Mens Health Blog. Medical Blog

Dark skin

Many women notice dark blotchy areas appear on the skin, and this may occur from an early date in pregnancy. Once more this is a side-effect of circulating hormones. The area surrounding the nipples and the nipple itself will become darker in colour.

It is usually more apparent in normally dark complexioned people and those with a normal olive-type skin. Exposure to the sun tends to aggravate it.

The forehead, cheeks and neck are frequently special at-risk areas. Scars and the midline area of the abdomen also seem to have a predilection for this pigmentation.

Generally, when the confinement is over and the hormonal levels revert to normal, many of these areas wane and disappear altogether. In some areas it persists, especially in the areola, the nipples, scars and the abdominal midline parts.

Women on the contraceptive pill (which contains similar types of hormones) often notice these dark markings. They are referred to as chloasma. A preparation called phiaquine creme is sometimes used with beneficial results in the more obvious parts. It is applied locally.

Vomiting

About 50 per cent of women experience nausea and possibly vomiting in the early stages of pregnancy. It often starts around the sixth week, and usually ceases by the twelfth week. In 45 per cent of cases it is mild; in 5 per cent of cases it is moderate, and only in about two cases in 1,000 does it reach serious proportions.

It may occur in the morning after gastric secretions have accumulated in the stomach overnight. But it can also occur at any time of the day. Emotional and psychological factors play a large part once it has become established. Tensions and anxieties can aggravate it. Travelling will often make it seem worse. Often it makes the patient feel miserable and unhappy. She tends to go off her food, which in turn aggravates the situation.

Eating small, dry meals (up to six a day or even more) can often bring relief. Avoiding fatty foods and spicy meals is recommended. Fluids are best taken between meals. The use of glucose-containing beverages may assist. Glucose is well known for its nausea-allaying powers, and it is also a readily absorbed and utilized food in itself.

If symptoms are causing considerable discomfort, the doctor may prescribe medication, although the fewer drugs taken during early pregnancy the better. No drug should be taken unless under specific medical advice. Many women probably remember a drug called Debendox which often dramatically reduced nausea, but this was removed from the market in 1983. However, an old-timer called pyridoxine, or Vitamin Be, nearly always successful, is now often used. It may be given as an injection by the doctor, and usually dramatically reduces nausea and vomiting. Being a natural vitamin it is perfectly harmless. Some doctors believe nausea is simply a symptom of a nutritional deficiency occurring during pregnancy, rather than an indication of any serious underlying pathology. Pyridoxine commonly produces a strange taste in the mouth, but doctors say this indicates that the body is receiving an adequate supply. It may be given with another member of the Vitamin  complex, aneurin, or Vitamin B1.

A severe form of persistent vomiting is called hyperemesis gravidarum. This may need hospitalization and more intensive medical measures. These cases are quite rare, averaging about two in each 1,000 pregnancies.

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Headaches, palpitations and fainting

The fainting heroine (who also happened to be pregnant) has been the clich? of thousands of old-time novels and movies. (The other one used and reused with monotonous regularity was the doctor delivering the baby at home. He needed buckets and buckets and more buckets of boiling water. Generations of modern-day doctors are still asking what he did with all that boiling water!)

However, as many pregnant women know so well, it is not uncommon to develop sensations of feeling faint. Or there may be recurring bouts of head pain, often mild, and seldom really severe. An awareness of the heart beating in the chest, with or without actual exercise is also quite common.

None of these symptoms is serious. Indeed, they may occur to a certain extent in most pregnant women. It is merely due to the altered nature of the body’s blood reservoirs.

With the advent of the pregnant womb, a large amount of blood is transferred from the usual body circulation to the pelvic regions where it is needed to succour the new, developing life.

For this reason, these other circulatory abnormalities tend to take place.

The symptoms are not serious. They are not dangerous. They do not indicate any sinister disease process. They are entirely self-limiting, and will phase out automatically in due course.

Varicose veins

The development of prominent blood-vessels, particularly in the lower limbs, is common during pregnancy. Indeed, very few women manage to escape this to some degree. In some cases it is very marked, and unfortunately these may persist after the confinement.

