Our Hormone University founder had a virtual interview with Mr.Colin Davis, a renowned gynecologist and fertility specialist based in the UK. We asked him some questions about women’s health, fertility, PMS, and lifestyle habits that can affect these.
Our biggest takeaway from Mr.Colin Davis is that no woman’s body is the same and that it is best to monitor what is ‘normal’ or not for you. Below are the questions we asked along with Mr.Colin Davis’s response to them.
Interviw with Mr.Colin Davis.
When should women first visit a gynecologist? Should women wait to visit a gynecologist or fertility specialist until they are planning to conceive/ have conceived or is it best to visit earlier on?
It depends on the natural cycle of women. When girls first menstruate around ages 11-16, it is key to keep a record of your cycle and how frequent you get a cycle. A gynecologist is more focused on menstrual cycles than a General Practitioner.
Look at what’s normal for you.
If periods last long, you have clots, or miss a period, it is important to track this. Doctors need to listen to what women say about their menstrual related pain.
- If things are out of the normal expected range, that’s a good time to seek a professional opinion
- Gynecologists will be more focused on women’s health than general practitioner
- Self awareness and self consciousness is the key to success
In the UK, it is recommended to have a smear test around the age of 25 and to be screened for HPV. It is good to get a smear test done once you start becoming sexually active. A lot can be done before you become sexually active to see if you have any risks of having pregnancy complications. You can have an ultrasound to test fibroids and endometriosis or you can research your family history and see if endometriosis or other conditions are common.
What are some steps I can take to analyze my risk of Endometriosis?
- Log your symptoms- have you experienced high pain during your menstrual cycle? What is ‘normal’ for you?
- Check your family history to see if other women have had endometriosis, PCOS, etc.
- Be proactive– if you can, get tested early if your ovulation cycle is not ‘normal’ for you.
What is a good ‘rule of thumb’ for women to know if they should visit a gynecologist for PMS related pain to check if it is a sign of another condition? What is the line between PMS and PMDD or a more serious condition?
The egg quality, egg number, and egg reserve are three important measures of fertility for women.
Healthy ovulation is very important to determine fertility health. However, it is better not to run 1000 tests to evaluate fertility but to ask yourself, “What is my menstrual cycle like? Have I had any changes?” to see what is ‘normal’ or not for you.
Tips for Healthy Ovulation:
- Diet should be high in protein and cooked vegetables. Avoid sweets and carb based foods.
- Incorporate Mediteranean foods into your diet
- Aim to exercise three times a week
- Take Vitamin D and multivitamin
- Before taking tests, make sure these are good
What are some red flags to watch out for?
- If it’s taking over 40 days to get a menstrual cycle
- If there are large clots during a menstrual bleed
- If you need lots of time off school or work
- In summary, if things are out of a normal expected range, it is best to visit a gynecologist
Fertility should be treated as a couple; men’s sperm can also contribute to infertility- men should avoid smoking, drugs, and wearing tight underwear. It may be beneficial to search the history of miscarriages and endometriosis in your family to better understand your risk.
Should I be testing my clotting system and uterus with an ultrasound?
Yes, testing your clotting system can potentially help prevent a miscarrage. Ultrasounds can check the shape of your womb in case there’s a problem with your ability to hold on to a pregnancy. An ultrasound can also pick up ovarian cysts, endometriosis, fibroids, or something that might prevent a pregnancy or make holding on to one more difficult.
What is a good ‘rule of thumb’ for women to know if they should visit a gynecologist for PMS related pain to check if it is a sign of another condition? What is the line between PMS and PMDD or a more serious condition?
A woman typically ovulates around the 14th day (if she has a 28 day cycle). After ovulation, the egg that is released changes from a dominant follicle to a corpus luteum, which in latin means ‘yellow body.
The corpus luteum produces progesterone and the level peaks one week after ovulation. We believe that this rapid change in progesterone precipitates the premenstrual symptoms. This will peak typically one week after ovulation. This change in progesterone is responsible for breast tenderness, agitated moods, and other symptoms. This can turn into PMDD if the symptoms are more extreme such as depression, anxiety, etc. The contraceptive pill suppresses ovulation and thereby reduces the risk of severe PMS.
Some natural remedies that can help treat symptoms:
- Breast tenderness can be improved by taking evening primrose oil and starflower oil
- Mood symptoms can be treated with Vitamin B6
Do you have any advice or words of wisdom for women who have been struggling to conceive?
