Boils after shaving??? Be careful to avoid Folliculitis.

Folliculitis is a common skin condition in which hair follicles become inflamed. It's usually caused by a bacterial or fungal infection. At first it may look like small red bumps or white-headed pimples around hair follicles — the tiny pockets from which each hair grows. The infection can spread and turn into nonhealing, crusty sores.
The condition isn't life-threatening, but it can be itchy, sore and embarrassing. Severe infections can cause permanent hair loss and scarring.
If you have a mild case, it'll likely clear in a few days with basic self-care measures. For more serious or recurring folliculitis, you may need to see a doctor.
Certain types of folliculitis are known as hot tub rash, razor bumps and barber's itch.

Symptoms

Folliculitis signs and symptoms include:

• Clusters of small red bumps or white-headed pimples that develop around hair follicles
• Pus-filled blisters that break open and crust over
• Red and inflamed skin
• Itchy or burning skin
• Tenderness or pain
• A large swollen bump or mass

Types of superficial folliculitis

Superficial forms of folliculitis include:

• Bacterial folliculitis. This common type is marked by itchy, white, pus-filled bumps. When bacterial folliculitis affects a man's beard area, it's called barber's itch. It occurs when hair follicles become infected with bacteria, usually Staphylococcus aureus (staph). Staph bacteria live on the skin all the time. But they generally cause problems only when they enter your body through a cut or other wound.
• Hot tub folliculitis (pseudomonas folliculitis). This type is caused by pseudomonas bacteria. You may be exposed to these bacteria in many places, including hot tubs and heated pools in which the chlorine and pH levels aren't well-regulated. You may develop a rash of red, round, itchy bumps one to four days after exposure. These may later develop into small pus-filled blisters (pustules).
  The rash is likely to be worse in areas where your swimsuit held contaminated water against the skin or where skin — such as the back of the thighs — came in direct contact with a contaminated surface.
  
• Barber's itch (pseudofolliculitis barbae). This is an inflammation caused by ingrowing hairs. It mainly affects black men who shave and is most noticeable on the face and neck. People who get bikini waxes may develop barber's itch in the groin area. This condition may leave dark raised scars (keloids).
• Pityrosporum (pit-ih-ROS-puh-rum) folliculitis. This type is especially common in teens and adult men. It's caused by a yeast infection and produces chronic, red, itchy pustules on the back and chest and sometimes on the neck, shoulders, upper arms and face. 

 

Types of deep folliculitis

 

Deep folliculitis, where the whole hair follicle is involved, comes in various forms:

• Sycosis barbae. This type affects men who have begun to shave. At first, small pustules appear on the upper lip, chin and jaw. They become more prevalent over days and weeks as shaving continues. Severe sycosis barbae may cause scarring.
• Gram-negative folliculitis. This type sometimes develops if you're receiving long-term antibiotic therapy for acne. Antibiotics alter the normal balance of bacteria in the nose. This leads to an overgrowth of harmful organisms called gram-negative bacteria. In most people, this doesn't cause problems, and the bacteria in the nose return to normal once antibiotics are stopped. In a few people, the gram-negative bacteria spread to the skin around the nose and mouth. This can cause new, severe acne.
• Boils (furuncles) and carbuncles. These occur when hair follicles become deeply infected with staph bacteria. A boil usually appears suddenly as a painful pink or red bump. The surrounding skin also may be red and swollen. The bump then fills with pus and grows larger and more painful before it finally ruptures and drains. Small boils usually heal without scarring. A large boil may leave a scar.
  A carbuncle is a cluster of boils. It usually appears on the back of the neck, shoulders, back or thighs. A carbuncle causes a deeper and more severe infection than does a single boil. As a result, it develops and heals more slowly and is likely to leave a scar.
  
• Eosinophilic (e-o-sin-o-FILL-ik) folliculitis. This type mainly affects people with HIV/AIDS. Symptoms include intense itching and recurring patches of inflamed, pus-filled sores on the scalp, face, neck and upper chest. The sores usually spread and often leave areas of darker than normal skin (hyperpigmentation) when they heal. The exact cause of eosinophilic folliculitis isn't known. But it may involve the same yeast-like fungus responsible for pityrosporum folliculitis.

