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 Posted: Tue Aug 23, 2005 6:47 am
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Posted: Tue Aug 23, 2005 6:49 am
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This is an article from the September 2005 issue of Cosmopolitan. My apologies for any typos in the re-typing of this article.
Table of Contents:
- Don't be so fat phobic.
- 3 questions you must ask your mom.
- 6 baby-making facts.
- Always have safe sex.
- Preseving his fertility.
- Back off the booze.
- Pay attention to your periods.
- Steer clear of cigarettes.
- Ditch the fad diets.
- What's your fertility IQ?
- Bad-girl rehab.
- 5 more baby-making facts.
- Monitor your mental health.
- 3 misleading statistics.
- Decode your cycle.
- Q & A #1.
- HIV update.
- 3 shower habits.
- Stop dorm disease.
- Q & A #2
____________________________________
Your Future Fertility: How To Protect it - Starting Now.
By: Hallie Levine.
At this point in your life, you probably give more thought to making sure you don''t get pregnant than to making babies. But that hardly means motherhood isn''t on your mind. In fact, if you''re like most young women, your ability to have kids one day is something you may have begun to fret about. It''s no surprise, considering the current deluge of day-to-day factors that can set off baby-anxiety.
For starters, there are all the scary stories about healthy women who can''t conceive, and how your fertility may take a nosedive in the not-too-distant future. Then, there''s the constant coverageof bulging celebrity bellies - you can''t pass a newsstand without seeing them. Add that to the news about friends your own age starting families, plus the assumption that you have no control over your baby-making ability. Pregnancy panic seems unavoidable, even for women who are in their 20''s.
Okay, now relax. There has been a slew of groundbreaking studies and recent advances in reprductive science, and experts now say that you can actually do things at this stage, before you''re anywhere near ready to be a mom, to preserve your chances of getting pregnant down the road. We''ve talked to experts, top doctors in the field, and with their guidance, put together this nine-page-protect-your-fertility package. Making these simple measures a regular part of your current lifestyle will have you breathing a huge sigh of relief.
Don''t Be So Fat Phobic
A little body cushioning actually keeps you fertile. Here''s how: Estrogen, the hormone that regulates ovulation, is made by your ovaries - as well as your fat cells. Without a body-mass index (aka BMI, your body-fat level based on your height and weight) of at least 18.5, you won''t generate a healthy amount of estrogen, and your perriods will become erratic or cease altogether, explains Robert Barbieri, MD, head of obstetrics and gynecology at Brigham and Women''s Hospital in Boston. In fact, 6% of all infertility cases are attributed to insufficient body weight, according to the American Society for Reproductive Medicine (ASRM).
Staying thin via continuous exercise will also affect your future chances of conceiving. One landmark study of women who started out running 4 miles a day, and then worked up to 10 miles daily found that they produced less progesterone, another hormone necessary for ovulation.
Your workouts are probably not quite so vigorous, but if you hit the treadmill for an hour in the a.m., and then bike a few miles in the evening, for example, you''re burning a similar number of calories as the study participants did, and possibly causing a similar result, says Dr. Barbieri. Stay safe by working out 30 minurwa daily and not overdoing it too often.
If your period stopped, in most cases, your cycle will return as soon as you pack on enough pounds. Optimally, your BMI should be between 20 and 25 (18.5 is the lowest you should go), and your body-fat percentage should be at least 20%. But don''t wait until y ou''re ready for motherhood to start adding fat, because there''s no guessing how long it will take to get pregnant once you do. "I have treated women who still weren''t ovulating months or even years after they quit exercising and gained weight," explains Frederick Licciardi, MC, associate director of infertility at New York University School of Medicine.
Making things even more complicated, it''s just as dicey to have too much fat. Obesity is to blame for another 6% of infertility cases. "If a woman has a BMI higher than 30, her fat cells begin producing too much estrogen," explains Michael Soules, a Seattle endocrinologist and past president of the ASRM. "As a result, her body acts as if she''s on a hormonal birth control by shutting down ovulation."
Once you lose the excess pounds, you should start ovulating normally. But as with gaining weight, don''t put it off. Dieting can be extremely hard, so the sooner you launch a healthy slim-down, plan, the better shape you''ll be in when it comes time to conceive.
~
3 Questions You Must Ask Your Mom
Fertility, like other traits, is at least partially inherited. If your mom answers "yes to any of these questions, let your gyno know.
1) Did you ever miscarry?
At least half of all miscarriages are due to genetic causes. If your mom lost 3 or more pregnancies, your odds of also having a miscarriage are higher.
2) Does anyone in our family have a thyroid disorder?
Thyroid problems can inhibit pregnancy. Symptoms are vague, so you may not know if you''ve inherited a disorder unless you have a reason to ask your MD for a test.
3) When did you go through menopause?
If your mom''s flow stopped early (like before she was 45), yours might too - which means you''ll want to start having kids well before then, since more women have no viable eggs left about 10 years before menopause.
~
6 Baby-making Facts
- Fact: Most babies are born in late summer and early fall than at any other time of the year. One theory why: A man''s level of testosterone is highest in the late - autumn months, driving him to procreate and become a parent in July, August, or September.
- Fact: in 2000, the typical woman in the US gave birth for the first time at 25 - an all-time high.
- Fact: The average ejaculate contains 80 million sperm. If a man has less than 40 million, he''s considered fertility-challanged... even though it takes only one sperm to make a baby.
- Fact: Women who have their first bambino between ages 27 and 34 are in better health and have healthier babies than women who join the motherhood club in their teens or early 20''s, reports researchers from the University of Texas.
- Fact: Five minutes: That''s how long it takes a sperm to reach the fallopian tube after leaving a man''s p***s, regardless of the sex position a couple was in. Once there, sperm can hang around for up to 5 days.
- Fact: Competition produces better-quality sperm. A recent study found that when men felt a sense of rivlary with other men, their sperm was more mobile than when their competition instinct wasn''t fired up.
~
Always Have Safe Sex
If you don't want a bun in the oven now, you may already use condoms. Well, here's another reason to insist that your guy wear a love glove: It'll protect you from pelvic inflammatory disease (PID) - an infection of the upper reproductive tract that can scar fallopian tubes, preventing sperm from reaching the egg, says Mitchell Creinin, MD< professor of ob-gyn and director of family planning at the University of Pittsburgh. Though surgery can sometimes clear the scar tissue, the effects may be irreversible: Up to 10% of women with PID will be unable to have kids on their own, according to the American Social Health Organization.
PID is most often caused by chlamydia and gonorrhea, two STD's that are easy to treat if caught early. But because they tend to have vague symptoms (such as burning during urination and a yellowish discharge), many women don't know they're infected. And you can't trust your guy when he tells you that he's STD free because he may not have any symptoms either.
Luckily, using a rubber every time you have sex should keep you protected. But if you do have unsafe sex, see your gyno pronto so she can test you for both infections. "You should also talk to your gyno at your annual checkup about being tested for chlymadia and gonorrhea," says Dr. Creinin. "The tests are not always included in an exam, so you may have to ask for them."
Another infection linked to PID is bacterial vaginosis (BV), an overgrowth of some bacteria that normally live in your v****a. Though experts aren't sure what causes BV or if it directly leads to PID, "they do know that about two-thirds of all women with PID also have the bacteria that causes BV in their fallopian tubes," says David Soper, MD, vice chairman of obstetrics and gynecology at the Medical University of South Carolina. So watch for symptoms, namely a milky-gray discharge and a fishy vaginal odor. If you detect either, see your gyno.
The Takeaway: Unless you're truly monogamous, always use condoms. Discuss being tested for chlymadia and gonorrhea at your annual exam, and request tests after having unsafe sex.
~
Preserving His Fertility
Urge your guy to safeguard his future-fathering ability with these tips.
- Convince him to get tested.
Chlymadia and gonorrhea can produce scarring in his sperm ducts.
- Steer him away from smokes and booze.
Both in excess have been shown to cause sperm abnormalities.
- Tell him to touch himself.
