# data[].attributes.attachment_link.title
The Breastfeeding Network | Independent Breastfeeding Support

# data[].attributes.attachment_link.description
The Breastfeeding Network (BfN) is an independent source of support and information for breastfeeding women and others.

# data[].attributes.body
Gold bottle = parovirus B19 serology

Repeat in 4 weeks

# data[].attributes.attachment_link.readable_text
How to refer

Referrals can be made online using the professionals referral form.

If you have any questions regarding suitability please call 01908 725099 and speak to the on call duty worker.

Referral and Eligibility Criteria

IAPT is a national initiative to provide a 'systematic way to organise the delivery of, and access to, evidence-based psychological therapies within the NHS'.

Over 17 and 9 months

Experiencing common mental health problems which impact on their ability to self-manage

Not at risk of suicide

Registered with a GP in Milton Keynes

Who is IAPT for?

Supporting adults with depression/anxiety who can be managed effectively in a 'uni-professional context'.

IAPT cannot treat issues directly relating to:

The IAPT service bases treatment decisions on the basis of presenting difficulties requiring support and not on the basis of diagnosis. All cases are considered on a case by case basis.

The service is not suitable for people assessed with significant risks. The service is suitable for those where the likelihood of acting out is very low and the impact would be minor, not requiring medical intervention. Examples include people who have suicidal ideation but with no plans or intent, or who may superficially cut or scratch but do not require medical intervention

The Improving Access to Psychological Therapies Manual (2017). National Collaborating Centre for Mental Health

# data[].attributes.attachment_link.description
Referrals can be made online using the professionals referral form. If you have any questions regarding suitability please call 01908 725099 and speak to the on call duty worker. IAPT is a national initiative to provide a 'systematic way to organise the delivery of, and access to, evidence-based psychological therapies within the NHS'.

# data[].attributes.body
Car park account

# data[].attributes.attachment_link.readable_text
Milton Keynes University Hospital Staff Parking - Welcome

Welcome to the Milton Keynes University Hospital NHS Foundation Trust (MKUH) online staff parking permit application portal. All staff either employed by the Trust or by Central and North West London NHS Foundation Trust (CNWL) who wish to park in any of the staff car parks at Milton Keynes University Hospital must apply for a parking permit via this portal.
Apply for a parking permit

# data[].attributes.attachment_link.description
Milton Keynes University Hospital Staff Parking - Welcome

# data[].attributes.attachment_link.readable_text
The Forward-leaning Inversion is a classic here at Spinning Babies ®. In short, it is a technique that creates room in the lower uterus. The baby can then use that space-with the natural pull of gravity-to snuggle into a more ideal position for birth. The Forward-leaning Inversion technique comes from Dr. Carol Phillips, DC who teaches Dynamic Body Balancing.

Is Down Dog the same as Forward-leaning Inversion?

The yoga position known as the "down dog" doesn't do the same thing, so you won't get the same benefits. Down dog doesn't let the uterus hang from the cervical ligaments, and thereby stretch. It is the going back up part that is the real technique here, not the inversion itself! However, you do get other benefits from down dog which you can learn more about here.

Why do the Forward-leaning Inversion in pregnancy?

The Forward-leaning Inversion potentially makes room for a good fetal position by untwisting any ligaments to the lower uterus and cervix that may be wound up from sudden stops or a twisted posture.

Kneeling afterward also allows temporarily lengthened ligaments to align the uterus with the pelvis. The cervix may become less tipped or tight and then be able to let the baby's head position better, and the cervix to dilate in labor more easily.

This technique may also reduce back pain, hip pain, or tailbone pain. Improved fetal positioning does occur too. It is a very worthwhile activity because simply turning the baby's head down is a notable achievement in and of itself.

How to do a Forward-leaning Inversion in pregnancy

Please be care when attempting this technique. Don't drop into place. Move slow and be controlled to prevent falls and protect your placenta.

Learn how to do the Forward-leaning Inversion by watching Gail Tully teach it to pregnant parents in our Spinning Babies® Parent Classand Daily Essentialsvideos. Parents across the globe are using these techniques for comfort in pregnancy and easier birth-and they're working! Both are available on DVDor digital download.

1. Kneel on the edge of a couch (or the top of the stairs). Kneel high to see what it feels like in your body.

2. Hold the edge of the couch, bed, or other surface you are kneeling on.

3. Carefully lower yourself to your hands on the floor and then lower yourself more to rest on your forearms. Keep your elbows out and hands close. Use a stool or step if you'd like, to help you walk your hands down.

4. Let your head hang freely, but keep your chin tucked. Don't rest your head on the floor. Your neck may need a little movement. Straighten your shoulders to make room for your head.

5. Your knees should be close to the edge, and your bottom up high. You can tilt or sway your hips if you'd like, or gently, slowly undulate your spine.

6. You can flatten your lower back (posterior pelvic tilt) to make more room for the top of your pelvis.

7. Take three breaths. Loosen your belly, but keep your shoulders strong. Tuck your chin and keep your neck long.

8. Come back up on your hands, then lift yourself up to a high kneeling position again (see image above) using a stool, a block, or an assistant. Take two breaths here, then sit on your heels.

9. Swing your feet out from under you. Keep your feet together, moving like a mermaid to prevent a pull on your symphysis pubis (pubic bone) and protect your pelvic stability.

10. After leaning forward on your elbows, come all the way back up to a high-kneeling position. Take two breaths and then sit on your heels for one more breath. That way you let your ligaments settle into a more symmetrical location while you catch your breath.

Do this once daily for 30 seconds (roughly three breaths).

For babies over 30 weeks gestation who are breechor transverse (lying sideways), see additional recommendations.

Please note: When we first get upside-down, our body warns us with a throbbing head. After 3-6 times your body will realize you intend to be upside-down and your head will stop pounding. Just get up early if this happens and try again, one time each day. The feeling will go away soon enough.

