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.
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A Woman’s Story of Overcoming PCOS | 20 (plus) things you Need to Know

If you are looking for the stuff you “need to know” from the title, it’s further on down in the article.  In observance of PCOS Awareness Month, we thought we would share the true story of a young woman living with polycystic ovary syndrome (PCOS).  I know her well but interviewed her for the article anyway.  She’s my super cool middle, Delaney.

Delaney grew up a very active, wonderfully gregarious kid who moved around a few times with the Navy until we exited and settled in SoCar – that’s South Carolina, for those who don’t know.  A natural athlete, fast, nimble and taller than her peers, she quickly found herself to be a standout soccer player.  She didn’t know she couldn’t score every time she had the ball at her feet, and so she did.  Because she was quick and had incredible endurance, she also was recruited by the track coach to run the varsity 800m in seventh grade, along with a teammate who was her opposite on the field.

But soccer was her thing, and she eventually dropped the spikes to focus solely on futbol.  Running upwards of 8 miles every day in practice – anywhere from trotting to full Sprint, even backwards and sideways as an outside midfielder, she was fit in all the ways a peak performing Athlete would be.  To fuel it all, she would eat FOUR big meals every day – each bigger than those her 220 lbs weight Training father would consume.  She ate it and burned it with a ferocity on the Field we all admired.

Attack, fight, victory was her personal motto, in everything and in all ways.  Then came college.  She decided to focus on her studies and didn’t go out for the team.  In fact, just about every bit of working out came to a screeching halt.  And then, her period stopped….for a full year.

She had gained the average “freshman fifteen”, which wasn’t surprising when considering her eating habits, if anything, were filling her with added calories, and she had stopped using those calories on the field.  So, if she had always had her period as an athlete and now had even more body fat, why was she experiencing amenorrhea  (the technical term for missing your period)?   Stress?  All the life changes in general?  Purely hormonal?

Poly cystic ovarian syndrome is, at its most basic level, a hormonal imbalance, where too much of the “male” hormones are produced in a female.  While the only apparent symptom she displayed at the time was amenorrhea, her ever diligent homeopathic healer in residence, aka, her mom, was convinced she had PCOS.

First stop, her old pediatrician, who told her everything was normal; but she could go on birth control to start her period again.  After all, having one is important for so many other things in a young woman’s life, like the other hormones it generates that aid in creating increased bone density.

Not enough info, so on to an Ob/Gyn.  There, the feedback was little more along the lines of what her mom had already assumed, but they were even skeptical.  “So, let’s get an ultrasound,” my wife suggested.  The physician said you couldn’t see PCOS on an ultrasound.  As a DMS, my wife knew better.

On ultrasound, it was clear her ovaries were encased in cysts.  They were covered in follicles too numerous to count – today, 20 on an ovary will typically be used as a clear diagnosis.

Diagnosis in hand, the physician gave her the long list of troubles she was set to endure in her life – infertility, type II diabetes, a constant struggle with weight gain, hirsutism, and skin issues to name a few.  And, as if on queue, while the lack of period was the only thing she went to the physician for, she began to experience all of the negative symptoms save diabetes.

“I started to use PCOS as an excuse to eat whatever I wanted,” she says today.  “I just stopped caring about what I put in my body,” and she may have even begun to somewhat celebrate the new-found freedom from lack of discipline around diet.  Pictures of food became the standard in her social feed, and she did start to suffer the weight gain her MD predicted.  Along with that came the added pain of body image issues.

She started taking birth control to manage her cycle, and it worked.  At least, it did ensure she became regular; but deep down inside, she knew it wasn’t fixing the problem.  “I knew it was a bandaid put on to cover what was really wrong, so I quit after a year.  It wasn’t really doing anything.  It definitely was not helping fix whatever was at the root,” she said to me this Labor Day morning.

She finished college as a star student, winning all but one of the math awards given out by the University of South Carolina.  I guess I forgot to mention, she’s also brilliant, and I am very proud, of her and all of our kids.  On to New York City!

Always called to serve, Delaney decided to teach in the high schools of the Bronx.  She was not sure if it was the added stress or the increased disregard for dietary discipline, but she added even more weight with the move, though she began to workout more than before.  And, the skin issues and extra hair growth kicked in….

“I began to understand I had to do something.  Thankfully, Mom has always been a huge proponent of natural healing, so I started a few different regiments of eating more mindfully and living more intentionally,” Delaney says now.  She went through a few rounds of Whole 30, and really started to stop eating when full.  “I used to empty my plate, no matter what;… but now come home with leftovers routinely,” she says.  “If I want to have pizza, I still have pizza.  I just don’t eat a WHOLE pizza.”

The changes in diet and exercise, along with a few other healthy changes in her life, over a two-year period, have restored this vivacious young lady to the same level of health she had when she entered college in 2011.  She would say her PCOS is in remission.

“I still wonder, on occasion, about my ability to have a family; but, since my cycle is normal, naturally, I am ovulating, and my health is optimized, I think that won’t be a problem, either.”  We hope not!  We love grandkids!

Delaney would tell anyone asking her results may not be normal.  She would encourage you to seek to control PCOS in the most natural ways possible – through diet, exercise and healthy living – but she also acknowledges those methods may not be for everyone.  Definitely seek medical counsel.

So, What Is PCOS, Really?

Polycystic ovary syndrome is a hormonal condition. Hormones are substances your body makes to help make different processes happen. Some are related to your ability to have a baby, and also affect your menstrual cycle. Those that are involved in PCOS include.

  • Androgens: Often called “male” hormones, women have them, too. Those with PCOS tend to have higher levels, which can cause symptoms like hair loss, hair in places you don’t want it (such as on your face), and trouble getting pregnant.
  • Insulin: This hormone manages your blood sugar. If you have PCOS, your body might not react to insulin the way that it should.
  • Progesterone: With PCOS, your body may not have enough of this hormone. That can make you to miss your periods for a long time, or to have periods that are hard to predict.

With PCOS, your reproductive hormones are out of balance. This can lead to problems with your ovaries, such as not having your period on time, or missing it entirely.  In women who have it, it can:

  • Affect your ability to have a child (fertility)
  • Make your periods stop or become difficult to predict
  • Cause acneand unwanted hair
  • Raise your chances for other health problems, including diabetesand high blood pressure

There are treatments for the symptoms, and if you want to get pregnant, that’s still possible, though you may need to try different methods.  Many women who have PCOS don’t have cysts on their ovaries, so “polycystic” can be misleading. You might have cysts, and you might not.

What Are the Symptoms of PCOS?

If you have things such as oily skin, missed periods, or trouble losing weight, you may think those issues are just a normal part of your life. But those frustrations could actually be signs that you have polycystic ovary (or ovarian) syndrome, also known as PCOS.

The condition has many symptoms, and you may not have all of them. It’s pretty common for it to take women a while – even years – to find out they have this condition.

Things You Might Notice

You might be most bothered by some of the PCOS symptoms that other people can notice. These include:

  • Hair growth in unwanted areas. Your doctor may call this “hirsutism” (pronounced HUR-soo-tiz-uhm). You might have unwanted hair growing in places such as on your face or chin, breasts, stomach, or thumbs and toes.
  • Hair loss. Women with PCOS might see thinning hair on their head, which could worsen in middle age.
  • Weight problems. About half of women with PCOS struggle with weight gain or have a tough time losing weight.
  • Acne or oily skin. Because of hormone changes related to PCOS, you might develop pimples and oily skin. (You can have these  PCOS, of course).
  • Problems sleeping, feeling tired all the time. You could have trouble falling asleep. Or you might have a disorder known as sleep apnea. This means that even when you do sleep, you do not feel well-rested after you wake up.
  • Headaches. This is because of hormone changes with PCOS.
  • Trouble getting pregnant. PCOS is one of the leading causes of infertility.
  • Period problems. You could have irregular periods. Or you might not have a period for several months. Or you might have very heavy bleeding during your period.

How Do I Know If I Have PCOS?

There’s no single test that, by itself, shows whether you have polycystic ovary syndrome, or PCOS. Your doctor will ask you about your symptoms and give you a physical exam and blood tests to help find out if you have this condition.

PCOS is a common hormone disorder that can cause problems with your period, fertility, weight, and skin. It can also put you at risk for other conditions, such as type 2 diabetes. If you have it, the sooner you find out, the sooner you can start treatment.

What Your Doctor Will ask

Your doctor will want to know about all the signs and symptoms you’ve noticed. This is an important step to help figure out whether you have PCOS, and to rule out other conditions that cause similar symptoms.

You’ll need to answer questions about your family’s medical history, including whether your mother or sister has PCOS or problems getting pregnant. This information is helpful — PCOS tends to run in families.

Be ready to discuss any period problems you’ve had, weight changes, and other concerns.

Your doctor may diagnose PCOS if you have at least two of these symptoms:

  • Irregular periods
  • Higher levels of androgen (male hormones) shown in blood tests or through symptoms like acne, male-pattern balding, or extra hair growth on your face, chin, or body
  • Cysts in your ovaries as shown in an ultrasound exam

What’s the Treatment for PCOS?

Treatments can help you manage the symptoms of polycystic ovary syndrome (PCOS) and lower your odds for long-term health problems such as diabetes and heart disease.

You and your doctor should talk about what your goals are, then you can come up with a treatment plan. For example, if you want to get pregnant and are having trouble, then your treatment would focus on helping you conceive. If you want to tame PCOS-related acne, your treatment would be geared toward skin problems.

Healthy Habits

  • One of the best ways to deal with PCOSis to eat well and exercise
  • Many women with PCOS are overweightor obese. Losing just 5% to 10% of your body weight may ease some symptoms and help make your periods more regular. It may also help manage problems with blood sugar levels and ovulation.
  • Since PCOS could lead to high blood sugar, your doctor may want you to limit starchy or sugary foods. Instead, eat foods and meals that have plenty of fiber, which raise your blood sugarlevel slowly.
  • Staying active helps you control your blood sugar and insulin, too. And exercisingevery day will help you with your weight.
  • Staying active helps you control your blood sugar and insulin, too. And exercisingevery day will help you with your weight.

Hormone Treatments and Medication

Birth control is the most common PCOS treatment for women who don’t want to get pregnant. Hormonal birth control — pills, a skin patch, vaginal ring, shots, or a hormonal IUD (intrauterine device) — can help restore regular periods. The hormones also treat acne and unwanted hair growth.

These birth control methods may also lower your chance of having endometrial cancer, in the inner lining of the uterus.

Taking just a hormone called progestin could help get your periods back on track. It doesn’t prevent pregnancies or treat unwanted hair growth and acne. But it can lower the chance of uterine cancer.

Metformin (Fortamet, Glucophage) lowers insulin levels. It can help with weight loss and may prevent you from getting type 2 diabetes. It may also make you more fertile.

If birth control doesn’t stop hair growth after 6 months, your doctor may prescribe spironolactone (Aldactone). It lowers the level of a type of sex hormone called androgens. But you shouldn’t take it if you’re pregnant or plan to become pregnant, because it can cause birth defects.

Weight Loss

When a healthy diet and regular exercise aren’t enough, medications can make losing weight easier. Different drugs work in different ways. For example, orlistat (Alli, Xenical) stops your body from digesting some of the fat in your food, so it may also improve your cholesterol levels. Lorcaserin (Belviq) makes you feel less hungry. Your doctor will prescribe the medication they think will be the most successful for you.

Weight loss surgery could help if you’re severely obese and other methods haven’t worked. The change in your weight afterward can regulate your menstrual cycle and hormones and cut your odds of having diabetes.

Hair Removal

Products called depilatories, including creams, gels, and lotions, break down the protein structure of hair so it falls out of the skin. Follow the directions on the package.

A process like electrolysis (a way to remove individual hairs by using an electric current to destroy the root) or laser therapy destroys hair follicles. You’ll need several sessions, and though some hair may come back, it should be finer and less noticeable.

Fertility

Your doctor may prescribe medication to help you get pregnant. Clomiphene and letrozole encourage steps in the process that trigger ovulation. If they don’t work, you can try shots of hormones called gonadotropins.

A surgery called ovarian drilling might make your ovaries work better when ovulation medications don’t, but it’s being done less often than it used to. The doctor makes a small cut in your belly and uses a tool called a laparoscope with a needle to poke your ovary and wreck a small part of it. The procedure changes your hormone levels and may make it easier for you to ovulate.

With in vitro fertilization, or IVF, your egg is fertilized outside of your body and then placed back inside your uterus. This may be the best way to get pregnant when you have PCOS, but it can be expensive.

What Are the Complications of PCOS?

If you have polycystic ovary syndrome, your ovaries may contain many tiny cysts that cause your body to produce too many hormones called androgens.

In men, androgens are made in the testes. They’re involved in the development of male sex organs and other male characteristics, like body hair. In women, androgens are made in the ovaries, but are later turned into estrogens. These are hormones that play a vital role in the reproductive system, as well as the health of your heart, arteries, skin, hair, brain, and other body parts and systems.

If you have PCOS and your androgen levels are too high, you have higher odds for a number of possible complications. (These may differ from woman to woman):

Trouble Getting Pregnant

  • Cysts in the ovaries can interfere with ovulation. That’s when one of your ovaries releases an egg each month. If a healthy egg isn’t available to be fertilized by a sperm, you can’t get pregnant.
  • You may still be able to get pregnant if you have PCOS. But you might have to take medicine and work with a fertility specialist to make it happen.

Insulin Issues

Doctors aren’t sure what causes PCOS. One theory is that insulin resistance may cause your body to make too many androgens.

Insulin is a hormone that helps the cells in your body absorb sugar (glucose) from your blood to be used as energy later. If you have insulin resistance, the cells in your muscles, organs, and other tissue don’t absorb blood sugar very well. As a result, you can have too much sugar moving through your bloodstream. This is called diabetes, and it can cause problems with your cardiovascular and nervous systems.

Other Possible Problems

You might have metabolic syndrome. This is a group of symptoms that raise the risk of cardiovascular disease, such as high triglyceride and low HDL (“good”) cholesterol levels, high blood pressure, and high blood sugar levels.  Other common complications of PCOS include:

  • Depression
  • Anxiety
  • Bleeding from the uterus and higher risk of uterine cancer
  • Sleep problems
  • Inflammation of the liver

Some complications of PCOS may not be serious threats to your health, but they can be unwanted and embarrassing:

  • Abnormal body or facial hair growth
  • Thinning hair on your head
  • Weight gain around your middle
  • Acne, dark patches, and other skin problems

Most women at some point have to contend with weight, but for women with polycystic ovary syndrome(PCOS), losing weight can become a constant struggle.

PCOS is the most common hormonal disorder in women of childbearing age and can lead to issues with fertility. Women who have PCOS have higher levels of male hormones and are also less sensitive to insulin or are “insulin-resistant.” Many are overweight or obese. As a result, these women can be at a higher risk of diabetes, heart disease, sleep apnea, and uterine cancer.

If you have PCOS, certain lifestyle changes can help you shed pounds and reduce the disease’s severity.

Why does polycystic ovary syndrome cause weight gain?

PCOS makes it more difficult for the body to use the hormone insulin, which normally helps convert sugars and starches from foods into energy. This condition — called insulin resistance– can cause insulin and sugar — glucose — to build up in the bloodstream.

High insulin levels increase the production of male hormones called androgens. High androgen levels lead to symptoms such as body hair growth, acne, irregular periods — and weight gain. Because the weight gain is triggered by male hormones, it is typically in the abdomen. That is where men tend to carry weight. So, instead of having a pear shape, women with PCOS have more of an apple shape.

Abdominal fat is the most dangerous kind of fat. That’s because it is associated with an increased risk of heart disease and other health conditions.

