Menstrual Health Education
December 2012 - How Eating the Right Foods Can Help Balance Your HormonesWe have all heard the old saying “you are what you eat”, but did you know that your diet can have a both positive and negative affect on your menstrual cycle? A nutritionally strong diet can help balance out your hormones and improve menstrual symptoms such as PMS, cramps and irregular cycles. The modern diet is full of processed foods high in sugar, saturated fat, refined carbohydrates and additives. These foods lack the vital nutrients the body needs and they upset the hormonal equilibrium in women. Weight loss diets and restricting certain foods can also make women nutritionally deficient.
So what should we eat?
Experts suggest eating a diet high in essential fatty acids, high in fibre and low in saturated fat. Diets that are high in saturated fat have been linked with oestrogen overproduction and causing blood cells to reduce in size which in turn causes period pain. Eating foods containing essential fats have a balancing effect on hormones and are commonly found in nuts, seeds, flaxseed oil, olive oil and fish. Foods high in fibre such as vegetables, beans, fruits, and whole grains are packed with nutrients and can help reduce excess oestrogen in the body by elimination via the bowel. Phytoestrogens which are sourced in beans, lentils, chickpeas are also fibre rich and effective at removing excess oestrogen from the body.
There is an on-going debate around Soya, its safety and its role in balancing hormones. Soya also contains phytoestrogens however some researchers have concerns that Soya has a negative effect on women’s hormones and fertility, particularly when eaten in large amounts. Dr Fiona McCulloch, a Naturopathic Physician and academic, reviewed these particular studies and concluded that because the studies were carried out using animals that it would be unwise to jump to conclusions about their effect on humans, as each species has a different genetic make-up.
There have been studies focusing on the effect of Soya on humans. These particular studies have shown that it could improve hormonal balance, menstrual health and PMS symptoms. Nutrition and Women’s health expert Marilyn Glenville believes the use of Soya is beneficial and prescribes avoiding genetically modified soya products and instead choosing traditional soya products such as organic soya milk, miso and tofu. She also suggests looking at lifestyle factors to improve hormone levels such as reducing alcohol, reducing caffeine and stopping smoking. She states that these substances deplete the body’s reserves of vitamins and minerals needed for hormonal balance. Glenville recommends taking a good quality daily multivitamin, mineral and essential fatty acid supplement to ensure that women have the key nutrients that you need.
Another factor to reduce is Synthetic Xenoestrogen chemicals which affect the endocrine system and hormonal balance in both men and women. They are commonly found in cosmetics, household cleaners, plastic food wrapping and pesticides. It is believed that there is a link between increased levels of Xenoestrogens in the environment and girls reaching puberty at an early age. It is therefore recommended that contact with synthetic Xenoestrogens should be reduced. Instead eating organic foods and using natural cleaning products and toiletries are advised.
So why not try balancing your hormones with your diet and see if it improves your menstrual health!
- Eat a natural diet, low in saturated fat, high in fibre and essential fats
- Reduce your intake of alcohol, caffeine and smoking
- Reduce your processed food and sugar intake
- If you choose to eat soya, eat it in its traditional form
- Reduce your contact with synthetic Xenoestrogens where possible
- Consider using a good quality multivitamin, mineral and essential fatty acid supplement
- Chlamydia and Gonorrhoea are both bacterial infections. Many people will have no symptoms at all. Symptoms include: pain when passing urine, pelvic pain in women, testicle pain in men and in Gonorrhoea a green or yellow discharge. If both infections are left untreated they can affect other parts of the body.
- Trichomoniasis is an infection caused by a parasite. Often there are no symptoms. Symptoms include soreness, swelling and itching around the vagina and inner thighs. Increased amount of discharge. Pain or discomfort when passing urine. Discomfort during sexual intercourse and pain in the lower abdomen.
- Genital Herpes may have no symptoms. When symptomatic you may experience painful red blisters around the genital area which burst and leave open sores.
- Genital warts can take up to a year to appear after being infected with the virus. The warts may develop anywhere on the genitals or anal area. In women, they can also develop inside the vagina or on the cervix, where they can’t be seen.
