Some of you may not experience difficulty conceiving when you make your decision to become a mother. But, if you have taken time out of your busy schedule to visit us, it is likely that you are concerned about the many issues and choices involved in conception. Because conception can sometimes be more difficult than expected and because without intervention it can sometimes take as long as a year to get pregnant, some of you may even be wondering What’s Wrong. And many of our visitors are often very anxious or confused about the reproductive process and the mechanics of The Female Body. I want to step back and take a moment to address these and other concerns that many of you are experiencing. I want to start with what it means to begin the journey toward motherhood.

If you feel a breast lump or mass see your doctor, who will examine your breasts carefully.
For normal breast tissue nothing need be done. Fibrocystic changes can be treated as above.

For a possible cyst or a fibroadenoma, one option is to measure the lump and have you return for an examination after you next period. If the lump is gone, it was probably a cyst.

If the lump is still there your doctor may recommend an ultrasound, which helps tell a cyst, which contains fluid, from a fibroadenoma, which is solid. Your doctor may also recommend needle aspiration of the mass. In this procedure, a needle is inserted into the mass and an attempt is made to withdraw fluid that would indicate a cyst. Mammograms are rarely done in adolescents because their breasts are so dense.

If aspiration of the mass can’t be done or no fluid comes out, or if the mass is hard, getting bigger, hurts a lot and is causing you and your family a lot of anxiety, then the mass can be surgically removed. Be sure to see a surgeon experienced with breast surgery in adolescents and learn about the risks and benefits of the procedure.

Breast Discharge
Breast discharge in adolescents may provoke anxiety but rarely indicates breast cancer.

One type of discharge is a milky discharge known as galactorrhea. Causes of galactorrhea in adolescents include:
pregnancy
breast manipulation (physical activity, sexual stimulation)
trauma
medications
thyroid problems
pituitary tumors
central nervous system tumors

See your doctor if you have any type of breast discharge.

Nipple Problems

Jogger’s nipple — This is caused by friction during jogging or sports. The nipples get irritated and sore. Common treatments are lubrication with petrolatum and protection with an adhesive bandage. A soft cotton bra without a seam in the cup may also help.

Nipple eczema — This is a type of dry, scaly rash involving one or both nipples. A good moisturizer and mild topical steroid treats the eczema. An antibiotic is needed if the area gets infected.

An internet drugstore may present you private manner to buy prescription medicines, often at a more inexpensive rate. No prescription online pharmacy are especially suitable in case you do not drive or live in a rural area.

Lack of breast development — This may be due to a health problem; an endocrine (hormonal) problem; a rare condition called amastia or radiation therapy involving the chest.

Breast hypertrophy — Also known as excessive breast growth, this can cause back pain, breast pain, shoulder pain, poor posture, rashes under the breasts and psychological concerns. Breast reduction surgery is an option after breast growth is complete.

Tuberous breasts — These breasts have narrow bases and very large nipple-areola complexes. Plastic surgery can be done for cosmetic reasons.

Significant breast-size differences — This may indicate an underlying problem, such as a cyst or a mass. A doctor can determine if this is the case. If no underlying problem is found, one option is to use bra padding or a bra insert for the smaller breast. Another option is plastic surgery. This can be considered once breast growth has finished.

If you are considering any type of breast surgery, be sure to see a plastic surgeon who has experience with that particular procedure in women your age. Learn about the risks and benefits of any surgery before you proceed.

Infections
Bacteria that enter small cracks or breaks in the skin cause breast infections. These can occur from:

• breast-feeding
• plucking or shaving hairs around the areolae
• sexual play
• nipple eczema
• trauma to breast skin

In breast cellulitis the skin is red, tender, warm and swollen. It is treated with an antibiotic and warm compresses.

A breast abscess is a collection of pus, which usually requires incision and drainage in addition to an antibiotic and warm compresses.

Yeast infections may occur under large breasts and appear as bright red rashes. A topical anti-fungal cream is used to treat it.

Seek medical care right away if you think you have a breast infection.

Lumps and Bumps
Breast cancer is extremely rare in adolescents. Since adolescent breasts are normally dense, firm and nodular, most of the lumps girls feel in their breasts are normal breast tissue or fibrocystic changes.

Fibrocystic changes are cyclic or menstrual-related breast changes. Symptoms include breast pain or discomfort the week before menstruation. Breasts are usually tender and feel granular due to small microcysts, which may merge into a larger cyst that can be felt as a mass. The cysts may go away then recur with successive menstrual cycles.

