Dr. Simone’s Mind Space

PCOS part 1

Polycystic ovary syndrome (PCOS), a hormone imbalance that causes infertility, obesity, and excessive facial hair in women, can also lead to severe mental health issues including anxiety, depression, and eating disorders.

A study supervised by Columbia University School of Nursing professor Nancy Reame, MSN, PhD, FAAN, and published in the Journal of Behavioral Health Services & Research, identifies the PCOS complications that may be most responsible for psychiatric problems. While weight gain and unwanted body hair can be distressing, irregular menstrual cycles is the symptom of PCOS most strongly associated with psychiatric problems, the study found.

 

Menstrual abnormalities in women with PCOS was the strongest predictor for mental health issues, particularly when there are so many other symptoms—like beard growth and infertility—that can make a woman feel unfeminine.

 

Women with PCOS had significantly higher levels of psychological distress than the general population. For more than half of those disorders, the women with PCOS had distress levels statistically similar to those of the female psychiatric patients.

 

Reame et al. 2014 found that when comparing participants with women in the general population, PCOS women had significantly higher scores on all of the symptoms evaluated and on corresponding psychological distress measures, particularly for anxiety, depression, somatization (the conversion of psychological distress to physical symptoms), and interpersonal sensitivity.

 

PCOS is estimated to affect 6 to 17 million women aged 18–44 in the U.S. It is one of the most common causes of infertility. There’s no single test to diagnose PCOS, and there’s no cure. The disorder is typically characterized by an excess production of the hormone testosterone, irregular ovulation, and cysts, or fluid-filled sacs, in the ovaries.

 

How to improve psychological and physical well-being?

-Acknowledging the challenges both the psychological and physical ones.

-Speak with an expert, to relive tension and stress.

-Changing habits can improve symptomatology.

-Exercise improves general, but particularly mental well-being.

-Diet and exercise in combination can boost your body-mind balance and improve symptomatology.

-Seek support for infertility. The earlier the better.

-Talk to other women in the same position and get support from likeminded women, facing similar challenge.

 

Sources: https://www.nursing.columbia.edu/news/psychiatric-complications-women-polycystic-ovary-syndrome-most-often-linked-menstrual

 

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PCOS and infertility challenges part 2

Having PCOS does not mean you can't get pregnant. PCOS is one of the most common, but treatable, causes of infertility in women. In women with PCOS, the hormonal imbalance interferes with the growth and release of eggs from the ovaries (ovulation). Without ovulation, it isn’t possible to get pregnant.

 

How to get treatment for infertility related to PCOS?

Talk to a fertility doctor about ways to help you ovulate and raise your chance of getting pregnant. You can also use an ovulation calculator to see which days in your menstrual cycle you are most likely to be fertile.

 

Treatments of PCOS to improve fertility

• Losing weight. If you have overweight or obesity, losing weight through healthy eating and regular physical activity can help make your menstrual cycle more regular and improve your fertility. Find a personalized healthy eating plan.
• Medicine. After ruling out other causes of infertility in you and your partner, your doctor might prescribe medicine to help you ovulate, such as clomiphene (Clomid).
• In vitro fertilization (IVF). IVF may be an option if medicine does not work. In IVF, your egg is fertilized with your partner's sperm in a laboratory and then placed in your uterus to implant and develop. Compared to medicine alone, IVF has higher pregnancy rates and better control over your risk of having twins and triplets (by allowing your doctor to transfer a single fertilized egg into your uterus).
• Surgery. Surgery is also an option, usually only if the other options do not work. The outer shell (called the cortex) of ovaries is thickened in women with PCOS and thought to play a role in preventing spontaneous ovulation. Ovarian drilling is a surgery in which the doctor makes a few holes in the surface of your ovary using lasers or a fine needle heated with electricity. Surgery usually restores ovulation, but only for 6 to 8 months.

 

PCOS and pregnancy complications

PCOS can cause problems during pregnancy for you and for your baby. Women with PCOS have higher rates of 6:

• Miscarriage
• Gestational diabetes
• Preeclampsia
• Cesarean section (C-section)
• Higher risk of a heavy baby (macrosomia) and of spending more time in a neonatal intensive care unit (NICU).

