Friday, 26 August 2016

Infertility and Your Relationship

Having a baby is one of the most exciting times in a couple’s life, but for couples coping with infertility and infertility treatments, conceiving a baby can be trying. The physical, emotional and financial stress of infertility can, if you’re not careful, hurt your relationship with your partner.

In fact, nearly one-fourth of women in a recent survey conducted by the nonprofit organization HealthyWomen reported that infertility had a negative impact on their relationships. The good news is that about a third of women in that same survey said their infertility struggle actually benefited their relationships with their partners.

Other good news:

About three-fourths of women say their partners were very or extremely supportive while they went through infertility treatment

Ninety percent of women are still with the same partner they were with when they went through infertility treatment. Those that separated said the treatments were not a major reason for the breakup.
The tips and information contained here will help you and your partner remain in that 90 percent group—emerging from your infertility journey with your relationship not only intact but stronger, regardless of what happens in your quest for a child.

Avoiding Blame

So you just got the diagnosis. Your husband’s sperm are “slow.” Or your endometriosis has blocked one of your fallopian tubes. Or the infection your husband had during his bachelor days damaged many of his sperm. It would be easy to turn to one another and shout, “It’s your fault!” But the reality is that no matter who plays the blame game, you both lose.
Does it really matter whose “fault” it is? After all, this is not something you have much control over. And it may be too late to change the few things you might have once controlled, such as trying to conceive when you were younger. The reality is what you’re facing today: Having a baby is going to be more difficult for the two of you than for many other couples.

To keep from turning down the blame lane:

Reassure your partner that you are both in it together
Remember how you feel about your partner, why you love him or her, why you want to have a child together.

Talk about your frustration and anger openly. Studies show that couples who keep their feelings hidden are much more likely to have problems related to the stress of infertility.
Attack the infertility issue as a united front. That means going to appointments together, coping with side effects together, grieving together, sharing the news together with friends and family.
Keeping Your Relationship HealthyThere are ways to protect your relationship from the potentially damaging stress of infertility, including:
Focus on yourselves. Remember that the two of you came first, before any thought of a baby. Even if you do have a child, the two of you still need to be a healthy couple before you can be good parents.
Schedule non-infertility dates. On these dates, neither of you is allowed to talk about children, infertility, medical treatments, adoption or anything to do with what you’re going through.
Bring spontaneity back into sex. Have sex dates that are not focused on reproducing. That can mean not discussing fertility before, during or after the sexual act or having sex without intercourse. Send a note inviting your partner to a pleasure-only sex date. Consider having sex in a different location or even a different environment. What about checking into a local hotel for just one night? Or go camping and let the fresh air energize you romantically. The key is to make it so spontaneous, so much fun, that you banish the “work” that sex has become.

Take a break. You and your partner might consider taking a monthlong break from trying to get pregnant. Reducing the stress and anxiety in your sexual relationship now will ensure that your sex life will remain a source of pleasure and relaxation for years to come.

Get physical together. Exercise is a fabulous stress buster. But why go it alone? Consider taking up tennis, dancing, bike riding or kayaking—all fun, physical activities you can do together. Consider taking a yoga class together. It will not only strengthen your body but also teach you deep breathing, which is helpful in relaxing and focusing. Of course, there’s nothing wrong with long walks either. Just remember to hold hands.

Respect your differences. Each of you will deal with the situation differently. Just because he doesn’t cry or talk for hours about the infertility doesn’t mean he isn’t hurting. Men are more likely to distance themselves from the issue and become irritable. Understand that this may be his way of coping.

Talk! He cannot read your mind. If you need him to be more supportive, tell him, but be specific. What do you mean by supportive? If you need time to be alone because you’re angry and upset and don’t want to take it out on him, tell him so he doesn’t think you’re shutting him out. If you have a hard time verbalizing your feelings, try writing them down in an e-mail or letter to him.
Agree on how far you’ll go. You can easily exhaust your bank account, marriage and emotional reserves through infertility treatment. It’s a good idea to talk before the rollercoaster ride begins about which treatments and how many you’ll undergo and how much money you’ll spend. You may not know at the outset what decisions you will face, but you can talk to other couples through a support group or ask your health care provider to give you research and possible scenarios that you can consider.

Seek outside help. Even if you think your relationship will weather the infertility storm, it’s still a good idea to talk to a couples’ therapist. You know the saying: “An ounce of prevention…” You also may consider joining a support group for people going through infertility treatments.
From the Male Perspective

Sometimes it may seem as if your wife or partner is the only one experiencing infertility. She’s the one who gets the hugs and flowers; she’s the one who is asked about her feelings, her health, her emotional state.

But what about you?

Chances are, you’re suffering too. A recent study found that the male partners of infertile couples were quite likely to feel depressed and to have erectile dysfunction and other sexual relationship problems. Unfortunately, too often men try to distance themselves from infertility, keep their feelings to themselves and focus on plans to “solve” the infertility, all of which are less-than-ideal ways of coping that can harm your relationship.

Discussing your feelings with your partner will allow you to bond over feelings of being out of control. Initiating and participating in fertility-free dates or intercourse-free dates may allow you to reexplore the eroticism of earlier times in your courtship and provide relief from goal-oriented sex.
These tips can help the two of you maintain a strong relationship as you work through the physical and emotional issues of infertility in your quest for a child.

5 Ways to Prepare for Pregnancy

Technology can help in many ways, but don’t overlook basic health practices when planning for pregnancy. For example, one of the most important things you can do for yourself and your baby is also one of the simplest: remember to take a daily vitamin before you try to get pregnant and throughout your pregnancy. Folic acid, found in prenatal vitamins, can slash the risk of major birth defects of the fetus‘ brain and spine between 50 and 70 percent. There’s even some evidence it can reduce the risk of other birth defects, including cleft palate, stomach problems and defects in arms and hands.

That’s why the U.S. Food and Drug Administration mandated fortifying all cereal products with folic acid in 1998. Since then, the incidence of neural tube defects dropped 26 percent.

All of which makes pre-pregnancy planning important, says Michelle Collins, CNM, a certified nurse midwife and clinical faculty member at Vanderbilt University in Nashville, TN. Pre-pregnancy or “preconception” planning involves a visit to your health care provider for a full medical evaluation, including a detailed medical history before you begin trying to get pregnant.

Consider the affect of preexisting conditions and current medications on pregnancy

It’s a time to consider how you’ll treat any preexisting condition that requires medication, such as . A woman with diabetes, for instance, runs the risk of having a child with cardiovasculardisease or other problems if her blood sugar levels aren’t well-controlled before and during her pregnancy, says Ms. Reynolds. Plus, certain anti-seizure medications may cause defects in the infant by interfering with a woman’s ability to use folic acid. And in late 2005, the FDA warned pregnant women not to use paroxetine(Paxil), a popular antidepressant, during pregnancy because of a potentially higher risk of birth defects.
That doesn’t mean you have to stop taking all medications during pregnancy, says Ms. Reynolds. Usually, there are alternatives available that have been shown to be safer during pregnancy.
Understand how your weight can affect your chances of conceiving

The time before pregnancy is also the time to address any weight problems. Studies find that being overweight can increase your risk of gestational diabetes and may even make it harder to get pregnant. Conversely, being underweight can interfere with fertility.
Quit smoking before you get pregnant

And, of course, it’s a time to quit smoking. Smoking not only increases the risk of having a low birth-weight baby, but also a baby with Down syndrome and a multitude of other birth defects.
Discuss preconception and genetic counseling with your health care provider and your options for pregnancy

In addition to preconception counseling, women might consider genetic counseling before they get pregnant, says Ms. Reynolds. During genetic counseling, a specially trained counselor takes a detailed medical history of you and your partner, as well as your families, to identify any potential or known genetic disorders. “Often, it is only when a woman becomes pregnant that genetic disorders come up, and for some, it’s too late to make a difference in promoting a healthy outcome,” she says. But even here, technology can step in.

