Women’s Health

Christiane Northrup, M.D., is a board–certified obstetrician/gynecologist whose best selling books, Women’s Bodies, Women’s Wisdom and The Wisdom of Menopause, have set the standard for women seeking a balanced and knowledgeable perspective on both conventional and complementary methods for restoring and maintaining health.

Her latest book, Mother-Daughter Wisdom: Creating a Legacy of Emotional and Physical (Bantam 2005) explores the mother-daughter bond. She is also the host of a PBS special on the same topic (airing in March 2005). She has also hosted four previous public television specials and authors a popular monthly e-letter on her website, www.drnorthrup.com, and a print newsletter, The Dr. Christiane Northrup Newsletter: Women’s Wisdom for Optimal Health and Healing. Her work has been featured on the Oprah Winfrey Show, the Today Show, NBC Nightly News with Tom Brokaw, The View, and Good Morning America. She and her family live in Maine.

In his interview with Dr. Daniel Redwood, Dr. Northup describes ways to use the physical and emotional changes of the female life cycle as tools for growth and transformation, discusses the symbolic and emotional aspects of illness, and offers suggestions for attaining optimum health at all stages of life.

DANIEL REDWOOD: What first led you to venture beyond conventional medical approaches to women’s health care?

CHRISTIANE NORTHRUP, MD: I was brought up that way. My parents were into Robert Rodale, organic gardening, composting, taking vitamins, whole foods, all of that. So it was kind of a natural transition, though I must say that when I got into medical school, I was temporarily very enamored with the medical model. So it took a while to actually combine the two worlds of natural medical approaches and the techno-medical model. I met Michio Kushi, who was the founder of the American macrobiotic movement, right at the end of my OB-GYN residency. I sat in with him as he did consultations and watched people change their health after being on a macrobiotic diet for a number of months. Because he had all of their medical records in front of him, I was able to review the charts and then see how people’s health dramatically improved with a change of diet. Because that came right at the end of my standard residency training, it was a perfect segue into private practice and I began to put the two things together.

REDWOOD: What’s your view at this point as to what comprises a healthy diet?

NORTHRUP: It has changed over the years. I believe that the healthy diet generally is anything that fully nourishes the cells with antioxidants and provides enough fiber. Most people do not eat as many vegetables as they should. Most eat too many grain products, but it’s devitalized grain products, the white foods and so on. So a healthy diet to me contains some animal protein or fish, enough omega-3 fats, plenty of fruits and vegetables, and that’s it. I don’t think everyone needs dairy food. In fact, for some people that’s contraindicated. The same thing goes with wheat products and some grains.

REDWOOD: Following the release of your first book, Women’s Bodies, Women’s Wisdom, you were the only woman and the only OB/GYN among the several leading physician-authors in complementary medicine. What was that like? Was it exhilarating? Stressful? How has it changed you?

NORTHRUP: It was terrifying, initially. When I first went into my hospital grand rounds after that book came out, I had never really talked with any of my colleagues about these ideas in an open forum. I had been president of the American Holistic Medical Association, so I certainly had my complementary-minded colleagues. But my OB-GYN colleagues were pretty much in the conventional realm. When the book came out, those two worlds, which I had kept separate, needed to come together. So I was very afraid but also extremely gratified with the response from the readers. Women said to me, “you have put into words feelings and thoughts that I’ve always had, but which I’ve never heard a doctor say.” So I touched a nerve which many women, and some men, have felt for a long time. And that was extraordinarily gratifying.

Also, because I didn’t do my first major media work until about 1998, that gave me about a four-year time frame in which to get used to the idea of being a more public figure. So it was pretty gradual. By the time The Wisdom of Menopause came out, I was more ready for the controversy and so on. At this stage, I’m amazed at the success of my work. When I began, I didn’t think my work would be accepted in my lifetime because of the way things were in medicine at the time. I knew I had something to offer which could really help a lot of people, and I decided to offer it, despite the risk. Times have now changed and people are far more open. It’s very gratifying.

