GP's view: Morning sickness

GP's view: Morning sickness
GP's view: Morning sickness
 


Pregnancy nausea, or morning sickness as it is known, occurs in most women, especially in the first trimester of pregnancy. It can occur at any time of the day but tends to be worse when you are tired or hungry. There are numerous measures that have been suggested to help alleviate morning sickness. These include vitamin B6, ginger and ginger tea, acupuncture, eating dry bread or crackers before getting up, avoiding spicy or greasy food, sucking on a lemon or something sour, getting fresh air, avoiding strong odours and drinking plenty of fluids. Responses can be variable (indeed, recent studies have suggested that ginger and acupuncture are actually no more effective than a placebo and excessive use of ginger can cause further gastrointestinal upset). See what works best for you and if you do not experience relief, talk to your doctor. For more severe symptoms, your doctor can prescribe medication to relieve the nausea. Most women prefer not to take medication, however if the vomiting is severe and there is a risk of dehydration, electrolyte disturbance, significant weight loss or malnutrition, it may be necessary.
The most severe form of morning sickness, known as hyperemesis gravidarum, occurs in 0.5 to two per cent of pregnancies. Women with this condition suffer dehydration, electrolyte disturbance and weight loss that is greater than five per cent of their total body weight and may need to be admitted to hospital for intravenous fluids, anti-nausea medication and monitoring. It is vital for the wellbeing of both mother and foetus that this type of severe nausea is managed promptly by experienced medical practitioners to avoid complications and serious risks to foetal development.
The good news is that, in most cases, morning sickness settles down by about the 12th to 16th week of pregnancy. In the majority of cases, morning sickness is simply a normal part of pregnancy caused by the hormonal changes and it will have no untoward effects on the baby. In fact, women may be comforted to learn that evidence suggests that those who experience morning sickness are actually less likely to have a miscarriage or stillbirth.
Read our fact sheet on pregnancy.
For a naturopath's thoughts on this topic, check out A naturopath's views on morning sickness by naturopathy expert Leah Hechtman

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Take a nap for better health

Take a nap for better health

Take a nap for better health
 
Experts at the University of Surrey have confirmed what Europeans have always known: an afternoon nap can be good for you. The researchers found older people who take an occasional afternoon nap are more able to lead an active life. Susan Venn, from the Department of Sociology, said: "Sleep is central to health and wellbeing, but as people get older, the quality of their sleep can deteriorate. They shouldn't feel guilty or think themselves lazy for having a nap."
The new research found many older people need a nap in the afternoon because they have disturbed sleep patterns at night. Venn said: "Many older people are prescribed medications to help them sleep, but research has shown that sleeping medication may impact on the lives of older people, such as increasing the risk of falls."
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Top tips from doctors

Top tips from doctors

Top tips from doctors
 
Women are constantly bombarded with health advice: cut out caffeine, eat the latest superfood ... but these instructions can be as fickle and changeable as the latest fashions. So how do we sort the fixes from the fads? We consulted five leading female doctors for genuine tips on how to stay healthy. Here's what they had to say.

Quit snacking

Many of us are programmed to believe we need regular snacks to keep our bodies going throughout the day. Not so, says Professor Kathy Samaras, associate professor of medicine at the University of New South Wales."Unless you are training as an athlete, you don't need to snack," she says. "And when you do eat, sit down at the table and savour it." Even healthy snacks such as yoghurt and health bars get the thumbs down in between meals.
"You can still become fat and unhealthy eating high-quality food," Professor Samaras warns. "It's the energy density and total kilojoule intake that counts." So why is snacking bad? It causes insidious weight gain, which leads to health problems. "The most common problems I see in women are diabetes, obesity and polycystic ovary syndrome (PCOS)," Professor Samaras says. "It's fundamental to manage your weight."

Have babies younger

The temptation is to put off starting a family until we're on top of our career, have met the right person, got married and settled down, done some travelling, bought a house, saved money ... but the reality is nature may not be prepared to wait. Dr Hilary Joyce has witnessed the devastating consequences of leaving it too late, even with IVF. "Being unable to fulfil a goal of pregnancy and a deeply desired child of one's own is heartbreaking," she says. "I advise, in fact implore, young women for whom having a baby is a high priority to attempt to conceive earlier rather than later. All too often, help is first sought at 39 or even in the early 40s, when female fertility is dramatically declining."

Use condoms

Being on the contraceptive pill is not enough protection when having sex with a new partner. "Use condoms," Professor Samaras says. "It's not only viruses that cause cervical cancer and sexually transmitted infections (STIs) - HIV is on the increase in Australia and the growth group is heterosexual women."