A relatively new form of in vitro fertilization called preimplantation genetic diagnosis (PGD) can enable couples who carry genes for genetic disorders like Tay-Sachs or sickle cell anemia to have a healthy child. The procedure involves removing one cell from an eight-cell embryo and studying it for any genetic abnormalities. Only those embryos with no obvious problems are implanted into the woman’s uterus.

The procedure isn’t 100 percent effective, however. University of Florida researchers find that about 1.5 percent of embryos may be implanted with undetected genetic disorders because of a rare condition called chromosomal mosaicism.
But for women who know they have a genetic risk for one of these devastating diseases, PGD can be a tremendous advantage.
Another advantage is a test given to women in the first trimester of pregnancy who have a risk of having a child born with Down syndrome. The disorder is the most common chromosomal abnormality, affecting about one in 800 babies born each year.

Previously, the only way to know if a woman was having a baby with Down’s was with second-trimester blood tests and/or invasive amniocentesis or chorionic villus sampling (CVS) tests, all of which carry a slight risk of miscarriage. If a woman then decided to terminate the pregnancy, she faced a more complex and emotionally wrenching second-trimester abortion.

But a major study published in the New England Journal of Medicine in November 2005 found that screening in the first trimester with an ultrasound and blood test can identify most fetuses with Down syndrome between the 11th and 13th weeks of pregnancy, allowing women to decide what they want to do earlier in their pregnancy.

The blood tests measure levels of certain proteins and hormones that could indicate Down’s, while the ultrasound assesses the thickness of the fetus’ neck, called the nuchal translucency. By learning of her risk in the first trimester, often before she even starts showing or telling people about her pregnancy, a woman has more privacy to make her decision and, if she decides to continue the pregnancy, more time to grow accustomed to the idea of having a child with Down syndrome, says Dr. Wu.

Know Your Options for Managing Pain after Surgery


If you find yourself heading to the operating room, you’re not alone. Each year, 51.4 million people undergo in patient surgical procedures in the United States for various reasons. While preparing for the surgery itself is important, preparing for what happens after the surgery is crucial to ensuring a smooth and comfortable recovery.

Working with your health care provider to develop a plan to manage postsurgical pain is an important first step.

Before undergoing surgery, read these must-know facts about postsurgical pain management:
The importance of pain management

Pain control not only makes you more comfortable, it can help you recover faster and may reduce your risk of developing certain complications after surgery, such as pneumonia and blood clots. If your pain is well controlled, you will be better able to complete important tasks such as walking and deep breathing exercises.
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Customizing your pain management plan

Your initial pain management plan will be decided before you go into surgery based on a review of your medical and surgical history, results from laboratory tests and a physical exam.
A combination of medications may be used to block the pain in different areas.  There are new options for pain management that you may not be familiar with, and your health care professional can advise you about which medications may be best suited to safely minimize your discomfort.
Ultimately, you are the one who decides which pain control options you’ll use. After surgery, you will be assessed frequently to ensure that you are comfortable and safe. When necessary, adjustments or changes to your pain management regimen will be made.
Pain management options

Many surgeons and hospitals now use a “multimodal approach” to pain management to reduce the total exposure to any one product, especially narcotics. This means that you may receive more than one type of pain treatment, depending on your needs and the type of surgery you are having, to control pain in different ways. Pain medications may be given before, during or after surgery. All pain medications are relatively safe, but, like any therapy, they are not completely free of risk. Before your surgery, discuss what options are best for you.

Pain management options include:

Acetaminophen: Acetaminophen (such as Tylenol) is generally used alone for mild to moderate pain and can be prescribed in addition to stronger pain killers for severe pain. Although side effects are generally mild, acetaminophen can cause liver damage when used in excess. Acetaminophen is often combined in a pill with a narcotic. If you are prescribed a medication that contains acetaminophen, speak to your health care provider before taking any additional over-the-counter products containing acetaminophen.
Aspirin: Aspirin is commonly used to relieve mild to moderate pain and can also be used to prevent blood clots. Aspirin can sometimes cause stomach upset and, in rare instances, may cause internal bleeding, which is why it is not usually prescribed after surgery.
NSAIDs: Nonsteroidal anti-inflammatory drugs, or NSAIDs, include medications such as ibuprofen (i.e., Motrin, Midol and Advil) and naproxen (i.e., Aleve and Naprosyn). NSAIDs help with swelling andinflammation but have been associated with bleeding and kidney or stomach problems in some patients. Because a lot of inflammation occurs after surgery, these medications are often prescribed.
Local anesthetics: Local anesthetics are another option to control pain. These are numbing medications that can be placed by your surgeon or anesthesiologist into the site of surgery, around the nerve that provides sensation to the surgical site (a so-called “nerve block”), or close to the spinal cord by a procedure called an epidural. One commonly recognized type of local anesthetic is Novocaine, often used by dentists to numb the mouth during dental procedures.  Most local anesthetics last for up to 8 hours when administered into the surgical site.

If your surgeon wants to prolong the effect, he or she may administer a long-lasting version that slowly releases the numbing medication over time to last as long as the most severe postsurgical discomfort.

Narcotic medications: After surgery, it’s common to receive a narcotic medication (such as oxycodone, hydrocodone or morphine), which dulls the body’s overall response to pain. Your health care professional may also refer to these drugs as opioids. You may receive a narcotic in the hospital after your surgery. Before leaving the hospital, you may also receive a prescription for additional narcotics to help manage your recovery.Narcotics are powerful pain relievers and can be important to manage some types of postsurgical pain. However, narcotics are commonly associated with nausea, vomiting and sedation. Some patients may also develop tolerance to narcotics over time, which means they need higher doses to get the same level of relief. If you are concerned about addiction, or have a history of substance abuse (alcohol or any drug), talk with your health care professionals. They will monitor you closely during your recovery. If issues arise following surgery, they will consult the appropriate specialists.

Types of postsurgical pain
Your postsurgical discomfort may not be limited to the incision itself. You may or may not feel the following:
Muscle pain in the neck, shoulders, back or chest from lying on the operating table
Shoulder pain resulting from the air injected into the abdomen during minimally invasive surgery
Sore or scratchy throat (if a breathing tube was used)
Pain when sitting up, walking and coughing
How to measure your pain

After your surgery, health care professionals likely will ask you to “measure” your pain on a scale of 0 to 10, with “0” being “no pain” and “10” being “the worst pain you can imagine.” Reporting your pain as a number helps them understand how well your treatment is working and decide whether to make any changes in your pain management. In addition to the 0 to 10 scale, you might be asked to rate your pain based on words, such as mild, moderate or severe, or using diagrams such as a frowning face or happy face. Remember that it’s important to be specific about the type of pain you are feeling (is it at the surgical site? Is it in your shoulder? Is it a headache?), this will help your surgeon better assess the situation.

If at any time you feel uncomfortable—for example, having difficulty breathing or coughing—it is crucial that you tell your attending health care professional, so adjustments can be made.
Managing pain at home

It’s important to stay ahead of your pain and not let it get out of control. If you wait too long to take your medication, you may need more to control the pain. In most cases, you will be given a prescription for pain medication before or after surgery. You may be able to fill the prescription at the hospital pharmacy or it may be sent in to your local pharmacy for pickup on your way home.
Be sure to follow the instructions that come with the prescription. The directions should tell you when and how often to take the drugs, whether you should take with food and how much you can take in a day. If you have any questions, ask your pharmacist or health care professional. Your health care professional may advise you to take your pain medication at regular intervals (such as every 4 to 6 hours).

Make sure to get enough rest, and if you’re having trouble sleeping, talk to your health care professional.
Recovery time
Recovery time varies based on the surgical procedure. Managing your postsurgical pain in an effective and safe way may speed your recovery and have you on your feet in no time.

