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Ovulation Pain or Mittelschmerz

Posted: Thursday, December 19, 2013 at 8:00:22 AM EST by Alyssa Tait

 Can you feel when you're ovulating?

That niggling pain is back again, low down in the left of your lower abdomen. It’d be nice to just sit down and put your legs up, but you’ve got to keep working.  That time of month again – no, you’re not due for your period for another two weeks! This is mid-cycle pain. Not only do you get period pain, but you’re hassled in the middle of the month by more pain! Why?

That cyclic stabbing pain in one side of the lower abdomen that some women experience is known as ‘’Mittelschmerz’’ (meaning middle pain) or ovulation pain. It is typically described as occurring at mid-cycle. However, this is dependent on the length of the cycle. It would be more accurate to say it occurs approximately 2 weeks before the menstrual period – that is, at the time of ovulation.

Ovulation pain tends to switch sides from month to month (depending on which ovary you are ovulating from, obviously). For most women it lasts a few hours or less – just enough to let them know they are ovulating. For some women, it lasts for more days. And for some very unlucky women, it is severe and can be accompanied by other symptoms such as nausea or even vomiting.

The precise cause of Mittelschmerz is uncertain. It may be due to the enlargement of the follicle before the egg bursts forth in ovulation, or the rupture of the follicle itself, with the spilling of its contents into the surrounding tissue. Whatever it is, if it is anything more than a minor nuisance, you may want to have it looked into.

Severe Mittelschmerz is often due to endometriosis, a condition where the inner lining of the uterus (the endometrium) ends up implanted in places it shouldn’t be. Endometriosis can only be definitively diagnosed with a laparoscopy – a relatively invasive procedure. Women with endometriosis usually have painful and heavy periods as well, and sometimes pelvic or abdominal pain at other times of the month. This can imitate irritable bowel syndrome.

In my experience, cyclical abdominal or pelvic pain is more likely to occur when there are ‘’tissue restrictions’’ around the organs involved (in this case, the ovary, fallopian tube and uterus). For example, endometriosis causes adhesions (scarring) within the tissue which causes it to tighten up and be less flexible. As your pelvic organs contain smooth muscle and are designed to be very mobile, these restrictions can result in you feeling things you shouldn’t (such as pain) – or feeling sensations more strongly than necessary. Tissue restrictions that can be palpated by an experienced physiotherapist are certainly present where there is endometriosis, but many women I see with these problems do not have a diagnosis of endometriosis (yet, anyway).  In my experience, ovulation pain, period pain and other pelvic or abdominal pains can be successfully treated by gently easing these tissue restrictions. This involves a form of tissue release known as visceral manipulation, or visceral-specific myofascial release. Visceral manipulation is very gentle and performed through the abdomen by a physiotherapist who has trained specifically in this technique. It can provide relief within just a few sessions.

Contact us for an assessment using this approach and possible visceral manipulation treatment, or just to make an enquiry.

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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 Draining Problem: Heavy Periods

Posted: Thursday, December 19, 2013 at 7:57:38 AM EST by Alyssa Tait

Anyone who experiences heavy menstrual periods knows how draining this can be.

Heavy bleeding, sometimes known as menorrhagia, is present in at least 15% of women.  Amazingly, most women just accept it as part of being a woman, and never do anything about it.

Were you put on the Pill for this?

The number of women who were ‘’put on the Pill’’ as young girls due to ‘’heavy periods’’- but without adequate medical investigation - continues to astound me. The Pill is not the out-and-out answer to heavy periods by any means. Because the Pill eliminates your body’s own natural hormonal cycles, any effect it has on reducing the heaviness of your periods is purely a ‘’Band-Aid effect’’. This is not to say that there is not a time and place for it! Unfortunately, however, it is used as a ‘’knee-jerk’’ reaction to heavy periods far too often, and risks and side-effects are sometimes not adequately weighed up. Heavy bleeding during your period can have many different causes, and it’s always important to have it investigated medically.

Just some of the potential causes of heavy bleeding include the following:

  • Growths, either benign or cancerous;
  • Endometriosis;
  • Clotting disorders, such as von Willebrand’s diseae;
  • Medications;
  • Thyroid dysfunction

Guess what two of the effects of heavy periods can be?

The first is easy - low iron (from all that blood loss). This can cause countless problems including exhaustion. The second is cruel: more heavy periods. This is because low iron itself can promote heavy periods! What a crazy vicious cycle.

