Are you experiencing labile mood changes, sleep disturbances, irritability, headache or migraine, significant weight changes excessive bloating, or breast symptoms that occur in the days leading up to, and during your menstrual period?

Are you experiencing unpredictable changes in your menstrual cycle length, increasingly heavy bleeding and cramping, accompanied by worsening sleep, increasing anxiety, sadness or irritability in the pre-menstrual period, and sadness about reduced or absent libido?

Are you wondering how to manage menopausal symptoms like worsening insomnia, increasing anxiety, inexplicable sadness or irritability, and brain fog?

Is your relationship with your significant other suffering due to emotional symptoms are changes in your intimacy?

Do you worry about your use of alcohol, prescription medications, or other substances as you move through hormonal changes later in life?

Menstrual-related mood changes, during reproductive years and menopause, can cause significant distress and challenges with significant others, children, work, and friendships.

Women are at particularly high risk of initiation of use of substances, risky use, and development of use disorders during times of hormone change.

Addressing menstrual-related mood concerns involves identifying symptoms, laboratory evaluation, and treatment interventions.

These are personalized to each woman and their unique life circumstances, reproductive considerations, medical and behavioral history, and co-occurring illnesses.

Hormone balance does not only address sex hormones but instead involves an understanding of the intimate relationship and the importance of optimizing the cortisol (fight or flight), thyroid, AND sex hormone systems.

Lifestyle behaviors that affect the blood sugar-insulin, gut-brain axis, and immune system are also critically important for optimizing hormone balance and addressing physical and emotional health concerns during the reproductive and menopausal years.

Pre-menstrual Syndrome – Mild to moderate symptoms occurring in the days leading up to and during the menstrual period. Symptoms include sadness, anxiety, irritability, sleep disruption as well as physical symptoms of weight changes, appetite changes, bloating, and headache or migraine.

Pre-menstrual Dysphoric Disorder – Severe symptoms in the days leading up to and during the menstrual period that create disruption in relationships and work. Symptoms include depression, anxiety and panic, irritability or anger, labile mood, and insomnia.

Perimenopausal Mood Changes – Perimenopause starts 8-10 years before menopause, usually in the mid 30’s- early 40s, and includes the development of or changes in the severity of pre-menstrual symptoms, new onset or worsening menstrual headache or migraine, insomnia, reduction in or loss of libido and sexual function, and brain fog as well as physical symptoms like heavy bleeding and weight gain.

Menopausal Mood Changes – Menopause marks the cessation of menstrual cycling and is diagnosed when women no longer have a period for 12 months. This occurs in most women between 45-55, with the average age being 51. Women in menopause will no longer make estradiol or progesterone, and will often experience a significant loss of testosterone. Once we are in menopause, we will NOT STOP being in menopause. It is the SYMPTOMS of menopause that can change or go away over time.

The abrupt loss of estrogen and progesterone, as well as reduction or loss of testosterone, can cause significant and very challenging changes in mood, sleep, sexual desire, and function, as well as physical changes like weight gain, heart palpitations, vaginal dryness, and pain or urinary tract infections, changes in cholesterol levels and blood sugar, and joint and muscle pain. Women in menopause often experience brain fog, memory changes, and emotional changes related to shifting relationships with partners, children, aging parents, and friends.

Menstrual-related mood changes, at any time during a woman’s lifetime, can create significant challenges and loss of stability in relationships, work, and most importantly, self-image and self-worth.

Addressing the mood-related changes experienced by women during reproductive, peri-menopausal, and menopause stages is critical to the health and well-being of women, their partners and families, and more broadly, their workplace and communities.

In a conventional allopathic system, menstrual-related mood concerns are often treated by busy obstetricians/gynecologists or primary care providers who may not have experience with hormone balance or integrative behavioral health modalities.

Not infrequently women are simply prescribed medications that may cause uncomfortable side effects without addressing the symptoms.

Women are often prescribed benzodiazepines like Valium, Klonopin, or Xanax for anxiety and insomnia.

These medications can quickly create tolerance and withdrawal symptoms and can be very difficult to stop taking.

They can even cause use disorders (addiction). Talk therapy can be very helpful for some women, but used alone may not be sufficient.

Often the challenges of menstrual-related mood concerns can be the start of ongoing behavioral health concerns, which can be complicated by ongoing medication trials resulting in medication side effects that then must be addressed.

These side effects can include emotional numbing, sexual side effects, and weight concerns that further complicate the presenting symptoms.

Addressing the root cause of these changes, including hormone imbalances, nutrition, sleep behaviors, movement, and stress management can significantly improve symptoms and allow women to return to their best selves.

Isolation, loneliness, and stigma contribute significantly to the development of behavioral health conditions, including menstrual-related mood concerns.

We know from AA and other mutual self-help groups, as well as from work by innovative providers like Dr. Jeff Geller and Dr. Dean Ornish, that healing happens better when together.

Group medical visits improve depression, anxiety, loneliness as well as chronic medical conditions like heart disease and diabetes.

The shared experience facilitates healing through accountability, knowledge sharing, and most importantly, connection to others.

Group and individual interventions are utilized in this practice and I invite you to explore opportunities to connect with other humans. You will not regret it.

Integrative Behavioral Health is a treatment approach that is guided by me as a provider, but executed by the individual who needs healing.

This is not a passive approach to care. This is your journey, and you alone have the power to make the change.

We will create a treatment plan guided by your needs, your current ability, and life circumstances, knowing that this will be a dynamic process, changing with time as you improve, have a setback, or see a new vision for yourself.

This is your work, and I am here to provide you with resources and guidance to improve your functionality, your resilience, and ultimately your best self.

If you are interested in approaching Hormonal changes, Behavioral Issues, and Wellness with an Integrative Approach, please reach out to schedule a Brief Consultative Call. 

Integrative behavioral health is the approach I am striving to provide for individuals who come to see me. My clinical training and experience in primary care, addiction medicine, and functional medicine have allowed me to look at behavioral health conditions, including postpartum depression and anxiety,  with a much wider lens.

Medications may be utilized, but do not form the foundation of care. Exploring the root cause of your symptoms, physical and emotional, and empowering patients to heal themselves forms the foundation of care with Heron Wellness. 

What is Integrative Behavioral Health? I have been working on this definition for a long time, and after finding a definition of Integrative Health from the California Institute for Integral Studies. The components of this approach I have developed are based on my training and clinical experiences with patients over the years. 

Integrative Behavioral Health

Patient-centered, coordinated, whole-person care with a focus on healing and wellness of body, mind, and spirit.

Therapeutic Components

Allopathic Medicine – Medications as needed for physical and behavioral health conditions. Coordination with specialists as needed. 

Evidence-Based Behavioral Health Interventions – Referral and coordination of care with therapists, psychologists, and treatment programs 

Functional Medicine – Conventional and specialized laboratory testing and evaluation and education and support for implementing positive behavioral changes related to the 5 MODIFIABLE LIFESTYLE FACTORS - NUTRITION, MOVEMENT, SLEEP, STRESS MANAGEMENT, SOCIAL CONNECTIVITY

Hormone Optimization – Focusing on addressing imbalances in cortisol (fight or flight), thyroid, and sex hormones 

Complementary Modalities – 5- Needle-Protocol (ear acupuncture), mindfulness, nutraceuticals and botanicals. Coordination with physical therapy, acupuncture, massage, therapeutic yoga, energy work

Traditional Healing Practices – Referral and coordination of care with healers in the community 

If you are interested in approaching Menstrual Related Mood Conditions with an Integrative Approach, please reach out to Schedule a Discovery Call