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Vitamin D has been a hot topic in the news over the past few years. With so much information coming out so quickly, it is easy to get overwhelmed and confused. Here is our take on what women need to know about Vitamin D and their health.
What is Vitamin D?
Vitamin D is a nutrient the body needs in order to maintain health. It is well-known for helping the body absorb calcium and for creating strong bones, but it is important for muscles, nerves, and the immune system too. It also plays a part in preventing many common diseases, including hypertension, diabetes, and cancer.
What are the sources of Vitamin D?
The sun can be a great source. Your body makes its own Vitamin D when your skin is exposed to direct sunlight or when you use a tanning bed. For most of the United States, the sun is not at the correct angle during the winter, but getting sun on your face, arms, and legs at midday during the summer helps increase your Vitamin D level. The length of time you should stay in the sun depends on how much skin is exposed and the color of your skin. Fair skin requires less time in the sun than darker skin. To reduce your skin cancer risk, however, sunscreen use is recommended if you are going to be exposed to sunlight for more than a few minutes, and sunscreen unfortunately prevents your body from making Vitamin D. The bottom line: It’s not easy to get all of your Vitamin D from the sun, and it’s not even possible in the winter.
Just a few foods naturally contain Vitamin D. Fatty fish such as sardines, salmon, herring, tuna, catfish, and mackerel have a lot, and mushrooms and eggs have a little. Foods like milk, cereal, orange juice, and soy foods are often fortified with Vitamin D.
Vitamin D is also available as a supplement. It’s a good idea to talk to your doctor about whether you need a supplement and how much you should take.
Should I be concerned about my Vitamin D level?
It is important for women to get enough Vitamin D, especially because women are at increased risk of bone loss as they get older. If you spend most of your time indoors, if you always wear sunscreen when you go outside, and if you don’t eat many of the foods that give us Vitamin D, you should talk to your doctor about having your Vitamin D level checked. Other groups that are at-risk include: the elderly, people with dark skin, people who are obese, and people who have cystic fibrosis, irritable bowel syndrome (IBS), or liver disease. Signs and symptoms may include bone pain and muscle weakness, but symptoms are often subtle. Many women are not getting enough Vitamin D.
On the other hand, it is possible to get too much Vitamin D too. This is an uncommon problem that occurs when someone gets too much Vitamin D from supplements. You will not get too much Vitamin D from the sun because your body knows when you have enough and will stop making it. Signs and symptoms of too much Vitamin D include fatigue, nausea, vomiting, and irregular heart rhythm. Bone pain and muscle weakness also fall into this category, so they can signal either too much Vitamin D or too little.
How can I check my Vitamin D level?
Your doctor can order a simple blood test to check your Vitamin D level. Doctors are well aware of the benefits of Vitamin D and the problems that come from not getting enough Vitamin D or from getting too much Vitamin D, and they can answer your questions and determine whether you need a blood test. If your Vitamin D level is low, your doctor will recommend over-the-counter supplements in most cases, or he or she will prescribe a higher dose of Vitamin D if needed. Your doctor will monitor your Vitamin D level over time and adjust your amount of supplementation.
As you can see, Vitamin D is an important nutrient that helps your body in many ways. Too little Vitamin D can cause health problems, but the good news is that getting enough is easy through a combination of sunlight, food, and possibly supplements. When it comes to Vitamin D, a fun and relaxing trip to the beach or pool may be just what the doctor orders!
Are your New Year’s resolutions still going strong? If so, congratulations! For most of us, our 2011 resolutions are already history, but that’s no reason to put off better health and more happiness until next year. Here are some simple ways you can improve your health and increase your happiness starting right now.
- Be Good to Yourself: We all must find time to be good to ourselves in order to be as happy and healthy as possible. Women notoriously feel guilty about taking time for themselves, but balancing your needs with the needs of others is absolutely necessary. If the idea sounds foreign, start by doing something small: read a book, call a friend, take a walk, cook your favorite meal, or take a nap. Schedule 10 minutes a day to meditate or engage in a hobby. Learn to say no when you’re asked to do too much. In short, actively work toward your own joy and balance.
