TRYING TO GET PREGNANT: 14 FERTILITY MYTHS DEBUNKED

Posted in Health by woman2womenblog

We live in the era of informatics. Knowledge is easily accessible to us: we can learn virtually anything by just googling it. But paradoxically too much information many times leads to misinformation.

When it comes to fertility issues, there is a lot of disinformation going around. Therefore, it is no surprising what a recent survey showed: knowledge regarding ovulation, fertility, and conception issues is limited among women, and many tend to believe certain myths and misconceptions.

These are 14 fertility myths most people believe, but that science has debunked:

MYTH #1. Maternity wise, 40s is the new 30s

Our life expectancy is longer, and we tend to postpone maternity due to career or study purposes. From that aspect, the 40s can be easily regarded as the new 30s. Unfortunately, this is not true for our ovaries: by the age of 30, a healthy woman has about a 20% chance of conceiving each month, by the time she reaches 40 her odds drop to about 5%.

This is one of the most commonly believed misconceptions: unaware of the age-related fertility decline, many women start seeking help to conceive in their 40s, when they may have already missed the opportunity to become parents.

You should be aware that there is a biological clock, and it’s ticking! If for personal reasons you cannot have a child right now, you may freeze your eggs to use them in the future.

MYTH #2. Certain sex positions increase the chances of getting pregnant

You will find plenty of (mis)information on this topic! In general, it is said that the best positions for getting pregnant are the missionary position (the woman lying on her back, her partner on top) and the “doggy position” (rear vaginal penetration, with the woman on her hands and knees) because they provide the deepest penetration, allowing the man to ejaculate closer to the opening of the cervix.

In fact, there’s no scientific evidence to prove that. This belief is largely based on a single study that looked at the position of the penis in relation to these two sex positions, but it didn’t address pregnancy chances at all.

Therefore, no position seems to be better when it comes to maximizing your chances of making a baby. Sperm can be found in the cervical canal just a few seconds after ejaculation, and within 5 minutes in the tube, regardless of the coital position.

MYTH #3. Lifting your legs in the air for 20 minutes after having sex will help you get pregnant

You have probably heard this one: “lie in bed with your feet in the air after having sex to increase your chances of getting pregnant”. In fact, this is not (totally) true. You may lay in bed for 10-15 minutes after intercourse, as by this time the sperm have largely reached the cervix, and many may even be inside the tube.

In fact, a new study challenged both beliefs: women having artificial insemination were split into two groups – one that rested on their back with their knees raised for 15 minutes after the procedure and one that got up immediately. It turned out that, after several courses of treatment, 32% of the immobile group fell pregnant, compared with 40% per cent in the active group.

Therefore, there is no need to put pillows under your bottom during intercourse to get an advantageous tilt, or to perform cycling motions with your feet in the air.

MYTH #4. If we have sex every day the sperm becomes too weak, reducing our chances of getting pregnant

How often should we make love to boost our chances of pregnancy? You will find all sorts of advice on the web: every other day, 3 times a week, every single day! Which one is correct?

One thing is clear: abstinence intervals greater than 5 days impair the sperm number and quality. Nevertheless, there is not much difference whether men ejaculate every day or every other day. Most fertility specialists used to recommend intercourse every other day, as this would increase sperm quality, particularly in men with lower sperm counts (oligozoospermia). However, recent studies show exactly the opposite: oligozoospermic men had better semen quality with daily ejaculation!

Recent scientific evidence suggests that making love every day confers a slight advantage: the highest chances of pregnancy (37% per cycle) were associated with daily intercourse, although sex on alternate days had comparable pregnancy rates (33%). On the other hand, we should keep in mind that the “obligation” to have sex every day may induce unnecessary stress to the couple, resulting in lack of sexual desire, low self esteem, and ultimately reduced frequency of intercourse.

Therefore, reproductive efficiency is highest when you have sex every day or every other day. The optimal frequency, though, is best defined by each couple’s own preference.

MYTH # 5. We only have sex when I ovulate, on day 14 of my cycle

Ovulation (when the egg drops from the ovary into the tubes) occurs once a month, usually between day 11 and day 21 of the cycle (measured from the first day of your period).

Each woman ovulates on her own schedule. While it is usually said that a woman with a 28-day cycle ovulates on cycle day 14, that’s not necessarily true: a study found that fewer than 10 percent of women with regular, 28-day cycles were ovulating on day 14.

We know that sperm cells are able to survive in the reproductive tract of a woman for about 5 days, and that once the egg is released, it will die in about 12-24 hours. Therefore, the fertile period -or “fertile window”- is a 6-day interval ending on the day of ovulation.

To boost your odds to become pregnant, have sex before and during ovulation, every day or every other day. If your cycles are irregular and you cannot figure out your fertile days, you may use an ovulation predictor kit, or otherwise visit a specialist, who can help you find your fertile window.

MYTH # 6. Smoking doesn’t affect our chances of getting pregnant. I will quit smoking as soon as I get pregnant

You are most likely aware that smoking during pregnancy is dangerous, as it can lead to miscarriage, premature birth, low-birthweight babies and -according to recent studies– congenital malformations.

But you should also know that smoking is harmful for your fertility: smoking as few as five cigarettes per day is associated with reduced fertility, both in women and men, and this seems to be true even for secondhand smoking. It has been estimated that smokers may have a 10-40% lower monthly fecundity (fertility) rate, and that up to 13% of infertility is due to smoking.

