Thursday, February 20, 2020
Pregnancy

At least 8,000 miscarriages could be prevented each year if women at risk were given a hormone in their next pregnancy, research suggests.

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Between 20 per cent and 25 per cent of pregnancies end in a miscarriage – the loss of a pregnancy during the first 23 weeks – having a major clinical and psychological impact on women and their families.

Experts say women with such a history, who have early bleeding in their pregnancy, could benefit from progesterone – naturally secreted by the ovaries and placenta in early pregnancy and is vital for healthy pregnancies.

There are scientific and economic advantages to giving a course of self-administered twice daily progesterone to women from when they first present with early pregnancy bleeding up until 16 weeks of pregnancy to prevent miscarriage, experts from the University of Birmingham and Tommy’s National Centre for Miscarriage suggest in two new studies. They are calling for women at risk to be given the hormone as a standard by the British National Health Service (NHS).

The first of the studies, published in the American Journal of Obstetrics and Gynaecology, examines the findings of two major clinical trials – Promise and Prism.

Promise studied 836 women with unexplained recurrent miscarriages at 45 hospitals in the United Kingdom (U.K.) and the Netherlands, and found a three per cent higher live birth rate with progesterone, but with substantial statistical uncertainty.

Prism studied 4,153 women with early pregnancy bleeding at 48 hospitals in the UK. It found a 5 per cent increase in the number of babies born to those who were given progesterone who had previously had one or more miscarriages, compared to those given a placebo.

According to the research, the benefit was even greater for women who had previous recurrent miscarriages – three or more – with a 15 per cent increase in the live birth rate in the progesterone group.

The second of the studies, published in BJOG: an international Journal of Obstetrics and Gynaecology, looks at the economics of the Prism trial. It indicates progesterone is cost-effective, costing on average £204 (N95,976) per pregnancy.

An unpublished survey by the University of Birmingham of 130 healthcare practitioners in the UK found that before the results of the Prism study just 13 per cent offered women at threat of miscarriage progesterone. While post publication of the results in the New England Journal of Medicine in May 2019 some 75 per cent now offer the treatment.

Dr. Adam Devall, senior clinical trial fellow at the University of Birmingham and manager of Tommy’s National Centre for Miscarriage Research, said: “We believe that the dual risk factors of early pregnancy bleeding and a history of one or more previous miscarriages identify high risk women in whom progesterone is of benefit. The question is how should this affect clinical practice?”

Dr. Pat O’Brien, consultant and vice president of The Royal College of Obstetricians and Gynaecologists, said: “This treatment offers an increased chance of a successful birth and appears to be cost effective for the NHS, so we hope Nice will consider this important research in their next update of the guidance.”

The National Institute for Health and Care Excellence (Nice) said it is currently updating its guideline on the diagnosis and initial management of ectopic pregnancy and miscarriage to consider new evidence on progesterone in treating threatened miscarriage.

Sexual problems are more common in postmenopausal women, which suggests that menopause can reduce libido.

The reduced sex drive is often caused by decreased estrogen levels, which can dampen arousal and result in sex being more painful.

In this article, we look at how menopause might affect someone’s sex drive, along with what can be done to improve libido.

Menopause and libido

What is menopause?

Menopause refers to when a woman stops having her period permanently, but it can affect more than a woman’s menstrual cycle.

Menopause can cause physical and emotional changes that impact a woman’s life, including her sex life.

Some symptoms and side effects associated with menopause include:

  • anxiety
  • bladder control issues
  • decreased sex drive and desire (libido)
  • depression
  • difficulty sleeping
  • thinning hair
  • weight gain

Each of these effects can impact a woman’s quality of life and relationship with her partner.

What is libido?

Libido refers to sexual interest and sexual enjoyment.

Some women going through menopause report reduced libido, but the causes vary from person to person.

According to one review, the reported rates of sexual problems in postmenopausal women are between 68 and 86.5 percent.

This range is much higher than in all women in general, which is estimated to be between 25 and 63 percent.

Why does menopause affect libido?

Decreased estrogen levels can result in reduced blood flow to the vagina, which can cause the tissues of the vagina and labia to become thinner. If this happens, they become less sensitive to sexual stimulation.

Decreased blood flow also affects vaginal lubrication and overall arousal. As a result, a woman may not enjoy sex as much and may have difficulty achieving orgasm. Sex may be uncomfortable or even painful.

Fluctuating hormone levels during perimenopause and menopause can also affect a woman’s mental health, which in turn, may cause a decrease in her libido.

Stress can also impact a woman’s libido, as she may be juggling a job, parenting, and be caring for aging parents. The changes in hormone levels a woman may experience during menopause may make her irritable or depressed, so dealing with everyday stress may feel more difficult.

According to an article published in the Journal of Women’s Health, women who have more significant side effects associated with menopause are more likely to report lower libido levels.

Examples of these side effects include hot flashes, depression, anxiety, trouble sleeping, and fatigue.

Other factors that make a woman going through menopause more likely to experience a reduced libido include:

  • history of chronic health conditions, such as heart disease, diabetes, or depression
  • history of smoking
  • engaging in low levels of physical activity

A woman should talk to her doctor about how these conditions could affect her sex drive.

Tips for improving libido

There are several steps a woman can take to increase her libido. These include medical treatments, lifestyle changes, and home remedies.

Medical treatments

middle aged couple enjoying a bike ride
Spending time together on shared hobbies, exercising, and planned dates will help increase a couple’s intamacy.

If a woman experiences changes to her vaginal tissue, such as thinning and dryness, she may wish to consider estrogen therapy.

Prescription estrogen can be applied directly to the vagina in the form of creams, pills, or vaginal rings. These usually contain lower doses of estrogen than regular birth control pills.

Some women may wish to take estrogen pills that contain higher levels of hormones. This treatment, known as hormone replacement therapy, might help reduce symptoms, such as hot flashes and mood changes, but may also carry risks.

A woman thinking about hormone replacement therapy should discuss it with her doctor before starting to take any medication.

One study found that women using hormone therapies reported higher levels of sexual desire compared with women who did not.

Less commonly, a doctor may prescribe testosterone therapy. However, not all women respond to this treatment, and the United States Food and Drug Administration (FDA) do not approve it for treating sexual disorders in women.

A woman may not experience any changes in her sex drive after using estrogen or testosterone therapies.

A woman may also choose to see a therapist who specializes in sexual dysfunction or enhancing sex. Sometimes, couples may want to attend therapy together.

Lifestyle changes

Some women may benefit from using water-soluble lubricants during sex. These can be purchased over-the-counter at most drugstores.

However, women should avoid non-water soluble and silicone-based lubricants, as these can break down condoms used to protect against sexually transmitted infections (STIs).

