FemHealth
For you, from doctors

What Is The Age For Perimenopause?

Perimenopause is the time when your body begins to make the transition from regular menstruation (having a monthly period) to permanent menopause (no longer having a monthly period). It is a time of hormonal changes, which can lead to some pretty dramatic symptoms—including hot flashes, mood swings, weight gain, sleep problems, and more.Menopause is defined as a woman’s final menstrual period and is diagnosed when she has not had a period for 12 consecutive months. Menopause occurs between ages 40 and 58: The average age of menopause (the final period) is 51.But, women don’t just suddenly stop having periods: They experience physical and hormonal changes years before their final period. This transitional time period is called perimenopause, and it is unique to every woman. Perimenopause usually starts between age 40 and 45 and lasts for about 4-10 years. On average perimenopause lasts from 4 to 8 years, with the majority of the years being before the actual occurrence of menopause. Perimenopause ends 1 year after menopause (the final menstrual period).Women whose transition into perimenopause occurs at a younger age usually will have a longer menopause transition overall. On the other hand, women who have a later onset of perimenopause tend to have a shorter time overall of transition. In addition, a large study that observed menopause symptoms and duration among women of a variety of ethnic backgrounds found that the transition time to menopause can be impacted by certain demographic factors. For example, African American women had on average a longer duration overall than white women. And greater body mass index (BMI) was associated with later onset menopausal transition. Menopause transition that occurs before age 40, whether naturally occurring or induced, is called premature menopause. This occurs in about 1% of women in the US. Induced menopause refers to amenorrhea (lack of menstrual cycle) due to surgical removal or other medical treatment of the ovaries or to chemotherapy or radiation therapy. Women who have induced menopause experience the common symptoms (such as hot flashes, vaginal dryness, and disturbed sleep) but without the gradual transition period. Women who experience premature menopause due to natural causes (not medical intervention) do experience the graduate transition. If you are experiencing premature menopause, whether it is induced or naturally occurring, speak to your ob-gyn. Your doctor can help you to understand what your options are and what the best practices in this area. Perimenopause is the time before and after menopause. The transition from a woman having reproductive fertility to then no longer having a period, and losing the ability to conceive children naturally, is a different experience for every person. The age ranges for onset and duration of perimenopause vary across demographic populations and also vary for other genetic or medical reasons. Each person's experience is unique, and the entire process, though challenging, is normal and natural. Ask your ob-gyn about any symptoms you may be experiencing or about any questions you have about this natural shift in a woman’s life.Sourceshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082400/ http://www.menopause.org/for-women/menopause-faqs-premature-early-and-induced-menopause https://www.acog.org/womens-health/faqs/the-menopause-years
3 min read

Thyroid Symptoms In Female - Underactive Vs Overactive

The thyroid gland is located in your lower neck region, and it is a gland that secretes hormones that help your body with several processes including development throughout childhood and even metabolism in adulthood.Typically, when your thyroid gland is functioning properly, you will not have any symptoms caused by your thyroid and will have normal thyroid hormone levels in your body (this is called “euthyroid”). However, when your thyroid gland is not working correctly, you usually will have some or even a combination of several symptoms which will be broken down in more detail below. Keep in mind that not everyone with thyroid gland problems will have symptoms, and sometimes doctors will find the problem only after doing bloodwork to test the function of the gland. This means it is very important to have regular check-ups with your doctor and ask them if you have any questions or concerns about your thyroid. Again, remember that not everyone has symptoms if there thyroid gland is not functioning correctly, but here are some of the most common symptoms associated with thyroid disorder:When your thyroid hormones are lower than a typical range, this is classically called “hypothyroidism.” A very common symptom is fatigue because your overall metabolic process can be slowed. Because of this slowed metabolic rate, you may also notice weight gain or even feel colder than you were previously used to feeling. Skin can also feel cold or even appear pale because blood flow can decrease when you have hypothyroidism. You also may notice your hair feels more coarse than it did before, or you may even have hair loss (this can be seen in multiple areas of your body, not just your scalp, and even can cause the lateral parts of your eyebrows to thin/lose a lot of hair) or brittle nails [1,14,15]. Not only can slowed metabolism lead to fatigue, but about 10% of patients with hypothyroidism will also have anemia (this can be due to autoimmune problems associated wi the thyroid, which causes anemia to happen). Anemia, or low hemoglobin/red blood cells in your body, can also cause you to feel tired [2,13].Another result of slowed metabolism from low thyroid is decreased heart rate and decreased heart contractions, which can cause less blood and oxygen to flow through your body. This can lead to shortness of breath or even not being able to have the stamina to exercise as you did previously [3]. One of the most common symptoms of hypothyroidism is constipation, and it can be mild or become severe enough to even cause a bowel obstruction. This is because the intestines naturally squeeze/move to pass matter through them, and this movement (or motility) is often slowed in hypothyroidism [4,15].Other common symptoms can affect your muscles and bones, such as weakness, cramping, painful and achy joints, and even feelings of being stiff.Women often will notice changes in their periods if they have hypothyroidism. It can be frustrating because menstrual changes can vary significantly from patient to patient where not all patients will have the same bodily changes noticed. A low thyroid level can cause periods to be absent or very light, but it can conversely cause some women to have very heavy periods. One study of women who were affected by hypothyroidism found just over 15% of women to have absent or light periods and 7% of women to have heavy periods. These changes in menstrual cycles can also cause decreased fertility rates, and hypothyroidism even has been linked to an increased chance of early trimester miscarriage. Decreased libido is another symptom that can be seen in patients who have hypothyroidism [5,10,11,13].When your thyroid hormones are too high in your body, this is called “hypothyroidism.” This can be caused by many different things, such as Grave’s Disease, thyroid gland inflammation and even certain tumors. Most people with hyperthyroidism (unless very mild) will have symptoms. A very common symptom is swelling of the thyroid gland causing a bulge in the neck, which is also known as a goiter.Unlike low thyroid, hyperthyroidism can cause increased flow of blood through your body and lead to skin feeling warm. As metabolic processes increase, you may also notice increased sweating, feeling excessively hot/intolerant to heat, or even experience skin darkening (hormones such as cortisol and ACTH ultimately cause this due to faster metabolism). Conversely, some people will have loss of skin pigmentation (vitiligo) as an immune response [6,13].High thyroid levels can affect your respiratory system, such as causing you to have a hard time breathing, and can even make people with asthma have flares or worsening of their asthma. Your diaphragm (the muscle that helps with breathing) can have weakness, which can cause breathing symptoms, or a goiter can cause pressure on your trachea (windpipe) and make it difficult to breathe [7].Just like hypothyroidism, hyperthyroidism can also cause anemia (low red blood cells). However, high thyroid hormone can also cause decreases in the number of other cells such as platelets (which can cause bleeding problems) and neutrophils (cells that help fight bacterial infections). Therefore, patients with hyperthyroidism may experience fatigue or shortness of breath if they have anemia, bleeding problems if they have low platelets, or potential infection complications if they have low neutrophils [8].As opposed to low thyroid, hyperthyroidism can cause increased heart rate/feeling of fast heartbeat, or even palpitations or a feeling that your heart beat is irregular. This is medically called “atrial fibrillation” and can happen in as much as 10 to 20% of people with hyperthyroidism. It can also cause increased blood pressure (usually patients do not have symptoms if blood pressure is slightly elevated, but they may experience headache, especially if their blood pressure is significantly high) [9,16].Since metabolic rate can increase, having high thyroid hormone levels can cause weight loss, diarrhea, or even vomiting. Additionally, a goiter can put pressure on the esophagus and make it difficult to swallow [14].With hyperthyroidism, many people will experience increased frequency of urinating, or even an increase in overnight waking due to needing to urinate. Women with hyperthyroidism may have increased sex-hormone binding globulin (this means that hormones such as estrogen are affected and can change the normal secretion of hormones that affect ovulation). As a result, women may not ovulate, may have irregular periods, or may experience difficulty with fertility [10,13].Less commonly, patients with hyperthyroidism may have anxious or depressed mood, irritability, poor concentration or even trouble sleeping. These are usually seen in more severe cases of high thyroid levels, such as a condition called thyrotoxicosis. Another symptom not common in all hyperthyroid patients but that is often seen in patients with Graves’ Disease (a type of thyroid disorder) is a bulging appearance of the eyes, which is called “exophthalmos” [12,16].What is important to remember is that thyroid disorders can vary widely, with some patients experiencing no symptoms and others having severe health conditions and problematic symptoms. It is always advised to seek guidance from your personal physician with any concerns or questions you may have regarding your thyroid health.Resources:
8 min read
Crying After Sex

Crying After Sex

Do you feel like crying after sex? While many people feel euphoric after sex, feeling sad may not be as uncommon as you think. There is even a scientific name for feeling tearful after sex. It is called Post Coital Dysphoria (PCD), also sometimes called postcoital tristesse. Tristesse is a French word for sadness. Both men and women can experience Post Coital Dysphoria. In fact, one study showed that 40% of men have experienced it once in their life, and almost half of female university students also had experienced PCD at least once in their life.The exact science behind crying after sex is unclear. It is likely due to multiple factors in a person's life combined with the intense hormonal changes that are happening in your body before, during, and after sexual intercourse. Interestingly, a study showed that crying after sex was not related to the level of intimacy a couple had in a relationship. Even people in very long-term relationships can feel like crying after sex. Post Coital Dysphoria does not specifically refer to crying after sex. It can also mean that someone feels sad, irritated, or anxious after sex, even if it is with a long-term partner that they love and have an intimate relationship with.The intense roller coaster of emotions can cause a different reactions in different people. Let's take a look at human sex psychology and what happens in our brain during sex.Leading up to sex the limbic system which is the emotional center of the brain, shows an increased sign of activity. The limbic system in the brain is made up of two main parts, and these are the hippocampus and the amygdala. In general, the limbic system functions to guide our behavioral and emotional responses in life. More specifically, the limbic system function is related to hunger, motivation, sex drive/libido, mood, pain, pleasure, appetite, and memory. Given these specifics, it's not surprising that limbic system activation could lead to crying after sex. The specific hormonal and neurotransmitter changes behind feeling sad after sex are not well understood. There is some research to support that people who are generally more emotional are more likely to experience it. Also, a person's style of how they attach to people can play a role. Additionally, a person's personal history also matters. If someone has a history of childhood sexual abuse or sexual trauma, they may be more likely to experience PCD and crying after sex. In general, however, the exact science and causal factors leading one person to experience PCD and one person to not experience it are not truly known. In addition to the limbic system, dopamine is released in large amounts during sex and especially during orgasm. After sex, there is a drop in dopamine and a rise in prolactin levels. For many people, this rise in prolactin levels should allow the feelings of pleasure and satisfaction from the orgasm to continue as dopamine drops. Because dopamine levels drop below their normal baseline for a period of time, it is possible that some people may be more sensitive to this. In these individuals, the rise in prolactin may not be able to compensate for this drop in dopamine. This may contribute also to feelings of sadness after sex. More research and studies in this area need to be done in order to find the exact science behind why some people experience Post Coital Dysphoria and others do not.Sources:https://qbi.uq.edu.au/brain/brain-anatomy/limbic-system#:~:text=The%20limbic%20system%20is%20the,and%20fight%20or%20flight%20responses.Anand KS, Dhikav V. Hippocampus in health and disease: An overview. Ann Indian Acad Neurol. 2012 Oct;15(4):239-46. doi: 10.4103/0972-2327.104323. PMID: 23349586; PMCID: PMC3548359.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3548359/https://en.wikipedia.org/wiki/Post-coital_tristesseBurri A, Hilpert P. Postcoital Symptoms in a Convenience Sample of Men and Women. J Sex Med. 2020 Mar;17(3):556-559. doi: 10.1016/j.jsxm.2019.12.009. Epub 2020 Jan 11. PMID: 31937518.https://pubmed.ncbi.nlm.nih.gov/31937518/Schweitzer RD, O'Brien J, Burri A. Postcoital Dysphoria: Prevalence and Psychological Correlates. Sex Med. 2015 Oct 5;3(4):235-43. doi: 10.1002/sm2.74. PMID: 26797056; PMCID: PMC4721025.https://pubmed.ncbi.nlm.nih.gov/26797056/https://www.psychologytoday.com/us/blog/myths-desire/201809/post-sex-blues-both-men-and-women-say-they-have-itMallick, H. N., Tandon, S., Jagannathan, N. R., Gulia, K. K., & Kumar, V. M. (2007). Brain areas activated after ejaculation in healthy young human subjects.Indian journal of physiology and pharmacology,51(1), 81.https://pubmed.ncbi.nlm.nih.gov/17877297/Dailly E, Chenu F, Renard CE, Bourin M. Dopamine, depression and antidepressants. Fundam Clin Pharmacol. 2004 Dec;18(6):601-7. doi: 10.1111/j.1472-8206.2004.00287.x. PMID: 15548230.https://pubmed.ncbi.nlm.nih.gov/15548230/
4 min read
What Is In Botox

What Is In BOTOX ®? Is it safe?

Are you wondering what is in BOTOX®? BOTOX® is the brand name for onabotulinumtoxinA. What many people don't know is that it is used not just for cosmetic purposes, but also for the treatment of many different diseases.BOTOX® has botulinum toxin in it. Specifically, it has onabotulinumtoxinA, which is a form of botulinum toxin. Botulinum toxin is actually made by a specific type of bacteria. The scientific name for this bacteria is Clostridium botulinum. There are other brands of botulinum toxin such as Dysport®. In high doses, botulinum toxin can be dangerous. When it is used for medical and cosmetic purposes, a very small amount of botulinum toxin is used. Botulinum toxin can be very dangerous for infants under 12 months old. Because honey can have the bacteria that causes infant botulism, it is not recommended to feed honey to children who are under 12 months of age. BOTOX® is a neuro-muscular blocker. This means it blocks specific chemical signals from nerves. These nerves are the ones that make muscles contract. It is commonly used to prevent wrinkles in the face because after being injected with onabotulinumtoxinA, the muscle is less likely to contract. If the muscle does not contract, then it won't cause repeated lines to form in the face. Repetitive muscle contraction and line formation in the skin over time can lead to wrinkles. After injecting botulinum toxin, people can see a reduction in muscle contraction for a period of 3 to 6 months on average.BOTOX® and BOTOX® Cosmetic have the same active ingredient, but they have different labeled indications. Because they have the same ingredient, the side effects and adverse events seen with BOTOX® can also be seen with BOTOX® Cosmetic. The side effects and adverse reactions of this drug depend on the location of where it is injected. For example, when it is in injected into the forehead for the prevention of forehead lines, about 9% of patients will get a headache and 2% of patients will have brow ptosis (a droopy brow). It is unlikely that the drug will make its way into breast milk but given the risk to infants of infant botulinum, it is not advised for pregnant or breastfeeding moms to have botulinum toxin. While most people tolerate botulinum toxin without any problems, remember that this is a serious drug and should be only administered by an expert who knows what they are doing. There have been reports of serious adverse events related to BOTOX administration especially in people who have pre-existing cardiac conditions. A Board Certified Dermatologist or Board Certified Plastic Surgeon is a great resource to ask more questions to if you are interested in getting BOTOX®. You can see more complete drug information and information on side effects of BOTOX® at https://www.botox.com/BOTOX® has botulinum toxin in it. Specifically, it has onabotulinumtoxinA, which is made by the bacteria is Clostridium botulinum. While it is usually well tolerated in small amounts, larger amounts can be dangerous. Also, there are certain patients who may be more at risk for side effects or adverse reactions from BOTOX®. It is important to engage a Board Certified Physician when considering having this drug injected for medical or cosmetic purposes. Sources:Dressler D. Botulinum toxin drugs: brief history and outlook. J Neural Transm (Vienna). 2016 Mar;123(3):277-9. doi: 10.1007/s00702-015-1478-1. Epub 2015 Nov 11. PMID: 26559824.https://pubmed.ncbi.nlm.nih.gov/26559824/Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006–. OnabotulinumtoxinA. 2020 Sep 21. PMID: 33017114.https://pubmed.ncbi.nlm.nih.gov/33017114/https://www.aao.org/eye-health/treatments/how-does-botulinum-toxin-botox-workhttps://www.cdc.gov/botulism/prevention.htmlhttps://www.botox.com/
4 min read
Nutrition In Green Beans

Nutrition In Green Beans

The serving size of green beans is about 1 cup. 1 cup of green beans has anywhere from 30 to 44 calories. Green beans are a great source of fiber and Vitamin C, Vitamin A, and Vitamin K.There is only 0.1 grams of fat in a serving of green beans and there is no saturated fat. Though they are pretty much a fat free food, be careful with how you cook green beans. Many people like to cook them in olive oil or butter which, of course, will add to the fat content of the meal. Here is the nutrition in green beans broken down:Calories: between 30 -44Fiber: 2.6gSodium: 6mgCarbohydrates: 7gSugars: 3.3gProtein: 1.8gVitamin C: 16.3mgVitamin A: 35mcgVitamin K: 43mcgThe nutrition in green beans can help to boost your immunity. One serving of green beans has almost 20% of the daily value for vitamin A. Vitamin A is important for immunity and good vision. Vitamin A deficiency is uncommon in developed countries because have many adequate food sources of Vitamin A. Certain disease can make you more likely to have Vitamin A deficiency and these include cystic fibrosis, Crohn’s disease, ulcerative colitis, and celiac disease. One sign of vitamin A deficiency is an eye condition called xerophthalmia, in which patients have difficulty seeing in dim light. Again, this is unlikely to happen if you are getting enough Vitamin A in your diet or through vitamin supplementation. Green beans also are a good source of Vitamin K. Vitamin K is a fat-soluble vitamin that is found in green beans and also in leafy green vegetables like spinach. Vitamin K plays an important role in blood clotting. If you are on any blood thinning medications, you should closely monitor your intake of foods that are rich in Vitamin K. Vitamin K helps to make four of the 13 proteins needed for blood clotting. The ability for your blood to clot is important because it stops bleeding. If you are a patient on a blood thinner for a medical reason, remember that Vitamin K consumption can interfere or counteract your blood thinning medication. Vitamin C is also found in green beans. Vitamin C plays a role in boosting immunity and can help wounds to heal faster. Vitamin C can also help you look younger by boosting collagen production. This is why there are so many facial products with Vitamin C in them. Vitamin C is also an antioxidant that helps to neutralize free radicals. Free radicals cause damage to the body's cells over time. Green beans also have folate which is essential for every pregnant person to have during their pregnancy. Eating green beans during pregnancy can help you get the folate that you need for your baby alongside a pre natal vitamin. Finally, green beans are a good source of fiber. Fiber is an important part of every person's diet. It helps to regulate your gut and also helps you to feel full so that you do not overeat.The nutrition in green beans make them a great choice to add to any meal as a side dish. Be careful about how you cook green beans so that you maintain the health benefits of them.
3 min read
Tampon Toxic Shock Syndrome

Tampon Toxic Shock Syndrome

In the debate of pads vs tampons, many people choose pads because they are worried about toxic shock syndrome. Toxic shock syndrome, sometimes abbreviated as TSS, can happen with tampon use. However, in order to avoid being at risk for TSS, it is important to know how often to change a tampon. A tampon should be changed every 4 to 8 hours or sooner than this if it is becoming soaked with blood. If you plan to sleep with tampons in, then you should not go longer than 4 to 8 hours without changing your tampon. Additionally, using super-absorbent tampons is more associated with TSS, so choose tampons that have regular absorbency. Toxic Shock Syndrome is caused by bacteria. It was more common in the 1980s when people used super-absorbent tampons. The incidence of TSS has declined over the last 30 years as there is more awareness about it. While Toxic Shock Syndrome has been associated with tampon usage, it can happen to other people. The name Toxic Shock refers to bacteria circulating in the body producing toxins. The bacteria needs a point of entry to your body and with tampons, it is from the tampon and in other people it could be from an open wound. While TSS is rare, it can be life-threatening. The bacteria most associated with Toxic Shock Syndrome are Staphylococcus aureus and Streptococcus pyogenes.It is important to know the signs of TSS or Toxic Shock Syndrome. Signs of TSS include symptoms of fever, headache, fatigue, exhaustion, body aches, sore throat cough, diarrhea, dizziness, fainting, difficulty breathing, and even confusion. In addition to some of the flu like symptoms described, some patients can also get a rash on their body that looks like a sunburn. The white part of your eyes can turn red as well. If you think you are experiencing any of these symptoms, seek medical care immediately.If you have a history of Toxic Shock Syndrome, then you should avoid using tampons in the future. This is because reinfection can occur. If you have not had TSS in the past, then remember correct tampon usage. This means keeping your tampons in a clean dry place before use, and changing them regularly even if they are not fully soaked. If your tampon is painful, take it out. Tampons should not be painful to use. Many people use a mix of both pads and tampons. This can help optimize for comfort and safety. Consider using pads overnight and tampons during the day. TSS from tampons is not as common as it use to be in the 1980s. This is because there is more awareness about correct tampon usage, and the use of super absorbent tampons has gone over time. If you think you are experiencing signs of TSS, you should seek emergent medical care. If you have a history of Toxic Shock Syndrome, there is a risk of reinfection and so in this situation, you may consider using pads over tampons. If you have not ever had TSS, then remember to use tampons correctly. Do not leave them in for extended periods of time. Sources:Hansen NS, Leth S, Nielsen LT. [Toxic shock syndrome]. Ugeskr Laeger. 2020 May 11;182(20):V11190673. Danish. PMID: 32400378.https://pubmed.ncbi.nlm.nih.gov/32400378/Smith RJ, Schlievert PM, Himelright IM, Baddour LM. Dual infections with Staphylococcus aureus and Streptococcus pyogenes causing toxic shock syndrome. Possible synergistic effects of toxic shock syndrome toxin 1 and streptococcal pyrogenic exotoxin C. Diagn Microbiol Infect Dis. 1994 Aug;19(4):245-7. doi: 10.1016/0732-8893(94)90038-8. PMID: 7851088.https://pubmed.ncbi.nlm.nih.gov/7851088/https://www.femhealthproject.com/article/pads-vs-tamponhttps://www.acog.org/womens-health/faqs/your-first-period
4 min read
Pads Vs Tampon

Pads Vs Tampon: Is One Better?

