Category Archives: Diet and Nutrition

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Vitamin D May Increase Fertility & Assisted Reproduction Success Rates.

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Research has shown that there is a relationship between a woman’s vitamin D status and the success rates of assisted reproduction therapy(ART), which includes IUI, IVF and ISCI.

While this is research is nothing new, and something I have been promoting for years, finally it is now official. Women trying to conceive should be taking vitamin D supplements, eating vitamin D rich foods, and getting a healthy dose of the sun daily.

Infertility, or what we call sub-fertility, is becoming an increasing problem and affects millions of people worldwide. More and more people have to turn to assisted reproduction therapy (ART) which now means more and more people are having to use IUI, IVF and ICSI.

The problem is that even with assisted reproduction therapy (ART), at best the success rates are only around 25- 30% on average, and that depends on the clinics individual success rates. Some clinics are also inflating and bodgying success rates to bring in unsuspecting customers.

While there has been much advancements in assisted reproduction (ART) such as IVF and improvements in success rates, the success rates not increased a great deal.

This is why couples need to look at all options and look at preconception care to help increase those success rates. This is why I have set up a fertility program to help educate a couple and assist a couple in everything they need to do in order to increase their chances of a health pregnancy. Couples need to look at a multimodality approach to increasing their chances of conception and this is something is also part of the fertility program.

I often explain to couples that it is like preparing for a marathon; because that is what doing ART can be like. You need to prepare the body (both the man and woman), get the right diet, get the right nutrients, prepare mentally, prepare physically and basically get the bodies into the best shape possible to give the best success. Nobody should ever run a marathon without adequate preparation and the same goes for assisted reproduction.

Vitamin D and reproduction

Researchers across the board know that there is room for improvement in ART success rates. A range of potential factors are being explored, and some scientists have turned their attention to the potential role of vitamin D. While vitamin D is something that needs to be explored, and something that I give to my patients, it needs to be combined with other things mentioned above. It isn’t just as simple as taking Vitamin D and all your fertility problems are gone. But, it is one of the things that can help increase your overall success rates and should be used.

Most of our vitamin D supply is generated in our skin after exposure to sunlight. We do get some from our diets as well. This means that individuals who live in colder or darker environments are more susceptible to lower vitamin D levels, or those who regularly wear clothes covering the majority of their skin, and those who rarely go outside.

The problem these days, many of us have jobs that require us to be inside most of the time and therefore were aren’t getting enough sunlight. The current figures actually show that up to 97% of Australians, and most probably other countries like the US are the same, are actually vitamin D deficient.

The other issue is that even though some of us do get out in the sun, it actually needs to be at a certain time of the day, for optimal absorption. The optimal times are 10am and 2pm in the afternoon. The thing is, most of us aren’t getting out in the sun at these times.

A link between vitamin D and fertility has been theorized for many years and based on a number of observations and studies.  This is one of the reasons I have been promoting the use of Vitamin D for more than 20 years now, for those who are on my fertility program. For instance, vitamin D receptors and enzymes have been found in the endometrium.

This is why Vitamin D may be beneficial for women with gynaecological issues such as endometriosis, adenomyosis and other gynaecological conditions.

Vitamin D deficiency has been shown to increase the risk of pre-eclampsia, pregnancy-induced hypertension, gestational diabetes, and lower birth weight. Vitamin D is also essential for a health immune system and reducing inflammation in the body too.  It also helps with bone health.

We have also seen that in animal studies, vitamin D deficiency causes poorer fertility and reduced function of the reproductive organs. Many of our breakthroughs in medical science, actually come from animal studies first, especially when it comes to ART and IVF. Many cows and other animals are now impregnated using ART and advancements in this area have helped with human studies.

Vitamin D deficiency and lower success rates

Getting back to the feature studies, Vitamin D was shown to help women undergoing IVF, or intracytoplasmic sperm injection (ICSI), frozen embryo transfer, or both.

All the participants’ vitamin D levels were checked by blood test. What people need to know is that many of the reference ranges still used  are actually under review and that if levels of vitamin D in the blood are under 100 Nmols\L, then you need to be supplementing. Anything under 75 Nmols/L is actually deficiency in vitamin D.

This analysis of the current research showed that when women, who underwent ART and had adequate vitamin D levels, were “one third’ more like to have a successful live birth compared to those who were deficient. When compared with women who had insufficient vitamin D concentrations, those with sufficient amounts were “46 percent more likely” to have a clinical pregnancy, and “34 percent more likely” to have a positive pregnancy test result.

Vitamin D is something that I promote and all of my fertility patients are on, as well as other beneficial supplements, diet, emotional support, and medicines etc.

Before you run off trying to buy vitamin D just remember it is just one thing that can help, and it isn’t a miracle cure, but, it may help.

Lastly, before using any supplementations, please consult with a qualified healthcare professional and please don’t self-prescribe, or buy products of the internet. Make sure you buy practitioner dispensed supplements only, which are known to be of the highest quality and not filled with all sorts of things such as heavy metal, low levels of arsenic, toxic fillers etc, which is what some supplements off the internet can have.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The International Fertility Experts

References

  • Abadia L, Gaskins AJ, Chiu YH, Williams PL, Keller M, Wright DL, Souter I, Hauser R, Chavarro JE . For the Environment and Reproductive Health Study Team. Serum 25-hydroxyvitamin D concentrations and treatment outcomes of women undergoing assisted reproduction. Am J Clin Nutr. 2016; 104 :729–35.
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The Truth About Natural Killer Cells & Miscarriage

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On a daily basis we get people, who are having failed IVF cycles, calling my clinic looking for some miracle pill, to supposedly eradicate the body of natural killers cell and wipe them off the face of the planet in some war like rage, all because they have been told this will bring an end to their fertility woes.

I wish it was that easy and when my staff go on to explain that treating natural killers cells (uterine killer cells), and especially looking at the cause of natural killer cells (uterine killer cells), is complex, there is no one miracle cure, nor some magic pill, people get annoyed and hang up the phone in a huff ,without listening to the reasons why.

One of the things I always say, when people ask me about regulating natural killer cells for fertility purposes, is “How long is a piece of string?”

This is because this subject is very complex and there are many reasons why natural killer cells may be impacting implantation. So, hence the response is always going to be “How long is a piece of string?”

While Natural killer (NK) cells have an important role in the early responses to viral infections, they have also been linked with failure of pregnancy.

Increasingly, clinics are offering blood tests, at an increased cost to the patient, to measure the number and activity of circulating NK cells. As a result of these investigations, many women are offered treatments such as steroids, intravenous immunoglobulins, and tumour necrosis factor blocking agents. The scientific rationale for these tests and treatments, however, is not always supported by our current knowledge of the function of uterine NK cells.

So, I thought it was about time I set the records straight on the BS information, that seems to being handed around as gospel, by money hungry fertility clinics run by big health conglomerates, and by the rotten Dr Google, about natural killer cells (uterine killer cells) and these supposed miracle pills, that will miraculously fix someone’s fertility issues.