Why do Forward-leaning Inversions in labor?

Sometimes labors have strong contractions without any progress in cervical dilation. Please consider doing a Forward-leaning Inversion in these situations. This technique is especially good if the baby is waiting to descend or rotate at -2 station, or remaining at 0 station but with strong contractions.

You can do Forward-leaning Inversion in early labor as your daily inversion, but if labor hurts or lasts longer than expected, then do another Forward-leaning Inversion at that point.

This technique is particularly helpful for a tight or swollen cervix, asynclitism (add Side-lying Release), deep transverse arrest (add Side-lying Release), or when a baby simply won't come down despite a good position (add psoas release).

How to do a Forward-leaning Inversion in Labor
Remember: Coming back up to kneeling makes this technique work best! Don't go fast, and do your best to protect yourself from falling.

1. In the hospital, get on your bed on hands and knees and face the foot of the bed.

2. Put your elbows on the foot portion of the hospital bed (or a chair beside the bed). Have your helper push the button to lower the foot of the bed until your hips are much higher than your shoulders.

3. Continue with instructions until you are through one contraction, then raise the foot of the bed and be helped up to a full kneeling position.

4. Carefully lower yourself to your hands on the floor and then lower yourself to your forearms. Put your elbows out and your hands close. Use a stool or step if you'd like, to help you walk your hands down.

5. Let your head hang freely and tuck your chin. Don't rest your head on the floor, as your neck may need a little movement.

6. Your knees should be close to the edge, with your bottom up high. You can tilt or sway your hips if you'd like.

7. Flatten your lower back (posterior pelvic tilt) if possible, to give more room to free your ligaments.

8. Take deep breaths and hang in there for 1 contraction, then come back up to kneeling with the help of an assistant. Keep your belly loose and your shoulders strong. Tuck your chin and keep your neck long.

9. Come back up on your hands, then lift yourself up to a high kneeling position again, using a stool, a block, or an assistant.

10. You can repeat this through one more contraction (or about 15 minutes later).

Repeat during each phase of labor (early, active, and pushing) if necessary, but be sure to have a provider ready to catch the baby if you were pushing, just in case this was the technique you needed!

How to do a Forward-leaning Inversion to help a breech baby turn head down

If your baby is breech, do the Forward-leaning Inversion for 30 to 45 seconds several times a day. I suggest 7 times in one 24-hour period for babies remaining breech after 32 or more weeks, but not day after day.

Then do theBreech Tiltfor 5-20 minutes and follow up with theOpen knee-Chestposition.Do not do Breech Tilt or Open-knee-Chest with an already head-down baby.

Balance your muscles and pelvis in more ways if a day of repeated FLIs does not flip the baby.

Alternatively, you could use an inversion table if you have access to one. See this and other techniques in Flip A Breech.

When should you do it?

All pregnant women without a contraindication can do the Forward-leaning Inversion in pregnancy and during each phase of labor (early, active, and pushing).

When should you not do it?

If medical contraindications exist for going upside down, such as high blood pressure or another risk of stroke

If you have heartburn, glaucoma, or hypertension

In cases where amniotic fluid levels are unusually large and the doctors are worried and measuring weekly

If you have a sinus infection and going upside down is especially uncomfortable

Right after eating, to avoid potential heartburn

If there is a suspected or known problem with the placenta in pregnancy, including bleeding

If you have uterine pain of an undetermined origin. If this is the case, get assessed immediately

If the baby is having, or has had, frantic vigorous movements. Be sure to have the baby assessed immediately

If the inversion causes unexpected pain. (Remember, your head may pound a bit for the first few times, but that's normal.) A severe headache should be evaluated by a physician immediately

If your labor is progressing normally. Enjoy your labor

If there has been abundant fluid in laborandthe baby is high at -2 station or above, and the water has released with the baby's head high (in which case, open the pelvic brim withWalcher'sor a variation of Walcher's)

If you simply don't feel that this is right for you (always trust the mother's intuition and respect her choice)

Be safe doing inversions

Ask for help the first few times you try this. Have someone help you to move slow.

If you are already in your third trimester, do a very mild (not steep) inversion a few days/times before a steep inversion.

Use a stable surface where you can carefully lean forward to rest your forearms below your knees. Hold this surfacebefore moving your hands to the floor. Do not go from a high kneeling position all the way to the floor in one movement!

Be sure to get up and down gently, without dropping, thumping, tumbling or twisting.

If your abdominal muscles have extreme separation you must be especially careful. Wear a pregnancy belt and go slow!

If your shoulders are weak or too tight to support you in an inversion, you'll feel stress. Roll your shoulders first and don't begin with a steep inversion.

Warnings, contraindications, and guidance-PLEASE READ!

Listen to your bodyand check out unusual symptoms with your physician BEFORE going upside down. Thousands of women are getting mild or dramatic benefits from the inversion, but there are risks. Here's what we know at this time.

Round ligament pain happens occasionally with an inversion. Round ligament pain is not typical, nor health-threatening. Round ligament spasms can be resolved with the Webster, self-care, warmth, or a specific sort of self-massage. It's okay to repeat the inversion carefully (for 30 seconds) even though this is happening. The inversions may resolve the spasm but the Webster is specific to resolving this type of ligament spasm.

A pain that persists more than a few minutes or is especially severe deserves attention. Report any abdominal or shoulder pain to your provider. Be sure you understand the warning signs in pregnancy.

Don't drop fast! One mother whose abdominal muscles were very separated dropped fast from a high bed and partially separated the placenta. She and the baby had to remain under observation in the hospital until she gave birth several days later (the mother and baby were both healthy). Another woman with a history of placental issue and high blood pressure experienced separation and had to have an urgent cesarean.
Please note: The cloth is NOT in the groin but rather on the thighs, helping hold the mother's weight. If done during a labor contraction, a doula or calm loved one would be in front of her face and under the table to give eye contact.

Are there any good alternatives?

