By Iris Farrou
06 Jan, 2021
Menstruation
Best gyns in Buffalo, Best OB practices in Buffalo, Best OBGYN Groups in Buffalo, Buffalo OB-GYN, Buffalo OBGYN, Chouchani MD, missed period, Normal menstruation cycle, WNY OB-GYN, WNY OBGYN
Irregular or missed periods happen for many reasons besides pregnancy. While most women have a period every 28 days, a healthy cycle can range from 21 to 35 days. So, it’s helpful to keep in mind that normal is relative to each person. There are many other reasons that can cause irregular or missed periods.
Most people have some amount of stress in their daily lives—let’s face it, in a pandemic, who isn’t experiencing some stress? Even with tactics to manage stress (working out, meditation, therapy, healthy eating, etc.), stress can cause physical symptoms, including altering your period. Significant stress can disrupt your hormonal balance, which may lead to delayed, irregular, heavy, or even missed periods.
- Weight loss/Too much exercise
While losing weight is usually good, losing weight too quickly can also affect your hormones. The loss of a hormone in fatty tissue called leptin can lead to the loss of other hormones, including estrogen, which may cause your period to be irregular.
- Low body weight/Eating disorders
Women with eating disorders, such as anorexia nervosa or bulimia, may also experience missed or irregular periods. In fact, women may stop ovulating if they weigh 10% below the normal range for their height. Gaining weight usually triggers the body to return to normal ovulation, but eating disorders are serious. Seeking medical help is imperative.
- Polycystic ovary syndrome (PCOS)
Affecting about 5% to 10% of women, PCOS is a medical condition caused by an imbalance of reproductive hormones. With an imbalance of estrogen, your period could come more or less frequently than normal.
Going on or off birth control may affect your cycle right away or even months later. Birth control pills contain hormones, estrogen and progestin, which stop your ovaries from releasing eggs. In fact, low-estrogen birth control pills, IUDs, and shots can even trigger a light or non-existent period. It may take up to three months for a period to return to normal after a women goes off birth control.
In addition to causing weight gain or weight loss, thyroid disorders can affect hormones, leading to irregular or missed periods. The thyroid regulates the body’s metabolism, which can alter hormone levels.
If you experience an irregular period with other symptoms (fever, severe pain, unusually heavy bleeding, etc.), you should contact your doctor right away. Otherwise, keeping a log of your period can help your doctor diagnose the issue.
More
By Iris Farrou
30 Dec, 2020
Pregnancy
Best gyns in Buffalo, Best OB practices in Buffalo, Best OBGYN Groups in Buffalo, Buffalo OBGYN, Chouchani MD, Healthy pregnancy, WNY OB-GYN, WNY Ob-gyn doctors, WNY OBGYN, women's health
There comes a time at every pregnancy when the delivery of the baby becomes the issue at hand; many mothers have a choice on whether to go through a natural birth—also referred to as vaginal birth—or request a Caesarian section, most commonly known as C-section. Sometimes a C-section is necessary, especially in cases of medical concerns for the health of the baby or the mother, but when faced with the option it is a wise idea to be informed of the differences between the two methods of delivery, as well as their respective risks and complications.
Overview
C-sections are a surgical procedure to deliver the newborn, and it takes place either when requested by the mother in lieu of natural birth, or when medical conditions make it necessary. Sometimes a C-section is pre-planned, while other times it may become necessary during labor. They are not as common as natural births, but the following conditions may make a C-section necessary for the safety of both the mother and the baby:
- General health medical concerns for the newborn
- Delivery of more than one baby
- Maternal infections or conditions, such as diabetes
- Problems with the placenta
- Delivery of a larger baby
- A labor that is not progressing in a timely manner, making it unsafe to continue naturally
A natural birth is a vaginal delivery, and it may take place with or without medical assistance for the pain. Natural births usually require a shorter hospital stay and have a faster recovery period. If the mother chooses to have a medical intervention to assist with a natural birth, this may be one of the following:
- Using Pitocin to induce labor
- An incision to help with the delivery of the baby without tearing the skin
- Artificially breaking the water, which would mean a rupture of the amniotic membrane
- A vacuum extraction
Procedure and Healing
Caesarean Delivery
In the case of a Caesarean section, the surgical procedure in general takes about 45 minutes. An incision is made through your abdomen and uterus to remove the baby, usually in the lower part of your uterus. As it is an operation, mothers may be given general anesthesia or an epidural block, where you will be awake during the procedure but not feel the lower part of your body.
