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Infertility & Reproduction Guide

Getting pregnant can be as simple as withholding contraception. Yet for some, it is an emotional, physical and financial burden. The experts at WebMD have selected material on infertility and reproduction. Learn the causes of infertility, infertility treatments and coping skills to deal with the stress that can tear a couple apart.

Understanding Ovulation and Fertility

Facts to Help You Get Pregnant

The first phase starts with the first day of your period. Your body releases hormones that stimulate eggs to grow within follicles inside your ovaries. Between day 7 and 11, those hormones also help thicken the lining of your uterus to get ready for the implantation of a fertilized egg.

Foreign Body, Vagina

Vagina Foreign Body Overview

Some objects are designed for use in a woman’s vagina. These include tampons, vaginal suppositories, and medications delivered through the vagina. Others are not intended to be inserted and may be placed there accidentally or intentionally. Doctors referred to objects found in the vagina as “foreign bodies.” These foreign bodies may produce symptoms or be asymptomatic for long periods of time.

Small objects inserted into the vagina, do not generally cause pain. Unusual objects, generally those larger than the customary vaginal diameter or size of the introitus, may cause pain because of distention. Other objects may cause pain due to sharp edges.

Vaginal foreign bodies are very commonly seen in children. Adolescent girls may present with foreign bodies, which primarily consist of forgotten tampons or broken portions of condoms. Adults may also present to the emergency department with vaginal foreign objects, which may have been placed there intentionally as part of a sexual encounter or placed as part of an episode of abuse.

While a variety of symptoms may result from a foreign body in the vagina, the most common symptoms are bleeding or foul-smelling vaginal discharge. Less common symptoms may include pain or urinary discomfort.
Rarely do foreign bodies produce a systemic infection except in circumstances such as severe immunocompromise or disruption of the vaginal wall with secondary infection. Perforation through the vagina into the abdominal cavity may also result in acute abdominal symptoms.

Vaginal Foreign Body Causes

The most common foreign body of the vagina in small children is small amounts of fibrous material from clothing, carpets, etc. Other foreign objects found in the vagina in children may be placed there at the time of self-exploration. They may be forgotten, or once placed in the vagina, unable to be removed by the child. Other common objects include marker caps or crayons. The objects found in children generally are small and do not cause pain from distention of the hymen or introitus at the time of placement. Children will generally not place objects larger than the vaginal entrance due to discomfort.

Adolescent women may use tampons once their menses begin. Occasionally, these tampons are forgotten and may not be removed for days. The breakage of a condom may also result in bits of latex or non-latex material being left in the vaginal vault.

Adults may place foreign objects into the vagina as part of a sexual experience. Less commonly unusual objects may be placed in the vagina as the result of abuse. Adults may also experience forgotten tampons or bits of a condom.
While small objects placed in the vagina may remain asymptomatic for a period of time, larger objects may produce pain or discomfort immediately, thus precipitating a visit to the healthcare provider.

Vaginal Foreign Body Symptoms

Common symptoms of a vaginal foreign body include the following:

  • Vaginal discharge, generally foul-smelling and yellow, pink, or brown
  • Vaginal bleeding, especially light bleeding
  • Vaginal itching or foul odor
  • Urinary symptoms such as discomfort with urination
  • Vulvar discomfort due to vaginal discharge producing skin irritation
  • Abdominal or pelvic pain from placement of large objects or perforation of a foreign body into the peritoneal cavity

Symptoms accompanying the presence of a foreign body include the following:

  • Skin redness (erythema)
  • Swelling of the vagina and introitus (entrance to vagina)
  • Rash in the vaginal area

The presence of a vaginal foreign body may alter the normal bacterial flora of the vagina, thus resulting in repeated efforts to treat a “vaginitis.” The presenting symptoms of a vaginal discharge may be interpreted as a vaginitis, a sexually transmitted infection or even a yeast infection by the patient or unaware healthcare provider. Repeated use of antibiotics or other medications will not remove the symptoms if a foreign body remains present.

