I have had quite a few questions related to anal beaching lately, I know that it was referenced in Bridesmaids, and I’ve heard quite a few one liners about it, but to be honest with you, I didn’t really know much about the topic.  Sadly, I now feel like quite an expert on the topic!  And there are a lot more health issues related to this practice than I had any idea about.

What is Anal Bleaching all about?

It is when you literally bleach the skin around your anus to lighten the skin color so it is all uniform. The treatments are either done at a salon/spa (gel lightener and or laser treatments) or there are some at home treatment options (gel and cream lighteners). I bet your follow up thought is ‘why is this an issue’? Apparently this is a trend started by adult film stars, who noticed that the skin around their anus was a different color than the skin of their butt.  There is a reason that the skin is different colors, it is a different type of skin cells, and I think for eons no one has ever really noticed, but with the popularity of the Brazilian bikini wax, people are uncovering areas that previously were always covered! Here’s the rub: anal bleaching is temporary, and the creams work by decreasing the melanin in your skin, but as soon as that skin is exposed to UV light, it will become darker than before! So it truly is a temporary treatment, and I guess it depends on how important having one skin tone back there really is for you.

Are there any risks associated with it?

Yes! Many of the creams/gels that are used for skin lightening, were created for rapid skin lightening, meant for people with skin pigmentation issues that are usually in less sensitive areas of the body that might need to be lightened to neutralize skin tones.  When these products that are made for less sensitive areas are used in your genital areas, you can have a whole slew of reactions that you probably were not expecting:

-ochronosis: bluish/brown/black pigmentation that can occur (which kind of defeats the purple of bleaching in the first place, right?)

-skin irritation: burning, itchy, dry, peeling skin that is a reaction to the harsh chemicals in the lightening products, and direct laser pulses.

-scarring: due to severe reactions to the treatments, the tissue can become so enflamed and irritated that scar tissue builds up, especially with the laser treatments.

-infections: when reactions and skin irritation occurs, it opens up the tissues with little micro tears and puts you at risk from infection from your own bodily functions and also if the salon/spa you are getting your treatment from does not change out applicators or use fresh treatment creams/gels/etc between clients you are at risk of getting any infection that the person before you has!

-pain: this whole process can be really painful, especially if you have any of these reactions, and it may take a while to completely treat and for your skin to go back to normal. The lasers can cause major discomfort during the layering process and afterwards.

-anal fissures: breaks or tears of the skin in the anal canal, related to a reaction from the creams/gels, especially if applied directly over the anus. It’s almost like a paper cut, but given the area of the body its in, it is NOT comfortable, and can take a while to heal.

There seem to be an awful lot of side effects for a treatment that is strictly temporary, and can actually make the affected skin darker if and when it is exposed to UV light in the future, right?  Melanin that is in our skin is there for a reason, and help to protect us from skin cancer with UV exposure, so why do we want to get rid of it?  Plus, unless you are an adult film star, or lingerie model, is anyone really going to be looking at your anus and comparing skin tones?  I would hope not.  I’m not judging at all, I just think that there are ether ways to spend your time and money….that is one area you do not want to have an allergic reaction, irritation, scarring, etc!

Yours in Good Health

B

There are a lot of people who have had deep vein thrombosis, with absolutely no idea what they are or if they were even at risk.  There are certain common medications that put you at risk, lifestyle choices, etc and they can be quite devastating. So let’s get to the bottom line of what DVTs are, how they occur, treatments, and risk factors.

What is a DVT?

It is blood clot (aka thrombus) that forms in one of the deeper veins of your body, usually in your legs, can occur without any symptoms, and can then break free and travel to your brain, lungs, or heart causing a pulmonary embolism, stroke, or heart attack (due to a lack of blood flow to major areas from the clots).  Almost half of all DVT’s form without any symptoms, which can be pretty scary.

What are the symptoms?

Despite the fact that DVTs can be silent (or symptomless) there are some symptoms that people can have:

-Swelling in the affected leg (calf, ankle, foot)

-Pain in your leg (or ankle/foot) that feels like a charlie horse or muscle cramp

-Warmth or redness in the affected area

Why do they form?