The doctor cuts the umbilical cord, removes the placenta and closes the incision while the nurses may need to check the baby and clear their airway before they return it to the mother. Unlike natural birth, it may be a few minutes before the mother is united with her baby after a C-section.
As it is a surgery, recovering from a C-section will be similar to that of any kind of operation. There is a two to four day required stay at the hospital, and pain is to be expected when moving around or getting in and out of bed. The scar from the procedure may be itchy or painful in the first few weeks, like with any surgical scar, and cramps or discharge for about four to six weeks are natural.
Vaginal Delivery
A vaginal delivery happens in the hospital or a birthing center, and sometimes at home. In some cases, mothers opt for an epidural to numb the pain. There are three stages to this procedure: early, active, and transitional. Periodically, your cervix will be measured to determine whether you are fully dilated.
A full dilation is when the cervix is at 10 cm, when it is time to push. As the baby moves down the birth canal, the medical team assists with the delivery and uniting the newborn with the mother immediately. While the baby may be out, more contractions to extract the placenta are expected. Unlike a C-section, natural delivery has no specific timeframe and may take hours.
Takeaway
When the time comes to consider the safest option for you and your baby, always consult with your medical professional or your doctor. The safest choice depends on your medical history.
More
There is no doubt, this year’s holiday season will be somewhat different. Many families will choose smaller events with only the people in their bubbles. Even with less pressure and tension from serving and hosting large groups, the stress and isolation due to the pandemic is weighing on most people. The good news is that smaller gatherings can be more intimate and encourage healthier holiday food options.
Healthy eating tips for this holiday season:
Break from tradition: Instead of feeling like you need to hit on every tradition and make every single dish that you usually have at your parties, this is a great excuse to try something new. Consider a themed holiday dinner (think French countryside, Tapas, or even Harry Potter) and opt for healthier dishes that include grilled meats and vegetables. Building a meal around a soup, stew, or chili main course could also be fun. Not only do soups warm up a cold body, but they can also be quicker and healthier than traditional plated meals.
Include the kids: While kids love decorating sweets and cookies, also include the kids in making healthy dishes like a Christmas tree crudités or crudités wreath. Be sure to include more kid friendly veggies like broccoli, tomatoes or carrots. If veggies aren’t your family’s thing, try a fruit Christmas tree or Grinch kabobs.
Don’t go overboard: Unless you’re planning to make cookies or cakes as gifts for family and friends, limit the amount of sweets coming into the house. Pick a few favorites, but don’t get carried away. Odds are you will have less people coming over, so there’s no reason to make a never-ending array of cookies and cakes. If desserts are a key aspect of your holiday celebrations, look for ways to lighten things up with healthier recipes or by choosing to make mini versions of your favorites like these mini cheesecakes.
Go vegetarian: In addition to helping the environment, eating vegetarian is often healthier than meat-based diets. Consider integrating one vegetarian meal on a major holiday this winter. This list includes classics from broccoli-cheddar casserole to butternut squash and spinach lasagna—so the options are endless.
Integrate exercise: Hopefully you’ve already found a groove for integrating some exercise into your weekly routines. Exercise is so important because it releases endorphins, which will boost your mood and well-being. Never under estimate the power of exercise. It’s never too late to get started. Make it a point to integrate 20+ minutes of exercise on days where you will be eating more than usual. This can include many at-home activities such as walking and workout videos (yoga, aerobics, etc.). The key is to work in exercises with some consistency, even if it’s just a couple of times a week.
