Dr. Doireann O’Leary shares her top tips on reproductive health & fertility

Feb 19, 2024

We sat down with Dr. Doireann O'Leary, a GP based in Cork City, to delve into her expertise on reproductive health and fertility. With a focus on women's health and general practice, Dr. Doireann is not only a LARC provider and registered cervical smear taker but also a lecturer at The University College Cork School of Medicine.

Her regular contributions to the media, including slots on The Last Word on Today FM and The Today Show on RTE 1, highlight her dedication to sharing insights on health and wellbeing. Through her social media channels and podcast, "Dr. Doireann’s Podcast," she continues to advocate for holistic healthcare.

What can women do to actively support our reproductive health?

Know your menstrual cycle. Track how long your cycle is in particular. Women with long cycles, infrequent or absent periods may have conditions like Premature Ovarian Insufficiency, Early Menopause, Over or Under Active Thyroid Disease or PCOS. These can all impact fertility. Knowing this empowers the woman to optimise fertility potential
Take note of menstrual pain and flow. Particularly painful periods may indicate endometriosis which impacts fertility; early diagnosis and treatment is vital for patients with endometriosis
Regular STI screening is important. Sexually transmitted infections like chlamydia and gonorrhoea are often silent in women; they have no symptoms. If left untreated this can progress to pelvic inflammatory disease which can reduce fertility. Early detection and treatment is key. Condoms reduce the risk of STIs.
Quit smoking; this negatively impacts fertility and reproductive health. Check out Quit.ie for more info. Also reduce alcohol intake or abstain from alcohol altogether. Women who are trying to conceive are advised not to consume any alcohol at all.
Take folic acid; this is vital for all women of reproductive age. Folic Acid reduces the risk of neural tube defects like Spina Bifida in developing babies. Up to 50% of pregnancies in Ireland are unplanned so it’s advisable for all women who may become pregnant to take it whether trying to conceive or not. Plus it supports hair growth in women too! Win win.
Stay up to date with cervical screening tests; these tests detect precancer and reduce risk of cervical cancer. They’re free for women in Ireland ages 25-65. See Cervical Check for more info.
Avail of the HPV vaccine; this is free for adolescents in Ireland but can be given to women in their 20s, 30s, 40s and even 50s too. It’s worth discussing it with your healthcare provider if you’ve never had it. It reduces the risk of vaginal, vulval and cervical cancers in women. It also protects against genital warts.

What are some of the most common misconceptions you’ve encountered regarding women’s reproductive health?

Misconception: women need a cervical screening test after pregnancy; if your cervical screening tests are up to date you don’t need an additional bonus test after pregnancy. If your test is due you should book it 3 months after delivery.
Misconception: HPV vaccine is for teenagers. The vaccine is most effective when given to adolescents but it can still be given to older men and women to reduce HPV related cancer risk. It’s free for teenagers in schools but after that patients will have to pay.
Misconception: The contraceptive pill reduces fertility: The contraceptive pill doesn’t reduce fertility.

What are some effective ways to manage PMS and period pain?

Lifestyle measures help hugely with PMS. Getting regular exercise, and eating healthy whole foods rather than ultra processed foods can reduce severity; often easier said than done when dealing with sugar cravings brought on by PMS. Smokers experience more severe symptoms; another reason to quit. Reduce caffeine intake as this can make symptoms worse. Acupuncture and chasteberry may help some women. The contraceptive pill works for some women too.
For more severe mood symptoms like depression, irritability or anxiety, taking prescription medications like ssris (selective serotonin re-uptake inhibitors) is required for the woman to maintain quality of life. These can be taken during the second half of the cycle only; this is called Luteal Phase therapy. Some patients prefer this rather than taking the medication for the full month.
For period pain, again getting regular exercise and reducing ultra processed foods plays a role. Smoking can make pain worse- need I say again that quitting is a good idea. Most women will need analgesia like paracetamol or ibuprofen for their period pain at some point. Antispasmodic medicines like Buscopan are also useful. Always discuss medicines with your pharmacist.
Some women will need higher strength prescription analgesia or the oral contraceptive pill to reduce period pain.

Are there any downsides to hormonal contraceptives, such as the pill?

Downsides some women experience are symptoms like low mood, reduced libido, unscheduled bleeding and breast tenderness. There is an increased risk of cervical cancer with the combined oral contraceptive pill. However, it does reduce the risk of ovarian and endometrial (womb) cancer so ultimately it has a net effect on cancer risk. Women experiencing bothersome effects from the contraceptive pill might benefit from other more slow release options like the contraceptive patch or the vaginal ring. Long acting contraception like the implant, the injection or the coil may also suit some women better.

What gynaecological signs and symptoms warrant a visit to our GP?

Gynaecological red flags include:

Post coital bleeding (bleeding after intercourse)
Intermenstrual bleeding (bleeding between periods)
Post menopausal bleeding
Persistent unexplained vaginal discharge
vulval skin changes
Persistent unexplained abdominal bloating
Change in bowel or bladder habit

All of these need to be reported to your GP.

What steps should women take when preparing to conceive?

Make sure cervical and STI screening is up to date
Take folic acid
Get some home ovulation test kits to see whether or not you’re ovulating. If you’re not ovulating see your GP to discuss further; they can do blood tests to assess for ovulation.
Abstain from alcohol and quit smoking
Make sure you’re rubella immune. You can get bloods with your GP for an overall health to pick up any abnormalities like low thyroid or vitamin deficiencies. If you do this it’s worthwhile asking for your rubella titres to be checked. You can get a booster before becoming pregnant if your levels show you’re not immune

When should a couple seek medical assistance if they’re having difficulty conceiving?

If the woman is under age 35 and the couple has been trying to conceive for one year they should attend their GP.
If the woman is over age 35 and the couple has been trying to conceive for six months they should link in with GP.

Supplements Made Simple

Dr. Doireann has also developed a hugely popular range of supplements under her brand 'Supplements Made Simple'. With the brand development, Dr. Doireann simplifies supplements for real health benefits. With so much online information, confusion reigns. She recommends four key supplements: Vitamin D, Folic Acid, Vitamin B12, and Omega 3 Fatty Acids. Her range, "Supplements Made Simple," prioritizes scientifically proven supplements for optimal health. Passionate about educating and empowering people, she ensures her range only includes evidence-based supplements. With 16 years of frontline experience, she understands patients' confusion and aims to provide clarity. Dr. O'Leary's personal daily routine includes these supplements, ensuring their efficacy. She has also recently added Marine Collagen to the range which sold out in record time. For more information or to purchase visit Supplements Made Simple here.

For more great advice follow Dr. Doireann on Instagram here or on TikTok here.