If you have an inversion board, you can use that instead. Standing sacral release and chiropractics are helpful too, although they don't have quite the same success.

What if my provider says not to do inversions?

Here's an example I received:

Gail,

I was hoping you could help me out... a CNM who saw one of my clients told her not to do inversions because it could cause the baby to become breech. Any help that you could offer would be greatly appreciated!

My response was that the CNM has palpated this mother's abdomen. Perhaps the mother has polyhydramnios (far too much amniotic fluid), or very loose muscle tone even with normal amniotic fluid. I add that Intrauterine Growth Retardation (IUGR), a condition caused by placental insufficiency, may be a reason not to do Forward-leaning Inversion.

A normal pregnant woman with a head-down baby who does the Forward-leaning Inversion for 30 seconds at a time is not likely to flip her baby to breech. Sometimes a concern means the provider will advise to avoid an inversion. I'm going to leave the decision-making between the care provider and, perhaps, her experienced myofascial worker/chiropractor.

A provider might confuse Forward-leaning Inversion with the breech tilt or the Open-knee Chest position. These are not the same inversions, as they are done much longer. I've been recommending FLI for years and following many women through their pregnancies using this technique successfully.

Please contact me if you have any concerns

Of the hundreds or possibly thousands of women doing this inversion, there are understandably going to be some bad outcomes. I would very much like to be told about these cases.

Report any complicationsof pain or immediate bleeding, and describe the situation exactly, including the date, gestational age, health concerns, the way you did the inversion, whether it was your first attempt or not, and the time of complication. You can email me at gail@spinningbabies.com.

# data[].attributes.attachment_link.title
Forward-leaning Inversion - Technique for Easier Birth - Spinning Babies

# data[].attributes.attachment_link.description
Create room in the lower uterus. Baby will use that space with gravity to snuggle into a more ideal position for birth. Help a breech baby turn head down.

# data[].attributes.body
Perineum massage

# data[].attributes.body
Newborn Observations

# data[].attributes.attachment_link.readable_text
The Early Development Group is for preschool children aged 1 - 4 years. Its aim is to provide early intervention to help children to develop to their true potential and to also help parents support their child's development and education.

The group provides specialist teaching appropriate to the specific learning style of children who have Down's Syndrome. The children are supported to develop fine and gross motor skills, develop speech and language skills, learn to read, learn their numbers and develop numeracy skills.

It provides vital play opportunities, teaching of appropriate social skills and the opportunity to interact with other children who also have Down's Syndrome.

It also provides the chance for parents to meet other parents and children who have Down's Syndrome which can develop invaluable friendships and support.

Sessions are from 1 - 3pm on the 1st and 3rd Friday of the month during term time. There is a charge for sessions, but the full costs of running the Development Group are heavily subsidised by the Support Group.

The Early Development Group has been very successful and beneficial to parents and children alike. The Support Group believe it is an ideal opportunity to provide early intervention that is totally devoted to children with Down's Syndrome and can help parents support their child's early learning and development and help the children achieve their true potential.

It also provides a fun, social environment with the opportunity for children and parents to make valuable friendships that may continue for years to come.

If you are interested in attending the Early Development Group or would like to know more, please contact us today!

# data[].attributes.attachment_link.description
The Early Development Group is for preschool children aged 1 - 4 years. Its aim is to provide early intervention to help children to develop to their true potential and to also help parents support their child's development and education. The group provides specialist teaching appropriate to the specific learning style of children who have Down's Syndrome.

# data[].attributes.attachment_link.title
CLAPA - Cleft Lip and Palate Association UK

# data[].attributes.body
Referral form

# data[].attributes.body
PNMH referral

# data[].attributes.attachment_link.title
Milton Keynes Perinatal Mental Health Service :: Central and North West London NHS Foundation Trust

# data[].attributes.attachment_link.description
The Milton Keynes Perinatal Mental Health Service offers treatment and support for pregnant and postnatal women experiencing mental health difficulties.

# data[].attributes.body
Email to add to MARF

# data[].attributes.body
MASH

# data[].attributes.body
Spina Bifida support

# data[].attributes.attachment_link.readable_text
As a member of the Shine family, you'll receive:

FREE access to national and regional support groups

Invitations to national and regional events

A network of friends and peers to help you.

FREE help and advice from our trained specialists

A FREE copy of our twice yearly magazine Together

Option to join our FREE home delivery service

Join the Shine family

# data[].attributes.attachment_link.description
As a member of the Shine family, you'll receive: FREE access to national and regional support groups Invitations to national and regional events A network of friends and peers to help you.

# data[].attributes.attachment_link.title
Positive about Down syndrome - Down Syndrome UK

# data[].attributes.attachment_link.description
Positive about Down syndrome (PADS) We provide support, information and resources to expectant, new and preschool parents. Join our Online Community Sign up for updates Who PADS is Positive about Down syndrome (PADS) works hard to ensure EVERY expectant and new parent of a baby with Down syndrome has access to the information and support...

# data[].attributes.headline
Any health or social care professional can make a referral on your behalf. You can also self-refer to the service in person or contact us by phone 01908 250730 or by email: cnwl.arc-mk@nhs.net

# data[].attributes.subject
Any health or social care professional can make a referral on your behalf. You can also self-refer to the service in person or contact us by phone 01908 250730 or by email: cnwl.arc-mk@nhs.net

# data[].attributes.attachment_link.title
ARC Milton Keynes :: Central and North West London NHS Foundation Trust

# data[].attributes.attachment_link.description
ARC Milton Keynes is a service provided in partnership by CNWL and We Are With You as a free and confidential service for people who live in Milton Keynes.

# data[].attributes.headline
Call the contact number and receive a voucher number to give to the woman to collect.

# data[].attributes.subject
Call the contact number and receive a voucher number to give to the woman to collect.

# data[].attributes.attachment_link.title
Screening in pregnancy: information leaflets

# data[].attributes.attachment_link.description
These publications explain NHS antenatal screening programme tests, possible results and follow-up tests.

