Incontinence, Bladder issues and Weak Pelvic Floor

Incontinence is often an embarrassing condition that will have more than a third of people suffering in silence because they are too embarrassed to seek treatment. Both men and women can suffer incontinence. Although patients don’t die of incontinence, they often can’t live a fully productive life, they may have to curtail their workload or change jobs. Many factory workers and school teachers are only allowed set times for toilet breaks, so patient with urge incontinence may have to change jobs. Patients who work in the military or the police force may have to resort to desk jobs. Too many women with incontinence stop having sexual intercourse, either because they are afraid they will leak during sex, or else they actually do leak, either at penetration, or at time of orgasm, which can be very disastrous. While men can also suffer incontinence, I am mainly going to focus on the causes of incontinence in women for this post.

Many people don’t seek treatment because they also believe that surgery is their only option. Nothing could be further from the truth and surgery should only be used as a last resort once conservative methods have been used and aren’t working. Even then, the surgical approaches used today are less invasive, are very effective and the recovery is very quick. It is not like it was 10-20 years ago. Keyhole surgery has really made major changes in this area and new surgical techniques are so highly effective.  I know people want to avoid any surgery, but sometimes it is needed and these days the recovery rates are so quick. A few days out of your life for recovery, can actually change your whole life. I just do not understand why anyone would put up with a life with incontinence, prolapse, or weak pelvic floor, when these issues are so easily fixed these days. I know many patients are so amazed at how easily their incontinence issues was fixed and how amazing they feel in getting their life back again. No more leakage when they laugh, cough, or exercise.

Some people never seek treatment believing that incontinence is just a normal part of life. Again, this is not true and all and I encourage anyone with incontinence to come and talk to me, or you pelvic floor specialist, so we can help treat you and can also refer you to the right people for treatment and management if needed. I know my pelvic floor/urodynamic surgeon is amazing and what he can do for women and these issues is amazing too. Then I just help with the management and strengthening moving forward.

Like I said before, surgery isn’t always needed. Many times conservative measures such as pelvic floor exercises, core strengthening, bladder toning, topical estrogen therapy, internal TENS (electrostimulation) and pulse magnetic therapy can all product fantastic long term treatment to this often debilitating condition, without the need for surgery. There are also some special rings and other devices that can be used to prevent leakage and support prolapsed bladder and also vaginal prolapse causing incontinence. Men with incontinence also have options at hand and these can also be explored well before surgery is needed. What people need to be aware of too, is that if you have been doing all the conservative treatments, and they aren’t helping, then it is time to get some surgical intervention. I think people think that pelvic floor exercises with fix all bladder and pelvic floor issues, and this doesn’t work, then there is nothing that can be done to help them. I need for all women (and men) to know that there is always help for bladder and pelvic floor issues and you just need to see a specialist, not just your GP.

On a natural medicine level, acupuncture has been shown to be very effective in the treatment and management of pelvic pain, prolapse and incontinence. Anyone with incontinence should be using acupuncture as part of their overall management. There are also Chinese herbal medicines that can help with toning the pelvic floor and bladder to help stop incontinence. Yoga and Pilates may also help toning of the pelvic floor and help managing incontinence, pelvic floor and post-surgical management of prolapse too.

Incontinence and bladder issues are defined as needing to pass urine more than 8 times per day, leakage of urine through cough, sneeze, urge, or without cause. It is important to seek help if you notice damp underwear, need to use pads because of leakage or are constantly running to the loo to pass urine.

There are many different types of incontinence with the main ones defined as stress incontinence, urge incontinence and voiding dysfunction/incomplete emptying. There is also mixed incontinence (mix of the 3 main ones) and also a term called overactive bladder syndrome which can be a mixture of all forms of incontinence. There are also inflammatory bladder conditions that cause incontinence such as bacterial cystitis and interstitial cystitis. Physical issues such as previous surgery, childbirth and prolapse can also cause incontinence too.

The first task for the clinician is to find out how severe the incontinence is, based on the frequency of leakage, whether the woman finds it necessary to use incontinence pads, and if so how many pads. Some patients may prefer to change their underwear more frequently, while others may tuck tissue paper inside their underwear, and just throw away the tissues whenever they are damp.

The classic feature of stress incontinence is that the patient leaks with coughing, sneezing, laughing, running, playing sport or lifting heavy objects

The classic feature of urge incontinence is that the patient rushes to the toilet with an urgent desire to pass urine, but as she gets to the loo and is taking down her trousers, the urine comes away from her- sometimes before she has even sat down. Unfortunately these patients cannot predict when these bladder spasms will come upon them, and therefore can’t really tell when they are likely to leak.

Nocturia is defined as being woken up by your bladder needing to go to the toilet- as opposed to being woken up by a crying baby, a snoring husband, or menopausal night sweats. However nocturia is age dependent. Nocturia is defined as waking 1 or more times per night if under 60 years of age

Typically this patient Voiding dysfunction/ Emptying difficulty has to strain to commence voiding (called “hesitancy”). She may also have observed that when she compares herself to other women urinating in the toilets at the movies or in airports, her stream seems poorer than others with the urine dribbling out more slowly. She will often also describe the sensation of incomplete emptying and may need to go back to the toilet within a relatively short time to re-void. Sometimes she will leak as she gets off the toilet, which is how she realises that she is not empty. This is called post-micturition dribble incontinence.

In males these symptoms most commonly occur when the prostate gland is enlarged- causing a relative urethral obstruction and making it more difficult for the urine to get out. These men have chronic high residual urine, so they end up going to the toilet very frequently in a vain attempt to empty out. They often dribble urine onto their clothes. When such men have prostatic surgery they usually find that their urine flow rate returns to normal and they usually stop dribbling.