Objects left in the vagina very rarely lead to serious complications. However, the medical literature has had several case reports of pelvic abscess and subsequent scarring.

When to Seek Medical Care

A health care provider should be consulted when any change in vaginal discharge is present, particularly discharge which is foul-smelling or abnormal in color. The presence of a foreign body may cause abnormal vaginal bleeding.

If a foreign object was placed in the vagina and may still be present, the health care provider should be informed of this information. Occasionally, an adult or adolescent woman may remember placing a tampon, but then be unable to remove it from the vagina. Recollection of the placement of a foreign body may assist the practitioner in the best method of care.

If a person places an object in the vagina and then is unable to remove it, a health care provider should be consulted promptly.

Unusual objects may need to be removed using sedation or anesthesia in order to avoid pain. This may be particularly true of objects placed in the vagina of a small child or an adult who is unable to be cooperative with a vaginal exam. Some emergency departments allow sedation and removal in the emergency department without going to an operating room setting.

Exams and Tests

Vaginal foreign bodies are seen more commonly in children than in adolescent or adult women. Children may not be able to supply the history of an object placed in the vagina; however, some children will say that they have lost an object in their vagina. In addition to obtaining specific information about a possible vaginal foreign body, a health care provider will perform a general history and physical examination as well.

It is appropriate for the health care provider to ask about questions related to sexual activity and sexual or physical abuse.

Methods for diagnosing and retrieving foreign bodies depend on the age of the female patient and sometimes the duration of time the object has been in the vagina.

For young girls, any visit to a doctor’s office can be frightening. If a foreign object is suspected in a young girl, the physician may gently examine the vulva and vaginal entrance by separating the labia and glimpsing the foreign object. This may allow removal in the office through such techniques as warm water lavage of the vagina, but other larger objects may require sedation or examination under anesthesia for removal.

An adolescent patient may easily have a foreign body removed from the vagina in the outpatient setting. This may also hold true for adults. Visualization of the foreign body using a speculum and removal with a forceps may be the most efficient treatment.

  • Unusual objects or those that may disrupt to the vaginal wall may require sedation or anesthesia for removal, and to complete a thorough exam of the vagina and cervix.
  • If an object has been present in the vagina for a long time, that object may cause erosion into the wall of the vagina. Acute placement of an unusual object in the vagina may cause perforation of the vaginal wall and secondary symptoms of an intra-abdominal infection. (For example, an unusual case report in the emergency medicine literature revealed placement of wood sticks in the vagina of an adult female 2 years before she began having pain in her hips. The sticks had been inserted in order to attempt to terminate a pregnancy. The sticks, however, remained in the vagina and eventually migrated through the vaginal wall to produce the hip pain.)
  • Although examination generally reveals the presence of a foreign body, some imaging techniques may also be helpful. These may include a CT (computerized tomography) scan or an abdominal x-ray. Ultrasonography may also assist in the location of a foreign body in the vagina or pelvis.

Vaginal Foreign Body Treatment

The best management of a foreign body is removal. This is generally the only treatment necessary.

Self-Care at Home

Some patients may be able to remove the foreign body themselves by simply placing their finger in the vagina, locating it, and removing it. Other objects may need to be removed by a health care provider.

Medical Treatment

Bacterial infections or alteration in the normal bacterial flora of the vagina may be due to the presence of a foreign body altering the usual acidic environment of the vagina. Removal may be performed with the forceps or with a warm water irrigation of the vagina. Once the foreign object is moved, antibiotics are generally not needed.

In children, vaginal lavage or irrigation is the method of choice to remove small bits of fibrous tissue. Removal of larger objects may be accomplished in the outpatient setting or may require sedation or evaluation in the operating room. Analgesia or anesthesia at the time of removal may make the procedure more comfortable.

Teenagers and older women may generally have foreign bodies removed in the outpatient setting; however, those patients who are unable to cooperate for an exam may also benefit from sedation or removal in the operating room.