Endometriosis deserves a special mention here.

Diagnosis of endometriosis can only occur via a surgical procedure. However, you may wish to fill out this quick self-test to see what your chances of having endometriosis might be.

Take care with treatment.

Treatment – whether you choose conventional medical, natural therapies, or a combination – should ALWAYS depend on the likely cause, so be wary of anyone – doctor or otherwise – who tries to institute a treatment without having tried to determine the likely cause.

Charting your cycles can be a great way to start tracking what is happening. This should be more detailed than just recording the days of your period. Learning the Billings Ovulation Method is a great technique for gaining insight into your reproductive health. This is also terrific if you are aiming to get off the Pill.

For a systematic method of approaching and helping heavy periods, get in touch with us at Equilibria.

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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

Epigenetics and Chronic Pain

Posted: Wednesday, December 18, 2013 at 12:25:00 PM EST by Alyssa Tait

How targeted nutrition can affect your pain experience

Epigenetics: it’s a bit of a buzzword floating around at the moment, but what does it actually mean?

Epigenetics is the study of how environmental factors influence what genes your body ‘’decides to express’’. We all know about our genes – in fact we often resign ourselves to a medical condition or symptom because it’s ‘’in our genes’’. However, it’s also the case that you can have the gene for something but not get the disease. This is because of epigenetics – the way our environmental influences affect our gene expression.

These environmental factors are not just the obvious ones: exposure to radiation from a nuclear disaster, exposure to chemicals in a factory accident, exposure to too many UV rays sunbaking on the beach. Environmental factors start in utero (that is, as a baby in the womb), and don’t stop as long as you are still breathing!

One important chemical processes in our cells that influence epigenetics is DNA methylation. The effects of diet on DNA methylation have been well studied. Your ‘’methylation status’’ greatly affects your likelihood of developing certain conditions that may be ‘’in your genes’’, such as heart disease, cancer and depression. The field of nutrition medicine (practised at Equilibria) focuses on optimising individual health via nutrition, and optimising methylation status is one way we do this.

A 2012 study in the journal Pain Medicine discussed the role of methylation and other epigenetic processes in chronic pain. Specifically, it focussed on how acute pain (which is normal in healing) turns into chronic pain (which is a living nightmare for millions of people).  How does epigenetics affect whether your pain will hang around and turn ugly?

Here are three mechanisms whereby improving your epigenetics (such as via nutrition) can reduce the transition of acute pain to chronic pain:

  • By altering your sensitivity to opioids, your natural pain-relieving chemicals
  • By altering the production of inflammatory chemicals, called ‘’cytokines’’
  • By altering how responsive your cells are to steroids (important hormones, such as vitamin D – so there’s a clear nutritional lead already!)

As a physiotherapist and nutrition medicine practitioner immersed in chronic pain, I treat people every day with chronic pelvic pain using not just physical techniques alone, but targeted nutrition strategies. It seems that research is heading more into this area. In the meantime, has your pain been affected by your nutritional status? I would be interested to hear people’s personal stories.

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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

Chronic Pelvic Pain - some media coverage at last!

Posted: Wednesday, December 18, 2013 at 12:22:26 PM EST by Alyssa Tait

ABC radio’s Health Matters show yesterday covered one of the most overlooked health problems in Australia: chronic pelvic pain.

One of my patients rang and let me know about it, for which I was very grateful. I downloaded the recording after work, and as I listened to it, I recognised in the stories things I am told over and over again in my clinic.

Despite the fact that everyone’s journey is unique, so many themes arise again and again: the physical suffering, the loneliness and social isolation, the despair at being made to feel like you’re crazy, malingering or exaggerating. The tendency to diagnose depression or anxiety when the symptoms don’t perfectly add up. The complete lack of awareness in a large majority of (otherwise capable) health professionals.

The symptoms that people mentioned echoed those of so many women and men I have seen over the years. To take just a handful of examples:

  • The constant burning pain
  • Being unable to sit down or find a comfortable position
  • The feeling of ‘’little cuts all over the vulva’’
  • The ‘’red hot poker up the backside’’ feeling

These symptoms are described to me every day by different patients, most of whom assume they are the only one who has them. But what I hear most commonly from my patients is

‘’Why did it take me so long to find you?’’

