Herbal Health

The muscles around the pelvis are very important in supporting the bladder, urethra, vagina and rectum. Regular practice of pelvic muscle exercises can help to strengthen these muscles. The first step is to identify the correct muscles to exercise.

• To identify the muscles around the rectum, sit or stand comfortably and imagine you are trying to control diarrhoea by consciously tightening the ring of muscles around the anus (back passage). Hold this ’squeeze’ for four seconds. Relax and repeat several times.

• Now go to the toilet and start passing urine. Try to stop the flow of urine in midstream. Once this is done recommence urinating until the bladder has emptied. The muscles used to stop or slow the flow of urine are the front pelvic muscles which help control the bladder.

• Some women find they can identify the correct pelvic muscles by inserting a finger into their vagina and then contracting the pelvic muscles to squeeze the finger. If there is no sensation of squeezing around the finger you may be exercising the wrong muscles. Note that you should not bear down as if trying to pass a bowel motion as this strengthens the wrong muscles. Do not despair if you do not seem to be making progress for several days; it may take a week or more to begin to identify the muscles that need to be exercised to strengthen and tone the pelvis.

The second step, having identified the target muscles, is to repeat the following series of exercises at least four times each day. Note that they should not be done while passing urine. With practice you will find that you can do them at any time — while waiting for a bus, watching television or setting the table.

1. While sitting or standing with thighs slightly apart, contract the muscles around the rectum followed by the front muscles around the vagina. Hold this contraction while counting to five slowly. Relax these muscles then repeat four more times. Try to be aware of the squeezing and lifting sensation in the pelvis that occurs when these exercises are done correctly.

2 While sitting or standing, tighten the muscles around the front and back passage together. Hold this contraction for just one second and relax. Repeat this exercise five times in quick succession. It is a good idea to return to the first step once every week or so, to check that you are using the correct muscles.

*77\198\4*

This is the most common reason for a miscarriage and is usually the result of a one-off genetic abnormality in the baby that is unlikely to recur. In other words nature is working according to the law of survival of the fittest. When the baby is abnormal it will try to stop that pregnancy continuing.

You and your partner each contribute 23 chromosomes to the baby, making 23 pairs in total. Each chromosome pair determines specific characteristics of your child and geneticists have given a number to each pair. For example, number 23 is the pair which determines the sex of the baby.

Only a small portion of chromosomal abnormalities are inherited and these can be screened. The others can occur before, during and after fertilisation, as the chromosomes divide. It is thought that up to 50 per cent of miscarriages can be due to a genetic abnormality.

The most common chromosomal abnormality diagnosed is where there are three chromosomes in the pair instead of two. Depending on which pair this happens to, it will give rise to a specific abnormality. Not all abnormalities always end in a miscarriage. For instance, Down’s Syndrome is caused by an extra chromosome on pair number 21 and for that reason is also called trisomy 21. It is thought that most trisomies are caused by an abnormal division in the egg which occurs before fertilisation.

This may explain why older women have always been thought to have a higher risk of having a Down’s Syndrome baby, since older women’s eggs are more likely to be abnormal. But the Down’s Syndrome Association claims that eight out of ten babies with Down’s Syndrome are born to mothers under the age of 35.The extra chromosome can also come from the man’s sperm. So, at the moment, scientists do not know for sure what causes Down’s Syndrome.

However, there are links between Down’s Syndrome and mineral deficiencies. For example, people with Down’s Syndrome children have lower levels of zinc and selenium compared with others of the same age. It has also been found that in Down’s Syndrome blood levels of the ‘antioxidant defense system’ enzymes (super-oxide dismutase and glutathione peroxidase) are over-produced. Both these enzymes are produced by the body to disarm free radicals. The building blocks for these enzymes include the minerals zinc and selenium.

Selenium is known to protect against chromosome (DNA) damage by protecting the body against toxins and pollutants, and future research may demonstrate the importance of prospective parents having good levels of this mineral in the months before conception when both sperm and eggs are maturing.

The idea that toxin damage could be implicated in Down’s has been borne out by a study in the wake of the Chernobyl nuclear disaster. Babies born nine months later showed a six-fold increase in cases of Down’s Syndrome. Studies on animals have also shown it is possible to damage the chromosomes by introducing a toxin.

So the opposite may also be true: that you can protect your chromosomes from damage by stopping your intake of all the toxins we have been talking about and making sure that you have enough antioxidants to fight unavoidable pollution (like traffic fumes).

Turner’s Syndrome

If one chromosome of the pair is missing the condition is called monosomy. The most common abnormality of this type is where one X (female chromosome) is missing from the sex pair (number 23).This condition is called Turner’s syndrome. It does not usually cause a miscarriage but the baby, which is always a girl, will have certain physical characteristics. She can have heart defects and fertility problems, because her ovaries may be absent or fail to develop and because of this she will have under-developed breasts. As she gets older, she will need hormone treatment and counseling.

