Gynecology & Hormone Health

Our Obstetrics and Gynecology services are offered through the conventional medical insurance system. At times, when you are evaluated in the Ob/Gyn side of our practice, Dr Buchert may recommend that you transition to one of our Functional Wellness options to reach your goals.

As a Gynecologist, Dr Buchert offers the full range of conventional care to women of all ages, including evaluation for fertility problems, pelvic pain or pain with sex, difficult menstrual periods, infections, menopause, PMS/PMDD, hormonal imbalance, contraception, and metabolic issues. Our knowledge of Functional Medicine helps us give better answers for metabolic concerns, inflammatory conditions, and hormone imbalance and replacement (including thyroid) for pre- and post-menopausal women. We strive to treat women in the least invasive method possible, but when surgery is required, Dr Buchert is skilled in Endometrial Ablation, Laparoscopy, and Physician Assisted Robotic Surgery for hysterectomy, ovarian surgery, and other needs.

*Depending on a person’s personal health concerns and goals, Dr Buchert may recommend that you transition to one of our Functional Wellness options to get the most in depth evaluation and maximize your chance at resolution!

For most women, a routine annual visit with her gynecologist includes briefly reviewing her menstrual cycle, addressing contraceptive needs, performing screening tests such as a pap smear and mammogram, and testing for infections if needed.
In addition to these, other important points you may want to bring up in your visit are hormonal issues, problems with sex, digestive problems, overall nutritional balance and health practices, preparing for pregnancy before you get pregnant, and preparing for a smooth transition through peri-menopause and menopause, just to name a few!

Some suggestions for my patients:
1) Your menstrual cycle can be a barometer for your health. Don’t ignore irregular cycles, as they can be the first predictor of problems down the road with your thyroid, hormones, insulin levels, and fertility. Avoid taking a birth control pill to force your cycle into regularity without understanding WHY it is irregular in the first place!

2) Most women wait until getting pregnant to think about how to care for the body during pregnancy. At a minimum, we should be preparing at least 3 months prior to getting pregnant. For many women, there are important nutritional, hormonal, environmental, and genetic issues to address to maximize the chances of a healthy pregnancy. This preparation goes way beyond just taking a prenatal vitamin.

3) Make sure you know ALL of your contraceptive options – there is so much more out there than just the pill, including non-hormonal methods with a unique set of benefits.

4) Pap tests screen for HPV and changes in the cervical cells that can lead to cervical cancer. When abnormal, in addition to monitoring the cervix with more frequent paps, colposcopy, and biopsies, there are also important nutritional and environmental changes to make to maximize your immune system’s ability to get rid of HPV.

5) We all know about screening for breast cancer with mammograms, but don’t forget about the impact of nutrition, a healthy body weight, hormone balance, genetic screening, and environmental exposures on lifelong breast health. Think prevention over detection!

6) Always feel comfortable talking about concerns regarding your hormones, pain with sex, low interest in sex, problems with your partner, mood changes, and really anything that is bothering you – I want to hear it! Sometimes it is hard to bring up a topic you may feel self-conscious about, but don’t wait until the end of the visit to mention it. I want to listen and give enough time for discussion. I promise you are not alone.

7) As women, our bodies are incredibly complex and change so much through each decade and phase of our lives. Everything is connected! Any difficulty is best addressed through a whole body approach and root cause analysis rather than treating symptoms in isolation. Just suppressing symptoms may improve the way you feel in the short term, but eventually may lead to taking more and more medications, without providing health and balance.

8) Surgery is a big deal and historically a treatment of last resort. All surgeons (myself included) are happy to treat conditions with surgery, but make sure you really understand all of your alternative options. Often a surgery can be avoided, preventing possible complications for you down the road.

As a couple who worked through all of the trials and tribulations of fertility difficulties, my husband and I are acutely aware of how difficult this can be! Unfortunately this is a common problem – 1 in 8 couples have trouble getting or staying pregnant – so you are certainly not alone.

