Leakage. There, we said it.

Also known as incontinence, the condition that afflicts more than 13 million people in the U.S. annually is hardly a taboo topic.

For those over the age of 65, incontinence occurs in 51 percent of the population, according to the Centers for Disease Control and Prevention. Women have a higher rate of incontinence than men. Incontinence encompasses leakages related to either or both the bowel and bladder.

Incontinence risk factors

For the aging, incontinence is associated with a number of factors, including chronic conditions such as diabetes and stroke, cognitive impairment and mobility impairment. Bladder incontinence can also be influenced by aging-related changes in the lower urinary tract, urinary tract infection and other health-related conditions to include mobility impairment.

Risk factors for bowel incontinence include chronic diarrhea, inadequate fiber and water intake and chronic constipation. Health factors include diabetes, stroke, neurologic and psychiatric conditions, cognitive impairment and mobility impairment.

In addition to the financial burden, people suffering from incontinence may carry an emotional burden of shame and embarrassment that adds to the physical discomfort and disruption of their lives.

Treating incontinence

Incontinence is not inevitable with age, however, and is a treatable and often curable condition. Tidewater Physical Therapy specializes in women’s health services, including the treatment of incontinence and pelvic pain. Tidewater Physical Therapy’s services are aimed at increasing a woman’s quality of life through self-management and using specific strategies to reduce symptoms and improve function.

People with incontinence suffer most commonly from stress incontinence or urge incontinence.

Stress incontinence stems from the increased abdominal pressure and weak muscles, resulting in the accidental release of urine— this happens, for example, when people laugh, cough, sneeze or jog.

Urge incontinence occurs when people must get to the bathroom right away from an immediate urge that there is no stopping.

But because people feel discomfort in talking about incontinence issues, many people fail to seek treatment. However, talking to a family doctor or gynecologist for a referral to see a physical therapist who specializes in women’s health, can truly help incontinence symptoms and ease feelings of shame, isolation and depression.

The role of physical therapy

Physical therapy helps incontinence patients gain control of their symptoms and will reduce the need for pads, special undergarments and medications.

In a private treatment room of the clinic, patients will have their pelvic floor muscles evaluated.

The pelvic floor is like a sling of muscles and it runs from the pubic bone in the front and goes all the way to the tailbone in the back. It’s one of the components that make up the core of the body.

Treatment includes heat to relax the muscles, electrical stimulation, ultrasound and manual therapy. The first day of therapy, 20 to 25 minutes is spent simply educating patients on what exactly the condition entails.

A therapist will help patients “find” the right muscles and use them correctly. The pelvic floor is one of the components that make up the core of the body, so it’s important to work on core exercises. Pelvic floor exercises, such as Kegel exercises, will work to strengthen the muscles that control your bladder, and put the patient in control of their urges again.

Finding a Physical Therapist

As part of your healthcare team, a physical therapist will make an assessment of your condition and create a plan to start you on the road to wellness. Our team will communicate with your physician of record and obtain a referral, if necessary, for your continued treatment. We will also work with your insurance carrier to make sure services are covered by your plan. To make your own appointment, find a clinic near you.

This article is sponsored by Tidewater Physical Therapy

I love my wife, my mom, my daughter, my sister-in-law; you get the idea.

That’s why when I discovered some of the shocking information on heart disease and women in America, I not only felt it was necessary to learn as much as I could, but to also support Go Red for Women and help spread the word on what a tremendous impact this disease has on so many families.

Women’s Health Magazine has these cute valentines to share

Are you aware that heart disease is the number one cause of death among women in America and is still mostly considered a man’s disease? According to the American Heart Association, it is the cause of “1 in 3 deaths each year. That’s approximately one woman every minute.”

Are you aware that a woman is more likely to have a heart attack without chest pain? Researchers at the University of British Columbia, in Vancouver, Canada and reported by the Journal of the American Medical Association Internal Medicine have determined that women are less likely to have classic chest pain associated with heart attack than men.

Are you aware that only 1 in 5 American women believe that heart disease is her greatest health threat?

The good news is it’s never too late to do something about it. Imagine dramatically reducing your risk of heart disease and getting things under control with just a few easy changes; seven to be exact. The American Heart Association suggests you manage your heart risk by understanding “Life’s Simple 7.”