Causes

Folliculitis is caused by an infection of hair follicles, usually from the bacteria Staphylococcus aureus. May also be caused by viruses, fungi and even an inflammation from ingrown hairs.
The condition is classified as either superficial or deep, based on how much of the hair follicle it involves. Deep folliculitis is usually more severe.
Follicles are densest on your scalp, and they occur everywhere on your body except your palms, soles, lips and mucous membranes. Damaged follicles are at risk of infection.
The most common causes of follicle damage are:

• Friction from shaving or tight clothing
• Heat and sweat, such as that caused by wearing rubber gloves or waders
• Certain skin conditions, such as dermatitis and acne
• Injuries to your skin, such as from scrapes or surgical wounds
• Coverings on your skin, such as plastic dressings or adhesive tape

Risk factors

Anyone can develop folliculitis. But certain factors make you more susceptible to the condition, including:

• Having a medical condition that reduces your resistance to infection, such as diabetes, chronic leukemia and HIV/AIDS
• Having acne or dermatitis
• Past damage to your skin, as from injury or surgery
• Taking some medications, such as steroid creams or long-term antibiotic therapy for acne
• Being overweight
• Regularly wearing clothing that traps heat and sweat, such as rubber gloves or high boots
• Soaking in a hot tub that's not maintained well
• Shaving

Complications

Possible complications of folliculitis include:

• Recurrent or spreading infection
• Large, itchy patches of infected skin (plaques)
• Boils under the skin (furunculosis)
• Permanent skin damage, such as scarring or dark spots
• Destruction of hair follicles and permanent hair loss

Prevention

You can try to prevent folliculitis from coming back with these tips:

• Avoid tight clothes. It helps to reduce friction between your skin and clothing.
• Dry out your rubber gloves between uses. If you wear rubber gloves regularly, after each use turn them inside out, rinse with soap and water, and dry thoroughly.
• Avoid shaving, if possible. For men with barber's itch, growing a beard may be a good option if you don't need a clean-shaven face.
• Shave with care. Use an electric razor or a clean, sharp blade every time you shave. Adopt habits such as:
  
  • Washing your skin with warm water and a mild facial cleanser before shaving
  • Using a wash cloth or cleansing pad in a gentle circular motion
  • Applying lubricating shaving cream or gel for five to 10 minutes before shaving to soften the hair
  • Applying moisturizing lotion after you shave
  Generally, men with barber's itch have been advised to shave in the direction of hair growth. But a study found that men who shaved against the grain saw their rash improve. Experiment to see what works for you. You may even want to consider hair-removing products (depilatories) or other methods of hair removal.
  
• Use only clean hot tubs and heated pools. And if you own a hot tub or a heated pool, clean it regularly and add chlorine as recommended.

For more free health information and questions,open our facebook link below,read contents carefully and consider inviting your friends and relatives you care about.

 Gynaecology-Centre-Nairobi

Galactorrhea

 

Galactorrhea (guh-lack-toe-REE-uh) is a milky nipple discharge unrelated to the normal milk production of breast-feeding. Galactorrhea itself isn't a disease, but it could be a sign of an underlying problem. It usually occurs in women, even those who have never had children or after menopause. But galactorrhea can happen in men and even in infants.
Excessive breast stimulation, medication side effects or disorders of the pituitary gland all may contribute to galactorrhea. Often, galactorrhea results from increased levels of prolactin, the hormone that stimulates milk production.
Sometimes, the cause of galactorrhea can't be determined. The condition may resolve on its own.

 

Symptoms

Signs and symptoms associated with galactorrhea include:

• Persistent or intermittent milky nipple discharge
• Nipple discharge involving multiple milk ducts
• Spontaneously leaked or manually expressed nipple discharge
• One or both breasts affected
• Absent or irregular menstrual periods
• Headaches or vision problems

Causes

•  Pituitary gland and hypothalamus

Galactorrhea often results from too much prolactin — the hormone responsible for milk production (lactation) when you have a baby. Prolactin is produced by your pituitary gland, a marble-sized gland at the base of your brain that secretes and regulates several hormones.
Possible causes of galactorrhea include:

• Medications, such as certain sedatives, antidepressants, antipsychotics and high blood pressure drugs
• Cocaine, marijuana or opioid use
• Herbal supplements, such as fennel, anise or fenugreek seed
• Birth control pills
• Noncancerous pituitary tumor (prolactinoma) or other disorder of the pituitary gland
• Underactive thyroid (hypothyroidism)
• Chronic kidney disease
• Excessive breast stimulation, which may be associated with sexual activity, frequent breast self-exams with nipple manipulation or prolonged clothing friction
• Nerve damage to the chest wall from chest surgery, burns or other chest injuries
• Spinal cord surgery, injury or tumors

 

Idiopathic galactorrhea

Sometimes doctors can't find a cause for galactorrhea. This is called idiopathic galactorrhea, and it may just mean that your breast tissue is particularly sensitive to the milk-producing hormone prolactin in your blood. If you have increased sensitivity to prolactin, even normal prolactin levels can lead to galactorrhea.

