We believe in the preventative approach to medical care and use patient education as a way to improve the health choices of the women who come to us for care. We enjoy every aspect of our practice, whether it is delivering a new baby, gynecological needs, or helping an infertile woman conceive her child. We are dedicated to our patients and their health.
The idea of “Summer Vacation” seems so dreamy before it starts, and then it can feel like an endless stream of days filled with children going bonkers in the house. That means it’s time to get out the door and head to five of Overlake employees favorite summertime activitie in the Bellevue area.
All of the places and activities listed below and tried and true favorites, and will help to keep the whole family sane (and away from screens!) during the summer months.
1. KidsQuest Children’s Museum
There is always something for everyone at KidsQuest, so it’s a year-round favorite. However, summertime means the museum’s Wild NW Weekends program, which is particularly interesting. Each weekend has a specific theme, which means your kids can take revel in the different “special visitors,” activities and arts/crafts that are on display and taking place in and around the museum.
Admission prices are reasonable, and the museum also offers special pricing through their Blue Star Museum and Museums for All programs.
2. Crossroads Water Spray Playground
Ideal for warmer days, the Crossroads Water Spray Playground is a way for kids to get wet, climb on their favorite sea-themed and rock sculptures and enjoy a picnic on the lawn. Planning a birthday party, BBQ, or family get-together? There are two, covered picnic areas available by reservation, which means no mess (or crowd) in the house. If they aren’t previously reserved, picnic shelters are open on a first-come-first-served basis – perfect for mid-week playdates, Moms Clubs and playgroups.
3. A Guided Canoe Trip at Mercer Slough
While some of us have made this the “thing ya’ do” with summertime guests, we couldn’t believe how many of our Bellevue native staff had never gone on a guided canoe trip at Mercer Slough Nature Park. The canoe trips take places (8:30 a.m. to noon-ish) on Saturdays, from May through September. Additional Sunday trips are offered during the peak months of July and August. Tours are available to those 5-years old on up and are a beautiful, hands-on (paddles-in) way to learn about the 320-acre, Mercer Slough wetlands – and to see stunning wildlife.
4. Meydenbauer Bay Park
This newly renovated park has been left off our previous Summertime Family Fun lists the past year or two because it was in the midst of a major renovation. Now, Meydenbauer’s facelift is (more or less) complete, and it’s impressive. Some of its many attractive features include a beach, a pedestrian pier, outdoor education areas, and a hillside woodland. REI also offers canoe and kayak rentals – and the park is open from 6 a.m. to 11 p.m daily.
Phase 1 of the project is complete, and future phases include Bellevue’s Grand Connection vision, which includes a pedestrian corridor that is planned to extend east through downtown Bellevue and eventually across Interstate 405 to the Eastside Rail Corridor. We’re all looking forward to when that phase is complete!
5. Funtastic Playtorium
It’s great to play outside, but sometimes indoor venues feel best – particularly if you’re in the later-stages of pregnancy and don’t feel like being up and on your feet as much. The same is true if older family members are visiting and their stamina isn’t up to children’s activity snuff.
In that case, take the family to the Funtastic Playtorium, which is every bit as great as its name implies. They have indoor playgrounds from children ages 1 – 10 years. It’s a great place to host a party or play date. If you sign-up for their special deals and offers you’ll receive discounts and coupons from time to time, which can come in handy on those three-day weekends during the school year.
While only 5% of all pregnant women experience preeclampsia, it’s a very serious diagnosis and puts you and you baby at high risk. Preeclampsia typically comes on after Week 20 of the pregnancy, and symptoms include:
Severe swelling in the extremities and face (called edema)
Shortness of breath
Feelings of anxiety
Sudden weight gain beyond the norm for pregnancy
Preeclampsia also involves high protein levels in the urine, high blood pressure and hyperreflexia (the knee/jerk reaction is heightened). If the condition continues undiagnosed, and a woman goes into full eclampsia (also called toxemia), it causes seizures, convulsions and comas – and is the leading cause of mother and fetal mortality worldwide.
There are notable risk factors for preeclampsia and if you know you are at risk, you’re more likely to pay attention to the symptoms listed above.
