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Dr. Vamsee Thalluri
We don\'t often talk about our ovaries. But when you consider that 1 in 10 women are affected by Polycycstic Ovary Syndrome (PCOS), we need to!
Just like 1 in 10 people are left-handed, or 1 in 12 have asthma - are we not talking about PCOS because we\'re not immediately affected by it? Maybe. But how do you know you\'re not?
Many women don’t find out that they have PCOS until they are actively trying to get pregnant, have trouble and then look to get their fertility hormones tested.
In fact, research estimates that about 70% of women with PCOS are either misdiagnosed or undiagnosed.
We deserve this information, and we deserve it much earlier in life!
PCOS is a condition where your reproductive hormones, more specifically, androgens (male sex hormones; like testosterone and DHEA) are out of balance. This imbalance encourages the ovaries to produce way more androgens than they should.
Studies have not been conclusive about how some women get PCOS and others don\'t. But researchers believe there are two things that can play a role:
🧬Genetics: Women with relatives with PCOS are more likely to have PCOS.
😈Insulin Resistance: When insulin is not working effectively, the body produces more insulin. When there’s more insulin hanging out in the blood, this can increase the production of androgens such as testosterone, causing an imbalance of hormones.
In Australia, the most widely-accepted criteria for diagnosing PCOS is known as the Rotterdam Criteria 2003.
If you show two of three of the following symptoms, it is grounds for a diagnosis:
For women who want to fall pregnant, getting told you have PCOS can feel like you\'ve just been passed a fertility bomb.
Despite its damning name, you can still have PCOS and not have cysts on your ovaries. But if you do, this is what’s happening.
Your ovaries are filled with immature follicles. Each month, a small group of these follicles are told by your reproductive hormones that they need to start growing.
If you ovulate, one of those follicles emerges as the dominant one - larger than the others - and basically tells the other follicles to take a hike.
However, if you don’t ovulate (which is sometimes what happens with PCOS), then you will not form a dominant follicle and suppress the other follicles.
Instead, the other follicles will keep on growing just a lil\' bit. The problem with this is that you end up with many small, undeveloped follicles. These undeveloped follicles are officially called \'cysts.\' This is what shows up in your ultrasound.
Symptoms for PCOS can be different for every woman. You could experience one or a combination of the following:
Bear in mind, if you\'re currently using hormonal contraceptives - these symptoms can be masked. In other words, as soon as you come off hormonal contraception, you might start noticing them again.
Also, if you had any of these symptoms before you went on hormonal contraception, they may still persist once you come off it.
As we mentioned earlier, PCOS is a commonly misdiagnosed or undiagnosed condition. This becomes a bigger problem beyond your fertility if it\'s not managed properly.
Poorly managed PCOS can sometimes lead to lifelong increased health risks - such as type 2 diabetes, heart disease, endometrial cancer and high blood pressure.
It\'s important that if you have PCOS, or suspect you may have the syndrome, you build relationships with doctors who are experienced and well-versed in PCOS. You may be referred to a gynaecologist as well.
Women with PCOS have irregular ovulation. This makes it hard to predict the timing of ovulation, if ovulation happens at all. Why does this matter? Well, in order to get pregnant you need 4 things:
Most women with PCOS will take longer to get pregnant because they might only release an egg every couple of months or perhaps not at all. But, there are options you can take to kickstart or regulate ovulation (more on this later!).
It\'s not a life-long fertility sentence - many women with PCOS go on to have healthy pregnancies and deliver healthy babies.
If you have PCOS and are struggling with any of the these symptoms, the first thing you need to do is make some lifestyle changes.
Studies have shown that weight loss of 5-10% can make a big difference in:
Come on, even the most anti-gym goer can admit - that is a lot in return for a max of 40 minutes of moderate exercise everyday.
Experts typically look at this based on your BMI, which is the number calculated by considering your weight to height ratio. You can use an online BMI calculator to check yours.
Generally speaking, the goal is to get your BMI to a healthy range, between 20-25.
If your goal is to maintain your BMI, aim for around 20 minutes a day at moderate intensity.
If your goal is to reduce your BMI, aim for around 40 minutes a day at moderate intensity.
If you’re new to exercising, start small! Remember, every bit of physical activity helps, even a brisk walk around the block counts.
Check out the Sweat app. We love it because it\'s designed for all women, regardless of what fitness and exercise level you are. It will help you stay accountable. It offers a lot of variety - jiu jitsu, pilates and boxing to name just a few that caught my eye. If you do love variety, then try out Class Pass which has been designed specifically to help you try a range of new exercise regimes. 😍
There\'s actually no right or wrong way to approach an exercise regime for PCOS. It\'s about finding what you enjoy, so you stick to it.
We don\'t like the word diet either. But research has found that what women eat can significantly help manage PCOS symptoms like acne, weight gain and fertility.
Generally speaking, women with PCOS have elevated insulin levels or insulin resistance. Being able to adjust your diet to keep these levels stable is key to reducing the impact of PCOS symptoms.
In fact, studies have shown that a low-GI diet can help your insulin levels behave.
Quick note on GI (short for Glycemic index): It measures how quickly a particular food raises blood sugar levels. A low-GI diet consists of eating foods that raise blood sugar levels slowly - like steel-cut oats - which help prevent insulin spikes and improves insulin resistance. You might want to introduce some anti-inflammatory foods too. They can assist with fatigue.
We\'ve broken down this into your own cheat guide. Pretty simple really, and there is nothing revolutionary. Just a whole lot of natural whole foods and not a huge deal of processed and packaged foods we\'re afraid.
But, just imagine how good you\'ll feel! 🤩
If you’re struggling with these changes and may need some help with early weight loss, Metformin may be something you discuss with your doctor, as studies have shown that Metformin helps to improve insulin sensitivity in women with PCOS.
Not ovulating regularly? If your BMI is below 35, there are safe medications that can be prescribed to help you release eggs more regularly.
It\'s a treatment either taken orally or can be injected at the beginning of your menstrual cycle. They work by stimulating the ovary to start or regulate your ovulation. The medication is typically called Clomid tablets or gonadotrophin injections.
Your doctor will monitor this treatment carefully by ultrasound and blood tests so they can tell you when you are due to ovulate. This will help you work out when it\'s the best time to schedule baby-making sex.
In Vitro Fertilisation (known as IVF) can be an option for some women. It\'s the most effective fertility treatment available. Yet, it\'s still not guaranteed to work and can be expensive.
The process of IVF starts with injecting fertility drugs to help stimulate your ovaries to start maturing as many eggs as possible. As many eggs as possible are then retrieved from the ovaries with a simple procedure, and combined with sperm in the clinic to fertilise them - with the hope that some embryos will form. If successful, one of these embryos are then transferred and implanted into the uterus.
Before you go jumping down the IVF path, there are a number of things you should consider to decide whether IVF is right for you. We\'ll cover that off in an IVF guide (watch this space!).
Unfortunately, it can. It does increase your risk of some pregnancy complications such as gestational diabetes, high blood pressure and miscarriage.
Which is why obstetricians will screen women with PCOS for diabetes when they become pregnant, and check in again later down the track (between 24 and 28 weeks).
If you are diagnosed, most pregnant women can maintain good blood sugar levels with diet and exercise.
Also, 1 in 7 women with PCOS will need to take insulin shots during the last part of their pregnancy.
Have a chat with your GP or obstetrician who can help you manage or reduce the risk of these complications by monitoring your blood sugar levels and other tell-tale symptoms.
Now, let\'s talk weight for a second. A touchy subject we know but when you\'re pregnant with PCOS, you need to be strict about a weight gain goal.
The best way to keep the weight off? Walking. Even if it\'s just a light 30 minute walk each day.
Hormonal contraceptives can help you balance out the reproductive hormones (in particular, reducing androgens) in your body. This helps manage PCOS symptoms like acne and unwanted hair growth.
Hormonal contraceptives include the pill, patch, ring, the Depo Provera shot, implants (like Implanon) and hormonal IUD. Not all of them will be suitable for you, so you\'ve got to discuss that with your Doctor so you find the right fit.
If you\'re getting into a tough headspace due to your PCOS symptoms, just know that you\'ve got this. It\'s frustrating as hell, but it\'s also in your control.
We believe there is strength in knowledge. By knowing what is happening in your body and what you can do about it can be used to your advantage.
Keep reminding yourself that you’re not alone in this (remember, 1 in 10!). Getting support from your friends, family or health professionals early can help ease the very real emotions you’re experiencing.
LYSN is a great online platform that puts you in touch with psychologists without having to leave the house.
But if you want to see someone in-person, in Australia, there’s a Mental Health Care Plan that you may be able to access if you have Medicare. Talk to your doctor about it - they\'ll find out if you\'re eligible. If you are, you’ll be entitled to access 6-10 sessions with a psychologist per year.
No doubt, PCOS can be a confusing and overwhelming diagnosis to receive. But as you can see, there is plenty you can do to help you take back control.
There is even a community that has been created by people with PCOS to share their experiences and support eachother. They call themselves "cysters" (um, amazing). Cysters often find each other online, through websites like Soul Cysters, in Facebook groups and awareness raising organizations. Get amongst it!
At the very least, find a doctor, endocrinologist or fertility specialist who you trust to help you manage and understand PCOS.
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Dr. Vamsee Thalluri
It’s one of the first questions that comes up about fertility: how old should you be when you have your first child? Well, there’s not really a magic number but there are statistics and hard truth facts you should be aware of.
What you might find interesting (or confronting) is that on average, Aussie women are having their first child at 31 years old.
Whether you’re single, in a stable relationship or maybe ending one (❤️) you might be looking at this number differently. Even if we were so sure we’d be having kids by a certain age, you’ll know by now that life plans can go to shit sometimes. And that’s okay.
We’re not going to sugarcoat this one, age is an incredibly important factor when it comes to your fertility journey. But, what matters is that you take the time to get to know what your options are and understand the ins and outs of the biological clock chat.
When it comes to your fertility, our most reproductive years are in our 20s. In our early 30s, our fertility starts to really decline. It starts to decline even more once we hit our mid-30s.
That’s right. As the number of candles on our birthday cake increases, our number of eggs decrease. Not the happiest of metaphors, but you can’t argue with science right? 😬
Even if you look or feel great (which does impact your fertility in positive ways), your ovaries know exactly how old you are. There’s no escaping it, age is the biggest influencing factor when it comes to your fertility. But how much exactly do our chances of pregnancy decline?
As you age, the quantity and the quality of your eggs decline. Both matter and neither can be reversed.
Our chances of conceiving every month is not 100%. For a healthy woman in her 20s, the chances of conceiving each month is 25%. This declines to 20% by the time you’re 30. But, by 40 years old, our chances of getting pregnant every month are around 5% per cycle.
The risk of miscarriage rises as a woman ages, with a dramatic rise starting after age 35.
As we grow older, the chances that our eggs will be abnormal increase (more on that later). When an abnormal egg is fertilised, the embryo is more prone to chromosomal abnormalities, such as Down Syndrome.
Surely we’re fine now that we have IVF as an option? We thought so too, but that’s not the case. IVF success rates decline as you get older. This holds for whether you freeze your embryos or use them fresh.
Alright, let’s take a breather.
We’ve put some pretty big discussion points on the table about fertility and ageing effects. But like we said, your fertility doesn’t just fall off a cliff by the time you’re 35.
Every woman’s fertility curve is different, every woman’s body is different and so are her eggs.
The rate at which we lose our eggs also varies person to person. In rare cases, some women experience early menopause, where they have almost no eggs left around the age of 40 or earlier.
The rate at which the quality of our eggs depletes is also different. The more our eggs are exposed to smoking, for example, the greater the chances that our eggs will be abnormal.
We are born with 1-2 million eggs.
That’s all the eggs we’ll ever have (this is called our ‘ovarian reserve’). Sure - that sounds like enough, but hitting puberty brings our egg count down to around 400,000.
So, where have all my eggs gone? Spoiler alert: It’s the whole age thing coming back to haunt you.
That’s still 400,000 chances to get pregnant, right? Not quite. Only about 300-500 of these eggs will mature enough to have the chance to roll down to funky town and get us pregnant.