Let’s Look at the Facts about Natural Killer Cells Relating to Miscarriage

  1. There is no miracle pill, or one supposed miracle treatment, or a one pill solution to treat, or get rid of natural killer cells. You do not want to get rid of NK Cells.
  2. Natural Killer Cells are a natural part of the immune system designed to target inflammation, kill of cancer cells, kill off bacteria and protect the body from harmful invasion of foreign organism
  3. There is huge difference between natural killer cells that are circulating in the blood stream, compared to uterine killer cells
  4. Uterine Killer Cells are in large numbers during a pregnancy to protect the embryo
  5. Natural Killer Cells are only in large number and are only being sent out by the immune system because there is some inflammatory process going on in the pelvis, or the rest of the body
  6. You cannot regulate Natural Killer Cells numbers unless you first address the inflammatory process that is causing them to be in high numbers in the first place (Eg- Inflammatory gynaecological conditions such as PID, Endometriosis, PCOS, Adenomyosis, Adhesions, STI’s, CIN, HPV, Herpes etc)
  7. Many people have not had the proper initial fertility investigations and testing needed to actually fall pregnant in the first place and looking at Natural Killer Cells, before all that proper testing etc is done, is actually not assessing the patient properly.
  8. If you do not treat the cause of the Natural Killer Cells being in high numbers, you will not be able to reduce the numbers of Natural Killer Cells that are actually doing the job they are meant to do, which is …. Protect the Body.
  9. Many of the so called treatments for Natural Killer Cells, regarding fertility, have never been approved for such treatment and research on it is still inconclusive.
  10. Some of the treatments being proclaimed as miracle cures (Intralipids etc) are purely money making exercises that are preying on the vulnerability of people who have been told wrong information and have this perception of some killer being inside their body attacking their embryos.
  11. Intralipids have never been proven to treat Natural Killer Cells and are derived from highly inflammatory soy based compounds, which then in turn can cause more inflammation.
  12. The drugs used in the treatment of Natural Killer Cells are steroidal based and carry many side effects and are for more harmful to the body that any natural killer cell will ever be. The steroids are also a category C drug that has been shown to have an effect on the neonate
  13. Steroids, such as Prednisone, do work on regulating NK cells, but they do so by suppressing the immune system, thus compromising a person’s immunity. There are also risk to peoples minerals by using these long term and there are also other side effects to the body.
  14. Natural Killer Cells are there to protect the body, not hurt it.
  15. Natural Killer Cells may only be attacking embryos because they are seen as foreign body as well and when they are there trying to kill of the diseases and issues causing inflammation in the body, they just happen to kill of any other foreign organism and inflammatory processes at the same time
  16. Again, to address natural Killer Cells, you need to address the inflammatory process as to why they are in high numbers in the first place
  17. The perception around Natural Killer Cells being this “thing” killing off embryos in the body is misguided and is actually not a true representation of what Natural Killer Cells actually do. It is purely often used to tug on the heartstrings of unsuspecting patients, who are highly emotive and clinics use these emotions to get them to pay for treatments that have never been fully proven to work.
  18. The name “Killer Cell” is too often exploited in the wrong context by many in the fertility world
  19. Blood tests cannot measure the number of Natural Killer Cells in the Uterus, Only a biopsy can do this.
  20. A Natural Killer Cell (uterine killer cells) Biopsy has to be done between the 24th and 28th day of your menstrual cycle to give the best results.
  21. Blood tests can only measure the circulating NK cells in the body and not the uterine killer cell activity, which can be the cause of recurrent miscarriage. So, if you have had a blood test, it is not measuring what is needed. Everyone will have circulating NK cells in their blood stream.
  22. The percentage of CD56+ NK cells in peripheral blood in normal healthy individuals varies from 5% to 29% (2)Despite this, more than 12% NK cells in women with infertility or miscarriage has been arbitrarily defined as abnormally raised and used as an indication for treatment (4)
  23. The percentage of NK cells in blood can be affected by many factors including sex, ethnicity, stress, and age too.
  24. There is now new evidence that shows that natural killer cells help with implantation and a healthy uterine environment, which now supersedes old outdated research.

Natural Killer cells (Uterine killer cells and other NK cells) are the main immune cell-type found in the uterus. Their numbers increase through the menstrual cycle to peak at the time of implantation. If an embryo does implant, NK cell numbers increase further to 70% of all cells.

Uterine NK numbers start to decrease at around the 20 week mark of pregnancy and are all but absent at the end of pregnancy.

Natural killer cells acquired their name as a result of the initial test used to identify them in vitro. Unlike T lymphocytes, NK cells are able to spontaneously kill cells in a non-MHC restricted manner.

Regrettably, this is a misleading name in reproduction, and the powerful image of maternal cells attacking the fetus is emotive and easily exploited. None the less, these NK cells can kill off the embryo at early stages of pregnancy, but there is nearly always a reason why. That reason is inflammation in the pelvic cavity and uterus. This needs to be addressed to regulate the number of NK cells, not some notion of killing off the “Killer Cells”.

Types of Inflammation causing high Natural Killer Cells (Uterine Killer Cells)

  • Endometriosis & Adenomyosis
  • PCOS/PCO
  • Fibroids, Myomas
  • Vaginal Infections & Bacteria
  • STI’s
  • Cancer, Trauma, Localised Lesions & Others
  • Stress

Yes, stress can lead to a compromised immune system, which then leads to high TNF (Tumor Necrosing Factor) and increase Natural Killer Cells, which then leads to prolonged increase activated T Cells, and this then causes reduced implantation of embryos.

This is also a reason why any inflammation in the uterus or pelvic cavity needs to be addressed to help fix this issue and one of the reasons why any woman having fertility issues needs to be investigated and treated properly.

This needs to involve proper differential diagnosis, proper pathology testing, genetic testing and surgical investigations such as laparoscopy prior to any further fertility treatment. A laparoscopy is the gold standard for addressing and treatment of issues in the uterine and pelvic cavity.

Natural Killer Cells (Uterine Killer Cells) may be a part of recurrent miscarriage, but we need to stop the misinformation and perception of them being some killer organism that isn’t meant to be in the body. They are meant to be in the body and the name is all too often exploited by many to offer unproven treatments and medications by clinics trying to increase profits.

If you want to regulate and treat natural killer cells (relating to recurrent miscarriage) properly, you need to find out what is causing them to be there in the first place. There is no magic pill to get rid of Natural Killer Cells.

You cannot rid the body of Natural Killer Cells anyway. They are meant to be there. You can only regulate the amount of killer cells doing their job and you need to find out why they are in higher numbers in the first place. This is usually because there is some sort of inflammation, infection, bacteria, or malignancy going on in the body that has not been investigated properly in the first place. Let’s not forget that stress, yes stress, increases the amount of Natural Killer Cells in the body too.

As part of my fertility program, I talk to couples about the facts about Natural Killer cells, and makes sure that proper investigations, testing and treatments are administered and managed properly. This can also be done alongside current medical protocols such as the Bondi protocol, or California protocol.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The International Fertility Experts

References

  1. Moffett-King A. Natural killer cells and pregnancy. Nat Rev Immuol 2002;2: 656-63.[CrossRef][Web of Science][Medline]
  2. Pijnenborg R, Vercruysse L, Hanssens M, Van Assche A. Incomplete trophoblast invasion: the evidence. In: Critchley H, MacLean A, Poston L, Walker J, eds. Pre-eclampsia. London: RCOG Press, 2003: 15-2615. Parham P. NK cells and trophoblasts: partners in pregnancy. J Exp Med 2004;200: 951-5.[Abstract/Free Full Text]
  3. Hiby SE, Walker JJ, O’Shaughnessy KM, Redman CWG, Carrington M, Trowsdale J, et al. Combinations of maternal and paternal innate immune genes influence the risk of pre-eclampsia. J Exp Med 2004;200: 957-65.[Abstract/Free Full Text]
  4. Aoki K, Kajiura S, Matsumoto Y, Ogasawara M, Okada S, Yagami Y, et al. Preconceptional natural-killer-cell activity as a predictor of miscarriage. Lancet 1995;345: 1340-2.[CrossRef][Web of Science][Medline]
  5. Ntrivalas EI, Kwak-Kim JY, Gilman-Sacchs A, Chung-Bang H, Ng SC, Beaman KD, et al. Status of peripheral blood natural killer cells in women with recurrent spontaneous abortions and infertility of unknown aetiology. Hum Reprod 2001;16: 855-61.[Abstract/Free Full Text]
  6. Bisset LR, Lung TL, Kaelin M, Ludwig E, Dubs RW. Reference values for peripheral blood lymphocyte phenotypes applicable to the healthy adult population in Switzerland. Eur J Haematol 2004;72: 203-12.[CrossRef][Web of Science][Medline]
  7. Kwak JY, Kwak FM, Gilman-Sachs A, Beaman KD, Cho DD, Beer AE, et al. Immunoglobulin G infusion treatment for women with recurrent spontaneous abortions and elevated CD56+ natural killer cells. Early Preg 2000;4: 154-64.
  8. RCOG Scientific Advisory Committee. Immunological testing and interventions for reproductive failure. London: RCOG, 2003. (Opinion paper 5.)
  9. Scott JR. Immunotherapy for recurrent miscarriage. Cochrane Database Syst Rev 2003;(1): CD000112.
  10. Daya S, Gunby J, Clark DA. Intravenous immunoglobulin therapy for recurrent spontaneous abortion: a meta-analysis. Am J Reprod Immunol 1998;39: 69-76.
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What You “Can” Eat During Pregnancy

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A while back, I put up a post to see what people thought that you (can) and (can’t) eat during… pregnancy, or if you were trying to fall pregnant. It was really interesting to see what foods people thought you could not eat during pregnancy.

It is really interesting that most people want to tell you want you can’t eat, but hardly anyone tells you what you can eat during pregnancy and while trying to fall pregnant.

What prompted this post was that a while back I overheard one of my staff and lovely mother to be, talking to another mother to be about what she has been cutting from her diet while she was pregnant and how her food choices were so limited.

I heard all kind of wonderful things from not eating any seafood; not eating any cold meat, not eating soft cheeses, not eating eggs, not eating nuts and nearly the whole food pyramid was being added.

