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Is An Alkaline Diet Good For Chronic Pelvic Pain, Vulvodynia and Interstitial Cystitis??

Posted: Wednesday, August 20, 2014 at 4:00:26 PM EST by Alyssa Tait

The state of the body's acidity vs alkalinity both reflects and affects health.

This is a topic I summarised in my last post. But what about the specific scenarios of chronic pelvic pain, vulvodynia and interstitial cystitis?

Does acidity or alkalinity have anything to do with chronic pain?

The short answer here is yes. We all know that after heavy exertion with exercise, we wake up with sore muscles; one explanation for this has been lactic acid in the tissues. There is also an interesting 2001 study that tested an “alkalising supplement” on people with chronic lower back pain. There was an improvement in pain scores; in fact they dropped by 50%, showing that acidity may be associated with pain, especially muscle or joint pain. The conclusion of the researchers was that "a disturbed acid-base balance may contribute to the symptoms of low back pain".

Does acidity or alkalinity have anything to do with specific types of pelvic pain, like vulvodynia or interstitial cystitis?

Vulvodynia

I often consider at the concept of tissue acidity in patients with chronic pain conditions such as vulvodynia. Acidity is often present in these patients. At times, tissue acidity can be assumed from a combination of symptoms and blood test measures that give information about pH. It is difficult to be certain whether the acidity is one of the causes of the symptoms of vulvodynia, caused by one of the underlying processes in vulvodynia, or completely unrelated. However, if there are enough clinical clues pointing towards acidity being a problem, I often guide treatment to influence it. This may encompass addressing a cause of the acidity (such as tissue inflammation or mineral deficiency) and experimenting with a change in diet.

stingingontoilet

Interstitial cystitis or painful bladder syndrome

Interstitial cystitis is a special case here. Tissue acidity may well be present, but a common trigger reported by people with IC is acidic foods – drinking coffee, carbonated beverages (fizzy drinks), oranges and tomatoes. A theory here is that the lining of the bladder, which can be “worn away” in parts in IC, may be directly vulnerable to the acid in these foods. Many of my patients with IC have been firmly committed to cutting these out – even foods like lemon, which are acidic in nature, but don’t affect overall tissue acidity. However, “IC diets” on the internet are often an over-simplistic solution. Individual food sensitivities can cause inflammation of the tissue, which may exacerbate symptoms of IC in some people. Identifying individual food sensitivities is, in my experience, a more reliable approach to the food question in IC.

So in summary, I do not use a "one-size-fits-all-alkaline-diet" for patients with chronic pelvic pain, vulvodynia or interstitial cystitis. While the acidity-alkalinity issue is relevant and worth addressing, this is best done via individualised assessment and evaluation of factors promoting acidity, such as presence of inflammation, mineral deficiency and digestive dysfunction. For more about these individual factors, see my last post.

 

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Alkaline Diet for Good Health: Myth or Reality?

Posted: Wednesday, August 20, 2014 at 10:45:44 AM EST by Alyssa Tait

There is a lot of talk about the balance between acidity and alkalinity for good health – at least in the natural health world.

“Alkalinity” is often equated with good health, and “acidity” something to avoid. The world of chronic pelvic pain occasionally enters the debate as well, especially websites and forums devoted to interstitial cystitis or painful bladder syndrome.

lemon

So is “becoming more alkaline” really a goal we should have in mind – and is it more important if there is chronic pelvic pain? And if it is, how to we go about achieving it?

While this is a pretty big topic, my aim in this blog post is to make this concept as simple as possible, in order to make a “murky” kind of topic more clear.

This first post will cover the alkaline-acid theory in general. My next post will relate it to chronic pelvic pain and interstitial cystitis.

So let’s start with the first question.

Is alkalinity-acidity a genuine concept, or something that some strange naturopaths have inherited from folk wisdom with no basis in fact?

ph

That one is easy. Acidity/alkalinity are concepts accepted by mainstream medicine as well as the natural health world. In mainstream medicine, being on the end of either spectrum is usually linked with fairly serious diseases. The blood pH (acidity level) is kept in a fairly narrow range in good health (7.35-7.45).  Based on blood test findings, it is possible to be placed in one of five categories:

Normal – most of the general population. No excessive alkalinity or acidity.

Metabolic acidosis – the blood is too acidic, and the reason is something to do with the metabolism (such as uncontrolled diabetes)

Respiratory acidosis – the blood is too acidic, and the cause is something to do with the respiratory system, such as hypoventilation

Metabolic alkalosis – the blood is too alkaline, and the reason is something to do with the metabolism

Respiratory alkalosis – the blood is too alkaline, and the reason is something to do with the metabolism.

