HIVES DURING PREGNANCY
Hives during pregnancy represent an allergic reaction to food, insect bites, medicine, chemicals, etc. With the increase in hormones and changes that happen in your body, it is possible that you become more sensitive to pathogens and experience hives while pregnant.
What Causes Hives During Pregnancy?
As your belly grows to keep up with your growing baby, skin discomfort in the form of itchiness and dryness can occur. Pregnant women can face more serious bouts of itchiness, hives or rashes, and 1 in 150 pregnant women will develop a more serious skin condition known as PUPP.
Hives are caused by allergic reactions. The dryness and stretching of your skin along with other changes can make you more susceptible to experiencing hives during pregnancy. Hives can be caused by an allergic reaction to almost anything.
Some common causes of hives during pregnancy are noted below:
- insect bites
- animal dander
- foods (i.e. dairy, nuts, shellfish)
Hives can be triggered or brought on by scratching, stress, or pressure on the skin. It is important to care for your skin carefully as to not aggravate or worsen the hives you experience.
Another condition that affects 1 in 50 women is cholestasis of pregnancy. This is a condition where intense itching is also accompanied by nausea, vomiting, and potentially jaundice. This condition can indicate there are problems with your liver. Should you see these signs or symptoms, it is important to contact your doctor immediately.
What is PUPP?
PUPP stands for pruritic urticarial papules and plagues of pregnancy. Women that develop PUPP will see outbreaks of red, raised patches on their skin.
The first site of the outbreak is generally the abdomen, but women with PUPP can see the condition spread to the arms and legs as well. Women with PUPP sometimes report extreme itching with these outbreaks.
Some research points to PUPP being linked to a genetic condition, as it seems to run in families, but ultimately, the cause of PUPP is still unknown. Generally, PUPP happens more often in a woman’s first pregnancy and is rarely seen in subsequent pregnancies.
How Can I Treat Hives During Pregnancy?
Minor rashes can have a tendency to go away on their own. However, it is important to not scrub the affected area. Soap can aggravate the condition, so cutting back on the amount of soap you use can be beneficial.
One technique that could reduce the itchiness is taking an oatmeal bath or using baking soda in your bath. Keeping your skin well-moisturized can also help with the itching and dryness.
There are several antihistamines that are considered safe to take during pregnancy such as Allegra, Benadryl, and Chlor-Trimeton, Claritin and Zyrtec. It is important to review the warnings on any medication and consult your pharmacist and healthcare provider before taking any medication.
For more serious skin conditions like PUPP, doctors may prescribe oral medications or a variety of anti-itch creams.
How Can I Prevent Hives During Pregnancy?
You might be someone who is more susceptible to hives in general. If that is the case, more than likely you know what foods or pathogens to avoid from previous experience.
Because you might be more susceptible and pregnancy tends to bring on dry and itchy skin, it is important to know steps you can take to prevent hives while pregnant. You at least want to know how you can minimize the hives you experience during pregnancy.
Here are some tips for minimizing or preventing hives during pregnancy:
- Avoid hot showers and hot baths (at least lower the temperatures)
- Avoid wearing tight fitted clothing
- Try not to scratch your skin as it itches
- Keep pressure off your skin
- Avoid stress and practice relaxation techniques
The above may not prevent all cases of hives, but it usually makes the cases of hives less severe and go away quicker.
PID: PELVIC INFLAMMATORY DISEASE
What are the symptoms of Pelvic Inflammatory Disease (PID)?
Women with PID may have only mild pain or no symptoms at all, even though serious damage to their internal reproductive organs may be occurring. Some women with PID may experience the following symptoms:
- Lower abdominal pain
- Vaginal discharge
- Painful intercourse
Can Pelvic Inflammatory Disease (PID) lead to other problems?
PID can cause permanent damage by developing scar tissue on the female internal reproductive organs. The scar tissue can completely block the fallopian tubes, which prevents the sperm and egg from meeting and causes infertility.
Approximately 100,000 women a year begin struggling with infertility as a result of PID. The scar tissue may partially block or slightly damage the fallopian tube.
This can prevent the fertilized egg from leaving the tube creating an ectopic or tubal pregnancy. Ectopic pregnancies can rupture the fallopian tubes causing severe pain, internal bleeding, and even death. Scarring of the fallopian tubes and ovaries can also lead to pelvic pain that lasts for months or even years.
What causes Pelvic Inflammatory Disease (PID)?
PID is caused by vaginal intercourse with a partner infected with Gonorrhea or Chlamydia. The more sexual partners a woman has, the greater the risk of PID. PID is a common progression from an infection of either chlamydia, gonorrhea, or in rare cases, bacterial vaginosis.
How is Pelvic Inflammatory Disease (PID) diagnosed?
PID is difficult to diagnose because symptoms are often mild and many cases go undetected. There are no specific tests for PID. If you are sexually active and experiencing lower abdominal pain, the first thing your healthcare provider will probably do is to run cultures of your cervix to test for chlamydia and gonorrhea. An ultrasound or possibly surgery may be necessary to diagnose PID.
What is the treatment for Pelvic Inflammatory Disease (PID)?
The bacteria that causes PID may be treated and cured with antibiotics administered orally or intravenously. The damage caused by scarring from PID may not be reversed. Approximately 25% of women with PID must be admitted to the hospital for treatment.
Can Pelvic Inflammatory Disease (PID) be prevented?
There are only two ways to prevent PID. The first is to refrain from sexual contact of any kind, allowing you to avoid contracting chlamydia and gonorrhea.
The second is to be in a long-term monogamous relationship such as marriage. The use of condoms does reduce the risk of transmission of chlamydia and gonorrhea, but it does not prevent it. According to a study presented at the 2002 National STD Prevention Conference, there is a 50% risk reduction by using condoms.
HUMAN PAPILLOMAVIRUS: HPV
HPV During Pregnancy: Symptoms, Treatment and Prevention
HPV, the Genital Human Papillomavirus, is a viral infection that affects nearly 6,200,000 new individuals each year. There are over 100 different types of HPV, including about 30 types that are spread through sexual transmission. Approximately 20 million Americans are currently infected with HPV. Between 50-75% of sexually active men and women have an HPV infection at some time in their life.
What are the symptoms of HPV?
In most cases there are no symptoms of HPV. Many people have HPV and do not know it. Some people will experience genital warts on the penis, scrotum, labia, vagina, cervix, or anus.
Can having HPV lead to other problems?
Most people that are infected with HPV feel fine and do not even know they are infected. HPV can cause genital warts which may return after treatment. HPV may cause pre-cancerous cells on the cervix resulting in abnormal Pap smears.
It may also lead to cancer of the cervix, labia, anus, or penis. There is no cure for HPV, which means that once you contract it, it can be a life-long infection. The good news is that the body’s natural immune system appears to get rid of the infection.
However, this may take months to years. Even though there are no visible symptoms, HPV may still be transmitted to another person.
How is HPV transmitted?
HPV is transmitted by genital skin-to-skin contact, which in most cases is through sexual activity including oral, anal, and vaginal intercourse. HPV may be transmitted even if someone does not exhibit symptoms.
How is HPV diagnosed?
HPV may be diagnosed by your health care provider.
HPV is diagnosed by one of the following ways:
- Pelvic exam looking for warts
- Pap smear of cervix to look for pre-cancerous/cancerous cells
- Biopsy (removing a piece of tissue) of warts, cervix, or other genital areas
The liquid-based Pap test is significantly more effective for detecting abnormal cervical cells than the conventional Pap smear. For the liquid-based Pap test, your health care provider will put the collected cells into liquid, rather than smearing them onto a slide.
This allows more cells to be preserved and minimizes blood, mucus, and inflammation. Most health care providers agree that the liquid-based Pap test is advised for women who have or are at risk of contracting HPV.
In 2003, the FDA approved a screening test that can be done in conjunction with a Pap test to determine if you have the HPV virus. The HPV DNA test can detect high risk types of HPV, such as types 16 and 18, before any abnormal cells can be detected on the cervix.
This screening is recommended for women over the age of 30, who are at an increased risk of a chronic HPV infection turning into pre-cancerous cells.
Men can carry and transmit the HPV infection without ever having symptoms. At this time, there is no test to detect HPV in men.
What is the treatment for HPV?
There is currently no cure for the HPV infection for those people whose immune system cannot eliminate the virus on its own. The warts may be treated or removed with chemicals, freezing, burning, laser, or surgery.
Researchers believe that cervical cancer is directly related to the human papillomavirus (HPV). There are over 100 different types of HPV, including about 30 types that are spread through sexual transmission and can possibly lead to cervical cancer. HPV causes approximately 70% of cervical cancer, but most women who receive treatment for HPV do not develop cervical cancer.
Most pre-cancerous cells on the cervix can be treated with freezing, burning, laser, or surgery. If the abnormal cells have turned into cancer, it can be treated through surgery, radiation, and/or chemotherapy. With proper screening, cervical cancer is preventable and avoidable.
Can HPV be prevented?