REDWOOD: Your books have become a standard for many women who seek a balanced and knowledgeable perspective on both conventional and complementary methods for restoring and maintaining health. For me, one of the most striking things about your writing is the emphasis you place on the role of emotions. You’ve said that symptoms like PMS or menopausal difficulties often are caused by, or coincide with, a repression of a woman’s needs or her voice. Could you expand on that?

NORTHRUP: The medical intuitive Caroline Myss has a great phrase, which is “our biographies become our biologies.” We know that every thought and every emotion is accompanied by a metabolic cascade of neurochemicals in the body and that the chemicals associated with feeling stupid, feeling wrong, feeling ‘less than,’ create a different biological terrain than feelings of mastery, acceptance, happiness, and so on. If you look at written history, you will see that the feminine has been denigrated and the masculine has been elevated for at least the last 5000 years. Women have been blamed for the downfall of mankind in the story of Eve in the Garden of Eden. The menstrual cycle, the cycle that is responsible for all life on Earth, has been called ‘the curse.’ Women were, and still are, feeling ashamed to be having their period or talking about it. And so, that history on planet Earthæof the put-down of the feminine parts of the body and the menstrual cycle, and so onæleaves a mark, as it were. Women have mixed feelings about their bodies and these all come out in the functioning of the body.

When one begins to reclaim the wisdom, however, of those natural cycles, of the menstrual cycle, for instance, you understand that it’s quite natural to have an outgoing part of the cycle and then a more inward, reflective part of the cycle, where you rest, where you give yourself more time, where you take long baths. In other words, the part just before your period or during your period. Once you understand the in-breath and the out-breath, and that your body is actually in tune with the cycles of the moon, then all of the negative feelings about your body go away. And then symptoms around PMS tend to go away as well.

I remember when I started to treat PMS in 1982, just as it hit the public consciousness as a result of an article in the magazine Family Circle. It’s very funny to me that it’s usually women who change the medical profession and not the other way around. Only after the Family Circle article did the subject appear in the OB-GYN literature, because women suddenly had a name for their monthly suffering and began to go to their doctors to ask about it. There were several doctors that began to have PMS clinics. So I did all the stuff that you always do that helps PMS, like having women stop caffeine, get on a good multivitamin with enough magnesium and B-vitamins, stopping the white foods in their diet, exercising more. Evening primrose oil was big at the time; now I use more omega-threes. You do all that and people get better.

But then what I noticed was that they didn’t stay better until they addressed the imbalances in their lives. I noticed, for instance, the most severe cases of PMS I ever saw were all, without exception, in adult children of alcoholics. These people had grown up where their home was a war zone, where the alcoholic controls everybody, and they grow up being rescuers, hiding dad or mom’s bottle, dragging mom or dad into the house. So they become adults at a very early age because they’re expected to take on adult responsibility for an adult who is not taking responsibility but is instead turning it over to a bottle. I saw the effect of that on people’s biology and only when they addressed that did they get better permanently. It’s almost as though the things that we holistic doctors recommend, the lifestyle changes, will only work up to a point and then one must address the fear, the grief, the resentment, the parts of your life that are shoved under the carpet. You know, Bernie Siegel really puts it succinctly and directly when he says, “The problem that most patients face is the inability to love themselves.” It all gets down to there being a part of you that you don’t feel is acceptable or lovable. A kind of bottom line, when you begin to shine a light on the parts of you that you feel are unlovable, and you start to accept them and eventually love them. Then you can heal just about anything.

REDWOOD: In your writing, you often use your own personal experiences to introduce or clarify key issues. One example was the story of how you developed uterine fibroids at a key transition point in your life. Could you tell that story and explain what it meant to you?

