Barb's Daily Dose

Contraceptive Convenience

Have you ever forgotten to take your birth control pill? What about trying to track down a condom and squinting in the dark to make sure it hasn’t expired? What about not having enough time to stop at the drug store to pick up a new pack of pills? And how many times, have you tried to remember the first day of your period so you can try to guestimate if you’re fertile?

Wouldn’t it be nice if we didn’t have to worry about birth control?

You know what? There are 2 options out there that can eliminate the day to day, month to month scrambling.

Mirena IUD – This is method that is great for women who’ve already had a baby. It’s good for 5 years and is over 99% effective. If a woman wants to get pregnant, once the Mirena is removed, she can start trying right away. There’s no delay.

Why heavy periods happen

A few days ago, I talked about heavy periods.  Now there's lots of reasons that this could happen, so it's important to find out why it's occurring and then provide treatment options.

Diagnostic Tests

Depending on the woman's age and her history of heavy bleeding one or more of the following may be ordered:

Your Menstrual Cycle

The menstrual cycle is my life. I know, it's crazy, but without knowing how it works, it's impossible to do my job.  If you understand this, then you will understand these important issues that most women face at some time in their lives:

• Why the pill works
• What happens when you can't get pregnant
• How you can get pregnant
• What happens in menopause
• What happens with PCOS
• What makes the world go around - sorry, couldn't resist  

The Typical Menstrual Cycle
This is a fast, quick explanation: 

The Typical Menstrual Cycle
This is a fast, quick explanation: 

Heavy Periods

"I decided to stay in the shower, because I was bleeding so heavily that it was just easier that way."

Did you know that 1 in 5 women suffer from heavy periods?  That's a lot of pads and tampons. Some women have heavy periods their entire lives and some only experience this particularly feminine challenge with perimenopause.

The quote above is from my friend J. She lives on the east coast and called to say that she was really worried, because her bleeding had become so bad that she couldn't leave the bathroom. 

She said, that she since was the only one at home and was bleeding so heavily that she decided to get into the shower because as she says, "I figured if bled to death in the shower, it would be easier to clean up."

This floored me. Always thinking of others first, putting ourselves last.  Really, she was doing the best she could at the time.  She also said that she was afraid that she couldn't drive to the doctors office 20 minutes away. 

Myths about Urinary Tract Infections

Here are my top 5 myths that I hear all the time about Urinary Tract Infections.

#1 Wiping matters - If only I had wiped myself differently, this wouldn't have happened.  Not true. Studies show that contrary to what your mom told you or you heard way back when, you don't have to wipe front to back or back to front or sideways. It doesn't matter.  

#2 Drink lots of water to flush out the bacteria - Ok, this was a trick. 

PCOS & Weight Control

I have written many posts on PCOS. Here's Part 1, Part 2, Part 3 and Part 4.  

Today, let's talk about Metformin.  I'm preparing a talk I'm giving in at the annual conference of the California Association of Nurse Practitioners. So I've been reading lots of up to the minute research. 

Weight control is more difficult

As you know from previous posts, PCOS is a complex condition that causes Insulin resistance, difficulty losing weight and increased appetite. Recently the FDA has approved the use of a medication used for people with Type 2 diabetes to help women with PCOS lose weight to help prevent them from developing Type 2 diabetes. 

Metformin

This is not a diet drug, but helps manage blood glucose levels and in several studies helped teenagers

Breast Cancer, Exercise & Diet

For a long time, we've known that by increasing exercise, in general women could decrease the likelihood that they would have breast cancer.  We didn't know why, but there was an association.  

My mom had breast cancer

I knew I was at higher risk for developing breast cancer and I had read enough of the studies to know that the more I exercised, the more I'd decrease my chance of hearing that the mammogram was worrisome or that the biopsy was not good. So, I dragged myself out to jog, or to spin class or to the gym.  

The Va Jay Jay is Dry Dry

Vaginal Dryness 

When you buy your ticket on the hormonal roller coaster, affectionately known as menopause, sorry, but there probably isn’t a stop at splash mountain. Nope, menopause brings lots of unexpected twists and turns and one big secret, your Va Jay Jay will be a lot dryer. 

Can you say Sahara? 

Yes, there will be more wrinkles, but you knew that. What many of my patients are surprised by is how dry their skin is, especially in the vagina. Gosh darn it! Sorry, I was just channeling Tina Fey, imitating a certain governor. Now that you don’t have to worry about pregnancy, all of a sudden, your ability to lubricate recedes like a middle-aged man’s hairline. 

Infections are more common 

Sorry to say, that when the vagina is dry, it means that the pH is off balance allowing less of the good health bacteria (lactobacillus) to grow and more of the bad bacteria that cause vaginal and bladder infections to grow. 

What to do? 

Think about talking to your health care provider about treatments. There’s good news. Even if you’re not interested in hormones to treat hot flashes and night sweats, a minimal amount of vaginal estrogen used regularly will help restore the balance and help you avoid infections. 

Interested in more information about sex during menopause?  Get my Menopause Download.

Vulvar Pain part 3

Last month, Mary Buxton, LCSW and AASECT Certified Sex Therapist wrote on Vulvar pain.  Today, we'll hear from the folks at the National Vulvodynia Association.

Michelle's Story

Michelle, is a 37 year-old woman, who has experienced pain in her external genital area (the vulva) since her very first gynecological exam. Like many women, she didn’t know that exams weren’t supposed to cause discomfort.  After suffering for many years with painful symptoms, Michelle knew something was wrong.  Yet, she had to consult four medical professionals over the course of 10 years before she finally obtained an accurate diagnosis of vulvodynia! Michelle is not alone. 

Yeastie Beasties part 2

A few days ago we talked about yeast infections and how they occur.  Today we'll cover treatment and prevention.

Treatment: 

There are many effective over the counter and prescription treatments for yeast infections. No matter what you use though, it takes 3 days to feel complete relief. There are creams and suppositories for the vagina that are offered in 1 day, 3 day or 7 day treatments.

You may also have been prescribed Diflucan, an oral medication. Partners usually don’t need to be treated. 

What about Yogurt? 

• Yes, I’m here to tell you, this works. Eat more yogurt for a few good reasons. 
• It’s loaded with calcium 
• It’s loaded with protein 
• The lactobacillus in yogurt helps your stomach and vagina maintain a healthy ph and prevents yeast from overgrowing.