Guts and Girl Bits Episode #55

In this episode of Guts and Girl Bits, Raul Pastrana joins us to discuss sperm health. An incredibly important but often overlooked aspect of fertility, we discuss the importance of looking into sperm health at the start of the fertility journey, what can go wrong with sperm health (and why) and some tips to improve it. Sperm issues can contribute to ~50% of fertility issues, as well as contribute to many issues during pregnancy. The quality of sperm also has a massive impact on the health of the child, influencing many things including their immune health, reproductive and neurological health.

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About Raul

Transcript

Because when we talk about fertility, we so often focus on the female side of things, our cycles, our hormones, our eggs, and we forget that sperm health plays a huge role, not just in the ability to conceive, but also in the health of pregnancy. And even the long-term health of the child. Sperm health has been linked to pregnancy outcomes like miscarriage and preeclampsia, and what’s fascinating is that while women are born with all of their eggs.

Eggs that were actually influenced by our grandmother’s health. Men are constantly making new sperm every few months, so that means that there’s a much faster impact on our offspring based on what is influencing the genetic expression of the sperm. [00:01:00] So lifestyle, nutrition and environmental factors can all have profound impacts on sperm quality, which in turn shapes not only fertility outcomes, but potentially even the health of and the development of our future generations.

So now that doesn’t necessarily mean that we’re talking about like evolving mutant powers anytime soon, but we are talking about how the choices that men make today can influence things like neurological, mental, and immunological impacts of our future generation and our future children. So to dive into this fascinating and often overlooked topic, I’m joined by Raul Pastrana.

Raul is a degree qualified naturopath. Specializing in fertility and reproductive health, he focuses on helping individuals and couples optimize their fertility with a particular emphasis on male reproductive health, which is a factor that’s often underestimated when it comes to conception outcomes.[00:02:00]

Raul works closely with patients through IVF Preconception Care and Natural Conception. He creates tailored plans based on each person’s unique presentation and goals, and importantly their blood pathology and semen analysis result. He’s also the author of the Sperm Factor Fertility, A Shared Responsibility where he explores how men can influence fertility outcomes and provide practical, strategies to improve sperm health.

So in our conversation today, we talk about why it’s so important to look at sperm health early in the fertility journey, some of the key factors that influence. Sperm quality and why what’s considered normal on a semen analysis might not actually be optimal. Raul will also share some really actionable tips on how men can start to improve their sperm health today.

So whether you are on your own fertility journey, whether you’re supporting a [00:03:00] partner or you’re just curious about how male reproductive health fits into the bigger fertility picture and evolution, this episode is full of insights that might just change the way that you think about conception and reproductive health and wellness.

So let’s get into it.

Thank you so much for joining me today.

Thank you for having me. It’s a pleasure.

But now we’ve got. On the podcast, we can really shine, shine some light on what is the actual relevant information that people can action. How can we do things about it? So I’m really excited to get into this.

Has had multiple blood tests, is already taking a few supplements because she has done some investigations to what could, what can she do in order to improve her outcomes. But in many cases, the male factor is under assessed undertreated and also under research.

And this is really puzzling as a practitioner because the research is telling us that this is wrong.

50% of all fertility cases are related with the male factor. So there is, at least from all the infer, uh, infertility issues out there, 50% of them, there will be some. Male factor contribution. And this is why if a couple is having trouble conceiving, both sides of the equation need to be investigated at the same time in order to have the best fertility potential and the best outcome.

And in that semen analysis that is just the most basic, uh, start, we need to assess, uh, the most common findings, which may be, um, your listeners are already familiar with, which are the semen quantity or how much, how much sperm is there in terms of concentration.

Mm-hmm.

But also how is that sperm moving that motivity.

And last, how is the shape or the morphology of that sperm?

So these are usually the three factors that they are first assessed when the Mel factor is assessed at all. If so.

And that’s where, where everyone should start with,

That’s, uh, [00:07:00] that’s the baseline. The one thing that I will say, it gets overlooked. More often is the DNA fragmentation as well. So the DNA fragmentation, it’s a test that can be done in the sperm to understand what percentage or how damage, uh, is the genetic material inside of the head of the sperm. So if the genetic material inside of the head of the sperm is fragmented, that’s gonna have repercussions for.

Conception, fertilization uh, pregnancy outcomes and the future health of the baby. The DNA fragmentation think about it as a, if the DNA is broken, the instructions to make the baby and the instructions for fertility outcomes, they’re not gonna be as good as we want them to be.

Mm-hmm.

So we want to make sure that we are addressing all the factors that they’re affecting male fertility, to [00:08:00] make sure that the copies of the DNA inside of the head of the sperm as are intact as possible.

And the thing is, it’s just much more easy to get it done all together. On the first analysis, so the then there is not, uh, need to pay again to get again to the clinic. So it’s better if you haven’t done one yet. And fertility is a concern I always recommend to include DNA fragmentation inside of the panel.

I completely acknowledge that finances can be a barrier, but when you think about the cost of some of these very expensive and very invasive. Artificial reproductive technique interventions paying a hundred of dollars to understand the quality of the DNA in that sperm it is in the scale of things is not that much.

And does it swim correctly and swim fast enough?

Mm-hmm.

Because it’s not just about the sperm, be able to move, but move in a, in a straight direction. So the egg, so the sperm can meet the egg, usually in the fallopian tube.

And then they can be fertilization of the egg.

Because I’ve seen it and, but you would have the data on that.

Since the year 2000, so is sperm is not only declining in quality, [00:12:00] it’s also declining faster than it used to be since the year 2000. Um, and because the average male. Sperm, it’s has a such a poor, low, low quality. Then when we are, when we are creating those reference ranges, we’re, we’re comparing ourself with a sample that is not very good in quality.

Anyway, so I dunno if you know how those reference ranges were established, but in the year 2010, the World Health Organization um, did a study with over 4,000. Men from 14 different countries, and all of those men were able to conceive with a female partner in less than a year. And then they analyzed the data from sperm concentration, sperm morphology, and sperm multi for those 1400 men, and then divided from the lowest quality to the highest quality.

And they divided in percentiles [00:13:00] and they established that. The fifth percentile was the normal range, uh, and that’s what was established as normal reference range.

Not really normal will be the medium and the medial should be the 50 percentile, not the fifth percentile.

Mm-hmm.

And if you’re trying to assess that, it’s better to compare it with the 50th percentile. Yeah. So for example, for spare concentration, it’s still of 15 million. One five. You want to get closer to 73 million like you just said.

And for morphology is the same, only 4%. It’s enough to pass only. You only need a 4% of your sperm to have optimal multi uh, morphology in order to pass the test. And don’t get me wrong, you don’t need, uh, this parameter of morphology doesn’t need to be close to the a hundred percent whatsoever. It is very normal to have a morphology on the 10%.

Even 9% is it’s enough to to have a good fertility potential, but the [00:15:00] 50% I will be 15%. So you see the huge disparity that is between what is considered normal or what the reference ranges were established and what actually health and good fertility potential represents.