Sources: https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome#:~:text=Having%20PCOS%20does%20not%20mean,you%20can't%20get%20pregnant.

 

@drschwank 

@unesurcent

Women run the world

As currently seven month pregnant woman, I feel more energetic and strong than ever before. A completely unexpected experience! I was expecting to feel low of energy, low in mood, huge, and unattractive. None of the above occurred, rather the complete opposite. I feel absolutely amazing, full of energy, up for new projects, ideas, and business opportunities. There’s no mountain high enough for women to climb. Perseverance, self-confidence, dedication, passion, and a clear vision to strive to the top. That’s what reflects me as a person. I’ve never ever given up in my life. No matter how strong the wind blew against me.

If Plan A didn’t work, I chose plan B, C, D, and back full speed to plan A. My passion and dedication to share this with other women never stops. I like to be an inspiration for other women, bring women together to exchange and encourage each other. That’s the goal of UNE SUR CENT, my female empowerment movement.

@unesurcent

@drschwank

Stress Management bei Endometriosis

Stress verschlimmert die endometriosen-induzierten Schmerzen, denn er führt zu einem Hormonungleichgewicht und kann die Ursache für einen niedrigen Progesteronespiegel sein, und so die Endometriose-herde unkontrolliert stimulieren. Zudem hat das Stressbedingt erhöhte Niveau an Kortisol im Blut einen entzündungsfördernden Einfluss und ist eine wesentliche Komponente der Verschlimmerung der Endometriose, die ebenfalls eine chronische Entzündung darstellt.

 

Was tun gegen Stress?

• Kleine Schritte führen zum Erfolg.
• Routinen etablieren.
• Bewegung in den Alltag einbauen.
• Zeit im Kalender für exklusive me-time blockieren.
• Psychologische Unterstützung, lieber früher als zu spät.
• Support ist immer eine gute Idee.
• Ernährungsberatung zur Unterstützung des Stressmanagements.
• Physiotherapie zur Schmerzlinderung und Aktivitätsförderung.

@drschwank

@unesurcent 

@optimalperformancezurich

Activity/ Sports to reduce symptoms of endometriosis

Stress-reducing activities, such as short HITT-units can reestablish your hormone balance and improve your immune system response. A hormonal equilibrium is essential to reduce symptom severity and general well-being. Exercise or stay active at least 2-3 days a week. Gentle exercises such as yoga, Pilates, tai chi, qi gong or walks combined with 7-15min HITT-units are a perfect choice. Start with the 5min daily exercise rule a day. Manageable routines you can keep up.

 

How to go about it?

-Routines rock!

-Small steps to a new weekly exercise habit.

-Find an exercise buddy, it‘s so much easier to commit!

-Set yourself reasonable, manageable goals.

-The 5min daily exercise/activity rule.

-Get yourself a nice outfit, that you like to wear during your activities. Motivation matters!

 

@drschwank

@unesurcent

@optimalperformancezurich

Shanghai Conference: Perinatal Mental Health

Implications for Improved Maternal Mental Health

●Expand web-based services in primary care.

●Results pre-COVID-19 clear preference for web-based support.

●Target policy-makers to increase awareness of perinatal mental health.

●Integrate mental health services in community centers.

●Peer support to bridge treatment gap.

Goal: Reduce the population burden of mental disorders through research, training, and advocacy. Passionate about using science to overcome burden of mental health problems. Focusing on major preventable causes of health problems globally.

@drschwank

@unesurcent

 

Me-time x2

After a blissful two days for my female empowerment movement @unesurcent, hiking, connecting, inspiring, and empowering each other. I’m enjoying a tranquil dinner by myself in the stunning lobby hall of @suvrettahouse. Life piano music, delicious Italian dinner, and exquisite hospitality, fully embracing my me-time. As an introvert, I knew how essential it was for me to recharge. Staying an extra night to recharge, exercise, solitude hike, swim, relax, dine, high tea afternoon, and enjoy! One of the very best decisions I’ve ever made in my life!! I could feel so clearly, how  essential it was, for my physical and mental well-being.

