Wednesday, September 28, 2011

Bleeding after sex: totally normal or worth freaking out about?

Up on various lady part centric websites and boards, you will usually find a whole lot of question on bleeding after sex. So, what gives? And should you be freaking about it?

First, in a large review study (a meta-analysis if you will), around 5-6% of women have post-coital bleeding. Rest assured that you are not alone if you do experience this.

But more importantly, why is it happening? Well, sorry to be the bearer of bad news ladies, but there are a range of lady part issues that can be associated with bleeding after sex:

  • Around 25 to 30 percent of bleeding can be caused by having fragile cervical tissue. In case you forgot were your cervix is, it is that spongy tissue at the end of your vagina that separates it from your uterus (see here for more info). Your cervix can be a little sensitive if you are young, on birth control, or are preggers. 
  • About 12 percent of bleeding after sex is associated with cervical polyps (little red growths that can be easily removed during an exam with that plastic duck thing, aka, the speculum), endometrial polyps or uterine fibroids (which can be seen with an ultrasound). 
  • Infections are the culprit in about 5% of the cases of post coital bleeding. Gonorrhea and chlamydia (which is not a flower) can cause cervical bleeding, as can bacterial vaginosis. 
  • Funky hormones can also cause bleeding after sex. About 35% of women that have bleeding are on some form of hormones. Also, conditions like polycystic ovarian syndrome (PCOS), thyroid issues, and obesity can all mess around with your hormones that can overly thicken the lining inside your uterus, causing it to bleed after sex.

Basically ladies, if you always bleed after sex (even if you like it on the rougher side), make an appointment with your lady parts doctor to get it checked out. It can be totally nothing, or it can be a sign of something more  serious. 

Thursday, September 22, 2011

What exactly is Endometriosis??

You hear it in conversation with some girlfriends. You see it discussed when talking about menstrual cramps and what not. But, honestly, you have no idea what the heck it is. Endometriwhat?

Yes, my readers, time to learn a bit about endometriosis - rather common condition that affects 12 to 30 percent of all menstruating woman. Chances are you know someone that has it, or perhaps you have it yourself. Endometriosis is when the lining of the uterus (what you shed every month during your period) ends up in other places in your body (other than your uterus). It can show up on your ovaries, bladder, or your colon for example. And as you can imagine, when you have tissue surfacing in places it shouldn't be, it can be PAINFUL. Heck yeah ladies, we are talking severe inflammation of the tissues, and even bleeding (just like your uterine lining would). Endometriosis can also cause cysts in the ovaries. Good times.

So, how would you know if you have endometriosis? Some scenarios: You are a young lady, you would have miserable horrible periods for years and want-to-crawl-in-a-hole-and-lay-in-the-fetal-position cramps, as well as constipation and lots of peeing during your period - you are pretty much living in chronic pain. You are trying to make babies for over six months, your partner checks out ok, and after doing a pelvic sonogram, your doctor says you have a mass on your ovaries. Or, you are a woman that has had awful cramps, painful sex, weird on and off bleeding during your period, and back and lower ab pain.

Your lady parts doc would probably do full physical and medical history to make sure nothing else could be the culprit, and then do a pelvic sonogram to see what is going on. If it looks like endometriosis is likely, they will start you out with some strong anti-inflammatory pills, and suggest you go on hormonal birth control, which seems to help most women. Some ladies don't seem to respond to this treatment, so they need to take it up a notch and have a laparoscopy done to see exactly what is going on in the pelvis, and have any endometriosis removed that the doctor sees. Removing the endometriosis usually helps in improving fertility and lowering the pain.

 And finally, what causes this? There seems to be some genetic component - you are more like to get endometriosis if you have a first degree relative that has it. Endometriosis is also fueled by estrogen, so if you are diagnosed, try to avoid dairy or animals that have been fed hormones, or soy (a natural occuring estrogen).

Now you are up to speed on what the E word is. Share your knowledge! Or better yet, tell your friends to check out the blog :).

Tuesday, September 20, 2011

Five questions to ask your partner before things get sexual

Sex is great. It's fun, it releases endorphins, it burns calories, it provides intimacy. All good things. Yet, there are some not so good things that come with sex too - both physically and emotionally. And while it can be a total mood killer to start grilling your partner, your long term wellness should always come first.

Here are five questions you should ask before you start taking of your clothes:
1. Are you married or have a girlfriend? If you are a-ok with being the other woman, that is fine, but you should at least be informed up front. And don't expect your partner to fess up without your prodding - people are very good at leaving out such details. There is a lot of baggage in sleeping with someone who is in a committed relationship, and you should have all the information in order to make your decision.

2. What is your sexual history? Remember in sex ed class when they taught that you not only have sex with your partner, but with everyone that they have had sex with too? Yup, that's true. And in today's day and age, that could be A LOT of people. You should totally ask your partner if they have any nether germs - STDs or HIV - and if they act kind of shady, perhaps pull your panties back up. Feel free to ask them to get tested if they haven't done so recently. On the other end, you also want to know if your partner is new to this sex thing, since that can chance your relationship with them as well.

3. What kind of sex do you like? Everyone has their own idea of what constitutes good sex. Some like it soft and gentle,some like it rough, some like leather, some like lace.It is good to say what you like and what are your boundaries so that you both are comfortable and feeling safe and excited before you start.

4. Are you comfortable with safe sex? While sex is good, safe sex is better. It is important to ask your partner if they are cool with using condoms, if they always do, and if they have ever had super risky sex (like with a sex worker). Remember that while these questions are often awkward in the rush to hook up, they can save your life. You only have one body and one set of lady parts.