Men get told, you’re fine, you’re in the reference ranges. But we do wanna aim for a little bit better. We want super sperm. But I was thinking, and when I was researching for this, I actually realized that humans are the only species that have such a low average morphology. Mm-hmm. Compared like animals, their morphology is pretty much always like 99% normal.

We are our nutrition as an overall society and the quality of our diets is declining. The quality of our food supply, it’s, uh. Poorer than ever before with more, like I said, endocrine disrupting chemicals in the food supply. So all this is having an effect not only in morphology, but in all the other parameters.

And look what I always say to my patients or to anyone that is thinking about improving their sperm health, you want improve. Your particular circumstances, if you don’t identify the barriers and those barriers will be different from you than from someone else. Even though there are some commonalities, it’s important to do a thorough investigation to see what is affect, why your sperm health has been affected.

Mm-hmm.

And [00:17:00] things won’t get better because you take a very fancy supplement from the internet. That’s not how it works.

But taking just sup, a random supplement with really good marketing behind it is not going to solve the issue.

So that’s one of the major things that causes the damage at that point, isn’t it?

Mm-hmm. So that’s why if there is high level of stress, if there is chemicals, a sperm synthesis is the first thing that can go. And it’s a pro, this sperm synthesis or a spermatogenesis, it’s something that takes around 72 to 74 days to fully develop. And I think this is a really important takeaway from anyone listening because your spend results.

Can be highly influenced by you making the right things. So if alcohol intake is the problem, if stress is the problem, if sleep is the issue and you resolve and address that factor, you can see results. In your [00:19:00] sperm quality and quantity in only three months because of that constant and dynamic process that is happening in the, at the testicular area.

So renewing those those sperm cells every 72 to 74 days.

And just a note about what you said. So yeah, it’s a very delicate process that can be affected and influenced in many different ways. But from those 72 days, like you mentioned, very correctly, the last 15 days when the sperm is going through the final the final track in the reproductive male system is highly, um, highly and easily damaged.

Hmm. So it’s at that stage where we want to be extra careful. What are we putting in our bodies? Alcohol intake, stress, et cetera. So what I do with my patients, if, especially for those that they’re gonna freeze their sperm and their sperm is gonna be used for XE procedures or IVF [00:20:00] procedures, I give them a high level.

Of antioxidants such as vitamin C, coq 10, lipoic acids, uh, nicotinamide riboside, and many others. Do. So we protect that testicular environment, uh, and that sperm going through the last 15 days before ejaculation.

So the DNA is intact. The morphology and the motility is as good as we, as we can.

I, um, wanted to share something that I found really fascinating when I was researching this is that when they are in the, um, epididymis, which is basically like a big, like collecting duct after they’ve gone through the testes. It’s like an a training center that they go through where they learn to swim really well and their [00:21:00] immune system changes.

And I saw some stuff where they said they, they took the sperm from the testes before they got to that point, and then they, they, but inseminated a woman with it and the immune system killed it straight away. Whereas after, had it been through the epididymis, it, it didn’t. Um, but we can talk about that immune onslaught of the sperm later because that’s also really interesting.

But they learned to, so they learned to swim. Their immune system develops and they learned to smell. How amazing I found that was just like so fascinating and that they learn to detect the smell of follicular fluid. And just like a shark, they can find one part per billion follicular fluid and this z and that’s how they know how to go.

And I was just like, I had no idea beforehand that sperm could smell.

So it’s believed that the egg is, some is releasing certain chemicals that, like you said, they are in such a low quantity, but the sperm can. Sort of smell them. Uh, and be attract to it. So it’s really fascinating. And like you said, the that training and that capacity to to have that sense is is highly influenced for what’s happening in the last 15 days before the sperm is ejaculated.

Um,

so like you said, it’s like a training center. It’s like the sperm are going through the gym in LA in those 15, last 15 days.

And that, that is where a lot of that [00:23:00] olfactory sense comes in as well, which is so super interesting too because of how we know that like, for instance, the microbiome of the oral health. And the re um, gastrointestinal health, that all influences reproductive health as well.

Uh, but we can also do a vagina microbiome. Mm-hmm. And that can give us some insight into if there are any immune. Factors that could be negatively influencing fertility potentials. And, um, there is still so much data coming out. There is a lot of science and a lot of money that needs to be still put on.

So we hit better and more quality studies regarding this, but it is clear that, for example, from the female, the vagina microbiome of the female in order to have a good [00:24:00] 30 degree potential needs to be lactobacillus dominance.

Mm-hmm.

So we know that much. And, and that will easy, that will have a huge influence to whether or not the sperm can actually fertilize.

Like we said, that motility needs to be happening. If there is not progressive motility, which is. Swimming on a straight, uh, on a straight line is not gonna reach the egg. So the, uh, the egg has been is released obviously from, from the ovary and travels to the fallopian tube. The sper, uh, the sper is ejaculated [00:25:00] and starts swimming.

The process of swimming usually takes around two days. In order for the sperm to reach, uh, the egg, and that’s when usually fertilization of the sperm in the egg happens in the fallopian tube. If everything is going well, then that embryo already created, starts traveling slowly towards the uterus.

And in that process of traveling, which can last around five to six days, the embryo starts developing in and subdividing and. Going through a process of cell division into something called blastos. It is the blastos then that arrives to the endometrium. And uh, and if everything is going well, there is good endometrial lining.

There is good endometrial receptivity and there is also good endometrial microbiome. Again the immune system having an influence to whether or not. The, that embryo will be able to attach itself to [00:26:00] that endometrial lining and create a pregnancy and hopefully a healthy pregnancy.

And on the way to get there, it has to sort of go through a bit of an immune onslaught, doesn’t it, from the woman’s immune system.

Nor bad. We need good levels of inflammation when we have, if we cut ourselves or or if we have an a pathogen in our system. But when inflammation is not resolved, becomes chronic, and if, um, there is chronic inflammation that’s gonna, uh, activate [00:27:00] chronically the immune system. Now, the process of pregnancy.

Is highly sensitive to this to immunity. So we need to be able to lower our immune defenses in order for that embryo to attach to the endometrial lining. And if notice is not going to happen, if that is constant hyper surveillance because of that low grade chronic inflammation the embryo will be rejected.

And I advise all my patients to get test. The DNA fragmentation on their first semen analysis sperm antibodies is on the other hand not my first line of, uh, assessment if for, that’s

Then we can investigate that.

What I would say with experiment antibodies is one of other little thing that, uh, will come in most cement analysis is something called agglutination, and [00:29:00] that is how is the sperm behaving the whether. They’re all together in the sample or, or not. And if agglutination of the sperm is very high, then I always test that.

Semen antibodies, sperm antibodies.

Um, and so the whole concept of like a woman having to lie down for a period of time after sex, like, so women, I think that they have to lie down for like, you know, half hour or an hour or something like that. Whereas it’s really not that long, um, because of how sticky it is. But I, that comes from like.

Like way back evolutionary times when a bit like a praying mantis or a spider, like the man’s gotta get in and run.