1. Get Active
Daily physical activity, even just 30 minutes a day, several times a week, will lower your risk of heart disease, stroke and diabetes. Have the energy to play with your kids and let them join in on the fun!

2. Control Your Cholesterol
Know your cholesterol number! Why? High bad cholesterol (LDL), combines with white blood cells and forms plaque in your veins and arteries, which can lead to blockages and increased risk of heart disease and stroke.

3. Eat Better
A healthy diet high in veggies, fruit, lean meats (including fish) and other whole foods, gives your body the essential building blocks for a healthy cardiovascular system and a healthy life.

4. Manage Blood Pressure
It’s been long known that high blood pressure or hypertension is a major risk factor for heart disease and stroke. Certain ethnic groups may be at higher risk of hypertension, so it’s important to know what your specific risks are. Hypertension causes increased strain on your heart, arteries, and kidneys and doesn’t always present symptoms. Know your numbers!

5. Lose Weight
Having excess fat – especially around your middle – means you’re at an increased risk of many factors which are associated with heart health problems such as high blood pressure, high cholesterol and diabetes. Just losing a few extra pounds – say 5 or 10 – can significantly reduce your blood pressure. Find out your BMI; know your numbers!

6. Reduce Blood Sugar
High blood sugar and insulin levels can lead to diabetes, and although it is a treatable disease, it can significantly increase your risk of cardiovascular disease. Most people with diabetes die from some form of heart or blood vessel disease. Know your numbers!

7. Stop Smoking
Cigarette smokers put themselves and those around them at a higher risk of developing cardiovascular disease. If you smoke; quit! It’s never too late to make the change. Quitting will also reduce your risk of many other debilitating and life threatening complications.

Click on each category for specifics or visit The American Heart Association

We hear it time and again: “Pain during pregnancy is normal… The baby must be sitting on the nerve…”  We are told so by our friends, our sisters, our mothers and even uninvited strangers.  But the truth is that pain during pregnancy is not normal. It is not expected because the baby is small and cushioned well, so he or she cannot be sitting on a nerve.  However, pain during pregnancy is common. Statistics show 50-80% of women experience back pain while pregnant.  This can range from significant to completely disabling pain– 80% will be unable to go through their daily routine because of their intense pain.

So the term “Pain is normal” is not a good enough answer for me.  I’m a Physical Therapist, trained to help you with your “mechanical pain”.  Mechanical pain means the pain that is coming from muscles, joints, lose ligaments, discs, and pre-existing asymmetries.  A trained Physical Therapist can evaluate each of these structures for you, determine what is causing your specific pain, and help create a plan to help relieve that pain.  Our evaluation results in a treatment plan that can implement in the office, and teach you an exercise program that you can take home to manage your pain.

Instability in the muscles and ligaments is the most common cause of the pain, resulting in other muscles working too hard to stabilize the tissues, resulting in spasms and shooting pain, that may even travel down the leg.  Learning how to safely do a pelvic floor muscle contraction is the start of that stability.

Let’s try it:  lie down, or sitting a chair, with your legs and back at rest. Then, squeeze up and in, imagine that you are trying to hold in urine.  Try your best not to squeeze your gluteals, your knees, or your feet together, really isolate those pelvic floor muscles. Hold for a count of five, and repeat the exercise ten times.  You can be make it harder by holding longer, or steadily increasing the intensity of the squeeze.

Another strong stabilizer is your abdominals! Again, sitting or lying, sink your belly button in to your spine, hold for a count of five, repeat ten times.  Another nice way to help reset unstable joints is rhythmic motions, sit close to the edge of your chair and rock your hips backward and forward. You will be making your pelvis tilt forward and back, repeat ten times.  All theses exercises can be done several times a day for the best results.

Here are some tips that will come in handy to help with your pain as well. Think about your posture. Imagine the string pulling your head up as you stand and walk. Keep your abdominal and pelvic floor muscles engaged when you change positions, like when you are going up and down stairs, or when lifting heavy objects or children.  Wear sensible shoes, not heels and flip flops, throw the Uggs back in the closet, and instead, chose a strong heel, and good arch support.

