Rising levels of anxiety

Anxiety is the body’s way of responding to a threat. If you were to come face-to-face with a tiger in the wild, chances are your response would be to either fight, flee, or freeze.

During this split-second reaction, our sympathetic nervous system is activated; our brain releases adrenaline, cortisol is sent out into our blood stream and our heart rate quickly rises to give ourselves the best chance of getting out of a terrifying situation. This is an excellent response if we are indeed in the wild and need to run, but not so helpful if we are sitting an exam or about to attend an important meeting.

While it’s normal to feel anxious from time-to-time, especially as we navigate our way through a global pandemic, for some people it can start to severely impact their daily lives.

Oxford Women’s Health Clinical Psychologist Dr Amy Montagu describes anxiety as the overestimation of a threat and the underestimation of a person’s ability to cope with the situation.

Once you have experienced an anxious episode, it takes time for your body to return to its baseline, and we can feel completely exhausted as a result.  “This is when the parasympathetic nervous system (rest and digest) comes into play to help restore the body,” she says.

If this sounds familiar, you are not alone. Dr Montagu says the rates of people living with anxiety are high, especially for those in Canterbury, who in the last decade have had to cope with earthquakes, the mosque shootings, and the COVID-19 pandemic, not to mention life’s daily stressors.

“People have had a lot to cope with and now we’re seeing changes to people’s jobs and the impact of lockdowns,” she says.

“Anxiety is a big issue across the country but in Christchurch there have been several extra layers to deal with.”

Amy Montagu

She says there are many effective ways to manage anxiety, so reach out to your GP early if you need support. While you are seeking help from a medical professional, there are also simple lifestyle changes you can make to help reduce anxiety. Here, Dr Montagu shares her top tips:

-       The immediate antidote for anxiety is diaphragmatic breathing, which is also known as belly breathing. This can activate the parasympathetic system and calm the body’s anxiety response.

-       Exercising three to four times a week is really helpful. The more intense the activity the better, but even just getting outside for a walk in the sunshine is a great idea. To help fit this into your day, schedule in a walk as part of your lunch break.

-       Find something to actively distract you from anxious thoughts - ruminating on an issue will only make it worse.

-       Limit your coffee intake and ensure you are eating a healthy diet.

-       Good quality sleep is so important but can be challenging during times of anxiety. You might find placing a notebook and pen beside your bed is helpful so you can jot down your thoughts on paper. Also stick to a good sleep routine by going to bed and getting up at the same time each day.

If you would like to make an appointment with Dr Montagu, please talk to your GP or contact Oxford Women’s Health directly on 03 379 0555.

Meet our New Team Member

We are delighted to welcome Gynaecologist and Obstetrician Anne Coolen to the Oxford Women’s Health team. Originally from the Netherlands, Anne began her career as a gynaecologist in 2012.

She moved to New Zealand with her family in February 2020 and has been working at Christchurch Women’s Hospital. Her special areas of interest include urogynaecology (prolapse and incontinence problems) and benign gynaecology (encompassing bleeding problems, contraception, and vulvar and vaginal issues). 

Anne is also able to provide advice or assistance with requests for elective/repeat caesarean sections.
A mum to three children, Anne enjoys spending time with her family and dog, and is relishing opportunities to explore the South Island on running
 

Anne Coolen

and cycling adventures. To make an appointment to see Anne, please contact our friendly team on 03 379 0555.

Menopause resources

This NHS article about menopause offers some great resources that you may find useful.

Alongside an overview of the signs, symptoms, and treatment options available to women experiencing menopause, it includes information about sexual wellbeing
 

and intimacy during and after menopause, managing symptoms in the workplace, and how menopause can impact on a woman’s mental health.

To view the series of informative articles, visit:

oxfordwomenshealth.co.nz/what-we-offer/menopause.html

The other microbiome

Gynaecologist Janene Brown has recently been working to increase understanding of the vagina’s microbiome to help in the treatment of recurrent thrush, Bacterial Vaginosis and other common health issues.

The gut microbiome has recently been getting plenty of attention but did you know that the vagina has a microbiome of its own? One of the most visible signs of a change in the microbiome is a vaginal discharge but gynaecologist Janene Brown says women need to be aware that not all discharge is cause for concern.

