when does pregnancy occur?

Forget everything you have heard about when pregnancy occurs. According to researchers at the National Institute of Environmental Health Sciences, only about 30 percent of women actually have their fertile period between days 10 and 17 of their menstrual cycle. This adds validity to what many 'accidentally' pregnant women, including myself, have long suspected.

Researchers found that the potential for fertility exists on almost every day of a woman's menstrual cycle. Most women in the study were between the ages of 25 and 35--prime reproductive age and the age when menstrual cycles are most regular. The window of fertility was found to be even more unpredictable for teenagers and women approaching menopause.

Data on tests of 213 women during almost 700 menstrual cycles concluded that even women with normally regular menstrual cycles should be advised that their fertile window can be significantly unpredictable. The NIEHS' Allen J. Wilcox, M.D., Ph.D., statistician David Dunson, Ph.D., and epidemiologist Donna Day Baird, Ph.D., described the results of these tests of otherwise healthy North Carolina women in a recent report in the British Medical Journal.

Women who seek to use their cycles to avoid pregnancy may face poor odds, according to the new scientific report. Data from the study suggests that there are "few days of the menstrual cycle during which some women are not potentially capable of becoming pregnant-- including even the day on which they may expect their next menses to begin."

According to Dr. Wilcox, "If the average healthy couple wants to get pregnant, they are just as well off to forget 'fertile windows' and simply engage in unprotected intercourse two or three times a week."

Researchers showed that 2% of women started their fertile window by day four of their menstrual cycle, and 17% by day seven. Day one of the menstrual cycle is the day that menstruation begins. More than 70% of women were in their fertile window before day 10 or after day 17. Women who regarded their menstrual cycles as "regular" had a 1 to 6 percent probability of being fertile even on the day that their next period was expected to begin. This leaves few "safe" days for natural birth control methods such as the "rhythm method." Women who participated in the study were required to provide daily urine samples that were tested for estrogen and progesterone. A sudden change in these hormones marks the occurrence of ovulation. This test was used to identify ovulation days during 696 menstrual cycles.

Previous reports by Dr. Wilcox and colleagues had shown that the fertile window spans six days and ended on the day of ovulation; however the new report found that even women whose menstrual cycles are normally regular can experience sporadic ovulation. Late ovulation causes 4 to 6 percent of women to potentially be fertile during the fifth week of their cycles--more than 28 days after menstruation last started.

Having sexual intercourse on your fertile day does not guarantee you will become pregnant. Other factors including the viability of the sperm and egg, and the receptivity of the uterus, as well as other individual factors among couples also influence whether pregnancy will result.

According to the NIEHS researchers, this report is the only modern test data that they are aware of on the range of the fertile window. During World War I, a German physician reported 25 pregnancies that were produced by single acts of sexual intercourse that occurred between menstrual cycle days 2 and 30 while soldiers were on leave--today, 84 years later this study suggests that the doctor's report was entirely plausible.

contraceptive...myths

During the last hundred years women were led to believe much about reproductive health that was simply untrue. Young girls were taught that menstruation was unmentionable-- a curse. Pregnant women in labor were often told to put a knife under their bed to "cut the pain." In the early 1900's birth control was illegal. Great controversy and debate over contraceptive use, even in marriage, existed.

1. I Won't Get Pregnant Having Sex On My Period
Many women believe that having unprotected sex during menstruation or during the first or last part of their menstrual cycle will keep them from becoming pregnant. The fact is while many women may be more likely to become pregnant midcyle, the chance of conceiving may be higher than previously thought at anytime of the month. Another fact to know: Sperm can live up to 5 days in a woman's body.

2. Breastfeeding My Baby Protects Me From Pregnancy
While ovulation and menstruation are not likely to happen while you are regularly breastfeeding your baby, eventually menstruation will return and you may ovulate without knowing it. So, yes it is possible to become pregnant while still breastfeeding your child. Tip: Most doctors recommend that women wait one year after giving birth before becoming pregnant again.

3. He Always Pulls Out Before He Ejaculates, I Won't Get Pregnant
This is one of the biggest falsehoods that women believe. Yes, you can get pregnant even if your boyfriend or husband pulls out before ejaculation. Before ejaculation occurs, a small amount of lubricating fluid is released which contains sperm. Fact: Any vaginal penetration by the penis can result in pregnancy, even if he always pulls out before ejaculation.