There are tons of reasons for these clots to occur, some are as simple as having a family history of clotting disorders, having surgery, or women who take birth control and smoke.  But there are a whole slew of other reasons that you could form a deep vein thrombosis: sitting for long periods of time driving or flying, prolonged bed rest (like when sick or in the hospital), injury to your veins, pregnancy (increased pressure on your veins along with hormonal changes), cancer, heart failure, pacemakers, intravenous lines (like when in the hospital), inflammatory bowel disease, family history or a prior DVT, being overweight, smoking, and tall men.  Yikes! There are tons of reasons that they form, but the important thing is to be aware of your family history, and the other risk factors, so that if there is anything you can alter (i.e. lose weight or stop smoking) you can, and if not, you can just be aware of what to look for.

How are DVTs diagnosed?

When you are suspected of having a DVT, there are a few tests that may be performed to diagnose the actual clot.  Your HCP will take some blood and test your clotting factors to see if they are elevated (you may be at a higher risk to clot) and they will also check a D-dimer, if you have a clot, your D dimer will most likely be elevated because it is a naturally occurring clot busting substance in the blood. You may also have an ultrasound to visualize the clot, in the area assume to be affected.  If there is a suspected clot that may have moved, your HCP may send you for a CT Scan or an MRI that may help to visualize the clot.  They can also do a venography, in which they shoot die into the vein to try to visualize the clot, but it is a lesser used method for diagnosis of DVT.

How do I treat a DVT?

The goal is to diminish the clot, prevent more form forming, and if you can’t get rid of it, prevent it from doing some major damage (like the aforementioned pulmonary embolism, stroke, heart attack).  The usual treatments are blood thinners that prevent your blood clot from getting any bigger and prevent new ones from forming, like heparin (which is injected or in intravenous form) and then coumadin (oral form).  Just remember, if you are taking coumadin (which is actually rat poison) you need to be careful about eating foods high in vitamin K (like green leafy vegetables) as Vitamin K can reverse the effects of coumadin. If your clot has progressed and might cause a pulmonary embolism, you may get a clot busting drug called tPA (tissue plasminogen activator), it is given through an IV but you need a lot of monitoring and need to be in the hospital as there are high risks of bleeding after getting the medication.  And, if the clots cannot be treated with the medications, due to side effects, then you may have a filter placed in your large veins; if the clots break off and travel, they will get caught in the filter and they will be unable to travel up an cause any other damage.

How to I prevent DVTs?

Keep active, lay off the smokes (especially if you are on birth control), try to live a healthy lifestyle, and being aware of the risks is the best for of prevention; if you know the risks, you can talk to your HCP if you have risk factors to come up with a prevention plan and/or just keep the conversation open so they can be aware and let you know what you can do to further prevent your risks.  You can also wear compression stockings when on your feet for long periods of time, they help to keep veins constricted so that your blood cannot pool and clot AND it helps to prevent swelling of your legs.  Also make sure to exercise your lower calf muscles, watch your vitamin K, and make healthy lifestyle choices like eat healthy and exercise.

Be aware of the risks, keep the symptoms in the back of your mind, and if you think you have a DVT, go see your HCP or to the ED immediately for treatment.

Yours in Good Health

B

Chagas disease is a virus that is a bigger threat in Latin America than HIV/AIDS. It infects about 18 million people a year and kills somewhere around 20,000.  The scary thing is that it is not well known about here in the US (or for that matter outside of Latin America) but because of traveling and/or relocation, this is becoming more of a threat in the EU and US. It is a blood born virus and we do not screen for it with blood transfusions as we do Hepatitis C, HIV/AIDS, and other viruses, so you may be at a higher risk than you are aware of!

What is Chagas Disease?

It is an inflammatory disease caused by a parasite that lives in the feces of a kissing bug (reduviid bug) and it is most common in South America, Central America, and Mexico. The kissing bug, acts just like a mosquito, and it bites to get to blood, and once it is done feeding, it poops, and the parasites in the poop, then have a direct link to the blood. It is usually diagnosed in children but it can be pretty detrimental if found later in life as it causes some severe cardiac damage and damage to the intestines. The goal is to catch the parasite while it is active a replicating, to kill it off and present any further damage.  Initial symptoms include:

-Swelling at the site of infection

-Fever

-Fatigue

-Rash

-Bodyaches

-Headaches

-Swollen glands

-Nausea, vomiting, diarrhea, and loss of appetite

-Enlargement of your liver or spleen (some stomach tenderness)

-Chronic infection can cause: congestive heart failure, irregular heartbeat, constipation (from an enlarged colon), and sudden cardiac arrest.