“Having some discharge is normal and it fluctuates with changes in hormones throughout the month,” she says. Thrush or candida with its characteristic curd-like discharge and itchiness is, however, all too familiar for many women. This yeast infection lives in the vagina and on the skin, and five to ten per cent of women who have recurrent problems with it, have it on their bodies all the time.

There are a variety of treatments for it when it flares up but none of them will necessarily eliminate it, Janene says. Disturbingly, thrush is also becoming increasingly resistant to medication. Treatment for thrush is further complicated by the fact that its symptoms are prompted by an immune response that as yet can’t be controlled.

Responses to thrush range from the 20 per cent of women who live with it with no symptoms, to those with hypersensitive immune systems, who regularly experience itching and discharge. If you have allergies and asthma, you are much more likely to have problems with recurrent thrush.

Triggers for thrush include anything that changes the environment of the vagina, such as antibiotics, sex, pregnancy, obesity, a compromised immune system, and stress. It particularly likes oestrogen which is why many women have problems with it in the week before their period and it is rarely an issue for post menopausal women.

Janene says to alleviate symptoms, you need to change the vaginal environment to be less hospitable. This might include medication or a different contraceptive pill and changing to a gut friendly diet. 

She says the links between the vagina’s microbiome and gut microbiome are not yet known but advises her patients

Janene Brown

that what is good for one is most likely to be good for the other. 

“What won’t help is putting yoghurt in your vagina, treating your partner for thrush, or taking up a low sugar diet. All have been proven to have no effect.

”Bacterial Vaginosis (BV), with its distinctively fishy smell, is another of the most common causes of vaginal discharge.

“BV bacteria are normally in the vagina but sometimes they can throw a party when blood or sperm change the pH of their environment,” Janene says.

She says there is no need to treat BV, as the body generally corrects itself, but if it is proving embarrassing or hard to shift there are medications available.

These include a large dose or five day course of the drug Metronidazole when it flares up; weekly or monthly Boric Acid treatments to prevent it; and other preventative measures such as using a condom during sex.

There has been some research on the effects of lactobacillus bacteria in preventing BV but Janene says there have been no positive results as yet. If women are experiencing other types of discharge, Janene recommends that a swab be taken to rule out anything more unusual.

She says sometimes products and potions used in the vaginal area can cause sensitivity and women need to be wary of these, particularly after menopause.

“The walls of the vagina can become very soft and deteriorate (after menopause), so oestrogen cream may be the treatment needed for postmenopausal discharge rather than antibiotics.”

Pregnancy and the oral contraceptive pill can have a similar effect on the vagina as menopause, causing painful sex and a discharge.
 

Thank you, Wakatipu Medical Centre

A huge thank you to the Wakatipu Medical Centre for supporting us while we are waiting for our new rooms to be built. The Queenstown Centre of Medical Excellence at Kawarau Park will be ready for us to move into in June 2022.

Gynaecologists Janene Brown, Ben Sharp and Olivia Smart will continue
 

to be available for appointments at the new site.
When it is open, you will be able to find us at unit G, opposite the new Southern Cross Hospital on the Frankton side of Queenstown.
 

The Breeze Canterbury's Bra Ride

We were pleased to lend our support to The Breeze Canterbury’s Bra Ride on 10 October to help promote the work of the Breast Cancer Foundation NZ.

The Hagley Park event was a very positive way to raise awareness of breast cancer and the work of the Foundation.

Oxford Women’s Health General Manager Catherine France says joining the Breeze Bra Ride to raise funds for The Breast Cancer Foundation was an obvious choice. “We all want to reduce the number of women dying from breast cancer, so supporting this event was a natural fit,” she says. 
 

“There were so many positives – raising funds and awareness of breast cancer while being out and about in our glorious Hagley Park, in a pink bra, no less.”

“We all know someone we love who has been affected by this serious illness, so we were happy to lend our support to this good cause.”
Well done to everyone who took part in this fun event!
 

Merry Christmas

The Oxford Women's Health team wish you a very happy Christmas and New Year. We hope you and your families have a wonderful holiday, and we look forward to seeing you again in 2022.

Oxford Women’s Health will close for the Christmas break at 5pm on Wednesday 22 December.

We will be back to start the New Year at 8am on Thursday 6 January.