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Dr. Kathleen Mahannah, ND

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Dr. Kathleen Mahannah, ND

Dr. Kathleen Mahannah is a Naturopathic Physician with a special focus in hormones and women’s health.

Integrating the best of modern and natural medicine to treat women and their families. Dr. Mahannah uses functional hormone testing to identify and treat hormone imbalances to help women overcome exhaustion, PMS, menopausal symptoms, and support fertility, naturally.

03/09/2026

🤨 What exactly is endometriosis?

Endometrial pain and related symptoms are caused by the presence of inflammatory, "endometrial-like” tissues outside the uterus.

⚡️ These lesions can arise in various locations, including on the ovaries, around the uterine ligaments, fallopian tubes, intestines, the appendix, the diaphragm, or the lungs. Endometriosis tissue has hormone-producing enzymes and hormone receptors, is inflammatory, and, over time, can develop into adhesions, fibrosis, and endometriomas (“chocolate cysts”), which can cause dysfunction in the organs to which they are attached.

⚡️ These tissues respond to estrogen, other hormones and inflammatory molecules. This means that as hormones fluctuate throughout the menstrual cycle, this tissue responds with an abnormally excessive inflammatory cascade, which causes pain and other symptoms.

➡️ I emphasize that these tissues are “like” but not the “same as” the endometrium.

The endometrium is the normal inner lining of the uterus that responds to monthly hormone fluctuations and sheds once a month as a period. Many medical resources will describe endometriosis as “abnormally displaced endometrial cells” located in areas they shouldn’t be, contributing to the pain symptoms. However, microscopic analysis of endometriosis tissue reveals that it is actually much different from the normal endometrial lining: it has altered hormone production and hormone receptor expression compared to normal endometrium. These factors all contribute to a much higher production of inflammatory cells, which seems to be what causes the pain and dysfunction.

🌸 Check out the link below for more information. More to come this week on the proper diagnosis of endo, and various medical and natural treatment options.

https://drkathleenmahannah.com/blog/endometriosis-natural-treatments

03/06/2026

🌟Endometriosis🌟 is a common, and unfortunately, commonly under-diagnosed pain condition that occurs in people who menstruate.

It is estimated that 10-15% of women have endometriosis (meaning, around 1 in 10 women – and that is a conservative number).

It is characterized by extremely painful or crippling menstrual pain, and can present with other symptoms such as:

➡️ Pain during sexual activity
➡️ Pain during bowel movements
➡️ Pain during exercise
➡️ Bowel or urinary pain or dysfunction
➡️ Heavy or irregular bleeding
➡️ Bloating, nausea or vomiting
➡️ Infertility, difficulties getting pregnant, or recurrent pregnancy loss
➡️ Allergies, migraines or fatigue that worsens around me**es
➡️ Lower back pain or leg pain during me**es

Unfortunately, endometriosis is often misdiagnosed as “dysmenorrhea” (painful cramps), and it can take years for a woman to get a correct diagnosis. I’m talking anywhere from 7-10 years. In my opinion, this is unacceptable. I have many women in my practice who have tried for years to get their doctors to listen to them when they describe how the weeks (not just a few days) of intense pain they experience each month.

Almost all women feel fatigued from being in so much pain, which in turn contributes to difficulties at work, in relationships, athletic performance, or even the ability to just get out of bed and function on a day-to-day basis.

🌟This month is , so I will be sharing more about the difference between “period cramps” and endometriosis and how you can tap into natural medicine to help manage both.

03/03/2026

Hormone testing in perimenopause often sounds like it should offer clarity, and there are many online messages that reinforce that idea.

Let’s gently unpack another common myth. 👇

Myth 5: “If hormone testing isn’t used, then care is guesswork.”

🌿 Why this feels unsettling:

Without numbers, decisions can feel arbitrary.

🌿 What the evidence shows:

Menopause care is not guesswork; it’s pattern recognition, clinical experience, careful response-based adjustment and evidence-informed treatment plans. This is how professional guidelines recommend care be delivered.

🌿 What helps more:

A collaborative approach where treatment decisions are revisited and refined based on how you feel over time.

*It makes sense to want proof. It makes sense to want certainty.

But in perimenopause and menopause, your symptom story matters more than a snapshot lab value.

