Summary of PCOS Causes

• Insulin resistance – elevated insulin stimulating excess androgen (testosterone) production
• Excess androgens from non-insulin causes – including adrenal hormones such as DHEA and androstenedione
• Androgen sensitivity – normal testosterone levels, but increased tissue response causing acne, hair growth or hair loss
• Post-pill hormonal disruption – temporary androgen surge after stopping oral contraceptives
• Inflammation – gut issues, autoimmune or inflammatory conditions influencing hormone receptors
• Adrenal conditions – including non-classical congenital adrenal hyperplasia (21-hydroxylase deficiency)
• Hormonal imbalances – high prolactin, thyroid dysfunction or chronic stress
• Nutrient deficiency or under-eating – especially low carbohydrate intake affecting ovulation
• Rare endocrine disorders – such as Cushing’s syndrome

What causes PCOS? Insights from our Sydney Clinic

Whilst insulin driven PCOS that drives elevated testosterone is a common cause, more and more in clinic I am finding women that been diagnosed with PCOS, yet their testosterone levels are normal and when I check insulin at fasting, 1 and 2 hours I find that insulin is also normal.

Often the hair growth or hair loss on the head, acne and fertility issues are the main trigger for women to seek answers as they are all events that can seriously impact quality of life and life dreams.

So, its androgens that are normally to blame but they can be stimulated by not just insulin.  I also see many women with hair growth and male pattern baldness that assume they have PCOS however they are having regular periods and testosterone on a blood test is normal.  Women in these cases can be suffering from a hypersensitivity to a normal amount of testosterone so the support I give is to reduce the impacts of testosterone on hair growth and also on acne and look I depth at why they are so sensitive.

How I diagnose my Sydney clients struggling with PCOS

There are several interpretations of how to correctly diagnosis PCOS, however it absolutely cannot be diagnosed on simply having polycystic ovaries as you must show signs or symptoms of excess androgens.  This may not just be on a blood test but can be acne, hair growth on the face or male pattern baldness.

• Androgens to test:   sometimes total testosterone and free testosterone are normal however our adrenal glands also produce androgens so in some cases, and I look at whether androstenedione and DHEA have also been tested.  I explain the different types of PCOS in my last PCOS blog as even inflammatory conditions in the body such as eczema, arthritis, gut disorders, food sensitivities may be driving the excess androgens due to the impact that inflammatory chemicals produced by your body have on hormone receptors

Other Causes of PCOS

It is important that other causes for androgen excess have been considered and they can include:

• Having just come off the pill = post pill means disrupted hormones and a surge of testosterone
• Non classical congenital adrenal hyperplasia: This is a genetic condition and is an often forgotten cause of excess androgens and I always make sure it has been ruled out.  It is a condition where an important enzyme, 21-hydroxylase that changes progesterone into cortisol doesn’t work as it should and progesterone becomes testosterone and other androgens.  It can look like PCOS and is often diagnosed as PCOS.  The test recommended to know for sure is 17-OH progesterone.
• High prolactin: this can be a cause and be a result of thyroid issues, stress and even excess stomach acid tablets so it needs to be looked at too.
• Lack of nutrients in your diet: Hypothalamic amenorrhea is when you don’t ovulate, and this is common when you under eat especially carbs. 
• Cushings Syndrome: This would be rare however this condition shows similar symptoms to PCOS.

As you can see, PCOS does not always mean inositol and zinc.  It is a deep investigation to make sure you are strategically focussing on the right treatment and strategies.

Personalised PCOS Treatment in Sydney’s Inner West

For support on managing or investigating your PCOS more thoroughly or an investigation as to hair growth/loss or acne, please book your initial consultation at our Stanmore clinic, our Leura clinic, or via telehealth.

The post A Conversation Around PCOS: Insights from a Sydney Naturopath appeared first on Performance in Health.

So, what is mastitis? Mastitis is an inflammation and/or infection of the breast tissue. It is often due to an underlying blocked duct, and there may or may not be an infection involved. 75-95% of mastitis cases happen during the first 12 weeks of breastfeeding. This is the time during which your body is still regulating supply, which can mean fluctuating milk production levels throughout the day or week.

Symptoms of mastitis include:

• Pain
• Swelling
• Redness of the breast
• Reduced milk production
• A general feeling of being unwell
• Fever

Mastitis can develop and progress very quickly. Without adequate treatment, it may also progress to abscess formation. It’s important to begin treatment for mastitis as soon as symptoms appear to avoid progressing to severe symptoms like a high fever or abscess, which would require urgent medical care.

Causes and Risk Factors

There are a number of underlying causes and risk factors that can contribute to mastitis developing, including:

• Blocked or clogged ducts
• Cracked nipples
• Antibiotic use during pregnancy or breastfeeding
• Attachment and feeding issues, including poor latch or positioning of baby during feeds
• Delayed feeding
• Incomplete emptying of breasts during feeds
• Infrequent nursing, or reduced frequency of feeds
• Oversupply (can be simply due to your body’s overproduction of milk, or can be due to pumping in between feeds)
• First pregnancy
• Age (either under 21 or over 35)
• Poor gut health and dysbiosis
• Compromised immune health
• Wearing tight-fitting bras

When looking to prevent future recurrence, it’s important to address any of the above factors which may have contributed to mastitis developing.

Naturopathic Understanding of Mastitis

Human breast milk naturally contains its own microbiome, in the much the same way as the gut and skin. The good bacteria in breast milk help to maintain the health of the ducts by preventing other bacteria to grow – such as the Staphylococcus bacteria which are associated with mastitis. Naturopathically, we understand that mastitis can be a presentation of dysbiosis (imbalance of the body’s bacterial populations) – the good bacteria naturally found in breastmilk have become outnumbered by the harmful bacteria, resulting in infection, and leading to inflammation and illness. Immune system suppression also frequently plays a role – new mothers’ bodies are under significant stress, with postpartum healing, balancing the mental and emotional stressors of motherhood, and sleep deprivation, too. All of this can cause the body’s defences to become depleted and less able to protect against infection and inflammation.

Naturopathic Treatment Strategies for Mastitis

Dietary Strategies

Avoid Foods that Suppress Immune Function

Healing mastitis requires a robust response from the immune system. Certain foods can supress immune function and so are best avoided during this time. Foods that suppress immune system function include:

• Caffeine – particularly as found in coffee and energy drinks. The caffeine in tea is largely counteracted by the beneficial effects of L-theanine, an anti-inflammatory and immune-boosting amino acid that naturally occurs in tea
• Alcohol
• Deep fried foods and foods high in saturated fats, including chips and many packaged snack foods
• Foods high in trans fats, including cakes, muffins, frozen ready-foods (such as chips and pizza)
• Foods high in sugar, such as chocolate, lollies, baked sweet foods, and soft drinks

Keep hydrated

Adequate hydration is vital for a healthy immune system and for milk production. We need plenty of water to keep our lymphatic fluid moving properly through the body – this is how our immune cells travel around the body. Keeping hydrated is doubly important during mastitis, as we need both milk production and lymphatic flow to help clear any duct blockages that are present. Aim for 2.5-3L of water per day, plus extra when exercising or sweating. In cold weather, or when you’re feeling unwell, it can be difficult to drink this much water cold. Hot tea (including herbal tea) can be a great alternative to keep up your fluid intake – check the “herbal medicines” section of this handout for herbal tea options suited for mastitis.

Eat Well-Cooked, East to Digest Foods

Well-cooked and easy-to-digest foods are ideal, as these foods are easier for your body to break down and absorb vital nutrients. Soups, stews, and slow-cooked curries are all great options, which you can load up with immune-boosting vegetables, herbs and spices, and good quality protein sources. These types of meals are also great options for batch cooking – you can cook large portions and freeze leftovers for later meals.

Eat Protein with Every Meal

Protein forms the building blocks for cells, including immune cells. It is a vital part of a healthy immune system, and we have higher protein requirements during illness. Some good sources of protein include:

• Red meat, like beef, lamb, and kangaroo. Try cooking in a slow cooker until tender, as it will be easier to digest.
• Poultry, including chicken and turkey. Try roasted or baked, and add to soups
• Legumes – lentils, kidney beans, black beans, chickpeas, and more. Be sure to thoroughly soak and wash before cooking, and always cook them until soft – this will ensure they are much easier to digest. Legumes are a great protein option to use in curries and stews.
• Tofu and tempeh – both of these are highly versatile and can be used in curries, soups, stews, and even broths – a low-sodium miso soup with tofu or tempeh and some dried kelp or wakame (seaweed) can be a good, warming option when you have a low appetite. Miso paste is readily available at health food stores and provides a good dose of probiotics to your diet.
• Eggs – free range eggs can be boiled, scrambled, or poached
• Fish – baked, grilled, or even added to curries, fish and other seafoods can be a great addition.

Include Antimicrobial Foods

Loading up on antimicrobial foods can give your immune system a helping hand when it comes to fighting off bacterial infections such as mastitis. Some easy options to add include:

• Garlic, onions, and shallots – can be added to virtually any savoury dish!
• Mushrooms – shiitake and oyster mushroom varieties are frequently available in supermarkets and have great immune-boosting and antimicrobial properties

Supplements and Herbal Medicines

Every mum is different, and a tailored treatment plan will ensure a strategic prescription however some of the more common recommendations include:

Vitamin C

Specific Probiotic strains & prebiotic fibres

Herbal medicines can be a really useful tool with mastitis, helping to support the immune system, promote lymphatic circulation to improve breast duct clearance, as well as providing symptomatic relief. Below are some examples of herbs that may be used in your treatment plan.  If a herbal tincture is provided for oral use, instructions will be provided and may include Echinacea, Poke Root, Oats Green and Comfrey and Parsley Leaf for use as a compress.

Lifestyle Strategies

• Apply warm compresses to the affected area and take warm showers
• Hand express or pump before or after feeding to relieve pain, if needed, or if baby won’t feed on that side
• Use an ice pack after feeding to reduce swelling.