How can I get it?

Well there are quite a few ways other than being bitten by a kissing bug that you can get infected with the parasite: eating food contaminated with the parasite or bug poop, being born from an infected mother, getting a blood transfusion or an organ transplant that are infected, from blood exposures of an infected person, or from an infected animal.  It is diagnosed by taking a blood sample, but your HCP will also want to check an electrocardiogram (a picture of your heart), possibly an x-ray of your abdomen, and an EGD (upper endoscopy- where a scope is sent into your upper gastric area to visualize any damage).

How do you treat it?

As I said earlier, the plan is to treat and kill the active parasite while it is replicating with drugs such as benznidiazole and nifurtimox, which are readily available in Central & South America and Mexico, but are only available directly from the CDC (Center for disease control) in the US, so that the parasite can be tracked. Once the disease gets to a chronic stage, you can only treat the symptoms, unfortunately, you cannot undo them.

How do I prevent it?

When traveling to the areas with the highest rates of Chagas disease, use pesticides to prevent bug bites, especially if camping or staying outdoors, and avoid sleeping in adobe houses (mud thatched huts and adobe houses tend to have higher rates of chagas disease).  Really the best prevention is to be aware of the risk, and do your best to prevent bug bites by using bug sprays, bug meeting over beds, and know the symptoms, so if you think you have been bitten, get seen by an HCP for treatment as soon as possible!

So hopefully you are prepared on your next visit to Central or South America, or Mexico and have lots of bug spray! Plus, if are concerned about your risk after an organ transplant or recent blood transfusion, talk to your HCP about your risk, as this is not something we normally screen for in this part of the world.  It is better to be safe than sorry!

Yours in Good Health

B

It was brought up to me that there is a “new” mental disorder known as the Truman Show Delusion, where people think they are constantly on a reality TV show.  Now, my best friend and I will joke about how awesome we are and that we should have a reality TV show….but we both know that we are not ON TV.  Apparently watching “The Real Housewives of….” is too much for some people to handle, mentally, and they think there is a TV crew following them too.  But, it is very interesting because the more I am reading about it, the more highly debatable it seems to be in the mental health field.  If you are at risk for the Truman Show Delusion because of watching reality TV, I am in TROUBLE!!

What is this Disorder?

This disorder is named after the movie The Truman Show, starring Jim Carey, in 1998, where he lived in this world, not knowing that how whole life was basically a scripted reality TV show, and he was secretly being taped, while the whole world watched his life.  There are two MDs, who happen to be brothers, Ian and Joel Gold, who claim that there are a few real cases of this disorder, where people believe that everyone in their lives (their families, significant others, co-workers, etc) are all interacting with them based off of a script, and their lives are secretly filmed for reality TV.  They believed that they first started to see these symptoms in patients in Bellevue Hospital in New York in 2002; it is a state of acute psychosis for these patients and they truly believe they are being secretly taped.

Does anything put you at higher risk?

The Golds have found certain traits in their patients that they have found to have this disorder. They say that most of the people that present with this disorder, choose to be at the center of attention most of the time, are very concerned with social standing and what others think of them, and they may actually fear being in the public eye.  Their fear may be so strong that it actually causes a psychotic break in which they believe they are the focus of everyone.  A hyper acute paranoia, stemmed from their biggest fears.

What is a delusion/psychotic break?

A delusion is a belief that someone holds firm to, that has been otherwise proved untrue.  So, if I said that I am the President of the US and I tell everyone that, and truly believe it, despite the fact that Barack Obama is the president, and it is  common knowledge, I would be delusional.  And psychosis, or a psychotic break, is when someone all of the sudden has no concept of reality at all; one day you are living your life with complete control and understanding, and the next you no longer trust or believe anything that you have accepted as truth your entire life.  Both of these issues can be scary to the person it is happening to and confusing to those around them, such as friends and family members. Anyone with an acute delusion or psychotic break should seek help immediately so the underlying reason for the delusions/psychosis can be treated and an HCP can help to ensure that they are safe.

What is the controversy with the Truman Show Delusion?