What many people don’t know is that I actually have a background in food science and that I used to teach about bacteria and food hygiene and the nasty consequences of what bacteria can do to the body.

Most pregnant women have the number one fear of foods containing Listeria. It is a rare form of bacteria but it can be fatal (very rare) to a lady if she is pregnant and cause issues such as miscarriage. So not discounting it at all and some countries around the world do not have the food hygiene standards we have here in Australia.

We only see about 5 cases per million people in Australia. Basically there is about 0.3-0.4% chance of getting it and we all make such a big deal about it. Again, this is not to discount it either. Listeria can be found in unpasteurised products such as diary and cheese and can be found in some forms of deli meats mainly. To be honest, it is usually the home made/backyard deli meats and cheeses you really have to watch, with regards to hygiene and bacteria.

But if a health issues such as Listeria poisoning is so rare, why do we make such a fuss about it and not warn women of other potentially worse factors that cause more cases per year, and can be potentially fatal too. The problem is if women only hear about the foods they can’t eat, many of them are going to be nutrient deficient all for the fear of a tiny chance of listeria causing an issue with a pregnancy.

The truth is, other bacteria such as Salmonella, Shigella and Camphyobacter have a higher rate of infection per year than listeria ever will and nobody ever talks about them. There are over 25,000 cases of these combined and most of the spread is through person to person contact, not just foods themselves.

Basically many food poisoning cases are actually from bacteria being on your own hands, which then at some stage end up in, or near your mouth. This is why smokers are at higher risk of food poisoning. To be honest, shopping trolley handles are probably one of the most unhygienic places you can put your hands on and probably cause more bacterial health issues than anything. Money can be the same.

Then we have a far wider implication of gestational diabetes, which account for about 15,000 plus, pregnant women per year, with an annual increase of 5% per year. When someone eats sugary foods, highly processed foods, grains etc during pregnancy, that are a major cause of diabetes, nobody says a thing. Yet mention the word Brie cheese, cold meats etc and everyone goes nuts. Oh yes, we now mention ‘nuts’ and people go nuts too. Again this is not to discount that some people have true allergies to nuts.

So what do pregnant women really need to know and what can you eat?

Basically the same food hygiene that is needed when you aren’t pregnant is to be observed when you are. There only needs to be a little bit more caution, not an ‘OMG’ stay clear of everything, that unreliable Dr Google, or ‘Someone’, has told you. I would love to know who ‘Someone’ is because he, or she, causes a lot of problems. Remember temperatures between 5 and 60 degrees C are you danger zone area. This is why foods need to be stored below 5 degrees and heated over 60 degrees C.

So what can you eat?

  • So basically you can eat any deli meats as long as they are cryo-vacced and in date. Cryovacced means the air has been taken out and not even bacteria can live in an non-oxygenated environment.
  • You can eat all seafoods as long as they are cooked and fresh.
  • You can eat all cheeses but need to be more careful around the soft cheeses. New research actually shows that small amounts can be beneficial for you. If you cook soft cheeses there is definitely no issue. Just don’t eat cheeses from unpasteurised sources.
  • You can have any form of pasteurised milk or UHT milk.
  • You can have soft serve ice-cream as long as the place you are getting it from looks hygienically clean. Maybe not a good idea to get them from the old ice-cream trucks that aren’t checked regularly by food standards.
  • You can eat nuts and now there is evidence to show that mums not eating nuts during pregnancy may now be the cause of nut allergies.
  • You can definitely eat eggs and you just have to make sure they aren’t raw. Boiled eggs, poached eggs and fried eggs are all fine. Egg custard is fine because it is cooked
  • You can eat all meats if they are cooked and you don’t have to char it until it resembles an old leather shoe. Medium is fine. You just need to cook all chicken right through because all chicken contains salmonella and cooking it kills it.
  • You can have coffee and tea and you just need to limit all caffeine to no more than two cups per day (remember tea has as much caffeine as coffee)

Basically the healthy food pyramid I teach at my clinic needs to be applied.

1. Take a good practitioner only Multivitamin, Omega 3 Oils, prebiotics and probiotics daily

2. Eat 2 handful of nuts daily or two tablespoons of healthy oils

3. Limit you grains to one serve (only) per day or cut them completely (best)

4. Eat 2 pieces of low GI fruits per day

5. Protein with every meal or snack

6. 3-5 serves of veggies or salads per day (just not from a salad bar)

7. 8 glasses of water

8. 2 serves of electrolytes per day when pregnant

9. 30 -45 minutes exercise 2-3 times per week

# No diet drinks or artificial sweeteners, or alcohol at all

Remember food is to be enjoyed and so is pregnancy. Don’t get too caught up in all the worry of what you can’t eat and look more at what you can eat and stick to those foods.

Take care

Regards

Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

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Alcohol Decreases Fertility & Makes Gynaecological Conditions Worse

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In today’s modern society, alcohol has become the cornerstone for social engagements, business dinners and after work relaxation. It is important to realise however, that alcohol can directly impact the fertility of both males and females.

In males it can decrease sperm quality, reduce testicular size, decrease libido and cause impotence, all of which can impair fertility.

In females it has a more systemic response, affecting the reproductive hormones, leading to abnormalities in the menstrual cycle and an increased risk of miscarriage.

Many men and women these days are actually consuming copious amounts of alcohol and may think that their drinking habits are normal, when compared to others around them.

When people do things on a regular basis, it becomes their normal. But truth be told, many people’s drinking habits, both men and women, are actually in the realms of alcoholism. The impacts of that are far reaching and fertility and gynaecological conditions are definitely impacted by alcohol consumption.

Effect of Alcohol on Conception for Men

Fecundability refers to the probability of conception during a particular menstrual cycle. It is dependent on the reproductive potential of both partners. Alcohol decreases fecundability by its effect on sperm quality and quantity. Men who continue to consume alcohol on a regular basis, can decrease their sperm motility, morphology and their DNA in the sperm. All of which are important factors in achieving fertility.

While outwardly a man’s sperm may look OK, many forget that inwardly, the sperm DNA could be highly fragmented and unless this is tested every ejaculation, you will have no idea how bad the sperm actually is. A one off DNA fragmentation analysis does not mean the sperm each time is OK. It only measures the sperm from the ejaculate that was tested and sperm quality can change by as much as 20% each ejaculation.

Testicular size is also affected by alcohol intake; and can also affect sperm production. Alcohol is a depressant of the central nervous system (CNS), and can disrupt the autonomic system of the CNS. These effects are temporary and short lived. Abnormal sperm production is also temporary and also can resume after abstaining from alcohol.

One study, this one looking at couples going through IVF treatment, found that for every additional drink a man consumed per day, the risk of conception not leading to a live birth increased by 2 to 8 times. This was especially true if the drinking occurred within a month of the IVF treatment.

Effect of Alcohol on Conception for Women

In women, alcohol affects fecundability, by disrupting the delicate balance of the menstrual cycle. Clinical research data published in the “British Medical Journal” suggests that women, who drank socially, 1-5 drinks per week, were at a greater risk of decreased fecundability when compared to women who remained abstinent. These findings underscore the importance of remaining abstinent while attempting to conceive.

Alcohol disrupts the hormonal imbalance of the female reproductive system, leading to menstrual irregularities, and even Anovulatory cycles, (menstrual cycles where ovulation fails to occur). Menstrual pain can directly be linked to the amount of alcohol consumed in the lead up to the menses and consumptions of alcohol, even small amounts, exacerbates most gynaecological conditions. These changes can drastically decrease a woman’s chance of becoming pregnant and thus affect fertility.

Alcohol effects fertility in both partners, and can do so in so many ways. For couples who desire to have a baby, it is best to stay away from drinking completely. Presently there is no safe limit of alcohol intake; even socially acceptable amounts of alcohol can affect fertility potential and outcomes.

Moderate drinking (1-2 drinks in one sitting) is probably okay, especially if you reserve those drinks to a few times a week, instead of daily. However, if you’re going through IVF treatment, or trying to conceive naturally, you might consider cutting out alcohol for the time being.

A woman that is trying to concieve, or trying to improve a gynaecological issues, or menstrual issues, should not be consuming more than 4 standard drinks per week.

A male who is trying to conceive, or have sperm quality issues, should have no more than 2 standard drinks in one sitting and be having at least 2 alcohol free days per week. These are all part of the healthy drinking set out in health department and government safe drinking guidelines.

Trying to conceive is a special time in a couple’s life, it should be filled with love, devotion and safe health practices, which means a healthy diet and lifestyle and having a healthy mind too. It also means having healthy drinking habits as well.