The great thing about this system is that it is nice and obvious, and can lead to a medical diagnosis of a serious illness. However, it is important to note that there is a difference between blood acidity and tissue acidity, and this test specifically measures blood acidity. Naturopaths often argue for the benefits of measuring tissue acidity, to see what is really happening inside the body tissues. This is a good point, as things need to be really out of balance in order to show up on this test. It is a reasonable argument to look for more subtle problems in the tissue itself to help reach optimal health. However, the measures often suggested to achieve this, such as testing the pH of the saliva, have no research support whatsoever and are not reliable. So even if measuring tissue acidity is the ideal, we lack reliable measures for it.

What influences acidity or alkalinity level of the tissue?

Although we can’t measure it, there are known influences on tissue alkalinity. One major one is mineral level. Another is the general composition of the diet. A third is digestive function. A fourth is level of inflammation in the body.

Composition of the diet

Traditional naturopathics often recommends a high vegetable, low animal diet to achieve an ideal level of alkalinity of the body. Sometimes there is an 80:20 ratio described: 80% of the diet should be vegetables, especially leafy greens. Meat is often demonised as being “acidifying” and discouraged if good health is desired. However, there are much stronger food influences on tissue acidity than meat. Sugar and refined carbohydrates are the major one, as well as coffee, alcohol and dairy products. It is sometimes assumed that food that is acidic in nature causes acidity, but this is not necessarily the case. Lemon and orange are high-acid fruits, but do not have a significant effect on the body’s acidity.

freshfood

Influence of minerals on alkalinity

A number of essential minerals have an effect of increasing alkalinity level. These include potassium (the major alkalising mineral of the body), iodine (a major alkalising mineral), calcium and magnesium level. If levels of these are low, it doesn’t matter whether you  have the “cleanest” of  raw food vegan diets – your system will still tend towards acidity.

The converse of this is the role of heavy metals. Heavy metals, such as mercury, lead and cadmium, have an extremely acidifying effect on the tissues. Mercury, for example, is a metal that is toxic to the body's cells. In order to deal with mercury, a high amount of acidic hydrogen atoms are produced. Additionally, by blocking zinc, mercury also blocks the enzyme carbonic anhydrase, which leads to increased acidity as well.

Digestion

There is often confusion, when discussing the relative merits of “alkalinity”, between tissue alkalinity and alkalinity of the digestive system. It is important to distinguish between the two. In fact, when the digestive system is functioning well, it is very acidic: the stomach has a high level of acid to digest effectively, and to absorb alkaline minerals effectively, which – you guessed it – are important for tissue alkalinity.

As well as this, a healthy colon is characterised by high levels of short chain fatty acids, such as butyrate, which are protective against bowel cancer.

So in short, an acidic digestive system is a requirement of tissue alkalinity. Taking bicarbonate-based supplements will have the short-term effect of alkalising the system – including the urine, helpful at times in painful bladder syndrome or interstitial cystitis – but if consumed close to eating, will actually counteract the normal gastric acidity and can have a counterproductive effect on tissue alkalinity.

Inflammation

A key concept of good health to understand is that inflammation, by virtue of the underlying tissue biochemistry, always tends to promote acidity in the tissue. The cause of the inflammation doesn’t matter: it can be inflammatory bowel disease or obesity – but there is always associated acidity.

Read my next blog post to find out what, if anything, acidity/alkalinity has to do with chronic pain in general, and pelvic pain, vulvodynia and interstitial cystitis in particular.
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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Could Vaginal Wind Be A Sign of Something More? (and an easy solution…)

Posted: Saturday, August 16, 2014 at 5:45:58 PM EST by Alyssa Tait

There’s no argument: passing wind from the vagina can be really embarrassing, whether it happens during a yoga class or when you are having sex.

shoulderstand

A recent study looked at a group of 800 women. Around 14% of them experienced vaginal wind, or “vaginal noise” as the study called it. When these women were examined by a gynaecologist, there was an interesting finding: 21% of the women with vaginal wind had a prolapse, whereas only 10% of the women without vaginal wind had a prolapse. That’s double the rate of prolapse in the vaginal wind group!

As well as that, women with vaginal wind were at least twice as likely to experience faecal incontinence – that is, accidental bowel leakage.

Accidental bowel leakage and prolapse are two problems that we can do a lot about and shouldn’t be ignored.

But what to do about the vaginal wind?