# data[].attributes.body
Speak in confidence to fully qualified counsellors and support specialists 24/7, 365 days a year to discuss any emotional, personal or work-related illness.

Talking to one of our experienced counsellors or psychotherapists can help you understand a problem, make a tough decision, try a different approach or just learn how to cope with a difficult situation.  The aim is to support you and find a solution to whatever is worrying you.

When you call, we will ask you a few simple questions so we can provide you with the very best service and support.  You will then be connected to one of our fully trained counsellors and support specialists who are highly experienced in clinical risk management, solution-focused therapies and other clinical approaches.

They will be more than happy to help in a time and place to suit you and provide you with ongoing support when you need it most.

There is no limit to the number of times you can call, and everything discussed is treated in the strictest of confidence.

Need to talk? Call 0330 380 0658

# data[].attributes.attachment_link.title
Ask Bill | Free and Impartial Help About Money and Bills

# data[].attributes.attachment_link.description
Find support on your bills or spending, or advice how to being kinder to the environment with water, gas and electricity use.

# data[].attributes.attachment_link.readable_text
What does our free debt advice include?

*Our advice is free, but if you sign up for a debt solution, a fee will apply for some solutions.

If you ever need our support in understanding the information you have read or been given, please get in touch.

Find the right solution to your problem debts

We are a debt solutions provider, currently helping thousands of UK residents with unaffordable debt.

We can offer you complete and personalised debt advice online, with the option to enter a solution with Angel Advance if there's one that suits your needs. If we can't offer you a solution, we will let you know where to go for help.

Our team is here to help you, either through web chat, or on the phone, and you can request a call-back from a trained advisor at any time.

How do you apply for a debt solution?

Before applying for any debt solution, from any provider, you first need to get debt advice. You should never start a debt solution without first knowing all the options.

It's impossible to enter a solution with a regulated organisation without getting debt advice first, so any firm that offers to enter you into a solution straight away is probably unregulated and should be avoided.

Most providers will need you to book a telephone appointment so they can give you debt advice. These can be lengthy - usually an hour or more - and not everyone is comfortable discussing their situation with a stranger on the phone. At Angel Advance, we recognise that this can, for some people, be a barrier to getting help, so we have made getting debt advice as easy and stress free as possible.

Our online service allows you to complete debt advice completely online. You don't need to speak on the phone unless you want to. You don't even need to provide a phone number, just your email address so you can save your progress and we can email you a copy of our advice.

At the end of your enquiry, we'll present you with your options, and let you know which one we recommend for you. You then have the option to apply for a debt solution online, or you can save your progress and come back later.

If you prefer to get debt advice over the phone, you can book a telephone appointment for a date and time to suit to you. We work hard to design our services to suit you and your needs. Talking about debt is never easy, so communicate with us in whichever way makes you most comfortable.

Frequently asked debt advice questions

How We Help You

1. You can get confidential debt advice online or over the phone with us.

2. We'll recommend the best solutions - completely based on your individual circumstances. We include every available solution in the UK.

3. If you choose a debt solution with us, then we take care of everything. We speak to your lenders and take care of all the paperwork, We do it all for you.

Popular Debt Solutions

Our promise to you

Already have an account?

Click retrieve saved details & continue your application

You can save your details and come back any time. Work at your own pace and edit/change your details until your situation is all accounted for. Help is at hand if you need it.

This website uses cookies to improve your experience. If you continue to use this site, you agree with the Privacy Policy

Okay

# data[].attributes.attachment_link.title
Online Debt Advice - Free Debt Advice Online - Angel Advance

# data[].attributes.attachment_link.description
Get confidential debt advice online or by phone. Our experts are available 24/7 to give debt advice, get in touch here.

# data[].attributes.attachment_link.readable_text
Menopause Symptoms
Why do menopausal symptoms occur and what can we do about them?
Menopausal symptoms, which affect about 70% of women, are believed to be due to the changing hormone levels, particularly estrogen, but many factors such as diet and exercise, lifestyle and other medication can influence the symptoms. Therefore, for some people, life-style factors such as reducing/stopping smoking, reducing alcohol intake, reducing caffeine intake, reducing stress, eating healthily and taking regular exercise can considerably help the symptoms of menopause. For others, HRT can be very beneficial, and indeed menopausal symptom control is the main indication for using HRT. If HRT is taken for symptom relief only, a trial period of stopping HRT is recommended every 2 years or so to assess whether or not treatment is still required. If, on stopping HRT, it's found that menopause symptoms recur then treatment can be restarted if it is felt that the benefits outweigh the risks. Alternative therapies may also be considered for menopause symptom control.

When do menopausal symptoms begin?

Many women notice early symptoms while still having periods, when the hormone production is declining very gradually. This stage of gradually falling and fluctuating hormone levels is often called the "climacteric" or the "change" and often begins in the 4th decade and can last for several years. Because ovarian function fluctuates, women may experience menopause symptoms intermittently. Some women experience an early, or premature menopause following which, symptoms may occur immediately, depending on the cause. Immediate onset of menopause symptoms often follows a surgical menopause. The duration of "early" symptoms is very variable from a few months to many years and the severity varies between individuals.