Hormone testing isn’t being avoided because your symptoms aren’t real... it’s avoided because it often doesn’t answer the question you’re probably actually asking:

“Why do I feel this way, and what will help me feel better?”

That answer comes from careful listening, experience, and individualized care, not from chasing hormone numbers in a blood test. 💚

💚 If you’re navigating symptoms and want care that’s thoughtful, collaborative, and tailored to you, I’d be honoured to support you.

02/27/2026

Hormone testing in perimenopause often sounds like it should offer clarity, and there are many online messages that reinforce that idea.

Let’s gently unpack another common myth. 👇

Myth 4: “More testing means better care.”

🌿 Why this feels reassuring:

Testing can feel proactive and thorough, like leaving no stone unturned.

🌿 What the evidence shows:

When hormone tests (estrogen and progesterone) are unreliable or poorly correlated with outcomes, they can create more confusion, anxiety, and over-treatment without improving results.

🌿 What helps more:

Care that prioritizes listening, context, and thoughtful follow-up over frequent hormone testing.

Proactive health testing IS important, and there are OTHER blood tests that are very insightful and valuable (a topic for another day). But it requires a reliable test to interpret it and make it actionable and helpful. Unfortunately, estrogen testing is just not reliable enough to be considered a *helpful* test.

Stay tuned as I uncover more common myths next week. 👀

02/25/2026

✏️ Hormone testing in perimenopause often sounds like it should offer clarity, and there are many online messages that reinforce that idea.

Let’s gently unpack another common myth. 👇

Myth 3: “If my estrogen level is ‘normal,’ my symptoms must be coming from something else.”

🌿 Why this feels discouraging:

This can feel invalidating, like your experience is being dismissed. All of your symptoms point to estrogen or perimenopause, and yet your levels are “”normal.””

🌿 What the evidence shows:

Hormone levels and symptoms do not correlate well in this life stage. “Normal” labs do not mean your symptoms aren’t hormonally influenced! In fact, some women’s brains are more sensitive to the rapid SWINGS in hormones (from high to low & vice versa), not the actual “”level”” of hormones. Hormones fluctuate wildly in perimenopause, and this can present as hot flashes, night sweats, worsened PMS symptoms or worsened mental health.

🌿 What helps more:

A clinician who understands that perimenopause is about hormonal variability and sensitivity, not just deficiency.

Stay tuned as I uncover more common myths this week.

02/23/2026

Hormone testing often sounds like it should offer clarity, and there are many online messages that reinforce that idea. Let’s gently unpack some of the most common myths.

Myth #2: “There’s an ‘optimal’ estrogen level I should be aiming for.”

❓ Why this feels true:

Many areas of medicine use target ranges, so it’s natural to assume hormones work the same way.

📚 What the evidence shows:�
For menopausal symptoms, there is no universally agreed-upon estrogen target level. Two people can have very different readings at the same lab value, and chasing a lab value often leads to unnecessary dose changes.

✅ What helps more:�
Finding the lowest effective dose that improves symptoms and feels sustainable for you.

✨ Stay tuned as I uncover more common hormone myths this week!

02/20/2026

When you’re not feeling like yourself, it’s natural to look for something concrete to explain why. 🤍

Hormone testing often sounds like it should offer clarity, and there are many online messages that reinforce that idea. Let’s gently unpack some of the most common myths.

Myth #1: “If we measure my estrogen, we’ll know what’s wrong.”

❓ Why this feels true:

We’re taught that blood tests reveal the truth about our health. So, when symptoms appear, it feels logical that a number must explain them.

📚 What the evidence shows:

In perimenopause and menopause, estrogen levels fluctuate too much to reliably explain symptoms. A single result often reflects timing rather than what your body is experiencing overall.

✅ What helps more:

Tracking symptom patterns over time gives far more useful information than a one-time hormone level.

✨ Stay tuned as I uncover more common hormone myths!

02/18/2026

🍜 Cooler weather means one thing: cozy soups on repeat! This is Thai-inspired noodle soup with coconut milk, curry paste, veggies, and your choice of chicken or tofu is my new go-to soup. It’s creamy, gingery, spicy, and nourishing.

