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Do You Have Anemia?

Anemia is a word that you have probably heard many times, but maybe you aren’t exactly sure what it means. Perhaps you even know some of the symptoms, including feeling fatigued, or headaches. So, what is anemia? It starts with hemoglobin. Hemoglobin is a protein in your blood that carries oxygen. Iron is needed for your body to make hemoglobin. When hemoglobin is lower than normal, this is called anemia.

In nonpregnant females, hemoglobin less than 12 is considered anemic. Due to regular physiologic changes in pregnancy, a lower cut-off is used to diagnose anemia which varies by trimester. In the first and third trimesters, hemoglobin less than 11 is considered anemic, while 10.5 is used as the cut-off in the second trimester.

Anemia occurs in almost one-third of reproductive age women and up to 40% of pregnancies. The most common cause of anemia is not having enough iron available in your body to produce adequate hemoglobin levels. This is called iron-deficiency anemia.

The amount of iron your body needs in pregnancy varies a lot depending on your gestational age. At baseline, 1 mg per day is required for the normal turnover of red blood cells. In the first trimester, your needs increase to 2 mg per day and continue to increase up to 7 mg per day as you approach your due date. Iron can be found in many foods, including meat, lentils, beans, and spinach. Additionally, many foods are fortified with iron, such as fortified breakfast cereals and cream of wheat. Another good way to get more iron is through your prenatal vitamin.

For women diagnosed with iron-deficiency anemia, additional supplementation of iron either by mouth or intravenously (IV) may be recommended. Taking iron orally is easy and inexpensive but can cause a metallic taste, nausea, diarrhea, or constipation. Iron given through an IV is usually reserved for those who need more rapid iron replacement, such as those within a month of their due date, those who don’t tolerate oral iron supplementation, or those with a history of bariatric surgery, which can impair iron absorption.

Now that you know what anemia means and how common it is, you may feel a little worried about being anemic. You say to yourself, “I do feel tired! I do get headaches! Isn’t that part of being pregnant?” You are right! It might just be part of being pregnant. Rest assured, we routinely screen for anemia in pregnancy with your initial prenatal labs and again at the end of the second trimester when screening for gestational diabetes. This way, we can identify anemia appropriately and start treatment to resolve it.

Pregnancy Planning and Birth Defects Prevention

If you are planning to become pregnant, there are certain things you can do to increase the odds of good health for you and your baby. Some actions you take in advance can also significantly decrease the risk of certain birth defects. While some birth defects cannot be prevented, others are linked to the mom’s health and actions before and during pregnancy.

Folic acid supplementation

Every woman who might become pregnant should take a prenatal vitamin with 400 mcg of folic acid. Folic acid, also called vitamin B9, is an essential nutrient that helps develop the baby’s brain and spinal cord. This development usually happens early in pregnancy before a woman knows she is pregnant, so planning is essential. Some foods are also enriched with folic acid, such as fortified bread, pasta, and cereals. Eating a healthy, varied diet in addition to taking a prenatal vitamin will ensure that your body is getting the nutrients it needs for a healthy pregnancy.

Avoid alcohol, smoking, and drugs

There is no known safe level of alcohol, tobacco, or drugs like marijuana to consume during pregnancy. These substances can be harmful at all stages of pregnancy, including in the very early stages. It is best to avoid these substances altogether if you plan to become pregnant. If you need help to stop smoking or using a drug, please reach out to your healthcare provider.

Prevent infections

Some infections can cause pregnancy complications and birth defects if the mother has them during pregnancy. These infections include rubella, cytomegalovirus (CMV), toxoplasmosis, mosquito-borne illnesses like Zika and West Nile viruses, and many sexually transmitted diseases. If you are pregnant or planning to become pregnant, you should protect yourself from these diseases. Ensure you are up to date on your immunizations and talk to your healthcare provider to see if you need additional vaccines. Avoid travel to places where high-risk diseases like Zika are common. If you have a cat, you should avoid changing the litter box, which is a potential source of toxoplasmosis infection. And of course, it is a good idea to practice basic sanitation and infection prevention techniques like frequent handwashing and avoiding sick people. 