Larger objects and those causing pain after placement in the vagina may require anesthesia for complete removal and inspection of the vaginal walls. These more complex procedures may require prophylactic or therapeutic antibiotics.

Medications

Larger objects and objects causing painful infections will require anesthesia for pain and relaxation of vaginal muscles. Objects that have moved from the vagina to the abdomen or to other parts of the body will require surgery for removal.

Once the object is removed and antibiotic medication is given, infection, fever, pain, and vaginal discharge should soon clear up.

Next Steps

If symptoms of vaginal discharge, bleeding, abnormal odor, or urinary tract symptoms continue after an object has been removed, a repeat evaluation by a health care provider is recommended.

Follow-up

If symptoms resolve once a foreign body is removed, follow-up may not be necessary.
Repeat examination may be recommended if the health care provider is not certain the entire object has been removed or if any complexities, such as secondary infection is diagnosed at the time of removal of the foreign body.

Prevention

Prevention of infections related to foreign objects in the vagina begins with good vulvovaginal hygiene.

  • In young children, parents should instruct perineal cleaning by wiping front to back. This will decrease the amount of bacteria and feces that may enter the vagina. Poor perineal hygiene may cause irritation of the vulva or vagina.
  • Parents can also aid in the prevention of foreign bodies of the vagina by talking with children about their bodies and teaching them the proper names of their body parts, such as vagina, urethra, anus, and rectum. Knowing the correct names of body parts will allow children to better communicate any problems. For example, children may be able to describe these body parts to adults in instances of pain, discharge, or possible abuse.
  • For older girls and women, good hygiene includes limiting the amount of time objects remain in the vagina. Tampons should be used no longer than 6-8 hours.
  • Sexual activities resulting in painful placement of objects in the vagina should be avoided.

Medications for vaginal infections or irritation should be used only when prescribed by a health care provider. Patients may commonly misdiagnose the etiology of a vaginal discharge. Douches or vaginal washes are not needed to clean the vagina. Repeated douching may increase the risk of infection due to washing away the normal bacteria which help to fight infection. Showers and baths are satisfactory for cleaning the vulva and perineum.

Outlook

Once the vaginal foreign body is removed, related symptoms of infection, pain, and discharge should quickly end.

  • If the foreign body has been in the vagina for a long period of time and has caused an infection, antibiotics may be prescribed; however, they are not customarily required.
  • Serious complications rarely occur, if infection enters the deep pelvic tissues or peritoneal cavity. Infections in the pelvis can cause secondary inflammation and scarring, resulting in pain or infertility.
Source: emedicinehealth.com – Last Editorial Review: 8/19/2005

Vaginitis in Children

Vaginitis refers to any inflammation or infection of the vagina. This is a common gynecological problem found in girls of all ages, with most having at least one form of vaginitis at some time during their lives. When the walls of the vagina become inflamed, because some irritant has disturbed the balance of the vaginal area, vaginitis can occur.The following are the most common symptoms of vaginitis in children. However, each youngster may experience symptoms differently. Symptoms may include:

  • vaginal itching
  • vaginal burning
  • vaginal discharge which may be clear or colored. It can be thin or thick with or without an odor. A white, cottage cheese-like vaginal discharge is typically seen in candida vaginitis.
  • occasionally girls complain of pelvic or abdominal pain

Vaginal Yeast Infections

Yeast infections are caused by one of the many species of fungus known as candida, which normally live in the vagina in small numbers. Since yeast is normally present and well-balanced in the vagina, infection occurs when something in a female’s system upsets this normal balance. For example, an antibiotic to treat another infection may upset this balance. In this case, the antibiotic kills the bacteria that normally protects and balances the yeast in the vagina. In turn, the yeast overgrows, causing an infection. Other factors that can cause this imbalance to occur include pregnancy, which changes hormone levels, children taking steroids and diabetes, which allows too much sugar in the urine and vagina. Other causes of yeast overgrowth include wearing tightly fitting clothing and if the girl is around too much heat and moisture.

