Dr. Lori Gore-Green | Women's Health Professional

Dr. Lori Gore-Green's Portfolio of Experience as a Women's Health Professional

9 Tips For Pregnant Women Encountering Mental Health Difficulties

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9-Tips-For-Pregnant-For-Women-Encountering-Mental-Health-Difficulties-Dr.-Lori-Gore-GreenBehavioral symptoms, such as anxiety and depression, uniquely impact pregnant women, who experience the complication and the effects of postpartum depression before they even give birth.  For this reason, conversations about mental health and pregnancy should be held early and often.

Some women go through their entire pregnancy without experiencing morning sickness, swollen feet, and troubled sleeping. However, many don’t escape pregnancy without experiencing pre-baby anxiety. The stress and the “what ifs” can be overwhelming. Lancet Psychiatry published a report in 2015, which stated that two-thirds of mothers with severe depression experienced mood shifts during their pregnancy ahead of postpartum depression. Maternal depression isn’t the same for all women. Approximately 20 percent of mothers experience depression or anxiety after giving birth. Those findings also linked postpartum depression biological triggers and dramatic dips in hormone levels.

There are nine things every pregnant should know about maternal depression and the importance of focusing on mental health during pregnancy:

Document Your Emotional Responses

Pregnant women should take their feelings seriously, and track them. If you notice that you’re feeling sad more often than not, or you feel extremely worried, relay that information to your therapist, doctor, or midwife.

Depression is Blameless

Perinatal mood disorder can be a challenge, and often pregnant women want to blame themselves or their partners for these emotional obstacles, but it’s no one’s fault. There are a number of factors that contribute to pregnancy-related mood shifts.

You’re Not The Only One

Too many women believe they’re the only ones struggling with mental health symptoms, which are some the most common complications of childbirth. The stigma surrounding maternal depression often means that women are too embarrassed to seek out health. Convinced that they should be overjoyed with the prospect of motherhood, sometimes fail to tell others when that they’re struggling.

Seek Treatment Sooner

Therapy can help to ease stress and manage mood disorders. Choosing to deal with one’s mood disorders sooner will ultimately improve your piece of mind, and it will enhance the bonding between you and your child.

Treatment Will Benefit the Baby

Depression and anxiety never simply affect one person, and this is particularly true depressive episodes are affecting a pregnant person. It’s challenging to be a mother, so seeking treatment means that your child won’t have to deal with the emotion and sadness that might could put both you or your child at risk.

Treatments Work

Frank conversations with your primary care physician and your therapist can alleviate anxiety and perinatal depression. It can also help to create a sense of balance and offer an understanding of what balance may look like for a woman in her new life.

You’ll See Progress

If you’re as serious about your mental health as you are about your impending motherhood, you’ll find that you feel better after just a few session. Of course, everyone is different. Even if it takes a bit longer for your mood to improve, know that progress is on the horizon. Take medication appropriately and stay committed to your sessions.

Support Groups, Also

While some women choose isolation, others find strength in knowing that others are going through the same thing. Support groups are incredible because offer a supportive network of like-minded individuals who also need to know that everything in their lives will be okay.

Find Support Online

The internet is great for things outside of news, online shopping, and cyber stalking exes, it’s also a great resource for individuals seeking out others for support.

Online, you’ll find countless resources for mental health and pregnancy wellness. Some things you’ll want to do are to hydrate, do abdominal exercises, eat a well-balanced diet, educate yourself on mental health, take your vitamins and supplements, and rest appropriately.

 

Contraception Fails: Plan B One-Step Users Weighing 165+ May Require Plan ‘C’

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Dr. Lori Gore-GreenWhen your initial choice of contraception fails, Plan B is expected to be work…however, a ‘plan c’ may need to be devised for women weighing 165 pounds or more.

