Menopause health

The menopause. It happens to us all sooner or later – some much sooner than others, unfortunately.

Because it’s such a natural part of life once you reach a certain age, it’s tempting to think that this is something you should get through on your own. After all, you didn’t feel the need to seek medical help when you started your periods, so why should you do so when they stop?

The menopause, however, is about much more than just stopping your periods. It marks a huge change in a woman’s body, and many of the symptoms associated with it can also be signs of something else. That is why a thorough health check can confirm that it is just the menopause you’re experiencing.

When should I go for a menopause health check?

There’s no right or wrong answer here – the menopause usually affects women between the ages of 45-55. But if you’re experiencing menopausal symptoms earlier, it could be that you are perimenopausal or even going through early menopause.

In fact, if you are having symptoms associated with the menopause before the age of 40, it is even more important that you seek medical advice.

Menopausal symptoms include, but are not limited to:

  • Lighter or heavier periods than usual
  • Irregular bleeding
  • Hot flushes
  • Mood swings
  • Depression
  • Weight gain
  • Vaginal dryness
  • Reduced sex drive
  • Fatigue
  • Insomnia

What happens at a menopause health check?

When you come for a menopause health check here at Surescan, you will receive a thorough consultation with a consultant gynaecologist. They will discuss all your symptoms with you, offer some lifestyle advice that could help to alleviate symptoms, and present you with all the information you need to make a decision on HRT (hormone replacement therapy) treatment.

We will also run some tests, including:

  • Blood pressure and BMI check
  • Abdominal and pelvic examination
  • Blood tests
  • Hormone profile if indicated
  • Vitamin D levels
  • Thyroid function tests

These tests are especially useful because there is a risk that if a woman is at menopausal age, symptoms get attributed to the menopause that are in fact caused by something more serious.

Both thyroid problems and vitamin D deficiency are relatively easy to treat but can be missed in women aged 40+ as the symptoms are strikingly similar to those experienced during the menopause.

If required, we can also include additional tests for ovarian and cervical cancer screening.

How often do I need a menopause health check?

We recommend that all peri and postmenopausal women undergo a full health check at least once a year. This should provide peace of mind with regard to your overall health and allow us to monitor the progress of any treatment.

For more information or to book a menopause health check, please call us on 0121 308 7774 or email info@surescan-womenshealth.co.uk.

Endometriosis Care

An All-Party-Political-Group (APPG) enquiry has published a report calling for an improvement in endometriosis diagnosis and care. This is welcome news for all women who have suffered whilst waiting for an endometriosis diagnosis.

With one in ten UK women affected by endometriosis, you might expect it to be top of the list of conditions to rule out when assessing a patient with pelvic pain. However, the APPG enquiry found that the average wait for an endometriosis diagnosis in the UK is eight years. And this has not improved in the past decade.

How did the enquiry work?

MPs from across the political parties came together to conduct the enquiry, which surveyed more than 10,000 women with endometriosis. It found that 53% of those surveyed had been to A&E with symptoms before being diagnosed. And 58% had visited their GP more than ten times before receiving a diagnosis.

A large majority also claimed their mental health had been affected. Around 90% said they would have liked some form of psychological support but were never offered it.

What is endometriosis?

Endometriosis is a condition where womb-like tissue grows outside of the womb, usually in the pelvic area. As with the womb lining itself, the tissue builds up and bleeds every month, but as it has no exit route from the body, it gets trapped, causing a lot of pain, swelling and scar tissue.

Some women experience no symptoms, and the problem is not uncovered until the pelvic area is scanned for another reason. But for many the condition causes debilitating problems. This includes chronic pain in the pelvis, painful sexual intercourse, difficulty in conceiving, and pain during bladder or bowel movements.

Why does endometriosis take so long to diagnose?

One major reason for the delay in endometriosis diagnosis is a lack of awareness about the condition, even among medical professionals.

