Welcome to the Integrative Medical Group of Irvine!

The Integrative Medical Group of Irvine blends the best of conventional, naturopathic, and holistic medicine, providing comprehensive, integrative health care for men and women of all ages.

We provide a wide range of care, including physical exams and annual women’s visits, acute and chronic care, and a full spectrum of preventive and wellness services. The practice was established by Felice Gersh, M.D., a gynecologist and fellowship-trained physician in Integrative Medicine. Because coordinated care at one site provides the best opportunity for achieving optimal health, the practice includes the specialties of integrative gynecology, weight management (including ProLon, the fasting mimicking diet developed at the Longevity Institute at USC), wellness and anti-aging medicine, aesthetics and skin care, along with nutrition and fitness. Additional services include, naturopathy and homeopathy, acupuncture, massage, IV therapy, Reiki and aromatherapy.

OUR EXPERTISE

We are a practice unlike any other, with exceptional skills and talents, and an amazing array of therapies and holistic tools available for your benefit. Our team is capable of tackling the most complex medical conditions, of both genders, and of all ages, addressing the intricate reality of the human body and all of its pressing issues.

ARTICLES

Managing Multiple Disorders in One Body

Managing Multiple Disorders in One Body

Women with PCOS exhibit a very high degree of medical complexity, including dysfunctions of key metabolic and immune mechanisms, affecting a wide range of organ systems. Such dysfunctions can manifest as multiple disorders in one body! Identifying the root causes and common conditions that weave their way through these multiple disorders will facilitate finding a unifying remedy, and eventually a cure, for PCOS and its related conditions. By understanding how foundational dysfunctions develop and then lead to a myriad of manifestations, we can take those crucial first steps. Conditions found at higher rates in PCOS women than in the general population includeautoimmune thyroid disease (Hashimoto’s Thyroiditis), endometriosis, uterine fibroids (leiomyomata), adenomyosis (uterine lining glands within the muscle of the uterus), and several cancers. Are women with PCOS simply unlucky to have so many medical maladies in one body, or is there a common theme to explain this? Once you delve beneath the surface, you come to recognize that all of these conditions have similar underlying mechanisms. Uniting all of them are the following: an abnormally functioning immune system, marked by chronic inflammation with elevations of inflammatory signaling agents called inflammatory cytokines, early age exposures to environmental toxicants (chemical endocrine disruptors), nutritional deficiencies, and gut microbiome abnormalities (dysbiosis). The ultimate unifying and underlying cause for all of these maladies in PCOS women is a foundational hormonalproblem: a major dysfunction of estrogen and its receptors, including its production and metabolic degradation. Estrogen is the master hormone, essential for metabolic health,and this requires a properly regulated immune system.  Sadly, PCOS women do not have proper metabolic or immune health. Let’s begin with a quick overview of the conditions mentioned above. Endometriosis involves a severe localized inflammation in the pelvis, with high levels of inflammatory cytokines within the intra-abdominal (peritoneal) fluid. Interestingly, most menstruating women have some uterine contents flow backwards with each menses, with fluids and tissue passing through and out the Fallopian Tubes. The body’s immune system normally dissolves and gobbles up that tissue, but in women with endometriosis, this process malfunctions, and little holes in the lining of the pelvis (the peritoneum) are created, allowing living cells from the uterine lining to implant and thrive. This process is controlled by a system of enzymes, called Matrix Metalloproteinases (which remodel tissue) along with immune cells of the body. These cells and processes are under the