Decreasing alcohol, having bete foods and looking at a healthy detoxification program is also a great idea for those trying to increase their fertility and get their reproductive systems working better. Healthy eggs and health sperm make healthy babies. Healthy reproductive systems also mean better menstrual cycles and better testicular health too.

Safe drinking everyone. This is something I talk about as part of my fertility program and preconception care. If you would like to find out more about my fertility program, please contact my friendly staff to find out more.

Regards

Andrew Orr

-Women’s and Men’s Health Advocate

– No Stone Left Unturned

-The International Fertility Experts

Pain With Sex Dyspareunia

Do you suffer pain with sex? (dyspareunia)

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Pain with sex, Intercourse pain, or dyspareunia, can cause problems in a woman’s life and it can be a cause of problems in couple’s sexual relationship. In addition to the physically painful sex, there is also the possibility of negative emotional effects. Then even when a woman may feel aroused and wanting sex, the fear of the pain can cause the whole process of wanting sex to stop.

How many people get Pain with Sex

It is estimated that about 20%-25% of women suffer vaginal pain with foreplay or intercourse. Pain can be acute, intermittent or chronic and can stem from a wide variety of causes that will be covered shortly. Unfortunately when women complaining of pain during sex, they are often dismissed as being inhibited, having psychiatric issues, or merely just making it up to get out of having sex. Many men would like to boast that it is them being well endowed that is causing the problem (they wish) but in fact if your partner is in pain, then you need to actually stop and listen to the reasons why. The fact is most of the time, their symptoms are related to legitimate medical issues that need to be investigated and treated accordingly. So guys, get your hand of it and start listening to your partner if she says she is getting pain.

What causes pain with Sex (Dyspareunia)?

In many cases, a woman can experience painful sex if there is not sufficient vaginal lubrication. There could be many reasons for this and one that is commonly seen in menopause. When this occurs, the pain can be resolved if the female becomes more relaxed, if the amount of foreplay is increased, or if the couple uses a sexual lubricant. Issues like this can easily be overcome, but there are some medical and gynaecological issues that could be causing the pain and being very much overlooked.

So what are the other causes of Pain with Sex?

Endometriosis – This is a condition in which the endometrial like tissue (lesions) that lines the uterus grows outside the uterus. It can cause all sort of pain in the pelvis, bowel and rest of the body, but it can cause pain with sex. It is one of the leading conditions that does cause pain with sex. Many women with endometriosis may not have symptoms of it, or may only have one symptoms like pain with sex. Symptoms do not correlate to the extent of the disease either. Some people with small amounts get lots of pain, while others can have lots of it and have no pain. Endometriosis can only be properly diagnosed via surgery (laparoscopy)

Adenomyosis – is a condition which is very similar to endometriosis. It is a conditions in which the inner lining of the uterus (the endometrium) breaks through the muscle wall of the uterus (the myometrium). Adenomyosis can cause menstrual cramps, lower abdominal pressure etc, before the menses and can result in heavy periods.  It can also cause pain with sex. The condition can be located throughout the entire uterus, or localized in one spot

Vaginismus-  This is a common condition. It involves an involuntary spasm in the vaginal muscles, which closes up the vagina and prevents penetration from happens. It is sometimes caused by fear of being hurt.

Pelvic Floor Hypertonus– Pelvic floor hypertonus occurs when the muscles in the pelvic floor become too tight and are unable to relax. Many women with an overly tight and non-relaxing pelvic floor experience pelvic health issues such as constipation, painful sex, urinary urgency, bladder issues and pelvic pain.

Vaginal Infections-  These conditions are common and include yeast infections such as thrush and candida and these can cause inflammation to the vagina and cause pain with sex and also localized bleeding.

Vaginal skin conditions– Dermatitis around the vulva and also a condition called Lichen Sclerosis can all cause pain with sex due to the inflammation of the skin.

Atrophic Vaginitis – Atrophic vaginitis is a vaginal disorder that usually happens after menopause, but it can happen long before this time as well. 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 and it can make sex uncomfortable, or extremely painful

Problems with the cervix (opening to the uterus) –In this case, the penis can reach the cervix at maximum penetration. So problems with the cervix (such as infections) can cause pain during deep penetration.

Problems with the uterus – These problems may include polyps, cysts, fibroids etc that can cause deep intercourse pain.

Problems with the ovaries – Problems might include cysts on the ovaries, or tubal disease.

Pelvic Inflammatory Disease (PID) – Often referred to as penis injected disease. With PID, the tissues deep inside become badly inflamed and the pressure of intercourse causes deep pain.

Ectopic Pregnancy – This is a pregnancy in which a fertilized egg develops outside the uterus, or into the tubes. It can cause immense pain and even death if not death with properly.

Menopause- With menopause, the vaginal lining can lose its normal moisture and tone and become dry. The vagina, uterus and surrounding organs can all suffer atrophy, which can cause bleeding and pain (see atrophic vaginitis above). It can also cause prolapse.

Intercourse too soon after childbirth, or surgery – Trying to have sex too soon after childbirth, or a surgery,  can cause pain during sex.

Sexually Transmitted Infections (STI’s) – These may include chlamydia, genital warts (HPV), genital herpes, or other STI’s.

Injury to the vulva or vagina- These injuries may include a tear from childbirth or from a cut (episiotomy) made in the area of skin between the vagina and anus during labor.

How Can Painful Sex In Women Be Treated?

Some treatments for painful sex in women do not require medical treatment. For example, painful sex after pregnancy can be addressed by waiting at least six weeks after childbirth before having intercourse, or when a women feels she is ready again. Make sure to practice gentleness and patience.

In cases in which there is vaginal dryness,  or a lack of lubrication,water-based lubricants will help. In the cases of some conditions such as menopause, topical estrogen creams may be needed to bring tone back into the vaginal wall, along with lubricants during sex.

Some of the conditions such as endometriosis, PID, fibroids, or trauma to the vagina and will require surgery and adjunct therapies such as hormones and other medications.

Other issues such as vaginal infections, bacterial infections, skin conditions, STI’s etc may just need medications such as antibiotics, antifungals, steroids and other medications for their treatment

Some conditions like vaginismus, or psychological traumas (sexual abuse), may require a person to see a counselor, psychologist, psychiatrist, or sex therapist.

There are also natural medicines such as Acupuncture, Chinese Herbal medicine,  herbal supplements etc which may assist with pain, either on their own, or in combination with medical treatments and talk therapy

Final Word

If you do have pain with sex, you need to go and speak to your healthcare provider, or seek the help of a gynaecologist, or women’s health expert.

Pain with sex is not normal, and you need to find out the cause of these issues and not put it off. Many times there are non-invasive and easy treatments to help.

If you need help in finding out how to manage pain with sex, and the causes, please give my friendly staff a call to find out how I can assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Women’s Health Experts

Thyroid

Could your health issues be coming from your Thyroid?

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Thyroid issues are common, especially in women and especially if there is a family history of thyroid disorders in your family. When your thyroid goes out of balance, it can cause all sorts of symptoms and issues in your body. You need to know what to look for.

When Your Thyroid Goes Awry

Does fatigue drag you down day after day?

Do you have brain fog, weight gain, chills, or hair loss?

Or is the opposite true for you: Are you often revved up, sweaty, or anxious?

Your thyroid gland could be to blame. This great regulator of body and mind sometimes goes haywire, particularly in women. Pregnancy and postpartum is when it can also go haywire too. Getting the right treatment is critical to feel your best and avoid serious health problems.

What Is the Thyroid Gland?

The thyroid is a butterfly-shaped gland in the front of the neck. It produces hormones that control the speed of your metabolism — the system that helps the body use energy. Thyroid disorders can slow down or rev up metabolism by disrupting the production of thyroid hormones. When hormone levels become too low or too high, you may experience a wide range of symptoms.

Symptom: Weight Gain or Loss

An unexplained change in weight is one of the most common signs of a thyroid disorder. Weight gain may signal low levels of thyroid hormones, a condition called hypothyroidism. In contrast, if the thyroid produces more hormones than the body needs, you may lose weight unexpectedly. This is known as hyperthyroidism. Hypothyroidism is far more common.

Symptom: Swelling in the Neck

A swelling or enlargement in the neck is a visible clue that something may be wrong with the thyroid. A goiter may occur with either hypothyroidism or hyperthyroidism. Sometimes swelling in the neck can result from thyroid cancer or nodules, lumps that grow inside the thyroid. It can also be due to a cause unrelated to the thyroid.

