Is Bleeding or Spotting During Ovulation Normal?

Whether you’re trying to conceive, trying not to conceive, or in the throes of menopause, bleeding outside of your normal monthly cycle can be alarming. It’s common to worry about irregular bleeding, especially when it is accompanied by other symptoms, or you have experienced health problems in the past. Tidewater Physicians for Women specializes in women’s reproductive health and can help you get to the bottom of it through expert, compassionate care.

What is Ovulation?

Most women have two ovaries, which contain all the eggs they will ever produce by the time they are born. During ovulation, an egg is released from an ovary and travels down a fallopian tube, where it has the opportunity to become fertilized in the right conditions. In some cases, two or more eggs are released (thus explaining fraternal twins, the result of the fertilization and implantation of two separate eggs during the same cycle).

The time of ovulation depends on the length of your cycle. Most women experience ovulation about once a month, and it typically occurs mid-cycle or in the middle of your menstrual cycle. For example, in a 28-day cycle, ovulation occurs about 14 days after the first day of your last period and about 14 days before the first day of your next period.

Many women know when they ovulate based on the signs and symptoms they experience during this phase in their cycle. Common signs of ovulation include an increase in basal body temperature, a surge in luteinizing hormone (LH) levels, cervical mucus that looks like egg whites and is more watery, a change in the position of the cervix, and a positive ovulation test (administered by your doctor or bought over the counter).

Additional symptoms of ovulation include breast tenderness, ovulation pain (mittelschmerz), bloating, and increased sexual desire. These signs and symptoms are so predictable for some women that they depend on them to predict ovulation and prevent conception by using a barrier method of birth control or abstinence during their fertility window.

What are the Causes of Bleeding During Ovulation?

Around 5% of all women who menstruate will notice minor bleeding or spotting during ovulation, which can be explained by hormonal changes. Luteinizing hormone (LH) levels surge 24-36 hours before ovulation. The estrogen levels in your body will rise steadily as your body prepares for ovulation and then suddenly drop once the egg has been released. After ovulation, progesterone levels begin to rise. This hormonal change — as you move from increased estrogen levels to increased progesterone levels — often causes some spotting or light bleeding that is much lighter than typical menstrual bleeding.

Does Bleeding During Ovulation Mean You’re Pregnant?

woman holding calendar and stomach in pain

Bleeding mid-cycle or during ovulation is not an indication of pregnancy. However, it might be an indication that you are in your fertile window, so those who regularly bleed when they release an egg will often either try to conceive or avoid conception, depending on their goals. It can also signify that something more sinister is occurring, especially if accompanied by signs and symptoms of infection like pain, odor, or abnormal discharge.

How Long Does Ovulation Bleeding Last?

While your menstrual period is likely heavier, darker in color, and longer-lasting, ovulation bleeding is much lighter and should only last for a day or two. You can tell the difference between ovulation bleeding and cycle bleeding because ovulation bleeding will be lighter, mid-cycle (about 14 days after the first day of your last period in a 28-day cycle), and possibly mixed with cervical fluid or cervical mucus.

How Much Bleeding Is Normal During Ovulation?

During ovulation, you shouldn’t notice a regular flow of blood. Ovulation spotting is usually light spotting at most: one or two drops at a time. Ovulation bleeding shouldn’t warrant tampon use.

What the Color of Your Discharge During Ovulation Means

The color of your discharge during ovulation could signal various conditions. Here is what each color means.

  • Clear to light yellow: A clear to light yellow coloring typically signifies healthy lubrication with not much to worry about. The only problem comes when the color is accompanied by a cottage cheese-like consistency and a strong odor. That could signify an infection.
  • Brown: A brown discharge is typically one of the variations of normal spotting, but the timing could indicate another condition. If you see brown spotting before you expect your period, you could be pregnant. If it occurs after you have gone through menopause, it could indicate endometrial cancer in some circumstances.
  • Pink: Pink usually indicates a small amount of mid-cycle bleeding, but that can be normal when spotting before a period. If you are in early pregnancy, however, it could be a sign of implantation bleeding. Spotting after ovulation can also be pink, as can discharge after intercourse if there are small tears or irritation in the vagina.
  • Green: Darker yellow or green discharge may indicate an infection that’s typically sexually transmitted in nature. If the hue is lighter in color, however, it could simply result from certain dietary supplements.
  • Gray: Any shade of gray is typically a sign of bacterial vaginosis, which is a fairly common bacterial infection. It can be treated with antibiotics, but you’ll want to see a doctor as soon as possible.

Does Cramping During Ovulation Mean Pregnancy?

No, ovulation cramping and implantation cramping are distinct, though they may feel similar. Cramping doesn’t necessarily mean that you are pregnant. The only way to know for sure is to take a pregnancy test no sooner than 12 days past ovulation or when you expect your next period to start.

Why Am I Bleeding After Sex During Ovulation?

Bleeding after sex during ovulation can be caused by a variety of factors. One potential cause is friction from sex due to tears in the vagina. This is typically not a big deal, though it could indicate a hormonal imbalance or vaginal dryness if it occurs repeatedly. It could also be a symptom of cervical ectropion, which is a condition in which cells that are supposed to be inside the cervix grow outside of the cervix. This is relatively common and usually harmless, but it can lead to light vaginal bleeding.
Some potentially concerning conditions that could cause bleeding include cervical polyps, endometriosis, and STIs like chlamydia or gonorrhea. It is always best to see your OBGYN to rule out any serious problems.

Why Am I Bleeding Heavily During Ovulation?

woman in jean skirt holding tampon

Ovulation should be accompanied by light bleeding in the vast majority of cases of mid-cycle spotting. Heavy vaginal bleeding or abnormal uterine bleeding could indicate other problems such as the following:

  • Uterine fibroids
  • Uterine or cervical polyps
  • Hyperthyroidism
  • Hypothyroidism
  • Polycystic Ovary Syndrome
  • STIs
  • Cervical cancer
  • Ovarian cancer

If you experience heavy bleeding during ovulation, you should see your OBGYN as soon as possible.

When Should I Worry About Ovulation Bleeding?

Normal menstrual bleeding occurs at regular intervals (usually starting every four weeks or so, although every person is different) and lasts between five and seven days. Some women also experience light spotting during ovulation, about two weeks after the first day of their last period or in the middle of their cycle for women who have a cycle that is longer or shorter than 28 days.

Sometimes, irregular bleeding is an indication of an underlying health condition and not just cycle spotting. Some of the most common causes of irregular bleeding outside of ovulation and implantation include fibroids, endometriosis, polycystic ovary syndrome (PCOS), polyps, menopause or perimenopause, pregnancy, and sexually transmitted infections (STIs).

It’s important to see your healthcare provider if:

  • You typically experience regular periods and have recently noticed that your menstrual bleeding patterns have changed
  • You notice bleeding that doesn’t occur during your menstrual cycle or spotting that doesn’t occur around the middle of your cycle (around 14 days after the first day of your last period)
  • Bleeding at any time during your cycle is accompanied by the signs and symptoms of an infection or severe pelvic pain
  • You experience ovulation bleeding while taking hormonal birth control (or any form of birth control)

Your physician will ask questions to better understand your history, symptoms, and risk factors; conduct a physical examination; and order additional labs or diagnostic imaging tests if necessary.

How Can I Prevent Ovulation Bleeding?

Most women don’t experience ovulation bleeding. Those who do can prevent bleeding by preventing ovulation through the use of hormonal contraceptives, which control hormone levels and stop the release of an egg. Women who are trying to conceive should not take steps to prevent ovulation or any associated spotting.

Tidewater Physicians for Women can help you understand all aspects of menstruating through compassionate women’s health services. Whether you’re ready to start a family, trying to better understand your cycle, or looking for relief from the symptoms of menopause, our team is here to help.

Services available at Tidewater Physicians for Women include:

  • Women’s health services, including vaccinations, health screenings, cancer screenings, sex education, menopause treatment, preconception counseling, nutrition screening, and weight control information
  • Gynecology services, including birth control, adolescent gynecology, annual preventative care, diagnosis and treatment of gynecological infections and disorders, surgery, and treatment for menopause
  • Obstetrics services, including comprehensive care before, during, and after pregnancy including ultrasound examinations and fertility services
  • Menopause, family planning, ultrasound, robotic surgery, and more

Even women who do not have concerns about their reproductive health need regular preventative care. Call our office today at 757-461-3890 to schedule an appointment in the Norfolk and Virginia Beach areas.

Can Breast Cancer Happen Before Adulthood?

Hearing stories of breast cancer patients online or from family members can be alarming. Breast cancer is a terrifying prospect, and while it has a high survival rate if caught early, many women and even some men still die from this disease every year. While it is most likely to develop in middle age and older women, it has, in some instances, appeared in young adults, and even rarer, in teenagers, so monitoring should be a part of every woman’s regular healthcare routine.

According to the American Cancer Society, breast cancer is the most commonly diagnosed form of cancer among women and the second leading cause of death among women. Understanding the symptoms and signs of breast cancer is the first step in preventing and getting an early diagnosis, which can make all the difference in the world. If you believe there is cause for concern after reading about the symptoms, you should schedule an appointment with a general practitioner or a specialist.

Breast cancer is a serious disease and should be evaluated if symptoms are present, regardless of how mild they are or how young the patient is. If you exhibit symptoms, schedule your appointment with Tidewater Physicians for Women. It could save your life.

Your Risk of Breast Cancer Increases with Age

Your risk of breast cancer increases as you age. The largest pool of those at risk for breast cancer is women in the over-45 age group. However, this does not mean that young women and teenagers are immune. Though it is rare in younger women, breast cancer can strike almost anyone at almost any age, and you are never too young to begin getting breast cancer checks.

What Is the Risk of Breast Cancer in a Teenager?

According to the National Cancer Institute, the risk of breast cancer in teenagers is highly uncommon, and pediatric breast cancer is exceedingly rare. Only two percent of adults under 34 are diagnosed with breast cancer. However, establishing a healthy lifestyle as soon as possible is essential. Activities such as tobacco smoking and drinking alcohol can potentially increase your cancer risk as you age.

Is Breast Cancer Hereditary?

Breast cancer is considered hereditary. Strains of this disease that are hereditary come from the mutation of either BRCA1 or BRCA2 genes. BRCA stands for BReast CAncer. These genes are inherited from your parents and are important for the upkeep of the cells that maintain your breasts, ovaries, and other female reproductive cells.

Am I More Likely to Get Breast Cancer if My Mom Has It?

Yes, your risk of developing breast cancer is significantly higher if you have a family history of breast cancer. If your mother or sister develops breast cancer, your chances of also developing the cancer are double those of someone in whose family it does not appear.

If a “first-degree” family member receives a breast cancer diagnosis, it does not mean that you are certain to get cancer. However, it does significantly increase your risks. Your doctor may recommend genetic counseling to help you make informed medical decisions based on your family history.

What Are the Symptoms of Breast Cancer?

woman looking in the mirror

There are several signs of breast cancer. These can vary in teenage girls and adult women. They may also vary based on the type of breast cancer you have, including inflammatory breast cancer, invasive breast cancer, or other forms of lymphoma or carcinoma.

Symptoms in Teenagers

If you are a teenager with cause for concern, the most important symptoms to watch for are painful, hard lumps on your breasts. As a teenager, lumps can be due to several reasons, not all of which are cancer.