- Syphilis symptoms are initially so mild that you are often unaware of them. The most common symptom is one or more painless sores or ulcers in the genitals and less commonly around the mouth and anus. If left untreated Syphilis can affect the organs of the body. (4)
- Use barrier protection (condoms, femidoms and dental dams) every time you have vaginal, anal and oral sex with casual or new partners. This will reduce your chance of getting an infection. There are a large variety of condoms including latex free versions available in clinics and shops. Also, using a small amount of water based lube with the condom can help prevent them from breaking. Femidoms are also latex free and can be used for vaginal and anal sex (remove the inner ring for anal). Condoms are advised for performing fellatio on a man and dental dams (thin piece of latex) for cunnilingus on a woman. All these barrier methods can be obtained free at your local Contraception and Sexual Health clinics.
- Use barrier protection with long term partners until you have been both tested for STIs and have agreed to be in a monogamous relationship
- Do not share sex toys. If you have been diagnosed with an STI remember to sterilise your sex toy as per manufacturers guidelines before using it again.
- Have a regular check-up for STIs, especially after each new sexual partner.
- If you have been treated for an STI then it is important to sterilise your Mooncup before using it by soaking it in sterilising solution/tablets for the manufacturer's recommended time(usually 7-10 minutes), or boil as prescribed for 5 to 7 minutes, fully immersed in bubbling water.
Irene - Mooncup Advisor
In 2010 the most common STI diagnosed in women in the UK was Chlamydia. There were 43,843 diagnoses of uncomplicated chlamydia, 2083 diagnoses of complicated chlamydia including Pelvic Inflammatory Disease and 18 babies born with chlamydia in their eyes contracted from their mother’s birth canal. It is a common assumption that it is young people under 25 years that are at the most risk of catching an STI. But actually this is not the case. Surprisingly the age group that showed the greatest increase of new diagnosis of an STI were in fact the over 45 year olds (2). So why is this happening?
Research has found that a high proportion of over 45 year-olds do not use condoms when sleeping with a new partner for the first time (3). This is often the age that men and woman come out of long term relationships where their only concern was pregnancy. They enter new sexual relationships and are either too embarrassed to bring up the subject of using a condom or don’t think about it (5).
What are the symptoms of Sexually Transmitted Infections?
Where do I go to get tested?
Click here to find your local Genito-urinary Medicine Clinic
How do I protect myself against STIs?
Sexually Transmitted Infections and the Mooncup
- Journal of the Royal Society of Medicine
- Health Protection Agency
- Royal College of Nursing
- Health Protection Agency
Talking to your daughter about periods
The Mooncup advice nurses have recently been working really hard talking to school nurses from all over the UK and offering information and samples of the Mooncup. It’s been very exciting!
This is because we get so many emails asking us to publicise the Mooncup more widely to young girls, so that they are aware of ALL the options available to them in sanitary protection.
So now, many schools nurses across the country are talking about the Mooncup and taking one to the puberty discussions so if you have a daughter at school, do not be surprised if she mentions this.
We have had much positive feedback about this and have been inspired to write this article about daughters and periods. We hope it’s helpful...
When do I do ‘the talk’?
Your daughter is going to have her periods and become a woman whether she has your support or not, but this journey will be so much easier for both of you if you can openly discuss her body changes.
So, as soon as you feel you can start to discuss it, the time is right. Start to discuss snippets of information very early on, rather than a full blown biology class at the last minute! Any relevant questions asked as she grows up are best answered in as open and factual a way as possible. Be aware that girls are reaching puberty younger (newscientist.com), often as young as nine.
What do I say?
It may feel strange and embarrassing getting into the nitty gritty of menstruation with your beautiful young daughter, but do bear in mind that a sound knowledge of her menstrual cycle will make her informed, and potentially more confident about discussing future issues too, such as contraception, sex and even smear tests. You could plan a quiet, relaxed time to talk (when various family members and the dog won’t come crashing through the door asking when tea is ready), or just chat when it feels right for the both of you! The relationship you have with your daughter will affect how you approach this, but she will respond to your attitude, so if you feel uncomfortable and embarrassed she will probably reflect this. The more relaxed you are, the more she will be open to what you are saying, and the more likely she will be to confide in you in the future.
