Preconception care offers support to couples with fertility problems and also for those who simply want their child to have the healthiest start to life. Our aim is not only to improve the chances of conception, but to also improve the chances of a natural and healthy pregnancy, birth and baby.  Starting by providing you and your partner’s bodies with nutritional ‘building blocks’ necessary for a healthy embryo we then work through the following:

• Toxicity and detoxification
• Healthy ovulation and charting the menstrual cycle
• Male fertility
• Reproduction dietary guidelines
• Stress management
• Optimizing conception- timing and techniques

At present it is estimated that 1 in 6 couples are infertile. This statistics are staggering, and unfortunately on the rise each year. It is thought that many of these issues are related to a Western lifestyle that has deteriorated rapidly. We live in a ‘toxic’ society. Environmental pollution, polluted water, toxic farming methods, chemicals, radiation, heavy metals are frequent problems. Nutrient levels in the soil are poor, we live sedentary lifestyle and don’t compensate with adequate exercise. Sugar, caffeine, alcohol and food additives are high in our diets. Add onto this the stress of progress and it becomes obvious as to why our modern lifestyle is affecting fertility levels. The approach is quite obvious- we simply want to bring prospective parents health back to optimal before conception takes place thereby giving your child the best chance of health and start to life!

The program consists of a monthly appointment for 4 months prior to conception. The reason that we advise on at least 4 months of preconception health care is to ensure optimal health of the sperm and egg. Sperm can take 116 days to generate and during this time are easily susceptible to damage. Similarly, the egg is vulnerable during maturation for around 100 days leading up to ovulation.

Fertility complications

 It is becoming more and more common for couples to experience difficulty conceiving a healthy child.

 Factors which can affect fertility health include but are not limited to:

• Environmental and lifestyle toxicity
• Nutritional deficiencies
• Age
• Stress
• Infection
• Immune problems

The same problems which lead to increased rates of infertility in developed nations also lead to increased rate of chronic health problems in our children, and the adults they become.

Conditions that natural medicine can be of assistance to which affect fertility include but are not limited to:

• Endometriosis
• PCOS
• Hormone imbalances
• Thyroid disease
• Blood sugar levels problems
• Obesity
• Immune problems
• Fibroids
• Amenorrhoea
• Problems with sperm (e.g. motility, morphology, count, etc)
• Varioceles
• Stress

Preconception Care

Preconception care involves the promotion of optimal health of ideally both partners in the time before conception.  This may include detoxification, nutritional and herbal supplementation, acupuncture and diet and lifestyle changes.

There is research showing the benefits of a good preconception care program in chances of conceiving, reduction of complications during pregnancy and birth and promotion of excellent health in the fetus and child, which continues into adulthood.

Preconception care aims to:

• Prevent congenital defects
• Prevent chronic health conditions such as asthma, allergy, immune dysfunction
• Support a healthy robust immune syndrome
• Support your child’s ability to resist damage from environmental and lifestyle toxicity
• Support the nutritional health of your child
• Ensure good fertility of your child

Couples are having children later and later (for various reasons) and a consequence of this is an increased difficulty conceiving, and increased risks of pregnancy complications and health problems in the child.  The good news is that the factors that cause this can be reduced with a good preconception care program.

Epigenetics

Diet and lifestyle has a big role to play in fertility.  Not just for you, but for your children and grandchildren’s fertility.  What you eat, drink and do in the 4 months leading up to conceiving affects the genetics of your offspring and their fertility health.

It can be pretty scary to think about, but what your grandparents ate and were exposed to can have an affect on the DNA of your offspring. There isn’t much you can do about that, but now we have the awareness of epigenetics it’s ideal to take steps to do everything to can to set up a good environment for conception.

For a bit of extra reading on epigenetics check out my previous article here.

If you are thinking of having a baby and you want to give yourself the best chances and give your child the best start in life, contact us today to start a preconception program.

Preconception Care Frequently Asked Questions

What is preconception care?

Put simply, preconception care is to ensure, as much as possible for any given couple the presence of all the factors required for fertility and creation of the healthy fetus and the absence of all the factors detrimental to fertility and for formation of a healthy fetus

Preconception care aims for the optimum general and reproductive health of both partners to ensure good fertility and the health of the egg, sperm and the womb.

It is the ultimate preventative medicine.  By undertaking preconception care you are reducing your risks of complications and promoting the health of your future child.