Types of Lumps

Types of breast lumps in teens include the following:

  • Secretory adenocarcinoma is the most common type of cancer found in teens. These carcinoma (tumors) are generally slow-growing, non-aggressive, and treatable.
  • Fibroadenoma is the most common type of benign or harmless lump that will not become cancer. These may be what are commonly called breast buds, part of normal breast development and breast changes during adolescence. However, they may indicate fibrocystic breasts, which is a different condition that may require treatment.
  • Cysts are another noncancerous type of lump comprised of fluid-filled sacs. Cysts can generally be treated or removed.
  • Pimples can also feel hard and lumpy and may feel similar to cysts but are a different skin condition. They often fade as adolescence progresses, but treatments may be available for severe acne.

Symptoms in Adults

Symptoms of breast cancer in adults are far more numerous than those in teens and should be taken seriously. These can include:

  • Lumps in the breast, lymph nodes, or armpits
  • Irritation or dimpling of the skin in the breasts
  • Unusual swelling in the breast
  • Flaky skin, redness, pain, or irritation around the nipples
  • “Pulling in” of the nipple
  • Any change in breast tissue shape or size
  • Breast pain in any area of the chest
  • Nipple discharge that is not breast milk, such as pus or blood

If you experience any of these breast conditions or anything else unusual in your breasts that is outside the normal changes you might see during your menstrual cycle, see your doctor immediately.

Treatments for Breast Cancer

Several different treatment options exist for treating breast cancer. Breast cancer treatments are more effective when the cancer is caught in an early stage and include surgery, chemotherapy, hormonal therapy, radiation therapy, and biological therapy.

Surgery

Surgery is an operation that sees the doctor cut away the cancer tissue. The most extreme form of surgery to treat breast cancer is the mastectomy or double mastectomy, wherein the doctor removes one or both breasts. This is the most extreme form of surgical treatment for breast cancer and is not always necessary. If you require a mastectomy, sometimes cosmetic surgery can be used to reconstruct the removed breasts. Talk with your gynecologist or general practitioner for options after your surgery.

Chemotherapy

Chemotherapy, or “chemo,” is a treatment that uses special medications to shrink or even kill the cells that cause cancer. Several different types of chemotherapy exist, including pills or intravenous drugs. Sometimes both forms are used as an aggressive treatment. It is a tried-and-true treatment, but it is also very hard on the body and can affect immune systems and weaken the patient. More recent drugs have lessened the side effects somewhat.

Hormonal Therapy

Hormonal therapy uses medications called hormonal blockers. These stop the production of hormones like estrogen and progesterone (a common birth control hormone) that the cancer cells rely on to grow, killing the cells.

Radiation Therapy

Radiation therapy uses targeted bursts of high-energy radiation, similar to X-Rays, which directly attack and kill the cancer cells. Like chemotherapy, radiation therapy can be hard on the body though it has advanced in recent years.

Biological Therapy

Biological therapy boosts your body’s immune system to fight cancer better. It can also be combined with other forms of treatment to boost the immune system and reduces side effects.

At What Age Should You Begin to Test for Breast Cancer?

There is no age at which you are too young to begin giving yourself breast exams in the shower in the morning. Your doctor can guide you through how to check yourself for lumps and symptoms.
You should, however, have your first risk assessment for breast cancer in your late twenties. At this point, the doctor will review your family history, your personal habits, and other indicators to determine your risk factors. If you have a high-risk factor for cancer, the doctor may recommend earlier screenings.

If your risk factors are otherwise normal and there have been no prior indications of early cancer or precancer, you will have your first mammogram or mammography when you turn 40. Your doctor will recommend regular mammograms from this point forward to continually monitor you, at least until you reach menopause. Remember, it is essential to catch cancer early. When breast cancer is caught early, treatment is much easier and more survivable.

Catch Your Cancer Early

doctor speaking to a patient

At Tidewater Physicians for Women, we provide comprehensive women’s healthcare services, including screening for many types of cancer, including breast cancer. Our doctors, nurse practitioners, licensed counselors, and specialists are here to help you live a long and healthy life. Whether you just need a checkup or are facing issues like secondary infertility or cancer, we are ready to provide the compassionate and dedicated care you need.

Remember, early detection is essential to stopping cancer and significantly increasing your survival rate. Take cancer screenings seriously and let Tidewater Physicians for Women help you stay healthy and happy for many years to come. Contact us at 757-461-3890 to speak to a team member and schedule your checkup or cancer screening today. We have offices in Virginia Beach and Norfolk, Virginia. Same-day appointments may be available.

How Often After 50 Should You Get a Pap Smear?

Did you know that the average age for a diagnosis of cervical cancer is 50 years old? Luckily, cervical cancer is detectable and very treatable if it is caught early. The ability to screen for precancerous cells has vastly increased the odds of beating this form of cancer, provided that patients get screened regularly. Learn about Pap smears and HPV tests, why they are vital to women’s health and gynecology, whether you still need to get them after age 50, and how Tidewater Physicians for Women can help.

What is a Pap Smear?

A Pap smear is a cervical cancer screening test wherein the cells of your cervix are tested for changes that indicate cancer or a precancerous condition called the human papillomavirus, or HPV. The test is also called cervical cytology. The screening process is fast and easy and can be part of your pelvic exam. While lying on an exam table, your doctor will use a speculum to open your vagina. They will then use a brush, swab, or other sampling instrument to take a small sample of cells from inside your cervix.
These cells are placed in a special liquid to preserve them and are sent to a testing lab where they are examined for abnormalities. For an HPV test, the cells are tested to see if the most high-risk types of HPV are present. Often, the same sample can be used for both tests, though in some cases, the doctor may take two separate samples.

Are There Risks Associated With a Pap Smear?

The risk factors associated with a Pap smear are exceptionally low. You may experience some pain or bleeding, and in the rarest cases, infections can occur. Still, the benefits of a Pap smear far outweigh any of these minor risks, as the test can quite literally save your life.

Pap Test vs. HPV Test

Doctor holding a brush

The samples taken and the methods to take them are the same for both Pap tests and HPV tests. The only difference is what the lab looks for when examining the cell samples. In a Pap test or Pap smear test, the sample is examined for cancerous cells or precancers, which are changes to the cervical cells that could become cervical cancer if the right treatments are not given.

In an HPV test, rather than looking for abnormal cells, the lab tests for certain varieties of the human papillomavirus. Everyone has this virus, but for most people, it remains dormant throughout their life. If the virus becomes active, certain strains of it can present a risk for cancer. Testing for active HPV can permit the virus to be treated and can help to prevent or properly fight any cancer that does arise.

Why is It Important to Get Cervical Cancer Screenings?

Cervical cancer is the most common form of cancer among U.S. women, according to the National Cancer Institute, but at the same time is also one of the most treatable and preventable with regular testing and healthcare. An abnormal Pap test reveals precancerous changes to the cervix, which can then be treated before they turn into cancer. If you have an abnormal Pap test, your healthcare provider will discuss options with you at a follow-up appointment. The Pap test has saved many lives over the years, and it can save yours.

If you are ready to get your test and protect yourself against precancers, Tidewater Physicians for Women is ready to help. Just call our office at 757-461-3890 to speak with a team member today.

Do I Still Need to Get a Pap Smear After Menopause?

You should absolutely continue to get Pap smear exams after menopause. Just because you are experiencing menopause symptoms or have gone through the change does not mean you are immune to cervical cancer. Women who have gone through menopause can still be vulnerable to cancer, and continued checking can save a life.

How Often Should You Get a Pap Smear After 50?

You generally have three options for testing after the age of 50:

  1. You can get both a Pap test and an HPV test every five years.
  2. You can get a Pap test only every three years.
  3. You can get an HPV test only every five years.

Many doctors recommend that women age 50 and over who have just entered menopause should still get Pap tests every three years if they have had normal Pap test results for three years in a row with no history of precancerous results.

If you have had precancerous results, you may need to continue to get tested more frequently. If you have no family history of cervical cancer, you received the HPV vaccine as a young adult or adolescent, and you have had at least three consecutive negative Pap test results or two consecutive negative HPV or co-test results, you may be able to extend the time between Pap smears. Speak with your doctor for advice on which option is best for you based on your medical history.

I Had a Hysterectomy. Do I Still Need Pap Smears?

You may still need regular Pap tests if you have had a hysterectomy, according to the American College of Obstetricians and Gynecologists (ACOG). It depends on the reason for your hysterectomy, whether your cervix was removed as part of a total hysterectomy procedure, and whether you have a history of cervical cancer or extreme cervical cell changes.

Even if your cervix has been removed, you may still have cervical cells at the top of the vagina. If you have had surgery for cervical cancer, or you have a history of cancer or high-grade cell changes in the cervix, you should continue screenings for 20 years after your initial surgery.

When Can I Stop Getting Pap Tests?

When you reach the age of 65, if you have no history of abnormal cervical cells or cervical cancer, and you have had either three negative Pap smear results in a row, two negative HPV tests in a row, or two negative co-tests in a row within the past decade, you may be able to stop getting Pap tests. Your most recent test should have been performed within the past three to five years, depending on the test, before you and your doctor agree that you can stop cervical cancer screening.

How to Prepare for a Pap Test

No exceptional preparation is needed for your regular Pap test. In general, you should avoid sex, douching, spermicide, and vaginal medication for two days before the test. If you have had sex within the past two days, inform the doctor at your checkup before they perform the test. You can even get a Pap test if you are menstruating.

Protect Your Health With Pap Tests

female physician talking to a patient

At Tidewater Physicians for Women, we take women’s health very seriously. Our OB/GYN doctors and medical staff are here to help you with all aspects of your health and wellness, including Pap tests and HPV tests. We provide caring, compassionate, comprehensive, and professional care for women with specific medical issues.

Our patients consist of women throughout every stage of life, from young adults seeking birth control to expectant mothers to those going through menopause and beyond. We are here to put your mind at ease and guide you through important healthcare decisions at every stage of life. If you are in the Virginia Beach or Norfolk area, contact us today by calling 757-461-3890 to speak with a team member and set up your appointment.

What is a Secondary Infertility and How Do You Manage It?

According to the CDC, approximately 14 percent of women with one or more prior births struggle to get pregnant or carry a pregnancy to term. If you and your partner have been trying to have another child without success, you may be wondering what changed and if you can fix it. Read on to learn about the most common causes of secondary infertility, how doctors diagnose it, and treatment plans. If you’ve been trying to conceive without success, contact Tidewater Physicians for Women to schedule an appointment with a medical provider. We’ll help you in your fertility journey.

What is Secondary Infertility?

OBGYN talking to a patient

Secondary infertility is the inability to conceive or carry a pregnancy to term after having previously given birth without fertility treatment. It’s common to assume that because you had no trouble conceiving your first child or children, conception will occur naturally going forward, but that’s not always the case. Many couples are surprised to learn that secondary infertility is just as common as primary infertility, affecting about 12 percent of women who are trying to conceive.

Emotional Impact of Secondary Infertility

Secondary infertility can be emotionally devastating for partners who are trying for another child. 

You may experience grief, anger, sadness, guilt, and a range of other negative emotions. Infertility may also impact your relationship with your partner.

Your family, friends, and even your healthcare providers may lack empathy for your situation. You might hear that you should be grateful to have even one child.

These feelings can be amplified if your treatment is not working.

If you are experiencing the emotional effects of secondary infertility, you should consider joining a support group to process your emotions. You should also consider mental health services, such as individual or couples therapy, to process your emotions and facilitate healthy communication with your partner during this emotionally taxing time.

