What to Expect From a 3D Mammogram

What to Expect From a 3D Mammogram

Are you wondering what to expect from a 3D mammogram? Many are a bit intimidated by the name and are unsure whether they need to undergo this test or not. Read on to learn more about the 3D mammogram, what to expect, as well as how it compares to the standard mammogram.A 3D mammogram is a procedure similar to the traditional mammogram, which doesn’t pose abnormal risks.As the name suggests, 3D mammograms will create a 3D image of one’s breast. The mammogram machine would send X-ray signals through breast tissue at different angles. This will then compile all images taken and turn into one 3D image.The 3D image will provide a complete and detailed impression of the breast, which doctors will use to detect signs of abnormal growth and/or cancer. The standard 2D mammogram is still the industry standard when it comes to imaging breast tissue. During this procedure, a technical will compress breast tissue, making it as uniform as possible. The 2D mammogram machine would create simple images of the breast tissue from various angles.With the 3D mammogram, you go through a similar process. However, the difference here is that the technician takes multiple images from more different angles. This will then be compiled into one digital recreation of the breast, giving a complete representation.3D mammograms allow medical professionals to check on small, individual sections of breast tissue which can be as thin as a millimeter. That way, specialists can detect forms of abnormal growth in breast tissue more accurately. Using this procedure may give medical professionals and individuals more certainty in diagnosis and follow-ups, if necessary. It is suggested that women over 40 years old should get yearly mammograms to check for breast cancer. The American Society of Breast Surgeons recommends 3D mammograms for all women who require to undergo a mammogram procedure. This is because 3D imaging will provide a better picture of underlying breast tissue, helping to identify any potential growths earlier. Doctors might have a few recommendations before taking the mammogram procedure. You may be recommended to schedule your appointment after your menstrual cycle so your breast tissue is less tender. Furthermore, you’ll be recommended to avoid wearing any deodorant or perfume, which may interfere with the imaging.The procedure for the 3D mammogram is similar to the standard mammogram, with the technician asking you to remove your clothing and change to a temporary garment, removing any jewelry. The technician will then place the breast on the compression plate of the mammogram machine and the second plate to flatten breast tissue, creating uniform thickness.Then, the 3D mammogram's imaging arm will move over the breast, taking X-rays from different angles. While it may take a bit longer compared to the standard mammogram, it isn't a noticeable change.Wrapping It Up3D mammograms are fairly new in the medical field, but more health facilities are now adopting the technology. While still a fairly similar process to the standard mammogram, the 3D mammogram would take even more images of breast tissue. There are no risks, and while it MIGHT be a little bit uncomfortable, it is nothing painful and worth going through in order to identify any abnormal growths to treat. I hope you learned even more about mammograms to help become aware of breast health. If you would like to get checked, do talk with your doctor to know your options and schedule a 3D mammogram. 
3 min read

How Many Eggs Does a Woman Have?

Before anything else, here’s a bit of knowledge about female eggs. Immature eggs are called oocytes, which rest in follicles in the ovaries until they start maturing. Follicles are fluid-filled sacs containing an immature egg.  Oocytes will then grow to become an ootid, further developing to an ovum (the plural word is ova), or a mature egg. For now, I'll continue referring to them as eggs or oocytes. Female babies are already born with ALL egg cells they will ever have. There will be NO new egg cells produced throughout your lifetime. When a fetus is still early in development, it will already have 6 million eggs!  The number of eggs is reduced upon birth, so the female baby will have around 1-2 million eggs. If that’s the case, why don’t babies begin the menstrual cycle? This is because the cycle will be put on hold until girls hit puberty, which would begin after the hypothalamus in the brain produces the gonadotropin-releasing hormone. The hormone will stimulate the pituitary gland, producing follicle-stimulating hormones. This is what will initiate egg development, causing one’s estrogen levels to increase.  Once girls reach puberty, they will have around 300,000-400,000 eggs. But wait, that’s far less than the 1-2 million eggs estimated during birth! What happened? Before puberty, over 10,000 eggs die every month. With that in mind, the number of eggs dying each month will decrease after puberty. After they begin their menstrual cycle, girls will lose around 1,000 immature eggs monthly, or about 30-35 eggs a day. There is no known cause as to why egg cells die, but what’s sure is that it isn’t influenced by factors we can control. However, smoking is shown to accelerate egg loss, along with certain chemotherapies and radiation.  When follicles mature, they will become sensitive to hormones during your menstrual cycle. They won’t all be winners though, as only one egg will ovulate, at least.  When one reaches her 30s, the fertility rate will start decreasing, declining further as she reaches 37 years old. Once she's 40, she will have only about 3% of her pre-birth egg supply. As you hit your 40s and 50s, your fertility will begin to decrease because of the fewer eggs left. When you run out of egg supply, the ovaries will stop making estrogen, and this is when you go through menopause. The time menopause occurs depends on the number of eggs you’re born with. If you were born with more eggs, then you’ll still be able to have biological children naturally up to your late 40s! However, this also depends on the quality of your eggs, which would decrease as you age.  Learning more about the number of egg cells women have can be very helpful if you are trying to get pregnant (or avoid it). Now that you know more about it, you're equipped with the proper knowledge to discuss your options with your doctor.  
3 min read
Stretching For Round Ligament Pain In Pregnancy

Stretching For Round Ligament Pain

Stretching for round ligament pain can be very helpful to provide relief in pregnancy. Read below for some simple stretches you can try at home.Round ligament uterus pain occurs because the round ligament is a connection between the uterus and the groin. As your belly grows during pregnancy this can cause pain on either side of the uterus as well as in the groin area. Sudden movements like twisting, coughing, or sneezing can aggravate this area of the body. Thus, exercises for round ligament pain relief focus on the pelvic area and make you able to tolerate movement better.Round ligament pain in pregnancy can be improved by the following yoga exercises which focus on the pelvic area of the body. Start with your hands and knees on the floor with your shoulders directly over your wrists, and your hips directly over your knees. While breathing in, drop your stomach down so that your back arches and your face looks slightly up. This is called the cow position. While breathing out, round your upper back, and allow your head to drop and face your belly. This is called the cat position. You should do this stretch at a slow pace for at least one minute. Then, take a break and then repeat it 2 to 3 times. You can do this exercise after you have done the Cat-Cow stretch since you will already be in the correct starting position. From all fours, extend your right leg back, press your heel back, and then gently lift your leg up. You can hold this position for 5 to 7 seconds and then repeat. Finally, switch sides and perform the same stretch with repetition.Start by lying on your back, and then bend your knees bent but keep your feet flat on theFloor. Inhale deeply and tighten your abdominal muscles. While holding your breath and your abdominal muscles, push the small of your back into the floor. Hold this position while breathing out for 5 to 7 seconds. Repeat this exercise for 1 to 2 minutes.Start by sitting upright on a firm surface. With good posture, place the soles of your feet together. Pulse your legs up and down, like the wings of a butterfly, until you feel a stretch in your inner thighs. For a deeper stretch, you can have a partner place their hands on your knees for resistance. Usually the Savasana pose in yoga practice is done lying on your back. As your pregnancy progresses, lying on your back can not only be uncomfortable, it can potentially cause issues as the growing uterus can put weight on the blood vessels that lead to your heart. For this reason, lying on your side, especially later in pregnancy is a better option. Lying on your left side, tuck your left arm beneath your head to provide a cushion. Place a pillow between your legs and flex your hips. You can also close your eyes if you choose to and breathe deeply to help eliminate any tension from your body. You can lie in this position for several minutes, and repeat this throughout the day. Due to the round ligament pain location, exercises for this discomfort focus on the pelvic area of your body. There are several yoga stretches and poses that you can try to help to relieve round ligament pain. Remember to chat with your doctor if round ligament pain is constant or severe as this could be a symptom of something more serious. 
4 min read

Hypothyroidism Symptoms Checklist - And More

Our hypothyroidism symptoms checklist below will help you with knowing the signs of having this condition. Hypothyroidism is a condition where the thyroid gland does not make enough thyroid hormone to meet your body’s needs. When this occurs, a lot of the body’s functions will slow down1. The thyroid is a small butterfly-shaped gland located in the front of the neck. It sends out hormones that can help control how your body uses energy. Since every part of the body uses energy, thyroid hormone plays an important role in the function of almost every organ, including the heart, brain, liver, kidneys, and skin1,2.  There are many causes of hypothyroidism. Among them are: Hashimoto’s Thyroiditis. The most common form of hypothyroidism is Hashimoto’s thyroiditis. It is an autoimmune disorder where the thyroid is attacked by your own immune cells and over time, your gland may produce less thyroid hormone2. Radiation Treatment. When patients with other medical conditions are treated with radiation in their head or neck, thyroid gland damage can cause it to produce less hormones3. Congenital Hypothyroidism. Sometimes, babies can have hypothyroidism if they are born with an absent or partially formed thyroid, or if their thyroid cells do not work correctly3. Pituitary gland damage. The pituitary gland in the brain sends out a hormone (TSH) which tells the thyroid gland how much thyroid hormone (T4 & T3) to make. If the pituitary is damaged by a tumor, radiation, or surgery, it may no longer produce TSH (thyroid stimulating hormone), resulting in the thyroid producing less T4 and T31. Too much or too little iodine. The thyroid gland needs iodine to make thyroid hormone. Having too little or too much iodine in the diet can cause or worsen hypothyroidism3. As outlined above, there are many different causes of hypothyroidism, so be sure to check with your physician to determine the cause.  *These symptoms are a generalized group that have been noted in individuals with hypothyroidism in the past, but they overlap with many other diseases. If you have any combination of these symptoms, it does not always mean you have hypothyroidism. Rather, they are an indicator that it might be good to check thyroid function. General/Metabolism-related factors 1,3●         Fatigue●        Drowsiness●        Depression●        Weight gain●        Fluid retention●        Decreased sweating●         Increased sensitivity to cold  Skin, Hair, and Nails 4●        Dry skin●        Coarse hair with increased hair loss●        Brittle nails GI●        Constipation Cardiovascular 5,6●        Decreased heart rate●        Anemia●        Elevated cholesterol levels  Since the symptoms of hypothyroidism can potentially overlap with hyperthyroidism, other endocrine diseases, or even non-endocrine causes, the best way to know if you have hypothyroidism is to visit your primary care physician or an endocrinologist. By reviewing your blood work and listening to your history, they can accurately diagnose and recommend a plan of care or follow-up.   TSH (thyroid stimulating hormone)TSH is a stimulating hormone released by the pituitary gland. It binds to your thyroid cells and stimulates it to release thyroid hormone. If TSH levels are high, it could indicate hypothyroidism since low thyroid hormone levels will cause the pituitary to release more TSH. T4 & T3T4 and T3 are your thyroid hormones. T4 is the one that is primarily checked, and if its levels are abnormally low*, it indicates hypothyroidism.*Important note- since the “normal” levels of T3 and T4 fall in a very wide range, individuals can have varying definitions of what a “normal” or “abnormal” level is for them. Thyroid antibodiesIf there are thyroid antibodies present in the bloodstream, it can indicate likelihood of an autoimmune disease being the cause of the hypothyroidism.  Hypothyroidism is treated by replacing the hormone that your own thyroid is struggling to make, in order to raise the levels of thyroid hormone to what they should be for you. Levothyroxine is a medication that is identical to the hormone that the thyroid normally makes. It comes in the form of a daily pill. The dosage of the medication will vary significantly from person-to-person, since it depends on your body’s specific thyroid levels.Your primary care physician or endocrinologist will require repeat blood work every 3 to 6 months initially in order to keep track of your thyroid hormone levels and adjust the dosage of medication as needed.  Authors: Dr. Anjanette Tan, MD, FACE; Yasasvhinie Santharam
4 min read
Does Stress Affect My Skin?

Does Stress Affect My Skin?

The skin is the body’s largest organ, serving a wide range of important functions. The skin is the body’s wrapper; the barrier between a person and the outside environment (1) that protects from external hazards, regulates body temperature and substances that enter or leave the body, and produces hormones like vitamin D, among many other functions (2). However, the skin is actually much more complicated as an organ. Beyond the defensive and regulatory functions, the skin also interprets, sends, and receives sensory information from the central nervous system (which includes the brain and spinal cord) via chemical messengers that evoke a variety of responses. Because of this, the skin is sometimes regarded as an “external brain” (1). Hence, the relationship between the brain and skin health is becoming increasingly popular as an area of research in dermatology.One of the factors that the skin responds to is stress. Stress can be defined as the reactions the body activates when it encounters something it perceives as a potential threat. These can be real or imaginary, and subsequently affect physical, mental and emotional balance, leading to physical changes in the body with the intention of responding and attempting to counter this change (1). Stressors vary from person to person depending on personal and internal characteristics, such as physiology, age, changes within one’s body, and genetics. There are external factors related to lifestyle that bombard the body every day, such as irregular sleep, consumption of a diet with an abundance of processed food, exposure to pollution, UV rays, and toxins such as alcohol and drugs that play a role. Internal stressors including emotional stress from work pressure, low self-esteem, and financial difficulties (among many other psychological situations) can also contribute (1)(3). Essentially, it is anything that puts strain on the body and makes it harder to maintain homeostasis.Encounters with stress are perceived by the central nervous system, activating pathways within the body known as the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic- adrenal medullary (SAM) axis (3). This is how the skin and the brain communicate through neuroendocrine activity - that is, chemical messengers traveling in the bloodstream. When the body detects stress, the HPA and SAM axes are activated, releasing a series of stress hormones, notably corticotropin-releasing hormone (CRH), glucocorticoids, adrenaline and cortisol (2)(1). Many cells involved in the body’s immune responses are influenced by the HPA axis and its secreted hormones, which is why stress has such a variety of far-reaching effects throughout the body (4).CRH release stimulates the anterior pituitary to release another hormone, Adrenocorticotropic hormone (ACTH). This acts on the adrenal cortex and adrenal medulla to release cortisol and other catecholamines (a specific type of neurotransmitter) to activate the sympathetic nervous system (SNS), the branch of the nervous system associated with the fight-or-flight response (5). The SNS is central in coordinating the body’s behavioral and chemical responses to stress (6). In fact, the skin also has fully functional peripheral HPA and SAM systems, where skin cells are able to produce CRH, ACTH, and catecholamines, and their receptors to detect and respond to the hormones (5). When the sympathetic nervous system is activated, it triggers the adrenal glands to release the catecholamines epinephrine and norepinephrine, causing changes in blood flow, immune function, and skin cell function in order to prepare the body for activity (6). The fight-or-flight reaction in the skin also sets off a series of behavioral and bodily changes to adapt the body to dealing with the pressure of stress which causes inflammation, itching sensations, and aging (1). One of the main hormones secreted and found everywhere as a result of stress is cortisol, which has a major impact on the body when there is an imbalance in conditions - when the body encounters a stressor. It is a member of the corticosteroids family and can be detected by glucocorticoid receptors - there are a very large number of these receptors on the surface of skin cells, which means the skin readily responds to stress. Research has shown that in addition to physical stressors that affect the body, UV exposure and emotional stress also increase the amount of cortisol in the skin (7). Prolonged exposure to stress-induced increases in cortisol and other corticosteroids are shown to impair processes that maintain health of the skin, including a decrease in collagen production which is essential in maintaining its elasticity and structure (4)(7). This also directly impacts skin barrier recovery with delayed wound healing, quicker aging of the skin, and a weakened immune response (7) which can trigger new conditions or make preexisting skin conditions worse (3).With the wide range of cells that are able to respond to a variety of stress hormones, there is a large number of responses in the body and skin that affect skin health. The diseases affected by this include, but are not limited to, acne, eczema, psoriasis, pruritus (severe itching of the skin), and could also make the body more susceptible to infection (1)(2). These can appear in stressful periods, such as with a breakout, or can be amplified by stress, such as worsened eczema and itching.Mind-body therapies (MBT) are shifting the way people think about health and well-being. It includes a range of holistic practices and treatments that take advantage of the two-way relationship between the brain and the body (6). Some easy strategies to implement when feeling stressed, or to prevent stress, include: meditation, exercise (in moderation - too much intense exercise can be a source of stress), and maintaining a healthy diet rich in antioxidants and anti-inflammatory compounds (2)(7).This type of treatment has been extended to “healthy aging” or “well-aging” (7). With the lifestyle that accompanies these therapies, the body is able to release another set of chemicals involved in the HPA axis, known for their association with a “feel-good” factor that has pain-relieving properties. Two of these chemicals the body produces, beta-endorphin and encephalin, are found in skin cells and have the ability to restore balance to the skin, thus allowing the re-introduction of regulation of immune responses, maintenance of tissue structure, and general healing (7). Therefore, engaging in such MBT activities that contribute to a healthier brain and body are shown to contribute to healthier aging, which improves overall skin health and can help in tackling skin conditions. Authors: Keira Barr, MD, Ashley WongMedically reviewed by Dr. Keira Barr, Board Certified DermatologistSources:
6 min read
sinus headache vs. migraine

Sinus Headache vs. Migraine: Identification and Treatment

The most common headache is a tension headache that usually comes as the result of stress, anxiety or muscle strains. They range from unpleasant to debilitating.  It can be hard to tell the difference between sinus versus migraine headaches. Early treatment can help reduce or eliminate the headache but if you don’t know which kind you have, it may be difficult to decide what to do or take.Both sinus headaches and migraines may exhibit the same or similar symptoms like a runny or stuffy nose, watery eyes, and most prominently, pressure in the forehead and cheeks.They do differ in that with a sinus headache there can also be a fever and the person’s breath may smell bad.When the passages (sinus cavities) behind the eyes, nose, cheeks and forehead become congested, a headache can occur.  The pressure or pain is not just in the head but anywhere in the sinus area and can be felt on either or both sides of the head.  Occasionally there is also fatigue, aching in the top of the jaw, or redness and swelling in the cheek area.They can occur because of the seasons like allergies, or at other times when something triggers a reaction.  These are severe headaches and they have additional symptoms including nausea, flashing lights or an aura sensation, sensitivity to light and/or sound, even temporary vision loss or vomiting.  Migraines usually only affect one side of the head, but not always.Triggers can include anxiety, alcohol, and hormonal changes.  Sometimes there are indicators a day or so before.At this time it is unclear if sinus headaches and migraines are related.There are a number of over-the-counter remedies for headaches available, like aspirin and ibuprofen.  Sometimes using warm compress on your head or shower can help.  There are also non invasive applications like massage, meditation and relaxation exercises. However, relief may not be immediate. If you can identify triggers, prevention is the best option though changing diet, or managing stress differently.There are prescription medications available to treat migraines that have been proven effective.  For sinus headaches that stem from infections, an antibiotic may sometimes be prescribed.If any type of headache becomes more severe or occurs more frequently, you should consult with a physician.  If you have tried OTC treatments but don’t receive enough relief, or if your daily activities have are becoming compromised, you should also make an appointment to have a thorough check up to rule out more serious issues.There are also some proponents of non-traditional or non-Western medical options.  Just be sure to loop your attending physician in on your choices.
3 min read
Egg Freezing Cost

Egg Freezing Cost

With age the fertility window and odds of natural pregnancy decline. Egg freezing is an option that many women seek out in a fertility clinic. However, high egg freezing prices are often a barrier to fertility preservation through egg freezing. The egg freezing process itself can cost up to $11,000. A study shows that out-of-pocket egg freezing expenses ranged from as little as $1000 per cycle to more than $18,000 per cycle. The average cost per cycle was $6966 (1). Remember that price shopping is a dangerous game to play when it comes to egg freezing. Patients should consider the expertise of the doctor, the lab the doctor works with, and the success rates of a particular clinic when making a decision of where to freeze their eggs. A smaller number of eggs in a more experienced clinic may yield better results than twice that number in a clinic with low success rates.Egg freezing cost also varies by geography with New York City being one of the costliest places to freeze eggs.Additionally, keep in mind that many patients may need more than one cycle to get pregnant or retrieve a number of eggs that give you higher chances of pregnancy. The more eggs you have frozen, the higher your chances are of having a live birth from them. Some clinics may also offer discounts for additional cycles done at the same clinic. Eggs frozen at a younger age are also more likely to yield a live birth and thus, patients who are older may want to freeze more eggs and undergo more egg freezing cycles than patients who are younger. On average, women undergo 2.1 cycles of egg freezing.In addition to the cost of the the egg freezing procedure, patients should also set money aside for the following costs:You will be using injectable medications that are required to stimulate the production of eggs around 10-12 days prior to the procedure. Egg freezing medications cost around $5000. There is also a fee to store the frozen eggs which can cost between $500 to $1000 per year. For USC fertility, egg freezing includes storage up to the end of the calendar year. All in all, the total egg freezing cost for one round without insurance can be up to $16,000 or maybe more depending on geography.This cost will incur at the time that you are interested to begin the fertilization process and is also not included in the egg freezing costs. Thawing, fertilization, and embryo transfer can cost $5000 or more. There are many different pathways for IVF and each of these has a different cost associated with it. In a situation where IVF is associated with a diagnosis of infertility, many states will mandate partial or entire coverage. Your ovaries develop a single egg per month. The egg freezing medications contain hormones that will stimulate your ovaries to produce more so you can have several available for retrieval. Most women above the age of 30 prefer to freeze around 20-30 eggs to maximize their chances at pregnancy.  Without the additional hormones you would not yield a high enough volume of eggs so egg freezing without hormones is generally not done. Whether insurance covers egg freezing is dependent on the terms of your insurance. It is generally not fully covered by insurance. However, if you have diagnosed fertility issues or are undergoing treatments (e.g chemotherapy), there are high chances it will be partially covered. There are many people who have insurance that covers a specific portion of the treatment. Employer: Some employer provided insurances will cover anywhere from 1 to 4+ egg freezing cycles. For example 27% of tech companies provide insurance that will cover reproductive procedures like egg freezing. This is much greater than the 14 percent of companies of those not in the tech sector that will cover such costs. (2)State: In some states, it is mandated that healthcare insurance cover fertility procedures. However, the rules on what is covered for fertility treatments can vary from state to state. According to the American Society of Reproductive Medicine there are 9 states that mandate medically necessary egg freezing (3):CaliforniaConnecticutDelawareIllinoisMarylandNew HampshireNew JerseyNew YorkRhode Island Sources: 
4 min read
Why is my vaginal area dark

Why is my Vaginal area Dark

With time we all expect to see a few age spots, sometimes called liver spots, or a darkening are usually on the hands, face, arms, or other areas that were overly exposed to the sun.  However, it may come as a surprise if you see the area around your genitals becoming darker.  While it is gradual, it may be a bit shocking when you finally notice it. The good news is that it is this is usually a normal process in aging and there is nothing to be concerned about.  It is called hyperpigmentation.  The color can be slightly different from one woman to another and women with paler skin tend to have less differentiation than others.  Darker skin will appear more brown.  It will affect the labia, scrotum, and anus. •         Hormones – The skin naturally produces melanocytes which, in turn, forms melanin, which is the same stuff that gives our hair, eyes, and skin its color.  In the genital area, this substance is particularly sensitive to hormones.  As our hormones change during puberty, pregnancy, and menopause, the color can increase.  In addition to the genital area, it can also cause darkening around the areolae of the breasts and even your anus.•         Friction – Intercourse creates friction and that will cause the melanocyte to increase in activity, creating more dark areas.  Skin folds in the groin can also become darker from daily rubbing against each other.  Some hair removal products and shaving will have the same effect.  If the area becomes inflamed like from a yeast infection or ingrown hair, this can have the same color change.•         Age – While it may seem like a fallback excuse, the fact is that getting older changes a lot of things, including pigmentation.  It is an accumulation of repeated trauma from shaving or intercourse and hormonal changes through the years. As a preventive measure, you can try to lessen the friction to minimize the darkening.  Some suggestions are:•         Avoid tight clothing especially underwear•         Moisturize your skin•         Limit the amount of sweat wicking clothing you wear•         Avoid excessive hair removal including waxing and shaving.  This can cause inflammation and folliculitis (red bumps or pimples caused by bacteria or infection). As mentioned, this is not dangerous in any way.  If you think it is due to some inflammation, keep close watch to be sure there is no infection.  Keeping the area clean and dry will help. However, any sudden or drastic change should warrant a phone call to your doctor's office.  They will probably run some tests to rule out any drastic systemic changes or pathology that caused the unexpected occurrence.  If there is itching it could be a reaction to some product or an infection. If you feel compelled to pursue this further, check with a dermatologist about safe options.  This is not a time for home remedies or suggestions from the internet.  Also, be sure it is your sole decision and not because someone else didn't care for it.  
3 min read

Sun Spot Removal: The Helpful Methods to Try

No one likes seeing sunspots, which are also called solar lentigines or liver spots. They are quite common though, with anyone able to get them due to sun exposure. However, they are much more common in those with fair skin, as well as those who are 40 years old and older. 1.    Intense Pulsed Light TherapyAlso known as IPL or photofacial, this utilizes laser technology, targeting one’s pigmented cells. It works with different wavelengths, focusing on removing the dark spots by heating up the cells and clearing it from your body.  Once cleared from the body, new skin cells appear and develop, replacing the dark spots. This method doesn't only remove dark spots, but it also removes unwanted tattoos or improve acne scars, too. Some clinics offer IPL with radio frequency, which evens out sunspots while giving a smoother and glowing skin.   2.    Chemical PeelWith chemical peels, it would encourage the skin to shed the top layer, including any damaged skin cells. This would help reveal the new and healthy skin underneath. Chemical peel would stimulate the body's collagen production, which is a protein giving skin structure, preventing any fine lines and wrinkles. During this procedure, a gentle acid solution will be applied on the face, and over the next few days, damaged skin cells begin to fall, so your skin gets a fresh start! There are different intensity levels for chemical peels, and your dermatologist will be the one to determine what you need based on your individual skin type. Besides removing sun spots, chemical peels can also help give you firmer and healthier skin, looking more vibrant with even skin texture and fewer acne scars.  3.    MicroneedlingThis is another treatment that helps in stimulating the body’s natural healing response, improving various skin conditions, like sunspots. This method uses a handheld roller that has fine needles, gently penetrating into the skin at a safe depth.  The penetration will help stimulate skin cells, encouraging it to produce collagen while repairing any affected areas from UV rays, among other factors or triggers. A lot of people prefer microneedling, which is said to be one of the most effective skincare solutions. It can also help fight against acne scars, aging, fine lines, stretch marks, among other skin issues. 4.    Microdermabrasion/DermabrasionThis treatment exfoliates the skin professionally. Using a handheld device, it will spray your face with fine crystals, polishing away your sun-damaged skin. It’s similar to a chemical peel, as it removes your skin's top dermal layer, getting rid of skin cells that have sunspots or show signs of aging. Throughout the process, it will encourage new tissue production, as well as the improved presence of collagen. I recommend using microdermabrasion, which is the gentlest option, as it’s the lighter version of dermabrasion.  But if you need a more intense method of removing sunspots, dermabrasion is a good option. With that said, it isn't suitable for all skin types and not necessary in most people. This will require a consult from your dermatologist to determine which method is safe and suitable for your current condition. Wrapping It UpI hope that this list of methods and treatments for sunspot removal can help you find the most suitable one. Head to your dermatologist for them to make the right recommendations and weigh the pros and cons of each.
3 min read
herpes vs hpv

HPV vs Herpes: What Are the Differences?

When talking about sexual health and sexually transmitted disease (STD), there is no question that is too specific or 'dumb' to ask. The more you ask, the more you learn about sexual health to prevent any negative consequences. Among all the different questions asked, one of the most common is regarding the differences between HPV vs herpes. This is actually a frequent question since HPV and herpes are the two most common STDs. Almost 80 million Americans have human papillomavirus (HPV), while 1 in 8 people between 14-49 years old has genital herpes. To learn more about the difference between these two conditions, read on! The reason why many people are unsure of what they have (HPV or herpes) is because both are common STDs that have many similarities. Both of them cause genital lesions or have no symptoms at all. With that in mind, here are some of their key differences: Those who have HPV don’t usually experience any symptoms at all. You might not even realize you have it!  However, the most common symptom is warts, though since there are over 150 HPV types, the symptoms depend on the type you contracted. Some can cause warts, others may increase the risk of you developing HPV-related cancer. Warts can occur in the genital area or the mouth and throat, growing as single growths or a cluster of growths, even looking like a cauliflower. As for herpes, there are two types: HSV-1 and HSV-2. Both types can affect parts of your body, causing either oral or genital herpes. Similar to HPV, herpes might not have symptoms or very mild to unnoticeable symptoms that you may confuse with other things, like ingrown hairs, skin conditions, or the flu. The symptoms depend on where herpes affects you. Either way, you are most likely to experience flu-like symptoms, redness, swelling, itching, or pain in the infected area, blisters or cold sores, among others. The way it was spread is also different. With HPV, it is through skin-to-skin contact with an infected person through vaginal, anal, or oral sex. With herpes, it can either be skin-to-skin contact or through saliva.To diagnose HPV, you can undergo an HPV test, which is also sometimes used during Pap tests. Or, visual examination of warts may diagnose certain cases. For herpes, physical exams are done if there are lesions taken. Samples may be taken to the lab to diagnose the viral cultures.  When treating HPV, the virus can't be cured, though you may be prescribed drugs for warts, or they can be removed when necessary. HPV that was noted from a pap test may have to be managed differently. The same goes for herpes, as the virus can’t be permanently cured as well. There are antiviral drugs that can treat symptoms and reduce any outbreaks. Prevention is similar for the two sexually transmitted diseases. While there isn't a way to eliminate the risk of the conditions, you will need to practice safe sex and make sure to get routine screenings. Make sure to practice safe sex not just for anal or vaginal sex, but for oral sex as well.  Hopefully, you were able to learn more about your sexual health and learn the differences between HOV and herpes. This will help you learn how to observe the symptoms and know what to tell your doctor in case you suspect an STD. Make sure that you use protection and safety precautions before intercourse to prevent this from happening, though! If you have any questions or would like to share your knowledge on sexual health and STDs, do comment below, all your thoughts are greatly appreciated.
4 min read

What is Endometriosis?

Vaishnavi Purusothaman, MDMaddie Cheong Medically Reviewed by Dr. Vaishnavi Purusothaman, Ob-GynEndometriosis is a disorder where the tissue that is similar to the tissue lining the uterus, known as the endometrium, is found in places outside the uterus. Some common places that endometriosis implants can be found are the fallopian tubes, the ovaries, the bladder, and the colon (1). Endometriosis on the ovary is called an endometrioma, which is a fibrous cyst filled with old blood, similar to a “blood blister” (2). Endometriosis affects approximately 10% of women and is most commonly diagnosed between 30 to 40 years of age (1). Endometriosis is more common in some women than others.  Women with a first- degree relative with a history of endometriosis or infertility are more likely to have endometriosis. Additionally, women giving birth for the first time after the age of 30 are also at greater risk of developing endometriosis (2). Menstrual cycles also play an important role in indicating the potential presence of endometriosis. Women experiencing short cycles (less than 27 days between periods) or unusually heavy cycles that last more than 7 days are also at a greater risk of having endometriosis (3). Symptoms of endometriosis are often concentrated in the pelvis, and can include pain during your period, pain during or after sex, and pain during bowel movements or urination. There are many ways in which endometriosis can cause pain. Just like the endometrium found in the uterus, endometriosis tissue found in other areas can also bleed once a month, causing inflammation and pain. Another reason for the pain may be due to endometriosis lesions pressing against nerve cells, relaying pain signals to the brain. Finally, it is also possible that chemicals released by the endometriosis lesions may cause pelvic organs to stick to each other and create scar tissue, which can also cause pain. However, it is important to note that the size or number of endometriosis lesions in the pelvis do not correlate with the severity of pain (4).  Moreover, not all women with endometriosis will display symptoms: approximately 25% of women with endometriosis are asymptomatic (5).About 40% of women with endometriosis experience infertility (1). Women with infertility are 6-8 times more likely to have endometriosis, and 30-50% of women with infertility have endometriosis (5). Endometriosis likely affects fertility through many mechanisms. Endometriosis on the ovary (also known as an endometrioma) has been shown to affect egg production and ovulation. Additionally, the inflammatory environment produced by endometriosis lesions has been shown to affect the quality and function of eggs, sperm, and embryos. Transport of the gametes (egg and sperm) is also affected by this inflammatory environment. The inflammation can alter motility in the fallopian tube and the uterus, which affects both fertilization of the egg and embryo implantation. Finally, endometriosis is thought to potentially alter the uterine lining by making it less receptive for an embryo to implant (6). Treatment of endometriosis often depends on the severity and frequency of symptoms. Mild symptoms can often be treated with over the counter pain medications, such as ibuprofen, that work to combat the inflammation caused by endometriosis. Another option is hormonal birth control, which can work to quiet the endometriosis lesions and make them inactive. There are also injectable and oral medications known as gonadotropin-releasing hormone (GnRH) agonists and antagonists that have been shown to alleviate pain. While these GnRH based treatments are very effective, they can be associated with side effects including hot flushes, vaginal dryness, and decreased bone density. These effects can be mitigated by using add-back hormonal therapy and using shorter durations of treatment (7).  Surgery is also an option for management of endometriosis. Surgical options can range from minimally invasive laparoscopic surgery to remove endometriosis lesions/implants to open abdominal surgery to do the same. Definitive surgical treatment of endometriosis involves removal of the uterus, fallopian tubes, and ovaries, and is used to treat patients with severe endometriosis who have not responded to other therapies (2). However, surgical treatments do not guarantee patients a complete eradication of symptoms; about 15% of women experience a recurrence of endometriosis related symptoms even after definitive surgical treatment (7).  References     
5 min read
PCOS Diagnosis Criteria

PCOS Diagnosis Criteria and PCOS Treatment

Polycystic Ovary Syndrome, abbreviated as PCOS, is a hormonal condition characterized by any two of the following: ·   Irregular menstrual periods·   Having signs or lab values of excessive androgens (“male hormones”)·   Polycystic ovaries on ultrasoundIt is the most common hormonal disorder in females of reproductive age (1). Females are at higher risk for PCOS if they have family members with PCOS or are obese (2). The following PCOS symptoms are a generalized group that have been noted in individuals with PCOS in the past, but they overlap with many other diseases. If you have any combination of these symptoms, it does not always mean you have PCOS. Rather, they are an indicator that it might be good to check if you do.See: PCOS Symptoms for more ·   Insulin Resistance·   Diabetes·   Weight gain·   Patients can have enlarged ovaries that have multiple cysts or follicles surrounding them. This can be seen on ultrasound·   Irregular menstrual cycles (less than 9 periods/year or intervals over 35 days)·   Pelvic pain·   Fertility issues ·   Hirsutism (excessive hair growth)·   Alopecia·   Acne·   Acanthosis nigricans (patches of thick, darkened, velvety skin in armpits, neck, and groin)·   Skin tags ·   Patients can have mental health struggles - specifically depression. There are many potential genes and environmental factors that can work together to cause PCOS. Doctors aren’t sure what exactly causes PCOS itself, but some of the factors that cause the endocrine changes of PCOS are: Androgens are sometimes called “male hormones” because male bodies generally make more than female bodies do. In females with PCOS, the hormones are out of balance since they have higher than normal levels of androgens, which can interfere with ovulation, cause ovarian cysts to mature, and cause symptoms like excess hair growth or acne (2). Insulin is the hormone produced by the pancreas which helps move sugar (aka glucose) from the blood into the cells to use as energy. If cells are “insulin resistant”, it means they might need 2, 3, or 4 molecules of insulin to open up each cell instead of just the normal one, and glucose stays in the blood at first. The body then starts to think it didn’t make enough insulin, so it produces more insulin to drive the glucose into the cells. This increase in insulin levels increases the production of androgens. For younger females with PCOS, their pancreas can usually keep up with the increased need for insulin production, but this can cause problems (including diabetes) later in life when the pancreas slows down. High insulin levels are also linked to a skin condition called Acanthosis nigricans (2). Your endocrinologist can monitor your insulin and androgen levels through blood exams, and work with you to come up with a treatment plan as needed. Insulin resistance is the key focus of endocrinologists when it comes to PCOS, since it can affect so many other factors in the body, as described above. Folks with PCOS who have insulin resistance can also have low levels of HDL (high density lipoprotein, aka the “good cholesterol”) and high levels of VLDL (very low density lipoprotein, aka “bad cholesterol”) and triglycerides (4). Your doctor will monitor cholesterol levels to check the status and see if any medication is needed to treat it.PCOS is closely linked with obesity, based on multiple epidemiological and genetic studies. In fact, a significant proportion of folks with PCOS (anywhere from 38-88%) are either overweight or obese (6). Insulin resistance and elevated insulin levels (hyperinsulinemia) are contributing factors to weight gain in PCOS. Your doctor can help with the weight gain through making diet and exercise recommendations that work best for you.Folks with PCOS have been shown to have higher rates of coronary artery disease (CAD). This is associated with the increased cholesterol levels, increased insulin resistance, weight gain around the abdomen, and hirsutism (6). Your endocrinologist may work with a cardiologist and your primary care physician to work on a diagnosis if they suspect cardiovascular disease.  Since the symptoms of PCOS can potentially overlap with other endocrine and non-endocrine causes, the best way to know if you have PCOS is to visit your primary care physician or an endocrinologist. By reviewing your blood work, insulin levels, and listening to your history, they can accurately diagnose and recommend a plan of care or follow-up.Check out How to know if you have PCOS for more PCOS is not curable but it can be treated. PCOS is treated differently in each individual, depending on the cause and severity. Your primary care physician or endocrinologist will obtain your medical history, blood tests and possibly ovary ultrasound imaging to recommend a plan of care. Treating PCOS involves (1): In overweight or obese folks with PCOS, exercise and calorie-restrictive diets are a first line treatment to help with weight loss and insulin resistance. Your healthcare provider may recommend a hormonal contraceptive since they have been shown to help keep the acne, irregular menstrual periods, and hirsutism under control. According to the Endocrine Society, there’s no particular form of hormonal contraceptive that’s best overall. So, you will work with your provider to figure out which form of hormonal contraceptives are best for your body. Metformin is given to PCOS patients who may have Type II Diabetes or insulin resistance that doesn’t adjust with lifestyle modifications. It also helps with improving menstrual cycles. Infertility treatments can be given to patients whose PCOS has impacted their fertility, if they wish to have children. Patients can work with their primary care physicians, endocrinologists, and also REIs (reproductive endocrinology and infertility physicians) to determine the best course of treatment.PCOS is a challenging condition that affects many persons. It requires involvement from multiple doctors including your Ob Gyn, an endocrinologist, a dermatologist, and possibly a mental health professional.Sources: 
7 min read

The Types of Fibroids You Should Be Aware Of

Fibroids are abnormal growth which develops in or on a women's uterus. These tumors may sometimes grow large, causing abdominal pain and heavy periods. Other times, they may not come with any signs or symptoms at all.Fibroid growths are usually benign or noncancerous, with the cause unknown. They are also known as myomas, fibromas, leiomyomas, or uterine myomas. Up to 80% of women may experience this by the turn they turn 50 years old, with most of them now having any symptoms, thus not knowing they have it. There are even different types of fibroids one must be aware of. So read on to find out what fibroid types are there. There are four types of fibroids, with each type developed depending on the location in or on one’s uterus. ·         Intramural fibroids are the most common type, appearing within the uterus’ muscular wall. They might grow larger, stretching the womb.·         Subserosal fibroids would form outside the uterus, which is known as the serosa. They might grow big enough to the point your womb appears larger on one side.·         Pedunculated fibroids are subserosal tumors that develop stems, which is a slender base supporting the tumor.·         Submucosal fibroids are tumors that develop in one’s middle muscle layer, called the myometrium, of the uterus. However, these aren’t as common compared to the other types mentioned.  While the causes of fibroid development are unknown, several factors may influence its formation, such as: Hormones produced by the ovaries, estrogen, and progesterone, would cause your uterine lining to regenerate every menstrual cycle. This may stimulate fibroid growth.Fibroids might run in your family, especially if your grandmother, mother, or sister has this condition.Pregnancy will increase the production of estrogen and progesterone in the body, which is why fibroids might develop and grow rapidly during this time. ·         Pregnant women·         Those with a family history of fibroids·         Women over 30 years old·         African American women·         Those with a higher body weight The symptoms experienced depend on how many tumors one has, as well as their size and location. For example, submucosal fibroids would cause heavy menstrual bleeding, with women having issues conceiving. For very small tumors or women going through menopause, you might not experience any symptoms, as fibroids would shrink during and after the stage. Women who experience menopause will experience a drop in their hormone levels, which are the ones that stimulate fibroid growth. Besides this, here are a few common symptoms of fibroids: ·         Menstruation lasts longer than what you’re used to, or heavy bleeding during your periods, including blood clots·         Pain in the lower back or pelvis·         Increased menstrual cramping ·         Frequent urination·         Pain during intercourse·         Feeling fullness or pressure in the lower abdomen·         Feeling an enlargement or swelling in the abdomen If you experience any of these symptoms, do have it checked by your gynecologist, who will perform a pelvic exam. Your doctor may also have you go through other tests, such as an ultrasound or pelvic MRI.  Fortunately, there are medications and home remedies you can follow to help with the symptoms. Wrapping It UpI hope that this article helped you learn more about the types of fibroids and what the condition is. Do become more acquainted with similar conditions so you know when you need to see a doctor to get checked. Stay healthy! If you have any questions or want to share your knowledge on fibroids, share them in the comments section below. All your thoughts are much appreciated. 
3 min read
infant reflexes

Infant Reflexes

Each of us is born with ingrained abilities; things no one needs to teach us, like blinking.  Here are some of those infant reflexes we all came equipped with at birth. •         Newborn crying: The sound every parent wants to hear is that first burst of crying at birth.  As you spend more time together, you will begin to recognize differences in the pattern and identify a hungry cry from a distress cry.•         Sneezing: Sneezing is an automatic reflex to get rid of irritants and excess mucus from the nasal area.  It does not necessarily mean a cold is coming on.This is an automatic response of the baby that includes sucking sounds when the baby's mouth or lips are touched.  This is a stimulus to eat and helps the baby find and latch onto the nipple.  This will only happen when the baby is hungry.  This should last until around the four month period.•         Sucking and Swallowing: This is the innate ability of feeding.  This ends between the second and fourth month when the baby is able to seek the nipple by choice.•         Stepping: As you hold your baby by the armpits and the baby's feet touch the floor, you will usually see one leg bend and the other straighten.  This is a reflex the baby developed in the womb in order to move around and prevent pressure sores.  At about two or three months this asymmetry  •         Calming: There are several techniques to soothe an upset baby.  Swaddling, side/stomach position, shushing, swinging, and sucking all will aid the child to calm down and in turn ease the stress on a parent.  Experts think that this is developed to prevent the baby from too much movement just before birth to avoid breech positions. It always gives an adult great pleasure when a baby grabs onto a finger with that tiny hand.  Actually in the animal world, it is critical to some species like apes and koalas that cling to their mother's fur while climbing trees.  Just be careful with your own child because before long those fun fingers will find their way to jewelry, glasses, and other tempting items.  This is sometimes called a startle reflex or “I'm falling”.  It is when the baby's arms open wide and then close into a bear hug.  This is to catch themselves from falling or thinking they are falling.  This will extend until the baby is about four or six months old.  Swaddling will prevent it from happening.  If it is not controlled early, it can result in over-sensitivity to other stimuli.  Growing up it can lead to impulse control, motion sickness, and anxiety.   There are a number of other infant reflexes that you can learn about.  If you find that your child is not demonstrating one or more, consult with your doctor to rule out other problems.  Similarly, if they do not disappear when scheduled, talk about it.  Maintaining some of these conditions could indicate an underlying problem that you want to identify as quickly as possible.
3 min read

How Does Breastfeeding Work?