It’s such a hot environment which causes the damage that oxidative stress.

And what a baril is, is nothing else than at function of the cardiovascular system. So it’s, um, part of the cardiovascular system that is not working well. So if it’s not working well, the blood that is arriving to the testicles to bring in nutrient. Reach and oxygen reach blood and removing waste products is not working well.

The other thing that an optimal cardiovascular system is doing at the testicular area is, uh, making sure that there is no rise in a scrotal temperature like you just mentioned. So. Again, we, we were talking about evolution and, and why things are the way are so, females, they have their ovaries inside of their body and that’s because the process of egg production and egg maturation doesn’t require different temperature than body temperature.

Um, for, for male [00:32:00] fertility, the process of experi nitrogen is requires around two degrees lower than. Total body temperature. So that’s why the male go nuts are hanging out,

right?

Mm-hmm. Now, if for whatever reason that temperature rises, one of the things would be vari cell because there is not enough.

Um. There is not enough blood flow, and blood flow is not optimized. Uh, but another thing is w wearing tight underwear, uh, being sitting for long periods of time, pushing the testicles towards the body, going to saunas, all those factors are gonna negatively influence the quality and the quantity of the sperm.

And what you were saying about you know, the cardiovascular, uh, the system and the vari cell. If we think about it, what is the number one cause mortality for men worldwide. It’s actually, poor cardiovascular health and cardio cardiovascular events. I mean, unless that it has changed [00:33:00] recently.

If it’s not, the number one is at the top, at the top there. So one dysfunction that happens from having issues with the cardiovascular system is having vari cell, which again, has a huge influence in sperm health. And the way to assess whether or not someone has vari cell ultimately is with an ultrasound of the testicular area.

Treatment, isn’t it?

Mm-hmm. Um,

and this is based on research and unfortunately, some couples don’t have their, that time on their hands. And then instead of, uh, surgically removing the Barco cell, other options are offered like IBF or other artificial reproductive techniques.

Tell me your clinical history. You have you had any major, uh, health events? Do you have any? Diagnose medical condition because that’s obviously gonna have a huge effect on your sperm health. So that’s how I start a consultation, letting the person speak. And if they haven’t talked about this, then I always chat about what I consider the pillars of health.

So that will be how is your nutrition, how is your sleep, how is your stress management? And are you exercising at all If those are not addressed. Usually I start from there.

Mm-hmm.

Uh, improving their diet, improving their sleep, their stress management, which goes hand in hand with the sleep. And then I always encourage someone to start exercising if they’re not exercising at all.

Little by little, so that will be the way that I think about a consult. But a above and beyond the four pillars of health. There are so many other [00:36:00] things affecting a sperm quality. One of the things that I speak a lot in my, in the book that is coming out, the Male Factor and why fertility should be a shared responsibility is about the role that pharmaceuticals play in, in, in male fertility.

For example the use of antidepressants has been linked with poor semen analysis. I remember this particular case for one of a patient that I had, um, a couple of years ago. Uh, this person was having this male patient was taking 150 milligrams of an particular SSRI, and then we analyzed.

Many of the other factors that could be influencing him, his diet, his sleep whether or not he had nutritional deficiencies, whether or not he had low testosterone, which obviously also influences sperm health and everything came as [00:37:00] normal. Nothing, nothing else than the antidepressant was an alarm bell.

So I obviously gave her, gave this person high level of antioxidants. Um, I gave him a multivitamin, an Omega-3 to make sure that we were protecting that testicular environment and giving a mass of the nutrients that the sperm that the, the body needs to create this sperm. But then the one thing that I work with.

As well as in conjunction with his doctor is to slowly reduce the dosage of the SSRI. And this is a case to case, uh, scenario. Some people, unfortunately, they cannot reduce the dosage of their antidepressants because they really need it, but in this particular case. The patient was open to, to try, and we worked together making sure that his his neurotransmitters were repleted, that everything was working as, as, as well as possible for him.

And he went from 150 milligrams to only [00:38:00] 25 milligrams in the course of six

I, I can’t remember on the exact number, but I think he’s concentration went from like something like 9 million to 39 million, something like that. Mm. Um, and. I think exercise plays hit a huge role and we will never know how much what was the percent of the influence. On each of the factors, but SSRIs is a good example of how a specific pharmaceuticals can have a huge effect on sperm health.

So we don’t need to study sperm, uh, in that case or female reproductive ’cause. God, I haven’t, haven’t forbid anyone study that. It’s like, it’s one of these things that is, it’s just an unknown and it often doesn’t get thought of at all until much later. Or it takes someone that’s a little bit more savvy to go, maybe it’s the medications causing the issue.

Potent form, DHT. So this medication prevents that conversion and therefore, because that doesn’t happen in the body head loss is prevented. So these days there are lots of 20 year olds, 30 year olds taking this medication. And, um, I have seen some preliminary studies that point towards how this medication is negatively affecting sperm health.

Clinically, I have seen a few cases of it where stopping the medication, uh, doing a bit of work with the male patient and retesting three to six months later lead to great improvements in sperm analysis. So, um. This is another factor, right? Um, this drug was not designed with the idea [00:41:00] in mind that could affect male fertility, but it is indicating that it, it does.

So if. A couple is having trouble to conceiving. I think it’s important to review all the medication that the two parts are taking the female part and the male part.

It is very common. It is, it is very common amongst teams, use users these days. I think, look, we could get into the rabbit hole of why is this happening in the first place, which will be, uh, social media putting body image placing attainable body, um, yeah. So social media these days, what I think it’s doing to our jam population is very clear.

It’s affecting their mental health, right? And then you have all these social media influencers telling [00:42:00] them, you can get the body that I have. You just have to follow this diet. And they’re not telling them the whole picture. In many cases, not all of them, but in many cases they might be using anabolic steroids.

And then this is filtering into the younger population. Everyday more and more I see, uh, the effect that anabolic steroids has in the medium and in the long term of a sperm health. So even if the person had used anabolic steroids a year ago or two years ago and they tr are trying to conceive the long-term effect that anabolic steroid had is still visible.

What you’re really doing is telling your brain you can shut down the communication between the brain. And the testicles. You don’t need to stim the brain doesn’t need to longer stimulate the testicles for more. Yes.

And

then like you said, how long do you [00:44:00] take the anabolic steroids for, and what doses did you take and how old were you when you were having this? All these will have an influence to how fast you recover if you recover.

So let’s, let’s share the way of. Responsibility when it comes to fertility. Let’s go to those [00:45:00] appointments. Let’s make sure that if we haven’t prescribed a supplement, we’ll take that supplement that if we’ve been told that we need to stop alcohol, which we haven’t spoken about, but obviously it’s huge, we stop alcohol altogether.

Or maybe you reduce from having seven drinks per week to just having one to two per these drinks per week with your friends, but do your contribution. That’s what I will say.

Or sperm health can lead to early miscarriage. Let’s do our part into supporting our counterparts, our partners, as much as we can, and share the weight [00:46:00] of responsibility.

