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Not Even Your Feet are Spared from the Changes of Pregnancy

Monday, February 25th, 2013

And you thought puberty was bad! When you become pregnant, your body will go through so many changes you’ll be left feeling like you were transported into a different body. Some of the strange bodily changes you’ll experience will go away. The extra curves, the thicker hair, and the pregnancy glow are a result of temporary hormonal changes. However, some changes will last forever. Unfortunately, your stretch marks are in that category, but we’ll save that painful discussion for another time. One surprising change you might notice is a bigger shoe size.

During pregnancy, your body produces large amounts of hormones that are meant to make the pregnancy and birthing process easier. One such hormone is known as relaxin. This hormone loosens the muscles and ligaments, which make your stomach’s expansion easier and will eventually make it easier for your baby to pass through your birth canal. Unfortunately, it doesn’t distinguish which muscles need to be loosened, so it affects all of them at once.

Now that you know what relaxin does, you’ll be able to imagine how it affects your feet during pregnancy. Since the arches of your feet are mainly made up of ligaments, the relaxin hormone will cause them to stretch out as you put weight on them. The bones in your foot will also adjust based on this expansion. After you’ve given birth, the relaxin will leave your body, but your feet will stay at their new, longer length.

Studies show that obese women will experience more of a stretch, so it is more likely your shoe size will change after pregnancy if you’re overweight. Similarly, women who spend a lot of time on their feet will suffer from a more increased shoe size.

Unfortunately, there is no telling how much the relaxin in your body during pregnancy will affect the size of your feet. However, you might be able to minimize it by achieving a healthy weight before pregnancy and spending as little time as possible standing. If your shoe size does go up, just think of it as the perfect excuse to buy more shoes.

 – Yvonne S. Thornton, M. D., M. P. H.


Research Shows Cause of Dry Mouth during Menopause

Thursday, January 31st, 2013

If you’ve ever had dry mouth, you know how uncomfortable it can be. No matter how much water you drink, it always comes back, and it makes both talking and eating laborious tasks. Dry mouth is a common symptom of many conditions, but one of the most common is menopause. Many women who are going through menopause struggle with dry mouth. Though finding a permanent solution can be difficult, a recent study actually defined the root of the problem, which could make treatment easier from a physician’s perspective.

The study showed that women who were going through menopause often had dry mouth because of the elevated levels of salivary cortisol. There is cortisol in everyone’s saliva, but the amount is regulated throughout the day. The rise in cortisol is a result of the increased and altered levels of hormones in the body as menstruation ceases.

Though there is no quick fix for this problem, you should talk to your doctor about treatments for increased cortisol that are safe during menopause as these could solve the dry mouth problem. He or she might have recommendations for medicated treatments to increase saliva production. Until then, there are a few home remedies you can try.

Chewing gum is a great way to combat dry mouth because the chewing motion increases saliva production in the mouth as your body gets ready to break down food. Also, eating waterlogged food such as celery or lettuce is a great way to get the glands working. Of course, staying hydrated is extremely important and cutting down on dehydrating liquids such as coffee and alcohol will help a lot. Make sure you are extra diligent with your dental hygiene when you have dry mouth because the lack of saliva production will leave your teeth prone to decay and cavities.

If you’re struggling with dry mouth as you enter menopause, know that you’re not alone. It’s a common problem, and the severity might actually fluctuate as your hormone levels rise and fall. Talk to your doctor about treatments that might address the cortisone levels and try a few home remedies in the meantime.

 – Yvonne S. Thornton, M. D., M. P. H.


Your Menopause Might Cause Hair Loss

Monday, January 21st, 2013

Think of your menopause as a reversed pregnancy. When you became pregnant earlier in life, all of your hormones were running rampant as they made way for your baby’s development. Your hair grew thicker, your breasts grew larger, and your moods grew less stable as your belly grew bigger. Since menopause occurs when the body slowly stops all of its baby-making abilities, your hormones will do the opposite, but you will certainly still feel the effects. Menopause brings on a whole new set of hormone-driven problems and issues that you’ve probably never had to deal with before, and it can make you feel absolutely crazy. Generally, the symptoms usually last all the way through the menopause, which is markedly over when you haven’t had your period for an entire year. One unfortunate and common change that happens to women going through menopause is hair loss and hair thinning.

Because your hormones are so abnormal during menopause, you could lose a considerable amount of hair. For anyone going through menopause currently, I don’t have to tell you how heartbreaking this can be as it seems to be a fast-paced and permanent slide into the age of the elderly. However, don’t worry too much if you notice your hair thinning during menopause because the change is not necessarily permanent. Studies show that hair often grows back after menopause has run its course. Your hormones will become regulated again someday after they have settled back into their usual routine. If your hair doesn’t seem to go back to normal after menopause has ceased, your doctor might want to check you for a metabolic or endocrine disease as hair loss can be an indicator.

The fact that we could lose our hair during menopause truly only adds insult to injury. Though it’s disheartening, you should keep in mind that the change—along with all the other changes—is temporary. In post-menopause, all of your hormones will regulate once again, and you will return to normal. Your hair will grow back, and your mood will stabilize. To offset some of the symptoms during menopause, stay as healthy as possible by getting adequate exercise and eating a healthy diet.