control of estrogen, which in PCOS women is not functioning correctly. One type of theseimmune cells – the Mast Cell, which isalso controlled by estrogen – accumulates within the pelvis of women with endometriosis, releasingmassive quantities of inflammatory cytokines and chemokines (signaling agents which call other inflammatory white blood cells to the scene.) Thiscreates and sustainslocalized inflammation, promotinglocal estrogen production, and further stimulating growth of the ectopic endometrial cells. In the case of uterine fibroids, malfunctioning Matrix Metalloproteinases and abnormal local production of estrogen and progesterone cause the muscle cells of the uterus to grow abnormally, creating muscle tumors – fibroids (leiomyomata). Likewise, adenomyosis involves the dysfunction of both the Matrix Metalloproteinases and of estrogen, resulting in the invasion of the endometrial (lining) cells into the muscle of the uterus. Hashimoto’s Thyroiditis, an autoimmune disease, also involves dysfunction of the immune system, gut dysbiosis,and impaired gut permeability (leaky gut), all related to abnormal estrogen function. Lastly, cancer, the ultimate immune dysfunction, involves uncontrolled inflammation and estrogen malfunction or deficiency. Not surprisingly, the incidence of many cancers is substantially higher in women with estrogen dysfunctions - PCOS, adenomyosis, fibroids, and endometriosis - compared with the rest of the female population. And what connects PCOS with those other conditions? What is the root cause of PCOS? We now understand that it involves chronic inflammation, gut dysbiosis, and leaky gut;and that estrogen malfunction is at the root of those problems. The cause for this estrogen malfunction involves exposures to endocrine disrupting chemicals at critical points of development – in utero, during infancy, and at puberty, in genetically susceptible women. This inflammatory state is exacerbated by continued chemical exposures and the consumption of a high fat/high sugar diet, filled with processed foods. Despite all of this, there is substantial reason for hope. A fiber rich diet, stress control, exercise, timed eating and periodic fasting, along with the judicious use of bioidentical hormones, can ameliorate these problems. More on my PCOS protocols for health will be forthcoming in future articles. References: Nielsen NM et al. Hum Reprod. 2011;26(6):1555-9 Smarr MM et al. FertilSteril. 2016 Jul 15. Soo15-0282(16)61389-4 Khoufache et al. Minerva Endocrinol. 2012;37(1):75-92 Burney et al. Fert and Steril, 2012;98(3):511-19 Konno et al. Human Cell. 2003;16(3):144-49 Cuevas et al. Reprod Sci.2012;19(8):851-62 Theoharides.ExpDermatol. 2017 Nat Rev Immunol. 2010 Hart, David. 2015. Intern J of Inflam. 2012;452095 Urb et al. PLOS Pathog. 2012;8(4) Abraham et al. Nat Rev Immunol. 2010;10(6):440-52 Menzies et al. Hum Reprod Update. 2011;17:383-96 Binda et al. ExpOpin on Ther Targets. 2017;21(1)67-75 Vliagoftis et al. Immunol Rev. 2005; 206:190-203 Qiao et al. Blood. 2006;107:610-18 Plos Pathog.2012;8(4):e1002619 Alvarez et al. Neuroscience. 2014;258:111-120 Hart, David. 2015. Intern J of Inflam. 2012;452095 Bulun et al. SmeRepr Med 2004;22(1):45 Sharpe-Timms et al. Ann NY Acad Sci.2002;955:147-56 Smarr MM et al. FertilSteril. 2016 Jul 15. Soo15-0282(16)61389-4 Bayoglu et al. Eur J Ob GynReprod Biol. 2015;184:1-6 Ozcan et al. GyncolEndocrinol. 2015;31(3):219-24 Yavuzetal.J Cancer Res Ther. 2014;10(2):324-9 Cao et al. Evid Based Complement Alternat Med. 2014;781684 Wang et al. Angiogenesis. 2013;16(1):59-69 Ricci et al. Hum Reprod. 2013;28(1):178-88 Xu et al. FertilSteril. 2011;96(4);1021-8 Jackson et al. Hum Reprod. 2005;20:2014-20 Halpam et al. Rev Assoc Med Bras 2015;61(6)519-23 Agostinis et al. Mediators Inflamm. 2015; 918089 Mojzis J et al. Pharmacol Res 2008. 57(4):259-65 Maia et al. Int J of Women’s Health;2012;4:61-65 Kim KA et al. PLOS one. 2012;7(10):47713 Heard ME et al. Endocrinology. 2016 Jul;157(7):2870-82
Do postmenopausal women need a laser treatment down there to stay sexually active

Do Postmenopausal Women Need a Laser Treatment “down there” to Stay Sexually Active?