Gardasil is a vaccine that may help guard against some HPV related diseases by possibly preventing HPV Types 6, 11, 16 and 18. There are approximately 30 other sexually transmitted HPV types that Gardasil does not prevent against.
Gardasil is given as a series of 3 injections over 6 months. Gardasil does not treat existing HPV infections, but most HPV infections resolve on their own.
Minor adverse reactions to the Gardasil vaccine include pain, swelling, fever and nausea. More severe reactions include headache, inflammation of the stomach, and arthritis.
Because Gardasil contains aluminum (aluminum hydroxyphosphate sulfate), the vaccine is not recommended for women who are pregnant or may become pregnant.
There are only two ways to prevent HPV. The first is to refrain from sexual contact of any kind. The second is to be in a long-term monogamous relationship such as marriage, with a person who has not had any other sexual partners.
There is no scientific evidence that condoms greatly reduce your chances of getting genital HPV.
HIV / AIDS
HIV does not instantly lead to AIDS. An HIV infected individual can lead a healthy life for several years before developing AIDS. HIV may be passed to another person when infected blood, semen, or vaginal fluids come in contact with skin tears or mucus membranes of an uninfected individual.
According to the Mayo Clinic, an estimated 38.6 million people are living with HIV. Nearly half of them are women and girls between the ages of 15 and 24.
In 2005, more than 4 million people were diagnosed with new cases of HIV. Twenty-five million people have died of AIDS (advanced stage of HIV) since the epidemic began about 25 years ago.
What are the symptoms of HIV?
The first symptoms of HIV can resemble symptoms of other conditions, such as a cold or flu virus, other sexually transmitted diseases, other infections such as mononucleosis or hepatitis. Stress and anxiety can also produce symptoms that are similar to HIV in some individuals.
The intensity of the symptoms can also vary from person to person. Some may experience very strong symptoms while others experience none at all.
General symptoms can occur within days or weeks of initial exposure to the virus and may include:
- Swollen lymph nodes
- Sore throat
These symptoms usually appear during a period called primary or acute HIV infection.
The following may be warning signs of advanced HIV infection:
- Rapid weight loss
- Dry cough
- Recurring fever or profuse night sweats
- Profound and unexplained fatigue
- Swollen lymph glands in the armpits, groin or neck (lymphadenopathy)
- Diarrhea that lasts for more than a week
- White spots or unusual blemishes on the tongue, in the mouth, or in the throat
- Red, brown, pink or purple blotches on or under the skin or inside the mouth, nose or eyelids
- Memory loss, depression, and other neurological disorders
No one should assume they are infected with HIV just because of these symptoms. Each of these symptoms can be related to other medical conditions. Because these symptoms are similar to other diseases, a person may not realize they are infected with HIV. The only way to determine if a person is infected is to be tested.
Even if someone doesn’t have symptoms it is still possible to transmit the virus to others. Once the virus has entered the body it begins to attack the immune system. The virus multiplies in the lymph nodes and begins to destroy the T-cells, which are the white blood cells that coordinate the entire immune system.
A person may be symptom free for nine years or more. During this time the virus continues to multiply and destroy immune cells.
Can having HIV lead to other problems?
The advanced stages of HIV have been identified by the term AIDS (Acquired Immunodeficiency Syndrome). According to the definition provided by the Centers for Disease Control & Prevention (CDC), AIDS includes all HIV-infected people who have less than 200 CD4+ T cells per cubic millimeter of blood.
This definition also includes 26 clinical conditions that affect people with advanced HIV disease. In people with AIDS, these infections are often severe and fatal because the immune system has been so damaged by HIV that the body cannot reject certain bacteria, viruses, fungi, parasites and other microbes.
How is HIV transmitted?
The most common ways that HIV is spread include:
- Vaginal, oral, or anal sex with someone who is infected with HIV
- Sharing needles or syringes with someone infected with HIV
Infected blood, semen or vaginal fluid (including menstrual blood) can enter the body through the vagina, rectum or mouth and surrounding tissue. The risk of becoming infected increases if there are sores (caused by herpes, syphilis and chancroid) on the genitals (vagina, vulva, penis). Sharing personal items can be risky if they have been in contact with another person’s blood, semen or vaginal fluid.
HIV is not spread through every day activities or casual contact. Activities such as hugging, kissing, cuddling, touching, or massaging do not spread HIV unless there is contact with the person’s blood, semen, vaginal fluid or breast milk.
HIV cannot be contracted from:
- Coughs or sneezes
- Being around an infected person
- Insect bites
- Using swimming pools or hot tubs
- Toilet seats
- Phones or computers
- Drinking fountains
- Straws, spoons, or cups
How is HIV diagnosed?
Because this disease has nonspecific symptoms, they are not a reliable way to diagnose HIV infection. The only way to know whether a person has been infected is through HIV testing.
HIV tests do not test for the actual HIV virus. One test detects HIV proteins while the other two detect HIV antibodies in the bloodstream.
- Elisa is the first portion of the HIV test. This test detects the presence of HIV antibodies in the blood. Negative results determine a person is not HIV infected. Positive results lead to the second portion of the test to confirm results.
- Western Blot is used to confirm a positive Elisa test result. The Western Blot test detects specific protein bands that are present with HIV infections. A positive Elisa test with a positive Western Blot test gives 99.9% accuracy in identifying HIV infection.
- PCR detects specific DNA and RNA sequences that indicate the presence of HIV in the genetic structure of anyone HIV infected. DNA and RNA from the HIV virus circulate in the blood. The presence of these “particles” indicates the HIV virus.
Testing for HIV antibodies is the only way to know if a person is infected. However, this test for HIV antibodies is effective only after the infected person’s immune system produces antibodies to HIV.
There is a time period between the initial infection and when the HIV antibodies are detectable which can be from 2 weeks to 6 months with an average length of 3 months. During this time period standard HIV testing is ineffective.
What is the treatment for HIV?
When the HIV/AIDS epidemic began in the early 1980s, AIDS patients were not expected to live more than a few years. Since then, the development of safe and effective drugs is enabling people with HIV to live longer and healthier lives.
At the present time there are 26 antiretroviral drugs that have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of HIV patients.
These drugs can be classified into three major groups:
- Reverse transcriptase (RT) inhibitors – interfere with the conversion of reverse transcriptase (an HIV enzyme) into HIV RNA to HIV DNA.
- Protease inhibitors (PI) – interfere with the protease enzyme that HIV uses to produce infectious viral particles.
- Fusion inhibitors – interfere with the HIV virus’ ability to fuse with the cellular membrane, thus blocking entry into the host cell.
Current drugs can suppress the HIV virus, even to undetectable levels, but are not able to completely remove HIV from the body. These drugs help to manage HIV but are not able to cure it. It is important that infected patients continue to take antiretroviral drugs.
Because HIV reproduces itself, new strains of the virus continue to emerge which can be resistant to antiretroviral drugs. Most health care providers recommend that HIV infected patients take a combination of antiretroviral drugs known as HAART.
This combination of drugs successfully suppresses the virus and decreases the rate of opportunistic infections by strengthening the immune system.
While the use of HAART can suppress the virus and has greatly reduced the number of deaths due to HIV/AIDS, the virus may still be transmitted. People infected with HIV who are taking antiretroviral drugs can still transmit HIV to others through unprotected sex and needle sharing.
The Pharmaceutical Research and Manufacturers Association of America maintains a database of new drugs in development to treat HIV infection. Scientists are also studying how immune modulators can help to increase the immune response to the HIV virus and make existing HIV drugs more effective. Therapeutic vaccines are being examined for this purpose.
Can HIV be prevented?
Not having sex is the only sure way to avoid the transmission of HIV.
If you decide to engage in sexual activity, in order to reduce the risk of infection you should:
- Have sex with only one partner who is not infected with HIV, who does not share needles or syringes and who has sex only with you. These things may be difficult to know about another person.
- Avoid contact with your partner’s blood, semen, or vaginal fluid.
- The correct use of a latex condom when having sex greatly reduces your risk of HIV infection.
- Use a water-based lubricant with the latex condom to reduce risk of breakage when engaging in vaginal or anal sex.
- Use a male condom without spermicide or a lubricant for oral sex.
- Further research is needed to determine the effectiveness of the female condom or dental dams in preventing HIV transmission.
What are the symptoms of hepatitis C?
The majority of people will not exhibit any symptoms when first infected. Symptoms usually take years to appear.
Symptoms of hepatitis C include:
- Jaundice (yellow skin or eyes)
- Dark Urine
- Abdominal pain
- Loss of appetite
Can having hepatitis C lead to other problems?
This disease leads to chronic liver disease in 70% of chronically infected individuals. Chronic liver disease may lead to liver failure, liver cancer, and death. This is the number one reason for liver transplants in the United States.
How is hepatitis C transmitted?
This disease is transmitted by microscopic exchange of infected blood. The most common transmission occurs in I.V. drug use.
Hepatitis C may be transmitted by any of the following:
- Sexual activity which includes anal or vaginal intercourse
- Intravenous (IV) drug use
- Although rare, mother to baby during birth
- Exposure to infected blood
How is hepatitis C diagnosed?
