Category Archives: OB-GYN

Postpartum Fitness Tips

A common question among new mothers is how long after giving birth can they get back into their pre-pregnancy fitness routine? While you may think you’ll be able to quickly get back to the way you lived before being pregnant after you give birth, you may want to think again. After giving birth you may suffer from bad posture, general fatigue, and an achy body amongst other things. This means doing many common activities you did before pregnancy, such as exercising, may be difficult to adjust to for a bit. The pregnant body takes around 40 weeks to form, and in some cases, it can take almost as long as that to get completely back to your pre-pregnancy body. At the end of the day, your doctor will let you know when you’re okay to start working out again, but when you do begin it’s important you approach it safely. Here are a few tips to help you out in postpartum fitness.

 

Ease Into It

It’s important that you take your time when getting back into your fitness routine. Pushing yourself too much so soon after birth can actually threaten your overall recovery. Many doctors will recommend that you avoid exerting yourself for about 2 weeks after giving birth. After that, a good way to start is by taking a 5-minute walk and seeing how you feel.  As long as you feel okay and there isn’t any bleeding or aching, you’re likely fine to take a slightly longer walk the next day and continue slowly building how long your walks are over time. After you build this up for about 2 weeks, you can move into gentle upper-body stretching or even take a postpartum exercise class.

 

Be Careful If Breastfeeding

Not every mother breastfeeds but if you are and you want to get back into fitness, it’s important you’re even more careful than usual. Weight loss shouldn’t be as much of a concern the first few weeks after giving birth until you’ve built up a stable milk supply. Some of the weight will naturally disappear during the first few days due to your body relishing the extra fluids it needed while pregnant. It’s also important you eat correctly if working out and breastfeeding, as breastfeeding mothers need an additional 500 calories a day than non-breastfeeding mothers.

 

Get Plenty of Rest

Getting rest and not overexerting yourself is more important than ever after having a baby. It’s easy to become sleep-deprived after having a baby, especially if your baby is waking up multiple times throughout the night, not letting you get a full night’s sleep. If this is the case, it’s important that you’re careful about overworking yourself. Exercise does have the potential to provide you with more energy but if your body is already lacking then it’s more likely it will just add to your exhaustion.

This article was originally published on DrLoriGore-Green.com

What Is Amenorrhea?

A woman’s menstrual cycle is stressful enough without complications. However, there are many factors that can interrupt or change a regular cycle. Here’s what you need to know about what amenorrhea is, how it’s caused, and its treatments. The more knowledge you have about it’s causes, symptoms, and treatments, the more prepared you’ll be if it happens to you.

Put simply, amenorrhea is the absence of menstrual bleeding in a woman who is of reproductive age. There are two different types of this condition, primary and secondary amenorrhea. Primary amenorrhea occurs when girls over age 15 have never had their period. Secondary amenorrhea occurs when a woman who previously had regular periods does not menstruate for over six months.

Causes and Risk Factors

There are a variety of factors than can contribute to the onset of this condition, including:

  • Obesity
  • Less than 17% body fat
  • Leptin deficiencies
  • Polycystic ovarian syndrome
  • Overactive thyroid glands
  • Extreme emotional distress
  • Excessive exercise
  • The use of some contraceptives
  • The use of some medications
  • Chemotherapy or radiation treatments
  • Scar tissue in the uterus
  • Genetic defects

Symptoms of Amenorrhea

While the main symptom is the lack of a period, there are other factors that can occur. If you think you may have this condition, consult with a doctor for diagnosis and treatment. The following symptoms may occur due to amenorrhea:

  • Weight gain or loss
  • Changes in breast size
  • Milky discharge from breasts
  • Acne
  • Hair loss
  • Increase in facial hair growth
  • Headaches and vision changes
  • Pelvic pain

Diagnosis and Treatment

Consulting a doctor should always be the first step whenever you feel you have a condition or illness. Be open and honest about your symptoms so they can properly determine the condition, cause, and then prescribe a treatment plan. Doctors and medical professionals will typically perform tests to check hormone levels or genetic markers and may perform pelvic ultrasounds, MRIs, or a CT scan.

Treatment will depend entirely upon the root cause of amenorrhea, but may include medication, surgery, lifestyle changes, or a combination of several. Taking steps to achieve and maintain a healthy weight may be a suggestion if obesity or low body fat is a cause. Medical treatments could include a change in birth control, estrogen replacement therapy, or removal of scar tissue.

What is an Ectopic Pregnancy?