It’s your first pregnancy
By and large, preeclampsia happens most often in first-time pregnancies. This is why we ask that you call us anytime you don’t feel comfortable about presenting symptoms. We always want to err on the safe side.
You’ve had preeclampsia before
If your previous pregnancy went preeclamptic, your healthcare professional is on high alert. While the majority of preeclampsia occurs in first-time pregnancies, women who’ve had preeclampsia in the past are seven-times more likely to have it again in successive pregnancies.
With women who’ve had preeclampsia in the past, African-American women and other non-white women are more likely to experience it again than white women.
You are obese
Obese women are more likely to have preeclampsia as well. This is one of the reasons why there different guidelines regarding pregnancy weight gain for women whose BMI puts them into the severely overweight or obese categories.
They run in your family
Women whose mothers have had preeclampsia are at higher risk. According to the World Health Organization, 20% to 40% of women whose mothers had preeclampsia will have it as well.
You’re 40-years old or more
Women 40-years old and older are more prone to pre-eclampsia, one of the reasons why “advanced maternal age” automatically places you in the high-risk pregnancy bracket.
Pregnant with multiples
Similarly, being pregnant with twins or higher-order multiples (triplets on up) also increases your preeclampsia risk.
Pre-existing Medical Conditions Can Also Increase Your Chances
There are pre-existing medical conditions that also make you more susceptible to developing preeclampsia. Those include:
It’s important to reiterate that preeclampsia is very rare. However, it’s also important to be aware of both the risk factors and the symptoms, so you can let your prenatal healthcare provider know at the first sign something may be amiss.
If you feel you are at high risk for preeclampsia, work with an OB/GYN who has experience monitoring and caring for women with high-risk pregnancies. Contact Overlake to schedule a consultation and meet with our exceptional team of physicians and midwives. We work closely with our patients to ensure the most positive outcomes possible.
Roughly 10% of women who experience some degree of pelvic organ prolapse (POP), fail to pursue any treatment at all. Others are ushered through major surgeries – like complete hysterectomies – by doctors who aren’t entirely familiar with the options.
Now, a general broadening of the women’s health arena, and the emergence of specialties such as women’s health physical therapy (WHPT), are creating an environment where women feel more comfortable being open about their symptoms with health care providers. It’s also easier than ever to find valuable information about the topic online.
General practitioners and gynecologists are better trained in how to screen for POP symptoms and treatment is often as simple as incorporating a few exercises into your daily routine.
Symptoms Of Prolapsed Pelvic Organs
The condition occurs when a general weakening of pelvic muscles and/or connective tissues in the pelvic area cause organs to shift, or sag, in position – putting pressure on and sometimes inside the vagina.
This sagging – or prolapsing – ranges from very mild to very severe. It is most often caused as the result of pregnancy and childbirth, although women who have never been pregnant can also experience varying degrees of pelvic prolapse.
Some women are more prone to developing pelvic organ prolapse than others. Women most prone to POP include those who:
Cystocele and urethrocele. The first (cystocele) is diagnosed when the bladder pushes into the front wall of the vagina. If the protrusion is caused by the urethra, rather than the bladder, it is called a urethrocele prolapse.
Rectocele. In this type of prolapse, the rectum bulges or protrudes into the rear wall of the vagina, and typically causes difficulty with defecation.
Uterine prolapse. Sometimes, the uterus itself drops down into the top of the vagina. It can be mild, making the cervix seem more pronounced, or it can be more serious, where the uterus can be felt or seen coming through the lower vagina. Post-hysterectomy, women can experience what is called vaginal vault prolapse, where the top of the vagina begins to sag – sort of like a sagging sock – onto the lower part of the vagina.
Vaginal vault prolapse. Prolapse of the vagina,
In mild cases, symptoms may include things like:
A heaviness or a feeling of pressure or “bearing down.”
Lower back pain or pressure.
Incontinence (stress incontinence being the most common – occurring when you laugh, exercise, jump or lift heavy objects).
If you experience any of the above symptoms, schedule an exam with your gynecologist. A routine pelvic exam is the only way to confirm whether you have POP or not.
Treatment for Pelvic Organ Prolapse – Surgery Is Not Your Only Option
While there are surgical fixes for prolapsing pelvic organs – it is rarely your only option. Invasive procedures should be avoided whenever possible as some of the surgical procedures have been fraught with post-surgical complications. Thus, women should first seek more natural solutions – such as pelvic floor physical therapy, which is often partially- or completely covered by health insurance providers.