And let’s do what were asking me. What are the main things that someone can do? Let’s tackle the big ones, right? Like the, the obvious ones. So alcohol, huge. Like, I mean, there is so much research and do we need more research? I mean, we always do need more research, but it’s very clear the toxic effect that alcohol has in sperm.

So just stopping alcohol is gonna have a huge, huge effect in improving your fertility outcomes, uh, making sure that you are sleeping well and that you’re prioritizing rest. It’s really, really, really huge. Um, I. Eating, eating well, uh, making sure that you’re getting your protein, your fiber, that you’re eating, a food that agrees with you.

Those are huge factors. And then what I will say as well, if you are not working with a health professional and you are unsure what the factors will be, that that’s when you need to ask for help. And I think females are much better than males are asking for help.

Mm-hmm.

There [00:47:00] is. There is not nothing wrong with saying, okay, I don’t know what to do who can help me to improve my outcomes.

I think that is an important factor to, to acknowledge when Google doctor is not enough and when you need to look for a health practitioner that can guide you in the right direction.

That will be my main takeout.

I can tell you the success rate was always [00:48:00] much higher.

Those have a big impact too, don’t they?

Maybe it’s not in the. First consult, but it’s in the second consult. Or I give them some some handouts for them to read or websites that they can visit to understand the if their. The things that they’re using at home to, to clean, uh, to clean the house is affect, could have a negative effect. So I like to give all those resources, which are very important.

Another big one is where are you working? What [00:49:00] are you spending most of your time? If it’s a pain factory, for example, then we know that that can definitely be one of the reasons for low or poor quality sperm. Mm

And then beyond there, we, we’d have to consider the things that are genetic or structural, like the vari CILs we mentioned, or conditions like, um, like Kleinfelter syndrome or mm-hmm. People who are structurally missing vans, deference, or other, other, like under sended, testes and those aspects. Mm-hmm.

So beyond when we get to that point, that’s when, you know, you have, we have the referral network and the dis usually at that point we’d be seeing very big things in the sperm analysis, like zero sperm. So that’s a big red flag to refer on for that. Um, so people don’t usually have to worry about [00:50:00] that.

If they have already got the sperm analysis, they can sort of go, okay, it’s probably not too bad.

To wanna talk about it. So if they have something that’s in front of them that they can sort of sit down and privately assess, that’d be really good. So I’ll, um, I’ll pop some links in the, in the show notes in the, in the description to help people find all of this as well. But can you just share your links.

So all those, uh, important conditions regard regarding the reproductive system and obviously male fertility. So that’s what I’m working at the moment. So, the website is rhreproductivehealth.com. For anyone interested to contact me, uh, they can do it through the website and I will be always happy to answer.

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Understanding and treating missing periods naturally.

Hypothalamic Amenorrhoea (HA) is a condition you may have been hearing about more frequently lately. Despite being a bit of a mouthful to pronounce, this condition is unfortunately more common than many women realise. In simple terms, HA occurs when your brain stops communicating properly with your reproductive system, causing your periods to go completely AWOL! Let’s explore this condition in depth to help you understand what’s happening in your body.

Understanding Primary vs Secondary Amenorrhoea

Before diving deeper, it’s important to understand the difference between primary and secondary amenorrhoea:

Primary amenorrhoea refers to when a young woman hasn’t started menstruating by age 16, despite having undergone other normal pubertal development.

Secondary amenorrhoea, which includes Hypothalamic Amenorrhoea, occurs when menstrual periods that were previously normal and regular stop for three or more consecutive months in a woman who was previously menstruating.

Photo by Rodolfo Sanches Carvalho on Unsplash

What is Hypothalamic Amenorrhoea?

Hypothalamic Amenorrhoea exclusively affects women, as it’s directly related to the female reproductive system. This condition is characterised by the absence of menstrual cycles for three months or longer, and in some serious cases, periods can disappear for years.

HA stems from disruptions in your hypothalamus function – a small but mighty structure located in your brain. The hypothalamus serves as the control centre for numerous vital bodily functions, including:

• Regulating body temperature
• Managing hunger and thirst signals
• Controlling blood pressure
• Governing your sleep-wake cycle
• Influencing sex drive
• Orchestrating hormone production and activity

When the hypothalamus senses that your body is under stress, it responds by reducing the production of gonadotropin-releasing hormone (GnRH), which subsequently affects the release of follicle-stimulating hormone (FSH) and luteinising hormone (LH) – both crucial for ovulation and menstruation.

What Causes Hypothalamic Amenorrhoea?

Several factors can trigger this protective response from your body:

• Nutritional deficiencies or inadequate caloric intake: Your body needs sufficient energy to maintain reproductive function
• Excessive exercise or overtraining: This can occur across many activities and sports, not limited to any particular field. Even regular fitness enthusiasts can experience HA if their exercise regimen is too intense relative to their individual needs and caloric intake
• Chronic or elevated stress levels: Both psychological and physical stress can disrupt hormonal balance
• Low body weight or rapid weight loss: Even if you’re not clinically underweight
• History of oral contraceptive use: Some women experience delayed return of menstruation after stopping the pill
• A combination of these factors: Often multiple stressors compound the effect

It’s important to note that susceptibility to HA varies significantly between individuals. Some women can maintain intensive exercise routines or experience temporary stress without losing their periods, while others are more sensitive to these factors. This is why comparing your diet and exercise regime to others isn’t a good idea – your body has its own unique thresholds and requirements.

Many women experiencing HA don’t fit any stereotype. Even moderate caloric restriction combined with regular exercise and everyday stress can be enough to trigger this condition in susceptible individuals.

Why Does My Body Stop Menstruating?

From an evolutionary perspective, your body has sophisticated mechanisms to protect you during times of perceived threat. When your brain detects signals of potential famine (insufficient calories), physical danger (excessive exercise), or emotional threat (chronic stress), it essentially puts reproduction on the backburner to conserve energy for survival.

Think of it as your body’s wisdom – if resources are scarce or conditions aren’t optimal, it’s not an ideal time to support a pregnancy. Your body prioritises vital functions over reproductive capabilities until conditions improve.

The intricate hormone cascade that regulates your menstrual cycle requires everything to be working in harmony. When disrupted, the delicate balance of oestrogen, progesterone, LH, and FSH becomes compromised, resulting in anovulation (lack of ovulation) and subsequently, no menstruation.

It’s important to note that while HA is a common cause of secondary amenorrhoea (periods stopping after they’ve been established), other conditions such as PCOS, thyroid disorders, and premature ovarian insufficiency can present similarly. This is why proper diagnosis through a healthcare provider is essential.

Signs and Symptoms of Hypothalamic Amenorrhoea

Beyond the obvious absence of menstruation, you might experience:

• Low energy levels and fatigue
• Mood changes, including anxiety or depression
• Disrupted sleep patterns
• Reduced sex drive
• Dry skin and brittle hair
• Cold intolerance (feeling cold frequently)
• Bone density concerns (if prolonged)
• Difficulty concentrating
• Digestive changes

Comprehensive Approach to Managing Hypothalamic Amenorrhoea

Restoring your menstrual cycle requires a holistic approach targeting the root causes. As a naturopath, I find that a balanced strategy incorporating lifestyle modifications, nutrition, targeted herbs, and supplements offers the most effective path to recovery.

