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Becoming pregnant is a major life change, even if you’ve been preparing for it. Many people who have just found out they’re pregnant find out the doctor won't schedule prenatal visits until nine weeks into a pregnancy. That can mean weeks of nervous waiting. Family physician Mara Gordon tackled the question of why it’s like this in NPR’s advice column “Real Talk with a Doc.”
Gordon says it’s true most providers won’t schedule patients until the eighth or ninth week of pregnancy, at the earliest. In medical school, many doctors are taught not to see patients for obstetric care in the first weeks of pregnancy, says Dr. Kavita Vinekar, an OB/GYN who researches early pregnancy. That’s because it can be difficult to visualize an early pregnancy on an ultrasound – and murky results can mean the patient goes through unnecessary stress.
If you want medical advice before nine weeks, Gordon’s advice is to try and get in to see your primary care provider or regular OB/GYN. These doctors can answer questions about symptoms like nausea and breast tenderness, and usually offer treatment options.
And if you think you might be having a miscarriage? Gordon says first don’t panic – light spotting in pregnancy can be normal. That said, the unfortunate reality is that prenatal practices aren’t set up to provide care to the estimated 15% of pregnancies that end in the first trimester. Vinekar says that’s another reason why they won’t schedule patients early on.
You may be able to make an urgent appointment with your OB/GYN, or at a Planned Parenthood or community health center. For heavy bleeding, Gordon says the ER is an option to get an ultrasound and help get pain under control. But she cautions ER physicians may not be able to answer all your questions.
Learn more about miscarriage risk and early pregnancy care.
Plus: I went through my pregnancy with strangers. It was the best decision I could've made |
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Quick question: Do you have a list of old books that you’ve always been meaning to get around to? You know — the sort of book that a friend recommended a hundred years ago, or maybe one that a teacher assigned (and you ignored), or a classic that everyone’s - allegedly - already read? Yep, us too.
Thankfully, we’ve just launched Books We’ve Loved, a brand-new, limited series from our Book of the Day podcast, with new episodes dropping on Saturdays throughout the fall. This is where we’ll be wrangling some of the most compelling lit nerds out there to make the case for picking up a book from the past.
We’re inviting a cast of literary luminaries – authors, critics, and familiar NPR voices – to argue why their book pick is worth your time. We’re asking our guests questions like — why can’t they get this book out of their head? How did this book shift a paradigm, shake the culture, or change their life? And, most importantly, why should you read it now? |
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MStudioImages/E+/Getty images |
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In a recent Saturday Night Live sketch Amy Poehler plays an “emo mom” with a lip piercing, a magenta hair streak, and a spikey jacket, whose mood swings aptly demonstrated how perimenopause and menopause can make women feel like they're teenagers again… and not in a good way. While her husband and kids try to talk sense to her, she sucks on a vape and complains about getting bullied at school (she's the superintendent), her pinched nerve, and a pelvic floor “on the ground!”
At a time of life when women are often juggling work and family and responsibilities, symptoms like mood swings, brain fog, hot flashes and night sweats can be a lot to bear. That’s why many advocates for menopausal women welcomed the news that the FDA is removing black box warnings from estrogen-based hormone replacement pills and patches. This follows updated data showing that newer hormone therapy formulations carry lower risks of cardiovascular disease and breast cancer, as NPR's Allison Aubrey reports.
In addition to tamping down hot flashes and regulating mood, hormone therapy can also protect against bone fractures and support heart health, says Dr. JoAnn Pinkerton, a menopause expert at the University of Virginia Health. If you're considering starting hormone therapy, it's important to take into account factors like your age, your health history, and the risks that do exist.
Here are a few things to consider:
When to start
Experts recommend starting estrogen therapy before the age of 60 or within ten years of the start of menopause. You've reached menopause when you've gone one year without having a period. In the years leading up to menopause, birth control can help with the symptoms brought on by fluctuating hormones. After you're through the transition, Pinkerton says it makes more sense to switch to menopause hormone therapy, which contains less estrogen.
Which product to try
Oral therapy can slightly increase the risk of blood clots and stroke, Pinkerton says. If you're at high risk for these conditions or you'd simply rather not take a daily pill, your doctor can prescribe a transdermal patch, gel or ring. Taking micronized progesterone may lower your breast cancer risk compared to a synthetic progestin. Depending on your symptoms, a low-dose vaginal estrogen cream could be a good option.
Alternative options
If you have estrogen-sensitive breast or uterine cancer or have had or are at high risk for heart disease, then hormone therapy is more risky, Pinkerton says. There are two newer non-hormonal oral medications available to reduce hot flashes. Lifestyle adjustments like limiting alcohol and caffeine and meditating may also help.
Here's a primer on hormone therapy for menopause.
Also: Perimenopause symptoms can be a drag. Here's when to seek treatment |
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Americans are obsessed with exercise. But it wasn’t always this way
Doctor in Sudan wins $1 million prize for his extraordinary courage:'It is my duty'
'What to Eat Now' nutritionist talks SNAP, food policy and the 'triple duty' diet
Why next year's flu shot might not be as good as it should be |
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We hope you enjoyed these stories. Find more of NPR's health journalism online.
All the best,
Andrea Muraskin and your NPR Health editors |
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