4. I Use Vaginal Douches After Sex To Keep From Getting Pregnant
I don't know how many women I have known over the years who believed this one. Vaginal douching or taking baths or showers after sexual intercourse will do nothing to help prevent pregnancy because the sperm has already traveled up towards the egg. Tip: Vaginal douching is almost never a good idea, read on to find out why.

5. I Won't Get Pregnant The First Time I Have Sex
If you have started your period, you can get pregnant.Generally, younger girls are more fertile than older women and can get pregnant very easily. Tip: Don't believe your boyfriend if he tells you that you won't get pregnant "just this one time." Insist on protection!

6. I Won't Get Pregnant or Get STDs, I'm On The Pill
Yes, it's true that the Pill is an effective method of birth control when used properly; however, the Pill does not protect against HIV or other sexually transmitted diseases. The only 100 percent foolproof method of preventing an unwanted pregnancy or STDs is abstinence. Fact: While condoms offer some protection against STDs and pregnancy, they are not foolproof.

7. I Had Unprotected Sex Only One Time
One time is all it takes to get pregnant, or to get a STD or HIV. Don't let your boyfriend talk you into having unprotected sex even once or you may pay for a lifetime through an unplanned pregnancy and the resulting consequences or by getting a STD that could impact your future reproductive health and ability to have children. Tip: Take care of yourself and your body and refuse unprotected sex.

8. I'm Too Old To Get Pregnant
As long as you are having periods you can become pregnant. While it is true that the older you get the less fertile you are, you must consider yourself fertile and able to get pregnant until you have been without periods for at least one full year. Tip: After one year without periods, you can forget about birth control and enjoy unprotected sex as long as you are in a mongomous relationship.

9. I Don't Have Sex Often Enough To Use The Pill
If it is hard to know when you are going to need to use birth control, try using condoms or the Today Sponge. Both can be saved for use when needed. The Sponge offers the benefit of 24-hour protection so you can insert it in the morning and be protected all day. Tip: If you use condoms do not carry them around in your pocket or purse. Using a spermicide with condoms increases their effectiveness.

10. I've Had Lots Of Female Problems, So I Don't Think I Can Get Pregnant
Unless your doctor has told you that you cannot get pregnant, you need protection. Even, if your doctor has told you that you "probably won't get pregnant" without surgery or treatment, use birth control-- My only grandchild was conceived under such circumstances. Fact: Abstinence is the only 100 percent effective method of birth control. A condom is the only protection against STDs

Urinary Tract Infection

The urinary tract is the body's filtering system for removal of liquid wastes. Women are especially susceptible to bacteria which may invade the urinary tract and multiply resulting in infection.

Although most urinary tract infections or UTIs are not serious, they are painful. Approximately fifty percent of all women will have at least one UTI in her lifetime with many women having several infections throughout their lifetime. Fortunately, these infections are easily treated with antibiotics that cause the symptoms to quickly disappear. Some women seem are more prone to repeated infections than others and for them it can be a frustrating battle.

What Causes Urinary Tract Infections?

The most common cause of UTI are bacteria from the bowel that live on the skin near the rectum or in the vagina which can spread and enter the urinary tract through the urethra. Once these bacteria enter the urethra they travel upwards causing infection in the bladder and sometimes other parts of the urinary tract.

Sexual intercourse is a common cause of urinary tract infections because the female anatomy can make women more prone to urinary tract infections. During sexual intercourse bacteria in the vaginal area is sometimes massaged into the urethra by the motion of the penis.
Women who change sexual partners or begin having sexual intercourse more frequently may experience bladder or urinary tract infections more often than women in monogomus relationships. Although it is rare, some women get a urinary tract infection every time they have sex.

Another cause of bladder infections or UTI is waiting too long to urinate. The bladder is a muscle that stretches to hold urine and contracts when the urine is released. Waiting very long past the time you first feel the need to urinate causes the bladder to stretch beyond its capacity which over time can weaken the bladder muscle. When the bladder is weakened it may not empty completely and some urine is left in the bladder which may increase the risk of urinary tract infection or bladder infection.

Other factors may also increase a woman's risk of developing UTI including pregnancy, having urinary tract infections or bladder infections as a child, having past menopause, and diabetes.

What are the Symptoms of Urinary Tract Infections?

Symptoms of UTI or bladder infection are not easy to miss and include a strong urge to urinate that cannot be delayed which is followed by a sharp pain or burning sensation in the urethra when the urine is released. Most often very little urine is released and the urine that is released may be tinged with blood. The urge to urinate recurs quickly and soreness may occur in the lower abdomen, back, or sides.