Week Pregnant: Preparing Your Body for Pregnancy

Week one of pregnancy begins on the first day of your last menstrual period, even though you haven’t actually conceived yet. This is the time when your doctor will begin counting down your 40 weeks of pregnancy. Confusing, isn’t it?

So why do we jump the gun on the countdown? Because each time you have a period, your body is essentially priming itself for pregnancy by sweeping away unfertilized eggs. Roughly two weeks after your cycle begins, your ovaries release a new egg—meaning that you’re ovulating and ready to get pregnant. Click here to try our ovulation calculator.

More specifically, a number of hormonal changes happen during your cycle that aid in conception. First, the follicle stimulating hormone(also known as FSH) begins inducing egg production. Then, as each egg-carrying follicle matures, estrogen is produced. This hormone encourages thickening of the uterine lining and spurs the production ofluteinizing hormone, which helps the follicles break through the ovarian wall. This process is known as ovulation.

Pretty amazing process our bodies go through each month, right? It happens without you even knowing it, but that doesn’t mean you can’t do things to help ensure that all goes smoothly.If you’re trying to conceive, talk to your doctor about prenatal vitamins. Typically, this consists of folic acid supplementation, which is known to help reduce the risk of certain birth defects. Your health care provider may prescribe between 400 to 800 micrograms daily during the months leading up to your pregnancy.You may also consider talking to your physician about any medical conditions you have and how they could affect your pregnancy. For example, women with may need to take certain precautions or ask for help getting their condition under control before trying to conceive. Additionally, discuss any medications you are taking to make sure they are safe for pregnancy. Click here for 10 questions to ask your health care professional.

This may go without saying, but you should also avoid drinking alcohol during this time and, if you’re a smoker, make every effort to kick the habit. You may also want to steer clear of toxic chemicals and cat feces, as the latter can contain a parasite that causes toxoplasmosis, a condition known to be harmful to fetal health.

2 Weeks Pregnant: Optimizing Your Chances for Fertilization


At week two, your menstrual period has ended and your uterine lining is thickening as your egg ripens, getting ready to be released into your fallopian tube. If all goes according to plan, toward the end of this week your egg should be perfectly positioned for fertilization.

Fertilization is the moment when the sperm makes its way to your egg, at which time a very important factor is determined. While it will be months before your health care professional is able to tell you if you’ll be having a boy or a girl, your baby’s gender is set as soon as the sperm completes its job.

Here’s how it works: A total of 46 chromosomes will make up your baby’s genetic material, and two will determine the sex. Your egg has an X chromosome, while sperm can carry either X or Y. If the sperm that gets through has an X chromosome, your baby will be a girl, but if it carries a Y, you’ll have a boy.

Now the trick is getting that sperm to your egg. Conceiving can be a little trickier than simply having sex—though, as we all know, that’s all it takes sometimes. Some experts recommend having intercourse every other day during this time to optimize your chances of conceiving. Knowing your ovulation cycle and timing intercourse around it are keys to success. Click here to use our ovulation calculator.

You now know that ovulation generally occurs toward the end of the second week of your cycle, but the exact timing varies from woman to woman. Signs that you’re ovulating include thin, slippery discharge, similar to the consistency of egg whites, and some women can feel their eggs being released. Typically, it feels like a slight twinge of pain on one side of the lower abdomen. In addition to becoming familiar with your cervical mucus, you may want to track your temperature throughout the month because it generally rises a small amount just after ovulation.

Some women prefer to use an ovulation kit. This is a daily at-home urine test that can be purchased at the drugstore to measure your levels of luteinizing hormone, which sends a signal to your ovaries to release an egg. To best detect the amount of this hormone in your urine, you should begin testing nine or 10 days after the first day of your last menstrual period.

When It’s More Than Just a Bad Headache


Migraines are much more than just an occasional bad headache. If you find your migraines regularly hijacking your to-do list, leaving you unable to play with your kids, get to work on time or socialize with friends at least half of the month, you may have a condition called chronic migraine.

Chronic migraine is a debilitating problem that affects up to 5 percent of the population, mostly women. Previously called “transformative migraine,” chronic migraine tends to worsen over time. Headaches may start in childhood or adolescence and then gradually strike more often and cause increasingly more pain. People with chronic migraine deal with headaches on 15 or more days a month. Women are three times more likely than men to experience migraines.

What are the symptoms of chronic migraine?
To be diagnosed with chronic migraine, you must meet the criteria established by the International Headache Society. These criteria include the following:
Headaches—either migraine headaches, tension-type headaches, or both—that occur on 15 or more days a month for at least three months
In addition, you must also have two or more of the following symptoms on eight or more days a month for at least three months:
Moderate to severe headaches
Headaches on one side of your head only
Pulsating headache pain
Headaches aggravated by routine physical activity
Headaches that cause nausea, vomiting or both
Headaches coupled with sensitivity to light and sound
What’s the difference between migraine and chronic migraine?

The biggest difference between migraine headaches and chronic migraine is their frequency. People with episodic migraine headaches have acute attacks that last between four and 72 hours and occur anywhere from several times a month to once every few years. People with chronic migraine, on the other hand, experience headaches at least 15 days a month and meet the additional criteria for the condition established by the International Headache Society.

What causes chronic migraine?

If you suffer from chronic migraine, surely you wonder what’s behind them. Could it be your third daily latte? Is it fumes from the carpet in your bedroom? Or could it be because your mother suffered from migraines all her life? Researchers are currently looking into why occasional migraines progress to chronic migraine in some people. The transformation may be due to physical conditions, environment, genetics or a combination of all three.

Studies suggest that certain people who get migraines are at risk for getting them more frequently. People who have suffered a closed head injury and individuals with a family history of migraine are likely to develop chronic migraine.

Chronic migraine can also be brought on by overuse of acute medications that are designed to get rid of an existing headache.

What should a woman do if she suspects she has chronic migraine?

In too many cases, people with chronic migraine mistake their symptoms for tension headaches or infrequent migraines, and they pop a quick-fix medication and go on with their lives. This only masks an escalating problem. If you notice your headaches becoming more frequent, more severe or both, talk to your health care professional. The sooner you get treatment for chronic migraine, the better. Ideally, you should see a qualified headache specialist; he or she will be able to provide the best possible treatment options.
How is chronic migraine treated?
The first goal in treating chronic migraine is to control the things that trigger the headaches. These triggers may include sleep problems, changes in eating habits (such as skipping meals), physical activity and numerous other factors. Alcohol, caffeine, smoke and some over-the-counter and prescription medications are considered triggers for migraines.
Keeping a headache diary, in which you write down how you felt, what you did and what you ate on a given day can help you pinpoint triggers. For instance, if you find your afternoon diet soda or nightly red wine are often followed by a throbbing head, cut back on these indulgences, or avoid them completely.
In addition to eliminating triggers, treatment aims to prevent migraines and ease head pain when they strike. There are two classes of medications for migraine headache:

Pain-relieving medications, or abortive treatments, are taken during migraine attacks to stop symptoms that have already begun. They include nonsteroidal anti-inflammatory drugs (NSAIDS) and migraine medications called triptans and ergotamines. These medications are used no more than two days per week; taking them more often can lead to rebound headache, a vicious headache cycle that occurs when the body adjusts to too much pain medication.

Preventive medications are taken regularly to reduce the frequency or severity of migraines. They include antidepressants, beta-blockers, calcium channel blockers and anticonvulsants.
What are some lifestyle changes that can help ward off chronic migraine?

The two best things you can do to prevent chronic migraine are to seek early treatment for headaches from a qualified medical specialist and avoid lifestyle factors that may trigger the condition. In terms of lifestyle, consider the following:

Keep your caffeine consumption to a minimum, only one cup of coffee or a caffeinated soda a day, if possible. And check caffeine contents—some popular brands contain three times as much caffeine as others, making even one cup too much. If you are supersensitive to caffeine, you may need to cut it out altogether.

