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TRYING TO GET PREGNANT: 14 FERTILITY MYTHS DEBUNKED

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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

FACT OR MYTH? TRUTHS, HALF-TRUTHS AND MISCONCEPTIONS ABOUT THE BIRTH CONTROL PILL

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When introduced in the 1960s, the birth control pill became a symbol of female liberation

The contraceptive pill made its appearance more than 50 years ago. Emerging during a period of social and political upheaval, it  gave women the possibility to choose how and when to have a family, and to enjoy their sexual life. Thus, it is regarded as one of the greatest scientific inventions of the 20th century and one of the utmost symbols of female liberation.

From the very beginning though, this revolutionary method of contraception has been a source of controversy: some people thought it would create “a society with unbridled sexuality likely to undermine the foundations of the family”; others feared harmful effects and the birth abnormal children.

Fifty years later, the pill remains even more controversial than before and -paradoxically enough- more and more women are “liberating” from their “liberator”: the pill’s popularity is on the decline, a trend observed in many countries. The reasons behind this shift are many, but fear of side effects seems to the most recurrent. Arguably the web and social media, with the spread of countless personal stories with dramatic headlines and numerous pill scares have influenced women’s perception on the pill’s risks. But are these fears legitimate? How dangerous is the contraceptive pill? What is true and what is false?

Let’s see what science answers to the pill’s most common assumptions…

1) The pill harms your future fertility

FALSE. All scientific evidence agrees that hormonal contraceptives do not make women sterile in the long run. Sometimes it may take three to six cycles for fertility to fully return, but within a year after going off the pill, women trying to conceive are as likely to get pregnant (80%) as those who were never on the pill. In certain cases of long-term use, there may be even increased likelihood of pregnancy within 6-12 months after discontinuing it.

Moreover, hormonal birth control may preserve fertility by offering protection against pelvic inflammatory disease, endometriosis, ectopic pregnancy, ovarian cysts, ovarian and uterine cancer (see below).

2) The pill reduces sexual desire

MOSTLY FALSE. In most cases, birth control pills don’t affect libido (sexual desire): out of 10 women taking the pill, 7  experience no change in their sex drive, 2 observe increased libido, and 1 will feel less desire.

Recently, a study provided evidence that the pill does not kill desire: contextual factors, such as the relationship with the partner, stress, fatigue, family problems, recent childbirth, have a more considerable impact on sexual drive than the type of contraception used.

3) The pill makes you fat

MOSTLY FALSE. A recent extensive review study showed no evidence that birth control pills cause weight gain in most women. Although some persons may gain some weight when they start taking it, it’s often a temporary side effect due to fluid retention, not extra fat. And, like most side effects, it usually goes away within 2 to 3 months.

A woman’s weight may fluctuate naturally due to changes in age or life circumstances. Because changes in weight are common, many times they will wrongly attribute their weight gain or loss to the use of the pill.

4) The pill increases the risk of blood clots

TRUE. From the 1960s it is known that combined contraceptives pills may increase the risk of venous thrombosis, that is, a blood clot obstructing a vein, a serious and potentially life-threatening complication. Combined contraceptives contain synthetic versions of the hormones estrogen and progesterone. It is the estrogen that is mostly associated with the formation of blood clots, but the latest years it became evident that the type of progesterone also influences the risk. Indeed, the most “modern” formulations of the combined pill – the so-called third and fourth generation – containing the synthetic progesterones gestodene, desogestrel and drospirenone are associated with higher risk of thrombosis.

The European Medicines Agency (EMA) provides the following values ​​for the incidence (frequency) of deep vein thrombosis in 100,000 women of childbearing age:

  • 5 to 10 in non-pregnant women who do not use oral contraceptives,
  • 20 for women using a second generation combination pill (containing levonorgestrel),
  • 40 among women taking third and fourth generation pill.

Factors that may increase the risk of thrombosis are smoking, high blood pressure, obesity, age over 35 years, and a family or personal history of vascular accidents.