More
Though the word “mammogram” may ring as scary for many women, it is essentially an X-ray imaging of your breasts to detect a tumor or other abnormalities. There is no suggested or ideal age at which medical professionals agree one should start getting a screening mammogram, but typically women get their first mammogram between ages 35 and 40. Depending on risk level and preferences, women should discuss the options and risks with their doctor.
Remember that getting a screening mammogram does not necessarily mean there is cancer present: even if you get a call back, which is most common in first mammograms, it is most likely to look at a certain area more carefully. An extra ultrasound may be more commonly required in women who are pre-menopausal and get a mammogram done.
Facility Tips
- Choose a facility that specializes in mammograms and conducts a number of them in a day, speaking to its credibility and expertise. To reassure yourself about the standards being met, you may request to see an FDA certificate. If possible, visit the same facility every year so that your record is kept and comparisons may be done easily.
- Get your records from any other facility you may have visited in the past, so the pictures can be compared, and you can save some time.
- Also bring with you a list of places and dates when other mammograms may have been done, as well as biopsies or other breast treatments.
Day of the Mammogram
- Avoid deodorant, cream, or powder under your arms on the day you are scheduled to have a mammogram as those substances may show up as white spots.
- Wear clothes that will make it easy to remove just the top and your bra on the day of the exam.
- Try to schedule the mammogram on a day when your breasts are not swollen, so as to get a better picture and be more comfortable.
The Exam
- Most technologists are women, and you and the technologist should be the ones in the room during the exam. They will position your breasts accordingly for the mammogram.
- Expect your breasts to be compressed between two plates, and the procedure should take about 10-20 minutes, while the breast compression will not be more than a few seconds.
- For a screening mammogram, two views of each breast are required. For women with larger breasts or breast implants, more photos may be necessary.
- There may be some discomfort or pain during the procedure, but you should alert the technologist so they can try and make it more comfortable for you.
Though getting a mammogram does not necessarily mean you have a malignant lump or cancer, you should check with the facility if you don’t hear back from them—until you are certain, you should not assume the mammogram is normal. The best quality of a mammogram is that it can detect breast cancer even if it is too small to be felt; this means that it is diagnosed at a very early stage giving it the best chances at a successful treatment.
More
More often than not, lactation is associated with pregnancy, breastfeeding, and the mother’s body preparing to care for the newborn baby. Though many times the mother’s body will produce milk on its own, sometimes the mother needs to receive additional help to produce enough milk for breastfeeding. Additionally, it is also possible to receive extended hormonal treatment for induced lactation. A small percentage of women can also begin lactating without any association to pregnancy—a condition known as galactorrhea where excessive milk is produced.
Natural Lactation
The mother’s body prepares to lactate in the final months of pregnancy, and it does so through three main hormones: estrogen, progesterone and placental lactogen. Especially at the time of delivery, the hormone prolactin levels increase to such an extent so as to initiate milk production, while at the same time the levels of estrogen and progesterone decrease. According to the CDC, the American Association of Pediatrics suggests that infants should be continuously breastfed during the first six months of their lives, while other foods are gradually introduced. It is also recommended that breastfeeding continues at intervals until about two years of age, but most infants are neither exclusively breastfed nor do they continue to breastfeed for as long as recommended.
Induced Lactation
Many mothers need to replicate the body’s process of milk production to either enhance the lactation process, or to recreate it because they are coming into motherhood without pregnancy. This is most common with mothers who wish to breastfeed their adopted baby. To achieve induced lactation hormone therapy is the first required step: supplemental estrogen or progesterone may be prescribed to mimic pregnancy, and it can last for months. A few months before the expected breastfeeding date, hormone therapy will cease and you will begin the process of pumping your breasts to encourage the release of prolactin. This is a lengthy process, and the pumping gradually increases in time and intensity. It is likely that in the case of induced lactation time may not be on your side, in which case other medications may be prescribed. However, what remains integral for the milk supply necessary for breastfeeding is the process of pumping.
