Smoking While Pregnant Is Not a Joking Matter

Nearly everyone knows that smoking causes cancers of the lungs, digestive systems, liver and other organs.  It is worth nothing that tobacco poses many other threats especially to pregnant women.

Pregnant women who smoke place their babies at risk for complications such as premature delivery and increase neonatal mortality.

Nicotine and carbon monoxide from tobacco smoke inhaled by pregnant women are especially harmful to fetuses, constricting the flow of blood and choking off their oxygen supply.  Babies born to mothers who smoke have lower birth weights as a result of their undeveloped bodies, increasing the risk of heart defects, lung damage, and impaired brain development.  Finally, smoking while pregnant increases the changes of miscarriage and still birth.  Yet despite the severe consequences, studies by the U.S. Centers for Disease Control and Prevention indicate that less than half of smokers who become pregnant quite during pregnancy.

Bottom Line:  If you are pregnant and care about your unborn child, stop smoking.

New Baby? Your Little Darling May Just Impact Your Sex Life

Many women experience sexual problems after giving birth. This blog will discuss the issues and concerns associated with childbirth and its impact on a woman’s sexual functioning.

Most obstetricians\gynecologists recommend that women avoid vaginal intercourse for at least six week after delivery. Sexual function may not return to prepregnancy levels for up to six months following delivery. The causes are the mother’s concerns about caring for a new baby, breastfeeding, fatigue, pain during attempted or actual intercourse, postpartum depression, pelvic floor problems, urinary incontinence and body image issues.

Sexuality in pregnancy is different in every woman. The frequency of sex may change and sexual enjoyment may decline during pregnancy. However, the good news is that relationship satisfaction remains unchanged. Many women experience a decline in sexual activity during the first trimester of pregnancy as a result of fatigue, fear of causing a miscarriage, breast tenderness, and nausea. The third trimester is also a time of diminished sexual activity due to overall physical discomfort.

Many women may avoid sex and orgasms because of the mistaken fear of causing bleeding, infection, injury to the fetus, premature labor, or breaking the bag of water (amniotic sac) too early. It is true that penetrative vaginal intercourse and orgasms should be avoided if there is imminent danger of a miscarriage in the second and third trimester. Women need to know that amniotic fluid and a thick cervical plug that makes it unlikely that the fetus will experience any pressure or impact from vaginal penetration protect the fetus.

Pregnancy and child delivery may be a difficult time for the partner. Changes in sexual activities and stress about new family obligations make take an emotional or physical toll on the partner. Couples should make every effort to communicate their feelings in a sensitive but honest fashion. The partner may also benefit with a discussion to a friend, doctor, or a counselor about feelings during this time.

Bottom Line: Pregnancy and childbirth are a special time for the mother and her partner. Sexual intimacy can be an important part of life during pregnancy and after the baby is born. If you have concerns about engaging in sexual intimacy before and after delivery over your baby, speak to your doctor.

Questions I Am Frequently “Axed”

I often discuss common medical conditions with patients and questions come up on multiple occasions. I have recorded these questions and will answer them periodically on this blog site. If you have any questions you like me to answer, please let me hear from you, nbaum@neilbaum.com.

I am 31 years old and have just had a baby. When can I resume sexual intimacy with my husband?
Whether you give birth vaginally or by C-section, your body will need time to heal. Many health care providers recommend waiting four to six weeks before having sex. This allows time for the cervix to close, postpartum bleeding to stop, and any tears or repaired lacerations to heal.
The other important timeline is your own. Some women feel ready to resume sex within a few weeks of giving birth, while others need a few months — or even longer. Factors such as fatigue, stress and fear of pain all can take a toll on your sex drive. If you have any questions contact your obstetrician.

I have loss of urine when I cough or sneeze or do any kind of exercise. My doctor said I have stress incontinence and he recommended a vaginal sling using mesh material. Is this safe?

Surgery to decrease or prevent urine leakage can be done through the vagina or abdomen. The urethra or bladder neck is supported with either stitches alone or with tissue surgically removed from other parts of the body such as the abdominal wall or leg (fascial sling), with tissue from another person (donor tissue) or with material such as surgical mesh (mesh sling).

