So what is endometriosis?
Only 20% of the general public have heard of it. Here’s the science bit: the cells or tissue that form the lining of the uterus, the endometrium, normally grow inside the uterine cavity. In endometriosis it grows elsewhere, such as the ovaries, pelvic ligaments, bowel, bladder, rectum or outside the uterine cavity entirely. In women with endometriosis, the displaced endometrial tissue (also known as implants) functions and is influenced by hormones just as a normal endometrium is, and therefore can bleed during menstruation. When the uterine lining is shed during a period, the implants also bleed, except the blood becomes trapped inside the body. The accumulated blood causes localised inflammation and is painful. Over time the growth of the implants, the repeated internal bleeding and inflammation may cause the development of adhesions or scar tissue.

What are the symptoms?
Endometriosis sufferers can experience a range of different symptoms which vary for each person depending on where the endometriosis is and the organs affected. Symptoms can include heavy, painful periods (dysmenorrhoea) with large clots, long or irregular cycles, bleeding between periods, lower abdominal pain, back pain, or chronic pelvic pain which can last all month long, painful sexual intercourse, pain during bowel movement or urination, rectal bleeding, swollen, painful ovaries, swollen abdomen, fatigue, and fertility problems.

What are the causes or risks of getting endometriosis?
​There are a number of causes and risk factors which may increase the chances of you getting endometriosis. The main cause is likely to be retrograde menstruation. This is when the endometrial tissue passes through the Fallopian tubes into the abdominal cavity, instead of passing out through the vagina. Women whose mother, grandmothers or sisters have endometriosis have an increased risk of getting it, as do those who have had a hysterectomy. Low progesterone disrupts hormonal imbalance overall. When progesterone is low, oestrogen usually becomes too high. Endometriosis is an oestrogen sensitive disease and symptoms are increased by oestrogen during the menstrual cycle. We are exposed to many xeno-oestrogens (meaning man-made) through foods, plastics and cosmetic products. These can increase the irritation and hormonal activity of the endometrial tissue. Symptoms are increased by inflammation. Today's western diet is highly inflammatory with an imbalance in the ratio of good to bad fats, processed foods and exposure to chemicals and hormones in non-organic foods, particularly meat and dairy. There is current research stating that endometriosis is classed as an auto-immune disease. This may explain why it tends to be hereditary, as auto-immune conditions are often passed through generations.
​

How can it affect my fertility?
Endometriosis is the second most common gynaecological condition in the UK, and up to 50% of ‘infertile’ women (presumably that means those who are trying to conceive and have been given an ‘unexplained infertility’ diagnosis) are affected by endometriosis. That’s huge. It is an oestrogen dominant condition so causes hormonal imbalance. Proper hormonal balance is essential for healthy fertility. Every month, the excess tissues bleed which cause inflammation and scar tissue, affecting the uterus, Fallopian tubes, and ovaries. This is known as chronic pelvic ‘congestion’ and may alter normal functioning of the ovaries, cause blockages in the Fallopian tubes, or make it harder for an embryo to attach properly to the wall of the uterus for implantation. Some research also suggests that the woman’s body may form antibodies against the misplaced endometrial tissue. These same antibodies may attack the uterine lining and cause miscarriages (up to three times the normal rate).

What is the treatment for endometriosis?
There is no cure for endometriosis. With conventional medicine, there are 3 main treatment options – surgery via laparoscopy, hormone therapy ie the pill or inducing medical menopause (which isn’t helpful if you’re trying to start a family), and pain management, usually with medication. I never did get to the bottom of what was causing me such painful, heavy bleeds as a teenager. My GP put me on the pill aged 14, and said that having a baby in due course would probably improve things greatly. Hmmm, not particularly sound advice to a 14 year old - I thought doctors were meant to be discouraging teenage pregnancies! For those with endometriosis, there are other more natural treatment options too, where the main aim is to support the proper functioning and health of the endometrium, endocrine system and immune system and allow you to live your life not limited by your condition. 