The following are the most common symptoms of a candida infection. However, each adolescent may experience symptoms differently. Symptoms may include:

  • a thick, white, cottage cheese-like vaginal discharge that is watery and usually odorless
  • itchiness and redness of the vulva and vagina
  • burning on urination (dysuria)

The symptoms of a vaginal candida infection may resemble other conditions or medical problems. Therefore, parents should always consult with their child’s physician for a diagnosis.

Treatment for candida may include:

  • anti-fungal, vaginal creams and suppositories
  • vaginal tablets
  • antibiotics

Prevention of candida vaginitis includes:

  • Washing and rinsing your daughter’s external genitals and bottom regularly.
  • Wearing clean underpants every day. Cotton panties with a cotton crotch are best.
  • Avoiding vaginal spray deodorants and irritating soaps.
  • Remind your daughter to wipe front to back, never back to front..

Vaginitis from Soap or Poor Personal hygiene

Most vaginal itching or discomfort is due to a soap irritation of the vulva. The usual irritants are bubble bath, shampoo, or soap left on the genital area after a bath. Occasionally, it is due to poor hygiene. Before puberty, the lining of the vulva is very thin and sensitive. If the vagina becomes infected, there will be a vaginal discharge. This problem almost always occurs before puberty.

Treatment includes:

  • Baking soda, warm water soaks in a basin or bathtub of warm water for 20 minutes. Add 4 tablespoons of baking soda per tub of warm water. Be sure she spreads her legs and allows the water to cleanse the genital area. No soap should be used. This will remove any soap, concentrated urine, or other irritants from the genital area and promote healing.
  • Hydrocortisone cream Apply 1% hydrocortisone cream (a nonprescription item) to the genital area after the soaks on the advice of your child’s doctor.
  • Prevention of recurrences
    1. Avoid bubble baths. Don’t put any other soaps or shampoo into the bath water. Don’t let a bar of soap float around in the bathtub. If you are going to shampoo your child’s hair, do this at the end of the bath.
  • Keep the bath time less than 15 minutes. Have your child urinate immediately after baths.
  • Wear cotton underpants. Discourage wearing underpants during the night so the genital area has a chance to “air out.”
  • Teach your daughter to wipe herself correctly from front to back, especially after a bowel movement.
  • Encourage her to drink enough fluids each day to keep the urine light-colored. Concentrated urine can be an irritant.

Vaginal Foreign Bodies

Young girls may put a foreign object in their vaginas. Common objects are toilet tissue, a crayon, or a bead. If the objects are not removed, then an infection can result. Often they are not discovered until the girl is brought to see a physician because she has developed a vaginal discharge.

The most common foreign body in young girls is toilet tissue. Teach your daughter to pat her vulva dry after going to the bathroom rather than rubbing it with tissue. Rubbing causes balls of tissue to break off and become lodged in the vagina.

It is important for parents to try NOT to remove the foreign object. This often pushes the object farther into the vaginal vault and makes it more difficult for the physician to remove it.

Bacterial Vaginitis

While yeast infections are the most commonly discussed vaginal infection, bacterial vaginitis (BV) is actually the most common type of vaginitis in females of reproductive age. This infection is caused by a bacteria, not yeast. With a bacterial vaginitis infection, certain species of normal vaginal bacteria grow out of control and trigger inflammation. The cause of bacterial vaginitis is not known.

The following are the most common symptoms of bacterial vaginitis. However, each adolescent may experience symptoms differently. Symptoms may include:

  • a milky, thin discharge at times, or a heavy, gray discharge.
  • “fishy” odor of discharge.

The symptoms of bacterial vaginitis may resemble other conditions. Always consult your physician for a diagnosis.

Trichomonas Vaginitis

What is trichomoniasis?

