Conditions
Explore conditions Dr. Sanika treats with personalized, evidence-based naturopathic care.
Acne & Hormonal Skin Issues
Acne is a common skin condition affecting approximately 50 million Americans annually, characterized by clogged pores, pimples, cysts, and inflammation. While often dismissed as a cosmetic issue, acne can significantly impact self-esteem and quality of life. Acne results from complex interactions between hormones, sebum production, bacterial overgrowth (particularly Cutibacterium acnes), inflammation, and pore blockage. Hormonal acne, particularly common in women, is driven by androgen hormones stimulating excess sebum production. Addressing acne requires understanding the underlying drivers including hormonal imbalances, insulin resistance, gut health, inflammation, and dietary factors.
Adenomyosis
Adenomyosis occurs when endometrial tissue grows into the muscular wall of the uterus. That tissue still responds to the menstrual cycle, so it bleeds within the muscle each month, producing inflammation, an enlarged and tender uterus, heavy bleeding and deep cramping pain. It has historically been described as a condition of women in their forties who have had children, but improved imaging has shown it is considerably more common in younger women than assumed, and it frequently coexists with endometriosis. Because a definitive diagnosis once required examining the uterus after hysterectomy, adenomyosis has been substantially under-diagnosed for decades.
Missing or Irregular Periods (Amenorrhea)
Amenorrhea is the absence of menstruation — primary when periods have never started by age fifteen, secondary when previously regular cycles stop for three months or more. It is not merely an inconvenience or a fertility issue. A cycle is a monthly signal about energy availability, thyroid function, pituitary signalling and stress load, and its absence usually means estrogen is low, which carries real consequences for bone density and cardiovascular health if it persists. Functional hypothalamic amenorrhea — the body suppressing reproduction because energy intake is inadequate relative to output — is among the most common and most misunderstood causes in otherwise healthy, active women.
Anxiety & Stress Disorders
Anxiety disorders are the most common mental health conditions, affecting approximately 40 million American adults. While occasional anxiety is a normal response to stress, anxiety disorders involve persistent, excessive worry and fear that interfere with daily activities. Anxiety manifests through both psychological symptoms like worry and fear, and physical symptoms including rapid heartbeat, sweating, and muscle tension. The mind-body connection in anxiety is profound, with gut health, hormone balance, nutrition, and lifestyle factors significantly influencing anxiety symptoms.
Bloating & Digestive Discomfort
Bloating is characterized by a feeling of fullness, tightness, or swelling in the abdomen, often accompanied by visible abdominal distension. It is one of the most common digestive complaints, affecting up to 30% of the general population. Bloating can significantly impact quality of life and may indicate underlying digestive dysfunction such as dysbiosis, food sensitivities, SIBO, or impaired gut motility.
Constipation & Bowel Irregularity
Constipation is characterized by infrequent bowel movements (typically fewer than three per week), difficulty passing stools, or a sense of incomplete evacuation. It affects approximately 16% of adults worldwide and up to 33% of people over age 60. Chronic constipation can significantly impact quality of life and may indicate underlying issues with gut motility, microbiome balance, thyroid function, or lifestyle factors including inadequate fiber, hydration, or physical activity.
Depression & Mood Disorders
Depression, or major depressive disorder, is a serious mood disorder affecting how you feel, think, and handle daily activities. It affects approximately 21 million American adults and is characterized by persistent sadness, loss of interest in activities, and a range of emotional and physical problems. Depression involves complex interactions between brain chemistry, hormones, inflammation, gut health, nutritional status, and environmental factors. While conventional treatment focuses on medication and psychotherapy, comprehensive naturopathic approaches address underlying physiological imbalances contributing to depression.