The procedures for pelvic prolapse symptoms typically look something like this:
Kegel exercises. In some cases, you may be experiencing prolapse and not even know it yet. Your doctor may recommend Kegel exercises (Click Here for a detailed tutorial) that will help to strengthen pelvic floor muscles.
Pelvic physical therapy. This specialized form of therapy works to strengthen the pelvic floor and core muscles via a range of tools. Depending on your particular symptoms and degree of POP, the therapist will work with you on exercises, electrical stimulation and even lifestyle and dietary changes that can relieve or correct the side effects of pelvic prolapse.
Vaginal Pessary. In some cases, a vaginal pessary can be worn, which provides support for the upper-vaginal walls, preventing the more debilitating aspects of prolapsed pelvic organs.
Only after more natural, and less-invasive, methods have proven unsuccessful should women proceed with a surgical fix.
Don’t let the symptoms of pelvic organ prolapse keep you in discomfort or hold you back from the life you want to live. Contact Overlake OB/GYN to schedule an exam. We’ll work with you to find the most natural and straightforward means possible to restore pelvic health.
Summertime and pregnant living isn’t always easy. There’s record breaking heat in the Northwest, other women are cooling off in cute little sundresses, and some of your favorite summer activities (sipping a cold beer at a BBQ, for example) may be off limits now that you’re pregnant. Plus, all that extra heat can also exacerbate typical pregnancy discomforts.
Tips For Surviving the Summer – Especially When You’re VERY Pregnant
For that reason, we put together this Summer Pregnancy Survival Guide that will help you to be comfortable, healthy, feeling good and having your fair share of summertime fun.
1. Drink plenty of water. Hydration is always important, especially when you’re pregnant. You want to keep your blood circulating, energy up, cells hydrated and the amniotic fluid replenished. Summertime can mean sweating more than usual because all the extra blood circulated by your pregnant body. That combined with an increased metabolism and elevated external temperatures, cause you to perspire without even realizing it. Air conditioning in your home, car and most businesses means breathing dryer air, which further dehydrates you.
Keep a large water bottle in all your favorite sitting and resting spots. If water isn’t your typical thirst-quencher of choice, try including freshly sliced lemon wedges, cucumber, oranges and/or mint leaves to add a little extra flavor boost. If possible, minimize drinks that act as diuretics such as caffeinated sodas, coffee and tea.
2. Learn a few new non-alcoholic cocktail recipes. All those frosty cocktails and drinks at summer parties and BBQs can look awfully tasty on a hot summer day or night – but alcohol is off limits for pregnant mamas. Check out these Favorite Nonalcoholic Drinks. The refreshing spritzers and other “mocktail” recipes listed there will give you the same fun flavor boost without the potentially damaging alcohol. Plus, other underage, pregnant or reformed party guests will appreciate the variety of options as well.
3. Embrace that belly. Pregnant bellies are revered, celebrated and considered a sacred feature. You are growing a human in there and summer is the best season to show that off. Most bikinis can accommodate the belly. If you prefer one-pieces or tankinis, knock yourself out because cute maternity versions of your favorite cuts and patterns are available. Maternity sundresses and tanks abound this time of year. We guarantee that when you embrace that belly and show it off, you’ll get oodles of positive attention and will feel sexy to boot.
4. Get those feet up. Your pregnancy should be peppered with small rest times, naps and earlier evenings whenever possible – especially when weather turns hotter, as social activities pick up or as your pregnancy progresses into the third trimester. Heat can exacerbate regular pregnancy swelling in your feet and ankles so getting your feet up as often as possible, barefoot preferred so your skin is unrestrained, will help to keep swelling to a minimal. Minimizing salty food intake will also help. If swelling seems more dramatic than normal or spreads into your hands and face, check in with your doctor to make sure everything is okay, especially if the swelling is accompanied by headaches, dizziness or other discomforts.
5. Eat smaller meals. It’s hard not to pig out at summertime festivities but, once you are in your 2nd and 3rd trimesters, a full stomach makes you more prone to heartburn and tummy upset because there simply isn’t a whole lot of room left in there. Eating smaller meals more often will make you feel better. Take advantage of all the delicious fruits and veggies available this time of year, which taste great, help to replenish fluids and are loaded with nutrients.