 

Galactorrhea in men

In males, galactorrhea may be associated with testosterone deficiency (male hypogonadism) and usually occurs with breast enlargement or tenderness (gynecomastia). Erectile dysfunction and a lack of sexual desire also are associated with testosterone deficiency.

 

Galactorrhea in newborns

Galactorrhea sometimes occurs in newborns. High maternal estrogen levels cross the placenta into the baby's blood. This can cause enlargement of the baby's breast tissue, which may be associated with a milky nipple discharge

When to see a doctor

If you have a persistent, spontaneous milky nipple discharge from one or both of your breasts and you're not pregnant or breast-feeding, make an appointment to see your doctor.
If breast stimulation — such as excessive nipple manipulation during sexual activity — triggers nipple discharge from multiple ducts, you have little cause for worry. The discharge probably doesn't signal anything abnormal, including breast cancer, but you should still see a doctor for evaluation.
Nonmilky nipple discharge — particularly bloody, yellow or clear spontaneous discharge that comes from one duct or is associated with a lump you can feel — requires prompt medical attention, as it may be a sign of an underlying breast cancer.Gynaecology-Centre-Nairobi

Why men often die earlier than women

Robert Shmerling, MD, 

My wife recently asked me, “Why do you assume you’ll die before me?”
Her question caught me by surprise. But it’s true, I have made that assumption. So, I answered, as matter-of-factly as I could, with one word: statistics.
I knew that, on average, women live longer than men. In fact, 57% of all those ages 65 and older are female. By age 85, 67% are women. The average lifespan is about 5 years longer for women than men in the U.S., and about 7 years longer worldwide.
It’s not hard to see the gender gap among the elderly. A glance around most nursing homes or assisted living facilities in the U.S. often tells the story: women will usually outnumber men, and the magnitude of the difference is often striking. I’m also told that when a man moves into a residential setting dominated by the geriatric set, he tends to be popular; and that’s especially true if he still drives.
Advertisers know this as well. I recently saw an ad for an organization called “A Place for Mom” that helps families find assisted living or other services for senior citizens. And while they help men as well as women, the name of the company reflects how much bigger the elderly female market is.

So why do men, on average, die first?

There are many reasons why the ratio of men to women (which is roughly equal in young adulthood) starts to favor women over time. Among the most powerful factors? Men tend to

• take bigger risks. Some of the reason seems to be “biological destiny.” The frontal lobe of the brain — the part that controls judgment and consideration of an action’s consequences — develops more slowly in boys and young men than in their female counterparts. This likely contributes to the fact that far more boys and men die in accidents or due to violence than girls and women. Examples include biking, driving drunk, and homicide. This tendency toward lack of judgment and consideration of consequences may also contribute to detrimental lifestyle decisions among young men, such as smoking or drinking to excess.
• have more dangerous jobs. Men far outnumber women in some of the riskiest occupations, including military combat, firefighting, and working at construction sites.
• die of heart disease more often and at a younger age. In fact, men are 50% more likely than women to die of heart disease. The fact that men have lower estrogen levels than women may be part of the reason. But medical risks, such as poorly treated high blood pressure or unfavorable cholesterol levels, may contribute as well.
• be larger than women. Across many species, larger animals tend to die younger than smaller ones. Although the magnitude of this effect is uncertain in humans, it tends to work against male longevity.
• commit suicide more often than women. This is true despite the fact that depression is considered more common among women and women make more (non-fatal) suicide attempts. Some attribute this to the tendency for men to avoid seeking care for depression and the cultural norms that discourage men from seeking help for mental illness.
• be less socially connected. For reasons that aren’t entirely clear, people with fewer and weaker social connections (including men) tend to have higher death rates.
• avoid doctors. According to the Agency for Healthcare Research and Quality, men are far more likely to skip routine health screens and far less likely than women to have seen a doctor of any kind during the previous year.

The uneven playing field for boys starts early. The Y chromosome tends to develop mutations more often than X chromosomes and the lack of a second X chromosome in men means that X-linked abnormalities among boys are not “masked” by a second, normal version. Survival in the womb is also less reliable for male fetuses (for uncertain, and probably multiple, reasons). Developmental disorders are also more common among boys; some of these could shorten life expectancy.