The newly developed vaginal lasers for rejuvenation are getting more and more common in the US and I was given the opportunity to buy one at the very onset ... and did not do so. Here's why: 1. Only a very small subset of women should truly not use hormones, particularly vaginal application of hormones. The laser folk make no claims that lasers are superior to hormones, they are just a novel approach. You know they create micro-injuries which Induce healing mechanisms to be instigated-increasing blood flow and tissue regeneration. I'll not deny it may work. But it is not superior to hormones. If I'm giving just vaginal hormones, then my preference is for Vaginal DHEA cream. Second is vaginal estriol, and last is vaginal estradiol. 2. I view the development of vaginal atrophy as the "canary in the room!" A woman with such damaged tissue from hormonal deficiency has many more sites of damage. The vagina is just the obvious issue. I view menopause as the drying up of the woman - dry eyes, dry bladder, dry brain, dry arteries, dry GI tract ... and yes ... dry vagina. A vaginal laser will do nothing for those other sites!! I am not into just symptomatic treatment (though symptoms do matter), I'm into addressing the root cause of the problems which is a hormonal, not a laser, deficiency!! 3. I see the vaginal lasers and those who speak for them, as a money grabs on menopausal women still inappropriately fearful of hormones. In fact, the laser mentality further embeds the fears they have deeper - for why use a laser if hormones are safe? 4. The cost for the single purpose laser was $220,000 and I think it's now $245,000. For a low price, I'd say, use it as a jump start only and also begin hormones for true rejuvenation. A doctor would have to push it like crazy to see a return on investment! I'd hate to see doctors who own these lasers working all the time trying to convince all women to get treatments! If you give the vagina the hormones it needs, it stays healthy. Same for all organs. I heartily believe in physiologic hormones. Cells do as they are told and hormones do the telling. It's that simple to me! And estrogen is the master of metabolic homeostasis! To function like a healthy woman, you need healthy hormone levels! So now you have my take on vaginal lasers!
The Health Benefits of Sweet Potatoes

The Health Benefits of Sweet Potatoes

Sweet potatoes are available all over the world, and if you only eat these delicious root vegetables when they've been baked until they are virtually unrecognizable, then you are missing out on one of nature's greatest nutritional gifts. They are not only rich in a vast range of nutrients, but they are also one of the best natural ways to regulate your blood sugar levels, making them an exceptionally beneficial food for diabetics. It also helps that they are absolutely scrumptious, and their sweet flavor is completely unlike any other found in the vegetable world. Indeed, sweet potatoes are so versatile that they're sure to liven up a whole range of dishes, even desserts!

Selecting and Storing Sweet Potatoes

There are different varieties of sweet potato, and many come in different colorings and hues. Here are some tips for selecting, storing and preparing the vegetable, so that you can benefit from as much goodness as possible.
  1. Choose the darker variety of sweet potato at the grocery store if possible, because they have the higher carotene content, essential for the production of vitamin A. Purple sweet potatoes, more commonly found in Asia, are also a great source of nutrients. Paler varieties are healthy but don't offer quite the same number of benefits as darker types, and many people often confuse them with yams.
  2. Avoid wrinkly, soft sweet potatoes and take time to select ones with good, firm flesh. If there are signs of green discoloring, then leave them alone.
  3. Store sweet potatoes in a cool, dark and well-ventilated place. Do not leave them in plastic bags, or keep them in the fridge. Consume within 7-10 days of purchase.
  4. Prepare sweet potatoes in the same way you would prepare normal white potatoes. However, bear in mind that the skin contains a large percentage of the nutrients, so try to leave it on if possible. You can make fantastic sweet potato fries by leaving the skin on, and chopping the vegetable into strips.
  5. You can steam, bake, boil or roast sweet potatoes, and still benefit from plenty of nutrients. But as with any vegetable preparation, try not to over-cook them.