So what are these alternatives which may help to you to manage your symptoms?
Here are our 12 top tips:

​1. Reflexology
My training with the Association of Reproductive Reflexologists (ARR) taught specific treatment protocols for endometriosis. The most effective time for a reflexology session is during the bleed, when lesions will be most active, so treatment can clear stagnation and debris in the system. It’s also the most useful time to manage any associated pain in the abdomen, bloating, constipation, etc. However, reflexology is also useful for balancing hormones throughout the whole menstrual cycle. In a small study carried out by the ARR, of those patients who presented with endometriosis, 65% became pregnant and 55% went on to have a live birth after having a course of reproductive reflexology treatments. Find a qualified Reproductive Reflexologist or book a reflexology treatment with me or one of my colleagues. 

2. Abdominal Massage for Fertility
This specialised massage treatment works on the lower back and abdomen, and can be beneficial to those with endometriosis in several ways. Oestrogen clearance takes place in the liver, therefore by increasing the circulation and strengthening the liver you are helping your liver to eliminate toxins including the excess oestrogens. Increased circulation will assist with maintaining hormonal balance. Hormones travel in our blood, therefore by clearing congestion in the pelvic region allows for a freer blood flow, thus encouraging the negative feedback loop between the ovaries and pituitary gland to function better. Scar tissue and adhesions which cause congestion are softened and reduced due to the increased circulation of blood and lymph. Increasing the circulation to the uterus will increase fresh oxygenated blood, which renews and repairs cells, so will increase uterine tone. On an energetic level, massage will release blocked pelvic energy. It also releases endorphins, which is a wonderful natural form of pain relief. Find a qualified Fertility Massage Therapist or book a massage treatment with one of my colleagues.

3. Eating the right food
Dietary changes specific to endometriosis are important. There are several types of food you may want to avoid because they have been linked to making endometriosis worse. Certain foods may trigger flare-ups, promote inflammation, or are ‘congesting’ to the body, feeding the congestive nature of endometriosis, while other foods may increase hormonal imbalance.
Foods to limit or avoid:

• Gluten, specifically wheat. Coeliac disease is common in women with endometriosis – both are considered to be auto-immune conditions. According to an American nutritionist, pain subsided in 80% of women with endometriosis when they removed wheat from their diet. It is recommended to remove gluten from the diet for a minimum of 2 months to see if pain is reduced or eliminated.
• Dairy products as these are ‘congesting’ to the body. Consumption of dairy products should be limited to about 2 times a week at most and choose organic, raw dairy products when possible. Milk alternatives such as almond, coconut or rice milk are good. Be sure that any dairy you do consume is organic as it will not contain any added hormones.
• Red meat, especially commercially raised beef or pork as they contain xeno-hormones and antibiotics which are toxic to the human body and disrupt the delicate balance of our hormones.
• Soy foods are highly processed and contain concentrated amounts of isoflavones which are known to be phytoestrogenic so may contribute to oestrogen dominance. Most soy is genetically modified and not organic, both of which have been linked to fertility issues.
• Non-organic foods. Exposure and consumption of pesticides, herbicides, synthetic fertilisers and GMO foods can create hormonal imbalance through endocrine disruption and suppressed immune function. Conventional fruits and vegetables are regularly sprayed with these chemicals and then not only do we eat them daily, but so do the animals that are raised for meat.

4. ​Bee Propolis
If you’re trying to conceive, consider taking bee propolis. It’s basically a resin-like substance made by bees consisting of beeswax, saliva, sap, and various botanical products from the surrounding area. A study showed that 60% of women with endometriosis related infertility who took bee propolis for 9 months became pregnant, as opposed to 20% in the placebo group. Suggested usage is 500mg of bee propolis, twice a day. It also provides amazing immune support and people who take it regularly never get colds or other lurgy apparently!

​5. NAC (N-acetyl cysteine)
NAC (N-acetyl cysteine) is an amino acid. A study was designed to compare the progression of ovarian endometriomas in NAC treatment patients and untreated control patients. Patients were given either NAC 600 mg three times daily, 3 consecutive days per week or not, for an observation period of 3 months. At the end of the 3 month observation period, endometriomas (ovarian cysts or chocolate cysts related to endometriosis), were evaluated by pelvic ultrasound, by a trained physician, who was blinded as to which group the patients had been in. In the NAC treated group, 24 patients cancelled their scheduled laparoscopy due to a decrease or disappearance of cysts, pain reduction or pregnancy. In the control group, only 1 patient cancelled surgery. Also in the NAC treated group, 14 women had decreased ovarian cysts (-1.5 mm average), 8 had a complete disappearance, 21 had pain reduction and 1 became pregnant.
​NAC influences the development of endometriosis in various ways. It decreases multiplication of abnormal cells, decreases the invasive behaviour of the endometriosis cells, decreases inflammatory substances, regulates expression of inflammation related genes, and stimulates cell differentiation. NAC may be useful for the treatment of current endometriomas, as well as endometriosis, and potential prevention of recurrence after a surgery. However, as with all supplements, it is best to get advice from a qualified nutritionist first. 