During each menstrual cycle, several follicles (fluid-sacs containing eggs) are recruited to prepare for ovulation. That’s right, multiple eggs.
But there is only one follicle that emerges as the ‘dominant’ one, containing the chosen egg.
Once that egg is released (the process we call ovulation), the rest of the eggs are sayonara too. No egg wants to be left behind so this number accelerates as we get older.
Your number of eggs continues to tick down until almost zero eggs are left. And you can’t ever get those eggs back.
That’s when we hit menopause. Menopause happens when your ovaries can no longer release an egg because we have almost none left. At this point, you won’t be able to conceive naturally, because you\'ll no longer ovulate an egg.
When it comes to your egg, quality is so key – it determines the likelihood of an egg being able to work with a sperm to produce an embryo.
As we age, so do our ovaries and every egg inside of them.
Let’s first talk about what we mean by ‘egg quality.’
Our eggs become more chromosomally abnormal as we age. As you ovulate, the egg cells go through a process of cell division. This is known as meiosis, where the chromosomes split in half. Each parent gives an equal number of chromosomes to a pregnancy. But when the eggs are abnormal, the chromosome split is uneven. This can lead to an embryo missing a chromosome or having an extra chromosome.
Egg quality is fairly black and white too - either an egg is genetically normal (euploid) or it’s not (aneuploid).
Once an egg becomes abnormal, it can’t turn back time and become normal again. So, as we age, a higher percentage of our eggs become abnormal.
Every month during our menstrual cycle, we ovulate one egg. This is our one chance to fall pregnant in that cycle. That same egg may be normal or abnormal.
If it’s a normal egg: Sweet. You’re off to a great start for a healthy pregnancy.
If it’s an abnormal egg: Things get tricky. They are typically less likely to become fertilised with sperm or implant on your uterus - both of which you need to achieve a natural pregnancy. In the rare case that a pregnancy is achieved (based on the age stats), you have a higher risk of miscarriage. If the egg leads to a live birth, it may result in genetic disorders in the child, like Down Syndrome.
You can’t test for the quality of your eggs, but you can do a test to understand more about the quantity of your eggs.
The best indicator for the quality of your eggs is your age.
On average, women in their early 20s have approximately 20% abnormal eggs, while women in their 40s have upwards of 60% abnormal eggs.
There are hormone tests you can take to check out how many eggs you’ve got chilling in your ovaries.
Three main hormones can indicate your egg count (or ovarian reserve):
To check the levels of these hormones in your blood, you can go see your doctor to request these from a blood test.
To learn more about these fertility tests, check out our Fertility Testing Guide.
If you want to know your egg count, recent studies have shown AMH is the best indicator for your ovarian reserve.
AMH is the hormone that is produced by the cells inside your follicles (the sacs that carry your eggs).
The level of AMH in your blood strongly correlates with the total number of follicles inside your ovaries, and therefore, your total egg count.
As a bonus, your AMH can also give you a clue as to when you’re likely to experience menopause and how your body will respond to procedures like IVF and egg freezing.
FSH can also give us an indication of our ovarian reserve, but it’s important to check E2 along with it, because high E2 levels can suppress FSH. Meaning, if your FSH levels are suppressed by E2, the FSH measurement may not accurately represent your ovarian reserve.
While AMH is the best test for egg count, to get the most holistic and complete picture of ovarian reserve and fertility in general, it’s great to test for AMH and FSH and E2. The more data, the better.
In fact, AMH is one of the main hormones we test in our Kin Fertility Test.
We’re familiar with the term menopause. It’s technically the final age where your fertile clock stops ticking. You have almost no chance of conceiving naturally, because you have no eggs left to fertilise.
In Australia and New Zealand, the average age for menopause is around 51 years old. Take this with a grain of salt - as the average will vary based on multiple factors, including ethnicity and family history.
While you still have chances of getting pregnant until you reach menopause, it’s important to know that women actually start to lose their fertility 4 to 8 years before menopause.
It’s time to get familiar with the term perimenopause. This is when your body goes through a 4 to 8 year transition process into menopause.
During this period you could still have eggs, but the majority of them are likely to be abnormal. Plus, you\'re more likely to be ovulating irregularly. Both of which, significantly reduces your chances of conceiving a healthy baby.
Yep, aging affects male fertility as well, but not to the same extent that it does female fertility. Why is this?
It’s partly due to the fact that unlike women and their eggs, men’s bodies develop sperm constantly - sometimes more than 100-200 million fresh new swimmers each day!
But, conception is 30% less likely for men over the age of 40 years as compared with men younger than age 30 years.
As men age, semen motility (their ability to swim) and the actual volume of semen a man produces decreases. On top of this, sperm becomes more and more abnormal as men age. This increases the chances of miscarriage, stillbirth and birth defects.
So it really does take two to tango.
Unfortunately no one is able to stop time, so you might consider freezing your eggs as a way to slow down your fertility clock. Or at least, stop your eggs from ageing.
Freezing your eggs is exactly what it sounds like.
Your gynecologist will collect a few of your eggs while you’re young(er) and freeze them in a lab until you’re ready to use them, effectively preserving egg quality. It gives you the option to use it later down the track when you’re ready.
When that time comes, your gynecologist will combine it in a lab with sperm and place it back into your uterus. A process called IVF (in vitro fertilisation).
Freezing your eggs is a great option to give you options down the track. But, it\'s equally important to know that it\'s not guaranteed to work, so it\'s not always the right decision for everyone. It can be expensive, physically invasive and emotionally and hormonally challenging.
There are questions you need to ask yourself before you decide to freeze your eggs. If you’re curious about whether it’s the right option for you, watch this space - we\'re cooking up an Egg Freezing guide.
We’re not getting any younger, but that doesn’t mean we are running out of options and can never get pregnant.
Sure, we can’t argue with science and turn back time on our fertility health. But what we can do is learn about our fertility health earlier in life. It’s the most powerful first step you can take to start taking control of your fertility.
Dr. Vamsee Thalluri
• DON’T PANIC! COVID-19 (aka coronavirus) is not going to kill us all.
• The most important goal is to #flattenthecurve.
• A few little precautions go a VERY long way.
• Staying in is fun anyway.
• We all need to make sacrifices to benefit society as a whole.
When you read about “coronavirus” you’re reading about COVID-19 (which is short for Coronavirus Disease - 2019). COVID-19 is a new strain of novel coronavirus, which is a type of viral infection that can cause severe respiratory illness in extreme cases.
If you’re older than 25, you might remember a big media storm over a similar disease called SARS back in 2002 and 2003. SARS (short for severe acute respiratory syndrome) is actually a precursor of sorts to COVID-19, in fact, the very same strain of the original SARS epidemic is most likely the cause of the current pandemic.
Both are thought to have originated from bats in China.
Self-isolation is one of the most effective ways to stop the spread of a viral infection. If you, or somebody with whom you have been in direct contact, has been officially diagnosed with COVID-19, it is imperative that you self-isolate for 14 days to ensure that you don’t infect anybody else.
The Australian Government is so serious about stopping the spread that self-isolation is also now enforceable by law if you have travelled overseas, have been diagnosed with COVID-19, or have been asked to self-isolate by a health authority due to a suspected case.
This means you cannot leave your residence for anything, including a trip to the shops, pub, or even a friend’s house, meaning a few simple lifestyle changes are in order to guarantee a fast and successful recovery, or time spent indoors that won’t drive you bonkers.
Not to sound like a broken record, but we will say it again: self-isolation is one of the most effective ways to stop the spread of a viral infection. If you or somebody with whom you have been in direct contact has been officially diagnosed with COVID-19, it is imperative that you self-isolate for 14 days to ensure that you don’t infect anybody else.
There are five main reasons to self-isolate:
In short, somebody will tell you, though it may not be because of a test result, and here’s why:
COVID-19 tests are in dangerously short supply the whole world over. This means that just because you think you need to be tested, or would like to be tested (just to be safe), it might not be possible.
If you arrive at a testing facility you will see all staff in personal protective equipment (like in the movies). To determine whether you qualify, you will be interviewed by a triage nurse who will ask you three questions.
You will only be swabbed if you are displaying symptoms AND:
Close-contact means having spent a significant time within a small distance from somebody who is confirmed, not just having attended a music festival or wedding where one person happened to get a sore throat.
If you do not have symptoms, or do not meet any of those three criteria, you won’t be swabbed, as there simply aren\'t enough swabs to go around (yes, this means don\'t bother going, you\'ll be safer staying home away from the queue of sneezing people anyway).
If you do have any cold or flu symptoms but don’t meet those three criteria, you will still need to self-isolate for 14 days.
If you DO meet the criteria, you will be given a face mask and asked to wait in line to be swabbed. If this happens, you MUST self-isolate until your test results are returned (currently around three days).
You’re also not allowed to travel home from the clinic on any public transport, including taxis and ubers, so be prepared for a long walk if you haven’t arranged a lift with a friend (preferably one with a face mask and hand-sanitizer in the glovebox).
Remember, this might all sound very extreme and confusing, but the sooner we slow the spread, the sooner we all go back to living "normal" lives.
For many, working from home will be an entirely new concept, but it’s a really important measure if you have the luxury of being able to do your job remotely (plus lunch hour is more fun with your partner/TV anyway).
It also comes with a whole array of advantages, including not wearing pants, being able to dress your cat or dog up as your secretary, and making transport to and from the office as simple as walking down the hallway.
But it can also be a bit of a shock to the system for those not used to it. Here are some tips for ensuring a productive day in “the office” when you’re not in the actual office.
Working from home can have many advantages and disadvantages, however you approach it. It can make or break any organisation at a time like a pandemic outbreak, so it’s important to set a few personal rules and stick to them, so that filing good, productive work wearing nothing but undies and a sloppy joe can be beneficial to all.
Food. Without it, you will get hungry, and eventually die. We strongly recommend the regular consumption of food during self-isolation to avoid this outcome.
What will be hard during self-isolation, especially if it is the enforced kind, is getting a decent supply of fresh food into your house (and stomach) without spreading any infection. A trip to the grocery store is off the cards, so try to use home-delivery services.
You can also, of course, get stuff delivered from your favourite restaurants. Now is probably a good time to support these businesses anyway to make sure they’re still there to serve you Aperol Spritzes and the like one we’ve collectively kicked coronavirus’ butt.
Here are the best ways to do that.
There are also meal-kit delivery services that make staying in, but still eating healthy meals that won’t break the bank, a reality. Here are four good ones:
Cancelling your plans to get on a flight to Hawaii for two weeks because 500-odd people have a cough might seem extreme, and it’s easy to get upset with the hysteria whipped up by the media right now, especially when it gets in the way of a beach, a tray of piña coladas, and a luau.
But it is important.
One of the most important things to keep in mind about coronavirus is that we still don’t have loads of information.
Going on the information we do have, it’s probably going to be okay for the most of us. But for a few, it can and will be devastating, and those few could easily be people in your own friendship circles, or even family.
The mortality rate isn’t terrifyingly high, and the symptoms are, for most, manageable. Like 95 per cent of the population, you probably won’t even need to be admitted to a hospital if you were to contract it.
But it’s not about you.
The vulnerable in society (i.e immunosuppressed people including the elderly and those on chemotherapy) are most at risk here, and it’s important that we keep our hospitals at or below capacity to provide the proper care and support to these patients.
Even though you might be “fine” coming down with a case of coronavirus, with mild symptoms for a few days then back to the office, this just isn’t safe, especially with so much still unknown about how COVID-19 spreads.
Worldwide, doctors are currently encouraging everybody to “flatten the curve”. This means slowing down the rate of infection drastically, so that emergency services and health workers aren’t swamped with a litany of cases all at once.
By taking extra precautions, individuals can essentially guarantee a slower, more drawn out pandemic that is far more manageable than a huge outbreak that could leave millions around the world without proper care.⠀⠀⠀⠀⠀⠀⠀
Social distancing is different to self-isolation in that it means you can still leave the house, though with a few precautions in place to stop the spread. This is something that is being heavily recommended around the world right now, for everybody’s sake.
