Out Run Aunt Flow! – Exercising on your Period!

periods

Running is one of my favorite things to do. But it can be even more challenging when you’re on your period. If you’re anything like me, your period can leave you feeling bloated, crampy, and irritable. Ugh! Exercise is often the last thing women want to do feeling like that! However, exercising on your period is not only safe; it’s actually GOOD for you!!!

Menstrual Cramps:

Exercising on your period has all kinds of benefits! Exercise releases endorphins (chemicals in your brain) which naturally reduce pain!!! Yes, exercise can actually make cramps less painful! That’s because the endorphins help break down the hormone that causes menstrual cramps!

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However, if you feel really ill or have extreme cramps, don’t force yourself to exercise. Sometimes when your body is asking for rest, it’s because all it really needs to recover is a bit of rest.

Protection:

Okay, so exercise is good for cramps but many women still worry about “springing a leak.” Fortunately, you can keep your period a secret by using the right tools!

Try using a tampon or menstrual cup rather than pads or panty liners; these options will trap the blood before it even leaves your body. If you’re still worried, double up your protection by using a panty liner with a tampon or menstrual cup.

Tampons:

A tampon is a cotton insert or other absorbent material placed into the vaginal canal to absorb menstrual flow. They come in all different sizes and with different (or no) applicators so you may want to try a few to see what feels most comfortable. And contrary to popular belief, tampons do not have any effect on virginity. I promise. Oh, they can also be worn while swimming!

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Menstrual Cup:

A menstrual cup is a flexible cup (usually made from medical grade silicone) worn inside the vagina during menstruation to collect menstrual fluid. Unlike tampons and pads, the cup collects menstrual fluid rather than absorbing it and can be worn for up to 12 hours! Menstrual cups are more cost-efficient and environmentally friendly than tampons, most cups are reusable, and can be used for up to 5-10 years. Like tampons, can also be worn while swimming!
CupsPanty Liners:

Super thin pad designed to absorb daily vaginal discharge, light menstrual flow, or “spotting.” Also used as a backup for tampons and menstrual cups.

Blog3Clothing:

Wearing the right workout clothes is always important but even more so when you’re on your period. Try wearing loose-fitting clothing; tight clothing can add pressure to an already bloated tummy (definitely not comfortable). Sports bras are the exception to that rule. Sports bras should be snug but not super tight (you should be able to comfortably take a deep breath). The straps should be wider than a normal bra and should not dig into your shoulders. Test the bra’s support by jumping or running in place. You’ll be able to feel whether it’s sufficiently supportive or not.

Sports Bras

For more information, click here to check out some tips to picking the right sports bra! Thanks Runner’s World!

ApixChoose pants that are in a dark color (black always works best). Avoid wearing anything super tight or super short. Also, avoid wearing thongs. Instead, wear boy-short type underwear which not only work great with panty liners but adds an additional layer of clothing in case of a leak. Lastly, throw on a dark sweatshirt or jacket before you head out; if you experience any leaks you can use the sweatshirt or jacket to tie around your waist to hide it! Outfit2

Want to learn more about periods? Check out these previously published posts or send me an email at justaskshawna@yahoo.com!

Aunt Flow’s Monthly Visit

Managing Your Period – Toolbox for Aunt Flow

When Aunt Flow Doesn’t Visit

In happiness & health,

Shawna

Reviewed by Andrea Raider, NP

Success Baby

Pearly Penile What???

Hi Shawna,

I just started having sex with my new boyfriend and I noticed he had some small bumps around the head of his penis. I asked him about it and he said that his doctor told him it was normal. He said it was called pearly pimples or something like that. What is that and is it something I should worry about it?

Thanks!
______________________________________________________________________

Great Question! Does it look something like this???

pearly-penile-papules

This is called Pearly Penile Papules, often abbreviated to PPP. They are tiny bumps that form a ring around the head of the penis. PPP is fairly common; about 20%-30% of the male population has them. We don’t know what causes them but we do know that PPP is nothing to worry about. PPP is not a sexually transmitted infection, it is not contagious, and poses no health risks. Although normal and totally not harmful, some men may choose to have them removed for aesthetic reasons (meaning, they don’t know like the way they look).