​6. Herbal Medicine
Herbs and supplements can be very helpful for women with endometriosis. Many of these plant based substances support the body in eliminating excess hormones, endometrial tissues, and inflammation, while promoting the reduction in endometrial growth. These herbal remedies may be beneficial in the treatment of endometriosis:

• DIM (Diindolylmethane) is found in cruciferous vegetables (broccoli, cabbage, cauliflower, kale, etc) and releases in the stomach after you chew and swallow them. It balances the hormones and aids in the breakdown of oestrogen. Oestrogen dominance is a major cause of fertility issues such as endometriosis.
• Goldenseal Root – this herb is antibiotic, antimicrobial and anti-inflammatory so heals any infection in the reproductive system. Also reduces pain and inflammation from foreign tissue growth.
• Jamaican Dogwood – is antispasmodic and analgesic. It reduces muscular cramps and spasms.
• Wild Yam – balances hormone levels and overall balance within the reproductive system. It may also help the uterus to work more efficiently during your period.
• Cramp Bark – reduces uterine spasm and cramping. It relaxes the smooth muscles of the body, especially the uterus.
• Peony Root – can help to increase progesterone levels, lowering testosterone and balancing oestrogen. Excellent hormone balancing support in general.

If you are in Edinburgh, Wendy Kelly is an experienced medical herbalist. You can book a consultation with her in person or online and she will make up a herbal prescription (tea, tincture or cream) tailored for you.

7. Castor Oil Packs
Castor oil packs have been said to help detoxify the liver naturally (therefore eliminating excess hormones), support uterine and ovarian health, improve lymphatic circulation, and reduce inflammation in the abdomen. There aren’t any conclusive studies on the use of castor oil packs externally (though there are some preliminary ones), but a long history of traditional use in many cultures. You can buy a complete kit or just the castor oil and use an old towel or woollen flannel. You soak the towel or flannel in castor oil and place it over your lower abdomen/uterus or wherever you are feeling pain. Make sure to cover the liver too which is on the right of your abdomen. Then cover it with a bit of cling film or plastic bag, followed by a hot water bottle or microwaveable heat pack. I love this one filled with cherry stones – it retains heat longer than wheat-filled ones, can be washed so is more hygienic and is 25x25cm so larger than many others and covers most of the abdomen. You then have to lie still with feet elevated for at least half an hour, so it’s a bit of relaxing time out to yourself which has health benefits in its own right! Do it at least twice a week if possible. The process can be a bit messy, so make sure you lie on top of an old towel or sheet/shower curtain combo to avoid castor oil drips on your best sofa. It’s definitely worth the effort though.

​8. Progesterone
If you have endometriosis, Dr. John Lee recommends using progesterone cream from days 8 to 26 of your cycle, to counter balance the effects of oestrogen on the body as it stimulates endometrial growth. Take a short week off to refresh your receptor sites. He has had success with controlling symptoms within six months. Once the outbreaks of endometriosis are tolerable reduce the usage to day 12 until you get your period.

9. Yoga
Yoga can help those who suffer from endometriosis in many ways – physically, emotionally and physically. Deep breathing techniques are important as they decrease stress hormones and increase the feel good hormones in your system. There are various poses which can help to stretch out the lower back, ease painful trapped wind, and increase blood circulation in the pelvis. If you’re in Edinburgh, try nurturing Well Woman Yoga classes at KnotStressed or there are lots of options online. 