Have you ever wondered, How Does Breastfeeding Work? From the way breast milk is made down to the process your body experiences to help provide your little one the nutrients he needs, there is a beautiful and interesting process to learn about. So read on to know more about breastfeeding and where milk comes from! Breastfeeding doesn’t start after you give birth! It actually begins when you’re in the middle of your pregnancy already. Here is the process:  The first milk the breasts create is colostrum, which is a thick and yellow-colored fluid, a concentrated source made of protein, minerals, and immune-protective factors. Your breasts begin making them halfway through your pregnancy. That's why during pregnancy, you may experience higher levels of prolactin, a milk-making hormone, in your bloodstream. But don't expect that your breasts create large volumes of breastmilk since you have high levels of progesterone, a hormone which ensures milk volume created stays low.

 After the birth of the placenta, the third stage of labor, your progesterone levels are reduced, allowing prolactin to begin making even larger volumes of milk about 40 hours after giving birth.  But before this process, the breastmilk created will be driven by hormones. Take note that the amount of milk made will be determined by the amount of milk removed. So even if you create larger volumes of milk around 40 hours after giving birth, it usually takes a bit longer before mothers feel the breasts creating larger volumes of milk, as well as the milk coming in.

 When your little one suckles at your breasts during feeding, this stimulates the nerve endings. This would cause oxytocin, a hormone, to release in the bloodstream. The hormone will make the muscles around the glandular tissue in the breasts contract, which would then push milk into milk ducts and come out from your nipple openings. This is a process called the milk ejection reflex, which is how your little one is able to breastfeed from you.

 When feeding your little one when he requires feeding, your breasts will make sure that he receives the milk he needs. And the more milk removed from your breasts, then the more milk they create. The less milk removed from the breasts, less is created. But this may leave you wondering if your breasts ever get empty or if you’ll have to wait for a certain time period for your breasts to fill with milk before breastfeeding again. Well, do remember that your breasts will never be empty, and you don’t need to wait for them to fill with milk before feeding again. Breastmilk is made continuously, and your little one drinks about only 2/3 of available breastfeed during every feed. Furthermore, the more drained your breast is, it may create a higher concentration of higher calories and fat-rich milk. The less drained your breast is, then the higher concentration of lower-fat and lower-calories. But regardless, it’s crucial to feed your baby whenever your little one needs to be fed.

I hope that this article gave you insight into how breastfeeding works and its process. This will help you know what to expect and provide the necessary advice on how to feed your little one.   Begin learning more about the wonders of pregnancy and breastfeeding to prepare for your little one in the next few months now! Good luck and stay healthy.
3 min read

Is Insulin A Hormone?

Yes.  Insulin is a hormone produced in the pancreas.  The pancreas is a glad situated behind the stomach that helps the body process glucose for energy.  Glucose is a form of sugar and is found generally in carbohydrates.The way it works is that the digestive tract breaks down carbohydrates and converts them to glucose.  Glucose migrates into the bloodstream through the small intestine.  Once glucose is in the blood, insulin will allow the cells to absorb the sugar and turn it into energy. If there is too much glucose in the blood, insulin notifies the body to store excess glucose in the liver.  When the glucose levels are lower, it is released.  The lower glucose levels are generally between meals or in times of stress.When the body doesn't use insulin properly or doesn't produce enough insulin, the diagnosis is diabetes.  •         Type 1 – This is considered an autoimmune disease.  The body simply cannot produce insulin. The body's immune system has malfunctioned and destroyed all the cells in the pancreas that produce insulin.  This is a condition that is more common in young people but certainly can occur in adults.•         Type 2 – In this case the body needs more insulin to get the same effects, so it produces more in order to keep glucose levels normal.  After too many years of overproduction, the cells in the pancreas that produce insulin wear out.  This can happen at any age but most commonly in later life. Insulin injections are used to replace the insulin the body is unable to produce.  Type 1 diabetics must inject insulin.  Type 2 diabetics can often regulate the insulin through lifestyle changes and oral medications.  If these measures are ineffective, the type 2 diabetic will need to begin insulin injections. All types of insulin produce the same effect, they imitate the natural insulin that is no longer being produced.  However, there are some variants in the type of insulin available.•         Rapid-acting – This insulin takes effect about 15 minutes after injection and lasts for about three or four hours.  It is most generally used before meals.•         Short-acting – This begins working in about 30 to 60 minutes and will last five to eight hours. Again, this is generally taken before a meal.•         Intermediate-acting – This will take about one or two hours to work but the effects last 14 to 16 hours.•         Long-acting – Although this does not take effect for as much as two hours, it will last 24 hours or longer. The need to inject insulin means significant lifestyle changes including monitoring blood glucose levels regularly and knowing when and how much to inject.  Under the care of a physician, you can create an effective treatment plan that can help keep you as healthy as possible for as long as possible.  It is important to treat this condition seriously and to keep all regular appointments, test blood as directed, and follow any other instructions.
3 min read

What are Inverted Nipples?

If a breast nipple points inward instead of out, it is known as an inverted nipple.  An inverted nipple is when the whole thing is inward and sometimes even below the surface of the colored portion of the breast, the areola.  Usually they will move back outward when stimulated, but in some cases they do not. This is more common than you might think.  It can happen with men as well as women and can be one or both nipples.  The person can be born with it or it may develop over a period of time.  However, if it happens suddenly or you have pain, contact your doctor right away. If it has been present since birth, it is because the connective tissue is tight or there is a problem with the ducts.   If it develops later, usually as an adult, but not always, it is an indication of some serious issues:•         Breast cancer including Paget's disease•         Duct ectasia, where the milk duct is thickened and can become clogged with fluid•         Fibrocystic breast disease•         Mastitis, or a clogged milk duct•         Surgery or trauma•         Tuberculosis, although this is rare Long term nipple inversion or retraction doesn't usually cause any problems except that breastfeeding can be challenging.  In this case it is beneficial to work with a lactation specialist.  In fact, breastfeeding has been shown to reverse this condition. Cosmetically this inversion can be annoying or embarrassing.  One low tech solution is a breast shield.  This is a plastic device that fits over the nipple.  Gentle but continuous pressure will slowly force the nipple outward.  Another solution is a suction that works in much the same way.  After a few weeks, the problem is resolved. There are also surgical options.  Once the only solution was to cut through the milk ducts in order to release the nipple.  This version means that the woman will be unable to breastfeed.  Newer techniques preserves the milk ducts.  The breast tissue fibers are released in order that they can spread and stretch and involves only a small incision in the areola.  Generally a few sutures are placed that can be removed or dissolve within a few weeks.  Either of these operations are considered cosmetic and are not covered by most insurance policies.  If you are interested contact a plastic surgeon for details. With age, the nipples may change, like most parts of our body.  Being familiar with the normal look of body parts, including the nipples, can alert you to some change that is not normal and can be an indicator of something more serious.  While this is not necessarily a sign of breast cancer, it can be an indication that something is wrong.  If the inversion occurs suddenly or if you notice any discharge or bleeding, this can also be a sign of some more serious condition.  In those events contact your physician promptly.    
3 min read
is my vagina normal

Is my vagina normal? Plus a Female Anatomy Chart

I see lots of women in my office with completely normal vulvar anatomy who ask "Is my vagina normal?". Many of us worry about this part of the body and how we measure up.  Everyday someone apologizes to me for not shaving, not showering in the past 2 hours, having a perceived abnormal odor, or even for just needing an exam.  All of this is pretty typical behavior and shows how anxious we are about our genitalia.  It is normal to wonder about odor, symmetry, length, width, and hair distribution.  There are lots of reasons why this happens.  ●        Most of us aren’t comfortable talking about our pelvic anatomy.  We may not even have the right words.  A study from the Eve Appeal, a British advocacy group, showed that only a third of women in the UK could identify the different parts of the female anatomy.●        Female sexual organs are mostly on the inside, resulting in some mystery and mystique.  Since we don’t see them, it is hard to recognize the full spectrum of normal.  Boys grow up changing in locker rooms and using urinals and have a much better understanding of their “normal.” ●        Media attention to the vulva tends to focus on a “Barbie-Doll” like image- hairless and fairly undefined.  This anatomy doesn’t really reflect normal or natural but is the standard comparison.1  ●        Medical images of the vulva focus on the location of the different organs but do not illustrate the great variation in size, shape and color that exists.●        Grooming and removing the pubic hair has become more common.  Removing the hair raises awareness about the vulva and can reveal personal asymmetries.2  Just like my left foot is slightly bigger than my right.●        There is an increasing amount of marketing about cosmetic genital surgery which suggests that there are lots of abnormal vulvas out there that need to be fixed.  Surgeries to make the labia minora smaller have increased 50% since 2014. There is also an increase in direct to consumer advertising about vaginal “rejuvenation”- a term used for laser and radiofrequency treatments of the vagina.  These procedures are poorly studied and not currently FDA approved but popular.2   Well, lets start with vulva anatomy 101.  female anatomy chartThere are the labia majora (big lips that are on the outside, one on the right and one on the left) and the labia minora (small lips that are more to the middle, one on the right and one on the left).  Not all things in anatomy are well named but these structures are, the names mean big and small lips.  The labia majora are usually about 8 cm long (just over 3 inches) and 2.5cm wide (1 inch).  This is roughly the size of my pointer finger.  But their dimensions are highly variable and usually change based on your weight.  These labia are analogous to the scrotum.  These lips have sweat glands and hair.  They are pigmented and have fat tissue.2The labia minora tend to be thinner.  On average, they are 4 cm long and 1.5 cm wide.4  That is a little smaller than my pinky.  Their size is highly variable, however, and depends on age, estrogen status, genetics, and the number of deliveries you have had.  These lips have little fat and no sweat or hair glands.  Jamie McCartney , an artist who did a project called “The Great Wall of Vagina” said, “There are as many appearances of the vulva as there are of the face.”  And that is largely because of the many normal shapes and sizes of the labia minora.  The labia minora often stick out past the rest of the anatomy.  Sometimes, they are tucked away.  One side can be bigger than the other.  Studies have shown that perfect symmetry is rare and one side is almost always bigger than the other.2,3  The labia frame the introitus which is the opening to the vagina.  The introitus can  get larger with deliveries and time.  It tends to be smaller if your levator or kegel muscles are strong.  An average size in 2-4 cm.  There is no magic “right size” to the vaginal opening.  And while it is common to think smaller is better, sometimes smaller just results in pain with sex.  The clitoris is at the top (12 o’clock).  It is around 4.5mm wide and 7mm long, roughly the size of a jelly bean.2 The anatomy is really only considered to be abnormal if it actively creates problems for you.  “Abnormal” is not diagnosed based on size and shape.  There have only been 3 times in my career when I have asked someone if their labia bothered them based on their appearance.  And only 1 woman felt that they were a problem.  The labia minora can be uncomfortable or painful if they are long enough to rub on clothing like skinny jeans.  They may also be bothersome during sports, like bike riding.  The labia can be torn during a delivery or an accident.  This can result in a sensitive area or big changes in the appearance of one labia.  They can pull and be uncomfortable during sex.  But if they aren’t causing physical symptoms, the rule of thumb is to leave your sensitive labia alone.   If you are more of a visual person and need to see the huge range of normal in the vulvar anatomy, check out the Great Wall of Vagina at greatwallofvagina.co.uk .  This project, which amazes me on so many levels, took 400 volunteers, aged 18 to 76, and created plaster casts of their vulvas.  Ten panels were then made out of the casts.  The goal was to normalize the anatomy.  And as they say, a picture is worth a thousand words. 
6 min read

What is Colic in babies?

Colic in babies is one of those mysterious diseases that come upon some babies and not others.  A healthy infant who is neither hungry nor needs a diaper change but who cries for more than three hours a day, more than three days a week, and/or more than three weeks, is diagnosed as colic.  Here are a few things we do know about it:•         Onset is at bout 2 weeks of age for a full-term baby but later for a prematurely born child.•         Dissipates at about 3 or 4 months of age, without any medical intervention.•         Can happen without regard to gender, birth order or whether they are bottle fed or nursed.•         There are no long term or residual effects.  The child will grow up normally. There is no definitive explanation for colic.  There are, however, some theories:•         Muscle spasms in a growing digestive system.•         Hormones•         Sensitivity to stimulation like lights or noise•         Development in the nervous system•         Early form of childhood migraine•         Emotions like fear, frustration, or excitement If you have ongoing concerns, there are tests the pediatrician can order to rule out other issues like:•         Infection•         Acid reflux•         Stomach issues•         Eating disorder•         Sensitivity to formula or milk•         Issue with the eye like a scratch•         Uneven heartbeat•         Injuries•         Inflammation in the brain or nervous system The symptoms usually appear in the evening, but if not then, usually at the same time each day.•         No apparent reason for the crying•         Appears that they are in pain•         Clenched fists, stiff arms, arched back, curled legs•         Turning bright red The persistent crying can cause the baby to swallow too much air.  This can accumulate in the stomach as gas and give the infant a tight or swollen belly. Colic is a diagnosis of exclusion.  That is after other possibilities are eliminated, colic is what is left.  The doctor will probably want to know about the symptoms and any other medical issues the baby may have or had.  The physical exam will include looking at:•         Energy level•         Skin color and tone•         Breathing•         Temperature•         Weight There is no standard treatment for colic and the condition usually remedies itself at about 4 months old.  There are some recommendations the doctor will make.  •         If you are breastfeeding, check any medications the mother is taking or foods that may be causing the baby to form an allergy.•         Try changing the baby's position from lying down to sitting up.•         Walk around with them or rock.•         Swaddle•         Hold them bare skin to bare skin•         Use white noise•         Put them in a swing or vibrating seat Parental Self Care Being a new parent is a challenge in itself.  Couple that with colic and parents are going to get more testy, overwhelmed, or express other emotions.  It is just as important to take care of yourself as the baby.  Ask for help from friends, family, or babysitters.  The baby will recognize when your own stress has been lowered and will respond.      
3 min read

Women Heart Disease Symptoms

Heart disease is a catch-all term for several heart conditions including heart attack and coronary artery disease. In the United States, heart disease is the leading cause of death for women - far exceeding all cancers combined! Every year, heart disease is responsible for 1 in every 5 deaths in women (1). Symptoms of heart disease, particularly heart attack, can be different in women than men, and women are less likely to receive proper treatment for their heart conditions than men (2). As a result, it’s super important to be aware of the possible symptoms and risk factors. Here’s what you need to know.A heart attack, or myocardial infarction, is a sudden loss of blood supply to the heart that can lead to death. It is usually caused by a clog in an artery that delivers blood to the heart. The main risk factors for heart attack are high blood pressure, high cholesterol, and smoking (4).Symptoms of heart attack can be different between men and women, with women sometimes having less classic or obvious symptoms. Women can and do have chest pain, but not always (3). Symptoms of women’s heart problems can include:Importantly, women sometimes experience atypical heart attack symptoms like fatigue and nausea that are not commonly recognized as concerns for a heart problem. Especially when chest pain is not always present, women may mistaken their symptoms as indigestion or a muscle ache. It is important to be aware of these unusual symptoms, especially in those who have risk factors for heart disease, in order to seek prompt medical care. Heart attacks are a life-threatening emergency where every second matters. Just as important as recognizing symptoms, understanding the risk factors for heart attack is crucial in order to prevent heart disease in the first place.As mentioned, the three most common risk factors for heart attack are high blood pressure, high cholesterol, and smoking. Just under half of Americans (47%) have at least one of these three risk factors (1).Genetics play a role as well, and many other medical conditions and lifestyle choices can put you at a higher risk for heart disease. These includeAlthough some factors are not within our control, there is a lot you can do to protect your heart health. Adopting healthy habits for exercising, eating right, getting high quality sleep, and avoiding smoking can significantly lower your risk of developing heart disease. Pregnancy-related complications can increase a woman’s risk for heart disease later in life.Pregnancy in all women places excess strain on the heart. Pregnancy causes a significant rise in blood flow and therefore extra work for the heart (5). Some women also experience temporary increases in blood pressure and blood sugar levels. Pregnancy-induced high blood pressure, known as gestational hypertension, as well as pregnancy-induced sugar problems, known as gestational diabetes, are pregnancy conditions that usually resolve soon after childbirth. However, many women do not realize that even though the symptoms have resolved, having these pregnancy complications increases the risk of heart disease, high blood pressure, and diabetes later in life (5). In addition, preterm birth and pregnancy loss is linked to a 2-fold increase in risk of heart disease, heart attack, and high blood pressure (6).Women who have experienced these pregnancy complications should be sure to alert their primary care doctor so they can take this into account when assessing their overall cardiovascular risk. Additionally, it becomes even more important to control all other risk factors in order to lower the risk of heart disease.Aside from pregnancy related complications, women also have other unique risk factors for heart disease. Premature menopause, in which menopause occurs before the age of 40,  is linked to an increased risk of high blood pressure (hypertension), diabetes, and heart disease. Polycystic ovarian syndrome (PCOS), an endocrine disorder that can cause infertility, and many autoimmune and inflammatory conditions such as lupus and psoriasis also increase the risk for heart disease (6).Furthermore, depression and mental health issues linked with chronic stress can affect the cardiovascular system, increasing risk of heart disease. Depression is two times more common in women than men and is a known risk factor for heart attack (6).Sources:
5 min read
Voice is hoarse young woman

My voice is hoarse! How do I keep my voice healthy?

Authors: Dr. Anju Patel, Shielah MauntanaMedically reviewed by ENT Surgeon Dr. Anju PatelMany of us take our voices for granted. We sing, laugh, talk, and yell with our voices every day, so it’s easy to never think about losing our voices. However, it’s important that we keep our voices healthy so permanent damage doesn’t occur. The larynx, or more commonly known as the “voice box”, is a passageway made of various tissues including muscle and cartilage that connects the upper throat or pharynx to the lungs. It is located in the neck and contains the vocal cords (also known as vocal folds). Your vocal cords are made of multiple layers including two muscles that move to produce the sounds that make up your voice. When you are not speaking, your vocal cords are typically not touching and the passage is open so you can breathe. When you are speaking, the vocal cords come together as air from the windpipe comes through, making the vocal cords vibrate and produce voice. (1)  Vocal cords and larynx in addition to parts of the throat differ in size and shape, depending on the person. The differences between each person are what make each person’s voice quality unique. An obvious factor that can differentiate voices is a person’s sex. During puberty, testosterone in males causes an elongation of the larynx’s cartilage and thickening of the vocal cords, which all correlates to lower vibrational frequency when speaking, leading to a deeper sounding voice. Females have shorter and thinner vocal structures which correlate with higher sounding voice. (2)These differences mean females are more prone to vocal disorders due to the relatively higher stress their vocal structures must endure; thinner and shorter structures make higher frequency sounds, which must go through more oscillations and stress to produce voice. (2) Studies have also shown that females must use more respiratory effort to produce the same vocal amplitude or loudness as men. This can lead to increased stress on the vocal cords and lead to vocal damage. (2)  Vocal damage can cause an unhealthy voice. Anyone can develop an unhealthy voice. Those who work in a field of frequent voice use, like teachers and singers, puts their voice at greater risk for developing problems. This is just like athletes being more prone to muscle injury. An estimated 17.9 million adults in the U.S. report voice problems. (1) If your voice develops any of these qualities, you may be developing an unhealthy voice: hoarseness, inability to sing high notes (that you could before), sudden change in the pitch of your voice, an irritated or painful throat, and throat clearing. (1) An unhealthy voice is trying to tell you that there is something else going on in your body. A lot of things can cause an unhealthy voice, some are benign causes and some need serious medical attention. A few causes of an unhealthy voice include: using your voice too much/too strenuously, acid reflux/heartburn (the acid can cause irritation to your larynx), respiratory infection (inflammation of the throat and decreased air flow through the larynx, which affects voice), vocal cord/larynx cancer, neurological diseases (affecting the way your vocal cords move), and psychological trauma. (1) What do I do if I have hoarseness? What do I do if I have damage to my vocal cords?The best thing to do if you think you have a voice problem is to ask a doctor to assess you. A doctor who can best diagnose a vocal disorder is an otolaryngologist aka an ENT. They focus on disorders of the ears, nose, and throat. (1) They can further refer you to a specialist called a laryngologist, who can focus on your vocal concerns, help you build healthy vocal habits, and offer procedures to help if needed. (3) How to keep your voice healthy In order to keep your voice healthy, it is important to keep in mind the stress you put on it when you speak. Avoid shouting, throat clearing, and pushing your volume to its highest limits. Mind your voice when you are sick to prevent permanent damage to your voice. (3) Being dehydrated and drinking alcohol can put stress on the vocal cords as well, so it’s important to drink water. 60-80 ounces is the recommended daily minimum. (3) For the times when you feel you have to raise your voice to be heard - like in a presentation or while teaching in person, the use of a microphone can reduce the stress on your voice. (3) This way, you can be heard while protecting your voice. (3) When you can, it’s important to rest your voice. Continuous use over long periods of time, like during back-to-back Zoom meetings, can strain your vocal cords and lead to long-term damage to your voice. Resting your voice for at least 10 minutes for every hour of speaking is a good rule of thumb. (3) These tips will help keep your voice healthy and heard. 
5 min read
Honeymoon Cystitis

The Unplanned Part of Your Trip: Honeymoon Cystitis

Sometimes called “Honeymoon Disease” is cystitis (bladder infection) that occurs as a result of sexual activity. Cystitis can be triggered by other actions in addition to sexual relations and all the symptoms are about the same. It is basically a urinary tract infection (UTI).Usually there is a burning sensation during urination and feeling the need to use the bathroom excessively. The intensity can vary from one flare up to another.  Call the doctor or visit a clinic if symptoms worsen or prolong, or include:If you have had a UTI in the past and you now see the symptoms resume, contact your doctor, especially if the urge to urinate lasts for several hours and is painful. If you notice blood in the urine, don't hesitate to contact a medical professional.Also, if you completed a course of antibiotics and still have the symptoms or they return quickly, you may need a different type of prescription.Cystitis can also be chronic and is usually called Interstitial Cystitis. This is a bladder condition and is mostly painful pressure or burning in the pelvic area accompanied by a frequent need to use the bathroom. This mimics a UTI but is more serious. It is often difficult to diagnose and treat.Chronic cystitis is an inflammation of the bladder that can last for quite some time. It begins as a normal UTI when bacterial start in the urethra, grow and then spread to the bladder. If this infection moves into the kidneys, there is a serious problem that can eventually lead to sepsis, which can be deadly.  There is still much to be learned about chronic cystitis including its exact cause. However, we do know some of the triggers like:It has also been noted that the cystitis is associated with the menstrual cycle as well as wearing form fitting, tight pants.If you develop chronic cystitis, your doctor will probably recommend some options to improve your daily activities and to better manage the condition. These include lifestyle changes, medication and sometimes physical therapy.Lifestyle includes modification of your diet, staying hydrated, increasing physical activities, and reducing stress, when able. Some physicians will also suggest bladder training techniques. Some of these options include being sure your bladder is full before using the restroom and keeping a record of the incidents.If you suspect that the UTIs are a symptom of chronic cystitis, discuss options with your doctor, starting with a urinalysis to see if there is an infection.  If there is, antibiotics are the first line of defense. If conditions persist, it may be necessary to perform a cystoscopy. This is a minimally invasive procedure where the doctor inserts a very thin tube with a camera through the urethra and into the bladder to get a better idea of the condition of the organs.
3 min read

Uterine Fibroid Embolization

Authors: Dr. Sumeet Bahl, Nikhita YadlapalliMedically Reviewed by Dr. Sumeet Bahl, Interventional RadiologistUterine Fibroid Embolization and uterine artery embolization are treatments often talked about by physicians but it is difficult to find accurate information about it.  Uterine fibroids are the most common benign tumors in women of childbearing age. Most women develop fibroids by the age of 50, however, more than half of women do not believe they are at risk according to a survey conducted by Harris Poll on behalf of the Society of Interventional Radiology (1). Research has shown that uterine fibroids will affect 70 percent of white women and 80 percent of black women in the United States by the time they are 50 years old (2). These fibroids are made up of muscle cells and other tissues that grow in and around the wall of the uterus, or womb. They are typically not dangerous and do not spread to other areas of the body as with cancerous tumors. The cause of these fibroids is unknown. Risk factors include being overweight, African American, over the age of 40, high blood pressure, having no children, or a family history of fibroids (4).   Many women show no symptoms when they have fibroids. However for some, symptoms may include heavy or painful periods, bleeding between periods, frequent urination, pain during sex, lower back pain, declining energy levels or feeling “full” in the lower abdomen. Women with reproductive problems such as infertility, multiple miscarriages, or early labor may also have fibroids (4). Fibroids may be identified during routine gynecological exams or during imaging tests. Since most women do not exhibit any symptoms, diagnosis may be confirmed using images of the pelvis, including ultrasound or MRI. Symptoms often resolve after menopause but that may be too long to wait for many women.  One in five women believe that the only treatment is hysterectomy, or the complete removal of the uterus (1). If a woman wants to keep her uterus and have the fibroids removed, she may undergo a myomectomy. Other treatments include drugs that can slow or stop the growth of the fibroids, such as birth control pills. Women who experience no symptoms may not elect for treatment at all. For others, the symptoms may become debilitating to a point where the pain worsens quality of life.  There is a minimally invasive alternative to hysterectomy and myomectomy, known as uterine fibroid embolization (UFE). A majority of women, about 62 percent, have not heard of this option despite its use in clinical practice for over 20 years (1). UFE is a non-surgical treatment option, performed by interventional radiologists. They perform this procedure through a small incision in the skin, where they enter an artery in the groin or the wrist. Using image guidance, a catheter is used to deliver particles to the fibroids that will then shrink the fibroids and cause them to die. This treatment option has a shorter recovery period in comparison to surgical treatments and produces less pain for patients. Typically, patients are sent home the same day with an oral pain medication regimen for a few additional days. Recovery time is usually about one week before patients can completely return to normal activity (2).  UFE preserves the uterus while controlling the symptoms of uterine fibroids and improving overall quality of life. The risks associated with this procedure are uncommon and include bleeding, infection at the incision site or adverse reactions to the imaging agents used during treatment, and non-target embolization, meaning particles going to unintended locations (SIR). Some women may experience symptoms such as pelvic pain, cramping, nausea, vomiting, fatigue and discomfort within seventy-two hours of undergoing UFE. These symptoms usually resolve by themselves and should disappear within a week. Patients will be closely observed by the interventional radiologist for any signs of infection.   Women who undergo UFE, who do not have previous infertility factors may demonstrate an encouraging capacity to deliver after the procedure according to a randomized controlled trial conducted in 2017 (3). Many women, who want to completely preserve their fertility may decide to live with their symptoms or consider myomectomy, depending on the number and location of their fibroids. UFE offers an alternative to hysterectomy that preserves their childbearing capacity. Despite the prevalence of the condition, more than a third of women have not been diagnosed or do not know of anyone who has been diagnosed with uterine fibroids (1). The lack of discussion surrounding the topic and limited awareness of treatment options pose a challenge in ensuring women are making informed decisions regarding their health.   
4 min read

Vitamin D Covid 19 - Low Vitamin D Associated with Higher Covid Positivity Rate

Author: Dr. Anjanette TanMedically reviewed by Anjanette Tan, MD, FACE, ECNU, EndocrinologistWhen we speak of adding layers to our armamentarium against Covid infection, along with mass vaccination, hand washing, mask wearing, social distancing, I assert that we need to add vitamin D supplementation into this patchwork. Vitamin D Covid 19 is an important addition. Vitamin D is a hormone.  The production of vitamin D3 requires UVB light on the skin.  The rate of formation is dependent upon the intensity of UVB and the degree of skin pigmentation, as melanin blocks UVB from reaching the vitamin D precursor, 7-dehydrocholesterol (7-DHC).  There are very few natural food sources of vitamin D, except a little amount in fatty fish.  Food has to be artificially fortified with D.   Vitamin D2 is usually the kind used for fortification. Vitamin D3 is the kind found in fish and what the skin converts.  The difference between D2 and D3 is in the side chain in D3 that causes faster clearance from the circulation, leading to less conversion in the liver.   The liver is the major source of 25(OH)D production.  Vitamin D2/D3 is hydroxylated in the liver by cytochrome P450 oxidases.The kidney then converts 25(OH)D into 1,25(OH)D through 1alpha-hydroxylase, regulated by parathyroid hormone (PTH).  Vitamin D1,25(OH) is known as the active vitamin D, binding to vitamin D receptors that are practically everywhere.  Vitamin D influences over 80 pathways that promote DNA repair, decrease oxidative stress and decrease cell death.  It is shown to exert a positive impact on metabolic processes and is anti-inflammatory. Along with the vast applications and studies on the effects of vitamin D on the skeleton, there have also been many studies on its effects on the immune system.  Vitamin D has the ability to upregulate anti-inflammatory cytokines and downregulate damaging cytokines. This may possibly tamp down the “cytokine storm” that is shown to be a late effect of severe Covid-19.  Interestingly, there are also studies showing possible regulation of the ACE2 system, known to be the initial viral entry point, by vitamin D. Researchers therefore looked into the correlation between vitamin D deficiency and SARS-CoV-2 positivity rates.   Kaufman et al, in a retrospective, observational analysis, looked at vitamin D 25(OH) levels drawn from 191.779 patients from all 50 states.  It was found that SARS-CoV-2 positivity rate was higher in those who were vitamin D deficient (<20 ng/mL) compared with those who had adequate levels (30-34 ng/mL) and those whose values were 55 ng/mL and over.  SARS-CoV-2 positivity was strongly and inversely associated with circulating 25(OH)D levels, a relationship that persisted across latitudes, races/ethnicities, both sexes and age ranges.  This means that SARS-Cov-2 positivity was found to be higher in those who had lower vitamin D levels.  The risk of SARS-CoV-2 positivity continued to decline until the serum levels reached 55 ng/mL. In light of these observational findings, do we venture to recommend vitamin D supplementation in our population?   This is a study showing a clear association.  Even if we find correlation, I would caution that it does not prove causality.  We know that observational studies are often alleyways that lead us to avenues of more robust investigation. In the Covid era however, when infections, hospitalizations and deaths are at an all time high, time is of the essence. Moreover, what is the harm in replacing vitamin D25(OH) up to a level that is well within the acceptable range between 30 to 100 ng/mL? The Institute of Medicine and the Endocrine Society both have guidelines on what is an adequate amount to supplement without a doctor’s supervision. The upper limit has ranged between 4,000 IU (IOM) to 10,000 IU (Endocrine Society) daily among adults in those who are known to be deficient. Generally, 2000 IU/day may be needed to keep levels above 30 ng/mL.     Vitamin D is a fat soluble vitamin.  It may accumulate, causing severe and symptomatic hypercalcemia.  However, in studies of long term supplementation, it has been established that long term doses of ergocalciferol (vitamin D2) 50,000 IU every 2 weeks for up to 6 years, kept vitamin D 25(OH) levels between 50-60 ng/mL.   I would caution against supplementation without medical supervision in patients with renal insufficiency, history of kidney stones, sarcoidosis or granulomatous disorders.   So here we have a plausible physiologic explanation, an observation of consistent association, no obvious harm in replacing what is deficient in the first place, cost effective measure to possibly reduce SARS-CoV-2 infection.  Every little bit helps. Please speak with your doctor regarding recommendations for your individual situation. Author: Anjanette Tan, MD, FACE, ECNU Sources:1.     Vitamin D Metabolism, Mechanism of Action, and Clinical Applications. https://doi.org/10.1016/j.chembiol.2013.12.0162.     SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels.  https://doi.org/10.1371/journal.pone.0239799.3.     Evaluation, Treatment, and Prevention of Vitamin D Deficiency:an Endocrine Society Clinical Practice Guideline.  https://doi.org/10.1210/jc.2011-03854.     Vitamin D Toxicity--A Clinical Perspective.  https://doi.org/10.3389/fendo.2018.00550
5 min read

What You Should Know About Tuberous Breasts

Tuberous breasts, also known as tubular breasts or breast hypoplasia, are a condition that is caused by breast tissue that does not proliferate properly during the puberty stage. This is not common, but it also cannot be considered rare as women don't usually seek treatment for this.  While this condition doesn't pose direct health threats, some women might seek treatment to correct it. Furthermore, tuberous breasts may also present issues for those who choose to breastfeed.  This article will tackle more about what tuberous breasts are, such as their symptoms, causes, and treatment.  Breasts come in different shapes and sizes, usually determined during puberty. With tuberous breasts, they can be any size but have characteristics in common, such as: ·         Cylindrical breast tissue, rather than rounded. The tissue would be the same shape from the base to the end of the breast.·         Tissue constriction at the breast’s base·         Saggy appearance to the breast/s because of abnormally elevated lower breast fold, or which is where your breast meets your chest)·         Areola hypertrophy, or when your areola is bigger than what is normal·         One breast may be affected, with one looking underdeveloped compared to the other. Other times, both breasts have irregular shapes.  There are three category types, which depend on the multiple features mentioned above. These types are: ·         Type I: Minor constriction·         Type II: Moderate constriction·         Type III: Severe constriction The causes behind tuberous breasts are still unknown. There are no confirmations of genetic links between tuberous breasts.  There is a study that suggests a genetic link when this condition is identified in twin brothers, though. Furthermore, the study suggests that the condition is caused by an excess amount of collagen in the facia and connective tissue components in breasts. It would result in abnormal gland development, thus changing breast shape.  Since tuberous breasts were described in 1976, doctors developed and improved the surgical techniques that improve this condition. Since the condition won't threaten one's health, people usually don't seek medical treatments. Speaking of risk factors, there are rarely, if not any, physical problems associated with tuberous breasts. However, the condition may have damaging effects on mental health and overall comfort. With the availability of approaches that can correct the condition for the short or long term, people can opt to have it 'fixed'. For instance, women can wear extra pads or inserts in bras for a more symmetrical appearance. If a permanent solution is wanted, then plastic surgeons perform procedures that can correct the appearance of tuberous breasts. Doctors have different approaches to the corrective surgery of the tuberous breast. Here is an example of one procedure: 1.    The doctor will make an incision that runs from the bottom of your areola up to the back of your breast2.    A new lower breast fold and the glandular flap will be formed3.    An implant will be inserted into the breast area4.    The surgical site is closed up using sutures At times, surgeons would correct the areola’s appearance and reduce the size.  Oftentimes, surgeons can correct the appearance of patients’ breasts in just one surgery. But if a patient has breasts that differ significantly, then there would be a two-step procedure.  The first procedure would focus on placing a tissue expander in the patient’s chest, and the second one will involve fitting breast implants. When considering surgery, make sure you are aware of any risks involved and speak with your doctor beforehand. Some common risks would include bleeding, infection, scarring, and risk of deformities. Furthermore, you will need to consider the cost and aftercare, so if you plan on undergoing an augmentation surgery, research and prepare ahead to make the entire process as smooth and comfortable as possible. Tuberous breasts may cause anxiety and lower confidence in some people. While this condition is not harmful in terms of physical health, there are ways to correct the appearance to help with one’s mental health and self-esteem.  Hopefully, this article taught you more about tuberous breasts and helped you understand what you need to know. If you believe you have tuberous breasts and would like to correct their shape permanently, talk with your doctor to weigh your options.
4 min read

What is a Vulvar Boil? A Quick Guide

A vulvar boil, also known as a vaginal boil, is a pus-filled and inflamed bump forming under the skin of the vaginal area. These would develop outside the vagina, in the pubic area, or even on the labia or vulva. While these boils would sometimes heal by themselves, others might require medical attention to prevent it from worsening and becoming an infection. Read on to find out what causes it and the treatments that can be done on vulvar boils. Different conditions may cause vulvar boils, such as: ·         Infectious organisms such as the Chlamydia trachomatis, Escherichia coli, and the Staphylococcus aureus.·         Skin conditions such as folliculitis, which is when bacteria have infected hair follicles. This is usually from shaving or waxing the pubic area, with the bump starting small and a bit painful, with the possibility of growing larger into a boil.·         Bartholin gland cyst·         Sexually transmitted infections·         If you have oily skin or thicker pubic hair growth Fortunately, there are various home remedies you can follow, such as: ·         Place a warm compress on the vulvar boil for 10-15 minutes. Doing so may cause the boil to leak pus. Do NOT squeeze the vulvar boil and cover the draining boil with a clean and dry bandage. ·         Have a sitz bath, which can be purchased in drugstores or online. Never use lotions, ointments, or baby wipes with fragrances. ·         Keep the affected area clean and dry, washing it with antibacterial soap and rinsing it off with water. Dry the area gently using a soft washcloth. Do NOT rub or touch the boil and wash your hands with soap and water before you cleanse or apply topical antibiotic ointments to the boil.·         Wear breathable underwear and avoid tight-fitting ones which may rub against the boils, inflaming it. It’s recommended to wear clean cotton underwear.·         If you feel some pain and discomfort in the affected area, then you may take an over-the-counter pain reliever like ibuprofen. If this does not work, do check with your doctor.  If the boil isn't responding to the at-home treatments or medications mentioned above, or it is causing pain or swelling in the area, then it's best to have it checked. It is also best to see a doctor if ever you experience other signs of infection, such as if the surrounding skin is hot or red, or if you have a fever.  The common and effective treatment to the vulvar boil is by draining it at a doctor's office. Your doctor may also apply antibiotic ointment and a sterile bandage for the boil to heal. If ever the boil is deeper in the skin or would show symptoms of cellulitis, this would require treatment involving oral or intravenous antibiotics.Once you have had the bulbar boil treated, follow proper hygiene down there to prevent vulvar boils from happening again.
3 min read
adenomyosis uterus

Adenomyosis

Adenomyosis is a benign condition in which tissue from the endometrial layer, or the innermost layer ofthe uterus, grows into a layer of muscle in the uterus. The uterus is a muscular organ with three layers:the endometrium (inner lining), the myometrium (middle muscular layer) and serosa (outer smoothlayer that covers the uterus) [1]. When the endometrial tissue grows into the muscle, it causes theuterus to enlarge. It is unknown what causes this condition; however, the most likely theory is that smallareas of trauma and inflammation in the myometrium causes the endometrium to grow into themuscular layer [2]. Adenomyosis can cause painful and distressing symptoms; however, it is a benigncondition that does not cause or increase the risk of cancer [2].Painful periods can be caused by several medical conditions, and adenomyosis often will present bypatients complaining of painful menstruation; however, some patients who have adenomyosis may notexperience any symptoms at all. The most common symptoms of adenomyosis are usually painfuland/or heavy bleeding during periods, chronic pelvic pain and irregular bleeding from the uterus.Abnormal uterine bleeding is when bleeding from the uterus happens at irregular times (not associatedwith periods) or there is bleeding for prolonged periods of time. Infertility may occur; however, theassociation is still unclear [4].The first step of diagnosing adenomyosis is to collect information on symptoms as well as pastmedical and surgical history. When a physician examines the uterus by gently palpating the pelvic area,the uterus typically feels soft and is symmetrical. Irregularities on the exam may include an abnormallylarge uterus, firmness, a palpable mass or even tenderness felt by the patient during the exam. Ifadenomyosis is suspected, a transvaginal ultrasound is then recommended to evaluate and diagnoseadenomyosis.There are multiple treatment options to help with symptoms. Nonsteroidal anti-inflammatory drugs(NSAIDS) can help improve pain and inflammation, and these include common over-the-countermedications such as ibuprofen. Other medication options include hormone therapy or oralcontraceptives. Specific hormones can decrease estrogen in the body, which is important since estrogencauses the endometrial layer to grow. These medications can limit the overgrowth of the endometriallayer of the uterus. The combined oral contraceptive pill is a combination of progestin and estrogenwhich works by decreasing ovulation and estrogen production within the body, working similarly todecrease endometrial growth [5].Surgical treatment can include a hysterectomy, or removal of the uterus, which is usuallydone in patients with severe symptoms or in patients who do not wish to become pregnant.Another method, known as uterine artery embolization, uses a procedure to blockuterine blood vessels in order to stop blood flow to this area. This will cause the tissue to die andprevent it from overgrowing. In patients who desire future pregnancy, it is possible to remove either thefocal adenomyosis or diffuse area around the uterine wall [3] while still keeping the uterus intact.Fibroids, also known as uterine leiomyomas, are very common benign growths of smooth muscle cells ofthe muscular layer of the uterus (myometrium). Between 40% and 60% of women can develop fibroids,though only 20% to 50% of patients with fibroids have symptoms [2,6]. Symptoms are similar toadenomyosis, with the most common being heavy or abnormal bleeding. Infertility is possible but rare(about 1% to 3% of infertility cases are due to fibroids) [5]. On pelvic exam, the uterus will be enlarged invarious locations and small, smooth masses can be felt. This is different from adenomyosis, where theentire uterus is enlarged. After an exam by your physician, fibroids are confirmed by a diagnostictransvaginal ultrasound. Treatment is similar to the treatment of adenomyosis with hormonal options.For women desiring future pregnancy, myomectomies (surgical removal of the fibroid only, whilekeeping the uterus intact) can be performed.Endometriosis is a condition in which the inner lining (endometrium) grows outside the uterus, asopposed to adenomyosis where the endometrium grows into the muscular layer in the uterus only anddoes not extend past this area. Tissue can grow on fallopian tubes, ovaries, bowel, appendix, bladderand other structures. It can cause painful periods, pain during intercourse, uncomfortable bowelmovements and even infertility. Infertility is more common with endometriosis than with fibroids oradenomyosis. Pelvic examination by a physician may demonstrate tenderness in the pelvic region, painwith movement of the uterus, or even an immobile uterus. However, many patients may not have anyabnormal findings. Diagnosis is usually made with laparoscopy, a procedure where a small camera isplaced inside the abdomen to look for endometrial tissue at internal structures such as the uterus,fallopian tubes, ovaries and bowel. Treatment is similar to adenomyosis with anti-inflammatorymedication to help with pain and hormonal methods to suppress tissue growth. Surgical treatmentincludes removing or destroying the abnormal tissue. As with adenomyosis, if a patient does not desireto have future pregnancy or has severe symptoms, surgery to remove the uterus, fallopian tubes, andovaries may be performed [2,5,7].Adenomyosis, uterine fibroids and endometriosis are common conditions that can cause no symptomsat all or become severe enough to cause significant pain and distress. This can depend on various factorssuch as age, ethnicity and location/extent of the abnormal tissue. While moderate to severe symptomscan be concerning for patients, they are typically benign conditions. However, there are several medicaland surgical treatment options available to help with these conditions. If you think you are experiencingsymptoms of adenomyosis, please consult your physician for a treatment plan that is right for you.AUTHORS: DR. ERIKA ARAGONA, SRIJAA KANNANResources:1. Anatomy of the uterus. (n.d.). Retrieved March 26, 2021, fromhttps://www.saintlukeskc.org/health-library/anatomy-uterus#:~:text=The%20uterus%20has%203%20layers,Myometrium2. Dougherty M.P., &amp;amp; DeCherney A.H. (2019). Benign disorders of the uterinecorpus. DeCherney A.H., &amp;amp; Nathan L, &amp;amp; Laufer N, &amp;amp; Roman A.S.(Eds.), CURRENTDiagnosis &amp;amp; Treatment: Obstetrics &amp;amp; Gynecology, 12e. McGraw-Hill. https://accessmedicine-mhmedical-com.proxy.unthsc.edu/content.aspx?bookid=2559&amp;amp;sectionid=2069646443. Stewart, Elizabeth et al. (2021). Uterine adenomyosis. UpToDate. Accessed on March 26,2021.4. Harada, T., Khine, Y. M., Kaponis, A., Nikellis, T., Decavalas, G., &amp;amp; Taniguchi, F. (2016).The Impact of Adenomyosis on Women&amp;#39;s Fertility. Obstetrical &amp;amp; gynecologicalsurvey, 71(9), 557–568. https://doi.org/10.1097/OGX.00000000000003465. Benign uterine pathology. Hoffman B.L., &amp;amp; Schorge J.O., &amp;amp; Halvorson L.M., &amp;amp; HamidC.A.,&amp;amp; Corton M.M., &amp;amp; Schaffer J.I.(Eds.), (2020). Williams Gynecology, 4e. McGraw-Hill. https://accessmedicine-mhmedical-com.proxy.unthsc.edu/content.aspx?bookid=2658&amp;amp;sectionid=2180953336. Stewart, Elizabeth et al (2021). Uterine fibroids (leiomyomas): Epidemiology, clinicalfeatures, diagnosis, and natural history. UpToDate. Accessed on March 26, 2021.7. Schenken, Robert, Barbieri, Robert, Eckler, Kristen (2021). UpToDate: Endometriosis:pathogenesis, clinical features, and diagnosis. UpToDate. Accessed on March 26, 2021.
6 min read
Does Insurance Cover Egg Freezing?