Who should do preconception care?

• Anyone planning to conceive can benefit, whether there have fertility issues or not.
• Both prospective parents (see below)
• Older parents
• Those who are overweight or obese
• Those with a history of environmental toxin exposure
• Those with a history of fertility problems, miscarriage or still births
• Those with a history of genetic defects, physical or mental health problems in their previously conceived children.
• Women who have previously been on medications which can cause nutritional deficiencies such as the oral contraceptive pill or methotrexate.
• Those undergoing IVF. Couples undergoing IVF are often having problems with egg and/or sperm quality, older in age, or have other factors affecting fertility health.  IVF is also associated with increased risks of genetic problems, pregnancy complications and miscarriage rate –  preconception care can help to reduce these.  Preconception care can also improve the success rates of IVF (saving you time, anguish and money).

What are the benefits of preconception care?

It can reduce risks of fertility, miscarriage, fetal defect, and unhealthy children.

It can also improve the chance of healthy conception, a healthy and full-term pregnancy, a natural, intervention free birth, reduce problems post birth such as post natal depression, and support long-term breastfeeding.

Comprehensive preconception care may reduce the risk of age-related sub fertility, miscarriage and fetal defects.

Diet and nutritional supplementation can affect genetics, reducing the rate of genetic conditions.  Essentially this means that good preconception care can switch off faulty genes in the developing fetus (like a light switch) and this benefit is passed onto their offspring as well.

By providing an optimally healthy environment, your child’s genetic blueprint will be strong and robust.  Not only will they be healthy children but that health continues into adulthood.  What a great gift for your child.

How long should I do preconception care for?

Preconception care should begin well before conception (minimum of 4 months) and continue through pregnancy and breastfeeding.

It takes 100 for eggs to mature and 116 for sperm to generate, so it is recommended that preconception care be undertaken for at least 4 months before you attempt to conceive.

The instant that egg and sperm combine an irreversible blueprint is formed for the development of the baby.  This blueprint is reflective of the health and toxicity levels of the egg and sperm in the 4 months prior to conception.

It is enough to just take Folic acid?

No.  Folic acid (the synthetic form of folate)  is well known for its ability to prevent neural tube defects – however folate is important for much more than this and it is NOT THE ONLY nutrient required during preconception and pregnancy. There are many other nutrients that have such as many important effects in preconcetion and pregnancy and are often forgotten – Vitamin B3 (Niacin), Iodine, Iron.

Additionally, too much folate taken without the rest of the other B vitamins can actually mask a deficiency of vitamin B12 – this can actually cause spinal development problems as well!

Some people have a genetic problem called MTHFR which affects their ability to convert folic acid to its activated form.  These people need folinic acid (the activated form available in Australia) and folate found in food (the naturally occuring form, not synthetic added form found in some packaged foods) and again this must still be taken with the other B vitamins.

While folate is very important, we require COMPREHENSIVE preconception care.

Should my partner do it too?

YES!  Sadly, many women incorrectly blame themselves for fertility problems and/or miscarriage.  Poor sperm health can contribute to miscarriage, genetic defects and fertility issues.  Problems related to sperm health do not end at conception.

• Sperm are more vulnerable than eggs because they are smaller, more exposed and are developed entirely within the present environment.
• Some studies have found that 75% of infertility is due to male factors.
• Sperm is at least 50% responsible for the health of the baby and the pregnancy.
• Studies have found certain conditions are linked to the health of the sperm such as leukemia, asthma, bronchial/respiratory system and mental development/disease.
• Not only does it affect fertility, miscarriage rate and the health of the baby, but poor sperm health can also affect the health of the mother during pregnancy. Partners of older males have been found to have an increased rate of pre-eclampsia, regardless of the age of the mother. So just because you have fallen pregnant in the past doesn’t mean the guy doesn’t have to help out too.

What is my partner doesn’t want to come to the appointment?

Ideally preconception care involves both partners.  However if for some reason the male partner cannot or will not undergo preconception care…  One partner is better than none.

What is I’ve already fallen pregnant?

Congratulations! Now take a deep breath, relax: just because I’ve been talking about how I think it is important for couples to undergo preconception care if they have the opportunity it does not mean that NOT doing it will mean you have an unhealthy baby or terrible pregnancy. There are plenty of healthy babies out there that were conceived accidentally or under non-ideal health situations, the human body is amazing!