6. Go Swimming! Have a pool, lake or ocean at your disposal? Take advantage of it! Your body will feel amazing when it is completely supported by water. Plus, it’s a great way to get an all-body cool down. If exercising has become more difficult for you, or exercising in the cool morning hours is a challenge, check into local water exercise classes or try swimming laps. Both are a wonderful way to burn calories, maintain strength and flexibility and work out in a completely supportive environment.
Looking for an OB/GYN or midwife this summer? Contact Overlake and schedule a consultation.
Are you thinking about switching from pads or tampons to a menstrual cup?
Originally designed as an eco-friendly, affordable alternative to pads and tampons, menstrual cups are small, flexible cups that are inserted – and seal – in the vagina, right below the cervix. The blood that would typically absorb into a pad or tampon during your period is collected in the cup. Depending on your typical flow – light, medium or heavy – you simply remove and empty the cup, and reinsert it again, until your period has finished.
The Menstrual Cup Low-Down
Before we proceed with pros and cons, let’s discuss a few of the FAQs regarding cups:
Menstrual cup brands
There are multiple menstrual cup manufacturers. Some of the most common are:
All are available online, and some brands are available in grocery stores, health food stores and pharmacy aisles where tampons and pads are sold.
The typical cost of a menstrual cup runs anywhere from $15 to $30+ dollars each.
How often do you need to change it?
It depends on your flow. For most women, the lightest days only require a change in the morning and the evening; for heavier days, you may need to empty and reinsert it at least three, four or five times per day. Either way, cups can hold notably more liquid than pads or tampons can absorb.
How do you insert it?
Menstrual cups are not all that different from tampons (especially o.b. or non-applicator style tampons) and are very similar to a diaphragm. If you’ve used either of those in the past, inserting the cup should be no problem. Each cup comes with specific insertion/application instructions.
Pros of Using a Menstrual Cup
Aside from eco-friendliness, the pros of using a menstrual cup include:
Affordability and fewer runs to the pharmacy. The cost of a single cup is typically around $25 to $30, but they last for up to three years when well cared for. Thus, this makes a menstrual cup exponentially cheaper than standard, pad or tampon alternatives. Similarly, you won’t have to go to the store for the sole sake of purchasing pads or tampons anymore.
Great on the go. Most women we know have two cups – one for their bathroom and one for their purse. Most come with their own little “pouch” that can be tucked easily a purse or toiletry kit so you’re always prepared and never have to make a 9-1-1 run to a pharmacy or grocery store in a strange town – or on vacation.
Less odor. Tampons and pads are known for having a less-than-desirable odor, but menstrual cups are tucked so high inside – and contain, rather than absorb the blood and other discharge – that no odor is distinguishable from “the outside.”
Healthier vaginal flora. Because the cup sits higher in the vagina and doesn’t absorb anything (rather, it contains the blood that flows into it), menstrual cups keep healthy, vaginal flora largely intact. This is different from tampons, which absorb vaginal fluids, including healthy bacteria, as well as blood.
More time between changes. Most women find they have to empty and reinsert (aka “change”) their cup far fewer times than they have to change a tampon or pad.
No need to remove it during intercourse. This is a personal choice, but many women like that they don’t have to remove the cup as the penis or finger can slide up alongside it – without requiring removal.
Cons of Using a Menstrual Cup
Women who use menstrual cups, love them, but there are plenty of women who aren’t as keen. Their typical complaints or list of cons include:
More mess. It takes a few times to figure out your method of removal, disposal and reinsertion – especially when you’re using public bathrooms. At home, you typically have the freedom to remove it, hold it upright and dump it in the toilet or the sink, rinse it out and reinsert. In a public restroom, we recommend removing it, dumping its contents in the toilet, wiping it off/out with some toilet paper and reinserting it. Your fingers may also have some blood residue after you remove the cup, but this is easily washed off.
Difficulty inserting/removing it. Some women have a hard time inserting it properly so that it fits where it’s supposed to (high up and around the base of the cervix). This is the only way for the cup to work properly. If it isn’t inserted properly, it can be uncomfortable and is more prone to leaking. When it comes to removal, forget about the stem. Bear down a bit to push the cup down, and then grab the base with your fingertips as you pull.