Does Insurance Cover Egg Freezing?

If you think you might want to delay pregnancy and may decide to have babies in your 40s or later, egg freezing can be a great option. But, the high cost of the procedure can make you think twice. So, does insurance cover egg freezing? Though health insurance policies cover most of the infertility diagnosis and treatment costs, procedures like egg freezing are rarely covered. This is because egg-freezing is considered elective by insurance companies.  Let’s take a look at the cost of egg freezing and help you decide if it is worth it.   A single egg-freezing cycle costs between $6,000 and $10,000. This cycle takes about six weeks and includes initial tests, injections, and retrieval surgery, excluding the annual storage fee for frozen eggs. Egg storage fees start at $600 annually.  The total cost of egg-freezing can be broken down as follows:●     Treatment: $11,000●     Medication: $5,000●     Storage: $2,000 (For four years)The costs vary depending on your location. For instance, the cost of one cycle of egg-freezing ranges from $13,800 in Boston to $17,800 in New York City. And, since most women undergo the cycle twice, the total cost can reach up to $40,000. Although egg freezing is usually not covered by your health insurance, some plans cover it when done with medical reasons. In May 2018, the federal Access to Infertility Treatment and Care Act introduced a bill to mandate insurance coverage for fertility preservation. The bill aims to support patients who undergo fertility preservation procedures, such as egg freezing, due to medically necessary procedures such as cancer treatments. In addition, some parts of the process, such as a physician consultation, ultrasounds, bloodwork, and ovarian reserve testing, may be covered by several insurance companies. Only 16 states in the USA require insurance companies to offer coverage for infertility diagnosis and treatment. You’d be surprised to know that top companies, including Google, Facebook, and Apple offer egg freezing as a company benefit to their employees. You are advised to review your insurance plan or contact your insurance company to explain the coverage to you. A study conducted by Yale Medicine revealed that there is only a 3-5% chance to have a baby with egg freezing. However, doctors often collect multiple eggs, thus increasing the chance of late pregnancy. Women considering egg freezing should not rush with their decision. Choose this procedure without any pressure and after a long discussion with your doctor. In addition, you should carefully consider your reproductive goals, health, and overall costs involved. Success also depends on the age of the woman and overall health. The older you are, the lower are your chances of getting pregnant with a frozen egg. Does your insurance cover egg freezing? If not, don’t lose hope! You can consider other funding options. Talk to your financial advisor to find some alternatives. Many fertility clinics also offer payment options for egg freezing. You can even opt for crowdsourcing and borrow from someone close to you. Summing up all points, it is safe to say that egg freezing is worth considering if your health goals and budget allow.  
3 min read

Is Yoga Safe In Pregnancy? When to Try Yoga

When you’re pregnant, it’s important that you still stay active with low-intensity exercises. One of the exercises many pregnant women look into is prenatal yoga, which is a great way to relax and stay fit.  The short answer is YES, yoga is beneficial during pregnancy, but you have to take precautions. Read on to learn more! Prenatal yoga is a healthy practice to take up during pregnancy, and these are the reasons why:             1.         It can support your ever-changing body, as yoga can help stretch and strengthen your muscles. This can ease the way your body supports your growing stomach. 2. Prenatal yoga can help tone your physical body, particularly your abdominal and hip muscles, and pelvic floor. This is important to prepare for childbirth!              3.         You learn more about mindful breathing, which will prepare you for labor as you loosen your body up. Your mind will also relax, feeling looser with your energy and mood levels up!            4.         Besides mindful breathing, you learn a lot about mindfulness as well, giving you a chance to connect with your growing baby! Certain poses allow you to sit and relax, breathing deeply as you stay in the moment, appreciating the time you have in this process.             5.         Do you suffer from pregnancy symptoms such as nausea, insomnia, lower back pain, or headaches? Prenatal yoga allows you to stretch and tone the muscles, which helps your blood circulate efficiently. This will then help release tension and lessen any pain you experience.             6.         One study shows that women who practice yoga during pregnancy are less likely to deliver a low-weight baby or have pre-term labor. This is because you are healthier, and a healthy mama will more likely have a healthy baby!  Now that you know the wonders of prenatal yoga, you can only reap the benefits when done right.  So make sure you follow these tips for a fun yoga session:             •           Avoid doing any poses using your back after your first trimester, as this reduces the blood circulation to your uterus. Also, don’t d poses that would stretch your muscles too much, particularly the abdominal muscles. This puts you at risk for injuries.            •           After the second trimester, your center of gravity begins to shift with a growing bellow. When you’re doing a standing pose, use your heel to the wall or have a chair for support to avoid losing balance.            •           Don’t do Bikram or hot yoga, which can endanger your baby’s health.            •           Listen to your body as you perform yoga poses. If you feel pain or discomfort, stop and take a break. If you can’t do certain poses, you can modify the pose when your body begins to change.             •           Butterfly stretch            •           Cat-cow            •           Cobra            •           Seated or standing forward bend            •           Triangle pose             •           Backbends or poses on your back             •           Poses that have you balance on one leg            •           Camel            •           Handstands or headstands I highly recommend that you join a prenatal yoga class, so your instructor will guide you to the right posture when performing various poses. Plus, you get to socialize with other pregnant mamas, making it a more fun experience! Yoga is an amazing exercise for everyone, including pregnant women. While it has many benefits for both you and your little one's mind and body, you also need to be wary about the poses you plan to do.  Make sure that you talk with your doctor to see if you’re allowed to do prenatal yoga and make sure to begin gradually. Good luck and have fun!
4 min read
Benefits of Breastmilk

10 Benefits of Breastmilk You Didn’t Know About

If you are newly pregnant or approaching your due date, you are likely weighing the benefits of breast and formula feeding. Besides well-known benefits of breastmilk, here are ten science-based benefits of breastfeeding.Many pediatricians say that they can touch the infant’s skin and tell whether the baby is formula-fed or breastfed. Breastfed babies often have nicer and smoother skin than formula-fed babies. On the other hand, formula-fed babies may have rougher skin with sandpapery patches. Studies found that the subcutaneous fat in formula-fed and breastfed infants has a different composition. Breastmilk has unique immune factors that ward off potential allergic reactions to food. It forms a protective coating around the baby’s intestine and keeps inflammation and allergies in check. These natural antibodies are not found in soy, cow’s milk, or any other formula. Babies who are not breastfed are relatively more likely to develop asthma and allergies. Multiple sclerosis is a common autoimmune disease. It affects our central nervous system. Breastfeeding could have protective effects against this sometimes disease.According to a study from the American Academy of Neurology, mothers who breastfeed for 15+ months are 53% less likely to suffer from MS.Breastfeeding may reduce the baby’s risk of developing many diseases and illnesses. These diseases include middle ear infections, respiratory tract infections, and gut infections. Breastfed babies are less likely to suffer from illnesses (intestinal tissue damage, diabetes, childhood leukemia and celiac disease) when compared to formula-fed babies.Researchers report the brain development may be different between formula-fed and breastfed babies. The difference is primarily attributed to physical intimacy, eye contact, and touch associated with breastfeeding.  Breastfed babies tend to have higher intelligence scores. Also, they are less likely to develop behavioral and learning problems as they grow older. During pregnancy, the uterus expands its size from that of a pear to filling the entire abdomen space. After delivery, it undergoes a process called involution.Involution helps the uterus return to its standard size. Oxytocin hormone helps drive this process. Women's bodies secrete a high amount of Oxytocin during breastfeeding. It reduces bleeding by uterine contractions so that the uterus returns to its previous size. Researchers report that mothers who breastfeed have a faster involution process. Breastfeeding pauses ovulation and menstruation. This delay ensures that there is some gap between pregnancies. Mom can also enjoy valuable time with their newborn without worrying about a monthly menstrual period.A study conducted by the Collaborative Group on Hormonal Factors revealed that breastfeeding women have a lower risk of breast cancer. The study compared breastfeeding mothers to mothers who didn't breastfeed, to reach this conclusion.  Reportedly, breastfeeding prevents tooth decay in babies. It also lowers the potential risk of cavities and needing teeth bracing in the future.  Breastfeeding is completely free. By choosing to breastfeed, you save money on formula-fed milk. You can spend more valuable time with your baby, instead of cleaning and sterilizing bottles constantly.Don't worry if you are unable to breastfeed. Best-quality formulas are safe and provide you and the baby with all the required nutrients.However, breastmilk has irresistible benefits, both for the mother and the baby. Plus, it gives you quality time to bond with your newborn. 
3 min read

Infant Eczema - What you need to know

Eczema is also called atopic dermatitis.  It is dry, flaky skin.  In infants it can appear in the first few months of infancy.  Many children simply outgrow it but it is also easily treatable. Eczema will look different on different babies.  Usually children with lighter colored skin will demonstrate patches of red skin.  For babies with darker skin, it can appear purple, brown, or gray.  It is more often harder to determine in children of color. Whatever the color, it is dry, itchy, and rough.  Generally it is on the face and in the joints of arms and legs, but can appear anywhere on the body.   Cradle cap (seborrheic dermatitis) is similar.  Cradle cap is generally confined to the scalp, sides of the nose, eyelids, and behind the ears.  It is less itchy and usually clears by eight months of age. Eczema occurs when the body does not make enough fatty cells which makes the skin lose water and become dry.  Another possible cause is that the barrier of the skin allows too much moisture to seep out and allows germs to creep in.  If a parent suffers from eczema, it is likely the baby will as well. The condition usually disappears on its own before school age, but it may persist into adulthood as dry skin.  There are triggers can are easily avoided.•         Low Humidity – Dry, winter air can make the skin drier and itch more.•         Irritation – Soaps, laundry additives, perfumes, and scratchy fabrics can all contribute to the itch.•         Foods – There is a theory that some foods like eggs, some fruits, and cow's milk can affect eczema.  You can try eliminating those foods one at a time to see if there is an effect.•         Stress – Stress becomes a factor in many conditions and can trigger eczema flares. There are some easy home remedies you can try.•         Moisturizing – Fragrance-free creams or ointments are available over the counter or through a prescription.  Even petroleum jelly will work.  Applied after the baby's bath, it will help retain moisture.•         Soaps – Switching to mild, unscented laundry products should help.  Antibacterial or scented hand soap can also be rough on a baby's delicate skin.•         Cleansing – Keep your baby clean but it may not be necessary to wash the entire body with soap every time.  Pat dry rather than rubbing.•         Soaking – Placing your baby in a lukewarm bath for about 10 minutes can ease the discomfort.•         Clothing – Always wash new clothes before you put them on the baby.  Don't overdress or use too many blankets because the heat and sweat can cause the condition to flare.•         OTC – Hydrocordisone may help but please ask your pediatrician before using anything to be sure they recommend it for the condition.  If the condition does not clear within a week, check with your pediatrician.  If the condition worsens, or you see anything new like blisters, make an appointment to have this checked out to rule out an infection or other condition.  
3 min read
how accurate is a pregnancy test

How Accurate is a Pregnancy Test

Pregnancy tests are readily available at drug stores or through your doctor’s office, but just how accurate is a pregnancy test?Each type of pregnancy test is a reliable indicator, if used correctly. Common errors include using a test that has expired or not following the instructions. So, be sure to check the expiration date on the package and read all the directions and follow them as indicated.When a fertilized egg attaches to the lining of a uterus, human chorionic gonadotropin (HCG) is produced. This hormone enters the bloodstream and is expelled through urine (pee). When you urinate on the stick in a home pregnancy test or the doctor checks your urine sample in the office, it will either be positive (you are pregnant) or negative (you are not pregnant).  Some home pregnancy tests state that they are accurate as early as the first day of a missed period but it is probably a good idea to wait at least a day or so before testing to be sure your results are correct. Ovulation may vary from month to month, even if you are very regular. The egg can therefore implant at different times. A good interval is about a week after a missed period.HCG production increases quickly, usually doubling every two or three days. So, if you are a bit patient, you will get a more accurate reading. If the test is positive, you should follow up with a medical professional for a second test of urine and/or blood work. This professional lab work will be able to determine the level or amount of HCG and provide a closer due date.Most home pregnancy tests tell you to place the end of the stick in the urine stream or to dip the stick into a container that has collected the urine. Instructions usually give you a timeframe about how long to wait before checking the results, which is generally two minutes or more.  Most tests have an indicator, like a line or symbol, to show that the test is working. If you don’t see that control indicator, the test is not performing correctly. You should likely take another test.Some tests are more sensitive to the amount of HCG than others.  This is another reason to wait a day or so before taking the test to confirm the results more accurately.The ultimate results are shown as either a plus or minus sign, or the words “pregnant” or “not pregnant”.  There are some medications or fertility treatments that contain HCG and can affect the read out.  However, generally antibiotics and birth control pills do not affect the accuracy.  Yes, it is possible to get a false positive result. This could be if you take the test too soon after starting fertility treatments, menopause, or problems in the ovaries. Negative results can also be incorrect if you take the test too early in the pregnancy and the test is unable to detect the HCG. Be sure to wait the allotted time to check the results; set a timer. It is also best to take the test the first thing in the morning because your urine will be more concentrated.  
3 min read

What to Eat Before Glucose Test Pregnancy For Accurate Results

There are a lot of doctor’s visits and tests you’ll need to have done to ensure that both you and your little one are healthy. One of these tests is the glucose test pregnancy, which is also known as the gestational oral glucose tolerance test (OGTT). This test would screen you to see if you are at risk of gestational diabetes. It’s taken between your 6th or 8th month of pregnancy if you haven’t been diagnosed with diabetes.  There is no preparation before the test, though your doctor will give you something to drink an hour before the test for your sugar levels to peak.  If you're worried about the results, there are dietary changes to help maintain your blood sugar levels before the test. Gestational diabetes happens when a pregnant woman’s body can’t regulate their glucose levels, resulting in high sugar levels. This happens due to hormones and weight gain from pregnancy.  You will need to fast about eight hours before going to your doctor’s office. They will draw blood for testing your fasting glucose level, then you will have the sugary drink (75 grams of glucose). They will then draw your blood one hour after drinking.  When figuring out what to eat during the days before the test, it's best to stick with nutrient-dense foods with complex carbohydrates and fiber. Here are some examples:Besides what to eat, there are also certain foods you have to avoid. You should NOT have simple carbohydrates or food high in sugar. This can have your blood sugar levels spike, leading to a false positive.  Do not have:I recommend that you still follow this list even after the glucose test, as this can manage your blood sugar levels to avoid such conditions.  Besides what to eat, you can also follow these extra tips when taking your glucose test:Eating these healthy foods won’t guarantee normal levels of blood sugar levels. When your body is already in gestational diabetes, then a change of diet won’t alter the test results. But don't worry, as this is also common since our hormones can change a lot during pregnancy and there are ways to live with the condition. Don't beat yourself up because of it! If the diagnosis is confirmed, then you can work with your doctor to help keep a healthier diet and an active lifestyle to manage it. Furthermore, gestational diabetes usually goes away after childbirth! Wrapping It UpDiet is crucial when pregnant, which can help regulate your hormones and maintain optimum health. Lessening food high in carbs and sugar can prevent or manage gestational diabetes, among other benefits. So start referring to this list on what to eat and avoid to make the proper dietary changes now.
3 min read
Benefits of infant massage

What Are The Benefits Of Infant Massage?

Infant massage is a process of gently rubbing the muscles and body of infants or babies in a manner designed specifically for them. Baby massage can be performed by a certified and professionally trained infant massage therapist or the parents, grandparents, or guardian of the baby who have been taught to properly to do it. Infant massage can provide several health benefits such as helping them sleep. Let us have a look at how massaging your baby can help your bundle of joy in several ways. Massaging, when done properly, may help to support the proper growth and development of your baby. Research studies have shown that infant massage is beneficial even for preterm infants including those admitted in the NICU. It can, in some cases, shorten their length of stay in the NICU, improve weight gain, and support the feeding tolerance of the babies. These studies have also shown that infant massage may promote neurodevelopment thereby improving the functions of the brain and nervous system. [1]Infant massage is commonly linked to improved muscle tone. The gentle massaging action would increase the circulation of blood through the muscles, ligaments, and tendons thereby strengthening and nourishing these tissues. It would promote healthy muscle growth and improve muscle tone. This may help your baby learn to walk or perform other physical activities with better ease and efficiency. [2]Massaging your baby may help to improve bone density and make their bones stronger. This benefit is also observed in preterm babies. Regular massage of preterm babies would support the development of the bones and improve bone strength. This is one of the reasons why infant massage is highly recommended. [3]Baby massage may help to provide relief from respiratory disorders such as asthma in infants and newborn babies. It is believed that infant massage can promote the elimination of mucus from the throat and lungs and allow smooth flow of air through the respiratory passages thereby providing relief from breathing difficulties. [4]Infant massage is beneficial not just for the baby but even for parents. Research studies have shown that massaging your baby would improve your attitude toward childbearing and enhance maternal or paternal satisfaction considerably. [5]It can also improve the bond between you and your baby and fill the moments with smiles and laughter. This would ease stress and anxiety in first-time moms and dads and increase their confidence about being able to take good care of their baby. [6]Infant massage can also be helpful for babies with gas and colic. ConclusionA gentle and caring touch is good for all. However, for infants, it holds more importance as they are new to the world and need assurance of having someone special caring for them. Other than this, massaging your baby can also help him or her in several other ways by improving blood circulation and relieving muscle stiffness. If you are due for delivery or have already welcomed your baby into the world, make sure you gift the goodness of massage to your bundle of joy. The caring touch will make your baby happy and his smile will bring more joy to the experience of parenthood. Just be sure to learn how to do it properly. References:1.      https://pubmed.ncbi.nlm.nih.gov/31059673/2.      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6617372/3.      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844909/4.      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5457772/5.      https://pubmed.ncbi.nlm.nih.gov/28866286/6.      http://www.healthofchildren.com/I-K/Infant-Massage.html#ixzz6aM4JrAnr
3 min read

Benefits of Compression Socks During Pregnancy

Pregnancy is a special phase in every woman’s life. You might develop glowing skin, thicker hair, and that first kick in the womb is perhaps the loveliest feeling. At the same time, your legs have to withstand a lot during pregnancy due to hormonal changes and growth of the womb. Because your body produces nearly 50% more body fluid when you're pregnant, swelling is a common condition that can lead to pain or discomfort. Compression therapy can be used during pregnancy to prevent tension and heaviness in the legs. Wearing compression socks during pregnancy can help with discomfort and can promote better blood circulation in the legs.According to the Centers for Disease Control and Prevention (CDC), Pregnant women are five times more likely to develop DVT than nonpregnant women. The blood in the pregnant woman is more inclined to clot. This is thought to provide defense against losing too much blood during labor. Leg tension and swelling are signs of a possible deep vein thrombosis (DVT). This serious condition requires immediate medical attention.DVT symptoms include pain, discolored skin, redness, and a feeling of warmth. In this condition, blood clots develop in the legs and pelvis, which break off and reach to lungs, saucing a pulmonary embolism. Wearing compression socks may prevent blood clots by making it easier for the heart to keep the blood flowing. It prevents the development of varicose veins.According to many medical experts, you can start wearing compression socks from the first trimester. Within the first four months, you may notice the signs of blood stagnation, swelling of the ankles, and a pulling sensation in your calves.Further, edema occurs more often in hot weather and late evening. So, you should ideally can put on compression socks in the morning before you get out of bed. Take off the socks upon retiring for the night or any time you would like to put your feet up for a bit. If you face difficulty putting on the stockings during the later stages of pregnancy, you can ask help from your loved ones. Finally, compression stockings are not recommended if they do not feel good on your skin or cause any medical complications or discomfort.Undoubtedly, pregnancy involves some possible unpleasant changes and complications. Compression socks in pregnancy are an easy thing to try for women struggling with painful, swollen legs. There are hundreds of styles and colors, along with different lengths and sizes. When buying a pair, make sure you choose the right type and size that suits your dimensions and needs and always ask your physician which strength of compression you should get.
3 min read

Hyperthyroidism

Hyperthyroidism, also known as “overactive thyroid”, is a condition where the thyroid glandmakes too much thyroid for what your body actually needs. This will alter the body’s organfunctions and generally push them to work too intensely (1). The thyroid is a small butterfly-shaped gland located in the front of the neck. It produces andsecretes thyroid hormones that can help control how your body uses energy. Since every part ofthe body uses energy, thyroid hormone plays an important role in the function of almost everyorgan, including the heart, brain, liver, kidneys, and skin (1,2).  There are many causes of hyperthyroidism. Among them are: Grave’s Disease. The most common cause of hyperthyroidism is Grave’s Disease. It is anautoimmune disorder where the thyroid is attacked by your immune cells and is stimulated toproduce too much thyroid hormone (1,2). Overactive thyroid nodules. Nodules are lumps in the thyroid that are generally benign andnot cancerous. However, if the nodules are overactive, as in the case of a single toxic nodule ora toxic multinodular goiter, these can lead to too much thyroid hormone in the circulation (1). Thyroiditis. The thyroid gland usually makes enough hormone to send out into the body, plusenough to store. Thyroiditis is a condition where an infection can cause the thyroid gland to leakout the thyroid hormone that it normally stores, raising thyroid hormone levels in thebloodstream (1,2). Too much iodine. The thyroid gland needs iodine to make thyroid hormone. Having too muchiodine in the diet can cause or worsen hyperthyroidism in an already susceptible gland. As outlined above, there are many different causes of hyperthyroidism, so be sure to check withyour physician to determine the cause.  *These symptoms are a generalized group that have been noted in individuals with hyperthyroidism in the past, butthey overlap with many other diseases. If you have any combination of these symptoms, it does not always mean youhave hyperthyroidism. Rather, they are an indicator that it might be good to check thyroid function. General/Metabolism-related factors (1,2)·   Nervousness or anxiety·   Irritability·   Weight loss·   Trouble sleeping·   Decreased tolerance to heat·   Enlarged thyroid gland  Gastrointestinal and Urinary Symptoms·   Frequent bowel movements·   Mild renal damage 3 Cardiovascular (2)·   Rapid heart rate·   Irregular heartbeat  Since the symptoms of hyperthyroidism can potentially overlap with hypothyroidism, otherendocrine diseases, or even non-endocrine causes, the best way to know if you havehyperthyroidism is to visit your primary care physician or an endocrinologist. By reviewing yourblood work and listening to your history, they can accurately diagnose and recommend a plan ofcare or follow-up.   TSH (thyroid stimulating hormone)TSH is a stimulating hormone released by the pituitary gland. It binds to your thyroid cells andstimulates it to release thyroid hormone. If TSH levels are low, it could (in combination with ahigh thyroid hormone level) indicate hyperthyroidism since high thyroid hormone levels willcause the pituitary to release less TSH (2). T4 and T3 are your thyroid hormones. T4 is the one that is primarily checked, and if its levelsare abnormally raised*, it indicates hyperthyroidism (2).*Important note- since the “normal” levels of T3 and T4 fall in a very wide range, individuals can have varyingdefinitions of what a “normal” or “abnormal” level is for them.Thyroid stimulating immunoglobulin (TSI) is the specific TSH receptor antibody that sticks tothyroid cell receptors and activates them, causing hyperthyroidism in Grave’s Disease. If thereare elevated levels of TSH receptor antibodies present in the bloodstream, specifically TSIs, thisturns on the thyroid and causes it to grow and secrete too much thyroid hormone. Hyperthyroidism is treated differently in each individual, depending on the cause and severity.Your primary care physician or endocrinologist will obtain your medical history, blood tests andthyroid  imaging to recommend a plan of care. Among the potential plans of care are (1,2,4): Thyroidectomy. Thyroidectomy is a surgery that can be partial (removing a part of the thyroid)or total (removing the whole thyroid). Antithyroid medication. Medications such as methimazole or propylthiouracil can beadministered to block the thyroid gland’s ability to make new hormones. Radioactive iodine. Radioactive iodine can be administered orally as a small capsule. Sincethe thyroid needs iodine to make more thyroid hormone, it takes up this oral iodine laced withradioactivity, which then destroys the cells that take it up and prevents them from making morehormone.  1. https://www.niddk.nih.gov/health-information/endocrine-diseases/hyperthyroidism2. https://www.thyroid.org/hyperthyroidism/3. Sönmez E, Bulur O, Ertugrul DT, Sahin K, Beyan E, Dal K. Hyperthyroidism influences renal function.Endocrine. 2019 Jul;65(1):144-148. doi: 10.1007/s12020-019-01903-2. Epub 2019 Mar 23. PMID:30904999.4. Reid JR, Wheeler SF. Hyperthyroidism: diagnosis and treatment. Am Fam Physician. 2005 Aug15;72(4):623-30. PMID: 16127951.
4 min read

Baby Teething Pain Relief

Teething is probably one of the most dreaded milestones for parents as their little ones head on to their toddler years, as this is a very uncomfortable time for them. While toothless smiles are adorable, this won’t last long, as babies will start growing their baby teeth, which may have you staying up at night from their pain! It's painful watching them cry from the discomfort but don't worry, there are safe and effective ways to treat teething pain in babies. Read on to find out! Most babies begin teething when they reach between four to seven months old, though some begin later. Each baby has his own timetable, so don't worry if it doesn't seem like he's growing his first set of pearly whites just yet. Even if teeth aren’t popping up yet, you’ll know when your little one begins teething based on these symptoms: ·         They feel more fussy or irritable, crying even more·         Have swollen and tender gums·         Have a slightly raised temperature around 101 degrees F or less·         Lots of drooling·         Gnawing, chewing, or even biting·         Coughing·         Pulling their eats·         Rubbing their cheeks·         They bring their hands to the mouth·         They have a change in eating and/or sleeping patterns If your little one starts to feel more pain to the point they have rashes, pus, or blood in the gums, high fever, diarrhea, or vomiting, do send them to the doctor immediately, as these are not typical signs of teething and you need to take them to their doctor right away. Try out these helpful tips to see what works best for your little one: ·         Freeze a clean and wet cloth or rag. Once frozen, give it to your little one for them to chew on. You may even massage your baby’s gums using the rag. This can decrease inflammation around the gums.·         Feed them cold soft foods like yogurt, applesauce, or frozen fruit, if they eat those solids.·         Teething biscuits can be used for those who are 8-12 months old, though be wary of their gum hygiene, wiping the gum area with a clean cloth after feeding them the biscuits.·         Teething rings and toys may be great to give pressure required for soothing sore gums, though make sure you choose ones made of safe material. You can refrigerate these toys and give them to your little one for the cold to soothe their gums.·         Rub their gums gently with your clean fingers or wet gauze, with the pressure easing their discomfort.  What NOT to DoBesides the treatments I mentioned above, make sure that you avoid the following “tips”:  ·         Do NOT put anything in your little one's mouth that has no scientific proof that it helps soothe teething. There are even a few teethers or teething aids that aren't safe, especially ones that have liquid inside, are made with breakable materials or are frozen solid. This is dangerous for your toddler to bite into and can hurt them·         Avoid using materials with harmful substances or choking hazards. If you do choose a teether, get one made of rubber or safe medical grade silicone.·         Avoid using teething necklaces such as the amber ones, as this can strangle your baby. It may also break, and your little one can choke on the beads.·         Don’t use over-the-counter teething gels or liquids with benzocaine, which has rare but serious side effects. Always consult your pediatrician before giving any pain relievers or medications to your baby, even topically.  Teething is an uncomfortable time for your baby, but it doesn’t mean there are no remedies to help relieve them a bit! Make sure to use any recommended remedy by your doctor and to avoid dangerous or unproven methods.
4 min read

How Long Should Babies Sleep?

Sleep is a critical element in overall physical health.  During sleep, the heart and blood vessels make any necessary repairs.  It allows for better concentration and productivity as well as more energy for physical activities including exercise. So, how long should babies sleep? Especially for children, sleep is important for good brain function, emotional development and behavior factors.  Parents often wonder if the infant, child, or adolescent is really getting enough satisfactory rest to perform well during the day.Until they are about 3 months old, infants should be sleeping 14 to 17 hours during a 24 hour day.  A good routine would be two or three naps during the day and a longer stretch at night after a feeding.  From age 4 months until they are almost a year, babies should get between 12 and 15 hours of sleep, with 3 or 4 of that coming during the day. Beyond that a toddler of 1 or 2 years old should be sleeping 11 to 14 hours; preschoolers about 10 to 13 hours and elementary school age at least 9 to 11 hours at night.  There are a number of factors that affect the proper amount of sleep.  If you have concerns, check with your pediatrician. A key factor is establishing and maintaining a bedtime routine.  Bathing, singing, and reading to infants and children are all good signals that it is the end of the day and time for rest.  Keeping a consistent pattern will help your child adapt to the routine. One way to do this, depending on your parenting style, is to put the baby in a crib while still awake but drowsy.  This helps the child learn to fall asleep on their own without rocking.  Some movement and even a bit of crying are normal.  If your baby is not hungry, ill or need a diaper change, leave him or her alone for a few minutes to see if he or she settles down and falls asleep on their own. When the baby wakes during a time when you want it to sleep, keep the lights low and don’t play.  Speak in a low voice but don’t talk for long periods of time.  In other words, try to avoid activities that will stimulate the baby and keep him or her alert. It may take a bit of time to establish the routine, but when successful, you will be glad. At around 6 months, a baby should have an extended night time sleep regimen.  If not, don’t worry.  Children develop at their own rate.Naps are very common and most children nap until they are 3 to 6 years old.  Newborns and infants will sleep during the day for three or four hours.  As the child ages, the nap time will decrease.  Research has discovered that frequent napping helps children consolidate memories and that these memories are important for learning and brain development. Even if you think your baby is getting enough sleep, be sure to add it as a discussion item with your pediatrician.  Your understanding of what is normal for your child is important and can help you gauge when he or she is not feeling well.
3 min read
what foods cause acne

Foods that Cause Acne - According to Dermatologists

Acne vulgaris is a very common dermatologic condition that affects about 9.4% of the population worldwide.[1] Acne is most common in adolescents and young adults, affecting 75-98% of 16-18 year olds. Acne is a serious condition which may cause permanent scarring of the skin if severe. Acne can also negatively affect mental health, social relationships and wellbeing.[2] In the teenage years, acne is more common in males but as acne persists into adulthood, it becomes more common in women. Approximately half of women experience acne in their 20s with one quarter of women remaining affected in their 40s.[3] A variety of factors influence the tendency to develop acne including our genetics, environment, hormones and diet.[4]   Before we get to the specific food categories, let’s talk about what happens to the skin before acne occurs. There are four key factors that occur in the skin that lead to acne: excess sebum or oil production, plugging of hair follicles by excess sebum and dead skin cells, bacteria proliferation and inflammation. Diet has been shown to influence acne formation through the action of hormones, increasing inflammation in the skin and changes in the bacteria on our skin.[5]   Some foods, like high glycemic load foods, may contribute to getting more acne, while some other foods, like those rich in omega 6 may help with reducing acne. Let’s take a closer look.  Carbohydrates in our foods are broken down into sugars by our bodies. Carbohydrate containing foods differ in how the sugars they produce affect blood sugar levels. The glycemic load (GL) is a measure of a food’s ability to raise blood sugar levels. High GL foods increase hormones circulating in the body that promote oil production in the skin and follicular plugging leading to acne. What are high glycemic load foods? Think white bread, pasta, baked goods, potatoes, rice, certain fruits, sugary foods and processed foods. Studies suggest that diets low in GL may reduce acne.[6]  Examples of low GL foods are nuts, vegetables, certain fruits, fish, eggs and meat.   Omega acids are types of fat found in foods. Western diets tend to have high omega- 6 levels and low omega-3 levels which favors acne by increasing oil production and inflammation in the skin.  By increasing omega-3 and reducing omega -6 in the diet, oil production and skin inflammation can be reduced and acne improved. Improvement in acne has been seen with omega-3 supplementation and increasing omega-3 containing foods in the diet such as seeds and oils made from chia, hemp, flax and walnut as well as fish.[7]  Milk increases hormones which stimulate oil production and follicle plugging. In particular, skim milk has a strong correlation with acne possibly due to other components that more drastically increase certain hormones compared to whole milk. Whole milk also contains more estrogen hormone which tends to reduce acne. This could also explain the difference between skim versus whole milk on acne.[8] Milk also contains leucine, an amino acid that promotes oil production and follicle plugging. Whey protein, which is a common protein source in protein bars, shakes and powders, is one of the protein components of dairy and contributes to acne through the same mechanisms as milk.[9]   Interestingly, cheese intake has not been associated with acne. This is likely because cheese has a lower glycemic load[10]  Meat also contains leucine that promotes sebum production and follicular plugging, which in theory would increase the likelihood of acne. However, the studies evaluating the effect of a vegan diet on acne have had mixed results.[11]   Study of the microbiome and how it relates to acne is an active area of research. Early studies on consuming probiotics show benefit to reducing acne. There are many potential mechanisms to explain how probiotics improve acne, however further research is needed.[12] In addition to supplements containing probiotics, adding probiotic rich foods to the diet such as sauerkraut, kimchi, and yogurt with live cultures may lead to improvement of acne.  There are many theories out there claiming that eating chocolate makes your skin worse. In reality, the effect of chocolate on acne has been widely discussed but remains unproven and controversial.[13]  Many say that drinking extra water can improve acne. While it is important to keep our body hydrated, there is no clear evidence of reduced acne with increased water intake.[14]  The relationship between diet and acne has been discussed for years but only recently become more widely accepted and remains an area of active research. The answer is yes and no.  There is strong support for avoiding dairy, in particular skim milk and whey protein, and focusing on low glycemic index foods to improve acne. Adding probiotic and omega-3 rich foods as well as decreasing omega 6 and meat consumption can be considered as well to gain control of acne.  Authors: Brooke Grant Jeffy, MD, Aarushi Jain Medically Reviewed By: Dr. Brooke Grant Jeffy, Board Certified Dermatologist 
5 min read

Vaginal Skin Tags - What are they and how to treat them

Vaginal skin tags are benign growths of skin made of loose fibers of collagen. These can be quite uncomfortable and embarrassing when they appear in and around the sensitive area of the vagina. Skin tags can also contain blood vessels and usually can look like a mole, wart, or a piece of skin that is hanging loosely.The proper diagnosis of any unusual skin lesions in the genital or vaginal area is a must. This is because the appearance of vaginal skin tags often gets confused with genital warts or other things which can be infectious or cancerous. Also, the places where vaginal skin tags grow are quite sensitive and need a proper diagnosis. Causes of Vaginal Skin Tags·         There is no certainty of why do skin tags appear, but some researchers suggest that people with human papillomavirus get skin tags.·         The other risk factors which can cause skin tags include being overweight, due to pregnancy, or having diabetes and insulin resistance.·         According to a 2010 study, most people with skin tags had insulin resistance. It also suggests that vaginal skin tags can also be related to a high body mass index. ·         Friction is another cause of vaginal skin tags. Friction from clothing or underwear under legs can favor the growth of skin tags. ·         During pregnancy, hormonal changes may increase the risk of developing vaginal skin tags in women. Diagnosis Of Skin Tags On the VaginaSkin tags usually have no prior symptoms and are not commonly painful. But if they get caught in clothes or scraped while shaving, then it may cause skin irritation or infection. If you see any bleeding on the skin tag or if it is painful, then you need to consult a doctor.Proper diagnosis of the skin tag includes a quick visual examination. A doctor can ask you to take a test for HPV if there are quite a number of skin tags near your genital area and they are concerned about genital warts. The doctor may perform a pelvic exam and may take a biopsy or culture of the tissue to check the growth out further.How to Get Rid of Vaginal Skin TagsVagina skin tags are loose and can be found in an area where the skin is folded or an area with dry skin. As they are usually harmless, if you don't feel any irritation and having it on your body doesn't bother you, there is no need for treatment if your doctors deems it harmless. But if it does bother you, you should consult a doctor for its treatment or removal. There are several ways to remove it safely from your skin. Do not try to remove a skin tag at home as it can be dangerous and can cause infection, scarring, or bleeding. ConclusionVaginal skin tags may occur in any woman of any age. Most of the time, these are harmless, but if you are concerned or it is bothering you, do consult your doctor immediately. Do not wait for the problem to grow or to turn into something serious.  
3 min read
Birth Control Pills vs. IUD

Birth Control Pills vs. IUD: Choosing The Right Method

Choosing a birth control method often seems like a difficult task. Women have to consider several factors including effectiveness, safety and side effects while choosing a birth control that is best suited for them. They also need to consider whether they wish to conceive in the near future before choosing any contraceptive. If you are finding yourself at a crossroad, read on to know the differences between the two most common contraceptives - birth control pills and IUD. We will also discuss the benefits and pros and cons of each so that you can take an informed decision about the best contraception suitable for you. If your overall health is good and you suffer from no illness linked to hormonal imbalances, hormonal contraceptives including both birth control pills (also called OC pills) and IUDs would be suitable for you.However, if you suffer from menstrual problems due to PCOD (Polycystic Ovarian Disease), hormonal imbalances, or thyroid disorders, it is best to choose non-hormonal IUDs to reduce the risk of worsening the hormonal imbalances.  You should be aware of the exact way your birth control works when choosing the best contraceptive. Oral Contraceptive (OC) pills work by creating a temporary balance of hormone that is not favorable for pregnancy the same way hormonal IUDs do. However, the hormonal changes caused due to IUDs may last a little longer than the changes caused due to oral pills. Progesterone-only and combined OC pills, as well as IUDs, are considered the best methods of contraception, though IUDs are considered more effective. The lower effectiveness of OC pills could be attributed to the failure of women to adhere to the dosing schedule due to a busy lifestyle or forgetfulness.It is important to choose a contraceptive that is convenient to use and easily available. OC pills, though easily available, have to be taken orally on a daily basis. Not taking the doses regularly might reduce their effectiveness. IUDs do not require any action from your side once it is inserted. IUDs can produce a contraceptive effect for 3 to 10 years. Hence, they are considered more convenient for adult women who are sexually active and wish to avoid pregnancy for several years.Which is the best contraceptive: IUD or birth control pills?Birth control pills are hormonal preparation you need to take orally on a daily basis. There are two types of OC pills including combined OC pills that contain estrogen and progesterone and progestin-only pills containing only progesterone.IUDs or intrauterine devices refer to a T-shaped device that is inserted into the uterus. There are two forms of IUDs called copper IUD and hormonal IUDs. Copper IUDs do not contain hormones and can be used for up to 10 years.Hormonal IUDs contain Levonorgestrel, a form of female sex hormones. Most hormonal IUDs work for 3 to 5 years.ConclusionThere is no one-size-fits-all method of contraception. You can choose the right birth control method suitable for you based on the factors we discussed above. 
4 min read
TDap Vaccine For Pregnancy

Tdap Vaccine For Pregnancy: Should You Get The TDAP Vaccine During Pregnancy?