We will also need to explore how inflammation of the urinary bladder leads to suprapubic pain, and consider the two main causes of this, Bacterial Cystitis and Interstitial Cystitis .It often feels difficult to treat incontinence in the presence of bacterial cystitis, because such patients are overwhelmed by frequency and urgency of micturition and they may experience disabling suprapubic pain. It is fixable with the right treatment though. It all gets back to who is managing you.

On the other hand, a separate cause of Urinary Pain, called Interstitial Cystitis, does not usually cause much incontinence at all- it just causes suprapubic (bladder) pain with severe frequency and urgency of micturition.

The overactive bladder (OAB) is a clinical syndrome, not a urodynamic diagnosis. It comprises frequency, urgency, and nocturia, with or without urge incontinence.

Gynaecological conditions such as Endometriosis and Adenomyosis etc can also cause issues with bladder and pelvic floor.

Please read my post on Atrophic vaginitis as this is also another cause of weakness in the pelvic floor and bladder and could be a cause of incontinence.

No matter what sort of incontinence you have, there is always an answer and a solution to your problem. Not all solutions are surgical either. More often than not some conservative treatments, some exercises and some acupuncture is all that is needed. Sometimes all some women need is some treatments with estrogen creams to help with tone in the vagina, bladder and pelvic floor

Surgery and now bionic devices are always an option for those whom have tried conservative options and aren’t getting the desired results. Surgery is often used because of quality of life issues. Again surgery these days is so effective and less invasive and the recovery is so much quicker due to keyhole surgery and new surgical interventions.

If you are experiencing incontinence or bladder issues, please book in and see me, or a good pelvic floor/urodynamic specialist, so you can be evaluated properly and see what is going on and implement the right treatment strategies to get your quality of life back again. Many times there may be an easy non-invasive treatment for your particular issues. Even when surgical intervention is needed, these days even this is less invasive than it used to be and the recovery and results are very quick.

Please read my post of Atrophic Vaginitis as well as this all ties into this area too, especially for those women in the menopause and post menopausal time of their life.

 

Regards

Dr Andrew Orr

Reproductive Medicine and Women’s Health Medicine Specialist

-No Stone Left Unturned

– Women’s & Men’s Health Advocate

The Different Colours of Semen and What These May Mean

Many men often believe they have healthy sperm and healthy semen just because they were born male. The fact is that these days men’s sperm is now not as good as men’s sperm was 50 years ago. Much of this is now blamed on environmental estrogens and also dietary and lifestyle factors. Let’s face it, many guys are big alcohol drinkers, they eat poorly and some of the population are also indulging in recreational drugs regularly too.

To put it honestly, many of the male populations sperm are drunk, stoned and have so many defects from the lifestyle their owner has been living. The fluid they swim in, the seminal fluid, is often contaminated and not that much better.

While many men may want to believe they could impregnate every woman in their sight, or at the local bar, many men are flat out getting the woman they are with pregnant.

As I have often said, many often look at the female as being the major factor in the reproductive and fertility journey, yet to be honest; men are more than 50% of the issues faced with fertility and up to 85% of miscarriage issues are related to chromosomal and DNA factors related to sperm. These chromosomal and DNA factors cannot be seen in a routine semen analysis either and does require specialised genetic testing.

Men’s overall health is reflected in his sperm and semen and this health is now known to be passed onto his offspring. Yes, what men eat, drink, smoke, think etc, is passed onto his offspring. That is why we say the healthier the man is, the healthier his sperm is. Healthy men produce healthy babies.

The colour of semen

Much can be seen in the quality of men’s sperm and much can also be seen by the colour of the seminal fluid that sperm are carried in.  While semen is typically a whitish-gray colour, there are some instances when semen may appear as a different colour, which is commonly yellow. Sometimes producing unusual coloured semen is a once-only occurrence. Other times, a man may notice a more consistent change in the colour of his semen. Although this occurrence is not always a cause for concern, there are some instances when semen colour change can be an indicator of an underlying medical condition, or that a man’s health and lifestyle may be affecting his seminal fluid and his sperm.

 

Fast facts about semen and colour changes

Semen is a gel-like liquid that males emit during ejaculation or sexual release. Semen contains sperm, which can fertilize a female egg. Several glands and male reproductive organs are responsible for producing semen and transporting it for ejaculation. Dysfunction of one or more of these areas could lead to semen colour changes. Treatments for unusual coloured semen will depend upon the underlying cause.

Semen as a substance is a combination of secretions from the male reproductive glands as well as sperm. Changes and disruption to these areas are what cause colour changes.

Colour changes to semen and what is could mean:

Yellow Semen

One of the main colour changes seen in sperm is that is changes to the colour yellow.
The urethra is the tube that urine and semen pass through, so urine may mix with semen to change the colour. Although semen is usually a whitish-gray color, some men may have sperm that can change to a yellow colour. However, if yellow semen represents a significant colour change for a man, this could be cause for concern.

While semen that is light yellow is not usually a cause for concern, there are instances when a man should see a doctor for yellow semen, especially when the semen is a dark yellow.

If a man has other symptoms, such as yellowing skin, fever and high temp, the semen that has a terrible smell, or he experiences pain when ejaculating, he should see his doctor.

Some potential causes associated with yellow semen include:

  • Jaundice: This results when the liver a dsyfunction of the liver, or when the liver is in overload. Jaundice can causes yellowing of the eyes and yellowing of the skin and the semen can appear yellow too.
  • Abnormally high white blood cells: Inflammation can produce excess white blood cells. When there is infection, or inflammation, additional white blood cells can cause semen to appear yellow.
  • STIs: A sexually transmitted infection may also cause yellow semen. It may also cause other symptoms and cause the semen to have a terrible smell too.
  • Dietary changes: Eating certain refined foods can cause yellow semen. The smell of ejaculate may also change if a man eats strong-smelling foods, or have too much alcohol, or recreational drugs.
  • Infrequent ejaculation: If a man has not ejaculated in some time; the semen is more likely to have mixed with urine. The quality of semen and sperm is affected by infrequent ejaculation too. Storing it up makes it worse, not better and this is why regular ejaculation is important for sperm quality.