Although these figures may look scary, they should be analyzed in perspective:

  • In absence of risk factors, the absolute risk of thrombosis is very low.
  • The mortality rate of clotting events is about 1%. Thus, the odds of dying as a result of having a clot attributable to the use of the pill would be about 2 to 4 per million women.
  • The risk remains considerably lower than that related to pregnancy and birth (estimated  1 in 1000- 2000 deliveries).
  • Indicative of this is the 1995 pill scare in the UK, when a warning was issued on the increased risk of thrombosis related to third generation pills. This led many women coming off the pill, resulting in 12,400 additional births and a 9% abortions rise in 1996.

Overall, the odds of having a thrombotic episode related to the pill are very low, in particular with combined pills containing low dose of estrogen (30 or less micrograms) and old-generation progesterone (such as levonorgestrel).

The minipill, also known as the progestin-only birth control pill, is a form of oral contraception that does not contain estrogen, and its progestin dose is lower than that in the combined formulation. Although its efficacy is slightly reduced as compared to the combined pill, the minipill does not increase the risk of venous thromboembolism or arterial thrombotic accidents (see below).

5) The pill increases the risk of heart attack and stroke

TRUE. An extensive review study looking at arterial vascular accidents attributed to the pill (myocardial infarction and ischemic stroke) showed that the overall risk of arterial thrombosis was 60% increased in women using oral contraceptive pills compared to non-users. Unlike venous thrombosis, the risk did not vary according to the type of synthetic progesterone. However, it was twice as high in women taking pills with higher doses of estrogen (the older formulations of contraceptive pills).

Therefore, the combined pill containing levonorgestrel and low dose estrogen (no more than 30 µg) is the safest oral form of hormonal contraception. The minipill may also be considered in high risk women (see above).

6) A woman should not take the pill if she smokes

TRUE.  There is some evidence that smoking may decrease the effectiveness of hormonal birth control. When taking the pill, smokers experience more frequently irregular bleeding than non-smokers; this could signal that the efficacy of the pill is lowered, but more research needs to be conducted to better understand the effect of smoking on the pill’s action.

But what we do know for sure is that smokers who take combined oral contraceptives have increased risk of venous thrombosis and heart disease (see above). This risk is higher for women that smoke more than 15 cigarettes/day, are older than 35 years old or take formulations with high estrogen levels.

If you are under 35 years old and smoke, you should be extremely careful about using the pill, and the decision to take it should be individualized considering other risk factors such as personal and familiar history of high blood pressure, high cholesterol or heart disease. Smokers aged 35 or over should not take the combined contraceptive pill.

If you smoke you may opt for the mini pill, which does not seem to increase the risk of venous thromboembolism or arterial thrombotic accidents; otherwise you should discuss with your doctor about another contraceptive method, such as the intra-uterine device (IUD).

7) The pill causes mood changes and depression

DEBATABLE. Most studies have shown no effect of the pill on depression and mood changes; some studies have even found a protective effect. In 2016, an extensive review on hormonal contraception and mood changes confirmed the existing evidence, and concluded that “… negative mood changes are infrequent and combined hormonal contraception may be prescribed with confidence”.

However, a recent publication came to challenge this assertion. Danish researchers went through the health records of more than a million women using hormonal contraception. They found that those on the combined pill were 23% more likely to be prescribed an antidepressant than those not on hormonal contraception. For those on the minipill (and on other progesterone-only methods, including the hormonal IUD), the figure rose to 34%. It increased even further, to 80% more likely, for girls 15 to 19 years old on the combined pill.

There are a few important points to consider about these results:

  • Depression is a complex condition whose cause is still poorly understood. Several factors seem to play a role: genetic, environmental, psychological and social. Therefore, it is very difficult to evaluate the link between depression and hormonal contraception.
  • The Danish study does not prove that hormones are responsible for the depression – “association” does not necessarily translate into “causation”.
  • The risk of being diagnosed with depression peaks at two to three months of contraceptive use, but then begins to fall.
  •  Even if these findings are confirmed, the number of affected women remains small: 2.2 out of 100 women who use hormonal birth control develop depression, compared to 1.7 out of 100 non-users.

In conclusion, the pill may have impact on some women’s emotions, but further research is needed to establish whether hormonal contraceptives are indeed the cause of depression and mood changes.