The Tdap vaccine provides combined protection against the diseases of tetanus, diphtheria, and acellular pertussis. The following diseases are fatal and infants are at high risk for the infections because newborns don't begin their vaccination series until about 2 months old.Tetanus: Also called Lockjaw, tetanus is a bacterial infection caused by Clostridium tetani that causes painful muscle spasms often in the neck and jaw. If the muscles that are involved in breathing are affected, it can even lead to death. Diphtheria: Diphtheria is also a bacterial infection caused by Corynebacterium diphtheriae that are poisonous. Symptoms can include difficulty breathing, heart failure, and paralysis which can be fatal.  Acellular Pertussis: Commonly called whooping cough, acellular pertussis is a respiratory disease caused by the bacteria Bordetella pertussis. It is extremely contagious and involves severe coughing (1,2).Infants under 2 months are too young to receive a vaccine for these diseases, which would allow them to produce their own antibodies. When the pregnant person gets the Tdap vaccine during pregnancy, it allows some of the antibodies produced by the mother to transfer to the baby which protects babies until they are able to receive their own vaccine. Outbreaks of Pertussis are increasing in the United States. According to the CDC, around 1,000 are hospitalized and around 5-15 die each year due to pertussis.  The CDC tracked around 1800 infants contracting whooping cough. The highest numbers are in infants that are too young to protect themselves. Infants can benefit from minimized risk through a Tdap vaccine during pregnancy. Getting a Tdap vaccine during pregnancy between 27 through 36 weeks lowers the risk of whooping cough in babies younger than 2 months old by 78%. (1, 2).   Vaccine Adverse Event Reporting System (VAERS) have not found a Tdap vaccine pregnancy risk, whether it’s pregnancy complications or harm to the mother or harm to the baby. Both the CDC and ACOG, which is the American College of Obstetrics and Gynecology, consider the vaccine to be safe for mothers during pregnancy.  The side effects of the Tdap vaccine include the common ones of most vaccines; tenderness/swelling at the site of injection, body aches, fever, fatigue. They are mild/moderate and generally resolve by themselves. Severe side effects are rare. If you have any concerns, discuss them with your doctor prior to getting the vaccine (1). The price of getting a Tdap vaccine can range from $75-$180. The baby can also be protected by “Cocooning”. Cocooning refers to vaccinating all those that come in contact with the baby. Unfortunately, this is very difficult to fully implement. This method is also more costly than having the person carrying the child get the Tdap vaccine during pregnancy. It should be noted, however, that getting the maternal Tdap vaccine shot along with cocooning provides the most protection to the baby (3). The Tdap vaccine lasts 10 years which is when a booster shot is recommended. The infant on the other hand should receive a Dtap Vaccine. The Dtap vaccine provides the same purpose for those under the age of 7. The first Dtap vaccine can be administered at the age of 2 months (4). The baby need 3 shots of Dtap which can be taken at the ages:The American College of Obstetrics and Gynecology as well as the CDC both recommend getting the Tdap vaccine while pregnant between 27 and 36 weeks (3rd trimester) of each pregnancy. The earlier the mother receives the vaccine, the more time there is for antibody response which increases the transfer to the baby. If the mother receives the Tdap vaccine after the baby is born, the antibodies may be passed on to the baby through breastfeeding. However it takes 2 weeks post vaccination for the mother to have protection against the diseases. This means the mother can still contract the diseases and pass it on to the infant during those two week.  Therefore it is best for the mother to receive the shot during pregnancy (5). Anyone who will be in close contact with the baby should also get a single dose of Tdap 2 weeks prior to being in contact with the baby. Sources:
5 min read
causes of heavy periods

Heavy Periods - What Are The Common Causes?

Heavy periods, called Menorrhagia in medical terms, can occur due to a variety of factors.  Menorrhagia refers to menstrual periods with prolonged or abnormally heavy bleeding. If not managed properly, women with heavy periods may develop more than normal blood loss due to which their risk of anemia, fatigue, and infertility can increase considerably. It may also cause significant mental stress and make them prone to depression. [1]Hence, there is a need to understand why heavy periods occur so that they can be managed in an appropriate manner. Here is a brief discussion about the common causes of prolonged and heavy periods and heavy periods with clots. what is considered a heavy periodHormone imbalances caused due to conditions such as polycystic ovary syndrome (PCOS), insulin resistance, obesity, and thyroid problems can lead to heavy periods. Ovarian dysfunctions can prevent the release of an egg during menstrual cycles. As a result, the body does not produce adequate levels of a hormone called progesterone during menstrual periods. This can lead to hormone imbalances and result in menorrhagia.Polyps are tiny growths that occur along the lining of the uterus due to which women may get heavy and prolonged menses.Uterine fibroids are a common causes of heavy or prolonged menstrual bleeding.Fibroids are the noncancerous or benign tumors formed in the uterus. These abnormal growths usually appear during the childbearing years of women. [2]In some women, heavy periods can occur due to adenomyosis, a condition that occurs when the glands in the endometrium become embedded within the uterine muscles. Women with adenomyosis may also experience severe pain during menses. Heavy and prolonged menses could also be a side effect of nonhormonal intrauterine devices (IUDs) used for birth control. However, you may choose alternative birth control measures if you develop heavy periods due to IUDs. A single menstrual cycle with the heavy and late flow could be due to a miscarriage. Women may also develop heavy vaginal bleeding during pregnancy due to the unusual location of the placenta or something more dangerous like an abruption. It may occur as a result of conditions like placenta previa or low-lying placenta. If you have any vaginal bleeding when pregnant head to an emergency room or your obstetrician's office right away [3]In elderly women, extensive vaginal bleeding may occur due to uterine or cervical cancer. It is more common in postmenopausal women. Diagnostic methods like Pap smear or a biopsy can help in the detection of these cancers at an early stage. While vaginal bleeding due to cancer can not be considered heavy periods, any bleeding after menopause must be checked out for the correct diagnosis of the underlying causes. Endometriosis, a disorder caused due to the abnormal presence of the tissue lining the uterus called endometrium outside the uterus, can cause heavy and painful periods. [4]Depending on the cause of heavy periods, women may be advised to use medications such as hormonal or other medications in order to treat the underlying cause and symptoms. [5]ConclusionHeavy periods can be treated by identifying the underlying abnormality responsible for it. The treatment should be aimed at eliminating the cause if at all possible. Getting this treated as soon as possible reduces the risk of anemia, mental stress, emotional distress, and other complications related to menorrhagia and even increase the chances of conception in women of childbearing age. Also, it is always good to make sure your symptoms are not caused by something more serious so always call your doctor when you have concerns. References:1.      https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-203528292.      https://www.health.harvard.edu/womens-health/heavy-bleeding-fibroids-and-polyps3.      https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=p024374.      https://www.nhs.uk/conditions/heavy-periods/5.      https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834
4 min read

Are bananas good for leg cramps?

Leg cramps, sometimes called Charlie Horses, happen when the muscles contract and won’t immediately release.  The symptoms last for a few seconds to a few minutes and can be extremely painful.  While they are pretty common, not a lot is known about them.These are involuntary contractions in either the muscle or a part of the muscle tissue.  When they occur, common treatments are to stretch or massage them, usually by walking around until the tension releases.The exact causes are unknown but frequently they are attributed to over exercise or dehydration.  There is also no cure.  However, there are ways to control or prevent them from occurring. It is found that if you ingest foods with key nutrients, leg cramps will be less prevalent.  These include potassium, sodium, calcium, and magnesium.  They are all electrolytes and can be found in a number of different food sources. Bananas contain three out of the four electrolytes that you need.  They are loaded with potassium, but also provide magnesium and calcium.  The average banana has 420 milligrams of potassium, or about 10% of the recommended daily requirement.   In addition to bananas, there are a number of foods that will help replenish this mineral and are solid additions to a healthy eating plan.  Sweet potatoes are high on the list.  In fact any type of potato will work.  In addition, they have a high water content so it will help if dehydration is one of the causes for your leg cramps.  Other choices are pumpkin, avocados, and watermelon.Some other preventive measures can include adding regular stretching to your daily exercise.  Sitting or standing all day can be a cause as well as overdoing alcohol or improper footwear.   Factors that can contribute to leg cramps are age considerations.  It is found that middle aged and older adults are more prone to leg cramping.   So, if you are in the middle of a leg cramp, the best thing is to massage it, use some heat or try putting weight on it.  Just be cautious of falls.  Eating a banana in the middle of a cramp won’t make it go away, but as part of a healthy diet and exercise plan, it can act as a deterrent.   If you follow all the rules and still have severe cramps especially frequently, if they don’t dissipate quickly or are in combination with other symptoms, speak with your regular medical provider.  They are linked to some serious conditions like hypothyroidism, diabetes, and Parkinson’s disease.  Only a qualified medical professional can adequately diagnose these conditions.    
3 min read

About Vulvar Varicosities: The Important Things to Know

Varicose veins appear when parts of your veins become dilated, enlarged, twisty, and/or overfilled with pooling blood. Because of this, you may feel pain, pressure, or discomfort in affected areas. Vulvar varicosities are varicose veins developed in the vulva, which is the external genital area in women. Many women would experience vulvar varicosities while pregnant, due to changes in their blood flow and the increased hormone levels causing veins in the vulva to grow. Fortunately, vulvar varicosities would disappear after childbirth, usually without treatment. If not, or you experience these symptoms outside pregnancy, there are treatments you can do to minimize the symptoms. Continue reading and learn more about vulvar varicosities.  Here are the causes of vulvar varicosities: ·         Pregnancy due to the hormonal changes and blood flow as well as pressure during childbirth·         Aging due to the veins becoming less efficient in function and structure, which causes the venous blood circulation to slow down·         Family history of varicose veins·         You are overweight·         Having pelvic varicose veins Varicose varicosities would usually occur on the labia major and labia minor, along with the vulva's lips and skin folds. You may notice that veins are appearing twisted and bulging out from the skin, which is soft and blue or purple.  Other women may experience other symptoms, such as: ·         Pain or pressure in the vulva·         Having a full feeling or heaviness in the vulva·         Discomfort while walking and/or pain during sexual intercourse·         Itchiness Your doctor would diagnose vulvar varicosities by asking about your symptoms and a physical examination. Sometimes, an ultrasound might be required to diagnose it to identify the varicose veins and their severity, such as blood clotting or flowing to the wrong area.  There are also other tests to determine the condition, especially if it is suspected that you have a larger venous condition. They may order the following tests to get a diagnosis: ·         Heart scan or CT scan of the pelvic·         Selective venography·         Magnetic Resonance Angiography There are at-home treatments that your doctor will recommend, such as: ·         Applying an ice pack to the affected areas·         Propping up your hips while lying down to improve blood flow·         Changing positions to relieve pressure on the body·         Wearing support garments and/or compression garments If even the symptoms are severe or you have other conditions, then your doctor might have these recommendations: ·         Use smaller amounts of gentle soap when bathing the vulvar area, then applying topical corticosteroid cream after bathing for itch relief.·         Taking prescription medication in case there is a blood clot in the vulvar varicosities to prevent blood clots and to break down existing blood clots.·         There are other aggressive treatments your doctor may perform, such as sclerotherapy, echosclerosis, phlebectomy, or transcatheter embolization.  Wrapping It UpVulvar varicosities are difficult to go through because of the pain and discomfort that is sometimes experienced. Usually, they would disappear within months after childbirth, and if the condition developed outside of pregnancy, it may need treatment. Fortunately, there are procedures to help alleviate its symptoms.  If you experience vulvar varicosities, do have it checked with your doctor to receive proper treatment and ensure there are no additional conditions from it.
3 min read

What are stretch marks?

Stretch marks are lines that appear on the skin in parallel to each other and look different than the surrounding skin.  Usually they can be purple to pink or a light gray.  The texture is different and you might feel a ridge or indentation.  They can be itchy or sore. These lines appear after a sudden change in weight like during pregnancy or during growth spurts in adolescence.  They are not dangerous and frequently disappear over time.  They can be anywhere but usually on the stomach, thighs and buttocks.  Sometimes on breasts and upper arms. Like their name suggests, they are the skin stretching and are generally accompanied by an increase in cortisone.  Too much cortisone will cause the skin to lose elasticity.  They can be caused when a pregnant woman's skin is stretching to accommodate a growing baby.  Rapid weight gain or loss can cause the skin to change.  Sudden growth spurts can result in marks.  Overuse of corticosteriod creams, lotions and pills.  Medically there are some disorders like Cushing's syndrome, Marfan's syndrome and Ehlers-Danlos syndrome that can result in stretch marks.  Stretch marks are most prevalent in Caucasian (especially pale skinned) women, or a family history of stretch marks.Stretch marks generally fade over time.  However, if you want to improve your appearance sooner you can try some of these remedies.  Just realize they will never disappear completely.•         Collagen restoring cream like Retin-A or Renova.  This is a fibrous protein that helps with skin elasticity and works best on recent marks that are red or pink.  Pregnant women should not use this product.•         Pulsed dye laser treatments will encourage the production of collagen and elastin and it works best on newer marks.  People with darker skin color may notice a discoloration.•         Fractional photothermolysis is very much like dye laser.  The laser is used to target smaller areas of skin and will result in less damage.•         Microdermabrasion polishes the skin with tiny crystals.  This exposes skin that under the marks. This is used for older stretch marks.•         Excimer laser stimulates melanin production, which is the element that produces skin color. This process will make the marks look more like the surrounding skin. These can be quite expensive and there is no guarantee of a cure.  Most procedures are considered cosmetic and not covered by insurance. Check with a dermatologist to see if they would be beneficial for you. There are some less expensive options.•         Vitamin A found in many over-the-counter cosmetics especially creams•         Sugar scrubs•         Aloe Vera as a skin softener applied after a shower.  Use pure aloe vera from a plant.•         Coconut oil has been shown to reduce the healing time in wounds.  Unless you have an allergy to coconuts, use virgin oil to remove the red appearance. As in so many other situations, prevention is the best treatment.  Keep your skin hydrated to prevent loss of elastin.  Use topical creams to keep your skin moisturized.  Over time most stretch marks fade and will be less prominent. 
3 min read

Is Nail Polish Safe?

For most of us we have become avid label readers.  We like to know what we put into and onto our bodies and are concerned about safety.  Organic is a term used frequently but unfortunately there is not a lot of governmental regulation to control it.  The term natural is also used but many substances found in nature are not good for us and can actually be toxic.  While some others may be benign, in combination, they become harmful.  This post will deal with nail polish. safe nail polishThere are three substances that you will frequently find in nail products. This is a chemical that makes products flexible and is often called a plasticizer.  Tests have been performed with this substance but no human testing has been published.  The studies have been on animal exposure.  So far, there seems to be no significant long or short term toxicity.  There may be some side effects like nausea and irritation in the facial area.  In animals studies there seems to be indicators that male reproduction can be affected. This is a colorless product used to even out color.  It is also an element used in making glue and is the inhalant in glue sniffing.  Because of its use in sniffing, it has been the subject of studies.  Side effects are dizziness, numbness, dry skin, and irritation in the nasal and throat passages.  Toluene in its liquid form is more dangerous than the gas but most nail polish uses levels below the danger level. You may remember this substance from high school biology.  That is what the frog was preserved in before your dissection.  It is also used as a hardening agent in nail polish and is well known as a carcinogen that can lead to cancer in humans.  This is one of those “natural products” that is found in very low levels in some fruits and are basically harmless.  However, in nail polish the limit can still be well above safe limits. Also found in some types of polish, triphenyl phosphate (TPHP) is a chemical that can disrupt hormones in the body.  The most frightening part of this substance is that it is absorbed into the body every time nail polish is applied.In general, staying away from chemicals on your skin and hair during pregnancy is probably best. There may be less toxic nail polishes but none have been studied in pregnant women. Even more alarming is that sometimes these chemicals are not listed on the product label.  If they are listed, it is likely that they are concealed among the other harmless materials.  Also, side effects are not listed on the tiny labels necessary on a bottle of nail polish. Another important thing to remember is that any of these ingredients can be included in not only the colored polish, but top coats, thinners, nail art, and combination products. Before you buy your next supply, you might want to check out reliable sources for a list of safe manufacturers.  Then you can bring your own choices into the salon or for use at home. And always ask your dermatologist before using any new products!
3 min read

Infant Eczema: Baby skin care and Baby Diaper Rash Care

When it comes to baby’s skin, less is more. The gentler we are with their delicate skin, the more we can enhance the skin’s natural barrier properties. Infant skin is the gateway to healthy immune functioning, healthy bacteria development, and may be a route for prevention of food allergies. Thus, skin care is paramount to healthy growth and development. 1. Don’t be scared to give baby baths Though daily baths are not necessary, a “soak and seal” with moisturizer is a great way to help soothe babies with dry skin. Soap is not needed every day and can be applied to only visibly soiled areas. Baths can also serve as part of a night time ritual that prepares baby for a consistent bed time routine, which is key to building good sleep habits. 2. Moisturize, moisturize, moisturizeIn some studies, moisturizing the skin has been shown to prevent the development of atopic dermatitis, a form of eczema. In a study of pre-term infants, babies who were applied sunflower oil, rich in linoleic acids, developed less infections while in the neonatal intensive care unit.1 Linoleic acids are naturally anti-inflammatory and can help build the skin barrier, protecting the superficial layer of the skin, the stratum corneum. 3. Avoid excessive wipingSome baby wipes contain chemicals that can cause contact dermatitis, a form of skin irritation.2 Excess wiping of the face after feeds can degrade the stratum corneum, which can create openings for allergens, and irritants to enter the skin. Use a barrier ointment before feedings, such as petrolatum, that will protect the skin against irritation from foods and wiping. I recommend use of soft washcloths if necessary, made of organic cotton or bamboo, and plain water.4.  MassageIn many South Asian and East Asian households, such as the one that I grew up in, massaging skin and scalp is a weekly ritual to keep skin and hair healthy. I can still hear my mother chastising me in the winter “you are not massaging your skin, this is why you look so dry”. Turns out mom was very right. In Ayurvedic traditions, abhyanga or daily oil massage is recommended to help not only the skin, but also circulatory, muscular, and neural health. Massage can help reduce stress levels and help build a bond with baby.3 5. Use commercial diapers and diaper cream every time While super absorbent diapers are a problem to the environment, from a skin perspective, disposable diapers that keep moisture away from the diaper area reduce diaper rashes and skin irritation.4 A barrier cream, such as zinc oxide, with every diaper change will protect the skin against chafing, and provide a barrier against irritation from pee and poop. 4Medically reviewed by Dr. Rupam Brar is a Board-Certified Pediatric Allergist & Immunologist at Hassenfeld Children’s Hospital part of NYU Langone Health, who specializes in eczema and food allergies. Dr. Brar also has specialized training in Pediatric Dermatology.References:1. Darmstadt GL, Saha SK, Ahmed AS, Chowdhury MA, Law PA, Ahmed S, Alam MA, Black RE, Santosham M. Effect of topical treatment with skin barrier-enhancing emollients on nosocomial infections in preterm infants in Bangladesh: a randomised controlled trial. Lancet. 2005 Mar 19-25;365(9464):1039-45. doi: 10.1016/S0140-6736(05)71140-5. PMID: 15781099.2. Chang MW, Nakrani R. Six children with allergic contact dermatitis to methylisothiazolinone in wet wipes (baby wipes). Pediatrics. 2014 Feb;133(2):e434-8. doi: 10.1542/peds.2013-1453. Epub 2014 Jan 13. PMID: 24420805.3.   Basler AJ. Pilot study investigating the effects of Ayurvedic Abhyanga massage on subjective stress experience. J Altern Complement Med. 2011 May;17(5):435-40. doi: 10.1089/acm.2010.0281. Epub 2011 May 13. PMID: 21568717.4. Blume-Peytavi U, Kanti V. Prevention and treatment of diaper dermatitis. Pediatr Dermatol. 2018 Mar;35 Suppl 1:s19-s23. doi: 10.1111/pde.13495. PMID: 29596731.
4 min read
female orgasm

Female Orgasm: 3 Myths Debunked by an ObGyn

Amongst friends, the conversation about sex always seems to go to “The Big O.”  We want to talk about sex, with our girlfriends, with our hairdressers, but not with our doctors. Why are we hesitant to discuss our sexual health with our providers, when nearly 43% of all women struggle with sexual dysfunction?[1] Yet, as a sexual health physician, these are all things I have heard in my office, behind closed doors in a safe space. “It takes forever to have an orgasm. What is wrong?”“I have never had an orgasm. Why?”“Ever since I started my Zoloft, I cannot have an orgasm.”“My orgasm feels so different; it’s almost not there.”“My partner does not know how to touch me -  I can only orgasm by myself.”“I am broken;I have never had an orgasm during sex. Sexual dysfunction can include problems with desire, arousal, pain or orgasm. The topic we talk most about, within the media and with our girlfriends: orgasms. However, there are many myths about the female orgasm. We have all heard these myths or seen them on full display in the movies as characters are ripping off their clothes and instantaneously aroused, almost immediately orgasming on screen. Without any safe places to discuss sexuality, this leads to a conundrum of misinformation. So, I am here to set the record straight.  First, let’s talk about why these myths about the female orgasm spread like wildfire. Up until now, there have been so many healthcare barriers women have had to face, specifically for sexual dysfunction. There is a profound lack of research, funding, female leadership, and trained sexual health providers. Women often live in the shadows as invisible patients, often dismissed even if they have had the courage to come forward to discuss these very personal issues.Currently there are no FDA approved treatment options for the millions of women who suffer from orgasm dysfunction. ISSWSH( International Society for the Study of Women’s Sexual health) describes orgasm dysfunction as: Problem with orgasm lasting 6 months or greater, that is distressing to the patient, and may be a problem with frequency, timing, frequency and pleasure. A woman may describe an orgasm that has muted intensity, never occurs, is devoid of pleasure or is delayed. Myth #1 - Most women can orgasm from penetrative sex.False.  I see women on a weekly basis in my office who genuinely think there is something wrong with them because they require some type of clitoral stimulation to have an orgasm. A comprehensive analysis of 33 studies over 80 years found that during vaginal intercourse just 25% of women consistently experience an orgasm, about half of women sometimes have an orgasm, 20% seldom or ever have orgasms, and about 5% never have orgasms.Let’s review some basic anatomy to understand why most women require some clitoral stimulation to orgasm.    Only a small portion of the clitoris is visible or external, the hood and the body. The bulbs (erectile tissue) and the crura (wings) of the clitoris which wrap around the vaginal opening are internal.  The glans of the clitoris - the external visible portion is the most responsive to sexual stimulation and is the most densely innervated part of the human body.[2] clitoris anatomy  With all of those nerve endings, the clitoris is crucial to sensation, pleasure and orgasm.  Most women will require stimulation of the clitoris to achieve orgasm; this can be attained with digital or oral stimulation or clever positioning during intercourse.A study that examined the size and location of the clitoris and its effect on the ease of ability to achieve orgasm was performed.  They found that a woman with a smaller clitoris that was located further from the vaginal opening struggled more with achieving orgasm with intercourse. [3]Another study found that women who reported that orgasm was a goal were more likely to report success in achieving orgasm during their most recent sexual encounter.[4]Myth #2  I CANNOT ORGASM BECAUSE IT’S ALL IN MY HEAD AND THERE IS NOTHING I CAN DO ABOUT ITFALSE. There are a multitude of reasons that may cause a woman to have problems with orgasm.   The most important piece of the puzzle is to determine why there is an issue with orgasm.  A visit to a provider that specializes in sexual health will often help.A thorough medical exam and history with review of medications is part of the work up. Problems with hormones, a side effect of a medication, menopause, problems with nerves, blood flow, the spinal cord, neurotransmitters, a brain injury or dermatologic or anatomic problems can render problems with orgasm.  A provider can check hormonal levels and order imaging as needed.Once a determination is made as to the etiology, or cause, of the orgasm dysfunction, a treatment option can be offered.  Currently, there are no FDA approved treatment options for orgasm dysfunction, but there are many treatment options. Treatment options can include hormones or off-label medications (an off -label medication is one that is FDA approved for a different reason, but has evidence that it can help with orgasm dysfunction). Sometimes surgery or a procedure is required to help with orgasm dysfunction.How do providers measure the level of orgasm dysfunction or response to medications?  There is a survey that women can fill out that measures all the domains of sexuality, including orgasm. This survey is called the Female Sexual Function Index, or FSFI. The survey is scored and responses to medications/treatments are measured and compared to pre-treatment levels.  MYTH #3 ALL WOMEN CAN HAVE MULTIPLE ORGASMSFalse. To understand this, we must explore the typical phases of an orgasm. In studies, about 15 - 42% percent of women report having experienced multiple orgasms.Let’s examine the data that exists; women that report multiple orgasms experience more than 1 orgasm in a single session in succession; timing between orgasms may be a few seconds to a few minutes. Masters and Johnson’s model further broke this down into women that experienced either repeated (multiple) or sequential orgasms. Repeated orgasms are described as orgasms separated by a rest period that does not fall below plateau; sequential orgasms are repeated orgasms without a plateau.[5] In a large data review of multiple orgasm the working definition was of 2 or more orgasms in a single sex session.[6] What were the findings in women that report multiple orgasms? So, yes, while it is possible for women to have multiple orgasms, this does not hold true for the majority of women.  The ability to have multiple orgasms is determined by both biology, brain chemistry, anatomy and circumstance. If achieving multiple orgasms is something you desire, there are ways to to increase your chance of multiple orgasms through exploration and play with your partner.   JD Salinger once wrote that “a woman’s body is like a violin; it takes a terrific musician to play it right.” With knowledge of our bodies and anatomy we can gain a better understanding of what we respond to and what will help us achieve orgasm. Self exploration can help in this - and, as we discover, we can guide our partners to be that terrific musician and help us reach orgasm.
7 min read

Essential Oils for Hot Flashes? The Experts Say Probably Not.

A hot flash is an abrupt sensation of extreme heat.  It starts when blood vessels located near the surface of the skin widen in an attempt to cool themselves.  At that point a woman will frequently start to sweat and her face can sometimes also turn red.  It can also be accompanied by an increase in the heart rate and sometimes even chills.  Essential Oils for Hot Flashes have not been shown to be effective, though they may smell nice and be a good distraction from the discomfort. We don’t know exactly what causes the hot flash to start but it is thought to be related to circulation.  It appears that the hypothalamus section of the brain that is involved in thermal control sends out a signal for the blood vessels to expand.  The body reacts to the rise in skin temperature by producing sweat to cool down. We do know that hot flashes occur in women as a symptom of menopause, when estrogen levels drop, or medical procedures that cause decreases in those hormones like ovary removals.  For men who receive androgen deprivation as a treatment for prostate cancer, they can also experience hot flashes. More than two-thirds of women experiencing menopause and perimenopause report hot flashes and 70% to 80% of males on androgen deprivation report them. Some women don’t experience hot flashes at all but for those who do, they can span a few months or up to 11 years.  The average is 7 years.  For men, since it is medication induced, they subside when the treatment is over. If you are going to have a hot flash, there is little to stop it, but there are certain triggers to avoid.  These include stress, caffeine, alcohol, spicy food, tight clothing, and tobacco smoke.  There are also some actions you can take to help with the problem.  Your gynecologist may also consider some prescription medications like fluoxetine, clonidine, or hormone therapy. Before you add any supplements or over the counter products, consult with your primary care physician and gynecologist.  Used in combination with other medications or treatments they can cause side effects that are far worse than hot flashes. 
3 min read
dry mouth during pregnancy

Dry Mouth During Pregnancy: Symptoms, Causes, & Treatment

Dry mouth during pregnancy is almost always normal. It occurs mainly because your body needs more water than normal, for the development of your baby. Besides, changing hormones in pregnancy also affect your oral health, and can lead to many issues like loose teeth, gingivitis, and dry mouth.   The most common causes of dry mouth in pregnancy are:When your body loses water faster than it intakes, it causes dehydration. Dehydration can be dangerous among pregnant women and may even cause constipation. Dehydration can lead to premature labor.Thus, you need more water during this time than you normally do.  Signs of dehydration are: ●     feeling overheated●     Extreme thirst●     Dizziness●     Dark urine●     Headache  Gestational diabetes can cause high blood sugar. Gestational diabetes occurs when the body fails to make extra insulin needed during pregnancy.This can cause problems for the mother and the baby, but is manageable with proper care, including a healthy diet and exercise and sometimes medications. Some common signs of gestational diabetes are excessive thirst, fatigue, and needing to urinate more often. Thrush refers to the overgrowth of Candida albicans in the mouth. We all have a small amount of Candida in our mouth, but it can outgrow if you have a weak immune system or have imbalances in healthy bacteria. Thrush can lead to a dry and cottony feeling in your mouth and sometimes pain. Other signs of thrush are:●     White, cheese-like lesions on your tongue and mouth●     Bleeding cheeks when scrapped●     Redness in your mouth ●     Loss of tastePregnant women may face sleep difficulties, including snoring and sleep apnea. Snoring is common during the second and third trimesters. It is more common if you smoke, are overweight, or have enlarged tonsils.  Changing hormones can also narrow your nasal and throat passages, causing breathing issues. Snoring makes you breathe with an open mouth while you are asleep. This makes saliva production difficult which can cause drying of your mouth.  You can treat mild dry mouth with home remedies, such as: ●        Staying Hydrated: Experts recommend drinking ten 8oz. cups of water every day during pregnancy to stay well hydrated. If you pass dark yellow urine, it means you should drink more water. Clear yellow urine means you are hydrated. ●        Avoiding Coffee and Soda: Beverages like coffee, soda, and alcohol can dry out the mouth. ●        Trying some Frozen Fruit or Ice: Consuming frozen fruit and sucking on ice chips quite frequently can moisten your mouth while keeping you hydrated.●        Using A Humidifier: At night, use a humidifier to retain moisture in the air, thus preventing dry mouth. Make sure you clean the humidifier always to prevent the growth of bacteria and mold. Buy a cool-mist humidifier to prevent or decrease the risk of bacteria growth. It works because bacteria grow in warm moist environments.●        Using Chewing Gum or hard candies: Chewing gum stimulates saliva flow and keeps your mouth moistened. Final WordsYou should always see a doctor if you experience other symptoms like tooth pain or decay, thrush, severe dehydration, sleep apnea, and gestational diabetes.  
3 min read
infertility depression and dealing with infertility

Dealing with Infertility and Infertility Depression - The Impact of Infertility on Mental Health

The word ‘infertility,’ often brings to mind doctor’s appointments, medications, ovulation cycles, and financial burden. While it is often not discussed, the mental toll of dealing with infertility can be equally as great, and infertility depression is just one way that can present. According to the Mental Health Professional Group of the American Society for Reproductive Medicine1, the psychological impact of infertility can invoke significant feelings of loss in people experiencing it. Between the organization and the cost of medical treatments, physiological effects of procedures, and uncertainties about results, the mental health burden can be high. MGH Center for Women’s Health - Harvard Medical School2 cites, “A number of studies have found that the incidence of depression in infertile couples presenting for infertility treatment is significantly higher than in fertile controls, with prevalence estimates of major depression in the range of 15%-54%3. Anxiety has also been shown to be significantly higher in infertile couples when compared to the general population, with 8%-28% of infertile couples reporting clinically significant anxiety4.”The Mental Health Professional Group suggests speaking with a fertility counselor or mental health professional if you’ve faced any of the following symptoms for a prolonged period of time:The primary goal of a fertility counselor is to help individuals and couples navigate and cope with the physical and mental changes that are associated with infertility. This can include managing stress, navigating partner responses (particularly if you and your partner have different outlooks and approaches to infertility), feelings of resentment about procedures and societal expectations, alternative family planning, and more. A counselor is trained to aid clients in honing existing coping mechanisms, discovering new strategies, implementing new methods, and maintaining healthy mental states while on the infertility journey. Keep in mind that many practitioners are able to practice telehealth, and counseling may be available over the phone.Finding a mental health professional comes with a few recommendations. The Mental Health Professional Group recommends that a practitioner should:Outside of finding a fertility counselor, reproductivefacts.org 5 has provided a list of coping mechanisms to use, for any persons or couples experiencing the challenges infertility brings. “Get accurate and current information to reduce anxiety. Utilize reliable sources such as the CDC, WHO and ASRM to ensure fact-based, scientific information. Sadly, nearly 1 in 8 couples experience infertility, according to the CDC. This breaks down to about 6% of married women ages 15 to 44 who have been trying to get pregnant for over a year. Men are affected as well with about one-third of infertility cases are caused by male reproductive issues. The remaining two thirds are split between female reproductive issues, and by both male and female reproductive issues or by unknown factors.6   Sources:
4 min read
where are your ovaries

Where Are Your Ovaries?

There is so much to learn about our bodies, with one thing women might want to know more about being their ovaries! With the many processes and cycles experienced, it can get confusing figuring out certain things about this important part of our bodies.One thing women question is, ‘where are your ovaries?’ While it may sound like an odd question, it’s actually a good one! So read on to find out more about the ovaries are and their amazing function.An ovary is a ductless reproductive glans where female reproductive cells are produced. Females will have one pair of ovaries, which is held by a membrane that's beside the uterus on each side of one's lower abdomen. What connects the uterus to our ovaries is the fallopian tubes, with the ovaries located on the upper right and left part of the uterusScientifically speaking, ovaries are paired with the oval organs part of the posterior surface of our uterus' broad ligament, beside the mesovarium, which is the fold of the peritoneum and continuous with outer surfaces of your ovaries.The ovary is required when reproducing as this is what produces female reproductive cells, known as the ova. Furthermore, they also produce sex steroid hormones, which are estrogen and progesterone, as a response to pituitary gonadotropins. This part of our body is also a part of the endocrine system since they produce female sex hormones. As mentioned, the ovaries are located on our lower abdomens. They are usually firm and smooth, being the size of an almond. While small, they play a huge role in our bodies, having three histological features, which are the surface, cortex, and medulla. Two peritoneal ligaments are attached to our ovary, which is the suspensory ligament and ligament of the ovary. During ovulation, a follicle, which is the small cavity in our ovary, will expel an egg through the stimulation of the gonadotropic hormones that were released by our pituitary gland, which is the luteinizing and follicle-stimulating hormone. The rest of the follicle, which is the corpus luteum, will secrete sex hormones, estrogen, and progesterone. These sex hormones will regulate menstruation and control sex organ development.Both these hormones will interact with one another to help control the menstrual cycle. As the egg matures, it will then be released, passing to the fallopian tube then the uterus. If the ovum will be fertilized by a male reproductive cell or the sperm, then conception occurs, and pregnancy begins.Wrapping It UpThere is still so much to learn about the ovaries, and that is just one part of our bodies that help women reproduce! But at least you now know where it is located, so in case you feel pain around the lower abdomen, it can help you identify the root cause, may it come from the ovaries or other organs in the area. Remember, it is important to be in sync with your body, especially because among the different reproductive tract cancers, ovarian cancer is prevalent in females. I hope you learned more about your bodies and that this article answered the question, ‘where are your ovaries?’ Now that you know even more about the ovaries, it’s time to begin knowing more about how your bodies reproduce. Do you have further questions or want to share your knowledge about the reproductive and endocrine systems? Let us know what you think in the comments section below, I appreciate all of your thoughts and insights!
3 min read

Bladder Control by Age: What to Expect

If you've noticed a change in your ability to hold your urine output, you may be wondering if evaluating bladder control by age makes the most sense. When evaluating bladder capacity by age there are a few things to consider.The bladder is an expandable organ. When empty its inner lining is compressed and folds in upon itself. The muscle in charge of emptying the bladder is thick and firm. It is made up of two tubes, known as ureters, that expel urine from the kidneys into the bladder. As it fills, the bladder wall becomes thinner and the bladder expands upward toward the abdominal cavity.  bladder capacityFor a child, you can calculate the bladder's capacity by taking the child's age and multiply it by two and then add another two ounces. For example, in a 3-year-old, it is 3 (age) x 2 plus 2, or a total of 8-ounce capacity.A health adult bladder usually holds about two cups of urine. The urge to urinate is triggered at about a quarter of its capacity.As a person increases in years of age, their bladder will grow and change, too. The tissue usually becomes less elastic which means it will not hold as much and cause the person to urinate more frequently. Additionally, the bladder wall and pelvic muscles can become weaker so it is more difficult for the bladder to fully empty.  All of this can cause leakage.This leakage, or urinary incontinence can cause daytime wetting, and cause an overactive bladder, making it harder to stay dry all day. You can attempt to do pelvic floor exercises to help combat this type of incontinence.The urinary system is composed of the bladder, kidneys, ureters, and urethra. The body processes what it needs from what we eat and drink and the excess fluid is passed through the kidneys.  In addition to the extra fluid, there will be other waste products in our urine as it moves into the bladder. When appropriate, the bladder will release urine through the urethra tube.A muscular valve, the internal sphincter, controls the release of urine and can help prevent leaking.  However, there are some common problems that will disrupt normal operation.There are infections that occur in the urinary tract (UTIs). These can occur anywhere in the system.  They are more common in women than men and happen as the bladder muscles weaken. Then the bladder is unable to fully empty itself.  If urine remains in the bladder for too long, it is more prone to infections.There are also lower urinary tract symptoms (LUTS) that indicate potential problems in the bladder and pelvic floor muscles.  These are indicated by trouble eliminating the urine, leaking, and frequent urges.There are many things that can affect the health of the bladder.
4 min read

Is Nail Polish Safe? Understanding Labels and Ingredients

Many of us have become avid label readers, or more aware of what our labels are actually saying. You may like to know what we put into and onto your body and are concerned about safety. When it comes to beauty products, many have asked: is nail polish safe?Organic is a term used frequently on labels but unfortunately is not regulated by any government entity for control. The term "natural" is also commonly used but many substances found in nature are not good for us and can actually be toxic. While some may be benign, when in combination, these things can become harmful, and are oftentimes found on nail polish labels. There are typically three substances that you will find in nail polish products.This is a chemical that makes products flexible and is often called a plasticizer. Tests have been performed with this substance but no human testing has been published. The studies have been on animal exposure. So far, there seems to be no significant long or short term toxicity. There may be some side effects like nausea and irritation in the facial area. In animals there seems to be indicators that male reproduction can be affected.Toluene is a colorless product used to even out color. It is also an element used in making glue, and is the toxic element that some sniff for a high. Because of its use in sniffing, it has been the subject of many studies. Side effects are dizziness, numbness, dry skin, and irritation in the nasal and throat passages. Toluene in its liquid form is more dangerous than the gas but most nail polish uses levels well below the danger level.You may remember formaldehyde from high school biology. That is what the frog you may have experimented on was preserved in before your dissection. It is also used as a hardening agent in nail polish and is well known carcinogen that can lead to cancer in humans. This is one of those “natural products” that is found in very low levels in some fruits and are basically harmless. However, in nail polish the limit can still be well above safe limits.Also found in some types of polish, triphenyl phosphate (TPHP) is a chemical that disrupts hormones in the body. The most frightening part of this substance is that it is absorbed into the body every time nail polish is applied.Even more alarming is that sometimes these chemicals are not listed on the product label. If they are listed, it is likely that they are concealed among the other harmless materials. If that weren’t enough, side effects are not listed on the tiny labels necessary on a bottle of nail polish.Another important thing to remember is that any of these ingredients can be included in not only the colored polish, but top coats, thinners, nail art, and combination products.Before you buy your next supply, you might want to check out reliable sources for a list of safe manufacturers. Then you can bring your own choices into the salon or for use at home.
3 min read
how long for scars to fade

Skin Care: How Long for Scars to Fade

Tumbling off a bike, surgery, acne, or burn will all leave scaring.  In fact, each of these scars presents itself differently.  How long for scars to fade depends on a number of factors.  First, we need to discuss what a scar is and how it forms. When there is a break in the skin, it is perceived as a likely target for infection. The body immediately starts to produce collagen to close up the gap. Over time, that collagen will remain, so the scarred area will never be pristine again. Small abrasions will probably never be noticeable, but the remnants of surgeries can be more visible.Areas of the body that are muscular will scar more deeply than those areas with thin skin like around the eyes. Also, some people are simply predisposed to replacing scarred skin with smooth.  While they may never completely go away, the appearance of scars can certainly be diminished.To help aid this process, it is important that you stay away and protect yourself from ultraviolet (UV) rays. A scar is more likely to become sunburned and when that happens it will appear more prominent and often with a brownish tinge.Major elements toward scar recovery is maximum blood supply and oxygen.  If you are a smoker, you will be depriving the body of both.There are some over-the-counter creams that help reduce the excess collagen and help. Mederma is probably one of the most well known. The process is to gently rub the scar repairing cream over the scar about twice a day.  The combination of the ingredients in the cream and the gentle massage will help the collagen remain smooth and soft. Less thickening of this collagen will help diminish the visual appearance of your scar.Particularly dreadful scars can be treated by a dermatologist. Using a pulsed dye laser, the doctor will treat the area to reduce the redness and encourage the production of normal collagen instead of scar collagen.  Another laser treatment is the use of a Fraxel laser.  This is used for an indented scar like the remainder of a surgical procedure.To reduce the appearance of scars:The initial phase of healing will take place within the first twelve hours and will last less than a week.  The bottom line is a scar will take from a few months to two years to fade.  A lot will depend upon the cause of the scar, its severity, hygiene, and treatment.If you have specific questions consult with a qualified dermatologist.
3 min read
retinol skin aging

How do Retinoids help my Skin?