Diabetes & Pre-Diabetes
Diabetes mellitus is a metabolic disorder characterized by elevated blood sugar levels due to insufficient insulin production (Type 1) or insulin resistance (Type 2). Pre-diabetes is an intermediate state where blood sugar levels are higher than normal but not yet in the diabetic range. Type 2 diabetes affects over 37 million Americans, while approximately 96 million adults have pre-diabetes. Without intervention, up to 70% of people with pre-diabetes will develop Type 2 diabetes. These conditions increase risk for cardiovascular disease, kidney disease, neuropathy, vision loss, and other serious complications.
Painful Periods (Dysmenorrhea)
Dysmenorrhea is menstrual pain severe enough to interfere with normal activity, and it affects a majority of menstruating women at some point. Primary dysmenorrhea is driven by prostaglandins — inflammatory signalling molecules released as the uterine lining breaks down, causing the muscle to contract hard enough to restrict its own blood supply. Secondary dysmenorrhea is pain caused by an identifiable condition such as endometriosis, adenomyosis or fibroids. The distinction matters enormously, because period pain that began years after menarche, is worsening, or does not respond to anti-inflammatories should be investigated rather than simply medicated.
Eczema & Atopic Dermatitis
Eczema, or atopic dermatitis, is a chronic inflammatory skin condition characterized by dry, itchy, inflamed skin. It affects approximately 31 million Americans, with onset commonly occurring in childhood though it can develop at any age. Eczema involves a complex interaction between genetic predisposition, immune dysfunction, skin barrier impairment, environmental triggers, and allergies. The condition often coexists with other atopic diseases including asthma, allergic rhinitis, and food allergies, suggesting shared underlying immune dysregulation.
Endometriosis
Endometriosis is a chronic inflammatory condition where tissue similar to the uterine lining grows outside the uterus, commonly on the ovaries, fallopian tubes, and pelvic tissues. This misplaced tissue responds to hormonal cycles, causing inflammation, scarring, and adhesions. Affecting approximately 10% of women of reproductive age (190 million worldwide), endometriosis is a leading cause of pelvic pain and infertility. Symptoms often begin in adolescence but diagnosis is frequently delayed by an average of 7-10 years.
Chronic Fatigue & Adrenal Dysfunction
Chronic fatigue and adrenal dysfunction encompass persistent tiredness that is not relieved by rest and often worsens with physical or mental exertion. Adrenal dysfunction, sometimes referred to as HPA axis dysregulation, occurs when the body's stress response system becomes imbalanced due to chronic stress, leading to abnormal cortisol patterns and widespread symptoms affecting energy, mood, sleep, and immune function. This condition affects millions of people, particularly women juggling multiple responsibilities.
Female Hair Loss
Hair loss in women usually presents differently from male pattern baldness: rather than a receding hairline, women typically notice a widening part, reduced ponytail thickness and diffuse thinning across the crown. Two mechanisms account for most cases. Telogen effluvium is a diffuse shed triggered by a systemic stressor — illness, surgery, childbirth, crash dieting, thyroid dysfunction or low iron — which pushes hair follicles prematurely into the resting phase, with shedding appearing two to four months after the trigger. Female pattern hair loss is progressive follicular miniaturisation with a genetic and androgen-related component. Distinguishing them matters, because telogen effluvium is usually reversible once the trigger is corrected.
Fibroids
Uterine fibroids (leiomyomas) are non-cancerous growths that develop in or on the uterus. Composed of smooth muscle and connective tissue, fibroids can range from seedling-sized to large masses that can distort the uterine shape. They are remarkably common, affecting 70-80% of women by age 50, with higher prevalence among African American women. While many fibroids are asymptomatic, approximately 25-30% of women experience significant symptoms requiring treatment. Size, number, and location determine symptom severity and treatment approaches.
Heartburn & GERD
Heartburn is a burning sensation in the chest caused by stomach acid flowing back into the esophagus. Gastroesophageal reflux disease (GERD) is a chronic, more severe form of acid reflux occurring at least twice weekly. GERD affects approximately 20% of Americans and can lead to complications including esophagitis, Barrett's esophagus, and increased esophageal cancer risk if left untreated. While often treated with acid-suppressing medications, addressing root causes provides more sustainable relief.