Causes of Secondary Infertility

There are several potential causes of secondary infertility affecting both women and men. In some cases, a combination of these factors are contributing to a single case of secondary infertility.

For Women

For women and people assigned female at birth (AFAB), causes include:

Being 35 or Older 

As you age, the quantity and quality of eggs decline, leading to reduced fertility and an increased risk of chromosomal abnormalities.

Complications From Past Pregnancy or Surgery

Complications from past pregnancy or surgery can cause damage to reproductive organs — like scarring or adhesions in your fallopian tubes or uterus — which can make it difficult for sperm to reach and fertilize an egg.

Weight Gain

Obesity can cause hormonal imbalances that affect your menstrual cycle or ovulation, leading to secondary infertility. Losing weight can help, and your healthcare provider can help you.

Lifestyle Factors Like Smoking or Excessive Drinking 

Smoking and excessive drinking can damage reproductive organs and disrupt your hormonal balance, making it harder to conceive.

Certain Medications

Medications like chemotherapy drugs, some antidepressants, certain immunosuppressants, and long-term use of NSAIDs can interfere with hormone levels, change cervical mucus, damage reproductive organs, or suppress ovulation.

Uterine Conditions Such as Uterine Fibroids or Adenomyosis

These conditions can distort the uterine cavity, impairing implantation and development of the embryo, causing blocked fallopian tubes, leading to hormonal imbalance, and increasing your risk of miscarriage.

Polycystic Ovarian Syndrome (PCOS

Women and people assigned female at birth might experience irregular ovulation, anovulation, hormonal imbalance, and ovarian cysts as a result of polycystic ovary syndrome — all of which can lead to trouble conceiving.

Endometrial Scarring

Endometrial scarring can damage the normal lining of your uterus, making it an unfit environment for implantation and development.

Sexually Transmitted Infections (STIs)

Like other conditions, STIs have the potential to damage your reproductive organs and cause lasting inflammation, both of which reduce fertility and increase the risk of complications during pregnancy.

Problems with Ovulation 

Ovulation is central to successful conception, so when mature eggs aren’t regularly released for fertilization, chances of conception are reduced.

Impaired Egg Quality or Quantity 

Problems with the quality or quantity of eggs can hinder successful fertilization and implantation.

Fallopian Tube Damage 

Eggs and sperm travel through the fallopian tubes in order to reach one another, so any damage to the fallopian tube that makes it more difficult to pass through can inhibit fertilization.

Identifying the exact cause or causes of infertility is an important first step so that an effective treatment plan can be identified and implemented.

For Men

Sometimes, secondary infertility is the result of male infertility, or changes in reproductive health for the male partner. For men and people assigned male at birth (AMAB), causes include:

Low Sperm Count 

Low sperm count, caused by genetic abnormalities, excessive heat exposure, hormonal imbalance, smoking, alcohol consumption, and certain health conditions, reduces the likelihood of conception.

Impaired Sperm

Impaired sperm have abnormalities in their mobility, structure, or composition, reducing their ability to reach or fertilize an egg.

Low Testosterone 

Low testosterone levels can decrease both sperm production and quality, ultimately leading to fertility issues.

Certain Medications 

Certain medications prescribed to men are known to contribute to secondary infertility cases, like some chemotherapy drugs and testosterone replacement therapy.

Weight Gain 

When men and people assigned male at birth gain weight, hormonal balance can shift, causing reduced sperm production, motility, and fertility.

Age 

Testosterone levels and the quality and motility of sperm decline with age, contributing to both primary infertility and secondary infertility.

There is also the possibility that the doctor cannot diagnose the cause of your secondary infertility. Approximately one in five cases of secondary infertility are unexplained. Even when the cause is unknown, treatment focuses on improving the chances of conception and implantation through lifestyle changes, ovulation tracking, IUI or IVF, assisted reproductive technology, and/or ovarian stimulation.

Risk Factors for Secondary Infertility

There are several conditions that can increase your risk of developing secondary infertility, including:

  • Hormonal imbalances
  • Irregular menstrual cycles
  • Previous miscarriages
  • PCOS
  • Endometriosis
  • Pelvic inflammatory disease (PID)
  • Sexually transmitted infections (STIs)

Can You Get Pregnant With Secondary Infertility?

Woman having an ultrasound

Yes. Secondary fertility is common and usually results in pregnancy with treatment. Your doctor will develop your treatment plan based on your diagnosis and goals.

When Should I See a Doctor For Secondary Infertility?

If you’re concerned you may be experiencing secondary infertility, you should speak with your doctor.

If you experience any of the following health symptoms alongside your inability to conceive, you should consult a medical professional as soon as possible.

For women and AFAB:

  • Irregular menstruation or no menstruation
  • Extremely painful periods
  • Endometriosis
  • History of miscarriages
  • History of PID
  • Known or suspected uterine or tubal disease
  • Previous chemotherapy or radiation

For men and AMAB:

  • Sexual dysfunction
  • History of infertility with another partner
  • Previous chemotherapy or radiation
  • Previous hernia surgery
  • History of testicular trauma

If you are under 35 and have tried to conceive for at least 12 months, you should schedule an appointment with your healthcare provider, a reproductive endocrinologist, fertility specialist, or urologist.

If you are over 35 and have tried to conceive for six months, you should schedule an appointment with your healthcare provider, a reproductive endocrinologist, fertility specialist, or urologist.

If you have experienced two consecutive miscarriages, you should make an appointment with a reproductive endocrinologist.

Receiving an early evaluation helps to keep as many treatment options open as possible.

How Does a Doctor Diagnose Secondary Infertility?

The doctor can conduct certain tests to pinpoint the causes of your secondary infertility, including:

  • Semen analysis to examine the quality, quantity, and motility of sperm in a semen sample to identify any abnormalities and determine next steps.
  • Transvaginal ultrasound to help identify problems like uterine fibroids, polyps, ovarian cysts, or tubal blockages, all of which can be secondary infertility causes.
  • Blood tests for hormone levels help diagnose male and female infertility by assessing the various levels of hormones involved in reproduction that, when imbalanced, might contribute to difficulty with conception.
  • Hysterosalpingogram is an X-ray that shows your medical provider your uterus and fallopian tubes to check for abnormalities, scar tissue, and blockages that might be contributing to infertility.

Treatment of Secondary Infertility

There are several avenues of treatment for secondary infertility that can lead to successful pregnancies. 

Some treatments include:

  • Medications that induce ovulation, such as letrozole (Femara) and clomiphene (Clomid). These medications can help treat secondary infertility by stimulating the release of eggs, increasing your chances of successful fertilization and addressing ovulation-related issues that might be contributing to difficulties in conceiving a second child.
  • Intrauterine insemination (IUI). IUI can help overcome secondary infertility by bypassing potential issues with cervical mucus or sperm quality and increasing the chance of fertilization by placing prepared sperm directly into the uterus at the right time during your cycle.
  • In vitro fertilization (IVF). IVF works by overcoming a wide variety of fertility challenges like poor egg quality, damaged fallopian tubes, or male infertility by retrieving eggs from the female partner, fertilizing them with sperm in a laboratory, and then transferring the resulting embryos back into the uterus.
  • Surgery. Surgery can correct uterine complications, such as removing fibroids, scar tissue, or polyps. Additionally, if the secondary infertility is caused by testicular issues, such as testicular varicocele, this can be surgically corrected. Testicular varicocele is responsible for approximately 30 percent of all male and AMAB infertility.

Your provider will determine the appropriate treatment based on your diagnosis.

We Can Help You Try Again

Whether you’re partnering with a physician for the first time or looking for a second opinion, the team at Tidewater Physicians for Women is here to help diagnose and treat your secondary infertility today. Take the next step toward growing your family by calling 757-461-3890 now.

Antibiotics and Birth Control: What You Should Know

According to the CDC, approximately 14 percent of U.S. women ages 15–49 — or nine million people — used hormonal birth control pills from 2017–2019.

Millions of women in the United States rely on hormonal birth control for contraception, hormonal regulation, and more. What are the risks to this population when they need antibiotics to fight infection? Which antibiotics are safe to take, and which ones will “cancel out” your birth control?

It can be easy to be led astray by myths and rumors about contraceptives. Here are some facts about the interactions between antibiotics and hormonal birth control. Learn how you can stay healthy while avoiding adverse drug interactions.

Can Antibiotics Affect Hormonal Birth Control?

woman holding a pack of birth control pills

Patients often ask if antibiotics can increase their risk of pregnancy. In fact, many patients have believed for years that they can’t take antibiotics while on birth control without risking the effectiveness of their hormonal birth control.

Some antibiotics can affect hormonal birth control. While pills might come to mind first, many contraceptives fit into this category, including implants, birth control pills, intrauterine devices (IUDs), vaginal rings, injections, and patches.

Certain antibiotics can make hormonal birth control less effective, increasing your risk of pregnancy. Before starting a new antibiotic, be sure to let your healthcare provider know if you’re using birth control. They can help you take the appropriate steps to prevent pregnancy during your treatment.

Rifamycin Antibiotics Can Impact Hormonal Birth Control

Rifamycin is an antibiotic medication used to treat uncommon bacterial infections. It can decrease the effectiveness of all birth control methods that administer hormones to prevent conception.

This is because rifamycin or rifampin can increase the liver’s production of enzymes that break down hormones in birth control, making them less effective at preventing pregnancy. As a result, you should use a backup method of birth control like condoms or a diaphragm while taking rifamycin and for at least seven days after you complete your treatment.

Luckily, rifamycin is not a commonly-prescribed antibiotic. It’s used to treat tuberculosis, H. pylori, and opportunistic infections in HIV-positive patients. If you’ve been prescribed an antibiotic for a sinus infection, ear infection, or urinary tract infection, it most likely isn’t rifamycin or a related drug. However, it’s important to note that doxycycline, a more common antibiotic used for sexually transmitted infections, rosacea, dental infections, and other issues, can also reduce the effectiveness of your birth control and lead to breakthrough bleeding or pregnancy.

Some forms of birth control are still very effective when taking rifamycin, like copper IUDs, cervical caps, diaphragms, spermicide, and condoms. To reduce your risk of unplanned pregnancy, visit your provider before starting a new medication. Be sure to share your medical history, including any medications and supplements you’re taking and what methods you’re using to prevent pregnancy.

Amoxicillin and Other Penicillin Antibiotics Do Not Impact Birth Control

woman laying on the couch blowing her nose

Amoxicillin, ampicillin, and other penicillins are used to treat a wide variety of infections, including bronchitis, pneumonia, and infections of the nose, throat, ears, skin, and urinary tract. You’re much more likely to be prescribed a penicillin-like antibiotic than rifamycin.

When it comes to amoxicillin and birth control, studies have found that there is no drug interaction. Amoxicillin and other penicillin antibiotics have not been shown to impact the effectiveness of birth control pills or other hormonal contraceptives. The reduction in gut bacteria caused by oral antibiotics doesn’t impact the absorption of hormonal birth control.

Other broad-spectrum antibiotics, including metronidazole or ciprofloxacin, are also safe to take while using hormonal contraceptives.

While there have been a few isolated cases of women experiencing unintended pregnancy while taking antibiotics and using birth control pills, these instances are rare. They are more likely due to user error or other factors. Your doctor can help you understand how to take your contraceptives to ensure efficacy.