The standard evaluation for a couple who is having trouble conceiving includes:

  • Assessment of the woman’s ovulation (through menstrual history, basal body temperature charting, and hormone levels)
  • Assessment of the man’s sperm quality (through a semen analysis)
  • Assessment of the woman’s fallopian tube patency and uterine cavity shape (through a special ultrasound or x-ray with dye, called an HSG)
  • And possibly blood work for predisposition to abnormal blood clotting, infection evaluation, thyroid function, and chromosomal analysis from both the man and the woman

When the answer is not apparent through our conventional systems, however, a deeper investigation with nutritional analysis (including allergies/sensitivities and digestion/absorption of nutrients), stress impact evaluation, a more thorough look at hormones, and toxin exposure evaluation may also be useful.

During a time of fertility struggles the importance of consuming antioxidant rich foods, an array of fruits/veggies, nuts/seeds, herbs, and adequate protein daily cannot be overestimated. Lastly, stress response management and avoidance of environmental and food toxins also deserves 110% attention!

How our metabolism is functioning is critically important to the rest of our health! Unexplained weight gain or the feeling you can’t weight off no matter what you do, feeling fatigued and sluggish, or simply not feeling that you have the energy, vitality, and focus you want shouldn’t be ignored. I truly enjoy helping women figure out how to demystify a sub-par metabolism. At a minimum, we need a thorough thyroid and insulin evaluation, which for most us is more involved than checking a stand-alone TSH and fasting blood sugar. For many women, a more complete evaluation including an investigation into intestinal function, inflammation, digestive insufficiency, metabolic and nutritional imbalance, and the need for detoxification will provide a much clearer path to improvement!

So many people feel that their hormones are “off” and need to be “fixed.” While this may be true on some level, the best place to start is not just with a hormone prescription! Many other elements of our health directly contribute to hormone balance. A root cause understanding of how digestion, nutrition, fitness, detoxification, stress, genetic predispositions, and many other contributing elements will get you farther down the road of feeling your hormonal (or non-hormonal) best!  

For women who need hormone replacement for any array of reasons, I don’t just write a prescription for a pharmaceutical, but discuss all of your replacement options, as well as how to maximize nutrient elements and supplementation to make your choice as safe and effective as it can be!  I also work with Bio-Te Hormone Optimization System to take your feel good options the extra mile.  See our Special Services to learn more about this option. 

PCOS is an increasingly common gynecologic and metabolic imbalance that can include some or all of the following symptoms:

  • Irregular or absent menstrual cycle
  • Weight gain or trouble losing weight (though many thin women have PCOS too!)
  • Skin changes, including breakouts
  • Increased hair growth (and not on your head!)
  • Mood changes, including anxiety and/or depression
  • Multiple cysts on the ovaries, seen on ultrasound
  • Insulin Resistance
  • Infertility

The common conventional treatments for PCOS include taking a birth control pill to regulate the cycle, and possibly taking Metformin for insulin changes and Spironolactone to decrease free testosterone levels.  These things are important and helpful, however they do not get to the root cause, and do not help the body heal from the imbalance causing the PCOS in the first place.  You will still be at increased risk in your life of diabetes, heart disease, mood symptoms, and uterine lining cancer.  You also may still have trouble getting pregnant (even if you use a medication called Clomid, commonly used to induce ovulation).  And lastly, if you are able to get pregnant, you are at a higher risk of pregnancy complications such as gestational diabetes and pregnancy induced high blood pressure, and other problems that can affect your child’s metabolic expression for the rest of his or her life!

So as you can see, addressing PCOS in a more complete way than our conventional systems provide for is extremely important!  Contributing factors that can be involved include:

  • Environmental/Food/Chemical sensitivities leading to Chronic Inflammation
  • Digestive and Microbiome imbalance
  • Genetic predispositions requiring advanced nutritional support
  • Micronutrient deficiencies
  • Toxic body burden interfering with appropriate metabolic functioning

For any woman, young or older, who is interested and motivated for a more complete approach to understanding and treating PCOS, there is fortunately a way to help you!

Dr. Betsy BuchertGynecology & Hormone Health