This cycle may repeat itself frequently during the day or night--most people urinate about six times a day, when the need to urinate occurs more often a bladder infection should be suspected.

When bacteria enters the ureters and spread to the kidneys, symptoms such as back pain, chills, fever, nausea, and vomiting may occur, as well as the previous symptoms of lower urinary tract infection.

Proper diagnosis is vital since these symptoms can also be caused by other problems such as infections of the vagina or vulva. Only your physician can make the distinction and make a correct diagnosis.

How is Diagnosis of UTI Made?

The number of bacteria and white blood cells in a urine sample is the basis for diagnosing urinary tract infections. Urine is examined under a microscope and cultured in a substance that promotes the growth of bacteria. A pelvic exam may also be necessary.

What is the Treatment for Urinary Tract Infections?

Antibiotics are the usual treatment for bladder infections and other urinary tract infections. Seven to ten days of antibiotics is usually required although some infections may require only a single dose of antibiotics.

It's important that all antibiotics are taken as prescribed. Antibiotics should not be discontinued before the full course of antibiotic treatment is complete. Symptoms may disappear soon after beginning antibiotic treatment. However, if antibiotics are quit early the infection may still be present and recur.

Another urine test may be ordered about a week after completing treatment to be sure the infection is cured.

Tips for Preventing Urinary Tract Infections

The most important tip to prevent urinary tract infections, bladder infections, and kidney infections is to practice good personal hygiene. Always wipe from front to back after a bowel movement or urination, and wash the skin around and between the rectum and vagina daily. Washing before and after sexual intercourse may also decrease a woman's risk of UTI.

Drinking plenty of fluids (water) each day will help flush bacterium out of the urinary system and emptying the bladder as soon as the urge to urinate occurs may also help to decrease the risk of bladder infection or UTI. Some physicians recommend urinating before and after sex as well as a mean of flushing out any bacteria that may enter the urethra during sexual intercourse.

Vitamin C makes the urine acidic and helps to reduce the number of potentially harmful bacteria in the urinary tract system.

Wear only panties with a cotton crotch--cotton allows moisture to escape whereas other materials may trap moisture and create a potential breeding ground for bacteria.

Cranberry juice often helps to reduce frequency of bladder infections. Cranberry supplements are available over-the-counter and many women find they work amazingly quickly when an UTI has occurred, however, a physician's diagnosis is still necessary even if cranberry juice or herbals reduce pain or symptoms.

If you experience frequent urinary tract infections changing sexual positions that cause less friction on the urethra may help. Some physicians prescribe an antibiotic to be taken immediately following sex for women who tend to have frequent UTIs.

Things to Remember...
Although urinary tract infections are common and distinctly painful they are usually easy to treat once properly diagnosed and only last a few days. When treated promptly and properly urinary tract infections are rarely serious.

self breast exam

How to Perform a Breast Self Exam

1 out of 8 women are at risk of developing breast cancer over their lifetime. Monthly breast self exam is one part of total breast care that includes annual physican exams and mammograms after age 40.

Difficulty Level: average Time Required: 10 minutes



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Here's How:

>Stand in front of a mirror. Look for any changes such as puckering, changes in size or shape, dimpling, or changes in your skin texture.

>Look for changes to the shape or texture of your nipples. Gently squeeze each nipple and look for discharge.

>Repeat these steps with your hands on your hips, over your head, and at your side.

>Raise your right arm and examine your every part of your left breast. Move in increasingly smaller circles, from the outside in, using the pads of your index and middle fingers.

>Gently press and feel for lumps or thickenings.
>Using body cream, if neccessary, continue to circle and gently massage the area outside your breast and under your arm.

>Repeat with your left arm and right breast.

>Lay down. Put a pillow under your right shoulder, and your right hand behind your head. Again gently massage and feel your breast for lumps or other changes.

>Repeat with towel under left shoulder with left hand behind head.


Tips:

Menstruating women should do breast self-exam a few days after their periods end. Women who use oral contraceptives should do breast self exam on the first day of a new pill pack.

Post-menopausal non-menstruating women should pick a day and do breast self exam on the same day each month. Notify your physician immediately if you notice any changes or lumps.

Breast self exam should be a routine part of every woman's life. Talk to your daughters about the importance of breast self exam so it will become a routine part of their lives.

Mammography

What is a mammogram?

A mammogram is an x-ray of the breast and surrounding tissues which can effectively detect cancers long before you might feel a change during your monthly breast self- exam. Mammography can detect breast changes which could signify very early breast cancer.

Is mammography safe?