Well, acute paranoia and delusional psychotic breaks are not new in the world of psychiatry.  And patients who are having these delusions or paranoia often are paranoid about things that are relevant in society.  For example, when radios were the hottest technology, patients were worried that they were being affected by radio waves and they were being emitted into their brains, changing how they acted and invading their thoughts.  Now it is more a fear of microchips being imbedded in them, or the fear of hidden TV cameras because there are so many reality TV shows/hidden camera shows in the media and on TV.  So, many in the medical field kind of think that this is just a lot of hype, to get 15 minutes of fame for the Doctors Gold, for something that is not new and has been part of delusions since inception of the diagnosis.

Just like after 9/11, people had psychotic breaks and delusions about terrorists everywhere; does this mean that the cultural obsession has created this phenomenon?  I think the biggest issue is that this is a culturally relevant take on an old psychiatric disorder. This isn’t a rampant diagnosis since the inception of reality TV, and there are risk factors.  BUT if you do know anyone that has any of these fears, you should get them to see their HCP immediately as they do need medical care to treat their psychosis, figure out the cause, and get them medications/treatment regimens.  But, rest assured, there is no research that says that watching reality TV will make you have a psychotic break and create the Truman Show Delusion!  So, keep on keeping on with the Kardashians and those “Real Housewives..” besides wasting a few hours of your life, you won’e become psychotic!

Yours in Good Health

B

I know that it should come as not shock to people when I tell them that the preferred route of obtaining medication is to have an issue, go to your HCP, obtain a prescription, go tot eh pharmacy, have it filled, and there you go.  Sometimes, especially for medication that they feel their HCP won’t write for them or they are just too embarrassed to ask for, they find other ways to get medications: the internet.  I want to be clear, going through your CVS/Caremark, Walgreens, Rite Aid, etc online drug programs is totally fine, as long as it is supported by your insurance company, and an FDA regulated company, you are all set; online pharmacies that tell you there is no prescription required is where the issues can happen!

How does it work?

I am sure that you have all received one (or a million) of those SPAM emails looking to sell online Viagra, Ativan, whatever the drug du jour is from these companies.  Those who are actually interested click on the link (PS- bad move all around, but we will get into that later), and you are charged a “consultation fee” with a “Doctor” that is usually from a foreign country, or from the US that is no longer allowed to practice within hospitals due to drug addiction, malpractice suits, etc.  Bottom line: your consultation is with a “doctor” that you wouldn’t even let touch an animal, never mind yourself.  But, the FDA requires a prescription for all medications, which is how they get by the loophole.  They charge you a hefty price, and send your meds off to you.  Sounds great and super easy. Right?  Hmmmm…..

What are the Risks?

Well, since these places aren’t actually pharmacies (it isn’t regulated like Walgreens and most likely is in someones house), you are getting a pill bottle labeled as viagra (as an example) but you don’t know that the pills you are getting are actually viagra.  There have been many cases where the pills are diluted, so they “pharmacists” cut the drugs with other things, decreasing potency, or add other things to them.  Recently there was a case where kids were buying adderall online to study for exams and what they were getting in the mail was actually tramadol (opiate pain reliever) and acetaminophen (Tylenol), which would make you SUPER tired and have the opposite effect! An analysis by the FDA of many “drugs” from online pharmacies found that most of the medications that they received were not what they ordered….not at all the correct drug.  This could be REALLY dangerous like if you have a drug allergy, or if you are taking other medications that could interact, or if you have any sort of past medical history: you could be taking something that could kill you, and you don’t even know what you are ingesting.

Also, let’s not forget, the people that run these web sites are not exactly cream of the earth kind of people, and they are many times phishing sites: you clink on that link, pay them using your credit card, and they steal your identity, your money, and they can ruin your credit and/or your life.

Why should I see my HCP?

The whole point of going to your HCP, being SEEN, having labs or other tests done, is part of being safe.  We want to make sure that we are giving you the right medication for the right purpose.  We like to prevent people from beaching dependent upon medications, and use all sorts of different treatments and therapies.  Plus, we make sure that you are getting a prescription from a pharmacy that is regulated by the FDA and giving you real medications; the medications that you need and will help you get better.  We do what is safe, and what is required by law to treat you; those sites do not, and could be giving you medications that could cause serious harm or death due to medication interactions, under dose, overdose, or allergic reactions.  Imagine just taking a pill form someone random walking down the street:

Random guy: “Hey dude, take this pill.”  You: “what does it do?” Random Guy: “I don’t know, just take it” You: “OK!”