Check-in with your healthcare provider

Stay in close contact with your healthcare providers before and during pregnancy. If you have any chronic health conditions, you should make sure these are well controlled before becoming pregnant. For example, diabetes is a common health condition that can affect a baby’s growth and development if not controlled. Blood pressure problems, bleeding and clotting disorders, mental health conditions, and many other health problems can also affect pregnancy. Some prescription medications can cause birth defects and are unsafe to take during pregnancy. If you take any prescription medications and might become pregnant, you should make an appointment with your healthcare provider to discuss a plan for these medications.

Take care of yourself

Finally, take care of yourself! Pregnancy is an exciting time, but it can also be quite stressful. It may seem like everyone has an opinion about what pregnant women should and shouldn’t do. Make sure you get your information from trusted sources. Remember that some aspects of pregnancy are simply out of your control, and trying the best you can to care for yourself and your baby is enough. At Canyon View Women’s Care, our goal is to help women have happy, healthy babies. We would love to take care of you before, during, and after your pregnancy and answer any questions you have. Call us at 801-465-2559 for a preconception consult or pregnancy-related visit.

Alyssa Heath, PA

Canyon View Women’s Care

10 Tips to Help You Prepare for Your Dog to Meet Your New Baby

My first baby was a 6½ pound, adorable, brown-eyed, soft ….. puppy!!! Our German Shorthair Pointer, Dakota, was our baby for several years before bringing home our firstborn from the hospital. She was protective, well-trained, and accustomed to frequent walks and our undivided attention. I was nervous about our dog adapting to a noisy, sometimes smelly, helpless newborn. Here are a few tips that can help you prepare for your dog to meet your baby. 

  1. Plan ahead. Take your dog in for a check-up if it has been a while. You won’t have extra hands or time once your newborn arrives. Make sure your dog is fully vaccinated.

Dr. Laraway and Willow

  1. Establish who is the real alpha male in your home. Reinforce consistent ground rules – like places off-limits or unacceptable behaviors like jumping. Consider an obedience training course with your pet before your baby arrives.
  1. Prepare for your newborn. As you set up your crib or nursery, do so in stages so your dog can adjust to the new environment. Pets rely on consistency, so make gradual additions, then play with your pet in those areas to help create positive feedback for your dog. Baby gates or closing doors are also effective in training your pet in what areas are off-limits. If your dog puts its paws on the crib or tries to jump in, this behavior needs to be stopped immediately. Keep the door to your baby’s room shut consistently if this is necessary. As you introduce smaller baby items to your dog, supervise it as it sniffs them on the floor. Do not let your dog put them in his mouth.
  1. Dogs have an incredible sense of smell. Some people even believe dogs can “smell” cancer. Help your dog become accustomed to baby smells by providing a treat while your dog explores new baby smells – like baby lotion, powder, or detergent. Introduce your newborn to your dog by allowing your dog to smell your baby first. Let your dog smell the blanket your baby has been wrapped up in before they meet.
  1. Dogs are typically very loyal and protective friends. Allow your dog to meet your newborn on neutral territory like the sidewalk, for example. When you enter your home with your newborn, it is essential to be calm and relaxed. Leash your dog and have a helper hold the leash and provide positive reinforcement with treats.
  1. Try to keep regular dog routines – such as walking or feeding – intact where possible. Set aside some particular time to spend each day with your dog. Choose an activity that your 4-legged companion enjoys while someone else watches your baby. Some research suggests that dogs feel jealousy, so being mindful of this can help ease the addition of a new baby to your home.
  1. We all know that dogs have exceptional hearing. They can detect higher frequencies and hear sounds four times further away than humans can. New baby noises and shrill cries could put your dog on edge at first. You can prepare your sensitive pet by softly playing videos of baby sounds (on YouTube) and gradually increasing the volume to help your dog accommodate new noises. Some dogs are calmed by classical music. Consider some gentle background noise as your household transitions to newborn sounds.
  1. Dogs are awesome stress-relievers. They can read emotions. After you tend to your newborn, spend a few minutes with your dog when you need a break from nurturing.  
  1. Always supervise your baby with your dog, no matter how gentle your animal seems. Supervision is even more critical as your child grows since infants may frequently hit, grab, or chase animals. You can practice familiarizing your dog with your baby by carrying around a doll for a few months before you deliver your baby.
  1. Never force your dog to interact with your baby, and remember some dogs become defensive if they feel threatened while eating or playing with their doggie toys. If your dog exhibits aggressive behavior toward your child, you should seek help from an animal behavior expert.   