Inherited Genetic Problems

This is a much less common reason for a miscarriage, and chromosome testing (karyotype analysis) would be recommended for both partners where couples have experienced recurrent miscarriages. One of the most common structural changes in chromosomes is translocation, where part of one chromosome comes away and reattaches to a different chromosome.

Some gene defects can cause miscarriages but it is more likely that the genetic problem will cause abnormalities in the baby, such as cystic fibrosis or muscular dystrophy.

*99/73/5*

Endometriosis is a chronic disease that will require ongoing treatment and investigations by a qualified specialist. It is important that you choose your doctor carefully.

If you are buying a car you would not take the first one you see, so why should shopping around for a doctor be any different?

Road test the doctor, ask questions, talk to other women. Your health is worth the effort. You should be encouraged to be involved in your health care and to make informed decisions about treatment and surgery.

Many women are surprised to learn they have a chronic illness, so they are usually in a state of shock when treatment options for their endometriosis are discussed.

You need a doctor who understands the emotional as well as the physical aspects of the disease and who can provide counselling and support.

For those women who have had little contact with the medical profession, or for teenagers who are not ready to be assertive or demanding with an adult, challenging your doctor or seeking a second opinion can be difficult.

Where do you start? How do you know if the doctor you have selected will be the best for you? How do you take control?

Many women have asked these questions before so do not feel you are in any way inadequate or foolish for being afraid to question your doctor. After all, they are professionals experienced in the treatment of gynecological problems so it is not uncommon to feel that your doctor knows best and should not be questioned.

Many women say they do not feel confident enough to seek a second opinion. Others may feel they should not waste their doctor’s time by asking questions. These feelings are also common but also learn to trust your own judgment. It should be possible for you and your doctor to work together. If the treatment schedule mapped for you is not what you expected, discuss the options with your doctor. Consider all the options and make sure you are happy with what has been planned.

Unfortunately, women frequently complain that they feel embarrassed that they may ask a ’stupid’ question. It is essential to overcome this. Many doctors incorrectly assume their patients understand what their illness is, how it developed and how it may be treated. And it can be confusing when doctors use medical terminology – with which only they can be expected to be familiar. For instance, a doctor may talk about ‘patent tubes’. What is really being said is that the fallopian tubes are functioning and normal.

Obviously it would be easier if doctors used a language that their patients understood, so do not feel embarrassed to ask for an explanation – even though it can be a normal tendency to sit back and pretend you know what the doctor is on about!

Remember, it is your health, your body, so it is up to you to take control and be assertive.

*89/41/5*

These include the possibility that in the development of the reproductive system in the growing foetus, something goes a bit wrong, and bits of endometrium later show up in the wrong places.

It has been demonstrated that during menstruation a little bleeding can go backwards, and spill out the end of the fallopian tube, instead of out the vagina. It may be that this spillage takes root and grows, but it is not obvious why it should happen in some people and not others.

It is more common in women who have not had a pregnancy, although it can develop in women who have borne children. It seems that having periods (uninterrupted by pregnancies) for five years increases the chance of being affected by this condition. Compared to our parents’ and previous generations we are tending to have children later in life. This may account for the apparent increase in the disease in our population. Some reports estimate that it may affect as many as one woman in ten in Australia.

The introduction of the laparoscope has allowed gynaecologists to see into the pelvises of women who have no symptoms of endometriosis, and are having an investigation or procedure for other reasons, like having fallopian tubes clipped. There is a growing suspicion among some gynaecologists that perhaps endometriosis is not always a problem. It may be that we are seeing it, presuming it must be abnormal, and treating it. It has been suggested that in fact small asymptomatic deposits may not require treatment, and may be considered almost ‘normal’. Further research will hopefully shed more light on this.

*184\52\4*

There may be factors in a woman’s past history or family history which alert a doctor to the possibility of an increased risk of certain conditions in the foetus. Some of these can be tested for in early pregnancy. Conditions which can be looked for include:

Chromosomal abnormalities

The most common chromosomal abnormality is Down’s syndrome. This occurs in one in 700 pregnancies on average, but the chances of it occurring increase with the pregnant woman’s age. (The age of the father does not affect die chances of chromosomal abnormalities.) If the woman is between the ages of 37 and 39 at delivery, the chance of a chromosomal abnormality in her baby is about one in 200. When the woman is 40 or 41, the risk is one in 100. Over the age of 41 the chance increases further.

If a woman or her partner has a chromosomal abnormality, or has had a child previously who has had one, there is also an increased risk.

Spina bifida. This condition results from incomplete closure of the tissues around the spinal cord during development of the foetus. The degree of lack of closure may be small or large, and it can be related to significant problems with the spinal cord. There are different classifications for the various degrees of spina bifida, and the incidence varies with each group.

The age of the parents is not related to the risk of spina bifida, but having had an affected baby in a previous pregnancy does increase the risk, so these women are offered testing.