Other semen colour changes and what they may mean

Semen can be other colours too. Some other potential colour changes a man may notice include:

  • Brown or red: Sometimes blood vessel may burst around the seminal vesicles. The release of blood can cause semen to take on a brown or red appearance. If the semen continues to be red after 1 to 2 days, a man should seek medical treatment.
  • Green-tinted: Green-tinted semen can indicate a potential infection of the prostate or surrounding tissues. A man who has green semen may need to see his doctor.

What do if your semen colour changes

It is not completely abnormal for a man to produce semen that varies in colour, texture, and even smell. This can be caused by a man’s diet, lifestyle, amount of alcohol he drinks, drugs consumed, medications he is taking, and the amount of time since he last ejaculated. Stress can also affect his sperm and semen.

If a man notices something out of the ordinary, or his semen remains discoloured for an extended period, he should contact his doctor who can diagnose the potential cause and provide peace of mind. Sometimes medications and antibiotics may be needed. In severe cases surgical intervention and hospitalisation may be needed too.

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-‘Women’s and Men’s Health Crusader’

-‘No Stone Left Unturned’

 

 

 

 

 

What Is Lichen Sclerosus?

Lichen sclerosus is a long-term problem of the skin. It mostly affects the genital and anal areas. Sometimes, lichen sclerosus appears on the upper body, breasts, and upper arms. For this article I am just going to talk about Lichen Sclerosus of the genital region (Vulva) and more around how this affects women and how it can be treated and managed. Lichen sclerosus can cause itching, pain and scarring of the affected areas, but there are treatments available that can relieve symptoms and prevent and treat scarring.

Who Does Lichen Sclerosis Affect?

While anyone can get lichen sclerosus at any age, women after the menopause have the highest risk. In fact, it is about 10 times more common in women than in men. It is possible, but rare, for children to be affected.

What Are the Symptoms?

Early in the disease, small white spots appear on the skin. The spots are usually shiny and smooth. Later, the spots grow into bigger patches. The skin on the patches becomes thin and crinkled. The skin may also be inflamed and red or ulcerated from scratching.

Skin affected by lichen sclerosus can tear easily, and there may be tiny fissures (cracks in the skin). When severe, there may be bleeding and blistering.Sometimes, the skin becomes scarred. If the disease is a mild case, there may be no symptoms. 
Other symptoms are:

  • Itching (very common)
  • Discomfort or pain
  • Bleeding

Genital lichen sclerosus

Lichen sclerosus that affects the vulva usually feels intensely itchy. There may also be pain, stinging, burning or discomfort, especially during sex or when urinating.

Lichen sclerosus is a chronic, or ongoing, condition, and over time it can lead to scarring. If this affects the vulva, it may narrow the entrance to the vagina, interfering with sexual intercourse.

Women with severe lichen sclerosus in the genitals may not be able to have sex. The disease can cause scars that narrow the vagina. Also, sex can hurt and cause the patches to bleed. However, treatment with creams or ointments can help. Women with severe scarring in the vagina may need surgery, but only after lichen sclerosus is controlled with medication. When the skin around the anus is affected, pain when emptying the bowels can lead to constipation.

What Causes Lichen Sclerosus?

Doctors don’t know the exact cause of lichen sclerosus. Some doctors think a too active immune system and hormone problems may play a role. In women, lichen sclerosus also seems to be associated with autoimmune diseases (conditions where the immune system attacks the body), such as lupus , alopecia and thyroid disease. It is also thought that people inherit the likelihood of getting the disease. There may also be a hormonal involvement as It is also more common after menopause, when there is less oestrogen in the body.

Lichen sclerosus is more likely to appear on skin that has been damaged or scarred from some other previous injury. Importantly, lichen sclerosus is not infectious and your partner cannot catch it during sex.

How Is It Diagnosed?

Lichen sclerosus can often be diagnosed from the appearance of the affected skin. It is important that your GP refer you to a pelvic floor/urodynamic specialist, reproductive medicine specialist or women’s healthy specialist that specialises in conditions affecting the female reproductive organs. Sometimes a referral to a dermatologist may also be needed also.

Besides visual diagnosis, a biopsy may be recommended to confirm the diagnosis. This involves taking a small sample of affected tissue for a pathologist to examine under a microscope. This allows specialists to make sure that it is not a different disease.

Treatment of lichen sclerosus

Treatment of lichen sclerosus is aimed at:

  • Relieving symptoms of itch and discomfort;
  • Healing the lesions (returning the affected skin to its normal colour and texture);
  • Preventing the development of scar tissue; and
  • Treating any scar tissue that has developed.

Medical Treatments for Lichen Sclerosus

Lichen sclerosus is usually treated by applying a strong steriod cream, or ointment to the affected area. This is usually applied daily for several weeks, or months, and then less frequently (once or twice per week) long-term to prevent a recurrence.

Corticosteroid ointment or cream should be applied only to the white patches and gently rubbed in. Try to avoid applying steroid to the normal surrounding skin to help prevent side effects.

Symptoms such as itch may improve within a couple of days of starting corticosteroid treatment. Healing of lesions generally takes longer.

Women with Lichen Sclerosis will need regular follow up consultations and management with their specialist while using these creams and ointments for a long time because they can cause the following

  • Thinning and redness of the skin
  • Stretch marks where the cream is applied
  • Genital yeast infections.

Sometimes, women just do not get better using this medication and there could be other things that could be stopping symptoms from clearing up. This could be from the following:

  • Low estrogen levels
  • Infection
  • Allergy to the medication.

Other treatments

If topical steroid treatment is not effective, your specialist may recommend other medications and treatments that target the immune system and help control inflammation.

