18th September 2018 | Posted by Admin
Planning on a Caesarean?
For an expectant mum, creating the right birthing plan is an important part of having a baby, but despite NICE guidelines, it’s not always possible to request a caesarean section unless the doctor has deemed it medically necessary. Mrs Pisal talks to SheerLuxe about the reasons why some women might decide a caesarean is more suitable delivery method. Click here to read the article.
14th September 2018 | Posted by Harriet Lewis
Fibroids and Pregnancy
Fibroids are extremely common with approximately 50% of women having fibroids in their lifetime. Fibroids are benign (non-cancerous) growths within the uterine muscle and most fibroids are small and asymptomatic. Some women are concerned that their fibroids may interfere with their ability to conceive, have a healthy pregnancy and give birth. In this article Consultant Gynaecologist, Ms Flemming, answers those concerns and discusses what can be done to optimise pregnancy outcomes.
Can fibroids affect the chances of getting pregnant?
Fortunately, in most cases fibroids don’t usually interfere with chances of getting pregnant. Most fibroids are small therefore don’t interfere with the cavity of the uterus or the fallopian tubes.
However, there are a few cases where fibroids can interfere with conception and this is largely down to the location of the fibroid. Submucous fibroids (those which encroach on the uterine cavity) can sometimes affect the process of implantation. This can lead to sub-fertility and sometimes early pregnancy loss. Fibroids in the upper corner of the uterus (known as the cornual region) can occasionally obstruct fallopian tubes and can be a cause of tubal factor subfertility. Similarly very large fibroids and an enlarged uterine cavity can be a cause of not getting pregnant.
In summary, if the fibroids are small, the uterine cavity is normal and the fallopian tubes are open (patent) there is no cause to worry.
Can fibroids interfere with pregnancy?
Fibroids usually cause no problems with pregnancy but can sometimes be associated with risks during the antenatal period, labour and postpartum. Fibroids can increase the risk of early pregnancy loss and preterm birth, especially if they are large or interfere with the uterine cavity (submucous fibroids).
Fibroids can grow in pregnancy, this may be hormonally driven. This can lead to increased discomfort and can also be associated with ‘red degeneration’, this is where the rapid increase in the size of the central area of the fibroid does not get enough blood supply and undergoes necrosis (dying). This is associated with pain and tenderness over the fibroid. Sometimes admission to hospital and rest is requested for pain relief, anti-inflammatory and supportive treatment.
Can fibroids interfere with childbirth?
The effect of fibroids on childbirth largely depends on the fibroid size and location. Fibroids in the lower part of the uterus can lead to fetal malposition such as transverse (sideways) or breech position necessitating a Caesarean Section. C-Section can sometimes be difficult and complex due to the location of the fibroids.
Post-delivery, fibroids can interfere with contraction of the uterus leading to post-partum haemorrhage. However, most small fibroids do not cause a problem.
What can be done to optimise pregnancy outcome?
A consultation with a gynaecologist and an ultrasound scan is often required to make an assessment. If the fibroids are found to be large or within the uterine cavity, further assessment or intervention may be necessary. Fibroids may be associated with anaemia and correction of iron levels may be required before embarking on pregnancy.
Surgical removal of submucous fibroids is associated with an improved pregnancy outcome and there should be no increase in risk during future pregnancy or labour. However some surgical procedures may mean that natural labour is not safe, your surgeon will be able to advise you if an elective C-Section is required.
How long should you wait after surgery to try for a baby?
If you are thinking of conceiving post fibroid removal surgery, you should discuss with your surgeon who can advise when it is safe to start trying. In general, it is wise to wait for a year post a myomectomy procedure and 3 months after a hysteroscopic procedure.
If you have any further questions or would like to book an appointment with one of our consultant gynaecologists please give us a call on 0207 10 11 700. If you would like to read more about fibroids and the possible treatment options please head to our specialist London Fibroids website.
21st August 2018 | Posted by Harriet Lewis
Eating Well During Menopause
Almost all women going through menopause will get some menopause symptoms, however in 50% of women menopause symptoms are severe enough to affect quality of life. Nutritional Therapist, Lauren Southern, helps understand which nutrients can support menopause and those which should be avoided during this time.