Prioritise Rest

It’s important to rest as much as possible, to give your body the time it needs to heal. This is especially important if you are still breastfeeding frequently at night and have broken sleep. Both sleep and rest are crucial for healing! Delegate tasks wherever possible, batch cook meals to reduce time spent preparing food, and take the opportunity to nap or rest whenever you can. You can also help to get more restorative sleep at night by turning off overhead lights (use low-light lamps instead) and switch off screens at least an hour before bed each night.

Continue to Feed Baby Often

Continue to feed baby as normal, focusing on draining the breast. It is fine to continue to feed on the mastitis-affected breast, so long as it is not too painful to do so!

Self-Massage

Gently massage the area with oil in between feeds, making sure to wipe off excess oil before you next feed baby. Massage in a circular motion working towards the nipple. This will help to improve circulation and encourage clearance of any blocked ducts. You may also wish to do this while in the shower, as the warm water will further boost circulation and clearance. You can use a pokeroot salve, calendula oil, comfrey oil, or even plain coconut oil to massage.

Use Warmth to Relieve Pain

Warm showers and warm compresses can help to relieve pain and reduce inflammation. A cloth soaked in warm water will do, or a herbal compress like those detailed in the “herbal medicines” section above.

Relieve Pain from Fullness

Hand-express or pump as needed to relieve pain, especially if baby won’t feed from that side. Be sure not to overdo it, though – you don’t want to stimulate more milk production.

Ice Pack for Swelling

If you are experiencing swelling, an ice pack wrapped in cloth applied to the breast will help.

To Reduce Oversupply

If oversupply is an underlying cause of your mastitis, the following tips might help:

• Apply frozen cabbage leaves to your breasts in between feeds – this is also very soothing!
• Drink 3 cups of sage tea per day – discontinue once your supply has balanced out
• Avoid pumping in between feeds – feed baby as needed and always aim to fully drain the breast before moving baby to the next breast. If you are prone to oversupply issues, avoid using a Haka or pump on the other side to catch the “overflow”, as this can signal to the brain to increase supply.

Book in to see me (Tanya Edwards) for Naturopathic support

If you’re struggling with mastitis and breastfeeding your baby, getting some professional guidance can be helpful.  A naturopathic consultation is a good start to help find the best treatment for you.  To find out more, contact Performance in Health today.

References

Amir, L. H., Forster, D. A., Lumley, J., & McLachlan, H. (2007). A descriptive stud of mastitis in Australian breastfeeding women: Incidence and determinants. BMC Public Health, 7(62).

Angelopoulou, A., Field, D., Ryan, C. A., Stanton, C., Colin, H., & Ross, R. P. (2018). The microbiology and treatment of human mastitis. Medical Microbiology and Immunology, 207, 83–94.

Barker, M., Adelson, P., Peters, M. D. J., & Steen, M. (2020). Probiotics and human lactational mastitis: A scoping review. Women and Birth, 33(6), 483–491.

Beim, M. (2022). Mastitis. https://mimbeim.com/mastitis/

Hurtado, J. A., Maldonado-Lobon, J. A., Diaz-Ropero, M. P., Flores-Rojas, K., Uberos, J., Leante, J. L., Affumicato, L., Couce, M. L., Garrido, J. M., Olivares, M., & Fonolla, J. (2017). Oral administration to nursing women of Lactobacillus fermentum CECT5716 prevents lactational mastitis development: A randomized controlled trial. Breastfeeding Medicine, 12(4), 202–209.

Jimenez, E., Fernandez, L., Maldonado, A., Martin, R., Olivares, M., Xaus, J., & Rodriguez, J. M. (2008). Oral administration of Lactobacillus strains isolated from breast milk as an alternative for the treatment of infectious mastitis during lactation. Applied and Environmental Microbiology, 74(15), 4650–4655.

Ojo-Okunola, A., Nicol, M., & du Toit, E. (2018). Human breast milk bacteriome in health and disease. Nutrients, 10(11).

Red Moon Herbs. (2019). Clogged milk ducts and mastitis: Poke root to the rescue. https://redmoonherbs.com/blogs/womens-health-and-herbal-medicine/clogged-milk-ducts-and-mastitis-poke-root-to-the-rescue

Soto, A., Martin, V., Jiminez, E., Mader, I., Rodriguez, J. M., & Fernandez, L. (2014). Lactobacilli and bifidobacteria in human breast milk: Influence of antibiotherapy and other host and clinical factors. Journal of Pediatric Gastroenterology and Nutrition, 59(1), 78–88.

Valls-Belles, V., Abad, C., Hernandez-Aguilar, M. T., Nacher, A., Guerrero, C., Balino, P., Romero, F. J., & Muriach, M. (2022). Human milk antioxidative modifications in mastitis: Furhter beneficial effects of cranberry supplementation. Antioxidants, 11(1).

WIllson, K. (2022). Mastitis prevention and treatment. https://www.pbcexpo.com.au/blog/mastitis-prevention-treatment

The post Mastitis – how a Naturopath can support you appeared first on Performance in Health.

The Benefits of Breastfeeding

There are a huge range of benefits that come from breastfeeding, for both mother and baby. Some of these benefits include:

• Improved immune protection for baby – breast milk contains high levels of antibodies to protect infants from disease. What’s most amazing is that breast milk is dynamic – your body will produce extra antibodies to protect baby against specific pathogens that your body encounters in your environment.
• Dynamic breast milk composition – in addition to changing antibodies, the composition of breast milk changes to suit your baby’s needs. For example, if baby is going through a growth spurt, your breast milk will provide baby with higher levels of protein and fat.
• Protection against illness – breastfeeding has been shown to protect infants against a number of diseases, including asthma, allergies, eczema, diabetes 1 and 2, and even reduces SIDS risk.
• Protects mums against long term illness risk – breastfeeding reduces your risk of developing certain cancers, including breast, ovarian, and endometrial, and also protects against osteoporosis, heart disease, and diabetes.

Supporting Optimal Lactation

Dietary Strategies

Eating well cannot be underestimated. I recently wrote a post on post-natal depletion so have a look at my “Postnatal Depletion” post here for dietary support and strategies.

Hydration

Breastfeeding requires increased water intake. Breastfeeding women require around 3-3.5L of water each day in order to meet their own needs as well as produce sufficient milk. Opt for filtered water where possible, to reduce your exposure to unnecessary toxins and heavy metals from tap water. Good quality water filters are readily available from health food shops, filter suppliers and Bunnings.

Food As Medicine: Oats

Oats are considered to be a galactagogue (help to increase production). Homemade oat bars or “lactation cookies” made with oats can be a great snack to have on-hand. There are some great recipes online, or you can purchase pre-made lactation cookies.

Herbs

There are a number of herbs that are considered to be “galactagogues” and can be great additions to your breastfeeding journey.  It is important that they are prescribed by a trained herbalist however as your babies age and other conditions always need to be considered.

• Fenugreek – a galactagogue, as well as a blood sugar stabiliser, and digestive herb
• Fennel seed – a galactagogue, and also helps to reduce bloating and IBS-type symptoms.
• Goat’s rue – a powerful galactagogue and also helps to reduce high blood sugar (caution in pregnancy)
• Stinging nettle leaf – a galactagogue and amazing nutritive herb that is very high in important minerals such as potassium, magnesium, and zinc.
• Hops – a galactagogue, nervine and phytoestrogen herb. It is also the herb used to make beer and is the reason why some people recommend drinking a stout beer to increase milk supply! (However, alcohol can lower prolaction, the breastfeeding hormone, so it is best avoided.)
• Milk thistle – a well-known liver herb, but also a useful galactagogue!

Many of these herbs are available in herbal liquids and lovely tea blends that can be sipped throughout the day (and can also help you to keep your hydration up!). Fennel and fenugreek can also be added to your cooking (think warming curries and stews) or can be brewed into a chai.

Supplements

Supplements will depend on your individual needs and how depleted you are from pregnancy however during this time it is very important to make sure that you are obtaining the following nutrients via whole foods as much as possible, and by continuing your prenatal multivitamin.  Magnesium, iron, Vitamin D, Zinc, Vitamin C and omega 3 fish oil supplements with vegan options are often prescribed.   My post on nutrition for postpartum recovery gives valuable information.

Additional Tips for Optimal Lactation and Breastfeeding:

• Offer the breast to your baby often – whenever they seem interested, or at least every 2-3 hours.
• Hold baby skin-to-skin frequently through the day
• Avoid giving supplements or “top-ups” with the bottle unless necessary
• Avoid dummies and bottles if possible
• Feed according to your baby’s needs, rather than following a set schedule.
• Stay in bed and rest, particularly in early postpartum, and prioritise feeding on demand. The housework can wait!
• Don’t forget that breastfeeding is more than just nutrition – it is for bonding and comfort as well. It’s okay to also offer the breast whenever you feel baby might benefit.
• Ensure correct positioning and latch – for diagrams and information on optimal positioning and latch, head to https://thepixelfarm.com/iable/membercontent/BFHandouts/IABLE_BF-Ed_Help_Baby_Latch.pdf and https://thepixelfarm.com/iable/membercontent/BFHandouts/IABLE_BF-Ed_Latching.pdf
• See An IBCLC-qualified lactation consultant for assistance with positioning and latch, if required.

Common Breastfeeding Issues

Pain During Breastfeeding

Breastfeeding should not be painful. If you are experiencing pain during breastfeeding, it’s important to seek advice on why this is happening. There are many reasons why breastfeeding might be painful, such as:

• Over or under production
• Structural anomalies in the breast causing latch issues
• Structural anomalies in baby’s mouth (such as tongue and lip ties) causing latch issues
• Mastitis or clogged ducts

At my naturopathic consultations for new mums, we will be discussing how I may support your unique situation.  You may also be speaking to your GP or seeking advice from a qualified IBCLC lactation consultation.