Remember that preconception care is about doing the best you can do, and if you’ve already conceived then take the steps now to work on your health, read more about naturopathic support in pregnancy here.

If you are thinking of having a baby and you want to give yourself the best chances and give your child the best start in life, contact us today to start a preconception program.  

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10/1/15

Vitamin D for healthy blood sugar levels in pregnancy

If you’re not getting enough Vitamin D while you’re pregnant, your blood sugar levels may suffer. This could mean that you’re more likely to get issues with blood glucose and insulin regulation, which can lead to conditions such as gestational diabetes (1).

The worse the vitamin D deficiency, the worse the blood sugar level control is. (2) Vitamin D deficiency usually occurs when your blood levels become lower than 50 nmol/L, but personally, I suggest keeping them around the 90-120 level for optimal health.

Over 3 in 5 pregnant women in Australia have insufficient Vitamin D, and during pregnancy you need about 4-5 times more Vitamin D, as it has such an important role to play in the health of yourself and the baby (3).

Vitamin D is involved in the regulation of calcium metabolism, blood sugar levels (4), immune health and is also an important nutrient for keeping breast cancer risk low. Vitamin D is also well known for it’s involvement in bone health.

Pre-eclampsia, low birthweight, preterm birth, increased risk of post-partum depression and autoimmune disease are also associated with Vitamin D deficiency during pregnancy. (5)(6)

Why so many people are deficiency in Vitamin D despite living in the ‘Sunny Country’ is still not completely understood. Unfortunately Vitamin D testing has recently been removed from the Medicare rebate list (except in rare circumstances), so this is a test that will need to be paid out of pocket. Because of this, and also because of the high safety levels of vitamin D supplementation it’s likely that the best course of action during pregnancy is to supplement at a range of 1000-2000IU Vitamin D in addition to what is contained in pregnancy multi-vitamins, as well as getting smart sun exposure. (5)(7)

Tips on how to get vitamin D from the sun while still being safe:

• Vitamin D is best absorbed between 10am and 3pm.
• Get 7-10 minutes of sun exposure to arms and legs.
• Follow with SPF30+ sunscreen.
• Always protect the face.

Works Cited

The post Vitamin D helps blood sugar level stability during pregnancy appeared first on Alison Mitchell Naturopath.

Ladies, this one is for you.

Certain types of pads and tampons contain chemicals that may worsen period pain, cause allergic reactions and irritation, lead to pelvic inflammatory conditions and even fertility problems.  They have a huge impact on our environment, as some of their ingredients never break down.  In this article I will look at what these synthetic products are doing to our body, and discuss some of the alternatives that are available to us.

Tampons – Is this the most important item to choose organic?

Chances are, if you’re interested in your health and wellbeing you have decided to ‘go organic’ – you shop for organic fruits and vegetables, you limit your use of house hold chemicals, you might also use organic body products.  But for women, an often overlooked source of chemicals is through our sanitary items – pads and tampons.

Most conventional pads and tampons use a variety or blend of rayon (wood pulp), viscose (synthetic product) and cotton.  Some tampons are also coated in polypropylene (a crude oil derived plastic) to make them ‘slippery’ as well as to bind and contain the synthetic fibres together (pure cotton tampons are much stronger so will not disintegrate).   Cotton is actually quite a ‘dirty’ crop – it is the most heavily sprayed crop in the world (26% of the world’s pesticides are used on cotton!) so cotton products contain a whole host of pesticides.  These cotton products are then bleached with chlorine, which as a result leaves a by-product called dioxin.  Most sanitary products also have added chemicals to absorb odour or create fragrance, however these are also derived from crude oil products.

This may in fact be one of the most important items with which to choose organic, as our ‘lady bits’ are actually extremely capable of absorbing chemicals.  This is not good news for the health conscious, and to make matters worse these chemicals can actually increase period pain!

The pesticides from cotton, the polypropylene that coats and exists within the tampon and the dioxin from bleach combine to create a hectic combination of chemicals that increase inflammation in our ‘lady parts’ and can also lead to other health problems such as endometriosis and infertility.  These chemicals are also commonly responsible for causing irritation and allergic reactions down there, so going organic can result in a much pleasanter time of the month.