Hepatitis C may be diagnosed by your healthcare provider through a blood test. The Association recommends testing for anyone that has injected illegal drugs, received blood products before 1992, or had sex with someone who has used IV drugs.
What is the treatment for hepatitis C?
There are medications that eliminate the virus in approximately 40% of cases. For others that do not respond to these medications, there is no cure.
Can hepatitis C be prevented?
This disease may be prevented by refraining from sexual contact of any kind or being in a long-term monogamous relationship such as marriage. It may also be avoided by not using illegal I.V. drugs. There is no vaccine for this disease.
What are the symptoms of hepatitis B?
Approximately 30% of infected people will show no symptoms. Symptoms include:
- Jaundice (yellow skin or eyes)
- Abdominal pain
- Loss of appetite
Can having hepatitis B lead to other problems?
There is no cure, which means that once you contract it, it is a life-long infection. Hepatitis B may lead to serious liver disease. Approximately 5,000 people die each year due to liver failure and liver cancer.
How is hepatitis B transmitted?
Hepatitis B is transmitted by sexual activity. It may also be spread from an infected mother to her baby during birth.
There are primarily four different ways that hepatitis B may be transmitted:
- Sexual activity which includes anal or vaginal intercourse
- Mother to baby during birth
- Contact with infected blood
- I.V. drug use
How is hepatitis B diagnosed?
Hepatitis B may be diagnosed by your healthcare provider through a blood test.
What is the treatment for hepatitis B?
Currently there is no cure. Medications are available to help slow the virus and prevent liver damage.
Can hepatitis B be prevented?
There are several ways to prevent hepatitis B. The first is to refrain from sexual contact of any kind. The second is to be in a long-term monogamous relationship such as marriage. The third is to avoid use of I.V. drugs. There is a vaccination; subsequently, one of the simplest ways to avoid this disease is to get vaccinated.
What are the symptoms of gonorrhea?
It is common for individuals infected to not have any symptoms. Females may experience a vaginal discharge and/or have pelvic or abdominal pain. Males usually experience pain while urinating, and they may have a discharge from the penis.
Can having gonorrhea lead to other problems?
Gonorrhea can cause pelvic inflammatory disease (PID) in females. PID involves a severe infection of the uterus, fallopian tubes, and ovaries which may lead to infertility, tubal pregnancies, and chronic pelvic pain. It is also easier to transmit or get infected with HIV if you are infected with gonorrhea.
How is gonorrhea transmitted?
Gonorrhea is transmitted by contact with infected secretions during sexual activity which includes vaginal, oral, or anal intercourse.
How is gonorrhea diagnosed?
Gonorrhea may be diagnosed by your healthcare provider using a lab test to assess the secretions from the infected area which may include the cervix, urethra, anus, or throat. The lab may also test your urine.
What is the treatment for gonorrhea?
Gonorrhea may be treated and cured with antibiotics administered orally or through an injection.
Can gonorrhea be prevented?
There are only two effective ways to prevent gonorrhea. The first is to refrain from sexual contact of any kind. The second is to be in a long-term monogamous relationship such as marriage.
The use of condoms does reduce the risk of transmission of gonorrhea, but it does not prevent it. According to a study presented at the 2002 National STD Prevention Conference, there is a 50% risk reduction by using condoms.
What are the symptoms of genital herpes?
In most cases there are usually no symptoms. Many people have herpes and do not know it. Some people experience painful blisters or sores around the genital area (HSV-2).
Can genital herpes lead to other problems?
There is no cure for genital herpes, which means that once you contract it, it is a life-long infection. Genital herpes makes you more susceptible to HIV. Some people will experience blisters or sores which come back throughout the years. Genital herpes may be spread to a baby during pregnancy or childbirth leading to serious health problems.
How is genital herpes transmitted?
Genital herpes is transmitted by skin-to-skin contact which in most cases is through sexual activity including oral, anal, vaginal intercourse, and outercourse. Genital herpes may be transmitted even if someone does not have visible sores or blisters. HSV-1, the herpes virus that normally causes sores in the mouth or on the lips, may be spread from the mouth to the genital area through oral sex.
There are primarily two different ways that genital herpes may be transmitted:
- Sexual activity which includes oral, anal, vaginal intercourse, and outercourse
- Mother to baby during pregnancy or birth
How is genital herpes diagnosed?
Genital herpes may be diagnosed by your healthcare provider. Genital herpes is diagnosed by one of three ways:
- Pelvic exam
- Culture of blisters or sores if present
- Blood test (usually not done)
What is the treatment for genital herpes?
Currently there is no cure for genital herpes; however, there are medications that may be used to manage the symptoms and decrease the frequency of outbreaks.
Can genital herpes be prevented?
There are only two ways to prevent genital herpes. The first is to refrain from sexual contact of any kind. The second is to be in a long-term monogamous relationship, such as marriage, with a person who has not had any other sexual partners. The use of condoms does reduce the risk of transmission of genital herpes, but it does not prevent it. According to a study presented at the 2002 National STD Prevention Conference, there is a 40% risk of reduction by using condoms.
What are the symptoms of chlamydia?
In most cases there are no symptoms. Some females may experience a vaginal discharge and/or pelvic or abdominal pain. Males usually have pain while urinating and may have a discharge from the penis.
Can having chlamydia lead to other problems?
Chlamydia can cause pelvic inflammatory disease (PID) in females. PID involves a severe infection of the uterus, fallopian tubes, and ovaries which may lead to infertility, tubal pregnancies, and chronic pelvic pain. It is also easier to transmit or get infected with HIV if you are infected with chlamydia.
How is chlamydia transmitted?
Chlamydia is transmitted by contact with infectious secretions during sexual activity which includes vaginal, oral, or anal intercourse. Chlamydia may also be spread from mother-to-child during birth.
How is chlamydia diagnosed?
Chlamydia may be diagnosed by your healthcare provider using a lab test to assess the secretions from the infected area which may include the cervix, urethra, anus, or throat. The lab may also use a urine sample for testing.
How is chlamydia treated?
Chlamydia may be treated and cured with antibiotics administered orally.
Can chlamydia be prevented?
There are only two effective ways to prevent chlamydia. The first is to refrain from sexual contact of any kind. The second is to be in a long-term monogamous relationship such as marriage.
What causes a yeast infection?
A yeast infection is caused by one or more of the following:
- Hormonal changes that come with pregnancy (See Yeast Infections During Pregnancy) or before your period)
- Taking hormones or birth control pills
- Taking antibiotics or steroids
- High blood sugar, as in diabetes
- Vaginal intercourse
- Blood or semen
What are the symptoms of a yeast infection?
Symptoms of a yeast infection can include:
- Itching, burning, soreness
- Thick, white, vaginal discharge that looks like cottage cheese and may smell like yeast/bread, though usually odorless
- Burning during urination and intercourse
- Swelling, soreness, or rash on the outer lips of the vagina
What else could I be experiencing?
If you are experiencing symptoms similar to a yeast infection, but a physician has ruled out this diagnosis, you may have one of the following:
- A sexually transmitted disease (STD) like chlamydia, gonorrhea, or trichomoniasis
- A vaginal infection called bacterial vaginosis
How do I know for sure if I have a yeast infection?
Your health care provider will use a simple, painless swab to remove discharge or vaginal secretions and examine the sample through a microscope in the office. Usually, upon a simple examination of the vagina, a physician can diagnose a yeast infection. In rare cases, the culture may be sent to a lab.
How are yeast infections treated?
A yeast infection can be treated by creams that can be applied vaginally. Monistat, Gyne-Lotrimin, or prescription Terazol or Vagistat provide immediate relief of burning on the vulva and should completely clear up the infection in a week.
Medications taken orally, such as prescription Diflucan, Sporanox, Nystatin, and Nizoral, clear up the infection within a few days but provide slower relief of burning and itching. Ask your doctor about using cream topically to relieve itching and burning as well as a one-dose oral medication to clear it up as quickly as possible.
How can I prevent yeast infections from occurring?
Yeast infections can usually be avoided by doing the following:
- Avoid tight-fitting, synthetic fiber clothing, leotards, or girdles.
- Wear cotton panties and panty hose with cotton crotches.
- Wash regularly, and dry thoroughly. Use your blow dryer on a low, cool setting to help dry your genital area.
- Always wipe from front to back after using the restroom.
- Shower immediately after you swim, and dry thoroughly. Change out of wet swimsuits or other damp clothes as soon as you can.
- Change underwear and workout clothes right away after exercise.
- Don’t douche or use feminine hygiene sprays, sanitary pads, or tampons that contain deodorant.
- Don’t use bubble bath or colored/perfumed toilet paper.
- Eat nutritious foods including yogurt with lactobacillus acidophilus; limit sugar intake, as sugar promotes the growth of yeast.
- Get plenty of rest to make it easier for your body to fight infections.
When should I contact my doctor?