- Eat Well: Food is one of life’s great pleasures, so make sure to eat food that you enjoy. At the same time, food is the fuel we use to build and maintain our bodies, so consuming nutritious food is very important. The U.S. government just released new dietary guidelines last week, so now is a great time to change your eating habits. The guidelines state that we should eat less food overall, fill half of our plate with fruits and vegetables at every meal, choose foods that show low sodium on the Nutrition Facts label, and drink water instead of sugary drinks. You can find much more information about the new guidelines and eating well at http://www.cnpp.usda.gov.
- Get Appropriate Health Screenings: Preventive screenings can help identify and treat developing health issues in the early stages. All women should have a yearly exam every year starting three years after becoming sexually active, or by age 21. As we wrote in a previous posting, yearly exams consist of a complete pelvic and breast exam and a pap smear to screen for cervical cancer. Your doctor may recommend more screenings for you depending on your health history, family history, and age. Screenings to consider include those for: colorectal cancer, breast cancer (mammogram), osteoporosis, diabetes, high cholesterol, high blood pressure, depression, and sexually transmitted diseases. Many insurance companies now cover the cost of several preventive screenings. Call the customer service phone number on your insurance ID card to learn about your preventive screening benefits.
- Make an Action Plan to Reduce Stress: Stress is a powerful force we all deal with, and too much stress negatively affects both health and happiness. To handle stress better, start by listing out all the stressful aspects of your life. Identify your biggest stressor and brainstorm changes you can make to lessen the level of stress it causes you. Make a realistic action plan and take small steps toward change. It might help to get support from family, friends, support groups, or online chat groups. Once you have success changing a stressful situation for the better, you’ll feel empowered to tackle other stressors in your life. Exercise also works wonders in dealing with stress, so make sure to keep up an active lifestyle!
- Know the Symptoms of Heart Disease in Women: Do you know that indigestion, unusual fatigue, sleep disturbances, shortness of breath, nausea, dizziness, sweating, and anxiety are common female symptoms of a heart attack? Heart attacks have long been associated with men, but according to the Mayo Clinic, more women than men die of heart disease each year. This is partly due to the fact that many women don’t experience intense chest pain or discomfort—the obvious symptoms of a heart attack, and therefore they believe they are suffering from indigestion, stress, or something else not related to the heart. Talk to your doctor about your risk factors and to learn more about heart disease in women, and take heart-related symptoms seriously.
You can be good to yourself, eat well, get appropriate health screenings, make an action plan to reduce stress, and know the symptoms of heart disease in women starting today. Here’s to a healthier and happier 2011!
Eating a nutritious and varied diet is extremely important during pregnancy, and our post “Nutrition During Pregnancy” gave basic nutritional guidelines about what to eat while you are pregnant. There are a few scenarios, like experiencing cravings for certain foods and experiencing morning sickness, which can complicate things. There’s no need to worry, though. You can overcome these challenges!
How should I handle cravings?
Food cravings are natural and can be very interesting. Cravings are often for sweet or salty foods, but they can also be for spicy, fatty, or sour foods. The best way to handle food cravings is to accept them and enjoy a small amount of whatever food you are craving.
Nobody knows exactly why cravings occur during pregnancy, but they may have to do with changing sensitivities to smells and tastes or the body’s need for extra calories. Some cravings may even signal nutritional deficiencies. Craving red meat and ice, for example, might be associated with iron deficiency, and craving chocolate might indicate that you need more magnesium or B vitamins. Focus on balancing the foods you crave with a nutritious diet, and ask your doctor about any concerns you have.
Occasionally some women crave very unusual non-food items like dirt, chalk, or toothpaste. This rare condition is called pica and usually indicates mineral deficiencies in the body. If you experience pica, call your doctor and do not give in to non-food cravings.
What should I eat when I have morning sickness?
Despite its name, morning sickness can actually occur at any time of day. Morning sickness is thought to be partially caused by the rapid hormonal changes taking place inside your body, but fluctuating glucose levels and a heightened sense of smell during pregnancy may also play a role. Morning sickness can be triggered by an empty stomach, but instead of feeling hungry, you may feel nauseated or you may vomit. Then again, you may feel nauseated on a full stomach too.
While every woman has a different experience, these general tips are useful:
- Eat small, frequent meals. Try not to go without eating for more than three or four hours during the day.
- You may want to avoid foods that have strong scents (such as onion or garlic).
- It may help to have someone else prepare the food (a great reason to have your husband or partner make dinner!).
- Some women find they need to avoid spicy and greasy foods.