Galactorrhea
A number of women begin lactating without any association to pregnancy, a condition known as galactorrhea. The most common symptom is one or both breasts producing excessive milk, while other symptoms may include random leaking from the nipples, enlargement of breast tissue, irregular periods, low sex drive, acne and headaches. In some cases the cause of this may be hard to find, but the general rule is that it happens due to hormone imbalances, or as a side effect of medications. Since the most common reason for milk production is increased levels of the hormone prolactin, galactorrhea may happen due to medications, underlying medical conditions, a tumor, or overstimulation of the nipples. As with any condition with various causes, how it can be treated depends on what is causing it and it is up to your healthcare provider to conduct the appropriate tests to pinpoint the cause.
More
Whether your child is back at school in-person, hybrid or e-learning, getting your child to focus on distance learning can be challenging. Parents are expected to be more involved and support hybrid and distance learning. But, remember, it’s also challenging to children because they are being asked to participate and engage with new learning modalities. Without an effective plan, it can be easy for children to become disengaged, causing frustration for the entire family.
Here are some tips for helping your kids get and stay on track.
- Adjust your expectations—hybrid and distance learning are not going to be exactly like full-time, in-person classes. Being in front of a screen all day is both mentally and physically taxing. While high schoolers can do work for longer periods of time, younger children will need more breaks and time for play.
- Make a flexible schedule—synchronous sessions (real-time video sessions with their teachers) helps structure the day and keeps a schedule, but it also leads to screen burnout. The amount of synchronous learning varies by school district, but many children are doing some work asynchronously (on their own). Making a schedule and dedicating time for all classes will help with consistency, but being flexible is recommended. This means, allow children to power through a task if they are focused and engaged, however, be willing to give children breaks when they seem overwhelmed.
- Take physical exercise breaks—sitting in front of a screen all day is draining, so it may seem like the best break is sitting and not looking at a screen, but actually the best break is being active. While some research claims that it’s best to get 10 minutes of physical movement for every 50 minutes of being stationary, incorporating as few as two (15-20 minute) exercise breaks in the day will immensely help you and your kids focus. Exercise ideas include short walks, bike rides/stationary cycling, yoga/stretching videos, and free weights.
- Reduce distractions by cultivating an ideal setting—when designating workspace for your family, do your best to reduce noise or clutter. Consider playing instrumental music or nature sounds to drown out any distractions that could distract from learning. Designate each family member their own clean, hard surface workspace such as a desk, kitchen table, or even a folding table. The key is to spread out enough so everyone has their own space.
- Rely on a checklist—help your kids stay organized by using a check-list system. Consider doing it by hand rather than digitally. Whiteboards are a great idea. Get one per family member, so that everyone has to take some responsibility for their own work.
- Give positive feedback—children need reinforcement and they are likely getting less from their actual teachers in hybrid and distance learning situations. Be sure to give your kids positive reinforcement when they have done a good job.
Above all else, stay positive and keep moving forward. Change is inevitable. Do your best to be adaptable to better handle and adjust to changing learning situations.
More
Menstruation and general health are intricately connected, and the patterns of a woman’s period can provide us with important information about their well-being. From the duration of the menstrual cycle, to its intensity and blood color, we can usually understand if our bodies are healthy or if something is off and requires further investigation. Though the absence or presence of periods is what usually alerts us to possible problems, the menstrual blood color can be an indicator of possible problems, as health conditions and hormonal changes affect the color and texture of period blood.
Different Colors of Menstrual Blood:
Bright Red
- We usually associate red blood with a normal period flow, and most of the times this is the case. Menstrual blood that is red is fresh blood, and at the start of the period it is this color; for some it remains red, while for others it turns brown in the later days of their period. However, bright red blood in between periods or when you do not expect it might indicate the presence of an STI or be cause for concern for other health issues associated with your uterine lining or cervix. Particular attention should be paid if that is combined with a heavy flow and longer periods, abnormal weight loss and pain in the lower back.
Dark Red or Brown
- Darker blood is not an immediate cause for concern, as many myths will have us believe. In reality, it is oxidized blood—or old blood—that has been in the uterus longer. It may appear at the beginning of a period as a remnant of the previous cycle, or at the end of a period as blood that had time to oxidize. The older the blood that is being discharged, the darker it will be: even if it appears closer to black, there is no cause for concern. If you are, however, experiencing abnormal symptoms on your own body, consult your doctor.
