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Interview with Dr. Christiane Northrup
on Menopause, PMS, Nutrition & many other Women's Health issues


Christiane Northrup, M.D., after being trained as a medical doctor, eventually co-founded the Women to Women Health Care Center in Yarmouth Maine, which became a model for women's clinics nationwide. Her book Women's Bodies, Women's Wisdom is a comprehensive women's health book that has become a bestseller and an inspiration to many women.

Interview by Janice Hughes and Dennis Hughes, Share Guide Publishers

Share Guide: I have read that a lot of women go to the doctor with your book Women's Bodies Women's Wisdom and ask questions. It seems that women are owning more of the responsibility of becoming a partner with the doctor in maintaining their health. Also, the internet has become quite predominant, so people can actually be in touch with you and other women healers and learn about cutting-edge research online.

Dr. Christiane Northrup: Yes, I consider that a godsend. None of this information will work unless you're also engaging your own intuition, because you have to be able to choose the treatment, the modality and the health practitioner that's going to work for you. Things have become more complex. Back in the 50's you went into the doctor and he said, "Mrs. Jones, this is what you do. I'll take care of you. You just follow my orders and you'll be fine." There's something very comforting about having an authority figure tell you exactly what to do. It doesn't work, but it can be comforting. Now no one can go back to that mindless way of being and expect it to work. You've got to own your own authority, and there's many people who would rather not.

Share Guide: Osteoporosis is a concern for many women. What do you think is the best approach to prevent it and what do you think about estrogen therapy for osteoporosis?

Dr. Christiane Northrup: There is a saying everyone needs to know: Osteoporosis is very common in women who are depressed and that is one in four women. It's because of higher cortisol levels than normal. That is the stress hormone. I think that is the predominant cause of osteoporosis--depression and unabated stress resulting in a hypercortisol state that dissolves the bones over time. Most women, the vast majority, will not get osteoporosis that will lead to a fracture if they take enough calcium and magnesium and also do regular weight bearing exercise. That includes lifting heavy weights. Women need to lift dumbbells that are up to 20 pounds.

Share Guide: Would you say then that brisk walking, although it is good for you if you do it every day, it's not enough exercise?

Dr. Christiane Northrup: It depends on the woman. A black woman has far less risk of osteoporosis because the collagen layer is much stronger. Asian women also have a little more melanin in their skin, and have a little more collagen in their bones. The birdlike Caucasian women--the ones who are real skinny, and very fair, with blonde hair and blue eyes--they have the highest risk. And that group is the least likely to lift weights. They are the ones that like to do the running and the long walks. But they are the ones who need the weights. I've also seen osteoporosis in a lot of women who do yoga. But if you are of a sturdier genetic stock, you don't need to do the weight training as much. It depends on your unique constitution in the first place, and it also depends on getting adequate vitamin D from the sun. We have vilified the sun in our culture to the point where no one gets any sun on their skin without a 30 SPF sunscreen. You need some daily doses of sun on the skin, and this will often build healthy bones.

Share Guide: How much sun are you talking about?

Dr. Christiane Northrup: Depending on your skin tone, about ten minutes of early morning sun or late afternoon sun; never at noon. You can build up to 20 minutes a day over time as long as you never get a reddening of the skin. Then you are getting a healthy dose of vitamin D. If you live in the northern climes like I do, that will actually last you from the end of October through the beginning of March, because you don't get the ultra violet rays that will make vitamin D during those winter months. We do know that women's bones get thinner over the winter, but can build back up if they get some natural vitamin D on their skin. You can also take cod liver oil and vitamin D supplements, which is helpful.

Share Guide: What your describing is a little bit different than lying in the sun for hours though.

Dr. Christiane Northrup: No, you definitely don't want to do that.

Share Guide: You have written that breast cancer is the leading cause of cancer death in women who are 40 to 55, which is the typical Share Guide reader's age. What would you recommend as the best approach to guard against breast cancer?