Breast Cancer Risk and Epigenetic BRCA Markers

Chances are you know someone who has been affected by breast cancer. For one out of every eight women, the risk of being diagnosed with it is relatively high. Hereditary breast cancers are only responsible for 5 to 10 percent of breast cancer cases. However, there is a significantly higher risk for women who have the BRCA1 BRCA2 genetic markers. 

Epigenetics is the study of how the environment and your behaviors can affect gene expression. The DNA sequence is not altered, but epigenetic changes affect how the body reads your DNA and determines health outcomes. 

Consulting with a genetic counselor or doing a genetic screening test is beneficial for at-risk individuals. These women have a family history that includes one of the conditions below.  

One (or more) first– or second-degree relative(s) with:

  • Breast cancer diagnosed at age 45 or younger in women
  • Triple-negative breast cancer diagnosed at age 60 or younger in women
  • Primary cancer of both breasts
  • Both breast and ovarian cancer in the same relative
  • Male breast cancer
  • Ovarian cancer
  • Two or more first– or second-degree relatives from the same side of the family with breast cancer, if at least one breast cancer was diagnosed before age 50.
  • Three or more first– or second-degree relatives from the same side of the family with breast or high-grade prostate cancer at any age.
  • Ashkenazi Jew Ancestry

BRCA1 and BRCA2 are examples of epigenetic changes that have significant consequences. BRCA genes are tumor suppressor genes that help combat breast cancer by making proteins to repair damaged DNA. These tumor-suppressing genes do not work correctly for women who have the BRCA1 or BRCA2 genetic marker. These women should be counseled appropriately regarding increased breast surveillance (clinical examinations and imaging/mammograms), starting a family, and possibly undergoing prophylactic surgery to decrease the risk of breast cancer.

Talk to your provider about your family history and potential genetic risk. Do not be fearful, be hopeful. Breast cancer is very treatable, mainly when it is discovered early and treated appropriately. On average, mammograms detect cancer two to three years before a lump is felt. Mammograms are usually covered 100 percent by insurance companies, and there is no copay on your part. If you do not have the means to have a screening mammogram done, contact the Utah County Health Department, as they may help cover the cost of this service. Please complete routine screening examinations and mammograms as recommended for your age and level of risk.


American Cancer Society (ACS). (2019). Breast cancer survival rates 

American Cancer Society (ACS). (2019). Breast cancer risk factors you cannot change 

Centers for Disease Control and Prevention (CDC). (2020). What is epigenetics? 

Dullens, B., de Putter, R., Lambertini, M., Toss, A., Han, S., Van Nieuwenhuysen, E., Van Gorp, T., Vanderstichele, A., Van Ongeval, C., Keupers, M., Prevos, R., Celis, V., Dekervel, J., Everaerts, W., Wildiers, H., Nevelsteen, I., Neven, P., Timmerman, D., Smeets, A., Denayer, E., … Punie, K. (2020). Cancer Surveillance in Healthy Carriers of Germline Pathogenic Variants in BRCA1/2: A Review of Secondary Prevention Guidelines. Journal of oncology2020, 9873954. 

National Breast Cancer Foundation (NBCF). (2021). BRCA: The breast cancer gene. 

U.S. Preventive Services Task Force (USPSTF). (2019, August 20). BRCA-related cancer: Risk assessment, genetic counseling, and genetic testing. 

What’s best for your breast?

October is breast cancer awareness month. It’s a great time to go over a few common questions women have regarding breast health and breast cancer detection. 

The first step in breast health is breast self-awareness, which means that you are aware of what is normal for your breast and can detect small changes. Self-detection results in almost one-half of all cases of breast cancer being found in women aged 50 years and older. A woman herself often finds breast cancer. In women younger than 50 years, more than 70% of breast cancer cases are self-detected.

Are there signs and symptoms related to breast cancer?

