Endometriosis

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Gestational diabetes is diabetes which affects a pregnant woman. It occurs during the second part of pregnancy and goes away once the baby is born[1]. 

Throughout our lives, one of the vital functions our body has is to produce insulin to maintain our blood glucose levels. When our blood glucose levels are too high i.e. when our body does not make enough insulin to bring down blood glucose levels, we become susceptible to being affected by diabetes. 

During pregnancy, hormones are made in the placenta to help the baby develop and grow[2]. During this time, these hormones produced in the placenta block the action of the mother’s insulin from working properly resulting in insulin resistance. This results in the mother’s body making even more insulin to ensure blood glucose levels are kept at the optimal level. The demand of insulin to keep blood glucose levels increases throughout pregnancy and if mother is unable to produce enough insulin to meet this demand, blood glucose levels rise and gestational diabetes develops. 

Development of gestational diabetes can occur in anyone but is more prevalent in women who:

• are older
• have a family history of type 2 diabetes
• overweight, and 
• are from certain ethnic backgrounds such as South Asian, Middle Easter and Chinese[3].

Management of gestational diabetes is important, because if uncontrolled, it may result in problems during birth as well as increasing the baby’s risk of being overweight (due to glucose crossing the placenta stimulating the baby’s pancreas to produce extra insulin) and developing type 2 diabetes later in life. 

Management strategies include[2]: 

• Constant monitoring of blood glucose levels
• Healthy eating (avoiding foods containing a lot of added sugar) 
• Regular physical activity 
• Education about how insulin works.

References

[1] Pregnancybirth&baby (2019, August) Gestational diabetes pregnancybirthbaby.org.au/gestational-diabetes

[2] Better Health Channel (2019, November) Diabetes – gestational betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-gestational

[3] The Royal Women’s Hospital. Gestational diabetes thewomens.org.au/health-information/pregnancy-and-birth/pregnancy-problems/pregnancy-problems-in-later-pregnancy/gestational-diabetes

Sexual intercourse is a time of intimate sharing that can be fun and exciting. It is an important part of a relationship. When this becomes less frequent than at least one party desires, or there is a reduction in the quality of the time spent together, this can lead to issues in the relationship.

Low libido (low sex drive) or libido loss is defined as a loss of interest in sex that is persistent and won’t go away outside of the normal fluctuations of your sexual desires. Loss or reduction of libido can be experienced at any age and can be caused by a range of factors, both physical and psychological. 

Loss of interest in sex is a common occurrence in both males and females[1].  Low libido causes distress in one third fo middle aged women, and 15% of 60 to 80 year old women[2]. Reduction in libido may be due to a range of factors both physiological and physical. 

1. Physiological factors include: 

• Anxiety
• Depression
• Fatigue
• History of physical or sexual abuse
• Illness
• Low self esteem
• Mental health problems such as anxiety or depression
• Poor body image and 
• Stress related to finance, work, or other issues

2. Physical causes in females may be due to:

• Changes in hormone levels during menopause and pregnancy 
• Contraception
• Fatigue
• Lifestyle habits such as drinking too much alcohol or smoking
• Pain during sex 
• Medications such as antidepressants 
• Menopause 
• Pregnancy
• Vaginal dryness

For men there may be:

• difficulty in achieving and maintaining an erection and 
• premature/delayed ejaculation in men[3]. 

In many cases, low sex drive may be due to your relationship. If you are unhappy in your relationship or the sex you are having is disappointing, it is likely your willingness to engage in sex will be reduced. There are many causes of libido loss, with varying strategies to manage and treat low libido. This can range from open communication with your partner, seeking couples counselling, hormone therapy (if appropriate), lifestyle changes, stress management and acupuncture.

As the desire for sex dramatically varies between individuals, there are multiple strategies to treat reduced libido. Professor Yoland Lim Health Care has a range of multiple management strategies. These may include professional counselling, hormone therapy, learning different sexual techniques, treatment for underlying illness (not limited to antipsychotics or antidepressants), stress management[4] improving relaxation and mental health and wellbeing.

References

[1] Health Direct (2017, October) Loss of male libido. racgp.org.au/ajgp/2019/april/insomnia-management

[2]  Healthed (2022, September). Trialing testosterone for postmenopausal women.  Healthed.com.au/clinical_articles/trialing-testosterone-for-postmenopausal-women/ 

[3] Better Health Channel (2018, July) Libido. betterhealth.vic.gov.au/health/healthyliving/libido

[4] Royal Australian College of General Practitioners (2017, February) Let’s talk about sex. The joy of life Vol 46 (1) 14-18. racgp.org.au/afp/2017/januaryfebruary/lets-talk-about-sex/

The commencement of menstruation (periods) (known as menarche) affects every woman with the typical onset between the ages of 11 to 14 years old[1]. The menstrual cycle is controlled by a number of different glands and hormones controlled by a region in the brain known as the hypothalamus and consist of four main phases: 

1. Menstruation (the elimination of the thickening lining of the uterus or endometrium from the vagina) 

2. Follicular phase

3. Ovulation

4. Luteal phase

Although menstruation affects every woman, the experience can differ significantly. This may be due to factors such as duration, pain (dysmenorrhoea), lack of periods (amenorrhoea), menstrual bleeding and irregular periods. If any of these conditions persist over an extended period of time, it is recommended to visit a health care professional[2]. 