Dr. Christiane Northrup: Living wholeheartedly in partnership, where you give and receive equally. I have so much to say about breast cancer. First of all, let me talk about mammograms. What they have done, unfortunately, is they have led to the frequent discovery of what's called ductile carcinoma in situ. But this may not be cancer at all. Autopsy studies have shown that 40% of women age 40 to 55 who died in accidents and were perfectly healthy, were found to have ductile carcinoma in situ if the pathologist sections the breast and looks at every bit of it under a microscope. What this means is that this is something you may die with but may never die from. We now have a whole screening program that picks up something that we would never die from, and it scares women to death because they are being told they have cancer stage zero which isn't cancer at all. So we need to understand what we are doing. By focussing on breast cancer awareness, I believe we have increased the incidence of it through the screening and with the attention to it. Women are actually led to believe that they were saved from breast cancer by having a breast removed with ductile carcinoma in situ, when in fact earlier and earlier diagnosis is not the whole answer. The other answer is EXERCISE. We know that women who exercise an hour a day have a 30% less chance of getting breast cancer. Those who nurse a baby one to two years also have less chance of getting breast cancer, and those who eat the most fruits and vegetables have less risk. I would rather we shift the focus to breast health. This includes the awareness that our breasts have the ability to be healthy, and that we can touch them and examine them with love and encouragement instead of this "search and destroy mission" breast exam that women are taught to do. By the way, the latest data from a huge study in China showed that breast self-exam did not do anything but increase the incidence of biopsy for benign conditions.

Share Guide: So living in a fear mode is bad, I agree. Here's another question. Marin County, California, near where I live, has been identified as having one of the highest breast cancer rates in the nation. Are you familiar with this, and do you have any idea why this is?

Dr. Northrup: They say the same thing about Long Island.

Share Guide: Is it the upwardly mobile, highly stressed, no time off type person?

Dr. Northrup: Yes, and the women who get superior medical care. Superior medical care in this particular instance is yearly mammograms and doing all the right things, but it is all in the fear mode. Here is the other thing: we are the baby boomer generation. We decided we could do anything a man could do. We went out there to get the degrees and get the careers and the whole thing. Many women did not have families or hadn't figured out how to balance a family with a career. As you know, women are doing more now than they have ever done. I think that this has led to a profound imbalance in the fourth chakra--the emotional center area which is the heart, the lungs, the breasts, the shoulders. We know that lung cancer is the number one cancer killer of women overall, but heart disease is hands down the winner in terms of premature death--about six times the death rate of breast cancer. All of them, though, are fourth chakra issues. I believe that women are just beginning to address how to work in the outer world while still longing to be home caring and nurturing their families in the inner world. In the past, the men went out to work, and the women stayed in the home. If you talked to women like my mother, she said that the men ruled everything. She couldn't take out a loan on her own. But again, just like going to the doctor and being told exactly what to do, it was easier for many women. This is your place, you are in the home, your job is to make the meals and I will go out and slay the dragons. Now what's happened is that the masculine and feminine is so imbalanced that women are doing all the tasks of the masculine as well as all the tasks of the feminine. She is supporting everything and everybody. That is the setting in which breast cancer is most likely to occur.


Share Guide: So this is what you refer to in your book as the pattern of over achieving. I believe you wrote that the antidote to that was taking time to listen to body signals, resting, and having vacations.

Dr. Northrup: That would be it. Of course, you are going to have to deal with your guilt if you rest, if you have fun--because you have been brainwashed into thinking you are not worthy as a woman unless you are a human doing instead of a human being.

Share Guide: If you have a body you are worthy of being healthy, if you ask me. If you are going to be healthy, you should listen to your body's signals and you should have some rest in your work week. All of my successful mentors take regular time off through the year to get away.

Dr. Northrup: If you are a woman, you are trained, especially if you want a career, that you have got to pay extra dues to have a home and a family. "Oh my God, he is going to LET me go to work!" We are still brainwashed into thinking that the husband knows best, or "Thank God at least I have a man so that I look normal." I see this as an evolutionary thing, not as any personal theory. I think it's just where we are in our culture now. I think it will be my daughter's generation that comes to more gender equity in the relationships of the heart. You and I both know it's much easier for a guy to go out and get his nurturing needs met if he divorces somebody when things get rocky at midlife. He'll just go marry someone 20 years younger and start over, instead of actually doing the transformational work of the heart. My antidote to all this is that you have to have partnership with your Self--that is what midlife is about, finding partnership with yourself.