The most common symptom of breast cancer is a new lump or mass. A painless, hard mass with irregular edges is more likely to be cancer, but breast cancers can be tender, soft, or round. They can even be painful. For this reason, it’s essential to have any new breast mass, lump, or breast change checked by experienced healthcare professionals. 

Other symptoms can include –  

  • Swelling of all or part of a breast (even if no lump is detected).
  • Skin dimpling (sometimes looking like an orange peel).
  • Breast or nipple pain.
  • Nipple retraction (turning inward).
  • Nipple or breast skin that is red, dry, flaking, or thickened.
  • Nipple discharge (other than breast milk).
  • Swollen lymph nodes (sometimes breast cancer can spread to lymph nodes under the arm or around the collar bone and cause a lump or swelling there, even before the original tumor in the breast is large enough to be felt).

Should I have a clinical breast exam?

Yes! A healthcare provider should perform a clinical breast exam and can help find lumps that may need further testing and evaluation. The exam should be done every 1-3 years for women aged 25-39 and women aged 40 and older should have an exam every year.

How do I know I am at an average or higher risk for breast cancer?

A woman is considered at higher risk if there is a family history of breast cancer, ovarian cancer, or other inherited types of cancer; BRCA1 and BRCA2 mutations; chest radiation treatments at a young age; and history of high-risk breast biopsy results. Women without these risk factors are at average risk. If you meet the criteria for higher risk, you should speak with a healthcare professional to develop a plan that may include earlier mammograms and/or genetic testing.

When should I start having mammograms?

The American College of Obstetricians and Gynecology recommends that a woman of average risk start at age 40 and have mammograms every 1-2 years. For more information regarding mammograms, click on the link in the reference section below or speak to your healthcare provider.

Early detection of breast cancer is an essential factor in survival rates. Having yearly wellness exams is a great way to stay on top of your health. We would love to answer any questions you have regarding breast health or any part of your wellbeing.    

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Making Your College Experience A Success!

Preparing for a fun-filled college adventure!

A day trip to Lagoon is a fun-filled adventure! The excited anticipation of the rides – the thrill and fear they bring. The sounds of people enthusiastically talking – both in passing time, waiting in long lines, and the jubilant exchanges after the ride is over. The speed of the coasters, gravity-defying movements, blur of colors, and action everywhere. The smell of burgers and fries, waffle cones, and hot pretzels. The refreshment of a cold drink and Dippin’ Dots. You don’t want the day to end, but as the sun begins to go down, the feeling of satisfaction and fatigue is real and you welcome the call of your comfortable bed.

A season at college for young adults is a life-changing experience! The nervous enthusiasm of starting a new chapter in life – both the dreaming and the dread. New friends and new classes. Confident venturing into unfamiliar buildings and landscapes. Novel self-reliance on finances, cooking, cleaning, and laundry. Adventuring to activities alone, without the familiarity of home and comfort of childhood friends. Being exposed to diverse ideas, people with varied upbringing and value systems, and having expansive dreams of the future. Days and nights are filled with fun, yet demand focus and perseverance. As the distant dream of graduation becomes a reality, the physical and mental exhaustion is real. The time spent in pursuing knowledge, skills, and friendships, however, can last a lifetime and has the potential to change you for the better – forever.

Whether you are dreaming of or dreading heading off to college, preparation will make this adventure more meaningful and fun. Here are some common challenges to consider when transitioning to college life:

  1. Living away from home. College facilitates decision-making skills, independent living, self-reliance, and responsibility. You will be staying in a tight living space with minimal storage. Less is more when it comes to packing. Bring items that can be shared.
  1. Managing your time and new found freedom. In college, it is your responsibility to go to class, do your homework and pass your tests.  You will be tempted to stay out too late, eat differently, and party.  You will need to figure out how to organize and motivate yourself, balance school, work, sports, social and religious activities.  Use technology to get organized and schedule your time wisely.  Learn to work your plan and plan your work.
  1. Navigating academic changes.  College classes necessitate more reading, writing, and analysis than you may be used to. They typically require more papers, have tougher exams, and rarely give extra credit.  Be proactive in the learning process. Meet with your professors, use college-tutoring labs, and find effective ways to study on your own and in groups.
  1. Feeling overwhelmed.  At times you will feel overwhelmed. Set high, but realistic expectations for yourself and learn how to deal with stress, and pick yourself up after failing. Avoid substance use as it may lead to abuse and impaired decision-making. Change your habits or attitude when necessary and ask for help when you get stuck. Seek counseling services if you are feeling lonely or having a difficult time adjusting to college life, roommates or stress. If suicide is a concern, call 800-273-8255.
  1. Finding a major.  It often takes time to figure out what you want to do with your life. Start with general education courses and work with a school counselor. Academic settings can do personalized testing to help you discover your talents and values which can point you in a career direction. Talking to professionals and job shadowing are beneficial. Remember, nothing is “perfect”. There will be pros and cons to every career.
  1. Avoiding drastic changes in nutrition and physical activity.  Without careful attention to diet, many college students put on the dreaded freshman 15 or even more. Many students go from being very involved in sports or physical activities in high school to sitting longer in class, staying up later to study, and eating to stay awake.  Physical activity needs to purposely be planned into your new lifestyle.  Do not wait until you have time or “feel like it,” because you probably never will. 

Use extreme caution with meal plans, eating out, and consuming empty calories (such as alcohol). Quick and easy foods are typically over-processed and loaded with calories. Create habits with nutrition and physical activity that will help you later in life. Remember, this is the only body you ever get.

  1. Learning how to budget. College is different from any kind of learning you have experienced before.  You get to pay for the privilege of going to school! Be realistic about your expenses and plan for them. Honestly decide what you need and what things you want. Take a class on basic budgeting or seek guidance from a trustworthy source. Prioritize basic living expenses first groceries, cooking utensils, cleaning supplies, toiletries. Plan for academic requirements – textbooks, school supplies, and classes fees. Entertainment and relaxation are vital to personal balance and fulfillment but do not need to be costly. You are accountable for your finances. Keep records of school expenses for tax purposes.
  1. Avoiding infections or unplanned pregnancy. Abstinence or consistent use of condoms are the only ways to protect against sexually transmitted infections or unwanted pregnancy. Please ask your provider what is the best method for you. Be aware of date rape, increased incidence of sexual assault with substance use, and learn self-defense strategies and techniques to help prevent these conditions.

Make this season of your life a fun-filled adventure! Meet new friends, discover who you are, establish a strong foundation for your future career and become a life-long learner. Talk to a trusted friend, adult, or care provider if you have questions about going to college.

For more information on this topic visit –

Hormones and the Menopausal Transition

Hormone therapy at the time of menopause and beyond is one of the most controversial subjects in Gynecology. Historically, the replacement of Estrogen and Progesterone was felt to have nothing but benefits. Increased bone health, reduction in hot flashes, and relief from atrophy of the genital tissues are all known benefits. It was once thought that Hormone Therapy (HT) improved heart health since women develop heart disease in general later than men. Lower risk of heart disease has not been proven, and it may increase the risk of certain cardiovascular conditions. There also appears to be a slight increase in the risk of some types of breast cancer in long-term users of HT. So, why would we use HT knowing the risks? In short, it is because menopause can be miserable for some women!

Menopause occurs on average around age 50 and is defined as no periods for at least a year. The transition leading up to menopause and afterward can be a time of great distress for many women. Hot flashes are often more than just a nuisance, and at night, when they manifest as night sweats, they can be very disruptive to sleep. Mood changes are common, and there can be gradual atrophy of genital tissues leading to dryness, irritation, painful intercourse, and urinary problems.

Many women have mild menopausal symptoms and don’t require HT. However, for the women who suffer from more severe symptoms, it can be a lifesaver to use Estrogen, usually along with Progesterone, to alleviate many of these symptoms. Essentially, one must weigh the risks that are small but real against the quality of life issues. Sleep disruption, in particular, can lead to poorer health and quality of life. Low doses of HT can diminish Hot Flashes and night sweats, decreasing distress and improving sleep quality.  Oral pills, topical gels, sprays, and patches are all effective. Vaginal estrogen creams can improve symptoms of genital atrophy in women for whom hot flashes are not a problem.