In UK primary schools, body changes are now discussed in Year Five as part of the national curriculum, and she may have gleaned lots of information (correct or not) from the television, internet, films and adverts - you may be surprised how much she already knows! The questions your daughter may ask will usually be an indicator of how much she needs to know at the time. It may be helpful to come back to it all once she has had some time to think things through initially.
Be clear about the facts, keep it positive and promote the idea that it's a sign that she is starting to develop into a woman.
Describing this in the style of Casualty or ER may be alarming for her, so as her mother you will understand how this information is best presented. Keep it realistic and personal too, perhaps sharing some of your own experiences will help her feel feminine about it all, rather than thinking it is all a bit yucky!
Honest and humorous
Keep it honest and straightforward: if you have a relaxed attitude towards the aches and pains and the embarrassing moments, then she will realise she is not alone when it's her turn. Do explain that menstruation is actually normal, and it can be really useful for her to know that there is a whole range of ‘normal’ too. You could explain that her and her friends’ length, flow and hormonal side-effects can all be different, and that this is OK!
If she has specific questions, answer them as best you can. If you feel embarrassed, or don’t actually know the answer, look it up together online (there are some good websites out there - see the links below) or get a book from the library. The key is to be open to talk about it - even if it is a little uncomfortable at first, it will probably get much easier.
She needs to know that yes, one day her period may start whilst queuing in the shops, and yes, she may be paranoid about marking her school uniform from leaks and feel she needs to ask her close friend to check her skirt.
You could also help explain how to chart her periods so she (and you) can try to predict when it may start each month. This means she can be prepared on those days, and keep some sanitary protection close by.
What about the rest of the house?
The male inhabitants of the house may have questions and need a few guided words too, perhaps some information about how their daughter/sister may be feeling and why, and discussing the changes that are going on in a male and female body around the time of puberty. If that feels like you are becoming a biology teacher, you could have an appropriate book on the kitchen table, which will be guaranteed to be opened at some point, and you could start the discussion there.
Practical motherly advice
Whenever your daughter starts her periods, she may well need some guidance.
Some useful and practical woman-to-woman solutions on how to dispose of used pads and wrappers discreetly, or a brief reminder on how frequently to attend to her sanitary protection will go a long way. A bin in her bedroom may be a necessary addition to save finding pads stuffed down the side of the bed when you next hoover round...and if your daughter’s chosen to use a menstrual cup, you could hand her some sterilizing solution, or even a saucepan all of her own!
During her period you could also encourage luxurious baths or showers to help her feel lovely, and maintain hygiene but do ensure the other family members get some time in the bathroom too!
Day to day
Perhaps give a gentle reminder on the mornings she has her period, to check she has all the sanitary protection she will need in her school bag too.
It may be worth working through with her how she will deal with P.E, swimming lessons and gymnastics, so she feels she is in control. Provide as a gift (or go out and choose together) - a makeup case or purse for her to carry around her sanitary towels/menstrual cup/tampons, and one for used ones too, if that is an issue.
All these things help, and continued little supportive actions and comments can go a long way to her knowing you are there. What more could a daughter want during one of the most significant changes her body will undertake in her lifetime?
- Start early, answer questions, keep it simple and honest
- Be relaxed and share your experiences
- Acknowledge and answer her aches, pains and questions
- Reassure her, and encourage coping strategies
Kate Lintott, Nurse Advisor Mooncup Ltd.
Useful linksNHS choices information and video about the start of menstruation
Easy health.org booklet ‘help I’ve started my periods’
Family Planning Association website and general sexual health information
Healthy Women website phases of menstruation
May 2010 - Cathy's Health Tips #5- Vaginal Discharge: the facts!The subject was selected by the advice nurses for this issue because we regularly get asked questions about vaginal discharge. “Can the Mooncup be used to collect it?” (no-it’s not licensed for this), and other questions that suggest that this daily discharge seems to cause concern for many women. The “conventional” sanitary protection industries also seem pre-occupied about it too-so what’s this all about?
What is vaginal discharge?Vaginal discharge is the wetness that collects outside the vagina every day, and it varies in colour, consistency and volume. It will appear in the gusset of your underwear or on your inner labia.
