Kegel Exercises for Your Pelvic Muscles

How do pelvic muscles get weak?

Pelvic muscles help stop the flow of urine. For women, pregnancy, childbirth and being overweight can weaken the pelvic muscles. For men, prostate surgery can weaken pelvic muscles. Weak pelvic muscles can cause you to leak urine. Fortunately, pelvic muscles are just like other muscles--exercises can make them stronger. People who leak urine may have better control of these muscles by doing pelvic muscle exercises called Kegel exercises.

This handout focuses on Kegel exercises for women because it is much more common for women to leak urine than for men. If you are a man who leaks urine, talk to your doctor about whether Kegel exercises can help you.

Which muscles control my bladder?

At the bottom of the pelvis, several layers of muscle stretch between your legs. The muscles attach to the front, back and sides of the pelvic bones. Two pelvic muscles do most of the work. The biggest one stretches like a hammock. The other is shaped like a triangle (see picture below).

How do I exercise my pelvic muscles?

You can exercise almost anywhere and any time--while driving in a car, at your desk or watching TV. To exercise these muscles, just pull in or "squeeze" your pelvic muscles (as if you are trying to stop urine flow). Hold this squeeze for about 10 seconds, then rest for 10 seconds. Do sets of 10 to 20 contractions per day.

Be patient and continue to exercise. It takes time to strengthen the pelvic muscles, just like it takes time to improve the muscles in your arms, legs or abdomen. You may not notice any change in bladder control until after 6 to 12 weeks of daily exercises. Still, most women notice an improvement after just a few weeks.

These are the same muscles that you would use to try to stop the flow of urine. They are the muscles you will exercise and strengthen.

A few points to remember

• Weak pelvic muscles often lead to urine leakage.
• Daily exercises can strengthen pelvic muscles.
• These exercises often improve bladder control.
• Ask your doctor or nurse if you are squeezing the right muscles.
• Tighten your pelvic muscle before sneezing, lifting a heavy object or jumping. This can prevent pelvic muscle damage and urine leakage.

Daily pelvic muscle exercise log

I exercised my pelvic muscles ______ times daily.

I spent _____ minutes exercising.

At each exercise session, I contracted my pelvic muscles _____ times.

Sex & Sexuality

Sex and sexuality have long been taboo topics. But as we become more comfortable with our bodies, we begin to understand more about sexuality and how it affects our lives. We have the answers to questions you may have been too embarrassed to ask, from sexuality to sex therapy to sex addiction. 

Chronic Illness: How it Can Affect Your Sex Life

How can a chronic illness affect my sex life?

A chronic illness is a health problem that you have over a long period of time, such as heart disease, diabetes, arthritis or cancer.

People who have a chronic illness can feel tired and depressed a lot of the time. They may have pain, stiffness or trouble sleeping. They may need medicines or other treatments that can affect their sex life. They may have a surgery that changes how their body looks. As a result, they may feel less interested in sex, or they may not enjoy sex like they used to.

Suggestions for keeping your sex life healthy if you have a chronic illness

Read about your illness. There are many self-help books that discuss sex and specific chronic illnesses. You can also join a support group to talk about your illness.

If you have a chronic health problem, the following might help you get ready for sexual activity:

• Plan sexual activity for the time of day when you have the most energy and your health problem bothers you the least.
• Be sure that you are rested and relaxed.
• Wait at least 2 hours after you eat to have sex.
• If you need pain medicine to feel better, take the medicine 30 minutes before sexual activity.
• Limit the amount of alcohol you drink, and avoid using tobacco in any form. Alcohol and tobacco can affect sexual function.

The following might help you maintain your sex life:

• Hold hands, hug and touch your partner, even when you do not plan to have sex.
• Use your senses to make sexual activity more enjoyable. For example, have satin sheets on the bed, light some scented candles or play music.
• Tell your partner what you like and do not like. Listen to your partner's likes and dislikes.
• Try different sexual positions to find positions that are comfortable for you and your partner, or use pillows for comfort.
• Try personal lubricants (one brand name: K-Y Jelly) to help reduce discomfort with sexual intercourse.

