Take the dog for a walk together or, if you have children, take them to the park and kick a ball.

Nutrition is also important. Encourage your partner to eat healthy foods and lead by example. If you bring home takeaway food for dinner, chances are your partner is going to find eating a healthier alternative challenging.

Losing weight can be hard, so take small steps each week. You might try swapping full-fat dairy products for low-fat alternatives one week, and the next week swapping unhealthy snacks for fruit or yoghurt.

As children, we are taught that commenting on someone's weight is considered bad manners and as adults we worry that our partners will think we don't find them attractive.

I can't give you any assurances there is a best way to approach the topic, or a guarantee that it won't be taken the wrong way. Just make sure it's not criticism, but an offer to take positive steps to achieve better health and avoid unwanted health problems - even disability - in the future.

I'm 32 and have just been diagnosed with endometriosis. Will it affect my chances of having a baby?

Endometriosis is a female medical condition where the tissue - the endometrium - that normally lines the uterus is found outside the uterus. It can be found on the ovaries, the fallopian tubes, on the surface of other organs of the pelvis and even outside the pelvis. Exactly why this happens isn't known.

It can often be hard to diagnose because other conditions can cause similar symptoms. And because it can be found in unusual places, the symptoms often mimic other conditions or are simply difficult to recognise.

It's believed that a laparoscopy is the only way to reliably diagnose the condition. This is a surgical procedure performed under general anaesthetic, whereby a medical camera is used to examine inside your abdomen and pelvis.

The most common symptom of endometriosis is pelvic pain, but other symptoms can include vaginal bleeding, bowel and bladder problems, and infertility. It is estimated that 30-40% of women with endometriosis may be infertile.*

In response to your menstrual cycle, the endometrium outside your uterus swells and thickens then sheds the same way the tissue inside your uterus does. However, the blood has nowhere to go, and instead of being expelled with your period, it causes inflammation that forms scar tissue, which in turn can block the fallopian tubes or interfere with ovulation.

Laparoscopic surgery, during which endometrial attachments are removed, is said to be the most effective treatment, though symptoms can be managed with hormone therapy (may include side effects) or even complementary therapies for some women, such as acupuncture.**

It is a myth that pregnancy can cure endometriosis - the symptoms may improve for some women, but worsen for others. Endometriosis is often responsive to the hormone cycle, as is the normal tissue in the uterus, so it can fluctuate with changes in the body's hormone levels.

It's important that you talk to your GP, who may refer you to a gynaecologist. Whether your endometriosis will affect your chances of having a baby will be determined by a number of factors, including the severity of your condition, based on the scarring and diseased tissue found.

Even if you are having difficulties conceiving, there are still many options available. It is a matter of identifying the problem and seeking advice as to what to do next.

* www.endometriosis.org/endometriosis.html
** www.betterhealth.vic.gov.au

 

 

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