Surgical mesh in the form of a “sling” (sometimes called “tape”) is permanently implanted to support the urethra or bladder neck in order to correct SUI. This is commonly referred to as a “sling procedure.”

The use of surgical mesh slings to treat SUI provides a less invasive approach than non-mesh repairs, which require a larger incision in the abdominal wall. The multi-incision sling procedure can be performed using three incisions, in two ways: with one vaginal incision and two lower abdominal incisions, called retropubic; or with one vaginal incision and two groin/thigh incisions, called transobturator. There is also a “mini-sling” procedure that utilizes a shorter piece of surgical mesh, which may be done with only one incision.

Complications of this type of procedure are rare but may occur. The most common complications include bleeding and infection, erosion or infection of the graft material (possibly requiring further surgery), injury to nearby structures, pain, inability to urinate (retention of urine), recurrent or worsening incontinence, new or worse vaginal prolapse, urgency or urge type-incontinence.

I am 65 years old man and had my prostate gland removed for prostate cancer three years ago. My PSA test is rising after several years being at an undetectable level. Is there anything else I can do?

First, I would get the test repeated. Although mistakes are rare, you need to confirm the results with a second test. Next a test has to be done to see if there has been any spread or recurrence of the cancer at the location of the surgical removal of the prostate gland. There are several tests that can be useful for this purpose including a bone scan to see if there has been any spread to the bones.

For men with less than five years life expectancy or with other medical conditions that may affect their longevity, then no treatment is needed and watchful waiting is an option.

For men with spread to other organs or to lymph nodes, hormone therapy is a consideration. This usually consists of medication to decrease the testosterone level which almost always results in loss of libido and erectile dysfunction.

Finally, if there is localized disease in the pelvis, radiation therapy is an option after surgery has failed to cure the disease.

The bottom line is that a rising PSA after surgery is usually treatable.

To Your Good Health,
Dr. Neil Baum

When Every Day Is A Bad Hair Day- Hair Loss In Women

It’s not just men who suffer from hair loss. As a matter of fact 40% of all people who suffer from the loss of their hair are women. It is certainly age related and with increasing age the likelihood of hair loss increases as 60% of women older than 70 are affected. You are not alone; female pattern baldness affects about 30 million American women. However, unlike men, women rarely develop a receding front hairline. This article will discuss the causes of hair loss in women and what treatment options are available.

For most women, hair is far more than a bundle of fiber; it’s an expression of style and personality. Research also suggests hair and self-image are closely intertwined. If an occasional “bad hair day” can make a woman feel low, hair loss can be a distressing sight to face every morning in the mirror.

The average scalp has 100,000 hairs. Each follicle produces a single hair that grows at a rate of half an inch per month. After growing for two to six years, the hair rests for awhile before falling out. It is soon replaced with a new hair, and the cycle begins again. At any given time, 85% of the hair is growing, and the remainder is resting or waiting to fall out.

Because resting hairs routinely fall out, most people shed about 50-100 strands every day. You’ll typically find a few in your hairbrush or on your clothes. Abnormal hair loss can occur in several ways. You may notice dramatic clumps falling out when you brush or shampoo. Or the hair may thin slowly over time. The first sign of hair loss that most women notice is often widening of their part or that their ponytail is smaller.
Hair loss in women can be triggered by about 30 different medical conditions, as well as several lifestyle factors. Sometimes no specific cause can be found. As a starting point, hair loss experts recommend testing for thyroid problems and hormone imbalances. In many cases, hair will grow back once the cause is addressed.

Causes of hair loss in women
The thyroid is a butterfly-shaped gland at the front of the neck. It produces hormones that regulate many processes throughout the body. If the gland makes too much or too little thyroid hormone, the hair growth cycle may falter and hair loss may occur.

Women with polycystic ovary syndrome (PCOS) have a chronic hormonal imbalance. The body makes higher levels of androgens than expected. This often causes extra hair to sprout on the face and body, while the hair on the scalp grows thinner. PCOS can also lead to ovulation problems and infertility, acne, and weight gain.

Alopecia areata causes the hair to fall out in upsetting and shocking patches. The culprit is the body’s own immune system, which mistakenly attacks healthy hair follicles. In most cases, the damage is not permanent. The missing patches usually grow back in six months to a year.

