The oral contraceptive pill (OCP or simply ‘the pill’) revolutionised contraception back in the 1960s and, since that time, there have been few changes to its design. Only a handful of new, different options have been made available to women, such as the IUD (e.g. Mirena), injections (e.g. Depo-Provera) and, of course, non-hormonal barrier methods such as condoms and diaphragms. Today, the pill remains the number one preferred contraceptive method.
How does the OCP work?
The pill essentially stops ovulation, thus preventing pregnancy, and provides synthetic forms of oestrogen and progesterone that mimic our natural hormones but don’t confer the same protective benefits. Lara Briden [https://larabriden.com/] describes it as putting women into a drug-induced form of menopause, depriving the body of these beautiful hormones.
The pill is often prescribed to ‘balance hormones’, reduce heavy and painful periods and improve skin health such as acne. However, all it is doing is masking the underlying problems. Please remember – a pill bleed is a drug-withdrawal bleed and not a natural period.
What does this mean for women’s health?
The pill is known to deplete various nutrients including B vitamins (especially folate), zinc and magnesium, and have a direct impact on gut health. Any woman wishing to have a baby needs to be aware of this, and I will speak more about what you can do later in this post. It is also important to consider the long-term effects of these nutrient deficiencies, and there is now substantial research to show that women who do not ovulate for extended periods of time (i.e. they are on the pill) are at greater risk of developing conditions such as osteoporosis and heart disease later in life.
What are the alternatives?
If you are taking the pill for contraception, there are numerous other non-hormonal methods available to you that will not negatively impact on your health. For many women in long-term relationships, simply learning how to properly track their menstrual cycle and using barrier methods such as a condom or diaphragm will be sufficient. I would encourage you to do your research here and reach out for additional support if necessary.
If you are taking the pill to reduce unwanted symptoms such as acne, heavy and/or painful periods, then I would always suggest working with a naturopath and getting to the root cause of the issue first. This is especially important for women with heavy periods, PCOS, fibroids and endometriosis, as the pill is simply masking your symptoms while the underlying biochemical drivers continue. For some women, the Mirena is the best option to reduce heavy blood flow and painful periods where other interventions don’t work. In my mind, it is the healthiest option as it contains low dose progestin only which acts locally to prevent build-up of the endometrial lining, thus preventing a bleed or, at the least, significantly reducing it for most women.
Coming off the pill
For many women, there are few issues with simply stopping the pill and they won’t notice any dramatic changes, particularly if their period wasn’t anything major before they started taking it. For others, they may experience changes to cycle length, bleed length and flow and a flare in acne.
If you have any concerns at all, it is always a good idea to work with a professional to determine the best course of action for you before you come off the pill to minimise unwanted side effects.
Preconception care and fertility support
It is essential that you give your body sufficient time to become replete in nutrients, including magnesium, zinc and folate, before trying to become pregnant. For this to occur, I would suggest a timeframe of at least 6 months and possibly as long as 12 months for most women. Folate (and choline) is essential for conception, a healthy pregnancy and, of course, a healthy baby at the end. Furthermore, make sure you get the right type of folate (i.e. NOT folic acid!). I recommend a pregnancy multivitamin that includes activated forms of folate (i.e. folinic acid) and methyl folate, as well as choline.
Next steps
Female hormones are complex and every single woman I see in clinic will have different genetics, meaning they will produce and metabolise their hormones differently.
Many of you will be able to come off the pill and address fertility on your own. However, if you have questions or concerns, I recommend seeing a naturopath who can give you specific guidance for your situation.
For women with a complex hormonal history, especially with a strong family history of oestrogen-dominant conditions such as endometriosis, I would recommend DNA testing. The power in understanding your unique biochemistry and learning the simple things you can do to improve your hormonal health is nothing short of incredible.
Written by Denise Berry BHSc Naturopath
For assistance with contraception options or preconception care, consult one of our naturopaths. They will ensure you are fully informed and offer advice and support relevant to your individual circumstances. Book an appointment.
The next few months will be fairly taxing on the immune system as we might start to experience symptoms of hay fever. Many of us look to boost the immune system but, especially with autoimmune and allergy symptoms, it is more important to modulate the immune response, as a lot of these symptoms are the immune system overreacting.
