News
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13th June 2024 | Posted by Alina Kalinina
How to help relieve period pain at home
Dr Claire Phipps, GP and Advanced Menopause Specialist at London Gynaecology, spoke to GoodToKnow about several strategies designed to provide relief and soothe menstrual pain during your period.
Period cramps can be debilitating, but there are several effective home remedies to alleviate the discomfort. Here are some doctor-recommended strategies to help you feel better:
1. Apply Heat
Using a hot water bottle or a heating pad on your lower abdomen can significantly reduce menstrual pain. A warm bath can also provide soothing relief.
2. Stay Active
Engaging in regular exercise helps to reduce cramps. Activities like yoga and Pilates are particularly beneficial for gentle stretching and muscle relaxation.
3. Massage
Gently massaging your abdomen can ease muscle tension and reduce pain. Use essential oils like lavender or peppermint for added relief.
4. Watch Your Diet
Certain dietary adjustments can make a difference. Avoid sugar and dairy, which can exacerbate inflammation. Instead, focus on anti-inflammatory foods like berries, nuts, and leafy greens.
5. Hydrate and Sleep Well
Drinking plenty of water helps reduce bloating, which can make cramps worse. Ensure you get adequate sleep to help your body manage pain more effectively.
6. Increase Magnesium Intake
Magnesium-rich foods such as bananas, almonds, and spinach can help relax muscles and reduce cramping.
7. Try a TENs Machine
A Transcutaneous Electrical Nerve Stimulation (TENs) machine can provide pain relief by sending mild electrical pulses through the skin.
Incorporating these strategies into your routine can help manage and alleviate period cramps, making your menstrual cycle more bearable.
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11th June 2024 | Posted by Alina Kalinina
Cost of Uterine Artery Embolisation for Fibroids
We understand that many patients self-fund their medical treatment, making early visibility of the costs involved essential. At London Gynaecology, we offer self-pay packages to ensure patients can easily understand the costs associated with their treatment.
What is the Cost of Uterine Artery Embolisation for Fibroids?
The cost for uterine artery embolisation (UAE) for fibroids starts from £7,750.
What Does the Cost Include?
The charges for the uterine artery embolisation procedure for fibroids include:
- Hospital fees
- Surgical fees
- Anaesthetist
- Post-procedure follow-up consultation
Does the Cost of Uterine Artery Embolisation for Fibroids Vary?
The cost is dependent on the specific case. An accurate quotation will be provided following your consultation with an Interventional Radiologist. Please note that the charges on this page are correct at the time of writing. For our latest fees, please visit our Fees page.
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15th May 2024 | Posted by Alina Kalinina
Hot Flushes in Pregnancy
Dr Shikha Kapour, Consultant Obstetrician and Gynaecologist at London Gynaecology, spoke to GoodToKnow about hot flushes in pregnancy.
Why do you have hot flashes when pregnant? / What causes hot flashes in pregnancy?
Hot flushes are a symptom we normally associate with menopause. It is when you experience a sudden sensation of excessive heat, mainly the face, neck and chest. Excessive sweating can also accompany this phenomenon. It is also a symptom of pregnancy and is reported in over a third of cases during pregnancy and in the postpartum period (Thurston et al 2013).
Can you get hot flashes in early pregnancy?
One study examining the appearance of hot flushes throughout pregnancy found that as many as 18% of women developed hot flashes within the first 20 weeks. In total, 35% reported hot flashes at some point throughout their pregnancy, and 29% experienced them postpartum (1).
While they typically peak in the third trimester, hot flashes can appear at any point during the course of pregnancy. A study found that 10% of women reported hot flashes within the first postpartum month (2)
Are hot flashes normal during pregnancy?
Hot flashes can occur during pregnancy and are considered normal for many women. Hot flushes are a result of hormonal changes driven by your pregnancy. These changes lead to an increase in the blood supply to the skin and result in a rise in body temperature.
Should I worry about hot flashes during pregnancy?
Hot flashes can occur during pregnancy and are considered normal for many women but it is distressing you please discuss it with your doctor or midwife so they can rule out any other underlying medical issues.
What should I do if I experience a hot flash in pregnancy? What can I do to ease/soothe symptoms?
- Wear loose clothes made from natural fibres
- Keep well hydrated
- Ice packs / cold towels used at pulse points – temples / back of the neck
- Stay in the shade
- Keep your room cool – electric fan
- Take a refreshing shower
- Avoid triggers – spicy food / hot drinks
How do you deal with hot flashes at night during pregnancy?
Wear loose clothes made from natural fibres, dress in layers, use a sheet instead of a duvet, use a fan and have cold shower before bedtime.