Be selfish

Women too often put their own needs last, behind those of a partner, family, friends, children and work. But constantly making sacrifices in order to give to others can be harmful to our health. Dr Cathy Hutton, deputy chair of the Australian Medical Association's Council of General Practice, says: "Many women come to see me when they feel they can't cope and are tired. I always check them over ... but often it comes down to putting their own health at a higher priority."
Dr Hilary Joyce, president of the National Association of Specialist Obstetricians and Gynaecologists, adds: "I recommend being selfish to be generous. Enhancing levels of wellbeing for women will benefit not only women themselves, but their families, their work performance and their wider community." Psychiatrist Dr Yvonne White says a dose of me time is vital for good mental health. "Make sure you make some time to do something that you like to do: reading, listening to music or going for a walk."

Watch what you consume

Being conscious of what you consume, whether it's food, alcohol or drugs, is the key to staying healthy. "It's best to eat whole, fresh foods, which can be prepared simply and quickly," Professor Samaras says. While an occasional social drink is fine, alcohol and drugs are responsible for many women ending their nights out in hospital, warns Dr Alex Markwell, who works in emergency medicine in Queensland. "This includes unwanted pregnancies and STIs from unprotected sex while intoxicated, injuries from fights, car accidents or falls and even long-term addiction."
We all know about the risk of lung cancer, but do you know the impact smoking is having on our health right now? "Smoking impacts adversely on every aspect of women's health," Dr Joyce says. "It impacts on the contraceptive pill, it compromises immunity to the wart virus and abnormal smears, affects fertility and pregnancy, adds risk to surgery, worsens and brings forward menopause and exaggerates the effects of ageing."

Have check-ups

The adage "prevention is better than cure" is particularly relevant to women's health. Early detection of disease can mean the difference between a healthy life and long-term illlness or even death. "Take up regular health checks and screening, including Pap smears and breast checks, and take up the relatively new six-month course of vaccination to minimise the risk of cervical cancer,"
Dr Joyce says. Dr Markwell says you should remember to have regular dental, blood pressure and cholesterol checks. "It is easy to it put off, but the investment in your health is worth it," she says. Dr Reid says it also pays to keep a close eye on your skin and get any unusual spots, non-healing sores or lesions that bleed checked out.

Ask for help

Resist the Superwoman title and use your support network, Dr White says. "Women need to develop their own level of self-confidence, try to do things one at a time and not let themselves get overwhelmed by trying to do too many things at once. They should not to be afraid to ask for help if they feel they need it nor should they feel it's a weakness." It doesn't have to be professional help either. "It's important to have a circle of friends you can confide in," Dr White adds.

Get moving

Many of us exercise simply because we want to look better, but there's a lot more at stake, say the medicos. "If I could advise women to take up one thing, it would be regular exercise, to be established as a routine in adolescence and the 20s," Dr Joyce says. "This will have immediate benefits in enhanced sense of wellbeing, and lifelong benefits of avoiding insulin resistance, diabetes and heart disease." Sedentary women are also more vulnerable to fertility, pregnancy and birth problems, she warns. Dr White recommends exercise to help prevent or alleviate conditions such as anxiety and depression.

Build up your bones

As we get older, our bones become thinner, making us more prone to osteoporosis and fractures. But because we can't see or feel this process, it's easy to ignore. Yet it's in our younger years that we should be laying down the foundations for strong bones. Dieting, child-bearing, some drug treatments and menopause can speed up bone loss.
"Regular, weight-bearing exercise, along with adequate vitamin D and calcium intake, will make a big difference to your bone strength as you get older," Dr Markwell says. "This is especially important when women are pregnant or breastfeeding, as they give up their bone stores to feed their baby."

Use sunscreen

Anti-ageing creams promise to banish signs of ageing and erase wrinkles. Sound too good to be true? Probably because they are. But we often get sucked in by marketing hype. "Moisturisers contain 55 to 90 per cent water, so you are paying for perfume and packaging," says Dr Catherine Reid, honorary secretary of the Australasian College of Dermatologists.
The real solution? Wear sunscreen, as sun exposure will accelerate ageing.But if you're still desperate for an anti-ageing cream, Dr Reid admits there is one medication that has credible scientific evidence that it works: tretinoin. At about $25 to $30 per tube, it's a vitamin A derivative originally developed as an acne treatment. But you need a prescription, so see your doctor.
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