– Yvonne S. Thornton, M. D., M. P. H.

Don’t Let Postpartum Depression Get the Best of You (And Your Baby)

Thursday, January 17th, 2013

You’ve been waiting nine long months, and you’ve finally had the baby you’ve always wanted. While you expect to be flooded with joy, you might find that you are stricken with fear, sadness, and even depression. If you have feelings of utter despair after delivery, you’re likely suffering from postpartum depression. Unfortunately, postpartum depression is difficult to predict and control, but it is not uncommon. There is absolutely no reason to be ashamed if you feel depressed, and you should bring it up to your doctor instead of hiding it. Research shows that trying to hide it makes the problem much worse and leaving it untreated could actually affect your baby’s behavioral development.

It’s obvious how postpartum depression will affect you. You might become withdrawn from your friends, uninterested in otherwise exciting activities, and you could resort to stress activities such as overeating. However, studies show that postpartum depression has a profoundly negative effect on babies, as well. When babies are born to mothers affected by this type of depression, they will have more cognitive development deficits and behavioral problems when they turn one than babies who were born to unaffected mothers. These developmental problems are measured by social behavior, fear, and stress reactivity, which are all indicators of life problems later down the line.

You might feel ashamed to admit that you have postpartum depression because you’ll feel like it makes you look like an inadequate mother. Doctors know that this is not the case, and that postpartum depression is actually a result of hormonal imbalances brought on by the pregnancy itself. Don’t be afraid to bring it up as soon as you start to feel sad. Early detection will lead to early treatment, which will let you get back to your new job as a mom sooner. By taking care of it early, you’ll help your baby develop more normally because you will not be hindered by the feelings of depression. No one will doubt your abilities as a mother when you admit that you’re feeling depressed. Instead, they will respect your courage and honesty and help you get to a mental state where you can raise your child as you know you should.

 – Yvonne S. Thornton, M. D., M. P. H.

What Causes Breakthrough Bleeding?

Monday, December 24th, 2012

Vaginal bleeding outside the schedule of your normal menstrual cycle is always disconcerting. Many women feel a rush of panic when they notice blood on their underwear during a random trip to the bathroom, and rightfully so. Bleeding is usually a sign that something is wrong with us internally. If you’re not on birth control, you should see your physician immediately to make sure nothing is wrong and also to receive a pregnancy test. If you’re bleeding randomly and you are on oral birth control medication, this is probably breakthrough bleeding or spotting. Though it’s frightening, it’s actually not something you should be overly concerned about. It’s common, and it’s a harmless side effect of contraception. Of course, it will still be a surprise when you notice it, so learning the cause might help you feel less worried when you do notice a bit of abnormal bleeding while taking contraception.  As always, with breakthrough bleeding, abstinence or an alternate form of contraception is in order.

Studies show that breakthrough bleeding on contraceptives is caused by the hormones they produce, such as lower dose progestins, which are forms of synthethic progesterone. Since the 1960s , the estrogen dose in oral contraceptive has decreased from more than 150 mcg of ethinyl estradiol to 35 mcg or less. The reduction in dose of the hormone has reduced the incidence of venous thrombosis and clots but also increased the incidence of breakthrough bleeding because of the lower dosage.  Without enough hormone to stabilize the lining of the uterus, the lining prematurely sheds causing breakthrough bleeding (metrorrhagia).  Progesterone-only implants and vaginal rings particularly have an increase in the prevalence of breathrough bleeding, specifically with the active component of etonorgestrel.  To solve this problem, many women find it helpful to go on a different type of contraceptive with a different ratio of hormones to see if their body might react differently.

If you do notice large amounts of blood outside of your normal menstrual cycle, you need to contact your  gynecologist. Though it might be normal spotting caused by your birth control, there is also a chance that it could be a sign of something more serious, or even pregnancy. If you find out it is in fact caused by your contraception, speak with your gynecologist who may switch brands, doses or types of hormonal contraception. In addition to making you worry, spotting and breakthrough bleeding is extremely inconvenient, so the sooner you solve the problem the better off you’ll be.

You can read more about abnormal bleeding and contraception in my women’s health book, INSIDE INFORMATION FOR WOMEN, now in paperback.

 – Yvonne S. Thornton, M. D., M. P. H.


Can you use the “morning after” pill as your main form of contraception?

Wednesday, May 20th, 2009

Some women wonder whether, since the morning after pill (a.k.a. “Plan B”) can prevent pregnancy, they can take it whenever they have intercourse and skip other forms of contraception.

Here’s the short answer: No.

Okay, now for the longer answer. Plan B delivers a wallop of hormones – at least twice the amount that you’d get in a high dose birth control pill. We doctors just don’t know what effect such a massive dose of hormones might have on a woman’s body over time, including an increase in the risk for blood clots and strokes. That’s because there have been no studies done on using the morning after pill as anything but a one-shot emergency contraceptive.

If you try to use Plan B as ordinary contraception, you will be, in effect, going into the “do-it-yourself” research business, with yourself as chief guinea pig. You’ll be risking your health while not developing a responsible approach to birth control. There are plenty of effective, tested contraceptives on the market. Use this medicine only for the purpose it was intended to serve.

– Yvonne S. Thornton, MD, MPH