Trichomoniasis, trichomonas, or “trich” as it is commonly called, is a sexually transmitted infection. It is caused by a one-celled parasite called Trichomonas vaginalis which passes between partners during sexual intercourse. Since most males do not present symptoms with trichomoniasis, the infection is often not diagnosed until the female develops symptoms of vaginitis.

What are the symptoms of trichomoniasis?

The following are the most common symptoms of trichomoniasis. However, each adolescent may experience symptoms differently. Symptoms may include:

  • a frothy, often musty-smelling, greenish-yellow discharge
  • itching in and around the vagina and vulva
  • burning during urination
  • discomfort in the lower abdomen
  • pain during intercourse

Some girls with trichomoniasis have no symptoms, or their concerns may resemble other conditions or medical problems.

Treatment for trichomoniasis:

Specific treatment for trichomoniasis will be determined by your young woman’s physician based on:

Both partners must be treated for trichomoniasis to avoid reinfection. Treatment generally involves taking oral antibiotics. If a female has more than one sexual partner, each partner (and any of their other partners) should also be treated.

Viral Vaginitis

Viruses are a common cause of vaginitis, with most being spread through sexual contact. One type of virus that causes viral vaginitis is the herpes simplex virus (HSV, or simply herpes) whose primary symptom is pain in the genital area associated with lesions and sores. These sores are generally visible on the vulva, or vagina, but occasionally are inside the vagina and can only be found during a pelvic examination. Often stress or emotional situations can be a factor in triggering an outbreak of herpes.

Another source of viral vaginitis is the human papillomavirus (HPV), a virus that is also transmitted through sexual contact. This virus causes painful warts to grow on the vagina, rectum, vulva, or groin. However, visible warts are not always present, in which case, the virus is generally detected by a Pap test.

Chlamydia Vaginitis

Chlamydia is the most commonly occurring sexually transmitted disease in the United States, although it often goes undiagnosed. If left untreated, chlamydia often leads to pelvic inflammatory disease (PID), which increases a female’s risk of infertility, pelvic adhesions, chronic pelvic pain, and ectopic pregnancy.

Chlamydia, caused by the bacterium chlamydia trachomatis, exists in a number of different strains. This form of vaginitis is most commonly diagnosed in young women between the ages of 18 and 35 who have multiple sexual partners.

What are the symptoms of chlamydia?
Unfortunately, many females have no symptoms, thus prolonging diagnosis and treatment and possibly spreading the disease. The following are the most common symptoms of chlamydia. However, each adolescent may experience symptoms differently. Symptoms of chlamydia may include:

  • increased vaginal discharge
  • light bleeding, especially after intercourse
  • pain in the lower abdomen or pelvis
  • burning during urination
  • pus in the urine
  • redness and swelling of the urethra and labia

The symptoms of chlamydia may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

Generally, treatment for chlamydia involves taking antibiotics.

Source: kidsgrowth.com
As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician.

Menstrual Calendar

Keep a Menstrual Calendar

It’s a good idea to keep track of your monthly menstrual cycle so that you, approximately, know when your period will start. That way you can be prepared, especially if you plan on taking a trip. By knowing when your period will start will also help you determine whether you are pregnant, if your cycle starts regularly every month, or suspect any menstrual problems.

Tip: Women close to their menopause or young teenagers are more likely to have irregular cycles.

Seek medical attention if:

  • You have irregular menstrual period, excessive or any other abnormal bleeding.
  • You have very severe pain during menstruation that is not relieved by over the counter pain killers.
  • You are experiencing pelvic pain that is not related to menstruation.
  • You are not having periods.
  • Your menstrual cycle is less than 21 days or more than 35 days apart.
  • Anything that seems abnormal for you about your period.
LEARN MORE Fertility and Charting Your Menstrual Cycle

Feminine Hygiene

As much as we may hate to admit it, women can sweat and have body odour similar to men and a regular shower and clean clothes takes care of that. While body odour usually indicates that one is due for a shower or bath, excess body odour (BO) can also be a sign that ones diet and lifestyle is out of balance, or that one has eaten something disagreeable (like excess garlic) or has an illness. 

