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Understanding the dynamics – breastfeeding, pregnancy and COVID vaccines

Understanding the dynamics - breastfeeding, pregnancy and COVID vaccines

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As Sri Lanka rolls out its vaccination program, the questions have shifted from “Which vaccine should I get?” to “Should pregnant and breastfeeding women get vaccinated?” 

The answer in short: Yes, everyone should get vaccinated when offered the chance.

For a more detailed answer on how the vaccine affects pregnant and lactating women, read more below.

Breastfeeding and vaccinations 🤱🏾

Women who have recently given birth or are still breastfeeding should get the vaccine. 

Initially, the clinical trials for the COVID-19 vaccines currently in use did not include women who were breastfeeding. So, there was no clinical data on the safety of vaccines in lactating women, effects of the vaccine in breastmilk production and the consequences on the baby. However, now according to the WHO and new research, lactating women can receive a COVID-19 vaccine.

Recent reports have shown that breastfeeding women who have received COVID-19 vaccines have antibodies that pass on to the baby via breast milk, helping in protecting the baby. 

 A study conducted in Israel with thePfizer-BioNTech vaccine, with 84 breastfeeding women, showed that IgA antibody (the first line of defence when exposed to an infection) secretion was present as early as 2 weeks after vaccination in the breast milk. This was followed by a spike in IgG antibody (important for remembering the virus to prevent future infections) 1 week after the second dose in the breast milk. This suggests a potential protective effect against infection in the infant as these antibodies are passed on to them via the milk. No mother or infant experienced any serious adverse event during the study period.

More data is needed to understand what protection these antibodies provide to the baby. Even though the studies on breastfeeding and vaccinations are not advanced, the present data shows no indication of harm to the mother or child.

Pregnancy and vaccinations 🤰🏾

As with many other vaccines, the effects of the COVID-19 vaccines on pregnant women have not been studied extensively yet. However, health professionals assess the risks of COVID19 vs. the COVID vaccine when deciding whether pregnant women should receive the vaccine. 

Pregnant women with any of the following conditions are at a higher risk of contracting severe COVID than women who are not pregnant: 

  • have underlying health conditions (for example diabetes, high blood pressure or asthma)
  • are overweight
  • are aged 35 years or over

Preliminary findings in a study conducted in the US on the effects of mRNA vaccine in pregnant women did not show obvious safety signals among pregnant women who received mRNA Covid-19 vaccines compared to the control group.

It must be noted that injection-site pain was reported more frequently among pregnant women than among non-pregnant women, whereas other side effects such as headache, chills, and fever were reported less frequently. However, a more detailed and longitudinal study is needed to understand the full impact of vaccination on pregnant women. 

We already know pregnant women are at a higher risk of getting severe COVID and also at a higher risk of delivering a baby prematurely. So in a country like Sri Lanka, where the transmission rate is high, the benefits of getting the vaccine far outweigh the risks. 

Fertility and vaccinations 🌸

Women who are planning to get pregnant in the near future can absolutely take the vaccine. There is no evidence of COVID vaccines affecting fertility or the chances of getting pregnant. So get your vaccine when it becomes available to you. 

If you want more detailed information on getting vaccinated you can speak to one of our on-demand GPs at any time via the oDoc app. If you or your loved ones are showing any COVID symptoms please consult a doctor via oDoc immediately or use the oDoc COVID symptom checker to understand what you should do next.

Sources

  1. Perl, S. H., Uzan-Yulzari, A., Klainer, H., Asiskovich, L., Youngster, M., Rinott, E., & Youngster, I. (2021). SARS-CoV-2–Specific Antibodies in Breast Milk After COVID-19 Vaccination of Breastfeeding Women.
  2. Vaccination Considerations for People Pregnant or Breastfeeding. (2021, June 16). Centers for Disease Control and Prevention. 
  3. Public Health Scotland. (2021, June 18). Pregnancy, breastfeeding and the coronavirus vaccine. The Coronavirus (COVID-19) Vaccine. 
  4. WHO. (2021, June 4). Episode #41 – Vaccines, pregnancy, menstruation, lactation and fertility. World Health Organisation.
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Is My Baby Drinking Enough Milk?

Is my baby drinking enough milk?

Milk supply myths debunked!

Nicole Parakrama | BSc Hons Molecular Cell Biology, UCL (UK) | 17th April 2021 | <5 minute read

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“Aney why is he crying so much?”…

…“Hungry-da?”…..