Well, studies have looked at a few possible solutions. Some have found the use of a vaginal pessary (like a support splint for the vagina) to eliminate the problem.

One case study found that wearing a tampon during the activity that provoked the vaginal wind completely resolved the symptoms! Sounds like a pretty straightforward solution, if it is during your yoga class that it occurs.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

A Guide to Getting Off The Pill Step 1

Posted: Thursday, January 8, 2015 at 4:08:22 PM EST by Alyssa Tait

Understand what you have been using and how it works

When considering whether the pros and cons of continuing with or stopping your current method of chemical contraception, it’s helpful first of all to understand how it works. We’ll consider firstly how they work as contraceptives, then consider the other reasons people might choose to use them.

First and foremost: contraception.

“The Pill” - The Oral Contraceptive Pill

thepill

The Pill contains a combination of two hormones, an oestrogen and a progestogen. Once you start it, it typically takes around 7 days to start providing protection (but read the leaflet). It only provides protection as long as you continue to take it correctly, and there are no other factors to prevent it working (such as vomiting).

How it works:

Preventing ovulation

Thickening the cervical mucus to make it hard for the sperm to move through

Thinning the lining of the uterus, making it more difficult for the fertilised egg to implant in the wall of the uterus

Effectiveness Rating:

99%, but around 92% in research studies, probably because of women not using it correctly (e.g. not allowing enough time for it to start working again after they have been vomiting, or forgotten to take it

“The Coil” - The Hormonal IUD , the Mirena

mirena

On the other hand, the Mirena involves no oestrogen, but rather a progestogen alone. This progestogen is secreted into the uterus from the IUD and provides contraception for around 5 years.The Mirena itself is a plastic device that is inserted into the wall of the uterus.

How it works:

Thickening the cervical mucus to make it hard for the sperm to move through

Thinning the lining of the uterus, making it more difficult for the fertilised egg to implant in the wall of the uterus

Effectiveness Rating:

99.9%

“The Rod/Implant” – Implanon

implanon

Implanon is a small rod inserted by a doctor via into the fat underneath the upper arm. It provides 3 years’ worth of contraception. Like the Mirena, it is progestogen-based (no oestrogen).

How it works:

Preventing ovulation

Thickening the cervical mucus to make it hard for the sperm to move through

Thinning the lining of the uterus, making it more difficult for the fertilised egg to implant in the wall of the uterus

Effectiveness Rating:

99.9%

“The Injection” - Depo Provera (DMPA)

depoprovera

Like the Mirena and Implanon, the Depo Provera injection is a progestogen (no oestrogen).

How it works:

Preventing ovulation

Thickening the cervical mucus to make it hard for the sperm to move through

Effectiveness Rating:

99%

Second: Other desirable side effects

Lighter Periods

Many women on the Pill and the Mirena report lighter periods. The MIrena thins the lining of the uterus (the endometrium), which means there is less blood to shed. This can be unpredictable – some women have no or infrequent bleeding on the Mirena. Other women have continual spotting.

A distinction that is important to make here is between “periods” and “withdrawal bleeding”. A period is the bleeding (shedding of the endometrium) that happens around two weeks after ovulation, when the egg has not been fertilised (i.e. you are not pregnant). A withdrawal bleed is bleeding (shedding of the endometrium) that happens when levels of hormones fall, even when there has not been ovulation. So on the Pill, you no longer experience “periods”, but rather, withdrawal bleeds. So, it is not actually that your periods get lighter. You no longer have periods while on the Pill. Instead, you take hormones for a while, and then you stop taking them briefly, leading to a withdrawal bleed. The hormones you take supersede your own natural hormones. So, the Pill acts to mask period problems such as heavy periods, by leading to a predictable withdrawal bleed when the artificial hormones are stopped. This is a desirable effect for some women, as the heavy bleeding may be causing them some problems.

Less Painful Periods

Every month I see dozens of women who were put on the Pill for painful periods. In fact, this often starts in the early teenage years. While the Pill, by stopping periods and replacing them with predictable withdrawal bleeds, can reduce pain intensity when bleeding, there are some considerations we'll address more in the next post, such as missing a diagnosis of endometriosis due to complacency once the pain eases.

More Regular Periods

From what you know now about the difference between periods and withdrawal bleeds, it's easy to see that the Pill does not "regulate your periods", despite that often being how doctors describe it. Rather, it stops your periods and masks the cause of the irregularity by giving you a predictable withdrawal bleed at regular intervals (i.e. whenever you stop taking the hormone pills). This can be very convenient. Lots of women - especially teenagers - have told me how much easier it is now that they can "plan for their periods", or just keep taking the Pill continuously so they can "skip their period". In the next post we'll talk more about the darker side to this, including masking serious causes of irregular bleeding such as polycystic ovarian syndrome.