What is an autoimmune condition?
Autoimmune disease is defined as a condition in which tissue injury and loss of function is caused by t-cell or antibody injury to self. It is a major cause of concern in the modern world and spans over many different systems of the body.
Examples of autoimmune diseases include diabetes type 1 & 2, IBD, Hashimoto’s, Graves’ Disease and ankylosing spondylitis (an inflammatory arthritis affecting the spine and large joints).
Some factors that increase the risk of autoimmune, immunity and allergies
Genetic factors
Infective triggers – often mixed with genetic factors, can dramatically increase the risk of autoimmune disease.
Environmental triggers – smoking
Poor diet – low nutritional stores of nutrients needed for immune function or irritating foods
Psychological factors
Sex hormones and gender – 75% of patients with autoimmune disease are women.
Ways to modulate the immune response
Caring for the gut epithelial barrier
While triggers may end up being the causative factor to tip the scales, the gut shouldn’t be underestimated as it is the barrier. The gut controls and decides between the self and what needs to be defended against. If the gut isn’t properly operating, the immune response it may send out could be an improper signal. By utilising herbs, nutrients and food as medicine, we can help to repair the gut lining and reduce inflammation at the gut wall.
Treating dysbiosis
Research shows that different ranges of microbiome make-up in the gut can predict a higher chance of developing an autoimmune disease like rheumatoid arthritis later in life.
If you are pregnant or looking to get pregnant, implementing probiotics into your treatment plan for pregnancy and lactation can help prevent food allergies and autoimmune conditions.
Caring for your microbiome will also help to support the health of the epithelial layer of the gut.
Caring for liver detoxification
When there is an increased load, the liver becomes overwhelmed. It only has so much capacity for waste removal. By reducing this, it reduces the load on the immune system to clear up dead cells, waste, toxins and reduce inflammation from trigger exposure.
Spring is a great time to focus on liver detoxification and support. We can easily clean up our diet to ensure that we are not adding more load to our liver and including bitter foods in our diet can also help to support and stimulate detoxification pathways.
Avoiding trigger foods
Keeping a journal is a great way to work out your trigger foods as these foods can disrupt immune functioning. Common foods that can cause reactions include cow’s milk, gluten, yeast, trans fats, alcohol and sulphur-containing foods.
Food as medicine
Antioxidants
These are crucial in every diet but so important for protecting the immune system. Antioxidants help reduce free radicals in the body which cause inflammation. Many of the components such as polyphenols also have a distinct action on our gut bacteria, helping to support the ones we want and kill of the nasty disease-causing bacteria.
Including at least five serves per day of foods rich in colour (berries, rosemary, turmeric, green tea, dark chocolate, citrus, apples, red cabbage) will help to reduce inflammation, look after our gut and modulate the immune response.
Papaya, kiwi fruit and pineapple
While some of these can cause a reaction in certain people, these fruits contain enzymes to aid digestion and are extremely anti-inflammatory. To get the best out of a pineapple, eat the core which is where it holds the most bromelain (active component). These fruits have been well researched and can help significantly improve symptoms. The active components can also be isolated and used in any treatment plan to see quick improvements.
Turmeric
We love this wonderful herb because it can be used in practitioner doses to get some amazing results. It also can be used as food as medicine easily. Turmeric exhibits some incredible properties that fit well with autoimmune conditions – it’s an antioxidant, anti-inflammatory, antimicrobial and depurative (purifying and detoxifying). It has also been well researched for pain conditions, a common feature of many autoimmune and immune complaints.
Written by Ally Stuart BHSc Naturopath
Get a head start on hay fever this season by working with one of our naturopaths to get your gut healthy, control your immune response and discover the best ways to use food as medicine. Book an appointment.
Coffee is one of the world’s most popular beverages. It contains caffeine which is a psychoactive stimulant drug that speeds up the messages travelling between the brain and the body.