Ways you can socially distance include:
It is also recommended that a few extra precautions are taken when out and about (if you must be out in the first place) to help slow the infection rate of COVID-19. These include:
The Australian Government made this handy resource if you’re still unsure, and remember, with anything like this, it’s better to be safe than sorry.
Unfortunately at times like this, it’s not just a nasty virus that can be shared. The other thing that has a tendency to spread like wildfire is misinformation.
“I heard that <insert wild rumour here>” and “somebody told me <bullshit, bullshit, bullshit>” is seriously unhelpful at a time when the information we do have is a precious commodity.
As such, it’s incredibly important that you don’t fall victim to rumour and hearsay.
Make sure any information you read, or share with anybody, whether on social media or in person, comes from a reliable news outlet, government department or with the relevant tick of approval by a registered doctor.
Misinformation can do a great deal of harm during a global pandemic, but unlike a virus, it doesn’t just spread from person to person without a deliberate action. We are all responsible for this.
Women owe a lot to Margaret Sanger, the pioneer of women’s reproductive rights and founder of the American Birth Control League, the precursor to Planned Parenthood. It was her life’s work to fight for women’s reproductive rights and family-planning support.
In 1951, she convinced Dr Gregory Pincus to develop the first oral contraceptive and run the necessary clinical trials. In 1960, the pill was officially approved by the Food and Drug Association (FDA).
The Pill quickly began making its way through the Western world, landing on Australian shores in 1961.
To be the only medication in history to universally be known simply as "The Pill" is no small feat. Oral contraceptive is still considered one of the biggest medical breakthroughs of the 20th century.
However, until 1972, freedom came with a hefty 27.5% luxury tax and was only available to the married ladies. Thankfully, that’s no longer the case, with around 27-34% of Australian women claiming the pill as their go-to for contraception.
There’s a lot more to The Pill than simply knowing that it’s 99% effective at preventing unwanted pregnancy (when used correctly), and to be honest, there are plenty more reasons that taking it can be beneficial.
But first things first.
The short answer is that it stops you from ovulating. If you don’t ovulate, there’s no mature egg released. Simply put, no egg = no chance to get pregnant.
The pill works by synthetically keeping the levels of estrogen and progesterone equal at all times.
This stops the pituitary gland in your brain from sending signals that release the two hormones that trigger ovulation, Follicle Stimulating Hormone, which signals the growth and maturation of ovarian follicles, and Luteinizing Hormone, which prepares a mature egg follicle to burst and release the egg.
In addition to this, the pill also helps prevent pregnancy by changing the consistency of your cervical mucus, making it harder for sperm to get through.
To break it down even further, there are two versions of the pill to choose from, and they work in different ways.
This is the OG birth control pill and the one that most people are referring to when talking about “the pill”. It’s made using a combination of estrogen and progestin, which works to prevent pregnancy in three ways.
Firstly, by preventing ovulation, as detailed above. Remember, no egg, no chance of pregnancy.
Secondly, it thins the lining of your uterus, essentially making it a hostile environment incapable of nurturing a fertilised egg (if one were to exist). Sounds harsh, but we promise no eggs were harmed in the thinning of this uterine lining.
Lastly, this combination of hormones thickens your cervical mucus, creating an ironclad barrier between your uterus and sperm.
Okay, maybe it’s not ironclad, but it makes it nearly impossible for the little swimmers to pass your cervix.
Three powerful forms of protection, one itty bitty pill.
The reason you still get your period when on birth control is because the sugar pills in your pack don’t contain any hormones, which triggers the body to release the uterine wall, even when one hasn’t really been built up. It’s essentially “withdrawal bleeding” from the reduction in hormones.
The good news is that a thinner uterine wall means lighter, shorter periods. Amen to that, sis.
The mini pill contains progestin only and is great for women for whom it may not be ideal to be exposed to additional estrogen.
It’s also commonly prescribed for breast-feeding mothers, as some studies have shown that estrogen can interfere with the lactation process.
Progestin is a synthetic form of the hormone progesterone, which is produced after ovulation by the corpus luteum (the discarded follicle sac of your mature egg) in a regularly ovulating body. It’s purpose is to support the development of the endometrium (uterine wall) to make it suitable to host a fertilised egg (aka embryo).
However, when the hormone is present at high levels, it not only prevents the body from ovulating, it actually regulates the uterine wall, preventing it from getting too thick.
A growing egg needs a nice, thick, cushy uterine wall to grow in. So, no chances of implantation here.
The other thing to note is that the mini pill consists of only active pills, meaning there are no placebo pills in the pack. While technically this means there will generally be an absence of the actual period, the lack of estrogen can still allow for some breakthrough bleeding to occur, especially if you miss a pill - even by a few hours.
One of the major draw-cards of taking birth control is the ability to forego that monthly ritual of letting it flow, which can, let’s be honest, feel a little like being a part of a sacrificial ceremony at times.
But is it safe to skip your period?
In short, yes. But the truth is, it really depends on your individual body.
There are heaps of reasons you may want to skip your period, which range from serious medical conditions like endometriosis and dysmenorrhea, to more practical reasons, like the beach holiday you’ve planned.
For many women, like active-duty military, who work in environments with limited access to clean bathrooms, the ability to control menstruation at work is not just convenient, it’s often necessary.
Severe menstrual symptoms like excruciating pain caused by endometriosis, intense mood disorders caused by PMDD, and menstrual migraines don’t get activated when you skip your period, so the benefits can reach far beyond convenience.
The effectivity rates of birth control drop to about 91% when factoring in human error, like inconsistency in the time of day you take The Pill. But let’s be real here, we’re all human. Other than the obvious reassurance that monthly bleeding does, in fact, confirm that you are not pregnant, there are a few other reasons that you may choose not to skip.
The process of menstruation and actually getting your period is a sign that your body is functioning properly, and if you suddenly stop, it could signal that there are other issues at hand that should be investigated with your GP.
Outside of safeguarding you against unwanted pregnancy (which let’s be honest, is huge), The Pill can regulate your body’s naturally occurring hormones, helping with all kinds of symptoms caused by imbalances, including acne, severe PMS, menstrual cramps, and irregular periods.
The Pill also helps reduce the symptoms of endometriosis and polycystic ovarian syndrome (PCOS).
There are some major benefits to taking The Pill, particularly for women who suffer from endometriosis, polycystic ovarian syndrome (PCOS), and their side effects.
It’s estimated that around 10% of women suffer from endometriosis or PCOS, and while it’s not exactly clear what causes these issues, they’re categorised by unbearable pelvic pain, irregular cycles and things like acne or hair in unusual places. So knowing there is some relief, is... well... a relief.
Endometriosis is the overproduction of the uterine lining, causing it to grow on other areas of the body, such as the ovaries, bowel, rectum, bladder, and around the pelvis. PCOS is the growth of numerous small or large cysts along the outer edge of the ovaries.
The Pill regulates hormone levels in the body and stops the uterine wall from building up excessively (called endometrial hyperplasia), as well as preventing the development of ovarian cysts, essentially keeping these two at bay.
While the oral contraceptive has been shown to improve symptoms, it shouldn’t be considered a one-size-fits-all solution. As always, it will depend on your individual body and needs. It’s always best to discuss your options with your doctor.
Yea, she’s tough, but there are still a few watch-outs when it comes to the effectiveness of your pill.
Some medications can reduce The Pill’s effectiveness by increasing the metabolisation of hormones.
Specifically, one study showed that consistent use of antibiotics such as rifampicin and rifabutin, drugs used to treat tuberculosis and meningitis, and a selection of anticonvulsants can prevent the pill from suppressing ovulation.
These drugs increase enzymes in your body, which can interfere with the processes of oral contraception. Others include:
• anti-fungal drugs
• certain drugs used to prevent seizures
• HIV medications
Even though the research on the interference of these medications with birth control is limited, it’s best to exercise caution if you’re taking anything that may put you at risk. Use a back-up method of birth control throughout the course of your treatment and for at least one week after.
Most supplements have no effect on contraception, but a select few herbs, extracts, and other natural supplements can make contraception less effective by decreasing absorption or interfering with the breakdown of the hormones. This has been particularly shown in studies of women taking St. John’s Wort and oral contraceptives.
The below listed supplements have also raised concerns of causing interference with The Pill. If you’re taking any of the below or additional herbal supplements, be sure to read the packaging carefully and speak to your pharmacist about the potential impact it may have on the effectiveness of your pill. Always use a backup form of contraception if you’re unsure.
• Saw Palmetto
• Garlic pills
• St. John\'s Wort
All of these supplements are best avoided if you use The Pill as your only form of birth control. If you accidentally take any of the supplements listed above, it’s best to use condoms or another secondary form of birth control to reduce your risk of pregnancy.
Your body needs to fully absorb each and every birth control pill you take in order to stop you from becoming pregnant. If you have a digestive or autoimmune disorder like Crohn’s disease, Celiac disease, or IBS, it could make the pill less effective.
Temporary digestive issues such as vomiting or diarrhea also have the potential to make The Pill less effective, so it’s important to use a second form of birth control, such as condoms, if you experience acute diarrhea that lasts for longer than 24 hours at a time.
If your BMI places you in the overweight or obese range, you have a higher risk of becoming pregnant while using contraception than women who BMI is lower.
In a 2015 study, researchers found that women with a BMI of 27.3 or higher had a 60% higher risk of becoming pregnant while using the birth control pill than women with a BMI that ranked in the mildly overweight category or lower.
Women with a BMI higher than 32.2 have a more than 100% higher risk of becoming pregnant while using contraception.
In general, the effectiveness of contraception decreases as your weight and BMI increases.
It’s important to take your pill at the same time every day for the best results and effectiveness.
For some, that means taking it first thing in the morning, or setting an alarm reminder at the same time every day.
But, life gets in the way.
If you miss a pill, take it as soon as possible (even if this means taking two pills on the same day). If you miss more than one pill, take the missed pill as soon as you remember, but ensure you’re using a back-up form of contraception until you’ve taken seven hormonal pills in a row.
Always refer to the instructions on the packaging of your specific pill to ensure you’re following the best procedure and are protected.
Just a note: if you miss a sugar pill, then there’s no need for concern.
In fact, some packs don’t even have sugar pills. Sugar pills contain no hormones and serve the purpose of only keeping you in the habit of taking the daily pill and keeping you on track when it comes time to start a new pack of hormonal pills.
The above advice does not apply.
If you’re taking the mini pill, your contraception has lower levels of hormones, meaning if you miss a mini pill by even three hours it may reduce the effectiveness.
It’s absolutely necessary to use a backup form of contraception for at least two days if you miss one of your mini pills.
There are a range of potential side effects that come with The Pill. For the most part, they aren’t incredibly serious and should subside after your body adjusts, usually within one month.
Some women experience bleeding during their cycle if they choose low dose pills or mini pills.
Similarly to what happens when taking the sugar pills in your pack, the lower dosage or lack of estrogen can trigger the body to release the uterine wall and cause spotting.
Perhaps one of the most common concerns when making the decision to go on the pill is weight gain. It’s not unheard of to pack on five kilos during your period, and lose it just as quickly. Well, almost as quickly, depending on how much chocolate you ate while binging Netflix under a heated blanket.
The key to that sentence is “lose it just as quickly.”
The truth is, there is actually no link between weight gain and oral contraceptive. What there is, however, is a link between increased levels of estrogen and fluid retention. Tricky, eh?
Medically, this is known as premenstrual fluid retention and it occurs naturally in your cycle as hormones fluctuate and estrogen and progesterone levels rise.
When taking the combined pill, estrogen levels can be anywhere from 6 to 10 times higher than normal, so naturally, fluid retention can be triggered.
If you notice a rapid increase on the scale within the first few weeks of taking the pill, without any major changes to diet and exercise, it’s most likely fluid rather than fat. As you maintain your normal health habits, you’ll notice your body will adjust and you’ll gradually make your way back toward the norm.
Again, similarly to what happens naturally during your cycle when your hormone levels increase, The Pill can stimulate breast tissue, resulting in anything from mild discomfort to enlarged breasts.
While The Pill can cause benign lumps to occur in your breasts, studies have actually shown a decrease in hospitalisation for the treatment of these non-cancerous growths amongst women who take the pill.
