Elaine Brown, MD
Elaine Brown, MD
Female, 48
Billings - MT
Specialties: Pregnancy, Gynecology
Interests: obstetrics & gynecology, Gynecology, Pregnancy, pregnancy over 35, Teen Pregnancies, Infertility, multiple births, twins, triplets, drawing, painting, artist/web designer, graphic art, Internet Marketing
Female, 48
Billings - MT
Specialties: Pregnancy, Gynecology
Interests: obstetrics & gynecology, Gynecology, Pregnancy, pregnancy over 35, Teen Pregnancies, Infertility, multiple births, twins, triplets, drawing, painting, artist/web designer, graphic art, Internet Marketing
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Feb 08, 2009 09:55PM
- 19 comments
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Unfortunately, many women are unaware of the availability of emergency contraception. Also known as the Morning After Pill or Post coital Contraception, emergency contraception is safe, effective and easy to obtain.
Emergency contraception is a therapy used to prevent pregnancy after unprotected intercourse, or in cases of contraceptive failure such as a broken condom. It involves taking only two doses of medication which can be completed within a 24 hours period.
There are two different types of emergency contraception. In the United States, Plan B is the most common preparation; its cost is between $10 and $50. It can be obtained without a prescription by women over 18 years of age, and with a prescription for those under 18. With a doctor's instructions, emergency contraception can also be made up from standard oral contraceptive pills to create the second type of preparation.
Emergency contraception works by several possible methods, the most likely being by delaying or preventing ovulation. It has no effect at all on a fertilized embryo, and should not be confused with medical abortion. Most data indicate that it will not cause birth defects in the event that it is inadvertently taken during pregnancy, and it will not cause abortion of an established pregnancy.
Emergency contraception is most effective when used as soon as possible after unprotected sex, but may be effective up to 120 hours after the fact. Studies indicate that use of emergency contraception prevents up to 75% of expected pregnancies.
There are very few people who cannot take emergency contraception. Even women who are not normally candidates for oral contraceptives, such as those with migraines, liver disease, or heart disease can take emergency contraception. Breastfeeding is not a contraindication.
Most women's health providers such as Planned Parenthood, primary care providers, and obstetrician/gynecologists
will prescribe emergency contraception to their established patients over the telephone without the need for an office visit or laboratory tests. Walk-in Clinics and Emergency rooms will prescribe emergency contraception to patients without an established physician.
Common side effects of emergency contraception are nausea/vomiting and irregular menstrual bleeding. Many health care providers prescribe anti-nausea medications which may be taken one hour prior to the dosage, to help reduce the symptoms. If vomiting occurs within 2 hours of the dose, the dose should be repeated. It is rare for the nausea to last more than 24-48 hours. Nausea is much less common with Plan B than with other preparations.
Irregular bleeding is very common. The normal period can come early or be delayed, spotting may also occur. Abnormal bleeding does not usually persist into the next menstrual cycle.
No follow up evaluation is needed after emergency contraception, unless the period is delayed by more than a week, irregular bleeding persists, or abdominal pain or other symptoms develop. A barrier method of contraception (such as condom or diaphragm) should be used for the remainder of the cycle. Emergency contraception can be repeated within
the same cycle if necessary. Emergency contraception is not recommended as a regular form of birth control. On-going hormonal or other contraception may be started immediately after emergency contraception or with the next menstrual period.
To summarize:
Emergency contraception requires only two doses of medication, and can be finished with in 24 hours.
It is available to women over 18 without a prescription, or a prescription can often be obtained over the telephone.
It can be used safely by almost anyone.
It can be used up to 120 hours after unprotected sex, although it is most effective if taken within the first 72 hours.
Side effects are minor and can be alleviated.
It is effective in preventing 75% or more of expected pregnancies, but will not cause abortion.
Plan B is the most common product in the United States; the cost of Plan B ranges from $10 to $50.
For more information go to:
http://www.go2planb.com
or
http://www.womenshealth.gov/faq/emergency-contraception.cfm
Emergency contraception is a therapy used to prevent pregnancy after unprotected intercourse, or in cases of contraceptive failure such as a broken condom. It involves taking only two doses of medication which can be completed within a 24 hours period.
