Dealing with Postpartum Hair Loss
I’ll never forget the moment after my daughter was born…
She was finally fed and content in her dad’s arms, so I snuck away for a shower…
And as I massaged my shampoo, enjoying a moment of peace…
I pulled my hands away to find a hamster-sized clump of hair in my hands!
Any postpartum mama knows what I’m talking about. Postpartum hair loss is no joke!
I knew that hair loss was a normal part of the postpartum period, but even with my super-thick and curly hair, the loss was really noticeable.
And at a time when women are often already feeling more fragile and vulnerable than usual, the sudden hair loss can be like adding insult to injury.
But is there anything we can do about it?
Let’s talk about it today.
What Causes Postpartum Hair Loss?
During pregnancy, estrogen levels are high. This prolongs the hair growth phase, leading to less normal hair loss and longer, thicker feeling hair.
But after pregnancy, estrogen levels drop really dramatically - from 5--100x the normal level during pregnancy to less than normal in breastfeeding. With estrogen suddenly so low, control of the hair follicles goes to testosterone, and specifically, a derivative of testosterone called DHT. With DHT in control, the hair growth phase shortens, and the result is significant hair loss.
In addition, the hormone prolactin plays a role as well. Prolactin is the hormone that rises to induce lactation after birth. But, prolactin also further suppresses estrogen and increases the expression of testosterone and DHT. More DHT expression may result in more hair loss.
And if you already have experienced androgen-driven hair loss, like that caused by Polycystic Ovarian Syndrome (PCOS), you may be even MORE sensitive to this shift after pregnancy.
I think of the postpartum period as a mini version of what can happen during menopause - that’s how big the hormonal shifts are. Women can become androgen-dominant in the postpartum period, causing hair loss and symptoms like vaginal dryness, low libido, and even vaginal atrophy—all of which can make sex less pleasurable or even downright painful. (If you’re wondering just how long your sex drive will be MIA for, it’s totally normal and common for it to be gone until you stop breastfeeding!)
Lactation-Safe Postpartum Hair Loss Solutions
First, remember that postpartum hair loss is 100% normal. And I pinky-promise, it is way more noticeable to you than to anyone else. I say this having gone through it recently myself!
But if trying to disguise it using ponytails isn’t enough, there are some evidence-based things you can try.
There are plenty of herbs that can help block DHT, and many of them can be safely used during lactation, without impacting milk supply.
However, not all DHT blocking herbs can be safely used during lactation: one to avoid until you’ve weaned your baby is saw palmetto. Saw palmetto is reported to block the response of prostate cells to prolactin, which are likely also upregulated by high prolactin in breastfeeding. It can work well for any remaining hair loss concerns after breastfeeding, but skip it until you’re done breastfeeding.
Now, let’s talk about the herbs that are safe in lactation!
- Stinging nettle
- Gingko
- 1-3 cups of green tea daily
In addition to these, there are a few more that deserve special mention.
#1 Fenugreek
In addition to blocking DHT, fenugreek also supports milk supply in some women. It may be especially helpful if you also experience any insulin resistance, such as that in PCOS. Those with PCOS often have high DHT and greater hair loss.
#2 Nigella Sativa (Black Seed)
This herb has been taken for centuries as a therapeutic medicine and for maintaining health, and animal studies show it also has the potential to block DHT. For mothers who are breastfeeding, black seed has been known to boost the breast refill rate. I especially recommend this to moms who have a low breastmilk supply issue due to insulin resistance.
#3 Reishi Mushroom
In a research study exploring the anti-androgenic effects of 20 species of mushrooms, reishi mushrooms had the strongest action in inhibiting testosterone. That same study found that reishi mushrooms significantly reduced levels of 5-alpha reductase, preventing conversion of testosterone into the more potent DHT. In addition, reishi has an extremely low toxicity profile and is a good adaptogen and immune support in new moms. This is another go-to for my PCOS patients.