Nourishing Nutrition for Hormone Health

• Increase caloric intake: Most women with HA need at least 2,000-2,500 calories daily, sometimes more depending on activity level and body composition
• Prioritise carbohydrates: Adequate carbohydrate intake is absolutely crucial for hypothalamic function and hormone production. Your brain relies heavily on glucose, and including plenty of complex carbohydrates is essential. Include foods like sweet potatoes, pumpkin, whole grains (freekeh, quinoa, buckwheat, rice), sourdough bread, legumes, and starchy vegetables to provide essential energy for hormone production
• Include quality protein: Aim for 1.2-1.8g per kg of body weight from varied sources like eggs, fish, legumes, and quality animal products
• Prioritise healthy fats: Your reproductive hormones are made from cholesterol and require adequate fat intake. Include avocados, olive oil, nuts, seeds, and fatty fish in your diet
• Don’t fear dietary fat: 30-40% of your calories should come from healthy fats to support hormone synthesis
• Support gut health: Consume fermented foods (yoghurt, kefir, sauerkraut) and prebiotic fibres to maintain the gut-hormone connection (Note: fermented foods may not be suitable for those with histamine intolerance)
• Important: Under no circumstances should you attempt a low or no-carb diet when dealing with HA – your body needs carbohydrates to signal reproductive safety

Supportive Lifestyle Practices

• Effective stress management: Practice daily meditation, journalling, or gentle breathwork
• Prioritise sleep quality: Aim for 7-9 hours of uninterrupted sleep in a cool, dark room
• Connect with nature: Forest bathing (shinrin-yoku) has been shown to reduce cortisol levels
• Sunlight exposure: 15-30 minutes of morning sunlight helps regulate circadian rhythms and vitamin D production, both crucial for hormone health
• Mindful breathing: Practice 4-7-8 breathing (inhale for 4, hold for 7, exhale for 8) several times daily to activate your parasympathetic nervous system
• Create boundaries: Learn to say no to excessive commitments that contribute to your stress load

Appropriate Exercise Modifications

During recovery from HA, it’s crucial to scale back high-intensity exercise until regular menstruation returns. Consider these gentler alternatives:

• Restorative yoga: Focus on yin or gentle hatha practices that activate the relaxation response
• Pilates: Build core strength without excessive cardio stress
• Mindful walking: Particularly in natural settings at a conversational pace
• Gentle swimming: Non-weight bearing and relaxing for the nervous system
• Mobility work: Maintain flexibility without taxing your adrenal system

Once your cycles have returned consistently for 3-6 months, you can gradually reintroduce more intensive exercise while carefully monitoring your menstrual health.

Herbs & Supplements for Hormonal Support

Herbal Allies:

• Adaptogenic herbs: Help balance the body’s stress response and support adrenal function
  • Withania (Ashwagandha): Helps reduce cortisol and supports thyroid function
  • Rhodiola rosea: Enhances stress resilience and energy without stimulation
  • Holy Basil (Tulsi): Balances stress hormones and supports metabolic health
• Nervous system supporters:
  • Chamomile: Gentle calming effect without sedation
  • Passionflower: Reduces anxiety and promotes restful sleep
  • Lemon balm: Uplifts mood while calming the nervous system

Targeted Supplements:

• Acetyl-L-carnitine: Supports LH production and egg quality
• Magnesium glycinate: Essential for over 300 enzymatic reactions, including hormonal pathways (300-450mg daily)
• Zinc: Critical for reproductive hormone function and thyroid health (15-30mg daily)
• Vitamin D3: Many women with HA have insufficient levels (2000-5000 IU daily, based on blood levels)
• B-complex vitamins: Support energy production and stress response
• Omega-3 fatty acids: Provide building blocks for hormone production (1-3g daily)

When to Seek Professional Support

Recovery from Hypothalamic Amenorrhoea typically takes 3-12 months, depending on the severity and duration of the condition. While some women see improvements within weeks of implementing these changes, others require more time and personalised support.

If you’re experiencing:

• Absence of periods for more than 3 months
• Symptoms that significantly impact your quality of life
• Concerns about fertility or bone health
• Difficulty implementing lifestyle changes alone

It’s time to seek professional guidance. As a naturopath specialising in women’s hormonal health, I can help identify the specific factors contributing to your HA and create a personalised recovery plan that addresses your unique needs.

Your Path to Hormonal Balance Starts Here

Hypothalamic Amenorrhoea is not just about getting your period back—it’s about restoring your body’s natural rhythms and creating sustainable health practices that support your hormonal wellbeing for life.

If your periods have disappeared or become irregular and you suspect Hypothalamic Amenorrhoea might be the cause, I invite you to book a consultation today. Together, we’ll investigate the root causes of your hormonal imbalance and develop a comprehensive plan to restore your menstrual health naturally.

Your body wants to heal—sometimes it just needs the right support to find its way back to balance.

References

Abou Sherif, S., Newman, R., Haboosh, S., Al-Sharefi, A., Papanikolaou, N., Dimakopoulou, A., Webber, L. J., Abbara, A., Franks, S., Dhillo, W. S., & Jayasena, C. N. (2021). Investigating the potential of clinical and biochemical markers to differentiate between functional hypothalamic amenorrhoea and polycystic ovarian syndrome: A retrospective observational study. Clinical endocrinology, 95(4), 618–627. https://doi.org/10.1111/cen.14571

Gordon, C. M., Ackerman, K. E., Berga, S. L., Kaplan, J. R., Mastorakos, G., Misra, M., Murad, M. H., Santoro, N. F., & Warren, M. P. (2017). Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline. The Journal of clinical endocrinology and metabolism, 102(5), 1413–1439. https://doi.org/10.1210/jc.2017-00131

Meczekalski, B., Katulski, K., Czyzyk, A., Podfigurna-Stopa, A., & Maciejewska-Jeske, M. (2014). Functional hypothalamic amenorrhea and its influence on women’s health. Journal of endocrinological investigation, 37(11), 1049–1056. https://doi.org/10.1007/s40618-014-0169-3

Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., Meyer, N., Sherman, R., Steffen, K., Budgett, R., & Ljungqvist, A. (2014). The IOC consensus statement: beyond the Female Athlete Triad–Relative Energy Deficiency in Sport (RED-S). British journal of sports medicine, 48(7), 491–497. https://doi.org/10.1136/bjsports-2014-093502

The post Hypothalamic Amenorrhoea – When your periods go AWOL appeared first on Alison Mitchell Naturopath.

How Toxin exposure can impact your hormonal health, fertility and the health of your children and grandchildren.

I’m joined with Naturopath extraordinaire Tabitha McIntosh in this episode of Guts and Girl Bits (formally ‘Health & Wellbeing Podcast’). We chat about how the chemicals* in our food and environment can impact on our health in more ways than we know.