However, know your boobs, ladies! Keep tabs on anything that feels out of the ordinary and when in doubt, see your doc.
While it may occur when you first start taking the pill, nausea is more commonly a result of emergency contraceptive use than regular birth control.
Because The Pill reduces the levels of androgens in your system, it can unfortunately have the adverse effect of lowering your sex drive, with about 15% of women reporting changes to their libido.
Testosterone is the major androgen associated with our sexual urges, and our bodies naturally ups its production during ovulation to encourage frisky business at prime fertilisation time.
We’re not only not ovulating when taking The Pill, but the increased levels of female sex hormones hinder the production of testosterone. You get the picture.
There are some less common, albeit more serious, side effects involved with the pill. Similarly to the above, the majority should subside, however, if any of the symptoms listed in this article persist or really strike you as out of the ordinary, speak to your doctor ASAP.
Increased risk of headaches and migraines is more common in users of the combined pill, so if you’re already susceptible, choosing the mini pill or a lower dose combined pill may be best.
Migraine headaches affect 37% of women of reproductive age and to be honest, can be completely debilitating.
Migraines are characterised by severe pain and throbbing, and can be accompanied by nausea, vomiting, and extreme sensitivity to light. They last from hours to days.
If you begin suffering migraines after starting birth control, speak to your doctor immediately, as it may signal an increased risk of stroke and it’s best to seek an alternative option.
Truthfully, the links between oral contraceptives and mood changes are understudied.
However, one particularly oft-cited study in Denmark has shown links between increased hormone levels (particularly progesterone) and depression. This is also why during a normal cycle you experience symptoms of PMS when progesterone levels are on the rise.
Keeping in mind your levels are elevated continuously whilst using contraceptives, there is a slightly higher chance to experience feelings of depression, anxiety or fear, with about four to 10% of women reporting negative changes to their mood.
While some studies show a link between breast cancer and birth control pills, they also show that risk increases slightly in women who use the pill for more than five years. However, the risk is ultimately small, increasing from about one times higher to 1.6 times higher.
That said, thanks to The Pill’s regulation of the development of the uterine wall, taking The Pill has actually shown a 50% reduction in risk of endometrial cancers, a reduced risk of developing ovarian cancer, and an almost complete cessation in the development of ovarian cysts.
That’s pretty fab news.
The FDA (Food and Drug Association) has reviewed a selection of studies identifying an increased risk of developing blood clots, including DVT, in women taking birth control pills containing progestin. The FDA found the risk at about three to five times higher than the average healthy, non-pregnant, non-birth-control-taking woman.
That may sound pretty scary, but to put this into perspective, the risk of developing blood clots during pregnancy is five to 20 times higher than the average woman, and even more so in postpartum.
While estrogen has been linked to an increase in blood clots, the risk is actually considerably low assuming you’re not predisposed to their development. If you are, it’s extremely important to have a conversation with your doctor about the best possible contraceptive solution for you.
You may be predisposed to blood clots if you’ve had surgery, trauma to the body or brain, pregnancy, hormonal therapy or are immobile.
Blood clots can also be genetic, so getting a good grasp on your family health history is important. If you have previously had any blood clots, or are aware of any family history of blood clots, it’s extremely important this is brought up with your doctor. It may not be appropriate for you to be on the combined pill and alternative options should be discussed.
This is a big one, as there is a lot of speculation around the fertility rates of long-time hormonal birth control users.
In short, years of taking the pill won’t affect your long-term fertility in itself.
In fact, a study out of UPenn showed 81% of subjects achieving pregnancy within a year of stopping the pills.
In some women, their menstrual cycle may take some time to return to normal after stopping the pill. If your cycle hasn’t returned after three months, speak with your doctor.
However, there are a number of other factors that can affect your fertility rates, so even while you’re adamantly preventing pregnancy in your early years, be sure you’re staying on top of your overall fertility knowledge if you do want kids one day.
That’s a whole lot of information, but all up, it’s super important to know the facts before you jump in, and that goes for just about anything.
Every body is completely unique and there’s no one-size-fits all solution. Assess what’s most important to you in terms of your contraceptive choices and speak to your doctor or get in touch with one of our Kin GPs. We can help you make a choice that’s right for you.
Claringbold, L., et al. Factors influencing you women’s contraceptive choices. Australian Journal of General Practice, 2019.
Stachenfeld, Nina S. Sex hormone effects on body fluid regulation. Exercise and sport sciences reviews, 2008.
Gallo, MF., et al. Effect of birth control pills and patches on weight gain. Cochrane Review, 2014.
Mishell, DR Jr., Noncontraceptive health benefits of oral steroidal contraceptives. American Journal of Obstetrics and Gynecology, 1982.
Nuttall, Frank Q. Body Mass Index: Obesity, BMI, and Health: A Critical Review. Nutrition Today, 2015.
Vessey, M., et al. Oral contraceptives and benign breast disease: an update of findings in a large cohort. Contraception Journal, 2007.
Skovlund, CW., et al. Association of Hormonal Contraception with Depression. JAMA Psychiatry, 2016.
Gingell, M., et al., Oral contraceptive use changes brain activity and mood in women with previous negative affect on the pill. Science Direct, Psychoneuroendocrinology, 2013.
Zimmerman, Y., et al. The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis. Human reproduction update, 2014.
Pastor, Z., et al. The influence of combined oral contraceptives on female sexual desire. The European Journal of Contraception and Reproductive Healthcare, 2013.
Morch, LS., et al. Contemporary Hormonal Contraception and the Risk of Breast Cancer. The New England Journal of Medicine, 2017.
de Melo, AS., et al. Hormonal contraception in women with polycystic ovary syndrome: choices, challenges, and non-contraceptive benefits. Open access journal of contraception, 2017.
FDA Drug Safety Communication: Updated information about the risk of blood clots in women taking birth control pills containing drosperenone, 2012.
Zhanel, G., et al. Antibiotic and oral contraceptive drug interactions: is there a need for concern? The Canadian Journal for Infectious Disease, 1999.
D’Arcy, PF., Drug interactions with oral contraceptives. Drug Intelligence and Clinical Pharmacy,1986.
Hitchcock, C., et al. Return to fertility after cessation of a continuous oral contraceptive, 2008.
Davis, AR., et al. Occurrence of menses or pregnancy after cessation of a continuous oral contraceptive, 2008.
Condoms and the Pill are typically the first two types of contraceptives we learn about when we\'re awkwardly sitting in a sex ed class as a teen.
It\'s crazy to think the Pill has actually been available in Australia since 1961. But not to all women. At the time, it was only available to married women and slapped with a 27.5% luxury tax! Not cool.
Now, fast forward to the 21st century, 70% of Aussie women use contraceptives AND we have the freedom of choice.
But with 13 different options (and counting) on our contraceptive menu, decision fatigue can consume us.
A word of warning: We won\'t lie, this is a big ass guide. But it\'s comprehensive and you can skip to the contraception options you want some more details on.
Choice is definitely a great thing when it comes to the personal decision of choosing a contraceptive.
But it does beg the question, how do we choose which one is right for us?
The truth is: this is a decision that will take some time to consider, as it really depends on what you’re after. Each of them work in different ways, some require surgery and they can have different effects on your body.
Let\'s have a top-level look at each of them and take a deeper dive later.
And no - the pull-out and pray method is not on the list. 🙅♀️
There\'s actually no contraceptive method that is completely risk-free. So, all you really can do is weigh up the pros and cons.
Here\'s a few things you can consider:
Effectiveness: This one’s a biggie. How effective is the contraception at actually preventing pregnancy? We go into more detail about this in the next section.
Convenience: How easy is it for me to use the contraception method consistently and correctly? For example, if you aren\'t taking the Pill like clockwork every day, this can impact its effectiveness. So, you might find that using an IUD is the easiest - just set and forget (for a few years!).
Hormonal: Are there hormones involved in the contraception you choose? Hormones already control so much of our mood, energy and body. Maybe you don’t want extra hormones rocking your body. Especially man-made ones!
Side Effects: What side effects are expected? If you’re using hormonal contraception methods, chances are that the hormonal cocktail will hit you with some side effects. It’s just a question of what side effects you’re willing to risk or put up with.
So, where do you start? Ask yourself what you value when it comes to effectiveness, convenience, hormones and side effects. From there, it’s about exploring the contraceptive options that align closest to what you need.
Let\'s get into the finer details 👇
A condom has done its job when it collects the sperm, stopping the swimmers from meeting the egg. We\'ve got a lot to be thankful for when it comes to the humble condom.
PRO: It doesn\'t need to pump our bodies with hormones and it can protect us from STIs.
CON: The downside though is they can pop like a balloon, leaving you completely susceptible to falling pregnant. And, let\'s face it the admin of putting them on disrupts the steamy foreplay.
Also known as the femidom (condom for females). It’s just as good as a male version, but not as commonly used. To use it, you need to insert one of the rings into the vagina (to act as the barrier) and the second is attached to the outside of your vagina to cover your vulva. You insert it like a tampon but it funcitons like an inverted male condom.
PRO: No hormones involved; which means no side effects. Plus, no interruptions! You can insert it up to 8 hours before sex. Considering we wear tampons for that long, it seems doable. That way when the opportunity arises, you can keep all the steam and spontaneity burning. Another tick is that it prevents against STIs as well.
CON: Just like a male condom, they can break or slip off. It can also get a little tricky for the penis to find its flight path and stay in its lane, if you get what I mean. Problem is, they didn\'t really teach us the application of a female condom in sex ed, did they? Kinda makes you wonder what fruit would have been used instead of a banana.
Made from soft silicone, shaped like a small cup; the diaphragm is like a vagina shield. Combined with a contraceptive gel (spermicide), it works by preventing the sperm from entering the uterus and fertilising the egg. Caya is the Diaphragm brand sold in Australia.
PRO: They are reusable for up to two years. You\'ll just need to keep buying the spermicide. They don\'t impact the steamy flow of sex, as they can be inserted up to 2 hours before. And, they don\'t pump your body with hormones; so no side effects.
CON: They aren\'t the easiest of things to put up there correctly, so you\'d need to learn that; and possibly have back-up protection until you feel like you\'ve nailed it. But even with confidence, you could still misplace it.
Spermicide is the non-negotiable partner to using the diaphragm and even its name can sound like you\'re pumping your vagina with pesticides that you use in your garden to kill weeds. In saying that, the spermicide can actually disrupt your vaginal microbiome (the organisms that keep your vagina healthy and happy).
The most popular option in Australia; the pill is taken orally every day. It contains a hormone mix of estrogen and progestin (aka combined) that work together to stop ovulation, thicken the cervical mucus and prevent sperm from swimming through.
PRO: No devices are inserted into your body and no surgery is required. It can help regulate your periods, make them lighter and also make your symptoms - like period cramps- less severe.
CON: It can be easy to forget taking the pill, which can reduce the effectiveness of it. There are also a bunch side effects and it really depends on the brand you use. The most common side effects include spotting, nausea, breast tenderness, headaches, mood changes and decreased libido.
The cost of the pill could be a pro or a con, but that\'s subjective. There are ranges that are relatively inexpensive around $15 per three months to up to $80 per three month. It depends on the pill brand you buy and which one is recommended to you by your Doctor. Which one you choose is entirely dependent on your body, your hormones and your susceptibility to symptoms.
The mini pill is very similar to the combined pill. The main difference is that it only has progestin and no estrogen. It works by thickening the mucus in the cervix which stops the sperm from reaching the egg.
You still take it every day, but you need to be even more hardcore with the timing and consistency of this. The reason for this is because the mini pill has a lower dose of hormones than the combined pill. Because it’s a lower dose of hormones than the combined pill, you need to take it around the same time every day. If you take it more than 3 hours late, it can be less effective.
PRO: The mini pill can be a better option for women who can\'t have estrogen due to certain health conditions, just recently gave birth, are breastfeeding or are trying to avoid the side effects of the combined pill.
CON: You\'re not totally in the clear from side effects. Some women taking the mini pill can still experience side effects such as headaches, mood changes, sore breasts and irregular bleeding.
The Vaginal Ring (AKA NuvaRing) is a soft plastic ring that’s inserted into the vagina like a tampon on the first day of your cycle, after your period.