- In general, foods that are low in fat and high in carbohydrates (crackers, popcorn, toast) help with nausea.
- Some women find they need to include a source of protein with each meal, especially at breakfast.
- Morning sickness is different for everybody, so experiment with these suggestions and see what works best for you!
When most foods are making you feel nauseated or causing you to vomit, eat whatever sounds good to you. If you can’t bring yourself to eat food, the most important thing is that you stay well hydrated. Drink juice, tea, water, soy milk, or miso broth. You may not be able to drink large quantities of liquid at one time, but try to take one sip every 10-15 minutes or chew on ice chips. You can also try lemon juice, lemon drops, vitamin B-6, ginger, or half of a Unisom tablet. Then resume a balanced, nutritious diet when you can. If none of these ideas help or you are persistently vomiting, call your doctor.
Although experiencing food cravings and morning sickness can make it harder to maintain a nutritious diet during pregnancy, you can definitely still do it. Variety of food and consistency in eating are key, so make sure to eat a wide range of healthy foods that you like every few hours, and talk to your doctor about any problems that come up. Happy eating!
Are you exercising regularly? It’s a question that can bring on groans and guilt. The reality is that many people read, talk, or think about exercising more than they actually do it. You know exercise is good for you and you know your doctor is going to ask you about it, but are you actually getting up and being active? If not, we hope to get you moving!
Why should I exercise?
You should exercise because your body was designed to move. Modern life—with office jobs, cars, and comfy couches—allows us to survive without exercise, but your body still craves movement and needs physical activity for optimal health. Exercise provides so many health benefits it’s hard to keep track of them all!
- Exercise helps prevent or manage chronic health conditions like heart disease, osteoporosis, diabetes, and cancer.
- Exercise promotes weight loss.
- Exercise helps you sleep better.
- Exercise boosts your energy level.
- Exercise strengthens your muscles and tones your body.
- Exercise can prevent and help treat depression.
- Exercise keeps your bones strong.
- Exercise relaxes you and helps reduce stress.
- Exercise promotes a strong immune system.
- Exercise can increase your libido.
- Exercise improves circulation and lowers your heart rate and blood pressure.
- Exercise can improve your complexion.
- Exercise can be fun, especially when you play a group sport or work out with a friend.
- Exercise can make you feel happier and more alive!
What if I don’t have time and don’t belong to a gym?
You can make some small changes today. Walking is great exercise, and it’s easy to add more walking into your daily routine.
- Take the stairs instead of the elevator from now on.
- Park in the furthest parking spot from the door.
- Walk on your lunch break, even if you only have 10 minutes to spare.
- Walk on a treadmill or simply march in place while you watch T.V.
- Catch up with a friend by walking together instead of talking on the phone.
- Walk instead of driving to the store, library, supermarket or anyplace that’s close enough.
Cleaning, dancing, and raking leaves count too. If you’re up and moving around, you’re exercising.
Recent studies show that as little as 10 minutes of physical activity improve your health. Thirty minutes per day several times a week is recommended, but 30 minutes can come in 10-minute chunks—whenever you can make time throughout the day.
How could I start an exercise routine?
If you want to begin an actual exercise routine, there are many things to consider:
- If you have any serious medical conditions, you should contact your doctor before starting to work out. Your doctor will let you know of any exercise restrictions for your medical conditions and medications.
- Think about what kind of exercise you want to try. Choose a realistic option for your fitness level, and choose something that interests you and sounds like fun.
- Decide when and where you will work out.
- Decide whether you would rather work out alone or with someone. If you would like company, figure out who would be a good workout companion.
- Come up with some realistic goals—and some rewards!
- Tell your friends and family about your plans, and think of at least one role model. Supportive people and role models can help you keep up your momentum.
- Get some athletic shoes, clothing, and any other necessary gear if you don’t already have them.
Any tips for my first work out?
- Always begin and end your workout routine with stretching. Some gentle warm-up and cool-down stretches will make the workout much easier on your body and help prevent strain, soreness, and injury. Think of stretching as part of the workout and be sure to leave time for it!
- Even after stretching, it’s very important to start a new exercise routine slowly—and we know this can be hard to do when you are excited to get going and see results. Keep in mind that if you push yourself too much too soon, you could end up with pain and injuries that prevent you from continuing to work out. You might also find that you lose your enthusiasm quickly. These are classic beginner’s mistakes, so really try to take it easy at first.