10. Avoid hormone disruptors via environmental toxins
We know that exposure to certain environmental toxins (synthetic xeno-oestrogens) may contribute to the development of endometriosis or make it worse because they are endocrine disruptors. These chemicals have the ability to interfere with the natural functions and development of our bodies. The main function of the endocrine system is to serve as our body’s message centre. Hormones deliver messages, the endocrine system coordinates the hormones.
Ways to support healthy endocrine function and avoid xenohormones:

• Eat organic foods
• Avoid exposure to pesticides, herbicides and synthetic fertilisers
• Use organic, natural feminine care products
• Use organic, natural body care products, including make up
• Avoid food preservatives and dyes
• Use low VOC paints
• Use recycled unbleached paper products
• Use non-chlorinated oxygen based bleach in the laundry
• Avoid plastics, especially water bottles and food containers

There are some wonderful companies selling safe, organic, natural body care and cleaning products such as Green People, Neal’s Yard, Planet Organic, and Ethical Superstore. You can also use the Yuka app to scan food, beauty products, etc to ensure they aren't full of chemical nasties.

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​11. Urinary Tract Infections
UTIs and cystitis can be common if you have endometriosis, especially if you experience painful sexual intercourse. The most common way of treating UTIs is with antibiotics, however, prolonged use of antibiotics due to recurrent UTIs can have several side effects, such as antibiotic resistance, adverse physical side effects eg rashes, nausea, and diarrhoea, and eradication of the normal flora (good bacteria) in the gut. These microorganisms are essential to the healthy function of the immune system, so overuse of antibiotics can lead to poor immunity and being susceptible to other infections and illnesses. An alternative treatment to antibiotics for cystitis and UTIs is the supplement D-Mannose. It works by "sticking" to E. coli lectins preventing the adhesion of E. coli to the lining of the bladder and urinary tract thus helping to prevent replication. Bacteria is then flushed away through normal urination. D-Mannose does not interfere with blood sugar regulation because it is non-glycaemic in humans. It’s definitely worth a try if you suffer from recurring UTIs. You can take 3 tablets per day as soon as you start to feel the onset of symptoms of cystitis or a UTI, or take one a day as a prophylactic. 

12. Get support
If you have endometriosis, you don’t have to suffer alone. There are some fantastic resources available to support you. Endometriosis UK is the largest endometriosis charity in Britain so have a good look at their website as it's full of great information. They also run local support groups in towns and cities all over the UK, including Edinburgh. Other sites with some fab resources and articles are The Endo Belly Coach and endometriosisnews.com
And just by using the hashtag endo, endometriosis, endo sister or endo warrior on instagram or facebook, you’ll find loads of other amazing women living their best lives with this debilitating condition so don't be scared of opening up and finding your tribe. #endendo

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We stayed up all night talking and there had been suicidal ideation. She said she'd been thinking about it, but it depended on the outcome of a particular situation. Teenage angst. None of us believed for a moment she would go through with it. It haunted me for many years, and still does really. Could I, we, that close-knit group of friends, have done anything to prevent it from happening? Should we have told someone, a responsible adult, our parents? We'd been sworn to secrecy and this was the mid-1980s. We stuck to that code and spent a lot of time and energy keeping things from our parents, rather than sharing. We didn't realise the enormity of what she was saying. Why would we? We were 13 and 14.

But we grew up overnight, our innocence gone. The horror of hearing what had happened by phone call on a Sunday teatime. The assembly at school the next day to our shell-shocked year group, but no offer of counselling or how to manage our grief. The collective teenage sobbing at the funeral and the absolute desolation on the faces of her family. The need to know and yet lack of detail surrounding the circumstances of her death which left us with gruesome hearsay only. It had a massive impact on our friendship group. I thought about her daily for at least 3 years, and even now, 36 years later, the memory of Jane lives on in our consciousness.

As I got older, other suicides seeped into my awareness. 

The friend of my parents who suddenly stopped coming to stay. Hosepipe attached to his exhaust in a locked garage. 115 people die by suicide in the UK every week – with 75% of those deaths being male.

A friend of a friend who hung herself off a remote bridge on the Isle of Skye. Leaving a husband and 2 tiny children. Suicide remains the leading cause of direct maternal death in the first postnatal year.

The 50 year old mother of 4 young adults who must have been deeply unhappy. Suicide rates for women aged 45 to 54 – the most common age for perimenopause and menopause – have risen 6% in 20 years.
​
And the many public figures who end their lives by suicide. Actors, musicians, artists, presenters. Brilliant, creative but often tortured souls who are desperate enough to think that suicide is the best option.

Over 700,000 people take their own life each year – that's one person every 40 seconds (Source: World Health Organization). And this is World Suicide Prevention Day. So what can we, society, do to reduce these numbers?

