What Is Endometriosis?

Endometriosis is a female reproductive disorder that causes normal tissue of the uterine lining to grow elsewhere in the body. Most often, this tissue grows in the abdomen. This extra tissue acts just like normal uterine lining tissue — it thickens, breaks down, and bleeds with each menstrual cycle. However, because it grows outside of the uterus, it has nowhere to go and becomes trapped, causing scar tissue and adhesions to form. In severe cases, this scar tissue can cause pelvic tissue and organs to stick to each other.

Endometriosis can cause pelvic pain, especially during menstruation and intercourse, but many women have no symptoms at all. It has been linked to infertility, making early detection and treatment important.

Signs and Symptoms of Endometriosis

There are five tell-tale signs of endometriosis:

• Painful periods
• Pain during intercourse
• Pain with bowel movements or urination
• Excessive bleeding
• Infertility

Pain associated with endometriosis is typically far more severe than normal menstrual cramps, and may begin before your period and last for several days. You may also experience pain in your lower back and abdomen.

When to See a Doctor for Period Pain

If your menstrual pain is severe and accompanied by any of the other signs of endometriosis, contact your doctor. Your doctor can perform a pelvic exam or laparoscopy to confirm any physical evidence of endometriosis. It can be helpful to track your symptoms in a notebook or app for reference — note the location of any pain and when it occurs.

If you are diagnosed with endometriosis, treatment will depend on how severe your symptoms are and whether or not you hope to become pregnant. Options include:

• Over-the-counter pain medication to alleviate symptoms
• Supplemental hormone therapy to slow tissue growth and reduce pain
• Laparoscopic abdominal surgery to remove endometrial tissue

You don't have to suffer through endometriosis. There are options to help you regain a higher quality of life, even during your period. If you think you may be dealing with signs and symptoms of endometriosis, contact us as soon as possible to set up an appointment.

MYTH: Manicures and nail polish are unsafe while pregnant

Manicures and pedicures are perfectly safe for both you and your baby! If you want to be extra cautious, look for nail polish brands that don't contain dibutyl phthalate, toluene, or formaldehyde. Experts do suggest avoiding gel polishes and manicures during pregnancy as the ultraviolet lights used to set the gel is something you want to avoid. If visiting a nail salon, look for one that is well ventilated, and ensure that equipment is properly sanitized — you're more prone to infections during this time.

MYTH: You should avoid perfumes and fragrances

Perfumes or scented lotions aren't harmful to you or your baby. However, they may upset your already sensitive stomach, especially in the first trimester. Certain scents such as peppermint, ginger, lavender, rose, chamomile, and citrus can actually help alleviate nausea.

Essential oils are different. You should avoid essential oils during your first trimester because they can potentially cause uterine contractions. If you do use essential oils in your second or third trimester, always dilute them with a carrier oil and check with your OB/GYN first.

MYTH: You can't treat acne while pregnant

Your acne doesn't have to go completely untreated. The FDA considers over-the-counter cleansing creams and washes with less than 5% benzoyl peroxide or 2% salicylic acid safe for pregnant women. Avoid acne solutions containing Accutane (isotretinoin), tetracycline, tazarotene, and spironolactone — these can cause serious birth defects.

MYTH: Warm baths can cause birth defects

Soaking in a warm bath is generally considered safe during pregnancy — it's hot tubs, steam rooms, and saunas you should avoid, as they're typically set to 104°F. Pregnant women should never let their core body temperature rise above 102°F. A regular bathtub is much safer because your upper body remains out of the water and the bath water cools over time.

MYTH: You can't dye your hair during pregnancy

Studies haven't found a direct link between dying your hair while pregnant and birth defects. Most experts agree that dying your hair one to three times during pregnancy is generally safe, but that you should wait until your second or third trimester. If you're uncomfortable with hair dye, opt for highlights or semi-permanent dyes that don't sit directly on your scalp.

MYTH: Avoid wearing makeup while pregnant

It's generally safe to wear makeup while pregnant. Because your skin is more sensitive during pregnancy, avoid products containing parabens, fragrance, or alcohol. If you're struggling with pregnancy acne, opt for products that are oil-free or non-comedogenic. Ingredients to avoid include retinol, triclosan, and artificial dyes.

As always, if you have specific questions about any product, consult your OB/GYN or dermatologist.

Benefits of Waiting to Get Pregnant

You're More Mature and Emotionally Prepared

While younger mothers may quickly lose patience, you're less likely to. Research suggests children of older mothers are more likely to be better behaved, well socialized, and emotionally healthy thanks to the more relaxed parenting that comes with having children later in life.

You're Comfortable in Your Relationships

You and your partner have likely been working on your relationship longer than younger couples. A stable relationship with your employer also means returning to work may be easier.

You're Financially Stable

By 40, you've had time to get your finances in order. Older mothers are more likely to have established a career and earn a higher salary, helping better manage the expenses that come with a child.

Risks of Getting Pregnant After 40

By the age of 40, 90% of your eggs are chromosomally abnormal, making it increasingly harder to conceive naturally. Your uterine lining also begins to thin, making implantation more difficult.