NO!  That should never happen, and you should go through the proper channels for prescription medications.  I get that it can be a pain to get an appointment, wait, tests, etc. I totally understand, I get annoyed by the same exact things, but it is all part of a checks and balances in the healthcare field making sure that you are being treated properly and appropriately, and you might think healthcare in the US is expensive, but HCPs won’t steal your identity and ruin your credit, and we make sure that you get the drug we write a prescription for.  Doesn’t sound so bad now, does it??  So stop clicking on internet pharmacies and get in touch with your HCP (plus many HCPs have moved to online sites to contact and refill prescriptions!!)

Yours in Good Health

B

 There has been a LOT going around on the internet recently about women eating their own placentas (AKA placentophagia) after giving birth, and I’ve gotten a lot of questions whether you are to eat it raw? Cook it? Do I eat the whole thing? Some of you are reading this vomiting in your mouth, and the others are thinking, “I am all about this.” I want to let people know all sides of the issue so you can make your own informed decision about what you want to do with your health…and your placentas.

What is a placenta?

The placenta is the organ that covers the inside of the uterus, it is about a pound, a dark red/maroon color,  and connects to the fetus to allow the mothers blood to pass into the fetus allowing gas exchange (“breathing”), food and nutrients, and eliminate waste (through the blood flow in the placenta).  It connects to the baby through the umbilical cord, which is where all of the blood exchange occurs from mother to placenta.  After birth (usually 15-30 minutes after delivery), the placenta has pulled apart from the uterine wall and is “delivered” or expelled from the uterus (just like the baby was right before). Once the placentas is delivered, there are all sorts of cultural differences with what is to be done with it: In western culture we tend to incinerate the placentas, other cultures have funerals for placentas, many different cultures bury the placentas in various places, and others eat them….

Why would I eat a placenta?

The research to back up all of the claims related to eating placentas is currently being researched by the NIH (National Institute of Health) as well as other independent studies are going on, but there are some claims that are heavily backed by the women who have tried it.  The placentas are heavily laden with the vitamins and hormones that support the fetus during pregnancy, and it remains a source of those vitamins and hormones right after birth: Oxytocin, Vitamin B6, CRH (Corticotropin-Releasing Hormone).  In China, Italy, and Vietnam it is pretty customary for people to eat part of the raw placenta directly after birth.  The oxytocin present is thought to prevent the post birth hemorrhage risk, the vitamin B6 levels can prevent post partum depression, and the CRH, which is a hormone created by the hypothalamus to decrease stress and is found in high levels in the placenta during the third trimester, is thought to also help decrease the risk of post partum depression.  It is assumed that because your CRH levels are so high during the third trimester and it takes a while for the hypothalamus to start re-secreting post birth, it can be one reason for post partum depression, and taking an oral supplementation, in the form of your own placenta, might help to stave off those blues. Traditional Chinese Medicine has been using placentas for treatment for hundreds of years, with a few small poorly done studies showing decreased rates of post partum depression and increased milk production when women eat placenta.  Clearly much more research needs to be done for humans.

What are the negatives?

There are truly no known negatives at this point per say, as it is lacking so much research.  I just fear that women will start eating their placentas because some random celebrities are doing it, and their may be some health risks associated with it, depending on your childs birth and any trauma that may have occurred to the placenta.  And while some of these celebu-moms claim that the placenta pills that they make (out of food processing their placentas along with fresh herbs) and they take multiple pills a day, there have also been accounts that the placenta pills make post partum moms feel miserable and extremely jittery and out of control.  It could be all of the concentrate hormones and the absorption post partum through the stomach with the other herbs that makes a big difference. But, many women who start these pills end up stopping taking them.  There are no other known negatives, other than the fact that its pretty gross to eat your own flesh (a bit cannibalistic, no?) but again, much research needs to be done in this area to truly know the positives and negatives.

