Welcome to our latest e-newsletter!Now that we are at Alert Level 1, we are pleased to confirm that Oxford Women’s Health is providing all of its usual gynaecology and obstetric services, including all surgeries. We’re also now able to see patients face-to-face. We would like to thank all of our patients for their understanding over the past few weeks. It has been a difficult time for many people, especially those waiting for surgery. If you are experiencing pain, bleeding or gynaecological symptoms that are not responding to other treatments, please talk to your GP or call us to arrange an appointment on 03 379 0555. You can also email us at info@oxfordwomenshealth.co.nz. No referral is required. If you are experiencing a medical emergency, please phone 111. Please don’t hesitate to advise anyone living with a gynaecological issue to contact us, so that we can offer support and discuss treatment options, if required. Best regards, Simon Jones Clinic Director The truth about hysterectomies At Oxford Women's Health, our specialists regularly perform hysterectomies for women who need them. Prior to surgery, they discuss a range of possible treatments with their patients, but sometimes a hysterectomy is the best option. One of our gynaecologists Ben Sharp offers the following advice to dispel some common myths about having a hysterectomy: After a hysterectomy, women immediately go through menopause Not so. Removing the uterus does not affect the hormonal cycle. The ovaries produce hormones and they are not usually removed during a hysterectomy. The only organs that are removed are the uterus (which will stop periods if the woman is of reproductive age), the cervix (which is the lower part of the uterus and means no more need for smears in most cases) and the fallopian tubes (removing these reduces the risk of ovarian cancer by up to 40%). Menopause will naturally occur at some stage after a hysterectomy, but often the hysterectomy is blamed for both menopause and a prolapse, which may occur later. After a hysterectomy, sex will not be as good/my libido will go Again, not true – it is usually improved because many conditions that lead to a woman having a hysterectomy cause sex to be painful. It’s major surgery with a long recovery Not usually. It depends on the type of hysterectomy but recovery is usually two to three weeks, and at most around six weeks. There are different approaches to performing a hysterectomy. The most common is laparoscopic, in which a small telescope is placed through the belly button, and then two or three other small incisions are placed in the abdomen. Usually, one overnight stay in hospital is all that's required, but two nights might be better, especially if there are young children at home. Often recovery involves only two or three weeks away from work. Hysterectomy causes prolapse It doesn’t and in fact a hysterectomy can be done in a way that reduces the chance of prolapse in later life. The reason for this misconception is that many women have a hysterectomy in their 40s, usually after they have had children. The main reason for prolapse is having children, but the damage done during pregnancy and childbirth is often hidden until the woman goes through menopause, which will be some time after a hysterectomy. PMS will go after a hysterectomy Unfortunately not because, as discussed previously, the ovaries are usually left behind during a hysterectomy and it is these that cause the cycle. After a hysterectomy, a woman may still be aware of a cycle although there will be no period and any mood swings are usually improved. Hysterectomy is my only option Most definitely untrue, especially if a woman is uncertain if her family is finished – there are always options. Guidelines encourage earlier diagnosis of endometriosis In March, the Ministry of Health released new guidelines for ‘The Diagnosis and Management of Endometriosis in New Zealand’. Oxford Women’s Health gynaecologist Mike East, and Endometriosis and Pelvic Pain Coach Deborah Bush were involved in the development of the guidelines, along with health consumers and representatives from the Ministry of Health, RANZCOG, RNZCGP, FPMANZCA, and Endometriosis New Zealand. Endometriosis affects up to 1 in 10 women and girls, and according to the guidelines document, slow diagnosis can lead to delays in appropriate management of the disease for many women. While the most common symptom of endometriosis is pelvic pain, others include bowel problems, painful intercourse, sub-fertility or infertility, and abnormal menstrual bleeding. Mike East says, “The guidelines are designed to assist early diagnosis of endometriosis, so that the disease can be managed well at a primary care level with timely intervention and management.” “They encourage a multi-disciplinary approach to treatment, as is already the practice at Oxford Women’s Health,” Deborah Bush says. “This includes coaching, dietary advice, physiotherapy and support from a clinical psychologist. If patients aren’t responding, then referral to a gynaecologist with experience in managing endometriosis is recommended.” Popular diets concern nutritionist Fasting and Keto diets that encourage people to ignore hunger signals are dangerous for anyone susceptible to developing an Eating Disorder, according to Oxford Women’s Health dietitian Sara Widdowson. Turning off hunger and fullness cues are not a good idea, especially when they may be accompanied by positive comments about weight loss, she says. “Disordered thinking can be triggered quite easily and people