Treatment Strategies for Cholangiocarcinoma

Kaye M. Reid Lombardo, M.D., and David M. Nagorney, M.D., discus treatment strategies for cholangiocarcinoma. Learn more: http://mayocl.in/2zQIW5Q

source

Some great steps to good mental health

Steps to good mental health

 

How does what I eat and drink affect my mental health?

The foods you eat and what you drink can have a direct effect on your energy levels and mood. Researchers think that eating healthier foods can have a positive effect on your mood.1

  • Getting the right balance of nutrients, including enough fiber and water, can help your mood stay stable. Sugary, processed foods increase your blood sugar and then make you feel tired and irritable when your blood sugar levels drop.
  • Some vitamins and minerals may help with the symptoms of depression. Experts are researching how a lack of some nutrients is linked to depression in new mothers. These include selenium, omega-3 fatty acids, folate, vitamin B12, calcium, iron, and zinc.2
  • Drinking too much alcohol can lead to mental and physical health problems.
  • Drinks with caffeine can make it harder for you to sleep, which can make some mental health conditions worse. Also, drinking caffeine regularly and then suddenly stopping can cause caffeine withdrawal, which can make you irritable and give you headaches.3 Don’t have drinks with caffeine within 5 hours of going to sleep.

Eating nutritious foods may not cure a mental health condition, but eating healthy is a good way to start feeling better. Ask your doctor or nurse for more information about the right foods to eat to help keep your mind and body healthy. You can also visit one of these sites for healthy and free recipe ideas and meal plans:

How does physical activity affect my mental health?

Physical activity can help your mental health in several ways:

  • Aerobic exercise can boost your mood. Your body makes certain chemicals, called endorphins, during and after your workout. Endorphins relieve stress and make you feel calmer.
  • Getting physical activity during the day can make it easier to sleep at night.4 Creating a routine can help you stay motivated and build a habit of getting regular physical activity.5
  • Physical activity may help with depression and anxiety symptoms.6 Studies show that regular aerobic exercise boosts your mood and lowers anxiety and depression.7
  • Physical activity may help slow or stop weight gain, which is a common side effect of some medicines used to treat mental health conditions.

Regular physical activity can benefit your health over the long term. Getting active every day (at least 30 minutes a day of moderate-intensity aerobic activity, like brisk walking) helps maintain your health. All Americans should also do strengthening exercises at least 2 days a week to build and maintain muscles.8 Your doctor or nurse may recommend exercise in addition to taking medicine and getting counseling for mental health conditions.

Learn more about how to be active for health.

How does aging affect my mental health?

As you age, your body and brain change. These changes can affect your physical and mental health. Older women may face more stressful living or financial situations than men do, because women live longer on average. They may also have spent more time staying home to raise children or care for loved ones instead of working outside of the home.

In the years leading up to menopause (perimenopause), women may experience shifts in mood because of hormone changes. They may also experience hot flashes, problems sleeping, and other symptoms that can make it harder to deal with stress or other life changes.

Learn more about how aging and menopause affect your mental health.

How does my physical health affect my mental health?

People who are not physically healthy may have trouble staying mentally healthy. People living with chronic (long-term) health problems such as diabetes and heart disease are often more likely to have higher stress levels, depression, and anxiety.9 Researchers are not sure which problems happen first, but many people have a chronic disease and a mental health condition. Having a chronic disease does not always mean you will have a mental health condition, but if you are struggling with both, know that you are not alone. Support groups and health care professionals can help. Healthy habits, like eating healthy and getting exercise, that help improve many chronic diseases may also help improve mental health conditions.

How does smoking, drinking alcohol, or misusing drugs affect mental health?

The chemicals in tobacco and alcohol can change the chemicals in your brain, making you more likely to feel depressed or anxious.10,11 People with mental health conditions are also more likely to smoke and drink alcohol.

Using illegal drugs, or misusing prescription drugs, is also linked to mental health conditions. Researchers are not sure whether drugs can cause mental health conditions, whether mental health conditions cause addiction, or whether both are linked to another health problem. People who have experienced trauma, whether physical or emotional (or both), are more likely to misuse drugs and alcohol.

How do traumatic or negative childhood events affect mental health?

Two out of every 3 women have experienced at least one serious traumatic or negative event during childhood, increasing their risk of adult health problems, including mental health conditions.12

  • Traumatic events can include physical or sexual abuse, neglect, bullying, neighborhood violence, natural disasters, terrorism, and war. While many people in the United States experience at least one traumatic event in their lifetime, most don’t suffer long-term problems as a result.
  • Negative events during childhood can include abuse (physical, emotional, verbal, or sexual), neglect, or a problem with an adult in the home, such as seeing domestic violence or having a caregiver go to prison. The more negative childhood events you have experienced, the higher your risk of a serious health problem as an adult. Learn more about negative (adverse) childhood events.

Women are more likely than men to experience certain types of trauma, such as sexual abuse or assault, and are at higher risk of developing a mental health condition.

What else can affect my mental health?

Mental health conditions affect women of all races and ethnicities. But your environment where and how you live — can have an effect on your mental health. Women who grew up in poverty or who live in poverty as adults and women in a sexual minority (such as women who identify as lesbian or bisexual) may be more likely to experience mental health conditions, such as depression.13

  • Some studies show that children who grow up in poverty can have a higher risk of developing certain mental health conditions, including depression and posttraumatic stress disorder, as adults.14
  • Children who witness domestic violence (also called intimate partner violence) are more likely to develop mental health conditions, such as depression and anxiety, as adults. Learn more about the effects of domestic violence on children.15
  • Lesbians and bisexual women are at higher risk of mood and anxiety disorders than heterosexual women.16

Do past or current difficulties in life mean I’ll develop a mental health condition?

No. Many people experience major stress in life, including poverty, unemployment, trauma, abuse, family difficulties, or chronic health problems. Experiencing these stressful situations does not mean you will definitely develop a mental health condition. But if you do experience serious, stressful situations and develop a mental health condition, know that it is not your fault. You can get help and treatment for mental health conditions.

Learning ways to manage stress and reaching out for help when you need it can help you protect your mental health. Learn more about steps you can take to protect your mental health.

Did we answer your question about supporting mental health?

For more information about good mental health, call the OWH Helpline at 1-800-994-9662 or check out the following resources from other organizations:

Sources

  1. Bodnar, L.M., Wisner, K.L. (2005). Nutrition and Depression: Implications for Improving Mental Health Among Childbearing-Aged Women. Biological Psychiatry; 58(9): 679–685.
  2. Leung, B.M.Y., Kaplan, B.J., Field, C.J., Tough, S., Eliasziw, E., Fajer Gomez, M., et al. (2013). Prenatal micronutrient supplementation and postpartum depressive symptoms in a pregnancy cohort. BMC Pregnancy Childbirth; 13: 2.
  3. American Psychiatric Association. (2013). Caffeine withdrawal. In: Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Arlington, VA: American Psychiatric Association.
  4. Otto, M.W., Smits, J.A.J. (2011). Exercise for Mood and Anxiety, Proven Strategies for Overcoming Depression and Enhancing Well-Being. Cambridge, MA: Oxford University Press.
  5. Substance Abuse and Mental Health Services Administration. (2016). Creating a Healthier Life: A Step-by-Step Guide to Wellness (PDF file, 387 KB). HHS Publication No. SMA 16-4958. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  6. Mota-Pereira, J., Silverio, J., Carvalho, S., Ribeiro, J.C., Fonte, D., Ramos. J. (2011). Moderate exercise improves depression parameters in treatment-resistant patients with major depressive disorder. Journal of Psychiatric Research; 45(8): 1005–1011.
  7. DiLorenzo, T.M., Bargman, E.P., Stucky-Ropp, R., Brassington, G.S., Frensch, P.A., LaFontaine, T. (1999). Long-Term Effects of Aerobic Exercise on Psychological Outcomes. Preventive Medicine; 28(1): 75–85.
  8. U.S. Department of Health and Human Services. (2008). Physical Activity Guidelines for Americans.
  9. Turner, J., Kelly, B. (2000). Emotional dimensions of chronic disease. The Western Journal of Medicine; 172(2): 124–128.
  10. Shivani, R., Goldsmith, J.R., Anthenelli, R.M. (2002). Alcoholism and Psychiatric Disorders. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism.
  11. Weir, K. (2013). Smoking and mental illness. American Psychological Association; 44(6). Print version: page 36.
  12. Centers for Disease Control and Prevention (CDC), Kaiser Permanente. (2016). About the CDC-Kaiser ACE Study. Atlanta, GA: CDC.
  13. Brody, D.J., Pratt, L.A., Hughes, J. (2018). Prevalence of depression among adults aged 20 and over: United States, 2013–2016. NCHS Data Brief, no 303. Hyattsville, MD: National Center for Health Statistics.
  14. Nikulina, V., Widom, C.S., Czaja, S. (2011). The Role of Childhood Neglect and Childhood Poverty in Predicting Mental Health, Academic Achievement and Crime in Adulthood. American Journal of Community Psychology; 48(3–4): 309–321.
  15. Monnat, S.M., Chandler, R.F. (2015). Long Term Physical Health Consequences of Adverse Childhood Experiences. Sociology Quarterly; 56(4): 723–752.
  16. Bostwick, W.B., Boyd, C.J., Hughes, T.L., McCabe, S.E. (2010). Dimensions of Sexual Orientation and the Prevalence of Mood and Anxiety Disorders in the United States. American Journal of Public Health; 100(3): 468–475.

This content is provided by the Office on Women’s Health.

Syndicated Content Details:
Source URL: https://www.womenshealth.gov/mental-health/good-mental-health/steps-good-mental-health
Source Agency: Office on Women’s Health (OWH)
Captured Date: 2018-08-29 21:23:00.0

What is Celiac Disease and Why Is It on the Rise?

Historically, the United States Senate has designated September 13th as “National Celiac Awareness Day.”  According to the original resolution, the Senate “recognizes that all people of the United States should become more informed and aware of celiac disease” and encourages all Americans to participate in activities to observe this day.

Why September 13th?  The 13th is the birthday of Samuel Gee, a pediatrician who published the first complete clinical description of celiac disease in 1888.  Gee was the first to recognize the symptoms of celiac disease are related to diet.

Celiac disease affects an estimated 3 million Americans, 85% of whom remain undiagnosed or misdiagnosed.  It is generally considered an autoimmune disorder with genetic predisposition. Some important exceptions notwithstanding, the prevalence of celiac disease is estimated to range between 0.6 and 1 percent of the world’s population.

The name celiac derives from the Greek word for “hollow,” as in bowels. Gluten proteins in wheat, barley and rye prompt the body to turn on itself and attack the small intestine. Complications range from diarrhea and anemia to osteoporosis and, in extreme cases, lymphoma.

Celiac disease

Overview

Celiac disease (gluten-sensitive enteropathy), sometimes called sprue or coeliac, is an immune reaction to eating gluten, a protein found in wheat, barley and rye.

If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction damages your small intestine’s lining and prevents absorption of some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications.

In children, malabsorption can affect growth and development, in addition to the symptoms seen in adults.

There’s no cure for celiac disease — but for most people, following a strict gluten-free diet can help manage symptoms and promote intestinal healing.

Symptoms

The signs and symptoms of celiac disease can vary greatly and are different in children and adults. The most common signs for adults are diarrhea, fatigue and weight loss. Adults may also experience bloating and gas, abdominal pain, nausea, constipation, and vomiting.