If you are struggling with your mental health, or having suicidal thoughts, please, please reach out to someone. Often it's easier to talk to a stranger. Here are some options:

- Call Samaritans directly on 116 123 (24 hrs a day)
- Text SHOUT to 85258 to start a confidential conversation with a trained Shout Volunteer
- Contact CALM (Campaign Against Living Miserably) on their national helpline 0800 585858 (5pm to midnight)
- Call Breathing Space 0800 838587
- Call the NHS on 111
- Contact your local Mental Health Assessment Service, in Edinburgh it's 0131 537 6000
- Call Edinburgh Crisis Centre on 0808 801 0414 or text 0797 442 9075 (24 hrs a day)

If you have been affected by the suicide of a friend or family member, or just want to do more to have the confidence to help people who are at that desperate stage of feeling that life isn't worth living, there are lots of courses available for suicide awareness and, more importantly, prevention. Just google 'suicide awareness training UK' and you will find options from organisations such as Samaritans, Papyrus UK, Zero Suicide Alliance, Every Life Matters, Grassroots Suicide Prevention and others. They are often FREE and don't take long. You could do a course as an individual or organise a training session for your workplace. Please take action.

So, so many people are impacted by suicide. We HAVE to reduce these numbers. Today is not just about awareness, but prevention of suicide.

RIP Jane. Long gone but never forgotten. ​

This is a very quick and easy recipe for indulgent but healthy truffles!  They are sugar free, dairy free, gluten free and raw, so even if you have a food allergy or intolerance, you can probably eat these. They also make perfect presents to take when visiting friends or family (especially those who are pregnant – read more below) over the festive season.  So here’s how to make them…

We welcomed Esther Hernandez into the Fertility & Pregnancy Edinburgh team in December 2018, and she has slotted in really well to the work we do around fertility, pregnancy, post-natal and hormonal cases in general. Esther is originally from Spain, but has lived and worked in Scotland since 2002. 

She qualified in Swedish massage in 2013, then completed a Sports and Remedial Massage Diploma in 2014.  She has also done specific training in hip and pelvis techniques, pregnancy massage, and Myofascial Release (MFR) and incorporates these techniques into her massages as needed. Esther has recently completed the Fertility Massage training, which she has found to be a really powerful tool aiding not only fertility, but various menstrual issues, such as PMS, menopausal symptoms, as well as stress and anxiety. Here she explains more about her passion for the work she does. ​

"Although the training I carried out was called Fertility Massage, for this post I have decided to include it all under Women’s Health Massage, as its aim is so much more than aiding fertility.

Last year I trained with two lovely souls learning techniques to help women during their conception journey, but also offering a helping hand with many other conditions. To name a few, these include:
​

• Problems with periods (irregular, heavy, painful or clotty)
• Polycystic Ovarian Syndrome (PCOS), endometriosis, fibroids
• Digestive issues (Irritable Bowel Syndrome (IBS), Crohn’s disease, constipation)
• Lower back pain
• Stress and anxiety

​The training in itself was empowering, self-discovering and extremely nurturing. Alongside a small group of women, I had the privilege to explore women’s health and menstrual cycles and learn more about myself and how to support others. It was what you could call a “Red Tent”, with incredibly caring and powerful women, all sharing their experiences as a woman and all with a deep desire to help other women to feel more empowered and balanced.

During this training I learned to connect deeper that I have ever done during my practice and also to hold the space for true transformation. The techniques are gentle yet deeply powerful and transforming. With a combination of different techniques (rocking, massage, energy work, wrapping), I aim to release blockages, physical, energetic and/or emotional, to allow the body to heal.

The message I took from this training is how little we often know about our own cycles (speaking for myself here!) and how much you learn about yourself when you tune in. This treatment helps you to connect at a deeper level, to listen to what goes on inside you and how to be kind to yourself.
Every woman could benefit from this treatment, if you are ready to give it a try, please get in touch, it would be lovely to work with you."

Esther is available for various types of massage (fertility, pregnancy, post-natal, women's health or general) on Thursdays at Central Studio, 14a Broughton Street Lane, Edinburgh, EH1 3LY. You can make a booking here, or if you would like to chat before making a booking please email me, or call me on 07919 001419.

I'm delighted to be welcoming the wonderful Andrea Clarke to Central Studio in Edinburgh in June. She'll be running a pop-up weekend of Holistic Pelvic Care treatments on 15th and 16th June. I didn't really know exactly what it was, but when she explained it to me, I jumped at the chance to host it as I think it will be relevant for lots of our clients and the awesome women of Edinburgh generally. Intrigued...? Andrea explains more below.