Improvement in Anaemia and Low Iron Status

One serious problem caused by heavy menstrual bleeding is anaemia, the end stage of low iron status. Anaemia is a serious problem and cannot be ignored. Even in women without anaemia, low iron stores can be a cause of fatigue and exhaustion. In women in whom the anaemia cannot be otherwise resolved, going on the Pill can be a lifesaver to stop the iron dropping further by replacing heavy periods with predictable light withdrawal bleeds.

Improvement in Acne

I see an enormous number of women who are on the Pill “for their skin”. It is certainly true that certain types of contraceptive Pill can reduce or resolve acne. It does this by raising the levels of a hormone called SHBG (sex hormone binding globulin), which is like a police officer that handcuffs the criminals - the hormones causing the problems, usually testosterone. Certain types of Pill are androgen-blockers, which means they specifically block testosterone as well.

In the next post we’ll talk about some of the considerations to be aware of if choosing to use any of these methods of contraception.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Eating for a Girl: Musings on a 2010 study

Posted: Tuesday, August 19, 2014 at 8:20:23 AM EST by Alyssa Tait

Are you ready?

This is a rare blog post for me: one where I get into the nitty-gritty of a study without restraint. But if you’re interested in the subject matter (natural sex selection using diet), it could be worth it. It may get a little heavy, and if you need to grab a coffee half-way through, feel free (just make sure you take a magnesium supplement at the same time). If this is way too much detail for you, you may prefer my earlier blog posts about diet as a method of sex selection and what some early studies say about diet and sex selection.

Recently my attention was brought to a prospective study of couples who desired a girl. Part of the study intervention was a “girl diet”, based on the theory I mentioned in my last blog post on the ionic theory of natural sex selection. The authors reasoned that if according to this theory, a lower sodium and potassium to calcium and magnesium ratio in the immediate environment of the ovary results in a greater likelihood of a girl, then providing a diet that fits with these criteria in the pre-conception period should increase the chances of a girl.

As far as I am aware, this is the first prospective study looking at manipulating diet for natural sex selection (and in my last post I mentioned that prospective studies carry far more rigour than retrospective studies when it comes to interpreting the effects of a particular intervention).  So that feature certainly lies in its favour. And some of the findings reported in the study findings certainly sound impressive – most importantly, it reported that the diet method reached statistical significance (that is, it is very likely that the increase in girls when following the diet program was due to the diet itself, and not due to chance). The authors report a p value for this finding being p=0.001, which in statistical terms means that it is extremely likely that the results were not simply due to chance.

The main reason for caution in interpretation of this study is that the intervention used to increase chance of a girl was two-pronged: dietary manipulation, and timing of intercourse in relation to predicted ovulation. The goal of the study, therefore, could only be to evaluate the effectiveness of the combination of diet and timing in achieving a girl (and the authors acknowledged this clearly in the introduction). So even though there are detailed statistical analyses outlined, justifying exactly how they interpreted how much of the success was due to the “diet factor” and how much to the “timing factor”, the bottom line is that you can’t reliably  tease a factor out when there is more than one factor in play. This is why in most intervention studies, a single intervention is tested. Statistics are notoriously easy to manipulate – but even if we give the study the benefit of the doubt in terms of the stats being completely appropriate, it is difficult to determine how strong the effect of one part of a two-pronged intervention was.

There were also a few flaws, I felt, in the reasoning that guided the dietary intervention.

One:  blood tests for calcium, magnesium, sodium and potassium levels were used to assess effectiveness of, and compliance to, the diet. This was justified by saying that “mineral concentrations [in the blood] are controlled by a tight homeostasis, so any significant change in these values must be related to the diet”. Firstly, it was never determined that the method of manipulating minerals to change blood levels of those minerals was valid”, (except for sodium which was checked for reliability in six subjects by checking their urine output of sodium as well).   Neither was it stated how changes in the mineral concentrations were judged to be “significant”. Serum levels of these minerals vary considerably from one time point to the next. Secondly, other factors can influence these levels (such as level of hydration), and, actually, in some cases, dietary intake does not influence serum levels – a 1986 study by Luft and colleagues, for example, showed that supplemental calcium did not change the serum levels of calcium. (Good clinical nutritionists know that serum calcium levels are controlled by parathyroid hormone, whose function in turn is influenced more by vitamin D and magnesium levels.) Thirdly, serum calcium and magnesium levels fluctuate during a woman's cycle (as a 1998 study showed) - and were they taking care to retest levels at exactly the same phase of each woman's cycle? They certainly don't specify this.