Smoking can affect ovulation, as well as the ability of the fertilized egg to implant in the uterus. The effect of tobacco is so harmful for the ovaries that menopause occurs, on average, one to four years earlier in smoking women than in nonsmoking ones.

Men are also affected by tobacco: decreases in sperm density, motility, and abnormalities in sperm morphology have been observed in men who smoke, which impact a man’s ability to fertilize an egg.

Therefore, before trying for a baby, do yourself a favor … and put out the cigarette for good!

MYTH # 7. You don’t need to worry about your age. There’s always IVF

Another common misconception! Many women believe that, if age-related infertility strikes, they can overcome their problem by getting treated with in vitro fertilization (IVF). In fact, just as natural fertility declines with age, success rates with IVF also decline as a woman gets older.

According to the USA Center for Disease Control and Prevention (CDC), women younger than 35 years old have 33% chances of having a baby after IVF; for women ages 38 to 40 the success rate drops to 17%, while those 43 to 44 years old have only 3% chances of giving birth after IVF (using their own eggs).

IVF is not a guarantee to have a baby, and does not extend a woman’s reproductive life. Despite the number of celebrities having babies in their mid-40s and beyond, they may have not necessarily used their own eggs. While every woman has the right to keep her privacy, there is a wrong perception left that fertility treatments can extend a woman’s fertility span. There is a very low probability of improving success of conceiving after age 43 by using assisted reproduction using your own eggs. Nevertheless, you may opt to use oocyte donation (eggs of a younger woman) if age-related infertility stands in the way of parenthood.

MYTH # 8. A woman can’t get pregnant if she doesn’t have an orgasm

For men, things are clear: no orgasm, no pregnancy, as ejaculation occurs during orgasm. Well, that’s not entirely true: semen can be released during intercourse prior to orgasm in the so-called pre-ejaculation fluid, or pre-come (read more here).

For women though, getting pregnant has nothing to do with an orgasm. But could female orgasm improve the chances for conception? The answer is not clear.

Researchers have wondered for years about the purpose of female orgasm, and many theories have been proposed:

Just the pleasure it provokes, so that women want to reproduce and preserve the species!
The “poleaxe” hypothesis: orgasms make women feel relaxed and sleepy so that they will lie down after sex and the sperm reach their destination more easily.
The “upsuck” theory: the contractions of the uterus “suck up” the sperm released in the vagina and help them travel through the uterus to the tubes.
Pair bonding: the hormones produced during orgasm (such as oxytocin and prolactin) contribute to warm feelings towards her partner.

Orgasms are not necessary to get pregnant, but there are plenty of good reasons to have one! Nevertheless, it is not uncommon that women trying to conceive link the desire for an orgasm with their desire to have a baby; this leads to psychological pressure and difficulty achieving orgasm, adding frustration to a process that is supposed to be pleasurable…

Try not to consider the orgasm just as goal to get pregnant. Enjoy the intimate time with your partner, without any pressure. If you have an orgasm, great. If not, that’s fine, too!

MYTH #9. We’ve already had one child, so conceiving again will be easy

Perhaps, but it’s no guarantee. Many individuals experience secondary infertility, or difficulty conceiving a second or subsequent child.

Secondary infertility may be caused by age-related factors, both for you and your partner. Sometimes, a new underlying medical condition develops. Eventually, a fertility issue that always existed gets worse; while it didn’t prevent pregnancy before, now it has become a problem. A previous pregnancy may actually be the reason you don’t get pregnant again: surgical complications or infection after childbirth may have provoked scarring, which may in turn led to infertility.

Things change with time. Even if you got easily pregnant on your own before, if you’re struggling to have another child talk to your doctor, who can advice you on the next steps to follow.

MYTH #10. Infertility is a woman’s issue

Typically, the causes of infertility break down like this:

Approximately one third of the couples struggle with male infertility;
In another third, the problem is female infertility;
The remaining third will either face both male and female fertility issues, or a cause will never be found (unexplained infertility).

Common causes of female infertily are: age, PCOS (polycystic ovary syndrome), tubal or pelvic issues, endometriosis, and family history.

Common causes of male infertility tend to be from prior surgery, infection, or a problem present at birth.

As part of the preliminary work-up to determine the cause and treatment of infertility, both women and men will need to undergo clinical and specialized complementary exams.

MYTH #11. Men’s age doesn’t matter

While some men can father children into their 50’s or 60’s, men’s fertility isn’t age-proof: it starts declining in their 40s, although less drastically as compared to women’s fertility.

As a man ages, the concentration of mobile, healthy sperm and semen volume overall will decrease. It is clear now that men over the age of 40 have higher chances of having children with chromosomal abnormalities, causing miscarriages in their female partners. Moreover, researchers have found a direct link between paternal age and an increased risk of autism and schizophrenia.

A man’s age does matter. While men may not have a complete drop off in fertility like women do, “advanced paternal age” is something couples should be aware of. Men’s biological clock is also ticking!

MYTH #12. If I take good care of my general health, my fertility will be in check too

Whereas a healthy body and mind may boost fertility in certain cases, most infertility situations cannot be resolved by a lifestyle or diet change, particularly those related to age.

It is a common belief that certain diet types can help you get pregnant. There is no evidence that vegetarian diets, low-fat diets, antioxidant- or vitamin-enriched diets will increase your chances of having a child.