Being 7 months pregnant, with four incredibly intense years of assisted reproductive health in the backpack, and conducting research on the impact of stress during the perinatal period, I’m extra, extra conscious of minimising my stress. Frequent massages, yoga, earlier boundary setting, more exercise time, and emphasising on work I have control over, are some of the strategies I follow.

Me-time, is however the most important of all of them! The days with my female friends learned and supported my strive for me-time too! They all found ways to curb out time for themselves. We all agreed, it’s the way to success, happiness, and a healthy life.

Coming December, the baby being born, I do wonder how it will be with the me-time. That’s why, I’ve arranged a babysitter that’s available from day one, daycare, grandparents visiting to support, and of course my husband taking time off to take care of our baby. We’ve also planned a first getaway in December to return to the amazing @suvrettahouse with him! Continuing a life we both love and don’t want to give up by any means. Couples time being as much to be cherished as me-time, especially after having a baby.

Thankfully, we will bring a baby phone and see with the Suvretta House regarding child care services.

 

To conclude: Dedication to oneself an essential pathway to life success and overall well-being.

Who of us is however living this credo?

Research has shown the consequences of stress on our physical and mental health.

As women, we’re taught to take a step back and set our own needs, behind others, leading to exhaustion and life dissatisfaction. It’s time to change these antique structures and celebrate the female me-time.

 

@unesurcent

@drschwank

UNE SUR CENT mountain retreat

Concluding two absolutely magnificent days high up in the Swiss mountains and enjoying hospitality at its peak @suvrettahouse. The event for my female empowerment movement @unesurcent themed: “There’s no mountain high enough for women to climb”, is one of the best events ever. The breathtakingly beautiful nature environment, hiking, coffee breaks, breakfasts, dinners which brought endless incredible conversations, new business ideas, and connections meant the world to me and as I understood to the participants too. What a success, as the participants shared too. They described how they managed and greatly appreciated to take out time for themselves.

It’s exactly what I’ve envisioned of the retreat and in general the mission of @unesurcent to inspire and empowerment women by bringing incredible women together. Together we’re strong and can rule the world.

There’s no mountain high enough for women to climb.

 

@unesurcent 

@drschwank 

Swiss Alpine Girls: There’s no mountain high enough for women to climb!

With a great passion for mountains and an unstoppable mindset, Agi @agichristine from @swissalpinegirls talks about her upcoming trip to Nepal, where she will climb the 6119m high Lobuche East Peak.

 

The Swiss Alpine Girls want to inspire women to get into the sport of mountaineering, which is still dominated by men.

 

She talks about why they chose Nepal and the long road of preparing for the 20 day trek where they will also pass the iconic Mount Everest Base Camp.

 

@drschwank

@unesurcent

Jealously and why it’s so common

Most of us know the feeling of being exposed to jealousy. Yet, it often takes a while to understand the dynamic and what the underlying emotion is, we’re feeling, when surrounded by a jealous person. It can be incredibly destructive to a degree of life threatening, for the person exposed to jealousy. Mobbing at work, schools, universities are often related to jealousy, domestic violence another common place for jealousy, as well as among friends, and acquaintances.

 

The fairytale Snow White is one of the best examples describing basic human interactions and feelings, such as jealousy.

 

Why are people jealous?

Often, it’s a feeling of inadequacy, dissatisfaction, low self-esteem of the jealous person that lead to the strong emotion of jealousy, when encountering other people that live an outwardly perfect life in the eyes of the jealous person. They seem to have all the jealous person desires and more. To the jealous person this appears unfair and self-doubts why do I not have all of the success, the amazing partner, the beautiful appearance like to other person, they targeted. A personal insecurity can transfer into jealousy, if a person is in proximity that meets the perfect ideal of the self of the patient. Often this isn’t obvious initially and needs time to sink in.

 

What can we do, when exposed to jealousy?

Jealous people will remain jealous, no matter what we do. If we try to be nice to them, respectful, friends or distance ourselves. They’ll always return with jealousy.

