The Menopausal Vagina- The Forgotten Organ

The Menopausal Vagina- The Forgotten Organ

As I listen to the concerns of my peri-menopausal, and menopausal  patients, I am amazed at the number of women who have severe vaginal dryness, vaginal atrophy, and pain with intercourse.  This terrible triad often results in a torture in the bedroom, a sexless marriage, and ultimately a needless divorce.  Other repercussions of declining vaginal health may include frequent urinary tract infections, urine leakage, and weakening of the pelvic floor muscles.  These suffering women have plenty of doctors. They see their internist every year for a “complete physical exam.”  He or she checks the patient’s heart, lungs, and nervous system,  but the exam is actually somewhat incomplete, since the internist hardly every checks the health of the vaginal tissues.   She then goes to her gynecologist for her “annual” where she gets a PAP and a breast exam to screen for cancer, but the issues of vaginal dryness, and pain with intercourse is usually not discussed, and is not addressed. Bottom line, none of these medical professionals are addressing her vaginal health, and the woman is left to suffer in silence, as she spirals downward into a life of increasing dryness, painful sex, no sex, self doubt, and sometimes divorce.

It breaks my heart to see this happen, because in the vast majority of cases a decline in vaginal health with changing hormones is totally unnecessary.   With proper care, vaginal health can easily and safely be maintained, and in most cases it can actually be restored as women go through life’s changes.  Vaginal dryness- gone. Pain with intercourse- a thing of the past. The love life can be enjoyable and robust once again.

The first step is to find a doctor who will take the time to listen to your concerns, and will take you seriously. I’ve had patients who were told by their doctor “ why are you concerned about libido, you’re 52.”  Or they are given a pat on the back and told “you’re just getting old.”  That’s not acceptable.  You have the right to maintain optimal vaginal health just as much as you have the right to maintain good heart health.   It is also your right to have a healthy sexual relationship as long as you want to, and this right should be supported by your doctor.

The next step is to get on a customized vaginal health program to bring this important organ get the respect it deserves.  If you have vaginal dryness, pain with intercourse, or increasing urinary tract infections talk to your medical provider about a vaginal health program, or come see us at McMinn Clinic for a thorough evaluation and a personalized treatment plan.  Take care of your whole body for your whole life,  including “the Forgotten Organ.”

Book Club and Film Club at McMinn Clinic

Please join us for

The Wellspring Connection Book Club

Tuesday, April 8, 2014 from 6:00 pm – 7:30 pm

Read with us or just come for the discussion & learn

The Immune System Recovery Plan by Susan Blum, MD, MPH with Michele Bender

A Doctor’s 4-Step Program to Treat Autoimmune Disease

Finally, a book that that helps you understand your fatigue, joint pain, bloating, among other symptoms, and shows you how to cure them by getting to the root cause!

We have limited space so please RSVP to

Questions? Contact Janie Hannah at 837-1727.


Join us Tuesday, March 11th from 6 pm – 7:30 pm.

Eat, Fast and Live Longer

Hosted by Michael Mosley

First aired on the BBC’s Horizon Program, then later on PBS

We will be meeting in the McMinn Studio – just down the hall from The McMinn Clinic.


Hormone Pellets for Women

Hormone Pellets for Women

Hormone replacement therapy clearly represents one of the most important cornerstones of anti-aging medicine.  While it is correct to assert that aging causes hormone decline, it is just as apt to say that to a great degree hormone decline is the mechanism by which we age.

Every woman is unique as to how she expresses hormone decline. The average of menopause is about 51 years old. However, long before then, at about age 35 a woman’s hormones may start to tumble. Some women sail through the entire process and barely blink, while for others it is a profound, life- altering experience.  The classic symptoms are the hot flashes, night sweats, poor sleep, weight gain, vaginal dryness, low libido, pain with intercourse, anxiety, irritability, irregular periods, “brain fog,” depression, and mood changes. The mood changes may feel like an out-of-body experience. She knows that she is being ill-tempered with her husband or kids, but she can’t stop. She is being driven, like a puppet on a string, to say things that she really doesn’t mean.  Real-time she can’t help it, but later she regrets it.