Share Guide: Since your most recent book covers the subject of menopause, I'd like to ask about this subject. You write that menopause is a lot more than just raging hormones, that it's actually a time of total transformation. Can you elaborate on this for our readers?

Dr. Northrup: The female human body has various stages when you are more apt to be in touch with your spirit or your wisdom. One of those is just before your menstrual period is about to begin; one is during birth and postpartem and during breast feeding; and the last period is during menopause, including perimenopause and the years leading up to menopause. If you don't pay attention to the material that comes up premenstrually each month, which is like a pool backwash system, then nature gives it another opportunity. What happens to women premenstrually is they say things like "I am not myself. I'm like Dr. Jeckyl and Mr. Hyde." But it is them. It's a part of themselves that they have pushed down and disowned--perhaps the angry part, or the part that feels ashamed. At menopause, all of this comes up to be cleansed. It's like a sewage treatment plant of your life. Your body is trying to clear all this out for the second half of life, because during this time you are going to be fuelled primarily by your spirit and your connection with your soul. When you can make that connection, it's as though your body gets fuelled by light. It is the most amazing thing after menopause, seeing people doing better than they've ever done. Relationships heal, things that no longer work leave your life, bodies can transform. What our culture does with that is try to make it a hormone deficiency or a Prozac or Zoloft deficiency. But there is an opportunity for growth which comes in the form of rage, or sometimes the need to be alone, etc. We take those symptoms and lead people to believe that they are caused by a deficiency of the human female body, when in fact they are simply the message of our soul knocking on the door of our heart and asking us to change something. That's what menopause really is--a kind of mother of all wake-up calls!

Share Guide: I know there is no one-size-fits-all answer, but do you recommend some form of hormone replacement therapy for women with menopause?

Dr. Northrup: Some women do very well with bioidentical hormones. One in three women currently have had their ovaries removed. This is a lot of women who do not have the benefit of their own ovaries in connection with their adrenals, which would usually link during the 13 year transition known as menopause. These women may benefit from a little estrogen or a little progesterone or possibly a little testosterone, but in no case should these be the conventional hormones that are synthetic. This is important for people to know: you cannot patent a naturally occurring hormone. The hormones that naturally occur in the human female body have been altered so that the drug companies can justify the R&D programs to patent a hormone and therefore make their money. It's frightening! I'll take my chances with the hormones that mother nature has taken at least 3 million years to come up with.

Share Guide: This is what you mean by bioidentical?

Dr: Northrup: Yes. Examples would be Climara, Vivelle or Estraderm. These products are biochemically identical to what the human body manufactures, and that is what you are looking for. These hormones are available as a skin patch. The drug companies have patented the patch technology, and I consider that a beautiful marriage of technology and nature's wisdom. People will tell you that Premarin is natural--yeah, it's natural if you are a horse! That is why the term bioidentical came into being. It's more precise than "natural."

Share Guide: You have a good quote in your book from a Dr. Joel Hargrove who said in reference to the popular HRT therapy, "Premarin is a natural hormone if your native food is hay."

Dr. Northrup: Right. Dr. Hargrove was actually the first person to patent bioidentical progesterone in an oral form. He grew up on a farm and knew early on that giving women things like synthetic progesterone (such as Provera or Depraprovera) was not good at all. The reason why it is so effective as birth control is because it makes women so ornery no one wants to come near them! These are things that women need to know.

Share Guide: What about not taking anything and letting nature take its course?

