What Is Your Wedding Health IQ?
Posted on February 10, 2015
Are you recently engaged, about to get engaged or the mother of the bride? Perhaps you have a big role to play in an upcoming wedding or event. As a bride-to-be myself, here are some top medical tips and information on how you can be your best and healthiest self on your big day from head to toe … and from inside out! Think of this as your wedding health checklist.
If you don't already have a good skin routine, now is the right time to start. Evaluate your skin to determine if it is oily, dry or a combination. You will want to invest in good moisturizer and under eye cream for those long nights agonizing over your guest list. If your skin tends to break out a lot, consider contacting a dermatologist who can help you with prescription medications to make your skin glow on your big day.
If you have cystic acne, some brides choose to start isotretinoin (Accutane) a year to six months before their wedding. This medication must be monitored by a physician as you must be using two forms of birth control while on it as it can cause birth defects if you are taking the medication while you are pregnant. However, Accutane is the only known cure for cystic acne. The medicine clears out of your system fast, and after a six month treatment, you are safe to attempt pregnancy after one full menstrual cycle. You also need to have your cholesterol levels and liver function tested periodically during your treatment.
You would not want to experiment with new medications close to your wedding date, so set up an appointment earlier rather than later. Dermatologists tend to book far in advance, so call today if you don't love the look and feel of your skin.
Avoid Tanning Beds
Although tempting, you should definitely avoid tanning beds. Just one indoor tanning session increases users' chances of developing melanoma by 20%, and each additional session during the same year boosts the risk almost another 2%. If you desire more color, budget for self-tanning lotion and use at least one month before the wedding to ensure you can apply it correctly without getting streaks or blotches.
If you wear glasses or contacts now is a good time to schedule your annual eye exam. You want to make sure that you can clearly see your soon-to-be hubby (or partner) dancing with his buddies from across the room. This is especially important if you are prone to wearing your disposable contacts for longer than prescribed, or you use expired contacts. When expired, contact lenses lose their protein permeability (for elements like oxygen) and can dry out, causing your eyes to suffer from lack of oxygen and lubrication and this can lead to:
- weaken your eye sight over time
If you have diabetes or take medications that require yearly exams, this is also a good time to schedule your eye exam. Medications that require patient to schedule routine eye exams include:
- Hydroxychloroquine (plaquenil)
Isotretinoin can also rarely cause acute loss of night vision, so contact your doctor if you experience this. If you are on any diabetic medications, you should be seen for a dilated retinal exam yearly.
It's not too early to start thinking about what kind of hairstyle you want for your wedding. If your hair is thinning or falling out, have your doctor check your levels for the following:
- Vitamin D
Over the counter Rogaine HP foam can be used, but for a noticeable change it must be used for at least six months and you should see a physician in advance.
Female Hair Loss
Female pattern hair loss (FPHL) is common in postmenopausal women. Contact a hormone specialist as hormone therapy if indicated, may be helpful. Compounded, unregulated topical testosterone use can also lead to hair thinning as well.
If excessive facial hair is bothersome, your doctor many consider undergoing a hirsutism workup. Polycystic ovaries are one common endocrine cause for hirsutism, and often respond well to the following:
- weight loss
- hormonal contraceptive therapy
The workup includes evaluating for signs of hyperandrogenism, and your doctor may order testosterone and DHEAs levels to see if these are elevated. Otherwise, if it is very bothersome and you do not have polycystic ovaries, sprinolactone may be used to help decrease facial hair, but cannot be used if you are trying to get pregnant as this medication can lead to birth defects.
Onychomycosis refers to nail infections caused by any fungus, including yeasts and molds. You may have one or several nails or toenails that may be affected. It can cause some discomfort, but is usually more of a cosmetic issue. It can be treated for cosmetic reasons, but must be treated in patients with a history of cellulitis or long standing diabetics with risk factors for developing cellulitis. Unfortunately, topical treatments and even oral treatments are often ineffective and are associated with recurrence of the nail fungus.
Topical solutions include amorolfine and ciclopirox, but again are often ineffective due to poor penetration into the nail bed. Oral treatments include terbinafine and itraconazole. Of note, if this is a concern, you will want to start treatment early, as results can take up to a full year to see. Also, you must have close follow up with a doctor as this treatment can have potential interactions with your other medications, and your liver studies must be followed periodically while taking these medications.
Take note of how you want to look and feel on your wedding day. Everybody is different and you should not aim for an unreasonable goal or to match up to society's high standards of beauty on your wedding day. Do what feels right for you.
Science suggests that the best diet for sustained weight loss is the Mediterranean diet, full of healthy fats such as:
- olive oil
- lean meats
If you are looking to start a new exercise plan, why not start one with your future partner? See my other article, Best Exercises for Women, for tips and advice on exercise.