In the debate of pads vs tampons, which is a better choice? The answer to this question in most cases is whichever works better for you! There are some situations where a pad is better and these are discussed below. Most people will use a mix of pads and tampons throughout their life to manage their menstrual period. There is a learning curve with tampon usage. In the beginning, pads may be easier to use because there is no learning curve. Just peel the sticker off the back of the pad and stick it to your underwear. Depending on how heavy your period is, you may have to use a thicker pad. Some women may find this uncomfortable so they prefer tampons. The first few times you try to put in a tampon it may be challenging. You may end up wasting a few tampons just figuring out how to get the tampon (which is the cotton part) out of the applicator (which is the plastic part). You may even experience some mild discomfort putting a tampon in. But, once the tampon is in, there should not be any pain. Tampons have the advantage of not being bulky and many find them more comfortable to use. Especially if you are wearing tight-fitting clothing, you may not want to have a pad on. If you prefer to wear thongs then tampons are also a better option, as you won't be able to wear a pad with this type of underwear.If you have had any procedure inside your uterus or vagina, the doctor will advise you not to use a tampon for a certain period of time. If you have recently given birth vaginally or by c-section, you should not put a tampon in for at least 6 months. The bleeding that happens naturally after birth should be controlled using a pad. If you. have a urinary tract infection, you should consider using a pad over a tampon in this situation as putting a tampon in may be more uncomfortable during a UTI. Finally, if you have ever had TSS or Toxic Shock Syndrome, then there is a chance of reinfection with tampon usage. So, persons with a history of TSS should use pads over tampons.For someone who has a very heavy period, you can use a tampon and a pad together. This can help prevent any leaks and help to keep your underwear dry. Another option is to use a tampon with period underwear that can help to absorb any leakage. If you have having very heavy flow, it is a good idea to change your tampon regularly and also be evaluated by a doctor to make sure that everything is okay. For some women a heavy flow period is normal, but there are some cases in which it could mean you have a medical issue. For example, fibroids in the uterus can cause a heavy period. Check with your doctor if you are having extremely heavy periods. Pads and tampons are both great ways to manage your menstrual period. There is a learning curve with tampon usage but many women find them more comfortable. They are also smaller than pads and easy to carry around in your purse, handbag or backpack. In addition to pads and tampons, you can also use a menstrual cup or period underwear. If you are someone who is already taking birth control, you may be able to skip your period entirely. This is done by skipping the placebo week of the pill and moving on to the next month of birth control pills. Ask your doctor if this is a good option for you.Sources:https://www.femhealthproject.com/article/How-To-Insert-A-Tampon-In-Your-Body
4 min read
Formula Shortages

Formula Shortages: Where To Buy

Formula shortages are causing undue stress on parents who are already stretched thin with caring for their baby. Here are some places you can turn to for buying formula. These brands have traditionally been available on Amazon. Given the formula shortages, as long as your baby does not require any special type of formula, and your baby does not have any allergies, it is usually okay to switch between brands of formula as well as the different types of formula. This means if you were previously using powder, but can only find ready to feed, it is okay to switch between the two. Remember that you should always follow the instructions on the package, because diluting formula with water or changing the proportions of it can be very dangerous and even lethal for your baby. Remember to always check with your doctor or baby's pediatrician for personalized medical advice for your child.1. Similac Infant Care 3602. Similac Alimentum with 2'-FL HMO Hypoallergenic Infant Formula 3. Similac 360 Total Care Sensitive Infant Formula 4. Enfamil Neuro Pro for Premature Baby5. Enfamil Neuro Pro 2 oz Ready To Feed - Great for middle of the night feeds Formula companies often drop off samples to both ob gyn offices and pediatrician offices. It is possible they may have samples for you to use. Many stores, such as Target, will list their local store inventory. You can buy this ahead of time online, and then head to the store to pick it up. This may save you the hassle of going store to store in search of what you are looking for. In Canada, parents generally start cow's milk on their children around 9 to 12 months. This is not a great option for children under 9 months because their gut is not mature enough to handle this. If they are over 9 months, discuss this option with your pediatrician. If you are giving your baby cow's milk, there is an increased concern for iron deficiency anemia, so be sure that your baby has enough iron in their diet. Femhealth's pediatricians have created an educational guide to help parents navigate the formula shortages. You can download it for free here.Sources:https://learn.femhealthproject.com/formulashortage
3 min read
How Often Newborn Bath Should Be Done

How Often Newborn Bath Should Be Done

The early days of being a parent are very overwhelming. One of the questions many parents have is, "How often should I bathe my newborn baby?". In the early days of a baby's life, parents do not need to bathe their child very often - just a few times a week. In the beginning, you give them a sponge bath. You can sponge bathe your newborn 2 to 3 times a week. When the umbilical cord falls off, the newborn can have a bath in a baby tub. The umbilical cord typically falls off around the first 1 to 3 weeks of the baby's life. Check out one of our favorite newborn tubs here. We love it because it can go from the early newborn stage to many months later. Newborn tubs with grates must be used in the shower, so it's not a great option if you plan to bathe your baby on the countertop next to the sink. The first newborn bath for your baby is usually done in the hospital. Typically, it is not done until the baby is 1 or 2 days old. If you are having difficulty establishing breastfeeding, you may want to delay the newborn bath so that you do not have too much time away from your baby. Or, be sure to make a request to the nurse taking the baby for the bath that you would like the baby to come back for their feed. If you have a home birth, you can do the first sponge bath on day 2 or 3 of your baby's life.Until the baby's umbilical cord has fallen off, you should keep the area dry and clean. This means that your newborn will not be able to go into a baby tub for the first few weeks of life. The umbilical cord falls off around 1 to 3 weeks of life. In the beginning you will give your baby a sponge bath. Mix clean warm water in a bowl with a lather of baby soap. Then, use a clean soft towel to pat the baby's skin. Do not scrape against the newborn's skin with the towel. After you have cleaned the baby with the warm soapy water, use a damp cloth without soap to pat the skin again. Finally, gently pat a dry towel over your baby's skin to dry them off. Remember to apply baby lotion right away to lock in moisture to the baby's skin. It is important in the first two weeks of life to keep the umbilical cord area of the baby clean and dry. Good umbilical cord hygiene will prevent your baby from having an infection in the area of their belly button. When you give your baby a sponge bath, make sure you avoid the area of the belly button and the umbilical cord. When you are changing the baby's diaper, be sure to fold the diaper down so that the umbilical cord stump is outside the diaper. Once the umbilical cord falls off you can start to bathe your baby in a baby tub.Give your newborn baby a sponge bath two to three times a week for the first two weeks of life. After the umbilical cord falls off, you can bathe your newborn in a newborn tub.  You can bathe your baby as often as you’d like, but it’s not necessary to do it daily.  
3 min read
What to Eat Before Glucose Test Pregnancy For Accurate Results

What to Eat Before Glucose Test Pregnancy For Accurate Results

One of the most important doctor's visits in pregnancy is for the glucose test pregnancy, which is also known as the gestational oral glucose tolerance test (OGTT). This test checks you to see if you are at risk of gestational diabetes. 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. The glucose test for gestational diabetes is taken between your 6th or 8th month of pregnancy (around 28 weeks) if you haven’t already been diagnosed with diabetes. If you have a history of gestational diabetes in a previous pregnancy you will be screened much earlier usually before 14 weeks.There is no preparation before the 1 hour glucose test. When you get to the office, your doctor will give you a sweet drink which will cause your sugar levels peak. After one hour, your blood will be drawn to see how your body reacts to the excess sugar in your body. If your body is able to handle the excess sugar, your blood draw will reflect that. If your body can not handle the excess sugar, your blood sugar levels will be high and this likely means that you have gestational diabetes. If you're worried about the results, there are dietary changes to help maintain your blood sugar levels before the test. Having a healthy diet that is low in processed sugar in your pregnancy can help. In the weeks and days leading up to your test you should also try to consume more vegetables over foods that are high in sugar. Fruits are okay, but choose fruits like berries that have low sugar content over something like mangoes, which have high sugar content. The most important thing, however, is to make sure you continue the healthy diet after your test as well. High sugar in pregnancy can be very dangerous to the pregnancy. Having gestational diabetes that is not treated could result in stillbirth. 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:We 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! Diet 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.
4 min read
Breastfeeding Benefits

8 Scientific Breastfeeding Benefits

If you are newly pregnant or approaching your due date, you should know that there are many breastfeeding benefits. Here are 8 science-based benefits to breastfeeding for mom and baby. Breastfeeding is associated with a 24% lower risk of invasive ovarian cancer. According to this study, if you have ever breastfed in your life, this was associated with a reduction in risk of all invasive ovarian cancers. Breastfeeding for longer durations showed an even greater reduction in ovarian cancer risk. Women who breastfed for less than 3 months had an 18% reduced risk and those who breastfed for 12 or more months had a 34% reduced risk. There is evidence that exclusively breastfeeding your infant for 3 to 4 months can decrease the risk of eczema in the first 2 years of their life. Breastmilk has unique immune factors that are protective against inflammation and allergies. These natural antibodies are not found in soy, cow’s milk, or any other formula. Multiple sclerosis is an autoimmune disease that affects women in much larger proportions. It affects the 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.Babies who are breastfed or are fed expressed breastmilk are at lower risk for SIDS compared to babies who were never fed breastmilk. According to research, the longer you exclusively breastfeed your baby (meaning not supplementing with formula or solid food), the lower their risk of SIDS.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 so you can be free of your period for some time. When your period (and ovulation) will return is largely dependent on how often you are breastfeeding and is very personal. You are more likely to not have a period if the only form of nutrition your baby gets is breast milk. Keep in mind that while it is unlikely to get pregnant while breastfeeding, it can still happen, especially because ovulation will happen before your period arrives. If you are sexually active and not prepared for another pregnancy, be sure to talk to your doctor about birth control that is safe to use while breastfeeding. 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.  Breastmilk has amazing benefits, both for the mother and the baby including reduced risk of diseases like breast cancer, ovarian cancer, ear infections, and eczema. It can also save time and money and is a chance to bond with your newborn. Not all persons are able to exclusively breastfeed. Any amount of breast milk that you are able to give your baby is beneficial to your baby - whether you are feeding it directly from the breast or you are pumping milk and bottle feeding it to your baby. While breastfeeding and breast milk should be strongly considered as a first option when possible, formula is safe and will provide your baby with all the required nutrients.  
4 min read
Formula Shortages

Formula Shortages : 5 Things Parents Can Do Now!

Here are 5 things parents can do now to deal with the infant formula shortage. These recommendations are not a replacement for medical advice from a pediatrician. If your baby has a true medical conditions or allergies, you may only be able to use specific forms of nutrition for them. For a complete, pediatrician developed educational guide to navigating the formula shortage, click here.Although parents were traditionally told to keep their baby on the same brand of formula (because you knew that the baby could tolerate it), any type of formula is still better than not having adequate nutrition for the baby. Formula is also a better choice over cow's milk. If you are able to find other types of formula, then it is okay to switch your baby to a different form. This means if you have been giving your baby powdered formula, but you can only find ready to feed, it is okay to give the baby ready to feed. The opposite is also true. No matter which type you choose or can get your hands on, remember that you should always follow the directions on the package. Do not dilute formula. Diluting formula has led to severe health problems in infants including seizures and death. Infants, especially those under 6-9 months old, definitely do not have mature enough guts to process large quantities of whole cow’s milk. They can become dehydrated, iron deficient, and can even have some gastrointestinal (GI) bleeding and malabsorption of nutrients. But sometime after 6 months, their GI system starts to mature and they are able to tolerate it. It is a gradual developmental process of the gut. So, it is reasonable to consider using whole cow’s milk especially if your baby is closer to 1 year old, is eating other solid foods, and isn’t taking too much of the cow's milk.The American Academy of Pediatrics usually recommends starting at 12 months, although right now the AAP has said “it may be OK for some babies over 6 months of age to have cow’s milk for a short period of time if no formula is available.” In Canada, pediatricians have been recommending whole cow's milk starting at 9-12 months for some time. If you choose to give whole cow’s milk, do not give more than 16-24 oz per day. The main concern is that whole milk doesn’t supply enough iron for your baby. So, be sure to give iron-rich foods when giving whole cow's milk and consider also giving your baby a multivitamin with iron. Do not give skim milk or low fat milk.Consider giving European baby formulas (HiPP and Holle are the most popular brands). The AAP recommends against imported formula mainly because of lack of FDA regulation, shipping and storage concerns, and delayed recall notices. However, this is a safer alternative compared to diluting formula. Do not dilute formula.Do check the nutrition label on imported infant European or toddler formulas if that’s all you can find. If there’s enough iron, consider a multivitamin with iron if there’s not (eg: Poly-Vi-Sol with Iron).If you are breastfeeding and are able to breastfeed longer, this is a great option. If you have recently weaned from breastfeeding ( in the last 2-3 weeks), you may be able to relactate. In order to get breast milk flowing again, you will need to pump frequently and you also may need to take some special medications. An expert in breastfeeding medicine will be able to help you manage this process. Do not feel guilt or shame if you have stopped breastfeeding. The formula shortage is not your fault!Sources:https://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/Are-there-shortages-of-infant-formula-due-to-COVID-19.aspx
4 min read
Vegan Restaurants In NYC

Vegan Restaurants In NYC 2022

There's no better place to find a vegan restaurant than in New York City! Here are our top vegan restaurants in NYC.Dirty Candy is a long standing NYC vegetarian restaurant, but nearly all of their dishes can be made vegan (according to their website). Not only is the food here 100% vegan, the dining experience is elevated. Dirt Candy offers a full bar and a multi course dining menu that will impress any diner - vegan or not. The tasting menu is about $90 per person.ABCV is another amazing restaurant from famous chef Jean-Georges Vongerichten. Located just north of Union Square, this NYC vegetarian and vegan restaurant has become a Manhattan staple. It is located right next to Jean-Georges other famous restaurants ABC Cocina and ABC Kitchen. This is another vegan hotspot that is more intended for a special night out rather than a casual or quick meal.Looking for an amazing vegan brunch in NYC? Head to the East Village where Ladybird serves up classic brunch specials that are made to be vegan. This is a tapas style restaurant where small plates reign king. Ladybird also serves dinner as well as brunch. Overthrow Hospitality is the team behind Ladybird as well as the number 4 dining venue on this list.If you're in the East Village and not in the mood for vegan tapas at Ladybird, check out another restaurant by Overthrow Hospitality. Just a stone's throw away is Avant Garde, where the dining is a little more upscale. This restaurant is only open for dinner and does not offer brunch like Ladybird.The iconic Eleven Madison Park went all vegan after its most recent re-opening. This is the fanciest restaurant on this list and is very deserving of a special night out. Reservations for this vegan nyc restaurant usually need to be made a least a month in advance. This is not a place you would go to every few weeks like some of the others on this list. The vegan tasting menu here will cost a hefty $300 per person. Definitely keep this place in mind for special occasions. At one point, Eleven Madison Park was rated the Number 1 restaurant in the world.Restaurants dedicated to serving vegan food are not a trend. They are here to stay. More and more people are choosing to have more plant forward diets. Luckily, New York City is one the best places to find a variety of restaurants with so many vegan options. With the many benefits that vegan and vegetarian food have to offer, it is not surprising to see more and more vegan restaurants popping up.
3 min read
Effectiveness Of Pulling Out Method

Effectiveness Of Pulling Out Method

Using the pulling out method during sex to avoid pregnancy is not very effective. This is also called the withdrawal method. One report estimates that about 22% of women using the pulling out method will become pregnant in one year of using it(1). Most doctors agree that the effectiveness of pulling out is not as good as many other family planning methods out there. Although it may seem logical to pull out the penis before climax, the reality is that during sex there is semen that leaks from the penis into the vaginal canal before ejaculation. If you are having penetrative sex and not using any other form of birth control, the chances of getting pregnant from precum released into your vaginal canal are about 22% over the course of one year. Precum is the semen that is released into the vaginal canal during sex before ejaculation. While people may consider the pull out method a form of birth control, most doctors agree that it is too unreliable to be used to truly prevent pregnancy. What Are The Chances Of Getting Pregnant From PrecumSome of the theory behind the pulling out method is that the majority of the semen is not released until ejaculation happens, and that the sperm is not as active. The sperm in the pre-ejaculation semen may be less motile than sperm inside the ejaculate semen. However, there is still enough motile sperm in pre-ejaculation semen to fertilize an egg. A study showed that about 37% of sperm are motile in a pre ejaculate sample (2). This means that there are motile sperm inside the vaginal canal prior to ejaculation. These motile sperm do have the ability to fertilize an egg and result in pregnancy.Becoming pregnant also depends on the timing of the menstrual cycle. If a woman is ovulating or near ovulation, then it is more likely that she will become pregnant. Ovulation is the release of the egg from the ovary. It happens around Day 14 of a person's menstrual cycle but can happen a few days before or a few days after. Day 1 of a person's menstrual cycle is the first full day of bleeding. The chances of getting pregnant on birth control and not pulling out is the same as that of just taking birth control. When doctors prescribe birth control they do not expect that their patients will pull out during sex. Birth control pills when taken properly are 99% effective at preventing pregnancy. Taking birth control properly means taking it during the same window of time every day and taking it daily without missing a dose. You are unlikely to get pregnant if you are using your birth control correctly. This is important because taking birth control regularly without missing a dose will determine its effectiveness of birth control. Pulling out in addition to using birth control does not add much in the way of pregnancy protection. If you want to use an additional method of birth control on top of oral contraceptive pills, consider using a barrier method. Barrier methods are different from hormonal methods because they physically prevent the sperm and egg from meeting. This prevents fertilization of the egg by the sperm and thus, prevents pregnancy. Two examples of barrier methods are the male condom and the female condom. An additional benefit of the male condom is that it is highly effective at protecting against sexually transmitted infections. Pulling out and hormonal birth control do not prevent against sexually transmitted infections.The pulling out method is not very effective in preventing pregnancy. If 100 women were to use this method, it is likely that 22 of them would become pregnant over the course of one year. If you are using hormonal birth control, like the birth control pill, or an IUD, pulling out will not give you more protection against pregnancy. If using birth control pills remember to take the pills regularly every day and to not miss a dose. Missing a dose of the pill can reduce birth control effectiveness. If you want to also protect against sexually transmitted infections, using a condom over the penis is one of the most effective ways to protect against STIs.Sources:(1) American College Of Obstetrics And Gynecology: https://www.acog.org/womens-health/infographics/effectiveness-of-birth-control-methods(2) Killick SR, Leary C, Trussell J, Guthrie KA. Sperm content of pre-ejaculatory fluid. Hum Fertil (Camb). 2011 Mar;14(1):48-52. doi: 10.3109/14647273.2010.520798. Epub 2010 Dec 15. PMID: 21155689; PMCID: PMC3564677.https://pubmed.ncbi.nlm.nih.gov/21155689/(3) Trussell J. Contraceptive failure in the United States. Contraception. 2011 May;83(5):397-404. doi: 10.1016/j.contraception.2011.01.021. Epub 2011 Mar 12. PMID: 21477680; PMCID: PMC3638209.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3638209/(4) CDC Website: https://www.cdc.gov/reproductivehealth/contraception/index.htm#Contraceptive-Effectiveness
5 min read
Pimple Or Cold Sore

Pimples Vs Cold Sores

Pimples are not the same thing as cold sores. Pimples are usually due to bacteria. On the other hand, cold sores are from the herpes simple virus. Let’s take a look at some of the differences between pimples and cold sores.A pimple is a small pustule or papule. Pimples develop when sebaceous glands, or oil glands, become clogged and infected, leading to swollen, red lesions filled with pus. Pimples most commonly happen on the face, back, chest, and shoulders. This is because there are many sebaceous glands in these areas of skin. Cold sores are also known as the fever blisters, and they are a common viral infection. Tiny fluid filled blisters appear in clusters and it is commonly seen in people on and around the lips. Blisters are grouped together in patches. After the blister breaks, a scab forms that can be seen for several days. A cold sore can spread from one person to another person by close contact like kissing. Cold sore are caused by the Herpes Simplex Virus Type1 (HSV 1). The blisters burst and scab over with time. Cold sores generally disappear without treatment in two to four weeks. Several types of prescription antiviral medications may speed the healing process. Here are some examples of medications that may be used : Acyclovir, Valcyclovir, Famciclovir, Penciclovir. Acyclovir and Valcyclovir (Valtrex) come in pill form, and the others come in creams form and can be applied to the skin to reduce the sores. Using lip moisturizers and lip balms can help also. Protect your lips from the sun with a zinc oxide cream or lip balm with sunblock. If your lips become dry, apply a moisturizing cream.Rest and try pain medication if needed. You can use over-the-counter pain relievers if you have a fever or if the cold sore is painful. Creams with lidocaine or benzocaine may give you some pain relief. Stress and lack of sleep may cause cold sores to heal slowly and recur more frequently. So, getting enough sleep and reducing stress is important. More various types of  pimples form when dead skin cells, oils, or bacteria block a pore. Hard pimples, such as nodules or cysts, are often deeper and more inflamed. To treat pimples at home, start with creams and ointments. Using an ice pack is a good way to reduce inflammation and pain. Ice may be very helpful for hard pimples, like nodules and cysts.If you have stubborn and recurrent acne, it is important to see a dermatologist. A dermatologist will closely examine your skin to see which type of pimples you are getting. Noninflammatory acne can usually be cleared up with over the counter ointments that have the active ingredients salicylic acid and benzoyl peroxide. Inflammatory acne may need prescription medications from a dermatologist. Birth control may also help to control acne. Pimples can appear as a bump or blemish that's white, black or cyst-like. They occur when any of the three natural contaminants to your skin like oil, dead skin cells or bacteria like clog a skin pore, resulting in inflammation and irritation. Cold sores appear in patches and can look like red blisters. If it's a first-time outbreak, a cold sore can also come with headaches. Acne is a result of bacteria on the skin and cold sores are from the HSV 1 Virus.Sources:https://www.aad.org/public/diseases/a-z/cold-sores-overviewhttps://www.aad.org/public/diseases/acne/really-acne/overviewhttps://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virushttps://www.nhs.uk/conditions/cold-sores/
3 min read
Breastfeeding As Birth Control

Breastfeeding For Birth Control

Using breastfeeding as birth control can be done but there is still a possibility that you can become pregnant. Even if done perfect, there is a 2% chance you can become pregnant. There are very strict guidelines to follow if you hope to use breastfeeding for birth control. Doctors refer to the breastfeeding birth control method as lactational amenorrhea or LAM. Using breastfeeding for birth control is called the lactational amenorrhea method. The word lactational refers to breastfeeding and the word amenorrhea means not having a menstrual period. It is a method of birth control that may work for some but it is not as effective as other methods of birth control. The benefit of LAM is that it is natural. However, the downside is that unless followed very strictly, it has varying reliability. Many people have gotten pregnant unintentionally by using breastfeeding for birth control. Getting pregnant within a year of giving birth can be dangerous for many mothers. In order to use breastfeeding for birth control, your baby has to be under 6 months old. Right after you deliver you are unlikely to ovulate in the first few months. The further you get from the baby's day of birth the more likely it is that your body will ovulate or release an egg. Once an egg is released and you are sexually active, there is a chance you can become pregnant. It is important to note that the egg is released from the ovary about 10 to 14 days before your period. This means that you will ovulate once before your period returns. It is during this ovulation that women become pregnant unexpectedly. They don't realize that their period has returned until 2 weeks later. If they had unprotected sex during this time, they could become pregnant. Breastfeeding For Birth ControlIf you would like to use the lactational amenorrhea method there are a few things you should know:Getting pregnant too quickly after you have given birth is not recommended. Most gynecologists recommend waiting at least 12 to 18 months after giving birth before getting pregnant again. It is not safe for your health or the health of the pregnancy. While breastfeeding will delay ovulation for a few months, it is impossible to know how long that amount of time will be. Only use breastfeeding as birth control if you are able to breastfeed exclusively, your period has not returned, and your baby is under 6 months old. If you follow this perfectly, there is still a 2% chance you could become pregnant. Using barrier contraception or progestin only birth control can also be an option for breastfeeding moms who want to protect against unwanted pregnancy. Sources:Finger WR. Research confirms LAM's effectiveness. Contraceptive update. Netw Res Triangle Park N C. 1996 Fall;17(1):12-14, 24. PMID: 12320442.https://pubmed.ncbi.nlm.nih.gov/12320442/https://myhealth.alberta.ca/sexual-reproductive-health/birth-control/natural-methods/lactation-amenorrheaVekemans M. Postpartum contraception: the lactational amenorrhea method. Eur J Contracept Reprod Health Care. 1997 Jun;2(2):105-11. doi: 10.3109/13625189709167463. PMID: 9678098. https://pubmed.ncbi.nlm.nih.gov/9678098/https://www.cdc.gov/reproductivehealth/contraception/mmwr/mec/appendixg.html
4 min read
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 To Insert A Tampon In Your Vagina

How To Insert A Tampon: Step By Step For Beginners

Tampons are a fantastic way to manage your period. Once you master how to use the tampon, it is usually very comfortable, and most people do not even feel it. Let's take a look at the steps below. Find some privacy and play around with the tampon before you insert it. If it is your first time inserting a tampon, it may take a few tries and a few tampons to get it right. Find a private place where you don't feel pressured to leave so you can take your time. Have 2 to 3 extra tampons so you can understand how the tampon leaves the applicator. It's a good idea to have a few extra tampons handy. Especially in the first few months of tampon usage, you may end up needing a few backup tampons. Before you even try to insert a tampon in your body, play around with the tampon and see how the cotton material comes out of the applicator. Some tampon brands do not come with applicators, and some do. The actual tampon is the cotton part, and the applicator is the plastic part. Before inserting a tampon into your body, play around with one tampon to see how it works. Push the plastic applicator so that the tampon (the white part with the string) leaves the applicator. When inserting the tampon into your vagina, you will push on the plunger part of the applicator. This will push out the tampon from the barrel part of the applicator. See the inserting tampon diagram below.Inserting Tampon DiagramFind a comfortable position and try to insert the tampon into your vagina. The vagina is the opening that is between the urethra (where you pee) and the rectum (where you poop). It is where blood from your menstrual period exits your body. Some people find it comfortable to stand with their legs shoulder width apart. Some women may want to place one leg on the toilet. Some people may also find it comfortable to lean forward slightly. Some women will stand to insert their tampon, while others may do it while sitting on the toilet. Standing up while inserting a tampon may give you the ability to maneuver your body. You have to figure out what position works for you to get the tampon to slide in with little resistance.How To Use The Tampon Insert the tampon applicator into your vagina. If you feel resistance or pain, stop, pull back and try a different angle. In the beginning, use tampons marked for light flow rather than heavy flow so that the tampon is smaller and easier to manipulate. It will also be easier to insert. How To Insert TamponRemove the applicator by pushing the tampon into the vagina. This is where playing with the applicator ahead of time can come in handy. You already know how the applicator works. Push the back of the applicator so it pushes the tampon out of the applicator and into your vagina. You should be far enough into the vagina so that the bulky cotton part of the tampon does not stick out, but you should not be so far into the vagina that you don't have enough of a tampon string to pull. Once you have inserted the tampon, dispose of the applicator.Diagram For Tampon InsertionIt is also important to know how to take out a tampon. Sit down on the toilet and find the string of the tampon. Take out the tampon by slowly but firmly pulling on the string. The tampon, which is likely soaked in blood at this point, can be flushed into the toilet.Many people use tampons in addition to menstrual pads and menstrual cups during their period. Tampons are a safe way to manage your period provided that you change your tampon at regular intervals. If you have a heavy flow period you may need to change your tampon every 3 hours, but if your flow is lighter you could go longer, like 6 to 7 hours. Always change your tampon at after 7 to 8 hours. Do not leave the same tampon in for longer than 8 hours even if it is not soaked with blood. Not changing your tampon at regular intervals puts you at risk for Toxic Shock Syndrome. If you are soaking through your tampon in a few hours you will want to change it more frequently to avoid staining your clothing.
5 min read
Does A Mammogram Hurt

Does A Mammogram Hurt?