Will Plan B Work If I’m Taking Antibiotics?

First, it is important to know how emergency birth control works. Plan B is a form of emergency contraception commonly referred to as the morning-after pill. Plan B can be used to prevent pregnancy after unprotected sex or birth control failure. Like birth control pills, Plan B contains progesterone, which can prevent ovulation, make it difficult for the sperm to reach an egg, or make the uterus uninhabitable for a fertilized egg.

Because Plan B is hormonal, antibiotics and other medications can make it less effective. As is the case with birth control pills, only rifamycin antibiotics (which might have different names, like rifabutin and rifadin) reduce the effectiveness of emergency birth control. Plan B is available over the counter, but connecting with your doctor is the best way to avoid drug interactions and ensure you have selected the most effective birth control option for you.

Talk to your healthcare provider about your options if you are taking antibiotics and considering emergency contraception.

Are There Other Medicines and Supplements That Can Reduce My Birth Control’s Effectiveness?

There are several other medications and supplements that can make your birth control less effective, increasing your risk of conception, including:

  • Anticonvulsants: Certain anticonvulsant medications, including carbamazepine, phenytoin, and topiramate, can increase your risk of pregnancy while taking birth control. Anticonvulsants affect birth control by accelerating the metabolism of progesterone and estrogen, decreasing hormonal levels in your bloodstream.
  • Antifungal medications: Some antifungal medications like griseofulvin might put you at greater risk of pregnancy, but the likelihood is low. Ask your doctor if you should use backup birth control while taking antifungals.
  • St. John’s Wort: This herbal supplement can reduce the effectiveness of birth control by speeding up the metabolism of estrogen and progestin, much like certain antibiotics and anticonvulsants.
  • HIV medications: Medications used to treat HIV, like ritonavir and efavirenz, can increase the likelihood of conception while on birth control.

You might not think about the vitamins and minerals you are taking when visiting your provider, but supplements can interact with prescription medications, too. Be sure to inform your doctor about all your medications and supplements.

How Can I Prevent Birth Control Pill Interference?

female doctor talking to her patient

Birth control is most effective when you take it at the same time every day, do not miss scheduled doses, recognize drug interactions early, and use a backup method when needed.

Because there are many medications and supplements that can make contraceptives less effective, your doctor is the best person to identify potential drug interactions. They can prescribe other medications or provide you with guidance on preventing pregnancy, helping you mitigate risk.

Your doctor can only help you identify potential side effects and interactions if you provide them with all the necessary information. Before starting oral contraceptives, let your provider know about all the medications and supplements you take. Share your complete medical history. Additionally, any time you are prescribed a new medication, ensure the prescribing doctor knows you are taking hormonal birth control. Follow their instructions closely, including using a backup method when taking any medication known to reduce the effectiveness of your birth control.

Stay Informed About Your Health With Us

Whether you are ready to find the right form of birth control for your health and lifestyle or wondering what types of antibiotics are safe to take, the doctors at Tidewater Physicians for Women can help.

Take charge of your health and well-being by visiting our obstetrics and gynecology team at Tidewater Physicians for Women today. From routine check-ups and medical advice to problem-focused exams, our expert physicians, nurse practitioners, and licensed counselors are here to assist you. Take the first step toward a healthier you and schedule an appointment by calling 757-461-3890 today.

Is Cervical Cancer Genetic?

According to the CDC, approximately 13,000 people in the United States are diagnosed annually with cervical cancer, and approximately 4,000 people die from cervical cancer every year. If you have relatives with a history of gynecological cancers, you may wonder if you are at a higher risk. Read on to learn about the risks and symptoms of cervical cancer and what you can do to mitigate your own risk. Call our team today to schedule an appointment to get a screening and discuss your health with an experienced women’s healthcare professional.

What Genetic Factors Increase the Risk of Cervical Cancer?

Most cases of cervical cancer are not caused by inherited genetic factors but rather by the acquisition of certain strains of the human papillomavirus (HPV) through sexual contact. The two most common types of cancer — squamous cell carcinoma and adenocarcinoma — are not hereditary.

However, there are two known, rare genetic risk factors for cervical cancer:

  • Peutz-Jeghers syndrome, or PJS, is a rare condition caused by a mutation in the STK11/LKB1 gene that increases the risk of cervical and related cancers.
  • Although uncommon, DICER1 gene damage can increase the risk of embryonal rhabdomyosarcoma — a type of cervical cancer.

It’s important to note that these genetic syndromes are very rare with low incidence, and most cases of cervical cancer are not caused by genetic factors. The best way to reduce your risk of developing cervical cancer is to vaccinate against HPV, practice safe sex, and get regular cervical cancer screenings.

It’s also important to note that even though most cases of cervical cancer are not related to genetic susceptibility, women who have a mother or sister with a history of cervical cancer are still at higher risk of developing it themselves. This might be related to an inherited genetic susceptibility to long-term HPV infection. However, epidemiologists believe it is more likely related to environmental factors or other non-genetic risk factors.

What Other Factors Can Increase the Risk of Cervical Cancer?

In the vast majority of cases, cervical cancer is attributed to risk factors and causes other than genetics. Other risk factors include:

  • HPV infection. Around 80 percent of women will contract HPV at some point in their lives, and 10 percent of those human papillomavirus infections will evolve into genital warts or long-lasting infections. Long-lasting HPV infections are capable of carcinogenesis, changing the cells lining the cervix and contributing to the development of cervical cancer. Using a condom during intercourse, limiting sexual partners, and getting immunized against HPV can help reduce your risk.
  • STI infection. While HPV contributes to the greatest number of cervical cancer cases, other sexually transmitted infections like chlamydia can also increase cervical cancer risk. Using a condom during sexual activity, limiting partners, and getting tested can help lower the likelihood of developing cancer.
  • DES (diethylstilbestrol) exposure. If your mother was prescribed diethylstilbestrol or DES to prevent miscarriage while pregnant, then your risk of developing certain gynecological cancers is slightly higher. While you do not have control over this risk factor, being informed can help you communicate effectively with your provider and schedule routine screenings for genital and gynecological cancers.
  • Weakened immune system. Because your immune system is responsible for the regression of HPV, a weakened immune response poses a risk. Women who have a weakened immune system because of HIV infection, cancer treatment, immune-suppressing drugs, or other reasons are at increased risk of developing long-last HPV infections and cervical cancer.
  • Smoking. It is common to associate smoking with lung cancer, but smoking introduces your entire body to carcinogens, doubling your risk for cervical cancer. Your primary care provider can help you quit and lower those odds.
  • Pregnancy history. Women who had their first baby before age 20 and women who have carried multiple pregnancies to term are at elevated risk. The reasons for this increased risk are complicated and may be associated with hormonal changes during pregnancy, cellular changes caused by childbirth, and increased incidence of HPV among pregnant women.
  • Long-term contraceptive use. Long-term use of contraceptives increases the risk of cervical and breast cancer. According to the American Cancer Society, women who are on birth control for over ten years experience the greatest increase in risk. That risk begins to decline once birth control is discontinued.
  • Low-income status. Because healthcare services like STI screenings, pap smears, and HPV screenings are pivotal in preventing cervical cancer, those who do not have access to adequate healthcare are at higher risk.
  • Poor Nutrition. The risk of cervical cancer increases with a diet lacking fruits and vegetables. People who consume a diet rich in fruits and vegetables can reduce their chances of cervical cancer. The Centers for Disease Control and Prevention recommends one and a half to two cups of fruit and two to three cups of vegetables daily.

How Can I Lower My Risk of Developing Cervical Cancer?

a woman receiving a shot in her arm from a doctor

In 90 percent of all cases, cervical cancer is caused by an HPV infection. You can dramatically reduce your likelihood of getting an HPV infection and subsequent cervical cancer by scheduling your HPV vaccination. HPV vaccines are recommended starting around age 11 or 12 and for all women up to age 26 who have not already been vaccinated. Women 27-45 years old may benefit from vaccination in some cases; your primary care provider or OBGYN can help you determine whether an HPV vaccine benefits you based on your lifestyle and other risk factors.

Other ways to reduce your risk of developing cervical cancer include quitting smoking, practicing safe sex, consuming a diet rich in fruits and vegetables, and getting regular cancer screenings. Visit with your provider at Tidewater Physicians for Women to learn more about reducing your chances of getting cervical cancer.

Signs and Symptoms of Cervical Cancer

In its earliest stages, cervical cancer typically does not produce lesions or symptoms, making it challenging to detect and treat early. Getting routine pap smears according to the schedule your OBGYN recommends can help you detect and treat cervical cancer early. Those with a family history of cervical cancer or a personal history of high-risk HPV infection may need more frequent pap tests.

As cervical cancer progresses, common signs and symptoms include:

  • Abnormal vaginal bleeding after sex, between periods, or after menopause
  • Abnormal vaginal discharge, potentially bloody or watery with a strong odor
  • Pain during sex
  • Pelvic pain

Advanced-stage cervical cancer produces different signs and symptoms, including:

  • Swelling of the legs
  • Difficulty urinating or having a bowel movement
  • Blood in the urine

All of these symptoms can be indicative of cervical cancer or — more commonly — other, benign conditions like a sexually transmitted infection or a urinary tract infection. Whether your symptoms indicate cancer or another condition, you may require treatment. People experiencing any of the signs or symptoms listed should see a doctor as soon as possible for screening and diagnosis.

Can I Get Screened for Cervical Cancer?

A woman talking to her gynecologist

Regular screening for cervical cancer can catch pre-cancerous and cancerous cells early and dramatically improve the chances of successful treatment. Precancer can be addressed before it evolves and spreads, reducing the risk of invasive cervical cancer, uterine cancer, and complications.

The primary screening tests for cervical cancer are the HPV test and a pap smear, which a gynecologist can perform during your routine pelvic exam. In some cases, the HPV test and pap smear are combined in a co-test if you’re due for both simultaneously. You can drive yourself to and from those appointments, as there is no recovery time after either of these tests.

There are over 100 variants or types of HPV, creating differing symptoms and risk levels. Most cervical cancers are caused by HPV 16 and 18. Testing can give you and your doctor the information necessary to act early.

Pap smears are recommended every three years for young women aged 21-29. Recommendations change based on risk factors like family and personal history, age, and lifestyle. Visiting your provider is the best way to determine how often you need an HPV and pap test.

Where Can I Learn More?

If you have questions or concerns or are experiencing any of the signs or symptoms of cervical cancer, you can make an appointment with your doctor to discuss your concerns and schedule any screenings he or she recommends. While it’s common to surf the web searching for the information you need, many sites share misinformation or information that’s only helpful when paired with the proper screening tests, a thorough examination from your physician, and your provider’s experience and expertise.

Prioritize Your Health Today

Your provider at Tidewater Physicians for Women can help if you are concerned about the risk factors for cervical cancer, experiencing troublesome symptoms that could indicate cervical cancer, or are interested in routine screening to detect and treat problems early. Prioritize your health today by scheduling a checkup with your doctor at Tidewater Physicians for Women.

To schedule an appointment, call our office at 757-461-3890. When it comes to cervical cancer, whether we’re giving you peace of mind or making a treatment plan, the same sentiment remains true: the sooner you visit our office, the better the outcome.

Should I Take Birth Control Pills or IUD?

