Health & Wellness

Parent Edition | 11th Annual | 2014

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42 I'm Never in the Mood. What Could Be Causing My Low Libido? Once you've determined your relationship with your partner is not one of the factors causing your low libido, there are several things we can look at. Are you overcommitted? Are you not nurturing or taking time for yourself? What is your method of preventing pregnancy? If you are on a birth control pill, some of the progestins in the pill can significantly lower free testosterone levels, causing a drop in libido. Are you getting older? Women's testosterone levels peak at age 20, and are half that peak level by our 40s. Are you on an antidepressant known as an SSRI? Do you take medications for high blood pressure or bipolar disorder? These can all lower your libido. And then of course there is menopause with loss of estrogen, expanding waistlines and painful intercourse for some. But also know studies have shown that as a woman, if you do not think of sex without your partner approaching you, you are normal as well. Many women do not think of or desire sex until invited appropriately. —Cindi Martin, Md all about Women's care, englewood What do I need to know about creating a birth plan? A birth plan is not absolutely essential before labor begins, as you will have no shortage of well-trained, labor-and-de- livery nurses providing help and advice. It is also important to keep your minds open, as one can never predict what will happen and should remain flexible. However, a birth plan can be helpful in spelling out some of your choices. F o r i n s t a n c e , p a i n c o n t r o l i s something to think about. About 90 percent of first-time mothers will opt to get regional anesthesia (an epidural), which offers the best pain relief during childbirth. Numerous studies have shown that these are safe and pose no harmful effects to babies. There are also analgesics, usually in the form of narcotics, delivered intravenously that will take the edge off the pain but can make the patient and baby sleepy. Alternative methods include breathing exercises, walking, hot tubs, and even hypnotherapy. O f t e n b i r t h p l a n s i n c l u d e y o u r preferences for support person, fetal monitoring, how to augment labor if it stops progressing, when you want your baby brought to you (immediately after delivery to your abdomen or after baby has been cleaned and swaddled in a blanket), whether you will breast or bottle-feed, whether you will circumcise (for boys), and whether you want your baby to have a pacifier. —grace Y Cheng, Md mountain vista Women's care, englewood Once pregnant, when should I see an obstetrician or midwife? W o m e n s h o u l d s e e t h e i r p r o v i d e r for an initial visit at about six week's g e s t a t i o n . T h i s a l l o w s n e w m o t h e r s the opportunity to receive education regarding dietary recommendations and lifestyle choices as well as to learn certain things to avoid while pregnant. The next visit, usually towards the end of the first trimester, includes a physical exam, lab tests, and a discussion about options for genetic screening. Regular prenatal care is important to provide support and information, in addition to ensuring that you and baby are both healthy and that the pregnancy is progressing normally. After the initial visits, appointments usually occur every four weeks until 28 weeks, every two weeks until 36 weeks, and then weekly until your delivery. In the rare event of a pregnancy complication, your provider might recommend more-frequent visits. If you feel that you need longer or more frequent visits, make sure you discuss this with your provider. —Sarah Scott, CnM rose midwifery, denver My PMS symptoms have intensified postpartum. Is this normal? If the pregnancy was stressful, antibiotics were taken during pregnancy or nurs- ing, or Mom had a positive GBS (group B strep) infection during labor, it is not unusual for her to notice new or inten- sified PMS (premenstrual symptoms). Common symptoms, which can be mild or severe, are moodiness (depression, anger or irritability), headache, insom- nia, bloating, breast tenderness and sugar cravings. These might last for a few days to even weeks and usually improve with onset of menses. Menses generally resumes within a few months of birth if women are not nursing. However, if a mom is nursing full time, her periods might not return until baby starts solid food or until nursing is completely stopped. Many w o m e n a r e r e l i e v e d b y t h i s l a c k o f ASK A wOMEN'S HEAlTH PrOvidEr Dr. Cindi Martin Dr. Grace Cheng Sarah Scott, CNM Dr. Susanna Choi Dr. Oscar Aguirre Five Questions on the minds of Women answered by Local Professionals

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