More personal intimacy than you want. Similarly, inserting and removing the cup requires the ability to insert your fingers up and into your vagina. For some, this is no big deal – for others, it is.
Maintenance. Because it can’t just be “thrown out,” menstrual cups should be boiled or sterilized with a solution made for baby bottles after each cycle. This keeps it free of harmful bacteria.
Are you thinking about giving menstrual cups a try? Go for it, but make sure the brand you select allows you to return it for a refund if you aren’t satisfied. And remember, it can take a cycle or two to become adept at the ins-and-outs of menstrual cup use.
Here are 9 signs it may be time to consult with a fertility specialist for infertility testing. It’s better to find out sooner, rather than later, if your pregnancy will require any type of fertility assistance. Please keep in mind: unless you are over the age of 35 or have struggled with infertility in the past, we always advocate trying for at least 6 months using ovulation as the timer before making an appointment with a fertility specialist.
You are 35 years or older. Before 30, give yourself 12-months or more before you begin looking at your fertility options. From 30 to 35, we say give yourself at least 6 months but don’t wait much longer than that. As much as women hate to face the reality, age definitely matters when it comes to conceiving naturally. Your fertility peak is in your 20s, fertility declines into your 30s and by age 35 to 40, there is a steep drop off.
Your partner is over the age of 40. Yes, men father children well into their 80s, but it’s not that common. Age matters when it comes to producing sperm with healthy morphology, motility and a high sperm count. If your partner is older and you haven’t gotten pregnant, have his semen analyzed to rule out any issues in that department.
You have a history of missed periods. We wouldn’t run out and see a specialist because of irregular periods without any other cause. However, if you have tried consistently for six months to a year with no luck – and you have a history of irregular periods – it’s worth having things checked out by a fertility specialist in case PCOS, endometriosis or other undiagnosed issues are complicating things.
You are diabetic. There is a direct correlation between insulin-resistance and infertility. If you have Type 1 or Type 2 diabetes, speak with your OB/GYN to see what she thinks. Depending on your age and medical history, a fertility specialist may be your first stop so a general exam and blood work can assess the situation.
You have been diagnosed with PCOS. Polycystic Ovarian Syndrome (PCOS) is another leading cause of fertility. It is quite the medical mystery and is often completely overlooked by OB/GYNs since there are a wide range of symptoms. However, PCOS often involves insulin-resistance and/or hormone imbalance – both of which can lead to infertility.
A sperm workup came up “abnormal.” Of course, all of the above involve the female half. In fact, it’s a pretty even 50/50 split when it comes to whose physiology is the source of the infertility. If your partner a had a run-of-the-mill sperm workup and it came back abnormal, schedule an appointment with a fertility specialist ASAP to see determine exactly what is going on and the best course of action.
You’ve had more than two miscarriages. It’s true that miscarriages are normal. They happen in about 10% to 25% of all recognized pregnancies, according to the American College of Obstetricians and Gynecologists (ACOG), and that doesn’t count all the fertilized eggs that are miscarried before a woman ever tests positive for pregnancy. However, if you have two or more, your doctor will probably want you to have a few extra tests done to rule out potential infertility issues that may be causing them.
You have/had uterine fibroid tumors in the past. A history of uterine fibroid tumors can make it more difficult to get pregnant. They can change the size and/or shape of the uterus or cervix which can make conception, implantation and gestation more of a challenge.
Are you having a hard time getting pregnant? Don’t wait. Come in and talk to us. We can meet with you, give you an exam and do some initial blood work to get things started. We are also happy to refer you to top-notch fertility specialists. Contact Overlake OB/GYN today.
Gestational diabetes, also known as diabetes mellitus, is a condition in which too much sugar stays in the blood rather than being used for energy. Some women are at risk via their current medical status and/or lifestyle choices. Other times, it is diagnosed in women who have never struggled with blood sugar issues in their life. In either scenario, gestational diabetes poses a health risk to both mother and baby, which is why healthcare providers work so carefully to avoid it, and treat it immediately once it is diagnosed.
What is Gestational Diabetes?