  • Sometimes other medications such as Retinoids, or vitamin A-like drugs are used and your specialist may also recommend laser treatment.
  • If scarring has occurred, this does not usually improve with steroid treatment. Scarring in females that is affecting sexual intercourse or urination may be helped by surgery
  • There are also some new medical treatments that are presently being researched and providing some amazing results options and I will discuss at a later date. They are actually natural medicines that are being used as a medical treatments. All I can say is that I have seen the results of this new treatment option and I think it is going to help many people. At present on of my colleagues, Dr Philip Hall, is using this treatment to help women as part of a research project. I will update people when I am allowed to say more about this new treatment.

Natural Medicine Treatments

  • There are natural medicine treatments that have been shown to help Lichen Sclerosus
  • Traditional Chinese Medicine
  • Acupuncture
  • Homeopathy
  • Herbal Medicine
  • Nutritional Supplements
  • Diet and nutritional changes ( to help reduce inflammation)
  • Counselling ( to help with dealing with the long term affects of dealing with this disease)

Self-care measures for genital lichen sclerosus

The following self-care measures may help in the treatment of lichen sclerosus that affects the genital area.

  • Gently wash the area daily with warm water and pH neutral soap cleanser.
  • Try not to rub or scratch the area. This can sometimes be really hard when it is itchy and inflamed
  • Avoid tight clothing and any activities that may aggravate itching and discomfort, such as bike riding.
  • Your specialist may recommend you apply cream to gently moisturise and protect the area.
  • Women should use a mirror to become familiar with the location and appearance of their genital lesions, and to apply cream or ointment to the affected area of the vulva.

Complications and follow-up

If you have been diagnosed with lichen sclerosus then it is advisable to have regular follow-up appointments with your specialist every 6 to 12 months. In addition, genital lichen sclerosus is associated with a small, but important, increase in the risk of cancer developing at the affected site. Frequent check-ups are important to detect any cancers early on, when they can be more easily treated.

I have treated many women with Lichen Sclerosus in my years in practice and I do find that a multimodality approach is the best way to treat and manage this disease effectively. Sometimes you need to have a team to help treat this, just like many other diseases women endure.So many women are are at their wits end with this disease and all sorts of treatments that have not worked. I can say this if this disease is treated and manage properly, it can give women their quality of life back.

Take care

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

Women’s & Men’s Health Crusader

-“No Stone Left Unturned”

 

 

 

 

Atrophic Vaginitis

Atrophic Vaginitis

Atrophic vaginitis is a vaginal disorder that usually happens after menopause. When estrogen levels fall, the vaginal walls can become thin, dry, and inflamed. This then causes the surrounding tissue to lose its elasticity and become atrophied. This can be uncomfortable. Gynaecological conditions such as endometriosis, adenomyosis and fibroids can make someone more prone to atrophic vaginitis as well.

As many as 40% of postmenopausal women experience symptoms of atrophic vaginitis after menopause, but only 20 to 25 percent will seek medical help. Many women will not seek treatment because they feel embarrassed due to the sensitive nature of the condition. Some women just put up with it believing it is normal. Untreated, it can affect a woman’s quality of life and even lead to increased risk of prolapse and other gynaecological and urological conditions. Many of the treatments are non-invasive and are very effective in a short amount of time.

Symptoms of Atrophic Vaginitis

  • vaginal dryness
  • pain during sexual intercourse, or dyspareunia
  • thin, watery, yellow or gray discharge
  • paleness and thinning of the labia and vagina
  • irritation when wearing certain clothes, such as tight jeans, or when on a bike seat
  • more frequent urinary tract infections (UTIs), or urinary tract like infections(which is from inflammation, with no infection present)
  • Vaginal Prolapse

Symptoms can also present in issues with the bladder and urination

  • painful urination
  • blood in the urine
  • increased frequency of urination
  • incontinence
  • increased likelihood and occurrence of infections, or irritation to the bladder that may feel like an infection

There may also be a reduction in pubic hair, and the vagina may become narrower and less elastic, which may cause a condition called vaginismus.

Causes

During perimenopause, menopause and post-menopause, a woman can have decreased levels of estrogen. When the ovaries stop making estrogen after menopause, the walls of the vagina become thin, and vaginal secretions are reduced. Similar changes can happen to women after childbirth, but these changes are temporary and less severe. These same changes can happen for women with endometriosis and adenomyosis and often why there can be changes to the wall of the vagina. Some of the medications used to help these conditions can also cause thinning of the vaginal wall and surrounding area. Many women with endometriosis, adenomyosis, fibroids etc, will have increased risk of atrophic vaginitis during the perimenopause, menopause and post-menopausal period.

Medications, or hormones, can be used as part of the treatment for breast cancer, endometriosis, adenomyosis, fibroids, or infertility to reduce estrogen levels. This decrease in estrogen can lead to atrophic vaginitis.

Other causes of atrophic vaginitis include:

  • severe stress
  • depression
  • Surgery, or treatment to the pelvic area
  • uncontrolled diabetes
  • rigorous exercise
  • chemotherapy

Other substances that can cause further irritation to the vagina are:

  • smoking
  • soaps
  • laundry detergents
  • lotions
  • perfumes
  • douches
  • tampons
  • yeast infections
  • condoms (due to latex allergy)

Diagnosis

The best person to see for this condition is a pelvic floor/urodynamic specialist, or a women’s health specialist. While you GP can help with diagnosis of this condition, it is preferable to see a specialist who has more training in this condition and can help manage this moving forward. A specialist will carry out proper examinations, be able to diagnose this correctly and ask about medical history. They may ask about the use of agents that can irritate the area and cause or aggravate symptoms, such as soaps or perfumes.

Your specialist will also do tests to rule out STI’s and other possible causes of infections such candidiasis, bacterial vaginosis etc. Atrophic vaginitis can make the area more susceptible to becoming infected. It can occur alongside an infection. A diabetes test may be performed to rule out diabetes. A biopsy may be taken to rule out cancer.