🤤 Bonus? It’s versatile, working well with almost any veggies you have around!

Simple methods. Big flavour.

✨ Ingredients ✨�
* 1 Tbsp coconut oil (or olive or avocado oil)
* 1 large shallot, thinly sliced (1 shallot yields ~3/4 cup or 90 g // or sub onion)
* 3 Tbsp minced fresh ginger
* 4 cloves garlic, minced (4 cloves garlic yield ~2 Tbsp or 18 g)
* 2 Tbsp red or yellow curry paste
* 1/2-1 tsp red pepper flakes (depending on heat preference and heat level of your curry paste)
* 4 cups broth of choice (chicken or vegetable)
* 1 (14 oz.) can light coconut milk (or full-fat for a richer soup)
* 2 Tbsp coconut aminos (or tamari)
* 1 ½ lb boneless skinless chicken breasts or thighs, cut into bite-sized cubes (or 14 oz. extra-firm tofu, cut into 1/2-inch cubes)
* 3-4 cups chopped bok choy (we used baby bok choy // 2 small baby bok choy yield ~3-4 cups or 225-300 g // or sub broccoli florets or finely chopped carrots)
* 2 cups sliced mushrooms (cremini, shiitake, or white button all work // or sub bell pepper or green beans)
* 1 cup snap peas, ends trimmed, cut into 1-inch pieces (optional // or sub frozen corn)
* 1-2 Tbsp lime juice (or lemon juice // 1/2 lime yields ~1-2 Tbsp juice // optional)

✨ For Serving ✨�
* 8 oz. brown rice noodles (or other pasta/noodles of choice // we like Annie Chun’s Pad Thai Noodles)
* Fresh mint and/or cilantro (optional)
* Chopped roasted peanuts or cashews* (optional)
* Lime or lemon wedges (optional)

Recipe and images courtesy of Minimalist Baker

https://minimalistbaker.com/cozy-curry-noodle-soup-thai-inspired/

02/17/2026

For the vast majority of women navigating perimenopause or menopause at the usual age, testing estrogen does not tell us how to treat symptoms or how much hormone therapy you “should” be on.

🤔 So what DOES help?

This is the part that matters most.

Even though there isn’t a helpful blood test, there is a much better way forward, and it starts with being truly heard.

👉 Swipe through to learn what actually guides effective perimenopause and menopause care, and why your symptoms matter more than a hormone number.

02/13/2026

📈 There are specific medical situations where estrogen testing makes sense. For example, in women who experience loss of ovarian function before age 40, and sometimes, women who can’t track their periods due to the Mirena IUD or because of a hysterectomy.

➡️ When menopause-like symptoms arise “too early.”

Some women experience early loss of ovarian function (called Primary Ovarian Insufficiency, or POI). This presents as irregular or absent periods, infertility, or menopause-like symptoms due to insufficient estrogen before the age of 40. In these cases, hormone testing helps confirm the diagnosis and, in some cases, supports long-term health decisions.

➡️ No periods due to the IUD or hysterectomy

Many people rely on periods as a roadmap. When bleeding is no longer a clue, it can feel like you’ve lost your main way of knowing what your body is doing

You might wonder: “Can’t we just check my hormones and get a clear answer?”

That’s a very reasonable question, especially because the lack of a period can make it harder to know whether you’re in perimenopause or menopause.

The menopause societies acknowledge that a diagnosis of menopause becomes more challenging in these circumstances. In some cases, hormone testing (with Follicle Stimulating Hormone, FSH) might be offered, but only if it makes a difference in what treatment decisions it influences.

The results need to be interpreted cautiously because, as you now know, hormones fluctuate a lot in perimenopause, and this can confuse the results. The British Menopause Society suggests that testing may be a “supportive tool,” but a single FSH or estradiol level cannot confirm menopausal status. At a bare minimum, these tests would need to be repeated at least twice to be somewhat more confident that they do suggest menopause.

But for the vast majority of women navigating perimenopause or menopause at the usual age, testing estrogen does not tell us how to treat symptoms or how much hormone therapy you “should” be on.

💚 If you’re navigating symptoms and unsure what applies to you, a personalized conversation and a taliored treatment plan can make all the difference.