Treatment includes a well-fitting support bra and nonsteroidal anti-inflammatory prescription medication. Oral contraceptives may be used for more severe cases.

Of all breast masses that are surgically removed in adolescents, the most common type is the fibroadenoma. Cancerous tumors are one of the least common types removed in adolescents.

A new and different class of drug is Effexor. It’s similar to the SSRIs in that it keeps mood balancing chemicals in the body’s system longer. A third class is Wellbutrin. “It’s the same drug as Zyban, which is prescribed to help people stop smoking,” Guthrie said. It affects mood and movement.

“Initially, prescribing medication is a bit hit or miss,” Guthrie said. “We know they all work. By knowing each drug’s side effects, we can narrow it down. And by knowing what other prescription drugs without a prescription a patient is taking, we can narrow it down a little more. Then after we see how you do, we can tailor it even further.

“But remember, it usually takes a couple of weeks for the drugs to fully enter your system,” she said. “And it may take that long before you to notice a change or an improvement. Some say these medications wake them up, while others say they narrow their mood swings.”

Other treatment includes psychotherapy or talk therapy, which may be effective in treating mild to moderate depression, Stotland said.

This involves talking with a trained mental health professional to help learn better ways of handling problems. Work is generally done over a short-term course with a specific number of sessions, Stotland said. For example, in cognitive/behavioral therapy patients work at changing the negative behaviors and styles of thought that may contribute to their depression. “This focuses on the here and now, which we have the power to change,” she said.

Interpersonal therapy focuses on learning to deal more effectively with other people and working to change relationships that can cause depression or make it worse.

“For many people, a combination of both medication and psychotherapy is best,” Stotland said. “Depression is a serious illness — so take it seriously. It’s a disease that must be treated. If you feel guilty or hopeless, remember it’s all part of the disease. Get help — and don’t give up. Keep going to someone until they make you better.

“By nature, women are loathe to take care of themselves,” Stotland added. “So tell yourself you’re doing it for your family — your husband, your children, your mother, your sister — then do it.”

Cognitive — this includes low self-esteem, negative thinking patterns, pessimism, excessive worry and/or the feeling that you have little control over your life.

Genetic — those with a family history of chronic depression are at increased risk for depression. Clinical depression, however, may occur in people without a family history of the illness.

Situational — hard life events like divorce, financial problems, death of a loved one, a move and/or a significant loss may contribute to depression.

“The biggest misconception about clinical depression is that you can get over it by force of will,” said Dr. Nada Stotland, chief of psychiatry at Illinois Masonic Medical Center in Chicago. “It’s a disease — a chemical imbalance — and once it’s started, it can’t be healed without treatment. It makes you feel hopeless and helpless — like nothing can be done to help.”

But it can be treated. Once diagnosed, clinical depression is one of the most treatable of all mental illnesses. Only a qualified health professional, however, can make an accurate diagnosis and prescribe treatment. As with most illnesses, the earlier treatment begins the more effective it can be.

Depression Treatments
The most commonly used treatments are medication and psychotherapy, or a combination of both. Medications have come a long way in their ability to effectively treat clinical depression. Until the late 1980s there were only two classes of cheap prescription drugs available — tricyclic antidepressants and monoamine oxidase (MAO) inhibitors.

“And they weren’t always well tolerated,” said Dr. Sally Guthrie, an associate professor in the College of Pharmacy at the University of Michigan in Ann Arbor. She also has an appointment with the university’s department of psychiatry. For example, the tricyclic antidepressants often caused a feeling of sedation, dry mouth, constipation, weight gain and diminished sex drive. And MAO inhibitors often caused dizziness and interactions with over-the-counter drugs, such as cold medications.

“That’s really all we had until the late 1980s when Prozac was introduced,” Guthrie said. “But today there are an awful lot more medications to choose from and we’re able to tailor — or fine tune — medications for patients’ specific needs and to allow these medications to co-exist with other prescription medications patients might be taking. This is especially helpful since it’s very common to suffer from more than one illness at a time.”

“I had this real sense of being stuck,” said Mendelson, 47. “I remember spending nights and weekends so depressed just sitting in a chair for hours, wondering, `Is this ever going to pass?’” Off and on for almost 20 years she tried various types of psychotherapy — but no medications. Then four years ago, Mendelson was diagnosed with clinical depression as well as obsessive-compulsive disorder and post-traumatic stress disorder — both anxiety disorders.