​About Andrea
She's a truly remarkable person, with an amazing backstory which has brought her to where she is now in her life. It's impossible to condense into a few lines, so read more about Andrea here.

Key details:
What - Holistic Pelvic Care™ 1:1 sessions
When - Saturday 15th and Sunday 16th June 2019
Where - Central Studio, 14a Broughton Street Lane, Edinburgh, EH1 3LY
How long - each session is 90 mins
Fee - £120. A non-refundable deposit is required to secure your place. Further ongoing support can be offered via Skype/Zoom

For more details, please visit the event page on Facebook.
If you are not on Facebook, you can email Andrea or call her for full details on 07866 806433. If you'd like to book a session, please contact Andrea directly to agree a convenient time.
​

September is PCOS awareness month. For those who know nothing about it, PCOS stands for Polycystic Ovarian Syndrome - a common condition that affects how a woman's ovaries work. The three main features of PCOS are:

• polycystic ovaries – your ovaries become enlarged and contain many fluid-filled sacs (follicles) which surround the eggs. It's important to note that, despite the name, if you have PCOS you don't actually have cysts.
• irregular periods - which means your ovaries don't regularly release eggs (ovulation).
• excess androgens – high levels of "male hormones" in your body, which may cause physical signs such as excess facial or body hair.

Jacqui Garnier (MAR), one of our reflexologists here at Fertility & Pregnancy and one of the founder members of Verity, the UK's leading PCOS charity, has first hand experience of living with PCOS, and here she shares her fascinating journey and how she overcame it.

My journey with PCOS was far from easy and it wasn’t until I corrected my diet, exercise and intake of the correct supplements, used IPL to become completely hair free (which was my daily reminder of living with PCOS!), that within a period of ten years, my scans showed no sign of PCOS and remained so. In my twenties, I had regular scans that showed I was heavily polycystic on both ovaries, with the familiar “string of pearl” appearance (see image above). Emotionally, I had suffered with hormonal mood swings that were more than just a mild irritation, depression and the worst self-esteem. I am glad to say that my “curing” of PCOS was successful, but if the lifestyle slipped, I’d develop other endocrine disorders such as fibroids, adenomyosis (a condition where the inner lining of the uterus breaks through the muscle wall of the uterus causing extreme cramps, bloating and heavy periods), and a troublesome menopause. Genetically challenged I may be, but without a doubt I rapidly learned that unless the lifestyle is tailored and you allow it to become an exciting new way of life, forget it. Hormones will always aim to rule the roost, so at least take the lead, refuse to be a victim and get a handle on those chemical critters!"

You can book a reflexology appointment with Jacqui Garnier, for help with PCOS, menstrual issues, fertility problems, pregnancy & post-natal, menopause, or for something more general. She's available at Central Studion in central Edinburgh on Tuesdays and Saturdays.

Other useful links for PCOS:

Verity, the UK's leading charity for PCOS. You can follow them on Facebook or Instagram and get involved with the #PCOSphotochallenge this month!

Buy the PCOS teal ribbon to help raise awareness.

Here are a list of books on PCOS by Colette Harris, which are well worth a read:

The Ultimate PCOS Handbook: Lose Weight, Boost Fertility, Clear Skin and Restore Self-Esteem

PCOS: A Woman's Guide to Dealing with Polycystic Ovarian Symdrome

PCOS Diet Book: How you can use the nutritional approach to deal with PCOS

PCOS And Your Fertility: Your Guide To Self Care, Emotional Wellbeing & Medical Support

The PCOS Protection Plan: How to Cut Your Increased Risk Of Diabetes, Heart Disease, High Blood Pressure & Obesity

It’s the end of June and elder trees are still abundant with gorgeous, fragrant elderflowers (in the UK anyway). These are too good to go to waste, so here’s my Dad’s fool proof elderflower cordial recipe. It’s a really refreshing, flowery-flavoured drink which is delicious diluted with still or sparkling water, or mixed with Prosecco for a summery cocktail. 

​Elderflowers have been used in herbal medicine by different cultures all over the world and have many health benefits. And just so you know, in France elderflower cordial is called ‘sirop de sureau’ – go on, try saying that with a heavy French accent! Here's the recipe...

