A. You’re most fertile at about the midpoint of your menstrual cycle. In a regular 28-day cycle, that would be about two weeks before your period starts. Of course, since most menstrual cycles aren’t perfectly regular, it’s hard to predict this timing in real life. The midpoint of the cycle is when an egg is released from one of your ovaries into one of your fallopian tubes, through which it travels toward your uterus. Right around this time, from just before the release of the egg to the time when it arrives in your uterus, is when you’re most likely to get pregnant. You’re least likely to get pregnant during menstruation, when the egg is being flushed from the body. However, it’s important to remember that you can get pregnant anytime, even during your period.
A. During pregnancy, the uterus is completely focused on protecting and nourishing the growing fetus. It sends out a sort of “busy signal” and can’t receive eggs as usual. Your body stops ovulating and shedding the lining of the uterus. As a result, you don’t have your period. After your baby is born, your body’s natural cycle of ovulation returns and your period returns as well.
A. Soon after childbirth, your body will readjust, ovulation will kick right back in and your menstrual cycle will return. For some women, this happens only weeks after giving birth; for others, it takes months. Rest assured that even though pregnancy is a very complicated process, most women’s bodies recover quickly.
A. During pregnancy, the fetus is pushing down on your bladder. Laughing, coughing and/or sneezing can cause small amounts of urine to leak out. This is called stress incontinence. Although a temporary condition, stress incontinence due to pregnancy can continue after you give birth until weakened pelvic muscles become stronger.
A. No need to worry, normal vaginal discharge, known as leucorrhea, is more common during pregnancy. While leukorrhea is normal for all women, pregnant women often notice increased leukorrhea. This discharge is usually whitish in color and has a mucous-like consistency.
A. You should alert your doctor. During pregnancy and after delivery, some women may experience a small amount of “spot” bleeding. If you experience this kind of bleeding, notify your OB/GYN immediately, just to make sure there is nothing to be concerned about.
A. Urinary incontinence is an inability to hold your urine until you get to a toilet. Women experience incontinence twice as often as men, due to factors such as pregnancy and childbirth, menopause, and the structure of the female urinary tract. Older women experience incontinence more often than younger women, but incontinence is not inevitable with age.
The body stores urine—water and wastes removed by the kidneys—in the bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body. During urination, muscles in the wall of the bladder contract, this forces urine out of the bladder and into the urethra. At the same time, sphincter muscles surrounding the urethra relax, letting urine pass out of the body.
Two structures that help keep urine in the bladder are the pelvic floor muscles and the urethral sphincter.
The pelvic floor muscles support the vagina, urethra and other organs in the pelvis. When the pelvic floor muscles are strong, the urethra and bladder cannot move out of place. This helps keep the urethra closed, so urine cannot leak from the bladder.
The urethral sphincter is a band of muscles around the urethra. When these muscles are strong, they squeeze tightly and keep urine in the bladder. When you want to urinate you can relax these muscles.
Incontinence in women usually occurs because of problems with pelvic floor muscles—which can be damaged during childbirth—or problems with the urethral sphincter.
Urinary stress incontinence and urge incontinence are the two most common types of incontinence in women. When these two conditions occur together, doctors may use the term "mixed incontinence."
- Urinary Stress Incontinence — If coughing, laughing, sneezing, or other movements that put pressure on the bladder cause you to leak urine, you may have urinary stress incontinence. Physical changes resulting from pregnancy, childbirth, and menopause often cause urinary stress incontinence. It is the most common form of incontinence in women and is treatable.
- Urge Incontinence — If you lose urine for no apparent reason while suddenly feeling the need or urge to urinate, you may have urge incontinence. The most common cause of urge incontinence is inappropriate bladder contractions.
If you experience urinary incontinence, whether it's urinary stress incontinence or urinary urge incontinence, the important thing to know is that incontinence is treatable and often curable at all ages. So even though you may feel embarrassed, discuss the problems you are having with your doctor.