8) The pill is 100% reliable

FALSE. Theoretically, with perfect use, the pill is 99.7% effective at preventing unwanted pregnancy. However, there are many factors that may interfere with the pill’s level of effectiveness: forgetting to take it, not taking it as directed, certain medications or medical problems…Therefore, when it comes to real life, the pill is about 92% effective: about 8 in 100 women using the combined pill will get pregnant in a year.

In any case, the birth control pill remains one of the most reliable contraceptive methods.

9) If you take the pill you don’t need the condom

FALSE. A survey conducted in France showed that “…one in ten young women 15 to 20 years old is not aware that the pill does not protect against HIV and sexually transmitted infections (STI)”. As stated before, the pill is a very good at preventing unwanted pregnancy but it offers no STI protection at all. In fact, the only contraceptive method that protects against sexually transmitted infections is the condom. Read more here.

10) The pill causes cancer

TRUE AND FALSE. The pill seems to increase the risk of certain cancers, but it protects again others. Overall, with the use of oral contraceptives the risk of endometrial and ovarian cancer is reduced, whereas the risk of breast and cervical cancer appears to be increased.

The protective effect on ovarian and endometrial cancer (the lining of the uterus) has been consistently demonstrated in many studies. This effect increases with the length of time oral contraceptives are used and continues for many years after a woman stops using the pill.

Long-term use of oral contraceptives is associated with an increased risk of cervical cancer. This correlation is not completely understood, as virtually all cervical cancers are caused by certain types of human papillomavirus (HPV). It has been suggested that women who use the pill may be less likely to use condoms, therefore increasing their risk of being exposed to HPV.

An extensive analysis of more than 70 studies suggested an increased risk of breast cancer among current and recent users of hormonal contraception. The risk was highest for women who started using oral contraceptives as teenagers. However, by 10 years after cessation of use, their risk was similar to that in women who had never used it.

Since most studies so far have evaluated birth control pill older formulations with higher doses of hormones, until recently it was assumed that the newer-generation pills available now would be safer regarding breast cancer risk. Yet a new study from Denmark found that even with the current pills, hormonal contraception users experienced a 20% increase in the risk of breast cancer compared to non-users; the odds rose among women who used hormones for more than 10 years. The risk was similar in magnitude to that of older pill types.

Whether oral contraceptive use increases the risk of liver cancer is not clear: while some studies found more cases of hepatocellular carcinoma ( a type of liver cancer) in women who took the pill for more than 5 years, others did not confirm this correlation.

Hormonal contraception seems to have a protective effect on colo-rectal (bowel) cancer, but this has not been yet consistently proven.

Since the pill seems to reduce the frequency of certain cancers and increase the risk of others, an interesting question arises: Does the pill increase the overall risk of cancer? The answer is NO. A recently published study provided epidemiological data on more than 40,000 women followed for more than 40 years. The results showed that users of oral contraceptives are protected from colo-rectal, endometrial, and ovarian cancer; this beneficial effect lasts for many years after stopping the pill. An increased breast and cervical cancer risk was seen in current and recent users, which appears to be lost within approximately 5 years of stopping oral contraception, with no evidence of either cancer recurring at increased risk in ever users with time. These results are reassuring and provide strong evidence that most women do not expose themselves to long-term cancer harm if they choose to use oral contraception; indeed, many are likely to be protected.

11) The pill has many bothersome side effects

TRUE AND FALSE. Some women refuse to take the pill because they fear certain annoying symptoms. Indeed, the birth control pill is a medication, and as such, it has possible side effects.

The most common adverse reactions associated with use of combined contraceptives include changes in bleeding patterns, nausea, breast tenderness, headaches, missed periods, vaginal discharge and visual changes with contact lenses; few women may also experience changes in sexual desire and mood changes, or temporary weight gain related to fluid retention (see above). In general, these side effects are not a sign of illness, and usually stop within the first few months of using the pill.