- Congratulate yourself for making exercise a priority. Smile and enjoy your workout!
Once you go from thinking and talking about exercise to actually adding more activity into your life, you’ll begin to reap the health benefits listed above. Before you know it exercise will become a natural part of your day, and when someone asks you if you are exercising regularly, you’ll be able to smile and tell them all about it!
You might expect teenagers to become pregnant without planning on it, but did you know that many women in their 20’s and 30’s also have unintended pregnancies—while using contraception? It’s hard to believe, but every year more than 1 million American women get pregnant while using birth control. In our last blog entry, we listed contraception methods and their effective rates, and you may have noticed that most methods fall in the 94%-99% effective range. So how are so many women on birth control getting pregnant?
The answer is usually human error. Many women either use their birth control incorrectly or they use it inconsistently.
The good news is that you are in control and can minimize your risk of having an unplanned pregnancy while on birth control. The table below shows the biggest mistakes to watch out for and tips to maximize effectiveness.
| Contraception Method |
Biggest Mistakes |
How to Maximize Effectiveness |
| The Pill |
- Forgetting to take the first pill in the pack
- Forgetting to take other pills in the pack
- Not taking pills at the same time each day,
- Taking medicine that reduces the effectiveness of the pill.
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- Make sure to take the first pill on the correct day.
- Create a routine to help you take your pill at the same time each day.
- If you miss a pill, use a backup method of birth control.
- When you start taking the placebo pills, check to see whether you have another pill pack. This gives you plenty of time to go to the pharmacy if you are out.
- If you begin taking a new medication, make sure your doctor knows you are on the Pill.
|
| The Patch |
- Forgetting to apply a new patch on the correct day.
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- Apply a new patch at the same time as something else you do weekly, like making a grocery list.
- Apply the patch to dry skin that doesn’t have lotion or oil on it.
- Make sure that your patch is in place after swimming or exercising, and always have an extra patch just in case one does fall off.
|
| Intrauterine Device |
- Forgetting to check for the string once a month to make sure the IUD is correctly positioned.
|
- Wait at least six weeks after having a baby before you get an IUD. This makes it less likely to fall out.
- Show up for your follow up visit so your doctor can make sure the IUD is in place.
- Ask your doctor to teach you how to check for the string.
- If you can’t find the string, use a backup method and make an appointment with your doctor.
|
| Vaginal Ring |
- Forgetting to insert a new ring on the correct day.
- For women who choose to take the ring out during sex, forgetting to reinsert the ring after sex.
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- Ask your doctor to watch you insert the ring to make sure you are doing it correctly.
- Check for the ring after sex to make sure it’s still there and positioned correctly.
|
| Subdermal Implant |
- Good news—you really can’t make a mistake.
|
- Your doctor inserts it into your upper arm, and it’s effective for three years. In rare cases, it may come out if it wasn’t placed properly or if you develop an infection in the area.
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| Depo-Provera |
- Forgetting to get your shot
- Not getting your shot in the correct timeframe.
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- Schedule your appointment with a few days to spare in case you have to reschedule.
- To ensure accuracy, figure the timeframe you’re due for another shot by weeks instead of months.
|
| Diaphragm / Cervical Cap |
- Forgetting to use it
- Failing to place it properly
- Not using spermicide with it
- Storing it incorrectly.
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- Ask your doctor to watch you insert it to make sure you know how to place it correctly.
- Use fresh spermicide every time you have sex.
- Clean it with soap and water
- Store it in a cool, dry place. Keep it away from sun and heat because they can break down the material.
- Have your doctor refit you every year, and get refitted if you gain or lose 10 pounds or more, or if you have a baby vaginally.
|
| Spermicide |
- Forgetting to use it
- Inserting it more than an hour before sex
- Not using enough
|
- Insert the recommended amount no more than an hour before having sex.
- You can increase effectiveness by using with a barrier like a condom or diaphragm.
- To be extra safe, avoid sex during days 10-18 of your cycle.
|
| Condom |
- Forgetting to use it
- Applying improperly—too early on a non-erect penis which can cause it to slip, or too late after penetration has occurred.
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- Use a new condom every time you have sex
- Apply it to an erect penis.
- Apply the condom before you begin to have sex—don’t wait until later on.
