How to Conduct an Effective Assessment of Female Hormonal Issues

Bruce Bond DC, DACBN

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Standard Process has not evaluated the legal status of any products (other than its own or those of MediHerb®), services, or recommendations with respect to state or federal laws, including scope of practice. Standard Process does not and cannot accept responsibility for errors or omissions or for any consequences from applications of the information provided and makes no warranty, expressed or implied, with respect to the information provided.

Dr. Bond’s recommendations for Standard Process product dosages are sometimes different than the dosages that appear on the product labels. Please refer to the product labels or to the product descriptions found in the product catalog or online at standardprocess.com for the Standard Process dosage recommendations.

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The Consultation• The motives of our heart must be right.

− People over money− Honesty over gain− Service over self

• Our partner in the conversation should be the benefactor.• Have an outward focus instead of an inward one.• An opportunity to connect with another “unpredictable miracle” in need.• An opportunity to lead someone down a different path.• Someone who is hurting both physically and emotionally is turning to you

and by their presence saying, “Can you help me?”• We are given a tremendous responsibility, and it is not to be taken lightly.

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During the Consultation Patients Will Ask Themselves:1. Do you care about me?• Character

− Defined: the sum qualities that make up an individual• “If I take care of my character, my reputation will take care

of myself.” —D.L. Moody• Character comes from within. Reputation comes from

without. − “Life is built on character, but character is built on

decisions.” —Andrew Wiersbe• Character is built over a lifetime.• Our speech has the capacity to unveil thoughts, feelings,

and emotions to reveal the person behind the words.

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During the Consultation Patients Will Ask Themselves:2. Are you credible?• Credible comes from the Latin credibilis meaning “worthy

to be believed.”− A credible witness’s testimony is trustworthy. If you are

credible, then you are to be believed and thus trusted.• Credibility/trust is initially given then earned. • Credibility is not about what you do or say. It’s about who

you are on the inside.− If we don’t make wise choices, then what message are we

sending to others?• You cannot fool people forever.• Your influence will have a lasting impact in direct

proportion to the integrity and authenticity of your life.

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During the Consultation Patients Will Ask Themselves:3. Can you help me?• Nobody wants to be sold, but everyone wants to be

helped.• The above is why it is important to focus on benefits,

not features. A feature may be not be relevant to the patient, but a benefit always is.

− People buy benefits, not features.− What’s in it for me? (WIIFM)

• What does the patient need to know? Not what does the clinician want to tell the patient.

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Communication

• Having a good product and becoming an expert on your product or your service is not enough.

• Capture the heart, and the rest is likely to follow.− A logical line of reasoning will not, in most

instances, cause one to change behavior.• Do people know they need to eat better and

exercise more?• Do most people know they need to spend less

than they make?• Do most people know they shouldn’t …?

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Communication• “The difference between the almost right word and

the right word is really a large matter; it is the difference between a lightning bug and the lightning.” —Mark Twain − Words can heal. Words can kill.1

− Words can tell. Words can repel.1

− Words and lead. Words can impede.1

• Our words can put another on a new path.• Our speech has the capacity to unveil thoughts,

feelings, and emotions—to reveal the person behind the words.− Our words should outlive us.

1. Hall, Kevin. Aspire. New York: William Morrow, 2010: IX. 8

Eliciting Their Story• It is important to ask questions to better understand what is

occurring.• Most patients present with multiple, vague, and unsmilingly

unrelated complaints. Knowledge of the constellation of symptoms allows you to process the information that the patient provides.

• A review of symptoms suggests areas of possible organ stress, potential patterns of organ imbalance, and possible organ dysfunction.

• Patients cannot always be relied upon to volunteer the relevant information.

• Look at the consultation as being an organ/system review.• Don’t feel that you need a third party to validate your clinical

reasoning.

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Eliciting Their Story• Chief complaint • Symptomatology• History of present complaints• Antecedents, triggers, and mediators• Past medical history • Review of organ systems • Family history • Dietary history• Medication and supplement history• Social, lifestyle, and exercise history • Physical exam findings• Laboratory and imaging evaluations (if needed)• + + +

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Organizing Their Story

• Cyclical• Perimenopausal• Menopausal

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Cyclical (i.e., Menstruating)• Inquire about “a day in the life.” − What time do they arise?− What do they do between arising and going to work?− What is their occupation?− What do they do when they get home until

going to bed?− If not working what is their day like (i.e., activities)?− What is their exercise routine (e.g., how often, what

type, what time of day)?Why is this information important?

