If so, be especially carefully with your weight gain during pregnancy.

Women who were habitual dieters before they became pregnant have a tendency to gain more weight during their pregnancy than those women who maintained a healthy weight without dieting. Researchers have found that women who were yo-yo dieters or “weight cyclers” on average gained an additional five extra pounds throughout their pregnancy than non-dieting women. A possible explanation for the additional pregnancy weight gain is that the repeated dieting and eventual overeating could distort the ability to know when you’re full.

So if you’ve been known to diet regularly before you became pregnant, be extra careful not gain those additional pounds. Obstetrics and gynecology experts recommend that 40 pounds should be the maximum prenatal weight gain. Gaining more than 40 pounds during your pregnancy can increase your risk for having a too heavy baby, along with other discomforts during pregnancy including lower back pain and problems sleeping.

Follow these tips to help you stay within the recommended prenatal weight gain:

Know How Much You Weigh & Follow Your Total Weight Gain

Even though the numbers start looking scary and you’re entering new heights you’ve never experienced or surpassed before, keep your eye on them. Getting on the scale backwards at the doctor’s office and not following your monthly weight gain can mentally allow you to be more lax about the foods you’re eating and the amount of exercise you’re getting.

Don’t Increase Your Caloric Intake in the 1^st Trimester

A woman who is at a normal weight (not underweight, overweight or obese) does not need any extra calories during her first trimester of pregnancy.

Remember You’re Not Really Eating For 2

During the 2^nd and 3^rd trimesters, a normal-weight pregnant woman needs an additional 300 calories per day. That’s not a lot. Drinking an additional one cup of skim milk per day already increases your caloric intake by 100 calories.

Choose Foods That Deliver the Goods

Nutrient dense foods have fewer calories and have the nutrients to support your baby’s proper growth and development. Examples include yogurt, spinach, whole grains, lean beef and chicken; a healthy combination of which contain protein, iron and calcium – all things you and your baby need. And do strive for variety in your diet. Along with your daily prenatal vitamin, choose from an assortment of foods to ensure you and your baby are getting the best balanced prenatal nutrition you need.

Don’t Eat Empty Calories

I know, pregnancy cravings are tough to ignore. And ignoring your sweet tooth or denying your fried food fix isn’t necessarily always the best idea. There’s not secret: the key is moderation. Eating a limited amount of foods high in fat and calories such as desserts will ensure you’re not feeling deprived – and it will also help you to not be tempted  to overeat in the long run.

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Premature ovarian failure is a term describing failure of the ovaries to function normally in a woman under the age of 40. Other names for the problem are primary ovarian insufficiency, or hypergonadism. The failure to function normally is not to be confused with menopause.

Premature Ovarian Failure Symptoms

• Irregular menstrual periods
• Infertility
• Low libido
• Painful intercourse
• Dry vagina

Diagnosing Premature Ovarian Failure

• Irregular menstrual periods
• Absence of menstrual altogether
• A blood test to measure follicle stimulation hormone

Causes of Premature Ovarian Failure

The cause is not clear, but for some reason the follicles in the ovaries cease to mature into eggs. If the follicles have a problem, they also stop forming the hormone estrogen, which is necessary for a woman’s good health. One of two scenarios may occur. A woman with follicle depletion has no follicles left and there is no way to make more. Or, the woman’s follicles do not mature into eggs.

Premature ovarian failure may be genetic. Somewhere between 10% to 20% for the woman who have the condition also have family members with the same problem. Other health problems created by premature ovarian failure are:

• Osteoporosis – Loss of bone density and strength. Getting enough exercise, vitamin D, and calcium can help reduce this risk.
• Addison’s disease – An autoimmune disorder in which the body has trouble handling physical stress, such as injury or illness, because of problems with the adrenal glands. About 3.2% of the women with premature ovarian failure also have Addison’s disease. This disease can be very dangerous, especially for women who do not realize the have it. Addison’s disease is not curable, but it is treatable.
• Low thyroid function – Affects metabolism and energy levels. This can be treated by replacement of the thyroid hormone.
• Heart disease – Reduce this risk by getting enough exercise, eating a healthy diet for weight control, and getting estrogen replacement therapy.

