Monday, May 23, 2011

To Worry or Not to Worry?

What to expect and what to be concerned about during the first few weeks of pregnancy.

By Sreedevi Sreenarasimhaiah, MD
Obstetrician/Gynecologist



Congratulations! You’re pregnant. This is the start of a wonderful journey. However, your body is going through many changes and it may be hard to know what is to be expected and what are reasons for concern.





Nausea & Breast Tenderness
Nausea and breast tenderness are one of the first symptoms that women experience. This is because of the rise in hormone levels in the body.

Human chorionic gonadotropin, also known as HCG, is the pregnancy hormone responsible for the nauseated feeling. Some women are more sensitive to the hormone than others. Some women will have vomiting. Vomiting is not dangerous to the baby and does not mean that anything is wrong with the pregnancy. Sometimes, women can be miserable if it is severe.

There are many conservative remedies to help with nausea, but if your condition is severe, call or see your healthcare provider to discuss measures you can take. A warning sign for the need for medical attention is the inability to keep even liquids down, like water or juice. Dehydration can occur if it is not controlled quickly.

Typically, nausea and vomiting typically improves by the completion of the 3rd month of the pregnancy.

Vaginal Bleeding
Another symptom that is important to discuss with your doctor is any vaginal bleeding that may occur. Vaginal bleeding can vary from as much as some spotting or old brown discharge to bleeding that requires a pad or sanitary napkin. Your doctor will want to make sure that bleeding is not because of a threatened miscarriage and may need to do a pelvic exam.

Not all bleeding is bad and does not mean the pregnancy is at risk. Sometimes bleeding can be seen with implantation of the pregnancy or with sexual activity as the surface of the cervix is easily irritated in pregnant women. In such cases, the bleeding is usually very minimal. Bleeding of any amount, however, should be discussed with your doctor.

Vaginal Discharge
Women may notice changes in vaginal secretions during this time. A mucous-type discharge or white discharge may be present. This is normal as the body develops a natural barrier for protection of the cervix during pregnancy. However, signs of a discharge that is not normal is that which itches, has a foul odor, or may have a curd-like appearance. You are encouraged to report such discharge to your healthcare provider.

Fatigue
A feeling of fatigue is very common during the first few weeks. The need for more sleep is also common and normal. This again is hormone mediated and will improve as the pregnancy progresses.

Aches & Pains
Finally, some general aches and pains, specifically on both sides of the groin area, are to be expected. This is called “round ligament pain.” These are the ligaments that support the uterus that are being stretched as the uterus grows. This pain may be crampy, but should not be severe or constant.

If you have pain that is severe or is associated with any fevers or bleeding, this is not round ligament pain and could be something else that requires immediate attention. Notify your doctor.

Baby Movement
During the first few months, you will not be able to feel the baby move. Movement of the baby may not be felt until the fifth month. This is normal. Until then, reassurance can be provided by hearing the baby’s heart beat on monthly visits by a doppler exam.

The first few weeks are full of changes, but it is the road to an amazing journey! If you are being seen by a Women’s Care provider, we encourage you to make an appointment and be seen in our office between 8 and 10 weeks of pregnancy.

Dr. Sreedevi Sreenarasimhaiah (“Dr. Sree”) is an Obstetrician/Gynecologist at the Appleton and Neenah locations of Women’s Care of Wisconsin. Contact Dr. Sree 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 http://www.womenscareofwi.com/.

Monday, May 2, 2011

Vulvovaginal Health: What Every Woman Needs to Know

The facts about women’s most private parts and tips on how to keep them healthy.


By Tatyana Shereshevsky, MD
Obstetrician/Gynecologist



Vulvovaginal health is an important area of women’s health, yet is often overlooked or disregarded. Knowledge about and comfort with your body, including the genitalia, is vital to maintaining good health.




Introduction to female vulvar anatomy or the 3 V’s: vulva, vestibule and vagina.

1. The Vulva.

The vulva is outside the body. It includes all the outer genitalia you can see between your legs. The vulva protects the women’s sexual organs, urinary opening, vestibule and vagina.

The vulva begins at the top with the mons, made mainly of a fat pad and covered with pubic hair. All together, it provides a cushion during sexual intercourse. The mons leads down on each side to the labia majora, that are also covered with pubic hair. The labia contain a fair amount of fat to act as a cushion for sexual intercourse as well.

The outer lips, or labia majora, surround two smaller, thin flaps of skin without hair, the labia minora. These are part of the protective covering for the vestibule, urethra and vagina. The inner lips of the labia minora might be visible or not. Either appearance is normal anatomy. In cases of significant enlargement, it can cause sexual discomfort, hygiene problems and pain with physical activities. If so, it might require medical attention.

The main function of the labia minora is sexual. At the top, labia minora meet under the clitoris and above the clitoris to form a hood.

2. The Vestibule.

The area between the labia minora is the vestibule. The name fits. Like the lobby, the vestibule is the site of two doorways: the urinary opening (urethra) and vaginal opening (introitus) lower. There are a few sets of glands that open into the vestibule. The major ones are Bartholin’s glands, which reside on the either sides of the vaginal opening. Their role is to assist in lubrication.

The thin membrane with one or more tiny openings in the middle of it that surrounds the vaginal opening is called the hymen. The hymen is a membrane of tissue at the opening of the vagina. It covers the opening of the vagina from birth until it is ruptured vaginal penetration, delivery, a pelvic examination, injury or sports. It has no known biological function.

3. The Vagina.

The vagina is truly inside the body. The vagina is a tube-like passage from the vulva to the cervix, which is the portion of the uterus that projects into the vagina. It is through a tiny hole in the cervix that sperm make their way toward the internal reproductive organs. The vagina is usually six to seven inches in length, and its walls are lined with mucus membrane and numerous tiny glands that make vaginal secretions.

The stretch of skin between the vagina and anus is called the perineum. Its skin covers a muscle called the perineal body. Providing resistance, it plays an important role in delivering babies.

Everyday Habits to Maintain Good Vulvovaginal Health.

1. It is so worth repeating: eat well, get adequate sleep, and exercise 2-3 times a week. Good general health is the best defense against infection and diseases.

2. Have smart sex. That means have one partner and use a condom.

3. Douching might destroy the normal bacteria in the vagina.

4. Avoid scented deodorant tampons or pads and spraying perfumes in the vaginal area.

5. Use tampons wisely. Choose the right absorbency tampon and change it regularly every 2-6 hours. A menstrual period usually produces around 4 to 12 teaspoons of menstrual fluid, about 20-60 gm.

6. Rethink powders. Corn starch is safer than talcum.

7. Loosen up. Thongs, bodysuits or tight spandex garments can trap sweat and feel abrasive.

8. Bathe right. Limit your time in hot showers or baths to 3 minutes. Mild soaps such as Dove, Basic, or Neutrogena are advisable. Never scrub the vulva. Occasional soaks in not-too-hot bubbles are fine. Lavender, rosemary, and clove oils should be diluted.

9. Wash diaphragms, cervical caps, spermicidal applicators and sex toys periodically.

10. Do not wear a pad or panty liner every day. It can be abrasive and irritating.

By educating yourself and being proactive about your feminine health, you can avoid discomfort, infections and diseases and ensure that you and your body are happy and healthy.
  
Dr. Tatyana Shereshevsky is an Obstetrician/Gynecologist at the Neenah and Oshkosh locations of Women’s Care of Wisconsin. Contact Dr. Shereshevsky 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 http://www.womenscareofwi.com/.