While PPP are harmless, other lumps or bumps in the genital area may not be. It’s always a good idea to be checked out by a clinician whenever in doubt.

In happiness & health,

Shawna

Reviewed by Kohar Der Simonian, MD

Dare to Bare? Shaving tips for pubic hair removal!

Pubic hair (hair around the penis, vulva, or anus) is a totally normal part of becoming an adult. However, some people (and it’s not just the ladies) would rather not have it, so they choose to shorten it or remove it all together (but if you aren’t one of them, don’t worry! Pubic hair is totally normal). The most common way of removing pubic hair is by shaving. Although shaving is meant to leave the area smooth and hairless, it can instead leave the area irritated! Razor burn and ingrown hairs are common concerns for those just starting to shave their pubic area so New Gen has come up with a few tips to help ya out.

Pubic Hair

1. If you have long hairs (usually those who have never shaved or haven’t shaved in a long time), trim the hairs with clippers or scissors first. Electric clippers are best for this purpose.

Trimming

2. The softer the hairs, the easier it will be for you to shave. Try taking a long, warm bath before shaving, or choose to shave at the end of your shower.

3. Apply shaving gel a few minutes before shaving to soften hairs. If you have sensitive skin, you might want to try a hypoallergenic or fragrance-free brand.

4. Use a sharp and or new razor. The sharper the razor blade, the better it will work and less irritation it will cause to your skin.

New razor

5. When shaving, don’t move the razor over the same area more than twice. This will help reduce skin irritation.

         On the first stroke, go with the direction of hair growth to remove most of the hair.

         On the second stroke, go against the direction of hair growth for a smooth, close shave. If going against the direction of the hair growth tends to irritate you (and for many it does, especially when they are new to shaving), then skip that and do both strokes going the same direction of hair growth.

shaving_directions

6. Clean the area after shaving with mild soap and water to reduce the risk of infection. Continue to practice clean hygiene, washing the area at least once a day to reduce sweat and oil build-up.

7. Go as long as possible between shavings to reduce skin irritation.

A few extra tips:

1. The skin around your genitals is extra sensitive. Some people can be allergic to some types of shave gel. If you have sensitive skin, you might want to try a hypoallergenic or fragrance-free brand of shave gel.

2. To reduce the risk of ingrown hairs and razor bumps after shaving, use an exfoliating brush or loofah sponge when washing the area daily.

ingrownhair razor bump

3. When the hair starts growing back, it can be uncomfortable and itchy. Chaffing is nearly unavoidable, but exfoliating the area regularly can help. Exfoliating means removing the outer most layer of dead skin cells. This can be done with a loofah or wash cloth.

Towels with Bath Spa Kit and Gladiolus

4. If you have tried shaving and you don’t like it for whatever reason but still want a sleeker look, consider closely trimming your hair instead of shaving. It provides many of the benefits of shaving without all the risks!

street_art_big_size_17

In happiness & health,

Shawna

Reviewed by Kohar Der Simonian, MD

Does the URGE to Go Leave You BURNING to Know? The Dreadful Urinary Tract Infection!

Hi Shawna,

I feel like I have to pee all the time and when I go nothing happens except for a lot of pain and burning. What’s wrong?

-Anonymous

Hi,

Before I begin to answer your question you need to know that I cannot diagnose your problem via email (meaning I can’t tell you exactly what’s wrong). Only an in-person visit with a clinician can tell you what is going on. If you live in the Bay Area, give us a call at 415.502.8336 to schedule an appointment.

That being said, I can tell you that these symptoms are commonly associated with a urinary tract infection.What is a urinary tract infection?

A urinary tract infection, often referred to as a UTI, is an infection in any part of your urinary system (the part of your body that makes pee) — your kidneys, ureters, bladder and urethra. Most infections happen in the lower urinary tract system — the bladder and the urethra. The bladder is where urine is stored before leaving the body. The urethra is the tube that connects the bladder to the outside of the body.Check out the diagram below.

