Common Female Issues
Some women get through their monthly periods easily with few or no concerns. Their periods come like clockwork, starting and stopping at nearly the same time every month, causing little more than a minor inconvenience. However, other women experience a host of physical and/or emotional symptoms just before and during menstruation. Symptoms such as heavy bleeding and missed periods to unmanageable mood swings.
As a fertility reflexologist, you will come across many conditions and it is vital that you have some knowledge of them and how they are determined through the various diagnostic tests that they use in the NHS and private hospitals. We will look at tests, scans and procedures in day two.
Endometriosis is also a very common. Endometriosis is when cells like the ones found in the lining of the uterus are found elsewhere on the body. Each month these cells react the same as the cells in the uterus building up and breaking down, during a normal cycle the cells in the uterus leave the body in the form of a period. The cells causing endometriosis also bleed but don’t have any way of leaving the body. This can cause in some cases extreme pain, inflammation blockages and scar tissue inside the pelvic cavity, in turn causing fertility issues in nearly 50 per cent of women with the condition.in some cases endometriosis scars can obstruct the fallopian tubes and stop ovulation from occurring. It’s more common in women over the age of 30 who have not had children but unfortunately can strike at any time of reproductive age. It’s often and debilitating condition and can cause extreme pain during menstruation effecting the woman’s ability to lead a normal life at this time.
Tests and treatment of Endometriosis
Endometriosis unless it is significant cannot be diagnosed during an abdominal/pelvic ultrasound. It can often only be picked up through a pelvic laparoscopy. There is no known cause or treatment of endometriosis other than surgical removal, however in most cases the cells do grow back.
Diet and lifestyle changes can improve the condition. Often when women are not trying to conceive they are put on the contraceptive pill.
Polycystic Ovary Syndrome (PCOS)
PCOS is very common and is one of the main reasons that women are unable to conceive, it can be a very distressing illness with range of symptoms from not ovulating, hair loss or hair growth on the face, acne and weight gain Symptoms of PCOS are associated with abnormalities in some of the hormones that control the menstrual cycle. These abnormalities typically include: higher than normal levels of LH and testosterone, and below normal levels of progesterone. Women using ovulations sticks or monitoring cervical mucus during their cycles may get false readings due to higher than normal levels of LH. It is advised that the Basal Temp method be used to track ovulation.
It is also thought that another hormone – insulin – may be involved in the development of PCOS. Insulin is a hormone produced by the pancreas to regulate the level of glucose in the blood. Many women with PCOS have been found to have a condition known as insulin resistance, in which the body’s tissues are resistant to the effects of insulin (particularly on the ability of insulin to get glucose into muscle tissue), so the body should produce more insulin to compensate. It seems that these high levels of insulin then affect the ovaries, contributing to the abnormal hormone environment.
Tests and treatment of PCOS
PCOS can be picked up in a blood test or can often be seen during an abdominal ultrasound. There is no known cure for PCOS, however the symptoms can be managed through diet (level insulin levels) and supplements. Often the drug Metformin or Clomid (sometimes both) to women with PCOS to enable them to ovulate.
Fibroids are non-cancerous growths that can range in size from tiny to bigger than a melon, they often go undetected as they may not cause symptoms. They can, however cause problems when trying to conceive especially if they are very large, causing the uterus to enlarge and distort making it very difficult for an embryo to implant properly. The exact cause of fibroids is not confirmed but they are thought to be caused by oestrogen. They are more common in obese women due to the potentially higher levels of oestrogen.
Tests and treatment for Fibroids
Often fibroids are picked up during a scan. There are many medications you can use to treat fibroids if you are not trying for a baby, however if you are and they are potentially causing a problem, they are often removed with surgery.
Blocked Fallopian tubes
The function of the fallopian tubes is to provide a vessel from the ovaries to uterus. Sperm swim along the tubes to locate the egg and once fertilised they also provide a home for the egg for around 5- 7 days before it travels to the uterus. If the tubes are blocked the sperm or the egg are not able to move freely to allow fertilisation or implantation to occur.
Tests for blocked fallopian tubes
A HyCoSy is the normal route for the diagnosis of blocked tubes. It is sometimes called a Tubal Patency Test or a Dye Test and can be a substitute for a HSG (Hysterosalpingography) or Laparoscopy and Dye, without the use of X-rays. A small thin catheter is passed through the cervix into the uterus and ultrasound contrast medium is passed through the fallopian tubes. The progress of the fluid can be monitored by ultrasound and any blockages or abnormalities can be detected. If the tubes are blocked, then surgical treatment via a pelvic laparoscopy should be carried out to see if the tubes can be unblocked or sometimes the tube may have to be removed.
Age related poor egg quality and low ovarian reserve
You are born with your life supply of eggs already in place (about 2 million) An older woman trying to conceive will have older eggs and by the time she is 45 she may well have only 10,000 eggs left, not all of which will be of a good enough quality to make a baby. The older the egg the more likely they are to have chromosomal defects that can either prevent fertilisation taking place or cause a miscarriage. On average fertility begins to decline around the age of 35. There are several blood tests available to detect the effect of aging on your reproductive system:
Blood tests for egg quality
- FSH (Follicle Stimulating Hormone) Blood test: Every month the body releases FSH to stimulate the follicles to grow on the surface of the ovaries. At the beginning of the month the number should be low (below 10) if a blood test taken of the 3rd day of a cycle reveals a high number; the pituitary gland is possibly releasing extra FSH as the ovaries are not responding.
- AMH (Anti Mullerian Hormone) Blood test: Ovaries produce AMH every month to encourage eggs to mature. The levels of AMH in the body can indicate how well the ovaries are working which in turn can give an indication of the quantity of eggs left in the ovaries, the lower the number the lower the egg reserve. This test is not normally carried out on the NHS. Private patients are likely to pay in the region of £120-150 for this test. A great book to read more in this area is by Rebecca Jett ‘It starts with an egg’
Treatment: Diet, supplements and lifestyle changes may increase egg quality but cannot increase egg reserve.