A very small dose of radiation is used in mammography, an amount equal to about two hours in the sun which places mammography in the safe range. In the United States, mammography clinics are certified to assure quality and safety. It is important to remember where your mammograms are performed so that results in future years can be compared.

I have no symptoms, do I still need a mammogram?

While the American Cancer Society and the American College of Obstetricians and Gynecologists recommend yearly mammograms beginning at the age of 40, other professional organizations including the American College of Physicians, the American Academy of Family Physicians, the Canadian Task Force on Periodic Health Examination, and US Preventative Services Task recommend annual screenings beginning at age 50. The difference is because the groups who recommend screening mammograms at age 50 believe that earlier mammograms may expose women to unnecessary amounts of radiation.
A mammogram can detect cancer as much as a year or two before you or your physician could feel it. Breast cancer found in its earliest stages offers the greatest chance of remission and survival.

What kind of breast changes should be reported to your physician?

-Any lump or thickening of the breast or surrounding tissue
-A dimpling or puckering of your breast
-Scaling of the skin surrounding the nipple
-Nipple discharge which is not associated with breast feeding
-Any other breast change which is different for you

It's important to remember that most breast lumps are not cancerous and the most common reasons for breast lumps is fibrocystic breast disease which is a benign condition.

Although annual mammography offers your best chance for early detection of breast cancer, no test is 100% accurate. And it's vital for you to maintain a schedule of yearly mammograms and perform monthly breast self-exam (BSE) to check for changes. Remember, the earlier breast cancer is detected, the better your chance of beating this insidious disease.

Vaccination against Cervical Cancer, Genital Warts, and other HPV-Related Cancers and Diseases

Is there a vaccine to prevent HPV?

In 2006, the United States Food and Drug Administration (FDA) approved a vaccine that helps protect against diseases caused by 2 types of HPV (HPV 16 and 19) that cause 70% of all cervical cancers. The vaccine also helps to protect against 2 types of HPV (HPV 6 and 11) that cause 90% of genital warts. This quadrivalent vaccine that prevents cervical cancer, vulvar and vaginal cancers as well as genital warts is approved by the Philippine Bureau of Food and Drugs (BFAD) and is available in the Philippines. It is approved for use in children and adolescents (male and female) from 9 through 17 years old and women 18 to 45 years old.

Another vaccine that protects against HPV 16 and 18 that cause cervical cancer has been approved by the BFAD for use in the Philippines. This bivalent vaccine is approved for use in the Philippines for females from 10 years of age onwards.


How do the HPV vaccines provide protection against cervical cancer and other HPV-related diseases?

HPV vaccines are believed to stimulate the body’s immune system to produce neutralizing antibodies that help protect against HPV in the skin cells of the genital area.

HPV vaccines are not intended to treat already existing cervical cancer and other HPV caused diseases.


Who should get vaccinated with the HPV Vaccine?

For the quadrivalent vaccine:
• Girls and women ages 9 to 45 years
• Boys and male adolescent ages 9 to17 years
• Catch-up vaccination is recommended for females aged 13 to 26 years who have not been previously vaccinated.

For the bivalent vaccine:
• Girls and women ages 10 onwards

To be most effective, HPV vaccines should be given before a person has any type of sexual contact with another person.


Can women who are already sexually active or who have experienced HPV diseases still get vaccinated?

• Women who are already sexually active may still benefit from vaccination. That’s because even if a woman has been exposed to HPV, it's unlikely that she has been exposed to all virus types covered by an HPV vaccine. So the vaccine could still help protect against HPV types the woman hasn't been exposed to.

How are the HPV vaccines administered?

• The Quadrivalent HPV vaccine administration schedule involves three doses administered intramuscularly within 6 months
(day 1, month 2, and month 6).

• The Bivalent HPV vaccine administration involves three doses administered intramuscularly within 6 months
(day 1, month 1, and month 6)


Why is Vaccination at a Young Age Recommended?

• HPV vaccination is most effective when given during childhood or adolescence, i.e. before sexual debut, when HPV infection risk is nil or at its lowest.

• Vaccination at a young age is also ideal because this is when the immune system is at its strongest and, therefore, will mount a robust response to the vaccine.


Is vaccination with the HPV vaccines safe?

Appropriateness of HPV vaccination for each patient should always be determined by a doctor. Vaccinations should be upon doctor's prescription.

HPV vaccines are contraindicated to those who are hypersensitive to the active substances or to any of the excipients of the vaccine.

Always tell the doctor if the person getting vaccinated has any severe allergies.