Treatment

The first line treatment is usually conservative treatments with topical estrogen creams inserted into the vagina and focuses treatment on the affected area. A low-dose estrogen cream can be used to stimulate rapid reproduction and repair of the vaginal wall, tissue and cells. Women should be shown how to insert the creams with an applicator and then use their finger to help disperse the cream properly to get good coverage of the vaginal wall.

Creams are much better than pessaries, because pessaries often do not disperse well and may only give coverage to a small area. These creams are also safe to use for those at risk of certain cancers, or who have had hormone dependent tumors.

Some women may also need to take Hormone Replacement Therapy (HRT), in the form of a tablet, gel, patch, or implant to supply estrogen to the whole body. These estrogens are effective, but there may be side effects. Patients should discuss the risks of long-term HRT (especially breast cancer risk) with their healthcare practitioner.

Some women may also need to use a water-soluble vaginal lubricant may help to provide relief during intercourse, for mild cases.

Regular exercise is important, as it keeps blood flow and genital circulation high. Pilates and yoga is very beneficial for the pelvic floor and core stability and should be part of a woman’s overall lifestyle management. Women in the perimenopause and menopausal periods of their life should be doing some form of weight baring and strengthening exercise regularly.

Diet is also important and very effective in the overall treatment of atrophic vaginitis, menopause and gynaecological conditions. A low GI/Low Inflammatory based diet should be adopted and it is important to see a qualified nutritionist to help set out the right individualized diet for you.

There are also herbal medicines, supplements, omega 3 oils, and other natural based formulas that can help with atrophic vaginitis. Acupuncture and Chinese herbal medicine are very effective in helping with atrophic vaginitis, menopause and gynaecological issues such as endometriosis and adenomyosis. There are many natural medicines and natural treatments that can help with pain, hormone regulation and micro-circulation for the vagina, uterus, bladder and reproductive organs.

Prevention

Regular sexual activity and stimulation of circulation to the vagina can help prevent atrophic vaginitis. It is more around climax helping, rather than just sexual activity, or intercourse. Some women have pain during intercourse, or experience dryness, so foreplay and being well lubricated can help this. Using a water-soluble vaginal lubricant can soothe mild cases during sexual intercourse. Masturbation and stimulation without intercourse to produce climax may help those women who have pain with intercourse, or who may not have a partner.

Regular climax and sexual activity can also show benefits for both the elasticity and flexibility of the region. Women who have regular climax and are sexually active report fewer symptoms of atrophic vaginitis when compared to women who do not regularly climax, or have regular sexual intercourse.

Regular exercise, such as Pilates and Yoga can help with the pelvic floor, vaginal tone, bladder and reproductive organs.

A low GI/Low Inflammatory based diet should be adopted and it is important to see a qualified nutritionist to help set out the right individualized diet for you.

There are also herbal medicines, supplements, omega 3 oils, and other natural based formulas that can help with the prevention of atrophic vaginitis and assist with circulation and hormone regulation.

Fast facts on atrophic vaginitis

  • Atrophic vaginitis refers to dryness of the vagina.
  • Symptoms include painful intercourse and an increase in urinary tract infections (UTIs), or urinary tract like infections (due to inflammation of the bladder, not from infection).
  • It is caused by a reduction in estrogen, normally following menopause or treatment with anti-estrogen drugs. It can also be caused from gynaecological conditions such as endometriosis, adenomyosis and fibroids.
  • Topical treatments and hormone replacement therapy (HRT) may help relieve symptoms
  • Around 40 percent of postmenopausal women experience symptoms of atrophic vaginitis, but many do not seek treatment.

If you you need help with any of the symptoms mentioned above, please book in to see me for a consultation and management. If you cant see me, please get your healthcare practitioner to refer you to a specialist for diagnosis, treatment and management of this condition and its symptoms

Take care

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-“The International Baby Maker”

-“No Stone Left Unturned”

 

Why Sperm Is The 51st Shade of Grey

Recently I have put up some serious posts about sperm and sperm quality and the importance of not storing it up, because it actually makes the sperm quality worse. It was intended for people trying to actually have a baby, but many of those still practicing, and not making, loved the post as well.

It is still good to promote healthy sperm production and reproductive function, even if you aren’t trying to have a baby.

But, while my post did raise a few eye bows, and caused a few giggles, or “There you go dear, I told you we need to have sex more often”.

However, I did see that there were some major misperceptions around the topic of sperm. So, I thought I’d better educate you all on the finer details of sperm

Biology 101 tell us that it takes a sperm and an egg, not just an egg (as many people seem to forget), to make a baby. The trouble is,over 50% of fertility issues are related to poor quality sperm and 85% of miscarriage issue are related to a man’s swimmers. So what do guys do when they hear this?

Well, they bury their heads in the sand and say “My boys are fine, I just know they are” and guzzle some more alcohol, that has their swimmers having two heads, two tails and swimming around like a drunk man in a pool. Guys are shockers when it comes to keeping their sperm healthy and why I will always be in business for fertility services.

But besides the downside of men and sperm, there are some good points to sperm, but most of the time Dr Google has you all believing things that just aren’t true at all.

So lets look at the facts about Sperm.