It is important to know that women who are carriers for the gene for Fragile X syndrome, or have the premutation for it, are more likely than other women to get premature ovarian failure. If you are a Fragile X carrier, or have the premutation, it is very important to get tested for Premature Ovarian Failure.

Premature Ovarian Failure Treatment

There are no treatments for Premature Ovarian Failure. Once the follicles cease to mature into eggs, there is no way to reverse the problem. However, there are treatments that can help some of the symptoms.

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• Couples who have been trying to get pregnant for a year or more, but have been unsuccessful (this applies to women age 34 and under)
• Couples who have been trying to get pregnant for 6 months or more and are age 35 and older
• Women who have uterine fibroids
• Women who have endometriosis
• Women who have amenorrhea (irregular menstrual cycles or no cycle at all)
• Women who have had more than one miscarriage
• Women who have had a stillbirth
• Women or men who have certain genetic conditions

Fertility Testing

How can fertility be tested? Of course you must see your doctor in order for fertility to be tested. Usually the first tests focus on the man. A sample of the man’s sperm is tested for shape, mobility, and quantity. Blood tests are usually taken from both the woman and the man to check hormones, and to check for any infection. These tests on the male can include:

• A test to see if the sperm can swim through mucus (called a mucus penetrance test)
• An x-ray of the mans reproductive organs
• A hamster-egg penetrance assay (to see if the sperm can penetrate a hamster egg cell, similar to penetrating female egg cells)

The first consideration for the female is determining if her menstrual cycle is regular and if ovulation is actually occurring.

There are a few ways to determine whether you are ovulating:

• By using a home ovulation kit (available at a pharmacy) to chart changes in her morning temperature.
• Examination of her cervical mucus which changes throughout her cycle
• Ultrasound of her ovaries
• Blood tests for hormone levels

If no problem is found with the woman’s ovulation, other tests can be done:

• An exam of the fallopian tubes for disease
• An exam to verify the fallopian tubes are open
• An exam of the uterus to check its shape and position, or disease
• An exam of other reproductive organs for infection or disease
• A biopsy of the uterine lining

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• If you believe you or your partner have fertility problems, talk with your doctor right away. Even if you are not planning pregnancy at the present time, age is an important issue in treating infertility, and you will be better off if you plan ahead.
• If you have been having unprotected intercourse for a year or more, and you are under the age of 35, and have been unsuccessful, it is time to see your doctor.
• If you have been having unprotected intercourse for 6 months or more, and are 35 years old or older, it is time to see your doctor.
• Or, as mentioned above, if you think you or your partner may have a fertility problem and plan to get pregnant in the future, consult with your doctor so you know what steps you can take now for a successful future pregnancy.

There are many ways to treat infertility. In some cases a prescribed medication may do the trick. Assisted reproductive technology (ART) has several procedural options for positive outcomes. Intrauterine insemination, either with your partner’s sperm or a donor’s sperm, has produced thousands of pregnancies. In some cases, a surgery may be needed. You just won’t know until you are tested which options are best for you.

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It is not uncommon to have trouble becoming pregnant or to experience infertility. Infertility is defined as not being able to become pregnant, despite trying for one year, in women under age 35, or after six months in women 35 and over. Or for men who are unable to impregnate a woman after at least one year of trying.

In women, the term is used to describe those who are of normal childbearing age, not those who can’t get pregnant because they are near or past menopause.

Women who are able to get pregnant but who cannot carry a pregnancy to term (birth) may also be considered infertile.

What causes infertility?

Infertility does not have a single cause because successful pregnancy is a multi-step chain of events.