You\'ll keep it in there for the next 3 weeks so that it can release estrogen and progestin into; the hormone combo that stops ovulation and thickens cervical mucus.
After 3 weeks, you take the ring out and your body will have a withdrawal bleed (your period).
You\'ll need a script from your Doctor before you make a trip to the pharmacy. Typically, you can get up to 4 vaginal rings at a time.
PRO: You can insert and forget for 21 days, rather than having to remember taking a pill every single day. Also, some women have used the vaginal ring to skip periods, reduce menstrual cramps and improve acne.
CON: It can be a bit more spenny than other types of contraception at $30 per ring. It can also cause side effects including increased discharge, nausea, tender breasts, headaches, bloating and mood changes.
Also known as the "jab" for lack of a better word. It\'s more medically known by their brand names “Depo-Provera” or “Depo-Ralovera." As it\'s described, a form of synthetic progestin is injected into your body every 12 weeks by your Doctor.
This injectable birth control solution works by preventing your body from ovulating an egg and thickening the cervical mucus, making it a hostile environment for sperm.
PRO: The pregnancy-preventing effects last a longer time compared to other contraception methods. One injection in either your butt (🍑) or upper arm lasts you for three months.
CON: There\'s the admin of booking in to visit a doctor to get the injection every 3 months. If you miss an appointment, the injection can be given up to 2 weeks late but any longer than that - you should use condoms until the injection has had time to get into your system and do its thing.
Another potential downside to injections is that it\'s pumping hormones into your body. This means side effects. Your periods may become unpredictable, it can cause weight gain, moodiness, headaches, acne and bone thinning if use for a long time.
If you’re thinking about having kids in the next few years, probs a good idea to stay away from this contraception method.
Let me tell you why.
Even though the pregnancy-preventing effects of the injection wears off eventually, there\'s no guarantee on how long it will actually take to do that. It\'s different for everyone.
Injections require pretty strong doses of hormones to be effective, so your body will be like \'wtf\' when you stop them. Ovulation won\'t kick back into gear until the effects of the injected hormones wear off.
On average, it takes around 6 months to get back to normal ovulation, but has been known to take up to 18 months for some women.
Oh and if you hate needles...you\'ve probably already skipped this as an option. But if you haven\'t, then we\'d like to warn you that this kind of contraception is probs your worst nightmare.
The Implant (aka the Implanon) is a small, flexible rod made of medical-grade material that is inserted under the skin of your upper arm. It releases a steady amount of progestin into the bloodstream to prevent ovulation and cause changes to the cervical mucus so the sperm swimmers can\'t make it to the egg.
This contraception option does require surgery and you\'ll need to see a Doctor to have it prescribed and inserted.
PRO: Long-lasting - 3 years in fact! After a few months, some women notice lighter (or no) periods at all and less menstrual cramps.
CON: You may experience side effects including headaches, mood swings, sore breasts and acne.
The IUD (Intrauterine Device) is a T-shaped device that gets inserted into your cervix by a doctor. In Australia the main brand available is called the Mirena - so you might have heard of that before.
They are designed to be long-lasting and make a comfortable home in your cervix for years. While they\'re living in there, they make themselves useful by releasing a type of progestin hormone (known as levonorgestrel). Again, what this does is prevent ovulation and thickens the cervix mucus to make it difficult for the sperm to swim through.
If this is something you’re considering, you’ll need to get a doctor to prescribe and insert it for you.
PRO: They’re 99% effective.- great odds! Studies have even shown that the IUD is comparable to female sterilisation. The biggest advantage is that they can last in your body for up to ~3-5 years (depending on the brand), and you can reverse its pregnancy preventing effects by getting a doctor to remove it when you’re ready.
Unlike oral contraceptive pills which release hormones into your bloodstream, the IUD is a localised hormone release - just in your uterus. This tends to result in less hormonal side effects than the contraceptive pill.
CON: It’s still a type of hormonal contraception so it still comes with listed side effects and risks. Most commonly, you may experience spotting in the first few months, longer and heavier periods or missed periods. Other possible side effects include irregular periods, cramping, backaches, cramping, nausea, ovarian cysts and mood changes.
There are also some more severe side effects.
While rare (like 1 in 1000 type rare), there is the risk that the IUD will dislodge and perforate your uterus and cause infection and severe bleeding.
Also rare, but if the IUD insertion procedure introduces bacteria into the uterus, there is a chance that you may get Pelvic Inflammatory Disease (PID).
What we recommend is that you seek out an experienced doctor and someone you really trust to insert your IUD.
The Copper IUD is similar to the hormonal IUD, but it doesn’t use hormones to work. It’s a T-shaped device that is inserted into your cervix by a doctor.
Again, these are long-lasting and make a home in your cervix for years. But the biggest difference is instead of releasing hormones - it releases copper ions into your cervix.
Copper makes your uterus a hostile environment for sperm by thickening the cervical mucus that sperm will struggle to navigate through to your egg.
Without repeating ourselves, the pros and cons for the Copper IUD are very similar to the Hormonal IUD. Scroll back up if you want the longer version👆🏽
PRO: Long-lasting, reversible and non-hormonal (so, less side effects).
CON: You can still experience side effects with the most common including menstrual cramps, spotting between periods and heavier and longer periods.
There’s also a (very) small risk that the IUD will dislodge and perforate your uterus.
You’re probably more familiar with the phrase “getting your tubes tied." Now this is another permanent contraceptive option for women. You\'ll need surgery where a surgeon will clip, cut or remove the fallopian tubes to ensure the egg can\'t move into the uterus to be fertilised.
PRO: It\'s 99% effective, making it one of the most effective contraceptive methods. If you\'ve made your mind up that you either don\'t want to birth a child or you\'ve finished creating a family, then this could be a suitable and convenient option for you solely based on the fact that you never have to deal with contraception again.
CON: A shorter-lived con would be that after the operation, you can expect to feel some abdominal pain, cramps and nausea for a few days.
And, if you do actually change your mind (which can happen) then you\'ve already made a permanent decision so that would have to be something you\'re prepared to live with.
However, tubal ligation can sometimes be reversed. If you’ve gotten your tubes completely removed, this can’t be reversed. However, if they have been cut, the surgeon can rejoin the cut tubes using small stitches, but there are very low success rates with this.
There are other possible risks that come with tubal ligation, including damage to nearby organs, infections, haemorrhages and infections in the wounds of the fallopian tubes.
In saying that, tubal litigation might not be right for you. Especially if you\'re relatively young. Even if you say you don\'t want kids now, circumstances can change. You just never know!
If you’re looking for a long-term method that’s set and forget, and not something permanent, it’s worth looking at the long-acting reversible contraceptives like the IUD.
A vasectomy is a permanent type of contraception where surgery is performed on the male to stop the sperm travelling through the tubes from the testicles (where the sperm are made) to the penis (and then to ejaculation).
It takes around three months from the time of the procedure for a vasectomy to begin working (i.e., for no sperm to be present in ejaculation). So make sure you take that into consideration before you get too comfy!
PRO: It’s 99% effective, another one of the most effective contraceptive methods. If you are sure you don\'t want his sperm for any more baby-making, then it could be a convenient solution so you can both forget about contraception!
CON: He might experience some post-surgery pain, bruising, lumps, infections and scarring.
While it\'s considered a permanent type of contraception, men can get the surgery reversed.
But, if you are relying on the fact that you can technically change your mind down the track, just know that it still comes with risks.
In a vasectomy reversal, your doctor needs to rejoin the tubes back together so that the sperm can reach the flow of semen again and be ejaculated.
There is the risk that even with the reversal, the sperm still isn\'t able to flow through. And without sperm, there\'s no fertilised egg and no chance of a natural pregnancy.
So it\'s not a decision to take lightly, even with the possibility of reversal.
If you’re looking for a long-term method that’s set and forget, and not something that interferes with your physical reproductive organs, it’s worth looking at the long-acting reversible contraceptives such as the IUD.
This is a method that doesn\'t require any surgery, implants, cutting tubes or hormones. It simply relies on you monitoring when your ovulation occurs, checking in on your cervical mucus and measuring your basal body temperature.
I guess you kinda become the product of your own science experiment.👩🏻🔬
The reason why you\'d do this is to figure out which days you need to avoid having sex. Basically, the days where your fertility is ready to rumble. Or, you can always just use this to cue the condoms if you don\'t want to abstain from sex.
The logic of this method relies on the fact that you can\'t get pregnant every day of the month. It considers your fertile window and the days you are most likely to get pregnant (usually 5 days before ovulation and the day of).
PRO: There’s no hormones to consume, devices to insert, rubber to apply or tubes to cut. It’s au naturale.
CON: As you could imagine, the biggest con compared to the other contraception types is its effectiveness - sitting at ~75%. That’s because ovulation is highly variable woman to woman.
There\'s also a bunch of factors that impact your ovulation and your ability to track it such as travel, illnesses and stress.
So, it’s not typically suitable for people with irregular cycles as it makes it much harder to predict when you’re likely to ovulate.
It requires commitment to daily monitoring of the changes in your basal body temperature (BBT) and cervical mucus. And, it requires the discipline to not have sex during your fertile window, which actually happens to be when your libido is running hot! However you could always wear a condom.
If you read this guide top to toe, then not only are you a legend but you\'ve also probably got a pretty sore head.
Considering everything you\'ve just read, here\'s what we recommend you do to move forward with a decision:
It will feel empowering once you making the right decision for yourself.\x3c!--kg-card-begin: html--\x3e
Dr. Vamsee Thalluri
• About 1 in 5 medically recognised pregnancies end in miscarriage.
• Miscarriage can happen to anyone, but there are a number of things like age, lifestyle, and underlying medical conditions that can have an impact.
• 80% of pregnancy loss happens within the first trimester.
• Between 50-80% of women who experience a miscarriage become pregnant again. However, it can be an emotionally tumultuous time.
The very first and single most important thing to know about miscarriage is that you are not alone.
When we go through situations that throw us into the pits of grief, shame and utter confusion, it can be difficult to remember this simple fact. While your situation, your experiences and your feelings are unique, it’s important to know there are other women out there who have experienced their own version and can relate, help guide, answer questions or just generally validate your feelings.
Medically, miscarriage may be referred to as spontaneous abortion, miscarriage or early pregnancy loss, all of which refer to a loss prior to 20 weeks, typically within the first trimester. If a loss occurs later than 20 weeks, it’s termed a stillbirth.
So, while this situation is devastating and can be hard to accept, it helps to remember this is your body ensuring the best for yourself during pregnancy and for the overall outcome.
The commonly cited statistic is that about 1 in 5 of medically recognised pregnancies end in miscarriage, according to the American College of Obstetrics and Gynaecology.
The earliest detection of pregnancy is two weeks after implantation, at the first sign of a missed period. Often, women who miscarry in these very early weeks mistake the situation as a late period, never knowing they were pregnant to begin with. On top of that, many fertilised eggs are lost prior to implantation, which is classed as implantation failure.
However, for those who are aware of their pregnancy, miscarriage can happen anywhere along the process of pregnancy. That said, about 80% occur within the first trimester.
Loss after 20 weeks is far less common, with only 2-3% of pregnancies ending into the second trimester.
There is so much information out there on the causes of miscarriage. It can be overwhelming to consider all of the factors that may or may not affect our health on a day-to-day basis, let alone that of our unborn child, and it can often feel like ‘if only you’d done something differently’, maybe this wouldn’t have happened to you.
While certain factors do put some women at higher risk, a miscarriage can happen to anyone, and the number one cause of miscarriage, random genetic error, is completely out of our control.
Essentially, during cell division, chromosomes misalign resulting in errors that would make normal fetal development impossible. Put simply, this is the body’s natural process for expelling a pregnancy that just wouldn’t be able to develop.
On the male side of things, poor sperm parameters – as well as poor lifestyle which increases DNA fragmentation in the sperm – has been associated with miscarriage.
As hard as the reality of losing your unborn child is to cope with, simply knowing that it isn’t your fault helps ease some of the heartache and mental blocks that may arise about the future of your fertility.
So, what factors can put women at a higher risk for miscarriage?