Choosing the right contraception can feel overwhelming when contraception does so much more than prevent pregnancy for those with a variety of gynecological conditions. You want birth control that is compatible with your body and individual lifestyle. Since every woman is unique, there is no one-size-fits-all birth control solution. Even among birth control and IUDs, there are several different options. If you don’t choose your birth control carefully, you’re more likely to experience unpleasant side effects or irritate pre-existing conditions. Tidewater Physicians for Women will help you find the right birth control for your needs.

What’s the Difference Between the Pill and an IUD?

The pill is taken by mouth daily while IUDs are inserted into the uterus once every several years.

Oral contraceptives, commonly called birth control pills, are used more than any other form of birth control. Birth control pills are taken once a day by mouth and release hormones that prevent pregnancy, regulate your menstrual period, reduce the risk of certain types of reproductive cancers, treat endometriosis, and improve acne symptoms for many.

Alternatively, an intrauterine device (IUD) is inserted into your uterus during an office visit by your doctor and prevents sperm from entering the uterus and fertilizing an egg. IUDs last several years.

Both the pill and the IUD are highly effective in preventing pregnancy for both short and extended periods of time. Each offers specific advantages and disadvantages depending on your lifestyle, needs, and health. However, neither prevents you from contracting sexually transmitted infections (STIs).

What are the Types of Birth Control Pills?

packages of birth control pills

There are two different kinds of pills: combination pills and mini pills. Combination pills contain two hormones, progestin and estrogen, while mini pills contain just progestin (and a smaller dose of it).

When we talk about the effectiveness of birth control, we look at perfect use and typical use. Perfect use is defined as taking the pill exactly as prescribed, while typical use is taking it the way the average woman takes it. She may not take it at the exact same time every day, or she might forget to take it from time to time, for example. The pill is over 99% effective with perfect use and 91% effective with typical use.

Combination Pills

Combination pills, which contain the hormones estrogen and progesterone, prevent pregnancy in three ways:

  • They change the cervical mucus to help prevent sperm from reaching the uterus.
  • They cause changes in the lining of the uterus to make it uninhabitable for a fertilized egg.
  • They prevent your ovaries from releasing an egg to stop fertilization from occurring.

Combination pills are often used to help reduce period pain, improve acne, regulate your menstrual cycle, make your period shorter and lighter, and reduce the risk of colorectal, endometrial, and ovarian cancers. They are also used to reduce the production of androgens in patients with polycystic ovary syndrome (PCOS). Common side effects of combination pills include breast tenderness, bloating, nausea, high blood pressure, headaches, and breakthrough spotting or bleeding.

Progestin-Only Pills

Progestin-only pills are often called mini-pills because they contain only progestin and a smaller dose of progestin than combination pills.

Not everyone is a good candidate for combination pills, and mini pills step up to the plate in many of those cases. Progestin-only pills can prevent pregnancy and lower your risk of cancer and are safe to take if you’re breastfeeding, have high blood pressure, migraines, or heart disease, or are sensitive to estrogen. However, it’s important to note that taking the mini pill at the same time every day is crucial to preventing pregnancy, so those who take this route should establish a good morning or evening routine that involves taking birth control at the same time every day.

What are the Different Kinds of IUDs?

IUD stands for intrauterine device. There are two primary kinds of IUDs available: copper IUDs (ParaGard) and hormonal IUDs (Mirena, Kyleena, etc.).

Hormonal IUDs

gynecologist holding a hormonal IUD

Hormonal IUDs are made of flexible plastic and prevents pregnancy in several ways:

  • They change your ovulation pattern.
  • They thin your endometrium to prevent implantation.
  • They thicken cervical mucus to make passage difficult for sperm.

While the amount of hormone in each brand of hormonal IUD can vary, they all contain progestin only.

Most people notice lighter periods and cramping after getting a hormonal IUD, and as many as 1 in 5 stop menstruating altogether. Women with IUDs begin menstruating again when the IUD is removed.

Hormonal IUDs like Mirena offer several benefits:

  1. There is no pill to take every day, so there is no difference between perfect use and typical use; once you have the IUD inserted, you have 99% protection against pregnancy.
  2. Hormonal IUDs can be removed any time you choose, with help from your doctor.
  3. They can be effective in treating PCOS and endometriosis symptoms.
  4. They can be used as emergency contraceptive when inserted within 5 days of unprotected sex.
  5. They remain effective for 7-12 years depending on the brand of hormonal IUD used.

The side effects of hormonal IUDs include pain and cramping during and immediately following insertion, irregular periods, and spotting between your regular periods.

Copper IUDs

The only copper IUD on the market is ParaGard. For women who have experienced side effects from hormonal birth control in the past, copper IUDs can be a suitable substitute.

Just like hormonal IUDs, copper IUDs are inserted into the uterus by a physician during an office visit. They last up to twelve years and do not require maintenance during that time aside from regular annual physicals. The motility and viability of sperm is significantly reduced in the presence of copper, so copper IUDs work by inhibiting a sperm cell and preventing it from reaching an egg. Copper IUDs do not changing your endometrium, ovulation schedule, or cervical mucus.

Like hormonal IUDs, copper IUDs are highly effective (99%) forms of emergency contraceptive when inserted within five days of unprotected sex.

Some of the reasons women choose ParaGard include the convenience (no pill to take every day), the lack of a hormonal component for those with sensitivities or side effects, and the complete reversibility when ready to start a family.

Potential side effects of copper IUDs include more cramping and heavier periods, which often resolve after 3-6 months.

Which is a Better Contraception Method: IUD or the Pill?

When it comes to an IUD vs. the pill, no method of birth control is superior or inferior. The right option depends on your medical history, treatment goals, and more. The only way to find the right birth control for your unique body and needs is to talk to a doctor and make the decision together. Even then, you may need to try more than one form of contraception before finding the one that works best for you.

Advantages of the IUD

IUDs are easier to use than the pill. You schedule an appointment with your women’s health doctor, and he or she inserts the device during an office visit. Depending on the brand and type of IUD you use, you won’t need it replaced for years. You do not have to remember to take a pill every day or worry that efficacy will decline because you forgot to take your pill (or took it later than usual).

Non-hormonal options (ParaGard) are available for those who are sensitive to hormones, who have experienced side effects, or who have contraindications that prevent them from using hormonal birth control. Because there is a non-hormonal option, nearly everyone is a candidate.

IUDs are long-acting. With some brands lasting up to 12 years, IUDs are a great option for women who do not want children soon or who do not want children at all.

Additionally, IUDs can help treat the symptoms of other gynecological conditions like polycystic ovary syndrome (PCOS) and endometriosis.

Finally, many of the side effects that come with oral contraceptives are much less common with IUDs. They do not increase your risk of developing blood clots like combination pills, making IUDs a much safer option for women over 35 and women who smoke.

Advantages of the Pill

The pill can be more effective for women who have uterine fibroids. Fibroids can change the landscape of the uterus, making IUDs less effective.

Birth control pills, whether combination or progestin-only, can reduce your risk of ectopic pregnancy.

Combination pills are helpful in preventing and treating acne, cysts in your ovaries, cysts in your breasts, infections in your reproductive system, iron deficiency, ovarian and endometrial cancer, and bone thinning.

Finally, birth control pills can make your periods shorter, lighter, and more predictable. Some brands give you the option to skip your period altogether.

Factors to Consider When Choosing Your Contraception Method

IUD placed next to a package of birth control pills

When it comes to your reproductive health, the decisions you make are personal and multiple factors will play a role. Your gynecologist or OB/GYN will help you make an informed decision, taking the following factors into consideration as you evaluate birth control options.

Your Lifestyle

Whether you feel like you can remember to take a pill at the same time every day will influence the decision. What does your daily routine look like? People who work rotating shifts or do not have a solid daily routine often have more difficulty remembering to take their birth control pill every day, around the same time, while those who in a structured schedule may be more successful.

Smoking also plays a role. Smoking and hormonal birth control both increase your risk of blood clots, so smoking typically makes you a stronger candidate for hormone-free birth control.

Your Medical History

Your healthcare provider will review your medical history in detail to determine whether you have any conditions that make one type of birth control more preferable for symptom management/treatment or less preferable due to risk or side effects. If you have been diagnosed with endometriosis, this will impact your birth control options.

It’s also important to take your period into consideration because most birth control methods have the potential to regulate your period, lighten your flow, reduce cramping, or skip your periods. If you are experiencing heavy periods, infrequent periods, or painful periods, let your doctor know so their medical advice can address birth control as an option for regulating your period and alleviating your symptoms.

Your Insurance Coverage

Your provider’s office can help you explore what kind of birth control methods are covered by your medical insurance. Even the most basic insurance plans typically cover generic birth control options, which provide the same protection as brand-name options, due to the provisions of the Affordable Care Act (ACA). Neither an IUD nor oral contraceptives are always cheaper; it just depends on your insurance plan, whether the option you’ve chosen is available in a generic form, and other factors.

Once you’ve evaluated potential birth control options that meet your needs with your OB/GYN, the billing office or your pharmacist can help you explore covered options and suitable substitutes. You might be surprised to find that you do not have to pay anything at all!

Clinics like Planned Parenthood offer sliding fee scales for patients who do not have insurance to ensure everyone has access to birth control that meets their family planning needs.

Keep in mind when making a decision that neither IUDs nor the pill protect against sexually transmitted infections, also called STIs (formerly called sexually transmitted diseases, or STDs). Using a condom or other barrier methods is the safest way to prevent sexually transmitted infections.

Discover the Best Options For You

If you’re ready to explore birth control options and find the solution that not only helps you prevent pregnancy with confidence but also helps you treat other gynecological symptoms, call Tidewater Physicians for Women at 757-461-6890 to schedule an appointment.

What Causes Spotting Right Before My Period?

Woman looking at a calendar holding her stomach

Bleeding during your period can already be inconvenient for you, interrupting social plans and staining your favorite clothes. When spotting occurs outside your normal period, it can be inconvenient and cause for concern. Spotting is considered abnormal vaginal bleeding, and if it persists, it can be an indication that something isn’t right.

Are you experiencing persistent spotting, heavy bleeding between periods, or spotting in conjunction with other signs and symptoms? Make an appointment with our knowledgeable physicians at Tidewater Physicians for Women to ensure your spotting between periods is not a symptom of an underlying problem.

What is Spotting?

Bleeding between periods, called intermenstrual bleeding, is called spotting when it’s light.

As a general rule, you can differentiate between bleeding and spotting based on what kind of product you need to absorb your bleeding. If you notice it only when wiping or can easily absorb any light bleeding with a pantyliner (or even just underwear), it’s spotting. If you need a pad or tampon to absorb bleeding between periods, it generally wouldn’t be considered spotting.

Bleeding outside of your menstrual cycle that requires a pad or tampon is typically abnormal and requires discussion with your healthcare provider. He or she can investigate further to determine what’s causing heavy bleeding between periods and whether there is cause for concern.

Is Spotting Normal?

If you are accustomed to a regular period with no breakthrough bleeding in between periods, spotting can be alarming. However, it’s actually very common. In most cases, this is not an indication of an underlying condition.

In some cases, spotting can signify something going on inside your body: a sexually-transmitted disease, pregnancy, uterine fibroids or polyps, polycystic ovary syndrome (PCOS), perimenopause, or your body adjusting to hormonal birth control.

If you have certain risk factors or other signs and symptoms along with spotting, seeing an OBGYN can help rule out more serious underlying causes and give you peace of mind about spotting outside of your menstrual cycle.