A mammogram for breast cancer screening may hurt in some cases. It is not the same experience for every person. There are different factors that determine whether or not a screening mammogram will be painful for you. Remember, that mammograms only take about 10 to 15 seconds for each breast. So, even if you do experience some pain, it is for a very short amount of time.First, let's take a look at how mammograms are done. During a 3D mammogram 8100/69 , your breast will be squeezed between two surfaces. A mammography machine is an X-ray machine. The machine moves around each breast. While it is moving, it is taking pictures (X-rays) of different parts of your breasts. Each breast is squeezed between two plates for 5 to 10 seconds. It is this squeezing that some people find uncomfortable. If you have breasts that are smaller, the technician may need to manipulate your breasts into the machine. If you have larger breasts, it may be technically easier to obtain the images that are needed. Again, this is very individual. Not all women with larger breasts have less pain with mammography. Similarly, not all women with smaller breasts have painful experiences with mammograms. Some radiology centers have mammogram machines that have SmartCurve comfort technology. This compression plate is shaped like breast tissue and it has been clinically proven to provide a more comfortable mammogram. SmartCurve reduces pulling and pinching of the breast tissue for a less painful experience.Having a mammogram can be painful. One of the most important factors depends on a person's individual tolerance for pain. If you have a high pain tolerance, you are unlikely to experience much pain or discomfort during a mammogram. If you have a low tolerance for pain, then a mammogram may be painful for you. The experience of pain is very variable. Even the same person can have different experiences of pain on different days. Some people do not realize that during a mammogram, you will need to stretch and move your neck so your head is out of the way of the very large mammogram machine. There are women who report that this is more painful than the squeezing of the breast tissue. The experience of the technician also matters. Technicians who are well trained in performing mammograms are more likely to be able to get the needed images quickly and accurately. A mammography technologist who has years of experience in properly positioning patients will likely be a better option for someone who has a low pain threshold. Most people will not be able to choose their technician so this is not something you can control in most cases. Breast tissue can be more sensitive when you are on your period. So, having mammography during periods may not be the best idea if you have a low threshold for pain. If you wait until after your menstrual cycle is complete, your mammogram may be less painful. If you have a low pain tolerance, schedule your mammogram approximately 4 to 7 days after you stop bleeding. There is no contraindication to having a mammogram during your period.The summary is, yes, a mammogram can be. However, it is a very quick test. Even in the most painful situations, the pain should be short-lived and not last more than ten to fifteen seconds. Some people may have some bruising or soreness for a day or so after the test. Patients can take over-the-counter pain relievers if needed for this discomfort. Having a mammogram at regular intervals for breast cancer screening is extremely important. Although it may be painful, most people tolerate them well. There are many benefits of early breast cancer detection through screening mammography. It is very important to not let the 15 seconds of pain discourage you from having your screening mammogram. Bottom line, painful, or not, your mammogram needs to be done!Sources:https://pubmed.ncbi.nlm.nih.gov/28644335/https://www.aafp.org/dam/AAFP/documents/patient_care/clinical_recommendations/cps-recommendations.pdfhttps://pubmed.ncbi.nlm.nih.gov/26757170/https://www.womenshealth.gov/a-z-topics/mammograms
4 min read
Skin Is Itchy With Bumps

Itchy Red Spots On Skin - 7 Causes You Need To Know About

So, your skin is itchy with bumps? Itchy red spots can happen on your skin for many reasons. When these bumps show up, they can cause unwanted stress or anxiety. Some types of itchy red bumps may resolve spontaneously, while others may require evaluation and management by a board-certified dermatologist. This article lists some of the most common conditions of itchy red bumps and key points to consider.What you may see: Hives are raised, red, itchy bumps that often arise in association with an allergic reaction to things like certain chemicals in food, medication, insect bites and sunlight. They can also be triggered by pressure on the skin, vibration, cold temperature, water or other causes. Urticaria is characterized as acute or chronic. Acute urticaria are hives that last less than six weeks and are most often associated with food allergies, medications, infection, insect bites or other disease. Chronic urticaria are hives that last longer than six weeks. The cause is often harder to determine. Thyroid disease, liver disease and cancer have been associated with hives and symptoms can affect the gastrointestinal tract, lung and muscles presenting as shortness of breath, muscle soreness, vomiting and diarrhea.How to treat? Hives typically appear and resolve within a few hours and may never recur though it’s possible to have many flare-ups. If you experience hives daily or nearly every day for six weeks or more, this is chronic urticaria and getting relief often requires getting medical support. Seeking support from a board-certified dermatologist can help you determine whether you have hives or another condition and how best to manage it.What you may see: Keratosis pilaris (KP) is a common skin condition often mistaken for tiny pimples and thought to resemble goosebumps or “plucked chicken skin”. KP appears as tiny bumps commonly found on the upper arms, fronts of thighs, back, buttocks  and children may have them on their cheeks. They feel rough to the touch and may appear reddish or brown depending on skin tone. They can become itchy and uncomfortable if the surrounding skin gets too dry or irritated.How to treat? KP typically thought of as harmless, is often treated with moisturizer or exfoliating ingredients like urea and lactic acid to reduce the appearance of the bumps. KP has been associated with vitamin A deficiency and genetics predisposition. What you may see: Hours to days after contact with something that irritates your skin or causes an allergic reaction, you can develop an itchy, red, bumpy, scaly rash. Contributing factors could include chemicals in personal care products, plants, and fabrics. Because so many everyday things can contribute to this condition, it can take some time and the expertise of a dermatologist to help sort out the causes.How to treat?  Relief requires avoidance of the cause, which means it could take time and/or the support of a board certified dermatologist who recommends treatment and who can help you:What you may see: Typically multiple little pink to flesh-colored bumps with a central white plug can be seen commonly on the extremities, torso and genitalia, although they can also occur on the eyelids. Often these bumps can be confused with pimples. Unlike pimples however, these bumps are caused by a virus and are highly contagious. This means that scratching, picking or rubbing the bumps can spread the virus to other parts of your skin and the germs on your hands and nails can infect the bumps with bacteria making them feel painful and/or contribute to developing a fever. It also requires that affected individuals do not share towels or personal items that touch affected areas. Of note, while this condition is commonly seen in children and referred to as “swimmer’s warts,” in adults MC is considered a sexually transmitted infection. If a person is immunocompromised for any reason, the virus may spread readily and can be difficult to control and treat. Moreover, if an individual develops recurrent MC infection, it might be a sign that they are immunodeficient. How to treat? First and foremost, avoid picking, rubbing, or scratching the bumps. In many instances, the virus may clear on its own, the timing of  which can be unpredictable depending on the health of an  individual’s immune system. New bumps may continue to appear over several months, while other bumps disappear. It can take six to eighteen months for the skin to clear completely and can be facilitated with the support of a board-certified dermatologist.What you may see:  Small red or pus-filled bumps on the palms, soles, wrists, around the belly button, and genitalia. Sometimes scabies can be widespread, especially in immunocompromised individuals, so the bumps may cover the majority of the body. How to treat? Not only does the person diagnosed need treatment, but everyone who has had close contact with that person needs to be treated. Due to the contagious nature of this condition, seeking treatment from a board-certified dermatologist is necessary because the medicine needed to treat scabies is only available with a doctor’s prescription. Moreover, all the bedding, clothing and all items  that have  been in contact with infected individuals should be treated as well. Resources for treatment recommendations can be found at aad.orgWhat you may see: Tiny, itchy, occasionally painful bumps with or without white pus inside. These bumps typically form on skin that’s irritated by friction from being  covered by clothing especially on the buttocks or thighs or as a result of a thin layer of skin growing over newly shaved or waxed skin trapping the underlying hair follicles.The friction and irritation by clothing or from picking can introduce bacteria, resulting in pustules that create a localized infection around the hair follicle. How to treat? Typically these bumps will resolve within a few days as long as they remain clean and free from manipulation. If the bumps persist, are painful or appear infected, seeking medical advice from a board certified dermatologist is recommended.What you may see: Common things being common, most itchy red bumps are not going to be pre-cancerous or cancer. That being said, skin cancer is the most prevalent cancer in the United States and in countries around the world. There are more new cases of skin cancer diagnosed each year than all other cancers combined. In fact,  one in five people in the US will be diagnosed with skin cancer during their lifetime, so it’s important to know what to look for. There are a variety of different cancer types that can present as red bumps on the skin including primary skin cancers including non melanoma skin cancer like basal cell carcinoma, squamous cell carcinoma and it’s precursor,  actinic keratosis as well as variants of melanoma.Of note, metastases from systemic cancers like renal cell carcinoma, breast carcinoma and lung carcinoma can present on the skin as wellHow to treat? If a bump appears and does not resolve quickly, enlarges or changes over time, or bleeds spontaneously, seek support from a board-certified dermatologist who can evaluate the bump for an accurate diagnosis.
6 min read
How BMI Is Calculated

How Is Body Mass Index Calculated In Women

How BMI is calculated depends on whether the person's weight is in pounds or kilograms. Before calculating the BMI you will need to know a person's weight in pounds and height in inches. If the weight is in pounds, the height must be converted to inches. If the weight is in kilograms, the person's height must be converted to meters in order to use the formula. You can calculate BMI by dividing weight (in pounds) by height (in inches) squared. Then, multiply this result by a conversion factor of 703. For example, for a person who weighs 100 lbs and has a height of 5 feet, you will first want to convert the height to inches. Five feet will be 60 inches. First, the number in pounds, which is 100, will be divided by 60 squared (or 60 x 60 which is 3600). The result of 100 divided by 3600 is 0.02777. This number is then multiplied by 703, for a resulting Body Mass Index of 19.53.The equation for how BMI is calculated for weight in pounds and height in inches will look like below:How BMI Is CalculatedThe calculation for BMI in Kilograms is slightly different. You will have to convert the person's height and weight into the metric system. Then divide the weight in kilograms by the person's height in meters squared. So for someone who is 60 kilograms and 1.5 meters tall (which is about 5 feet tall), the calculation is as below:How BMI Is Calculated KilogramsFor the BMI calculation in kilograms there is no need to have the conversion factor of 703 that is required for calculating the BMI in pounds. Body Mass Index, abbreviated as BMI, is calculated the same way for all genders in people who are above 20 years old. If you are younger than 20 years old the calculation is different for men and women. There are two different formulas for calculating BMI. One formula requires that the weight be in pounds and the height be in inches. This formula also requires the use of a conversion factor of 703. The second formula is the formula to use if you have a person's weight in kilograms and their height in meters. If you do not want to do the calculation yourself, there are also calculators available online to do the conversion for you. BMI estimates do not apply to people who are pregnant. Finally, Body Mass Index is just a number. It needs to be used in context with a complete health assessment by your doctor. Sources:https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html#Interpretedhttps://www.cancer.org/healthy/eat-healthy-get-active/take-control-your-weight/body-mass-index-bmi-calculator.html
3 min read
Covid-19 Vaccine

Covid-19 Vaccine: Eliminating Misinformation

Despite evidence showing the effectiveness of the Covid-19 vaccine at protecting people from hospital admissions and deaths from Covid infection, there is still a lot of misinformation surrounding Covid-19 and the Covid-19 Vaccine. Here we address some common myths surrounding vaccination.Fact: The COVID-19 vaccine will not affect fertility. During the Pfizer vaccine tests, 23 women volunteers involved in the study became pregnant, and the only one who suffered a pregnancy loss had not received the actual vaccine, but a placebo. On the other hand, not being vaccinated can pose a risk to a healthy pregnancy. There is an increased risk of hospitalization and death in pregnant persons who are unvaccinated and contract Covid-19. This risk also extends to the postpartum period. Additionally, there is a risk to the unborn baby as well. Having COVID-19 during pregnancy increases the risk of delivering a preterm (earlier than 37 weeks) or having a stillborn infant. Fact: Certain populations are more vulnerable to severe consequences from infection with the Covid-19 virus. The risk of being hospitalized, requiring a ventilator and even dying is more common in high risk groups. These groups include people who are older, people with chronic illnesses, The number of deaths among people over the age of 65 is ninety-seven times greater than the number of deaths in people who are 18 to 29 years old (3). BIPOC and Hispanic communities are also more adversely affected by the Covid-19 virus as well as those individuals who have chronic illnesses like cancer, diabetes, heart disease, diseases that make someone immunocompromised, obesity, pregnancy, and sickle cell disease. Vaccination is particularly important in at risk populations.Fact: Having Covid does protect you from future infection in the same robus way that the COVID-19 vaccine does. Being fully vaccinated against Covid-19 is the best protection against the disease. A study done in 2021 showed that in people persons who have had SARS-CoV-2 infection, being fully vaccinated gives additional protection against future reinfection. Therefore, even if you have been previously infected with Covid your risk of getting reinfected is more than two times higher than for those who were infected and got vaccinated.Fact: The mRNA vaccines, made by Pfizer and Moderna COVID-19 vaccines, are very safe and have limited side effect profiles. Some of the side effects include pain at the injection site, fever, headache, and body aches. These side effects typically do not last longer than one or two days. If you are concerned about an allergic reaction to the vaccine, be sure to keep an EpiPen that can help to combat a serious allergic reaction to the vaccine. There has been concern with the Jansenn (Johnson & Johnson) vaccine because there were reported cases of thrombosis with thrombocytopenia syndrome and Guillain-Barré syndrome after getting the Janssen COVID-19 vaccine. Although it was safely administered to the vast majority of people, the CDC stated in December of 2021 that the two mRNA vaccines were preferred (4).Fact: The mRNA vaccines do not change your DNA. Although the messenger RNA from Pfizer and Moderna vaccines do enter cells, they do not enter the nucleus of the cells which is where a cell’s DNA lives (5).Covid-19 has killed millions of people and vaccinations with an mRNA vaccine is one of the best ways to stay healthy. Everyone, and especially at risk populations, should strongly consider becoming fully vaccinated against Covid-19. Sources:
4 min read
Thyroid Diet

Thyroid Diet And Nutrition

Many people wonder what kind of foods they should eat or avoid when they have thyroid diseases. Is it okay to eat iodized salt? Should soy products be avoided? What about cruciferous vegetables? Here are the evidence based answers to these questions:The thyroid is a small butterfly-shaped gland located in the front of the neck. It produces and secretes thyroid 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 skin (1).  Iodine is used by the thyroid gland’s cells to make the thyroid hormones (T3 and T4) that circulate in your body. The body cannot make iodine on its own, so it is an essential part of the diet (1).The daily recommendation for iodine intake is 150 micrograms (mcg) per day for adults, 220 mcg for pregnant women, and 290 mcg for breastfeeding women. The average American diet already contains 300 mcg of iodine/day (2). Iodine is difficult to identify in foods, since the amount of iodine in a food is not included on nutrition labels in the United States. According to the American Thyroid Association (1), iodine can be found in varying amounts in:People who do not use iodized salt, pregnant women (due to a higher requirement for iodine), vegans, those who eat less dairy products/seafood/eggs, people living in regions with iodine deficient soils (the Himalayas, Alps, Andes, and river valleys in South and Southeast Asia) (2).***Important note: It is important to not take too much (more than 1,100 mcg/day) iodine, especially with susceptible glands. Too much iodine in people with hypothyroidism, such as Hashimoto’s thyroiditis, can lead to worsened hypothyroidism. Too much iodine in folks with hyperthyroidism, such as Grave’s disease, can lead to worsened hyperthyroidism (1).Broccoli, cabbage, brussels sprouts, kale, turnips, cauliflower, and collard greens are all in the cruciferous vegetable family. Although eating vegetables in this family may interfere with thyroid hormone synthesis (the body’s creation of thyroid hormone), the amount matters! If you eat these veggies raw, in high amounts such as 1-1.5 kg/daily for months, then yes, they will have an effect. Also, remember that cooking these vegetables degrades the glucosinolates that interfere with thyroid hormone synthesis. The verdict? Recent studies show that there is no need to stop eating these healthy foods, which also provide many other essential nutrients. To quote a study: “in fact, consuming these foods as part of a varied, colorful, plant-based diet should not pose significant risks in healthy individuals, and, conversely, may be of great benefit. In addition to beneficial glucosinolates, cruciferous vegetables provide a plethora of other health-promoting phytochemicals, fiber, and essential vitamins and minerals.” (3)Dietary soy products contain phytoestrogens, which have estrogen-like effects. Isoflavones can inhibit the action of thyroid peroxidase, leading to decreased thyroid hormone production. The verdict? Studies have shown that high consumption of soy products showed either no effects at all, or very modest changes in thyroid function of trial participants (4). So normal consumption of soy products is generally safe!Selenium is a micronutrient that is important for thyroid hormone metabolism. Intake varies depending on global location due to variations in the soil content of selenium. It is obtained mainly through meat, seafood, grains, and brazil nuts. The recommended daily intake is 55 mcg, and the tolerable upper intake level is 400 mcg/day (5).The verdict? In folks with Grave’s disease, selenium supplementation has occasionally led to faster remission of thyroid disease and improved quality of life (5).Hashimoto’s autoimmune thyroid disease is often accompanied by Celiac disease. Celiac disease is an autoimmune disease that results in gluten intolerance (6).The verdict? A gluten free diet may bring clinical benefits to women with autoimmune thyroid disease, but more evidence is still needed to support this claim (6).Supplementing with zinc, copper, or magnesium is not supported by enough scientific evidence to be helpful in patients with thyroid disease. The normal daily values of these are recommended.  
5 min read
Is Birth Control Effective

Is Birth Control Effective?