Early Menopause Symptoms

Early menopause symptoms include Physical, Sexual and Psychological problems.
Physical symptoms include:

The hot flush, or flash, is well known as the classic menopausal symptom and affects 60-85% of menopausal women. Hot flushes and sweats are called vasomotor symptoms and vary immensely in both their severity and duration; for many women, they occur occasionally and do not cause much distress, but for about 20% they can be severe and can cause significant interference with work, sleep and quality of life. Women are affected by vasomotor symptoms on average for about 2 years but, for about 10%, symptoms can continue for more than 15 years. Hot flushes usually last 3-5 minutes and are thought to be caused by a change in the temperature-controlling part of the brain.Normally, there is a daily pattern of rises and falls in your body temperature, being lowest at about 3am and highest in the early evening. These small changes are not normally noticed, but a menopausal woman may flush with every temperature rise, whether these are normal changes or not - for example, moving between areas of different temperature or having a hot drink - because of a change in the setting of the temperature control centre in your brain; your body thinks that it is overheating even when it isn't. To try to cool your body down, a variety of chemical reactions cause the blood vessels in the skin to open up, giving the sensation of a rush of heat, and sweat glands release sweat to dissipate heat. It is believed that the changes in various hormone levels that occur around the time of the menopause, lead to the change in the setting of the temperature control centre, but the exact underlying mechanism is still unclear. Other factors that can also cause flushes include being overweight, alcohol, excess caffeine, spicy foods, monosodium glutamate and some medications. Eating a healthy diet and losing weight if necessary can be helpful. Other simple measures that can help include:

wearing cotton clothing rather than man-made fibres

wearing loose thin layers of clothing rather than thick tight-fitting clothes

keeping your bedroom temperature fairly cool at night - either leave a door or window open or consider a fan (partner permitting of course!).

Flushes affect every woman differently and, for many, no specific treatments will be required. When flushes are embarrassing, disruptive and affecting your quality of life, then help is available and your doctor will give you an individualised treatment plan - we are all unique! Headaches, palpitations (sensation of heart racing) and dizziness can be associated with vasomotor symptoms. Excess caffeine can worsen palpitations, so take coffee, tea and caffeinated soft drinks in moderation. Visit the flushes discussion on our Forum to find out how others have coped with flushes.

Insomnia (sleeplessness) or disturbed sleep (leading to tiredness and fatigue), may be partly due to the night sweats, control of which can lead to an improved sleep pattern.
Link: womens-health-concern.org/insomnia
Link: Visit our forum and read how other women have dealt with insomnia.

Joint aches commonly occur, often affecting neck, wrists, and shoulders but recognition of their possible association to menopause is often lacking. Visit our Forum for more information on menopausal joint aches and to find out how others have coped.

Psychological menopause symptoms such as mood swings, irritability, anxiety, difficulty concentrating, difficulty coping and forgetfulness may be related to hormonal changes, either directly or indirectly e.g. due to sleep disturbance. However, other life events such as worry over elderly relatives, teenage children, and pressures from work commonly occur around the time of menopause and may contribute to such "symptoms".

Sexual Problems may be caused by vaginal dryness due to low estrogen levels, resulting in discomfort during intercourse. Effective treatments are available. As both men and women get older, interest in sex may decrease but this particularly affects women. Treatment of other menopausal symptoms may indirectly improve libido by improving feelings of well-being and energy levels, e.g. by improving sleep through control of night sweats, but restoring hormone levels can also improve sensation. Relationship problems have an obvious effect on libido, so hormonal treatment may not always be the "magic" solution!

Later Menopause Symptoms

Later menopause symptoms are due to the effects of estrogen deficiency on the bladder and vagina and include:

Passing urine more often by day and/or by night

Discomfort on passing urine

Urine infection

Leakage of urine

Vaginal dryness, discomfort, discharge, burning and itching

Although bladder and vaginal symptoms can occur in the early stages of the menopause, they most often occur a few years after the last period, or a few years after stopping HRT.

Vaginal and bladder symptoms are very common and can cause significant distress yet are often under-reported and under-treated. Women are frequently too embarrassed to discuss these problems. Very effective treatments are available and should be discussed. For vaginal dryness, non-hormonal vaginal moisturisers may be used. For bladder and vaginal symptoms, and to treat the underlying cause, ie lack of estrogen, local vaginal estrogen (tablet, cream, pessary or ring) can be very helpful. Low dose, vaginal estrogen can be used when systemic estrogen is inappropriate and can be continued in the long-term without any known adverse effects. Vaginal estrogen may be required in addition to systemic HRT since in some women, the systemic HRT, although helping symptoms such as flushes, may not be sufficiently helpful for vaginal symptoms.

Download a checklist of symptoms you can print out and take to your GP or nurse to help you start a discussion:PDF (117K)

For more information about bladder problems,
visit our sister website
www.bladdermatters.co.uk

Downloads

Download the Love Hurts leaflet (pdf file, 4 pages, 219Kb, added 20th October 2008).

Vaginal symptoms questionnaire September 2005: See the results here.

Movie

Watch a 5 minute movie (wmv file, 10Mb).
Entitled "Breaking the silence", it deals with the common menopausal problem of vaginal atrophy and its treatment.

Other menopause symptoms

Otherlater menopause symptoms include effects from changes in collagen production, a protein in skin, hair, nails and tendons. As its production is affected by falling estrogen levels, the skin may become dryer, thinner, less elastic, more prone to bruising and skin itching may occur. Occasionally, a "crawling" sensation may be experienced but it is unclear whether this is due to skin changes or changes in the peripheral nerves. Skin symptoms often respond to estrogen replacement, but some women have developed skin itch when taking HRT. In this situation, a change in type or route of HRT may help.

thinning, dryness and the growth of unwanted hair can be explained by the lack of estrogen and the relative excess of androgens in the menopause (the adrenal glands and the ovaries continue to produce some androgens including testosterone, the effect of which is no longer overridden by estrogen). However, hair loss may be more dependent on age rather than hormone related and response to HRT is unclear. Thyroid disease and iron deficiency can also cause hair loss and should be considered, particularly if there are other signs.

Score Sheet: Measure your own symptoms by completing the menopause symptom score sheet

Books: See our recommended menopause and self-help books.

# data[].attributes.attachment_link.description
Menopause and treatment options. An independent, clinician-led site aiming to provide accurate information about the menopause.