We also chat about how chemical exposure can impact on fertility, pregnancy outcomes and can impact on the health of our children, and even our grandchildren. We also talk about how certain chemicals and pollutants can affect hormonal health and wellbeing.

But just chatting about how these chemicals can impact on our health isn’t that good unless we also talk about how to reduce your exposure and help your body to heal. Tabitha shares some of her recommendations to reduce toxin exposure to toxins and pollutants from many different sources.

Some points we cover include:

• What sort of impact is toxin exposure having on people?
• Is there an increase in defects in newborns? How common are these?
• Are these defects related to nutrition or chemicals? Can we prevent them?
• Are these chemicals having an affect on a couples ability to conceive?
• What are some sources of toxins that we need to be avoiding?
• How long does it take for chemicals to be eliminated through the body?
• What was Tabitha’s Ah-Ha moment, that led her into this journey of spreading chemical awareness.
• What are the safety measures put in place in Australia with chemicals?
• There are many chemicals permitted in Australia that have been banned in Europe. How many chemicals that have been banned there are still used here, why is the such a difference?
• Not everyone reacts to chemicals the same way, some people may experience symptoms or hormonal imbalances, but some people are symptomless. What are some of the reasons this might be?
• What are Tabitha’s suggestions for taking the first step in toxin reduction.
• How fast food is having an impact on our environment and adding to future food security issues.
• Tabitha’s tips on reducing chemical exposure, in particular by improving air quality and reducing toxins around the home.

Listen to the podcast here:

Or click here to listen via soundcloud.

*I would like to address the often presented argument that “everything is a chemical”. I agree that this is very close to the truth (with the exception of sound and light which is actually matter). However, in this instance we are using the term chemicals for the sake of convenience, and actually referring to toxic and Endocrine Disrupting Chemicals, substances which are known or suspected to be capable of interfering with hormone receptors, hormone synthesis or hormone conversion which are in commercial use and have been proven or suspected of contributing to disease and dysfunction in humans, and chemicals which have shown to cause damage in ways such as mitochondrial dysfunction, neurodevelopmental toxicity, immune toxicity, oxidative stress and various levels of inflammation.

Subscribe to the podcast here:

iPhone   Stitcher   Youtube   Soundcloud  Spotify 

About Tabitha

Tabitha McIntosh is an experienced and respected Naturopath, clinical Nutritionist and educator. After attaining her Bachelor of Medical Science (University of NSW, 2001), she went on to pursue her passion for Integrative healthcare by completing an Advanced Diploma Naturopathy & Diploma Nutrition (Nature Care, 2005), and Post Grad Diploma in Nutritional & Environmental Medicine (Swinburne Uni, 2006).

Absolutely passionate about improving the health of everyone she comes in contact with, Tabitha’s impressive resume includes presenting at conferences and professional development seminars around Australia, lecturing in Nutrition at both Nature Care College and Endeavour College of Natural Health, International Community Health work, and contributing to Publications and Natural Medicine textbooks.

Tabitha is founder & director of Awaken Your Health in Woollahra, Sydney, where she has run her own private clinical practice for 13 years: integrating Naturopathic healing principles with the latest scientific research to educate and empower her clients, and implementing therapeutic diets to help clients reach their potential.

Tabitha is also a published author releasing her first book in 2016, co-authored with Dr Sarah Lantz, on nutritional and environmental health solutions, called One Bite at a Time: Reduce Toxic Exposure and Eat the World you Want. This book helps it’s readers to better navigate consumer and industrial chemicals found in our every day environment, to understand their significant impact on the human body and health; and outlines practical strategies and effective solutions for protecting our health so that we can live happier, heartier lives.

See www.onebite.com.au to learn more.

With both her book and her recently launched e-course I Quit Chemicals, Tabitha feels privileged to be able to inspire her clients and peers to maximise health outcomes by making conscious choices for the health of the planet, and the health of the future generations.

Check out her website www.awakenyourhealth.com.au for more information or to make a booking.

Related posts:

• What is preconception care?
• Why you should choose chemical free products for you and your baby
• Interview with Therese Kerr
• Choosing the right products for that time of the month
• A gut feeling – the gut brain axis

The post Reducing Chemicals to Protect Future Generations appeared first on Alison Mitchell Naturopath.

Health & Wellbeing Podcast #37

Nikki Warren is a Naturopath with a passion for supporting women and men through preconception period and pregnancy. In this episode we chat about the importance of quality nutrition during this time, and get into detail about some of the key nutrients we need to have when trying to conceive and throughout pregnancy. 

We talk about why you should choose a superior quality nutrition supplement during this time and what are some of the things to look for.

You’ll learn things like:

• What nutrients do you need during pregnancy? (Hint: it’s not just folic acid)
• Why some people have a hard time processing folic acid and need a different form of this nutrient
• What form of Vitamin B12 is best
• What nutrients are needed for healthy sperm
• Why it’s better to improve your stores of certain nutrients before you conceive
• Why you should take nutrients before you try to conceive, and how long for
• How your nutritional needs change during pregnancy

You can listen via the embedded player below or click here to listen on soundcloud.

iPhone   Stitcher   Youtube   Soundcloud  Spotify 

Get in touch with Nikki: 
nikkiwarrennaturopath.com/
www.facebook.com/nikkiwarrennaturopath/
www.instagram.com/nikkiwarrennaturopath

Find the range of Naturobest products at naturobest.com

P.S. the name of this podcast will soon be changed to Guts and Girls Bits.

The post Preconception and Pregnancy – Nutrition and Supplements appeared first on Alison Mitchell Naturopath.

Polycystic ovarian syndrome is a condition that is affecting more and more women and girls – it affects 1 in 7 women worldwide making it one of the most common endocrine disorders to affect women of reproductive age.

This is one of the most common conditions that I see in our clinic, as women are usually frustrated by the lack of conventional treatment options available to them.  Unfortunately, this condition is often incorrectly diagnosed and misunderstood in a lot of women. It is also being increasingly diagnosed in young girls – often unnecessarily

It really seems that PCOS is becoming an epidemic, and information about this condition is greatly lacking!  PCOS is a 20th century condition, along with the increase of heart disease, diabetes and obesity.  And the reason they are all increasing together is because they are all being (mostly) caused by the same things.  We’ll get into what that is later, but first we should cover what PCOS actually is.

The name poly-cystic ovarian syndrome implies that the main feature of the condition is the presence of small cysts on the ovaries, however with current diagnostic criteria this is actually not required for a diagnosed, and not all women with PCOS have cysts on their ovaries.  This is just one of the possible symptoms that makes up this condition.

In this article I wrote for Western Sydney Mum’s Hub I discuss what PCOS actually is, as well as outline the symptoms of PCOS and debunk some myths. I also talk about the causes of PCOS, and my key natural treatments.