A woman’s weight plays a role in fertility: those who are either very thin or obese may find it hard to conceive. If you are trying to get pregnant, learn more about some lifestyle tips to boost your chances of getting pregnant here.

MYTH #13. If a man can ejaculate, his fertility is fine

Many myths surround male fertility and their sexual performance. It is a common (and unfortunate) myth that if a man’s fertility is compromised, this means his sexual performance is the problem. This is not true. Problems with sperm count, shape, and movement are the primary causes of male infertility.

Another common myth is that you can tell there is a problem with the sperm just by looking at the semen. In fact, even men that have no sperm cells at all (azoospermia) usually have normal-looking semen.

For the vast majority of men with infertility, there are no visible or obvious signs that anything is wrong. Healthy erectile function and normal ejaculation are not guarantee that the sperm is in good shape.

That said, erectile dysfunction can be a possible symptom of infertility; it may due to low testosterone levels or a physical injury. Difficulty with ejaculation can also be a signal certain medical problems. But these are uncommon signs of male infertility.

If you are struggling to get pregnant, have your partner check in with his doctor. A semen analysis will help clarify whether his sperm are fit for conception.

MYTH #14. The birth control pill will affect your future fertility

All scientific evidence agrees that hormonal contraceptives do not make women sterile. Moreover, they may confer increased likelihood of pregnancy with long-term use, and in certain cases they can also preserve fertility. Read more on the contraceptive pill here.

To summarize:

Myths and misconceptions regarding fertility and conception are, unfortunately, widely disseminated. This is a serious problem, as misinformation may lead not only to unnecessary stress, but also to take wrong decisions…

Get yourself well informed! Consult your gynecologist, who can help you with any concerns you have. Your doctor can also give you some tips on lifestyle changes to optimize your fertility, prescribe some exams, and tell you when to come back if you don’t achieve pregnancy on your own.

Last, a good piece of advice: if you want to get pregnant, have lots of sex – as much as you want, whenever you want – and enjoy it! After you have had sex, do whatever you want – just don’t smoke 😉

Photo credits

Intro: pixabay.com; 1: rma-fl.com; 2: motherandbaby.co.uk; 3: romper.com; 4: pixabay.com; 5: wsaw.com; 6: babycenter.com; 7: nexter.org; 8: irishtimes.com; 9: health.clevelandclinic.org; 10: thefertilechickonline.com; 11: businessinsider.com; 12: hayatouki.com; 13: livescience.com; 14: pinterest.com

4Nov2018

HPV TEST: A NOVEL TECHNIQUE TO PREVENT CERVICAL CANCER

Posted in Health by woman2womenblog

You have probably heard the term Pap test and know that you should be getting it regularly. Pap tests are important because they allow us to detect abnormalities in the uterine cervix before they turn into cancer. Thus, Pap tests have saved millions of women’s lives for more than 70 years now.

Nevertheless, as valuable as this test has been for so many years, new technology has come to improve even further our ability to find pre-cancer or early cancer of the cervix. This novel exam is called the HPV test.

In this article you will find all the information you need to know regarding this new technique, which is becoming a routine exam in most countries.

Background

Cervical cancer is the second-most-common cancer affecting women worldwide. It is a type of cancer that can easily be prevented, as its cause is known: the human papillomavirus (HPV, read more here).
Not all types of HPV are responsible for the development of cancer of the uterine cervix. Approximately 15 types of HPV are related to cancer, these are known as high-risk types or oncogenic viruses.
While most HPV infections resolve without treatment, infections with high-risk HPV strains that persist over time can cause precancerous changes in the cervix.
Precancerous conditions are not cancer, but if these abnormal changes are not treated, they may become cervical cancer. It may take 10 years or more for precancerous conditions to turn into cancer, but eventually this happens within a shorter time period.
Pre-cancer lesions of the cervix do not cause any symptoms. Symptoms only appear in advanced cancer. That is why all healthy women should undergo preventive exams.
The mainstay of cervical cancer screening for the last 70 years has been the Pap test (also called Pap smear or Test Papanicolaou). During the procedure, cells from the cervix are gently scraped away with a brush and then examined for abnormal growth, usually called cervical dysplasia, CIN (cervical intraepithelial neoplasia), or SIL (squamous intraepithelial lesions).
More recently, newer technologies have become available to test for the cancer-causing types of HPV and determine if you may be at risk. This test is called the HPV test.

What is the HPV test?

The human papillomavirus (HPV) test detects the presence of the types of HPV virus that can lead to the development of cervical cancer.
The HPV test is available only to women. Although men can be infected with HPV and pass the virus along to their sex partners, no HPV test yet exists to detect the virus in men.

Why test for HPV?

The Pap test is a simple test that has saved uncountable women lives. However, it is not 100% accurate. The Pap test detects certain cervical abnormalities that will never progress to cancer; on the other hand, it may miss abnormal cells even when they are there.
Thus, knowing whether you have a type of HPV that puts you at high risk of cervical cancer will provide valuable information on the next steps in your health care, such as follow-up monitoring, further testing, or treatment of precancerous cells.
Recent studies have shown that HPV testing is more effective than Pap smears at detecting precancerous lesions.
A Pap test plus an HPV test (called co-testing) is the most effective way to find pre-cancer or early cervical cancer in women 30 and older.