We have touched on some important exercises and tips to help you with your back pain, but there so much more to learn.  Be sure to tell your ObGyn about your pain, no matter how small, even if you are in your first trimester! Ask if a Physical Therapist would be safe and appropriate for you. Remember, back pain is not “normal” and something you need to live with, but it is common. So don’t settle for dealing with unnecessary pain.

Mona Saeed DPT, Certified MDT, CHT earned her Bachelor of Science degree fromBarnard College, Columbia University, New York, NY, and her Doctorate in Physical Therapy from Stony Brook University, Stony Brook, NY.

In addition to general orthopedics, Mona is experienced and certified in McKenzie’s method to treat cervical and lumbar spine dysfunction. She also has the unique experience of treating patients with pain related to pregnancy as early as 6 weeks to full term, in both high risk and “normal” pregnancies.

Many of the physical therapists at Tidewater Physical Therapy Inc. hold Direct Access Certification through the Virginia Board of Physical Therapy allowing them to evaluate and treat patients without a prescription. As part of your healthcare team, a physical therapist will make an assessment of your condition and create a plan to start you on the road to wellness. Our team will communicate with your physician of record and obtain a referral, if necessary, for your continued treatment. We will also work with your insurance carrier to make sure services are covered by your plan. To make your own appointment, find a clinic near you.

This article is sponsored by Tidewater Physical Therapy.

It’s coming around the corner…
January.

That’s the time where we all make our New Year’s Resolution to lose a few and in doing so, we shlep ourselves to the gym on a cold January morning, drop the kids off at the gym daycare, only to find all the treadmills are taken.

FIT4MOM Richmond offers a different approach to fitness with their Stroller Strides classes. Stroller Strides combines quality time with your little one and a killer work out for a fun way to get fit.  These 60 minute classes focus on cardio, strength and core exercises while your stroller-aged child comes along for the ride and is entertained with songs and games!

Stroller Strides classes at FIT4MOM Richmond allows moms to bond with their babies and meet other moms while getting a really great workout.  Additionally, FIT4MOM Richmond offers a free weekly playgroup with Our Village so moms can form lasting friendships through organized playdates, moms’ nights out, and activities for the whole family.  Take the Wednesday class and go to the playgroup afterwards or take any other class and join in just for the fun at the playgroup.

If you don’t have a stroller-aged child but you do want a fun, inspiring workout, there’s something for you too! FIT4MOM’s  Body Back program is a results-based workout designed for women, whether they just had a baby or their last child was born twenty years ago! Most importantly, it will help women unlock their personal possibilities in an inspiring and powerful environment. Body Back clients experience targeted high-intensity workouts, nutritional guidance, before & after assessments, weekly challenges and TONS of support! The small-group format fosters inspiration and motivation in every class.

FIT4MOM Richmond offers classes throughout the Richmond area at local parks including Sunday Park and Maymont. During the winter months, classes are indoors at the Richmond Volleyball Club at 2921 Byrdhill Rd. every Monday through Friday at 9:30am. Or, on Southside at the Martial Arts World in Brandermill every Monday and Wednesday at 10am. You can expect classes to start being held outside in March & April.

A new 8 week Body Back session begins the week of January 5th 2015 and there are 4 locations to choose from. Register online today at www.richmond.fit4mom.com.

This article is sponsored by FIT4MOM

There’s no need to be shy when talking to your doctor about sexual health.

I have bad news, mamas.

1 in 3 women experience pain during intercourse at some point in their life.

Women are more likely to complain about sexual dysfunction before menopause.

And the number 1 libido killer? Kids.

That means we’re smack dab in the middle of prime sex-might-actually-suck-for-you time.

But I also have good news.

Something can actually be done about it.

I was invited to attend Let’s Talk About Sex at Virginia Women’s Center at St. Francis and as weird as it might sound, spending an evening with a bunch of people who know more about your vagina than you do and about 30 some strangers was actually a really good time. Before I get into what we talked about, here’s a little bit about who was there:

Virginia Women’s Center brought in four different experts on various aspects of women’s health for an open and mature conversation about sex, sexual health, and sexual dysfunction.