Increasing physical activity, such as getting 30 minutes or more of exercise on a routine basis, may help reduce menopause-related symptoms, including a low libido. Eating a healthful diet can also enhance a person’s overall sense of well being.

Changing sexual habits

There are many ways a person can foster a sense of intimacy with their partner, including:

  • Changing sexual routines: Try spending extended periods on foreplay, use vibrators or other sex toys to enhance an intimate experience, or engage in sexual activity or touching without the goal of orgasm.
  • Relieving stress together: There are many stress-relieving techniques a couple can do outside of the bedroom to increase intimacy. Examples include going on planned dates together, taking a walk, or spending time doing hobbies together, such as exercise, crafts, or cooking.
  • Practicing masturbation: Spending time alone and exploring what types of touch and sexual stimulation work well for an individual can help them talk to a partner about their needs and preferences. It can also help a person feel more comfortable with sexual activity without the pressure of a partner.

Natural remedies

Some women use natural supplements to try to increase their libido. It is important to keep in mind that the FDA do not regulate herbs and supplements, so women should be sure to choose a reputable brand.

Some natural remedies used to increase libido in women include:

  • black cohosh
  • red clover
  • soy

A woman should discuss these remedies with a doctor before taking them to ensure they will not interact negatively with other prescriptions and supplements she may be taking. Soy contains estrogen, so it may react with other estrogen therapies.

When to see a doctor

A woman should speak to her doctor whenever perimenopause or menopause is having a significant impact on her day-to-day activities, including sexual activity.

Sometimes, a doctor can recommend changes in health habits as well as discuss whether prescription medications may help relieve the symptoms, including a low libido.

Speaking with a doctor can also rule out any other underlying medical conditions that may cause a reduced libido. These conditions include urinary tract infections, uterine prolapse, endometriosis, or pelvic floor dysfunction.

Outlook

While some women do experience a decreased libido in menopause, others do not.

Some women may even experience a heightened libido after menopause. This can be due to reduced stresses over pregnancy and fewer child-rearing responsibilities.

If a woman’s libido is impacted after menopause, she should talk to her doctor about treatments that could enhance her quality of life.

Certain foods and drinks contain compounds that may improve vaginal health and symptoms of vaginal conditions. These include probiotics, prebiotics, and fermented food and beverages.

The vagina uses natural secretions, immune defenses, and “good” bacteria to keep itself healthy. Eating a healthful, balanced diet might also further prevent infections and improve vaginal conditions.

This article discusses what little research there is into the effects of diet on vaginal health, looks at dietary choices for common vaginal conditions, and identifies other ways to improve vaginal health.

People should speak to a doctor before using diet to address any health concerns.

Balancing pH levels

The vagina is a moderately acidic environment with a pH of around 4.5. This acidity helps healthful bacteria to grow and prevents harmful microbes from developing.

Some good bacteria, such as probiotics, may help balance vaginal acidity levels.

Probiotics

Lactobacillus species bacteria is the most dominant type of “good” bacteria found in a healthy vagina.

Research has suggested that Lactobacillus could benefit vaginal health in the following ways:

  • regulating the microflora in the vagina
  • improving the vagina’s acidity levels
  • stopping harmful microbes from attaching to the vaginal tissues
  • working with the body’s immune system

2016 study indicated that using vaginal Lactobacillus supplements after taking antibiotics hindered bacteria growth in people with bacterial vaginosis (BV), and significantly reduced vaginal pH.

2015 review study found “no significant evidence” that probiotics were more beneficial than using a placebo or no treatment. However, the authors noted that due to a lack of evidence, “a benefit cannot be ruled out.”

Probiotic supplements are available, but some nutritionists recommend getting them from fermented foods and drinks, such as:

  • yogurt and kefir
  • kimchi and sauerkraut
  • pickles
  • tempeh
  • kombucha

Prebiotics

Prebiotic compounds may also help stabilize vaginal pH by promoting the growth of healthy bacterial populations. Foods rich in prebiotics include:

  • leeks and onions
  • asparagus and Jerusalem artichoke
  • garlic
  • whole wheat products
  • oats
  • soybeans
  • bananas

It is important to note that prebiotics can worsen bowel conditions, such as irritable bowel syndrome (IBS).

Preventing UTIs

Urinary tract infections (UTIs) occur when bacteria enter parts of the urethra, bladder, or kidneys, causing symptoms such as burning or pain during urination and bad smelling or cloudy urine. According to the Urology Care Foundation, about 60% of women will experience a UTI at some point.

Drinking lots of fluids might help prevent a UTI.

Cranberry juice

According to the Urology Care Foundation, drinking cranberry juice or taking cranberry tablets may prevent UTIs from developing.

Research supports this idea — in a 2016 study, researchers found that drinking 8 ounces (oz), or 240 milliliters (ml) of a 27% cranberry juice drink each day for 24 weeks lowered the rate of UTIs in adult women who had recently had a UTI.

Cranberries are rich in antibacterial compounds that kill bacteria. These include antioxidants and organic acids, such as:

  • proanthocyanidins and anthocyanins
  • organic and phenolic acids
  • vitamin C
  • flavanols and flavonols

Research into diet and UTIs has mainly focused on cranberries, but many fruits, especially citrus fruits and berries, are also rich in antioxidants and may have similar effects.

Reducing candida infections

Candida infections, or yeast infections, are the second most common cause of vaginitis, or vaginal inflammation.

There is no scientific proof that any foods can reduce candida infections. However, some foods contain ingredients that the fungus uses to grow. These ingredients include refined sugar, preservatives, yeasts, fungi, allergens, and trace antibiotics. People may benefit from avoiding these foods.

Researchers are studying the possible benefits of natural remedies with antifungal, anti-inflammatory, or antioxidant properties for candida infection, including tea tree oil, coconut oil, and garlic.

Other ways to improve vaginal health

Regularly eating a healthful, balanced diet that contains fermented products with probiotics and prebiotics can improve vaginal health.

Following some of these lifestyle habits might also help:

  • cleaning the genital region with mild, unscented soap before rinsing well and patting dry daily or as needed during menstruation
  • wiping from front to back
  • using antibiotics appropriately and only when necessary
  • reducing sweat around the vagina
  • exercising regularly
  • maintaining a healthy weight
  • staying hydrating
  • reducing stress
  • wearing loose-fitting cotton underwear

Avoiding or limiting things that can imbalance the body’s systems or irritate the vagina can help, such as:

  • douching
  • holding in urine or rushing urination
  • personal care products with dyes, flavors, or fragrances
  • spermicidal foam or diaphragms
  • tight pants or underwear
  • smoking
  • prolonged exposure to moisture
  • alcohol
  • processed or heavily refined foods
  • foods or drinks with artificial hormones

Summary

Many nutrients contribute to vaginal health. Eating a healthful, nutrient-rich diet can improve all body systems.