Who should do the HPV test?

The HPV test is recommended if:

You are age 30 or older. The HPV test may be done alone or in combination with a Pap smear.
Your Pap test showed atypical squamous cells of undetermined significance (ASCUS). ASCUS is a common finding in a Pap test; it may be a sign of HPV infection, although many times it is just related to benign cervical polyps, a bacterial infection, or low hormone levels (menopause).
You had a surgical removal of a precancerous lesions, usually 6 months after the treatment. This is called “test of cure”.

Although recommendations vary in different countries, all women aged 30 to 65 years old should have the HPV test every 3 to 5 years.

Routine use of the HPV test in women under age 30 is not recommended, nor is it very helpful. HPV spreads through sexual contact and is very common in young women. Most of the times, HPV infections clear on their own within a year or two. Since cervical changes that lead to cancer take several years — often 10 years or more, younger women are usually advised to follow a watchful waiting instead of undergoing treatment for cervical changes resulting from an HPV infection.

What are the risks of HPV testing?

Although the HPV test is very accurate, it carries (like any other test) the risk of false-positive or false-negative results.

• False-positive. This means that the test showed a high-risk HPV when you really don’t have it. A false-positive result could lead to an unnecessary follow-up procedure, such as colposcopy or biopsy, and undue anxiety over the test results.

• False-negative. A false-negative test result means you really do have an HPV infection, but the test indicates that you don’t. This might cause a delay in appropriate follow-up tests or procedures.

How should I prepare for an HPV test?

The HPV test is usually done at the same time as the Pap test. You can take these measures to make both tests as accurate as possible:

Avoid intercourse, douching, or using any vaginal medicines or spermicidal foams, creams or jellies for two days before the test.
Try not to schedule the test during your menstrual period. The test can be done, but a better sample of cells can be collected at another time in your cycle.

How is the HPV test done?

The HPV test, alone or in combination with the Pap test, is performed at the doctor’s office and takes only a few minutes.
While you lie on your back with your knees bent, your doctor will gently insert an instrument called a speculum into the vagina.
The speculum allows the visualisation of the cervix. Samples of the cervical cells are taken using a soft brush.
Usually this doesn’t hurt, sometimes it may cause a mild discomfort.
After the procedure, you can do your normal daily activities without any restrictions.
Ask your doctor about when you can expect to receive your test results.

What do the results mean?

Results from your HPV test will come back as either positive or negative.

Positive HPV test. This means that you have a type of high-risk HPV that is linked to cervical cancer. While most women who are infected with HPV will never develop cervical cancer, it’s a warning sign that cervical cancer could develop in the future.
Negative HPV test. A negative test result means that you don’t have any of the types of HPV that cause cervical cancer, and you will continue with normal monitoring.

Depending on your test results, your doctor may recommend one of the following as a next step:

Normal monitoring. If you’re over age 30, your HPV test is negative and your Pap test is normal, you will follow the generally recommended schedule (differences apply for each country).
Colposcopy. In this follow-up procedure, your doctor uses a special magnifying lens (colposcope) to more closely examine your cervix.
Biopsy. Done in conjunction with colposcopy, a sample of cervical cells (biopsy) is taken to be examined more closely under a microscope.
Removal of abnormal cervical cells. To prevent abnormal cells from developing into cancerous cells, your doctor may suggest a procedure to remove the areas of tissue that contain the abnormal cells.

The bottom line…

It is true that a visit to the gynaecologist may sound frightening. You may be too busy, and feel that you don’t have the time. You may believe that you are not at risk for cancer. While all this may be true, you should know that every sexually active woman is at risk for cervical cancer, the HPV test is a simple, painless test that takes 5 minutes to be done, and will prevent some serious issues in the long run. Have your HPV test! Five minutes of your time can save your life!

References

Photo credits

telegraph.co.uk; cmdrc.com; twitter.com; erewashccg.nhs.uk; everydayhealth.com; healthxchange.sg; margaretmccartney.com

25Sep2016

WHEN SEX IS PAINFUL: 8 COMMON PROBLEMS – AND HOW TO FIX THEM

Posted in Health by woman2womenblog

Sexual intercourse is supposed to provide pleasure, satisfaction and fulfilment. We -particularly women- tend to expect flawless, movie-like sex, romantic, luscious or passionate, with music playing in the background! Well, in real life sex is not always that perfect: according to an American survey, about 1 out of 3 women reported pain the last time that they have had sex. What’s more, many women feel ashamed to talk about it, giving up the idea of pleasurable sex. It is not unusual for these women to avoid having intercourse, leading to couple conflicts and eventually to psychological problems…

But why so many women feel pain while making love?

Whether it happens each time or occasionally, you feel just some discomfort or unbearable pain, dyspareunia (painful intercourse) can be related to a gynecological or medical problem, to your emotions or your state of mind; occasionally your partner is to blame, or maybe both of you, let’s not forget that it takes two to tango!

Below you will find 8 common painful situations you may encounter during intercourse. Understanding the type and location of the pain will help us pinpoint its cause, so that you can take some measures to get over it!

Problem # 1: “I feel a burning sensation outside the vagina”

You may feel a painful, burning sensation in your vulva (the external genitals), the area may be red and eventually swollen.