Pregnant women should not get the vaccine.

Particular Safety Data for Each Vaccine:

For the Quadrivalent Vaccine:

Individuals exhibiting hypersensitivity to the active substances or to any of the excipients of the vaccine should not get the vaccine.
Individuals who develop symptoms indicative of hypersensitivity after receiving a dose of the vaccine should not receive further doses of the vaccine.

Women who are breastfeeding may get the vaccine.

Common adverse events include: pyrexia, pain in extremity, and erythema, pain, swelling and pruritus at the injection site

For the Bivalent Vaccine:

The effect on breastfed infants of the administration of the bivalent vaccine to their mothers has not been evaluated in clinical studies. The bivalent vaccine should only be used during breastfeeding when possible advantages outweigh the possible risks.

Common adverse events include: headache, GI including nausea, vomiting, diarrhea and abdominal pain, itching, pruritus, rash, urticaria, myalgia and arthral gia, pain redness and swelling at the injection site, fatigue and fever (=38°C).

For more information, please refer to the American Cancer Society (ACS) Frequently Asked Questions (FAQs).

HPV Vaccine may be effective in women 24 to 45 years old: according to study

June 16, 2009 — The quadrivalent human papillomavirus (HPV) vaccine may be effective in women aged 24 to 45 years who are not infected with the relevant HPV types at enrollment, according to the results of an ongoing multicenter, parallel, randomized, placebo-controlled, double-blind trial reported in the June 2 Online First issue of The Lancet.

"Although the peak incidence of...HPV infection occurs in most populations within 5-10 years of first sexual experience, all women remain at risk for acquisition of HPV infections," write Nubia Muñoz, MD, from the National Institute of Cancer in Bogotá, Colombia, and colleagues. "We tested the safety, immunogenicity, and efficacy of the quadrivalent HPV (types 6, 11, 16, 18) L1 virus-like-particle vaccine in women aged 24-45 years."

Clinical Context

The prevention of HPV infection and related disease has undergone a major change in the last several years with the introduction of the quadrivalent HPV vaccine. This vaccine is currently indicated for girls and women between the ages of 9 and 26 years, which makes sense as a preventive strategy because most women in the United States acquire HPV infection between the ages of 15 and 25 years. The vaccine has been demonstrated to reduce the risks for HPV infection and cervical dysplasia among younger women.

There is evidence that the risk of acquiring HPV in the third or fourth decade of life is increasing, although there are limited data regarding the use of the HPV quadrivalent vaccine in this population. The current study addresses this issue.

Clinical Implications

• Currently, the quadrivalent HPV vaccine is indicated for girls and women between the ages of 9 and 26 years.
• The quadrivalent HPV vaccine was effective in the current study in the prevention of HPV infection and genital/cervical disease among women between the ages of 24 and 45 years, particularly among women not infected with the relevant HPV types at the time of treatment.

HPV Vaccine for men & boys

Yes, clinical trials of Gardasil on males concluded in November 2008 and found the vaccine to be about 90% effective in preventing genital lesions/warts in men. It may also prove to reduce the incidences of HPV-related cancers in men. For more information, please see published reports online.

So, how soon will we see Merck begin to market a male HPV vaccine? And, how the public will respond -- will parents of boys rush to get their sons protected? Will sexually-active young men see this as important preventive healthcare? I would still like to see a major health education campaign about HPV so that all of us know what this virus is, how it spreads, how to get tested, what treatments are available, and the full list of health ramifications -- not only for women but also for men.

HPV or Human Pappiloma Virus??

Cervical cancer is caused by a virus. This common and highly infectious virus is the human papillomavirus or HPV.

What is HPV?

• Over 100 types of HPV have been identified. Most are relatively harmless, causing skin warts (kulugo) commonly found on the hands and feet.

• In most cases, HPV is cleared by the body’s immune system. In people who do not clear the virus, however, the health consequences depend on the type of HPV involved.

• “Low-risk” types (6 and 11) can cause genital warts and abnormal cervical changes that result in abnormal Pap tests

• “High-risk” types (16 and 18) can cause cervical, vulvar, vaginal, penile, and anal cancers and abnormal cervical changes that sometimes lead to cancer

• HPV 6 and 11 cause approximately 90% of genital warts cases.

• HPV 16 and 18 cause approximately 70% of cervical cancer cases.

• At least 50% of sexually-active people will get genital HPV infection. Most will not know that they are infected. (Based on US data)

• About 10% of women in the general population have cervical HPV infection at a given time (Based on US data)


How is HPV infection spread?