Certain nutrients, antioxidants, and probiotics may have particular benefits for vaginal health. However, researchers need to do more studies to work out which nutrients help boost vaginal health and prevent vaginal infections.

Fish Oil supplements could make men’s testicles bigger and boost their sperm count, a study claims.Men who took the pills, which contain omega-3 fatty acids, were found to have testicles 1.5ml larger and to ejaculate 0.64ml more sperm, on average.The men, who had an average age of 18, were included as regular supplement-takers if they had consumed fish oil for at least 60 out of the past 90 days. Larger testicles and more sperm creation are linked to higher testosterone levels and better fertility, although the study did not test how fertile the men were.

The research was published in the journal JAMA Network Open, by the American Medical Association. The experiment was described by scientists as ‘well-conducted’ and ‘insightful’ but it was clear that it did not prove fish oil makes men more fertile. Researchers from the University of Southern Denmark did their study using 1,679 young Danish men going through military fitness testing.

In Denmark military service is mandatory for all healthy men over the age of 18, so the men in the study were not yet soldiers. Each of the men was screened for Sexually Transmitted Infections (STIs), had physical exams, gave sperm samples and then answered questions about their diets and lifestyles. If someone was considered a regular fish oil supplement user, the research found, they produced millions more sperm in an average ejaculation.

The researchers wrote in their paper: “Fish oil supplements were associated … with higher semen volume and total sperm count, and larger testicular size.”Ninety-eight men in the study said they took fish oil supplements regularly, while another 95 took vitamin D or C supplements. Men in the fish oil group were less likely to have fertility problems, which were judged against the World Health Organization’s low sperm count limit of 39 million sperm per ml of semen.

The scientists found that 12.4 percent of the men who took fish oil supplements (12 out of 98) had sperm counts below the World Health Organisation’s (WHO’s) measure. This compared to 17.2 percent (192 out of 1,125) men who took no supplements. And the longer someone had been taking supplements for, the more sperm they were likely to produce.

The researchers added that, based on a model fit and healthy 19-year-old: “Total sperm count was 147million for men with no supplement intake, 159million for men with other supplement intakes, 168million for men with fish oil supplement intake on fewer than 60 days, and 184million for men with fish oil supplement intake on 60 or more days.”

The study did not give exact measurements for men’s testicle volume or sperm volumes – they only compared the two groups. And the scientists could not explain why – if it was true – the fish oil improved sperm quality.It was also not clear whether increased sperm volume was caused by – or caused – the change in testicle size. Scientists not involved with the research said the study had been well-conducted but it didn’t say how much fish oil the men took.

And nor did it reveal the men’s diets, which may have shown they were getting omega-3 from other sources such as fresh fish.Professor Sheena Lewis, reproductive medicine expert at Queen’s University, Belfast, said: “This is a large well-designed study and the association between fish oil intake and improved semen quality is compelling.

“However, the study focuses on healthy young men; mostly with sperm counts already in the fertile range.“There is no evidence from this study that infertile men with low sperm counts benefit from fish oil.”Dr. Frankie Phillips, of the British Dietetic Association, said missing information about the men’s diets did make the study’s results less convincing.She added: “Antioxidants, including vitamin C, selenium and vitamin A, as well as zinc and omega-3 fats all have a role in the production of healthy sperm.

“There is much focus on the diets of women who are trying to conceive, ensuring that they are in the best possible position to achieve a healthy pregnancy, but diet might also be a factor involved in men’s reproductive health.“Omega-3 is present in a both animal and plant derived foods, but oily fish stands out as an excellent source of long chain omega-3, and the UK population currently consume way below the recommended ‘at least one portion of oily fish per week”.

“So including omega-3 is already part of current dietary recommendations – this study on its own can’t prove that upping omega-3 will itself improve testicular function.”Also, according to researchers, women who have sex every week may have a lower chance of an early menopause. University College London experts asked nearly 3,000 women – who were tracked for 10 years – about how often they had sex. Women of any age who had sex each week were less likely to have been through the menopause, compared to those who did so less than once a month.

For example, those who had regular sex were 28 percent less likely to have entered the menopause at age 51, compared to their counterparts. Sexual activity included full-blown intercourse, oral sex, touching and caressing, or self-stimulation. Scientists said if a woman is not having sex and there is no chance of pregnancy, the body ‘chooses’ to stop investing energy into ovulation.

Instead, their bodies may decide to invest energy elsewhere, such as in looking after grandchildren. The theory, known as the grandmother hypothesis, says the menopause evolved to help mothers have more children. It suggests that grandmothers would aid their offspring to have more of their own children by caring for the existing grandchildren. A woman’s immune function is hampered during ovulation, making the body more susceptible to disease.

And so if a pregnancy is unlikely because of a lack of sexual activity, the body would divert its focus from a costly process to aiding existing relatives. The menopause is when a woman stops having periods and is no longer able to get pregnant naturally. The process is a natural part of ageing and usually occurs among women between 45 and 55. Researchers used data collected from 2,936 women who took part in the Study of Women’s Health Across the Nation (SWAN) in the United States (U.S.).

The women, an average age of 45 at the start of the study in 1996, were asked if and how often they had had sex in the past six months. They were also asked whether they had oral sex, sexual touching, or engaged in self-stimulation in the last six months. The researchers found that the most frequent pattern of sexual activity was weekly (64 percent). None of the women who took part had already entered the menopause, but 46 per cent were starting to experience symptoms (known as peri-menopause). Fifty-four per cent were pre-menopausal, meaning they had not yet displayed any symptoms and were still having their periods.

Interviews were carried out both when the women first took part and then ten years later. Women who had sex weekly were less likely to experience the menopause, compared to those who had sex lass than monthly. And women who had sex monthly were less likely to experience menopause at any given age, compared to those who had sex less than monthly. Prof. Ruth Mace, who co-authored the study, said: “The menopause is, of course, an inevitability for women, and there is no behavioural intervention that will prevent reproductive cessation.“Nonetheless, these results are an initial indication that menopause timing may be adaptive in response to the likelihood of becoming pregnant.”

How can a man’s diet affect his fertility?
The body must get all the chemicals it needs from the diet, meaning what you eat controls your health. Certain foods can improve – or worsen – a man’s fertility. The general rule is that a healthy, balanced diet is better for fertility than one too high in sugar or fat.

Fruits and vegetables are good
Fruit and veg are rich in nutrients such as vitamins C and A, polyphenols, magnesium, folate and fiber, which act as antioxidants in the body. Research has suggested a direct association between the production of reactive oxygen species in sperm cells and intake of antioxidants, which help to reduce this damage by neutralizing them.