What are the risks associated with PCOS-related weight gain?

No matter what the cause, weight gain can be detrimental to your health. Women with PCOS are more likely to develop many of the problems associated with weight gain and insulin resistance, including:

  • Type 2 diabetes
  • High cholesterol
  • High blood pressure
  • Sleep apnea
  • Infertility
  • Endometrial cancer

Many of these conditions can lead to heart disease. In fact, women with PCOS are four to seven times more likely to have a heart attack than women of the same age without the condition.

Experts think weight gain also helps trigger PCOS symptoms, such as menstrual abnormalities and acne.

What can I do to lose weight if I have polycystic ovary syndrome?

Losing weight not only cuts your risk for many diseases, it can also make you feel better. When you have PCOS, shedding just 10% of your body weight can bring your periods back to normal. It can also help relieve some of the symptoms of polycystic ovary syndrome.

Weight loss can improve insulin sensitivity. That will reduce your risk of diabetes, heart disease, and other PCOS complications.

To lose weight, start with a visit to your doctor. The doctor will weigh you and check your waist size and body mass index. Body mass index is also called BMI, and it is the ratio of your height to your weight.

Your doctor may also prescribe medication. Several medications are approved for PCOS, including birth control pills and anti-androgen medications. The anti-androgen medications block the effects of male hormones. A few medications are used specifically to promote weight loss in women with PCOS. These include:

  • Metformin (Glucophage). Metformin is a diabetes drug that helps the body use insulin more efficiently. It also reduces testosterone production. Some research has found that it can help obese women with PCOS lose weight.
  • Thiazolidinediones. These should be used with contraception. The drugs pioglitazone (Actos) and rosiglitazone (Avandia) also help the body use insulin. In studies, these drugs improved insulin resistance. But their effect on body weight is unclear. All patients using Avandia must review and fully understand the cardiovascular risks. Research has found that Flutamide (Eulexin), an anti-androgen drug, helps obese women with PCOS lose weight. It also improves their blood sugar levels. The drug can be given alone or with metformin.

In addition to taking medication, adding healthy habits into your lifestyle can help you keep your weight under control:

  • Eat a high-fiber, low-sugar diet. Load up on fruits, vegetables, and whole grains. Avoid processed and fatty foods to keep your blood sugar levels in check. If you’re having trouble eating healthy on your own, talk to your doctor or a dietitian.
  • Eat four to six small meals throughout the day, rather than three large meals. This will help control your blood sugar levels.
  • Exercise for at least 30 minutes a day on most, if not all, days of the week.
  • Work with your doctor to track your cholesterol and blood pressure levels.
  • If you smoke, get involved in a program that can help you quit.

PCOS and Your Fertility — and What You Can Do About It

One of the most common reasons a woman has trouble getting pregnant is a condition called polycystic ovary syndrome (PCOS).  It’s a hormone problem that interferes with the reproductive system.   When you have PCOS, your ovaries are larger than normal. These bigger ovaries can have many tiny cysts that contain immature eggs.

Hormone Differences

PCOS causes a woman’s body to produce higher-than-normal levels of androgens. These are hormones that are usually thought of as male hormones, because men have much higher levels of androgens than women.

Androgens are important in the development of male sex organs and other male traits.  In women, androgens are usually converted into the hormone estrogen.

Ovulation Problems

Elevated levels of androgens interfere with the development of your eggs and the regular release of your eggs. This process is called ovulation.

If a healthy egg isn’t released, it can’t be fertilized by sperm, meaning you can’t get pregnant. PCOS can cause you to miss your menstrual period or have irregular periods. This can be one of the first signs that you may have a problem such as PCOS.

Regulating Your Period

Fortunately, there are some treatments that can help women with PCOS have healthy pregnancies.

Your doctor may prescribe birth control pills that contain man-made versions of the hormones estrogen and progestin. These pills can help regulate your menstrual cycle by reducing androgen production.

If you cannot tolerate a combination birth control pill, your doctor might recommend a progestin-only pill.

You take this pill for about 2 weeks a month, for about 1-2 months. It’s also designed to help regulate your period.

Medicines to Help You Ovulate

You won’t be able to get pregnant while you’re taking birth control pills for PCOS. But if you need help ovulating so that you can become pregnant, certain medicines may help:

  • Clomiphene is an anti-estrogen drug that you take at the beginning of your cycle.
  • If clomiphene doesn’t help with ovulation, you may be prescribed the diabetes drug metformin.
  • If clomiphene and metformin don’t work, your doctor may prescribe a medication containing a follicle-stimulating hormone (FSH) and a luteinizing hormone (LH). You get this medicine in a shot.
  • One other drug that helps with ovulation is letrozole. It’s sometimes used when other medications aren’t effective.

If you have PCOS and you want to get pregnant, you should work with a doctor who is a specialist in reproductive medicine. This type of doctor is also known as a fertility specialist.

A specialist will help make sure you get the right dose of medicines, help with any problems you have, and schedule regular checkups and ultrasounds to see how you’re doing. (An ultrasound is a machine that uses sound waves to create images of the inside of your body. It’s a painless procedure that can track the growth and development of your baby).

Lifestyle Changes

For some women, gaining a lot of weight can affect their hormones. In turn, losing weight, if you’re obese or overweight, may help get your hormones back to normal levels. Losing 10% of your body weight may help your menstrual cycle become more predictable. This should help you get pregnant.

In general, living a healthier lifestyle with a better diet, regular exercise, no smoking, less stress, and control of diabetes and other medical conditions should improve your fertility odds.

Remember, if your period isn’t happening when it should, or you’ve already been diagnosed with PCOS, work closely with your doctor to help get it under control. And if you want to get pregnant, talk with a fertility specialist.

Getting Help  

If you’re having irregular periods or are unable to get pregnant, see your doctor. The same holds for:

  • Mood changes
  • Unexplained weight gain
  • Changes in your hair or skin

These symptoms may might not be caused by PCOS but could signal other serious health issues.

If anything is this article sounds like something you are dealing with, get connected with a doctor in your area who can help.  Using HealthLynked, you can find a physician and securely share relevant health information with them, collaborating more closely on your healthcare than ever before possible.

Ready to get Lynked?  Sign up today for Free at HealthLynked.com!

Adapted from – WebMd

10 Facts about A [little] Fib that May Surprise You

Atrial fibrillation, also called AF or AFib, is the most common type of heart rhythm disorder. People with this condition are at higher risk for serious medical complications, such as dementia, heart failure, stroke, or even death. Too many of those affected by the condition don’t realize that they have it, and many who have it don’t realize the seriousness of the affliction. All too often, healthcare providers may also minimize the effects of the condition.

September is Atrial Fibrillation Awareness Month, designated to help patients and healthcare providers learn more about this complex condition. In addition to stroke prevention, additional know-how can improve the overall wellness of those suffering from AFib. Often, those with AFib have a lower quality of life than those who have suffered a heart attack. And, unfortunately, some healthcare providers may not know about treatment options that can essentially put a stop to the condition.

For those who have AFib, seeking information about the ailment and  finding early treatment are imperative. The longer someone has AFib, the more likely they will convert from intermittent AFib to enduring it all the time, making it much more difficult to stop or cure.

What is atrial fibrillation?

Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications.  A racing, pounding heartbeat that happens for no apparent reason should not be ignored, especially when other symptoms are also present — like shortness of breath with light physical activity or lightheadedness, dizziness, or unusual fatigue. AFib occurs when the heart muscles fail to contract in a strong, rhythmic way. When a heart is in AFib, it may not be pumping enough oxygen-rich blood out to the body.

Why is AFib associated with a five-times-greater risk for stroke?

When the heart is in AFib, the blood can become static and can be left pooling inside the heart. When blood pools, a clot can form. When a clot is pumped out of the heart, it can get lodged in the arteries which may cause a stroke. Blocked arteries prevent the tissue on the other side from getting oxygen-rich blood, and without oxygen the tissue dies.

Any person who has AFib needs to evaluate stroke risks and determine with a healthcare provider what must be done to lower the risks. Studies show that many people with AFib who need risk-lowering treatments are not getting them. Learn more about stroke risks with the CHA2DS2–VASc tool.

If I don’t have these symptoms, should I be concerned?

There are people who have atrial fibrillation that do not experience noticeable symptoms. These people may be diagnosed at a regular check-up or their AFib may be discovered when a healthcare provider listens to their heart for some other reason.

However, people who have AFib with no symptoms still have a five-times-greater risk of stroke. Everyone needs to receive regular medical check-ups to help keep risks low and live a long and healthy life.  Many may experience one or more of the following symptoms:

  • General fatigue
  • Rapid and irregular heartbeat
  • Fluttering or “thumping” in the chest
  • Dizziness
  • Shortness of breath and anxiety
  • Weakness
  • Faintness or confusion
  • Fatigue when exercising
  • Sweating
  • Chest pain or pressure

Are there different types of AFib?

The symptoms are generally the same; however, the duration of the AFib and underlying reasons for the condition help medical practitioners classify the type of AFib problems.

  • Paroxysmal fibrillation is when the heart returns to a normal rhythm on its own, or with intervention, within 7 days of its start. People who have this type of AFib may have episodes only a few times a year or their symptoms may occur every day. These symptoms are very unpredictable and often can turn into a permanent form of atrial fibrillation.
  • Persistent AFib is defined as an irregular rhythm that lasts for longer than 7 days. This type of atrial fibrillation will not return to normal sinus rhythm on its own and will require some form of treatment.
  • Long-standing AFib is when the heart is consistently in an irregular rhythm that lasts longer than 12 months.
  • Permanent AFib occurs when the condition lasts indefinitely and the patient and doctor have decided not to continue further attempts to restore normal rhythm.
  • Nonvalvular AFib is atrial fibrillation not caused by a heart valve issue.

Over a period of time, paroxysmal fibrillation may become more frequent and longer lasting, sometimes leading to permanent or chronic AFib. All types of AFib can increase your risk of stroke. Even if you have no symptoms at all, you are nearly 5 times more likely to have a stroke than someone who doesn’t have atrial fibrillation.

How are heart attack symptoms different from AFib symptoms?

Fluttering and palpitations are key symptoms of AFib and are the key differences, but many heart problems have similar warning signs. If you think you may be having a heart attack, DON’T DELAY. Get emergency help by calling 9-1-1 immediately. A heart attack is a blockage of blood flow to the heart, often caused by a clot or build-up of plaque lodging in the coronary artery (a blood vessel that carries blood to part of the heart muscle). A heart attack can damage or destroy part of your heart muscle. Some heart attacks are sudden and intense — where no one doubts what’s happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help.

People living with AFib should know the Warning Sings

As stated earlier, having atrial fibrillation can put you at an increased risk for stroke. Here are the warning signs that you should be aware of:

Heart Attack Warning Signs

Chest Discomfort

Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

Discomfort in Other Areas of the Upper Body

Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Shortness of Breath

With or without chest discomfort.

Other Signs

May include breaking out in a cold sweat, nausea or lightheadedness.

Stroke Warning Signs

Spot a stroke F.A.S.T.:

  • Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile.
  • Arm Weakness : Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
  • Speech Difficulty: Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence, like “the sky is blue.” Is the sentence repeated correctly?
  • Time to call 9-1-1: If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately.

Call 9-1-1 immediately if you notice one or more of these symptoms, even if they are temporary or seem to disappear.

10 ATRIAL FIBRILLATION FACTS THAT MAY SURPRISE YOU

  1. AFib affects lots of people.  Currently as many as 5.1 million people are affected by AFib — and that’s just in America. By 2050, the number of people in the United States with AFib may increase to as many as 15.9 million. About 350,000 hospitalizations a year in the U.S. are attributed to AFib.  In addition, people over the age of 40 have a one in four chance of developing AFib in their lifetime.
  2. AFib is a leading cause of strokes.  Nearly 35 percent of all AFib patients will have a stroke at some time. In addition to leaving sufferers feeling weak, tired or even incapacitated, AFib can allow blood to pool in the atria, creating blood clots, which may move throughout the body, causing a stroke. To make matters worse, AFib strokes are fatal nearly three times as often as other strokes within the first 30 days. And according to a recent American Heart Association survey, only half of AFib patients understand that they have an increased risk of stroke.
  3. The U.S. Congress recognizes the need for more AFib awareness. StopAfib.org, along with several other professional and patient organizations, asked Congress to make September AFib Month. On September 11, 2009, the U.S. Senate declared it National Atrial Fibrillation Awareness Month.
  4. Barry Manilow has AFib. In 2011, Manilow spoke to Congress about AFib, urging the House of Representatives to pass House Resolution 295, which seeks to raise the priority of AFib in the existing research and education funding allocation process. The resolution does not seek any new funding. Other celebs with AFib include NBA legends Larry Bird and Jerry West, politicians George H. W. Bush and Joe Biden, Astronaut Deke Slayton, Billie Jean King, music mogul Gene Simmons and Helmut Huber, the husband of daytime TV star Susan Lucci.
  5. Healthcare professionals often minimize the impact of AFib on patients.  According to recent research in the Journal of Cardiovascular Nursing, “Compared with coronary artery disease and heart failure, AFib is not typically seen by clinicians as a complex cardiac condition that adversely affects quality of life. Therefore, clinicians may minimize the significance of AFib to the patient and may fail to provide the level of support and information needed for self-management of recurrent symptomatic AFib.”
  6. AFib patients may go untreated.  AFib can fly under the radar as some patients don’t have symptoms and some may only have symptoms once in a while. Thus, patients may go for a year or two undiagnosed, and sometimes not be diagnosed until after they have a stroke or two. Because some health care professionals perceive that AFib doesn’t affect patients’ everyday lives, a common approach is to just allow patients to live with the condition. But…
  7. The quicker the treatment, the greater the chance AFib can be stopped.  For those who have AFib, information about the ailment and treatment options are imperative. The longer someone has AFib, the more likely they will convert from intermittent to constant AFib, which means it’s more difficult to stop or cure.
  8. AFib changes the heart.  Over time, AFib changes the shape and size of the heart, altering the heart’s structure and electrical system. Research at the University of Utah shows that this scarring (fibrosis) from long-term remodeling is correlated with strokes.
  9. Treatments continue to rapidly evolve.  For years, the standard treatment for AFib patients was to send them home with medications, some of which caused harm. Now there are additional options for stopping AFib, including minimally invasive ablation procedures performed inside and outside the heart. For stubborn and long-lasting AFib, open-heart surgery may provide a cure.
  10. You can make a difference in an AFib patient’s life.  This month, forward a link to someone you may know who could have the condition. Attend an AFib awareness raising event or webinar. Or share StopAfib.org siteand ALittleFib.org with patients and friends.  Something as simple as that can help someone become free of AFib.

Prevention and Risk Reduction

Although no one is able to absolutely guarantee a stroke or a clot is preventable, there are ways to reduce risks for developing these problems.

After a patient is diagnosed with atrial fibrillation, the ideal goals may include:

  • Restoring the heart to a normal rhythm (called rhythm control)
  • Reducing an overly high heart rate (called rate control)
  • Preventing blood clots (called prevention of thromboembolism)
  • Managing risk factors for stroke
  • Preventing additional heart rhythm problems
  • Preventing heart failure

Getting Back on Beat

Avoiding atrial fibrillation and subsequently lowering your stroke risk can be as simple as foregoing your morning cup of coffee. In other words, some AFib cases are only as strong as their underlying cause. If hyperthyroidism is the cause of AFib, treating the thyroid condition may be enough to make AFib go away.

Doctors can use a variety of different medications to help control the heart rate during atrial fibrillation.