Ingredients:
 35-40 elderflower heads (see image)
2 lemons, sliced thinly
2.5 pints (1.6L) water
3 lbs (1.3kg) white sugar (granulated is fine)
25g of citric acid (available in pharmacies or online)
 
Method:

1. Mix the sugar and water in a stainless steel pan and heat gently, stirring until all the sugar is dissolved. Boil for 2 minutes to make a sugar syrup. Remove from heat and add the citric acid while the syrup is still hot. Stir to dissolve it. Slice the lemons and add to the pan. Then leave this mixture to cool.
2. Take an elderflower head and give it a shake upside down to get rid of bugs. Then snip off the flowery bits into a large bowl or pan and get rid of as much of the thick stalk bits as possible.
3. Pour the cooled sugar syrup, including lemons, over the flowers. If the syrup is hot the flowers will lose their perfume so it’s really important that it is cool.  Stir gently and cover the pan or bowl with a lid or clean cloth. Leave it for 24 hours, stirring occasionally.
4. After 24 hours, remove the flowers and lemons by hand, squeezing each handful dry and getting rid of the remaining pulp. Strain the remaining juice through a sieve lined with a muslin cloth or clean tea towel which you can also squeeze dry to get as much of the juice as possible.
5. Pour into clean glass bottles – make sure they are rinsed thoroughly so there is no washing up liquid left in them. You can reuse wine or spirit bottles. I always keep any pretty bottles I have for my annual cordial making! This recipe should make about 2.25L of cordial. Keep the cordial in the fridge and dilute to taste. You can also freeze the bottles and use throughout the year. However, remember to leave space in the bottle to allow for expansion when it freezes, and best frozen in an upright position if possible. Enjoy!

Top tips to make an excellent batch of cordial:
 
You can find elder trees all over the place – around playing fields, on the side of foot paths, any patch of waste ground really.  Don’t confuse elderflowers with cow parsley, which looks quite similar but grows up from the ground on a thick stalk rather than on a tree.
 
Pick them on a dry day and if possible when they have had a bit of sun on them as the blossom is even more fragrant.  Snip off the blossom heads with scissors.
 
Pick them away from roads and traffic fumes – you don’t want carbon monoxide flavoured cordial. Likewise, don't pick low hanging elderflowers which might have been peed on by dogs!

If you have an ornamental elder tree (such as the ‘Black Beauty’ variety) in your garden, you can use the blossoms for this recipe and it will produce the most amazing bright pink cordial!
 
Bottle the cordial in small glass bottles, say a quarter litre, and give as a wonderful home-made gift. You can reuse vinegar bottles for this.
 
You can also use elderflower blossom to make fritters – a sort of flowery tempura. Here’s a simple and delicious recipe from Nigel Slater.

And later in the year, any flowers which haven't been picked will grow into elderberries, which you can make into delicious jam, full of immune boosting antioxidants. Check out my recipe here!​

In my desperation to convince myself I was coping, I had become very controlling about little things and wouldn't accept help. I remember refusing to let my Mum take away a load of washing as she didn't fold babygrows properly! Looking back, it does sound totally farcical, but it really mattered to me at the time. Quite soon after this photo was taken, my Mum told me she thought I might not be managing too well and suggested I talk to my health visitor. She arranged to visit me at home and did the post-natal depression questionnaire (EPDS), where I scored pretty highly. This is the one test in your life when you want to get a low score! So I was put on anti-depressants for a year (I had Sertraline which is safe while breastfeeding), had regular counselling with a very wise and compassionate lady, and had tons of support, both emotional and practical, from my amazing family and friends. Just opening up about it was a massive relief. And eventually I came out from under that dark cloud and into a more sunny place. ​

Once I was feeling better, I wondered if there were reasons why I had got PND in the first place? It turns out there are factors which can increase your risk of getting post-natal depression or anxiety, but don't necessarily mean you will get it. Here are some of them:

• Pre-pregnancy - a history of depression or previous/undiagnosed anxiety, fertility problems or fertility treatment/IVF 
• During pregnancy - low social support ie if you have emigrated or moved location during pregnancy, lack of support from partner, a change in mental health during pregnancy ie stress or anxiety, severe pain, illness or Hyperemesis Gravidarum during pregnancy, pregnancy loss at any stage
• During the birth – baby loss/still birth, birth trauma, premature/ICU baby, use of synthetic oxytocin
• Post-birth - low social/partner support, lack of sleep, physical problems eg incontinence/prolapse, multiples or having another very young child
• Social factors - domestic abuse (physical/emotional), loss of a close relative, adverse childhood experience (abuse/chaos during your own childhood)  