UTIAlthough men can get UTI’s, it isn’t very common. That’s because the urethra, the tube that connects the bladder to the outside of the body, is shorter in women then it is in men making it much easier for bacteria (the germs that cause the infection) to travel from the outside of the body into the inside.

Most UTI symptoms include

  • A frequent and strong urge to pee
  • Despite the frequent and strong urge to pee, there may actually be little to no pee when trying to go
  • A burning sensation when peeing
  • Pee that appears cloudy
  • Pee that appears red, bright pink or cola-colored — a sign that blood may be present in your pee (not a good thing)
  • Strong-smelling pee
  • Pelvic pain in women (lower abdominal/stomach area pain)
  • Rectal pain in men (pain in the butt, literally)

It’s important to see a clinician right away if you are experiencing any of these symptoms because an untreated UTI can lead to more serious complications, like a kidney infection. Once a clinician diagnoses a UTI, antibiotics are given to clear the infection.

There are a few things you can do to prevent UTI’s and that includes wiping from front to back after using the bathroom. That will help prevent bacteria from the anus (butt-hole) finding their way into the urethra and into the bladder. Also, drinking plenty of water and peeing when you feel the need will flush bacteria from the bladder often and prevent them from multiplying and causing a problem. Lastly, for women, emptying your bladder right before and right after sex can really help reduce your risk of getting a UTI!

As always, let me know if you have any questions.

In happiness & health,

Shawna

Reviewed by Koher Der Simonian, MD

Period pain? Birth control can help!

This week we have an awesome article written by New Gen’s very own clinician, Meredith Warden!!! The article was originally published on Bedsider but it’s a concern we hear at NGHC all the time so we thought it was worth sharing!

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Meredith Warden MD, MPH is a Family Planning Clinical Fellow and an Ob/Gyn at the University of California, San Francisco. She lives in San Francisco with her fantastic skateboarding husband and their little mini dachshund named Stretch. She loves being outside doing anything, and reading anywhere, anytime.

 

Hormonal birth control is one of the best ways to manage painful periods.

Having a painful period can mess up your day, or week—or weeks! Every woman’s period is different and the same woman’s periods are often different over time. So how do you know if the pain you have with your period is normal? And what can you do to make your periods  less painful?

For more information on periods, check out some previous blogs!

Aunt Flow’s Monthly Visit

When Aunt Flow DOESN’T Visit

My periods are really painful. Am I normal?

It’s normal for women to have some cramping, bloating, nausea, or diarrhea before their period starts each month. These symptoms can continue for a few days after the period starts, and they can be annoying—but they shouldn’t interfere with going to school or work, or with otherwise living life.

Here’s what’s not normal:

  • Moderate to severe cramps or lower belly pain with every period.
  • Periods so bad that they interfere with work, school, or life in general

crampsSo what’s the problem, exactly?

Periods like this may be dysmenorrhea—a fancy medical term for pain with menstruation. There are several possible causes of severe period pain, some of which have special treatment options.

  • The cells from the lining of the uterus may be growing into the muscles of the uterus (adenomyosis) or on other organs in the body (endometriosis).
  • The muscle of the uterus may be growing fibroids.
  • The uterus may be releasing too much of a substance called prostaglandins, causing its muscles to contract irregularly and leading to big-time pain.

The good news is that you don’t have to put up with this pain! If you’re having abnormally bad periods, talk to your health care provider about what might be causing the pain and how to treat it. There are a few things you can do to make your periods less painful, shorter, or go away altogether.

And what are the solutions?

1. Make your periods less painful. You can buy pain killers like ibuprofen (Advil or Motrin) at the drug store. Start taking them right when you first start feeling symptoms, or if your cycle is really regular, take them just before you expect your period.

3-02-11-ibuprofen2. Make your periods lighter. All types of hormonal birth control are even better at reducing pain than over-the-counter meds. The hormonal IUD, the implant, the shot, the pill, the patch, and the ring will all make periods lighter. This is because these methods of birth control make the lining of the uterus thinner. There’s less tissue in the uterus to shed, so periods are lighter. One special note on the implant and the shot: for some women, these methods cause more days of spotting or bleeding, but periods become lighter and less painful overall.