Black
- Like dark red or brown, black blood is old blood that has remained in the uterus a long time and has oxidized. As discussed above, it is no cause for concern as the sole symptom, though sometimes it may be a sign of a blockage inside the vagina. If that is the case, other symptoms of a blockage may include itching or swelling in the vaginal area, difficulty urinating, fever and foul-smelling discharge.
Remember that it is normal for your period blood to change colors in the duration of your period, as it does not always start from fresh blood. There may be old blood and uterine lining that needs to be shed, and that also usually results in blood clots or other discharge. If you suspect that the color of your period blood may be indicating a health issue for you, or you are experiencing concerning health symptoms during your period, always consult your healthcare provider or a health expert.
More
Women deciding to give birth at an older age is nothing new, and the average maternal age in the last decade has risen from 21 to 26. Becoming a mother for the first time comes even later in life for women with a college degree and a career, as reported by the New York Times. In general, women in their 30s, or even 40s, who decide to become pregnant are faced with a number of myths regarding pregnancy and maternity. Myths based on health reasons thrive, as do myths around social standing and becoming a parent later in life.
Myth of Infertility
Though it is true that fertility declines after the age of 35, that does not make it impossible for women to conceive after that age, nor does it mean that every woman who becomes pregnant after 35 has used IVF. The difficulties may be more, but they can be addressed with preventive fertility care, a healthy lifestyle, and prenatal planning with the support of your doctor. Keep in mind that issues leading to infertility are not always age-related, such as endometriosis. Therefore, there is no need to jump to conclusions about pregnancy over 35 as the challenges may have nothing to do with a woman’s age, and we can never know the capabilities of each body.
Myth of Putting the Child at Risk
Similar to the issue of infertility, the rumor that children born to mothers over 35 may be autistic or be diagnosed with Down Syndrome is alive and well. However, there is no evidence that directly links the mother’s age to such issues; there may be a higher risk of carrying a healthy pregnancy to term, or a risk of augmented complications, but only 1% of the cases of children born with autism since the 1990s has been due to maternal age. As with any maternal age, the mother’s overall health, diet and well-being has more of an impact on the baby’s health and on her pregnancy than her age per se.
Myth of Selfishness
Many women who decide to prioritize their education and career over starting a family fresh out of college, or even fresh out of high school, are criticized as being selfish. Another perspective on this issue, however, shows us that women who have kids early on face major difficulties in the workplace—from lack of childcare to limited opportunities to advance—and as a result have more trouble supporting their families. On the other hand, women who start their families having established a career earn about double the income than younger mothers and the opportunity to better support their kids.
Myth of Not Being Around
In addition to all of the above, women who give birth at a later age face the criticism that they will either be too old when their child reaches important milestones in their life or that they will not be around at all. Motherhood seems to provide such vitality to women that in the Journal of Health and Social Behavior in March 2005 it was reported that women who become mothers in their 40s are four times as likely to live to be 100! Additionally, we should remember that there are really no guarantees of “being around” at any particular age, as not everything always depends on natural causes.
More
The vast amount of online resources on healthy eating and living can be overwhelming. On average, women need between 1,600 and 2,400 calories per day. However, there is so much more involved than simply targeting a number. Healthy eating involves some basic principles for food selection.
- Whole foods: Choose whole ingredients over pre-made food, as processed foods contain added sugars. This means, opt for proteins, fruits, and veggies that are in their natural state. For example choose an apple over applesauce or apple juice. Consider adding honey and nuts to plain oatmeal instead of pre-packaged honey nut oatmeal. Remember, every choice adds up.
- Lean protein: Chicken, turkey, fish, eggs, beans, and tofu are great sources of protein with low calories. Avoid fattier meats such beef and bacon.
- Whole grains: Whenever possible choose brown rice over white rice and wheat bread over white bread. While white bread and rice may taste smoother, they lost many nutrients during the refining process.