There are two different types of emergency contraception. In the United States, Plan B is the most common preparation; its cost is between $10 and $50. It can be obtained without a prescription by women over 18 years of age, and with a prescription for those under 18. With a doctor's instructions, emergency contraception can also be made up from standard oral contraceptive pills to create the second type of preparation.
Emergency contraception works by several possible methods, the most likely being by delaying or preventing ovulation. It has no effect at all on a fertilized embryo, and should not be confused with medical abortion. Most data indicate that it will not cause birth defects in the event that it is inadvertently taken during pregnancy, and it will not cause abortion of an established pregnancy.
Emergency contraception is most effective when used as soon as possible after unprotected sex, but may be effective up to 120 hours after the fact. Studies indicate that use of emergency contraception prevents up to 75% of expected pregnancies.
There are very few people who cannot take emergency contraception. Even women who are not normally candidates for oral contraceptives, such as those with migraines, liver disease, or heart disease can take emergency contraception. Breastfeeding is not a contraindication.
Most women's health providers such as Planned Parenthood, primary care providers, and obstetrician/gynecologists
will prescribe emergency contraception to their established patients over the telephone without the need for an office visit or laboratory tests. Walk-in Clinics and Emergency rooms will prescribe emergency contraception to patients without an established physician.
Common side effects of emergency contraception are nausea/vomiting and irregular menstrual bleeding. Many health care providers prescribe anti-nausea medications which may be taken one hour prior to the dosage, to help reduce the symptoms. If vomiting occurs within 2 hours of the dose, the dose should be repeated. It is rare for the nausea to last more than 24-48 hours. Nausea is much less common with Plan B than with other preparations.
Irregular bleeding is very common. The normal period can come early or be delayed, spotting may also occur. Abnormal bleeding does not usually persist into the next menstrual cycle.
No follow up evaluation is needed after emergency contraception, unless the period is delayed by more than a week, irregular bleeding persists, or abdominal pain or other symptoms develop. A barrier method of contraception (such as condom or diaphragm) should be used for the remainder of the cycle. Emergency contraception can be repeated within
the same cycle if necessary. Emergency contraception is not recommended as a regular form of birth control. On-going hormonal or other contraception may be started immediately after emergency contraception or with the next menstrual period.
To summarize:
Emergency contraception requires only two doses of medication, and can be finished with in 24 hours.
It is available to women over 18 without a prescription, or a prescription can often be obtained over the telephone.
It can be used safely by almost anyone.
It can be used up to 120 hours after unprotected sex, although it is most effective if taken within the first 72 hours.
Side effects are minor and can be alleviated.
It is effective in preventing 75% or more of expected pregnancies, but will not cause abortion.
Plan B is the most common product in the United States; the cost of Plan B ranges from $10 to $50.
For more information go to:
http://www.go2planb.com
or
http://www.womenshealth.gov/faq/emergency-contraception.cfm
Nov 26, 2008 03:30PM
- 27 comments
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Period Facts:
Menstruation occurs only in humans and other closely related species (like chimps).
Other mammals have estrous cycles in which the uterine lining is completely reabsorbed by the animal. (sounds nice!)
The average age of onset of menstruation is age 12.
When counting the cycle, the first day of blood flow is counted as Cycle day 1.
The average duration of a cycle is 28 days but any cycle length between 21 and 34 days is considered normal.
The average duration of flow is 4 days but anything from 2 to 7 days is considered normal.
On a typical 28 day cycle, ovulation occurs on day 14.
The menstrual period is always exactly 14 days after ovulation. The time from period end to ovulation is variable.
A woman is most likely to get pregnant on the three days preceding or the day of ovulation.
There are four major players involved in regulating a woman's menstrual cycle:
The HYPOTHALAMUS: an area of the brain just above the pituitary gland.
The PITUITARY GLAND: a little gland that hangs from a stalk just behind the eyes.
The OVARIES: a pair of glands, each about the size of a walnut that most typically sit
behind the uterus in close proximity to the fallopian tubes.
