Equilibria - Equilibria Blog http://www.equilibriahealth.com.au/Blog/equilibria-blog Equilibria Blog - Ten Reasons Why Sex Hurts http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ten-reasons-why-sex-hurts <h2>Ideally, sex is a loving connection between two people &ndash; so what does it mean when sex hurts?</h2> <p><strong>You&rsquo;re not in the mood.</strong></p> <p style="padding-left: 30px;">Sometimes, you are too tired or just not up to it. You can choose to say no at these times, or alternatively, you can choose to get into the mood. Focus on emotional connection and lots of foreplay &ndash; or only foreplay.</p> <p><strong>Your body is telling you no.</strong></p> <p style="padding-left: 30px;">Pain with sex can be your body&rsquo;s way of telling you something&rsquo;s not right. There are many reasons for this, including emotional. If you&rsquo;ve had negative sexual experiences or a history of trauma to this area, pay attention to your body&rsquo;s signals.</p> <p><strong>Your libido is shot.</strong></p> <p style="padding-left: 30px;">Sexual pleasure and <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=13">libido</a> often go together. While it is possible to get yourself in the mood and enjoy it even if your sex drive is low at the outset, it makes more sense to take steps to increase your sex drive.</p> <p><strong>Medication is having an effect.</strong></p> <p style="padding-left: 30px;">Lots of meds can reduce libido. Are you on the Pill? On antidepressants? Ask your pharmacist if this could be killing your sex drive.</p> <p><strong>It&rsquo;s not the right time of month</strong>.</p> <p style="padding-left: 30px;">At certain times of month, you may be more in the mood than others. <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=51">Vaginal dryness</a> is also normal for many women at certain times of month. Aim to learn more about the effect of your hormones on the environment down there.</p> <p><strong>Blame your hormones.</strong></p> <p style="padding-left: 30px;">A drop in oestrogen tends to lead to vaginal dryness. After a while, this can lead to deterioration in the tissue quality, sometimes called <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=53">vaginal atrophy</a> or <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=53">atrophic vaginitis.</a> This is common after menopause, and when breastfeeding.</p> <p>T<strong>hings aren&rsquo;t right down there.</strong></p> <p style="padding-left: 30px;">If you have<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=52"> thrush</a> or a <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=34">urinary tract infection</a>, things definitely won&rsquo;t feel good with sex. Get this checked out and treated.</p> <p><strong>Your IBS is playing up.</strong></p> <p style="padding-left: 30px;">The bowel and the vagina &lsquo;&rsquo;speak&rsquo;&rsquo; to each other, so a flare-up of your <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=12">irritable bowel</a> can have the effect of putting the vagina &lsquo;&rsquo;off limits&rsquo;&rsquo;.</p> <p><strong>You&rsquo;ve got vaginismus.</strong></p> <p style="padding-left: 30px;">When your vaginal muscles are in spasm or tense up and cause pain with sex, this needs professional treatment. A pelvic floor physiotherapist with specific experience with <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a> can help you.</p> <p><strong>You&rsquo;ve got &lsquo;&rsquo;provoked vestibulodynia&rsquo;&rsquo;.</strong></p> <p style="padding-left: 30px;"><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=56">Vestibulodynia</a>, sometimes called <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=56">vulvar vestibulitis</a>, tends to overlap with the vaginismus described above and with a condition called vulvodynia. This is a highly complex condition that needs treatment by an experienced and qualified clinician. But to get an idea, try my quick <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=28">Vulvodynia Self Test </a>to see if it's likely that you have it. </p> <p>Of course, this is not a complete list, but it may give you a starting point. Understanding the cause allows you to take action to help. Some causes are simple and easy to fix, while some are more complex.</p> <p>&nbsp;If your relationship is being affected by painful intercourse, we strongly recommend you seek professional help, including a medical assessment. In the meantime, it might help to explore the possibilities listed.</p> <p>If you have already been medically checked out, it may be a good time to make an appointment with us to address the cause.</p> <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Doing Your Pelvic Floor Exercises Wrong? Top Ten Mistakes and the Repercussions Part 1 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/doing-your-pelvic-floor-exercises-wrong-top-ten-mistakes-and-the-repercussions-part-1 <h2><strong>You&rsquo;re trying to do your pelvic floor exercises, but how do you know you&rsquo;re getting it right?</strong></h2> <p>It&rsquo;s true that you&rsquo;ve got to get your pelvic floor working &ndash; but more to the point, you&rsquo;ve got to get it working right! That&rsquo;s why you need to know the top signs to look out for that reveal you&rsquo;re doing it wrong.</p> <p>Now for a brief refresher. A healthy pelvic floor is important for preventing and correcting <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=10">incontinence</a> and <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=16">vaginal prolapse</a>. The basics of a pelvic floor exercise, or Kegel exercise as it is sometimes called, is this: you imagine you&rsquo;re stopping the flow when doing a pee. It feels like a tightening,'' pulling up and in'' sensation inside. You might feel it around where you pee, or you might feel it in the vagina. After holding it there, you let go. Have you got it? Now check you&rsquo;re not making these common mistakes, and discover the repercussions of each mistake.</p> <table border="0"> <tbody> <tr> <td> <h3><strong>Common Mistake:</strong></h3> </td> <td> <h3><strong>Repercussion:</strong></h3> </td> </tr> <tr> <td> <h3><strong>You&rsquo;re actually stopping your pee mid-stream.</strong></h3> <p>Some people are still following the old advice to actually stop the flow to work their pelvic floor.&nbsp;</p> </td> <td> <p>&nbsp;</p> <p>This interrupts the complex neurological process of emptying the bladder, and in some cases can make you empty incompletely, leading to its own problems</p> </td> </tr> <tr> <td> <h3><strong>You&rsquo;re getting down on the floor to do them.</strong></h3> <p>They may be called ''pelvic floor exercises'' - but this is because the muscles line the floor of the pelvis<strong>.</strong></p> </td> <td> <h3><strong><strong>Repercussion:</strong></strong></h3> <br /> <p>If you really want to, you can lie on the floor to do them - but you don't have to. It would be like wearing a red hat every time you do them - harmless but unnecessary!</p> </td> </tr> <tr> <td> <p>&nbsp;</p> <h3><strong>You&rsquo;re doing a pelvic tilt.</strong></h3> <p>If your pelvis visibly moves when you're doing it, you're not doing a pelvic floor exercise. I'll never forget an elderly client demonstrating her pelvic floor exercise for me - not only did she tilt her pelvis, she half-stood and leaned so far forward her back was nearly parallel to the ground!</p> </td> <td> <h3><strong><strong><strong><strong>Repercussion:</strong></strong></strong></strong></h3> <p>All your hard work can be in vain if you're simply moving your pelvis instead of pulling up and in inside your pelvis. Fine for some types of sore back, but for pelvic floor, barking up the wrong tre</p> </td> </tr> <tr> <td> <h3><strong>You&rsquo;re squeezing your bottom, sucking in your abs strongly or tightening your legs.</strong></h3> <p>''Buns of steel'' and ''rock hard abs'' are not the goals here. You shouldn't see your legs move when you do your pelvic floor. You shouldn't lift off the chair - in fact, if anyone can tell you're doing them, you're doing them wrong!</p> </td> <td> <h3><strong><strong><strong><strong>Repercussion:</strong></strong></strong></strong></h3> <p>At best, working all the wrong muscles can mean you will get nowhere fast! At worst, you can create a major muscle imbalance in your pelvic floor. I've seen this plenty with women who are only doing their pelvic floors during Pilates. Try lying in front of a mirror without underwear on, or using a hand mirror. When you do your pelvic floor contraction correctly, you should actually see the perineum (area between vagina and anus) draw inward into the body. Try it, you might be surprised how obvious it is!</p> </td> </tr> <tr> <td> <p>&nbsp;</p> <h3><strong>You&rsquo;re bearing down.</strong></h3> Some women think they are doing their pelvic floors, but they are actually pushing down, like they're having a baby! Please - this action should be confined to exactly that - having a baby!<br /> <p>&nbsp;</p> </td> <td> <h3><strong><strong><strong><strong>Repercussion:</strong></strong></strong></strong></h3> <p>Bearing down or pushing down weakens the pelvic floor over time and can make symptoms of<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=16"> prolapse</a> and <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=10">incontinence </a>worse - and means you're not getting any of the benefits of correct pelvic floor exercises.</p> </td> </tr> </tbody> </table> <p>Found any of your own mistakes yet? Don't get too comfortable - there's another post coming with 5 more common mistakes before you can relax! Keep an eye out for Part 2. On the other hand, if you know you've got it wrong, and need to be put on the right track, contact us for an appointment.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> Top Ten Pelvic Floor Mistakes and Repercussions Part II http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/top-ten-pelvic-floor-mistakes-and-repercussions-part-ii <h2>Get your pelvic floor exercises right.</h2> <p>Be sure to avoid the final five of the top ten errors when doing pelvic floor exercises, and check the previous post for the first five!</p> <p>&nbsp;</p> <table style="width: 100%;" border="1" cellpadding="0"> <tbody> <tr> <td> <p><strong>Mistake</strong></p> <h3><strong>You&rsquo;re breathing too shallow or too deep.</strong></h3> <p>Easy does it - natural breathing is the way to go.</p> </td> <td colspan="2"> <p>&nbsp;</p> <p><strong>Repercussions</strong></p> <p>Shallow breathing may mean you don't have the right pattern &nbsp; of contraction. Yet, in my clinic I see many women who are breathing too &nbsp; deeply, and losing the contraction as they go - especially when the muscles &nbsp; are weak and poorly co-ordinated. When your muscles are rip-roaring &nbsp; fantastic, you can usually hold them while breathing any old way you like.</p> </td> </tr> <tr> <td colspan="2"> <h3><strong>You&rsquo;re holding your breath.</strong></h3> <p>This is bad news! If you're holding your breath while you &nbsp; do your pelvic floors, you may as well not be doing them. If try as you &nbsp; might, you can't hold and breathe at the same time, you need a specialist &nbsp; pelvic floor physio. Believe me, we have ways!</p> </td> <td> <p><strong>Repercussions</strong></p> <p>If you breathe in when you tighten your pelvic floor, you &nbsp; teach the muscles to only hold then, and to let go when you breathe out. The &nbsp; pelvic floor muscles are postural muscles - that is, they should be &nbsp; ''switched on'' through your daily activities. Train them with natural &nbsp; breathing.</p> </td> </tr> <tr> <td> <h3><strong>You&rsquo;re not holding for long enough.</strong></h3> <p>A lot of women are taught to do ''quick squeezes''.</p> </td> <td colspan="2"> <p>&nbsp;</p> <p>&nbsp;</p> <p><strong>Repercussions</strong></p> <p>When the coordination is poor or the muscles are weak, &nbsp; this does nothing for the muscles. Unless your muscles have been specifically &nbsp; assessed, concentrate on learning to hold for the length of one natural &nbsp; breath in and out, then build up to 10 seconds.</p> </td> </tr> <tr> <td> <h3><strong>You&rsquo;re just not getting around to it.</strong></h3> <p>When I ask patients how often they do them, the common &nbsp; answer is ''well, I <em>try</em> to do...'' or, ''I <em>aim</em> to do...''</p> </td> <td colspan="2"> <p><strong>Rerpercussions</strong></p> <p>&nbsp;</p> <p>Sorry, but this is one situation where it is not the &nbsp; thought that counts! Set a goal with your physio, and stick to it. If you &nbsp; fall off the wagon, do more to offset the break.</p> </td> </tr> <tr> <td> <h3><strong>The only time you think about the pelvic floor is when &nbsp; you do the exercises.</strong></h3> <p>Although many people need to improve the strength of these &nbsp; muscles, the bottom line is, they are ''functional'' muscles.<strong> </strong></p> </td> <td colspan="2"> <p>&nbsp;</p> <p><strong>Repercussions</strong></p> <p>Strong muscles are great, but if you don't use them in &nbsp; your daily function - lifting toddlers, washing the car, vacuuming, jogging, &nbsp; coughing, gardening - you may as well not have them! Put your pelvic floor to &nbsp; work. Getting them working while you're active will help you reap the &nbsp; benefits of a strong back, good bladder control and good sexual awareness.</p> </td> </tr> </tbody> </table> <p>It's easy to make these common mistakes - but now you know what they are, be on the look out for them. If you aren't making these mistakes, there's a good chance your pelvic floor will be working well for you. If you have checked and don't think you're making these mistakes, but don't seem to be getting results with your exercises (for example, you are still experiencing <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=10">incontinence</a> or <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=16">prolapse </a>symptoms), you'll need a pelvic floor physiotherapist. That's what I'm here for! I can do an individualised assessment and give you specific strategies to change the situation.</p> <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Back Pain: Part and Parcel of Pregnancy...or is it? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/back-pain-part-and-parcel-of-pregnancy-or-is-it <h2>Picture this: you&rsquo;re 25 weeks pregnant. You&rsquo;re supposed to be radiant and glowing. In reality, your back is killing you.</h2> <p>You feel exhausted from the pain.</p> <p>Work is a nightmare.</p> <p>At night, you can&rsquo;t find a comfortable position.</p> <p>You don&rsquo;t even feel better when you wake up in the morning!</p> <p>Terrible thoughts keep going round in your head:</p> <p><strong>&lsquo;&rsquo;How am I going to get through to maternity leave?&rsquo;&rsquo;</strong></p> <p><strong>&lsquo;&rsquo;If it&rsquo;s this bad now, how bad is it going to be by the time I&rsquo;m due?&rsquo;&rsquo;</strong></p> <p><strong>&lsquo;&rsquo;Is this going to affect my labour and birth?&rdquo;</strong></p> <p>Sensibly, you bring it up with your obstetrician at your next antenatal appointment. You&rsquo;re pleased to know your blood pressure is fine, and you passed the oral glucose tolerance test, so you don&rsquo;t have gestational diabetes. But the back! The back pain is unbearable!</p> <p><strong>&lsquo;&rsquo;Look, don&rsquo;t worry, you&rsquo;re healthy, the pregnancy is going fine. Back pain is just part and parcel of pregnancy.&rsquo;&rsquo;</strong></p> <p>Sadly, I&rsquo;ve heard this story hundreds of times. Usually, it is when pregnant women are seeing me for their first physio appointment over half-way through their pregnancy. They&rsquo;ve had the back pain for 3 months now. Why didn&rsquo;t they come to see me earlier?</p> <p>Usually, because they&rsquo;ve been told that back pain is to be expected in pregnancy, and there&rsquo;s nothing they can do about it. Often they have been told this by their obstetrician, but it could also have been their GP or a well-meaning friend. I have even heard it said by physiotherapists with limited experience treating pregnant women. The problem is, <strong>it&rsquo;s just not true</strong>.</p> <p>There are as many types of back pain in pregnant women as there are in non-pregnant women. If you have had back pain before, or a past injury such as a disc bulge, it is likely to flare up during the pregnancy. It is equally likely that a mild biomechanical problem in your back and pelvis that was pain-free beforehand will flare up due to the physical demands of pregnancy. And then of course there is new pain from conditions you are susceptible to in pregnancy, such as <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=41"><strong>symphysis pubis dysfunction</strong></a> (SPD) or <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=31"><strong>sacro-iliac joint dysfunction.</strong></a></p> <p>Don&rsquo;t accept back or pelvic pain in pregnancy without having a thorough assessment by a physiotherapist specifically experienced in helping pregnant women. We can almost always help you &ndash; sometimes a lot, occasionally a little. Either way, you&rsquo;ll walk away empowered, and with a sense of control.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Causes of Bladder Pain Part 1 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/causes-of-bladder-pain-part-1 <h2>Bladder pain: what could be behind it?</h2> <p>Pain in the bladder can be downright distressing. Like all &lsquo;&rsquo;organ&rsquo;&rsquo; pain, it is compounded by the anxiety associated with &lsquo;&rsquo;something being wrong&rsquo;&rsquo; with an important body system.</p> <p>There is a range of experience of bladder pain. Some aspects include:</p> <p>-Pain when passing urine</p> <p>-Pain that feels like it&rsquo;s coming from your bladder, which increases as your bladder gets fills up</p> <p>-An ongoing discomfort with urge; a feeling of constantly needing to go to the toilet, which doesn&rsquo;t really ease when you go</p> <p>So what are some of the possibilities when your bladder hurts?</p> <h3><strong>Urinary tract infection.</strong></h3> <p>The good old UTI is probably the most common cause of pain in the bladder, and usually is accompanied by a &lsquo;&rsquo;triad&rsquo;&rsquo; of symptoms: frequency (going to the toilet more often, often for only small amounts), urgency (a feeling that you can&rsquo;t put off the urge and have to rush to the toilet) and dysuria (pain with passing urine, usually worse at the end of the stream). Sometimes the body can fight this off, especially if you alkalise the urine with Ural or bicarbonate of soda, but if symptoms persist, it&rsquo;s important to get to a doctor who can do a dipstick to check for white blood cells and send it off for culture. You will most likely need antibiotics. It is critical that the infection does not reach the kidneys, as this can cause long-term damage. You should always act quickly, particularly if you have a fever.</p> <h3><strong>Stones.</strong></h3> <p>Bladder stones are made up of minerals and proteins in the urine. Sometimes bladder stones can remain in the bladder with no symptoms. However, passing stones is normally (but not always) extraordinarily painful. A dipstick test with the doctor will show up blood in the urine (which may not be visible to the naked eye). An X-ray can show up some types of stones (calcium oxalate, but not uric acid stones), or a cystoscopy (camera in the bladder) may be necessary to diagnose them. They normally occur in older people or people who have become dehydrated.</p> <h3><strong>Vaginal infection.</strong></h3> <p>Sometimes, an infection in the vagina (bacterial or yeast infection) can cause pain in what feels like the bladder; it is also possible to have pain when passing urine, as the urethra (bladder tube) can be inflamed (this is called urethritis). Especially if your symptoms are not the &lsquo;&rsquo;classic triad&rsquo;&rsquo; and don&rsquo;t show up as a urinary tract infection on a culture, it is important to have a vaginal swab to rule out vaginal infection. It is important to consider chlamydia, an extremely common sexually transmitted infection, which in some women causes no symptoms at first, but can cause pain with passing urine.</p> <p>That's just the beginning - watch this space in the next few days for some more causes of bladder pain and arm yourself with information!</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Causes of Bladder Pain Part 2 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/causes-of-bladder-pain-part-2 <h2>What Else Could Be Behind Your Bladder Pain?</h2> <p>This is Part Two - so make sure you scroll down to the post below to get the full story on possible causes of bladder pain!</p> <h3><strong>Cancer.</strong></h3> <p>Let&rsquo;s get this one out of the way! While bladder cancer or a bladder tumour, is an uncommon cause of bladder pain, especially in younger people, it is important to be ruled out. It is always important to identify the cause of blood in the urine, either macroscopic (meaning visible to the naked eye) or microscopic (meaning it shows up on a dipstick test).</p> <h3><strong>Obstruction.</strong></h3> <p>If the urethra (bladder tube) gets blocked, the bladder can overfill and become distended like a balloon, and cause pain. Obstruction may occur for many reasons, including prostate enlargement in men, bladder stones, tumours, scar tissue, or bladder prolapse in women. It is uncommon in women, and would occur with the symptom of difficulty emptying the bladder or a change to the urine stream.</p> <h3><strong>Incomplete bladder emptying.</strong></h3> <p>If the bladder does not empty completely it is possible for the bladder to overfill and cause pain, as in obstruction. This could occur with damage to sensory nerves of the bladder, such as with gynaecological surgery or a traumatic childbirth. There is also a rare condition in young women known as Fowler&rsquo;s Syndrome, where the urethra (bladder tube) does not relax properly when trying to pass urine, leading to urinary retention.</p> <h3><strong>Interstitial cystitis or painful bladder syndrome.</strong></h3> <p>Interstitial cystitis (IC) is also known as painful bladder syndrome (PBS) or bladder pain syndrome (BPS). It is a condition causing pain (or pressure or discomfort) associated with the bladder, usually worse as the bladder is filling, and relieved to some degree with passing urine. It is a chronic condition (present for at least 6 weeks) where a urinary tract infection has been clearly ruled out. A dipstick test may show blood in the urine. A cystoscopy will normally show bleeding wounds in the wall of the bladder called &lsquo;&rsquo;glomerulations&rsquo;&rsquo; or petechial haemorrhages. However, it is possible to have PBS without this classic sign of IC. Antibiotics will not change the symptoms.</p> <h3><strong>Endometriosis.</strong></h3> <p>Endometriosis is a condition where the endometrium, or uterine lining, grows abnormally in places that it shouldn&rsquo;t, such as the bowel, the bladder and the pelvic cavity. Endometriosis often causes pelvic pain, usually exacerbated during menstruation. Sometimes the pain can feel specific to the bladder. With bladder endometriosis, a dipstick test may show pyuria (pus or white blood cells) in the urine, but a culture for a urinary tract infection will be negative. Antibiotics will not change the symptoms.</p> <h3><em><strong>A Final Message About Bladder Pain</strong></em></h3> <p>Bladder can be acute and self-limiting (meaning that it is related to clear cause and resolves predictably) or it can be chronic, where the cause is more difficult to find. When it persists for a period of weeks or months, it takes on the characteristics common to chronic pain, such as neurogenic inflammation and central sensitisation. Recurrent urinary tract infections are another issue that need expert help to resolve. Here at Equilibria, we have the expertise to help you solve these problems once and for all.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> In Search of That Elusive Libido http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/in-search-of-that-elusive-libido <h2>Ladies&rsquo; Libido&hellip;a slippery creature indeed!</h2> <h3>The topic of a future blog post, for the time being I would like to share some wonderful resources for women who are seeking that elusive creature.</h3> <p>You may find these resources useful if you:</p> <ul> <li>Have noticed that your sex drive has dropped</li> <li>Have never really felt much with sex</li> <li>Are motivated to improve your libido and your sensation with sex</li> </ul> <p><a href="http://www.amazon.co.uk/The-Book-Doctors-Complete-Vulvovaginal/dp/0553381148/ref=sr_1_1?ie=UTF8&amp;qid=1336706645&amp;sr=8-1">The V Book &ndash; A Doctor&rsquo;s Guide to Complete Vulvovaginal Health</a> by Elizabeth G Stewart</p> <p>This is a must for any woman who is not sure what&rsquo;s what &lsquo;&rsquo;downstairs&rsquo;&rsquo;. It very clearly takes you through the anatomy of the vulva and helps you become familiar with that part of your body that is often lacking in attention and awareness!</p> <p>The following three on this list are more like &lsquo;&rsquo;workbooks&rsquo;&rsquo;. They are designed to be worked through, not just read!</p> <p><a href="http://www.amazon.co.uk/Becoming-Orgasmic-sexual-personal-programme/dp/0749929138/ref=sr_1_1?s=books&amp;ie=UTF8&amp;qid=1336706669&amp;sr=1-1">Becoming Orgasmic</a> by Julia Heiman</p> <p>Despite its slightly cheesy title, this is an all-time &lsquo;&rsquo;classic&rsquo;&rsquo; in women&rsquo;s sexuality. It helps you explore the reasons that may be stopping you from experiencing ideal sexual pleasure.</p> <p><a href="http://www.amazon.co.uk/The-Elusive-Orgasm-Womans-Guide/dp/1600940234/ref=sr_1_2?s=books&amp;ie=UTF8&amp;qid=1336706669&amp;sr=1-2">The Elusive Orgasm</a> by Vivienne Cass</p> <p>In no way all about orgasm, this is a more modern book written by a psychologist and sex therapist doctor that is easy to read and very non-intimidating. A great one to start with.</p> <p><a href="http://www.amazon.co.uk/Womens-Anatomy-Arousal-Sheri-Winston/dp/057803395X/ref=sr_1_1?s=books&amp;ie=UTF8&amp;qid=1336706721&amp;sr=1-1">Women&rsquo;s Anatomy of Arousal</a> by Sheri Winton</p> <p>This was awarded Book of the Year in 2010 by the American Association of Sexuality Educators, Counselors and Therapists. It really is a tremendous book that brings many age-old &lsquo;&rsquo;secrets of sexuality&rsquo;&rsquo; from Eastern traditions into the mainstream, in a way that is humourous, irreverent, and easy-to-read. Highly recommended to share with your partner.</p> <p>Don&rsquo;t forget to check your local library for these books. Otherwise, they are easily accessible on Amazon.com.</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Solutions To Vaginal Dryness http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/solutions-to-vaginal-dryness <h2>The Six Key Areas You Need to Focus On</h2> <ul> <li> <h3><strong>Good hormone levels.</strong></h3> </li> </ul> <p>Oestrogen promotes strong and healthy tissue in the vulva. It also promotes good levels of vaginal lactobacilli (see above). In women of fertile age, it promotes production of mucus by the cervix at certain times of your cycle, which produces a <a href="http://www.equilibriahealth.com.au/Page/how-do-i-know-if-my-vaginal-discharge-is-normal">normal discharge</a>. At other times of month, the vaginal walls can produce a different type of normal vaginal discharge, which is a sign of a <a href="http://www.equilibriahealth.com.au/Page/the-healthy-and-balanced-vagina">healthy, balanced vagina.</a> Withdrawal of oestrogen (for example, at menopause or with prolonged breastfeeding) can therefore lead to a feeling of vaginal dryness, as well as increased vulnerability of the tissue to micro-tearing and trauma, especially with intercourse.</p> <ul> <li> <h3><strong>Good balance of vaginal flora.</strong></h3> </li> </ul> <p>A normal, healthy vagina contains good amounts of beneficial flora, especially certain strains of lactobacilli. Lactobacillus bacteria produce the protective &lsquo;&rsquo;acid mantle&rsquo;&rsquo;, or the normal protective coating on the vaginal walls, which increases resistance to infection, but also makes the vagina feel less dry, sensitive or &lsquo;&rsquo;stingy&rsquo;&rsquo;.</p> <ul> <li> <h3><strong>Nutrients for formation of healthy skin.</strong></h3> </li> </ul> <p>Like any skin of the body, the &lsquo;&rsquo;skin&rsquo;&rsquo; or epithelium of the vagina is constantly &lsquo;&rsquo;re-healing&rsquo;&rsquo;, as part of normal cell &lsquo;&rsquo;turnover&rsquo;&rsquo;. Specific nutrients are essential for this, including vitamin A, vitamin E, vitamin C, protein, zinc and essential fatty acids. A lack of any of these nutrients (which is surprisingly common) can make the vagina feel dry, irritated, chafed or prone to microtrauma.</p> <ul> <li> <h3><strong>Healthy thoughts, emotions and libido.</strong></h3> </li> </ul> <p>Stress promotes what is called the &lsquo;&rsquo;sympathetic response&rsquo;&rsquo; of the nervous system. This works against producing healthy moisture with arousal, and acts as a very effective block against libido , so that you&rsquo;re less likely to be in a situation of sexual arousal in the first place!</p> <ul> <li> <h3><strong>Lots of healthy sexual stimulation.</strong></h3> </li> </ul> <p>Sexual stimulation that feels good and right for you is the key component in your body&rsquo;s production of vaginal fluids, which work as a natural lubricant. Sometimes, just taking more time on this, focusing on what is really feeling right for you, helps a lot. Even in situations where there are other factors at play, neglecting to spend enough time on this can contribute to penetration being uncomfortable.</p> <ul> <li> <h3><strong>A really good natural lubricant.</strong></h3> </li> </ul> <p>A great lubricant can make things feel a lot better. Most lubricants contain petroleum derivatives and/or other unnatural chemicals. These can cause reactions in some women, and are best avoided. A natural, organic lubricant is a wonderful help.</p> <h3><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><strong>E-mail us</strong></a> to enquire about purchasing a fully organic, natural personal lubricant.</h3> <h3>Want more detail? This is just a summary of a summary! <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2"><strong>Sign up for our Vaginal Health E-Bulletin</strong></a>, a series of newsletters focusing on attaining optimal vaginal health.Make sure you tick ''<strong>Vaginal Health, Thrush and BV</strong>'' as well as any other topics you are interested in!</h3> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Magnesium and Your Bladder http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/magnesium-and-your-bladder <h2>What Is The Connection?</h2> <h3><strong>What role does magnesium have in good bladder function?</strong></h3> <p>More than you would think!</p> <p>Magnesium is a mineral with an important role in muscle relaxation throughout the body. This effect occurs in both skeletal muscle (which is why magnesium may help muscle cramps) and smooth muscle (such as in the bladder, called the detrusor muscle).</p> <p>Mineral works closely with other minerals, especially calcium. While calcium leads to muscle contraction, magnesium counteracts this. &nbsp;Where there is an imbalance between available magnesium and calcium, there can be symptoms of contraction with insufficient relaxation e.g. muscle cramp, spasm, twitch, flicker or &lsquo;&rsquo;jump&rsquo;&rsquo;. (This twitch, flicker or &lsquo;&rsquo;jump&rsquo;&rsquo; often occurs in the eyelid, and gives you an annoying twitching feeling that you feel everyone else can see). So, magnesium has been described as a &lsquo;&rsquo;natural calcium-channel blocker&rsquo;&rsquo; in the body &ndash; it counteracts the effects of calcium.</p> <p>Muscle contraction in the body relies on electrical activity (nerve impulses) in the nerve that connects to that muscle. The end of the nerve is called the synapse. The release of a chemical called acetylcholine at the synapse is responsible for the continuation of the electrical impulse further down the chain of nerves.</p> <p>Magnesium actually inhibits this release of acetylcholine at the synapse. So, when a nerve is being &lsquo;&rsquo;overstimulated&rsquo;&rsquo;, magnesium can actually calm it down. This is why magnesium is used as an anti-convulsant &ndash; something that reduces seizures. It decreases the excessive amount of nerve stimulation within the nervous system that leads to a seizure. It has also been used for bronchospasm in asthma, to help relax the smooth muscle contraction in the airways.</p> <h3><strong>Is it possible that magnesium could help your bladder, if you have a deficiency?</strong></h3> <p>While no studies have been done on this, it is theoretically possible. In a condition called detrusor overactivity, the bladder contracts without you &lsquo;&rsquo;giving it permission&rsquo;&rsquo;. This can be associated with a feeling of urgency and sometimes leakage of urine. If you have other signs of a need for magnesium, such as leg cramps at night, it could be worth trying magnesium to see if it helps your bladder. It is possible that it may help compete with the &lsquo;&rsquo;excess of nerve messages&rsquo;&rsquo; your bladder is being given to contract. A 1998 study from the British Journal of Obstetrics and Gynaecology found a significant effect of taking magnesium in women with detrusor overactivity. A 1992 study in the British Journal of Urology found that magnesium decreased spontaneous contractions in the detrusor muscle, which are often seen in women with overactive bladder.</p> <h3><strong>So is it worth having your magnesium levels tested?</strong></h3> <p>Not in my opinion. I have seen many women in my practice with normal serum levels of magnesium who have responded well to supplementing with magnesium.&nbsp; One reason for this may be that serum levels are not particularly reliable. Serum magnesium only represents about 0.3% of the body&rsquo;s total magnesium. Most of it is found in the bone, muscle and soft tissue. These different &lsquo;&rsquo;pools&rsquo;&rsquo; of magnesium in the body may take up to 6 months to reach equilibrium. What this means is that you could have a magnesium deficiency in the muscle, but it won&rsquo;t show up in the blood test for six months. In my experience, if you get muscle cramps in your legs or feet, you probably would benefit from taking extra magnesium.</p> <p>Magnesium is one of the safest minerals to supplement with. Even so, the wrong type or amount can cause diarrhoea or stomach upsets in some people. This is especially so with magnesium oxide. It is important to take the right form and dose of magnesium for the best effects.Organise an appointment for advice on this. </p> <p><strong><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a><br /></strong></p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> The Healthy and Balanced Vagina http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-healthy-and-balanced-vagina <h2>Concerned that your vagina may be ''out-of-whack''?</h2> <p>There is a lot of talk about the importance of health and balance these days &ndash; and the vagina is no exception!</p> <p>What makes for a healthy vagina? When the vagina is comfortable and there are no symptoms of abnormal discharge, unpleasant odour, itching, <a href="http://www.equilibriahealth.com.au/Page/vaginal-dryness">dryness</a>, irritation or discomfort, the vaginal environment is likely to be in balance. (<a href="http://www.equilibriahealth.com.au/Page/solutions-for-vaginal-dryness">By the way, there are six key areas to focus on to resolve vaginal dryness</a>). </p> <p>A normal, healthy vagina contains high populations of good bacteria &ndash; mainly lactobacilli. These are similar to the &lsquo;&rsquo;good bugs&rsquo;&rsquo; 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.</p> <p>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 &lsquo;&rsquo;bad&rsquo;&rsquo; bacteria is present in what has been recently called &lsquo;&rsquo;aerobic vaginitis&rsquo;&rsquo;, which is a state of inflammation in the vagina.</p> <p>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.</p> <p>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.</p> <p>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 &lsquo;&rsquo;migrate&rsquo;&rsquo; 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 &ndash; improving stress management!</p> <p>So what do you do when your vaginal flora is &lsquo;&rsquo;out-of-whack&rsquo;&rsquo;? It&rsquo;s important to have a swab test with the GP if you have any symptoms of itching, irritation, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/how-do-i-know-if-my-vaginal-discharge-is-normal">change in discharge</a> or pain with passing urine. There are also naturopathic treatment approaches for unbalanced vaginal flora, many of which have research studies to support them.</p> <p>It is sometimes hard to know <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/how-do-i-know-if-my-vaginal-discharge-is-normal">if your vaginal discharge is normal.</a> This depends both on the general characteristics of the discharge, as well as how it might vary from what you've experienced previously. <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/how-do-i-know-if-my-vaginal-discharge-is-normal">A few guidelines</a> can help you work out if it is part of a healthy pattern of variation or not.</p> <p>If you are concerned that you are out of balance from the vaginal perspective, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><strong>make an appointment</strong></a> at Equilibria for tips on how to get this tested as well as possible treatment options.</p> <p>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 &lsquo;&rsquo;Vaginal Health, Thrush and BV&rsquo;&rsquo; for a series of free e-newsletters on the topic.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2"><img title="subscribe_newsletter_button" src="http://www.equilibriahealth.com.au/images/subscribe_newsletter_button.png" alt="subscribe_newsletter_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Coccydynia: The Can't Sit Down Syndrome http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-cant-sit-down-syndrome <h2>Tailbone Pain and What Can Be Done About It</h2> <h3>Can&rsquo;t sit down without pain? You don&rsquo;t realise how disabling this is until it happens to you.</h3> <p>Tailbone pain, or coccydynia (also called coccygodynia) refers to pain felt in the area of the tailbone &ndash; that is, right where you sit! It is almost always due to a trauma: a fall on the bottom while ice skating, rollerblading or skiing, and childbirth being some of the most common traumatic incidents I see.</p> <p>Coccydynia after childbirth is terribly difficult to deal with &ndash; not least because you are trying to focus on getting the feeding right, and if you can&rsquo;t sit because of pain, this is almost impossible.&nbsp; Tailbone pain is more likely to occur with difficult deliveries, use of forceps, and use of the vacuum. Subluxation of the coccyx (i.e. the tailbone being moved out of position) is the most common cause of pain, but fracture is possible (albeit rare).</p> <p><img title="coccydynia" src="http://www.equilibriahealth.com.au/images/coccydynia.jpg" alt="coccydynia" width="183" height="275" /></p> <h3><strong>So what can you do about it?</strong></h3> <p>Well, the obvious thing (that you have figured out already!) is to <em>get off it</em> &ndash; to reduce the pressure as much as possible.&nbsp; Lying on your stomach is ideal. Sitting backwards on a chair (i.e. straddling the chair) and leaning forward into a pillow resting on the back of the chair can be a lifesaver. Doughnut cushions are controversial; I rarely recommend them, as in the postpartum period, they can increase the pooling of swelling at the perineum and make the whole area even more sore.</p> <h3><strong>So how do you fix it?</strong></h3> <p>I hate to be the bearer of bad tidings, but to fix coccydynia &ndash; that is, to really get rid of the coccyx pain and not let it linger on long-term &ndash; the best form of treatment is manual therapy. Unfortunately, the best way of accessing the coccyx is via a rectal examination. This sounds awful, but most people I see with tailbone pain get over the potential embarrassment quickly because they are so keen to get rid of the pain. It is easy to gently mobilise the coccyx during a gentle rectal examination, and to treat the tailbone muscles, which are usually in spasm.</p> <p>Most sufferers of this debilitating condition are very glad they go ahead and have this form of treatment. It often only takes one to two sessions to dramatically improve things. It can be effective surprisingly quickly with people who have suffered from tailbone pain for a long time as well. I frequently see women who have had the pain for ten years, who are so glad to know that something can be done.</p> <p><img title="sittingcomfortably" src="http://www.equilibriahealth.com.au/images/sittingcomfortably.png" alt="sittingcomfortably" width="225" height="225" /></p> <p>Of course, it is important that you see a practitioner who is licensed to perform these examinations, and also skilled and experienced in the area. This is a service we provide at Equilibria.</p> <p>As a postscript, I must add that a former patient of mine swears by a supplement I gave her for her tailbone pain! I will leave the last word to her:</p> <p><em><strong>''I have nearly run out of the supplement you have given me, and they have been an absolute treasure for me, when I get the pain in my Coccyx,</strong></em></p> <p><em><strong>which I might add is not very often these days, but I would not like to be without them.'' (Mrs G, age 59).</strong></em></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Tampon troubles...why they hurt or won't go in http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/tampon-troubles-why-they-hurt-or-wont-go-in <h2>Problems with using tampons?</h2> <p>This is more common than you might think! Many women choose not to use them. They may find tampons difficult to use at the outset, when they first start using them, or problems may develop even when they used to find tampons fine to use before.</p> <p>To work out likely causes of the problem &ndash; and therefore the solutions &ndash; we need to look at the main symptoms.</p> <h3><strong>Problem: I can&rsquo;t get the tampon to go in!</strong></h3> <p>Many young women, when they first start using tampons, find that getting them in is not as simple as it seems in the instructions in the tampon packet! You might find you try every position they recommend: sitting on the toilet seat, standing with one leg up on the toilet seat, or lying down, and nothing seems to make a difference. You start wondering whether you are trying to put it in the right place&hellip;if only there was a map of the territory!</p> <h3><strong>Solutions:</strong></h3> <p>Study a map of the area &ndash; that is, a lifelike picture or photograph of the vulva! These are available in wonderful educational books such as The V Book and A New View of A Woman&rsquo;s Body. Even better, take a closer look at the actual territory in question: use a large hand mirror to have a look at your own vulva! (Alternatively, lying in front of the mirror door of your wardrobe works well.) This may sound very ''1970s women's liberation'', but believe it or not, the feminists started encouraging women to do this for a good reason! If you don&rsquo;t know what your vulva looks like, how are you going to know what&rsquo;s normal for you? Finally, you need to investigate the territory. Have a look and see where the vaginal opening is. Experiment with gently inserting your finger. If you can insert your finger, you know where you&rsquo;re going when you start to use tampons.</p> <h3><strong>Problem: I know where my vagina is, but it just plain hurts to put the tampon in!</strong></h3> <p>This is incredibly common in the women I see. I see women of all ages who describe how, when they first started to use tampons, it was painful and difficult. Some of them never persisted because they were so put off by this. Don&rsquo;t worry! You&rsquo;re not alone. If you do find it hurts, you probably have what is known as &lsquo;&rsquo;high-tone pelvic floor muscles&rsquo;&rsquo;. This means your pelvic floor muscles are too tense at rest, in the same way as someone working on the computer too much has high-tone neck and shoulder muscles. This makes them sore, tight and tense. No wonder the tampon won&rsquo;t go in!</p> <h3><strong>Solution:</strong></h3> <p>Sometimes pushing your tummy out gently when you try to push it in will help. But if it doesn&rsquo;t, don&rsquo;t push it! You would benefit from seeing a pelvic floor physiotherapist specialising in pelvic floor pain. (This is our forte here at Equilibria!) You may have what is known as <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=17"><strong>vaginismus</strong></a>, which is spasm of the pelvic floor muscles. This has many causes and you need the help and guidance of an expert.</p> <p>Watch this space for <strong>Part II: When tampons won&rsquo;t stay in.</strong></p> <p>Difficulties using tampons is a very common symptom I encounter in women I see. Make an appointment with me at Equilibria if this is a problem for you.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Stinging After Sex http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/stinging-after-sex <h2>That smarting, chafing feeling&hellip;what does it mean?</h2> <p>It really has a way of putting a dampener on things when you get stinging and discomfort after sex. After it&rsquo;s all over, the vaginal entrance feels tender and irritated. It&rsquo;s often worse when you go to the toilet to do a pee after sex. What does it mean, and what can be done about it?</p> <p>A 2008 study for the Journal of Sexual and Marital Therapy looked at this very issue. The authors described &nbsp;conversations with 24 women about pain after sex. All the women experienced stinging after sex, which they described as a burning or smarting pain. 70% of them had pain with passing urine after sex. Sometimes this will be a spontaneous stinging feeling, and sometimes it will be stinging on the toilet when peeing after sex.</p> <p><img title="stingingontoilet" src="http://www.equilibriahealth.com.au/images/stingingontoilet.jpg" alt="stingingontoilet" width="271" height="186" /></p> <p>So who were these women? They were all women with either (or both) <strong><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a></strong> and <strong><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=56">vulvodynia</a></strong>. With all of them, their symptoms had started off as pain after sex (usually for around 2 hours). As time went on, they started having pain during sex (which they described as a ripping or cutting pain). Many of them eventually stopped having sex because it was too painful.</p> <p>Painful sex is incredibly common. <strong><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">Vaginismus</a></strong> and <strong><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=56">vulvodynia (or provoked vestibulodynia</a></strong>) are conditions that may be present if you have pain with sex. Most importantly, don&rsquo;t ignore the early warning signs! It is not normal for there to be stinging or burning after sex, with or without doing a pee. It is also not normal to have painful intercourse (known as <strong><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=54">dyspareunia</a></strong>).</p> <p><strong>If you are wondering whether you might have vulvodynia, try my quick <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=28">Vulvodynia Self-Test.</a> It's a super-quick questionnaire you can do <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=28">here. </a></strong></p> <p>While much can be done to help vaginismus and vulvodynia, getting in early is even better. Don&rsquo;t sit around hoping it will get better on its own. Seek help from an expert in vaginismus and vulvodynia.</p> <p>Here at Equilibria, helping women with vaginismus and vulvodynia is what we do &ndash; day in and day out! So if you suspect you might have a problem, simply give us a call or drop us an e-mail.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Ovulation Pain or Mittelschmerz http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ovulation-pain-or-mittelschmerz <h2>&nbsp;Can you feel when you're ovulating?</h2> <p>That niggling pain is back again, low down in the left of your lower abdomen. It&rsquo;d be nice to just sit down and put your legs up, but you&rsquo;ve got to keep working.&nbsp; <strong><em>That time of month</em></strong> again &ndash; no, you&rsquo;re not due for your period for another two weeks! This is <strong>mid-cycle pain</strong>. Not only do you get period pain, but you&rsquo;re hassled in the middle of the month by more pain! Why?</p> <p>That cyclic stabbing pain in one side of the lower abdomen that some women experience is known as &lsquo;&rsquo;<strong><em>Mittelschmerz</em></strong>&rsquo;&rsquo; (meaning middle pain) or <strong>ovulation pain</strong>. 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 &ndash; that is, at the time of ovulation.</p> <p>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 &ndash; 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.</p> <p>The precise cause of <em>Mittelschmerz </em>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.</p> <p>Severe <em>Mittelschmerz</em> is often due to endometriosis, a condition where the inner lining of the uterus (the endometrium) ends up implanted in places it shouldn&rsquo;t be. <strong>Endometriosis</strong> can only be definitively diagnosed with a laparoscopy &ndash; a relatively invasive procedure. Women with <strong>endometriosis</strong> usually have painful and heavy periods as well, and sometimes pelvic or abdominal pain at other times of the month. This can imitate <strong>irritable bowel syndrome</strong>.</p> <p>In my experience, cyclical abdominal or pelvic pain is more likely to occur when there are &lsquo;&rsquo;tissue restrictions&rsquo;&rsquo; around the organs involved (in this case, the ovary, fallopian tube and uterus). For example, endometriosis causes <strong>adhesions</strong> (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&rsquo;t (such as pain) &ndash; 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).&nbsp; 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 <strong>visceral manipulation</strong>, 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.</p> <p>Contact us for an assessment using this approach and possible visceral manipulation treatment, or just to make an enquiry.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <p>&nbsp;</p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Reflux Medications: What Are You Risking? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/reflux-medications-what-are-you-risking <h2>If so many people are on them, doesn't it mean they are safe?</h2> <p>Reflux, that burning feeling of &lsquo;&rsquo;something coming back up&rsquo;&rsquo; your oesophagus after eating, is sometimes called heartburn but is technically known as GORD or Gastro-oesophageal Reflux Disease. A group of medications called the PPIs (proton-pump inhibitors) is commonly prescribed for symptoms of this. In fact, the prescription of PPIs is so common that they are in the top ten medications prescribed in Australia. Everyone and their dog seems to be on these! But are they actually safe long-term?</p> <p>The Food and Drug Administration (or FDA, an American health body) has issued warnings about the link between PPIs and an infectious diarrhoea caused by a type of bacteria called Clostridium difficile. They have warned people to seek medical attention if they develop diarrhoea while on PPIs that does not resolve. PPIs work by blocking acid secretion in the stomach, which makes it harder to kill off harmful bacteria that enter your body.</p> <p>Eight weeks after starting PPIs, there was an increase in bloating, flatulence, abdominal pain, diarrhoea and constipation in a 2011 study. After 6 months, a quarter of the patients had small intestinal bacterial overgrowth (SIBO), a condition that can cause <a href="http://www.equilibriahealth.com.au/Page/irritable-bowel-syndrome"><strong>irritable-bowel</strong></a> type symptoms.</p> <p>Because of the acid-blocking effect of PPIs in the stomach, absorption of important minerals such as calcium is also diminished. In 2011 the FDA issued a warning about increased risk of osteoporosis and fracture from PPIs. After a review of the research, they concluded that this risk would be minimal &ndash; as long as you only use the PPIs for short periods &ndash; e.g. up to 14 days, up to 3 times per year. Are you, like many PPI users, using them much more frequently and long-term than this?</p> <p>Just last week, a study came through showing that use of PPIs also leads to low magnesium levels in the blood. This is not surprising to nutrition medicine practitioners, because good levels of acidity in the blood aids in the absorption of magnesium. This should be taken seriously, considering the number of annoying symptoms that can be improved with increased magnesium levels, such as muscle cramps, poor energy, poor sleep and anxiety or difficulty relaxing. However, the article reported a specific condition called PPI-induced hypomagnesaemia (PPIH) that could lead to severe symptoms such as tetany, seizures, convulsions and cardiac arrhythmia.</p> <p>The bottom line is to consider carefully, and discuss with your doctor, how much you really need to take your PPI. Is it something that can be controlled with diet, changing your eating behaviour, losing weight or stress management? Consider your options carefully. If you do need to be on PPIs long-term, supplementation with magnesium is a must.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Link Between Prolapse and Osteoporosis http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/link-between-prolapse-and-osteoporosis <h2>Hot off the press&hellip;</h2> <p>&hellip; from the recent International Urogynaecology Association meeting in Brisbane comes some important health information for women: having a vaginal prolapse puts you at increased risk of low bone density or osteoporosis.</p> <p>Two separate studies were reported &ndash; one an Australian study by Professor Pauline Chiarelli, and one a Japanese study by Abe and colleagues. They both had similar findings &ndash; that women with prolapse were more likely to have osteoporosis as well. However, they had quite different theories about why this would be the case.</p> <p>Abe and colleagues proposed the possibility it could be to do with a change in collagen type (one of the proteins that makes up connective tissue, which is involved in both bone and pelvic organ support). They also highlighted a possible role of declining oestrogen impacting on both bone and the pelvic floor.</p> <p>Chiarelli put forward the idea that osteoporosis could be related to prolapse in the following way: the reduction in height caused by osteoporosis could potentially put pressure on the pelvic organs, promoting prolapse.</p> <p>Whatever the mechanism, it seems clear that vaginal prolapse and osteoporosis are linked. What can we get out of this? Keep active &ndash; this helps keep your bones strong and keeps your muscles going, which is important for both these conditions. If you know you have prolapse, consider getting your bone density checked, especially if you are approaching menopause. If you have low bone density, or a family history of osteoporosis, have your pelvic floor assessed by a pelvic floor physiotherapist and get onto a program to keep it healthy!</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Chronic Pain - Do You Really Get It? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/chronic-pain-do-you-really-get-it <p>You step on a thumbtack, and yow! &ndash; your body pulls your foot back faster than you know what hit you.</p> <p>You accidentally touch that hot plate, and eeek! &ndash; you&rsquo;ve pulled your hand back off it in the blink of an eye.</p> <p>&lsquo;&rsquo;Pain is the message your body part sends your brain when your body part is being damaged&rsquo;&rsquo;&hellip;right?</p> <p>WRONG. This is a huge misunderstanding of pain, especially the area of chronic pain or persistent pain. It is a big mistake to make. If you misunderstand your pain, it can actually impede your recovery.</p> <p>So what is pain, then, actually? Pain is what is PRODUCED by your brain and nerves (your central nervous system, or CNS) in response to a THREAT to the body tissues. That&rsquo;s right, a THREAT. It does not have to be real or true damage. In fact, in chronic pain, it rarely is. Instead, your brain senses the body is in danger, and responds accordingly. It actually puts together an individualised pattern of pain in order to protect you from this potential threat. Believe it or not, this is what modern neuroscience research teaches us!</p> <p><img title="brainonfire" src="http://www.equilibriahealth.com.au/images/brainonfire.jpg" alt="brainonfire" width="275" height="183" /></p> <p>Of course if you have persistent pain, it is very important to have all the appropriate investigations done to rule out (or at least tease out) any causes directly related to tissue damage. If nothing can be found &ndash; or if pain is out of proportion to what would be expected for the specific tissue damage &ndash; then you can be sure that your central nervous system (CNS) is playing a big role in maintaining your pain.</p> <p>The complex pattern of pain that your CNS puts together can involve a contribution from multiple systems in your body. As well as pain, you might have emotional or psychological changes (anxiety or depression), muscular changes (tense, sore muscles that are bracing you to deal with your pain, or run away from it) circulation changes (heat or cold in the sore area), tissue changes (weak or fragile skin in the painful area) and hormonal changes, which can affect your energy, sleep and the health of your whole body. All of this put together is like a big personalised puzzle of pain! Putting together the different parts of the puzzle is very important in overcoming the persistent pain.</p> <p>In summary, persistent pain (or chronic pain) is complex but enormously changeable. In order to solve the puzzle of your persistent pain, you need to be able to put the pieces of the puzzle together, and bit by bit, see the picture clearly. Retraining the brain is an important part of resolving chronic pain; <strong><a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/chronic-pain-in-the-vulva-and-pelvis-retrain-your-brain">retraining the brain in chronic pain in the vulva and pelvis</a></strong> is a particular focus of mine as a clinician. </p> <p>If you experience persistent pain &ndash; regardless of the cause &ndash; you need to address the central nervous system. You may benefit from a physiotherapy session dedicated to learning about pain and what causes it to persist &ndash; and how you can change this. When you book in for an appointment, mention you are wanting &lsquo;&rsquo;pain education&rsquo;&rsquo; &ndash; and if you can, bring your loved one with you, so they can understand your pain as well. If you are a female and pain is somewhere in the pelvis, you can also start work on retraining your brain by using my<strong><a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain"> e-book Outsmart Your Pain</a>.</strong></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Painful Sex and the Older Woman http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/painful-sex-and-the-older-woman <p>Sex: whether talking about it, thinking about it, or doing it, it often seems as though our society is obsessed. But if you paid attention to how sex is depicted in our society, you could be forgiven for thinking it is only the young and beautiful doing it! The reality is that sex is part of life for the majority &ndash; including older women. And when a potentially rewarding aspect of life is not working well, it&rsquo;s time to sit up and take notice.