In theory, this all sounds super easy. Of course, everyone knows chicken is healthier than beef, and we should all eat our veggies! However, so many people rely on packaged foods for convenience. Many women have families to also think about, so fast and convenient is important. Thus, we’ve put together a roundup of the best online resources to help you get started.
Meal prep: While it may sound like a ton of work, meal prepping doesn’t need to be an all-day affair. Check out 25 Healthy Meal Preps and Skinnytaste for numerous recipes to get started on meal prepping. Remember, even meal prepping just one meal per day (yogurt parfaits or overnight oats for breakfast, or hearty soup for lunch) will save you time and calories.
Time-saving dinners: Yes, it’s so very tempting to pick up Panera, Chipotle, or even Buffalo’s favorite, Mighty Taco, on your way home. It’s quick and your entire family will eat it. Eating out once a week isn’t too bad, but anymore than once and the calories will add up. Consider quick and healthy weeknight meals by opting for pre-cut proteins such as ground turkey and chicken breast tenderloins. Additionally, Buffalo-area grocery stores, such as Wegman’s and Dash’s, offer many options for pre-cut fruit and veggies. For fast dinner ideas, check out Cooking Light, Taste of Home, and Olive.
Helpful Apps: Even with making some changes in your diet with a focus on whole foods, lean protein, and whole grains, it may still be hard to find your ideal body weight. There are so many online resources and phone apps, but our favorites are MyFitnessPal and iTrackbites (similar to the Weight Watchers concept). Both are free (though you can update for a reasonable fee for a premium) and are easy to use. In addition, you can download the app to have quick access to log food on your phone.
More
With the increased consumption of processed foods, we lose many of the nutrients necessary for our overall health. A large number of women turn to dietary supplements and multivitamins to make up for what they are not getting via their diet. The effort required for a healthy and balanced diet is sometimes too much to be accommodated through the rapid tempo of daily life, so even though women could get a lot of the necessary nutrients through food this is not always realistic. Vitamins, multivitamins and mineral supplements, are especially helpful for the following categories:
- Women who are or may become pregnant: to lower the risk of birth defects, pregnant women should have a daily intake of at least 400 micrograms of folic acid.
- Postmenopausal women: due to hormonal changes after menopause, women tend to lose bone density at a faster rate—especially when compared to men. Calcium and vitamin D are optimal to prevent osteoporosis, and they are not adequately provided through nutrition. A supplement that includes those, along with B-12 and weight exercises will help prevent osteoporosis and any associated health problems.
- Vegetarians: the consumption of plant products and vegetables may mean that women who follow a vegetarian diet are more in need of vitamins generally found in animal products. Most commonly, vitamins B-12 and B-2, as well as vitamin D lack in vegetarian, and especially vegan, diets.
Though it is easy to turn to dietary supplements and minerals to make up for the low levels of these vitamins in food, it is not impossible to make dietary choices that provide you with the necessary nutrients. These are some of the foods that contain important vitamins and minerals for your health, though you should always listen to your body and consult your health care provider if you make major dietary changes or are experiencing health challenges:
- Vitamin B9 (folic acid): spinach and other dark green leafy vegetables, oranges, pure orange juice, nuts, beans, chicken, lean beef, whole grains, and cereals with added folic acid
- Vitamin B-12: low-fat or fat-free milk, eggs, liver, poultry, clams, sardines, flounder, herring, blue cheese, and nutritional yeast. It may also be found in food that have B-12 added, such as cereal, fortified soy beverages, and veggie burgers.
- Vitamin D: tuna, salmon, and fortified foods
- Calcium: low-fat or fat-free yogurt, cheese, and milk. Dark green leafy vegetables and canned salmon make good sources of calcium as well. It’s found in calcium-added foods such as select soy beverages, 100% orange juice, tofu, and cereals.
- Iron: lean red meats and chicken, seafood, cereals/breads with added iron, oysters, beans, dark chocolate, liver, spinach, tofu, and canned tomatoes.
More