Thankfully, there is a cure with bioidentical hormone replacement therapy.  The hormones used in this approach are 100% identical to those already in the body, unlike many other hormones which are different than those naturally in the body.  The issue then becomes, what is the best mode of administration for these hormones. There are several different options including topicals (creams and gels), shots, pills, and pellets.  The ideal route depends on each individual woman.  However, many of my patients love the convenience and effectiveness of the hormone pellets.

Hormone pellets come in 2 varieties:  estrogen, and testosterone. They are inserted under the skin in the area of the upper/ outer buttocks via a simple and virtually painless procedure. They start to take effect in a couple of days, and they generally last about 3-4 months. The pellets reach a peak level and maintain tissue levels without any fluctuations.  Most women who get the pellets seem to love them, and almost always come back for more. The hormone pellets relieve menopausal symptoms, maintain bone density, restore a normal sleep pattern, and they improve sex drive, libido, and sexual response.  In some women, they may also improve energy, relieve depression, improve memory and concentration, and improve body composition (more muscle mass, and less fat mass).

Call McMinn Clinic at 205-868-1313, and ask about bioidentical hormone pellets with Dr. McMinn. You’ll be glad you did.

Autoimmune Disease- Immune Function Gone Wild!

Many years ago as a young doctor, it seemed that autoimmune disease was relatively rare. However, this dreaded disease has become the most prevalent cause of chronic illness in our land, affecting over 23 million Americans.  Autoimmune disease is basically a case of a confused immune system. The main role of the immune system is to protect the body from outside invaders, such as viruses and bacteria.  Think of it as our own personal homeland security department. The immune system constantly roams the body looking for any breaches in security. When it detects an outside invader, it sends out alarm bells which then cause “antibodies” to swoop down on the uninvited invader.  Unfortunately, every now and then, the security system gets confused and it mistakenly thinks that a part of our normal body is “non-self” and it attacks the innocent normal tissue with antibodies, often rendering the attacked tissue seriously harmed, or even useless. Some examples would be when the immune system attacks the pancreas it causes that organ to shut down, which leads to type 1 diabetes.  Likewise, the confused and overly ambitious immune system may attack the gut- causing Crohn’s disease; the thyroid- causing Grave’s thyroiditis; or the joints- causing rheumatoid arthritis.  Other forms of autoimmune disease include lupus, celiac disease, MS, blood disorders, and myasthenia gravis.   In fact, there are now over a hundred known autoimmune diseases, and there are approximately forty more diseases which are suspected of being autoimmune in nature.  These diseases are often crippling, and they usually last a lifetime.

What causes the immune system to go haywire?  Since autoimmune disease seems to run in some families, there seems to be a genetic predisposition.  However, there is often a trigger such as a virus, which starts the ball rolling down the path of immune dysfunction.  Other triggers are thought to be chronic stress, antibiotics, poor diets, gut health, alterations in the “human microbiome,” and toxins (including heavy metals and pesticides).

Just a few words about the human microbiome: this has emerged as one of the hottest areas of medical research these days. It has to do with the critters that live on us and in us.  In fact, there are more bacterial cells in your body than human cells!  Establishing and maintaining a proper mix of “good bacteria,”  “bad bacteria,” and yeast is vitally important for overall health including immune regulation. In fact, C-section babies have been found to have more autoimmune disease than vaginal birth babies. The reason for this is that the C-section babies don’t get colonized with the bacteria from the vaginal vault like vaginal birth babies, which goes on the affect their “microbiome” and thus their propensity to get autoimmune disease.