</p> <p>Older women (in this post, meaning women after menopause) may experience changes in aspects of their sexual life. In particular, a natural decline in oestrogen can promote a thinning and &lsquo;&rsquo;shrinking&rsquo;&rsquo; of the vagina and external genitals, known as &lsquo;&rsquo;<strong>urogenital atrophy</strong>&rsquo;&rsquo; or '<strong>'vaginal atrophy'</strong>'. This often leads to vaginal symptoms such as <strong>dryness, itching, pain with passing urine and pain with sex</strong> (although the latter can have more serious causes too, and should be checked by your doctor). An interesting survey run on menopausal women in the United States revealed the following:</p> <ul> <li>22% of women felt uncomfortable with discussing this issue with their partners</li> <li>57% of women avoided intimacy because of sexual discomfort and 31% of women stopped having sex altogether</li> <li>64% of women found sex painful and 30% found sex less satisfying due to discomfort</li> <li>65% of women reported a loss of libido</li> <li>35% of women no longer felt sexually attractive due to vaginal discomfort</li> <li>39% of men and women thought the effect of menopause on their sexual relationship was worse than expected.</li> </ul> <p>This shows a pretty significant impact!</p> <p>(Now - before I go on - I need to make the point that we should not jump to conclusions about the cause. While vaginal atrophy is the most common cause in this age group, other causes to consider include<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=56"> vulvodynia</a> and <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=56">vestibulodynia</a>, and also <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a>. All of these conditions are treated every day here at Equilibria). <strong>If you want to get an idea whether you could have vulvodynia,</strong> try my quick questionnaire <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=28">here</a>. </p> <p>The researchers made the point that the major treatment for <strong>vaginal atrophy</strong> (a main cause of painful sex after menopause) is vaginal oestrogen cream or pessaries. Less than one-third of women with these symptoms used such a cream or pessary! Of those who did, over half found that it <strong>reduced pain with intercourse.</strong> Although figures are not known for Australian women, it is a point worth thinking about. A simple treatment for this is available and reasonably effective: vaginal oestrogen.</p> <p>And why not just use vaginal lubricants? While I am a big proponent for <strong>vaginal lubricants and moisturisers</strong> (and stock the best available here at the practice) they do not address the underlying changes in vaginal atrophy (loss of surface cells, a change to a more alkaline pH, and shrinking of the vagina). Some women will do well with lubricants or moisturisers in conjunction with pelvic floor physiotherapy if there have been changes to muscle function. Some women, however, will notice better improvements through the use of vaginal oestrogen. Make this a starting point for discussion with your doctor.</p> <p>&nbsp;<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=8"><img title="atoz_button" src="http://www.equilibriahealth.com.au/images/atoz_button.png" alt="atoz_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> One More (Very Good) Reason to Cut the Carbs http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/one-more-very-good-reason-to-cut-the-carbs <p>&nbsp;You&rsquo;ve heard about carbohydrates and diabetes and obesity, but carbs and colon cancer? It&rsquo;s not a link that usually comes to mind.</p> <p>Even so, a study just out shows that high-carbohydrate diets can worsen prognosis after a diagnosis of bowel cancer. People with colon cancer who ate a high-carb diet after their diagnosis were more likely to have recurrence of the cancer.</p> <p>It is thought that insulin, which is produced when the diet has a &lsquo;&rsquo;high-glycaemic load&rsquo;&rsquo;, as in a high-carb diet, causes the cancer to spread.</p> <p>Reducing carbohydrate load in the diet has a number of health benefits in terms of weight loss or maintaining ideal weight, reducing sugar cravings and helping maintain a healthy lipid profile in the blood, thereby protecting the cardiovascular system. It may be that another benefit of keeping the carbs low has just been found.</p> <p>There are a number of different approaches to keeping the carbs low in the diet, but the most healthful is to simply eat more vegetables &ndash; veggies for breakfast, lunch and dinner in conjunction with healthy protein sources. This may sound a little crazy when you&rsquo;re used to your milk, cereal and toast, but with a little imagination and motivation, you are sure to reap the benefits.</p> <p>For more help with finding the right eating plan for you &ndash; and practical ideas of how to manage it &ndash; get in touch for a naturopathic appointment.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Exhausted, Fatigued, Anaemic: Any Truth to the Low Iron Cliche? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/exhausted-fatigued-anaemic-any-truth-to-the-low-iron-cliche <p>We&rsquo;ve all heard of &lsquo;&rsquo;anaemia&rsquo;&rsquo;, or more specifically, &lsquo;&rsquo;iron-deficiency anaemia&rsquo;&rsquo;.</p> <p>&lsquo;&rsquo;Anaemic&rsquo;&rsquo; brings to mind an image of a pale, wan, drawn person, so fatigued a gust of wind could them blow over. Then there&rsquo;s the description &lsquo;&rsquo;a little bit anaemic&rsquo;&rsquo;, as in: &lsquo;&rsquo;I always get a little bit anaemic during my period&hellip;&rsquo;&rsquo;. It may not be quite accurate, but many women can identify with it! So we know that anaemia can be debilitating, and if a GP suspects it, they will order a full blood count, where chiefly the haemoglobin rating helps them identify this.</p> <p><em><strong>But what about when your haemoglobin is normal?</strong></em></p> <p>The GP tells you &lsquo;&rsquo;Well, you&rsquo;re not anaemic, so I&rsquo;m not sure why you&rsquo;re so tired. Probably just the general pressures of life.&rsquo;&rsquo; What then?</p> <p>The next thing to do, if you really suspect that low iron is a problem (that big juicy steak makes you feel so much better during your period!) is to ask to have full iron studies done. This is the only way to get an idea of your iron stores.</p> <p>Your iron stores reflect your &lsquo;&rsquo;money in the bank&rsquo;&rsquo;, whereas the haemoglobin represents the cash in your wallet. You might have fifty bucks in your wallet, but if that&rsquo;s all the money you have in the world, you wouldn&rsquo;t exactly call yourself flush with funds. On the other hand, if you have $50 in your wallet and a few thousand in the bank, you&rsquo;ve got a bit of a buffer for if an unexpected bill comes along. Your iron stores, represented by the &lsquo;&rsquo;ferritin&rsquo;&rsquo; level on a full iron studies test, gives you an idea how much buffer you&rsquo;ve got in your overall iron status. If you&rsquo;ve got enough to see you through the day, but throw in an unexpectedly hectic visit from relatives, you might find you&rsquo;re feeling really drained&hellip;because you didn&rsquo;t have any stores to back you up.</p> <p>So if you are exhausted, fatigued, and have <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/in-search-of-that-elusive-libido">low libido</a>, finding out your iron stores is essential. Your haemoglobin can look fine on a full blood count, but your ferritin can show up low in full iron studies.</p> <p>But there&rsquo;s more&hellip;new research confirms what I see in clinical practice all the time: just because your ferritin is in the &lsquo;&rsquo;normal range&rsquo;&rsquo;, doesn&rsquo;t mean it&rsquo;s high enough to not be causing fatigue. A 2012 study looked at menstruating women with ferritin below 50ug, who did not have anaemia. They were divided into two groups: one received 80mg/day of iron (the dose often used in anaemia) and the other received a placebo tablet. Surprise, surprise! The iron group resulted in the reported fatigue being cut in half. So, don&rsquo;t rule out low iron causing your fatigue, just because you&rsquo;ve been told you don&rsquo;t have anaemia.</p> <p>To help interpret your iron results, book an appointment now at Equilibria.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> A Draining Problem: Heavy Periods http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-draining-problem-heavy-periods <h2>Anyone who experiences heavy menstrual periods knows how draining this can be.</h2> <p>Heavy bleeding, sometimes known as menorrhagia, is present in at least 15% of women.&nbsp; Amazingly, most women just accept it as part of being a woman, and never do anything about it.</p> <h2>Were you put on the Pill for this?</h2> <p>The number of women who were &lsquo;&rsquo;put on the Pill&rsquo;&rsquo; as young girls due to &lsquo;&rsquo;heavy periods&rsquo;&rsquo;- 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&rsquo;s own natural hormonal cycles, any effect it has on reducing the heaviness of your periods is purely a &lsquo;&rsquo;Band-Aid effect&rsquo;&rsquo;. This is not to say that there is not a time and place for it! Unfortunately, however, it is used as a &lsquo;&rsquo;knee-jerk&rsquo;&rsquo; 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&rsquo;s always important to have it investigated medically.</p> <h2>Just some of the potential causes of heavy bleeding include the following:</h2> <ul> <li>Growths, either benign or cancerous;</li> <li><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=25">Endometriosis</a>;</li> <li>Clotting disorders, such as von Willebrand&rsquo;s diseae;</li> <li>Medications;</li> <li>Thyroid dysfunction</li> </ul> <p>Guess what two of the effects of heavy periods can be?</p> <p>The first is easy - <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/exhausted-fatigued-anaemic-any-truth-to-the-low-iron-cliche">low iron</a> (from all that blood loss). This can cause countless problems including <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/exhausted-fatigued-anaemic-any-truth-to-the-low-iron-cliche">exhaustion.</a> The second is cruel: more heavy periods. This is because low iron itself can promote heavy periods! What a crazy vicious cycle.</p> <h2>Endometriosis deserves a special mention here.</h2> <p>Diagnosis of <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=25">endometriosis </a>can only occur via a surgical procedure. However, you may wish to <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=26">fill out this quick self-test</a> to see what your chances of having endometriosis might be.</p> <h2>Take care with treatment.</h2> <p>Treatment &ndash; whether you choose conventional medical, natural therapies, or a combination &ndash; should ALWAYS depend on the likely cause, so be wary of anyone &ndash; doctor or otherwise &ndash; who tries to institute a treatment without having tried to determine the likely cause.</p> <p>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 <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=90">Billings Ovulation Method</a> is a great technique for gaining insight into your reproductive health. This is also terrific if you are aiming to get off the Pill.</p> <p>For a systematic method of approaching and helping heavy periods, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21">get in touch with us at Equilibria</a>.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Protect Your Baby from Allergy http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/protect-your-baby-from-allergy <h2>It&rsquo;s something every mother-to-be dreads:</h2> <p>The idea of inadvertently passing on to your unborn baby something you&rsquo;d rather spare them from, whether it&rsquo;s your tendency to depression, your asthma or your food allergies.</p> <p>Well, there&rsquo;s good news: the science of epigenetics is revealing more every day about the positive influence we can have on our unborn babies.</p> <p>Epigenetics is the science of how environmental factors act on genes, and influence whether the genes you pass on to your baby are expressed (&lsquo;&rsquo;acted out&rsquo;&rsquo;) or not.</p> <p>Are you a bit of an &lsquo;&rsquo;allergy ball&rsquo;&rsquo;? New research suggests you can reduce the risk that bub will grow up with the same problems you&rsquo;ve had.</p> <p>This study showed it was possible to reduce likelihood of eczema by 36%, and egg allergy by 38%.</p> <p>And how did they do it?</p> <p>Simple. They gave pregnant mums 800mg DHA and 100mg EPA from week 21 of pregnancy until the baby was born. The babies were assessed at one year of age. (The group who got the placebo tablet did not receive the same benefits for their babies).</p> <p>So simple &ndash; why wouldn&rsquo;t you do it? It&rsquo;s so easy to take fish oils during pregnancy. It&rsquo;s important, though, to take the quantities that were used in this study.</p> <p>It&rsquo;s also important to make sure any fish oil you take is not contaminated with mercury. For more information about how to find the right fish oil, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21">contact us now.</a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> A Pain Up the Backside: Proctalgia Fugax Explained http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-pain-up-the-backside-proctalgia-fugax-explained <h2>&lsquo;&rsquo;A knife-like pain in the rectum&rsquo;&rsquo;...</h2> <h2>&rsquo;&rsquo;A red-hot poker up the bum&rsquo;&rsquo;&hellip;</h2> <h2>&rsquo;&rsquo;A feeling of being stabbed in the anus, which takes my breath away&rsquo;&rsquo;&hellip;</h2> <p>These are just some of the descriptions that my patients suffering from <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=40">proctalgia fugax</a> give.</p> <p>Somewhat surprisingly for something so unpleasant, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=40">proctalgia fugax</a> has a pretty straightforward cause.</p> <p>It&rsquo;s simply a matter of the anal muscles (part of the pelvic floor muscles) going into sudden spasm. In that way it is very similar to a leg cramp, foot cramp or toe cramp that you might get in bed at night. Not so coincidentally, this is often when episodes of <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=40">proctalgia fugax</a> occur &ndash; at night. Sufferers are often sleeping soundly before they are suddenly woken by an intense pain in the rectum, where all they can do is lie completely still and attempt to breathe while they wait for it to subside. Pain relief rarely helps. It&rsquo;s simply a matter of waiting until the spasm relaxes. This may take a few seconds or minutes, or up to two hours.</p> <p>However, night is by no means the only time that <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=40">proctalgia fugax</a> episodes occur. It is very common to be suddenly gripped by a painful spasm while going about your daily business.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=40">Proctalgia fugax</a> occurs because the external anal sphincter muscle, which surrounds the anus like an elastic ring or short tube, is &lsquo;&rsquo;overactive&rsquo;&rsquo;. It may be that you pull in the muscle unknowingly during the day, such as when you are stressed or emotional, and the fibres of the muscle shorten. When magnesium levels drop, as they do at night, you become prone to any sort of muscle cramp or spasm &ndash; including <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=40">proctalgia fugax</a>. It is common for proctalgia fugax to occur in people who are also prone to <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=39">anal fissures</a>, constipation, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=71">tailbone pain</a>, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=12">irritable bowel syndrome</a>,&nbsp;<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=20"> chronic pelvic pain</a> and <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=78">painful sex.</a> (At Equilibria, we not only treat the <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=40">proctalgia fugax</a>, but explain the links with these other conditions and treat them as well.)</p> <p>Many people experience a one-off episode of <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=40">proctalgia fugax</a> in their life. Because it is so distressing, if it happens more than once within the space of a few months, it should really be treated &ndash; especially because it is usually exceptionally easy to treat. Treatment involves gentle stretching of the muscles, either via the vagina or anus. Sometimes malalignment in the sacro-iliac joints is contributing and treatment dramatically reduces tendency for attacks to return.</p> <p>Additionally, magnesium can not only help the muscles &lsquo;&rsquo;normalise their behaviour&rsquo;&rsquo;, but the right form of magnesium taken at the time of an attack can often get rid of the pain almost immediately. (interestingly, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=69">magnesium issues can also be related to bladder problems</a>).</p> <p>Recognise these symptoms? Get in touch with us today for rapid and successful treatment.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Epigenetics and Chronic Pain http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/epigenetics-and-chronic-pain-nutrition <h2>How targeted nutrition can affect your pain experience</h2> <p>Epigenetics: it&rsquo;s a bit of a buzzword floating around at the moment, but what does it actually mean?</p> <p>Epigenetics is the study of how environmental factors influence what genes your body &lsquo;&rsquo;decides to express&rsquo;&rsquo;. We all know about our genes &ndash; in fact we often resign ourselves to a medical condition or symptom because it&rsquo;s &lsquo;&rsquo;in our genes&rsquo;&rsquo;. However, it&rsquo;s also the case that you can have the gene for something but not get the disease. This is because of epigenetics &ndash; the way our environmental influences affect our gene expression.</p> <p>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 <em>in utero</em> (that is, as a baby in the womb), and don&rsquo;t stop as long as you are still breathing!</p> <p>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 &lsquo;&rsquo;methylation status&rsquo;&rsquo; greatly affects your likelihood of developing certain conditions that may be &lsquo;&rsquo;in your genes&rsquo;&rsquo;, 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.</p> <p>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).&nbsp; How does epigenetics affect whether your pain will hang around and turn ugly?</p> <p>Here are three mechanisms whereby improving your epigenetics (such as via nutrition) can reduce the transition of acute pain to chronic pain:</p> <ul> <li>By altering your sensitivity to opioids, your natural pain-relieving chemicals</li> <li>By altering the production of inflammatory chemicals, called &lsquo;&rsquo;cytokines&rsquo;&rsquo;</li> <li>By altering how responsive your cells are to steroids (important hormones, such as vitamin D &ndash; so there&rsquo;s a clear nutritional lead already!)</li> </ul> <p>As a physiotherapist and nutrition medicine practitioner immersed in chronic pain, I treat people every day with <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=20">chronic pelvic pain</a> 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&rsquo;s personal stories.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Should You Take That Pain Medication? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/should-you-take-that-pain-medication <h2>People with chronic pain are caught between a rock and a hard place.</h2> <p>On the one hand, they may not be that keen to take strong medications; on the other hand, just trying to get through the day can be a major challenge without having something to help them. And if the doctor prescribed it, surely that means it&rsquo;s okay&hellip;?</p> <p>A 2012 study looked at the prescribing habits of Australian GPs.&nbsp; It studied the way GPs prescribe opioids, a strong class of pain relievers including morphine, Endone and others, in people with &lsquo;&rsquo;chronic non-malignant pain&rsquo;&rsquo; (that is, people with chronic pain who don&rsquo;t have cancer &ndash; cancer patients are a special group that need to be considered separately).</p> <p>It showed that in the previous fortnight, GPs had prescribed long-term opioids for an average of 7 patients. They tended to follow guidelines on avoiding high-dosage or fast-acting drugs.</p> <p>However, they were less likely to follow guidelines on strictly minimising individual and public harm, such as initiating the use of these strong drugs on a trial basis. 30% of GPs followed most guidelines for prescribing opioids.</p> <p>Strong drugs have an important place in the lives of many people with chronic pain. Making sure you are getting the best outcome possible, though, is important. Has your doctor referred you to a physiotherapist experienced in chronic pain management? Has your medication regime been carefully examined? Make sure you know and are comfortable with the answers.</p> <p>At Equilibria our expertise is in chronic pain affecting the vulva, vagina, bladder, bowel, gut and pelvis. Among others, this includes the rehabilitation of vulvodynia, vestibulodynia, interstitial cystitis, menstrual pain and irritable bowel syndrome. Contact us if you need help.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Coffee - could it be good for you after all? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/coffee-could-it-be-good-for-you-after-all <h2 class="MsoNormal">You love your coffee. You&rsquo;ve never wanted to believe that it&rsquo;s bad for your bladder, bad for your arteries, and a crutch allowing you to work too hard.</h2> <p class="MsoNormal">So it&rsquo;s been great to hear the good news stories about coffee being good for you after all...but can we trust them?</p> <p class="MsoNormal">I owe the blog post idea to a friend who reported with delight that he&rsquo;d heard from an expert on the radio that due to its health benefits, coffee should be drunk at a rate of six cups a day. As someone who quit coffee at age 16, and counsels women regularly to give it up for the sake of their <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=61">overactive bladder</a>, I agreed with him that this was worth some investigation.</p> <p class="MsoNormal">A 2008 study of 30 000 people showed that 6 cups of coffee per day is not linked with increased deaths. Still, knowing that statistically, death is no more likely if I indulge in coffee is not quite enough to convince me to take up the habit. You could say the same about nose-picking.</p> <p class="MsoNormal">Unexpectedly, some studies have found a link between coffee consumption and reduced stroke risk (but not if you are not already a regular coffee drinker). Others showed a less risk of developing Alzheimer&rsquo;s and Parkinson&rsquo;s disease with coffee drinking. And even more startling, drinking more than 6 or 7 cups a day reduced diabetes risk.</p> <p class="MsoNormal">So, there&rsquo;s no denying there seem to be some positive links between coffee and your health. However, the important thing to remember is that these are associations only &ndash; and an association is not the same as a cause-effect relationship.</p> <p class="MsoNormal">It&rsquo;s important not to oversimplify these findings. One theory about the effect on diabetes risk was that coffee contains magnesium, which is important for insulin regulation. This is an oversimplification. In reality, coffee is a diuretic, and by producing more urine, it results in increased loss of magnesium from the body. So if coffee does actually cause positive change (and remember, we can&rsquo;t prove cause, only association), it isn&rsquo;t because of this.(And by the way, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=69">magnesium has positive effects on your bladder</a>).</p> <p class="MsoNormal">Over-focusing on these findings also tends to make us ignore the big picture. It makes scenarios like these possible:</p> <ul> <li>Despite the fact I have an enormous amount of visceral (abdominal) fat, I believe that drinking coffee will prevent me getting diabetes</li> </ul> <ul> <li>I reach for that seventh cup of coffee because the scientists are telling me it&rsquo;ll reduce my diabetes risk, but meanwhile, I increase my risk of bladder cancer and possibly osteoporosis</li> </ul> <ul> <li>I deny any harm of my coffee habit &ndash; despite the fact I never have a coffee without a cigarette</li> </ul> <p class="MsoNormal">It also focuses on serious diseases at the expense of general well-being and quality-of-life issues. For example, drinking coffee:</p> <ul> <li>Increases the excretion or blocks the uptake of numerous essential minerals, such as iron, calcium, zinc and magnesium</li> </ul> <ul> <li>Can reduce the quality of your sleep</li> </ul> <ul> <li>Makes you pee more often, and for some, can make it harder to get to the toilet without leaking</li> </ul> <ul> <li>Stimulates the bowel in some (but not all) people, which could be a good or a bad thing, depending on whether you tend towards diarrhoea or constipation (but is definitely not good if you experience any level of <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=65">accidental bowel leakage</a>)</li> </ul> <p class="MsoNormal">Still, a scan of the research literature about coffee proves surprising. There seems to be no link with gout, and no link with <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=11">bladder pain syndrome/interstitial cystitis</a>. Even when it comes to your bladder control &ndash; incontinence and overactive bladder &ndash; there is not very convincing research evidence to convict coffee.</p> <h3 class="MsoNormal">What&rsquo;s the take-home message?</h3> <p class="MsoNormal">It seems that coffee is not necessarily the demon it is made out to be. It definitely improves your short-term mental performance, and is related in some way to a reduce risk of certain diseases (though we can&rsquo;t say it directly causes this).</p> <p class="MsoNormal">Having said that, research evidence looks at trends in a large population group. It is not the same as discerning an effect for yourself. That&rsquo;s why I do suggest to all my <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=61">overactive bladder</a> patients that they have a caffeine-free trial. Many of them notice no difference whatsoever when they cut out coffee. Others notice a startling improvement, which drastically improves their quality of life, and <span>&nbsp;</span>makes it all worthwhile.</p> <p class="MsoNormal">This just shows that reporting of research, while essential, does not account for individual variations. Where there&rsquo;s no risk involved, it&rsquo;s always smart to test out the hypothesis on yourself. Feel better after a week off coffee? <span>&nbsp;</span>Bladder problems disappear when you lose the coffee? Great. Cut it out. The proof is in the pudding.</p> <p class="MsoNormal"><span>&nbsp;</span>If you don&rsquo;t see the benefits from losing the coffee, then don&rsquo;t feel guilty about your coffee drinking. But be realistic. You&rsquo;ll know if you&rsquo;re using it as a crutch or if it&rsquo;s linked with other poor health habits like reaching for a cigarette, eating too many biscuits, working too hard or being a couch potato. And please, if you do love your coffee, think about taking magnesium and zinc supplements to make up for your losses.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Chronic Pelvic Pain - some media coverage at last! http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/chronic-pelvic-pain-media-coverage-abc-health-matters <h2>ABC radio&rsquo;s Health Matters show yesterday covered one of the most overlooked health problems in Australia: <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=20">chronic pelvic pain</a>.</h2> <p>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.</p> <p>Despite the fact that everyone&rsquo;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&rsquo;re crazy, malingering or exaggerating. The tendency to diagnose depression or anxiety when the symptoms don&rsquo;t perfectly add up. The complete lack of awareness in a large majority of (otherwise capable) health professionals.</p> <p>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:</p> <ul> <li>The constant burning pain</li> <li>Being unable to sit down or find a comfortable position</li> <li>The feeling of &lsquo;&rsquo;little cuts all over the vulva&rsquo;&rsquo;</li> <li>The &lsquo;&rsquo;red hot poker up the backside&rsquo;&rsquo; feeling</li> </ul> <p>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</p> <h3>&lsquo;&rsquo;Why did it take me so long to find you?&rsquo;&rsquo;</h3> <p>My patients have typically seen ten or more health professionals before me who either</p> <ul> <li>Didn&rsquo;t take the problem seriously</li> <li>Didn&rsquo;t recognise the symptoms</li> <li>Didn&rsquo;t refer appropriately</li> <li>Wrote the symptoms off as caused by depression, anxiety, or a lack of sex life</li> <li>Did not seem to care, and even seemed skeptical</li> </ul> <p>It is a relief for people to finally find someone who understands <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=20">chronic pelvic pain</a>. To be frank, health professionals who really &lsquo;&rsquo;get it&rsquo;&rsquo; 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 &ndash; so we know the people you need to see for the essential multi-disciplinary approach.</p> <p>An important point raised during the broadcast as well as from listeners&rsquo; e-mails is that pelvic pain can have important identifiable medical causes, such as fractures and cancer.</p> <p>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 <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=20">chronic pelvic pain</a>.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=20">Chronic pelvic pain</a> has many subtypes, some of which are diagnoses in themselves. There are also concepts that anyone with<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=20"> chronic pelvic pain</a> will want to understand. You may want to investigate the following:</p> <ul> <li><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=56">Vulvodynia and vestibulodynia</a></li> <li><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=40">Proctalgia fugax</a></li> <li><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=11">Painful Bladder Syndrome/Bladder Pain Syndrome/Interstitial Cystitis</a></li> <li><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=49">Central sensitisation</a></li> <li><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=50">Neurogenic inflammation</a></li> <li><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=95">Pudendal neuralgia and pudendal nerve entrapment</a></li> <li><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=23">Surgical adhesion-related pain</a></li> <li><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=12">Irritable bowel syndrome</a></li> <li><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=24">Coccydynia or tailbone pain</a></li> </ul> <p>All of these are conditions I have successfully treated here at Equilibria for the past eight years.</p> <p>I&rsquo;m not sure how long the broadcast will be available for download, but it is thoroughly recommended listening.</p> <p>Go to:</p> <p><a href="http://www.abc.net.au/radionational/programs/lifematters/pelvic-pain/4502250#comments">http://www.abc.net.au/radionational/programs/lifematters/pelvic-pain/4502250#comments</a></p> <p>&nbsp;If you are suffering from chronic pelvic pain, come in and get some help.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Butterflies, ulcers and the irritable bowel http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/butterflies-ulcers-and-the-irritable-bowel <h2>Why stress is so bad for your gut</h2> <p>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 &ndash; 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&rsquo;t forget about stress!</p> <h3>So what are some of the negative effects of stress on your gut?</h3> <p>The concept of the &lsquo;&rsquo;brain-gut axis&rsquo;&rsquo; 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 &ndash; more than in the spinal cord. This is sometimes known as the &lsquo;&rsquo;gut mini-brain&rsquo;&rsquo; or the &lsquo;&rsquo;second brain&rsquo;&rsquo;. This &lsquo;&rsquo;second brain&rsquo;&rsquo; can initiate and perpetuate many of these effects itself &ndash; which is what makes gut function so complex</p> <h3>Some of the effects of stress on your gut are:</h3> <h4>1)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; changes in gastrointestinal motility</h4> <p>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.</p> <h4>2)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; increase in visceral perception</h4> <p>This means that stress makes you more sensitive. It makes you feel every little movement and every little sensation more strongly than normal.</p> <h4>3)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; changes in gastrointestinal secretion</h4> <p>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.</p> <h4>4)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; increase in intestinal permeability</h4> <p>Increased permeability of the intestinal wall is colloquially known as &lsquo;&rsquo;leaky gut&rsquo;&rsquo;, 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.</p> <h4>5)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; negative effects on regenerative capacity of gastrointestinal mucosa and mucosal blood flow</h4> <p>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.</p> <h4>6)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; negative effects on intestinal microbiota.</h4> <p>Intestinal flora, or the &lsquo;&rsquo;good bugs&rsquo;&rsquo; that keep your gut healthy, &nbsp;get (deservedly) quite a lot of press. Stress depletes these &lsquo;&rsquo;good bugs&rsquo;&rsquo; within hours.</p> <h4>7)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Immune effects</h4> <p>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.</p> <p>Does all this sound like <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=12">irritable bowel syndrome</a> (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.</p> I don&rsquo;t want to imply that IBS, or other gut issues, are &lsquo;&rsquo;all in the mind&rsquo;&rsquo;. 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&hellip;well, literally irritable! <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Accidental Bowel Leakage: What You Need to Know http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/accidental-bowel-leakage-what-you-need-to-know <h2>It&rsquo;s one of the worst feelings there is: the sense you&rsquo;re going to lose control of the bowels.</h2> <h3>And if <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=65">accidental bowel leakage</a> actually occurs, it can feel like the worst calamity.</h3> <p>It&rsquo;s human nature for this to be one of the worst fears. Control of our bodily functions is integral to our sense of dignity as adults. Loss of control brings with it the potential for deep shame and can make us feel either childlike (like before we developed control) or as though we are &ldquo;old and worn-out&rdquo; (which we dread, no matter what our age). And if loss of bladder control can feel disastrous, loss of control of the bowels is that much worse.</p> <h3>Accidental bowel leakage is often known as &ldquo;<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=65">faecal incontinence</a>&rdquo;.</h3> <p>If you have this problem, then giving it this label probably makes it even worse. It conjures up the most extreme possible images. In actual fact,<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=65"> accidental bowel leakage</a> is a spectrum from the &ldquo;barely there&rdquo; mark or stain on the underwear, to the &ldquo;worst case scenario&rdquo; of loss of a full bowel motion in a public place. It can occur with urge (you needed to go but couldn&rsquo;t get there in time) or with physical exertion (such as squatting or sneezing). It can occur with no sensation whatsoever &ndash; you go to the toilet and notice a mark on your underwear, having no idea it occurred. It can be so slight that there is not even a sign on the underwear &ndash; but you feel that awful sense that something is coming out, and when you go to the toilet, there is something to wipe away. <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=65">Accidental bowel leakage</a> also covers the problem of passing wind without meaning to, or when trying not to. This commonly occurs when bending over, squatting, or moving from sitting to standing, but can also occur with coughing, sneezing or even laughing (which has a way of immediately wiping the smile off your face).</p> <p>Overall, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=65">accidental bowel leakage</a> can appear in a variety of ways, and can be socially devastating &ndash; even if it is simply the fear and dread that it is going to happen. It can affect your life in so many ways. One young man I saw was a mechanic in the army and had to keep leaving his work to go to the toilet. His problem had occurred after <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=32">haemorrhoid</a> surgery. Another young girl who had severe bowel urgency while in hospital with a stomach problem went on to develop a <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=9">chronic pelvic pain</a> syndrome because she was &ldquo;hanging on so tight&rdquo; for fear of leakage. I have seen several people with full loss of bowel control from the effects of radiation for cancer. It can even occur in association with <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=12">irritable bowel syndrome</a>. And postnatally, loss of bowel control is cruelly prevalent, especially after injury to the anal sphincter, as in a third-degree tear or episiotomy.</p> <p>Despite its devastating impact, research from last year showed that more than two-thirds of women with <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=65">accidental bowel leakage</a> do not seek help for it. Considering that this is treatable and often curable, this seems to me to be the real tragedy.</p> <p>Watch this space for an upcoming blog post describing what can often be a simple solution for accidental bowel leakage.</p> <p>If you are concerned about an issue you might have with your bowel, send me a <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21">confidential e-mail</a> for advice.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Polycystic Ovarian Syndrome, or Just Polycystic Ovaries? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/difference-between-polycystic-ovarian-syndrome-and-polycystic-ovaries <h2>Is it possible to have polycystic ovaries and not have Polycystic Ovarian Syndrome (PCOS)?</h2> <h2>And conversely, is it possible to have Polycystic Ovarian Syndrome, but no sign of polycystic ovaries?</h2> <h3>As you may have guessed, (as there needs to be a point to writing this blog post), the answer to both these questions is YES.</h3> <p>If you have a pelvic ultrasound and you are told you have polycystic ovaries from the images they can see, this in no way confirms that you have the condition known as Polycystic Ovarian Syndrome (PCOS).</p> <p>And likewise, you can well and truly have PCOS, even if the scan does not show up multiple cysts on your ovaries.</p> <h3>So what does it all mean? Are you supposed to have cysts on your ovaries, or not?</h3> <p>If you are of menstruating age and ovulating, the ovum (or egg) is produced from what is called &ldquo;the dominant follicle&rdquo; on the ovary. One follicle has to &ldquo;win the race&rdquo; to result in ovulation. If several follicles grow at the same rate, none of them win the race, and therefore ovulation does not occur. It is as though the system has &ldquo;stalled&rdquo; or &ldquo;got stuck&rdquo;. The appearance of the ovary will be of multiple cysts (i.e. polycystic ovaries). This can occur in any woman (including young teenagers) when ovulation is not occurring. So polycystic ovaries is a much broader situation than the specific &ldquo;Polycystic Ovarian Syndrome&rdquo; or PCOS</p> <h3>So what is PCOS exactly?</h3> <p>PCOS is a complex metabolic disorder involving hyperandrogenism (too much &ldquo;male hormone&rdquo; activity) and ovulatory dysfunction (i.e. not ovulating regularly), and an increased risk of insulin resistance. There is often (but not always!) overweight or obesity, and reduction in body fat is one of the most important ways of managing this genetic disorder. PCOS can neither be diagnosed by ultrasound alone, nor is it automatically ruled out if your ultrasound is clear!</p> <h3>And what can you do for PCOS?</h3> <p>Once a diagnosis of PCOS is established, nutritional therapies, lifestyle therapies and specific herbal medicines can play an important role in management. Herbal medicines should only be prescribed (and supervised) by a qualified herbalist.</p> <p>To find out more, or to tell us about your situation,&nbsp; contact us at Equilibria.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Fertility: Not So Sweet After All http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/fertility-low-carbohydrate-high-protein-diet <h2>The positive effect of low-carbohydrate eating on infertility</h2> <p>Recent research confirms what common sense should tell us. Too much sugar or carbohydrate is not good for our health overall, so it&rsquo;s no surprise it&rsquo;s no good for our fertility either.</p> <p>The study from the recent conference of the American Congress of Obsetricians and Gynecologists showed that a low-carbohydrate diet improved pregnancy and birth rates with women undergoing IVF.</p> <p>The 36 and 37-year-old women in the study had their diets analysed, and were divided into two groups: those whose diet was more than 25% protein, and less than 25% protein. By definition, these diets are lower-carbohydrate and higher-carbohydrate respectively.</p> <p>The higher protein (lower carbohydrate) women had double the pregnancy rates and five times the live birth rates. It was found that this was due to better development of the blastocyst (the early stage of development in pregnancy).</p> <p>Previous studies had a similar finding in women with and without polycystic ovarian syndrome. The lower-carbohydrate diet was more beneficial, despite the fact that the women did not have diabetes.</p> <p>This tells us a lot: not just about how to increase chances of pregnancy in infertility, but about what kind of diet is related to good health and development from the earliest age.</p> <p>For help with establishing a healthy lower carbohydrate, higher protein diet, contact us at Equilibria.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Recovery From Vulvodynia: Share What Has Helped You http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/recovery-from-vulvodynia-share-what-has-helped-you <p>When you've lived through something as difficult as vulvodynia, your heart goes out to others experiencing the same.</p> <p>Your insights on what helped (or helps) you can really help other women. In fact, as much as I believe a good team of health professionals is essential in recovery from vulvodynia, there is equally no subsitute from the help and support of others who have been there.</p> <p>I would be grateful to hear about what helped you so that I can include some of these insights in a book designed to help women recover from vulvodynia.</p> <p>I am interested less in particular techniques or therapies (much as I hope my own techniques have played an important role for you!) and more interested in what thoughts, concepts, paradigm shifts and approaches have been key in turning things around for you.</p> <p>Please feel free to submit comments below, or contact me directly (with assurance of confidentiality) at alyssatait@equilibriahealth.com.au (please copy and paste the e-mail address)</p> <p>I will take the submission of your comments as tacit permission for possible inclusion (anonymously) in a future book about vulvodynia.</p> <p>With thanks!</p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Coeliac Disease: could you spot this in your child? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/coeliac-disease-how-to-identify-this-in-children <h2>Up to one in one hundred people have coeliac disease. The problem is, most of these don&rsquo;t know it.</h2> <p>What signs would alert you to this in your child, or the children you treat?</p> <p>A 2013 study suggests the common symptoms of coeliac disease depend on the age of the child.</p> <p>Kids younger than six with coeliac disease are most likely to have diarrhoea and failure to thrive (that is, be small for age, short and skinny, with poor growth).</p> <p>Kids older than six with coeliac disease are more likely to have the same symptoms an adult with coeliac disease would: &ldquo;irritable bowel&rdquo; symptoms. Abdominal pain and nausea are two of the key symptoms here. This is interesting, as nausea is not often thought of as a symptom of coeliac disease.</p> <p>Abdominal pain was the most common symptom, being present in more than 50% of the sample of kids who were diagnosed with coeliac disease. It&rsquo;s interesting to note than only just over a quarter of the kids had the symptom of diarrhoea, which people often mistakenly think of as the key symptom of coeliac disease.&nbsp; In fact, in the seven-to-thirteen age group, there was actually constipation in over 10%, and in the under-sixes, it was present in almost a quarter. This makes it clear that we should not forget about the possibility of coeliac disease in our paediatric patients with constipation!</p> <p>Big tummies are also the other thing to look out for, especially in the under-sixes, one-third of whom had abdominal distension.</p> <p>One final note was that in this group, approximately 13% of them were IgA deficient. Note well: this means that a blood screen for coeliac disease will produce a false negative in these kids. In other words, the (correct) diagnosis of coeliac disease will be missed! This is because the standard blood tests for coeliac disease (transglutaminase antibody and IgA antigliadin) both are IgA-based. They rely on normal amounts of IgA being present in the serum. If there is IgA deficiency, the individual will not test positive to coeliac disease on blood tests even when they have it.</p> <p>Finally, coeliac disease is hard to diagnose in the under-fours. This is because until four years of age, coeliac serum testing is unreliable. So don&rsquo;t assume that if your four-year old patient had a negative test for coeliac disease a year ago, she is clear of the disease. If you suspect it&rsquo;s a possibility, make sure you refer appropriately for testing.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Pelvic Pain, Vulvodynia and the Link with Chemical Contraception http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/pelvic-pain-vulvodynia-and-the-link-with-chemical-contraception <h2>A Bitter Pill to Swallow?</h2> <p>There&rsquo;s been research on the link between the birth control Pill or Oral Contraceptive Pill (OCP) and <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=56">vulvodynia</a> going on for a little while. So what&rsquo;s the story? Let me take you through a brief history.</p> <p>A study in 2008 found a 30% risk of vulvodynia in OCP-takers (a risk that was highest among those that started the Pill before age 18. However, this was not statistically significant, which means, in essence, there&rsquo;s a strong chance it could have been caused by chance!</p> <p>In 2010, a case study was presented of a woman who developed <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=56">vestibulodynia</a> once on the OCP, and whose symptoms resolved completely once she stopped the OCP. While this is interesting &ndash; and provided ground for further research &ndash; a study of a single person is not very convincing of what happens &rdquo;en masse&rdquo;.</p> <p>Then, in 2012, a review found that the OCP can have negative effects on various aspects of a woman&rsquo;s sexuality. Some of the things they looked at included libido and <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ten-reasons-why-sex-hurts">painful intercourse</a>.</p> <p>In summary, the research hasn&rsquo;t been very conclusive &ndash; while those of us in clinical practice working with <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=56">vulvodynia</a> became more convinced there could be a link.</p> <p>Hot off the press is a study presented at the American Urological Association conference in 2013. It has found that the low-dose contraceptive Pill (i.e. the type commonly taken) can increase the risk of pelvic pain, including <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ten-reasons-why-sex-hurts">pain with intercourse</a>.</p> <p>The hypothesis of the researchers was that the OCP could possibly lead to vulvodynia via its effects on serum estradiol (estrogen), free testosterone levels, hormonal receptors, and vulvar mucosa. There were 957 women in the study (a lot more than the 177 women in the 2008 study cited above). They put these women into three groups:</p> <p>-did not use the OCP (&ldquo;nonusers&rdquo;)</p> <p>-used the &ldquo;low-dose&rdquo; OCP, 20ug ethinyl estradiol or less</p> <p>-used the &ldquo;normal-dose&rdquo; OCP, more than 20ug ethinyl estradiol</p> <p>Low-dose users were significantly more likely to meet the criteria for a diagnosis of chronic pelvic pain than nonusers. Twice as many low-dose users than nonusers reported pain during orgasm (25% vs 12%).</p> <p>Because the high-dose users were not more likely than nonusers to have chronic pelvic pain or pain during orgasm, the investigators suggested that women with pain could be put on a higher-dose Pill. That certainly warrants consideration. So does reconsidering whether the Pill is the right contraception for you if you have problems with pelvic pain or vulvodynia. One study in 2012 found an increased pain sensitivity in women on the Pill who had a certain genetic make-up. This possibility is also currently being explored by<a href="http://www.cvvd.org/home"> Dr Andrew Goldstein</a>, one of the world&rsquo;s foremost clinicians dealing with vulvodynia.</p> <p>For now, it seems that taking the OCP for contraception should not be treated as a decision to be taken lightly, especially if you have persistent pelvic pain &ndash; and especially if it came on after you started the Pill.</p> <p>If you are wondering whether you could have vulvodynia, but haven't had a diagnosis yet, try my short <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=28">Vulvodynia Self-Test.</a></p> <p>&nbsp;</p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Nutrients in Chronic Pain http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/nutrients-and-chronic-pain <h2>Part 1: Magnesium</h2> <p>Chronic pain is complex; no one can deny that. Anyone who is experiencing chronic pain can think of their pain as a giant puzzle. There are many pieces that make up the picture, and an often-overlooked piece is the nutrition piece. Nutrients, which trigger certain (normal) physiological functions, are one part of this nutrition piece, and magnesium is a single one of these numerous nutrients that play a role in the process of persistent pain.</p> <p>What is the role of magnesium in the body? Magnesium is a cation that plays numerous roles in various body compartments.</p> <p>It helps maintain the internal &ldquo;balance&rdquo; (homeostasis) within the cell, so is imperative in cellular function. Magnesium has a &ldquo;calcium channel blocking&rdquo; action.</p> <p>It is present in high amounts in the extracellular compartments, influencing excitability of nerves and nerve conduction. It has a role in skeletal, smooth and cardiac muscle function.</p> <p>It is a cofactor for many enzymes, including those involved in the production of brain and gut neurotransmitters, thus influencing both gut and brain function.</p> <p>Magnesium seems to be linked to various pain disorders and has some potential to help them:</p> <p>One study showed a statistically significant link between low serum magnesium levels and myofascial pain syndrome. A 2012 study showed that magnesium supplementation helped to prevent migraine. Magnesium reduced pain in primary <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=14">dysmenorrhea</a> in a 1992 study. Furthermore, a 2007 systematic review of randomised trials found evidence for decreased postoperative analgesic requirements when magnesium was given.</p> <p>Is there any evidence for the efficacy of magnesium administration in chronic or persistent pain?</p> <p>One study showed that giving magnesium before surgery could help reduce both muscle fasciculations (twitching or spasms) and myalgia (muscle pain) experienced post-operatively.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=49">Central sensitisation</a> is a key process underlying chronic or persistent pain. An experiment was done with rats, whereby a drug called fentanyl was administered to produce delayed hyperalgesia (a sort of &ldquo;exaggerated pain&rdquo;). This was to try to create an animal model of <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=49">central sensitisation</a>.&nbsp; Administering magnesium to the rats partially offset this process, resulting in less pain.</p> <p>In chronic pain, we know there is abnormal processing of sensation. This is part of the &ldquo;syndrome&rdquo;, if you like, that is chronic pain (regardless of where in the body you feel it). Certain receptors called the NMDA (N-methyl-D-aspartate) are involved as &ldquo;gates&rdquo; that help process this sensation. Activation of the NMDA receptor leads to abnormal processing of sensation &ndash; therefore increased pain. This effect &ndash; part of what is known as &ldquo;<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=49">central sensitisation</a>&rdquo; &ndash; has effects in the spinal cord, in an area called the dorsal horn, as well as in the brain itself. Magnesium is involved in blocking the NMDA receptor, so that process cannot take place.&nbsp; This was shown in an experiment with rats with in whom neuropathic pain was induced. The rats developed something called &ldquo;allodynia&rdquo; (where a stimulus that is not usually painful becomes painful) and mechanical hypersensitivity (where touch or pressure feels oversensitive). Giving magnesium to the rats &ldquo;fixed&rdquo; the allodynia (i.e. made them not feel this abnormal pain to normal stimulus) and delayed the onset of mechanical hypersensitivity, and stopped the change that takes place at the dorsal horn of the spinal cord. Hyperalgesia and allodynia are two aspects of the pain experience that we test in women who have vulvodynia and similar pelvic pain conditions. This makes these findings especially interesting to anyone experiencing these conditions.</p> <p>Another group of rats was subjected to treatment that creates hyperalgesia. In this experiment, opioid agonists were used to try to resolve the pain (drugs like morphine). The morphine didn&rsquo;t work &ndash; except when the group of rats were given magnesium first, which enhanced the analgesic effect of the morphine. Morphine works in the brain &ndash; so it seems that magnesium helps the &ldquo;brain side&rdquo; of chronic pain.</p> <p>Finally, a 2013 study gives us some nice findings on magnesium in neuropathic pain. A 2-week intravenous magnesium infusion followed by 4 weeks of oral magnesium supplementation can reduce pain intensity and improve lumbar spine mobility during a 6-month period in patients with refractory chronic low back pain with a neuropathic component.</p> <p>Ultimately, magnesium is cheap and fairly harmless as long as you don&rsquo;t have a kidney disorder. &nbsp;It&rsquo;s certainly worth using if you experience persistent pain &ndash; and judge for yourself whether it helps. Clinicians working with people with pain should also consider giving magnesium early &ndash; before the pain becomes chronic. This might save a whole lot of grief. Not all magnesium supplements are the same, however; absorption (and therefore effectiveness) varies markedly across the different forms. For help in choosing an appropriate magnesium supplement, contact us at Equilibria.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Pudendal Neuralgia: Pain from the Nerve Downstairs http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/pudendal-neuralgia-a-little-known-cause-of-pelvic-pain <h2>A Little-Known Cause of Pelvic Pain</h2> <p>How well do you know the nerves of your pelvis? Chances are you don&rsquo;t even think about the nerves of your pelvis &ndash; unless you have pain in the area. While most of us are vaguely aware that problems with the sciatic nerve can cause &ldquo;sciatica&rdquo;, it&rsquo;s not so obvious that troubles with the pudendal nerve of the pelvis can cause a condition called &ldquo;<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=95"><strong>pudendal neuralgia</strong></a>&rdquo;. In fact, this is so obscure that even your doctor may be somewhat foggy on it.</p> <p>The pudendal nerve is a nerve that runs very close to the sciatic nerve in the pelvis. Instead of running down the back of the leg, however, it curls back around into the inside of the pelvis and runs close to the inside of your &ldquo;sitting bones&rdquo;. Like all nerves, it branches out into many parts. Specific branches of the pudendal nerve run to some highly important areas &ndash; the anus, the vagina and perineum, and the clitoris, or their equivalent areas in men. Not a nerve to be underestimated!</p> <p>Issues with the pudendal nerve can create pain in the lower pelvic areas, anywhere from the clitoris to the anus. Sometimes the nerve is trapped, being &ldquo;held&rdquo; or &ldquo;bound down&rdquo;. This is known as <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=95"><strong>Pudendal Nerve Entrapment</strong></a>, and is due to tightness in the ligaments or fascia (connective tissue, like &ldquo;cling wrap&rdquo; around your muscles) near the nerve.</p> <p>However, the nerve can be irritated without actually being entrapped. This situation is known more generally as <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=95"><strong>Pudendal Neuralgia</strong></a>. The most common causes of this are prolonged or repeated pressure on the nerve (e.g. from cycling) or prolonged or repeated stretch to the nerve (e.g. from giving birth vaginally). It can also occur due to damage during gynaecological surgery or due to pressure from a tumour. Commonly though, it is due to a myofascial syndrome. This basically means tightness or overactivity in the muscles that the nerve runs close to: the <strong>pelvic floor muscles</strong> and the <strong>obturator internus muscles.</strong></p> <p>It can be hard to diagnose pudendal neuralgia. While it tends to cause burning pain in the pathway of the nerve, worse in sitting than standing, it can only be clearly diagnosed by having a pudendal nerve block. Sometimes, it is labelled less precisely by your doctor as "<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=81"><strong>generalised vulvodynia</strong></a>" because it causes vulval pain. All the confusion in diagnosis aside, the <strong>symptoms of <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=95">pudendal neuralgia</a> can often be helped enormously by specific physiotherapy treatment.</strong></p> <p>No, we&rsquo;re not talking general back exercises or stretches here. The type of physiotherapy required for <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=95"><strong>pudendal neuralgia</strong></a> usually involves internal muscle and connective tissue treatment &ndash; that is, via a vaginal exam or a rectal exam. This is done by a physiotherapist who not only has specific training in the pelvic floor area, but <strong>specialised expertise in manual therapy treatment in this area</strong>. Don&rsquo;t see your knee physio about this one! Ask questions to make sure your physio has the exact skills required. Physios with experience in this area have the skills to make this as comfortable and dignified as possible for you, while providing effective treatment.</p> <p>If you have had your pain for a while, it may also be important in pudendal neuralgia to work on <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/chronic-pain-in-the-vulva-and-pelvis-retrain-your-brain">retraining the circuits in your brain</a>. Persistent pain is often&nbsp; a sign that the brain has got into faulty patterns, which need to be retrained.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=95"><strong>Pudendal neuralgia</strong></a> is a condition I&rsquo;ve been treating for several years, and is a special interest area of mine. In fact, I am so interested in this area that in September 2013 I&rsquo;m travelling to Canada in order to do further specialised training on the manual therapy treatment of this condition, where physiotherapists refine their skills on each other! I wouldn&rsquo;t ask you as my patient to have anything done I haven&rsquo;t experienced myself!