Morning sickness often begins 4 to 6 weeks after conception and may continue until the 4th month of pregnancy. Some women have morning sickness during their entire pregnancy. This happens most often for women who are carrying more than 1 baby.
It is called morning sickness because the symptoms are more likely to occur early in the day, but they can occur at any time. For some women, morning sickness lasts all day.
The exact cause of morning sickness is not known.
· Most experts think changes in the woman's hormone levels during pregnancy cause it.
· Other factors that can make the nausea worse include a pregnant woman's enhanced sense of smell and gastric reflux.
Morning sickness that is not severe does not hurt your baby in any way. In fact:
· It may even be a sign that all is well with you and your baby.
· Morning sickness may be associated with a lower risk of miscarriage.
· Your symptoms probably show that the placenta is making all the right hormones for your growing baby.
· Take them at night, since the iron they contain may irritate your stomach. At night, you might be able to sleep through this. Also take them with a little food, not on an empty stomach.
· You may have to try several different brands of prenatal vitamins before finding one you can tolerate.
· You can also try cutting your prenatal vitamins in half. Take half in the morning and the other half at night.
Some other tips are:
· Keep your morning activities slow and calm.
· Avoid poorly ventilated spaces that trap food odors or other smells.
· DO NOT smoke cigarettes or be in areas where people are smoking.
· Get extra sleep and try to lessen stress as much as possible.
Try acupressure wristbands that apply pressure to specific points on your wrist. Often these are used to ease motion sickness. You can find them at drug stores, health food stores, travel stores, and online.
Try acupuncture. Some acupuncturists are trained to work with pregnant women. Talk to your health care provider beforehand.
Vitamin B6 (100 mg or less daily) has been shown to ease symptoms of morning sickness. Many health care providers recommend trying it first before trying other medicines.
There are no drugs currently approved by the Food and Drug Administration to treat morning sickness. Your provider may not advise medicines to prevent nausea unless your vomiting is severe and will not stop.
· The drug doxylamine (brand name Unisom) may be taken along with vitamin B6 to treat nausea and vomiting. Ask your provider before taking it.
· In severe cases, you may be admitted to the hospital, where you will receive fluids through an IV (into your vein).
· Your provider might prescribe other medicines if your morning sickness is severe.
Toxic nodular goiter starts from an existing simple goiter. It occurs most often in older adults. Risk factors include being female and over 55 years old. This disorder is rare in children. Most people who devaelop it have had a goiter with nodules for many years.
Sometimes, people with toxic multinodular goiter will develop high thyroid levels for the first time. This mostly occurs after they take in a large amount of iodine through a vein (intravenously) or by mouth. The iodine may be used as contrast for a CT scan or heart catheterization. Taking medicines that contain iodine, such as amiodarone, may also lead to the disorder.
Beta-blockers (propranolol) can control some of the symptoms of hyperthyroidism until thyroid hormone levels in the body are under control.
Certain drugs can block or change how the thyroid gland uses iodine. These drugs may be used to control the overactive thyroid gland in any of the following cases:
· Before surgery or radioiodine therapy occurs
· As a long term treatment
Radioiodine therapy may be used. Radioactive iodine is given by mouth. It then concentrates in the overactive thyroid tissue and causes damage. Some people, but not all, may need to take thyroid replacement afterwards.
Surgery to remove the thyroid may be done when:
· Very large goiter or a goiter is causing symptoms by blocking the airway
Toxic nodular goiter is mainly a disease of older adults, so other chronic health problems may affect the outcome of this condition. An older adult may be less able to tolerate the effect of the disease on the heart. However, the condition is often treatable with medicines.
Thyroid crisis or storm is an acute worsening of hyperthyroidism symptoms. It may occur with infection or stress. Thyroid crisis may cause:
· Abdominal pain
· Decreased mental alertness
People with this condition need to go to the hospital right away.
Complications of having a very large goiter may include difficulty breathing or swallowing. These complications are due to pressure on the airway passage (trachea) or esophagus, which lies behind the thyroid.
Both males and females of all ages have normal breast tissue. This tissue responds to hormone changes. Because of this, lumps can come and go.
Breast lumps may appear at any age:
· Both male and female infants may have breast lumps from their mother's estrogen when they are born. The lump will most often go away on its own as the estrogen clears from the baby's body.
