The influence of pregnancy upon acute cardiovascular responses to slow and deep breathing.

Slow and deep breathing (SDB) is a promising intervention that has provided reductions in blood pressure (BP) in primary hypertension when practised daily and has potential as an intervention to treat women who develop hypertension during pregnancy. Before SDB can be introduced in a clinical setting during pregnancy, it is important to understand whether normal cardiovascular changes that accompany pregnancy influence the acute responses to SDB. Additionally, known structural and mechanical differences in the respiratory systems of men and women may also influence cardiovascular responses to SDB. As most published studies include only male participants this has not been fully investigated. In preparation for a clinical study of SDB with women who develop pregnancy-induced hypertension, this thesis characterised the acute cardiovascular responses to a range of different SDB protocols in three distinct population groups (men, women and pregnant women). Novel analysis techniques were applied to delve deeper into the acute cardiovascular responses, by analysing the inter- and intra-breath phase cardiovascular fluctuations induced by breathing. The results highlight the limitation of using averages to understand the cardiovascular changes induced by SDB. Analysis of within-breath (peak-valley) haemodynamics revealed an increase in the amplitude of oscillations during SDB, whilst the average was unchanged. Respiratory sinus arrythmia tripled during SDB compared with rates during normal breathing across all participant groups. The observed increase of the amplitude of BP oscillations provides clues to potential error signal(s) linking daily practise of SDB to chronic BP reductions. This thesis makes an original contribution to existing knowledge by furthering our understanding of the acute cardiovascular responses to SDB and the need to look more closely at peak-valley haemodynamic oscillations. It provides evidence to support the development of an evidence-based SDB intervention to be used with pregnant women, supporting womencentred care and improving the health and experiences of pregnant women

How do women feel cold water swimming affects their menstrual and perimenopausal symptoms?

Objective This study aimed to determine how women felt cold water swimming affected their menstrual and perimenopausal symptoms. Study design An online survey that asked women who regularly swim in cold water about their experiences. The survey was advertised for 2 months on social media. Questions related to cold water swimming habits and menstrual and perimenopausal symptoms were analysed. Main outcome measures Quantitative and qualitative data including; frequency of menstrual and menopause symptoms, the effect of cold water swimming on these symptoms. Results 1114 women completed the survey. Women reported that cold water swimming reduced their menstrual symptoms, notably psychological symptoms such as anxiety (46.7%), mood swings (37.7%) and irritability (37.6%). Perimenopausal women reported a significant improvement in anxiety (46.9%), mood swings (34.5%), low mood (31.1%) and hot flushes (30.3%). The majority of women with symptoms swam specifically to reduce these symptoms (56.4% for period and 63.3% for perimenopause symptoms). Women said they felt it was the physical and mental effects of the cold water that helped their symptoms. For the free text question, five themes were identified: the calming and mood-boosting effect of the water, companionship and community, period improvements, an improvement in hot flushes and an overall health improvement. Conclusion Women felt that cold water swimming had a positive overall effect on menstrual and perimenopause symptoms. Studies on other forms of exercise to relieve menstrual and perimenopause symptoms may show similar findings

Effects of slow and deep breathing on reducing obstetric intervention in women with pregnancy-induced hypertension: A feasibility study protocol

Objective: To evaluate whether a slow and deep breathing (SDB) intervention is acceptable to pregnant women. Methods: The trial aims to recruit 67 pregnant women who have developed pregnancy-induced hypertension (clinicaltrials.gov: NCT04059822). SDB will be undertaken daily for 10 min using a video aid and women will self-monitor blood pressure (BP) daily. At 36-weeks gestation women will complete an online questionnaire. Adherence, recruitment rates, and acceptance of the intervention will be evaluated. Conclusion: The findings from this trial will evaluate if women accept SDB as a treatment method. Initial analysis will evaluate if BP and/or obstetric interventions reduce following SDB intervention

The swimming habits of women who cold water swim

Background: Cold water swimming is growing in popularity, especially amongst women. We have previously reported that women felt that cold water swimming helps with their menstrual and menopause symptoms. But little is known about the habits of women who cold water swim. Objectives: To determine the habits of women who cold water swim Design: This was a mixed methods study. Methods: An online survey asked women who cold water swim about their experience of swimming and how this affected their menstrual and menopause symptoms. The survey was advertised for 2 months on social media, with a focus on advertising in cold water swimming Facebook groups. In this paper, only the questions on the women’s swimming habits were analysed. Results: The analysis of 1114 women, mainly from the UK, revealed that most had been swimming for 1-5 years (79.5%). Most swim in the sea (64.4%) and only 15.5% swim alone. The majority (89.0%) swim all year around, swimming for mainly 30-60 mins in the summer and 5-15 minutes in the winter. The women mostly swim wearing swimming costumes (skins) throughout the year. The majority of the free text responses showed women found mental and physical benefits from cold water swimming. Conclusion: It was not surprising to learn that women swim for longer in the summer than the winter, but hearing how they feel cold water swimming helps their physical and mental health is important. With the limitations on access and safety of many wild swimming sites in the UK, it is time to ensure that cold water swimming is safer and more supported

Supplemental Material - How do women feel cold water swimming affects their menstrual and perimenopausal symptoms?

Supplemental Material for How do women feel cold water swimming effects their menstrual and perimenopausal symptoms? by Megan Pound, Heather Massey, Sasha Roseneil, Ruth Williamson, C Mark Harper, Mike Tipton, Jill Shawe, Malika Felton and Joyce C Harper in Post Reproductive Health.</p