Painful, Cracked and Bleeding Nipples

Nipple pain is a common issue but is not a normal part of breastfeeding and shouldn’t be ignored. If you have cracked or bleeding nipples, it’s important to uncover the cause of the issue to prevent further pain and nipple damage from occurring. Common causes of painful, cracked and bleeding nipples include:

• Poor latch or positioning
• Incorrect use of breast pump, such as incorrectly sized flanges
• Nipple thrush
• Oversupply, causing baby to bite down on your nipple

Once the underlying cause has been determined and addressed, nipple pain shouldn’t be an issue. To lessen pain in the meantime and encourage healing:

• Use lanolin ointment on your nipples after feeds to protect and encourage healing.  A cream made specific for you wither herbs including calendula may be appropriate.
• Gently wipe breastmilk onto your nipples to assist in healing
• Keep nipples dry between feeds by using clean cloth nipple pads

Clogged Ducts

A clogged duct occurs when milk is not draining sufficiently out of a particular duct in the breast. This can present as a swollen, lumpy and sometimes painful area in the breast and can be accompanied by redness in the affected area. If you have a clogged duct:

• Continue feeding baby at the breast often
• Pump or hand express between feeds
• Firmly massage the area to help move the lump towards the nipple
• Apply a warm compress onto the affected area
• Try changing baby’s feeding position – move baby so their nose or chin is pointing towards the clogged duct, as this will help to drain this area more thoroughly

Mastitis

Mastitis is an inflammation and/or infection of the breast tissue, often due to a clogged duct. Symptoms of mastitis include pain, swelling, redness, a general feeling of being unwell, and fever. If you suspect you have mastitis, you will be provided with a specific handout on mastitis causes and herbal treatment such as echinacea, probiotics, poke root, vitamin C however some basic advice includes:

• Continue to feed baby often
• Apply warm compresses to the affected area and take warm showers
• Gently massage the area during feeds
• Hand express or pump before or after feeding to relieve pain, if needed
• Use an ice pack after feeding to reduce swelling.

If fever and pain persist, or you notice a red line spreading outwards from the site of inflammation, seek urgent medical care.

Low Supply

Under-production or low supply is a common concern for many breastfeeding mothers; however it is often easily remedied by addressing the underlying cause. Some common causes of low initial supply include:

• No breast changes during pregnancy – most women experience at least some changes to their breasts during pregnancy, such as increased breast size, or darkening of the nipples and areolas. A lack of changes in the breasts during pregnancy can sometimes coincide with low supply.
• Low levels of breast tissue – insufficient glandular tissue, also known as breast hypoplasia, can make breastfeeding difficult
• PCOS: some women with PCOS have difficulties with supply, however others are able to breastfeed successfully.

If you have already established breastfeeding and have previously had a good supply, but are now finding your supply is dropping, it may be due to issues such as:

• Not enough feeding – supply follows demand when it comes to breastfeeding. Offer baby the breast frequently (every 2 to 3 hours in the beginning and then 8-12 times every 24 hours)
• Feeds are too short – avoid timing feeds and simply allow baby to feed as long as they need to until they come off the breast by themselves. Some babies may only feed for 5-10 minutes, but others might spend up to 30 minutes or more. (Note: newborns need to have sufficient rest in between feeds. If your newborn is spending extended periods of time feeding and you feel they are not getting enough, seek advice from an IBCLC.)
• Topping up with formula – Supply follows demand, so if your baby is getting additional feeds with formula top-ups, there will be less demand for breast milk, causing a drop in supply.
• Hormonal changes – some women find their supply drops during ovulation and menstruation.
• Maternal illness – sometimes women may find their supply drops temporarily if they are ill.
• Substances – certain substances such as caffeine, nicotine and alcohol can affect supply and let down.

To help increase your supply:

• Follow the “optimal lactation” steps listed above
• Try offering additional “snack feeds”
• Offer your baby the breast for comfort, instead of using a dummy
• Offer both breasts – but be sure to fully empty the first breast before offering the second. Generally, it is best to wait until baby comes off the breast by themselves and then swapping sides.
• Ensure baby is positioned well and has a good latch – if you are unsure, speak to an IBCLC
• Feed baby in a comfortable, relaxed position away from distractions and noise.
• Massage your breast, working towards the nipple, or compress the breast as baby feeds, to help fully empty the breast.
• Remember that even if you are not able to exclusively breastfeed your baby, any amount of breastmilk is giving your baby amazing benefits!

Over Production and Engorgement

Sometimes women will produce too much milk, causing pain for the mother and frustration for baby. Signs of over production include:

• Baby is very fussy and restless during feeding and may arch their back and cry
• Baby bites down on your nipple (in an attempt to slow down milk flow)
• Baby may be very cough and splutter during feeding, especially during let-down
• You may feel a very forceful letdown
• You may experience frequent clogged ducts or mastitis
• Your breasts don’t feel like they are sufficiently empty after feeding

Causes of oversupply include:

• Overactive thyroid
• Excessive, frequent pumping – some women will pump early and often in order to build up a bank of frozen milk
• Timing feeds and switching sides after a set number of minutes, not letting baby fully drain the breast
• Baby breastfeeding frequently for comfort can also increase supply
• Some mums simply produce more milk than others!

This over supply can lead to engorgement or hardening of the breast as it becomes very full of milk. To relieve engorgement:

• Apply a warm cloth to breasts or have a warm shower before feeding to help soften the breast and encourage let-down. If your breasts are extremely hard and engorged, do not use heat – cold applications only.
• If baby is having trouble latching because of breast fullness, hand express some milk or use a breast pump for a few minutes first before feeding.
• Gently massage your breasts between feeds
• Hand express between feeds to relieve some of the pressure, but don’t overdo it – you don’t want to further increase supply!
• Apply cold cabbage leaves or cold packs to breasts for 15-20 minutes after feeds

Supporting new mums on restoring health & nutrients after baby is born is critical for a heathy breast feeding experience.  Breastfeeding issues  can be terribly distressing for any new mum and for baby, so I offer guidance and treatment and introductions to other specialists where needed.

Contact me today for more information or book an appointment at our award winning naturopath in Sydney‘s Inner West.

References

Australian Breastfeeding Association. (2022). Australian Breastfeeding Association. breastfeeding.asn.au

Australian Breastfeeding Association. (2022). Polycystic ovarian syndrome and breastfeeding. https://www.breastfeeding.asn.au/resources/polycystic-ovarian-syndrome-and-breastfeeding

Bone, K. (2003). A clinical guide to blending liquid herbs: Herbal formulations for the individual patient. Elsevier.

Institute for the Advancement of Breastfeeding & Lactation Education. (2017a). Breastfeeding after a Cesarean Birth. https://thepixelfarm.com/iable/membercontent/BFHandouts/IABLE_BF-Ed_Cesarean.pdf

Institute for the Advancement of Breastfeeding & Lactation Education. (2017b). Latching. https://thepixelfarm.com/iable/membercontent/BFHandouts/IABLE_BF-Ed_Latching.pdf

Institute for the Advancement of Breastfeeding & Lactation Education. (2017c). Positioning to help your baby latch well. https://thepixelfarm.com/iable/membercontent/BFHandouts/IABLE_BF-Ed_Help_Baby_Latch.pdf

Killings, N. (2020). Plugged ducts and mastitis. https://www.lactationtraining.com/resources/handouts-parents?task=document.viewdoc&id=45

Krumbeck, E. (2015). Herbs to increase supply: A guide to galactagogues. https://naturopathicpediatrics.com/2015/07/15/herbs-to-increase-milk-supply-a-guide-to-galactagogues/

La Leche League International. (2022). La Leche League International. llli.org

Rosenblum, N. (2022). Breastfeeding 101: Q&A with lactation expert Nadine Rosenblum. https://www.hopkinsmedicine.org/health/wellness-and-prevention/breastfeeding-101-qanda-with-lactation-expert-nadine-rosenblum

The post Breastfeeding: Supporting Optimal Lactation & Dealing with Common Issues appeared first on Performance in Health.

Restoring nutrient stores especially if your diet prior & during pregnancy was not optimal is a critical KPI for your health and wellbeing.

As a naturopath, supporting women throughout preconception, pregnancy and post-partum recovery is important for mum, baby, and the whole family. 

Whilst the baby blues is quite common following the first week after delivery, it usually begins to subside by week two or thereabouts. Postnatal depression on the other hand is a different condition entirely and can appear in the first 6 months after delivery and strike a debilitating blow for many, making motherhood an incredibly challenging time.

Supporting women so that they may understand and be aware of some of the signs of post-natal depression is critical in getting support early and recognizing when it’s time to ask for help.

In my clinic, we have mental health professionals to support women at this time working alongside myself and it’s important that your GP is fully aware of what is occurring for you also.  Having a wholistic team to nurture you back to physical and emotional can be very important.

The postpartum period is a time of immense physical and emotional change, as you not only recover from pregnancy and childbirth, but also move into a brand-new phase of life: motherhood. This is a period that can bring stress, exhaustion and overwhelm, but for some, the postnatal period can also lead to mental health challenges too, with postnatal depression (PND) affecting 10-12% of postpartum women in Australia. This handout looks at postnatal depression, its underlying factors, and naturopathic strategies for coping with PND.

About Postnatal Depression

The Baby Blues vs. Postnatal Depression

The baby blues is an extremely common experience – between 50-85% of women experience the baby blues, which is a period of increased emotional sensitivity and teariness, peaking at around 4 or 5 days after giving birth. Post-natal depression, however, is a more significant mental health condition. PND can begin any time after delivery and up to one year after giving birth. Post-natal depression can be debilitating, yet many mothers delay seeking treatment.

Risk Factors and Underlying Causes

Some of the risk factors and underlying causes for developing postnatal depression include:

• Antenatal depression (depression that begins during pregnancy) or a history of depression
• Being in poor physical health
• Experiencing financial hardship
• Lack of partner support or relationship issues
• Lack of social support
• Having a Caesarean section delivery or a negative birth experience may also increase the risk
• Hormonal changes – significant changes to your hormones, including a drastic drop in oestrogen levels, can lead to depressive symptoms.
• Nutritional deficiencies – many women are nutritionally depleted following pregnancy and childbirth. Nutrients such as vitamin B12, folate, vitamin D, zinc, iron, and omega 3 fatty acids are all commonly depleted in postpartum women and are associated with an increased risk of developing PND.