What If Spotting Occurs a Week Before My Period?

There are a variety of reasons that you might experience bleeding before your period, but the most common is hormonal imbalance. Your menstrual cycle is regulated by the reproductive hormones estrogen and progesterone. When these hormones are balanced, you’ll have a predictable cycle. Progesterone levels are high until your period begins, and then they drop, causing your uterus to shed its lining, which is menstruation.

In many cases, progesterone levels begin dropping a little prematurely, leading to cramping, tender breasts, mood swings, and spotting before your period.

It’s common to mistake bleeding associated with a premature decline in progesterone as implantation bleeding. Implantation bleeding occurs when a fertilized egg attaches itself to the lining of the uterus. This is about 10-14 days after conception or around the time you would expect your period to start.

When is Spotting Not Normal?

Spotting that occurs rarely and without other symptoms or risk factors is typically normal, but spotting can also be a sign of a more nefarious issue. Spotting might be abnormal if:

  • You are pregnant or think you might be pregnant.
  • It happens consistently for several months (even if there are breaks in spotting) or becomes heavy.
  • You are worried about your spotting because of risk factors like family history or sexual activity.
  • You have other symptoms like pelvic pain, abdominal pain, abnormal discharge, or a foul odor.

The best course of action if you think your spotting might be abnormal or an indication of a problem is to schedule an appointment with your women’s health physician.

What Causes Spotting?

Many women automatically think of sexually transmitted infections or STIs (formerly known as STDs) when they experience spotting between periods, but STIs rarely cause spotting. In most cases, the cause is either harmless or something else. Some of the more common culprits include pregnancy, birth control, ovulation, trauma, cervical polyps, and rarely, cancer.

Pregnancy

While bleeding is often associated with lack of conception, spotting mid-cycle can be an early sign of pregnancy.

When a fertilized egg attaches to the uterine lining, some women experience some light spotting called implantation bleeding. Implantation bleeding occurs at or just before the time you expected your period to start and is a sign of pregnancy. Implantation bleeding should never be more than a little spotting, noticeable when you wipe or easily absorbed by a panty liner.

No treatment is required for implantation bleeding, but it can be hard to differentiate this type of spotting from others until you see a positive pregnancy test. Once the pregnancy is confirmed, you’ll want to schedule an appointment to explore next steps and ensure you receive the best care possible if you choose to move forward with the pregnancy. If you choose not to move forward, now is the best time to connect with your provider to discuss that, too.

Birth Control

It can take your body several months to adjust to hormonal birth control. In the first several months that you use hormonal contraceptives — whether it’s a pill, patch, injection, or intrauterine device (IUD) — it’s common to experience breakthrough bleeding while your body adjusts. In fact, you might bleed on and off the entire time, depending on the form of birth control and the way your body responds.

Additionally, it’s common to experience breakthrough bleeding if you miss one or more pills or take your birth control pills inconsistently in general. Birth control should be taken every day, around the same time of the day, to ensure consistency. When you skip a pill, it’s just like taking a ‘period pill’ — it will trigger withdrawal bleeding to begin regardless of the time of the month. The cause of this type of bleeding is different from menstrual bleeding, but it still concerns many women.

If you’ve been using the same type of birth control, consistently and as prescribed, for more than three months, and you’re still experiencing irregular periods or menstrual bleeding outside of your regular cycle, let your provider know. It’s typically a strong indication that the birth control you’re using is the wrong one for you, and we can help you evaluate and explore other options, including non-hormonal birth control, that might alleviate those symptoms.

Ovulation

Ovulation itself doesn’t typically cause spotting, but it triggers hormonal changes in your body that can lead to some spotting outside of your normal cycle. Once you release an egg or eggs, which is called ovulation, your progesterone levels start rising, preparing your body for conception and implantation. As you transition from increased estrogen levels to increased progesterone levels, it’s normal to experience some spotting. This would occur mid-cycle, or about two weeks after your last period if you have a 28-day cycle.

If this happens occasionally, there is no cause for concern. If it happens more frequently, sporadically, or bleeding becomes heavy, it might be an indication of a hormonal imbalance that could be causing more problems than intermittent spotting. Your provider may want to investigate frequent or heavy mid-cycle bleeding to ensure your hormone levels are balanced and your body is working as intended.

Cancer

Rarely, certain reproductive cancers, like uterine and cervical cancer, can lead to spotting. Cancer is not often the explanation for women under 40, but becomes slightly more likely as you approach or pass menopause.

Many women worry about cancer when they notice spotting outside of their cycle, but in the vast majority of cases, the cause is benign. However, women who are at higher risk of reproductive cancers due to age, family history, genetics, or other factors should let their provider know about any new spotting between periods, especially after age 40 and even if there are no other symptoms. While it’s one of the least likely causes, it is important to be screened to ensure early detection and intervention when cancer is to blame. The best way to ensure early detection is to get your Pap smear according to the recommended schedule.

Trauma

Spotting between periods can be a side effect of an injury to your cervix or vagina, caused by abuse, sexual activity, a medical procedure, or an accident. If your bleeding results from sexual abuse, seek medical attention immediately. If bleeding becomes heavy, you experience unmanageable pain, or your symptoms worsen instead of improve, also seek medical attention.

If you notice spotting after a minor injury, no treatment is typically required. Take special care to keep the area clean to avoid infection or further injury while it heals.

Cervical Polyps

Cervical polyps are small growths originating from the cervix, which is the lower end of the uterus that connects to the vagina. Polyps are very common, especially in women over 40 who have had children. Some women don’t have any symptoms at all, while others experience heavy bleeding during their periods, abnormal bleeding between periods, or bleeding after sexual intercourse or douching.

Many women live with cervical polyps and don’t require treatment. For those who have symptoms that interfere with their quality of life, though, medical treatment can help treat heavy periods, breakthrough bleeding, and bleeding after sex.

Other Causes

Miscarriage, ectopic pregnancy, pelvic inflammatory disease (PID), polycystic ovary syndrome (PCOS), endometriosis, thyroid disease, and infections like chlamydia and gonorrhea can also cause spotting between periods. Additionally, it can take girls about a year to settle into a regular menstrual pattern after they start their periods. If you are worried about spotting in the first year of menstruation, know that it is common while your body grows and changes and your hormones adjust.

woman sitting down looking at her phone

When Should I Consult a Physician About Spotting?

Knowing when to consult your doctor about spotting between periods can be challenging. It’s important to know that it’s always okay to reach out, even if you think your symptoms might not be cause for concern.

You should reach out to your doctor if:

  • You think you might be pregnant or know that you are pregnant.
  • Your spotting has been consistently happening between periods for several months now.
  • The spotting becomes heavier and requires a pad or tampon.
  • You have a family history of reproductive cancer.
  • You are having other symptoms that might indicate an underlying problem.
  • You are worried about it for any other reason.

Other symptoms that might indicate that it is time to see a gynecologist include abdominal pain, green or yellow vaginal discharge, foul odor, heavy periods, pain with urination, or constipation.

Additionally, if you have had an endometrial ablation in the past and have new pelvic pain and spotting or bleeding, you should see a gynecologist.

Is Your Spotting Normal or Cause for Concern?

Bleeding between periods can be worrisome, especially for women who have personal or family history of reproductive problems or women who are trying to conceive. If you’re like many of the women we treat at Tidewater Physicians for Women, you might be reluctant to schedule an appointment for something like spotting, which can be normal in many cases.

Our providers believe that peace of mind is just as good a reason as any to see your healthcare provider. Whether we provide peace of mind by confirming that there is no cause for concern or we identify and treat an underlying cause, the appointment was well worth your time and ours.

If you’re experiencing irregular bleeding or spotting between periods and you feel worried about it for any reason, schedule an appointment at Tidewater Physicians for Women. If there is an underlying cause, your provider can identify the diagnosis and develop a treatment plan to help you get back to your normal routines.

When Should I Be Concerned About Nausea During My Period?

Menstruating can be a difficult time of the month for many women, especially if you experience painful symptoms. Nausea is one of these symptoms and is often passed off as a typical, common irritation of PMS. It can, however, be a cause for concern.

Nausea during menstruation, in some cases, may indicate a more serious issue, particularly when accompanied by other symptoms. If you suffer from severe nausea during your period, accompanied by other serious symptoms, it is best to reach out to the healthcare providers at Tidewater Physicians for Women to check on your health.

Why Do You Feel Nauseous During Your Period?

Many women experience nausea during menstruation. This is common and can be due to hormonal changes during the menstrual cycle. Many women experience additional symptoms such as menstrual cramps, headaches, and other symptoms that can make the nausea even worse. The body also releases chemicals called prostaglandins during this time that can create these hormonal changes, and some women are more sensitive than others.

What Are Common Causes of Nausea When You Are Menstruating?

Many causes of nausea during your period are due to hormonal changes. Some are more serious than others, and some women experience them with greater intensity than others.

Dysmenorrhea

Dysmenorrhea is a technical term for extremely painful menstrual cramps. This is the most common cause of menstrual nausea. It can present as a primary or secondary condition. Primary dysmenorrhea is the result of uterine contractions caused by increased prostaglandins. Secondary dysmenorrhea is the result of another condition.

Premenstrual Syndrome (PMS)

Most women know what PMS is; its symptoms typically present a week or two before your period and disappear a few days after. It can result in cramps, nausea, diarrhea, bloating, headaches, back pain, tender breasts, constipation, and mood swings.

Premenstrual Dysphoric Disorder (PMDD)

Premenstrual dysphoric disorder, or PMDD, is the name for severe PMS that disrupts your daily life. It is related to hormonal symptoms but can lead to reduced serotonin levels, which causes intense emotional symptoms. Besides typical PMS symptoms, PMDD can cause panic attacks, difficulty focusing on tasks, serious fatigue, irritability, and even paranoia. PMDD only affects about 5% of women.

Endometriosis

After ovulation, your uterus sheds its endometrium, or the tissue lining your uterus. This is what happens during typical menstruation. For some women, however, this lining tissue grows outside the uterus. This is a condition called endometriosis. It affects the fallopian tubes, ovaries, and other tissues surrounding the uterus. Because it cannot be properly shed from the uterus, the tissue causes pain and irritation. It can also cause vomiting, fatigue, diarrhea, pain during sex, bloating, painful urination or bowel movements, heavy bleeding even between periods, and infertility.

Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease, or PID, is an upper reproductive tract infection. It often happens due to a sexually transmitted infection (STI) that spreads inside the body. The most common STIs responsible for PID are chlamydia and gonorrhea. PID can also be caused by bacteria that enter following childbirth.

Not all women have symptoms of PID. Those who do might experience abdominal or pelvic pain, irregular periods, abnormal vaginal discharge, pain during sex, or painful urination. If you experience nausea, vomiting, fever, or chills, you may have a severe case requiring medical attention.

When is It Time to Call a Healthcare Provider?

PMS is normal and can usually be managed with over-the-counter solutions. If, however, you continuously experience severe nausea combined with vomiting, you cannot retain fluid, and your symptoms progressively worsen, it is time to seek medical advice from your gynecologist, primary care physician, or other healthcare provider.

Ways to Manage Feeling Nauseous While on Your Period

Many remedies exist for PMS and menstrual nausea. You may start with heating pads or cool compresses, and be sure you are drinking enough fluids. Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, have been known to help.

