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The Healthy and Balanced Vagina

Posted: Thursday, July 17, 2014 at 4:25:02 PM EST by Alyssa Tait

Concerned that your vagina may be ''out-of-whack''?

There is a lot of talk about the importance of health and balance these days – and the vagina is no exception!

What makes for a healthy vagina? When the vagina is comfortable and there are no symptoms of abnormal discharge, unpleasant odour, itching, dryness, irritation or discomfort, the vaginal environment is likely to be in balance. (By the way, there are six key areas to focus on to resolve vaginal dryness).

A normal, healthy vagina contains high populations of good bacteria – mainly lactobacilli. These are similar to the ‘’good bugs’’ present in a healthy digestive system, but may be slightly different species. Higher amounts of lactobacilli are associated with reduced dryness in menopausal women, and those with more diversity of species had more dryness. In women of menstruating age, there is a reduction of lactobacilli during the menstrual period.

The lactobacilli help maintain a protective acidic environment in the vagina. The higher the lactobacilli, the lower the other bacteria. Where there is more variety of bacteria, the pH is higher (that is, the vagina is less acidic). So, the vagina is a case where less variety is actually a good thing! Lower amounts of lactobacilli in the vagina increases the risk of both sexually-transmitted infections and bacterial vaginosis. This can be associated with miscarriage or premature rupture of membranes in pregnancy. An increase in the ‘’bad’’ bacteria is present in what has been recently called ‘’aerobic vaginitis’’, which is a state of inflammation in the vagina.

What helps promote these good bacteria? Firstly, good oestrogen levels. Oestrogen helps promote lactobacilli, which keep the vagina acidic and help to fend off harmful bacteria. Interesting though, oestrogen also promotes the growth of thrush, which is why it is common to increase during pregnancy and while on the Pill. The acidic environment does not therefore fully defend against thrush, but certain species of lactobacillus do help resist Candida albicans (thrush) colonisation.

Secondly, avoiding artificial hormones and implants helps promote normal healthy vaginal flora. The balance tends to shift with the use of not only the oral contraceptive Pill, but the IUD (intra-uterine device). Studies have shown an increase in the harmful bacteria in the vagina, which does not occur when using condoms for contraception.

Thirdly, the balance of gut flora has an influence on the vaginal flora. As the vagina and the anus are in such close proximity, the bowel flora tend to ‘’migrate’’ to the vagina. It is therefore important to have a good balance of gut flora by eating fermented foods and/or taking probiotic supplements, as well as avoiding unnecessary antibiotics. Stress depletes the good bugs within hours, so this is our fourth important factor – improving stress management!

So what do you do when your vaginal flora is ‘’out-of-whack’’? It’s important to have a swab test with the GP if you have any symptoms of itching, irritation, change in discharge or pain with passing urine. There are also naturopathic treatment approaches for unbalanced vaginal flora, many of which have research studies to support them.

It is sometimes hard to know if your vaginal discharge is normal. This depends both on the general characteristics of the discharge, as well as how it might vary from what you've experienced previously. A few guidelines can help you work out if it is part of a healthy pattern of variation or not.

If you are concerned that you are out of balance from the vaginal perspective, make an appointment at Equilibria for tips on how to get this tested as well as possible treatment options.

If you would like to know more about achieving a healthy, balanced vaginal environment, go to our homepage and subscribe to our newsletter via the button below, ticking the box for ‘’Vaginal Health, Thrush and BV’’ for a series of free e-newsletters on the topic.

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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

Butterflies, ulcers and the irritable bowel

Posted: Wednesday, December 18, 2013 at 12:21:26 PM EST by Alyssa Tait

Why stress is so bad for your gut

It used to be generally held wisdom that stress gives you ulcers. Then a smart Australian found that a bacterium called Helicobacter pylori was able to directly cause ulcers. This was a pivotal discovery – but does it mean we should throw out the baby with the bathwater? It is important to acknowledge the extent to which stress really does harm your gastrointestinal tract. While other (often more direct) causes are continually discovered, don’t forget about stress!

So what are some of the negative effects of stress on your gut?

The concept of the ‘’brain-gut axis’’ is important here. The brain and the gut are very closely linked and the brain affects the gut in a variety of ways. However, the gut has a huge number of nerves – more than in the spinal cord. This is sometimes known as the ‘’gut mini-brain’’ or the ‘’second brain’’. This ‘’second brain’’ can initiate and perpetuate many of these effects itself – which is what makes gut function so complex

Some of the effects of stress on your gut are:

1)      changes in gastrointestinal motility

Stress affects the movement of food through your digestive tract. It can speed it up, slow it down or cause uncoordinated movement, resulting in spasms or cramps.

2)      increase in visceral perception

This means that stress makes you more sensitive. It makes you feel every little movement and every little sensation more strongly than normal.

3)      changes in gastrointestinal secretion

Stress alters the production of hydrochloric acid, digestive enzymes and bile. Normal amounts and normal timing of production of these is critical for healthy, comfortable bowel function.

4)      increase in intestinal permeability

Increased permeability of the intestinal wall is colloquially known as ‘’leaky gut’’, but is a well-established medical fact in various gut conditions and systemic conditions. It can increase your potential for allergic reaction and other forms of immune activation.