Retinoids are a class of medications derived from vitamin A that are used to treat numerous skin conditions. Retinoids can be used topically on the skin as well as ingested orally. Topical retinoids are most commonly used to treat psoriasis, acne, melasma, hyperpigmentation from chronic sun exposure and fine wrinkles. Retinoids work by regulating skin cell growth, promoting collagen development and minimizing inflammation in the skin.1 There are many topical retinoids available in the United States including tretinoin, adapalene, retinol, trifarotene and tazarotene that come in gel, liquid, and cream forms.1  The oral retinoid, isotretinoin, is used to treat severe, scarring acne.2 Acitretin is an oral retinoid used to treat psoriasis.3  Most retinoids require a prescription, however retinol and adapalene containing products are available over the counter. This article focuses on topical retinoids.Tretinoin is the most studied retinoid used to treat age related changes.  Numerous studies confirm tretinoin to improve fine lines, texture changes, elasticity, hyperpigmentation and sallowness through its positive effects on collagen and regulation of skin cell turnover.1 Topical retinoids improve comedonal acne (blackheads and whiteheads) through effects on skin cell turnover by unclogging pores. Topical retinoids can help more inflammatory types of acne (pimples, cysts) by minimizing inflammation.4 In patients with psoriasis, retinoids reduce excessive skin cell production to reduce the thickness of psoriatic plaques and also reduce the overall chronic inflammation in the skin caused by this disease.1Topical retinoids can be applied to the skin once daily. All topical retinoids, with the exception of adapalene, are degraded by light exposure so are generally applied at night. Often it is recommended to start by using just twice per week and increasing as tolerated. Studies show that the beneficial effects on the skin happen even with just twice weekly use. The most common side effects are redness, peeling, burning and itching of the treated skin. These side effects are more common with tretinoin and tazarotene than the other topical forms. To minimize these effects, retinoids should be applied in the recommended amount and either mixed with moisturizer or followed immediately by a moisturizer. Application on dry skin also may minimize potential for irritation.5 For acne treatment, early improvement may be visible after six weeks of usage but most studies  document improvement at 12 weeks. When used to treat age and sun related changes,  improvement can be seen at 3 months.5 Retinoids in any form should not be used during pregnancy due to the risk of birth defects. During the initial months of using a topical retinoid, the skin will be more sensitive to sun exposure and more prone to sunburn. Patients using retinoids should avoid excessive sun exposure during initial treatment because of this increased risk. However, sun protection should really be used indefinitely to optimize the potential benefits of the retinoid on sun induced changes and of course to reduce the risk of skin cancer.5  Authors: Brooke Jeffy, MD, Aarushi JainMedically Reviewed By Board Certified Dermatologist Dr. Brooke Jeffy 1. Retinoids, topical - American Osteopathic College of Dermatology (AOCD). https://www.aocd.org/page/Retinoidstopical.2. Isotretinoin: Overview. https://www.aad.org/public/diseases/acne/derm-treat/isotretinoin.3. Psoriasis treatment: Oral retinoids. https://www.aad.org/public/diseases/psoriasis/treatment/medications/oral-retinoids.4. Leyden, J., Stein-Gold, L. & Weiss, J. Why Topical Retinoids Are Mainstay of Therapy for Acne. Dermatol. Ther.  7, 293–304 (2017).5. Mukherjee, S. et al. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin. Interv. Aging 1, 327–348 (2006).
3 min read
do women have a prostate

Do Women Have A Prostate? A Review Of Female Pelvic Anatomy

The quickest answer is yes! Women have two small anatomical structures called the Skene's glands. These glands are referred to as the female version of a prostate. Skene’s glands are located on either side of your urethra and link your urethra with the vagina.  The fluid released by the Skene glands lubricates urethra’s opening. The fluid has antimicrobial properties, and it protects the bladder and urinary tract from potential bacterial infections.  However, it is important to note that these glands drain into small ducts in urethra. Like male’s prostate gland, these glands also keep infection under the bay to prevent it from affecting other body parts from infections.  Since the Skene glands are situated in the pelvic, it is important to understand female pelvis anatomy. So, let’s get started: Female Pelvis Anatomy The lower part of the torso between the legs and the abdomen is called pelvis. Pelvis supports intestines and contains reproductive organs, bladder, and the Skene’s glands.  Parts of female pelvis anatomy are: ●      Hip bones: Our body has two hip bones, one on the right side and the other on the right. Hip bones form one part of the pelvis known as the pelvic girdle, and they join to the skeleton’s upper part through attachment at the sacrum. Each hip bone consists of three smaller bones, including Ilium, Pubis, and Ischium.●      Sacrum: The sacrum is connected to the vertebrae’s lower part. It consists of five vertebrae, all fused together. The thick sacrum supports our overall body weight.●      Coccyx: Also known as the tailbone, coccyx is connected to the sacrum’s bottom by several ligaments. It consists of four vertebrae, all fused into a triangle-like shape.●      Levator ani muscles: These are the largest muscles in the pelvis for supporting several functions, such as supporting the pelvic organs. It is a group of three different muscles, including Puborectalis, Pubococcygeus, and Iliococcygeus. ●      Coccygeus: It is a small pelvic floor muscle that originates at the ischium. This muscle connects to the coccyx and sacrum. Organs in Female Pelvic Some organs found in the female pelvic are: ●      Uterus: This thick-walled, hollow organ is the place where the baby develops. During the reproductive years, the uterus’ lining sheds during menstruation until pregnancy.●      Ovaries: Uterus has two ovaries located on either side. This part produces eggs and releases hormones, including progesterone and estrogen. ●      Fallopian tubes: Fallopian tubes in women’s bodies connect ovaries to the uterus. Cilia, specialized cells in the fallopian tubes direct eggs from the ovaries toward the uterus.●      Cervix: Cervix widens to allow sperms to pass into the uterus. It also produces mucus that prevents bacteria from reaching the uterus.●      Vagina: It connects the external female genitalia and the cervix. Also known as the birth canal, the baby passes through the vagina during birth. Final Words To sum up, women have a female version of the prostate that is called the Skene glands. These glands produce the same hormones that men's prostate glands produce. It plays a crucial role in our reproductive systems by working with the pelvic.
3 min read
breast milk color

Breast Milk Color - Understanding The Meaning

Breast milk color is often thought to be white. So, when you notice a different colored substance coming out of your breast, it’s understandable to be concerned.  Well, there is nothing to worry about! It's quite normal for breast milk to be yellowish and even change color over time. In this post, we will talk about the different colors of breast milk and what they mean.   The “normal” color of breast milk Most often, break milk is light in color, usually pale yellow. It can have bluish or other yellowish tints as well.  During the first few weeks after delivery, the milk changes its composition, amount, and color quickly. The normal changes by stage are: Color of Colostrum: The highly nutritious and concentrated colostrum is the first breast milk your body produces. It is sometimes clear and watery, and can be orange or yellow and thick. Colostrum contains high levels of beta-carotene that can give it a dark yellow or orange color. Color of Transitional Milk: As the production of breast milk increases, the body starts making transitional milk. During this transition period, breast milk changes its color from yellow to more white.  Color of Foremilk: Foremilk is lower in fat and thinner. This foremilk is thin and can look clear or bluish. Color of Hindmilk: As you continue to breastfeed, the fat in the milk increases. And, with increased fat content, breast milk becomes creamier milk called hindmilk that appears white or yellow.Certain medications, herbs, foods, and nutritional supplements can change the color of breast milk. Note that breast milk changes its color after also freezing, but without damaging its nutritional value.  These changes are usually diet-related and harmless. Some different colors of breast milk are: ●       Green Breast Milk: The green tone of your break milk is when you eat a lot of green foods or edible products that contain green dyes. Green-colored beverages and green vegetables like spinach and seaweed can also cause the greenish color of your breast milk. ●       Pink, Red, and Orange: The orange, pink, and red-tinged breast milk are due to eating foods that are naturally these colors. Other reasons could be having drinks or foods that contain orange, red, and yellow food dyes. Orange and sometimes, reddish fruit drinks orange soda, beets, etc., can also leads to differently colored milk with tints of orange, red, and pink. Pink can also be due to droplets of blood leaking into the milk from a nipple or breast duct injury.●       Brown and Blood-Tinged Breast Milk: When older blood leaks into your body’s milk ducts, the breast milk may appear brown, rust-colored, or dark orange. When breast milk appears like dirty water, it is called rusty pipe syndrome (blood in the ducts from breast engorgement). ●       Black Breast Milk: Black breast milk is often due to the antibiotic Minocin that also causes skin darkening. Minocin is not recommended when nursing. So make sure you consult with your doctor before taking any medication during breastfeeding. Conclusion Most breastfeeding mothers do not notice color variations unless they pump often, or the baby spits up the breast milk with a color. Knowing the reason behind the color change can reassure you if you are concerned about your baby's milk. In case of any doubt, it is always good to consult with your doctor if you have any concerns about your breastmilk
3 min read
ectopic pregnancy

What Is an Ectopic Pregnancy?

Normally, pregnancy occurs when a fertilized egg implants and develops into an embryo inside the uterus. It attaches to the lining of the uterus. So what is an ectopic pregnancy then? An ectopic pregnancy occurs when a fertilized egg gets implanted outside the uterus, including fallopian tubes, cervix, and even within the abdomen. According to the data of the American Academy of Family Physicians, 1 out of every 50 pregnancies is ectopic.Ectopic pregnancies that occur in the fallopian tube are also known as "tubal pregnancies." The fallopian tubes are the tubes that connect the ovaries to the uterus. Sometimes an egg gets stuck in them and causes danger to a woman's health if the pregnancy continues. This is because the fallopian tubes do not have enough space for a pregnancy to develop and grow. As the fetus grows, the chances of tube being injured or bursting increases.Any woman of childbearing age can be at risk for an ectopic pregnancy. Sometimes, the reason for such pregnancies will never be determined. However, below are a few common causes of ectopic pregnancies.Symptoms and DiagnosisThe common symptoms of uterine pregnancy and ectopic pregnancies are nausea and breast soreness. However, abdominal pain, absence of menstrual periods, and vaginal bleeding raise the concern for a diagnosis of ectopic pregnancy. The doctor usually diagnoses it through a blood hormone test and by doing a pelvic ultrasound. Treatments for an Ectopic Pregnancy·         Medication – your gynecologist can give you an injection of powerful medicine to stop the growth of pregnancy out of the uterus.·         Surgery – the doctor can perform surgery like laparoscopy under the general anesthetic to remove the fetus or fertilized egg from the fallopian tube or other location. PreventionThere is no possible prediction and prevention in this type of pregnancies, but you can reduce it's risk. Follow a healthy diet and maintain good reproductive health to lower the risks of ectopic pregnancy. Also, try to visit your doctor for regular gynecological examinations, especially if you are trying to get pregnant. ConclusionRemember that ectopic pregnancy can happen in any woman and may pose a dangerous risk to her health.  So, if you have any unusual symptoms like abdominal pain and might be pregnant, be sure to see your doctor to rule this out.  
3 min read

Dry Hair: Causes and Treatments

Dry hair affects both men and women and can happen at any age, but is most likely to develop with age and damage from products and chemicals/dyes. When your hair and scalp don’t get enough moisture through the oil it naturally produces, you will notice that your hair is not as shiny and is frizzy and dull. Hair is comprised of three layers. The scalp produces oil to protect the outer layers. Because it is oil, it will reflect light so healthy hair will look glossy and shiny. As hair becomes dry, the outer layer breaks down and you will notice that it has lost its sheen.There are two main causes of dry hair: environmental and hair care practices.EnvironmentalHair CareSince hair relies on the oil that is made at the roots under the scalp, both dry hair and dry scalp go hand in hand.  As the scalp dries, it flakes off and sheds creating what we term dandruff. Giving your hair some protection from sun and wind, like wearing a hat, can help retain the moisture both need.Age is also a major factor. As we age, the hair follicles make less oil. Hormone changes can also affect the production of oil.  If your scalp is oily but ends are dry, it is best to apply conditioner and treatments to the ends of the hair only. There are a few things you can do to combat dry hair. Washing your hair less frequently is one of them.There are some pretty simple things you can do to help with dry hair. Washing your hair less frequently is one of them. Consider shampooing every other day or even as little as twice a week. With fewer washings, should come less frequent blow drying and styling with heated curlers or relaxers.When you do shampoo choose a product made for dry hair and finish with a moisturizing conditioner. Check with your hair stylist about deep conditioning and keeping your split ends trimmed.Eat a balanced diet and exercise regularly. There are also vitamins and minerals that will help keep your hair in good condition like iron, vitamins D and B12, selenium and others.Especially if the dry hair persists and is accompanied by fatigue, mention it to your primary care physician. There are some medical conditions that manifest themselves in the hair’s inability to retain moisture.  Issues with your thyroid can also be a factor. If your thyroid production is too low (hypothyroidism), hair will become dry and brittle. This can be discovered through a simple blood test and corrected with medication.  More serious conditions are eating disorders like anorexia nervosa or bulimia. These may take work through personal and professional interventions, but can be controlled. At that point, hair will start to return to its healthy condition.
3 min read
pcos symptoms

PCOS Symptoms

PCOS is the most common cause of female infertility. During each menstrual cycle, the ovaries release an egg into the womb. This ovulation process occurs once a month. But women with PCOS fail to ovulate or ovulate infrequently, which means absent or irregular periods and difficulty getting pregnant. In women with PCOS, the ovaries develop multiple small follicles that appear as cysts, hence the term “polycystic.”  These cysts are immature ovarian follicles that failed to ovulate. Thus, most women discover they have PCOS when they try to get pregnant unsuccessfully.PCOS requires immediate medical attention because, in the long-run, it could lead to health risks, such as depression, high blood pressure, lipid abnormalities, obstructive sleep apnea, and diabetes to name a few. Getting treatment at the right time can reduce or prevent these risks. So, it is important that you know some symptoms of PCOS.While irregular periods and pregnancy failure are the most common signs of PCOS, you may experience random, unrelated symptoms as well. Since it mainly affects your hormones, women with PCOS may experience all or some of the following symptoms:1. Abnormal Hair Growth After puberty, if you experience heavy hair growth in uncommon body parts, including face, belly, chest, lower abdomen, and back, it could be a warning sign of PCOS. This condition is termed as Hirsutism. More than 70 percent of women with PCOS grow excessive hair on their body. Making the matter worse, excessive levels of male hormones have opposite effects on the scalp. That means it lleads to hair loss or thinning hair on the scalp, causing male-pattern baldness. 2. Excessive Weight GainWhen you have PCOS, our body has difficulty using the hormone insulin, causing insulin resistance. Insulin helps convert starches and sugars obtained from foods into energy. PCOS makes the body resistant to insulin. As a result, insulin, sugar, and glucose build up in the bloodstream.Combining this with high androgens levels leads to weight gain, especially around our abdomen and waist. That’s why women with PCOS have more of an apple body shape instead of peach shape. 3. Anxiety And DepressionAbout 40% women, particularly young girls, with PCOS experience anxiety, depression, and other mental health conditions. Although there is less or no evidence supporting the direct connection between PCOS and depression, it could be due to the combination of several factors. For instance, one study shows that people with insulin resistance report frequent symptoms of depression, stress, and anxiety.PCOS patients with anxiety may have lower levels of neurotransmitters like serotonin, GABA and acetylcholine, thus worsening the situation.  4. Abnormal Oily Skin and Acne Problems Higher levels of androgens among women play an important role in acne development. It is because androgens cause sebaceous glands in the skin to produce an excessive oily substance called sebum. In order to produce the right amount of progesterone, testosterone, and oestrogen, our body depends on signals from the pituitary gland. PCOS interrupts these signals, leading to increased testosterone levels. It further enlarges sebaceous glands and the production of too much oily sebum. 5. Heavy Menstrual BleedingBlood clots during periods are normal. But, if you regularly and abnormally have blood clots the size of 10p piece or larger, it could be a warning sign of PCOS. PCOS also causes heavier blood flow during periods. It is because the uterine lining builds up for longer, causing periods heavier than normal. It can lead to other conditions, including anaemia, fatigue, and bleeding between periods.First of all, see a doctor as soon as possible, especially if you’ve had difficulty getting pregnant, excessive hair growth, and diabetes symptoms. Next, make the necessary diet and lifestyle changes and get regular exercise.  
4 min read
causes of vulvar pain

5 Vulvar Pain Causes You Should Know About

The vulva is the area of tissue around your vagina’s opening, including the outer folds of skin. It is not uncommon to experience the occasional pain or discomfort around this area, such as during your period.  However, if you have been experiencing pain without any apparent cause, or if it is too painful to bear, this may be due to an underlying health condition.  But why would you experience it? Read on we show you some possible causes of vulva pain. As with most skin and deeper infections, a yeast infection can cause irritation, itching, pain, and discomfort. Symptoms, other than pain, include rash, discharge changes, itching, redness, burning, and inflammation.  The vulvar area and its nerve endings may become damaged from sexual activity (such as rough intercourse, sexual activity without enough lubrication), childbirth, or other activities. Other activities may cause vulvar pain, especially when it puts pressure on your vaginal region. Activities like cycling, spinning, horseback riding, and other similar activities may harm your nerve endings and tissue, resulting in pain. Some people may have genetic differences, which case their cells to overreact to hormones or inflammation. This can cause pain, especially when the inflammation occurs around the vulvar area. The inflammation would cause the tissue to swell and fill up with more blood than required, resulting in a hot and sore feeling. Those with chronic pain conditions are also at higher risk of vulvodynia (vulva pain). Women with these types of conditions are up to three times more likely to have other chronic pain conditions as well, such as fibromyalgia or irritable bowel syndome - IBS. Some studies have suggested that these might be inflammatory related diseases, which is why some types of vulvar pain may be related to inflammation. Products you use around your vaginal region can cause vulvar pain as well, due to sensitivity or even an allergic reaction. This is because allergic reactions can cause irritation and inflammation, leading to pain. Avoid irritants if at al possible.  If you use any soaps, gels, lotions, lubricants, or feminine deodorants, it’s best to stop applying them and introducing such products one by one to see if one of the products is causing the allergic reaction. Childbirth, pregnancy, nerve injuries, obesity, pelvic surgery, and trauma to the area can all cause pelvic floor dysfunction. Pelvic floor dysfunction can cause bowel and bladder issues, pelvic organ prolapse, and pain in the vulva as well as the lower back or pelvic area. It is also possible that a UTI could cause some pain similar to vulvar pain or radiating to that area, as could a kidney or bladder stone.  Wrapping It UpFortunately, treatment for vulvar pain exists, which is why you’ll need to visit your gynecologist to address the issue for suitable therapy or medications.  Furthermore, you can also make a few lifestyle changes to try to treat and also prevent vulvar pain from happening again. Make sure that you wear comfortable clothes and underwear, use products that are safe and non-irritating, and minimize activities that worsen your pain. By following your doctor's instructions and proper hygiene habits, you will be able to find the cause and hopefully treat the pain effectively.
3 min read

Preventing Eye Injuries in Children: Advice from a Cornea Specialist

Our most prized possession (okay maybe I’m a bit biased), is our vision. Moms out there, I cannot imagine how challenging it may be at home to make sure everything is optimized to keep your children safe from potential accidental eye injury. In this post, I will explore both chemical eye injury and then overall eye injuries in the pediatric population. A topic that was special to me in my residency and that I developed into a poster presentation in 2019 at The Association for Research in Vision and Ophthalmology (ARVO) was chemical-related eye injuries in pediatric patients across the country. We analyzed seventeen years of data from one hundred pediatric emergency departments in the country. Let me start first with the trends we found and then we can explore ways through which you can prevent eye injuries for your children.  In terms of chemical-related eye injury, the most common culprit was laundry soap and laundry detergent pods! This most commonly occurred for children in the summer, at home, and usually in kids between ages one to four years old. Other culprits included swimming pool cleaners and household cleaners. What do I mean in terms of chemical-related eye injuries? Well, any substance or chemical depending on its composition can cause a spectrum of injuries to our eyes, ranging but not limited to infection and compromise to the cornea’s ability to maintain its layers. Every injury to the eye, whether it be traumatic or related to a chemical, should be treated seriously and should be evaluated by an Ophthalmologist in an emergency setting.  Now let’s shift gears into looking at more broad pediatric eye injuries.  Pediatric eye injuries are wide-ranging, but often include animal bites/scratches, chemicals, and trauma (for instance an object to the eye). This was the foundation of many of my consults during training. Thus, I have developed from my experience six pearls for parents - in either preventing or managing an eye injury for your child: 1)      Keep things out of reach! One of the most simple ways to prevent injury is to keep items such as detergents, cleaners, sharp objects, hot objects etc. out of reach! 2)      If your child has sustained a traumatic eye injury, try not to manipulate the eye before an Ophthalmologist conducts their exam.If your child has sustained aa trauma to the eye, do not manipulate/touch the eye in case there is serious injury. Ensure your child does not touch his or her eye and then bring him or her in to see an Ophthalmologist as soon as possible (same day)!3)      In the instance of a chemical injury to the eye, the best thing you can do is flush and irrigate your child’s eye(s) with water. If you have saline at home, you can use this also. Irrigate until you can’t irrigate anymore! This is the best initial treatment for this injury and can prevent progression of chemical injury to the cornea and ocular surface.4)      Do not assume a red eye is just a red eye.Often parents notice redness on a child’s eye and attribute it to irritation or nothing serious. Do not underestimate what a red eye could really mean. It is only with appropriate instrumentation and a thorough exam by an Ophthalmologist that severe eye injury can be ruled out. 5)      Do not buy over the counter topical therapy (drops, ointments) to use on your child’s eyes until an Ophthalmic exam has been performed.Often the general population does not realize that over the counter drops and ointments are not all benign and totally harmless. Certain ingredients and formulations can worsen a preexisting eye condition or injury, so it is always best to hold off on treatment until your child has been seen by an Ophthalmologist. 6)      If you have a pet at home, ensure that his or her vaccinations are maintained and updated, and that their claws (if applicable) are appropriately managed and trimmed. Even the kindest, sweetest pets sometimes do not know better, and children can sustain significant injuries near or within their eyes as a result. With these pearls, you will be better prepared in anticipation of any potential eye injury that your child may face. Through education, discussion, and anticipation you can really do a lot in minimizing the risk of a child undergoing an incidental eye injury. I encourage dynamic discussion between each caretaker of a child to ensure that these precautions are being implemented in all of the settings a child may be in on a given day.  As always, I welcome, encourage, and love answering questions.  I hope this blog post helps even one parent out there! Nitasha Khanna, MDCornea and External Disease FellowOphthalmologist Follow her on Instagram Reference: Khanna N, Yilmaz T, Simon M, Migliori M. Epidemiology of Pediatric Chemical-related Eye Injuries Treated in US Emergency Departments (2000-2017). Annual Meeting, The Association for Research in Vision and Ophthalmology, Vancouver, Canada, May 2019.
5 min read
Online Fertility Calculators

5 Online Fertility Calculators You Can Use Today

If you’re trying to conceive, then one of the things you should begin doing is to understand your body and its cycles. This means tracking your menstrual cycle and days you ovulate. One way to do that is using an online fertility calculator. Today’s technology has made it even easier to track your ovulation, showing your most fertile days for higher chances of conception.  But of the many different mobile apps and online tools we can use, which are the best fertility calculators and trackers? Read on for the top five choices and reviews! 1. Clue Period Tracker, OvulationThis free mobile app takes the clue and guesswork out of your cycles, hence the name. This period tracker app utilizes research and science to help you conceive.  It comes with an ovulation calculator with fertility predictions, as well as a platform to log in your basal body temperature, giving you more useful information. 2. Glow Cycle and Fertility TrackerWhat’s great about the Glow Cycle and Fertility Tracker is that it doesn’t only provide an ovulation calculator, but a tracker as well.  You can track your cycle and record sexual activity, any symptoms experienced, as well as your daily moods. All these can improve your chances of conception! This is a free mobile app that has garnered many positive reviews thanks to its accuracy and ease of use. 3. Clearblue Ovulation CalculatorThe Clearblue Ovulation Calculator is a great online tool that shows when you are most likely to ovulate. Simply put in the date your last period began, and your usual cycle length.  The website will also show you more information regarding your ovulation calendar results. They have a Frequently Asked Questions section below the calculator, sharing basic and useful information on fertility. 4. Tommy’s Ovulation CalculatorTommy's is an organization centered on women, tackling pregnancy-related research and information. Their website offers a straightforward ovulation calculator that shows accuracy and quick results.  What makes them a suitable online tool is how easy it is to use and understand the results. They will also show different useful information right after, such as the best times to conceive, how the menstrual cycle works, and spotting the signs of ovulation 5. Office on Women’s Health Ovulation CalculatorThe Office on Women's Health provides a variety of tools you can easily access online, including their ovulation calculator. It's very easy to navigate the website, and the ovulation calculator is straightforward, sharing what the tool is about.  Put in the start date of your period and average length of your menstrual cycle, then you’ll get instant results. You can also learn more about your fertility with their other tools, and articles to help you conceive or find a suitable birth control method. With all these tools in mind, they are best used as a basis of your ovulation, but shouldn't be the sole method to track your cycle. These tools help you know more about your cycle and the approximate times you'll ovulate, but every woman's body is different, despite having a similar period start dates and menstrual cycle lengths. For a more accurate basis, there are other ways you can track your ovulation alongside these free tools. There are ovulation tests, among other methods to help you know more about your body. Wrapping It UpTracking your ovulation and fertility doesn’t need to be so challenging, as there are online tools you can use on your phone! Not only will it assist you in tracking your cycle, but they also hold useful information for conception, birth control, among more valuable advice for women.  Begin using any of these fertility calculators today and good luck!
4 min read
breast lump in pregnancy

Breast Lump Pregnancy - Should you worry?

Finding a breast lump in pregnancy can be very scary, and a lot of things may be in your head right now. BUT, don’t fill yourself with too much worry and anxiety.  Having breast cancer while pregnant is rare, even more so for women under 35 years old. Furthermore, you will experience a lot of changes in your breasts when expecting, so some changes can be normal.  But what exactly does a breast lump during pregnancy mean? Read on to learn more! Even during your second trimester, your breasts begin preparing to nurse your little one. Sometimes, a milk duct may get blocked, and even enlarged, during this process. You will know for sure as clogged milk ducts are typically hard and sometimes even reddened lumps, which feel tender or hot to the touch. Fortunately, they usually clear and feel better after a few days, or they sometimes continue clogging up and you may need antibiotics or surgical drainage. Other reasons your breasts would change during pregnancy is from the increase of hormones. You may feel tenderness or changes around your breasts and nipples from these hormones. You may also experience an increase in your breast size, changes of size and color of your nipples and areola, as well as bigger and noticeable Montgomery glands (the small bumps around your areola). Once you're in your fourth month and later, your breasts may produce colostrum and some people have small amounts of leakage or crusting of colostrum in the nipple area. Besides clogged milk ducts, the breast lumps during pregnancy may be due to many other things such as:             •           Cysts or fluid-filled sacs            •           Galactoceles or milk-filled cysts            •           Fibroadenomas, developing in your breasts’ lobules These are benign breast conditions, meaning they are NOT cancerous.  Also, the good news is that those pesky bumps show that your body is starting to prepare to nourish your little one! And when you choose to breastfeed, it can reduce the risk of breast cancer in the future. Furthermore, it's great that you are aware of the changes in your breasts during and after pregnancy. Since they change a lot, it's a great time to log in your breast shape and present feeling in a diary. If you do have a new breast lump or changes in the existing lump that has already been checked out, you should still have it checked with your doctor as any change could be a sign of an early or new cancer.  If your breast lumps are caused by clogged milk ducts, it can feel a bit uncomfortable from the tenderness.  Fortunately, you can help make your breasts feel a bit better by applying a warm compress to the affected area regularly. Or, you can run warm water on the lump while you shower. You can also try to massage the lump and clogged duct to unclog the milk buildup, eliminating or reducing the lump size.  Again, if the lump doesn’t get any better in a day or so, do check with your doctor as you might need antibiotics or surgery to relieve the issue.  If you’re worried that it’s breast cancer, your feelings are valid. It’s also best to know how to tell if your lumps are a sign of the condition. Breast cancer lumps aren’t usually red or painful when they appear, and they won’t clear up after hot water and/or a massage or antibiotics.  However, it can be difficult to distinguish the difference between benign and cancerous lumps, so if you feel anything suspicious in your breast, among any other new symptoms, then do get it checked immediately.  Wrapping It UpHopefully, our article on breast lumps during pregnancy informed you of the possible causes of a new lump during pregnancy. If you have a lump in your breast, make sure to get it checked out as soon as you can.
4 min read
baby sleep regression

What Are Baby Sleep Regressions? What to Know and How to Handle Them

Is your little one waking up every 20 minutes and keeping you from having a good night’s sleep? He may be going through baby sleep regressions!After becoming a parent, you’ve probably heard about these sleep regressions without really knowing what to expect. To learn more about what they are and how to move past them, read on! Baby sleep regression is the time when your little one’s sleep patterns start to shift. They will wake up more throughout the night, having a difficult time sleeping again. Unfortunately, once they awake, so will you. It’s frustrating, but manageable, especially when you know how to handle it well and know why it happens. Baby sleep regressions are totally normal and fortunately, a temporary period. But why does it happen? Sleep regressions may mean that your little one is going through a growth spurt, and/or that his brain is going through some development. Since the brain is developing, your baby is starting to learn new skills and master existing skills, such as rolling over or sitting up. With every major milestone or development, a sleep regression usually is there to accompany it.  During this time of growth, development and learning, it might be tiring, stressful and frustrating for your little one. As a result, it impacts their sleep patterns. That is what is called a sleep regression. It’s not truly a regression in that is just means there is less regular sleep or a change in sleep to a pattern you may have seen more when they were infants.  Baby sleep regressions usually begin when your little one turns four months old. Note that there may be more regressions occurring in the future, usually every two to three months until they reach the toddler stage.  Usually, the first sleep regression at four months old is the hardest for parents, as it is the first they’ll experience and they may have had better quality of sleep for a period before it.  This period can last between three to six weeks or longer, and it can catch you off guard! Your baby may have been sleeping well, only to begin waking up more at night, taking shorter naps, or even skipping them without an obvious reason. You will know when your baby is going through a sleep regression when you notice a sudden worsening of their sleep patterns.              •           Waking up multiple times at night            •           Less napping             •           More fussiness            •           Appetite changesWhen it does happen, don’t worry! This usually doesn’t mean something is wrong. Reassure yourself that this is temporary and it means your little one is growing and learning new things as regressions occur, as they are engaging with their environment even more. But if your little one experiences other symptoms such as fever or other signs of illnesses, do consult their doctor. While baby sleep regressions are a technically sign of a good thing (development), I can’t deny that it’s frustrating for parents as well.  Baby sleep regressions don’t last forever. With the right knowledge, coping strategies, and tips, you can help them learn new skills as the entire family sleeps healthier. Good luck!
4 min read
neon yellow pee causes

Neon Yellow Pee- What causes it?

Urine should be yellow.  Each person has a different “normal” in the color range from very pale to darker shades of yellow.  You should recognize when your urine color is average for you.  When you drink the proper amount of water a day, urine is probably pretty light yellow.  The more dehydrated you are, the darker it will look.  If your urine is cloudy, a color other than yellow, or brown, consult your medical professional. Diet can also be a factor in the color of your urine.  Beets and berries can cause your urine to be pink or reddish.  Some processed foods also contain dyes that will affect the color.  The beta carotene that we are encouraged to consume in carrots and sweet potatoes converts to Vitamin A that can make your urine darker or even orange. If you have recently switched or added certain vitamins to your regimen, you should realize that the B vitamins like B-2 and B-12 can cause urine to fluoresce into almost a yellow-green color.  This includes those shakes that have a lot of riboflavin and cobalamin.  Vitamin C may show up darker or even orange.  Vitamin C is also high in foods like tomatoes, strawberries and broccoli. As mentioned, keeping hydrated is a good thing, especially if you exercise vigorously.  If you have worked out or have been dealing with summer heat, you probably should increase your water intake.  If your urine is darker than usual after exertion, have a glass of water.  If you are consistently dehydrated, you will notice your urine is brownish like a cola or tea.  Especially if you are also experiencing muscle pain, seek medical attention quickly.  This is serious.Medications can also affect the appearance of urine.  This includes over-the-counter as well as prescription versions.  Examples include phenazopyridine (Pyridium) and rifampin are known to produce an orange hue.  Laxatives and some chemotherapy treatments also change the color of urine. If you have ruled out dehydration, food sources, and medicines, but you still notice discoloration, cloudiness, or an unusual odor, you may have developed an infection or issues with your kidneys or bladder.  This can be a sign of a serious illness or condition.  Consult a physician as soon as possible to rule out anything critical.  Especially if the discoloration is accompanied by any other symptoms like fever, pain, or vomiting. Age and gender play important roles in the chances of developing some condition or illness.  Most women will, at some point, develop a uterine tract infection (UTI) and men can have problems with their prostate gland, either of which can cause bleeding expelled through the urinary tract.  For children, urinary tract bleeding is very serious and should be addressed quickly by medical personnel. When you visit the doctor and he or she orders a urinalysis, you should be prepared to answer a number of questions especially when the discoloration began, sleep patterns, smoking, unexplained weight loss, rashes, and any changes in your regular routine.  Through a physical examination and the results of your blood work, the physician should be able to direct you to a cause and treatment options. 
3 min read

Is Pregnancy Brain Real? What to Know

You might have heard of the term “pregnancy brain” at least once in your lifetime, and if you’re pregnant, it may cause some worry! Well, not to worry because you aren’t alone, with many pregnant women experiencing the same brain fog, a sort of hallmark of pregnancy.  Some women may forget appointments, what they were supposed to get in groceries, or whether or not they’ve left the television on. Other times, you might have forgotten your phone number! So if you’re wondering, “is pregnancy brain real?”, it definitely is. But what causes it and is it really normal? Read on to learn more. As mentioned, pregnancy brain is real and actually very common, even in the most organized, the master of multitasking, and with great memory!  The good news is: While pregnancy brain is normal, it is temporary. It does get frustrating losing organizational skills and becoming more forgetful, so don’t worry about this being a long-term issue. Your brain will soon come back to normal a few months after giving birth. Pregnancy brain is really just about your hormones having a bit of fun and doing its thing, which is a natural part of pregnancy. Unfortunately, your memory is affected from it.   There are also several reasons why pregnancy brain happens, including lack of quality rest due to discomfort when sleeping. Plus, since you’re usually out of energy carrying a beautiful baby, it can affect your brain function and focus. Again, tiredness during this time is normal! Besides this, all of the huge and exciting changes going on throughout your pregnancy may impact the way you think and focus, causing the pregnancy brain. Furthermore, there has been research proving that a brain does function differently during pregnancy. It increases activity in the side connected with emotional skills! Also, the brain-cell volume decreases in the third trimester of pregnancy.

I'm sure you wouldn't want to just plop down and let the pregnancy brain consume you! There are things you can do to cope up with the pregnancy brain and avoid the fog from negatively impacting your life. Here are some tips you can follow: ·         Don’t be too hard on yourself if you forget things or feel overwhelmed with typical tasks. Take a deep breath and avoid stressing out, as negative feelings can cloud your brain further. Instead, have a good laugh and find the funny part in these moments.·         If you have to remember something, such as purchasing groceries or setting appointments, make sure to write it all down. Take a big note and leave it in obvious places, or a handy notebook in your everyday bag.·         Place reminders on your phone to help stay organized and less forgetful.·         Have support and backup system, delegating jobs to other people, such as your partner, family, and trusted friends.·         Consume choline-rich foods, as well as DHA-rich foods, which can help with your overall memory and brain function. Some supplements can provide these nutrients. Furthermore, avoid consuming ginkgo Biloba supplements, which aren't proven safe to take during pregnancy. Wrapping It UpPregnancy brain is a real thing, but it doesn’t mean it’s the end of the world (at least, during your pregnancy). There are things you can do to cope with the brain fog and to have a better quality of life as you carry your little one until delivery. Again, this is only temporary, so let time take its course and enjoy the journey as you begin parenthood!  
3 min read

Discharge Changes When You Ovulate: What to Know

A woman's body produces many fluids (that are totally normal), and cervical mucus is one of them! Also known as discharge, it usually comes in different forms throughout the menstrual cycle.  If you’re trying to get pregnant, you can track your discharge to learn more about your cycle and know when you’re ovulating, the time you’re most fertile. But how will you know if you’re ovulating based on your discharge? Read on to learn about the different  Are you already tracking your basal body temperature (BBT)? Then you might want to accompany it with cervical mucus tracking.  Your BBT will identify if you ovulated only after it happened. But tracking your cervical mucus changes can tell you when you’re about to ovulate, which can help you time sex to conceive successfully.  When ovulation is approaching, your discharge would change to a sperm-friendly consistency. After ovulation, your hormone progesterone will cause discharge to become sticky and thicker, stopping sperm from getting through your uterus. (https://www.hhs.gov/opa/reproductive-health/fact-sheets/vaginal-discharge/index.html) While all our bodies are different, these are the general changes in your discharge:             1.         Menstruation            2.         Dry or sticky consistency            3.         Creamy-like lotion            4.         Wet and watery            5.         Raw egg white consistency            6.         Dry or sticky consistency            7.         Then back to menstruation, with the cycle repeating.  When the mucus is wet and watery or in the raw egg white consistency part, then ovulation is coming. This would be the best time to have sex for more chances of a successful conception.  When checking your cervical mucus, follow these steps: 1. Wash and dry your hands or wear gloves. Make sure they are clean before touching your vagina to prevent any infections. 2. Sit on the toilet, squat, or stand up with one leg on the toilet seat, whichever position is most comfortable.  3. With your index or middle finger, reach inside your vagina carefully, making sure you don’t scratch yourself. Reach until you get a sample nearing your cervix. 4. Remove your finger and check the consistency of your cervical mucus. You can do this by looking at the mucus, rolling it between your finger and thumb. Press your fingers together, slowly separating them. 5. You can refer to the different discharge changes above and mark it down on your chart for accurate ovulation monitoring. While you can make your own handwritten chart, you can also use a mobile app for tracking and monitoring.  (https://www.med.unc.edu/timetoconceive/study-participant-resources/cervical-mucus-testing-information/) Here are some extra tips when checking your cervical mucus:             •           Do NOT check your discharge during or right after sexual intercourse. You won’t be able to tell the difference between arousal fluids, semen, and cervical mucus.            •           You can also check your discharge looking at your underwear or toilet paper after wiping. This is a good alternative if you feel uncomfortable putting your finger inside.             •           Never try to wash away your body’s natural fluids, using methods like douching. These fluids are normal and healthy, and if you use various cleaning methods, it can do more harm than good. If ever you don’t get fertile-quality cervical mucus, let your doctor know. This may be a problem with hormones or fertility, or it can be due to some medication you’re taking.  Wrapping It UpIt’s good to track your discharge changes when you ovulate, which can help you learn more about your fertility cycle. While it does take a bit of time to learn how to track it, you’ll be able to recognize your discharge changes and cycle more. That way, you have another powerful tool to help you conceive!
3 min read
Serena Williams pregnancy story

Life or Death: On Being Pregnant and Black

In 2018, tennis star Serena Williams, while recovering in the hospital from delivering her child via C-section, began to experience shortness of breath. Due to her history of pulmonary embolism, she explained to the nurse that she needed a CT scan and possibly IV anticoagulant medication.  The nurse dismissed her concerns, believing that the world class athlete’s pain medications were causing confusion.  Serena did not yield, and hours later, a CT scan revealed small blood clots in her lung, which could have easily ended the new mother’s life. My husband and I have been together for about 5 years and vacillate over whether we want children or not. We discuss the loss of our personal freedoms; the financial expense raising children entails in the United States and how parenthood alters a couple’s dynamic.  However, our worries oftentimes lean to the morbid, as we contemplate whether I would survive a pregnancy.  According to the CDC, Black women in the USA die at a rate of 41 per 100,000 live births.  When comparing maternal mortality rates across the world, the figures are alarming.  White women in the U.S. die at a rate of 13 per 100,000 live births, which is comparable to the maternal mortality rates in the former Soviet bloc countries like Latvia, Hungary and Romania.  Conversely, in Western European countries, the average rate of maternal deaths is between 1.9 to 5 deaths per 100,000 live births.   In other words, although Black women may experience more adverse outcomes during childbirth than White women in the U.S.; compared to women in other Western nations, American White women’s statistics are not good either.Data collected for over five years by the New York City Department of Health and Mental Hygiene highlighted that access to prenatal care, and being highly educated did not protect Black women from the inherent biases in the healthcare system.  In one study it revealed that “Black college-educated mothers who gave birth in local hospitals were still more likely to suffer serious pregnancy- or childbirth-related complications compared with women of other races or ethnicities who never graduated from high school.”In 2016, Dr. Shalon Irving, an epidemiologist at the CDC, died from hypertensive complications, three weeks after delivering her first child.  What could be regarded as more than a stroke of irony, Dr. Irving’s work focused on understanding how structural inequality, trauma and violence made people sick.   In a 2017 NPR article, it states that despite “...two master's degrees and dual-subject PhD., her gold-plated insurance and rock-solid support system...”; race alone was the main factor predicting Dr. Irving’s  fatal outcome.Although the majority of my African-American friends have had relatively easy pregnancies with uncomplicated deliveries, the fear that I’ll be the one to succumb to childbirth, remains constantly on my mind.  Despite being a healthy, young woman, I often wonder if bringing life into this world could result in my own physical demise.  Equipped with the frightening statistics and information about societal inequities, how does society begin to change a system that is disproportionately killing Black mothers?During slavery, Black women were likened to mares and expected to produce as many children as possible, to continue the slave based economy.  The denigration of the Black female body has been one of the legacies of slavery manifesting in the current Black maternal health crisis. As Black people continue to fight for basic human rights, it is not surprising that Black women experience increased health risks and negative outcomes, during such a vulnerable period like childbirth.There is a need for the federal and state governments to create public health initiatives that promote and improve the disparities in maternal care.  Practitioners must be educated during medical school and residency about their implicit and explicit biases that are resulting in the deaths of specific demographics.About 5 years ago, a friend who was in her second trimester asked me to accompany her to her prenatal appointment, as her husband was out of town. During the visit, the OB was emphatic as she instructed my friend to train for the delivery, likening labor to a triathlon.  My friend, a surgical resident living in a Miami high rise with amenities like a gym and pool; as well as a husband with above average cooking skills, could adhere to her OB’s recommendations. But what about other Black women, who aren’t as privileged?  Would they be able to prepare for the undue harm and stress pregnancy and delivery might put on their bodies? Due to structural racism, a large segment of women of color typically reside in food deserts without access to healthy fresh food, as well as few safe spaces to exercise.  With minimal activity and poor food options, Black women are often at greater risks of obesity and cardiovascular disease.  Bearing these inequities in mind, some individuals do not have the option of healthy food choices and remaining physically active, during pregnancy.  So, if a woman must train for pregnancy and the delivery like an upcoming sports event, then it must be imperative that all women have the access to resources that will allow them to maintain good health and decrease the risk of maternal mortality and morbidity.According to an article posted on LAIST, “What Pregnant Black Women Need To Know To Have A 'Safe And Sacred Birth', Black women have to be proactive  in their care.  They must:-Find a birth experience that works for their family-Advocate for themselves in the doctor’s office-Find providers who will work to improve birth outcomes-Have the wider Black community support pregnant women Last fall, I made an OB Gyn appointment for a problem visit. Over the past few years, I had noticed that my premenstrual mood swings were intensifying.  My mother told me that in her early 30s she had experienced a similar shift, so I decided to see a specialist. As I sat in the doctor’s office and relayed my symptoms, she barely made eye contact.  She dismissed my claims and seemed squeamish about performing a pelvic exam. I eventually dug in my heels, and pulled the ‘doctor card’. This garnered me a glance and a half smile. However, she quickly stated that I was exaggerating my PMS irritability, and as a psychiatrist, I was overanalyzing, looking for a problem. I left her office feeling gutted. I quickly went to Google reviews and discovered that other professional Black women had experienced similar treatment with this  practitioner.  After the encounter, I began to re-evaluate my already tenuous plans for motherhood.  If concerns about my period could be summarily discredited, then what might happen if I had any concerns during a pregnancy? A month after that experience, I journeyed several miles north to see a Black OB Gyn, who was recommended by a friend. She listened to all of my symptoms, as well as my unspoken concerns. She did a thorough examination and agreed that I was experiencing Premenstrual dysphoric disorder and offered me a variety of treatment options. After careful review, I decided on natural supplementation, which has made a difference in my monthly menses. But beyond that, I felt heard. I felt validated. I felt understood.  The stark difference in the two experiences has shown me that by using my network and seeking out the right practitioner, I can become a mother, without being fearful of death.Dr. Cisse is a board-certified psychiatrist, who provides care for adult patients. She is also passionate about exploring psychopathology at the intersections of race, gender and class, within the African Diaspora.
7 min read
How Early Can You Take a Pregnancy Test

How Early Can You Take a Pregnancy Test? The Real Answers Here!

