Endocrines and pregnancy: The hormonal connection

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With exception to the pubertal stage, pregnancy is one of those times that women become really affected by raging hormones. All the physical changes and emotional vacillations that accompany pregnancy all boil down to a single cause: hormones.

In fact, every symptom we know of pregnancy is a result of the interplay of many hormones. Two major hormones produce the most significant effects during pregnancy: estrogen and progesterone.

Estrogen

While this remains abundant even without pregnancy, estrogen levels greatly increase during pregnancy to support uterine growth and production of other key hormones. Early on, it plays an important role in the growth of breasts in preparation for the expected milk production. It also regulates bone density, increases blood flow, and causes the skin to be more sensitive to stimuli. Estrogen, together with progesterone and the melanocyte-stimulating hormone, causes notable skin discolorations that affect areas such as the areola, facial skin, and underarms.

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Progesterone

Touted as the “hormone of pregnancy,” progesterone plays a vital role in this phase. Much like estrogen, it helps keep the uterine lining thick and promotes the growth of breast tissue in preparation for lactation. Moreover, it helps keep the placenta functioning properly and limits the natural uterine contractions that occur every so often pre-pregnancy, thus allowing for the fetus’ growth. Together with the hormone relaxin, progesterone causes all smooth muscles to lax in their contraction activities. This decreased soft muscle activity may result to the gastrointestinal discomforts of pregnancy, which include indigestion, constipation, and flatulence.

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REPOST: What is a high risk pregnancy

Not all pregnancies go smoothly. Some women may experience what doctors refer to as a high-risk pregnancy. Having said this, what are the things that should be done to prevent potential complications that could affect both the mother and the baby? This WebMD.com article shares the details.

Your pregnancy is called high-risk if you or your baby has an increased chance of a health problem. Many things can put you at high risk. Being called "high-risk" may sound scary. But it's just a way for doctors to make sure that you get special attention during your pregnancy. Your doctor will watch you closely during your pregnancy to find any problems early.

The conditions listed below put you and your baby at a higher risk for problems, such as slowed growth for the baby, preterm labor, preeclampsia, and problems with the placenta. But it's important to remember that being at high risk doesn't mean that you or your baby will have problems.

Your health plan may have its own list of what makes a pregnancy high-risk. In general, your pregnancy may be high-risk if:

You have a health problem, such as:

-Diabetes.

-Cancer.

-High blood pressure.

-Kidney disease. -Epilepsy.

-You use alcohol or illegal drugs, or you smoke.

-You are younger than 17 or older than 35.

-You are pregnant with more than one baby (multiple pregnancy).

-You have had three or more miscarriages.

-Your baby has been found to have a genetic condition, such as Down syndrome, or a heart, lung, or -kidney problem. -You had a problem in a past pregnancy, such as:

  -Preterm labor.

  -Preeclampsia or seizures (eclampsia). - Having a baby with a genetic problem, such as Down syndrome.

- You have an infection, such as HIV or hepatitis C. Other infections that can cause a problem include cytomegalovirus (CMV), chickenpox, rubella, toxoplasmosis, and syphilis.

- You are taking certain medicines, such as lithium, phenytoin (such as Dilantin), valproic acid (Depakene), or carbamazepine (such as Tegretol).

- Other health problems can make your pregnancy high-risk. These include heart valve problems, sickle cell disease, asthma, lupus, and rheumatoid arthritis. Talk to your doctor about any health problems you have.

How will your doctor care for you during your pregnancy?

You will have more visits to the doctor than a woman who does not have a high-risk pregnancy. You may have more ultrasound tests to make sure that your baby is growing well. You will have regular blood pressure checks. And your urine will be tested to look for protein (a sign of preeclampsia) and urinary tract infections.

Tests for genetic or other problems also may be done, especially if you are 35 or older or if you had a genetic problem in a past pregnancy.

Your doctor will prescribe any medicine you may need, such as for diabetes, asthma, or high blood pressure.

Talk to your doctor about where he or she would like you to give birth. Your doctor may want you to have your baby in a hospital that offers special care for women and babies who may have problems.

If your doctor thinks that your health or your baby's health is at risk, you may need to have the baby early.

What type of doctor will you see for a high-risk pregnancy?

Some women will see a doctor who has extra training in high-risk pregnancies. These doctors are called maternal-fetal specialists, or perinatologists. You may see this doctor and your regular doctor. Or the specialist may be your doctor throughout your pregnancy.

What can you do to help have a healthy pregnancy?

You can help yourself and your baby be as healthy as possible:

-Go to all your doctor visits so that you don't miss tests to catch any new problems.

-Eat a healthy diet that includes protein, milk and milk products, fruits, and vegetables. Talk to your doctor about any changes you may need in your diet.