When should you see a doctor about hot flashes in pregnancy?
Hot flushes are not harmful but you should inform your midwife of any symptoms that are bothering you. They will be able to reassure you. Your midwife will also be able to check that you are not having a fever which is a sign of an underlying infection and may need treatment.
1. Thurston RC, Luther JF, Wisniewski SR, Eng H, Wisner KL. Prospective evaluation of nighttime hot flashes during pregnancy and postpartum. Fertil Steril. 2013;100(6):1667-1672. doi:10.1016/j.fertnstert.2013.08.020
2. Gjerdingen D.K, Froberg D.G, Chaloner K.M, McGovern P.M. Changes in women’s physical health during the first postpartum year. Arch Fam Med. 1993; 2: 277-283
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1st May 2024 | Posted by Alina Kalinina
Fibroids in Pregnancy
Mr Narendra Pisal, consultant gynaecologist, contributed to Goodtoo article explaining the management of pregnancy with fibroids.
Can fibroids affect pregnancy? How?
Fortunately, fibroids do not usually interfere with chances of getting pregnant. Most of the fibroids are small and do not interfere with the cavity of the uterus or the fallopian tubes. 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 (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.
So, in general, if the fibroids are small (smaller than 6cm) AND if the cavity is normal AND if the fallopian tubes are not affected, there is no cause to worry.
In what ways can fibroids impact you when pregnant?
Fibroids usually cause no problems with pregnancy but can sometimes be associated with risks during antenatal period, labour and post-partum.
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 tend to increase in size with hormones and increased blood supply of pregnancy. This can lead to increased discomfort. Increase in size is also associated with ‘Red degeneration of Pregnancy’. This happens due to rapid increase in the size of fibroids where the central area of a fibroid does not get enough blood supply and undergoes ‘necrosis’. This is associated with pain and tenderness over the fibroid. Sometimes admission to the hospital and rest is required for pain relief, anti-inflammatory and supportive treatment.
Fibroids in the lower part of the uterus can lead to malposition such as transverse lie or breech presentation necessitating Caesarean Section. Caesarean Section can sometimes be difficult and complex due to location of the fibroids.
Post-delivery, fibroids can interfere with contraction of the uterus leading to post-partum haemorrhage and hence a hospital delivery is often recommended.
How big does a fibroid have to be to affect pregnancy?
There isn’t always a correlation between the size of fibroids and effect on pregnancy. If the fibroids are external to the uterus (growing outside), even large fibroids will have minimal effect on pregnancy. Whereas a small 2cm fibroid within the uterine cavity may interfere with chances of getting pregnant or even cause a miscarriage. So, location of fibroids carries more significance that just the size.
Can you have a safe, full-term pregnancy with fibroids?
Yes, in most cases, fibroids and pregnancy can co-exist without any problems and the pregnancy can progress as planned with good chance of a normal delivery.
How do you manage fibroids during pregnancy?
Fibroids are almost always managed conservatively in pregnancy. If you have fibroids, please let your obstetrician know, who will be able to keep an eye on the size of fibroids and any symptoms. Also, a scan in the third trimester is a good idea to see if the fibroids may interfere with the presentation and delivery. A hospital delivery is recommended as there is a higher chance of post-delivery bleeding in women with uterine fibroids.
Is there any treatment for fibroids that someone can have while pregnant? Is treatment necessary?
Fibroids are almost always left alone in pregnancy and no treatment is recommended apart from watchful supervision of an experienced obstetrician.
Are fibroids anything to worry about during pregnancy?
As discussed, pregnancy will usually progress without any problems in presence of fibroids. You should discuss your particular case with your obstetrician who will be able to guid you through your pregnancy journey and also delivery options.
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| Posted by Alina Kalinina
Endometriosis in Pregnancy
Mr Hemant Vakharia, Consultant Gynaecologist and Advanced Laparoscopic Surgeon, contributed to GoodToKnow article explaining the impact of endometriosis on pregnancy and fertility.
How does endometriosis affect fertility?
Endometriosis is a condition where tissue similar to the lining inside the uterus (endometrium) grows outside the uterus, leading to various symptoms, including painful periods, pain with intercourse, heavy periods and in some people difficulty conceiving.
The prevalence of endometriosis in women of reproductive age in the UK is approximately 10%; in women with subfertility it increases to 25–50%.
