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Care with Respect, dignity, Compassion and Commitment

Dr Anu Kaur MBBS,FRANZCOG
Obstetrician, Gynaecologist, IVF Specialist

Preconception Nutrition

What is Preconception Nutrition?

Preconception health and nutrition care focus on things you can do before and between pregnancies to increase the chances of having a healthy baby

Why is it important?

Preconception nutrition research has shown that food and healthy nutrition are tied to fertility health in both women and men. Additionally, there are substances that can hinder fertility.

What is involved in preconception nutrition?
Preconception Nutrition Preparation.
Begin making healthy changes 3 months to a year before you conceive. Evidence shows that healthy nutrition and fertility is linked in both men and women. Below is a list of suggestions for healthy nutrition prior to conception:
• Folic Acid: The recommended dose that women of childbearing age obtain 400 micrograms (0.4 milligrams) of folate or folic acid each day. This B vitamin helps reduce a baby’s risk of neural tube birth defects such as spina bifida.
If your family has a history of neural tube defects or certain medical conditions, you may need an increased dose regime which your doctor can guide you. Folic acid may be obtained naturally through leafy, dark green vegetables (i.e. spinach), citrus fruits, nuts, legumes, whole grains, and fortified bread and cereals. These foods can be supplemented with a Prenatal Multivitamin which usually contains 500 – 800mcg of folic acid.
• Calcium: It is recommended that women get at least 1,000 mg of calcium a day. Calcium may be obtained from natural sources such as low-fat yogurt, canned salmon, sardines, rice, and cheese.
• Supplements & Vitamins: In addition to a healthy diet, many healthcare providers will encourage you to take supplements to increase the probability that you get all the nutrients you need.
• Caffeine: It is important to wean yourself off of caffeine (including chocolate), as research has shown that more than 200-300 milligrams of caffeine per day may reduce fertility by 27 percent. Caffeine also hinders the body’s ability to absorb iron and calcium.
• Things to Remove: Artificial sweeteners, alcohol, recreational drugs and cigarettes and passive smoking all have the potential of harming your soon to be conceived baby.
A Nutrient That Can Benefit Both of You
Oysters contain high levels of zinc – a nutrient that contributes to semen and testosterone production in men, and ovulation and fertility in women.
There are several studies that indicate that deficiencies in zinc affect both male and female fertility.
Maintaining the recommended dietary allowance of zinc (15 mg a day) can help keep your reproductive system functioning well.

Dr Kaur sees patients for preconception counselling at her clinic in Spring Hill. You can make an appointment by calling (07) 3839 0552 and one of her friendly staff can help you or submit a request online on the website “www. aurorawomenshealth.com.au”

Vulva And Vaginal Irritation

The vulva is a regular name given to the outer parts of the female genitals. Vaginal discharge or secretion happens in all women; it helps to keep their vulva and vagina moist and get rid of bacteria and dead cells.

If you are faced with vulva irritation, seeking medical advice from your doctor regarding the causes of irritation is essential. However, before hitting your doctor with a call, this piece will assist you in having a profound understanding of your causes and treatments that are available.

What is Normal?

Understanding what is rational about differences and variations is vital in all women. Although individual’s woman’s Vulva has unique sizes and appearances that include differences between the left and right labia. Other changes include length, shape, and size. These natural variations and differences in women are healthy.

But, why is it difficult for women to see what their Vulva looks like? It is only because they can’t see it. Nonetheless, these can help: A mirror can come handy to familiarize yourself with it and identify what is normal for you; detect changes in appearance, bumps occurrence, cracked skin and thickening and thinning of the skin.

Symptoms

Vulva and vaginal irritation can be highly delicate and could lead one’s susceptibility to an extensive range of infection. These symptoms include:
Redness
Vaginal inflammation or discharge
Burning
Skin cracking or splitting
Whitening of skin
Itching
Odorless white discharge.

Diagnosis

In most cases, there occurs a cycle of itch, skin tearing and splitting, scratch and secondary infection.
Many women with this condition shy away from discussing their symptoms and problem leaving it for many years before they will finally resort to seeking medical help.

Rather than trying to treat this problem yourself, it is highly essential to see your gynecologist prior any action. These are some of the tests that will be carried out by your doctor:
Blood Test
Urine Test
Vulva or Vaginal Test
Vulva Biopsy
These tests are necessary for diagnosis.

Causes

It is relieving that Vulva, and Vaginal irritation has known causes. These causes include
Vaginal Secretion
Sweating
Skin conditions which include: Eczema, Lichen Sclerosus, and Dermatitis
Fungal, Viral and Bacterial Infection which include: Genital Herpes, Candidiasis (thrush) and trichomonas.
Use of medications, local anesthetics or preservative.
Allergies to substances like Laundry detergent, perfume, wax, soaps, bath and hair products, and feminine hygiene products.

Management And Treatments

The treatment for Vulva and Vaginal irritation depends solely on the causes. Therefore treatments that will be handed to individual patients will be subject to their cases. Their causes will bring forth the type of treatment that will be selected.