- Make sure to open the package carefully so you don’t tear the condom.
|
| Female Condom |
- Forgetting to use it
- Not inserting it correctly
|
- Make sure to follow insertion instructions
- Use a new female condom every time you have sex.
|
| Male Sterilization |
- Forgetting to use a backup method for the first three months.
|
- Make sure to use a backup method for three months after the surgical procedure.
- Sterilized men should follow up according to their doctor’s instructions to make sure they no longer ejaculate sperm.
|
| Female Sterilization |
- Good news—you really can’t make a mistake.
|
- This method is effective immediately.
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Some surprises are great, but an unplanned pregnancy can be unsettling and stressful. To avoid this type of surprise, make sure you always use your contraception method correctly and consistently. Remember that mantra, and you will decrease your chances of having an unplanned pregnancy.
Ok ladies, let’s be honest. We’ve all had questions related to OB/GYN issues that we didn’t feel like actually asking anyone–even our doctor. Maybe you’ve asked your friends or read magazine articles but wondered if you were getting accurate information. We, the OB/GYN doctors at Women’s Health Associates, decided to bypass the question asking and simply address several sensitive questions by giving a series of presentations in the Kansas City area. We found that women were very receptive to this topic and wanted to hear the answers as long as they didn’t have to ask the questions. Over the next several blog entries, we’ll be addressing OB/GYN issues you may have questions about. You’ll get the facts you need without having to ask the questions!
Do I really need a yearly exam every year? Why?
The answer is yes! A yearly exam provides you with a complete gynecological checkup at a regular interval. During a yearly exam, your doctor checks for any abnormalities in your pelvic area and breasts, and a pap smear is performed to check for abnormal cells that could lead to cervical cancer. A pelvic exam consists of your doctor feeling your uterus and ovaries in order to check for enlargement or masses, and your doctor will also examine your genital area visually for any lesions. During a breast exam, your breasts are palpated to check for masses and your lymph nodes are checked for enlargement. To perform a pap smear, your doctor will insert a speculum into the vagina and then use a small brush in order to get a sample of cervical cells. The cells are then sent to a laboratory to be screened. In addition, yearly exams give you the opportunity to ask personal health questions and discuss health concerns with your doctor. Yearly gynecological exams are important so that any abnormality or problem can be recognized and treated as soon as possible.
Do I still need a pap smear if I’ve had the Gardasil vaccine?
Yes. Gardasil is a vaccine that helps protect you from four strains of Human Papillomavirus, or HPV. Gardasil protects against the two strains of HPV that are most likely to cause cervical cancer, as well as two strains of HPV that cause genital warts. This protection is beneficial, but keep in mind that there are over 100 strains of HPV. A pap smear screens for abnormal cervical cells, which can develop from other strains of HPV or separately from HPV entirely, and detects cell changes that may be an early sign of pre-cancer of the cervix.
What should I do to smell better / look better “down there” for the doctor?
Simply take a shower. You don’t need to do anything extra before coming in for an exam. We recommend that you don’t douche (ever) because douching can actually bring on vaginal infections. For the 24 hours prior to your exam, you should avoid having intercourse and using vaginal medications, spermicides, or lubrication. Also, make sure to schedule your exam for a day when you won’t be on your period.
May I keep my socks and/or shoes on during my exam?
Yes. Socks and shoes may be left on, but all other clothing items need to be removed for the exam.
Why do pap smears and vaginal exams sometimes hurt?
Pap smears and vaginal exams can be uncomfortable for many reasons including vaginal dryness, vaginal infection, or anxiety. Placing a speculum in the vagina exerts some pressure on the vagina, which can cause discomfort for some people. We tell women that they may feel some pressure during the exam, and most women find pap smears and vaginal exams tolerable when this is explained beforehand.
We hope you find the above information about yearly exams helpful. Over the next several blog entries, we’ll be addressing many more OB/GYN issues you may have questions about. Check back to learn the answers without having to ask the questions!
Are you thinking about becoming pregnant? If so, you’ve probably got a lot of exciting thoughts running through your mind. You might be making lists of baby names or picking out colors for the nursery. You might also be thinking about health changes you’ll make when you’re pregnant. Pregnancy is a special experience in a woman’s life, and many women know they should take extra good care of their health while they’re pregnant.
Did you know that a healthy pregnancy can actually begin even before conception? You can take charge of having a healthy pregnancy and a healthy baby before you even become pregnant by taking care of your health now.