The UTERUS: a muscular cavity typically the size of a pear that inhabits the space between
the bladder and the rectum in the female pelvis.
There are five major hormones involved in creating a cycle:
(Hormones are messengers that carry messages/instructions from one tissue to another)
GONADOTROPIN RELEASING HORMONE (GnRH)
FOLLICLE STIMULATING HORMONE (FSH)
LUTEINIZING HORMONE (LH)
ESTROGEN
PROGESTERONE
What Is Happening During a Cycle?
***In the first half of the menstrual cycle--also known as the Follicular Phase:
The HYPOTHALAMUS is signaling the PITUITARY GLAND to produce FSH and LH--it does this by secreting pulses
of GnRH every hour. It also secretes a continuous small amount of GnRH, but the pulses are very important.
The PITUITARY GLAND is producing LH which instructs the ovaries (theca cells) to produce estrogen.
The PITUITARY also produces FSH which tells the follicles (tiny cysts containing eggs) to start to grow.
Approximately 30 follicles will begin to grow. By cycle day seven, the dominant follicle is established
and continues to grow while the other follicles degenerate. The dominant follicle will ultimately be the
only egg ovulated in this cycle. (Ocassionally there is more than one).
The OVARIES (in addition to making the follicle) are busy producing estrogen which tells the uterine lining (endometrium) to thicken and grow.
The UTERINE LINING after menstruation is very thin, only about 1-2mm thick, and will look like
a single, thin white line on ultrasound.
***At mid-cycle:
The dominant follicle is producing approximately 500 mcg of estrogen daily, it is also producing a
small amount of progesterone. The follicle is now about 2.0 cm in diameter, and easily seen on ultrasound.
It has the appearance of a small dark fluid-filled cyst.
When estrogen levels have been this high for two or more days the LH surge is elicited--the pituitary gland
secretes a large bolus of LH. This LH surge is detectable in the urine and is the basis for ovulation predictor kits.
There is also an FSH surge. Rapid peaking of these two hormones signals the ovary to initiate rupture of the
follicle and ovulation of the egg. Ovulation occurs within 24-48 hours after the LH surge.
If sperm are available at this point, now is their chance. If a sperm penetrates the zona pellucida ( a special membrane which surrounds the egg and permits only passage of Human sperm ) then fertilization occurs; if no one gets lucky, the second half of the cycle occurs.
The egg then goes on its merry way down the fallopian tube, while the follicle
from which it was expelled becomes the corpus luteum cyst. This cyst too, like the follicle is visible
on ultrasound, but has a very different appearance.
***In the second half of the cycle--also known as the Luteal Phase:
The HYPOTHALAMUS is sending out pulses more slowly--it is producing a pulse of GnRH about every
2-3 hours. Again, this is signaling to the pituitary gland to produce LH.
The PITUITARY GLAND continues to produce higher levels of LH in the second half of the cycle than
it did in the first half. High levels of LH signal to the corpus luteum cyst (the cyst the was produced
when the follicle burst) to produce progesterone.
The OVARY continues to produce progesterone in increasing quantities for about 7 days after ovulation.
It is also producing estrogen in high quantities. If pregnancy has not occurred, these high levels
of progesterone and estrogen signal the pituitary gland to turn off production of FSH and LH.
It is believed that the high levels of progesterone in the ovary which produced the
follicle prevent maturation of new follicles in the same ovary--in other words, if right ovary ovulated this month then left ovary will ovulate next month.
The UTERINE LINING, under the influence of high progesterone levels, has stopped thickening and
started maturing in preparation to receive the embryo (if any). One thing the uterus lining tissue
does is start to store glycogen (sugar) within the lining cells. This sugar will be released into the uterine
cavity to nourish an embryo (if any) until it can implant in the uterine wall. At this stage the uterine lining has a trilaminar (three lines) appearance on ultrasound and is about 12mm thick.
***Menstruation:
If no conception has occurred, exactly 14 days after ovulation the menstrual period will begin.
During menstruation, the uterine lining is sloughed and comes out as the menstrual flow.
The uterus in effect, cleans itself down to the "roots" and the whole process begins again.