Dr. Northrup: Yes, that would be the first thing you would want to try. But then again, let's say you are 38 years old, and you are in there for a fibroid surgery or something, and you didn't know any better, so the guy says let's take out your ovaries while we are in here, and that will prevent ovarian cancer later. Because women are trained to be terrified of their bodies, they agree to this. This is the kind of woman who is going to need hormones for a while. For the women who have healthy ovaries and healthy adrenals, they may not need them. But you have to do some nutritional support, such as omega 3 fats, and B vitamins to help clear estrogen dominance from your system. When you skip ovulations and you don't have progesterone to balance the estrogen, that can create a state of anxiety, jitters, and headaches. (That is also a drive for the brain to change things in your life.) So you might want to take some soy or ground up flax seed, which helps a great deal to give you plant hormone support while your body is making the transition.

Share Guide: No discussion of women's health would be complete without talking about smoking. You've written that one out of every six deaths in America is related to tobacco, and that once hooked, women are less likely to quit than men. There are many women that are health conscious and yet haven't given up their cigarettes. What are your thoughts on this?

Dr. Northrup: The problem with women is that tobacco is used for weight loss and weight maintenance. Many Hollywood actresses who are role models for young girls smoke. I think it's absolutely tragic that women are still saying that they would rather be dead eight years earlier than be fat. That's one of the big problems. Also, smoking shuts down emotions. It shuts down feeling; it shuts down the energy of the heart. What you really have to do is all that inner work of getting in touch with your pain and your sadness and your fear of feeling it and allowing it to be released.

Share Guide: And follow your breath. Smoking is often the urge just to take a deep breath and let out a sigh.

Dr. Northrup: I'm glad you brought up the breath, because if you're breathing in fully and especially breathing out fully through your nose, it activates the vagus nerve in the lower parts of your lungs. This not only aerates your lungs more but it fires up the parasympathetic nervous system, so each breath is actually a way to restore your body. Many women just breathe in the top part of their lungs. Tell them to take a deep breath and they raise their shoulders. When you take a deep breath, I like to see the lower part of the lung and the lower part of the chest expand. The shoulders should stay where they are. When you breathe fully, it's actually part of the digestive system of the emotional body.

Share Guide: So hypothetically, instead of taking a five minute smoke break, you could go outside and walk in the fresh air. You could take five minutes just to watch your breath. In reality, I know there are chemical reactions when you smoke tobacco, but part of it I think is just related to the breath. If people did the breathing that they do with the cigarette, without the cigarette, I think that they would find they'd probably get half of what they get out of a cigarette without the cigarette. Does that make sense?

Dr. Northrup: Yes. Deep breathing would increase endorphins and tap into the natural morphine-like substances in the blood.

Share Guide: How do you feel about the health effects of birth control pills and what about the new patch that's now on the market?

Dr. Northrup: I have to tell you that compared to an unwanted pregnancy, birth control pills and the birth control patch are fine. When someone goes in for the third or fourth abortion because they don't believe that birth control is natural, then I have to say, well this is certainly imbalanced. So, if you're not going to use anything else, then by all means use birth control pills or the patch. Actually, I think that the patch is very good. At least the hormones go right into the blood and they don't have to go through the gut circulation and increase the enzymes in the liver. So I think that that's actually a little safer. But these are all made from synthetic hormones. It's the same stuff that we found didn't work so well in the women's health initiative.

Share Guide: So what is the best way to go for birth control?

Dr. Northrup: The best way to go for birth control is to be in a committed relationship where you use a barrier method like condoms or a diaphragm, or if you have a child an IUD can be just fine. If you're not in a monogamous relationship, you need some other protection besides birth control pills. You need protection against sexually transmitted diseases, such as the condom. While we're on the subject, let me just say that this epidemic of oral sex among teenagers is a problem. I don't have the statistics, but apparently about 25% of teenagers have oral sex with multiple partners thinking that it's safe, whereas intercourse is not. But this is certainly not true.

Share Guide: Because you're still exchanging fluids?

Dr. Northrup: You've got it. What I'd love to see are women valuing their bodies and their sexuality enough to discuss this stuff with their partner. Go get an AIDS test or a gonorrhea test or whatever. You need to do all this stuff before you actually have sex. But I understand that that's another planet besides Earth, so given that, I would prefer women use something to protect them. Ideally, women would value their bodies so much that they would say to any prospective sexual partner, "I don't want to be on the pill. I don't like what this does to me. If you value your relationship with me you will use a condom." Also, one of the problems with the pill is it can decrease libido, and it puts you out of touch with your lunar cycle. Instead, you get in touch with the cycle of the pharmaceutical company! It kind of puts your pelvis to sleep for a while.