The female body is beautiful and extremely complex. Pregnancy can be very tricky and come with many complications. There are also rare and complicated pregnancies every woman should be aware of. Although many women have heard of an ectopic pregnancy, not many of them understand what it is exactly. It’s important for every woman to know and understand what it is, how common it is, and what it does to the body:

What Is It?

Common pregnancies carry the fetus in the uterus. When a woman has an ectopic pregnancy, the fertilized egg attaches itself to a place other than inside the uterus. Most of the time an ectopic pregnancy will involve a fertilized egg found in the fallopian tubes. Since the fallopian tubes are not designed to carry out a pregnancy, it can not develop properly and must be removed as soon as possible.

What Causes This?

A fertilized egg attaching to anywhere but a uterus sounds bizarre, which is why many women want to understand why this happens and what causes it. There are many causes that can lead to ectopic pregnancy. An infection or inflammation in the fallopian tube can cause it to become partially or entirely blocked, leading to an ectopic pregnancy. Other causes include scar tissue from a previous infection or a surgical procedure on the tubes or pelvic area and abnormal growths or a birth defect can result in an abnormality in the tube’s shape.

What are the Symptoms?

There are some symptoms an ectopic pregnancy shares with a normal uterine pregnancy, such as nausea and breast soreness. Symptoms that differ from a uterine pregnancy are sharp waves of pain in the abdomen, pelvis, shoulder, or neck and light to heavy vaginal spotting or bleeding. Other symptoms of an ectopic pregnancy include dizziness or fainting and rectal pressure. If a woman experiences any or all of these symptoms, they must seek medical attention immediately.

What are the Risks?

There are certain factors that can put a woman at risk of having an ectopic pregnancy. If a woman is between the ages of 35-44 while trying to conceive, her risk is much greater. If a woman has had an ectopic pregnancy before, several abortions, or is a smoker, she is also at great risk. Women with Endometriosis or Pelvic Inflammatory Disease (PID) have a greater potential of having an ectopic pregnancy as well.

Common Causes of Menstrual Irregularities

No two menstrual cycles are alike. Every woman’s body is different, therefore every woman will experience their own different cycle. Although women often share similar period symptoms, each cycle is unique. However, sometimes a cycle can be so different that it can be irregular. There are many causes for menstrual irregularities every woman should be made aware of:

Pregnancy

The most common cause of menstrual irregularities is pregnancy. Pregnancy puts a woman’s period to a halt for nine months after conception. There may be a bit of light spotting, but this is a common sign a woman may be pregnant. Other symptoms are nausea, breast soreness, and fatigue.

Birth Control

Another way to cause menstrual irregularities is by taking birth control. Hormonal birth control pills and hormone-containing intrauterine devices (IUDs) can cause irregular bleeding during a woman’s cycle. An IUD can also cause very heavy bleeding.

Perimenopause

As a woman get older, her body begins to go through major changes. When her period stops due to her age, this is called menopause. The time between their period coming to a stop and entering menopause is called perimenopause. This can cause them to have a very irregular period, sometimes going months without bleeding. Women can also experience hot flashes, mood changes, difficulty sleeping, and vaginal dryness.

Being Overweight

It’s important for men and women to stay healthy. Being overweight can cause many health issues. For women, it can lead to menstrual irregularities. When a woman is overweight, their obesity impacts hormone and insulin levels and interferes with your menstrual cycle.

Eating Disorders and Extreme Weightloss

It’s important for your body to find a healthy balance. Obesity isn’t the only weight issue that can lead to an unhealthy menstrual cycle. If a woman has an eating disorder or is experiencing extreme and rapid weight loss, it can interfere with their body producing the hormones needed for ovulation.

Stress

Mental health can have a major impact on the body. For women, stress can be a major factor when dealing with menstrual irregularities. Research has found that stress can interfere with a woman’s menstrual cycle by temporarily obstructing the part of the brain in charge of controlling the hormones responsible for regulating your cycle.

What is Postpartum Depression ?

Childbirth can be an emotional experience for new parents. As you settle in with your bundle of joy, you might encounter something unexpected – depression. Postpartum depression is often left undiscussed but affects many parents. What separates this from postpartum “baby blues”? Sometimes a rare but more severe condition called postpartum psychosis can develop. 

Defining Postpartum Depression

By definition by the National Institute of Mental Health, postpartum depression is a mood disorder that can affect women and birthing parents after childbirth. New parents often experience “baby blues” after childbirth, where they might experience mood swings, crying spells, anxiety, and difficulty sleeping. The symptoms of postpartum depression may be similar but tend to be more severe and last longer, sometimes interfering with your ability to care for your baby and complete other daily tasks.  