Keith P. Berkle, M.D.
Dr. Berkle diagnoses and treats disorders of the vulva including vulvar pain syndromes and has a special interest in minimally invasive surgical techniques, such as laparoscopic hysterectomies, myomectomies and single incision laparoscopic gynecologic surgeries.

Tovia M. Smith, M.D.
Dr. Smith is a urogynecologist and uses non-surgical as well as advanced technologies such as the daVinci Surgical system to reconstruct the pelvic floor for women who suffer prolapse, urinary incontinence and fecal incontinence.

Cora Huitt, PT, DPT, BCB-PMD
Practicing physical therapy for 41 years, Cora Huitt  is a certified women’s health specialist and specializes in treating women with pelvic floor dysfunction

Sara Bolden, DPT, WCS
Dr. Bolden is a licensed physical therapist and board certified women’s health specialist specializing in pelvic pain, urogynecologic disorders and pelvic floor dysfunction.  Dr. Bolden is also the author of What A Girl Wants: The Good Girl’s Guide to Great Sex.

 

So what did they talk about?
Here’s a brief overview.

The vagina… it’s complicated.
Well, not just the vagina, the pelvic floor itself has a lot of layers, so there’s a lot that could be troubling you. If you’re experiencing discomfort, head to a doctor you can trust or someone who specializes in your particular concern. When you’re there, be prepared for a loooot of questions, and don’t be shy about answering them (they really have heard it all). Sometimes it’s a simple fix, sometimes it’s a lot more than that, sometimes it’s physical, sometimes there’s a psychological factor as well. The more honestly you share, the more you’ll get out of your appointment.

Hang on, you missed a spot.
There is, perhaps, a g-spot, but as it turns out there’s also a u-spot and an a-spot. (And now I know where they are, don’t I feel special.) Don’t worry, the directions are written down for you.  Yes, further proof that though we took sex ed in high school, and even had kids of our own, but there’s a lot you might not know about your own body.

Coconut oil is a great lube and lube well, isn’t a great lube.

Popular lubricants, soaps, feminine products and other things can be drying and cause irritation. If you’re experiencing discomfort, the answer may be as simple as a product switch or dropping a bad habit or two. A couple of easy switches: Choose coconut oil or olive oil for lubricant over potentially drying store bought lubricants and when shopping for feminine products, consider switching to a more natural fiber (cotton) rather than the synthetic or scented types.

There are 26 drugs marketed for the treatment of male sexual dysfunctions.

For women? 0.
There is no FDA approved drug for the most common type of sexual dysfunction for women (hypoactive sexual desire disorder).  That doesn’t mean doctors can’t help you, they can, there are therapies that can be used to treat HSDD.  There are drugs out there, but they have yet to be approved by the FDA.  For more information visit EventheScore.org.

You don’t have to suffer in silence.

Sexual dysfunction can affect more than just your sex life. It can affect your confidence and your relationship. It is suspected that many women’s health problems are underreported due to embarrassment, but nearly half of all women suffer from sexual dysfunction at some point in their lives such as pain during intercourse, trouble reaching orgasm or decreased desire. And, it’s not just sexual health that may concern you, 50% of postpartum women experience urinary incontinence, and while something can done about it but only 60% of women seek help.
If it bothers you, it’s worth seeing a professional.

Let’s Talk About Sex was hosted by

Virginia Women’s Center 

and Women’s Health Physical Therapy
at St. Francis Medical Center.

This article was sponsored by Virginia Women’s Center and Women’s Health Physical Therapy.

Join the Lupus Foundation of America, DC/MD/VA Chapter on October 11, 2014 at Bon Secours Red Skins Training Camp for the 6th Annual Virginia Walk to End Lupus Now.

Because lupus can be extremely debilitating, the walk is short (less than 2 miles) so that everyone can participate, you could even take the route twice! A short walk also makes this event perfect for families with small children to get outside and make a difference!  Information will be available about lupus on site, face painting and balloon animals for the kids, as well as a post-walk celebration.

Our signature walks build momentum and provide funding for the Lupus Foundation of America, DC/MD/VA Chapter to provide FREE education, support, and outreach services to the more than 40,000 people living with lupus in Virginia. The Virginia Walk to End Lupus Now attracts over 1,000 walkers who unite on Walk day to take steps towards a cure and raise awareness about this little known disease. Our Walk continues grow each year through increased media coverage and its ability to connect a population that lives with a very lonely disease. Walk day is a powerful experience that provides the local lupus community with hope and renewed energy to overcome challenges associated with lupus. Register at www.VirginiaWalktoEndLupus.org today!

