Most helpful critical review
225 of 267 people found the following review helpful
Some significant inaccuracies
on October 26, 2013
As a Family Medicine physician and public health professional, I was intrigued by this book. I read an interview with the author and the premise seemed interesting. I wanted to check it out not only for potential information for my patients, but also for myself, since I have had various digestive issues over the years.
First, the good: the book, while very basic info for me, will probably be a good resource for the average layperson. I like how she describes the function and importance of the GI tract, and the matter-of-fact way she talks about the health issues associated with the gut. I think it is a good resource for the average person. While her "program" is basically a brief food-avoidance regimen, I think probably some people who haven't read about such regimens before will get some interesting new information. For my part, I already avoid the majority of the items she mentions (alcohol, caffeine, soy, processed food, sugar, etc) but the book did inspire me to increase my veggie intake and perhaps try a trial of no dairy for a couple of weeks.
Now, the bad: The chapter on hormones is very minimal and is so inaccurate and full of holes that I am amazed it was written by a medical professional. Here are some quotes:
"Birth control pills and hormone replacement therapy are also forms of xenoestrogens and a major cause of bloating." This is a gross oversimplification; there are tens of different formulations of oral contraceptives (OCPs) and how each woman responds to them is extremely individual. If your OCP is causing so much bloating that you are uncomfortable and noticing it, for heaven's sake talk to your OB/Gyn or other health professional to change it!
Here's another quote: "Weight loss on a high-estrogen BCP may be extremely challenging due to fluid and salt retention and weight gain." This is either completely misleading or totally incorrect. First of all, it is unclear what she considers a high estrogen OCP. The old formulations (from the 60s and 70s) were indeed high-estrogen, but nobody is taking those anymore! Today's OCPs are half or less of the doses of those older pills. Furthermore, there have been many studies done with tens of thousands of women and NONE of them have shown any weight gain in OCP users that was not also present in non-OCP users in the same age bracket. The only hormonal birth control that has been shown to cause weight gain is DepoProvera, which is a progesterone-only form of birth control (contains no estrogen). There is absolutely no link between estrogen-containing OCPs and weight gain.
She also seems to emphasize that estrogen is the culprit behind GI problems, but then goes on to recommend only non-hormonal birth control without making ANY mention of the four available forms of birth control available to women containing only progesterone (Depo-Provera, the progesterone-only pill, the implantable progesterone rod, and the progesterone-coated IUD), all of which are great options for women who do not like the side effects of estrogen.
She likewise makes NO mention of endometriosis, which is a diagnosis that needs to be explored in EVERY woman who has GI symptoms which worsen during her menses. The primary treatment for endometriosis is--guess what?--combination birth control pills.
She also recommends instead (because all hormones are BAD!) the copper IUD and condoms as your alternatives. Not only does this recommendation set women's birth control options back about 100 years, it is also based on a completely illogical premise. She recommends the copper IUD as better, but seemingly does not understand how it works: by creating inflammation inside the uterus (along with just mechanically blocking implantation). Thus, many women on the copper IUD experience heavy painful periods (and more bloating and GI symptoms with them). For my patients who have bloating, heavy periods, and the like, I recommend the progesterone-coated IUD as it frequently treats these symptoms very well and makes their periods lighter or nonexistent.
Finally, she makes no mention of one of the huge advantages of combination OCPs: a very significant reduction in ovarian cancer risk; in some studies as high as 80% less ovarian cancers in OCP users over 10 years compared to never-users. Other studies put the numbers at about 40-60% depending on the length of use.
I'm not going to get into the specifics of her comments on HRT because this review would get even more ridiculously long, but suffice it to say they are likewise not terribly accurate and certainly don't provide sufficient information to make an informed decision.
Bottom line ladies: if you have GI symptoms which you think are related to your menstrual cycle or your hormones, go to a good Ob/Gyn or Nurse Practitioner specializing in Women's Health. This book does not provide you with nearly the depth or accuracy of information, nor educate you about your options.
I give it 3 stars due to the above inaccuracies and false information; otherwise I would give it 4-5. Because it is only one chapter out of the book, I think 3 stars is fair, as the rest of the information seems pretty accurate (although fairly basic).