What we can do to help men live longer

While there’s not much that can be done about some of these factors, others are modifiable. For example, since men tend to avoid medical care far more often than women, getting men to report symptoms (including depression) and go for regular follow-up for chronic medical problems (such as high blood pressure) could counter some of the tendency for them to die younger.
It’s also worth noting that the survival gap between men and women reflects an average tendency among large numbers of people. In fact, plenty of wives predecease their husbands. Individual risk factors (such as smoking, diabetes, or a strong family history of breast cancer) can outweigh the general tendency for women to live longer.
Perhaps we’ll be more successful in the future in avoiding preventable, premature death among men (and women) — and, because many of these efforts will have a bigger impact on men, the gender gap among the elderly may eventually narrow. Until then, my wife and I will do what we can to stay healthy. But, statistics don’t lie. I’ll probably die first.

                                         +254(0)706666542

5 Everyday Habits That Are Causing Your Boobs to Sag

 Stop stretching out your set!

 

We hate to deliver depressing news, but the fact is, some breast sag is inevitable. Having a baby, breastfeeding, and racking up more birthdays all contribute to a loss of elasticity of collagen, the connective tissue under the skin—leaving your set more deflated than firm. Sag can also be a matter of genetics. If your mother had a droopy pair, you might be predisposed to one, too (thanks, Mom!).

Here's the thing: Some boob behaviors that seem like they have nothing to do with sag can actually contribute to it—so if you avoid them, your breasts will be better off. And considering that a recent UCLA study found that breast tissue ages two to three years faster than the rest of your body, you might want to quit any habit linked to a flaccid pair—like these.


Crash Dieting
Cycling back and forth between the same five to 10 pounds probably won’t make a dent in your set. But yo-yo dieting 30 or so lbs over and over? Definitely. Each time you gain and lose weight, breast tissue becomes more slack, kind of like old tights, says Michael Edwards, M.D., a breast surgeon and president of the American Society for Aesthetic Plastic Surgery.

Smoking
Even your breasts can’t escape the damage cigarettes do. “Any amount of smoking weakens and ages skin by decreasing the blood supply to the skin surface,” says Edwards.
Skipping Sunscreen
Exposing your face to UV rays without a protective coating of sunscreen can lead to premature wrinkles, and it has the same effect on breast sag by stretching out collagen and damaging skin, says Edwards.

Wearing an Unsupportive Bra
Whether it’s the boulder holder you wear during the day or the sports bra you change into at the gym, not sporting proper support is a big reason for droop. “The more your boobs bounce around, the more stressed breast skin and collagen become,” says Edwards. Stop in a lingerie shop and ask for a fitting just to make sure you’re wearing the right bra for your shape.

 High-Impact Workouts
The research is scant right now, but some experts say that the back-and-forth repetitive motions that happen when you run or do a similar workout can lead to a breakdown of breast collagen. But before you swear off the track or treadmill, read up on the details (and keep in mind that exercise helps you keep up a youthful appearance in other ways).

How Your Vagina Changes in Your 20s, 30s, and 40s

A three-decade snapshot of your snatch

 

In Your 20's...
Normal Shrinkage
Puberty's totally over (thank gawd), and your organs have reached their adult size. Except, that is, for your labia majora, the outer "lips" that enclose the rest of your privates. Don't be shocked to see these looking slimmer. As you age, subcutaneous fat, including that of your genitals, decreases.

In Your 30's...
Dark Shadows
The hormone shifts that come with pregnancy or aging can cause your labia minora, the "inner" lips that encircle the clitoris and vaginal opening, to darken in color. So you can relax if, on your next self-check, it's like 50 shades of (mauve-ish) gray down there.
The Big Stretch
The uterus balloons to watermelon proportions during pregnancy—then shrinks back down within six weeks after birth. Some 32 percent of women now deliver by C-section, sparing their vag opening similar stretching (though their surgery scars can ache or tingle for years).

In Your 40's...
Short Stuff
Though a woman's egg supply dwindles rapidly in her early forties, she still ovulates and (sigh) gets her period. Cycles are a bit shorter, though, and tend to peter out by age 51—i.e., menopause. Your body puts the kibosh on fertility five to 10 years before that.
Deep Squeeze
Your repro organs are supported by a hammock of tendons, tissue, and muscle. Extra pounds, aging, or years of high-impact workouts can loosen this pelvic floor, straining organs and causing bladder leakage or a "heavy" feeling down below. Your move: Kegels. Lots of 'em.
Desert Rescue
Lower estrogen levels affect the vagina's acid-alkaline balance, which can spur inflammation—along with thinning and drying of the vaginal walls, which can cause itching, burning, and redness. Silver lining: Regular sex can prevent this atrophy (hop to it!).