If you are experiencing the symptoms described in this article, you should call your doctor now. Yeast infections symptoms can be similar to other infections and STD’s. Proper diagnosis every time you think you may have a yeast infection is vital for the most effective, immediate treatment, or your condition may worsen.
If you see no improvement within three days, or the symptoms worsen or come back after treatment, you should contact your health care provider again.
URINARY TRACT INFECTION: BLADDER INFECTION
What causes urinary tract infections?
A urinary tract infection may be caused by one or more of the following conditions:
- A new sex partner or multiple partners
- More frequent intercourse
- A history of diabetes, sickle-cell anemia, stroke, kidney stones or any problem that causes the bladder not to empty completely
- Pregnancy increases your risk for developing a UTI. (See Urinary Tract Infections During Pregnancy.)
- Use of products such as harsh skin cleansers
- Use of contraceptives such as diaphragms and spermicides
- A history of UTI’s, especially if the infections were less then six months apart
- Waiting too long to urinate
What are the signs and symptoms of urinary tract infections?
If you have a urinary tract infection, you may experience one or more of the following symptoms:
- Pain or burning (discomfort) when urinating
- The need to urinate more often than usual
- A feeling of urgency when you urinate
- Blood or mucus in the urine
- Cramping or pain in the lower abdomen
- Pain during sexual intercourse
- Chills, fever, sweats, leaking of urine (incontinence)
- Waking up from sleep to urinate
- Change in the amount of urine, either more or less
- Urine that looks cloudy, smells foul or unusually strong
- Pain, pressure, or tenderness in the area of the bladder
- If bacteria spreads to the kidneys you may experience: back pain, chills, fever, nausea, and vomiting.
How do I know if I have a urinary tract infection (UTI)?
The number of bacteria and white blood cells in a urine sample is the basis for diagnosing a UTI. Proper diagnosis is vital since these symptoms can also be caused by other problems such as infections of the vagina or vulva. Only your physician can make the distinction and make a correct diagnosis.
What is the treatment for urinary tract infections?
Urinary tract infections are most commonly treated by antibiotics. You may take a single dose antibiotic, or you may take an antibiotic for 3-10 days. Take all your medications as prescribed, even after the symptoms are gone. If you stop taking your medication before the scheduled end of treatment, the infection may come back.
Pyridium may be prescribed to relieve painful urination while the antibiotics are treating the infection (this medication may turn your urine a dark orange color). Symptoms usually will subside within 2-3 days, but if symptoms continue for more than 3 days you will need to contact your health provider again.
How can I prevent urinary tract infections?
You may do everything right and still experience a urinary tract infection, but you can reduce the likelihood by doing the following:
- Drink 6-8 glasses of water each day.
- Eliminate refined foods, fruit juices, caffeine, alcohol, and sugar.
- Take vitamin C (250 to 500 mg), beta-carotene (25,000 to 50,000 IU per day) and zinc (30-50 mg per day) to help fight infection.
- Develop a habit of urinating as soon as the need is felt, and empty your bladder completely when you urinate.
- Urinate before and after intercourse.
- Avoid intercourse while you are being treated for a UTI.
- After urinating, blot dry (do not rub), and keep your genital area clean. Make sure you wipe from the front toward the back.
- Avoid using strong soaps, douches, antiseptic creams, feminine hygiene sprays, and powders.
- Change underwear and pantyhose every day.
- Avoid wearing tight-fitting pants.
- Wear all cotton or cotton-crotch underwear and pantyhose.
- Don’t soak in the bathtub longer than 30 minutes or more than twice a day.
TIPPED UTERUS: TILTED UTERUS
What causes a tipped uterus?
A tipped uterus may occur for several reasons including:
- As a woman matures the uterus may not move into a forward position.
- Childbirth can tip the uterus forward or backward. If the ligaments holding the uterus in place stretch, or lose their tension during pregnancy, the uterus can become tipped. In most cases, the uterus returns to a forward position after childbirth.
- Scarring from adhesions as a result of endometriosis or fibroids can also cause the uterus to shift to a tilted or retroflexed state. Sometimes a uterine suspension is used in conjunction with treatments for endometriosis to prevent the formation of adhesions after surgery.
What are some symptoms of a tipped uterus?
Some women do not experience any symptoms.
However, the primary symptoms of a tipped uterus are:
- Pain during sexual intercourse or dyspareunia.
- Pain during menstruation or dysmenorrhea.
Other symptoms may include:
- Back pain during intercourse
- Minor incontinence
- Urinary tract infections
- Fertility problems
- Difficulty using tampons
How is a tipped uterus diagnosed?
Your physician can perform a simple physical exam to determine if you have a tipped uterus. This can be done during a routine pelvic exam. If you suspect that you have a tipped uterus, discuss it with your physician.
What other terms are used to describe a tipped uterus?
There are many alternate ways of referring to a tipped uterus. However, all of the terms mean that the uterus is tipped backwards toward the back of the pelvis.
Common terms include:
- Retroflexed uterus
- Tilted uterus
- Backward uterus
- Retroverted uterus
- Tilted womb
Medical professionals may use the following terms:
- Uterine retroversion
- Uterine retroflexion
- Retroversion of the uterus
- Symptomatic uterine retroversion
- Symptomatic uterine retroflexion
- Uterine retrodisplacement
- Reflexion of the uterus
What is the treatment for a tipped uterus?
If you have a tipped uterus and are experiencing symptoms, your physician may recommend surgery to reposition the uterus. A uterine suspension can typically reduce the pain experienced during intercourse and/or menstruation. This surgical procedure is used to reposition a tipped uterus from its backward facing position to a forward facing position.
The UPLIFT procedure is a newer and improved method of performing a uterine suspension. It has been proven to have fewer postoperative complications than other uterine suspension procedures. Uterine repositioning provides lasting pain relief in most cases of painful sex and in some cases of painful menstruation.
A tipped uterus can also be repositioned by:
- “Knee-chest”: An exercise that may help reposition a tipped uterus temporarily. However, this exercise will not be effective if the uterus has become tipped because of endometriosis, fibroid tumors, or pelvic infections.
- Pessary: A plastic or silicone device that is placed in the vagina to reposition a tipped uterus. It is generally considered a temporary solution for pelvic pain because long term use can lead to vaginal infections.
Can a tipped uterus prevent pregnancy?
Typically a tipped uterus is only thought to be the cause of infertility after all other possible reasons for fertility problems have been ruled out. Your doctor might recommend a uterine suspension or UPLIFT procedure if there is no other explanation for your fertility problems. However, this is not common.
How can a tipped uterus affect my pregnancy?
Usually between the 10th -12th week of pregnancy, your uterus will no longer be tipped or “backwards.” This should cause no difficulty for the pregnancy or for labor and birth. If the uterus does not move into a “middle” position, miscarriage can occur, but this is very rare.
PUBERTY: A BASIC GUIDE FOR YOUNG WOMEN
These hormones guide the physical changes but also produce emotional changes. The following describes changes in girls through puberty.
When does puberty begin?
The average age for puberty is 12 years old.Click To Tweet
The earliest expected age is 8 years old and the latest expected age is 16 years of age.
What causes puberty?
Puberty is triggered when the pituitary gland, a pea-sized gland near the brain, signals the body to release hormones.
Hormones then stimulate the growth and development of reproductive organs as well as other changes throughout the body.
What changes should I expect?
- Breast changes will begin to occur. The breasts will begin to grow in size, including the nipples. It is normal for one of your breast to be larger than the other and for them to feel sore at times.
- Hair will begin to grow in new places during puberty. Pubic hair will slowly begin to grow in a triangular pattern in the pubic area. Hair under the arms will start to grow as well. You may also notice darkening of the hair on your legs or arms.
- Sweating increases and there is a change in body odor. This is a good time to start using deodorant.
- Skin will begin to become more oily than usual. This can cause acne and pimples on your face and back. There are over-the-counter medications and cleaning agents to help treat acne, and if these don’t work, there are prescription medicationsthat should help make a difference.
- Your body will begin to change shape. The hips and thighs will widen, and the pelvis expands. Your body will begin to have more curves. You are becoming a woman!
- About six months to a year before your period starts, you may notice a clear, white vaginal discharge. This is normal and might turn yellow on contact with underwear. If the discharge has a fishy odor or is so much that you would need to wear a panty liner, contact your doctor because this may be a yeast infection.
- At puberty, you will experience your first menstrual period.
What is the menstrual period?
- This is the discharge of blood and tissue from the lining of your uterus each month. During ovulation the lining of the uterus begins to thicken, and if the egg is not fertilized, it is shed during the menstrual period. This discharge of blood is referred to as the menstrual period but is most commonly called the period, and it is a normal function of the female body.
- A girl’s first menstrual period usually starts somewhere between age 8 and 16.
- Periods usually last 3-7 days and happen once a month.
- A girl’s average cycle, the time from the first day of bleeding of one period until the first day of bleeding for the next period, is an average of 28-32 days, although this may vary and be irregular in the beginning.