Symptoms

Parents can experience depressed mood or severe mood swings, excessive crying, and difficulty bonding with their baby. Other common symptoms include changes in appetite, social withdrawal, and sleep disturbances. Symptoms will usually begin within the first few weeks after giving birth but may begin earlier (during pregnancy) or later, up to a year after birth. More severe symptoms may occur, such as thoughts of harming oneself or the baby, and these require serious and immediate attention. 

Causes

Physical changes and emotional issues play a role in postpartum depression, but there is no single cause for the condition. Hormonal changes after childbirth, such as dramatic drops in levels of progesterone and estrogen, may contribute to postpartum depression. Your risk of developing postpartum depression may increase if you have a history of depression or other mood disorders.

Treatments

Fortunately, postpartum depression is treatable.Treatment and recovery time will vary depending on your individual needs and the severity of the depression. Your medical provider will work on treating the underlying causes and may refer you to a mental health professional. Generally, treatment for depression includes psychotherapy, medication, or both. It is important to continue treatment even after you begin to feel better, as stopping treatment too early may lead to relapse.  Left untreated, postpartum depression can last for many months or longer. 
This post was originally published on DrLoriGoreGreen.org

Constantly Evolving: Weight Gain During Menopause

Women between the ages of 40 and 50 will begin to exhibit changes in their body as it prepares to end their menstrual cycles. Menopause is the time in a woman’s life where they cease menstruation and the ability to reproduce. It is diagnosed officially once a woman has gone 12 months without her period. Just as hormones brought on menstruation, a shift in hormones brings it to an end.

Symptoms of menopause may include: hot flashes and chills, mood changes, weight gain, thinning hair and dry skin, vaginal dryness, and problems with sleep. During this hormonal shift, the body experiences many changes.

Menopause and Weight Gain

When a female begins to go through menopause, it’s not uncommon for them to gain weight. Some believe that the weight is caused by hormonal shifts that mess with metabolism, but this is not the case. Hormonal therapy is almost always given to help balance moods and other unpleasant symptoms, and these supplements also get blamed for middle-aged women being overweight. However, science finds no evidence of any such connections.

As a person begins to age, their metabolism naturally slows. People in their 20’s have an easier time losing weight than that of a person in their 40’s. The fat that has accumulated for many years is very stubborn, and with a body mass decrease, the fat is nearly impossible to lose. To fight the battle of the bulge takes physical activity, but this is the point when most women are ready to settle down and avoid rigorous exercise routines.

A woman in her 40’s or 50’s isn’t typically as physically active as she was in her younger years. With this reduced activity comes a decrease in muscle mass and an increase in weight. However, there may be more to worry about than just a few extra pounds.

While menopause cannot be associated with weight gain, it can be related to a change in the way the body distributes fat. Thus, it affects body composition. Many women change from a pear-shaped body to that of an apple like shape with age. Additional studies are needed to find out exactly how menopause affects body composition. The problem is that most women are overweight by the time they reach this point in their life.

Carrying additional weight around puts a woman at an increased risk for hypertension, osteoarthritis, cancer, and type 2 diabetes. Additionally, her compromised health can cause issues with mobility, self-image, and many other factors. It’s imperative to stay active to be healthy at all ages, but it’s especially important during menopause. A sedentary lifestyle creates too many risks that are not worth taking. Physical Activity is a must.

Originally posted on DrLoriGoreGreen.org on May 13, 2019.

Constantly Evolving: Puberty and Menstruation

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Constantly evolving is a new series documenting the ways in which women’s bodies change. Based on the time of the month or period of life, the series hopes to highlight the magnificence of the woman’s body.  

The previous “Constantly Evolving” article focused on external physical changes girls experience when going through puberty. In conjunction to evolutions in physical appearance, the female body undergoes a massive change internally with the start of ovulation and menstruation.

When girls are born their ovaries contain thousands of eggs called ova. During puberty, the ovaries begin to release estrogen and progesterone leading the lining of the uterus to become thicker.

Simultaneously, the hormones mature an egg and release it from the ovary. The egg travels through the fallopian tube and eventually reaches the uterus. This process is known as ovulation.

This lining of the uterus builds up in preparation for a fertilized egg, which would attach itself to the lining and begin developing. If there is no fertilized egg, the uterus sheds its thick lining and bleeds. The shedding of the uterus is what we call menstruation. This process then repeats month to month.