Frequently the limbs will ache, and the more prominent the veins, the greater the discomfort. They are aggravated by long hours of standing, especially on hard surfaces such as concrete floors. Many women who continue working during pregnancy and have to stand all day may find the complaint quite distressing.

Varicose veins are often an inherited factor, so if your parents had them severely, then you are most probably headed in a similar direction.

They are produced by the increasing mass in the pelvis pressing on the great veins as they return blood from the lower limbs. With the increased stress, the valves in the vessels that help the return of blood frequently break down, and this often produces lumpy nodules so characteristic of varicose vessels.

Much can be done to assist, however. Keeping off hard surfaces for prolonged periods of time is important.

Wearing elasticized stockings can often be very helpful. Special maternity fashions are available in many areas which provide both for this type of hosiery, as well as adequate room for the expanding abdomen. They are highly successful.

Whenever possible, keep the lower limbs elevated, preferably at a level equal to or higher than the hips. This assists the blood flow back to the body with the help of gravity. Some women find it helpful to lie on their backs on the floor and place their limbs at right angles to their body up against the wall. This has a similar mechanical beneficial effect. It can add greatly to personal comfort. Simple massaging of the limbs, using a soft, sweeping movement from the feet upwards, can also help.

Sometimes doctors may inject some of the more prominent veins, but this is best left until after the confinement. Many vessels will disappear at this time, and then the most persistent problems may be dealt with. But other doctors feel that varicose veins should not be tampered with until after the reproductive days are over permanently.

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Here are some of the more likely reasons as to why a legal termination may be considered by the gynaecologist:

• Severe heart disease. If pregnancy is complicated by severe forms of heart disease, and cardiac surgery to the mother is impractical, then termination may be the only way out for her, to save her own life.

• Chest disease. T.B. is rare today, but occasionally this may be a reason, particularly if the patient is unable to tolerate her medication.

• Kidney disease. If the kidneys are severely diseased, it may be imperative to terminate the pregnancy.

• Psychiatric conditions. Certain cases benefit from a termination. (Indeed, this is the aspect most openly abused. However, the doctor should genuinely assess each case that presents, and make a decision after carefully examining the full case-history.)

• Cancer. Malignant disease in young women is often rapidly growing, and may prove fatal in the event of pregnancy. Such a patient would be a certain candidate for termination.

• Disorders of pregnancy. Sometimes severe symptoms occurring in pregnancy warrant termination.

• Viral infections. Rubella contracted in the first twelve weeks of pregnancy is almost certain to yield severe congenital malformations. Termination is usually offered to these women. Some other viral infections are also possible reasons for interference.

• Rh disease. Certain severe cases of Rh disease warrant termination.

• ”Eugenic reasons.” Some high-risk pregnancies warrant termination, particularly when it is suspected with a high degree of accuracy (and this is often possible today with newer concepts of prenatal diagnosis) that the infant will be mentally defective or malformed. (Conditions in this category include Down’s syndrome – mongols, and infants with spina bifida, a serious malformation of the spinal system.)

• Sexual assault: Rape, incest, and similar forms of sexual assault are also considered to be suitable reasons for legal termination.

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During pregnancy there is a natural increase in the normal vaginal secretions. This is not serious, and should cause no worry.

However, there are two organisms which have a predilection for reproducing in the vagina of the pregnant woman.

(a) Candida albicans. This is a fungus, and is a common occurrence in the vaginal region during pregnancy. It is also more common in the diabetic patient (pregnant or otherwise).

It produces a whitish discharge, which may be copious. This in turn causes tenderness, and often a marked itch at the vaginal entry.

The doctor can readily check this, and on inspection can be fairly certain of the diagnosis. But simple tests are available which reveal the fungus under the microscope.

Treatment is usually quite successful. Suppositories of nystatin canesten or other “antifungal” antibiotic are inserted once or twice a day for a week, thence daily for a further fortnight, or even longer. Re-infection from the sexual partner may occur, producing further problems unless therapy is continued.