Eat foods rich in zinc, selenium and vitamin C
Zinc can be found in foods such as meat, cheese, shellfish wholegrain cereals and nuts. Inadequate intakes of zinc in the diet have been linked to low sperm count and reduced testosterone levels. Selenium can be found in foods such as brazil nuts, fish, poultry and eggs. This mineral is required for normal sperm production and development and men should aim to get 55mcg per day. Vitamin C is thought to help prevent sperm cells clumping together (common with infertility) and men should aim to get 80mg per day.

Limit dairy foods
Intake of dairy foods in association with sperm production is somewhat controversial but the theory goes that as around 75 per cent of the milk we consume comes from pregnant cows, there may be a high level of naturally occurring oestrogens, which could affect sperm production.

Limit meat intake
Although not fully proven, it has been suggested that meat and processed meats may impact on fertility in men by way of xenobiotics (mainly xenestrogens) used in the farming process. Over-exposure to these compounds, which have estrogenic effects in the body, may play a role in the decline of sperm quality in men.

Avoid excessive amounts of sugar
Excessive intake of sugary foods may lead to overweight and obesity, driving insulin resistance, which may negatively influence sperm quality as a result of inflammation and oxidative stress. Diets high in sugar can also lead to blood sugar imbalances, which may disrupt the hypothalamic-pituitary-testicular axis impacting on sperm production.
*Culled from Daily Mail UK

Adnexal masses are lumps that occur in the adnexa of the uterus, which includes the uterus, ovaries, and fallopian tubes. They have several possible causes, which can be gynecological or nongynecological.

An adnexal mass could be:

  • an ovarian cyst
  • an ectopic pregnancy
  • a benign tumor
  • a malignant tumor

A family doctor can usually manage benign masses. However, prepubescent and postmenopausal individuals will need to see a gynecologist or oncologist.

Malignant adnexal masses require treatment from a specialist.

In this article, we discuss the characteristics of adnexal masses. We also review how doctors diagnose and treat adnexal them.

Symptoms

People report different symptoms, depending on the cause of the adnexal mass.

People with an adnexal mass may report:

  • severe lower abdominal or pelvic pain that is usually on one side
  • abnormal bleeding from the uterus
  • pain during sexual intercourse
  • worsening pain during a period
  • painful periods
  • abnormally heavy bleeding during periods
  • abdominal symptoms, including a feeling of fullness, bloating, constipation, difficulty eating, increased abdominal size, indigestion, nausea, and vomiting
  • urinary urgency, frequency, or incontinence
  • weight loss
  • lack of energy
  • fatigue
  • fever
  • vaginal discharge

Different causes of adnexal masses may have similar symptoms, so doctors usually conduct further investigations to determine the exact cause.

Once the doctor has worked out the cause of the adnexal mass, they can recommend treatment and management.

Causes

Adnexal masses include a variety of different conditions that range in severity from benign growths to malignant tumors.

The cause of adnexal masses could be gynecological or nongynecological.

Some of the causes of adnexal masses include:

  • Ectopic pregnancy: A pregnancy where the fertilized egg implants somewhere outside the uterus.
  • Endometrioma: A benign cyst on the ovary that contains thick, old blood that appears brown.
  • Leiomyoma: A benign gynecological tumor, also known as a fibroid.
  • Ovarian cancer: These tumors of the ovary may be ovarian epithelial cancers that begin in the cells on the surface of the ovary or malignant germ cell cancers that begin in the eggs.
  • Pelvic inflammatory disease: Inflammation of the upper genital tract, which includes the uterus, fallopian tubes, and ovaries. It occurs due to an infection.
  • Tubo-ovarian abscess: An infectious adnexal mass that forms because of pelvic inflammatory disease.
  • Ovarian torsion: A gynecological emergency involving a complete or partial rotation of the tissue that supports the ovary, which cuts off blood flow to the ovary.

Diagnosis

A doctor may diagnose an adnexal mass by:

  • taking a complete medical history
  • asking questions about symptoms
  • conducting a physical examination
  • obtaining blood samples

Most of the time, people will need a transvaginal ultrasound to allow doctors to evaluate the characteristics of an adnexal mass.

Females who have had a positive pregnancy test result and report abdominal or pelvic pain and vaginal bleeding might have an ectopic pregnancy. An ovarian torsion causes sudden, severe pain with nausea and vomiting. Immediate medical attention is necessary to treat both an ectopic pregnancy and ovarian torsion.

People with pelvic inflammatory disease or a tubo-ovarian abscess may experience gradual pelvic pain with nausea and vaginal bleeding.

Early ovarian cancer may sometimes present with nonspecific symptoms. Sometimes, doctors may only detect cancer when the tumor has become malignant.

Malignant tumors may have one or several of the following characteristics:

  • a solid component of the tumor
  • parts of the tumor have thick divisions larger than 2–3 centimeters separating them
  • they are present on both sides of the reproductive tract
  • the presence of fluid filled lumps

Treatment

A doctor will choose the most appropriate treatment depending on the cause of the adnexal mass. Women with an ectopic pregnancy will have to end their pregnancy. A doctor may choose one of the following procedures:

  • the administration of a single or two-dose intramuscular methotrexate
  • laparoscopic surgery
  • a salpingostomy or salpingectomy, which are surgical procedures involving the fallopian tubes

Doctors have not yet determined the optimal management of an endometrioma, according to a study that featured in Obstetrical & Gynecological Survey.

Currently, the possible treatments for an endometrioma include:

  • watchful waiting
  • medical therapy
  • surgical intervention
  • inducing ovulation and using assisted reproductive technology in females with infertility

People with pelvic inflammatory disease will require courses of intravenous antibiotics, which may include:

  • cefotetan (Cefotan)
  • cefoxitin (Mefoxin)
  • clindamycin (Cleocin)

Some people can receive treatment outside of the hospital setting with oral doxycycline (Vibramycin) and intramuscular ceftriaxone (Rocephin) or another third generation cephalosporin antibiotic. In some cases, doctors will need to add oral metronidazole (Flagyl).

In the past, tubo-ovarian abscesses required surgical removal of the uterus, ovaries, and fallopian tubes. However, doctors can now prescribe broad-spectrum antibiotics. A person with a ruptured tubo-ovarian abscess may still require surgery.

Ovarian torsion is a gynecological emergency. The only treatment is surgery to prevent severe damage to the ovaries and fallopian tubes.

People with leiomyomas or fibroids may receive hormonal treatments or nonsteroidal anti-inflammatory drugs to control the symptoms. Once a person stops taking medication, the symptoms may return, and the fibroids may continue to grow. Surgery is the most successful treatment for fibroids.