</p> <p>If you think you might need help with <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=95"><strong>Pudendal Neuralgia</strong></a>, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21">contact me and tell me your story.</a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Minimising Pain Via Healthy Scars: How Nutrients Help http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/minimising-pain-via-healthy-scars-how-nutrients-help <h2>Injury, trauma and surgery leave their mark.</h2> <h3>It&rsquo;s inevitable &ndash; scars are a normal part of the healing process.</h3> <p>Sometimes this is obvious &ndash; like <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/why-you-need-to-play-with-your-caesarean-scar">Caesarean scars</a> or the abdominal scar after a hysterectomy. These are easy to see (which doesn&rsquo;t always make us happy! Scars that are painful are also obvious &ndash; like, for some women, <a href="http://www.equilibriahealth.com.au/admin/index.cfm?Fuseaction=Blog.BlogPost&amp;BlogPostID=42">episiotomy scars</a> that make <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=54">sex more painful.</a></p> <p>Movement is an important part of healthy scar healing - y<a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/why-you-need-to-play-with-your-caesarean-scar">ou really need to play with your scars!</a> However, an often-neglected factor in healthy tissue and scar healing is nutrition.</p> <h2>Why is nutrition relevant in scar healing?</h2> <p>Availability of certain nutrients has an impact on various aspects of healing and scar formation:</p> <ul> <li>&ldquo;Cleaning up&rdquo; the initial inflammatory process</li> <li>Preventing infection</li> <li>Laying down healthy tissue</li> <li>Manufacturing new blood vessels</li> <li>Increasing the strength and flexibility of the scar</li> </ul> <h3>The &ldquo;Clean-Up&rdquo; and preventing infection</h3> <ul> <li>Vitamin A &ndash; immune effects for healthy inflammation</li> <li>Vitamin C &ndash; acts as an antioxidant to &ldquo;sweep up debris&rdquo;; higher doses help counter constipation from pain medications</li> <li>Zinc &ndash; deficiency results in poor healing</li> <li>Bromelain &ndash; reduces swelling and pain, speeds up resolution of bruising</li> <li>Protein &ndash; a deficiency results in prolonged inflammation and delayed healing</li> <li>Glutamine &ndash; promotes healthy inflammation</li> </ul> <h3>Rebuilding the House: Laying down healthy tissue</h3> <ul> <li>Vitamin A and vitamin C &ndash; improves collagen production</li> <li>Bromelain &ndash; speeds up healing</li> <li>Glucosamine &ndash; leads to production of hyaluronic acid to hasten healing</li> <li>Gotu Kola &ndash; a herb that increases collagen production</li> </ul> <h3>Getting the Plumbing In: Manufacturing new Blood vessels</h3> <ul> <li>Vitamin C and copper &ndash; help produce down blood vessels</li> </ul> <h3>Bouncing Back: Strength and flexibility of the scar</h3> <ul> <li>Vitamin A</li> <li>Zinc &ndash; deficiency results in a weaker scar</li> <li>Glucosamine &ndash; leads to production of hyaluronic acid for a stronger scar</li> <li>Protein &ndash; a deficiency results in a weaker scar</li> <li>Gotu Kola &ndash; a herb that improves strength of the scar</li> </ul> <p>I was very aware of all of this when I recently had surgery for a broken ankle. This was a serious injury with a very decent scar. To cover my bases, I have taken all of the above nutrients each day in addition to a high protein, high vegetable diet. The body has amazing healing capacity &ndash; but it still appreciates a helping hand by having plenty of raw materials on-hand for rebuilding!</p> <p>If you have had or are planning surgery, and want to really get off on the right foot, contact us at Equilibria for a tailored nutrient program.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Adhesions: Why You Need To Play With Your Caesarean Scar http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/why-you-need-to-play-with-your-caesarean-scar <h2>Does your scar move how it should?</h2> <p>Try this: pick up the skin on the back of your hand, lift it up and drop it. Notice how stretchy it is? Good, healthy tissue, like a healthy body in general, MOVES. That&rsquo;s right, mobility is as important for skin is it is for the rest of the body.</p> <p>Scars, on the other hand, don&rsquo;t have good natural mobility. Scarring, or the formation of tissue adhesions after injury or surgery, is a healing process. The priority for healing tissue is to become strong quickly to protect the injured area and prevent re-injury. Unfortunately, as part of this process, tissue becomes tight, stiff and inflexible. Scars become stuck to the tissue below, whether this be muscles, tendons, ligaments or even organs. How stuck they get depends on a lot of things: the part of the body; how deep the cut was; how well your healing process occurred (including how good your<a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/minimising-pain-via-healthy-scars-how-nutrients-help"> nutrition for healing </a>was); how early you start movement rehab; how well you stick to your program; how much stretching you do, and more.</p> <p><img title="massagescar" src="http://www.equilibriahealth.com.au/images/massagescar.png" alt="massagescar" width="276" height="183" /></p> <p>I can give a personal example here. Twelve weeks ago I broke my ankle on both sides and had surgery. There is a scar of several inches on the outside of my lower leg where they inserted a plate. I dutifully followed the surgeon&rsquo;s instructions and kept my ankle completely immobilised for two weeks, then introduced controlled movement in one plane only. Despite following the correct protocol, by the time I was allowed to walk on the leg again (at six weeks) the ankle was incredibly stiff and horribly painful to take weight or to move or twist in any way. Now, at twelve weeks, I need to do painful stretches every day for around 2 minutes at a time in order to get the movement back. As in any orthopaedic rehabilitation, this is a slow and painful process.</p> <p>Now take abdominal surgery. If you have had a Caesarean section, this is exactly the same process. The obstetrician cuts through many layers to get to your uterus: the skin, the fat, the fascia (tight connective tissue wrapping) of the muscle, the muscle itself, more fascial layers and finally the organ itself. So the scar you see in your lower tummy, neat as it is, is only the tip of the iceberg.</p> <p>Try an experiment. Grasp your lower tummy in your hands &ndash; thumb above the scar, fingers below. Now pick up the skin and move it around. Stretch it, wiggle it, lift it, move it every which way. Does it move easily and painlessly? Can you even lift it?</p> <p>When scarring is adhered to the underlying tissues, it&rsquo;s hard or even impossible to lift. The edges of skin you try to lift collapse inwards into the crevasse that is the scar, tightly bound to the what&rsquo;s underneath. It&rsquo;s all gummed up under there, restricting circulation and compromising your range of motion; it can be responsible for underlying muscle tension and spasm and even pain. This is a common source I see of &ldquo;unexplained&rdquo; pain, where all medical investigations have come up with nothing. If your pain is new since your surgery, and other causes have been ruled out, you need to get your physiotherapist trained in connective tissue manipulation to check this.</p> <p><img title="abdominalconnectivetissuemassage" src="http://www.equilibriahealth.com.au/images/abdominalconnectivetissuemassage.png" alt="abdominalconnectivetissuemassage" width="276" height="183" /></p> <p>It doesn&rsquo;t feel nice to stretch a scar. In fact, it can feel quite horrible: it can sting, give you strange hypersensitive sensation and feel sore after you stretch it. But it is essential to get it as mobile as you can &ndash; and as much of this as possible needs to occur between the six-week and the twelve-week mark post surgery, because after this, scar tissue gets tighter (or stronger).</p> <p>From the two-to-six-week mark, I massaged my strange-looking, bruised, hypersensitive leg with caution, trying to both remove swelling and get my nerves used to the sensation. From six weeks, when I tried &ldquo;picking up&rdquo; the scar, I realised how tight it had become &ndash; it was so &ldquo;gummed up&rdquo; I had almost no inward movement of my ankle. While this restriction is often less obvious in a Caesarean scar, it is absolutely an issue. I have seen many patients whose tight scar tissue is restricting their movement and promoting pain; in some, it&rsquo;s even promoting dysfunction of the underlying organs.</p> <p>Movement is essential for good health! And this goes for scars as well. If you are before the six-week point post-surgery, ask your physiotherapist for specific, safe mobilisation exercises for your scar. If you are past the six-week point post-surgery, get your scar moving vigorously. Pull it and stretch it every which way. Just play with it! For help with getting your tissue healthy and moving again, contact me at Equilibria.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Adhesions: A Cry For Help From Your Episiotomy Scar http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-cry-for-help-from-your-episiotomy-scar <h2>I suspect we underrate the negative impact of episiotomy scars.</h2> <p>My last post was about <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/why-you-need-to-play-with-your-caesarean-scar">scar tissue after surgery</a> and how it can cause real problems, both in the short and long term. I used the examples of an orthopaedic surgery scar and a Caesarean scar. Both of these are considered major surgery, and when you really stop to think about it, it makes sense that they require some rehabilitation. (As an aside, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/minimising-pain-via-healthy-scars-how-nutrients-help">nutrition has a big impact on healing of scars,</a> and should be a major focus in the first three months after any surgery).</p> <p>But what about perineal scars from childbirth injury? These include scars from episiotomy, OASIS (obstetric anal sphincter injuries), and all types of tears to the vagina and perineum, whether first-, second-, third- or fourth-degree. Won&rsquo;t these types of scars benefit from rehabilitation too? Of course they will &ndash; in fact, I think we need to be much more proactive about this.</p> <p>When the obstetrician gives you your six-week postnatal &ldquo;clearance&rdquo;, this is just the beginning. In fact, many women see their GP and have no perineal or vaginal examination at their six-week check-up. If they do have an examination, the aim is to ensure healing is adequate and there are no signs of infection. This quick check is not designed to confirm your tissue is back to its fighting best!</p> <p>Many women I see, when they see their doctor for their six-week check, have not started having penetrative intercourse again yet. This is perfectly natural; not everyone feels ready by this point. However, when they are given the &ldquo;all-clear&rdquo; by the doctor, it comes as a rude shock when they first try to have intercourse two, four or six weeks later &ndash; to find that it&rsquo;s horribly painful and not at all what they were expecting.</p> <p>For some women, this initial pain with penetrative intercourse eases up quickly; for others it is mild or not significant in the first place. However, for a significant number of women, this pain is severe, persistent and very disruptive of their intimate relationships.</p> <p>Pain with sex after childbirth is quite common, and in a way should come as no surprise. Think about this: you break your ankle and it is immobilised for six weeks in a cast or moonboot. Finally the day comes when it can be taken off. With joy and enthusiasm you throw your weight onto it &ndash; in fact, you don&rsquo;t just try to walk, but jump off a high step and throw yourself into an exuberant set of dance moves. OUCH! It&rsquo;s excruciatingly painful, isn&rsquo;t it? Of course it is. Your body is not designed to go from zero to a hundred in the blink of an eye after a significant injury.</p> <p>Well, an episiotomy or perineal tear is a significant injury to your vulva. While it might be mild and you get away with token, short-lived discomfort, you may be like many women I see for whom it is actually quite a hard road back to enjoyable, pain-free intercourse. &nbsp;I often describe penetrative sex to women as being what a marathon run is to an ankle sprain. You wouldn&rsquo;t jump straight into a marathon once your ankle sprain heals! But for some reason, women expect (or society expects us!) to be straight up for sex after the perineum heals postpartum. As I mentioned, some women have no ongoing problems. But if you find that the low-level discomfort (or strong pain) doesn&rsquo;t get better and better each time you try, you need to get going with some perineal rehab!</p> <p>The longer you leave this, the harder it is. A number of women I have seen with post-partum vulval pain and painful sex were so sensitive in the area of the scar they could barely stand light touch, let alone entry of their partner&rsquo;s penis. This is more likely to occur the longer you leave it, and may involve sensitisation of the nervous system (where the brain, spinal cord and nerves become hypersensitive to touch and normal sensations become interpreted as pain: this is called <em><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=49">central sensitisation</a></em>). &nbsp;The pelvic floor muscles become both tight/overactive and weak &ndash; not a good combination!</p> <p>A good way to start to help this is some nice perineal massage daily with olive oil, apricot kernel oil or jojoba oil. You can do this yourself, and if you like, progress to allow your partner to do it. (You may need to have an agreement that nothing sexual proceeds from this, unless you yourself wish to initiate it.) If this does the trick, that&rsquo;s fine. However, often more specific therapeutic input is required. A physiotherapist trained in connective tissue mobilisation and myofascial release can help your vulva and vagina restore its natural movement, flexibility and sensation. This requires specific training, and it&rsquo;s worth enquiring of your physiotherapist whether they have this specific set of skills. With the right type of therapy, you can get back your good health in this area, get rid of pain, and restore the quality to your sexual experience. Contact me to get help for this.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Why Aren't You Taking Fish Oils? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/why-arent-you-taking-fish-oils <h2>There is really only one good answer to this question.</h2> <h3>But in order to get to that answer, we need to understand what &nbsp;omega-3s are.</h3> <p>Omega 3 fatty acids belong to a group known as essential fatty acids. This means exactly what it sounds like: our bodies cannot function effectively without them. (Compare this with essential amino acids, the building blocks of protein that we must take in for growth and repair of our cells).</p> <p>Here is a very summarised list of potential effects of low essential fatty acids:</p> <p>Reproductive problems, dry, scaly skin, depression, anxiety, learning difficulties, behavioural problems, coronary artery disease, inflammation.</p> <p>Our bodies are very versatile, and can often make substances from other substances. For example, if you don&rsquo;t get enough vitamin B3, your body can make it from the amino acid tryptophan. However, the important point about essential fatty acids is this:</p> <h3>Your body is unable to make essential fatty acids.</h3> <p>This means that the only way you are going to get these substances (which, don&rsquo;t forget, are essential to human health) is to take them in through your diet. The only meaningful sources of omega-3s in the diet are oils from cold water fatty fish, including salmon and sardines, and flaxseed or linseed. There are also small amounts of omega-3s in dark leafy greens. (You can imagine how small these amounts are, as leafy greens are not exactly what you&rsquo;d describe as oily).</p> <p>So that&rsquo;s easy! You eat salmon (or its less effective cousin, tuna) three times a week already. Safe!</p> <h3><em>If only it were that simple!</em></h3> <p>Eating other fats and oils interferes with the amount of omega-3s that reaches your cells. There are two major fatty acids that compete. One is called arachidonic acid. This is a non-essential fatty acid, the major source of which is meat. The second is the other group of essential fatty acids, the omega-6s. Omega-6 fatty acids are found in all nuts and seeds, and all oils made from nuts and seeds.</p> <p>That&rsquo;s lucky, you might think. You don&rsquo;t eat almond oil, or sunflower oil, or sesame oil, or peanut oil, and only eat nuts occasionally.</p> <p>Even if this is the case, you may be getting a lot more omega-6s than you think. Anything marked &ldquo;vegetable oil&rdquo; will almost certainly be high in omega 6s. This includes &ldquo;blended vegetable oil&rdquo;, all margarines and soft butter blends, and also the increasingly popular rice bran oil. It also includes any packaged items that contain vegetable oil. Have a look at the packet &ndash; even when they&rsquo;re baked, not fried &ndash; you might be surprised to see that many packaged foods contain vegetable oil.</p> <p>Furthermore, the trans fats present in any oil-containing food that has been heated at a high temperature also compete with omega-3 in the body.</p> <h3>So getting enough omega-3s is not just about eating omega-3 rich food regularly.</h3> <p>Doing that is rarely enough. It is much more so about reducing the competitors to omega-3s in the diet, including vegetable and seed oils, margarine, nuts, seeds and any food containing these, such as muesli. In fact, reducing the omega-6-rich foods can have an enormous impact on cellular levels of omega-3.</p> <p>Reducing omega-6 intake to just 2.5%&nbsp; of daily calories can increase tissue levels of omega-3 by over 50%(that's without taking any fish oil tablets!) On the other hand, we may need over 3000mg of omega-3 EPA and DHA to counter high intake of omega-6s in the diet. This is not a "one-size-fits-all" approach.</p> <p>It&rsquo;s worth doing a close study of your diet to see whether the balance of omega-3s to omega-6s is as good as you think it is. There is a website where you can go to find the &ldquo;omega-3 score&rdquo; of a huge number of foods. This is a score that takes into account both its omega-3 and omega-6 content &ndash; in other words, that which adds points and that which takes points away!</p> <p>Go to <a href="http://www.fastlearners.org">www.fastlearners.org</a> and see whether your diet consists of foods in the positive or in the negative.</p> <p>&nbsp;If your diet is made up of a lot of the positive foods, it increases the likelihood that your tissue levels of omega-3s are good, but it doesn&rsquo;t guarantee this. The only way to really know what your tissue levels are like (which depend on your lifetime eating habits) is to have a blood test done through a functional laboratory. I can order this for you here at Equilibria.</p> <h3>And that brings us to the answer to the question.</h3> <p>The only reason to not be taking omega-3s as a supplement is that you are confident of your tissue levels of omega-3s, and you are eating a diet that will maintain them. This diet would consist of a high intake of oily fish &ndash; probably daily &ndash; and some flaxseed. ALA from flaxseed has some benefits, but does not convert well to the required EPA and DHA. The enzyme that aids this conversion can be slowed down by lack of zinc, magnesium, B vitamins and vitamin C.</p> <p>If, like most of us, maintaining this diet at times becomes a little too arduous, you should be taking omega-3 supplements, ideally from fish oil or algae rather than flaxeed. Your skin, your brain, your heart and arteries, your memory and your hormones will thank you.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> How Do I Know If My Vaginal Discharge Is Normal? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/how-do-i-know-if-my-vaginal-discharge-is-normal <h2>Vaginal discharge, vaginal mucus, vaginal secretions&hellip;whatever you call it, it&rsquo;s a normal part of being female.</h2> <p>Even so, there aren&rsquo;t many women around who haven&rsquo;t wondered at some stage whether their vaginal discharge is normal.</p> <p>But how do you tell if your vaginal discharge is normal? It&rsquo;s not exactly something you discuss in everyday conversation.&nbsp;</p> <p>If you have discharge that you&rsquo;re concerned about, you should discuss this with your health professional. However, I&rsquo;ve put together a few tips to figure out whether it&rsquo;s likely to be normal or not.</p> <p>In your reproductive years (that is, between puberty and menopause) it is normal to have cyclical changes in vaginal discharge. This is because rising oestrogen levels lead to the cervix producing mucus to nourish and protect the sperm to help them travel the distance to the fallopian tubes, to help fertilise the egg. Whether you want a pregnancy at the time or not doesn&rsquo;t affect the fact that you produce fertile mucus during a part of your cycle (usually for several days around 2 weeks before your period). This cervical mucus trickles down to the entrance to your vagina, where you experience is as vaginal discharge. However, it is technically known as mucus, to distinguish it from other types of vaginal discharge that do not come from the cervix. As a general rule (with exceptions!), fertile mucus tends to be thinner, clearer, stretchier and wetter than other types of discharge. Cervical mucus is an important part of your fertility, and a healthy sign. Cervical mucus is no longer produced when you are no longer fertile. Therefore, after menopause, you will not experience cyclical changes in vaginal secretions anymore. You would expect any discharge (if you have it) to be fairly similar day after day when you are no longer ovulating.</p> <p>Cervical mucus can be affected by a lot of things, including being on the Pill, surgery to the cervix (e.g. for abnormal cells or CIN), and terminations. These things may result in a reduction in the amount or type of mucus your cervix produces, or it may change from being cyclical to being constant. When this occurs, your cervix is not at its most healthy, and its function is being affected. A lack of the cervical mucus (that is, the cyclical production of mucus, which increases over several days two weeks before your period, and has fertile characteristics) is a sign of your fertility being compromised. The Mini-Pill works in exactly this way for contraception: it changes the quality of the mucus to make it unfriendly to sperm, resulting in rapid death of the sperm, as occurs in the usual non-fertile times of your cycle.</p> <p>Non-fertile discharge doesn&rsquo;t come from the cervix, but rather the walls of the vagina. This vaginal discharge occurs in many women in the early part of the cycle. In the early part of your cycle, before your fertile time, this discharge (if you do have it) is normally the same day after day. It is not until oestrogen starts to stimulate your cervix to produce mucus that your experience of vaginal discharge changes. Vaginal discharge is due to circulation changes, as well as normal cell turnover by the healthy cells of your vagina.</p> <p>Vaginal secretions are also produced when you are sexually excited or stimulated. These secretions are produced from a number of places: the vaginal walls, due to an increased blood flow to your sexual organs; glands called the Bartholin&rsquo;s glands, around the vaginal entrance; and possibly the Skene&rsquo;s glands, which are around the entrance to the urethra. Other things that increase the circulation to the vagina can result in an increase in discharge, such as a Pap Smear.</p> <p>Normal vaginal secretions, whether mucus or discharge, is white, yellowish or clear, and has a faint musky smell. Vaginal secretions of a different colour, or odour, or accompanied by symptoms such as <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=36">vulval or vaginal itching</a>, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=37">pain with passing urine</a>, or <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=15">pelvic pain</a>, should be investigated by your doctor.</p> <p>Vaginal discharge that is new or different to what you have previously experienced may warrant investigation. This is especially the case when it cannot be explained by a change in circumstances, such as starting or stopping chemical or physical contraception such as the Pill or an IUD, including the Mirena; changing time of your cycle; or new phase of life, such as pregnancy or menopause.</p> <p>It&rsquo;s a helpful skill to know how to spot what is normal for you with your discharge. An excellent way of doing this is learning to chart changes through your cycle. Teachers of the Billings Ovulation Method tend to be experts in vaginal discharge &ndash; or rather, very good at helping women become experts in their own discharge. This is because it is a natural method of contraception, of promoting pregnancy, and of monitoring reproductive health, which is based on the woman&rsquo;s experience of moisture at the vulva (the entrance to the vagina). Although the primary focus of this method is on the sensations of moisture you experience, it encompasses increased insight into the vaginal discharge as a whole, and is an excellent method for all women of reproductive age to learn, as part of knowledge of their bodies.</p> <p>In summary, vaginal discharge is usually normal if it:</p> <ul> <li>Follows a cyclical pattern that can be related to your hormonal changes (this may require the help of an Accredited Billings Ovulation Method Teacher to interpret)</li> <li>Does not have an offensive smell or unusual colour, and is not associated with symptoms such as <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=36">itching</a>, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=34">pain with passing urine</a> or <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=15">pelvic pain</a> in general</li> <li>Does not suddenly change without explanation, in quality, colour or amount</li> </ul> <p>For help with interpreting your vaginal discharge, contact us at Equilibria.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Nutrition: Nothing In Moderation (Except Moderation) http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/nutrition-nothing-in-moderation-except-moderation <h2>&ldquo;You&rsquo;re a nutritionist, tell us what we should all be eating!&rdquo;</h2> <p>Well, I might be a nutritionist for short, but in actuality I&rsquo;m a nutrition medicine practitioner.</p> <p>Nutrition medicine: I&rsquo;ve been practising this for nine years now, but still struggle to explain to people what it is. My patients know &ndash; because they are collaborating in a treatment program involving it. But the elevator spiel to the person next to me? I have yet to perfect it, or even create it.</p> <p>So now let me make an attempt with a short anecdote.</p> <p>I was in Melbourne recently, presenting at a conference on constipation and herbal medicine. I was on the bus back to the airport eavesdropping on a conversation next to me between an older man and a younger woman. The woman was a sports nutritionist, and the man was interested in the relevance of this to his horses.</p> <p>The woman had to race off before the bus set off, as she&rsquo;d left a package on her last bus. She got back on just in time and we exchanged joking pleasantries about her close call. The older man then chided her on the nature of the package, which was chocolate. The young woman defended herself by saying</p> <h3>&ldquo;I&rsquo;m a dietitian &ndash; I preach everything in moderation!&rdquo;</h3> <p>Now I&rsquo;m not sure whether she was speaking for all dietitians, but I thought this an interesting place to start on trying to explain what nutrition medicine is &ndash; and how it differs from dietetics.</p> <p>I would describe nutrition medicine as an approach that counsels the opposite, that is:</p> <h3>Nothing in moderation (except maybe moderation)!</h3> <p>Nutrition medicine is based on individual nutrient requirements. I don&rsquo;t recommend one diet for all people at all times. In fact, I am not in the business of giving general guidelines at all &ndash; and the closest I would go to this might be &ldquo;eat more vegetables, especially greens&rdquo;.</p> <p>We are not all identical. We have different genes, different health issues and different &ldquo;weak spots&rdquo;. Nutrition medicine is about pinning down which of these weak spots are impacting on our health. Technically, we aim to identify what processes in the body are malfunctioning to allow symptoms to arise. These might be neurological (e.g. neurotransmitter production), endocrinological (e.g. thyroid hormone action) or biochemical (e.g. nutrient availability in the relevant tissue). All of these &ndash; not just the last &ndash; are influenced by the raw materials we provide the body with (that is, food and, specifically, nutrients). We can influence these pathways by the way in which we facilitate the availability of different nutrients.</p> <p>That&rsquo;s why I don&rsquo;t believe in moderation.</p> <p><strong>Several pieces of fruit a day? <em>Not if you have fructose malabsorption-related irritable bowel syndrome.</em></strong></p> <p><strong>400ug folate for all? <em>Not if you have the MTHFR gene polymorphism.</em></strong></p> <p><strong>Daily protein requirement = body weight x 0.8g? <em>Not if you&rsquo;re recovering from surgery.</em></strong></p> <p><strong>Just take a multivitamin?<em> Not if you have a relative copper overload.</em></strong></p> <p><strong>Six slices of wholegrain bread a day? <em>Now, don&rsquo;t get me started&hellip;</em></strong></p> <p>Nutrition medicine is a rational, scientifically-based adjunct to physiotherapy (or any medical, paramedical or non-medical therapy, for that matter) based on individual requirements. These individual requirements are determined from a combination of general or functional laboratory testing and the clinical picture. Yes, they are guided by research&hellip;but then modified for the individual.</p> <p>But if anyone can come up with a good elevator spiel on what nutrition medicine is, I would be very open to hearing it!</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Going Gluten-Free: What You Should Do First http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/going-gluten-free-what-you-should-do-first <h2>Gone are the days (I hope) that people believe gluten-free is just the latest fad.</h2> <p>It&rsquo;s undeniable that many people, for many different reasons, feel much better on a gluten-free diet.</p> <p>It is important that a person has a coeliac screen before going gluten-free. The reason for this is that if they go on a gluten-free diet and feel fabulous, they are likely to never let so much as a wheat cracker pass their lips again (which is great) - but this precludes ever doing a coeliac test again, as you need to be eating wheat in fair quantities for a coeliac blood test to be reliable.</p> <h3>&nbsp;So why does the coeliac test matter?</h3> <p>It matters because there IS a difference between being coeliac and non-coeliac gluten sensitive. Coeliac disease brings with it some well-documented significantly increased risks of things like bowel cancer and osteoporosis. Non-coeliac gluten sensitive doesn't (though keep in mind research is in its early days.</p> <h3>So you need to know why you are removing gluten.</h3> <p>If you are coeliac, you need to be much stricter in order to avoid these risks. If you are non-coeliac gluten sensitive, you may choose not to consume gluten, but chances are, the occasional crumb from someone else's toast is going to find its way into your butter, and that may not do you serious &nbsp;harm. If you are coeliac, this WILL do you harm, and you need to take extra measures to avoid it.</p> <p>The second comment is this: non-coeliac gluten intolerance may be on the rise, but so is FODMAPS intolerance, which also causes digestive symptoms when bread is consumed. In one recent study of a group of patients with functional gastrointestinal disorders (e.g. <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=12">irritable bowel syndrome</a>), 60% had a FODMAPS intolerance! It is important we don't label ourselves as "non-coeliac gluten intolerant" when it is actually a FODMAPs intolerance we have, as this creates confusion and&nbsp; scepticism about the concept of gluten intolerance, which doesn't help the kid with autism, the kid with diabetes, and all the rest of the people with genuine non-coeliac gluten intolerance. This is a bit like the impact that "pescovegetarians" or fish-eating vegetarians have on the genuine vegetarian movement - it dilutes the concept and makes it much harder for genuine vegetarians to defend their stance.</p> <h3>By all means let's get rid of the wheat and/or gluten out of our diets because it's great for our health and makes us feel good.</h3> <p>&nbsp;But - let's leave it at that and not use research that may not apply to us to convince others. Or, alternatively, get yourself tested - make sure you are not coeliac, which carries its own special health risks due to unintended ingestion of tiny amounts of gluten - and see if the reason you feel better without wheat is a FODMAPs intolerance, which may then lead you to realise you also feel a lot better on a true low-FODMAPs diet, which requires exclusion of more than just gluten-containing foods.</p> <p>I do need to add the caveat that coeliac testing is not as straightforward as it appears to be either. But that&rsquo;s the topic for another post.</p> <p>In the meantime, <a href="http://theglutensummit.com/order/">here is a link </a>to a great educational web-event called the Gluten E-Summit, part of which is still being aired free, for around the next 24 hours. For access to an economical&nbsp;digital package which I would thoroughly recommend as providing some of the most up-to-date information on gluten from some top researchers, <a href="http://theglutensummit.com/order/">click here</a>.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Small Intestinal Bacterial Overgrowth: Could This Be Behind Your IBS? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/small-intestinal-bacterial-overgrowth-could-this-be-behind-your-ibs <h2>Ever felt that everything you eat makes you bloat?</h2> <h3>Have your symptoms been dismissed as irritable bowel syndrome? You could have SIBO.</h3> <p>SIBO&nbsp; - that is, small intestinal bacterial overgrowth. Research is slowly growing on this common cause of abdominal bloating and pain. However, as with all early research, it won&rsquo;t necessarily have found its way into the mindset of your local GP or gastroenterologist yet.</p> <p>Research shows that SIBO is common to develop in people who have been put on proton pump inhibitors (for example, Nexium, Losec and Pariet). SIBO may also be present after bowel surgery, which may lead to changes in motility (i.e. the movement through the gut). (On the former topic, there are a number of <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/reflux-medications-what-are-you-risking">unwanted side effects of reflux medications</a>, or proton pump inhibitors).</p> <p>Some research shows SIBO is present in around 40% of people with IBS, but it may be even higher. Common symptoms are diarrhoea (more common than constipation), abdominal pain and bloating. Longer term symptoms can be nutrient deficiencies, leading to low iron (for example) or even iron-deficiency anaemia,</p> <h3>So what is SIBO &ndash; how can you find out if you have it &ndash; and what can you do about it?</h3> <p>To understand SIBO, you need to know a little about the normal gut. It is normal to have large numbers of normal bacteria in the colon, or the large intestine. However, numbers of normal bacteria in the upper gut, or small intestine, should be much lower. In SIBO, there is an increase in the numbers of normal bacteria in the small intestine. These bacteria are not the &ldquo;bad guys&rdquo; &ndash; so it&rsquo;s not the same as having an infection &ndash; rather, there are simply too many of them in the wrong place. In this situation, using probiotics (&ldquo;good bacteria&rdquo;) is a bad idea. It won&rsquo;t help, and can possibly make the problem worse.</p> <p>This increased number of bacteria in the upper gut causing increased fermentation when you eat, leading to the common symptoms of irritable bowel syndrome, especially bloating and pain.</p> <p>Interestingly, though, SIBO may contribute to symptoms in a whole range of other conditions as well, from fibromyalgia to interstitial cystitis.</p> <h3>Here&rsquo;s what you need to know about diagnosing SIBO.</h3> <p>SIBO cannot be diagnosed via a blood test or stool test. It can&rsquo;t be diagnosed via an endoscopy. This also means it cannot be ruled out by an endoscopy. So if you have had a normal endoscopy, and your gastroenterologist says &ldquo;you&rsquo;re fine, it&rsquo;s just a little bit of irritable bowel syndrome&rdquo;, SIBO is a possibility.</p> <p>It&rsquo;s always important to get the main medical things ruled out first. Other conditions with overlapping symptoms include inflammatory bowel disease, coeliac disease, non-coeliac gluten sensitivity and FODMAPS malabsorption. As I have said in another blog post, it's i<a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/going-gluten-free-what-you-should-do-first">deal to aim for an accurate diagnosis before excluding gluten from the diet.</a> Symptoms of coeliac disease vary, and there are essentials you should know if <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/coeliac-disease-how-to-identify-this-in-children">suspecting coeliac disease in your child. </a>It may also help to<a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/butterflies-ulcers-and-the-irritable-bowel"> understand the effects of stress on irritable bowel syndrome</a> in more detail.</p> <p>But if you have had these things ruled out, you may wish to investigate SIBO.</p> <p>If SIBO is confirmed, there is a very effective herbal antimicrobial and specific dietary regime available for treatment. We are trained in the this at Equilibria.</p> <p>If you would like more information on whether you could have SIBO, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21">contact us.</a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Do You Understand Your Fertility? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/do-you-understand-your-fertility <h2>Normal fertility is a key part of good health as a woman.</h2> <p>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.</p> <p>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.</p> <p>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.</p> <h2>So what is the most important sign of fertility?</h2> <p>Most people&rsquo;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.</p> <p>However, bleeding (whether regular or irregular) is not a reliable sign of fertility. Bleeding can happen &ndash; in fact it can even be regular &ndash; 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.</p> <h2>So is it blood level of hormones, then, that is the best sign of fertility?</h2> <p>No, it&rsquo;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 &ndash; and are sometimes essential &ndash; they are not the be-all-and-end-all of fertility awareness, by any means.</p> <p>So again, what sign does the body give us that we can tune into for most reliable information about our fertility?</p> <h2>It&rsquo;s mucus &ndash; that is, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/how-do-i-know-if-my-vaginal-discharge-is-normal"><strong>vaginal</strong> <strong>discharge</strong></a>.</h2> <p>That&rsquo;s right, it&rsquo;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 &ndash; such as in the early breastfeeding period, or around the time of menopause &ndash; it&rsquo;s this lack of changes that gives you important information about your changing fertility.</p> <h3>If you are like most women, you have never learned <strong><a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/how-do-i-know-if-my-vaginal-discharge-is-normal">how to work out if your vaginal discharge is normal.</a></strong></h3> <h2>So where do we learn this important way of having insight into our fertility?</h2> <p>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</p> <h2>&ldquo;Knowledge of her body that every woman ought to have.&rdquo;</h2> <p>The Billings Ovulation Method <em>cannot be reliably learned from a book or the Internet</em>. 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 <span class="skype_c2c_print_container">1800 335 860</span><span class="skype_c2c_container" dir="ltr" onmouseover="SkypeClick2Call.MenuInjectionHandler.showMenu(this, event)" onmouseout="SkypeClick2Call.MenuInjectionHandler.hideMenu(event)"><span class="skype_c2c_highlighting_inactive_common" dir="ltr"><span class="skype_c2c_textarea_span"><img class="skype_c2c_logo_img" src="resource://skype_ff_extension-at-jetpack/skype_ff_extension/data/call_skype_logo.png" alt="" /><span class="skype_c2c_text_span">1800 335 860</span></span></span></span>. You can find more information at <a href="http://www.thebillingsovulationmethod.org/">http://www.thebillingsovulationmethod.org/</a>. Beware of imitation sites, which often provide inaccurate information.</p> <p>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.</p> <h2>If you need help with your fertility as a whole, you may be interested the <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=26"><strong>unique combined approach to fertility</strong></a> that we use at Equilibria Physiotherapy &amp; Nutrition.</h2> <p>&nbsp;</p> <div id="skype_c2c_menu_container" class="skype_c2c_menu_container" style="left: 598px; top: 901.4px; display: none;" onmouseover="SkypeClick2Call.MenuInjectionHandler.showMenu(this, event)" onmouseout="SkypeClick2Call.MenuInjectionHandler.hideMenu(event)"> <div class="skype_c2c_menu_click2call"><a id="skype_c2c_menu_click2call_action" class="skype_c2c_menu_click2call_action" href="http://www.equilibriahealth.com.au/admin/skype:+611800335860?call&amp;origin=FFTB/SPNR/7.1.15383.6004/http%3A%2F%2Fwww.equilibriahealth.com.au%2Fadmin%2Findex.cfm">Call</a></div> <div class="skype_c2c_menu_click2sms"><a id="skype_c2c_menu_click2sms_action" class="skype_c2c_menu_click2sms_action" href="http://www.equilibriahealth.com.au/admin/skype:+611800335860?sms&amp;origin=FFTB/SPNR/7.1.15383.6004/http%3A%2F%2Fwww.equilibriahealth.com.au%2Fadmin%2Findex.cfm">Send SMS</a></div> <div class="skype_c2c_menu_add2skype"><a id="skype_c2c_menu_add2skype_text" class="skype_c2c_menu_add2skype_text" href="http://www.equilibriahealth.com.au/admin/skype:+611800335860?add&amp;origin=FFTB/SPNR/7.1.15383.6004/http%3A%2F%2Fwww.equilibriahealth.com.au%2Fadmin%2Findex.cfm">Add to Skype</a></div> <div class="skype_c2c_menu_toll_info"><span class="skype_c2c_menu_toll_callcredit">You'll need Skype Credit</span><span class="skype_c2c_menu_toll_free">Free via Skype</span></div> </div> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> I've Had A Baby...Can I Ever Exercise Again? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ive-had-a-baby-can-i-ever-exercise-again <h2>If you are keen to get back into exercise after having a baby, congratulations!</h2> <p>The motivation to exercise after having a baby is a great thing. If you can be keen to exercise amidst a life turned upside down by a wee new arrival, that&rsquo;s a great start! Returning to exercise after baby has so many potential benefits:</p> <ul> <li>improved energy and resilience to stress</li> <li>keeping up with the physical demands of kids</li> <li>a better body image</li> <li>help with your libido</li> </ul> <h2>But wait&hellip;what about the pelvic floor?</h2> <p>What about wetting yourself on the trampoline, what about your pelvic organs falling out? &nbsp;Is exercise going to be detrimental to pelvic floor function? Could it even cause irreversible damage?</p> <p>Some women return to exercise after the baby only to suffer serious setbacks; the mum who returns to netball and becomes incontinent, the mum who starts Pilates and develops a prolapse. These are serious side effects and not only impact on your ability to exercise, but can cause a major blow to your self-esteem. It&rsquo;s essential that your return to exercise takes into account your pelvic floor &ldquo;situation&rdquo; and is graded accordingly.</p> <h2>But how do you know what is safe &ndash; how much your pelvic floor can take?</h2> <p>There is no one-size-fits-all approach here. That&rsquo;s the bad news. Any general advice you hear does not take into account your individual circumstances, such as:</p> <ul> <li>Your episiotomy tear took a while to heal and still hurts</li> <li>Bub had a huge head and weighed over 4kg</li> <li>You had pubic symphysis pain during the pregnancy</li> <li>You had a five-finger abdominal separation (diastasis rectus abdominis muscles)</li> <li>You did yoga until the day before you gave birth</li> <li>You&rsquo;ve been a runner for ten years</li> <li>You put on 20kg during the pregnancy</li> <li>The vacuum didn&rsquo;t work and they ended up using forceps</li> </ul> <p>All of these factors influence exercise suitability after birth.</p> <h2>The great news is, you can be given an individualised, progressive exercise program based on your pelvic floor risk.</h2> <p>Very recent research allows us to now measure how &ldquo;risky&rdquo; a pelvic floor you have after childbirth. Some aspects of this risk, such as your pelvic floor muscle strength, can be changed. An individualised assessment with a pelvic floor physiotherapist trained in this approach can answer such questions as:</p> <ul> <li>Am I safe to return to netball?</li> <li>Can I ever run again? If not, how can I keep fit?</li> <li>Is Pilates going to be good for me?</li> <li>Can I do stomach crunches?</li> <li>How can I reduce my risks to the pelvic floor?</li> <li>What other alternatives are available to me &ndash; I&rsquo;m bored with swimming and walking!</li> </ul> <p>If you would like to find out exactly what exercise you are able to do without harming your pelvic floor, give us a call.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> No, You Can't Get It All From Food: Six Reasons Why http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/no-you-cant-get-it-all-from-food-six-reasons-why <h2>&ldquo;I don&rsquo;t need supplements; I prefer to get it from food&rdquo;?</h2> <p>Ever heard anyone say that? Maybe you say it yourself! I hear it every day. I&rsquo;m sorry to say, I just don&rsquo;t buy it! That&rsquo;s right: for optimal health, I think we need specific supplements. There are six main reasons why, which I&rsquo;ll tackle individually in further bog posts.</p> <p>Before I start, I&rsquo;d like to emphasise that it&rsquo;s not a choice between food and supplements. Of course we need an excellent diet to promote ideal health &ndash; a diet that is varied, rich in micronutrients, high in fresh unprocessed food and includes fermented food. (We also need a healthy digestive system to properly assimilate the nutrients &ndash; but that&rsquo;s another blog post.) But it&rsquo;s not about an &ldquo;either/or&rdquo; &ndash; we can have a faultless diet (which, let&rsquo;s face it, few people do) and STILL obtain benefits from supplementation. So let&rsquo;s start with the most obvious one first: our diets aren&rsquo;t always perfect</p> <h2>A Sometimes Imperfect Diet&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</h2> <p>It&rsquo;s well known in nutrition research that people always remember their diets as better than what they actually are! That&rsquo;s right, even with our best intentions, when we recall our diet, we always conveniently forget the worst bits!</p> <p>Do this experiment: note down every single thing you eat or drink for three days. At the end of it, can you honestly say that you</p> <ul> <li>Ate no packaged food?</li> <li>Ate a mix or fresh and cooked vegetables at two to three meals per day?</li> <li>Didn&rsquo;t consume sugar?</li> <li>Ate all organic?</li> <li>Consumed only grass-fed meat?</li> <li>Included &ldquo;live foods&rdquo;, such as home-fermented sauerkraut or home made yoghurt?</li> <li>Didn&rsquo;t eat any foods that don&rsquo;t make your body feel good?</li> <li>Didn&rsquo;t overeat anything?</li> </ul> <p>There are plenty of other possible criteria for optimal diets, but you get the idea! It's probably kind to say we all have a "sometimes imperfect diet". How often does life get in the way of ideal nourishment?</p> <p>As a clinical nutritionist, I have done plenty of computerised nutritional analyses of my clients&rsquo; diets. One advantage of this is the estimation of what&rsquo;s known as the RDIs, or Recommended Dietary Intakes, of various nutrients. I&rsquo;ll talk more later on the relative merit and potential problems of the RDI system, but for now, think of it as a starting point for determining the nutrient richness of your diet. If you fall below the RDI for a certain nutrient, you are not obtaining enough of that nutrient for normal body function (that&rsquo;s right &ndash; not optimal function, but simply normal function).</p> <p>In all my analyses, I only came across one client who was meeting the RDIs for all measurable nutrients (and keep in mind that most nutrients cannot currently be measured in Australian foods). She was an Olympic longjumper, eating massive quantities of food that would be far in excess of the energy requirements of most of us non-athletes!</p> <p><a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/nutrients-in-food-are-lower-than-you-think">Next post</a>, I&rsquo;ll start getting into the meat of this issue, on the topic of nutrient depletion in our food.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> How Badly Is Stress Affecting Your Physical Health? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/how-badly-is-stress-affecting-your-physical-health <h2>A Simple Method to Quantify the Effects of Stress on You on a Daily Basis</h2> <p>We all know that stress is bad for our health. Sometimes the pressure to squeeze &ldquo;de-stressing&rdquo; in to our already chaotic lives is a source of stress in itself! But how do you know when the stress is so significant that it is a major factor in your low energy, youar sleep problems, or your health issues?</p> <h3>There is a simple test you can do yourself at home without going to your doctor.</h3> <p>This test is especially useful if you have anxiety or <strong>depression, insomnia, headaches, low energy, fatigue, hormonal imbalance, infertility, poor immunity</strong> or <strong>blood sugar problems</strong>. I also see evidence of adrenal issues in women with <strong>vulvodynia</strong>, <strong>irritable bowel syndrome </strong>and <strong>chronic pain. </strong>(For more information, see my post on<a href="http://www.equilibriahealth.com.au/Page/butterflies-the-irritable-bowel-and-ulcers"> the effects of stress on the gut)</a>.<strong><br /></strong></p> <p>The test looks at your cortisol levels as they change through the day. As you can see from the diagram below, cortisol is high to start the day, then gradually drops into the evening, so that you develop a nice, natural tiredness as a signal you need sleep to recharge your body and mind. Cortisol then begins to slowly rise in the hours before 6am to ensure you wake up again &ndash; ideally, bright-eyed and bushy-tailed!</p> <p>&nbsp;<img src="data:image/png;base64,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" alt="" /></p> <p>A number of things can go out of balance with this system. As stress causes you to release cortisol, if your stress rises towards the evening, the cortisol can spike or fail to drop as low as it should.</p> <h3>This can result in sleep problems:</h3> <ul> <li>Difficulty falling asleep</li> <li>Unrefreshing sleep</li> <li>Early waking</li> </ul> <p>The last one is especially common. If you have a busy, stressful or active evening, the cortisol spike may result in you waking at 4 or 5am, even though you actually need more sleep for your health.</p> <p>If you are constantly busy, overcommitted and stressed, you are under great demand to produce cortisol. Your cortisol may actually be too high, making you feel edgy and overstimulated, and as though you can&rsquo;t sit still without doing something. If this continues on too long, you start to drain your adrenal glands, a bit like using the mobile phone without recharging it. If your battery starts to run low, you can then, over time, have trouble producing enough cortisol, and approach &ldquo;burnout&rdquo;. Classic signs of this include</p> <ul> <li>Feeling groggy and unable to get going in the morning</li> <li>Low energy despite plenty of sleep</li> <li>Feeling unrefreshed after sleep</li> <li>Low mood and difficulty getting motivated for anything</li> </ul> <h3>A simple test that can track your cortisol rhythm is the Adrenal Hormone Profile.</h3> <p>This is completed at home by spitting into a test tube four times per day &ndash; 8am, 12pm, 6pm and 10pm. The cortisol is then measured by the lab.</p> <p>This test is not ordered by your doctor, who will tend to order only a morning cortisol, which will not give the full picture. The Adrenal Hormone Profile needs to be ordered by an integrative practitioner who is experienced at interpreting the cortisol patterns.</p> <h3>Contact us now if you would like to order this test and gain some insight into the impact of your adrenal function on your health.</h3> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Nutrients in Food Are Lower Than You Think http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/nutrients-in-food-are-lower-than-you-think <h2>A Second Reason Why You Can't Get It All From Food</h2> <p>It&rsquo;s sad but true. While we&rsquo;d like to think we can get all our essential nutrients from food, it&rsquo;s not easy.</p> <p>Last post in this series,&nbsp; I talked about how <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/no-you-cant-get-it-all-from-food-six-reasons-why">our diets are never as good as we&rsquo;d like to think</a>. Most of us know this intuitively, and research confirms we&rsquo;re not meeting our nutrient requirements.</p> <p>For example, a 2014 study of Australian adolescents showed that <strong>fewer than 50% of females got enough calcium, magnesium, folate or vitamin D or E, and the males fared no better. 50% of males did not get adequate magnesium, potassium, pantothenic acid, folate, vitamin D or E</strong>. A multitude of studies shows inadequate nutrient intakes in special groups of people, including <strong>breastfeeding mums, people on a gluten-free diet, and older adults.</strong></p> <p>So this brings me back to another key reason we are not getting enough nutrients:</p> <h2>We can&rsquo;t get the nutrients from food if they&rsquo;re not there.</h2> <p>Australian soils are low in zinc, molybdenum, manganese and zinc.&nbsp; There has been a dramatic reduction in the amount of nutrients in the soil that grows our fresh food since the 1920s. Magnesium levels in the soil, for example, have declined as the use of fertiliser has risen. This is because increasing levels of phosphate in the soil (from fertiliser) result in the plant taking up less magnesium.</p> <h2>Many heavy metals block the uptake or the action of essential minerals in our body.</h2> <p>Cadmium, which is present in fertiliser, blocks the uptake of zinc. Mercury and lead, which we are exposed to every day, strongly block calcium, iron, zinc, selenium, and other essential trace minerals.&nbsp;</p> <h2>Other chemicals in our environment also compromise nutrient intake.</h2> <p>For example, the fluoride in our water interferes with iodine and molybdenum, minerals that are both essential to our good health.</p> <p>This is a reality of 21<sup>st</sup> century living: even when we try to eat the best quality and freshest produce possible, we can&rsquo;t rely on the level of nutrients being sufficient for our needs.</p> <h2>Next post in this series will focus on common &ldquo;nutrient thieves&rdquo; in your diet and lifestyle, some of which may surprise you.</h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> The Gut - Thyroid Link (In Under A Hundred Words) http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-gut-thyroid-link-in-under-a-hundred-words <p class="MsoNormal">How do gut problems lead to Hashimoto&rsquo;s disease? This comes up often with my patients.</p> <p class="MsoNormal">The explanation is rather long and convoluted (but fascinating, I promise!) so strap yourselves in for the first leg of the ride, for which I&rsquo;ll use diagrams to start you thinking. This will be the first in a Gut-Thyroid series of blog posts to help you navigate the territory and apply the knowledge to your own health.</p> <p class="MsoNormal">(And yes&hellip; this is the only way I could keep within the word count promised!)</p> <p class="MsoNormal">Watch this space for more and see also <a href="http://thethyroidsummit.com/">The Thyroid Summit</a>.</p> Paralysed By Choice: Three Steps to Working Out What Diet is Right for You http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/paralysed-by-choice-three-steps-to-working-out-what-diet-is-right-for-you <h2>Gluten-free, Paleo, grain-free, low-FODMAPs, Specific Carbohydrate Diet, GAPs, raw, liver detox, low-salicylate/amine/glutamates, high-fibre, high-protein, low-carbohydrate, anti-Candida, low-oxalate, alkalising, Weston A Price, vegetarian&hellip;how do you sift your way through?</h2> <p>Some of these diets can be questionable, especially the way they are described or interpreted on some websites or by less experienced practitioners.</p> <p>But most of these diets can be helpful &ndash; even ideal &ndash; for some people for short or long periods of their life. It is rare that one diet will cover all of your needs for your whole life. So where do you start in working out what diet will suit your body&rsquo;s needs right now?</p> <p>There is a wealth of information on the Internet about ideal diets for gut health, thyroid health, autoimmune disease, hormone-balancing, weight loss, best energy, you name it, as well as testimonials from people who are convinced of the benefits of these diets. There are sites galore promoting <a href="http://www.equilibriahealth.com.au/Page/dissecting-interstitial-cystitis-painful-bladder-syndrome-and-bladder-pain-syndrome">interstitial cystitis</a> diets, IBS diets, <a href="http://www.equilibriahealth.com.au/Page/small-intestinal-bacterial-overgrowth-is-this-behind-your-ibs">diets for SIBO (small intestinal bacterial overgrowth)</a>, anti-<a href="http://www.equilibriahealth.com.au/Page/information-on-thrush">Candida</a> diets. But sometimes, the wealth of information can leave you feeling no closer to figuring out what is right for your body&rsquo;s needs at this stage of your life.</p> <h2>Let me give you a simple formula to work out what is right for you.</h2> <h3><strong>Listen to your body.</strong></h3> <p>This may sound obvious, but it&rsquo;s amazing how often people ignore it. These are just a few of the comments I hear all the time:</p> <p>&ldquo;I feel bloated if I eat too much wheat&rdquo;.</p> <p>&ldquo;Too much dairy gives me diarrhoea&rdquo;.</p> <p>&ldquo;When I eat eggs, they go straight through me.&rdquo;</p> <p>An integrative nutritionist can help you joint the dots on factors in your history that give important clues. For example, chronic sinus issues are often associated with a dairy intolerance, as is bedwetting in children and acne (in fact, a 2014 review in the Journal of Clinical and Experimental Dermatology) comments on the link between acne and dairy, which requires further investigation). The <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-gut-thyroid-link-in-under-a-hundred-words">link between gluten sensitivity and thyroid disease</a> is also well established in the research.</p> <p>Don&rsquo;t ignore these clues! Without wishing to oversimplify, it is important to start somewhere &ndash; and following the already-established links is a good place to start.</p> <h3><strong>Testing, testing, testing</strong></h3> <p>Going in the direction that has helped others with your condition is only a starting point at best &ndash; and at worst, it can take you for a ride on the &ldquo;health website merry-go-round&rdquo;, where you half-follow one diet after the other without ever systematically measuring the results.