“These medications, such as beta blockers and calcium channel blockers, work on the AV node,” says Dr. Andrea Russo of University of Pennsylvania Health System. “They slow the heart rate and may help improve symptoms. However, they do not ‘cure’ the rhythm abnormality, and patients still require medication to prevent strokes while remaining in atrial fibrillation.”

AFib Treatment Saves Lives & Lowers Risks

If you or someone you love has atrial fibrillation, learn more about what AFib is, why treatment can save lives, and what you can do to reach your goals, lower your risks and live a healthy life.

If you think you may have atrial fibrillation, here are your most important steps:

  1. Know the symptoms
  2. Get the right treatment 
  3. Reduce risks for stroke and heart failure

Finding the right physician who gets your AFib, understands all the options for treatment, and will openly collaborate with you in your care is key.  Use our first of its kind healthcare ecosystem to find one near you.

As a patient, you can take control of your healthcare.  Go to HealthLynked.com, right now, to sign up for Free!

 

Sources:

Heart.org

Aug 29, 2012 | ArticlesDoctor’s Voice | 12  |

 

 

Tobacco, Nicotine, & E-Cigarettes | Drug Facts for Teens

What are tobacco, nicotine, and e-cigarette products?

broken cigarette sitting alongside an e-cigarette ©Shutterstock/CatherineL-Prod

Also known as:

Cigarettes: Butts, Cigs, and Smokes

Smokeless tobacco: Chew, Dip, Snuff, Snus, and Spit Tobacco

Hookah: Goza, Hubble-bubble, Narghile, Shisha, and Waterpipe

Tobacco is a leafy plant grown around the world, including in parts of the United States. There are many chemicals found in tobacco leaves or created by burning them (as in cigarettes), but nicotine is the ingredient that can lead to addiction. Other chemicals produced by smoking, such as tar, carbon monoxide, acetaldehyde, and nitrosamines, also can cause serious harm to the body. For example, tar causes lung cancer and other serious diseases that affect breathing, and carbon monoxide can cause heart problems.

Teens who are considering smoking for social reasons should keep this in mind: Tobacco use is the leading preventable cause of disease, disability, and death in the United States. According to the Centers for Disease Control and Prevention (CDC), cigarettes cause more than 480,000 premature deaths in the United States each year—from smoking or exposure to secondhand smoke—about 1 in every 5 U.S. deaths, or 1,300 deaths every day. An additional 16 million people suffer with a serious illness caused by smoking. So, for every 1 person who dies from smoking, 30 more suffer from at least 1 serious tobacco-related illness.1

How Tobacco and Nicotine Products Are Used

Tobacco and nicotine products come in many forms. People can smoke, chew, sniff them, or inhale their vapors.

  • Smoked tobacco products.
    • Cigarettes (regular, light, and menthol): No evidence exists that “lite” or menthol cigarettes are safer than regular cigarettes.
    • Cigars and pipes:  Some small cigars are hollowed out to make room for marijuana, known as “blunts.” Some young people do this to attempt to hid the fact that they are smoking marijuana. either way, they are inhaling toxic chemicals.
    • Bidis and kreteks (clove cigarettes): Bidis are small, thin, hand-rolled cigarettes primarily imported to the United States from India and other Southeast Asian countries. Kreteks—sometimes referred to as clove cigarettes—contain about 60-80% tobacco and 20-40% ground cloves. Flavored bidis and kreteks are banned in the United States because of the ban on flavored cigarettes.
    • Hookahs or water pipes: Hookah tobacco comes in many flavors, and the pipe is typically passed around in groups. A recent study found that a typical hookah session delivers approximately 125 times the smoke, 25 times the tar, 2.5 times the nicotine, and 10 times the carbon monoxide as smoking a cigarette
  • Smokeless tobacco products. The tobacco is not burned with these products:
    • Chewing tobacco. It is typically placed between the cheek and gums.
    • Snuff: Ground tobacco that can be sniffed if dried or placed between the cheek and gums.
    • Dip: Moist snuff that is used like chewing tobacco.
    • Snus: A small pouch of moist snuff
    • Dissolvable products (including lozenges, orbs, sticks, and strips)
  • Electronic cigarettes (also called e-cigarettes, electronic nicotine delivery systems, or e-cigs). Electronic cigarettes are battery-operated devices that deliver nicotine and flavorings without burning tobacco. In most e-cigarettes, puffing activates the battery-powered heating device, which vaporizes the liquid in the cartridge. The resulting vapor is then inhaled (called “vaping”). See What About E-Cigarettes? to learn more.

1 Centers for Disease Control and Prevention. Smoking and Tobacco Use: Fast Facts. Atlanta, GA. December 2015. Available at http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm.

What happens in the brain when you use tobacco and nicotine?

Like other drugs, nicotine increases levels of a neurotransmitter called dopamine. Dopamine is released normally when you experience something pleasurable like good food, your favorite activity, or spending time with people you care about. When a person uses tobacco products, the release of dopamine causes similar effects. This effect wears off quickly, causing people who smoke to get the urge to light up again for more of that good feeling, which can lead to addiction.

A typical smoker will take 10 puffs on a cigarette over the period of about 5 minutes that the cigarette is lit. So, a person who smokes about 1 pack (25 cigarettes) daily gets 250 “hits” of nicotine each day.

Studies suggest that other chemicals in tobacco smoke, such as acetaldehyde, may increase the effects of nicotine on the brain.

When smokeless tobacco is used, nicotine is absorbed through the mouth tissues directly into the blood, where it goes to the brain. Even after the tobacco is removed from the mouth, nicotine continues to be absorbed into the bloodstream. Also, the nicotine stays in the blood longer for users of smokeless tobacco than for smokers.

What happens to your body when you use tobacco and nicotine?

When nicotine enters the body, it initially causes the adrenal glands to release a hormone called adrenaline. The rush of adrenaline stimulates the body and causes an increase in blood pressure, heart rate, and breathing.

Most of the harm to the body is not from the nicotine, but from other chemicals in tobacco or those produced when burning it—including carbon monoxide, tar, formaldehyde, cyanide, and ammonia. Tobacco use harms every organ in the body and can cause many problems. The health effects of smokeless tobacco are somewhat different from those of smoked tobacco, but both can cause cancer.

Secondhand Smoke

People who do not smoke but live or hang out with smokers are exposed to secondhand smoke—exhaled smoke as well as smoke given off by the burning end of tobacco products. Just like smoking, this also increases the risk for many diseases. Each year, an estimated 58 million Americans are regularly exposed to secondhand smoke and more than 42,000 nonsmokers die from diseases caused by secondhand smoke exposure.2 One in four U.S. middle and high school students say they’ve been exposed to unhealthy secondhand aerosol from e-cigarettes.3

The chart below lists the health problems people are at risk for when smoking or chewing tobacco or as a result of exposure to secondhand smoke.

Increased Risk of Health Problems
Health Effect Smoking tobacco Secondhand Smoke Smokeless tobacco
Cancer Cancers: Cigarette smoking can be blamed for about one-third of all cancer deaths, including 90% of lung cancer cases. Tobacco use is also linked with cancers of the mouth, pharynx, larynx, esophagus, stomach, pancreas, cervix, kidney, ureter, bladder, and bone marrow (leukemia). Lung cancer: People exposed to secondhand smoke increase their risk for lung cancer by 20% to 30%. About 7,300 lung cancer deaths occur per year among people who do not smoke.4

 

Cancers: Close to 30 chemicals in smokeless tobacco have been found to cause cancer. People who use smokeless tobacco are at increased risk for oral cancer (cancers of the mouth, lip, tongue, and pharynx) as well as esophageal and pancreatic cancers.

 

Lung Problems Breathing problems: Bronchitis (swelling of the air passages to the lungs), emphysema (damage to the lungs), and pneumonia have been linked with smoking.

Lowered lung capacity: People who smoke can’t exercise or play sports for as long as they once did.

Breathing problems: Secondhand smoke causes breathing problems in people who do not smoke, like coughing, phlegm, and lungs not working as well as they should.  
Heart Disease / Stroke Heart disease and stroke: Smoking increases the risk for stroke, heart attack, vascular disease (diseases that affect the circulation of blood through the body), and aneurysm (a balloon-like bulge in an artery that can rupture and cause death). Heart disease: Secondhand smoke increases the risk for heart disease by 25% to 30%. It is estimated to contribute to as many as 34,000 deaths related to heart disease.5 Heart disease and stroke: Recent research shows smokeless tobacco may play a role in causing heart disease and stroke.
Other health Problems Cataracts: People who smoke can get cataracts, which is clouding of the eye that causes blurred vision.

Loss of sense of smell and taste

Aging skin and teeth: After smoking for a long time, people find their skin ages faster and their teeth discolor.

  Mouth problems: Smokeless tobacco increases the chance of getting cavities, gum disease, and sores in the mouth that can make eating and drinking painful.
Pregnant Women and Children Pregnant women: Pregnant women who smoke are at increased risk for delivering their baby early or suffering a miscarriage, still birth, or experiencing other problems with their pregnancy. Smoking by pregnant women also may be associated with learning and behavior problems in children. Health problems for children: Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome, lung infections, ear problems, and more severe asthma.  
Accidental Death Fire-related deaths: Smoking is the leading cause of fire-related deaths—more than 600 deaths each year.6    

2Centers for Disease Control and Prevention. Smoking and Tobacco Use: Fast Facts. Atlanta, GA. December 2015. Available at http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm.

3 Wang TW, Marynak KL, Aguku IT, et al. Secondhand Exposure to Electronic Cigarette Aerosol Among US Youths. JAMA Pediatrics. 2017, e1.

4 Centers for Disease Control and Prevention. Smoking and Tobacco Use: Health Effects of Secondhand Smoke. Atlanta, GA. February 2016. Available at http://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/health_effects/index.htm.

5 Centers for Disease Control and Prevention. Smoking and Tobacco Use: Health Effects of Secondhand Smoke. Atlanta, GA. February 2016. Available at http://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/health_effects/index.htm.

6 Centers for Disease Control and Prevention. Smoking and Tobacco Use. Tobacco-Related Mortality. Atlanta, GA. February 2016. Available at http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/.

 

Can you die if you use tobacco and nicotine products?

Yes. Tobacco use (both smoked and smokeless) is the leading preventable cause of death in the United States. It is a known cause of cancer. Smoking tobacco also can lead to early death from heart disease, health problems in children, and accidental home and building fires caused by dropped cigarettes. In addition, the nicotine in smokeless tobacco may increase the risk for sudden death from a condition where the heart does not beat properly (ventricular arrhythmias); as a result, the heart pumps little or no blood to the body’s organs.

According to the Centers for Disease Control and Prevention (CDC), cigarette smoking results in more than 480,000 premature deaths in the United States each year—about 1 in every 5 U.S. deaths, or 1,300 deaths every day.7 On average, smokers die 10 years earlier than nonsmokers.8 People who smoke are at increased risk of death from cancer, particularly lung cancer, heart disease, lung diseases, and accidental injury from fires started by dropped cigarettes.

The good news is that people who quit may live longer. A 24-year-old man who quits smoking will, on average, increase his life expectancy (how long he is likely to live) by 5 years.9

7 Centers for Disease Control and Prevention. Smoking and Tobacco Use: 2014 Surgeon General’s Report: The Health Consequences of Smoking—50 Years of Progress. Atlanta, GA. 2014. Available at http://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/index.htm.

8 Centers for Disease Control and Prevention. Smoking and Tobacco Use: Fast Facts. Atlanta, GA. December 2015. Available at http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm.

9 Centers for Disease Control and Prevention. The Health Benefits of Smoking Cessation: A Report of the Surgeon General. Atlanta, GA. 1990. HHS Publication No. 90-8416.

Are tobacco or nicotine products addictive?

Yes. It is the nicotine in tobacco that is addictive. Each cigarette contains about 10 milligrams of nicotine. A person inhales only some of the smoke from a cigarette, and not all of each puff is absorbed in the lungs. The average person gets about 1 to 2 milligrams of the drug from each cigarette.

Studies of widely used brands of smokeless tobacco showed that the amount of nicotine per gram of tobacco ranges from 4.4 milligrams to 25.0 milligrams. Holding an average-size dip in your mouth for 30 minutes gives you as much nicotine as smoking 3 cigarettes. A 2-can-a-week snuff dipper gets as much nicotine as a person who smokes 1½ packs a day.

Whether a person smokes tobacco products or uses smokeless tobacco, the amount of nicotine absorbed in the body is enough to make someone addicted. When this happens, the person continues to seek out the tobacco even though he or she understands the harm it causes. Nicotine addiction can cause:

  • tolerance: Over the course of a day, someone who uses tobacco products develops tolerance—more nicotine is required to produce the same initial effects. In fact, people who smoke often report that the first cigarette of the day is the strongest or the “best.”
  • withdrawal: When people quit using tobacco products, they usually experience uncomfortable withdrawal symptoms, which often drive them back to tobacco use. Nicotine withdrawal symptoms include:
    • irritability
    • problems with thinking and paying attention
    • sleep problems
    • increased appetite
    • craving, which may last 6 months or longer, and can be a major stumbling block to quitting

What about e-cigarettes?

E-cigarettes are fairly new products. They’ve only been around for about ten years, so researchers are in the early stage of studying how they affect your health.

How E-cigarettes Work

E-cigarettes are designed to deliver nicotine without the other chemicals produced by burning tobacco leaves. Puffing on the mouthpiece of the cartridge activates a battery-powered inhalation device (called a vaporizer). The vaporizer heats the liquid inside the cartridge which contains nicotine, flavors, and other chemicals. The heated liquid turns into an aerosol (vapor) which the user inhales—referred to as “vaping.”

How E-cigarettes Affect the Brain

E-cigarettes may be less harmful than regular tobacco cigarettes because users do not inhale burning smoke, which has cancer causing and other harmful ingredients. But we don’t yet have enough research to show potential harmful effects of the vaping mist.  Also, recent research shows that many teens start smoking regular cigarettes soon after being introduced to nicotine through electronic vaporizers. It is important to remember that nicotine in any form is a highly addictive drug. Health experts have raised many questions about the safety of these products, particularly for teens:

  • Testing of some e-cigarette products found the aerosol (vapor) to contain known cancer-causing and toxic chemicals, and particles from the vaporizing mechanism that may be harmful. The health effects of repeated exposure to these chemicals are not yet clear.
  • There is animal research which shows that nicotine exposure may cause changes in the brain that make other drugs more rewarding. If this is true in humans, as some experts believe, it would mean that using nicotine in any form would increase the risk of other drug use and for addiction.
  • Some research suggests that e-cigarette use may serve as a “gateway” or introductory product for youth to try other tobacco products, including regular cigarettes, which are known to cause disease and lead to early death. A recent study showed that students who have used e-cigarettes by the time they start 9th grade are more likely than others to start smoking traditional cigarettes and other smoked tobacco products within the next year.10
  • The liquid in e-cigarettes can cause nicotine poisoning if someone drinks, sniffs, or touches it. Recently there has been a surge of poisoning cases in children under age 5. There is also concern for users changing cartridges and for pets.
  • Some research shows that secondhand e-cig vapor pollutes the air quality with particles that could harm the lungs and heart.11
  • Some research suggests that certain brands of e-cigs contain metals like nickel and chromium, possibly coming from the heating of coils.12

Regulation of E-cigarettes

Yes. The U.S. Food and Drug Administration (FDA) announced in 2016 that the FDA will now regulate the sales of e-cigarettes, hookah tobacco, and cigars. Therefore:

  • It is now illegal to sell e-cigarettes, hookah tobacco, or cigars in person or online to anyone under age 18.
  • Buyers have to show their photo ID to purchase e-cigarettes, hookah tobacco, or cigars, verifying that they are 18 years or older.
  • These products cannot be sold in vending machines (unless in an adult-only facility).
  • It is illegal to hand out free samples.