(b) Trichomonas vaginalis. This is an infection with a micro-organism which has a wildly wagging tail and can propel itself along. It produces a very irritating yellowish discharge. The organism can be detected with straightforward pathology tests. When detected, natamycin suppositories are ordered and these are usually highly effective. Frequently, local applications are needed to reduce the external irritation brought about by the discharges. This condition is usually contracted from an infected partner at intercourse.

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Infections which occur in the bladder, and which spread into the narrow tubes leading to the kidney (called the ureters) are common during pregnancy, particularly after the twentieth week.

Because of increased amounts of hormone in the bloodstream, the ureters tend to dilate, and this may encourage germs to travel from the bladder into the cavities of the kidney.

Due to changes occurring in the pelvis, complete emptying of the bladder is often difficult. Small amounts of urine are left, forming a reservoir for proliferating germs. Here they multiply rapidly. Frequently, no symptoms occur, and the infection simply smoulders on silently.

But when the germs commence moving into the ureters and on into the kidneys, symptoms can suddenly flare. Elevated temperatures, chills, fevers, aches in the lower back region, aches and pains all over, frequency of urination, the desire to empty the bladder a short time after this has already been done, with little satisfaction, all become commonplace symptoms. Vomiting and a high pulse-rate might also occur.

These demands prompt medical attention. The doctor will probably order a laboratory test on the urine. In this manner the organism producing the infection can be isolated, and the antibiotic to which it is most responsive determined. Treatment is usually commenced at once. Bed rest and lots of fluid are essential.

The results are usually satisfactory, and reduction in discomfort, temperature and the frequency of passing urine and a lessening of the scalding sensation take place rapidly. However, as re-infections are highly likely, continuation of treatment for the remainder of the pregnancy is often necessary.

Stick closely to the doctor’s recommendations. Take the medication given exactly as prescribed. This is the quickest way to recover.

Although the use of medication during pregnancy has been discussed previously, when serious symptoms arise, it is often essential to embark on suitable medication. Any risks of this must be carefully weighed against the risks of the infections. The doctor will order medication with a careful eye on all aspects of risks.

However, many of the complications do not arise until the second half of pregnancy. By this time, the major risks have disappeared. The major cell multiplication and the development of each organ are long since complete, and for these reasons the risks of congenital malformations decrease.

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Young people usually choose to handle this problem in one of three ways: sneak round behind their parents’ backs; go along with their parents’ rules and wait until their parents say they’re old enough; try to change their parents’ minds. Let’s look at each of these choices.

Sneaking round behind your parents’ backs just isn’t a good choice. Sooner or later young people who do this almost always get caught. If you do get caught, you may get into a lot of trouble and may do serious damage to your relationship with your parents. In fact, your parents may find it hard to trust you in the future. Even if you don’t get caught, you’ll probably feel guilty about lying and sneaking. Going out should be a fun and pleasurable part of your life. Having to sneak round just complicates your life. Who needs the added complication of having to go behind your parents’ backs? In short, sneaking round behind your parents’ backs just isn’t worth the ‘price’ you may have to pay.

On the other hand, it can be awfully hard to go along with your parents’ rules and wait until you’re older, especially if there’s a special someone you’d like to go out with. But parents who make these sorts of rules aren’t usually trying to be mean or unfair. They’re trying to protect you from ‘getting in over your head’ by starting your romantic life when you are too young. After all, you have a lot of years ahead of you. So if you parents want you to wait, think honestly about it. Maybe they’re right. If your parents say no, ask yourself these questions: are the other kids my age allowed to go out? would I really lose anything by waiting until I’m older?

If your honest answer to these questions is no, then perhaps waiting is the best choice for you. If, however, you feel that your parents are being too strict or too old-fashioned, you might want to consider the third choice, changing their minds.

Changing your parents’ minds probably wouldn’t be an easy job, but it’s worth a try. For starters, find out exactly why they’ve made these rules. What are they worried about? Once you understand their feelings, you may be able to come up with a compromise. If, for instance, your parents think you’re too young to go out, maybe they’d allow you to go on group dates. Or if they won’t allow dates for the cinema, perhaps they’ll allow you to go to a boy-girl party or invite someone to your house.