• HPV infection is spread mainly by direct genital contact during vaginal or anal sex.

• Other modes of transmission:

- Hand-genital transmission
- Oral-genital transmission

• Very rarely, a pregnant woman with genital HPV can pass HPV to her baby during vaginal delivery. In these cases, the child may develop warts in the throat or voice box – a condition called recurrent respiratory papillomatosis (RRP).

Who is at risk for HPV infection?

Those who:

• Have many sex partners
• Are younger than 25 years of age
• Have started sexual intercourse at age 16 or younger
• Have a partner who has had several different partners

A person who has had sex with only one partner can get HPV if that partner already has the virus. HPV can also be picked up from having sex with an infected person at any age.

What are the Diseases Caused by HPV?

HPV can lead to Cervical Cancer and Other Cancers

• Most HPV infections do not progress to cancer. However, those that do cause considerable suffering among patients and their family.

• Half of women afflicted by cervical cancer are between 35 to 55 years of age—the peak years of productivity. Many were probably exposed to one of the high-risk HPV types during their teens or 20s.

• Virtually 100% of cervical cancer cases worldwide (with almost 500,000 new cases and 270,000 deaths each year) are caused by HPV.

• Approximately 40% of vulvar and vaginal cancer cases are caused by HPV.

• Approximately 90% of anal cancer cases are caused by HPV.

• Approximately 40% of penile cancer cases are caused by HPV.

• Approximately 12% of oropharynx (tongue and tonsils) cancer cases and 3% of mouth cancer cases are caused by HPV.

HPV causes Genital Warts

• Genital warts are the most easily-recognized sign of genital HPV infection. They appear within weeks or months after infection, usually within 3 months.

• Two out of three individuals who have sex with a partner with genital warts will develop warts.

• Genital warts appear soft and moist, flesh-colored, in clusters, smooth and flat, or raised with a rough texture.

• In women, genital warts develop on the vulva, cervix, vagina and anus. In men, genital warts can appear around the anus or on the penis, scrotum, groin, or thighs.

HPV causes RRP

• Recurrent respiratory papillomatosis (RRP) is a rare condition in which warty growths develop in the larynx (voice box) of children and young adults. If not surgically removed, the warts can obstruct the airway and cause asphyxiation.

Because of its recurrent nature, RRP may require surgery under general anesthesia as often as every few weeks.

Gallery

Healthy Cervix	Cervical Cancer	CIN

Genital Warts Female	Genital Warts in Female

Genital Warts in Male	genital warts in male

What are the signs of abnormal vaginal discharge?

Some signs that may indicate an abnormal vaginal discharge and infection include:

*Changes in color, consistency, or amount
*Constant, increased vaginal discharge
*Presence of itching, discomfort, or any rash
*Vaginal burning during urination
*The presence of blood when it’s not your period time
*Cottage cheese-like vaginal discharge
*A foul odor accompanied by yellowish, greenish, or grayish white vaginal discharge

If you have a vaginal discharge along with any of these signs, consult your health care provider for diagnosis and treatment. Vaginal discharges are common and you it’s likely you’ll have at least one vaginal infection in your life. The most common vaginal infection is bacterial vaginosis. Vaginal yeast infections are also very common and over-the-counter treatments are available; however, it’s important to never self-diagnose a vaginal yeast infection unless you have previously been diagnosed by your health care provider. Another common vaginal infection is called trichomoniasis.

let's talk about vaginal discharge...

Do you know the difference between normal vaginal discharge and abnormal vaginal discharge? Did you know that having a vaginal discharge is normal? Let’s take a look at various types of vaginal discharges so that you’ll know when you have an abnormal vaginal discharge.

The Natural Vagina

The basic function of you vagina is to provide a route from the outside of your vagina to your uterus and the rest of your internal reproductive system. The natural, acidic, pH of your vagina acts to prevent infections. The acidic nature of your vagina is caused by natural, good, bacteria produced by your body. When your vagina is healthy, the vagina keeps itself clean and in a healthy state by producing secretions of normal vaginal discharge. The natural balance of the vagina can be disrupted by anything that interferes with its’ normal environment.

What is Normal Vaginal Discharge?

First it’s important to understand that all women experience some amount of vaginal discharge. Glands in your vaginal and cervix produce small amounts of fluid that flows out of your vagina everyday taking with it old cells that line the vagina. Your normal vaginal discharge helps to clean the vagina, as well as keep it lubricated and free from infection and other germs. A normal vaginal discharge does not have a foul odor and usually has no odor at all. Normal vaginal discharge often appears clear or milky when it dries on your clothing; occasionally you may notice white spots or a normal vaginal discharge that is thin and stringy looking.