YES! But, it is important to note that some methods of birth control are more effective than others. Also, you MUST use each type of birth control correctly and you must give yourself enough time to allow it start working. Let’s break down the different types of birth control, how effective they are, and how long they take to start working. Remember, that while you are in the window of waiting for your birth control to become effective, you should use a barrier method of contraception such as a condom.YES! Birth control pills are very effective at preventing pregnancy. But, they MUST be taken correctly, which means every day, without missing a day, and ideally at the same time each day. If you start taking birth control pills for the first time within the first 5 days of your period, they should be effective right away, but if started after this time period, a backup method should be used for at least 7 days. If taken as directed and without any missed doses, oral contraceptives are 99% effective in preventing pregnancy. However, for people who miss doses or fluctuate when they take their dose, the overall effectiveness can drop to 91%. Also, since oral birth control pills do not prevent sexually transmitted infections, many women choose to use barrier methods such as condoms in addition to birth control.IUDs are also very effective at preventing pregnancy. There are two types of IUDs - copper and hormonal. The copper IUD starts working immediately after it is inserted, while the hormonal IUD takes about 7 days to start working. If placed within first 7 days of menstrual cycle, backup may not be needed.The copper IUD has a pregnancy rate of approximately 0.8%, which means that anywhere from about 8 people out of 1000 people will become pregnant on this type of birth control. The hormonal IUD releases a small amount of progestin each day to keep you from getting pregnant. The hormonal IUD stays in your uterus for up to 3 to 6 years, depending on the device. It has a failure rate of between 0.1% and 0.4%. This means that anywhere from 1 to 4 people out of 1000 people will become pregnant on this type of birth control. There are other combined hormonal methods like the patch and the vaginal ring. They work similarly to combined OCPs and should be started in the same timeframe. This skin patch is worn on the lower abdomen, buttocks, or upper body (but not on the breasts), and it works by releasing progestin and estrogen into your bloodstream. With typical use, the average failure rate is 7%, which means about 70 women in 1000 could get pregnant while using the patch for birth control. The vaginal ring works similarly in that it also releases hormones into your blood stream. With typical use, the average failure rate is 7%, which means about 70 women in 1000 could get pregnant while using the patch for birth control. Nexplanon is a subdermal implant is a progestin containing contraception. The rod contains a progestin that is released into the body over 3 years. This has a failure rate of 0.1%, or 1 in 1000 people will become pregnant. If you have already had sexual intercourse and want to prevent pregnancy, emergency contraception, “Plan B,” or the “morning after pill” is your best option. Plan B also works through hormones which delay ovulation. It is more effective the sooner it is taken, so it should be taken as soon as possible, within 3 days of unprotected intercourse Plan B does not protect against HIV/AIDS or other STIs, and will not affect an existing pregnancy. The morning after pill is about 93% effective in preventing pregnancy. It is available at pharmacies without a prescription.  The morning after pill came out in the 1990s and another emergency contraception pill called Ullipristal came out in 2010. It is also called Ella and it requires a prescription. Ullipristal can be used within 5 days (120 hours) of having unprotected sex and it is 98% effective at preventing pregnancy. Birth control pills need to be taken correctly in order to maximize their effectivity, which can be as high as 99%. IUDs are also very effective with a very low pregnancy rate that is between 1 and 8 pregnancies per 1000 people. Finally, if you need to take emergency contraception, it is important to take that as soon as possible after you have unprotected sex. Sources:https://www.acog.org/womens-health/infographics/effectiveness-of-birth-control-methodshttps://www.cdc.gov/reproductivehealth/contraception/index.htm#Birth-Control-Methodshttps://www.womenshealth.gov/a-z-topics/birth-control-methods
4 min read
Birth Control Acne

Birth Control Acne Improvement 

Acne affects more than 40 million people in the world half of whom are adult women over the age of 25. Acne can be improved with the use of hormonal birth control. Yes, hormonal therapy which includes oral contraceptives (birth control pill) can help to improve acne. For many patients topical treatmentsare not enough. Birth control pills help because they affect the hormones that play a large role in acne. It may take up to 3 months before seeing results after starting to use birth control for acne.There are 4 oral contraceptives that have been approved by The Food and Drug Administration (FDA) for the treatment of acne. All of these types of birth control contain estrogen in the form of ethinyl estradiol plus a form of progesterone. Multiple studies conducted over the span of 6 period cycles (about 6 months) show a reduction in inflammation and acne in study participants taking these oral contraceptives. Pills that only contain progesterone, also known as the “mini pill,” can actually make acne worse (1).Studies showed subjects treated with Estrostep to havestatistically significant reductions in inflammatory and total lesion count and improvements in acne. Estrostep is approved for use in women over 15. The progesterone in Yaz, drospirenone, has diuretic properties beneficial for reducing weight gain due to fluid retention that can be caused by estrogen. It is approved for use in persons above 14, and also can be used for the treatment of PMDD (premenstrual dysmorphic disorder).Studies showed reductions in inflammatory and total lesion countsand is approved for use in women over 15.Beyaz is approved for moderate acne for women at least 14 years. It is a combination pill that also contains folate. Folate supplementation reduces the risk of neural tube defects in future pregnancies. Like Yaz, it can treat symptoms of premenstrual dysphoric disorder (PMDD) for women. It contains drospirenone (DRSP), ethinyl estradiol and levomefolate.When excess sebum is produced by your body, it mixes with dead skin cells and other particles which can plug follicles, resulting in acne. Androgens are a group of hormones that increase sebum production thereby increasing the potential for acne. Reducing the production of androgens can control sebum production and in turn treat acne. Birth control pills are considered an ovarian androgen blocker (3). They have the hormone estrogen that inhibits the activity of LH and FSH. LH and FSH are hormones that increase the production of androgens. Birth control reduces the effect of androgen on sebaceous glands and, therefore, reduces the production of sebum and acne (1).The use of birth control, specifically oral contraceptives, improves acne in many people. The 4 FDA approved oral contraceptives for acne treatment are Estrostep, Yaz, Beyaz, and Ortho Tri-Cyclen. It is generally the estrogen component of the oral birth control pill that assists with hormonal regulation and acne control. Persons on progesterone only oral contraception may actually experience an increase in acne. Chat with a doctor about your options for using birth control for acne improvement. Sources
3 min read
Pregnancy After A Miscarriage

Pregnancy After A Miscarriage

Miscarriages are a devastating and terrible reality for so many people who are trying to get pregnant. 1 in 4 women will experience a miscarriage. In the aftermath of this, people also wonder when it is safe to become pregnant again. If you miscarried within the first three months of your pregnancy, the body may restore its normal functions more quickly. After an early pregnancy loss, your hormones will return to normal levels within a few weeks. This means that you may ovulate and you could become pregnant sooner than you would if you had lost the pregnancy in the third trimester. If the pregnancy was an ectopic or molar pregnancy, the guidance will be different. In these situations, the interval within which you can try to conceive again will likely be longer than your first missed period.If you experience a complete first trimester pregnancy loss spontaneously, meaning, all tissue and debris passed and no remaining signs of tissue in the uterus, you may be able to conceive as soon as you feel ready. This is because the body is already fully prepared for another pregnancy, the uterine lining has returned to its normal thickness and your hormones will likely have returned back to normal.In 90% of cases, the body will expel the pregnancy naturally, within 6-8 weeks. In rare cases of a spontaneous first trimester miscarriage, there may still be tissue left in your uterus. This remaining tissue has a risk of causing an infection. If you continue to have bleeding or pain following passing tissue, your doctor may order an ultrasound in order to evaluate the contents of your uterus. In these cases, a physician may recommend medication to assist in passing the pregnancy or even surgery to remove the pregnancy from your uterus. The name of the surgery is a dilatation and curettage and its purpose is to remove the remaining tissue to prevent complications in the future. Dilatation and curettage is a safe and effective way to remove the remaining tissue. In addition, this surgery is safe and has an extremely low risk of complications. It has an extremely low risk of affecting your ability to become pregnant in the future.If you experience an incomplete miscarriage as above, and some tissue remains in the uterus, doctors will likely recommend waiting until your next period to attempt another pregnancy.  This gives your body a chance to heal itself and prepare for another pregnancy naturally.After a second trimester loss, it's recommended that you wait at least three months before attempting to get pregnant again. This allows your body time to heal, and your hormone levels to return to normal. It is important to allow your uterine lining to go back to the optimal thickness in order to allow the placenta to implant appropriately the next time you conceive.Getting pregnant again after a third trimester pregnancy loss is very different, as your body has changed significantly. At this stage, a pregnancy loss will most likely need to be delivered, and labor will be induced. A pregnancy loss will likely be delivered vaginally regardless of whether you have had a cesarean section previously. Cesarean section for pregnancy loss is usually reserved for emergency situations. Because you will actually be delivering the fetus, you should follow the same recommendations as someone who did not have a stillbirth, and wait at least 12 months before becoming pregnant again. In addition, close follow-up after delivery of a stillborn baby is recommended. Once you do conceive, it is important to contact your Obstetrician as soon as possible, as you may need additional prenatal care during the pregnancy.For all miscarriages and pregnancy losses, there are some reasons to consider waiting. One reason is that if you have been through an emotionally taxing experience, it may be helpful to take some time to grieve your loss and process your feelings before trying again. Additionally, after any pregnancy loss, you may be able to evaluate the tissue for a cause of miscarriage. This testing could take some time to come back and waiting for these results could help guide you in trying to conceive in the future.If you had a known chromosomal abnormality in the child with whom you lost the pregnancy, this may affect your future pregnancies, so it is important to talk with your care provider about your options and how long you should wait after a loss on a case-by-case basis. Finally, be sure to talk with your health care provider about any questions you may have regarding your mental and emotional well-being after losing a pregnancy.
4 min read
Baby Blues Syndrome

Baby Blues Syndrome Vs Postpartum Depression

The days and months after giving birth can be a psychologically challenging time as well as emotional time for persons who have just had a baby. You are adjusting to a new routine with your little one and are also undergoing large hormonal changes. Baby blues is a term that is often used to describe the time frame immediately after birth in which a new mom feels sad, upset, anxious, or angry. Baby blues typically begins 2 to 3 days after childbirth (1) and happens in almost 85% of women. Baby blues should resolve on their own and without any treatment within 2 weeks of symptom onset. Women may feel depressed, anxious, or upset. Baby blues may result in anger with the new baby, anger towards a partner, as well as feeling upset with other family members. Baby blues include the following symptoms, and usually do not last past a few weeks after giving birth.It’s important to note that baby blues will come and go for a few days to a few weeks after the birth of the child as the body changes, adjustments are made, and families acclimate to the new circumstances. Baby blues often do not require treatment and the syndrome will improve on its own. If you feel that your baby blues are not resolving, this could be a sign of PPD or postpartum depression.Postpartum depression (PPD) is described as being more intense and lasting longer than those of baby blues (2). It typically begins 1-3 weeks after childbirth and can occur up to 1 year after having a baby(1). Depression, postpartum or not, is a serious illness that often requires professional help and intervention. The CDC reports that 1 in 8 women experience symptoms of postpartum depression (3). Estimates vary by state and can be as high as 1 in 5 women(2).  According to the American Psychological Association(4), “PPD can affect any woman—women with easy pregnancies or problem pregnancies, first-time mothers and mothers with one or more children, women who are married and women who are not, and regardless of income, age, race or ethnicity, culture or education.”Postpartum depression can present itself in a number of ways that are important to recognize and seek help for it. The symptoms for postpartum depression include, but aren’t limited to (2), the following:Once symptoms are recognized, it is very important to seek help quickly and encourage a person you know who is experiencing these symptoms to speak with their healthcare provider as soon as possible. For most persons, there is no one specific cause for postpartum depression. Some pregnant persons are at higher risk for PPD than others. These risk factors include(2):Postpartum depression can also occur without having any of the risk factors above. Even if you are fortunate to have a healthy pregnancy and birth, PPD can still happen to you. It is important to stay vigilant of the symptoms and communicate any struggles you are having to your doctor. Unfortunately, there is no quick cure for PPD or postpartum depression. There are many treatments, however, and you should make your doctor aware of how you are feeling as soon as possible. The most common treatments for postpartum depression are therapy and medication (5). In therapy, a mother speaks with a therapist, psychologist, or social worker to develop coping strategies to counter the way depression makes you think, feel, and act. Medication may also be used and must be prescribed by a doctor or nurse. Antidepressants may take a few weeks to start working, and you can ask your doctor about which ones can be taken safely while breastfeeding.Baby blues are common, while PPD is less common. You should expect to have baby blues as it is a syndrome that is experienced by most pregnant persons in the postpartum period. If you feel that your symptoms are severe or lasting longer than a couple weeks following the birth of your child, please let your doctor know. This could be PPD, and there are ways to treat postpartum depression that are safe and effective. If you ever have thoughts about harming yourself or your baby, you should seek medical help immediately. 
5 min read

Gaslighting In A Relationship

Yes. Gaslighting is a type of psychological abuse where the offending partner tries to convince their significant other that their thoughts and beliefs are wrong or mistaken. They want the person to feel as if they are being unreasonable and want to label their partner as being ‘crazy’ for having the feelings they are having.Gaslighting in a relationship, especially in a relationship where a man is gaslighting a woman, is one of the more common situations in which this type of emotional manipulation occurs. The following are gaslighting phrases that may be used by your partner. By using this gaslighting phrase, your abuser will make you feel as if you are not correctly remembering the facts of a scenario or situation. An example of this could be if your partner flirts with someone outside your relationship or crosses boundaries but then completely denies that they did that. Denial is a common example of gaslighting manipulation. Perpetrators may blatantly lie, and will often avoid evidence that proves them wrong (1)The person will try to make their partner feel as if any emotional reaction such as sadness, crying or anger is inappropriate. They will turn a situation around in which they are wrong to making you feel as if you are person who has done something inappropriate or reacted incorrectly. Many victims of gaslighting are women who are manipulated by men. Many gaslighting techniques are rooted in associating femininity with being irrational (2), thus making women an easier target for this type of abuse.Gaslighters will avoid taking blame for anything and will subsequently blame you for their bad behavior. This gaslighting phrase is used to make the victim feel guilty even though ultimately each person’s actions are their own choice. Another example of gaslighting is when a person tries to attack someone’s entire identity. Sometimes they may attack the identity you have in the relationship you have with them, such as girlfriend or spouse, but oftentimes they will also attack the other parts of your identity as well. Especially if they know that you have a strained relationship with your child or with your parent, the abuser may use this to keep you feeling vulnerable or to make you feel inadequate. Another example of gaslighting is when your partner waits or “forgets” to do things and intentionally makes you feel as less of a priority. They may even blatantly lie about their intent to do something and then not follow through to test you. All these actions allow them to maintain a perceived balance of power in the relationship. They want to push you to your limits and when you reach them and react, they can then call you “irrational” or “crazy” which then leads to you questioning your beliefs and thoughts.Gaslighting can happen in any relationship including, but not limited to, a relationship between a boss and their employee, a parent and their child and even between friends. The most common example of gaslighting, however, happens in romantic relationships especially those between a man and a woman. This is because many men rely on manipulating a woman’s sense of femininity and equating it to being irrational. Sadly, gaslighting in a relationship can also occur alongside verbal, emotional, and physical abuse. Unfortunately, in most relationships where gaslighting is going on, it can be challenging to recognize as well as subsequently deal with. Many of these relationships are unable to recover from this type of manipulation. Sources:
4 min read
Does Stress Affect My Skin?

Does Stress Affect My Skin?

The short answer? Yes! 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). 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 physiology, age, and genetics. Also, 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, and pruritus (severe itching of the skin). Stress can 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 WongSources:
6 min read

What Is Gaslighting And What You Can Do About It

Gaslighting is a form of emotional abuse where the victim starts to question their own reality. It can be often difficult to pick up because it tends to happen gradually. What starts out as small seemingly minor offenses can then become a pattern of gaslighting where the abuser wants to have control over the other person. Gaslighting can happen in romantic relationships, in the workplace, between friends, between a parent and child, and even by a public figure to his / her constituents.Gas Light was a movie made in 1944 starring Ingrid Bergman, who played Paula, and Charles Boyer, who played her husband Gregory. In the movie, Gregory manipulates Paula in order to steal from her and makes her feel “crazy.” In one particular part of the movie, Gregory intentionally makes the gaslights in the house flicker, but when Paula mentions it, he claims that it is not actually happening. The term gaslighting comes from this movie’s portrayal of psychological manipulation between the two main characters. Most situations that involve gaslighting are not as obvious or with such malicious intent. Nevertheless, gaslighting is not part of a healthy relationship, and it should be recognized and addressed.This is one of the more common forms of gaslighting, and while it can occur in any romantic relationship, it is often seen in a power dynamic between a man and a woman. Many male gaslighters manipulate an association between being feminine and being “overly sensitive” to make their female partners feel as if they are “over reacting” or “making a big deal” of something. Learn more about gaslighting in a relationship hereGaslighting at work can happen between employees as well as between managers and bosses and the persons they are in charge of. This is especially ripe to occur when you are a new employee or person at an organization, even at senior executive level positions. Something as simple as gossiping at work can be gaslighting. If you see a colleague who is continually spreading rumors or telling lies about another colleague, it should raise concern for bullying and gaslighting. If these rumors center around your ability to perform or be mentally fit for the job, you should involve human resources immediately. Here are some examples of gaslighting and how they can occur in a multitude of different relationships. You have missed a meeting or deadline at work and your boss or manager refuses to accept that they could have made a mistake about a deadline or meeting time. This happens repeatedly in more than one instance and they blame you for being incompetent. You are waiting for your boyfriend to come home and when you ask him why he is late he changes the subject and gets mad at you instead for being paranoid. People who gaslight want to divert energy from having blame placed on them and will often undermine their victim for even questioning them. One of your parents fails to show up again to an important family event. When you approach your parent about it, they tell you that you are being “overly sensitive” and “making a big deal” out of the situation. When you try to discuss it with them, they trivialize it and may even try to divert energy as above or change the subject. So, is there anything you can do about gaslighting? Because victims of gaslighting will often be uncertain about certain events, start to write things down. If needed, send yourself an email with the events that transpired and copy a good friend that you can trust. Write down the date, the time and the detailed context in which the events transpired. If there is physical abuse involved, it is very important to seek help as soon as possible. It may also be important to take pictures of any bruises you may have along with the dates and times they happened. If you think you may need these for a future legal proceeding, be sure to also send them to yourself via email and additionally to a friend that you trust. Depending on the context in which the gaslighting is occurring, you should strongly consider seeking personal and professional help. You may need to do this discreetly if you are concerned for your safety. In many cases,  victims of gaslighting become out of touch with their close friends and family. It may be a direct or indirect result of being in an unhealthy and toxic relationship. Your abuser may put ideas in your head that your close friends and family are toxic in order to divert energy from the toxic relationship you are in with your abuser. Your partner may feel that reconnecting with friends and family is a threat to your relationship, and this is a red flag that they are trying to hold control over you. Reconnecting with friends and family and being open with them about your struggles can also help to provide perspective on your situation. It will also give you a support system to lean on if you end the relationship with your abuser.In some situations, especially highly toxic, manipulative, and abusive ones, leaving the relationship safely may be your only option. It is not easy to do this and you may need to have a plan in place in order to safely leave your relationship. Having a support system, whether it is friends or family, can be very helpful as you transition out of a toxic romantic relationship, workplace gaslighting, or any other relationship. If there is physical abuse involved or you are questioning your safety, it is important to make a plan so that you can leave your relationship safely. Here are some resources on how to find help locally where you live. If you are in immediate danger, never hesitate to call 911. Being a victim to a person who gaslights you can have devastating personal consequences. Even after you recognize that someone has done this to you, you may blame yourself for being naive about the situation. It may also make you very reluctant and hesitant of future relationships that have a similar nature. For example, if you were gaslight in a workplace scenario, you may be suspicious of future bosses, and it may be difficult for you to have a “clean slate” going forward.  If you find yourself in a situation where you think you are having long lasting effects from a previous interaction with someone who manipulated you, it is important to seek help. The first part of this journey involves recognition that the behavior took place. Because victims of gaslighting may be embedded in self doubt when they leave the relationship, it can be difficult to acknowledge that certain things did actually happen in the relationship. If you have written experiences down, or recorded them for yourself, it can be helpful to revisit these so that you are reminded of the actual circumstances that occurred. If you find this too triggering to do on your own, you should strongly consider involving professional help such as a therapist. It is important to be able to trust your own instincts again, and having supportive individuals in both a personal and professional capacity can assist with this. A therapist with a background in abusive relationships can be very helpful.Let go of trying to convince the person who manipulated you that they were wrong to do so. Many persons who gaslight someone often have deep rooted issues themselves and some may even have a personality disorder like narcissistic personality disorder. Unfortunately, in many situations the abuser has a severe lack of self awareness and attempting to show them their wrong doings will only result in further gaslighting and attempts at manipulation. It is often unfair to have to leave a job because of a boss that is treating you this way, but if you are unable to resolve it through appropriate channels such as human resources, it may hinder your personal and professional growth. You may also need to let go of the perception others have of the person that mistreated you. It is not uncommon where someone who acts one way around one person is a totally different person around others. Gaslighters will often present their best selves to the world, but behind closed doors are very different. Convincing people around you that someone treated you poorly is likely to only take energy from you. Focus on healing yourself from the relationship, as well as on moving forward.Gaslighting is emotional and psychological abuse. It can have varying degrees and may not always be intentional but it is never acceptable behavior in any relationship. If you find yourself always apologizing, feeling constantly uncertain about your role somewhere, or generally unhappy in a particular relationship, start to write down the experiences you are having that you think could be contributing to this. Seeking out friends and family for support is important and if gaslighting is associated with physical abuse, you should seek help immediately from domestic abuse resources in your area. If you are able to remove yourself from a situation in which gaslighting is happening, seek out help in order to move on. While difficult, try to give future relationships a chance even though trusting others can be very challenging after such an experience. 
8 min read
Signs Of Food Allergies In Babies

Signs Of Food Allergies In Babies

Your child ate something and is now neither looking nor feeling too good, but how can you tell if it’s a food allergy or simply a food intolerance?  Because of the overlap of symptoms and lots of outdated and some misinformation out there, it is often hard to differentiate food allergies versus food intolerances.  Food allergies and food intolerances differ at the physiological level.  A true food allergy is the result of your body creating an immune response (using an “antibody”) to the food you are eating (the target of the antibody, or the “antigen”).  This is similar to a vaccine targeting a particular bacteria or virus.  The type of antibody made is called IgE, and it is specific for a particular type of food.  When it binds to that food, it releases something called histamine which ultimately leads to the symptoms of an allergic reaction and sometimes, anaphylaxis (a more severe allergic reaction) (2). Some IgE-mediated food allergies are outgrown in early childhood, and some stay for life (2).  IgE to particular foods is something a doctor can measure through a blood or skin test.  Food intolerances are characterized by problems with your child’s digestion and/or digestive system (1). These are generally less severe and easier to treat, as many food intolerances can be treated by changing either the form of the food or what it is taken with to aid its digestion (1). For example, taking lactase pills before consuming lactose will likely allow an individual with lactose intolerance to consume lactose-containing items (1). Food intolerances are often referred to as “non-IgE mediated allergies”, although this term is misleading and confusing for parents. Unlike those with food allergies, individuals with food intolerance are not at risk for anaphylaxis (1).Some causes of food intolerance are unknown. Some food intolerances also may not last long, especially at a young age. There are some food intolerances that have an identifiable cause.  These include: Symptoms of food allergies can range from mild to severe. Since they induce an immune reaction that affects various organs in the body, the symptoms can be diverse (1). Some signs of food allergies include (3):• Skin – Itching, flushing, hives (itchy, raised red bumps) • Eyes – Redness or swelling • Nose and mouth – Sneezing, runny nose, nasal congestion, swelling of the lips or tongue• Lungs or throat– Trouble breathing, wheezing, coughing• Digestive system – Vomiting, diarrhea or pain leading to fussiness • Other signs include - limpness, lethargy On the other hand, since food intolerance is more targeted to digestive system problems, symptoms are often (but not always) limited to vomiting, diarrhea, or abdominal pain (1). Some babies will develop constipation or gas with certain foods or even a change in stool pattern.  These symptoms are often not consistent with an allergic reaction and you should discuss with your doctor to help determine if they are indeed allergic in nature. In almost all cases, the answer is yes. Babies with food allergies and intolerances can continue to breastfeed. Generally, the mother does not need to remove the allergenic food from her diet prior to breastfeeding unless the baby is exhibiting immediate symptoms or if the baby is intolerant to cow’s milk protein (4).  For babies that have cow’s milk protein intolerance, moms have to remove dairy from their diet, and in some cases soy, if they want to continue breastfeeding.  Otherwise, they have to place the baby on a soy formula (if tolerated), a hydrolyzed formula that partially or fully breaks down the milk protein, or an elemental formula which does not contain any intact proteins.  The good news is, most babies outgrow this intolerance by around one year of age!  Currently, there are no official recommendations on other foods not to consume when breastfeeding when concerned about an allergy or intolerance, but research in that sector is constantly evolving (4). If you are concerned about your baby reacting adversely to your breast milk, it is best to consult with an allergist, who will help you determine the next best steps.The most challenging part about feeding babies with concerning symptoms is determining what they are allergic to. Allergy testing can be done in babies but are often not reliable and need to be interpreted by an expert (4).  Therefore, unless a specific food is identified that you are concerned about, specialists do not recommend a panel of allergy labs “just to see” if your baby has an allergy.  This can lead to unnecessary elimination of foods from a child’s diet and can lead to nutritional deficits.  Therefore, it is always recommended you see your pediatrician or allergist to discuss any concerns you may have with your baby’s diet and they can help you take the proper next steps.  Sources
5 min read
Is red wine good for my heart?

Is Red Wine Good For You? A Cardiologist Explains The Link Between Red Wine And Heart Disease. 