Girls most often get their periods for the first time between 9 and 14 years of age. Menstruation is often linked to weight, so many girls will not get their period until they exceed 90 pounds. If menstruation hasn’t begun by age 16, seeing a doctor is recommended. Periods may be irregular at first. With time, they begin to fall into a pattern that is easy to track and predict.

Periods can last anywhere from three to seven days. Some pain and discomfort is common, as the uterus is expanding and contracting to shed its lining. Pain can vary in severity, with some girls experiencing extreme cramping and back pain while others only find the cramps annoying. These variances are often caused by the level of prostaglandins the body releases. If experiencing severe cramps that interfere with daily life, girls should speak to their doctors to determine the cause.

Though information about menstruation is readily available, studies show that many women felt unprepared, shocked, and confused when they got their first period. The Constantly Evolving series strives to shine a light on the beauty of the female body and all the changes it endures to create and support new life. Sex education, as well as open communication about puberty, is necessary to break down stigmas and enhance appreciation for the female body.

This post was originally published on DrLoriGoreGreen.org on April 17, 2019. 

Constantly Evolving: External Physical Changes During Puberty

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Constantly evolving is a new series documenting the ways in which women’s bodies change. Based on the time of the month or period of life, the series hopes to highlight the magnificence of the woman’s body.  

During puberty, the body changes in incredible ways as it prepares itself to enter biological adulthood. Starting as early as 8 years old and as late as 13, the brain begins to release estrogen, the female growth hormone, which induces growth and change in the body.

Puberty is often a difficult time for young women. The body changes in very drastic ways which can be debilitating, uncomfortable, and confusing. Many young women also experience increased levels of self-consciousness during this period of their lives. These feelings are normal, as the amount of change can often make a young girl feel like an alien in their own skin. During this time of life the body changes in a variety of ways:

Weight Gain and Growth Spurts

Two of the first signs of puberty are growth spurts and weight gain. Many young girls will be taller than their male peers at this age since males experience growth spurts later in puberty. Body fat during this period can increase from 8% to 21% as the body prepares itself for menstruation and reproduction.

Body Hair Appears

Hair on the body will begin to grow on areas that have previously been smooth and hair-free, and may become darker and thicker on the arms and legs. Girls will start to develop a few hairs in the pubic area. As puberty progresses, more hair follicles will produce strands and they will start to get thicker and curlier as they grow.

Development of Acne

As hormones begin to surge through the body, girls will often start to experience breakouts of whitehead, blackheads, and pimples. The hormones that are likely to blame for this change are known as androgens, which enlarge the size of pores and create more sebum. Acne during puberty can also be caused by hereditary factors.

Developing Breasts and Hips

Puberty will cause areas of the body to widen. Hips, thighs, and butts will grow during this period since the body is preparing for eventual reproduction and childbirth.

During puberty, girls will also begin to develop breasts. Many girls will feel self-conscious when they start to develop if they feel like they are growing too big too quickly, not fast enough, or unevenly. Breasts continue to grow until women are well into their teens, and if they are growing at uneven speeds will usually even out eventually.

The nipples also begin to change at this time. Some girls nipples will become pink or dark brown, inverted or turned out, and hair may begin to grow in the region. These changes are normal and are mostly based on hereditary factors, as final breast size. Looking to maternal female relatives will often give a clue as to what breasts will look like when they finish maturing.

The ways in which hormones change the physical shape and appearance of women’s bodies is nothing short of incredible, but it can often disrupt a young girl’s sense of self. Suddenly, puberty can make who they see virtually unrecognizable to who they were a year ago. Other evolutions in the body can exacerbate these feelings, such as internal and cognitive changes, which will be discussed in the next few blogs. Check back soon to learn more!

The 101 on Feminine Hygiene Products

Have you ever asked yourself: “Is my discharge normal?” or “Am I supposed to smell this way?” You wouldn’t be the first. In fact, you’re only one of many. To accommodate these fears, the market in the last few years has been flooded by feminine hygiene products aimed at making women more confident surrounding their vaginal cleanliness.

Many doctors are wary of these products, suggesting that they may do more harm than good. After all, the vagina is a balanced ecosystem that produces healthy bacteria and fluids aimed at warding off infections. These normal processes are often mistaken for uncleanliness, so women turn to products aimed at hindering natural smells. Doing so, however, can lead to a variety of issues concerning vaginal health.