Gestational diabetes is typically diagnosed around the 24th week of pregnancy, via a glucose screening test, when a mother’s blood sugar levels are consistently higher than they should be. In most cases, women diagnosed with gestational diabetes have never had diabetes before and will not have it again. While its causes are not completely understood, it is thought the hormones produced in the placenta block the mother’s natural insulin processes, causing insulin resistance, which makes it harder for her body to regular blood sugar levels.
Once your body is no longer able to make and use the correct amount of insulin to convert glucose (sugar) into energy, glucose levels begin to rise. This condition is called hyperglycemia. All that extra glucose passes through the blood stream, into the placenta, through the umbilical cord and directly into your baby. This is where things can become unhealthy for both you and baby.
Now, your baby’s body is working overtime, trying to produce enough insulin via his or her own pancreas to handle all that extra sugar. In the meantime, all that extra sugar (energy) isn’t being used so it starts packing on as extra fat pounds. This leads to a condition called macrosomia, or a “fat” baby.
Risks for developing GD include:
Being 25 years or older when you get pregnant. Gestational diabetes risk increases after age 25 and with each passing year.
Family medical history. If your mother, grandmothers and/or sisters had gestational diabetes, you’re more likely to have it as well.
Personal medical history. If you are pre-diabetic or have higher-than-normal blood sugar levels before pregnancy, you’re more likely to develop gestational diabetes.
Excess weight. Try to keep your body mass index (BMI) below 30 to minimize risk.
Non-white ethnicity. Women who are of Latin, Asian and African decent are at higher risk for gestational diabetes.
Gestational Diabetes Leads to Several Health Risks for Mother & Baby
Fat babies are cute, but babies with macrosomia are heavier than nature intended. Plus, as you can imagine, all that extra weight is bad for mama and baby when it comes time for labor and delivery. Some of the health risks caused by gestational diabetes include:
Extra-large babies. Now, the reality is that your body was designed to birth a baby naturally – and healthy babies can range from six to ten pounds on average. However, “naturally” is the key word. Gestational diabetes leads to UN-natural weight gain, and this can cause baby to struggle when it’s time to get through the birth canal, putting you at risk for a C-Section.
Pre-term birth leading to respiratory distress. If you have gestational diabetes, your doctor may decide your baby needs to be born earlier, rather than full-term, because he’s getting too big. Babies born pre-term can lack fully developed lungs, which can lead to respiratory distress syndrome and a risk of further complications.
Low blood sugar after birth. For every action, there is an equal and opposite re-action, right? Thus, many babies who have all that extra glucose in their system (via the mother) have increased insulin production. Once out of the womb, this can cause severely low blood sugar levels (called hypoglycemia). In infants, severe hypoglycemia can cause seizures.
Higher risk of Type 2 diabetes. Babies born of mothers with GD have a higher risk of developing type 2 diabetes later in life. If you have gestational diabetes, you are also more likely to develop type 2 diabetes when you get older.
Infant mortality. In cases where gestational diabetes goes untreated, it can lead to infant death.
Risk of high blood pressure and pre-eclampsia. Women with gestational diabetes have higher rates of high blood pressure and are at higher risk for developing a very dangerous condition called pre-eclampsia.
All of the above are examples of why prenatal care is so important. Catching gestational diabetes before it becomes a problem is integral to the health of you and your baby. Once diagnosed, your doctor will work closely with you on diet and lifestyle changes that can naturally reduce blood sugar levels. She will continue to monitor you and your baby carefully, ensuring you are both as healthy as possible. If necessary, medications may be prescribed to further keep blood sugar levels in check.
The ability to adjust a woman’s hormones manually, via hormone replacement therapy (HRT), is very new in the larger scheme of human existence. As a result, researchers continually find pros and cons to the variety of options available- as well as dosage and formulas.
Currently, one of the biggest debates is whether patches or pills are the safest option, with the least amount of harmful side effects.
Hormone Replacement Therapy Regulates Hormone Imbalance During Menopause
Menopause typically begins about 10 years before periods cease altogether. The initial phase, called perimenopause, begins in the 40s and the symptoms can creep up on you. Most women weather the transition just fine, but are likely to experience symptoms such as:
If you’re able to make the transition without hormone supplements, that’s the ideal – and things like a menopause-focused diet and exercise are some of the best tools to do that. However, some women need more support.