Heavy Menstrual Bleeding
Heavy menstrual bleeding — menorrhagia — means blood loss substantial enough to interfere with physical, social or emotional quality of life. Practically, that means soaking through a pad or tampon hourly for several consecutive hours, passing clots larger than a coin, bleeding beyond seven days, needing double protection, or waking at night to change protection. It affects roughly one in three women at some point and is chronically under-reported, largely because women have no way to compare their flow to anyone else’s and so assume theirs is normal. It is also the leading cause of iron deficiency in premenopausal women.
High Cholesterol & Dyslipidemia
Dyslipidemia refers to abnormal levels of lipids (fats) in the blood, including elevated LDL cholesterol, low HDL cholesterol, or high triglycerides. High cholesterol affects approximately 93 million American adults and is a major risk factor for atherosclerosis, heart disease, and stroke. While genetics play a role, diet, lifestyle, and metabolic factors significantly influence cholesterol levels. Understanding the complexity beyond total cholesterol—including particle size, oxidation status, and inflammatory markers—is essential for cardiovascular risk assessment.
Hypertension (High Blood Pressure)
Hypertension, or high blood pressure, is a chronic condition where the force of blood against artery walls is consistently too high, typically defined as 130/80 mmHg or higher. It affects nearly half of American adults and is a major risk factor for heart disease, stroke, kidney disease, and other serious health complications. Often called the 'silent killer' because it typically has no symptoms, hypertension develops over years and is influenced by genetics, diet, lifestyle, stress, and underlying metabolic dysfunction.
Hypothyroidism
Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormone to meet the body's metabolic needs. This underactive thyroid can slow down metabolic processes, leading to fatigue, weight gain, cold intolerance, and cognitive difficulties. It affects approximately 5% of the general population, with women being significantly more likely to develop the condition, especially during and after menopause.
IBS (Irritable Bowel Syndrome)
Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by recurrent abdominal pain and altered bowel habits including diarrhea, constipation, or both. It affects approximately 10-15% of the global population, with women being twice as likely to develop IBS as men. While IBS does not cause structural damage to the digestive tract, it significantly impacts quality of life. The condition involves complex interactions between the gut microbiome, gut-brain axis, intestinal motility, and visceral sensitivity.
Incontinence
Urinary incontinence is the involuntary leakage of urine, affecting approximately 50% of women at some point in their lives, with prevalence increasing with age, childbirth, and menopause. Types include stress incontinence (leakage with coughing, sneezing, exercise), urge incontinence (sudden strong urge followed by leakage), and mixed incontinence (combination of both). While extremely common, incontinence is not a normal part of aging and significantly impacts quality of life, physical activity, social engagement, and emotional wellbeing. Many women suffer in silence, unaware that effective treatments exist.
Indigestion & Acid Reflux
Indigestion, also called dyspepsia, refers to discomfort or pain in the upper abdomen often associated with eating. Acid reflux, or gastroesophageal reflux, occurs when stomach contents flow back into the esophagus, causing heartburn and irritation. These conditions affect approximately 20% of the population and can significantly impact quality of life. While occasional indigestion is common, persistent symptoms may indicate underlying issues such as low stomach acid, H. pylori infection, hiatal hernia, or stress-related digestive dysfunction.
Infertility Support
Infertility is defined as the inability to conceive after 12 months of regular unprotected intercourse (or 6 months for women over 35). Affecting approximately 1 in 8 couples, infertility can result from female factors, male factors, or a combination of both. Common causes include ovulatory disorders, endometriosis, blocked fallopian tubes, uterine abnormalities, poor egg or sperm quality, age-related decline in fertility, and unexplained infertility where no specific cause is identified. The emotional toll of infertility is significant, often involving grief, anxiety, relationship stress, and financial burden. Comprehensive naturopathic support can address underlying factors, optimize fertility potential, and support couples through their conception journey whether pursuing natural conception or assisted reproductive technologies.