-Take any medicines, iron, or vitamins that your doctor prescribes. Don't take any vitamins or medicines (including over-the-counter medicines) without talking to your doctor first.

-Take folic acid daily. Experts recommend that you take 0.4 mg to 0.8 mg (400 mcg to 800 mcg) of folic acid every day. Folic acid is a B vitamin. Taking folic acid before and during early pregnancy reduces your chance of having a baby with a neural tube defect or other birth defects.

-Follow your doctor's instructions for activity. Your doctor will let you know if you can work and exercise.

-Do not smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. Avoid other people's tobacco smoke.

-Do not drink alcohol.

-Stay away from people who have colds and other infections. -Your doctor may ask you to keep track of how much your baby moves every day. One way to do this is to note how much time it takes to feel 10 movements.

What symptoms should you watch for?

Like any pregnant woman, you need to watch for any signs of problems. This doesn't mean that you will have any problems. But if you have any of these symptoms, it's important to get care quickly.

Call 911 or other emergency services right away if you think you need emergency care. For example, call if:

-You passed out (lost consciousness).

-You have severe vaginal bleeding.

-You have severe pain in your belly or pelvis.

-You have had fluid gushing or leaking from your vaginaand you know or think the umbilical cord is bulging into your vagina.

-If this happens, immediately get down on your knees so your rear end (buttocks) is higher than your head. This will decrease the pressure on the cord until help arrives.

Call your doctor now or seek medical care right away if:

-You have signs of preeclampsia, such as:

- Sudden swelling of your face, hands, or feet.

- New vision problems (such as dimness or blurring).

-A severe headache. You have any vaginal bleeding.

-You have belly pain or cramping.

-You have a fever.

-You have had regular contractions (with or without pain) for an hour.

-This means that you have 8 or more in 1 hour or 4 or more in 20 minutes after you change your position and drink fluids.

-You have a sudden release of fluid from your vagina.

-You have low back pain or pelvic pressure that does not go away.

-You notice that your baby has stopped moving or is moving much less than normal.

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Pica: The strange case of strange cravings during pregnancy

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Many people know how strange pregnant women can get when it comes to cravings. They may initially crave specific food items, which vary according to mood. Then it gets weird; pregnant women begin craving substances that have no little or no nutritional value. And when people think that eating ice, chalk, or paper is out of the ordinary, then they might not have heard of pregnant women who engage in coprophagia (consumption of feces) and trichophagia (consumption of hair or wool)—behaviors which, according to modern norms, are downright outlandish.

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This kind of behavior, however, cannot be singularly classified as a kind of mental disease. Instead, it is referred to as pica, a word that originated from the Latin word for magpie, a bird that is infamous for its unusual eating behaviors, which include eating anything regardless of nutritional value—incidentally similar to the behaviors being exhibited by pregnant women with pica.

There are many theories surrounding the cause of this phenomenon. While there is no definitive cause yet, the Journal of the Academy of Nutrition and Dietetics claims that pica may be a result of iron deficiency anemia. It is worth noting that during pregnancy, the increase in plasma volume causes a condition called “pseudoanemia,” which may ultimately trigger the cravings.

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Childbirth talk: The perks of doing Kegel exercises

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Ask women about their top fears regarding childbirth and a majority will give the same answer: “fear of not being able to manage the pain of labor.” Researchers have gone all the way to claim that “labor pain is one of the most severe pains which have ever been evaluated,” thus causing many women to fear natural delivery.

The solution to this dilemma, however, comes in only two words: “Kegel exercises.”

Kegel exercises, also known as pelvic floor exercises, involve the repeated contraction and relaxation of the muscles that comprise the pelvic floor. It has been proven to be effective in helping strengthen the muscles that support the uterus, bladder, bowels, and most importantly, the vagina. As a result of improved vaginal muscle strength, pregnant women who performed Kegel exercises before delivery found it easier to control their muscles during labor and delivery, thus experiencing an easier and less painful childbirth.

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But the advantages don’t stop there. With the improved tone of pelvic floor muscles, expectant mothers will also be able to mitigate two common problems during pregnancy: decreased bladder control and hemorrhoids. If done AFTER pregnancy, Kegel exercises can promote faster healing of the perineum (which gets damaged as a result of natural delivery) and regain bladder control (which has been compromised due to the exaggerated distention during pregnancy).

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REPOST: Junk food addiction linked to pregnant mothers' eating habits, research says

This Huffington Post article explains how mothers' eating habits during pregnancy could cause their children to have junk food addiction. 

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Women know they shouldn't smoke, drink alcohol, or do drugs while they're pregnant. But a new study on rats suggests that even females who eat junk food during pregnancy may be setting up their children for a lifetime of addiction.