Autoimmune disease may be extremely difficult to treat.  There are many drugs out on the market these days, which may be helpful, but many of them may have a significant side effect profile.  I have found that a plan which includes significant dietary changes, detoxification, stress reduction, treating any occult infections, and optimizing the microbiome may be quite helpful in bringing about some relief for many of these patients.

As with many difficult to treat diseases, an integrative medical approach, which utilizes multiple modalities, as well as a functional approach, which looks for and treats the underlying root cause may be a valuable adjunct to the treatment plan for patients with autoimmune disease.

Wellness Connection – February Meeting

Our next book club meeting will be on FEBRUARY 11, 2014, 6:00 – 7:30 pm

AntiCancer, A New Way of Life by David Servan-Schreiber, MD, PHD

This is the moving story of how a researcher and scientist who believed only in conventional treatments was transformed into an integrative physician who realized the importance and power of the body’s natural defenses against chronic disease. Dr. Servan-Schreiber’s advice details how to find the right blend of traditional and alternative health care; how to develop a science-based anticancer diet (and the small changes that can make a big difference); the top ten household products to replace; understanding the effects of helplessness and “unhealed wounds” both physical and emotional, and how to regain balance; and how to reap the benefits of exercise, yoga, and meditation. Anticancer takes us on an inspiring personal journey and ultimately guides us to a new way of life.

For more information please contact Janie Hannah  at:


December SPA Special

Purchase three Dermaplane Facials and receive one free!

Dermaplaning is a technique where the outer layers of skin are exfoliated with the use of a blade. Dermaplaning is an effective way to resurface the skin. Along with exfoliating it also helps remove the unwanted velus hairs from the face. Usually, you can see a difference after the first treatment.

Call to schedule your appointment today!!

Bio-Identical Hormones with Pellets

Welcome to McMinn Clinic, the “Go To Place for Wellness” in Birmingham, Al.  where Dr. James E. McMinn, M.D. specializes in bio-identical hormone pellet therapy for women and men.

Natural Bioidentical hormone replacement therapy can be delivered using tiny pellets. Implanted just under the skin, pellets consistently release small, physiologic doses of hormones providing optimal therapy and usually without adverse effects. The hormones in pellets are 100% identical to those created by the human body and are derived from natural plant-based ingredients.

One or more pellets (depending on the needs of the individual, and based on lab results) are inserted in the upper outer buttock. Local anesthesia is administered then a small incision is made. The pellets are then inserted and the area is closed with steri-strips. The entire procedure takes about 5 minutes.

If you have any further questions, please feel free to ask Dr. McMinn or the staff at McMinn Clinic.  Also, see a more detailed explanation of pellets by Dr. McMinn at

Skin Wellness- How to Maintain Your Beautiful Exterior

True story:  Her hands were cracked, dried, bleeding and painfully burning.  She had tried all of the usual over-the-counter remedies, and had been to 4 different dermatologists.  She had been placed on numerous prescription salves, and she had taken oral steroids and other medications.  Still she suffered for months on end with no relief.  Nothing was working. She came to see me as the doctor of last resort.  I started with a history and then proceeded with an examination.   She was dry all over, but her hands were in particularly bad shape as described above.  After contemplating the issue, I started her on a targeted nutritional program to build her skin health from the inside out.  When I saw her back in the office a few months later, I could hardly believe my eyes!  Her hands were as smooth as a baby’s bottom.  The thick, dry skin was gone. There was no sign of the cracking and bleeding. The patient was relieved that she didn’t have to live a life of suffering with this painful condition, and she was delighted with the outcome. I shared her joy in seeing such an amazing recovery.  All of this was accomplished with no drugs, but only by fixing her gut and giving her body the nutrients it needed to heal itself.

I use this story to illustrate the importance of skin health, and to point out that we need to build skin health from the inside out.  We tend to take our skin for granted until something goes wrong.  Also, we focus on the cosmetic topical aspect of skin care while ignoring the underlying functional and structural integrity of the skin. Certainly topicals may be helpful, but attention to the fundamentals of nutrition, hydration, hormone optimization, detoxification, and stress management plays a crucial role in optimal skin health.