Sleep about six to eight hours per night. More or less sleep can trigger migraines. If you snore or have sleep apnea, see a health care professional for treatment.

Maintain a healthy weight. Women with a body mass index of 30 or more or whose waists are larger than 35 inches in circumference are at an increased risk for chronic migraine.

Practice relaxation techniques, such as meditation, yoga or guided imagery, especially when facing stressful life events.

Exercise regularly with an activity you enjoy, such as walking, swimming or biking; be sure to check with your health care professional before starting any physical exercise.

Menopause and Your Changing Body

In our culture, menopause is frequently seen as a negative milestone, a time of loss and is sometimes viewed as a disease or medical condition requiring a cure. With messages like this from the medical establishment and the media, it’s no wonder many healthy women in the midst of this transition develop negative feelings towards their bodies.

What’s an average woman to expect regarding her body as she travels through her perimenopausal years (typically her mid- and late- 40s)? Should she yearn for the 30-year old physique she may once have had? Is it possible to achieve that objective? What’s a healthy and realistic goal for women hoping to optimize their body composition as well as their body image as they move through the last endocrinological change in their life?

Here are some facts. An average woman can expect to gain from two to five pounds during the menopausal transition, usually ending up in the lower tummy area. The main reason women experience this weight gain is the decline of estrogen. Fat cells in the hip, thigh and buttock areas have receptors for estrogen. Estrogen, in most women, drives most fat storage to the lower part of the body. As estrogen levels begin to decline, however, estrogen loses its hold on fat storage below the waist and instead, fat starts to show up in the “pinch an inch” area of the waistline. It usually extends from the belly button down to the top of your pubic hairline. It’s like a small, soft pouch. I refer to this as the “menopot” and the great news is that it is not associated with life-threatening medical illnesses.
Unfortunately, many women are at risk for greater weight gain during the perimenopause and this excess fat usually is deposited deep inside the tummy, under the abdominal muscle wall. I call this Toxic Weight since this fat is unique in its ability to increase a woman’s risk for diabetes, heart disease and cancer.

A woman notices that she is fighting the tendency to shape shift from a pear to an apple. Along the way, she is may be experiencing mental frustration about the weight shifts and gains.
By menopause, most women have a rich and fulfilling life history making them prouder and wiser. However, it’s tough to focus on self-acceptance and emotional well being when your body feels like it has a life of its own and is gaining weight and getting harder to manage.

A growing number of women feel less attractive as they reach menopause. Recent American Society of Plastic and Reconstruction Surgeons statistics show cosmetic surgery has risen 47 percent for 51 to 64 year old women over the past five years. The media tells mature women to focus on “slowing down the ravages of time”, and “reducing telltale signs of aging”. These messages can affect our ideas about ourselves. The older a woman gets the harder it is to live up to the beauty standards set by an 18 year old supermodel.

So what’s the answer? Stop listening and agreeing with the media hype about negativity in the menopausal years. Reject these negative messages now. Women today have many options as they undergo natural, physical changes due to menopause. You can promote peace between your mind and body during this complex life transition.

Here are some tips to help you get started.
Physical activity has been scientifically proven to increase body confidence and sense of pleasure in life. It is also the key predictor of healthy weight maintenance.

Check your nutritional status. One of my patients summed this up eloquently when she said, “You know, when I eat crap, I feel like crap!” No kidding. Seems simple, yet so many of us aren’t eating healthful foods.
Get a life! Find some activities you enjoy and start doing them. If you are lonely, seek out new forms of social support or reconnect with old friends. Make the time to do this.

Be mindful and fully present each day. Each day is a gift just for you. Grasp the moment and enjoy.
Take walks or hikes in nature. Being in nature is one of the best ways to reclaim the feelings of connectiveness to the world. Gardening can also be extremely uplifting for the spirit.

While menopause is a normal transition and a biological certainty, every woman’s experience is unique. Let’s take the lead from many nonwestern cultures where women look forward to the joys of aging. Drastic measures to preserve youth such as extensive cosmetic surgery are not valued in these cultures. Certainly, they should never be used as a substitute for healthy living.

Finding meaning in volunteerism and work, spending time with your family and friends, being in nature and seeing the glory in the ordinary are all roads to self and body image acceptance.
Your body is there to help you “do life” in the most meaningful way. Realizing and being thankful for this will help you appreciate, celebrate, and take care of your body.

3 Weeks Pregnant: Spotting the First Signs of Pregnancy

After your egg is fertilized (and so now known as a zygote), it makes an astounding transformation by dividing several times and turning into a ball of cells about the size of a grain of sand. This cluster is called a blastocyst, and it will now travel from your fallopian tube to your uterus, the place it will call home for the next nine months.

Of course, you won’t notice all of this action going on, and most likely it would be too early to take a pregnancy test, however, you may experience some signs of pregnancy.

You might have heard of something called implantation bleeding, which occurs anywhere from six days to two weeks after conception. This happens when your little blastocyst attaches to the wall of your uterus. Some women don’t have any bleeding, while others only see slight spotting and some may have what seems like a full-on period.

There may also be a slight rise in your basal body temperature upon conception. This is because your body is producing more estrogen and progesterone, which help it prepare for the changes it will undergo and may also lead to some unwanted side effects, like nausea. If you’ve been tracking your temperature for conception, you may notice this very early sign of pregnancy.

Speaking of nausea, you may soon begin to experience telltale morning sickness, which, deceivingly, can occur at any time of the day. Feelings of nausea can happen with or without vomiting and may be triggered by certain smells because your olfactory senses are now heightened. Your sensitive sense of smell may also cause cravings or aversions to certain foods.

Many women note changes in their breasts soon after conceiving. They may become tender, swollen or fuller than usual. Additionally, hormonal changes may make your nipples appear darker. Read more about physical changes that happen during pregnancy.

Other symptoms that the surge in hormones may cause are fatigue, mood swings, dizziness and constipation. If any of these get severe, contact your health care professional to find safe, effective ways to alleviate them

The Pros and Cons of Hormone Therapy

The issue of hormone therapy to treat menopausal symptoms used to be a simple one. You had hot flashes, sleep disturbances, vaginal changes—you took hormones. Worried about your bones and heart—you took hormones.

All that changed, of course, in the summer of 2002 with the announcement of the results of part of the Women’s Health Initiative (WHI), the first-ever, long-term study of the effects of hormone therapy (HT) on postmenopausal women. One of the study’s main goals was to investigate whether usingestrogen (Premarin) or estrogen plus progestin (Prempro) as part of a hormone therapy regimen could prevent coronary heart disease in healthy women between the ages of 50 to 79. The investigators chose these two hormone products to study, because at the time they were the most-used form of hormone therapy. Researchers abruptly ended the Prempro arm three years early, because initial results showed an increased risk of breast cancer, heart disease, blood clots in the lungs and stroke in women taking hormone therapy.

You know what happened next—millions of women panicked, ditched their hormone therapy and frantically searched for options. A couple of years later, when the estrogen-only (Premarin) arm of the WHI found an increased incidence of stroke in women on the drug with no cardiovascular benefits, it seemed that hormone therapy as a treatment for menopausal symptoms would go the way of the typewriter.

But don’t write off estrogen therapy yet. As researchers looked more closely at the WHI results, they found the data wasn’t as dire as first presented. Experts note that the WHI study included women who were more than 10 years older (average age 64) than the average hormone therapy user. And, in fact, a 2006 publication based on data from the long-running Nurse’s Health Study found that women who started hormone therapy soon after menopause reduced their risk of coronary heart disease 30 percent.
Plus, the risks identified in the WHI and a similar study called the Heart and Estrogen/progestin Replacement Study (HERS) were actually quite small, a message that finally began resonating with women and their doctors. Basically, of 10,000 women taking Prempro, over the course of one year, 23 additional women would develop dementia, eight more would have blood clots in the lung, strokes or breast cancer, and seven more would have heart attacks or other coronary events, than women not taking Prempro. And don’t forget the study’s good news: Over the course of a year, those 10,000 women taking Prempro would have five fewer hip fractures and six fewer incidences of colon cancer.
Further analysis of the data, announced in April 2006, revealed that women taking estrogen-only therapy (ET) had no increased risk of breast cancer. Estrogen-only therapy is typically given only to women who no longer have a uterus.