Insulin Resistance
Insulin resistance is a state in which cells respond poorly to insulin, so the pancreas compensates by producing more of it. Blood glucose can stay entirely normal for years while insulin runs high — which is why standard fasting glucose and HbA1c testing frequently miss the condition during the long window when it is most reversible. In women, insulin resistance is central to polycystic ovary syndrome, where high insulin drives ovarian androgen production and disrupts ovulation, and it becomes more common through perimenopause as declining estrogen worsens insulin sensitivity. It is a major driver of type 2 diabetes, cardiovascular disease, fatty liver and pregnancy complications.
Interstitial Cystitis & Bladder Pain
Interstitial cystitis, also called bladder pain syndrome, is chronic bladder pain and urinary urgency and frequency in the absence of infection. It affects women far more often than men, and it is one of the most consistently misdiagnosed conditions in women’s health — patients typically spend years cycling through repeated courses of antibiotics for negative urine cultures before the diagnosis is considered. The pain characteristically builds as the bladder fills and eases briefly after voiding, which drives a pattern of frequent, small-volume urination that can reach dozens of times a day and severely disrupt sleep.
Iron Deficiency & Anemia
Iron deficiency is the most common nutritional deficiency in the world and it falls overwhelmingly on menstruating women. Iron is lost with every period, and when intake or absorption fails to keep pace, stores draw down over months to years. Crucially, symptoms begin long before haemoglobin drops: ferritin — the storage form — can be low enough to cause profound fatigue, hair shedding, breathlessness and poor concentration while a standard complete blood count still reads as entirely normal. Many women are told they are not anaemic and are therefore fine, when in fact they are iron deficient without anaemia.
Menstrual & Hormonal Migraine
Menstrual migraine is migraine triggered by the sharp fall in estrogen that occurs in the days immediately before menstruation. It is a distinct clinical entity rather than ordinary migraine that happens to coincide with a period: menstrually related attacks tend to be longer, more severe, more likely to recur after treatment, and less responsive to standard acute therapy than attacks at other points in the cycle. Migraine is roughly three times more common in women than men after puberty, and that gap opens at menarche and narrows after menopause — which tells you how much of it is hormonally driven.
Mood Imbalances & Emotional Health
Mood imbalances encompass a range of emotional fluctuations and dysregulation that don't necessarily meet criteria for major depression or anxiety disorders but significantly impact quality of life. These include irritability, emotional reactivity, low motivation, mood swings, and general emotional instability. Mood regulation involves complex interactions between neurotransmitters, hormones, blood sugar, gut health, inflammation, sleep, and stress. Women are particularly susceptible to mood fluctuations related to hormonal changes throughout the menstrual cycle, pregnancy, postpartum, and perimenopause.
Ovarian Cysts
Ovarian cysts are fluid-filled sacs on or within an ovary. Most are functional — follicular or corpus luteum cysts that form as a normal part of ovulation and resolve on their own within one to three cycles. These are so common that they are better understood as a feature of a working reproductive system than as a disease. A smaller number are pathological: endometriomas from endometriosis, dermoid cysts, cystadenomas, or, rarely, malignant lesions. The clinically useful question is almost never "do I have a cyst" but "what kind is it, and does it need anything done".
PCOS / PMOS (Polyendocrine Metabolic Ovarian Syndrome)
PCOS — renamed Polyendocrine Metabolic Ovarian Syndrome (PMOS) by global consensus in 2026 — is a hormonal and metabolic disorder affecting roughly one in eight women. It causes infrequent or prolonged menstrual periods, excess androgen levels, and ovaries that develop numerous small follicles and fail to release eggs regularly. The name was changed because the so-called cysts are not cysts at all but stalled follicles, and because the old name obscured the insulin resistance and endocrine dysfunction that actually drive the condition. PCOS and PMOS are the same diagnosis; most clinics and billing codes still use PCOS.