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People used to think that children didn’t have strong romantic feelings or much interest in anything sexual before the age of puberty. We now know that even young children may have strong romantic and sexual feelings and that they often are curious about sex at a very young age. Of course, not all young children have strong feelings of this nature and not all are curious about sex. As we’ve said, each of us has his or her own personal timetable. But, many children do have a curiosity about sex and strong feelings during childhood. It’s important for you to know that it’s normal if you do have strong romantic and sexual feelings during childhood and it’s also normal if you don’t.

When we talk about childhood sexual feelings and curiosities, one topic that always comes up is sex play. Many youngsters engage in some form of sex play during their childhood. For instance, many children ‘play doctor’ or invent other games that involve taking off their clothes and looking at or touching each other’s sex organs.

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There are special medical tests that can be done to determine whether or not a person has an STD, and if so, what kind. One way in which people find out that they have an STD is that they develop symptoms. The symptoms may lead the person to see a doctor who tests him or her for STDs.

However, one of the big problems with STDs is that people sometimes have the disease without knowing it. For example, it usually takes many years for a person infected with HIV to develop any obvious signs or symptoms of AID S. Women with chlamydia and gonorrhoea frequently don’t have any symptoms or the symptoms are so mild or so temporary that the woman doesn’t see a doctor. However, the germs are still in the body, can be passed on to others and may lead to serious medical problems such as PID. A person may have genital warts without knowing it, which can be a serious problem for women because untreated genital warts may lead to cervical cancer.

Because a person can have these and other STDs without knowing it and because untreated STDs can lead to serious health problems, it is vitally important that anyone who has an STD or thinks he or she might have one should seek medical attention immediately. Anyone diagnosed as having an STD should inform all his or her sexual partners, so these people can be tested and, if necessary, treated. Even if the sexual partners don’t have any symptoms, they must, none the less, be tested and treated.

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Most females discover that they are pregnant because they fail to have their menstrual period at the expected time. Sore breasts and nausea are also early signs of pregnancy. However, there are many reasons, other than pregnancy that could cause a female to miss her menstrual period or to have sore breasts or nausea. But, pregnancy is the most common cause of missed periods in sexually active females. Anyone who thinks she might be pregnant should have a pregnancy test.

Standard pregnancy tests are done on a urine sample collected in the early morning. In order for the test to be accurate, at least fourteen days must have elapsed since the time of the expected menstrual period, that is, the girl or woman must be at least fourteen days iate’ in getting her period. These standard pregnancy tests are available from some family doctors, family planning clinics and Brook Advisory Centres. Pregnancy tests that can detect pregnancy earlier, that is, before the girl or woman is fourteen days late in getting her period, are available from one of the pregnancy charities.

In addition, home pregnancy test kits are available from chemists. If a person follows the directions and uses these tests properly, they are quite reliable. However, it is possible to get a false test result. For example, the test may indicate that someone isn’t pregnant when, in reality, she is or vice versa. If the home pregnancy test indicates a female isn’t pregnant, but she still doesn’t get her period or she has other signs of pregnancy (swollen, tender breasts or nausea) or if she feels unsure about the test results, she should have a test done at a doctor’s surgery or clinic.

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This method, which is also called the’jag’ or ‘jab’, is not as widely used as some of the others, and is not a first-choice method. It involves an injection of large amounts of a hormone similar to the hormone used in the mini-pill. It prevents pregnancy in the same manner as the mini-pill. The hormone is injected into the woman’s muscle and is then released into the woman’s body slowly over a period of months. A single injection usually protects against pregnancy for two to three months.

The ‘morning after’ pill and IUD-Considered emergency methods, these methods are used only in cases where a woman fears she might become pregnant because she hasn’t used birth control, she’s used her method improperly or she thinks that her method might not have worked properly. The morning after pills contain a high dose of hormones like the ones in combined birth control pills, and must be taken within seventy-two hours of unprotected intercourse in order to work.

Inserting an IU D within 5 days of unprotected intercourse will also prevent pregnancy, although this is usually done only in cases where the woman plans to go on using the IUD as her regular method of contraception and where it is medically suitable to do so.

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