However, a 2010 update of the WHI study, using 11 years of follow-up, showed that breast cancer had spread to the lymph nodes at a significantly higher rate in women taking the combined estrogen-progestin hormone therapy than in nonusers. One piece of good news is that the risks associated with hormone therapy apply only to women who are currently taking or who have recently taken combined hormone therapy. Once you stop taking hormone therapy, your breast cancer risk drops to that of the general population (if you have no other risk factors).

Confused? Don’t be. Here are the basics you need to know based on extensive evaluation of existing data by the North American Menopause Society (NAMS):

The primary reason to use hormone therapy—whether estrogen alone (for women without a uterus) or estrogen plus progesterone (for women with a uterus)— is for treatment of moderate to severe menopause symptoms, primarily hot flashes, sleep disturbances from night sweats and vaginal changes. HT has no significant impact on general health or quality of life factors, such as energy, mental health, symptoms ofdepression or sexual satisfaction.

If you use HT, start at the lowest dose for the shortest amount of time needed to gain relief. NAMS recommends the combined estrogen-progestin therapy not be used longer than three to five years, but because estrogen-only therapy carries fewer risks, it can be used for longer durations.
If you have had blood clots, heart disease, stroke or breast cancer, your health care provider may not recommend HT.

In most healthy women below age 60, HT will not increase your risk of heart disease, though studies also have shown that HT does not help women with heart disease and may make existing heart conditions worse. (Some research shows that ET may decrease risk of heart disease when taken early in the postmenopausal years; study is continuing.)

Talk with your health care professional about the appropriate form of hormone therapy for your symptoms. For instance, if your primary symptom is vaginal dryness, then a vaginal form of estrogen, such as a pill inserted into the vagina or a cream, might be best.

Hormone therapy can still be used to prevent osteoporosis for women at high risk of the condition (most forms of hormone therapy are approved for this purpose), but you and your health care professional should weigh the pros and cons of hormone treatment against other osteoporosis therapies.

And keep in mind that there are literally dozens of hormone therapy formulations—from low-dose pills to patches, rings and even a clear, odorless gel you rub on your arm. Biodentical hormone options—FDA-approved hormone formulations that are structurally identical to the substance as it naturally occurs in your body—are included in this range of offerings.

Bottom line: Only you and your health care professional can decide if hormone therapy is right for you, which type is best and for how long you should use it.

4 Weeks Pregnant: Suspecting Successful Conception


The embryo will eventually turn into a fetus, but for now it’s about the size of a very small freckle, and the amniotic sac is forming around it. Encapsulating the tiny new life is the placenta, which will help deliver nutrients to your developing baby and carry away waste.

Embryos have three layers, which will ultimately make up specialized organs and body parts. The innermost layer is the endoderm. This part will become your child’s digestive system, liver and lungs. The second layer is the mesoderm, and it is the early stages of a heart, sex organs, bones, kidneys and muscles. The outermost layer is known as the ectoderm, which will comprise the nervous system, skin, hair and eyes.

As all of these important little details are developing, you may just now be suspecting that you’ve successfully conceived. You may have missed a period and experienced some of the early symptoms of pregnancy like breast discomfort, fatigue, nausea and more. Click here to find out the first signs of pregnancy.

Because you’re going to need a doctor to confirm your pregnancy even after receiving a positive at-home test, week four may be a good time to choose a health care professional.

There are a few key factors you should consider at this point, like whether you want a male or a female provider, and if you want to pick an obstetrician, your family doctor or a midwife. Studies find that care provided by midwives, family physicians and obstetricians is equally effective, although women are slightly more satisfied with care from midwives and family physicians.

Choosing a health care professional is an important decision, so you may want to talk to family and friends about their recommendations, as well as conduct interviews with prospective health care providers. If you know where you want to deliver your baby (such as at home or at a specific hospital or birthing center), make sure the health care professional you choose can deliver at that place

5 Weeks Pregnant: Preparing for a Healthy Pregnancy

Your baby is still pretty small—about the size of a beauty mark. He resembles a small tadpole as the beginnings of a spinal  develop and form a tail. His umbilical cord has formed, and your placenta is hard at work helping to deliver nutrients and keeping the bad stuff away from his fragile body.

Perhaps you are wondering if you should tell your family and friends the good news. It’s important to examine the pros and cons and make this choice with the help of your partner. You may need time to adjust to the news and to discuss options with your partner for your pregnancy and beyond (Keep working? Work part-time? Quit your job?). If you’re employed, you may want time to consider how to discuss your pregnancy with your employer.

Plus, the first three months are the most common time for miscarriage. Some women prefer to keep the news quiet until the baby has had time to get settled, while others prefer to share their pregnancy with close friends and family so they’ll have support, if needed.

In the meantime, if you haven’t already, now is a great time to begin forming habits that will contribute to a healthy pregnancy. This includes regular exercise and getting ample nutrients to support your growing baby. You’ll gradually want to work up to 300 more calories a day in your second trimester.

Your diet should ideally consist of whole grains, fruits, vegetables and lean protein. Go light on the saturated fat (for example, red meat and whole-milk dairy products) and aim for as few processed foods as possible. Don’t eat raw or undercooked seafood or meats or unpasteurized milk, cheese and juices. For more on nutrition dos and don’ts during pregnancy

6 Weeks Pregnant: Emotional Ups and Downs

And that circulatory system that was just starting to form last week? Well, this week it may be fully functioning, with a tiny heart pulsing 100 to 160 times each minute. Additionally, she’s starting to develop buds that will eventually grow into arms and legs, as well as a pituitary gland that will spur the formation of muscles, bones and a brain.

If your mind keeps wandering between feelings of elation and anxiety, you should know that this is normal. You may be excited wondering whether your baby will have your mother’s nose or your partner’s eyes—and concerned about the big life changes ahead of you. Many women feel continual mood shifts at this point in pregnancy.

Mood swings occur for a number of reasons, both external and internal. If there are things happening around you, such as problems at work or family issues, they can seem even more intense in light of your pregnancy. Don’t think that you need to suffer in silence during these conflicts. Consider talking things over with your partner, a close friend, your health care professional or a licensed counselor.

But your may also be related to hormone fluctuations, which can make you dancing-on-the-tabletops happy one minute and sobbing-in-the-fetal-position sad the next. It may help to remind yourself that your shifting emotions are a perfectly normal part of pregnancy. Additionally, relaxing activities like taking a nap, going for a walk, getting a massage or doing some light yoga can help slow your thought process and bring your mind back to its normal state.

7 Weeks Pregnant: Your Baby’s Brain Cells Are Quickly Forming


His brain isn’t all that’s coming along; she’s also growing other integral organs, such as a heart and kidneys. In fact, he likely has a heart rateof about 100 beats per minute at this point. Additionally, your baby may be developing a tongue, arms and legs.

Toward the end of your seventh week, your child is nearly double the length he was at the beginning, reaching roughly 13 millimeters, with the head making up the majority of the volume.

Even though your baby is no bigger than a berry at seven weeks, you may begin to feel pressure on your bladder. This isn’t only due to your expanding uterus, but also an increase in a hormone called human chorionic gonadotropin (hCG), which helps to get blood flowing to yourpelvis. This is a good thing, because blood flow stimulation allows you to better get rid of waste, and hCG plays an integral role in placenta development—so just try to remember that the next time you’re racing to the bathroom.