02/12/2026

😰 One of the most frustrating realities is this:

Two women can have the same estrogen level and feel completely different.

Some women feel relatively well with very low levels. Others feel miserable even when blood levels look “okay.” That’s because symptoms are influenced by many factors, including how sensitive your brain and nervous system are to hormonal shifts, not just the hormone level itself.

So when someone says, “Let’s just check your estrogen,” it can sound reassuring… but it often leads to more confusion, not clarity. 🤔

Stay tuned to find out when estrogen testing IS used (and why that is different)! 🌟

02/09/2026

Estradiol (a form of estrogen) is the hormone most people think of when they think about perimenopause and menopause. So why not just measure it? 🤔

The challenge is that during perimenopause, and even after menopause, estradiol levels:

🌟 Fluctuates dramatically, sometimes day to day or even hour to hour. This means that a single blood test might reflect your blood levels at the time it was drawn, but levels can be vastly different even 1 hour later. This makes the test result unreliable.

🌟 Can be affected by stress, sleep, illness, alcohol, medications, and supplements, among other factors.

🌟 Become very low and difficult to measure accurately with standard lab tests. Lab assays are not precise enough, especially at low levels; results vary widely across labs, and small numerical differences often lack clinical significance.

🌟 Can vary dramatically depending on your hormone therapy dose, delivery system, and when you last took it. For those on hormone therapy, blood levels can vary dramatically depending on your dose timing, whether you use the patch or gel, and even your skin texture (e.g., dryness), among many other factors that influence individual hormone therapy absorption and metabolism.

Even with the best available testing, estrogen levels at this stage of life are often too variable and too imprecise to reliably explain symptoms or guide treatment decisions. Furthermore, the inaccuracy of blood estrogen testing makes it easy to over-interpret results and cause unnecessary worry or hasty treatment changes.

In fact, large menopause organizations have looked carefully at the evidence and consistently concluded that routine estrogen testing does not improve care for most women in perimenopause or menopause (including the Menopause Society, British Menopause Society, and the Society of Gynecologists and Obstetricians).
�That’s not because your symptoms aren’t real. It’s because the available tests aren’t good enough. 📊

✨ If you’re feeling confused by hormone testing, book in with me to talk through your symptoms, options, and a plan that makes sense for your body.

Address

#319/1277 Lynn Valley Road
North Vancouver, BC
V7J2A1

Opening Hours

Monday	9am - 5pm
Tuesday	9am - 5pm
Wednesday	9am - 5pm
Thursday	12pm - 8pm

Website

http://www.drkathleenmahannah.com/

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Dr. Kathleen’s Story

I’m a North Shore native; a former high performance athlete-turned outdoors enthusiast; and a Naturopathic Physician. I’m passionate about empowering women in their healthcare so that they can take on their career, family and life goals feeling supported, energized and vibrant.

Growing up as an athlete in North Vancouver, I've always been fascinated by the human body. I never cease to be amazed with the ability of the body to grow, change, build up and break down. Coming from a family of medical professionals, I gravitated towards the healthcare field and studied Exercise Science at Capilano College and then Physical Health and Education at the University of Toronto. As a varsity athlete for both my college and university varsity volleyball teams, I experienced the transformation that occurs with dedicated high performance training. Graduating with honours from a top Canadian university also humbled me how stress, and the way in which one’s thoughts and intentions can impact your physical mental and spiritual health. I explored various healthcare careers before I settled on a career in naturopathic medicine. I’m thrilled to be practicing in my hometown of Lynn Valley, North Vancouver at Restoration Health Clinic.

I believe that women should have a strong and supportive health care team dedicated to providing her with thorough testing, time to discuss natural and medical treatment options, and a comprehensive plan spanning medicine to dietary support and lifestyle changes. Most importantly, she should feel heard and cared for. This is what I seek to provide as a Naturopathic Physician. I treat women of all ages and their families, prioritizing safe, effective, natural medicine. I also use my prescription authority when needed, so that we can combine the best of modern and traditional medicine. Most importantly, I treat you by ensuring you feel heard, involved and empowered in your health and healing.

Thank you for visiting my page! If you’d like to learn more about how to use food, herbs and natural medicine to heal yourself and support your family, ‘like’ my page and let’s keep in touch :)