Mothers of infants might find this line of questioning familiar!

In our culture, we tend to cajole and bribe our children into eating more, with the goal of making them as chubby as possible. However, when we don’t allow our children to regulate their hunger for themselves, this can lead to unhealthy eating patterns (see this study here) with repercussions all the way into adulthood (some other great longitudinal studies here and here). We do our children a great disservice when we don’t take into account their varying body structures, feeding patterns, and metabolisms when considering when and how often we feed them.

“Aney why is he crying so much?”…

…“Hungry-da?”…..

Mothers of infants might find this line of questioning familiar!

In our culture, we tend to cajole and bribe our children into eating more, with the goal of making them as chubby as possible. 

 This same culture can extend to breastfeeding as well, with negative repercussions as a result! A study conducted by Rodrigo et al among 249 mothers at the Colombo North Teaching Hospital, found that “a family member telling mothers that their milk supply was low had

However, when we don’t allow our children to regulate their hunger for themselves, this can lead to unhealthy eating patterns (see this study here) with repercussions all the way into adulthood (some other great longitudinal studies here and here). We do our children a great disservice when we don’t take into account their varying body structures, feeding patterns, and metabolisms when considering when and how often we feed them. This same culture can extend to breastfeeding as well, with negative repercussions as a result! A study conducted by Rodrigo et al among 249 mothers at the Colombo North Teaching Hospital, found that “a family member telling mothers that their milk supply was low had the most

the most significant impact on Perceived Inadequacy of Milk (PIM)”.  In other words, we can give undue weight to the opinion, however well-intentioned, of someone who is (to put it simply) not the mother of our baby. 

It is not surprising, then, that one of the most Googled questions on breastfeeding is – “How can I tell if my baby is drinking enough milk?”  This is an understandable concern, as we simply cannot see how much milk our baby is taking in at the breast, so we have to guess!  Rest-assured, our babies are very clever at making their needs known – and they will usually drink as much milk as they need.  In turn, our breast tissue will respond over time and produce a supply of milk to match their demands. There ARE instances where concerns are warranted, and supply is low for medical reasons, but this is very often not the case.

This same culture can extend to breastfeeding as well, with negative repercussions as a result! A study conducted by Rodrigo et al among 249 mothers at the Colombo North Teaching Hospital, found that “a family member telling mothers that their milk supply was low had the most significant impact on Perceived Inadequacy of Milk (PIM)”.  In other words, we can give undue weight to the opinion, however well-intentioned, of someone who is (to put it simply) not the mother of our baby. 

It is not surprising, then, that one of the most Googled questions on breastfeeding is – “How can I tell if my baby is drinking enough milk?”  This is an understandable concern, as we simply cannot see how much milk our baby is taking in at the breast, so we have to guess!  Rest-assured, our babies are very clever at making their needs known – and they will usually drink as much milk as they need.  In turn, our breast tissue will respond over time and produce a supply of milk to match their demands. There ARE instances where concerns are warranted, and supply is low for medical reasons, but this is very often not the case.

significant impact on Perceived Inadequacy of Milk (PIM)”. In other words, we can give undue weight to the opinion, however well-intentioned, of someone who is (to put it simply) not the mother of our baby. 

It is not surprising, then, that one of the most Googled questions on breastfeeding is – “How can I tell if my baby is drinking enough milk?” 

This is an understandable concern, as we simply cannot see how much milk our baby is taking in at the breast, so we have to guess!  Rest-assured, our babies are very clever at making their needs known – and they will usually drink as much milk as they need.  In turn, our breast tissue will respond over time and produce a supply of milk to match their demands. There ARE instances where concerns are warranted, and supply is low for medical reasons, but this is very often not the case. 

A longitudinal study by Nielsen et al studied the milk intake of 50 healthy, exclusively breastfed babies over 6 months, and found the milk intake and fulfilment of energy values to be in excess of literature values.

Unfortunately, it is this fear of having a low supply which can become a roadblock in our breastfeeding journeys, far more often than it being an actual medical issue.

At a very high level, the rule of thumb is – if your baby comes off the breast looking relaxed, and if the number of heavy, wet diapers in 24 hours is more than or equal to the number of days old (for newborns up to one week), and 5-6 thereafter, your baby is very likely getting adequate milk (check out this comprehensive presentation by the Sri Lanka College of Pediatricians, particularly slides 41-46).