# data[].attributes.attachment_link.description
However you choose to manage your menopause symptoms, your lifestyle choices are going to be the cornerstone of any treatment plan you choose. Hormone Replacement Therapy (HRT), Cognitive Behavioural Therapy (CBT) and other complementary and alternative treatments can all be very helpful, but the transition to menopause is a good time to review your lifestyle.

# data[].attributes.body
https://www.acacia.org.uk/dads-partners/acacia-dads/

# data[].attributes.attachment_link.readable_text
What are perinatal mental health problems and how common are they?

Maternal/paternal mental health problems, or perinatal mental health problems as they're often called, are more common than you think. In fact one in 5 new mums experience them and up to one in 10 new dads or partners. These mental health problems can range from anxiety, low mood and depression to more severe obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and psychosis. Some will have suffered mental health problems before but, for others, symptoms are new and frightening for the whole family.

Depression and anxiety are the most common mental health problems during pregnancy and new parenthood, with around 12% of women and 6% of men experiencing depression and 13% of women or 6.5% men experiencing anxiety at some point; many will experience both. People who are experiencing depression/anxiety have a number of changes to their mood, their thinking, their behaviour and their bodily functioning which persist for weeks or months and which can lead to major disruption in their lives.

The other mental health problems like panic disorder, OCD, PTSD, postpartum psychosis, exacerbation of eating disorders and tokophobia (fear of giving birth) are less common but still account for up to 8% of all new mums and can also affect their partners. It is important to remember that all of these problems, even the most severe, are usually temporary with the right treatment and support.

The mums and dads who experience perinatal mental health problems cannot control their symptoms on their own. It is not their choice and will require love, patience, understanding and support to get them through this. The symptoms may lead to poor bonding with the baby and difficulties with breastfeeding for the mum (which can itself lead to distress, anxiety and low mood).

Good parental mental health is very important for the the development of the baby before and after birth. This makes it really important to recognise the problem quickly, to talk about it, and to get help. This is really important for partners too. If your wife or partner is experiencing maternal mental health problems you have a one in 2 chance of developing your own and you can still develop your own even when your partner doesn't. Having a baby is a highly stressful time, fuelled by sleep deprivation and the huge increase in responsibility that comes with a baby. Nothing quite prepares you for this and when, on top of all this, your partner becomes ill, it puts you at high risk of developing a mood disorder yourself.

What are the signs?

The most common symptoms can include persistent feelings of sadness and low mood, poor concentration, feeling unable to cope, loss of interest in sex, tiredness, avoiding contact with people, change in appetite, loss of pleasure in normally enjoyed activities, unable to get out of bed, thoughts of suicide and/or harming self and/or the baby.

Anxiety symptoms can also include feeling persistently afraid, worried, nervous, on edge, detached, panicky. You may also find it hard to learn and apply the new skills and tasks of fatherhood and get into an effective routine, start to feel that the family would be better off without you, have frequent worries about the health and welfare of your partner and/or the baby, have persistent, intrusive and frightening thoughts that you or they might harm baby constantly think things like, "I'm a terrible father/parent/partner" or "They're going to take my baby away"

You are unlikely to experience all of the symptoms at the same time but if you recognise yourself amongst them please don't ignore it. This Q&A section will help give you some basic advice about what to do and the links on this page offer free services of who can help.

Who does it normally affect?

Anybody can get mental health problems when having a baby, at any time of life, irrespective of gender, age, culture or social background. It happens to men as well as women and is really common. It's important to keep in mind that this is not a sign of a 'weak character' or other inadequacy. Many gifted, successful and powerful people have experienced mental health problems in their lives. Additional risk factors include: if a close relative has experienced mental health problems, psychological make up and personality, major life events, physical illnesses, isolation, relationship breakdown, money worries.

If my partner develops perinatal mental health problems how might that affect me?

In addition to the normal worries that many new parents have to deal with, it can feel that your wife or partner has now become a different person to the one you once knew. You may feel emotionally neglected and physically rejected. Your partner may have become irritable, hostile and abusive to you at times. Whatever you try nothing you do seems to be right.

This change in your relationship and family dynamics which will normally include a change in pecking order all adds to the pressure. You're also likely to be experiencing quite a bit of sleep disturbance and changes in your normal routine in the early weeks and months. You may be spending time at work or elsewhere pre-occupied and worrying about how things are at home. On the other hand work might be a welcome refuge from home, so you try and spend more time there. This in itself may give you conflict and guilt over where your loyalties should lie.

You may feel very isolated and alone with these concerns, not knowing who you can talk to about them and whether they're normal. One of the worst fears is often whether you and/or your partner will ever be able to return to the way you were before, or is this the way it will always be from now on?

What are the types of perinatal mental health problems?

There are many types of perinatal mental health problems and most of them include some aspect of depression and/or anxiety. Most of them can affect both parents.

Postpartum Psychosis is a rare but serious and potentially life threatening mental health issue. It takes the form of severe depression or mania or both. For the few women who experience postpartum psychosis, it occurs in the first 3 months after birth, usually within the first 2 weeks and develops rapidly.

Post Traumatic Stress Disorder (PTSD) is an anxiety disorder caused by very stressful, frightening or distressing events such as traumatic labour/birth. Someone with PTSD often relives the traumatic event through nightmares and flashbacks and may experience feelings of isolation, anger, frustration, disappointment, irritability and guilt.

Obsessive Compulsive Disorder (OCD) is an anxiety disorder which causes people to experience obsessive thoughts followed by compulsive behaviours. Obsessions are overwhelming unwanted thoughts which cause anxiety, disgust or unease and lead to the need to carry out activities usually repetitively in an attempt to temporarily relieve the distressing feelings of the obsessive thoughts.

Tokophobia is a specific phobia of childbirth ie an overwhelming, debilitating fear of childbirth, which can be so intense that pregnancy and/or childbirth is avoided.

Postnatal depression (PND) is a type of mood disorder which is usually accompanied by increased anxiety. It can range from mild to severe and occur any time from pregnancy up to 2 years following birth. Sometimes anxiety can be the dominant symptom.