The psychoactive effects of caffeine influence neurotransmitters (mood hormones) such as dopamine and norepinephrine which leads to better mood, greater alertness, energy and improved cognitive function. Along with these positive psychoactive effects, coffee contains several minerals and antioxidants which provide a benefit to health. Research has shown that because of the caffeine, minerals and antioxidants found in coffee, regular or daily coffee consumption can help with:
reducing the risk of cardiovascular diseases including heart attack, heart failure and stroke
reducing the risk of developing type 2 diabetes
reducing the risk of developing neurological diseases such as depression, Parkinson’s disease and Alzheimer’s disease
improving physical performance
promoting longevity or a longer life span.
Although there are many health benefits that come with regular or daily consumption of coffee, there are also many negative health effects for individuals due to the caffeine quantity.
On average, a cup of coffee contains anywhere between 60–350 mg of caffeine depending on your individual order. A standard Australian-made coffee contains approx. 100 mg of caffeine. If you order a large/double-shot coffee, that is approx. 200 mg of caffeine. If you have another large/double-shot coffee later in the day, that’s another 200 mg and so on. You can see how quickly and easily this could add up. Additionally, items such as energy drinks, tea (including green tea), soft drinks and even chocolate all contain caffeine which means your caffeine intake is not just limited to your coffee.
Here is how a high caffeine intake may be negatively affecting your health:
Stress and anxiety
Caffeine stimulates our adrenal glands to produce adrenaline and cortisol – our ‘stress hormones’. These are the hormones that activate our fight-or-flight response and amplify our reaction to stressful situations. As such, consuming coffee recreates a stress response but the body can’t tell the difference; it is just responding accordingly to the increased levels of adrenaline and cortisol in the system. This will lead to symptoms including shakiness, heart palpitations, racing heart and hyper-vigilance which leaves us feeling jittery, anxious and on edge.
Over time, continually elevated adrenaline and cortisol levels deplete the adrenal glands and they are no longer able to produce these hormones to keep up with demand, leading to a feeling of being ‘wired but tired’ and is the sign that the adrenal glands are fatigued. This has a flow on effect and begins to negatively affect other hormones.
Sleep quality and quantity
As mentioned earlier, caffeine is a psychoactive stimulant drug – it gives us that buzz and keeps us alert! Depending on how well our liver detoxification pathways are functioning, caffeine can remain in the system for up to 8–12 hours. If you are consuming caffeine in the afternoon, there is a strong chance that it will still be in your system in part when it comes time to go to bed, making it much harder to fall asleep. Caffeine also inhibits the uptake of the hormone adenosine in the brain which is required in high concentrations for sleep onset.
As a general rule, you should drink caffeinated beverages after 8 am, after you have eaten breakfast and no later than 11 am, especially if you are sensitive to caffeine.
Digestive health
Caffeine is very acidic which contributes to inflammation and is incredibly irritating to the gastrointestinal tract lining. Caffeine also increases gastrointestinal tract motility, causing a laxative effect, which is why bowel motions, looser stools or diarrhoea are commonly reported after caffeine consumption. The increase in gastrointestinal tract motility, or laxative effect of caffeine, negatively impacts the digestion process, resulting in improper digestion of food and nutrients. This influences the body’s nutrient levels, see below. Caffeine may also suppress appetite, as well as trigger bloating, heartburn and reflux.
Nutrient levels
Consuming caffeinated beverages with meals interferes with the metabolism and reduces the absorption of many important nutrients including magnesium, vitamin C, B vitamins, calcium and iron, each of which perform hundreds of different important functions in the body. Separate caffeinated beverages from your meals by 1–2 hours to assist your gut to metabolise, digest and absorb these important nutrients.
If you find you cannot get through the day without coffee, you are having issues with sleep onset at night-time or you are experiencing some of the above mentioned digestive issues, it might be time to start thinking about reducing your caffeine intake. It is worthwhile seeking the assistance of a naturopath to help restore your body’s own energy production and other system or organ functions that may have been impacted by excessive caffeine consumption over time.
Every behaviour your child has is for a reason, and poor or unhelpful behaviour signals a deeper issue within their body that needs to be addressed.
Parents don’t often make a connection between their child’s mind and their gut but these systems are intertwined more than any other two systems in the body. There are many neurotransmitters produced within the gut, and there is a constant communication going both ways between the mind and gut.