My patients have typically seen ten or more health professionals before me who either

  • Didn’t take the problem seriously
  • Didn’t recognise the symptoms
  • Didn’t refer appropriately
  • Wrote the symptoms off as caused by depression, anxiety, or a lack of sex life
  • Did not seem to care, and even seemed skeptical

It is a relief for people to finally find someone who understands chronic pelvic pain. To be frank, health professionals who really ‘’get it’’ are thin on the ground. The good news is that, because there are so few with good expertise in this area, those of us who understand it have good networks – so we know the people you need to see for the essential multi-disciplinary approach.

An important point raised during the broadcast as well as from listeners’ e-mails is that pelvic pain can have important identifiable medical causes, such as fractures and cancer.

However, when appropriate medical investigations have been done, and no clear cause has been found (and keep in mind a laparoscopy is required to definitively rule out endometriosis), then this is a case of chronic pelvic pain.

Chronic pelvic pain has many subtypes, some of which are diagnoses in themselves. There are also concepts that anyone with chronic pelvic pain will want to understand. You may want to investigate the following:

All of these are conditions I have successfully treated here at Equilibria for the past eight years.

I’m not sure how long the broadcast will be available for download, but it is thoroughly recommended listening.

Go to:

http://www.abc.net.au/radionational/programs/lifematters/pelvic-pain/4502250#comments

 If you are suffering from chronic pelvic pain, come in and get some help.

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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

The Five Sources of Painful Sex (And Not One of Them Starts With "V")

Posted: Thursday, December 11, 2014 at 12:21:26 PM EST by Alyssa Tait

Vaginismus, vulvodynia, vestibulodynia, vaginitis, vulvar lichen sclerosus, vaginal atrophy, vulvitis…

Any of these might be names that your “painful sex” has been given, but they don’t tell you much about the root cause. Painful sex itself is medically termed “dyspareunia”- but again, if a doctor tells you that you have dyspareunia, it doesn’t leave you any wiser.

Even after you have been given a diagnosis (and many women never are), it is more important to understand the cause of your pain. While there is rarely one source of the pain, these are five areas that can contribute to the cycle of pain to ask your health professional about.

Skin.

vaginalepithelium_sm_sm

The external skin of the vulva or the internal skin of the vagina is an often overlooked source of pain. Raw, chafed, inflamed skin is painful to rub on your arm, so why would it be any different in the vulva or vagina? Sore, vulnerable and fragile vaginal or vulval skin can be due to many causes, including hormones, allergies, mucosal inflammation from other sources or nutrient deficiencies. Vaginal dryness can be a contributing factor, but is often not the only cause (or even the most important cause). Tight scar tissue in the skin from episiotomies is another source of pain with sex. Has your health professional ruled all of these out?

Nerves.

Nerves convey information about sensation to your brain. Sometimes, though, the nerves themselves get “caught up in the action” creating a type of nerve inflammation called neurogenic inflammation. This creates over-sensitive nerves, technically known as “peripheral sensitisation”.

Organs.

uterusandcervix

Tender or inflamed organs can be painful when pressure is applied to them. A problem with your bladder can give you pain with sex, especially in specific positions. Possibilities include urinary tract infection, urethritis or interstitial cystitis/painful bladder syndrome. Irritable bowel syndrome can also cause pain with sex, as there is often significant pressure on the rectum and the small intestine through the walls of the vagina. Endometriosis is an inflammatory condition leading to formation of adhesions or internal scars, and a common cause of painful sex.

Muscles.

It is rare that I see a woman with painful sex who does not have some muscular cause as part of the picture. Stinging after sex can be an issue with the skin - but it can also be an early sign of problems with the muscles. It is important that all parts of the pelvic floor muscles, from the surface to the deep muscles, are assessed, as well as the deep internal hip muscles (obturator internus).  More commonly, it is assumed that muscles are the sole cause when there are other causes that need to be addressed as well. While muscular problems are important to address, it is rarely sufficient to work only on the muscular causes of painful sex.

Brain.

brainonfire

The brain causes of painful sex fall into two categories: the over-blamed brain and the under-blamed brain. In the over-blamed brain, it is assumed that stress, relationship problems and psychological problems are to blame for most of the painful sex. This is rarely the case. In the under-blamed brain, the contribution of the central nervous system to the maintenance of your pain is undervalued. Central sensitisation is the medical term for when your brain and nervous system are actually helping to drive your pain - and it does not mean you are being a hypochondriac! Your health professional should be able to describe the ways in which the brain acts to perpetuate pain. In this situation it is a must to retrain your brain. My e-book Outsmart Your Pain describes the brain’s role in your pain and how to break the cycle.  It can be ordered here.