Specific Health Benefits of Sweet Potatoes

Although they are soft, creamy and sweet enough to be used in some desserts, sweet potatoes offer a surprisingly huge range of nutritional benefits, many of which have specific health benefits. 1. Great for Heart HealthSpecific Health Benefits of Sweet Potatoes The high levels of vitamin B6 and potassium found in sweet potatoes provide excellent benefits for your heart. B6 vitamins break down homocysteine, a substance which can harden blood vessels and block arteries. Potassium, meanwhile, helps balance fluid and blood pressure levels, while providing your body's cells with electrolytes that help regulate your heart beat. 2. Great Source of Vitamin A Sweet potatoes contain a huge amount of beta-carotene, a carotenoid that gives certain vegetables their orange color. The body can turn carotenoids into vitamin A, which is linked to cancer prevention, the maintenance of good vision, and also provides a number of anti-ageing benefits. Indeed, one large sweet potato is capable of providing 100% of your recommended daily intake of vitamin A according to the U.S. Food and Drug Administration. 3. Great for Blood Sugar Levels Although they are sweet tasting, sweet potatoes are low on the glycemic index, which means they are a very good blood sugar regulator. Many starchy foods, including white potatoes, encourage blood sugar levels to spike and rise rapidly, but sweet potatoes release sugar into the bloodstream much more slowly. This makes them a great choice for diabetics, who can safely consume the carbohydrates without associated problems. 4. Great for Skin Care Sweet potatoes can work to improve the appearance of your skin from both inside and outside your body. The high levels of vitamin C and E contained within sweet potatoes helps boost the body's defenses against the sun's harmful UV rays and encourages the production of collagen, which keeps the skin strong and supple. But it isn't only the consumption of sweet potatoes that can benefit your skin. If you boil them, don't throw away the water afterwards. Take a cup and use your fingers to gently apply the water to your face. This can help clean your pores, remove impurities from the skin and even reduce dark circles around your eyes. Health Benefits of Sweet Potatoes 5. Great for Digestion Sweet potatoes are a great source of dietary fiber, while still being low in calorie content. Fiber promotes a healthy digestive tract, helping your body pass toxins and waste products out quickly and efficiently while guarding against constipation and bloatedness. 6. Great for Emphysema Prevention Emphysema is a condition that gradually damages the air sacs in the lungs, leaving sufferers short of breath. It is often associated with smokers, or people exposed to smoking on a regular basis.  Smoking reduces levels of vitamin A, which helps regenerate the cells in the lungs. The beta-carotene contained within sweet potatoes encourages the production of vitamin A and helps heal the respiratory system. 7. Great Source of Vitamins and Minerals Sweet potatoes contain a significant amount of vitamins C, E, B5, B6, riboflavin and copper. These nutrients offer a range of benefits for your immune system, red blood cell production, sleep patterns, mood, wound repair, disease prevention, muscle weakness and pain. 8. Great for Stress Relief Sweet potatoes contain high amounts of magnesium, often considered to be one of the best minerals for promoting relaxation, calmness and improved mood. As we already know, they are also rich in potassium, which helps regulate your heart beat when you are anxious or stressed.

Dr. Gersh has been my doctor for 25 plus years. She is brilliant and constantly up to date on new studies, re-educating herself and her team to give the most integrative and thorough medical service. She is a caring and inspiring doctor.

-JS, Irvine
Tame The Flame
Women with PCOS live in a state of chronic inflammation. Click the button below to sign up for your free mini-ebook report to learn how you can tame the flames of your PCOS.