If pregnancy occurs, menstruation does not, but that is another story!
So, to simplify even further and summarize:
The cycle starts with menstruation. In the first half of the cycle, the ovaries are producing
estrogen which tells the uterine lining to grow. The follicle is developing.
At mid cycle ovulation occurs.
In the second half of the cycle the egg is sent down the fallopian tube while the cyst cavity left behind
begins to produce progesterone. Progesterone tells the uterine lining to stop growing and start
storing up sugar for the embryo. If no conception occurs hormone production decreases and
the uterine lining is shed in the form of the next period.
Next month the follicle develops within the oposite ovary and the whole process starts over.
Of note the whole process falls apart if no ovulation occurs, but that is another story too!
Lots more information is available at:
http://www.womenshealth.gov/faq/menstruation.cfm
http://en.wikipedia.org/wiki/Menstrual_cycle
Menstruation occurs only in humans and other closely related species (like chimps).
Other mammals have estrous cycles in which the uterine lining is completely reabsorbed by the animal. (sounds nice!)
The average age of onset of menstruation is age 12.
When counting the cycle, the first day of blood flow is counted as Cycle day 1.
The average duration of a cycle is 28 days but any cycle length between 21 and 34 days is considered normal.
The average duration of flow is 4 days but anything from 2 to 7 days is considered normal.
On a typical 28 day cycle, ovulation occurs on day 14.
The menstrual period is always exactly 14 days after ovulation. The time from period end to ovulation is variable.
A woman is most likely to get pregnant on the three days preceding or the day of ovulation.
There are four major players involved in regulating a woman's menstrual cycle:
The HYPOTHALAMUS: an area of the brain just above the pituitary gland.
The PITUITARY GLAND: a little gland that hangs from a stalk just behind the eyes.
The OVARIES: a pair of glands, each about the size of a walnut that most typically sit
behind the uterus in close proximity to the fallopian tubes.
The UTERUS: a muscular cavity typically the size of a pear that inhabits the space between
the bladder and the rectum in the female pelvis.
There are five major hormones involved in creating a cycle:
(Hormones are messengers that carry messages/instructions from one tissue to another)
GONADOTROPIN RELEASING HORMONE (GnRH)
FOLLICLE STIMULATING HORMONE (FSH)
LUTEINIZING HORMONE (LH)
ESTROGEN
PROGESTERONE
What Is Happening During a Cycle?
***In the first half of the menstrual cycle--also known as the Follicular Phase:
The HYPOTHALAMUS is signaling the PITUITARY GLAND to produce FSH and LH--it does this by secreting pulses
of GnRH every hour. It also secretes a continuous small amount of GnRH, but the pulses are very important.
The PITUITARY GLAND is producing LH which instructs the ovaries (theca cells) to produce estrogen.
The PITUITARY also produces FSH which tells the follicles (tiny cysts containing eggs) to start to grow.
Approximately 30 follicles will begin to grow. By cycle day seven, the dominant follicle is established
and continues to grow while the other follicles degenerate. The dominant follicle will ultimately be the
only egg ovulated in this cycle. (Ocassionally there is more than one).
The OVARIES (in addition to making the follicle) are busy producing estrogen which tells the uterine lining (endometrium) to thicken and grow.
The UTERINE LINING after menstruation is very thin, only about 1-2mm thick, and will look like
a single, thin white line on ultrasound.
***At mid-cycle:
The dominant follicle is producing approximately 500 mcg of estrogen daily, it is also producing a
small amount of progesterone. The follicle is now about 2.0 cm in diameter, and easily seen on ultrasound.
It has the appearance of a small dark fluid-filled cyst.
When estrogen levels have been this high for two or more days the LH surge is elicited--the pituitary gland
secretes a large bolus of LH. This LH surge is detectable in the urine and is the basis for ovulation predictor kits.
There is also an FSH surge. Rapid peaking of these two hormones signals the ovary to initiate rupture of the
follicle and ovulation of the egg. Ovulation occurs within 24-48 hours after the LH surge.