There are 9 common occurrences that may worry mothers, but which are not necessarily an indication of inadequate milk supply:

1. My baby wants to nurse very frequently

Breast milk is actually digested very efficiently (usually within 1.5-2 hours) and frequent feeding is common as a result.  Some babies are also more ‘sucky’ than others or require more skin contact.

2. My baby suddenly nurses more frequently, or for longer durations

This may be a growth spurt, which usually lasts a few days to a week. Since milk production is supply & demand-based, allowing your baby to feed extra will result in your breasts producing more milk to catch up.

3. My baby suddenly nurses less frequently, or for shorter durations

With age, as your baby gets more efficient at extracting milk, and the size of their little tummy increases, this will happen and is not an indicator of low supply.

4. My baby guzzles down a bottle of milk after nursing

Many babies will take a bottle of milk even after a full breastfeed, due to their suckling reflex, and then fall asleep due to exhaustion rather than satiation.

5. My breasts don’t leak milk, or only leak a little, or have stopped leaking

Leaky breasts have nothing to do with your milk supply adequacy. Leaking often stops once your milk supply has adjusted to your baby’s needs, and/or as the feeds become more predictable.

6. My breasts seem softer, or don’t get engorged anymore

Again this often happens once your milk supply has adjusted to your baby’s needs, and/or as the feeds become more predictable.

7. I don’t feel a let down sensation

Some women may never experience a let down sensation (tingling, pins & needles or a feeling of warmth), or find that it reduces over time. This is not connected to a reduction in supply.

8. I get very little milk when i pump

There are many reasons why this could be… pumping technique, pump type, flange size etc. At the best of times, your baby’s suck will always be more efficient at draining your breasts than the pump can mimic.  Pump output should not be used as a reliable indicator of production.

Hopefully you will find some reassurance if you are in this boat of questioning your supply.  However, if you have already found it in yours or your baby’s best interest to give formula, there is no guilt or shame in that. Breastmilk, while optimal, is not the only way to feed your baby. There are many circumstances where combination feeding (formula + breast milk) or only formula is necessary, and your child will be none the worse for it.  A well-fed baby combined with a happy mother really is the best end result.

How I became ‘The Milk Coach’

When my first child was born, I was quite unprepared for what lay ahead.  Particularly when it came to breastfeeding – I was naïvely expectant that I could just place him onto my chest, and let nature take its course.  What a surprise I was in for!  Cracked nipples from sub-optimal positioning, and my milk taking its own time to come in, led to terrible pain.  This pain became excruciating when my son developed oral thrush which travelled through to my milk ducts.  Fortunately, thanks to a lot of research and some wise mum friends, I was able to power through those awful first few months.  Most crucially, I was able to advocate for myself with health professionals (and I’m thankful for the ones who listened to me when I did!).

This birthed a passion to peer-to-peer counsel, share with and advocate for my fellow Sri Lankan mums, to support them to achieve their breastfeeding goals. To this end I am working to add to a science background (in Molecular Cell Biology) with an accreditation by La Leche League International (LLLI). 

Join the conversation, follow @themilkcoach on Instagram or Facebook.

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How to relieve menstrual cramps

How to relieve menstrual cramps

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Ladies, is it that time of the month? Are we feeling subtle cramps in our stomach, lower back pain, maybe some strange mood swings? Maybe we have to make a trip to the supermarket and buy our monthly stock of pads and tampons. We get it! Your period is here, which means those uncomfortable, painful cramps are here too. We’re here to help ease the burden by giving you some ways you can relieve the pain and discomfort.

What are menstrual cramps?

Period cramps, or dysmenorrhea, refers to the discomfort women feel in their abdomen, lower back and thighs during their menses. Cramping can vary in intensity from woman to woman. Some may feel a slight discomfort and others may feel more severe pains that can affect certain aspects of their life.

What are menstrual cramps?

Period cramps, or dysmenorrhea, refers to the discomfort women feel in their abdomen, lower back and thighs during their menses. Cramping can vary in intensity from woman to woman. Some may feel a slight discomfort and others may feel more severe pains that can affect certain aspects of their life.

Why do period cramps happen in the first place?

During your period, the uterus contracts to help shed its lining. Hormone-like substances (prostaglandins) trigger the contractions which causes pain and inflammation. Higher levels of prostaglandins can lead to more severe menstrual cramps.