Symptom: Changes in Heart Rate

Thyroid hormones affect nearly every organ in the body and can influence how quickly the heart beats. People with hypothyroidism may notice their heart rate is slower than usual. Hyperthyroidism may cause the heart to speed up. It can also trigger increased blood pressure and the sensation of a pounding heart, or other types of heart palpitations.

Symptom: Changes in Energy or Mood

Thyroid disorders can have a noticeable impact on your energy level and mood. Hypothyroidism tends to make people feel tired, sluggish, and depressed. Hyperthyroidism can cause anxiety, problems sleeping, restlessness, and irritability.

Symptom: Hair Loss

Hair loss is another sign that thyroid hormones may be out of balance. Both hypothyroidism and hyperthyroidism can cause hair to fall out. In most cases, the hair will grow back once the thyroid disorder is treated.

Symptom: Feeling Too Cold or Hot

Thyroid disorders can disrupt the ability to regulate body temperature. People with hypothyroidism may feel cold more often than usual. Hyperthyroidism tends to have the opposite effect, causing excessive sweating and an aversion to heat.

Other Symptoms of Hypothyroidism

Hypothyroidism can cause many other symptoms, including:

  • Dry skin and brittle nails
  • Numbness or tingling in the hands
  • Constipation
  • Abnormal menstrual periods

Other Symptoms of Hyperthyroidism

Hyperthyroidism can also cause additional symptoms, such as:

  • Muscle weakness or trembling hands
  • Vision problems
  • Diarrhea
  • Irregular menstrual periods

Thyroid Disorder or Menopause?

Because thyroid disorders can cause changes in menstrual cycle and mood, the symptoms are sometimes mistaken for menopause. If a thyroid problem is suspected, a simple blood test can determine whether the true culprit is menopause or a thyroid disorder — or a combination of the two.

Who Should Be Tested?

If you think you have symptoms of a thyroid problem, ask your doctor if you should be tested. People with symptoms or risk factors may need tests more often. Hypothyroidism more frequently affects women over age 60. Hyperthyroidism is also more common in women. A family history raises your risk of either disorder.

Thyroid Neck Check

A careful look in the mirror may help you spot an enlarged thyroid that needs a doctor’s attention. Tip your head back, take a drink of water, and as you swallow, examine your neck below the Adam’s apple and above the collarbone. Look for bulges or protrusions, then repeat the process a few times. See a doctor promptly if you see a bulge or lump.

Diagnosing Thyroid Disorders

If your doctor suspects a thyroid disorder, a blood test can help provide an answer. This test measures the level of thyroid stimulating hormone (TSH), a kind of master hormone that regulates the work of the thyroid gland. If TSH is high, it typically means that your thyroid function is too low (hypothyroid). If TSH is low, then it generally means the thyroid is overactive (hyperthyroid.) But just measuring TSH levels is not enough. People with thyroid disorders can have normal TSH levels and the other thyroid hormone levels and this is why thyroid antibody testing is probably the most important testing to be done. High thyroid antibodies mean you have a thyroid condition and your thyroid gland is under attack. Hopefully doctor will want to check all the other thyroid hormones in your blood. If he/she doesn’t, make sure they do. They should always check TSH, Free T3, Free T4, Reverse T3 and Thyroid antibodies. In some cases, imaging studies are used and biopsies are taken to evaluate a thyroid abnormality.

Hashimoto’s Disease

The most common cause of hypothyroidism is Hashimoto’s disease. This is an autoimmune disorder in which the body attacks the thyroid gland. The result is damage to the thyroid, preventing it from producing enough hormones. Hashimoto’s disease tends to run in families. This is why thyroid antibodies needs to be checked because people with Hashimotos disease can actually have normal TSH levels and normal Free T3, Free T4 and reverse T3 levels.

Other Causes of Hypothyroidism

In some cases, hypothyroidism results from a problem with the pituitary gland, which is at the base of the brain. This gland produces thyroid-stimulating hormone (TSH), which tells the thyroid to do its job. If your pituitary gland does not produce enough TSH, levels of thyroid hormones will fall. Other causes of hypothyroidism include temporary inflammation of the thyroid or medications that affect thyroid function.

Graves’ Disease

The most common cause of hyperthyroidism is Graves’ disease. This is an autoimmune disorder that attacks the thyroid gland and triggers the release of high levels of thyroid hormones. One of the hallmarks of Graves’ disease is a visible and uncomfortable swelling behind the eyes. Again this is why testing thyroid antibodies is so important.

Other Causes of Hyperthyroidism

Hyperthyroidism can also result from thyroid nodules. These are lumps that develop inside the thyroid and sometimes begin producing thyroid hormones. Large lumps may create a noticeable goiter. Smaller lumps can be detected with ultrasound. A thyroid uptake and scan can tell if the lump is producing too much thyroid hormone.

Thyroid Disorder Complications

When left untreated, hypothyroidism can raise cholesterol levels and make you more likely to have a stroke or heart attack. In severe cases, very low levels of thyroid hormones can trigger a loss of consciousness and life-threatening drop in body temperature. Untreated hyperthyroidism can cause serious heart problems and brittle bones.

Treating Hypothyroidism

If you are diagnosed with hypothyroidism, your doctor will most likely prescribe thyroid hormones in the form of a pill. This usually leads to noticeable improvements within a couple of weeks. Long-term treatment can result in more energy, lower cholesterol levels, and gradual weight loss. Most people with hypothyroidism will need to take thyroid hormones for the rest of their lives.

Treating Hyperthyroidism

The most common treatment for hyperthyroidism is antithyroid medication, which aims to lower the amount of hormones produced by the thyroid. The condition may eventually go away, but many people need to remain on medication for the long term. Other drugs may be given to reduce symptoms such as rapid pulse and tremors. Another option is radioactive iodine, which destroys the thyroid gland over the course of 6 to 18 weeks. Once the gland is destroyed, or removed by surgery, most patients must begin taking thyroid hormones in pill form.

Surgery for Thyroid Disorders

Removing the thyroid gland can cure hyperthyroidism, but the procedure is only recommended if antithyroid drugs don’t work, or if there is a large goiter. Surgery may also be recommended for patients with thyroid nodules. Once the thyroid is removed, most patients require daily supplements of thyroid hormones to avoid developing hypothyroidism.

What About Thyroid Cancer?

Thyroid cancer is uncommon and is among the least deadly. The good thing with thyroid cancer is that it is encapsulated, so it won’t spread. Once the thyroid gland is removed, the cancer is removed also. The main symptom is a lump or swelling in the neck, and only about 5% of thyroid nodules turn out to be cancerous. When thyroid cancer is diagnosed, it is most often treated with surgery followed by radioactive iodine therapy or, in some cases, external radiation therapy

Complementary Medicine For Thyroid Issues

There are complementary medicines that may assist thyroid issues and it is important that you have a consultation and talk to a qualified healthcare practitioner about these options.

There are also supplements and other herbal medicine that may assist thyroid function, or balancing the thyroid hormones.

Diet and lifestyle changes are also very important for thyroid health, as is working on the gut and microbiome to reduce inflammation in the body and assist the immune system as well. There are also compounded natural thyroid medications that may assist thyroid issues as well.

Please make sure you see your healthcare practitioner, or endocrinologist for help with thyroid issues and ongoing management and never try to manage things on your own.

If you need assistance with thyroid management and management of other hormonal issues, please call my friendly clinic staff and they will be able to book you in for a consultation and explain more.

Regards

Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

01 Dr Andrew Orr 1

3d image of sperm cells

Facts About Sperm Health and Their Lifespan

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There is a lot of misinformation with regards to facts about sperm health and their lifespan.

Typically, millions of sperm cells are produced in the testicles every day. During this time, many things can affect their formation and interfere with their quality and maturity.

It takes around 90-120 days for a sperm to become motile

From a tiny sperm cell it can take between 90-120 days before a sperm is fully mature. The sperm eventually develops a head and tail, so that its cells start to resemble the shape of a tadpole.

The head contains all of the DNA, or genetic material, and the sperm uses the tail to help it move. A sperm doesn’t reach full motility until it actually reaches the egg, where when touching the egg it creates a reactions that causes “super motility” to give it the final power to push inside the egg. This is called the acrosome reaction.

There has been lots of debate about the actual time it takes for a sperm to mature and become fully motile, but general consensus is that it will take somewhere between 90-120 days.

This is why it is important that men look after their health long prior to conception, because the sperm they ejaculate today was created around 90-120 days ago and what they did to their bodies at that time, will influence how healthy those sperm are.

A man’s lifestyle affects his sperm quality

So if a man had a poor diet, was drinking, smoking, had heaps of stress and goodness knows what, this can all have an impact of the maturing sperm and this can result in poor sperm quality and damage to the DNA of the sperm, which will then be carried onto his offspring, should the sperm be successful in fertilising an egg. This is why the couple need to be healthy prior to conception, not just the female.