This list could go on, there are endless factors which might have an impact. For me, I was very fortunate that I got pregnant easily and was physically fine throughout. I had a very straightforward, quick birth, in a pool, in hospital. So in my case, it was definitely emotional factors. My marriage was disintegrating, so it was high stress and anxiety during pregnancy and a complete lack of partner support which had an impact on me. I also had a 17 month gap between my two children so day to day living was pretty full on, on top of the fact I was grieving the end of my relationship.

PS If you would like to know more about perinatal mental health, please come to an event I'm involved with this Wednesday 2nd May in Edinburgh - EGG Talks: Maternal Mental Health. It will be an open discussion with a panel of experts, looking at maternal mental health from every angle. Please register for tickets using the link above, or if you're not a member of EGG, please email them.

Here are some other links to national and Edinburgh-based organisations which you might find useful:
Birth & Beyond
Juno Perinatal Mental Health Support
CrossReach Perinatal Services
Maternal Mental Health Alliance
PANDAS Foundation UK
​ANPI - Association for Post Natal Illness 
Mothers for Mothers
​BACP - British Association for Counselling & Psychotherapy
​Health In Mind

If you’re stuck for something to do this weekend, try foraging for wild garlic. I’m a big fan of foraging for wild food, especially as it’s free!

I had a lovely spring walk last weekend at Dalkeith Country Park just outside Edinburgh with my children. The air was thick with the smell of wild garlic, which covered most of the woodland floor. So we picked a bagful, took it home and I knocked up a batch of wild garlic pesto – keep reading for the recipe.

 The Eco-Egg is also great for sensitive skin or those with allergies, for instance children with eczema. It is the only product endorsed by both Allergy UK and the National Eczema Society. It’s been clinically proven to wash clothes as well as regular detergents, and can be used on all fabrics at temperatures up to and including 60 degrees. I’ve got the large pack size which can do 720 washes. Although the initial cost might seem quite a lot, it should last me around 3 years and cost me just 3p per wash! More importantly, nobody has come forward to tell me my clothes smell a bit off, but please don’t be shy if you think that’s the case!!

​Easter is always associated with eggs so I thought I’d share this interesting article about the origins of Easter and the links with fertility. As the writer says

​It is no coincidence that the ancient Mediterranean spring goddess Eostre not only gives us our words Oestrogen and Oestres (basically the fertile window in female mammals when ovulation occurs and conception is likely to happen), but also Easter.

This is a great time of year to review where you are with your fertility plans. Ultimately, you know that you want to achieve having a family, but are there different ways to achieve this? If you’ve been having fertility reflexology, you might want to try fertility massage instead, or vice versa. You might want to consult a nutritionist to give your diet a complete detox and overhaul. You could try acupuncture and/or Chinese herbs. Or maybe take a break for a couple of months from tracking your cycle, charting your temperature, and just be spontaneous for a while. You may want to start the referral process for IVF, or start the conversation as to whether you would consider egg/sperm donation, surrogacy or adoption. Or do you want to get back to basics and start again naturally? Spring is definitely a time of new beginnings and fresh opportunities, so maybe take a bit of time over the Easter weekend to think about this, and do get in touch with us if you’d like to discuss options for enhancing your fertility naturally. We can work with you ourselves, or put you in touch with other trusted and recommended practitioners.

Talking of eggs, if you are trying to improve or maintain the quality of your own eggs, this book by Rebecca Fett is worth a read – It Starts with the Egg: How the Science of Egg Quality Can Help You Get Pregnant and Prevent Miscarriage. It is well-researched and has some good tips on how to improve egg quality by minimising environmental toxins, good nutrition and taking the right supplements.

​There is another meaning for Easter eggs –  an intentional inside joke, a hidden message, or secret feature of an interactive work (for instance a computer programme, video game or film). The name is used to evoke the idea of a traditional Easter egg hunt. Pixar are famous for Easter eggs in their films. They are really subtle and hard to spot! Click here to see the best of them… Fun huh?! Have a lovely Easter weekend...