The treatment options for ovarian cancer include surgery, chemotherapy, and targeted therapy. Oncologists will consider the following factors before recommending a treatment plan:

  • the type of ovarian cancer and how much cancer is present
  • the stage and grade of the cancer
  • whether the person has a buildup of fluid in the abdomen causing swelling
  • whether surgery can remove the whole tumor
  • genetic changes
  • the person’s age and general health status
  • whether it is a new diagnosis, or if cancer has come back

Risk factors

Risk factors depend on the cause of the adnexal mass. Females with ovarian masses have an increased risk of developing ovarian torsion. More than 80% of females with ovarian torsion have masses of 5 cm or larger.

Doctors diagnose fibroids in about 70% of white females and more than 80% of black females by the age of 50 years. Other factors may increase a person’s risk of developing fibroids, such as:

  • starting periods early in life
  • using oral contraceptives before 16 years of age
  • an increase in body mass index (BMI)

Ovarian cancer can run in families. People with a family history of ovarian cancer may have an increased risk of developing ovarian cancer. Other risk factors include:

  • inherited genetic changes
  • hereditary nonpolyposis colorectal cancer
  • endometriosis
  • postmenopausal hormonal therapy
  • obesity
  • tall height

The likelihood of developing cancer also tends to increase with age.

Summary

Adnexal masses are lumps that doctors may find in the adnexal of the uterus, which is the part of the body that houses the uterus, ovaries, and fallopian tubes. Not all masses are cancerous, and they do not all require treatment.

Different types of adnexal mass can share many of the same symptoms. As a result, doctors need to collect a full medical history and data from physical examinations, blood tests, and medical imaging, including transvaginal ultrasounds.

Doctors need to pinpoint the location and cause of an adnexal mass to determine the appropriate management and treatment.

New studies have shown that the ethanolic root bark extract of African cherry may damage fertility in men. African cherry is a plant, which has been used in traditional/alternative medicine in Nigeria to treat several health problems, as various parts of this herb have been proved to have a wide range of therapeutic effects.

The plant is a rich source of natural antioxidants, which have been established to promote health by acting against oxidative stress related disease such as; diabetics, cancer and coronary heart diseases.Its bark is used for the treatment of yellow fever and malaria while the leaf is used as an emollient and for the treatment of skin eruption, stomachache and diarrhea. The cotyledons from the seeds are used as ointments in the treatment of vaginal and dermatological infections in Western Nigeria and also possess anti-hyperglycemic and hypolipidemic effects, among other health benefits.

However, studies have shown that African cherry herbs can also have anti-fertility effects in men.Botanically called Chrysophyllum albidum, African star apple, which belongs to the plant family Sapotaceae is an edible tropical fruit known by various tribal names. It is called Utieagadava in Urhobo; Agbalumo in Yoruba; Udala in Ibo, Efik and Ibibio; Ehya in Igala, Agwaluma in Hausa tribes of Nigeria.

In southern Benin, it is called Azongogwe or Azonbobwe in local language.Several studies have been conducted to investigate the antifertility effect of the ethanolic root bark extract of C. albidum on the hormonal levels (pituitary-testicular axis) and caudal epididymal fluid parameters in wistar rats.

A study titled: “The effect of Chrysophyllum albidum fruit on testicular functions in rats” investigated the effects of C. albidum fruit methanol extract on the reproductive functions of male Wistar rats. Fifteen male Wistar rats were divided into three and received distilled water, which also served as control and extract respectively for 28 days via oral gavage.

The sperm count, motility, percentage sperm aberration, histology of testes and epididymides were examined by microscopy. The results showed the serum levels of luteinising hormone (LH), follicle‐stimulating hormone (FSH) and testosterone were quantified using ELISA. However, the sperm count significantly increased in, while the serum testosterone level decreased.

Findings from the study showed that the architecture of sections of testes and epididymides showed anomalies. C. albidum fruit adversely altered reproductive functions of male Wistar rat. Also, another study published in International Journal of Applied Research in Natural Products by Nigerian researchers validated the antifertility effect of extracts of African cherry in men.

The study is titled: “Antifertility Effects of Ethanolic Root Bark Extract of Chrysophyllum Albidum in Male Albino Rats. According to the researchers, the present study was conducted to investigate the antifertility activity of the ethanol root bark extract of Chrysophyllum albidum on sperm parameter and hormonal levels in rats. Eighteen male rats were divided into three groups of six animals each, as each group were administered distilled water that serve as control, ethanol root bark extract on a daily basis. The caudal epididymal sperm count; motility and sperm morphology were observed compared with the control.

The result showed that ethanol extract of the root bark of C. albidum suppresses the hormonal levels and sperm production in rats, according to the study.The researchers conclude that the study demonstrated that the root bark of ethanolic extract of C. albidum produces a pronounced inhibition of serum testosterone and gonadrophins concentration.

However, these extract had antifertility effect on the testes of albino wistar rats and could be further investigated for possibility of developing a cheap, acceptable and easy available male contraceptive.The researchers said: “The findings of the present study showed that the ethanolic root bark extract of C. albidum could significantly alter the fertility potential of male rats. The fact that there was significant increase in body weight

(p<0.05) on treated animals does not rule out the possibility of a systemic toxicity at the doses treated due to behavioral alterations observed within the treated groups which showed progressive decrease in agility. Furthermore, the significant increase in body weight (p<0.05) indicates that the extract may have toxic effect on the rats. The analysis of caudal epididymal fluids of these treated rats revealed a concomitant decrease in the sperm concentration which may be due to the inhibition in spermatogenesis which has been reflected here by the low count.” [ad] The researchers observed that the “present study also reveals a significant decrease in sperm motility, which focuses the direct effect of the extract on matured and stored sperm in epididymis, also increased abnormal sperm morphology.”Another study evaluated the effects of ethanolic leaf extract of Chrysophyllum albidum on hormones and sperm analysis of laboratory rats. The study titled: “Ethanolic Leaf Extract of Chrysophyllum albidum on sperm analysis, hormonal profile, SOD and testicular histology of adult male wistar rats” was published in the Agriculture And Biology Journal of North America. The researchers in their findings showed that “C. albidum leave extract reduced serum levels of gonadotrophins probably by affecting hypothalamic- pituitary-gonadal axis. The treatment does not cause suppression of spermatogenesis but decrease the hormonal profile. The researchers from Faculty of Basic Medical Sciences, Madonna University, River State concluded that the “C. albidum leave extract reduced serum levels of gonadotrophins probably by affecting hypothalamic- pituitary-gonadal axis. The reduced levels of FSH, LH and T do not have effect on the testicular spermatogenesis for 21 days. However there was an increase in the SOD enzyme activities above the control level thereby improving its antioxidative capacity.”

The muscles, ligaments, and tissues of the pelvic floor support the bladder, rectum, and sexual organs. When the supportive structures weaken or become especially tight, doctors describe it as pelvic floor dysfunction. It is a common health issue.

When a person has pelvic floor dysfunction, the organs in the pelvis may drop. They often press down on the bladder or rectum, causing a leakage of urine or stool. Or, a person with this condition may have trouble urinating or passing stool.