6th Annual Virginia Walk to End Lupus Now
Saturday, October 11
Registration begins at 9am
Walk Starts at 10am

Vaginal bleeding: For the first three days after delivery, you may experience a bloody discharge of leftover blood, mucus and tissue from your uterus. This discharge, called lochia, is generally as heavy or heavier than a menstrual period and may contain several clots. The discharge will turn pink, then brown and finally a yellowish-white as it decreases in quantity. The bright red flow may resume when you are breastfeeding or during periods of increased activity. Normally, this will stop completely within four to six weeks.

Things to help: Sanitary pads

What to watch for: Saturating more than one pad an hour for more than a few hours or discharge that has a bad odor

Abdominal cramps (afterbirth pains): Abdominal cramps, or “afterbirth pains,” are caused by contractions of the uterus as it returns to normal. They may be more obvious while you are nursing and will gradually subside within a week.

Things to help: Change positions, empty your bladder, take Tylenol® or Motrin® (Ibuprofen)

What to watch for: Severe abdominal pain, nausea/vomiting

Perineal discomfort: The stretching and bruising of the perineum during delivery can cause discomfort, pain and numbness. If your perineum was torn or if you had an episiotomy, you will have stitches. In most cases, this area will be very tender and sore for three to four days following delivery. Your stitches will dissolve in about 15 days, but tenderness may last several weeks.

Things to help: Warm sitz baths, witch hazel soaked in gauze pads or Tucks®, local anesthetic spray, Tylenol®

What to watch for: Increasing pain, swelling or discharge

Cesarean incisional pain: If you delivered by cesarean birth, your wound will be painful and you may experience numbness or a tingling sensation when the anesthesia wears off. Medication to relieve your pain will generally be ordered by your physician. Avoid lifting anything other than your baby, and try to keep stair climbing to a minimum.

What to watch for: Fever, increasing pain or drainage from your incision site

Constipation: Your first bowel movement after childbirth may be difficult.

Things to help: Fiber (whole grains, fresh and dried fruit), drinking water, Colace®, Milk of Magnesia® or Dulcolax® tablets

Hemorrhoids: If you have hemorrhoids, they can become swollen and painful and protrude after delivery.

Things to help: Laxatives, Anusol® or Preparation H®

Infant feeding: If you are bottle-feeding, remember to wear a well-fitting bra and avoid breast stimulation. Breast engorgement will generally improve two to four days following delivery.

If you are breastfeeding, you may not produce milk for three to four days after delivery. When your baby nurses, he or she will receive a clear liquid, called colostrum. This fluid contains important antibodies. When your milk finally begins to come in, your breasts may become enlarged, tender or unusually firm.

Things to help: Nurse your baby more frequently, apply warm compresses to your breasts or take a warm shower.

What to watch for: Body aches, chills and a fever of 101⁰ or 102⁰ as these can be signs of a breast infection called mastitis. With mastitis, one breast may become extremely firm, red hot and tender.

As always, you are welcome to call our office at 804.288.4084 with any questions or concerns you may have. If you experience any of the following symptoms, please call us immediately.

• Elevated fever over 100.4
• Nausea and vomiting
• Painful urination, burning and urgency
• Heavy vaginal bleeding
• Pain, swelling and tenderness in the legs
• Chest pain or cough
• Hot, tender breasts
• Persistent pain in the perineum with increasing tenderness
• Vaginal discharge with a bad odor
• Feelings of hopelessness that last more than 10 days after the delivery

Additional Resources:

• Postpartum mental health
• Safe medications while breastfeeding
• Returning to normal activities

About Virginia Women’s Center
Our care team – comprised of OB-GYNs, high-risk pregnancy specialists, nurse practitioners, ultrasound technologists, psychologists and a genetic counselor – are experienced in all aspects of pregnancy and welcome the opportunity to provide care that revolves around you. We have added all of these services and specialists to our practice not only for your convenience, but also because we believe that you will benefit from a coordinated and comprehensive approach to your pregnancy care. For more information, visit www.VirginiaWomensCenter.com, or find us on Facebook, Pinterest and Twitter.