Because your body is older, you have a higher risk of pregnancy complications including high blood pressure, diabetes, and placental problems. For your baby, there's an increased risk of premature birth, low birth weight, and congenital birth defects. Frequent doctor's visits and proper care will help you manage pregnancy and reduce these risks.

Options for Getting Pregnant After 40

Traditional Conception

Women over 40 have approximately a 5% chance of getting pregnant in a given month. Consider asking your doctor for a fertility test if you've been trying without results. Since the onset of menopause generally occurs between ages 40 and 60, your cycle may begin to shorten and the timing of ovulation can change.

Egg Freezing / IVF

IVF, where the doctor fertilizes your eggs in a lab and plants them in your uterus, is commonly recommended for older women who have unsuccessfully tried to conceive for more than a year. In about 20% of IVF cases, multiple embryos implant successfully.

Egg Donation

If your egg production has decreased too much for traditional conception or IVF, egg donation — where donated fertilized eggs are planted in your uterus — has seen large success rates. This is different from surrogacy, where another woman carries the pregnancy for you.

Just because the statistics say you shouldn't wait, that doesn't mean it's the rule. Meet with your doctor when you're ready — every woman and every pregnancy is unique.

Signs of Gestational Diabetes

Some women have no obvious signs or symptoms of gestational diabetes, and many common signs overlap with normal pregnancy experiences. The most common symptoms include:

• Nausea
• Frequent urination
• Frequent bladder, vaginal, or skin infections
• Fatigue
• Blurred vision
• Extreme thirst
• Sugar in the urine

If you experience these symptoms, or notice any new or unusual symptoms during pregnancy, talk to your doctor about the possibility of gestational diabetes. Although usually temporary, gestational diabetes can cause serious health risks including premature birth, higher birth weight, and low blood sugar levels in the baby at birth.

Diagnosing Gestational Diabetes

Many women who have gestational diabetes catch it through routine pregnancy check-ups. You'll likely receive a screening test between 24 and 28 weeks into your pregnancy. If you have higher risk factors, you may be screened earlier and more frequently.

Screenings may include an initial glucose challenge test, where you drink a glucose solution and have your blood sugar levels tested. If results are higher than normal, you'll have a follow-up glucose tolerance test — fasting overnight, drinking a glucose mix, then having blood sugar checked three times over three hours.

What Happens If I Am Diagnosed with Gestational Diabetes?

The best treatment is to control blood sugar levels through diet and possible insulin therapy. Your doctor will monitor your blood levels throughout pregnancy, and you may also need to self-monitor your own glucose levels. Diet and exercise management help with the condition, but insulin therapy may be required in some cases.

When diagnosed early and treated effectively, the risk of complications goes down dramatically. Women who are diagnosed and treated go on to deliver healthy babies. Regular prenatal care is the best way to ensure a healthy pregnancy and birth.

What causes sciatic nerve pain during pregnancy?

During pregnancy, levels of the hormone relaxin increase. This hormone helps prepare your pelvis for childbirth by relaxing ligaments and widening your hips. As your belly grows and ligaments loosen, your center of gravity shifts, which can cause the sciatic nerve to get pinched or irritated — causing a shooting pain sensation down the buttocks and back of the legs.

Other signs of sciatica include a sharp pain on either side of the buttocks, numbness down your legs, or sharp lower back pain that increases upon sitting.

Stretches to ease sciatic pain

1. Pigeon pose

This pose targets the hip rotator and flexor muscles. Place your hands and knees on the floor, gently slide your right knee forward between your hands, and slide your left leg back. Place a yoga block or rolled towel under your right hip to make room for your belly. Repeat for the opposite leg.

2. Bound angle pose

Sit with your legs straight in front of you, raising your pelvis on a blanket if your hips or groin are tight. Exhale, bend your knees, pull your heels toward your pelvis, then drop your knees out to the sides and press the soles of your feet together.

3. Child's pose (wide)

With your face to the ground, slightly part your feet with toes to the ground. Stretch both arms out as far as possible. Nestle your tummy between your thighs and gently lower yourself face down with arms outstretched.

4. Table stretch

Stand facing a table with your feet slightly wider than your hips. Lean forward with your hands on the table, keeping your arms straight and your back flat. Pull your hips away from the table until you feel a stretch in the lower back and back of the legs.

Other remedies

Prenatal massage: Foam rolling tight muscles or booking a prenatal massage may help ease your pain. Be sure to explain the pain you're experiencing to your therapist, and check with your doctor before booking.

Applying heat: Try applying heat to the area where you're experiencing the most pain. Although it may just be temporary relief, it can help with soreness. Avoid applying a heating pad directly on your belly for a long period of time.

Pregnancy girdle: Some women swear by pregnancy girdles for sciatic nerve pain. The girdle helps evenly distribute your pregnancy weight and can help with posture.

The good news is that many pregnancy side effects, including sciatic nerve pain, will go away after pregnancy. If you have more questions, speak with Dr. Rodriguez or our team.