Biology 101 tells us it take a sperm and an egg to make a baby, not just an egg. Sperm quality issues make up a big part of fertility issues and they can also be a big part of miscarriage issues too. I have spoken about this many times in previous posts. Up to 85% of miscarriage issues can be related to chromosomal and DNA factors related to poor quality sperm and this is often very much overlooked.

What factors impact on sperm health?

There are always many factors that can affect the sperm formation process and interfere with sperm quality and the DNA of the sperm.

Health and lifestyle factors

  • Recreations drugs, medications or alcohol use
  • job, or occupation
  • tobacco use, or smoking in general (including recreational drugs)
  • stress
  • overheating the testicles (spas, saunas, bike riding)
  • excess weight gain and excess body fat
  • Trauma
  • Bike riding (due to heat and trauma through the seat of the bike)
  • Poor diet and nutrition
  • Excess sugars and additives
  • Preservatives and artificial colours and artificial sweeteners

Environmental causes

  • exposure to industrial chemicals
  • heavy metals
  • radiation or X-rays

Medical reasons

  • infection of the testicles
  • cancer of the testicles
  • swelling of the veins (varicoceles etc) that drain blood from the testicle
  • hormone imbalances
  • physical problems in the tubes that carry sperm through the reproductive system
  • chromosomal or genetic disorders (such as Kleinfelters syndrome)
  • certain medications
  • surgery involving the pelvis, abdomen, or reproductive organs
How long do sperm live inside the female body?

There is always a huge misperception about how long sperm can survive outside the man’s body and when they enter into the female reproductive tract. Many women are told all manner of untruths of sperm lasting for weeks at a time. The truth is that sperm cannot survive for long once they are released.

Precisely how long they can survive depends on the environment that they are released into and how quickly the fluid surrounding the sperm cells dries up.

Sperm lifespan inside the female body

After ejaculation, sperm may be able live inside the female body for several days, but that is dependent on many varying factors once they enter a woman’s body.  To be honest, most of the 300-500 million sperm are dead with an hour. That is a fact.

The fluid in a woman’s reproductive tract, especially the fallopian tubes, has all of the nutrients that sperm need for their survival during that time. But while the woman’s body can help sperm on their way to meet the egg, it can also hinder it their survival as well.

An egg has 24 hours to be fertilised, otherwise it dies

But even so, sperm really only have about 24 hours to fertilise an egg once it is released. After 24 hours, if the egg isn’t fertilised it will die, so really, it doesn’t matter how long the sperm can survive for if the egg has already died.

Poor sperm have to contend with many things when they enter a woman’s body. A woman’s vagina is coated in acids, to protect her from infections and bacteria, but it is also lethal to sperm. This is why within minutes and hours, most of the 300-500 million sperm that set off in search of the egg will be dead. Only a few million will survive to swim through cervix.

Climax helps with getting sperm into the uterus

A woman’s body can help to get the sperm going up into to the cervix though. Through climax (orgasm) contractions are created that can help pull sperm up and into the uterus. Through these contractions the cervix is dipped time and time again into a pool of waiting sperm and this then helps carry the sperm up into the second stage of their journey through the uterus and then up into the tubes.

Only a small number is sperm survive the journey

Once inside the female reproductive tract, the sperm cells must swim through the cervix and into the uterus to reach the fallopian tubes and then on to find the female egg. It is a very long journey for sperm to make and very few survive. Many get lost inside the uterus and some are attacked by the woman’s immune system along the way. By the time the survivors make it to the fallopian tubes to have a rest, there will only be less than 20 or more left to make the final journey.

After the sperm have a rest in the tubes and actually feed off some of the nutrients in the tubes many more will die, or be lost inside the tubes and by the time the final sperm reach the egg, there will be less than 10 single sperm left. Only one may then go on to fertilise the egg and an embryo is then started to be created.

All men should have there sperm quality tested

This is why all men need to have their sperm quality checked by a proper andrology lab and some men will need further testing of the DNA (DNA fragmentation analysis) and further genetic testing if the semen results are poor.

This should all be done prior to trying to conceive, as 50% of fertility issues are related to men. If a man has any of these risk factors, he should try to change them at least 3-4 months before trying to conceive, since that is how long it takes for sperm to fully mature. Some men may need longer than this, depending on what is causing their sperm to be of poor quality.

I will discuss some more myths and facts around sperm and what the most important parameters are to look at with sperm, in some later posts.

Regards

Dr Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

-The International Fertility Experts

hurry 2119711 1920

Are you Stressed? … or are you in Denial?

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Most people suffer from stress at some point in their lives. There is good stress and there is bad stress and how people cope with these stresses in different for each and every individual. It is all about how you cope with it. Showing signs of stress does not mean that you are a weak person, just human like everybody else.

But, the word stress is probably not used correctly at times. Many people are actually suffering anxiety, or running on adrenalin and then say they are stressed .The word stress is such a broad term. These days the word stress probably means either you have anxiety, or you are busy being busy.

What do we now define as stress?

Stress is the description used for strain, pressure or force on a system. That system may be you. Stress can be the result of trivial annoyances like driving in heavy traffic, or a life-altering major crisis such as the death of a loved one. Stress can also be someone being busy, or someone running on adrenalin too much. Like I said before, stress could also be someone who is suffering from anxiety and then terms it as stress.

Stress can be used both to refer to the event that is causing the disturbance or the effects of that event on your body. Usually when we say we are feeling stressed we are talking about the symptoms caused by our body’s stress response.

There are different forms of stress

There is no doubt that there are different forms of stress and probably the biggest issue for people these days is actually realising that their body is in distress. It is that constant low grade stress that affects so many people and causes so many issues in the body. That low grade stress is the one that eventually catches up with people and can sometimes have very detrimental effects.

Stress can be a cause of many health issues

The one thing we know for sure is that stress is a cause of a lot of our health issues, immune system issues, reproductive issues, gynaecological issues, mental health issues, respiratory and cardiovascular issues, sleep issues and so on.

Nobody is born stressed, or is predisposed to being stress. It is a learnt behaviour that can be unlearnt and that is why seeing someone to help with coping strategies around stress is so important. There are also supplements and medicines that can help to deal with stress more effectively too.

What are the Symptoms and effects of stress?

Some of the symptoms and health problems that can be caused or exacerbated by high levels of ongoing stress include:

  • migraine or tension-induced headaches;
  • insomnia, fitful sleeping or nightmares;
  • anxiety, anger or irritability;
  • low, irritable or unstable mood;
  • memory lapses;
  • shoulder, neck or back pain;
  • fatigue;
  • rapid heartbeat;
  • high blood pressure;
  • skin eruptions and worsening of conditions such as eczema;
  • heartburn, nausea (feeling sick), diarrhoea or constipation;
  • reduced libido;
  • shortness of breath;
  • problems with your immune system;
  • heart disease; and
  • chronic pain.

Like I mentioned before, stress can also affect the reproductive system, cardiovascular system, nervous system, immune system and so much more.

How stress affects your body

At the first sign of alarm, certain sensory nerves in your body are stimulated and hormones are released that automatically trigger physical reactions to stress. Your heart rate increases, blood is diverted to your muscles and brain, breathing rate increases, digestion slows down, saliva production stops (your mouth feels dry), perspiration increases and your pupils widen. You feel tense, you startle easily and your attention narrows to focus on possible threats.

This is the ‘fight or flight’ phenomenon, which makes your body tense, alert, and ready for action. After this reaction to a real or perceived threat, your body stays on alert until you feel the danger has passed. When the stressor is gone, the brain signals an ‘all clear’, and your body gradually returns to normal.

While some short-term stress is thought to be good for you, pushing you to make that extra effort in a sporting event or game, chronic or long-term stress can be harmful to your health. This kind of stress is when you feel under constant, intense pressure, or you just cannot see a way out of a terrible situation. The problem for some people is that they do not realise they are stressed, or they actually have anxiety, and their body is in the state of constant adrenal overload that eventually catches up with them and their whole body shuts down completely. We see this with adrenal fatigue and chronic fatigue

Dealing with stress

Dealing with stress effectively can be complicated, but usually involves:

  • general measures to improve your overall wellbeing; and
  • learning coping skills and setting healthy boundaries
  • specific steps to deal with stress and particular challenging situations.
  • learning what your triggers may be
  • learning ways to deal with stress and how to be more relaxed

It is about getting coping skills to deal with the body having to deal with stress, or at point of perceived crisis.