Keep reading to learn more about pelvic floor dysfunction — including the symptoms, treatments, and some exercises that may help.

What is pelvic floor dysfunction?

The pelvic floor is made up of muscles, ligaments, and tissues that surround the pelvic bone. The muscles attach to the front, back, and sides of the bone, as well as to the lowest part of the spine, called the sacrum.

The function of the pelvic floor is to support the organs in the pelvis, which can include the:

  • bladder
  • rectum
  • urethra
  • uterus
  • vagina
  • prostate

People with pelvic floor dysfunction may have weak or especially tight pelvic floor muscles.

When the muscles tighten, or spasm, people may have trouble urinating or passing stool. When they weaken, the organs within the pelvis may drop and press down on the rectum and bladder.

The table below outlines several common types of pelvic floor dysfunction.

Type of pelvic floor dysfunctionDescription
Obstructed defecationThis occurs when stool enters the rectum, but the body cannot fully evacuate the bowels.
RectoceleThis involves tissue from the rectum protruding into the vagina. Stool may get caught in this pocket, forming a bulge in the vagina.
Pelvic organ prolapseThis refers to the pelvic floor stretching and the pelvic organs dropping as a result of age, childbirth, or a collagen disorder.
Paradoxical puborectalis contractionThis involves a pelvic floor muscle called the puborectalis contracting. When it happens, trying to pass stool may feel like pushing against a closed door.
Levator syndromeThis involves the pelvic floor muscles spasming after bowel movements. It can cause lasting dull pain or achy pressure high in the rectum.
CoccygodyniaThis refers to pain in the tailbone that worsens during and after bowel movements.
Proctalgia fugaxThis involves painful spasms of the rectum and muscles in the pelvic floor.
Pudendal neuralgiaThis refers to irritation or damage to the pudendal nerves, which help the pelvis function.
UrethroceleThis refers to the urethra pressing into the vagina.
EnteroceleThis involves the small intestine descending and pushing into the vagina, forming a bulge.
CystoceleThis involves the bladder dropping and pushing into the vagina.
Uterine prolapseThis refers to the uterus descending and pushing into the vagina.

Symptoms

Pelvic floor dysfunction can cause a variety of symptoms, and some can interfere with daily life.

Depending on the type of pelvic floor dysfunction, a person may experience:

  • pelvic pain
  • pressure
  • a bulge somewhere in the lower pelvic region
  • stress urinary incontinence, which involves a small amount of urine leaking from the body due to an activity such as coughing
  • involuntary leakage of stool
  • incomplete urination
  • bowel movement dysfunction
  • pain during sexual intercourse

Also, some people who see their doctors about bladder overactivity find that pelvic floor dysfunction is responsible.

Causes

Many issues can cause the structures of the pelvic floor to weaken, including:

  • age
  • systemic diseases
  • lasting health issues that cause increased pressure in the abdomen and pelvis, such as a chronic cough
  • pregnancy
  • trauma during delivery
  • multiple deliveries
  • large babies
  • operative delivery

Research indicates that stress urinary incontinence, pelvic organ prolapse, or both occur in about half of all women who have given birth. These issues are closely associated with birth-related injury to the pelvic floor muscles.

The pelvic floor muscles can also stretch naturally with age. Stress urinary incontinence and pelvic organ prolapse become more common with increasing age in females, for example.

Collagen disorders can also affect the muscles’ ability to support the pelvic organs.

Meanwhile, coccygodynia usually stems from trauma to the tailbone, such as from a fall. That said, in about one-third of people with the condition, the cause of coccygodynia is unknown. The pain can make having a bowel movement difficult.

Exercises

Doctors recommend pelvic floor exercises in various situations.

They may particularly benefit pregnant women because the pelvic floor muscles can stretch and weaken during labor. Strengthening these muscles may help prevent incontinence after the baby is born. Some doctors recommend that women who wish to become pregnant start the exercises ahead of time.

Males can also benefit from pelvic floor exercises, though the dysfunction is more common in females. In males, these exercises can help prevent pelvic organ prolapse and urinary incontinence and improve sexual intercourse.

To exercise these muscles, a person should be sitting comfortably. Then, they should attempt to squeeze their pelvic muscles without holding their breath.

It is important to isolate the correct muscles without tightening those of the stomach, buttocks, or and thighs.

Doctors recommend that females aim to do 10 long squeezes — holding each for 10 seconds — followed by 10 short squeezes. However, initially, it may be a good idea to practice holding a squeeze for a few seconds at a time.

By practicing frequently, a person should be able to add more contractions to their routine week by week. It is important to do this gradually and to avoid overworking the muscles.

Within a few months, a person may notice a reduction in their symptoms. Even if symptoms resolve completely, a person should continue strengthening these muscles.

There are physical therapists who specialize in pelvic floor dysfunction. A person may find that consulting one of these professionals leads to a better outcome.

Treatment

Doctors determine the cause of pelvic floor dysfunction before recommending treatment because different types of dysfunction require different approaches.

The purpose of treatment is to relieve or reduce symptoms and improve the person’s quality of life. For some people, a combination of treatment methods works best.

Doctors may recommend:

  • Dietary changes: For example, eating more fiber, drinking more fluids, and taking certain medications can make bowel movements easier.
  • Laxatives: Taking a daily laxative may help people with pelvic floor dysfunction pass stool, but it is important to consult a healthcare provider first because not all laxatives are equally effective.
  • Pain relief: Some people require injections of pain relief or anti-inflammatory medication to relieve their symptoms.
  • Biofeedback: This involves electrical stimulation, ultrasound therapy, or massage of the pelvic floor muscles to help improve rectal sensation and muscle contraction.
  • Pessary: A doctor or nurse inserts a pessary into the vagina to support prolapsed organs. This type of device can help treat various symptoms of pelvic floor dysfunction, either as an alternative to surgery or while a person awaits surgery.
  • Surgery: When prolapse interferes with daily activities, a doctor may recommend surgery. Large rectoceles also require surgery if the person experiences symptoms.

Stem cell therapies

Researchers behind a 2016 study investigated whether a stem cell-based therapy could resolve pelvic floor dysfunction in rats.

The researchers engineered the stem cells to produce and release elastin and collagen into the pelvic floor and injected them into rats with pelvic floor dysfunction.

The elastin and collagen promoted the repair of pelvic floor structures and decreased signs of stress urinary incontinence.

In a final component of the study, the researchers developed stem cells that blocked a factor that stops the production of elastin. This promoted increased production and release of elastin into the pelvic floor.

With further studies, researchers may find that similar therapies are effective in humans.

When to see a doctor

Anyone who experiences painful bowel movements, difficulty urinating or passing stool, pelvic pain, or pain during sexual intercourse should speak with a doctor.