Simply described, pregnancy includes the following steps: A woman’s ovaries must be able to release a viable egg, which then must be able to travel down the fallopian tube. The man must be able to ejaculate, and his sperm must be able to travel to the fallopian tube. The sperm and egg must unite to fertilize the egg. The fertilized egg must attach to the inside of a receptive uterus (or implant) and be nurtured by the body to allow the fetus to develop and grow until it is ready for birth.

Problems with any of these steps can lead to infertility.

The cause of infertility can rest in the woman or the man, or can be from unknown factors or a combination of factors. In some cases, environmental factors can contribute to infertility. In other cases, genetic conditions or other health problems are the main cause of infertility.

Reasons for infertility may include:

• Your age
• Female Infertility or health problems in women
• Male infertility or health problems in men

Treating Infertility

Infertility CAN be treated. Treatments include:

• Drugs
• Surgery
• Assisted Reproductive Technology (ART)
• In Vitro Fertilization (IVF)

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Amenorrhea is the absence of a menstrual period.

• Primary amenorrhea is when a young women has not yet had her menstrual period by age 16.
• Secondary amenorrhea is when a women has had her menstrual periods but stopped for at least 3 months. This includes pregnancy.

Signs of Amenorrhea

• Of course the main sign of having amenorrhea is not having a period for 3 months
• Amenorrhea is expected during pregnancy. But regular periods when you are not pregnant is a sign of good health. If you miss a couple of periods, and you are not pregnant, see a doctor. Anything that may be going wrong is best dealt with as soon as possible.

Causes of Amenorrhea

Primary Amenorrhea Causes

• Chromosomal or genetic abnormalities can cause the eggs or follicles to deplete too early in life.
• Problems with reproductive organs, hypothalamic problems, or a malfunctioning pituitary gland can be the cause
• Eating disorders, such as anorexia or bulimia can cause amenorrhea
• Excessive exercise
• Extreme physical or mental stress, or a combination of the two

Secondary Amenorrhea Causes

• Pregnancy
• Breastfeeding
• Some medications
• Some contraceptives
• Hormonal problems involving the hypothalamus, ovary, adrenal glands, thyroid, pituitary gland
• Extreme mental or physical stress
• Low body weight, or eating disorders

Treatment for Amenorrhea

Treatment for amenorrhea depends on its cause. If stress, weight, or physical activity is the cause, a change in lifestyle can solve the problem. In other cases, medication can be the answer. For more information, talk to your doctor.

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Most cases of infertility in women result from problems with ovulation.  Some conditions affecting ovulation include premature ovarian failure, in which the ovaries stop functioning before natural menopause, and polycystic ovary syndrome (PCOS), in which the ovaries may not release an egg regularly or may not release a viable, healthy egg.  Among women who have PCOS, even when a healthy egg is released and fertilized, the uterus may not be receptive to implantation of a fertilized egg, which results in infertility.

Other causes of infertility might include:

• Blocked fallopian tubes due to endometriosis, pelvic inflammatory disease, or surgery
• Physical problems with the uterine wall
• Uterine fibroids

A woman’s risk for infertility can also be affected by certain lifestyle and environmental factors, including (but not limited to):

• Age
• Stress
• Poor diet
• Being overweight or underweight
• Smoking, drugs, and alcohol
• Medication
• Environmental toxins
• Genetic conditions, such as being a carrier of Fragile X syndrome
• Other health problems, such as sexually transmitted diseases

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Like female infertility, male infertility can result from physical problems, such as testes that don’t make enough normal sperm, hormonal problems, and lifestyle or environmental factors, including (but not limited to):

• Age
• Stress
• Exposing the testes to high temperatures, which can affect the ability of the sperm to move and to fertilize an egg.  For instance:
  • Cryptorchism is a condition where the testes do not descend into the scrotum.  Although it does not usually affect the ability to have and sustain an erection, cryptorchism means that the testes are still inside the body cavity, which has a higher temperature than the external scrotum.
  • Tight underwear-For some men, wearing tight underwear can also increase the temperature of the testes.
• Smoking, drugs, and alcohol
• Medications
• Environmental toxins
• Genetic conditions, such as Klinefelter syndrome
• Other health problems

