Women’s health issues

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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 You might become withdrawn from your friends, uninterested in otherwise exciting activities, and you could resort to stress activities such as overeating.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.

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Calcium Will Ease the Pains of PMS

Thursday, December 27th, 2012

It’s almost that time of the month. Your skinny jeans don’t fit, you’re crying about the dishes in the sink, and chocolate is all you want for dinner. Premenstrual syndrome (PMS) affects at least 85% of all women in some way. Some don’t have the same symptoms as others, but many women will have at least one as part of their cycle. You might get acne, tender breasts, fatigue, bloating, cravings, muscle pain, trouble with memory, irritability, mood swings, and anxiety all at once. In many ways, these symptoms interfere with everyday life by making even the most simple and mundane tasks more difficult. The fatigue can feel paralyzing, and the mood swings can make you feel like a monster. Even the most casual conversations can turn into fights or tear-jerkers.

For women who are predisposed to it, PMS is impossible to avoid. Sometimes, contraceptives can ease the symptoms, but other times they actually become much worse. There are also a few easy remedies you can try to ease symptoms, such as exercise and diet adjustment. By exercising, you release much of the tension and stress built up in your body, which will make each problem seem a lot less intense. Avoiding junk food and alcohol can also make symptoms fade away faster, but this only works for some women. However, there is one easy treatment for PMS that has been repeatedly proven to work in a clinical setting. An increased intake of calcium will help ease the symptoms of PMS. In the study, women who increased their intake by 1200-1600 mg every day had significantly less symptoms than before they began the supplementation.

Always consult with your doctor before making any changes to your diet, but increasing the amount of calcium you eat while you are experiencing PMS is easy. You don’t even need to pay for the supplements if you try adding more calcium-rich foods to your diet. Milk, yogurt, beans, tofu, kale, spinach, and orange juice are all excellent sources of calcium. When that time of the month rolls around and you feel too bloated to function and too emotional to face your friends, stock up on calcium rich foods to get over your PMS before it gets the best of you.

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

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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.

 

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Blue Christmas is an Annual Reality for Some

Thursday, December 20th, 2012

Unfortunately, Elvis isn’t the only one who has experienced a “Blue Christmas.”  Depression during the holiday season is actually very common.  Although people can be depressed any time of year, we are often more aware of it during the holidays, because the festive season causes us to notice how non-festive our lives are.

Most of us would love for our holidays to be filled with joy, but making it happen can be stressful in itself.  There are so many factors to consider this time of year that it can be difficult to pin down the actual cause of someone’s holiday blues.  Depression can stem from financial constraints, stress from over-scheduling, frustration due to the inability to spend time with family, or, conversely, anxiety due to spending too much time with family.  High expectations and fatigue can also greatly contribute to holiday depression.  With all of the tasks that need to be accomplished before our dinners, present-openings, and get-togethers, stress can be at an all-time high.  On the other hand, for those who are removed from family and friends either due to distance or death, this time of year can be particularly lonely.  For still others, the time after Christmas is the most depressing, because of the letdown after all of the excitement and activities.  The most common cause of depression during the winter though, is Seasonal Affective Disorder, known appropriately as SAD.  As you probably already know, SAD is caused by the limited amount of sunlight the body receives during these short days.  Feeling sad isn’t the only symptom of depression either.  This emotional disturbance can cause severe anxiety, overeating or loss of appetite, insomnia or excessive sleeping, and in some, even physical pain.  How depression manifests itself varies by the individual.

Luckily, depression during the holidays is normally temporary.  However, if your depression lasts for several weeks or longer, it could be considered clinical depression.  In which case, you should visit your physician to discuss treatment.  There are a variety of treatments, and the one your doctor chooses for you will depend on the cause of your depression.  For instance, for SAD, light therapy can be very effective.  For more severe forms of depression, such as PTSD, long-term therapy from a qualified counselor may be needed.

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

 


 

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You’ve Been Diagnosed with HPV. Now What?