Which is Safer: The Patch or The Pill?
While some medical experts are leaning towards the patch (or gel/cream forms) over the pill, most doctors agree that that case-by-case management of HRT, that focuses on the appropriate dose per patient is the best way to minimize patient risk, regardless of whether women are taking oral or topical forms.
Pills may increase your chance of blood clots (VTE)
In recent studies, women who use pill forms of HRT are more likely to experience serious blood clots (venous thromboembolism or VTE), because oral pills are processed by the liver, and this increases the risk of clotting.
However, that particular side effect is already considered rare, and the increased risk associated with clots from taking hormone pills was only minimally higher (15% or less) than the risk of experiencing VTE with patches or without any hormone replacement therapy at all.
High estrogen doses increase other risks
What most doctors are learning through reviews of cumulating data pertaining to HRT is that accurate dosing is key to minimizing risks of harmful HRT side effects.
UCLA and other medical research centers have found direct correlations with higher-doses of estrogen and increased risk of heart attacks, strokes, and breast cancer. When reviewing eight consecutive years of medical records, for more than 45,000 postmenopausal women between the ages of 50 and 79, researchers found:
Women taking oral estrogen at doses of .625 mg per day, in combination with progestogen, had lower risks of negative outcomes or side effects than women taking more than .625 mg of estrogen per day.
They found no difference in health risk between women taking oral forms of estrogen, versus those using patches or pills – as long as they remained at the .625 mg per day dose or less.
This study is believed to be the most comprehensive study performed in the U.S. and is becoming the new standard when reviewing HRT options and deciding which method – if any – of HRT is right for you.
All Things in Moderation – Including HRT
Perhaps the moral of this story really goes back to the idea of “all things in moderation.” When reviewing whether to pursue HRT, consider:
Speaking with your doctor about how long it makes sense to remain on HRT before easing back to no HRT after menopause. Having an exit strategy is a smart way to ensure your body doesn’t wind up receiving more estrogen than is good for it.
Are symptoms so severe that you really need it, or is it worth biding your time for a while longer to see if they subside as your hormones achieve a better postmenopausal balance?
Can you start with the lowest dose possible and work up to a moderate form (if needed), rather than starting at the top and dialing back?
Your newborn’s fresh circumcision site can be painful to look at – and painful to emphatically support as your son expresses just how tender it is.
The good news is that when newborn circumcisions are cared for properly, pain recedes and they heal surprisingly quickly. On average, circumcisions heal completely within 10 days, and most of the pain, inflammation and wound drainage goes away after the first several days.
Keep the circumcision site as clean as possible
When you’re changing his diaper, have a soft damp cloth, warm water and unscented soap formulated for sensitive skin on hand. If any of your baby’s poop is on or near the wound, gently clean it and rinse it, allowing it to air dry completely before putting the new diaper on.
This means you’ll also want to have a soft dry cloth nearby in case baby begins to urinate during the drying phase, and before you’ve secured his diaper, to protect you from being peed on.
To bandage or not to bandage
Most pediatricians apply petroleum jelly or an antibiotic ointment to the tip of the penis and wrap it with a small piece of gauze before sending you home. Some prefer that you continue this practice with each diaper change for a few days, others prefer the wound be left open. Follow the advice your pediatrician provides.
If s/she doesn’t recommend keeping the wound covered (increasingly more common) odds are you’ll be told to apply petroleum jelly or a triple-antibiotic ointment regularly to protect it from urine, poop and to facilitate its healing for the first day or two.
Provide lots of comfort that first day or two
While circumcision is a fairly straightforward procedure, it can (understandably!) cause your baby to be uncomfortable or in pain with no way of understanding why. Make sure to spend extra time snuggling with your newborn so he has ample access to your comfort. Breastfeeding can also support the healing process as nursing releases oxytocin, which is a mild pain reliever in addition to being an emotional soother.
Know the signs of infection or a problem
Taking care of the wound is important, but it’s also important that you know the signs of an infection or a circumcision that is not healing as it should. Redness, a little weepy or fluid release (like clear or slightly yellowish, clear ooze) and a wee bit of blood are all normal.