But, in some cases, health care providers cannot determine a cause for infertility in the man or woman. In addition, some known causes of infertility do not have any treatments

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Here are some ways to take care of yourself before you get pregnant:

• Eat healthy foods, exercise regularly (30 minutes per day most days of the week is best), and get enough rest and sleep. Talk to your doctor about what kinds of food and exercise are best for you.
• Get 400 micrograms (mcg) of folic acid (one of the B vitamins) every day. The best way to do this is to take a daily multivitamin with this amount of folic acid. Getting enough folic acid every day before you get pregnant and during early pregnancy can help prevent certain birth defects. Many breakfast cereals and other grain products are enriched with folic acid. But only some products contain 400 mcg of folic acid per serving. Always check the labels to be sure you’re getting your daily dose.
• See your doctor for a complete check up. Make sure that you’ve had all your shots, especially for rubella (German measles). Rubella can cause serious birth defects. Chickenpox can also be dangerous during pregnancy. If you’ve had chickenpox and rubella in the past, you should be immune to them.  If not, talk to your doctor about the vaccines.
• Tell your doctor about any prescription or over-the-counter medicines (including herbal remedies) you are taking. Some medicines are not safe to take during pregnancy.
• Stop smoking cigarettes, drinking alcohol, or taking drugs. Ask your doctor for help. Members of your faith community, counselors, or friends can also give support.

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HRT, sometimes called estrogent replacement therapy or ERT, refers to a woman taking supplements of hormones such as estrogen alone or estrogen with another hormone called progesterone (progestin in its synthetic form). HRT replaces hormones that a woman’s body should be making or used to make.

Why would a woman take HRT?

Estrogen and progesterone normally regulate a woman’s menstrual cycle and reproductive health. Estrogen is also important for bone health.

Generally, health care providers prescribe HRT for two groups of women:

• Women going through menopause and who had already gone through it (called post-menopausal) – the natural levels of these hormones drop during menopause. This drop can lead to symptoms such as hot flashes, night sweats, vaginal dryness, and sleep disturbances. HRT may be used to help lessen some of these symptoms
• Women with certain health conditions – in some cases, women’s bodies don’t make normal levels of the hormones because of a medical problems, such as premature ovarian failure.  For these women, HRT replaces the hormones that their bodies should be making.

What are the risks of HRT?

The risks of HRT differ depending on the health status of the woman taking it, and on the type of HRT.

Risks for healthy menopausal and post-menopausal women

The NIH conducted the Women’s Health Initiative (WHI) trial to learn about the risks and benefits of continuous estrogen+progestin HRT for post-menopausal women.

• In one arm of this trial, researchers found that healthy post-menopausal women who took the therapy were at increased risk of invasive breast cancer, coronary heart disease, stroke, and blood clots. There were also benefits of estrogen plus progestin, including fewer cases of hip fractures and colon cancer.
• Because the harm of HRT for healthy post-menopausal women in this trial was greater than the benefit, the researchers stopped the trial.
• In light of the findings, the U.S. Food and Drug Administration noted that even though HRT effectively lessened some menopause symptoms in healthy post-menopausal women, it carried serious risks. Women should discuss the potential benefits and risks of HRT with their health care provider. The FDA recommends HRT for post-menopausal women be at the lowest doses for the shortest amount of time to reach treatment goals.

Risks of HRT for pre-menopausal women with certain health conditions

Women whose bodies have stopped making estrogen or don’t make enough estrogen often take HRT to reduce symptoms and maintain overall health.

• For instance, low estrogen levels in women with premature ovarian failure put these women at risk for osteoporosis and heart disease.  HRT helps maintain bone health and reduce the risk of heart disease.
• In these cases, HRT is actually replacing hormones that the women’s bodies should be making-hormones that they need for their overall health.
• HRT taken by women with certain health conditions is different than that taken my post-menopausal women.  The risks associated with post-menopausal HRT do not apply to pre-menopausal women taking HRT.

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