Pre/postnatal depression/anxiety (PND) is the most common perinatal mental health problem and accounts for almost two-thirds of all recorded cases of perinatal problems. In addition many cases of PND/anxiety go undiagnosed as dads tend to try and just press on through! PND is a depressive illness which develops in mothers and partners before or after childbirth. Anxiety is almost always a component of PND and sometimes the anxiety is the dominant symptom. In some parents it happens fairly suddenly and usually within a few weeks after giving birth. They often describe it as "like a switch has been turned off." In others it develops gradually over a period of weeks and may not be noticed by those around them for quite some time. It can occur at any time in the first year or so and in some parents it can actually start during pregnancy.

Postnatal depression may last for weeks or months and in some it may last into the child's second year if not detected and treated adequately. The symptoms a parent will experience are very much the same as those of depression generally. The important difference with postnatal depression is that there is a new and dependant baby in the mix. Also, postnatal depression develops at a time when both parents usually anticipate pleasure and fulfilment in the experience of parenthood and this can add additional pressure to ignore and play the symptoms down and pretend everything is alright.

How is it treated?

The good news is that perinatal mental health problems can be treated. Most mums and dads make a full recovery and, as with all health conditions, the sooner they are recognised, and appropriate help is sought, the better.

At the milder end of the scale, measures aimed at giving mums and dads some space to talk about their feelings along with increasing practical and social support are helpful. This can be achieved through enlisting the help of family and friends to relieve some of the practical load or to spend time providing a non-judgemental listening ear and encouragement. It is worth googling your local voluntary organisations and Home-Start as these can play very useful roles in recovery. You can also use the Hearts and Minds locator Map further down the page to search for local groups. Just enter your postcode.

Further on up the scale antidepressants or other medications are often useful and sometimes more specialist psychological help such as cognitive behavioural therapy (CBT). These can usually be arranged through the GP (or local IAPT service) along with more specialist support for those with higher needs.

For the most poorly parents treatment may include referral to the community specialist perinatal team and/or to the Mother and Baby Unit where they can receive more intensive specialist support for themselves and baby. Referrals can be made by your Midwife, Health Visitor or GP.

A usual episode of depression/anxiety will generally resolve within a matter of weeks or months. Recovery rarely follows a smooth path and typically involves ups and downs. The best advice is to take it one day at a time.

More severe mental health problems may vary in duration but the sooner help is sought, and begins, the sooner things will start to improve.

How can I help my partner?

The first thing to say is that this advice may be really challenging for you right now, especially if you are experiencing your own struggles and perinatal mental health problems. Please remember that this advice is not meant to be another way of measuring and judging yourself about whether you're measuring up! This season will pass and it's great you've taken the first step to get a bit more information on how you can help yourself and your partner. Just remember to take it easy on yourself and not to set the bar too high during this difficult time.

The first step is to recognise and acknowledge that your wife or partner is ill right now. Talk to them about it and find out more about postnatal depression and other maternal mental health problems for yourself. Use the links on this website and watch some of the videos of other mums who have been through it.

Listen to them and take their worrying thoughts seriously. They may seem trivial and unwarranted to you, but to them they're very serious and real.

Support your partner to seek help. The GP, Midwife and Health Visitor are key people to speak to. If they have already sought help then support them in that and involve yourself in the support they are offered.

Try not to judge or criticise. They're probably doing a lot of that themselves right now. Try not to retaliate in kind when they're irritable and snappy with you. This can be really challenging but remind yourself that it isn't the real person behaving like that.

Reassure your partner that you are there for them and that things will improve in time. Show love and affection but try to avoid overly sexual demands. Your wife/partner won't be ready for that for a while yet Involve yourself as much as you can with supporting the parenting and housework.

How can I help myself to get better?

In addition to supporting your wife/partner it's very important that you recognise your own needs and take care of your own health. You are not being selfish in doing this. It will be impossible for you to look after your partner and the baby if you are struggling yourself. And, did I mention that around 50% of dads whose wife has perinatal mental health problems will develop their own?! This is really common.

Ways of supporting your own mental health:

Try to do some regular exercise and relaxation activities â€" as much as time will allow right now. After all a baby gives you a good reason for a walk around your local park, which will also give you and/or your wife/partner some much needed time to yourselves.

It might sound simple but it's so important to maintain a healthy (ish) diet and eat regularly - don't skip breakfast! Your brain and your body needs energy if you want it to function well and cope with increased stress.

Find someone to confide in about it. A close friend or family member perhaps. If you live in Birmingham, Acacia provides such a service. If you live elsewhere please use the links on this page to access national support services or visit the Hearts and Minds Map to see what's available locally.

If you suspect that you may be becoming overly anxious or depressed then it's very important that you seek appropriate advice for yourself sooner rather than later. Speak to your GP. Be totally honest about how you are feeling. You won't be saying anything that they haven't heard before and the sooner you can get some help the sooner you can start the journey back to wellness.

Most importantly don't try and sweep it under the carpet and don't be tempted to try to fix it yourself by drinking more alcohol or taking other recreational drugs. This will not help the situation in the long term.

And finally, please don't put it off any longer to get the ball rolling. You owe it to yourself, your wife/partner, and your new baby to ensure that you're well and at your best right now. If you feel like you are struggling check out what's available.

Ben and Bob Chew the Fat

Birmingham and Solihull Based Support

Local Support Groups and Services Elsewhere in the Country

National Mental Health Support Available Wherever You Are

Self Help Resources and Guides

Other Types of National Support Services and Information for Dads Which Can Be Accessed Anywhere i

PANDAS Dads - Closed Facebook Group

Additional Local Services in Other Areas

When Your Baby Won't Stop Crying

Instagram

Instagram pages worth a follow:

# data[].attributes.attachment_link.keywords[]
postnatal support services west midlands

# data[].attributes.attachment_link.title
Acacia Family Support | Postnatal Depression Support Services | Dads / Partners | Acacia Dads

# data[].attributes.attachment_link.description
Acacia Family Support - Prenatal Depression and Postnatal Depression Support Services

# data[].attributes.headline
Mental health support for Dads  shttps://www.dad.info/   

# data[].attributes.subject
Mental health support for Dads  shttps://www.dad.info/   

# data[].attributes.attachment_link.title
DAD.info | Free expert advice and support for Fathers

# data[].attributes.attachment_link.description
Dads play an important role in a child's life. We provide information, advice & support to help dads in their fatherhood journey.

