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Miserable Menopause ?

Posted on 2017-11-27 by Heather Coppard

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The Menopause is experienced differently by every single woman. Some of us may embrace this time of transition and feel liberated by the absence of periods whilst others may experience unwanted symptoms, such as hot flushes, anxiety and intimate dryness.

The good news is that we can effect a positive change on our bodies and our experience of menopause. Simple lifestyle changes to areas such as sleep, diet, exercise and stress management can have a profound improvement on menopausal symptoms.

At Female Health Hypnotherapy, I offer one to one menopause support for women. This program adopts a holistic approach to your menopause and includes hypnotherapy and mindfulness sessions individually tailored to your specific needs.

Hypnotherapy has been shown to be particularly useful in helping with the menopause (see article below). Please contact me for further information about how this great course could support you. Heather


This is my (as yet unpublished) response to the article published in the Guardian newspaper

Posted on 2017-10-27 by Heather Coppard

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Yesterday, I read the anonymous letter about Vulvodynia in the Guardian with great sadness and empathy. Sadness, because this is an all too familiar story from my clients and empathy because I too had a very similar journey. Even as a qualified nurse with over 20 years experience, I still found it difficult to find and access health professionals who were knowledgeable in Vulvodynia. With striking echoes to the published letter, I too went from doctor to doctor, undergoing countless procedures and investigations in the hope of finding answers.

Eventually after much research I started to make contact with superb health professionals including specialist physiotherapists, dermatologists, gynaecologists, nutritional therapists and mental health support (CBT, Mindfulness and hypnotherapy). I am fortunate to have accessed such great care and have made a successful recovery, but it made me acutely aware of the difficulties that many women experience when they develop this intimate pain.

Most people have probably not even heard the term vulvodynia and yet it has been suggested that up to 4 in every 10 women may experience varying degrees of this condition. Vulvodynia is defined by the International Society for the Study of Vulvovaginal Diseases (ISSVD) as vulval discomfort, most often described as burning pain, occurring in the absence of relevant visible findings or a specific clinically identifiable neurological disorder. Some women may experience pain on intercourse, inserting tampons or having medical procedures etc. This is referred to as provoked pain. Other women may have unprovoked pain or even a combination of both. The specific location of the pain may also vary from person to person.

There can be many causes of vulval pain including, infections, inflammation, dermatological and neurological issues, hormonal problems, psychosexual issues and mechanical/musculoskeletal problems. Vulval pain disorders can be complex and often muli faceted with more than one element often involved. For example in my own case, I had a rare type of Candida, but the pain I endured for two years caused me to develop heightened nerve sensitivity and musculoskeletal issues that also needed to be addressed.

In recent years, however, there has been increased awareness and recognition of vulval disorders including vulvodynia.

The British Society for the Study of Vulval Diseases (BSSVD) have now produced guidelines to help clinicians assess and manage patients with vulvodynia. This comprehensive list of recommendations should improve the experience of women accessing health services with vulval pain disorders including Vulvodynia. This information is available on the vulval pain society website- www.vulvalpainsociety.org and at www.bssvd.org

The summary of recommendations from the BSSVD

An adequate pain history should be taken to assess the degree of symptoms and the impact on the woman. The clinician should categorize which subgroup of vulvodynia the patient has according to the International Society for the Study if Vulval Diseases (ISSVD) definitions (e.g. provoked/unprovoked pain). If appropriate patients with sexual pain (dyspareunia) should have a sexual history taken to identify sexual dysfunction. A team approach may be necessary to address the different components of vulvodynia. A lead clinician should triage patients and consider referral to other health professionals who have a role in vulvodynia management, e.g. psychosexual health, medicine, physiotherapy, pain management teams. Combining treatments should be encouraged. Patients should be given an adequate explanation of their diagnosis, relevant written information and suggested contact information. When prescribing treatments clear instruction should be given on how to take medication. Topical agents should be used with caution to avoid the problem of irritancy. A trial of local anaesthetic aganet may be considered in all vulvodynia subsets.Tricyclic antidepressant drugs (TCAs), e.g. amitriptyline or nortriptyline, are an appropriate initial treatment for unprovoked vulvodynia. Other drugs may be considered including gabapentin and pregabalin which can be given in addition to a TCA. Surgical excision of the vestibule may be considered in patients with local provoked vulvodynia (vestibulodynia) after other measures have been tried. Only a minority of patients may be suitable for surgery. If surgery is offered, adequate counselling and support should be given to the patient both pre and post operatively. Pelvic floor muscle dysfunction should also be addressed in patients with vulvodynia who have sex related pain. Techniques to desensitise the pelvic floor muscles are likely to be beneficial. Acupuncture may be considered in the treatment of unprovoked vulvodynia. Intralesional injections may be considered i patients with provoked vulvodynia