Which nutrients support menopause & why?
- Essential Fats: essential fats are needed to synthesise hormones and neurotransmitters, as well as protect the heart, support joints and plump up skin. We get essential fats from oily fish (“smasht”- sardines, mackerel, anchovies, salmon, herring, trout) and from some plants (olives, olive oils, avocado, nuts and seeds)
- Phytoestrogens: these are special plant compounds which have a mildly oestrogenic affect, and can therefore create a slight oestrogen increase which is useful when oestrogen is on the decline. Studies have shown phytoestrogens can help prevent bone loss, boost libido and protect the heart. Best sources are fermented soya, flax seed, oats, barley, sesame seeds, yams, and red clover.
- Calcium, Magnesium & Vitamin D: These vitamins are essential for bone protection. The decline in oestrogen due to the menopause means that bones stop being protected. Bones need calcium, vitamin D and magnesium and it’s important to obtain these from your diet, as well supplementation. High levels of calcium come from small fish bones, eg anchovies, sardines and canned salmon. Sesame seeds are also a good source – try tahini paste on your salad, or hummus. Magnesium is present in nuts, seeds, wholegrains and dark green leafy veg. Make these an integral part of your diet. Vitamin D is hard to obtain from food as our bodies synthesize it from the sun. It’s advised to supplement vitamin D daily.
Which nutrients should be avoided during menopause & why?
High sugar foods and high processed foods are best avoided. This is for a number of reasons:
- These foods provide very little nutrition, so they fill you up without giving anything supportive to the body.
- High sugar foods can play havoc with blood sugar. For hormone balance it is essential to have a balanced blood sugar. If it’s not balanced it can lead to mood swings, fatigue, excess sweating, food cravings and weight gain.
- A diet high in processed foods and sugar will also negatively impact on digestion. If digestion is not functioning optimally then it will become harder to absorb any of the essential nutrients provided from food and supplements.
Should caffeine & alcohol be avoided during menopause?
Both caffeine and alcohol can have a negative impact on blood sugar(seeabove) and can also prevent absorption of nutrients.
- Caffeine, specifically coffee can make night sweats and hot flushes worse, and the tannin in tea can prevent absorption of minerals such as iron and calcium.
- Alcohol unfortunately can also exacerbate depression and anxiety which can occur due to menopause, as well as affect sleep and cause dehydration which can negatively affect hot flushes.
18th July 2018 | Posted by Harriet Lewis
Your BMI & Getting Pregnant
A healthy BMI improves your chances of getting pregnant, both naturally and through IVF as extra weight can upset the balance of hormones that affect fertility, such as oestrogen and insulin. Consultant Gynaecologist Mr Pisal speaks to The Mirror about the importance of being a healthy weight when trying for a baby. Read the full article here.
| Posted by Harriet Lewis
What Makes Good Feminine Hygiene?
Good feminine hygiene is important for overall gynaecological health and with a wide array of products available it can difficult to know what’s best to use. In this article, Consultant Gynaecologist Mrs Pisal shares top tips for good feminine hygiene:
Tips to ensure good menstrual hygiene:
- If you use sanitary pads it is important to change them regularly
- If you use tampons ensure that they are not kept in for more than 8 hours
- Don’t forget about tampons. As strange as it might sound it can be easy to forget about tampons We have seen women with retained tampons where they have forgotten the tampon and then presented with irregular bleeding and smelly discharge. They are at risk of developing Toxic Shock Syndrome.
“There are many feminine hygiene products on the market from soaps to wipes and sprays. Do I need these products?”
There are an increasing number of ‘feminine hygiene’ products on the market. But these products are not necessary. Mild and gentle ‘skin friendly’ soap or just water is enough to clean down below.
“Is having recurrent thrush due to a hygiene problem?”
Frequent washing of the vagina, especially with harsh soaps, will take away the good bacteria and oil from the skin and therefore can increase the risk of infections, especially thrush.
If you have any concerns about your gynaecological health, don’t hesitate to give us a call on 0207 10 11 700.