However, more than half of adults with celiac disease have signs and symptoms that are not related to the digestive system, including:

  • Anemia, usually resulting from iron deficiency
  • Loss of bone density (osteoporosis) or softening of bone (osteomalacia)
  • Itchy, blistery skin rash (dermatitis herpetiformis)
  • Damage to dental enamel
  • Mouth ulcers
  • Headaches and fatigue
  • Nervous system injury, including numbness and tingling in the feet and hands, possible problems with balance, and cognitive impairment
  • Joint pain
  • Reduced functioning of the spleen (hyposplenism)
  • Acid reflux and heartburn

Children

In children under 2 years old, typical signs and symptoms of celiac disease include:

  • Vomiting
  • Chronic diarrhea
  • Swollen belly
  • Failure to thrive
  • Poor appetite
  • Muscle wasting

Older children may experience:

  • Diarrhea
  • Constipation
  • Weight loss
  • Irritability
  • Short stature
  • Delayed puberty
  • Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), learning disabilities, headaches, lack of muscle coordination and seizures

Dermatitis herpetiformis

Dermatitis herpetiformis is an itchy, blistering skin disease that stems from intestinal gluten intolerance. The rash usually occurs on the elbows, knees, torso, scalp and buttocks.

Dermatitis herpetiformis is often associated with changes to the lining of the small intestine identical to those of celiac disease, but the disease may not produce noticeable digestive symptoms.

Doctors treat dermatitis herpetiformis with a gluten-free diet or medication, or both, to control the rash.

Causes

Celiac disease occurs from an interaction between genes, eating foods with gluten and other environmental factors, but the precise cause isn’t known. Infant feeding practices, gastrointestinal infections and gut bacteria might contribute to developing celiac disease.

Sometimes celiac disease is triggered — or becomes active for the first time — after surgery, pregnancy, childbirth, viral infection or severe emotional stress.

When the body’s immune system overreacts to gluten in food, the reaction damages the tiny, hair-like projections (villi) that line the small intestine. Villi absorb vitamins, minerals and other nutrients from the food you eat. If your villi are damaged, you can’t get enough nutrients, no matter how much you eat.

Some gene variations appear to increase the risk of developing the disease. But having those gene variants doesn’t mean you’ll get celiac disease, which suggests that additional factors must be involved.

The rate of celiac disease in Western countries is estimated at about 1 percent of the population. Celiac disease is most common in Caucasians; however, it is now being diagnosed among many ethnic groups and is being found globally.

Risk factors

Celiac disease can affect anyone. However, it tends to be more common in people who have:

  • A family member with celiac disease or dermatitis herpetiformis
  • Type 1 diabetes
  • Down syndrome or Turner syndrome
  • Autoimmune thyroid disease
  • Microscopic colitis (lymphocytic or collagenous colitis)
  • Addison’s disease
  • Rheumatoid arthritis

Complications

Untreated, celiac disease can cause:

  • Malnutrition. The damage to your small intestine means it can’t absorb enough nutrients. Malnutrition can lead to anemia and weight loss. In children, malnutrition can cause slow growth and short stature.
  • Loss of calcium and bone density. Malabsorption of calcium and vitamin D may lead to a softening of the bone (osteomalacia or rickets) in children and a loss of bone density (osteoporosis) in adults.
  • Infertility and miscarriage. Malabsorption of calcium and vitamin D can contribute to reproductive issues.
  • Lactose intolerance. Damage to your small intestine may cause you to experience abdominal pain and diarrhea after eating lactose-containing dairy products, even though they don’t contain gluten. Once your intestine has healed, you may be able to tolerate dairy products again. However, some people continue to experience lactose intolerance despite successful management of celiac disease.
  • Cancer. People with celiac disease who don’t maintain a gluten-free diet have a greater risk of developing several forms of cancer, including intestinal lymphoma and small bowel cancer.
  • Neurological problems. Some people with celiac disease may develop neurological problems such as seizures or peripheral neuropathy (disease of the nerves that lead to the hands and feet).

In children, celiac disease can also lead to failure to thrive, delayed puberty, weight loss, irritability and dental enamel defects, anemia, arthritis, and epilepsy.

Nonresponsive celiac disease

As many as 30 percent of people with celiac disease may not have, or be able to maintain, a good response to a gluten-free diet. This condition, known as nonresponsive celiac disease, is often due to contamination of the diet with gluten. Therefore, it’s important to work with a dietitian.

People with nonresponsive celiac disease may have additional conditions, such as bacteria in the small intestine (bacterial overgrowth), microscopic colitis, poor pancreas function, irritable bowel syndrome or intolerance to disaccharides (lactose and fructose). Or, they may have refractory celiac disease.

Refractory celiac disease

In rare instances, the intestinal injury of celiac disease persists and leads to substantial malabsorption, even though you have followed a strict gluten-free diet. This combination is known as refractory celiac disease.

If you continue to experience signs and symptoms despite following a gluten-free diet for six months to one year, your doctor may recommend further testing and look for other explanations for your symptoms. Your doctor may recommend treatment with a steroid to reduce intestinal inflammation, or a medication that suppresses your immune system. All patients with celiac disease should be followed up to monitor the response of their disease to treatment.

Celiac is on the Rise

While we know proteins called gluten provoke celiac disease; and, we understand the disease is treated with a gluten free diet, the rapid increase in prevalence of celiac disease, which has quadrupled in the United States in just 50 years, is mystifying.

Scientists are pursuing some intriguing possibilities. One is that breast-feeding may protect against the disease, and it has been on the decline in our fast paced, Self-care society.  Another is that we have neglected the microbes teeming in our gut — bacteria that may determine whether the immune system treats gluten as food or as a deadly invader.  The microbiome wants us to survive.

Nearly everyone with celiac disease has one of two versions of a cellular receptor called the human leukocyte antigen, or H.L.A. These receptors, the thinking goes, naturally increase carriers’ immune response to gluten.

This detailed understanding makes celiac disease unique among autoimmune disorders. Two factors — one a protein, another genetic — are clearly defined; and in most cases, eliminating gluten from the patient’s diet turns off the disease.

When to see a doctor

Consult your doctor if you have diarrhea or digestive discomfort that lasts for more than two weeks. Consult your child’s doctor if your child is pale, irritable or failing to grow or has a potbelly and foul-smelling, bulky stools.

Be sure to consult your doctor before trying a gluten-free diet. If you stop or even reduce the amount of gluten you eat before you’re tested for celiac disease, you may change the test results.

Celiac disease tends to run in families. If someone in your family has the condition, ask your doctor if you should be tested. Also ask your doctor about testing if you or someone in your family has a risk factor for celiac disease, such as type 1 diabetes.

Get Help

Find a physician in our first of its kind, social ecosystem for healthcare.  We are here to help patients connect with providers who really care, and who will collaborate closely on your care.

Ready to get Lynked to a physician who understands the microbiome and celiac?  Go to HealthLynked.com, sign up for free, and start healing your gut today!

 

Sources Adapted from:

MayoClinic.org

nyt.com

 

 

 

What is anxiety | What are some anxiety disorders

Anxiety disorders

Anxiety is a normal response to stress. But when it becomes hard to control and affects your day-to-day life, it can be disabling. Anxiety disorders affect nearly 1 in 5 adults in the United States.1 Women are more than twice as likely as men to get an anxiety disorder in their lifetime.2 Anxiety disorders are often treated with counseling, medicine, or a combination of both. Some women also find that yoga or meditation helps with anxiety disorders.

What is anxiety?

Anxiety is a feeling of worry, nervousness, or fear about an event or situation. It is a normal reaction to stress. It helps you stay alert for a challenging situation at work, study harder for an exam, or remain focused on an important speech. In general, it helps you cope.

But anxiety can be disabling if it interferes with daily life, such as making you dread nonthreatening day-to-day activities like riding the bus or talking to a coworker. Anxiety can also be a sudden attack of terror when there is no threat.

What are anxiety disorders?

Anxiety disorders happen when excessive anxiety interferes with your everyday activities such as going to work or school or spending time with friends or family. Anxiety disorders are serious mental illnesses. They are the most common mental disorders in the United States. Anxiety disorders are more than twice as common in women as in men.

What are the major types of anxiety disorder?

The major types of anxiety disorder are:

  • Generalized anxiety disorder (GAD). People with GAD worry excessively about ordinary, day-to-day issues, such as health, money, work, and family. With GAD, the mind often jumps to the worst-case scenario, even when there is little or no reason to worry. Women with GAD may be anxious about just getting through the day. They may have muscle tension and other stress-related physical symptoms, such as trouble sleeping or upset stomach. At times, worrying keeps people with GAD from doing everyday tasks. Women with GAD have a higher risk of depression and other anxiety disorders than men with GAD. They also are more likely to have a family history of depression.3
  • Panic disorder. Panic disorders are twice as common in women as in men.4 People with panic disorder have sudden attacks of terror when there is no actual danger. Panic attacks may cause a sense of unreality, a fear of impending doom, or a fear of losing control. A fear of one’s own unexplained physical symptoms is also a sign of panic disorder. People having panic attacks sometimes believe they are having heart attacks, losing their minds, or dying.
  • Social phobia. Social phobia, also called social anxiety disorder, is diagnosed when people become very anxious and self-conscious in everyday social situations. People with social phobia have a strong fear of being watched and judged by others. They may get embarrassed easily and often have panic attack symptoms.
  • Specific phobia. A specific phobia is an intense fear of something that poses little or no actual danger. Specific phobias could be fears of closed-in spaces, heights, water, objects, animals, or specific situations. People with specific phobias often find that facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety.

Some other conditions that are not considered anxiety disorders but are similar include:

  • Obsessive-compulsive disorder (OCD). People with OCD have unwanted thoughts (obsessions) or behaviors (compulsions) that cause anxiety. They may check the oven or iron again and again or perform the same routine over and over to control the anxiety these thoughts cause. Often, the rituals end up controlling the person.
  • Post-traumatic stress disorder (PTSD). PTSD starts after a scary event that involved physical harm or the threat of physical harm. The person who gets PTSD may have been the one who was harmed, or the harm may have happened to a loved one or even a stranger.

Who gets anxiety disorders?

Anxiety disorders affect about 40 million American adults every year. Anxiety disorders also affect children and teens. About 8% of teens ages 13 to 18 have an anxiety disorder, with symptoms starting around age 6.5

Women are more than twice as likely as men to get an anxiety disorder in their lifetime.2 Also, some types of anxiety disorders affect some women more than others:

  • Generalized anxiety disorder (GAD) affects more American Indian/Alaskan Native women than women of other races and ethnicities. GAD also affects more white women and Hispanic women than Asian or African-American women.6
  • Social phobia and panic disorder affect more white women than women of other races and ethnicities.7

What causes anxiety disorders?

Researchers think anxiety disorders are caused by a combination of factors, which may include:

What are the signs and symptoms of an anxiety disorder?

Women with anxiety disorders experience a combination of anxious thoughts or beliefs, physical symptoms, and changes in behavior, including avoiding everyday activities they used to do. Each anxiety disorder has different symptoms. They all involve a fear and dread about things that may happen now or in the future.

Physical symptoms may include:

  • Weakness
  • Shortness of breath
  • Rapid heart rate
  • Nausea
  • Upset stomach
  • Hot flashes
  • Dizziness

Physical symptoms of anxiety disorders often happen along with other mental or physical illnesses. This can cover up your anxiety symptoms or make them worse.2

How are anxiety disorders diagnosed?

Your doctor or nurse will ask you questions about your symptoms and your medical history. Your doctor may also do a physical exam or other tests to rule out other health problems that could be causing your symptoms.