Selective serotonin reuptake inhibitors, or SSRIs, are a class of antidepressants that can increase serotonin in the brain. These can also be helpful in treating PMS and PMDD. They are mostly indicated, however, for the treatment of emotional symptoms, and some SSRIs have side effects that include nausea.

Finally, home remedies exist that have anecdotal effectiveness for relieving nausea. These include ginger tea, fresh air, peppermint, cinnamon, and fennel, which can be taken as dietary supplements. Some say that acupressure applied to the inner wrist at the Nei Guan, or P6, pressure point may help with nausea.

Few of these home remedies, however, have a great deal of peer-reviewed evidence behind them. It is always a good idea to speak with medical professionals before trying any home remedy.

Is There a Way to Prevent Nausea During Your Period?

It is not always possible to prevent nausea during your period. There are, however, ways to help by improving your diet in general. The BRAT (banana, rice, applesauce, and toast) diet is said to be easy on the digestive tract and may help to ease nausea, but it is a short-term fix. While these foods are gentle on the stomach, they are high in carbohydrates and not nutritionally dense.

For some women, oral contraceptives (birth control pills) can help regulate hormones during your menstrual cycle. They can help relieve both the physical and emotional symptoms of PMS and PMDD and can be prescribed by your healthcare provider as a preventative measure if you suffer from severe menstrual periods.

If you do suffer serious nausea during your period, especially when it is combined with other symptoms that interfere with your daily life, you should contact a healthcare professional. Your symptoms could indicate a more serious underlying problem.

Our Team Can Help Get Period Symptoms Under Control

Tidewater Physicians for Women provides all-inclusive obstetrics and gynecology services to women across the Virginia Beach region, from birth control to pregnancy tests, diagnosis and treatment of gynecological disorders, gynecological surgery, annual preventative care, and women’s health treatments for all ages from adolescence through menopause.

We accept the majority of indemnity, PPO, and HMO plans offered in the Hampton Roads area including Anthem, Aetna, Cigna, Optima, UnitedHealthcare, Virginia Health Network, and others. We seek to take comprehensive care to a higher level, and our experienced team of qualified physicians, nurse practitioners, and licensed counselors offers family planning, well-woman exams, preconception counseling, and help with all of the physical and mental health challenges women face every day.

If you are concerned about menstrual nausea you experience during your period, we may be able to help. From determining whether your nausea is part of typical PMS or is due to an underlying condition and treating any conditions, we are here to help you get healthy once more. Give us a call today at 757-461-3890 to make an appointment.

Appetite Changes? It Might Be Your Pregnancy

When you become pregnant, your body undergoes a myriad of physical and hormonal changes that lead to all kinds of signs and symptoms. It is common (and completely normal) to experience increased hunger during pregnancy.

In addition to changes in your appetite, you might notice odd cravings and eating habits that last into the postpartum period, sometimes called the fourth trimester. For some women, weight gain can be worrisome and cause additional stress during their pregnancy and health issues after they deliver. However, hunger during pregnancy is normal, and a qualified healthcare provider can help you manage your hunger in healthy ways that support your baby’s growth and development as well as your well-being beyond delivery.

If you are worried that your hunger could be caused by something else or you worry that it may not be healthy for you or your baby, schedule an appointment with an obstetrician at Tidewater Physicians for Women. We can rule out – or diagnose – any underlying condition and make recommendations for a healthy pregnancy.

Reasons You’re in Constant Hunger

If you feel like hungry nearly all the time, you are in good company. One of the most common complaints or concerns we hear from expectant mothers is that they are always hungry, and the hunger and food cravings make it harder than ever to make health-conscious dietary choices. Cravings rarely lead to fresh fruits and veggies, but with appropriate help, it is totally possible to satisfy your cravings while fueling your body.

Understanding the factors contributing to your hunger is the first step in managing it. While it is common to believe that pregnancy alone is responsible, there are a myriad of reasons you might be experiencing an appetite increase — and not all of them are related to your pregnancy symptoms.

Pregnancy

You’re pregnant! If you are experiencing the early signs of pregnancy like tender breasts or a missed period or have had a positive home pregnancy test, pregnancy is the most likely culprit for your increase in hunger.

Changing hormones — specifically fluctuations in progesterone and estrogen — lead to an increase in appetite. This is likely your body’s way of letting you know that you need more calories to meet your baby’s demands for nourishment. Most women will need to take in about 300 more calories per day while pregnant during the first and second trimesters and 500 more calories per day during the third trimester.

Stress

Did you know that when your body is under a great deal of stress, it thinks you need more food to meet the demand? As a result, it sends out hunger signals, making you stressed out…and hungry. Pregnancy can be a particularly stressful time for many women as they adjust to their changing bodies and hormonal fluctuations, prepare to support a child (or another child) financially, make childcare arrangements, and make major life decisions about their role as a parent, their home, and more.

New Medication

Certain medications are known to cause an increase in appetite, such as steroids, some antidepressants, and anti-seizure drugs. In some cases, if your medications are the culprit, there might be a suitable substitute that provides the same therapeutic effect without the side effects. Visit with your obstetrician about your suspicions; he or she may be able to recommend comparable medications while ensuring that any new medication does not pose an undue risk to your unborn child.

Unbalanced Meals

You might be hungry all the time because you are not eating the right foods to fill up and stay full. Protein, complex carbohydrates, and fat are important components of a healthy, filling diet.

Pregnancy cravings can make it easy to choose empty calories; that is, foods that fill you up temporarily but fail to provide nourishment, needed nutrition, or lasting fullness. These foods (chips, candy, and ice cream are examples) are often to blame for increased hunger (for all people, whether pregnant or not).

When Does Pregnancy Hunger Start and Peak?

Pregnancy hunger usually starts and peaks in the second trimester for two reasons: many women are just getting over morning sickness and the lack of appetite that comes with the first trimester, and the baby’s growth is increasing more rapidly during this time.

How Long Does the Increased Appetite Due to Pregnancy Last?

For most women, the worst hunger, craving, and hunger pangs occur during the second trimester when their bodies need additional calories and the baby is not yet putting pressure on their internal organs and making them feel full.

Although you need more calories during the third trimester than you need in early pregnancy, the growing baby can put pressure on your stomach and make it harder to eat a full meal. During this time, eating frequent small meals that are rich in whole grains, healthy fats, fruits, and vegetables will ensure you meet your caloric requirements.

Can I Take Appetite Suppressants to Help Me Feel Less Hungry?

Appetite suppressants, diet pills, and weight loss medications are not safe to take during pregnancy. Instead, visit with your obstetrician about your concerns. He or she can help you:

  • Ensure you are getting enough extra calories to meet your nutritional needs as well as your baby’s
  • Offer guidance for a healthy diet that provides the nutrients and energy your body needs to support pregnancy
  • Monitor for adequate hydration and provide advice regarding how many cups of water you should drink per day
  • Recommend nourishing meals and healthy snacks that support weight management and nourish you and baby
  • Provide advice for differentiating between psychological hunger and physical hunger
  • Find foods that are both healthy and appealing when suffering from pregnancy-related problems like heartburn, indigestion, and constipation

If you have taken appetite suppressants, let your obstetrician know right away.

Ways to Help Manage Hunger During Pregnancy

While hunger is an important way that your body encourages you to get the 300-350 extra calories you need to support your baby’s growth, it can be frustrating for expectant mothers who are trying to manage their weight or who are gaining more than expected.

While you should never starve yourself during the course of your pregnancy or take weight loss medications, managing your weight is important for your long-term health and wellness. There are steps you can take to help manage your hunger so it is a helpful signal and not an uncontrollable urge.

Stay Hydrated

It is very common for the human body to confuse hunger and thirst, and just like your body and baby demand more calories during pregnancy, they also demand increased fluids. Pregnant women need 12-13 cups of water to support increased blood volume during pregnancy.

Eat Healthy Snacks

Choosing healthy snacks can help prevent you from over-indulging when you feel hungry. It is easy to sit down with a few potato chips and eat the whole bag, but you are much less likely to grab an apple and accidentally eat ten. Some healthy substitutes for indulgent snacks include:

  • If you are craving something salty, choose low-fat popcorn like HealthyPop or SmartFood.
  • If you are craving ice cream, consider substituting low-fat yogurt or frozen yogurt – even freezing a yogurt cup can emulate ice cream.
  • If you are craving something crunchy, opt for fresh fruits and vegetables like cucumbers, carrots, apples, celery, or even pickles.
  • If your pregnancy cravings include carbohydrates – like bread, pasta, and potatoes – choose snacks that offer complex carbohydrates: whole wheat crackers, oatmeal, and fruit are great examples.

Are You Worried About How Your Eating Habits Affect Your Baby?

If you are worried that your hunger or eating habits are not normal and may be harming your developing baby, seek medical advice from an obstetrician who specializes in women’s health and nutrition. He or she can:

  • Determine whether an underlying condition or contributing factor might be causing your hunger.
  • Determine whether your weight gain is healthy for your gestational period.
  • Develop a treatment plan if there are any issues identified.
  • Offer dietary guidance to ensure your diet is providing you and your growing baby with the nutrients you need.
  • Reassure you that your hunger and cravings are a normal and healthy part of pregnancy in most cases.

Don’t lose sleep over your appetite, cravings, or weight gain during this transformational time in your life. It is completely normal to be hungrier than usual. You need more calories when pregnant than you needed before, and there are all kinds of tips and tricks that can help you make healthy choices despite the challenges that come with pregnancy. The team at Tidewater Physicians for Women is here to provide support and expertise without judgment, whether you are trying to conceive, pregnant, or postpartum. Call our office at 757-461-3890.

Methods to Treat Chronic Pelvic Pain During Pregnancy

Carrying a child can come with a whole onslaught of new pains and discomforts. Hormonal changes can cause muscle pain and body aches, your growing uterus will cause round ligaments to stretch and pull, and the added weight of the baby all concentrated in one place can lead to lower back pain and pelvic girdle pain. Adding chronic pelvic pain to an already uncomfortable pregnancy can make routine daily activities feel daunting or even impossible to complete. While pelvic pain during pregnancy is uncomfortable or inconvenient for most, it can cause severe pain in the worst cases.

This pain can make it difficult to care for yourself, take care of other children in the home, or work. There are many steps you can take at home to alleviate the symptoms of pelvic pain during pregnancy, but sometimes medical intervention is required. Continue reading to explore solutions that might help alleviate your pelvic pain, or come see one of our obstetricians today.

Why Does Your Pelvis Hurt During Pregnancy?

While any new pain might feel worrisome, pelvic pain is very common – even expected – in pregnancy. In most cases, it is not a cause for concern. The most common factors contributing to new pelvic pain in pregnancy are growth spurts, symphysis pubis dysfunction (SPD), pressure from the weight of the baby, and the hormone relaxin softening your ligaments to prepare your body for delivery.

Growth Spurts

When the baby goes through periods of rapid growth, so does your uterus. When this growth is rapid during a growth spurt instead of slow and gradual, the round ligaments supporting your uterus are stretched. This can cause dull aches and sudden, sharp pains.

Symphysis Pubic Dysfunction (SPD)

SPD, pelvic girdle pain, or pubic symphysis and is common in pregnant women. SPD is the result of a myriad of body changes in preparation for pregnancy and delivery which ultimately lead to pelvic pain and instability. SPD can make it challenging to scale stairs, roll over in bed, get in or out of the car, or even walk.

Pressure from Baby’s Weight

As the baby grows, the uterus puts increasing pressure on the lower body and pelvic floor. This can cause pain and pressure in the vagina, pelvis, or hips.