Why?This is how the vagina cleans and regulates itself!!- and is a sign of a healthy, normal vagina and reproductive system. The acidity of the discharge (Ph 3.5 to 4.5) puts most bacteria and viruses off entering and causing infections, such as candida (thrush). The mucous acts like a barrier too, by causing an obstructing any potential pathogens. The vaginal discharge will not cause any illness when it collects outside the vagina like faeces (poo) or urine can do; it is harmless except to invading bacteria and germs. If women did not have the discharge, they would get more infections, find penetrative sex very painful and the vagina would start to smell offensive!
What is normal discharge?
- White thicker/slightly yellow discharge is usually at the beginning and end of every cycle
- In between periods it becomes clear and stretchy (at the time of ovulation)
- It is also clear and stretchy during sexual arousal
- The discharge continues when on your period, it’s just difficult to tell because of the bleeding too
- It is normal and healthy to have a daily vaginal discharge during the reproductive years, and this is influenced by hormonal fluctuation, (including pregnancy, menopause and use of the contraceptive pill)
- Vaginal discharge contains salts, oils and water, all working to maintain the clever balance in this vital area of reproductive health
- Vaginal discharge is produced by the ovaries, cervix, Fallopian tubes and uterus too
How much is normal?There has been no conclusive research but an estimated amount, depending on where you are in your cycle, has been put forward as 5ml (about a teaspoon) in 24 hours.
Smells?Normal vaginal discharge is a natural odour that varies with the cycle. It is a mild and not unpleasant scent. It is normal that the smell changes slightly when a man has ejaculated into the vagina for up to a couple of days later.
How to manage vaginal discharge for optimal health
- Most doctors will tell you that it is better to wear cotton next to your skin rather than synthetic fibres and plastics, as found it pantyliners
- If the discharge is uncomfortably wet, it’s healthier to change to a fresh pair of cotton knickers than use a pantyliner
- Washing once a day with a non-irritating hypoallergenic soap is all you need to clean the area
- AND many health care professionals advise that using just water to clean the vaginal area is far better for maintaining the vaginal balance and keeping the vagina healthy
- Do not douche the vagina to try and eliminate the discharge, has this has been shown to increase the chances of infection
- Fragrances in general (as found in soaps, pantyliners, personal intimate wipes,) are unhealthy for the vagina and its delicate skin, as they can contain preservatives and parabens
- If you experience an unusual discharge which has changed in colour, smell or consistency, then go and see a doctor, gynaecologist or nearest sexual health service provider
- Remember a little wetness and scent in the gusset of your knickers is a sign of a healthy, efficient vagina
- Get to know your vagina and labia, so that if there are any changes that occur, you can immediately deal with them-and contact your health provider as needed. The importance of self-awareness can't be overstated!
- Do not douche! Douching will alter the finely balanced acidity in your vagina, and will not protect you from sexually transmitted diseases or pregnancy. Douching can make odour and discharge worse, not better. Remember, discharge is perfectly normal during the reproductive years, and staining in the underwear is completely ordinary. The vulva has many sweat glands, and sweat produces odour-this is to be expected. The vagina is a dynamic organ with its own changing eco-system-do not mess with it!
- Keep the scents out! Avoid vaginal sprays, scented vaginal deodorants, wipes, tampons and pads-these can cause allergic reactions, irritation and candida., to both your vagina and labia. Your own natural smell is not “bad” or in need of masking.
- Do not over protect. Repeated used of pantyliners or pads can be irritating and abrasive.
- Keep the powders off! Talcum powder can make its way into the vagina, again altering the fine balance. When the talc reaches the normal vaginal discharge, it can cause clumps that are uncomfortable and unhealthy.
- Wear loose, cotton underwear and trousers that do not hug the area uncomfortably. Thongs, bodysuits, tights and underwear made from spandex can cause discomfort and itching, as they do not allow the area to breathe.
- Bathe with care. Frequent lengthy soaking in hot water can also cause irritation and dry skin. Use simple and pure unscented soaps. Bubble bath can also be very drying and irritating to the vulva and vagina, so keep everything as simple and natural as possible. Pat dry the area gently too!