Other things that may cause changes in the appearance or consistency of your vaginal discharge include:
-Your menstrual cycle
-Emotional stress
-Pregnancy
-Any prescribed or OTC medications you take including hormones such as in the Pill
-Sexual excitement
-Breastfeeding
-Ovulation
-Your diet

Other things that can upset the natural pH balance of your vagina and lead to vaginal infections include vaginal douches, feminine hygiene products, perfumed or deodorant soaps, antibiotics, pregnancy, diabetes, or the presence of another infection.

How does your period affect your vaginal discharge?

Your menstrual cycle has a significant affect on the type of vaginal discharge you experience throughout the month. Did you know you’re more likely to experience vaginal infections just before or during your period? This is because the pH balance of your vagina varies during your monthly cycle causing the acidic level of your vagina to be at its’ lowest point a few days before and during your period. About halfway between your periods an increase in vaginal discharge that appears clear is normal. This increased wetness and clear vaginal discharge is an indication of ovulation.

menorrhagia

At some time in your reproductive life, you've probably experienced heavy bleeding during your menstrual period. If you're like some women, every period you have causes enough blood loss and cramping that you can't maintain your usual daily activities. The medical term for periods like these — excessive or prolonged or both — is menorrhagia.

Although heavy menstrual bleeding is a common concern among premenopausal women, few women experience blood loss severe enough to be defined as menorrhagia. If you have menstrual bleeding so heavy that you dread your period, talk with your doctor. There are many effective treatments for menorrhagia.

Normal menstrual flow:

• Occurs every 21 to 35 days
• Lasts four to five days
• Produces a total blood loss of about 2 to 3 tablespoons (30 to 44 milliliters)

The menstrual cycle isn't the same for every woman. Your period may be regular or irregular, light or heavy, painful or pain-free, long or short and still be considered normal. Menorrhagia refers to losing about 5 1/2 tablespoons (81 milliliters) or more of blood during your menstrual cycle.

The signs and symptoms of menorrhagia may include:

• Menstrual flow that soaks through one or more sanitary pads or tampons every hour for several consecutive hours
• The need to use double sanitary protection to control your menstrual flow
• The need to change sanitary protection during the night
• Menstrual periods lasting longer than seven days
• Menstrual flow that includes large blood clots
• Heavy menstrual flow that interferes with your regular lifestyle
• Tiredness, fatigue or shortness of breath (symptoms of anemia)

When to see a doctor
Doctors generally recommend that all sexually active women and women over the age of 21 have yearly pelvic exams and regular Pap tests. However, if you experience heavy or irregular vaginal bleeding, schedule an appointment with your doctor and be certain to record when the bleeding occurs during the month. If you're having heavy vaginal bleeding — soaking at least one pad or tampon an hour for more than a few hours — seek medical help. Call your doctor if you have any vaginal bleeding after menopause.

In some cases, the cause of heavy menstrual bleeding is unknown, but a number of conditions may cause menorrhagia. Common causes include:

• Hormonal imbalance. In a normal menstrual cycle, a balance between the hormones estrogen and progesterone regulates the buildup of the lining of the uterus (endometrium), which is shed during menstruation. If a hormonal imbalance occurs, the endometrium develops in excess and eventually sheds by way of heavy menstrual bleeding.
• Dysfunction of the ovaries. Lack of ovulation (anovulation) may cause hormonal imbalance and result in menorrhagia.
• Uterine fibroids. These noncancerous (benign) tumors of the uterus appear during your childbearing years. Uterine fibroids may cause heavier than normal or prolonged menstrual bleeding.
• Polyps. Small, benign growths on the lining of the uterine wall (uterine polyps) may cause heavy or prolonged menstrual bleeding. Polyps of the uterus most commonly occur in women of reproductive age as the result of high hormone levels.
• Adenomyosis. This condition occurs when glands from the endometrium become embedded in the uterine muscle, often causing heavy bleeding and pain. Adenomyosis is most likely to develop if you're a middle-aged woman who has had many children.
• Intrauterine device (IUD). Menorrhagia is a well-known side effect of using a nonhormonal intrauterine device for birth control. When an IUD is the cause of excessive menstrual bleeding, you may need to remove it.
• Pregnancy complications. A single, heavy, late period may be due to a miscarriage. If bleeding occurs at the usual time of menstruation, however, miscarriage is unlikely to be the cause. An ectopic pregnancy — implantation of a fertilized egg within the fallopian tube instead of the uterus — also may cause menorrhagia.
• Cancer. Rarely, uterine cancer, ovarian cancer and cervical cancer can cause excessive menstrual bleeding.
• Inherited bleeding disorders. Some blood coagulation disorders — such as von Willebrand's disease, a condition in which an important blood-clotting factor is deficient or impaired — can cause abnormal menstrual bleeding.
• Medications. Certain drugs, including anti-inflammatory medications and anticoagulants (to prevent blood clots), can contribute to heavy or prolonged menstrual bleeding. Improper use of hormone medications also can cause menorrhagia.
• Other medical conditions. A number of other medical conditions, including pelvic inflammatory disease (PID), thyroid problems, endometriosis, and liver or kidney disease, may cause menorrhagia.