Relaxin

Your sacroiliac joint – between your spine and your pelvis – is supported by a network of ligaments that pull the joint together and stabilize it. In order to make room for your growing baby and uterus and ease childbirth, a hormone called relaxin is released during pregnancy, causing those pelvic ligaments to relax. While this is conducive to successful childbirth, it can lead to hypermobility in pelvic joints and pelvic pain during pregnancy.

What are the Symptoms of PGP?

PGP or pelvic girdle pain prevalence is high: it affects about 20% of all pregnant women. Having PGP in a previous pregnancy, a history of low back pain, previous pelvic injury, obesity, a job that’s physically demanding, and pregnancy with multiples are all risk factors for developing PGP.

You might be dealing with pelvic girdle pain if:

  • you experience pain at the pubic bone (front center of the pelvis, even with your hips)
  • you have pain on one or both sides of your lower back
  • you have pain in your perineum (the area between your bottom and your vagina)
  • the pain worsens when walking, standing on one leg, scaling stairs, rolling over in bed, or trying to move your legs apart

Some women also notice audible popping in their pelvis when trying to do one or more of the activities above.

Will Having Chronic Pelvic Pain Affect My Baby?

The good news is that pelvic girdle pain does not change pregnancy outcomes. Although the pain might limit what you can do in a day, most women with PGP or even chronic pelvic pain are able to deliver vaginally without complications. However, during delivery, it is also important to notify the delivery team that you have PGP. Once you receive an epidural, you will no longer feel pain if you spread your legs too far.

However, pelvic pain can be a cause for concern when it isn’t PGP. It’s important to see your obstetrician right away if you have pelvic pain along with any of the following symptoms.

Vaginal Bleeding

Vaginal spotting or bleeding along with pelvic pain during pregnancy requires prompt medical attention.

Severe Pain

If your pain is severe, it can be an indication that something more sinister is going on. Health professionals are trained to investigate and intervene if necessary in cases like these.

Chills or Fever

Fever or chills can be a sign of infection somewhere in your body; see your women’s health provider for diagnosis and treatment.

Lack of Fetal Movement

Whether you have pain in your pelvic area or not, if you were feeling baby move and now you’re not, it’s important to seek immediate medical attention.

Lightheadedness

Lightheadedness might be a sign of an underlying problem; visit your OBGYN. Fainting requires immediate evaluation in urgent care, an emergency room, or an obstetric clinic.

Blood In Your Stool

If you notice blood in your stool (which can be dark in color and look like coffee grounds), visit your healthcare provider for evaluation. Blood in your stool should not wait until your next appointment.

Vomiting

While morning sickness is common, nausea and vomiting accompanied by pelvic pain during pregnancy should be checked out.

Fluid Coming From Your Vagina

If you are having pelvic or abdominal pain and notice fluid coming from your vagina, check with your OBGYN.

What Is the Best Treatment for Pelvic Girdle Pain?

Interventions for pelvic girdle pain in pregnancy range from rest and home exercise to physiotherapy. Common treatments include:

Steps at Home

There are several things you can do at home to help alleviate pelvic girdle pain and improve your quality of life:

  • Do as much as you can without causing pain; do not avoid movement altogether but if you notice pain, limit your range of motion to ensure pain-free movement
  • Wear shoes that are flat and supportive; avoid high heels, wedges, and other shoes that change the position of your hips and pelvis
  • Sleep in a comfortable position; try different positions until you find something that works, keeping in mind that a knee pillow is often helpful
  • Sit down when getting dressed so you do not have to stand on one leg at a time; ask for help if you need it
  • Adjust the way you climb up or down stairs; taking them one at a time or ‘scooting’ up them on your bottom might be easier
  • Take time to rest when you can; it’s important not to become inactive, but you still need daily rest. If you have a physically-demanding job, explore ways to adjust duties temporarily.
  • Engage in relaxation techniques (meditation, journaling, baths, etc.) to help reduce tension and take care of your mental health during your pregnancy; chronic pain can take a toll on mental health

A Pelvic Support Belt

Your OBGYN or physiotherapist can prescribe a pelvic support belt to help stabilize the pelvis and sacroiliac joint and prevent hypermobility. In most cases, insurance will cover the cost of the belt. Pelvic support belts are easy to use and many patients say that they feel almost immediate relief when they put it on.

Physiotherapy or Physical Therapy

If your OBGYN’s recommendations and a pelvic support belt are not helping, he or she might refer you to a physiotherapist. Often called pelvic, obstetric, and gynecological physiotherapy (POGP), a physiotherapist will develop a customized exercise program, administer manual therapy, and offer advice on daily activities and posture.

Will My Pelvic Pain Persist After Giving Birth?

For most women, pelvic pain is worst in the third trimester and resolves by about three months postpartum. However, some women experience chronic pelvic pain that can last for long periods of time – even before and after pregnancy. This goes above and beyond pregnancy-related pelvic girdle pain and requires evaluation and treatment. Common causes of chronic pelvic pain include:

  • endometriosis
  • irritable bowel syndrome
  • painful bladder syndrome
  • fibroids
  • chronic pelvic inflammatory disease
  • pelvic congestion syndrome
  • other conditions

Your provider can order diagnostic tests to determine whether your issues are related to weakened pelvic floor muscles from pregnancy or an underlying condition, and then recommend the most appropriate treatment. In any case, chronic pelvic pain requires evaluation to rule out more serious underlying conditions.

Chronic Pelvic Pain? See How an Obstetrician Can Help You Find Relief

If you are experiencing chronic pelvic pain, the team at Tidewater Physicians for Women can help. Whether your pelvic pain is pregnancy-related or a symptom of a larger problem, we have the diagnostic tools to get to the bottom of it and the expertise to treat it. We understand how hard it can be to get away with a new baby at home, but you’re best able to care for your little one when you’re healthy and pain-free. One quick appointment is the first step!

Do not live with pelvic pain when there are treatments available; call 757-461-3890 today to schedule an appointment.

Guide To Antepartum Depression

Pregnancy is typically a time of joy and excitement for new moms. For some women though, the months before childbirth are filled with feelings of sadness and anxiety. The condition is called antepartum depression, and about 18% of pregnant women will experience it. Fortunately, the health care team at Tidewater Physicians for Women offers treatment so you and your baby enjoy a happy, healthy pregnancy.

What is Antepartum Depression?

Also called antenatal or prenatal depression, antepartum depression is a mood disorder that occurs before childbirth. It is less well known than postpartum depression, which occurs in the year after the baby is born. The condition causes feelings of sadness, worthlessness, anxiety, and fatigue that make it challenging to perform daily tasks or care for yourself or family members. It can also put the health of your unborn baby at risk, so seeking antepartum care quickly is vital.

Perinatal depression is quite common. According to the American College of Obstetricians and Gynecologists (ACOG), 7.4% of women will experience depression during the first trimester of gestation, while 12-12.8% of women experience it during their second or third trimesters.

What are the Causes and Symptoms of Antepartum Depression?

While there is no single cause for depression during pregnancy, doctors believe the condition results from the combination of pregnancy-induced hormonal changes and emotional disturbances associated with pregnancy. Women with a personal or family history of depression or those who have had perinatal depression previously may be at greater risk. Women facing high-risk pregnancies may also be at increased risk. Other risk factors include:

  • Lack of social support
  • Poor relationship quality
  • Domestic violence
  • Poor nutrition, specifically low levels of vitamins D and B 
  • Unintended pregnancy
  • Lack of health insurance/financial concerns

Many pregnant women do not realize they have the condition. That is because symptoms can mimic normal pregnancy symptoms, making it difficult to determine when to seek treatment. Similar symptoms include:

  • Fatigue and an overall lack of energy
  • Changes in appetite, including no appetite or overeating
  • Changes in sleep patterns, such as sleeping too much or not enough
  • Lack of sex drive

More significant symptoms may include:

  • Feelings of extreme anxiety
  • Feelings of dread
  • Feelings of hopelessness
  • Irritability and agitation
  • Loss of activities you usually enjoy
  • Difficulty concentrating
  • Aches, pains, headaches, or cramps that do not have a clear physical cause
  • Feelings that you are not prepared for parenthood
  • Lack of self-care and/or unwillingness to follow a prenatal care plan
  • Use of tobacco products, alcohol, or drugs
  • Suicidal thoughts or ideations

Not everyone will experience the same symptoms. You may only have a few symptoms while others experience many of these.

What are the Common Concerns of Women with Antenatal Depression?

Women have many medical conditions to worry about during pregnancy including fetal growth and abnormalities, placenta rupture, and preterm labor. Unfortunately, depression gives them more causes for concern.

Women with antenatal depression are more likely to experience complications such as preeclampsia or high blood pressure that occur during pregnancy. This is a serious condition that often requires inpatient care in an antepartum unit at a medical center.

Additionally, women with depression are more likely to deliver a preterm baby. A study published in the May 2016 journal Obstetrics & Gynecology found women who have depression while pregnant are 1.82 times more likely to have a preterm baby and 1.28 times more likely to have a low-birth weight baby. When babies are born early or underweight, they may spend time in a NICU where neonatologists treat them until they are healthy enough to go home.

How Do Obstetric Professionals Treat Antepartum Depression?

Just like postpartum depression, you can not just snap out of antepartum depression. Treatment by a health care provider is required to ensure your well-being and your baby’s health.

Doctors have several ways to treat antenatal depression. First, your doctor may prescribe antidepressant medications. There are many types that are safe to take during pregnancy, including Zoloft, Cymbalta, Celexa, and Wellbutrin. However, some women may feel more comfortable with non-pharmaceutical options.

Research has shown that counseling or therapy can help reduce symptoms and improve your well-being. Support groups where women experiencing similar conditions discuss their feelings and emotions may also help.

Self-care is another great way to improve your wellness during pregnancy. While you should speak to your healthcare provider as soon as you realize you are having symptoms of antenatal depression, you can also take steps on your own to feel better.

Get enough exercise. Physical activity helps boost endorphins, which are brain chemicals that help you deal with pain or stress. Therefore, doing gentle, regular exercise can improve your mood. Your obstetrician can help if you are not sure what types of activities are safe during pregnancy.

Improve sleep habits. Sleeping during pregnancy, especially during the last trimester, can be difficult. However, poor sleep quality has been linked to an increased risk of suicidal thoughts (1). Supportive pillows can increase your comfort while sleeping.

Eat nutritious meals. Eating healthy foods is not only important for your baby’s development, but it also gives your body the nutrients it needs to be healthy. Always follow a diet appropriate for antepartum care to ensure your good health.

Can Antepartum Depression Lead To Postpartum Depression?

While there is some clinical evidence to suggest depression during pregnancy carries over after the baby is born, that is not always the case. Many women who experience depression during pregnancy cope well and experience no difficulties after childbirth.

During pregnancy, it is essential to recognize that feelings of sadness, worthlessness, or extreme anxiety are more than just the “baby blues.” These feelings can be symptoms of a serious medical condition that requires treatment. Call us today at 757-461-3890 or reach us through our contact page to learn how we can help.

Tidewater Physicians for Women
a division of Mid-Atlantic Women’s Care
VA Beach

828 Healthy Way Unit 330
Virginia Beach, VA 23462

Fax: 757-467-0301

Norfolk

844 Kempsville Road #208
Norfolk, VA 23502

Fax: 757-461-0836

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