FDA regulation also means that the Federal government will now have a lot more information about what is in e-cigarettes, the safety or harms of the ingredients, how they are made, and what risks need to be communicated to the public (for example, on health warnings on the product and in advertisements). They will also be able to stop manufacturers from making statements about their products that are not scientifically proven.

Regulation does not mean that e-cigarettes are necessarily safe for all adults to use, or that all of the health claims currently being made in advertisements by manufactures are true. But it does mean that e-cigarettes, hookah tobacco, and cigars now have to follow the same type of rules as cigarette manufacturers.

10 Rigotti NA. e-Cigarette use and subsequent tobacco use by adolescents: new evidence about a potential risk of e-cigarettes. JAMA. 2015;314(7):673-674.

11 Schober W, Szendrei K, Matzen W, et al. Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases FeNO levels of e-cigarette consumers. International Journal of Hygiene and Environmental Health. 2014; 217:628-637.

12 Hess CA, Olmedo P, Goessler W, Cohen E, Rule AM. E-cigarettes as a source of  toxic and potentially carcinogenic metals. Environmental Research. 2017;152:221-221.

 

How many teens use tobacco and nicotine products?

Smoking and smokeless tobacco use generally start during the teen years. Among people who use tobacco:

  • Each day, nearly 3,200 people younger than 18 years of age smoke their first cigarette.13
  • Every day, an estimated 2,100 youth and young adults who have been occasional smokers become daily cigarette smokers.14
  • If smoking continues at the current rate among youth in this country, 5.6 million of today’s Americans under the age of 18 – or about 1 in every 13 young people – could die prematurely (too early) from a smoking-related illness.15
  • E-cigarettes are the most commonly used form of tobacco among youth in the United States.
  • Young people who use e-cigs or smokeless tobacco may be more likely to also become smokers.16, 17
  • Using smokeless tobacco remains a mostly male behavior. About 490,000 teens ages 12 to 17 are current smokeless tobacco users. For every 100 teens who use smokeless tobacco, 85 of them are boys.18

A survey of teens in the United States shows cigarette smoking is on the decline. That could be in part due to the introduction of e-cigarettes. Teens today are more likely to smoke an e-cigarette than a regular cigarette.19

Past-year e-vaporizer use and what teens are inhaling: Nearly 1 in 3 students in 12th grade report past-year use of e-vaporizers, raising concerns about the impact on their long-term health.

Below is a chart showing the percentage of teens who use tobacco and nicotine products:

Swipe left or right to scroll.

Monitoring the Future Study: Trends in Prevalence of Various Drugs for 8th Graders, 10th Graders, and 12th Graders; 2017 (in percent)*
Drug Time Period 8th Graders 10th Graders 12th Graders
Cigarettes (any use) Lifetime 9.40 15.90 26.60
Past Month [1.90] 5.00 9.70
Daily [0.60] 2.20 4.20
1/2-pack+/day 0.20 0.70 1.70
Smokeless Tobacco Lifetime 6.20 9.10 [11.00]
Past Month [1.70] 3.80 [4.90]
Daily 0.40 0.60 2.00
Any Vaping Lifetime 18.50 30.90 35.80
Past Year 13.30 23.90 27.80
Past Month 6.60 13.10 16.60

* Data in brackets indicate statistically significant change from the previous year.

For more statistics on teen drug abuse, see NIDA’s Monitoring the Future study.

13 Centers for Disease Control and Prevention. Smoking and Tobacco Use: Fast Facts. Atlanta, GA. December 2015. Available at http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm.

14 Centers for Disease Control and Prevention. Smoking and Tobacco Use: Fast Facts. Atlanta, GA. December 2015. Available at http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm.

15 Centers for Disease Control and Prevention. Smoking and Tobacco Use: Fast Facts. Atlanta, GA. December 2015. Available at http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm.

16 Centers for Disease Control and Prevention. Smoking and Tobacco Use: Smokeless Tobacco Use in the United States. Atlanta, GA. July 2016. Available at https://www.cdc.gov/tobacco/data_statistics/fact_sheets/smokeless/use_us/.

17 Leventhal AM, Stone MD, Andrabi N. Association of e-Cigarette Vaping and Progression to Heavier Patterns of Cigarette Smoking. JAMA. 2016; 316(18):1918-1920.

18 Centers for Disease Control and Prevention. Smoking and Tobacco Use: Smokeless Tobacco Use in the United States. Atlanta, GA. July 2016. Available at https://www.cdc.gov/tobacco/data_statistics/fact_sheets/smokeless/use_us/.

19 Miech RA, Schulenberg JE, Johnston LD, et al. National adolescent drug trends in 2017: Findings released [Press release]. Ann Arbor, MI. December 2017. Retrieved from http://www.monitoringthefuture.org/.

 

What do I do if I want to quit using tobacco and nicotine products?

Treatments can help people who use tobacco products manage these symptoms and improve the likelihood of successfully quitting. For now, teen and young adult smokers who want to quit have good options for help. Find out more at SmokeFree and Tips From Former Smokers.

Nearly 70% of people who smoke want to quit.20 Most who try to quit on their own relapse (go back to smoking)—often within a week. Most former smokers have had several failed quit attempts before they finally succeed.

Some people believe e-cigarette products may help smokers lower nicotine cravings while they are trying to quit smoking cigarettes. However, several research studies show that using electronic devices to help quit cigarette smoking does not usually work in the long term, and might actually discourage people from quitting21.  One recent study showed that only nine percent of people using e-vaporizers to quit smoking cigarettes had actually stopped smoking a year later22.

If you or someone you know needs more information or is ready to quit, check out these resources:

Teens

Adults

  • Call 1-800-QUIT-NOW (1-800-784-8669), a national toll-free number that can help people get the information they need to quit smoking.
  • Visit SmokeFree.gov.

20 Centers for Disease Control and Prevention. Smoking and Tobacco Use: Fast Facts. Atlanta, GA. December 2015. Available at http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm.

21 Kulik MC, Lisha NE, Glantz SA. E-cigarettes Associated With Depressed Smoking Cessation: A Cross-sectional Study of 28 European Union Countries. Am J Prev Med. 2018;54(4):603-609. doi:10.1016/j.amepre.2017.12.017

22Weaver SR, Huang J, Pechacek TF, Heath JW, Ashley DL, Eriksen MP. Are electronic nicotine delivery systems helping cigarette smokers quit? Evidence from a prospective cohort study of U.S. adult smokers, 2015–2016. PLOS ONE. 2018;13(7):e0198047. doi:10.1371/journal.pone.0198047

Where can I get more information?

Drug Facts

NIDA Resources:

Other Resources:

Statistics and Trends

NIDA Resources:

Other Resources:   

Syndicated Content Details:
Source URL: https://teens.drugabuse.gov/drug-facts/tobacco-nicotine-e-cigarettes
Source Agency: National Institute on Drug Abuse (NIDA)
Captured Date: 2018-08-31 17:14:00.0

Top 10 Hidden Hazards to Baby’s Safety at Home

This year, we had the great privilege of being introduced to our first grandbaby.  She’s an incredibly beautiful bundle of energy who will soon be moving about to explore on her own.  Luckily, our home has always been “baby proofed”, but feeling this great responsibility for her wellbeing, and not having had a baby around in quite a while, it is time to seriously think about what else needs to be done.

September is Baby Safety Month, sponsored annually by the Juvenile Products Manufacturers Association (JPMA), so there is no better time than now to survey the safety of your abode.

The Basics

Ideally, the best time to babyproof is early in your pregnancy, before you register, so you can include needed safety items on your registry list.  The best way to babyproof? Get down on your hands and knees and think like a baby! This is a great activity for both mom and dad, as males and females may look for and inspect different aspects of the home and safety measures in general.

Take care of all the obvious hazards, such as exposed electrical sockets and blind cords, but be on the lookout for those not-so-obvious items – empty dishwashers, hanging tablecloths that can be easily pulled down, and poisonous plants.  Remember,  babies at any age are curious explorers and want to touch, feel, lick, smell, and listen to everything and anything they can get their little hands on. Your job is to make your home as safe as possible so they can roam without worry. After all, this new addition is not a temporary guest and should be able to safely investigate every space in your home.

Consider child-proofing an ongoing process.  Monitor your child’s growth and development and always try to stay one step ahead. For example, don’t wait until your baby starts crawling to put up stairway gates. Install them in advance so the entire family gets used to them and baby doesn’t associate his new-found milestone with barriers.

If you are preparing for baby #2 or #3, don’t underestimate your “seasoned” approach to babyproofing from the first time around. In fact, having an older sibling creates additional hazards – you should be aware of small parts from toys and your toddlers’ ability to open the doors, potty lids, and cabinets you have so ingeniously secured.

Top Hidden Hazards

  • Magnets — Small magnets can be easily swallowed by children. Once inside the body, they can attract to each other and cause significant internal damage. Keep magnets out of your child’s reach. If you fear your child has swallowed magnets, seek medical attention immediately.
  • Loose Change — Change floating around in pockets or purses may wind up on tables around the house, where curious children may be attracted to the shiny coins and ingest them. A wonderful way to ensure this doesn’t happen is to assign a tray or jar for loose change and keep it out of a child’s reach.
  • Tipovers — Tipovers are a leading cause of injury to children and the best way to avoid them is to make sure all furniture and televisions are secured to the wall.
  • Pot Handle Sticking Out from Stove — When cooking, it is best that pot handles turn inward instead of sticking out from the stove where little ones may reach up and grab the hot handle. In addition, if holding a child while cooking, remember to keep the handles out of the child’s reach.
  • Loose Rugs or Carpet — Area rugs or carpet that is not secured to the floor causes a tripping hazard for little ones who may already be unstable on their feet. Make sure that all corners are taped down and bumps are smoothed out.
  • Detergent Pods — It is estimated that thousands of children have been exposed to and injured by detergent pods. Easily mistaken by children as candy, these pods pose a risk to the eyes and, if ingested, to their lives. It is important to keep these items out of reach of children.
  • Hot Mugs — A relaxing cup of coffee or tea can quickly turn into an emergency if hot mugs are left unattended or are placed to near the edge of tables where little hands can grab them.
  • Cords — Cords can pose strangulation hazards to children, whether they are connected to blinds, home gym equipment or baby monitors. It’s important to keep cords tied up and out of reach of children. In addition, remember to keep cribs away from cords that the child may reach while inside the crib.
  • Button Batteries — Button batteries are flat, round batteries that resemble coins or buttons. They are found in common household items such as flashlights, remotes or flameless candles.
  • Recalled Products — Make sure you’re aware if a product you own has been recalled. In addition, check that any second-hand products you own have not been recalled. The best ways to ensure your products are safe is to fill out your product registration card as well as check for recalls at recalls.gov.

How to Choose and Use Products

Choose a baby carrier or sling made of a durable, washable fabric with sturdy, adjustable straps.  Use a carrier or sling only when walking with your baby, never running or bicycling.

Choose a carriage or stroller that has a base wide enough to prevent tipping, even when your baby leans over the side.  Use the basket underneath and don’t hang purses or shopping bags over the handles because it may cause the stroller to tip.

Choose a swing with strong posts, legs, and a wide stance to prevent tipping.  Never place your swing or bouncer on an elevated surface such as sofas, beds, tables or counter tops.

When choosing a changing table, before leaving home, measure the length and width of the changing area available on the dresser and compare to the requirements for the add-on unit before purchasing. Check for attachment requirements.  When changing baby, always keep one hand on baby and use restraints.

It is vital the car seat/booster is appropriate for a child’s age, weight, and height.  Always follow the manufacturer’s instructions for both the vehicle and the seat.  As of this writing, the American Academy of Pediatrics used to recommend rear-facing seats for children until at least age 2. Now, the organization is updating its guidelines and wants parents to keep their children in rear-facing seats until they reach the seat’s maximum height and weight limit — even if they’re older than 2. Under the new guidelines, most kids would keep using rear-facing seats until they’re about 4 years old.

Choose a crib mattress that fits snugly with no more than two fingers width, one-inch, between the edge of the mattress and the crib side.  Never place the crib near windows, draperies, blinds, or wall-mounted decorative accessories with long cords.

Choose the right gate for your needs. Before leaving home, measure the opening size at the location the gate will be used.  Gates with expanding pressure bars should be installed with the adjustment bar or lock side away from the baby.

Use waist and crotch strap every time you place a child in the high chair to prevent falls from standing up or sliding out.

And, consider these things when introducing products to your inventory:

  • Safest Option – Keep in mind that new products meeting current safety standards are the safest option.
  • Second-Hand Products – It is recommended secondhand products should not be used for baby. However, if it is necessary to use older products, make sure all parts are available, the product is fully functional, not broken, and has not been recalled.
  • Register your products — Through product registration, parents can establish a direct line of communication with the manufacturer should a problem arise with a product purchased. This information is NOT used for marketing purposes.

Fun Tips and Tricks for New Parents

  • Trying to lose the baby weight? Cut down on late night snacks by brushing your teeth after you put the kids to bed so you won’t be likely to ruin clean teeth.
  • Keep allergens away from your toddler and older children simply by changing their pillow. Don’t know when the last time you changed it was? Buying a new one every year on their birthday is an easy way to remember!
  • While nursing or feeding baby #2, encourage your toddler or older children to read stories to the new baby. Even just telling a story through the pictures keeps your toddler in site and occupied during this already special time.
  • For toddlers working on mastering stairs, install a child safety gate two or three steps up from the bottom stair to give your child a small, safe space to practice.
  • If the sight of blood terrifies your child, use dark washcloths to clean up cuts and scrapes. Better yet, try storing the cloths in plastic bags in the freezer  the coldness will help with pain relief.
  • Keep baby happy and warm during baths. Drop the shampoo and soap in the warm water while you are filling the tub. When it’s time to lather baby, the soap won’t be so cold.
  • Cranky teething baby? Wet three corners of a washcloth and stick it in the freezer. The rough, icy fabric soothes sore gums and the dry corner gives them a “handle”.
  • Having a tough time getting baby to stay still while diaper changing? Wear a silly hat or bobble headband. As a reward for staying still, be sure to let your baby or toddler wear the hat when finished!
  • Before baby #2 arrives, put together a “fun box” for the older sibling that she is only allowed to play with when you nurse or feed baby #2. Inexpensive toys, coloring books, and snacks are all great ideas to include. Be sure to refresh the items once a week to keep an active toddler interested.
  • Put a plastic art mat underneath the high chair while they learn to eat to contain the mess.
  • Tape pics of family members or animals to the ceiling or wall near of your changing table so baby has something to look when diaper changing.
  • Baby or kid yogurt containers make great snack cups on the go. Some yogurt containers cannot be recycled, so why not wash and reuse? They are perfect snack size portions, easy for little hands to grab and even fit in the cup holders of stroller trays. They can also hold just the right amount of crayons for on the go coloring!
  • Can’t get little ones to sit still while you brush or style hair? Put a sticker on your shirt and tell them to look at the sticker. As they get older, make it a game and see if they can count to 50 before you can get those ponytails in!

It’s A Fact

Most injuries can be prevented! Parents and caregivers play a huge role in protecting children from injuries.  Choosing the right baby products for your family can be overwhelming, but safety should never be compromised.

What Can You Do?

  1. Choose and use age and developmentally appropriate products.
  2. Read and follow all manufacturer’s instructions, recommendations for use, and warning labels.
  3. Register your products and establish a direct line of communication with the manufacturer.
  4. Actively supervise — watch, listen and stay near your child.
  5. Frequently inspect products for missing hardware, loose threads and strings, holes, and tears.
  6. Monitor your child’s growth and development and discontinue use when needed.

