2017 HCHB_digital

CONTINUING OTC EDUCATION
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Diet can affect fertility in the short and long term.
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A healthy body mass index (BMI) of between 20 and 25 is required by most
women to sustain ovulation. Obesity affects ovarian function and can lead
to abnormal menstrual cycles.
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Weight loss and a significant lack of body fat are related to the cessation
of ovulation.
• Cigarette smoking decreases sperm count in men and increases the risk of
miscarriage, ectopic pregnancy, and premature birth in women.
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Smokers are only 60% as likely to conceive each month as non-smokers.
• Alcohol also affects sperm count and if taken during pregnancy can increase
the risk of birth defects in babies.
• Caffeine can detrimentally affect fertility if more then two cups of caffeinated
drinks are drunk per day.
• 60% of couples get pregnant within three months; this increases to 80% by
six months. Most couples with relative infertility eventually conceive and only
5% have complete infertility.
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Around 30% of infertility is attributable to a problem with female fertility,
30% to a problem with male infertility, and in 20% there is a problem with
both partners. No clear or definite cause is ever found for the other 20%.
Supplements
Folic acid should be taken at least one month before conception and three
months after to reduce the incidence of neural tube defects in the developing
baby (see Product options on opposite page).
Iodine should be taken throughout pregnancy and while breastfeeding to support
normal brain growth and development in the unborn baby and newborn infant.
Pregnant women should also talk with their doctor or midwife about other
supplements (eg, calcium, iron, vitamin D) that may also be needed during pregnancy.
Pregnancy points
• Breast changes (eg, fullness, tenderness) are often the first signs of pregnancy.
The nipples also enlarge as pregnancy develops.
• Shorter, lighter bleeding may occur during early pregnancy in some women, at
the expected time of their period.
• Certain foods (eg, cold meats, raw eggs, uncooked seafood, unpasteurised
cheese/milk) are not recommended during pregnancy. See www.foodsmart.
govt.nz for a list of safe foods in pregnancy.
• Leg and foot cramps are common in pregnancy. Supplements may help.
Initial assessment
Discuss folic acid and iodine supplementation with any woman coming into the
pharmacy for a pregnancy or ovulation test kit (see Product options opposite
for more details). Women who are planning to conceive should also refrain from
drinking alcohol, smoking cigarettes or other substances, and minimise caffeine
intake. If a woman not been previously vaccinated against rubella (German measles),
she should talk to their doctor about getting vaccinated before conception.
Refer to
PHARMACIST
The following questions aim to identify customers who would
benefit from further input from a pharmacist. Your initial
assessment may have already provided some answers. Decide if any
further questions still need to be asked and refer any “yes” answers
to a pharmacist.
• Does the woman have any other health conditions (eg, epilepsy,
thyroid problems)?
• Does the woman take any other medication or herbal remedy,
either prescribed by a doctor or bought from a shop or
supermarket?
• Would the woman be worried if she was pregnant?
• Has the woman missed a period but pregnancy tests have been
negative?
• Does the woman usually have irregular periods so is not quite
sure when her next period is/was due?
• Has the woman had a positive pregnancy test but has not yet
seen a doctor?
• Has the woman been having abdominal pain or period problems?
• Does the woman have any allergies to supplements?
Advise women who are pregnant to organise a lead maternity carer (LMC)
as soon as possible – this can be a midwife or specialist doctor. See www.
findyourmidwife.co.nz or ask your doctor for a local list of LMCs.
Advice for customers
• If the woman’s menstrual cycle varies in duration so that period dates cannot
be predicted, test first thing in the morning when HCG concentration is at its
strongest. Use a mid-stream urine sample.
• Retesting after a few days is recommended if a women gets a negative result
after using an early pregnancy test seven days post ovulation.
» » Alternatively, blood tests (from a doctor) are sensitive at detecting HCG
from about six to eight days after ovulation.
• For more information on medications that can be safely taken during
pregnancy see Drugs in Pregnancy, page 210.
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