Skin is the largest of all of our bodily organs.  It is what interacts with and protects us from our environment; heat, cold, chemicals, UV radiation, and infection. It has many important bodily functions such as: detoxification, regulating hydration, and controlling body temperature. It carries blood vessels, and is home to many of our nerve endings.  It houses the fifth sense, which is the sense of touch. Finally, it is the first thing that we and others see, so understandably it is important for our appearance to others and our own sense of self.

It is also important to understand that many underlying medical conditions, including nutrient deficiencies and toxins, may manifest themselves as skin conditions. Drug reactions, cancer, infections, gut dysfunction, rheumatologic conditions, allergies, and more may present as skin conditions.  Stress, both acute and chronic, may affect the appearance and health of the skin.  All sorts of skin conditions, including eczema, psoriasis, and hives may experience an exacerbation during a time of intense stress.

As you can see, skin is not just something to hold our innards in. It deserves its rightful place, right up there with heart and brains, in the list of complex and important organs. Now here are some tips to help you maintain beautiful, glowing, youthful, healthy skin at all stages of life.

*Attend to the foundations of wellness: Nutrition, optimal hydration, exercise and restorative sleep.  All of these affect your skin health.

*Diet: It all starts with what you eat.  Start with a whole food (not processed food), mainly plant food diet, with added lean protein, and some “good fats.”  Your body needs the fiber to keep the gut healthy which affects the skin.  Your skin needs the bioflavenoids for healthy vessels and blood supply for the skin. It needs the protein to help build the skin. It needs the good fats to build healthy cell walls and lubricate the skin.

*Foods rich in the “good fats” include: salmon (and other cold water fish), walnuts, canola oil, olive oil, flax seed, flax oil, and fish oils.

*Maintain good gut health. Good digestion, absorption, and metabolism are important for these nutrients to get to the source.

*Add a good multi-vitamin and multi-mineral

*Also add extra beta-carotene, biotin, and B complex

*Add extra anti-oxidants:  Vitamin A, C, E, D, and selenium.

*Antioxidant rich foods such as blackberries, blueberries, strawberries, plums, and green tea may also be helpful.

*Avoid frequent prolonged hot baths and hot tubs.

*Avoid harsh detergents.

*Avoid over exposure to household cleaners and chemicals.

*Avoid lotions, oils, sprays, sunscreens, etc. with toxins and harsh chemicals.

*Acupuncture and Chinese herbals may also be helpful.

*Avoid sugar, simple carbs, and processed food.

*Get your hormones tested, optimized, and balanced. Hormones play a critical role in maintaining skin health.

*Healthy levels of testosterone for men and women are important for skin moisture thickness.

*As women lose their estrogen, everything dries out, creating a significant increase in facial wrinkles.  Supplementation with bio-identical estrogen can help tremendously.  Also, topical estriol face cream may also be very effective for wrinkles, and skin moisture

*Don’t smoke- this is disastrous for your skin.

*Avoid overexposure to the sun or tanning beds.

*Use natural skin care products without toxins.

*Dry brush exfoliation in the AM before your shower may also be helpful.

*Topical Vit C and Vit E, and regular skin care may also be helpful.

Bottom line:  Take care of your skin, so that it can take care of you.


Osteoporosis (thinning bones) is one of the most dreaded diseases of women, and with just cause.  Like a silent killer it sneaks up on its victim without symptoms, until finally it becomes a potentially fatal disease. About 30 million Americans suffer from osteoporosis, 80% of whom are women.   In fact, in the United States nearly 50 percent of all women between the ages of forty-five and seventy suffer from some degree of osteoporosis.  About a quarter of these will eventually go on to have a hip fracture later in life, many of whom will die of complications related to the fracture.  In fact, the lifetime risk of death from a broken hip for a 55 year old woman rivals the death risk from breast cancer.  The ravages of osteoporosis are not confined to broken hips however.  Thinning bones also result in other fractures, as well as collapsed vertebrae, disfigurement, disability, and chronic pain. Overall osteoporosis results in an $18 billion price tag for the American health care system.