While some women may experience bothersome symptoms, the pill provides important non-contraceptive health benefits:

  • Decreased risk of certain cancers (see above)
  • Improved bone mineral density (in older women)
  • Protection against pelvic inflammatory disease
  • Prevention of ovarian cysts
  • Reduction of menstrual bleeding problems
  • Prevention of menstrual migraines (with non-stop formulations)
  • Protection against iron-deficiency anemia
  • Reduction of ovulation pain
  • Treatment of acne
  • Treatment of bleeding from fibroids
  • Treatment of dysmenorrhea (painful periods)
  • Treatment of excess hair on face or body
  • Treatment of premenstrual syndrome (PMS)
  • Reduction of endometriosis symptoms
  • Reduction of polycystic ovarian syndrome symptoms
  • Induction of amenorrhea for lifestyle considerations (when you need to stop your period for a while; you can also advance or delay your period with the pill)

So, how dangerous is the pill?

There is no perfect contraception method. I wish there were. And it is true that hormonal contraception, like any other medication, may have annoying side effects and serious health risks. Does it mean that no one should take the pill? Of course not!

We should keep in mind that severe risks are very rare and most bothersome symptoms are short-lived; in addition, the pill offers many non-contraceptive health benefits. But when discussing about the pill’s pros and cons, sometimes we forget a very important issue: the birth control pill is one of the most effective contraceptive methods. And effective birth control prevents from unwanted pregnancy, which may have not only devastating psychological consequences, but may also lead to severe physical harm.

Therefore, the potential problems of the birth control pill should be analyzed in perspective: we shouldn’t just pay attention to downsides, forgetting to place them in context with the upsides. Every woman considering taking the pill should thoroughly discuss with her healthcare provider not only the possible risks, but also its significant benefits, which for many women will be greater than the harms.

 

Photo credits

Heading: vintag.es; 1: thebump.com; 2: breakingmuscle.com; 3: thejewel.com; 4: health.harvard.edu; 5: newhealthadvisor.com; 6: pinterest.com; 7: pinterest.com; 8: pinterest.com; 9: blog.path.org; 10: purelyb.com; 11: buzzfeed.com; Conclusion: bigthink.com

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

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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”

painful-intercourse-burning-loveYou 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”

painful-sex-bumpYou 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”

painful-intercourse-obstacleYou 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”

painful-intercourse-pins-and-needlesEven 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”

painful-intercourse-tap-waterWhile 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

painful-intercourse-dont-want-to-talk

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

  1. The American College of Obstetricians and Gynecologists: When sex is painful.
  2. Lori J, Heim LTC: Evaluation and Differential Diagnosis of Dyspareunia. Am Fam Physician. 2001 Apr 15;63(8):1535-1545.
  3. NHS UK: Why does sex hurt?

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

PREGNANCY SYMPTOMS: WHAT TO EXPECT THE SECOND TRIMESTER

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You just made it through the first trimester of your pregnancy! Congratulations!

The second trimester – which lasts from the beginning of week 14 through the end of week 27- is for most women, the easiest of all three: the annoying symptoms of the first trimester usually disappear and you feel full of energy again! In addition, you will be less heavy, tired and anxious than during the third trimester…

The fact that you feel better doesn’t mean that nothing is going on! Your baby grows very fast during this period, and your body is working incessantly; thus you will notice many changes…

From all the symptoms you had during the first trimester (see here), many will disappear, other persist and some new will show up.

These symptoms usually disappear or ease during the second trimester:

  • 2nd trimester B&Wnausea and vomits,
  • food aversions,
  • heartburn,
  • frequent urination,
  • acne.

These are symptoms that may persist:

  • dizziness,
  • bleeding of gums and nose,
  • stuffy nose,
  • vaginal discharge,
  • headache,
  • constipation,
  • food cravings.

In this article we will focus on the symptoms that make their appearance during the second trimester, or that are somewhat different now. Here is what you can expect:

1) Backache

While back pain during the first trimester is mostly related to mild uterine cramping, as pregnancy progresses it’s caused by weight gain and  the shift of your center of gravity as a result of the growing uterus. Thus, you gradually adjust your posture, which results in back pain or strain.