The guidelines emphasize the importance of a ‘team’ approach and the potential benefits of combining different treatments to address the varying components of vulvodynia. I firmly believe that for me the ‘Team’ approach of dealing with the infection, combined with physiotherapy, nutritional advice, mindfulness and hypnotherapy was the key to my recovery.

During my recovery I completed a course in mindfulness and had several sessions of hypnotherapy. This had a huge impact for me in terms of both pain management and also stress relief. The psychological and emotional impacts of vulvodynia can be devastating as it pervades the most intimate parts of you. Day to day bodily functions like going to the loo can become a source of anguish, whilst the loss of sexual intimacy can be damaging to the strongest of relationships. Like many people, however, I was initially resistant to having psychological support as I felt this meant the pain was somehow imagined, but the support and benefit I gained from using these approaches cannot be underestimated.

Following on from my recovery, I decided to retrain as a hypnotherapist and mindfulness practitioner and now specialise in the management of chronic pain conditions, including vulvodynia.

I feel extremely lucky to now be in a position to offer this support to women and am passionate about improving the services available for women with vulvodynia. In addition to my work I chair a support group for women with Vulval pain conditions: The Manchester Vulval Support Network (MVSN) was established in 2016 at St Marys Hospital in Manchester, by myself-Heather Coppard (Hypnotherapist/ Mindfulness practitioner and patient representative), Sarah Benjamins (Nutritional Therapist and patient representative), Dr Ursula Winters (Consultant gynaecologist, CMFT), Dr Kate Parker (Consultant Gynaecologist, CMFT) and Donna Ellis (Specialist Assistant Practitioner). The group meets every three months providing a forum for women affected by vulval conditions to share helpful advice, enjoy informative talks from a range of speakers and to create a local network for patients and professionals to share best practice.

Vulvodynia can be a challenging condition, potentially impacting on every part of your life, but treatment and support is available. Heather Coppard ADCHyp, GQHP, BSc Professional Nursing Studies Hypnotherapist and Mindfulness practitioner,
Bramhall Osteopathic practice
Tel: 0161 440 0298 Mob: 07855 525 283.
e-Mail: Heather.coppard@cheshirebridgehypnotherapy.co.uk

The Vulval pain society –www.vulvalpainsociety.org
British Society for the study of Vulval Diseases-www.BSSVD.org

The Dailymail - Miscarriage & Hypnosis

Posted on 2017-10-27 by Heather Coppard

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Chronic Pain & its Management

Posted on 2017-09-27 by Heather Coppard

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Chronic Pain

Pain can take so many different forms and is really unique to each of us. Most of us will have experienced acute pain such as stubbing a toe or bumping an elbow. It is deeply unpleasant but usually short lived and quickly forgotten. But what about when the pain doesn't go away? This is the reality for thousands of people in the UK who are living with chronic pain conditions. The causes of chronic pain are vast, but may include long term illness or disease, injuries or ongoing conditions. It would be difficult to list every condition, but more common causes of long term pain include arthritis, fibromyalgia, cancer, multiple sclerosis and pelvic pain conditions.