So why is this becoming such an epidemic?  As with many other common diseases, the modern American diet,  sedentary lifestyle, and stress have a lot to do with it.  In some less developed cultures, osteoporosis is actually quite  rare. Our high sugar, processed food, fast food diets often don’t have the vitamins and minerals needed to build new bone. Also, we don’t get out in the sun as much as we used to. This creates a lack of vitamin D, which is necessary for building  healthy bones.   Weight bearing exercise also stimulates bone strengthening, but more and more, we have become a sedentary society.  Finally, our body reacts to this stressed out culture we live in by raising levels of the hormone cortisol, which then results in thinning of the bones.

What actually happens in osteoporosis?  Childhood, adolescence, and early adulthood are the prime opportunities for building strong bones. Our skeletal system reaches its greatest density at about the age of thirty.  After that we start a long steady decline. With the onset of menopause, women begin an accelerated period of bone loss.  In fact white women in America tend to loose 30-40% of their bone mass between the ages of 55-70.

So who’s at risk?   Women are at greater risk than men, and caucasian women are at greater risk than African-American women.  Asian women fall somewhere in the middle. In general you’re at greater risk if you’re fair skinned and blue eyed, if you’re thin or small framed, if you smoke, if you’re sedentary, if you rarely get out doors, if you drink too much alcohol or coffee, or if you went through long term depression. You’re also at increased risk if you went through late puberty or early menopause, if you have a poor diet, if you have a history of chronic liver or kidney disease, if you took steroid drugs for an extended period of time, if you had a hysterectomy with ovariectomy, if you have a  history of anorexia or bulimia, if you’ve had a prolonged absence of menstrual periods, or if you don’t get enough calcium in your diet. Stress and a poor immune system may also contribute to bone loss.  Osteoporosis tends to run in families, so if your mom has it, you’re more likely to get it. Some drugs such as those in the Prilosec or Nexium family put the patient at significant increased risk of osteoporosis.

The key is to get tested. Ideally one should get tested with a bone density screening either before  or during perimenopause. Although the fractures don’t show up until later, it helps to get a baseline test in order to establish a trend later on.

Hormones play an important role in bone health.  In fact, the primary cause of osteoporosis is hormonal imbalances that interfere with the bone-forming cells. Estrogen prevents bone loss.  Progesterone, and to a lesser degreee, testosterone,  actually help to build new bone.  Together, progesterone and estrogen offer a powerful one-two punch against thinning bone disease. DHEA, melatonin, growth hormone, and calcitonin  also support sturdy bones.  On the other hand excessive levels of cortisol (the stress hormone), and too much thyroid can lead to bone loss. When it comes to using hormones for bone health, I prefer to use bio-identical hormones.  Artificial progestins have actually been found to cause bone thinning.

Here is a game plan to help you to keep your bones strong:

*Healthy diet

*Regular exercise (especially weight bearing)

*Stress reduction

*Targeted nutritional supplementation

*Bio-identical hormone Optimization.

The optimal bone- building diet should include foods that are rich in the building blocks of bones such as nuts, seeds, flax, soy, fish,  yogurt, broccoli, and green leafy vegetables. At the same time we should avoid excessive caffeine and alcohol, sugar, and refined grain. Eliminate soda  from your diet and reduce red meat. Keep a lid on the added salt and avoid processed foods.  Supplements should contain calcium, magnesium,  vitamin D, boron, silicon, vitamin C, strontium, and vitamin K.

Take care of your bones and they’ll carry  you  through into your happy, healthy, vibrant golden years.