Thursday, April 14, 2011

Sexually Transmitted Infections: More Common Than You Think

What you need to know about bacterial and viral STDs

By Kirsten Wengeler MS, APNP
Nurse Practitioner

Sexually transmitted infections (referred to as STIs or STDs), are a group of infections that are transmitted through sexual contact. This sexual contact can be vaginal, oral, or anal and in some cases through intimate skin to skin contact. A person with an STI can pass it to others by contact with the skin, the genitals, the mouth, the rectum or through body fluids. In many cases this person may not even be aware that they have one of these infections and could pass it along.

Some quick facts on STIs include:

• STIs affect people in all age groups, races, and backgrounds
• Centers for Disease Control (CDC) estimates that there are approximately 19 million new STI infections each year
• They cost the U.S. healthcare system $16.4 billion annually
• They cost individuals even more in terms of acute and long-term health consequences

STIs can be broken down into two categories, bacterial and viral.

Bacterial STIs:
• Often has no symptoms, especially in early phases
• Can be treated and cured with antibiotic therapy
• If not found and treated early enough their consequences can be permanent, including infertility
• Examples of bacterial STIs are chlamydia, gonorrhea and syphilis

Viral STIs:
• Often has no symptoms, especially in early phases
• There is presently no cure
• Can cause life-long symptoms and in some cases even death
• Examples of viral STIs include herpes, HPV (Human Papilloma Virus), HIV (Human Immunodeficiency Virus) and Hepatitis B

Limiting Your Risk

There is really no way to have a sexual relationship with another person that does not put you at risk for STIs, unless you are both tested prior to being intimate. However, limiting the number of sexual partners you have in your lifetime reduces your risk of acquiring an STI, and the correct and consistent use of condoms has been shown to decrease one’s risk of acquiring an STI (but does not entirely prevent the transmission of STIs).

The only sure way to protect yourself from an STI is abstinence. This is avoidance of all types of sexual activity. Someone who practices sexual abstinence does not run any risk of contracting an STI or having an unwanted pregnancy.

Ideally you should wait to have sex until you are ready for a long-term relationship with just one person. This person should be equally committed to this relationship and to only having sex with you. Even in this situation, there is a risk of STDs if you or your partner has had other sexual relationships prior to this relationship.

If you are or have been sexually active it is important that you see your healthcare provider for STI testing. Your healthcare provider will also be able to help you assess your risk and provide you with information to reduce your likelihood of acquiring an STI.

Kirsten Wengeler is a Nurse Practitioner at the Neenah location of Women’s Care of Wisconsin. Contact Kirsten at 920-729-7105 or meet her here.

About Women’s Care of Wisconsin: The providers at Women’s Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care. From adolescence through menopause and beyond, you can depend on us. Meet our providers and learn more about gynecology, pregnancy care, infertility, procedures and surgery, incontinence, osteoporosis, menopause and more at

Monday, April 4, 2011

I Want My Body Back!

Reliable, safe exercise tips for after baby is born

By Michelle Landsverk, DPT

So congratulations! You’ve had your baby, and now you’re excited to get back into those favorite clothes that you haven’t worn in quite awhile. You feel like they should fit, because after all, your baby is five weeks old already. But, your jeans are still two sizes too small.

So, what do you do? You promptly jump onto the treadmill, turn up the incline, and start jogging. Fast. For like, two minutes. And then something happens. You notice that you’re wet. Not wet with sweat, just wet. In the saddle region, and at that moment you realize that your body is not quite like it used to be prior to that beautiful baby you now have. The very next thing you do is call your girlfriend, mom, sister, or all three and shout, “DID THIS HAPPEN TO YOU!?” 

It’s true, and it happens all the time. Women have a baby, and then they want to pick up their life where it left off prior to pregnancy. The little story I just told you about is only one of several potential hiccups that new moms experience when they are ready to resume their pre-pregnancy workouts, or simply start exercising altogether.

So, let’s take a step back together and figure out a safe, effective, and successful way to get back into a healthy and active lifestyle once your baby is born. After all, a “simple” thing like going for a jog may not be all that simple. 

The first thing you need to do is take into account exactly how the delivery of your baby went:
• Did you have him or her vaginally, or via c-section?
• If you had the baby vaginally, did you push forever and a day, or was the delivery very fast?
• Did your perineum tear, or did you have an episiotomy?
• If you had a c-section, did your incision heal properly in a timely manner?

These factors may influence how quickly you will feel ready to start a post-pregnancy exercise program.