Is red wine good for my heart…or not? From wellness experts to media outlets, many talk about the health benefits of consuming red wine, claiming the heart benefits of it. But, science has shown us that alcohol consumption is detrimental to our health by increasing risks to particular diseases like coronary heart disease and liver disease.  So, what's the verdict?Red wine may be cardioprotective because it contains some amount of resveratrol and antioxidants. Resveratrol, a natural phenol, can lower blood pressure and body fat. Also, red wine contains some anti-inflammatory and anti-thrombotic agents. Anti-thrombotic agents prevent blood clots. However, despite the possible health benefits that red wine may have, the amount of resveratrol, antioxidants, and anti-inflammatory and anti-thrombotic agents varies quite a lot between different red wine brands, and are not present in sufficient quantities to be considered health supplements. While red wine may have some cardioprotective components, studies have shown that many are drinking much more than recommended, and this has an increased mortality attributed to it. Currently, it is estimated that around 37 million US adults excessively intake alcohol, and binge drink an average of 7 drinks on an occasion. As a result, there is a higher mortality rate from excessive alcohol consumption with an estimated 95,000 deaths a year in the United States. (1)The idea that there may be health benefits from consuming red wine originates from an observation made about heart disease rates in France. Despite a relatively high consumption of saturated fat and use of cigarettes, there seemed to be a relatively low mortality rate of heart disease. This became known as the French Paradox (2). It was thought that the lower risk of heart disease was from the French people’s relatively high intake of red wine, which was thought to have some protective effects. There still is a lack of consensus on the validity of this theory, which became known as the French Paradox.There are several epidemiologic studies that look into the relationship between alcohol intake and heart disease and some have found that there may be some benefits associated with low to moderate alcohol intake. Studies have found that a J-shaped curve modeled the relationship between alcohol intake and heart disease. As suggested from its name, the curve follows a pattern in the shape of the letter J, dipping at the lowest point of the curve. This point is also known as a “sweet spot” where a light-moderate alcohol intake is associated with the lowest mortality rate (3). However, it is crucial to acknowledge that there has been no randomized controlled trial data that tests for red wine’s role in cardioprotection. So should you drink alcohol, and specifically red wine to protect your heart? In the context of a healthy diet, occasional moderate wine intake may be reasonable. “Moderate consumption” is very important here, and may be a lot less than most of us are used to.  As defined by the Dietary Guidelines for Americans, 2020-2025 edition, one alcoholic drink consists of 14 grams (0.6 fl. oz) of pure alcohol with 5 fluid ounces of wine equivalent to one drink. Moderate alcohol consumption is defined as no more than 1 drink per day for a woman (4). It is also important to avoid binge drinking, which is defined as consuming 4 or more alcoholic drinks at a time for a woman (4). Binge drinking has many adverse effects on health and can be a sign of alcohol addiction. Do you enjoy a glass of wine or a great cocktail every now and then? Great, be sure to enjoy responsibly and drink in moderation. On the other hand, if you don’t particularly enjoy wine or other types of alcohol, there is no solid evidence you should start drinking for the prevention of heart disease. Also, remember that the possible heart benefits from alcohol consumption must be balanced out with other well-established health risks of alcohol consumption like liver disease and breast cancer in women.  While occasional moderate wine intake is probably ok if it is something you enjoy, eating a healthy diet and getting regular exercise are the best practices for cardioprotection and good heart health. Sources:
4 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 Cholesterol Is Good?

Cholesterol is an important organic molecule that is essential to forming cellular membranes, producing vitamin D and is involved in making some hormones. It is a type of lipid (fat) that travels through the bloodstream, so having high cholesterol can cause blockage of blood vessels and can increase one’s risk of heart disease. There are both harmful and good types of cholesterol and the two main types are high-density lipoprotein (HDL) and low-density lipoprotein (LDL).HDL is the “good” type of cholesterol that helps remove other forms of cholesterol from your body through the liver. As a result, HDL can protect arteries and prevent plaque build-up in your blood vessels. This type of cholesterol is known as “good cholesterol” and aiming to have higher levels of HDL in your body is beneficial. Women should ideally have levels higher than 55 mg/dL and men should have levels higher than 45 mg/dL. Avoiding smoking, as well as making sure to exercise regularly and eat soluble fiber and healthy fats such as coconut oil and fatty fish are all ways to elevate your HDL levels.LDL cholesterol contributes to plaque formation in blood vessels and can lead to constricted blood flow and partial, or even total, vessel blockages. As a result, this can increase your risk for coronary artery disease, heart attack, and stroke. LDL levels should be lower than 130 mg/dL if you do not have diabetes or atherosclerotic disease, and even lower if you have an underlying condition or a predisposition to having high cholesterol, so it is best to check with your doctor to see what levels are advised specifically for you. In some cases, if you have multiple risk factors your doctor may even advise that your levels are below 100 mg/dL. Cholesterol is only found in animal food sources such as meat, poultry and eggs. Cholesterol intake should not exceed 200 milligrams a day if you are at risk of or predisposed to heart disease. For others without such risks, cholesterol intake should not exceed 300 milligrams a day. If one does have high cholesterol, there are a variety of medications you can take such as statins, fenofibrates and others to lower LDL levels.A cholesterol ratio can be used as a predictor for heart disease. It is calculated by dividing your total cholesterol number by your HDL cholesterol number. For example, if your total cholesterol number is 250 mg/dL and your HDL is 50 mg/dL, your cholesterol ratio would be 5-to-1. Having a higher ratio is indicative of a higher risk of heart disease. Research states that having a cholesterol ratio of less than 5 and around 3.5 is desirable.If you are concerned about your cholesterol levels, getting a blood test is a way to determine your amounts of cholesterol. A complete lipid profile will calculate your total blood cholesterol, LDL cholesterol levels, HDL cholesterol levels and triglyceride levels (triglycerides are another form of fat that stores calories). For total blood cholesterol, less than 200 mg/dL is considered ideal. For LDL cholesterol, less than 100 mg/dL is considered normal. For HDL cholesterol, having more than 40 mg/dL is recommended. For triglycerides, less than 150 mg/dL is considered normal.The National Heart, Lung and Blood Institute (NHLBI) recommends getting a cholesterol screening at 9-11 years of age and repeating it every few years. Men ages 45-55 and women ages 55-65 should receive cholesterol screening every 1-2 years. People over the age of 65 should get tested annually. For people who are at higher risk for coronary diseases, have diabetes, are overweight/obese or are undergoing cholesterol-lowering treatment, talk to your physician about getting tested more regularly.Commonly before a cholesterol blood test, you will be asked to fast for 9-12 hours. Be sure to consult your doctor about the proper pre-testing procedure, as not all levels are affected by fasting.Yes, it is possible to have cholesterol that is too low, but it is much less common than high cholesterol. Low cholesterol has been associated with depression, cancer, and anxiety; however, the relationship between these medical conditions and lower cholesterol needs to be further researched.Cholesterol levels are important for female health as many women are at risk of having high cholesterol, which can directly affect the blood vessels in the heart. This is important to consider as cardiac/heart disease is the leading cause of death in women. A survey found that around 45% of women over the age of 20 have elevated total cholesterol levels of 200 mg/dL or above. However, many women do not know their cholesterol levels.Importantly, women’s cholesterol levels can fluctuate and are impacted by menopause and age. For example, estrogen (a hormone that promotes HDL levels) is affected during menopause and can cause higher total cholesterol levels and lower HDL (good cholesterol) levels. As a result, it is important to be informed about your cholesterol levels and communicate with your doctor if you have any concerns or questions.Sources
5 min read
how long to breastfeed

How Long To Breastfeed?

The American Academy of Pediatrics recommends exclusive breastfeeding until 6 months of age, but many parents still want to know how long to breastfeed their children. Exclusive breastfeeding means that the baby receives only breast milk for nutrition and any medically necessary supplements, such as Vitamin D, for the first six months. Many parents will choose to continue breastfeeding beyond 6 months. The World Health Organization recommends breastfeeding until a minimum of two years, with the added suggestion that parents may continue breastfeeding even beyond 2 years. 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. If you would like to continue breast milk in your baby’s diet, this is an important question to ask when evaluating the right daycare that meets both your baby’s and YOUR needs.It is also important to be very clear with your child’s caretaker as to how to prepare and dispense breast milk. You should carefully go over how to prepare, store and save portions that are intended for use when you are not present. Feeding the baby breast milk in smaller bottles when you are not home will allow for complete usage of the breast milk and avoid unnecessary wastage. 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 extend beyond these age milestones.  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.Ultimately, breastfeeding can be a wonderful way to provide your baby nutrition while also encouraging mother-infant bonding. However, there are many ways to bond with your child even if breastfeeding is too difficult or not an option for the child or mother. Remember, although breast milk has so many wonderful nutritive and immunologic benefits, fed is best – and this can include exclusive breastfeeding, partial breastfeeding, exclusive pumping, formula or a combination of any of these! 
4 min read
How Often Feeding Newborn

Feeding For Newborn: How Much? How Often?

Feeding newborns can seem like a daunting task. Remember that each baby is unique and has different needs, but here are some general tips to keep in mind to have a happy feeding journey.At this age, your baby has a tiny belly, so prefers smaller, more frequent feedings. Your baby will likely feed 1 to 3 ounces every 1 to 3 hours. Breastfed infants often take less at each feed but they will feed more frequently than formula-fed infants. If breastfeeding, feeding frequently (every 2 hours or on baby’s demand which could be even more often) in this initial time period helps with increasing lactation and allows your baby to practice sucking and swallowing in order to efficiently empty the breast(1).For exclusively breastfed babies, the average interval between feedings will usually increase from 1 to 3 hours to 2 to 4 hours but sometimes, they may feed as often as every hour (especially in the first month) or with gaps up to 4 hours (1). Most infants will feed 8 to 12 times in 24 hours for 10 to 15 minutes on each breast (4). For formula-fed babies, the average interval between feedings is 2 to 4 hours (1). Most infants will feed 6 to 10 times in 24 hours and up to 4 ounces at a time depending on their interval.  If your baby hasn’t been fed in 4 hours during the first month of life, try gently waking your baby up to feed.  At this young age, babies can not maintain their blood sugar levels and need to be fed in order to do so. Your pediatrician can help guide you if healthy weight gain is an issue. Keep in mind that your baby goes through mini growth spurts (around 2-3 weeks, then 3-4 weeks, then 3, 4 and 6 months) and during that time their feeding demand will increase.  Your baby’s milk needs should roughly increase by about 1 ounce per feeding per month until they reach a maximum of 7 to 8 ounces per feeding. In 24 hours, your baby should not be drinking more than 32 ounces (3). If you notice your baby’s average feeding needs falling under or over this rough estimated amount, please talk to your pediatrician. In the first 3 months of life, your baby should be gaining about 25 to 30 grams a day or approximately 1 ounce per day. This is about 1 pound (16 ounces) every two weeks (2).  For most parents, there is no need to regularly weigh your baby at home, unless indicated by the doctor. During this time period, you will be seeing your child’s pediatrician frequently so they can monitor growth and development.  At 6 months, both breastfed and formula-fed infants can be introduced to solid foods. However, breastmilk and/or formula still remain their primary source of nutrients. It is natural for your infant to start gradually decreasing their breast milk or formula intake as solids are introduced, but it still remains a staple part of their diet until 12 months of age (1). At 6 months, infants drinking formula milk should consume 6 to 8 ounces of formula over 4 to 5 feedings in 24 hours. This can total anywhere between 24 and 40 oz in one day.A general rule is that your baby should be consuming about 2.5 ounces of formula a day for every pound of body weight. This is just a rough estimate, as each baby’s feeding needs are unique, so base your baby’s feeding schedule on cues your baby gives and guidance from the doctor (3).Below are suggested guidelines to follow when determining how much to feed your baby. Remember your baby is unique and these are only suggestions. Always discuss your newborn’s care with their pediatrician.Only introduce solids below if your child can break down food and swallow appropriately. Talk to your doctor about when and how to introduce nutrition beyond breast milk and formula. Only introduce solids below if your child can break down food and swallow appropriately. Talk to your doctor about when and how to introduce nutrition beyond breast milk and formula. *Healthy babies require little or no extra water for hydration.  However, in extremely hot temperatures or sometimes after solids are introduced, they may need some water. Water should not be fed to infants less than 6 months. If your baby consumes too much water, it may discourage them from drinking breast milk or formula which is more nutritious than water. During the first few weeks, your baby is rapidly growing. Dynamic changes in their feeding schedule is necessary to supplement them with enough nutrients during this growth period. Each baby is unique so try experimenting through this feeding journey to find what works best for you and your baby. Although it might be hard at times, it is a chance to get to know your baby better. If you ever have any questions or concerns, don’t hesitate to reach out to your baby’s pediatrician. Happy feeding!Sources
6 min read
Baby Formula

Baby Formula: 5 Things You Need To Know

Many people use formula to supplement breast milk and breastfeeding, and you may also be using it as the primary source of nutrition for your child. While formula is generally very safe, there are a few very important things to know about formula before using it.Ready to feed formula is formula that is pre-mixed and can be opened and given to your baby right away in most cases. Because it does not require preparation it is very convenient when compared to powdered formula. More importantly, however, is that ready to feed is much less likely to be contaminated with bacteria that can harm your baby. The downside is that ready to feed formula is almost always more expensive than powdered formula.Due to the risk of contamination in powdered formulas, it is strongly recommended that you boil water which can help to kill any contaminants in powdered infant formula. This preparation must then be cooled in order to be safely fed to your newborn. The process is as follows: boil water, then mix hot water with powdered formula, then cool to a safe temperature for your baby to consume without getting burned. One of the most common reported contaminants is a bacteria called Cronobacter. Cronobacter can cause a life-threatening infection called sepsis. It can also cause meningitis which is an inflammation of the membranes that protect the brain and spine and there have also been reports of this bacteria causing bowel damage.If you are using powdered formula it is very important that you combine the correct proportions of water and formula. DO NOT dilute infant formula as this could result in your baby getting inadequate nutrition. Follow the instructions on the formula packaging to correctly prepare the bottle for your baby with the correct proportions of powder to formula. Your baby does not need any additional water other than the exact amount that is needed to prepare powdered formula or the hydration that is already present in ready to feed formula preparations. There have been reports of contamination in formula and periodically the FDA will release announcements on the recall of certain formulas. It is very important to pay close attention to this so that you can immediately stop using any products that have been recalled. Cronobacter and Salmonella have been reported as contaminants in infant formula and have contributed to hospitalizations and even death in babies. You can use your search engine to set up alerts regarding this so that you are aware.If you are able to breastfeed or provide pumped breast milk to your child, it should be strongly considered when possible. Not only does breast milk have certain immune properties that aren’t found in formula, but you also do not have to worry about contaminants or mixing the right proportions, or heating and then cooling. Additionally, if you are able to directly feed your baby at the breast, then you also do not have to worry about sterilizing and cleaning bottles. And, breast milk is free! If you want to learn more about the basics of breastfeeding, you can download the free Breastfeeding Basics In 10 Minutes E-Book here.
3 min read
Postpartum Depression Symptoms

Symptoms For Postpartum Depression

It is critical that women and pregnant persons are supported mentally, physically, and emotionally in the days and months following delivery of a baby. While a postpartum depression screener should be done by your OB GYN at your post delivery visits, it is a good idea to be aware of the symptoms of postpartum depression. Here are some of the most common symptoms of postpartum depression, also abbreviated as PPD. Women may experience symptoms beyond those listed below as well (1). Postpartum most commonly starts about 1–3 weeks after childbirth.In order to identify symptoms for postpartum depression, it is important to be vigilant yourself, but also to communicate what you are feeling with your doctor. Many pregnant persons suffer in silence or think that feeling very sad is common and something they should just endure. Postpartum depression is more severe than having baby blues. Baby blues typically resolve within 1 to 2 weeks with no treatment.The American College of Obstetrics and Gynecology recommends all postpartum persons should have contact with a maternal care provider within the first 3 weeks following delivery. For some people, it may not be sufficiently addressed during this time, and many people will need the help of a therapist or mental health professional to help them through this time. After the 3 week visit, the need for ongoing care should be assessed. If it is determined that no interim care is needed, this visit should be followed up with a comprehensive postpartum visit no later than 12 weeks after giving birth (2).Recently, the term postpartum depression is being used less and the term peripartum depression is being used more. Peripartum depression includes depression that can happen during pregnancy or after childbirth, and thus is inclusive of the postpartum time period. By using the word peripartum, the scientific community is recognizing that depression associated with having a baby may not start after delivery, but can even begin during the pregnancy itself (3).You may need treatment for postpartum depression if you are experiencing several of the symptoms listed above for longer than two weeks, if your depressive feelings are getting worse, and you are having difficulty taking care of your child or yourself. Additionally, seek medical attention immediately if you have thoughts of suicide, thoughts of harming yourself, or harming your child.Peripartum depression, which includes postpartum depression, can be managed with psychotherapy (talk therapy), medications, lifestyle changes and building a supportive environment. If you are pregnant or breastfeeding, it is recommended by the American Psychiatric Association that talk therapy be started as first line treatment, but only if the symptoms of postpartum depression and postpartum anxiety are mild. If you are having more severe symptoms, then medication use may be needed. You will need to discuss with your doctor which medications are safe for use depending on your individual situation. There are studies to show that postpartum depression and peripartum depression can occur in about 1 in 7 pregnant persons, or approximately 13% to 14% of pregnancies (4). Postpartum depression is a serious illness that requires close follow up and medical attention. For moms experiencing perinatal depression, one or two follow up appointments with medical doctors may not be enough. Many patients with PPD will require frequent follow up and chronic care from a multitude of specialists ranging from mental health professionals as well as an OB GYN and a primary care doctor. The term peripartum depression is being used as well now by clinicians and the medical community to account for the fact that depression may happen during pregnancy as well and continue into the postpartum period. It is important to communicate symptoms to your healthcare provider and not suffer in silence. If you have thoughts of harming yourself or someone else, seek medical help immediately.Sources:
4 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
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 usually 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 have 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
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

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 the procedure.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
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
dangers of homemade douche

What Is Douching And Why Is It Dangerous?

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 clean their vaginas is through vaginal douching. This is when one washes the inside using a mix of water and fluids with a plastic bottle that sprays the fluid into the vagina. This is to help eliminate odors and further "clean" the vagina. This is not necessary because the vagina (the inside tube), as opposed to the vulva (the outside skin), does NOT need to be cleaned. The vagina is able to balance itself!Usually, for homemade douches, vinegar is mixed with water, with prepackaged douche products containing ingredients like baking soda, iodine, or even antiseptics and fragrances. While douching is not recommended, it is still 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. The vagina has a balance of many different bacteria and yeast and the good bacteria want to flourish over the “bad” bacteria or opportunistic bacteria. The “good” bacteria helps to prevent irritation and stops infections by keeping the vaginal pH optimal and balanced. Anything that decreases or kills the “good” vagina flora can allow the opportunistic bacteria (the "bad" bacteria) to overgrow—causing discomfort and even possible harm.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:Healthy pregnancies require many different things including the fallopian tubes’ ability to allow the sperm and egg to meet. Additionally, the uterine lining must be able to allow the embryo to implant safely.  Vaginal douching can change these critical areas and this can potentially increase the risk of pregnancy complications like miscarriage, preterm deliveries, or ectopic pregnancies (where the pregnancy grows outside of the uterus, typically in the fallopian tube).As mentioned, a healthy balance of bacteria in the vagina can prevent the normal vaginal yeast from overgrowing. When you eliminate this natural pH balance by douching, the yeast flourish, causing an overgrowth of yeast and can lead to symptomatic yeast infections.Additionally, people who douche are 5 times more likely to develop infections like bacterial vaginosis (where the “opportunistic” bacteria overgrow and cause a bacterial infection associated with a watery fishy-smelling discharge) compared to those who don’t douche. And, for those who believe that washing the vagina can eliminate infection, this is wrong. Douching can actually worsen an infection. By douching, you could be spreading the bacteria to other parts of the reproductive system.Pelvic Inflammatory Disease is an infection of a woman's reproductive organs. It is usually caused by certain sexually transmitted infections, like chlamydia and gonorrhea. Because douching eliminates the “good” flora and allows the “bad” bacteria to overgrown, it makes the vagina, cervix and uterus more susceptible to STIs. If you have an STI (sexually transmitted infection) like gonorrhea or chlamydia, it can then travel from the vagina through the cervix and into the uterus and out of the tubes into the pelvis and lead to the more widespread infection called Pelvic Inflammatory Disease (PID). PID can be very painful and can lead to scarring of the uterine lining and the pelvis AND it can be very dangerous as well. 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. This inflammation is sometimes also caused by STIs. Women who douche are also more likely to develop cervicitis. It may also cause vaginal irritation, in addition to other uncomfortable pain.While douching is a common practice, you should NEVER do it. There are more risks than benefits. With many experts advising against douching, we have excellent evidence to prove that it causes harm without helping at all, so it’s best to stay away from the practice. Talk to your Gynecologist to learn how to clean your vagina properly and safely. Ultimately the best way to “clean” your vagina is to understand that it doesn’t need separate “cleaning”. You can use water on the outside (this part is called the “vulva”) BUT the vagina (the inside) itself does not need anything. If you notice an unusual odor, you should visit your Gynecologist to be evaluated for the source of the unusual smell (like a retained tampon or bacterial infection).
5 min read
Weight Gain In Menopause

Weight Gain In Menopause

Many people wonder if weight gain in menopause is common. The truth is that many people going through menopause will gain weight, but it is not due to the process of menopause itself. In general, there is a trend for people to gain weight as they get older. In fact, women gain an average of 1-1.5 pounds per year between the ages of 45 and 60. In the US, almost two-thirds of women between age 40-59, and three-fourths of women over 60 are overweight. There is no good evidence to support metabolism actually slowing down, until the age of 60. During the transition to menopause (called perimenopause), estrogen production decreases, leading to a variety of symptoms such as hot flashes, decreased sexual desire, changes in skin and hair, and other symptoms. Many women also gain weight during this period, but weight gain in mid-life is not necessarily caused by menopause. Instead, weight gain is likely due to age and lifestyle. Regardless of the cause, obesity and overweight are associated with increased risk of cardiovascular and metabolic disease. From pear-shaped to apple-shapedAlthough menopause itself is not thought to cause weight gain, the hormonal changes of perimenopause is correlated with a redistribution of body fat. In fact, estrogen produced by the ovaries causes fat to be stored around the hips, thighs, and buttocks. It is thought that as estrogen decreases, the stores of fat in the body reflect this new ratio of hormones. Many women notice that rather than around the hips, thighs, and buttocks, fat begins to settle around the abdomen.Diet, metabolism, and menopauseAs women age, their metabolism slows, and lean muscle mass decreases. It’s important that they continue to build muscle in order to burn calories more efficiently and to protect bones. Both cardio and strength-training exercises will help to build lean muscle.In addition to decreased muscle mass, women's calorie needs also decrease with age. During their 50s, women need about 200 fewer calories per day than during their 30s and 40s. Eating unprocessed foods rich in nutrients, such as vegetables and lean proteins, helps to satiate hunger without exceeding calorie needs.Some studies have shown that Vitamin D and Omega-3 fatty acids can protect against metabolic disorders and reduce BMI and waist circumference in postmenopausal women. In North America, some foods such as milk and enriched cereals are often fortified with Vitamin D. Foods containing Omega-3 fatty acids include flaxseeds, walnuts, and soybeans as well as seafood. Medical solutions for menopausal weight gainSome studies show that estrogen or estrogen-progestin therapies may decrease the accumulation of total body fat and abdominal fat. However, more studies are needed in order to make evidence-based recommendations on who can benefit from hormone therapies for metabolic health. Talk to your doctor or ob-gyn if you are considering hormone therapies for any menopause-related symptoms.Sourceshttp://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife/changes-in-weight-and-fat-distribution https://www.science.org/doi/10.1126/science.abe5017https://nationalmenopausefoundation.org/weight-gain/ https://www.menopause.org.au/health-info/infographics/maintaining-your-weight-and-health https://www.menopause.org.au/hp/news/weight-loss-and-hot-flush-reduction https://pubmed.ncbi.nlm.nih.gov/22978257/ https://pubmed.ncbi.nlm.nih.gov/31941004/ 
3 min read
Swaddle When To Stop