Doing a regular scrotal self-check can help him detect suspicious growths. If he feels a soft "knot" in his balls, it may be a varicocele - a varicose vein that can hidner sperm production.
- Warn him about getting a gut.
When a man packs on belly fat, his body produces less testosterone - a hormone needed for sperm production. So urge your guy to keep his body fat down and his waist circumference under 40 inches.
~
Back Off the Booze
Making moderate drinking a habit now may mean hassle-free conception later. "Alcohol lowers your estrogen levels, so when you do overdo it, you're less likely to ovulate regularly," explains Elizabeth McGee, M.D., a fertility specialist at the University of Pittsburgh Medical Center.
Though experts aren't sure how much booze will throw your cycle out of whack, one recent study offers some guidelines: Women who downed five or fewer drinks a week were nearly twice as likely to conceive within 6 months months as were women who consumed more than 10 drinks. "You should be able to conceive once you cut back, ideally to one drink on average per day," says Dr. McGee. "But it's better to get your drinking under control before you want children, so your cycles are normal by the time you do want to be a mom."
Another reason to dry out: Alcohol drains your body's stash of B vitamins and folic acid, nutrients you need to make a healthy baby.
The Takeaway: Alcohol can impair ovulation, so limit your intake to one drink (aka one glass or bottle of beer, shot of liquor, or glass of wine) per night.
~
Pay Attention to Your Periods
(Parts of the article in bold font are symptoms to look out for)
It's normal to menstruate every 21 to 35 days and even to skip a month here and there. But if you miss more than 3 periods in a row, experience very painful periods, or if your flow shows up at longer intervals, see your ob-gyn. Any of these could tip you off to a fertility-robbing condition.
The most serious threat is endometriosis, a disease that occurs when tissue from the uterine lining grows in other areas of the pelvic cavity, potentially scarring the fallopian tubes. Symptoms include a stabbing pain during sex, and killer menstrual cramps.
Scarily, the disorder affects 5.5 million women in North America, and 40% of the women with the condition are infertile. But if you diagnose it early, you've got a better chance at limit damage. "Taking birth control pills can prevent the diease from progressing, which may help preserve your fertility," says William Parker, M.D., chairman of the department of ob-gyn at St. John's Hospital and Health Center in Santa Monica, California.
Another pregnancy peril is polycystic ovarian syndrome (PCOS), a hormone imbalance in which your ovaries don't release an egg every month. It affects 10 to 15% of American women, says Loren Wissner Greene, an endocrinologist at New York University School of Medicine. "Usually, the main sign is infrequent periods, or no periods at all," says Dr. Greene. Many women with PCOS will go on to have a baby with the help of ovulation drugs. But their odds improve the sooner the condition is diagnosed.
Periods that get heavier and more painful each month can indicate uterine fibroids - benign growths in the uterus that affect at least 25% of women. "Fibroids impair fertility in two ways: They can prevent a fertilized egg from implanting, and they may decrease blood supply to an embryo, causing a miscarriage," says Dr. Parker. If caught early, "They can be removed via surgery," he adds.
The Takeaway: See your ob-gyn if your periods are ultrapainful, irregular, or MIA. The conditions that are causing these symptoms are usually fixable.
~
Steer Clear of Cigarettes
You may have heard that your own smoking habit can harm your baby odds: Nicotine and other toxins in cigarettes make embryos more prone to genetic abnormalities, if they don't kill off the eggs first. And unlike other bad habits, lighting up offers no benefit of moderation. "One cigarette per week has a detrimental effect on your ovaries," explains Amos Grunebaum, M.D., director of clinical maternal-fetal medicine at Weill Medical College of Cornell University in New York City. Further proof puffing is poisonous to your eggs: A landmark study from The National Institute of Environmental Health Sciences found that women who smoked less than a pack a day were 25% less fertile than non-smokers.
But it isn't just your habit that harms your ovaries. A growing body of research shows that simply being in the vicinity of another person's smoke can damage your reproductive system. one U.K. study demonstrated that women who were regularly exposed to passive smoke throughout the day were less likely to conceive than non-smokers. "We know that if you frequently breathe secondhand smoke, you're at a higher risk of heart disease and lung cancer, so it makes sense that you may have fertility problems as well," says Dr. Grunebaum.
The good news: Stop lighting up or hanging around other puffers now, and you'll start reversing the ill effects immediately. "Only you're no longer exposed to smoke, your chances of conceiving may not be different than those of a woman who never smoked," says Dr. Barbieri.
The Takeaway: Exposure to cigarette smoke --whether it's your own or somebody else's-- can harm your eggs, thwarting conception.
~
Ditch the Fad Diets
A low-carb plan can reduce your thighs... as well as your chances of carrying a healthy pregnancy. "If youe at excessive amounts of protein daily, your body produces higher levels of a compound called ammonium to break it down, which could damage an embryo before implantation," explains sutdy author David Gardner, PhD, scientific director of the Colorado Center for Reproductive Medicine.
Gardner's research appears to back this up: A study he conducted showed that mice fed a hig-protein diet were less likely to conceive and more likely to miscarry than those fed a more moderate amount. "Based on this study, limiting protein to no more than 20% of your failt calories is sensible," says Gardner.
Very low-fat diets may also mess up your motherhood plans. A study from the University of California at San Diego linked daily fat intake of 16% to total daily calories to the abcence of periods. "Obtaining 25 - 35% of your daily calories from 'good' fats such as olive oil, nuts, avacado and salmon will help keep your cycles regular," advises Dr. Barbieri.
A major problem with all fad diets is that they don't include a wide variety of foods, so you can't get enough of all the nutrients you need for a healthy future pregnancy. One biggie: folic acid - a B vitamin found in fruits, veggies, and fortified grains. "At least 400 micrograms each day taken before you conceive can prevent birth defects in a developing embryo and undo any fertility damage caused by past alcohol binges," explains Chistiane Norhtrup, an ob-gyn and author of Mother-Daughter Wisdom. Another must-eat mineral: zinc. "Women who are severely zinc-deficient have lower levels of reproductive hormones, which can impair conception," says Dr. Northrup. Aim for 8 milligrams a day; lean cuts of meat, seafood, dairy, and whole grains are good sources.
Other necessary pre-pregnancy nutrients include: iron (you need 18 milligrams daily; red meat and leafy green veggies are loaded with it)(, and calcium (1,000 milligrams each day via dairy products or leady greens will help you continualy store this bone-building material so you have enough to share with a growing fetus). Because even a balanced diet has gaps, pop a daily multivitamin, just to be covered
The Takeaway: Forgo fad diets, be sure to eat a varied diet, and get plenty of iron, folic acid, zinc and calcium.
~
What's Your Fertility IQ?
An Abortion:
"There is a small chance the procedure may cause scar tissue to form in the uterus, possibly making it difficult for an embryo to develop," says Robert Anderson, MD, founder of the Souther California Center for Reproductive Medicine. The earlier into a pregnancy you have an abortion, however, the lower the risk.
Herpes and HPV:
"These STD's have no effect on reproduction," explains Frederick Licciardi, MD, director of infertility at New york University School of Medicine.
Emergency Contraception: "The amount of estrogen in the so-called morning-after pill is not high enough to impair feretility, even if you take it several times," says Dr. Licciardi.
Illegal Drugs:
"The regular use of drugs like cocaine and ectasy over a period of years is linked to a higher incidence of infertility," says Dr. Anderson. "Also, the toxins in marijuana smoke reduce the quality of your eggs."
The Age You Start Menstruating:
"How old or young you are when you get your period is unrelated to when you'll hit menopause, or your overall fertility," says Mitchell Creinin, MD, professor of ob-gyn at the University of Pittsburgh.
~
Bad-Girl Rehab
Bad Habit: Smoking.
Bounce-back Plan: Dial 800-QUIT-NOW to hook up with a personalized counsellor who can give you a kick-butt plan. Also, ask your MD about taking the antidepressant Zyban while you wean yourself off cigs. Or combine Zyban with a nicotine-replacement product (like the patch or gum).
