News

• 10th December 2018  |  Posted by Florence Wildblood

  The 6 key pregnancy hormones

  There are 6 key pregnancy hormones, which contribute to the emotional and physiological changes women tend to experience when pregnant. In this article, Consultant Gynaecologist Pradnya Pisal provides information on each of these hormones:

  HCG

  • Pregnancy stage: HCG appears on the 8th day after ovulation, one of the earliest secreted hormones from the conceptus, and can be detected usually by 5-6 days after ovulation but definitely by 10 days after ovulation.
  • Peak time: it generally doubles every 48 hours, reaching its maximum level at 8-10 weeks.
  • Function: its only function is supporting the corpus luteum. 
  • Side effects: headache, irritability, restlessness, fatigue, insomnia, nausea, vomiting (can be excessive and abnormal) and fluid retention. 

  Oestrogen

  • Pregnancy stage: oestrogen is produced from pre-pregnancy until about 10-12 weeks from the follicle area in the ovary, where the egg is released from. After this, the placenta and fetal adrenal gland produce it until term.
  • Peak time: late third trimester.
  • Function: preparing uterine lining for the implantation of the embryo. It is helpful in preventing miscarriage, and acts as a catalyst for chemical changes for growth, development and energy in the baby. It steps up blood circulation and regulates the production of other key hormones, as well as promoting breast engorgement in early pregnancy and regulating bone density. 
  • Side effects: increased blood flow to mucous membranes leading to headache, postnasal drip and nasal congestion; sensitive skin and some areas showing hyper-pigmentation (especially nipple areola and along midline on abdominal wall); melasma.

  Progesterone

  • Pregnancy stage: progesterone is produced from pre-pregnancy until about 10-12 weeks from the follicle area in the ovary where the egg is released from. The placenta then produces it until term. There is a second gradual increase after 32 weeks.
  • Peak time: late third trimester
  • Function: preparing uterine lining for the implantation of the embryo, suppressing maternal response to fatal antigens and prevents the rejection of trophoblast. It maintains quiescence of the uterine muscle and is helpful in preventing miscarriage and pre-term labour. It also encourages breast tissue growth.
  • Side effects: GI discomfort, including indigestion, heartburn, constipation and bloating.  Aching hips (pubic bone and back), bleeding from teeth and gums and increased sweat gland secretion. 

  Relaxin

  • Pregnancy stage: produced by the corpus luteum and the placenta from early pregnancy to late pregnancy.
  • Peak time: at 14 weeks and around the time of delivery.
  • Function: preparing uterine lining for the implantation of the embryo, uterine growth and accommodation, the control of myometrial activity to prevent preterm labour, and cervical ripening and the facilitation of labour. It is also important in reducing insulin resistance.
  • Side effects: joint and ligament pains and backache. It can also cause heartburn as it relaxes the smooth muscle and sphincter of the stomach, so acid comes up into the food pipe.

  Oxytocin

  • Pregnancy stage: produced by the hypothalamus and released from the pituitary gland in the mother’s brain throughout pregnancy.
  • Peak time: oxytocin levels rise from the first to the third trimester and fall during the postpartum period.
  • Function: stimulates the ripening of the cervix, leading to successive dilation during labour. Along with other hormones, it causes the release of prostaglandins, which play an important role in the ripening of the cervix. It also aids bonding with the baby. 
  • Side effects: can cause irritability and awareness of normal uterine contractions, Braxton-Hicks.  Can lead to excessive hair growth. 

  Prolactin

  • Pregnancy stage: secreted by the decidua, endometrial lining and also by maternal pituitary gland, starting in early pregnancy. 
  • Peak time: starts in early pregnancy and there is a sustained rise until the third trimester and postnatally.
  • Function: enlargement of the mammary glands and preparation for milk production, which normally starts when levels of progesterone fall by the end of pregnancy and a suckling stimulus is present.
  • Side effects: n/a

   

• 6th December 2018  |  Posted by Florence Wildblood

  What happens to your period as you get older?

  Our periods change over time. They are affected by many factors, from age and body mass index to contraception, pregnancies, breastfeeding and menopause. Below, Consultant Gynaecologist Narendra Pisal explains how these things can have an impact on hormone balance, and in turn cause period issues as we move through different stages of our lives.