· Young girls often develop "breast buds," which appear just before the beginning of puberty. These bumps may be tender. They are common around age 9, but may happen as early as age 6.
· Teenage boys may develop breast enlargement and lumps because of hormone changes in mid-puberty. Although this may be upsetting to boys, the lumps or growth almost always go away on their own over a period of months.
Lumps in a woman are often caused by fibrocystic changes, fibroadenomas, and cysts.
Fibrocystic changes are painful, lumpy breasts. Fibrocystic breast changes do not increase your risk of breast cancer. Symptoms are most often worse right before your menstrual period, and then improve after your period starts.
Fibroadenomas are noncancerous lumps that feel rubbery. They move easily inside the breast tissue. Like fibrocystic changes, they occur most often during the reproductive years.They are most often not tender. Except in rare cases, they do not become cancerous later. A health care provider can feel during an exam whether a lump is a fibroadenoma. The only way to be sure, however, is to remove or biopsy the lump.
Cysts are fluid-filled sacs that often feel like soft grapes. These can sometimes be tender, often just before your menstrual period.
Other causes of breast lumps include:
· Breast cancer.
· Injury. Blood may collect and feel like a lump if your breast gets badly bruised. These lumps tend to get better on their own in a few days or weeks. If they do not improve, your provider may have to drain the blood.
· Lipoma. This is a collection of fatty tissue.
· Milk cysts (sacs filled with milk) and infections (mastitis), which may turn into an abscess. These typically occur if you are breastfeeding or have recently given birth.
Your provider will get a complete history from you. You will be asked about your factors that may increase the risk of breast cancer. The provider will perform a thorough breast exam. If you don't know how to perform a breast self-exam, ask your provider to teach you the proper method.
You may be asked medical history questions such as:
· When and how did you first notice the lump?
· Do you have other symptoms such as pain, nipple discharge, or fever?
· Where is the lump located?
· Do you do breast self-exams, and is this lump a recent change?
· Have you had any type of injury to your breast?
· Are you taking any hormones, medicines, or supplements?
Steps your provider may take next include:
· Order a mammogram to look for cancer, or a breast ultrasound to see if the lump is solid or a cyst
· Use a needle to draw fluid out of a cyst, which will be examined under a microscope to look for cancer cells
How a breast lump is treated depends on the cause.
· Solid breast lumps are often removed with surgery.
· Cysts can be drained in the provider's office. If the fluid removed is clear or greenish, and the lump disappears after it is drained, you do not need further treatment. If the lump does not disappear or comes back, it is most often removed with surgery.
· Breast infections are treated with antibiotics.
· If you are diagnosed with breast cancer, you will discuss your options carefully and thoroughly with your provider.
Atrophic vaginitis is caused by a decrease in estrogen.
Estrogen keeps the tissues of the vagina lubricated and healthy. Normally, the lining of the vagina makes a clear, lubricating fluid. This fluid makes sexual intercourse more comfortable. It also helps decrease vaginal dryness.
If estrogen levels drop off, the vaginal tissue shrinks and becomes thinner. This causes dryness and inflammation.
Estrogen levels normally drop after menopause. The following may also cause estrogen levels to drop:
Medicines or hormones used in the treatment of breast cancer, endometriosis, fibroids, or infertility
Surgery to remove the ovaries
Radiation treatment to the pelvic area
Severe stress, depression, or intense exercise
Some women develop this problem right after childbirth or while breastfeeding. Estrogen levels are lower at these times.
There are many treatments for vaginal dryness. Before treating your symptoms on your own, a health care provider must determine the cause of the problem.
Try using lubricants and vaginal moisturizing creams. They will often moisten the area for several hours, up to a day. These can be bought without prescription.
Use a water-soluble vaginal lubricant during intercourse may help. Products with petroleum jelly, mineral oil, or other oils may damage latex condoms or diaphragms.
Avoid scented soaps, lotions, perfumes, or douches.
Prescription estrogen can work well to treat atrophic vaginitis. It is available as a cream, tablet, suppository, or ring. All of these are placed directly into the vagina. These medicines deliver estrogen directly to the vaginal area. Only a little estrogen is absorbed into the bloodstream.
You may take estrogen (hormone therapy) in the form of a skin patch, or in a pill that you take by mouth if you have hot flashes or other symptoms of menopause.
Women should discuss the risks and benefits of estrogen replacement therapy with their provider.