Talking to your partner

Even with the best of intentions and preparation, there may be times during your illness when you decide that you do not want to be sexually active. Talk to your partner about how you feel and why you feel that way. Talk about how you can help your partner deal with his or her feelings and interest in sexual activity.

Talking to your doctor

Talk to your doctor about any concerns you have about your sex life. Your doctor may have some suggestions that can help.

Be sure to let your doctor know if you are feeling depressed or if you think that side effects from a medicine are affecting your sex life.

The Vaccines Every Teenager Needs

A Word About Vaccines

Vaccines have received a bad rap in some circles in recent years. Certain celebrities have spoken out against them, and some parents even choose to homeschool their children in order to avoid vaccinations. This line of thinking is misguided, and puts many people at risk—not just the minority of people who go unvaccinated. Without the protection of vaccines, our world would be a very different place, and countless lives would be lost to horrible, preventable diseases

Herd Immunity

Vaccines are important for two reasons. One is obvious: they protect vaccinated people from disease. The second reason may be less obvious: they provide what is known as “herd immunity.” This means that when most people are vaccinated against a certain disease, even people who can’t be vaccinated receive some protection. Herd immunity keeps the disease from getting into the community because so many people are immune to it.

Why Teenagers Are at Risk

Teenagers have a lot going on. Many move into group living situations, like a college dorm or a military barracks. This kind of living quarters can become a breeding ground for disease. Other teens may become sexually active, putting them at risk for sexually transmitted diseases.

Which Vaccines Do Teens Need?

Some vaccines need to be kept current at all ages. DTaP, for example, is a vaccine received in childhood that protects against tetanus, diphtheria, and pertussis (whooping cough). Teenagers are ready for the booster shot, known as Tdap.

The flu vaccine is needed every year. This is because it is developed based on the most common strains of flu every season.

Other vaccines, such as the HPV and meningitis vaccines, are particularly important for teenagers because of their age and changing life situations.

Meningococcal Vaccine

The meningococcal conjugate vaccine, or MCV4, protects against a certain bacterium that causes meningitis. Meningococcal meningitis is very dangerous, and is the most common cause of meningitis outbreaks in boarding schools and college dorms. Keeping teens vaccinated can help ensure that this life-threatening disease doesn’t sweep through large groups of people.

When and Where?

MCV4 is recommended around the age of 11 or 12, and a booster is recommended at age 16. Teenagers who missed the first dose of MCV4 should get the vaccine at age 16, and certainly by the age of 18. This is especially important for teenagers who are about to move into a college dorm or a military barracks. Your child’s pediatrician or a family practice doctor can administer the vaccine at the appropriate times

HPV Vaccine

The HPV vaccine protects against the human papillomavirus, a leading cause of certain types of cancer. Because this virus is spread through sexual contact and is widely known to cause cervical cancer, some people still think that the vaccine is only for young women. The truth is that it also causes genital warts and cancer of the anus, and is dangerous to both young women andmen.

When and Where?

Two vaccines are available. Cervarix is only for girls, and protects against cervical cancer. Gardasil is for both boys and girls, and protects against genital warts and four types of cancer. In both cases, three doses should be received before the person becomes sexually active. The first dose is usually given to children around the age of 11 or 12. Talk to your child’s pediatrician or a family doctor for more information.

Talk to Your Child’s Doctor

Make sure your child continues to receive medical checkups into their teenage years. Their doctor can make sure that they stay up to date on all recommended vaccinations, help you understand which vaccines are needed, and why.

Joint Pain: Is Low Testosterone the Cause?

Part 1 of 6: Overview

Low T and Pain

When you hear the term “joint pain,” you may be likely to think of arthritis. Arthritis can cause both pain and swelling (inflammation) in joints, which are the areas where bones in the body meet.

Arthritis isn’t the only possible cause of chronic pain. Hormonal imbalances, such as those in low testosterone (low T), may contribute to these types of issues. The key is to undergo a proper evaluation to determine whether your pain is associated with low T, arthritis or an unrelated medical condition.