An unusual bulge in the lower pelvic region may also be a reason to see a doctor, though a bulge alone may not be a cause for concern.

People with pelvic floor dysfunction have plenty of treatment options. While the topic may be uncomfortable to bring up with a doctor, it is important to seek professional advice about these symptoms.

While some family doctors may not be familiar with pelvic floor dysfunction, specialists such as colorectal doctors, urologists, and gynecologists can help diagnose the issue and recommend the best course of action.

Summary

Pelvic floor dysfunction can affect anyone, but pregnant women have the highest risk.

The various types of pelvic floor dysfunction stem from different causes, and a doctor must identify the underlying issue before developing a treatment plan.

Exercises can help some people with pelvic floor dysfunction. Depending on the cause, a doctor may also recommend dietary changes, medication, a pessary, biofeedback, or surgery.

A big stress factor that isn’t usually addressed is pre-menopausal or menopause effect on sleep. If you’re 40 or over, you can agree that insomnia is real! This culprit must be addressed. Many women experience sleep problems before and during menopause when hormone levels and menstrual periods become irregular. Often, poor sleep sticks around throughout the menopausal transition and after menopause.

Hormones shift throughout women’s lives, and changes to estrogen, progesterone and other hormones can lead to recurring sleep problems well before the transition to menopause actively begins. You might think that a good night’s sleep is nothing but it becomes a precious commodity once you reach a certain age.

Hot flashes are sometimes referred to as, “personal summers.’ Any woman in this stage of life will tell you that if feels like your body has turned into an oven. Sleeplessness due to menopause is often associated with hot flashes. These unpleasant sensations of extreme heat can happen during the day or at night. Nighttime hot flashes are often paired with unexpected awakenings.

There are changes in the brain that lead to the hot flash itself, and those changes — not just the feeling of heat — may also be what triggers the awakening.

When they happen at night, hot flashes are called night sweats. Some women find that hot flashes interrupt their daily lives. The earlier in life hot flashes begin, the longer you may experience them. Research has found that black women get hot flashes for more years than white and Asian women.

Lifestyle changes to improve hot flashes
Before considering medication, first try making changes to your lifestyle.
If hot flashes are keeping you up at night, keep your bedroom cooler and try drinking small amounts of cold water before bed. Layer your bedding so it can be adjusted as needed. Some women find a device called a bed fan helpful. Here are some other lifestyle changes suggested by research:
• Dress in layers, which can be removed at the start of a hot flash.
• Carry a portable fan to use when a hot flash strike.
• Avoid alcohol, spicy foods, and caffeine. These can make menopausal symptoms worse.
• If you smoke, try to quit, not only for menopausal symptoms, but for your overall health.
• Try to maintain a healthy weight. Women who are overweight or obese may experience more frequent and severe hot flashes.
• Try mind-body practices like yoga or other self-calming techniques. Early-stage research has shown that mindfulness meditation, may help improve menopausal symptoms.

Here is what works for me and my suggestions from a few years of trial/errors, research, doctor’s input, etc:
1. Stop worrying about sleep! Period. It also meant I had to address other areas of my life. Most of what ails us is addressed holistically. As a first born with a type A personality, my default to is to find solutions which means my brain is working constantly. Sometimes, I ponder problems that have not yet been invented. Which also means that I’m not present in the moment. I lived in the future somewhere. However, I’ve learned to pay attention to the Here and Now, and enjoy those in my life circle. I endeavor to Live my best life and not try to fix everything. This helps quiet my mind.
2. It is perfectly okay to give yourself a limited amount of time to ‘stress or fuss’ after which you stop and move on to a mindless activity. Sleep will come.
3. Exercise is my go-to therapy. When I run, I sleep better.
4. Sex is a great precursor to sleep but only after both parties are fully satisfied. If the woman is a passive participant, she’ll have to watch her partner sleep joyfully next to her.
5. I am an avid aromatherapy advocate. We must be consistent in this. It takes a while for your body to acclimate to a particular scent. My scent of choice is lavender because it calms me.
6. I drink chamomile or any relaxing tea at night. This is a staple.
7. I love baths and my doctor suggested I take one before I sleep. I soak in the tub with bath beads, light candle. OR take a shower in the dark but rub your body with aroma oils and inhale.
8. Finally, once in a while, I find my way to my massage therapist, who usually says that my body is knotted up; however after 2 hours or so, I am loose and ready to climb in bed

Lower abdominal pain is pain that occurs below a person’s belly button. Bloating refers to a feeling of pressure or fullness in the abdomen, or a visibly distended abdomen. Sometimes, these symptoms occur together.

Though occasional lower abdominal pain and bloating are common, a person should speak to their doctor if it becomes a regular occurrence. In some cases, this combination of symptoms may indicate an underlying issue that requires medical treatment.

Keep reading for more information on some of the more common causes of abdominal pain and bloating. We also outline various treatment options for this combination of symptoms.

Causes of both abdominal pain and bloating

There are several causes of combined lower abdominal pain (LAP) and bloating. Some relatively harmless, or benign, causes include:

  • consumption of high fat foods
  • swallowing too much air
  • stress

In some cases, LAP and bloating can occur as a result of an underlying medical condition, such as:

  • constipation
  • food intolerances, such as lactose or gluten intolerance
  • gastroesophageal reflux disease (GERD), although this more commonly causes upper abdominal pain-gastroenteritis, which is inflammation of the gastrointestinal (GI) tract that causes vomiting and diarrhoea
  • diverticulitis, which is inflammation or infection of part of the large intestine
  • ileus, which is a condition that slows the function of the small and large intestine
  • delayed stomach emptying, or gastroparesis, which is a complication of diabetes mellitus
  • intestinal obstruction
  • inflammatory bowel disease (Crohn’s disease or ulcerative colitis)

Other conditions that can cause LAP and bloating are specific to females. These include:

  • menstrual pain
  • endometriosis
  • ovarian cysts
  • pelvic inflammatory disease (PID)
  • pregnancy
  • ectopic pregnancy

LAP and bloating can also be due to conditions that do not necessarily affect the stomach, intestines, or reproductive organs. These conditions include;

  • drug allergies
  • side effects of certain medications
  • hernia
  • cystitis, or infection of the urinary tract infection
  • appendicitis, or inflammation of the appendix
  • kidney stones

When to see a doctor

If the cause of LAP and bloating is relatively benign, symptoms should go away within a few hours to days.

A person should see a doctor if:

  • their symptoms last longer than a few days
  • their symptoms begin to interfere with their daily life
  • they are pregnant and are unsure of the cause of LAP and bloating

People should seek immediate medical attention if vomiting or the inability to pass gas occur alongside LAP and bloating.