Anxiety disorders are diagnosed when fear and dread of nonthreatening situations, events, places, or objects become excessive and are uncontrollable. Anxiety disorders are also diagnosed if the anxiety has lasted for at least six months and it interferes with social, work, family, or other aspects of daily life.2

How are anxiety disorders treated?

Treatment for anxiety disorders depends on the type of anxiety disorder you have and your personal history of health problems, violence, or abuse.

Often, treatment may include:

How does counseling help treat anxiety disorders?

Your doctor may refer you for a type of counseling for anxiety disorders called cognitive behavioral therapy (CBT). You can talk to a trained mental health professional about what caused your anxiety disorder and how to deal with the symptoms.2

For example, you can talk to a psychiatrist, psychologist, social worker, or counselor. CBT can help you change the thinking patterns around your fears. It may help you change the way you react to situations that may create anxiety. You may also learn ways to reduce feelings of anxiety and improve specific behaviors caused by chronic anxiety. These strategies may include relaxation therapy and problem solving.

What types of medicine treat anxiety disorders?

Several types of medicine treat anxiety disorders. These include:

  • Antianxiety (benzodiazepines). These medicines are usually prescribed for short periods of time because they are addictive. Stopping this medicine too quickly can cause withdrawal symptoms.
  • Beta blockers. These medicines can help prevent the physical symptoms of an anxiety disorder, like trembling or sweating.8
  • Selective serotonin reuptake inhibitors (SSRIs). SSRIs change the level of serotonin in the brain.2 They increase the amount of serotonin available to help brain cells communicate with each other. Common side effects can include insomnia or sedation, stomach problems, and a lack of sexual desire.
  • Tricyclics. Tricylics work like SSRIs. But sometimes they cause more side effects than SSRIs. They may cause dizziness, drowsiness, dry mouth, constipation, or weight gain.
  • Monoamine oxidase inhibitors (MAOIs). People who take MAOIs must avoid certain foods and drinks (like Parmesan or cheddar cheese and red wine) that contain an amino acid called tyramine. Taking an MAOI and eating these foods can cause blood pressure levels to spike dangerously. Women who take MAOIs must also avoid certain medicines, such as some types of birth control pills, pain relievers, and cold and allergy medicines.12 Talk to your doctor about any medicine you take.

All medicines have risks. You should talk to your doctor about the benefits and risks of all medicines. Learn more about medicines to treat anxiety disorders.

What if my anxiety disorder treatment is not working?

Sometimes, you may need to work with your doctor to try several different treatments or combinations of treatments before you find one that works for you.

If you are having trouble with side effects from medicines, talk to your doctor or nurse. Do not stop taking your medicine without talking to a doctor or nurse. Your doctor may adjust how much medicine you take and when you take it.

What if my anxiety disorder comes back?

Sometimes symptoms of an anxiety disorder come back after you have finished treatment. This may happen during or after a stressful event. It may also happen without any warning.

Many people with anxiety disorders do get better with treatment. But, if your symptoms come back, your doctor will work with you to change or adjust your medicine or treatment plan.

You can also talk to your doctor about ways to identify and prevent anxiety from coming back. This may include writing down your feelings or meeting with your counselor if you think your anxiety is uncontrollable.

Can complementary or alternative medicine help manage anxiety disorders?

Maybe. Some women say that complementary or alternative medicine (CAM) therapies helped lower their anxiety.

CAM therapies that may help anxiety include:

  • Physical activity. Regular physical activity raises the level of brain chemicals that control mood and affect anxiety and depression.9 Many studies show that all types of physical activity, including yoga and Tai Chi, help reduce anxiety.10
  • Meditation. Studies show meditation may improve anxiety.11 Regular meditation may help by boosting activity in the area of your brain responsible for feelings of serenity and joy.

Learn more about CAM therapies for anxiety disorders.

Will my anxiety disorder treatment affect my pregnancy?

If your treatment is counseling, it will not affect your pregnancy.

If you are on medicine to treat your anxiety disorder, talk to your doctor. Some medicines used to treat anxiety can affect your unborn baby.

If I take medicine to treat my anxiety disorder, can I breastfeed my baby?

It depends. Some medicines used to treat anxiety can pass through breastmilk. Certain antidepressants, such as some SSRIs, are safe to take during breastfeeding.

Do not stop taking your medicine too quickly. Talk to your doctor to find out what medicine is best for you and your baby. Learn more about medicines and breastfeeding in our Breastfeeding section. You can also enter your medicine into the LactMed® database to find out if your medicine passes through your breastmilk and any possible side effects for your nursing baby.

How do anxiety disorders affect other health conditions?

Anxiety disorders may affect other health problems that are common in women. These include:

  • Depression. Anxiety disorders can happen at the same time as depression. When this happens, treatment for both anxiety and depression may not be as effective. You may need a combination of treatments, such as counseling and medicine.
  • Irritable bowel syndrome (IBS). IBS symptoms are common in people with anxiety disorders. Generalized anxiety disorder is also common among people with IBS.12 Worry can make IBS symptoms worse, especially gastrointestinal (GI) symptoms such as upset stomach or gas. GI symptoms can also be stressful and lead to more anxiety. Although treatments for IBS can help treat anxiety, it’s important that you treat both conditions.13
  • Chronic pain. Anxiety disorders are common in women with certain diseases that cause chronic pain, including rheumatoid arthritis, fibromyalgia, and migraine.
  • Cardiovascular disease. Anxiety and depression increase the risk for heart disease, the leading cause of death for American women. Anxiety can also make recovery harder after a heart attack or stroke.
  • Asthma. Studies link asthma to anxiety disorders. Stress and anxiety can trigger asthma attacks while the shortness of breath and wheezing during asthma attacks can cause anxiety. Studies show that breathing retraining may help asthma control and ease anxiety.14

What is the latest research on anxiety disorders and women?

Researchers are studying why women are more than twice as likely as men to develop anxiety disorders and depression. Changes in levels of the hormone estrogen throughout a woman’s menstrual cycle and reproductive life (during the years a woman can have a baby) probably play a role.

Researchers also recently studied the male hormone testosterone, which is found in women and men but typically in higher levels in men. They found that treatment with testosterone had similar effects as antianxiety and antidepressant medicine for the women in the study.15

Other research focuses on anxiety disorders and depression during and after pregnancy and among overweight and obese women. For more clinical trials related to anxiety disorders and women, visit ClinicalTrials.gov.

Did we answer your question about anxiety disorders?

For more information on anxiety disorders, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:

Sources

  1. McLean, C.P., Asnaani, A., Litz, B.T., Hofmann, S.G. (2011). Gender Differences in Anxiety Disorders: Prevalence, Course of Illness, Comorbidity and Burden of IllnessJournal of Psychiatric Research; 45(8): 1027-1035.
  2. National Institute of Mental Health. (2015). What are Anxiety Disorders?
  3. Vesga-Lopez, O., Schneier, F.R., Wang, S., Heimberg, R.G., Liu, S.M., Hasin, D.S., Blanco, C. (2008). Gender differences in generalized anxiety disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)Journal of Clinical Psychiatry; 69(10): 1606-16.
  4. National Library of Medicine. (2013). Panic disorder.
  5. National Institute of Mental Health. (n.d.) Anxiety Disorders in Children and Adolescents (Fact Sheet).
  6. Centers for Disease Control and Prevention. (2011). Mental illness surveillance among adults in the United StatesMorbidity and Mortality Weekly Report, 60(3), 1–32.
  7. Asnaani, A., Richey, J.A., Dimaite, R., Hinton, D.E., Hofmann, S.G. (2010). A Cross-Ethnic Comparison of Lifetime Prevalence Rates of Anxiety DisordersJ Nerv Ment Dis; 198(8): 551-555.
  8. National Institute of Mental Health. (2015). Mental health medications.
  9. Anderson, E., Shivakumar, G. (2013). Effects of Exercise and Physical Activity on AnxietyFrontiers in Psychiatry; 4:27.
  10. Harner, H., Hanlon, A.L., Garfinkel, M. (2010). Effect of lyengar yoga on mental health of incarcerated women: a feasibility studyNursing Research; 59(6): 389-99.
  11. National Center for Complementary and Integrative Health. (2014). Meditation: What You Need to Know.
  12. Lackner, J. M., Ma, C. X., Keefer, L., Brenner, D. M., Gudleski, G. D., Satchidanand, N., … Mayer, E. A. (2013). Type, rather than number, of mental and physical comorbidities increases the severity of symptoms in patients with irritable bowel syndromeClinical Gastroenterology and Hepatology, 11(9), 1147–1157.
  13. Kaplan, A., Franzen, M. D., Nickell, P. V., Ransom, D., & Lebovitz, P. J. (2014). An open-label trial of duloxetine in patients with irritable bowel syndrome and comorbid generalized anxiety disorderInternational Journal of Psychiatry in Clinical Practice, 18(1), 11–15.
  14. American Psychological Association. (2013). Breathing easier.
  15. McHenry, J., Carrier, N., Hull, E., & Kabbaj, M. (2014). Sex differences in anxiety and depression: role of testosteroneFrontiers in Neuroendocrinology, 35(1), 42–57.

This content is provided by the Office on Women’s Health.

Syndicated Content Details:
Source URL: https://www.womenshealth.gov/mental-health/mental-health-conditions/anxiety-disorders
Source Agency: Office on Women’s Health (OWH)
Captured Date: 2018-08-30 14:17:00.0

We Join in Celebrating and Remembering Our 9/11 Heroes

Remembering Our 9/11 Heroes

September 11th is now known as Patriot Day in the United States, observed as the National Day of Service and Remembrance for the victims of the 9/11 attacks. Across the country, numerous events will solemnly honor the devastating loss of thousands of souls and the destruction designed to rip the very fabric of our great nation. We join in remembering those lost, celebrating those who bravely responded where terror struck, lifting up those who still suffer today as a result of the attacks, and honoring those who serve around the globe, fighting to protect freedom.

Seventeen years ago, 19 militants tied to the Islamic extremist group al-Qaeda killed more than 3,000 people (including more than 400 police officers and firefighters) and wounded more than 10,000 others during three coordinated attacks on 9/11.  Masterminded by Osama bin Laden, it  was the deadliest attack on the US in history and the most devastating foreign act of war on American soil since the attack on Pearl Harbor.

Eleven days after the towers fell, the Office of Homeland Security coordinated a comprehensive national strategy to safeguard the country against terrorism and respond to future attacks in an effort to get us to our new normal. Operation Enduring Freedom, the American-led international effort to oust the Taliban, began on October 7, 2001.

Many of us witnessed all this, either on scene, in service or as it aired on live TV. The images of crumbling icons, burning bastions of might, the brave dashing to save, the distraught fleeing and the efforts to rescue, then rebuild and memorialize will forever be emblazoned in our minds.

While our entire nation has suffered and many still endure emotional or physical scars from that day of anguish and its aftermath, survivors and family members of those taken from us have come forward with stories of bravery and triumph we celebrate.  The Taliban has been weakened, Osama bin Laden has been eliminated, and the fight continues.

On that fateful Tuesday, September 11, 2001, which erupted in flames and dust, President George W. Bush addressed the nation with this formal statement: “Terrorist attacks can shake the foundations of our biggest buildings, but they cannot touch the foundation of America. These acts shatter steel, but they cannot dent the steel of American resolve.”

Let us all, each one, resolve to remember and honor those we lost, those who rushed to rescue, and those who still serve today to protect freedom and project strength around the globe. Let us all be buoyed by the memories of how we have rebuilt and can continue, as one nation, to grow stronger each day.  Let us join together and embrace “this timeless truth: When America is united, no force on Earth can break us apart. Our values endure; our people thrive; our Nation prevails; and the memory of our loved ones never fades.”