Bioidentical Progesterone for Postpartum Hair Loss
Another treatment option during lactation is adding cyclical bioidentical progesterone. Biodientical progesterone helps because progesterone reduces 5-alpha reductase activity, which converts testosterone to its active metabolite dihydrotestosterone (DHT).
And if you’re wondering, is that safe? It is indeed. Think about it this way: many women get pregnant with their second (or third….or…. fourth) while still breastfeeding an infant. When we are pregnant, progesterone skyrockets, going up by a factor of ten. This shift - which is known to be safe - is much, much more dramatic than the increase in progesterone from adding cyclical bioidentical progesterone therapeutically. Some progesterone will pass into breast milk, but, again, it’s much lower than what would pass through milk if a woman were pregnant.
And, cyclical bioidentical progesterone is an FDA-approved treatment for postpartum depression. That’s why I often use it with breastfeeding moms, even when hair loss is not a top concern. It can help normalize the menstrual cycle after baby, improving mood and PMS-symptoms.
Nutrient Support for Postpartum Hair Loss
But before herbs or cyclical bioidentical progesterone, I like to start all women with simple nutrient support.
First up, make sure you’re still taking a great prenatal vitamin. Nutrient needs while breastfeeding are even higher than when pregnant. This Is Needed and Designs For Health are my two favorites.
Next, I recommend getting iron and vitamin D levels checked with a quick blood test. Low levels of vitamin D drive hair loss, and supplementing is so easy if needed. Optimal vitamin D levels are between 50 and 80 ng/mL.
Low iron is also really common postpartum, and low iron is associated with increased rate of hair shedding. Blood loss = iron loss, and childbirth often involves a significant amount of blood loss. Anemia is also very common in pregnancy, and not everyone has iron stores that just bounce back. If a serum ferritin level shows your iron levels are low (anything below 30, but optimal is above 50 and within range), supplement with a high-quality supplement. This is my recommended iron supplement.
Finally, don’t forget minerals! Your body will prioritize providing minerals in your breastmilk over meeting your own body’s needs. That means baby might be stealing all our minerals, through no fault of their own!
#1 Zinc is essential for supporting hair and skin health, plus zinc acts as a DHT blocker by reducing 5-Alpha-reductase. Zinc levels can easily get low in pregnancy and postpartum. If you’re going to supplement with more than what is included in your prenatal, I recommend testing along with copper. If taking zinc, you’ll also need to take copper to keep the two from becoming imbalanced. Serum Zinc should be 64-126, and copper should be 81-157, and the ratio between zinc/copper should be between .85-1.2. I use this product the most, in clinic.
#2 Magnesium is something every nursing or postpartum mama should be on. I suggest 300 mg per day minimum, but some women need more. This one is great!
#3 Copper and Selenium are also important, but should be part of any postpartum vitamin worth it’s merit. Check your prenatal and be sure these are included.
Hang In There, Mama!
Becoming a new mom is tough for so many reasons. I hope this information can help ease that transition a bit.
And if you’re looking for more natural but no-nonsense, judgement-free support from another woman who has been there - look no further! Whether you’re looking for support with hormone issues, fertility, or postpartum life, myself and my team of clinicians would be honored to help.
>>> Click here to book a no-obligation free consult at a time that works for you
- Brie
PS - Struggling with wild hormones, the baby blues, milk supply, or anything else postpartum? Yes, hormone shifts are a normal part of the postpartum period… but NO they do not have to make you miserable. Let me help.
Healing HPV with Functional Medicine Part 2
In Part 1 of this series, I explained the western vs. functional medicine approach to HPV. Read Part 1 here.
Even though HPV is a very common infection, treating it requires a completely individualized approach.
Quick recap: For the vast majority of people, the immune system is able to clear HPV on it’s own.
For the people who get HPV and can’t clear it, there can be numerous factors at play. As your functional medicine practitioner, my job is to not only identify these factors, but help you implement an affordable, manageable plan to address them.
In real life, I break this into two steps. Let’s look at them both.
Step 1: The Foundation
It sounds too simple… but for the majority of people who struggle with HPV, it is changing the basics that makes the biggest impact.