The APPG enquiry has called for more training for medical professionals in the diagnosis and treatment of endometriosis. As well as investment in research into the causes and management of the condition.

It has also called for better menstrual education within schools, as lack of awareness is another factor in misdiagnosis.

Sir David Amess, MP, chair of the APPG, said:

“The report provides a stark picture of the reality of living with endometriosis, including the huge, life-long impact it may have on all aspects of life.

“It is not acceptable that endometriosis and it’s potentially debilitating and damaging symptoms are often ignored or not taken seriously. Neither should they be downplayed as linked to the menstrual cycle and periods.”

If you’re concerned about endometriosis or feel that you might be experiencing some of the symptoms, please contact us on 07835 736627 to book a confidential consultation with one of our women’s health specialists.

Fertility and Mental Health

If you have experienced fertility issues, it might not surprise you to hear that there is a link between infertility and mental health. Ninety percent of men and women struggling with fertility, surveyed by Fertility Network UK, felt depressed, and 42% even had suicidal thoughts. So perhaps it’s time to give more attention to the mental health of those battling fertility problems.

Fertility problems aren’t all about conception

Whilst the Fertility Network UK survey focused on couples trying to conceive, a separate study from Imperial College London looked at women who had experienced pregnancy loss in the form of miscarriage or ectopic pregnancy.

Of the 650 women studied, 29% suffered post-traumatic stress one month after losing their pregnancy, 24% had anxiety and 12% had depression. After nine months, those figures had fallen slightly to 18% experiencing post-traumatic stress, 17% moderate to severe anxiety, and 6% moderate to severe depression.

How can you protect your mental health throughout fertility treatment and pregnancy?

There’s no escaping the fact that pregnancy loss will affect you emotionally, and whilst you and your medical team will of course do everything to prevent that loss from happening, it is unfortunately a risk of every pregnancy.

However, by protecting your mental health throughout the conception process and pregnancy, you may be able to avoid suffering long-term damage.

Some of the best ways you can support your mental health during fertility treatment are to:

  • Keep talking – to yourself, in terms of acknowledging your pain, but also to your partner, and maybe to a counsellor. Being open about the emotions you are experiencing can help to prevent them from overwhelming you.
  • Find a support group – in these unusual times, an in-person support group might be difficult to find, but there are hundreds of groups online, full of people who will be going through very similar things to you.
  • Practise self care – whether that’s by allowing yourself the odd treat, by ensuring you get eight hours’ sleep a night, or by pushing yourself to go out for a jog every day – whatever makes you feel healthier, calmer and happier.

And the great news is that if you’re undergoing fertility treatment, then reducing your stress levels and looking after yourself can only improve your chances of conception.

If infertility is already impacting your mental health

Seek help now. Let your GP or fertility specialist know that you are struggling and they will be able to refer you for counselling or point you towards a support group.

Know that you are not alone, and that you will get through this. Talk things through with your partner, too, if you have one. Chances are, they are probably feeling much the same way as you, so talking things through together might help you both feel better.

Egg freezing rules

A UK ethics body, Nuffield Council on Bioethics, is claiming that the current ten-year limit on storing frozen eggs in the UK is arbitrary. And this is being used by some companies to pressurise women into making decisions about their fertility.

Why the ten-year limit?

The ten-year limit only applies to those women who have chosen to have their eggs frozen privately, for personal reasons. Eggs frozen by the NHS can be stored for up to 55 years. But the NHS will only fund egg freezing for medical reasons, such as for women about to undergo cancer treatment.

According to Nuffield, there are very few arguments against increasing the limit on “social” egg storing. The council claims that doing so would allow women to make a more informed decision about when to have a baby.

How does ‘social’ egg freezing work?

‘Social’ egg freezing really refers to the most common form of egg freezing. Women can freeze their eggs privately to allow them more time to think about starting a family.

Whilst this process gives women more freedom in terms of their careers and relationships, Nuffield claims that some less reputable fertility clinics have been using the ten-year limit to their advantage. Preying on anxious women with online advertising and alcohol-fueled marketing events.