Symptoms of menstrual cramps may include:

  • Cramping in the lower abdomen
  • Lower back pain
  • Pain radiating down the legs
  • Nausea
  • Vomiting
  • Diarrhea
  • Fatigue
  • Weakness
  • Fainting
  • Headaches

Symptoms of menstrual cramps may include:

  • Cramping in the lower abdomen
  • Lower back pain
  • Pain radiating down the legs
  • Nausea
  • Vomiting
  • Diarrhea
  • Fatigue
  • Weakness
  • Fainting
  • Headaches

What can you do to relieve the pain from cramps during your menses?

For mild and temporary cramps, some home remedies can provide comfort and relief.
Here are a few things for you to try:

Applying heat to your lower abdomen and lower back can relieve pain. If you don’t have a heating pad or hot water bottle, take a warm bath or use a hot towel.

Applying heat to your lower abdomen and lower back can relieve pain. If you don’t have a heating pad or hot water bottle, take a warm bath or use a hot towel.

Applying heat to your lower abdomen and lower back can relieve pain. If you don’t have a heating pad or hot water bottle, take a warm bath or use a hot towel.

Avoid foods that cause bloating such as fatty foods, alcohol, carbonated drinks, caffeine or salty foods. Instead have some tea with ginger or mint, hot water with lemon or strawberries

Avoid foods that cause bloating such as fatty foods, alcohol, carbonated drinks, caffeine or salty foods. Instead have some tea with ginger or mint, hot water with lemon or strawberries

Avoid foods that cause bloating such as fatty foods, alcohol, carbonated drinks, caffeine or salty foods. Instead have some tea with ginger or mint, hot water with lemon or strawberries

Maintain a consistent diet of minimally processed foods, fiber and plants. Try having more papaya, brown rice, walnuts, almonds, broccoli, fish, leafy green vegetables and flax seeds.

Maintain a consistent diet of minimally processed foods, fiber and plants. Try having more papaya, brown rice, walnuts, almonds, broccoli, fish, leafy green vegetables and flax seeds.

Maintain a consistent diet of minimally processed foods, fiber and plants. Try having more papaya, brown rice, walnuts, almonds, broccoli, fish, leafy green vegetables and flax seeds.

Drink more warm or hot water and eat water-based foods to increase your hydration such as cucumber, watermelon, lettuce and celery.

Drink more warm or hot water and eat water-based foods to increase your hydration such as cucumber, watermelon, lettuce and celery.

Drink more warm or hot water and eat water-based foods to increase your hydration such as cucumber, watermelon, lettuce and celery.

Exercise! Although the last thing we want to do during our menses is work out, exercise releases endorphins which relieves some menstrual cramp pain.

Exercise! Although the last thing we want to do during our menses is work out, exercise releases endorphins which relieves some menstrual cramp pain.

Exercise! Although the last thing we want to do during our menses is work out, exercise releases endorphins which relieves some menstrual cramp pain.

When to see a doctor:

  • If period cramps disrupt your life in some way every month
  • Your symptoms get progressively worse and you are in intense pain every month
  • If you started having severe menstrual cramps after the age of 25

You can speak to a VOG doctor by consulting an Obstetrician or Gynecologist on the oDoc app. GPs and Family Physicians are also available to consult.

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PCOS – breaking the stereotype

PCOS - breaking the stereotype

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There is so much noise around women’s health. Specifically, PCOS and most of it seems to be scientifically incorrect. PCOS is one of the most common endocrine disorders in women, affecting one in four women of reproductive age, which is 25% of the entire female population, so it is only fair to bust the myths around it. Before we debunk the misconceptions, here’s a little about PCOS.

A little about PCOS

Polycystic Ovary Syndrome or PCOS is an endocrine disorder that affects the way a woman’s ovary works. Women who suffer from PCOS either have an irregular period, excess production of male hormone or polycystic ovaries (where there are multiple cysts on the ovary). The excess androgen and cysyts in the ovaries prevent ovaries from releasing eggs every month. However, the exact cause of PCOS is still unknown.

Let’s go on and bust the myths around it because separating myth from fact can help you live a healthier life with PCOS. 