You always have to look at the couple’s individual circumstances. I would say test early to be guided on the best individualized treatment. It is very important to have the egg reserved checked as well as the sperm function checked, as well as the fallopian tubes. You don’t want to be trying naturally for two years and then find out the woman has severe endometriosis and needs IVF treatment. Delaying IVF can allow the egg reserve to go down so much that it may affect the chances of a couple becoming pregnant.
Getting the right tests done and determining lifestyle changes is important, but counseling and support is important because ultimately you don’t want the relationship to be detrimentally impacted by the stress of going through fertility treatment. I think it’s really important to be supported holistically but also directly give them the most important treatment rather than jumping into IVF. Maybe things like surgery can be done or insemination if the woman finds it difficult to have sex during ovulation.
We’ve heard about couples who unexpectedly become pregnant, or couples who when they were about to adopt because they could not conceive become pregnant. What explanation is there for couples who suddenly become pregnant after being infertile?
If you are stressed about pregnancy, this may affect your ovulation. For example, ballerinas who are thin or stressed may not ovulate. When they take that stress out of the way, they ovulate again. If a woman goes into a stressful environment or loses a lot of weight this will happen.
The thing that is rarely discussed is that men produce having sex on demand. They find it very difficult, contrary to society, speaking in general, if they know that Wednesday and Thursday is a fertile window sometimes they can’t manage it or miss that window. When a couple is done with fertility treatment and a couple tends to think less about becoming pregnant, they sometimes have the right egg and the right sperm come at the right time and they can become pregnant. Even with IVF, some women report becoming pregnant naturally.
This is a common reason why unplanned pregnancies happen for couples that had issues conceiving. Many people get pregnant naturally after, so stress levels and lifestyle changes can affect chances of pregnancy. Creating the right support for a couple is key.
What advice do you have for women with Endometriosis?
First and foremost, it is important to recognize that there is a problem. It is important to get tested in order to make an informed decision about the next steps to take in treating endometriosis. If you take a painkiller for endometriosis, it is good to know there is a difference between bowel related pain and inflammation and that there are different medications for different pains.
What is your approach when a patient has Stage IV Endometriosis?
It is best to put it into context; in other words, this all has to be individualized.
We can ask if there is any chance of during surgery to help a patient, for example. Some other ways to evaluate each woman is to ask:
- How long have they tried to become pregnant?
- Is it safe to do an IVF for this patient? (sometimes IVF makes it worse)
- What are the priorities of women? Is egg freezing an option for them if they are not in a relationship?
Analyzing some of the responses to these questions can help us have an individualized approach to treatment.
We have read some reports about Endometriosis possibly being an Autoimmune disease. What are your thoughts?
There is an immune aspect to it because a menstrual bleed is the endometrium shedding, and about one in four women experience endometriosis. There are some women who may experience a inflammatory reaction to endometriosis; some women will react severely to endometriosis, others will react less severely to it.
For example, if you get stung by a bee, you may swell up a little and be fine after a couple of hours. But if your friend gets stung by a bee, they may react completely differently to it and have to go to a hospital because they can’t breathe from the reaction. This bee sting response varies from person to person almost like endometriosis.
Some research has been done by our team with EBV (epstein barr virus) to see if it somehow causes an inflammatory response. If someone has had glandular fever they may be more susceptible to over responding to endometriosis- it’s a theory, but hasn’t been proven. There may be a link, but science hasn’t gotten there to the underlying cause.
What are some common chemicals that are used in creams, oils, or dietary supplements to help women with fertility problems and Endometriosis? Do you know of any natural or herbal chemicals that have potent functioning? (Ex; Wild Yam, Evening Primrose Oil, Ashwagandha)?
Magnesium may help with bowel related symptoms, magnesium helps constipation and bowel symptoms. With wild yam roots, don’t add too many wild yam roots to your diet because you don’t want to add too many hormones. Extra estrogen can upset endometriosis.
Vitamin C and Zinc- We know that when we are fighting a virus having Vitamin C and Zinc in our bodies can help. It is good to take Vitamin C 1000 mg a day and 1 zinc tablet a day. Regarding Chinese herbal medicine, I don’t push it too much because there is estrogen and other hormones in there that we can’t really quantify and we know that conditions like Endometriosis can be made worse by excess estrogen.
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We hope you enjoyed our interview with Mr.Colin Davis and learned new information about fertility and reproductive health. We will be having other interviews with experts in different fields within women’s health and hormonal health- follow us on instagram at @hormoneuniversity to be the first to know of our next post!