Health problems before and during pregnancy

Pregnancy complications

Complications of pregnancy are health problems that occur during pregnancy. They can involve the mother’s health, the baby’s health, or both. Some women have health problems before they become pregnant that could lead to complications. Other problems arise during the pregnancy. Whether a complication is common or rare, there are ways to manage problems that come up during pregnancy.

Health problems before pregnancy

Before pregnancy, make sure to talk to your doctor about health problems you have now or have had in the past. If you are receiving treatment for a health problem, your doctor might want to change the way your health problem is managed. Some medicines used to treat health problems could be harmful if taken during pregnancy. At the same time, stopping medicines that you need could be more harmful than the risks posed should you become pregnant. Be assured that you are likely to have a normal, healthy baby when health problems are under control and you get good prenatal care.

Health problems before pregnancy
Condition How it can affect pregnancy Where to learn more
Asthma Poorly controlled asthma may increase risk of preeclampsia, poor weight gain in the fetus, preterm birth, cesarean birth, and other complications. If pregnant women stop using asthma medicine, even mild asthma can become severe.
Depression Depression that persists during pregnancy can make it hard for a woman to care for herself and her unborn baby. Having depression before pregnancy also is a risk factor for postpartum depression.
Diabetes High blood glucose (sugar) levels during pregnancy can harm the fetus and worsen a woman’s long-term diabetes complications. Doctors advise getting diabetes under control at least three to six months before trying to conceive.
Eating disorders Body image changes during pregnancy can cause eating disorders to worsen. Eating disorders are linked to many pregnancy complications, including birth defects and premature birth. Women with eating disorders also have higher rates of postpartum depression.
Epilepsy and other seizure disorders Seizures during pregnancy can harm the fetus, and increase the risk of miscarriage or stillbirth. But using medicine to control seizures might cause birth defects. For most pregnant women with epilepsy, using medicine poses less risk to their own health and the health of their babies than stopping medicine.
High blood pressure Having chronic high blood pressure puts a pregnant woman and her baby at risk for problems. Women with high blood pressure have a higher risk of preeclampsia and placental abruption (when the placenta separates from the wall of the uterus). The likelihood of preterm birth and low birth weight also is higher.
HIV HIV can be passed from a woman to her baby during pregnancy or delivery. Yet this risk is less than 1 percent if a woman takes certain HIV medicines during pregnancy. Women who have HIV and want to become pregnant should talk to their doctors before trying to conceive. Good prenatal care will help protect a woman’s baby from HIV and keep her healthy.
Migraine Migraine symptoms tend to improve during pregnancy. Some women have no migraine attacks during pregnancy. Certain medicines commonly used to treat headaches should not be used during pregnancy. A woman who has severe headaches should speak to her doctor about ways to relieve symptoms safely.
Overweight and Obesity Recent studies suggest that the heavier a woman is before she becomes pregnant, the greater her risk of a range of pregnancy complications, including preeclampsia and preterm delivery. Overweight and obese women who lose weight before pregnancy are likely to have healthier pregnancies.
Sexually transmitted infections (STIs) Some STIs can cause early labor, a woman’s water to break too early, and infection in the uterus after birth. Some STIs also can be passed from a woman to her baby during pregnancy or delivery. Some ways STIs can harm the baby include: low birth weight, dangerous infections, brain damage, blindness, deafness, liver problems, or stillbirth.
Thyroid disease Uncontrolled hyperthyroidism (overactive thyroid) can be dangerous to the mother and cause health problems such as heart failure and poor weight gain in the fetus. Uncontrolled hypothyroidism (underactive thyroid) also threatens the mother’s health and can cause birth defects.
Uterine fibroids Uterine fibroids are not uncommon, but few cause symptoms that require treatment. Uterine fibroids rarely cause miscarriage. Sometimes, fibroids can cause preterm or breech birth. Cesarean delivery may be needed if a fibroid blocks the birth canal.

Pregnancy related problems

Sometimes pregnancy problems arise — even in healthy women. Some prenatal tests done during pregnancy can help prevent these problems or spot them early. Use this chart to learn about some common pregnancy complications. Call your doctor if you have any of the symptoms on this chart. If a problem is found, make sure to follow your doctor’s advice about treatment. Doing so will boost your chances of having a safe delivery and a strong, healthy baby.

Health problems during pregnancy
Problem Symptoms Treatment
Anemia – Lower than normal number of healthy red blood cells
  • Feel tired or weak
  • Look pale
  • Feel faint
  • Shortness of breath
Treating the underlying cause of the anemia will help restore the number of healthy red blood cells. Women with pregnancy related anemia are helped by taking iron and folic acid supplements. Your doctor will check your iron levels throughout pregnancy to be sure anemia does not happen again.
Depression – Extreme sadness during pregnancy or after birth (postpartum)
  • Intense sadness
  • Helplessness and irritability
  • Appetite changes
  • Thoughts of harming self or baby
Women who are pregnant might be helped with one or a combination of treatment options, including:

  • Therapy
  • Support groups
  • Medicines

A mother’s depression can affect her baby’s development, so getting treatment is important for both mother and baby. Learn more about depression during and after pregnancy.

Ectopic (ek-TOP-ihk) pregnancy – When a fertilized egg implants outside of the uterus, usually in the fallopian tube
  • Abdominal pain
  • Shoulder pain
  • Vaginal bleeding
  • Feeling dizzy or faint
With ectopic pregnancy, the egg cannot develop. Drugs or surgery is used to remove the ectopic tissue so your organs are not damaged.
Fetal problems – Unborn baby has a health issue, such as poor growth or heart problems
  • Baby moving less than normal (Learn how to count your baby’s movements on our Prenatal care and tests page.)
  • Baby is smaller than normal for gestational age
  • Some problems have no symptoms, but are found with prenatal tests
Treatment depends on results of tests to monitor baby’s health. If a test suggests a problem, this does not always mean the baby is in trouble. It may only mean that the mother needs special care until the baby is delivered. This can include a wide variety of things, such as bed rest, depending on the mother’s condition. Sometimes, the baby has to be delivered early.
Gestational diabetes – Too high blood sugar levels during pregnancy
  • Usually, there are no symptoms. Sometimes, extreme thirst, hunger, or fatigue
  • Screening test shows high blood sugar levels
Most women with pregnancy related diabetes can control their blood sugar levels by a following a healthy meal plan from their doctor. Some women also need insulin to keep blood sugar levels under control. Doing so is important because poorly controlled diabetes increases the risk of:

High blood pressure (pregnancy related) – High blood pressure that starts after 20 weeks of pregnancy and goes away after birth
  • High blood pressure without other signs and symptoms of preeclampsia
The health of the mother and baby are closely watched to make sure high blood pressure is not preeclampsia.
Hyperemesis gravidarum (HEYE-pur-EM-uh-suhss grav-uh-DAR-uhm) (HG) – Severe, persistent nausea and vomiting during pregnancy — more extreme than “morning sickness”
  • Nausea that does not go away
  • Vomiting several times every day
  • Weight loss
  • Reduced appetite
  • Dehydration
  • Feeling faint or fainting
Dry, bland foods and fluids together is the first line of treatment. Sometimes, medicines are prescribed to help nausea. Many women with HG have to be hospitalized so they can be fed fluids and nutrients through a tube in their veins. Usually, women with HG begin to feel better by the 20th week of pregnancy. But some women vomit and feel nauseated throughout all three trimesters.
Miscarriage – Pregnancy loss from natural causes before 20 weeks. As many as 20 percent of pregnancies end in miscarriage. Often, miscarriage occurs before a woman even knows she is pregnant Signs of a miscarriage can include:

  • Vaginal spotting or bleeding*
  • Cramping or abdominal pain
  • Fluid or tissue passing from the vagina

* Spotting early in pregnancy doesn’t mean miscarriage is certain. Still, contact your doctor right away if you have any bleeding.

In most cases, miscarriage cannot be prevented. Sometimes, a woman must undergo treatment to remove pregnancy tissue in the uterus. Counseling can help with emotional healing. See our section on Pregnancy loss.
Placenta previaPlacenta covers part or entire opening of cervix inside of the uterus
  • Painless vaginal bleeding during second or third trimester
  • For some, no symptoms
If diagnosed after the 20th week of pregnancy, but with no bleeding, a woman will need to cut back on her activity level and increase bed rest. If bleeding is heavy, hospitalization may be needed until mother and baby are stable. If the bleeding stops or is light, continued bed rest is resumed until baby is ready for delivery. If bleeding doesn’t stop or if preterm labor starts, baby will be delivered by cesarean section.
Placental abruptionPlacenta separates from uterine wall before delivery, which can mean the fetus doesn’t get enough oxygen.
  • Vaginal bleeding
  • Cramping, abdominal pain, and uterine tenderness
When the separation is minor, bed rest for a few days usually stops the bleeding. Moderate cases may require complete bed rest. Severe cases (when more than half of the placenta separates) can require immediate medical attention and early delivery of the baby.
Preeclampsia (pree-ee-CLAMP-see-uh) – A condition starting after 20 weeks of pregnancy that causes high blood pressure and problems with the kidneys and other organs. Also called toxemia.
  • High blood pressure
  • Swelling of hands and face
  • Too much protein in urine
  • Stomach pain
  • Blurred vision
  • Dizziness
  • Headaches
The only cure is delivery, which may not be best for the baby. Labor will probably be induced if condition is mild and the woman is near term (37 to 40 weeks of pregnancy). If it is too early to deliver, the doctor will watch the health of the mother and her baby very closely. She may need medicines and bed rest at home or in the hospital to lower her blood pressure. Medicines also might be used to prevent the mother from having seizures.
Preterm labor – Going into labor before 37 weeks of pregnancy
  • Increased vaginal discharge
  • Pelvic pressure and cramping
  • Back pain radiating to the abdomen
  • Contractions
Medicines can stop labor from progressing. Bed rest is often advised. Sometimes, a woman must deliver early. Giving birth before 37 weeks is called “preterm birth.” Preterm birth is a major risk factor for future preterm births.

Infections during pregnancy

During pregnancy, your baby is protected from many illnesses, like the common cold or a passing stomach bug. But some infections can be harmful to your pregnancy, your baby, or both. This chart provides an overview of infections that can be harmful during pregnancy. Learn the symptoms and what you can do to keep healthy. Easy steps, such as hand washing, practicing safe sex, and avoiding certain foods, can help protect you from some infections.

Infections during pregnancy
Infection Symptoms Prevention and treatment
Bacterial vaginosis (BV)

A vaginal infection that is caused by an overgrowth of bacteria normally found in the vagina.

BV has been linked to preterm birth and low birth weight babies.

  • Grey or whitish discharge that has a foul, fishy odor
  • Burning when passing urine or itching
  • Some women have no symptoms
How to prevent BV is unclear. BV is not passed through sexual contact, although it is linked with having a new or more than one sex partner.

Women with symptoms should be tested for BV.

Antibiotics are used to treat BV.

Cytomegalovirus (SEYE-toh-MEG-uh-loh VEYE-ruhss) (CMV)

A common virus that can cause disease in infants whose mothers are infected with CMV during pregnancy. CMV infection in infants can lead to hearing loss, vision loss, and other disabilities.

  • Mild illness that may include fever, sore throat, fatigue, and swollen glands
  • Some women have no symptoms
Good hygiene is the best way to keep from getting CMV.