The word that we term “Stress” commonly results when you feel your resources — for example, time, money or skills — are insufficient to deal with your responsibilities. Take check of what is causing you stress and where you examine your demands and resources can be a useful first step in dealing with stress. There is where the practice of mindfulness is very useful and also talking to a counsellor/psychologist can help you identify triggers for stress and have coping skills to deal with stress.

Problem solving techniques and coping skills may help you with problems and issues creating stress. You may also need to work on limiting your obligations, or asking for extra resources to help you cope with stress better. You may need to accept that there are times in life where you simply can’t do everything that others in your life, or you yourself are expecting.

One way to help deal with stress is to maintain a healthier mind and body. Here are some of the things you can do to deal with stress better.

Ways to Deal With Stress Better
  • Regular exercise to help with stress and tension in the body. It also helps with moods.
  • Make sure you get at least 1-4 hours “You” time per week. Treat yourself to sufficient relaxation time so that you can switch off from you daily routine. This will help to give you a refreshed and energetic outlook on life. Learn yoga, meditation or other relaxation exercises such as mindfulness. There are some great mindfulness courses available now.
  • Make sure you get enough sleep. Melatonin is the hormone that helps you sleep and lack of sleep and stress depletes it. Lack of sleep also puts the body into distress.
  • Maintain a balanced diet. Without a balanced and health diet, your body will have inflammation and this will cause stress and disharmony in the body too.
  • Learn to accept what you cannot change but also learn to be more assertive, especially if you are one of those people who always say ‘yes’. Healthy boundaries are so important.  Assertiveness training, setting clear boundaries and learning to say no can be very helpful in avoiding overload.
  • Make sure you do something that you love at least 1-2 times per week. Spend time with people you enjoy seeing, listening to music, playing sport, reading a book, watching a funny movie, gardening etc.
  • Talk therapy and coping skills: Talk therapy with a trained professional that can help you deal with stress and help you with coping skills is very important.
  • Avoid the use of drugs or alcohol as a means of coping with stress.
  • Acupuncture and Chinese Medicine can help with stress and studies have shown that it is as effective as some medication and equal to talk therapy in its effect. ( http://doi.org/10.1371/journal.pumed.1001518)
  • There are natural medicines that may assist you deal with the effects of stress and please talk to a qualified healthcare professional how best these can help and what to use. Do not self prescribe ever.

How do I know if I need help?

Many people think that they can deal with stress on their own, but the truth is it is better to get a trained professional to help you deal with it properly. This way you commit to actively doing something too and you are also learning coping skills at the same time. You should consider seeking help if:

  • you constantly worry and have trouble concentrating;
  • you feel a lot of guilt;
  • your sleep, energy and motivation is poor;
  • you can’t be bothered doing things anymore;
  • you experience several of the physical symptoms associated with stress;
  • you recognise that you are turning to self-destructive behaviours for temporary relief;
  • everything and everybody around you is being affected by the way you feel; or
  • you feel as though there’s nowhere to turn.
  • Friends keep telling you that you look stressed, or look like you need to slow down

There are qualified professionals who can help you with dealing with stress. It is important that you do see the right person to help you and your individual situation. You can always speak to your doctor or healthcare practitioner and ask them for a referral to someone. There are also mindfulness courses and relaxation courses you can do also. Exercise it important and again, it is a good idea help from a professional to get started and keep going.

Please take the risk of burnout and running on Adrenalin tests below and see how you are fairing (see below)

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

Risk of Burnout Challenge
  1. Do you feel let down by other people around you?
  2. Are you too busy for close friends and family?
  3. Are you too busy to do even routine things like send out thank-you notes, return phone calls or mail birthday cards?
  1. Do you tire more easily than you used to?
  2. Are you working harder but accomplishing less?
  3. Are you increasingly cynical and disenchanted?
  4. Are you often invaded by a sadness that you can’t explain?
  5. Do you forget appointments, deadlines, possessions?
  6. Are you increasingly irritable? More short tempered?
  7. Does you body ache or are you having trouble shaking a cold?
  8. Are you finding it harder to be happy and joyful?
  9. Have you lost your sense of humour?
  10. Have you lost interest in sex or have a low libido?
  11. Are you less talkative than you used to be?
  12. Do you think of work all the time, even at rest?
  13. Do you find it hard to say ‘no’ to people or things that require your own personal time?
  14. Do you take time-out for others but do not take time-out for yourself?

Your score

To find your total , add up your “yes” answers.

(0 – 5) >> Cruising along nicely

(5 – 10) >>  Borderline burnout

(10 – 17) >> Burnout candidate

Running on Adrenalin Challenge

  1. I feel there isn’t enough time in the day to do all the things need to do.
  2. I speak more quickly than other people, even finishing their sentences for them.
  3. My relatives and friends say I eat too quickly.
  4. I would rather win than enjoy a game.
  5. I am very competitive at work, sports or games.
  6. I tend to be bossy and dominate others.
  7. I prefer to lead than follow.
  8. I feel pressed for time even when I’m not doing something important.
  9. I become more impatient when I have to wait for something or when I’m interrupted.
  10. I tend to make decisions quickly and compulsively.
  11. I take on more than I can accomplish.
  12. I become irritable and even angry, more than other people.
  13. I feel a strong compulsion to be doing something while at home or even on holidays.
  14. I fidget often and become restless, pacing, leg kicking, or fast gum chewing.
  15. I get a vague sense of depression whenever I stop an activity.
  16. I have forgotten how to, or don’t know, how to relax.

Score description

0 – This does not apply to me

1 – This statement applies to me less than once per month

2 – This statement applies to me on a regular basis

Total score

Out of a possible score of 32 you would have fallen into one of the 4 following categories…

(0 – 10) >> Relaxed

(10 – 15) >> Typical

(15 – 20) >> On the edge

(20 +) >> Adrenalin Junkie!

How to deal with endometriosis

How to cope with endometriosis and manage it moving forward

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Endometriosis can be a challenging condition to deal with, both physically and emotionally. But with proper interventions and proper management and treatments after diagnosis, you can be shown how to deal with the associated symptoms of endometriosis and improve your quality of life. Please have a read of some of the best ways to cope with endometriosis.

What is Endometriosis?

Endometriosis can be painful disorder that is characterized by tissue that behaves like the lining of the uterus but that grows outside the uterus. Endometriosis is really normal tissue growing in abnormal places. This tissue can be found in various places, such as the ovaries, fallopian tubes, and pelvic lining, and even in or around the bladder and bowel.

Endometriosis affects around 1 in 10 women and girls and those are only the ones diagnosed. This mean these figures are grossly under-diagnosed and downplayed with many women not being diagnosed properly and those that do not even know they have the disease. Endometriosis can cause symptoms during the reproductive years, between the ages of 12 and 60, but it can show up in young girls under 10 years old too.  Many people with the condition remain undiagnosed and many more and missed and dismissed with many taking up to ten years or more to be diagnosed.

What are the symptoms of Endometriosis?

The main symptom of the condition is usually pelvic pain typically associated with the menstrual period. While women can experience some discomfort during their menstrual period, some of those with endometriosis describe pain that is worse than usual. For some it is actually unbearable.

There are also other symptoms such as painful periods, pelvic pain, ovulation pain, pain with sex, chronic fatigue, irritable bowel like symptoms, bladder issues and pain and bleeding on bowel movement. This is why all women need to know that period pain is not normal, because many times, period pain can actually be a sign that a woman has an underlining gynaecological conditions such as endometriosis.

We also need for everyone to know that endometriosis is not just about period pain. There are many other symptoms women face when dealing with endometriosis.

There is no cure, but there ways to manage Endometriosis

There is no cure for endometriosis (not yet anyway), but there are treatment options and lifestyle changes that can ease your symptoms so that the condition does not interfere with your day-to-day life.

The main thing with endometriosis is to manage the disease and try and create a quality of life moving forward. While there is no cure for endometriosis, it is possible for women to become asymptomatic (meaning having no symptoms) and this requires the right treatments and management of the disease and to see the right people from the beginning.

Again, it all gets back to who you are seeing and their experience with knowing about endometriosis. This is one the biggest issues women face when trying to get treatment. Many just do not know much about the disease at all and why women are left to deal with the horrible symptoms. But with the right treatment and management, women can have a better life and be able to cope with this horrible disease.

Before we look at proper management for women with endometriosis, it is important that all understand the facts because there is so much misinformation out there and this is part of the bigger issue for women with this disease.

Surgical intervention and medications alone are not enough

While surgical interventions are hormones/medications are needed for women with endometriosis, alone, or in combination are not enough. We know that despite the best surgical and medical intervention that women are still in pain and still having the associated symptoms of endometriosis. This is why women do need a multimodality/team approach, and a combination of different modalities to effectively manage endometriosis.