3. Have fewer periods. The ultimate solution may be to have as few periods as possible. Several methods of birth control can make periods go away for months or even years at a time:

  • One of the best ways to treat painful periods is to get the hormonal IUD Mirena. This IUD makes periods lighter and shorter for nearly all women, and many stop getting periods even after one year of use. The chance that you’ll stop getting your period increases the longer you use it. Periods should be light or nonexistent as long as you use a Mirena—up to 5 years. (Of course you don’t have to use it for all 5 years—you can have it removed anytime you want to. Your ability to get pregnant returns right after it’s removed.)

Mirena-In-Uterus

  • You can use the pill or the ring continuously. Some brands of the pill are packaged for 3 months of continuous use (e.g. Seasonale or Seasonique). But you don’t need a fancy brand: with a monophasic pill, instead of having a few days of placebo pills when you’d normally get your period, you can just start a new pack of active pills. Here are more details on how to use the pill this way. (However, this may not be an option for those using Family Pact, the little green card we give you at New Gen, to pay for their pills because Family Pact will only give 3 packs of pills every 3 months – ask NGHC for more information about this.) For the ring, instead of having the ring out for a few days when you’d normally get your period, you can just change your ring once a month and skip the week without one. After 3-6 months, you may have break-through bleeding.

endo_cont_horm_instructions

  • You can try the shot, which causes about half of women to stop getting periods after a year of use.

DMPAWhen hormonal birth control stops your period, it’s because the lining of the uterus gets so thin that there’s nothing to shed. It’s totally safe to skip periods this way, so if you suffer from serious period pain, talk to your provider about what you can do about it.

If you have questions or you are experiencing period pain, come see us at New Gen! We would love to help put an end to your period pain!

Thank you for reading,

Meredith Warden, MD

Happy Pride Everyone!!!

New Gen joins in on celebrating LGBTQI Pride!

We are not claiming to be experts on this subject. Like all kinds of people, many LGBTQI people have their own way of explaining what their identity means to them or what their experience may be . This blog is just a brief view into what is a huge and active conversation around the world. If you find yourself wanting to learn more, or want to join in on that conversation, we include some sites to check out at the end of this blog.

This past weekend, June 29-30, was Pride Weekend in San Francisco—a weekend when people from across the country and throughout the Bay Area come together to celebrate the LGBTQI community. According to the SFPride website, this event is “the largest LGBT gathering in the nation.” This is something for all San Franciscans to be proud of!

Identifying with one or more of these terms is totally personal. It is 100% OK if you don’t identify with any of these terms or don’t know which of these you consider yourself right now. It’s also totally normal if how you identify changes over a lifetime. While the identities represented by all these letters may be separate, many of the people in these groups have come together to support each other and work for a common cause of acceptance, equal rights and access to services. Even if we don’t personally identify with any of these letters, many of us have loved ones, friends, coworkers, and neighbors who do. As a clinic, we welcome LGBTQI patients and do our best to make every person comfortable!

 So what do all these letters stand for exactly? They represent different kinds of

Sexualities—Based on sexual attraction and romantic love: homosexual, heterosexual, bisexual, queer.

Gender Expression—Based on how a person wants the world to see them: feminine, masculine, transgender*, androgynous*,   or genderqueer*.

*Some transgender people may identify simply as female or male, while others may identify as trans.

*Androgynous: some people desire to look neither masculine nor feminine.

*Genderqueer: some people desire to look sometimes feminine, sometimes masculine, sometimes both or neither, and not stick to one gender at all times.

Biological sexesBased on sexual anatomy: male, female, intersex.

All three of these identities can and do include more than just appearance — identity is never that simple. As you read on, you’ll see there is a lot of grey in between.

Gingerbread

http://itspronouncedmetrosexual.com/2011/11/breaking-through-the-binary-gender-explained-using-continuums/

L: Lesbian. Women who are attracted to other women.

G: Gay. Someone who is attracted to other people of the same sex. A man who is attracted to other men OR a woman who is attracted to other women.

B: Bisexual. A person who is attracted to people of both sexes.