No treatment is currently available. But studies are looking at antiviral drugs for use in infants. Work to create a CMV vaccine also is underway.

Group B strep (GBS)

Group B strep is a type of bacteria often found in the vagina and rectum of healthy women. One in four women has it. GBS usually is not harmful to you, but can be deadly to your baby if passed during childbirth.

  • No symptoms
You can keep from passing GBS to your baby by getting tested at 35 to 37 weeks. This simply involves swabbing the vagina and rectum and does not hurt.

If you have GBS, an antibiotic given to you during labor will protect your baby from infection. Make sure to tell the labor and delivery staff that you are a group B strep carrier when you check into the hospital.

Hepatitis B virus (HBV)

A viral infection that can be passed to baby during birth. Newborns that get infected have a 90 percent chance of developing lifelong infection. This can lead to liver damage and liver cancer. A vaccine can keep newborns from getting HBV. But 1 in 5 newborns of mothers who are HBV positive don’t get the vaccine at the hospital before leaving.

There may be no symptoms. Or symptoms can include:

  • Nausea, vomiting, and diarrhea
  • Dark urine and pale bowel movements
  • Whites of eyes or skin looks yellow
Lab tests can find out if the mother is a carrier of hepatitis B.

You can protect your baby for life from HBV with the hepatitis B vaccine, which is a series of three shots:

  • First dose of hepatitis B vaccine plus HBIG shot given to baby at birth
  • Second dose of hepatitis B vaccine given to baby at 1-2 months old
  • Third dose of hepatitis B vaccine given to baby at 6 months old (but not before 24 weeks old)
Influenza (flu)

Flu is a common viral infection that is more likely to cause severe illness in pregnant women than in women who are not pregnant. Pregnant woman with flu also have a greater chance for serious problems for their unborn baby, including premature labor and delivery.

  • Fever (sometimes) or feeling feverish/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Feeling tired
  • Vomiting and diarrhea (sometimes)
Getting a flu shot is the first and most important step in protecting against flu. The flu shot given during pregnancy is safe and has been shown to protect both the mother and her baby (up to 6 months old) from flu. (The nasal spray vaccine should not be given to women who are pregnant.)

If you get sick with flu-like symptoms call your doctor right away. If needed, the doctor will prescribe an antiviral medicine that treats the flu.

Listeriosis (lih-steer-ee-OH-suhss)

An infection with the harmful bacteria called listeria. It is found in some refrigerated and ready-to-eat foods. Infection can cause early delivery or miscarriage.

  • Fever, muscle aches, chills
  • Sometimes diarrhea or nausea
  • If progresses, severe headache and stiff neck
Avoid foods that can harbor listeria.

Antibiotics are used to treat listeriosis.

Parvovirus B19 (fifth disease)

Most pregnant women who are infected with this virus do not have serious problems. But there is a small chance the virus can infect the fetus. This raises the risk of miscarriage during the first 20 weeks of pregnancy. Fifth disease can cause severe anemia in women who have red blood cell disorders like sickle cell disease or immune system problems.

  • Low-grade fever
  • Tiredness
  • Rash on face, trunk, and limbs
  • Painful and swollen joints
No specific treatment, except for blood transfusions that might be needed for people who have problems with their immune systems or with red blood cell disorders. There is no vaccine to help prevent infection with this virus.
Sexually transmitted infection (STI)

An infection that is passed through sexual contact. Many STIs can be passed to the baby in the womb or during birth. Some effects include stillbirth, low birth weight, and life-threatening infections. STIs also can cause a woman’s water to break too early or preterm labor.

STIs can be prevented by practicing safe sex. A woman can keep from passing an STI to her baby by being screened early in pregnancy.

Treatments vary depending on the STI. Many STIs are treated easily with antibiotics.

Toxoplasmosis (TOK-soh-plaz-MOH-suhss)

This infection is caused by a parasite, which is found in cat feces, soil, and raw or undercooked meat. If passed to an unborn baby, the infection can cause hearing loss, blindness, or intellectual disabilities.

  • Mild flu-like symptoms, or possibly no symptoms.
You can lower your risk by:

  • Washing hands with soap after touching soil or raw meat
  • Washing produce before eating
  • Cooking meat completely
  • Washing cooking utensils with hot, soapy water
  • Not cleaning cats’ litter boxes

Medicines are used to treat a pregnant woman and her unborn baby. Sometimes, the baby is treated with medicine after birth.

Urinary tract infection (UTI)

Bacterial infection in urinary tract. If untreated, it can spread to the kidneys, which can cause preterm labor.

  • Pain or burning when urinating
  • Frequent urination
  • Pelvis, back, stomach, or side pain
  • Shaking, chills, fever, sweats
UTIs are treated with antibiotics.
Yeast infection

An infection caused by an overgrowth of bacteria normally found in the vagina. Yeast infections are more common during pregnancy than in other times of a woman’s life. They do not threaten the health of your baby. But they can be uncomfortable and difficult to treat in pregnancy.

  • Extreme itchiness in and around the vagina
  • Burning, redness, and swelling of the vagina and the vulva
  • Pain when passing urine or during sex
  • A thick, white vaginal discharge that looks like cottage cheese and does not have a bad smell
Vaginal creams and suppositories are used to treat yeast infection during pregnancy.

When to call the doctor

When you are pregnant, don’t wait to call your doctor or midwife if something is bothering or worrying you. Sometimes physical changes can be signs of a problem.

Call your doctor or midwife as soon as you can if you:

  • Are bleeding or leaking fluid from the vagina
  • Have sudden or severe swelling in the face, hands, or fingers
  • Get severe or long-lasting headaches
  • Have discomfort, pain, or cramping in the lower abdomen
  • Have a fever or chills
  • Are vomiting or have persistent nausea
  • Feel discomfort, pain, or burning with urination
  • Have problems seeing or blurred vision
  • Feel dizzy
  • Suspect your baby is moving less than normal after 28 weeks of pregnancy (If you count less than 10 movements within two hours. Learn how to count your baby’s movements on our Prenatal care and tests page.)
  • Have thoughts of harming yourself or your baby

This content is provided by the Office on Women’s Health.

Syndicated Content Details:
Source URL: https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/pregnancy-complications
Source Agency: Office on Women’s Health (OWH)
Captured Date: 2018-06-06 20:56:00.0

What Are the Signs of Fetal Alcohol Spectrum Disorders?

International Fetal Alcohol Spectrum Disorders (FASD) Awareness Day, recognized every year on Sept. 9th, is an important reminder prenatal alcohol exposure is the leading preventable cause of birth defects and developmental disorders in the United States. Almost 40 years have passed since it was recognized drinking during pregnancy can result in a wide range of disabilities for children, of which fetal alcohol syndrome (FAS) is the most severe. Still, 1 in 13 pregnant women report drinking in the past 30 days. Of those, about 1 in 6 report binge drinking during that time.

The disabilities associated with FASD can persist throughout life and place heavy emotional and financial burdens on individuals, their families, and society. Alcohol use during pregnancy can cause physical, behavioral, and intellectual disabilities. Often, a person with an FASD has a mix of these problems. It is recommended women who are pregnant or might be pregnant not drink alcohol. Fetal alcohol spectrum disorders are completely preventable if a developing baby is not exposed to alcohol before birth.

What We Know

  • Women who are pregnant or who might be pregnant should be aware that any level of alcohol use could harm their babies.
  • All types of alcohol can be harmful, including all wine and beer.
  • The baby’s brain, body, and organs are developing throughout pregnancy and can be affected by alcohol at any time.
  • Alcohol use during pregnancy can also increase the risk of miscarriage, stillbirth, preterm (early) birth, and sudden infant death syndrome (SIDS).

Cause and Prevention

FASDs are caused by a woman drinking alcohol during pregnancy. Alcohol in the mother’s blood passes to the baby through the umbilical cord. When a woman drinks alcohol, so does her baby.

There is no known safe amount of alcohol during pregnancy or when trying to get pregnant. There is also no safe time to drink during pregnancy. Alcohol can cause problems for a developing baby throughout pregnancy, including before a woman knows she’s pregnant. All types of alcohol are equally harmful, including all wines and beer.

To prevent FASDs, a woman should not drink alcohol while she is pregnant, or when she might get pregnant. This is because a woman could get pregnant and not know for up to 4 to 6 weeks. In the United States, nearly half of pregnancies are unplanned.

If a woman is drinking alcohol during pregnancy, it is never too late to stop drinking. Because brain growth takes place throughout pregnancy, the sooner a woman stops drinking the safer it will be for her and her baby. Resources are available here.

FASDs are completely preventable if a woman does not drink alcohol during pregnancy—so why take the risk?

Signs and Symptoms

FASDs refer to the whole range of effects that can happen to a person whose mother drank alcohol during pregnancy. These conditions can affect each person in different ways and can range from mild to severe.

A person with an FASD might have:

  • Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum)
  • Small head size
  • Shorter-than-average height
  • Low body weight
  • Poor coordination
  • Hyperactive behavior
  • Difficulty with attention
  • Poor memory
  • Difficulty in school (especially with math)
  • Learning disabilities
  • Speech and language delays
  • Intellectual disability or low IQ
  • Poor reasoning and judgment skills
  • Sleep and sucking problems as a baby
  • Vision or hearing problems
  • Problems with the heart, kidneys, or bones

Types of FASDs

Different terms are used to describe FASDs, depending on the type of symptoms.

Fetal Alcohol Syndrome (FAS): FAS represents the most involved end of the FASD spectrum. Fetal death is the most extreme outcome from drinking alcohol during pregnancy. People with FAS might have abnormal facial features, growth problems, and central nervous system (CNS) problems. People with FAS can have problems with learning, memory, attention span, communication, vision, or hearing. They might have a mix of these problems. People with FAS often have a hard time in school and trouble getting along with others.

Alcohol-Related Neurodevelopmental Disorder (ARND): People with ARND might have intellectual disabilities and problems with behavior and learning. They might do poorly in school and have difficulties with math, memory, attention, judgment, and poor impulse control.
Alcohol-Related Birth Defects (ARBD): People with ARBD might have problems with the heart, kidneys, or bones or with hearing. They might have a mix of these.

Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE): ND-PAE was first included as a recognized condition in the Diagnostic and Statistical Manual 5 (DSM 5) of the American Psychiatric Association (APA) in 2013. A child or youth with ND-PAE will have problems in three areas: (1) thinking and memory, where the child may have trouble planning or may forget material he or she has already learned, (2) behavior problems, such as severe tantrums, mood issues (for example, irritability), and difficulty shifting attention from one task to another, and (3) trouble with day-to-day living, which can include problems with bathing, dressing for the weather, and playing with other children. In addition, to be diagnosed with ND-PAE, the mother of the child must have consumed more than minimal levels of alcohol before the child’s birth, which APA defines as more than 13 alcoholic drinks per month of pregnancy (that is, any 30-day period of pregnancy) or more than 2 alcoholic drinks in one sitting.

Diagnosis

The term FASDs is not meant for use as a clinical diagnosis. CDC worked with a group of experts and organizations to review the research and develop guidelines for diagnosing FAS. The guidelines were developed for FAS only. CDC and its partners are working to put together diagnostic criteria for other FASDs, such as ARND. Clinical and scientific research on these conditions is going on now.

Diagnosing FAS can be hard because there is no medical test, like a blood test, for it. And other disorders, such as ADHD (attention-deficit/hyperactivity disorder) and Williams syndrome, have some symptoms like FAS.