“I was so relieved,” she said. “I’d always felt that if only I tried harder or if only I had a better character, I could overcome my feelings and be well. I was so happy to learn that there were names in medical books for what I was feeling. Now I knew that I had an illness — a chemical imbalance in my brain — and it could be treated like any other medical illness.”

Today, Mendelson takes the antidepressant Paxil and is a member of a support group. “I was so grateful when the medication kicked in. I felt more in control and happier. It helps level my playing field and helps me enjoy my life,” she said.

Mendelson has become an advocate and activist for mental health. Her goal is to help end the stigma of mental illness as a dark and shameful secret rather than a treatable disease. She also recently married. “Life is better that it’s ever been,” she said. “Because I’m recovering, I can be the person I always wanted to be. I always had that glimmer of hope. Now I’m trying to help others realize there’s help on the other side.”

Mendelson is not alone. In fact, she’s one of the millions of women affected by clinical depression each year. Researchers say women are twice as likely as men to experience clinical depression and 1 in 4 women can expect to develop it during their lifetime. In addition, untreated clinical depression can also increase a woman’s risk for heart disease and hypertension — especially among black women, studies say.

Early ejaculation is a trouble that frustrating many couples. Fortunately, there is info out there that may help out you to stop you premature ejaculation issue.

The good news is that U.S. Food and Drug Administration (FDA) testing confirmed in 1999 that asbestos is not an ingredient or trace contaminant in any American brand of tampon. The bad news: certain types can be hazardous to your health and the environment for other reason, including low-level dioxin exposure. The average woman uses over 12,000 tampons over the course of her life. Not minor exposure by my count.

Tampons in the U.S. are made of either cotton, rayon, or a cotton-rayon blend. Most tampons-and pads, for that matter-are bleached using chlorine dioxide, which is elementally chlorine-free and therefore, according to the FDA, “safe”. Some environmental and women’s health advocates disagree. Notes E Magazine. “The FDA acknowledges that chlorine dioxide,,,can still ‘theoretically generate dioxins at extremely low levels’, and, according to the Environmental Protection Agency (EPA), no safe level for dioxin exposure exists.”

The EPA says high levels of dioxin exposure can cause cancer in adults, and low levels can result in reproductive, developmental, and behavioral abnormalities.

To further complicate matters, many best-selling tampon brands are made at least in part from viscous rayon. Again, the FDA maintains that rayon tampons are just as safe as the all-cotton kind. However, some worry that rayon increases the risk of Toxic Shock Syndrome (TSS), including Dr. Philip Tierno, director of clinical microbiology and diagnostic immunology at New York University Medical Center.

Independent studies reveal that synthetic fibers amplify breeding conditions for staphylococcus aurenus bacteria, which cause TSS. A better option is to use all-cotton tampons, says Tierno in Utne Reader.

The safest option for women who use tampons is to choose those made of certified organic cotton. Cotton that’s certifies organic has been grown without toxic fertilizers or pesticides. Consider that over 6.5 billion tampons and there packaging end up in sewers or landfills every year. Organic is the least harmful to your body and to the environment. The choice is yours. Make a better one for us all.

Sources for Organic Tampons:

One way to express milk is to use hand expression, or the Marmet Technique. There is a great description of this on the La Leche League website at Making it Work. This method is great for occasional expression, but for some moms, it can take a long time.

Another way to express milk is by using a manual or electric breastpump. These come in all sorts of shapes and sizes, but the ones that have come the most highly recommended in my chats are the ones from Medela.

The most important tips for expressing breastmilk are:

Take advantage of your let down reflex. If you are having a hard time letting down, try looking at a picture of your baby, make a tape recording of your baby babbling, or apply a warm compress and massage your breasts.

Relaxation is very important. Play some soft music, sit in a comfortable chair, and take deep breaths.

Above all, if you find that you are one of those moms who just cannot express a drop using any method, don’t panic! Your baby is MUCH more effective than any pump can be. And don’t despair! If you can’t pump, remember that after about 4 months of age, babies can usually go three to four hours between feedings — plenty of time for dinner or a movie.

If you’re working outside the home, you may be able to sneak in a nursing session during lunch time too.

Breastmilk is so important, it’s nice to know that we can provide for our babies when we can’t be there!

I am also fantasizing about the baby’s room. I am giddy with the thought that I don’t have to ask any sour landlord permission to paint the walls (either Golden Goddess or Rising Sun, I’m still debating). I can fiddle with the exact arrangement of the darling crib, dresser, and rocking chair. I am even contemplating a serious artistic task — painting the ceiling a sky blue with white, fluffy, quasi-realistic looking clouds. I love this dream.