Bad Habit: Eating Junk Food.
Bounce-back Plan: Get the nutrients you need by making a few easy food swaps during the day on a regular basis. For example, trade diet soda with vegetable juice or a low-fat smoothie. Or swap a sandwich on a roll for one on vitamin-loaded whole-grain bread.
Bad Habit: Being Overweight.
Bounce-back Plan: The safest and most successful goal is to lose a pound a week. That means cutting back on about 500 calories a day. The simplest way: Slash 250 calories from your daily meal plan and then burn off another 250 calories via exercise.
Bad Habit: Feeling Stressed or Depressed.
Bounce-back Plan: Do little things to cut your stress level, like allowing yourself at least an hour of unscheduled time to chill out each day. If you have the blues for more than 2 weeks straight, ask your primary-care doc for a referral to a mental-health specialist.
~
5 More Baby-Making Facts
Fact:
Older mothers are now back in style: The birth rate for women between 35 and 39 is at its highest level in more than 3 decades.
Fact: Since 1940, about 90,000 more boys were born each year in the United States than girls.
Fact: A possible fertility aid? Cough syrup. A common ingredient in it, guaifenesin, thins out cervical mucus, making it easier for sperm to make their way to an egg. Of course, a woman should talk to her doctor before chugging a bottle of the stuff; the jury is out on what effect, if any, high amounts of guaifenesin has on a fetus.
Fact: More boys are conceived in autumn than at any other time of the year, according to a recent Italian study. Girls, on the other hand, are more likely to be conceived in the springtime. Experts believe it may be because newborn males tend to be more fragile at birth then females, so nature favors them being born when conditions are better and survival rates are highest.
Fact: Men produce more and faster sperm in the late afternoon, reports one research study. The slowest, fewest of the little swimmers are usually generated around 7 in the morning.
~
Monitor Your Mental Health
Chronic stress causes physical changes in your body that may make it difficult to conceive. "When you're tense, your body churns out the stress hormone cortisol, which can lower estrogen levels and halt ovulations," explains Dr. Northrup. While stress doesn't appear to thwart pregnancy permanently, it's better to learn how to get a grip now. "If you don't and your stress escalates, you may have an even harder time getting the upper hand on anxiety when you want to get pregnant," said Dr. Alice Domar, PhD, director of the Mind/Body Center for Women's Health at Boston IVF.
Also, don't blow off a chronic case of the blues or even low-grade depressive feelings: One 1995 Brown University study found that women with a history of depressive symptoms were twice as likely to have trouble getting pregnant as were women with sunnier dispositions. And another study, from the University of minnesota, showed that clinically depressed women had abnormal levels of a hormone that regulates ovulation. "Women who are depressed or anxious may be more likely to have changes in brain chemistry that, in turn, upset reproductive hormones," says Kate Lapane, Phd, associate professor of medical science at Brown University Medical School.
The Takeaway: Stay stress- and depression -free by vowing to chill out: Schedule regular time with friends, unwind at the gym, even play outdoors with a pooch.
~
3 Misleading Statistics
A few headline-grabbing fertility stats have left young women fearful. Here's what the numbers really mean:
Scary Statistic: "A nearly 50% drop in yuor fertility occurs between your early 20's and mid-30's."
Real Deal: The 50% drop refers to a woman's chances of having a baby per cycle, not her overall odds of getting pregnant, which are significantly higher.
Scary Statistic: "75% if women who try to conceive for the first time at age 30 will begin a successful pregnancy within a year, 66% at age 35, and 44% at age 40."
Real Deal: The wild card here is the "within a year" part; for many women, it takes more time. After four years, the success rates are 91% for those who started at 30, 84% at 35, and 64% at 40.
Scary Statistic: "Two million married couples are infertile."
Real Deal: This stat doesn't define infertility, nor does it make clear that the majority of "infertile" couples go on to get pregnant eventually without any assistance from fertility drugs or treatment.
~
Decode Your Cycle
We get to the bottom of four period-erratic patterns.
"My period comes 5 weeks apart."
A flow that shows up every 5 - 6 weeks is probably normal for your body. Even if your periods are usually monthly but once in awhile arrive more than 4 weeks apart, don't worry. The delay may be triggered by stress or sudden weight loss.
"Sometimes I skip a period."
The factors that can make your periods come several weeks apart are behind the no-show flow. If you know you're not pregnant, and more than 3 months pass without a period however, visit your gyno.
"My flow laasts 2 weeks."
If your 2 week period is really one week of light bleeding and another week of light spotting, don't panic (but let your gyno know at your next exam). If it truly lasts more than 7 days, it would be a sign of uterine fibroids - benign browths that can cause bleeding.
"Lately I've been spotting mid-cycle."
This is a common side effect of oral contraceptives. So if you're on the Pill, see your doctor about switching to a hormone combo that won't cause it. If you're not, tell your MD about the sudden spotting. It may be a sign of a benign cervical polyp.
Health Hint: Taken right, the Pill rate has a failure rate as low as .1%; the "user failure rate" is about 3%. -- Planned Parenthood.
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Q & A #1
"After my last pap test, I bled a little. Is this normal?"
Yes - a few drops of blood are nothing to worry about. "To do a pap test, your ob-gyn brushes a spatula-like devide against your cervix, collecting mucus that under a microscope might reveal abnormal cells," explains Lee Shulman, MD, professor of ob-gyn at the Feinberg School of Medicine at Northwester U niversity. "It's possible for the device to scratch your cervix, triggering a small amount of bleeding." But alert your ob-gyn if the spotting goes on for more than 24 hours, or if it's a flow of steady blood. Either is a sign of a potentially serious infection.
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HIV Update
Why MDs are urging young women to get tested.
Next time you go to your gyno for a check-up, don't be surprised if she offers you an HIV test. A growing panel of researchers is now urging primary care physicians --including ob-gyns-- to regularly offer this simple blood test to all sexually active patients.
The reason the test should be routine: A quarter of all people who are infected don't know they have the virus, which makes them more likely to engage in risky behavior and pass HIV to others, explains Tim Flanigan, MD, an HIV researcher at Brown University Medical School in Providence and a member of the panel. And it's especially important for young women to know their HIV status, since women make up 41% of the new cases in the 21 - 24 year old age group. If your gyno doesn't offer you an HIV screening, request it.
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3 Shower Habits
Here's how to take care of your pair while you bathe.
Use mild soap.
Cleansing your twins with a gentle moisturizing soap will prevent breakouts, which are caused by excess bacteria on your skin. If you're prone to pimples, wash with an over-the-counter benzoyl-peroxide formula or mild salicylic-acid cleanser as well. These products are usually intended for your face, but they'll help keep breast skin zit free as well.
Put down your razor.
It's normal to have several hairs between your set and surrounding your nipples. But resist the urge to razor away these stray stands - they blade can trigger a rash or cause hair follicles to become infected. Instead, pluck each hair while your skin is wet, when pores are open and each strand is looser.
Feel for suspicious lumps.
Warm water makes it easier for your fingers to glide over your breasts, so the shower is the ideal place to familiarize yourself with how your boobs normally feel, and to check for any suspicious lumps or growths beneath the skin. After stepping out of the shower, give your girls the once-over in the mirror, looking for any new or changing moles, blemishes and red patches, which may indicate skin cancer.
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Stop Dorm Disease
A simple vaccination can protect you from meningitis.
The Centers for Disease Control and Prevention (CDC) now recommends that all adolescents and college freshmen living in dorms be vaccinated against meningococcal meningitis - a rare bacterial infection that's relatively common on colelge campuses. It starts out like the flu but, within hours, can cause brain damage and even death. The shot, called Menactra, consists of just one injection, and it protects for up to 10 years, explains Nancy Rosenstein, MD, a meningitis expert at the CDC's Nation Center for Infectious Diseases. Ask your doctor about getting vaccinated (it costs about $80 [American money]), or visit your student-health center as soon as you arrive on campus.
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Q & A #2
"Is it easier to get a UTI via sex in the missionary position?"