Symptoms

Symptoms of postnatal depression include:

• Low mood and severe mood swings
• Excessive crying and sadness
• Brain fog, difficulty concentrating
• Fatigue, low energy, insomnia, or excessive sleeping
• Difficulty with remembering or concentrating
• Trouble bonding with your baby
• Loss of appetite, or significantly increased appetite
• Loss of interest in things you sued to enjoy & normal activities
• Feelings of hopelessness, worthlessness, shame, or guilt
• Feeling like you’re not a good mother
• Feelings of anger – towards self, children, and/or partner
• Extreme concern & worry about your baby
• Thoughts & fear about harming yourself or your baby

It is important to know that many of the symptoms mentioned above may also overlap with common depressive disorders, so if you do have a history of depression or a mental illness, it is important that you reach out for support as your risk factor in development post-natal depression is higher.   For those mums without previous depression however, you are still at risk.

Understanding changes in your body that occur at this time

There are a number of changes in your reproductive & stress hormones that play a part in post-natal depression and when combined can lead to the “perfect storm” of post-natal depression.

Estrogen and progesterone: Bothof these reproductive hormones go into sharpdecline following the birth of your baby.

Oxytocin: this hormone has a huge role in bonding with your baby which is why it is known as the love hormone.  Lower levels of this important hormone is thought to play a role in post-natal depression.  As breast feeding is associated with higher mean oxytocin levels in scientific studies, breastfeeding may have a positive impact.

Cortisol:  this stress hormone increases throughout pregnancy with a drop after birth until it fully normalises over several months.

Naturopathic Testing in Postnatal Depression

With post-natal nutrient depletion being so common, some standard tests that may be ordered due to their role in mood, energy and recovery may include:

• Full blood count
• Iron studies
• Thyroid panel
• Serum vitamin D
• Serum vitamin B12 and folate
• Hormonal profile including progesterone (depending on how long ago you gave birth)

Dietary Strategies for Post Natal Depression

From physically recovering after childbirth, to accounting for the increased nutritional demands of breastfeeding, your body is in great need of vital nutrients after giving birth. Supporting yourself nutritionally is also important for your mental health – studies have shown that deficiencies in key nutrients, including folate, iron, vitamin D, and essential fatty acids, can increase the risk of postnatal depression. Please refer to my postpartum recovery blog here for detailed nutritional suggestions, and my blog on post-natal depletion which also highlights specific nutrients.

Specific Nutrients for Post-Natal Depression

These are unique to each person however common deficiencies include iron, Vitamin D, B vitamins and magnesium.  It is important you seek professional advice especially if you are breast-feeding.

Herbs for Postnatal Depression

As with supplements, herbs need to be prescribed with an understanding of where you are at with breastfeeding, however the following herbs are all generally considered safe during postpartum and breastfeeding and may be prescribed to help you.

St John’s Wort

St John’s wort is a wonderful mood lifting herb that works by increasing your serotonin levels. It also reduces anxiety and promotes a feeling of calm. Be aware that St John’s wort is not safe to take at the same time as conventional anti-depressant medications.

Ashwagandha

Ashwagandha is a wonderful restorative tonic. This herb can help you to cope with the new stressors in your changing life, improve your immune response, and can also help to boost your iron levels, too.

Nettle

Nettle leaf is considered to be one of the most nutritive plant foods known, with a high content of many important minerals such as zinc, calcium and magnesium, so it makes a wonderful herb for replenishing your nutrient status in the postpartum period. Nettle can be taken as a herbal extract or as a tea.

Oats Seed

Oats seed extract is a wonderful, nutritive and restorative herb. It can also help you to feel calmer and less anxious and is healing to the nervous system.

Skullcap

Skullcap is a gentle nervous system restorative herb that can help to reduce feelings of anxiety and boost mood.

Lifestyle

Enjoy Daily Exercise

Daily physical movement or exercise is a must for mental health. If you are still in the early recovery phase of your postpartum journey, please be mindful that you are recovering from a major physiological event and should treat your body with care while you are healing. Go slow and build up as you feel up to it. Gentle activities such as walking, and yoga are ideal at this time. If you can, combine your physical movement with some morning sun exposure, as this will help you to boost your vitamin D levels, balance your cortisol, and will also be beneficial for baby as they establish their circadian rhythm. If you are feeling physically recovered and are past the fourth trimester phase, you can push yourself to do higher intensity activities, including team sports, jogging, swimming, HIIT, and even weightlifting. Find activities that you are motivated to participate in and enjoy, as this will make it easier for you to commit to doing them each day. Lean on your partner, family, and friends to help you with childcare while you exercise or look into joining a gym with a creche.

Prioritise Rest, Especially in Early Postpartum

During the first 12 weeks postpartum, bonding with baby and resting often should be the priority. Delegate tasks to other people in your life as much as possible, so that you can keep your focus where it is needed. Beyond the fourth trimester, resting when you need to is still important! Sleep is needed not just for physical health but for mental health, too. When we are asleep our brains repair and renew themselves, reducing inflammation and clearing away toxins. Without adequate sleep, these processes can’t be properly done, which can worsen mental health symptoms. Prioritise sleep and don’t be afraid to nap when you need some extra rest. Negotiate with your partner a schedule that works for both of you to get enough sleep.

Speak to a Professional

If you don’t already have a regular counsellor or psychologist, it is worthwhile pursuing this. Cognitive behavioural therapy has been found to be an effective treatment strategy for women with postnatal depression and speaking to a professional psychologist or counsellor is an important step for anyone experiencing postnatal depression. Here at Performance in Health we are lucky to have many great mental health professionals on the team who can help with both in-person and virtual appointments.

Share the Parenting Workload

Many new mums try to take on the additional workload of parenthood on their own, or try to keep partner support to a minimum, especially if their partner is back at work. However, this can make your workload overwhelming. Speaking to your partner about how you can both share the workload in a way that works for you both is important. Likewise, your baby will benefit from receiving care from both parents. This includes nappy changes, bathing, feeding (if not exclusively breastfed), and settling.

Make Time for Social Engagement

Motherhood with a newborn can feel isolating, especially if you are a new mum, but social connection and support are vital for lasting mental wellbeing. We are social creatures and need that connection in our lives Making time for social engagement and connection can help you to feel less alone. Friends and family have a positive influence and finding friends who are in a similar life stage to you can make a big difference. If you don’t have friends who are also parenting babies and young children, try reaching out to your local play group to find other local parents.

Additional Tips for Coping with Postnatal Depression

• Remember that this is a challenging experience for all new parents – you are not alone in feeling the way you do!
• Accept help from family and friends and don’t be afraid to delegate tasks to visitors when they come by, so that you can focus on rest, bonding with baby, and self-care. Tasks such as hanging out washing, emptying the dishwasher, and even cleaning the bathroom can be easily delegated!

Additional Resources

The following additional resources may be useful to you:

PANDA

PANDA (Perinatal Anxiety and Depression Australia) is a dedicated organisation for helping parents coping with perinatal anxiety and depression. They have a dedicated helpline that you can call Mon-Sat on 1300 726 306 and offer lots of useful information on their website – www.panda.org.au

Beyond Blue

Beyond Blue have a 24/7 helpline that can connect you with a mental health professional any time. Call 1300 224 636

Lifeline

If you need urgent crisis support or are having suicidal feelings, Lifeline is available 24/7 by calling 13 11 14

For thorough naturopathic support in nurturing your body back to health, please reach out for an initial consultation or fact find call via my contact tab here

References

Amer, C. (2022, June). An RD’s guide to postpartum nutrition, plus easy postpartum meals. https://www.humnutrition.com/blog/postpartum-nutrition/

Ball, L., de Jersey, S., Parkinson, J., Vincze, L., & Wilkinson, S. (2022). Postpartum nutrition: Guidance for general practitioners to support high-quality care. Australian Journal of General Practice, 51(3).

Bell, A. F., & Andersson, E. (2016). The birth experience and women’s postnatal depression: A systematic review. Midwifery, 39, 112–113.

Bone, K. (2003). A clinical guide to blending liquid herbs: Herbal formulations for the individual patient. Elsevier.

Elwood, J., Murray, E., Bell, A., Sinclair, M., Kernohan, W. G., & Stockdale, J. (2019). A systematic review investigating if genetic or epigenetic markers are associated with postnatal depression. Journal of Affective Disorders, 253, 51–62.

Huang, L., Zhao, Y., Qiang, C., & Fan, B. (2018). Is cognitive behavioural therapy a better choice for women with postnatal depression? A systematic review and meta-analysis. PLOS One.

Minerva Natural Health and Fertility. (2021, November). Postpartum nutrition goals. https://minervanaturalhealth.com.au/2021/11/14/postpartum-nutrition-goals/

Ogbo, F. A., Eastwood, J., Hendry, A., Jalaudin, B., Agho, K. E., Barnett, B., & Page, A. (2018). Determinants of antenatal depression and postnatal depression in Australia. BMC Psychiatry, 18.

Ou, C. H. (2018). Anger in the context of postnatal depression: An integrative review. Birth Issues in Perinatal Care, 45(4), 336–346.

Rochford, T. (2022). Simple postpartum diet and nutrition tips. https://tararochfordnutrition.com/simple-postpartum-diet-and-nutrition-tips/

Sparling, T. M., Henschke, N., Nesbitt, R. C., & Gabrysch, S. (2017). The role of diet and nutritional supplementation in perinatal depression: A systematic review. Maternal and Child Nutrition, 13(1).

Sparling, T. M., Nesbitt, R. C., Henschke, N., & Gabrysch, S. (2017). Nutrients and perinatal depression: A systematic review. Journal of Nutritional Science. https://doi.org/10.1017/jns.2017.58

Whitley, J., Wouk, K., Bauer, A. E., Grewen, K., Gottfredson, N. C., Meltzer-Brody, S., Propper, C.,     Mills-Koonce, R., Pearson, B., & Stuebe, A. (2020). Oxytocin during breastfeeding and maternal mood symptoms. Psychoneuroendocrinology, 113, 104581. https://doi.org/10.1016/j.psyneuen.2019.104581

The post Postnatal Depression appeared first on Performance in Health.

Physical Healing in the Fourth Trimester

Your body has been through a lot in the last 9 months and is now in the important healing and recovery phase. Pregnancy and giving birth are both intense, physically demanding journeys and, depending on your birth experience, you may now have significant physical healing to do. Loss of nutrients and blood following pregnancy and birth, combined with significant sleep deprivation and stress, can leave you in a vulnerable state that can negatively affect your recovery and wellbeing. Your immune system function can also be supressed, and healing may be compromised. For this reason, it’s important to prioritise your healing where possible during this time, to avoid further health issues down the track.