The basics of a healthy lifestyle lay the foundation for a healthy pregnancy:
- Get into the routine of eating healthy meals—lots of fiber, low in fat, and include lots of fruits and vegetables. If you are a vegetarian, make sure you are getting enough protein.
- Exercise 3 or more times each week
- Get to within 15 pounds of your ideal body weight, which is based on your body mass index and calculated by age and height.
In addition:
- Take a daily vitamin that includes 400 micrograms of folic acid. This reduces the chance of some birth defects and congenital heart disease.
- Go to the dentist. It’s best to get any dental work you need taken care of before you become pregnant.
- Make an appointment with your primary care physician. Tell your doctor you are trying to become pregnant so the prescription and over-the-counter medications you take can be evaluated for safety during pregnancy.
- Your doctor may order blood tests to check your immunity to certain diseases, such as rubella and chicken pox, even if your vaccinations are up to date. If you are no longer immune, your doctor may recommend receiving the vaccination before you become pregnant.
- You may want to consider genetic testing for diseases such as Cystic Fibrosis, Sickle Cell Anemia, Tay-Sachs disease, and Canavan disease.
The first weeks of pregnancy are crucial to a baby’s development, and many women don’t know they are pregnant right away. If you are trying to become pregnant:
- Don’t drink alcohol
- Don’t smoke
- Don’t use recreational drugs
- Minimize your exposure to hazards such as lead, solvents, x-rays, and other potent chemicals.
- Avoid drugs used to treat acne.
These substances can cause your baby to develop abnormally and can lead to birth defects.
In addition:
- Take precautions to limit your risk of getting a sexually transmitted disease. Avoid having multiple sexual partners, avoid partners who use intravenous (IV) drugs, and avoid partners who have other sexual partners. STDs can complicate pregnancy and even lead to miscarriage.
- If you have a cat, find someone else to change the litter box. Cats can carry toxoplasmosis, which is passed in their feces and can cause birth defects in human babies.
You may also want to prepare for other aspects of pregnancy and having a baby.
- If you don’t currently have an obstetrician and/or pediatrician, do some research in order to find a doctor you feel comfortable with
- Look into health insurance options and understand your policy
- If you work, think about how you’ll schedule your prenatal care and what you’d like to do about childcare
- When making financial decisions, keep in mind the day-to-day baby expenses you will soon have
Once you become pregnant, be sure to get regular prenatal care. At that point, your obstetrician will give you much more information and help guide you through a healthy pregnancy.
As you can see, taking charge of your own health now is good for both you and your future baby. By following these guidelines, you’ll be well on your way to a healthy pregnancy!
Vegetarian and vegan diets need special consideration during pregnancy. Our article “Nutrition During Pregnancy” gives general nutritional guidelines about what to eat while you are pregnant, but there is more you need to know if you are a vegetarian or vegan.
Can I still eat a vegetarian or vegan diet while I’m pregnant?
Yes, you absolutely can. Vegetarian and vegan diets are healthy for you and your baby during pregnancy as long as you make sure to get enough calories (2,000—2,500 per day) and enough of all the required nutrients. It’s important to let your doctor know that you are a vegetarian or vegan.
What if my doctor isn’t familiar with vegetarian or vegan diets?
While most doctors are knowledgeable about general nutrition, they may not be as familiar with vegetarian or vegan diets. You may want to keep a food diary for several days so your doctor can better understand your diet and then decide whether or not you need supplements. If you have specific concerns and questions, it may be helpful to work with a registered dietician or nutritional health coach.
What are the specific nutritional concerns for vegetarians and vegans?
Vegetarians and vegans need to make sure they are getting enough protein, calcium, iron, Vitamin B-12, Omega-3 fatty acids, Vitamin D, zinc, and iodine in their diet during pregnancy.
Below we’ve listed each of these nutritional requirements, the amount you need, and good food sources. Keep in mind the amount of nutrients in a serving size depends on the food, so be sure to read labels. Remember also that serving sizes are much smaller than most people think. One serving is equal to just a ½ cup of pasta or 2 tablespoons of nuts!
Protein: You need 71 grams per day. Good sources include beans, lentils, tofu, tempeh, nuts, nut butters, seeds, eggs, leafy green vegetables, whole grains (especially quinoa), milk, yogurt, and cheese.