And it’s not just fertility clinics taking advantage of social egg freezing. Some companies are offering their female employees egg freezing as part of an employment benefit package. Some see this as a way of providing more gender equality in the workplace. However, others claim it is putting pressure on women to delay motherhood in order to focus on their career.

How effective is egg freezing?

According to the Human Fertilisation and Embryology authority, about one in five IVF treatments using a patient’s own frozen eggs, results in a live birth. That’s compared to around one in four generally for IVF treatment.

However, it’s important to note that eggs harvested from women under 35 are much more likely to ‘take’ then those from women aged 35 and over. And this is the main concern of the ethics body. Clinics are using the ten-year limit to put pressure on women. To freeze their eggs, without providing them with all the facts.

What are the chances of the ten year rule being changed?

The government is currently assessing the ten-year rule, but there is no indication of when any change would come into effect.

If you are considering egg freezing for personal reasons, it is important to be fully informed of all the advantages and disadvantages of the process.

One option in the first instance might be to undergo a fertility MOT, or at least to have a full consultation with a fertility specialist. For more information, please contact us.

Pelvic Pain

Researchers from a group of top UK universities have conducted a study into the effectiveness of gabapentin in treating chronic pelvic pain. But they have found it to be no more effective than the placebo used in the control group.

Gabapentin is routinely used to treat pelvic pain, with 74% of GPs and 92% of gynaecologists saying that they would consider prescribing the drug for this purpose, according to one survey.

However, after publishing the results of the study, the researchers have recommended against prescribing gabapentin for pelvic pain.

How did the study work?

Researchers conducted a randomised clinical trial, involving 306 women who suffered from chronic pelvic pain with no known underlying cause.

Of those 306 women, 153 were given gabapentin to take for 16 weeks, while 153 were given a placebo. They were then asked to rate their pain on a weekly basis, using a scale of zero to ten.

Neither the women, nor the doctors prescribing the drugs, knew which drug they had been given.

At the end of the trial, researchers discovered that there was very little difference in reported pain levels between the two groups.

The group taking gabapentin did, however, report more side effects, including dizziness and mood swings, than the control group. This led the researchers to recommend against its use for this purpose.

What is chronic pelvic pain?

There are many reasons why women experience ongoing pelvic pain, with two of the most common being irritable bowel syndrome (IBS) and endometriosis. In some women, however, the underlying cause of the pain is never found.

If you are suffering from pelvic pain, it is important to see your GP and ask them to refer you to a specialist, to rule out any underlying condition.

But if endometriosis is the cause, it can be difficult to diagnose and is often overlooked. It is not unusual for a woman to suffer with the symptoms for up to ten years before receiving her diagnosis. So if you suspect you might have it, do try to be explicit with your doctor.

How can chronic pelvic pain be treated if gabapentin doesn’t work?

The most important first step in any pelvic pain treatment is to identify an underlying condition, if there is one, and treat that.

In around 24% of women worldwide, however, a cause for their pelvic pain is never found. These are the women who until now were prescribed gabapentin.

Professor Andrew Horne, lead researcher from the University of Edinburgh’s MRC Centre for Reproductive Health, said:

“We have been prescribing this drug for many years with little evidence of its effectiveness.

“As a result of our study, we can confidently conclude that gabapentin is not effective for chronic pelvic pain in women where no cause has been identified.

“More research is needed to explore if other therapies can help instead.”

Some possible treatment options suggested by the researchers included alternative drugs, as well as physiotherapy or even cognitive behavioural therapy. Some physicians believe there may be a psychological reason behind the pain.

If you are experiencing pelvic pain and would like to speak to a specialist in confidence, please call us on 07835 736627.

fertility MOT

Whether you’re currently trying for a baby or just wanting to keep your options open for the future, having some idea of how fertile you are can be useful.