Emotional Healing in the Fourth Trimester

Pregnancy, birth, and new motherhood are periods of considerable emotional upheaval. Perhaps you have journeyed from Maiden to Mother for the first time, or maybe you are learning to mother a newborn whilst also parenting older children, too. Your birth experience can also bring up strong emotions that may need to be processed throughout the fourth trimester period. Not only are there big changes in your life to process, but the hormonal fluctuations that occur post-birth can also contribute to the emotional rollercoaster of the post-partum period. It’s no wonder then that looking after your emotional health is just as important as looking after your physical health at this time.

The Baby Blues

The baby blues is an extremely common experience – between 50-85% of women experience the baby blues, a period of increased emotional sensitivity and teariness, which peaks around 4 or 5 days after giving birth. If you experience the baby blues, give yourself grace and allow yourself to feel your feelings, knowing that you will come back into balance soon.

Post-Natal Depression

Post-natal depression, on the other hand, is a more significant mental health condition that develops up to one year after giving birth. Post-natal depression can be debilitating, yet many mothers delay seeking treatment. While there are many different risk factors for developing perinatal depression, including having a history of depression and other mental health conditions, nutrition certainly plays an important role here. Studies have found that low levels of important nutrients such as vitamin D, selenium, folate, iron, zinc, and fatty acids, are all associated with an increased risk of developing postnatal depression. Many of the dietary strategies in this blog – Click here and provided during my naturopathic consultations will help you to replenish these important nutrients to help you with both your physical and emotional recovery and help reduce your risk of postnatal depression.

Naturopathic Testing in Post-Natal Depletion

If post-natal depletion is suspected, there are a range of tests that may be recommended for you, to help get a clear picture of your current health and to assess for targeted treatment with supplements and herbs.  I may look at your iron levels, thyroid, blood sugar levels, B12, folate, vitamin D as an example due to their role in energy, mood and overall recovery.

Dietary Strategies for Post Natal Depletion

From physically recovering from childbirth, to accounting for the increased nutritional demands of breastfeeding, your body is in great need of vital nutrients during this time, and careful nutritional support can be immensely helpful in coping with this stage of life. This blog on nutrients at this stage provides a basic level of guidance as to some of the key nutrients to consider for helping to support your recovery during the months that follow childbirth, as well as some general guidelines for a healthy diet that supports both you and baby.  Each person is unique depending on their diet pre and during pregnancy, any issues experienced such as sleep, stress & nausea, so this is a broad overview.

Your energy and nutrient needs are increased during the fourth trimester, as your body undergoes significant healing and recovery with energy needs increased even further if you are breastfeeding so now is not a time for calorie-restriction and losing weight – your priority should be with healing.  There are many easy to prepare and nutritious meals on my recipe section of the website which will ensure adequate protein, carbs and fat at this time

Specific Nutrients for Post-Natal Depletion

If you are breastfeeding, depending on the age of your newborn there are certain herbs and supplements that can be prescribed for you however during this time it is very important to make sure that you are obtaining the following nutrients via whole foods as much as possible, and by continuing your prenatal multivitamin.  Magnesium, iron, Vitamin D, Zinc, Vitamin C and omega 3 fish oil supplements with vegan options are often prescribed.  If you are not breastfeeding, you are then at a stage where more varied and additional herbs & supplements can be prescribed to assist you in restoring your optimal nutrient levels.

Herbs for Post-Natal Depletion

As with supplements, many herbs may not be suitable while breastfeeding, however a range of beautiful herbs are generally considered safe during postpartum and breastfeeding and may be prescribed to assist in your recovery.  Some of my favourites are Ashwagandha, Nettle, Oats Seed Shatavari, Skullcap and Reishi.

Galactagogue herbs for breast milk production may also be required if you are having problems with breast milk production which is a common issue for mums and naturopathic herbs to improve volume and flow may include Goat’s Rue, Hops, Fenugreek.  Fennel tea is also supportive.  Again, self-prescription is never recommended with lactation herbs.

Lifestyle

Enjoy Gentle Daily Movement

Whether you had a vaginal delivery or caesarean section, you are recovering from a major physiological event and should treat your body with care while you heal. Gentle movement each day, such as a gentle walk through the neighbourhood, will help to keep you active without placing undue stress on your body. This can also be a great opportunity to get some vitamin D and to rebalance your cortisol levels at the same time, whilst also being beneficial for baby developing their circadian rhythm. Many women will feel ready to slowly reintroduce exercise after around 6 weeks, however this will depend on your pregnancy, delivery circumstances, and the type of exercise you are wishing to do.

Prioritise Rest

Bonding with baby and resting often should be the priority for these 12 weeks. Delegate tasks to other people in your life as much as possible, so that you can keep your focus where it is needed.

Speak to a Professional

Whether your pregnancy and childbirth experiences were easy and blissful, or perhaps more challenging, there can be a lot mentally and emotionally to unpack from what you have been through. Speaking to a professional can be of tremendous help in working through emotional issues that have come to the surface, or for talking about any negative or challenging experiences you encountered. A psychologist or counsellor is a great place to find. We have wonderful mental health professionals on the team at Performance in Health who can help you, with both in-person and virtual appointments available. View details about our team here.

Additional Tips for The Fourth Trimester and Post-Natal Depletion

• Don’t try to do it all yourself – accept offers of help and have friends and family go food shopping and cook meals for you.
• Listen to your hunger cues and eat when hungry – the fourth trimester is a time to focus on recovery, not weight reduction.
• When you do cook, choose meals that you can easily cook in large batches, so that you can freeze extra portions for later.

References

Amer, C. (2022, June). An RD’s guide to postpartum nutrition, plus easy postpartum meals. https://www.humnutrition.com/blog/postpartum-nutrition/

Ball, L., de Jersey, S., Parkinson, J., Vincze, L., & Wilkinson, S. (2022). Postpartum nutrition: Guidance for general practitioners to support high-quality care. Australian Journal of General Practice, 51(3).

Bone, K. (2003). A clinical guide to blending liquid herbs: Herbal formulations for the individual patient. Elsevier.

Minerva Natural Health and Fertility. (2021, November). Postpartum nutrition goals. https://minervanaturalhealth.com.au/2021/11/14/postpartum-nutrition-goals/

Rochford, T. (2022). Simple postpartum diet and nutrition tips. https://tararochfordnutrition.com/simple-postpartum-diet-and-nutrition-tips/

White, C. (2021). Common nutrient deficiencies in postnatal depletion. https://www.spacetoflow.com/journal/common-nutrient-deficiencies-in-postnatal-depletion

The post Post Natal Depletion appeared first on Performance in Health.

This blog post breaks down the underlying mechanisms of PCOS, how it develops and how it affects your health. We will also look at each of the 4 major types of PCOS, including the underlying causes and how they manifest, to help give you a better understanding of what might be going on for you. We will also look at some treatment strategies PCOS naturopaths use to help combat this condition, including diet, nutritional supplements, and herbal medicines.

What is PCOS?

So, what is PCOS? The answer is complicated. Whilst PCOS (or polycystic ovary syndrome) is often discussed as if it is a singular condition, it is in fact a complex syndrome with many varying presentations and causes. Being a syndrome means PCOS isn’t one condition; the term ‘PCOS’ is simply the name given to a collection of similar symptomatic presentations. There are four major ‘types’ of PCOS, and each type has its own constellation of symptoms and underlying causes, but there is a considerable amount of overlap, too.

There are a wide range of symptoms associated with PCOS, but the most common symptoms include acne, missed periods (or a very long and irregular menstrual cycle), male-pattern hair growth on the face, chest and back (also known as hirsutism), overweight or obesity, acne, hair loss, and infertility. PCOS is a very common condition, affecting around 5-10% of women of reproductive age worldwide. PCOS is the most common hormonal disorder affecting women and one of the leading causes of infertility. Despite how common it is, there is still much that isn’t understood about how it manifests or its underlying causes. Making it even more complicated is that with some aspects of PCOS, such as insulin resistance, it is unclear whether it is a cause of PCOS, or whether insulin resistance is in fact a symptom. And whilst many symptoms such as hair loss and acne might seem superficial to some, the long term risks of PCOS are serious. The syndrome places women at higher risk of developing cardiovascular conditions in later life, including heart disease, high blood pressure and high cholesterol. It can also lead to an increased risk of developing type 2 diabetes and metabolic syndrome. The health risks of PCOS aren’t all physical, either. PCOS increases the risk of low self-esteem, eating disorders, depression, and anxiety, and leads to significantly reduced quality of life.

So, what exactly is going on in the body? Contrary to popular belief, PCOS and ovarian cysts are not the same condition, and, in fact, the “cysts” in PCOS aren’t really cysts at all. Confusing, isn’t it! The underlying mechanisms of PCOS are complicated, but primarily it is a disorder of disrupted ovarian function and hormone imbalance, with higher-than-normal levels of both oestrogen and androgens (“male” hormones like testosterone), and a higher ratio of androgens to oestrogen overall. Most PCOS cases also involve insulin resistance, too. This hormone imbalance is what disrupts the ovaries from functioning normally and stops ovulation from occurring.

In a normal menstrual cycle, hormones released by the pituitary gland in the brain trigger the ovary to produce multiple follicles (small, immature eggs). These follicles grow and secrete oestrogen, until day 7 of your cycle, when all but one of the follicles will be dissolved. The one remaining follicle will continue developing and maturing into an egg or “oocyte”, ready for ovulation on day 14 of the menstrual cycle. In PCOS, elevated insulin levels over-stimulate the ovaries and cause them to release higher than normal amounts of hormones. This leads to higher overall levels of both oestrogen and androgens in the body. Insulin then further exacerbates this hormonal imbalance, as insulin resistance in fat tissues converts oestrogen into male hormones inside fat cells. This means even higher androgen levels and an even bigger hormonal imbalance. Back in the ovaries, this hormonal imbalance causes too many follicles being produced each month, but their development is halted part way through the menstrual cycle before they can either mature into a functioning egg or be dissolved by the body. The follicles remain, partially matured, in the ovaries and appear as cyst-like formations on the ovaries during ultrasound. This is the reason for the “polycystic” portion of PCOS’s name. They are not really cysts but are, in fact, immature follicles that merely look like cysts. To make matters even more complicated, the presences of these “cysts” is also not diagnostic for PCOS and in fact, for many women, having lots of follicles in your ovaries can be normal, especially for younger women.