One of the most anxious moments women go through is taking the pregnancy test. It gets confusing as to when you should take it, and if you can get accurate results as soon as possible! So, how early can you take a pregnancy test, anyway? Read on to learn about the accuracy of pregnancy tests and how early you can take them. How Early Can You Take a Pregnancy Test? Unfortunately, you can’t take a pregnancy test and expect it to be accurate immediately after intercourse.  You are only able to take a pregnancy test and expect accurate results anytime after you experience a late period. This is when they work the best, which is why it’s recommended to take a pregnancy test if you experience a missed period and had sexual intercourse recently.   If you have an irregular period, or can't wait until your next period to find out, then the rule of thumb is to take a pregnancy test two to three weeks after your last sexual intercourse. This is the earliest time you can take a pregnancy test that shows accurate results. Pregnancy tests claim to work even before a missed period, though the results aren’t as accurate. If you come across “easy results” pregnancy tests, this may still be too early for you to get an accurate result, especially since all of our bodies are different and have different menstrual cycles and fertility phases.  If you take it too soon, such as a week after intercourse or before your period is due, then you may get a false negative. You will need to take another test after a week or two if so.  For those who are a bit confused about when to take pregnancy tests, there are online calculators that can help you. Simply put in the day your last period began and your average cycle length, and it will give you the earliest date you can take a pregnancy test. Another thing to take note of is the time of the day you should take the test for accuracy. It's much better to take it first thing in the morning, at least a day after your period is late. Your urine is more concentrated the moment you wake up, giving you more accurate results The Test AccuracyWhen you read and follow the instructions carefully, you get 99% accuracy when doing the pregnancy test on the day you miss your period. However, the 99% accuracy doesn't apply when doing the test early. Furthermore, some of these 99% accuracy claims may not even be true! Research studies have shown that the tests can be between 46-89% accurate. That’s why it’s best to take the pregnancy test when you miss your period and another test for confirmation.  For those who received a positive result, it’s best to check with your doctor for confirmation. This is when you can begin asking for advice and what steps to take. How About a Blood Test?Besides the usual over-the-counter pregnancy test, you can also go for a blood test. There are two types of blood tests to consider, which are: Qualitative tests measure if you have the minimum amount of pregnancy hormones in your blood to indicate you are pregnantQuantitative tests measure the exact amount of pregnancy hormone in the blood, which usually shows the progress of your pregnancy These also do not provide an accurate result when done too early. It is only best to take a blood test if you have gotten negative at-home pregnancy tests but still missed your period by a few days. As always, call your doctor if you are uncertain about any pregnancy test results or if you have any symptoms or issues.
4 min read
fertility by age

Fertility by Age

 Fertility changes with age for both men and women. However, men’s fertility decreases to a lesser extent compared to women’s.  So, what is the change in fertility by age? For women, the peak reproductive period is between the late teens and late 20s. Fertility starts to decline as we reach 30, and it drops even faster once you reach your mid-30s.  After crossing 45 years of age, women’s reproductive potential has declined so much that getting pregnant can become difficult or lead to complications.   According to a PLoS One study, by age 35, women are only 12 percent likely to get pregnant within a specific three-month period, and by age 40, that number declines to 7 percent. Fertility decreases with age because both the quality and number of eggs gets lower. An egg is transferred from the ovaries to the womb every month after puberty to menopause. When sperms bind with the egg in the womb, you get pregnant.  A woman’s body does not make new eggs every month. Instead, women are born with all the eggs they ever have. As you age, eggs get older naturally and progressively. This decline is gradual until early 30 but accelerates after the mid-30s.  Older mothers often face difficulties like stillbirth, miscarriage, and babies with health issues. Such women are more likely to have a higher risk of complications, such as preeclampsia and gestational diabetes. Pregnant women aged 40+ years develop a higher risk of preeclampsia. It is because they tend to have more health issues before getting pregnant compared to younger women. Regardless of this, studies have shown that older women can still have complicated pregnancies solely due to the age factor even without any health conditions.  Late childbearing is troublesome not only for the mother, but for the baby also. It increases the risk of having a baby with damaged, missing, or extra chromosomes. Down syndrome is one common chromosome issue associated with later childbearing.   The success rate of infertility treatments like IVF, egg freezing, and other fertility treatments is lower among older women than in younger women. On top of that, these could impose the risk of mental and physical health problems, especially if you already have a medical disorder, like diabetes or high blood pressure. But, it does not mean you cannot get pregnant. Despite the challenges mentioned above, many women aged above 35 years and even 40 years have healthy pregnancies and babies. We just said that chances are less, but it’s not impossible.  Ideally, you should consult with a reputed gynecologist and fertility specialist and discuss your condition with them transparently. Seeing professional health care and receiving good prenatal care while you are pregnant can help a lot.   Women’s reproductive potential progressively declines as women get older. But, the time and rate of decline vary widely in women. If you age 35 or above and want to get pregnant, you should obtain information and appropriate treatment while being realistic about everything.  By learning about your options, you will be in a better position to make the right decision.
3 min read
hormonal imbalance

Hormone Imbalance: Causes, Symptoms, and More

 Hormonal imbalances occur if there are too much (or little) hormones in your bloodstream. Since they are a crucial part of your body, even the smallest changes and imbalances can cause discomfort and symptoms.  Read on to learn more about hormonal imbalance, from its causes and symptoms, down to what you can do to remedy it. Everyone experiences hormonal imbalance or fluctuations during various parts of their life.  There are cases unique to women, related to their reproductive hormones. Such causes include:  However, there are also other common causes, such as:  The symptoms of hormonal imbalance depend on the glands and hormones affected. The common symptoms include:  If you experience any of these symptoms, it’s best to get checked with your doctor for a diagnosis.  There is no single test for medical professionals to diagnose hormonal imbalances. During your check-up, you will need to prepare a list of all your medications, vitamins, and supplements you currently take. Furthermore, you will need to describe your symptoms, as well as their timeline.  Your doctor will then suggest you take a few diagnostic tests:  There are also home testing kits that measure follicle-stimulating hormones in your urine. These levels would increase as you enter menopause, usually rising and falling during your normal menstrual cycle. This won’t be able to show if you have any serious hormonal imbalance issues, but it can tell whether or not menopause might have begun. Treatments for hormonal imbalance would depend on its cause. Here are some of the treatment options available:  yoga for hormone imbalanceThere are also various lifestyle changes and natural remedies you can try to treat hormone imbalance.   You don’t need to suffer through the pain and discomfort of hormonal imbalance. For those who are experiencing any of these symptoms, do check yourself with a medical professional.
3 min read
Stress Incontinence Of Urine

Stress Incontinence Of Urine

Medically Reviewed By Dr. Jessica Lubahn, Urologist and Founder of ONDRwearStress incontinence of urine is the uncontrolled leakage of urine. Stress incontinence can happen after childbirth, and it is much more common as a person ages. After age 65, 1 in every 2 women may find themselves with unwanted bladder leakage periodically. Besides the physical toll, this condition can also impact women emotionally. Women find themselves afraid to participate in normal activities or on a constant hunt for the toilet. Bladder leakage itself is not a disease, but rather a symptom of other underlying conditions. There are several forms of incontinence. One of the most common is stress incontinence. Stress incontinence of urine is caused by weak or damaged pelvic floor or sphincter muscles. The chronic conditions listed below can lead to damaged pelvic floor muscles.The pelvic floor refers to a grouping of muscles that are attached to your pelvis and form the base of your core. These muscles have a variety of roles, one of which includes bladder control. Your pelvic muscles surround your bladder and urethra (the tube that is responsible for carrying urine out of your body) and help to maintain the control of urine as you pee.If your pelvic muscles have been weakened or stretched, you may find yourself leaking pee when exercising or any other physical activity that puts pressure on the bladder. Common triggers include sneezing, coughing, laughing, lifting, bending. The leakage may be as mild as a few drops to as severe as several tablespoons (1). Just because you have this issue, does not mean there is nothing that can be done. Here are some immediate changes that can improve your situation.Getting help from a pelvic floor physical therapist can be of great benefit. Pelvic floor muscle exercises can help many people. Kegel exercises are a great place to start when you’re trying to put an end to leaking pee!Kegel exercises can be done pretty much anywhere and help strengthen the muscles of your: A visit to a pelvic floor physical therapist may be even more effective. Specially trained in pelvic floor dysfunction, pelvic floor physical therapists can give you a professional assessment to determine the exact cause of your pelvic issues (2).They can then create an individualized plan for you that may include things such as:A 2010 study found that losing weight can help to reduce the incidence of stress urinary incontinence episodes. Since losing extra body weight removes some pressure on the bladder and pelvic floor, it can help decrease urinary incontinence (3).It may be counterintuitive to exercise more when you are leaking pee with exercise, but maintaining a regular exercise routine can help strengthen your pelvic muscles.You will want the focus of your exercise to be on strengthening your pelvic floor, so instead of high-impact workouts like aerobics, CrossFit, or jogging, try exercises that strengthen your core, such as Pilates. Core exercises can help to put an end to leaking pee when exercising (3).A vaginal pessary is a pliable, removable device that is placed into the vagina to help support areas of pelvic organ prolapse (POP). POP results when the bladder, uterus, or rectum drops or bulges down towards a woman’s vagina (4).Typically made of silicone, pessaries come in a variety of types, including:Over the counter, disposable vaginal suppository options are also available. Your doctor will be able to help determine the type of pessary that will be the best option for you to prevent peeing when exercising.Bladder training is a common way to manage urinary incontinence and put an end to peeing when exercising.A pelvic floor physical therapist or pelvic pain doctor can help with this option and may recommend methods such as:In case of severe stress incontinence, surgery may be required. Most surgeries for bladder incontinence fall into the following categories:As with any surgery, incontinence surgery comes with a list of risks, including:Due to its invasive nature, surgery is usually done as a last resort.Sources:
5 min read
Reverse Tubal Ligation

Reverse Tubal Ligation: What You Need to Know About the Process

Have you had a tubal ligation procedure for contraception but changed your mind after a few years? If that’s the case, you may be able to undergo a tubal ligation reversal. As the name suggests, a tubal ligation reversal would reconnect your fallopian tube’s blocked or cut areas. Surgeons would either reopen, reconnect, or untie your tubes, increasing your chances of conception and having a baby naturally. Unfortunately, not all women are able to have their tubal ligation procedure reversed. Your doctor needs to consider various factors before deciding whether you’re a good candidate or not: • The type of tubal ligation you had before, as some types aren’t reversible • How much of your fallopian tube is undamaged. There is more success if there are more healthy fallopian tubes • Your age, as the procedure is more successful when you’re youngerBody Mass Index, as being obese or overweight will make the procedure less successful • Your general fertility. If you have fertility issues, the reversal may be less successful • If you suffer from other health conditions like autoimmune diseases, which affect conception and/or pregnancy • Your birth history, if you have given birth before and its successIf you have had only a small part of your Fallopian tube removed or if they were closed using clips or rings, you may be a good candidate. The best candidate for the reversal is those younger than 40 years old when they had a tubal ligation after childbirth.The average cost of the procedure in the US is about $8,700. But this can go higher and lower, depending on where you live, the tests required, and the hospital you visit. The costs can range between $5,000 to $21,000.Unfortunately, insurance doesn’t cover the surgery, but the hospital may offer payment plans to make it easier on the wallet.The entire procedure will take between 2-3 hours, requiring general anesthesia. Your surgeon will remove damaged sections of the Fallopian tubes, as well as other devices used for the tubal ligations. They will then stitch the undamaged ends of the Fallopian tubes. If the surgery was successful, you’re able to go home 3 hours after your surgery. The recovery time can take between 1-2 weeks. You may feel some pain and tenderness around your abdomen, which can be remedied with pain medication. Also, you need to avoid sexual activity or heavy lifting, and to wait for two days before taking a bath. Visit your doctor for follow-up checkups weekly until you have completely recovered. When you have recovered, you have a 50-80% chance of a successful pregnancy. BUT, this depends on other factors, like your age, sperm count, and quality, the healthy Fallopian tubes left, sterilization type, among others.Just like any other surgical procedure, the reversal may have complications due to the anesthesia, bleeding, or any infections. However, these are rare and you will discuss such risks with your doctor before the procedure.Besides that, the reversal may increase the risk of an ectopic pregnancy, with the rate being 3-8%. That's why you will need to consider your options carefully.There are also other alternatives to get pregnant, such as in vitro fertilization (IVF). Some evidence supports IVF as being the better choice compared to the reversal in women over 40 years old. The same study also shows that the reversal may be better for women under 40 years old. If you’re considering tubal ligation reversal, talk with your doctor about it to see if this is a good procedure for your future. 
4 min read
skin elasticity

Skin Elasticity: Reducing the Onset of Elastosis

The human skin has an elastic quality to it. This skin elasticity allows it to stretch out and then bounce back to its original condition. Over time, this elasticity will falter as part of the natural aging process. This loss is called elastosis and will make the skin sag, wrinkle, and appear leathery.Collagen is a protein that is produced naturally in the body. It helps keep the skin plump and youthful looking. Elastin is another protein found in the dermis (the middle and thickest layer of skin), inter-connective tissues, and other parts of the body. This gives the tissue a rebound or snap back into position. As the body ages, cells die and over time the collagen and elastin are simply not produced in sufficient quantity to maintain the elasticity we would like.Besides the aging process, there are some other factors that will accelerate the loss of elasticity. These include sun exposure, smoking, rapid and extensive weight loss, air pollution, and poor nutrition.There are some things that you can do to help reduce the onset of elastosis.There are ways to help your skin look better.  Some of these are:There are other treatments like hyaluronic acid, genistein isoflavones, hormone replacement treatments, creams, chemical peels, and laser treatments. However, before embarking on any changes or treatments, it is best to consult with your primary care physician and dermatologist. These are qualified professionals who can make recommendations based on your skin type and condition as well as overall health and any genetic or medical issues that may be present.
3 min read
Sleep Hygiene Checklist

Sleep Hygiene Checklist: Tips to Getting Restful Sleep

Instating a sleep hygiene checklist that incorporates both physical and emotional habits that will lead to high quality sleep on a consistent basis. Sleep is important to everyone in order to maintain good mental and physical health. Sadly, many people have difficulty falling asleep or staying asleep. A good rest will improve productivity and make you feel better in general.You can develop your own sleep hygiene checklist or routine to improve your sleep habits. It may be that you are already practicing some of these items. If you need to alter your pattern, just change one or two things at a time. It will make the transition easier. You may also need to be patient; it can take several days or weeks for the changes to reflect in your life.Sleep hygiene is the good sleep habits can help you get a good night’s sleep.It may seem odd but a good night’s rest is partially dependent on your daily activities.  An orderly process can create a rhythm for your body to understand it is time to go to sleep.Sleep Hygiene Checklist: Set up a bedtime routine.Sometimes it is difficult to actually drift off, or you will wake in the middle of the night and find it hard to return to sleep.
3 min read
Questions to ask Fertility Doctor

5 Questions to ask Fertility Doctor

Social media, the internet, and even friends and family may make pregnancy seem like a simple task. But for some, pregnancy doesn’t come so easily.Approximately 12% of women between the ages of 15-44 have issues with their fertility. Males are the partner with an identifiable cause of infertility in about 8% of all heterosexual couples who are seeking help with having a child. (CDC.gov)When do you have to visit a fertility specialist? How do you know what to expect? And what Questions to ask Fertility Doctor?Fertility in women decreases with each year of life, with a more dramatic decline beginning at age 35. According to the ASRM, a healthy woman in her 20s or early 30s has a 25-30% chance of conception each month. By the age of 40, chances are 10% or less. Experts suggest that if a woman is under 35, she should try to conceive for one year. If unsuccessful, it’s time to visit a fertility specialist. This recommendation changes with women who are over 35 - the window to try and conceive is 6 months before speaking with a specialist. A prospective parent should also visit a specialist if they have a history of miscarriages or a family genetic history that may impact pregnancy.Trying for a baby can be a challenging experience if it doesn’t come as easily as the world makes it out to be. Visiting a specialist may seem like a stressful or daunting experience, but it doesn’t have to be negative.We’ve compiled a list of the five questions you should ask on your first visit, so that you can feel empowered, in control, and confident about the path you’re about to take.So many factors impact fertility. Some issues aren’t within a person’s control, such as anatomical abnormalities, endometriosis, genetics, and aging. Other contributing factors to fertility are more manageable by the person trying to get pregnant, like smoking, alcohol usage, weight gain or weight loss, emotional stress, caffeine intake, sleep, and nutrition. A fertility specialist may be able to recommend lifestyle changes that increase fertility. Be honest about your habits - it allows a specialist to get a big picture and details about your life and make the best recommendation for you.A doctor may ask if you’ve tried certain methods to aid conception - timing sexual intercourse to fall within the right time in a menstrual cycle, basal temperature measurements, and monitoring ovulation.It takes two to create a baby - and tests should be run on both prospective parents to navigate the best treatment. A thorough medical history is the first step in recommending testing.A fertility specialist will ask a wide range of questions: both partners’ medical histories, family histories, occupations (some are more high risk than others), previous sexual relationships, forms of birth control used in the past, smoking, alcohol and drug usage, any history of sexually transmitted diseases and more. Be honest! Once again, this gives the fertility specialist an idea about what direction to take testing and treatment, if they are needed.Testing may include any of the following (or more):Each treatment takes into account the health of the parents, their anatomy, their hormones, age, and whether the pregnancy will be viable. Sometimes one person needs treatment. Sometimes both do.Some treatments include:Make sure to ask your doctor what the rate of success is for each procedure. Some treatments may be better for you than others, and success rates may vary.Fertility treatments can be expensive, both emotionally and financially. Insurance does not always cover fertility treatments. Unfortunately in the United States, many procedures are considered elective. Ask your doctor how much various procedures will cost, whether insurance will cover them, and how their payments are paid (installations or at one time). Don’t forget to verify this with your insurance company after your appointment! Without insurance IVF can cost anywhere from $5,000 to $15,000 per cycle.You may want to consider the success rate of each procedure as you evaluate the financial cost that these treatments may set you back. Talk to your doctor about what the best recommendation is and how your finances may tie into those options.What does our process look like from here?Going to a fertility doctor may be stressful, upsetting or uncertain. But going in informed, being honest about your health, and asking questions can soothe any nerves you may have about this sometimes-daunting process. Your doctor should be able to go over a plan with you so that you leave the appointment feeling content about how your future will look as you try to conceive.
6 min read
HPV from a toilet seat

Can You Catch HPV From A Toilet Seat?

HPV is referred to as the human papillomavirus; it is a widespread and common virus. It is easily spread, but the question is, can you get HPV from a toilet seat? There are about 200 types of HPV that affect different parts of the body. Some low-risk types can cause only genital warts. And the high-risk types can cause oral, anal, cervical cancer. Genital warts are the skin growths in the groin, genital, or anal areas. They can vary from different sizes and shapes. There is no known treatment for HPV, but a vaccine can protect against some of the strains of viruses of HPV. In women, genital warts most often appear on the vulva, around the vagina, on the groin, and the cervix. For males, it can occur on the testicles, anus, penis, tongue, and top of the mouth and around thighs and groin.These warts do not hurt, but they can increase your risk of cancer on the skin surrounding areas of infection. To reiterate, HPV is not cancer, but it can cause types of cancer and pre-cancers, which is one of the reasons the vaccine against HPV was created.The risk of becoming infected with HPV by sitting on a public toilet seat seems frightening, and the answer is generally no. It is exceedingly rare to catch HPV from touching surfaces like doorknobs and toilet seats or even towels or clothing. There have been cases where transmission has happened on wet fabrics such as a wet towel, but again it is extremely rare. Usually it is transmitted by skin-to-skin contact with someone who is infected. HPV can also spread from one area to another on the body, such as from the genitals to the mouth. HPV is incredibly common, nearly 80 million people at some point get HPV. Many people don’t know they are infected because it can show no symptoms until many years after exposure. HPV should be taken seriously because it can even increase your risk of certain types of cancers. The HPV vaccine is extremely effective and is recommended to all girls and boys around the age of 9- 12.HPV screening can be done with few tools and the naked eye to detect the abnormalities taking place on the person's skin before it develops into cancer.Practicing safe sexual intercourse, using condoms, and limiting your number of sex partners can help you reduce your risk of HPV.Exercising regularly, eating healthy, avoiding smoking, and maintaining good hygiene with regular health care checkups can prevent you from transmitting HPV or developing cancer from HPV.Maintaining proper sanitation and hygiene practices in general is crucial as this can prevent you from getting this virus and save your life. Use your own towels and clothing, particularly if they are wet and have been recently used by someone else. Wash hands regularly, and don’t touch your face or mouth after using the bathroom or have contact with your genital area unless you have washed your hands thoroughly.Please talk with your health care professional if you have any questions or concerns about HPV.
3 min read
what is vaginismus woman with vaginismus

What is Vaginismus - and Why Does it Occur?

Vaginismus occurs due to the spasm or squeezing of the muscles in a woman’s vagina. It typically occurs when something is inserted into the vagina such as the penis during intercourse or a tampon. Vaginismus can be mildly uncomfortable or extremely painful. [1]The most obvious sign of vaginismus is painful sex, also called dyspareunia. The pain occurs most commonly during penetration and usually goes away or reduces after withdrawal. However, in some cases, the pain may persist for a some time after the withdrawal of the penis or other object. [2]Dyspareunia is often described by women as a burning sensation or a feeling as if the penis is hitting a hard wall.It is also common for women with vaginismus to experience discomfort while inserting a tampon or having a pelvic examination at the doctor’s office.Some other common symptoms that can occur due to vaginismus include:·         Fear or anxiety of pain ·         Anxiety before sexual activity ·         Inability to have penetrative sex ·         Difficulty in inserting a tampon ·         Loss of sexual desireThese symptoms tend to be involuntary, which means a woman can not avoid them without proper treatment.While the exact cause of vaginismus is not known, it is believed that it might occur due to the fear and anxiety around sexual activity. However, in many cases, it becomes difficult to ascertain what came first: the anxiety or the vaginismus. [3]Some physical health problems such as infections and excessive dryness of the vagina or cervix can also lead to painful intercourse and cause vaginismus. [4]Physical therapy, sometimes called pelvic physical therapy, involves training the women to control the spams of the vaginal or pelvic floor muscles and it can be highly effective for the management of vaginismus. [5]Exercising at home can also help women to learn to control the contractions of the muscles in the vagina and pelvic floor. This is known as progressive desensitization that allows women to avoid anxiety and gradually feel more comfortable during activities requiring vaginal penetration.Progressive desensitization involves strengthening the pelvic floor muscles by practicing Kegel exercises. This is followed by the insertion of one finger into the vagina, up to the first knuckle, while doing Kegel exercises. Women may apply a lubricant on the fingers before insertion to avoid pain. Starting with inserting one finger, they can work their way up to inserting two and later, three fingers until they can feel comfortable.Once they find the insertion of 3 fingers to be comfortable, they can try putting specially designed inserts called vaginal dilators into the vagina to help the muscles get accustomed to pressure and size. This therapy can be helpful for women who suffer from vaginismus due to fear or anxiety. ConclusionIt is possible to treat vaginismus by identifying the possible causes such as anxiety, infections, or dryness and seeking appropriate treatment. Physical therapy or exercising the vaginal muscles can help to relieve the spasms and provide considerable amount of relief from vaginismus.References:1.      aafp.org/afp/2011/0915/p705.html2.      nhs.uk/Conditions/Vaginismus/Pages/Introduction.aspx3.      mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-203759674.      https://www.webmd.com/women/guide/vaginismus-causes-symptoms-treatments#15.      ncbi.nlm.nih.gov/pmc/articles/PMC5913379/
3 min read
how long to breastfeed

How Long to Breastfeed?

The American Academy of Pediatrics recommends exclusive breastfeeding until 6 months of age at least, but many parents still want to know how long to breastfeed. Many parents will choose to continue breastfeeding beyond 6 months. The World Health Organization recommends breastfeeding until two years or even beyond. There is no evidence to support that weaning a child after one year is more difficult, but there is some evidence to support that breastfeeding for as long as possible may have benefits for the child and for the mother.One thing to note is that daycares and preschools in some states discourage the use of breast milk after one year. This may impact a breastfeeding schedule or weaning process. Be sure to have a plan in place on how to handle this especially if you want to continue giving your child breast milk.It is also important to be very clear with your child’s caretaker as to what you want done with breast milk, and carefully go over how to store it and save portions that are safe to use. Feeding the baby breast milk in smaller bottles when you are not home will allow for complete usage of the breast milk and avoid wasting it. Ultimately, the decision should be made based on what is best for the baby and for mom, and rest assured there is no cut-off point for breastfeeding. For some parents this may be 6 months, for others it may be 2 years, and for some it may be beyond that. There are a few situations where mothers may need to stop breastfeeding, like the use of certain medications or if you’ve been diagnosed with HIV, common illnesses like the cold and flu are not transmitted through breast milk.If you just have the common cold or a mild illness, there may be some protective benefit for the child. When someone is ill, their body produces antibodies to protect them against reinfection. These antibodies pass through breast milk, meaning that a baby may get protective benefits from their mother when nursing. Nursing through illness may give your child powerful antibodies to the sickness you’re experiencing.You can continue to breastfeed your baby well into their toddler years if you would like to. Remember that the addition of foods should begin around 6 months and this is something that should be discussed with your doctor. Be sure to also discuss Vitamin D supplementation (400 International Units) with your baby’s doctor as most breastfed children will require this. While getting pregnant in the early days of breastfeeding is unlikely, this becomes more common the older the baby gets. Remember that breastfeeding does not protect against pregnancy. Discussing a birth control method that is appropriate for you and that will not affect breastfeeding is important. Options include, but are not limited to, barrier contraception such as condoms, as well as a progestin only pill, often called “the mini pill.”. It is important to note that the progestin only pill has a higher failure rate over the combined estrogen and progestin oral birth control pill. Once you stop breastfeeding, it is important to choose an appropriate birth control method. (Cleveland Clinic)Breastfeeding may reduce chances of pregnancy - but there is no guarantee and any contraceptive abilities of breastfeeding are temporary. Remember that you will ovulate before your first period comes back. If you happen to have sex during this time, it is possible you could become pregnant without realizing. If you are certain you do not want more children for the next year or more, talk to your doctor about what options are available to you.
4 min read
sleep and weight loss

Sleep and Weight Loss

Losing weight isn’t just about eating properly and working out more. It’s also about getting enough sleep!  Researchers report that women who sleep less than five hours a night weigh more compared to those who sleep for seven to nine hours a night.  Furthermore, those who sleep six hours a night are 12% more likely to experience weight gain, and 6% have a higher risk of obesity, compared to those sleeping seven hours a night.  These are such numbers we can’t ignore, showing how crucial sleep is for weight loss and overall health. But how does it work? Read on as we answer the question, “does sleeping more help you lose weight?”  While most people don’t know it, sleep is actually the foundation we need to help support our healthy eating and exercise habits. Here are some points you should consider when it comes to sleep and weight loss: When we don't get enough sleep, it will be challenging to control our behavior and energy levels. Lack of sleep would strengthen the want for rewards, leading to unhealthy eating and to replace exercise for quick fix rewards like watching television.  To be more specific, fewer hours of sleep can affect hormones that regulate your appetite. With less sleep, your hormones will stimulate cravings for high-carb food. Plus, the more time we are awake, the more waking time we have to eat! Our sleep would also affect our cortisol levels, which usually spike in the morning for better energy throughout the day. With poor sleeping habits, the cortisol levels are elevated, which negatively affects weight loss and disturbs your sleep cycle. This then makes it difficult to implement and act on a good weight loss program.  Furthermore, less sleep can also have us feel more stressed and exhausted, especially when we have to work while lacking sleep. This would have us stress eat or skip workouts from feeling too tired or tense! While lack of sleep can affect your weight, so can TOO MUCH sleep. Sleeping more can help you lose weight if you were previously lacking it. But if you are sleeping for over ten hours a day, this can be a problem. Just like sleeping for less than seven hours daily, it affects your hormone levels, having you crave for carb-rich food. Furthermore, it gives you less time to focus on your work for the day, resulting in skipped workouts and exercise.  Now that we know how too little or too much sleep leads to poor eating and exercise habits, how can you sleep well for better weight loss results? Here are some tips to follow to avoid poor sleep habits:             •           Keep a consistent sleep schedule that allows you at least seven hours of sleep a night            •           Prioritize relaxing and doing stress-free activities, especially during the evening, which can help wind you down for sleep            •           Do not perform any stimulating or exciting activities and avoid electronics an hour before bedtime            •           Reduce or eliminate alcohol and caffeine consumption. Also, consume your last meal two to three hours before bedtime  Wrapping It UpSleep affects many aspects of your lifestyle, from weight loss to health. With better sleeping habits, you are more inclined to eat healthier and exercise more, making you feel happy and reach your weight goals! So make sure that you learn more about how you can sleep better and create a consistent schedule to achieve more. Start now, we wish you the best of luck!
4 min read

Endometriosis Bloating: What is Endo Belly?

If you’re familiar with the condition Endometriosis, then you are probably aware of one of its symptoms: Endometriosis bloating. In fact, it’s one of the most common symptoms, to the point that people call it the “endo belly”.  For those who aren’t aware of endometriosis and the bloating associated with it, read on to find out. Endometriosis is a condition that causes the endometrial tissue, which would line one's uterus, to develop outside one's uterus. This may cause chronic pain, infertility, as well as heavy or irregular periods. Those who have it have reported bloating and weight gain as well, among other uncomfortable symptoms. More than 10% of reproductive-aged women are affected by endometriosis.  Endometriosis bloating, or endo belly is the term that describes the uncomfortable and painful swelling and/or bloating associated with the condition.   Causes and SymptomsWith endometriosis, the tissue located in places out of the uterus would act the way the endometrium does. It will build up and break down, bleeding every month, similar to your uterus lining. However, the tissue won’t have a way to leave the body, so it becomes trapped. The tissue surrounding it becomes irritated and inflames, causing scar tissue to form. It may also cause tissue in the pelvis to stick together.  As mentioned, bloating and fluid retention are some of the more common symptoms of endometriosis. An older study showed that 96% of women with the condition have experienced belly bloating, compared to the 64% who don’t have the condition.  ·         The buildup of the endometrial-like tissue may cause inflammation in and around your abdomen, resulting in bloating, swelling, and/or water retention.·         Endometrial-like tissue may cover and/or grow into your ovaries. The trapped blood may form cysts, causing the bloating.·         Women with endometriosis are more susceptible to small intestinal bacterial overgrowth and fibroids, conditions that may cause bloating.·         The condition usually causes digestion issues, including constipation and gas. The main symptom of endometrial bloating is severe bloating, particularly during or before one's period. This is when your abdomen will fill up with air or gas, looking larger. The belly may also feel tight and/or hard. Such bloating may cause pain and discomfort, along with pressure on the back and abdomen. It may last for a few hours, or even days and weeks. There are self-care measures you can follow to help reduce the pain and bloat, mainly improving your diet. Make sure you avoid inflammatory foods and test out a low FODMAP diet, which can ease bloating and gas. It’s also best to increase your fiber intake, which prevents constipation, as well as drinking plenty of water. However, if your endometriosis bloat gets so painful or happens frequently, lasting for long periods, it’s best to get checked with your doctor right away. They will find the reason behind your bloating, as there may be cysts, scars, or other issues that require medical intervention.Hopefully, you found insight into what endometriosis bloating is and the ways to treat it. If you suspect you have endometriosis and suffer from bloating, do talk with your doctor about it to find the right solution. Stay healthy!
3 min read
signs of postpartum depression newborn baby with mother

5 Signs of Postpartum Depression to Watch Out For

About 10% of moms who have just given birth experience postpartum depression. Unfortunately, not many moms even know they are depressed, thinking that this is the way all new moms feel.  But while being tired with a newborn is normal, feeling sad and hopeless all the time isn’t. That’s why it’s important to learn about postpartum depressions and to watch out for the signs. This will allow you to intervene and have you feel like yourself, enjoying your time with your new family.  1. The Baby Blues Don’t Go AwayIt’s typical to experience low moods during the first two weeks after giving birth. Afterward, you should slowly be feeling better and begin focusing on the next stage of your life. However, if you still feel sad, or even hopeless, after a few weeks, and these feelings are getting intense, then it may be more than just the typical blues. 2. You Start to Lose Interest In ThingsAre you beginning to lose interest in the things you used to love doing? Do you still feel affectionate with your partner or enjoy your favorite foods? Or are you feeling down and just want to stay in bed because nothing seems to cheer you up? Another sign is if you start to lose care and have trouble making any decision, no matter how simple it is. If you aren't able to decide to get out of bed and shower or not or to even change your little one's diaper and spend time with them, this may be an early sign of postpartum depression.  If ever you don’t find anything exciting or interesting anymore, especially when it comes to caring for your baby, then it’s time to talk with your doctor about these mood changes and new habits.  3. Continuous Sadness and Guilt FeelingsFeeling sad or upset once in a while is typical, especially as you adjust to the new changes and care for your little one. But if you’ve been experiencing a lot of random crying spells or even feel unhappy about being a mom, this is something more. Furthermore, if you feel guilty and talk yourself down as a mom, then this is one of the first signs or symptoms of postpartum depression. Another thing to note about is your feelings towards being a mom. Sure, all moms worry about not being a good mom, but if you have constant doubts as a mother despite doing well, it could mean something else.  4. Sleep Patterns Changed… WeirdlyOf course, your sleeping patterns have changed with a baby crying every few hours for feeding! This is normal. But once you aren’t able to even take a nap or feel rested while your baby is napping or sleeping, or if you’re sleeping all the time, then this might be something other than adjusting to a new sleep pattern.  This is because changes in mood, appetite, and even sleep are one of the early signs of depression. 5. You Have Thoughts About Harming YourselfDo you have thoughts about hurting yourself or the baby? Or even suicide? This is an advanced sign of postpartum depression that must be addressed immediately. If ever you do feel like harming yourself or anyone around you, do reach out for help and call your doctor right away to get the treatment you need. For new mothers who have experienced one or more of these signs, do reach out to your partner and loved ones, as well as a medical professional. You are not alone and can get through postpartum depression!
3 min read
IUDs For Birth Control

IUDs For Birth Control: 10 Questions Answered By An Expert Doctor

IUD stands for “intrauterine device”. It is a small device that is shaped like a “T” and is inserted in the uterus to prevent patients from becoming pregnant [1]. There are different types of IUDs: hormonal and non-hormonal (copper-based called Paragard). The hormonal IUD contains a hormone called progestin or levonorgestrel. The progestin is released by the IUD and thickens the cervical mucus which can disrupt implantation of the egg and can prevent fertilization, and sometimes can even prevent ovulation [2]. These types of IUDs usually last 3-7 years depending on the brand (Mirena, Liletta, Skyla, and Kyleena) [1]. The other type of IUD is a copper IUD. The exact mechanism of action is unknown, but it is thought to kill sperm, interfere with fertilization and can stop sperm movement [3]. This is usually effective for up to 12 years. IUD insurance coverage can vary but usually IUDs are fully or partially covered by Medicaid, most health insurance plans, and other government programs. This depends on the type or brand of IUD. If you are interested in an IUD, please be sure to contact your insurance provider to see what your options are. If your plan does not cover the hormonal IUD your doctor recommends, you can request a waiver or exemption from your insurance plan [1,4].   The cost of an IUD without insurance can range from $600-1,400, and includes the cost of the exam, necessary testing, and the cost of the IUD itself. The price can vary depending on the type of IUD you get [1]. Typically, there is a pre-insertion STD testing that costs $25- $200. There is a pregnancy test that needs to be done prior to insertion which is $20 or less. The cost of the IUD is about $400-$1,000. The cost of insertion/removal is $125-$400 [5]. All these costs together can amount to about $1400.   IUD insertion can cause cramping and pain, but usually will not last for too long. Physicians often may advise taking ibuprofen or other nonsteroidal antiinflammatory medication before insertion to help with these symptoms. Less often, your doctor may inject lidocaine, which is a numbing medicine, on the cervix if the cervix needs to be dilated or moved during insertion of the IUD [6]. Cramping and mild bleeding can occur after IUD placement but should improve with time.   IUD removal is quick and usually painless. Your provider will retrieve the IUD strings with a device called a forceps and pull the IUD out gently and swiftly. Some cramping or spotting is normal during removal, but again it should be for a short duration after the removal.   Both types of IUDs (hormonal and non-hormonal) are long-acting, reversible and more than 99% effective at preventing pregnancy. The copper IUD is also the most effective method of emergency contraception. It is > 99.9% effective at preventing pregnancy within 5 days after unprotected intercourse [1].    IUDs are usually placed by a physician in an outpatient clinic. The doctor begins by examining your vagina, cervix, and uterus. They then put a speculum into the vagina to look at the cervix. The physician then dilates the cervix, measures the size of the uterus, and then uses an inserter to place the IUD into the uterus. IUDs can be placed and taken out at any point in your menstrual cycle [1].   Although it is possible, it is not likely to become pregnant with an IUD in place. With the non-hormonal copper IUD, the chances of becoming pregnant over time are between 1%-1.8%. With the hormonal progestin IUD, the chances of becoming pregnant overtime are between 0.6-1.6% [2]. Compared to other forms of reversible contraception, these are among the most effective. Condoms, when used correctly, are supposed to be effective 98% of the time; however, due to human error and condom breakage, the actual effectiveness of a condom is around 82%. Combined oral contraceptive pills, if used properly every day without missing a dose, are effective 99.7% of the time. However, due to patients missing doses, the actual effectiveness across the population is about 91% [7]. The actual versus theoretical effectiveness of IUDs are around the same at about 99%. Overall, after placing an IUD, the risk of pregnancy is low.   Overall, IUDs are a safe and effective way to prevent pregnancy. Though rare, there is a small but serious risk of uterine perforation or the uterus being pierced and damaged by the IUD. Uterine perforation due to an IUD is seen in 0.05 to 13 cases out of 1000 IUD placements [8]. This is a medical emergency. Other unlikely complications include an infection from IUD placement or the IUD slipping out of the uterine cavity. Remember to ask your doctor about your personal risk for any complications related to IUDs before having one placed so you can make an informed decision.  Before making the decision to have an IUD placed, discuss contraception options with your doctor to find the best type of birth control for you.  Sources:
6 min read
Contractions For Labor What Contractions Feel Like

Contractions For Labor: What Contractions Feel Like

A contraction is when the muscles of your uterus tighten and relax during pregnancy. Real contractions are what’s needed to push the baby out of the uterus into the birth canal. When a person is in real labor, the contractions are painful, last about 30 to 60 seconds, occur at evenly spaced intervals, and the time between intervals decreases as true labor progresses. For example, you may experience a one minute contraction every 10 minutes that then goes to a one minute contraction every 7 minutes. However, in false labor, Braxton Hicks contractions do not have a pattern of occurring at regular intervals and Braxton Hicks contractions do not get closer together. Braxton hicks are more likely to occur earlier in pregnancy whereas real contractions will happen closer to one’s due date. Additionally, false labor is not associated with a dilation of the cervix, which does happen in true labor. Perhaps one of the most important distinctions is the level of pain associated with a real contraction. In most pregnancies, contractions for labor are very powerful. It is challenging to talk when you are experiencing a real contraction. You may feel winded and the labor contractions will get stronger with time. Braxton Hicks may cause a tightening sensation in the stomach and pelvic area but they are usually not extremely painful. They also don’t become more intense with time. Finally, Braxton Hicks may resolve if you drink water, change your body position or go to the bathroom. If you are in true labor and having real contractions, hydrating yourself, changing the way you are sitting, or emptying your bladder will not cause true labor to stop. So, what does a labor contraction feel like in someone who is about to having a baby? A real contraction in labor is often described by pregnant persons as a gradual increase in pain, a peak in the pain that is associated with a hardening of the belly area, and then a fading away of the pain. Contractions and early signs of labor can present differently in different people. Some pregnant persons may experience pain in their back or in their pelvic area, and some may even have pain that is similar to menstrual cramping. For some people, the pain of a real contraction can start in the back and then move to the front of the body. In others, the pain can be similar to the cramping you may experience when you are having diarrhea (1). According to the American College of Obstetrics and Gynecology, pain in false labor is not usually felt in one’s back. False labor is typically only associated with pain in the front part of the body (2).In true labor, contractions will be evenly spaced, and as the intensity of the contraction increases, the time between each contraction will also get shorter. While occasional braxton hicks can be painful, these are generally not extremely intense and they may go away with positional changes, drinking water, or using the bathroom. Real contractions are also associated with a dilation of the cervix as your body prepares to push the newborn through the birth canal. It is important to time your contractions as well as contact your doctor, or go to the hospital if you suspect that you are in real labor. Sources:
3 min read
Adenomyosis And Fertility