Monday, December 10th, 2012

Have you gotten your HPV vaccination yet? If not, go get one now. HPV, or the human papillomavirus, is the single most common cause of cervical cancer in women. In many cases, women don’t even realize that they have HPV. For that reason, it’s important that every sexually active person is vaccinated because it is technically an STD (sexually transmitted disease) transmitted through intercourse. The HPV vaccination is simple, especially compared with the possible consequences of cancer treatment without it.  As stated in a prior blog in 2009, the benefits of being vaccinated against HPV far outweigh the small potential dangers.  If you are between 9 and 26, you should seriously consider getting the vaccination.

If you’ve been diagnosed with HPV, you’re probably wondering what happens next. It is too late to get vaccinated at this point, but it’s important that you understand how high your risk for getting cancer is. Though HPV (depending on its type) causes cancer in many instances, it is not to say that you’ll get it for certain. Many high-risk HPV infections simply go away on their own without leaving anything more than a few cell abnormalities. This spontaneous clearance of the virus usually occurs in women who are younger than 30 years of age.  It’s also important that you understand ways to decrease your risk once you’re diagnosed with HPV. Smoking and poor oral hygiene have both been linked to increase cancer risk following an HPV diagnosis, so it’s important that you take proper preventative measures.

In some ways, your HPV diagnosis is a perfect way for your doctors to more closely monitor your risk of developing cervical cancer. Many women who have cervical cancer can go years without even knowing that the cells are developing. It is a silent progression from a precancerous lesion to full-blown cervical cancer.  After your HPV diagnosis, doctors will know to check for cervical and anal cancer regularly. If they notice a tumor, they can take action quickly, which is the best way for you to beat it. It can take up to twenty years for cancer cells to develop after an initial HPV infection, so regular screening is necessary. Even if a tumor forms, you still have very good chance that it is not even cancerous.

You might be devastated when you first learn that you’ve contracted HPV. However, depending your age, it may resolve or it may persist.  If it does persist, then it certainly increases your risk for cervical cancer.  However, it does not necessarily mean that you will get it for sure. Stay on top of your regular screenings and stay positive.

Read more about HPV and cervical cancer in my newly updated health book, INSIDE INFORMATION FOR WOMEN.

– Yvonne S. Thornton, M. D., M. P. H.

 

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How Endometriosis Might affect Your Fertility

Thursday, December 6th, 2012

When you’re trying to get pregnant to become a mom for the first time, you feel as though you won’t let anything get in your way. You’ll stick to a proper diet, you’ll avoid alcohol, and you’ll time conception carefully so that ovulation lines up with each attempt. However, past conditions can sometimes affect your ability to conceive. Endometriosis is one such condition, and women who have had it in the past often have a difficult time getting pregnant, even if they’ve undergone surgical procedures to reverse the effects of the condition. Endometriosis is, in fact, the most common cause of infertility in women over 25 years of age.

If you’ve had endometriosis at any point in your past, you might have undergone laparoscopic surgery to remove the excess tissue that causes the condition. Depending on the severity and the stage of endometriosis, even if all excess tissue has been removed, your ovarian reserve may be significantly lower than that of a woman who has never had the condition. While this won’t necessarily cause infertility, it will certainly make conception more difficult. Conception is partly up to chance as it is, so a limited ovarian supply will make the process much more difficult.

If you’ve had endometriosis and you’re trying to get pregnant, talk to your physician, preferable a reproductive endocrinologist, about fertility treatment options.  With the right combination of treatments, you’ll be able to conceive, though it might take you longer than the average woman. .  In vitro fertilization is a viable alternative in those women who are infertile by virture of  having severe endometriosis.  As long as you and your partner are both committed to making serious attempts though, you can become pregnant even after going through surgery for endometriosis. Since the condition directly affects the reproductive system in women, it’s impossible to tell just what effect it might have on fertility without close evaluation by a trained reproductive endocrinologist.