Myth #1: Having polycystic ovary syndrome means you have cysts in your ovaries

This is untrue. The name of the disorder is very misleading. If you have PCOS, it doesn’t mean you have cysts in your ovaries and having cysts in your ovaries doesn’t mean you have PCOS.

To be diagnosed with PCOS, you need to have at least 2 of the following symptoms:

Let’s go on and bust the myths around it because separating myth from fact can help you live a healthier life with PCOS. 

Myth #1: Having polycystic ovary syndrome means you have cysts in your ovaries

This is untrue. The name of the disorder is very misleading. If you have PCOS, it doesn’t mean you have cysts in your ovaries and having cysts in your ovaries doesn’t mean you have PCOS.

To be diagnosed with PCOS, you need to have at least 2 of the following symptoms:

Let’s go on and bust the myths around it because separating myth from fact can help you live a healthier life with PCOS. 

Myth #1: Having polycystic ovary syndrome means you have cysts in your ovaries

This is untrue. The name of the disorder is very misleading. If you have PCOS, it doesn’t mean you have cysts in your ovaries and having cysts in your ovaries doesn’t mean you have PCOS.

To be diagnosed with PCOS, you need to have at least 2 of the following symptoms:

Excess androgen – elevated male hormones levels may result in physical signs, such as excess facial and body hair (hirsutism) and occasionally, severe acne and male-pattern baldness.

Irregular periods – this is when you have less than nine periods a year with more than 35 days in between your periods. 

Multiple cysts in your ovaries – your ovaries can be enlarged with tiny follicles that trap the eggs, preventing them from being released every month, causing the ovaries not to function properly. 

So, having just cysts in your ovaries doesn’t necessarily mean you have PCOS. 

If you have any of the above symptoms and would like to get professional advice, you can consult a gynaecologist from the comfort of your home via oDoc.

Myth #2: You can’t get pregnant if you have PCOS

INCORRECT! YOU CAN GET PREGNANT EVEN IF YOU HAVE PCOS. 

PCOS is a common cause of  infertility due to the irregular release of eggs from the ovaries and the hormonal imbalance which interferes with fertilisation, BUT this isn’t the case for everyone. You can still get pregnant both naturally and after fertility treatment. Many medications can stimulate ovulation which is the leading cause of infertility. Women with PCOS who want to start a family can try different fertility treatments. Have a sit down with your gynaecologist to understand your body and treatment options better.

Myth #2: You can’t get pregnant if you have PCOS

INCORRECT! YOU CAN GET PREGNANT EVEN IF YOU HAVE PCOS.

PCOS is a common cause of  infertility due to the irregular release of eggs from the ovaries and the hormonal imbalance which interferes with fertilisation, 

BUT this isn’t the case for everyone. You can still get pregnant both naturally and after fertility treatment. Many medications can stimulate ovulation which is the leading cause of infertility. Women with PCOS who want to start a family can try different fertility treatments. Have a sit down with your gynaecologist to understand your body and treatment options better.

Myth #2: You can’t get pregnant if you have PCOS

INCORRECT! YOU CAN GET PREGNANT EVEN IF YOU HAVE PCOS. 

PCOS is a common cause of  infertility due to the irregular release of eggs from the ovaries and the hormonal imbalance which interferes with fertilisation, BUT this isn’t the case for everyone. You can still get pregnant both naturally and after fertility treatment. Many medications can stimulate ovulation which is the leading cause of infertility. Women with PCOS who want to start a family can try different fertility treatments. Have a sit down with your gynaecologist to understand your body and treatment options better.

Myth #3: You can only get PCOS if you are obese or overweight

Again, nope. This is not true. PCOS is more common in overweight women than lean women, and obesity can worsen the symptoms, but it can affect women of any body type and size.

One of the causes of PCOS is excess insulin in your body. This happens due to your cells forming a resistance to insulin which causes your blood sugar level to increase, and your body might produce more insulin to tackle it. Excess insulin causes more androgen to be produced, which causes difficulty with ovulation. 

The body’s inability to use insulin properly can lead to weight gain. That’s why getting into the habit of eating healthy and exercising regularly is recommended as part of most women’s treatment plan.

Myth #3: You can only get PCOS if you are obese or overweight

Again, nope. This is not true. PCOS is more common in overweight women than lean women, and obesity can worsen the symptoms, but it can affect women of any body type and size.