Adenomyosis And Fertility

It is controversial whether adenomyosis and infertility are linked because there are several medical factors that can contribute to infertility. For example, a patient commonly can have both endometriosis and adenomyosis at the same time. Let’s start by differentiating the two conditions.   Adenomyosis is a benign condition in which tissue from the endometrial layer (innermost layer of the uterus) grows into the muscular layer of the uterus. This causes the uterus to abnormally grow or thicken. Risk factors for adenomyosis include having multiple pregnancies, miscarriages, abortions, overgrowth of the endometrial layer, endometriosis, and a history of uterine surgery [1,2]. It can cause painful and prolonged bleeding during periods, irregular bleeding between periods, chronic pelvic pain, and possible infertility.  Read more about adenomyosis here.   Endometriosis is when the endometrial layer grows into other areas of the body that are outside the uterus, such as the fallopian tubes, ovaries, and even bowel. Endometriosis causes similar symptoms to adenomyosis and it is shown to cause infertility. In fact, almost 4 in 10 women with infertility have been found to have endometriosis [3].   Studies have shown that there is an association between adenomyosis and endometriosis in terms of the disease process [4,5], which is why adenomyosis is an important factor to consider in potential causes of infertility. Endometriosis has been shown to cause infertility in patients, though studies have not readily confirmed if adenomyosis alone can cause infertility, and studies that are available have only been done on small numbers of cases [1,6]. This poses the question of whether infertility is caused by endometriosis, adenomyosis or a combination of the two. Another factor to consider is that an increased number of women are attempting to conceive at later ages, now in their 30s and 40s, and infertility rates may be due to decreased ovarian reserve (egg supply) as the result of older age, adenomyosis or endometriosis, or a combination of the above [1,7,8]. Various studies have shown that, in general, adenomyosis alone may be associated with a decreased reproductive potential [1,9]. Additionally, adenomyosis is thought to be associated with increased pregnancy complications such as miscarriage and preterm birth [1,6]. Interestingly, patients who have pursued assisted reproductive technology (ART), including procedures such as in vitro fertilization or frozen embryo transfer, have been found to have a higher incidence of adenomyosis compared to the general population [9]. In addition, treatment of adenomyosis has been shown to improve fertility [1]. These associations demonstrate there are multiple factors involved in a potential link between adenomyosis and infertility, though a clear association has not yet been fully established.       Adenomyosis and its association with infertility is still being studied. There is various conflicting data, most of which state that it is hard to determine the exact prevalence. One study showed that in a group of patients with infertility, 24.4% of those older than 40 years of age had adenomyosis and 22% of patients less than 40 years of age had adenomyosis [10]. Patients seeking assisted reproductive technology notably have a higher incidence of adenomyosis than patients who have not sought reproductive assistance. Some reports show it to be as high as 70% of patients with adenomyosis are infertile [9]. However, another study showed that in patients who were infertile with dysmenorrhea (but did not have endometriosis), 53.8% had adenomyosis [11]. Another study’s results suggested that 24.4% of people with adenomyosis were infertile [8].    There are treatment options available for patients who want to conceive despite having a history of infertility. These include conservative surgery (such as removing the focal adenoma or surgical removal around the uterine wall) [9], hormonal therapies, and even a combination of both. In fact, studies demonstrate that patients who are treated with hormonal therapy before assisted reproductive technology have a higher pregnancy rate [7,9]. A collection of studies showed that 47% of patients with adenomyosis who received treatment were able to become pregnant (including natural conception, surgical intervention, and/or with ART) [7]. In these studies, most of the patients were at an advanced maternal age, with a median age of 38 years.For younger patients with adenomyosis, who typically have a higher ovarian reserve than that of older patients, pretreatment with hormonal therapy before natural conception is recommended. In older patients with less ovarian reserve, immediate combination ART with hormonal treatment can be used as a first-line approach. There is limited evidence for improved outcome after surgery, and it generally should be an option for patients who failed ART. If you are concerned that you have adenomyosis, have a diagnosis of adenomyosis and would like to become pregnant, or have other questions regarding fertility, it is recommended to consult your physician so you may work together to find a treatment plan that is best for you. Authors: Dr. Erika Aragona, Srijaa Kannan Sources:
6 min read
when to start sippy cup

When to Start Sippy Cup: The Best Time for Your Baby

Are you unsure about when you should introduce the sippy cup to your baby? In short, it depends, but there are signs to be aware of to see if your child is ready to make the move. What is a Sippy Cup?Sippy cups are training cups usually made of plastic, having a screw or snap-on lid and spout so your little one can drink without spilling the liquids. Some models come with and without handles, along with sippy cups with different kinds of spouts.These cups are a good way for your little one to transition from bottle-feeding or nursing to drinking from regular cups. It also improves hand-to-mouth coordination and motor skills, so they have independence without making a huge mess.When to Start Sippy CupThere isn’t an exact time to introduce the sippy cup to all babies, as it depends on their preference and if you feel like they are ready. The typical time to introduce the sippy cup is between 6-12 months, many recommending starting the sippy cup when your baby reaches 9 months old. In fact, a recent Pediatrics study found out that 9 months is the “ideal” age when transitioning little ones from the bottle, and that they should begin drinking exclusively from a sippy cup when they reach 12 months old.Besides that, other signs that your baby might be ready include: Prolonged bottle use may lead to cavities and/or iron-deficiency anemia, and it may encourage them to drink even more milk than needed. So it is recommended to work to have your baby transition to a sippy cup sooner rather than later. This may increase the risk of obesity, tooth decay, and even affect the development and positioning of adult teeth later on in life.How to Introduce Your Little One to the Sippy CupNow that you know when to introduce your little one to the sippy cup, how can you do so gradually? Here are quick tips to follow:Talk to your pediatrician if you have more lingering questions regarding the sippy cup transition. Don't stress! You will make the right decision when makes the most sense for your family.
3 min read
Round Ligament Pain In Pregnancy

Round Ligament Pain In Pregnancy

Round ligament pain in pregnancy is common because the round ligament connects the front part of the uterus to your groin. There is one round ligament on each side of your uterus. While early pregnancy round ligament pain can happen, round ligament pain in third trimester is common because the uterus has greatly increased in size. Round ligament pain, sometimes called “lightening crotch”,  is a sharp, sometimes jabbing feeling in the lower belly or groin area on one or both sides. The pain usually lasts a few seconds, but can be longer. Lightning crotch typically affects the right side, but it can happen on both sides. When the round ligaments stretch, they are more susceptible to sudden movements which cause the round ligament to tighten. When the ligament tightens it pulls on the fibers of the nerve which results in pain. Exercise and sudden movements like sneezing, coughing, or even standing up too quickly can cause round ligament pain.Stretching for round ligament pain can be very helpful. One stretch is the cat-cow stretch done in many forms of yoga. Start with your hands and knees on the floor with your shoulders directly over your wrists, and your hips directly over your knees. While breathing in, drop your belly so that your back arches and your face looks slightly up. This is called the cow position. While breathing out, round your upper back, and allow your head to drop and face your belly. This is called the cat position. You should do this stretch at a slow pace for at least one minute, take a break and then repeat it. Additionally, you should consider modifying your natural movements so that you don’t make abrupt positional changes that could trigger the pain. When going from sitting down to standing up or vice versa, do it slower than you usually would.  In general, you will want to avoid sudden movements that could lead to stretching of the ligament and subsequent discomfort. Avoid positions that aggravate the pain and protect yourself from sudden movements by flexing your hips holding your lower belly. This can be especially helpful if you are laughing, coughing, or feel a powerful sneeze coming on.If conservative methods are not working, you may consider using pain relievers that are safe in pregnancy for round ligament pain. Typically, acetaminophen (Tylenol) can be used for pain in pregnancy, but always check with your Ob-gyn first. Additionally, remember that round ligament pain can be experienced for several months so exercising and behavior modification may serve you better than constant medication use. It may also be helpful to use a heating pad in the areas of your discomfort as well as consider taking a warm bath. Remember that the water should not be too hot because sitting in a hot tub, or anything too hot, is advised against during pregnancy. You may need to combine some of the above methods to achieve long term round ligament pain relief. Be certain to discuss your plans with your doctor as well.It is normal to experience round ligament pain during pregnancy. Because the round ligament connects the uterus and the groin, it is common to experience pain as your uterus grows with each trimester of your pregnancy. Round ligament pain usually happens only while someone is pregnant. Uncommonly, round ligament pain can happen in persons who are not pregnant, which could be a sign of endometriosis or another health concern. If you are experiencing any pain or additional symptoms that are concerning to your health, be sure to contact your doctor. For round ligament pain in pregnancy, try to avoid sudden movements that can aggravate round ligament pain. Stretching for round ligament pain can also be very helpful.
4 min read
breastfeeding let down

What is Breastfeeding Let Down and is it Bad?

In terms of breastfeeding, “let down” is a good thing. It is a reflex that the body uses to let mom know that the mammary glands are ready to release the milk they have produced.  let down reflex breastfeedingThe let down reflex can be indicated by a tingling sensation. If the breasts are full of milk, or feeding is overdue, there can also be a small discharge of milk. This reflex drips can also occur if you hear your baby cry, or even if you just think about your new little one.The technical term is milk ejection reflex or MER. As baby latches on and begins to suck, the brain receives a signal to release the hormones prolactin and oxytocin. Prolactin allows the body to produce milk and oxytocin is the trigger for the let down.The sensation varies from woman to woman.  Some feel pressure, warmth, or prickly feelings (like pins and needles) or burning.  Let down actually occurs several times during the feeding process, but it is usually only the first release that are noticeable.  The sensations differ from slight discomfort to pain.  Some women don’t feel anything and that is also normal.  As long as the baby is feeding sufficiently and progressing, there should be no concern.  However, if baby is not getting enough milk, you should contact your physician or lactation consultant.  A significant decrease in milk may result in your child not receiving enough nutrition and the resulting milk production to continue to decrease.If there are issues with breastfeeding, some of the origins could be from:If you are having issues breastfeeding please contact a lactation consultant or pediatrician near you. Follow your medical professional’s instructions, but here are a few things you might want to try.breastfeeding issuesRemember that this is a reflex reaction.  If you create a routine, you can condition your bodily response appropriately.  This should include looking at, touching and smelling your child, settling with the baby skin to skin, and an area free of distractions or with calm music playing.Nursing your newborn for at least the first six months provides baby with nutrients and antibodies.  It also helps with the bonding process and is beneficial for both mother and child.  In addition, it saves money on formula and has been shown to accelerate maternal weight loss.  
3 min read
hormonal acne

What is Hormonal Acne? Everything You Need to Know

Acne is common, it occurs in most people to some degree at some point in their lives. However, you may notice that it happens mostly during puberty and times of stress or other changes, such as before periods, during pregnancy or during or after menopause. This is likely to be hormonal acne.  Hormonal acne happens because your hormone levels are rising or fluctuating, which affects your skin health and cell activity.  But what is hormonal acne and how can you treat it properly? Read on to find out! Hormonal acne is exactly what it sounds like, which is acne connected to hormone fluctuations. It’s usually associated with hormone fluctuations in puberty, though it can affect adults throughout any age, especially in women. Various factors contribute to hormonal acne, particularly menstruation, pregnancy, and menopause. There may also be underlying medical conditions that affect your hormone levels as well, thus causing acne. During puberty, hormonal acne might appear around your forehead, nose, and/or chin. In hormonal adult acne, it usually forms on the lower area of your face, such as around your jawline or cheeks.  The symptoms of hormonal acne include seeing whiteheads, blackheads, cysts, nodules, papule, or pustules around your face. There may also be lesions on your face other parts of your body, such as the neck, back, chest, and shoulders. The hormonal acne can be mild, moderate, or severe, with the intensity depending on various factors such as genetics, diet, environment, as well as the way you care for your skin.              •           Menstruation            •           Menopause            •           Increased androgen levels            •           Polycystic ovarian syndrome When hormone levels fluctuate, it aggravates acne issues as it increases skin inflammation, oil/sebum production in your pores, clog skin cells around the hair follicles and even increases the production of acne-causing bacteria. Hormonal acne IS treatable and can be prevented with the right tips and products. Here are some ways you can manage hormonal acne regardless of your age: Wrapping It UpHormonal acne is irritating, but treatable with the right knowledge and tips. The timeline differs from person to person, but if you use the right treatments, it can take 8-10 weeks to lessen acne and prevent it from coming back.If your hormonal acne persists and worsens, do talk with your doctor for a long-term treatment plan for better results.
4 min read
Vulvar Dystrophy

Vulvar Dystrophy: Causes, Symptoms, and Treatment

Vulvar dystrophy refers to a medical condition that changes the skin of the vulva. Vulvas are skin folds around the opening of the urethra and the vagina.Different types of dystrophy exist that may cause grey or white patches on the skin. Some dystrophy types may cause skin thickening or thin, itchy skin patches, grey skin patches, or painful sores.  It left untreated; dystrophy can scar or shrink the inner folds of the vulva. As a result, the opening of the birth canal can get smaller and may even get closed. Thus, it would help if you had the right treatment for Vulvar Dystrophy at the right time.Though there are no clear causes of vulvar dystrophy, it can result from skin irritation. Irritation can result from douching, bike or horseback riding, poor personal hygiene, wearing wet underwear for a long time, and a yeast infection. Skin irritation in the vulva can also result from wearing synthetic underwear, incontinence, or swimming in chlorinated water. Certain vaginal hygiene products can also cause skin irritation. These include topical vaginal creams, laundry detergents, vaginal sprays or douches, perfumed or colored toilet paper. Some other medical factors can be diabetes, herpes, dermatitis, and pubic lice, causing vulvar dystrophy.Patients with vulvar dystrophy may experience symptoms, including:To diagnose, your physician may discuss the symptoms you might be experiencing. A physical examination of your body will help provide accurate insight into this condition. They may perform urinary tests to check out the causes of similar symptoms, such as yeast infection and discomfort in the vagina. Many times, the diagnoses involve a biopsy that takes a sample of your vulvar tissue. The treatment of this condition depends on the type and severity of the dystrophy you have. Usually, your physician will prescribe an impactful steroid cream. You can apply or put this cream on your vulva area. Make sure you use steroid medicine in the same way as your healthcare provider prescribes. Never use less or more of it than prescribed by the doctor. Also, do not use it for more than the prescribed duration of time. Also, avoid using a steroid without the approval of your physician.Note that practicing good vaginal hygiene is always helpful in reducing symptoms. Use unscented soaps. Rinse your genital area thoroughly after toileting. Keep your vaginal area as dry as possible, and use underwear made of cotton material to make this area breathe easily. Some other ways to take care of you and to avoid or treat vulvar dystrophy are:By following these tips, you can prevent or reduce the symptoms of vulvar dystrophy.
3 min read
vaginal atrophy treatment

Vaginal Atrophy Treatment: Different Remedies You Can Try

Vaginal atrophy, known as atrophic vaginitis, refers to the drying, inflammation of one’s vaginal walls. This may happen when a woman’s body has or produces less estrogen, occurring most often after going through menopause.  There many vaginal atrophy treatments, both medical and natural. So read on to learn more about this condition and how you can remedy its symptoms! Vaginal atrophy is caused by a decrease in estrogen production. With less estrogen, it makes the vaginal tissues more fragile and less elastic, feeling thinner and drier.  The drop in estrogen may happen due to the following:             •           Before or after menopause            •           After the surgical removal of both ovaries            •           During breastfeeding            •           Adjustments in medications that affect estrogen levels, like birth control            •           After chemotherapy or pelvic radiation therapy for cancer            •           A side effect of hormonal treatments for breast cancer There are also risk factors, such as smoking, having no sexual activity, or no vaginal births.               •           Vaginal dryness, burning, discharge, and/or itching            •           Burning urination, as well as frequent and urgency with urination            •           Urinary incontinence            •           Recurrent urinary tract infections            •           Discomfort and/or light bleeding during or after intercourse            •           Decreased vaginal lubrication during intercourse            •           Vaginal canal shortens and tightens Vaginal atrophy may increase your risk of urinary problems and vaginal infections, which is why it’s best to have it checked and diagnosed with your doctor if you feel any of the symptoms mentioned above.  Fortunately, there are ways to treat vaginal atrophy, such as: 1. Natural RemediesThere are a few lifestyle changes you can follow, which are:             •           Give up smoking            •           Staying sexually active can help to increase blood flow to your genitals            •           Avoid using perfumed products, including deodorants, douches, powders, soaps, and certain perfumed spermicides or lubricants            •           Keep hydrated and drink eight glasses of water a day to maintain your body’s moisture levels            •           Exercise regularly and maintain good physical activity to help with hormone balance 2. Your DietRight now, there is still little evidence to support claims about how dietary changes help with vaginal atrophy. However, it’s still best to maintain a healthier diet and if you choose to use herbal supplements and vitamins, check with your doctor beforehand.  Some have reported positive effects when consuming probiotics, which can help with urinary problems and vaginal dryness and infections. While further research needs to be done, you may try incorporating probiotics to your diet. 3. Using Moisturizers and LubricantsLubricants can soothe and lubricate your genitals safely. You can try using the following: 4. Medical Treatment Besides lifestyle changes and the mentioned remedies, some medications may help treat vaginal atrophy:                        •           Use topical estrogen cream to the vagina for symptom relief and to reduce exposure of bloodstream to estrogen            •           Oral estrogen or an estrogen-releasing ring to release hormones properly            •           Systemic estrogen therapy, which comes as a skin patch, tablets, topical gel, or as an implant under your skin. However, this may have side effects you’ll need to talk about with your doctor Make sure to check with your doctor before putting any products into your vagina or ingesting any supplements or medications.  Vaginal atrophy is uncomfortable but treatable and manageable. Try any of these safe treatments under the guidance of your doctor and see what works best for you now!
3 min read
Egg Freezing Process

Egg Freezing Process

Here are the essentials to know about the egg freezing process.Egg freezing, or “oocyte cryopreservation,” is a rising trend amongst womxn to preserve fertility. Eggs, or oocytes, are drawn out through ovarian stimulation and frozen, using cryoprotectants (which keep the egg from developing ice crystals and impacting critical proteins). These eggs can then be used in combination with sperm during an IVF procedure to have a child. First, you’ll make an appointment with a fertility clinic - specifically, a reproductive endocrinologist. They may order a few tests:Next, you’ll undergo ovarian stimulation. Typically, ovaries produce one egg a month. During the egg freezing process, a doctor may prescribe injectable drugs to stimulate your ovaries to produce more eggs. They may also prescribe an injection that prevents premature ovulation.You’ll be monitored throughout the process. Blood tests are usually required either daily or every other day so that the doctor can monitor hormone levels. An ultrasound is also done several times a week so that the ovaries can be observed and the development of follicles (fluid-filled sacs where eggs develop) can be monitored. The whole process typically lasts around 2 weeks and is individual based on how your body reacts to the medications.After 10-14 days, depending on your cycle, an injection of human chorionic gonadotropin or another medication may be given to help eggs mature.Egg retrieval is done under sedation. You’ll go into your doctor’s office, be sedated, and, commonly, a transvaginal ultrasound locates the follicles on the ovaries. A needle and suction device are then guided through the vagina to the follicle, where eggs are removed. The more eggs, the better the chances of future success.Eggs are then frozen through a process called vitrification, which prevents ice crystals from forming and damaging the proteins inside the egg through the use of cryoprotectants. (Mayo Clinic)According to this article on the NCBI, “The American Society for Reproductive Medicine - Society for Assisted Reproductive Technology practice guideline estimates that the survival rate of oocytes after vitrification and thawing is 90%–97%, the fertilization rate is 71%–79% and the implantation rate is 17%–41%. The clinical pregnancy rate per vitrified and thawed oocyte is 4.5%–12%.” The American Society for Reproductive Medicine has stated, “Embryos from previously vitrified oocytes show rates of fertilization, implantation, and clinical pregnancy that are comparable to those for embryos from fresh oocytes, although there can be variation among clinics.”It is critical to speak to a few different fertility clinics and doctors, learn about their procedures and processes, and hear about their rates of success. It’s also critical to note whether facilities keep their eggs on-site, whether they freeze them elsewhere, whether there are storage costs associated with the egg freezing, and how long the eggs are kept for.Egg freezing has increased amongst womxn in the United States for a few reasons. According to the American Society for Reproductive Medicine, the rate of first births to womxn between the ages of 35-39 has risen since the 1970s, and is currently at a plateau. The rate of first births to womxn between 40-44 has increased since the 1980s. This can be attributed to socioeconomic factors, education levels, societal norms, and more, but an important takeaway is that the period of career advancement in a person’s 20’s and 30’s often coincides with their most fertile years.The Cleveland Clinic states, “Egg freezing is a newer technology, but it is no longer considered experimental and may be an ideal option for young women, women without a partner, or patients who have personal concerns about embryo freezing."Other reasons for freezing your eggs can include cancer treatments which may affect fertility, illnesses such as lupus, gender diversity, and more.Some of the limitations of egg freezing include cost and insurance coverage. Learn more about if egg freezing is covered by insurance here.According to this article from the American Society for Reproductive Medicine, there are a few elements of egg freezing that have yet to be studied.Data on long-term safety and efficacy of oocyte cryopreservation aren’t complete yet. The process was approved within the last fifteen years, and enough time hasn’t passed for significant numbers of womxn to take on the process, have children, and observe those children to recognize whether there are negative effects from the process.In addition to physically putting one’s body through large hormonal shifts, as well as the emotional changes one may experience, there are additional aspects to consider. The financial burden of egg freezing, particularly if it isn’t covered by insurance, can be considerable. After a person has paid for the procedure itself, there is also a yearly storage fee, which can be close to $1,000 a year. Additionally, a person may want to evaluate how they may feel if the oocytes are never used, such as if they are able to get pregnant naturally or change their minds about childbearing. In addition to never using them, it’s important to think about how you may feel about destroying the oocytes if they are never used. Destruction of any oocytes may present a moral dilemma for some.
5 min read
vaginal itching

Top 5 Causes of Vaginal Itching

 Vaginal itching is an uncomfortable and sometimes painful condition that mainly arises due to benign causes like yeast infections. But, there are many other potential causes of itching in the vaginal area. While vaginal itching can often be treated with over-the-counter remedies, the condition can sometimes grow more serious if overlooked. So, it is important to be familiar with possible reasons for itching other than yeast infection: vaginal itching causes Genital itching is one common symptom of many STDs. STDs can occur due to sexual contact with a person who has an infection of some type. According to the Centers for Disease Control and Prevention (CDC), STDs occur at a very high rate, with millions of cases reported annually.  People can reduce the risk of suffering from STDs by: ●       Having safe sex (using barrier precautions) ●       Getting yourself tested for STDs before having sex●       Preventative measures like the HPV (human papillomavirus) vaccine BV is a common bacterial infection that often affects women after puberty. It occurs when the healthy bacteria in the genitals become unbalanced. Many times, BV does not show any symptoms. But, it can cause watery vaginal discharge with a bad odor and a burning sensation around the vagina.Some known causes of BV are:●       Smoking●       Douching (can upset the vagina’s natural bacteria)●       Bathing with antibacterial or antiseptic products●       Using scented products in the vagina or surrounding areas●       Using harsh clothing detergentsBV can be dangerous to pregnant women and their fetuses. So, pregnant women must see their gynecologist for any vaginal itching or discharge. The feeling of bugs crawling around any part of your body is really disturbing. This is sometimes caused by public lice, an easily transmittable infestation of tiny, crab-like creatures can make your vagina itch like crazy.  Public lice may attach to any body areas covered in hair. Bites or eggs from these bugs can cause vaginal itching and irritation in the surrounding areas. You can treat public lice using store-bought lice-killing lotions. In severe cases, you may need prescription medication.Hormones fluctuate during menstrual cycles and pregnancy. This can lead to drier vaginal tissue than normal, which can result in itching. Besides, perimenopause - the time period before menopause starts, causes a dropped level of estrogen. This can further lead to dryness and itching in the vagina. OTC moisturizers that are gentle and unscented can treat vaginal itching. Your physician may prescribe you an estrogen cream for external vaginal itching if they feel it is caused by your hormones or menopause. Women sometimes have procedures like waxing done to have less hair on their vulvar area. Due to these treatments, you can develop irritation, skin injury, rashes, and ingrown hairs which can all cause itching.If you are using any new treatment for hair removal, consider that they may be causing your itching. The Bottom LineOverlooking vaginal itching is never a good idea, as you may miss a serious cause. So, it is important to consult with your physician in a timely manner to get the appropriate diagnosis and treatment. Everyone's vagina is a bit different, if you're concerned about something with your vagina, learn more about whats normal about it.  
3 min read
dyspareunia

What is Dyspareunia: Causes, Symptoms, and Treatments

Dyspareunia is the recurring genital or pelvic pain that occurs when sexual intercourse or other related activities are attempted. Women with dyspareunia may feel a sharp or intense pain in the vagina, labia, or clitoris. The pain can occur during, before or after sexual intercourse. Though both men and women can experience dyspareunia, women are more likely to suffer from it. According to the American College of Obstetricians and Gynecologists, up to 75 percent of women experience it during intercourse at some point.  In this post, we will briefly discuss the common causes, symptoms, and treatment of dyspareunia.  The intensity of dyspareunia pain varies among women, depending on various factors. Women with this condition may feel superficial pain at the vagina’s entrance, or deeper pain when penis penetrates or thrusts.  Pain may occur: ●       in the urethra, bladder, or vagina.●       during or after intercourse●       during penetration●       in the pelvis during sex●       only during specific circumstances or with specific partners●       when using tampon ●       feelings of burning, aching, or itching●       stabbing pain, or pain like menstrual cramps  For some women, dyspareunia can be a sign of a serious health problem. That’s why it is important to understand the underlying causes of dyspareunia. Causes vary based on whether the pain is deep or superficial.  The Vagina feels dry when it secretes less fluids and this can cause pain. Also, as women grow older, the vagina’s lining becomes thinner and dry due to decreased estrogen levels.  Other causes of superficial pain may include: ●       Increased genital sensitivity to pain ●       Genital inflammation or infection ●       Inflammation of the urinary tract●       Genital injuries ●       Radiation therapy can cause changes in the vagina that can cause pain●       Involuntary contractions of the vagina called vaginismus●       Congenital abnormality or a hymen being present●       Narrowed vagina due to surgery or injury  Deep pain occurs during or after sexual intercourse and can be due to: ●       Infection or inflammation of the uterus, cervix, ovaries or fallopian tubes ●       Endometriosis●       Pelvis tumors and ovarian cysts●       Scar tissue between organs in the pelvis  Besides these, emotions can also affect sexual activity and pain. Emotional factors of dyspareunia include psychological issues, such as anxiety, depression, and relationship problems. Stress and history of sexual abuse can also cause this pain.   There are several ways to treat dyspareunia. Pain caused by underlying infection or conditions can be treated with things like moisturizers, antibiotics, antifungal medicines, and topical corticosteroids.  There are several home remedies you can try out: ●     Use water-soluble lubricants.●     Empty your bladder before sex.●     Have sex when both of you are relaxed.●     Calm burning after sex by applying an ice pack to the vulva. ●     Take a store-bought pain reliever before sex.  Make sure you consult with your physician if you feel intense pain. In more severe cases, doctors may recommend therapies, such as sex therapy, vaginal dilation, or desensitization therapy.   Though there is no particular prevention of dyspareunia, you can make some changes to try to reduce the pain. After childbirth, do not perform sexual intercourse for at least six weeks to avoid any injury or infection. Use proper hygiene and get adequate medical care. Use condoms to prevent sexually transmitted diseases, and use vaginal lubrication. If required, seek medical care before the issue begins to affect your life and relationship.    
3 min read

When Do Babies Start Laughing? The Developmental Stages to Know

As your little one begins to grow and achieve milestones, you’re excited to have them hit certain ones, especially when they begin laughing! After all, what parent doesn’t want to see their little one smile and laugh? Seeing your little one laugh is one of the best parenting moments new moms and dads wait for, and once they start, you won’t get enough! However, their laughter won’t happen the moment they’re born. You’ll need to be patient and wait until that time comes. When do babies start laughing anyway? Read on to find out! When Do Babies Start Laughing? Most babies will first laugh out loud when they hit 3-4 months old. However, the first laugh might come at later months for other babies. Just like any other milestone, the timeline varies from baby to baby, so be patient and let it come on their own time. You can even help your little one discover their first laugh, with many ways to have them feel delighted enough to chuckle. Their first laughs would usually be inspired by anything that makes them happy, from simple things like their favorite toys, or even seeing you laugh, too! Another interesting motivator for their laughs is their curiosity- They want to hear their own voice and see the positive reactions of others around them! Once your little begins to laugh, he’ll start to laugh even more, as it feels great, it’s a cute sound, and he’ll love seeing you do the same.  If it takes a bit longer than 4 months and they haven’t laughed yet, there’s nothing to worry about. Some babies are naturally serious, not laughing as much compared to others. This is okay, as long as they are meeting all of the other developmental milestones. Focus on all the age-appropriate milestones (like smiling, recognizing people, and making other sounds), not just this one! If you’re worried about your child not laughing or meeting the other developmental milestones, then it’s best to bring it up with your baby’s doctor during his next check-up. His doctor will ask about different milestones met, so take note of these for a complete ‘report’. He will give you professional advice based on his evaluations, recommending therapy or other exercises as needed.  There are also other ways you can encourage your baby to have their first laugh, such as: ·         Make funny noises like kissing or popping sounds, talk in squeaky voices, or blow your lips together. These are more interesting noises than your normal voice, which can have your baby laugh. You can also give them noisemakers, provided that these are safe toys to play with·         Tickle or blow on your baby’s skin gently, or kissing their hands and feet·         Play fun games like peek-a-boo, which is a great way to have babies begin laughing Among the many memorable events you can’t wait to experience with your little one, laughing must be one of the top of your list! This wonderful milestone will be reached eventually, only taking a few months. If not, this is totally OK, your little one will learn to laugh eventually, and your home will be filled with that adorable giggle. Hopefully, we answered your question, ‘when do babies start laughing?’ Wait patiently and allow your little one to take time until they learn different actions, they’ll be giggling in no time!
3 min read

Third Trimester Of Pregnancy: Everything You Need To Know!

Many people often wonder, “When does the third trimester begin?” The third trimester begins in week 28. The third trimester lasts from week 28 to the end of pregnancy, usually going not much longer than 40 weeks and 6 days. The third trimester is when you may begin to increase the frequency of your doctor’s visits from once a month to perhaps once in 2 weeks. In the last month of the third trimester, pregnant persons may be seeing your doctor every week. In the beginning of the third trimester, you will also get your TDap vaccine for pregnancy, as well as undergo your glucose tolerance test. The third trimester lasts around 3 months (months 7, 8 and 9) and goes on till you give birth (around week 40). Pregnancy headaches are commonly experienced by many people and are more common in the first and third trimester. They can occur due to changing hormones and a myriad of causes. While mild ones are okay and can be self-treated you should let your healthcare provider know if you're having more severe headaches. Severe headaches during the third trimester headaches can sometimes be caused by Preeclampsia which is a condition of hypertension (high blood pressure).  Mayo clinic deems it abnormal, if your blood pressure is above 140/90 on 2 different occasions at least 4 hours apart. (1)It is recommended to try and relieve mild headaches by natural means. If not, it is important to talk to a healthcare provider about any medications that you may be taking for these headaches.Spotting in pregnancy, during any trimester, should prompt you to call your doctor. You can expect your doctor to check for cervical polyps and ensure that your cervix is closed. The doctor may also do an ultrasound to evaluate the health of the growing fetus and the viability of the pregnancy. (4)According to the Mayo clinic, the best time for pregnancy travel is before 36  weeks. Remember to discuss the details of your travel with your ob-gyn to ensure maximum comfort and care. However, you can expect that it will be more difficult to move around or sit for extended periods during travel. Most airlines allow flying until 36 weeks (well into the third trimester). Radiation exposure at the altitude of air travel is not considered problematic for flying during pregnancy. (2) Remember that there is still a possibility of going into labor between 35 and 36 weeks. If you do choose to travel this late in pregnancy, be sure to choose a destination with adequate medical care available. Make sure to stay hydrated and stretch often! There are some situations in which third trimester travel is not recommended. Pregnant persons experiencing the following 3 P’s are recommended not to travel during pregnancy: 1. Preeclampsia: High blood pressure in pregnant women2. Prelabour rupture of membranes (PROM): rupture of amniotic membranes that generally should not happen before labour. 3. Preterm labor: This usually occurs shortly after PROM False labor (Braxton-Hicks contractions): False labor contractions may start in preparation for childbirth.Difficulty breathing: Some women may experience third trimester shortness of breath. Improvements in posture may help your lungs expand to help your breathing. Pregnancy Swelling Ankles and Feet: During pregnancy swelling feet can happen. Elevating your legs and exercising will help ease the swelling. In some cases, pregnancy swelling can be a sign of something more dangerous like a blood clot. Be sure to show your swelling to your doctor, and if you have pain or swelling that is one-sided, seek medical care immediately.Third Trimester Back Pain: Hormones released during pregnancy cause the connective tissue around your bones to relax which causes back pain in the third trimester. This increases the need for good posture through exercise to strengthen your muscles and with the help of chairs that provide back support. Heartburn: Pregnancy hormones also relax the lower esophageal sphincter (the valve between the stomach and esophagus). This allows for stomach acid to back up into your esophagus. Eating frequent smaller quantity meals and avoiding acidic foods like citrus fruits along with fried or spicy food may prevent heartburn. Heat: At this time, the fetus begins to radiate body heat which can make you feel hotter than normal. Red-purple/swollen veins: There is an increase in blood circulation in your body to keep up with yours as well as the fetus’s needs. This causes red-purple veins to surface on your face neck and arms. It may also cause your veins to swell. High fiber and fluid intake is important. Hair growth: Pregnancy hormones can cause courser and faster growth of hair on your arms legs and face.Frequent urination: Third trimester pregnancy involves the baby moving deeper into the pelvis creating more pressure and the frequent need to urinate. This can also cause leaking. Panty liners may be useful to manage leaking when you laugh, cough or sneeze. Colostrum leaking: The first form of milk begins to leak from your nipples until breastmilk is ready for your baby.Leukorrhea: This is white vaginal discharge that is normal to produce at this time as it contains more mucus. Other Third Trimester Symptoms: Leg cramps, stretch marks, loss of sex drive, skin pigmentation, constipation, hemorrhoids, dry or itchy skin due to stretching of the skin around your abdomen are amongst other changes and symptoms you may experience during this time. (3)Sources: 
6 min read
dry skin

Dry Skin: Causes, Treatment & Prevention

The top layer of skin is called the epidermis and it is considered the least important layer as it gradually sheds and comes off, only to be replaced by new layers. When there is a lack of natural skin oils and lubricants or the body is not hydrated, this layer becomes dry and will flake off more than usual. Sometimes it will be itchy and if it persists, cracks can appear.Anyone at any age can experience dry skin. Usually it is a result of low humidity and the skin will simply not retain enough water. The epidermis is composed of many layers of flattened skin cells.  Sebaceous glands are small oil-producing glands that are present in the skin. If the oil is washed away too frequently or using strong soaps/chemicalsThere can be internal or external causes for dry skin. External forces include cold temperatures and low humidity. Internally age is a factor since the body produces fewer cells overall and that will include the oils necessary to keep us moisturized. Also genetics and other medical conditions including thyroid problems can affect the skin.  Some medications used to control blood pressure, high cholesterol, and acne will contribute to skin dryness. Some fibers used in the manufacture of clothing will cause an allergic reaction which can worsen dry skin. This can include wool and some synthetics.handwashing dry skinOver-washing the skin can cause dryness, but that doesn’t mean you should stop showering or washing your hands. Bathing actually adds water to the skin, but when it evaporates, the oils dissipate and the skin feels tight. Just follow up with a good moisturizer. Be sure to follow the package directions on using moisturizing products and to use enough to do the job properly. Also, stick to gentle cleansers that don't strip the skin too much. If you notice rough, dry, and even red, patches on your arms hands, and lower legs, you probably have dry skin. Other areas can include the abdomen and areas that are prone to rubbing like ankles and the soles of feet. It is common for the itchiness to occur during sleeping and the individual will scratch the area without even knowing it, which will only aggravate the situation.Excessive scratching and rubbing will make the skin thicken and feel leathery. Sometimes there are small red bumps which can become irritated by scratching.  In fact, too much abrasion can open the areas and leave them prone to infection.If left untreated, dry skin will become more sensitive and will be more apt to develop a rash. Serious complications can include eczematous dermatitis, bacterial infections, cellulitits and skin discoloration.The best prevention is to shy away from harsh soaps and chemical cleansers. Treatment is usually using lotions and moisturizersIf you have serious concerns, discuss it with your primary care physician or consult a dermatologist.Check out our article on Dry Hair
3 min read
sleep training

5 Sleep-Training Methods For Babies You Can Follow

As new parents, it may be difficult adjusting to your baby's sleeping habits, especially when they wake up crying in the middle of the night! Once they reach a few months old, it's time to begin training them to sleep peacefully on their own, and at the right time. How can you do it?Here are the 5 different sleep-training methods for babies you can consider trying: sleep training your babyAlso known as the Check-and-Console Method, there are different variations but a similar principle: Continue checking on your little one at preset intervals but you don't feet or lull them to sleep, as this would mean they won't sleep on their own. Once you go through the typical bedtime routine, put your little one in the crib and leave the room, waiting for a specific amount of time (a minute or two). Then go in and reassure your little one with a few words or a simple pat or rub. Do NOT pick the baby up and leave the room again, continuing to leave and check on them until they fall asleep.  While effective, some parents report that going into their room would aggravate their baby more. With that said, consider the next option, CIO. You do not respond to any crying as your baby tries to sleep. Go through the bedtime routine and put them in their crib and walk out.  This is a controversial sleep-training method that's still up for debate. What you do next is what works for you and your little one. Expect a lot of crying, though it's short-term and as long as you know they are safe (check through a baby monitor and camera), then it's worth a try. This is a gradual sleep-training method that needs a lot of patience and discipline.  Prep your little one for bed but instead of walking out, stay near the crib and sit down. Once they fall asleep, leave the room but once they wake up, sit back in the chair until they are asleep again. You should console them from your chair, if possible, and not closer. Every few nights, move your chair further away until you are outside the room.  If your baby is younger than seven months, then this is a suitable method where you’re staying in the room without having to provide too much help for your baby to fall asleep. Simply stand over your baby’s crib and start shushing him by patting his tummy for reassurance. You can also let your baby fuss over for a short while and pick him up, then put him in his crib before he falls asleep. These methods work well for younger babies but it may make some babies more upset because of overstimulation. With the Bedtime-Routine Fading technique, simply continue whichever sleep-training method works for you. But every few days, decrease the amount of time spent doing it until you won't have to do it anymore. As for the Bedtime-Hour Fading, you place your baby in the crib at the typical time they start dozing off, then make that their bedtime for a few nights. Then start to slowly move the bedtime at an earlier time, such as 20 minutes earlier until your little one nods off at the desired bedtime. Beyond these sleep-training methods for your baby, make sure that you do much more research and talk to your doctor for more advice. What can work for others may not work for you and your baby, so trial-and-error is needed here, as well as a lot of patience. The good news is that for most babies, sleep continues to improve over time regardless of which sleep training methods you use. Good luck!
4 min read

Peak Ovulation: 5 Ways to Track Ovulation Effectively

If you are trying to conceive, tracking your peak ovulation period is helpful to know when you are most fertile.  With that in mind, how can you monitor when you ovulate? These are the top 5 ways to track your ovulation: 1. The Calendar Method to Find Peak OvulationThis is a suitable method for those who have regular periods and if their menstrual cycle usually occurs during the same number of days every month. If that’s the case, it’s safe to say that you ovulate every two weeks before expecting your period. However, this may vary based on one’s individual menstrual cycle. For those with 35-day cycles, you may ovulate on the 21st day.  This isn’t best for those who have irregular periods.  But if you are thinking of using the calendar method, there are ovulation tracking apps and online calendars to keep you in check. (https://www.womenshealth.gov/ovulation-calculator) 2. Basal Body Temperature ChartingThis method involves taking your temperature the moment you wake up, even before getting out of bed.  When you maintain a chart of your basal body temperature throughout your menstrual cycle, you may be able to detect a sustained temperature increase, which can indicate you finished ovulated. In certain cases, this method might even hint whether or not you have conceived, using the “implantation” dip. 3. Ovulation Predictor KitsOvulation predictor kits are similar to pregnancy tests, as they are urine tests showing specific color patterns. It shows when the luteinizing hormone levels rise, which indicates that you will start ovulation within the next 12-36 hours. (https://medlineplus.gov/ency/article/007062.htm) When the test predicts ovulation, it's best that you have sex daily for the next few days if you would like to try conceiving. I recommend that you take these tests on consecutive days to detect the LH surge accurately. When testing for more than five days, there’s an 80% chance of predicting ovulation accurately. If done for more than ten days, it rises to a 95% chance. There are computerized fertility monitors that work like ovulation predictor kits, but they are more precise and can detect ovulation earlier. While extremely accurate, it’s quite a pricey option. 4. Cervical Mucus ChangesThis method isn't for all women, but it gives you a good idea of when you're ovulating. During your time of ovulation, one’s cervical mucus is thin and clear, having similar appearance and consistency to raw egg whites. This is compared to the usual creamy and sticky consistency! The reason for its thin and clear mucus is to allow sperm to pass through your cervix during sex, providing sperm a more alkaline environment for them to thrive.  This method is best used with BBT charting for more accurate results. 5. Saliva Ferning TestsSaliva testing is another way to detect ovulation, and a cheaper option compared to using ovulation predictor kits. The method works through highlighting crystal formations that develop in saliva as you ovulate. During your most fertile period in the menstrual cycle, your saliva will have chemical changes. When the saliva dries, there is residue, which shows fern-like crystals you don’t see in other stages of the menstrual cycle.  The test kit has a lens where you place a drop of saliva, and after five minutes, it will show if the crystals develop. If so, then ovulation will most likely happen within 24-72 hours. As long as you have no underlying reproductive issues, then using one of these peak ovulation tracking methods can help increase the chances of conception. But if you would like to use these to prevent pregnancy, it’s best to talk with a medical professional regarding reliable birth control options.
3 min read

Spotting in Pregnancy

While spotting is a relative common occurrence in early pregnancy, it can nevertheless be concerning. According to The American College of Obstetricians and Gynecologists, approximately 15-25 percent of women experience bleeding in early pregnancy. Spotting in first trimester pregnancies, or the first 12 weeks, is typically lighter in color than what one would experience with a regular menstrual flow. The color may also vary from a pinkish hue to red or even brown. Although it is easy to be worried when experiencing spotting during pregnancy, it’s important not to panic. Most women who experience spotting during pregnancy continue on to have a completely healthy pregnancy and deliver a healthy baby. If you’re wondering how common is bleeding during pregnancy 6 weeks, you should rest assured that it is relatively common. In fact, spotting or light bleeding can occur anytime between one and two weeks after fertilization occurs. This happens when the fertilized egg becomes implanted in the lining of the uterus. At this time, the cervix may be more prone to bleeding as a result of more blood vessels being present. Implantation bleeding may last for a few days and typically occurs before a woman even realizes she’s pregnant. In fact, this type of bleeding is sometimes mistaken for a regular period. There is no need to be worried about implantation bleeding. It should be kept in mind that any time bleeding or spotting occurs after a woman would have expected her period, it’s usually not implantation spotting, but is instead likely associated with early pregnancy instead. Understanding the Difference Between Bleeding and Spotting During PregnancyIn understanding whether to be concerned about spotting in first trimester pregnancies, it’s important to also understand the difference between actual bleeding and spotting. Vaginal bleeding that occurs during early pregnancy involves a discharge of blood that comes from the vagina. This type of bleeding can occur any time from the point of conception all the way through the end of the pregnancy.Spotting is relatively common during the first three months. There is usually no need to be alarmed. This is particularly true if you only notice a few drops of blood. As long as there is not enough blood to fill an entire panty liner, there is no need to be worried. By comparison, bleeding occurs when there is a much heavier blood flow. With actual bleeding, it will be necessary to wear a liner or even a pad in order to prevent blood from soaking through your clothing. Regardless of whether you are spotting or bleeding, it is typically best to get in touch with your healthcare provider and then describe to him or her the symptoms you are experiencing. It should be kept in mind that quite a few changes occur in the cervix during pregnancy. This is due to the high production of hormones that takes place during pregnancy. The presence of such hormones can cause the cervix to become softer. In addition to bleeding at the time of implantation, there can be many other causes for spotting to occur during pregnancy. Among those causes is a cervical polyp, which is a growth on the cervix. During periods of high estrogen levels, such polyps are more likely to bleed. This is particularly true during an exam or sexual intercourse. Cervical polyps are completely harmless. Other common causes of bleeding during early pregnancy include:In some cases, a vaginal infection can also lead to bleeding. When the cause of bleeding is a vaginal infection, it may also be accompanied by vaginal discharge. Certainly, no one ever wants to consider that bleeding might result in a loss of pregnancy, but miscarriage may also be a cause of bleeding that occurs during pregnancy. It’s certainly understandable that bleeding might trigger a concern regarding loss of pregnancy. According to a study; however, only 12 percent of the small number of women who experience bleeding in pregnancy actually had a loss of pregnancy. It should be noted that approximately two-thirds of women who do have a miscarriage experience bleeding. Given this; it’s important not to simply ignore bleeding during pregnancy. A healthcare professional can perform tests to determine a possible cause of bleeding in pregnancy. For instance, an ultrasound can determine whether bleeding stems from pelvic organs, such as an ovarian cyst. Blood tests may also be ordered to measure hCG, the pregnancy hormone. Low levels of this hormone might indicate that a pregnancy is not progressing properly. In some cases, progesterone levels may also be checked, as low levels of progesterone might result in bleeding or could indicate the presence of an abnormal pregnancy. Bleeding in Pregnancy as a Result of Abnormal PregnanciesWhen a pregnancy is not developing correctly, bleeding may be one of the first noticeable symptoms. For instance, if there is a genetic defect related to the embryo, bleeding could indicate an impending miscarriage. Once a miscarriage is in progress, it usually cannot be prevented. Molar pregnancies, also sometimes referred to as gestational trophoblastic disease, refers to a pregnancy in which there is something abnormal about the fertilization. This results in abnormal tissue growing in the uterus. Although the pregnancy is not normal, a woman may experience the same symptoms associated with early pregnancy. Depending on the type of molar pregnancy that has occurred, there may or may not be a fetus present in the uterus. In some cases, there is only tissue and no fetus at all. In other cases, there may be an abnormally formed fetus. When this is the case, the fetus typically has severe birth defects. Molar pregnancies are not able to progress toward the delivery of a normal fetus. One of the early symptoms of a molar pregnancy is bleeding or vaginal spotting. Molar pregnancies are diagnosed with an ultrasound or sonogram. When a fertilized egg does not implant in the uterus as it should, the result is an ectopic pregnancy. The egg may instead implant inside the Fallopian tubes. As the pregnancy progresses, there is a risk of the tube rupturing. Symptoms of an ectopic pregnancy may include vaginal bleeding and abdominal pain. A ruptured Fallopian tube can result in a significant amount of blood loss and could be potentially fatal. Emergency surgery and a blood transfusion may be necessary to resolve this life-threatening emergency.Anytime a pregnant woman experiences bleeding in pregnancy, it’s important to speak to a doctor. Although the bleeding or spotting could be completely harmless, it’s still important to determine the cause of the bleeding. While it’s quite likely that the cause of the bleeding is something relatively minor, other more serious causes of spotting or bleeding in pregnancy may include placental abruption, uterine rupture, placenta previa, or preterm labor. The best course of action is to see a healthcare professional as quickly as possible.In order to help manage spotting or bleeding in pregnancy and improve the chances of a healthy pregnancy continuing, a pregnant woman may be advised to stick to bed rest, stay well hydrated, spend time off her feet, limit physical activity, and elevate her feet.
7 min read
what causes dark circles under eyes

What Causes Dark Circles Under Eyes? What to Watch Out For!