  The teenage years 

  The average woman starts her periods at around 11-14 years. It is normal to have irregular periods during the teenage years as the ovulation is still sporadic and unpredictable. It can take a few years (until the early 20s) for regular ovulation to establish and for periods to develop a particular pattern.

  Twenties and thirties

  This is a more stable period for the menstrual cycle and the periods are often regular and predictable.

  If you’re on birth control, this can affect your periods. Read our blog for more information on periods and contraception here. 

  A missed period or late period can occur because of several reasons or sometimes for no reason at all. The common causes are:

  • Pregnancy: If there is any chance of pregnancy at all, please do a pregnancy test. You should do this even if you are using contraception.
  • Polycystic ovaries: Polycystic ovaries are common and occur in around 22% of women. Some women with polycystic ovaries can also have anovulation (lack of ovulation) and this can lead to a late or missed period. A scan and blood tests may be necessary to make this diagnosis.
  • Hormonal imbalance: Thyroid hormone problems or pituitary (a gland in the brain) hormone issues can cause delayed or absent periods. Your doctor will be able to check for this.
  • Eating disorder: Anorexia can cause reduced body fat and can affect ovarian function leading to late or even absent periods.
  • Extreme exercise: The same can happen with a lot exercise. Many of the Olympic athletes often miss their periods due to reduced body fat.
  • Perimenopause or menopause: Cycles can often be delayed around the time of menopause. This is because of unpredictable ovulation and ovarian function.
  • No cause: Sometimes, periods can be late due to no obvious reason. Stress or long distance travel or some medications can affect the cycle too. If pregnancy is ruled out, it is OK to wait for a few more weeks before seeing a doctor. Keep a record of your period dates and any other symptoms you may have.

  Thirties and forties

  If you’ve had a baby, your periods will change afterwards.

  • Breastfeeding stops the periods for up to twelve months. One can still get pregnant while breastfeeding, so it is best to use some form of contraception.
  • Periods often improve after delivery. The cervix is more open and hence the periods are less painful.
  • It is not uncommon for conditions such as fibroids or polyps to develop and cause period problems. So heavy, prolonged or irregular periods should always prompt a doctor’s visit.

  As you approach peri-menopause in the mid-forties, periods can become heavier and more frequent (or sometimes even more spaced out). Whilst cycle length can vary, bleeding between periods and prolonged or heavy periods should act as red flag symptoms.

  Fifties and beyond

  Menopause is the period in a woman’s life when menstruation ceases. In normal circumstances this usually occurs after the age of 45.

  During this time ovarian function declines and periods become irregular, unpredictable and eventually stop. This decline in ovarian function means the decreased release of hormones oestrogen and progesterone and this change in hormone level causes menopause symptoms such as hot flushes, night sweats, mood swings, lack of libido and vaginal dryness.

  Menopause is a retrospective diagnosis and is made 12 months after the last period. The symptoms above can point towards onset of menopause and can sometimes affect your life in a major way. It’s best to see your doctor to see if hormone replacement therapy may be a solution for you.

  If you are concerned about any changes in your period it is best to seek medical advice with either your GP or gynaecologist.

• 5th December 2018  |  Posted by Florence Wildblood

  Changes in the second trimester of pregnancy

  Meghan Markle’s pregnancy took a toll on her during her Australian tour, and the Duchess had to skip a few days of engagements. However, she is expected to attend more events in the next few weeks as she enters a new transition in her pregnancy. Consultant Gynaecologist Pradnya Pisal speaks to Express.co.uk about the improvement in symptoms that tends to come with the second trimester of pregnancy. Read the article here.

•  |  Posted by Florence Wildblood

  Organic tampons

  Over the past year or so, organic menstruation products have been steadily rising in widespread popularity, spurred on by ambitions to things better by the environment and by women. Consultant Gynaecologist Meg Wilson contributes to an article on organic menstrual products. Read it here.

•  |  Posted by Florence Wildblood

  4 things a gynaecologist really wants you to know

  A woman’s vagina changes over the course of her life, often in response to hormone changes through puberty, pregnancy, breastfeeding and the menopause, as well as to issues such as prolapse and infections like thrush and bacterial vaginosis. Consultant Gynaecologist Meg Wilson talks through these changes with NetDoctor. Read the article here.