Possible causes:

Yeasts or other infections: a yeast infection will cause “cottage cheese-like” discharge; other bacteria can produce yellow or green discharge which may also be foul-smelling.
Contact dermatitis: you may realize that the problem starts after using certain lubricant, soap or cream, laundry soaps or softener; certain clothes can also be responsible.
Allergic reaction to condoms: the burning feeling starts after having sex, usually within 48 hours.
Menopause: although menopause generally causes vaginal dryness, some women also feel intense burning, which gets worse with intercourse.

What to do about it:

Check with your doctor, who can give you a treatment for your yeast infection, if you are prone to get them, over-the-counter medications are available.
In the doubt, your doctor may order a culture, to see which bacteria is responsible for your symptoms.
In case of dermatitis or allergic reaction, stay away from possible irritants, your doctor can prescribe you a cream to soothe discomfort.
If you are allergic to latex (the material condoms are made of), stick to non-latex condoms.

Problem # 2: “I have a painful bump in my vulva”

You may feel a sharp, localized pain; while trying to precise its location you may touch a “bump” in the vulva. If you look with a mirror you may be able to identify the spot. Sex, due to rubbing, will make it even more painful.

Possible causes:

Pimple or ingrown hair: these are the commonest “bumps” appearing in the genitals. They can be quite sore if they become infected. A clogged sweat gland can also cause a painful pimple.
Bartholin gland cyst: they are soft cysts arising at the opening of the vagina. They can be very large (like a walnut) and become extremely painful if they get infected.
Herpes: genital herpes is a sexually transmitted infection. It causes itchy, burning and painful lesions that often start as a sore spot, becoming over a few days one or several blisters. Read more here.
Other dermatological or medical problems: rarely, diseases causing genital ulcers may be the cause of pain.

What to do about it:

Check with your doctor if you are not sure what is causing you pain.
Pimples may require a local cream to relief pain. If they are infected antibiotics may be necessary; more rarely incision and drainage are needed.
Bartholin cysts are treated with warm sitz baths. If infected antibiotics, incision and drainage may be necessary.
Herpes is managed with antiviral medications (locally or by mouth), painkillers may also be required.

Problem # 3: “I’ve tried everything, but penetration is impossible and triggers excruciating pain”

You were never able to have penetration; even introducing tampons is impossible because you feel there is an “obstacle”.

Possible causes:

Hymen problems: you hymen may be abnormally thick, or imperforate.
Vaginal problems: your vagina can be too narrow or have a septum.
Vaginismus: see below.

What to do about it:

If penetration was never possible, check with your doctor who can rule out any anatomical problem; most of them can be solved with a simple surgical intervention.

Problem # 4: “I have intense pain in the opening of the vagina during penetration”

Even if you are aroused and willing to have sex, penetration triggers an intense pain in the entrance of the vagina; this is called entry dyspareunia.

Possible causes:

First time: we tend to have high expectations about our first intercourse; however many times it is less extraordinary than expected, and this includes pain; sometimes (but not always) bleeding may occur.
Trauma: this can be the result of childbirth (a tear or an episiotomy) or surgery; occasionally injury can be sex-related.
Vaginitis: due to yeast or other infection (see above).
Vulvodynia: it is a distressing, long-lasting condition in which the vulva is so sensitive that just touching the area makes the woman jump with pain. When pain is confined to the vestibule (the area around the opening of the vagina), it is known as vulvar vestibulitis syndrome (VVS). Its cause is unknown.
Emotional reasons: see below.

What to do about it:

If it is your first time, don’t worry too much about it. Many women have pain or discomfort during their first intercourse, an even a larger percentage will not have an orgasm. Be patient, try to be as relaxed as possible, discuss with your partner the means to reduce pain. If the problem persists, discuss it with a doctor.
If your just delivered, wait to have intercourse for at least six weeks after childbirth; some discomfort may persist for a few months, especially if you breastfeed, since your vagina also feels dry (see below). If pain continues for a long time or is very intense, talk to your doctor.
Vulvodynia may require medications, or eventually surgery. Read more here.

Problem # 5: “My vagina feels too dry”

Vaginal dryness is extremely common, and does not always mean problem. While some women produce a lot of vaginal secretions, others are drier. However, there are factors that influence natural lubrication levels: sexual stimulation increases the amount of secretions; therefore, adequate and prolonged foreplay will help you being aroused. Sometimes though, your vagina keeps being dry and sex becomes painful.

Possible causes:

Menopause: due to the low level of estrogen (the hormone in charge of lubricating your genitals), your vagina will feel extremely dry and sex can be very painful, sometimes impossible.
Breastfeeding: also related to low estrogen.
Medications: some medications such as birth control pills, decongestants and antihistaminics may reduce vaginal moisture; contraceptive pills can also decrease sexual desire.
Medical problems: certain medical conditions can indirectly affect sexual response: diabetes, cancer, and thyroid problems, among others.
Your emotions: see below.

What to do about it:

Use a lubricant. Water-soluble lubricants are the best choice if you experience vaginal irritation. Silicone- based lubricants last longer and are more slippery. Do not use petroleum jelly, baby oil, or body lotion with condoms, as they can cause the condom to break (read more here).
For chronic cases, you may try long-acting vaginal moisturizers which, unlike lubricants, are absorbed into the vaginal lining for 3 to 4 days, mimicking natural secretions.
For menopausal women, when lubricants or moisturizers won’t work, a vaginal estrogen product may be necessary. More info here.
In any case, talk to your doctor if lubricants or moisturizers don’t help.