If you’re hoping to be a mom someday soon, endometriosis can be a major road block. However, by following your doctor’s advice and staying committed to a fertility treatment plan, you can increase your chances of becoming pregnant despite the setbacks of the condition.   For more information about endometriosis, read my women’s health book, “Inside Information for Women”.

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

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Sex, Lies, and HPV

Monday, December 3rd, 2012


All women have the right to keep their sex lives a secret and only share details with an intimate crowd of friends and partners. However, you might be surprised when your gynecologist asks for details about your first sexual experience. He or she might ask what age you had your first sexual partner and even what type of intercourse occurred. While you might be hesitant to share the details at first, it’s actually extremely important that you’re as honest as possible. Your gynecologist needs to know the details because recent studies have linked the age of your first intercourse with the likelihood that you’ll contract the human papillomavirus (HPV).  HPV has been found to be a precursor and is linked to cervical cancer.

In many cases, women who had sexual intercourse for the first time at a young age contracted HPV later in life. Even if you don’t have HPV now, your sexual history will help your gynecologist decide which types of infections and viruses to look out for.  Also, he or she may recommend being vaccinated against HPV with the Quadrivalent vaccine (Gardisil). The reasoning behind the connection between sexual history and HPV is partly because of sexual choices. There is a good chance that someone who had sex early on will have had more sexual partners than other adults, which will directly increase her likelihood of contracting HPV. Your gynecologist will also ask if you ever had any non-consensual sex, because the types of partners you’ve had and their health will also contribute to whether or not you’ll get HPV.

When your physician asks about your early sexual history, don’t worry about being judged. The best thing you can do for your own health is to be honest and share any detail you can remember. It might seem strange sharing such information with a stranger, but rest assured that she will keep the information confidential and within the walls of the office. If you’re concerned about your gynecologist’s honesty and you don’t trust that the information will remain private, it’s time to start looking for a new one. Your health is paramount, and you should feel comfortable sharing any information that will make for a more accurate diagnosis.

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

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What to Do about Bloating during Menstruation

Thursday, November 29th, 2012

Especially for women trying to lose weight through diet and exercise, fluid retention during each menstrual cycle can be especially disheartening. More commonly known as “bloating”, fluid retention will make your favorite jeans too tight and will make the numbers on the scale creep up more than you’d expect. Luckily, bloating is no indication of your actual weight, and it’s quite literally excess water in your body that has been stored between layers of tissue. During your period, your body holds on to this water because of hormonal changes and minor swelling of the tissue.  It is extremely common during menstruation, but it can be even more inconvenient than the usual cramps and back pain.

The only way to ensure that your bloating won’t get in the way of any major events is to plan those events around your period. You won’t want to try squeezing your bloated belly into your wedding dress or honeymoon bikini on the big day, but you’ll probably have planned your wedding around your period anyway. However, if you need to deal with bloating for one reason or another, there are some home remedies you could try to ease the discomfort.

First, make sure you eat a healthy and balanced diet during menstruation. Cut back on salt and sodium, as these will make your body retain even more water. Eat more vegetables and less fat and sweets to keep the fluids in your body moving properly through you. Next, exercise through your menstrual cycle. Not only will this ease any cramps you might have, but it will also help you sweat out the excess water trapped in your tissues. Although it seems counterintuitive, make sure you drink plenty of water. Proper hydration will keep the rest of your system working properly, so that when your period is finally over, the bloating will subside quickly and without incident.

Bloating is the modern woman’s worst nightmare. Months of exercise and healthy eating seem to go down the drain as menstruation begins and your designer jeans won’t even make it to your waist.  Luckily, the home remedies listed will help relieve the fluid retention somewhat. Until the relief kicks in, there’s no shame in sweatpants.

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

 

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How Kegel Exercises Can Help You Long after Birth

Thursday, November 22nd, 2012

Of course you’ve heard about Kegel exercises before. In fact, you probably did some of your own when you were pregnant. When you perform Kegel exercises, you strengthen the floor of your pelvis, which is an excellent way to prepare your body for birth and push more effectively in the delivery room when the big day finally arrives. Believe it or not though, Kegel exercises can be helpful even if you’re not planning on giving birth any time soon. Actually, they’re extremely helpful for women going into menopause. Studies show that Kegel exercises are a great way to prevent incontinence.