Two: although the diet was manipulated, not all of the dietary manipulations made sense. Reducing sodium is fairly easy to control, but reducing potassium while maintaining high levels of magnesium is more difficult to achieve. This is because many high magnesium foods, such as bananas and green leafy vegetables, are also high in potassium. The diet also aimed for high calcium and required 500g of dairy products per day – but yoghurt, for example, is also very high in potassium – so did the diet really restrict potassium? The diet probably influenced nutrient levels more significantly because of the calcium, vitamin D and magnesium supplementation it included. Even so, it is debatable whether supplementation of each nutrient was directly responsible for altering serum levels, which is what they used as a measure. It is therefore difficult to determine which aspects of the diet and supplement regime (if any) added to the effectiveness of the timing plus diet intervention in achieving a girl baby.

Three: only the subjects who “stuck to the diet” were included in the final analysis, the protocol group. For good quality research, what is known as an intention-to-treat analysis needs to occur – where all the subjects allocated to an intervention group are analysed as part of that treatment group at the end of the study, regardless of whether they stuck with the treatment, stopped it or even did the opposite treatment! While this can be hard to get your head around, it’s a reality in research world. It means that if an intention-to-treat analysis was not followed, the results need to be interpreted with a lot more caution.

The statistics in the study is beyond me and most non-statisticians; however, the authors worked out that the best predictors for having a girl was the sodium and calcium concentrations before the diet and at the time of conception. Magnesium and potassium levels in the blood were not found to be significant, which isn’t surprising as in people with normal health, they do not typically respond to changes in diet. (As a nutritionist, you would never use serum magnesium to determine someone’s magnesium status).

It is interesting that serum levels of sodium and calcium were found to predict a girl, but it still does not prove that diet and supplementation caused a change in levels that then led to a girl baby. In research this is known as an association, and by definition, it cannot prove a cause-effect relationship. For example, other factors may influence these serum levels, and may be related to why subjects were more likely to conceive a girl. There could be what is known as confounding variables.

Overall, though, it was a very interesting study. The main difficulty is that we still do not have a prospective study of the effects of nutrients (or diet) alone on the chances of conceiving a girl. As I mentioned at the start, this was a combination study, which also taught the subjects the method of timing of intercourse to increase chances of conceiving a girl. And the timing of intercourse is the subject I will continue with in my next blog post in this series.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter
Tags: fertility,

Do You Understand Your Fertility?

Posted: Saturday, August 16, 2014 at 6:26:56 PM EST by Alyssa Tait

Normal fertility is a key part of good health as a woman.

Naturally, the definition of normal fertility changes depending on the stage of life you are in. If you are approaching menopause, then declining fertility is absolutely normal. If, on the other hand, you are a teenager, then normal fertility can take some time to develop, but is usually in place two years after your periods start. Whatever your life stage, understanding your fertility is important to understanding your health.

Luckily, the body gives us clear signs of normal fertility, if we are trained to look out for them. Unfortunately, most of us do not receive this training as part of our journey into womanhood. There is no rite of passage in our culture that teaches us the signs of normal fertility and how to work with them. However the onset of menstruation in young girls is approached, the approach rarely includes teaching the signs of fertility.

Understanding the signs of fertility is a very useful skill. Not only can it help us to manage our fertility (i.e. avoid unwanted pregnancies, and achieve desired pregnancies) but it can also be an important signpost to reproductive issues that need looking into, when we see an unexpected change that does not fit with what we would expect in our life stage.

So what is the most important sign of fertility?

periodtracking

Most people’s first guess would be menstruation; the regularity of our bleeding. Even many doctors would think this is the case.

However, bleeding (whether regular or irregular) is not a reliable sign of fertility. Bleeding can happen – in fact it can even be regular – without ovulation occurring. This is common in the perimenopause, where bleeding often continues for quite a time after ovulation has ceased. All that is required for bleeding is sufficient fluctuation in hormone levels. Another good example is when on the Pill, where bleeding occurs due to withdrawal of hormones, even without ovulation occurring.

So is it blood level of hormones, then, that is the best sign of fertility?

hormonecycle

No, it’s not that either. Blood levels of hormones are a snapshot in time, and fertility is by definition based on cyclical changes. So while blood tests can be useful – and are sometimes essential – they are not the be-all-and-end-all of fertility awareness, by any means.