Many women suffer skin infections and some of these are attributed to poor hygiene, however often the real cause is another health problem, or using to much soap/cleanser and failing to remove the soap/cleanser residues which cause a bacterial buildup in folds of the skin and under the breasts. To avoid this, use minimal soaps and cleansers, rinse off thoroughly and dry off completely as damp skin may encourage infections.

Vaginal Hygiene

Keeping clean seldom requires more than taking a daily bath or shower, but many girls and women are concerned that their vagina may smell. However unless there is a heavy infection present, there is no way any vaginal odour can be detected by anyone else (except perhaps a lover).

The vagina is completely self cleansing and never requires any internal cleansing except in times of infection. All that needs to be done is regular washing of the outer parts when you shower, but note soaps are best avoided as soaps and chemicals can upset the natural balance and harmony of vaginal chemistry.

Douching – The flushing of the vagina with water.
Vaginal douches are usually plain and slightly warmed water, although water mixed with vinegar, or even antiseptic chemicals are commonly used with medical advice to help restore the natural bacterial culture of the vagina following illness.

Douching has been touted as having a number of supposed but unproven benefits such as cleaning the vagina of unwanted odors and douching has also been ineffectively* used after intercourse as a method of birth control.

Many health care professionals agree that douching interferes with both the vagina’s normal self-cleaning processes and the natural bacterial culture of the vagina. Douching may cause irritation or introduce infections such as bacterial vaginosis, and pelvic inflammatory disease (PID). Frequent douching with water, especially if any soap is present may result in an imbalance of the pH of the vagina which may cause vaginal infections, especially yeast (thrush) infections.

Deodorants

Feminine sprays and deodorants are often heavily perfumed and, like douching, can lead to allergic reactions, irritation, and infections. Your vagina has its own natural cleaning system that flushes out bacteria, so you don’t need to add any chemicals to help it.

Making your vagina smell like a flower shop does not help you, simply washing at least once every day with plenty of warm water will keep your vagina clean and only use a very mild soap.

How do you manage during menstruation?

While for some, there may be some anxiety around period time, do not be put off by the sight of a little blood, simply clean it away and stay healthy.

Hygiene is not difficult as the vagina is completely self cleansing, but once you begin menstruating, you’ll need to use a pad or tampon to soak up the menstrual blood and if a period comes on, or if you are not prepared, some folded toilet paper or cloth can be used.

While our distant ancestors would have washed in a stream and used some dry grass or moss to wipe with, today pads, tampons and cups are purpose made for comfort and ease of use.

Tampons

A popular choice for feminine protection during the menstrual period, the cotton tampon absorbs blood inside the vagina. Tampons come in different sizes for heavier and lighter periods and they can be inserted into the vagina using an applicator or just with your fingers. Tampons may need to be changed every 3 or 4 hours or more frequently if your period is heavy.

Sanitary pads or Napkins

Are usually made of layers of cotton and come in various thicknesses for heavier or lighter periods, or for day or nighttime use. Pads fit inside panties and depending on how heavy the flow is and they will need to be changed every 3 or 4 hours, or sometimes more often when your period is heavy.

Panty Liners

Also called panty shields; these are similar to pads but are shorter and thinner and are not as absorbent as tampons or pads. They are best worn on very light days, or as added protection in combination with a tampon or cup.

Cups

Another effective but less popular feminine hygiene option is the cup, it is a soft, little disposable cup you wear inside the vagina to hold rather than absorb your monthly flow. It fits over your cervix conforming to your anatomy to create a personal, comfortable fit which helps prevent leakage. You can wear it for up to 12 hours (or until it is full), and then empty it out, rinse it, and use it again.

Which ever sanitary product you choose will let you feel most comfortable while at work and enjoying doing the things you love even when you have your period.