Pelvic Pain
Chronic pelvic pain is persistent pain in the lower abdomen or pelvis lasting six months or longer. It affects approximately 15% of women of reproductive age and can significantly impact quality of life, relationships, and daily functioning. Pelvic pain can stem from gynecological conditions, gastrointestinal disorders, urological issues, musculoskeletal dysfunction, or nerve sensitization. Many cases involve multiple overlapping conditions. The pain may be constant or intermittent, sharp or dull, and may worsen with certain activities, positions, or during specific times in the menstrual cycle.
Perimenopause & Menopause
Perimenopause is the transitional period before menopause when ovarian function gradually declines and hormonal fluctuations intensify. Menopause is defined as 12 consecutive months without menstruation, marking the end of reproductive years. The menopausal transition typically begins in the mid-40s and lasts 4-8 years, though timing varies widely. During this time, declining estrogen, progesterone, and testosterone affect multiple body systems. Approximately 75% of women experience vasomotor symptoms (hot flashes and night sweats), while many others face sleep disturbances, mood changes, cognitive shifts, and metabolic changes.
PMS/PMDD
Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are hormone-related conditions affecting women in the luteal phase of their menstrual cycle. While PMS involves mild to moderate physical and emotional symptoms, PMDD is a severe form causing significant mood disturbances, depression, irritability, and anxiety that can interfere with daily functioning. Studies suggest PMS affects up to 75% of menstruating women, while PMDD affects approximately 5-8% of women of reproductive age.
Postpartum Recovery
Postpartum recovery encompasses the physical, hormonal, and emotional transition following childbirth, traditionally known as the "fourth trimester." This critical period involves profound physiological changes as the body returns to a non-pregnant state, including uterine involution, hormone shifts, tissue healing, establishment of milk supply, and musculoskeletal recovery. Beyond the standard 6-week postpartum check, comprehensive recovery typically requires 6-12 months or longer. Common challenges include fatigue, mood changes, pelvic floor dysfunction, diastasis recti, pain, difficulty breastfeeding, and difficulty regaining pre-pregnancy fitness or body composition. Many women feel unsupported during this vulnerable transition, struggling with unrealistic expectations while managing the demands of newborn care.
Preconception Care
Preconception care focuses on optimizing health and wellness before pregnancy to support fertility, healthy conception, and the best possible pregnancy outcomes. This proactive approach addresses nutritional status, hormonal balance, detoxification pathways, and lifestyle factors that influence egg and sperm quality, implantation success, and fetal development. Ideally beginning 3-6 months before attempting conception, preconception care creates the optimal internal environment for pregnancy. This period allows time to address nutrient deficiencies, balance hormones, reduce toxic burden, establish healthy habits, and resolve underlying health conditions that could affect fertility or pregnancy health.
Psoriasis
Psoriasis is a chronic autoimmune condition affecting approximately 8 million Americans, characterized by rapid skin cell turnover leading to thick, scaly plaques. While psoriasis manifests in the skin, it is a systemic inflammatory condition with genetic, immune, and environmental components. The condition occurs when the immune system mistakenly attacks healthy skin cells, accelerating their production cycle from about 28 days to just 3-4 days. This rapid turnover causes cells to accumulate on the skin surface, forming characteristic raised, red, scaly patches. Psoriasis often coexists with other inflammatory conditions including psoriatic arthritis, inflammatory bowel disease, and increased cardiovascular risk.
Recurrent UTIs
Recurrent urinary tract infections (UTIs) are defined as two or more infections within six months or three or more within one year. Affecting millions of women annually, recurrent UTIs significantly impact quality of life, sexual health, and emotional wellbeing. While acute UTIs are common, experiencing frequent recurrences suggests underlying factors that need to be addressed beyond antibiotic treatment alone. Contributing factors may include incomplete bladder emptying, hormonal changes affecting the urinary tract lining, disrupted vaginal microbiome, structural abnormalities, or lifestyle factors. Chronic antibiotic use for recurrent UTIs can further disrupt beneficial bacteria and contribute to antibiotic resistance.