NORTHRUP: Yes. I had often said in my practice, when I was in my 30s, that fibroids were creativity that had not yet been birthed. And I, of course, had seen hundreds and hundreds of women with fibroids and diagnosed them over and over again. I was horrified at the age of 42 to have my annual exam and have a fibroid the size of a tennis ball. So thus began my own journey into what was the creativity that I hadn’t yet birthed. The other thing that fibroids can represent is pouring energy into a creative endeavor that is, in fact, a dead end. Despite acupuncture, despite the right diet, despite doing everything, the fibroid continued to grow, and one time I gave a lecture in New York City, got on the stage, and blurted out, “I have a fibroid the size of my husband’s head.” Sometimes we say these things that are the truth. Then I got tired of dressing around the fibroid so I had a myomectomy where the fibroid was removed, when I was, I think, 47.

When I went under anesthesia, I asked the anesthesiologist to repeat to me the phrase, “and when I awaken, the pattern that created this will be gone.” Two years later I was divorced. And I’ve never had the problem come back. It was one single fibroid that grew to the size of a soccer ball. The process of taking Synerel, a GnRH [gonadotropin releasing factor] agonist, to shrink the fibroid, put me into a temporary and premature menopause, where all of the stuff I had been putting under the rug in my own relationship kind of came up and hit me between the eyeballs. I found that the relationship that I had, which I thought would last my entire life, had come to the end of its viability. So my own experience with the fibroid was that I had indeed been trying to make a dead-end relationship work. My health improved very rapidly after that. So, you know, it was another case of “Physician, heal thyself,” take your own medicine.

REDWOOD: What are some of other symbolic meanings of particular symptoms or illnesses that you’ve seen?

NORTHRUP: Thyroid disease, which many women have, as you know, is about not having a say or being with somebody who doesn’t want to hear what you have to say. Very often women are censored with partners, or in jobs, where someone is telling them to keep their voice down or please say it in a different way. Breast issues are always about giving and receiving, generally giving more than you receive. Or at least having the perception that you’re giving more than you’re getting back and then feeling resentment under the surface. Because breasts are symbolic, obviously, of nurturing others, and to nurture others well one must be fulfilled in the nurturance department. So many women are giving from an empty cup, literally.

Heart disease is all about whether you live passionately and feel the flow of joy in your life. Basically, every different chakra of the body has different meaning. Hips and knees are about moving forward in one’s life. I had plantar fasciitis very severely at the age of 13 and also developed severe astigmatism around the same time. The plantar fascia and the eyes are all on the liver meridian in Chinese acupuncture theory, and the liver meridian is always about anger. Obviously, as an adolescent girl, there were many things I was seeing in my family, in my life, that I didn’t like to see and was angry about, but didn’t have a suitable outlet for it. So it came out as menstrual cramps, losing my ability to see clearly, and also the foot problem.

Each time in my life that I’ve had something like this, I’ve simply followed my own advice and worked on the emotions behind the symptom so that the symptom eventually goes away when you heed the message. I had classical migraines and was hospitalized for those when I was 14. Eventually those went away when I stopped driving myself relentlessly. I also had a big old skin rash around my throat and chest fairly recently that went away. That was about stuff that I needed to say that I couldn’t say, that I needed to get off my chest. I talk about that in my latest book, which is Mother-Daughter Wisdom. What I find is that the most personal things in our lives, if we can approach them objectively and realize that we’re just part of humanity, part of the human race, we can learn so much about ourselves that also can be used to help others. Because the deal is not to judge our symptoms or judge ourselves as wrong or bad, but to see what is this symptom leading us toward, what is the greater fulfillment that the symptom is talking to us about, and that we’re blocking. So it’s never a judgment or a “you’re doing it wrong or you wouldn’t have this.” The sort of New Age approach to illness that was very prevalent in the 1970s was all about that awful judgment. If you were doing it right, you’d never get cancer, you’d never get a fibroid, you’d never get anything. That’s simply not the case at all.

REDWOOD: What kinds of behaviors constitute a healthy lifestyle for women at different stages of the life cycle? How does it change as you move through the seasons of life?