So again, what sign does the body give us that we can tune into for most reliable information about our fertility?

It’s mucus – that is, vaginal discharge.

uterusandcervix

That’s right, it’s the moisture that you perceive at the vulva, which undergoes changes during different parts of a fertile cycle. When you are in a life stage where these fluctuations are not occurring – such as in the early breastfeeding period, or around the time of menopause – it’s this lack of changes that gives you important information about your changing fertility.

If you are like most women, you have never learned how to work out if your vaginal discharge is normal.

So where do we learn this important way of having insight into our fertility?

The best structured method is by learning the Billings Ovulation Method, a technique based entirely on observations of moisture changes at the vulva. The Billings Ovulation Method can be used contraception (with a 99% effectiveness rate, without drugs or chemicals); in can be used to help achieve pregnancy; or it can simply be used as a way of being aware of an important signpost of your health: your fertility, and your changes in fertility through your life. It has quite accurately been described as providing

“Knowledge of her body that every woman ought to have.”

The Billings Ovulation Method cannot be reliably learned from a book or the Internet. It needs to be taught by an accredited teacher of the Billings Method, which is inexpensive. You can find an accredited teacher in your area by phoning Billings Australia on the toll-free number 1800 335 8601800 335 860. You can find more information at http://www.thebillingsovulationmethod.org/. Beware of imitation sites, which often provide inaccurate information.

billingslogo

As an Accredited Teacher of the Billings Ovulation Method, I can teach you the Billings Method via a combination of face-to-face and Skype or e-mail consults.

If you need help with your fertility as a whole, you may be interested the unique combined approach to fertility that we use at Equilibria Physiotherapy & Nutrition.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

How To Make Your Own Probiotics at Home

Posted: Thursday, August 7, 2014 at 12:46:03 PM EST by Alyssa Tait

Probiotics…research is overflowing on their importance for good gut health and proper immune system function, to name two.

All probiotics are not alike, however, and strain specificity is important. This means that to treat a specific condition, use of the specific strain of flora supported by good research is the only way to go.

However, there are also major potential benefits from simply increasing the number and variety of probiotic organisms in your diet – and this is where fermentation comes in.

This couldn’t be easier than making your own sauerkraut at home.

(Trust me – I burn pans when I'm boiling water, so if I can do it successfully, then anyone can!)

Haven’t eaten sauerkraut, or feeling a bit dubious? Think of it just like a tangy pickle that can add some tasty zing to just about any savoury food (and immediately multiply – exponentially – its health benefits). Purple cabbage makes a gorgeous sauerkraut and is ridiculously high in vitamin C and antioxidants.

And even if you are on a low FODMAPs diet (for example, for irritable bowel syndrome), you may find that sauerkraut works for you where non-fermented cabbage doesn’t.

This is because the FODMAPs are dramatically reduced in the fermentation process.

Best of all, it’s cheap, and all you need is a cabbage, a jar, and some salt.

Simple Steps To Making Sauerkraut

  1. Slice whole cabbage into strips and put in a large bowl.
  2. Add 1 tsp salt. (I love to add a tablespoon of caraway seeds as well).
  3. Massage the salt into the cabbage for 10 minutes. Squeeze the cabbage hard!
  4. (Set the kitchen timer and consider this your upper body workout for the day)
  5. By the end of ten minutes, there should be fluid coming out of the cabbage.
  6. Pack the cabbage into a jar, squishing it down firmly with (for example) a pestle or end of a rolling pin.
  7. MOST IMPORTANT STEP: All the cabbage leaves must be UNDER the fluid. If any are above the fluid level, you will have a mouldy mess! Best method is to leave a glass or heavy ceramic tea strainer in the jar to weight the cabbage down – it keeps the cabbage leaves firmly pressed under the top of the fluid.
  8. Put the jar on a shelf out of the way, covered with a tea towel to keep out any bugs.
  9. After 24 hours, if there is not enough fluid covering the cabbage, add just enough brine to cover, in the ratio of 1 tsp salt to 1 cup water.
  10. Leave to ferment for 7 days then put a lid on it and refrigerate.

Give it a try – you’ll be hooked!

 

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Diet as a Method of Sex Selection of Your Baby: Some Early Studies

Posted: Tuesday, August 5, 2014 at 6:53:01 PM EST by Alyssa Tait

On the internet, information abounds about how eating a certain way could increase your chances of (for example) a girl baby. But concrete research with real people? That’s a little thin on the ground.