One of the causes of PCOS is excess insulin in your body. This happens due to your cells forming a resistance to insulin which causes your blood sugar level to increase, and your body might produce more insulin to tackle it. Excess insulin causes more androgen to be produced, which causes difficulty with ovulation. 

The body’s inability to use insulin properly can lead to weight gain. That’s why getting into the habit of eating healthy and exercising regularly is recommended as part of most women’s treatment plan.

Myth #3: You can only get PCOS if you are obese or overweight

Again, nope. This is not true. PCOS is more common in overweight women than lean women, and obesity can worsen the symptoms, but it can affect women of any body type and size.

One of the causes of PCOS is excess insulin in your body. This happens due to your cells forming a resistance to insulin which causes your blood sugar level to increase, and your body might produce more insulin to tackle it. Excess insulin causes more androgen to be produced, which causes difficulty with ovulation. 

The body’s inability to use insulin properly can lead to weight gain. That’s why getting into the habit of eating healthy and exercising regularly is recommended as part of most women’s treatment plan.

Myth 4: Losing weight is how you get rid of PCOS

Unfortunately, there is no cure for PCOS, so losing weight will not make PCOS go away, but it can help manage many of the symptoms. It is said that 10% reduction in body weight can reduce clinical symtoms by 80-90%. Losing weight will help with balancing the hormones. Lifestyle changes, such as healthy eating and regular exercise, improve the way your body uses insulin and, therefore, regulates your hormone levels better, thus helping your symptoms.

Myth 4: Losing weight is how you get rid of PCOS

Unfortunately, there is no cure for PCOS, so losing weight will not make PCOS go away, but it can help manage many of the symptoms. It is said that 10% reduction in body weight can reduce clinical symtoms by 80-90%. Losing weight will help with balancing the hormones. 

Lifestyle changes, such as healthy eating and regular exercise, improve the way your body uses insulin and, therefore, regulates your hormone levels better, thus helping your symptoms.

Myth 4: Losing weight is how you get rid of PCOS

Unfortunately, there is no cure for PCOS, so losing weight will not make PCOS go away, but it can help manage many of the symptoms. It is said that 10% reduction in body weight can reduce clinical symtoms by 80-90%. Losing weight will help with balancing the hormones. Lifestyle changes, such as healthy eating and regular exercise, improve the way your body uses insulin and, therefore, regulates your hormone levels better, thus helping your symptoms.

Myth 5: Women with PCOS do not need to use contraception

If you are not planning on getting pregnant, then you should always use contraception during sex. As mentioned above, ovulation is irregular when you have PCOS, so you never know when the egg will be released. So if you want to avoid unplanned pregnancies, always use a form of contraception.

Myth 5: Women with PCOS do not need to use contraception

If you are not planning on getting pregnant, then you should always use contraception during sex. As mentioned above, ovulation is irregular when you have PCOS, so you never know when the egg will be released. So if you want to avoid unplanned pregnancies, always use a form of contraception.

Myth 5: Women with PCOS do not need to use contraception

If you are not planning on getting pregnant, then you should always use contraception during sex. As mentioned above, ovulation is irregular when you have PCOS, so you never know when the egg will be released. So if you want to avoid unplanned pregnancies, always use a form of contraception.

Myth 6: Irregular periods = PCOS

No! Having PCOS may mean that you might have irregular periods but there are various other factors which can lead to irregular periods such as stress, extreme dieting and other endocrine disorders. Regular periods range between 3-7 days and occur every 21-35 days. Anything longer than this can be considered irregular. If you are experiencing irregular periods, speak to a doctor to get more information.

Myth 6: Irregular periods = PCOS

No! Having PCOS may mean that you might have irregular periods but there are various other factors which can lead to irregular periods such as stress, extreme dieting and other endocrine disorders. Regular periods range between 3-7 days and occur every 21-35 days. Anything longer than this can be considered irregular. If you are experiencing irregular periods, speak to a doctor to get more information.

Myth 6: Irregular periods = PCOS

No! Having PCOS may mean that you might have irregular periods but there are various other factors which can lead to irregular periods such as stress, extreme dieting and other endocrine disorders. Regular periods range between 3-7 days and occur every 21-35 days. Anything longer than this can be considered irregular. If you are experiencing irregular periods, speak to a doctor to get more information.

These are just a few of the misconceptions about PCOS. If you want more information or are experiencing any of the symptoms mentioned in this blog, please seek medical advice from an SLMC registered gynaecologist or GP via oDoc. Do not self-diagnose or self-treat PCOS. 