New research suggests that the most popular emergency contraceptive, which is a morning-after pill that uses the hormone levonorgestrel that prevents ovulation, is less effective for women weighing more than 165 pounds. However, one should bear in mind that the average weight of the American woman is 162 pounds during her 20s. During her 30s, the American woman weighs about 169 pounds.

Likewise, European-made Norlevo, a morning-after pill, loses effectiveness for those weighing 165 pounds. Furthermore, it’s isn’t at all effective for women weigh more than 175 pounds. Despite the fact Norlevo is chemically identical to the U.S.-made Plan B, the Food and Drug Administration has insisted the data was inconclusive, warranting no warning here in the U.S.

Alison Edelman, a professor in the Department of Obstetrics and Gynecology at the Oregon Health and Science University, lead a new study that analyzed the effectiveness of levonorgestrel-based contraceptive among women with a BMI within the normal range, comparing that to the BMI of women considered obese. It was discovered that it would take twice the dosage of Plan B to increase an obese woman’s hormone level of women weighing less than 160 pounds. However, taking two pills for the purposes of emergency contraception isn’t recommended yet, according to Elizabeth Dawes Gay of Women’s Health Magazine. The ovulation-inhibiting hormone could be doubled, but more test would need to be done before learning what how those hormones may affect a woman’s ovaries.

Plan B is emergency contraception that’s generally effective and safe, and it’s a backup plan that helps to prevent pregnancy with 72 hours following birth control failure, preventing 7 out of 8 potential pregnancies. Side effects of the pill are tiredness; a headache; dizziness; breast tenderness; vomiting; lower abdominal pain/cramps; and lighter, heavier, later or early periods. The FDA-approved emergency contraception is accessible over the counter, and should not be considered if you’re already pregnantΩ and shouldn’t be used as birth control.

Medical Screenings & Tests Save the Lives of Women

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Dr. Lori Gore-GreenWomen benefit from routine medical screenings, which are necessary for maintaining a healthy lifestyle.

Women, as well as men, encounter gender-specific testing that acts as a tactical preventative step for ensuring they’re in tune with their personal health. There are a number of important tests and screenings women should submit themselves to, so that they stay abreast of diseases or conditions that threaten their long-term health, such as exams that screen for breast, lung, cervical, skin, colon, endometrial, and ovarian cancers.

Cervical Cancer: Health care professionals ask that women receive pelvic examinations as early as 21-year-old, or earlier if a woman is sexually active. Pap smear testing is instrumental for discovering if cancerous cells are present on and/or around the cervix, which could suggest cervical cancer. The general consensus is that women age 30 and older should receive pap smears every three years if they had no abnormal tests in the past. However, women who have abnormalities should chat with their gynecologist with regards to how frequently they should be tested for cervical testing.

Breast Cancer: Woman and men alike can develop breast cancer, but women face a greater risk of falling victim to cancer that develops from breast tissue. Approximately one-in-eight women in the U.S. will develop invasive breast cancer at some point in her lifetime, according to BreastCancer.org. The sooner a woman learns she has breast cancer, the more likely she is to survive. Breast cancer that’s discovered early on is more likely to be caught, and less likely to spread to the lymph nodes. Industry professionals recommend that women self-examine, but they should also receive mammograms. Women should develop an individualized plan with their doctors regarding a mammogram screening schedule.

Skin Cancer: There are three main types of skin cancer: basal cell cancer, squamous cell skin carcinoma, and melanoma, with the most serious being melanoma. These deadly forms of cancer have increased in incidence among young women. Screenings can help to identify melanoma and nonmelanoma cancer early on. Dermatologists and other healthcare professionals should be able to diagnose melanoma.

Osteoporosis: Bone density tests are administered to screen for the weakening of bones, which leads to fragility. This is also known as osteoporosis, a condition that’s frequently discovered after a fracture. Women face the additional risk of osteoporosis, particularly those going through menopause. Estrogen declines during menopause can lead to bone loss. Screening for changes through bone mineral density tests and embracing healthy living habits can help to identify issues early on. Women should begin receiving bone density tests ahead of their 65th birthday.