It has been well researched that non human mammals eat their placentas all the time, and it helps ease after pains of birth, restore lost nutrients (including iron), and it ignites the parental instincts in animals.  We, as humans, don’t really need that; we give birth with HCPs surrounding us, we know how to care for our offspring, and we have numerous medical treatments to help with iron stores, etc. Plus we don’t know if there are actually benefits to eating a part of our own flesh; most people would prefer not to eat things that come out of them, if they don’t need to right? This is one thing that I will really urge you to think hard and long about before trying and really talk to your HCP about the benefits that you are looking for, for both you and your new offspring, before diving headfirst into this practice.

Yours in Good Health

B

We all know that the sun can be super harmful to our skin, UVA and UVB rays can cause damage to your skin and lead to skin cancer, but did you also know that the sun can also do some major damage to your eyes? Unfiltered sunlight to the eyes can create long lasting effects on your eyes and cause irreversible damage….makes you think twice about shelling out some extra cash on sunglasses; they aren’t just cute accessories, they are preventative medicine!

What damage can sun do to your eyes?

–Cataracts: Cataracts are when the lens of the eye becomes cloudy, making for vision blurry and very distorted.  It can make reading, watching TV, etc very hard and really limit your abilities to do anything that requires keen eyesight.  They can eventually lead to blindness and cataracts are currently the leading cause of blindness.  Continued exposure to UV rays from the sun can cause the lens of the eye to thicken over time, and increase your risk of getting cataracts; the lens will thicken, then become cloudy and cause the blurry vision.

–Macular Degeneration: Macular degeneration is an abnormal growth of blood vessels in the eye, and opaque deposits on the retina (the light sensitive portion of the back of the eye), and an increase of pigment in the retina, leading to decreased vision.  It is common with aging, but many studies have shown that over exposure in your teens, 20’s, 30’s to unfiltered sunlight can significantly increase your risk, and there is truly no cure/treatment for macular degeneration.

–Photokeratitis (AKA Snowblindness): an actual form of blindness, that can be temporary and cause extreme pain and total blindness due to the cornea getting burned.  It is called snow blindness because it can happen easiest when there is sun reflecting off of snow, it can be super bright, and burn the cornea, and you cannot see for a short period of time.  Obviously the longer the exposure, the longer the blindness.  Your eyes start to burn a few hours after exposure and it can feel like sand is in your eyes; the only known treatment is keeping out of sunlight and the use of pain medications.  Prevention is key!

What can I do for prevention?

A hat and sunglasses go a LONG way to help and decrease your risk of getting sun damage to your eyes.  Multiple studies have shown that protection of the eyes in sunlight (with a hat or sunglasses), even with large amounts of exposure, your eyes are at a much lesser risk of getting any of these long term eye issues. Of course, as an HCP, I will always suggest limiting sun exposure to decrease your risk of skin cancer, but if you are wearing your SPF, and doing everything right, you should be able to spend time in the sun…..just make sure to protect your eyes.  Don’t stare at a glaring white page of a book for hours without sunglasses, and same with being on the ocean, the suns reflection can cause some major problems, and wear goggles when you go skiing!  Make sure to check that the sunglasses/goggles you buy say that they have UVA/UVB protection, and you should be all set!

So not only do sunglasses protect your eyes and prevent those wrinkles from squinting, they totally can make your outfit pop too! Now, if only we could get Prada covered by our health insurance, I would be one happy girl….

Yours in Good Health

B

I have so many friends that have been trying to get pregnant, for what seems like a long time, and it is a really emotional, embarrassing, and frustrating. You don’t know if you should talk about it, not talk about it….and how to do you fend off those nosey people asking when you are going to start a family?  Believe me: been there, done that.  It is always in the back of your mind, no matter what else is going on, and it is a constant stress.  After talking to one of my good friends a few weeks ago, I realized that she was trying to get pregnant without luck. When we were talking she was saying how she didn’t understand why she was never ovulating (after peeing on tons of those sticks) but nothing was wrong with her, per labs tests, etc. And what did she realize?  She was miscalculating when she was supposed to be ovulating. This is a common misconception (no pun intended) among women, and there are some tricks of the trade to know when you are ovulating.  Having sex (unprotected…I hope goes without saying) when you ovulate drastically increases the chances of making a baby!  Plus, it is important to keep in mind that healthy couples in their 20’s and 30’s only have a 20% chance of getting pregnant each month….with those odds, it makes those “oops” pregnancies seem like such bad luck.

What is ovulation?