Common symptoms leading up to menstruation include: 

• cramps or pain in the lower abdomen
• tiredness
• acne
• diarrhoea
• bloating in the abdomen, and 
• constipation before menstruation[3]

Furthermore, as menstruation is heavily controlled by hormones, women may experience premenstrual syndrome (PMS) whereby a range of side effects can occur before a period such as headaches, irritability, fatigue, breast tenderness and fluid retention. 

References

[1] Better Health Victoria (2018, August) Menstrual cycle betterhealth.vic.gov.au/health/conditionsandtreatments/menstrual-cycle 

[2] ABC Health and Wellbeing (2013, August) Fact File: Period problems abc.net.au/health/library/stories/2006/10/11/1831478.htm

[3] Health Direct (2018, May) Menstruation (Periods) healthdirect.gov.au/menstruation

Labour (childbirth) can be a very satisfying experience, however for many there is usually significant discomfort involved. For women who are having their first baby, the experience and consequently the reaction to labour may be unpredictable or varied. 

There are a multitude of options available for pain relief, both medical and non-medical. There are three main medical drug pain-relieving options for labour[1]:

1. Nitrous oxide known as laughing gas

2. Pethidine

3. Epidural anaesthesia 

Natural pain relief options include TENS, aromatherapy, relaxation techniques, water immersion and acupuncture[2]. A medical study published in Cochrane medical journals investigated the effectiveness of acupuncture for pain management during labour and found acupuncture may increase satisfaction with pain management and reduce use of pharmacological pain relief[3]. Another study confirmed these findings with acupuncture reducing the level of pain during labour[4]. 

Professor Yoland Lim was the first to give acupuncture to assist in the birth of a baby in the 1970’s in Australia. 

References

[1] Better Health Channel (2014, August) Childbirth – pain relief options betterhealth.vic.gov.au/health/HealthyLiving/childbirth-pain-relief-options

[2] Health Direct (2020, January) Non-medical pain relief during labour pregnancybirthbaby.org.au/non-medical-pain-relief-during-labour

[3] Smith et al (2020, February) Acupuncture or acupressure for pain management during labour cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009232.pub2/full

[4] Lee (2004, November) Acupuncture for labor pain management: A systematic review ajog.org/article/S0002-9378(04)00510-1/pdf

Polycystic ovaries is a common condition that may be confused with polycystic ovarian syndrome (PCOS). Polycystic ovaries is the presence of multiple cysts in the ovaries, whereas PCOS is the condition which not only includes the presence of multiple cysts in the ovaries, but also other symptoms, which determine then if PCOS is diagnosed by your medical practitioner. 

The reason for the development of polycystic ovaries (ie multiple ovarian cysts) is unknown and in many cases may be asymptomatic[1]. 

Although similar in name, polycystic ovaries and PCOS are quite different in a number of ways. 

1. Whilst PCOS affects roughly 12-21% of women of reproductive age, polycystic ovaries occurs with up to 1 in 4 women of reproductive age. 

2. PCOS often is accompanied by symptoms whereas polycystic ovaries are generally asymptomatic and is typically discovered incidentally

3. PCOS is linked to a hormonal disorder whereas having polycystic ovaries is not and may be caused by a variety of factors. 

References

[1] FertilitySA (2017, November) Polycystic Ovaries & PCOS fertilitysa.com.au/service-post/polycystic-ovaries-pcos/

Labour is the process of giving birth and is divided into three stages[1]: 

1. The first stage where the cervix is dilated. In this stage the cervix softens and becomes quite thin. Symptoms and signs include lower back pain, loose bowel motions, period-like pain that comes and goes and a sudden gush or slow leak of fluid from the vagina.
2. The second stage describes the period where the cervix is fully dilated to when the baby is born. Here, contractions may be longer and stronger, there may be a desire to push, increased pressure in your bottom and a stretching and burning sensation in your vagina. 
3. The third stage begins when the baby is born and finishes when the placenta is delivered. Commonly, more contractions are experienced in this stage in order to expel the placenta. 

Studies have identified the beneficial role acupuncture like Professor Yoland Lim’s Fong Yang therapy, can play in preparation and induction of labour[2]. The effects of acupuncture during this period have shown to ripen the cervix, initiate labour, and reduce labour pain[3]. Studies investigating the effectiveness of acupuncture in preparation of labour have shown this treatment is effective in inducing labour as it can increase the readiness of the cervix[4].

Furthermore, acupuncture treatment in pregnancies in women over the age of 40 has shown positive effects on pregnancy and delivery[5]. As pregnant women over the age of 40 have higher risk factors for both the mother and baby, in these women, acupuncture prior to labour resulted in spontaneous natural vaginal births. 

Professor Yoland Lim Health Care treats patients in conjunction with Obstetricians who are delivering babies.

References

[1] The Royal Womens Hospital. Stages of Labour thewomens.org.au/health-information/pregnancy-and-birth/labour-birth/stages-of-labour

[2] Lim et al (2009) Effect of acupuncture on induction of labor doi: 10.1089/acm.2009.0100

[3] Curtis et al (2006) Acupuncture for Birth Preparation and Delivery: How Investigating Mechanisms of Action Can Generate Research doi.org/10.1177/1533210106298060

[4] Smith and Armour (2017) Acupuncture or acupressure for induction of labour doi.org/10.1002/14651858.CD002962.pub4

[5] Handayani (2019)Pre-Labour Acupuncture for Delivery Prepation in Multiparous Women Past Age 40  doi: 10.1089/acu.2019.1357