Julia Winter

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since Aug 31, 2012
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Pediatrician with a Master's Degree in Nutritional Sciences. Moved to Portland, Oregon in the summer of 2013. Took Geoff Lawton's first online PDC in 2014.
Moved from south central WI to Portland, OR
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Recent posts by Julia Winter

I can confirm, advising women to have babies is no longer standard of care.  In general I find the online textbook UpToDate to offer good "standard of care" information and here's what they say:

There are several treatment options for endometriosis:

●Nonsteroidal anti-inflammatory drugs (NSAIDs)

●Hormonal birth control

●Other forms of hormone treatment (gonadotropin-releasing hormone analogs)


Each treatment option is discussed in more detail below. The best treatment depends on your symptoms and whether you might want to get pregnant in the future.

Medications — While medications will not get rid of endometriosis, they can help relieve pain. If the medication(s) you try first does not improve your pain within one to three months, your provider may suggest trying another type of medication, or surgery can be discussed as a reasonable next step.

Nonsteroidal anti-inflammatory drugs — NSAIDs are a type of pain medicine that can help to relieve the pain caused by endometriosis. They work by stopping the release of prostaglandins, one of the main chemicals responsible for pain in general as well as painful menstrual periods. Starting these medications one to two days before your period works best to prevent prostaglandin production and therefore reduce menstrual pain. It may take some time, and several doses, for the NSAIDs to block the prostaglandin production and reduce pain. NSAIDs do not shrink or prevent the growth of endometriosis tissue.

Most NSAIDs are available without a prescription, including:

●Ibuprofen (sample brand names: Advil, Motrin) – Follow the package instructions carefully. In general, two tablets are taken for the first dose and one tablet every four to six hours as needed thereafter. These should be taken with food and may be most effective if started one to two days before the onset of pain. Physicians may prescribe higher doses.

●Naproxen (sample brand names: Aleve, Naprosyn) – Follow the package instructions as the dose and frequency differ depending on the formulation. In general, two tablets are taken for the first dose, and one tablet is taken every 8 to 12 hours as needed thereafter, depending on the formulation. All tablets should be taken with food and a full glass of water. Like ibuprofen, naproxen may be more effective if begun a day or two prior to the onset of typical menstrual pain. Physicians may prescribe higher doses.

●Prescription NSAIDs – If over-the-counter NSAIDs are not effective, prescription strengths and formulations may be helpful.

The disadvantage of NSAIDs is that they do not always relieve endometriosis-related pain. NSAIDs probably work better when combined with another treatment, like hormonal birth control. Serious side effects from NSAIDs, although uncommon, include stomach upset, kidney problems, and worsened high blood pressure.

Hormone therapy

Hormonal birth control methods — Hormonal birth control methods, including oral pills, patches, and vaginal rings, are often helpful in treating pain because they reduce or prevent menstrual bleeding, especially when used continuously (only taking active pills or always using the ring in order to skip the monthly period). Daily oral progestin pills as well as injectable and implantable long-acting progestins may be very effective in managing endometriosis-related pain. A progestin-containing intrauterine device (IUD) can also be very effective in treating pain.

The most common side effects of estrogen-containing hormonal birth control are:


●Breast tenderness

●Irregular vaginal bleeding or "spotting" between periods

These side effects usually improve after using the treatment for several months. Serious side effects (eg, blood clots, stroke, heart attack) are rare in people who do not smoke.

Progestins — Progestins are a synthetic form of a natural hormone called progesterone. This treatment might be recommended if you do not get pain relief from or cannot take hormonal birth control that contains estrogen (for example, if you smoke). Progestins require a prescription and are usually given as a pill or injection. They are not used if you are trying to get pregnant. A progestin-containing IUD delivers very low levels of progestin directly to the uterus and results in markedly lighter and less painful periods. (See "Patient education: Long-acting methods of birth control (Beyond the Basics)", section on 'Intrauterine device'.)

Side effects of progestins can be bothersome for some people. The most common side effects include bloating, weight gain, irregular vaginal bleeding, acne, and, rarely, worsened depression.

I didn't share the entire thing, because this is supposed to be about natural remedies!  It is true that it's more common in women who haven't had a pregnancy, but even being on OCPs seems to be protective (which might explain why I never got endometriosis despite multiple risk factors - early menarche at age 10 and no pregnancies until I was over 35 - I was on OCPs, which basically mimic pregnancy, kinda, sorta, from age 21-35).  It's less common in women with late menarche (first period not until age 14, for example) and in women with multiple pregnancies.

To bring this back to the idea of natural remedies, there is strong evidence that increased omega-3 intake decreases your risk.  Hurray for grass fed everything and fish oil! I would guess this is one of the anti-inflammatory effects of omega three fatty acids.
1 week ago
Welcome new gardeners!  It's great to have more hands on deck! (Especially since this old hand is mostly unavailable right now.)
Hi, I posted your page to the Portland Permaculture Group email list and this realtor was recommended: Catia Juliana in Eugene: https://catiajuliana.exprealty.com/agents/Catia+Juliana
I love the carved "S" "M" and "L" for the glove boxes!

That's the kind of little thing that just makes the place better.

2 months ago
That looks great!  I'm glad your oven is working so well.  
3 months ago
It's been a long while (sorry!) but I'm curious - have you done something with this structure?
4 months ago
Now's a good time for finishing a rocket oven, doncha think?
4 months ago
I've kept my rocket oven at 350F steadily for an hour or two.  It's helped by the fact that I have a couple of pizza stones in there, so the mass helps hold the temperature steady.

I've found that one bigger piece of wood works better for this than lots of small pieces of wood (which tend to burn fast and hot).

I think you could build a rocket oven for this task, but I can't make any guarantees.  If you had even more mass inside the oven space, it would take longer to heat up, but it would be easier to keep the temperature steady.
4 months ago
This looks great!  How does it work?  Have you made pizza?

I'm impressed that you've made so many, especially for community gardens.  This is such a great tool for community building (let's all have a meal together!)
4 months ago