- There are many choices of feminine hygiene products, such as sanitary napkins and tampons, that can be used during your period. Take time to try different products to find which feels the most comfortable for you.
Why should I keep a calendar?
It is best to start keeping track of your periods on a calendar. Simply mark the first day your period starts on your calendar with an “X”. Count the first “X” as “day one” of your cycle.
Count the days until your next period. If you do this every month, you will know when your next period will begin. Keep in mind that in the beginning this may vary and be irregular.
Discomforts and Premenstrual Symptoms:
During or before your period, you may experience some cramping (dysmenorrhea).
This happens because the uterus is a muscle, and like all muscles, it will contract and relax. During menstruation the uterus contracts more strongly than at other times of the month. This can produce the uncomfortable feeling of cramps.
Cramps will feel like a dull ache or a sense of pressure in the lower abdomen.
Sometimes they come and go, growing stronger and then fading.
Other discomforts that may occur days or weeks before your period are bloating, tender breasts, headaches, feeling tired, mood swings, and food cravings.
Not everyone going through menstruation will have all of these symptoms, but these are the most common.
How can I feel more comfortable during my period?
- Use a hot water bottle or heating pad to relieve cramps and aches.
- Exercise can help relieve some of the cramping.
- Over-the-counter pain medicine such as naproxen, ibuprofen or acetaminophen can help relieve symptoms.
- Taking vitamin B regularly may lessen symptoms.
- If the cramps are unbearable and cause you to miss school or normal activities, you can visit with your doctor and get a prescription for medication which can help regulate your period and relieve some of the pain.
PREMATURE OVARIAN FAILURE: PREMATURE MENOPAUSE
No matter what season of life, it is overwhelming and many times there are questions that are left unanswered. The following are some of the most frequently asked questions about POF.
What is Premature Ovarian Failure (POF)?
Premature ovarian failure is the loss of ovarian function in women under the age of 40. Women with POF do not ovulate (release an egg) each month. This loss of function can be due to a less than normal amount of follicles or a dysfunction in the ovaries.
How does ovulation work?
Before we begin to understand ovarian failure we need to understand ovulation. In brief, a female is born with about 2 million ovarian follicles. As she gets older and reaches puberty she will only have about 300,000-400,000 left. The body does not make anymore. These follicles are very important because they mature to be eggs that will be released during ovulation. Now 300,000 may sound like a lot, but not every follicle becomes a mature egg.
When your menstrual cycle begins, your estradiol (estrogen) levels are low. Your hypothalamus (which is in charge of maintaining your hormone levels) sends out a message to your pituitary gland which then sends out a follicle stimulating hormone (FSH).
This FSH triggers a few of your follicles to develop into mature eggs. Remember only one follicle will be the lucky one to become a mature egg. As the follicles mature they send out another hormone, estrogen. Estrogen sends a message to the hypothalamus to stop producing FSH. If the follicles do not mature and produce estrogen to stop the production of FSH, FSH will continue to produce and rise to high levels.
This is why women with POF are checked for high levels of FSH. Once the levels of estrogen are high enough, the hypothalamus and pituitary gland know that there is a mature egg. A lutenizing hormone (LH) is then released; this is referred to as your LH surge.
Within 24-36 hours of the LH surge the mature egg is released and ready for fertilization. During this period, progesterone has been thickening and preparing your uterine lining for implantation. If fertilization does not occur, then the egg dissolves and a few days later your hormone levels will decrease and your uterine lining will begin to shed. This is called menstruation (menstrual period) and brings us back to day 1 of your cycle. The journey then begins all over again.
Is there a difference between Premature Ovarian Failure (POF) and Menopause?
Menopause usually occurs on average around age 51. Premature ovarian failure can occur at any age before 40, usually on average around age 27. When a woman experiences menopause, she no longer has follicles to produce into eggs and therefore no longer gets her menstrual period.
A woman with premature ovarian failure, or premature menopause, may still have follicles, but there may be a depletion or dysfunction of these. Therefore, she can still get her period; however, most of the time her period is irregular. Irregular periods are one of the signs for POF. Keep in mind that there may be other explanations for an irregular period. Always discuss any irregularity in your menstrual cycle with your healthcare provider.
What are the Symptoms for Premature Ovarian Failure (POF)?
- Irregular periods (different length of bleeding or change in flow)
- Hot flashes
- Night sweats
- Decrease in sexual drive
- Painful sex
- Thinning and drying of vagina
Some women may continue to have normal periods and show no symptoms. Diagnosis may only be discovered when the FSH levels are measured and come back with elevated levels. Discuss any menstrual changes or symptoms with your healthcare provider before coming to any conclusion about POF.
What are my options if I have Premature Ovarian Failure (POF)?
Options for women who have POF and are seeking to have children include: using donor eggs, fertility treatments or seeking to adopt a child.
Doctors may also try a variety of fertility treatments such as:
- Gonadotropin-releasing hormone (GnRH)
- Estradiol and corticosteroids (such as prednisone)
- Clomid (Clomiphene citrate)
- Human menopausal gondotropins (hMG)
None of these treatments have been proven to be effective in restoring fertility, but they are often still used. However, 8% of women with POF who have conceived were using Hormone Replacement Therapy (HRT). Even though there is no absolute treatment, HRT has been one aid in helping women achieve pregnancy.
What causes Premature Ovarian Failure (POF)?
Unfortunately, for most women the cause is unknown.
There are, however, some causes that may be identified which include:
- Autoimmune disorder
- The end of a treatment for cancer with radiation or chemotherapy
- Hysterectomy with both ovaries removed
- Thyroid dysfunction
- Turner syndrome
- Viral infection
- Inadequate gondaotropin secretion or action
- Eating Disorders
If you suspect that you may have symptoms of POF, contact your healthcare provider.
PREMENSTRUAL SYNDROME (PMS) & PREMENSTRUAL DYSPHORIC DISORDER (PMDD)
What are the symptoms of PMS?
- Behavioral symptoms: fatigue, insomnia, dizziness, changes in sexual interest, food cravings, or overeating
- Psychological symptoms: irritability, anger, depressed mood, crying and sadness, anxiety, tension, mood swings, lack of concentration, confusion, forgetfulness, restlessness, loneliness, decreased self-esteem, tension
- Physical symptoms: headaches, breast tenderness and swelling, back pain, abdominal pain and bloating, weight gain, swelling of extremities, water retention, nausea, muscle and joint pain
What are the symptoms of PMDD?
- Behavioral symptoms: decreased interest in usual activities (e.g. work, school, friends, hobbies), sleeping too much or too little, tiring easily and lack of energy, change in appetite, overeating, or specific food cravings
- Psychological symptoms: depressed mood, feelings of hopelessness or self-deprecating thoughts, anxiety, tension or feelings of being keyed up or on edge, suddenly feeling sad or tearful or increased sensitivity to rejection, persistent anger or irritability or increased interpersonal conflicts, difficulty in concentrating, a sense of being overwhelmed or out of control
- Physical symptoms: breast tenderness or swelling, headaches, joint or muscle pain, a sensation of bloating, or weight gain
What should I do if my symptoms are interfering with daily activities?
Keep a premenstrual daily symptom diary for 2-3 months. Then consult with your doctor, and he or she will make the correct diagnosis.
How are PMS and PMDD treated?
The treatment varies; some options might be: making changes in your lifestyle, taking dietary supplements, and/or taking prescription drugs. You should consult with your doctor to determine which treatment is best for you.
POLYCYSTIC OVARIAN SYNDROME
What are the causes of polycystic ovarian syndrome (PCOS)?
Unfortunately, the exact cause of PCOS is unknown. There may be a genetic factor with PCOS, but further testing is needed. Many women who have PCOS also struggle with weight issues; researchers are currently investigating a correlation between the body’s ability to make insulin and PCOS. A symptom of PCOS is that the body produces too much insulin. This can result in an excess production of male hormones which can cause acne, hair growth, weight gain, and ovulation issues.
What are the symptoms of polycystic ovarian syndrome (PCOS)?
The symptoms of PCOS include:
- Infrequent, irregular, or absent menstrual cycles
- Infertility due to irregular or absent ovulation
- Increased hair growth on face, neck, stomach, back, hands, and feet
- Acne, oily skin, and dandruff
- Pelvic pain
- Weight gain/obesity- normally around the waist
- High cholesterol
- High blood pressure
- Thinning hair
- Skin tags located on the neck or armpits
- Dark or thick skin located on the neck, arms, thighs, and/or breasts
- Sleep apnea
How is polycystic ovarian syndrome (PCOS) diagnosed?
Unfortunately there is not a specific test to diagnose PCOS at this time. Normally a diagnosis of PCOS is reached after your health care provider has taken a medical history, performed a physical exam, pelvic exam, ultrasound, and various blood tests. The blood tests check hormone and glucose (sugar) levels. During the physical examination, the health care provider will examine the ovaries and uterine lining. Any abnormal findings are often verified by an ultrasound.
What treatments are available for women who have been diagnosed with polycystic ovarian syndrome (PCOS)?