A fertility MOT offers women the chance to find out how likely they are to conceive easily. It’s not an exact science. A positive result doesn’t mean you’ll get pregnant on first try, just as a negative one needn’t send you directly down the route of IVF, but it can be useful to have a rough idea of your fertility level, so you can plan accordingly.

What’s involved in a fertility MOT?

  1. Egg count

After a consultation with one of our fertility specialists, the first step is to undergo a test to find out the size of your ovarian reserve. This is a simple blood test, which checks the level of Anti-Mullerian Hormone (AMH) in your blood. Your AMH level will give us an idea of your remaining egg count.

This test is often used in IVF, to help us work out how your body will respond to ovarian stimulation. Low AMH doesn’t automatically mean you won’t be able to conceive, but it may be advisable to start trying soon, or you may wish to consider freezing some of the eggs you have left.

  1. Pelvic ultrasound

An ultrasound of your pelvic and ovarian region lets us take a look at your womb and ovaries, so we can see if they are healthy and functioning normally. We can also do a further check on your ovarian reserve at this point, by measuring the number of antrical follicles in the ovaries.

The scan is totally painless and gives us a good indication of your fertility level.

  1. General healthcheck

This may be done as part of the initial consultation, or it could be part of a follow-up session. It is very easy to forget how great a role physical health plays in fertility.

At this point, we will check your height, weight and BMI, as a BMI which is much higher or lower than the ‘healthy’ range of 18.5-24.9 can impact on your ability to conceive.

We’ll also look at other lifestyle factors, such as alcohol consumption, smoking, diet, exercise and stress levels.

Why have a fertility MOT?

A fertility MOT isn’t for everyone, but many women find it reassuring to have an idea of their ovarian reserve and be able to plan their lives accordingly.

In the past, we would marry and start families in our late teens or early twenties, when our fertility is at its highest. These days many women choose to wait until their career is well established, or just don’t meet the person they want to have children with until later in life.

Whatever your reason for wanting it, a fertility MOT can help you to plan for the future. For more information, or to book an appointment, please contact us.

male fertility

A new study has shown that use of smartphones, tablets and other digital devices late at night could be having a detrimental effect on male fertility.

The study, conducted by the Sleep and Fatigue Institute in Tel Aviv, Israel, examined semen samples from 116 men, aged between 21 and 59, who were undergoing fertility evaluation. Participants were also asked to answer questions about their socio-economic status, health, lifestyle and sleep variables, including their daily exposure to digital media.

The results seemed to show that consistent late-night use of digital devices was linked to reduced sperm motility (that’s their ability to swim strongly) and concentration. Yet another reason to tell your partner to put his phone down at bedtime!

Are the fertility check results all they seem?

While it’s not unlikely that screen time has an effect on fertility, it might not be as direct a link as it first appears.

Male fertility does seem to be on a downturn – a 2018 study by Hebrew University and Mount Sinai Medical School showed that sperm counts in the United States, Europe, Australia and New Zealand have fallen by fifty percent in the past forty years.

One thing that experts think could be a major factor in this sperm count reduction is a lack of melatonin, or the the sleep hormone.

Sleep and sperm count

In the animal world, the link between melatonin and reproduction is well established, and some experts believe that the same could be the case for humans.

After assessing the results of the sperm count and correlating them with the questionnaires, the researchers also assessed participants’ sleepiness, using the Karolinska Sleepiness Scale (KSS). Dr Amit Green, who led the study, commented:

“We demonstrated a positive correlation between sleep duration and sperm total and progressive motility. A significant negative correlation was observed between subjective sleepiness and total and progressive motility, as well as total motile sperm number. Thus, people should sleep 6-8 hours in order to keep healthy way of life.”

Device use and sleep

It comes as no news to most of us that the use of digital devices late at night has a negative impact on our sleep.

Previous studies have shown that evening exposure to the short wavelength light emitted by smartphones and their ilk reduces our melatonin levels, making it harder for us to switch off and go to sleep.