Chronic pain can have a huge impact on our lives, potentially limiting our mobility and altering our ability to work and participate in social/exercise activities. The mental health of a person experiencing chronic pain can also be dramatically affected often resulting in feelings of depression and anxiety.

So what can we do to improve the situation?

Within the world of pain management, there is currently great excitement about the potential benefits of mindfulness in improving patients experience of pain.

You may well have heard about mindfulness in the news. Indeed recently there has been increased interest in the use of mindfulness in schools, businesses and health care, but what's it all about?

Mindfulness

Well, put simply, Mindfulness is learning to be present in the moment, without worrying about the past or being concerned about the future. The practice allows us to bring caring attention to our present experience but without being judgemental or critical of it.

So how can this help us with chronic pain?

Toni Bernhard (2015) explains that there are three components to physical discomfort: the unpleasant physical sensation itself, our emotional reaction to it (often anger or frustration) and the stressful thoughts we spin that may have no basis in fact (eg- thinking the pain will just keep getting worse). It is interesting to note that two of the three components that make up our experience of pain are mental in origin.

This does not mean that the pain is in your head or doesn't exist, but it highlights the importance of the brain-body connection and how the mind plays an integral role in our experience of pain.

Indeed we now understand that psychological factors can play a significant role in maintaining or exacerbating pain, for example:

  • Worrying about the pain can lead to bodily tension and greater pain
  • The experience of pain can lead people to avoid formerly pleasurable activities for fear of exacerbating it- this tends to bring down our mood, increasing a negative view of ourselves.
  • Feeling that we cant control the pain can lead to a sense of helplessness and hopelessness- this lack of perceived control is likely to increase stress
  • Our thoughts and emotions affect the intensity with which pain is experienced (Newbury Helps, 2015).

Mindfulness can help us learn to catch stressful emotions when they first arise, so we can mindfully note their presence and turn our awareness to self compassion, instead of launching ourselves into stressful stories (Bernhard, 2015). Indeed we may not be able to change the pain itself but we can change our response to it and prevent ourselves from piling up unnecessary secondary suffering.

Certain parts of our brains are now known to increase our feelings of stress or anxiety and heighten our response to pain. The amygdala is a primal region of the brain, associated with fear and emotion. This 'fight or flight' centre is involved in the initiation of the body's response to stress (Ireland, 2014). Amazing research from Harvard neuroscientists has recently shown that after undertaking just 8 weeks of regular mindfulness practice the amygdala actually shrinks. In real terms to us this means that it calms down and becomes less over reactive to stress.

The research also showed a fascinating change in the thickness of the pre frontal cortex. Indeed after the 8 weeks of mindfulness practice the area of the brain associated with awareness, concentration and decision making actually thickened.

For years people have reported an enhanced sense of peace and well being after mindfulness practice, with many chronic pain sufferers also anecdotally reporting a reduction in their experience of pain sensation. This latest research, however, adds tangible evidence to support the benefits of mindfulness practice.

On a personal level I have used mindfulness techniques for the last four years to help manage a chronic pelvic pain condition. I believe it has been fundamental in my treatment and enabling me to live an active, enjoyable and fulfilling life.

Heather Coppard
Tel: 0161 440 0298
Mob: 07855 525 283
Bramhall Osteopathic Practice.

The Guardian - Mind over maternity

Posted on 2017-09-27 by Heather Coppard

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Can mindfulness reduce fear of labour and postpartum depression?

Posted on 2017-06-10 by Heather Coppard

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Whilst there are certain aspects to this article that I disagree with such as the concept of 'forced meditation' (how is that even truly possible???), it is still great to see the potential benefits of mindfulness being used by women to support them through pregnancy and beyond. When I work with pregnant women, I use the skills I developed on my KGH Hypnobirthing course and also introduce some mindfulness techniques, to empower women with a variety of tools and strategies. Different things appeal to different people and that's why I love being able to tailor my therapies to suit the individual person and their particular circumstances and preferences. If you have any questions about any of this or want to have a chat about how this may work for you, then please get in touch.

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