  1. Sperm can help fight depression in women– Research has shown that have oral sex, or unprotected sex (not that I advocate this unless in a healthy relationship), have less depression, have healthier moods and have healthy immune systems and are happier in general. Sperm helps increase oxytocin, prostaglandins and seretonin in women according the The State University of New York study.
  2. Sperm can make you more fertile – Semen isn’t just vehicle for carrying sperm – it also plays a crucial role in triggering ovulation, according to a new study.Scientists have discovered the protein in the sexual fluid acts as a hormonal signal on the female brain.This triggers the release of other hormones that signal the ovaries to release an egg.
  3. Sperm can help Embryo Implantation– Studies have shown that sperm actually assist in embryo implantation via several chemicals and hormones. Yet many people are told refrain for having sex after IVF. I can tell you that you need to have more sex and not listen to the BS and listen to the research that proves otherwise.
  4. Storing up sperm does not make it better– Research has shown that regular ejaculation improves sperm quality and the resulting transport of seminal fluids. (as was told to you in previous posts). Storing it up, does not make it better, it makes it worse. Regular ejaculation also helps the prostate.
  5. Sperm do not last for days– On ejaculation into a woman, most of the 300-500 million sperm that set off are dead within an hour and only about 5-10 single sperm actually survive the journey to the tubes, where many more half of those die off once more. Sperm are killed by acids,killed by the woman’s immune system, die in the uterus, get lost in the uterus, die on the tubes and so on. Only the fittest survive the race to pregnancy. (The human body series BBC)
  6. You can cook with it– Yep, there are cooking books that use semen to cook recipes with. (Natural Harvest – A Collection of Semen-Based Recipes). Where semen is described as “Semen is not only nutritious, but it also has a wonderful texture and amazing cooking properties. Like fine wine and cheeses, the taste of semen is complex and dynamic” Well there you go, crack open the bottle of grange now.
  7. Sperm is good for your skin– Sperm contains minerals such and zinc, vitamin C, prostaglandins, collagen, vitamins, amino acids and many other health things to help with skin. Bioforskning, a Norwegian company, has synthesized the compounds into a facial cream. According to Bioforskning, the cream Spermine is 30 times more effective than vitamin E and can delay the aging process by 20 percent. However, nature’s most natural facial cream can cost you a whopping $250. I’d like to see them try to market that at Myer 🙂
  8. The first sperm under a microscope- Antonie van Leeuwenhoek was the person to view sperm under a microscope. It’s a bright day in 1677, in the city of Delft, and Antonie van Leeuwenhoek is making love to his wife. But moments after he shudders with orgasm, he hurries out of bed to grab his microscope. After all, he’s not just spending time with his wife: he’s running an important scientific experiment at the request of the Royal Society in London. Sounds like nothing much has changed for some men. Now some are just rushing to watch the footy.

Well, there you go. 8 things Wikipedia can’t tell you about sperm. The good, the bad and the down right outrageous. You heard it hear first. The doc provides you news that other people are to scared to report. I hope all of you have a great up and coming week. Pardon the pun. Life is too short to be serious, about a serious topic.

References

1.http://www.dailymail.co.uk/health/article-2190863/Semen-good-womens-health-helps-fight-depression.html

2.http://www.dailymail.co.uk/health/article-2191495/Does-having-sex-make-women-fertile-Semen-trigger-ovulation-mammals.html

3.http://humrep.oxfordjournals.org/content/15/12/2653.short?rss=1&ssource=mfr

4 & 5. World Health Organization. WHO Laboratory Manual for the Examination of Human Semen and Sperm – Cervical Mucus Interaction (4th Edition). Cambridge University Press, Cambridge, UK (1999)

6. Human Body Series (BBC) – Conception

7.http://cookingwithcum.com

8. http://www.medicaldaily.com/extraordinary-things-you-can-do-sperm-242190

9.http://rstl.royalsocietypublishing.org/content/9/101-111/121.full.pdf+html

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Specialist

The International Baby Maker and Women’s and Men’s Health Advocate

-No Stone Left Unturned

Male Exposure to Chemicals, Alcohol, Diet and Drugs, linked to Longer Time to Conceive

 

I was going to add some further information to the last post of how males need to be held more accountable in the fertility journey and look after their health better, but I found some research that explained some more about this subject. There is so much more research on how a man’s diet and lifestyle and exposure to chemicals, does affect his ability to conceive and also what he passes onto his future offspring. Often issues in a man, are actually a bigger factor in not falling pregnant, yet most of the time, women are the ones under the microscope. It really just does not make sense.

It’s well known that what a woman eats, drinks, breathes and puts on her body while she’s pregnant or nursing can all affect her reproductive system and the health of her baby. But there is plenty of research to show that a man’s exposure to harmful chemicals plays an important role, too.

Research has found that the concentration of heavy metals,  persistent organic pollutants, alcohol, drugs and phthalates in a man’s body had more effect on how long it took a couple to conceive than the concentrations of those chemicals in the woman.

In this study, researchers looked at data from the Longitudinal Investigation of Fertility and the Environment (LIFE) Study at the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The study explored the relationship between environmental chemicals and fertility by following 501 couples for up to a year while they tried to conceive, tracking such factors as time-to-pregnancy, miscarriages, infertility, birth size and more.

The research published in the April edition of the journal Andrology, measured the amounts of certain chemicals in the urine and blood samples of both partners. Male exposures were associated with as much as 30 percent reduction in “couple fecundity,” as measured by the amount of time it took them to conceive.

Reference: – http://onlinelibrary.wiley.com/doi/10.1111/andr.12171/abstract
Things such as alcohol exposure, heavy metal exposure, cigarette smoking, recreational drug use, endocrine disruptors and dietary exposures cannot be measured in a semen analysis.

To be honest, semen analysis is just a brief overview of what is going on for a males reproductive system. Just because a man meets the minimum parameters on a semen analysis, does not mean he has good sperm to conceive naturally, or with assisted reproduction, quite the opposite actually. Semen analysis is not what normal sperm, for natural conception parameters should be, or are based on.

Semen analysis parameters are only an evaluation for Assisted Reproduction levels only, and we know that these parameters only need to be very low to meet the requirements for IVF and ICSI. If you meet the minim parameters of this test, it does not mean you have good sperm, or sperm good enough for natural conception. Quantitively normal semen, does not mean it is qualitatively good. Plus, you can’t measure DNA damage and other environmental damage to sperm on a semen analysis. This is why so many couples are still having failed cycles, because they are told everything is OK, when in fact it isn’t.