While many children may have a genetic predisposition to behavioural disorders, this is not the cause of the issue. A common analogy is to think of genetics as the gun and environmental factors as what pulls the trigger – all have a distinct effect on the gut.
Factors affecting microbiota and digestion:
C-section delivery – no ingestion of bacteria found in birth canal to initiate their own gut bacteria
Diet – including variances between breast milk and formula
Sterile environment – exposure to lots of cleaning products with no exposure to dirt and a range of bacteria
Reduced exposure to a variety of people and animals
Antibiotic exposure – wipes out good bacteria, potentially causing an imbalance
Stress – causes microbiome changes and shuts down digestive processes and secretions.
A large number of children with behavioural disorders have distinct gastrointestinal symptoms. This can cause a primary trigger due to gastrointestinal pain which the child might not be able to communicate. In addition, these symptoms can cause changes in production in neurotransmitters, immune system changes, gut permeability and malnutrition which, in combination, cause rampant inflammation.
So, how does this all tie together and what does it have to do with your child’s behaviour?
The microbiome can cause immune activation directly at the gut surface. When the gut lining is not optimal, opportunity arises for disease-causing bacteria to populate and immediately signals an immune response. This is a normal response in someone with a diverse number of good bacteria which can overcome the bad bacteria, ensuring this happens less often. However, when gut integrity is low and the bacteria unbalanced, the immune response is constantly set off. This then signals nerves associated with serotonin which is a neurotransmitter associated with many behavioural disorders. It also creates inflammation within the brain which has a direct effect on the efficiency of mental processing.
As mentioned before, the gut and the brain also have a two-way conversation which is called the gut brain axis. Activity within each organ signals a response. For example, high level of stress within the brain signals the gut to slow down digestive functioning even if there is food coming through. This can cause poor digestion and inflammation within the gut, signalling the processing of neurotransmitters sending out stress signals, making your child’s behaviour change dramatically.
A poorly functioning digestive system may include slower digestion, impacted stools and fermentation. Having high amounts of digestive toxins may trigger inflammation within the body, again causing poor neurotransmitter production and inefficiency. Large amount of pollutants such as heavy metals, histamine, hormones and oxidants have been directly linked to autism, ADHD and other behavioural conditions. Optimising gut function will help detox and remove these pollutants.
The gut lining is where the conversion of food to minerals, vitamins, fats, proteins and carbohydrates occurs. If there is inflammation and problems with the microbiome, the conversion process will be inefficient. Even if the child is eating a healthy, nutrient-dense diet, they may still be deficient in certain nutrients. This deficiency affects the whole body and its processes, including production of neurotransmitters and inflammation.
There are so many ways your child’s behaviour can be affected so it is important to get a clear picture of what is going on within the gut. Understanding where the problem lies can be achieved through investigative questioning and functional testing, with the information used to tailor treatment and develop a personalised plan specific to your child and their needs. The goal is to get their health in order as soon as possible.
Now, you may be thinking this is all well and good but it’ll be almost impossible to get my child to eat well and take supplements. Well, it might not be easy but it will be well worth the extra effort! Together we can discover ways to introduce healthy and balanced food into your child’s diet. Even if your child exclusively eats chicken nuggets and vegemite on toast, we can start working on some healthy alternatives that you can prepare ahead of time and which are specifically designed to reduce the mood swings and behavioural symptoms. And in doing so, you will be helping your child’s mental health as well as your own. You will also be helping your child in the long run by introducing and replacing foods that not only replenish stores of essential vitamins but also promote good microbiome health. And that is the ultimate goal!
If you would like help to improve your child’s behaviour through gut health, please make an appointment with one of our naturopaths. Our knowledge of the gut and how it impacts all areas of your health have helped many people just like you and your child to turn their health around and live a well and happy life, naturally. Get right to the cause today!
We all have to eat, right? But have you ever stopped to think about the effect the foods you consume have on your health, mood, energy levels and the planet? Do you know exactly where your food comes from and how it gets to be on your plate? Are you aware of how what’s in the food affects how your body functions and the impact it has on your health and wellbeing?
Every single function of our body, every minute of every day, requires nutrients.
Without nutrients in the correct form and ratios, things don’t work so well.
There are three main sources from which we get our nutrients.