Newborns in your home or on the way?  In addition to getting your home in order, you’ll want to find a great pediatrician you can really connect with….Find one in our first of its kind social ecosystem built for healthcare.  In HealthLynked, you can make appointments with your providers on the go and create your own personal, portable medical records.  You can also create and manage one for baby.

Ready to get Lynked?  Go to HealthLynked.com today, sign up for Free, and take control of your healthcare!

 

Source:  BabySafetyZone.com

 

Working with a mental health condition

Millions of Americans living with mental health conditions lead happy, successful lives. People with very serious mental health and substance abuse problems might have trouble with basic needs, like finding a place to live, a job, or health care. Learn more about your legal rights, finding a job, and how to stay healthy during stressful transitions.

How can I find a job?

Many people with mental health conditions can and do work. Finding a job you enjoy can help improve your mental health and give you a sense of purpose. Studies show that most adults with a serious or severe mental health condition want to work1 and about 6 out of 10 can succeed with the right kind of support.2 More than 1 in every 4 women who work have a disability of some type (a physical disability or a mental health condition).3

Women whose mental health conditions have affected their ability to accomplish daily tasks may have more trouble finding a job, especially if they have been out of the workforce for a long time. If you don’t have a full-time job right now, you may want to try a part-time job or volunteering before committing to full-time work. You can also take an online test, called a skills assessment or an interest assessment, which can help you learn more about the types of work you might enjoy.

Check with the mental health agency where you receive mental health services. Your state may offer several different ways to find employment, including:

  • Vocational rehabilitation (rehab) services. Rehab services help a person with a serious mental health condition or disability find and keep a job. Different states and communities have different requirements for who is eligible to get vocational rehab services.
  • Supported employment. This type of program helps people with serious mental illnesses get jobs in the community and be successful in the workplace.4
  • Clubhouses. Clubhouses are settings that allow people with serious mental health conditions to live and work together, providing services and support to one another.
  • Local public employment office. The Department of Labor (DOL) operates employment offices in all 50 states. You can find job counselors and information about opportunities available in your area. Visit the DOL’s service locator to find an office near you.

If I can’t work, what do I do about money?

If you are unable to work because of a mental health condition or any other disability, there are some options for financial support. These include disability insurance and disability payments through Social Security.

  • Disability insurance. Some people purchase disability insurance policies, either on their own or through their employer, before a disability happens. If you’ve been paying each month into a disability insurance policy and now you are disabled and can’t work, you may be able to receive payments. Contact your employer or insurance company for more information.
  • Social Security Income (SSI). SSI is cash assistance for people who have little to no income. The amount of cash you receive from SSI depends on your other income and living arrangements. Currently, the standard amount is about $700 per month for an individual, but your payment may be more or less, depending on where you live and what other help you may get. To find out whether you qualify for SSI benefits, visit the Social Security Administration (SSA) website or call the SSA at 1-800-772-1213.
  • Social Security Disability Insurance (SSDI). SSDI provides monthly income to people who become disabled by a physical or mental health condition before retirement age. More than 1 in 3 people who receive SSDI get it because of a mental health condition.5

If you are a member of the military, you can get your Social Security application processed faster. Learn more at the SSA’s site for veterans.

How do I pay for treatment?

Most health plans cover preventive services, like depression screening for adults and behavioral assessments for children, at no additional cost. Most health insurance plans must cover treatment for mental health and substance use problems in the same ways medical or surgical problems are covered.

  • If you have insurance, contact your insurance provider to find out what’s included in your plan.
  • If you have Medicaid, your plan will provide some mental health services and may offer services to help with substance use disorders.
  • If you have Medicare (PDF file, 882 KB), your plan may help cover mental health services, including hospital stays, visits to a therapist, and medicines you may need.

If you do not have insurance, see whether you are eligible for free or low-cost health insurance (including Medicaid or the Children’s Health Insurance Plan) at HealthCare.gov.

Learn more about other resources in your community.

Should I tell people I work with that I have a mental health condition?

There is no law that requires you to share personal health information, including mental health conditions, with anyone you work with. Telling others about your mental health condition can affect your job in the future. If you want to tell someone you work with about your mental health illness, think about your reasons carefully. It might help to make a list of the good and bad outcomes of telling your manager or someone in human resources.

Your employer must make reasonable accommodations if they know about your mental health condition, but employers do not have to accommodate disabilities that they don’t know about. This may help you decide whether you tell your employer about your mental health condition.

Learn more reasons to tell or not tell your employer about a mental health condition from the U.S. Equal Employment Opportunity Coalition and the National Alliance on Mental Illness.

What laws protect people with disabilities?

Many federal laws protect the rights of people with disabilities, including mental health conditions. The main law is the Americans with Disabilities Act (ADA). It mostly protects people from discrimination at work and in public places and programs.

Under the ADA, you are protected if:

  • Your mental health condition (if left untreated) interferes with your ability to get things done at home or at work
  • You can perform the essential functions of a job you have or hope to get, with or without reasonable accommodations (such as a flexible work schedule)

Other laws that protect people with disabilities include:

  • The Fair Housing Act. This law makes it illegal to deny housing to a renter or buyer because of a disability. Owners must also make reasonable accommodations to people with disabilities.
  • The Individuals with Disabilities Education Act. This law requires that a free public education be made available to children and youth with disabilities. It also requires that the education be designed to meet their unique educational needs.
  • The Rehabilitation Act of 1973. This law is very broad and requires that all federal programs, activities, and employment be accessible to people with disabilities. It served as the foundation for the ADA and helps people with disabilities become employed and independent.

How does the Americans with Disabilities Act protect me at work?

The Americans with Disabilities Act (ADA) protects you from discrimination based on disability, including harassment related to disability. For example, you cannot be fired just because you take medicine for a mental health condition. However, an employer can fire you for poor performance. It is better to ask for reasonable accommodations before a disability causes problems with job performance. Under the ADA:

  • Your employer must make reasonable accommodations if they know about your mental health condition. Your employer is allowed to ask for documentation from a health care professional about your condition. The documentation does not need to be detailed.
  • Employers do not have to accommodate disabilities that they don’t know about. This may help you decide whether you tell your employer about your mental health condition.
  • If your employer knows about your disability and you are having a difficult time doing your job, your employer is allowed to ask whether you need reasonable accommodations.
  • An employer can’t legally ask questions about your medical or psychiatric history during an interview.
  • An employer is allowed to ask you questions that help the employer decide whether you can perform essential duties of a job. An employer may ask you about your ability to meet the physical requirements for jobs involving physical labor, your ability to get along with people, or your ability to finish tasks on time and to come to work every day.

What is an example of a reasonable accommodation at work for someone with a mental health condition?

Examples of reasonable accommodations for people with mental health conditions may include:

  • Providing self-paced workloads and flexible hours
  • Adjusting your job responsibilities
  • Allowing leave (paid or unpaid) if you are hospitalized or temporarily unable to work
  • Assigning a flexible, supportive, and understanding supervisor
  • Changing your work hours to allow you to attend psychiatrist or therapist appointments
  • Providing more support or supervision, such as writing to-do lists and checking in more often with your supervisor

An employer does not have to provide these specific accommodations, but these types of accommodations are often considered reasonable for some jobs.

What do I do if I have been discriminated against because of my mental health condition?

If you have experienced employment discrimination because of your mental health condition, you can file an administrative charge or complaint with the U.S. Equal Employment Opportunity Commission (EEOC) or a state or local anti-discrimination agency. You can also file a lawsuit in court, but only after filing an administrative charge.

The Fair Housing Act bars discrimination in rental housing for people with disabilities. This means that property owners or managers cannot refuse to rent to you because of a disability, including mental health conditions. Learn more about the Fair Housing Act. If you believe you have been discriminated against, you can file a housing complaint online through the Fair Housing Act.

Learn more at the EEOC website or the Department of Justice Disability Rights Section website.

What steps can I take to protect my mental health?

During stressful times like job and housing transitions, you can try the following tips to stay mentally healthy:

  • Take your medicines. If you take medicines for a mental health condition, do not stop taking them without first talking with your doctor or nurse.
  • Have a plan. Learn about the things that help you feel well and about the things that cause you to feel stressed. Develop a plan so that you can identify warning signs that your mental or physical health might be slipping and an action plan for getting the support you need to stay well.
  • Get enough sleep. Lack of sleep can affect your mental and physical health. It can also make it more difficult to cope with mental health conditions. Learn more about how sleep affects mental health.
  • Reach out to your support network. Tell your friends and family if you are going through something like a job or housing transition. Ask for help if you need it.
  • Be physically healthy. Getting active, quitting smoking, limiting alcohol, and eating the right amount of healthy foods from across the food groups help your body and mind feel better.
  • Get professional help. Keep your appointments with a mental health professional such as a therapist, counselor, or social worker. This person can help notice signs of mental health conditions getting worse.

Learn more about steps you can take for good mental health.

Did we answer your question about working with a mental health condition?

For more information about working with a mental health condition, call the OWH Helpline at 1-800-994-9662 or check out the following resources:

Sources

  1. McQuilken, M., Zahniser, J.H., Novak, J., Starks, R.D., Olmos, A., Bond, G.R. (2003). The Work Project Survey: Consumer Perspectives on Work. Journal of Vocational Rehabilitation; 18: 59–68.
  2. Marshall, T., Goldberg, R.W., Braude, L., Dougherty, R.H., Daniels, A.S., Ghose, S.S., et al. (2014). Supported Employment: Assessing the Evidence (PDF file, 504 KB). Psychiatric Services; 65(1): 16–23.
  3. U.S. Department of Labor. (2016). Table A-6. Employment status of the civilian population by sex, age, and disability status, not seasonally adjusted.
  4. Substance Abuse and Mental Health Services Administration. (2009). Supported Employment (PDF file, 777 KB).
  5. National Alliance on Mental Illness. (n.d.). Supplemental Security Income (SSI) And Social Security Disability Insurance (SSDI).

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

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Captured Date: 2018-08-29 21:33:00.0

Yes, there are different types of depression

Depression

Life is full of ups and downs, but when you feel sad, empty, or hopeless most of the time for at least 2 weeks or those feelings keep you from your regular activities, you may have depression. Depression is a serious mental health condition. Women are twice as likely as men to be diagnosed with depression.1 Depression is not a normal part of being a woman. Most women, even those with the most severe depression, can get better with treatment.

What is depression?

Depression is a mental health illness when someone feels sad (including crying often), empty, or hopeless most of the time (or loses interest in or takes no pleasure in daily activities) for at least 2 weeks. Depression affects a person’s ability to work, go to school, or have relationships with friends and family. Depression is one of the most common mental health conditions in the United States.2 It is an illness that involves the body, mood, and thoughts. It can affect the way you eat and sleep, the way you feel about yourself, and the way you think about things.

It is different from feeling “blue” or “down” or just sad for a few hours or a couple of days. Depression is also different from grief over losing a loved one or experiencing sadness after a trauma or difficult event. It is not a condition that can be willed or wished away. People who have depression cannot just “pull themselves” out of it.

Are there different types of depression?

Yes. Different kinds of depression include:

  • Major depressive disorder. Also called major depression, this is a combination of symptoms that affects a person’s ability to sleep, work, study, eat, and enjoy hobbies and everyday activities.
  • Dysthymic disorder. Also called dysthymia, this kind of depression lasts for 2 years or more. The symptoms are less severe than those of major depression but can prevent you from living normally or feeling well.

Other types of depression have slightly different symptoms and may start after a certain event. These types of depression include:

  • Psychotic depression, when a severe depressive illness happens with some form of psychosis, such as a break with reality, hallucinations, and delusions
  • Postpartum depression, which is diagnosed if a new mother has a major depressive episode after delivery. Depression can also begin during pregnancy, called prenatal depression.
  • Seasonal affective disorder (SAD), which is a depression during the winter months, when there is less natural sunlight
  • Bipolar depression, which is the depressive phase of bipolar illness and requires different treatment than major depression

Who gets depression?

Women are twice as likely as men to be diagnosed with depression.1 It is more than twice as common for African-American, Hispanic, and white women to have depression compared to Asian-American women. Depression is also more common in women whose families live below the federal poverty line.3

What causes depression?

There is no single cause of depression. Also, different types of depression may have different causes. There are many reasons why a woman may have depression:

  • Family history. Women with a family history of depression may be more at risk. But depression can also happen in women who don’t have a family history of depression.
  • Brain changes. The brains of people with depression look and function differently from those of people who don’t have depression.
  • Chemistry. In someone who has depression, parts of the brain that manage mood, thoughts, sleep, appetite, and behavior may not have the right balance of chemicals.
  • Hormone levels. Changes in the female hormones estrogen and progesterone during the menstrual cycle, pregnancy, postpartum period, perimenopause, or menopause may all raise a woman’s risk for depression. Having a miscarriage can also put a woman at higher risk for depression.
  • Stress. Serious and stressful life events, or the combination of several stressful events, such as trauma, loss of a loved one, a bad relationship, work responsibilities, caring for children and aging parents, abuse, and poverty, may trigger depression in some people.
  • Medical problems. Dealing with a serious health problem, such as stroke, heart attack, or cancer, can lead to depression. Research shows that people who have a serious illness and depression are more likely to have more serious types of both conditions.4 Some medical illnesses, like Parkinson’s disease, hypothyroidism, and stroke, can cause changes in the brain that can trigger depression.
  • Pain. Women who feel emotional or physical pain for long periods are much more likely to develop depression.5 The pain can come from a chronic (long-term) health problem, accident, or trauma such as sexual assault or abuse.

What are the symptoms of depression?

Not all people with depression have the same symptoms. Some people might have only a few symptoms, while others may have many. How often symptoms happen, how long they last, and how severe they are may be different for each person.

If you have any of the following symptoms for at least 2 weeks, talk to a doctor or nurse or mental health professional:

  • Feeling sad, “down,” or empty, including crying often
  • Feeling hopeless, helpless, worthless, or useless
  • Loss of interest in hobbies and activities that you once enjoyed
  • Decreased energy
  • Difficulty staying focused, remembering, or making decisions
  • Sleeplessness, early morning awakening, or oversleeping and not wanting to get up
  • Lack of appetite, leading to weight loss, or eating to feel better, leading to weight gain
  • Thoughts of hurting yourself
  • Thoughts of death or suicide
  • Feeling easily annoyed, bothered, or angered
  • Constant physical symptoms that do not get better with treatment, such as headaches, upset stomach, and pain that doesn’t go away

How is depression linked to other health problems?

Depression is linked to many health problems in women, including:6

  • Heart disease. People with heart disease are about twice as likely to have depression as people who don’t have heart disease.7
  • Obesity. Studies show that 43% of adults with depression have obesity. Women, especially white women, with depression are more likely to have obesity than women without depression are.8 Women with depression are also more likely than men with depression to have obesity.8
  • Cancer. Up to 1 in 4 people with cancer may also experience depression. More women with cancer than men with cancer experience depression.9

How is depression diagnosed?

Talk to your doctor or nurse if you have symptoms of depression. Certain medicines and some health problems (such as viruses or a thyroid disorder) can cause the same symptoms as depression. Sometimes depression can be part of another mental health condition.

Diagnosis of depression includes a mental health professional asking questions about your life, emotions, struggles, and symptoms. The doctor, nurse, or mental health professional may order lab tests on a sample of your blood or urine and do a regular checkup to rule out other problems that could be causing your symptoms.

How is depression treated?

Your doctor or mental health professional may treat depression with therapy, medicine, or a combination of the two. Your doctor or nurse may refer you to a mental health specialist so that you can begin therapy.