As we get older, our ability to hold in urine when we really have to go lessens. It’s simply a part of aging, and it usually comes on during menopause. Whether you’re having a laughing fit with the girls over brunch or rushing to the bathroom at a crowded sports game, you just won’t be able to hold it in like you used to. It’s common and nothing to be ashamed of, but regular Kegel exercises will improve your ability to hold it until you find a bathroom.

Your physician can help you learn how to do Kegel exercises if you’ve never done them before, but once you get the hang of it you’ll be able to do them anywhere.  Your daily Kegel routine will involve contracting and relaxing the muscles for a short period of time every day.  As stated in my women’s health book, Inside Information for Women, it takes about one to two hundred repetitions a day in divided segments of twenty at a time.  It’s important that you don’t do your Kegel exercises while urinating though, as this could lead to a urinary tract infection. Never interrupt the flow of urine once it begins. These exercises are especially helpful in obese women who have reached menopause and are experiencing incontinence.

It makes sense that Kegel exercises can help you better control the flow of your bladder. Just like any other muscular exercise, you will become stronger over time and have more control in general. The best part about the exercises is that you don’t need a gym or even privacy to do them. They are extremely discrete, so you could even do your routine at your desk or anywhere else you can sit comfortably. Of course, speak with your physician if your incontinence is seriously affecting your daily routine, but if it’s only a minor inconvenience, Kegel exercises might be the only treatment you need.

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

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Stopping UTI’s before They Start

Monday, November 19th, 2012

I could tell you that urinary tract infections (UTI’s) are common in women all over the world, but it would be an understatement. The fact is, they are extremely common, and few women make it to age forty never having experienced one.  They’re relatively easy to treat and harmless when taken care of early, but they’re also inconvenient and uncomfortable. Treating them is as easy as taking abstinence from intercourse. If caught early enough, your gynecologist might even simply prescribe more water. However, most women don’t catch their UTI’s until they feel the symptoms of burning and frequent urination. By that point, antibiotics are usually necessary.

That means treatment requires a quick trip to the doctor and a prescription. However, to make your life even easier, you should try to prevent UTI’s before they even start. Some women are more susceptible to UTI’s than others because their urinary tract is short or shaped in a way that traps bacteria. If you get them often, you need to be even more diligent in taking the proper steps to prevent them. UTI’s will clear up easily with treatment, but without treatment they could creep up your system and turn into a kidney infection (pyelonephritis), which could eventually kill you. A UTI will require antibiotics, but a kidney infection could require hospitalization.

The easiest and most beneficial way to prevent UTI’s is to drink plenty of water. You should be drinking at least eight glasses a day already, and getting that recommended amount will help flush out any bacteria that might get caught in your bladder. While it has long been believed that cranberry juice can help prevent all-too-common bladder and kidney infections, a new study from the well-respected Cochrane Library says its unlikely to do any good. (http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001321.pub5/abstract)   Taking proper measures to keep your bladder free from bacteria is also important. Always remember as well to wipe from front to back, and urinate after intercourse to flush out bacteria that made its way into your system. Of course, good personal hygiene in the shower helps, and you should always wear clean, cotton underwear that keep those germ-sensitive areas covered.   Recent studies have concluded that the best way to prevent uncomplicated urinary tract infections is to abstain from sexual intercourse (link to New England of Medicine).   However, being the healthy females that we are, intercourse is a fact of life and refraining from intimacy may be a price to big to pay for not having a urinary tract infection.

Urinary tract infections are inconvenient and sometimes painful. They’re extremely common, but by practicing good health and hygiene you’ll increase your chances of avoiding them. Even if you feel like one might be coming on, plenty of fluids, short hiatus from intercourse can ward it off before you even call the doctor.

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

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