So, if sleep is necessary for male fertility, it stands to reason that using your smartphone or tablet late at night could also make you less likely to conceive.

Fertility, for both men and women, is affected by many things, however. So, if you have been trying for a baby without success, whilst reducing your device use can’t do any harm, it might be advisable to see a fertility expert and find out whether there is something else preventing you from conceiving.

investigating endometriosis

As with so many women’s health issues, endometriosis can be difficult to diagnose, as the symptoms vary from person to person. In fact, sometimes those women with the most severe-looking lesions have virtually no symptoms.

A recent study published on the British Medical Journal website aims to solve these diagnostic issues, by suggesting that endometriosis be reclassified as a ‘syndrome’ rather than a ‘disease’.

What is a syndrome and how does endometriosis fall into this category?

The word ‘syndrome’ comes from the Ancient Greek word for ‘running together’ and is used to describe groups of symptoms that usually occur alongside each other, where the root medical cause is unknown or not fully understood.

As mentioned above, symptoms of endometriosis can be varied – some women suffer from pelvic pain, difficult periods and pain during sexual intercourse, whilst others may experience fatigue, or irritable bowel symptoms.

There may be obvious endometriotic lesions around the uterus, with virtually no other symptoms, or there could be severe symptoms with almost non-existent lesions. The link between lesions and other symptoms is not fully known.

The authors of the study claim that reclassifying endometriosis as a syndrome would allow for better and faster diagnosis and treatment, thus improving patients’ quality of life.

How would reclassifying endometriosis mean faster diagnosis?

There is currently an average delay of seven to eight years between the onset of symptoms and an official diagnosis of endometriosis.

One of the problems causing a delay in endometriosis diagnosis is a lack of surgical services within the NHS to allow doctors to confirm the existence of the lesions. Reclassifying the disease as a syndrome wouldn’t help with this aspect.

However, currently the main symptom that is officially recognised in endometriosis is persistent pelvic pain. Many women with lesions do not experience pelvic pain, whilst many women with pelvic pain do not have lesions.

As a syndrome, the definition of endometriosis would allow for a much broader range of symptoms. So, clinicians would be more likely to refer women for investigation if they had irritable bowel syndrome, or fatigue, for example, rather than assuming it could not be endometriosis because of the lack of pelvic pain.

What other benefits are there to reclassifying endometriosis?

One major benefit of the reclassification would be a more targeted treatment. With diseases, treatments are aimed at the cause, whereas with syndromes the aim is to treat the symptoms.

So currently, treatment for endometriosis is based solely on removing the lesions, which can put women at risk, and often doesn’t resolve the symptoms.

Treating it as a syndrome would allow clinicians to offer a more holistic approach, helping to manage the symptoms, which – for most sufferers – are the biggest issue.

If you have been experiencing any of the symptoms associated with endometriosis, why not contact us on 07835 736627  today and make an appointment to see one of our specialists.

Endometriosis Diagnosis

Around one in ten women around the world suffer from endometriosis, making it a relatively common disease. And yet, despite this it can often take years to diagnose – in the UK, the average time from onset of symptoms to clinical diagnosis is between eight and ten years.

That means many women are spending up to a decade of their lives suffering from painful symptoms such as pelvic pain, bowel and bladder problems, when they could be receiving treatment. So why does it take so long to diagnose endometriosis?

Endometriosis symptoms can be embarrassing

There is no way that patients can be held accountable for the delay in diagnosis. However, one issue is that the symptoms involved can often be ones that we would prefer not to discuss publicly: pain during sexual intercourse, painful periods, bowel and bladder problems.

Many of the symptoms of endometriosis are considered ‘normal’

Painful periods, for example, are often just accepted as a fact of life, and so women don’t think to mention them to their doctor, just as doctors – including gynaecologists – often don’t think to enquire about menstrual pain.

For many women, bowel problems are also just an uncomfortable part of their daily life, as food intolerance and IBS are often dismissed or overlooked by doctors.

