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To dye or not to dye

1/22/2019

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It's so hard to feel like yourself when you are pregnant: Your clothes don’t fit, your body is constantly changing, you feel tired all the time, and you can barely see your toes.  You just want to feel normal and spoil yourself, but don’t know what is safe while you are pregnant.  This segment will focus on hair and hair products- what’s safe and what’s not based on the latest research. 

1. Can I color my hair while I am pregnant?  I get this question all the time.  You can get highlights in any trimester because the chemicals don’t touch the scalp, but you should wait until after the first trimester to dye your hair.  Because the color is placed directly on the scalp, it can potentially get absorbed into your blood and make its way to the baby via the placenta.  The first trimester is very important for growth and development and products that can be potentially harmful to a developing baby should be avoided in the first trimester.  Though we do not actually have any studies that show that hair dye is harmful to developing babies, that is because it is really hard to get pregnant women to volunteer to test out various chemicals while they are pregnant.  Because there is so much blood flow to the scalp, it is best to avoid chemicals that could potentially cause birth defects in the first trimester.  If you absolutely need to dye the roots in the first trimester, please use a vegetable based dye, which means avoiding any products that use ammonia or peroxide.  Many women use a henna product since it is plant based.   

2. What about a relaxer or a Brazilian Blowout?  Again, we don’t know the effects of these chemicals on a developing baby.  So the answer is, if you absolutely need to get one of these types of treatments, please wait until after the first trimester.  Also be aware that because your hair and skin undergo changes from the hormonal milieu while you are pregnant, these treatments may not have the same result while you are pregnant.  Another thing to consider is that these products have a very strong odor: Just as you can have sensitivity to certain types of foods while pregnant, you may have a more intense reaction to the smell of these chemicals while pregnant.  

3. What’s the best way to get rid of unwanted hair while I am pregnant?  Shaving and waxing remain safe methods to get rid of hair while you are pregnant, but many women experience more pain and sensitivity when they are pregnant.  Avoid hair removal or bleaching creams-similarly to dying your hair, they can be absorbed through your skin into your blood stream.  Also avoid laser hair removal because it can cause pigmentation changes (light or dark spots where the hair is removed).  Electrolysis is also not recommended: It either uses an electric current or heat to remove hair, and the safety of these methods are not known.  Electrolysis can also cause pigmentation changes while pregnant.  

There you have it, a general guide to hair care in pregnancy!  As always, if you have specific questions be sure to discuss these with your provider, but remember, you can still treat yourself to the hair look you want during pregnancy :)

​Dr. Pam
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Obesity and Cancer:  How Excess Body Weight May Increase Your Risk

1/15/2019

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Looking for a little more motivation to keep up with your New Year’s health goals?  New data from the American Cancer Society suggests that being overweight or obese increases your risk of both developing and dying from cancer.  As many as 8% of all cancers and 7% of all cancer deaths are thought to be caused by excess body weight, even if you’re otherwise healthy.

There is a clear association between obesity/being overweight and endometrial cancer, (menopausal) breast cancer, colon cancer, esophageal, renal (kidney) and pancreatic cancer.  There may also be a link to ovarian, cervical, gallbladder, liver, multiple myeloma, and non-Hodgkin lymphoma as well as aggressive prostate cancer (while prostate cancer is not a concern for women, it may affect your partner).  Even for normal weight women, having increased belly fat is associated with the development of cancer. 

Why do researchers think this happens?  It seems like “healthy” and “obese” may not go together after all, as obesity can have negative effects on immune function, inflammation, and hormone.  These changes can impact not only overall health but may play a role in the development of certain cancers.  For instance, excess estrogen production from adipose (fat) tissue can change the flow and length of the menstrual cycle, and this unopposed estrogen is associated with the development of endometrial cancer.  This same mechanism may contribute to some types of breast cancer as well.

Even a small amount of weight loss may be helpful for decreasing cancer risk, and, of course, there is a reduction in heart disease and diabetes.  Weight loss can also be helpful in bringing some predictability back to the menstrual cycle without the need for hormonal birth control to regulate bleeding. 

Given all of the benefits above, not to mention an improved sense of overall wellbeing, now is the perfect time to start making and working toward your own health goals for 2019.  Whether that’s to take an exercise class, run an 5K or just lose those pesky (fill in the blank) pounds, we hope that this information can help provide some motivation.  Good luck living your best 2019!
​
Dr. Nick
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Ovarian Cysts:  Are they normal?

1/8/2019

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​I get this question a lot- my doctor found an ovarian cyst on ultrasound- what does this mean?  This really depends on what kind of cyst it is, and trust me there are lots of different types of ovarian cysts.  The most common type of cysts are functional cysts, so let’s go over those first.
There are two types of functional cysts (also known as simple cysts): Follicle cysts and corpus luteum cysts.  Functional cysts rarely cause pain and often disappear on their own without any intervention.
  1. Follicle Cysts: During the menstrual cycle, an egg grows in a sac called a follicle, which is in the ovaries.  Usually this sac will break open and release an egg (Ovulation!).  Sometimes the follicle won’t break open and the fluid inside the follicle can form a cyst on the ovary.   This is part of normal female physiology and rarely causes any issues.  That being said, occasionally ovulation can cause a small amount of bleeding into an ovary (a hemorrhagic cyst), and this can be painful.  The good news, though, is that even hemorrhagic ovarian cysts often resolve on their own without intervention, kind of like a bruise that can be sore at first but then gets better.  Even though this type of bleeding can occur in both follicular cysts and corpus luteum cysts, it is still pretty uncommon. 
  2. Corpus luteum cysts: During ovulation an egg is released from a follicle.  If pregnancy occurs, the follicle will seal off and a mass of cells on the inside will help produce progesterone during early pregnancy.  This progesterone is important in maintaining a pregnancy and this cyst will continue to produce this hormone until the placenta takes over.  This type of cyst is usually easily visualized on ultrasound in early pregnancy. 
Complex cysts:
  1. Dermoid cysts: These are also known as teratomas and can contain hair, skin and teeth because they form from embryonic cells.  While this sounds scary, these cysts are usually benign and very slow growing.  If they are large, they can cause pain and you may at risk for ovarian torsion (torsion is where the ovary twists on itself which decreases the blood flow to the ovary and can cause severe pain).  In this situation, your doctor may encourage you to have it removed.  However, if it is small, it is reasonable to watch it unless it is causing problems.
  2. Cystadenomas: This is a benign tumor that arises from the surface of the ovary and can be filled with fluid or mucous.  Often these can be very large which can cause pain and increase your risk of ovarian torsion.  Based on the appearance, size and whether it is causing symptoms, your provider may encourage you to have it removed.
  3. Endometriomas: These are blood filled cysts that form on the ovaries because of a condition called endometriosis.  Treatment of endometriosis and endometriomas is complex and you will likely need to have an extensive discussion with your provider based on symptoms and appearance on imaging. 
  4. Polycystic Ovaries: Polycystic ovarian syndrome is a condition where multiple small simple ovarian cysts form because of a hormone imbalance that prevents ovulation.  This can cause menstrual irregularities and infertility.  Treatment would be geared towards symptoms being experienced by PCOS. 
  5. Cancer: While this is not common, some ovarian cysts can be malignant as well
The treatment for cysts is based on what these cysts are.  Remember most cysts in reproductive age women are functional or simple cysts and they usually resolve on their own without any intervention.  If you are having unusual pelvic pain, please visit your physician to discuss whether you need an imaging study to determine what is causing the pain, and obviously for severe pain, please visit the ER.  Hope this helps!

​Dr. Pam
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