For more watsup/call 0706666542.

Teenage pregnancy: Helping your teen cope

Teenage pregnancy can have a profound impact on a teen's life. Help your daughter understand the options, health risks and challenges ahead

Pregnancy can be one of the most difficult experiences a teenage girl ever faces. Understand how to support your daughter as she deals with teenage pregnancy.

Provide support

Teenage pregnancy is often a crisis for a young girl and her family, as well as the baby's father and his family. Common reactions might include anger, guilt and denial. Your teen might also experience anxiety, fear, shock and depression.
Talk to your daughter about what she's feeling and the choices ahead. She needs your love, guidance and support now more than ever.

Discuss the options

A pregnant teen has a variety of options to consider:

• Keep the baby. Many pregnant teens keep their babies. Some marry the baby's father and raise the baby together. Others rely on family support to raise the baby. Finishing school and getting a good job can be difficult for a teen parent, however. If your daughter plans to keep the baby, make sure she understands the challenges and responsibilities involved.
• Give the baby up for adoption. Some pregnant teens give their babies up for adoption. If your daughter is considering adoption, help her explore the different types of adoption available. Also, discuss the emotional impact.
• End the pregnancy. Some pregnant teens choose to end their pregnancies. If your daughter is considering an elective abortion, discuss the risks and emotional consequences. Be aware that some states require parental notification for a legal abortion.

In addition to talking to you, encourage your daughter to talk about the options with the father of the baby and his parents or guardians, her health care provider, or a specialist in pregnancy counseling. Talking to a psychologist or social worker might be helpful, too.
Also, keep in mind that in some states, a pregnant teen is considered to be an emancipated minor who has the right to make her own decision about her pregnancy.

Understand the health risks

Pregnant teens and their babies are at higher risk of health problems than are pregnant women who are older. The most common complications for pregnant teens — especially those younger than age 15 and those who don't receive prenatal care — include a low level of iron in the blood (anemia), high blood pressure and preterm labor.
Babies born to teen mothers are more likely to be born prematurely and have a low birth weight.

Promote proper prenatal care

A pregnant teen can improve her chances of having a healthy baby by taking good care of herself. If your daughter decides to continue the pregnancy, encourage her to:

• Seek prenatal care. During pregnancy, regular prenatal visits can help your daughter's health care provider monitor your daughter's health and the baby's health.
• Get tested for sexually transmitted infections (STIs). If your teen has an STI, treatment is essential.
• Eat a healthy diet. During pregnancy, your daughter will need more folic acid, calcium, iron, protein and other essential nutrients. A daily prenatal vitamin can help fill any gaps. In addition, your daughter might need extra calcium and phosphorus because her own bones are still growing.
• Stay physically active. Regular physical activity can help ease or even prevent discomfort, boost your teen's energy level, and improve her overall health. It can also help her prepare for childbirth. Encourage your daughter to get her health care provider's OK before starting or continuing an exercise program, especially if she has an underlying medical condition.
• Gain weight wisely. Gaining the right amount of weight can support the baby's health — and make it easier for your teen to lose weight after delivery. Encourage your daughter to work with her health care provider to determine what's right for her.
• Avoid risky substances. Alcohol, tobacco, marijuana and other illegal drugs are off-limits during pregnancy. Even prescription and over-the-counter medications deserve caution. Remind your daughter to clear any medications or supplements with her health care provider ahead of time.
• Take childbirth classes. These classes can help prepare your daughter for pregnancy, childbirth, breast-feeding and being a parent.

If your daughter lacks the money or transportation to obtain prenatal care — or needs help continuing her education — a counselor or social worker might be able to help.

Prepare for the future

Teenage pregnancy often has a negative impact on a teen's future. Teen mothers are less likely to graduate from high school and to attend college, are more likely to live in poverty, and are at risk of domestic violence. Teen fathers tend to finish fewer years of school than do older fathers. They're also less likely to have a job.
Children of teen parents also are more likely to have health and cognitive conditions and are more likely to be neglected or abused. Girls born to teen parents are more likely to experience teenage pregnancy themselves.
If your daughter decides to continue the pregnancy, address these challenges head-on. Discuss her goals and how she might go about achieving them as a parent. Look for programs to help pregnant teens remain in school or complete course work from home. Encourage your daughter to take parenting classes and help her prepare to financially support and raise a child.
Whatever choice your daughter makes, be there for her as much as possible. Your love and support will help her deal with pregnancy and the challenges ahead.

