.  Each person responds to the weather differently.  To tailor a treatment plan to specifically address your needs, think about coming in for an appointment.images

The Probiotics Way

Probiotics have gotten a lot of press in the past year.  Traditional cultures have long known the benefits of eating foods containing probiotics.  Most of these foods are fermented at least partially. A short list of probiotic food choices includes miso soup, some soft cheeses, yogurt products like kefir, sauerkraut and many pickles. 80% of our immune system is in our GI tract, and an imbalance of bacteria in the GI system causes a host of health issues. This article from goes into a bit more detail about probiotics and their role in healthy living and Naturopathic medicine.  It's important to seek these little guys out in your daily diet or as part of your supplementation as food processing has changed so much in the last several decades.  We simply don't get dosed routinely, and as a result allergies, digestive diseases, food intolerances, and auto-immune conditions are on the rise.


I work with several patients who have arthritis, and it seems like there is no one "right" way to treat this condition.  In fact, I'm finding that to be true about many conditions.  It would be nice if everyone who came to my office with joint pain could be given the same 3 treatment ideas and sent on their happy way. It just isn't usually the case.  Each of us has our very own story of how we got to where we are and why our symptoms manifest the way they do.  Since none of us arrive at the same destination for the same reason, why is it then assumed that two people with the same condition need the same intervention?    One patient may have arthritis because  they have played soccer for 30 years and the joint is shot.  Another patient may have arthritis because they have a constant level of inflammation in their body due to food sensitivities.  Through trial, time, and patience, the solutions become clear. The time spent learning the root cause of why someone develops arthritis pays off in achieving healing at a much deeper level.

I marvel at the individuality of each person.  Why are we all the same and all so different?  It makes my job a real challenge and a real joy.

Evidence-based medicine?

I went to a naturopathic medicine conference this past weekend.  One of the keynote speakers was John Abramson, MD.  Dr. Abramson took a sabbatical from his busy Massachusetts practice to write a book on the medical research community, trends in U.S. healthcare, and how big drug companies are paying for the evidence to get skewed in their favor.  He scoured drug research, and he also poured through research on diet, exercise, and lifestyle modifications and their effectiveness against heart disease, weight management, and mood disorders.  Guess what he found?  Changing diet, nutrition, and exercise was more effective than taking medication in almost all cases.  We're not even talking just a little bit more effective.  In most cases, taking prescription meds was less than half as effective compared to making lifestyle changes.  We as a nation spend twice as much as any other nation on healthcare and yet we are the second sickest nation in the industrialized world when it comes to preventable disease. It's easy to place the blame on MD's and say that they should be reading the research and limiting the amount of drugs they prescribe.  However, there were a number of MD's at this conference who explained that they had been indoctrinated into the world of pharmaceuticals as soon as they began medical school.  Some even explained that their professors had been paid to discuss certain drugs during lectures.  The MD's rely very heavily on the research to guide their prescribing.  This in itself is not a problem.  The problem lies in the fact that large drug companies are paying to have certain research published and other research pushed to the back burner.  It all comes down to money, and very little of it has to do with patient care.

Dr. Abramson's book Overdosed America covers these statistics and others.  This week there was an article in the Willamette Week about the same topic.  It seems that MD's are getting fed up with prescribing drugs that aren't necessarily warranted and aren't making their patients better.  As a naturopathic physician, I feel fortunate in knowing that the treatments I use really work and really help people become healthy individuals.  I have a newfound gratitude for being able to use whatever medicines I want to use in my practice, not the ones I have been paid to promote.  I commend the MD's who are starting to question big pharmacy.  It's time to bring the balance back to patient care.