There are pros and cons to HT, and some women should avoid it altogether if they have specific medical issues. For those who do need HT, we usually try for the lowest dose and consider discontinuation after a time. Whether or not to use HT is a joint decision between you and your doctor. Fear of hormones should not deter women from using HT when appropriate. After all, your body was making these same hormones for 40 years before menopause!

5 Reasons Your Menstrual Bleeding Might Be “Off”

Menstruation is part of the average woman’s life for about forty years – from early adolescence until menopause. That’s a lot of periods! While menstruation is a normal bodily function, dealing with the routine of your period can be a pain sometimes. It can be even harder when something is wrong with your period. Whether your periods are too heavy, too crampy, too unpredictable, or just seem off, it is a good idea to get checked out by your healthcare provider. It can feel awkward to talk about something as personal as your period, but please don’t worry – it’s our job to help with all aspects of your health. There are a lot of reasons abnormal menstruation can occur. The good news is that there are treatments that can help with abnormal periods. Here are five common reasons something could be off with your period:

  1. Problems with the uterus.

    Sometimes, there is an anatomical or structural cause of abnormal bleeding. These can include different types of benign growths inside the uterus, including endometrial polyps and uterine fibroids. You can also have polyps of the cervix. These things might be diagnosed with an exam or imaging. There are also diseases such as adenomyosis, which involves inappropriate growth of glands into the muscle of the uterus, and endometriosis, which is when small pieces of uterine lining implant outside of the uterus.

    1. Problems with ovulation.

      Normally, you should ovulate, or release an egg, about halfway through your cycle every month. If you are not ovulating regularly, this can cause problems with your period in addition to making it harder to get pregnant. Polycystic ovarian syndrome (PCOS) is a common disease that falls into this category. Thyroid disorders and other hormonal problems can also interfere with ovulation. It is also possible for the timing and regularity of ovulation to be affected by age, weight, exercise, and other factors.

      1. Bleeding disorders.

      If you have abnormal periods, it is important to let your healthcare provider know if you have a known family history of bleeding disorders. You should also watch for other types of abnormal bleeding. For example, do you get frequent nosebleeds? Have you been told you bleed excessively after a surgery or dental procedure? Did you experience postpartum hemorrhage with the delivery of a baby? There are many clues that can point towards a bleeding disorder. The most common inherited (genetic) bleeding disorder is Von Willebrand Disease, which affects about 1% of the population. Many other bleeding disorders exist, so talk to your healthcare provider if you have a concern.

      1. Cancer and abnormal cell growth.

      While we always hope that cancer is low on the risk of possibilities when something is wrong with our health, it is important to know that uterine cancer can be a cause of abnormal bleeding. Most cancers of the uterus come from the lining, called the endometrium. Endometrial cancer becomes more common with increasing age, excess weight, or long episodes of irregular bleeding Any vaginal bleeding after menopause needs to be evaluated by your healthcare provider. In addition, your healthcare provider can decide if abnormal or heavy bleeding could be a sign of noncancerous abnormal growth of the endometrium, which is called endometrial hyperplasia.

      1. Medications.

      With some types of birth control, changes to your menstruation are common and expected side effects. For example, heavier bleeding is a known side effect of the non-hormonal intrauterine device (IUD), while the hormone-containing IUDs may make bleeding lighter. Your bleeding schedule may also change with some types of hormonal birth control. You should also know that certain medications can affect your menstruation. These include anticoagulants and some psychiatric medications. If you have questions about your medications and your bleeding, talk to your healthcare provider.

      As you can see, there are a lot of things that can affect your period! This list is by no means comprehensive, and each topic mentioned above could have an entire textbook written about it. If you have any concerns about your menstruation and your health, please don’t hesitate to have a conversation with your healthcare provider. If you aren’t sure what is considered “abnormal” with periods, ask! Some women live with difficult periods when they do not have to, and we may be able to identify the cause of the problem. The proper evaluation and treatment of period problems is so important to a woman’s quality of life. As an OB/GYN Physician Assistant, I am especially passionate about helping women with their menstrual and reproductive health. It is such an important aspect of our lives that is sometimes overlooked. We are always happy to listen to your concerns, answer your questions, and help you manage your health.