To diagnose FAS, doctors look for:

  • Abnormal facial features (e.g., smooth ridge between nose and upper lip)
  • Lower-than-average height, weight, or both
  • Central nervous system problems (e.g., small head size, problems with attention and hyperactivity, poor coordination)
  • Prenatal alcohol exposure; although confirmation is not required to make a diagnosis

Treatment

FASDs last a lifetime. There is no cure for FASDs, but research shows early intervention treatment services can improve a child’s development.

There are many types of treatment options, including medication to help with some symptoms, behavior and education therapy, parent training, and other alternative approaches. No one treatment is right for every child. Good treatment plans will include close monitoring, follow-ups, and changes as needed along the way.

Also, “protective factors” can help reduce the effects of FASDs and help people with these conditions reach their full potential. These include:

  • Diagnosis before 6 years of age
  • Loving, nurturing, and stable home environment during the school years
  • Absence of violence
  • Involvement in special education and social services

What Can Be Done to Prevent Fetal Alcohol Spectrum Disorders

Women Can

  • Talk with their healthcare providers about their plans for pregnancy, their alcohol use, and ways to prevent pregnancy if they are not planning to get pregnant.
  • Stop drinking alcohol if they are trying to get pregnant or could get pregnant.
  • Ask their respective partners, families, and friends to support their choice not to drink during pregnancy or while trying to get pregnant.
  • Ask their healthcare providers or other trusted people about resources for help if they cannot stop drinking on their own.

Healthcare providers can

  • Screen all adult patients for alcohol use at least yearly.
  • Advise women not to drink at all if there is any chance they could be pregnant.
  • Counsel, refer, and follow up with patients who need more help.
  • Use the correct billing codes so that alcohol screening and counseling is reimbursable.

Get Help!

If you or the doctor thinks there could be a problem, ask the doctor for a referral to a specialist (someone who knows about FASDs), such as a developmental pediatrician, child psychologist, or clinical geneticist. In some cities, there are clinics whose staffs have special training in diagnosing and treating children with FASDs. To find doctors and clinics in your area visit the National and State Resource Directory from the National Organization on Fetal Alcohol Syndrome (NOFAS).

At the same time as you ask the doctor for a referral to a specialist, call your state’s early intervention program to request a free evaluation to find out if your child can get services to help. This is sometimes called a Child Find evaluation. You do not need to wait for a doctor’s referral or a medical diagnosis to make this call.

Where to call for a free evaluation from the state depends on your child’s age:

If your child is younger than 3 years old, Call your state or territory’s early intervention program and say: “I have concerns about my child’s development and I would like to have my child evaluated to find out if he/she is eligible for early intervention services.”

If your child is 3 years old or older, contact your local public school system. Even if your child is not old enough for kindergarten or enrolled in a public school, call your local elementary school or board of education and ask to speak with someone who can help you have your child evaluated.

Conclusion

Research to understand how alcohol exposure during pregnancy interferes with fetal development and how FASD can be identified and prevented is ongoing. Scientists continue to make tremendous strides, providing important new insights into the nature of FASD and potential intervention and treatment strategies.

The message is simple, not just on Sept. 9, but every day. There is no known safe level of drinking while pregnant. Women who are, who may be, or who are trying to become pregnant, should not drink alcohol.

If you or pregnant, may become pregnant, or are a new parent wondering about the effects of alcohol on your child, find a caring physician who can advise you using the first of its kind social ecosystem for HealthCare.  At HealthLynked, your can connect with providers in new and unique ways to collaborate on your wellness and the health of your family.

Ready to get Lynked?  Got to HealthLynked.com to sign up for Free, and start taking control of your health today?

Sources:
CDC.gov

References

Streissguth, A.P., Bookstein, F.L., Barr, H.M., Sampson, P.D., O’Malley, K., & Young, J.K. (2004). Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. Developmental and Behavioral Pediatrics, 5(4), 228-238.

Streissguth, A.P., Barr, H.M., Kogan, J. & Bookstein, F. L., Understanding the occurrence of secondary disabilities in clients with fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE). Final report to the Centers for Disease Control and Prevention (CDC). Seattle: University of Washington, Fetal Alcohol & Drug Unit; August 1996. Tech. Rep. No. 96-06.

What are the First Five Steps in First Aid?

According to a Red Cross Survey, too many people have a fear of taking action when someone needs help. The report suggests, for anyone finding themselves in a life-threatening emergency situation, there’s a 50-50 chance  someone will actually step forward to offer first aid.

The survey found:

  • While most (88%) would want someone to come to our aid, only half (50%) of adults would actually feel confident about helping.
  • The majority of those asked (70%) said that they would worry about making it worse or doing something wrong.
  • Most worryingly, just 4% of people knew the correct first aid skills, and said they were both confident and likely to help someone in three of the most life-threatening scenarios, such as heavy bleeding or someone stopping breathing.

By administering immediate care during an emergency, you can help an ill or injured person before EMS, or Emergency Medical Services, arrive.  You may even help save a life.  However, even after training, remembering the right first aid steps – and administering them correctly – can be difficult.  In order to help you deliver the right care at the right time, the Red Cross has created this simple step-by-step guide that you can print up and place on your refrigerator, in your car, in your bag or at your desk.


1.  Before administering care to an ill or injured person, check the scene and the person. Size up the scene and form an initial impression.

Pause and look at the scene and the person before responding. Answer the following questions:

  • Is the scene safe to enter?
  • What happened?
  • How many people are involved?
  • What is my initial impression about the nature of the person’s illness or injury?
  • Does the person have any life-threatening conditions, such as severe, life-threatening bleeding?
  • Is anyone else available to help?

2.  If the Person is awake and Responsive and there is no severe life-threatening bleeding:

  • Obtain consent: Tell the person your name, describe type and level of training, state what you think is wrong and what you plan to do, and ask permission to provide care.
  • Tell a bystander to get the AED and first aid kit: Point to a bystander and speak out loud.
  • Use appropriate personal protective equipment (PPE); Put on gloves, if available.
  • Interview the person: Use questions to gather more information about signs and symptoms, allergies, medications, pertinent medical history, last food or drink and events leading up to the incident.
  • Conduct a head-to-toe check: Check head and neck, shoulders, chest and abdomen, hips, legs and feet, arms and hands for signs of injury.
  • Provide care consistent with knowledge and training according to the conditions you find.

3.  If the Person Appears Unresponsive:

Shout to get the person’s attention, using the person’s name if it is known. If there is no response, tap the person’s shoulder (if the person is an adult or child) or the bottom of the person’s foot (if the person is an infant) and shout again, while checking for normal breathing. Check for Responsiveness and breathing for no more than 5-10 seconds.

4.  If the person is breathing:

  • Send someone to call 911 or the designated emergency number and obtain an AED and first aid kit.
  • Proceed with gathering information from bystanders using questions.
  • Conduct a head-to-toe check.
  • Roll the person onto his or her side into a recovery position if there are no obvious signs of injury.

5.  If the person is NOT breathing:

  • Send someone to call 911 or the designated emergency number and obtain an AED and first aid kit.
  • Ensure that the person is face-up on a firm, flat surface such as the floor or ground.
  • Begin CPR (starting with compressions) or use an AED if one is immediately available.
  • Continue administering CPR until the person exhibits signs of life, such as breathing, an AED becomes available, or EMS or trained medical responders arrive on scene.

Note:  End CPR if the scene becomes unsafe or you cannot continue due to exhaustion.


Often, the first responders that save lives are not medically trained professionals.  It is essential, in those first few minutes, those who need medical attention receive care, even from those not necessarily medically trained.

The first steps you take in medicine are often the most important.  Just like taking control of a First Aid situation, taking control of your healthcare today can be the first important step toward wellness.  At HealthLynked, we can help.

Mange your own medical records and those of your family, carry them with you wherever you go, and make appointments on the fly.  All this for Free!

Go to HealthLynked.com, now, to take the fist steps to better wellness.

What Are the Signs and Symptoms of Ovarian Cancer?

Each year, the first Friday in September is designated as Wear Teal Day.  On this day, organizations unite in an effort to encourage you to dress in teal and educate yourself and those around you about the symptoms and risk factors of Ovarian Cancer.

What is Ovarian Cancer?

Ovarian cancer is a disease in which, depending on the type and stage, malignant (cancerous) cells are found inside, near, or on the outer layer of the ovaries. An ovary is one of two small, almond-shaped organs located on each side of the uterus that store eggs, or germ cells, and produce female hormones estrogen and progesterone.

Cancer Basics

Cancer develops when abnormal cells in a part of the body (in this case, the ovary) begin to grow uncontrollably. This abnormal cell growth is common among all cancer types.

Normally, cells in your body divide and form new cells to replace worn out or dying cells, and to repair injuries. Because cancer cells continue to grow and divide, they are different from normal cells. Instead of dying, they outlive normal cells and continue to create new abnormal cells, forming a tumor. Tumors can put pressure on other organs near the ovaries.

Cancer cells can sometimes travel to other parts of the body, where they begin to grow and replace normal tissue. This process, called metastasis, occurs as the cancer cells move into the bloodstream or lymph system of the body. Cancer cells that spread from other organ sites (such as breast or colon) to the ovary are not considered ovarian cancer. Cancer type is determined by the original site of the malignancy.

What is the general outlook for women diagnosed with ovarian cancer?

In women ages 35-74, ovarian cancer is the fifth leading cause of cancer-related deaths. An estimated one woman in 75 will develop ovarian cancer during her lifetime. The American Cancer Society estimates that there will be over 22,280 new cases of ovarian cancer diagnosed this year and that more than 14,240 women will die from ovarian cancer this year.

When one is diagnosed and treated in the earliest stages, the five-year survival rate is over 90 percent. Due to ovarian cancer’s non-specific symptoms and lack of early detection tests, about 20 percent of all cases are found early, meaning in stage I or II.

If caught in stage III or higher, the survival rate can be as low as 28 percent. Due to the nature of the disease, each woman diagnosed with ovarian cancer has a different profile and it is impossible to provide a general prognosis. With almost 80% of women diagnosed in advanced stages of ovarian cancer, when prognosis is poor, we know that more needs to be done to spread awareness of this horrible disease that will take the lives of more than 14,000 women this year.

What are the Signs & Symptoms of Ovarian Cancer?

Ovarian cancer is difficult to detect, especially in the early stages. This is partly due to the fact that the ovaries – two small, almond-shaped organs on either side of the uterus – are deep within the abdominal cavity. The following are often identified by women as some of the signs and symptoms of ovarian cancer:

  • Bloating
  • Pelvic or abdominal pain
  • Trouble eating or feeling full quickly
  • Feeling the need to urinate urgently or often

Other symptoms of ovarian cancer can include:

  • Fatigue
  • Upset stomach or heartburn
  • Back pain
  • Pain during sex
  • Constipation or menstrual changes

If symptoms are new and persist for more than two weeks, it is recommended that a woman see her doctor, and a gynecologic oncologist before surgery if cancer is suspected.

Persistence of Symptoms

When the symptoms are persistent, when they do not resolve with normal interventions (like diet change, exercise, laxatives, rest) it is imperative for a woman to see her doctor. Persistence of symptoms is key. Because these signs and symptoms of ovarian cancer have been described as vague or silent, only approximately 19 percent of ovarian cancer is diagnosed in the early stages. Symptoms typically occur in advanced stages when tumor growth creates pressure on the bladder and rectum, and fluid begins to form.

Treatment Options

Surgery

Surgery to remove the cancerous growth is the most common method of diagnosis and therapy for ovarian cancer. It is best performed by a qualified gynecologic oncologist.

Most women with ovarian cancer will have surgery at some point during the course of their disease, and each surgery has different goals.

