One
woman described how she'd had two miscarriages already. The first one
was at 21 weeks, the second was at eight weeks. And she found out during
her second pregnancy that she had a dermoid cyst on her right ovary.
And she writes in that we consulted a doctor that said it wasn’t the
cause of my miscarriage, and can I still try getting pregnant? It was
almost a year passed since I had my second miscarriage, and I'm trying
to get pregnant, but what I just observed with myself now is I can't get
pregnant as easily now like before, any advice? First of all, the first
advice is she had two miscarriages, miscarriages are extremely common.
Twenty percent of all pregnancies miscarry before 12 weeks, it's
nature's way of ridding vaginetic products. The miscarriage at 21 weeks
was rather unusual. I'm assuming that this was something that was looked
into, and probably was not a cause of anything that would repeat
itself. The dermoid cyst on her right ovary, well if she knows she had a
dermoid cyst on the right ovary, that must have been removed. We were
probably given part of the information because no doctor's going to
leave a dermoid cyst. As far as her so-called - her concerns about
infertility since that dermoid cyst, pregnancy is not as easy as one
thinks. Pregnancy - the average couple who have intercourse the average
number of times, which is 2.5 times per week will conceive 90 percent of
the time in one year, in two years 95 percent. But you still have ten
percent that are not going to conceive in one year. So one year of lack
of conception is not an infertility concern in my mind. So my advice is
just continue trying, don’t worry about the cyst, and hopefully
pregnancy number three will be absolutely normal. Let's see, there was
something else here. Oh, there is an increasing number of women - since
we mentioned some drugs, we should mention Tamoxifen. Tamoxifen is an
anti-breast cancer drug, the most commonly used. Women are often on it
five years, very effective. The good news is Tamoxifen works, being an
anti-estrogen effect on the breast, it stops the estrogen receptors.
Because breast tumors many times have - they like estrogen. So this
particular anti-cancer drug works by blocking estrogen. But it has some
good news too, it has a positive estrogen effect on bone and on the
heart. And we know that estrogen can be good for bone growth, that's why
many women are given estrogens after menopause. And it can be good on
bone growth and prevent heart disease. The one problem with women on
this particular drug though is that it causes in some cases a slight
increase in uterus cancers, because it has the positive estrogen effect
on the uterus. And it can in some cases increase any cysts that are
there. But to my knowledge there is no evidence that it can cause ovary
cancers. So we have some effects from this powerful anti-breast cancer
drug that are positive, no ovary bad effects except it can cause an
increased size in the cysts. And these would be managed like any other
cysts. I think one thing here is - one woman writes in and she says is
surgery a must for a cyst measuring 20 centimeters? 20 centimeters is
huge. Greater than 10 centimeters is huge. The answer is unequivocally
20-centimeter cyst is in risk of torsion, it should be operated upon, no
questions asked. And we don’t know the age of this woman, but the odds
are most likely in her favor because it's a cyst. And the other one here
is - I have one question I think is very good. Is a hysterectomy the
best option for an ovary cyst on a 68-year-old woman, any other options?
I'm going to answer that because I'm from the school of thought that
says if you're going in for a hysterectomy in the menopausal years, I
believe those ovaries should come out. Now this is Doctor Christopher
Freeville's philosophy, many colleagues agree with me, some do not. But
the ovary has very little function after menopause. At menopause it
doesn’t have any except it can serve as a place for bad tumors and bad
cysts to grow. So if for some reason one has to have a hysterectomy at
the menopausal time in life, my strong recommendation would be discussed
with your doctor should the ovaries come out. Because unfortunately,
ovary cancers, which are not really the topic of this discussion, often
don’t show up and have symptoms until they're somewhat progressed.
That's something I wanted to throw in there.
5 Heart Healthy Exercises You Can Do During Pregnancy
Pregnancy
is a time of celebration, love, and unwanted but necessary weight gain.
However, being pregnant doesn’t mean that your health and figure has to
suffer permanent damage. You can gain weight in a healthy fashion while
doing some very easy and safe heart healthy pregnancy exercise
routines. One of the simplest and most effective pregnancy exercises you
can do is walking. Not only is walking one of the best cardiovascular
exercises, it is also one of the safest pregnancy exercises you can
engage in. Walking is one of the few pregnancy exercises that you can do
for the complete duration of your pregnancy. Another extremely
beneficial heart healthy pregnancy exercise is swimming. Countless
doctors and pregnant women have attested to the wonderful benefits of
swimming during pregnancy. A weekly pregnancy exercise routine of
swimming gives both the arms and legs a great workout while promoting
cardiovascular health. Because of the nature of being subdued in water,
swimming will also remind expectant mothers what it felt like before the
pounds were added on. This is definitely a welcome change every now and
then. The third pregnancy exercise routine you can start doing to keep
your body healthy is enrolling in an aerobics class. Many fitness
centers and community centers offer low impact aerobics classes for
pregnant women. One of the nicer benefits of this pregnancy exercise is
that it is done in the company of other pregnant women under the
watchful eye of a professional aerobics instructor. This means you are
going to get a safe workout catered to the special needs of pregnancy.
