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Think you know the best way to get pregnant, think again, says Dr Zoe Williams

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Dr Zoe Williams answers some common questions sent in by readers
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Dr Zoe Williams answers some common questions sent in by readersCredit: The Sun

It’s also that time of year when you should consider taking a vitamin D supplement.

Our bodies create vitamin D thanks to sunlight on our skin, and it is vital for healthy teeth, bone and muscle.

But during autumn and winter, when the sun is weaker, a supplement can top you up, and is recommended by the Government.

Your pharmacist can help you choose one.

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In the meantime, here’s what readers asked me this week . . . 

Q: WHAT is the best way to start a family?

A: I love this question.

Some may think the answer is glaringly obvious, but it’s actually a lot more complex than most realise.

I remember being taught in school, in an awkward sex education class, that if you have unprotected sex just once then you would get pregnant — who recalls being told the same thing?

The truth is far from this for most and, in fact, one in seven heterosexual couples experience infertility — meaning the failure to achieve a pregnancy after 12 months or more of regular unprotected sex, without contraception.

About 84 per cent of couples will conceive naturally within a year if they have unprotected vaginal sex every two or three days and the woman is under 40.

Of those who do not conceive in the first year, about half will do so in the second year — this means that 90 per cent of couples will conceive within two years.

While this is reassuring, for those who are actively trying to conceive, two years is a long time, so there are some additional things you can do to optimise your chances of conception.

First, let’s talk about lifestyle, because living healthily can boost your fertility, and this is true for both men and women.

In fact, lifestyle can impact the quality of eggs in women, something I think we should be taught at school.

Smoking, body weight, physical activity, a healthy diet and stress levels can all impact the health and quality of our eggs.

For men, because new sperm are being produced all the time, current lifestyle behaviours can impact on the quality.

A 2012 study found that heavy smoking was associated with decreased sperm counts, and alcohol consumption was associated with increased numbers of abnormal sperm.

Next on the list is optimal timing for having sex.

While the NHS advises simply having sex every two to three days, this might not always work for couples due to busy schedules, or just choice.

Once an egg is released from the ovary, which is called ovulation, you have about 24 hours in which it needs to come into contact with live sperm, otherwise it dissolves.

Live sperm can survive inside the female body for up to five days.

Biologically speaking, ovulation day is the only day you can get pregnant, as this is when the sperm and egg actually meet.

So couples trying to conceive should have sex multiple times on the days just before ovulation.

This means that the real key is being in touch with your body and knowing when you ovulate.

Ovulation happens mid-cycle, so in people who have a 28-day cycle, this will be around day 14, with day one being the first day of your period.

However, dates alone cannot be relied upon as we are all different, and relying solely on this could mean you miss your window of fertility.

The best indicator of ovulation is changes to cervical secretions, or vaginal discharge.

Around the time of ovulation it tends to become more wet, transparent and stretchy. It is often described as being like egg white.

Other techniques involve taking basal temperatures, alongside apps and devices such as “Natural Cycles, “Daysy” and “Mira” or using ovulation sticks, which can also predict ovulation.

My advice though is never to be fully dependent on these measures, and if you can continue to have sex regularly, at least either side of your probable fertile window, then do so.

And a reminder that all women who are trying to get pregnant should be taking folic acid and vitamin D supplements.

Q: RECENTLY had a private health screening and when my urine was tested it was flagged as amber.

My result was “seven” and they have told me to contact my GP. Should I?

A: Absolutely, 100 per cent yes.

Your GP or nurse can simply do a dipstick test of your urine to check for any microscopic blood traces, which is blood that cannot be seen with the naked eye.

If there is blood then your GP may want to send off a sample to check for infection.

If there is no infection, then you will most likely require further investigations to determine the cause of the blood’s presence.

In addition to infection, causes include kidney stones or inflammation, prostate problems and also bladder or kidney cancers.

And remember: What’s the point in having a private health screening if you’re not going to act on the results?

Q: I’M a 60-year-old woman with thinning hair.

Blood tests came back normal but it’s affecting my confidence. What can I do?

A: I’m so sorry to hear that you are experiencing this and that it is affecting your confidence.

The most common cause is a condition called female pattern hair loss.

It’s caused partly by our genetics and partly by hormonal factors.

The pattern of hair loss is different to what we see in men, though.

In females, there is gradual widely spread thinning of the hair, mainly on the crown of the scalp.

The hairline at the front of the scalp often remains normal.

The hairs produced by the affected follicles become progressively smaller in diameter, shorter and lighter until eventually the follicles shrink completely and stop producing hair.

You may be more likely to have it if your parents experienced hair loss.

In women, the age of onset is later compared to male pattern hair loss — usually occurring in the 50s or 60s, though it can occur earlier.

Although not dangerous to physical health, it can impact hugely on confidence, mental health and quality of life.

There is no cure, but there are some treatments available that can slow down the progression of hair loss, but sadly they are not great.

Applying minoxidil solution, known by the brand name Regaine, to the scalp every day may help to slow down the progression and even partially restore hair in some women.

However, it is expensive, not available on the NHS, and can take several months before a change is noticeable.

Also if you stop using it, any hair maintained/restored can be lost.

There are some oral treatments that have been shown to be effective, such as spironolactone, cyproterone acetate, flutamide and cimetidine, which may lead to some improvement in hair loss.

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But these treatments have downsides too — they are not licensed for use in female pattern hair loss, so will not be prescribed by your GP, plus they will only work while the treatment is used.

Some women find wigs, toupees and hair extensions can be helpful in disguising hair loss.

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