The problem for many is that once they have the surgery, they believe their endometriosis is gone, or that they don’t have to do anything else. This is where many go wrong and why they end up having to have multiples surgeries. Women need proper ongoing management after surgery, which includes medications, hormones, other therapies, counselling, physiotherapy, mindfulness, exercise, diet and lifestyle interventions and so much more. Without this, endometriosis cannot be effectively managed.

The Facts About Endometriosis

  1. Period Pain IS NOT Normal
  2. A significant portion of women with Endometriosis are asymptomatic
  3. Symptoms DO NOT correlate to the extent of the disease
  4. The only way to diagnose Endometriosis definitely is via surgical intervention
  5. There is NO cure for Endometriosis
  6. Having a baby will not cure endometriosis
  7. Endometriosis does not always cause infertility
  8. Endometriosis is Estrogen Driven and is not caused by Estrogen dominance
  9. The Pill, or Contraceptives DO NOT fix endometriosis
  10. You can have Endometriosis at a Young, or Older Age
  11. Hysterectomy does not cure endometriosis
  12. Endometriosis requires a multi-modality approach to be managed properly. You need a team for proper management
  13. Endometriosis IS NOT an autoimmune disease
  14. There Are Hereditary and Genetic links
  15. Endometriosis can cause many other issues in the body
  16. The first line approach for hormone therapy should be the use of progesterone only options
  17. Endometriosis needs to be excised (cut out) by an advanced laparoscopic surgeon, who has had extra years of specialised surgical training, and who specialised in the excision of the disease and specialised in the disease itself. Surgery should be performed by anyone other than an advanced laparoscopic surgeon and not by just a regular gynaecologist
  18. Not all women with endometriosis have suffered sexual abuse
What Women Can Do To Help Manage Endometriosis

1.Seeing the Right Specialist & Surgeon

First and foremost make sure you have seen someone who specialises in endometriosis and the management and treatments moving forward. You also need to make sure that your first surgery is your best surgery and that you have seen an advanced laparoscopic surgeon to ensure you have had the proper surgical intervention. This is many women’s biggest issue as they have not seen the proper surgeon initially and they aren’t seeing someone who specialises in the management of the disease moving forward.

2.Watch your diet

Eating the right foods may provide some protection from the symptoms of endometriosis. The role of diet in endometriosis has been investigated in recent years due to the influence of diet on some of the processes linked to the disease, such as inflammation, prostaglandin metabolism, and estrogen activity. Many of the so called endometriosis diets out there are now outdated and have outdated nutritional and dietary advice that don’t really help much at all. Women need to adopt an anti-inflammatory diet (grain free, non-refined food ) to help with settling any inflammation in the body and also helping the immune system. This also needs to include prebiotic and probiotic bacteria to help with digestive function, immunity and gut health.

Certain environmental estrogens such as preservatives, plastics, pesticides and insecticides that can be ingested through certain nutrients have been suggested as risk factors for exacerbating endometriosis too.

Excess body fat, now known as obestrogens (because it is estrogenic) needs to be controlled and managed through diet and exercise too. We know that estrogen drive endometriosis and that any estrogens (dietary, body fats, environmental etc) needs to be regulated and controlled.

3.Boost intake of omega-3 fatty acids

Researchers have also found that the type of fat included in your diet makes a difference in your risk of endometriosis. Studies have shown that people whose diets were heavily laden with trans fats increased their risk of the expression of endometriosis by 48 % when compared with individuals who ate the least of these. By comparison, women whose diets were rich in omega-3 oils lowered their risk of endometriosis by 22 % compared with those who consumed the least amount.

Eating foods high in omega-3 fatty acids, such as salmon, flaxseeds, almonds, and walnuts, may be helpful for endometriosis. Women should also be supplementing with Omega 3 oils too. Just remember, it is all about reducing inflammation.

4.Exercise

Often, people who experience pain fear exercising, in case it causes more problems for them. But over time, regular physical activity may decrease the pain and discomfort that you feel. High-intensity exercise and resistance training can help to reduce the symptoms of endometriosis.

Exercise may help those with endometriosis in many ways, including:

  • encouraging the circulation of blood to your organs
  • maintaining nutrients and oxygen flow to all your body systems
  • decreasing estrogen production
  • reducing stress
  • releasing endorphins in the brain, which are pain-relieving, “feel good” chemicals

Women who regularly exercise may be likely to have the symptoms associated with endometriosis. Research has shown that those who engage in frequent high-intensity physical activity have fewer symptoms of  endometriosis than women who do not participate in regular exercise. High-intensity physical activity, such as running, swimming, weight training etc, may be beneficial for reducing your symptoms.

Low-intensity exercise, including Yoga and Pilates may provide some relief in endometriosis, too. Yoga and Pilates can stretch and strengthen your muscles, help with core strength, help with circulation, which all may be beneficial for pelvic pain management and stress reduction.

5.Managing Stress Levels

Stress is a big factor in any disease and can make any disease worse. Not only can stress be exacerbated by endometriosis, but so can endometriosis symptoms be exacerbated by stress, in a never-ending cycle. Endometriosis could contribute to making your stress levels worse, due to the impact that the associated symptoms have on all aspects of your life, including family and personal relationships and work.

Stress management, Counselling, Mindfulness and Relaxation techniques can help to reduce stress that exacerbates endometriosis-related symptoms and pain.

Women with endometriosis need to manage stress by using mindfulness and relaxation techniques. These can help you to increase your awareness of your body, refocus on something calming, and reduce the activity of stress hormones and inflammation in the body. It is all about learning coping mechanisms and what works best for you, not what works best for others.

6.Try complementary medicine and therapies

Many women with Endometriosis find symptom relief from using a range of different complementary and alternative medicines. The Royal College of Obstetricians and Gynaecologists also recommends that women try natural medicines to help with the management of endometriosis and the associated symptoms. There is now some good research to support many natural medicines treatments such as acupuncture, Chinese herbal medicine, vitamins, omega 3 oils, probiotics, chiropractic/osteopathy, yoga, pilates and more, alongside medical interventions.

Acupuncture and Chinese medicines has some good research around period pain and pelvic pain and may be beneficial to those suffering this disease and its associated symptoms, alongside medical interventions.

Certain strains of prebiotics and probiotics have also been shown to help with the immune system, microbiome, bowel, and digestive associated symptoms of endometriosis. Probiotics have also been shown to not only help with digestive and immune function, but also with the psychological function as well. It does need to be specific strains of probiotics though.

Just like with medical treatments, when it comes to complementary medicines, it is important to find someone who is a qualified practitioner and who specialises in endometriosis. Just like in the medical model, this can also be hard to find.

7.Medications

Your endometriosis specialist can provide you with a list of treatment options for endometriosis and outline the risks and benefits of each. They will take into account your age, your symptoms, whether you want to become pregnant, and any treatments that you have had previously. It is important to manage pain and inflammation so that you can have a life and to be able to function daily.

You may need to use different forms of pain medications on script, as well as those that can be purchased over the counter. Please ensure you speak to your healthcare provider about setting up a pain management plan when using medications

You will also need to look at hormone therapy to help slow down the growth and expression of the disease and microscopic implants and also help with the associated symptoms of the disease. Hormones will usually be in the form of progesterone only medications and gonadotropin-releasing hormone antagonists and agonists. You may be prescribed other hormones depending on your individual case and symptoms.

Although all of these hormone therapies are effective at treating endometriosis, but,  they all have different side effects. You need to talk to your doctor and pharmacists about the side effects and risk factors of any medications and hormones that you are taking.

In Summary

It is important to know that women with endometriosis will need a multi-modality, or team approach to deal with this disease. The team you need and modalities that you will need will be dependent on your individual symptoms.

Try and find healthcare professionals that can offer you a multi-modality approach for ongoing care and support and who also have a team of other people who are experts in the disease too. Again, the approach that you and your healthcare profession choose to take will vary depending on your signs and symptoms, and whether or not you would like to become pregnant in the future.

Before starting any treatment, it is important to know all of your options and the potential outcomes of all of them and to know that the people that you are seeing are and expert in endometriosis and know how to manage the disease properly. That can often be the hardest thing to find and why you need to do your homework and see people who are experts in this area of medicine.

Regards

Andrew Orr

-No Stone Left Unturned

-Period Pain IS NOT Normal

-The Endometriosis Experts

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The Different Colours of Semen and What These May Mean

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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

Andrew Orr

-Master of Reproductive Medicine and Women’s Health Medicine

-‘No Stone Left Unturned’