Getting good sleep - 7-9 hours per night, in a dark room, with the same sleep and wake time on average every day.
Healthy diet - removing foods that are troublesome for you, increasing whole foods, decreasing processed and inflammatory foods.
Exercise you enjoy - adding in exercise if you’re sedentary, and cutting back if you’re overdoing it at the gym, since over-exercise can suppress immune function.
Stress management - this varies person to person. It can be as simple as adding a meditation practice or as life-changing as quitting your job or moving.
Finding happiness and joy - not just reducing stress, but actively adding in things that you love and fill you with joy.
Spending time outside - camping, hiking, even a walk in the park. It’s all about re-connecting with nature.
Many people find that just making these changes not only ramps up their immune function (helping them clear HPV) but that it transforms their entire life.
To give proper attention to how important this step of the healing process is, I’ve teamed up with 2 health coaches who specialize in helping people make enjoyable, sustainable lifestyle changes for better health.
>>> Learn more about our health coaches here
Step 2: Specific Immune Support
Step 2 is the part where my specialty comes in - creating customized supplement protocols. While every client’s treatment plan is unique, here are some of my go-tos for HPV treatment:
Green Tea - Epigallocatechin gallate, a compound in green tea, has been evaluated on the cells of the cervix and has been shown to inhibit HPV and induce cell death of abnormal cells. In a case study of patients with CIN-2, those treated with green tea had a greater response than those given other treatments.
Coriolus versicolor - Also known as turkey tail, research has shown that in women with abnormal pap smear results, using a vaginal cream containing this mushroom led to significantly higher numbers of normal pap smears 3 and 6 months later.
Indole-3-carbinol - This substance is found in cruciferous veggies. A case study looked at the effects of indole-3-carbinol on high-grade lesions. Subjects were given 400mg of indole-3-carbinol per day. None of the placebo group showed complete regression, but 4 of the 9 who took the indole-3-carbinol showed complete regression after 12 weeks.
Beta glucan - This well-known immune modulator has been shown to have anti-cervical cancer properties.
In addition to these supplements, I like to use green tea, curcumin, probiotic and vitamin E suppositories. I also use a Chinese herbal liquid extract based on formula used in women’s gynecology for thousands of years, “Yin Care,” applied as a vaginal rinse in the morning.
Finally, I find that there is almost always a lack of adequate folate in my clients with HPV concerns. This can be due to poor absorption, a lack of folate in the diet, folate-depleting medications (commonly the birth control pill), or genetic SNPs that make keeping an adequate folate status more difficult. Rather than just prescribe a folate supplement, I recommend testing first. Not everyone needs more folate, and there is such a thing as overmethylation.
Case Study: A Real Life HPV Success Story
Now that you know what my treatment basics are, let’s look at how this works in real life. I want to tell you about a patient of mine who recently cleared her HPV and reversed her abnormal cells.
My client went in for a routine pap smear only to be told her results were abnormal and she was positive for HPV. A follow-up colposcopy showed she had CIN-1 and CIN-2-3 cells.
Her doctor recommended a LEEP, but my client was hesitant due to the potential side effects. Instead, she decided to turn to me. We had already had great results working together on her adrenal function, chronic Epstein-Barr virus, and food sensitivities.
Because she had already addressed the majority of foundations discussed above, the only lifestyle change we made was eliminating sugar. From there, we went straight into step 2, treating her immune system and the infection systemically.
We started with a 60-day customized plan that included:
- Coriolus extract
- DIM
- Methyl-b-complex
- Vitamin A
- Vitamin D
- Antiviral herbs (both western and Chinese)
- Green tea suppositories
- Probiotics both orally and vaginally
After 60 days on this protocol, she went for a repeat colposcopy… and the abnormal cells were gone! This was a huge success.
There were still signs of cervicitis (inflammation of cervix), but with reparative change, meaning things were getting better.