The pelvic floor is a set of muscles, ligaments and connective tissue in the lowest part of the pelvis that supports a woman’s internal organs, including the bowel, bladder, uterus, vagina and rectum. Weakened pelvic muscles or tears in the connective tissue can occur when excessive strain is put on the pelvis through childbirth, repeated strenuous activity or pelvic surgery. Other factors that can increase the risk of pelvic floor disorders include repetitive heavy lifting, menopause, chronic disease, tobacco use and family history.

What conditions can a urogynecologist treat?

• Pelvic organ prolapse: One or more of the organs in the pelvis drops down causing a sense of pressure or a bulge in the vagina. It may also cause urinary incontinence, pain or constipation.
• Stress urinary incontinence: Leakage of urine with coughing, sneezing, laughing or any other activity that increases the pressure on the bladder and/or the supporting tissue.
• Overactive bladder syndrome: Frequency, urgency (a sudden and strong desire to urinate that is bothersome) and nocturia (waking up more than once at night to void) with or without urge incontinence (accidental urine loss associated with a sudden and strong desire to urinate).
• Anal and fecal incontinence: Involuntary leakage of gas and/or stool.
• Fistulas: An abnormal connection between two organs (i.e. bladder and vagina or vagina and rectum)
• Complications from third and fourth degree tears following vaginal childbirth

What treatment options are available?

There are a variety of non-surgical approaches as well as surgical options that can help relieve the symptoms associated with pelvic floor disorders. After consultation, you and your physician will work together to find the solution that works best for you, your lifestyle and your overall health.

Why should I see a urogynecologist?

While many of the symptoms and conditions listed above are very common, it is important to know that these are not a normal part of aging or something that women need to put up with. Consulting with a urogynecologist will provide you with specialized expertise to help determine the best way to relieve your symptoms and restore your quality of life.

At Virginia Women’s Center, we are excited to welcome our first urogynecologist, Dr. Tovia Smith. Dr. Smith will work with female urologist Dr. Lonny Green and gynecologists Dr. Elizabeth Roberts and Dr. Louis Thompson to care for women whose qualities of life are being affected by bladder and pelvic health issues.

About Virginia Women’s Center
Since 2006, Virginia Women’s Center has been dedicated to helping women with urinary incontinence and other bladder problems find solutions to restore their quality of life. For more information, visit www.VirginiaWomensCenter.com, or find us on Facebook, Pinterest and Twitter.

The loss of a child through miscarriage can be a difficult and emotional experience. Even in the early weeks of pregnancy, many women develop a strong bond with their unborn child and feel a deep sense of loss when miscarriage occurs.

Common responses include shock or denial, disappointment or anger, helplessness or perceived loss of control, sense of failure, feelings of inadequacy, guilt or self-blame, sadness or fear. Everyone responds in a different way to the grief process. There are no “shoulds” or “right” ways to feel. Keep in mind that whatever your feelings, it is important to be gentle with yourself. Although there are many ways to lessen the pain, the only thing that truly diminishes grief is time. Some women will move through this loss freely, while for others, it will take far longer.

During your recovery, it is important to eat properly, get plenty of rest, exercise – and most importantly, do not be afraid to ask for what you need.  Reach out to others and request help; allow friends to make meals, watch other children or help with household duties.

When you feel ready, talk about your experience. You may be surprised how many other women can offer their love and support because they have been down this road too. Although it does not ease your grief, miscarriage occurs in 10 to 20 percent of pregnancies making it a very difficult common experience. However, be prepared that when you talk about your experience, you may also encounter some misunderstanding. Many people who have not experienced a miscarriage consider it the end of a pregnancy rather than the loss of a child. They may question your grief or suggest that you keep busy and forget about your loss. Be assured that your grief is real and allow your tears to flow. In time, with love and support, your pain will subside, but the loss will always be a part of your life.

It is likely that you will not want to be around other pregnant women or that you will be unable to attend a friend or relative’s baby shower. This is a very natural reaction and does not indicate jealousy or selfishness on your part. It is important to honor these feelings and to be honest with others about them; they will understand.