PCOS SYMPTOMS

Symptoms may include:

·       Irregular or absent periods

·       Insulin resistance (high insulin levels picked up in a blood test)

·       High testosterone (androgen) levels in a blood test

·       Hirsutism (Excess hair growth, usually in areas such as the lip, arms, lower back)

·       Acne

·       Sugar cravings

·       Blood sugar fluctuations (e.g. feeling irritable or dizzy if you skip a meal)

·       Weight gain or difficulty losing weight, especially from around the middle

·       Ovarian cysts (picked up by ultrasound)

·       Thinning head hair

·       Painful periods or pain on ovulation

·       Fertility problems including difficulty conceiving and increased miscarriage rates

·       Skin tags

·       High cholesterol levels

Diagnosis

The condition is diagnosed differently according to different criteria, however most commonly it is by the presence of 2 of the following 3 factors:

·      Irregular or absent ovulation/periods

·      High androgen levels (the male hormone) found in blood tests

·      Symptoms of high androgen levels such as hirsutism and acne.

·      Other conditions which cause these symptoms must be ruled out.

LET’S CLEAR UP SOME PCOS MYTHS

1. 1. Having cysts on the ovaries is not the main way of diagnosing PCOS. Not all women with PCOS have cysts, and as a stand-alone symptom having cysts on the ovaries isn’t enough to diagnose PCOS.
   2. It’s normal for cysts to grow on the ovaries – these are actually your ovarian follicles (or eggs) growing and releasing, however in PCOS these do not grow properly and this is what can result in the typical appearance of a PCOS ovary.
   3. PCOS doesn’t always affect your fertility negatively. This understanding is mostly based on people with severe cases of PCOS and so the understanding of to what degree it affects the fertility of those with milder forms of PCOS is lacking.
   4. You aren’t always stuck with PCOS for life. Many young girls who are diagnosed with PCOS can grow out of this condition by the 30s.
   5. The oral contraceptive pill is not the best way to treat PCOS. Yes it can bring on a regular, predictable bleed, but remember that this is not a true period, and the pill can make the condition worse after stopping.
   6. If you get period pain it is not due to PCOS – there is likely something else going on that is contributing to the period pain such as endometriosis or primary dysmenorrhea (the fancy term for period pain not attributed to an obvious cause). It is possible to have both endometriosis and PCOS.
   7. Thin women and girls can have PCOS too, and can still have insulin resistance.

Top causes of PCOS

Insulin Resistance

Nearly all cases of PCOS have insulin resistance.  Insulin resistance is when the cells have difficulty taking up glucose from the bloodstream, often resulting in an increased secretion of insulin, which worsens the symptoms of PCOS.

Even if your blood sugar levels are normal, you can still have insulin resistance. It is vital that insulin levels are tested too, but they aren’t always automatically done, so you may need to ask.

As I was mentioning earlier, I believe that insulin resistance is the link between these 20^th century conditions.   Insulin resistance can be a genetic problem, but the food choices that we make play the biggest role in the development of this condition.  Highly processed foods, refined carbohydrates and excess sugar are the evil culprits that lead to the development of insulin resistance by causing our blood sugar levels to be elevated over a long period of time.  Insulin is a hormone that is secreted by the pancreas in response to high blood sugar levels.  Its job is to put the sugar into the cells.  When the levels of sugar in our blood are high for an extended period of time, insulin is produced more and more, and our cells begin to ignore it (like in The Boy Who Cried Wolf).  This leads to high circulating insulin, and this is where the problem comes from.

Insulin is known for its ability to lower blood sugar levels.  The way that insulin does this is by storing the sugar in the form of glycogen – but the body can only store so much of this, and when it’s full the sugar gets stored as fat (most commonly in the abdomen, causing the typical apple body shape).

High androgen levels

Androgen are a group of hormones that includes testosterone. They may be called ‘male hormones’ but both men and women produce androgens, just in different amounts and with different actions.

There are a few different types of androgen markers that are tested in blood tests, including total testosterone, SHBG, androstenedione and DHEA.

For most women with PCOS the insulin resistance is usually the biggest issue which causes high androgen levels. However, for some (approximately 20%), high androgen levels may be present unrelated to insulin resistance, and this is most often due to stress.

Other causes

Sometimes there can be some less common causes of PCOS. This can include nutritional deficiencies (such as iodine or zinc), inflammation and thyroid disorders. For some women they may have developed PCOS because of taking the oral-contraceptive pill. Often this will resolve within about a year (herbal medicine can reduce this time frame to 3-4 months).

Key Natural Treatments for PCOS

What treatment is used for PCOS depends on the underlying cause and a practitioner can guide you further on this. These are some of my favourite treatment tools:

1. Test for and treat insulin resistance, typically with an exercise regime and a low-GI diet (you can read some tips for a Low GI, Nutrient Dense Diet here).
2. Cut out/down sugar in the diet.
3. Cut out/down dairy.
4. If androgen levels are high without insulin resistance, herbs and nutrients that can reduce the excess of this hormone include Saw Palmetto, Peony and Licorice, and the mineral Zinc.
5. If DHEA is high or there is a lot of stress around the time of puberty or currently, herbal medicine to support the nervous system such as nervine and adaptogen herbs, the mineral magnesium and B vitamins can be helpful.
6. The amino acid myo-inositol is helpful for supporting blood sugar levels and reducing anxiety and can be a great tool in the kit to treat PCOS.

If you or your daughter has been diagnosed with PCOS or you suspect that this may be an issue for you, seek advice from a naturopath experienced in this area as there is much that can be done to help.

The post Busting the PCOS Myths appeared first on Alison Mitchell Naturopath.

It may alarm you to realise that in countries such as Australia and America there are very limited regulations on the safety of which chemicals* are used in household and beauty products, and that this lack of protection can have a significant impact on not only your health, but also your babies and even your grand babies.

Chemicals that we are exposed to can be pass through our to offspring, and can even cross generations. This can unfortunately have a mutli-generational effect on health and fertility. Fertility rates are declining through generations and while there are many factors responsible for this, chemical exposure that passes through to our babies and affects their fertility and their children’s fertility is something that we need to become educated about and take responsibility for.

In a article I have written for Casa de Karma I discuss the benefits of reducing and removing chemical exposure from your diet and lifestyle, for both yourself and for your children. You can read a preview below, or click the link to read the full article which also discusses the relationship between chemicals and genetics, which chemicals to watch out for, the effect of chemicals of sperm health and some ways to reduce chemical exposure.

Read the full article here: http://casadekarma.com.au/why-choose-chemical-free-products-mum-baby/

Chemicals found in newborns

A study by the Environmental Working Group in 2005 examined the umbilical cord blood of 10 newborn babies and found a total of 287 chemicals, with an average of 200 chemicals present per baby. 28 of these were waste byproducts such as Formaldehyde, PCBs, Mercury, Petroleum and Dioxin 1, 4. 47 of these were consumer products such as Bisphenol A, Dioxins, Pthalates, Triclosan, Brominated Flame retardants, Pesticides and Preservatives.  Of these, 212 chemicals and pesticides had actually been banned or restricted in use 30+ years ago, giving us a scary insight into how chemicals can be stored in our bodies and be passed onto our offspring despite not having current exposure to them.