Share Guide: Many girls these days are reaching puberty at very young ages. There also seem to be more women entering menopause early. I hear this is due to the proliferation of chemicals and toxins in our environment, and hormones in our food. Do you know anything about this?

Dr. Northrup: I think most of the early puberty is because kids are being overfed the wrong stuff. We have an epidemic now of childhood obesity. When body mass index (which is the ratio of height to weight) goes up, then puberty tends to come earlier. Girls who have a lower percentage of body fat tend to not go through puberty until later. At the turn of the century, Native American girls tended to get their first menstrual period at the age of 17. But if you are overweight, you are going to get your period more likely at age 9, 10 or 11. And yes, there are estrogens in the environment and so on that aren't helping this any. Again, it is one of those cases where it's easier to point the finger at someone else than to look at your own behavior. The other thing that I think is driving this relates to something that Rudolph Steiner said, the founder of Waldorf Education. He said that when you over stimulate the areas of the brain that have to do with reasoning, reading, learning and sexuality, you are actually promoting premature puberty. So you have the Britney Spears generation--little girls running around with their midriff tops and so on. They are over sexualized and they are also pushed academically. Kids don't have any down time. I believe all of this contributes to growing up too fast, which manifests in the body as premature puberty. Most women with early puberty go through menopause later. This is another reason for the incidence of breast cancer, because the breasts receive too much estrogen for too long.

Share Guide: Many women are now choosing to have babies in their late 30's and early 40's. There is still a stigma in some people's minds that this is unsafe. What do you think about that?

Dr. Northrup: It depends totally on the biological age of the woman. There are women that I have seen at 40 who have a biological age of 25, so there is absolutely no problem. I don't have any trouble with older women getting pregnant except that I will say this: In the grand scheme of life, one of the things that happens as you approach 50 (or even by your mid 40's), is that your energy is tending to turn inward as you prepare for the second half of life. It just happens. We are living things just like the plants and the trees. So when you have a two year old running around, and you are going through this kind of withdrawal phase to reassess your life, it can be psychologically more difficult. My advice to women would be that if you possibly can, and it's convenient, it's nice to have a baby before 35, just for the future and the way life is. On the other hand, women are much younger now at 50 than they were 20 years ago at the same age. I think that we are actually younger biologically, if not chronologically. Having a child then and living through a child's eyes can be a very good thing.

Share Guide: In the past you have written about the medicalization of childbirth. How do you feel about midwives and the trend of having babies at home?

Dr. Northrup: I just love it! But this is heresy for a board certified obstetrician and gynecologist to say. The truth is that in other countries, such as Holland, the majority of babies are born at home with midwives. Birth is a natural process and women who have babies at home with a midwife are bringing a child into the world in the most loving setting, with utter trust in their bodies and their ability to birth normally. There is a childbirth educator who says that the way a woman gives birth is the way the woman would be a mother. So being at home or being in a birthing center with a midwife, the trust you develop in your body by going through that process (normally in an unmedicated way), imprints your body and that of your baby with a sense of safety and security in the universe that is so potent you can never talk a woman out of it. It's very exciting to have a baby that way. And you are much less apt to be scared of your body from that moment on.

Share Guide: Do you think hospitals and doctors are becoming more holistically oriented toward childbirth these days?