It’s important to remember that pain is not a symptom of PCOS. As discussed above, the “cysts” in PCOS are not actually cysts but immature follicles. If you are experiencing pain, this is not a part of PCOS and warrants investigation with your health care practitioner.

Diagnosis of PCOS

Diagnosis of PCOS will often have at least two of the following:

• Evidence of multiple “cysts” (immature ovarian follicles) demonstrated on ultrasound
• High androgens (e.g., testosterone or DHEAs) on blood tests
• Physical signs and symptoms of PCOS, such as acne, hirsutism, and hair loss

It is important to note however that it is normal for some women to have a higher number of follicles, especially younger women and for this reason, relying purely on an ultrasound to confirm a PCOS diagnosis cannot be done.  Polycystic ovaries, whilst common in PCOS can simply be follicles or eggs on a normal ovary so other tests must be part of the diagnosis.

In addition to this, women can still have PCOS whilst also having ovaries that appear normal.

This is why naturopathically speaking, further tests might also be done to help determine some of the underlying causes and to help guide treatment plans. Tests might include an oral glucose tolerance test, and blood tests to assess levels of insulin, SHBG (sex hormone binding globulin), and the ratio of luteinising hormone and follicle stimulating hormone (to assess for ovulation and hormone balance).

Causes of PCOS

So, what really causes PCOS? It is often discussed as being a “lifestyle” disease (i.e., a condition that is caused by a sedentary lifestyle and poor diet), but the truth is more complicated than that, and framing it as a lifestyle condition can be upsetting for women who have spent years trying to manage symptoms through lifestyle habits without success. PCOS is generally the result of both genetic and environmental causes, and whilst lifestyle can certainly play a role, it is not the only underlying trigger to the development of PCOS. Other underlying causes include:

• Genetics: Several genes have been identified by scientists as playing a role in the development of PCOS. Although it’s not clear yet how strongly they are linked, it is clear these genes at least predispose certain women to developing PCOS. Studies also show that it is at least partly inheritable, and often runs in families.
• Inflammation: Chronic inflammation can work in much the same way as insulin resistance, triggering the ovaries to produce excess androgens.
• The pill: Although post-pill PCOS is not “true” PCOS, coming off the pill can cause a temporary hormone imbalance that can lead to PCOS-type symptoms
• Stress: Although not necessarily a cause of PCOS, studies do suggest that stress can worsen symptoms.

The 4 Types of PCOS

• Insulin Resistant PCOS

Insulin-resistant PCOS is by far the most common type of PCOS, accounting for upwards of 80% of PCOS cases. This is the “classic” PCOS type with the underlying mechanisms as described above. Women with this type of PCOS often struggle with their weight and may be overweight or obese even despite efforts to lose weight. Reducing insulin resistance is the primary focus for treatment with this type of PCOS, through the use of dietary and lifestyle changes, and supplements such as inositol, magnesium, and even chromium.

• Post-Pill PCOS

Post-pill PCOS is less common. Whilst many women may first discover they have PCOS when they come off the pill and develop symptoms, it doesn’t always mean that they have post-pill PCOS. Sadly, many women are unaware they even have PCOS until they come off the oral contraceptive pill in order to start having children. They may have been prescribed the pill in their early teens for “irregular periods” (which is normal in early adolescence), or to “treat” acne, and have stayed on the pill ever since. It is only when they come off the pill that their hormonal imbalance is identified. Its’s important to note, however, that the pill does not actually treat PCOS – it simply masks its symptoms. This is why symptoms return once you stop taking the pill.

It is only considered to be post-pill PCOS if your periods were well-established (you’d had them for 7 or more years) and regular before you went on the pill and are only irregular since stopping the pill. While uncommon, for some women, coming off the pill leads to a temporary rebound effect on hormones, leading to a hormonal imbalance that causes PCOS-type symptoms. Although it is temporary, it can be distressing, and naturopathic approaches can help to mitigate symptoms while hormone levels balance out again. Treatments such as the herbs liquorice and peony can be helpful in re-establishing normal ovarian function and hormone levels, as can supplements such as zinc.

• Inflammatory PCOS

Chronic inflammation is something that is common in many women with PCOS. Chronic inflammation affects the ovaries by stimulating higher than normal androgen production, disrupting ovarian function and ovulation in much the same way as insulin resistance does. Women with inflammatory PCOS will generally have other symptoms associated with chronic inflammation that aren’t typical to PCOS, such as fatigue, joint pain, or chronic skin issuses like eczema. In inflammatory PCOS, it’s important to address the underlying cause (or causes) of the chronic inflammation. For some, this may be a food intolerance, commonly gluten or dairy. For others, it may be chronic gut issues or dysbiosis, or even histamine intolerance.

• Adrenal PCOS

Adrenal PCOS is much less common than insulin-resistant PCOS, accounting for around 10% of cases. This is where adrenal dysfunction leads to high levels of cortisol (the “stress” hormone). High cortisol leads to increased levels of just one type of androgen – DHEAS – but doesn’t affect testosterone levels. This means that for women with adrenal PCOS, blood tests will show high DHEAS levels and normal levels of the other androgens, testosterone and androstenedione. For this type of PCOS, stress management and adrenal tonic herbs such as ashwagandha are the priority for treatment. As mentioned above, studies do suggest that stress in general plays a role in PCOS and therefore needs to be addressed even if your PCOS doesn’t fit the adrenal type.

Naturopathic Treatment Strategies for PCOS

The specific types and combinations of treatments that are used for PCOS vary depending on the type of PCOS. The following is an example of some of the common naturopathic treatment strategies used.

Eliminate Sugar

Sugar is often a significant driver of disease when it comes to PCOS. This is because sugar increases insulin requirements in the body, leading to the development and worsening of insulin resistance. All forms of refined and added sugar should be eliminated from the diet. This includes “hidden” sugars that can be found in supposedly healthy foods such as smoothies, commercial muesli and protein bars – see our blog post on hidden sugars in smoothies. Too much fruit can also be an issue, so it’s best to keep it to no more than 2 serves per day. Whilst eliminating sugar from the diet can be really tough, it’s worth it to get your insulin levels back on track. The good news is, once your insulin function improves, you’ll be able to enjoy the occasional sweet treat again.

 The Mediterranean Diet

Multiple studies have demonstrated the beneficial effects of the Mediterranean diet on PCOS, and it stands to good reason – this diet is low in sugar and pro-inflammatory foods and high in antioxidants, good quality proteins, and healthy fats – all the foods needed for managing PCOS symptoms.

16-8 Fasting

16/8 intermittent fasting (fasting for 16 hours per day and eating only during an 8-hour window each day) can help with PCOS symptoms by improving insulin sensitivity.

Exercise

Daily exercise is an absolute must when it comes to PCOS! Whatever your choice of exercise may be, aim to work up a good sweat each day and engage in at least 30 minutes of vigorous activity (but preferably aim for 60 minutes). Exercise helps to utilise glucose in the blood and improve insulin sensitivity. Over time, increased muscle mass from exercise can make our bodies even more efficient at maintaining our glucose and insulin levels even when we are at rest.

Supplements and Herbs

There are a whole host of supplements and herbs that are marketed towards PCOS management, but the truth is that the treatments that will suit you best will depend on your PCOS type and your individual symptom picture. Your naturopath will be able to guide you towards the best treatment plan for you, but the info below gives you some insight into how these treatments can help.

Liquorice and Peony

These two herbs are a common combination for treating PCOS. The two work synergistically together; liquorice helps balance hormone levels by improving the ovary’s ability to transform testosterone into oestrogen, while peony works to heal the ovaries.

Ashwagandha

Ashwagandha is an Ayurvedic herb that acts as an adrenal tonic, helping to improve adrenal function and improve cortisol function. This is particularly helpful for adrenal PCOS, or for instances where stress is making your symptoms worse.

Spearmint

Spearmint tea might be a surprising addition to the list, but several studies have found it to be effective. Drinking spearmint tea 3 times a day has been found to be effective at reducing androgen levels and has even been found to reduce hirsutism (chin and chest hair growth).

Supplements

Supplements are also frequently used, including:

• Inositol: One of the most popular supplements on the market for PCOS, and for good reason. Multiple studies have shown that inositol can improve many aspects of PCOS, including lowering testosterone levels, improving insulin sensitivity, reducing acne, and improving fertility.
• Zinc: helps improve insulin function but is also a great supplement for healthy ovary functioning and hormone health. Studies have shown it can help to reduce hair loss and hirsutism in people with PCOS.
• Magnesium: a powerhouse mineral that is involved in hundreds of different processes in the body. Magnesium helps to make cells more sensitive to insulin but is also important for reducing high cortisol levels associated with adrenal dysfunction.
• Omega 3 fatty acids: a vital nutrient that so many of us are lacking, omega 3s are needed for healthy cell walls and reducing inflammation. Omega 3 fatty acids are found in fatty fish such as salmon and tuna but can also be taken in supplement form if required.
  – Many omega 3 supplements on the market are poor quality, so I do recommend you look to your naturopath for a quality product, to make sure you’re getting benefit from your supplement. Vegan omega 3 supplements are also available and are usually algae derived.
• Chromium: Another nutrient needed for healthy insulin function. Studies have shown chromium supplementation to improve menstrual cycles and ovarian health and reduce testosterone levels in people with PCOS.

To find out more about how a PCOS naturopath can help you, please contact Performance in Health in Sydney. We are an award winning clinic located in Stanmore, in Sydney’s Inner West and you can contact us or book an appointment online.

References

Akdogan, M., Tamer, M. N., Cure, E., Cumhur Cure, M., Koroglu, B. K., & Delibas, N. (2007). Effect of spearmint (Mentha spicata Labiatae) teas on androgen levels in women with hirsutism. Phytotherapy Research, 21(5), 444/447.