Problem # 6: “My vagina is just not opening”

Each time you try to have sexual intercourse, your vagina “closes”; any attempt of penetration is painful, and usually impossible.

Possible causes:

Vaginismus: it is a tightening (or reflex contraction) of the muscles of your vagina which occurs during penetration, but eventually also while attempting to insert a tampon, or during a gynecological exam. Its cause is unknown, although it is frequently related to anxiety, or fear of having pain during sex. Learn more here.
Your emotions: see below.

What to do about it:

Progressive desensitization consists of special exercises aimed at learning to relax your vaginal muscles.
Medical treatment may be useful in certain situations.
For women whose vaginismus is related to fear or anxiety, psychotherapy usually helps.

Problem # 7: “I feel pain in my bladder during intercourse together with constant urge to urinate”

While having intercourse, you feel low abdominal pain and a persistent need to pee.

Possible causes:

Cystitis: read more here.
Interstitial cystitis (IC): also called bladder pain syndrome (BPS) is a chronic problem, which causes a feeling of pain and pressure in the bladder area, together with burning during urination. IC may feel like a bladder infection, but it’s not an infection; in fact, its cause is unknown.

What to do about it:

Read here to see what you can do if you have a bladder infection, particularly if you get one very often.
Regarding BPS, check with your doctor. No single treatment works for every woman, it should rather be individualized and based on symptoms. Learn more here.

Problem # 8: “I feel a deep pain in my abdomen during sex”

A deep pain or cramping in your abdomen during sex -or deep dyspareunia – can be the result of numerous problems.

Possible causes:

Gynecological problems: endometriosis, fibroids, ovarian cyst, adhesions, or infection (pelvic inflammatory disease). Many of these also cause painful periods.
Irritable bowel syndrome: a chronic condition that affects the large intestine; it commonly causes cramping, abdominal pain, bloating, gas, diarrhea and constipation. More info here.
“Collision dyspareunia”: a funny name to describe the pain you may feel if the tip of your partner’s penis hits your cervix. This can happen if your partner is longer than average, if you’re not fully aroused, or if your cervix is unusually positioned. Read more here.
Other reasons: constipation, a retroverted uterus, a forgotten object in the vagina (usually a tampon).

What to do about it:

Although many of the causes of deep dyspareunia are not important, some of them can be serious; therefore, you should see a doctor, especially if it is a new-onset problem. Many of these situations will be treated with medications, others require surgical intervention.

THE EMOTIONAL FACTOR

Our emotions are tightly related to our sexual life; thus, negative emotions are frequently the source of painful sex. Some examples are:

The way you feel about having sex: fear, embarrassment, guilt, being concerned about your physical appearance, being to too anxious about “doing it right” can all may make you unable to relax; therefore, arousal is difficult and you end up having pain.
Stress, fatigue, anxiety, depression: your everyday life problems can affect your desire to have sex. In addition, your vaginal muscles tend to tighten; this can also contribute to painful sex.
Relationship problems: problems with your partner may be related to painful sex by reducing arousal or provoking vaginismus.
A previous bad sexual experience: such as women with a history of sexual abuse, who tend to relate sex with something bad or negative.

WHEN YOUR PARTNER IS THE PROBLEM…

Painful sex is not always your fault!

Your partner may have sexual problem, which in turn can make you feel anxious about sex.
If your partner is taking a drug for erectile dysfunction, he may have delayed orgasm, causing long and painful intercourse.
Size problem: feel that your partner is “too big”? In fact, when a woman is aroused and relaxed, the vagina extends by several inches – so most women should be able to accommodate most males! Nevertheless, if size is indeed a problem, try a lubricant, and check which sex positions are less likely to make you hurt. Come close, a new device can be a good option for you.

SHARED PROBLEM: SEXUAL MISMATCH

Besides size mismatch, or differences in the way you both enjoy sex, a common issue leading to painful sex is mismatched sexual desire. Read more here.

TAKE HOME MESSAGE

If you have pain during sex, talk about it! It may be embarrassing to discuss your sexual problems with a doctor, but you should know that, with proper care most problems can be solved; therefore there is no reason to condemn yourself to a pleasureless, painful sexual life!

In the meantime, these are some tips that may help you relieve your pain:

Talk to your partner: mutual communication is essential. Discuss with your partner where and how is the pain, so you can both find ways to avoid it or minimize it.
Use a lubricant: a simple measure that can ease your suffering. It’s a good idea to keep always one with you.
Make time for sex: not always easy to include sex into our busy schedules! Nevertheless, try to find a moment of the day when you and your partner will be less tired or anxious.
Engage in sexual activities that don’t cause pain: if penetration is painful, you may consider other forms of pleasure, such as oral sex.
Try different sex positions: if you have deep dyspareunia, it can be worse in certain positions. Try to find those that are less likely to trigger pain.
Include relaxing activities: your partner may give a massage.
Take steps to relieve pain before making love: take a warm bath, empty your bladder, take a painkiller.
If you experience burning after intercourse: apply a frozen gel pack or some ice wrapped in a towel to your vulva.