Some people with milder forms of depression get better after treatment with therapy. People with moderate to severe depression might need a type of medicine called an antidepressant in addition to therapy. Antidepressants change the levels of certain chemicals in your brain. It may take a few weeks or months before you begin to feel a change in your mood. There are different types of antidepressant medicines, and some work better than others for certain people. Some people get better only with both treatments — therapy and antidepressants.

Having depression can make some people more likely to turn to drugs or alcohol to cope. But drugs or alcohol can make your mental health condition worse and can affect how medicines that are used to treat depression work. Talk to your therapist or doctor or nurse about any alcohol or drug use.

I think I may have depression. How can I get help?

Talk to someone like a doctor, nurse, psychiatrist, mental health professional, or social worker about your symptoms. You can also find no-cost or low-cost help in your state by using the mental health services locator on the top left side (desktop view) or bottom (mobile view) of this page.

What if I have thoughts of hurting myself?

If you are thinking about hurting or even killing yourself, get help now. Call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

You might feel like your pain is too overwhelming to bear, but those feelings don’t last forever. People do make it through suicidal thoughts. Many thoughts of suicide are impulses that go away after a short period of time.10

Can I take St. John’s wort to treat depression?

Taking St. John’s wort for depression has not been approved by the Food and Drug Administration (FDA). Studies show mixed results about the plant’s ability to treat depression.11

It may be dangerous to take St. John’s wort if you also take other medicines. St. John’s wort can make many medicines not work at all or may cause dangerous or life-threatening side effects. The medicines used to treat heart disease, HIV, depression, seizures, certain cancers, and organ transplant rejection may not work or may have dangerous side effects if taken with St. John’s wort. St. John’s wort may also make birth control pills not work, which increases the chance you will get pregnant when you don’t want to.12 It is crucial that you tell your doctor or nurse if you take St. John’s wort.

Depression is a serious mental illness that can be successfully treated with therapy and FDA-approved medicines. FDA-approved medicines and natural treatments can have side effects. It’s best to talk to a doctor or nurse about treatment for depression.

Does exercise help treat depression?

For some people, yes. Researchers think that exercise may work better than no treatment at all to treat depression.13 They also think that exercise can help make depression symptoms happen less often or be less severe.14 Researchers do not know whether exercise works as well as therapy or medicine to treat depression.13 People with depression often find it very difficult to exercise, even though they know it will help make them feel better. Walking is a good way to begin exercising if you haven’t exercised recently.

Are there other natural or complementary treatments for depression?

Researchers are studying natural and complementary treatments (add-on treatments to medicine or therapy) for depression. Currently, none of the natural or complementary treatments are proven to work as well as medicine and therapy for depression. However, natural or complementary treatments that have little or no risk, like exercise, meditation, or relaxation training, may help improve your depression symptoms and usually will not make them worse.

Will treatment for depression affect my chances of getting pregnant?

Maybe. Some medicines, such as some types of antidepressants, may make it more difficult for you to get pregnant, but more research is needed.15 Talk to your doctor about other treatments for depression that don’t involve medicine if you are trying to get pregnant. For example, a type of talk therapy called cognitive behavioral therapy (CBT) helps women with depression.16 This type of therapy has little to no risk for women trying to get pregnant. During CBT, you work with a mental health professional to explore why you are depressed and train yourself to replace negative thoughts with positive ones. Certain mental health care professionals specialize in depression related to infertility.

Women who are already taking an antidepressant and who are trying to get pregnant should talk to their doctor or nurse about the risks and benefits of stopping the medicine. Learn more about taking medicines during pregnancy in our Pregnancy section.

Did we answer your question about depression?

For more information about depression, call the OWH Helpline at 1-800-994-9662 or check out these resources from the following organizations:

Sources

  1. Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality. (2017). 2016 National Survey on Drug Use and Health: Table 8.56A (PDF file, 36.7 MB).
  2. SAMHSA Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (PDF file, 2.3 MB). HHS Publication No. SMA 16-4984, NSDUH Series H-51. Rockville, MD: SAMHSA.
  3. 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.
  4. Kang, H.-J., Kim, S.-Y., Bae, K.-Y., Kim, S.-W., Chin, I.-S., Yoon, J.-S., et al. (2015). Comorbidity of Depression with Physical Disorders: Research and Clinical Implications. Chonnam Medical Journal; 51(1): 8–18.
  5. Trivedi, M.H. (2004). The Link Between Depression and Physical Symptoms. The Primary Care Companion to the Journal of Clinical Psychiatry; 6(Suppl 1): 12–16.
  6. Chapman, D.P., Perry, G.S., Strine, T.W. (2005). The Vital Link Between Chronic Disease and Depressive DisordersPreventing Chronic Disease; 2(1): A14.
  7. Lichtman, J.H., Bigger, J.T., Blumenthal, J.A., Frasure-Smith, N., Kaufmann, P.G., Lespérance, F., et al. (2008). Depression and Coronary Heart Disease. Circulation; 118: 1768–1775.
  8. Pratt, L.A., Brody, D.J. (2014). Depression and Obesity in the U.S. Adult Household Population, 2005–2010. NCHS Data Brief No. 167. Hyattsville, MD: National Center for Health Statistics.
  9. Linden, W., Vodermaier, A., Mackenzie, R., Greig, D. (2012). Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. Journal of Affective Disorders; 141(2–3): 343–351.
  10. Cáceda, R., Durand, D., Cortes, E., Prendes-Alvarez, S., Moskovciak, T., Harvey, P.D., et al. (2014). Impulsive choice and psychological pain in acutely suicidal depressed patients. Psychosomatic Medicine; 76(6): 445–451.
  11. National Center for Complementary and Integrative Health (NCCIH). (2016). St. John’s Wort and Depression: In Depth.
  12. NCCIH. (2016). Fact Sheet: St. John’s Wort.
  13. Cooney, G.M., Dwan, K., Greig, C.A., Lawlor, D.A., Rimer, J., Waugh, F.R., et al. (2013). Exercise for depression. Cochrane Database of Systematic Reviews; 9.
  14. U.S. Department of Health and Human Services. (2008). Physical Activity Guidelines for Americans (PDF file, 8.4 MB).
  15. Casilla-Lennon, M.M., Meltzer-Brody, S., Steiner, A.Z. (2016). The effect of antidepressants on fertility. American Journal of Obstetrics and Gynecology; 215(3): 314.e1–314.e5.
  16. Driessen, E., Hollon, S.D. (2010). Cognitive Behavioral Therapy for Mood Disorders: Efficacy, Moderators and Mediators. Psychiatric Clinics of North America; 33(3): 537–555.

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

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What is Binge eating disorder

Binge eating disorder

Binge eating disorder is the most common type of eating disorder in the United States. People with binge eating disorder often feel out of control and eat a large amount of food at one time (called a binge). Unlike other eating disorders, people who have binge eating disorder do not throw up the food or exercise too much. Binge eating disorder is a serious health problem, but people with binge eating disorder can get better with treatment.

What is binge eating disorder?

Binge eating disorder is a type of eating disorder. Eating disorders are mental health problems that cause extreme and dangerous eating behaviors. These extreme eating behaviors cause other serious health problems and sometimes death. Some eating disorders also involve extreme exercise.

According to the American Psychiatric Association, women with binge eating disorder feel out of control and eat too much (binge), at least once a week for at least three months. During binges women with binge eating disorder usually eat faster than normal, eat until they are uncomfortable, eat when they are not physically hungry, and feel embarrassed, disgusted, or depressed because of the binges. Women with this type of eating disorder may be overweight or obese.

What is the difference between binge eating disorder and other eating disorders?

Women with eating disorders, such as binge eating disorder, bulimia, and anorexia, have a mental health condition that affects how they eat, and sometimes how they exercise. These eating disorders threaten their health.

Unlike people with anorexia or bulimia, people with binge eating disorder do not throw up their food, exercise a lot, or starve themselves. People with binge eating disorder are often overweight or obese. But not all people with binge eating disorder are overweight, and being overweight does not always mean you have binge eating disorder.

It is possible to have more than one eating disorder in your lifetime. Regardless of what type of eating disorder you may have, you can get better with treatment.

Who is at risk for binge eating disorder?

Binge eating disorder affects more than 3% of women in the United States. More than half of people with binge eating disorder are women.1

Binge eating disorder affects women of all races and ethnicities. It is the most common eating disorder among Hispanic, Asian-American, and African-American women.2,3,4

Some women may be more at risk for binge eating disorder.

  • Women and girls who diet often are 12 times more likely to binge eat than women and girls who do not diet.5
  • Binge eating disorder affects more young and middle-aged women than older women. On average, women develop binge eating disorder in their early to mid-20s.6 But eating disorders are happening more often in older women. In one study, 13% of American women over 50 had signs of an eating disorder.7

What are the symptoms of binge eating disorder?

It can be difficult to tell whether someone has binge eating disorder. Many women with binge eating disorder hide their behavior because they are embarrassed.

You may have binge eating disorder if, for at least once a week over the past three months, you have binged. Binge eating disorder means you have at least three of these symptoms while binging:8

  • Eating faster than normal
  • Eating until uncomfortably full
  • Eating large amounts of food when not hungry
  • Eating alone because of embarrassment
  • Feeling disgusted, depressed, or guilty afterward

People with binge eating disorder may also have other mental health problems, such as depression, anxiety, or substance abuse.

What causes binge eating disorder?

Researchers are not sure exactly what causes binge eating disorder and other eating disorders. Researchers think that eating disorders might happen because of a combination of a person’s biology and life events. This combination includes having specific genes, a person’s biology, body image and self-esteem, social experiences, family health history, and sometimes other mental health illnesses.

Studies suggest that people with binge eating disorder may use overeating as a way to deal with anger, sadness, boredom, anxiety, or stress.9,10

Researchers are studying how changing levels of brain chemicals may affect eating habits. Neuroimaging, or pictures of the brain, may lead to a better understanding of binge eating disorder.11

Learn more about current research on binge eating disorder.

How does binge eating disorder affect a woman’s health?

Many, but not all, women with binge eating disorder are overweight or obese. Obesity raises your risk for many serious health problems:12

  • Type 2 diabetes
  • Heart disease
  • High blood pressure
  • High cholesterol
  • Gallbladder disease
  • Certain types of cancer, including breast, endometrial (a type of uterine cancer), colorectal, kidney, esophageal, pancreatic, thyroid, and gallbladder cancer13
  • Problems with your menstrual cycle, including preventing ovulation, which can make it harder to get pregnant

People with binge eating disorder often have other serious mental health illnesses such as depression, anxiety, or substance abuse. These problems can seriously affect a woman’s everyday life and can be treated.

How is binge eating disorder diagnosed?

Your doctor or nurse will ask you questions about your symptoms and medical history. It may be difficult to talk to a doctor or nurse about secret eating behaviors. But doctors and nurses want to help you be healthy. Being honest about your eating behaviors with a doctor or nurse is a good way to ask for help.

Your doctor may also do blood, urine, or other tests for other health problems, such as heart problems or gallbladder disease, that can be caused by binge eating disorder.

How is binge eating disorder treated?

Your doctor may refer you to a team of doctors, nutritionists, and therapists who will work to help you get better.

Treatment plans may include one or more of the following:

  • Psychotherapy. Sometimes called “talk therapy,” psychotherapy is counseling to help you change any harmful thoughts or behaviors. This therapy may focus on the importance of talking about your feelings and how they affect what you do. For example, you might talk about how stress triggers a binge. You may work one-on-one with a therapist or in a group with others who have binge eating disorder.
  • Nutritional counseling. A registered dietitian can help you eat in a healthier way.
  • Medicine, such as appetite suppressants or antidepressants prescribed by a doctor. Antidepressants may help some girls and women with binge eating disorder who also have anxiety or depression.

Most girls and women do get better with treatment and are able to eat in healthy ways again.14 Some may get better after the first treatment. Others get well but may relapse and need treatment again.

How does binge eating disorder affect pregnancy?

Binge eating disorder can cause problems getting pregnant and during pregnancy. Pregnancy can also trigger binge eating disorder.

Obesity raises the level of the hormone estrogen in your body. Higher levels of estrogen can stop you from ovulating, or releasing an egg from the ovary. This can make it more difficult to get pregnant. However, if you do not want to have children right now and have sex, you should use birth control.

Overweight or obesity may also cause problems during pregnancy. Overweight and obesity raises your risk for:

  • Gestational hypertension (high blood pressure during pregnancy) and preeclampsia (high blood pressure and kidney problems during pregnancy). If not controlled, both problems can threaten the life of the mother and the baby.
  • Gestational diabetes (diabetes that starts during pregnancy). If not controlled, gestational diabetes can cause you to have a large baby. This raises your risk for a C-section.15

Pregnancy can raise the risk for binge eating disorder in women who are at higher risk for eating disorders. In one study, almost half of the women with binge eating disorder got the condition during pregnancy. The research suggests that binge eating during pregnancy may be caused by:16

  • Worry over pregnancy weight gain. Women may binge because they feel a loss of control over their bodies because of the pregnancy weight.
  • Greater stress during pregnancy
  • Depression
  • History of smoking and alcohol abuse
  • Lack of social support

After pregnancy, postpartum depression and weight from pregnancy can trigger binge eating disorder in women with a history of binge eating. Women with binge eating disorder before pregnancy often gain more weight during pregnancy than women without an eating disorder. Researchers think that weight gain during pregnancy may cause some women who had binge eating disorder before pregnancy to binge eat during pregnancy.17

If I had an eating disorder in the past, can I still get pregnant?

Yes. Women who have recovered from binge eating disorder, are at a healthy weight, and have normal menstrual cycles have a better chance of getting pregnant and having a safe and healthy pregnancy.

Tell your doctor if you had an eating disorder in the past and are trying to become pregnant.

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

Maybe. Some medicines used to treat binge eating disorder can pass through breastmilk. Certain antidepressants can be used safely during breastfeeding.

Talk to your doctor to find out what medicine works best for you. Learn more about medicines and breastfeeding in our Breastfeeding section. You can also enter a medicine into the LactMed® database to find out if the medicine passes through breastmilk and about any possible side effects for your nursing baby.

Did we answer your question about binge eating disorder?