Ask your health professional if they have ticked off all five sources of pain in your assessment.

They should be able to give you a rough percentage that each is likely to be contributing to your pain.

If identifying potential sources of the pain is important, it’s even more important to identify the processes causing your continuing pelvic pain – but that’s the topic for another blog post.

Now that you know what areas are involved, you may be interested in a brief summary of ten reasons why sex hurts. There may also be special considerations for pain with sex in the older woman. And let's face it, sometimes it can just be a challenge to track down that elusive libido!

If you would like to solve your painful sex – whatever “V-Word” it might have been called - contact us to make an appointment.

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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 (or IUD, or injection, or implant…)

Posted: Wednesday, January 14, 2015 at 12:42:00 PM EST by Alyssa Tait

The Pill has its upsides and downsides.

Most of us women have been on the Pill at one time or another – 82%, to be precise. But many women have not been satisfied with it. In fact, between 2006 and 2008, one-third of women who had ever used the Pill discontinued it because they were dissatisfied with it. 

More and more women are telling me that they would really like to get off the Pill.

Some of them are switching to the IUD, (such as the Mirena), and finding that it trades one set of problems for the other.  The most common reason for ceasing the Mirena in a 2013 study was cramping.

But many women persist with the Pill despite problems.

In my experience this is largely for one of two reasons:

  • The perceived reliability and convenience of the Pill
  • The “welcome” side effects of the Pill

The reliability (or not) of the Pill

We often think of the Pill as a fairly watertight method of contraception. It is commonly quoted at an effectiveness of around 99%. However, with typical use, the failure rate of the Pill over one year was 9%. This means that for every 100 women that use the Pill for one year, 9 of fall pregnant unintentionally. This compares with 7% of Depo Provera (injectable) users, less than 1% of IUD users, and 17% of condom users.

The “welcome” side effects of the Pill

Before I talk about unwelcome side effects of the Pill, it’s important to point out that some women go on the Pill – and stay on it – because of perceived positive side effects. The two most common are

  • Help with acne
  • Help with painful periods

So women are in a constant state of “push-pull” when it comes to the Pill and other chemical contraceptives.

They are not really comfortable with what it’s doing to their bodies – or at least feel uneasy about effects in the long-term – but there seem to be too many good reasons to stay on it.

It’s also easier to keep doing what you’re doing than make a change – so some women stay on it, despite their misgivings, because of it’s the easier choice.

But what if you would really like some help to come off it?

Maybe you’re concerned about your future fertility, or your risks of hormone dependent cancers. Maybe you don’t like how it makes you feel, or don’t like the side effects you’ve had of decreased libido and weight gain. Or maybe it just doesn’t feel right to you. For any of these reasons, this blog post series of A Guide to Getting Off the Pill is for you.

To read the first step to getting off the Pill, click here.

If you would like to sign up to receive this free information series, go to our Newsletter Signup page and tick the box “Getting Off the Pill”, or just click on the button below.

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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

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

Herbal Medicine for Period Pain

Posted: Thursday, August 28, 2014 at 4:46:02 PM EST by Alyssa Tait

Period pain is a destructive force in many women’s lives.

Time off work, pressure on relationships, stopping participation in sport and hobbies are just some of the effects…not to mention the untold suffering from the pain itself.

What can you do?

Many of my female clients report pain during their periods (also called dysmenorrhea) or an exacerbation of their chronic pelvic pain or vulvar pain. But what can you do about it, aside from the all-too-common “solution” of going on the Pill, or over-relying on non-steroidal anti-inflammatory drugs, and risking their significant side effects?

In a word: herbs.

I’m sorry to sound simplistic, but I’ve seen herbs work so often for painful periods that I’m pretty black and white about this. Try herbs for period pain. Especially before you resort to the Pill – or if you want to get off the Pill, but are worried about your period pain returning.

But don’t take it from me. Let’s look at what the studies say.

Yes, there is research supporting it to silence the naysayers.

Promising results for herbal medicine in dysmenorrhea were found by a 2008 Cochrane systematic review (considered one of the highest levels of evidence in medicine).