If sperm are available at this point, now is their chance. If a sperm penetrates the zona pellucida ( a special membrane which surrounds the egg and permits only passage of Human sperm ) then fertilization occurs; if no one gets lucky, the second half of the cycle occurs.
The egg then goes on its merry way down the fallopian tube, while the follicle
from which it was expelled becomes the corpus luteum cyst. This cyst too, like the follicle is visible
on ultrasound, but has a very different appearance.
***In the second half of the cycle--also known as the Luteal Phase:
The HYPOTHALAMUS is sending out pulses more slowly--it is producing a pulse of GnRH about every
2-3 hours. Again, this is signaling to the pituitary gland to produce LH.
The PITUITARY GLAND continues to produce higher levels of LH in the second half of the cycle than
it did in the first half. High levels of LH signal to the corpus luteum cyst (the cyst the was produced
when the follicle burst) to produce progesterone.
The OVARY continues to produce progesterone in increasing quantities for about 7 days after ovulation.
It is also producing estrogen in high quantities. If pregnancy has not occurred, these high levels
of progesterone and estrogen signal the pituitary gland to turn off production of FSH and LH.
It is believed that the high levels of progesterone in the ovary which produced the
follicle prevent maturation of new follicles in the same ovary--in other words, if right ovary ovulated this month then left ovary will ovulate next month.
The UTERINE LINING, under the influence of high progesterone levels, has stopped thickening and
started maturing in preparation to receive the embryo (if any). One thing the uterus lining tissue
does is start to store glycogen (sugar) within the lining cells. This sugar will be released into the uterine
cavity to nourish an embryo (if any) until it can implant in the uterine wall. At this stage the uterine lining has a trilaminar (three lines) appearance on ultrasound and is about 12mm thick.
***Menstruation:
If no conception has occurred, exactly 14 days after ovulation the menstrual period will begin.
During menstruation, the uterine lining is sloughed and comes out as the menstrual flow.
The uterus in effect, cleans itself down to the "roots" and the whole process begins again.
If pregnancy occurs, menstruation does not, but that is another story!
So, to simplify even further and summarize:
The cycle starts with menstruation. In the first half of the cycle, the ovaries are producing
estrogen which tells the uterine lining to grow. The follicle is developing.
At mid cycle ovulation occurs.
In the second half of the cycle the egg is sent down the fallopian tube while the cyst cavity left behind
begins to produce progesterone. Progesterone tells the uterine lining to stop growing and start
storing up sugar for the embryo. If no conception occurs hormone production decreases and
the uterine lining is shed in the form of the next period.
Next month the follicle develops within the oposite ovary and the whole process starts over.
Of note the whole process falls apart if no ovulation occurs, but that is another story too!
Lots more information is available at:
http://www.womenshealth.gov/faq/menstruation.cfm
http://en.wikipedia.org/wiki/Menstrual_cycle
Sep 11, 2008 05:24PM
- 72 comments
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Manufacturer's of today's home pregnancy tests claim that they are 99% effective when properly
used. The only more accurate tests are blood tests administered by physicians. But when
and how to use them, and which are the most accurate are questions that still remain. Are they all
the same? What if the test is negative, but "I just have that feeling. . ."?
Pregnancy test work by detecting Beta-hCG (human chorionic gonadotropin), a hormone produced
by the placenta in a pregnant woman's uterus. The hormone is then released into the blood stream and ultimately excreted in the urine. HCG usually becomes detectable in the urine about 10 days after conception, or about 4-5 days before the missed menstrual period. Because it can be difficult to know exactly when conception occurred, or
when exactly the period is supposed to start, most experts recommend waiting 5-10 days after the period is late
to ensure that the test is accurate.
Most pregnancy tests on the market will show a positive result by 7-10 days after the missed menstrual period. Often though, it may be desirable to have the result earlier. Some of the home tests are accurate enough to detect the HCG as soon as it is present, even at very low levels. Two studies have confirmed claims of the manufacturers of FIRST RESPONSE Early Result Test to detect a pregnancy five days before the missed period. Clear Blue Easy claims to be accurate within 4 days before the missed period. If you want to know as quickly as possible,these two brands are probably the best tests to use, but you will need to be willing to pay a little extra for that privilege!