For more information about binge eating disorder, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:

Sources

  1. Hudson, J.I., Hiripi, E., Pope, H.G., Jr., Kessler, R.C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry; 61: 348-58.
  2. Nicdao, E.G., Hong, S., Takeuchi, D.T. (2007). Prevalence and correlates of eating disorders among Asian Americans: results from the National Latino and Asian American Study. International Journal of Eating Disorders; 40: S22-S26.
  3. Alegria, M., Woo, M., Cao, Z., Torres, M., Meng, X.-l., Streigel-Moore, R. (2007). Prevalence and correlates of eating disorders in Latinos in the United States. International Journal of Eating Disorders; 40: S15-S21.
  4. Marques, L., Alegria, M., Becker, A.E., Chen, C., Fang, A., Chosak, A., et al. (2011). Comparative Prevalence, Correlates of Impairment, and Service Utilization for Eating Disorders across U.S. Ethnic Groups: Implications for Reducing Ethnic Disparities in Health Care Access for Eating Disorders. International Journal of Eating Disorders; 44(5): 412-420.
  5. Neumark-Sztainer, D. (2005). I’m, Like, SO Fat!; Helping Your Teen Make Healthy Choices about Eating and Exercise in a Weight-Obsessed World. New York: Guilford Press.
  6. Berkman, N. D., Brownley, K. A., Peat, C. M., et al. (2015). Management and Outcomes of Binge-Eating Disorder. Comparative Effectiveness Reviews, No. 160. Agency for Healthcare Research and Quality (US), Rockville , MD.
  7. Gagne, D.A., Von Holle, A., Brownley, K.A., Runfola, C.D., Hofmeier, S., Branch, K.E., et al. (2012). Eating disorder symptoms and weight and shape concerns in a large web-based convenience sample of women ages 50 and above: Results of the gender and body image (GABI) study. International Journal of Eating Disorders; 45(7): 832-844.
  8. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association Publishing; 2013.
  9. Joke, V., Vansteenkiste, M., Soenens, B., Boone, L., Mouratidis, A. (2013). Daily ups and downs in women’s binge eating symptoms: The role of basic psychological needs, general self-control, and emotional eating. Journal of Social and Clinical Psychology; 32(3): 335-61.
  10. Kelly, N.R., Lydecker, J.A., Mazzeo, S.E. (2012). Positive cognitive coping strategies and binge eating in college women. Eating Behaviors; 13(3): 289-92.
  11. Rikani, A.A., Choudhry, Z., Choudhry, A.M., Ikram, H., Asghar, M.W., Kajal, D., et al. (2013). A critique of the literature on etiology of eating disorders. Annals of Neurosciences; 20(4): 157-161.
  12. National Heart, Lung, and Blood Institute. (2013). What Are the Health Risks of Overweight and Obesity?
  13. National Cancer Institute. (2012). Obesity and Cancer Risk.
  14. Fairburn, C. G., Cooper, Z., Doll, H. A., et al. (2000). The natural course of bulimia nervosa and binge eating disorder in young women. Arch Gen Psychiatry, 57(7), 659–665.
  15. Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2012). NIH Obesity Research Featured in HBO’s The Weight of the Nation.
  16. Berg, C.K., Torgersen, L., Von Holle, A., Hamer, A., Bulik, C.M., Reichborn-Kjennerud, T. (2011). Factors associated with binge eating disorder in pregnancyInternational Journal of Eating Disorders; 44(2): 124-133.
  17. Knoph, C., Von Holle, A., Zerwas, S., Torgersen, L., Tambs, K., et al. (2013). Course and predictors of maternal eating disorders in the postpartum period. International Journal of Eating Disorders; 46(4): 355-368.

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

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Stress and how it affects your health

Stress and your health

Stress is a reaction to a change or a challenge. In the short term, stress can be helpful. It makes you more alert and gives you energy to get things done. But long-term stress can lead to serious health problems. Women are more likely than men to report symptoms of stress, including headaches and upset stomach. Women are also more likely to have mental health conditions that are made worse by stress, such as depression or anxiety.1

What is stress?

Stress is how your body reacts to certain situations, such as sudden danger or long-lasting challenge. During stressful events, your body releases chemicals called hormones, such as adrenaline. Adrenaline gives you a burst of energy that helps you cope and respond to stress. For example, one kind of stress is the jolt you may feel when a car pulls out in front of you. This jolt of adrenaline helps you quickly hit the brakes to avoid an accident.

Stress can range from mild and short-term to more extreme and long-lasting. Chronic (long-lasting) stress can affect your mental and physical health.

What are some symptoms of stress?

Stress affects everyone differently. Some ways that chronic or long-term stress affects women include:

  • Pain, including back pain
  • Acne and other skin problems, like rashes or hives
  • Headaches
  • Upset stomach
  • Feeling like you have no control
  • Forgetfulness
  • Lack of energy
  • Lack of focus
  • Overeating or not eating enough
  • Being easily angered
  • Trouble sleeping
  • Drug and alcohol misuse
  • Loss of interest in things you once enjoyed
  • Less interest in sex than usual

What causes stress?

People can feel stress from many different things. Examples of common causes of short-term stress include:

  • Getting stuck in traffic or missing the bus
  • An argument with your spouse or partner
  • Money problems
  • A deadline at work

Examples of common causes of long-term stress include:

  • Poverty and financial worries. Depression is more common in women whose families live below the federal poverty line.2 Women in poverty who care for children or other family members as well as themselves may experience more severe stress.3,4
  • Discrimination. All women are at risk for discrimination, such as gender discrimination at work. Some women experience discrimination based on their race, ethnicity, or sexual orientation.5,6 Stressful events, such as learning a new culture (for those new to the United States) or experiencing discrimination, put women at higher risk for depression or anxiety.
  • Traumatic events. Experiencing trauma, such as being in an accident or disaster or going through emotional, physical, or sexual assault or abuse as a child or an adult, may put you at higher risk of depression7 and other disorders.8 Women are more likely than men to experience certain types of violence, such as sexual violence,9 that are more likely to cause mental health conditions, such as post-traumatic stress disorder (PTSD).

Ongoing, low-level stress can be hard to notice, but it can also lead to serious health problems. If you feel stressed, try these tips to help you manage your stress. If you need more help managing stress, talk to a doctor, nurse, or mental health professional.

How does stress affect women’s health?

Some of the health effects of stress are the same for men and women. For example, stress can cause trouble sleeping and weaker immune systems. But there are other ways that stress affects women.

  • Headaches and migraines. When you are stressed, your muscles tense up. Long-term tension can lead to headache, migraine, and general body aches and pains. Tension-type headaches are common in women.10
  • Depression and anxiety. Women are twice as likely as men to have depression.11 Women are more likely than men to have an anxiety disorder, including post-traumatic stress disorder, panic disorder, or obsessive-compulsive disorder.12 Research suggests that women may feel the symptoms of stress more or get more of the symptoms of stress than men. This can raise their risk of depression and anxiety.1
  • Heart problems. High stress levels can raise your blood pressure and heart rate. Over time, high blood pressure can cause serious health problems, such as stroke and heart attacks. Younger women with a history of heart problems especially may be at risk of the negative effects of stress on the heart.13 Learn more about stress and heart disease.
  • Upset stomach. Short-term stress can cause stomach issues such as diarrhea or vomiting. Long-term stress can lead to irritable bowel syndrome (IBS), a condition that is twice as common in women as in men.14 Stress can make IBS symptoms such as gas and bloating worse.
  • Obesity. The link between stress and weight gain is stronger for women than for men.15 Stress increases the amount of a hormone in your body called cortisol, which can lead to overeating and cause your body to store fat.
  • Problems getting pregnant. Women with higher levels of stress are more likely to have problems getting pregnant than women with lower levels of stress. Also, not being able to get pregnant when you want to can be a source of stress.16
  • Menstrual cycle problems. Women who experience chronic or long-term stress may have more severe premenstrual syndrome (PMS) symptoms17 or irregular periods. Some studies link past abuse or trauma to more severe PMS.18
  • Decreased sex drive. Women with long-term stress may take longer to get aroused and may have less sex drive than women with lower levels of stress. While not surprising, at least one study found that women with higher stress levels were more distracted during sex than other women.19

What is post-traumatic stress disorder (PTSD)?

PTSD is an illness that some people experience after going through trauma. PTSD can happen to someone who has lived through or witnessed a violent crime or war. It can also happen after a sudden traumatic event like a death of a loved one, physical or sexual abuse, or a severe car crash.

Women are about twice as likely as men to develop PTSD. Some PTSD symptoms also are more common in women than in men. For example, women are more likely to:20

  • Be jumpy
  • Have more trouble feeling emotions
  • Avoid whatever reminds them of the trauma
  • Feel depressed and anxious

Learn more about the symptoms and treatments for PTSD.

Do women react to stress differently than men do?

Yes, studies show that women are more likely than men to experience symptoms of stress. Women who are stressed are more likely than men who are stressed to experience depression and anxiety.21 Experts do not fully know the reason for the differences, but it may be related to how men’s and women’s bodies process stress hormones. Long-term stress especially is more likely to cause problems with moods and anxiety in women.22

How does stress affect pregnancy?

It is normal to feel stressed during pregnancy. Your body and your hormones are changing, and you may worry about your baby and the changes he or she will bring to your life. But too much stress during pregnancy can hurt you and your baby’s health.

Stress during pregnancy can make normal pregnancy discomforts, like trouble sleeping and body aches, even worse. It can also lead to more serious problems, such as:

  • Depression. Depression during pregnancy or after birth can affect your baby’s development. Learn more about depression during and after pregnancy.
  • Problems eating (not eating enough or eating too much). Women who are underweight or who gain too much weight during pregnancy are at risk for complications, including premature delivery (delivery before 37 weeks of pregnancy) and gestational diabetes. Get a personalized recommendation on how much weight to gain during pregnancy.
  • High blood pressure. High blood pressure during pregnancy puts you at risk of a serious condition called preeclampsia, premature delivery, and having a low-birth-weight infant (baby weighing less than 5½ pounds).

Talk to your doctor about your stress, and try these tips to help manage your stress. Learn about how stress affects breastfeeding too.

What can I do to help manage my stress?

Everyone has to deal with stress at some point in their lives. You can take steps to help handle stress in a positive way.

  • Take deep breaths. This forces you to breathe slower and helps your muscles relax. The extra oxygen sends a message to your brain to calm and relax the body.
  • Stretch. Stretching can also help relax your muscles and make you feel less tense.
  • Write out your thoughts. Keeping a journal or simply writing down the things you are thankful for can help you handle stress.
  • Take time for yourself. It could be listening to music, reading a good book, or going to a movie.
  • Meditate. Studies show that meditation, a set time of stillness to focus the mind on a positive or neutral thought, can help lower stress.23 In addition to traditional medical treatments, meditation also may help improve anxiety, some menopause symptoms, and side effects from cancer treatments and may lower blood pressure.24 Meditation is generally safe for everyone, and free meditation guides are widely available online.
  • Get enough sleep. Most adults need 7 to 9 hours of sleep a night to feel rested.
  • Eat right. Caffeine or high-sugar snack foods give you jolts of energy that wear off quickly. Instead, eat foods with B vitamins, such as bananas, fish, avocados, chicken, and dark green, leafy vegetables. Studies show that B vitamins can help relieve stress by regulating nerves and brain cells.25 You can also take a vitamin B supplement if your doctor or nurse says it is OK.
  • Get moving. Physical activity can relax your muscles and improve your mood. Physical activity also may help relieve symptoms of depression and anxiety.26 Physical activity boosts the levels of “feel-good” chemicals in your body called endorphins. Endorphins can help improve your mood.
  • Try not to deal with stress in unhealthy ways. This includes drinking too much alcohol, using drugs, smoking, or overeating. These coping mechanisms may help you feel better in the moment but can add to your stress levels in the long term. Try substituting healthier ways to cope, such as spending time with friends and family, exercising, or finding a new hobby.
  • Talk to friends or family members. They might help you see your problems in new ways and suggest solutions. Or, just being able to talk to a family member or friend about a source of stress may help you feel better.
  • Get help from a professional if you need it. Your doctor or nurse may suggest counseling or prescribe medicines, such as antidepressants or sleep aids. You can also find a therapist in your area using the mental health services locator on the top left side (desktop view) or bottom (mobile view) of this page. If important relationships with family or friends are a source of stress, a counselor can help you learn new emotional and relationship skills.
  • Get organized. Being disorganized is a sign of stress, but it can also cause stress. To-do lists help organize both your work and home life. Figure out what is most important to do at home and at work and do those things first.
  • Help others. Volunteering in your community can help you make new friends and feel good about helping others.

Did we answer your question about stress and your health?

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

Sources

  1. Hammen, C., Kim, E.Y., Eberhart, N.K., Brennan, P.A. (2009). Chronic and acute stress and the predictors of major depression in women. Depression and Anxiety; 26(8): 718–723.
  2. 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.
  3. Wadsworth, M.E. (2012). Working with Low-income Families: Lessons Learned from Basic and Applied Research on Coping with Poverty-related Stress. Journal of Contemporary Psychotherapy; 42(1): 17–25.
  4. Sapolsky, R.M. (2004). Social Status and Health in Humans and Other Animals. Annual Review of Anthropology; 33: 393–418.
  5. Perry, B.L., Harp, K.L.H., Oser, C.B. (2013). Racial and Gender Discrimination in the Stress Process: Implications for African American Women’s Health and Well-Being. Sociological Perspectives; 56(1): 25–48.
  6. Meyer, I.H. (2003). Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. Psychological Bulletin; 129(5): 674–697.
  7. Chapman, D.P., Whitfield, C.L., Felitti, V.J., Dube, S.R., Edwards, V.J., Anda, R.F. (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders; 82(2): 217–225.
  8. Gilbert, L.K., Breiding, M.J., Merrick, M.T., Thompson, W.W., Ford, D.C., Dhingra, S.S., et al. (2015). Childhood adversity and adult chronic disease: an update from ten states and the District of Columbia, 2010. American Journal of Preventive Medicine; 48(3): 345–9.
  9. Smith, S.G., Chen, J., Basile, K.C., Gilbert, L.K., Merrick, M.T., Patel, N., et al. (2017). The National Intimate Partner and Sexual Violence Survey: 2010–2012 State Report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
  10. Farooq, K., Williams, P. (2008). Headache and chronic facial pain. Continuing Education in Anaesthesia, Critical Care & Pain; 8(4): 138–142.
  11. Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality. (2017). 2016 National Survey on Drug Use and Health: Table 8.56A (PDF file, 36.7 MB).
  12. Substance Abuse and Mental Health Services Administration. (2013). Table 4: Specific mental illness and substance use disorders among adults, by sex: percentage, United States, 2001/2002. Behavioral Health, United States, 2012. HHS Publication No. (SMA) 13-4797. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  13. Vaccarino, V., Shah, A.J., Rooks, C., Ibeanu, I., Nye, J.A., Pimple, P., et al. (2014). Sex differences in mental stress-induced myocardial ischemia in young survivors of an acute myocardial infarction. Psychosomatic Medicine; 76(3): 171–180.
  14. Grundmann, O., Yoon, S.L. (2010). Irritable bowel syndrome: epidemiology, diagnosis and treatment: an update for health-care practitioners. Journal of Gastroenterology and Hepatology; 25(4): 691–699.
  15. Michopoulos, V. (2016). Stress-induced alterations in estradiol sensitivity increase risk for obesity in women. Physiology & Behavior; 166: 56–64.
  16. Louis, G.M., Lum, K.J., Sundaram, R., Chen, Z., Kim, S., Lynch, C.D., et al. (2011). Stress reduces conception probabilities across the fertile window: evidence in support of relaxation. Fertility and Sterility; 95(7): 2184–2189.
  17. Gollenberg, A.L., Hediger, M.L., Mumford, S.L., Whitcomb, B.W., Hovey, K.M., Wactawski-Wende, J., et al. (2010). Perceived Stress and Severity of Perimenstrual Symptoms: The BioCycle Study. Journal of Women’s Health; 19(5): 959–967.
  18. Bertone-Johnson, E.R., Whitcomb, B.W., Missmer, S.A., Manson, J.E., Hankinson, S.E., Rich-Edwards, J.W. (2014). Early Life Emotional, Physical, and Sexual Abuse and the Development of Premenstrual Syndrome: A Longitudinal Study. Journal of Women’s Health (Larchmont); 23(9): 729–739.
  19. Hamilton, L.D, Meston, C.M. (2013). Chronic Stress and Sexual Function in Women. Journal of Sexual Medicine; 10(10): 2443–2454.
  20. U.S. Department of Veteran Affairs, National Center for PTSD. (2015). Women, Trauma, and PTSD.
  21. Verma, R., Balhara, Y.P.S., Gupta, C.S. (2011). Gender differences in stress response: Role of developmental and biological determinants. Industrial Psychiatry Journal; 20(1): 4–10.
  22. Bangasser, D.A. (2013). Sex differences in stress-related receptors: “micro” differences with “macro” implications for mood and anxiety disorders. Biology of Sex Differences; 4(2).
  23. Goyal, M., Singh, S., Sibinga, E.M.S., Gould, N.F., Rowland-Seymour, A., Sharma, R., et al. (2014). Meditation Programs for Psychological Stress and Well-Being: A Systematic Review and Meta-analysis. JAMA Internal Medicine; 174(3), 357–368.
  24. National Center for Complementary and Integrative Health. (2015). 8 Things to Know About Meditation for Health.
  25. Stough, C., Scholey, A., Lloyd, J., Spong, J., Myers, S., Downey, L.A. (2011). The effect of 90 day administration of a high dose vitamin B-complex on work stress. Human Psychopharmacology; 26(7): 470–476.
  26. U.S. Department of Health and Human Services. (2017). 2008 Physical Activity Guidelines for Americans. Chapter 2: Physical Activity Has Many Health Benefits (PDF file, 8.8 MB).