This is why I always treat both the female and male, because over 50% of fertility issues are related to males and 85% of miscarriage issues are related to chromosomal factors relating to the male. It takes two people to have a baby, not just the female, unless you are a single female doing it on your own, or are in a same sex relationship. Even then, sometimes the frozen sperm has issues too and a new batch is required to bring about success.

If a man is really serious about having a baby, then he will have no issue in giving up the things that are known to affect sperm. It is all about where his priority lies. If alcohol, cigarettes, drugs etc are the priority, then it begs the question, is this the right person to be trying to conceive with.

If you aren’t having success and need some answers, well, you know where to find me

Regards
Dr Andrew Orr
“The International Baby Maker” & “Women’s & Men’s Health Crusader”
-Leaving No Stone Left Unturned

 

Women’s Health Consultations

Women’s Health Consultations

*Are you sick of Painful Periods?
*Are you getting pain with sex?
*Is your period irregular and messing with your life?
*Are you getting bad acne?
*Are you getting increased bladder frequency?
*Are you getting some incontinence with exercise?
*Are you sick of having to put up with mood swings and hormone imbalance?
*Sick of healthcare professionals and friends telling you that your symptoms are normal?
 
Many of these issues are not normal, but more importantly many of these issues can easily be treated quite easily with the proper investigations, treatments and proper management. 
 
Everyday I see women who are sick of being ‘missed’ and ‘dismissed’ by everyone they see and they just want to get some sort of normal life back. This is where as a Reproductive Medicine and Women’s Health Specialist, with over 20 years experience with fertility, pregnancy and women’s health, I can really help. My motto is “No Stone Left Unturned” and I apply this to every person I have helped.
 
I am proud to announce that I now have a better way of being able to doing consultations for anyone needing help with gynaecology, fertility and other health issues. It doesn’t matter where you live, now I can help more people from around the globe and get them the answers they should be getting. 
 
Before we only had skype, which had limitations of not being able to screen share the important information that I need to share in a consultation with patients
 
Well, now I can do consultations through Zoom and these are nearly the same as if you were with me in person and share the same information, just the same as if you were in person.
 
Reports and Treatment medicinals and supplements are then mailed to you.
 
This is for patients who live out of the Brisbane area, or are interstate and overseas and it gives so much more scope to help everyone who wants my help.
 
If you want to get the best advice, best care and see someone with over 20 years experience in helping people, who is a Reproductive Medicine and Women’s Health Specialist (medical) as well as having qualifications in complementary medicine, then you need to see book in with me.
 
My multi-modality approach has helped over 12,500 plus babies into the world and helped tens of thousands of women with women’s health issues and gynaecological conditions such as Endometriosis, Adenomyosis, PCOS, Fibroids, Bladder & Bowel Issues, Pelvic floor stability, Thrush, Migraines, Hormone Imbalance and so much more. I can help with all Women’s Health and Reproductive issues.
 
As a Baby Maker and Women’s Health expert my motto is “No Stone Left Unturned” and I apply that to every person I help. It is because I care and want to help care for you as well.
 
If you would like to organise an online, or in-person consultation with me, please give my staff a call on +61 7 32795697, or email info@shentherapies.com.au. You can also submit an online enquiry through my website www.drandreworr.com.au too.
 
I hope to be able to help you and care for you all soon
 
Regards
Dr Andrew Orr
Reproductive Medicine & Women’s Health Specialist
-No Stone Left Unturned
“The International Baby Maker & Women’s and Men’s Health Advocate”

Exciting New Online Consultations

Exciting New Online Consultations

*Are you sick of Painful Periods?
*Are you getting pain with sex?
*Is your period irregular and messing with your life?
*Are you getting bad acne?
*Are you getting increased bladder frequency?
*Are you getting some incontinence with exercise?
*Are you sick of having to put up with mood swings and hormone imbalance?
*Sick of healthcare professionals and friends telling you that your symptoms are normal?
 
Many of these issues are not normal, but more importantly many of these issues can easily be treated quite easily with the proper investigations, treatments and proper management. 
 
Everyday I see women who are sick of being ‘missed’ and ‘dismissed’ by everyone they see and they just want to get some sort of normal life back. This is where as a Reproductive Medicine and Women’s Health Specialist, with over 20 years experience with fertility, pregnancy and women’s health, I can really help. My motto is “No Stone Left Unturned” and I apply this to every person I have helped.
 
I am proud to announce that I now have a better way of being able to doing consultations for anyone needing help with gynaecology, fertility and other health issues. It doesn’t matter where you live, now I can help more people from around the globe and get them the answers they should be getting. 
 
Before we only had skype, which had limitations of not being able to screen share the important information that I need to share in a consultation with patients
 
Well, now I can do consultations through Zoom and these are nearly the same as if you were with me in person and share the same information, just the same as if you were in person.
 
Reports and Treatment medicinals and supplements are then mailed to you.
 
This is for patients who live out of the Brisbane area, or are interstate and overseas and it gives so much more scope to help everyone who wants my help.
 
If you want to get the best advice, best care and see someone with over 20 years experience in helping people, who is a Reproductive Medicine and Women’s Health Specialist (medical) as well as having qualifications in complementary medicine, then you need to see book in with me.
 
My multi-modality approach has helped over 12,500 plus babies into the world and helped tens of thousands of women with women’s health issues and gynaecological conditions such as Endometriosis, Adenomyosis, PCOS, Fibroids, Bladder & Bowel Issues, Pelvic floor stability, Thrush, Migraines, Hormone Imbalance and so much more. I can help with all Women’s Health and Reproductive issues.
 
As a Baby Maker and Women’s Health expert my motto is “No Stone Left Unturned” and I apply that to every person I help. It is because I care and want to help care for you as well.
 
If you would like to organise an online, or in-person consultation with me, please give my staff a call on +61 7 32795697, or email info@shentherapies.com.au. You can also submit an online enquiry through my website www.drandreworr.com.au too.
 