No. "A UTI happens when bacteria that may be present near your vaginal opening migrate up the urethra to the bladder," explains Adelaide Nardone, an ob-gyn in Providence and medical adviser for the Vagisil Women's Health Center. "Any type of intercourse can propel these bugs into your urethra - triggering the abdominal pain, burning sensation while urinating, and constant urge to go, which are typical UTI symptoms." Before you do the deed, reduce your UTI odds by gently washing your vaginal zone with mild soap and water, which will reduce the amount of bacteria outside your vaginal opening. And after sex, pee ASAP.
(rest of article to be continued in Dec. 2005 issue of Cosmo)
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Posted: Tue Aug 23, 2005 7:01 am
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Posted: Tue Aug 23, 2005 7:02 am
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This thread will be about a girl's first pelvic exam, breast exam, and pap smear. Also included will be some information about STD testing, because it can be done at the same time as a pelvic exam/pap smear.
Credit for this thread goes to Itami_25. 3nodding
There's some medical details in here, but nothing too gory or disturbing, so just view this at your own discretion.
At the end of the thread, I've included my own personal experiences for reference.
Thanks for taking the time to read this! heart
_____________________________________________________
The First Pelvic Exam, Breast Exam and Pap Smear
Taken from: http://kidshealth.org/teen/your_body/medical_care/obgyn.html
Your mom just made an appointment for your first gynecologic exam and you're feeling:
- Totally panicked. You start praying for an avalanche, four flat tires on the car, that the gynecologist will get a broken arm, anything to avoid that appointment.
- Pretty calm. You don't really mind going to the doctor that much, and if your friends can handle it, so can you. But how will the doctor look at the inside of your v****a, exactly?
- Confused. You don't feel sick at all, and you just had some vaccinations for school and a physical for sports. Why waste time going to a doctor when you're OK?
These are just some of the feelings that girls may have before their first gynecologic (or "gyn") exam, and it's not surprising. You might be asking yourself "Why me? Why now?" The answer is that you're older and have gone through puberty, so you need to have a physical exam appropriate for a young woman. That's where breast and pelvic exams come in.
Why You Need These Kinds of Exams
There are a number of reasons why yearly breast and pelvic exams are important for girls, including:
- as a routine check. You'll want to be sure you're developing normally. Many doctors recommend that a girl get her first gynecologic exam by the time she turns 18 (sooner if a girl has become sexually active or if there is a concern about her reproductive system health).
-to prevent pregnancy or infection. After becoming sexually active, a girl should have a pelvic exam as soon as possible to discuss methods of birth control and preventing sexually transmitted diseases (STDs).
-to deal with a problem. There may be a number of concerns that lead to a pelvic exam. For example, if you have menstrual bleeding problems, missed periods, pain, signs of infection, and worries about development, it's a good idea to see a doctor.
Choosing the Right Doctor:
If you're going to be involved in deciding who you'll see for your pelvic exam, you have a few choices. Many family doctors and pediatricians perform pelvic and breast exams and advise teens on birth control and STD prevention. So you may be able to see the doctor you know and feel comfortable with for your first pelvic exam. There are also a number of different kinds of doctors and nurses who have special training in women's reproductive health:
Gynecologists are doctors who have been specially trained in women's health issues. Gynecologists are the doctors who most frequently prescribe birth control and teach patients how to use it.
Adolescent medicine doctors have been trained in the health and management of teen issues. They are familiar with the concerns most girls have about their reproductive systems and can advise girls on birth control and STD prevention.
Nurse practitioners have had advanced training that allows them to give gynecological exams and pay special attention to women's reproductive health.
Whether you want to see a male or female health care professional is up to you. Some women say that they prefer being examined by a female doctor or nurse because it puts them more at ease and they feel like they can talk more openly about women's health problems and sexuality issues. Other women feel comfortable being examined by a male doctor or nurse. If the doctor or nurse is male, he will usually have a female assistant in the room with him during all parts of the exam.
It's best to involve your parents in your health care. If you want to go to a doctor's office for your exam, you may need to involve an adult for insurance purposes (it may be expensive otherwise). If for some reason you can't involve your parents, you can take advantage of health clinics like Planned Parenthood. These clinics have fully trained staffs who can often care for you at a lower cost and respect any need for confidentiality.
The most important thing is that you feel comfortable with the person who is examining you. You want to be able to talk with him or her about important personal health and relationship issues, including birth control.
What Happens When You Go for Your Pelvic Exam:
You don't need to do anything special before going for your exam. When you make the appointment, try to schedule the exam for a time when you won't have your period. For many girls, that can be hard to predict, though - lots of girls have irregular periods at first. Ask the doctor's office or clinic when you make the appointment what you should do if you get your period. Some doctors say it's OK to come for an exam if your period is just beginning or just ending and it's very light, but everyone has a different policy.
When you arrive for your appointment, you may be asked to fill out some forms while you wait. These forms ask questions about any illnesses or conditions you have, your health habits (like whether you drink or smoke), any family illnesses that you know of, and your history regarding sexual activity, pregnancy, and birth control. It's important to answer everything truthfully - nothing you write will be something the doctor or nurse hasn't seen before or that they will share with anyone else. You might also be asked to write down the date of your last period (or a doctor or nurse will ask during your exam).
When you first go into the exam room, a nurse or medical assistant will do a few things that your doctor has probably done a million times before, such as recording your weight and taking your blood pressure. You'll then be left alone to change out of your clothes. It may feel weird taking off even your underwear because you may not have had to undress completely for a medical exam before. The nurse or medical assistant will leave you a paper sheet or gown - or maybe both - to cover you. If you're cold, most doctors and nurses won't mind if you keep your socks on.
The Breast Exam:
After a few minutes, the doctor or nurse practitioner will knock on the door to make sure you're in your gown. If you're ready, he or she will come in and start the exam. He or she may start by going over anything you wrote down on your forms, or you may talk about these things later. If this is your first gynecologic exam, let the doctor know. That way, he or she will know to go slowly and explain everything that's going on. Now is also the time to ask about birth control or sexuality if you need to. Some doctors like to discuss these things before the exam, and some like to do it after. Your aim is to make sure you get your questions answered.
During the physical part of the gynecologic exam, you'll be asked to lie on your back on the table. You'll have the paper sheet or gown covering you, and the doctor or nurse practitioner will only uncover the parts of your body that he or she is examining.
The doctor or nurse practitioner will give you a breast exam by lightly pressing on different parts of your breasts. After finishing, he or she may show you how to examine your own breasts. This helps you become familiar with how your breasts feel so you know which lumps are normal and which may be the result of a change.
The doctor or nurse practitioner will then examine your abdomen by pressing on your belly to feel for any problems with your spleen, liver, and kidneys. You'll sit up and the doctor or nurse practitioner will use a stethoscope to listen to your heart and lungs. He or she may also look into your ears, eyes, and nose.
The Pelvic Exam:
During the pelvic part of the exam, the doctor or nurse practitioner will ask you to lie on your back and move down so your behind is at the end of the table. You'll bend your knees and rest your feet in two stirrups, which are metal triangular loops that stick out from the end of the table. These might look a little scary, but they're just there to rest your feet in and keep you more comfortable. The doctor or nurse practitioner will ask you to relax your knees out to the sides as far as they will go. It might feel a little funny to be lying with your legs opened like this, but everyone feels that way at first.
The doctor or nurse practitioner will put on gloves and examine the outside of your v****a. He or she will look to make sure that there are no sores or swelling and that everything looks OK on the outside.
Next, the doctor or nurse practitioner will want to look at the inside of your v****a and will do so with the help of a speculum (pronounced: speh-kyuh-lum). A speculum is a thin piece of plastic or metal with a hinged piece on one end that allows it to open and close. He or she will warm the speculum with water, and then slide the speculum into your v****a. Usually the doctor or nurse practitioner will tell you when he or she is about to place the speculum inside you so it doesn't come as a surprise.