- Rectocele (prolapse of the rectum) - This involves a prolapse of the back wall of the vagina. When this wall weakens, the rectal wall pushes against the vaginal wall, creating a bulge
- Cystocele (prolapse of the bladder) - This occurs when the front wall of the vagina prolapses. As a result, the bladder may move into the vagina. When this condition occurs, the urethra usually follows too
- Enterocele (herniated small bowel) - The weakening of the upper vaginal supports can cause this type of vaginal prolapse. This can occur following a hysterectomy
- Prolapsed uterus (womb) - This involves a weakening of ligaments at the top of the vagina. This causes the uterus to fall, which commonly causes both the front and back walls of the vagina to weaken as well
- Pregnancy and childbirth are believed to be the main cause of vaginal prolapse. Pregnancy can put a lot of strain on the supportive net, caused by the weight of the baby and the stresses and strains of labour and birth. Multiple pregnancies and births increase the risk of prolapse
- Menopause is a time when oestrogen levels begin to drop. This fall also causes less flexibility and strength in the pelvic support structures.
- Obesity –creates extra pressure on the abdominal area
- Certain genetic conditions that cause dysfunction of the nerves and tissues
- Chronic coughing or strain. Long term coughing, from smoking, asthma or bronchitis, for example, can increase the risk of prolapse. Strain from ongoing constipation can also contribute to an increased risk
- Prior pelvic surgery, including hysterectomy and bladder repair
- A feeling of pressure in the vagina or pelvis - of something weighing down and being “out of place”
- Sexual intercourse becoming painful
- A lump at the opening of the vagina
- Recurrent urinary tract infections
- Stress incontinence
- To find a treatment for the prolapse, the doctor will need to do an internal examination. Having a proper diagnosis to determine which type of prolapse it is is critical in order to select the right cure
- Many women can treat and help themselves. Some use diet and exercise, for example
- Kegel exercises can help to increase the pelvic tone and strengthen some of those significant muscles
- Pessaries (a type of supportive ring) can be placed in the vagina to provide the support needed
- Surgery may also be needed to correct the problem, if the prolapse is significant and the symptoms challenging
- The skin directly around the vaginal opening known as the vestibule. The urethra, above the vaginal opening, through which you urinate
- The inner lips (labia minora), which are hairless and directly surround the vestibule, vaginal and urethral openings
- The outer lips (labia majora) surrounding the inner lips and covered in pubic hair
- The clitoris, which is just inside where the labia minora join at the front of the genital area
- The perineum - the area of skin below the vaginal opening, between the point where the labia and the anus meet
- Breasts start to develop around the ages of 9-11, and sometimes they grow at different rates - it is not unusual for one breast to be slightly different in size from the other
- Once the breasts have stopped growing, oestrogen and progesterone levels during the menstrual cycle cause changes
- Breast tissue can have a tendency to swell and the milk ducts enlarge and retain water. Breasts may temporarily feel swollen, painful, tender, or lumpy The changes are usually resolved or become less significant after your period. So, if your symptoms persist or you detect changes in your usual pattern - inform your doctor and get it checked out
- During pregnancy, the breasts have a tendency to become more tender and sensitive as they prepare for milk production. The aureola, as well as the breasts, increases in size and the nipples become darker
- With the menopause, lumps become more common and breast tissue transforms, as the milk producing ducts change to fatty tissue. It is important to understand that these changes are normal and that lumps are more common at this time. If in doubt about the significance of these changes, contact your G.P.
- The NHS Breast Screening Programme provides free breast screening every three years for all women in the UK aged 50 and over, but remember - mammograms don't replace breast self-exams!
- At least once a month take the time to observe and feel how your breasts are. Doing this around the same time each month is a good idea too, because of the changes that occur monthly
- Many women find that the easiest and most relaxing way to feel their breasts is when their skin is wet, so prefer to do this in the shower or bath
- Always be sure to feel all the breast tissue - just beneath your skin with a soft touch and down deeper with a firmer touch. Also extend your search to under your armpits as the breast tissue extends to here
- Observe your breasts in the mirror too, and check that they are the usual size, shape, and colour
- Finally, report any changes without delay to your doctor
Bye for now, Cathy " x
"My health tips are all about concentrating on simple habits that can make a BIG difference to the health of the vulva and vagina! I receive a lot of emails from women who describe a history of itching and discomfort, fearing that they may have an illness, so wanted to let you know some of the most important things you can do to keep the vagina and labia healthy and comfortable.