Dr. Northrup: I think there is far more choice in the hospitals than there ever was before. There are hot tubs that you can get in and labor in the water and so on. Most hospitals, however, still run on a schedule. Unless you go to one that has true family-oriented birthing care, there's still this sense that the clock is ticking when you go in there. If you don't go into labor within a certain amount of time, they are apt to give you pitocin, which is an artificial hormone to make your uterus contract. We are seeing now far more labor inductions. Even though there is a tendency for more choice with birth, we have far too many women choosing induction of labor for convenience. "My mother is coming in on the nine o'clock plane. I'd like to have the baby today, thank you." That kind of thinking is on the rise. And with induction, there is an increase in caesarian sections. Too many women are having caesarian birth. Some women are choosing, believe it or not, elective caesarian birth to prevent things like urinary stress incontinence later in life. This is despite the fact that there are studies showing that nuns who have never had children are as likely to get urinary stress incontinence later in life as are women who have had normal vaginal birth. So there is still a medicalization of childbirth. When I was a medical student, labor induction was very popular. Then it went out of favor because the fetal monitor came in and you could see the effects of hyperstimulation, and contractions that were too difficult, and so on. Now it is back in. It kind of goes along with that whole mindset of "I'm going to plan my life around my palm pilot." That is not the wisdom of nature.

Share Guide: PMS is a big problem for many women. You've written that there are a lot of nutritional factors contributing to PMS.

Dr. Northrup: Yes. Over consumption of caffeine is a big one, and alcohol, and not enough B vitamins or omega 3 fats. The beauty of PMS is that the menstrual cycle puts us in touch with an innate cycle like day and night, or like the seasons, so that you have a time of outward activity in the world, then inward rest and reflection. Just before your period starts and during your period, that is a time of inward rest and reflection. Women need to follow that and their bodies will work much better. But we live in a 24/7 culture, which teaches us that we need to be equally productive all the time, without ever having the field lie fallow to replenish itself. PMS stems directly from that inability to rest and restore.

Share Guide: You've written about hysterectomies being performed for the wrong reasons, and that there are good reasons for women to keep their reproductive organs. Are doctors still performing hysterectomies too frequently?

Dr. Northrup: Yes, and women need to start valuing these organs more. There are many alternatives. A lot of women don't want to change their diets, or go through the introspection of why they are having health problems. Now I don't want women to make a career out of trying to keep their uterus. I've seen women do that for 10 years, fighting heavy bleeding, etc. There's a place for everything. But if you are living according to your inner guidance and in tune with the seasons, the rates of all these things (ovary removal, uterine removal, etc.) would just go down to nothing.

Share Guide: Chronic anxiety has been recognized as contributing to poor health. It seems to be pretty common among working women. What's going on with this huge proliferation of prescription drugs such as Prozac and Zoloft? If you believe the TV ads, anytime you are stressed you should just pop a pill.

Dr. Northrup: In women, anxiety and depression have a huge overlap. Of course, all the original depression and anxiety studies were done on men, and the drugs were designed for men. But in women, the two areas of the brain have a huge overlap, so often anxiety is depression, and depression is anxiety. It's related to what is going on in the person's life, but they don't want to really look at. Here is what happens: You are really terrified that your marriage isn't working, but instead you focus on making sure that everything you put in your mouth is organic. Then you sneak around and smoke, or pop a little Zoloft. If you try to cover up the big stuff, your body is going to keep giving you the signal and it's going to keep upping the game. But the drug market is so huge! If you spend much time watching television or reading newspapers, you are actually being barraged with the bad news from all over the world. If you have ever worked in journalism, you know the deal, "if it bleeds it leads," therefore they choose the news to have an effect on your arousal system to make you even more anxious.

Share Guide: So turn off the TV and meditate, or go for a walk.

Dr. Northrup: Right! 50% of mild to moderate depression can be cured by exercise. Basically, regarding anxiety, it all comes down to that saying, "feel the fear and do it anyway." It's at midlife that many women get agoraphobia. They just trap themselves in a corner and become paralyzed with anxiety. Sooner or later they need to do whatever it takes to put one foot in front of the other. Otherwise those habits become so well worn that they become holed up somewhere completely dependent on their family to take care of them. A lot of anxiety issues are dependency issues. It's women being overly dependent.

Share Guide: Issues of weight and body image are very important to women, as we've talked about. There are many women with eating disorders. Can you comment on that?