NORTHRUP: This is really interesting. I find that we are given by our genetic heritage, as it were, about 35 to 40, maximum 50, years of health potential. And then after the age of 50, your health stays good only to the degree that you’ve earned that health. In general, you can get away with some pretty unhealthy behaviors through your 20s. In your 30s, that’s the time when PMS is at its peak, and for a woman in her 30s it simply means that the cyclic wisdom that is her birthright has to be attended to. In other words, she has to have periods of reflection and rest every month. Otherwise, that will turn into PMS, and the same holds true with diet. Ideally, one would exercise and follow a healthy diet throughout life, but from 35 on, it is absolutely crucial that you clean up your act because you are then setting the stage for the rest of your life. And it really doesn’t matter what your health has been like for the first 35 years, you can completely transform it in the second half of your life with information that you might not have known as a child or young adult. But by the time you are 28, at least, you should be able to be responsible for your choices. And then, your state of health is pretty much up to you.

Resistance training, weight training, exercise, meditation, yoga, things like Pilates are absolutely essential for any woman over the age of, I’d say, 45. Because by then the effects of gravity and the effects of the aging process have to be consciously attended to on a daily basis. And then you can create the best health of your life, because you’ve got the wisdom of your age but with the consciousness of knowing what to do. So I think it’s just so crucial for women to understand that the little old lady thing that we see all around us, as bent-over women, with hip problems and so on, is largely a choice. It is not inevitable.

REDWOOD: In The Wisdom of Menopause, you wrote that “the brain catches fire at menopause.” What are the most important ways that women can harness this fire rather than being consumed by it?

NORTHRUP: Well, that is one great question. The thing is to realize that it is all about you, not about the people you have surrounded yourself with. This is the number one key thing. If you start using that fire to lash out at others in your life, to become a flame thrower, you’re not harnessing the power of it. You must realize that whether it is a marriage that is no longer working, a relationship with a child that’s no longer working, or with a parent, it is not particularly because of anything they’re doing, but because you have spent years teaching them how to act around you. So the person who needs to change now is you and the most important way to make this change is taking time for introspection and making yourself healthy. During perimenopause – which is a 7- to 13- year process during which we start skipping ovulations and the brain changes – many women talk about the fact that their lives would be fine if they could just go into a cave and not have to fold the towels for a while. So you have to make time for yourself in a way that, perhaps, you never did before. It has to be a priority. You can no longer put everyone’s needs ahead of your own and silently resent it, and silently wait for someone to give you permission to rest. If you continue that pattern, you will set the stage for the rest of your life being one of disease and decrepitude. So I see it as a crossroads in your life. One road says ‘grow’ and the other says ‘die.’ And this ‘brain catching fire’ is designed to get you to pay attention because it becomes too uncomfortable to continue ignoring yourself.

REDWOOD: In the past few years there has been a dramatic about-face on the part of the medical profession following the release of large-scale research demonstrating larger than expected problems with hormone replacement therapy for women in menopause. What is your current understanding of where we are on this issue?

NORTHRUP: The very good thing about the Women’s Health Initiative and the study on Prempro is that we realize that one dose of one type of hormone, in other words [practicing medicine with] a herd mentality, does not work. So that’s very good news. I don’t think that that approach ever worked. The bad news is that the results of just that one study, with one type of hormone, scared women about all kinds of hormone replacement, and scared them in a way that I think is undue and unjust.