When To Stop Swaddling Your Newborn

Many parents use a swaddle in the early days of their baby's life. However, once your baby starts to roll, it is time to stop using a swaddling on the baby. This typically happens around 2 months of age, but it can happen earlier. It is important to watch your baby for signs of rolling. If your baby shows signs of rolling, you should stop swaddling your baby immediately. Swaddling is safe only when done correctly and before a baby can roll. Swaddling your baby once the baby is able to move or roll, on the other hand, is unsafe. This is because the baby could roll over and due to the swaddle not be able to roll themselves back. Generally, if a baby is able to roll from their back to their stomach they should be able to roll from their stomach to back. However, if their hands are trapped in the swaddle they will not be able to do this. In this situation, their face could get caught in the bedding material and they could suffocate. It is very important to stop swaddling once a baby can roll. Swaddling helps to prevent the Moro reflex which is the startle reflex. In this reflex, the baby's arms go up and away from the baby's body. The baby usually awakens and is startled by their own reflex. The baby can have the Moro reflex several times during a sleep session and swaddling helps to prevent this reflex by keeping the baby's arms close to their chest. The Moro reflex, or the startle reflex, may stick around until the baby is almost 6 months old. It varies from baby to baby. Because babies will begin to roll around 2 months old and the startle reflex may last until 6 months old, there is likely going to be a period of time when your baby will awaken from the startle reflex. It is important to help your baby learn how to self-soothe so that they can put themselves back to sleep. This will help the baby sleep better and help you sleep better.It is very important to give your child lots of tummy time. When doing tummy time, make sure the baby is being supervised. Tummy time is important because it helps to build the baby's core, neck and back muscles. If the baby happens to turn themselves onto their stomach, having strong muscles will help them to flip over onto their back. Tummy time should be done every single day. You can slowly increase the amount of tummy time as your baby gets older. In the early days of their life, even 5 minutes a day of tummy time is enough. Ask your pediatrician what amount of tummy time is right for your child's age.There are many different types of swaddles. Swaddles that keep your baby cool are important. It is dangerous for babies to overheat. A swaddle is simply a cloth that you wrap in a certain way to contain the startle reflex. Some swaddles are just small thin blankets. Some companies also make swaddles that are pre stitched so all you have to do is zip them up and velcro them to keep your baby from lifting their hands. Read more about our favorite types of swaddles here. Swaddling must be stopped immediately once you see signs that your newborn can roll. If your baby is rolling, swaddling them is dangerous. This is because if they roll over onto their stomach while swaddled, they will not have the ability to roll themselves onto their back. This can cause them to suffocate and die. Rolling typically begins around month 2, but your child may begin to roll sooner than this. The rate of SIDS is highest between months 2 and 4 and this is thought to be because babies are beginning to roll and they get caught in the bedding. It is important that your baby sleeps in the same room as you (but not the same bed) during the first 6 to 12 months of life. You are more likely to hear them move or struggle if you are sleeping in the same room as them.
4 min read
Braxton Hicks Vs. Contractions

Braxton Hicks Vs. Contractions In Real Labor

Braxton Hicks contractions happen in almost all pregnancies, but some women may not be aware of them. On the other hand, some people may experience Braxton Hicks contractions very often. Having frequent and powerful Braxton Hicks contractions may lead to pregnant women seeking urgent medical care because they think that they are in labor. While the majority of Braxton Hicks contractions tend to occur in the third trimester, sometimes they can happen as early as the second trimester. Braxton Hicks contractions feel like a tightening but it is not as strong as a true contraction. Additionally, braxton hicks contractions are usually localized to the front part of the belly or the woman's abdomen. Real labor contractions are also felt in a woman's back. Because they tend to be weak, people are often able to talk while they are having a contraction and the braxton hicks contraction does not "take their breath away" as a real contraction might.A true contraction is when the muscles of your uterus tighten and relax during pregnancy. It is these contractions that help to push the baby out of your uterus into the birth canal towards the vaginal opening.A real contraction in labor is associated with a gradual increase in pain. When the pain peaks or reaches its greatest intensity, the person may also sense a hardening of the belly area. Finally, after a predictable interval, the pain tends to fade away. 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. It is unlikely for Braxton Hicks contractions to last for hours. 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. When a person is in actual labor, the contractions last about 30 to 60 seconds, and occur at evenly spaced intervals, and the time between intervals decreases as true labor progresses. The pattern tends to be more predictable in real contractions than when someone is experiencing Braxton Hicks. 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 usually 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 dilation of the cervix, which does happen in true labor. Sources:(1) Rhoads GG, McNellis DC, Kessel SS. Home monitoring of uterine contractility. Summary of a workshop sponsored by the National Institute of Child Health and Human Development and the Bureau of Maternal and Child Health and Resources Development, Bethesda, Maryland, March 29 and 30, 1989. Am J Obstet Gynecol. 1991 Jul;165(1):2-6. [PubMed](2) MacKinnon K, McIntyre M. From Braxton Hicks to preterm labour: the constitution of risk in pregnancy.Can J Nurs Res.2006 Jun;38(2):56-72.[PubMed](3) Oosterhof H, Dijkstra K, Aarnoudse JG. Fetal Doppler velocimetry in the internal carotid and umbilical artery during Braxton Hicks' contractions. Early Hum Dev. 1992 Aug;30(1):33-40. [PubMed]
4 min read
Signs Of Early Menopause

Signs Of Early Menopause

One of the earliest signs of menopause is irregular bleeding patterns in relation to your menstrual cycle. This means if you usually have a 28 or 31 day menstrual cycle and this pattern becomes irregular or you begin to skip periods, it could be a sign that you are starting to have changes related to menopause. Changes to your menstrual cycle that happen before your 40s could be a sign of early menopause. Before menopause comes a period called perimenopause, during which time a person can have physical and mood changes many years before their last period. This transitional time of perimenopause can last from 4 to 8 years. Perimenopause ends 1 year after the person's last menstrual period.Early-stage perimenopause is typically defined by occasional skipped menstrual cycles. Some women report heavier bleeding during the menstrual cycle, but longer periods of amenorrhea (lack of menstrual period) between each cycle. When a woman has amenorrhea for 60 days or more, she is considered to be in late-stage perimenopause.Menopause is when a person has their final menstrual period and it is diagnosed when you have not had a period for 12 months in a row. Menopause occurs between ages 40 and 58, and the average age of menopause (the final period) is 51. Many menopausal symptoms are attributed to fluctuating, and ultimately decreased, levels of estrogen. As the ovaries reduce estrogen production, a woman’s body may reflect that hormonal change in a variety of ways. Being in perimenopause is the most likely predictor of impending menopause. As mentioned above, a person in perimenopause will have irregular periods. There is a small subset of people who may experience only this one symptom of irregular menstruation until their periods finally end. Most other people will report a variety of other symptoms, including hot flashes, night sweats, vaginal changes, sexual changes, mood changes, and difficulty sleeping. The intensity of these and other symptoms varies greatly for all women, and they are considered a normal part of the menopause transition. In fact, it is believed that 90% of women worldwide seek treatment for menopause symptoms.Hot flashes are the most commonly reported menopausal symptom. Night sweats are simply hot flashes that occur at night, often disrupting sleep. A hot flash is the sudden feeling of heat rising from the chest and neck up to the face and down the arms. They typically last 1–4 minutes and are often followed by a cold chill. These symptoms, clinically called vasomotor symptoms (VMS) tend to be more intense and more frequent in late-stage perimenopause and postmenopause. But again, every woman experiences menopausal transition in her own unique way.Genitourinary Syndrome of Menopause (GSM), is a fancy term to refer to the collection of symptoms involving the  genitourinary tract (labia majora, labia minora, vestibule, introitus, clitoris, vagina, urethra, and bladder). Lower levels of estrogen in the body can lead to vaginal atrophy, or the drying and thinning of vaginal tissues. This can lead to a feeling of vaginal tightness and soreness or burning during sexual intercourse. The thinning tissues could also lead to urinary incontinence.The transition to menopause and postmenopause is at once unique to every woman and a normal, natural part of a woman’s life cycle. We have explored a few of the most commonly reported symptoms of various stages of this transitional time, and there are many other symptoms that can be associated with menopause transition. Talk to your ob-gyn to learn more about your unique situation.Sourceshttp://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/menopause-101-a-primer-for-the-perimenopausal https://pubmed.ncbi.nlm.nih.gov/33263443/https://pubmed.ncbi.nlm.nih.gov/31941004/https://www.liebertpub.com/doi/10.1089/jwh.2019.7913 https://pubmed.ncbi.nlm.nih.gov/29952797/ 
3 min read
Baby Teething Pain Relief

Baby Teething Pain Relief

Try out these helpful tips to see what works best for your little one:Cold temperatures can help to relieve pain in a baby's gums and emerging teeth. 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. You can also feed them cold soft foods like yogurt, applesauce, or frozen fruit, if they eat those solids. Most babies will not start on solids until 4 to 6 months old. 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.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.Another option is that parents can rub their gums gently with your clean fingers or wet gauze, with the pressure easing their discomfort.  Besides the treatments mentioned above, make sure that you avoid the following: 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.It is never okay to use a teething necklace. Teething necklaces are dangerous and they can strangle your baby. Any baby jewelry is dangerous and has the potential to break, and your little one can choke on the parts of the baby jewelry. Teething necklaces, teething bracelets, or anything the baby wears other than their well fitted clothes can pose a hazard to your child. 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 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.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

Best Period Tracking App

Tracking your period is important, but in your already busy schedule, it seems like another painful thing to add to your “to-do” list. Well, things are easier now than they use to be, and luckily there are tons of digital tools that can help with period tracking. So, what is the best period tracking app? We couldn’t pick just one, so we listed some of our favorites.This app allows you to share data with your partner which can help to plan sexual activity. Often times the burden of scheduling sex for the purpose of family planning falls on the female in the relationship. The Cycles app allows your partner to be aware of when your most fertile windows are. The period tracking app also can provide pill reminders, and also allow you to log other things like mood and ovulation.This app has an easy-to-use interface and that allows you to log your period as well as other symptoms. It also provides data on predicted ovulation. It has a free version as well as a premium version that users can upgrade to if they choose.Clue promises to be inclusive of all genders and ages. Like all the other apps, it allows you to track mood, sexual activity and also allows you to track your exercise (not a feature in all apps). It is also free with a paid upgrade available to unlock more features. All the period tracking apps mentioned above are free! While there are premium features you need to pay for, downloading and using the free versions are a no-brainer. Many of the apps also feature content on different aspects of the menstrual cycle to help you understand more about your body. Most of the interactive features of the apps mentioned above are only available through the premium versions. If you’re not sure which period tracking app you like the most, you can try out one or two and then use the one that best suits your needs.One of the biggest reason you should track your period is to ensure that you're actually having periods at all. Sometimes when women are on hormonal birth control, they can stop having full-blown periods and just get something called "breakthrough bleeding." Breakthrough bleeding means that your body is still getting all the hormones it needs from the hormones in your method of birth control—but it is not enough to create a fully-developed uterine lining (the lining gets shed during menstruation). Period tracking can help you to identify skipped periods which will then allow you to investigate why you have skipped a period. One of the first signs of pregnancy is a skipped period and other medical conditions like PCOS can also cause skipped or irregular periods. Additionally, extremely heavy periods could be a sign of fibroids or another medical issue. Being able to show your period data to your doctor can be very helpful in identifying a potential medical problem. So, what is the best period tracking app? It’s the one that works best for you! Check out the suggestions above to get started!
3 min read

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
How Fibroids Are Removed

How Fibroids Are Removed

Fibroids are benign smooth muscle tumors that grow in a woman’s uterus. Another name for a fibroid is uterine myoma. When fibroids become very symptomatic, several different surgical approaches can be used to remove them. The procedure to remove a fibroid is called a myomectomy, and the approach to a myomectomy depends on several factors. Let’s break down how fibroids are removed by the symptoms a patient with fibroids experiences. People with fibroids can experience heavy and irregular menstrual bleeding. This is one of the most common symptoms caused by fibroids. In this case, fibroids are often found in the cavity of the uterus and are typically 1-3 cm in size. These fibroids can be removed via a procedure called a hysteroscopy. A hysteroscope is an instrument that is introduced through the cervix and unto the uterus to visualize the uterine cavity. Once the fibroid is seen,  it can be shaved or chopped using specialized blades and removed from the cavity. This procedure lasts about 30-60 mins, and the patient can go home the same day. It can be performed under sedation in the operating room or even in the office in some cases.Hysteroscopy is also used prior to Invitro fertilization, to remove small fibroids or polyps that are inside the cavity. This is done to prepare the cavity for implantation of an embryo.Patients with fibroids can often feel pain or pressure in their pelvis. This can lead to urinating a lot, having gas pains, and having difficulty with bowel movements. In such situations, the fibroids are usually large and are either in the wall of the uterus or on the surface of the uterus. These fibroids can be removed laparoscopically, robotically, or via a larger incision in the lower abdomen called a laparotomy (similar to a c-section). Laparoscopic or robotic surgeries involve a few small incisions on the abdomen (about 5-8 mm in size) and the entire surgery is done using those small incisions. The fibroid is then placed in a bag and the incision around the belly button is enlarged to about 2 cm. The bag is brought to the surface of the abdomen and the fibroid is cut into pieces using a knife. This is called morcellation. It is important to remember that this type of morcellation is different than what used to be commonplace a decade ago. Gynecologic surgeons used to use a power morcellator which would cut up the fibroid, scattering small pieces of fibroids through the abdomen.  Although rare, if the fibroid was cancerous, it could spread throughout the pelvis in this way. There was much controversy around power morcellation around year 2014, after which it has essentially become obsolete. Surgeons now use hand morcellation to remove the fibroid from the abdomen. If the fibroid is extremely large (greater than approximately 12 cm), or there are many fibroids (greater than 5-6) that need to be removed, a larger incision may be needed on the abdomen. This procedure is called a laparotomy or open surgery. This incision is similar to that of a c-section. Multiple fibroids can be removed this way in a safe manner. The recovery is also longer, there is more blood loss, and patients usually have a longer hospital stay. Fibroids can also prohibit a woman from getting pregnant or carrying a pregnancy successfully to term. These fibroids can be located in the uterine cavity or in the wall. They can be seen on ultrasound and removed via a hysteroscope, laparoscopy, or robotics as outlined above. All of the procedures discussed thus far are attempts to remove a fibroid while preserving a woman’s uterus and her fertility. If these treatment modalities fail or a woman does not wish to preserve her uterus anymore, a hysterectomy is recommended.  A hysterectomy is a surgical procedure that removes the uterus along with any fibroids contained in it. Fibroids can be removed using many different techniques. These include a procedure called a hysteroscopy, robotic surgery, laparoscopy, laparatomy, or even a hysterectomy. Each individual case is treated and handled differently. Sources:De La Cruz MS, Buchanan EM. Uterine Fibroids: Diagnosis and Treatment. Am Fam Physician. 2017 Jan 15;95(2):100-107. PMID: 28084714. https://pubmed.ncbi.nlm.nih.gov/28084714/https://www.womenshealth.gov/a-z-topics/uterine-fibroids
4 min read
What Is Menopause Age

At What Age Is Menopause Going To Happen To Me?

Many people wonder about what age menopause will occur. Menopause means that a person has gotten their final menstrual period. Menopause is diagnosed when a person has not had their menstrual period for 12 months in a row. The average age of menopause in a woman (the final period) is 51. Although 51 is the average age, there is a wide range in the age for menopause to occur. This range is between the ages of 40 and 58. Leading up to menopause, women have many changes physically and mentally several years before their final period. This transitional time is called perimenopause, and it is unique to every woman. On average perimenopause lasts from 4 to 8 years, and it ends 1 year after the final menstrual period.As mentioned above menopause is defined when a person has had no periods for 12 consecutive months. There is also some lab work that your doctor may order to confirm the transition from perimenopause to menopause. The first lab test is testing your blood level of a hormone called FSH, or follicle stimulating hormone. An FSH level that is higher than 35 on two separate tests usually coincides with the transition to menopause. Another test your doctor may order is an estradiol level. A person who is in menoapuse will have a low estradiol level, in the range of 0 to 20. Symptoms also will appear or become more prominent if you are already having symptoms. Some common symptoms you may experience include hot flashes and night sweats. Many people also experience anxiety, increased irritability and even depression. There are a variety of early symptoms of menopause that people may experience. One thing you may notice is an irregularity in your menstrual cycle. People may also experience fatigue and a feeling of being very tired. Additionally, you may have trouble sleeping or even experience insomnia. Many people who are in perimenopause or menopause also have hot flashes and may also have unwanted weight gain. If you think you may be experiencing these changes, you should talk to your doctor about your options for symptom relief and treatment.
2 min read
Teether Molars

Best Teether For Molars In Baby?

Teething hurts! Every parent needs to have a great teether handy for when the molars start to come in. A teether for molars is important because it is especially painful when these larger teeth in the back of the baby's mouth come in. Here are some of our favorite teethers that are commonly used by patients and doctors alike.The banana-shaped teether is a great option because of the design. The loops on either side of the teether means that it is easy for the baby to grab the teether. Given that you will want to rinse and clean anything the baby drops at a young age, a teether that is less likely to fall is always a great idea. Older babies will also be able to more easily manipulate the teether into a position that helps soothe their pain. The design of the teether also allows it to get to the teeth in the back of the mouth. It also has bristles so you can use it when you begin to brush your baby's teeth after they come in. It is a good idea to buy at least two so that you always have one handy to use while the other one is being cleaned. Teether MolarsThe cactus shaped teether is also a great option for molars because of the three prongs. It has multiple teething surfaces and this can help your baby easily manipulate the teether into a comfortable spot. It is also BPA free and has bristles. This means it can also double as a toothbrush when needed. Though it is a little harder to hold on to because it does not have loops like the banana teether, it has 3 far reaching areas to get to those tough to reach molars in the back of your baby's mouth. Having one of each of these teethers is likely a good idea. This is a great option as your baby's first teether and likely less useful for molars. It is great though because it can be easily cleaned in the dishwasher for frequent use. It also has a bumpy surface which helps with soothing sore gums and tactile stimulation. Finally, it's easy to put in the freezer and give to your baby as something soothing and cold for their first few teeth. So which teether should you buy? Most families will need at least 4 to 8 of teethers for the first year of life. Especially before 6 months of age, babies are very fragile and you want to make sure that the teether is always very clean, if not sterile, before they use it. Given that your baby is likely to drop their teether frequently, it's important to have plenty of back up options. This is important so you are not spending your precious time washing teethers throughout the day. Remember to never use teething necklaces or any teethers that have smaller parts which could come apart inside your baby's mouth. Remember to pay attention to your baby when they are using their teether.
3 min read

Gestational Diabetes Symptoms

Gestational diabetes symptoms can be subtle, making it difficult for patients to realize that their blood glucose may be high. Gestational diabetes mellitus (GDM) is a high blood glucose condition that happens during pregnancy and occurs in about 6% of pregnancies (1). Many women with gestational diabetes do not experience any symptoms. However, it is possible that you may experience some symptoms of gestational diabetes, and one of these may be increased thirst. You may also sweat more than usual when working out. You may also be hungry throughout the day. Other gestational diabetes symptoms may include abdominal swelling and bloating, frequent urination, or low blood sugar episodes and even depression. Because pregnancy itself has so many changes, it may be difficult to distinguish between normal pregnancy changes and symptoms of gestational diabetes.Gestational diabetes is usually screened for around the 28th week of pregnancy, but it can occur earlier. If you have had gestational diabetes in a previous pregnancy, your doctor will likely screen you at 14 weeks or maybe even sooner. Unless you have other risk factors, like a previous pregnancy with GDM, there is limited utility to screening before 24 weeks (2). If it's not properly managed, gestational diabetes can have potentially serious health effects for both mother and baby. In general, every pregnancy has some degree of increased insulin resistance. Because placental-produced hormones increase through the second trimester and much of the third trimester, insulin resistance is greatest in the third trimester. The increase in insulin resistance is primarily the result of the effects of several placental hormones, including human chorionic somatomammotropin (human placental lactogen), progesterone, prolactin, placental growth hormone, and cortisol. Therefore, just the placenta alone increases a person’s risk for gestational diabetes. But, the majority of people will not have a pregnancy complicated by GDM.Gestational diabetes is a temporary condition that occurs during pregnancy and affects how your cells use sugar (glucose), one of the main sources of energy. Your body breaks down the carbohydrates you eat into glucose and sends it into your bloodstream. The glucose then travels to your cells with the help of insulin, a hormone made by the pancreas.The pancreas normally makes more insulin when your blood sugar is high, such as after a meal, to keep glucose levels stable. But, if you have gestational diabetes, this process doesn't work properly and leads to high blood sugar levels. Too much glucose in your bloodstream can be harmful to you and your baby. Patients with gestational diabetes can have a high degree of insulin resistance, which makes it harder for the insulin that’s being made to work properly to reduce your blood sugar.About 6- 7% of pregnant persons get gestational diabetes. Some studies report a higher prevalence of around 11% in Asian populations (3). Some of the risk factors for gestational diabetes are advanced age (≥35 yrs.), obesity, excessive gestational weight gain, excessive central body fat deposition, family history of diabetes, short stature (<1.50 m), hypertension or preeclampsia in the current pregnancy, history of recurrent miscarriage, GDM during prior pregnancies and polycystic ovary syndrome. In addition to the most common factors, a sedentary lifestyle may also be a risk factor for GDM.Gestational diabetes in a mother can lead to excessive weight gain in the baby, which can increase the risk of complications during delivery and beyond. Babies whose mothers have had poorly controlled gestational diabetes are themselves at higher risk of developing type 2 (adult-onset) diabetes later in life.  In addition to risks to your baby and your pregnancy, there is also a risk to you. The lifetime risk of going on to develop Type 2 Diabetes in individuals who have had gestational diabetes is an alarming 70%. One to two months after delivering your baby, you should make an appointment to have your blood glucose checked, and you should continue to monitor your blood glucose at regular intervals with your primary care physician.If you think you are experiencing increased thirst or other symptoms of gestational diabetes, schedule a visit with your doctor as soon as possible. The only way to determine if you have GDM is by testing for it. If you do, treating gestational diabetes is extremely important for your baby's health and your health. Sources:
5 min read