*144\52\4*

It is pretty difficult to totally avoid this bug, particularly if it likes living in your gut. The simple, common-sense things are worth trying. These include avoiding the things which are recognized as precipitants or aggravators of thrush:

• avoid wearing tight-fitting clothes for prolonged periods

• if wearing pantyhose, wear cotton-gusset types

• avoid nylon underpants

• avoid lycra pants

• carefully dry pubic hair after showering—even using a hair dryer

• avoid vaginal deodorants, or excessive soap.

All of these suggestions aim to make the pubic area less warm, moist, and irritated, so less of a haven for thrush.

If the bug is in your gut, it is probably not a bad idea to prevent wiping the bugs past your vagina. When you wipe your bottom after going to the toilet, wiping from front to back rather from back to front has been recommended. I’m not sure how much difference this really makes, as I don’t think many researchers have spent a lot of time on it, but it seems to make sense.

If you are taking antibiotics for an infection you may find you end up with thrush. Some women have told me that eating yoghurt daily, or applying it to the vagina each day while taking antibiotics helps prevent thrush, although the scientific evidence to back this up may be lacking.

Dietary changes have been promoted by many people as a treatment for this bug. Yeast-free diets, and low-sugar diets seem to be the most commonly recommended. This is out of the field of my own experience and expertise, so I cannot comment for or against it, but many people, particularly natural therapists, advocate dietary manipulations.

Some women notice that their thrush is related to their menstrual cycle. If you have a regular recurrence, say, just before your period, using yoghurt or a medication like a pessary or cream for a night or two may be helpful around this time. Often this form of ‘therapeutic prevention’ breaks the cycle of recurrent thrush.

Women may notice that their thrush is aggravated or precipitated by having sex. Certainly if the skin is damaged there is a higher chance that any organism, thrush included, will have more of a chance to cause a problem. So it may be that intercourse is causing damage to the vaginal skin. A way of preventing this may be to use a lubricant (preferably a water-based lubricant like K-Y Jelly, which is unlikely to damage the skin or cause a reaction, and is safe to use with condoms). Using a lubricant means that you are not depending on your natural vaginal lubrication, which may be reduced for a variety of reasons. It can be particularly important if you are resuming sexual activity after a bout of thrush, because the infection may have made the vaginal skin more sensitive and more easily damaged.

*65\52\4*

Sex (or engaging in sexual contact, to be more specific), is a natural thing. Biologically it is what we animals are made for, and it is an important part of our instinctive drive to survive and reproduce. But we humans are not like other animals in many ways. Our sexual behaviour is one of the things which distinguishes us. Because it is such an important part of our lives, not getting it right can cause a great deal of stress and trauma. When it all happens well, it can be the best thing since, well, anything.

Most of us learn about sex as we grow up. We go from a state of not being consciously aware of the sexual nature of the world, to often thinking we know it all. Then many of us go through a stage of realising that there is a lot more to learn. This second stage of enlightenment usually coincides with recognising that we were learning the wrong stuff in the beginning.

The common images we see of sexual contact make it seem fairly exciting, glamorous, and universally satisfying. We see a beautiful couple on the screen, wrestling passionately and wildly until they both have simultaneous orgasms, amid shots of waves crashing on the shore, and stallions rearing up on their haunches.

The harsh, cold reality is that sex is rarely like it is on the screen, or in books and magazines. It is not all gloom and doom. There are traps for young (and old) players, but it can also be a pretty special thing to share an intimate, sexual relationship. It can be better than on the screen. It can be absolutely fantastic.

It is not somebody’s place to tell you whether or not you should be having sex, with whom, or how often, or in what positions, or pass moral judgements about sexual behaviours. The responsibility for your sexual (and other) choices rests entirely with you. Acting on your choices, however, should not infringe the rights of other people. Sexual activity should only take place between consenting participants.

What is this thing called sex? It is how babies are made. That is what we are taught when we are little. We may also be taught that it is a special thing that daddies and mummies do when they love each other very much. No one does it in public. Nice people don’t talk about it.

If we are lucky, we learn about the mechanics of sex—what fits where in order to make babies—in reproductive biology lessons, sometimes called sex education. But otherwise, we are usually on our own to glean as much information as we can from any sources. A lot of this will come from other kids, who in fact don’t know much more than us, or from ‘folk lore sexuality’, which usually hands down time-honoured traditional lies and misinformation.

Obviously, as humans, we do have sex a bit more often than is absolutely necessary for having babies. It therefore has other uses. It is, generally, an extremely pleasant and enjoyable recreational activity. Because it is such an intimate thing to do, and we tend not to have sex with just anyone, it serves a purpose in relationships.

There have been sex scientists for years exploring the scientific intricacies of sex, measuring bits and pieces during different phases of stimulation and arousal, etc. They have been useful in many ways, in letting us know how normal we really are, and getting people talking about sex. Unfortunately some have just added to the confusion.

The common names used for sex include: having sex, sexual intercourse, making love, coitus, screwing, fucking, rooting, doing it, bonking, banging, and many more (please, feel free to make up your own). Because there are so many different names used, and we have already established that we don’t often know what we are talking about, we should probably sort out a few things.

*26\52\4*