For help/more info watsup or call +254 706 666 542     mail : gyncentre@gmail.com  Tweet @gyncetre

Ultrasound scans

What is an ultrasound scan?
An ultrasound picture is formed using sound waves, which are passed through the uterus and reflected back as an image on a screen.
Ultrasound scans in pregnancy may be routine or they may be offered because of pain or bleeding or because of problems in a previous pregnancy.

How is it done? 





There are two ways of doing an ultrasound scan.

In early pregnancy, especially before 11 weeks, it is usual to have a trans-vaginal (internal) scan, where a probe is placed in the vagina.  This gives the clearest and most accurate picture in early pregnancy.  It may also be offered after 11 or 12 weeks if a trans-abdominal scan doesn’t give a clear enough picture.
From 11 or 12 weeks, including at the routine booking-in scan, it is more common  to have a trans-abdominal scan.  The person doing the scan spreads a special gel on your lower abdomen (below your belly button and above the line of pubic hair).  He or she then moves the scanner over the gel, sometimes pressing down, until the uterus (womb) and pregnancy can be seen.

What if I don’t want an internal scan?
If you don’t want a trans-vaginal scan, you can ask for a trans-abdominal scan. That may give some information about your pregnancy, but it is less clear than an internal scan and that could possibly delay diagnosis.

Can scans harm the baby?
There is no evidence that having a vaginal or an abdominal scan will cause a miscarriage or harm your baby. If you bleed after a vaginal scan, it will most likely be because there was already blood pooled higher in the vagina and the probe dislodged it.

When can I have a scan? When can you see the baby’s heartbeat?
An ultrasound scan may be able to detect a pregnancy and a heartbeat in a normal pregnancy at around 6 weeks, but this varies a great deal and isn’t usually advised.  All too often, a scan at 6 weeks shows very little or nothing, even in a perfectly developing pregnancy, whereas waiting a week or 10 days will make the findings much clearer. 

Routine scans
Most pregnant women are referred for their first routine ultrasound scan somewhere between 11 and 18 weeks of pregnancy.  The purpose of the scan is:

• to confirm that there is a heartbeat
• to assess the baby’s size and growth
• to estimate the delivery date and
• to check whether there is one baby, or twins or more.

Some women may be offered a nuchal scan between 11 and 14 weeks. The purpose of this scan is to try to detect some chromosome abnormalities, such as Downs syndrome.
Many hospitals also offer a further anomaly scan at 20 weeks, making a more detailed check of the baby’s development.
You can find out more about nuchal and anomaly scans at the website of the charity ARC – Antenatal Results and Choices

Sadly…
Sadly, sometimes these scans show that the baby has died, possibly some weeks earlier and often without any signs or symptoms such as bleeding or pain. This is often called a “missed” or “delayed” miscarriage. This can come as a considerable shock and it may take time before you can take this information in.
You may also have to make some difficult decisions about how to manage the miscarriage process. You can read more about this here.


Early scans
You may be referred for an early scan because of vaginal bleeding or spotting, or possibly because you have had problems in a previous pregnancy.
The best time to have a scan is from about 7 weeks’ gestation when it should be possible to see the baby’s heartbeat in a normal pregnancy. But it can be hard to detect a heartbeat in early pregnancy and in those cases it can be hard to know whether the baby has died or not developed at all, or whether it is simply smaller than expected but still developing.
For that reason, you may be asked to return for another scan a week or so later.  At that time, the person doing the scan will be looking for a clear difference in the size of the pregnancy sac and for a developing baby and a heartbeat.
Sometimes, it can take several scans before you know for sure what is happening.  It can be very stressful dealing with this uncertainty – some women describe it as being “in limbo”.  You may need to find some support for yourself if this happens to you.
There’s a heartbeat, but I’m still bleeding…
If the scan does pick up a heartbeat and the baby appears to be the right size according to your dates, this can be very reassuring, even if you are still bleeding.
Research amongst women with a history of recurrent miscarriage has shown that those who saw a heartbeat at 6 weeks of pregnancy had a 78% chance of the pregnancy continuing.  It also showed that seeing a heartbeat at 8 weeks increased the chance of a continuing pregnancy to 98% and at 10 weeks that went up to 99.4%.
The numbers may be even more positive for women without previous miscarriages.
So things could still go wrong and sadly sometimes do, but as long as there is a heartbeat, the risk of miscarriage decreases as the weeks go by.