I hope to be able to help you and care for you all soon
 
Regards
Dr Andrew Orr
Reproductive Medicine & Women’s Health Specialist
-No Stone Left Unturned
“The International Baby Maker & Women’s and Men’s Health Advocate”

Exercises For Better Sex

Exercises for Better Sex

Being a Baby Maker, I thought it’s was time to talk about what you can do to have better sex. While good food, healthy lifestyle, mindfulness and reducing stress can help with improving the sex life and your libido, many exercises can also benefit your sexual health too. These exercises also have other benefits, while making feel good and feel healthier at the same time.

1. Cardio – Getting physical can ramp up the pleasure for you and your partner. Any activity that gets your heart beating faster and you breathing harder, from brisk walking to cycling, can boost blood flow — including to your nether regions. That’s a plus for both genders: stronger erections for men, and greater arousal for women (a whopping 169% more in one University of Texas study).

2. Weight training– Using compound lifts such as dead lifts, squats, bench press etc, all add to strengthening your core, burning fats and strengthening your whole body. They also increase testosterone and other hormones, which help with improving sex drive; increasing orgasm intensity and making you feel good at the same time.

3. Swimming– Harvard researchers found that male and female swimmers in their 60s had sex lives similar to people 20 years younger. Swimming builds endurance, boosts blood flow, improves flexibility and strength, and slashes stress. It also burns some serious calories, a plus for anyone who’s overweight (extra pounds lower libido), especially obese men with erectile dysfunction.

4. Core & Abs Work– A strong, flexible core underpins most everything you do. That includes performing between the sheets. Bonus: You may be one of the lucky people who can have an orgasm while exercising — sometimes called a “coregasm.” It tends to happen during core-strengthening workouts like crunches. Pilates is a great way to work on core and abs.

5. Kegels, Ba wan Balls and Yoni eggs– Kegels was developed to treat urinary incontinence, these strengthen your pelvic floor muscles, and that means explosive orgasms. But Yoni eggs and Ba wen balls have been around for centuries to help with developing muscles in the vagina and pelvic floor and also helping with lubrication, increased circulation and also stimulation of certain hormones such as oxytocin (the love hormone). These exercises and eggs/balls can also help with gynaecological conditions such as Adenomyosis and endometriosis too. Women may be more familiar with Kegels, but probably less familiar with Yoni Eggs and Ba wen balls, but Kegels exercises can also help men prevent premature ejaculation.

6. Plank– This is a perfect way to strengthen the deepest layer of your ab muscles (transversus abdominis), along with your upper arms, thighs, and buttocks. These muscles help stabilize you so you can stay close to your partner when and where it counts most. Do it once a day, and build up to 60 seconds or longer. If it’s too challenging on your toes, try balancing on your knees instead.

7. Cat/Cow Stretch– Think of this yoga pose as another form of foreplay. It limbers your spine, helps get you into an even breathing rhythm, and improves focus — so your mind stays in the moment. Move with a steady flow, so that each rounding up (the cow part) takes a full breath out and each arching downward (the cat part) takes a full breath in.

8. Pelvic Thrusts – Whether your favourite position is missionary or cowgirl, this move is a key part of it. But powerful pushes can be exhausting when you’re out of shape. Work your glutes, calves, and hamstrings to build stamina and flexibility. Pelvic thrusts also sculpt your booty, so you feel good and look good.

9. Better Together– Couples who sweat together stay together; so make an exercise date with your significant other. Studies show that challenging physical activities spark arousal. You’ll be more attracted to your partner post-workout, too. Coordinate your actions (for example, run at the same pace) to strengthen your emotional connection even more.

As I always say to couples, is that having a healthy sex life is so important to a relationship and so vital to connection for the couple. Healthy couples have healthy sexual function and healthy libidos, so healthy diet, mindfulness and a healthy lifestyle is so important to maintaining a healthy sex life. Healthy couples also have healthy babies.

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Specialist

-Leaving No Stone Unturned

“The International Baby Maker & Women’s and Men’s Health Advocate”

 

Having More Sex Enhances Positive Relationship Satisfaction

Having More Sex Enhances Positive Relationship Satisfaction

While part of my job is to make sure couples are having enough sex, in order to have babies, part of my education to couples is about maintaining a health and happy relationship too. Sex is a big part of a relationship and it helps couple connect on a much deeper level than just being about the act of pleasure. While that part is nice too, couples still need to learn to connect and share on a much deeper level too.

I always find it sad to see couples who aren’t having sex anymore and are so disconnected. It is also sad to see my fertility couples stop this connection, once the “Job is done” and the baby making is complete. I always explain that if they cannot connect and maintain that health relationship now, how are they going to survive once a baby comes along. It is something that many just don’t think about and often it all becomes about the all consuming goal of “I want a baby”. But at what cost to a relationship?

I do also understand that when couples have been trying so long and there are failures and fertility drugs mixed into the equation, it does become hard. But, you still need to move past that and still find time to connect, otherwise the relationship will die. I get all the reasons why, but at the end of the day, that lack of connection is a big part of the reason so many couples relationships end. For couples going through fertility issues, there is up to an 80% separation rate and this is often tied back to that lack of physical and emotional connection, through bonding through sexual connection.

A health relationship should be having sex at least 1-3 times per week and this helps to promote this deep bonding and connection needed for a relationship to survive. Regular sexual activity can also help promote good physical health and also help with mental and emotional health too. A relationship isn’t all about the sex, but it sure helps make it stronger, as many studies like the one quoted below have shown.

When was the last time you connected on this deep level with your partner?

Might be time for a weekend away, or a date night real soon

Source: Hicks LL, McNulty JK, Meltzer AL et al. Capturing the Interpersonal Implications of Evolved Preferences? Frequency of Sex Shapes Automatic, but Not Explicit, Partner Evaluations. Psychological Science. 2016.

Dr Andrew Orr

Reproductive Medicine & Women’s Health Specialist

-Leaving No Stone Unturned