Some women find it helpful to honor the existence of their baby by giving their baby a name and participating in a funeral or ritual to mark the loss. In addition, prepare yourself for future dates, such as your unborn baby’s due date and subsequent anniversaries. These dates will likely have a place in your heart for years to come.

One issue that exacerbates this loss is that there are not always explanations for miscarriage. While it is important to ask your health care provider if there is an explanation, understand that often there is no specific medical problem.

Given the many hormonal changes, you may experience mood swings, fatigue, irritability, heart palpitations, poor appetite and a desire to withdraw from social activities. All of these symptoms are normal and will gradually diminish. However, if you find these symptoms to be persistent or severe, call your health care provider immediately.

Physical Healing After a Miscarriage

Physically, it may take several weeks or months for your body to return to normal. In the beginning, you may notice spotting or light vaginal bleeding, mild cramping, nausea and fullness in your abdomen and breasts.

To help prevent infection, use sanitary napkins instead of tampons and avoid sexual intercourse until your bleeding stops. Call your health care provider immediately if:

• You have a fever of 100 degrees or more
• Bleeding increases significantly or lasts more than several weeks
• Bleeding changes color to bright red
• You experience pelvic pain or unusual cramping
• Your vaginal discharge appears yellow, green or has a bad odor

Planning for the Future

If you are considering becoming pregnant in the future, discuss your risks and options with your health care provider. Every situation is unique, but in most cases, the chances of suffering another loss are not significantly increased unless you have had three or more miscarriages. Whatever you decide, remember to give yourself ample time to recover physically and emotionally from your miscarriage before making the decision to get pregnant.

Subsequent pregnancies may create a number of psychological issues, including anxiety about possible recurrent miscarriages and the fear of not being able to have children. Anxiety will be greatest up until the time that the first miscarriage occurred. It is understandable that you would experience this type of response. In order to cope, stay in the here-and-now and focus on being pregnant again and not what could possibly happen.

Additional Resources

If you want more structured, formal help, you may wish to pursue counseling at Virginia Women’s Center with one of our two psychologists: Dr. Lisa Cuseo-Ott or Dr. Mary Polce-Lynch. There are also many support organizations and groups in the Greater Richmond area that you may find helpful, including:

• Compassionate Friends
  • www.compassionatefriends.org or 804.254.0588
• Family Extended
  • www.familyextended.org
• Full Circle Grief Center
  • www.fullcirclegriefcenter.org or 804.357.5924
• M.I.S.S. Foundation
  • www.missfoundation.org or 800.726.4322
• Bliley’s Internment of Angels
  • Bliley Funeral Home offers monthly funeral services for families who have experienced a miscarriage or stillbirth. The services are at no cost to you and close family and friends are welcome to attend. To learn more, call Bliley’s at 804.355.3800.

About Virginia Women’s Center

At Virginia Women’s Center, we value the complete health of women. As researchers continue to identify the significant relationship between physical and mental health, Virginia Women’s Center has emerged as a leader in innovative health care for women by providing psychological counseling services to our patients since 2005. For more information, visit www.VirginiaWomensCenter.com, or find us on Facebook, Pinterest and Twitter.

Virginia Women’s Center is a sponsor of Richmondmom.com

Sarah Maddux is now a Certified Holistic Health Coach that focuses on women’s reproductive health

Despite my childhood aversion to dolls and anything feminine, I have always known that I wanted to be a mother. I spent my days chasing frogs, catching spiders and would not be seen within a 5-mile radius of Barbie. My Grandfather loved to tell stories of the days when I would run up to greet him and promptly introduce the earthworm collection in the pocket of my dress. Even back when summers seemed infinite and I closed my eyes every night wearing 101 Dalmatian pajamas, I knew that “when I grew up”, I wanted to have children of my own. From a very young age, the ability to become a mother largely defined what I saw as the essence of myself as a woman.

In March 2013, I was diagnosed with Polycystic Ovary Syndrome (PCOS) and was told that it would be nearly impossible for me to become pregnant without medical intervention. I remember hearing my doctor’s words and feeling my blood turn to ice. His sentences were incomprehensible but I sensed that each word erased a small part of the family picture I had painted for myself. I would marry the man of my dreams in June of that year and could not bear the thought of telling him that our plans to start a family might need reconsideration. I returned home with a few pamphlets in my hand and an overwhelming amount of hopelessness and fear in my heart.