Other investigations
In some cases, if there is no sign of a pregnancy in the uterus, you may be given a blood test and possibly asked to return two days later for a repeat test.
These blood tests measure the level of the pregnancy hormone ßhCG. In a normally developing pregnancy the hormone levels double about every 48 hours and if the pattern is different, this can help to identify what is happening to the pregnancy.
If there is no sign of a pregnancy in the uterus and you have symptoms that suggest ectopic pregnancy, you are more likely to have both a blood test and an investigation called a laparoscopy, which is done under general anaesthetic. You can read more about this in our leaflet Ectopic pregnancy.
Scan results – and what they mean
The ultrasound scan may show:

• A viable ongoing pregnancy.  There is a heartbeat (or heartbeats if it’s a twin or multiple pregnancy) and the pregnancy is the “right size for dates” – that is, the size that would be expected based on the first day of your last period.  Those are positive signs, but if you continue to bleed, you may need a further scan in a week or two to check what’s happening.

• An ongoing pregnancy that suggests a problem.  Perhaps the pregnancy is much smaller than it should be according to dates or the heartbeat is particularly slow or faint.  Perhaps there is something that suggests a problem with the baby’s development. With a twin or multiple pregnancy, the scan may show that one (or more) baby has a heartbeat and one (or more) doesn’t.  You may be asked to come back for another scan, possibly in a week or two when things should be clearer.

• A pregnancy of unknown location (PUL).  The pregnancy is too small for the heartbeat to be visible, or there may be nothing much to see at all and it’s not clear what is happening.  You will probably be asked to come back for another scan, possibly in a week or two when things should be clearer.  Or if the doctor thinks you might have an ectopic pregnancy, you will have blood tests and/or a laparoscopy.

• A complete miscarriage.  The pregnancy has miscarried.  There may still be a small amount of tissue or blood in the uterus.

• A non-viable pregnancy. This means a pregnancy that hasn’t survived but hasn’t yet miscarried.  You may hear this described in one of the following ways:

• Missed miscarriage (also called silent or delayed miscarriage or early embryonic demise) This is where the baby has died or failed to develop but your body has not miscarried him or her. The scan picture shows a pregnancy sac with a baby (or fetus or embryo) inside, but there is no heartbeat and the pregnancy looks smaller than it should be at this stage.  You may have had little or no sign that anything was wrong and you may still feel pregnant.

• Blighted ovum or anembryonic pregnancy (which means a pregnancy without an embryo). This is a rather old-fashioned way of describing a missed miscarriage (see above). The scan picture usually shows an empty pregnancy sac.

• Incomplete miscarriage The process of miscarriage has started but there is still pregnancy tissue in the uterus (womb) and you may still have pain and heavy bleeding.

In all of these situations, the pregnancy will fully miscarry with time, but there are several ways of managing the process. You may be offered a choice, or the hospital might make a recommendation. In most cases, you should be able to have time to think about what you can best cope with. You can read more here.

The ultrasound scan might show

• An ectopic pregnancy. This means a pregnancy that is developing outside the uterus (Ectopic means “out of place”). Ectopic pregnancies usually develop in one of the Fallopian tubes, but they can develop elsewhere inside the abdomen. You can read more in our leaflet Ectopic pregnancy.

• A molar pregnancy. This is a pregnancy where the baby can’t develop but the cells of the placenta grow very quickly. It can’t always be diagnosed on scan so you might find out only after the miscarriage. You can read more in our leaflet Hydatidiform Mole.

How to Tighten Loose Skin After Pregnancy

During pregnancy, the skin in your mid-section can stretch due to weight gain and a growing abdomen. That post-pregnancy loose or flabby skin doesn't have to hang around forever.

Some simple exercise can help you tighten up your tummy skin and help you return to your pre-pregnancy shape.

Tightening Loose Skin After Pregnancy
Be patient.

Remember, it took nine months to gain any pregnancy weight. So instead of going on a crash diet after delivering your baby, it's best to lose any pregnancy weight slowly; no more than 1 to 2 pound a week.

Although not being able to wear your pre-pregnancy clothes may test your patience, a slow and steady approach to weight loss with give your skin a better chance to adjust to slow changes to your body and lessens the chance you'll be left with saggy skin around the middle..

Build strength.

Although exercise won't tighten your skin, it can help you build and tone muscles to minimize the appearance of loose skin.

Crunches (sometimes called sit-ups) and other exercises that work out your core (abdomen, stomach and back) done twice a week can help improve the appearance of your midsection.

Aerobic exercise also helps.