</p> <p>Working with a practitioner experienced in testing is essential. Choosing the right tests is important, as is choosing the right order of tests. Which are most important? Which ones should you prioritise? Are there key ones you should include before a dietary change? (One example is in <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/going-gluten-free-what-you-should-do-first">making sure you do the right testing before you try going gluten-free</a>.) Some of the key tests in establishing what kind of diet is appropriate to your body include:</p> <ul> <li>IgG food sensitivity testing</li> <li>Lactulose breath testing</li> <li>Fructose breath testing</li> <li>Coeliac screening</li> <li>Bioimpedance (Body Composition) testing</li> </ul> <p>In some cases, further important information is gained from tests such as:</p> <ul> <li>Functional Liver Detoxification Profiles</li> <li>Hormonal Testing</li> <li>Autoimmune marker testing, such as thyroid antibodies</li> <li><a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/how-badly-is-stress-affecting-your-physical-health">Adrenal Hormone Testing</a></li> <li>Red Cell Essential Fatty Acids</li> </ul> <p>A functional medicine practitioner will be able to order any of these tests that are appropriate to your situation. Much of this testing is done through what is known as &ldquo;functional pathology&rdquo; as opposed to &ldquo;general pathology&rdquo;. This usually means reasonable out-of-pocket expense. Some of these tests can cost a few hundred dollars. However, they will probably save you far more in consultation and supplement expenses, not to mention medical expenses over the years as undiagnosed problems turn into more serious medical conditions.</p> <h3><strong>Put your history and test results together with a skilled functional medicine practitioner or integrative nutritionist.</strong></h3> <p>It&rsquo;s important to find an experienced practitioner to help you navigate the territory. This may be a naturopath, a clinical nutritionist or a medical doctor. Look for someone who uses or understands the terms &ldquo;functional medicine&rdquo;, &ldquo;nutrition medicine&rdquo; or &ldquo;integrative nutritionist&rdquo;. Generally, if they provide rebates, the rebates will be under naturopathy, not dietetics.</p> <p>Self-treating is a minefield, even when you have good knowledge and awareness of your body. In fact, functional medicine practitioners (FMPs) often see other FMPs to help them with their own health!</p> <p>Improving your health through optimal nutrition is anything but &nbsp;a one-size fits all approach. It requires commitment on your part, a skilled and experienced functional medicine practitioner, and the careful collection of information from your history, your symptoms and specific testing. The great news is, you&rsquo;ll find that the effort pays off, helping you achieve the best health possible.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> The Five Sources of Painful Sex (And Not One of Them Starts With "V") http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-five-sources-of-painful-sex-and-not-one-of-them-starts-with-v <h2><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">Vaginismus</a>, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=81">vulvodynia</a>, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=56">vestibulodynia</a>, vaginitis, vulvar lichen sclerosus, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=53">vaginal atrophy</a>, vulvitis&hellip;</h2> <p>Any of these might be names that your &ldquo;painful sex&rdquo; has been given, but they don&rsquo;t tell you much about the root cause. Painful sex itself is medically termed &ldquo;dyspareunia&rdquo;- but again, if a doctor tells you that you have dyspareunia, it doesn&rsquo;t leave you any wiser.</p> <p>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.</p> <h2>Skin.</h2> <p><img title="vaginalepithelium_sm_sm" src="http://www.equilibriahealth.com.au/images/vaginalepithelium_sm_sm.jpg" alt="vaginalepithelium_sm_sm" width="286" height="215" /></p> <p>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. <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=68">Vaginal dryness</a> can be a contributing factor, but is often not the only cause (or even the most important cause). Tight <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=113">scar tissue in the skin from episiotomies</a> is another source of pain with sex. Has your health professional ruled all of these out?</p> <h2>Nerves.</h2> <p>Nerves convey information about sensation to your brain. Sometimes, though, the nerves themselves get &ldquo;caught up in the action&rdquo; creating a type of nerve inflammation called <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=50">neurogenic inflammation</a>. This creates over-sensitive nerves, technically known as &ldquo;peripheral sensitisation&rdquo;.</p> <h2>Organs.</h2> <p><img title="uterusandcervix" src="http://www.equilibriahealth.com.au/images/uterusandcervix.jpg" alt="uterusandcervix" width="200" height="200" /></p> <p>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 <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=11">interstitial cystitis/painful bladder syndrome</a>.<a href="http://www.equilibriahealth.com.au/Page/irritable-bowel-syndrome"> Irritable bowel syndrome</a> 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. <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=25">Endometriosis</a> is an inflammatory condition leading to formation of adhesions or internal scars, and a common cause of painful sex.</p> <h2>Muscles.</h2> <p>It is rare that I see a woman with painful sex who does not have some muscular cause as part of the picture. <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=73">Stinging after sex</a> 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). &nbsp;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.</p> <h2>Brain.</h2> <p><img title="brainonfire" src="http://www.equilibriahealth.com.au/images/brainonfire.jpg" alt="brainonfire" width="275" height="183" /></p> <p>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. <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=49">Central sensitisation</a> 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 <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/chronic-pain-in-the-vulva-and-pelvis-retrain-your-brain">retrain your brain</a>. My <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">e-book Outsmart Your Pain </a>describes the brain&rsquo;s role in your pain and how to break the cycle. &nbsp;<a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">It can be ordered here.</a></p> <h3>Ask your health professional if they have ticked off all five sources of pain in your assessment.</h3> <p>They should be able to give you a rough percentage that each is likely to be contributing to your pain.</p> <p>If identifying potential sources of the pain is important, it&rsquo;s even more important to identify the processes causing your continuing pelvic pain &ndash; but that&rsquo;s the topic for another blog post.</p> <p>Now that you know what areas are involved, you may be interested in a brief summary of <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ten-reasons-why-sex-hurts">ten reasons why sex hurts</a>. There may also be special considerations for <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/painful-sex-and-the-older-woman">pain with sex in the older woman.</a> And let's face it, sometimes it can just be a challenge to <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/in-search-of-that-elusive-libido">track down that elusive libido! </a></p> <p>If you would like to solve your painful sex &ndash; whatever &ldquo;V-Word&rdquo; it might have been called - contact us to make an appointment.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> How Badly Is Stress Affecting Your Physical Health? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/how-badly-is-stress-affecting-your-physical-health-salivary-cortisol <h2>A Simple Method to Quantify the Effects of Stress on You on a Daily Basis</h2> <p>We all know that stress is bad for our health. Sometimes the pressure to squeeze &ldquo;de-stressing&rdquo; in to our already chaotic lives is a source of stress in itself! But how do you know when the stress is so significant that it is a major factor in your low energy, youar sleep problems, or your health issues?</p> <h3>There is a simple test you can do yourself at home without going to your doctor.</h3> <p>This test is especially useful if you have anxiety or <strong>depression, insomnia, headaches, low energy, fatigue, hormonal imbalance, poor immunity</strong> or <strong>blood sugar problems</strong>. I also see evidence of adrenal issues in women with <strong>vulvodynia</strong>, <strong>irritable bowel syndrome </strong>and <strong>chronic pain.</strong></p> <p>The test looks at your cortisol levels as they change through the day. As you can see from the diagram below, cortisol is high to start the day, then gradually drops into the evening, so that you develop a nice, natural tiredness as a signal you need sleep to recharge your body and mind. Cortisol then begins to slowly rise in the hours before 6am to ensure you wake up again &ndash; ideally, bright-eyed and bushy-tailed!</p> <p>&nbsp;<img src="data:image/png;base64,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" alt="" /></p> <p>A number of things can go out of balance with this system. As stress causes you to release cortisol, if your stress rises towards the evening, the cortisol can spike or fail to drop as low as it should.</p> <h3>This can result in sleep problems:</h3> <ul> <li>Difficulty falling asleep</li> <li>Unrefreshing sleep</li> <li>Early waking</li> </ul> <p>The last one is especially common. If you have a busy, stressful or active evening, the cortisol spike may result in you waking at 4 or 5am, even though you actually need more sleep for your health.</p> <p>If you are constantly busy, overcommitted and stressed, you are under great demand to produce cortisol. Your cortisol may actually be too high, making you feel edgy and overstimulated, and as though you can&rsquo;t sit still without doing something. If this continues on too long, you start to drain your adrenal glands, a bit like using the mobile phone without recharging it. If your battery starts to run low, you can then, over time, have trouble producing enough cortisol, and approach &ldquo;burnout&rdquo;.</p> <h3>Classic signs of these kind of energy problems include:</h3> <ul> <li>Feeling groggy and unable to get going in the morning</li> <li>Low energy despite plenty of sleep</li> <li>Feeling unrefreshed after sleep</li> <li>Low mood and difficulty getting motivated for anything</li> </ul> <h3>A simple test that can track your cortisol rhythm is the Adrenal Hormone Profile.</h3> <p>This is completed at home by spitting into a test tube four times per day &ndash; 8am, 12pm, 6pm and 10pm. The cortisol is then measured by the lab.</p> <p>This test is not ordered by your doctor, who will tend to order only a morning cortisol, which will not give the full picture. The Adrenal Hormone Profile needs to be ordered by an integrative practitioner who is experienced at interpreting the cortisol patterns.</p> <p>Contact us now if you would like to order this test and gain some insight into the impact of your adrenal function on your health.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> No, You Can't Get It All From Food Part 2: Nutrients in Food are Lower Than You Think http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/part-2-nutrients-in-food-are-lower-than-you-think <h2>It&rsquo;s sad but true.</h2> <h3>While we&rsquo;d like to think we can get all our essential nutrients from food, it&rsquo;s not easy.</h3> <p>Last post I talked about how are diets are never as good as we&rsquo;d like to think. Most of us know this intuitively, and research confirms we&rsquo;re not meeting our nutrient requirements.</p> <p>For example, a 2014 study of Australian adolescents showed that fewer than 50% of females got enough calcium, magnesium, folate or vitamin D or E, and the males fared no better. 50% of males did not get adequate magnesium, potassium, pantothenic acid, folate, vitamin D or E. A multitude of studies shows inadequate nutrient intakes in special groups of people, including breastfeeding mums, people on a gluten-free diet, and older adults.</p> <p>So this brings me back to another key reason we are not getting enough nutrients:</p> <h3>We can&rsquo;t get the nutrients from food if they&rsquo;re not there.</h3> <p>Australian soils are low in zinc, molybdenum, manganese and zinc.&nbsp; There has been a dramatic reduction in the amount of nutrients in the soil that grows our fresh food since the 1920s. Magnesium levels in the soil, for example, have declined as the use of fertiliser has risen. This is because increasing levels of phosphate in the soil (from fertiliser) result in the plant taking up less magnesium.</p> <h3>Many heavy metals block the uptake or the action of essential minerals in our body.</h3> <p>Cadmium, which is present in fertiliser, blocks the uptake of zinc. Mercury and lead, which we are exposed to every day, strongly block calcium, iron, zinc, selenium, and other essential trace minerals.&nbsp;</p> <h3>Other chemicals in our environment also compromise nutrient intake.</h3> <p>For example, the fluoride in our water interferes with iodine and molybdenum, minerals that are both essential to our good health.</p> <p>This is a reality of 21<sup>st</sup> century living: even when we try to eat the best quality and freshest produce possible, we can&rsquo;t rely on the level of nutrients being sufficient for our needs.</p> <p>Next post in this series will focus on common &ldquo;nutrient thieves&rdquo; in your diet and lifestyle, some of which may surprise you.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> No, You Can't Get It All From Food Part 3: Nutrient Thieves http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/nutrient-thieves <h2>What you might be doing to rob yourself of essential nutrients might surprise you!</h2> <p>We all know that getting enough nutrients is important for general health and normal functioning of the body. But it&rsquo;s not just about eating a healthy diet (as <a href="http://www.equilibriahealth.com.au/Blog/Equilibria-Blog">nutrients in food may be lower than you think</a>). Even if you are getting the nutrients from your food, something in your diet or lifestyle may be stealing them away before your body can use them. Some of these Nutrient Thieves are obvious, and some less so.</p> <h3>Alcohol</h3> <p>Alcohol depletes almost every nutrient from the body. Drinking alcohol makes you need more B-vitamins, magnesium, potassium</p> <h3>Coffee, Tea and Other Caffeine Sources</h3> <p>Unfortunately, coffee increases your need for all of the B vitamins, magnesium, and potassium.</p> <h3>Medications</h3> <p>Many medications have an effect on nutrient levels in the body, and the established adverse effects probably only represent a small portion of the nutritional impact on the body. Anti-epilepsy drugs increase need for vitamin E, antibiotics and methotrexate increase need for folate, antacids increase need for iron and phosphorus. The negative effects of proton pump inhibitors on nutrition is an issue I have addressed in a separate post.</p> <h3>The Pill</h3> <p>While the oral contraceptive Pill is, of&nbsp; course, a medication, it is often not recognised as such (many women leave it off the list when I ask them for medications). Taking the Pill makes you need more vitamin B2, magnesium, vitamin C, folate, zinc and more.</p> <h3>Nutrient Supplements</h3> <p>Even taking supplements can be a problem: vitamin D can deplete the other fat-soluble vitamins A, K and E for example, and calcium, zinc and iron can all block each other.</p> <h3>Food Additives</h3> <p>Even additives hidden in our food increase the need for particular nutrients. One example is tartrazine, the green colour found (inexplicably) in Tim Tams, which increases the body&rsquo;s need for zinc.</p> <h3>Malabsorption</h3> <p>Malabsorption can be due to many causes from coeliac disease to inflammatory bowel disease (Crohn&rsquo;s or ulcerative colitis) to low gastric acid to small intestinal bacterial overgrowth and irritable bowel syndrome. Malabsorption increases your need for all nutrients because fewer are finding their way into the cell where they are required. Most common nutrients at risk include vitamin B12, zinc and iron.</p> <h3>Pregnancy</h3> <p>Don&rsquo;t forget that while pregnancy requires only a small increase in calorie intake, almost all nutrients are required in higher amounts &ndash; and this is tricky when you weren&rsquo;t managing to get them beforehand, and now you are constantly feeling queasy! It&rsquo;s important not to take this lightly, as levels of some nutrients, such as omega 3 fatty acids, can have a far-reaching impact on your child&rsquo;s health and behaviour for years down the track.</p> <h3>Stress</h3> <p>Battling stress throughout the day relies on a constant demand of B-vitamins, magnesium and vitamin C to support the adrenals.</p> <h3>Sugar and Refined Carbohydrate</h3> <p>It&rsquo;s a cruel double-whammy: not only is sugar and excessive carbohydrate bad for us, but it also makes us need more nutrients. These include the B-vitamins, chromium, magnesium and potassium</p> <h3>Fibre</h3> <p>The high-fibre diet: it seems to be the pinnacle of good health. A healthy diet is by definition high in fibre, but there is a downside. Phytic acid, present in all plant foods, binds important minerals to form phytates. These phytates remove minerals from the body, including zinc, iron and calcium. Bran cereal for breakfast? Forget about any nutrients for that meal!</p> <p>This is only the beginning. Genetic variability is another major reason why the nutrients you are getting in your diet may not be enough for you - and this is the topic of another blog post.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Chronic Pain in the Vulva and Pelvis: Retrain Your Brain http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/chronic-pain-in-the-vulva-and-pelvis-retrain-your-brain <h2>Have you ever wished there was a manual to help you outsmart your pain?</h2> <p>Good news &ndash; there is. In fact, it is called &ldquo;Outsmart Your Pain: Twelve Key Insights for Conquering <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=81">Vulvodynia</a> and Persistent Pelvic Pain&rdquo;. I wrote this as an <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">e-book</a> to make it accessible to the largest number of people in the shortest possible time frame.</p> <p>Recent research shows that persistent pain has a lot to do with the brain. The brain begins to process sensation inaccurately, and needs to be retrained in order to resolve the chronic pain.</p> <p><img title="brainonfire" src="http://www.equilibriahealth.com.au/images/brainonfire.jpg" alt="brainonfire" width="275" height="183" /></p> <h3>But firstly &ndash; why would we need a <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">book specifically on pelvic pain</a> anyway?</h3> <p>Persistent pain at the vulva has a lot in common with persistent pain anywhere else in the body, like the back or the knee for example.</p> <p>However, it is at the same time quite different.</p> <p>The female genitals are a region of intense privacy and emotional vulnerability. The vulva and vagina are important symbols of femininity, womanhood and sexual identity for many women.</p> <p>Therefore, pain in this region may be of a different quality and have a particular psychological and emotional impact.</p> <p>The difficulty in talking about and coming to terms with pain in this area can hamper recovery.</p> <p>On the flip side, these identity issues can be addressed through education, therapy and self-help methods that are referred to throughout the <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">e-book.</a> These include methods for retraining your brain.</p> <p><img title="calmbrain" src="http://www.equilibriahealth.com.au/images/calmbrain.jpg" alt="calmbrain" width="194" height="259" /></p> <p>The <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">e-book</a> also contains a Recovery Workbook designed for you to use over twelve weeks. This section summarises each section and its Practical Tips, and gives you a structured system for following the concrete tips I give you. This is not a complete manual on any type of <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=15">pelvic pain</a> or <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=17">vulvar or vaginal pain</a>, but rather a summary of the neuroscience aspect of persistent pain, structured as an educational tool and workbook to help you in your recovery.</p> <h3><a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">Get the e-book here.</a></h3> <p>If you need the specific help that only a health professional experienced in this area can provide, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><strong>contact me to make an appointment</strong> </a>and get started on your recovery.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> The Muscle You Need to Train to Improve Your Singing (or for the non-singers…your shouting) http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-muscle-you-need-to-train-to-improve-your-singing <h2>No, it&rsquo;s not a throat muscle, and it&rsquo;s not your abdominals.</h2> <p>Of course, the abdominals are very important in good singing technique. Any good singing teacher will teach you how to breathe diaphragmatically and activate your abdominal muscles correctly to maximise your air flow, essential to good singing technique.</p> <h3>But there is one humble muscle that is often forgotten &ndash; the pelvic floor.</h3> <p>The muscles that form the floor of the pelvis need to coordinate with the abdominals and the diaphragm for effective technique in singing.</p> <p>And it&rsquo;s not just singing, but other more mundane daily activities. Take this quick quiz:</p> <h3>Can you coordinate your pelvic floor muscles with your abdominals and diaphragm when you&hellip;</h3> <h3>&hellip;speak?</h3> <h3>&hellip;hum?</h3> <h3>&hellip;whistle?</h3> <h3>&hellip;blow out a match?</h3> <h3>&hellip;sing?</h3> <h3>&hellip;shout?</h3> <h3>&hellip;blow your nose?</h3> <h3>&hellip;cough?</h3> <h3>&hellip;blow up a balloon?</h3> <p>See the link below from the clever people at Burrell Education &ndash; the <a href="http://www.burrelleducation.com/wp-content/uploads/2014/01/Breathe_titled.gif">dynamic image will give you a sense of how these muscles coordinate together.</a></p> <p><a href="http://www.burrelleducation.com/wp-content/uploads/2014/01/Breathe_titled.gif">http://www.burrelleducation.com/wp-content/uploads/2014/01/Breathe_titled.gif</a></p> <p>If the abdominals and diaphragm work correctly, but the pelvic floor doesn&rsquo;t play its part, not only will you produce sound less efficiently, but you put yourself at risk of causing or worsening things like <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=16">prolapse</a> and <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=10">bladder leakage</a>.</p> <p>I frequently see women who can coordinate the diaphragm and the abdominal muscles, but the pelvic floor gets left behind.</p> <p>Yes, it is a bit like patting your head and rubbing your tummy at the same time&hellip;but it can be trained!</p> <p>The pelvic floor, like the abdominals, should be released during the intake of breath, and activated during the production of sound for best airflow.</p> <h3>I give my musical patients a very structured program to incorporate the pelvic floor correctly in order to improve their singing or instrument playing.</h3> <p>These exercises are a must to incorporate into your singing warm-ups and singing training.</p> <p>And for those who avoid singing anywhere except the shower, you may find that training this way makes you want to break into song outside of the bathroom!</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> A Guide to Getting Off the Pill (or IUD, or injection, or implant…) http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-guide-to-getting-off-the-pill-intro <h2>The Pill has its upsides and downsides.</h2> <p>Most of us women have been on the Pill at one time or another &ndash; 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.&nbsp;</p> <h3>More and more women are telling me that they would really like to get off the Pill.</h3> <p>Some of them are switching to the IUD, (such as the Mirena), and finding that it trades one set of problems for the other.&nbsp; The most common reason for ceasing the Mirena in a 2013 study was cramping.</p> <h3>But many women persist with the Pill despite problems.</h3> <p>In my experience this is largely for one of two reasons:</p> <ul> <li>The perceived reliability and convenience of the Pill</li> <li>The &ldquo;welcome&rdquo; side effects of the Pill</li> </ul> <h3>The reliability (or not) of the Pill</h3> <p>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.</p> <h3>The &ldquo;welcome&rdquo; side effects of the Pill</h3> <p>Before I talk about unwelcome side effects of the Pill, it&rsquo;s important to point out that some women go on the Pill &ndash; and stay on it &ndash; because of perceived positive side effects. The two most common are</p> <ul> <li>Help with acne</li> <li>Help with painful periods</li> </ul> <h2>So women are in a constant state of &ldquo;push-pull&rdquo; when it comes to the Pill and other chemical contraceptives.</h2> <p>They are not really comfortable with what it&rsquo;s doing to their bodies &ndash; or at least feel uneasy about effects in the long-term &ndash; but there seem to be too many good reasons to stay on it.</p> <p>It&rsquo;s also easier to keep doing what you&rsquo;re doing than make a change &ndash; so some women stay on it, despite their misgivings, because of it&rsquo;s the easier choice.</p> <h2>But what if you would really like some help to come off it?</h2> <p>Maybe you&rsquo;re concerned about your future fertility, or your risks of hormone dependent cancers. Maybe you don&rsquo;t like how it makes you feel, or don&rsquo;t like the side effects you&rsquo;ve had of decreased libido and weight gain. Or maybe it just doesn&rsquo;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.</p> <p>To read the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-guide-to-getting-off-the-pill-step-1">first step</a> to getting off the Pill, click <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-guide-to-getting-off-the-pill-step-1">here.</a></p> <p>If you would like to <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2">sign up to receive this <strong>free</strong> information series</a>, go to our <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2">Newsletter Signup page</a> and tick the box &ldquo;Getting Off the Pill&rdquo;, or just click on the button below.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2"><img title="newsletter_button" src="http://www.equilibriahealth.com.au/images/newsletter_button.png" alt="newsletter_button" width="248" height="106" /></a></p> Sex Selection of Your Baby: Can You Do It Naturally? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/sex-selection-of-your-baby-can-you-do-it-naturally <h2>"Of course I just want a healthy baby...but...I wouldn't mind having a girl this time..."</h2> <p>Sometimes I am asked whether it is possible to increase the likelihood of having a girl as opposed to a boy, or vice versa. This is from parents who are grateful for the gift of a child and would love and welcome the child regardless, but (for example) have a gaggle of girls and would love a boy.</p> <p>When it comes to assisted reproduction &ndash; for example, sex selection in IVF &ndash; this is controversial and ethically debatable. However, many people feel comfortable if this &ldquo;odds increase&rdquo; is based on natural methods, and often ask what I know about the topic.</p> <p>Certain factors have often been cited as increasing or decreasing numbers of boy or girl babies born relative to the opposite sex. The most well-known of these is <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/how-badly-is-stress-affecting-your-physical-health-salivary-cortisol">stress, the impact of which can be measured using a test done at home</a>.</p> <p>A recent study (Catalano et al 2013) after the 2011 eastern Japan earthquake found that in areas most affected by the disaster, there was a decrease in male babies conceived relative to females. Sadly, spontaneous abortion of male foetuses increased in Japan in the period following the earthquake.</p> <p>It has also been proposed that boys born following a period of major stress (e.g. famine) grow up into a cohort of men who are relatively more robust because of a selective increased loss of male babies, thus acting as a &ldquo;culling&rdquo; of weaker males in utero.</p> <p>Additionally, more female babies are born to women with what are perceived as &ldquo;high-stress jobs&rdquo; (Ruckstuhl et al 2010). However, this effect was blunted where there was a high-earning partner; clearly financial security can have a stress-relieving impact.</p> <h2>So, overall, stress seems to select for the birth of more girls than boys.</h2> <p>(Interestingly, no one has suggested purposely increasing your stress levels to increase the chance of a girl, as the above research would suggest &ndash; clearly, we are all stressed enough already!)</p> <h2>There are two main natural methods discussed for &ldquo;sex selection&rdquo; of the baby.</h2> <p>(This would more accurately be termed &ldquo;increasing the odds of a particular sex&rdquo;, but for simplicity&rsquo;s sake, we&rsquo;ll keep it at &ldquo;sex selection&rdquo;!)</p> <p>One method of proposed natural sex selection is <strong>timing of sexual intercourse in relation to ovulation.</strong></p> <p>A second method of proposed natural sex selection is <strong>diet and supplementation.</strong></p> <p>These will be addressed in turn in future episodes of this Blog Series.</p> <p>Interested in concepts related to fertility?<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2"> Sign up for our Fertility Blog Series here.</a></p> Connective Tissue Dysfunction in Vulvodynia and Chronic Pelvic Pain http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/connective-tissue-dysfunction-in-vulvodynia-and-chronic-pelvic-pain <h2>Your vulva hurts. Your vagina hurts. You&rsquo;ve been told you have <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=81">vulvodynia</a>.</h2> <h3>One doctor says the problem is in your nerves. Another says the problem is in your muscles.</h3> <h3>But has anyone checked your connective tissue?</h3> <p>There is no doubt that in most cases of <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=81">vulvodynia</a> there is a problem with the nerves &ndash; 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 <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=81">vulvodynia</a> are more accurately termed <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=95">pudendal neuralgia</a> (a problem with the pudendal nerve, which goes to the vulva).</p> <p>Equally, most women with vulvodynia have a problem with the pelvic floor muscles &ndash; 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 <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a> &ndash; confusing!</p> <p>But the connective tissue is an often overlooked area that can contribute to vulvodynia as well.</p> <h3>So, what exactly is connective tissue, and what does it have to do with vulvodynia?</h3> <p>Connective tissue is the wrapping that covers your muscles and organs, and separates them from each other. It separates different layers of the body &ndash; 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.</p> <p>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!</p> <h3>With this connective tissue surrounding and connecting all parts of your anatomy, can you imagine some of the effects if it&rsquo;s tight or inflexible?</h3> <p>That&rsquo;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 &ldquo;something getting stuck&rdquo;.</p> <p>Part 2 in this series will help you understand your connective tissue further - including how to get it healthy and flexible.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Connective Tissue Dysfunction in Vulvodynia and Chronic Pelvic Pain Part 2: Evaluation and Treatment http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/connective-tissue-dysfunction-in-vulvodynia-and-chronic-pelvic-pain-evaluation-and-treatment <h2>Connective tissue dysfunction in vulvodynia is often missed, and needs to be treated.</h2> <h3>Confused about connective tissue? Picture a whole lot of fruit in a plastic bag, sitting in a bowl of jelly.</h3> <p>apricots, plums, grapes and so on. The fruit can be moved and jiggled around within the jelly, even within the plastic bag.</p> <p>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&rsquo;t move so well. The jelly doesn&rsquo;t get swished around so much, and hardens up.</p> <h3>Your muscles and organs are the fruit, and the connective tissue is the cling wrap.</h3> <p>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 &ndash; the fluid you never noticed unless it increases, causing swelling and possibly pain and even abdominal bloating).</p> <p>The connective tissue around the organs is called visceral connective tissue. Treatment of this connective tissue is known as <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=92">visceral manipulation</a>, and can be a very useful component of treatment of<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=81"> vulvodynia</a> and <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=20">chronic pelvic pain</a>.</p> <p>A specific type of connective tissue restriction will be very familiar to you:</p> <h3>The most common type of connective tissue restriction is a scar.</h3> <p>When scars are deeper in the body, they are often called <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=23">adhesions</a> (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 <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-cry-for-help-from-your-episiotomy-scar">episiotomy</a> or <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/why-you-need-to-play-with-your-caesarean-scar">Caesarean scar</a>, or <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=25">endometriosis</a>).</p> <h3>What does connective tissue mobilisation (CTM) feel like?</h3> <p>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&rsquo;t feel that comfortable, it&rsquo;s probably a good sign you&rsquo;ll benefit from it! Sometimes one side of your body will feel fine and the other uncomfortable &ndash; guess which one needs the treatment?</p> <p><img title="abdominalconnectivetissuemassage" src="http://www.equilibriahealth.com.au/images/abdominalconnectivetissuemassage.png" alt="abdominalconnectivetissuemassage" width="276" height="183" /></p> <p>However, slow and gentle is the key. Too much CTM too soon can stir you up &ndash; 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 &ndash; and especially with central sensitisation &ndash; and plenty of experience in treating it.</p> <h3>Getting treatment for vulvodynia?</h3> <p>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.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Can What You Eat Really Influence The Sex of Your Baby? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/can-what-you-eat-really-influence-the-sex-of-your-baby <h2>(Before conceiving, of course!)</h2> <p>If you have your heart set on a boy rather than a girl (or vice versa), you may be aware of &ldquo;sex-selection diets&rdquo; that supposedly increase your chances in the direction you favour.</p> <h3>Is there really anything to these diets, or are they just pulled out of nowhere?</h3> <p>There is some basis for the recommendations that are given &ndash; certain studies that have found an association between the sex of the baby and the mum&rsquo;s of pre-conception diet. The question is whether the findings of the studies are strong enough to warrant these recommendations.</p> <p>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&rsquo;s sex &ndash; women who ate breakfast cereal were more likely to deliver boys.</p> <h3>Does this mean that if you are hanging out for a girl, you should eat less food and never touch breakfast cereal?</h3> <p>Unfortunately, these conclusions don&rsquo;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 &ndash; so it could be that stress itself is the marker. Stressed and rushed women may be less likely to eat breakfast &ndash; 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.</p> <h3>While these associations are interesting, they do not really provide any sensible course of action that could be recommended.</h3> <p>Skipping breakfast does not do anyone&rsquo;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.&nbsp;&nbsp; And certainly, calorie restriction is much more likely to lead to nutrient deficiencies, which is exactly what you don&rsquo;t want when you are aiming for a healthy conception.</p> <p>A research trial with real couples is really what was required &ndash; 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.</p> <p>To <a href="http://www.equilibriahealth.com.au/Form/sign-up-to-pelvic-pain-updates">sign up for our Fertility Blog Series</a>, sign up to our newsletter and tick "Fertility".</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Diet as a Method of Sex Selection of Your Baby: Some Early Studies http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/diet-as-a-method-of-sex-selection-of-your-baby-some-early-studies <p>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&rsquo;s a little thin on the ground.</p> <h3>But first: why should what you eat influence who you conceive, anyway?</h3> <p>The theory is known as the &ldquo;ionic theory&rdquo;. Stolkowski and Choukroun explain this as the ratio of sodium and potassium to calcium and magnesium influencing ovarian metabolism &ndash; that is, the likelihood that the ovary will attract a sperm containing the X chromosomes (girl) &nbsp;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.</p> <p>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&rsquo;t explain why they were excluded &ndash; you hope it wasn&rsquo;t because including their results would have affected the outcomes they reported). In any case, they reported &ldquo;about an 80% success rate&rdquo;.</p> <p>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.</p> <p>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 &ldquo;desired sex&rdquo; &ndash; around 77%. An important point here is that the study was intended to be much larger &ndash; the authors tell us that 75% of the women dropped out (i.e. failed to follow the diet).</p> <p>What all of these studies don&rsquo;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 &ldquo;timing of intercourse&rdquo;? 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 &ldquo;confounding variable&rdquo;.</p> <p>While these figures sound promising, they are all based on retrospective analysis &ndash; 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 &ndash; 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.</p> Exactly such a study was done in 2010 - and this is the topic of the next blog post in the series. <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> How To Make Your Own Probiotics at Home http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/how-to-make-your-own-probiotics-at-home-sauerkraut <h2>Probiotics&hellip;research is overflowing on their importance for good gut health and proper immune system function, to name two.</h2> <p>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.</p> <p>However, there are also major potential benefits from simply increasing the number and variety of probiotic organisms in your diet &ndash; and this is where fermentation comes in.</p> <h3>This couldn&rsquo;t be easier than making your own sauerkraut at home.</h3> <p>(Trust me &ndash; I burn pans when I'm boiling water, so if I can do it successfully, then anyone can!)</p> <p>Haven&rsquo;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 &ndash; exponentially &ndash; its health benefits). Purple cabbage makes a gorgeous sauerkraut and is ridiculously high in vitamin C and antioxidants.</p> <h3>And even if you are on a low FODMAPs diet (for example, for <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=12">irritable bowel syndrome</a>), you may find that sauerkraut works for you where non-fermented cabbage doesn&rsquo;t.</h3> <p>This is because the FODMAPs are dramatically reduced in the fermentation process.</p> <p>Best of all, it&rsquo;s cheap, and all you need is a cabbage, a jar, and some salt.</p> <h3>Simple Steps To Making Sauerkraut</h3> <ol> <li>Slice whole cabbage into strips and put in a large bowl.</li> <li>Add 1 tsp salt. (I love to add a tablespoon of caraway seeds as well).</li> <li>Massage the salt into the cabbage for 10 minutes. Squeeze the cabbage hard!</li> <li>(Set the kitchen timer and consider this your upper body workout for the day)</li> <li>By the end of ten minutes, there should be fluid coming out of the cabbage.</li> <li>Pack the cabbage into a jar, squishing it down firmly with (for example) a pestle or end of a rolling pin.</li> <li>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 &ndash; it keeps the cabbage leaves firmly pressed under the top of the fluid.</li> <li>Put the jar on a shelf out of the way, covered with a tea towel to keep out any bugs.</li> <li>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.</li> <li>Leave to ferment for 7 days then put a lid on it and refrigerate.</li> </ol> <p>Give it a try &ndash; you&rsquo;ll be hooked! </p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Do You Understand Your Fertility? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/do-you-understand-your-fertility-vaginal-discharge <h2>Normal fertility is a key part of good health as a woman.</h2> <p>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.</p> <p>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.</p> <p>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.</p> <h2>So what is the most important sign of fertility?</h2> <p><img title="periodtracking" src="http://www.equilibriahealth.com.au/images/periodtracking.png" alt="periodtracking" width="225" height="152" /></p> <p>Most people&rsquo;s first guess would be menstruation; the regularity of our bleeding. Even many doctors would think this is the case.</p> <p>However, bleeding (whether regular or irregular) is not a reliable sign of fertility. Bleeding can happen &ndash; in fact it can even be regular &ndash; 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.</p> <h2>So is it blood level of hormones, then, that is the best sign of fertility?</h2> <p><img title="hormonecycle" src="http://www.equilibriahealth.com.au/images/hormonecycle.png" alt="hormonecycle" width="259" height="194" /></p> <p>No, it&rsquo;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 &ndash; and are sometimes essential &ndash; they are not the be-all-and-end-all of fertility awareness, by any means.</p> <p>So again, what sign does the body give us that we can tune into for most reliable information about our fertility?</p> <h2>It&rsquo;s mucus &ndash; that is, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/how-do-i-know-if-my-vaginal-discharge-is-normal"><strong>vaginal</strong> <strong>discharge</strong></a>.</h2> <p><img title="uterusandcervix" src="http://www.equilibriahealth.com.au/images/uterusandcervix.jpg" alt="uterusandcervix" width="200" height="200" /></p> <p>That&rsquo;s right, it&rsquo;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 &ndash; such as in the early breastfeeding period, or around the time of menopause &ndash; it&rsquo;s this lack of changes that gives you important information about your changing fertility.</p> <h3>If you are like most women, you have never learned <strong><a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/how-do-i-know-if-my-vaginal-discharge-is-normal">how to work out if your vaginal discharge is normal.</a></strong></h3> <h2>So where do we learn this important way of having insight into our fertility?</h2> <p>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</p> <h2>&ldquo;Knowledge of her body that every woman ought to have.&rdquo;</h2> <p>The Billings Ovulation Method <em>cannot be reliably learned from a book or the Internet</em>. 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 <span class="skype_c2c_print_container">1800 335 860</span><span class="skype_c2c_container" dir="ltr" onmouseover="SkypeClick2Call.MenuInjectionHandler.showMenu(this, event)" onmouseout="SkypeClick2Call.MenuInjectionHandler.hideMenu(event)"><span class="skype_c2c_highlighting_inactive_common" dir="ltr"><span class="skype_c2c_textarea_span"><img class="skype_c2c_logo_img" src="resource://skype_ff_extension-at-jetpack/skype_ff_extension/data/call_skype_logo.png" alt="" /><span class="skype_c2c_text_span">1800 335 860</span></span></span></span>. You can find more information at <a href="http://www.thebillingsovulationmethod.org/">http://www.thebillingsovulationmethod.org/</a>. Beware of imitation sites, which often provide inaccurate information.</p> <p><a href="http://www.thebillingsovulationmethod.org/"><img title="billingslogo" src="http://www.equilibriahealth.com.au/images/billingslogo.png" alt="billingslogo" width="219" height="65" /></a></p> <p>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.</p> <h2>If you need help with your fertility as a whole, you may be interested the <a href="http://www.equilibriahealth.com.au/Page/fertility-problems"><strong>unique combined approach to fertility</strong></a> that we use at Equilibria Physiotherapy &amp; Nutrition.</h2> <div id="skype_c2c_menu_container" class="skype_c2c_menu_container" style="left: 598px; top: 901.4px; display: none;" onmouseover="SkypeClick2Call.MenuInjectionHandler.showMenu(this, event)" onmouseout="SkypeClick2Call.MenuInjectionHandler.hideMenu(event)"> <div class="skype_c2c_menu_click2call"><a id="skype_c2c_menu_click2call_action" class="skype_c2c_menu_click2call_action" href="http://www.equilibriahealth.com.au/admin/skype:+611800335860?call&amp;origin=FFTB/SPNR/7.1.15383.6004/http%3A%2F%2Fwww.equilibriahealth.com.au%2Fadmin%2Findex.cfm">Call</a></div> <div class="skype_c2c_menu_click2sms"><a id="skype_c2c_menu_click2sms_action" class="skype_c2c_menu_click2sms_action" href="http://www.equilibriahealth.com.au/admin/skype:+611800335860?sms&amp;origin=FFTB/SPNR/7.1.15383.6004/http%3A%2F%2Fwww.equilibriahealth.com.au%2Fadmin%2Findex.cfm">Send SMS</a></div> <div class="skype_c2c_menu_add2skype"><a id="skype_c2c_menu_add2skype_text" class="skype_c2c_menu_add2skype_text" href="http://www.equilibriahealth.com.au/admin/skype:+611800335860?add&amp;origin=FFTB/SPNR/7.1.15383.6004/http%3A%2F%2Fwww.equilibriahealth.com.au%2Fadmin%2Findex.cfm">Add to Skype</a></div> <div class="skype_c2c_menu_toll_info"><span class="skype_c2c_menu_toll_callcredit">You'll need Skype Credit</span><span class="skype_c2c_menu_toll_free">Free via Skype</span></div> </div> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Eating for a Girl: Musings on a 2010 study http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/eating-for-a-girl-musings-on-a-2010-study <h2>Are you ready?</h2> <p>This is a rare blog post for me: one where I get into the nitty-gritty of a study without restraint. But if you&rsquo;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 <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/can-what-you-eat-really-influence-the-sex-of-your-baby">diet as a method of sex selection </a>and <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/diet-as-a-method-of-sex-selection-of-your-baby-some-early-studies">what some early studies say about diet and sex selection. </a></p> <p>Recently my attention was brought to a prospective study of couples who desired a girl. Part of the study intervention was a &ldquo;girl diet&rdquo;, based on the theory I mentioned in my <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/diet-as-a-method-of-sex-selection-of-your-baby-some-early-studies">last blog post on the ionic theory of natural sex selection</a>. 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.</p> <p>As far as I am aware, this is the first prospective study looking at manipulating diet for natural sex selection (and in my <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/diet-as-a-method-of-sex-selection-of-your-baby-some-early-studies">last post</a> I mentioned that prospective studies carry far more rigour than retrospective studies when it comes to interpreting the effects of a particular intervention).&nbsp; So that feature certainly lies in its favour. And some of the findings reported in the study findings certainly sound impressive &ndash; most importantly, it reported that the diet method reached <em>statistical significance</em> (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 <em>p value</em> 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.</p> <p>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 <strong>combination</strong> 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 &ldquo;diet factor&rdquo; and how much to the &ldquo;timing factor&rdquo;, the bottom line is that you can&rsquo;t reliably&nbsp; 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 &ndash; 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.</p> <p>There were also a few flaws, I felt, in the reasoning that guided the dietary intervention.</p> <p>One:&nbsp; 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 &ldquo;mineral concentrations [in the blood] are controlled by a tight homeostasis, so any significant change in these values must be related to the diet&rdquo;. Firstly, it was never determined that the method of manipulating minerals to change blood levels of those minerals was valid&rdquo;, (except for sodium which was checked for reliability in six subjects by checking their urine output of sodium as well). &nbsp;&nbsp;Neither was it stated how changes in the mineral concentrations were judged to be &ldquo;significant&rdquo;. 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 &ndash; 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. </p> <p>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 &ndash; but yoghurt, for example, is also very high in potassium &ndash; 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.</p> <p>Three: only the subjects who &ldquo;stuck to the diet&rdquo; were included in the final analysis, the protocol group. For good quality research, what is known as an <em>intention-to-treat analysis</em> needs to occur &ndash; 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&rsquo;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.</p> <p>The statistics in the study is beyond me and most non-statisticians; however, the authors worked out that the <strong>best predictors for having a girl was the sodium and calcium concentrations before the diet and at the time of conception</strong>. Magnesium and potassium levels in the blood were not found to be significant, which isn&rsquo;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&rsquo;s magnesium status).</p> <p>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 <em>association</em>, 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 <em>confounding variables</em>.</p> <p>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.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> A Guide to Getting Off The Pill Step 1 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-guide-to-getting-off-the-pill-step-1 <h2>Understand what you have been using and how it works</h2> <p>When considering whether the pros and cons of continuing with or stopping your current method of chemical contraception, it&rsquo;s helpful first of all to understand how it works. We&rsquo;ll consider firstly how they work as contraceptives, then consider the other reasons people might choose to use them.</p> <h3>First and foremost: contraception.</h3> <h4>&ldquo;The Pill&rdquo; - The Oral Contraceptive Pill</h4> <p><img title="thepill" src="http://www.equilibriahealth.com.au/images/thepill.jpg" alt="thepill" width="282" height="179" /></p> <p>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).</p> <h4>How it works:</h4> <p>Preventing ovulation</p> <p>Thickening the cervical mucus to make it hard for the sperm to move through</p> <p>Thinning the lining of the uterus, making it more difficult for the fertilised egg to implant in the wall of the uterus</p> <h4>Effectiveness Rating:</h4> <p>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</p> <h4>&ldquo;The Coil&rdquo; - The Hormonal IUD , the Mirena</h4> <p><img title="mirena" src="http://www.equilibriahealth.com.au/images/mirena.png" alt="mirena" width="259" height="194" /></p> <p style="text-align: left;">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.</p> <h4>How it works:</h4> <p>Thickening the cervical mucus to make it hard for the sperm to move through</p> <p>Thinning the lining of the uterus, making it more difficult for the fertilised egg to implant in the wall of the uterus</p> <h4>Effectiveness Rating:</h4> <p>99.9%</p> <h4>&ldquo;The Rod/Implant&rdquo; &ndash; Implanon</h4> <p><img title="implanon" src="http://www.equilibriahealth.com.au/images/implanon.png" alt="implanon" width="276" height="183" /></p> <p>Implanon is a small rod inserted by a doctor via into the fat underneath the upper arm. It provides 3 years&rsquo; worth of contraception. Like the Mirena, it is progestogen-based (no oestrogen).</p> <h4>How it works:</h4> <p>Preventing ovulation</p> <p>Thickening the cervical mucus to make it hard for the sperm to move through</p> <p>Thinning the lining of the uterus, making it more difficult for the fertilised egg to implant in the wall of the uterus</p> <h4>Effectiveness Rating:</h4> <p>99.9%</p> <h4>&ldquo;The Injection&rdquo; - Depo Provera (DMPA)</h4> <p><img title="depoprovera" src="http://www.equilibriahealth.com.au/images/depoprovera.png" alt="depoprovera" width="299" height="168" /></p> <p>Like the Mirena and Implanon, the Depo Provera injection is a progestogen (no oestrogen).</p> <h4>How it works:</h4> <p>Preventing ovulation</p> <p>Thickening the cervical mucus to make it hard for the sperm to move through</p> <h4>Effectiveness Rating:</h4> <p>99%</p> <h3>Second: Other desirable side effects</h3> <h4>Lighter Periods</h4> <p>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 &ndash; some women have no or infrequent bleeding on the Mirena. Other women have continual spotting.</p> <p>A distinction that is important to make here is between &ldquo;periods&rdquo; and &ldquo;withdrawal bleeding&rdquo;. 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 &ldquo;periods&rdquo;, 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.</p> <h4>Less Painful Periods</h4> <p>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 <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=25">endometriosis</a> due to complacency once the pain eases.</p> <h4>More Regular Periods</h4> <p>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 <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=137">polycystic ovarian syndrome</a>.</p> <h4>Improvement in Anaemia and Low Iron Status</h4> <p>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.</p> <h4>Improvement in Acne</h4> <p>I see an enormous number of women who are on the Pill &ldquo;for their skin&rdquo;. 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.</p> <p>In the next post we&rsquo;ll talk about some of the considerations to be aware of if choosing to use any of these methods of contraception.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Could Vaginal Wind Be A Sign of Something More? (and an easy solution…) http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/vaginal-wind-could-it-be-a-sign-of-something-more <p>There&rsquo;s no argument: <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=66">passing wind from the vagina </a>can be really embarrassing, whether it happens during a yoga class or when you are having sex.</p> <p><img title="shoulderstand" src="http://www.equilibriahealth.com.au/images/shoulderstand.png" alt="shoulderstand" width="198" height="255" /></p> <p>A recent study looked at a group of 800 women. Around 14% of them experienced vaginal wind, or &ldquo;vaginal noise&rdquo; 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 <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=16">prolapse</a>, whereas only 10% of the women without vaginal wind had a <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=16">prolapse</a>. That&rsquo;s double the rate of prolapse in the vaginal wind group!</p> <p>As well as that, women with vaginal wind were at least twice as likely to experience <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=65">faecal incontinence </a>&ndash; that is, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=103">accidental bowel leakage</a>.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=103">Accidental bowel leakage</a> and <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=16">prolapse </a>are two problems that we can do a lot about and shouldn&rsquo;t be ignored.</p> <p>But what to do about the vaginal wind?</p> <p>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.</p> <p>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.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Alkaline Diet for Good Health: Myth or Reality? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/alkaline-diet-for-good-health-myth-or-reality <p>There is a lot of talk about the balance between acidity and alkalinity for good health &ndash; at least in the natural health world.</p> <p>&ldquo;Alkalinity&rdquo; is often equated with good health, and &ldquo;acidity&rdquo; 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.</p> <p><img title="lemon" src="http://www.equilibriahealth.com.au/images/lemon.png" alt="lemon" width="225" height="225" /></p> <h2>So is &ldquo;becoming more alkaline&rdquo; really a goal we should have in mind &ndash; and is it more important if there is chronic pelvic pain? And if it is, how to we go about achieving it?</h2> <p>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 &ldquo;murky&rdquo; kind of topic more clear.</p> <p>This first post will cover the alkaline-acid theory in general. My next post will relate it to chronic pelvic pain and interstitial cystitis.</p> <p>So let&rsquo;s start with the first question.</p> <h3>Is alkalinity-acidity a genuine concept, or something that some strange naturopaths have inherited from folk wisdom with no basis in fact?</h3> <p><img title="ph" src="http://www.equilibriahealth.com.au/images/ph.jpg" alt="ph" width="301" height="168" /></p> <p>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).&nbsp; Based on blood test findings, it is possible to be placed in one of five categories:</p> <h4>Normal &ndash; most of the general population. No excessive alkalinity or acidity.</h4> <h4>Metabolic acidosis &ndash; the blood is too acidic, and the reason is something to do with the metabolism (such as uncontrolled diabetes)</h4> <h4>Respiratory acidosis &ndash; the blood is too acidic, and the cause is something to do with the respiratory system, such as hypoventilation</h4> <h4>Metabolic alkalosis &ndash; the blood is too alkaline, and the reason is something to do with the metabolism</h4> <h4>Respiratory alkalosis &ndash; the blood is too alkaline, and the reason is something to do with the metabolism.</h4> <p>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.</p> <h3>What influences acidity or alkalinity level of the tissue?</h3> <p>Although we can&rsquo;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.</p> <h4>Composition of the diet</h4> <p>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 &ldquo;acidifying&rdquo; 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&rsquo;s acidity.</p> <p><img title="freshfood" src="http://www.equilibriahealth.com.au/images/freshfood.png" alt="freshfood" width="274" height="184" /></p> <h4>Influence of minerals on alkalinity</h4> <p>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&rsquo;t matter whether you&nbsp; have the &ldquo;cleanest&rdquo; of&nbsp; raw food vegan diets &ndash; your system will still tend towards acidity.</p> <p>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.</p> <h4>Digestion</h4> <p>There is often confusion, when discussing the relative merits of &ldquo;alkalinity&rdquo;, 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 &ndash; you guessed it &ndash; are important for tissue alkalinity.</p> <p>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.