You may also keep in mind that some women experience alleviation in their constant need to go once they enter their second trimester. But it also may reappear toward the end of your pregnancy when your little one settles down into your pelvis, leaving not much space for your bladder.

What’s important to remember is that even though your urge to urinate may seem intense and never-ending at times, don’t try to cut down on time spent in the bathroom by forgoing fluids. You and your baby need to remain hydrated, and a lack of fluids may cause a urinary tract infection, which is most unpleasant.

8 Weeks Pregnant: Preparing for Your First Prenatal Visit

If you could see your baby, you’d notice that she has teeny webbed fingers and toes and perhaps even small eyelids that will soon cover her sensitive eyes. The very tip of her nose may also be starting to form, as well as the upper lip. Behind the face, nerve cells are beginning to connect with one another and form what will eventually become complex neural pathways.
A little farther down, your baby’s breathing tubes are developing to reach her lungs. Moreover, her very important aortic and pulmonary valves in her heart have formed, helping the muscle to beat at an amazing 150 pulses per minute.
If your pregnancy is considered high risk, you’ll likely have already been to see your health care provider. However, for many pregnancies, the first prenatal visit takes place somewhere between now and week 10.
At your first appointment, your health care provider will complete a comprehensive health history. He or she will ask whether you have any medical or psychosocial issues, the date of your last menstrual period, your history of birth control methods and other medications, if you’ve previously been hospitalized, whether you have any drug allergies and about your family’s medical history. You may want to write down these details if you think you could have trouble remembering everything.
The visit will include measuring your blood pressure, height and weight, as well as a breast and pelvic exam, with a pap test if you haven’t had once recently. They’ll also likely take blood to test for your blood type,anemia and other medical and genetic conditions. It’s still a little early to hear your baby’s heartbeat, so this exciting milestone may have to wait until your next visit.

Your health care provider may also talk to you about more extensive genetic testing and offer you screening tests that can give you some information about your baby’s risk for Down syndrome as well as other chromosomal problems and birth defects.

There is a new two-part prenatal screening that can be done between weeks 9 and 13. It combines a blood test and a specialized ultrasound to assess your baby’s risk for Down syndrome or trisomy 18. This screening is less invasive than amniocentesis or chorionic villus sampling (CVS) but is not definitive. If risk is indicated, the screening may help you decide whether you want further testing.

If so, CVS is a genetic test that can be performed between weeks 10 and 12 of pregnancy. The doctor removes a small piece of your placenta to check for potential genetic problems. Although CVS cannot detect neural tube defects, some women prefer it because they can get results sooner than with an amniocentesis, which is usually done between weeks 15 and 18.

Both tests are invasive and include a very slight risk of complications, including miscarriage, so it’s important to do your research and talk to your partner and health care professional to decide what testing is right for you.Click here to learn more about genetic testing.

Finally, your provider may speak to you about lifestyle considerations, including nutrition and exercise. Bring a list of questions regarding your concerns and current habits. Now is the time to ask about activities that you are concerned about continuing during pregnancy.

You also might want to ask about the practice’s birth philosophy to make sure it’s in line with your own. For instance, if your goal is to have a natural childbirth, talk to them about it and make sure they are supportive of your plans.

If you leave your visit doubting your choice of providers, keep in mind that you can always change practices if you feel uncomfortable or are concerned that their philosophy of childbirth differs from yours. If you want to continue with the provider you’ve chosen, you’ll likely schedule an appointment for four weeks later before leaving the office.

9 Weeks Pregnant: Time to Go Bra Shopping


If you could view your baby in detail, you might see that the tail formed by his spine, called the embryonic tail, is now gone. You’d also observe that he has little earlobes and fully formed eyes, even though his lids will stay fused shut until around week 27.

Things you wouldn’t quite be able to see include her heart, which may now have four distinct chambers and developing valves, and his forming nerves and muscles. Additionally, he likely has teensy teeth and external sex organs, though you still can’t view them even with an ultrasound.

Your baby is also likely moving around a lot, though you probably can’t feel it, unlike the discomfort that you may be experiencing in your breasts. While sore, swollen breasts are one of the very first signs of pregnancy, now may be the time when you notice this symptom the most because your milk-producing glands are expanding in preparation to feed your little one.

In addition, pregnancy hormones may be causing growth in your breast tissue, so don’t be surprised if your bras no longer fit well. This enlargement will keep going for another month or so. (If you and your partner are loving this new change in your body, run with it. After all, the increased blood flow to your pelvis may mean that you’re friskier than ever.)Also, you may notice more visible blue veins as they expand to deliver blood to your breasts and itchiness as the skin stretches. To alleviate itchiness and minimize stretch marks, you can moisturize your breasts (and belly too!) with cocoa butter.

10 Weeks Pregnant: Alleviating Morning Sickness


Week 10 is at the very beginning of your baby’s fetal period, during which time she’ll do most of her tissue and organ development. The foundation has already been laid, because her kidneys, intestines, brain and liver are all there and beginning to get to work doing their respective jobs and continuing to develop.
Her extremities are also making some serious progress. Her fingers and toes have probably lost their webbing and are beginning to grow teensy nails at the ends. Moreover, her joints are allowing for some serious movement, including kicking and flexing of the wrists. If you could see her, you might notice a bit of peach fuzz on her delicate skin, as well as a bulging forehead that contains her swiftly developing brain.
Feeling happier, but still a little nauseous? No worries. You’re not alone here, because about half of all women experience morning sickness, which, despite its name, is as likely to happen at dinnertime as it is breakfast. You may be vomiting multiple times a day or perhaps it’s just a constant feeling of nausea.
No one knows exactly what causes nausea and subsequent vomiting during pregnancy, but it is often attributed to a combination of hormones and other physical changes. The good news is that for half of the women who experience morning sickness, their symptoms will go away by 14 weeks of pregnancy. If you were underweight before pregnancy and are not gaining a healthy amount of weight during pregnancy, it could affect your baby’s weight, so talk to your health care professional. You also may want to discuss your morning sickness if:

The vomiting or nausea is severe, especially if you can’t keep down any food or drinks for more than 12 hours or you see blood in the vomit

You see signs of dehydration, such as dark or infrequent urine or dizziness when you stand
You have abdominal or pelvic pain or cramping

Your heart is racing
You lose more than 5 pounds

Morning sickness isn’t usually harmful to women or their babies, but it is unpleasant. Make every effort to keep taking your prenatal vitamin to maintain healthy nutrients for your developing baby. If you have trouble keeping it down, try taking it at night or with a snack or chew gum or suck on hard candy after taking the vitamin. If these steps don’t help, talk to your health care provider.
Here are some things you can try to help prevent nausea and vomiting, keeping in mind that they don’t always work for everyone:

Eat smaller meals often throughout the day, avoiding an empty stomach.

Drink fluids regularly, particularly 30 minutes before eating. Water, ginger ale, lemonade and other cold, clear, carbonated or sour fluids are good choices. You also may want to suck on ice chips or ice pops.

Eat plain crackers, such as saltines, because the salty, neutral flavors have been shown to calm tummies. Some women find it helps to eat a few crackers or piece of dry toast before getting out of bed in the morning to settle an empty stomach. Foods that are high in carbohydrates and low in fat may be easier to digest.

Smell fresh lemon, mint or orange, either fresh or using an oil diffuser.
Steer clear of greasy, fatty and spicy foods, if they seem to upset your stomach. That plateful of nachos or loaded pizza before bedtime may not be a great idea.

Avoid foods and smells that trigger your nausea. This varies from person to person and may even vary from one pregnancy to the next, but, for some women, perfume, coffee, chemicals and smoke are common triggers.

Avoid visual or physical motion, such as flickering lights, driving mountain roads or going on a boat.
Get a breath of fresh air when you need to, because getting overheated may add to feelings of nausea, and exercise may alleviate them. Weather permitting, open windows when you can.