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

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Pregnancy and lupus – What you should know

Pregnancy and lupus

Pregnancy and lupus

Women with lupus can safely get pregnant and most will have normal pregnancies and healthy babies. However, all women with lupus who get pregnant are considered to have a “high risk pregnancy.” This means that problems during pregnancy may be more likely for women with lupus. It doesn’t mean there will definitely be problems.

I have lupus and want to have a baby. Is it safe for me to get pregnant?

Yes. Women with lupus can safely become pregnant. If your disease is under control, pregnancy is unlikely to cause flares. However, you will need to start planning for pregnancy well before you get pregnant.

  • Your disease should be under control or in remission for six months before you get pregnant. Getting pregnant when your lupus is active could result in miscarriage, stillbirth, or other serious health problems for you or your baby.
  • Pregnancy is very risky for certain groups of women with lupus. These include women with high blood pressure, lung disease, heart failure, chronic kidney failure, kidney disease, or a history of preeclampsia. It also may include women who have had a stroke or a lupus flare within the past six months.

You will need to find an obstetrician (a doctor who is specially trained to care for women during pregnancy) who manages high-risk pregnancies and who can work closely with your regular doctor.

How does pregnancy affect lupus?

Pregnant women with lupus have a higher risk for certain pregnancy complications than women who do not have lupus. You may also have other problems that happen during pregnancy.

  • You may get flares during pregnancy. The flares happen most often in the first or second trimester. Most flares are mild. But some flares require medicine right away or may cause you to deliver early.1 Always call your doctor right away if you get the warning signs of a lupus flare.
  • About 2 in 10 pregnant women with lupus get preeclampsia,2 a serious condition that must be treated right away. The risk of preeclampsia is higher in women with lupus who have a history of kidney disease. If you get preeclampsia, you might notice sudden weight gain, swelling of the hands and face, blurred vision, dizziness, or stomach pain. You might have to deliver your baby early.
  • Pregnancy can raise your risk for other problems, especially if you take corticosteroids. These problems include high blood pressure, diabetes, and kidney problems. Good nutrition during pregnancy can help prevent these problems during pregnancy. Regular doctor visits can help find problems like these early so they can be treated to keep you and your baby as healthy as possible.

How can I tell if the changes in my body are normal during pregnancy or a sign of a flare?

You may not be able to tell the difference between changes in your body due to pregnancy and warning signs of a lupus flare. Tell your doctor about any new symptoms. You and your doctor can figure out whether your symptoms are because of your pregnancy or your lupus. This way, you can help prevent or control any flares that do happen.

I have lupus and am pregnant. Will my baby be healthy?

Most likely, yes. Most babies born to mothers with lupus are healthy.

Rarely, infants are born with a condition called neonatal lupus. Certain antibodies found in the mother can cause neonatal lupus. At birth, an infant with neonatal lupus may have a skin rash, liver problems, or low blood cell levels.

Infants with neonatal lupus can develop a serious heart defect called congenital heart block. But, in most babies, neonatal lupus goes away after three to six months and does not come back.

Your doctor will test for neonatal lupus during your pregnancy. Treatment can also begin at or before birth.

Can I breastfeed if I have lupus?

Yes. Breastfeeding is possible for mothers with lupus. However, some medicines can pass through your breastmilk to your infant. Talk to your doctor or nurse about whether breastfeeding is safe with the medicines you use to control your lupus.

Visit our Breastfeeding section to learn more. 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.

Did we answer your question about pregnancy and lupus?

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

Sources

  1. Longo, D.L., et al. (2012). Harrison’s Principles of Internal Medicine, 18th edition.
  2. Clowse, M. (2007). Lupus Activity in Pregnancy. Rheum Dis Clin North Am; 33(237).

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

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Hormone Therapy to Treat Cancer

Hormone Therapy to Treat Cancer

Credit: iStock

Hormone therapy is a cancer treatment that slows or stops the growth of cancer that uses hormones to grow. Hormone therapy is also called hormonal therapy, hormone treatment, or endocrine therapy.

Hormone Therapy to Treat Cancer

Hormone therapy is used to:

  • Treat cancer. Hormone therapy can lessen the chance that cancer will return or stop or slow its growth.
  • Ease cancer symptoms. Hormone therapy may be used to reduce or prevent symptoms in men with prostate cancer who are not able to have surgery or radiation therapy.

Types of Hormone Therapy

Hormone therapy falls into two broad groups, those that block the body’s ability to produce hormones and those that interfere with how hormones behave in the body.

Who Receives Hormone Therapy

Hormone therapy is used to treat prostate and breast cancers that use hormones to grow. Hormone therapy is most often used along with other cancer treatments. The types of treatment that you need depend on the type of cancer, if it has spread and how far, if it uses hormones to grow, and if you have other health problems.

How Hormone Therapy Is Used with Other Cancer Treatments

When used with other treatments, hormone therapy can:

  • Make a tumor smaller before surgery or radiation therapy. This is called neo-adjuvant therapy.
  • Lower the risk that cancer will come back after the main treatment. This is called adjuvant therapy.
  • Destroy cancer cells that have returned or spread to other parts of your body.

Hormone Therapy Can Cause Side Effects

Because hormone therapy blocks your body’s ability to produce hormones or interferes with how hormones behave, it can cause unwanted side effects. The side effects you have will depend on the type of hormone therapy you receive and how your body responds to it. People respond differently to the same treatment, so not everyone gets the same side effects. Some side effects also differ if you are a man or a woman.

Some common side effects for men who receive hormone therapy for prostate cancer include:

Some common side effects for women who receive hormone therapy for breast cancer include:

  • Hot flashes
  • Vaginal dryness
  • Changes in your periods if you have not yet reached menopause
  • Loss of interest in sex
  • Nausea
  • Mood changes
  • Fatigue

How Much Hormone Therapy Costs

The cost of hormone therapy depends on:

  • The types of hormone therapy you receive
  • How long and how often you receive hormone therapy
  • The part of the country where you live

Talk with your health insurance company about what services it will pay for. Most insurance plans pay for hormone therapy for their members. To learn more, talk with the business office where you go for treatment. You can also go to the National Cancer Institute database, Organizations that Offer Support Services and search “financial assistance.” Or call toll-free 1-800-4-CANCER (1-800-422-6237) to ask for help.

What to Expect When Receiving Hormone Therapy

How Hormone Therapy Is Given

Hormone therapy may be given in many ways. Some common ways include:

  • Oral. Hormone therapy comes in pills that you swallow.
  • Injection. The hormone therapy is given by a shot in a muscle in your arm, thigh, or hip, or right under the skin in the fatty part of your arm, leg, or belly.
  • Surgery. You may have surgery to remove organs that produce hormones. In women, the ovaries are removed. In men, the testicles are removed.

Where You Receive Hormone Therapy

Where you receive treatment depends on which hormone therapy you are getting and how it is given. You may take hormone therapy at home. Or, you may receive hormone therapy in a doctor’s office, clinic, or hospital.

How Hormone Therapy May Affect You

Hormone therapy affects people in different ways. How you feel depends on the type of cancer you have, how advanced it is, the type of hormone therapy you are getting, and the dose. Your doctors and nurses cannot know for certain how you will feel during hormone therapy.

How to Tell If Hormone Therapy Is Working

If you are taking hormone therapy for prostate cancer, you will have regular PSA tests. If hormone therapy is working, your PSA levels will stay the same or may even go down. But, if your PSA levels go up, this may be a sign that the treatment is no longer working. If this happens, your doctor will discuss treatment options with you.

If you are taking hormone therapy for breast cancer, you will have regular checkups. Checkups usually include an exam of the neck, underarm, chest, and breast areas. You will have regular mammograms, though you probably won’t need a mammogram of a reconstructed breast. Your doctor may also order other imaging procedures or lab tests.

Special Diet Needs

Hormone therapy for prostate cancer may cause weight gain. Talk with your doctor, nurse, or dietitian if weight gain becomes a problem for you.

Working during Hormone Therapy

Hormone therapy should not interfere with your ability to work.

Posted: April 29, 2015

This content is provided by the National Cancer Institute (www.cancer.gov)

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Captured Date: 2018-08-08 16:10:21.0

Stem Cell Transplants in Cancer Treatment

Stem cell transplants help restore blood-forming stem cells in people who have had theirs destroyed by certain cancer treatments.

Credit: National Cancer Institute

Stem cell transplants are procedures that restore blood-forming stem cells in people who have had theirs destroyed by the very high doses of chemotherapy or radiation therapy that are used to treat certain cancers.

Blood-forming stem cells are important because they grow into different types of blood cells. The main types of blood cells are:

  • White blood cells, which are part of your immune system and help your body fight infection
  • Red blood cells, which carry oxygen throughout your body
  • Platelets, which help the blood clot

You need all three types of blood cells to be healthy.

Types of Stem Cell Transplants

In a stem cell transplant, you receive healthy blood-forming stem cells through a needle in your vein. Once they enter your bloodstream, the stem cells travel to the bone marrow, where they take the place of the cells that were destroyed by treatment. The blood-forming stem cells that are used in transplants can come from the bone marrow, bloodstream, or umbilical cord. Transplants can be:

  • Autologous, which means the stem cells come from you, the patient
  • Allogeneic, which means the stem cells come from someone else. The donor may be a blood relative but can also be someone who is not related.
  • Syngeneic, which means the stem cells come from your identical twin, if you have one

To reduce possible side effects and improve the chances that an allogeneic transplant will work, the donor’s blood-forming stem cells must match yours in certain ways. To learn more about how blood-forming stem cells are matched, see Blood-Forming Stem Cell Transplants.

How Stem Cell Transplants Work against Cancer

Stem cell transplants do not usually work against cancer directly. Instead, they help you recover your ability to produce stem cells after treatment with very high doses of radiation therapy, chemotherapy, or both.

However, in multiple myeloma and some types of leukemia, the stem cell transplant may work against cancer directly. This happens because of an effect called graft-versus-tumor that can occur after allogeneic transplants. Graft-versus-tumor occurs when white blood cells from your donor (the graft) attack any cancer cells that remain in your body (the tumor) after high-dose treatments. This effect improves the success of the treatments.

Who Receives Stem Cell Transplants

Stem cell transplants are most often used to help people with leukemia and lymphoma. They may also be used for neuroblastoma and multiple myeloma.

Stem cell transplants for other types of cancer are being studied in clinical trials, which are research studies involving people. To find a study that may be an option for you, see Find a Clinical Trial.

Stem Cell Transplants Can Cause Side Effects

The high doses of cancer treatment that you have before a stem cell transplant can cause problems such as bleeding and an increased risk of infection. Talk with your doctor or nurse about other side effects that you might have and how serious they might be. For more information about side effects and how to manage them, see the section on side effects.

If you have an allogeneic transplant, you might develop a serious problem called graft-versus-host disease. Graft-versus-host disease can occur when white blood cells from your donor (the graft) recognize cells in your body (the host) as foreign and attack them. This problem can cause damage to your skin, liver, intestines, and many other organs. It can occur a few weeks after the transplant or much later. Graft-versus-host disease can be treated with steroids or other drugs that suppress your immune system.

The closer your donor’s blood-forming stem cells match yours, the less likely you are to have graft-versus-host disease. Your doctor may also try to prevent it by giving you drugs to suppress your immune system.

How Much Stem Cell Transplants Cost

Stem cells transplants are complicated procedures that are very expensive. Most insurance plans cover some of the costs of transplants for certain types of cancer. Talk with your health plan about which services it will pay for. Talking with the business office where you go for treatment may help you understand all the costs involved.

To learn about groups that may be able to provide financial help, go to the National Cancer Institute database, Organizations that Offer Support Services and search “financial assistance.” Or call toll-free 1-800-4-CANCER (1-800-422-6237) for information about groups that may be able to help.

What to Expect When Receiving a Stem Cell Transplant

Where You Go for a Stem Cell Transplant

When you need an allogeneic stem cell transplant, you will need to go to a hospital that has a specialized transplant center. The National Marrow Donor Program® maintains a list of transplant centers in the United States that can help you find a transplant center.

Unless you live near a transplant center, you may need to travel from home for your treatment. You might need to stay in the hospital during your transplant, you may be able to have it as an outpatient, or you may need to be in the hospital only part of the time. When you are not in the hospital, you will need to stay in a hotel or apartment nearby. Many transplant centers can assist with finding nearby housing.

How Long It Takes to Have a Stem Cell Transplant

A stem cell transplant can take a few months to complete. The process begins with treatment of high doses of chemotherapy, radiation therapy, or a combination of the two. This treatment goes on for a week or two. Once you have finished, you will have a few days to rest.

Next, you will receive the blood-forming stem cells. The stem cells will be given to you through an IV catheter. This process is like receiving a blood transfusion. It takes 1 to 5 hours to receive all the stem cells.

After receiving the stem cells, you begin the recovery phase. During this time, you wait for the blood cells you received to start making new blood cells.

Even after your blood counts return to normal, it takes much longer for your immune system to fully recover—several months for autologous transplants and 1 to 2 years for allogeneic or syngeneic transplants.

How Stem Cell Transplants May Affect You

Stem cell transplants affect people in different ways. How you feel depends on:

  • The type of transplant that you have
  • The doses of treatment you had before the transplant
  • How you respond to the high-dose treatments
  • Your type of cancer
  • How advanced your cancer is
  • How healthy you were before the transplant

Since people respond to stem cell transplants in different ways, your doctor or nurses cannot know for sure how the procedure will make you feel.

How to Tell If Your Stem Cell Transplant Worked

Doctors will follow the progress of the new blood cells by checking your blood counts often. As the newly transplanted stem cells produce blood cells, your blood counts will go up.

Special Diet Needs

The high-dose treatments that you have before a stem cell transplant can cause side effects that make it hard to eat, such as mouth sores and nausea. Tell your doctor or nurse if you have trouble eating while you are receiving treatment. You might also find it helpful to speak with a dietitian. For more information about coping with eating problems see the booklet Eating Hints or the section on side effects.

Working during Your Stem Cell Transplant

Whether or not you can work during a stem cell transplant may depend on the type of job you have. The process of a stem cell transplant, with the high-dose treatments, the transplant, and recovery, can take weeks or months. You will be in and out of the hospital during this time. Even when you are not in the hospital, sometimes you will need to stay near it, rather than staying in your own home. So, if your job allows, you may want to arrange to work remotely part-time.

Many employers are required by law to change your work schedule to meet your needs during cancer treatment. Talk with your employer about ways to adjust your work during treatment. You can learn more about these laws by talking with a social worker.


Posted: April 29, 2015

This content is provided by the National Cancer Institute (www.cancer.gov)

Syndicated Content Details:
Source URL: https://www.cancer.gov/publishedcontent/syndication/915540.htm
Source Agency: National Cancer Institute (NCI)
Captured Date: 2018-08-08 16:10:21.0