Bye for now, Cathy " x
"There is a network of muscles, ligaments and skin in and around a woman's vaginal area that supports the uterus, rectum, bladder, urethra, small bowel and the vagina itself. Imagine a very strong net that weaves around these organs and helps to keep them stable and in position. Weakening or stretching of the muscles, ligaments and skin causes the net to become slack. This is when a vaginal prolapse can occur - the organs slip from their usual place and cause the vagina to change shape.Although a prolapse sounds very scary, it can occur with no symptoms at all. Also, the treatment does not always require drastic measures.
Types of prolapse
There are several stages described by doctors according to how severe the prolapse is. Symptoms vary from having none at all to significant symptoms that can affect a woman’s quality of life.
Who gets vaginal prolapses?
Approximately 30-40% of women develop some type of vaginal prolapse in their lifetime. Most women who develop this condition are 40 years old or more
Some factors that could increase the likelihood of vaginal prolapse are:
What are the symptoms to look out for?
Some women are reluctant to talk with their doctor because they are too embarrassed by their symptoms. I would encourage them to be brave and get it sorted out! Prolapse is very common and is nothing to be ashamed of.
What will happen?
Please do remember: Prolapse is very common and is nothing to be ashamed of. Help is available and the uncomfortable, difficult symptoms can be eliminated!Bye for now, Cathy " x
In November, I had the opportunity of running a Mooncup stall at the Wellbeing of Women Show at the Royal College of Obstetrics and Gynaecology in London.
Whilst there, I met Fabia Brackenbury, the founder of the Vulval Health Awareness Campaign (VHAC), and would like to share some of the important information she gave me with you.
What struck me most was how little advice is given about the vulva. According to Cancer Research UK, 1,022 cases of vulva cancer are diagnosed in the UK every year, with 380 cases being fatal (see their website for more information). Like any other part of the body, being informed and knowing what changes to look for can have a significant impact on health. Still, although the Department of Health have run campaigns about breast self-examinations, the vulva seems to be somewhat of a neglected area. So here are some tips and information to help you learn more.
What is the Vulva?
The term 'vulva' refers to a woman's external genitals and includes:
Becoming familiar with your vulva and noticing any changes is very important. To carry out an effective vulval self-examination, women are advised to lie down on a comfortable surface and prop their back and shoulders up with pillows. Hold a mirror in one hand and, with the other hand, part the labia majora and take the time to have a good look!
Check for any lumps, warts, difference in skin colour, or thickening of the skin. If you are experiencing any itching, burning or pain whilst having sex, these can also be signs that need to be checked out.
Pain, itching, burning and irritation of the vulval area can be the result of an infection such as thrush or bacterial vaginosis, or the result of a non-infectious skin problem such as dermatitis, eczema or lichen sclerosis. There are also vulval problems where the exact cause of pain is unknown.
You can visit the VHAC website for more information. They run a helpline and here you will be able to discuss this very personal topic with an experienced advisor.
Alternatively, book an appointment with your doctor, gynaecologist or the nearest genito-urinary clinic.
Wellbeing of Women is the only UK charity dedicated to solving problems related to womens’ reproductive health. (You can find out more on their website ).Bye for now, Cathy " x
Did you know that breasts are constantly changing, from puberty to menopause, and also during the menstrual cycle? Familiarity with the normal anatomy and physiology (function) of the breasts is extremely important, so that early signs of possible abnormalities can easily be recognised and then be reported to quickly to your doctor.
How the breasts change over time
The breast is made of glandular, fatty and fibrous tissues. A layer of fatty tissue surrounds the breast glands and extends throughout the breast. The fatty tissue gives the breast a soft consistency
How get to know your breasts - seeing and feeling.
The Department of Health's policy on breast awareness now encourages women to check their breasts for what is normal for them, and no longer recommends a specific technique.
Rather than checking breasts in a prescriptive way (which deterred many women), women can now decide for themselves how and when to do this. So to those women out there who have been put off, please re-consider and take charge of your own health!
Learning the art of breast examination will, like using the Mooncup, help you to better understand your body’s phases and changes and keep you healthy, too. For more information you can call the Breast Cancer Care helpline free on 0808 800 6000 or visit their website.Bye for now, Cathy " x
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