There are common and various reasons why dark circles develop, and finding out why can help you know what solution to follow. So, what causes dark circles under eyes?This is the most common reason why people have dark circles under their eyes. A lack of sleep and too much sleep can cause dark circles. Oversleeping or extreme fatigue, as well as even just staying a couple of hours past your typical bedtime, may end up with you waking up with dark circles.This is because sleep deprivation causes the skin to become dull and/or pale, which allows dark tissues and blood vessels underneath the skin to show. Furthermore, lack of sleep may cause fluid build-up under the eyes, which is why they sometimes look puffy. The dark circles may be shadows from puffy eyelids.Another common cause of those dark circles under your eyes is aging. When you turn older, the skin becomes thinner and you begin losing fat and collagen, which are required to maintain skin elasticity. As a result, the dark blood vessels under your skin will become more visible, which causes the areas under the eyes to darken.If you are in front of a computer or television screen for hours on end, without any breaks, that can be straining on your eyes. This strain would result in enlarged blood vessels around the eyes. This may cause the surrounding skin of the eyes to darken.Both allergic reactions and dry eyes may trigger dark circles.If you experience an allergic reaction, the body will release histamines, responding to the harmful bacteria. As this occurs, you’ll experience a few symptoms, such as itchiness redness, and/or puffy eyes. Histamines may also cause the blood vessels to dilate, making them look more visible from under the skin.Also, because allergies may increase the urge to scratch and rub your eyes, it can worsen the symptoms and cause inflammation, swelling, and even broken blood vessels. This is what causes dark shadows under the eyes. This is another common reason why people have dark circles under their eyes. When the body doesn’t receive the right amount of water, the skin under your eyes will begin to dull, with your eyes looking sunken. Sun overexposure may cause the body to produce too much melanin, which is a pigment providing the body with color. Too much sun around the eyes might cause the pigmentation in the surrounding skin to darken further.Your family history can play a part in the dark circles developing under the eyes. It might be an inherited trait that shows in childhood, which might worsen or disappear with age. Inheritable medical conditions may also result in dark circles under the eyes.Wrapping It UpHopefully, this list of the reasons why you might have dark circles under your eyes helped you out. Identify the root cause of the dark circles under your eyes and see what you can do to help them disappear now!
3 min read
An embryologist fertilizes eggs in a laboratory

What Is Egg Freezing?

Freezing eggs is a decision that some women may want to explore based on their lifestyle or health. There are many questions that surround the process of egg freezing and it can leave many feeling overwhelmed. Today we answer the most common questions asked and we also go into detail on how the procedure is completed. If you or someone you know is interested in freezing eggs for future use, then read ahead. Freezing your eggs can be done for a number of reasons ranging from wanting to get pregnant later in life to having certain medical conditions. Egg freezing doesn’t require sperm, unlike embryo cryopreservation. However, it will require you to take fertility drugs to start the ovulation process so that your body will produce multiple eggs. Those that might want to consider egg freezing are:Egg freezing is not something you want to take lightly. The first step you want to do is find a fertility clinic that has experts in this matter. These experts are commonly referred to as a reproductive endocrinologist. Each clinic you look into should list their data of live births, pregnancies, and some will even include the ages of the women they treat. This information can be found on a clinic’s website, an in-person consultation, and the Society for Assisted Reproductive Technology has more information on the data surrounding US fertility clinics. Before you begin the freezing process, you will have to undergo various testing. These tests include:There are 3 steps to completing the egg freezing process. The first is ovarian stimulation, the second is the egg retrieval, and the third is freezing.Egg freezing doesn’t happen without any risks. There can be complications due to the procedure or fertility drugs. Some of these risks include:This will depend on your insurance company. Some will pay for medication but not the procedure or the testing. Others will pay for testing only. Overall, egg freezing isn’t covered by most insurances, but some will cover partial or full coverage if you suffer from a special circumstance such as cancer or early menopause. Those that don’t have insurance that covers this procedure or any insurance at all may find a fertility clinic that can help finance you, you can fundraise money, look into getting personal loans, or even some government and state grants can be applied for. The cost of egg freezing varies depending on a few factors. One factor is the clinic you choose. Each one charges their own prices for the services they offer, usually between $7,000 and $12,000 and that cost includes the medication, procedure, and testing. There is also variation of cost depending on which city you are freezing your eggs in.The storage fees will vary based on the clinic as well, but many charges somewhere between $500 to $1,000 a year. There is also no time limit on when you have to unfreeze your eggs, but keep in mind that if you intend to get pregnant, many clinics have cut off ages unless you plan to use a surrogate. It’s best to check with the clinic on their policies first.Another factor is how many rounds you may need to undergo. As you age, your body will naturally make fewer eggs so while someone in their early 20s or 30s may need 1 cycle, mid-30s and late 30s may need 2 or 3 cycles to get the necessary amount of eggs needed for freezing. This also can be affected by your egg quality as well. If you have poorer egg quality, you may need to do several cycles. Unfreezing your eggs when you feel it’s time to try for pregnancy can cost around $5,000 to $7,000.
7 min read
how to increase female libido

5 Effective Ways on How to Increase Sex Drive in Women

If you have a low sex drive, it’s not a problem and many women have experienced it a few times. Fortunately, there are how to increase sex drive in women.Read on to find out how to increase female libido with these natural methods:When you have higher levels of anxiety, it can affect sexual functioning and libido. It may be anxiety from life stress or sex-related, especially for those who have intense work schedules and stressors. Because of anxiety, you tend to feel fatigued and have lower sexual desire. (https://www.betterhealth.vic.gov.au/health/healthyliving/libido)That’s why it’s important to manage your stress and anxiety, which boosts both sexual and mental health. Follow these tips:When you have a better sexual experience, it can increase your desire for sex and loose libido. There are many ways to enhance your sexual experience, starting with foreplay.Spend more time on kissing and touching, performing oral sex, and even using sex toys. This is especially important for women, as research shows how stimulation of their clitoris is needed for a successful orgasm. Having a healthier diet can help with your sex drive, as it promotes better circulation and overall heart health. You can also remove foods that may decrease libido and cause metabolic syndrome or heart diseases.Prioritizing meals filled with fruits and vegetables, while still being low in sugar, is a great way to feel good in your skin. Focus on increasing your intake of lean proteins to prevent disorders that affect your libido. The healthier and more natural your diet is, the better!Furthermore, start lessening or quitting vices like alcohol and smoking. These harm your cardiovascular system, which is important for better sexual functioning and energy levels for sex.Studies show have exercise can help cope with many issues, such as body image issues, low libido, as well as changes in the relationship. It can also help you become healthier and more flexible to make intercourse and foreplay more fun!Make sure you get regular exercise, which can help your mental and physical health to get ready for better sexual experiences. For women, I recommend doing pelvic floor exercises, which is useful for women and their libido, as well as their abdominal organs that affect intercourse.Furthermore, proper diet and exercise are helpful to maintain a healthy weight range, which is necessary to maintain a good sex drive. This is because being overweight or obese has been linked to low sex drive and reduced fertility, as wells as lower body confidence which affects their libido.There isn't much research that proves the effectiveness of herbal remedies in improving sexual function and libido. However, some people find them beneficial, making it worth the try.A small review study has reported emerging data on how these herbal remedies can improve one’s libido and sexual function: • Ginko • Ginseng • Maca • TribulusHowever, it’s best to get your doctor’s approval when trying these herbal treatments before using them. Having a low libido is a complex issue that may be caused by various reasons, whether physical, psychological, or even within the relationship. Be sure to find the cause so you can find the best treatment and talk with your doctor about it.
3 min read
when to start cows milk

When to Start Cow’s Milk for Baby: Making the Switch

If you are considering making the switch to cow's milk for your baby, there are a few things to consider, including when to start cow's milk. It varies slightly, but a consensus is, around a year.When to Start Cow’s Milk for BabyBased on the advice of the Children’s Hospital of Philadelphia, it’s best to wait until your baby turns a year old or over that. Once they hit the 1-year milestone, you can begin switching out breastmilk and/or formula with cow’s milk. As you introduce cow's milk, make sure you start with whole milk, not skim or non-fat. The fat in whole milk is beneficial for the brain, which is crucial for better development during their first 2 years. But if you have a family history or are at risk of heart diseases or obesity, then it’s best to speak with a pediatrician regarding the best choices of milk for your little one.Why Wait to Start on Cow's Milk?You’re probably wondering- Why wait for a year rather than start weaning off breastmilk or formula? Sure, it’s tempting to begin introducing your little one to cow’s milk sooner than a year old, but you shouldn’t rush it.Breastmilk and formula contain iron, vitamin C, among other important nutrients that you don’t find in cow’s milk, or at least not in adequate quantities for your little one to develop well. But when your baby reaches a year old, they can compensate for lost nutrients once they begin eating solids, having a diet consisting of fruits, vegetables, lean protein, whole grains, and dairy. To add to this, here are reasons why you shouldn’t replace breastmilk or formula with cow’s milk too soon:The Benefits of Cow’s MilkMilk is a great source of calcium and vitamin D, which is good for bone development and to protect your body from various conditions, like diabetes and cancer. Just make sure that you feed cow's milk in appropriate amounts, 2-3 servings a day. Wrapping It UpIt’s important to learn when to feed your little one the appropriate and nutritious foods. With cow’s milk, you’ll need to wait for at least a year, and once you do, they can enjoy the health benefits this yummy drink has to offer.
3 min read
pregnancy and constipation

Constipation During Pregnancy

Yes! Unfortunately, pregnancy and constipation often go hand in hand. But, you are not alone in experience pregnancy constipation pain, and discomfort. Recent statistics show that as many as half of all pregnant women may suffer from constipation during pregnancy.While it may be reassuring to know that constipation in pregnancy is a fairly normal experience to have, it doesn't answer the question of how best to achieve pregnancy constipation relief. Treating constipation in pregnancy looks different than it does when you are not pregnant. Find out what is and isn't recommended to find constipation relief in pregnancy.The American College of Obstetrics and Gynecology (ACOG) defines constipation as follows:According to the American Pregnancy Association, there are a number of factors that can cause constipation in pregnancy.Changing hormone levels, and in particular, a spike in progesterone can contribute to a sluggish gut. Progesterone is so important for helping your muscles to relax and expand as your baby gets bigger.But progesterone also has this effect on the gut muscles, which has an unintended side effect: pregnancy constipation. To make matters even more uncomfortable, as one research study explains, when progesterone levels increase, this inhibits motilin, a hormone that stimulates the smooth muscles of the gut to contract. For many pregnant women, morning sickness symptoms and food cravings or aversions can throw off their usual dietary routine. The gastrointestinal system does not like change and may react with constipation and other unpleasant side effects like gas, bloating, cramping and pain.In general, eating a diet low in fiber is one of the main dietary causes of constipation in pregnancy as well as in other times of life. Another main cause is poor hydration.Inadequate intake of dietary fiber combined with too-low intake of water is a reliable recipe for constipation in pregnancy. Make sure to drink enough water to keep your bowels moving.For some women, pregnancy can cause nausea, vomiting, fatigue and other physical symptoms that may lead to inactivity. Inactivity can cause sluggish gut motility that makes pregnancy constipation worse. Because working out during pregnancy can be challenging, even remembering to take regular walks during your day can help pregnancy constipation symptoms.While learning you are pregnant is exciting, it can also be stressful. In fact, all types of stress, both "bad" (distress) and "good" (eustress) impact your body in essentially the same way.Stress, worry, and anxiety are normal and natural during pregnancy but they can also send your body into fight-or-flight mode. The American Psychological Association (APA) notes that stress of any kind can affect how and how rapidly food matter moves through your gut, which can lead to constipation. Being in a relaxing environment can help you to go to the bathroom. As the Mayo Clinic points out, one of the pregnancy supplements most frequently implicated in pregnancy constipation is iron. Because taking prenatal vitamins is essential during pregnancy, remember to keep your water and fiber intake at adequate levels as well.Other medications may also contribute to constipation - always talk with your healthcare provider if you suspect constipation in pregnancy is linked to any medications or supplements you are taking. Always talk with your doctor before adding any new supplements.Pregnancy constipation can and does change as pregnancy itself progresses. This is due both to ongoing hormonal fluctuations at different stages of pregnancy and also because of physical changes.For example, the entire abdominal structure stretches and widens as your baby grows. This can put pressure on existing structures and internal organs, including the intestines, colon, rectum and bladder.The first trimester is when most women experience the set of symptoms commonly referred to as "morning sickness."In this first stage of pregnancy, constipation is more likely to arise because of sheer upset to your system as hormone levels spike and fall and your diet tries to adjust to symptoms like nausea and fatigueAs mentioned here earlier, progesterone spikes reduce gut motility and slow the progress of waste matter through and out of your body.As well, as John Hopkins Medicine explains, constipation naturally arises as your uterus begins to change shape and exert pressure on the intestines and rectum.During the second trimester, your baby really starts to grow. While the majority of morning sickness symptoms will begin to disappear, your growing baby will actually push your uterus up and out of the pelvic cavity, in part relieving the pressure on your intestines and rectum.However, for many women, the second trimester is the time when appetite increases. Increased food intake combined with back aches, body aches and pains and disrupted sleep can in turn cause constipation in the second trimester, according to John Hopkins Medicine.After experiencing constipation in the second trimester, you may feel quite hopeful that it will finally ease up in the third trimester.Unfortunately, according to John Hopkins Medicine, this is unlikely to be the case. The reason is because your baby is now large enough to once again put pressure on both your bladder and bowel, causing leaking in the former and constipation in the latter.The onset of hemorrhoids, another common pregnancy complication, may make constipation symptoms feel more intense.Treating constipation in pregnancy correctly is important both for your baby's health and safety and for your own.First step: try to resolve constipation naturally.The best first step is always to try to resolve the constipation symptoms naturally, as the American Pregnancy Association (APA) explains.As best you are able, try to increase fiber and water intake and daily exercise. The APA recommends aiming for 20 to 30 minutes of moderate exercise at least three times per week. Swimming and walking are excellent choicesHowever, always talk with your doctor before adding anything new to your daily diet or exercise routine.In some cases, it may be possible to switch to a different type of iron supplement or take smaller doses more frequently to ease constipation symptoms.Separating out iron supplements from your other prenatal vitamins can also help ensure you keep taking in appropriate levels of all.If possible, you may be able to work with your provider to take in more dietary iron instead of taking it in supplement form.Here again, never make any changes without talking with your doctor first.There are three general categories of medical remedies that your doctor may recommend for pregnancy constipation that does not respond to other things you have tried: stool softeners, laxatives and bulk-producing agents. The Mayo Clinic states that stool softeners are generally considered to be safe for use during pregnancy.The Cleveland Clinic also publishes a list of constipation remedies considered safe for use while you are pregnant.The American Pregnancy Association reports that Milk of Magnesia is one remedy that is also considered to be safe for use during pregnancy.Thankfully, constipation during pregnancy is considered a highly treatable symptom. Now you know you have multiple options to help your gut acclimate to the widespread changes occurring throughout your body.Always seek a doctor's guidance before treating constipation in pregnancy that does not respond to other natural lifestyle modifications. This is for your baby's safety.
7 min read
what is libido

What is Libido? A Quick Review

What is Libido?The term "Libido" simply means the desire for sex. In women and men, libido is linked to androgen hormones. As men have about 40 times as much androgen as women, they often have a more intense sexual drive. According to WHO (World Health Organization), sexual health is a state of physical, mental, social, and emotional well-being in sexuality. That's why libido is now considered a critical indicator of the quality of life and general health.   Undoubtedly, sexual health varies from person to person and may even fluctuate in the same person too. Everything from your lifestyle, personal preferences to health history, hormone levels, and medications can impact your libido. Familial responsibilities, job stress, and friend dynamics can also affect libido. While natural fluctuations of libido are normal in everyday life, abnormal libido levels can be a concern.  There are both physical and psychological causes of low libido. Physical causes include low testosterone, too much or too little workout, prescription medicines, and excessive substance abuse.  Psychological issues include relationship or social difficulties, depression, and stress. Other causes of low libido include aging, chronic illnesses, and dyspareunia. Nearly 4 in 10 men over age 45 experience low libido, while about one-third of women ages 18-59 suffer from the lost sex drive.  Clearly, there is no single reason behind the lost sexual desire. It is best to discuss the issue with your doctor for the best advice.   If sex is center in your mind every minute, then you probably have a high libido. Though having such a high libido may not be a bad thing, it becomes an issue if it causes problems with your sex life and life beyond sex. High libido can be termed as hypersexuality, sexual addiction, or compulsive sexual behavior. And, there could be some physical and even mental conditions behind hypersexuality.  Many people with anxiety can consider sex as a form of self-medication. Deeply entrenched feelings, like low confidence and unresolved embarrassment, can increase sex drive.  Moreover, certain drugs may also cause sky-high libido. Drugs like crystal meth, cocaine, caffeine, and ecstasy can jolt your brain like over-the-counter stimulants. Wellbutrin also causes increased libido as its side effect.  Treatment of Libido When it comes to low libido, testosterone replacement therapy is considered to be effective. In addition, depending on the actual cause, the following treatments could help: ●       Improve your diet●       Healthier lifestyle choices●       Regular exercise●       Proper sleep●       Reduce stress●       Quit smoking, alcohol, and substance abuse●       Change to a new medication●       Counseling If you experience high libido, you can try out things like interrupting your sexual urges, use your energy to other areas, find satisfying sex, or talk to someone about this.  Your physician may recommend mental therapies in case of a psychological cause. These sessions and therapies can sort out the issues and let you enjoy a happy and satisfactory sexual life.  The Bottom Line Understand the behavior of your body and discuss your feelings with your doctor transparently. That’s the only best way to know the root cause of the problem - physical, emotional, social, or if it’s something else.
3 min read
dangers of using a homemade douche

4 Dangers of Using a Homemade Douche

It’s extremely important to take care of your vagina, but is douching an appropriate precaution? The dangers of using a homemade douche and douching in general can be very serious. One way people try to cleanse their vaginas is through vaginal douching. This is when one washes the inside using a mix of water and fluids. This is to help eliminate odors and further “cleaning” the vagina.Usually, vinegar is mixed with water, with prepackaged douche products containing ingredients like baking soda, iodine, or even antiseptics and fragrances. This is a common cleaning method, with one in five women between 15-44 years old using douches, some even homemade, regularly. Many women choose to use a vaginal douche as a way to “cleanse” their vagina and rid it of odors. Others believe that douching can help prevent sexually transmitted diseases (STDs), rinse away blood from periods, and prevent pregnancy and infections. This is untrue. Douching isn’t necessary to further clean your vagina, nor will it protect you from STDs or pregnancy. In fact, the dangers of homemade douche may be even more severe. This is why the American College of Obstetrics and Gynecology does not recommend the use of any douching products. The vagina needs a healthy pH balance and is naturally filled with critical bacteria, known as vaginal flora. These bacteria helps prevent irritation and stop infections. When you reduce the healthy bacteria in the vagina, then the problematic bacteria might flourish, leading to serious complications. Here are the specific risks associated with vaginal douching:Those who douche regularly have more of a chance to experience pregnancy complications, including miscarriage or early childbirth. It may also lead to ectopic pregnancies or difficulty in conceiving.As mentioned, a healthy balance of bacteria in the vagina can prevent vagina yeast from overgrowing. When you eliminate this natural pH balance, the yeast would flourish, causing yeast infections.Those who douche are 5 times more likely to develop infections like bacterial vaginosis compared to women who don’t douche. And for those who believe that washing the vagina can eliminate infection, it can actually worsen it. By douching, you could be spreading the bacteria to other parts of the reproductive system.This is an infection that would develop in your reproductive organs, usually caused by STDs. Using a douche can increase the risk of this disease by 73%, and may also hinder your success conceiving.Cervicitis is the inflammation of the cervix, also caused by STDs. But women who douche are also more susceptible to develop cervicitis. It may also cause vaginal irritation, among other uncomfortable pain.While douching is a common practice, it isn’t something you should do, as there are more negatives than benefits. With many experts advising against douching, it’s best to stay away from the practice. Talk to your Gynecologist to learn how to clean your vagina properly and safely.If you have questions or want to share tips in cleaning your vagina, do share them in the comments section below.
3 min read
how much weight should you gain during pregnancy

How Much Weight Should You Gain During Pregnancy?

During pregnancy it is expected that the woman will gain weight to properly grow the fetus. However, it can be hard to figure out just how much weight you should ideally gain during your pregnancy. While you might want to excuse yourself from a diet, thinking you need extra food to nourish you and your little one, it’s still best to keep an eye on your weighing scale for both you and your baby’s health. But you may want a better breakdown- just how much weight should you gain during pregnancy?Some people suggest that you gain between 25-35 pounds when pregnant. However, there are several factors to consider before sticking to that range.The 25-35 pounds weight gain range is best for those whose body mass index (BMI) is in the normal weight before they got pregnant. Your BMI is measured with your height and weight, so you’ll need to know this before pregnancy to know how many pounds you should gain healthily when expecting.Refer to this:Besides your BMI, you should also consider if you’re carrying twins. If so, then here is the recommended weight gain:You may also have certain individual conditions that affect how much you should weigh and gain during pregnancy. It’s best that you talk with your doctor about your weight to ensure that you stay healthy and to prepare the body for nursing.Here’s a breakdown for a typical 30-pounds pregnancy weight gain:You should also keep an eye on how much weight you should gain per trimester, as you shouldn’t pack on the pounds immediately and all at once! This is a recommendation from the American College of Obstetricians and Gynecologists, made for those with a normal BMI before pregnancy:Gain only 2-4 pounds during your first trimester, as your baby is still small. You may even lose a bit of weight from morning sickness or a lack of appetite, which is fine, as long as you continue gaining weight in the next six months.Gain about 12-14 pounds during your second trimester, when your baby is starting to grow.Gain around 8-10 pounds during the third trimester, which is when the baby starts to weigh more but your weight tapers a bit.Take note that all of these are just averages and not the exact formula to follow. That is why it’s important to communicate with your doctor. While it's crucial to keep an eye on your weight, it will be just as unhealthy if you stress over the weight in itself. As long as your weight during pregnancy is within a healthy range and you gain at a healthy pace, you're right on track. Focus your nutrition on healthy and nutrient-dense foods to keep yourself feeling full and fueled.
3 min read
chemical pregnancy

What Is a Chemical Pregnancy? The Things You Need to Know

Have you gotten a positive pregnancy test only to get your period a week after? It’s probably confusing (and a bit frightening), but this actually happens a lot.This means you might have experienced a chemical pregnancy, which is nothing to be afraid of.A chemical pregnancy is an early pregnancy loss, happening when the egg fertilizes but does not completely implant in your uterus. This usually happens at week four or five of the menstrual cycle. These pregnancies are very common, with experts believing that it accounts for up to 70% of conceptions. In normal pregnancies, the fertilized egg would implant in the uterine wall, a few weeks after your last menstrual period. Cells that become the placenta start producing hCG, the pregnancy hormone. In chemical pregnancies, the implantation wasn’t successful and the cells won’t become an embryo and placenta. As a result, you experience bleeding for a week after your period. Most times, the only indication of this pregnancy loss is a late period. Some women don't even realize they have had a chemical pregnancy unless they took an early pregnancy test after conception.These are signs of a chemical pregnancy: • You had an early positive pregnancy test result • You’re experiencing a late period • Heavy bleeding with menstrual-like crampsHowever, light spotting or bleeding after your positive pregnancy test result doesn’t automatically mean it’s a chemical pregnancy. It may be light implantation bleeding, a sign that you’re pregnant. Regardless, if you experience any form of bleeding after the positive test result, it’s best to visit your doctor for confirmation.One of the most common causes of chemical pregnancies is from chromosomal abnormalities.The sperm or egg has too many or not enough chromosomes, and the abnormality would cause errors, making it hard for the zygote to develop normally. Rather than implanting on the uterine walls, the fertilized egg will be released from your body in the form of your period. This happens randomly and to anyone. This won't affect successful conceptions in the future.While common, there are risk factors that increase the chances of an early pregnancy loss, such as: • Being older than 35 years old • Any untreated clotting or thyroid disorders • Medical conditions, like uncontrolled diabetesrecovering from a chemical pregnancyWhen we see it medically, chemical pregnancies are more of a cycle than a “true” miscarriage, as the pregnancy never happened. But emotionally, this is a different story, with many feeling upset when they have been trying for a child. This is natural, so it’s okay to grieve if you want to. Chemical Pregnancies can happen to anyone and there is nothing that can be done to prevent/reverse one.Furthermore, an early miscarriage doesn't mean you're at risk for another. You can still continue trying to get pregnant after a chemical pregnancy. While chemical pregnancy doesn't need medical intervention, you can consult your doctor for advice on what to do when trying to conceive.Wrapping It UpI hope that this short guide answered your question, “what is a chemical pregnancy?” If you feel like you experienced one, do check with your doctor for advice on how to conceive successfully. For women who need emotional support, reach out to your loved ones, and get in touch with your doctor or organizations who can help you out. 
3 min read
is dry shampoo safe

Is Dry Shampoo Safe? Potential Damage & Usage Recommendations

Dry shampoo is a product designed to freshen hair between showers or traditional shampooing - but Is dry shampoo safe for regular use? Dry Shampoo is an alcohol- or starch-based substance.For some people, dry shampoo is beneficial during camping trips or traveling where daily showers are not always available. For other it is just a convenience to avoid washing hair quite as often. This is good if you have hair that needs more moisture or after menopause when hair is less oily.  It can give a boost for an extra day or so between washes.Dry shampoo is safe to use on an occasional basis but if overused, it can damage hair and even cause problems with the scalp. That will result in hair breakage, clogged follicles and even hair loss. Physicians recommend that it be used for no more than two days in a row.Proper usage is also important. Holding the canister about 6 inches from the head, spray only the hair, not the scalp. Use it only on oily areas like the temples or crown, where the oil is more noticeable. Using a comb or your fingers make sure any accumulated spray is moved from the roots and distributed evenly over the oily areas.Dry shampoo is not a cleaning agent. It is just designed to absorb extra oil. It has no effect on dirt and really doesn’t even remove all of the oil.Some of these hair care products have alcohols that will dry out hair and when you comb or brush your hair, it will snag on the comb or on each other and then break off. If you leave the dry shampoo on too long, it will build up on the scalp which can cause the follicles to clog or even develop a bacterial or fungal infection.Dry shampoo does not seem to directly cause hair loss, but hair that grows from a follicle damaged by the fungal or bacterial infection is not very well anchored and is more likely to fall out. The scalp is covered with follicles that not only grow hair but produce a natural oil called sebum. Sebum softens the scalp, gives hair texture, and protects the skin.Cancer LinkSome of these dry shampoos are made from or contain talc. In its natural state, talc is composed of asbestos particles. Products produced in the US or imported for use are prohibited from the use of asbestos because of its carcinogenic qualities. You may have read about the possible link between talcum powder (non-asbestos) and ovarian cancer. There is no known link between that condition and the use of dry shampoos but the American Cancer Society recommends avoiding talc-related products pending additional research.AlternativesOf course, the best thing is to keep your hair clean and well conditioned.  There are shampoo and other products that are organically made.  There are also some home made versions that use cornstarch and rice starch.  Add a few drops of essential oils and you are ready.So the take-away is that if you want to use a dry shampoo, do it in moderation and avoid those products made with talc.  
3 min read
What is VBAC

What is VBAC? All About Vaginal Birth After C-Section

Are you considering having a VBAC? While it shows good rates of success, it may not be for everyone and you may have some concerns about it if you will want to go over with your doctor.  To help you decide, read on as we talk more about VBAC, from its pros and cons down to how you can prepare for it.  VBAC stands for Vaginal Birth After Cesarean. If you have delivered a baby via C-section and are pregnant again, you can choose between a repeat C-section or VBAC, if your obstetrician feels it is safe for you.  Many women have tried labor and a vaginal delivery after cesarean, which is possible and with a success rate of around 70%, in some studies. Many women choose a trial of labor after cesarean (TOLAC), because:             •           It can help prevent risks from multiple cesarean deliveries, like placenta accreta or placenta previa. This is beneficial for women who plan to have more children in the future            •           There are fewer and lower risks of any surgical complications that come with C-section delivery. Successful VBAC procedures are associated with lower rates of infection, blood clotting, and excessive bleeding. It may also decrease risks of requiring a hysterectomy and injury to one’s abdominal organs, like the bowel or bladder            •           There is a shorter recovery time when undergoing a VBAC versus a C-section, meaning a shorter hospital stay and shorter wait time before you can go back to your normal activities            •           It gives you the chance to experience a vaginal delivery  Those who are the best candidates for VBAC are the following:             •           Those pregnant with one baby and has had a history of 1-2 low transverse C-sections without problems that prevent VBAC            •           Those pregnant with one baby and have had a history of one C-section that underwent an unknown uterine incision type without problems that prevent VBAC. *This is unless your doctor suspects you have had a high vertical, or classical, uterine incision            •           Those pregnant with twins and have a history of one low transverse C-section and are a good candidate for twin vaginal delivery Prior vaginal delivery is also a great predictor of a successful VBAC procedure.  However, there are also those who are not candidates for VBAC, such as women having risk factors that decrease the chance of a successful VBAC. It’s best to check with your healthcare provider to see if you are an eligible candidate.  While there are numerous benefits from having a VBAC, there are also risk to consider.  If you experience a failed TOLAC, there may be more complications, such as uterine rupture. Though not to worry, as this is very rare and only happens to less than 1% of those who attempt a TOLAC. A uterine rupture occurs when the cesarean scar on your uterus opens. This risk is life-threatening for both you and the baby, and an emergency C-section is required to prevent any life-threatening complications if this happens. Your doctor may need to remove your uterus and perform a hysterectomy if this occurs. This is another reason why it’s important to weigh the pros and cons, as well as discuss the risks and success rates with your doctor, before choosing to do a VBAC. If you do choose to undergo a VBAC, you can prepare by talking about it with your healthcare provider. Discuss all your concerns and know what you can expect during VBAC. Submit your complete medical history, especially those that include records from your previous C-sections and other uterine procedures that may have been done. The healthcare provider will use your medical history to calculate the success rate of your expected VBAC. As long as you provide complete information and follow your doctors' advice, you can have a successful VBAC with no complications. Good luck!
4 min read

What causes breast pain?

The real answer is . . . We don’t know. But we do know there’s a 99% chance it’s NOT cancer (Kushwaha et al.). Breast pain is extremely common and as many as 70% of women will experience it at some point in their lifetime (Kataria et al.). Sometimes it is a dull ache, like increased heaviness and sensitivity that corresponds with the menstrual cycle. Sometimes it’s in both breasts, sometimes only one. Pain which fluctuates with the cycle is called “cyclical pain”. What scares women is when it’s a sudden, sharp pain in one area in one breast. That is referred to as “focal pain”. Focal pain is more likely than cyclical pain in women in their 40s and 50s. In multiple studies conducted among women with focal breast pain and no other symptoms, 1% were found to have breast cancer. Breast cancer is far more likely to present with an abnormal finding on a mammogram or a lump in the breast, Regardless, we ALWAYS double check with imaging tests. The best test is an ultrasound to check the area(s) of pain and sometimes a mammogram as well. Occasionally the ultrasound will show a cyst in the area which is causing the pain, but most of the time, there’s nothing there.most commonly what’s seen is normal, healthy breast tissue and nothing which looks abnormal on the imaging tests. “So what’s causing my pain then, Doc? Can you fix it??” is the conversation which starts as soon as I tell someone we didn’t find any cause for the pain. The truth is hormonal changes in the breast are complicated and we don’t know the exact cause or the best treatment for breast pain. There are ongoing studies and theories, but we are still working on understanding the interactions between breast tissue and the rest of the body. Additionally there are other disorders which can cause referred breast pain, such as inflammation of the cartilage of the ribs. Even if the cause or an easy fix for breast pain has not been identified, there are treatment options available. Studies have shown that over 70% of women wear improperly fitting bras and switching to a more supportive bra or a sports bra will help. Non steroidal anti-inflammatories like Ibuprofen have also been shown to be effective in 80% of women (Kataria et al). For focal pain, there is a topical version of Ibuprofen which works better than other treatments. Relaxation techniques such as meditation and acupuncture which work for other forms of pain may also help. But as you probably noticed, none of these are treatments designed to treat only breast pain specifically. Studies on breast specific pills such as evening primrose oil and danazol have not had convincing enough results to recommend them for everyone. Additionally, they can have serious side effects such as diarrhea or facial hair growth. Most of the time breast pain goes away on its own, especially as we get older and our breast tissue becomes less active. Studies have shown that non cyclical breast pain may resolve on its own in up to 50% of patients (Kataria et al.). If not, changing bras and/or taking Ibuprofen may help. If none of the above works, there are other medications which are worth trying. Before taking anything, please discuss the risks and benefits with your doctor and decide on a plan that works for you. After reading this if you develop breast pain, what should you do? If it’s new and doesn’t go away in a day or two, see your primary care doctor or Ob Gyn. Make sure your care plan includes an ultrasound and/or mammogram and not just a physical exam. If your doctor doesn’t order an imaging test - don’t be afraid to ask about it. Your care plan is always something you should fully understand. If you’re worried about insurance coverage, new breast pain is a clear indication for an imaging test, even if you’ve had a normal mammogram recently. You should not have to pay out of pocket, provided your insurance covers imaging studies at baseline. Once you get the ultrasound +/- mammogram, be prepared for the results. Most of the time there won’t be a cause for your pain and sometimes that’s hard to hear. The most important thing is that cancer has been ruled out.Even if we don’t know the cause we do have treatment options. You will expand on your care plan with your doctor - you do not have to keep living with breast pain! In most situations, one of the above mentioned treatments works well, or in some women, the pain gets better on its own. It may take some trial and error to figure out the best combination of therapies for your pain. Rest assured, you will not need another doctor’s visit or repeat imaging.However, if the pain is persistent despite treatment or you develop new breast pain, have it checked out. Don’t assume it’s nothing because you’ve had negative imaging tests recently. You should feel empowered to consult your physician with ANY new breast symptoms, not just breast pain. And of course, if you’re over 40 or have a strong family history, make sure you get yearly mammograms and take control of your breast health!Dr. Amani Jambhekar MDBoard Certified in General SurgeryFellowship Trained in Breast Surgical OncologyKataria, et al. “A Systematic Review of Current Understanding and Management of Mastalgia.” Indian J Surg. 2014 Jun; 76(3): 217–222.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141056/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4960349/https://www.ajronline.org/doi/full/10.2214/AJR.17.18879
5 min read

How to know if you have PCOS or Polycystic Ovarian Syndrome?

PCOS is also known as Polycystic Ovarian Syndrome. It is a hormonal imbalance that occurs in some women and adolescent girls. The condition is so common, up to 10% of all women may have PCOS. (Dumesic, Daniel A et al. )That means that one in every 10 girls or women have PCOS. So for example, if there is a room of 100 girls, 10 of them will have PCOS. Girls with PCOS have problems with their period. Some girls have no periods, whereas others can have very frequent periods. If your period happens more often than every 21 days or less often than every 45 days you should see your doctor as this can be a sign of PCOS. Some girls can go a year or more with no periods. It is important to understand, however, that menstrual periods can be irregular for up to two to three years after a girl starts having her period. Most physicians will wait to diagnose PCOS until a girl hs had her period for at least 2 years before saying it is irregular. (Legro, Richard S et al. Girls with PCOS can also have increased hair on their bodies in places that girls and women do not like to have hair such as their face, stomach, chest and lower back. Some girls with PCOS can also have severe acne. Girls with PCOS can also have a harder time losing weight or can gain weight more easily. Girls and women with PCOS also can have a higher risk of developing high blood sugars or a condition like Type 2 diabetes. Some girls with PCOS can also have feelings of sadness, anxiety or depression. If you are diagnosed with PCOS, this does not mean that you have “cysts” on your ovaries. Girls with PCOS usually have normal looking ovaries but they may look slightly bigger than normal. The enlarged ovaries usually do not cause any pain.Doctors don’t know the exact cause of PCOS but it is thought to be genetic, meaning that someone in the girl’s family most likely has PCOS as well but this is not always the case. In PCOS, there are specific hormones called androgen hormones that are higher than normal. One of these androgens is called testosterone and it is higher than normal. This imbalance in androgen hormones can cause the periods to be irregular because these hormones can prevent an egg from being released from the ovary every month. The higher testosterone level can also cause girls to have an increase in facial and body hair and can cause acne.
Usually your doctor will talk to you first about your symptoms and family history. Then they will want to do a physical exam. They will usually want to order some blood tests to help figure out if you have PCOS. Sometimes, an ultrasound of the ovaries is done to help understand if you truly have PCOS.The treatment of PCOS is geared towards what specific symptoms you have and what is bothering you the most. If you have irregular periods, usually the first line treatment is birth control pills. Many of the symptoms of PCOS like irregular periods, acne and frequency of growth of hair on the face and body can be controlled with birth control pills. You may also need to be treated by a dermatologist or laser specialist for acne and hair growth.For girls that are overweight, doctors will recommend weight loss with diet changes and exercise to prevent further weight gain or to start a weight loss program.Exercise and weight loss sometimes can help periods become more regular and they can help prevent diabetes. Exercise is also help with mood symptoms including anxiety and depression. Another commonly prescribed medication is metformin which is a medicine used to treat diabetes. Sometimes at higher doses of this medication, menstrual periods can return to normal.( Legro, Richard S, et al).Once girls are treated for PCOS, they generally are very well controlled. Girls and women with PCOS may be an increased risk of developing type 2 diabetes in the future. They may have a hard time getting pregnant in the future but this is not always the case. Girls and women should still use birth control pills to help prevent unwanted pregnancies if they are sexually active.Your doctor is always a good resource if you have other questions.Dumesic, Daniel A et al. “Scientific Statement on the Diagnostic Criteria, Epidemiology, Pathophysiology, and Molecular Genetics of Polycystic Ovary Syndrome.” Endocrine reviews vol. 36,5 (2015): 487-525. doi:10.1210/er.2015-1018Legro, Richard S et al. “Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline.” The Journal of clinical endocrinology and metabolism vol. 98,12 (2013): 4565-92. doi:10.1210/jc.2013-2350Witchel SF, Oberfield SE, Peña AS. “Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls. J Endocr Soc. 2019 Aug 1;3(8):1545-1573. doi: 10.1210/js.2019-00078. eCollection 2019 Aug 1. Review. PubMed PMID: 31384717; PubMed Central PMCID: PMC6676075.Carmina E, Oberfield SE, Lobo RA. The diagnosis of polycystic ovary syndrome in adolescents. Am J Obstet Gynecol. 2010 Sep;203(3):201.e1-5. doi: 10.1016/j.ajog.2010.03.008. Epub 2010 May 1. Review. PubMed PMID: 20435290.
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