A team of Australian scientists found a chemical basis behind this junk food addiction, pinpointing psychoactive chemicals that are produced as a reward response and trigger a natural high in the brain.

"When we eat foods high in fat and sugar, this increases the release of opioids and the feel-good peptide dopamine in the reward centre of the brain and creates a pleasurable sensation that keeps us going back for more," Dr. Beverly Mühlhäusler, a postdoctoral fellow at the University of Adelaide who led the study, told The Huffington Post in an email.

For the study, the team fed some of the rats a diet high in fat and sugar -- foods like sugary cereal, meat patties, potato chips and peanut butter. Then they looked at these rats' offspring after they were weaned, and found that the offspring of junk food-fed mothers preferred more high-fat foods compared to a control group fed a diet low in fat and sugar. They also found that the gene expression in the reward pathway of these rats' brains was altered -- they had an increased predisposition to junk food addiction later in life.

"In the same way that someone addicted to opioid drugs has to consume more of the drug over time to achieve the same 'high', continually producing excess opioids by eating too much junk food results in the need to consume more foods full of fat and sugar to get the same pleasurable sensation," said Dr. Mühlhäusler.

But does this junk food phenomenon extend to humans, too? The researchers suspect so.

"The take-home message for women is that eating large amounts of junk food during pregnancy and while breastfeeding will have long-term consequences for their child's preference for these foods, which will ultimately have negative effects on their health," Dr. Mühlhäusler said in the statement.

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REPOST: Is your fertility window closing?

Melanie Haiken shares in her article on Health.com the options that women, especially those who are in their 30s and early 40s, can use to measure their fertility rate.

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Women in their 30s and early 40s have new options for gauging whether they’re still fertile: Doctor’s-office and at-home tests supposedly can estimate the number of viable eggs in their ovaries. There is a booming market for this kind of ovarian-reserve testing. In the United Kingdom, a private company associated with the University of Sheffield is even selling a mail-in blood test (it’s not yet available in the United States).

How they work: The U.K. test and also some U.S. fertility-clinic tests measure levels of Anti-Müllerian hormone (AMH) and other substances called inhibin B and follicle-stimulating hormone (FSH), which are present when egg-producing follicles are growing. Higher hormone levels suggest more fertility. Another test uses ultrasound to count the follicles with devel­oping eggs. And the most common test measures FSH along with one form of estrogen. These tests, individually or in combination, may be able to tell if your ovaries are functioning normally.

Experts say: All this science has some flaws. Knowing that your ovaries are still working isn’t the same as knowing how many viable eggs you have—or predicting the future. Even positive results don’t mean you can count on a big window. At the same time, negative results don’t mean you’re out of luck.

“These tests can’t tell you the prognosis a year from now,” says Marcelle Cedars, MD, director of the reproductive endocrinology division at the University of California, San Francisco. “I’d hate to see people make important life decisions based on the results.”

Bottom line: Ultimately, age is still the most important factor when it comes to fertility prediction, says Mark Perloe, MD, medical director of Georgia Reproductive Specialists in Atlanta. If you’re in your early 40s, the odds are against getting pregnant without help, no matter what the tests say. The odds are much better in your late 30s or younger. In short, the tests may be encouraging or discouraging, but they cannot accurately determine how much time you’ve got left for motherhood.



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Reproductive aging: Knowing egg freezing before it’s too late

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Freezing eggs so that they may be fertilized and implanted at a future time is now an option for women who plan to delay pregnancy. Egg freezing is a modern method used to preserve a woman's reproductive potential. It helps women take advantage of their body’s fertility at a time when eggs are at their prime age.

As the National Infertility Awareness has just concluded, more and more women have become aware that egg freezing is one of the easiest ways to radically slow down the biological clock. What should women know about this method? Dr. Jeffrey Steinberg shares and answers via CNN news two of the most common queries about egg freezing:

What’s the best age for a mother to undergo egg freezing?

Dr. Steinberg says that the younger the eggs the better, since they have the capacity to endure the freezing process. Hence, a mother in her 20s or 30s is the best candidate to undergo such procedure. Beyond that age range may be a little too late.

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Will a young mother run out of eggs due to egg freezing?

“This is a common misconception that could not be further from the truth. We're using eggs that you would have otherwise lost,” explains Dr. Steinberg.

A woman reproduces eggs, but she is only able to produce enough fertility hormones to ovulate an egg. This means that the eggs that didn’t get the fertility hormone just die naturally.

Ob-gyns, like Cristian Andronic and Michael R. Leb, can help mothers understand how egg freezing works, what the potential risks are, and whether this fertility method is right for all.

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