# data[].attributes.attachment_link.title
Living Life to the Full | helping you help yourself

# data[].attributes.body
https://pandasfoundation.org.uk/

# data[].attributes.attachment_link.description
Postnatal depression (PND) is a type of depression that many parents experience after having a baby. It can affect any parent, regardless of whether they've suffered from a mental health condition before. Postnatal depression is linked directly to giving birth and is a common problem, affecting 1 in 10 women within a year of giving birth.

# data[].attributes.body
https://dadsmatter.org.uk/

# data[].attributes.attachment_link.readable_text
Our October adventure was a resounding success, not only did we manage to raise much-needed funds, allowing us to continue our support for dads, mums, children, and whole family groups. The Snowdon ascent allowed members of Dads Matter to come together, some for the first time, and not only demonstrate our dedication towards one another but, more importantly, show our commitment to each other and our individual issues.

It was also an amazing opportunity to meet with some of our TikTok friends and hear about their amazing journey too.

We especially loved hearing about the journey, trials, and tribulations of one of our closest friends "ThatCMSguy" have a look at his channel for more information and amazing interviews HERE

# data[].attributes.attachment_link.description
Dads Matter UK provides support and information for dads throughout the UK. Whether you're a new dad or an experienced father, our website offers resources to help you be the best dad you can be.

# data[].attributes.body
https://apni.org/

# data[].attributes.attachment_link.provider_name
APNI - Association for Post-Natal Illness | Post Natal Depression

# data[].attributes.attachment_link.title
APNI - Association for Post-Natal Illness | Post Natal Depression

# data[].attributes.attachment_link.description
Association for Post-Natal Illness and Post Natal Depression. APNI relies solely on the generosity of the public to fund our charity.

# data[].attributes.body
https://www.app-network.org/get-help/support-for-dads-and-co-parents/

# data[].attributes.attachment_link.description
Postpartum psychosis is a traumatic experience for both women and their partners. Find information and support for dads and co-parents here.

# data[].attributes.body
Shout 85258 is a free, confidential, 24/7 text messaging support service for anyone who is struggling to cope. Shout exists to provide support to anyone, anywhere and at any time who may be experiencing a challenging time with their mental health. Just text SHOUT to 85258. The text is free and anonymous on all major UK networks.

# data[].attributes.body
Prolonged jaundice email

# data[].attributes.attachment_link.title
Twins Trust - We support twins, triplets and more...

# data[].attributes.attachment_link.description
Supporting you through every milestone of your journey with twins, triplets or more. From being pregnant with twins, triplets or quads through to parenting twins, triplets or quads, we are here for you.

# data[].attributes.body
Twin Anaemia-Polycythaemia Sequence (TAPS) is a rare complication that is specific to monochorionic pregnancies (babies who share a placenta) and occurs in 3-5 percent of these pregnancies.

Small blood vessels can form in the placenta between the babies, connecting their blood supplies, allowing a slow passage of blood from one baby to the other. This can cause the baby donating the blood (donor) to become anaemic (low blood levels), and the baby receiving the blood (recipient) to become polycythaemic (high blood levels), which can lead to overload and strain on the heart.

# data[].attributes.headline
Twin Reversed Arterial Perfusion sequence (TRAPs)

# data[].attributes.subject
Twin Reversed Arterial Perfusion sequence (TRAPs)

# data[].attributes.body
Twin Reversed Arterial Perfusion sequence (TRAPs) is a very rare complication that is specific to monochorionic pregnancies (babies who share a placenta) and occurs in roughly 1 percent of these pregnancies.

This occurs after one fetus develops normally whilst the other fails to develop but there are blood vessels that form in the placenta, connecting them. This results in the normal baby pumping blood directly into the fetus that didn’t develop, which becomes an abnormal appearing mass that continues to grow (undeveloped fetus). The normal baby will eventually become tired and begin to show signs of strain.

Usually involves laser therapy, to stop the blood flowing into the undeveloped fetus.

Following the procedure, the normal baby will continue to be monitored closely. Occasionally, this is discovered later in the pregnancy, and provided the normal baby is well, you may be closely monitored without intervention.

Twin Reversed Arterial Perfusion sequence (TRAPs) is a very rare complication that is specific to monochorionic pregnancies (babies who share a placenta) and occurs in roughly 1 percent of these pregnancies.

# data[].attributes.headline
Twin to Twin transfusion syndrome/  TTTS

# data[].attributes.subject
Twin to Twin transfusion syndrome/  TTTS

# data[].attributes.body
This is a rare complication that only affects twins who share a placenta (Monochorionic). In TTTS, a blood transfusion occurs from one twin (the ‘donor’) to the other (the ‘recipient’). The donor twin becomes smaller and may suffer anaemia, while the recipient twin is put under strain. Often the donor twin also has less amniotic fluid but the recipient has lots, which can cause the mother’s belly to become larger than would be expected. If TTTS is diagnosed, your pregnancy will be closely monitored by frequent ultrasounds to check on the babies’ growth. If necessary, you may be offered laser ablation therapy to separate the blood vessels in the placenta.

Although monochorionic monoamniotic twin and triplet pregnancies are very rare, they have a high risk of adverse pregnancy outcomes (MCMA pregnancies occur in about 1 in 10,000 pregnancies overall and triplet pregnancies occur in about 3 per 10,000 pregnancies).