Endometriosis is not well recognised

Even among clinicians, there can be a lack of awareness around endometriosis. As most of the symptoms could also be associated with something else, it often does not occur to doctors or patients that endometriosis could be the cause.

If public awareness of endometriosis were greater, women might be more likely to go to their doctor about their symptoms, and doctors would be more likely to refer them for the n necessary tests. However, there is another problem that causes delays in diagnosis.

There is no simple test for endometriosis

Because the only definitive way to diagnose endometriosis is to establish the presence of ‘endometriotic lesions’ – that is, the existence of womb-like tissue outside of the womb – it can only be confirmed by a surgical procedure.

Unfortunately, within public health services, the surgery involved is categorised as of low importance, which leads to further delays. Add to this the fear many of us have around undergoing surgical procedures, and it’s understandable that many women prefer to stick with the pain they have become used to.

How to get endometriosis diagnosed quickly

If you think you might be experiencing symptoms of endometriosis, here are some ways to ensure you get a diagnosis in good time:

  • Keep a diary of your symptoms: if you are experiencing any of the symptoms associated with endometriosis on a regular basis, keep track of them in a diary so that you have something to show the doctor
  • Choose a doctor with the right kind of knowledge: your GP might not be fully familiar with endometriosis and its symptoms, so ask to be referred to a specialist, or book into a private women’s health clinic
  • Be open about your concerns: if you think your symptoms could be attributed to endometriosis, say that outright to your doctor. If they aren’t familiar with the disease, it might not occur to them otherwise

For more information or to book an appointment, please contact us on 07835 736627 to book an appointment.

Over the years, several studies have shown that women with endometriosis suffer from poor sleep quality, but a new project from a group of researchers in Iran claims to be the first to have investigated the effect of lifestyle factors on the sleep quality of women with endometriosis.

Why is sleep quality and endometriosis linked?

As with many aspects of endometriosis, the link between the disease and poor sleep quality is not fully known, although it is thought to be associated with pain.

This study aimed to take a more holistic look at endometriosis and sleep quality, examining whether lifestyle factors such as diet, exercise, socio-economic level, history of smoking etc could also be having an impact.

How was the study carried out?

The research team took a group of 156 infertile women, of whom 78 had endometriosis and 78 functioned as a control group.

At the beginning of the study, each participant completed a checklist of questions about their physical activity, demographics, reproductive and menstrual status, among other things.

Different aspects of sleep quality were assessed using the Pittsburgh Sleep Quality Index, which looks at elements of sleep quality such as:

  • sleep latency
  • sleep duration
  • sleep disturbances
  • daytime dysfunction

The researchers then used various approved statistical analysis tools to examine links between various lifestyle factors and poor sleep quality in women with endometriosis and the control group.

What were the results of the study?

Sleep quality was found to be significantly lower amongst the women with endometriosis than those in the control group.

The factors found to be most strongly linked to poor sleep quality were dysmenorrhea (menstrual pain), dyspareunia (painful sexual intercourse), pelvic pain, low physical activity and low consumption of dairy produce, fruits and nuts.

What are the implications of this for women with endometriosis?

Whilst many of the sleep-affecting issues are direct symptoms of endometriosis, other factors, such as diet and exercise can be changed to impact on quality of sleep.

The study found that women with endometriosis were significantly less likely to have a diet rich in tryptophan, which aids melatonin production, which in turn allows for a better night’s sleep.

Exercise levels were also much lower in women with endometriosis sufferers, and those with a physical activity level rated ‘high’ (more than three hours per week) were found to have a much better quality of sleep than those who did little to no exercise.

If you have been having problems sleeping and you suffer from any of the other symptoms associated with endometriosis – severe pelvic pain, painful periods, pain during intercourse, bowel or bladder issues – why not contact us today to arrange a consultation with one of our specialists. Call SureScan today on 07835 736627 to book an appointment.