A 2011 study showed effectiveness of the herb Valerian for dysmenorrhea, probably due to anti-spasmodic effects.

corydalis

The herb Corydalis is the most common herb used in Taiwan for dysmenorrhea – used in one-third of prescriptions for period pain for women aged 13-25. Analgesic effects were confirmed in a 2010 study. Corydalis is one of the most common herbs I use as well – not just for dysmenorrhea, but other forms of visceral pain or neuropathic pain.

A 2012 study showed that ginger for dysmenorrhea was more effective than placebo in reducing severity and duration of period pain. It was most effective when started 2 days before the onset of bleeding.

ginger

And you don't have to take it all month long.

The great thing about herbs for dysmenorrhea is that they can be used “lazily” – that is, just reserved for use during your periods. Unlike herbal formulas for many other conditions, which I usually get people to take twice per day on an ongoing basis, herbs for painful periods work even when just used at the time of the pain.

A recent example is a client of 17, who I had been seeing for persistent vulvar and urethral pain and dyspareunia (painful sex), and a diagnosis of vulvodynia and vaginismus. This is one of my many patients where physiotherapy has formed only a small component of the treatment, largely being nutritional therapy. This young lady experienced period pain that she described as “like someone shooting knives up me” , and a “constant burn in the back passage” . She would get extreme cramps in the abdomen, anus (like proctalgia fugax) and down her legs. This would start within one hour of her bleeding. She described herself as feeling “borderline suicidal” from the pain.

The next month she used a herbal combination of corydalis, ginger and some other herbs. The difference was startling. She had no pain at all during her period. No pain, period. (Pardon the pun.)

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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

Getting Off The Pill Step 2

Posted: Thursday, January 8, 2015 at 4:07:31 PM EST by Alyssa Tait

Understand the problems – both the hypothetical and the real

In deciding whether to continue with (or change to ) the Pill, or the Mirena, or Implanon, you need to weigh up the pros and cons for you. My last blog post talked about the pros: the possible reasons people use these medications. This post focuses on being aware of some of the potential issues with the Pill, technically known as the combined oral contraceptive Pill. The next two posts will look separately at the Mirena and the injection (Implanon).

How does it work?

The Pill contains a synthetic type of oestrogen and progestogen that gives messages to a part of your brain to stop you producing your own oestrogen and progesterone, by making your brain think you are pregnant. It aims to stop you ovulating, but does not always do this (ovulation occurs 2% of the time on the regular oestrogen Pill and 1% of the time on the lower oestrogen Pill). This means you are not having normal cycles, and you are not producing your own progesterone (which occurs with ovulation). The progestogens you are receiving in the Pill do not have identical physiological effects to your own body’s progesterone. So in summary, the Pill makes your body behave in a “high-oestrogen” way, which may explain some of the side effects and risks.

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What are the less serious side effects? (note, if these are more than mild, they could be considered serious!)

  • Nausea
  • Breast tenderness
  • Mood changes
  • Breakthrough bleeding
  • Headaches

What are the more serious side effects?

  • Loss of sexual arousal and pleasure, orgasm and lubrication
  • Folate and other nutrient deficiency, which can lead to neural tube defects if a pregnancy occurs
  • Insulin resistance, a precursor of diabetes
  • Increased risk of thrombosis (a blood clot that can lead to death even in young women)
  • Increased risk of cervical cancer and breast cancer

There are other reasons you may not feel comfortable with using the Pill.

Masking the underlying cause of the problem

Many women first go on the Pill due to acne or painful, heavy periods. While the Pill can improve these symptoms, this benefit is actually a double-edged sword. Two common underlying causes here are polycystic ovarian syndrome (the most common hormonal disorder in young women) and endometriosis (a serious inflammatory disorder leading to scarring and possible infertility). The Pill actually only acts to mask these problems, not fix them. Being on the Pill can have the negative effect of delaying diagnosis and proper treatment.

Fertility problems: it’s worth thinking about.

Even if you are not thinking about children just yet, it is important to consider the risks of staying on the Pill long-term and only coming off when you’re in your thirties and planning to have children. If you have underlying endometriosis or polycystic ovarian syndrome, these are masked by the Pill, and you may find that you have fertility problems when you come off the Pill. It is better for these to be identified and treated as early as possible, rather than finding out it’s too late.

Especially if you haven’t been 100% happy on the Pill, the side effects and risks may not be worth it. It’s important to remember that in practice, 8 out of 100 women will fall pregnant in one year. For some, these statistics for contraceptive effectiveness are not convincing enough.

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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.

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