I spent a few weeks in a combination of shock and denial before deciding that I would learn as much as possible about PCOS, why I had found myself as one of the estimated 5 million American women struggling with the symptoms of this condition, and what I could do to improve my changes of conceiving naturally. It is my hope that sharing my experience with PCOS will be a source of information, inspiration, and empowerment.

If you are someone struggling with PCOS or suspect you have symptoms of the condition, you are not alone. PCOS is the most common source of infertility in women today. The cause is unknown, but there appears to be a genetic component to the condition. If you have a mother or sister who has/had PCOS, your will likely be at a higher risk.

Becoming educated and empowered is the best thing you can do for yourself and your family. Unbeknownst to many, PCOS can be managed and even reversed through changes in diet and lifestyle. As cruel as PCOS can be, especially for women trying to conceive, there are countless reasons to have hope. Most women with PCOS are able to become pregnant. Yes, it may take time and patience and seemingly impossible optimism, but you can (and will) become a mother!

There are numerous dietary and lifestyle changes that one can make to improve, or even reverse, PCOS.

Learn to manage stress. For my entire life I had been known as the borderline obsessive-compulsive girl who color codes everything and has a special talent in making mountains out of molehills. My nervous system was in overdrive. After my PCOS diagnosis, I was able to put everything into perspective. Was striving for perfection and the toll it was taking on my body really worth sacrificing my health? I began practicing yoga regularly, learned breathing techniques to manage stress, allowed myself to sleep even when my mind told me I had not accomplished enough to warrant sleep. I realized what happiness was made of; my health and a family of my own.

Eliminate caffeine. As someone who began a serious coffee habit at the age of 16, I was quite sure this was an impossible feat. Coffee got me out of bed in the morning, got me though my afternoon slump, and a drink I happened to consider the most vital and delicious on earth. Despite our reliance on caffeine, it wreaks havoc on the endocrine system. The rush we experience after a cup of coffee may be welcome as we head to work in the early morning, but our stimulated adrenal glands pay the price.

Remove processed foods. While processed foods are generally unhealthy, they are especially detrimental to those with PCOS.  Strive to maintain a whole foods diet to the greatest extent possible. That means vegetables, fruits, legumes, high quality meats if desired, nuts, seeds, and plenty of water. As I often tell my clients, foods with only one ingredient are always the best option. While this is not always realistic, keep in mind that ingredients that are not easily pronounced are probably not fit for consumption.

Adopt a low glycemic diet. Women struggling with PCOS are often insulin resistant. In a nutshell, the body is not able to process sugar as it should.  Make changes to the diet to gradually eliminate sugar. Remember, sugar is not just what we use for baking. Sugar is also hidden behind other terms such as fructose, cane juice, corn syrup, maltodextrin, maltose, sucrose, dextrose, glucose, and rice syrup, just to name a fraction. Remember that white flour is processed as sugar in the body, so the elimination of both sugar and processed flour will be important in the maintenance of a low glycemic diet.

The aforementioned dietary and lifestyle suggestions are just a few of the changes that women with PCOS can use to improve their lives and chances of conceiving. I wholeheartedly believe that the relatively simple changes I made to my daily life allowed me to become pregnant naturally. I hope that my story has offered at least a small amount of hope to women with PCOS.

Through diet and lifestyle, I healed my body and through the opportunity to become a mother, my body has healed my spirit. I believe the same is possible for you.

I am a Certified Holistic Health Coach that focuses on women’s reproductive health. Health Coaches are knowledgeable advisors that provide ongoing guidance as clients set goals and make sustainable changes to improve health and happiness. I design personalized programs to fit the needs of each client, provide a wealth of advice and information ranging from nutrition to self-care, and empower clients to achieve their wellness goals.

After years of PCOS, I balanced my hormones naturally and became pregnant on my own. I use my knowledge and inspiration to help women with PCOS and related conditions reclaim their health, fertility, and vitality.

Visit Sarah’s blog: www.EssentialWellnessbySarah.com