Wear an acupressure or “seasickness” bracelets, which can be found in drugstores. Acupuncture and hypnosis are other alternative treatments that some women find helpful.

Your health care professional also may talk to you about taking supplements, such as vitamin B6 and doxylamine, or antihistamines or other anti-nausea medicines. Do not take any supplements or medications without discussing them with your health care professional.

Friday, 12 August 2016

The Pros and Cons of Hormone Therapy

The issue of hormone therapy to treat menopausal symptoms used to be a simple one. You had hot flashes, sleep disturbances, vaginal changes—you took hormones. Worried about your bones and heart—you took hormones.

All that changed, of course, in the summer of 2002 with the announcement of the results of part of the Women’s Health Initiative (WHI), the first-ever, long-term study of the effects of hormone therapy (HT) on postmenopausal women. One of the study’s main goals was to investigate whether usingestrogen (Premarin) or estrogen plus progestin (Prempro) as part of a hormone therapy regimen could prevent coronary heart disease in healthy women between the ages of 50 to 79. The investigators chose these two hormone products to study, because at the time they were the most-used form of hormone therapy. Researchers abruptly ended the Prempro arm three years early, because initial results showed an increased risk of breast cancer, heart disease, blood clots in the lungs and stroke in women taking hormone therapy.

You know what happened next—millions of women panicked, ditched their hormone therapy and frantically searched for options. A couple of years later, when the estrogen-only (Premarin) arm of the WHI found an increased incidence of stroke in women on the drug with no cardiovascular benefits, it seemed that hormone therapy as a treatment for menopausal symptoms would go the way of the typewriter.

But don’t write off estrogen therapy yet. As researchers looked more closely at the WHI results, they found the data wasn’t as dire as first presented. Experts note that the WHI study included women who were more than 10 years older (average age 64) than the average hormone therapy user. And, in fact, a 2006 publication based on data from the long-running Nurse’s Health Study found that women who started hormone therapy soon after menopause reduced their risk of coronary heart disease 30 percent.
Plus, the risks identified in the WHI and a similar study called the Heart and Estrogen/progestin Replacement Study (HERS) were actually quite small, a message that finally began resonating with women and their doctors. Basically, of 10,000 women taking Prempro, over the course of one year, 23 additional women would develop dementia, eight more would have blood clots in the lung, strokes or breast cancer, and seven more would have heart attacks or other coronary events, than women not taking Prempro. And don’t forget the study’s good news: Over the course of a year, those 10,000 women taking Prempro would have five fewer hip fractures and six fewer incidences of colon cancer.
Further analysis of the data, announced in April 2006, revealed that women taking estrogen-only therapy (ET) had no increased risk of breast cancer. Estrogen-only therapy is typically given only to women who no longer have a uterus.

However, a 2010 update of the WHI study, using 11 years of follow-up, showed that breast cancer had spread to the lymph nodes at a significantly higher rate in women taking the combined estrogen-progestin hormone therapy than in nonusers. One piece of good news is that the risks associated with hormone therapy apply only to women who are currently taking or who have recently taken combined hormone therapy. Once you stop taking hormone therapy, your breast cancer risk drops to that of the general population (if you have no other risk factors).

Confused? Don’t be. Here are the basics you need to know based on extensive evaluation of existing data by the North American Menopause Society (NAMS):

The primary reason to use hormone therapy—whether estrogen alone (for women without a uterus) or estrogen plus progesterone (for women with a uterus)— is for treatment of moderate to severe menopause symptoms, primarily hot flashes, sleep disturbances from night sweats and vaginal changes. HT has no significant impact on general health or quality of life factors, such as energy, mental health, symptoms ofdepression or sexual satisfaction.

If you use HT, start at the lowest dose for the shortest amount of time needed to gain relief. NAMS recommends the combined estrogen-progestin therapy not be used longer than three to five years, but because estrogen-only therapy carries fewer risks, it can be used for longer durations.
If you have had blood clots, heart disease, stroke or breast cancer, your health care provider may not recommend HT.

In most healthy women below age 60, HT will not increase your risk of heart disease, though studies also have shown that HT does not help women with heart disease and may make existing heart conditions worse. (Some research shows that ET may decrease risk of heart disease when taken early in the postmenopausal years; study is continuing.)

Talk with your health care professional about the appropriate form of hormone therapy for your symptoms. For instance, if your primary symptom is vaginal dryness, then a vaginal form of estrogen, such as a pill inserted into the vagina or a cream, might be best.

Hormone therapy can still be used to prevent osteoporosis for women at high risk of the condition (most forms of hormone therapy are approved for this purpose), but you and your health care professional should weigh the pros and cons of hormone treatment against other osteoporosis therapies.

And keep in mind that there are literally dozens of hormone therapy formulations—from low-dose pills to patches, rings and even a clear, odorless gel you rub on your arm. Biodentical hormone options—FDA-approved hormone formulations that are structurally identical to the substance as it naturally occurs in your body—are included in this range of offerings.

Bottom line: Only you and your health care professional can decide if hormone therapy is right for you, which type is best and for how long you should use it.


3 Weeks Pregnant: Spotting the First Signs of Pregnancy

After your egg is fertilized (and so now known as a zygote), it makes an astounding transformation by dividing several times and turning into a ball of cells about the size of a grain of sand. This cluster is called a blastocyst, and it will now travel from your fallopian tube to your uterus, the place it will call home for the next nine months.

Of course, you won’t notice all of this action going on, and most likely it would be too early to take a pregnancy test, however, you may experience some signs of pregnancy.

You might have heard of something called implantation bleeding, which occurs anywhere from six days to two weeks after conception. This happens when your little blastocyst attaches to the wall of your uterus. Some women don’t have any bleeding, while others only see slight spotting and some may have what seems like a full-on period.

There may also be a slight rise in your basal body temperature upon conception. This is because your body is producing more estrogen and progesterone, which help it prepare for the changes it will undergo and may also lead to some unwanted side effects, like nausea. If you’ve been tracking your temperature for conception, you may notice this very early sign of pregnancy.

Speaking of nausea, you may soon begin to experience telltale morning sickness, which, deceivingly, can occur at any time of the day. Feelings of nausea can happen with or without vomiting and may be triggered by certain smells because your olfactory senses are now heightened. Your sensitive sense of smell may also cause cravings or aversions to certain foods.

Many women note changes in their breasts soon after conceiving. They may become tender, swollen or fuller than usual. Additionally, hormonal changes may make your nipples appear darker. Read more about physical changes that happen during pregnancy.

Other symptoms that the surge in hormones may cause are fatigue, mood swings, dizziness and constipation. If any of these get severe, contact your health care professional to find safe, effective ways to alleviate them

5 Weeks Pregnant: Preparing for a Healthy Pregnancy

Your baby is still pretty small—about the size of a beauty mark. He resembles a small tadpole as the beginnings of a spinal  develop and form a tail. His umbilical cord has formed, and your placenta is hard at work helping to deliver nutrients and keeping the bad stuff away from his fragile body.

Perhaps you are wondering if you should tell your family and friends the good news. It’s important to examine the pros and cons and make this choice with the help of your partner. You may need time to adjust to the news and to discuss options with your partner for your pregnancy and beyond (Keep working? Work part-time? Quit your job?). If you’re employed, you may want time to consider how to discuss your pregnancy with your employer.

Plus, the first three months are the most common time for miscarriage. Some women prefer to keep the news quiet until the baby has had time to get settled, while others prefer to share their pregnancy with close friends and family so they’ll have support, if needed.

In the meantime, if you haven’t already, now is a great time to begin forming habits that will contribute to a healthy pregnancy. This includes regular exercise and getting ample nutrients to support your growing baby. You’ll gradually want to work up to 300 more calories a day in your second trimester.