What can you do about it:

  • avoid standing up for long periods of time,
  • sit up straight; use a chair with good back support,
  • sleep on your side; a pillow tucked between your legs may help,
  • avoid carrying anything heavy,
  • wear comfortable, low-heeled shoes with good arch support (read more here),
  • a heating pad may provide some relief,
  • if you feel really uncomfortable you may have a pregnancy massage.

If these measures don’t work or if the pain is strong, call your doctor, who can prescribe you a pain medication suitable for pregnancy.

2) Breast enlargement

2nd trimester breastsWhile the tenderness and swelling you experienced during the first trimester usually wear off by now, your breast will keep growing in preparation for breastfeeding. You may occasionally have some leakage of milk.

What can you do about it:

  • wear a support bra; most likely you will need a bigger size,
  • avoid lacy or wired bras.

3) Emotional changes

2nd trimester emotional prenatal yogaAs pregnancy progresses your body changes, so do your emotions! Your hormones certainly play a role, but it’s not only that: there is so much going on! So it’s natural to be worried or anxious at times, or to have mood swings (see here).

You will most likely feel less tired and with more energy than before, so enjoy your pregnancy! Start preparing yourself for the coming of your baby, you can learn more about labor and delivery. Focus on healthy lifestyle regarding nutrition (read here) and physical activity (here). This may be also a good time to indulge yourself with a trip, or some vacations! (see here).

Some women experience increased sexual desire during this period of pregnancy (more info here); others may feel unattractive as the womb grows. Spoil yourself with some beauty treatments! (read more here).

Although mood swings are an inextricable part of pregnancy, keep in mind that if you feel constantly down or overwhelmed, if you have negative or suicidal thoughts, if you can’t go ahead with your daily life you must discuss it with your doctor.

4) Hair changes

2nd trimester hairHormonal changes during pregnancy favour hair growth. This may be great for the hair on your head, which usually becomes thicker, but not so great for hair growing on your face, arms or back!

What can you do about it: 

  • Shaving, tweezing and waxing are safe options, although not always easy to implement as your belly grows!
  • Regarding laser, electrolysis and depilatory creams the experts’ opinions are divided (read more here).

You may discuss with your doctor which is the best technique for you.

5) Hemorrhoids

2nd trimester hemorrhoidsMost women will feel, at some point in their pregnancy, some soft lumps around the anus. In fact, hemorrhoids are swollen veins, which enlarge in pregnancy due to the increased pressure exerted by the growing uterus.

Although sometimes hemorrhoids are asymptomatic, the can be itchy, or painful; they may eventually bleed.

What can you do about it:

  • avoid constipation – they will get worse,
  • you may try a sitz bath (that is, you sit in warm water),
  • if they are too uncomfortable, you may ask your doctor about a hemorrhoid ointment.

6) Leg cramps

2nd trimester leg crampsPainful leg muscle contractions typically affect the calf, foot or both; they are common during pregnancy, and usually occur at night.

The exact cause of leg cramps isn’t clear; possible reasons include pregnancy hormones, compression of the legs’ blood vessels, and calcium or magnesium deficiency.

What can you do about it:

  • regular physical activity might help prevent leg cramps; stretch your calf muscles before bedtime,
  • stay hydrated,
  • choose comfortable footwear with good support,
  • a hot shower, warm bath, ice or muscle massage can all help,
  • eat magnesium-rich foods, such as whole grains, beans, dried fruits, nuts and seeds.

Discuss with your doctor whether it’s OK for you to take a magnesium or calcium supplement.

7) Restless leg syndrome (RLS)

2nd trimester restless legIf you are among the 20% of pregnant women who suffer from this condition, you may have felt an itchy, pulling, burning or creepy-crawly sensation which causes an overwhelming urge to move your legs.

RLS usually strikes at night, when you are lying down or sitting for prolonged time periods; it may also affect the arms. Once you move your legs or arms, the feeling subsides; the problem is that, by then, the movement has already woken you up, making you feel tired and cranky during the day…

The cause of RLS is unknown, but in some women it may be triggered by a deficiency of iron or folic acid.