Amr, N., & Abdel-Rahim, H. E. (2015). The effect of chromium supplementation on polycystic ovary syndrome in adolescents. Journal of Pediatric and Adolescent Gynecology, 28(2), 114–118.

Arentz, S., Abbott, J. A., Smith, C. A., & Bensoussan, A. (2014). Herbal medicine for the management of polycystic ovary syndrome (PCOS) and associated oligo/amenorrhoea and hyperandrogenism; A review of the laboratory evidence for effects with corroborative clinical findings. BMC Complementary and Alternative Medicine, 14.

Barrea, L., Arnone, A., Annunziata, G., Muscogiuri, G., Laudisio, D., Salzano, C., Pugliese, G., Colao, A., & Savastano, S. (2019). Adherence to the Mediterranean Diet, dietary patterns and body composition in women with polycystic ovary syndrome (PCOS). Nutrients, 11(10).

Briden, L. (2021). 4 types of PCOS (a flowchart). https://www.larabriden.com/4-types-of-pcos-a-flowchart/

Cuciureanu, M. D., & Vink, R. (2011). Magnesium and stress. In Magnesium in the central nervous system. University of Adelaide Press.

Damone, A. L., Joham, A. E., Loxton, D., Earnest, A., Teede, H. J., & Moran, L. J. (2018). Depression, anxiety and perceived stress in women with and without PCOS: A community-based study. Psychological Medicine, 49(9).

Fazelian, S., Rouhani, M. H., Bank, S. S., & Amani, R. (2017). Chromium supplementation and polycystic ovary syndrome: A systematic review and meta-analysis. Journal of Trace Elements in Medicine and Biology, 42, 92–96.

Grant, P. (2010). Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome: A randomized controlled trial. Phytotherapy Research, 24(2), 168–188.

Jamilian, M., Foroozanfard, F., Bahmani, F., Talaee, R., Monavari, M., & Asemi, Z. (2016). Effects of zinc supplementation on endocrine outcomes in women with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled trial. Biological Trace Elements Research, 170(2), 271–278.

Khan, M. J., Ullah, A., & Basit, S. (2019). Genetic basis of polycystic ovary syndrome (PCOS): Current perspectives. Applied Clinical Genetics, 12, 249–260.

Merviel, P., James, P., Bouee, S., Le Guillou, M., Rince, C., Nachtergaele, C., & Kerlan, V. (2021). Impact of myo-inositol treatment in women with polycystic ovary syndrome in assisted reproductive technologies. Reproductive Health, 18.

Sadinpour, A., Seyedi, Z. S., Arabdolatabadi, A., Razavi, Y., & Ajdary, M. (2020). The synergistic effect of Paeonia spp and Glycyrrhiza glabra on polycystic ovary induced in mice. Pakistan Journal of Pharmaceutical Sciences, 33(4), 1665–1670.

Unfer, V., Facchinetti, F., Orru, B., Giordani, B., & Nestler, J. (2017). Myo-inositol effects in women with PCOS: A meta-analysis of randomized controlled trials. Endocrine Connections, 6(8), 647–658.

Wekker, V., van Dammen, L., Koning, A., Heida, K. Y., Painter, R. C., Limpens, J., Laven, J. S. E., Roesters van Lennep, J. E., Roseboom, T. J., & Hoek, A. (2020). Long-term cardiometabolic disease risk in women with PCOS: A systematic review and meta-analysis. Human Reproduction Update, 26(6), 942–960.

Yang, K., Zeng, L., Bao, T., & Ge, J. (2018). Effectiveness of omega-3 fatty acid for polycystic ovary syndrome: A systematic review and meta-analysis. Reproductive Biology and Endocrinology, 16.

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Protein

Eating quality protein is important for any kind of physical recovery period, and the postpartum period is no different. Protein is important for tissue repair and collagen production, as well as for normal hormone balance.

Incorporating a source of high-quality protein in each of your main meals will help to ensure you are eating adequate amounts for optimal recovery. Try incorporating healthy protein sources like lean meats, chicken, free-range eggs, nuts and seeds, lentils and other legumes.

 

Complex Carbohydrates

Carbohydrates are essential for energy production, which is an important consideration for busy, sleep-deprived mums! In addition, glucose is required for producing the lactose found in breastmilk, so breastfeeding mothers have a slightly increased carbohydrate requirement during this time. However, it’s still best to avoid highly sugary foods such as pastries, cakes, white bread and sweets, which provide only short-term sugar spikes and lack other nutrients.

Choosing high quality complex carbohydrates such as brown rice, whole grain breads, and starchy vegetables likes potato and sweet potato, will help to ensure you are also eating adequate fibre, and will help to boost your intake of important micronutrients such as B vitamins.

Healthy Fats

Healthy unsaturated fats are important for ensuring your body can absorb fat-soluble vitamins such as vitamin A and vitamin D and can help to reduce inflammation in the body. Omega-3 fatty acids are particularly important to pay attention to in the postpartum period.

Following childbirth, previously elevated oestrogen levels drop significantly. This drop in oestrogen is associated with depressive symptoms and may play a role in postnatal depression. Omega 3 fatty acids have been shown to help improve oestrogen levels postnatally and should be an important consideration for helping to support your body during postpartum recovery.

Food sources of omega 3 fatty acids include oily fish such as salmon, tuna and sardines, flax seeds, walnuts, and chia seeds. Other unsaturated fats can be found in foods such as almonds, cashews, avocados, olives and extra virgin olive oil.

Iron

Iron is truly one of the most important micronutrients to consider in the postpartum period. Iron deficiency is a relatively common issue among pregnant women and can be further exacerbated following blood losses during childbirth.

Iron is not only vital for energy levels and transporting oxygen to body tissues but is also vital for your baby’s growth and development. Depleted iron stores can lead to issues with fatigue and may also leave women at increased risk of postnatal depression.

Iron can be found in lean red meat, lentils, chickpeas, kidney beans, sunflower seeds, pumpkin seeds, and even dried apricots.

Calcium

Calcium is vital for bone development and cardiovascular functioning for your baby. It is so crucial that during both pregnancy and breastfeeding, your body will draw calcium out of your bones to supply to baby. Ensuring you are consuming sufficient calcium helps to protect your bone density and also protects baby from health risks.

Healthy calcium sources include Calcium-rich food sources include dairy products, eggs, green leafy vegetables (such as spinach, kale and collards), sardines, walnuts, almonds, and broccoli.

 

Vitamin D

Vitamin D is important for immune function and also plays an important role in helping to maintain calcium levels in the body for bone, muscle and heart health. Studies have shown that having adequate levels of vitamin D may be important in preventing postnatal depression. Healthy food sources of vitamin D include fish (such as salmon, sardines and tuna) and free-range eggs. Sunlight exposure is however the best source of vitamin D – even just 15 minutes of sun exposure per day can help to improve your vitamin D levels.

Iodine

Iodine is a crucial nutrient for infant brain development and thyroid function – iodine deficiency in early life can significantly affect baby’s cognitive development.

Alarmingly, up to 50% of children and pregnant and breastfeeding women in Australia are low in iodine. This is partly because Australian soils contain only low amounts of iodine, which reduces the amount found in Australian-grown fruits and vegetables.

Commercially produced breads in Australia are fortified with iodine to help combat this issue, but iodine can also be found in seafoods, free-range eggs and meats.

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Sub-fertility is a significant issue in Australia – around 16% of Australian couples have trouble conceiving, with both male and female-related issues affecting fertility rates. Fertility and preconception is an area of health that can feel entirely foreign when you begin trying to conceive, and the jumble of information available online can feel overwhelming. If you’re having difficulty conceiving, or even if you’ve only just begun your preconception journey, this article about fertility naturopath treatment will help you to understand some of the key factors that might be impacting on your fertility, as well as provide tips to help you boost fertility and help you to conceive naturally.

Female Fertility 101

Before getting into the factors which disrupt female fertility, it’s important to have a brief look at how fertility in women works on an anatomical and biochemical level, to help us understand what we’re dealing with (and how we can help to improve fertility outcomes).

In a normal menstrual cycle, a woman releases one egg (also known as an ovum or oocyte) from one of her ovaries into the fallopian tube – the process known as ovulation. It is here that the egg is able to be fertilised by sperm, before travelling through the fallopian tube and into the uterus, where the newly fertilised egg, now known as an embryo, implants into the endometrial lining of the uterus. The release of a healthy egg from the ovaries, as well as the development of a healthy endometrial lining for the embryo to implant in, requires a balance of hormones such as oestrogen, follicle-stimulating hormone, luteinising hormone, and progesterone, as well as adequate nutrients for the development of a healthy egg, embryo and endometrium. The factors that can interrupt this process are varied, and may affect just one portion of the process, or may impact the process as a whole.

Image by FreePik

Factors Affecting Fertility

So, what factors can impact on female fertility and conception? You may have an idea of some of the major factors, such as age, but there are many physical and lifestyle factors that can contribute, and you may find there are multiple issues you need to address when it comes to improving your fertility. Some of the major factors are:

• Age
• Genetics
• Nutrition
• BMI
• Stress and lifestyle
• Chemical/ toxin exposure
• Pre-existing medical conditions

Some of these, such as age and genetics, we unfortunately aren’t able to change, but there are many factors here that we can address.

Below is a more detailed look at some of these issues, and what we can do to help mitigate their effects.

How Can Nutrition Affect Female Fertility?

Nutrition is a huge area of focus when it comes to preconception and fertility. The old adage “you are what you eat” is particularly true for fertility. A poorly balanced diet, or one with specific nutrient deficiencies, leaves you without the key building blocks needed for successful conception and healthy foetal growth. Certain micronutrients, such as zinc, selenium, iron, iodine, B vitamins (especially folate and B12), and vitamin C (among others!) all play important roles in conception and embryonic development. Likewise, a balanced intake of macronutrients (protein, carbohydrates and fats) from healthy sources is essential. For example, eating a diet with too many high glycaemic index (GI) carbohydrate foods has been shown to increase insulin levels, which can contribute to an increase in the body’s production of androgens (“male” type hormones), disrupting normal hormone balances needed for successful conception.