may get to the stage that they don’t know what a normal day of eating looks like because their association with food has become so out of kilter.” Sara is attracting an increasing number of clients with Eating Disorders and in February she attended further training in Melbourne. “She says that while dietitians and GPs are often the first to identify that someone has an Eating Disorder, the best outcomes are achieved by a multidisciplinary team involving an Eating Disorders specialist, General Practitioner, dietitian and psychologist/counsellor who can provide wraparound care and treatment. "People with an Eating Disorder have a much better chance of recovery, if they can be diagnosed and treated as quickly as possible by the right people.” Eating Disorders include Binge Eating Disorder (BED), Bulimia Nervosa (BN), Anorexia Nervosa (AN), Other Specified Feeding and Eating Disorders (OSFED) and Avoidant Restrictive Food Intake Disorder (ARFID). Sara says that while Anorexia Nervosa is highly visible and the most discussed, people with Binge Eating Disorder, Bulimia and other disorders can slide under the radar if they have a normal BMI or are overweight. “Eating Disorders effect people of all shapes and sizes. For example, someone with Bulimia may show no outward signs of being unwell but their illness may be seriously effecting their heart and teeth and a blood test will show they have abnormal protein and creatine levels.” While Binge Eating is the most prevalent eating disorder, Sara stresses not everyone in a bigger body has an eating disorder, and a person in a larger body isn’t necessarily unhealthy. "People with an eating disorder have complicated thoughts about their bodies and food,” she says. “A lot of people think Binge Eating is about a lack of self-control, but it is linked to people avoiding feelings, self-sabotage and using food to soothe. All eating disorders are mental health disorders, involving mental distress.” Sara Widdowson has been a Nutrition Consultant and Dietitian for Oxford Women's Health since 2015. While Eating Disorders are incredibly complex, Sara’s underlying advice is simple – “We should all be eating about six times a day (including meals and snacks) and encouraged to think about food as a pleasurable, sociable part of life.” “Alongside GPs and psychologists, dietitians also have a role in Eating Disorder Recovery. This involves normalising portions, providing appropriate meal plans, guidelines and teaching clients about the role of nutrition.” Sara sees people needing nutritional advice at different stages of life and for a wide range of health issues. To make an appointment with her visit the Oxford Women’s Health website or call 03 379 0555. Massage therapy, a remedy for tension headaches For many people, tension headaches have become an unfortunate side-effect of modern-day living, as we find ourselves at desk jobs and staring at computer screens for long periods of time. The good news is there are exercises and techniques that can help to relieve and prevent the pain. The following Question and Answer session with Oxford Women's Health Massage Therapist, Stacey Harris, was recently published in Metropol magazine. Tell us about tension headaches and what causes them? I’d say up to 70% of my clients have headache issues at times and the vast majority of these would be tension headaches. We spend a lot of our time with our head in a forward position, which tightens and stretches all the muscles in the back of the neck, and shortens the muscles at the front. We see this with people working at computers, reading books, studying, or on phones. How do we know we’re experiencing a tension headache or if it’s something more serious? As a massage therapist, I’m not qualified to make a medical diagnosis, but I always look for red flags. A tension headache is more likely to be worse at the end of the day. They happen when you’ve been working long hours, are under stress, have been grinding your teeth or experiencing muscle tension. But headaches can also indicate an ear or tooth infection, or a migraine which is a completely different ballpark, and you need a doctor to diagnose it. If in doubt, see your GP, especially if you’re experiencing double-vision or dizziness. How does the tightened muscle actually trigger the headache? A thick band of connective tissue connects muscles in the front of our forehead to muscles in the back. If you have a restriction, like a tight muscle in the back, then it can affect the muscles in the front, causing headaches Stacey Harris is a massage therapist for Oxford Women's Health. She is a registered member of Massage New Zealand and also a Southern Cross easy claim provider. What techniques can you offer at Oxford Women’s Health to ease tension headache discomfort? Primarily deep tissue massage and relaxation techniques. I work on the shoulder and upper trapezius muscles that go through the shoulders and right up into the neck. I aim to stimulate the client’s own relaxation responses, and there are other techniques, like dry needling and cross-fibre techniques that can be used. What can we do at home to avoid headaches? If I get a headache, I don’t use a pillow if I’m lying down. It gives the muscles a chance to relax. Exercises can strengthen the muscles in the back of the neck to balance any issues and drink water, it’s good for you. Hydration is key. Above all, get up and move every hour for a few minutes. It’s about doing little things. Prioritise yourself. Taking 10 minutes out regularly during your day is important! |