Once the speculum is in the v****a, it can be opened to allow the doctor or nurse practitioner to see inside. Putting in and opening the speculum isn't painful, although some women say that it can cause a bit of pressure. Naturally, if this is your first exam, you might feel a little tense. Because the v****a is surrounded by muscles that can contract or relax, the exam can be more comfortable if you try to stay calm and relax the muscles in that area.
If you feel like you're tensing up the muscles in your v****a, try breathing deeply or doing some breathing exercises to help you stay relaxed. Sometimes humming your favorite song or making small talk with the doctor or nurse practitioner can distract you and allow you to feel more relaxed.
After the speculum is in place, the doctor or nurse practitioner will shine a light inside the v****a to look for anything unusual, like redness, swelling, discharge, or sores. He or she will then do a Pap smear, which involves scraping some cells from the cervix. The cervix is the opening to the uterus, and it's located at the very top of the v****a. To do a Pap smear, the doctor or nurse practitioner uses what looks like a very long mascara wand or cotton swab to gently scrape the inside of the cervix. This doesn't hurt at all; some women say they feel a little twinge, but it only lasts a second.
The cells that have been collected are sent to a laboratory where they are studied for any abnormal cells, which might indicate infection or warning signs of cervical cancer. (Like breast cancer, cervical cancer is very unusual in teen girls.)
If you are sexually active, the doctor or nurse practitioner may test for STDs. He or she will swab the inside of the cervix with what looks like a cotton swab. The speculum is then slid out of the v****a. As with the Pap smear, the sample is sent out to a laboratory where it is tested for various STDs.
Because the ovaries and uterus are so far inside a girl's body that they can't be seen at all, even with the speculum, the doctor or nurse will need to feel them to be sure they're healthy. While your feet are still in the stirrups, the doctor or nurse practitioner will put lubricant on two fingers (while still wearing the gloves) and slide them inside your v****a. Using the other hand, he or she will press on the outside of your lower abdomen (the area between your v****a and your stomach). With two hands, one on the outside and one on the inside, the doctor or nurse practitioner can make sure that the ovaries and uterus are the right size and free of cysts or other growths.
During this part of the exam, you may feel a little pressure or a twinge or two, but it isn't painful. Again, it's important to relax your muscles and take slow, deep breaths if you feel nervous. At this point, the physical part of the exam is usually over. Your own doctor may do the exam in a different order, but it will probably include all these steps.
After the Exam:
Although reading this article may make it seem long, the entire pelvic exam (the parts involving your v****a, cervix, uterus, and ovaries) really only takes about 3 to 5 minutes.
Afterward, you'll be left alone to get dressed. Some women say that they bleed a tiny bit from the Pap smear after the exam, so they like to put a pantiliner in their underwear as they get dressed. If you bleed a tiny bit, it's no big deal - it's nothing like a period and it won't last.
If you haven't discussed your questions before the exam, now's the time. Don't be afraid of questions that sound stupid or silly - no question about your body is stupid, and this is the best time to get answers.
About 1 month from the day of your exam, you may receive a phone call, postcard, or letter from the doctor or nurse practitioner or the lab with the results of your Pap smear. Many doctors don't contact you for confidentiality reasons - they ask you to call in for your results. If you are concerned about confidentiality, let the doctor and office staff know so you can talk about the different options for getting your results.
The Pap smear is almost always normal in teen girls. But if for any reason the doctor or nurse practitioner needs to see you again, the office or clinic will let you know. Unless you notice any health problems, you won't need to go for an exam for another 6 months to a year.
It's very important to go for pelvic exams on a yearly basis - even when you're feeling good - because they help detect any problems early on. If you don't want to return for another exam because you didn't like the doctor or nurse practitioner, look into finding a new doctor or clinic. Almost all health care professionals treat teens with care and respect, but if anything about your experience left you feeling weird, pay attention to your intuition.
And if the physical discomfort of the exam left you not wanting another, remember that each time it gets easier and easier to relax. Naturally, no one loves getting an exam, but having a good relationship with the doctor or nurse practitioner is very important.
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STD (STI) Testing
Taken from: http://www.dph.sf.ca.us/sfcityclinic/services/stdservices.asp
Specially trained healthcare providers are available for evaluation, testing and treatment for common sexually transmitted diseases such as chlamydia, gonorrhea, genital warts, herpes, non-gonoccocal urethritis (NGU), syphilis, and vaginal infections (trichomoniasis, yeast, and bacterial vaginosis). There are also testing and treatment services available for many lesser known STDs like chancroid, crabs, lymphogranuloma venereum, molluscum contagiosum, mucopurulent cervicitis, pelvic inflammatory disease (PID), and scabies, among others.
In addition to clinical exams and evaluation, the Clinic offers on-site lab testing, on-site dispension of medications and STD patient education and partner notification and treatment services.
Hepatitis A and Hepatitis B immunization series are made available to some people after they've had an STD evaluation at the Clinic. Both vaccination series are offered to men who have sex with men and injection drug users. Hepatitis B shots are also offered to any sexually active person under age 30. People who don't meet these criteria may be offered immunizations on a case-by-case basis after speaking to a clinician. The Hepatitis A series is two shots at 0 and 4-6 months. The Hepatitis B series is 3 shots at 0, 1, and 6 months. You must complete an entire series for full protection against that particular strain of the virus.
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Info on HIV testing: http://www.goodsamaritanproject.org/TESTING FAQS.htm#How does HIV testing work?
How does HIV testing work?
HIV tests detect the antibodies that the body produces to fight HIV once infection has occurred. A positive result means that HIV antibodies are present in the blood. In other words, a person is infected with HIV and can infect others. A negative result means that no HIV antibodies were found in the blood at the time it was drawn. It ordinarily takes three to six months (the window period) for people infected with HIV to develop enough antibodies for HIV to be accurately detected. This may mean that you need to be tested again if you may have been infected during this period.
There are a number of different ways to screen for HIV today, including:
- Blood test. This is the most common means of HIV testing. A health care provider draws a blood sample, which is sent to a lab for screening. Results are generally available within a few days to two weeks, depending on the testing site.
- Rapid HIV test. A health care provider draws a blood sample, which is processed at the testing location. Test results can be ready in about ten minutes. Currently, only one rapid test-Abbott/Murex Single Use Diagnostic System (SUDS) HIV-1-has been licensed by the FDA for commercial use. It is not available at all testing sites.
- Oral test. Under the supervision of a health care provider, the person getting tested is swabbed with a tiny brush on the inside of his or her mouth and the provider sends the sample to a lab for screening. Results are generally available within a few days to two weeks, depending on the testing site. OraSure is the only Food and Drug Administration (FDA) approved oral fluid HIV test available today. It is not available at all testing sites.
- Home test. This is a self-administered test in which the person getting tested pricks his or her own finger to draw a blood sample and then sends it to a lab for processing along with a personal identification number (no name is used). A trained counselor gives test results over the phone within a few days. Home Access is the only FDA-approved home HIV test. It may be purchased by phone (800-HIV-TEST), on-line (www.homeaccess.com), or over the counter in some drugstores. The average cost for Home Access, which takes about seven days to get results, is $45. Home Access Express, which takes about three days to get results, can be purchased for $55. A positive home test should be confirmed with a test by a health care provider as soon as possible.
- Urine test. The person getting tested provides a urine sample, which the health care provider sends to a lab for screening. Results are generally available within a few days to two weeks, depending on the testing site. Calypte is the only FDA-approved urine HIV test. It is not available at all testing sites.
Many people assume that their provider will test them for STDs or HIV as a part of a routine checkup. But unless you have a direct conversation with your provider about getting tested for HIV and other STDs, you can't be sure you are being tested. HIV testing requires informed consent from the person seeking testing-that means confirmation that he or she wants the test and understands what is involved. So if you have not discussed it, don't assume: Ask!
When I get tested, where will that information go?
In the United States, HIV tests are either anonymous or confidential. With an anonymous HIV test, your name is not linked to your test results; you are assigned a number matched to your results. With confidential testing, your name is recorded along with your test results, which are provided to the state health department for the purpose of tracking the spread of the epidemic. These results may be made available to medical personnel.