The U.S. Preventive Services Task Force recommends that women get screened for a number of conditions in the interest of disease prevention, including colorectal cancer, cholesterol, blood pressure, and diabetes.

Bright, Fun Ideas for Maintaining a Healthy Weight in the New Year

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Dr. Lori Gore-GreenThe deliciously creamy desserts and savory dishes consumed during the holiday season stay with us well after the moment it touched our lips. Unfortunately, this influx of sugary, fatty, and/or salty items translate to weight gained. The good news? There are a number of fun and simple ways to shed those new pounds, which should encourage you to maintain a healthy weight in the new year and years to come!

Brighten Up Your Diet

Perhaps you’re feeling sluggish and underfed after devouring a salty or sweet snack? It’s not a secret that processed and packaged foods are filled with empty calories and other things you don’t necessarily want in your body. Instead, try leafy greens and other fresh foods. Access to organic food may or may not available depending on your location or your economic situation, but most individuals should live in fair proximity to a market, facilitating the purchase of brussels sprouts, collard greens, kale, grapefruit, pears, sweet potatoes, passion fruit, papaya, grapefruit and dates. There are plenty of delicious choices!

Zumba and Hula Hoops

Zumba is a fun, Latin-inspired aerobic workout that’s gained popularity over the last decade. It incorporates elements of hip hop, soca, reggaeton, flamenco, mambo and so much more. Many swear by it, but others enjoy other activities, such as yoga, hula hoop sessions, skating, frisbee, kickboxing, badminton, swimming and trekking. These exciting activities can be adjusted to different limitations or skill levels, and they burn hundreds of calories.

 Buddy Up!

For every individual experiencing difficulty losing weight, there are countless others struggling with the same issue. Why not work together to lose weight. Finding a partner who wants to weight loss as much as you do isn’t just fun, it brings accountability into the equation. Collaborative 2-hour treks through the park and partnered trips to the gym sound much more exciting than going it alone. It’s particularly rewarding when you push one another to go a little farther each time.

Become Julia Child

The American-born French chef didn’t just cook, she loved food. The 6-foot tall aficionado loved the smell of food, the taste of food and preparing quality food. 

If you truly fall in love with food and the preparation of food, you’ll come to create food that truly speaks to your palate, not just your unhealthy cravings. Also, preparing food at home will help you avoid the numerous additives added to restaurant food. When preparing food at home, you’ll know the name of each ingredient going into your dish. Also, you know how much salt and seasoning is added to it.

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Know that weight loss isn’t instantaneous, it’s a journey. It’s a gradual process. Improving your diet, exercising and eating healthy items regularly will nourish your body, and it will provide you the energy needed to take on the day.

4 Reasons to Get Your Flu Shot Today

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Dr. Lori Gore-Green

Pregnant Women : Protect Yourself, Protect Your Newborn

The U.S. Advisory Committee on Immunization Practices (ACIP) recommends an annual flu vaccine for anyone 6 months of age or older. This includes pregnant women, if there are no contraindications (however, if you are pregnant, make sure to consult with your physician prior to receiving a flu shot). It’s important to note that pregnant women cannot use the FluMist live nasal flu vaccine and must receive the inactivated influenza vaccine. Even with these standards in place, in addition to the vaccine protecting pregnant women against the flu, there’s an added value of protecting their newborn infants for up to the first six months of life. This is great to keep in mind since infants are too young to receive the vaccine themselves. 

Collect Your Paycheck

If someone gave you the choice of getting compensated for your work or staying home, feeling ill and not getting paid or using up vacation days, it’s unlikely that you would choose the latter. Every year, the flu season costs millions of lost work days and billions of dollars. And even though the general public is advised to get the flu vaccine when it first becomes available (generally in mid-August), most people wait until the temperatures drop. Although the vaccine doesn’t always cover every strain of the actual virus, it will undoubtedly provide more protection than not getting vaccinated. And the 2015-2016 vaccine has even been updated with 2 new strains.