When ringworm, a fungus, affects the scalp, the fungus triggers a distinct pattern of hair loss — itchy, round bald patches. Bald areas can appear scaly and red. Ringworm of the scalp is treated with antifungal medication. The fungus is easily spread by direct contact, so family members should be checked for symptoms, too.

Some women may notice their hair seems fuller during pregnancy. That’s thanks to high levels of hormones that keep resting hairs from falling out as they normally would. Alas, the reprieve is short-lived. After childbirth, when hormone levels return to normal, those strands fall out quickly. This can mean a surprising amount of hair loss at one time. It may take up to two years for the hair to return to normal.

A little known side effect of birth control pills is the potential for hair loss. The hormones that suppress ovulation can cause the hair to thin in some women, particularly those with a family history of hair loss. Sometimes hair loss begins when you stop taking the pill. Other drugs linked to hair loss include blood thinners and medicines that treat high blood pressure, heart disease, arthritis, and depression.

You may lose more than weight with a crash diet. People may notice hair loss 3-6 months after losing more than 15 pounds, but hair should regrow on its own with a healthy diet. Be prepared to shed some locks if your diet is very low in protein or too high in vitamin A.

It’s no myth: wearing cornrows or tight ponytails can irritate the scalp and cause hair to fall out. The same is true of using tight rollers. Let your hair down, and it should grow back normally. Be aware that long-term use of these styles can cause scarring of the scalp and permanent hair loss. So if you have those tight cornrows on your head, you may be choking off the blood supply to the hair follicle resulting in hair loss. Leave the cornrows in the farmer’s field and not on your head.

Hair loss is an infamous side effect of two cancer treatments, chemo and radiation therapy. In their quest to kill cancer cells, both treatments can harm the hair follicles, triggering dramatic hair loss. But the damage is almost always short-lived. Once the therapy is finished, the hair usually grows back.

Extreme physical or emotional stress can cause a sudden shedding of one-half to three-quarters of the hair on your head. Examples include:
Serious illness or major surgery
Trauma involving blood loss
Severe emotional trauma
The shedding may last six to eight months.

Treatment options for hair loss
Minoxidil (Rogaine) is approved by the FDA for female pattern hair loss. It can slow or stop hair loss in most women and may help hair grow back in up to a quarter of those who use it. You have to be patient, as noticeable results usually take three to four months and the product must be used twice a day. The benefits are lost when you stop using it. For women with alopecia areata, corticosteroids can help regrow hair. And if you have an underlying medical problem or a nutritional deficiency, hair usually grows back on its own once that condition is under control.
Devices that emit low-energy laser light may stimulate hair growth to help fight thinning hair. They’re available in some clinics and as hand-held devices to use at home. At least one device has gained FDA approval for both men and women, based on a small study that showed effectiveness in at least some of those who tested it. It took 2-4 months to see the results. The FDA does not require the same rigorous testing for devices as for medicines. The long-term safety and effectiveness are unknown.

Hair transplants involves moving hair to thinning scalp areas from donor sites. The trouble is, female pattern baldness causes thin hair all over, so good donor sites may be limited. The exceptions are women with male pattern baldness or hair loss caused by scarring. There are several doctors in the New Orleans area that perform hair transplants in women.

A quick Internet search will turn up dozens of products intended to stop hair loss or regrow hair. Unfortunately, there’s no way to know whether before and after pictures have been doctored. To evaluate a hair-loss treatment, consumers can check with:
A dermatologist (MD)
The FDA medical devices division
The Federal Trade Commission (FTC)

When all else fails, you may consider a weave, a hairpiece, a scarf, or a hat to cover bald spots. Good quality wigs are more comfortable than ever — and they rarely have bad hair days. If hair loss interferes with your job or social life or makes you reluctant to leave the house, think about talking with a counselor.

Bottom Line: Women are not immune to hair loss and the psychological impact for women is just as devastating as it is for men. Most women with hair loss can be helped and many can be cured. See your doctor or your dermatologist.

This article was modified from an article posted in WebMD: http://www.webmd.com/skin-problems-and-treatments/hair-loss/ss/slideshow-womens-hair-loss