Your diet should ideally consist of whole grains, fruits, vegetables and lean protein. Go light on the saturated fat (for example, red meat and whole-milk dairy products) and aim for as few processed foods as possible. Don’t eat raw or undercooked seafood or meats or unpasteurized milk, cheese and juices. For more on nutrition dos and don’ts during pregnancy

6 Weeks Pregnant: Emotional Ups and Downs

And that circulatory system that was just starting to form last week? Well, this week it may be fully functioning, with a tiny heart pulsing 100 to 160 times each minute. Additionally, she’s starting to develop buds that will eventually grow into arms and legs, as well as a pituitary gland that will spur the formation of muscles, bones and a brain.

If your mind keeps wandering between feelings of elation and anxiety, you should know that this is normal. You may be excited wondering whether your baby will have your mother’s nose or your partner’s eyes—and concerned about the big life changes ahead of you. Many women feel continual mood shifts at this point in pregnancy.

Mood swings occur for a number of reasons, both external and internal. If there are things happening around you, such as problems at work or family issues, they can seem even more intense in light of your pregnancy. Don’t think that you need to suffer in silence during these conflicts. Consider talking things over with your partner, a close friend, your health care professional or a licensed counselor.
But your may also be related to hormone fluctuations, which can make you dancing-on-the-tabletops happy one minute and sobbing-in-the-fetal-position sad the next. It may help to remind yourself that your shifting emotions are a perfectly normal part of pregnancy. Additionally, relaxing activities like taking a nap, going for a walk, getting a massage or doing some light yoga can help slow your thought process and bring your mind back to its normal state.

Managing Menopausal Symptoms

If you’re having hot flashes, problems sleeping and other menopausal symptoms, you may want to explore your options for relief. While hormone therapy remains the most common and most effective treatment for many menopausal symptoms, a few lifestyle changes can sometimes make a huge difference in how you feel. Specifically:

Exercise. Whether your idea of exercise is a walk, a run or a Pilates class, there’s good evidence suggesting that it may reduce the number and severity of your hot flashes. In one study, Swedish researchers evaluated 793 postmenopausal women on their exercise habits and prevalence of hot flashes. Only five percent of highly physically active women said they experienced severe hot flashes, compared to 14 to 16 percent of women who got little or no weekly exercise. One possible reason for the difference, researchers theorized, is that regular physical exercise may affect brain chemicals that regulate body temperature.

Quit smoking. It makes intuitive sense that lighting up a cigarette won’t cool your hot flashes. And research proves it. One study found that smokers were nearly twice as likely to have moderate or severe hot flashes as those who never smoked and more than twice as likely to have daily hot flashes as nonsmokers. The more the women smoked, the more they flashed. So talk to your health care professional today about ways to quit.

Lose weight. It’s no secret that overweight people suffer from the heat more, whether or not they’re having hot flashes. But studies also find that women who are obese are more likely to have frequent and severe hot flashes than women with a healthy weight. Although it gets harder to lose weight in middle-age, talk to your health care professional about options. A healthy diet coupled with moderate daily exercise can make a world of difference.

Dress for menopause. If you’re having hot flashes, the “weather” inside or outside can be as unpredictable as the stock market. So dress for every contingency by dressing in layers. For instance, start with a silk camisole, then a short-sleeved blouse, then a light blazer. When a flash hits, peel off a layer; as you cool down, put it back on. And stick with natural materials that breathe, such as cotton and silk.

Create a “menopausal” environment. That means keeping the temperature on the cool side (try to take control of the thermostat in your office and home) and buying a small fan for your desk.
Practice stress reduction techniques. Deep breathing, mindful meditation and visualization can help you relax and either avoid a hot flash or render it less intense. Such efforts can also help combat insomnia, whether it occurs as you’re trying to fall asleep or when you wake in the middle of the night.

Turn your bedroom into a menopausal haven. Whether you’re having trouble falling asleep, staying asleep or are waking up too early, there are numerous steps you can take to get a good night’s sleep.
Nix the caffeine. It interferes with sleep and makes you jittery. Unfortunately, that also goes for the caffeine in chocolate.

Cool off your room. Install an overhead fan or buy a standing fan and aim it right at the bed. Open a window or lower the air conditioner. If your partner is too cold, toss him or her an extra blanket.
Go natural. Either sleep in the nude, with just a thin sheet covering you, or stick to light, all-cotton or all-silk sleep clothes.

And remember, even if you are taking hormone therapy to manage your menopausal symptoms, incorporating these lifestyle changes should make the medication more effective and may enable you to take a lower dose.

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7 Weeks Pregnant: Your Baby’s Brain Cells Are Quickly Forming

His brain isn’t all that’s coming along; she’s also growing other integral organs, such as a heart and kidneys. In fact, he likely has a heart rateof about 100 beats per minute at this point. Additionally, your baby may be developing a tongue, arms and legs.

Toward the end of your seventh week, your child is nearly double the length he was at the beginning, reaching roughly 13 millimeters, with the head making up the majority of the volume.

Even though your baby is no bigger than a berry at seven weeks, you may begin to feel pressure on your bladder. This isn’t only due to your expanding uterus, but also an increase in a hormone called human chorionic gonadotropin (hCG), which helps to get blood flowing to yourpelvis. This is a good thing, because blood flow stimulation allows you to better get rid of waste, and hCG plays an integral role in placenta development—so just try to remember that the next time you’re racing to the bathroom.

You may also keep in mind that some women experience alleviation in their constant need to go once they enter their second trimester. But it also may reappear toward the end of your pregnancy when your little one settles down into your pelvis, leaving not much space for your bladder.

What’s important to remember is that even though your urge to urinate may seem intense and never-ending at times, don’t try to cut down on time spent in the bathroom by forgoing fluids. You and your baby need to remain hydrated, and a lack of fluids may cause a urinary tract infection, which is most unpleasant.

Fitness: An Empty Nest Can Be the Perfect Setting to Get in Shape

Mothers sometimes say that it’s hard for them to get in their daily 30 minutes of exercise because they spend the majority of their time juggling a career and taking care of a house full of kids. Well, now that the chicks have flown the coop, you have the space and time to get fit right in your own home.

Expensive gym memberships are hardly necessary, and you don’t even need to buy extensive amounts of equipment to perform certain activities at home. Moreover, exercise need not be boring.
For example, there are no teenagers around to roll their eyes at you if they come home to see you dancing in the living room, right? Take advantage of this! Dancing burns tons of calories, keeps you flexible and can benefit the heart and the brain with its mood-enhancing effects. You can even multitask by putting on some good music—as loud as you want—and shimmying and shaking while you clean the house.

Yoga has been touted for centuries as an effective way to build strength and flexibility. The mind-body practice is also perfect for minimalists, because all you need is some snug but not tight clothing, a mat for stability and perhaps a few props, like foam blocks or straps. There are a number of instructional programs both on television and DVD. However, it may be a good idea to take a couple of beginner’s courses before trying yoga at home, because the guidance you get from a teacher can help you avoid strain or injury.

Going back to the basics of strength training—think push-ups, sit-ups and pull-ups—is a great way to stay fit because you probably already know how to practice good form, because these were often the cornerstone of physical education classes in the 1960s and ’70s. There are also modern variations you can use with these.

For example, this twist—literally!—on the sit-up works the oblique abdominal muscles as well as those located centrally. Get in your starting position, with your back on the floor, knees bent in front of you and arms wide behind your head. (Remember to keep your elbows out, otherwise you’re cheating.) As you bring yourself up, gently twist to one side, bringing your right elbow toward your left knee, and alternating sides each time you sit up.

And remember that regular exercise can help prevent bone loss, especially weight-bearing exercises like weight training, walking, hiking, jogging, stair climbing, tennis and dancing. Now that the children are gone and the house is yours to use as you’d like, get moving and take care of your health.