Protect Loved Ones and Those at Risk

Every year, thousands of children under five years of age are hospitalized owing to the flu. Young children and those with health problems such as asthma or diabetes are at an even higher risk, because they have a greater chance of developing complications. With this in mind, unless you or your family members are contraindicated for receiving the vaccine, you owe it to others who are at a higher risk, to get vaccinated and prevent the infection of others. 

Inexpensive and Accessible

We are lucky in that we now live in a time when the flu vaccine has never been easier to obtain. Waiting in endless lines and making  follow up appointments are a thing of the past. Now the flu vaccine is available at many pharmacies and large retailers like; Target, CVS or Walgreens. Throughout the country, the majority of pharmacists are licensed to immunize, which means that they can administer the vaccine with little waiting. Furthermore, most pharmacies and clinics accept insurance for the vaccine which translates to little or no copay for you. And even if you don’t have insurance, find out if your local health clinic or retail pharmacy offers free vaccines. If not, however, the average vaccine costs roughly thirty dollars. 

New Predictors for Gestational Diabetes

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Dr. Lori Gore-GreenEarlier this month, Diabetes Care published a prospective cohort study that suggests that women who have high levels of abdominal fat (or abdominal adiposity) during their first trimester are at a greater  risk for developing diabetes later on in their pregnancy.

The study was limited to 485 women who were assessed for subcutaneous, visceral, and total adipose tissue depth with ultrasound between 11 and 14 weeks of gestation.

All of the subjects were between the ages of 18 and 42 years old, and the results accounted for confounding factors like; age, family history, ethnicity, BMI and more. Even with these factors addressed, researchers still found that women with higher levels of fat in their abdomens were likelier to develop diabetes between weeks twenty four to twenty eight of their pregnancy than their counterparts with less abdominal fat early on in pregnancy. To learn more about gestational diabetes, please see the video below:

Endometriosis : Is Your Pregnancy at Risk?

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Dr. Lori Gore-GreenFindings of a recently released study of 15,000 women suggest that women with endometriosis had a greater chance  of suffering from serious complications throughout the duration of their pregnancy as compared to women without the condition. These complications also increased the chance of ectopic pregnancy, miscarriage and premature birth.

Endometriosis is a medical condition wherein the uterine lining or the “endometrium” grows in other places like the fallopian tubes, ovaries, vagina or pelvis. Over time, this lining builds up and can cause cysts, heavy periods, severe cramping and possibly infertility. Approximately 5 million women in the US alone have this condition, though the true number is unknown, as it may go undetected.

However, there are certain symptoms that some patients with the condition tend to share.

Pain, both acute and chronic tend to be a marker of endometriosis, for some. Painful menstrual cramps that worsen over time are a commonly shared symptom of the affliction as is chronic pain of the lower back and pelvis.Pain during or after sexual intercourse that is often described as a “deep pain”  is often a common symptom of endometriosis. Intestinal pain can be a symptom, as can painful bowel movements. Stomach and digestive problems resulting in diarrhea, constipation, bloating and/or nausea – particularly during menstrual periods can be a symptom of the condition. Painful urination – particularly during menstrual periods is another symptom of endometriosis. In rare cases, blood found in stool or urine can indicate the condition. Bleeding and spotting in-between periods can also be a symptom, as can infertility. If you are someone you know suffers from any of these symptoms, see a doctor as it may be a symptom of another endometriosis or another condition.