Dr. Northrup: I think it all relates to the "fast food nation" we have become. If you go to Europe, you don't see nearly the rate of obesity or the rate of eating disorders. I think it's because of the way in which meals are incorporated into the day. Meals have more ritual and more nourishment associated with them. People breast-feed their infants for at least a year, if not two. The pace of life is slower, therefore there is a feeling of being nourished. All eating disorders, at their base, are a lack of nourishment at the soul level. You just don't feel like you are taking in nourishment.

Share Guide: Many girls these days are reaching puberty at very young ages. There also seem to be more women entering menopause early. I hear this is due to the proliferation of chemicals and toxins in our environment, and hormones in our food. Do you know anything about this?

Dr. Northrup: I think most of the early puberty is because kids are being overfed the wrong stuff. We have an epidemic now of childhood obesity. When body mass index (which is the ratio of height to weight) goes up, then puberty tends to come earlier. Girls who have a lower percentage of body fat tend to not go through puberty until later. At the turn of the century, Native American girls tended to get their first menstrual period at the age of 17. But if you are overweight, you are going to get your period more likely at age 9, 10 or 11. And yes, there are estrogens in the environment and so on that aren't helping this any. Again, it is one of those cases where it's easier to point the finger at someone else than to look at your own behavior. The other thing that I think is driving this relates to something that Rudolph Steiner said, the founder of Waldorf Education. He said that when you over stimulate the areas of the brain that have to do with reasoning, reading, learning and sexuality, you are actually promoting premature puberty. So you have the Britney Spears generation--little girls running around with their midriff tops and so on. They are over sexualized and they are also pushed academically. Kids don't have any down time. I believe all of this contributes to growing up too fast, which manifests in the body as premature puberty. Most women with early puberty go through menopause later. This is another reason for the incidence of breast cancer, because the breasts receive too much estrogen for too long.

Share Guide: Interesting. The nurturing qualities of women are essential to healing. What percentage of medical doctors are women today, and is this growing?

Dr. Northrup: Yes, it's growing, I know in OB/GYN it's over 50% of the people entering the profession are women. I consider this a very good sign. But on the other hand, it's not just the MD's and the DO's--we have nurse practitioners, midwives, physician assistants, acupuncturists, homeopaths. I am really thrilled by the growth of complementary practitioners learning ancient systems of health care. When I look at my own health care, I go to an acupuncturist; I don't go to a MD.

Share Guide: What do you see on the horizon for women's health care?

Dr. Northrup:There is nowhere to go except inward. I think for the next decade or so we are going to have a two tiered system. We will have people like you and me who are increasingly aware and doing exercise, yoga, and eating lots of organic vegetables, and so on. Then we will have the other system which is the old rescue model, and that will continue on. What we are going to find is that that old rescue model is simply not sustainable economically. That will lead to the collapse of the medical system as we know it. There will be increasing incentives to keep your weight normal, to exercise, to not smoke, and so on. For example, there's the Adverse Childhood Experience Study, which was out of San Diego Kaiser Permanente Group. The Kaiser people started a huge study of something like 60,000 people. They found that well over 50% of the people had some major adverse childhood event, such as someone in prison, an alcoholic parent, and so forth. These were the people who were consuming the most health care--emergency room visits, drugs, and all of that. It was middle class, middle aged people. We are going to have to look at this and start with children. We need to start with cognitive behavioral therapy. We are going to have to look at the way certain mental health categories are eating up the money.

Share Guide: You are right. When I am a senior, I don't know how senior centers are going to look, but I'm hoping that they will be more holistic. When I am really old, whether I am living at home or at a center, I see myself teaching Tai Chi and Yoga. I haven't taught them yet but I have been a student of them for so long, by then I certainly will be able to help those around me.

Dr. Northrup: I have a couple of friends who are doing that. One is teaching at a senior center and she is 85. This is what we will be doing!

Share Guide: You mentioned heart disease earlier. Many people do not realize that heart disease is the leading killer of postmenopausal women. I've read about the connection between diet and heart disease, and specifically about over-consumption of carbohydrates as a risk factor. Can you talk about this a little?