Calcium: You need 1200 milligrams per day. Good sources are broccoli, kale, collard greens, soybeans, yogurt, milk, cheese, fortified soymilk, figs, almond butter, tahini, and fortified orange juice.
Iron: You need 30 milligrams per day, which is much more than you need when you are not pregnant. Iron deficiency anemia is a concern for all pregnant women, and iron supplements are routinely recommended during the second and third trimesters. Foods rich in iron include whole grains, green leafy vegetables, dried fruit, prune juice, cashews, mushrooms, and fortified breads.
Vitamin B-12: You need 2.6 micrograms per day. This vitamin is naturally found only in foods that come from animal sources. So if you are vegan, you must take a supplement or make sure you are eating fortified foods. Good sources are fortified cereals, fortified soymilk, fortified meat substitutes, nutritional yeast, milk, cheese, yogurt, and eggs.
Omega-3 fatty acids: You need 300 milligrams of DHA, which is one of the Omega-3 fatty acids, per day. Good sources include flaxseed, canola oil, tofu, soybeans, and walnuts.
Vitamin D: You need 400-800 international units (IU) per day. Good sources are sun exposure for 25 minutes three times per week, fortified cereal, fortified soymilk, and fortified milk.
Zinc: You need 11 milligrams per day. Good sources include whole grains, legumes, soybeans, tofu, yogurt, hard cheeses, nuts, and seeds.
Iodine: You need 150 micrograms, or a little more than a ½ teaspoon of iodized salt, per day. Other good sources are garlic, soybeans, asparagus, seaweed, spinach.
Which supplements should I take?
Talk to your doctor about supplements. You may need supplements for calcium, iron, vitamin B-12, and vitamin D. Your doctor can also help you choose a prenatal vitamin that includes high amounts of these nutrients. We recommend that you talk to your doctor before taking herbal supplements during pregnancy.
Pregnant women can rest assured that they can continue to eat vegetarian and vegan diets. As long as you eat 2,000—2,500 calories per day and meet the nutritional requirements listed above, your vegetarian or vegan diet will be healthy for both you and your baby.
We’ve all had questions related to OB/GYN issues that we didn’t feel like actually asking anyone–even our doctor. We, the OB/GYN doctors at Women’s Health Associates, decided to bypass the question asking and simply address several sensitive questions by giving a series of presentations in the Kansas City area. We found that women were very receptive to this topic and wanted to hear the answers as long as they didn’t have to ask the questions. Now we’re addressing the same questions through blog entries. You’ll get the facts you need without having to ask the questions!
What is vaginal discharge?
Vaginal discharge is a fluid secreted by glands in the cervix and vagina. The female body produces vaginal discharge to clean the vagina, keep it lubricated, and help keep it free from infection.
What should vaginal discharge look like?
Vaginal discharge varies in color and consistency from person to person, and it varies for each woman from day to day based on hormone cycle and activity level. Normal vaginal discharge is clear, whitish, or light yellow. It may be a watery liquid, a thicker paste-like substance, or sticky and stringy mucus. It’s a good idea to get to know what is normal for you. If you notice abrupt changes in the consistency and amount of discharge, or if you experience green, red, brown, or grey discharge, you should make an appointment with your doctor.
How much vaginal discharge is normal?
The amount of vaginal discharge varies from woman to woman and even day to day throughout the menstrual cycle. The normal amount should be between none and a teaspoon of vaginal discharge each day. In other words, you should not need to wear a pantyliner. Some women have no vaginal discharge or very little, and that is ok.
Why does the amount of vaginal discharge vary on different days?
The amount of vaginal discharge is influenced by the hormone cycle in a woman’s body.
A woman tends to have more vaginal discharge right before the start of her period. Many women also notice an increased amount of vaginal discharge mid-cycle, when they ovulate. In addition, women tend to have more vaginal discharge during pregnancy.
What should discharge smell like, and what should I do if it smells bad?
Normal vaginal discharge has a faint, non-offensive odor or no odor at all. Vaginal discharge that does have a strong, offensive odor may indicate a yeast or bacterial infection or a sexually transmitted disease. If you notice that your discharge has a strong odor, you should make an appointment with your doctor. While several medicines are available over the counter, it’s important to be evaluated so you can make sure you are treating the actual problem.