References

Photo credits

Intro: dailymedicalinfo.com; 1: rascoecam.wordpress.com; 2:liferunning.wordpress.com; 3: daroachbooks.blogspot.gr; 4: pixabay.com; 5: scienceclarified.com; 6: newauthors.wordpress.com; 7:diversehealthservices.wordpress.com; 8: everythingselectric.com; Take home: pinterest.com

17Jan2015

PREGNANCY DO’S AND DON’T’S (Part 3)

Posted in Health, Pregnancy by woman2womenblog

EXERCISE, SEX, WORK AND TRAVEL

The first post on Pregnancy do’s and dont’s analysed what is allowed and what discouraged during pregnancy concerning food, beverages, alcohol and cigarette (see here). The second part dealt with beauty treatments and medications (see here). Check out this third article on do’s and dont’s regarding exercise, sex, working and travel while pregnant…

EXERCISE

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Why to exercise: Beginning or continuing a moderate course of exercise during pregnancy is not associated with adverse outcomes. In fact, exercise may have many health benefits: it lessens some of the discomforts of pregnancy, it helps strengthen the muscles used in labor and delivery, it may give you more energy and make you feel better. There is also some evidence that exercise may prevent pregnancy-related diabetes and high blood pressure. The American College of Obstetrics and Gynecology recommends for pregnant women 30 minutes of moderate exercise per day on most days of the week.

Check with your doctor first! There are certain circumstances in which women should not exercise, such as those with asthma or heart problems, or pregnancies complicated with bleeding, low placenta, weak cervix or premature contractions.

Exercises that are safe: The type of exercise you can do during pregnancy depends on your health and how active you were before getting pregnant. This is not a good time to start a very demanding sport. But if you were active before, you can continue to be, within reason. The following activities, in moderation, are especially good during pregnancy:

Swimming (it should be OK even in chlorinated pools)
Brisk walking
Prenatal exercise classes
Prenatal yoga

Exercises to avoid: Pregnant women should avoid the following:

High-impact or vigorous sports that may involve the risk of abdominal trauma, falls or excessive joint stress.
Holding your breath during activity
Exercises that require lying flat on your back for more than three minutes (especially after the third month of pregnancy)
Heavy exercise spurts followed by periods of no activity
Exercise in hot and humid weather
Activities in hot water (see more here)
Vigorous racquet sports
Activities where falling is likely (e.g. skiing, horseback riding, mountain biking)
Contact sports: football, basketball, volleyball, softball
Scuba diving, which may result in birth defects and fetal decompression disease.

Tips for safe exercise: Even though exercise can be beneficial, you should be careful. During pregnancy, your centre of gravity shifts and your balance changes. Your joints and ligaments get more relaxed. This may put you at a greater risk for falls. You tire more easily. Caution should be the rule!

These are some tips for exercising while pregnant:

Avoid getting overheated.
Limit outdoor exercise in hot weather.
Avoid exercise that makes you very tired, or with high risk of falling or getting an abdominal trauma
Get up slowly after doing floor exercises, to avoid getting dizzy
Drink lots of water
Consume extra calories if you exercise regularly
Wear good support shoes and bra
Don’t push yourself too much! Listen to your body and slow down when you feel tired.

Signs to stop exercising: You should stop exercising and call you doctor if you feel one of the following:

Dizziness, fainting or nauseated
Rapid or irregular heatbeat
Short of breath
Pain in your chest
Recurring abdominal pain or uterine contractions
Swelling in your calf
Intense headache
Blurred vision
Vaginal bleeding
Fluid leaking from your vagina
A decreased or absence of baby’s movements

SEX

Is it safe? Sexual intercourse in pregnancy is not known to be associated with any adverse outcomes; therefore, it can be safely continued throughout pregnancy.

The baby is well protected inside the uterus! The uterine wall, the amniotic sac and the mucus plug (thick mucus that seals the cervical canal to prevent infections) will all keep the baby safe.

Keep in mind that intercourse can cause uterine contractions: the orgasm itself, nipple stimulation and prostaglandins (a substance contained in sperm) will all may make the uterus contract. In general, these contractions are mild and harmless.

Love making has been long proposed as a measure to induce labor at term. Although there is no scientific evidence that sex triggers labor, it may help, and it won’t harm!

Does sex feel the same while pregnant? Sex during pregnancy can be different than before. For some women, it may be more pleasurable, due to the high hormonal levels, genital engorgement and increase in vaginal secretions. For others though, sexual desire may be reduced for many reasons: nausea and dizziness during the first trimester, genital swelling which may sometimes cause discomfort, or you may just feel uneasy with your body changes…

Furthermore, your breasts get very engorged and tender, which may be pleasant for some women, but annoying for others…

Love making in practice… needless to say, certain positions will be uncomfortable, or impossible as your womb gets bigger…You may need to experiment a little bit to find which positions are fine for you… Especially during the third trimester, you should avoid lying flat on your back, because the pressure of the womb on the major blood vessels may cause a drop in blood pressure and dizziness. Although oral sex is fine, blowing into the vagina is to be avoided, as it may cause air embolism (a bubble of air entering the blood circulation), which may have fatal consequences.

When to avoid intercourse: there are certain situations, in which sexual intercourse is discouraged: if you have vaginal bleeding, a history of repeated miscarriages, preterm uterine contractions, or a weak cervix. In addition, you will be told to abstain from sex if you have a diagnosis of placenta previa (when the placenta lyes low in the uterus or covers the cervix). Always check with your doctor to make sure it’s OK for you to have sex.