</p> <p>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 &ndash; including the urine, helpful at times in painful bladder syndrome or interstitial cystitis &ndash; but if consumed close to eating, will actually counteract the normal gastric acidity and can have a counterproductive effect on tissue alkalinity.</p> <h4>Inflammation</h4> <p>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&rsquo;t matter: it can be inflammatory bowel disease or obesity &ndash; but there is always associated acidity.</p> 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. <br /> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Is An Alkaline Diet Good For Chronic Pelvic Pain, Vulvodynia and Interstitial Cystitis?? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/is-an-alkaline-diet-good-for-chronic-pelvic-pain-vulvodynia-and-interstitial-cystitis <h2><strong>The state of the body's acidity vs alkalinity both reflects and affects health. </strong></h2> <p>This is a topic I summarised in my<a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/alkaline-diet-for-good-health-myth-or-reality"> last post</a>. But what about the specific scenarios of <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=9">chronic pelvic pain</a>, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=81">vulvodynia</a> and <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=11">interstitial cystitis</a>?</p> <h3><strong>Does acidity or alkalinity have anything to do with chronic pain?</strong></h3> <p>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 &ldquo;alkalising supplement&rdquo; 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".</p> <h3><strong>Does acidity or alkalinity have anything to do with specific types of pelvic pain, like vulvodynia or interstitial cystitis?</strong></h3> <h4>Vulvodynia</h4> <p>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<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=81"> vulvodynia</a>, 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.</p> <p><img title="stingingontoilet" src="http://www.equilibriahealth.com.au/images/stingingontoilet.jpg" alt="stingingontoilet" width="271" height="186" /></p> <h4>Interstitial cystitis or <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=11">painful bladder syndrome</a></h4> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=11">Interstitial cystitis</a> is a special case here. Tissue acidity may well be present, but a common trigger reported by people with IC is acidic foods &ndash; drinking coffee, carbonated beverages (fizzy drinks), oranges and tomatoes. A theory here is that the lining of the bladder, which can be &ldquo;worn away&rdquo; 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 &ndash; even foods like lemon, which are acidic in nature, but don&rsquo;t affect overall tissue acidity. However, &ldquo;IC diets&rdquo; 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.</p> <p>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 <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/alkaline-diet-for-good-health-myth-or-reality">last post</a>. </p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Herbal Medicine for Period Pain http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/herbal-medicine-for-period-pain <h2>Period pain is a destructive force in many women&rsquo;s lives.</h2> <p>Time off work, pressure on relationships, stopping participation in sport and hobbies are just some of the effects&hellip;not to mention the untold suffering from the pain itself.</p> <h3>What can you do?</h3> <p>Many of my female clients report pain during their periods (also called dysmenorrhea) or an exacerbation of their <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=9">chronic pelvic pain</a> or vulvar pain. But what can you do about it, aside from the all-too-common &ldquo;solution&rdquo; of going on the Pill, or over-relying on non-steroidal anti-inflammatory drugs, and risking their significant side effects?</p> <h3>In a word: herbs.</h3> <p>I&rsquo;m sorry to sound simplistic, but I&rsquo;ve seen herbs work so often for painful periods that I&rsquo;m pretty black and white about this. Try herbs for period pain. Especially before you resort to the Pill &ndash; or <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-guide-to-getting-off-chemical-contraception-understand-how-it-works">if you want to get off the Pill</a>, but are worried about your period pain returning.</p> <p>But don&rsquo;t take it from me. Let&rsquo;s look at what the studies say.</p> <h3>Yes, there is research supporting it to silence the naysayers.</h3> <p>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).</p> <p>A 2011 study showed effectiveness of the herb Valerian for dysmenorrhea, probably due to anti-spasmodic effects.</p> <p><img title="corydalis" src="http://www.equilibriahealth.com.au/images/corydalis.png" alt="corydalis" width="138" height="200" /></p> <p>The herb Corydalis is the most common herb used in Taiwan for dysmenorrhea &ndash; 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 &ndash; not just for dysmenorrhea, but other forms of visceral pain or <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=50">neuropathic pain</a>.</p> <p>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.</p> <p><img title="ginger" src="http://www.equilibriahealth.com.au/images/ginger.png" alt="ginger" width="225" height="225" /></p> <h3>And you don't have to take it all month long.</h3> <p>The great thing about herbs for dysmenorrhea is that they can be used &ldquo;lazily&rdquo; &ndash; 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.</p> <p>A recent example is a client of 17, who I had been seeing for persistent vulvar and urethral pain and <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=131">dyspareunia (painful sex)</a>, and a diagnosis of <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=81">vulvodynia</a> and <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a>. 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 &ldquo;like someone shooting knives up me&rdquo; , and a &ldquo;constant burn in the back passage&rdquo; . She would get extreme cramps in the abdomen, anus (like <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=96">proctalgia fugax</a>) and down her legs. This would start within one hour of her bleeding. She described herself as feeling &ldquo;borderline suicidal&rdquo; from the pain.</p> <p>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.)</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Getting Off The Pill Step 2 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/getting-off-the-pill-part-2 <h2>Understand the problems &ndash; both the hypothetical and the real</h2> <p>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).</p> <h3>How does it work?</h3> <p>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&rsquo;s progesterone. So in summary, the Pill makes your body behave in a &ldquo;high-oestrogen&rdquo; way, which may explain some of the side effects and risks.</p> <p><img title="thepill" src="http://www.equilibriahealth.com.au/images/thepill.jpg" alt="thepill" width="282" height="179" /></p> <h3>What are the less serious side effects? (note, if these are more than mild, they could be considered serious!)</h3> <ul> <li>Nausea</li> <li>Breast tenderness</li> <li>Mood changes</li> <li>Breakthrough bleeding</li> <li>Headaches</li> </ul> <h3>What are the more serious side effects?</h3> <ul> <li>Loss of sexual arousal and pleasure, orgasm and lubrication</li> <li>Folate and other nutrient deficiency, which can lead to neural tube defects if a pregnancy occurs</li> <li>Insulin resistance, a precursor of diabetes</li> <li>Increased risk of thrombosis (a blood clot that can lead to death even in young women)</li> <li>Increased risk of cervical cancer and breast cancer</li> </ul> <p>There are other reasons you may not feel comfortable with using the Pill.</p> <h3>Masking the underlying cause of the problem</h3> <p>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 <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=25">endometriosis</a> (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.</p> <h3>Fertility problems: it&rsquo;s worth thinking about.</h3> <p>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&rsquo;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&rsquo;s too late.</p> <p>Especially if you haven&rsquo;t been 100% happy on the Pill, the side effects and risks may not be worth it. It&rsquo;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.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Dairy Dilemma: What's the Link Between Constipation and Cow's Milk Protein Intolerance? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/link-between-chronic-constipation-and-cows-milk-protein-intolerance <p>As a naturopath, you can&rsquo;t help but see some patterns that come up over and over again. When it comes to cow&rsquo;s milk protein (CMP) intolerance, we see links to kids&rsquo; health problems like recurrent ear infections, tonsillitis, eczema and late bedwetting.</p> <h2>Another clear link is between cow's milk protein (CMP) intolerance and constipation.</h2> <p>To the kids who love milk and their long-suffering parents, telling them that dairy could be causing their child&rsquo;s suffering is hardly music to their ears (though it may be music to their rears, if you&rsquo;ll pardon the pun).</p> <p>I realise how difficult it can be to take kids off dairy. So I usually try other things first: probiotics, prebiotics, toilet habits, fibre, fluid, behavioural things, laxative manipulation and so on.</p> <p>But often, it comes back to an overwhelming suspicion that the child is not tolerating something in their diet&hellip;</p> <p>And dairy tops the list of usual suspects.</p> <h2>At this point, I usually suggest we do food sensitivity testing.</h2> <p>This is not the same as food allergy testing, so it (like all tests) is not a perfect test to rule out a problem with cow&rsquo;s milk protein (CMP). But it&rsquo;s amazing how often dairy comes up as a positive on this test, and how removing dairy from the diet makes a difference to the patient.</p> <p>My experiences may or may not convince you, so&hellip;</p> <h2>Wwhat does the research say about this?</h2> <p><br /> A 2014 review of ten studies found that a CMP-free diet had a 28-78% success rate in childhood constipation.</p> <h3>The authors recommend a 2-4 week exclusion period to test the theory.</h3> <p>A Russian study from 2013 on infants with constipation and dermatitis found that if probiotics were added to a CMP-free diet, the effect was more pronounced.</p> <h3>Adding probiotics is always a must.</h3> <p>Another 2013 study showed that patients with food intolerance had higher anal sphincter pressures. What is fascinating here is that the patients had anal fissures (a painful condition associated with constipation), and that healing of these anal fissures was higher in the group who were put on an elimination diet. What&rsquo;s more, the fissures came back when CMP and wheat were (separately) re-introduced! The patients who reacted to these challenges had higher amounts of eosinophils in the anus, suggesting an allergic response.</p> <h3>So anal fissures, a notoriously difficult to treat condition, could be related to CMP intolerance as well.</h3> <p>A group of children placed on a soy formula instead of CMP achieved resolution of chronic constipation in another 2013 study. This study also compared the effects of A1 and A2 milk protein, and while there were better effects on the A2, this was not statistically significant.</p> <p>Reflux in infants commonly overlaps with CMP allergy, and where this is the case, a 2-4 week CMP free diet can resolve the reflux symptoms, according to a 2013 review.</p> <h3>So how common is CMP allergy?</h3> <p>One study found that in a group of children with chronic constipation, 77% were CMP allergic!</p> <h3>And how long does the child need to remain CMP-free for?</h3> <p>One study looked at the &ldquo;development of tolerance&rdquo; &ndash; that is, the ability to reintroduce the food without causing the same reaction. It found that if CMP was reintroduced in six months, only 22% of children had developed tolerance. On the other hand, of reintroduction was at twelve months, a full 88% had achieved tolerance!</p> <p>It&rsquo;s sad news for the constipated kids who love their milk &ndash; like my 2-year-old patient from this week, who drinks over a litre a day. But the stats are there, and if your child suffers from chronic constipation, the time and effort taken to see if they are reacting to CMP could be well and truly worth it.</p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Sing Your Way to Pelvic Floor Recovery http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/sing-your-way-to-pelvic-floor-recovery <h2>Or, Pelvic Floor Rehab Doesn't Need to Be Boring!</h2> <p>So your pelvic floor seems to be failing you. Maybe you are leaking urine when you run (<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=10"><em>stress incontinence</em></a>), maybe you are now having to run to make it to the toilet (<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=61"><em>urge incontinence</em></a>), or maybe things feel heavy and bulgy down there (could be a <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=16"><em>prolapse</em></a>).</p> <p>You&rsquo;ve been told by well-meaning health professionals you shouldn&rsquo;t be running, lifting, straining, doing sit-ups, bending, or even daring to move without making sure you have your pelvic floor zipped up and locked on.</p> <p>In fact, you are even in danger of losing urine with laughing now. Talk about sucking the joy out of life!</p> <p>Yikes! Life has never felt so dangerous. There seem to be so many activities that seem to put pressure on the pelvic floor!</p> <h3>Well, I have more bad news for you. (But don&rsquo;t worry, I will then follow it up with some delightful news.)</h3> <p>The bad news is that other seemingly benign activities also put pressure on your pelvic floor &ndash; activities like walking, getting out of the chair, and prolonged standing. (And, as I mentioned, laughing!)</p> <p>I talk to women every day who feel like anything physical is now off the agenda. But at least you can sing without any qualms, right?</p> <p>Wrong. Singing, like any forced exhalation, also potentially places pressure on your pelvic floor.</p> <h3>The good news is that singing is also a wonderful method for rehabilitating the pelvic floor.</h3> <p>Good singing technique involves coordinated activity of the diaphragm, deep abdominal muscles and &ndash; yes, you guessed it &ndash; the pelvic floor muscles.</p> <p>So doing some vocal exercises commonly used in singing training can be a fabulous way to rehabilitate pelvic floor and abdominal function with all forced exhalation activities, including coughing, laughing, sneezing, nose blowing and raising your voice.</p> <h3>And more good news &ndash; you don&rsquo;t have to be singing in tune to do it &ndash; just with correct technique!</h3> <p>A good singing teacher can teach correct vocal technique - but only a qualified pelvic floor physiotherapist can accurately integrate pelvic floor function into this.</p> <p>Come and see me at Equilibria for a fun and practical progressive program to rehabilitate your pelvic floor.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> I'm in pain...do I need a physiotherapist, or an integrative nutritionist? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/pain-do-i-need-a-physiotherapist-or-an-integrative-nutritionist <h2>(Or: An Open Letter to My Dear Patients)</h2> <p>The majority of people I see are referred to me by a health professional (usually a GP, specialist, physio or osteopath) for my expertise as a physiotherapist.</p> <p>This is the field in which my training started.</p> <p>It is also the field in which I specialised (in pelvic floor dysfunction) and then sub-specialised (in pelvic floor pain syndromes).<br /> <br /> The expectation of patients, therefore, is often that I will be treating them using physical or manual means.<br /> <br /> Most of you know I am dually trained in physiotherapy and integrative nutrition, but this can be hard to get your head around, especially when you are expecting a certain type of treatment when you come.</p> <p>The longer I am in practice, though, the better I get at pinpointing which approach is going to work best for you. This is usually obvious to me within the first session.</p> <p>The surprising thing is, sometimes this may not match your expectations. Your condition (or symptoms) may seem to fit entirely within the realm of the physical &ndash; the biomechanical &ndash; the anatomical &ndash; the structural &ndash; or whatever you would like to call it.</p> <p>But particularly with conditions involving pain, the lines start to get blurry.</p> <p>For example, despite its obvious nutritional nature&nbsp; -</p> <h3>I can treat <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=12">irritable bowel syndrome</a> from a physical or manual therapy standpoint, using techniques like <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=92">visceral manipulation</a> and connective tissue mobilisation.</h3> <p>And conversely, despite the obvious role of physiotherapy &nbsp;-</p> <h3>I can treat <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=81">vulvodynia</a> from a nutritional or biochemical standpoint.</h3> <p>Most commonly, I like to take a joint approach (as well as recommending any other types of input you may benefit from).</p> <p>I will always take into account your preferences. Occasionally I see a strong need for nutritional intervention, but the patient lets me know they do not want to go this direction&hellip;sometimes just with the non-verbals!</p> <p>I was recently interviewed for the magazine of the Australian Physiotherapy Association about this combination approach I take. I was quoted as saying:</p> <h3>The vast majority of patients are really excited when they know there is another angle that their health can be looked at from. If we broaden the vision a little bit, then it gives us more scope for treatment.</h3> <p>My hope for you as my patient is that you will keep an open mind. I have seen many people be surprised by the success of an approach they didn&rsquo;t initially expect when they walk through the door. &nbsp;I hope you will let my dual training work as an advantage for you.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Do Probiotics Work? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/do-probiotics-work <h2>A (Greatly Truncated) Response to the Question of Whether Probiotics are Overrated</h2> <h3>Probiotics: myth or miracle?</h3> <p>It&rsquo;s the kind of grab-your-attention, oversimplified, dichotomized headline we are used to in the media. But, I was grateful to be asked for my opinion on an article of this name:</p> <p><a href="http://www.theguardian.com/lifeandstyle/2014/nov/30/probiotics-myth-or-miracle-prebiotics">http://www.theguardian.com/lifeandstyle/2014/nov/30/probiotics-myth-or-miracle-prebiotics</a></p> <h3>So here is the quick 10-minute version of my opinion on this, straight from my Facebook response.</h3> <h3>This article is better than I expected from the headline - at least they correctly cited some conditions there is evidence for treating with probiotics, such as IBD and traveller's diarrhoea. Until the concluding line! Just focus on consuming good quality yoghurts, my foot! Do they exist?! Aside from the ones you make yourself, that is. There are two problems with this statement.</h3> <h3>Problem number one: numbers in yoghurt are too low.</h3> <p>For therapeutic effect - that is, not just to "stay healthy" (never mind that most people trying to "stay healthy" have symptoms or conditions they could be treating nutritionally) but to treat a condition, you simply need higher numbers than are in yoghurt - especially standard store-bought yoghurt. Problem number two: strain specificity. While a healthy gut has hundreds of different species and strains (and by extension we can assume we need to be consuming these, unless of course we have a perfect gut microbiome handed down from a mother with a perfect microbiome, have never had antibiotics etc) to actually treat a health condition (such as ulcerative colitis) the specific strains used in the research are necessary. Assuming that taking Inner Health is going to correct all our microbiomial shortcomings is analagous to taking a multivitamin and expecting it to correct the health problems arising from the epigenetic problems from the MTHFR polymorphism (i.e. doesn't work).</p> <p><img title="probiotics" src="http://www.equilibriahealth.com.au/images/probiotics.png" alt="probiotics" width="281" height="179" /></p> <p>This article has picked and chosen a couple of conditions there is evidence for. Actually, there is evidence for probiotic treatment of urinary tract infections, thrush, bacterial vaginosis, (for more information on these, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2">subscribe to our newsletter</a> and tick "vaginal health, thrush and BV") allergic rhinitis, eczema, diarrhoea from chemotherapy, cow's milk protein allergy, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=12">irritable bowel syndrome</a>, lactose intolerance, diarrhoea from radiation, viral gastroenteritis. The bottom line is strain specificity.</p> <p>Asking "do probiotics work?" is like asking "does physiotherapy work, or is it overrated?" Work? For what? What kind of physiotherapy approach/technique? We don't give staged basal expansions (i.e. breathing exercise) for patellar maltracking (i.e. a biomechanical problem at the knee). Choose the intervention according to clinical reasoning, basic science, clinical experience and, ideally and where available, the evidence base. We need to remember that a lack of available evidence to show effect is not the same as availability of evidence showing no effect.</p> <p>And make no mistake: with the very real problem of antibiotic resistance, the price we pay for being too skeptical about probiotic therapy is prohibitively high.</p> <p>Sure, there's a lot more research to be done. But there is research available, and not making ourselves aware of it (and thus failing to educate our patients) is a mistake. I am so glad to see physios interested in the concept of the microbiome and probiotic therapy. What I find discouraging is the idea that people will read an article like this on probiotics and fail to change their habits (overusing antibiotics, failing to incorporate fermented foods into the diet, not considering probiotics and adjuncts to therapy for their particular health condition) due to a misinterpretation that the probiotic thing is overrated and a fad.</p> <p>And by the way, as the article points out, prebiotic foods ARE incredibly important...but they can only feed what is there. If you lack bifidobacteria - as I see frequently on stool analyses of my patients - then eating artichokes and onions is not going to make them magically materialise. Take home message: don't just lucky dip and hope for the best. See a functional medicine practitioner! Or at least read their blogs :)</p> <p>Perhaps start with this one on the role of the microflora in a healthy and balanced vagina.</p> <p><a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-healthy-and-balanced-vagina">http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-healthy-and-balanced-vagina</a></p> <p>And please&hellip;tell me about your experience with probiotics by commenting below!</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> My Favourite Secret Exercise to Do At Traffic Lights (Hint: Not Pelvic Floor Exercises) http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/my-favourite-secret-exercise-to-do-at-traffic-lights-not-pelvic-floor-exercises <h2>&ldquo;Squeeze that pelvic floor every time you&rsquo;re at a red light&rdquo;: have you ever heard that one?</h2> <p>I am not a big fan of this, and here&rsquo;s why.</p> <p>It&rsquo;s not functional (meaning, it&rsquo;s not practical and a true-to-life way of using these muscles).</p> <p>It&rsquo;s too easy to do it wrong this way, due to both the position of the pelvis sitting in a car, and the obvious distractions around you.</p> <p>And I see too many people that hold tension in their pelvis as they are rushing around all day feeling stressed about the next thing they need to get to.</p> <p>Isolated muscle training requires focus &ndash; mindfulness - and this strikes me as a fairly mindless way of using the pelvic floor muscles.</p> <h2>But there is another exercise I like to encourage at red traffic lights.</h2> <p>And it fits quite nicely with the fact that most people are tense, rushed and stressed when driving.</p> <p>It&rsquo;s diaphragmatic breathing, otherwise known as belly breathing.</p> <p>This is the natural form of breathing that your body engages in when you are relaxed. It follows that by consciously employing this method of breathing, you can help your system be more relaxed.</p> <p>Now, by relaxed, I don&rsquo;t mean sleepy, zoned out or slowed down &ndash; if so, I obviously wouldn&rsquo;t be encouraging it while you are driving a car.</p> <p>No, by relaxed, I mean:</p> <h3>Alert but calm.</h3> <h3>Ready to respond but not tense.</h3> <h3>Able to invest the right amount of energy for the task at hand.</h3> <h3>The best, most effective version of yourself, in fact.</h3> <h2>If this sounds a bit like what you are trying to achieve with meditation, then that&rsquo;s no accident.</h2> <p>Belly breathing, when performed at 3-5 breaths per minute, is very similar to the breathing pattern used in meditators, according to a study way back in the 1980s.</p> <p>A more recent study on yoga mantras and the rosary is one of my favourite atudies on breathing.</p> <p>It showed that specifically breathing at a rate of six breaths per minute, either by a method of saying the Hail Mary or yoga mantras, resulted in an increase in parasympathetic nervous system activity (that is, the &ldquo;rest and digest&rdquo; arm of your unconscious nervous system).</p> <p>Learn belly breathing with your physiotherapist, and consider using it whenever you need to&hellip;well&hellip;breathe. (And make sure you talk to your pelvic floor physiotherapist about when you really SHOULD be activating your pelvic floor).</p> <p>So rest easy at the red traffic lights, and enjoy the relaxation that comes from belly breathing!</p> <p>Driving is my favourite time to do belly breathing. What's yours?</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> The Essential Fertility and Preconception Test Your Doctor Will Not Send You For http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-essential-fertility-and-preconception-test-your-doctor-will-not-send-you-for <h2>Epigenetics: it&rsquo;s more than a buzzword.</h2> <h3>It&rsquo;s the way you can influence your genes.</h3> <p>It&rsquo;s the element of control you have over whether you inherit your mum&rsquo;s endometriosis or your dad&rsquo;s bipolar disorder.</p> <h3>And when you are planning for a baby, the idea of being able to influence the genes for the health of your baby takes on a whole new significance.</h3> <p>Conventional preconception care is pretty basic at best. Sexually transmitted infections and general blood screens are sometimes the limit, maybe with minimal thyroid function screen and iron studies. You are told to take a preconception supplement containing folic acid, and to just let nature take its course.</p> <h2>But what if you have the MTHFR gene polymorphism?</h2> <p>(The what?)</p> <p>In a nutshell, MTHFR is an enzyme used in a process in your body called methylation, and is critical for folate metabolism. As with other genes, you can have one or more copies of a mutation. In this situation, a mutation or polymorphism results in diminished activity of this important enzyme. The end result is an increased risk of just about any disease you care to name (but more accurately, <strong>cardiovascular disease, cancers, neurological diseases, diabetes, autoimmune disease and CIN &ndash; or a bad result on a Pap Smea</strong>r, and a precursor to <strong>cervical cancer</strong>). Elevated homocysteine in the blood (or homocysteine at the upper end of the range) can be a marker for this.</p> <p>Specifically relevant to conception is the issue that the MTHFR polymorphism increases risk for:</p> <ul> <li><strong>Male infertility</strong></li> <li><strong>Recurrent miscarriage</strong></li> <li>Hypertension in pregnancy</li> <li>Pre-eclampsia</li> <li><strong>Pre-term labour</strong></li> <li>Health issues in the infant, such as <strong>neural tube defects</strong> (e.g. <strong>spina bifida</strong>) or<strong> Down syndrome</strong></li> </ul> <p>But there are two pieces of good news:</p> <h2>Finding out your MTHFR status is easy, and cheap.</h2> <p>I frequently send patients for this test as a cheek swab (what a bonus, no blood test needed!) and is around $50. A small price to pay for a critical piece of information about your own and your future baby&rsquo;s health.</p> <h2>Even better, there&rsquo;s something you can do about your risks if you do have the polymorphism.</h2> <p>It involves judicious supplementation with certain B-vitamins to offset your risk.</p> <p>And what about the recommendation to take folic acid supplements from 4 weeks before a pregnancy? A 2014 study pointed out this is not long enough to normalise homocysteine, optimise red blood cell folate and reduce risk in the majority of women, and that only 20% of women are doing this. It is critical to get good folate intake in the diet.</p> <h2>So there&rsquo;s no way out of it girls &ndash; eat your greens! And see my <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-yummiest-way-to-get-folate">blog post</a> for a <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-yummiest-way-to-get-folate">delicious way of getting folate</a> in your diet.</h2> <h3>So why not just take megadoses or folic acid, like those available over the counter at the pharmacy?</h3> <p>As in many cases, something that sounds like a bad idea IS a bad idea! Taking too much folic acid can mask a vitamin B12 deficiency, which is very bad news for a pregnancy. Folic acid is also not the optimal form of folate for use by the body. Folic acid is a synthetic form, which must be metabolised to tetrahydrofolate by the body in order to be of use. And you guessed it, there are multiple factors that influence this &ndash; so taking folic acid is by no means a complete solution.</p> <h3>Ideally, all women should ascertain their MTHFR gene status before falling pregnant and work with their functional medicine practitioner or integrative doctor to support their health.</h3> <p>Genetics can be slightly scary or overwhelming &ndash; but hooray for epigenetics, which means we can do something about it!</p> <h2>Do you know your MTHFR status?</h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> The Yummiest Way to Get Folate http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-yummiest-way-to-get-folate <h2>For best fertility and a healthy pregnancy we know we need to be getting enough folate, and for at least 3 months before conception.</h2> <p>But how many women are doing this? Only 20% are taking a preconception supplement containing folic acid at the time of falling pregnant.</p> <h3>Coeliac disease? You&rsquo;re even more at risk.</h3> <p>At least 10% of women diagnosed with coeliac disease have a folate deficiency, even if they had been on a watertight gluten-free diet for two years.</p> <h3>On the Pill?</h3> <p>The Pill depletes folate in the body and may increase risk of birth defects if you fall pregnant while on it (which occurs in around 1 woman for every 100 who take it in a year).</p> <h3>Bad genes? </h3> <p>Up to 18% of women have both copies of the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-essential-fertility-and-preconception-test-your-doctor-will-not-send-you-for">MTHFR mutation</a>, which confers specific requirements for folate (and even more have one copy, which may also change your folate needs). (Read my blog post about MTHFR <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-essential-fertility-and-preconception-test-your-doctor-will-not-send-you-for">here</a>).</p> <p>Folate, the natural form of the vitamin (as opposed to synthetic folic acid) is available in raw vegetables and some fruit, but levels are variable. Unless you are regularly eating unusual foods like amaranth leaves and acerola cherries &hellip;</p> <h3>Your best sources of folate are likely to be these:</h3> <table border="0" align="left"> <tbody> <tr> <td>Highest folate fruit and vegetables (raw)</td> <td>Micrograms per cup</td> </tr> <tr> <td>Avocado</td> <td>122</td> </tr> <tr> <td>Mango</td> <td>71</td> </tr> <tr> <td>Orange</td> <td>70</td> </tr> <tr> <td>Kiwifruit</td> <td>45-63</td> </tr> <tr> <td>Papaya</td> <td>54</td> </tr> <tr> <td>Beetroot</td> <td>148</td> </tr> <tr> <td>Turnip greens</td> <td>107</td> </tr> <tr> <td>Red capsicum</td> <td>69</td> </tr> <tr> <td>Lettuce (cos/romaine)</td> <td>64</td> </tr> <tr> <td>Sprouts (e.g. mung bean)</td> <td>63</td> </tr> <tr> <td>Sprouts (e.g. mung bean)</td> <td>61</td> </tr> <tr> <td>Chinese cabbage (e.g. pak choy)</td> <td>46-60</td> </tr> <tr> <td>Broccoli</td> <td>58</td> </tr> <tr> <td>Oyster mushroom</td> <td>57</td> </tr> <tr> <td>Celery</td> <td>56</td> </tr> <tr> <td>Kale</td> <td>36</td> </tr> </tbody> </table> <p>&nbsp;</p> <h3><br />Some weird folate facts for you:</h3> <p>Broccoli stalks are higher than the florets.</p> <p>Some tinned or frozen foods are higher than raw &ndash; such as asparagus and frozen blackberries (this may be because they are snap-frozen, and folate starts declining rapidly after harvesting &ndash; so ideally pick it straight from the garden and eat it.)</p> <p>Cos lettuce is much higher than iceberg or leaf lettuces.</p> <p>Silverbeet has only a measly 5 ug per cup (I must say I was relieved to discover this).</p> <h3>My best tip for a delicious dose of folate, especially for summer in Australia?</h3> <p>A spinach-mango smoothie.</p> <p>Truly, this is delicious and ridiculously easy, with only two ingredients. Simply blend a mango (remove the skin and seed first!) with 1 to 2 cups of spinach leaves, eat with a spoon and share with a folate-needing friend &ndash; i.e. any human being!</p> <h2>What&rsquo;s your tip for a yummy way to get your folate?</h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> If I'm Not Supposed to Do My Pelvic Floors at Traffic Lights, When Am I Supposed to Do Them? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/if-im-not-supposed-to-do-my-pelvic-floors-at-traffic-lights-when-am-i-supposed-to-do-them <h2>If you&rsquo;re like my patients you&rsquo;re a woman with a million things on her plate&hellip;how on earth are you supposed to remember to do your pelvic floors?</h2> <p>I recently <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/my-favourite-secret-exercise-to-do-at-traffic-lights-not-pelvic-floor-exercises">blogged</a> about how I <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/my-favourite-secret-exercise-to-do-at-traffic-lights-not-pelvic-floor-exercises">don&rsquo;t like the common advice to do your pelvic floor exercises at traffic lights</a>.</p> <p>This came at some disappointment to one of my patients!</p> <p>Quite reasonably, she asked &ldquo;when am I supposed to do them then?&rdquo;</p> <p>I understand the need for something to link your exercises to.</p> <p>A mental association, a trigger.</p> <p>A way to actually guarantee they get done.</p> <p>A way to form the habit.</p> <p>While we pelvic floor physios wish our patients would have the pelvic floor on the brain all day (as most of us do!), we do realise this can be a big ask!</p> <p>So yes, I do agree it is a good idea to have a mental trigger that it&rsquo;s Pelvic Floor Time.</p> <h2>My favourite activity triggers are those in which it is normal and helpful to be activating the pelvic floor.</h2> <h3>Favourite Trigger #1: Every time you turn on the tap.</h3> <p>This is because a drop in pressure inside the urethra is normal in everyone when they hear running water. In some people, though, the pressure can drop too low, leading to a feeling of urgency like you need to pee.</p> <p>Tightening the pelvic floor muscles increases the pressure inside the urethra and can prevent this from happening. Turning on the pelvic floor muscles is a natural action when you hear the sound of running water. So it makes sense to&hellip;</p> <h2>&nbsp;&ldquo;Turn it on when you turn it on!&rdquo;</h2> <h3>Favourite Trigger #2: Every time you stand up.</h3> <p>The pelvic floor muscles should be working every time you move. They work as a team with your other muscles of posture that stabilise your spine. In fact, these muscles should be so smart, they actually start to tighten even before you stand! That&rsquo;s why my second tip is to&hellip;</p> <h3>&ldquo;Pull up when you stand up!&rdquo;</h3> <h2>When&rsquo;s your Pelvic Floor Time? Have you got any nifty triggers to share with the rest of us?</h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> The Pesky Piriformis Muscle…How to Lengthen It Without Stretching It http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-pesky-piriformis-muscle-how-to-lengthen-it-without-stretching-it <h2>Helping The Muscle That Is Literally A Pain In The Buttock</h2> <p>I have a dear patient who loves to express how much she despises the piriformis muscle.</p> <p>She continually wonders aloud at what the point of having this muscle is, and laments its existence at all. She thinks it exists purely to wreak havoc on the pelvis and that its sole mission is to cause pain.</p> <p>She does have a point: there seem to be an extraordinary number of situations where piriformis is causing hassles. I see this in sacroiliac problems, chronic pelvic pain, sciatica inside and outside of pregnancy, and after gynaecological surgery. Moving house, gardening and dancing can trigger it. Problems with the piriformis can be provoked by starting a new fitness regime such as running or gym classes.</p> <p>When you have struggled with piriformis problems, it may seem like the piriformis is nothing but a menace to society.</p> <h3>But is it a case of just shooting the messenger?</h3> <p>For any of you who don&rsquo;t know this muscle&hellip;lucky you! It probably means it hasn&rsquo;t caused you many hassles (or that you haven&rsquo;t found anyone who can tell you what your annoying buttock pain is!)</p> <h3>So what causes the piriformis to become a menace?</h3> <p>One simple issue is a short, tight piriformis muscle. You will probably be aware of how tight muscles can be uncomfortable &ndash; take sitting all day in a chair in the office, or holding a baby for hours a day, and imagine how your neck and shoulders feel.</p> <p>If you are standing all day, you may feel active and even fit. But did you know your piriformis is quite tight in this position? There is a position many of us avoid that helps keep the length in this muscle:</p> <h3>Cross-legged sitting. &nbsp;</h3> <p><img title="pregnantwomancrossleggedsitting" src="http://www.equilibriahealth.com.au/images/pregnantwomancrossleggedsitting.jpg" alt="pregnantwomancrossleggedsitting" width="195" height="219" /></p> <p>In cross-legged sitting (sometimes called the tailor position) the piriformis is over 20% longer than in standing, and over 11% longer than in normal sitting, according to a 2006 study.</p> <p>I have seen a number of patients with problems related to shortness of the piriformis muscles and surrounding soft tissue, such as a fit elderly man with <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-pain-up-the-backside-proctalgia-fugax-explained">proctalgia fugax</a> (spasms in the rectum) and a tennis coach with chronic pelvic pain who had spent 20 years in a semi-crouch position on the tennis court. Many people with <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-cant-sit-down-syndrome">tailbone pain</a> or <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-cant-sit-down-syndrome">coccydynia</a> tend to have problems in this muscle too.And there are very few women I see with <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-five-sources-of-painful-sex-and-not-one-of-them-starts-with-v">painful sex</a> where this muscle isn't causing problems.</p> <p>Many of us stop cross-legged sitting as adults, and I don&rsquo;t think this is a good idea. If you don&rsquo;t feel confident in your leg strength getting on and off the floor, try cross-legged sitting on the couch or bed.</p> <h3>This is not to say that stretching the piriformis is always a bad idea.</h3> <p>There are circumstances where this is extremely helpful. However, there are other times where it can exacerbate buttock and leg pain. Best to talk to your physiotherapist about what&rsquo;s right for you.</p> <p>Aside from muscle tightness, though, there is an even bigger reason that the piriformis plays up.</p> <h3>It is usually due to an imbalance of muscles in the pelvis.</h3> <p>This means that with ordinary everyday movement, you use less of the muscles that you should (such as the glutes, or buttock muscles) and this leaves all the work to the poor little measly piriformis muscle. It&rsquo;s like asking your youngest child to carry all the luggage &ndash; rather unfair really.</p> <p>So play fair with your piriformis, and see your physiotherapist to help reduce its load.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Five Top Tips for Sticking With Your Pelvic Floor Exercises http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/five-top-tips-for-sticking-with-your-pelvic-floor-exercises <h2>Why, oh why, is it so difficult to stick with pelvic floor exercises?</h2> <p>When we are so good at multitasking, pelvic floor still falls to the bottom of the pile. And yet we know how essential they are for preventing, improving and resolving <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=10">bladder leakage</a>, or <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=10">incontinence </a>as it's unglamorously known!</p> <p>Somehow, by the end of another day, we still haven&rsquo;t got to those pesky pelvic floor exercises. And then we are back at the pelvic floor physiotherapist with that famous line:</p> <h3>&ldquo;I haven&rsquo;t done as many as I should&hellip;&rdquo;</h3> <p>Is there a way to change this? Of course there is! Several in fact! Here are a few of my top tips. Many of these have been given to me by my own patients who they have worked for.</p> <p>But first, can I remind you, please <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/my-favourite-secret-exercise-to-do-at-traffic-lights-not-pelvic-floor-exercises">don't do your pelvic floor exercises in the car.</a> There are so many reasons you can read about <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/my-favourite-secret-exercise-to-do-at-traffic-lights-not-pelvic-floor-exercises">here</a>. And remember the ultimate aim is to <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/if-im-not-supposed-to-do-my-pelvic-floors-at-traffic-lights-when-am-i-supposed-to-do-them">get the pelvic floor muscles working properly in practical ways </a>- read my top two tips for that <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/if-im-not-supposed-to-do-my-pelvic-floors-at-traffic-lights-when-am-i-supposed-to-do-them">here. </a></p> <h2>Visual reminders</h2> <p>The old chestnut: stickers. Putting stickers up around the house &ndash; or even innocuously coded post-it notes (e.g. &ldquo;buy milk&rdquo;) works for some! Keep changing the colour and location to stop yourself from looking straight through them! Put them in places it makes sense to do them: at the baby change table, on the electric socket for the vacuum cleaner, in the laundry.</p> <h2>Auditory reminders</h2> <p>Set the alarm on your phone. Whether it&rsquo;s hourly (for pelvic floor awareness and activation through movement) or daily (for a stint of pelvic floor exercises), this one works a treat.</p> <h2>Making them fun</h2> <p>You try to make it fun to go to the gym, don&rsquo;t you? Put some music on and use the rhythm to do some pelvic floors &ndash; ask your pelvic floor physio about holds and rests!</p> <h2>Play a CD</h2> <p>Sometimes we just need someone telling us to do what we should. So many patients have said to me &ldquo;I wish I had you on my shoulder during the day reminding me what I should be doing!&rdquo; So the next best thing: use a <a href="http://www.equilibriahealth.com.au/Product/track-2-exercises">pelvic floor audio</a> to talk you through your pelvic floors once a day, like <a href="http://www.equilibriahealth.com.au/Product/track-2-exercises">this one</a>, which can be downloaded to your phone and available at any time!</p> <h2>Involve your friends</h2> <p>We involve our friends with anything else fun...why not pelvic floor? We all know it&rsquo;s fun to work out with friends. It's also great to laugh with friends. Combine both by sharing your pelvic floor exercising status on Facebook! You can make your commitment to pelvic floor public by posting &ldquo;I&rsquo;m doing my pelvic floor exercises. How about you?&rdquo; as your status on Facebook. Go on, do it now...what are you waiting for?</p> <p>(Part 2 of my top tips coming up soon...while you're waiting, enter your top tips in the Comments, and share your Pelvic Floor Exercises Status on Facebook now!)</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Best Ways to Help Tampons Go In - In Ten Easy Steps http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-tampons-go-in-ten-easy-steps <h2>Tampons can be tricky to use. What's the solution?</h2> <p>I'd like to help you to solve this common problem.</p> <p>I hear about the problem inserting tampons all the time from my patients in my practice. When tampons won't go in, no matter how you try, it can be frustrating.</p> <h3>You would be surprised how many women have struggled - and still struggle - with using tampons.</h3> <p>Many of the women I see have long since given up trying to put in a tampon. Some women never tried, because they felt too apprehensive. Many more tried and had a bad experience, so have not kept trying.</p> <p>But there are ways to make it easier.</p> <h3>So who has problems inserting tampons?</h3> <p>Maybe you're a fourteen-year-old girl working up the courage to try tampons so you can swim during your period.</p> <p>Or maybe, like many of my patients, you're a woman in your twenties, thirties or forties struggling with painful sex. You have never been able to use tampons, but you came to terms with that. You just didn't go swimming during your period. But years later when you starting have sex you realised there was a bigger problem than not being able to use tampons - not being able to allow your vagina to accept your partner's penis (or finger). This is sometimes called <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus </a>(correctly or incorrectly - and that's an issue for another blog post).</p> <h3>Painful sex - or not being able to have sex&nbsp; - is often a later problem for women or girls who have trouble using tampons.</h3> <p>So when you have problems with penetration of your partner's penis, learning to insert tampons can be a helpful first step to a solution.</p> <p>So, back to the problem at hand: how to make tampons easier to use? I have written a <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/tampon-troubles-why-they-hurt-or-wont-go-in">previous blog post on this</a>, which I would like to elaborate on over a number of posts.</p> <h3>This is a ten-part series on how to solve the problem of difficulty inserting tampons.</h3> <p>Each post will focus on a single strategy. Start with the first strategy and see if that solves your problem. If not, incorporate the strategy in the second blog post, the third blog post, and so on. Best of luck, and please share your experiences in the Comments!</p> <h3>Read the first tip <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-look-and-you-will-find">here.</a></h3> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Best Ways to Help A Tampon Go In Step 1 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-look-and-you-will-find <h2>Look and You Will Find</h2> <p>When you have trouble inserting a tampon, you need a plan of action. This is the first tip in a ten part series on making tampons easier to use.</p> <h3>I hate to state the obvious.</h3> <p>But sometimes the simple things can be overlooked. You need to know where this thing needs to go. You need to know what's what down there.</p> <p>It never ceases to amaze me how little we women know the intimate parts of our bodies. The vulva (the area between the legs from the bone at the front all the way to your anus) is a mysterious, often unexplored territory.</p> <h3>The best advice I can give here is:</h3> <p>Be brave. Have a look with a mirror. Find out where you're going.</p> <p>Not keen? Don't worry. I'm not asking you to love this process (yet). I'm not going to go all 1970's hippy feminist sexuality class on you (but not to say this doens't work for some!).</p> <p>Just be sensible. Think rationally. You don't try to get a contact lens in your eye with your eyes closed, do you? (Maybe that's a silly analogy, but I think you get the point).</p> <p>Look at what you're doing (at first - you won't need to do this forever). (And mums - please encourage your daughters to do this! They very likely will not want you there. But make sure they have the resources they need to do this successfully - a large hand mirror, perhaps The V Book by Blah Blah.)</p> <p>Get the mirror out, lie on the bed and hold it between your legs. Or, lie down in front of your wardrobe mirror. (Lock the door first.)</p> <p>Separate the labia. In English, that means pull your lips apart. The lips (or labia) are the folds of skin around the vaginal opening.</p> <p>Have a good look and/or feel until you are happy you know where the vaginal entrance is.</p> <h3>I know of people who have been trying to put the tampon in the "wrong hole".</h3> <p>I even know a husband and wife who were trying to get the penis in the "wrong hole" - the urethra, or entrance to the bladder.</p> <h3>Don't panic though - it's much more common to think it's the "wrong hole" and for it to actually be the "right hole".</h3> <p>In these cases, it's difficult for other reasons.</p> <p>We'll get to some of those reasons in the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-use-the-information-on-the-packet%20">next blog post</a>, and the one after.</p> <p>For now, don't be afraid to look. Remember, it's just being practical. And please, share your stories of the discoveries you have made when you do this.</p> <h3>Did "looking where you were going" help you?</h3> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Five Top Tips For Sticking With Your Pelvic Floor Exercises Part 2 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/five-top-tips-for-sticking-with-your-pelvic-floor-exercises-part-2 <h2>What could possibly make pelvic floor exercises easy to stick with?</h2> <p>My <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/five-top-tips-for-sticking-with-your-pelvic-floor-exercises">last post</a> gave you some tips including l<a href="http://www.equilibriahealth.com.au/Product/track-2-exercises">istening to an audio on pelvic floor exercises</a> able to be downloaded to your phone or desk top.</p> <p>But different things work for different people. Here's five more tips to get you sticking with your pelvic floor exercises.</p> <h3>Add them to your workout</h3> <p>You&rsquo;re committed to the gym and you&rsquo;ve been going twice a week. So no excuses for not having pelvic floor exercises the FIRST workout you do, before the class starts, before your personal trainer arrives, or your &ldquo;rest&rdquo; exercise between your harder sets.</p> <h3>Pick an easy time</h3> <p>Don&rsquo;t expect the right time to present itself! Pick something predictable you know you do every day (like your shower) or several times a day (like washing your hands). Many women I know do them on the toilet AFTER emptying their bladder. It might be the only peace and quiet they get all day. And it can be a virtuous way of stalling before getting back to work that no one will notice but you!</p> <h3>Log your progress</h3> <p>Like many people I love the satisfaction of ticking off as done or crossing it off the list. We know that training logs work for other exercise &ndash; why not create a simple log on your phone or computer to tick off when you&rsquo;ve done them? There are even apps to help you monitor your training, like the Kegel Trainer Pro!</p> <h3>Make deals with yourself</h3> <p>Let&rsquo;s face it, we all have habits we are not proud of. One common one is drinking too much coffee. While you are trying to cut down, a great deal you can make with yourself is to add a healthy habit if you give in to an unhealthy one, and do your pelvic floors every time you boil the jug. (While you&rsquo;re at it, have a glass of water too &ndash; it&rsquo;s a great way to partially offset some of the issues of too much coffee!)</p> <h3>Have more sex</h3> <p>I couldn&rsquo;t leave this one out. Many women tell me their favourite time to do their pelvic floors is during sex. They often get very good feedback when doing this &ndash; so it&rsquo;s a win-win situation!</p> <h3>What tips work best for you?</h3> <p>One of the most common comments I get is that women don't know if they're doing them right, so they have no motivation to do them. This one is easily fixed! See a pelvic floor physio. Women I see tell me they come out of the session feeling much more confident.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Getting Off The Pill Step 3 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/getting-off-the-pill-step-3 <h2>Consider Your Alternatives</h2> <p>You now know you would like to get off chemical contraception, whether it is the Pill, the injection (Depo Provera), &nbsp;the implant (Implanon) or the hormone-secreting IUD (Mirena).</p> <p>You <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-guide-to-getting-off-chemical-contraception-understand-how-it-works">understand how they work</a> and don&rsquo;t feel happy with what they are doing to your body.</p> <p>Or, you may already have experienced negative side effects. <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/getting-off-chemical-contraception-part-2-side-effects">You understand the problems</a> or the potential problems.</p> <h3>It&rsquo;s just not worth it to you.</h3> <p>But what on earth are you going to do instead?</p> <p>This depends a lot on whether you are using it for contraception or for a health issue like acne, irregular periods or <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=14">heavy, painful periods</a>. We&rsquo;ll cover the alternatives to deal with health problems in another series. All I will say now is that complementary medicine has a lot to offer these issues, be it naturopathy, Chinese herbal medicine, Western herbal medicine, or acupuncture.</p> <p>But let&rsquo;s focus on the conundrum of contraception and the alternatives to chemicals.</p> <h2>There are permanent options and temporary options.</h2> <p>If you have decided you don&rsquo;t want anything involving putting chemicals into your body, there is a finite list of contraceptive alternatives. Let&rsquo;s divide these into two groups: permanent and temporary.</p> <p>The permanent options include male sterilisation (vasectomy), female sterilisation (tubal ligation) and hysterectomy (taking out the uterus).</p> <p>The temporary options include condoms and fertility awareness methods including the Billings Ovulation Method, the Sympto-Thermal Method, the Creighton Model, and Natural Fertility Management.</p> <p>Let&rsquo;s go through these one by one.</p> <h2>Permanent Methods</h2> <h3>Vasectomy &ndash; &ldquo;Getting the Snip&rdquo;</h3> <p>The first three months after a vasectomy is a &ldquo;wash-out&rdquo; period, but after this, it is very effective for contraception: only up to 20 couples out of 10 000 will fall pregnant in the first year. This compares with 500 couples out of 10 000 using the Pill as contraception. Vasectomies are very safe and considered a minor surgical procedure. If you are after permanent contraception, talking your partner into this one could be a good option!</p> <h3>Tubal Ligation &ndash; &ldquo;Getting Your Tubes Tied&rdquo;</h3> <p>Getting your tubes tied so that sperm and egg can&rsquo;t unite is over 99% effective for avoiding pregnancy. The downside is that if you are unlucky enough to fall pregnant, there is a high chance (up to 80%) of this being an ectopic pregnancy. This is where the pregnancy occurs in the tube instead of the uterus and can be dangerous. On the up side, the laparoscopic or &ldquo;keyhole&rdquo; method makes this procedure a safer surgery than in previous years. It is commonly done at the same time as a Caesarean section when a woman is sure she doesn&rsquo;t want to have any more children.</p> <h3>Hysterectomy</h3> <p>Hysterectomy, quite logically, is 100% effectiveness in avoiding pregnancy. A drastic choice though! The only reason I have included it is as an acknowledgement there are other reasons other than contraception that women are on the Pill, such as extremely painful or heavy periods. I have seen women with endometriosis choose to have a hysterectomy rather than stay on the Pill for this reason.</p> <h2>Condoms</h2> <p>Condoms are convenient. That is their major advantage. But after that, it&rsquo;s not great news.</p> <p>Let&rsquo;s face it. Condoms are risky. 1400 couples out of 10 000 will fall pregnant using condoms in one year (compared again with 500 out of 10 000 on the Pill).</p> <h2>Fertility Awareness Methods</h2> <p>This next section covers the systems of contraception based on awareness of fertility signs. On the whole, the studies into these methods have not been as &ldquo;scientifically rigorous&rdquo; as we&rsquo;d like. This means it may be harder to interpret their effectiveness. As a group, they have about a 1-3% failure rate &ndash; that is, up to 3 couples out of 100 fall pregnant unintentionally using the method.</p> <h3>Billings Ovulation Method</h3> <p>Teachers of this method are called Accredited Teachers of the Billings Ovulation Method,</p> <p>This is the system with the most published research studies of all the fertility awareness-based methods. Again, while it is hard to compare the results of research with drug-based contraception, we do have some figures from studies. The most recent figures find that the Billings Method is greater than 99% effective for contraception. This means that in a year of use, up to 1 couple out of 100 will unintentionally fall pregnant.</p> <p>Information on the <a href="http://www.thebillingsovulationmethod.org/">Billings Ovulation Method</a> can be found on the<a href="http://www.thebillingsovulationmethod.org/"> official website.</a></p> <h3>Sympto-Thermal Method</h3> <p>A 2007 study that looked at them as a group found just a 0.6/100 pregnancy rate in 13 cycles (which in a &ldquo;textbook woman&rdquo;, might be approximately a year). By my calculations this is 6 couples out of 1000 or 60 out of 10 000, which seems to compare remarkably well with the vasectomy and Pill examples above. Note that this was when sexual activity was (correctly!) avoided during the fertile times! The real-life situation was that couples didn&rsquo;t always &ldquo;follow the rules&rdquo; and in 13 cycles, 1.8 women out of 100 fell pregnant unintentionally. By my calculations, this equates to 180 out of 10 000. Again, this still seems to compare favourably with the Pill. As I mentioned in a previous blog post, human error is common with the Pill &ndash; women forget to take it or fail to take precautions if they have had vomiting and so on, so the actual &ldquo;real life&rdquo; effectiveness of the Pill drops for this reason.</p> <p>More information on the Sympto-Thermal Method can be found <a href="http://naturalfertilityaustralia.org.au/client-services/sympto-thermal-method/">here.</a></p> <h3>Creighton Model</h3> <p>The Creighton Model describes itself as &ldquo;a standardised modification of the Billings Method&rdquo;. It is more prescriptive than the Billings Method, giving a limited array of options for women charting their fertility signs. Teachers of this model are called Fertility Care teachers. At the time of writing this post, there were fewer Creighton Model teachers in Australia than Billings Method teachers.</p> <p>The effectiveness rates for this system were similar to Billings &ndash; a study of almost 2000 couples found a greater than 99% effectiveness rating. But note! This study also looked at &ldquo;user effectiveness&rdquo;, also called &ldquo;user failure&rdquo;. It compared user effectiveness with method effectiveness, which means what happened in &ldquo;real life&rdquo; rather than what happened if all rules were strictly followed. (Basically, couples break the rules at times, and this can be their downfall!) User effectiveness dropped to around 96%.