It’s an unfortunate fact of biology that as we age our fertility naturally decreases. We’re born with all of the eggs we’ll ever produce already in our ovaries, which is kind of wild to think about.
While the ability to get pregnant naturally, and carry a full-term, healthy baby will always vary from individual to individual, chances decrease as both women and men age. For a couple in their early 30s, the chances of falling pregnant per month are about 1 in 4, whereas these decrease to 1 in 10 for women over 40.
However, the risk of genetic abnormalities in the pregnancy increases as you get older (this includes through IVF, or in-vitro fertilisation) the chances of random genetic errors occurring also increases. In fact, nearly 80% of miscarriages in women over 35 are the result of chromosomal abnormalities, according to research done by Dr Ruth Lathi of Stanford University.
One study done at the University of New South Wales shows that the risk of any chromosomal abnormality steadily increases with the mother’s age, reaching 1 in 8 by the age of 49.
As always, every individual body is different, and plenty of women are able to conceive and carry viable pregnancies later in life, but it’s important to have all of the information at hand if you’re planning on having children.
In some cases, uterine abnormalities or health conditions may raise your risk of miscarriage. Thankfully, knowing if you have any of these conditions means you can work closely with your doctor to take the best route in decreasing the effects of these issues on your pregnancy.
One such condition is uterine fibroids, the most common benign tumours in women of child-bearing age. Fibroids are associated with infertility in 1-2% of cases, and women who have them are 20-30% more likely to miscarry than women without.
Not all fibroids have an impact on fertility. The only fibroids that have been proven to cause fertility problems are those that impact into the uterine cavity. There is also an increased risk of miscarraige if there is a uterine septum.
If you’re experiencing symptoms of fibroids or know you have them, speak to your doctor about options for treatment and how they may affect your plans to become pregnant.
Other factors that may increase the risk of miscarriage include:
When these diseases are undiagnosed or poorly managed, they drastically increase the risk of fertility issues, recurrent miscarriage and a range of other intrauterine concerns including growth restriction.
However, when diagnosed and managed properly before and during pregnancy, the risk caused by these issues were drastically reduced.
If you suspect you may have, or have been diagnosed with one of the above, talk to your doctor about the best preparation for a healthy pregnancy.
Just up front we’d like to mention that any type of excessive drug or alcohol intake will increase a range of risks during pregnancy, including, but not limited to, chances of miscarriage.
An analysis of a series of studies over the last 50 years strongly proves that alcohol intake and miscarriage rates are closely correlated. Of the participants studied, those who were drinking up to five alcoholic drinks per week increased their risk of miscarriage by 6% with every additional drink.
If you feel you may be at risk of excessive use of substances, speak to your doctor about treatment plans and the best options for a successful pregnancy.
Outside of illegal drug use, it’s also important to note that there are a range of other over-the-counter and prescription drugs that can create complications and increase risks during pregnancy, including some consideration towards nutritional supplements and complementary medicines (such as herbal medicines).
For example, in Denmark, a study of pregnant women using a selection of herbal medicines for general well-being indicated that taking licorice supplements was associated with increased blood pressure. They also found that often the patients’ healthcare providers were unaware of their consumption of alternative medicines.
Overall, the use of alternative medicine during pregnancy is still being studied in detail, but the important thing is to be sure to include any supplements and herbal medications you’re taking in discussion with your doctor.
One Danish study showed that the use of anti-epileptic drugs increased the risk of miscarriage by 13%, while a study out of Quebec suggested that the use of non-steroidal anti-inflammatory drugs (NSAIDs) was associated with a 2.4 times higher risk of miscarriage. However, the Canadian Medical Journal reported that the study didn’t prove these risks were caused by NSAIDs alone.
Being completely open and honest with your doctor about your medical history and anything you currently or have recently taken (including recreationally) will help ensure the best outcome of your pregnancy.
Women whose body mass index (BMI) was classified as overweight by the World Health Organisation (WHO) standards correlated with an increased reoccurrence of miscarriage.
Menstrual disorders, infertility, and sporadic pregnancy loss are associated with women who fall into higher BMI, and complications later in pregnancy including gestational diabetes, hypertension, preeclampsia, thromboembolism, and antepartum stillbirth all increase with higher BMI.
If you feel that your BMI may put you at risk for any of these, we’d recommend speaking with your doctor about weight management or precautions you can take prior to and during your pregnancy.
Strangely, it’s a topic that medical professionals seem to disagree on, with many medical associations claiming that psychological stress doesn’t have any effect on rates of miscarriage. That said, a 2017 analysis of eight medical studies, showed significant evidence that prior psychological stress did indicate an increase in the occurrence of early pregnancy loss.
Psychological stress has a significant negative impact on the nervous, endocrine, and immune systems, therefore it is fair that it raises concerns amongst women, and stress-management should be considered when planning for a pregnancy.
When it comes to the process of supporting new life, it’s understandably easy to worry that something may go wrong, and to err on the side of caution more often than not.
We encourage any woman who is having concerns to see your doctor, because we believe you’ll rest more easily knowing you’ve acted on your concerns.
If you have questions about common symptoms and signs during pregnancy, such as bleeding and cramping, speak to your obstetrician or midwife upfront, they should be able to give you the rundown on what you can expect and what’s not so normal.
That said, here are some common warning signs which warrant a visit to your doctor ASAP.
Spotting during early pregnancy is common and 20-30% of women experience some bleeding within the first trimester.
What many women may not realise is that it’s common to experience what’s known as implantation bleeding. This is when a small amount of spotting occurs when the embryo is implanted into the uterine wall. Implantation bleeding usually occurs around the first couple of days of a missed period, so women may mistake this for a period, even though it’s generally much lighter.
All of that aside, some light bleeding during early pregnancy may be okay, but anything heavy or accompanied by cramping should be cause for concern, including the appearance of clots or tissue. If you are worried about bleeding, go to your doctor or nearby hospital. Depending on the stage of pregnancy, they may be able to do a blood test or scan to hopefully ensure all is OK.
Risk of experiencing one of these can be associated with a Cesarean section, trauma, previous uterine surgery, or the baby’s position in the womb. They are also more likely to occur if you’ve experienced them in prior pregnancy.
While some bleeding may be normal, cramping is not. Women experience cramping during our normal cycle when the uterus is contracting to shed the uterine lining, and we experience cramping during labour when the uterus is contracting to deliver the baby.
Any cramping during pregnancy could be a sign of distress, showing that your body is reacting in a way to expel the pregnancy. This includes back pain, which may not be cause for concern if it’s mild, but we’d recommend speaking to your doctor if any of these occur.
Sometimes a pregnancy just doesn’t progress and the only way you’ll know is when your obstetrician doesn’t find a heartbeat at one of your checkups. There may just be no signs or symptoms.
Bear in mind that morning sickness (or nausea, because let’s be honest, it doesn’t only happen in the morning) usually fades after 13 or 14 weeks, but for some women it can last the entire pregnancy (known as Hyperemesis Gravidarum).
If you are experiencing morning sickness early in your pregnancy and it suddenly stops, particularly if it’s accompanied by any other precautionary signs (such as bleeding or cramping), see your doctor immediately.
As previously mentioned, 80% of pregnancy loss happens within the first trimester. Based on a study out of Victoria, Australia, performed over a two year period at an antenatal clinic, the chance of miscarriage after 13 weeks (with no other symptoms), is low, at 1.6% or less after a healthy gestational visit at 11 weeks.
The same study shows that chances of loss continuously decrease week-on-week as a pregnancy progresses up to 13 weeks.
That said, late term pregnancy loss can still occur, and the above study doesn’t consider any causes other than duration of pregnancy.
When diagnosed as a miscarriage, your doctor may refer to your loss as either complete, incomplete or missed. Complete means all of the pregnancy tissue has already passed, incomplete refers to a scenario when some of the tissue has passed but some still remains in the uterus, and missed is when the pregnancy has stopped growing but the tissue has not passed and the sac surrounding the embryo or foetus is still within the uterus.
Once a loss occurs, there are three treatment options.
The first option is to wait and let the tissue pass naturally, which can take up to two weeks. The experience can be intense, for a number of reasons, not least the pain of the contractions that assist the body to expel the pregnancy. For the most part, in the early stages of pregnancy, it’s healthy for a woman to miscarry naturally, but the situation will depend on your general health, background, and if you feel mentally able.
Women may choose this method to avoid taking medication and avoid needing to stay in the hospital but the difficult side of this aside from the above listed, is that you won’t know how long it will take to start or to pass, which can cause a lot of pain and anxiety.
You can also choose to take medication to expel the tissue within a week, which means less time waiting for the tissue to pass naturally and a less invasive process than the dilation and curettage procedure, known as D&C.
The pros of taking a medical miscarraige include speeding up the process, avoiding being put under anesthetic and avoiding the surgical procedure of the D&C. However, similar to naturally miscarrying, the process can be very painful. Additionally, with both medical miscarraige and natural miscarriage, there will always be a chance that not all pregnancy tissue will pass and you’ll end up needing to proceed with a D&C regardless.
Dilation and curettage
Dilation and curettage is the third option, which is a medical procedure used to dilate the cervix and scrape out the tissue. Many women prefer the procedure of the above options because it’s the fastest option. You’ll also be under anesthetic, which means some of the physical and emotional pain of actually passing the the tissue may be avoided. It’s also much more likely that all of the tissue will be removed the first time around with a D&C.
D&Cs can for the most part be avoided if you prefer not to go through the procedure or have the experience in the hospital, however, the procedure should especially be avoided if you have a pelvic infection, issues with clotting, or other medical issues that may raise concern (your doctor can help you understand the risks).
Complications can arise from D&C procedures including haemorrhage, infection, and perforation of the uterus. Additionally, the procedure comes with a very small risk of Asherman Syndrome, the formation of thick scar tissue, which can lead to infertility. That said, Asherman Syndrome is very rare and generally only occurs in women who’ve had multiple D&Cs.
D&C can be a good option for women who don’t feel prepared to experience the pain and processes of naturally completing a miscarriage, and while it comes with its own risks, with a proper ultrasound and medical pre-check, most can be avoided.
It seems unfair knowing that your body is switched on enough to naturally expel a nonviable pregnancy, but doesn’t recognise that once a stillbirth occurs, there is no need to carry on the rest of the birthing process. Yet, after a stillbirth, breastmilk will still be produced.
This can add to the emotional distress of the event overall, and it’s something that often gets left off when discussing the experience, meaning when it happens, it can feel crueler and more shocking.
First up, women who experience stillbirth are given medication to suppress lactation, so this will hopefully be minimal. However, if any does occur, applying ice packs and taking a mild pain relief tablet will help ease the pain of swollen and engorged breasts which occur due to milk production.
It’s normal to experience cramping similar to labour contractions as your uterus reduces back to normal size. Medication can help ease some of the pain.
Again, there are some natural birthing processes that still must occur during stillbirth, including lochia, which is the heavy period that women experience after birth. Lochia is the body shedding the lining of the womb and blood from where the placenta was attached, generally lasting around two weeks.
In a world where social media makes it easy to put our best life forward for all to see, the world of pregnancy loss can be even more harrowingly lonely and silent.
Nearly 20% of women who experience miscarriage become symptomatic for depression and anxiety. Continuing regular mental health checks starting at 6 weeks after your loss can help you manage these conditions.
Lacking the belief that society understands or accepts your experience can exacerbate these emotions. That’s why it’s important to talk about your loss (when you’re ready) and seek support from friends, family and professionals.
Because miscarriage is so uncommonly discussed, many women and couples will not only not realise it’s common, but are inclined to believe something they’ve done has caused it.
It’s easy (and normal) to be plagued with questions about why any shocking or traumatic experience has happened to you, and pregnancy loss is no exception. Particularly for a mother whose body is carrying the child, it’s easy to feel that something you’ve done has meant you haven’t provided properly for that pregnancy to grow.
But as we mentioned at the very beginning of this guide, not only is pregnancy loss common, it’s often due to completely random development issues, and while there are some factors about the mother’s health that can contribute, they are much less likely to cause miscarriage.
Something else about grief that feels important to mention: healing is not selfish. When you start to feel better (how ever long it takes) it in no way denotes your lack of care or memory of your unborn child.