People who experience LAP and bloating along with one or more of the following symptoms should seek emergency medical attention:

  • sudden worsening of pain
  • fever
  • unusual vaginal discharge
  • bloody stool
  • unexplained weight loss
  • severe nausea and vomiting

Diagnosis

To make a diagnosis, a doctor will begin by carrying out a physical examination. An initial examination will involve applying pressure to the abdomen. This will help the doctor to check the location of pain and to feel for any abnormalities.

A doctor will also make a note of the person’s medical history, and any other symptoms they experience. They may also ask whether there is anything that triggers the pain or makes it worse.

Diagnostic tests, such as urine, blood, or stool tests, may also be necessary. These can help to identify signs of infection or other underlying conditions.

In some cases, a doctor may order one of the following imaging tests to check for abnormalities in the abdomen:

  • ultrasound
  • X-ray
  • CT or MRI

If the imaging tests come back normal, a doctor may perform a colonoscopy for a closer look inside the intestines.

Treatment

The following are some general home treatment options that may help to alleviate symptoms of LAP and bloating:

  • increasing fluid intake
  • exercising to help alleviate gas and bloating
  • taking over-the-counter (OTC) pain medications
  • taking OTC antacids

If home treatments do not work, a person should speak to their doctor about other treatment options. These will vary, depending on the cause of LAP and bloating. However, some examples include:

  • prescription medications to treat pain and bloating
  • antibiotics to help treat a bacterial infection
  • emergency surgery to remove a ruptured appendix

Prevention

There are some steps a person can take to help alleviate LAP and bloating. Two key steps include quitting smoking and avoiding trigger foods.

The following are examples of foods that may cause or contribute to LAP and bloating:

  • high fat foods
  • certain plant-based foods, such as cabbage, lentils, and beans
  • dairy products if a person is lactose intolerant
  • carbonated drinks
  • beer
  • chewing gum
  • hard candy

Also, people may benefit from increasing their intake of high fiber foods such as fruits, vegetables, and whole grains. This will help to prevent constipation and associated bloating.

If an underlying condition is the cause of LAP and bloating, then treating the condition should help to alleviate these symptoms.

Outlook

There are many potential causes of lower abdominal pain and bloating. Some causes are relatively benign and easy to treat, while others may be more serious.

Occasional lower abdominal pain and bloating are usually not a cause for concern. However, people should see a doctor if their symptoms worsen, last more than a few days, or disrupt their daily activities.

People who experience additional symptoms, such as vomiting, fever, or blood in the stool, should seek emergency medical attention.

In some cases, people can prevent lower abdominal pain and bloating by avoiding foods that may trigger these symptoms.

People may have heard that peeing after sex is beneficial, especially for women. This is because peeing flushes bacteria out of the body, which may help prevent a urinary tract from developing.

Here, we look at how peeing after sex may help to prevent urinary tract infections. We also discuss whether there are any other benefits to peeing after sex.

Benefits of peeing after sex

Sexual intercourse is a risk factor for urinary tract infections (UTIs).

During sex, bacteria can pass from the genitals to the urethra.

The urethra is the tube that connects the bladder to the urethral opening where urine comes out. Bacteria can then make its way from the urethra to the bladder, resulting in a UTI.

Peeing after sex helps to flush bacteria out of the urethra, helping to prevent UTIs.

How can it help prevent UTIs?

Females are up to 30 times more likely to get a UTI than males. This is due to two reasons: Firstly, the female urethra is close to the vagina and anus. This means that bacteria can easily spread from these areas to the urethra. Secondly, the urethra is shorter in females than it is in males. This means that bacteria that enter the urethra can reach the bladder more easily.

In women, peeing after sex can help to flush any bacteria away from the urethra.

For males, peeing after sex is less important. This is because males have a longer urethra. As a result, bacteria from the genital area is less likely to reach the bladder.

Although there is no solid evidence to confirm that peeing after sex can prevent UTIs, there is no harm in following this practice. It may help to reduce the risk of UTIs, especially in women and people who are more prone to UTIs.

Does it prevent pregnancy?

Peeing after sex will not prevent pregnancy. The urethra and vagina are separate parts of the female anatomy. As a result, peeing will not affect any sperm that enter the vagina. Using some form of birth control is the only way to prevent pregnancy during sex.

Does it prevent STIs?

Peeing after sex does not prevent sexually transmitted infections (STIs). People contract STIs by absorbing bacteria through the mucous membranes inside their bodies during sexual intercourse. Peeing after sex will not prevent these bacteria from entering the body.

Using a condom or other form of barrier contraceptives during sex can help to reduce the risk of STIs.

How soon after sex should you pee?

There is no recommended time to pee after having sex, although some anecdotal sources suggest peeing within 30 minutes after sex. In general, the sooner people pee after sex, the sooner they can flush out bacteria before it travels up the urethra.

If people are struggling to pee after sex, drinking a glass or two of water may help. A larger amount of urine will also be more effective in flushing out bacteria.

Other ways to prevent UTIs

The following tips may also help to reduce a person’s risk of getting a UTI:

  • drinking 8-10 glasses of water each day to ensure regular flushing of bacteria out of the urethra
  • peeing whenever the urge arises, rather than holding in urine
  • avoiding going more than 3 or 4 hours without urinating
  • always wiping from front to back after going to the toilet
  • cleaning the genitals with warm water each day
  • avoiding using scented female hygiene products
  • avoiding douching
  • avoiding using spermicides if prone to UTIs
  • wearing loose cotton underwear
  • avoiding tight clothing
  • avoiding staying in wet bathing or workout clothes that can trap moisture and harbor bacteria around the genitals
  • limiting baths to 30 minutes or less, or taking showers
  • drinking cranberry juice or taking cranberry extracts

When to see a doctor

People should see a doctor if they experience the following symptoms of a UTI:

  • painful or burning sensation when urinating
  • feeling the need to urinate often, despite passing only a small amount of urine each time
  • cloudy urine
  • foul-smelling urine
  • blood in the urine
  • pressure or pain in the lower abdomen
  • feeling tired, weak, or shaky
  • confusion

If people have a UTI, a doctor will likely prescribe antibiotics to clear the infection. People will usually start feeling better within a few days.

In some cases, a UTI can make its way up to the kidneys. A kidney infection can be severe and requires immediate medical treatment. Symptoms of a kidney infection include:

  • a fever
  • chills
  • nausea
  • vomiting
  • pain in the lower back

People should also see their doctor if they notice any unusual or painful symptoms during or after sex. These could be symptoms of an STI.

Summary

Peeing after sex may help to flush bacteria out of the urethra, thereby helping to prevent a urinary tract infection (UTI). It may be especially helpful for women, or people who are prone to UTIs.

However, peeing after sex will not prevent pregnancy or sexually transmitted infections (STIs).

People should see a doctor if they experience symptoms of a UTI or STI. Some people may require treatment with antibiotics.