We hope you find the above information about vaginal discharge helpful. Over the next several blog entries, we’ll be addressing many more OB/GYN issues you may have questions about. Check back to learn the answers without having to ask the questions!
Contraception has come a long way in recent years. The pill is still available in several forms, but women now have many other options to choose from too. We understand that the variety and sheer number of contraception methods available is confusing, so we’ve put together a guide to help you better understand the options that are available today.
Contraception methods fall into two main groups—hormonal and non-hormonal. Hormonal contraception relies on hormones that are released into your body to prevent pregnancy. Non-hormonal contraception prevents pregnancy without the use of hormones, by either creating a barrier between the egg and sperm or by killing the sperm. Here is a breakdown of the different methods:
Hormonal
- Oral Contraceptives: This is “the pill.” Pills that contain hormones are taken every day to prevent ovulation. (99% effective rate)
- The Patch: A new hormonal patch is applied to your skin every week to prevent ovulation. You wear the patch for three weeks out of the month, and then you take a week off in order to have your period. (99% effective rate)
- Intrauterine Device (IUD): A device which has a hormonal coating that does not allow conception to occur is placed in the uterus by your doctor. It is effective for up to five years. (99% effective rate)
- Vaginal Ring: You insert a hormonal ring that prevents ovulation into your vagina and leave it in place for three weeks out of every month. You take it out the fourth week in order to have your period. (99% effective rate)
- Subdermal Implant: This is a small, hormonal rod which is inserted under the skin of your upper arm by your doctor. It prevents ovulation and is effective for three years. (99% effective rate)
Non-Hormonal
- Intrauterine Device (IUD): A copper device that does not allow conception to occur is placed in the uterus by your doctor. It is effective for up to 10 years. (99% effective rate)
- Diaphragm: This is a device placed into the vagina before sex that prevents sperm from entering the uterus. Your doctor will fit you for the correct size and teach you how to use it. This is always used with spermicide. (94% effective rate)
- Cervical Cap: This is a device placed into the vagina before sex that prevents sperm from entering the uterus. Your doctor will fit you for the correct size and teach you how to use it. This is always used with spermicide. (84% effective rate if you’ve had a baby; 91% effective rate if you have not had a baby)
- Spermicide: This is a substance that kills sperm, which is placed in the vagina no more than one hour before sex. It comes in foams, jellies, creams, and vaginal suppositories, and it is more effective when used with a diaphragm, cervical cap, or condom. (94% effective rate)
- Condom: This is a device that is placed over the penis before sex but after the penis has become erect. It catches the sperm and prevents it from entering a woman’s body. A new condom must be used every time you have sex. (97% effective rate)
- Female Condom: This is a device that is placed in the vagina up to eight hours before sex. It catches the sperm and prevents it from entering a woman’s body. A new female condom must be used every time you have sex. (95% effective rate)
- Sterilization: Men and women can be sterilized through surgery. Men can have a vasectomy, a surgery which interrupts the vas deferens and prevents the sperm from entering the semen so that semen is ejaculated without sperm. Women have two surgery options. They can have a tubal ligation to cut or pinch shut their fallopian tubes, or they can have coils placed inside their fallopian tubes to create blockage and scarring. Both methods prevent the egg from getting to the uterus. Sterilization is a permanent form of birth control. (Greater than 99% effective rate)
How do I decide which contraception method is best for me?
Choosing the best method for you depends on whether or not you can take hormones, and whether or not you want to take hormones. Women who are 35 or older and smoke, and women with certain medical conditions, should not take hormones. Your doctor can tell you whether hormonal contraception methods are safe for you.
Once you know whether you’ll be using hormonal or non-hormonal contraception, become informed about how the different methods work, and take several things into consideration when deciding which exact method to use. Since some hormonal methods are long lasting, think about whether or not you want to become pregnant in the future, and if so, when you would like to become pregnant. For each method you are considering, think about how likely you are to use it correctly, how safe it is, how effective it is, how much it costs, and whether it offers protection from STD’s. Keep in mind that more than one method can be used at the same time. For example, a hormonal method is often used with condoms.
No matter which method you and your doctor choose, make sure you know how it works, how to use it correctly, and what possible side effects you might experience. Keep in mind that as your needs change, you may want to look at the options again and choose a different method.
We hope you find the above information about contraception options helpful. Our next blog entry will address why contraception methods sometimes fail and how to maximize the effectiveness of different methods.
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