There is no cure for PCOS, but it can be managed so that other problems are prevented. The treatment plan is determined by the symptoms that a woman is experiencing. A health care provider may use one plan or a combination of plans, depending on a woman’s situation.
The following list includes common treatment options:
- Healthy lifestyle and weight- Maintaining a healthy weight is also a way to manage PCOS. A healthy diet and exercise can manage weight, help the body to use insulin more effectively, lower glucose levels, and help regulate periods.
- Birth control pills – Women who are not trying to conceive may find it beneficial to begin taking birth control pills. These can help regulate periods and improve acne and hair growth. Symptoms can return if a woman stops taking the pills. Birth control pills containing only progesterone can help with the irregular periods but will not help with acne or abnormal hair growth.
- Fertility medications – The primary fertility problem with PCOS is the lack of ovulation. However, additional fertility testing may be completed to make sure that there are not other problems present. Different medications can be prescribed to help the ovaries release eggs, but women who take such medications need to know that they are at an increased risk for a multiple pregnancy. In vitro fertilization (IVF) can also be used to help a woman with PCOS conceive.
- Diabetes medications – Metformin/Glucophage can regulate the production of glucose and the male hormones. The abnormal hair growth should slow down, and ovulation may return in a few months. Taking metformin will not cause a person to become diabetic.
- Medication for increased hair growth or too many male hormones – These medications should only be used if a woman is not trying to become pregnant. Non-medical treatments such as electrolysis or laser hair removal are effective in treating unwanted hair. Hormones can be taken to prevent new hair from growing. If a woman is pregnant or trying to conceive, she needs to consult with her health care provider before undergoing any kind of hair treatment for unwanted hair.
- Surgery – While surgery is not normally used as a first line of treatment, a laparoscopic procedure (in which a small electric current is applied to the ovary) may be considered. A small portion of the ovary is destroyed which can decrease the production of male hormones and increase ovulation. It will not help with excessive hair growth and also carries the risk of scar tissue forming on the ovaries. Normally, results only last a few months, and then the symptoms return.
How can polycystic ovarian syndrome (PCOS) affect pregnancy?
Women who have PCOS appear to have an increased risk of miscarriage, pregnancy-induced hypertension, gestational diabetes, and premature delivery.
Can polycystic ovarian syndrome (PCOS) place a woman at risk for any other conditions?
Women who have been diagnosed with PCOS seem to be at a greater risk of developing endometrial cancer, diabetes, high blood pressure, high cholesterol, and heart disease. Getting symptoms controlled as soon as possible can decrease a woman’s chance of developing any of these other conditions.
When should I have a Pap smear?
It is recommended that all women get a Pap smear done at age 21. Recent changes to testing guidelines have removed the need for anyone under the age of 21 to be tested, regardless of sexual activity. Pap smears should then be done every 3 years until they are 29. Women between the ages of 30 and 65 can either be Pap-tested every 3 years, or every 5 years with a Pap/HPV cotest. Discuss with your health provider what they recommend for a Pap smear schedule as some still encourage that they are done yearly. Even if your health care provider recommends you have a Pap smear every 2-3 years, you still should see your gynecologist every year for pelvic exams, information regarding other women’s health issues, and breast exams. Women should have a Pap smear in the middle of their monthly cycle, or about 10-20 days after the LMP (last menstrual period) began. At least 2 days before the test, women should avoid having anything in the vagina including sexual intercourse, douching, vaginal creams/suppositories, or spermicide. These could interfere with the results of the test and cause an abnormal result.
What happens during a Pap smear?
As part of your pelvic exam, your physician will use a small spatula, brush, or swab to remove a few cells from your cervix. You may feel some discomfort, but it is not painful. The cells are placed on a microscope slide and sent to a lab for results. You can help your clinician obtain a good Pap smear by not having intercourse, not douching, or not using any products/medications in the vaginal area for at least two days prior to the examination.
What do the results of a Pap smear mean?
A negative result means that your cervix is normal. A positive result indicates the presence of abnormal cells. Your physician may also call this an abnormal Pap. Remember that this is a test, not a diagnosis. A positive result does not prove that you have cancer or even dysplasia (a pre-cancerous condition). However, it usually means you should have further evaluation, such as a colposcopy (microscope used to look into the cervix) or a biopsy (removing a small amount of tissue from the cervix). Your doctor will discuss the results with you. One in ten Pap smears indicates some abnormality, though most are not serious. Further testing will be required to determine if you have infection, inflammation, a yeast infection, trichomonas, herpes, or the human papilloma virus. Researchers believe that cervical cancer is directly related to the human papilloma virus (HPV).
There are over 100 different types of HPV. About 30 types are spread through sexual transmission and can possibly lead to cervical cancer. HPV is the main risk factor for cervical cancer, but most women who receive treatment for abnormal cells caused by HPV, do not develop cervical cancer. In 2003, the FDA approved a screening test that can be done in conjunction with a Pap smear to determine if you have the HPV virus.The HPV DNA test can detect high risk types of HPV before any abnormal cells can be detected on the cervix. This screening is recommended for women over the age of 30, who are at an increased risk of an HPV infection turning into pre-cancerous cells. Some Pap smears indicate an unsatisfactory sample because of recent sexual activity or use of vaginal creams and douches. Regardless of the reason, an abnormal Pap will require another Pap smear in a few months. With proper screening, cervical cancer is preventable and avoidable.
What if I am pregnant, and I have an abnormal Pap smear?
A Pap smear is a routine part of your pre-natal care and poses no risk to the fetus. If you have an abnormal Pap during pregnancy your physician will discuss treatments which can be done safely during pregnancy, or depending on diagnosis, delay treatment until after your baby is born. If your physician suggests a colposcopy or cervical biopsy, there can be slight bleeding from the external part of the cervix, but this is not a serious complication. If your physician is considering doing an internal biopsy into the endocervical canal, there may be a slight risk of a pregnancy complication. But your health care provider has your best interest in mind and will only do what is medically necessary. Your doctor may perform additional Pap smears during your pregnancy if necessary. Many times the birth of your baby will wash away any abnormal cervical cells.
When can a woman stop having Pap smears performed?
According to the National Cancer Institute, women who are over the age of 70 and have a history of normal Pap smears are very unlikely to develop cervical cancer and therefore can discuss the option of not needing any further pap smears. Women who have had a hysterectomy with both the uterus and cervix removed, for reasons not related to cancer, can also discuss the option of not needing any further Pap smears.
Who needs pap smears more often?
Women who are taking immunosuppressant medications or have a condition that weakens the immune system should have more frequent Pap smears. These women need to discuss what type of testing schedule they should be on with their health care providers.
MENSTRUATION: A JOURNEY THROUGH YOUR CYCLE
Why do I bleed once a month?
It’s hormones! Hormones trigger your ovaries to produce and release one egg from either your right or your left ovary. This is called ovulation. Before ovulation occurs, your uterine lining is thickening to prepare for a fertilized egg to implant in the uterus. If an egg is not fertilized, then the uterine lining sheds. This is called menstruation or your menstrual period.
Why is my period different from Jane’s?
Every woman’s cycle (the time from the first day of your menstrual period until the first day of your next menstrual period) is different. On average, a woman has her menstrual period for 3-7 days. The average length of a woman’s cycle is 28-32 days. This leaves plenty of room for a woman to vary from her neighbor, friend, or co-worker. Women also vary in the severity of symptoms that occur before and during menstruation.
Before and during menstruation:
Approximately 85% of women who menstruate report changes in the days or weeks before their menstruation that cause problems that affect their normal lives. This is known as Premenstrual Syndrome (PMS).
During menstruation, the uterus, which is a muscle, contracts and relaxes more than it does at other times in the month. This can produce the uncomfortable feeling of cramps. Using a heating pad or hot water bottle may help ease some of the discomfort.
Taking over-the-counter pain relievers such as naproxen, ibuprofen, or acetaminophen may also help. Other discomforts during menstruation may include breast tenderness, bloating, headaches, fatigue, mood swings, and food cravings. Some women will experience these symptoms more than others will, and not every woman will experience all of these symptoms.
What if my period is late or I missed my period?
Sometimes a period may come late or be missed for the month. Frequently, a woman’s first thought is that she is pregnant. Yes, that could be the case, but there are times when a woman may be late or miss her period for other unsuspected reasons.
These reasons include:
- Significant weight gain/loss
- Hormonal problems
- Ceasing to take the birth control pill
- Increase in exercise
View and print an Ovulation Calendar to better understand your menstrual cycle and ovulation.
FIBROID TUMORS; FIBROID UTERUS
Fibroid Tumors: Causes, Diagnosis and Treatment
Fibroid tumors are usually undetected non-cancerous masses that grow in the uterus. There are several types of fibroids found in the uterus, and it is common for women to have multiple fibroids of various sizes. In most cases, fibroid tumors are painless. Fibroids may also be referred to as myoma, leiomyoma, leiomyomata, and fibromyoma.
What causes fibroids in the uterus?