The best approach to that whole issue is to individualize treatments using bioidentical hormones at the lowest possible dose for the least amount of time necessary. But some women do well with some hormones for many years, up to 10 to 15, particularly women who have had hysterectomies, either with their ovaries removed or even with their ovaries left in, because when you do a hysterectomy you change the blood supply to the ovaries. For women who have gone through a hysterectomy or a premature menopause, the right kind of hormone replacement for as long as necessary can be very helpful for their sense of well-being. We also know that if you are going to replace hormones, you should replace them at a physiological level, perhaps at the age of a 35-year-old woman, using the three different hormones, in combination or singly. Those are, of course, androgen, estrogen and progesterone. For a long time we’ve made hormone replacement just be about estrogen and have ignored the role of bioidentical progesterone, which can be so helpful for many women during perimenopause, when so many suffer the effects of estrogen-dominance, too much estrogen relative to progesterone. And they get through perimenopause, many of them, much easier with a little progesterone, which helps with anxiety, headaches, PMS symptoms and so on. So we don’t want to throw the baby out with the bath water at this point.

REDWOOD: What do you consider the most pressing non-gynecological women’s health issue today?

NORTHRUP: Heart disease, absolutely. One in three women will die of heart disease. For women, the next six causes of death combined don’t come close to heart disease. It begins in childhood and progresses, with a real growth spurt right around perimenopause.

REDWOOD: If Roe v. Wade is overturned by the U.S. Supreme Court sometime in the next several years, what implications do you foresee both for the availability of abortion and also for possible spillover effects on other women’s health needs such as contraception?

NORTHRUP: I shudder to think what will happen if Roe v. Wade gets overturned. If you read Margaret Sanger’s work, and she’s the founder of Planned Parenthood from the 1930s, you read it and it almost feels like we’re still having the same argument. It’s just hard for me to believe that we would still be carrying out a political agenda on women’s bodies. It’s pretty well-documented that approximately a third of the women coming in to publicly funded gynecological services in the 1950s, before abortion was legalized, were there because of botched illegal abortions. Women will die. There isn’t a question that more women will die if there isn’t access to legal and safe abortion.

On the other hand, there are ways that women have always dealt with their fertility. The best case scenario for me, the sort of pie-in-the-sky ideal, would be for women to see the fertility as a gift and to protect it, to learn their ovulation cycle and to never allow themselves to be with a partner who they wouldn’t willingly have as the father of a child, but also a partner who respected their fertility. Now I understand that that’s a very elevated view. Contraceptives fail, women get raped, and some women don’t have enough self-esteem to stay out of lousy relationships, or the relationship changes. So women will get pregnant who don’t intend to. Currently 50 percent of all pregnancies are either unwanted, unplanned or both. That’s kind of where we stand. I’d like to have women learn the 17 forbidden acupuncture points that they can use to regulate their periods and also perhaps to induce an early miscarriage if necessary. Those are available in a book called Woman, Heal Thyself, by Jane Blum.

REDWOOD: One more question. Which methods of complementary health care have you found most helpful for yourself and your patients?

NORTHRUP: Acupuncture, without a doubt. Acupuncture and traditional Chinese medicine. Pilates, which is a form of exercise. Meditation. I learned Transcendental Meditation, but there are many kinds of meditation. Yoga. And nutritional medicine with supplementation.

REDWOOD: Is there anything else that we haven’t touched upon that you would like to include?

NORTHRUP: I would say this: currently the baby boom generation, which is five times the number of people who came before or came after [in an equal number of years], is all reaching perimenopause and menopause. This is an enormously influential group. The beauty of the baby boomers is that we’re the ones who said “don’t trust anyone over 30.” This is a group that does not want to age or does not want to see themselves as old. They will be driving the trends in health care, and because of the generational distrust of authority figures, this is a group that will increasingly embrace complementary and holistic medicine because these types of medicines work, and they are safe. I believe that the wellness industry and the whole complementary approach to medicine is not only here to stay, but that we’ve only just begun to see its impact.

Daniel Redwood, a writer for the past 25 years, practices chiropractic and acupuncture in Virginia Beach, Virginia. Dr. Redwood is the author of the textbook, Fundamentals of Chiropractic (Mosby, 2003) and Associate Editor of The Journal of Alternative and Complementary Medicine. A collection of his writing is available at www.drredwood.com. He can be reached by email at danredwood@aol.com.