If the test is being paid for by your health insurance, then the health insurance company will know that you have been tested, although the results should remain private as part of your confidential medical records. If your health care coverage is provided through your employer, your employer may also have a record of your test.
Those concerned about the privacy of their test and results should discuss ahead of time with their health care provider what kind of test is being provided and confirm directly who will have access to this information.
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General STD Testing
Taken from: http://www.indiana.edu/~health/std.html
What STD (Sexually Transmitted Disease) Testing is available and will one blood test cover all diseases?
There are a variety of tests available for STD's. Although we can do several tests from one tube of blood, there is NOT one test that will cover all STD's. Some tests require blood and others require urine or genital samples. The most common tests ordered are:
- Chlamydia/Gonorrhea - This can be done on samples from inside the
v****a in females and on a sample from inside the tip of the p***s OR on urine samples on males. Most males prefer to collect a urine sample. Our test can detect chlamydia approximately 30 hours after infection and gonorrhea (GC) 48 hours after infection.
- HIV - blood test. Our test can detect HIV infection in most people anywhere from 6 weeks to 6 months after infection.
- Syphilis (RPR) - blood test. Our test can detect syphilis infection from 3-90 days after infection.
- Herpes - a culture is done if a lesion is present. There is also a blood test available for exposure. The blood test will detect HSV-2 in most people from a few weeks - few months after infection.
- Gram Stain and Wet Prep - This is done on samples from inside the v****a in females. These tests are used to detect yeast infection, bacterial infection, and trichomonas.
- Human Papilloma Virus (HPV or Genital Wart Virus) - this is most often detected on a pap smear on females or by visual exam in females or males. There is a test to identify HPV in females.
NOTE: Other tests may be indicated - you MUST consult with a physician or nurse practitioner who will decide along with you which tests are appropriate.
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And just for comparison, I've had 2 done. The first time I got a pelvic exam and pap smear was when I went on birth control, when I was 17. I lay on my back on the examing table, clothing removed. The doctor put some lubrication on the speculum and inserted it slowly. Then she "cranked" it open a notch, and then one more. And just when I thought I couldn't be "opened" any more, she "cranked" it open one more notch. xd sweatdrop There was some pain and discomfort, so she suggested wiggling my toes, which is supposed to make you relax and take your mind off of what's going on. I tried that, and it worked. smile
They did do the swabs, to check for cervical cancer I think it was, and that didn't hurt too much. I could feel the pressure from the swabs, but for me personally it wasn't painful.
As for the pelvic exam when the doctor inserted 2 fingers in my v****a to feel around to see if there was anything wrong, that felt kinda weird. Not really painful, just lots of pressure.
I was shown how to do a breast exam too, and again no pain or anything. I don't remember how to do it, but it can be looked up online (about how to do a proper breast exam on oneself).
I didn't bleed at all, I just had to use a tissue to wipe off the excess lubrication after the exam was over.
The second time I had a pelvic exam/pap smear sort of thing was when I went back to get tested for STDs. Again they inserted the speculum, lubrication and all, and did several swab tests. I had been with only my ex previously by this point, and we were both virgins so my doctor and I agreed during my first pap smear that STD testing wasn't necessary. But because I wanted to be sure now that I had a new boyfriend, I went and got it done. I turned out to be clean, but the 2nd time was basically the same as the first. Had to relax, etc etc. I actually made the speculum pop out accidently because I had a "muscle reflex" and my vaginal muscles squeezed it out on reflex. redface So it had to be reinserted so the doctor could do the rest of the swabs.
Those are my experiences with pap smears and the lot. redface 3nodding
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Other personal experiences that might be helpful:
Chalda
Alright so I had my first exam today. Needless to say I was nervous but ready. When I got there they asked me for a urine sample so it was a good thing I hadn't gone at work when I had needed to. After that I went in and the woman asked about my last period day and my weight and height. Next I took off everything but my socks and put on the gown and tied it up.
The next 15 minute wait was the worst part of it all. The doctor came in and took my blood pressure and then got me to lay back and did a breast exam. She found some possibly abnormal tissue in one of them but said she would like to re-evaluate it when I finish my next period rather then in the middle between them. I'm a bit worried about this but there isn't anything I can do about it so I will just have to wait and see. She is thinking about doing an ultrasound depending on what she feels next time we are there but once again we shall just wait and see.
Since I was already laying down I remained there and she moved down to the end of the table and got me to put my feet in the stirrups. She had to ask me to move my butt closer to her three times since I guess I was still a little nervous.
We had already started talking about the birth control and I mentioned the upcoming wedding so we discussed that while she did the exam. She inserted the speculum and opened it quite quickly which I found fairly painful. I forgot to wiggle my toes and all since we were talking. I assume she took the swab but I didn't feel anything other then the pain of the speculum. It was a plastic one so it was cold at all. whee
Next she took that out and let me know she was going to feel around a bit. Maybe it was because the speculum had just been there but if she put two fingers in it didn't feel like that many. I could tell she was specifically feeling my ovaries and everything and then it was over. We talked a little bit more about the birth control and she wrote a prescription and it was done. I think it took longer to write this then the actual exam did. It was really quiet quick.
I have had some lingering pain from the speculum. It's about 7 hours later now and although it is getting better I can still feel it. For about 3-4 hours it was about the same level as when it occurred. Nothing terrible or needing medication mind you, just enough to be aware of.
Honestly I was thinking that I would feel invaded and violated and all that but I really don't. It wasn't as big a deal as I was anticipation and like I said the 15 minute wait before was much worse then the 5 minutes in there.
Now all I'm really concerned about is that my breast is healthy but I will have to wait until later in the month to really find out.
I hope that reading this helps some of you feel more comfortable and will encourage you to go to your doctors and have your exams. I'm very glad I did.
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Link added 7/15/07: New sticky!
http://www.gaiaonline.com/guilds/viewtopic.php?t=9583373 |
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Posted: Tue Aug 23, 2005 7:04 am
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Other Cosmo Articles
Gyno Habits That Can Harm You
(from the Oct. 2005 issue of Cosmo)
In a perfect world, you'd have plenty of time and energy to take top-notch care of your body, particularly your below-the-belt area. But with your day-to-day life so hectic and demanding, it's hard to resist scaling back some seemingly minor down-there health habits.
Bad idea. "Taking certain shortcuts may seem harmless, but you could suffer major consequences like a vaginal infection, an STD, or an unplanned pregnancy," explains Elizabeth McGee, MD, assistant professor at the University of Pittsburgh School of Medicine. Yikes - good thing we're got the latest news on the souther-region cutbacks you simply can't afford to make.
Gyno Shortcut #1 - You leave a tampon in while you sleep.
During the day, you never let 8 hours pass without changing your tampon (changing it every 4 hours is what gynos recommend). But at night, if you're tired and your flow is super light, you may not be willing to haul yourself out of bed for a spare.
Here's why you should: "Bacteria thrive in even small amounts of blood, and within 8 hours, the bacteria on your tampon will have multiplied to potentially hazardous levels - causing a foul odor and itching, and possibly escalating to a full-blown infection that requires antibiotics to cure," explains Jill Maura Rabin, MD, head of urogynecology at the Long Island Jewish Medical Center in New York.
So if you think you might snooze through the night and maybe even the next morning, switch to a pad. Yeah it's bulky, but you'll sleep tight knowing that it's unlikely to cause a gnarly infection.
Gyno Shortcut #2 - You don't check out your salon before getting a bikini wax.
It's the day before a long weekend away with your guy, and you're in a hurry to de-fuzz your nether region. So you hop on the waxing table without knowing if the salon follows crucial safety procedures. That's when things can get hairy.
"If a waxer doesn't pay attention to standards of hygiene, your vaginal area might come into contact with her germs or the germs of the last few customers," explains Sandy Tsao, MD, clinical insttructor of dermatology at Harvard Medical School. Odds are, you won't contract anything. But if she or the previous customers have a bacterial infection like staph -which can be life threatening- you might pick it up. Another danger is hepatitis C, a chronic liver disease transmitted when an infected person's blood gets into your bloodstream. "It could happen if your skin is sensitive and you bleed after a wax," says Dr. Tsao.