</p> <p>Information on the <a href="http://www.creightonmodel.com/">Creighton Model</a> can be found on the <a href="http://www.creightonmodel.com/">official website.</a></p> <h3>Natural Fertility Management</h3> <p>This is a method that combines the Symptothermal Method with an awareness of the lunar cycle. The website promotes a high success rate of over 99% if used effectively by committed couples. Unfortunately, there are no research studies published on it.</p> <p>Some of the studies of the fertility awareness methods mentioned that couples sometimes dropped out of these methods after a year or so of use &ndash; sometimes less. This makes sense; they do involve rules, commitment and discipline. They require both partners to be committed.</p> <p>My next post looks at preparing to take the plunge getting off the Pill by getting your health and your nutrition in hand.</p> <p>In the meantime, I'd like to hear your thoughts. What do you consider the pros and cons of these different methods?</p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Getting Off The Pill Step 4 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/getting-off-the-pill-step-4 <h2>Prepare by taking your nutrition and your health in hand</h2> <h3>Are you scared to take the plunge and get off the Pill?</h3> <p>There is no need to be! In this post I'll talk about covering your bases to make the transition as smooth as possible.</p> <p>Hopefully be now you have followed the first three steps in getting off the Pill.</p> <p>Step 1 &ndash; <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-guide-to-getting-off-the-pill-step-1">understanding how the Pill works</a> (and its relatives the Mirena, Depo Provera and Implanon)</p> <p>Step 2 &ndash; <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/getting-off-the-pill-part-2">being aware of the side effects of the Pill</a> (and its relatives)</p> <p>Step 3 &ndash; <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/getting-off-the-pill-step-three">considering the different alternatives available</a></p> <p>And now it&rsquo;s time for the fourth step &ndash; setting some good habits in place to minimise the chance of side effects of coming off the Pill.</p> <h2>So what kind of side effects of coming off the Pill are we talking about?</h2> <h3>There are two types of side effects when coming off the Pill.</h3> <h4>Problems that were already there before, which are masked by the Pill</h4> <p>First of all, anything that was there before you went on the Pill in the first place: acne, irregular periods, painful periods. My recommendation here is to see a good naturopath, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/pain-do-i-need-a-physiotherapist-or-an-integrative-nutritionist">integrative nutritionist</a> or functional medicine practitioner. They can help solve the puzzle of why you had these issues in the first place, and help bring your system back into balance.</p> <p>For example, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/difference-between-polycystic-ovarian-syndrome-and-polycystic-ovaries">polycystic ovarian syndrome (PCOS)</a> is the most common hormone disorder in younger women. The main symptom is irregular or infrequent periods. If this is why you went on the Pill fifteen years ago as a teenager, then there is a good chance you have this, and it should be investigated. PCOS will also make acne more likely and more severe. When I see women who have known PCOS and are deciding to come off the Pill, we put into place an action plan for their hormones before they even stop it, which includes stress management, exercise, dietary changes and nutrient supplementation. Once they come off the Pill, I add herbs to help regulate their hormones.</p> <p>And then there is the problem of painful periods (dysmenorrhea). The great news is that <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/herbal-medicine-for-period-pain">herbal medicine can be very helpful for period pain</a>. So can a gentle form of abdominal massage called<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=92"> visceral mobilisation</a>. Additionally, nutrients are important. <a href="http://www.ncbi.nlm.nih.gov/pubmed/22261128">Supplementing with omega 3 fatty acids</a> and<a href="http://www.ncbi.nlm.nih.gov/pubmed/24559600"> zinc </a>are just two things I use to improve period pain. I often use a combination of these techniques with women coming off the Pill to lower the chance of their returning periods being painful.</p> <h4>New problems, caused, promoted or triggered by the Pill</h4> <p>The main one we&rsquo;ll talk about here is &nbsp;the fertility issue. Let&rsquo;s say you&rsquo;re coming off the Pill because you want to fall pregnant. It is important you don&rsquo;t try to fall pregnant immediately when coming off the Pill. There are a few reasons for this.</p> <p>Nutrient depletion</p> <p>The Pill depletes a number of nutrients from the body including zinc, magnesium, vitamin C and vitamin B6 (and more). Even more critically, it depletes folate, and it&rsquo;s essential that you have good folate levels for at least 3 months before you fall pregnant, as folate is essential in the cell division processes that will ultimately lead to a healthy baby.</p> <p>Hormonal imbalance</p> <p>It often takes several months for the hormones to balance out after the Pill. While a <a href="http://www.ncbi.nlm.nih.gov/pubmed/24769943">2014 study</a> showed that a quarter to a half of women ovulated within three weeks after stopping the Pill, the rest of them didn&rsquo;t!</p> <p>But fertility is more than a return of bleeding, hormone balance and even ovulation. You can have all three of these back but still not be fertile if your cervix is not producing the right kind of mucus to help the sperm survive. A <a href="http://www.ncbi.nlm.nih.gov/pubmed/21219248">2011 study</a> compared women who had just stopped the Pill with women who had not been on it for a year. It showed that quality of mucus produced by the cervix was indeed compromised in women who had come off the Pill. Getting to recognise and interpret your <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/do-you-understand-your-fertility-vaginal-discharge">mucus patterns is probably the most important aspect of understanding your fertility.</a></p> <p>If you have chosen the Billings Ovulation Method as your new method of contraceptive, you&rsquo;re in luck, as this system acquaints you with your mucus signs. If you have decided to forego contraception as you&rsquo;re planning to fall pregnant, I would strongly recommend you learn the Billings Method and use it to track your returning fertility before trying to fall pregnant.</p> <p>It&rsquo;s important when coming off the Pill that you get some good habits in place. These include good stress management, a healthy, high-vegetable, unprocessed diet, and regular exercise. This will go a long way towards making it an easy transition.</p> <p>What actions are you taking to prepare your body for coming off the Pill?</p> <p>&nbsp;</p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Best Ways to Help A Tampon Go In Step 2 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-use-the-information-on-the-packet <h2>Use the Information on the Packet (But Don't Take It Too Seriously)</h2> <p>You've had trouble inserting tampons. You didn't really know where you were going. Like the excellent TV ad, you didn't know if you were going for the "wrong hole". But now <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-look-and-you-will-find">you've had a look.</a> You used a mirror, you maybe looked at a diagram, and you think you're getting to know the territory.</p> <p><img title="tampon" src="http://www.equilibriahealth.com.au/images/tampon.png" alt="tampon" width="275" height="183" /></p> <p>So again, I'm going to mention something obvious, but important. Have a look at the tampon packet. Read the instructions carefully.</p> <p>And while we're talking about the tampon packet, choose the smallest tampons you can. Even if you have a menstrual flow like a tropical tsunami, choose the mini tampons while you are still a rookie.</p> <p>Applicator or no applicator? This is very much a matter of personal preference. I know a lot of women who have found the ones with the applicator easier to learn with. If you have any reluctance to put your finger in your vagina, the applicator tampons can be a great one to start with. However, a later goal (for a lot of reasons) would be for you to feel comfortable putting your finger in your vagina - more about that in a later post.</p> <p><img title="tamponwithapplicator" src="http://www.equilibriahealth.com.au/images/tamponwithapplicator.jpg" alt="tamponwithapplicator" width="294" height="171" /></p> <p>The applicator is nice and smooth. It also takes the guesswork out of how far to put the tampon in. Overall, I would probably recommend starting with applicator tampons.</p> <p>So, back to the packet. Every packet of tampons will contain instructions. There is important&nbsp; safety information on it about toxic shock syndrome. Please, don't get too caught up in this. While it is important for it to be there for legal reasons - and important to go by the guidelines recommended - it's important not to get freaked out. This is a bit like not going ahead with minor surgery due to the long list of rare and serious complications that they, by law, need to read out to you. Tampons are very safe and will not harm you when used as recommended.</p> <p>The instructions will give you a number of options for position to be in when inserting the tampon.</p> <h3>For a beginner, there are two positions I would recommend.</h3> <p>One is lying down in front of a mirror with your head fully supported on pillows, so your abs are not working. (Working your abs, like with "sit ups", can make it harder for the tampon to go in.) This position is great, because you can see where the tampon is going, and use other body cues to help it on its miniature journey (more about this in future blog posts).</p> <p>The second is standing up with one foot up and rested, say on the bath (or toilet lid). This is great because it separates your legs that little bit, and changes the angle of your vagina by tucking your pelvis under a little bit.</p> <p>Don't worry too much about the diagrams on the packet. It can be really hard to picture what's going on inside. Sometimes too much talk of angles and directions makes inserting a tampon a bit too much like a bad memory of Maths class.</p> <h3>So in summary:</h3> <ol> <li>Choose a mini applicator tampon.</li> <li>Don't re-read the warnings on the packet until you're a nervous wreck.</li> <li>Pick one of two helpful positions - reclined (lying down with head raised) or standing with one foot up on the bathtub.</li> </ol> <p>In these positions, you can more easily work out what your <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-3-contract-and-relax-your-pelvic-floor">vaginal muscles are doing and how to get them as relaxed</a> and easy-going as possible - the topic of the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-3-contract-and-relax-your-pelvic-floor">next blog post</a> in this series.</p> <h2>Liked this post? <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2">Subscribe to our newsletter</a> and get loads more useful info!</h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Best Ways to Help A Tampon Go In Step 3 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-3-contract-and-relax-your-pelvic-floor <h2>Contract and<em> RELAX</em> Your Pelvic Floor</h2> <p>OK, you're getting there! <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-look-and-you-will-find">You've had a good look with a mirror</a> and you're starting to get to know the landscape down there. You're confident y<a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-use-the-information-on-the-packet">ou've chosen the right position </a>to insert the tampon.</p> <h3>But for some reason, when you try to put it in, it just feels like there's a wall there.</h3> <p>Like there's nowhere to go.</p> <p>I can't tell you how many women have told me that "nothing will go in there". They start to doubt they even have the right anatomy. When they try to insert a tampon (or have sex) they feel a blockage or obstruction, like there's something in the way.</p> <h3>I've got great news for you. There is nothing in the way.</h3> <p>It just feels like there is because the walls of the vaginal opening collapse together at rest.</p> <p>The walls of the vagina are basically made of muscle. This is called the pelvic floor muscle. These muscles make the walls firm but elastic. These muscles help "keep the door closed" to keep out unwanted visitors. They are like the Guardians of the Gate.</p> <p>It's their job to decide if the visitor is a friend or foe. If the muscles realise the visitor is friendly, they relax. They make space. They allow an opening - but it's a bit like a secret opening.</p> <h3>A secret entrance.</h3> <p><img title="secretentrance" src="http://www.equilibriahealth.com.au/images/secretentrance.jpg" alt="secretentrance" width="259" height="194" /></p> <h3>Can you feel how to "close" the vagina?</h3> <p>Some people say it's like winking or blinking, if the vagina was an eye. Others say it's like squeezing and lifting the vagina from the inside. If you don't mind getting graphic, it's like slowing down and stopping the flow of urine, or tightening around the anus ("bum-hole") as though trying not to pass wind.</p> <h3>I like to think of the muscles of the vagina like the roof of an exotic circus tent.</h3> <p>It's made of a velvety, silky, flowy material. This material hangs from the ceiling and billows up and down as it's lifted and lowered. See if you can "lift your circus tent". This closes the vagina. Then lower or drop your circus tent. This allows an opening. Remember, it isn't a big wide open door, advertising to everyone that it's open. It's a secret opening, designed for entry by members of the "inner sanctum" only.</p> <p><img title="circustent" src="http://www.equilibriahealth.com.au/images/circustent.png" alt="circustent" width="209" height="123" /></p> <p>Using the position you decided on earlier (and the mirror if you need to refresh your memory), hold the tampon at the entrance to the vagina. Try lifting and lowering your circus tent (or any of the cues above). If you have the mirror, you may get an idea of the secret entrance opening.</p> <h3>When you lower the circus tent, let the opening envelop the top part of the tampon.</h3> <p>See if you can feel that there is a little bit of "give" - the secret entrance is opening and there is "somewhere to go". The tampon doesn't have to slide in first go. You just don't want it to be pushed away.</p> <p>If this doesn't work for you, here's another idea. Keep the tampon in the same position.</p> <h3>Try gently bearing down, like you're laying an egg.</h3> <p>(This "laying an egg" analogy I owe to the wonderful American pelvic floor physical therapist Ramona Horton).</p> <p>As you "lay the egg" the secret entrance opens. You may not see it - but you will feel that little bit of "give". Do this as many times as you need to feel that the tampon is being enveloped further into the vagina.</p> <h3>Experiment! Don't worry if it doesn't work first time.</h3> <p>What tips have you found best for relaxing your pelvic floor muscles?</p> <p>Go to the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-4-lubricate-the-tampon-like-crazy">4th blog post in this series.</a></p> <h2>Liked this post? <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2">Subscribe to our newsletter</a> and get loads more useful info!</h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Pelvic Floor-Safe Exercise - The Ten Most Non-Boring Options! http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/pelvic-floor-safe-exercise-the-ten-most-non-boring-options <h2>We hear it over and over again: exercise that's safe for your pelvic floor is walking, cycling, and swimming.</h2> <p>And actually, cycling here probably means boring, easy cycling on flat (as we know that standing cycling puts enormous pressures on the pelvic floor). Or stationary cycling. Stationary cycling so predictable and unchanging that you could do it in your sleep (or that it puts you to sleep). Stationary cycling that may as well be stationary.</p> <p>(Of course, I am exaggerating. Stationary cycling CAN be made challenging and interesting. But if you find it so, this post is not for you.)</p> <p>So without a stationary bike, or in the absence of living on top of a plateau or a vast, unchanging plain, we are down to walking and swimming being our options for pelvic floor - safe exercise.</p> <h2>Boring!</h2> <p>Now, perhaps you love walking. Perhaps you find it stimulating and regenerating, and it fulfills both your physical and mental health requirements of exercise. But if that is the case, you will probably not be reading this blog post (or will stop reading it at this point).</p> <h2>So let's think laterally. What are some other options...</h2> <p>...for <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ive-had-a-baby-can-i-ever-exercise-again">exercise that is a safer option for your pelvic floor,</a> whether you have (or are at risk for) incontinence or prolapse? And/or, you have <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ive-had-a-baby-can-i-ever-exercise-again">ever had a baby or been pregnant and actually want to exercise again</a>? And (rather more self-indulgently) what is my favorite option?</p> <h3>Let's look at the requirements for pelvic floor safe exercise.</h3> <p>We are looking for</p> <p>Low impact.</p> <p>No excessively high intra-abdominal pressures generated.</p> <p>This generally translates into no jumping, no running, no heavy weights, no sit-ups or crunches, and no uncontrolled/unexpected movements.</p> <p>Sadly, this <strong>seems to rule out all forms of running, jogging, racing and fun-runs, virtually all team sports, most gym classes, most standard personal training sessions, boxing, and most styles of dancing, whether Latin, ballroom, modern, ballet or just leaping around the room to your favorite opera or hard rock album.</strong></p> <p>I would like to interject in my own blog post here. (That is one of the major benefits of blogging - that no one can stop you interjecting). I am not saying that all of these restrictions apply at all times for all women at risk of pelvic floor problems.</p> <h3>In fact, despite the excellent intentions and professional expertise behind these standard pelvic floor safe exercise recommendations, I believe that the best action any woman can take is to have an <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ive-had-a-baby-can-i-ever-exercise-again">individualised assessement of her exercise "risk"</a> via a pelvic floor examination with an experienced pelvic floor physiotherapist that offers this expertise.</h3> <p>(Ask your pelvic floor physiotherapist how specific they can be about your exercise risks upon having an assessment, and keep searching until you find one who will offer you more than the general recommendations). Individualised pelvic floor assessments have evolved in the last few years with pelvic floor physiotherapists undergoing further research-based training to give you much more individualised exercise advice than ever before. How, you ask? Ve have vays, my friend, ve have vays!</p> <p>But until you have had an individual assessment, your safest non-walking, non-swimming options which are possibly the least boring, include:</p> <h3>Tai Chi.</h3> <h3>Yoga.</h3> <h3>Belly dancing.</h3> <h3>Rock climbing.</h3> <h3>Pole Fitness.</h3> <h3>Scootering.</h3> <h3>Skateboarding.</h3> <h3>Surfing.</h3> <h3>Rollerskating.</h3> <h3>Rollerblading (i.e. inline skating).</h3> <p>Please don't take this list absolutely at face value. All return to exercise - and, especially, starting a new exercise regime - should ideally be advised upon by your pelvic floor physiotherapist and based on individualised assessment, that is, assessment of YOU.</p> <p>More about these fantastic options for your new exercise life in a future blog post.</p> <p>And I plan to play favourites here. The final option - rollerblading - being my favourite option, will have its own blog post devoted to it.</p> <h3>Prepare to kiss boring exercise goodbye!</h3> <p>Any other suggestions for fun pelvic floor-safe exercise? Let's have a conversation about it!</p> <h2>Liked this post? <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2">Subscribe to our newsletter</a> and get loads more useful info!</h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Best Ways to Help A Tampon Go In Step 4 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-4-lubricate-the-tampon-like-crazy <h2>Lubricate the Tampon Like Crazy</h2> <p>By nature, tampons are not the easiest things to get in the vagina. This is because they are usually made of cotton or a similar material - in order to be absorbent - which creates friction.</p> <p>So here's a simple way to make it easier.</p> <h3>Get rid of the friction. Make it slippery.</h3> <p>Remember your childhood Slip'n'Slide in the backyard? Just the hose running on it wasn't that much fun. The way to really increase the slippery factor was to put detergent on it. But wait! Obviously, don't do that in this situation!</p> <p>So how do you make the tampon as slippery as possible?<br /> Easy. Lots and lots of lubricant.</p> <h3>What kind of lubricant?</h3> <p>If you already own some regular water-based lubricant, just use that. This is usually known as "personal lubricant" and comes in brands like Ansell and KY Jelly. Whatever you do, choose one with no fragrance, at the very least.</p> <p>But for the best, most natural and healthy option, try the Yes organic water-based personal lubricant. This is the only one I sell at my practice, because I think it's gentle and respectful to a girl's body. You can purchase it on-line easily.</p> <h3>But most importantly, just put lots on.</h3> <p>Make it really, really slippery. Believe me, this makes a difference.</p> <p>(By the way, that goes for sex as well. It's almost impossible to have too much lubricant. Always err on the side of too much lubricant rather than too little. Especially if you are having <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=17">pain with sex</a>, you <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=51">feel dry</a>, or you have been told you have <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a> or <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=81">vulvodynia</a>).</p> <p>And don't forget to <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-3-contract-and-relax-your-pelvic-floor">RELAX your pelvic floor muscles</a>, which you know how to do from the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-3-contract-and-relax-your-pelvic-floor">last post</a>. It might also make it easier to try a tampon with applicator first, as it's smoother and more friction-free than a <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-use-the-information-on-the-packet">non-applicator tampon, and choose your best position</a>.</p> <p>So there it is: simple but effective. Put lots of lubricant on the tampon. And don't forget to <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-5-pick-the-best-time-of-the-month">try at the best time of month</a> - more on this in the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-5-pick-the-best-time-of-the-month">next blog post</a>.</p> <h2>Liked this post? <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2">Subscribe to our newsletter</a> and get loads more useful info!</h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Best Ways to Help A Tampon Go In Step 5 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-5-pick-the-best-time-of-the-month <h2>Pick the Best Time of Month to Practise</h2> <p><a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-4-lubricate-the-tampon-like-crazy">Last post</a> I mentioned that using <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-4-lubricate-the-tampon-like-crazy">lots of lubricant on the tampon</a> helps when it feels like the tampon just won't go in. This may seem obvious, but most women I speak to haven't tried it.</p> <p>So here is a second tip that may seem obvious, but again, many women are not doing.</p> <p>Pick the right time of month to practise putting in a tampon in order to maximise your chance of success.</p> <p>(Of course, some of the steps I have talked about can be helpful at any time. <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-look-and-you-will-find">Exploring the territory of the vulva</a>, for example, is best all month round when you are not bleeding, as it can make things easier to see.)</p> <p>But once you are up to actually practising putting the tampon in, it is best to practise this the heaviest days of your period. You want the flow to be well and truly flowing. You can't ride the rapids unless there's some decent flow in the river - you'll end up getting stuck on the rocks!</p> <p>For many women, the days of heaviest flow are days 1 and 2. (Day 1 is the first day of your period.) For others, the flow starts slowly, and day 1 is too "dry". For these women, it might be days 2 and 3. For lots of women I know, the flow is slowing right down by day 3, so that might not be your best bet.</p> <p>Another thing to keep in mind is discomfort. If you have an enormous amount of <a href="http://www.equilibriahealth.com.au/Page/herbal-medicine-for-painful-periods">pain with your period</a>, you may want to try before this really sets in. Or, you may want to have a good amount of pain relief on board. Otherwise, your body can feel a bit defensive. It's already in pain, and it's having to experience something new it is apprehensive about. It's better for your body to feel comfortable in order to "trust" the new experience of putting in a tampon.</p> <p>You can learn more about learning to trust your body, and retraining your brain when it comes to pain, in my e-book <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">Outsmart Your Pain</a>.</p> <p>Countless patients who use tampons have told me they have trouble using them later in their period when the flow starts to dry up. (Stick with pads on the whole from that point, I say.)</p> <p>But the point is that if women who are able to use tampons have some difficulty when the flow eases, then start when you have a decent flow going.</p> <p>To keep reading about more ways to make inserting tampons easier, watch this space for the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-6-dont-be-too-squeamish">next post</a> about <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-6-dont-be-too-squeamish">getting over your squeamishness</a>.</p> <h2>Liked this post? <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2">Subscribe to our newsletter</a> and get loads more useful info!</h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> The Alien Concept of Vaginal Dilators Part 1 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-alient-concept-of-vaginal-dilators-part-1 <h2>Or, &ldquo;You Want Me To Put What Where?&rdquo;</h2> <table border="0"> <tbody> <tr> <td><img title="vaginaldilators" src="http://www.equilibriahealth.com.au/images/vaginaldilators.png" alt="vaginaldilators" width="166" height="144" /></td> <td> <p>In my experience, vaginal dilators can really freak people out.</p> <p>The idea of an inanimate object designed to be inserted into the vagina to help with difficulty with sex (e.g. <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a>) can be very confronting. This is understandable! I&rsquo;d like to go through some of the reasons people find the idea of vaginal dilators unappealing, and how we can work around these feelings.</p> <p>But first, what are vaginal dilators?</p> </td> </tr> </tbody> </table> <br /> <table style="width: 832px; height: 184px;" border="0"> <tbody> <tr> <td>Vaginal dilators, as you may know, are a nifty invention for conditions such as <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a>. (They can also be used for other conditions, but we will focus on vaginismus for now). Vaginal dilators are a little family of plastic, glass or silicone tubes in different sizes, which help you get used to the feeling of something going into (and being in) the vagina. They often fit inside each other like a rather charming set of Russian nesting dolls (Babushka dolls).</td> <td> <p><img title="russiannestingdolls" src="http://www.equilibriahealth.com.au/images/russiannestingdolls.png" alt="russiannestingdolls" width="225" height="225" /></p> </td> </tr> </tbody> </table> <p>But that&rsquo;s as far as the comparison goes with something friendly and adorable like a doll. Most of my patients with <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a> find dilators rather clinical and &ldquo;medical&rdquo;. When they arrive in the mail, they take one look at them and push them back in the packet. They often bring them in to me in the original bag, still fully wrapped in the bubble wrap. They just can&rsquo;t face them.</p> <h3>At the very least, women feel apprehensive about using dilators.</h3> <p>At worst, they may be physically repulsed by them. This is understandable &ndash; but can actually form a big part of the problem. Getting to the point where it doesn&rsquo;t feel offputting to use dilators is a major milestone and, I find, usually means the finish line is in sight. While there may be that bit of work to do yet, it&rsquo;s a fairly predictable path to the end goal of successful intercourse at this point.</p> <h3>But the negative feelings about using dilators represent an age-old challenge to our nervous system, and a major activator of the stress response : threat.</h3> <p>Any negative emotion is a threat to your sense of well-being, your sense that &ldquo;all is right in your world&rdquo;. Threat is a major activator of the stress system. Activation of the stress system sets off a protective reaction in your muscles, promoting <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a>&hellip;and thus the vicious cycle continues.</p> <p>So addressing and working through this sense of threat is essential in overcoming <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a>, and learning to be okay with your dilators is one of your major tasks.</p> <p>You can start working through a self-help program to resolve this "threat situation" by <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">downloading my e-book Outsmart Your Pain</a>. You can start that straight away <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">here.</a></p> <p>If this is your experience, you will be most interested to follow up with Part 2 of this post.</p> <h2>Liked this post? <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2">Subscribe to our newsletter</a> and get loads more useful info!</h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Get Ready to Shimmy: Belly Dancing For The Pelvic Floor http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/get-ready-to-shimmy-belly-dancing-for-the-pelvic-floor <h2>Ever been drawn to the exotic world of belly dancing? Feel intrigued but a bit scared at the same time?</h2> <h3>You may have some of the same questions I did.</h3> <p>My <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/pelvic-floor-safe-exercise-the-ten-most-non-boring-options">last post</a> brainstormed some <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/pelvic-floor-safe-exercise-the-ten-most-non-boring-options">options for pelvic floor-safe exercise that aren't boring</a>. So here, as promised, is the first in a series that goes into these fabulous options in more detail, especially from the point of view of the pelvic floor.</p> <p>In this post I interview Lorelle Hawes, experienced belly dancing teacher and physiotherapist.</p> <h3>We talk about the reasons it's a pelvic floor safe exercise, when to start post-partum, and the lure of the music!</h3> <h4><strong>Can you summarise your background &ndash; how long have you been teaching, and how did you get into belly dancing?</strong></h4> <table style="width: 832px; height: 277px;" border="0"> <tbody> <tr> <td>I first tried belly dancing back in 1990, my final year of physiotherapy. The UQ Sports Association was running an 8 week course and a friend convinced me to come along. She dropped out after a couple of lessons, but I was instantly hooked! I think I taught my first class in about 1993, but didn&rsquo;t teach regularly until about 1997. For the last 5 years, I have only taught as a &lsquo;relief&rdquo; teacher and try to keep my hand in by attending classes when I can.</td> <td><img title="lorellehawesbellydancing" src="http://www.equilibriahealth.com.au/images/lorellehawesbellydancing.jpg" alt="lorellehawesbellydancing" width="189" height="266" /></td> </tr> </tbody> </table> <h4><strong>What do you love most about belly dancing?</strong></h4> <p>I would have to say the music, and how your movements are intimately guided by the music and the emotions that it evokes. Whether it&rsquo;s plaintive vocals, energetic drum rolls or complex orchestral arrangements &ndash; your body has an answer!</p> <blockquote> <h2>"Your body has an answer!"</h2> </blockquote> <h4><strong>What advantages does belly dancing have over other forms of dancing &ndash; and exercise in general?</strong></h4> <p>Belly dancing doesn&rsquo;t feel like exercise. It is fun, creative, sensual and expressive. There are many different Middle Eastern dance styles taught under the umbrella of belly dance so you never get bored. Belly dance is accepting of all body types and ages, so it is accessible to a wide range of women. Just in case anyone is wondering, you don&rsquo;t need to expose your belly in a belly dance class &nbsp;- but of course you can if you want to!</p> <blockquote> <h2>"Belly dance is accepting of all body types and ages"</h2> </blockquote> <h4><strong>What makes belly dancing pelvic floor-friendly?</strong></h4> <p>On the whole, belly dance is low impact and you can pace yourself within the class environment. It is a woman friendly environment and the pelvic floor is often referenced during a class.</p> <blockquote> <h2>You don't need to expose your belly in a belly dance class - but of course you can if you want to!"</h2> </blockquote> <h4><strong>Any warm up exercises a woman should learn before launching herself into the world of belly dancing?</strong></h4> <p>Not really, a good teacher will always start with a warm up and break down new movements slowly.</p> <h4><strong>Is there any special care a woman should take if she has a prolapse?</strong></h4> <p>Yes. There are some folkloric styles that involve some light jumping, so be careful with that. Also, there are some movements that can potentially bear down on a prolapse if the pelvic floor is not responsive. For example strong undulations/belly rolls; sharp hip movements and vigorous shimmies. Ideally, the pelvic floor co-contracts with all of these movements to counter any downward pressure, but if you have a weak pelvic floor you should ease off the intensity with which you perform these moves. There may be some moves you will want to avoid if you feel downward pressure.</p> <blockquote> <h2>"Ideally, the pelvic floor co-contracts with all these movements"</h2> </blockquote> <h4><strong>How soon can a woman start belly dancing postpartum &ndash; if she has never done it before?</strong></h4> <p>I would say 3- 6 months.&nbsp; I will never forget one of my past students turning up to class 4 days after having had her baby! That was definitely not on my advice! She was so passionate about it and couldn&rsquo;t bear to miss anything.</p> <p><strong>Does a woman need to think about her pelvic floor while belly dancing?</strong></p> <p>If you do have some pelvic floor weakness then take care with the above mentioned movements. When you are learning new movements, you should be cued to draw in your lower abdominals frequently during class &ndash; take that as a prompt to also draw up the pelvic floor. However, once you have the basics under your belt, you should be able to enjoy dancing freely.</p> <blockquote> <h2>"You should be able to enjoy dancing freely"</h2> </blockquote> <h4><strong>Some critics say belly dancing might over-emphasise the global abdominals. What are your thoughts on this?</strong></h4> <p>Compared to a typical gym or Pilates class where you might be performing curl ups and table top exercises, belly dance is far less focussed on the global abdominals. A lot of belly dance movements are generated through the legs only to look like an abdominal action. We do use the oblique muscles (and quadratus lumborum) quite a lot&nbsp; to achieve different movements, but there is usually no resistance, including from gravity, involved.</p> <blockquote> <h2>"A lot of belly dance movements are generating through the legs only to look like an abdominal action."</h2> </blockquote> <h4><strong>How might a woman find a good belly dancing teacher?</strong></h4> <p>It is trial and error to find someone whose teaching style you enjoy and are comfortable with. There are no regulations governing belly dance teaching. I would advise to ring around and ask the teacher how many years she has been teaching, how many people in class (ideally less than 20) and whether she has any group exercise teaching qualifications. If you have a prolapse, let her know, so she is aware you may pace yourself or modify some movements to suit.</p> <p>I must admit, I would not recommend belly dance to women who have no pelvic floor contraction. There are many moves where you would hope there is automatic co-contraction happening. &nbsp;However, compared to sports and most gym classes it is PF friendly.</p> <p>Thanks for the opportunity to be part of your blog!</p> <h3><strong>Thank you Lorelle, and shimmy on!</strong></h3> <h2>Liked this post? <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2">Subscribe to our newsletter</a> and get loads more useful info!</h2> <p><strong><br /></strong></p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Best Ways to Help A Tampon Go In Step 6 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-6-dont-be-too-squeamish <h2>Don't Be Too Squeamish</h2> <p>You have been trying hard to use all the right tricks to insert a tampon. You have <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-look-and-you-will-find">become famiilar with your anatomy</a>. You are <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-use-the-information-on-the-packet">using the best position</a>. You are becoming aware of what your <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-3-contract-and-relax-your-pelvic-floor">muscles are doing to "close up" your vagina and to "allow it to open</a>".</p> <p>But somehow, you seem to be hitting a roadblock. There is some obstacle in the way. It just feels like it won't go in, and quite frankly, it's starting to gross you out.</p> <p>Sometimes this is exactly the problem.</p> <h3>Sometimes, inserting a tampon feels, as one of my patients memorably described it, like "touching your eyeball".</h3> <p>There is no better way to make a muscle contract than fear. What does this have to do with tampons?</p> <p>Well, remember, the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-3-contract-and-relax-your-pelvic-floor">vagina "opens" and "closes"</a> due to the actions of the vaginal muscles: the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-3-contract-and-relax-your-pelvic-floor">Guardians of the Gate</a>. The Guardians of the Gate are given their commands by the Empress - the brain. When the empress is not happy, she commands the Guardians to "close the gate"!</p> <table border="0"> <tbody> <tr> <td> <p>In fact, any negative emotions will cause a reflex "closing command" from the Empress. She is rather</p> <p>like the Queen of Hearts in Alice's Adventures in Wonderland...the slightest annoyance results in a</p> <p>knee-jerk hysterical reaction, and next thing you know she is shrieking "Off With Their Heads!"</p> </td> <td><img title="queenofhearts" src="http://www.equilibriahealth.com.au/images/queenofhearts.png" alt="queenofhearts" width="240" height="180" /></td> </tr> </tbody> </table> <p>(By the way, the Empress &ndash; the brain, that is - doesn't have to be this irritable. There are many ways to train her to be more relaxed, more like a pussy cat than a sabre-toothed tiger. But here I want to focus on emotions).</p> <p>To get the Empress (that was the brain) in a good mood, so she doesn't send a wild command to the Guardians of the Gate to "CLOSE!" just because there is a mild breeze, you need to channel some positive emotions her way.</p> <p>This means working on re-interpreting what you might be feeling.</p> <h3>If you feel squeamish, read this as a sense of adventure faced with the unfamiliarity of the territory.</h3> <h3>If you feel frustrated, sense this as fuel to accomplish your task.</h3> <h3>If you feel tense, interpret this as power.</h3> <p>I'm not asking you to deny what you are feeling - simply read it in a different language.</p> <p>Knowledge is power, and practice brings a sense of ease. You may need to practice every day for a week even looking at the area, so it starts to become more familiar. This is Mind Work, just as important as Body Work!</p> <p>Practice your Mind Work <em><strong>before</strong></em> your period is due, and <em><strong>before you will be using tampons</strong></em>.</p> <h3>This is like an explorer going on a reconnaissance mission before the real thing.</h3> <p>Understand that the vagina and vulva are resilient and strong. You can't hurt this by doing this. They are an incredibly resilient part of a woman's body. To quote the great actress Betty White:</p> <p><img title="bettywhitegrowsomeballs" src="http://www.equilibriahealth.com.au/images/bettywhitegrowsomeballs.png" alt="bettywhitegrowsomeballs" width="300" height="168" /></p> <p>Keep working your mind - or put another way, make it work for you!</p> <p>Go to the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-7">seventh blog post in this series</a> by clicking <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-7">here. </a></p> <h2>To get started on your Mind Work straight away, download my book <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">Outsmart Your Pain</a>, available <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">here</a>.</h2> <h2>Liked this post? <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2">Subscribe to our newsletter</a> and get loads more useful info!</h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> A Guide to Getting Off The Pill Step 5 - The Final Step! http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-guide-to-getting-off-the-pill-step-5-the-final-step <h2>So now you&rsquo;re almost ready to make the decision to get off the Pill and launch yourself into a Pill-free life!</h2> <p>Or maybe you're not convinced, and need some more guidelines for making your decision.</p> <h3>How do you actually make your decision about which contraception is right for you?</h3> <p><br /> I&rsquo;d like to give you some guidelines as to how to choose another form of contraception, from all the information we&rsquo;ve discussed so far. A kind of road map of contraception, if you will.</p> <p>If you are still not sure about getting off the Pill, this road map will help you decide. Who knows? The Pill might be your best option at present. But at least you&rsquo;re making a more informed choice.</p> <p>Before you look at the road map of contraception, take note that it may not all make perfect sense on first read.</p> <p>Unless you&rsquo;ve read this blog series on <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-guide-to-getting-off-the-pill-intro">Getting Off the Pill</a> very carefully, some of the terms may be unfamiliar to you.</p> <p>So use the pointers below the flow chart to help you as you&rsquo;re looking through it:</p> <p><img title="infographic10-choosingtherightcontraceptionforyou" src="http://www.equilibriahealth.com.au/images/infographic10-choosingtherightcontraceptionforyou.jpg" alt="infographic10-choosingtherightcontraceptionforyou" width="629" height="642" /></p> <h2>A few pointers for when using the flow chart:</h2> <h3>Complete, permanent and reversible contraception</h3> <p>The terms complete, permanent and reversible are used loosely, except for hysterectomy and total abstinence, which are probably the only ones that truly make pregnancy impossible.</p> <h3>Ethical and personal considerations</h3> <p>Along the way, you&rsquo;ll be guided by your own philosophical, moral, ethical, and personal compass. Ultimately, no one can tell you what&rsquo;s right for you except you. This goes for all the steps, even though I have only included it in a more obvious section on the bottom left, when deciding among hysterectomy, periodic abstinence, and tubal ligation. I particularly included the &ldquo;ethical/personal&rdquo; dimension here because of many women telling me over the years that they objected to the idea of a hysterectomy (for example, for uterine prolapse or painful periods) if it wasn&rsquo;t completely necessary.</p> <h3>Sexually Transmitted Infections (STIs)</h3> <p>Be aware that there are no methods of contraception that are 100% protection against sexually transmitted infections. (Take particular care not to misinterpret my simplified guideline for if &ldquo;STI focus is needed&rdquo;.) Be very clear as to whether this needs to be your focus or not.</p> <h3>The Reality of Reliability</h3> <p>&ldquo;Reliability focus&rdquo; is also an over-simplified concept. As I said, no form of contraception is 100% reliable. I have differentiated the three of Mirena IUD, Implanon implant and Depo Provera injection from the Pill not because of the theoretical effectiveness &ndash; the Pill is right up there at 99% - but because it happens that women forget the Pill, lose effectiveness due to illness etc and lack protection, ending up with an unintentional pregnancy. Many women have told me they chose Depo Provera, Implanon or the Mirena IUD for this reason &ndash; they can&rsquo;t trust themselves with the Pill.</p> <h3>Natural Family Planning Methods</h3> <p>Finally, I have differentiated the Billings Ovulation Method from other forms of &ldquo;natural family planning&rdquo;, as they&rsquo;re known, (Symptothermal Method, the Creighton Model and Natural Fertility Management) because there is more research on Billings and often a wider availability of teachers. If you choose a natural family planning method, don&rsquo;t do it from a book, website and especially not an app! Learning with a teacher is a must if you want the high effectiveness rating possible with these methods.</p> <p>So there you have it! Enjoy finding your own answer to the contraception question. I would love to hear which contraception you have chosen for yourself right now and why. Comment below, or on my Facebook page Equilibria, or find me on Twitter at @AlyssaTait1.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> A Roadmap to Choosing Contraception http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-roadmap-to-choosing-contraception <h2>Simplifying the Contraception Decision - At A Glance</h2> <p>For a brief explanation of the flow chart, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-guide-to-getting-off-the-pill-step-5-the-final-step">click here</a>.</p> <p>For a fuller explanation of the theory behind the development of this flow chart, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-guide-to-getting-off-the-pill-intro">start here. </a></p> <p><img title="infographic10-choosingtherightcontraceptionforyou" src="http://www.equilibriahealth.com.au/images/infographic10-choosingtherightcontraceptionforyou.jpg" alt="infographic10-choosingtherightcontraceptionforyou" width="629" height="642" /></p> The Alien Concept of Vaginal Dilators Part 2 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/or,-you-want-me-to-put-what-where-part-2 <p><a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-alient-concept-of-vaginal-dilators-part-1">Last post </a>I talked about the concept of vaginal dilators, which are an ingredient in the success recipe for many women experiencing <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a> and painful sex. (Not everyone, mind you, so be cautious if self-treating, or if your treating clinician doesn&rsquo;t seem experienced or flexible in their treatment).</p> <h2>I observed that many women feel apprehensive about using dilators.</h2> <p>They may find them alien, weird, confronting, distasteful or even distressing. And particularly when these feelings are intense, they need to be respected and "coaxed around" rather than repressed or forced through.</p> <p>Now, I admit I am rather blas&eacute; about the concept of dilators due to ten years of clinical exposure. But I do take great care to ease people into the idea. I gauge their readiness, and raise the idea when I judge the time is right. I explain how helpful they are going to be, and emphasise the positive. I show them a picture before the real-life object.</p> <p>(By the way, this is just like phobia therapy. I trained myself to look at photos of spiders before observing real-life ones. It may seem a dramatic comparison, but actually, anything you have negative feelings about can respond to a similar technique used in phobias called &ldquo;graded exposure&rdquo; or &ldquo;desensitisation&rdquo;. More about this in another blog post &ndash; but you can find a detailed plan for &ldquo;graded exposure&rdquo; to sex in my e-book <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">Outsmart Your Pain</a>, which you can download and start reading immediately <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">here</a>).</p> <table border="0"> <tbody> <tr> <td>Though I use sensitivity when introducing the concept of vaginal dilators, I am not able to diffuse the apprehensiveness completely. I see the change that comes over women&rsquo;s faces as they regard the picture of the dilators. Overcoming this reluctance to try them is sometimes the biggest hurdle in resolving the vaginismus and attaining the goal of enjoyable, pain-free sex.</td> <td> <p><img title="stressedwoman" src="http://www.equilibriahealth.com.au/images/stressedwoman.jpg" alt="stressedwoman" width="174" height="219" /></p> </td> </tr> </tbody> </table> <p>&nbsp;</p> <p>This got me thinking. How can we make the idea of using the dilators less unappealing?</p> <h2>This might be the key to success!</h2> <p>This series of blogs, therefore, focuses on strategies to make using dilators more appealing. Enjoy! And remember, there is a lot more to achieving painless, enjoyable sex than using dilators. A system of &ldquo;graded exposure&rdquo; to increased &ldquo;sensory input&rdquo; to the vulva and vagina is available in the Appendix of my e-book, <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">Outsmart Your Pain</a>, recommended for all women with vaginismus, painful sex, vulvodynia and persistent pelvic pain.</p> <p>A kind of disclaimer:</p> <p>Whether you need to use vaginal dilators at all is another question that cannot be answered by this blog post. Whether vaginal dilators are the best solution for you right now is an even more complicated question, which you might like to discuss with a clinician experienced in treating <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a> and other issues of painful sex. And finding an experienced clinician in this field, who is right for you and the place you are at, may be the greatest challenge of all! This final issue is a topic for another blog post.</p> <p>&nbsp;</p> <p>&nbsp;</p> <p><a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-alient-concept-of-vaginal-dilators-part-1">Last post </a>I talked about the concept of vaginal dilators, which are an ingredient in the success recipe for many women experiencing <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a> and painful sex. (Not everyone, mind you, so be cautious if self-treating, or if your treating clinician doesn&rsquo;t seem experienced or flexible in their treatment).</p> <h2>I observed that many women feel apprehensive about using dilators.</h2> <p>They may find them alien, weird, confronting, distasteful or even distressing. And particularly when these feelings are intense, they need to be respected and "coaxed around" rather than repressed or forced through.</p> <p>Now, I admit I am rather blas&eacute; about the concept of dilators due to ten years of clinical exposure. But I do take great care to ease people into the idea. I gauge their readiness, and raise the idea when I judge the time is right. I explain how helpful they are going to be, and emphasise the positive. I show them a picture before the real-life object.</p> <p>(By the way, this is just like phobia therapy. I trained myself to look at photos of spiders before observing real-life ones. It may seem a dramatic comparison, but actually, anything you have negative feelings about can respond to a similar technique used in phobias called &ldquo;graded exposure&rdquo; or &ldquo;desensitisation&rdquo;. More about this in another blog post &ndash; but you can find a detailed plan for &ldquo;graded exposure&rdquo; to sex in my e-book <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">Outsmart Your Pain</a>, which you can download and start reading immediately <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">here</a>).</p> <table border="0"> <tbody> <tr> <td>Though I use sensitivity when introducing the concept of vaginal dilators, I am not able to diffuse the apprehensiveness completely. I see the change that comes over women&rsquo;s faces as they regard the picture of the dilators. Overcoming this reluctance to try them is sometimes the biggest hurdle in resolving the vaginismus and attaining the goal of enjoyable, pain-free sex.</td> <td> <p><img title="stressedwoman" src="http://www.equilibriahealth.com.au/images/stressedwoman.jpg" alt="stressedwoman" width="174" height="219" /></p> </td> </tr> </tbody> </table> <p>&nbsp;</p> <h2>This got me thinking.</h2> <h2>How can we make the idea of using the dilators less unappealing?</h2> <h3>This might be the key to success!</h3> <p>This series of blogs, therefore, focuses on strategies to make using dilators more appealing. Enjoy! And remember, there is a lot more to achieving painless, enjoyable sex than using dilators. A system of &ldquo;graded exposure&rdquo; to increased &ldquo;sensory input&rdquo; to the vulva and vagina is available in the Appendix of my e-book, <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">Outsmart Your Pain</a>, recommended for all women with vaginismus, painful sex, vulvodynia and persistent pelvic pain.</p> <p>Watch this space for the first blog in the series.</p> <p>A kind of disclaimer:</p> <p>Whether you need to use vaginal dilators at all is another question that cannot be answered by this blog post. Whether vaginal dilators are the best solution for you right now is an even more complicated question, which you might like to discuss with a clinician experienced in treating <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a> and other issues of painful sex. And finding an experienced clinician in this field, who is right for you and the place you are at, may be the greatest challenge of all! This final issue is a topic for another blog post.</p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Best Ways to Help A Tampon Go In Step 7 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-7 <h2>Use Your Finger</h2> <p>The idea of putting your finger inside the vagina may not be very appealing. But before you skip this blog post in disgust, just hear me out.</p> <p>You've been having trouble putting in a tampon, despite <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-look-and-you-will-find">getting familiar with the landscape down there</a>, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-use-the-information-on-the-packet">trying different positions</a>, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-3-contract-and-relax-your-pelvic-floor">relaxing your pelvic floor (vaginal) muscles</a>, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-4-lubricate-the-tampon-like-crazy">lubricating the tampon like crazy</a>, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-5-pick-the-best-time-of-the-month">picking the best time of month to practise</a> and<a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-6-dont-be-too-squeamish"> managing any negative emotions.</a></p> <p>Maybe the "ick factor" is still there, and putting your finger in your vagina is the last thing you feel like doing.</p> <p>But trust me: if you have got to this point, and haven't had any success yet, practising with your finger could be the "game-changer" you need.</p> <p>When I was a young teenager struggling with periods, I remember something my sister said to me:</p> <h3>"You should be able to put your own finger in the vagina. That is just something every girl should be comfortable doing."</h3> <p>My sister must have been all of sixteen. Still, these wise words have stayed with me, and I think of them now every time a patient tells me she can't put her finger in her vagina. Or won't.</p> <p>There's a few things we girls learn as we grow up. We learn to wipe front to back. We learn not to wash the vulva with soap. We learn to count the days between our periods to give us the best chance of predicting when the next period is coming. We learn to feel our breasts on the first day of the month, to recognise what's normal for us, so we can be alert to any changes that might need to be checked.</p> <h2>These are all skills we need as women.</h2> <p>And this is an important one to add to the list: to comfortably insert your finger in your vagina. This is an important way to have knowledge of your own body. It empowers you by making you familiar with yourself. Don't forget, your vaginal muscles are "The Guardians of the Gate". They need to know when to guard, and when to be at ease. If they don't have a chance to be at ease, they will overreact by being in "guarding mode" all the time. They will try to "close the gate" even for a light breeze.</p> <p>Your finger is the equivalent of "a light breeze". Allowing the gates to open for a light breeze is a starting point for choosing to open the gates for other visitors (for example, someone else's finger, or penis, or a speculum to have an important health check or Pap smear).</p> <p>So now I'd like to suggest you go back to <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-look-and-you-will-find">Step I, Look and You Will Find</a>, and repeat all the steps with the aim of inserting your finger in the vagina.</p> <p>Three more things.</p> <p>Cut your nails (obvious). Wash your hands before and after (double obvious).</p> <p>And/or - wear latex gloves (if not allergic). No need to wear gloves of course - but for some women this creates the mental barrier they need to give it a try. Over time, progress to no gloves.</p> <p>Has being able to insert your finger into your vagina helped you? I'd love to hear from you in the Comments.</p> <p>The <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-8-dont-feel-weird-about-using-a-sex-toy">next post in this series</a> (an 18+ post - please get parental permission if under 18) - can be found <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-8-dont-feel-weird-about-using-a-sex-toy">here. </a></p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Catch A Wave: Surfing For Your Pelvic Floor http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/catch-a-wave-surfing-for-your-pelvic-floor <h2>Staying Low Impact in the Impact Zone</h2> <h3>I'm very excited to bring you my second interview in my blog series about the least boring pelvic floor-friendly exercise options.</h3> <p><strong>Madeleine Newton</strong> is an ex-pro surfer who happens to also be a women's health physiotherapist working on Queensland's Gold Coast. I don't know much about surfing, except that it looks like an awful lot of fun - and potentially a great all-body low-impact exercise that might be a good pelvic floor-friendly option. Madeleine set me straight on a few things, including how and when it is and isn't pelvic floor friendly, and how your body might feel when you first try to get back to it after childbirth. There's plenty of stuff here to get you amped about surfing!