Other studies have shown that many of these chemicals were passed down the line from the grandmothers generation, however the chemicals were present in higher amounts in the children, suggesting that they are transferred across the placenta and breastmilk.

A precautionary approach

What does this mean? One of the lessons I take from this information is that chemicals which are currently viewed as safe but are not inert, are still best to avoid, as many of the harmful chemicals detected in this test were at one stage viewed as safe.

In Australia, the approach to chemical regulation is different to countries more progressive in this area – an absolute evidence of harm is required before a chemical is removed by use in Australia, compared to the EU where a more precautionary principle is in place – they believe that “When human activities may lead to morally unacceptable harm that is scientifically plausible but uncertain, action shall be taken to avoid or diminish that harm.”

In order to navigate this lack of protection we must take more responsibility ourselves.

Penelope Jagessar said in her Ted Talk: The Toxic Baby “It is only a parent’s awareness that stands between chemicals and our children”…

You can read the rest of the article here: http://casadekarma.com.au/why-choose-chemical-free-products-mum-baby/

*I would like to address the often presented argument that “everything is a chemical”. I agree that this is very close to the truth (with the exception of sound and light which is actually matter). However, in this article I am using the term chemicals for the sake of convenience, and actually referring to toxic and Endocrine Disrupting Chemicals, substances which are known or suspected to be capable of interfering with hormone receptors, hormone synthesis or hormone conversion which are in commercial use and have been proven or suspected of contributing to disease and dysfunction in humans, and chemicals which have shown to cause damage in ways such as mitochondrial dysfunction, neurodevelopmental toxicity, immune toxicity, oxidative stress and various levels of inflammation.

The post Why You Should Choose Chemical-Free Products For You & Your Baby appeared first on Alison Mitchell Naturopath.

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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Unless you’re in the business of making babies and have encountered some snags along the way, this is not an issue many people are aware of, but varicoceles can make falling pregnant rather tricky.

Varicoceles are like a varicose vein in the scrotum, and when these are present they produce a lot of heat, which essentially cooks some of the sperm, resulting in impaired sperm morphology (odd looking sperm) and activity (they might swim in circles rather than a straight line).

Omega-3 polyunsaturated fatty acids make up a large part of the sperm function and structure, so we know that we need plenty of our Omega-3s for sperm health, but we’ve also realised that men with varicoceles have lower levels of Omega-3s and higher oxidative DNA damage compared to other males.

What can we do with this knowledge? Well it’s not a magic answer to the varicocele problem, but it does give us some insights into how we can help and possibly prevent them.

Aim to keep your omega 3 : omega 6 ratio in check, and consider supplementing with omega 3s (ensure you have a good quality product, if in doubt check with your practitioner).

Works Cited

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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.

It’s no new news that you should eat well while you’re pregnant. But what a lot of people don’t realize is the importance of eating well BEFORE you fall pregnant – during the preconception period. I try to teach my patients the importance of a healthy preconception care diet for both mother and father for at least 4 months before they are going to try to conceive.

Considering how hard it is to eat a healthy, nutrient dense diet when you have morning sickness, it makes the 4 month preconception care period all the more important (although I don’t think there’s a period of life when you shouldn’t eat well).

The reason for this time frame is because sperm can take 116 days to generate and during this time they are easily susceptible to damage. Similarly, the egg is vulnerable during maturation for around 100 days leading up to ovulation.

The damage that I’m referring to is of the genes of the sperm and the egg. If the genes of either are altered, then the foetus is more likely to develop a stronger tendency to genetic conditions such as autism, schizophrenia, genetic cancers, physical malformations and can increase general ill-health.

The thing about DNA is that some genes can be turned on and off like a light switch. Our environment i.e. the food that we eat and the chemicals that we’re exposed to control these switches – this concept is referred to as epigenetics. Methylation is another player in this whole process – it is a chemical ‘tagging’ process which aids in activating certain proteins in our body and silencing some genes.  This process is dependent on healthy levels of certain B vitamins – deficiencies in these vitamins can lead to an increase in DNA damage and when methylation isn’t working properly it can also cause problems in adults as well, such as heart disease, mood disorders and more.

Epigenetics research

While the research in this field is still in its infancy (haha, get it?) the research that we do have available is certainly interesting.

Most of the research that has been done in this field has been on mice. Any information that we get from animal research can never be fully extrapolated into recommendations for humans because mice and human metabolisms are worlds apart. It is a starting point however.

The human research that has been done has mostly been on the mother, and until recently it has mostly been during pregnancy. I believe the diet and supplements for the preconception period are just as important for the father however, and while there is some research in this area it is minimal in comparison.

The most well known study is that of the agouti mice. A selection of mice that were genetically identical were exposed to certain chemicals or dietary changes during their pregnancies that triggered gene changes in their pups, which was displayed as the production of the agouti protein, which turned their hair yellow. This same protein also prevented the mice from being able to feel full, and they developed obesity and were more prone to cancer and diabetes.  Some of the mice did not express this gene and so remained of normal weight and brown and some mice developed a mottled yellow-brown colour, only having partial gene expression. They were all genetically identical, however their gene expression was different.

Figure 1 The Yellow Agouti Mouse Model

Diet during pregnancy

Another study found that mice fed a high fat diet during pregnancy produced mice with altered metabolisms and also had brain changes which resulted in an impaired ability to feel when they were full. The third trimester and breastfeeding period were most important in this aspect.   Something to note is that the ‘high fat’ diet that these mice are fed is actually a concoction of hydrogenated vegetable fats, mixed with sugar. This is a far cry from what is commonly understood to be ‘fats’, as the production of these fats turns them into rather toxic substances. Your everyday, whole-food sort of fat found in avocadoes, nuts and seeds, fish and meat are not going to cause the same issue but hydrogenated fat found in fast food and processed food are going to cause problems.

A human study compared the amount of weight a mother gained in each of her pregnancies, and found that if the mother gained too much weight during a pregnancy the child was more likely to develop obesity, even more than 10 years later, compared to when the mother kept to a healthy weight range during her pregnancy. There are a lot of factors which could influence this, but a possible mechanism is that methylation can be reduced in those who are overweight.

This study looked at a group of women in Gambia and analyzed their diet and nutrient status during the preconception period. There were two groups of women analyzed – one who had conceived at the peak of the rainy season, and one who had conceived at the peak of the dry season. The women who had conceived at the peak of the rainy season had greater nutrient levels, notably the B vitamins essential for healthy methylation, and their babies were found to have greater amounts of DNA methylation. The study also found a correlation between the mothers BMI and methylation levels.

This study doesn’t mean that we have to wait until it rains to try to conceive, but rather it highlights the importance of eating nutrient dense food.

The moral of the story? If you’re planning to conceive, are pregnant or breastfeeding aim to eat a variety of fresh, whole, seasonal , nutrient dense foods and avoid exposure to environmental chemicals as much as possible.

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