Healing is healthy, it’s natural, and it will allow you to move back into the swing of things, rebuild connections with friends, family, and your partner, and eventually, if you want to, continue to plan for a family.
Shame is one of the heaviest emotions we are capable of feeling. Different to guilt over our actions or embarrassment over how we’re being perceived, shame denotes our internal feelings about ourselves – the idea that we are fundamentally bad.
It’s one of the top emotions women recall after pregnancy loss. A feeling that your body doesn’t work properly, or that you’ve let your partner down, or worse, that as a mother you haven’t been able to save or care for your baby. Or simply that you are different or worse than everyone else because you weren’t able to carry a full-term pregnancy.
In these cases it’s important to remember not only that miscarriage is common, but that it’s a natural occurrence in the body that cannot be stopped.
Speaking with your doctor after a loss and covering all of the information of what happened is a good option to help ease the questioning in your mind about why something like this has happened.
It may help you feel more in control being armed with the information, to help control the feelings of shame, guilt and loss that occur. It’s a good reminder that the loss wasn’t your fault and that, if you want to try again down the line, it doesn’t mean this will happen again.
One study out of Imperial College in London, surveyed 113 women after early pregnancy loss, monitoring their mental conditions at one, three, and nine month after the event. In this study, 38% of women reported symptoms of PTSD three months after their loss.
The Mayo Clinic defines post-traumatic stress disorder (PTSD) as a mental health condition triggered by experiencing or witnessing a terrifying event. Symptoms can include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event.
Bear in mind that miscarriage is a traumatic experience on a variety of levels, including physically, emotionally and socially. So, the fact that so many experience PTSD as a result, isn’t at all a surprise.
If you feel that you may be experiencing symptoms of PTSD, seek medical support.
Sharing your experience
Talking about your experience openly can help ease the pain, because not only will you be releasing some of the burden of holding your feelings in, but you’ll likely find that many women around you can relate or have had similar experiences, which can make you feel less alone and in turn, make them feel less alone too.
There’s really no way to avoid or ease the sense of loss of a miscarriage, it’s important to take the time you need to heal and to seek help of a mental health professional if you feel that your pain isn’t easing naturally.
As with any traumatic experience, miscarriage can test a relationship and create change. As both partners grieve, it can be difficult to know how to support one another. Many couples report that this experience creates a disconnect in communication.
While everyone has their own way of processing tough emotions, maybe the most important thing to remember is that open, honest communication is key.
Both partners should feel that they are supported in the emotional process and that their own emotions and thoughts are valid. One of the best ways to understand that is through sharing with your partner and getting their own feelings and perspectives.
Remember that as a partner, you’re experiencing both the loss of the unborn child and the pain of watching your partner endure it. And while it’s not your body that’s been through the experience, it will still have traumatic effects.
If you’re having trouble discussing the miscarriage with each other, seek professional help in grieving together. It can be hard to understand how we process and support each other through trauma if we’ve never experienced it in the relationship before.
As the partner of a woman who’s experienced a pregnancy loss, seeking outside support may be beneficial in a number of ways. Particularly, as in the early stages, she may not feel ready or capable of supporting you. Plus, outside or professional support may bring valuable insight that you can share.
The partner who experiences the miscarriage may feel that their partner lacks the depth of grief if they attempt to carry on as normal, such as going back to work or showing less emotion, and that in itself can be hard to deal with.
For both partners, it’s important to remove expectations around how the other should be reacting. Everyone experiences emotions differently, and the most important thing for anyone is knowing their feelings are valid and being given the space to experience them and the support when needed.
The most important thing to consider in any tough situation in partnership is to be kind to each other.
As much as you can try to hear and understand each other’s thoughts, feelings, and emotions, and feel completely comfortable in sharing, it will help you feel stronger and more supported as a couple and as individuals.
If you’re ready to start trying again sooner rather than later after a miscarriage, it’s important to speak to your doctor about if there are any medical reasons for you to wait.
Deciding to try again after miscarriage is a personal choice, and your mental health and physical health should be carefully considered.
That said, a study done at Mater Research Institute at the University of Queensland showed that 66% of couples who experienced stillbirth were able to conceive within the year. The participants themselves, as well as those in another study conducted in Ireland, suggested they required more frequent examinations in their subsequent pregnancies to ease their concerns about recurrent miscarriage or stillbirth.
When you feel ready to start trying again is entirely up to you, as long as you’ve been cleared by your doctor. It’s important to consider all aspects of how you’ve processed the loss and how the new pregnancy might make you feel, but it can be difficult to know until you’re experiencing it, so having the support you need in place can help ease some of the anxieties and concerns that may arise.
As most of the evidence in this guide suggests, miscarriage is fairly common, and they are commonly one-off experiences. Unfortunately, this isn’t the case for everyone.
Approximately 1% of those trying to conceive experience recurrent miscarriages, which are defined as three or more successive miscarriages.
Having a miscarriage can be a traumatic experience, full stop, so understandably, experiencing consecutive losses can take a toll and prevent couples from wanting to continue trying.
There are a few things that can increase the chances of recurrent losses, one of which is repeated genetic errors, which is the cause in 2-5% of couples.
As the leading cause of miscarriage, there is a chance that you or your partner may have chromosomal abnormalities, or the tendency to pass them along, which can be tested with a blood test, called karotyping. If this is the case, working with a geneticist for further testing to determine the cause and risks will be recommended.
Other causes include blood clotting disorders, uterine problems (such as an abnormally shaped uterus) or cervical weakness. But unfortunately, often, recurrent miscarriage cannot be attributed to any one cause.
Between 50-80% of women who experience a miscarriage become pregnant again. However, it can be an emotionally tumultuous time. While you may feel elated and hopeful, the understandable anxieties of a repeat loss will be present.
According to the above study out of the US, 68% of women reported they were still upset two years after their experience and 64% said it affected their decision to become pregnant again.
These stats are real, and being afraid is normal.
No one can tell you what you’ll feel once you do become pregnant after a miscarriage, the most important thing is setting in place the support you need to help you throughout the process mentally and physically.
Perhaps the light at the end of the tunnel of all of this information, is that becoming pregnant again and carrying a full-term, viable pregnancy is likely, and there are plenty of people in place to help you through both the processes of loss, and new pregnancy.
Planning for a baby can be full of exciting and daunting emotions all bundled into one journey.
But, key advice to any future or current expectant parent is to seek information well ahead of time.
As you could probably imagine, when you\'ve just welcomed a new baby into your family, it can be terribly hard to transition back into work straight away. Besides, you want to spend some quality time with your little human!
In Australia, more parents are spending longer at home with their newborn. About 2 in 5 women go back to work when the baby is 7 months or older.
However, sometimes it\'s actually not financially viable for some people to take the entirety of parental leave. And that\'s okay.
But it\'s still important to know the ins and outs of what exactly you are entitled to as an employee. It will give you not only peace of mind, but you\'ll be able to devise a plan on how you will take advantage of this opportunity; while still leaving you financially stable and supported.
There are a number of parental leave entitlements (paid and unpaid) that you may not be aware of, and could be eligible for.
Parental leave allows employees (full-time, part-time or casual) to take time away from work when:
If you fit the above scenario criteria, you are entitled to 12 months of unpaid parental leave, and can request an additional 12 months of leave by chatting to your employer.
The only catch is: you need to have worked for your employer for at least 12 months. If you\'re casual or part-time, you just need to have worked for 12 months on a regular or systematic basis.
And, if you do request the additional 12 months, your employer may refuse this on reasonable business grounds, which needs to be stated in writing.
These entitlements apply both to you as the mother or your partner.
The Australian Government have gone and done a nice thing where they will fund 18 weeks worth of parental leave, at the national minimum wage.
That\'s $740.60 per week before tax. Not too shabby.
Am I eligible? 👇🏼
What other criteria do I need to meet? 👇🏼
What if I\'m self-employed? You\'re still eligible as long as you meet the work test.
By the way, this also doesn\'t affect the unpaid parental leave entitlements. If you are eligible for the paid parental leave, you can get both.
What about the partners? Well, for eligible fathers and partners (including same-sex partners), the Australian Government will fund 2 weeks of leave paid at the minimum wage.
That’s $740.60 per week before tax.
Am I eligible? 👇🏼
What other criteria needs to be met? 👇🏼
More Aussie employers (currently 50%) are starting to fund their employee\'s Parental Leave.
They\'ve finally caught onto the fact that paid parental leave is a pretty attractive component to a modern workplace.
It\'s a great way for companies to attract better talent, encourage diversity and improve the work-life balance of their employees.
And the great thing about this is that you can be paid for both your employers\' paid parental leave AND the Australian Government\'s Paid Parental Leave Scheme.
Double noice 👏🏼
But the amount of time that is offered varies from employer to employer.
Also, the amount paid varies from employer to employer too.
Once you\'ve figured out where you stand in terms of the entitlements offered, you need to give your employer a certain amount of written notice and evidence if they request it.
🙋🏼 How much notice do I need to give my employer?
Under the Fair Work Act, you\'ve got to give your employer 10 weeks notice before starting your leave.
Ideally, this should be in writing and say how much leave you intend to take (and when you intend to take it).
Then, four weeks prior to your planned parental leave date you should confirm your intended leave dates with your employer in writing.
🙋🏼 How far in advance can I take leave before the expected birth or adoption?
Your leave can start up to 6 weeks before the expected birth of your child.
If you want earlier, you can chat with your employer and come to an agreement.
💁🏼 But I want to work right up until the birth, then what?
You might need a medical certificate that states you are fit to work if you want to work through part of the last six weeks of pregnancy.
🙇🏼♀️ OK, I\'ve changed my mind and want to extend my leave - is that okay?
Absolutely. But you will need to give around 4 weeks of notice before your expected return date that you originally agreed on.
You’re entitled to a bunch of extra rights if you happen to be carrying another human life.
If you experience pregnancy-related illness (morning sickness, anyone?) you are able to take sick-leave (instead of dipping into your annual leave).
This special leave is reserved for the mamas out there who are going through the awful experience of a miscarriage, abortion or stillbirth.
Also note that special maternity leave won’t reduce the amount of unpaid parental leave that an employee can take. Take your time.
Regardless of whether or not you’re entitled to maternity leave, all pregnant women are entitled to move to a safe job if it isn’t safe for them to do their usual job because of their pregnancy.
If you move to a safe job, you are still entitled to the same pay rate, hours, or work and other entitlements you get in your usual job. Nothing should change in that regard.
If you\'re not able to find a suitable safe job in your workplace, you\'re entitled to paid No Safe Job Leave. Which means you are paid at the base rate of pay for ordinary hours of work for a full-time or part-time employee.
If you are a casual employee, it will be paid at the base rate of pay (not including casual loading) for the average number of hours you would usually work.
Here are a few extra entitlements to be aware of when you\'re off work caring for your little one.
While you\'re taking parental leave, you\'re allowed to work up to 10 days without ending the parental leave period or formally returning to work if you are taking unpaid parental leave.
The 10 days doesn\'t need to be consecutive either, and can be spaced out according to what you and your employer agree on.
These days are paid at your usual rate and are designed to assist you in keeping in touch with your employer and colleagues while you are on leave.
It\'s a good way to help you return to employment after leave gradually.
Your employer must also consult with you if there are any significant changes to your job while you’re on leave.
You might decide to shorten the amount of leave than originally planned. If that\'s the case, you need to have this discussion with your employer.
In this case, they can choose to agree or not agree. If they don’t agree, you have to return to work on the planned date.
But, there is an exception: If you want to reduce or cancel your period of unpaid leave because of a still birth or death, you can end your leave by giving your employer 4 weeks notice.
If you are taking unpaid leave, you are able to apply to extend your time off. The amount of time will depend on your original leave period.
Extending leave in the first 12 months: You can extend your leave period up to the 12 month limit if your original unpaid leave period was less than that. Your employer needs to agree for anything above and beyond the 12 months.
Extending leave beyond the initial 12 months: If you’ve taken 12 months unpaid parental leave, you can apply to extend your leave to a total of 24 months. But, your employer can refuse the request on reasonable grounds but they need to have a discussion with you first.