The types of the treatments that will be chosen for a patient battling with Vulva and Vaginal irritation are:

Use water only or non-soap substitute for washing your vulva.
Lean forward when passing urine
Swim in salt water
Avoid the use of talcum powder
Wear underwear that are made of cotton.

You can make an appointment with Dr Kaur on (07) 3839 0552
This article is written to be informative and does not substitute seeking a professional consultation from a medical professional.

Endometrial ablation is a surgical procedure in which the endometrium (or uterine lining) is removed permanently. The endometrium is the lining of the inside of the uterus, and its growth and subsequent shedding is what causes the bleeding of menstruation.
The burning away or removal of the endometrium is not exactly a permanent procedure, because the endometrium does grow back – especially in younger women. However, having more than one ablation is not advised.
Women who choose this procedure usually undergo it as a last resort. It is tantamount to sterilisation, especially in older women whose endometrium will not likely grow back.

Why is it done?

Some women have abnormally long or heavy menstrual periods, which could be caused by a host of factors including polycystic ovarian syndrome (PCOS) and fibroids. However, in a percentage of women, the causes of the bleeding is not known, this condition is called dysfunctional uterine bleeding (DUB).
Endometrial ablation is one method for treating DUB; the removal of the endometrium will cause the bleeding to cease.

It can also be a treatment for severe PMS and dysmenorrhoea (painful periods), albeit a rather fatalistic one. In fact, it should be approached as a last resort treatment because of its invasive process and the complications it can incur. In addition to that, women who still want children will have to find other methods for treating bleeding problems and painful periods.
Independent studies have shown that women who undergo the procedure are satisfied with the results; living a period and pain-free life can be liberating.

Types Of The Procedure

Endometrial resection: an instrument called a reteroscope and an electrode is used to destroy the endometrium in small sections. The surgery is specialised and can take up to an hour.
Non-reteroscopic ablation (or global ablation): This procedure is simpler and faster, and is gaining popularity. This method uses new devices like microwave endometrial ablation (MEA), Novasure and cryotherapy.
Success rate of endometrial ablation is up to 90%.

Benefits

Cessation of menstrual periods in up to 50% of women, with light bleeding in 40%.
No need for further treatment for abnormal bleeds.
Painful periods are stopped.

Complications

As with every surgery, there are complications attached to this procedure. However, these are very rare, with those complications in 1/200 of patients.
Reaction to anaesthesia occurs in a small percentage of patients.
Some patients could have abnormal bleeding and haemorrhaging after the procedure.
In 10% of patients, the surgery does not take. These patients might have to have a hysterectomy.
Uterine perforation could occur in some women.
There is risk of infection.
Pregnancy is possible, but the chances are very narrow. These pregnancies are usually rife with complications and cannot be carried to full term.

The recovery time after the surgery is just about a week, as it is not a major surgery. Women who have had this procedure will still need to employ hormonal and barrier methods of contraception, as there is a slim chance of pregnancy afterwards.

SOURCES
http://www.advancedgynaecologymelbourne.com.au/Endometrial_Ablation

You can make an appointment with Dr Kaur on (07) 3839 0552
This article is written to be informative and does not substitute seeking a professional consultation from a medical professional.

Abnormal uterine bleeding (sometimes referred to as dysfunctional uterine bleeding – DUB) is categorized as irregular uterine bleeding that occurs devoid of recognizable pelvic pathology, general medical disease, or pregnancy. The condition is symptomatic of a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining of the uterine wall lining.

Experts largely point to hormonal disturbances as the major precipitator: where reduced levels of progesterone engender low levels of prostaglandin F2alpha and cause menorrhagia (abnormally heavy flow); while increased levels of tissue plasminogen activator (TPA) (a fibrinolytic enzyme) lead to more fibrinolysis.
In Australian, the statistics reveal interesting facts. Up to 20 percent of Australian women in the reproductive age bracket complain of menstrual loss. As much as 1 in every 25 women in the country consults a doctor or another specialist on Abnormal Uterine Bleeding and other related issues. Surveys also reveal that over 50 percent of the cases of reported cases of Abnormal Uterine Bleeding usually end up being normal blood loss upon deeper examination.

Normal vs Abnormal Bleeding

Determining acceptable levels of bleeding is dependent on a number of factors including the physiology and physiopathology of the menstrual cycle. A good number of girls in Australia begin their ovulation cycles on or before the age of 13. Note that dysfunctional bleeding might be common in the first 2 to 3 years following the first ovulation cycle as a consequence of many anovulatory cycles resulting in irregular periods and heavy menses.

Once a regular pattern for ovulation and menstruation has been established (every 28 days or so), the woman is able to predict the duration/occurrence with a certain level of precision. Any deviation from this computed structure can be considered Abnormal Uterine Bleeding.