Chemotherapy

Before treatment begins, it is important to understand how chemotherapy works. Chemotherapy is the treatment of cancer using chemicals designed to destroy cancer cells or stop them from growing. The goal of chemotherapy is to cure cancer, shrink tumors prior to surgery or radiation therapy, destroy cells that might have spread, or control tumor growth.

Radiation

Radiation therapy uses high-­energy X­-rays to kill cancer cells and shrink tumors. Please note that this therapy is rarely used in the treatment of ovarian cancer in the United States. It is more often used in other parts of the body where cancer has spread.

Complementary Therapies

Some women with ovarian cancer turn toward the whole ­body approach of complementary therapy to enhance their fight against the disease, as well as to relieve stress and lessen side effects, such as fatigue, pain, and nausea.

Complementary therapies are diverse practices and products that are used along with conventional medicine. Many women have tried and benefited from the complementary therapies listed below. Speaking with other women, in addition to the healthcare team, can suggest the therapies that may be most helpful and appropriate for each woman’s lifestyle.

Clinical Trials

Clinical trials are research studies designed to find ways to improve health and cancer care. Each study tries to answer scientific questions and to find better ways to prevent, diagnose, or treat cancer. Many women undergoing treatment for ovarian cancer choose to participate in clinical trials. Through participation in these trials, patients may receive access to new therapy options that are not available to women outside the clinical trial setting.

How am I Diagnosed with Ovarian Cancer?

Most women with ovarian cancer are diagnosed with advanced-stage disease (Stage III or IV). This is because the symptoms of ovarian cancer, particularly in its early stages, often are not acute or intense, and present vaguely. In most cases, ovarian cancer is not detected during routine pelvic exams, unless the doctor notes that the ovary is enlarged. The sooner ovarian cancer is found and treated, the better a woman’s chance for survival. It is important to know that early stage symptoms can be difficult to detect, though are not always silent. As a result, it is important that women listen to their bodies and watch for early symptoms that may present.

Did You Know?

The Pap test does not detect ovarian cancer. It aids in evaluating cells for the detection of cervical cancer.

Screening Tests

Although there is no consistently-reliable screening test to detect ovarian cancer, the following tests are available and should be offered to women, especially those women at high risk for the disease:

  • Pelvic Exam: Women age 18 and older should have a mandatory annual vaginal exam. Women age 35 and older should receive an annual rectovaginal exam (physician inserts fingers in the rectum and vagina simultaneously to feel for abnormal swelling and to detect tenderness).
  • Transvaginal Sonography: This ultrasound, performed with a small instrument placed in the vagina, is appropriate, especially for women at high risk for ovarian cancer, or for those with an abnormal pelvic exam.
  • CA-125 Test: This blood test determines if the level of CA-125, a protein produced by ovarian cancer cells, has increased in the blood of a woman at high risk for ovarian cancer, or a woman with an abnormal pelvic examination.

While CA-125 is an important test, it is not always a key marker for the disease. Some non-cancerous diseases of the ovaries can also increase CA-125 levels, and some ovarian cancers may not produce enough CA-125 levels to cause a positive test. For these reasons the CA-125 test is not routinely used as a screening test for those at average risk for ovarian cancer.

Positive Tests

If any of these tests are positive, a woman should consult with a gynecologic oncologist, who may conduct a CT scan and evaluate the test results. However, the only way to more accurately confirm an ovarian cancer diagnosis is with a biopsy, a procedure in which the doctor takes a sample of the tumor and examines it under a microscope.

Research into new ovarian cancer screening tests is ongoing, and new diagnostic tests may be on the horizon. The National Ovarian Cancer Coalition monitors the latest scientific developments. Please visit their Research page for additional information.

Getting Help

To locate a physician in your area who can help with the symptoms you are suffering and aid in treatment, if necessary, please find one today using HealthLynked.com.  We are the first of its kind social ecosystem designed to connect physicians and patients for the efficient exchange of information in a secure platform designed for communication and collaboration.

Ready to get Lynked?  Go to HealthLynked.com, right now, to start getting the help you need, for free.

 

Source:

Ovarian.org

What is infertility

Infertility FAQs

Frequently Asked Questions

What is infertility?

a flower in bloom

In general, infertility is defined as not being able to get pregnant (conceive) after one year (or longer) of unprotected sex. Because fertility in women is known to decline steadily with age, some providers evaluate and treat women aged 35 years or older after 6 months of unprotected sex. Women with infertility should consider making an appointment with a reproductive endocrinologist—a doctor who specializes in managing infertility. Reproductive endocrinologists may also be able to help women with recurrent pregnancy loss, defined as having two or more spontaneous miscarriages.

Pregnancy is the result of a process that has many steps.

To get pregnant

  • A woman’s body must release an egg from one of her ovaries (ovulation).
  • A man’s sperm must join with the egg along the way (fertilize).
  • The fertilized egg must go through a fallopian tube toward the uterus (womb).
  • The fertilized egg must attach to the inside of the uterus (implantation).

Infertility may result from a problem with any or several of these steps.

Impaired fecundity is a condition related to infertility and refers to women who have difficulty getting pregnant or carrying a pregnancy to term.

Is infertility a common problem?

Yes. About 6% of married women aged 15 to 44 years in the United States are unable to get pregnant after one year of trying (infertility). Also, about 12% of women aged 15 to 44 years in the United States have difficulty getting pregnant or carrying a pregnancy to term, regardless of marital status (impaired fecundity).

Is infertility just a woman’s problem?

No, infertility is not always a woman’s problem. Both men and women can contribute to infertility.

Many couples struggle with infertility and seek help to become pregnant, but it is often thought of as only a woman’s condition. However, in about 35% of couples with infertility, a male factor is identified along with a female factor. In about 8% of couples with infertility, a male factor is the only identifiable cause.

Almost 9% of men aged 25 to 44 years in the United States reported that they or their partner saw a doctor for advice, testing, or treatment for infertility during their lifetime.

What causes infertility in men?

Infertility in men can be caused by different factors and is typically evaluated by a semen analysis. When a semen analysis is performed, the number of sperm (concentration), motility (movement), and morphology (shape) are assessed by a specialist. A slightly abnormal semen analysis does not mean that a man is necessarily infertile. Instead, a semen analysis helps determine if and how male factors are contributing to infertility.

Disruption of testicular or ejaculatory function

  • Varicoceles, a condition in which the veins on a man’s testicles are large and cause them to overheat. The heat may affect the number or shape of the sperm.
  • Trauma to the testes may affect sperm production and result in lower number of sperm.
  • Unhealthy habits such as heavy alcohol use, smoking, anabolic steroid use, and illicit drug use.
  • Use of certain medications and supplements.
  • Cancer treatment involving the use of certain types of chemotherapy, radiation, or surgery to remove one or both testicles
  • Medical conditions such as diabetes, cystic fibrosis, certain types of autoimmune disorders, and certain types of infections may cause testicular failure.

Hormonal disorders

  • Improper function of the hypothalamus or pituitary glands. The hypothalamus and pituitary glands in the brain produce hormones that maintain normal testicular function. Production of too much prolactin, a hormone made by the pituitary gland (often due to the presence of a benign pituitary gland tumor), or other conditions that damage or impair the function of the hypothalamus or the pituitary gland may result in low or no sperm production.
  • These conditions may include benign and malignant (cancerous) pituitary tumors, congenital adrenal hyperplasia, exposure to too much estrogen, exposure to too much testosterone, Cushing’s syndrome, and chronic use of medications called glucocorticoids.

Genetic disorders

  • Genetic conditions such as a Klinefelter’s syndrome, Y-chromosome microdeletion, myotonic dystrophy, and other, less common genetic disorders may cause no sperm to be produced, or low numbers of sperm to be produced.

What increases a man’s risk of infertility?

  • Age. Although advanced age plays a much more important role in predicting female infertility, couples in which the male partner is 40 years old or older are more likely to report difficulty conceiving.
  • Being overweight or obese.
  • Smoking.
  • Excessive alcohol use.
  • Use of marijuana.
  • Exposure to testosterone. This may occur when a doctor prescribes testosterone injections, implants, or topical gel for low testosterone, or when a man takes testosterone or similar medications illicitly for the purposes of increasing their muscle mass.
  • Exposure to radiation.
  • Frequent exposure of the testes to high temperatures, such as that which may occur in men confined to a wheelchair, or through frequent sauna or hot tub use.
  • Exposure to certain medications such as flutamide, cyproterone, bicalutamide, spironolactone, ketoconazole, or cimetidine.
  • Exposure to environmental toxins including exposure to pesticides, lead, cadmium, or mercury.

What causes infertility in women?

Women need functioning ovaries, fallopian tubes, and a uterus to get pregnant. Conditions affecting any one of these organs can contribute to female infertility. Some of these conditions are listed below and can be evaluated using a number of different tests.

Disruption of ovarian function (presence or absence of ovulation (anovulation) and effects of ovarian “age”)

A woman’s menstrual cycle is, on average, 28 days long. Day 1 is defined as the first day of “full flow.” Regular predictable periods that occur every 24 to 32 days likely reflect ovulation. A woman with irregular periods is likely not ovulating.

Ovulation can be predicted by using an ovulation predictor kit and can be confirmed by a blood test to check the woman’s progesterone level on day 21 of her menstrual cycle. Although several tests exist to evaluate a woman’s ovarian function, no single test is a perfect predictor of fertility. The most commonly used markers of ovarian function include follicle stimulating hormone (FSH) value on day 3 to 5 of the menstrual cycle, anti-müllerian hormone value (AMH), and antral follicle count (AFC) using a transvaginal ultrasound.

Disruptions in ovarian function may be caused by several conditions and warrants an evaluation by a doctor.

When a woman doesn’t ovulate during a menstrual cycle, it’s called anovulation. Potential causes of anovulation include the following

  • Polycystic ovary syndrome (PCOS). PCOS is a condition that causes women to not ovulate, or to ovulate irregularly. Some women with PCOS have elevated levels of testosterone, which can cause acne and excess hair growth. PCOS is the most common cause of female infertility.
  • Diminished ovarian reserve (DOR). Women are born with all of the eggs that they will ever have, and a woman’s egg count decreases over time. Diminished ovarian reserve is a condition in which there are fewer eggs remaining in the ovaries than normal. The number of eggs a woman has declines naturally as a woman ages. It may also occur due to congenital, medical, surgical, or unexplained causes. Women with diminished ovarian reserve may be able to conceive naturally, but will produce fewer eggs in response to fertility treatments.
  • Functional hypothalamic amenorrhea (FHA). FHA is a condition caused by excessive exercise, stress, or low body weight. It is sometimes associated with eating disorders such as anorexia.
  • Improper function of the hypothalamus and pituitary glands. The hypothalamus and pituitary glands in the brain produce hormones that maintain normal ovarian function. Production of too much of the hormone prolactin by the pituitary gland (often as the result of a benign pituitary gland tumor), or improper function of the hypothalamus or pituitary gland, may cause a woman not to ovulate.
  • Premature ovarian insufficiency (POI). POI, sometimes referred to as premature menopause, occurs when a woman’s ovaries fail before she is 40 years of age. Although certain exposures, such as chemotherapy or pelvic radiation therapy, and certain medical conditions may cause POI, the cause is often unexplained. About 5% to10% of women with POI conceive naturally and have a normal pregnancy.
  • Menopause Menopause is an age-appropriate decline in ovarian function that usually occurs around age 50. By definition, a woman in menopause has not had a period in one year. She may experience hot flashes, mood changes, difficulty sleeping, and other symptoms as well.