T: Transgender. A person who identifies as a different gender than the biological sex they were assigned at birth based on their sexual organs. The gender with which someone identifies does not necessarily have to do with their sexual orientation (heterosexual, homosexual, bisexual, queer).

Q: Queer. Some people prefer to call themselves “queer” instead of “gay” or “bisexual” because they feel it is less confining (they may feel attracted to people regardless of gender or not want to think about attraction in terms of two genders or sexes).

I: Intersex. A person who is biologically both sexes. This can mean they have the hormones, genes, and/or anatomy of both a male and female.

It can be a huge leap for someone to open up to friends, family, health care providers, employers or coworkers about any one of these identities. That’s what make events like Pride Weekend so awesome!

Happy Pride Everyone! This past weekend and everyday!

Barbara Haupt

For more information check out:

San Francisco LGBT Community Center – Resources for LGBTQI people an queer education.

LyricActivities, tutoring, recreation, health and sex ed. for GLBTQ youth

SFQueer A Calendar for Queer events and activities in the Bay Area

The Trevor Project 24 hr. suicide prevention and crisis hotline

Transgendered San Francisco Support and social group for the Transgender community.

Intersex Society for North America

National Center for Lesbian Rights

Pregnancy Options 101

options

In the last post, we discussed pregnancy testing at New Generation Health Center and said that we would follow up with more about options available to pregnant women.  So as promised, here is a bit of information on parenting, abortion, and adoption.

pregnancy-options

As a heads up, there are a few references to anatomy (such as the uterus and cervix).  If you don’t remember what those are, click here.  And this stuff can be a bit difficult to understand so if I used words you don’t understand or something didn’t make sense, please ask me to clarify.

P.S. Sorry it’s a week late.  This is really important information and I wanted to be sure I was explaining it well.  I appreciate your patience.

Continuing the Pregnancy and Parenting

Continuing a pregnancy and becoming a parent can bring about all kinds of feelings, both physically and emotionally.  All are totally normal.  In order to have the best possible outcome it is very important to begin prenatal care as soon as possible, ideally within the first 12 weeks of pregnancy.  What is prenatal care?  Prenatal care is the specific kind of health care needed during a pregnancy.  It includes check-ups throughout the pregnancy to help maintain and enhance the health of the mother and developing fetus (fetus is the term used for baby while it’s still in the uterus).  Prenatal care visits are also a great place to receive information about nutrition, exercise, breast feeding, body changes, and any feelings or concerns that may be experienced during pregnancy.  During pregnancy it is important to avoid certain substances, like alcohol, cigarettes, caffeine and other drugs including most medication (even over the counter medications), which could all harm the health of the fetus.

When selecting a prenatal care provider, the most important thing is to feel comfortable with the provider (doctor).  Some people ask friends or family members with young children where they went for their prenatal care to get a recommendation.

In California, women who are uninsured can qualify for a program called Medical that covers any medical expenses related to the pregnancy, including prenatal care and deliver.  We can help you apply here at New Gen. You can also check out the Medical website by clicking here.

Continuing the Pregnancy and Adoption

Adoption is the process of permanently placing the child with another family and giving all parental rights and guardianship to that family.  Because the pregnancy will be carried to term (meaning to be born) prenatal care is strongly recommended (see above for more information about prenatal care).

Although the biological mother (the woman who is pregnant) is primarily the person to initiate this process, it’s important to know the biological father may also have some legal rights to the child.  These rights vary from state to state and it is highly recommended that any woman considering adoption look into these rights within her state.

There are two types of adoption: open and closed.  In an open adoption, the pregnant mother chooses the adopting family and may decide to create a relationship with them.  Depending on the adoption agency, the biological mother may have ongoing contact with the adoptive family and the child after adoption placement.  In a closed adoption, the biological mother will not have any information about the adopting family and they will not have any information about her.  No relationship between the two is created and the biological mother does not have contact with the child after she/he is placed.  In some cases, when the child turns 18, he or she may be able to find out information about birth parents.  Adoption agencies can guide interested biological parent(s) through the process and decide if an open or closed adoption is right for them.  However, it is important to note that differences do exist between adoption agencies and it’s important to find one that is best suited for the needs of the biological parent(s).