When to call your doctor: you should call your healthcare provider if, after sex, you have intense abdominal pain, cramping, foul smelling discharge or bleeding coming from the vagina.

WORKING DURING PREGNANCY

Embed from Getty ImagesIf you are a healthy woman and you have a normal pregnancy, most likely it will be safe to continue working during pregnancy. Don’t forget to talk to your doctor about your work environment. There are certain occupations that may be dangerous, and others that may require certain modifications:

Exposure to radiation and radioactivity: there is evidence to support an association between x-rays or radioactivity exposure and miscarriages, birth defects and other pregnancy complications. You should inform right away your doctor and your employer if you receive occupational x-rays or radioactivity exposure.

Exposure to chemicals: Studies results are less conclusive for occupational exposure to chemicals, but there seems to be some increased risk of miscarriages and eventually malformations. Some examples of jobs with chemical exposure are dry-cleaning, painting industries, operating rooms, jobs involving pesticide or heavy metals exposure (lead, mercury). Inconclusive evidence also exists for women working in beauty salons (for more info check here).

Physically demanding work: jobs with prolonged standing (such as cooks, police officers, nurses) and heavy weight lifting may be associated with poor pregnancy outcome, that is, more likely to deliver prematurely, have low-birth-weight-babies and develop high blood pressure.

Stressful jobs and long working hours: Some research has shown that pregnant women who reported high work stress in combination with a long workweek (more than 32 hours a week) have two times higher risk of giving birth to a small baby.

The evidence on prolonged hours and shift working is inconclusive.

Desk jobs: Although some studies in the 80s had suggested that computers may increase the risk of pregnancy complications, many studies have been done since then, and these findings have not been confirmed. In fact the dose of radiation emitted by a computer is extremely low. The problem of a desk job lies mostly in sitting for a long period of time, which may lead to neck, eyes, wrist and back strain. If you have an office job, try to get up frequently and take a break from time to time.

Other possible occupational risks may include exposure to infections or heavy noise.

TRAVEL

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Is it safe? For uncomplicated pregnancies, it is safe to travel throughout most of the pregnancy, usually until the last month (36 weeks). Inform your doctor whether you plan to travel, and precise where and when you plan to go. There are certain women that should not be traveling, such us those with vaginal bleeding, high risk of preterm labor or increased chances of forming blood clots.

Land travel: It is fine to travel by car, train or bus. It is very important that you wear your three-point seatbelt (shoulder and lap), above and below the womb, not over it. Try to avoid very long trips, stop or walk from time to time to stretch your legs in order to keep the blood circulating.

Sea travel: Traveling by boat is safe in pregnancy, but keep in mind that the boat’s motion may accentuate, or provoke, nausea and vomiting. So be prepared for that! In addition, avoid destinations which may not have easy medical access; if you are on a cruise make sure they have a healthcare provider on board.

Air travel:

For most of pregnant women, traveling by plane is permitted. Most of the companies will allow traveling up to 32 weeks of pregnancy, many others up to 36 weeks (you will need to provide a doctor’s permission). Check always with the airline company before making your reservation…
You should’n worry about walking through metal detectors at the airport security check, the radiation dose they emit is extremely low.
In order to avoid heavy luggage lifting, you may prefer to use suitcases with wheels to make travel as easy as possible.
Long-haul air travel is associated with an increased risk of venous thrombosis (blood clots formation), a potentially serious pregnancy complication. This risk is attributed predominantly to immobility during air travel, especially when traveling in economy class, where the space between the seats is very narrow. Precautionary measures include:
- wear loose-fitting clothes and comfortable shoes,
- do isometric calf exercises (stretch your legs from time to time),
- walk regularly around the aircraft cabin,
- avoid dehydration: drink plenty of water, minimise alcohol and caffeine intake,
- check with your healthcare provider the possibility of wearing special elastic stockings in order to improve blood circulation.

Travelling abroad: Travelling overseas may present certain challenges. Keep in mind the following:

Discuss with your doctor possible safety risks for you and your baby.
Certain destinations are best avoided: places with difficult access to health care, or high risk of contracting infections or other diseases.
Special consideration should be taken when travelling to countries where yellow fever vaccination or malaria prevention medication may be needed. Make sure that any vaccines or medications required are not contraindicated in pregnancy. You may check the authoritative site of the US Centers for Disease Control and Prevention (CDC) for useful information (see here), but you must talk about it with your doctor.
You may take with you a copy of your medical records, in case anything is needed in your foreign destination.

References

NICE: Antenatal Care- Routine Care for the Healthy Pregnant Woman. March 2008, UK

HAS: Comment mieux informer les femmes enceintes? Avril 2005, France

http://www.nhs.uk/conditions/pregnancy-and-baby/pages/pregnancy-exercise.aspx#close

http://www.hse.gov.uk/pubns/indg373.pdf

http://www.cdc.gov/niosh/topics/repro/employers.html

http://www.abcd-study.nl

Planning Your Pregnancy and Birth Third Ed. The American College of Obstetricians and Gynecologists, Ch. 5.

http://wwwnc.cdc.gov/travel

Photo credits

Exercise: Getty images; media3.onsugar.com; sohanews2.vcmedia.vn; Jose Gabriel Lugo, Flickr.com;

Sex: Trevor, Flickr.com; Melissa Segal, Flickr.com;