Carbohydrates– a group of foods including sugars, starches and cellulose.
Carbohydrates provide fuel and energy for the cells of the body and the brain. They are digested by the enzyme amylasewhich cleaves the bonds between the sugars, breaking them down into their smallest form. Digestion of carbohydrates begins in the mouth and continues briefly in the stomach before being completed in the small intestine.
Proteins – made of amino acids, which are commonly found in meats and animal products but can also be acquired through nuts and legumes. The protein you eat is broken down into amino acids by HCl acid in the stomach and the enzyme pepsin. These amino acids are absorbed through the small intestine and combine to form new proteins which are used to help the body grow, break down food, repair tissue and perform many other body functions.
Lipids (fats)– Lipids are abundant building blocks in our body – our cells, brains and hormones are made of fat. They are also a fuel source for energy production. Digestion of fats begins in the mouth through the enzyme linguallipase. Lipids then continue to the stomach where chemical digestion continues by gastric lipase. Once digested, they move to the small intestine where pancreatic enzymes and bile finish off the digestive process, making the lipids small enough to be absorbed through the intestinal wall.
Sadly, it’s not as simple as eat the good food and get the good nutrients. A lot must happen in our body from the time we take a bite of food, to the time it comes out the other end. Our food just isn’t the same quality it once was. We have over-farmed the soil and lost the natural minerals and nutrients from our soil quality. More sprays, pesticides and chemicals are used in growing, picking, harvesting, transporting and storing raw food materials, not to mention what is done to our food when it is processed and packaged. Any wonder our foods don’t contain high levels of nutrients any more!
Decades of treating our food this way, and our over consumption of heavily processed foods, has caused our bodies not to work as effectively.
A large percentage of the population has somedegree of digestive dysfunction. This can manifest in many ways, with the most common being:
reflux/heart burn
indigestion
pain/nausea/bloating/discomfort after eating
excessive wind
altered bowel habits
food intolerances
skin conditions
headaches
Most people have had these symptoms for so long they begin to think it’s ‘normal’.
So, let’s talk about that for a minute. What does normal digestionlook like?
Basically, our digestive tract is a long, hollow tube that starts at the mouth and ends… you know where. This is pretty much it, with a few twists and turns in-between. Starting at the top, the eyes and nose are pretty important in the whole process. When you see food, think about food and smell food, it’s a signal to your mouth to produce saliva, which triggers your stomach to produce gastric acid in preparation to digest food.
But your mouth is more than just the entry point. We have three pairs of salivary glands that produce saliva to keep our mouth moist, help to digest food and provide bacterial protection for our bodies. Saliva is mostly made of water but also contains enzymes, antibacterial compounds, mucus, minerals and electrolytes. All of these things help to digest food and keep our teeth and gums healthy.
Our teeth chew and breakdown our food (masticate), reducing it to small pieces. Our tongue is a muscle that helps to move the food around our mouth and taste the different components of our food, which is very important as this sends signals further down the line as to what is coming. We have five main perceptions of taste: sweet, sour, salty, bitter and umami. The taste perceived on our tongue sends a message to the brain as to the likely types of food about to enter the gut so our body can prepare to digest and absorb the food we eat as efficiently as possible.
Our mouth and throat contain immune tissue which helps to prevent any nasties from entering the body. This is found in the form of our tonsils. (Most people are only familiar with their tonsils once they become infected – tonsillitis.) These are called your palatine tonsils, but they aren’t the only ones in there! There is a ring of immune tissue that circles the back of the throat known as Waldeyer’s ring. This tonsil group are like ‘security guards’, checking everything that comes through to make sure it is ok for the body. Anything suspect trying to sneak past is detained and dealt with by the immune system. This is what is happening when our tonsils are swollen and painful.
Once our food (now called bolus) gets past the security guards, it enters our oesophagus, a straight chute down to the right-hand side of our stomachs. The oesophagus is lined with muscular rings which stretch to accommodate the bolus and, as it moves along, the muscles contract back to their normal position once it passes, preventing things from going back up. Fun fact – These one-way muscle contractions are so strong the food will still reach your stomach even if you are standing on your head! (Please don’t try this!) The oesophagus is also sealed at the bottom end with a muscular ring known as a sphincter, the lower oesophageal sphincter to be exact. It opens briefly to allow the bolus to enter the stomach and then snaps shut again.