What can you do about it:

Be patient! RLS goes away right after birth… If your RLS is not that severe, simple lifestyle changes may help:

  • avoid drinking beverages with caffeine (coffee, soda, etc), particularly during the afternoon or evening,
  • don’t exercise close to bedtime (exercising can wind you up),
  • establish a sleep routine: go to bed and wake up at the same time every day,
  • relax before bedtime: take a warm bath, read a book…

When you wake up with RLS:

  • massage your  legs,
  • apply warm or cold compresses to your leg muscles,
  • get up and walk or stretch your legs,
  • a vibrating pad placed under the legs (Relaxis) seems to help some women.

The treatment of severe RLS is challenging during pregnancy, as medications used for its treatment are possibly dangerous for the baby.

  • You may ask your doctor to check your iron levels, if they are low you can take an iron supplement.
  • If RLS makes you feel miserable, discuss with your doctor the possibility of a medical treatment (opioids); this would be the last resort as opioids can cause withdrawal symptoms in the baby.

8) Round ligament pain 

2nd trimester round ligament painAs the womb grows, the ligaments that support it start stretching, making them more likely to become strained.

Round ligament pain is one of the most common complaints during pregnancy. Sudden movements can cause the ligaments to tighten quickly, which provokes a quick jabbing feeling, often felt in the lower belly or groin area on one or both sides, most commonly on the right side. Generally the pain is triggered by exercise, sneezing, coughing, laughing, rolling over in bed or standing up too quickly, and lasts only a few seconds or minutes.

What can you do about it:

  • avoid sudden movements,
  • flex your hips before you cough, sneeze, or laugh,
  • mild exercise will help you strengthen your abdominal muscles,
  • stretching exercises and yoga can be helpful,
  • a heating pad or a warm bath may ease pain,
  • you may take a painkiller such as acetaminophen.

Round ligament pain usually doesn’t last long. If you have severe pain that lasts more that a few minutes, or if it is accompanied by fever, burning with urination, or difficulty walking you should call your doctor right away.

9) Skin changes

2nd trimester skin changes woman with hatPregnancy hormones and your growing uterus are responsible for numerous skin changes that you will start noticing from now on. Here are the most common:

Pregnancy glow: pregnant women often look as though they are “glowing” because hormones increase the skin oil production and vascularisation, thus your face may appear flushed and shiny.

Mask of pregnancy: also called chloasma;  an increase in the pigment melanin leads to brown marks on the face.

Linea nigra: related as well to increased melanin, it’s a dark line down the middle of the abdomen.

These skin changes should fade after the baby is born. In the meantime, you can use makeup to conceal them.

Keep in mind that your skin is more sensitive to the sun right now, so make sure to wear a high-protection sunscreen;  limit also your time in the sun, especially between 10 am and 4 pm; a hat and sunglasses will provide extra protection.

Itchy skin: as your skin stretches due to your growing belly -and weight gain- it may feel itchy and dry, especially around your womb and breasts2nd trimester skin changes.

To relieve it, moisturize often with mild skin care products; do not take hot showers and baths, which will dry out even more your skin. Also, avoid synthetic clothing which may irritate your skin.

Inform your doctor if your itching is unbearable, she/he can recommend you a medication adequate for pregnancy, and eventually rule out certain rare conditions which may be dangerous for you or your baby (though they usually appear during the third trimester).

Stretch marks: as with itching, stretch marks are the result of your skin expanding. Starting now, you may notice red or purple lines on your abdomen, breasts or thighs.

Watch your weight gain! The more weight you gain, the more likely to get stretch marks. Many creams and lotions are available to prevent them, although their efficacy is not backed up by much scientific evidence… In any case, most stretch marks will fade on their own after delivery.

10) Sleep problems

2nd trimester sleep problemsWhile everybody tells you to rest now to get prepared for the sleepless nights ahead once the baby is born, sleeping in pregnancy is not easy! A recent study showed that 3 out of 4 women! experience poor sleep quality: from all women included in the study, all of them reported frequent awakening, mostly due to frequent urination and difficulty finding a comfortable sleep position; insomnia, breathing problems (snoring and sleep apnea) and restless leg syndrome (see above) were also common complaints.