Notes:

  • When it comes to odours caused by infections, the treatment is not a spray, but a prescription medication that treats the infection rather than covering it up. If you think you may have an infection, see a doctor or gynecologist right away.
  • Be familiar with your vaginal chemistry, regularly dip your finger and smell and taste so that if there is any change, you are onto it before any infection gets established.
  • Wearing cotton underwear, especially in hot weather will help you feel fresher because cotton and other natural fibers are more breathable. Synthetic garments limit transpiration and encourage bacteria and odours.
  • Leaving a tampon in for too long increases the risk of infection and Toxic Shock Syndrome** (TSS).
  • Do not dispose of tampons, pads, panty liners or cups down the toilet as they can block the toilet and sewerage system.
  • Avoid faecal contamination of the vagina as it may cause infection, wipe front to back.
  • During your period, change your pads or tampons often and its often a good idea to always have a tampon at hand for you or your girlfriend who is less prepared and to keep a spare pair of knickers in your bag at period time in case of any leakage.

*The suggestion that douching with any substance immediately following intercourse works as a contraceptive is untrue. While it may seem like a sensible idea to try to wash the ejaculate out of the vagina, it is not likely to be effective. Due to the nature of the fluids and the structure of the female reproductive tract – if anything, douching spreads semen further towards the uterus. Some slight spermicidal effect may occur if the douche solution is particularly acidic, but overall it is not scientifically observed to be a reliably effective method.

** TSS is caused by a toxin made by Staphylococcus aureus, a bacteria which may occur from certain super absorbent tampons, especially if they are left in longer than is recommended. It can enter the body from inside of your vagina, then invade the bloodstream, releasing toxins that may cause shock and multiple organ dysfunctions.

Source: The Health Information Network

Signs of pregnancy

The most obvious sign is a missed period, but there are other things to look out for.

Am I pregnant?

Many women don’t suspect they’re pregnant until they’ve missed a period, but there may be other indications, sometimes even before that missed period, too.

  • Sickness and/or feelings of nausea
  • A strange, ‘metallic’ taste in your mouth
  • Breast tenderness, tingling and enlargement
  • The small bumps – ‘Montgomery’s tubercules’ – on your nipples becoming more obvious
  • Stomach pains
  • Tiredness
  • Constipation
  • Needing to urinate more often
  • Going off certain things, such as coffee and fatty foods
  • Increased vaginal discharge
  • Some women experience very light bleeding (called ‘spotting’) that they mistake for their period

When should I do a test?

Home pregnancy tests can be used on the first day of your missed period, and some very sensitive tests can be used sooner than this.

The tests work by detecting the hormone human chorionic gonadotrophin (hCG) in your urine. A chemical in the stick changes colour when it comes into contact with this hormone, so the usual way of testing is to urinate on the end of the stick and watch for the result in the window of the stick.

Pregnancy tests are very accurate as long as you use them properly. It’s possible to have a false negative, when the test says you aren’t pregnant but you are. If your period still doesn’t arrive, repeat the test or check with your GP.

You can buy home pregnancy tests online, in the supermarket or at your local chemist. Some GPs, family planning clinics and young people’s services (such as Brook Centres) offer free tests, as do some pharmacies, the British Pregnancy Advisory Service and Marie Stopes International clinics.

When is my baby due?

The length of your pregnancy is dated from the first day of your last period, even though you actually conceive two weeks or so after this date (depending on the length of your cycle). Your baby is likely to be born two weeks either side of the due date.

Check your due date and what’s happening within your body week by week with our pregnancy calendar. All you need to know is the first day of your last period.

Most women see their GP to arrange antenatal care, but you can book directly with a community midwife if you prefer. Call your doctor’s surgery, or your primary care trust, to find out how to do this.

Does a GP need to confirm my pregnancy?

If you’ve had a positive home test, you just need to tell your doctor. They’re unlikely to test you again. You may be offered a ‘dating’ scan, even if you’re sure of your dates. This is an ultrasound scan done in early pregnancy to find out the size of your uterus and the embryo, to help determine how many weeks pregnant you are.