But even with these good results, her doctor still recommended a LEEP. We didn’t let that deter us, though, and continued with the 2nd phase of treatment. We added:
- High dose vitamin C
- Zinc
- Switched up the antiviral herbs
- Added the Chinese herbal formula Xiao Fu Zhu Yu Tang which has been shown to reduce cervicitis
- Added curcumin extract caps vaginally and Vitamin E suppositories
- Added a Chinese herbal liquid extract as a vaginal rinse, based on the “Yin Care” formula used in women’s gynecology for thousands of years
After 6 weeks on this protocol, she then had a repeat pap smear and… (drum roll please….)
She was negative for all dysplasia and negative for HPV!
We then moved into the final phase of her treatment: ongoing antiviral support and new suppositories to focus on repairing any remaining cervicitis: calendula, vitamin E, vitamin A, and DHEA.
Become An HPV Success Story Yourself
This client’s experience isn’t an unusual one - with the right support, it is to be expected that your body can heal HPV and the abnormal cells it causes long before it ever progresses to cancer.
If you’re dealing with HPV or abnormal cells, I’d love to chat with you about a customized protocol that could help you have similarly fantastic results.
The first step is to book a free intro call with my team. These calls are totally free and no-obligation. It’s like a first coffee date: low stakes, but it could lead to something amazing!
If you like what you hear, we’ll help you build a customized treatment plan tailored to your needs, lifestyle, and budget.
>>> Book a free intro call here
PS - Already had a LEEP? Just found out you have HPV? Wherever you are on the journey - and no matter what treatment choices you’ve already made - I would be honored to help you find the path forward toward healing. Book a free call to learn how.
Addressing HPV with Functional Medicine Part 1
HPV is a scary diagnosis… you can’t see it, you probably can’t feel it… and suddenly you’re hearing the big “C” word: Cancer.
It’s overwhelming and scary… and sadly, many western practitioners don’t do much reassuring, explaining, or even provide all the options for treatment and management.
And they definitely don’t want to talk about natural treatments for HPV…
But the truth is that you DO have options when it comes to treating HPV and the abnormal cells it can cause.
Today, I’m writing for anyone facing an HPV diagnosis. I know it is frightening and overwhelming - and I want to help. Let's talk about HPV, and I'll share a case study of one of my real-life patients who took a more natural route to treating HPV, with amazing results.
What Is HPV?
HPV stands for human papillomavirus. HPV is the most common sexually transmitted infection.
In 2018 alone, the CDC reported 43 million HPV infections. The bottom line is that most sexually active people have HPV at some point in their life.
Why is HPV so common?
Unlike other STIs, HPV can be spread even without any symptoms. In general, men are not routinely screened and have no symptoms, so they are often unknowingly spreading it. And, like men, women with HPV often have no outward symptoms. Because symptoms aren’t noticeable, it could be years after you contract HPV that you find out you have it during a routine pap smear or STI test. That makes tracking back to where you got it, and who you might have spread it to, nearly impossible.
But the most important thing to know about HPV is that in the vast majority of cases it is no big deal. Most people contract HPV and clear the virus on their own. Think of getting over a cold: your immune system does the work and takes care of it.
But for the people who aren’t able to clear HPV on their own, it can cause problems. That’s what we’re going to discuss today.
When HPV Doesn’t Resolve On Its Own
When HPV doesn’t resolve on its own, it can cause the development of abnormal cells on the cervix that can eventually lead to cervical cancer.
HPV doesn’t typically cause noticeable symptoms, and this is one of the reasons women need routine pap smears. We can’t see or feel the start of cervical cancer without an exam, but if caught early and addressed, it can be stopped before it evolves into full-blown cancer.
Even if you’re working with an alternative practitioner, don’t skip your GYN exam. It’s really important.
Pap Smear
So you did it, you went in for your pap smear or gynecological exam… only to get bad news: either your pap smear or your HPV test was abnormal.
Depending on your doctor, you might have been tested for HPV and gotten a positive result, and then come back for a pap smear… or your doctor might have started with a pap smear, and found abnormal cells on your cervix - also called cervical dysplasia.