For more information about adoption check out the National Adoption Information Clearinghouse.

Abortion

*In California, a woman does not need parental or partner consent for an abortion.
*The following information is based on abortion laws in California and may not be applicable to other states.

I have briefly described the various abortion options below.  It’s important to know that every abortion clinic may differ on a number of aspects.  It is also important to know that the experience of having an abortion is different for every woman.  By no means does this blog post attempt to cover all the details and various aspects of abortion.  If you have further questions, please come see us at New Generation Health Center.

Abortion is a medical procedure that ends a pregnancy.  Women can get an abortion up to 24 weeks of pregnancy (however, abortion may still be an option after 24 weeks of pregnancy if there are serious health risks to the fetus or pregnant mother).  Although it is important to take as much time as needed when considering abortion, health risks associated with abortion increase the further along in the pregnancy.  Still, abortion is safer than labor and delivery, and has no impact on future ability to have children.

There are two kinds of abortion: an in-clinic abortion (often referred to as a surgical abortion) and the abortion pill (often called medical abortion).

The Abortion Pill:

The abortion pill is a medicine that ends a pregnancy.  It is an option for women who are less than 9 weeks pregnant.  The medication is taken in a two-step process; the first medication stops the development of the fetus and the second medication causes the uterus to contract in order to expel its contents.  Essentially, it is a miscarriage caused by medication.  Although it may sound like a simple process, there are various other effects from the medication.  If this is an option someone is considering, it is important that they be somewhere safe and comfortable.  It is also recommended to have a support person, like a trusted friend or family member.  Most clinics require a follow-up appointment to make sure the abortion was successful.  This may involve an ultrasound and/or blood test.

In-clinic Abortion:

First trimester procedures (up to 12 weeks – although may vary slightly from clinic to clinic):

Most in-clinic abortions involve a procedure called an aspiration that involves placement of an instrument the size of a pencil into the uterine cavity and use of suction to remove the pregnancy.  This suction can be done manually with a hand held vacuum, or with a machine, which is usually used in women over 10 or 11 weeks pregnant.  While a woman may be at the clinic for several hours, the actual procedure takes typically less than 5-10 minutes.  During the procedure, there may be some cramping ranging from mild to intense; it is different for every woman.  Various pain medications may be available but may require the woman to have a ride home.  After the abortion, a woman will generally stay in the clinic until they are ready to leave (usually less than an hour).  There may have cramping after the abortion so it’s a good idea to take it easy the rest of the day.

Second trimester abortions (usually after 12 weeks) are more involved and often require a longer OR a 2 part visit depending on exactly how far along the pregnancy is.  Usually, if a woman is between 12-16 weeks (again, varies by clinic), a medication may be given to a woman to help soften the cervix.  This process may take a few hours and therefore the appointment is usually longer.  Post 16 weeks, a 2 part visit is usually required.  During the first visit, a clinician may place absorbent dilators into the cervix to help it dilate overnight.  At the next visit, the abortion procedure will be performed, usually under full anesthesia.

When facing an unplanned pregnancy, many women find it difficult to decide which option is best for them.  At New Gen, our goal is to help women explore these options and support them in making the best decision for themselves.

CHoice

We also often refer patients to Backline a free hotline which promotes unconditional and judgment-free support for the full spectrum of decisions, feelings and experiences with pregnancy, parenting, adoption and abortion.  Backline’s number is: 1-888-493-0092.

If you have had an abortion or know someone who has, you may be interested in reading a previous post on the subject by clicking here.

In addition to Backline, here are a few other resources that can provide more information about the options available to pregnant women.

Adoption Connection
National Adoption Information Clearinghouse
Women’s Options Center at San Francisco General Hospital
The Nurse-Midwives of San Francisco of General Hospital
Planned Parenthood
Homeless Prenatal (you don’t have to be homeless!)
Bay Area Doula Project

Again, if you have any questions or concerns, don’t hesitate to send me an email at askshawna@yahoo.com or come into the clinic.

In happiness & health,

Shawna

Reviewed by Kohar Der Simonian, MD