And now we are in the stomach – the weird lopsided j-shaped organ that sits just below the breastbone, with the heart and lungs perched on top of it. The stomach is also a muscle-lined organ, with three muscle layers which work to mix and churn the food (retropulsion). The stomach has four main areas, all with their own individual functions, and two routes the food can take. Liquids pretty much pass straight through and into the duodenum (small intestine). Some carbohydrates move through relatively quickly as well. Solid foods, which take a bit longer to digest, are sent down the other path so they can be macerated and mixed with gastric secretions to form a soupy liquid calledchyme. Carbohydrates are digested first in the stomach and pass fairly quickly down the line, with proteins and fats held longer as they require more work to digest fully.
As we all know, the stomach can stretch to accommodate food; when it is empty, it hangs loose with wrinkles (rugae). Our stomach is the stretchiest part of our digestive tract, enabling it to hold an entire meal until the small intestine is ready to do its part.
In addition to the muscular contraction of the stomach to mechanically digest our food, there is also chemical digestion taking place. The wrinkles and folds in the stomach lining form pits into which gastric juice is secreted. This gastric juice is a combination of substances produced by three different types of cells: mucus neck cells (produce mucus which keeps things moist and slimy and moving along), parietal cells (produce intrinsic factor needed for the absorption of vitamin B12, in addition to secreting hydrogen [H+] and chloride [Cl-] separately, which, when combined, produce hydrochloric acid [HCl]) and chief cells (secrete pepsinogen and gastric lipase, which are the enzymes required to break down fat and protein into their smallest form).
Once all these chemicals have dissolved the food particles and the muscles have churned, it is time to move on to the small intestine (duodenum). The bottom of the stomach has a sphincter (just like at the top) to allow macerated food to pass into the duodenum. The small intestine is where all the magic happens! This is where the whole food has become micronutrients for our body to use. The small intestine is long – anywhere from 2 metres up to 10 meters long. It is lined with specialised skin cells called enterocytesthat have hair-like projections of skin (microvilli) on them. This helps to increase the surface area of this long tube and aids with propulsion, moving the liquid onwards, all the while absorbing nutrients across the thin membrane and into the blood stream for transport around the body to be used for growth, repair, energy, maintenance and the millions of amazing things our bodies do every second of every day.
Once the food has been absorbed and any undigestible matter is moved to the large intestine, the small intestine sends in the cleaning crew. It is called the migrating motor complex (MMC) and sweeps the entire length of the tube. It can only do this when the stomach and small intestine are empty. This is why it is important to have a break between eating so the housekeeping and maintenance can take place.
Anything that is moved along enters the large intestine. Any essential nutrition has been removed from the food, absorbed into the blood stream and utilised by our body. Anything that is left is essentially a waste product and needs to exit the system in a timely manner. The large intestine is home to the greater portion of the microbial ecosystem that lives within us. This helps to further breakdown the waste product and decompose it. Sounds gross, right?!
There are no microvilli here to move things onward; the motion of the large intestine is called peristalsis. The length of this organ is divided into sections of band-like muscular rings which stretch and contract in response to the fullness of the bowel. As a section fills up, it stretches the muscle wall and the wall pushes back against the bulk, squeezing it on to the next section, until it makes its way through and out the other end.
This a general outline of what ‘normal’ digestion looks like. From here we can determine if something isn’t working well. If you have any digestive symptoms, or things just don’t feel right, book a naturopathic consult and get to the bottom of the issue.
Vaginal thrush or yeast infection is the common name for an infection of the vagina and vulva most commonly caused by the pathogenic yeast Candida albicans. Thrush is an opportunistic infection, meaning it takes advantage of the body’s weakened defence mechanisms including a weakened immune system, alterations in the microbiota and permeability of the epithelial cell wall barrier of the vagina.
Approximately 75 per cent of women will experience vulvovaginal candidiasis during some stage of their lives. Thrush is also more common throughout pregnancy, affecting up to 40 per cent of pregnant women, in post-menopausal women, with uncontrolled diabetes and with use of oral contraceptive pill and antibiotics.