Consider this rough equation:

• A woman with a regular cycle will have 11-13 periods a year.  Assuming she has a standard menarche from 13, and enters menopause at 51, that’s 456 periods.
• Take out about 42 periods for an average of 3 children (9 months pregnancy, approx 5 months of no periods during breastfeeding) to reach 414 periods.
• The average women has a period for 3-7 days (so let’s say 5), and can use anywhere from 3-6 tampons or pads a day (so let’s say 5).  That’s 25 pads and/or tampons a period.
• 25 pads/tampons a period x 414 periods = 10,350 pads/liners in a lifetime (oh and don’t forget the thousands of liners we’re probably going to use as well!)

That’s a lot of pads and tampons, and cumulatively, a lot of exposure to chemicals that you don’t want down there!

Photo by Karl Wiggers on Unsplash

GOING ORGANIC

Nowadays, many people are making efforts to reduce their exposure to chemicals – for good reason.  Good quality research papers have shown that many pesticides in our food can disrupt hormones, nervous system health and our immune system, and in addition can lead to several cancers and conditions such as chronic fatigue syndrome.

Going on from this, we can extrapolate from the knowledge that eating chemicals is bad for us, so therefore applying chemicals to our skin is bad as well.  (Cue an abundance of body creams and lotions with ‘organic’ labels, and another booming industry fraught with misinformation that misleads consumers (organic body products are not regulated in the same way that organic foods are, and many products labelled as organic may still contain harmful chemicals) – regardless of whether it is labelled as organic we should still diligently check ingredients of products we choose, and buy from reputable companies/suppliers).  Using (actual) organic body care products is another good move; in fact it may be even more important than using organic food as our digestive system, when working properly has a lot of acids and enzymes (e.g. in our saliva and stomach) that help to break down and eliminate chemicals.  Our skin is an amazing organ, and it has a great capacity to absorb anything that we apply to it, particularly when it is rubbed on in an oily based i.e. a cream.  This comes in very handy when we want to apply therapeutic creams, however not so good when the creams contain nasties.

The mucous epithelial membranes that exist within regions such as the rectum, nose, lungs and vagina have an even greater absorptive ability than the skin, which is why pessaries and suppositories have such a fast and effective action.  In addition to this the blood supply from the vagina goes directly into the pelvic plexus (the same veins the ovaries normally empty into), so when certain hormones and chemicals are applied to the vaginal mucous membranes they are directed towards the uterus before they are assimilated into the rest of the blood stream(1).

Pads and tampons are a major source of chemicals, due to the excessive spraying of cotton crops.  Tampons that contain other fibres, such as rayon, can leave trace amounts of fibre and chemicals on the vaginal wall after removal – this is an issue for not only chemical exposure, but greater risk for toxic shock syndrome.  According to Dr. Philip Tierno, a Clinical Professor of Microbiology and Pathology at NYU Medical Centre, 100 percent cotton tampons “consistently test under detectable levels for TSS toxins.”(2)  This is because non-cotton products have a structure that is more likely to shed fibres.  In the attempt to bind these fibres together tampons are coated in a type of plastic coating called polypropylene.

Check out this video to see the different tampon types hold their fibres together.  These polypropylene chemicals do not break down or decompose.  Remembering how many tampons are used in a life time this could accumulate, potentially contributing to health concerns, but it the immediate sense it can also cause irritation of the sensitive vaginal area.  Vulvovaginitis is a problem that many women experience and if it is worsened by sanitary items, it can make that time of the month a very uncomfortable time.

I have experienced in both myself and my patients a significant reduction in period pain with the use of organic sanitary items.  While there is limited research on this matter, I theorise the pain reduction to be due to a few reasons:

• By avoiding the polypropylene there is less of a topical irritation, creating less inflammatory chemicals in the area.
• Insertion and removal of tampons cause micro-tears in the vaginal wall, in which tampon residue can remain.  Synthetic tampons have a greater likelihood of leaving residue and the nature of their fibres can be more irritating.
• The removal of chemicals which can mimic oestrogen can both reduce prostraglandin production as well as reduce the exacerbation of conditions such as endometriosis, pelvic inflammatory syndrome and fibroids.

WHAT ARE OUR OPTIONS?

Organic pads and tampons

There are several brands that use organic products, and organic cotton tampons.  While they are usually a little pricier than conventional brands, I personally consider it to be worth it.

Organ(y)c, TOM Organic and Natracare are good options.  TOM Organic is an Australia based company, and also offers ‘subscription’ service, a novel idea considering this is something we use on a regular monthly basis (ooh and they’re pretty!).  Other less widely available brands include Seventh Generation.