When you make an appointment, ask if the waxer has an aesthetician or waxing licence; either proves she has had the appropriate training. Before you bare all, make sure she covers the table with a clean towel or sheet of paper. And check that she opens a sterile dipping device instead of the one already sitting on the pot. "She should also prep your bikini line with alcohol or an antibacterial lotion, which kills bugs on the spot," says Dr. Tsao.
Gyno Shortcut #3 - You buy birth control pills from an online-only drugstore.
So the mailing address is a post-office box in some rinky-dink town, and the "oharmacist" who runs the site doesn't bother to verify that you actually have a prescription. The is the Pill no matter where it comes from, right? Wrong answer. "You have no idea if the oral contraceptives an online site sends you contain the right hormones, or if the expiration date has already passed," says Dr. Rabin. "A lot of cyber-drugstores operate outside the US, and have no fixed address, and they're not accountable to the standards that a regular pharmacy is." Shell out the extra bucks and get the Pill at a legit pharmacy.
Gyno Shortcut #4 - You sit around in sweaty workout clothes.
After spin class, you skip the showers at your gym and spend the next few hours hanging out in your now air-dried workout gear. It may be comfy, but it's definitely not healthy.
"Bacteria and yeast love sweat, so the longer you wear your gym shorts and underwear even after they've dried, the greater your risk of a bacteria-triggered UTI or of a yeast infection," says Dr. Rabin. All that sweat and salt can clog pores, causing folliculitis -infected, pimple-like hair follicules- on your V zone.
If you can't shower post-workout, wear cotton underwear and gym clothes. "Cottom wicks sweat away from your body and helps skin dry fast," says Dr. Tsao. Or stick a panty liner while you exercise, which can absorb sweat but can be tossed once you're finished.
Gyno Shortcut #5 - You diagnose your own vaginal infections.
You've had yeast infections and UTIs in the past, so you're sure you recognize the symptoms when they crop up again, and skip the hassle of a gyno visit. Without an MD degree and your own diagnostic lab however, you have no way of knowing what's really going on down below. Not to mention that you need a prescription from a doctor to cure most infections anyways.
"The itching that you think is caused by yeast could really be the result of herpes or a skin allergy," says Dr. McGee. "And the burning while peeing you're sure is a UTI symptom might be triggered by chlymadia or another STD. While you waste time with OTC remedies, the real infection would worsen." Bottom line: When any symptom strikes, suck it up and see your gyno.
Gyno Shortcut #6 - You hold in your urine.
It's only been an hour since your last trip to the toilet, and you've got to go again. Thing is, you're too wrapped up in your job to take a 5 minute pee break. Holding it in won't make your baldder burst - but it can boost your risk of a UTI. "Going to the bathroom rids the bladder of bacteria that breed in urine," says Suzanne Merrill-Nach, an ob-gyn in San Diego. "Ignoring the urge to go gives the bacteria more time to reproduce, which can trigger an infection."
Another time you should never post-pone peeing: before sex. :When your bladder is full, your urethra is more open and vulnerable to bacteria from your v****a and/or your man's p***s," says Dr. Rabin. If the bacteria get inside and thrive, it's UTI city.
4 Crotch Culprits
Thongs: Wedged into your butt crack, the string provides bacteria a direct path to your V zone.
Supersnug jeans: They trap sweat and discharge, helping bacteria and yeast set up shop.
Scented body wash or soap: The chemicals used to produce the fragrance may irritate your vulva, causing an itchy rash.
A piping-hot shower: Steamy water can inflame the skin o fyour v****a and wash away skin oils, making it dry and itchy.
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Posted: Tue Aug 30, 2005 11:37 pm
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Ectopic Pregnancy Information
Taken from: http://www.nlm.nih.gov/medlineplus/ency/article/000895.htm
Alternative names
Tubal pregnancy; Cervical pregnancy; Abdominal pregnancy
Definition
Ectopic pregnancy occurs when a fertilized egg implants in tissue outside of the uterus, and the placenta and fetus begin to develop there. The most common site is within a fallopian tube. However, ectopic pregnancies can rarely occur in the ovary, the abdomen, and in the lower portion of the uterus (the cervix).
Causes, incidence, and risk factors
Ectopic pregnancies are usually caused by conditions that obstruct or slow the passage of a fertilized ovum (egg) through the fallopian tube to the uterus. This may be caused by a physical blockage in the tube. Ectopic pregnancy may also be caused by failure of the zygote (the cell formed after the egg is fertilized) to move down the tube and into the uterus.
Most cases are a result of scarring caused by previous tubal infection or tubal surgery. Up to 50% of women with ectopic pregnancies have a medical history of salpingitis or PID (pelvic inflammatory disease). Some ectopic pregnancies can be traced to congenital tubal abnormalities, endometriosis, tubal scarring and kinking caused by a ruptured appendix, or scarring caused by previous pelvic surgery and prior ectopic pregnancies. In a few cases, the cause is unknown.
On occasion, a woman will become pregnant after elective tubal sterilization. The risk of an ectopic pregnancy occurring in this situation may reach 60%. Women who have had surgery to reverse previous tubal sterilization in order to become pregnant also have an increased risk of ectopic pregnancy when reversal is successful.
The administration of hormones, specifically estrogen and progesterone, can slow the normal movement of the fertilized egg through the tubal epithelium and result in implantation in the tube. Women who become pregnant despite using progesterone-only oral contraceptives have a 5-fold increase in the ectopic pregnancy rate.
Women who become pregnant despite using progesterone-bearing IUDs also have an increased risk of ectopic pregnancy. Ectopic pregnancy rates for those who become pregnant despite non-medicated IUD are 5%, while the rate for medicated IUD users who become pregnant despite the device is 15%. Note that these rates only refer to percents of the tiny proportion of women who become pregnant while using these methods -- they do not refer to women who have once used these methods and later become pregnant, or to the percent of women who become pregnant while using these methods.
The "morning after pill" is associated with a 10-fold increase in risk of this condition when its use fails to prevent pregnancy.
Ectopic pregnancies occur from 1 in every 40 to 1 in every 100 pregnancies. This rate increased four-fold between 1970 and 1992.
Increased risk is associated with women who have a history of salpingitis or PID, tubal surgery of any type (including tubal ligation and its reversal), or prior ectopic pregnancy.
Symptoms
- Lower abdominal or pelvic pain
- Mild cramping on one side of the pelvis
- Amenorrhea (cessation of regular menstrual cycle)
- Abnormal vaginal bleeding (usually scant amounts, spotting)
- Breast tenderness
- Nausea
- Low back pain
If rupture and hemorrhaging occurs before successfully treating the pregnancy, symptoms may worsen and include:
- Severe, sharp, and sudden pain in the lower abdominal area
- Feeling faint or actually fainting
- Referred pain to the shoulder area
Signs and tests
A pelvic examination may reveal uterine adnexal (Fallopian tube or ovary region) tenderness.
- There is usually a positive pregnancy test.
- Urine HCG (qualitative) tests may be falsely negative in up to 17.5% of them.
- In contrast, serum HCG (quantitative) tests have only a 2% incidence of false-negative results.
- A hematocrit test may be normal or decreased.
- The white blood count may be normal or increased.
- A culdocentesis may be performed to determine if free blood is present in the abdomen.
- An ultrasound (transvaginal ultrasound or pregnancy ultrasound) illustrates an empty uterus. Products of conception may be evident elsewhere.
- A laparoscopy or a laparotomy may be necessary for adequate diagnosis.
- A D and C may be indicated to rule out a nonviable intrauterine pregnancy.
This disease may also alter the results of the following tests:
- Serum progesterone -- a value of 25ng/mL or more is, 98% of the time, associated with a normal pregnancy in the uterus, while a value of less than 5ng/mL indicates that the pregnancy, regardless of location, is not going to be successful.