Types of Abnormal Uterine Bleeding

Ovulatory Abnormal Uterine Bleeding
Under this class of bleeding, progesterone secretion is prolonged because estrogen levels are low or depleted. This depletion precipitates the irregular shedding of the uterine lining, resulting in breakout bleeding. Such bleeding is also associated with tender blood vessels in the uterus.

Anovulatory Abnormal Uterine Bleeding
This class of AUB is more prevalent with rates of incidence reaching as high as 90 percent in women, Australia inclusive. In this case, ovulation is not occurring. This is common in reproductive ages such as early puberty and menopause. For the former, ladies who have not developed fully may see the release of a mature egg. This release precipitates the non-formation of the corpus luteum. As a result of this non-formation, estrogen is produced in copious amounts, leading to an overgrowth in the lining of the uterus, which leads to Abnormal Uterine Bleeding.

Management and Treatment
Usually, the age of the patient, causative factors as well as future plans for conception will determine the appropriate treatment/management route for each individual case. Depending on the age of the woman, the following treatment paths are suggested for the following groups:
Teenagers
At this age, doctors will recommend watching and ascertaining the regularity of your ovulation cycle, as maturity sets in. For unusual cases, progestin or birth control pills may be recommended to regularize your cycle.
Irregular Menstruation
In this scenario, doctors may opt for hormonal therapy such as a hormonal IUD to regularize your monthly cycle.

Regular Ovulation
Under this class, medical experts recommend administering birth control pills. In more profound cases, the woman may decide to undergo an endometrial ablation or hysterectomy, if there are no future plans for conception.
You can make an appointment with Dr Kaur on (07) 3839 0552
This article is written to be informative and does not substitute seeking a professional consultation from a medical professional.

Urinary incontinence occurs when a person urinates even when they do not want to. This means there’s an involuntary discharge or leakage of urine. It usually happens either as a result of weakened or loss of control over the urinary sphincter. This is a common problem that affects a whole lot of people.

This condition is a common occurrence among women with approximately 30 percent of women aged between 30 and 60 believed to suffer from urinary incontinence. There are different reasons why urinary incontinence can occur, but smoking and obesity are risk factors for it.

This loss of bladder control is often an embarrassing problem and the severity of the problem varies. From occasional leaks of urine when you sneeze or cough to as much as having an urge to urinate suddenly that you’re not able to get to the toilet before letting go. While it occurs more with age, it isn’t an inevitable result of aging and for some people a little lifestyle changes or medical treatment will ease the discomfort or even stop urinary incontinence completely.

Symptoms
Urinary incontinence can come with minor, and occasionally leaks of urine while others could let out small to moderate amounts of urine more regularly.

Types
There are different types urinary incontinence based on how it happens and what causes it.

Stress incontinence: this happens when urine leaks as a result of increased pressure on the bladder by sneezing, coughing, lifting something heavy or laughing.
Urge incontinence: there’s an intense and sudden urge to urinate that’s usually followed by an involuntary release of urine. This condition might be caused by infections, diabetes or neurological disorders. There’s always a need to urinate more often, even throughout the night.
Functional incontinence: this is either a mental or physical impairment such as arthritis that does not allow you get to the toilet on time.
Overflow incontinence: this type of incontinence is as a result of a bladder that never empties completely. It leads to a constant leaking of urine.

Finally, when a person experiences more than one type of urinary incontinence the condition is known as mixed urinary incontinence.

Causes
Since urinary incontinence isn’t a disease but a symptom of bad results of some underlying physical or medical conditions or even everyday habits, with a thorough evaluation by a medical doctor, the cause of urinary incontinence can be determined.

Prevention
Although urinary incontinence isn’t all that preventable, there are a few things that can be done to help decrease the risk of experiencing this condition.

Try as much as possible to do without bladder irritants such as alcohol, acidic foods and caffeine
Eat diet that contain more fibre, that would help prevent constipation which is a cause of incontinence
Try as much as possible to maintain a healthy weight
Engage in pelvic floor exercises

Treatment
For those already experiencing the condition, the treatment of urinary incontinence depends on different factors like age of the patient, mental state, type of incontinence and general health.

Behavioral treatment:
This might be all that is needed for some people in the treatment of urinary incontinence. For people with stress incontinence, limiting how you drink can help reduce incontinence and those with urge incontinence are usually advised to avoid spicy foods, carbonated drinks and caffeine. This is because these foods irritate the bladder. Generally, exercises that strengthen the pelvic floor muscles should be done to help control the condition.

Drugs:
There are different drugs that can be prescribed for incontinence based on the type. One of such medications includes anticholinergics (or antimuscarintics) which is known to help prevent bladder spasms in the treatment of urge incontinence.

Devices and absorbent products:
There are also different products such as panty liners and pads to help avoid embarrassing situations.

Surgery:
In situations when the treatments do not offer enough relief for incontinence, surgery is usually prescribed.

You can read more about Urinary Incontinence HERE. You can make an appointment with Dr Kaur on (07) 3839 0552
This article is written to be informative and does not substitute seeking a professional consultation from a medical professional.