Source: BBC – Health

Vaginal Discharge(USMLE Algorithms)

by Joseph Medman
This algorithm video clip discusses all the most common causes of vaginal discharge, how to distinguish between them.
These video clips are algorithms that were made specifically for students preparing for the USMLE exams. They have been cross references with the most up to date medical resources, but if you have any questions, or comments, please do not hesistate..ENJOY!!

LEARN MORE Joseph Medman’s Channel

The Good Ol’ Menstrual Cycle

by gutsy

Menstrual cycles can be baffling, and that’s why I really wanted to make this special poster explaining this special time of the month, mostly so I can justify to my poor husband exactly why I am feeling totally insane. “It’s not me, honey, it’s the progesterone spiking,” or, “Can you understand now why I’m being a total bee-yatch? I’ve got at least five different hormones coursing through my body right now. I’m on drugs.” Marvel at the leuteinizing hormone! Be amazed as the estrogen takes a nosedive right before ovulation! Check out the egg as it takes its long journey through your reproductive system! Anyway, check it out and give me feedback — calling all OB/GYNs! Editors! Anatomy nuts! Sex educators! — before I send this thing to the printer. I know it’s a little crazy-looking, design-wise, but then again, so’s the menstrual cycle.

LEARN MORE I Heart Guts

Vaginal Thrush (candida)

Thrush – is one of the more common vaginal infections

There are a number of microorganisms that may cause vaginal infection and several may co-exist.

  • Candida.

Candida vulvovaginitis - vaginal thrush and vulval thrush infection. Note the typical picture appearance like milk-curds.

These are yeast organisms that are found in the vagina in 25% of women usually without any symptoms. The most common species of candida to be found in the vagina is Candida albicans which is an organism that lives in the bowel and can easily be transferred from back to front passage. Symptoms occur when there is an excess of the yeast. High blood sugar levels (diabetes mellitus), pregnancy, antibiotics and steroid administration tend to increase the incidence of candidiasis. An acidic environment encourages the growth of the candida.

Symptoms of vaginal candida.

Typically, acute candida vaginitis (inflammation of the vagina) is accompanied by symptoms of intense irritation and at times pain. vaginal candida is colloquially known as thrush. The discharge is thick and white (described as milk curds). The skin of the vulva surrounding the vaginal entrance may be acutely red.

Recurrent vaginal thrush (vaginal candida). How can this be prevented?

About one per cent of women will have more than six episodes of vaginal candida a year.

Swab tests should be taken to confirm that you really are having bouts of thrush. Whilst most people have heard of thrush, relatively few know about bacterial vaginosis and this is more common than thrush.

It is prudent to exclude underlying illness and to correct other causes of vaginal discharge such as cervical ectropion (erosion cervical erosion).

Preventative measures include

  • Avoiding clothes that keep the genital area moist.
  • Natural fibres such as cotton are preferable to nylon.
  • Underclothes should be thoroughly rinsed.
  • Daily bathing/showering may be helpful
  • but frequent vaginal douching should be avoided as this may remove protective organisms.
  • Irritant soaps and bubble baths should be avoided.
  • Shampoos should not be used in the bath.
  • Use a soft clean towel and dab rather than rub.
  • Rough flannels should not be used.
  • Wiping the anal area from front to back may help to prevent transfer of candida to the vagina; soft toilet paper should be used.

One of the orally active agents may eliminate the reservoir of candida in the bowel although this may subsequently recur.

The objective is to prevent recurrence.

  • As antibiotics may be associated with acute episodes, those particularly at risk should re quest treatment for candida at the same time.
  • The male partner should be offered local or oral treatment.
  • Some women will require regular preventative treatment usually administered after each period.

Related Medical Abstracts:

LEARN MORE Vulvodynia (also called “vestibulodynia”)
Bacterial Vaginosis
Common Vaginal Infections
Vaginal Discharge
Source: 2womenshealth.com
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