      If you have questions or concerns about menstrual bleeding please contact our office at 801-465-2559

      Improving Urinary Incontinence

      Urinary incontinence is a common problem that is often ignored. It can be embarrassing. It can be annoying. It can keep you from doing things that you would otherwise like to do such as jumping on the trampoline with your children and exercising. It can leave you looking for bathrooms everywhere you go. Nobody wants to talk about it, but did you know that an OB/GYN can help?

      Urinary incontinence falls into two main categories: urge incontinence and stress incontinence. Urge incontinence means you feel an urge to void, but can’t hold it long enough to make it to the bathroom. Overactive bladder is a similar problem that can overlap or be considered a milder form, where no actual urine leakage occurs. 

      Stress incontinence means urine leaks with any straining or pressure on the bladder such as when you sneeze, cough, or bear down. Stress incontinence will occur more often when your bladder is full. A third category is mixed incontinence, which simply means you have features of both urge and stress incontinence.

      Many things can contribute to incontinence such as medication, infection, dietary and lifestyle choices, childbearing, pelvic organ prolapse (such as uterine or bladder prolapse), and other medical conditions. 

      As part of an evaluation for urinary incontinence, these factors will be assessed to help guide you to the proper treatment. A wide variety of treatments exist and should be tailored to your particular cause of incontinence. The goal of treatment is to alleviate symptoms and improve quality of life. Potential treatments include bladder training, pelvic floor exercises (Kegels), lifestyle or dietary changes, oral medications, surgery, or incontinence pessaries (pessaries are available for one-time use over the counter or from your doctor as a reusable silicone disc that inserts into the vagina to apply pressure to the bladder).

      Many women have at least occasional urinary incontinence. While urinary incontinence is not dangerous, it can be bothersome. If you are bothered by urinary incontinence or if it is keeping you from doing or enjoying activities, then make an appointment with your OB/GYN today to get started on a road to a leak-free future.

      Dental Health and Pregnancy

      If you’re pregnant, Congratulations! That’s great! So now, let’s talk about your teeth. Oral and dental health is an often-overlooked part of a healthy pregnancy. While women often avoid seeing a dentist for treatment or a hygienist for cleanings out of concern for their growing baby, it is not only safe to be seen for regular cleanings and dental work; it is also recommended. In addition, the oral health of the mother affects the infant and pregnancy.

      A common concern during pregnancy is whether or not taking x-rays is safe. Dental x-rays are very low dose and are safe at any point throughout pregnancy. Wearing a lead apron is standard at most dental offices. Taking x-rays is an essential part of diagnosing cavities and infections and is considered a routine part of a good dental exam. Women should continue to see the dentist and hygienist regularly. It may be easier during the second trimester when nausea has subsided, and it is still comfortable to lay on your back.

      During pregnancy, hormone changes alter the response of your gums to plaque and can cause more inflammation, known as gingivitis. Using a soft brush twice a day can help keep plaque to a minimum. There is some evidence that inflammation from gingivitis can increase the risk of pregnancy complications, so it is vital to keep your gums healthy.

      One of the unfortunately familiar parts of pregnancy is vomiting and acid reflux. Stomach acid can be hard on teeth. While you may feel the urge to brush your teeth immediately after vomiting to remove the taste, it is best to avoid brushing for at least 30 minutes to keep from brushing stomach acid into the enamel and eroding it. The best option is to rinse with water and 1 tsp baking soda to neutralize the stomach acid if tolerated. If that isn’t tolerated, rinse out with some plain water or fluoride-based mouth rinse instead. Acid reflux can erode tooth enamel and can be safely treated with over-the-counter medications.

      If you need dental care for a cavity or infection, the typical medications used by dentists are safe. Including antibiotics and medicines for “Numbing you up.” It may, however, be best to avoid Nitrous Oxide (laughing gas).

      So, in short, dental health is essential because you need your teeth for the rest of your life. Therefore, you should not neglect your dental care during your pregnancy.

      Haley Pledger, PA
      Women’s Care
      Matthew Walton, DO
      Austin Bills, DO
      Family Medicine
      Aaron Fausett, PA
      Family Medicine
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