Menorrhagia is most often due to a hormonal imbalance that causes menstrual cycles without ovulation. In a normal cycle, the release of an egg from the ovaries stimulates the body's production of progesterone, the female hormone most responsible for keeping periods regular. When no egg is released, insufficient progesterone can cause heavy menstrual bleeding.

Menstrual cycles without ovulation (anovulatory cycles) are most common among two age groups:

• Adolescent girls who have recently started menstruating. Girls are especially prone to anovulatory cycles in the first year and a half after they have their first menstrual period (menarche).
• Older women approaching menopause. Women ages 40 to 50 are at increased risk of hormonal changes that lead to anovulatory cycles.

Excessive or prolonged menstrual bleeding can lead to other medical conditions, including:

• Iron deficiency anemia. In this common type of anemia, your blood is low on hemoglobin, a substance that enables red blood cells to carry oxygen to tissues. Low hemoglobin may be the result of insufficient iron. Menorrhagia may deplete iron levels enough to increase the risk of iron deficiency anemia. Signs and symptoms include pallor, weakness and fatigue.

  Although diet plays a role in iron deficiency anemia, the problem is complicated by heavy menstrual periods. Most cases of anemia are mild, but even mild anemia can cause weakness and fatigue. Moderate to severe anemia can also cause shortness of breath, rapid heart rate, lightheadedness and headaches.

• Severe pain. Heavy menstrual bleeding often is accompanied by menstrual cramps (dysmenorrhea). Sometimes the cramps associated with menorrhagia are severe enough to require prescription medication or a surgical procedure.

Your doctor will most likely ask about your medical history and menstrual cycles. You may be asked to keep a diary of bleeding and nonbleeding days, including notes on how heavy your flow was and how much sanitary protection you needed to control it. Your doctor will do a physical exam and may recommend one or more tests or procedures such as:

• Blood tests. A sample of your blood is evaluated in case excessive blood loss during menstruation has made you anemic. Tests may also be done to check for thyroid disorders or blood-clotting abnormalities.
• Pap test. Your doctor collects cells from your cervix for microscopic examination to detect infection, inflammation or changes that may be cancerous or may lead to cancer.
• Endometrial biopsy. Your doctor takes a sample of tissue from the inside of your uterus to be examined under a microscope.
• Ultrasound scan. This imaging method uses sound waves to produce images of your uterus, ovaries and pelvis.

Based on the results of your initial tests, your doctor may recommend further testing, including:

• Sonohysterogram. This ultrasound scan is done after fluid is injected through a tube into the uterus by way of your vagina and cervix. This allows your doctor to look for problems in the lining of your uterus.
• Hysteroscopy. A tiny tube with a light is inserted through your vagina and cervix into the uterus, which allows your doctor to see the inside of your uterus.
• Dilation and curettage (D and C). In this procedure, your doctor opens (dilates) your cervix and then inserts a spoon-shaped instrument (curet) into your uterus to collect tissue from the uterine lining. This tissue is examined in the laboratory.

Doctors can be certain of a diagnosis of menorrhagia only after ruling out other menstrual disorders, medical conditions or medications as possible causes or aggravations of this condition.

Consider these tips for successful self-care of menorrhagia:

• Get your rest. Your doctor may recommend rest if bleeding is excessive and disruptive to your normal schedule or lifestyle.
• Keep a record. Record the number of pads and tampons you use so that your doctor can determine the amount of bleeding. Change tampons regularly, at least every four to six hours.
• Avoid aspirin. Because aspirin interferes with blood clotting, avoid it. However, other nonsteroidal anti-inflammatory medications, such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve), often are very effective in relieving menstrual discomfort.