You also need to think about what exercises you have available to you. For example, many women will begin a running program either because they own a treadmill, or running is easy because all you need to do is step outside. Problem is, when running, each time your foot strikes the ground, there is considerable force on your pelvic floor, like, seven-times your body weight. Think about that for a second. A 150-lb woman running strikes the ground with 1,050 lbs of force with each stride! In my opinion, that’s way too much for any woman until she’s closer to twelve weeks post-partum (I know there are plenty of moms out there who disagree with me, but for the vast majority of American women, twelve weeks is a better guideline).

Many women go to the library and check out exercise DVD’s of various sorts. Often times the most popular DVD’s are those that correspond with the latest exercise fad, or reality TV show. The latest exercise class crazes are definitely zumba and kettlebells, and Jillian Michaels is the most popular exercise guru right now, bar none. Interestingly her video, “30 Day Shred” is one of the most sought after DVD’s for those people interested in weight loss. Now, I don’t want to pick on Jillian too much, after all, she has been and continues to be an incredible vehicle for change. However, one of her promises is “killer exercises.”

Well, I’m here to tell you, as a physical therapist, the number one reason for a failed exercise program is burnout or injury from choosing exercises that are simply too tough for a de-conditioned body. I do in fact see plenty of patients in the clinic who have injured themselves doing a new exercise program. So please, if you do choose to do a DVD work-out, avoid any exercise that doesn’t feel right, or stop doing any exercise that hurts to do.   

Finally, I do need to make one point about working out those abdominal muscles. Oh, our poor abs! First we stretch them beyond recognition, and then we expect them to bounce back with vigor. Second, there’s exercising abdominal muscles in order to get them stronger or more toned…which is the more correct mindset for exercising them. And there’s exercising the abs in order to shed excess fat around the waistline, which is a less healthy to approach exercising them.

Let me explain why: despite the claims of popular infomercials, you cannot spot-train any particular area of the body, especially the middle! In other words, you cannot achieve a smaller waist by simply exercising your abdominals. There are other factors involved. You need to increase your aerobic (cardio aerobic) exercise, AND decrease your caloric intake in order to decrease the size of your midline. This is a very hard concept to grasp for a lot of frustrated women out there, but once you embrace it, you will find that your clothes fit better and you will feel better about your body!

There are some wonderful exercise options out there for women. If you have access to a full-service gym, you can get your cardio aerobic exercise by swimming, and by using various pieces of exercise equipment like the elliptical trainer, recumbent or upright bikes, and rowing machines. Treadmills are excellent, but again, I recommend only walking for the first 12 weeks after your baby is born.

If you don’t have access to the gym, and the weather is agreeable, taking your baby for a walk in the stroller is wonderful for you and him or her. Fresh air is great for the two of you, and the resistance of the stroller will help increase your heart rate for the cardio aerobic workout your body needs.

Resistance exercise, or weight training, is also great. Although I do recommend that you use weights for toning and light strengthening, versus heavy resistance training. Working out with heavy weights, particularly if you are doing standing-type exercises, is not good for your pelvic floor muscles for the first 12 weeks after the baby is born.

And finally, exercise classes, like zumba and yoga will help you with balance, coordination, flexiblity and strength. Plus, exercise classes give you the camaraderie that you might need to draw upon on those days that it is hard to motivate yourself to get going.

My point is really this: there are healthy ways to view exercise, and I’m here to help you pick out good, safe options to lose that baby weight. The healthiest way is to set realistic goals for yourself, and to stick with the basics of diet (i.e. portion control) and exercise. Please realize that your weight wasn’t put on in a few short weeks, and it will not come off in a few short weeks. Eat right, and get your sleep, and pick some exercises that feel right to do. In addition, check out these online resources for post pregnancy exercise tips:

• Post Pregnancy Exercise: Getting Back in Shape
Post Pregnancy Fitness

Michelle Landsverk is a Doctor of Physical Therapy at Women’s Care of Wisconsin/PT Center for Women, 3913 W Prospect Ave, Suite LL2, Appleton, WI 54914. Contact Michelle at 920-729-2982 or meet her here.

About the PT Center for WomenAt PT Center for Women, our focus is on helping women incorporate lifestyle changes that will improve the quality of their lives. This includes gentle therapeutic exercise to both improve and maintain muscle tone, to rehabilitative exercise designed to get you back to your previous level of function and activities. From managing crippling abdominal and pelvic pain, to teaching proper sleeping postures and body mechanics at home and at work, we’re here for women. Learn more at