Dr. Northrup: Absolutely. As you know, we now have an epidemic of diabetes. If you are Black or Hispanic, you've got a one in two chance of having adult onset diabetes. Adult onset diabetes gives you too much glucose in the blood at all times, which is a precursor to plaque in all of the arteries, and in the heart. Excess glucose in the blood actually increases the triglyceride level in the blood as the sugar gets converted into blood fat, and it's associated with obesity as well. That is usually due to the consumption of too many white foods. White bread, white flour, and so on. And it's more than that; it's eating the foods in a quick manner. Ever go to the airport and see these awful places where you are supposed to stand up and eat your food?

Share Guide: Dr. Barry Sears, the creator of the Zone Diet, recommends a diet that carefully balances carbs, proteins, and fat. He talks about the average diet being too high in carbohydrates, and it seems that what you are saying is in agreement with that regarding postmenopausal women and heart disease. Is that right?

Dr. Northrup: It is. The only thing I don't like is the 30/30/40 ratio that Barry Sears recommends. It is too cumbersome. I remember when Barry's first book came out and I started to switch over to that kind of diet in the late 1980's, early 1990's. It clearly made a huge difference in how I felt. Before then, I had been on a kind of macrobiotic diet, with the addition of fish. I ate way too many carbs, because even brown rice, if it's taken to excess, can be too much even though it's a complex carbohydrate.

Share Guide: Yes. Many vegetarians don't have balance and eat too many carbs.

Dr. Northrup: That's right. What I was noticing in all of my patients, as well as myself, was hair getting dull, splitting fingernails, and then as midlife approached, this weight gain that you just couldn't seem to exercise away. So I think that Barry Sears made a huge contribution to the literature with his focus on the'"eiconsanoids," those evanescent short lived hormones in the cell that actually drive the metabolism of the cell. What he pointed out is when the diet drives up toward excess series-two eiconsanoids, then we get inflammation, cancer, heart disease, and so on. By the way, all the major drugs like Celabrec, aspirin, Advil, all those drugs work by blocking the series-two eiconsanoids like prostaglandins and cytokines, so they're working at the end organ level to block something that started way upstream--from diet and stress and so on.

Share Guide: Consequently that's symptomatic?

Dr. Northrup: You've got it. If you can move upstream and change your diet to fewer and healthier carbs, more protein, and the right kind of fat, then you're going to create the biochemistry of balance in your body. Particularly important (and I know Dr. Sears talks about this), are the omega 3 fats found in salmon and other cold water fish, flax seed, and so on. With the right diet you think more clearly and you lose weight more easily. I think for midlife women, Dr. Sears' Zone Diet works better than the Atkins Diet. Atkins starts with an induction diet, where virtually no carbohydrates are allowed. Well, the body of a midlife woman is going to do everything in the power of nature to maintain weight because body fat is like a third ovary. It produces estrogen and hormones. That's why women gain weight at midlife. The body is just desperate to keep those hormones balanced. Also, if you do an Atkins diet, what's interesting is that it can be so high in fat that your weight doesn't budge. I personally gained weight on the Atkins Diet, during the induction part. But for the woman with an apple shaped figure, the ones who are prone to diabetes and so on, the Atkins Diet may work fine, and so will the Zone Diet, and so will using protein powder. The bottom line is just fewer carbs. And when you do eat carbohydrates, make them good ones. But I don't know too many women who are going to go without dessert for the rest of their lives. So when I go out to eat, and I have to have dessert, I share it with someone, and I really savor it. You want to really enjoy it, because the way you eat your food actually changes the way it's metabolized, and contributes to whether or not you gain weight or whether or not you get high blood sugar. You probably know about the slow food movement that originated in Italy.

Share Guide: Right. If you eat that dessert slowly and savor each little bite because you're not going to have a giant piece, that's a lot better than feeling guilty about having it.

Dr. Northrup: Yes, and it doesn't even register in your body. You don't feel satisfied.

Share Guide: Right. You block the joy, and it's all about the guilt.

Dr. Northrup: Yes. And if you are going to eat on the run, have a Balance Bar or something like that. Those things are a great invention in my opinion.

For more information about Dr. Christiane Northrup and women's health, visit her website at www.drnorthrup.com

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