Once cervical dysplasia has been found, the next step is usually a procedure called a colposcopy. This procedure takes tiny biopsies of the cervix for a closer look (compared to just scraping the top layer of the cervix in a pap smear).
The colposcopy shows what level of abnormal cells you have: low, moderate, or high, called CIN-1, CIN-2, or CIN-3.
In most cases, if your results show just CIN-1 or 2, your doctor will recommend a “watch and wait” approach. The hope is that your body will fight off the HPV and reverse the abnormal cells on its own.
If you have CIN-3 or CIN-2-3 (which means it's unclear if cells are CIN-2 or CIN-3), the next step is typically a loop electrosurgical excision procedure, better known as a LEEP. The LEEP takes a larger biopsy piece to get a better diagnosis and hopefully removes all the abnormal cells, too.
Doctors also often hope that as the body heals the cervix after the LEEP procedure, it will also recognize the HPV virus and fight it off.
After the LEEP procedure, you’ll follow up with another pap smear, with the hope that the abnormal cells are gone. You can also expect more frequent pap smears over the next few years.
If your follow-up pap smear isn’t clear, the next step could be another LEEP… or even a hysterectomy, depending on the circumstances.
What Western Medicine Gets Right (And Sometimes Wrong)
As a functional medicine practitioner, what I like about the western medicine approach is that it involves being proactive.
But here’s what I find frustrating…
It is estimated that only 5% of CIN-2 and 12% of CIN-3 cervical dysplasia cases will progress to invasive cancer if untreated.
And, in general, it takes 10 to 20 years for abnormal cells to progress to cancer, and that progression requires persistent HPV infection to occur.
That means that even if you have abnormal cells, you have a LOT of time to address it before cancer becomes a serious concern.
Secondly, the LEEP procedure is not without risk. While some have only minor bleeding and no other side effects, all of the following have been reported after one or more LEEP procedures:
- Miscarriages - Per one study from 2015, in 116 women studied, an 18% increased risk of miscarriage was reported among those previously treated with LEEP. A different study cited a positive association with second trimester miscarriage.
- Depression
- Cervical stenosis - narrowing of the cervix, which can make getting pregnant difficult or cause problems with passage of fluids like menstrual blood.
- Chronic pelvic pain
- Pain during sex
- Inability to orgasm, low libido, loss of sensation in vagina, cervix, or clitoris
- PTSD - a form of sexual trauma experienced that stays traumatizing when thinking or talking about the procedure.
And while there is a *hope* that the LEEP procedure will help your body identify and fight the HPV as a side effect… western treatment does nothing to address the root cause of the abnormal cells: the HPV infection!
And that’s where the functional medicine approach really shines.
The Functional Medicine Approach to HPV Treatment
No matter what stage of HPV you’re dealing with - from just a positive test result to CIN-3 cells - the very first step should be taking proactive steps to support your immune system in fighting HPV itself.
Remember that most people are able to clear the HPV virus without intervention. If you’re not, here are the red flags I look for:
- Low nutrient status
- Poor sleep
- Stress or poor stress management
- Genetic predisposition
- Other chronic infections
Together, all these factors can lead to low immune expression and a susceptibility to chronic viral infections of all types.
But the good news is that the majority of these factors are modifiable.
That means, with the right support, you might be able to shift from someone who isn’t able to clear HPV on your own, to someone who is.
And on top of this, we can also use antiviral protocols to give your body a leg up in fighting the infection.
A healthy immune system should be able to handle HPV all on its own - so the approach that makes the most sense is to treat your immune system, and then let your body get rid of the HPV and heal the abnormal cells.
No matter where you are in the process - from just finding out to having already completed one or more LEEPs - this approach can help.
In Part 2 of this post, I’ll share my HPV treatment plan and a case study of one of my real patients who reversed abnormal cells and HPV using this approach. Read Part 2 here.
- Brie
PS - ready for help with HPV? You don’t have to wait for Part 2. Book a free intro consultation with my team today to get started on your customized treatment plan. Book your intro call here.