</p> <h3><strong>How did you get into surfing? &nbsp;</strong></h3> <p>I have always had a love for the ocean and was always in it, from as far back as I can remember- &nbsp;swimming, bodyboarding, you couldn't get me away from the beach or out of the water! &nbsp;My parents signed me up for Nippers and I competed for years in that, which was great for developing surf safety skills and learning to save and help others. &nbsp;But one day at a Nippers competition, in between events, I was out in the water practising and just started to stand up on my Nipper board and surf. The feeling was amazing, I was instantly addicted and I just couldn't stop! &nbsp;My older brother bought me a lovely little old surfboard and I just never looked back! I started competing in local events and started getting really good results and had a heap of major sponsors, so that lead me to compete around Australia in the junior and school titles and on the Australian junior surfing series until I made it onto the world qualifying series (WQS) which took me to USA, South Africa, Europe, Indonesia and all around the world.</p> <table border="0"> <tbody> <tr> <td> <p><img title="madeleinesurfshot_sm" src="http://www.equilibriahealth.com.au/images/madeleinesurfshot_sm.jpg" alt="madeleinesurfshot_sm" width="403" height="267" /></p> </td> <td> <h3><strong>What was your best result?</strong></h3> <p>I was ranked in the top 16 in the world one year and came 2nd in the Australian Junior Titles and 3rd in the world grommet titles also. &nbsp;</p> <h3><strong>What do you love most about it? &nbsp;</strong></h3> <p>Being in the ocean, there's something healing and magical about it! It's freedom! And the feeling of being one with the ocean diving through waves and riding them. The old saying "only a surfer knows the feeling" really is true. It's hard to describe the feeling and nothing else really compares!</p> </td> </tr> </tbody> </table> <br /> <h3><strong>How long did you have off surfing after having your baby?</strong></h3> <p>Despite desperately wanting to be back in the water after having my first baby, it took about 6 months before I got back to surfing. My body was just not ready for it. &nbsp;The combination of extreme tiredness, low iron, recurrent bouts of mastitis, learning how on earth to feed and look after this gorgeous little human properly and having quite a difficult first birth meant I just wasn't able to get back into the water. As much as I love &nbsp;surfing, it just wasn't a priority for me at that stage, and I felt it had to be put on the back burner while I concentrated on the most important job in the world (and just surviving &nbsp;really!). &nbsp;Some women just ease straight into motherhood and make it look so easy, but that wasn't the case for me. My body was so heavy, sore and tired, and having a little creature to look after and care for 24/7 was a huge shock for me (especially having been quite independent previously), it was a very steep learning curve. &nbsp;I'm very lucky though, to have the most amazing and supportive husband in the world who continuously encouraged me to get back into the water!</p> <h3><strong>What did it feel like to get back on the board for the first time after bub? &nbsp;</strong></h3> <p>Because it had been a while, I had lost a lot of muscle tone and strength (and had put on a lot of weight too) and I was still quite sore. I remember struggling, fitness wise, to paddle out the back and getting quite frustrated, as I used to be such a high level surfer previously. &nbsp;I also remember doing a breastroke kick to propel myself onto my board and my groin muscles and pelvis killing me with pain. I think I only stayed out for about 10 minutes and came in and cried to my husband! &nbsp;But just as I had persevered to get to an elite sports level in the past, and with some help from a personal trainer (doing a mums group training session 1-2x/week) I eventually regained the strength, found I was still able to surf just as well, lost some of the weight, and was back surfing in 6-8ft Indonesian waves again, within 1-2 years. &nbsp;I guess it's not the picture perfect answer you might have been expecting, but I guess my point is, that for some mums, it's a bit of a struggle after having kids, but if you keep persevering, setting and achieving small goals, you will eventually get there, just as long as you dont give up!</p> <h3><strong>Was your experience any different following the birth of your second baby?</strong></h3> <p>Yes totally different. My second baby was a breeze in comparison. &nbsp;I was surfing on a rubber mat right upto the day my second baby was born. I was a lot stronger and fitter, I seemed to handle the pregnancy better (no back or pelvis pain this time), labour better and I knew what to do with the baby the second time round. &nbsp;I was back surfing at around 6 weeks. Being a physiotherapist with a special interest in women's health, I knew the dangers of going back too early and the risks of injury due to joint laxity (and also mastitis from lying on or hitting those enormous boobs) and I was very cautious to only go out in small safe conditions. &nbsp;My main worry was slipping on the board and stretching already lax ligaments, but that never happened and I found surfing helped me get stronger, fitter, healthier and much much more happy!!! I was a better mum for it too.</p> <h3><strong>Do you think surfing helped you bounce back after having a baby?</strong></h3> <p>Definitely! I felt human again. It gave me "me" time (alone or with friends) in the surf. The feeling was amazing. I felt refreshed and started regaining my strength and energy. It's just an awesome sport for lots of reasons.</p> <table border="0"> <tbody> <tr> <td> <h3><strong>Do you ever think about your pelvic floor muscles when surfing?</strong></h3> <p>I don't really think about them, but since having children I am much more aware of my pelvic floor muscles and a correct contraction, and I do notice when they are contracting. For example during paddling, along with some of the other back (multifidus &amp; erector spinae) and core muscles (transversus abdominus), I sometimes feel the pelvic floor muscles co-contracting aswell. &nbsp;And sometimes I am aware of them 'bracing' prior to and during certain maneuvers and turning the board and so on. &nbsp;Surfing definitely helps strengthen all muscles including the pelvic floor. &nbsp;And SUPing (stand up paddle boarding) has been great for small days too. &nbsp;SUPing is great for the core, arms and legs.. well, the whole body really!</p> </td> <td><img title="madeleinesurfing_sm" src="http://www.equilibriahealth.com.au/images/madeleinesurfing_sm.jpg" alt="madeleinesurfing_sm" width="401" height="264" /></td> </tr> </tbody> </table> <h3><strong>As a physiotherapist, a surf coach, surfer and mum, what advice would you give to mums trying out surfing for the first time?</strong></h3> <p>Just have fun with it. &nbsp;It's your time away from the kids to enjoy. &nbsp;Expect (&amp; embrace) a bit of a workout, and allow yourself some time to learn. &nbsp;It usually takes a few sessions to get up and standing. &nbsp;It's &nbsp;also worth getting a qualified surfing instructor to give you some tips to start off with, even the tiniest tips, can help you stand up and ride that wave right through to the shore. Keep persevering, because once you get that feeling, you won't want to stop! &nbsp;Oh and also, the learn to surf boards can be heavy so make sure you buddy up with someone to help carry your board down to the water to protect your pelvic floor and back, especially if your women's health physiotherapist has advised you not to lift! &nbsp;Just be aware also not to strain to get the surfboard into position, you can ask your instructor for easy ways to manage your surfboard without having to lift or strain to position it (things like pulling the board around from the leg rope on top of the water rather than trying to lift the board against the water current etc). &nbsp;Even just laying down and paddling in some safe, flat water is a great low risk way to get used to the board, get a bit of fitness in and get out in the water with your friends!</p> <h3><strong>And great bonus news, mums...you can see Madeleine as your women's health physiotherapist at Pindarra Physiotherapy and Sports Medicine on the Gold Coast. But whatever you do, make an appointment and don't just <em>drop in</em> - it's the ultimate surfing no-no!</strong></h3> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Ten Ways to Make Using Your Vaginal Dilators Less Unappealing - Reclassify Them! http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ten-ways-to-make-using-vaginal-dilators-uneappealing-reclassify-them <h2>Women who use vaginal dilators generally don&rsquo;t do it for fun.</h2> <p>If you&rsquo;ve been recommended vaginal dilators, it&rsquo;s probably for the problem of <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-five-sources-of-painful-sex-and-not-one-of-them-starts-with-v">painful sex</a> or <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a>. You can read more about the common reluctance to use vaginal dilators <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-alient-concept-of-vaginal-dilators-part-1">here</a>, and learn about the concept of removing the &ldquo;threat&rdquo; associated with using them <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/or,-you-want-me-to-put-what-where-part-2">here</a>.</p> <p>But in this blog post I&rsquo;d like to focus on my first suggestion for making vaginal dilators more appealing to use (or, at least, less unappealing).</p> <h3>The way you see an object is influenced and shaped by its name.</h3> <p>Would you agree? For example, wouldn&rsquo;t you rather wear a &ldquo;chemise&rdquo; than a singlet? &ldquo;Go for a pedicure&rdquo; rather than &ldquo;have your corns filed off&rdquo;? Take something to &ldquo;settle your stomach&rdquo; rather than &ldquo;stop the belching&rdquo;?</p> <p>Well, your vagina agrees. Like you, your vagina has class.</p> <h3>And therefore, your dilators need to be re-class-ified.</h3> <p>You could reclassify the dilators as &ldquo;trainers&rdquo; if you want to feel sporty or focus on your achievements. (<strong><em>&ldquo;I&rsquo;m just going to go have a session with my trainers.&rdquo;</em></strong>)</p> <p>Or perhaps &ldquo;helpers&rdquo; &ndash; wouldn&rsquo;t your vagina rather be &ldquo;helped&rdquo; than &ldquo;dilated&rdquo;? (<strong><em>&ldquo;Gee I&rsquo;m glad I&rsquo;ve got these helpers to use!&rdquo;</em></strong>)</p> <table border="0"> <tbody> <tr> <td> <p><img title="russiannestingdolls" src="http://www.equilibriahealth.com.au/images/russiannestingdolls.png" alt="russiannestingdolls" width="225" height="225" /></p> </td> <td> <p>Maybe &ldquo;Baboushka dolls&rdquo; would lend a nice vibe, and be suitable for a little family of objects that fit inside each other. (<em><strong>&ldquo;I guess it&rsquo;s time to get out the Baboushka dolls.&rdquo;</strong></em>)</p> <p>Or what about just &ldquo;gizmos&rdquo;? (This is how I tend to refer to them). Remember Gizmo from the movie Gremlins? Well, dilators are much more like the cute little mogwai Gizmo than a nasty reptilian gremlin. (<em><strong>&ldquo;Where did I put my little gizmos?&rdquo;</strong></em>)</p> </td> <td> <p><img title="mogwai" src="http://www.equilibriahealth.com.au/images/mogwai.jpg" alt="mogwai" width="180" height="280" /></p> </td> </tr> </tbody> </table> <h3>Even better, how about you name them individually?</h3> <p>It may sound silly, but the human brain works in funny ways. You&rsquo;re much more likely to feel accepting of &ndash; even a fondness for &ndash; something you&rsquo;ve named. Think of something that&rsquo;s a set, a family or a group, like the seven dwarves or Santa&rsquo;s reindeer, for example. (<em><strong>&ldquo;Well &ndash; Prancer was a walk in the park.. And I&rsquo;ve blitzed my way through Blitzen. Dasher&rsquo;s done his dash. Can&rsquo;t wait to get started with Vixen!&rdquo;</strong></em>)</p> <table border="0"> <tbody> <tr> <td> <p>And if you feel silly naming inert plastic tubes, consider storing a tiny Guatamalan worry doll in each. Again, this may seem silly to your conscious brain. However, your unconscious brain will find the dilators (<em><strong>trainers, helpers, gizmos</strong></em>) much more appealing if they have been associated with an endearing little doll. (Worry dolls or trouble dolls are a set of tiny dolls that are placed under your pillow each night after being told a worry to. The legend is that you then leave the worry in the hands of the worry doll to sort out for you while you are sleeping).</p> <p>You can get these little cuties for just a few dollars from an<a href="http://www.oxfamshop.org.au/products/13988543/3096908"> Oxfam Shop online.</a></p> </td> <td><img title="worrydolls" src="http://www.equilibriahealth.com.au/images/worrydolls.jpg" alt="worrydolls" width="259" height="194" /></td> </tr> </tbody> </table> <p>But does it really matter what we call them? Well, it&rsquo;s important not to take these little tools too seriously. ("DILATORS"&nbsp; sounds terribly serious and medical to me, and I suspect to many women). They are simply a practical means to a valuable end &ndash; painless, comfortable sex and intimacy.</p> <h3>Check this out:</h3> <p>A research study had participants taste different substances named either as simple numbers or as appealing labels such as lemon, coffee jelly, caramel candy and consomm&eacute; soup. Guess what? They were rated as tastier when they had appealing names. It may seem only a small thing, but renaming things in your environment that seem unappealing or even threatening can really help to defuse that threat.</p> <h2>(For a whole program on defusing the threat in order to help your pain, read my e-book <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">Outsmart Your Pain</a>.)</h2> <p>I would love to hear your stories about how using different terms or nicknames has helped you in this situation!</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Best Ways to Help a Tampon Go In Step 8 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-8-dont-feel-weird-about-using-a-sex-toy <h2>Don't Feel Weird About Using a Sex Toy to Help Your Tampon Problem&nbsp;</h2> <h3>Firstly, this is an 18+ post.</h3> <p>If you do not fall into this category, please go get your at-least-eighteen-year-old-mother and respectfully ask her permission for you to read this together. However, my target group for this post is the woman over eighteen who, despite her best efforts and my expert advice (starting with my first tampon blog), struggles to use tampons comfortably.</p> <h3>Let&rsquo;s start with a technicality.</h3> <p>The term &ldquo;sex toy&rdquo; can be very offputting for some. I do wish there was another name for sex toys. (Though some of them deserve a tacky name like that.)</p> <p>For the purpose of this blog, could we call them Attraction Contraptions? Objects d&rsquo; Heart? Mojo Gizmos? A Love Science Appliance? Not exactly catchy. Now I know why they are simply &ldquo;sex toys&rdquo;.</p> <table border="0"> <tbody> <tr> <td> <h3>Apparently the word &ldquo;dildo&rdquo; is from the Italian &ldquo;diletto&rdquo;, or &ldquo;delight&rdquo;.</h3> <p>I would like to suggest in this post you become a dabbler in sex toys &ndash; a Diletto Dilettante, if you will.</p> <p>I would firstly like to get it straight that I am not making an overall judgment on sex toys, for good or for bad. I am simply suggesting that in the scenario of having difficulty with tampons, they should not be discounted. They could after all be a useful tool.</p> </td> <td> <p><img title="fluteplaying" src="http://www.equilibriahealth.com.au/images/fluteplaying.jpg" alt="fluteplaying" width="292" height="173" /></p> </td> </tr> </tbody> </table> <h3>At first blush - perhaps literally? - suggesting the use of sex toys when you are struggling with inserting tampons may seem like a bad joke.</h3> <p>The mere sight of them (or even thought of them) may be enough to make you recoil.</p> <h3>But trust me. There is good theory behind this apparently crazy idea.</h3> <p>What we need to do is to help the idea of using tampons stop being threatening. We need tampons to become a friend instead of a foe. My sex therapist friends tell me that for some women, using sex toys can help develop "friendlier feelings" in this area. If you read <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-3-contract-and-relax-your-pelvic-floor">my post</a> about the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-3-contract-and-relax-your-pelvic-floor">Empress in charge of the Guardians of the Gate</a>, this concept will be familiar. We are looking for ways to turn the cranky Empress into a purring pussycat. And sex toys do have an excellent track record of doing this for women.</p> <p>I am certainly not an expert. But if you are just a little open to the idea, becoming familiar with a vibrator, for example, may help develop some positive experience with the landscape.</p> <p>Some vibrators are very small, discreet and tasteful. (And if that's not your style, there are plenty of other styles as well!) The advantage of the small vibrators is that they can be used to develop awareness of pleasurable sensations anywhere around the vulva, but they can also be inserted in the vagina. (Perhaps it's better to think of this as the vibrator "being embraced by the vagina"?) In fact, there are <a href="https://www.pelvicfloorexercise.com.au/shop/womens/berman-dilator-set">sets that double as vibrators and <strong>dilators </strong></a>&ndash; the topic of my next blog post in the series &ndash; like <a href="https://www.pelvicfloorexercise.com.au/shop/womens/berman-dilator-set">this one</a>.</p> <p>A number of my patients with difficulty inserting tampons, inserting their finger, or allowing entry of a penis tell me something interesting.</p> <h3>All of a sudden, the difficulties evaporate (or at least improve) after orgasm.</h3> <p>This makes sense; when you are aroused, the vagina expands. The <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-3-contract-and-relax-your-pelvic-floor">silky tent roof </a>we have talked about before becomes billowy and even more flexible, creating lots of space. So becoming aroused - with or without a sex toy, of course - can be a marvelous preparation to experimenting with inserting a tampon.</p> <p>You're almost there! The <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-9">ninth blog post in this ten-part series</a> can be found right <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-9">here. </a></p> <h2>Liked this post? <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2"><strong>Subscribe to our newsletter</strong></a> and get loads more useful info!</h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Anxiety, MTHFR and the Nutrition Solution http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/anxiety-mthfr-and-the-nutrition-solution <h2>Does nutrition have anything to do with mental health? Or is it in your genes? Yes to both.</h2> <p>Nutrition is critical for best physical health. More and more people consider seeing a clinical nutritionist to help their body feel at its best. But as for mental health? Leave that to the psychologists. That&rsquo;s nothing to do with nutrition, right?</p> <p>Wrong.</p> <h2>I never thought I&rsquo;d say this, but you can actually believe some things you read in the newspaper.</h2> <p>The Courier Mail (a daily paper in Brisbane, Australia) published an article recently that got me jumping up and down with excitement. It described a genetic issue with a gene called "MTHFR", and a treatment approach that we as integrative clinical nutritionists are using &ndash; and with reasonable accuracy at that!</p> <h3><a href="http://www.couriermail.com.au/news/national/how-a-vitamin-cured-my-anxiety-elisa-blacks-story-of-lifelong-struggle-and-new-hope-for-the-future/story-fnii5yv5-1227251037624?utm_content=SocialFlow&amp;utm_campaign=EditorialSF&amp;utm_source=CourierMail&amp;utm_medium=Facebook">&ldquo;How a vitamin cured my anxiety: Elisa Black&rsquo;s story of lifelong struggle and new hope for the future&rdquo;.</a></h3> <p>A vitamin cured her anxiety? Surely that&rsquo;s just another sensationalist tabloid headline?</p> <p>Well in this case, no.</p> <h2>This was a story of personal triumph based on a nutritional link with anxiety, depression and other mood disorders that is supported by research and finally gaining a mainstream foothold.</h2> <p>The condition she describes &ndash; the MTHFR gene polymorphism &ndash; is increasingly being tested for by a range of clinicians due to its relevance to a huge range of health conditions, some life-threatening, some chronic, but all causing enormous suffering.</p> <p>If you missed it, <a href="http://www.couriermail.com.au/news/national/how-a-vitamin-cured-my-anxiety-elisa-blacks-story-of-lifelong-struggle-and-new-hope-for-the-future/story-fnii5yv5-1227251037624?utm_content=SocialFlow&amp;utm_campaign=EditorialSF&amp;utm_source=CourierMail&amp;utm_medium=Facebook">read it in full here</a>. It&rsquo;s not long, and is skilfully written &ndash; it manages to condense a complex topic into an easy to understand summary within a touching real-life story.</p> <p>I am treating an enormous number of patients with anxiety &ndash; some officially diagnosed, and some just plainly obvious to them and to me. I am also treating numerous patients with an MTHFR gene polymorphism as described in the article. And of course &ndash; I am treating quite a number of patients with both.</p> <h2>Aside from mental health issues, other conditions my MTHFR patients have include chronic pain, recurrent miscarriage, infertility, thyroid issues, gut issues, migraines and chronic fatigue.</h2> <p>Identifying the MTHFR gene polymorphism, if present, is step one.</p> <p>Step two is implementing a specific nutrition program (with attention to lifestyle as well) to help the body compensate for the &ldquo;weak link in the chain&rdquo; that is the MTHFR gene polymorphism.</p> <p>Here are my recommendations:</p> <ol> <li> <h3>Read the article <a href="http://www.couriermail.com.au/news/national/how-a-vitamin-cured-my-anxiety-elisa-blacks-story-of-lifelong-struggle-and-new-hope-for-the-future/story-fnii5yv5-1227251037624?utm_content=SocialFlow&amp;utm_campaign=EditorialSF&amp;utm_source=CourierMail&amp;utm_medium=Facebook">here.</a></h3> </li> <li> <h3>Share it with your doctor.</h3> </li> <li> <h3>If your doctor is not knowledgeable about testing for and treating this, find a clinician who is (myself, for example).</h3> </li> </ol> <p>To start solving your health problems, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21">contact me for an appointment.</a></p> <p>I can directly refer you for the test, and have undergone specialised training in the relevant nutritional treatment.</p> <h2>I&rsquo;ll get you on the path to recovery.</h2> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Urinary tract infections - not as cut and dried as you think! http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/urinary-tract-infections-not-as-cut-and-dried-as-you-think <p>For a long time, urinary tract infections have been treated as though they are simple, garden-variety ailment that is straightforward to treat. This seems to be the attitude of both the doctors treating them and many of the women suffering from them: oh well, another UTI, better get to the doctor and get antibiotics!</p> <p>Recent research seems to show that UTIs are not as clear-cut as we might have thought &ndash; they are more complex both in the diagnosis and treatment.</p> <p>An overview of studies on urinary tract infection recently came up with some interesting findings.</p> <h2>Pyuria - it sounds nicer than "pus in the urine"</h2> <p>Pyuria charmingly means &lsquo;&rsquo;pus cells in the urine&rsquo;&rsquo; and is the common finding where the square on the dipstick turns purple.</p> <p>Pyuria has been thought to be a strong indicator of a urinary tract infection. In very few cases, women with UTIs do not have pyuria. However, in almost 40% of cases, pyuria was found where a UTI was not diagnosed. That is, there was a &lsquo;&rsquo;positive dipstick&rsquo;&rsquo; (indicating pyuria) but when a culture was done, the lab could not confirm an infection.</p> <p>What does this mean? It could mean that these women indeed were free of infection, and that there was another cause of the white blood cells in the urine. It could be that these women had recently already started on antibiotic treatment, and it had sufficiently &lsquo;&rsquo;killed off&rsquo;&rsquo; the bugs to make culture difficult.</p> <h2>But, intriguingly, there is a third possibility.</h2> <p>It is equally possible that there was actually an infection, but the lab technique was unable to culture it sufficiently to reach the level required for a true UTI diagnosis.</p> <p>This latter explanation has been proposed by researching urologist Professor James Malone-Lee, who points out that original &lsquo;&rsquo;cut-offs&rsquo;&rsquo; for UTI were based on just seventy-four women, who had been hospitalised with pyelonephritis (severe kidney infection), which may actually be a different kettle of fish to a &lsquo;&rsquo;plain old UTI&rsquo;&rsquo;.</p> <p>Intrigued? Watch this space for <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-gray-area-of-urinary-tract-infections">part 2: "The Gray Area of UTIs"</a>, where the plot thickens!</p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> MTHFR or MTHFaRrrrgh? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/mthfr-or-mthfarrrrgh <h2>Working On Your Methylation The Wrong Way</h2> <p>MTHFR is a huge buzzword. &ldquo;Have you got MTHFR?&rdquo; &ldquo;Get your MTHFR tested.&rdquo; &ldquo;Heck, I&rsquo;ve got MTHFR, what do I do now?&rdquo; &ldquo;Quick, treat that mischievous MTHFR before it wreaks havoc!!&rdquo;</p> <p>Hold your horses!</p> <p>You don&rsquo;t &ldquo;treat MTHFR&rdquo;. You don&rsquo;t leap into any sort of treatment. And you definitely don&rsquo;t self-treat!</p> <p>Here&rsquo;s the long and short of it.</p> <p>MTHFR is an enzyme important in a critical metabolic process called methylation.</p> <p>We have a gene for this enzyme, and just like with other genes, things can go wrong. You can have a mutation.</p> <h2>Having a mutation in the MTHFR gene does not make you a mutant.</h2> <p>But a certain type of mutation (called &ldquo;homozygous C677T&rdquo;) on this gene can reduce your function of that enzyme by around 70%. This can have widespread effects on metabolic processes, and is linked with many health conditions such as:</p> <h3>Neural tube defects such as spina bifida</h3> <h3>Cancers including cervical cancer</h3> <h3>Parkinson&rsquo;s disease</h3> <h3>Polycystic ovarian syndrome</h3> <h3>Hypertension (high blood pressure)</h3> <h3>Pregnancy hypertension</h3> <h3>Recurrent miscarriage</h3> <h3>Schizophrenia</h3> <h3>Bipolar disease</h3> <h3>Depression</h3> <p>The MTHFR enzyme is responsible for the important final step in the body&rsquo;s metabolism of folate (called methyl-folate). But remember, a mutation (also called a SNP, or single-nucleotide polymorphism) does not mean this stops working entirely. It just potentially slows the enzyme down by up to 70%. The important process of methylation in your body is dependent on a lot more than just this.</p> <h2>So if you find out you &ldquo;have MTHFR&rdquo;, please don&rsquo;t do what my patient did! (BEFORE I saw her, that is.)</h2> <p>My proactive patient read <a href="http://www.adelaidenow.com.au/lifestyle/sa-lifestyle/how-a-vitamin-cured-my-anxiety-elisa-blacks-story-of-lifelong-struggle-and-new-hope-for-the-future/story-fnizi7vf-1227251037624">an article on MTHFR</a> and recognised a lot of her own symptoms.</p> <p>She had her GP test her for the gene mutation, and when it came up positive, she started self-treating with folinic acid, and her doctor started doing vitamin B12 injections, because that&rsquo;s the treatment the woman in the <a href="http://www.adelaidenow.com.au/lifestyle/sa-lifestyle/how-a-vitamin-cured-my-anxiety-elisa-blacks-story-of-lifelong-struggle-and-new-hope-for-the-future/story-fnizi7vf-1227251037624">article</a> had done.</p> <h2>This is not the way to do it! There is NOT a one-size-fits-approach to an MTHFR mutation.</h2> <p>Treatment is only needed if there are signs that it is causing problems.</p> <p>You need to be treated by a clinician with good understanding of methylation, nutrigenomics and MTHFR.</p> <p>There need to be other tests done besides the gene test.</p> <p>There needs to be monitoring of what you&rsquo;re doing.</p> <p>If you start on any any supplements, this doesn&rsquo;t mean you take them every day for the rest of your life.</p> <p>And don&rsquo;t attempt to self-treat without supervision by a clinician who is trained in this area.</p> <h3>Remember, the Internet is a double-edged sword. Increased exposure to knowledge can be empowering. But by the same token, a little bit of knowledge can be a dangerous thing.</h3> <h2>If you suspect methylation issues or have tested positive to MTHFR and don&rsquo;t have a knowledgeable clinician to help, get in touch with me for an in-clinic or Skype consultation.</h2> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Stuck on that Last Dilator? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/stuck-on-that-last-dilator-part-1 <h2>Getting From the Plastic Thing to the Real Thing &ndash; Part 1</h2> <h3>Pain with sex can be a bit of a project to resolve.</h3> <p>I&rsquo;ve written a lot about painful sex due to muscular causes. (The old term is vaginismus. I still use this term because usually that&rsquo;s what the doctor has called it to the patient coming to see me. And the new official term, &ldquo;Genito Pelvic Pain/Penetration Disorder&rdquo; has a way of making you quake at the knees.)</p> <p>I&rsquo;ve often said to the women I see that I wish I could make their vaginismus with sex go away with the wave of a magic wand. But muscles don&rsquo;t switch on and off with the click of your fingers.</p> <p>Retraining your muscles takes time.</p> <p>Retraining your muscles takes attention.</p> <p>Retraining your muscles takes motivation!</p> <p>If you&rsquo;ve used vaginal dilators as part of your program to resolve vaginismus, you&rsquo;ll have first-hand experience of the commitment and discipline required to solve this problem.</p> <p>Many women who use dilators progress well through the program and experience the reward of pain-free sex at the end of it &ndash; and the elation that comes with it!</p> <p>But if you had solved the problem, you probably wouldn&rsquo;t be reading this post.</p> <p>Maybe you are finding the dilators really hard to get going with.</p> <p>In that case, you will love my series on <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-alient-concept-of-vaginal-dilators-part-1">The Alien Concept of Vaginal Dilators</a>, as well as <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ten-ways-to-make-using-vaginal-dilators-uneappealing-reclassify-them">Ten Ways to Make Using Your Dilators Less Appealing</a>!</p> <p>Sometimes the barrier is actually not a physical one. Sometimes it&rsquo;s your brain that&rsquo;s putting up the most resistance, and not allowing you to move forward.</p> <p>In this situation, you may want to know more about <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/chronic-pain-in-the-vulva-and-pelvis-retrain-your-brain">retraining your brain in vaginal and pelvic pain</a>.</p> <p>But if you have been persisting with your dilators for a while, have made it to the biggest one, but just can&rsquo;t move on from there, this blog series is for you.</p> <h3>Training with dilators is all about small, measurable steps.</h3> <p>In this series I'll go through some ways you can structure your training sessions.</p> <p>I'll also help you with some stepping stones from the training to the "real thing".</p> <h3>Can't wait? Need help now?</h3> <p>For one-on-one training in making this transition, make an appointment to see me.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Ten Ways to Make Using Your Vaginal Dilators Less Unappealing http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ten-ways-to-make-using-vaginal-dilators-less-unappealing-get-acquainted-with-them <h2>Get Acquainted With Them</h2> <p>In <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a> and <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-five-sources-of-painful-sex-and-not-one-of-them-starts-with-v">painful sex</a>, using dilators is often part of your rehab program.</p> <p>Let&rsquo;s face it, anything unfamiliar can be a bit scary. A new experience is always a bit daunting, even when it&rsquo;s positive. And it makes sense from an evolutionary sense to be cautious when encountering a new object, even if it ends up being good for you.</p> <h3>It&rsquo;s natural to feel some trepidation about starting work with your dilators.</h3> <p>As it is, you&rsquo;re probably feeling a bit nervous or anxious already. You have been experiencing <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-tampons-go-in-ten-easy-steps">difficulty using tampons</a> and possibly painful sex, and your super smart brain is working overtime to warn you of any other possible dangers out there.</p> <p>(It&rsquo;s great to have the ultra-developed brain of a human being, which learns from experience and tries to look out for you. But this is one situation where you&rsquo;re going to have to convince your brain you&rsquo;re in no danger of harm, and that trying something new &ndash; using dilators &ndash; is actually going to help you.)</p> <p>I&rsquo;ve already talked about how <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ten-ways-to-make-using-vaginal-dilators-uneappealing-reclassify-them">naming your dilators can help</a>. Another important step in convincing your brain that using dilators is actually ok is to get acquainted with them.</p> <p>Get to know your dilators! Get a bit more familiar with them!</p> <h3>This uses a concept known among psychologists and pain therapists as &ldquo;graded exposure&rdquo;.</h3> <p>Graded exposure is the opposite of throwing yourself in the deep end. It&rsquo;s just dipping your toe in the water, realising that the water is a bit cold but won&rsquo;t kill you, and gradually dipping more and more of your body in. This way, you get used to it. You don&rsquo;t think you can do it when you start, but you take small steps to give you confidence.</p> <p>What are some things you can do to get acquainted with dilators?</p> <h3>One of the best things you can do to get to know any object is just to hold it.</h3> <p>When you are just using your eyes, your brain works overtime in dreaming up all kinds of intimidating thoughts. If you use your other senses, such as touch, it takes away that sense of a &ldquo;foreign object&rdquo;.</p> <p>So take out your dilator kit, and hold them one at a time. Start with the smallest.&nbsp; Feel how smooth it is. Feel its temperature.</p> <p>Place it against the skin of your arm to get a sense of how it feels to the body.</p> <p>You can do this as gradually as you like. You may want to keep the bigger ones hidden away for a while if they are psyching you out. There is no reason you need to store all the dilators together. You can even start by just keeping the small one somewhere you see it, like your underwear drawer, so that your brain gets lots of &ldquo;incidental exposure&rdquo;.</p> <p>There is research showing that if you have seen a stranger before &ndash; without realising &ndash; when you next see them you unconsciously rate them as more friendly. I can&rsquo;t see why dilators would be any different! The more you see them, the less scary they will be.</p> <h3>Even more powerful would be to store them with something appealing, unexpected or humorous.</h3> <p>You could store your dilator in your sock drawer, in a zany sock or a lacy stocking. This will automatically make your brain have more positive associations with it.</p> <p>You could use it as a jewellery or ring stand on your dresser.</p> <p>You could keep them with your knitting needles. (Even casting on a few stitches to them while they&rsquo;re waiting to be used, in your favourite colour yarn).</p> <p>Or even in a bowl of fake fruit on your dresser!</p> <p>These suggestions might sound silly, but that&rsquo;s exactly why they work. They shock the brain into a different mode and remove the &ldquo;threat&rdquo; associated with the dilators. In pain science, this is called &ldquo;homuncular refreshment&rdquo;. It&rsquo;s a legitimate technique!</p> <h3>So think like the experts.</h3> <p>Start yourself on some graded exposure to dilators, using homuncular refreshment!</p> <p>More about graded exposure in the next instalment. In the meantime, you might want to refresh your memory on some other cute ideas of getting used to your dilators in my <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ten-ways-to-make-using-vaginal-dilators-uneappealing-reclassify-them">first pos</a>t in this series.</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> The Secret to Conquering Pain With Sex http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-secret-to-conquering-pain-with-sex <h2>The One Absolute &ldquo;Must-Have&rdquo; In Vulvodynia and Vaginismus</h2> <h3>I see dozens of women in my clinic every month who have pain with sex.</h3> <p>Some of them have been diagnosed with vaginismus. Some have been diagnosed with vulvodynia, but have vaginismus as well. Some have been diagnosed with vaginismus, but their symptoms are more like vulvodynia. And some have no diagnosis, but just know the most important thing &ndash; that they have pain with sex they wish they didn&rsquo;t.</p> <h3>The &ldquo;secret&rdquo; to conquering pain with sex &ndash; or at least a big part of it &ndash; is the same as overcoming any obstacle.</h3> <p>Most of the women I see do really well. Some women, of course, don&rsquo;t continue with treatment. When I contact them, some of them tell me their reasons. Sometimes they haven&rsquo;t come back because their symptoms resolved after the first two treatments. More often than not, they cite other reasons: family, finances, or the all-too-frequent &ldquo;I&rsquo;ve just been so busy!&rdquo;</p> <h2>So how do you ensure that you are one of the women who are a &ldquo;Vulvodynia/Vaginismus Success Story&rdquo;?</h2> <p>After more than a decade of seeing hundreds of women with vulvodynia and vaginismus every year, I have a long and fascinating list of answers to this question. But today I want to focus on just one of them. In the words of one of my patients today (with vulvodynia):</p> <h2>&ldquo;You have to want it.&rdquo;</h2> <p>A big part of recovery from vaginismus and vulvodynia is motivation: that powerful drive to solve the problem, and the strength of character to persevere until you get there.</p> <p>(Now, I am not for one minute suggesting that&rsquo;s all you need. Please don&rsquo;t be offended if you know you want this more than anything, and have done everything in your power to fix the problem, but haven&rsquo;t yet seen success. Of course, there are many other factors involved in success as well. So if you already know you are super-committed, this post is not for you. You don't need this.)</p> <h3>But without motivation and commitment, you&rsquo;ll be treading water at best.</h3> <p>This commitment needs to be visible through all of your daily actions, the choices you make, the way you live your life. It needs to pervade your whole lifestyle and be more than just words. As we all know, actions speak louder than words.</p> <h3><br /> Here&rsquo;s an example of where a person&rsquo;s actions tell the story of their life.</h3> <p>I recently visited my sister in her self-designed, self-built Tasmanian hideaway. I spent a morning with her watching her chop wood for an hour. At her place, if you don&rsquo;t chop wood, you don&rsquo;t get warm. There is no getting out of it: it&rsquo;s either do the hard yards, or suffer the consequences. After she finished woodchopping she went and practised her flips on the trampoline for twenty minutes. She has very specific targets in her gymnastics training (which she only started as a mother of two a few years ago). She knows she won&rsquo;t master the skill without the dogged, repetitive practice.</p> <p>As we wandered back up the hill towards the house, my sister muttered to herself, &ldquo;Hmmm, I need to find time to do a training session today.&rdquo; My sister does high-level gymnastics-style body weight training, which enables her to get to the second floor of her house by climbing a rope (arms only, no legs), as there is no staircase in her house. (She does have legs, she just chooses not to use them when climbing a rope).</p> <p>As I chuckled to myself at her comment &ndash; which was made in all seriousness &ndash; it got me thinking about how we all live our lives.</p> <p>When we talk about what we want &ndash; or about what&rsquo;s not going right in our lives &ndash; do we take action? Do we really put our money where our mouth is? And is our commitment visible through our actions and habits, day in, day out?</p> <p>My sister did manage to squeeze in the training session, and her results are visible from this repeated commitment. But even if she had missed the training session she felt she needed, her lifestyle already tells the story. She had spent an hour and a half being physical in a way few women commit to. She had chopped wood and jumped on the trampoline. The day before she&rsquo;d probably be up on the roof checking the solar panels. The month before she&rsquo;d been rendering the walls of their cabin. The year before she'd been planing the logs to finish building the walls. Her lifestyle is a commitment to physical activity and maximising her body&rsquo;s capabilities to achieve the goal in her mind's eye.</p> <h3>Commitment is easy to spot from the pattern of how you live your life.</h3> <p>What do your patterns say about your commitment? Are you watertight on your program, your stretches, your dilators, whatever it is? Are you prioritising decreasing stress in your life? Are you working on maintaining the best mental health and attitude? Are you keeping a journal of your progress?</p> <p>There are no guarantees with health of course &ndash; or life in general. But commitment is the closest you will get to a guarantee of results, and progress, in some shape or form, is a certainty.</p> <h3>For more ideas and motivation on how to harness the power of your brain to resolve pain with sex, see my e-book <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain"><strong>Outsmart Your Pain: Twelve Key Insights for Conquering Vulvodynia and Persistent Pelvic Pain.</strong> </a></h3> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> The Gray Area of Urinary Tract Infections http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-gray-area-of-urinary-tract-infections <h2>The ever-present UTI is anything but boring.</h2> <h3>In fact, it turns out it's rather a shady character.</h3> <p>My <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/urinary-tract-infections-not-as-cut-and-dried-as-you-think">last post </a>introduced some of the controversies in diagnosis of urinary tract infections.</p> <p>The fact is, the dipsticks used may not be sensitive enough, as the cut-offs were originally based on a small group of women with pyelonephritis (a serious kidney infection). Where does that leave us? Let me pick up where I left off.</p> <h3>If not a dipstick, what then?</h3> <p>If the simple dipstick in the doctor's office is not reliable, ideally your urine should be cultured &ndash; right? (This means your pee in a jar gets sent away for the lab to analyse and see what they can grow. As the bugs grow, the one that grows the most &ldquo;wins&rdquo;, and its name is given to your infection, e.g. &ldquo;you had an E. coli UTI&rdquo;).</p> <h3>Secret Hideouts</h3> <p>Well, unfortunately it&rsquo;s not that simple either. Recent studies show that when chronic, the infection can actually take place inside the cells of the bladder wall. This work has been done by a urology professor in London, James Malone-Lee, and his team.</p> <h3>The Case of the Mysteriously Vanishing Leucocyte</h3> <p>As well as that, when the urine is looked at under the microscope, white blood cells (leucocytes) that were in it originally may not be seen. This is because they gradually disappear over time &ndash; in fact 40% of the cells may be gone by 4 hours, regardless of how well the urine is stored (James Malone-Lee&rsquo;s team again, 2013. This guy is everywhere.)</p> <p>An earlier study in 2010 (same team) had shown that the microscopy was no better than the dipstick for finding white blood cells. Both techniques found the existing urinary tract infection only just over half the time.</p> <p>Tune in to my next instalment about the fascinating world of UTIs: &ldquo;Mixed Up About Mixed Growth?"</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> New Mums...Don't Succumb To Vaginal Amnesia! http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/new-mums-dont-succumb-to-vaginal-amnesia <h2>It&rsquo;s a situation I see regularly in my clinic: new mums with vaginal amnesia.</h2> <p>Let me explain.</p> <h3>Vaginas are sensitive creatures.</h3> <p>It&rsquo;s an obvious statement, but it&rsquo;s worth stating the obvious. They are easily overwhelmed by stress, tension and pain. New mums usually have a fair bit of all three going on. The pain of the stitches might fade fairly quickly (if you&rsquo;re lucky), and then the aching back and aching shoulders sets in, from all the hours of baby holding, baby feeding, baby jiggling&hellip;and the stress of this time goes without saying.</p> <p>I frequently see new mums for the first time six or so months down the track. It seems to be the time when life is getting (just barely) manageable, and the mum has time to notice for more than a few seconds that things don&rsquo;t feel right &ndash; deep pelvic aching, pelvic dragging, lower back pain. And as for sex! Well, don&rsquo;t even go there. The pain with sex can hang around a lot longer than what it takes for the stitches to fully heal.</p> <p>I&rsquo;ve talked in other posts about the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/a-cry-for-help-from-your-episiotomy-scar">role of the episiotomy or perineal tear scar,</a> and how like any scar, it needs to become flexible and supple again.</p> <p>But that&rsquo;s just part of it. This post is about something different.</p> <h3>It&rsquo;s about those poor, vulnerable, frazzled nerves of the vagina.</h3> <p>Frequently, I do vaginal exams on my postnatal patients, and find that the scar tissue is not the main issue. Instead, the nerves are objecting to any touch. The nerves have been on the defense for so long (often due to prolonged pain, coupled with the effects of stress) that the lightest touch becomes painful. This is seen by gentle, light touch within the vagina being reported as very painful, despite minimal pressure against scar tissue or muscles.</p> <p>I see this as a situation of unintentional neglect. The focus has been on anywhere but the vagina, and in response, the vagina is crying out for attention and a bit of &ldquo;TLC&rdquo;. The new sensitivity is the nerves&rsquo; way of expressing a sense of &ldquo;danger&rdquo;. This has often started with a general reluctance to touch the area due to early pain due to the inflamed stitches. But this progresses to a persistent fear of pain, a defensiveness of the area. The nerves have &ldquo;forgotten&rdquo; how to feel sensation normally. What shouldn&rsquo;t be painful (like light touch, pressure or stretching of the vagina) becomes painful.</p> <h3>Sex is not on the agenda at first.</h3> <p>When it eventually comes time to go down this road again, there is a great amount of fear and trepidation. This leads to an avoidance of sex&nbsp; - easy to do anyway, when life with a baby is so busy and exhausting! &ndash; but this may end up inadvertently making the problem worse.</p> <p>If you have <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-five-sources-of-painful-sex-and-not-one-of-them-starts-with-v">pain with sex</a> after having a baby, and it doesn&rsquo;t ease with the first few times, it could be a kind of &ldquo;vaginal amnesia&rdquo; developing.</p> <h3>It&rsquo;s important to see a pelvic floor physiotherapist for evaluation, and a program to help your body get back on track.</h3> <p>Then you can aim to forget all about vaginal amnesia!</p> <h2>For lots more detail &ndash; and practical help &ndash; about persistent pain in the pelvis, see my <a href="http://www.equilibriahealth.com.au/Product/outsmart-your-pain">e-book Outsmart Your Pain: Twelve Key Insights for Conquering Vulvodynia and Persistent Pelvic Pain.</a></h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Epigenetics and Pain - Why You Should Know About It http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/epigenetics-and-pain-why-you-should-know-about-it <h2>Epigenetics! Everyone&rsquo;s talking about the interaction of our genes with the environment, and how it affects our health.</h2> <h3>Even more fascinating &ndash; and empowering &ndash; is that once we understand the influence of our genes, we have the knowledge to change our health.</h3> <p>The power to change the future &ndash; and the present, for that matter! &ndash; is in our hands.</p> <p>We know genes influence our susceptibility to all kinds of illnesses. But what about pain? Is pain any exception?</p> <p>Clearly, the answer is &ldquo;no&rdquo;! Susceptibility to pain &ndash; and pain syndromes, with complex names and even more complex explanations &ndash; is just as much influenced by your genes as anything else. And the concept of epigenetics &ndash;how the environment influences your genetic expression, and hence your health &ndash; tells us that once you know about it, you have the opportunity to do something about it.</p> <p>Everyone knows someone that doesn&rsquo;t seem to feel pain. We also know people who seem unaffected by medications &ndash; people for whom it takes a super-powered dose to have an effect. These are two simple characteristics that tell us something about the variation in the ways in which pain works in people&rsquo;s lives.</p> <p>We know that the role of genes in migraine is up to 58%, the role of genes in lower back pain is up to 67% and the role of genes in menstrual pain (painful periods) is up to 55%.</p> <h3>Genes affect your likelihood of injury.</h3> <p>For example, genes that code for collagen type have an influence on how likely you are to injure tendons or cartilage.</p> <h3>Genes also have a role in how you perceive sensation, and the pain experience your system has.</h3> <p>The enzyme COMT influences your body&rsquo;s production of neurotransmitters involved in sensation and pain, and the MAO enzyme influences your body&rsquo;s metabolism of these neurotransmitters.</p> <h3>Genes certainly influence how you will respond to pain medications.</h3> <p>The CYP450 enzymes are involved in metabolism of hormones and how you metabolise medications. They influence the detoxification of various substances through the liver.</p> <h3>Knowledge is power! Once you know where the weak links are in your chain, you can work on fortifying them.</h3> <p>Genetic testing is now widely available to the general public &ndash; and is relatively affordable. I work with people who have various symptoms (including chronic pain) who want to work out how nutritional biochemistry is contributing &ndash; and how to use this knowledge to their advantage.</p> <h2>Get in touch with me&nbsp; if you would like advice on where to go for genetic testing, and how to get the ball rolling.</h2> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Chronic Pain is Complex - But Can Be As Simple as A, B, C http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/chronic-pain-is-complex-but-can-be-as-simple-as-a-b-c <h2>Chronic pain is not easy to live with.</h2> <p>And it&rsquo;s no more easy for researchers to fully understand. It&rsquo;s also not easy for clinicians working with people living with chronic pain. A clinician who thinks there&rsquo;s a simple solution is not likely to be the best one to help you!</p> <p>That aside, let&rsquo;s not forget the simple stuff! At times, there can be a clear and simple contribution to chronic pain from nutrient deficiency: vitamin A, vitamin Bs, vitamin C&hellip;you get the idea!</p> <h3>For example, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=vitamin+B12+and+lower+back+pain+2000">one study </a>showed that vitamin B12 helped chronic lower back pain.</h3> <p>This study was doubled-blind, randomised and placebo-controlled, which is a good start for trusting the findings. It included people from age 18-65 who had had lower back pain for at least six months. The test group was given a vitamin B12 injection, while the placebo group was given a dummy injection. The test group had a greater reduction in pain and disability, and took fewer painkillers. Interestingly, there had been no attempt to investigate if there were signs of a vitamin B12 deficiency &ndash; and it still worked! While giving everyone with pain vitamin B12 injections would be a pretty haphazard approach, it does suggest that if you have had persistent pain, you should consider getting your vitamin B12 levels checked, then working with an integrative nutritionist like myself who understands the subtleties of B12 testing and treatment, and the pathways in the body it affects.</p> <h3><a href="http://www.ncbi.nlm.nih.gov/pubmed/18628971">Another study</a> showed that people with chronic, intractable pain in the joint of their jaw were nutrient deficient.</h3> <p>They were deficient in, on average 3 of a possible 10 tested nutrients, including beta-carotene, folate, serum iron, ferritin, zinc, magnesium, and vitamins B1, B6, B12, and C.</p> <h3><a href="http://www.ncbi.nlm.nih.gov/pubmed/22728166">Another study</a> showed that vitamin C and vitamin E supplementation reduced not only pain, but markers of inflammation in endometriosis.</h3> <p>I could go on and on - but this is a blog, not a book!</p> <p>By no means do I wish to suggest that chronic pain is simple. As a clinician working in the field of pain for many hours a day, I know how complex pain can be.It takes a combination of approaches to address all the factors associated with chronic pain.</p> <p>But I do want to make the point that we should avoid missing the simple things.</p> <h3>Sometimes in the complexity of what the research tells us about chronic pain, it is easy to miss basic nutrition. &nbsp;</h3> <p>That&rsquo;s why I incorporate nutritional assessment into evaluation of every patient I see with chronic pain, and with the patient&rsquo;s permission, we explore this avenue of treatment. Almost without exception, the patient feels the benefits.</p> <p>Thanks to Skype, it is now possible for me to do a nutritional consult with you even if you can't get to my clinic in Brisbane!</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> MTHFR and Migraines: A Right Royal Pain in the Head http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/mthfr-and-migraines-a-right-royal-pain-in-the-head <h2>The MTHFR gene mutation gets a lot of bad press.</h2> <p>Its role in cardiovascular disease susceptibility is undisputed, and a long, long list of chronic diseases is related to its unlucky presence in your gene pool.</p> <p>I&rsquo;m afraid this post will be yet further bad press for the not-so-innocent MTHFR.</p> <h3>Migraine is yet another one of those conditions.</h3> <p>A caveat, before I begin: MTHFR doesn&rsquo;t equal disease &ndash; far from it. Keep the concept of epigenetics in mind at all times: the way the environment affects your genes, and influences the way they express and affect your health. As they say, &ldquo;genes load the gun, and the environment pulls the trigger&rdquo;.</p> <p>That said, it&rsquo;s worthwhile knowing the link between a health condition you have and MTHFR. Knowledge it power. If this leads you to get tested for MTHFR, and other markers, it gives you the opportunity to change the environment to prevent the trigger being pulled.</p> <p>My focus here is on migraine.</p> <p>The <a href="http://www.ncbi.nlm.nih.gov/pubmed/20663228">MTHFR gene mutation increases susceptibility to migraine</a>, particularly with aura. Migraine with aura is more common in people who are homozygous for the C677T variant of MTHFR (that is, they have not one, but two dud copies).</p> <p>Mutations in the MTHFR gene influence your ability to produce methyl folate in the body. It often leads to increased levels of a chemical in your body called homocysteine, as your body has more difficulty in metabolising it. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19384265">A study</a> found that nutrient supplementation to reduce homocysteine levels had some pretty exciting effects on migraine: reduced disability, reduced pain frequency and reduced pain severity.</p> <h3>But let&rsquo;s not exaggerate the effect of MTHFR.</h3> <p>There are other genes at play here as well. Another study found that mutations in the gene for the MTRR enzyme had an influence, completely independent of the MTHFR influence. MTRR is an enzyme involved in your metabolism of vitamin B12. Both enzymes MTHFR and MTRR could be described broadly as influencing your body&rsquo;s methylation process, among many others.</p> <h3>Rather than making MTHFR the automatic scapegoat, it would be more accurate to say that your epigenetics surrounding methylation have a major influence on migraine.</h3> <p>As an integative nutritionist, your methylation process is one major focus of my evaluation of your migraines.</p> <h3>MTHFR is a great place to start.</h3> <p>It&rsquo;s simple and cheap to test, and is a great first step. I frequently test MTHFR in my patients with migraine.</p> <h3>The results of treating what we find nutritionally are often spectacular &ndash; lifelong migraines completely gone within a few weeks.</h3> <h2>Get in touch if you would like to explore a nutritional epigenetic solution for your migraines.</h2> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Chronic Thrush, Painful Sex and Vulvodynia http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/chronic-thrush-painful-sex-and-vulvodynia <h2>When The Likely Suspect Is The Culprit!</h2> <p>Getting an accurate diagnosis of <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=81">vulvodynia</a> is usually a long and difficult process. You have had burning and stinging pain with sex, you have seen doctor after doctor, and they have put it down to thrush and given you creams and tablets galore, all to no avail. Then you finally see a clinician with experience in <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=81">vulvodynia</a> and you find out that it isn&rsquo;t thrush, and no wonder the thrush treatments aren&rsquo;t working. It&rsquo;s a completely different pain condition of the vulva called vulvodynia.</p> <p>That&rsquo;s the common scenario I see in clinic, day after day. But that&rsquo;s not what this blog post is about!</p> <p>This post is about the opposite situation &ndash; when it&rsquo;s been called vulvodynia &ndash; maybe they&rsquo;ve used the word vaginismus as well &ndash; but the problem is actually due to chronic thrush. The chronic thrush hasn&rsquo;t gone away with the medical treatment. But once we manage to get rid of it, your symptoms are gone. Yes, it does happen like this &ndash; and more often than you&rsquo;d think!</p> <p>Let me give you an example from a recent patient in her mid-forties who developed pain with sex six months before she came to see me after a particularly nasty bout of thrush (or vulvovaginal candidiasis, as it&rsquo;s technically known). I will call her (for no particular reason) Z. Z had had antibiotics over several months before she developed symptoms. Not one course &ndash; not two &ndash; but four. Four lots of antibiotics! If something is going to give you a chronic thrush problem, this is it.</p> <p>The thrush she developed was so persistent, Z needed to have the antifungal tablet (fluconazole) once a week for 6 months. When she stopped the tablet, the thrush came back. This is the point she was referred to me to help with her &ldquo;<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a>&rdquo; &ndash; that is, the tightness/protectiveness in her pelvic floor muscles she&rsquo;d developed from being so uncomfortable for so long.</p> <p>Well, on examination it was clear that her poor old pelvic floor muscles were doing what was only natural when everything is so irritated. Her vestibule &ndash; the area outside the vaginal entrance &ndash; stung to touch (<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=56">vestibulodynia</a>), and the labia stung when touched as well. There were signs that the thrush was still present, despite being on strong antifungal medication. The problem was, the enemy was being gradually defeated, but the clean-up operation had not yet begun.