A definitive cause of fibroids is unknown, but they appear to be related to estrogen. This relationship between fibroids and estrogen is known because tumors grow when taking birth control pills containing estrogen and during pregnancy when more hormones are released. Following menopause, when estrogen is no longer produced, tumors tend to shrink and even disappear.
What are the different types of fibroids in the uterus?
Fibroids are classified according to their location within the uterus. There are four primary types of fibroids:
Subserosal Fibroids: Fibroids that develop in the outer portion of the uterus and continue to grow outward. These typically do not affect a woman’s menstrual flow but can cause pain due to their size and pressure on other organs.
Intramural Fibroids:Fibroids that develop within the uterine wall and expand, which makes the uterus feel larger than normal. Symptoms associated with intramural fibroids are heavy menstrual flow, pelvic pain, back pain, frequent urination, and pressure. This is the most common type of fibroids.
Submucosal fibroids: A type of fibroid that develops just under the lining of the uterine cavity. This is the least common type of fibroid; however these types of fibroids commonly cause symptoms such as heavy prolonged menstrual periods.
Pedunculated fibroids: This type of fibroid occurs when the fibroid grows on a stalk. Pedunculated fibroids can either develop in the uterus or grow on the outside of the uterus.
It is common for a woman to have multiple fibroids, and it is possible that she has one or all of these types of fibroids.
How are uterine fibroids diagnosed?
Fibroids are usually discovered when your health care provider performs a pelvic examination and feels lumps in your uterus. To make an accurate diagnosis, your health care provider will perform either a CT scan or an ultrasound. These are non-invasive procedures that allow the viewing of your internal organs.
What is the health concerns related to uterine fibroids?
Fibroid tumors may not be a problem for some women, and in some cases treatment may be directed at managing the symptoms. Fibroid tumors may cause problems for women who wish to get pregnant because the tumors may be growing all along the uterine wall making implantation of a fertilized egg doubtful. Fibroid tumors may also cause some women to experience pelvic pain and heavy bleeding.
What are the treatments for uterine fibroids?
If there are multiple fibroids, it will be hard to determine which fibroid(s) are causing your symptoms. In many cases, there will be small fibroids that are undetected, so you should anticipate having multiple fibroids when discussing treatment options.
The selection of the appropriate procedure is determined between you and your health care provider, but the following factors contribute to the recommended approach:
- Size and location
- Severity of symptoms
- Childbearing plans
Severe symptoms often lead to the recommendation of a hysterectomy.
Each of the following procedures serves as a treatment option, particularly for women who still wish to have children:
- Myomectomy: A surgical procedure done to remove only the tumors from the uterus. This procedure is more dangerous than a hysterectomy, but it is an option if you still desire to get pregnant.
- Embolization: This is a surgical procedure that involves cutting off the blood supply to the fibroid. This is a common procedure when symptoms are not severe.
- Myolysis: A procedure which uses electric shock to shrink the fibroids.
This lining continues to be aggravated at the times of ovulation and menstruation and can break down and bleed, tear away, or form painful scar tissue.
These implants or lesions grow abnormally leading to pain and discomfort. According to the Endometriosis Research Center, this disease affects more than 7 million women in the US and is the leading cause of female infertility, chronic pelvic pain, and gynecologic surgeries.
What causes endometriosis?
There is no known cause for endometriosis. Some experts have come up with a few possibilities, but nothing has been conclusively proven. One possible cause of endometriosis is that during menstruation, menstrual tissue backs up into the fallopian tubes, enters the abdominal cavity, and implants.
Most physicians believe that all women experience some type of back up at some point, but women who have immune problems go on to develop endometriosis.
Another theory is that endometriosis is a genetic birth abnormality in which the endometrial cells develop outside of the uterus during fetal development. Once this female is grown and begins to experience menstruation, these misplaced cells become lesions or implants that cause pain and discomfort.
There is also a genetic theory that is being studied worldwide by doctors based in London. This theory bases strong evidence on the idea that endometriosis is hereditary. Early studies show that women with a family history of endometriosis are more likely to have daughters who suffer from the disease.
What are the symptoms of endometriosis?
Symptoms of endometriosis may include one or more of the following:
- Chronic or intermittent pelvic pain
- Dysmenorrhea (painful menstruation)
- Painful sexual intercourse
- Painful bowel movements
- Heavy or irregular bleeding
- Pain during ovulation
- Gastrointestinal problems (constipation, diarrhea, bloating)
- Painful urination
- Lower back pain
How is endometriosis diagnosed?
Endometriosis can only be diagnosed through surgery. Ultrasounds, MRIs, and CAT scans are not conclusive when diagnosing endometriosis. A physician will usually study the history of symptoms and decide whether a surgical procedure is needed to make a diagnosis. A laparoscopy or laparotomy procedure is used when trying to diagnose endometriosis.
Is there a cure for endometriosis?
There is not a cure for endometriosis, but there is treatment to help women manage and deal with their symptoms.
What is the treatment for endometriosis?
The treatment of endometriosis can be handled in one or more of four ways:
Pain Medication: Some over-the-counter pain medications such as aspirin, acetaminophen, and ibuprofen may lessen the discomfort for women when dealing with endometriosis. Prescription medication may be needed if the pain does not respond to over-the-counter drugs.
Hormonal Drug Therapy: Hormonal drugs are given to try to stop ovulation for as long as possible in order to keep the implants or lesions from being aggravated. These can include oral contraceptives, progesterone drugs, and GnRH agonists.
Most of these therapies can only be given for a limited amount of time, and the side effects can cause problems for some women. Hormonal drug therapy is used to ward off symptoms and is often most effective when used after surgical treatment has been done.
Surgery: Conservative surgery is used to diagnose, remove growths, relieve pain, and increase the chances of pregnancy. Conservative surgery is usually done through a laparoscopy or a laparotomy. In some cases, a more radical surgery such as a hysterectomy is recommended for treating endometriosis.
Alternative or Natural Therapy: Some women have found different types of natural remedies to use when dealing with endometriosis. Remedies such as vitamins and herbs, diet changes, acupuncture, myofascial release and Chinese medicine have proven to be useful therapies when managing endometriosis.
Talk with a certified dietician, acupuncturist, physical therapist or homeopathic physician on alternative ways to deal with symptoms of endometriosis.
FAQ’s about endometriosis:
Does pregnancy cure endometriosis?
There is no cure for endometriosis, but for some women pregnancy can lessen the symptoms and effects.
If I have a hysterectomy, will that make my endometriosis go away?
A hysterectomy is not the cure for endometriosis, but it can make a difference for some women. Discuss all of your options with your doctor before choosing to have a hysterectomy.
How can I prevent endometriosis?
There is no known prevention at this time. Researchers have not discovered a conclusive reason why women get endometriosis, therefore they do not have a way to prevent it from occurring.
Where are endometriosis lesions found?
The most common areas for endometriosis to implant are on the ovaries, the outside wall of the uterus, fallopian tubes, pelvic cavity, and reproductive organ ligaments. Lesions can also be found on the bladder, bowel, cervix, vagina, and abdominal surgery scars.
I have all the symptoms of endometriosis, but my doctor said that I do not have it… could he be wrong, or is this all in my head?
Yes, your doctor could be wrong, and NO, it is not in your head! Endometriosis is one of the most misunderstood diseases in women’s health. This does not mean that your doctor is not a good physician, but with any disease, a specialist is the best at making a conclusive diagnosis.
The average amount of time it takes for a woman to get an accurate diagnosis from the onset of symptoms is about 10 years. This is due to the lack of research and information getting to doctors and the fact that endometriosis can mimic many other diseases and disorders. The best thing is to seek out an endometriosis specialist and let him/her confirm the possibility of endometriosis.
If I have been diagnosed with endometriosis, does that mean I cannot get pregnant?
Endometriosis can cause infertility in many women, but with proactive treatment, the possibility of pregnancy is increased. Discuss treatment options with your doctor to decide what would be the best course to take to increase your chances of pregnancy.
They also spread directly through the tissue next to the cervix. If cancerous cells are found before they have spread, treatment is more likely to succeed.
How common is cervical cancer?
In the United States, cervical cancer accounts for nearly 2.4% of all cancers in women. There are about 9,700 new cases of invasive cervical cancerand 3,700 deaths from cervical cancer each year.
Who is at risk for having cervical cancer?
Women between ages 35-50 are at risk for having cervical cancer because it develops after abnormal cells have been present for several years. Those women who have had a sexually transmitted viral infection (such as genital warts), started having sex before age 18, or have had many sexual partners are also at risk for developing cervical cancer.
What are the symptoms of cervical cancer?
Unfortunately there are often no symptoms to warn you of cervical cancer; however, the following symptoms could be potential warning signs:
- Abnormal bleeding, spotting, or discharge from the vagina after intercourse, between periods, or after menopause
- Watery, bloody discharge from your vagina; it may be heavy and have an unpleasant odor.
- With advanced cancer, there may be pain, problems urinating, and swelling in the legs.
What else could these symptoms mean?