You have every right to resign from your job while you\'re on parental leave. Just make sure you give the correct notice period to your employer and use your parental leave as the notice period.
These are your entitlements when it\'s time to return to work after your parental leave.
If you were entitled to parental leave under the Fair Work Act, then you have the right to work guarantee. What this means is that you have the right to reutn to your pre-parental leave position. Exactly the way you left it (unless your employer spoke to you about any changes while you were on leave).
If you were transferred to a safe job before you took leave you are entitled to return to the job you had before the transfer.
If, for some reason, your position no longer exists then you are entitled to another position that is similar in status and pay.
That\'s the work guarantee.
Going back to work while having a little human to care for requires some flexibility. That means you are entitled to request flexible working arrangements if you\'ve worked for at least 12 months with your employer before making the request.
You can ask for things like changes to your start and finish times, job sharing or working from home.
You can also request flexible working arrangements if you are a parent, or have the responsibility of care for a child who is school aged or younger.
Your employer has the right to refuse the request on reasonable business grounds, however, the reasons for refusal must be in writing.
The same goes for casual employees. If you’ve been working for 12 months consistently and have a reasonable expectation of continuing employment with the employer on a regular basis.
It\'s best practice for an employer to support their employees who are breastfeeding by ensuring they have suitable facilities to store and pump breast milk. You should also be given the appropriate breaks to breastfeed.
Also know that breastfeeding is a protected ground of discrimination. That means failure to provide adequate facilities may constitute discrimination and a breach of work health and safety laws.
Thinking about having another child after this one? Well, the good news is that if you have taken parental leave, you don’t have to work for another 12 months before you can take another period of parental leave with the same employer.
But, if you started work with a new employer, you will still need to work with that employer for at least 12 months before you are entitled to parental leave.
Once you\'ve worked out the type of parental leave you\'re entitled to, make sure you give your employer adequate notice.
Once you\'ve got the calendar dates set, then it\'s best to go straight to the source of truth (aka Australian Government Site) to gather extra information around what documents you might need to provide, or forms you need to fill in to ensure you get any payments you\'re eligible for.
It\'s best to get all of this admin done as soon as you can, mainly because it\'s not that fun and you could instead be buying cute baby things.\x3c!--kg-card-begin: html--\x3e
Dr. Vamsee Thalluri
Exactly how it sounds, the process of freezing your eggs involves retrieving them from your ovaries, freezing them and storing them for future use.
As we age, so do our eggs. This is a major factor in why it can be so hard for women to fall pregnant as they age.
This is where egg freezing can help. It helps your eggs stop time and maintain their youth.
This means you can keep your eggs healthy and of high quality, until you want to make a call on whether you will use them or not later in life.
It\'ll give you the choice to use the same eggs that might have otherwise declined in quality as you aged.
Well, there are both medical and social reasons for putting eggs on ice.
Medical: It\'s about fertility preservation. There are situations where women can lose their fertility earlier in life due to medical conditions such as cancer treatment, Endometriosis or signs of early menopause. In fact, egg freezing was developed initially to help women preserve their fertility who were undergoing chemotherapy or radiation treatment.
Social: Then we have women who are choosing to freeze their eggs so they can keep their options open.
The cultural mindset around having kids is changing, and women are choosing to start their families later; for a variety of reasons.
Their careers could be really taking off, they are taking the time to tick a few more things off their bucket list or they want to build a bigger financial safety net.
So, you might not be ready for babies right now, but you know it’s definitely something you want to consider later in life.
You could still be considering whether you actually want kids or not or you haven\'t met the right person yet.
Either way, because the biological realities of our fertility declining with age aren’t changing, freezing eggs might give you choices in the future.
There are 5 main steps involved in egg freezing (and then using those eggs):
1. Ovarian stimulation
This is your time to prime. Over a period of approximately 2 weeks before the retrieval procedure, you have to give yourself hormone injections that help you ‘grow’ multiple follicles in your ovaries.
During this time, your doctor will be monitoring this amazing work your body is doing through transvaginal ultrasounds. This is to help the doctor count and measure your follicles. They\'re looking for a good amount of healthy-looking eggs.
They might also do some blood hormone tests on you as well. This helps them adjust the dosage of the medication if it\'s needed.
As soon as the follicles on your ovaries are looking primed, you will have to take a "trigger shot" of a hormone called Human Chorionic Gonadotropin (HCG for short). Simply put, this tells your body to get ready to release the eggs.
The timing of the HCG shot is really important.
The doctor needs to plan the shot with your surgery. This is because your egg retrieval has to occur at just the right time so you do not ovulate before your doctor collects your eggs.
But don\'t worry, your doctor will help you work out this timing. It won\'t be all on you.
2. Egg retrieval
After lots of monitoring, a fertility specialist inserts a long and very thin ultrasound-guided needle via your vagina to retrieve your eggs.
In most cases, you’re under anesthesia for this so you shouldn\'t feel a thing! The whole process is known as a ‘cycle.’ Recovery time for this surgery is often a 1-5 days.
3. Egg freeze
If you’re freezing your eggs, after they are retrieved, they will go through a process called vitrification. Basically, this is where the freezing part happens.
They use high levels of antifreeze that protects each egg from damaging ice crystals. Then, they’re placed in a freezer and stored there until you’re ready.
And when I’m ready to use my eggs?
4. Thawing and fertilisation
When you’re ready to use your eggs, they will be thawed and fertilised. Fertilisation can be done through a standard procedure of combining a concentrated amount of quality sperm with the egg on a petri dish, in hopes that the magic of fertilisation will happen.
Alternatively, if male fertility is an issue, a process known as ICSI (Intracytoplasmic Sperm Injection) can be used, where a single sperm is injected into the egg. Once the egg is fertilised, it’s officially an embryo. 🙌🏼
5. Embryo transfer
About three to five days after the fertilisation, an embryologist (cool title) will identify the healthiest looking embryo, sometimes done through genetic testing.
Then, they\'ll transfer the embryo into the uterus via a thin, flexible catheter through the vagina and cervix.
Unfortunately the math doesn’t quite check out here, because one egg does not equal one kid.
The reality is, egg freezing is not an insurance policy.
You should be prepared for the fact that when you collect a batch of eggs, there’s no guarantee that any of them will be ready to become an embryo.
They won’t all make it through the next steps of thawing, fertilising, growing a good quality embryo, implanting and then making it through the pregnancy.
In each part of the process, we lose some eggs.
So, on average, each egg frozen has a 2-10% chance of turning into a live birth.
So really, it’s a bit of a numbers game. The more eggs retrieved from the egg freezing cycle, the more chances there are for a baby.
So, how many eggs should you freeze to give yourself the best chance?
Your fertility specialist will be the best person to help you set a good target number of eggs for you.
This will primarily depend on the age you choose to freeze your eggs and how many children you want to have with those frozen eggs.
Success with egg freezing still depends on collecting and freezing a batch of healthy eggs. But remember, as we age, so do our eggs and their quality declines.
And the older you are, the more eggs you\'ll have to collect to ensure a fair chance of achieving at least one live birth from those eggs. So if you want multiple children, freeze more eggs.
A 2017 study suggests the following as an estimate for success rates from egg freezing:
If you want to have multiple children with the eggs you’ve frozen, check out this tool that was created from the results of this study.
Knowing how many eggs you need to collect versus being able to physically collect those eggs is the consideration here.
It largely depends on your ovarian reserve (your egg count).
In an average cycle, around 9-15 eggs are collected. This number decreases as you age.
If your ovarian reserve is on the lower end, it could be harder to collect the optimal amount of eggs. Which means you may require multiple cycles (and therefore, it’ll cost you more money too).
Every woman is different, and you can test your ovarian reserve by testing your AMH.
Your AMH results will also help your fertility specialist determine what dose of medication to start you on to stimulate your ovaries for egg retrieval. If you have a lower ovarian reserve level, they are likely to start you on a higher dose to try to stimulate more eggs.
The earlier the better, right? It\'s not that simple unfortunately.
When you\'re in your early to mid 20s: For the women out there who are ready to jump on the egg freezing train in your early to mid 20s, there is a chance you might not use them. You\'ve still got many years ahead of you and you can\'t predict the future.
You could meet someone, start a family the old-fashioned way and then you\'re going to be out of pocket for not only the initial procedure, but for every year you\'re storing them it can cost you up to $500 per year. That\'s a lot of moolah for no return.
But, before you go jumping to any conclusions. Let me explain the other side of the age debate with egg freezing.
When you\'re in your late 30s or early 40s: Egg freezing does rely on being able to harvest a good amount of quality eggs. And as we\'ve said before, it gets harder to retrieve a good amount of eggs as we age. Plus, even if we do have a good amount of eggs, the quality of the eggs aren\'t guaranteed.
So, waiting to freeze our eggs around our late 30s or early 40s may mean that the eggs we collect may not be good enough to produce embryos capable of creating babies. Or, it may mean we need a few more egg retrieval cycles to retrieve more eggs to give us better chances for a baby. Which, of course, costs money.
For women in their late 20s or early 30s, specialists agree these are the optimal years to freeze your eggs.
This is when most women have a sturdy ovarian reserve and healthier eggs.
But, keep in mind that everyone is different. If you suspect you may have conditions that may impact your future fertility, it’s a good idea to speak to a fertility specialist to understand what your options would be.
Once you\'ve decided and planned to start an egg freezing cycle, the first thing you need to do is make sure you have a flexible enough schedule for a few weeks (at least).
There can be limited flexibility in monitoring schedules and appointment times (which are often in the mornings).
During this process, injections would need to be taken at the same time, every day.
Plus, you don’t have much say on timing when you need to take a trigger shot and schedule the egg retrieving procedure because your body decides when it\'s ready.
The first step of egg freezing is to inject yourself with hormones. So, be prepared to get hormonal. It\'s totally normal, but you might have some days with ups and downs.
To future-proof those shitty days, make sure you surround yourself with friends, families and medical professionals who can support you during this time.
But the main risk with the egg freezing hormones is over-stimulating your ovaries. This is a condition known as Ovarian Hyperstimulation Syndrome. It can cause severe bloating, stomach pains and nausea.
You are at greater risk of over-stimulating your ovaries if you have high AMH levels.
So, if your AMH levels are high, it’s a good idea to talk to your provider about adjusting your dosage of medication.
AMH is the main hormone we test in our Kin Fertility Test.
Hate to sound like a broken record, but the answer is - it depends.
The cost of egg freezing can vary greatly and depends on the clinic, whether you’re eligible for Medicare and the level of private health insurance you have.
🔎 The average cost of an egg freezing cycle is around $5,000 - $8,000.
This cost typically includes:
If your fertility specialist determines there are medical reasons for freezing your eggs, some of these costs can be covered by Medicare, leaving an out-of-pocket expense of around $2,000 - $4,000.
In addition to the egg freezing fee, you may need to pay separately for hormone medication ($500 - $1,500 on average), day surgery and anesthesia ($1,000 - $2,000 on average). Plus, there is typically an annual storage fee of around $500 for each year you leave them on ice.
It’s a good idea to check with your private health insurer (if you have one) as they may cover some of the day surgery and anesthesia costs.
When it comes time for you to thaw, fertilise and transfer those eggs, that’s an average cost of $3,000 - $5,000 per cycle.
Lots of numbers (and money), I know! So let’s pull it all together:
When you choose a clinic, you choose the medical team and the lab that comes with it. Make sure you feel comfortable with the medical team you surround yourself with and you trust the lab that will be handling your eggs. After all, they play a huge role in the success of your egg freezing treatment.
Hang tight, we’re putting together an Egg Freezing Discussion Guide of the questions you should be asking your clinic and fertility specialist if you’re considering freezing your eggs.
Egg freezing can make you feel empowered. It gives you options and the freedom to choose your own flight path. You\'re not ready for kids now, but want to have that option in the future.
Just remember, it shouldn\'t be treated as an insurance policy. It\'s not going to cover you if things go south with your fertility.
So, making the decision with all the facts about your chances, the number of eggs you might need to collect, the number of cycles you might need and the costs of those cycles is critical to determine whether egg freezing is for you or not.\x3c!--kg-card-begin: html--\x3e
Dr. Vamsee Thalluri