</p> <p>Z had a lifelong history of constipation. Four lots of antibiotics was enough to wipe out her protective flora, which left the vulva and vagina vulnerable to an enemy invader &ndash; thrush. Lack of a Peace Corps (the protective flora) meant that when the enemy numbers had been reduced (via the antifungal treatment) there was no one there to restore and maintain peace, which meant the enemy invader could continue to go out of control.</p> <p>So, we started to restore her Peace Corps. We used a combination of a probiotic containing bacteria that live in the vagina. She took this by mouth as well as vaginally. She took a particular prebiotic that feeds the good flora. She took a mineral supplement that suppresses yeast growth. <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-healthy-and-balanced-vagina">Getting a healthy and balanced vagina</a> is an important part of comfortable sex.</p> <p>Over a few months, pain with sex completely disappeared. Also, the itch that she had been experiencing over certain parts of her cycle drastically diminished. And despite her diagnosis of <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a>, we didn&rsquo;t need to do any work on her pelvic floor muscles, aside from making sure she had good awareness of relaxing when she wanted to relax.</p> <p><a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-five-sources-of-painful-sex-and-not-one-of-them-starts-with-v">Pain with sex can have many causes</a>. Sometimes there is more than one cause. Sometimes the cause is complicated, as in vulvodynia with sensitisation of the nervous system. But sometimes the cause is straightforward. How will you know? The only way you&rsquo;ll know is to see a clinician with experience in this area.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Can You Have Sex With A Prolapse? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/can-you-have-sex-with-a-prolapse <h2>The word prolapse, for many women, conjures up terrifying images of their internal organs falling out.</h2> <p>While severe prolapse can involve the involved organ coming quite a distance out of the vagina, most cases of prolapse are much milder. Prolapse is the technical term used for any stage of the organ (whether bladder, uterus or rectum) moving out of its anatomical position. This is evaluated by a gynaecologist or pelvic floor physio. If you have a minor bulge of the bladder into the vagina, it is still technically a prolapse. And by this, the correct definition:</p> <h3>75% of women who&rsquo;ve ever had a baby will have a prolapse &ndash; that&rsquo;s a clear majority!</h3> <p>It is often very distressing for a woman to discover she has a prolapse. Aside from the fears for the future &ndash; will this get worse? Are things going to come out completely? &ndash; it is a more personal, and therefore potentially distressing, area to experience a problem &ndash; much more so than your elbow, for example. And due to the intimacy of sex, in no part of the body is a problem more of a shared problem than the vagina.</p> <h3>So the natural question is: can I still have sex? Is sex going to be different? Will it cause damage?</h3> <p>Well, the <a href="http://www.ncbi.nlm.nih.gov/pubmed/22404171">research</a> does suggest that sex is different if you have a prolapse. Women with prolapse tend to score higher on sexual dysfunction scores. This may sound depressing &ndash; but keep in mind these scores are self-report questionnaires, which describe a woman&rsquo;s take on her experience of sex. So women with prolapse don&rsquo;t find sex as satisfying or problem-free. And interestingly, this doesn&rsquo;t always depend on how bad the prolapse is, but rather, just depends on the existence of prolapse, full-stop.</p> <p>That said, advanced prolapse (stage III or IV, which describe the organ coming out of the entrance of the vagina) tends to negatively affect sexual self-image, especially in elderly women. Surgery for prolapse has been shown to improve sexual function.</p> <p>However, other <a href="http://www.ncbi.nlm.nih.gov/pubmed/19493287">research</a> shows that this mainly has to do with two things: firstly, the woman&rsquo;s body image, and secondly, how bothered she is by her prolapse in general. Both of these things are very subjective, so it&rsquo;s likely that by changing the way you view the prolapse as a problem, and nourishing your self-image and in particular your sexual self-image, you have the power to change this.</p> <p>And thankfully, there is no evidence that prolapse is more likely &ndash; or that existing prolapse worsens &ndash; with consensual sexual intercourse, if surgery has not recently occurred.</p> <p>So if you have a prolapse and are feeling awkward about prolapse - you're not alone. But be assured there are ways of working around it - and it is not harmful in the least.</p> <h2>See your pelvic floor physiotherapist for help.</h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> What Can You Lose to Gain Back Your Pelvic Health? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/what-can-you-lose-to-gain-back-your-pelvic-health <h2>Why The First Step to Recovery Can Be Losing Something</h2> <h3>You&rsquo;ve got an annoying pelvic condition. It might be incontinence, prolapse, vaginismus, thrush, constipation.</h3> <p>It might seem a strange hypothetical question to ask: what can you lose first in order to recover?</p> <p>But if you think about it, it makes perfect sense. Sometimes there are big obstacles in the way of your recovery. Sometimes they have been there so long you fail to see them anymore (in the same way as a long-term wearer of glasses no longer notices there is something perched on their face).</p> <p>And often, you know the answer to this question, deep down. There might be (and usually is) more than one answer.</p> <p>And of course, symptoms can sometimes be improved &ndash; even &ldquo;fixed&rdquo; &ndash; without Losing This Thing. The important thing is though, without Losing This Thing, the effect may well be temporary. Your bugbear has a good chance of coming back to bite you if you don&rsquo;t Lose This Thing.</p> <h3>But let&rsquo;s look at some obvious examples:</h3> <p>If you really, really want to recover&hellip;if it&rsquo;s truly important to you&hellip;what is something you need to lose in order to correct</p> <p>&hellip;stress incontinence?</p> <p>(a smoking habit)</p> <p>&hellip;.prolapse?</p> <p>(abdominal obesity)</p> <p>&hellip;vaginismus?</p> <p>(fear or negativity around sex)</p> <p>&hellip;thrush?</p> <p>(that sugar addiction)</p> <p>&hellip;vulvodynia?</p> <p>(intense stress)</p> <p>Irritable bowel syndrome?<br /> (eating on the run&hellip;the hectic lifestyle)</p> <h3>This does NOT mean that&hellip;.</h3> <p>Smoking is the CAUSE of stress incontinence.</p> <p>Abdominal obesity is the CAUSE of prolapse.</p> <p>Negativity around sex is the CAUSE of vaginismus.</p> <p>Sugar is the CAUSE of thrush.</p> <p>Stress is the CAUSE of vulvodynia.</p> <p>Eating on the run is the CAUSE of irritable bowel syndrome.</p> <p>No, that would be much too simple. (Don&rsquo;t you wish life was simple?)</p> <p>All of these factors, though, are a massive influence on the named condition. So massive, in fact, that it is sometimes hard for the clinician (that&rsquo;s me) to help you resolve your symptoms (permanently) without you addressing the big factor.</p> <h3>And that big factor is usually the answer that pops up in your head when you ask yourself&hellip;</h3> <h2>&ldquo;What do I need to lose in order to gain back my pelvic health?&rdquo;</h2> <p>You could call this a functional medicine approach to your health. Or you could just call it good common sense.</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> When was the last time you felt exhilarated? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/when-was-the-last-time-you-felt-exhilarated <p>This morning? OK, this post is not for you&hellip;it&rsquo;s for the rest of you, which would have included me at one point.</p> <p>There&rsquo;s lots of talk about stress. Plenty about depression and anxiety. But far less about positive human experiences. That&rsquo;s why I want to talk about exhilaration today.</p> <p>Exhilaration is a hard feeling to define but one we instantly recognise. It&rsquo;s a sense of freedom and quiet inner joy. It&rsquo;s when you feel a sense of rising above the banalities of life. You are lost in the moment.</p> <p>Something like what I&rsquo;m calling exhilaration has been described well in a book called &ldquo;Flow&rdquo; by Mihaly Csikszentmihalyi (and if I&rsquo;d been able to spell his surname from memory, that probably would have been a cause for momentary exhilaration.)</p> <p>Abraham Maslow, in classic psychology literature, talked about something he called &ldquo;peak experiences&rdquo; in life. I&rsquo;m not sure that that is quite the same as what I&rsquo;m describing, in that peak experiences are described as &ldquo;rare&rdquo; and &ldquo;exciting&rdquo; &ndash; &nbsp;whereas the experiences I&rsquo;m referring to don&rsquo;t need to necessarily be grand or exceptionally memorable. However, he does use the term &ldquo;exhilarating&rdquo;, which is the feeling I&rsquo;m describing here. We might call them &ldquo;peak moments&rdquo;, and they are worth pursuing. &nbsp;</p> <p>I have felt this sense of exhilaration in many contexts:</p> <ul> <li>Running while listening to music through various times in my life&hellip; lost in Angels &amp; Airwaves, Placebo, the Cure, Queensryche (although you may not agree with the specifics, feeling exhilaration while absorbed in music is a common experience)</li> <li>Playing the clarinet alone in my room for hours</li> <li>Doing astanga yoga in silence in a room full of yogis with Krishna Dass thumping through the speakers</li> <li>Singing with a huge choir at maximal volume</li> <li>Riding my bike down a hill at breakneck speed through Toohey Forest (actually, I&rsquo;m not much of a daredevil, and the &ldquo;breakneck speed&rdquo; is undoubtedly mainly in my own mind)</li> <li>Rollerblading at maximal speed</li> <li>Rollerblading at maximal speed while singing at (submaximal) volume (aren&rsquo;t you glad you don&rsquo;t live in my neighbourhood?)</li> </ul> <p>I&rsquo;ve had periods of my life when that feeling of exhilaration was lacking, or at least very rare. This is not the same as being depressed or even apathetic. It&rsquo;s almost more a &ldquo;forgetfulness&rdquo; about how to experience the full range of inner experiences. Now, before I get any more philosophical, let me defer to an expert.</p> <p>Csikszentmihalyi (yes, I had to look back to spell it) presents some aspects of a concept called &ldquo;flow&rdquo; that describe what I&rsquo;m attempting to here.</p> <ul> <li>Complete absorption in what you are doing</li> <li>Merging of action and awareness</li> <li>Loss of reflective self-consciousness (this describes well the rollerblading + singing example above!)</li> <li>Distortion of temporal experience &ndash; meaning time passes faster than normal</li> </ul> <p>As suggested by the last point, you &ldquo;lose time&rdquo; when you feel exhilarated. But in a strange way, you gain time as well, because nothing exists except in that moment. It is the ultimate experience of living outside of time.</p> <p>Why am I writing about this? Because I think we underestimate how incredibly valuable this experience is for our health and well-being.</p> <p>Euphoria is known to relate to the production and binding of endorphins and endocannabinoids in the brain. These are involved in the experience of the so-called &ldquo;runner&rsquo;s high&rdquo;. Interestingly, the experience of music involves these substances as well as dopamine (the &ldquo;reward&rdquo; neurotransmitter).</p> <p>Producing endorphins enhances your stress response and is linked with feelings of pleasure.</p> <p>Sounds like something we should all be pursuing a bit more, don&rsquo;t you think? What&rsquo;s your favourite way to experience exhilaration?</p> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Unlucky Top 13: 13 Habits You Can Turn Around to Avoid Endocrine Disrupting Chemicals Affecting Your Family http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/unlucky-top-thirteen-habits-you-can-turn-around-to-avoid-endocrine-disrupting-chemicals-affecting-your-family <p>There&rsquo;s been a lot written about the dangers of endocrine-disrupting chemicals (EDCs) &ndash; that is, chemicals that mess up the finely-tuned orchestra that is our hormonal system. In short, they have been linked to <strong>infertility</strong>, <a href="http://www.equilibriahealth.com.au/Page/pelvic-pain-endometriosis"><strong>endometriosis</strong></a>, <strong>thyroid dysfunction</strong>, <strong>obesity</strong> and much more.</p> <p>For the purpose of this post, I am assuming you know about these dangers already. Sometimes hearing further about the dangers can make you feel overwhelmed, without giving you any action you can take. So the simple aim of this post is to give you a range of ideas for reducing your exposure.</p> <ol> <li>Keep a tally of the number of cans you use in cooking for the week. Aim to cut it in half.</li> <li>Examine your plastics for the number &ldquo;7&rdquo; in the triangle. Avoid buying anything with this, as it likely contains BPA. Limit plastics overall. Teach this habit to your kids. My son was appalled when my daughter emerged from the fruit shop with the bananas in a bag. We usually make a spectacle of ourselves traipsing down to the car, each of us full to the brim with groceries because we've forgotten our reusable bags. It's a task that's spatially and physically challenging, while being a great boost for the environment and our own health!</li> <li>Buy a stainless steel water bottle for each member of the family and have each family member take responsibility for it (wash it up each day, make sure it&rsquo;s ready for each outing, etc).</li> <li>Buy physical block sunscreens (those whose active ingredient is zinc oxide or titanium dioxide). Sadly, the others contain EDCs.</li> <li>Ban conventional air fresheners from your house and car, such as Air Wick, which contain phthalates. Use essential oils, beeswax candles, or eucalyptus/tea tree sprays.</li> <li>Use a bowl or plate to cover food as opposed to plastic wrap, or glass containers with plastic lids (available from the supermarket).</li> <li>Save nailpolish for special occasions. Don&rsquo;t give it to your daughters. Don&rsquo;t give manicure vouchers as gifts. Choose low-toxin nailpolishes. See <a href="http://www.sarahwilson.com/2013/05/how-to-buy-toxin-free-nail-polish/">Sarah Wilson&rsquo;s excellent blog post</a> on this.</li> <li>Check your ingredients lists of cosmetics and household products. Considering it a flashing red light with sirens if you see the terms PROPYLPARABEN, ISOPROPYLPARABEN, BUTYLPARABEN, ISOBUTYLPARABEN. Try Aware washing powder and get two health bonuses for the price of one by avoiding the support of unsustainable palm oil production, which ultimately harms human beings.&nbsp;</li> <li>Wash all fruit and vegetables before eating them. Buy whatever you can afford organic, especially high-pesticide produce like spinach, broccoli, lettuce and strawberries.</li> <li>Stop using anti-bacterial washes. Triclosan, which they contain, is an endocrine disrupter. Just Use Plain Soap And Water.</li> <li>If you have Gore-Tex products for travel, take good care of them so you don&rsquo;t need to replace them. They contain perfluoroalkyl acids (PFOA), which have been shown to disrupt the thyroid. This saves even more of these chemicals ending up in our environment, so is a community service you can do! Of course, if you have concerns about your own thyroid, you might want to get rid of them!</li> <li>Throw away peeling Teflon (non-stick) pans immediately. Just use more olive oil on regular pans and cook on lower temperatures to stop food burning &ndash; it&rsquo;s much better for you!</li> <li>Avoid fast food. The wrappings and containers contain endocrine disrupters. And that&rsquo;s before we even get started on the contents of the containers!</li> </ol> <p>More ideas? Comment!</p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Taking Care of Calcium in the Vegan Diet: The Vegan Calci-Culator http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/taking-care-of-calcium-in-the-vegan-diet-the-vegan-calciculator <h2 style="text-align: left;">Vegan and so you don&rsquo;t eat dairy? Is this cause for calcium hysteria?</h2> <h3 style="text-align: left;">Absolutely not.</h3> <p>Eating a variety of plant foods that are a rich source of calcium is a perfectly acceptable way to meet your calcium needs!</p> <p>You&rsquo;ve probably seen lists of vegetable calcium sources before. While these lists are helpful, it can sometimes still be difficult to know what combination of foods will allow you to meet your calcium needs on any given day.</p> <h2>That&rsquo;s where the&nbsp;<em>Vegan Calci-Culator</em>&nbsp;comes in!</h2> <p>I&rsquo;ve developed the&nbsp;<em>Vegan Calci-culator</em>&nbsp;to make it really easy for you to ensure you are getting a decent amount of calcium per day. While calcium recommendations differ, I have selected the common target of 800mg of calcium per day. If you and your treating health professional estimate that you need more, this can of course be done by adding more of the foods listed &ndash; but the easiest way would be to add another cup of fortified soy, rice or almond beverage. Please, talk to your health professional about your best target - in Australia, for example, the recommendation for Australian adults 18-50 is 1000mg/day.</p> <h3><strong><span>How to Use the&nbsp;<em>Vegan Calci-Culator</em>&nbsp;to reach around 800mg/day of calcium:</span></strong></h3> <p><strong>The goal is to get to 25 POINTS/DAY through using any combination of the GOLD, SILVER or BRONZE foods PLUS 1 cup of your calcium-fortifed beverage*.</strong></p> <p>*A &ldquo;calcium-fortified beverage&rdquo; is soy milk, rice milk or almond milk with added calcium (typically 300mg per cup)</p> <h3><strong>EXAMPLE DAILY OPTIONS</strong></h3> <table border="0"> <tbody> <tr> <td style="text-align: left;"><span>OPTION A</span></td> <td>OPTION B</td> <td>OPTION C&nbsp;</td> <td>OPTION D</td> </tr> <tr> <td> <p>1 cup of calcium-fortified beverage</p> <p>+</p> <p>3 GOLD</p> <p>+</p> <p>4 SILVER</p> <p>+</p> <p>5 BRONZE</p> </td> <td> <p>1 cup of calcium-fortified beverage</p> <p>+</p> <p>3 GOLD</p> <p>+</p> <p>6 SILVER</p> <p>+</p> <p>1 BRONZE</p> </td> <td> <p>1 cup of calcium-fortified beverage</p> <p>+</p> <p>2 GOLD</p> <p>+</p> <p>6 SILVER</p> <p>+</p> <p>5 BRONZE</p> </td> <td> <p>1 cup of calcium-fortified beverage</p> <p>+</p> <p>4 GOLD</p> <p>+</p> <p>3 SILVER</p> <p>+</p> <p>3 BRONZE</p> </td> </tr> </tbody> </table> <p>&nbsp; &nbsp; &nbsp;&nbsp;&nbsp;<strong>OR, JUST ADD UP YOUR POINTS!</strong></p> <p><strong><br /></strong></p> <h3><strong>Now all you need is the list of vegan calcium-rich foods, conveniently categorised into GOLD, SILVER and BRONZE.</strong></h3> <h3><strong>That&rsquo;s way too big for this blog post!</strong></h3> <h2><strong>To get the list, as well as a 3-day meal plan to give you a feel for how to meet your calcium needs as a vegan, <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21">e-mail us</a> with your name and "Vegan Calci-Culator".</strong></h2> <p><strong>(Please make sure you give us your name so we know you're a human...we hate spam as much as you do!)</strong></p> <h2><strong></strong>Get the free Vegan Calci-Culator and more by <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=2">signing up to our free newsletters</a> and ticking "Nutrition Medicine"!</h2> <p><strong><br /></strong></p> Best Ways to Help a Tampon Go In Step 9 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-9 <h2>Use Vaginal Trainers or Dilators</h2> <p>Well done for getting this far in the series about making tampons easier! If you have missed any of the episodes on this channel, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-look-and-you-will-find">start here at the first post</a> and work your way through.</p> <p>If you are still having troubles, it may be worth changing tack a little. It may be worth trying something other than a tampon in order to achieve the goal of being able to use tampons. What am I talking about? Let me explain.</p> <p>A tampon is designed to be absorbent. That&rsquo;s pretty obvious, isn&rsquo;t it? But this fact may actually be part of the difficulty you have. Tampons are kind of fuzzy and furry. They are usually made of cotton or rayon, or a combination. The unintended effect of this is to increase friction. When you try to put the tampon in, it might feel slightly scratchy. It might feel like it&rsquo;s dragging the skin inside.</p> <p>Now imagine you had a tampon shaped object that was perfectly smooth. Smooth and flat, like glass or ice. There&rsquo;s a reason it&rsquo;s easiest to ice skate on ice, not grass! Smooth, flat surfaces like glass or ice are a lot more slippery and cause less friction.</p> <p>Now, I&rsquo;m not suggesting you try to insert an &ldquo;icypole&rdquo; or &ldquo;Popsicle&rdquo;. But I do have good news. There are these things called dilators, which are tube-shaped objects usually made of very smooth plastic. They are designed exactly for this purpose &ndash; to allow the vagina to comfortably expand. They are used for certain medical conditions, including <a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=55">vaginismus</a> and vaginal agenesis.</p> <p>I see a lot of women who have difficulty inserting tampons, and we work together on a &ldquo;dilator program&rdquo; &ndash; gradually learning to insert a dilator with relaxed muscles, and keep the muscles relaxed. Over time, they progress to larger dilators as each one gets easier. Most women find using tampons easy after doing this program.</p> <h3>Freaked out about the concept of vaginal dilators? <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ten-ways-to-make-using-vaginal-dilators-less-unappealing-get-acquainted-with-them">Click here</a> to start reading my blog post series about <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/ten-ways-to-make-using-vaginal-dilators-less-unappealing-get-acquainted-with-them">Ways to Make Your Dilators Less Unappealing.</a> </h3> <p>Vaginal dilators are easy to get online. It&rsquo;s just usually a case of &ldquo;too many choices&rdquo;! A pelvic floor physiotherapist is the best health professional to give you advice on what to choose.</p> <p>And here is the finish line! Click <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-10">here</a> for the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-10">final post in this blog series.</a> </p> “Gut Memories”: Why Pelvic Pain and IBS Are More Common in Women http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/gut-memories-why-pelvic-pain-and-ibs-are-more-common-in-women <h2>Chronic pain in the pelvis and abdomen is a huge mystery that even specialists struggle to solve.</h2> <p>Depending on what specialist you see, and what tests are done, it might be given the name &ldquo;<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=20">chronic pelvic pain</a>&rdquo;, &ldquo;<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=12">irritable bowel syndrome </a>(IBS)&rdquo;, &ldquo;<a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Page&amp;PageID=37">painful bladder syndrome</a>&rdquo; or &ldquo;functional abdominal pain&rdquo;, to name a few examples. If you have endometriosis, it is possible &ndash; even likely &ndash; that you will be diagnosed with IBS as well. You may not really care what they call it. To you it&rsquo;s just pain without much of an explanation.</p> <h3>Men do get chronic pelvic pain and IBS, but statistics show that the majority of those with it are women.</h3> <p>Why is that?</p> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/24398396">Recent research</a> reveals why this might be the case.</p> <p>The study in question looked at &ldquo;aversive visceral learning&rdquo;. This is a way of saying &ldquo;what the organs learn when exposed to stress or pain over and over&rdquo;.</p> <h3>Brave volunteers had their rectums distended repeatedly.</h3> <p>While this sounds like a method of torture, it is actually the accepted method of measuring normal sensation of the gut. When the gut is unusually sensitive, as in irritable bowel syndrome, the person feels pain sooner with rectal distension. That is, they are not as tolerant of it as other people would be (if anyone can be said to be tolerant of having their rectum inflated like a balloon).</p> <h3>Together with the rectal distension, the experimenters presented another stimulus &ndash; a slightly distressing picture or photograph.</h3> <p>Over time, the people&rsquo;s brains learned to show the same anxiety response, even without the rectal distension. (For those of you interested in psychology, this is the classic "Pavlov's Dog" response, otherwise known as "classical conditioning". By repeatedly being brought their food to the sound of a bell, Pavlov's dogs soon learnt to salivate to the sound of the bell alone.) The really interesting bit?</p> <h2>This happened even more with women.</h2> <p>This was the case even where the women and men <strong>reported equal pain</strong>, and <strong>measured equal pain thresholds</strong> and stress responses.</p> <p>So, women&rsquo;s brains seem to learn to associate pain with unpleasant memories more than men&rsquo;s do. The researchers called this &ldquo;reactivation of old fear memory trace&rdquo;. More memorably &ndash; and accurately, I feel &ndash; they called it forming &ldquo;gut memories&rdquo;.</p> <h2>What &ldquo;gut memories&rdquo; do you think you could be storing in your chronic abdominal or pelvic pain?&nbsp;</h2> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Best Ways to Help a Tampon Go In Step 10 http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-10 <h2>Time to fix the issue once and for all!</h2> <p>I hope you have been following this series about solutions for the problem of being unable to put a tampon in. If not, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-tampons-go-in-ten-easy-steps">head straight back to the start </a>to not miss a thing!</p> <p>I have devoted 9 individual blog posts to different tips to make it easier to put a tampon in, including <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-look-and-you-will-find">using a mirror,</a> <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-use-the-information-on-the-packet">picking the best position</a>, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-3-contract-and-relax-your-pelvic-floor">relaxing your pelvic floor muscles</a>, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-6-dont-be-too-squeamish">not being squeamish</a>, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-7">using your finger,</a> <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-4-lubricate-the-tampon-like-crazy">lubricating the tampon like crazy</a>, <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-5-pick-the-best-time-of-the-month">picking the best time of your period,</a> <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-8-dont-feel-weird-about-using-a-sex-toy">considering using a "sex toy" to help</a>, and <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/best-ways-to-help-a-tampon-go-in-step-9">using vaginal dilators as trainers</a>.</p> <h2>But I've kept the best one for last!</h2> <p>(Mainly because if the other tips have worked so far, you won't need this one - but this is the most sure-fire way to solve the problem if the other tips haven't worked yet!)</p> <p>My very best tip on solving the problem of being unable to put a tampon in is this:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</p> <h2>Work with an expert.</h2> <p>This may sound strange - even outlandish - but let me explain.</p> <p>If you just can't get that reverse park, you would work with a driving instructor, wouldn't you?</p> <p>If you can't get the technique naturally when learning butterfly, you would ask for the expertise of a swimming teacher, wouldn't you?</p> <p>The problem is, as young girls and women, we often don't have an obvious "expert" on women's issues at our fingertips. We might be too embarrassed to ask our friends, assuming they can all do it already. We might be too intimidated to ask the doctor. This goes for whether the problem is putting in a tampon or successfully having sex with penetration - getting a penis in the vagina.</p> <p>Well, great news.</p> <h3>There are experts out there - they are called pelvic floor physiotherapists.</h3> <p>We not only understand the anatomy of the area in detail, but we have the experience to help you overcome these problems that other health professionals may lack. Best of all, we are a pretty nice bunch of people! (I'm not just saying this. Most pelvic floor physiotherapists move into this field because of a great compassion for women with these troubles. Many women's health physios even have first-hand experience with all sorts of women's troubles. While we won't spill the beans on that, it does give us a lot of understanding and you will find that we put you at ease.)</p> <p>So don't be nervous! Find a pelvic floor physiotherapist to help you with this. Helping women successfully put tampons in is part of our job description. Wherever you live, you can ring your national physiotherapy organisation and ask how to find a pelvic floor physiotherapist with the training and experience to help you.</p> <p>If you are in or near (or can get to) Brisbane, Australia, I would be more than happy to help you overcome this problem and put it behind you so it stops interfering with your life!</p> <h2>Make an appointment without delay!</h2> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Hidden Infection When Your UTI Isn't A UTI http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/hidden-infection-when-your-uti-isnt-a-uti <h2>&nbsp;</h2> <h2>Can you be sure that your bladder, urethral or vaginal symptoms are not due to infection?</h2> <h3>When is a urinary tract infection (UTI) not a UTI and when is it?</h3> <p>It&rsquo;s harder to be sure when the tests for infection are fraught with such shortcomings. Make sure you've read my blog posts on <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/urinary-tract-infections-not-as-cut-and-dried-as-you-think">why dipsticks are so unreliable</a> and the <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-gray-area-of-urinary-tract-infections">difficulty with urine cultures</a>.</p> <p>Mysterious urethral pain that feels like a urinary tract infection, yet tests come up negative...it&rsquo;s a mysterious condition with many possible causes. But we have to acknowledge that some of those causes &ndash; including those hard to uncover &ndash; involve infection.</p> <h2>Here&rsquo;s one you probably didn&rsquo;t know about: ureaplasma infection.</h2> <h3>And here&rsquo;s ten things I bet you didn&rsquo;t know about ureaplasma infection.</h3> <ul> <li><span style="font-size: 12px; line-height: 1.5;">It can be there even when the usual culture for urinary tract infection (UTI) is negative (i.e. doesn&rsquo;t show up anything).</span></li> <li><span style="font-size: 12px; line-height: 1.5;">What&rsquo;s more, it can be there even with a negative midstream urine test (i.e. when you pee on the dipstick, it doesn&rsquo;t show up anything).</span></li> <li><span style="font-size: 12px; line-height: 1.5;">Ureaplasma is known as an &ldquo;opportunistic pathogen&rdquo;, which means while it hangs out to some degree in most people (</span><a style="font-size: 12px; line-height: 1.5;" href="http://www.ncbi.nlm.nih.gov/pubmed/25865969">40-80%</a><span style="font-size: 12px; line-height: 1.5;">), it can cause disease if things get out of balance.</span></li> <li><span style="font-size: 12px; line-height: 1.5;">It is a reasonably common cause of urethritis (i.e. inflammation of the urethra) when it isn&rsquo;t gonorrhoea (a sexually transmitted infection).</span></li> <li><span style="font-size: 12px; line-height: 1.5;">It is also </span><a style="font-size: 12px; line-height: 1.5;" href="http://www.ncbi.nlm.nih.gov/pubmed/25865969">linked</a><span style="font-size: 12px; line-height: 1.5;"> with increased susceptibility to HIV infection, infertility, kidney stones, premature labour, miscarriage and stillbirth, and inflammatory joint disease.</span></li> <li><span style="font-size: 12px; line-height: 1.5;">It can only be detected using a special DNA test, such as a vaginal PCR DNA test.</span></li> <li><span style="font-size: 12px; line-height: 1.5;">Ureaplasma loves to form biofilms &ndash; that is, &ldquo;walled cities&rdquo; to protect itself from eradication by antibiotics (which makes it more likely to become resistant, and antibiotics not to work).</span></li> <li><span style="font-size: 12px; line-height: 1.5;">It is common for ureaplasma to be resistant to trimethoprim (the most common antibiotic prescribed for urinary tract infection).</span></li> <li><span style="font-size: 12px; line-height: 1.5;">If you test positive for it, your partner should be treated as well, as </span><a style="font-size: 12px; line-height: 1.5;" href="http://www.ncbi.nlm.nih.gov/pubmed/26220178">research</a><span style="font-size: 12px; line-height: 1.5;"> shows you could be transferring it back and forth to each other.</span></li> <li><span style="font-size: 12px; line-height: 1.5;">While a recent </span><a style="font-size: 12px; line-height: 1.5;" href="http://www.ncbi.nlm.nih.gov/pubmed/25717022">review</a><span style="font-size: 12px; line-height: 1.5;"> 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 </span><a style="font-size: 12px; line-height: 1.5;" href="http://www.ncbi.nlm.nih.gov/pubmed/21805206">study</a><span style="font-size: 12px; line-height: 1.5;"> showed that the chemicals produced by lactobacilli inhibit ureaplasma.</span></li> </ul> <p>Thankfully, the common treatments for it &ndash; the antibiotics doxycycline,&nbsp;azithromycin, clotrimazole, and fluconazole&nbsp;&ndash; do not seem to have severe negative effects on the vaginal lactobacilli, according to one <a href="http://www.ncbi.nlm.nih.gov/pubmed/7502179">study</a>.</p> <p>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 &ndash; not to mention the systemic problems implicit in damage to the gut microbiome.</p> <p>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 &ndash; discuss this with your trusted clinician. But don&rsquo;t ignore the potential impact on the microbiota.</p> <h3>My approach involves co-administering natural compounds that address the following:</h3> <ul> <li>Minimise damage to the gut microbiome</li> <li>Maximise the effectiveness of the anti-microbial action against the &ldquo;bad bugs&rdquo;</li> <li>Restore the gut and urogenital microbiome</li> <li>Reduce risk of recurrence and risk of other problems like thrush and bacterial vaginosis</li> <li>Maximising immune system protection, both systemic and local (i.e. the environment of the vagina, urethra and bladder)</li> </ul> <p>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&rsquo;t get to Brisbane, Australia&hellip;but thorough investigation is critical and must be pursued from where you are.</p> <h2>Get in touch if you need a guide and a plan for recovery.</h2> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img class="null" title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <img title="photoforwebsitesmallest" src="http://www.equilibriahealth.com.au/images/photoforwebsitesmallest.jpg" alt="photoforwebsitesmallest" width="100" height="150" /> <p>&nbsp;</p> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a> Annoying Abdominal Adhesions: Start Here http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/annoying-abdominal-adhesions-start-here <h2>Abdominal Adhesions: when pain after surgery persists and a technique to resolve it</h2> <p>You&rsquo;ve had abdominal surgery.</p> <p>Now you&rsquo;ve got persistent abdominal pain.</p> <h3>Not the result you were after.</h3> <p>Well, don&rsquo;t look back now &ndash; most likely, you had to have the surgery &ndash; it was the best or only choice available to you. And you can&rsquo;t go back, only forward!</p> <p>So how to move forward with this abdominal pain after surgery when you&rsquo;ve had all the medical checks, and they tell you it&rsquo;s &ldquo;just&rdquo; adhesions?</p> <h3>Well, first things first.</h3> <p>What are adhesions? &ldquo;Adhesions&rdquo; is really just a fancy name for scar tissue, but doctors often use it to refer to scar tissue they assume is more extensive or more restrictive as a way of explaining your pain. Occasionally, they&rsquo;ll use the word &ldquo;adhesions&rdquo; because they actually found them when doing your surgery, as in</p> <p>&ldquo;<strong><em>Boy, everything was a mess in there!</em></strong>&rdquo; or</p> <p>&ldquo;<em><strong>Gosh, everything was stuck to everything else!</strong></em>&rdquo;</p> <p>(These comments don&rsquo;t do anything for your confidence, and may actually play a role in worsening the pain you experience via some complicated brain mechanisms. For more about that, see my post on <a href="http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/chronic-pain-in-the-vulva-and-pelvis-retrain-your-brain">chronic pain in the pelvis and the brain</a>. But back to the story.)</p> <p>Adhesions form in an estimated 50-100% of cases of surgery (I know, a pretty broad statistic.) They start forming within hours of the surgery. When they become a problem (i.e. are assumed to be responsible for ongoing abdominal pain after surgery) &ndash; the suggested treatment is: surgery. (Yes, strange but true.)</p> <h3>But there is another technique that works.</h3> <p>(And whether or not you need to have surgery for adhesions or not, it is always a good idea to have this technique done after to maximise recovery).</p> <h3>Visceral manipulation is the technique.</h3> <p>It&rsquo;s a mouthful to say but very easy to have done, providing you can find an appropriately-trained therapist.</p> <p>Visceral manipulation is something I do a lot of in clinical practice in Brisbane, Australia. More to come on this wonderful technique, but in the meantime, make an appointment with us or track down a therapist trained in visceral manipulation closer to you.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> Avoiding Muscle Soreness of Olympic Proportions http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/avoiding-muscle-soreness-of-olympic-proportions <p>Inspiring watching the best athletes in the world, isn&rsquo;t it? It makes you participate in your chosen physical pursuit with just that bit more enthusiasm&hellip;until you wake up the next morning and every movement is agony, and you realise you overdid it.</p> <h2>You&rsquo;ve got DOMS (delayed onset muscle soreness).</h2> <p><img title="catweightlifting" src="http://www.equilibriahealth.com.au/images/catweightlifting.jpg" alt="catweightlifting" width="259" height="194" /></p> <p>So is it just a lack of conditioning? Just need to improve your fitness? (Just push through. No pain, no gain, right?)</p> <p>No way.</p> <p>Of course you are likely to get less DOMS as you get fitter, particularly if you keep doing the same thing. But the amount of DOMS you experience along the way has everything to do with the biochemistry of nutrition within your cells.</p> <p>To fix it, we need to understand what actually causes DOMS (without the boring detail). So in a nutshell:</p> <p>They used to say DOMS was caused by &ldquo;a build-up of lactic acid&rdquo;. More on this later. But for now, it&rsquo;s worth knowing that:</p> <h2>DOMS is a reflection of injury to your muscle cells.</h2> <p>That&rsquo;s right. When you wake up feeling every muscle in your body, and you say you smashed yourself at the gym, you are pretty much right.</p> <p>Get your muscle cells under a microscope and you&rsquo;d see all the signs of inflammation and muscle damage.</p> <h3>Does that mean you just have to progress slower? Stick to a more tame level of activity?</h3> <p>Thankfully not. It would kill me with boredom to do a progressive walking, gym or jogging program.</p> <p>{Everytime I go on a group inline skate I am feeling it in every fibre of my body for several days. If I backed off and took it gradually, it would take me months to work up to it and I would have a whole lot less fun in my life.)</p> <h3>By optimising your nutrition before and after your chosen pursuit, you can have your cake and eat it too.</h3> <p>(Well uh&hellip;maybe not cake.)</p> <p>But does this mean expensive, fancy, hard-to-get supplements? Not at all. There is lots of research for things that might either be in your kitchen, or in your vitamin cabinet.</p> <h2>So what does the research say about food, plant extracts, and nutrients to prevent/reduce DOMS?</h2> <h4>Eat straight after the workout, preferably a decent amount of protein.</h4> <h4>Take a relatively modest dose of antioxidants (vitamin C and vitamin E) for the ten days leading up to the workout.</h4> <h4>Take fish oils, 6g/day, for 7 days before the exercise bout.</h4> <h4>2.7g/day may be enough if done for 30 days before the exercise (that is, taken as a daily supplement).</h4> <h4>Take curcumin (an extract of turmeric spice) twice a day, 2.5g.</h4> <h4>Ginger 4g/day for the 7 days before the workout won&rsquo;t help the DOMS, but will accelerate your muscle recovery.</h4> <p>Simple as that? Well, probably not.</p> <p>The amount of DOMS you get is also affected by the general health and functioning of the cell &ndash; your cellular nutritional biochemistry. There are many things that can go wrong here even with apparently normal, healthy people.</p> <h3>If you are bothered by bad DOMS which is affecting your life after exercise, see a clinical nutritionist trained in functional medicine.</h3> <p>We can select the right tests to diagnose the underlying problem and get you active and loving it, minus the price tag of the severe DOMS afterwards!</p> <h2><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21">Enquire</a> about an assessment now.</h2> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="contact_us_button" src="http://www.equilibriahealth.com.au/images/contact_us_button.png" alt="contact_us_button" width="248" height="106" /></a></p> An Interview with Alyssa Tait - Adhesions, Chronic Pain, and the Nervous System http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/an-interview-with-alyssa-tait-adhesions-chronic-pain-and-the-nervous-system <h2>It's not often someone gives me the floor for 45 minutes to talk about the web of connections linking adhesions, pain, visceral manipulation, the gut and the nervous system...</h2> <p>Stephen Anderson's questions were so thought-provoking, I just kept talking!</p> <p>Here's the interview: <a href="http://theholisticpractitionerpodcast.com/alyssatait/">Alyssa Tait on Pelvic Pain, Adhesions, and SIBO</a></p> <p>This <a href="http://theholisticpractitionerpodcast.com/alyssatait/">interview</a> will either be a great cure for insomnia, or a useful insight into how my brain sees this broad and fascinating field.</p> <h3>We traversed the physical, the emotional and even the metaphysical!</h3> <p><a href="http://theholisticpractitionerpodcast.com/alyssatait/">Listen here</a>.</p> <p>We covered all sorts of topics...</p> <h3>...the curious pathway of my career and how it led me to visceral manipulation</h3> <h3>...the emotions and your organs</h3> <h3>...chronic abdominal and pelvic pain and visceral manipulation</h3> <h3>...adhesions, and how they are more than just structural, but neurological as well</h3> <h3>...endometriosis and how these adhesions differ from surgical adhesions</h3> <h3>...central sensitisation in chronic pain and its links to visceral hypersensitivity in irritable bowel syndrome</h3> <h3>....the power of the words "let's see" in therapy</h3> <h2>Have a <a href="http://theholisticpractitionerpodcast.com/alyssatait/">listen</a> now!</h2> <p>Stephen's highlights and insights include...</p> <p>....the power of the nervous system to increase neurological tone as a means of self-protection, and how this might impact the function of the organs</p> <p>...the importance of engaging in fun, nurturing and nervous-system relaxing activities to take care of ourselves</p> <p>....the need as practitioners to be careful with our language with our patients and not be "part of the problem".</p> <h2>Please <a href="http://theholisticpractitionerpodcast.com/alyssatait/">listen</a>, and give your rating or review on <a href="https://itunes.apple.com/au/podcast/holistic-practitioner-podcast/id1085279606">itunes</a>!</h2> <p>&nbsp;</p> <table border="0"> <tbody> <tr> <td><img title="alyssa_may16_1868_highres_headshotcropped_1_resize" src="http://www.equilibriahealth.com.au/images/alyssa_may16_1868_highres_headshotcropped_1_resize.jpg" alt="alyssa_may16_1868_highres_headshotcropped_1_resize" width="164" height="246" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Nutritional Nuggets: Nine Big Culprits Behind The Rise of Autoimmune Disease http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/nine-big-culprits-behind-the-rise-of-autoimmune-disease <h2>Autoimmune disease is exploding: Hashimoto&rsquo;s, Graves, rheumatoid arthritis, lupus, Crohn&rsquo;s&hellip;but why?&nbsp;</h2> <p>One major factor in the development of autoimmunity is increased intestinal permeability.</p> <h3>Or, in fewer letters: leaky gut.</h3> <p>If your gut is a mosquito net, imagine puncturing a few small holes in it: that&rsquo;s leaky gut. Sounds minor, but as anyone who has had a holey mosquito net when camping can attest, it&rsquo;s a BIG deal.</p> <p>Leaky gut exists in such diverse autoimmune diseases as type 1 diabetes, inflammatory bowel disease and coeliac disease.</p> <p>But what causes the leaky gut? Lots of things.</p> <h3>Alcohol is a big one, but it&rsquo;s temporary.</h3> <h3>Aspirin and anti-inflammatories.</h3> <h3>Gluten.</h3> <h3>Too much glucose and salt.</h3> <h3>Weird additives used in food processing like organic solvents, nanoparticles and microbial transglutaminase. (Hint: stop eating packaged processed food.</h3> <h2>But the one I really want to harp on about? Imbalance of gut bacteria.</h2> <p>Lousy gut flora is a big trigger for leaky gut.</p> <p>And the causes of this?</p> <p>Medications.</p> <p>Stress.</p> <p>The Pill.</p> <p>ANTIBIOTICS.</p> <p>&ldquo;But I have not had antibiotics for thirty years, and then only once!&rdquo;</p> <p>Oh yeah? How&rsquo;s this then:</p> <p>Being born in the age of antibiotics when they were used by all ancestors over multiple generations.</p> <p>Luckily, manipulating the gut microbiome and using specific nutritional strategies can sew up those little holes in the mosquito net. Keep an eye out for future blog posts on this topic.</p> <p>Or to cut to the chase, see your trusty functional nutritionist. Skype appointments available.</p> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <table border="0"> <tbody> <tr> <td><img title="alyssa_may16_1868_highres_headshotcropped_1_resize" src="http://www.equilibriahealth.com.au/images/alyssa_may16_1868_highres_headshotcropped_1_resize.jpg" alt="alyssa_may16_1868_highres_headshotcropped_1_resize" width="164" height="246" /></td> <td> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel issues, fertility, and irritable bowel syndrome.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> </td> </tr> <tr> <td style="vertical-align: top; text-align: right;" colspan="2">Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a></td> </tr> </tbody> </table> Can You Trust Your Supplements? Four Corners and the Australian Complementary Medicines Industry http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/can-you-trust-your-supplements-four-corners-and-the-complementary-medicines-industry <h2>Natural medicines&hellip;are they all just forms of snake oil in different coloured (and flavoured!) packages?</h2> <p>If you watched the Four Corners special, you might think you are being taken for a ride!</p> <h3>Here&rsquo;s a few things to consider if you watched the Four Corners special.</h3> <ol> <li>The program focused almost entirely on multivitamins and &ndash;minerals, which are by definition hardly targeted interventions. Multivitamins are by definition a &ldquo;safety net&rdquo; &ndash; something you take even if you&rsquo;re not sure if they&rsquo;ll help &ndash; a kind of insurance policy. The world of nutritional supplementation to support optimal health is vast, and doesn&rsquo;t really include multivitamins &ndash; for most health practitioners trained in this field, we will use them rarely if at all.</li> <li>They touched on a famous and much-cited study that showed that certain antioxidants actually increased risks &ndash; specifically, beta carotene increased risk of cancer in smokers. This is why seeing a trusted health professional who follows the research is so important. No health professional worth their salt would recommend isolated beta-carotene supplementation, whether you are a smoker or not.</li> <li>The conflict of interest issue is a serious one and applies equally to complementary medicines and pharmaceuticals. As was pointed out, much of pharmaceutical research is funded by pharmaceutical companies, and there is also a publication bias for positive studies (meaning that studies that don&rsquo;t show a result are simply less likely to be published, which skews the available studies to looking possibly more positive overall than they are.)</li> <li>There was a lot of talk about hidden &ldquo;evidence&rdquo; &ndash; studies that you can&rsquo;t access kept secret by the vitamin companies. This is simply a red herring; most research on complementary medicines is available to the public, easily searched on databases like PubMed, which any Australian with an internet connection can access.</li> <li>Much of the talk about pharmacies selling inferior products, and/or products making false claims, has definite merit. This doesn&rsquo;t mean that products that do work don&rsquo;t exist. Many of these products are not sold in pharmacies and health food stores. Every day, patients bring in to me their useless supplements that they have been sold at the pharmacy and health food store by staff who don&rsquo;t understand the product. Once again, it comes down to establishing a relationship with a health professional you trust to follow the research and prescribe in accordance with research findings.</li> </ol> <h3>Here&rsquo;s some facts you need to know to complete the picture.</h3> <p>Australia has one of the most stringent quality-control systems in place for natural medicines in the world.</p> <p>You need to take care when ordering any supplements on-line as most countries, including the USA, lack the quality-control we have across the board. Analysis of complementary medicines sold in the USA has found countless incidences of the supplement not containing what it claims to contain &ndash; including containing fragments of pot plants instead of active therapeutic herbs listed on the label.</p> <p>There is strong and rapidly growing evidence for the use of complementary medicines. Anyone who denies efficacy of all complementary medicines is not following the research.</p> <p>Complementary medicine has a huge role to play in the management of chronic disease.</p> <p>A good natural health practitioner will not only follow and understand the research on natural medicines and health conditions, but will use research as a guide for precise use of natural medicines &ndash; for example, the exact strain of the probiotic, the exact type of the curcumin, and the exact extract strength of the exact species of the herb. She will understand potential interactions among supplements, and between supplements and pharmaceutical drugs and explain all this to you so you feel confident in what you are using.</p> <p>A point to add: interesting that the only people they spoke to you were healthy people who used supplements &ldquo;just in case&rdquo;&hellip;not the people who modern medicine was powerless to help, whose lives have been turned around by the use of carefully selected supplements under the guidance of an experienced health practitioner. This is the daily experience of health professionals like myself.</p> <p>Bottom line? Stop believing one report or the other, one blog post or the other. Delve into the research. If you can&rsquo;t, follow my page and be directed via links straight to the studies.&nbsp;</p> <img title="alyssa_may16_1868_highres_headshotcropped_1_resize" src="http://www.equilibriahealth.com.au/images/alyssa_may16_1868_highres_headshotcropped_1_resize.jpg" alt="alyssa_may16_1868_highres_headshotcropped_1_resize" width="164" height="246" /> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a> Thrush Issues? Time to Ditch the Sugar! http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/thrush-issues-time-to-ditch-the-sugar <h2>Vaginal thrush and sugar&hellip;do you really need to cut it out?</h2> <h3>Thrush loves sugar, Candida loves candy: it&rsquo;s a piece of naturopathic wisdom. Or is it just folklore? Is there any real evidence for it?</h3> <p>Many women who have experienced chronic or recurrent vaginal thrush suspect it: Sugar is not the vagina&rsquo;s friend. I treat women with ongoing thrush problems all the time, and when I regretfully bring up the sugar issue, they stop me even before I have finished.</p> <p>&ldquo;I know, I know&hellip;I&rsquo;ve got to get rid of the sugar. It&rsquo;s just so hard!&rdquo;</p> <p>But gynaecologists will rarely tell you to cut out the sugar, or watch the carbohydrate load in your diet. Why is that?</p> <p>Modern medical practice is ruled by research evidence, and there just isn&rsquo;t that much evidence for sugar and thrush in humans.</p> <p>Back in 2002, a <a href="https://www.ncbi.nlm.nih.gov/pubmed/10357735">study</a> looked at the effects of sugar on Candida in women.</p> <p>They looked at the link between Candida in the mouth and faeces of women who eat differing amounts of carbohydrate, and didn&rsquo;t find a connection between high-carb and Candida. Then they got the women to eat high-sugar diets, and reported a &ldquo;limited effect&rdquo; on Candida counts. But when looking at the fine detail, they did find that in some women with high Candida in their mouth, the high-sugar diet increased the Candida in the faeces. So even back then there were signs that sugar was not completely neutral when it comes to Candida.</p> <p>Now this has been confirmed. A <a href="https://www.ncbi.nlm.nih.gov/pubmed/23799070">recent study using pretty fancy DNA technology</a> to analyse gut microorganisms did confirm what we suspect: Candida was higher in those with higher carbohydrate diets, and lower in those with diets higher in fats and protein. The highest likelihood that they would find thrush? If you just ate carbohydrates.</p> <h3>Yes, it appears that Candida loves sugar.</h3> <p>So why doesn&rsquo;t every woman have raging thrush, considering our society&rsquo;s sugar addiction? Well, maybe many women do. Maybe overgrowth of Candida is a part of foggy brain, low energy, gut symptoms as old naturopathic folklore tells us. But that&rsquo;s a discussion for another time.</p> <h3>For now, suffice to say that women with thrush issues probably handle sugar worse than women who don&rsquo;t.</h3> <p>A<a href="https://www.ncbi.nlm.nih.gov/pubmed/12388993"> study</a> found that women with recurrent thrush actually had impaired glucose tolerance &ndash; the same thing you find in pre-diabetes! And could this be the reason why so many women with polycystic ovarian syndrome (PCOS) have chronic thrush issues? PCOS is linked with blood sugar dysregulation and insulin resistance.</p> <h3>It seems pretty clear. If you have recurrent thrush issues, it&rsquo;s time to ditch the sugar.</h3> <h2>If you need help working out a diet that allows you to feel satisfied and get healthy while tackling your thrush issue, that is exactly the kind of thing I help women with all the time at Equilibria - just contact us for an appointment. Skype appointments available!</h2> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <img title="alyssa_may16_1868_highres_headshotcropped_1_resize" src="http://www.equilibriahealth.com.au/images/alyssa_may16_1868_highres_headshotcropped_1_resize.jpg" alt="alyssa_may16_1868_highres_headshotcropped_1_resize" width="164" height="246" /> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a> Recurrent UTIs…could the problem be your vagina? http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/recurrent-utis-could-the-problem-be-your-vagina <p>&nbsp;</p> <h2>"I'm p****ing razor blades again..."</h2> <p>It&rsquo;s a lament I heard from a friend twenty-five years ago that still echoes in my ears every day, from different patients, if in different words!</p> <p>Recurrent urinary tract infections are not only painful but emotionally debilitating.</p> <p>Feeling that first sting of pain and knowing that, once again, sex has triggered a UTI causes frustration and heartache to countless women and their partners.</p> <p>Infections in the bladder are usually thought of as quite separate to those in the bladder&hellip;but are they really so isolated? We know that bacteria from the rectum (mainly E. coli) is a key culprit in UTIs&hellip;why couldn&rsquo;t vaginal bacteria also play a role?</p> <p>For the vagina to be healthy, it needs to be dominated by Lactobacillus species of bacteria. If it isn&rsquo;t, it increases the risk of all kinds of vaginal infection. If the balance of bacteria swings far enough away from Lactobacillus dominance, it&rsquo;s called bacterial vaginosis (BV).</p> <p>Gardnerella species are key bacteria present in BV, where lactobacillus numbers have sufficiently declined.</p> <h3>Well guess what? <a href="https://scienceblog.com/493187/vaginal-bacteria-can-trigger-recurrent-utis/">New research</a> shows that Gardnerella has a role to play in recurrent urinary tract infection.</h3> <p>E. coli, the main species of bacteria responsible for urinary tract infections, can remain dormant within the bladder after antibiotic treatment. Even when symptoms have resolved, the sneaky critters can be reactivated after sex, causing yet another urinary tract infection.</p> <p>Guess who&rsquo;s the culprit of this &ldquo;reactivation&rdquo; of UTI?</p> <p>That&rsquo;s right, gardnerella.</p> <h3>That&rsquo;s why it&rsquo;s really, really important to get on top of BV and to strive for a lactobacillus-dominated vagina.</h3> <p>This is my bread and butter here at Equilibria.</p> <h2>Need help with this? Make contact. Skype appointments available.&nbsp;</h2> <p><a href="http://www.equilibriahealth.com.au/index.cfm?Do=View.Form&amp;FormID=21"><img class="null" title="appointment_button" src="http://www.equilibriahealth.com.au/images/appointment_button.png" alt="appointment_button" width="248" height="106" /></a></p> <img title="alyssa_may16_1868_highres_headshotcropped_1_resize" src="http://www.equilibriahealth.com.au/images/alyssa_may16_1868_highres_headshotcropped_1_resize.jpg" alt="alyssa_may16_1868_highres_headshotcropped_1_resize" width="164" height="246" /> <p><strong><a href="https://plus.google.com/105945938573367332023/?rel=author" target="_blank">About&nbsp;Alyssa Tait</a></strong></p> <p class="p1">Alyssa runs Equilibria Physiotherapy &amp; 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.</p> <p class="p1">Alyssa&rsquo;s website <a href="http://www.equilibriahealth.com.au/"><span class="s1">www.equilibriahealth.com.au</span></a> is an information hub related to all things relating to the function of the female pelvis.</p> <p class="p1">She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.</p> <p class="p1">Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.</p> Connect with Alyssa &nbsp;|&nbsp; <a href="https://www.facebook.com/pages/Equilibria/165951933428442"><img title="Facebook" src="http://www.sitezero.com.au/images/1362745630_facebook.png" alt="Facebook" width="15" height="15" /></a>&nbsp;&nbsp;|&nbsp; <a href="https://plus.google.com/105945938573367332023/posts"><img title="Google Plus" src="http://www.sitezero.com.au/images/1362745624_google_plus.png" alt="Google Plus" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="http://www.linkedin.com/profile/view?id=93132020&amp;locale=en_US&amp;trk=tyah2&amp;trkInfo=tas%3Aalyssa%20Tait%2Cidx%3A1-1-1"><img title="linkedin" src="http://www.brightwater.com.au/images/linkedin.png" alt="linkedin" width="15" height="15" /></a>&nbsp;|&nbsp;<a href="https://twitter.com/AlyssaTait1"><img title="Twitter" src="http://www.sitezero.com.au/images/1362745633_twitter.png" alt="Twitter" width="15" height="15" /></a>