Fallopian tube obstruction (whether fallopian tubes are open, blocked, or swollen)

Risk factors for blocked fallopian tubes (tubal occlusion) can include a history of pelvic infection, history of ruptured appendicitis, history of gonorrhea or chlamydia, known endometriosis, or a history of abdominal surgery.

Tubal evaluation may be performed using an X-ray that is called a hysterosalpingogram (HSG), or by chromopertubation (CP) in the operating room at time of laparoscopy, a surgical procedure in which a small incision is made and a viewing tube called a laparoscope is inserted.

  • Hysterosalpingogram (HSG) is an X-ray of the uterus and fallopian tubes. A radiologist injects dye into the uterus through the cervix and simultaneously takes X-ray pictures to see if the dye moves freely through fallopian tubes. This helps evaluate tubal caliber (diameter) and patency.
  • Chromopertubation is similar to an HSG but is done in the operating room at the time of a laparoscopy. Blue-colored dye is passed through the cervix into the uterus and spillage and tubal caliber (shape) is evaluated.

Abnormal uterine contour (physical characteristics of the uterus)

Depending on a woman’s symptoms, the uterus may be evaluated by transvaginal ultrasound to look for fibroids or other anatomic abnormalities. If suspicion exists that the fibroids may be entering the endometrial cavity, a sonohystogram (SHG) or hysteroscopy (HSC) may be performed to further evaluate the uterine environment.

What increases a woman’s risk of infertility?

Female fertility is known to decline with

  • Age. More women are waiting until their 30s and 40s to have children. In fact, about 20% of women in the United States now have their first child after age 35. About one-third of couples in which the woman is older than 35 years have fertility problems. Aging not only decreases a woman’s chances of having a baby, but also increases her chances of miscarriage and of having a child with a genetic abnormality.
  • Aging decreases a woman’s chances of having a baby in the following ways:
    • She has a smaller number of eggs left.
    • Her eggs are not as healthy.
    • She is more likely to have health conditions that can cause fertility problems.
    • She is more likely to have a miscarriage.
  • Smoking.
  • Excessive alcohol use.
  • Extreme weight gain or loss.
  • Excessive physical or emotional stress that results in amenorrhea (absent periods).

How long should couples try to get pregnant before seeing a doctor?

Most experts suggest at least one year for women younger than age 35. However, for women aged 35 years or older, couples should see a health care provider after 6 months of trying unsuccessfully. A woman’s chances of having a baby decrease rapidly every year after the age of 30.

Some health problems also increase the risk of infertility. So, couples with the following signs or symptoms should not delay seeing their health care provider when they are trying to become pregnant

  • Irregular periods or no menstrual periods.
  • Very painful periods.
  • Endometriosis.
  • Pelvic inflammatory disease.
  • More than one miscarriage.
  • Suspected male factor (i.e., history of testicular trauma, hernia surgery, chemotherapy, or infertility with another partner).

It is a good idea for any woman and her partner to talk to a health care provider before trying to get pregnant. They can help you get your body ready for a healthy baby, and can also answer questions on fertility and give tips on conceiving. Learn more at the CDC’s Preconception Health Web site.

How will doctors find out if a woman and her partner have fertility problems?

Doctors will begin by collecting a medical and sexual history from both partners. The initial evaluation usually includes a semen analysis, a tubal evaluation, and ovarian reserve testing.

How do doctors treat infertility?

Infertility can be treated with medicine, surgery, intrauterine insemination, or assisted reproductive technology.

Often, medication and intrauterine insemination are used at the same time. Doctors recommend specific treatments for infertility on the basis of

  • The factors contributing to the infertility.
  • The duration of the infertility.
  • The age of the female.
  • The couple’s treatment preference after counseling about success rates, risks, and benefits of each treatment option.

What are some of the specific treatments for male infertility?

Male infertility may be treated with medical, surgical, or assisted reproductive therapies depending on the underlying cause. Medical and surgical therapies are usually managed by an urologist who specializes in infertility. A reproductive endocrinologist may offer intrauterine inseminations (IUIs) or in vitro fertilization (IVF) to help overcome male factor infertility.

What medicines are used to treat infertility in women?

Some common medicines used to treat infertility in women include

  • Clomiphene citrate (Clomid®*) is a medicine that causes ovulation by acting on the pituitary gland. It is often used in women who have polycystic ovary syndrome (PCOS) or other problems with ovulation. It is also used in women with normal ovulation to increase the number of mature eggs produced. This medicine is taken by mouth.
  • Letrozole (Femara ®*) is a medication that is frequently used off-label to cause ovulation. It works by temporarily lowering a woman’s progesterone level, which causes the brain to naturally make more FSH. It is often used to induce ovulation in woman with PCOS, and in women with normal ovulation to increase the number of mature eggs produced in the ovaries.
  • Human menopausal gonadotropin or hMG (Menopur®*; Repronex®*; Pergonal®*) is a medication often used for women who don’t ovulate because of problems with their pituitary gland—hMG acts directly on the ovaries to stimulate development of mature eggs. It is an injectable medicine.
  • Follicle-stimulating hormone or FSH (Gonal-F®*; Follistim®*) is a medication that works much like hMG. It stimulates development of mature eggs within the ovaries. It is an injectable medication.
  • Gonadotropin-releasing hormone (GnRH) analogs and GnRH antagonists are medications that act on the pituitary gland to prevent a woman from ovulating. They are used during in vitro fertilization cycles, or to help prepare a woman’s uterus for an embryo transfer. These medications are usually injected or given with a nasal spray.
  • Metformin (Glucophage®*) is a medicine doctors use for women who have insulin resistance or diabetes and PCOS. This drug helps lower the high levels of male hormones in women with these conditions. This helps the body to ovulate. Sometimes clomiphene citrate or FSH is combined with metformin. This medicine is taken by mouth.
  • Bromocriptine (Parlodel®*) and Cabergoline (Dostinex ®*) are medications used for women with ovulation problems because of high levels of prolactin.

*Note: Use of trade names and commercial sources is for identification only and does not imply endorsement by the US. Department of Health and Human Services.

Many fertility drugs increase a woman’s chance of having twins, triplets, or other multiples. Women who are pregnant with multiple fetuses may have more problems during pregnancy. Multiple fetuses have a higher risk of being born prematurely (too early). Premature babies are at a higher risk of health and developmental problems.

What is intrauterine insemination (IUI)?

Intrauterine insemination (IUI) is an infertility treatment that is often called artificial insemination. In this procedure, specially prepared sperm are inserted into the woman’s uterus. Sometimes the woman is also treated with medicines that stimulate ovulation before IUI.

IUI is often used to treat

  • Mild male factor infertility.
  • Couples with unexplained infertility.

What is assisted reproductive technology (ART)?

Assisted Reproductive Technology (ART) includes all fertility treatments in which both eggs and embryos are handled outside of the body. In general, ART procedures involve removing mature eggs from a woman’s ovaries using a needle, combining the eggs with sperm in the laboratory, and returning the embryos to the woman’s body or donating them to another woman. The main type of ART is in vitro fertilization (IVF).

How often is assisted reproductive technology (ART) successful?

Success rates vary and depend on many factors, including the clinic performing the procedure, the infertility diagnosis, and the age of the woman undergoing the procedure. This last factor—the woman’s age—is especially important.

CDC collects success rates on ART for some fertility clinics. According to the CDC’s 2015 ART Success Rates, the average percentage of fresh, nondonor ART cycles that led to a live birth were

  • 38% in women younger than 35 years of age.
  • 32% in women aged 35 to 37 years.
  • 23% in women aged 38 to 40 years.
  • 14% in women aged 41 to 42 years.
  • 7% in women aged 43 to 44 years.
  • 3% in women older than 44 years of age.

Success rates also vary from clinic to clinic and with different infertility diagnoses.

ART can be expensive and time-consuming, but it has allowed many couples to have children that otherwise would not have been conceived. The most common complication of ART is a multiple pregnancy. This is a problem that can be prevented or minimized by limiting the number of embryos that are transferred back to the uterus. For example, transfer of a single embryo, rather than multiple embryos, greatly reduces the chances of a multiple pregnancy and its risks such as preterm birth.

ART Success Rates

What are the different types of assisted reproductive technology (ART)?

  • In vitro fertilization (IVF), meaning fertilization outside of the body, is the most effective and the most common form of ART.
  • Intracytoplasmic sperm injection (ICSI) is a type of IVF that is often used for couples with male factor infertility. With ICSI, a single sperm is injected into a mature egg. The alternative to ICSI is “conventional” fertilization where the egg and many sperm are placed in a petri dish together and the sperm fertilizes an egg on its own.

Older ART methods that are rarely used in the United States today include

  • Zygote intrafallopian transfer (ZIFT) or tubal embryo transfer. This is similar to IVF. Fertilization occurs in the laboratory. Then the very young embryo is transferred to the fallopian tube instead of the uterus.
  • Gamete intrafallopian transfer (GIFT), involves transferring eggs and sperm into the woman’s fallopian tube. Fertilization occurs in the woman’s body.

ART procedures sometimes involve the use of donor eggs (eggs from another woman), donor sperm, or previously frozen embryos. Donor eggs are sometimes used for women who cannot produce eggs. Also, donor eggs or donor sperm are sometimes used when the woman or man has a genetic disease that can be passed on to the baby. An infertile woman or couple may also use donor embryos. These are embryos that were either created by couples in infertility treatment or were created from donor sperm and donor eggs. The donated embryo is transferred to the uterus. The child will not be genetically related to either parent.

Gestational Carrier

Women with ovaries but no uterus may be able to use a gestational carrier. This may also be an option for women who shouldn’t become pregnant because of a serious health problem. In this case, a woman uses her own egg. It is fertilized by her partner’s sperm and the embryo is placed inside the carrier’s uterus.

Related links

  • Trying to Get Pregnant? – (March of Dimes)
  • Infertility – (MedlinePlus)
  • RESOLVE: The National Infertility Association – RESOLVE is a national consumer organization that offers support for men and women dealing with infertility. Their purpose is to provide timely, compassionate support and information to people who are experiencing infertility and to increase awareness of infertility issues through public education and advocacy.
  • Path 2 Parenthood – Path2Parenthood (P2P) is nonprofit organization that helps people create their families by providing outreach programs and educational information.
  • PCOS Challenge – PCOS Challenge is a support organization for women with polycystic ovary syndrome.
  • American Society for Reproductive Medicine -The American Society for Reproductive Medicine (ASRM) is a multidisciplinary organization that provides information, education, advocacy, and standards in reproductive medicine.
  • Society for Assisted Reproductive Technology – The Society for Assisted Reproductive Technology (SART) promotes and advances the standards for the practice of assisted reproductive technology to the benefit of patients, members, and society at large.
  • American Urological Association – The American Urological Association promotes the highest standards of urological clinical care through education, research and the formulation of health care policy.
  • Urology Care Foundation – The official foundation of the American Urological Association provides educational services and referrals to benefit patients with male infertility, and is committed to advancing urologic research and education to improve patient’s lives.
  • CDC’s National Assisted Reproductive Technology Surveillance System – CDC’s Division of Reproductive Health collects and publishes information on assisted reproductive technology (ART) procedures performed in US fertility clinics. The reports include individual clinic tables that provide ART success rates and other information from each clinic.
  • Human Cell, Tissues, and Cellular and Tissue-Based Products – A list of ART clinics registered with FDA.
Content provided and maintained by the US Centers for Disease Control and Prevention (CDC). Please see our system usage guidelines and disclaimer.