Signs you should check in with the pediatrician include:
Persistent bleeding (a blood stain on his diaper that is the size of a quarter or larger)
Redness that increases over time, rather than decreases
Drainage that is yellow/green, thicker than it was originally
Foul smelling drainage
Swelling that doesn’t go away
Sores that are crusty
Always call your pediatrician if you notice these or other signs that your son’s circumcision isn’t healing as it should.
Double-diaper and add ice for comfort
Some mothers find their babies seem happier when they’re double diapered. This provides extra padding for the raw and tender circumcision site. For the first day or two, your baby may like to have an ice pack put between the two diaper layers (a Ziploc baggy and ice will suffice) to minimize swelling and discomfort.
Again, most circumcisions heal well within 10 days. After this, the penis shouldn’t require any extra-special care. That being said, you should always clean poop off of the penis, especially from the tip, to minimize your son’s risk of a UTI. If there is still a little of the foreskin left, gently pull it back during bath time to keep the fold(s) clean.
The team at Overlake is here to provide support for women of all reproductive ages, including postpartum mothers who need some support and advice. Contact us and we’ll be happy to answer your questions or schedule a consultation.
Tired of listening to the negative stories about menopause? So are we! We see hundreds of women in their menopause years with bright shining faces (no, the shine is not related to hot flashes!) and energetic spirits who are loving life now that they are done with periods and no longer have to worry about getting pregnant and child rearing.
These positive and empowered women tell a different menopause story than the one we’re used to hearing, and we’d like to share it with you. Menopause is not a depressing ending – it’s an inspiring beginning, and there are multiple reasons to celebrate and stay positive throughout your menopause journey.
1. Learn to pay attention to your body. During the family and child-rearing years, it can feel like our bodies cease to be our own. They are wholly the property of our gestating and then breastfeeding babies to start. Then they become the holding tank, the perpetual lap and often the means of getting from one place to another during the toddler years. Once your child is older, you hardly have a minute to spare for your own body since you’re working, minding the house, running hither and yon for school/sports/music/dance/etc. Whew!
That can translate into complete disconnection from your inner- and outer-self. If you ignore the subtle changes that occur during menopause, the more moderate symptoms may force you to wake up! Keep in mind that early menopause is a possibility as well. Pay attention to any changes in your body like temperature fluctuations, irritability, or discomfort during sex and mention them to your OB/GYN. The sooner menopause is identified, the better you will be at staying on top of it and mitigating its symptoms.
2. It’s the perfect reason to make those dietary changes you’ve been meaning to implement. Diet plays a critical role in your body’s ability to weather the menopause storm. All those guilty pleasures, like processed foods, sugars, unhealthy fats, etc., can actually exacerbate your symptoms and/or will make you gain more weight. Once your estrogen levels begin to drop, a well-balanced diet can be your best line of defense when it comes to feeling good. Increasing foods like yams, whole grains, peas, dried beans and unprocessed soy (which contain natural phytoestrogens) can help a little to balance any symptomatic discomforts.
3. Have sex whenever you want (and wherever you want if your kids are gone). You might not even realize how much you have worried about getting pregnant until getting pregnant isn’t an option any more. As you meander through your 40s, consider migrating away from any hormonal-based birth control options so you can see what your real hormones are up to these days. That, in itself, may bring about some celebratory changes in terms of weight loss, fewer headaches, and the ceasing of other birth control-related side effects. Once you haven’t had a period for 12 months in a row, your doctor will make the official “Menopause!” diagnosis and you can have worry-free sex whenever and wherever you want.
4. Kick the smoking habit once and for all. That aforementioned healthy diet will help you out quite a bit, but lower estrogen levels can affect your heart health. Post-menopausal women are at greater risk for heart disease so smoking cigarettes is even more risky than it was before. Use this biological transition as a reason to make some more concrete physical transitions in your life and quit smoking. There are so many options to help people quit these days. Talk to your doctor about the cessation method(s) that will work best for you.
5. You are alive!Use menopause as an opportunity to hone your relationship with yourself. Think of the friends and relatives whose sparks were snuffed out as children, teenagers or young adults. So many women never have the luxury of knowing life in the menopause years. That, in itself, is enough to make you celebrate being alive and counting your many blessings.