Basically, ovulation is when a mature egg is released from your ovary, into the fallopian tubes (helps carry the egg to the uterus) and is ready and available to be fertilized.  The lining of the uterus thickens to help to prepare for the egg to be fertilized so that it can embed in the lining once the egg is fertilized, that is where it will thrive and grow and turn into a little baby!  If fertilization does not occur, then that thickened uterine wall sheds along with the egg and that is when you have menstruation.  Now, figuring out the perfect timing of all of this is the trick! A mature egg lives usually 12-24 hours after leaving the ovary and it is only that timeframe that it can be fertilized, but sperm can live three to six days inside of the uterus (so that gives us a fighting chance!!).  When you think about it in those terms, it seems really hard to get pregnant, yet some people breed non-stop….which I know is frustrating for those of you who are having a difficult time with this.

How do I know if I am ovulating?

1. Ovulation usually occurs in the middle of your cycle, Ideally, you would be like a calendar on a 28 day cycle, so day 13-15 would be our fertile period.  Fun trick?  Most women aren’t so clock work about their menstrual cycles and the average cycle is 23 to 35 days.  So one good way to start here is to figure out your cycle: mark on a calendar when you get your period, when it ends, and do this for a couple of months, so that you can kind of have a better idea of how long your cycle is: then have sex a LOT during the middle of that timeframe, and hope for the best!  Plus there are cool online trackers like this Ovulation Calendar.

2. Pay attention to mittleschmerz (German for middle pain).  Many women have a light pain/twinge in their ovaries when their egg is released, like a quick cramp. Now a bunch of you are thinking “doesn’t happen to me” but pay attention next month, and I bet you feel it.  And that is the exact moment that ovulation occurs…kind of cool if you have time to think about it.

3. Take a basal body temperature. There are specific basal body temp thermometers that you can use to check your temp FIRST thing in the morning, the second you wake up, before you sit up, pee, do ANYTHING.  You check your temperature and it will let you know when you are ovulating.  The first half of your cycle, yoga re driven by estrogen, so you have a lower body temp, then after ovulation, progesterone takes over and your body temp increases (because if you get pregnant, it helps to keep the fertilize egg in that lining of the uterus wall and thrive).  So, the day that your body temp is the LOWEST, then abruptly spikes up, you are ovulating! This is a tough one to get correct, and it is so super sensitive, but people who are Type A and very routine oriented seem to do well with this.

4. Increased cervical mucous.  MMMMM, a yummy thought, I know.  But as your body gets ready to get pregnant, your cervix loosens up, gets ready to help that sperm swim on up into the uterus and start making some babies, so the normal discharge that you might have, becomes more sticky, clear (instead of cloudy) and more the consistency of an egg white.  This helps to point the sperm in the right direction and get them to the right place.  You can sometimes notice this change in discharge in your underwear or it may come out of you when you are using the bathroom.  I know, I am full of fun stuff this morning…sorry!

5. Ovulation prediction kits (OPK) are your friend!  You might feel like you are going to lose it if you pee on another stick, but these kits are really accurate, and while expensive (they range from $6-$30) and annoying (when you don’t ever see a fertile period) they can help you to know when you are ovulating without worrying about the calendars, temps, looking for changes in discharge!  They are quick and easy, and done with the first pee of the day.  You can use on every day of your cycle to find out the length of your cycle (from when your period begins to the start of your next period) to find out the length and help you to know when you ovulate.

IF you have none of these changes, and an OPK never gives you a fertile period, don’t wait, go see your HCP and get referred to an infertility specialist.  Some states cover all infertility treatments by insurance and some don’t. So it can be frustrating and expensive, but know that there are others out there facing what you face and we are all in the battle for babies together.  Plus, if things don’t work out for you, there are always other options. If you are worried there is something wrong with you or your partner, go get checked out, there is no harm, and you might be able to take medications that are cheap that might help increase your chances of pregnancy.

The good and bad news is that there are SO many people having trouble getting pregnant right now: we live in a stressful society where people work WAY more than 40 hours a week, don’t have time to do everything to make their bodies and their own needs their priorities. So, please let’s make a deal that we will not bug other people about when they are going to have babies and start making a family, as it is such a sensitive and personal issue, and let’s also make time to care for ourselves and nurture our bodies during a stressful time when we need to care for us, and make things as stress-free as possible.

Yours in Good Health

B