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Estrogen Dominance• Barring pathology

− Estrogen dominance• Stress-induced anovulation

− Excessive physical and/or emotional stress− No ovulation, no or very little progesterone

• Overweight− Extra-ovarian estrogen formation

• Androstenedione from ovaries and adrenals to estrone in adipose tissue2

• Hyperprolactinemia− Can result from a number of causes including stress response and

etiology2

− Can result in a spectrum of ovulatory changes2

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References for Previous Slide

1. J Clin Endocrinol Metab. 1998;83(12):4220.

2. Fritz, Mark A. and Leon Speroff. Clinical Gynecologic Endocrinology and Infertility. Philadelphia: Lippincott Williams and Wilkins, 2011: 497.

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Perimenopause“Perimenopause refers to the transitional period of time before menstruation actually stops, which is marked by changes in the menstrual cycle, along with other physical and emotional symptoms. Perimenopause can last two to 10 years, and during this time the following processes are occurring within a woman's body:”• Ovary release of eggs less regularly• Gradual decrease of estrogen and other hormones produced from

ovaries• Estrone, estradiol, progesterone, androstenedione,

testosterone• Decrease in fertility• Shorter menstrual cycles, less ovulations, and increased

irregularity

The Ohio State University Wexner Medical Center. 14 May 2013 http://medicalcenter.osu.edu/patientcare/healthcare_services/womens_health/menopause/perimenopause/Pages/index.aspx 15

Menopause• Menopause strictly means the end (pause) of

menses.1

• Menopause is a hypo-estrogenic state.2

− By menopause estrogen levels diminish to:2

• Estradiol by 85 percent2

• Estrone by 58 percent2

• Progesterone levels by 99 percent2

• Androstenedione (from the ovaries) by 67 percent2

• Testosterone levels by 29 percent2

• Uncomfortable symptoms• Possibly disruptive1

1. Fritz, Marc A. And Leon Speroff. Clinical Gynecologic Endocrinology and Infertility. Philadelphia: Lippincott Williams and Wilkins, 2011: 6812. Eskin, Bernard, The Menopause Comprehensive Management. New York: Parthenon Publishing, 2000, p. 56. 16

Options• Symplex® F• Hypothalamus PMG®

• Chaste Tree (MediHerb)• Ovex®

• Drenamin®

• Tribulus (MediHerb)• Cramplex (MediHerb)• Black Currant Seed Oil• Tuna Omega-3 Oil, Cod Liver Oil, or Calamari Omega-3 Liquid• Catalyn®

• + + +

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The Contrast PrincipleContrast principle

• The second item, which is different than the first, will be seen more different then it actually is.1

Cold water

Warm water

Hot water Paint-Protection

Extended Warranty

1. Cialdini, Robert B. Influence: The Psychology of Persuasion. New York: Harper Collins, 2007: 11-16. 18

The Rule (i.e., Standard of Behavior) of Reciprocation• A conditioned response where people feel obligated

to return the kindness, favor, gift, or concession• Can be used as a tool of influence

− By beginning with an extreme request that will probably be rejected, the negotiator can then retreat back to a lesser demand that was desired all along. The lesser demand is then more likely to be accepted, as it appears to be a concession. Research indicates, that aside from increasing the likelihood that a person will say yes to a request, the rejection-then-retreat technique also increases the likelihood that the person will carry out the request and will agree to future requests.

Cialdini, Robert B. Influence: The Psychology of Persuasion. New York: Harper Collins, 2007: 17-56. 19

Commitment and Consistency Rule

• Human beings have a desire to be and appear consistent with what we say we will do or what we have already done. − Why?

• Inconsistency is commonly thought to be an undesirable personality trait.

• Once a decision has been made one does not need to think hard about the issue anymore. The decision has eliminated the need to sift through the storm of information and expend mental energy to identify pros and cons along with relevant facts.

• Once a stand is taken, we have a natural tendency to behave in ways consistent with the stand.

Cialdini, Robert B. Influence: The Psychology of Persuasion. New York: Harper Collins, 2007: 57-113. 20

Proper Motives• We are here to serve others.• We are not peddling

nutrition for profit.• The rules mentioned are not

a tactic to manipulate people. They are a way to lead people down a new path.

• In the end, our lives will be remembered by our dash.

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Thank You for Attending

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