Pathogenic Candida albicans are able to destroy cells within the vagina leading to inflammation, immune responses and, as a result, the symptoms associated with this condition.
What are the symptoms?
Symptoms of vulvovaginal candidiasis are specific to the vagina or vulva regions of the body and can include:
Inflammation (redness) Intense itching Thick, white vaginal discharge, usually resembling cottage cheese Pain during intercourse or urination.
The body’s own defence against candidiasis
Vaginal pH
The pH of the vagina should ideally be between 3.5–4.2, which provides an acidic environment that inhibits the growth of pathogenic microorganisms including Candida albicans.
Microbiota
One of the body’s defence mechanisms against Candida albicans is the microbiota that live within the vagina. Certain strains of bacteria within the vagina produce antimicrobial substances as well as lactic acid, which promote a more acidic environment and which pathogenic microorganisms are unable to survive in. Studies have shown that women with a microbiota that is Lactobacillus-dominant have a reduced risk of reproductive tract infections.
Epithelial cell barriers
The epithelial cells of the vagina are part of the innate immune system and contain receptors that respond to various pathogens by triggering immune responses and the release of antimicrobial and antifungal substances. These cells also trigger the release of substances that function in repairing and remodeling the epithelial cells following damage caused by pathogens such as Candida albicans.
Recurrent thrush
Recurrent thrush is the presence of four to six vulvovaginal candidiasis infections a year. Research suggests that a contributing factor to the recurrence of thrush is the result of biofilm. A biofilm is a structure that may be formed on the surface of vaginal epithelial cells, which certain microorganisms may embed in. This structure provides protection of the embedded microorganisms against external unfavourable environments or threats such as antibiotics and the body’s own immune defences. Biofilms allow microorganisms to persist for longer periods of time and re-emerge when conditions within the vagina are more favourable, providing an explanation as to why infection may re-emerge even after treatment. Certain Candida albicans have also demonstrated the ability to neutralise the acidic environment of the vagina created by lactobacilli as well as alter immune responses, which allow these microorganisms to persist against the body’s natural defence mechanisms.
Naturopathic treatment of thrush
As with all naturopathic medicine, the focus on the treatment of thrush is to aid the body’s own healing mechanisms. In the case of thrush, this treatment aims to support the body’s mechanisms to efficiently fight off infection and prevent further infection and susceptibility. But how do we do this? First, we need to remove risk factors which may be contributing to changes in the environment of the vagina and that promote the overgrowth of Candida albicans.
Creating changes in the microbiota diversity of the vagina with probiotics
We currently stock a practitioner-only probiotic supplement specifically for the treatment of female reproductive tract infections, including candidiasis. This supplement contains two probiotic strains – Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14, both of which have been shown in clinical trials to inhibit the growth of Candida albicans.
Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 have also been shown to disrupt genito-urinary biofilms which may assist in the prevention of recurrent thrush.
What other factors disrupt the stability of vaginal microbial communities?
Sex hormones
The presence of glycogen within the epithelial cells of the vagina positively influences the presence of probiotic Lactobacillus spp. Lactobcillus spp. use glycogen as a source of energy and, throughfermentation of glycogen breakdown products glucose and maltose, produce lactic acid.Oestrogen promotes the availability of glycogen to the epithelial cells. Therefore, throughout various stages of the cycle when oestrogen levels are low, glycogen becomes less available and numbers of lactobacilli decrease. Progesterone and oestrogen also play a role in the regulation of the pH of the vagina, therefore an imbalance of these hormones may create a more alkaline environment which is favourable for the overgrowth of Candida albicans. This is particularly important in individuals who are experiencing hormonal imbalances or women who are going through menopause, as oestrogen levels are naturally declining, resulting in a heightened susceptibility to infection.
Menses
Alterations to bacterial colonies within the vagina have been shown throughout the different stages of a woman’s cycle. During menses, a decrease in the number of beneficial lactobacilli, as well as disruption to remaining lactobacilli, has been shown in a number of longitudinal studies. Low levels of lactobacilli have also been reported in the phase immediately following menses. This means susceptibility to infection may be heightened at this time.