When it comes to fertility, endometriosis can affect it in several ways:
- Inflammation and Scarring: The endometriotic tissue outside the uterus can cause inflammation (the body’s response to injury or infection) and scarring (fibrous tissue that replaces normal tissue after an injury). This can affect the ovaries, fallopian tubes, and the lining of the pelvic cavity, potentially hindering the movement of the egg and sperm and also causing adhesions (structures sticking together)
- Impaired Egg Quality: Endometriosis when affecting the ovaries directly can lead to the formation of cysts known as endometriomata. These cysts can negatively impact ovarian tissue, potentially affecting the quality and quantity of eggs.
- Blocked Fallopian Tubes: The scarring caused by endometriosis as described above can lead to the fallopian tubes becoming blocked, preventing the egg and sperm from meeting, which is essential for fertilisation. Up to 30% of women with endometriosis have tubal pathology (obstruction, adhesions or hydrosalpinx – (swollen fallopian tube)).
- Altered Pelvic Environment: Endometriosis can lead to changes in the hormonal environment necessary for ovulation (the release of an egg from the ovary), fertilization, and implantation of the embryo in the uterus.
Crucially not all individuals with endometriosis will experience difficulty conceiving as the impact of endometriosis on fertility can vary greatly from person to person.
What are the options for getting pregnant with endometriosis?
The chances and challenges of achieving pregnancy with endometriosis largely stem from how the condition affects the reproductive organs in an individual. As mentioned above, inflammation and scar tissue can distort the anatomy of the pelvis, making it harder for the sperm to reach the egg or for the fertilised egg to implant in the uterus. The quality of the eggs can also be compromised, and the environment within the uterus may become less conducive to implantation, further complicating the process of getting pregnant. These are all unique variable to an individual and therefore the chances of conceiving depend on individual circumstances.
Despite these challenges, there are several options for those looking to conceive with endometriosis:
I. Medical Treatment: Hormonal treatments can sometimes be used to manage the symptoms of endometriosis and reduce inflammation until the patient is ready to conceive. Medical therapies do not eradicate the endometriosis however and studies have shown no benefit in endometriosis related infertility
II. Surgery: Surgery to remove endometriosis tissue can alleviate pain and may improve fertility, particularly for those with mild to moderate endometriosis. This is typically done laparoscopically, a minimally invasive procedure that removes endometrial implants and scar tissue. The evidence for the benefit for surgery in severe disease is less clear and depends on individual circumstances
III. Assisted Reproductive Technologies (ART): Techniques such as in vitro fertilisation (IVF) can be helpful for those with endometriosis especially in those with blocked fallopian tubes. IVF involves fertilising an egg outside the body and then implanting the embryo into the uterus, bypassing many of the challenges endometriosis may pose to natural conception.
IV. Lifestyle Changes: Whilst not a direct treatment for difficulty conceiving, adopting certain lifestyle changes can support overall reproductive health. This includes maintaining a healthy weight, reducing stress, and stopping smoking.
Does everyone with endometriosis require infertility treatment? What does that entail?
The short answer is ‘No’. Not everyone with endometriosis will require fertility treatment and some patients may not realise they have endometriosis until it is picked up on imaging or during a surgical procedure.
Can you get pregnant naturally with endometriosis?
Absolutely! I have seen patients with severe endometriosis conceive naturally but again this depends on their individual circumstances.
Does endometriosis affect pregnancy? How?
Endometriosis can affect pregnancy in a number of ways. Studies have shown that endometriosis in pregnancy is associated with an increased risk of spontaneous miscarriage, pre-eclampsia, postpartum haemorrhage (bleeding after birth), caesarean section, placenta praevia, fetal growth restriction, prematurity and adverse neonatal outcomes.
Those with mild disease are considered less at risk and in general can expect a normal pregnancy and labour.
Those with serve disease are considered high-risk and require additional antenatal and intrapartum care.
How can I prepare my body for pregnancy with endometriosis?
There is no specific advice in this context but it is important to discuss your pregnancy with your midwife and be booked under consultant led care, especially in those with severe disease. Of course, general lifestyle measures such as maintaining a healthy weight, reducing stress, and stopping smoking apply as they do to all patients.
Can endometriosis cause ectopic pregnancy? Is there anything that can be done to help avoid this?
In patient with tubal disease (blocked fallopian tubes/swollen tubes) there is an increased risk of a tubal ectopic pregnancy. In some cases, to improve fertility outcomes, patients may be advised to have the affected tube clipped or removed to reduce this risk. If not, then there is nothing specific that can be done to avoid this, but patients are advised to have an early scan in pregnancy.
Can you give birth naturally with endometriosis?
Yes, in general there is no reason why you cannot deliver vaginally but there may be individual circumstances for specific patients where a specialist may recommend a vaginal birth.
Can you develop endometriosis after pregnancy?
Yes, Endometriosis can develop after pregnancy.
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