These symptoms could also mean you have dysplasia, which is a type of cervical disorder that occurs when there is a change in the cells on the surface of the cervix. Normal, benign cells are replaced by abnormal cells. Cells exhibiting dysplasia are not cancerous, but these cells can become cancer cells if not treated.
How is cervical cancer diagnosed?
Cervical cancer is diagnosed by a Pap smear. Using a small wooden spatula, brush, or cotton swab, your physician gently scrapes the entire surface of your cervix to gather cells and also takes a cell sample from inside your cervical canal by inserting a brush. The cells are sent to a laboratory for microscopic analysis. A negative result means that your cervix is normal.
A positive result does not necessarily indicate cancer or even dysplasia; but more tests, such as a biopsy, are needed. A biopsy is a procedure in which small pieces of cervical tissue are removed for study. A biopsy most often can be done in the doctor’s office or clinic. You may experience mild cramping or a pinching feeling. This test will determine if any cancer exists and has spread to the uterus.
How serious is cervical cancer?
Cervical cancer is serious if it has spread beyond the uterus. Invasive cervical cancer accounts for 3% of cancer related deaths in American women each year.
How is cervical cancer treated?
Treatment of cervical cancer depends on the size of the tumor and the extent (if any) to which it has spread.
Some treatment options include:
- Dilation and curettage involves gently scraping your uterine lining for tissue samples to find out whether the cancer has spread to your uterus.
- A radical hysterectomy is a procedure in which the surgeon removes the uterus (including the cervix),the upper vagina, surrounding tissue, lymph nodes, and the fallopian tubes. The ovaries may be left in place for younger women.
- Radiation therapy involves both radiation delivered by a machine and internal radiation from radioactive material implanted in the uterus or in the upper part of the vagina. These implants are left in the uterus for several days while you remain in the hospital. Side effects may include diarrhea, rectal bleeding, and fatigue.
What are the symptoms of bacterial vaginosis?
The symptoms of bacterial vaginosis include a white or grayish vaginal discharge with an unpleasant, fishy odor. Women with bacterial vaginosis may also have burning during urination or itching around the outside of the vagina, or both. However, some women with bacterial vaginosis report no signs or symptoms at all.
Can bacterial vaginosis lead to other problems?
Although most cases of pelvic inflammatory disease (PID) are caused by Gonorrhea or Chlamydia, bacterial vaginosis can lead to PID. involves a severe infection of the uterus, fallopian tubes, and ovaries which may lead to infertility, tubal pregnancies, and chronic pelvic pain. Bacterial vaginosis also makes you more susceptible to HIV, gonorrhea, and chlamydia. Pregnant women with bacterial vaginosis are more likely to have babies who are born prematurely or with low birth weight.
How is bacterial vaginosis transmitted?
Bacterial vaginosis is not transmitted from one person to another like most STDs, but it is associated with having vaginal intercourse. Women who have a new sex partner or who have had multiple sex partners are more likely to develop bacterial vaginosis.
How is bacterial vaginosis diagnosed?
Bacterial vaginosis is diagnosed by your health care provider through a pelvic exam. The vaginal fluid is tested for an increase in harmful bacteria.
How is bacterial vaginosis treated?
Bacterial vaginosis may be treated and cured with antibiotics administered orally or through a vaginal cream or gel.
Can bacterial vaginosis be prevented?
Bacterial vaginosis can occur in women who have never had sexual intercourse, but it is rare. The best way to prevent bacterial vaginosis is to refrain from sexual contact of any kind, or be in a long-term monogamous relationship such as marriage.
ABNORMAL PAP SMEAR
Women are encouraged to start getting yearly Pap smears at the age of 21 or within 3 years of becoming sexually active. When women are faithful in having regular Pap smears, they increase their chances for early detection and treatment of any potential problems.
What does an abnormal pap smear mean?
Being alarmed or worried is a completely normal reaction when told your Pap smear is abnormal. An abnormal Pap smear may indicate that you have an infection or abnormal cells called dysplasia. It’s important to remember that abnormal Pap smear results do not mean you have cancer. These results just show that further testing should be done to verify whether or not there is a problem.
What could cause an abnormal pap smear result?
An abnormal Pap smear may indicate any of the following:
- An infection or an inflammation
- Recent sexual activity
- HPV (Human Papilloma Virus) This is also called genital warts (up to 60% of women may carry this virus on their cervix, genital area, or skin and are completely unaware of it).
- Dysplasia (abnormal cells that can be pre-cancerous)
What is the treatment for an abnormal Pap smear?
A positive result indicates the presence of abnormal cells, also called an abnormal Pap. Remember that this is a test, not a diagnosis. A positive result does not prove that you have cancer or even dysplasia (a pre-cancerous condition).
However, it usually means you should have further evaluation, such as another Pap smear, a colposcopy (using a microscope to look into the cervix) or a biopsy (removing a small amount of tissue from the cervix). Your doctor will discuss the results with you.
One in ten Pap smears indicate some abnormality, though most are not serious. Further testing will be required to determine if you have infection, inflammation, a yeast infection, trichomoniasis, herpes or the Human Papilloma Virus (HPV).
HPV is the main risk factor for cervical cancer, but most women who receive treatment for abnormal cells caused by HPV, do not develop cervical cancer.
In 2003, the FDA approved a screening test that can be done in conjunction with a Pap smear to determine if you have the HPV virus.The HPV DNA test can detect high risk types of HPV before any abnormal cells can be detected on the cervix. This screening is recommended for women over the age of 30, who are at an increased risk of an HPV infection turning into pre-cancerous cells.
Some Pap smears indicate an unsatisfactory sample because of recent sexual activity or use of vaginal creams and douches. Regardless of the reason, an abnormal Pap will require another Pap smear in a few months.
If the abnormal cells are persisting, you may need further treatment, which may include the following:
- A colposcopy is an examination in which a speculum is inserted into the vagina, and the cervix is painted with a vinegar solution which makes any abnormal areas stand out. When an abnormal area is located, a sample (biopsy) of the area may be taken for accurate diagnosis by a pathologist.
- Cryosurgery, or a freezing of the abnormal cells, is usually performed next. Cone biopsy is a procedure in which a triangle of cervical tissue is removed including the abnormal cells; this is either performed in a doctor’s office or as an outpatient procedure. Bleeding and watery discharge are common after this treatment.
- The LEEP procedure is similar to a cone biopsy, but a loop-shaped instrument is used to remove the abnormal area. Bleeding and discharge may also occur.
What check-ups are necessary after treatment?
Check-ups following treatment are necessary to make sure all the abnormal cells are gone and the cervix has healed. Early detection is the key to minimize the risk of cancer developing. After treatment, women will be advised by their health care providers as to how often they will need to have routine Pap smears.
What if I have an abnormal pap smear during pregnancy?
It is safe to have a Pap smear during pregnancy. If your Pap smear results are abnormal, a colposcopy could be performed during your pregnancy. However, further treatment will probably be delayed until after your baby is born.
Frequently, the birth of your baby will wash away any abnormal cervical cells. Having an abnormal Pap smear does not pose a risk to your baby.
When Sex Hurts: Vaginismus
What is Vaginismus?
Vaginismus is an involuntary contraction, or reflex muscle tightening, of the pelvic floor muscles that generally occurs when an attempt is made to insert an object (tampon, penis, speculum used for a Pap test) into the vagina. This muscle tightening causes pain, which can range from mild discomfort to severe burning and aching. Vaginismus may be primary (i.e. lifelong), or secondary (occurring after a period of normal sexual function). It may also be global (occurs in all situations and with any object) or situational (may only occur in certain situations, such as with one partner but not others, or with sexual intercourse but not with tampons or pelvic exams or vice versa).
Deciding about Vaginismus
If you thinking to do the treatment, you should be clear about the “why” & the “who” – why you want it and with whom you should do it. You can expect pain free sexual intercourse with your partner after the succeful treatment
Choose your Doctor
Choice of your doctor is the right dicision here, who have relevent experience in this procedure and with great success rates. Doctor Roya is one of the kind and the only Doctor in Middle East who has been involved with this treatment of sever Vaginismus in last 10 years.
Preparing for initial meeting with the Doctor
Once you are ready to meet doctor you can call us and fix an appointment with doctor. On the appointment day with our chosen expert doctor who is going to do the procedure will cunsult you, you should expect the following
- Discussion on your need of treatment and reasons
- Understanding your medical history
- Chechking you current health status
- Physical exmanination
- Explanation of the procedure. Risks and complication
Treatment : Dr Roya .Pourghorban has been treating vaginismus mostly with botax injection in affected vaginal muscles to treat the muscular spasm in this area and patients always have been happy with treatment even after 4 to 6 years sever vaginismus that has made them unable to do sexual intercourse.
Vaginismus in Dubai – why at RMC?
Roya medical center is dubai’s best clinic for treatment of Vaginismus, Treatment will be done by Dr. Roya Pourghorban one of the best best in this procedure. She is the fist doctor in Middle East who has been involved with treatment of sever Vaginismus with Botax in last 17 years.