Low Back Pain In Pregnancy

As many as two thirds of pregnant people experience low back pain during pregnancy. In fact, it's one of the most common complaints reported to doctors during pregnancy (1).As you gain weight during pregnancy and begin to carry more weight in front, you may compensate by leaning back. Leaning back changes your posture and puts strain on the lower back. This shift in the center of gravity causes more stress on your spine and back muscles. Besides putting strain on your lower back, leaned back posturing makes it difficult to manage intrabdominal pressure and connect to your core muscles, which are the muscles that support and stabilize the spine.  Additionally, the growing baby inside your uterus can put weight and pressure on nerves leading to lower back pain. This nerve compression can also cause hip, thigh or pelvic pain, shooting pains down your legs, or a tingling sensation in your legs.Finally, the body produces a hormone called relaxin during pregnancy, which loosens and relaxes your joints and softens ligaments. This helps prepare your body for labor and delivery. Ligaments in your body support the weight of your uterus as it expands, and they can be stretched by the weight of your growing baby. The stretching of these ligaments may also cause pain.Acetaminophen (the generic name for Tylenol) is generally considered safe to use during pregnancy, although you should consult your doctor before taking it. Aspirin and ibuprofen are not recommended during pregnancy. Acetaminophen is a Category-B drug and is generally considered safe for use during pregnancy, especially during the second and third trimesters. It is important to talk with your doctor regarding how much acetaminophen you can take safely. NSAIDs (Advil, Motrin) are classified as Category D and should not be taken during pregnancy.For severe back pain due to disc herniations and nerve impingement, it may also be possible to get a local injection of steroid to reduce inflammation and help with pain. This should only be done under the advisement and direction of your physician. No matter what, always check with your doctor and Ob before taking medications during pregnancy. Even if they are considered to be safe, there is no substitute for having your doctor advise you on what to put into your body during pregnancy. While having pain in your lower back is common during pregnancy, any type of excessive pain or unusual symptoms should prompt you for a workup for something more serious. Pain that is relieved by changing positions is likely due to the pregnancy. Changing positions, using a support belt, , and getting a massage are all ways to help alleviate low back pain in pregnancy. If the pain is excessive or severe, talk to your doctor about the possibility of taking medications that are safe to use during pregnancy for relief. Sources:1. Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev. 2015 Sep 30;2015(9)
https://pubmed.ncbi.nlm.nih.gov/26422811/2. Fontana Carvalho AP, Dufresne SS, Rogerio de Oliveira M, Couto Furlanetto K, Dubois M, Dallaire M, Ngomo S, da Silva RA. Effects of lumbar stabilization and muscular stretching on pain, disabilities, postural control and muscle activation in pregnant woman with low back pain. Eur J Phys Rehabil Med. 2020 Jun;56(3):297-306.
https://pubmed.ncbi.nlm.nih.gov/32072792/3. Silva JBG, et al. Acupuncture for low back pain in pregnancy – a prospective, quasi-randomized, controlled study. Acupunct Med. 2004; 22(2):60-67.
https://pubmed.ncbi.nlm.nih.gov/15253580/
6 min read

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

Sustainable Underwear Brands

Looking to live that sustainable life? With the fashion industry being the second largest contributor to carbon production, even your underwear choices can have a huge impact. While some shop for form (lace, anyone?) and others look at function (no wedgies, please!), underwear is a great place to dip your toe into the world of sustainable and ethical fashion, especially since these are not items you would buy second hand, which is the purest form of sustainability.  Their organic cotton underwear are made with eco-friendly materials including Global Organic Textile Standard cotton and Oeko-Tex certified dye, are made in a Fair Trade Certified factory, and use renewable energy in their supply chain.  They work with an NYC non-profit to recycle old undergarments, turning them into insulation and rug pads. Their body positive sizes range from 2XS to 3XL. Hara means green in Hindi, and these bamboo-based pieces fit the bill of being green.  This Australia-based company focuses on conscious creation of items for their customers and our planet. They reuse most of their offcuts to minimize textile waste, manufacture locally to reduce carbon production, and use low impact non-toxic dyes in all of its products. The company claims to be “Earth’s FavoriteTM Clothing,” and with soft, GOTS cotton and Fair Trade practices, they are well on their way.  80% of their organic cotton comes from India and they keep their production local, which saves energy.  Plus, organic cotton uses 81% less water than conventional cotton.  They offset their carbon production through investments in global wind energy and use post-consumer recycled paper for packaging.  While they have used wool in the past, hemp and elastane are currently the only non-cotton items in any blends.This popular Danish brand only uses biodegradable, recycled, renewable, or natural textiles, as well as employing techniques which reduces waste and increasing fabric resilience. Vegans take note, this does include recycled wool. It uses renewable energy and is an active member of 1% For The Planet, which means they give at least 1% of revenue to environmental causes. They also have a formal statement regarding workers’ rights. With a name like that, this Australian company was made for underwear.  They use organic bamboo, organic cotton, LYOLYTE® (bamboo lyocell), and minimal spandex, all vegan and PETA approved.  The bamboo is grown using rainwater, produces oxygen, and absorbs carbon dioxide.  Once formed into LYOLYTE®, it is biodegradable and compostable and has little water or fabric waste in processing.  Boody audits their factories and partnered factories in China, India, and Vietnam and ensures workers’ safety and living wages.  They use eco-friendly packaging and printing materials.If you want to take it a step further, period underwear is where it’s at.  The average person who menstruates uses around 11,000 disposable period products in their lifetime, while approximately 20 billion sanitary napkins, tampons and applicators are dumped into North American landfills every year.  Period underwear are a comfortable, safe, and sustainable alternative.This brand encompasses Thinx (period underwear), Thinx BTWN (period underwear for teens), and Speax (underwear for bladder leaks). The company’s initiatives include the EveryBody campaign that educates and empowers young people and MAS’ Women Go Beyond initiative at their facility in Sri Lanka.  Their underwear materials are all OEKO-TEX certified to be non-hazardous.Known for its menstrual cups, this B-corp certified company launched period underwear in fall of 2020. Their offerings absorb up to three regular tampons worth of blood and are available in a variety of styles. They use recycled plastic water bottles to make the polyester, which are certified PFAS-free and certified OEKO-TEX. They give 2% back to fund initiatives in education, sustainability, and menstrual health. They are ethically made in Sri Lanka with partners that work to improve their communities by working for things like access to clean drinking water.These brands are just the tip of the iceberg when it comes to sustainable intimates, and companies are based all over the world.  To reduce carbon emissions with shipping, look out for brands based near you!  Hopefully changing to sustainable and ethical underwear will just be the start of your sustainable journey.  Trust me, your nether regions and your planet will thank you!
4 min read
Cord Blood

Cost For Cord Blood Banking

Cord blood banking is something to consider if you are pregnant. Cost for cord blood banking can be a barrier for many patients who are considering doing it at the time of birth. Cord blood transplants have been successful in correcting metabolism, blood, immune diseases amongst others. Over 35000 transplants of cord blood have been performed in both children and adults (1). There are costs that come with the collection, storage and usage of cord blood. Cord blood is the blood that is left in the umbilical cord and placenta after a baby is born. The blood from the umbilical cord has hematopoietic stem cells that give it properties that can treat and potentially cure certain diseases. Hematopoietic stem cells are different from other cells in that they can grow and multiply into different types of cells in the body. Other cells can only make copies of themselves. These cells can either be found in the blood or bone marrow in both children and adults. (2)Cord blood banking is the collection and storage of cord blood at the time of birth so that it may possibly be used later for the treatment of diseases. You will need to coordinate with your doctor as well as the company you will be using for storage of the cord blood to ensure that this happens correctly at the time of birth. Your Ob-Gyn will collect the cord blood after the baby is born when the umbilical cord is cut and clamped. This process takes around 10 minutes. Note that consent must be given before the birth and not all hospitals may provide this service.  If your baby arrives much earlier than expected or your pregnancy is threatened by high risk complications, your doctor will prioritize the health and well being of you and your child over collecting cord blood. It is a good idea to discuss cord blood banking with your Ob early in your pregnancy if it is something you are considering.Cord blood can be used to treat many diseases. According to ACOG The American College of Obstetricians and Gynecologists over 70 diseases can be treated by cord blood. Whether as a primary treatment or as experimental research treatments they have proved to be beneficial for the treatment of certain diseases. These can include: There are two types of banking to store cord blood: Public cord blood banks: Blood stored in these types of banks are usually used for Allogeneic transplants since the blood can come from any other person. Blood is stored on a donation basis and therefore there is no cost to collecting, processing or storing the blood. While some cases involve a directed donation where you may donate to a family member in need, most of the time the blood can be used by anyone that matches. Cost for Public Cord blood banking: $0Private cord blood banks: Private banks are used for autologous transplants or directed donation. This type of storage requires a yearly fee. Donations for directed use may sometimes be stored free of charge depending on the bank. When storing blood at a private bank, you need to consider the following costs: charges for collecting and processing blood, as well as storage fees Cost for Private Cord blood banking: $575-$1495 along with a $150-$185 cost per year for storage. These numbers reflect the costs indicated by the following private banks:  There are around 30 private banks in the US. Costs vary based on the bank and state. Most banks have offers for storage if you purchase it for a certain number of years of storage (e.g 20 years) or lifetime. Storage fees for most banks start after the first year of storing it. (3, 4, 5)Considering this blood could save someone’s life and public banking has no cost, saving cord blood could be beneficial. Because private banking does have a significant cost associated with it plus a yearly storage fee, going this route requires more consideration. The diseases that cord blood can potentially treat are still limited and the overall likelihood of your child developing one of these conditions is low. Of course, if you are financially able, having cord blood available for your child to possibly use later in life is always a great idea, but it may not be practical for many families. If your child does need to be treated for a disease that cord blood can help with, when compared to bone marrow transplant, cord blood is considered more likely to match as well as less likely to be rejected. Cord blood is also easier to collect with no pain or interference with the birth while bone marrow can be painful and risky to the donor. Cord blood can be used long after being collected as it can be stored, while bone marrow cannot. However when compared to bone marrow, it contains less stem cells, often requiring multiple donations per transplant. It is however possible that not enough cord blood is collected. This is especially true if there are complications during the birth in which case collecting blood becomes second priority to yours and your baby’s health. (2)Sources: 
5 min read

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

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
Implantation Bleeding Pregnancy

Can Implantation Bleeding Be Heavy ?  

It is unusual for implantation bleeding to be heavy. Heavy bleeding is the type of bleeding that a person would experience on their period. Implantation bleeding is usually a light spotting that caused by the fertilized egg implanting itself into the uterine wall. Spotting or light bleeding is when there are a few drops of blood on your underwear. It is usually not enough blood to require using a panty liner or pad. Implantation can occur anywhere from 6 to 12 days after ovulation, but it usually happens about 7 days after ovulation. The earliest signs of implantation are usually light pink or brown spotting. It is also possible to experience implantation cramping during this time. The bleeding usually lasts for one to three days, but some women experience spotting for up to a week. If you're having any other symptoms including cramping or fatigue, it's best to talk with your doctor before taking any over-the-counter medications or vitamins.Implantation bleeding is a sign of pregnancy if the bleeding is in fact due to the fertilized egg implanting into the uterine wall. The best way to determine if you are pregnant is to take an at home pregnancy test as well as schedule a visit with your doctor to have a blood test done for pregnancy. Other causes of bleeding include an ectopic pregnancy, a miscarriage, your menstrual period, or breakthrough bleeding. Bleeding from a miscarriage or your menstrual period tends to be heavier and very noticeable. Breakthrough bleeding tends to not be as heavy for most people.  If you experience vaginal bleeding between two weeks before and two weeks after ovulation, it could be implantation bleeding or something more serious, like an ectopic pregnancy. An ectopic pregnancy occurs when a fertilized egg implants itself outside of your uterus. This location is usually in the fallopian tubes, but can be elsewhere. Because it is impossible to tell if someone is having an ectopic pregnancy without a medical evaluation involving a doctor, it is important to schedule an in person appointment with an Ob Gyn as soon as you think you may be pregnant. The doctor can draw blood, perform a physical exam, and also do an ultrasound to begin to evaluate the cause of bleeding.Breakthrough bleeding can occur with the use of any hormonal birth control, like birth control pills, a hormonal IUD, a birth control implant, a ring, a patch, or a shot, like Depo-Provera. Out of these birth control methods, breakthrough bleeding is more common with low-dose and ultra-low-dose birth control pills, the implant, which is placed under the skin of the arm, and hormonal intrauterine devices (IUDs).After IUD placement, women often have spotting in the first couple months after placement, and it should resolve by 6 months. With the birth control implant, the bleeding can continue beyond the first few months. Implantation bleeding is not heavy bleeding. It is usually light bleeding or spotting. If you are having heavy bleeding, please contact your doctor right away. Sources:https://medlineplus.gov/ency/patientinstructions/000614.htmhttps://www.acog.org/womens-health/experts-and-stories/the-latest/what-you-should-know-about-breakthrough-bleeding-with-birth-controlMummert T, Gnugnoli DM. Ectopic Pregnancy. 2021 Dec 9. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 30969682.https://pubmed.ncbi.nlm.nih.gov/30969682/
3 min read
Breast Feeding Nipple Cream

Nipple Cream When Breastfeeding? What Are Your Options?

While breastfeeding your baby has many benefits for both mom and baby, it is not exactly "easy" to do. Breastfeeding has many challenges and one of them is sore and cracked nipples. You can also have painful nipples if you are pumping breast milk as well for your baby. When breastfeeding, buying an appropriate nipple cream can be very helpful in your breastfeeding journey. If breastfeeding parents are not in pain, they are more likely to be able to breastfeed their baby longer and also with more enjoyment. So, what is the best nipple cream while breastfeeding? Let's take a look at some of the popular products on the market so you can understand your options. Be sure to purchase a nipple cream for breastfeeding either towards the end of your pregnancy or immediately after your child is born, as you may start to experience sore nipples right away. The early days of breastfeeding are the most important in terms of establishing your breast milk supply. This means getting the baby to the breast very often (almost every 2 to 3 hours), or using the breast pump every 2 to 3 hours. If your nipples are in pain, then this can directly affect your ability to not just feed but it can also affect your milk supply long term. You will want to be as prepared as possible for your breastfeeding journey.This is one of the most popular breastfeeding products out there. In order to minimally expose your newborn to this, place the ointment onto your nipples just after you have finished a feed. One of the best parts about this nipple cream is that it comes in a variety of sizes so you have options. We recommend buying 2 to 3 of the smaller sizes and keeping it in different locations in your house and one in your handbag. That way you aren't running around looking for it when you need it.This nipple cream is popular because it is a lanolin free option (but remember that many breastfeeding persons use lanolin nipple cream without any problems). Motherlove nipple cream is made of extra virgin olive oil, beeswax, shea butter, marshmallow root, and calendula flower. This nipple cream is also USDA Certified Organic, and it is also non-GMO. One of the downsides to this nipple cream is that it only comes in jar form. It is not as convenient for being on the go and of course the glass of the jar can break. You may want to have this option at home and use the Lanolin breastfeeding nipple cream for when you are on the go.A nipple shield can help in the early days of breastfeeding by protecting the nipple and by making it a little easier for the baby to latch. For parents who are concerned about putting a cream or substance on their nipple, nipple shields can be a way to help with sore and cracked nipples. Unfortunately, nipple shields do not work well for everyone and keep in mind that they must be sterilized and cleaned just like a bottle. However, it is a good option to have one available to you if you are struggling with nipple pain or getting the baby to latch onto the breast properly. Many people will also use a small amount of breast milk over their nipples before or after a feed to help soothe sore nipples. People really like this option since it is viewed as the most natural and many parents are concerned that any products applied to their nipples could be harmful for the baby to ingest. If using breast milk as nipple cream works for you, it is a great option. However, for most breastfeeding parents, this is unlikely to be enough soothing for nipples that are painful and cracked from breastfeeding and pumping. Many people use the above options for nipple cream safely during breastfeeding. It is always a good idea to discuss any products you use with your baby's pediatrician.It is important to be as prepared as possible for breastfeeding. In addition to having nipple cream handy, you may also want to consider a nipple shield. Remember to talk to your doctor about what is safe for your baby. While breastfeeding should not be painful, the reality is that until your baby learns how to properly latch, it can be a painful learning process. Learning how to breastfeed is something that requires guidance and practice, so do not be discouraged if it doesn't "happen naturally." If you want to learn how to breastfeed newborn babies, download Femhealth's physician developed educational guide for free at learn.femhealthproject.com/breastfeeding.
5 min read
Symptoms Of An Overactive Thyroid

Symptoms Of An Overactive Thyroid (Hyperthyroidism Symptoms)

Hyperthyroidism, also known as “overactive thyroid”, is a condition where the thyroid gland makes too much thyroid for what your body actually needs. This will alter the body’s organ functions and generally push them to work too intensely (1).The thyroid is a small gland located in the front of the neck. It makes thyroid 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 skin (1,2).The most common cause of hyperthyroidism is Grave’s Disease. It is an autoimmune disorder where the thyroid is attacked by your immune cells and is stimulated to produce too much thyroid hormone (1,2). Nodules are lumps in the thyroid that are generally benign and not cancerous. However, if the nodules are overactive, as in the case of a single toxic nodule or a toxic multinodular goiter, these can lead to too much thyroid hormone in the circulation (1).The thyroid gland usually makes enough hormone to send out into the body, plus enough to store. Thyroiditis is a condition where an infection can cause the thyroid gland to leak out the thyroid hormone that it normally stores, raising thyroid hormone levels in the bloodstream (1,2).The thyroid gland needs iodine to make thyroid hormone. Having too much iodine in the diet can cause or worsen hyperthyroidism in an already susceptible gland. Since the symptoms of hyperthyroidism can potentially overlap with hypothyroidism, other endocrine diseases, or even non-endocrine causes, the best way to know if you have hyperthyroidism 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 ofcare or follow-up. 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 low, it could (in combination with a high thyroid hormone level) indicate hyperthyroidism since high thyroid hormone levels will cause 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 levels are abnormally raised*, it indicates hyperthyroidism (2). It is important to note that 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 stimulating immunoglobulin (TSI) is the specific TSH receptor antibody that sticks to thyroid cell receptors and activates them, causing hyperthyroidism in Grave’s Disease. If there are elevated levels of TSH receptor antibodies present in the bloodstream, specifically TSIs, this turns 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 and thyroid  imaging to recommend a plan of care.Thyroidectomy is a surgery that can be partial (removing a part of the thyroid) or total (removing the whole thyroid).Medications such as methimazole or propylthiouracil can be administered to block the thyroid gland’s ability to make new hormones.Radioactive iodine can be administered orally as a small capsule. Since the thyroid needs iodine to make more thyroid hormone, it takes up this oral iodine laced with radioactivity, which then destroys the cells that take it up and prevents them from making more hormone.  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

Thyroid Eye Bulging And More Thyroid Eye Disease Symptoms

Thyroid eye disease is a condition that occurs in nearly half of patients who have underlying autoimmune hyperthyroidism. Because hyperthyroidism occurs more commonly in women, thyroid eye disease is also seen more often in women. While thyroid eye disease symptoms are often seen with Graves’ disease, it can also be associated with hypothyroidism and even in some patients with normal thyroid function. Often, eye symptoms will present around the same time as systemic thyroid symptoms, but they sometimes can show up before the start of thyroid dysfunction, or even months after. Thyroid eye disease symptoms can happen in one eye, both eyes equally, or may affect one side more than the other. Early diagnosis is important so that patients can be referred to a specialist (such as an oculoplastics doctor) for close monitoring, and treatment can be started if needed. Thyroid eye disease has two general phases – an active or progressive phase  and a stable or chronic phase. In the active / progressive phase there is ongoing inflammation and change. Patients may notice that their symptoms fluctuate, and they may notice changes in the appearance of their eyes. The active phase lasts on average from 6 months to 2 years. Once patients enter the chronic / stable phase of the disease, their symptoms are usually stable and don’t change quickly. For example, if a patient has eye bulging or eyelid retraction, this will likely not change once the stable phase has been reached, though it’s important to note that these symptoms do not typically reverse in the stable phase. Doctors will typically wait, if possible, to do surgery during the stable phase. This is because the predictability of surgical outcomes can be better predicted during the stable phase. Rarely, patients may experience re-activation of their thyroid eye disease months or years after entering the stable phase. If you think you have thyroid eye disease, make an appointment to see an ophthalmologist or an oculoplastic surgeon as soon as possible. 
4 min read

PGT Testing: What Is Preimplantation Genetic Testing In IVF?

Preimplantation genetic testing (PGT) is a way for people planning to have children through IVF (in vitro fertilization) to know if their embryos are at risk of a genetic condition prior to implantation for pregnancy. Types of PGT testingThere are three types of PGT, named for the type of genetic issue at hand: preimplantation genetic testing for aneuploidy (PGT-A, previously referred to as PGS), preimplantation genetic testing for monogenic disorders (PGT-M, previously referred to as PGD), and preimplantation genetic testing for chromosomal structural rearrangements (PGT-SR). Let’s get into what each of these means.In humans, each cell normally contains 23 pairs of chromosomes, for a total of 46. Twenty-two of these pairs appear the same in men and women. The 23rd pair is the sex chromosome pair and, thus, is different between males and females. Aneuploidy means an incorrect number of chromosomes being present in an embryo, and therefore PGT-A involves analyzing a sample of embryonic cells to determine whether it has the correct number of chromosomes (46). This approach helps identify embryos that are more likely to implant and turn into a healthy pregnancy. Embryos with an abnormal number of chromosomes will typically fail to implant, result in miscarriage, or result in fetuses with Down Syndrome, Turner’s Syndrome, or a handful of the other rare chromosomal patterns that increase the risk of birth defects and developmental delays but can still make it to live birth. Because males and females have different chromosomal makeup (46, XY versus 46,XX), genetic sex can also be identified through this type of testing. In short, PGT-A testing can help provide information on which embryos are most likely to result in a healthy pregnancy, and is particularly relevant as women age. While the majority of embryos created by a 30-year-old will likely have the correct number of chromosomes, the opposite is true by the time the late 30s are reached, and by the mid-40s, it becomes nearly impossible to obtain an embryo that tests normal by PGT-A.PGT-M screens for specific genetic mutations the embryos are known to be at risk of inheriting. This typically happens after one or both parents are found to be carriers of a relevant genetic mutations. Some genetic mutations, such as the cancer-causing BRCA1 mutation or the mutation causing Huntington’s Disease, can pose a risk even if only one parent has the mutation and passes it along (dominant inheritance). For the majority of genetic diseases in humans, both parents have to carry the same mutation and pass along the abnormal copies to the embryo for there to be a possible risk (recessive inheritance). Prior to PGT-M, even if you knew of a genetic risk, you could only find out if your child had an inherited genetic condition by undergoing amniocentesis in the second trimester, or by waiting after they were born. For a mutation with severe consequences, pregnancy termination could be considered if a diagnosis was confirmed by amniocentesis, but this is of course incredibly traumatizing for the family, and not always an easily available procedure. PGT-M allows you to learn about possible conditions in your child before you know anything about them, giving you the option of deciding whether or not you want to transfer an embryo that carries this risk.Finally, PGT-SR is performed if a parent is known to have a genetic translocation or inversion, meaning that their own chromosomes are arranged in a unique fashion. These genetic changes in a potential parent increase the chances of aneuploidy in their embryos, and thereby increase the risk of miscarriage. Therefore, if a genetic translocation or inversion has been diagnosed, PGT-SR can be performed.Being able to access this information sounds very exciting, but there can be risks as well. The risks of preimplantation genetic testing include:1. Technical error: Embryo biopsy can cause damage to the embryo, though in skilled hands this is incredibly unlikely.2. False positive/false negative results: In some cases, PGT will fail to detect a genetic disorder or give false positive results when there isn't actually any abnormality present at all. The rates of these false results vary by genetic testing laboratory.3. The chance that one of your embryos will be accidentally transferred instead of the tested embryo you wanted transferred. [not sure about including this, it’s not really a risk specific to PGT testing]4. Unclear guidance about what to do with certain embryo results. The biggest issue here is likely that of mosaicism, where certain embryos may have a mixture of cells with the correct and incorrect number of chromosomes. The risks of transferring mosaic embryos are still being researched, though likely the biggest risk is just that if the embryo primarily turns out have the genetically incorrect number of chromosomes, a miscarriage will likely follow. Embryos that may be able to turn into liveborn babies but carry certain genetic abnormalities may also be a gray area in what is considered ethical to transfer.Additionally, PGT testing is not a catch-all. There is no test that will 100% reduce the risk of genetic issues for one’s children. There are many genetic diseases that cannot yet be detected by PGT screening.When Is PGT recommended?PGT-A can be offered to anyone who desires this information and is undergoing IVF, however the increase in success rate attributable to using this technique will correlate positively with age. Typically more embryos are likely to be abnormal than normal by the mid-late 30s. That said, many couples desire having as much information as possible about their embryos, and will pursue PGT-A regardless of age. PGT-M or PGT-SR are offered and/or recommended only if at least one parent has a relevant genetic mutation that would render the technique relevant. Whether you decide to have PGT testing on your embryos is a personal decision, and it is always a good idea to discuss any concerns or questions about it with your doctor. 
5 min read
Is PCOS Treatable?