Weight training is also a very beneficial pregnancy routine to keep your
body healthy. Although you must only use very light weights when
engaging in this pregnancy exercise, weight training is an excellent way
of toning your body and increasing muscular strength. The last heart
healthy pregnancy exercise you can do to stay fit is Pilates/yoga. Both
of these body conditioning exercises promote stretching and flexibility
within the muscles. Yoga is also a nice accompaniment to walking. By
doing a combination of these pregnancy exercises, you can have a healthy
balanced cardiovascular routine. Being pregnant doesn’t mean that you
have to sacrifice exercise and health. By walking, swimming, doing
aerobics, weight training, and engaging in a Pilates/yoga routine, you
can have a healthy and fit pregnancy.
WHAT IS AN ECTOPIC PREGNANCY?
The
dictionary definition of the word ‘Ectopic’ is an organ or body part
existing in an unusual position or form. In simple terms, an ectopic
pregnancy is a pregnancy, which is developing in the wrong place. An
ectopic pregnancy occurs when the fertilized egg (or ovum) fails to move
down the fallopian tube and into the womb (or uterus) in the normal
manner. Instead, the egg or ovum implants itself outside of the womb.
Most often, (in 95% of cases), ectopic pregnancies develop in a
fallopian tube and rarely, elsewhere in the abdominal cavity or pelvic
area. For example, an egg can attach itself on an ovary, on the neck of
the womb (cervix) or on another organ within the pelvic or abdominal
area (1.5% abdominal, 0.5% ovarian & 0.03% cervical). Ectopic
pregnancies do not usually survive and many will result in a spontaneous
miscarriage, others will develop until a serious problem becomes
apparent, which will require immediate medical attention.
WHAT CAUSES AN ECTOPIC PREGNANCY?
Sometimes
the ovum fails to implant itself and it becomes fertilized outside of
the reproductive system. More commonly, the fertilized ovum is trapped,
in the fallopian tube and the baby continues to grow inside the tube
where it can cause the tube to burst or otherwise severely damage it. A
burst tube is life threatening and requires urgent medical attention. In
many cases, ectopic pregnancies occur when the expectant mother has
damaged fallopian tube(s). Tubes damaged, by infections such as pelvic
inflammatory disease or by previous surgery, scar tissue, endometriosis
or previous ectopic pregnancies are a high-risk factor, which
significantly, increase the likelihood of a pregnancy being ectopic.
Another risk factor associated with ectopic pregnancies is becoming
pregnant, whilst using a contraceptive-coil or a progestogen only
contraceptive pill. Pregnancies resulting from in vitro fertilization
(i.e. test-tube methods) can be ectopic - even though, the fertilized
egg is placed directly into the womb, it may still attach itself
elsewhere. In some cases, none of the above risk factors are present in
the expectant mother.
WHAT ARE THE WARNING SIGNS OF AN ECTOPIC PREGNANCY?
Pain
In the Abdomen - The first sign of an ectopic pregnancy can be a pain
on one side of the abdomen. This pain can be constant and severe and its
onset, sudden. Pain in the Shoulder - An alternative warning sign could
be a pain in the shoulder, which intensifies when breathing in and out.
Pain Using the Lavatory - If you suspect you are pregnant and
experience pain during visits to the bathroom you should report this to
your medical practitioner. Other Warning Signs Vaginal bleeding or
unusual periods, lighter or heavier than normal, or a strange color etc
Sickness Diarrhea Pallid complexion (paleness) Light-headedness Collapse
Increasing pulse rate Falling blood pressure
DIAGNOSING AN ECTOPIC PREGNANCY
Ectopic
pregnancies can be hard to detect as in many cases, the symptoms are no
different from those of a normal, early pregnancy, i.e. tender breasts,
nausea, vomiting, missed periods or frequent urination. If you are a
sexually active woman of childbearing age and you experience symptoms of
an early pregnancy plus any, of the above warning signs, of an ectopic
pregnancy, contact your medical practitioner immediately. A urine
pregnancy test will usually be positive but is not always apparent.
However, a specialized hCG blood test will always show a positive
result. If a pregnancy is ectopic, the womb will often be smaller than
the average womb at that stage of pregnancy and this will be detected
during an internal pelvic examination. A doctor can sometimes detect a
swelling, during an internal examination, which is evidence of an
ectopic pregnancy existing. An ultrasound scan will differentiate
between a possible miscarriage, a normal pregnancy and an ectopic
pregnancy. The majority of women diagnosed with an ectopic pregnancy
will require surgical intervention and/or medication. In the worst-case
scenario, without this intervention, an ectopic pregnancy can be fatal
to the mother. Medical and technological advancements mean that ectopic
pregnancies are easier to detect than ever before and therefore, they
carry less risk than they did in previous years. Technological
advancements have significantly improved the treatment of ectopic
pregnancies - keyhole surgery is just one example of this. It is vital
to seek the opinion of a medical practitioner if you suspect you are
carrying an ectopic pregnancy.
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