But first: why should what you eat influence who you conceive, anyway?

The theory is known as the “ionic theory”. Stolkowski and Choukroun explain this as the ratio of sodium and potassium to calcium and magnesium influencing ovarian metabolism – that is, the likelihood that the ovary will attract a sperm containing the X chromosomes (girl)  versus the XY chromosomes (boy). They report that higher ratios of sodium and potassium to calcium and magnesium results in a greater likelihood of a boy.

These authors had published a few studies and the abstracts can be found on PubMed. In 1980, they described using this method in 281 couples, 21 of whom were later excluded from the study. (It doesn’t explain why they were excluded – you hope it wasn’t because including their results would have affected the outcomes they reported). In any case, they reported “about an 80% success rate”.

In 1981, they published an article that reported that since using this method since 1970 in 47 births, only 7 of them failed to produce the expected sex. I am not sure how this relates to the previous study they published, which seemed to include much larger numbers.

In 1983, was a very small French study of 58 women. 45 of the women who followed the sex selection diet ended up with a baby of the “desired sex” – around 77%. An important point here is that the study was intended to be much larger – the authors tell us that 75% of the women dropped out (i.e. failed to follow the diet).

What all of these studies don’t tell us is, how was adherence to the diet measured? That is, how do we know who stuck to the diet? Do we know that dietary manipulation changes the minerals in the immediate environment of the ovary anyway? How were other factors controlled? Do we know that they were not combining this with “timing of intercourse”? If they were motivated to have a baby of a particular sex, they may well have sought out other methods to increase their chances. In research, this is known as a “confounding variable”.

While these figures sound promising, they are all based on retrospective analysis – that is, a reporting of what was done with a series of patients in a clinic after it was done. They are a great way of generating interest for further study – but prospective studies are a must for measuring more accurately (with less risk of bias) whether the outcomes are actually due to the intervention, rather than to other factors.

Exactly such a study was done in 2010 - and this is the topic of the next blog post in the series.
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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Can What You Eat Really Influence The Sex of Your Baby?

Posted: Thursday, July 31, 2014 at 4:17:42 PM EST by Alyssa Tait

(Before conceiving, of course!)

If you have your heart set on a boy rather than a girl (or vice versa), you may be aware of “sex-selection diets” that supposedly increase your chances in the direction you favour.

Is there really anything to these diets, or are they just pulled out of nowhere?

There is some basis for the recommendations that are given – certain studies that have found an association between the sex of the baby and the mum’s of pre-conception diet. The question is whether the findings of the studies are strong enough to warrant these recommendations.

A 2008 study analysed the diets of women during their pregnancy and during the preconception phase. It found that women who had higher-calorie diets were more likely to have boys and vice versa. Higher potassium diets were associated with boys as well. There was also an association between eating breakfast cereal and the baby’s sex – women who ate breakfast cereal were more likely to deliver boys.

Does this mean that if you are hanging out for a girl, you should eat less food and never touch breakfast cereal?

Unfortunately, these conclusions don’t necessarily follow on from these findings. Firstly, these were associations only. Other factors could explain the link. For example, breakfast cereal is the most common breakfast food eaten in the UK, where the study was done, so it is possible that the association with breakfast cereal has nothing to do with the cereal itself, but with the actual fact of eating breakfast. Skipping breakfast will need to a different blood glucose profile, which affects the levels of physiological stress – so it could be that stress itself is the marker. Stressed and rushed women may be less likely to eat breakfast – and there is a known link between higher stress levels and increased girl babies born. Relative deprivation (via a low calorie diet) could act as a physiological stress also, so perhaps it is not the food per se but the stress that results from a particular eating pattern.

While these associations are interesting, they do not really provide any sensible course of action that could be recommended.

Skipping breakfast does not do anyone’s health any favours. On the other hand, switching from eggs and greens to breakfast cereal in the hope of conceiving a boy is not only a longshot, but could be a step backwards nutritionally, as most breakfast cereals do not have much to recommend them.   And certainly, calorie restriction is much more likely to lead to nutrient deficiencies, which is exactly what you don’t want when you are aiming for a healthy conception.

A research trial with real couples is really what was required – and in 2010, such a study was performed. The details of this study, its findings and its interesting conclusions, are explored in the next instalment of this blog series, which will also talk about timing of intercourse.

To sign up for our Fertility Blog Series, sign up to our newsletter and tick "Fertility".