5)      negative effects on regenerative capacity of gastrointestinal mucosa and mucosal blood flow

The mucosa is the protective inner lining of your gut. Stress affects its ability to heal quickly, and affects the circulation that keeps it healthy.

6)      negative effects on intestinal microbiota.

Intestinal flora, or the ‘’good bugs’’ that keep your gut healthy,  get (deservedly) quite a lot of press. Stress depletes these ‘’good bugs’’ within hours.

7)      Immune effects

Mast cells are chemicals that translate the stress signals into the release of a wide range of neurotransmitters and proinflammatory chemicals called cytokines, which can significantly affect gut function.

Does all this sound like irritable bowel syndrome (IBS)? Not surprisingly, interventions that target stress have been shown to help IBS. For example, there is strong evidence for the benefits of mindfulness meditation, cognitive behavioural therapy and gut-directed hypnotherapy in IBS.

I don’t want to imply that IBS, or other gut issues, are ‘’all in the mind’’. Future posts will focus on some of the specific pathophysiology behind IBS. However, the effects of stress on the gut should not be underestimated. It appears that the irritable bowel is…well, literally irritable!
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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

Do You Understand Your Fertility?

Posted: Tuesday, April 1, 2014 at 8:16:15 AM 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?

Most people’s first guess would be menstruation; the regularity of our bleeding. Even many doctors would think this is the case. And certainly, lack of regular bleeding, as in amenorrhea and polycystic ovarian syndrome, is not a good sign in your fertile years.

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?

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.

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.

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

Hidden Infection When Your UTI Isn't A UTI

Posted: Wednesday, June 29, 2016 at 7:54:29 AM EST by Alyssa Tait

 

Can you be sure that your bladder, urethral or vaginal symptoms are not due to infection?

When is a urinary tract infection (UTI) not a UTI and when is it?

It’s harder to be sure when the tests for infection are fraught with such shortcomings. Make sure you've read my blog posts on why dipsticks are so unreliable and the difficulty with urine cultures.

Mysterious urethral pain that feels like a urinary tract infection, yet tests come up negative...it’s a mysterious condition with many possible causes. But we have to acknowledge that some of those causes – including those hard to uncover – involve infection.

Here’s one you probably didn’t know about: ureaplasma infection.

And here’s ten things I bet you didn’t know about ureaplasma infection.

  • It can be there even when the usual culture for urinary tract infection (UTI) is negative (i.e. doesn’t show up anything).
  • What’s more, it can be there even with a negative midstream urine test (i.e. when you pee on the dipstick, it doesn’t show up anything).
  • Ureaplasma is known as an “opportunistic pathogen”, which means while it hangs out to some degree in most people (40-80%), it can cause disease if things get out of balance.
  • It is a reasonably common cause of urethritis (i.e. inflammation of the urethra) when it isn’t gonorrhoea (a sexually transmitted infection).
  • It is also linked with increased susceptibility to HIV infection, infertility, kidney stones, premature labour, miscarriage and stillbirth, and inflammatory joint disease.
  • It can only be detected using a special DNA test, such as a vaginal PCR DNA test.
  • Ureaplasma loves to form biofilms – that is, “walled cities” to protect itself from eradication by antibiotics (which makes it more likely to become resistant, and antibiotics not to work).
  • It is common for ureaplasma to be resistant to trimethoprim (the most common antibiotic prescribed for urinary tract infection).
  • If you test positive for it, your partner should be treated as well, as research shows you could be transferring it back and forth to each other.
  • While a recent review found it was not higher in women who had urethral pain syndrome than in women without, it is likely linked with reduced protection by good bacteria. For example, one study showed that the chemicals produced by lactobacilli inhibit ureaplasma.

Thankfully, the common treatments for it – the antibiotics doxycycline, azithromycin, clotrimazole, and fluconazole – do not seem to have severe negative effects on the vaginal lactobacilli, according to one study.

Even so, we know that antibiotic treatment alone at best fails to address the major issue (i.e. an underlying imbalance in the urogenital microflora and other local immune factors). At worst, it can perpetuate a cycle of increasing susceptibility to this and other urogenital conditions – not to mention the systemic problems implicit in damage to the gut microbiome.

Because my focus is on the short- and long-term health of the whole person, I do not recommend stopping at antibiotics. They may be important – discuss this with your trusted clinician. But don’t ignore the potential impact on the microbiota.

My approach involves co-administering natural compounds that address the following:

  • Minimise damage to the gut microbiome
  • Maximise the effectiveness of the anti-microbial action against the “bad bugs”
  • Restore the gut and urogenital microbiome
  • Reduce risk of recurrence and risk of other problems like thrush and bacterial vaginosis
  • Maximising immune system protection, both systemic and local (i.e. the environment of the vagina, urethra and bladder)

Navigating your way through this poorly understood (even by doctors) area can be incredibly difficult and frustrating. I accompany many women along this journey! Skype appointments are possible if you can’t get to Brisbane, Australia…but thorough investigation is critical and must be pursued from where you are.

Get in touch if you need a guide and a plan for recovery.

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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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