Checked by Dr. Haroon Thowfeek and Dr. Mohamed Rishard

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Let’s talk about UTIs

Let’s talk about UTIs

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Chances are if you are a woman reading this, you’ve suffered from a urine tract infection (“UTI”) at some point in your life. Whether it has crept up on you or was caused by sex or other irritation, the constant urge to urinate, the pain and discomfort in the lower abdomen and seeing blood in the urine is enough to make anyone pretty miserable.

What is a UTI

Mayo Clinic defines a UTI as “an infection of any part of your urinary system (kidneys, ureters, bladder and urethra)”. More than half of all women are expected to suffer from a UTI at least once in their lifetimes and for some women, it can be a recurring, painful battle.     

Women are more prone to these bacterial infections as we have a shorter urinary tract compared to men so bacteria and toxins can cause trouble easily. An infection can start off in the bladder (cystitis) and move up to the kidneys & ureter (uretheritis).

What are the most common symptoms of a UTI?

UTI infection symptoms include the constant urge to pee, a burning sensation when peeing, passing small (to no) amounts of urine, cloudy urine (sometimes rosey coloured with blood) and pelvic pain. 

Older people with UTIs can present with confusion whilst in young children, it often manifests as fever and/or wetting themselves.

Why they occur

  • There are numerous reasons why these infections occur but the most common is human anatomy: the female urinary tract is short, the space between the anus and the urethra is shorter than it is for a male and therefore the distance gut bacteria have to travel to enter the bladder is shorter. 
  • Sex could lead to UTIs due to bacteria from the genital area entering the urinary tract.
  • It’s sometimes found to be a predisposition caused by genetics where females in certain families are more prone to UTIs.
  • Dehydration and limited water intake results in poor flushing of urine from the bladder causing bacterial build up.
  • Material of underwear makes a difference where nylon, spandex and lycra materials reduce the breathability in the area.
  • Hygiene is an important factor where wiping from back to front has caused E.Coli (bacteria) to enter from the gut/anus to the urethra.
  • Pregnancy often causes UTIs as the growing foetus puts pressure on the bladder and urethra causing urine to leak. During pregnancy, a woman’s urethra expands resulting in increased bladder volume but reduced muscle tone causing urine to become more “still” and allowing bacterial growth.

When to contact a doctor

If you experience or are experiencing UTI symptoms, contact an on demand family doctor/GP on oDoc to obtain immediate medical advice and treatment.

How are UTIs treated

Your doctor would generally prescribe you a course of antibiotics to treat the infection. It is vital that you continue to take the antibiotics even after your symptoms subside so as to not build antibiotic resistance to the drug.

Your doctor may request a urine test to ascertain the type of bacteria and match treatment. You can conduct the test from the comfort of your own home via oDoc’s oLabs mobile lab service.

How to prevent a UTI

Anyone who’s experienced a UTI probably never wants to experience one again!

Follow these preventative steps to keep UTIs at bay:

  • Make sure to not hold your pee in, if you need to go, go!
  • Pee before AND after sex to ensure bacteria are flushed out of the system.
  • Avoid wiping back to front.
  • Drink water, especially if you are only in the fledgling state of a UTI. Avoid caffeine and alcohol but gulp down litres of water to flush out the bladder.
  • Although the science is out on this one, Cranberry juice and supplements are said to help ease symptoms and prevent UTIs.
  • Wear cotton underwear, especially given this tropical Sri Lankan climate.

Whilst we may never be able to fully protect ourselves from contracting a UTI, following these simple steps can significantly reduce our chances. If you do develop one or are currently suffering from one, speak to a Sri Lanka Medical Council registered GP or family doctor on oDoc and obtain medical advice, treatment and ultimately, relief!

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Sources

  • Medina, M et al. (2019). An introduction to the epidemiology and burden of urinary tract infections. Thev Adv Urol, 11.
  • Foxman, B., (2003) Epidemiology of urinary tract infections: Incidence, morbidity, and economic costs., Elsevier.,49:53-70.
  • Hisano, M. et al (2012). Cranberries and lower urinary tract infection prevention., Clinics 67:661-667
  • Mayo Clinic, Urinary Tract Infections.
  • Platte, R. (2019) Urinary Tract Infections in Pregnancy., Medscape

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