Treatment
In the event that pelvic organ rupture has occurred because of the ectopic pregnancy, internal bleeding or hemorrhage may lead to shock. This is the first symptom of nearly 20% of ectopic pregnancies.
Shock is an emergency condition. Initial treatment may be keeping the woman warm, elevating her legs, and administering oxygen. Treatment with intravenous fluids and sometimes a blood transfusion is performed as soon as possible.
Surgical laparotomy is performed to stop the immediate loss of blood (in cases in which rupture has already occurred), or to confirm the diagnosis of ectopic pregnancy, remove the products of conception, and repair surrounding tissue damage. In some cases, removal of the involved fallopian tube may be necessary.
In non-emergency cases, mini-laparotomy or laparoscopy are the most common surgical treatments. Such procedures have similar outcomes. However, they are less invasive and are available at a lower cost because they require minimal hospitalization or outpatient treatment.
Non-surgical (medical) management for ectopic pregnancies without suspected immediate danger of rupture is being implemented in many medical centers . In such cases, methotrexate is administered with careful outpatient monitoring of the woman and serial quantitative HCGs, CBCs, and liver function tests.
Ectopic pregnancies cannot continue to term (birth), so removal of the developing cells is necessary to save the life of the mother.
Expectations (prognosis)
About 85% of the women who have experienced one ectopic pregnancy are later able to achieve a normal pregnancy. A subsequent ectopic pregnancy may occur in 10 to 20% of cases. Some women fail to become pregnant again, while others become pregnant and spontaneously abort during the first trimester.
The maternal death rate from ectopic pregnancy in the U.S. has decreased in the last 30 years to less than 0.1%.
Complications
Rupture, with resulting hemorrhage leading to shock and the need for blood transfusion, is the most common complication. Death from rupture is rare.
Infertility occurs in 10 to 15% of women who have experienced an ectopic pregnancy.
Calling your health care provider
A woman who has an early pregnancy, or who thinks she might be pregnant and has symptoms (especially lower abdominal pain or abnormal vaginal bleeding) should notify her health care provider. Ectopic pregnancy can occur in any woman who is fertile and sexually active, regardless of contraceptive use.
Prevention
Forms of ectopic pregnancy, other than tubal, are probably not preventable. However, tubal pregnancies, which make up the majority of ectopic pregnancies, may be prevented in some cases by avoiding those conditions that might cause scarring of the fallopian tubes. Such prevention may include:
- Avoiding risk factors for PID -- multiple partners, intercourse without a condom, and sexually transmitted diseases (STDs)
- Early diagnosis and adequate treatment of STDs
- Early diagnosis and adequate treatment of salpingitis and pelvic inflammatory disease (PID)
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Posted: Sat Sep 03, 2005 11:09 pm
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Polycystic Ovarian Syndrome Information
Taken from: http://www.pcosupport.org/
Support website for women with Polycystic Ovarian Syndrome.
~
Taken from: http://www.nlm.nih.gov/medlineplus/ency/article/000369.htm
Alternative names
Polycystic ovaries; Polycystic ovarian syndrome (PCOS); Stein-Leventhal syndrome; Polyfollicular ovarian disease.
Definition
Polycystic ovary disease is characterized by enlarged ovaries with multiple small cysts, an abnormally high number of follicles at various states of maturation, and a thick, scarred capsule surrounding each ovary.
The syndrome was originally reported by Stein and Leventhal in 1935 when they described a group of women with amenorrhea (absence of menses), infertility, hirsutism (unwanted hair growth in women), and enlarged polycystic ovaries.
Today, it is known that those with polycystic ovaries may have some, but not necessarily all, of the "classic" symptoms included in Stein-Leventhal syndrome.
Causes, incidence, and risk factors
Polycystic ovary disease is an endocrine disorder, which means normal hormone cycles are disrupted. Hormones direct many functions throughout the body. For example, hormones regulate reproductive functions, including the normal development of ova (eggs) in the ovaries. It is not completely understood why or how hormone cycles are disrupted, although there are several working theories.
In polycystic ovary disease, under-developed follicles accumulate in the ovaries. Follicles are sacs within the ovaries that contain ova. The ova in these follicles fail to mature and, therefore, cannot be released from the ovaries. Instead, they accumulate as cysts in the ovary. This can contribute to infertility. The lack of follicular maturation and inability to ovulate are likely caused by low levels of follicle stimulating hormone (FSH) and higher-than-normal levels of androgens (male hormones) produced in the ovary.
Insulin resistance also seems to be a key feature in polycystic ovarian syndrome. In addition to other hormones, insulin helps regulate ovarian function. When someone is insulin resistant, this means that cells throughout the body do not readily respond to insulin circulating in the blood. For this reason, the amount of insulin remains high in the blood (called hyperinsulinemia). High levels of insulin can contribute to lack of ovulation, high androgen levels, infertility, and early pregnancy loss.
Polycystic ovaries are two to five times larger than normal ovaries, and they have a white, thick, tough outer covering. Women are usually diagnosed when in their 20s or 30s.
Many women with polycystic ovary disease have irregular menses and may have scanty menstruation (oligomenorrhea) or no menses at all (amenorrhea).
Women diagnosed with this disorder frequently have a mother or sister with similar symptoms commonly associated with PCOS (polycystic ovarian syndrome).
Conception is frequently possible with proper surgical or medical treatments. Following conception, pregnancy is usually uneventful.
Symptoms
If you have polycystic ovary disease, you are likely to experience some of the following symptoms:
- Abnormal, irregular, or scanty menstrual periods (oligomenorrhea)
- Absent menses (amenorrhea), usually (but not always) after having one or more normal menstrual periods during puberty (secondary amenorrhea)
- Weight gain, even obesity
- Insulin resistance and diabetes
- Infertility
- Increased hair growth (hirsutism); distribution of body hair may be in a male pattern
- Virilization -- development of male sex characteristics in a female. This may include an increase in body hair, facial hair, a deepening of the voice, male-pattern baldness, and clitoral enlargement.
- Decreased breast size
- Aggravation of acne
Signs and tests
In a pelvic examination, the health care provider may note an enlarged clitoris (very rare finding) and enlarged ovaries.
Tests include:
- FSH levels -- low or normal
- LH levels -- generally high
- Androgen (testosterone) levels -- high
- Estrogen (primarily estrone and estradiol) levels -- relatively high
- Urine 17-ketosteroids -- possibly high
- Vaginal ultrasound and, possibly, abdominal ultrasound
- MRI
- Laparoscopy
- Ovarian biopsy
Other blood tests that may be done as part of the initial evaluation to look for other potential causes of the symptoms include:
- Serum HCG (pregnancy test) negative
- Thyroid function tests
- Prolactin levels
Treatment
Medications used to treat the symptoms of polycystic ovary disease include birth control pills, spironolactone, flutamide, and clomiphene citrate. Treatment with clomiphene induces the pituitary gland to produce more FSH, which in turn stimulates maturity and release of the ova. Occasionally, more potent ovulation induction agents (fertility drugs, human menopausal gonadotropins) are needed for pregnancy.
Weight reduction, which may be very difficult, is also very important. For those with polycystic ovaries who are overweight, weight loss can reduce insulin resistance, stimulate ovulation, and improve fertility rates. Sometimes, part of the treatment for polycystic ovaries is use of insulin sensitizing medication like metformin.
Expectations (prognosis)
Pregnancy may be achieved with appropriate treatment.
Complications
- Sterility
- Obesity-related conditions, like high blood pressure and diabetes
- Increased the risk of endometrial cancer -- this is because the endometrium (lining of the uterine wall that sheds when you menstruate) can get thicker and thicker (hyperplasia) due to the lack of ovulation
- Possible increased risk of breast cancer
Calling your health care provider
Call for an appointment with your health care provider if you are experiencing the symptoms of this disorder.
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Posted: Sat Sep 03, 2005 11:11 pm
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Posted: Mon Oct 03, 2005 10:37 pm
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Posted: Sun Oct 30, 2005 2:01 pm
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Posted: Fri Sep 07, 2007 12:31 pm
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Reply