Any cardio exercise (running, biking, swimming, brisk walking) can also improve the health and appearance of your skin. Aerobic exercise increases delivery of oxygen to your organs, including your skin, which can promote tighter, more attractive and youthful appearance of skin.

Aim for 30 minutes of cardio activity 2 to 3 times a week.

Because they can stimulate production of collagen, a connective tissue in the body that gives skin its elasticity and firmness, vitamins C and E can help promote tight, youthful skin. Daily servings of leafy greens, citrus fruits, almonds, tomatoes and avocados can help promote production of collagen in the skin, helping it appear firmer and healthier.

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ADENOMYOSIS

What Is Adenomyosis?

 

Adenomyosis is a condition in which the inner lining of the uterus (the endometrium) breaks through the muscle wall of the uterus (the myometrium). Adenomyosis can cause menstrual cramps, lower abdominal pressure, and bloating before menstrual periods and can result in heavy periods. The condition can be located throughout the entire uterus or localized in one spot.

Though adenomyosis is considered a benign (not life-threatening) condition, the frequent pain and heavy bleeding associated with it can have a negative impact on a woman's quality of life.

 

What Are the Symptoms of Adenomyosis?

While some women diagnosed with adenomyosis have no symptoms, the disease can cause:

• Heavy, prolonged menstrual bleeding
• Severe menstrual cramps
• Abdominal pressure and bloating

 

 

Who Gets Adenomyosis?

Adenomyosis is a common condition. It is most often diagnosed in middle-aged women and women who have had children. Some studies also suggest that women who have had prior uterine surgery may be at risk for adenomyosis.

Though the cause of adenomyosis isn't known, studies have suggested that various hormones -- including estrogen, progesterone, prolactin, and follicle stimulating hormone -- may trigger the condition.

 

 

Diagnosing Adenomyosis

Until recently, the only definitive way to diagnose adenomyosis was to perform a hysterectomy and examine the uterine tissue under a microscope. However, imaging technology has made it possible for doctors to recognize adenomyosis without surgery. Using MRI or transvaginal ultrasound, doctors can see characteristics of the disease in the uterus.

If a doctor suspects adenomyosis, the first step is a physical exam. A pelvic exam may reveal an enlarged and tender uterus. An ultrasound can allow a doctor to see the uterus, its lining, and its muscular wall. Though ultrasound cannot definitively diagnose adenomyosis, it can help to rule out other conditions with similar symptoms.

Another technique sometimes used to help evaluate the symptoms associated with adenomyosis is sonohysterography. In sonohysterography, saline solution is injected through a tiny tube into the uterus before an ultrasound is given.

MRI -- magnetic resonance imaging -- can be used to confirm a diagnosis of adenomyosis in women with abnormal uterine bleeding.

Because the symptoms are so similar, adenomyosis is often misdiagnosed as uterine fibroids. However, the two conditions are not the same. While fibroids are masses of tissue attached to the uterine wall, adenomyosis is a growth within the uterine wall. An accurate diagnosis is key in choosing the right treatment.

How Is Adenomyosis Treated?

Treatment for adenomyosis depends in part on your symptoms, their severity, and whether you have completed childbearing. Mild symptoms may be treated with over-the-counter pain medications and the use of a heating pad to ease cramps.

Anti-inflammatory medications. Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve mild pain associated with adenomyosis. NSAIDs are usually started one to two days before the beginning of your period and continued through the first few of days of your period.

Hormone therapy. Symptoms such as heavy or painful periods can be controlled with hormonal therapies such as a levonorgestrel-releasing IUD (which is inserted into the uterus), aromatase inhibitors, and GnRH analogs.

Uterine artery embolization. In this minimally invasive procedure, tiny particles are used to block the blood vessels that provide blood flow to the adenomyosis. The particles are guided through a tiny tube inserted into the vagina through the cervix. With blood supply cut off, the adenomyosis shrinks. This procedure, however, is most commonly used to help shrink fibroids.

Endometrial ablation. This minimally invasive procedure destroys the lining of the uterus. Endometrial ablation has been found to be effective in relieving symptoms in some patients when adenomyosis hasn't penetrated deeply into the muscle wall of the uterus.

 

 

Does Adenomyosis Cause Infertility?

Because many women who have adenomyosis also have endometriosis, it is difficult to tell precisely what role adenomyosis may play in fertility problems. However, some studies have shown that adenomyosis may contribute to infertility.

 

 

Can Adenomyosis Be Cured?

The only definitive cure for adenomyosis is a hysterectomy, or the removal of the uterus. This is often the treatment of choice for women with significant symptoms.