Antioxidants are another important nutritional consideration, as a diet low in antioxidants is considered a risk factor for reduced fertility. Normal bodily processes as well as exposure to harmful chemicals in daily life contribute to the development of free radicals within the body, which lead to oxidative stress. Our bodies counteract the damaging effects of free radicals with antioxidant compounds that work to neutralise free radicals. Certain vitamins, such as vitamins C and E, as well as other nutritional compounds like glutathione, lycopene, resveratrol, and coenzyme Q10 (CoQ10), all act as important antioxidants within the body. It is vital that we are eating sufficient levels of these nutrients in order to keep the body in balance, especially when trying to conceive.

In addition, high caffeine intake has been shown to increase the risk of early spontaneous pregnancy loss, and studies have shown it to increase the time it takes to conceive. With that in mind, it’s best to skip the second (or third, or fourth) cup of coffee!

Improving Nutrition During Preconception

• Eat a balanced diet high in nutrient-dense foods and ensure you are eating adequate amounts of key fertility-boosting nutrients
  • Plenty of fresh fruits and vegetables – aim for as much variety as possible, focusing on eating as many different colours of vegetables as you can each day (always be sure to wash your fruits and vegetables before consumption)
  • Opt for high quality protein sources, such as wild caught fish, legumes, grass-fed organic meats and free-range eggs. Reduce your intake of highly processed meats such as sausages, and deli meats like ham and pastrami.
  • Choose lower GI, wholegrain carbohydrates such as brown rice and wholegrain breads
• Boost your intake of key micronutrients for healthy conception
  • Zinc: Found in beef, eggs, milk, seafood, sunflower seeds, pumpkin seeds, blueberries, broccoli and capsicum
  • Selenium: Found in Brazil nuts, cashews, eggs, fish such as tuna, oysters and other seafood
  • Iodine: Found in fish, kelp, mushrooms, dairy products and sunflower seeds
  • Iron: Found in beef, chicken, eggs, spinach, tahini
  • B vitamins: Found in green leafy vegetables, lentils and other legumes, avocado, mushrooms, sunflower seeds
  • Vitamin C: Found in strawberries, oranges, broccoli, tomatoes, kiwi fruit, sweet potatoes
• Eat plenty of antioxidant-rich foods: fresh fruits and vegetables in plenty of different colours
• Reduce your caffeine intake, or avoid caffeine altogether

Can My BMI Affect My Fertility?

Being overweight or obese (BMI above 25), has been shown to reduce rates of conception and increase the risk of miscarriage. A high BMI is also associated with adverse pregnancy outcomes such as premature birth, hypertension, and gestational diabetes, further highlighting the importance of achieving and maintaining a healthy weight prior to conceiving.

Reducing the Effect of BMI on Fertility

The best way to approach this is to speak with your naturopath about a weight reduction plan appropriate to your needs. Remember that even a small reduction in body weight can help to improve ovulation and improve pregnancy outcomes.

 

Cigarette Smoking, Alcohol and Recreational Drugs

Cigarette smoking affects female fertility in a number of ways, including increasing the risk of spontaneous miscarriage and directly damaging eggs, reducing your ovarian reserve (i.e. the number and quality of eggs left in your ovaries).  Although alcohol only indirectly affects fertility, foetal alcohol spectrum disorder is a major consideration in the recommendations for women abstaining from alcohol altogether when trying to conceive. Marijuana use can also affect fertility. Cannabinoids within marijuana have been shown to disrupt hormonal regulation and ovarian function, leading to ineffective implantation.

Reducing their Effects on Fertility

It is vital to eliminate cigarettes, alcohol and recreational drugs from your lifestyle while trying to conceive and during pregnancy and breastfeeding. With regards to cigarette smoke, it is also important to avoid second-hand smoke exposure, which can also be dangerous.

Stress

Both psychological and physical stress can play a role in reduced fertility in women. Stress activates the body’s hypothalamic-pituitary-adrenal axis (HPA axis), also known as the “flight or fight response”, leading to elevated levels of hormones such as cortisol. Over time these stress hormones negatively affect fertility by altering the body’s secretion of important fertility hormones like oestrogen and luteinising hormone, and altering ovulation, fertilisation, and implantation. This stress might include a physically or psychologically demanding job, or other types of stress such as relationship and family issues, insecure housing or employment, or financial stress.

Reducing the Effects of Stress on Fertility

The good news is that stress management techniques have been shown to help improve fertility outcomes. There are a range of options available to help reduce the effects of stress, including:

• Regular physical activity – aim for 30 minutes of moderate intensity exercise on most days of the week
• Yoga, tai chi, or Qi Gong
• Meditation – if you find the thought of self-guided meditation daunting, there are many group classes available nowadays, both in-person and online
• Counselling and talk therapy

 

Chemical and Toxin Exposure

It’s no secret that our modern world is full of harmful chemicals and toxins, to which we are exposed daily. Some of these toxins are particularly worrisome when it comes to preconception and it is worth looking into how we can avoid exposure. One of the primary reasons these chemicals are concerning during preconception is because of they way they can act as endocrine disruptors (sometimes also known as xenoestrogens), affecting hormone balance and disrupting the body’s ability to regulate its own hormones. They may also lead to increases in oxidative stress within the body, affecting healthy egg production. Chemicals that may impact fertility are:

• Pesticides, including garden sprays and herbicides, insect sprays and rodent baits
• Heavy metals, including mercury and lead, which can be present in contaminated water and food, as well as air pollution
• Certain plastics, such as phthalates and bisphenol-A (BPA)
• Chemicals in your cleaning products at home plus perfumes, make-up, shampoo & conditioner, hairsprays, toothpaste, skincare, soaps, body washes, hair dyes and nail-polish. Our blog on estrogen dominance goes into these chemicals in more detail, you can check it out here.

Reducing their Effect on Fertility

The best way to reduce their effect on fertility is to reduce your exposure:

• Avoid exposure to pesticides
  • Choose organic gardening methods and avoid using Round-Up in your garden
  • Wash fruits and vegetables thoroughly before eating and choose organic where possible
• Avoid exposure to heavy metals
  • Use a water filter to reduce impurities and contaminants from tap water
  • Reduce consumption of foods which may be contaminated with heavy metals, particularly fish such as shark, swordfish and bluefin tuna – opt for lower mercury varieties such as sardines, mackerel and salmon
• Avoid exposure to BPA and other harmful xenoestrogens
  • Avoid plastic food containers and water bottles
  • Do not microwave food in plastic containers – reheat foods on the stove top or in the oven, or if you do choose to use a microwave, use microwave-safe glass containers

Image by University of Vienna

Pre-Existing Medical Conditions

There are a vast range of pre-existing medical conditions which can impact on fertility in women, whether as a result of the condition itself or through the medications and other treatments that may be used for the condition’s management. It’s beyond the scope of this post to list every condition that might affect female fertility, but a few of the major conditions, including female reproductive conditions, are listed below.

Some female reproductive conditions which may impact your fertility are:

• PCOS is a relatively common hormonal condition, affecting approximately 20% of women, which is associated with high levels of androgens (“male” hormones), which can disrupt ovulation, leading to “immature” eggs that don’t function as they should
• Endometriosis is a complicated hormonal condition that involves abnormal growth of the endometrium, which lines the uterus
• Uterine fibroids are a type of benign tumour within the uterus which cause a physical barrier to fertility. Depending on their exact location and manifestation, uterine fibroids may negatively affect implantation and increase the risk of miscarriage.

Other conditions to be aware of are:

• Infections, including sexually transmitted and genitourinal infections, may disrupt fertility in a number of ways. For example, sexually transmitted infections such as chlamydia can cause irreparable damage to the fallopian tubes, significantly impacting fertility. These infections can be asymptomatic, so it is important to speak to your GP about keeping up to date with STI screening.
• Thyroid disorders
• Diabetes
• Autoimmune conditions

 Reducing their Effects on Fertility

If you have concerns about a diagnosed health condition or prescribed medications and how it may affect your plans to conceive, always speak with your naturopath or GP for advice. With regards to female hormonal conditions, your naturopath may also be able to prescribe herbs, such as shatavari, white peony, or chaste tree, to help mitigate the effects of the condition and improve hormonal regulation and promote ovulation.

Find out more about how we can support you through fertility and contraception – we are an award winning naturopath in Sydney’s Inner West, so please make contact or book an appointment.

References

Conforti, A., Mascia, M., Cioffi, G., De Angelis, C., Coppola, G., De Rosa, P., Pivonello, R., Alviggi, C., & De Placido, G. (2018). Air pollution and female fertility: A systematic review of literature. Reproductive Biology and Endocrinology, 16(117). https://doi.org/10.1186/s12958-018-0433-z

Family Planning NSW. (n.d.). Infertility. Retrieved February 22, 2021, from https://www.fpnsw.org.au/factsheets/individuals/fertility-and-infertility/infertility

Hechtman, L. (2012). Clinical naturopathic medicine. Elsevier Australia.

Lisiecki, M., Paszkowski, M., & Wozniak, S. (2017). Fertility impairment associated with uterine fibroids: A review of the literature. Menopause Review, 16(4), 137–140. https://doi.org/DOI: https://doi.org/10.5114/pm.2017.72759

Palomba, S., Daolio, J., Romeo, S., Battaglia, F. A., Marci, R., & La Sala, G. B. (2018). Lifestyle and fertility: The influence of stress and quality of life on female fertility. Reproductive Biology and Endocrinology, 16(113). https://doi.org/10.1186/s12958-018-0434-y

Rattan, S., Zhou, C., Chiang, C., Mahalingam, S., Brehm, E., & Flaws, J. A. (2017). Exposure to endocrine disruptors during adulthood: Consequences for female fertility. Journal of Endocrinology, 233(3), R109–R129. https://doi.org/DOI: 10.1530/JOE-17-0023

Silvestris, E., Lovero, D., & Palmirotta, R. (2019). Nutrition and female fertility: An interdependent correlation. Frontiers in Endocrinology, 10(346). https://doi.org/10.3389/fendo.2019.00346

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