Problematic Science Involved

Since vaginal washes and wipes aren’t used internally, any claim that the soap is pH-balanced is unlikely. Even if it is, since it is used externally, doctors are skeptical that they have any effect at all on pH. Dr. Ugwumadu, a consultant gynecologist at St. George’s Hospital in London, writes, “There will be no difference in the pH of a woman using such products and a woman who washes with a normal shower gel – except that one will be lighter of pocket.”

More Prone to Infections

The natural processes your vagina goes through helps to keep you safe from infection. The efficacy of these processes depends on your vagina’s pH. A healthy pH ranges from 3.5-4.5. The bacteria produced helps to keep that pH balanced. Washing with soap, using douches, deodorants and wipes can eat away at that healthy bacteria, essentially making you susceptible to infections.

Not Regulated

The Food and Drug Administration (FDA) does not monitor the production of or the ingredients in feminine hygiene products. Since they are classified as cosmetics, the FDA considers them low-risk products. Because of this, it is important that women have an understanding of the ingredients these products may contain. While some are safer than others, steer free of products containing fragrances, alcohols, and glycerin, all of which can put you at risk for irritation or infection.

Doctors do not generally recommend these products, since they are rather unnecessary. However, it is acknowledged that feminine hygiene products may have a placebo effect that leads women to feel more confident about their smell and health. For that reason, as long as the ingredients are safe, women should feel free to use such products at their discretion.

The Healthcare Crisis of Rural America

If you live in a metropolitan area, the chances of finding a doctor are high. There are many specialists and general practitioners at your fingertips with a single search.  However, in rural parts of the U.S., residents are hard-pressed to find a family doctor, yet alone a pediatrician or an obstetrician.

Access to healthcare is fundamental to the health of a community, but residents of rural areas face challenges that block their ability to receive adequate care. Some of these challenges include the cost of health care, lack of transportation, communication barriers, social stigma, privacy concerns, shortage of healthcare workers and/or a complete lack of healthcare facilities.

Healthcare and Transportation Costs

Statistically, citizens in rural areas are less likely to have health insurance than those in metropolitan areas. Without insurance, people living in rural areas have increased difficulty paying for adequate healthcare. In 2016, a report from the Office of the Assistant Secretary for Planning and Evaluation, found that 43.4% of rural residents without insurance did not have a physician for regular health care.

Furthermore, the cost of transportation to healthcare facilities can also be a deterrent since many rural areas lack specialists and hospitals. Unlike more densely populated areas, rural communities rarely have cost effective public transportation. Therefore, residents must take time away from work and spend extra money on gas to keep an appointment.

Communication Barriers and Health Literacy

A patient’s understanding of healthcare information or a doctor’s recommendation and diagnoses is referred to as their health literacy. Yet, poverty and low educational levels hinder some residents’ ability to grasp information given to them by their doctors. Such a communication barrier can often cause animosity toward physicians due to frustration from a patient.  This may increase the chance that this patient will avoid seeking healthcare in the future.

Social Stigmas and Privacy Concerns

Small communities can rarely keep secrets. Everyone knows each other and their business. This can become especially concerning for rural residents who fear that their private health information may become public knowledge. Those seeking care for their sexual health, mental health, pregnancy, or substance abuse may have an increased fear due to community stigmas.

Lack of Healthcare Facilities and Workers

A November 2018 report by the Bureau of Health Workforce Health Resources and Services Administration found that over 59% of the areas that lacked primary healthcare were rural areas. Such areas are not popular career destinations for healthcare professionals and even residents of rural areas who are trained in the health field often relocate to more populated areas. Many states are thinking out of the box when it comes to attracting and retaining health professionals. Some communities in Vermont, the most rural state in the country, are offering assistance repaying student loans to attract more doctors and healthcare workers. Other states such as

However, even if rural areas manage to attract doctors and healthcare workers, health professionals still face challenges when it comes to medical supply shortages and a lack of proper health facilities. If the closest hospital is 50 miles away, rural residents must often need to travel a great distance to see a specialist – potentially putting their lives in danger.

As an OBGYN, the lack of healthcare in rural communities is especially concerning.  Thousands of women do not have access to proper treatment or care during pregnancy. In 2017, the the American College of Obstetricians and Gynecologists found that half of the country’s counties do not have an obstetrician-gynecologist. Furthermore, by 2020, “there will be up to 8,000 fewer OB-GYNs than needed.”  This is a problem that is worsening for America.

Although the cost of health insurance and medical procedures are complaints that are widely heard, the fact that Thousands of Americans face life without adequate healthcare is barely a whisper. Many doctors are adding small communities to their workload.  Yet the lack of healthcare facilities, and the cost of treatment makes their jobs and the care they can provide a lot more difficult.