Remember, the key to weight loss truly is diet, but can be supplemented with exercise for all its added health and emotional benefits.
Emotional Health and Reducing Stress
Emotions can be high when planning your big day. Even though you want everything to go perfectly, it is important to realize that not all factors are controllable. Differing opinions from friends, family, in-laws and your spouse-to-be can all factor into higher stress. It is important to keep the big event in perspective, to delegate and to enjoy the process. Simplify plans as much as you can and you may want to consider hiring a wedding planner. You and your partner should sit down as a couple along with family and loved ones well in advance to outline your goals and plans.
Post Wedding Fertility Issues
Many newlyweds are excited to start a family after the stress of the wedding. Some couples want to wait or may not want to have children. Remember, pregnancy can happen without contraception so if you prefer to wait for a family or don't want children, ask your doctor about starting on contraception.
Long acting reversal contraception has been shown to be the most superior form of birth control. This includes the Intrauterine Device (or IUD) or the implanon device. Both can last for several years and their advantages include not having to remember to take a pill daily or not having injections.
The IUD is also beneficial if you have heavy or painful menstrual bleeding, and sometimes helps with heavy bleeding and endometriosis. In contrast to some myths about the IUD, it can be used in a woman who has never been pregnant, and does not cause infection. In fact, most women love their IUDs and they are the most commonly used contraceptive option amongst female OB-GYNS. They are also useful during perimenopause to help stop erratic bleeding. Other contraceptive options include:
- Birth control pills
- The Patch
- Nuva Ring (link to birth control tx guide)
These are all contraindicated if you are over 35 years of age and smoke, have a clotting disorder or have any contraindication for taking estrogen. Barrier methods, such as diaphragms and condoms, are used less frequently as they are associated with higher failure rates.
First note, if you are just coming out of some form of birth control, there may be a timing effect. IUDs don't stop ovulation (they work by increasing cervical mucus and making the uterus toxic to sperm) and you can become pregnant immediately after it is removed.
If you have been on depo-provera, it may take time for you to ovulate again. As a rule, you may need to wait some time to restore your hypothalmus-pituitary-ovarian axis (or HPA axis) and start ovulating, especially if you have been using it for a long time.
If you have been on hormonal contraceptives, the timing to when you ovulate again can vary. Some women's HPA access kicks in shortly after stopping and for some women it takes longer.
An easy way to tell if you are ovulating is to start a menstrual calendar. If your period becomes regular in any interval, you are likely ovulating. The best time to try and get pregnant is to count backwards 14 days from the start of your menstrual cycle.
If you have not become pregnant in one year (after your periods become regular) you qualify to be seen by a fertility specialist. If you are over the age of 35 and have not become pregnant in six months it is preferable that you see a fertility specialist due to lower rates of fertility starting at age 35.
Remember to start prenatal vitamins early especially, folic acid/folate as this helps ensure normal levels at the time of contraception. The brain and spinal cord of your baby begins before you even know you are pregnant. Also, remember to stop smoking if you are a current smoker as this can cause your baby to be small or possibly delivered early. It's also time to stop all alcohol use to an effort to prevent fetal alcohol syndrome.
If you and your new partner are off celebrating your new union, vaginal infections are not uncommon. Most are not medically concerning, but can be annoying and frustrating.
One of the most common vaginal conditions is bacterial vaginosis (BV), a common cause of benign discharge due to an overgrowth of normal vaginal flora. Typically, there is copious white or clear discharge that may have a fishy odor. Do not douche. You can use over the counter repHresh vaginal gel, which lowers the vaginal pH and helps keep BV and yeast away. You may want to pack some repHresh gel on your honeymoon. BV is treated with antibiotics and your gynecologist can do a simple vaginal swab to detect it.
A yeast infection is also common, and typically there is a white clumpy discharge that may take on a typical 'cottage-cheese' appearance, and is often odorless. This is often treated with once daily dosing of an antifungal or over the counter anti-yeast creams. Note that these conditions often co-exist together and if you don't get better you need to see a health care practitioner for an exam.
Urinary Tract Infection
A urinary tract infection is also not uncommon post-honeymoon, due to sexual activity pushing bacteria up the short urethra. Be sure to urinate before and after any sexual activity and see your doctor if you have signs or symptoms such as:
- painful urination
- urinating frequenctly
- urination urgency
If you are prone to post sexual activity bladder infections, you may want to carry prophylactic antibiotics with you. Women can self-treat for uncomplicated bladder infections as long as they have previously seen a physician, are not pregnant or not diabetic.
Overall, enjoy your big day! If you start now, you will be your healthiest and happiest as you shine at the start of this new chapter in your life.
Be Strong. Be Healthy. Be in Charge!
-Heather Foreman, MD
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