Is PCOS Treatable?

Polycystic Ovary Syndrome, abbreviated as PCOS, is the most common hormonal disorder in females of reproductive age (1). Fortunately, PCOS is very treatable! Females are at higher risk for PCOS if they have family members with PCOS or are obese (2).When talking about treating PCOS, you must treat all the different PCOS symptoms that can affect a person. These include insulin resistance, diabetes, weight gain, fertility issues, irregular menstrual cycles, pelvic pain, excessive hair growth (hirsutism), alopecia, acne, acanthosis nigricans (patches of thick, darkened, velvety skin in armpits, neck, and groin), skin tags, and mental health struggles like depression.Treating PCOS involves treating each individual symptom of it from treating the insulin resistance to treating skin changes. Keep reading for more details.Treating PCOS acne should start with the basics of good skincare. Cleanse your face twice a day. Also, try using a benzoyl peroxide containing cleanser or a spot treatment cream that has benzoyl peroxide. If unable to tolerate benzoyl peroxide, use a gentle cleanser such as cerave hydrating cleanser or cetaphil gentle skin cleanser. Birth control can be a great treatment through your dermatologist or your gynecologist Some patients can also benefit from treatment with a drug called spironolactone, which also helps with hirsutism. Spironolactone is a great option for PCOS related acne (and really all acne in women). Spironolactone is generally prescribed by a dermatologist. It is great for adult women but can be used in adolescence as well. Patients who are also on medication for high blood pressure should discuss this with their doctor, and there may be a need to monitor potassium in women who are on this drug. Spironolactone should be avoided pregnancy.  In PCOS weight gain, the first step to battle this is exercise and calorie-restrictive diets. This will help patients with weight loss and will also help with insulin resistance.Your doctor may recommend a hormonal contraceptive for helping with PCOS because 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 doctor 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.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. PCOS is a challenging condition that affects many persons, but it is treatable. Because it affects so many different parts of your body, treatment usually involves input and opinions from multiple doctors including your Ob-Gyn, an endocrinologist, a dermatologist, and also possibly a mental health professional.Sources:
5 min read
Hair Loss From Stress

How To Deal With Hair Loss From Stress

Many people wonder if their hair loss is related to their stress levels. The truth is that, yes! Hair loss can be caused by stress. Keep reading to understand why and what you can do to stop the shed!Stress affects the immune system, and this can interfere with the body's natural ability to fight infection. Under normal circumstances, a person's immune system responds as needed to help the body heal and recover from illness or trauma. However, it is possible for the body to overreact to changes and conditions that are not actually harmful.Cortisol, a hormone that your body releases when you're stressed, is likely the culprit that is causing hair loss. Your adrenal glands, which are located on top of your kidneys, react to stress by releasing too much cortisol. The stress hormone imbalance causes thinning hair all over the scalp, or in some cases, complete hair loss on the head. Stress can also cause an increase in other hormones that cause hair loss, like testosterone and dihydrotestosterone.Although it may seem like a complicated process, stress-related hair loss is actually quite common and is called telogen effluvium. While stress is a common cause of telogen effluvium, other causes include the post-partum state, starting a new medication, and infections, like COVID-19. The key is recognizing whether stress has been a factor in your own hair loss and understanding what causes it.The confusing thing about stress related hair loss is that hair shedding typically does not become apparent until three months after the stress has occurred. That is because the hair follicle has a shedding phase that takes three months to complete. So while cortisol levels may signal the hair to enter the shedding phase, the hair loss does not become apparent until much later. Luckily, stress-related hair loss is temporary and will reverse itself once the person stops being stressed out, usually within 3-6 months. For example, if you're experiencing hair loss due to stress in your job then you should take steps to reduce your stress level at work if possible before your hair starts growing back on its own again.If stress-related hair loss persists for more than six months then you should be seen by a physician to make sure other causes of hair loss have been ruled out. If a rare condition called chronic telogen effluvium, is made, then you may benefit from minoxidil available over the counter. Fortunately, there are several steps you can take to reduce your stress levels and help prevent hair shedding. First, try to reduce your stress levels. There are many ways to do this like meditation and yoga. Other people find that exercise helps them to reduce stress. Regular exercise can help reduce stress levels as well as promote heart health and lower blood pressure—both of which may contribute to an increase in cortisol production over time.Also, be sure to get enough sleep! It's important to get plenty of rest each night so that your body has time to recover from the day's events and repair itself. If you are having trouble getting restful sleep, talk to a doctor about treatment options like cognitive behavioral therapy (CBT). You may also want to talk to a mental health professional about your stress symptoms which may be hindering quality sleep.Of course, what you put into your body also matters. Eating right will help you feel better overall and keep your cortisol levels in check. Add more vegetables and fruits into your diet while cutting down on sugar and processed foods like white bread or chips if possible.Of course, there is a normal amount of hair loss that occurs in nearly every person. It may be hard to believe, but on average losing 100 hairs a day is considered normal. You may not notice this as many of these hairs may come out when you wash your hair, while you’re sleeping, or just during the day while you are not paying attention. Additionally, as we age, it is normal to experience a slight increase your rate of daily hair shedding. Typically, a fistful of hair loss per day is considered consistent with levels seen in telogen effluvium.The good news is, yes, stress related hair loss typically grows back on its own, without any medical intervention. However, while hair shedding typically improves within 3-6 months, it may take up to 12 months before your normal hair density is restored to its baseline.Resources: https://www.aad.org/public/diseases/hair-loss/insider/sheddinghttps://www.americanhairresearchsociety.org/telogen-effluvium/
4 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
Underactive Thyroid Symptoms

Symptoms For Underactive Thyroid (Hypothyroidism)

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 happens, a lot of the body’s functions will slow down.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 skin.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. ●        Fatigue●        Drowsiness●        Depression●        Weight gain●        Fluid retention●        Decreased sweating●        Increased sensitivity to cold●        Dry skin●        Coarse hair with increased hair loss●        Brittle nails●        Constipation ●        Decreased heart rate●        Anemia●        High 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.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 hormones (3)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 correctly (3)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. 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.
4 min read
Insomnia In Pregnancy

Insomnia In Pregnancy

Insomnia in pregnancy is very common. Studies estimate that anywhere from 40% to 97% of women experience sleep challenges during pregnancy, especially during the first and third trimesters. Insomnia is defined by having trouble falling asleep, staying asleep, or both. With the variety of emotions that come along with being pregnant, add insomnia into the mix and it can make things even more challenging. Because there’s so much happening emotionally and physically during pregnancy, there are a number of factors that contribute to pregnancy-related insomnia. These include: A couple of disorders that are important to identify as possible causes of insomnia are restless leg syndrome (RLS) and obstructive sleep apnea (OSA). Both of these disorders can occur during pregnancy even if you didn’t have symptoms before, and lead to disturbed sleep and daytime fatigue. Restless leg syndrome (RLS) is also known as Willis-Ekbom disease and is typically related to low iron levels. There’s a higher demand for nutrients like iron during pregnancy, which puts women at risk of developing RLS during this time of life. RLS can cause an urge to move the legs at bedtime or a creepy-crawly sensation and make it hard to fall asleep. Obstructive sleep apnea (OSA) is a condition where breathing stops and starts during sleep. During pregnancy, there can be swelling of the nasal passages and other changes in the airway related to hormonal or fluid shifts that put women at a higher risk of developing OSA. Some of the signs to look out for include snoring, your partner noticing that you stop breathing at night, or feeling excessively drowsy during the day. Non-medication treatments are considered the safest option during pregnancy and are preferred by most women. A good place to start is with lifestyle changes, including: Your sleeping environment is also important. Keep a calm, cool, clean, and comfortable bedroom to help you relax and sleep well. Use pillows to support your body so you can get into a comfortable position. Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment for chronic insomnia, and may also reduce symptoms of depression, anxiety, and fatigue during pregnancy. This can be done in person or online. Do consider other underlying factors that might be disrupting your sleep like RLS, OSA, or heartburn. Supplementing with iron, folate, magnesium, and increasing your intake of nutrient-dense foods may help with RLS and overall energy. If you suspect OSA, talk to your doctor about getting a sleep study. Sleep issues are highly treatable and there’s no one-size-fits-all solution. If you have tried all of the above, have a conversation with your doctor to see what other options might be appropriate for you. Sources:Chaudhry SK, Susser LC. Considerations in Treating Insomnia During Pregnancy: A Literature Review. Psychosomatics. 2018 Jul-Aug;59(4):341-348. doi: 10.1016/j.psym.2018.03.009. Epub 2018 Mar 21. PMID: 29706359.https://pubmed.ncbi.nlm.nih.gov/29706359/Miller MA, Mehta N, Clark-Bilodeau C, Bourjeily G. Sleep Pharmacotherapy for Common Sleep Disorders in Pregnancy and Lactation. Chest. 2020 Jan;157(1):184-197. doi: 10.1016/j.chest.2019.09.026. Epub 2019 Oct 14. PMID: 31622589; PMCID: PMC6965691.https://pubmed.ncbi.nlm.nih.gov/31622589/Okun ML, Ebert R, Saini B. A review of sleep-promoting medications used in pregnancy. Am J Obstet Gynecol. 2015 Apr;212(4):428-41. doi: 10.1016/j.ajog.2014.10.1106. Epub 2014 Oct 31. PMID: 25448509.https://pubmed.ncbi.nlm.nih.gov/25448509/Sedov ID, Anderson NJ, Dhillon AK, Tomfohr-Madsen LM. Insomnia symptoms during pregnancy: A meta-analysis. J Sleep Res. 2021 Feb;30(1):e13207. doi: 10.1111/jsr.13207. Epub 2020 Nov 2. PMID: 33140514.https://pubmed.ncbi.nlm.nih.gov/33140514/Sedov ID, Goodman SH, Tomfohr-Madsen LM. Insomnia Treatment Preferences During Pregnancy. J Obstet Gynecol Neonatal Nurs. 2017 May-Jun;46(3):e95-e104. doi: 10.1016/j.jogn.2017.01.005. Epub 2017 Mar 24. PMID: 28343943.https://pubmed.ncbi.nlm.nih.gov/28343943/
4 min read

When Does Birth Control Start Working?

There are several forms of birth control, and when they start working depends on which method of contraceptive is being used. Barrier methods like condoms are most effective at the time of sexual intercourse and when used properly. For oral contraceptive medications, when birth control starts working is less obvious. Let’s break down the types of birth control and when they begin to work.Oral contraceptives are medications that contain a progestin and estrogen, hormones that are used to prevent pregnancy. They are the most common form of birth control. Oral contraceptives can be started at any time in the cycle and should be taken every day at the same time. This allows for a steady level of the hormones inside your body, which play a key role in preventing pregnancy. If started within the first 5 days of menses, they will be effective right away, but if started after, backup should be used for at least 7 days. If taken as directed and without any missed doses, oral contraceptives are 99% effective in preventing pregnancy. However, for people who miss doses or fluctuate when they take their dose, the overall effectiveness can drop to 91%. Also, since OCP’s do not prevent sexually transmitted infections, many women choose to use barrier methods such as condoms in addition to birth control.There are two types of birth control pills - those that contain both estrogen and progestin (a synthetic form of progesterone) and those that contain only progestin. Estrogen containing contraceptives are not recommended in people who have certain medical conditions like migraines with aura. Typically, a progestin only pill (also called a minipill) is used when a person is breastfeeding so that the birth control does not affect the breast milk supply. Progestin only pills may be appropriate for people who are unable to take estrogen but are not ready for a long acting contraceptive. Both combination and minipill contraceptives use hormones to prevent pregnancy by preventing ovulation and thickening the cervical mucus to block sperm. Combination pills usually come in cycles of 21 or 28 days and may also help with acne. There are two types of IUDs - copper and hormonal. The copper IUD starts working immediately after it is inserted, while the hormonal IUD takes about 7 days to start working. If placed within first 7 days of menstrual cycle, backup may not be needed. The copper IUD and 7 year progestin IUD may also be used as emergency contraception. There are other combined hormonal methods like the patch and the vaginal ring. They work similarly to combined OCPs and should be started in the same timeframe. Nexplanon which is a subdermal implant is a progestin containing contraception.If you have already had sexual intercourse and are trying to prevent pregnancy, emergency contraception, “Plan B,” or the “morning after pill” is your best option. Plan B also works through hormones which delay ovulation. It is more effective the sooner it is taken, so it should be taken as soon as possible, within 3 days of unprotected intercourse Plan B does not protect against HIV/AIDS or other STIs, and will not affect an existing pregnancy. The morning after pill is about 93% effective in preventing pregnancy. It is available at pharmacies without a prescription.  The morning after pill came out in the 1990s and another emergency contraception pill called Ullipristal came out in 2010. It is also called Ella and it requires a prescription. Ullipristal can be used within 5 days (120 hours) of having unprotected sex and it is 98% effective at preventing pregnancy. If you are planning to be sexually active, it is a good idea to think about your birth control options and which ones are right for you. Planning ahead will give you ample time to start an oral contraceptive or to make an appointment to have an IUD placed. Discuss any medical conditions  you have with your doctor that may make certain birth control options unsuitable.Sources:ACOG Practice Bulletin, Emergency Contraception: https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2015/09/emergency-contraceptionACOG Practice Bulletin, LARCs and IUDs: https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/11/long-acting-reversible-contraception-implants-and-intrauterine-devicesCurtis KM, Tepper NK, Jatlaoui TC, Berry-Bibee E, Horton LG, Zapata LB, Simmons KB, Pagano HP, Jamieson DJ, Whiteman MK. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR Recomm Rep. 2016 Jul 29;65(3):1-103. doi: 10.15585/mmwr.rr6503a1. PMID: 27467196.https://www.cdc.gov/mmwr/volumes/65/rr/rr6503a1.htmTurok DK, Gero A, Simmons RG, Kaiser JE, Stoddard GJ, Sexsmith CD, Gawron LM, Sanders JN. Levonorgestrel vs. Copper Intrauterine Devices for Emergency Contraception. N Engl J Med. 2021 Jan 28;384(4):335-344. doi: 10.1056/NEJMoa2022141. PMID: 33503342; PMCID: PMC7983017.https://pubmed.ncbi.nlm.nih.gov/33503342/
4 min read
What PCOS means

What PCOS Means

PCOS stands for Polycystic Ovary Syndrome. PCOS is a hormonal disease characterized by any two of the following: ·   Irregular menstrual periods·   Having physical signs or lab values of excessive androgens (“male hormones”) in your body·   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).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.Sources:Rasquin Leon LI, Anastasopoulou C, Mayrin JV. Polycystic Ovarian Disease. [Updated 2021 Jul 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459251/https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/causesNdefo, U. A., Eaton, A., & Green, M. R. (2013). Polycystic ovary syndrome: a review of treatment options with a focus on pharmacological approaches. P & T : a peer-reviewed journal for formulary management, 38(6), 336–355.Kim, J. J., & Choi, Y. M. (2013). Dyslipidemia in women with polycystic ovary syndrome. Obstetrics & gynecology science, 56(3), 137–142. https://doi.org/10.5468/ogs.2013.56.3.137Barber, T. M., Hanson, P., Weickert, M. O., & Franks, S. (2019). Obesity and Polycystic Ovary Syndrome: Implications for Pathogenesis and Novel Management Strategies. Clinical medicine insights. Reproductive health, 13, 1179558119874042. https://doi.org/10.1177/1179558119874042Robert A. Wild, Enrico Carmina, Evanthia Diamanti-Kandarakis, Anuja Dokras, Hector F. Escobar-Morreale, Walter Futterweit, Rogerio Lobo, Robert J. Norman, Evelyn Talbott, Daniel A. Dumesic, Assessment of Cardiovascular Risk and Prevention of Cardiovascular Disease in Women with the Polycystic Ovary Syndrome: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society, The Journal of Clinical Endocrinology & Metabolism, Volume 95, Issue 5, 1 May 2010, Pages 2038–2049, https://doi.org/10.1210/jc.2009-2724
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
Pregnancy Vaccines

Pregnancy Vaccines

There are several vaccines that are safe and important to receive either before or during pregnancy. The TDAP vaccine provides combined protection against the diseases of tetanus, diphtheria, and acellular pertussis. Both the CDC and ACOG, which is the American College of Obstetrics and Gynecology, consider the vaccine to be safe for mothers during pregnancy.Infants under 2 months are too young to receive a vaccine for tetanus, diphtheria and acellular pertussis. Getting a vaccine would allow the baby 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 during pregnancy which protects babies after birth until they are able to receive their own vaccine. 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).Over the last two years, we have seen that pregnant persons are at much greater risk of hospitalization and death if they are unvaccinated and contract Covid-19. Both the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) recommend that all pregnant persons be vaccinated against COVID-19 (3). If you have not been vaccinated before becoming pregnant, it is advised that you do so during your pregnancy. You can also choose to become vaccinated before you become pregnant.The American College of Obstetricians and Gynecologists (ACOG) states that the mRNA COVID-19 vaccines are preferred over the J&J/Janssen COVID-19 vaccine for all people who are eligible to receive a vaccine. It is safe for patients to receive the COVID-19 vaccine at the same time as other vaccines, such as TDAP vaccine and the flu vaccine. If you are moderately or severely immunocompromised, you should receive an additional dose of the vaccine, so, for the mRNA vaccines, immunocompromised individuals need a 3-dose primary series.The mRNA vaccines (Pfizer and Moderna) are not live virus vaccines. The vaccines do not enter the nucleus and do not alter human DNA. Thus, mRNA vaccines cannot cause any genetic changes (3,4).In the United States, the influenza season usually lasts from October to May. If you are pregnant, do your best to obtain the flu shot before the end of October, or as soon as it is made available to you. You do not have to get this with your Ob-Gyn. Your primary care doctor can also administer this vaccine for you.The flu can be a serious illness and if it happens during or after pregnancy, there is a higher chance of the pregnant person getting pneumonia, being hospitalized, and having an ICU admission. There is also a risk of poor neonatal outcomes. The CDC and ACOG recommend that all adults receive an annual influenza vaccine and that women who plan to be pregnant during influenza season receive an inactivated influenza vaccine as soon as it is available (5). The TDAP, Covid, and Flu vaccines are all safe to receive during pregnancy. The TDAP vaccine is mainly for the protection of your unborn child, while the Covid vaccine and Flu vaccine can help to prevent hospitalization and death in pregnant persons. Ask your doctor about these vaccines so you can ensure a safe and healthy pregnancy for you and your baby. Sources:
3 min read
Pregnancy Test Very Faint Line

Pregnancy Test Very Faint Line : What Does It Mean?

A very faint line on a pregnancy test means that there are hormones of pregnancy rising in your body. It is very likely that you are pregnant. It is important to look at the urine pregnancy test and make sure that the control line is also appearing. If the control line does not appear, you should take another test, because it means that the pregnancy test is not valid. If you have a positive urine pregnancy test (a pregnancy test with a very faint line), it is likely that you are pregnant. If you take a second pregnancy test and the positive line is more intense than the faint line on the initial test, this could be an indicator that hCG levels in your body are rising. Human chorionic gonadotropin, or hCG, is a hormone produced by the placenta when you are pregnant. The hCG hormone is made once the embryo (the egg that has been fertilized by sperm) attaches to the wall of the uterus. In a person with a 28-day menstrual cycle, hCG can be detected in the urine as early as 12 days after ovulation, and the window for early detection of a pregnancy is approximately 12 to 15 days after ovulation.For the most reliable results, test 7 to 14 days after you miss your period. Ideally you should use the first morning urine for the urine pregnancy test. If you are pregnant, it will have more hCG in it than later urines. If you think you are pregnant, but your first test was negative, you can take the test again after a few days. The amount of hCG increases quickly when you are pregnant, so it is more likely to have a positive test 1 to 3 days later. There are some people who have circulating antibodies in their body that interact with the hCG antibody. The most common of these are called heterophilic antibodies. People who may be more likely to have this interaction and have these antibodies are those who have worked as animal laboratory technicians, have spent time in veterinary facilities, or people who were raised on farms. The presence of these antibodies can interfere with pregnancy test results, but the vast majority of people do not have these antibodies. The pregnancy test can only have a positive result once your body starts to produce a hormone HCG, which stands for human chorionic gonadotropin. Fertilization takes place in the fallopian tube, and it is the joining of an egg with a sperm into a single cell. This single cell then divides into multiple cells while it moves from the fallopian tube to the uterus. Around day 6 to day 10 after conception, the cluster of cells implants into the uterine wall and is called an embryo. During implantation, you may have some cramping and even some mild bleeding. This bleeding can occur for a few days or even up to a week.  Significant bleeding is not typical for implantation bleeding. If you have a pregnancy test that you think is positive, the best thing to do is to schedule an appointment with your doctor to have a blood test done. The blood test can provide more specific data on the stage of your pregnancy and it is also something that the doctor will want to monitor. Blood levels of HCG that do not rise as expected could be a sign that something may be wrong. Sources:Cole LA, Rinne KM, Shahabi S, Omrani A. False-positive hCG assay results leading to unnecessary surgery and chemotherapy and needless occurrences of diabetes and coma. Clin Chem 1999;45:313 – 4.https://pubmed.ncbi.nlm.nih.gov/9931066/Rotmensch S, Cole LA. False diagnosis and needless therapy of presumed malignant disease in women with false-positive human chorionic gonadotropin concentrations. Lancet 2000;355:712–5.https://pubmed.ncbi.nlm.nih.gov/10703803/Check JH, Nowroozi K, Chase JS, Lauer C, Elkins B, Wu CH. False-positive human chorionic gonadotropin levels caused by a heterophile antibody with the immunoradiometric assay. Am J Obstet Gynecol 1988;158:99–100.https://pubmed.ncbi.nlm.nih.gov/2447778/https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2002/11/avoiding-inappropriate-clinical-decisions-based-on-false-positive-human-chorionic-gonadotropin-test-resultshttps://www.fda.gov/medical-devices/home-use-tests/pregnancy 
4 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

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
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

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
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

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
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
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
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

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

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

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

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

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

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
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

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
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
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
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
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

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

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

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

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

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
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
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

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
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

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
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

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
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
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
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
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
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

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
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
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

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? 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
Adenomyosis And Fertility