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter
Tags: fertility,

Connective Tissue Dysfunction in Vulvodynia and Chronic Pelvic Pain Part 2: Evaluation and Treatment

Posted: Saturday, August 16, 2014 at 6:30:48 PM EST by Alyssa Tait

Connective tissue dysfunction in vulvodynia is often missed, and needs to be treated.

Confused about connective tissue? Picture a whole lot of fruit in a plastic bag, sitting in a bowl of jelly.

apricots, plums, grapes and so on. The fruit can be moved and jiggled around within the jelly, even within the plastic bag.

Now imagine a several layers of cling wrap around each piece of fruit. The wrinkles of the cling wrap stick to each other. The fruit doesn’t move so well. The jelly doesn’t get swished around so much, and hardens up.

Your muscles and organs are the fruit, and the connective tissue is the cling wrap.

If it gets tight and thick, it restricts movement. Any restriction of movement in your body, whether in muscles, skin, nerves or organs, can create dysfunction and pain. (The jelly is what is called the interstitial fluid of your body – the fluid you never noticed unless it increases, causing swelling and possibly pain and even abdominal bloating).

The connective tissue around the organs is called visceral connective tissue. Treatment of this connective tissue is known as visceral manipulation, and can be a very useful component of treatment of vulvodynia and chronic pelvic pain.

A specific type of connective tissue restriction will be very familiar to you:

The most common type of connective tissue restriction is a scar.

When scars are deeper in the body, they are often called adhesions (but they are the same thing by a fancier name). Connective tissue mobilisation is a brilliantly effective technique for tight scars and adhesions, which are sometimes playing a part in vulvodynia (especially when there has been surgery, such as an episiotomy or Caesarean scar, or endometriosis).

What does connective tissue mobilisation (CTM) feel like?

CTM feels like a skin-rolling type of massage. It can be very relaxing and soothing. It can also be quite uncomfortable, especially when there is dysfunction. In fact, if CTM doesn’t feel that comfortable, it’s probably a good sign you’ll benefit from it! Sometimes one side of your body will feel fine and the other uncomfortable – guess which one needs the treatment?

abdominalconnectivetissuemassage

However, slow and gentle is the key. Too much CTM too soon can stir you up – irritate local nerves, irritate the skin, even cause bruising. But the right kind and amount of CTM is wonderful for freeing up tight tissues and helping them move the way they should, improving circulation and skin condition and helping to desensitise your nervous system. The health professional treating your connective tissue should therefore be very familiar with your condition – and especially with central sensitisation – and plenty of experience in treating it.

Getting treatment for vulvodynia?

Make sure you ask whether your connective tissue has been checked, and if it would benefit from treatment. Treating your muscles, nervous system and connective tissue together and restoring their normal movement and function will get you the best results.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Connective Tissue Dysfunction in Vulvodynia and Chronic Pelvic Pain

Posted: Thursday, July 24, 2014 at 5:17:27 PM EST by Alyssa Tait

Your vulva hurts. Your vagina hurts. You’ve been told you have vulvodynia.

One doctor says the problem is in your nerves. Another says the problem is in your muscles.

But has anyone checked your connective tissue?

There is no doubt that in most cases of vulvodynia there is a problem with the nerves – either the local nerves of the vulva, or the central nervous system (the nerves that travel through your spinal cord and brain). In fact, some cases of vulvodynia are more accurately termed pudendal neuralgia (a problem with the pudendal nerve, which goes to the vulva).

Equally, most women with vulvodynia have a problem with the pelvic floor muscles – either as a cause (they were tight first, and caused dysfunction) or an effect (sex hurts so much it makes muscles tense up). Sometimes this is called vaginismus – confusing!

But the connective tissue is an often overlooked area that can contribute to vulvodynia as well.

So, what exactly is connective tissue, and what does it have to do with vulvodynia?

Connective tissue is the wrapping that covers your muscles and organs, and separates them from each other. It separates different layers of the body – skin from fat, fat from muscle, muscle from deeper muscle, and organs from muscle. It is everywhere in your body, connecting and holding everything together.

Connective tissue wraps around your blood vessels (veins and arteries), your lymphatic vessels (which carry fluid) and around your nerves. It is even wrapped around individual strands of your nerves, and individual fibres of muscle!

With this connective tissue surrounding and connecting all parts of your anatomy, can you imagine some of the effects if it’s tight or inflexible?

That’s right: pressure, tension, pulling, tugging, squashing and restriction of muscles, nerves and blood vessels. This can lead to pain that feels like burning, tugging, pinching, grabbing, swelling and “something getting stuck”.

Part 2 in this series will help you understand your connective tissue further - including how to get it healthy and flexible.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter
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