Sexual intercourse
Disruption to the numbers of lactobacilli has also been reported immediately following sexual intercourse, again increasing the opportunity for an overgrowth of pathogenic yeast. Other factors to take into consideration are the type of lubrication and contraception methods used. The majority of personal lubrication products on the market have a pH that is higher than the ideal range of the vagina and which can create changes to the vaginal environment. Furthermore, it is also important to take into consideration the osmolality of personal lubricant. The osmolality of a lubricant being too high or too low can cause damage to the epithelial cells of the vagina by causing them to either rupture or dehydrate. Damaged cells increase the risk of vaginal infection. It is recommended that the osmolality of personal lubrication should not exceed 380 mOsm/kg to prevent epithelial damage.
In clinic, we also see a number of preconception clients with vaginal infections such as thrush. Sexual practices, particularly when trying to conceive, can also impact on the pH of the vagina due to semen having an average pH of between 6–7, creating a less acidic vaginal environment which may promote thrush infection. This places emphasis on the importance of education when trying to conceive and knowing when you are most fertile to avoid disrupting the pH of the vagina during less fertile times in the cycle. Avoidance of sexual practices during infection is also recommended.
Vaginal hygiene practices
The use of vaginal douches and intimate hygiene products has been shown to create alterations in the pH of the vagina, favouring conditions for the overgrowth of Candida albicans. Prolonged damp conditions have also been shown to contribute to the overgrowth of Candida albicans. Ensuring the external vaginal area is completely dry, through the avoidance of prolonged wearing of a wet bathing suit or damp or wet underwear, reduces the risk of infection. Ensuring that you wipe front to back after voiding the bladder or bowel is also important in preventing the translocation of microorganisms from the bowel to the reproductive tract.
It is also recommended that cotton underwear should be worn, that tight clothing is avoided and personal clothing should be washed in hot water and ideally separated from others.
Diet
There are also a number of dietary factors that impact on the growth of pathogenic yeasts within the body. Naturopathic consultation for the treatment of vulvovaginal candidiasis involves an extensive assessment of both dietary and lifestyle factors which may be contributing to a thrush infection, individual to each client.
If you would like more information on the dietary and lifestyle factors that contribute to thrush or other female reproductive infections, or you would like assistance in treating thrush naturally, book an appointment with our naturopath, Karly, by clicking here.
References:
Brooks, J. P., Edwards, D. J., Blithe, D. L., Fettweis, J. M., Serrano, M. G., Sheth, N. U., … Jefferson, K. K. (2017). Effects of combined oral contraceptives, depot medroxyprogesterone acetate and the levonorgestrel-releasing intrauterine system on the vaginal microbiome. Contraception, 95(4), 405–413. https://doi.org/10.1016/j.contraception.2016.11.006
Cassone, A. (2015). Vulvovaginal Candida albicans infections: Pathogenesis, immunity and vaccine prospects. BJOG: An International Journal of Obstetrics and Gynaecology, 122(6), 785–794. https://doi.org/10.1111/1471-0528.12994
Crucitti, T. (2017). Eve’s garden: myths, legends and secrets unmasked. Research in Microbiology, 168(9–10), 773–781. https://doi.org/10.1016/j.resmic.2017.07.004
Martins, N., Ferreira, I. C. F. R., Barros, L., Silva, S., & Henriques, M. (2014). Candidiasis: Predisposing Factors, Prevention, Diagnosis and Alternative Treatment. Mycopathologia, 177(5–6), 223–240. https://doi.org/10.1007/s11046-014-9749-1
O’Hanlon, D. E., Moench, T. R., & Cone, R. A. (2013). Vaginal pH and microbicidal lactic acid when lactobacilli dominate the microbiota. PLoS ONE, 8(11), 1–8. https://doi.org/10.1371/journal.pone.0080074
Tachedjian, G., Aldunate, M., Bradshaw, C. S., & Cone, R. A. (2017). The role of lactic acid production by probiotic Lactobacillus species in vaginal health. Research in Microbiology, 168(9–10), 782–792. https://doi.org/10.1016/j.resmic.2017.04.001
Smitten Kitten’s shopping guide to lube (2015)
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