An amazing Jungian colleague of mine once said. If someone is toxically jealous, the only thing that works is running away!

A wise advice, particularly because jealous people implant a feeling of inadequacy into us. A feeling of low self-esteem, second guessing of our choices and who we consider to be.

 

Who are targets of jealousy?

Strong, independent, successful, and attractive women are often a target and exposed to severe jealousy. To degrees that are life threatening. Jealousy from both other females, but also male counterparts.

 

What can we do, when exposed to jealousy?

-Knowing about jealousy, noticing the signs early, and understanding that it’s not our person that’s the core of the problem, but the jealousy of another person, is essential in order to deal with it appropriately.

-It is important, to learn already during childhood, how to cope with uncomfortable emotions, such as jealousy.

-We shouldn’t protect our children of these emotions, since without knowing the wold being cruel, the child will be much more vulnerable and an easy target for a jealous person.

-Fairytales in use for educational purpose. Fairytales, such as Snow White can be incredibly valuable sources, serving as metaphors for situations, interactions happening in the real world.

-In certain situations, the best choice is simply to “run away”. To avoid being further exposed to a toxic environment of jealous people, engaging in bullying, negative roomers, destructive behavior towards the person they’re jealous of.

 

“Surround with people that feel like sunshine”

@drschwank

@unesurcent

Endometriosis and Infertility: A review of the pathogenesis and treatment of endometriosis-associated infertility

Endometriois has been associated with infertility, however the mechanism by which it affects fertility are still not fully understood. A recent systematic review by Marcer and Taylor from Yale Medial School has reported.

 

Current treatment options of endometriosis-associated infertility include surgery, superovulation with IUI, and IVF. It’s also discuss potential future treatments for endometriosis related infertility such as stem cells transplantation and immune therapy.

 

Endometriosis has been estimated to affect up to 10–15% of reproductive aged women (1). The association between endometriosis and infertility is well supported throughout the literature, but a definite cause-effect relationship is still controversial. The prevalence of endometriosis increases dramatically to as high as 25%–50% in women with infertility and 30–50% of women with endometriosis have infertility (2).

 

The fecundity rate in normal reproductive age couples without infertility is estimated to be around 15% to 20%, while the fecundity rate in women with untreated endometriosis is estimated to be anywhere from 2% to 10% (3, 4).

Endometriosis is an estrogen-dependent benign inflammatory disease characterized by the presence of ectopic endometrial implants (5).

 

Treatment of Endometriosis-Associated Infertility

Expectant Management

Medical Treatment

Surgical Treatment

Combined Medical and Surgical Treatment

Superovulation and Intrauterine Insemination

Assisted Reproductive Technology

 

Key Points

• Endometriosis is an estrogen-dependent disease that affects between 10%–15% of reproductive aged women
• There is a well-established association between endometriosis and infertility; however, as evidenced above, it appears to be multi-factorial involving mechanical, molecular, genetics, and environmental causes
• The optimal method for treatment of endometriosis-associated infertility is an individualized decision that should be made on patient-specific basis
• In vitro fertilization is currently the most effective treatment of endometriosis-associated infertility
• Mental health care support for couples and individual partners

 

References

1. Olive DL, Pritts EA. Treatment of endometriosis. The New England journal of medicine. 2001;345(4):266–275. 

2. Verkauf BS. Incidence, symptoms, and signs of endometriosis in fertile and infertile women. The Journal of the Florida Medical Association. 1987;74(9):671–675. 

3. Endometriosis and infertility: a committee opinion. Fertility and sterility. 2012;98(3):591–598. 

4. Hughes EG, Fedorkow DM, Collins JA. A quantitative overview of controlled trials in endometriosis-associated infertility. Fertility and sterility. 1993;59(5):963–970. 

5. Giudice LC, Kao LC. Endometriosis. Lancet. 2004;364(9447):1789–1799.

 

Macer ML, Taylor HS. Endometriosis and infertility: a review of the pathogenesis and treatment of endometriosis-associated infertility. Obstet Gynecol Clin North Am. 2012 Dec;39(4):535-49. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538128/

 

@drschwank

@optimalperformancezurich

@unesurcent