The findings of the recently published longitudinal study on endometriosis, though important, are not wholly surprising  as endometriosis is associated with both structural and functional changes in the endometrium and the uterus. Researchers discovered that this condition increased the odds of a miscarriage by 76 percent, the risk of premature birth by 26 percent and the incidence of needing a caesarean section by 40 percent. The chances of sustaining an ectopic pregnancy (this is where the fetus develops outside of the womb) nearly tripled.
This study was based in Scotland and a longitudinal study conducted from 1981 to 2010 with a mix of women who had and did not have endometriosis. Although infertility is a known side effect of endometriosis, this newly collected data will hopefully return the focus to antenatal care particularly for pregnant patients with endometriosis.

Rural Areas Suffer Drop in OB/GYN Recruitment

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Dr. Lori Gore-GreenTraveling for healthcare services may be common for patients living in remote areas, but the difficulties accessing quality OB/GYN services has a direct link with an increased death rate among new mothers and their babies.

The face of the healthcare industry has been steadily changing over the last 30 years. As world-class tertiary hospitals pay doctors bigger salaries and buy out surrounding practices to stay afloat, the number of rural hospitals providing specialized services has dropped significantly. This is particularly the case with quality OB/GYN care — between 1985 and 2000, rural hospitals providing these services dropped by 23%, and that trend shows no sign of slowing down.

It has become notoriously difficult to recruit obstetricians and gynecologists to rural and remote areas. Smaller pay is only one of the barriers facing OB/GYN doctors considering the move — the lifestyle change is another. Getting accustomed to a small-town life isn’t necessarily easy for doctors who have grown up and studied in a suburban or urban environment.

Some hospitals are incentivizing the deal by offering new doctors things like student loan forgiveness, extra vacation time, and shortened work weeks. Mercy Medical Center, which serves the northern Iowa and southern Minnesota areas, is even offering a guaranteed income loan for the first year, which will then be forgiven after three years of service.

Only time will tell whether this trend really takes off. In the meantime, small rural hospitals are doing their best to partner up with clinicians in different specialities so they can continue to offer the right combination of skills to their patients. This works for about two-thirds of pregnancies who only need the kind of support offered in a rural clinic, but the other third require a more advanced care setting with emergency services.

The 6 Preventative Screening Tests That Are Critical For Women’s Health

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Dr. Lori Gore-GreenGetting preventative screening tests is one of the most important ways that you can take charge of your health and make sure that you’re continuing to make healthy choices. Certain personalized factors may increase your chances of getting a condition, so always check with your doctor to see if you should get tested more often.

Here are 6 of the most important preventative screening tests for women’s health:

Blood Pressure Test: Blood pressure is important to track because high rates of blood pressure can dramatically increase your risk of heart disease and stroke. At the same time, high blood pressure does not normally have obvious symptoms associated with it, so make sure to get checked at least once every two years to keep an eye on this important number.

Mammography: Mammography imaging of your breasts is critical to detecting abnormalities and tumors. There are different recommendations out there, but the American College of Obstetricians and Gynecologists (ACOG) now recommends that women get themselves checked out each year starting at the age of 40.

Blood Glucose Tests: Over 23 million Americans have type 2 diabetes with another 86 million estimated to have prediabetes. Untreated, this disease can cause serious medical issues, including heart disease and stroke. It’s recommended that you get a blood glucose test every three years, starting at the age of 45, and more frequently if you have an increased risk.

Lipid Panel: It’s a good idea to get a fasting lipoprotein profile (lipid panel) every four to six years once you’re 20 years old to keep an eye on your cholesterol and triglyceride levels. If your doctor determines that you have an increased risk for stroke or heart disease, then you’ll want to get yourself checked more regularly.

Pap and HPV Tests: The Pap test (also known as a Pap smear) and the HPV test are both used to screen women for cervical cancer. The USPSTF recommends starting these tests at the age of 21 and getting screened once every three years.

Colonoscopy: Most colorectal cancers can be prevented by getting regular colonoscopies every 10 years or so. They aren’t fun, but they’ll help your doctor detect any small polyps so they can be removed before they turn into a cancerous issue down the road. Start scheduling your regular colonoscopy appointment once you turn 50 years old.