And let’s not forget heartburn, leg cramps, stuffy nose, eventually vivid dreams or nightmares…

What can you do about it:

  • avoid caffeine in the afternoon or evening,
  • stay away from sugar at night,
  • don’t drink too much right before bedtime to avoid frequent visits to the toilet,
  • work out, but only until early evening, as exercise can be energizing,
  • have a light snack before bedtime to prevent “hunger attacks” at night,
  • a glass of warm milk before sleeping may help,
  • take a warm bath just before bed,
  • keep your room cool; research has shown that is useful for better sleep,
  • a massage before sleeping can soothe you, as well as relaxation exercises, deep breathing, meditation, yoga, etc,
  • making love can also help!

You should mention any sleep problems to your doctor, who might be able to suggest more tips or eventually prescribe you medications that are safe during pregnancy.

11) Spider and varicose veins 

2nd trimester spider and varicose veinsYour blood circulation increases to send more blood to your baby; this can cause tiny red veins known as spider veins. Pressure on your legs from the growing uterus can result in swelling of your legs’ veins, which become blue or purple; these are called varicose veins.

What can you do about it:

Spider veins usually fade once your baby is born.

Varicose veins should improve within three months after you deliver. In the meantime, you may prevent them from getting worse:

  • avoid standing up for long periods of time,
  • get up often, move throughout the day,
  • keep your legs elevated (prop them on a stool) whenever you have to sit for a long time,
  • wear support hose.

12) Swelling of the ankles and feet

2nd trimester swollen legsA very common symptom, is experienced by about three in four pregnant women, starting at about week 22 of pregnancy and lasting until delivery.

What can you do about it:

  • try to keep active,
  • avoid long periods of standing or sitting,
  • if you can’t avoid sitting or standing for a long time, move regularly your feet, or
  • keep your legs elevated while sitting,
  • support hose can help.

What else to expect

“Quickening”, baby movements

At about 20 weeks you will probably start feeling the first flutters of movement in your belly, which is often called quickening. Quickening may be first felt as early as week 15, but usually around weeks 18 to 22. A multipara (that is, a woman who has been pregnant before) usually feels the baby earlier. Some women won’t experience quickening until week 26, so don’t worry!

Keep in mind that babies, like the rest of us, are all different: while some are very active, others are more calm; activity also varies among different days and within the same day.

Weight gain

2nd trimester what elseYour appetite should be back during the second trimester, once nausea and vomits have diminished or gone away. Since now you will feel hungrier, be aware of how much you’re eating! You only need about an extra 300 to 500 calories a day during the second trimester, and you should be gaining about 1,4 -1,8 kilograms a month until delivery. However, if you were overweight before pregnancy, your doctor may recommend gaining less weight.

Discuss with your health care provider what’s best in your case in order to manage your weight throughout pregnancy.

Braxton Hicks contractions

During the second trimester, your uterus may start contracting. These contractions, called Braxton Hicks, should be weak and come and go unpredictably.

If contractions become painful or regular, they could be a sign of preterm labor, so you should inform your doctor.

When to worry

2nd trimester warningAny of these symptoms could be a sign that something is wrong with your pregnancy. Call your doctor right away if you experience:

  • Severe abdominal pain or cramping
  • Bleeding
  • Severe dizziness or fainting
  • Rapid weight gain or intense swelling
  • Fever (unrelated to a cold)
  • Watery vaginal discharge
  • Abundant green, yellow, foul-smelling discharge.

 

References

  • NICE: Antenatal Care- Routine Care for the Healthy Pregnant Woman. March 2008, UK
  • HAS: Comment mieux informer les femmes enceintes? Avril 2005, France

Photo credits

Intro: Getty images, businessinsider.com; 1) simplebackpain.com; 2) pinterest.com; 3) kentuckianamommies.com; 4) drdina.ca; 5) hemorrhoidexpert.org; 6) newkidscenter.com; 7) babygaga.com; 8) viphealthandfitness.com; 9) woolworthsbabyandtoddlerclub.com.au, beautysouthafrica.com; 10) thebabychecklist.com; 11) pinterest.com; 12) pinterest.com; What else: popsugar.com; When to worry: earlypregnancy.net.