5. What kind of birth control should we use? Pull and pray is not a answer unless you are ready to face the consequences of a possible pregnancy. If you aren't on hormonal birth control or have an IUD, condoms or the cervical cap are good options. Ovulation can happen at any point during your cycle (not just around day 14), and sperm do live in your lady parts for up to three days, so ALWAYS take precautions.

And lastly click here for some more information on how to make safe sex fun.

Thursday, September 15, 2011

IUDs protecting against pregnancy and cervical cancer!!

I have said it before, and I'll say it again : IUDs rock. They are uber protective against pregnancy - the most effective form of contraception, short of sterilization.

And now, in a study of nearly 20,000 women, IUDs were found to lower cervical cancer risk by 45! Now, bear in mind, there was no protective effect for IUDS in women that had HPV - so make sure that you either get the vaccine, or get checked out regularly.

 What is kind of interesting about this finding is that the investigators found no difference in the protective effect by years of use. So women who used it for only a short period of time had the same level of protection as those women who have used it for a decade.

Scientists think that the mechanism of protection has something to do with the inflammatory response in the cervix and a long lasting immune response to clear HPV infections and lesions.

Good stuff, right? All together another reason to consider an IUD. If you are looking for a great, safe, longer term birth control option, that also protects against cervical cancer, talk to your lady parts doc about an IUD

Tuesday, September 13, 2011

Vitamin D is good for you!

As the days are slowly getting longer, we are no longer lounging by the pool or splashing by the beach. And for most of us, that means we probably aren't getting enough vitamin D. Using sunblock also decreases your vitamin D absorption from the sun (and yes keep using sunscreen). Vitamin D insufficiency is all the rage these days in the research world, and it has been linked to everything from heart disease to breast cancer. So, what is the deal with vitamin D?

Ok, first things first, you need the D for strong bones and muscles. Vitamin D enhances calcium absorption which keeps bones from breaking down and improves muscle strength. Think of it as spinach, ala Popeye.

Vitamin D is also good for your heart. Studies have found that not having enough D leads to high blood pressure, diabetes, stroke, and heart failure(!). Not good. You also need D to lower your risk for breast cancer, infections, autoimmune, and metabolic diseases.

How much D do you really need? Well you need about 600 IU a day if you are under 70, and for those ladies over 70, you need an extra boost of 800 IU. Don't OD on the stuff though - you should take at most 4000 IU in one day. Try taking D3 as a supplement, since it is easy to absorb and you can take it with or without food.

As for me, I usually take a supplement during the winter, but rely on my multivitamins, walks around NYC and egg/milk consumption during the summer months (all three of them. Sigh).

Friday, September 9, 2011

What to do when you miss your birth control pill

OMG! You totally forgot to take your birth control pill yesterday. You could have sworn you took it, but then the phone rang, or the latest episode of the Bachelor came on, or maybe you popped the pill out of the pack and it went flying, never to be found again. And while some of us are religious about taking their pill - having the equivalent of a three car alarm to remind them to take it at the same time every day (you know who you are) - sometimes life gets a little messy and we forget to take the pill. I would say a large number of posts onVagina Pagina's community page are about ladies freaking out because they missed a pill. 

missing birth control pills
What is one to do (other than call me in a panic)? First, off, don't freak out. It's not going to help. And no, you aren't pregnant because you forgot to take the pill yesterday and you just happened to have sex last night too. For most types of birth control pills, just take one as soon as you realize that your forgot (it is okay to take two in one day), and if you so happened to forget to take it for two days (!!), take two the first day and two the second and you should be golden. If you are still worried about it, use condoms for the rest of the month to give yourself peace of mind, and maybe give a ring into your lady parts doc to run things by them.

This situation happen regularly? Maybe time to switch up your method of contraception. Talk to your lady parts doc about the Nuvaring or IUDs as an alternative to the daily pill taking regimen.

Wednesday, September 7, 2011

Reasons to use Birth Control other than controlling birth

Many of us use hormonal birth control (HBC) because we don't want to get knocked up. Some use hormonal birth control because otherwise their periods would be all over the place and anywhere in between.

The gals at Gyno Gab listed 10 other reasons to use hormonal birth control:

1. Control heavy bleeding : yup, you can have much lighter periods when you are on HBC.
2. Control menstrual cramps : tired of being in the fetal position during your period? HBC can help with that too.
3. Control of acne: feel like an awkward teenager going through puberty because your skin hasn't caught up to your age? Hormones may be the culprit, and HBC can help tame those pimplies.
4. Less PMS: HBC can take out the beast in you during that time of the month.
5. Better bones: estrogen helps keeps bones strong and healthy.
6. Lowers risk for uterine cancer: the protective effect increases the longer you are on HBC and continues many years after you stop taking it.
7. Lowers risk for ovarian cancer: After just one year on HBC, you lower your risk for ovarian cancer by 10-12%, and after 5 years you lower your risk by approximately 50 percent.
8. Less pelvic inflammatory disease:it is thought that since HBC thickens cervical mucus it acts as a barrier to infections that cause PID.
9. Lower risk for colon cancer: HBC lowers levels of certain digestive chemicals that are thought to cause cells to become cancerous at high levels.
10.Fewer fibrocystic breast changes: if you get lumpy boobs in relation to your cycle, HBC can help lower the hormones that cause these cystic changes.

There are lots of reasons to take hormonal birth control. Have a discussion with your lady parts doctor on what kind of birth control would be right for you.

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