Unpacking Upstream And Downstream Hormone Health Care

Written By Dr. Chelsea Dakers ND | Originally posted on thehealthcreationlab.com

In a recent article I shared some reflections after spending time in the audience at a talk about advanced reproductive technologies (ART).

I use the “upstream/downstream” analogy often. Let’s take a ride down the hormone health stream of care and discover why I ultimately chose an “upstream” approach.

Picture a river. Beautiful, flowing water, riverbanks... Now imagine a huge group of people struggling to stay afloat. There are emergency services fishing people out with all sorts of fascinating technologies— cranes, flotation devices, nets, resuscitation centres... a really robust display of front line support. This is “downstream”... we haven’t discovered why all these people are in the river, but they are receiving advanced and urgent support to get them out of there.

If you took an eagle eye view, flying above this river, you would see what was happening further upstream. You could see the various ways that people were making it into the river in the first place... Some falling in by walking too close to the edge, some wading around in the shallows and getting caught in a current, some doing activities that were improperly executed and got themselves in a tricky situation, etc. As you turned your vision further upstream, you’d notice that the sense of emergency would fall and less intensive rescue measures would be needed to support these people. In this analogy, upstream approaches might look like installing guard rails along the banks, signage about the current, swimming lessons, and personal flotation device education.

When it comes to hormone health care, some people are exclusively looking for downstream support. Uncovering and treating root causes as to why they are not conceiving or have flooding menses is less of a priority. For these folks, there is a strong desire paired with determination to meet a goal.

The people that are gravitating towards an upstream approach have gained that eagle eye view. Maybe they were downstream, recovered and thought, “how the heck did I get here?”...Others were receiving downstream interventions and got a sense that they wanted a different approach. Further, there is a group of people noticing that they are getting pulled down river and they fight to get back to the rivers edge, they arrive exhausted, and not sure where to go from there...

Upstream approaches in hormone health care may look like engaging learning opportunities, community healing experiences, and immersive one-on-one care that hones in on root causes and sustainable whole person changes.

What I learned after providing naturopathic care for people with hormone, pelvic or menstrual related health concerns, is that upstream approaches are desperately needed.

There are many commonalities to why people are falling into the river and needing downstream interventions... regardless of the diagnosis people might be receiving in these scenarios - PCOS, unexplained infertility, recurrent pregnancy loss, premature ovarian failure, endometriosis, prolactinoma, uterine fibroids, autoimmune thyroiditis... when we go upstream, there are foundational skills and education that everyone needs.

That’s where high quality & targeted education becomes invaluable. This upstream approach is cost effective and carries high impact. Sometimes people just need to know to paddle hard and in which direction.

And all those diagnosis I just mentioned? Many of these are lifestyle mediated and relatively new in our human story. The underlying mechanisms fuelling these imbalances need strategies that address these unhealthy conditions. Hence, “hormone health creation”; creating the conditions for hormones to heal naturally.

One of the most imperative truths to hold when working upstream is this: health is an emergent phenomenon. When one truly integrates this into their philosophies, and even better, into their approaches, the game changes and miracles happen. Human physiology is that spectacular. It was designed to be this epic, and well executed upstream approaches work with this natural healing capacity.

Downstream approaches require a focus in pathology. The mainstream biomedical model of disease has this angle mastered. Because the need is urgent, the approaches are prioritizing what needs to be done RIGHT NOW. How are things going wrong and how do we stop or suspend this from happening? In hormone health care, this can look like IUI, IVF, hysterectomy, ablations and pharmaceuticals like oral contraceptive medications.

In many cases, upstream approaches facilitate long-term resolution without needing advanced, invasive or highly specialized therapeutics.

When the education delivery system is sophisticated enough to meet the needs of the learners, yet simple enough to gain knowledge with relative ease and effective enough to facilitate health goal achievement, we all win.

This is less pressure on the public health care system and more people walking around contributing their gifts and talents (instead of suffering through incapacity). In my hormone health dream world, the conditions for healthy hormones, pelvises and menses are pristine. Everyone’s physiology is given the space to function optimally, and health emerges by design.

Upstream hormone health approaches create the conditions for this dreamy endocrine scenario. Clients meet their goals, care providers don’t burn out and innovations occur all along the stream of care.

Join the conversation on Instagram @chelseacreateshealth.

The disclaimer… The amazing thing about humans is that we all have incomparably unique health profiles and needs. The health-related information contained in this article is intended to be general in nature and should not be used prescriptively or a as a substitute for a visit with a naturopathic doctor. This info is intended to offer general information to individuals. If you have questions about how these strategies could be used in adjunct to your current heath regime, book and appointment with us or consult a licensed naturopathic doctor for individualized care.