Rosacea
Rosacea is a chronic inflammatory skin condition affecting approximately 16 million Americans, characterized by facial redness, visible blood vessels, and sometimes acne-like bumps. While the exact cause remains unclear, rosacea involves vascular dysfunction, inflammatory processes, immune dysregulation, and microbiome alterations. The condition typically affects the central face including cheeks, nose, chin, and forehead. Rosacea is more common in fair-skinned individuals and often begins after age 30. Beyond cosmetic concerns, rosacea can cause burning sensations, eye irritation, and psychological distress impacting quality of life.
Sexual Dysfunction
Female sexual dysfunction encompasses a range of concerns affecting desire, arousal, orgasm, or causing pain during sexual activity. Studies suggest that 30-45% of women experience some form of sexual concern at various points in their lives, with prevalence increasing with age. Sexual health is an important component of overall wellbeing and relationship satisfaction. Common presentations include low libido, difficulty with arousal or lubrication, inability to reach orgasm, or pain during intercourse (dyspareunia or vaginismus). Sexual dysfunction often has multiple contributing factors spanning physical, hormonal, psychological, and relational domains that benefit from comprehensive assessment and treatment.
SIBO (Small Intestinal Bacterial Overgrowth)
SIBO is an excess of bacteria in the small intestine, where bacterial counts should be low. Those bacteria ferment carbohydrate before it can be absorbed, producing hydrogen, methane or hydrogen sulphide gas. The result is bloating that worsens through the day, distension that can be dramatic, and altered bowel habit. SIBO is strongly associated with IBS — a substantial share of people diagnosed with IBS have demonstrable overgrowth — and it is frequently the missing explanation for someone who has been told their extensive GI workup was normal.
Sleep Disorders & Insomnia
Sleep disorders encompass a range of conditions affecting the ability to fall asleep, stay asleep, or achieve restorative sleep. Insomnia, the most common sleep disorder, affects approximately 30% of adults and is characterized by difficulty initiating or maintaining sleep, early morning awakening, or non-restorative sleep despite adequate opportunity for rest. Chronic sleep deprivation impacts every aspect of health including hormone balance, immune function, metabolism, cognitive performance, and emotional wellbeing.
Thyroid Nodules
Thyroid nodules are discrete lumps within the thyroid gland. They are remarkably common — detectable by ultrasound in a large share of adults, with prevalence rising with age — and they are several times more common in women than in men. The overwhelming majority are benign, and most cause no symptoms and require nothing more than periodic monitoring. The clinically important task is a proportionate one: identify the small minority that need biopsy or intervention, and avoid subjecting the large majority to unnecessary anxiety and procedures. A minority of nodules are autonomously functioning and produce excess thyroid hormone, which requires a different approach entirely.
Recurrent BV & Yeast Infections
The vagina hosts a microbial community normally dominated by Lactobacillus species, which produce lactic acid and keep pH low and inhospitable to other organisms. Bacterial vaginosis occurs when that Lactobacillus dominance is lost and mixed anaerobic bacteria overgrow; vulvovaginal candidiasis occurs when Candida overgrows. Both are extremely common, and both have a recurrence problem that conventional single-course treatment handles poorly — more than half of women treated for bacterial vaginosis experience recurrence within a year, largely because the antibiotic clears the overgrowth without restoring the protective Lactobacillus population that prevents it returning.
Weight Management & Metabolic Health
Weight management encompasses achieving and maintaining a healthy body weight that supports overall health and reduces disease risk. Approximately 42% of American adults have obesity, with another 32% classified as overweight. Excess weight, particularly visceral abdominal fat, significantly increases risk for Type 2 diabetes, heart disease, certain cancers, sleep apnea, and numerous other conditions. Effective weight management requires addressing complex interactions between metabolism, hormones, gut health, sleep, stress, genetics, and environmental factors beyond simple calorie restriction.