It is certainly possible to have a false negative (test result is negative when the woman actually is pregnant).
A study done in 2004 evaluated 18 different home pregnancy tests and found that they missed up to 85% of pregnancies when testing was done on the first day of the missed period. Almost all of them had become positive by
one week after the missed period. So if your first test is negative wait a week and test again.
How to improve the accuracy of your tests:
*Use urine collected first thing in the morning--it is more concentrated. You can collect the urine and save it in a labeled container in the refrigerator if you need to run to the store for the test kit.
*Don't drink too much fluid before testing. This will dilute the urine.
*If you are testing later in the day, make sure it has been at least four hours since you last emptied your
bladder.
*Check the expiration date on your test.
*Follow the directions exactly as specified in the package insert.
*Read the instructions to make sure you are not taking any medications that will alter the test results
Other things to note: A pregnancy problem (impending miscarriage, tubal pregnancy, etc.) can cause a false negative result. Rarely infertility medications can cause a false positive result(test result is positive when the woman is not pregnant). Finally, HCG causes some of the typical early pregnancy symptoms such as breast tenderness and nausea, so eventually, your own body will be likely to alert you.
The best way to double check if you suspect your test is not accurate, or if you simply need peace of mind, is to visit your doctor or local clinic. Many doctor's offices or clinics offer free pregnancy tests--so inquire before going in.
If you would like more information go to: http://www.womenshealth.gov/faq/pregtest.htm
used. The only more accurate tests are blood tests administered by physicians. But when
and how to use them, and which are the most accurate are questions that still remain. Are they all
the same? What if the test is negative, but "I just have that feeling. . ."?
Pregnancy test work by detecting Beta-hCG (human chorionic gonadotropin), a hormone produced
by the placenta in a pregnant woman's uterus. The hormone is then released into the blood stream and ultimately excreted in the urine. HCG usually becomes detectable in the urine about 10 days after conception, or about 4-5 days before the missed menstrual period. Because it can be difficult to know exactly when conception occurred, or
when exactly the period is supposed to start, most experts recommend waiting 5-10 days after the period is late
to ensure that the test is accurate.
Most pregnancy tests on the market will show a positive result by 7-10 days after the missed menstrual period. Often though, it may be desirable to have the result earlier. Some of the home tests are accurate enough to detect the HCG as soon as it is present, even at very low levels. Two studies have confirmed claims of the manufacturers of FIRST RESPONSE Early Result Test to detect a pregnancy five days before the missed period. Clear Blue Easy claims to be accurate within 4 days before the missed period. If you want to know as quickly as possible,these two brands are probably the best tests to use, but you will need to be willing to pay a little extra for that privilege!
It is certainly possible to have a false negative (test result is negative when the woman actually is pregnant).
A study done in 2004 evaluated 18 different home pregnancy tests and found that they missed up to 85% of pregnancies when testing was done on the first day of the missed period. Almost all of them had become positive by
one week after the missed period. So if your first test is negative wait a week and test again.
How to improve the accuracy of your tests:
*Use urine collected first thing in the morning--it is more concentrated. You can collect the urine and save it in a labeled container in the refrigerator if you need to run to the store for the test kit.
*Don't drink too much fluid before testing. This will dilute the urine.
*If you are testing later in the day, make sure it has been at least four hours since you last emptied your
bladder.
*Check the expiration date on your test.
*Follow the directions exactly as specified in the package insert.
*Read the instructions to make sure you are not taking any medications that will alter the test results
Other things to note: A pregnancy problem (impending miscarriage, tubal pregnancy, etc.) can cause a false negative result. Rarely infertility medications can cause a false positive result(test result is positive when the woman is not pregnant). Finally, HCG causes some of the typical early pregnancy symptoms such as breast tenderness and nausea, so eventually, your own body will be likely to alert you.
The best way to double check if you suspect your test is not accurate, or if you simply need peace of mind, is to visit your doctor or local clinic. Many doctor's offices or clinics offer free pregnancy tests--so inquire before going in.
If you would like more information go to: http://www.womenshealth.gov/faq/pregtest.htm