Reusable pads.

Reusable pads usually consist of organic cotton and come in a variety of shapes and colours.  They are clipped onto the bottom of the panties and when used, need to be soaked overnight then washed as per normal.  This is considered to be more environmentally friendly than disposable pads and tampons, and many women consider this to be more comfortable as well – they feel like normal underwear and are silent (no plastic crinkling sound).  While the need to wash these pads may turn some women off, the environmental benefits are good and these are a viable option for those who do not wish to use an insertable product.

Wemoon is an Australian based company that offers a variety of reusable pads.  Lunapads also offer products online in a variety of fun colours, and also stock liners.

Menstrual cups.

Menstrual cups are bell shaped silicon or latex cups that are inserted into the vagina to collect menstrual flow.  This is a concept that has been around for a long time, however it is not commonly used or known about these days, perhaps due to a perceived ‘ick factor’?

According to the Diva Cup website, once you have tried menstrual cups you realise that most concerns are unwarranted – i.e. a typical flow is only 30mL per day, therefore removing the cup really isn’t going to be like a scene from a horror movie, and menstrual blood only smells once exposed to oxygen, so using the cup isn’t going to create more of an odour (in theory it will be less so!).  They can take a few cycles to get the hang of, to ensure they are positioned correctly.

Menstrual cups do have an impressive list of benefits – they are good for the environment, they can be kept in for 12 hours, reduce period pain (see above) and save money in the long term (while they cost about $60 to buy outright, they can save you up to $150 a year compared to buying disposables).

A good brand is the Diva Cup, which is approved by TGA in Australia.  Other brands include JuJu, Lunette, The Keeper (made from rubber) and The Moon Cup (made from silicon).

EDIT 3/10/17: I wanted to share my personal experience with a menstrual cup. Not long after writing this article I invested in a Diva Cup, and I can share with you that it has made my time of the month much easier, as having to change the cup only once in the morning and night means I can essentially forget about my period while I am out and about. I also have not had to buy any tampons, and only bought about 2 packets of pads (excluding maternity pads for post-partum) in the 4 years since getting the cup. I used to experience a lot of period pain, and when starting to use this I did notice there was some discomfort on the days I was worse, so I chose to use a pad on those days, however as time has gone on I now don’t have any period pain (I think due to improving my chemical exposure, using herbs, exercise, yoga and having a baby) so I can use the cup for my whole period. I used to have to wear a liner with it during the night and on day one of my period, but not at the moment. I found that it took a few cycles to get practiced enough to insert it confidently, having to learn the right angle to put it in and how to hold it so I could twist it into position, but now I can do it easily. I have on occasion had to change it whilst away from home but it is easy enough to do, I just tidy it up with some toilet paper and give it a good clean when I get home. I did read some reviews that the cup stains, but I haven’t found that to be the case, and this is 3+ years later. I also have been fine to exercise with it in, as long as it is inserted correctly to begin with. So essentially, I would definitely recommend getting a menstrual cup!

Absorbent Underwear

Companies such as Modibodi and THINX offer underwear that has absorbent section where a pad would be. They can be worn as a back up for menstrual cups or tampons, or on their own for those with a moderate-light flow. You can choose the type of absorbency that’s right for you – the range goes from 2.5ml absorbency (1/2 tampon) to 10-20mL (2 tampons).

They are reusable, so great for the environment, and save money for you over time. For athletes who don’t like wearing pads, tampons and cups during exercise, this is a great option.

Other options (that I haven’t research too extensively…)

• Reusable tampons (hard to find, most I’ve seen appear to be knitted, could that could be your next craft project?)
• Sea sponges (think re-usable tampons from the sea)
• Free bleeding (you were just going to wash those clothes anyway, I guess?)

Have you tried some of the less conventional options?  Or have you noticed a change from using organic pads and tampons?  Let me know your thoughts.

Works Cited

1. Touitou, Elka and Brian, W Barry. Enhancement in drug delivery. Boca Raton, Taylor & Francis Group : CRC Press, 2007.

2. Women Beware: Most Feminine Hygiene Products Contain Toxic Ingredients. Mercola.com. [Online] 22 May 2013. [Cited: 6 November 2013.] http://articles.mercola.com/sites/articles/archive/2013/05/22/feminine-hygiene-products.aspx.

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