What I don’t love so much is doing battle with Mother Nature. She’s a tough competitor. Just as the old Nesting Syndrome is kicking in, I am waddling through a maze of as-yet-unpacked moving boxes. I look at them forlornly, knowing that to lift, stoop, or carry is verboten. My husband, bless him, is doing the best he can, but right now I’m wishing for some “Bewitched” or “Bionic Woman” type powers to get it all done perfectly, right now. Of course, I tell myself, patience is a virtue (one that will certainly come in handy pretty darn soon), as is learning to live with less than perfection. But I tell you, this desire for neatness, order, and cleanliness is not easily denied.

Here’s another observation about pregnancy, a lesson I didn’t know I was going to learn: When you are pregnant, suddenly your body is in charge. Hunger, thirst, fatigue, full bladder, none of these physical impulses can be denied. As a good American girl, I trained myself to ignore my body whenever it was an inconvenience. In college and grad school, going without sleep or food is natural, almost expected. You’re busy. A pretentious boy I knew in school once said, “Last weekend, I painted, and I slept, I painted, and I slept, and when Monday rolled around, I realized I had forgotten to eat. And that’s when I knew I was an artist!”

Well, exactly. We don’t know how to take the body’s signals seriously. The brain is in charge, and sometimes the heart, but to let any other organ rule (well, almost any other) is tantamount to weakness. And this is where the clash of ancient and modern comes into play.
Try our practical advices on how to get pregnant naturally, fast, easy, you may stand a greater chance of delivering and conceiving a strong, healthy, beautiful baby.
Women have been giving birth for millions of years, right? And long ago, those poor cavewomen, dragged about by the hair, didn’t know Ben & Jerry’s, 24-hour supermarkets, Fisher-Price, or even epidurals. And we are happy and grateful for these conveniences and luxuries, for these inventions geared toward making our lives easier. We aren’t running from woolly mammoths, or wondering if Grog killed a big enough buffalo to see us through the winter. Yet, for all this scientific sophistication, we are further removed than ever from the natural world. From its rhythms and lessons. Chances are, we haven’t all grown up watching our mothers, aunts, cousins, sisters, and neighbors breastfeeding and caring for their young. We have to be taught these things. We have to read books, contact experts, and surf the web for answers.

I am grateful for the nine-month, full-on body awareness and indulgence. There is no guilt associated with obeying my body’s directives. Tired? Rest. Hungry? Eat. Bladder about to burst? Go. And everyone understands and encourages this behavior in the Pregnant One, even as they themselves stay up until 2 a.m. and live on frozen burritos. I hope I can come away from this experience more mindful of my body and appreciative of its wonders and powers to create and sustain two lives at once.

When you are breastfeeding, the quantity of milk produced by your breasts is in a very delicate balance with the quantity of milk demanded by your baby or babies. The early milk, or colostrum, is there in perfect small amounts while your baby learns to suckle. When the next milk comes in, your body doesn’t yet know how much your baby might need. Consequently, your breasts prepare to feed an army, or at least to provide a veritable banquet for your baby. There is also extra tissue fluid and vascular distention, which contribute to fullness and discomfort. In the next few days of breastfeeding, your baby will tell your body how much he or she needs, and your body will adjust accordingly by producing the amount of milk your baby needs.

The day prior to engorgement, a new mom’s breasts are likely to feel heavy. The next day, she may wake up with taut, tender, swollen breasts that are hot to the touch. Severe engorgement is characterized by hard and tender breasts with skin that can become shiny and red. At one time, engorgement was called “breastmilk fever” and was presumed to be an infection; now experts believe that it is the natural result of overproduction of breastmilk and inadequate removal of milk from the breasts.

To put it succinctly, extreme engorgement typically means that your breasts are not properly drained. Breastfeeding as soon as possible after birth and feeding the baby regularly from both breasts at each feeding can help to prevent the problem.

Treatment is similar to prevention. Try to feed your baby frequently and use both breasts. If your breasts are so swollen that your nipples do not stand out for baby to latch onto, try manual expression before attempting to get the baby on the nipple.

Common relief measures include a good nursing bra and alternating cold and hot packs on the breasts. Hot packs are frequently recommended before nursing and may help encourage your let down reflex, but they will also draw more blood into your breasts, which are already hot and distended with extra blood flow and fluid. Cold packs between nursings may help most of all by relieving your breast pain pills and reducing the inflammation. Warm showers can be a good place to relax and express your milk by hand in order to make you feel more comfortable.