Part 2 of 6: Low T Symptoms

Common Symptoms of Low T

Low T develops when testosterone levels decrease in the body. This sex hormone is the primary one of its kind in the male body. According to the Hormone Health Network, low testosterone may be diagnosed if your testosterone level is under 300 nanograms per deciliter (ng/dL) of blood. While the natural aging process can lead to gradual drops in testosterone, it’s not normal to experience a significant decrease over a short period of time.

Some of the most common symptoms of low T include:

• excessive fatigue
• loss of sex drive
• infertility
• anxiety and depression
• enlarged breasts
• weight gain

In addition to its role in the male reproductive system, testosterone also helps maintain bone health.

Part 3 of 6: Weight & Pain

Weight and Joint Pain

Arthritis is known for joint pain, but it comes in different forms with varying causes. The two main forms are osteoarthritis (OA) and rheumatoid arthritis (RA). RA is an autoimmune disease. On the other hand, OA develops over time due to wear and tear on your joints. While it’s possible to have both low T and arthritis at the same time, testosterone problems are unlikely to cause RA. However, if your low T leads to excessive weight gain, you may be at a higher risk of developing OA.

When caused by excessive weight gain, joint pain is most likely to occur in the knees, hips, and back. Still, pain may be experienced at any point where bones meet. Some arthritis patients can also have pain in the toes, wrists, and fingers. 

Part 4 of 6: Osteoporosis

Low T and Osteoporosis

One of the long-term risks of low T is osteoporosis. Unlike arthritis, osteoporosis is a disease in which your bones become fragile. Testosterone maintains bone density, so low T may contribute to osteoporosis.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, osteoporosis can be identified using a bone mineral density (BMD) test. The test can compare your bone density to the norm. The more your BMD deviates from the norm, the more severe and more established your osteoporosis.

Maintaining bone density is important to preventing a loss of bone mass, as well as subsequent fractures. Unlike joint pain, osteoporosis pain typically only occurs when you develop bone fractures. You may also experience back pain due to weakened vertebra. Recovering after fractures can be painful. While this can feel similar to joint pain, osteoporosis pain is not the same as arthritis.

Part 5 of 6: Solutions

Solutions for Both Low T and Achy Joints

Testosterone replacement therapy is the most common form of low T treatment. Depending on your prescription, it may be taken orally or used topically as a patch or gel. Not only does hormone therapy help improve low sex drive and energy, it can also increase bone density. Over time, you may find it easier to manage your weight and take pressure off achy joints. These treatments aren’t without risk, and they should not be used in men with a history of prostate cancer.

While low T treatments may help improve bone density and weight management, these medications won’t alleviate joint pain on the spot. If you experience regular joint pain, you need separate treatment. Acetaminophen and ibuprofen are among the most common over-the-counter pain relievers, and they also come in prescription strength. Regular exercise, though difficult at first, can go a long way in preventing future joint pain.

Part 6 of 6: Outlook

Outlook

When it comes to joint pain and low T, the two conditions aren’t necessarily related. However, it’s possible to have both at once. Men who are obese are also at a greater risk of developing OA from excess pressure on the joints. Feeling better is dependent on treating both conditions. Low T therapies are unlikely to alleviate joint pain on their own. See your doctor on a regular basis to make sure you’re getting the right treatments so you can move in comfort.

BMI Calculator

roximate measure of body fat. It is based on your height and weight. A BMI between 19 and 25 is considered a normal amount of body fat. If someone's BMI is 25 to 29.9, that person is said to be overweight. A person is said to be obese if his or her BMI is 30 or higher. The higher your BMI, the greater your risk for diseases such as diabetes, heart disease, arthritis, and certain cancers. If you are concerned about your BMI or just want more information, talk with your family doctor.

Enter your height (in feet and inches) and weight (in pounds). Then click the "Calculate BMI" button in one of the tools below. The first tool calculates adult BMI. The second tool can be used to calculate BMI for children and teens ages 2 through 19 years old.

Nocturnal Seizures-Identifying and Treating

Identifying and 

Treating 

Nocturnal Seizures

Epilepsy and Seizures During Sleep

For some people, sleep is disturbed not by dreams but by seizures. You can have a seizure while you sleep with any type of epilepsy. But with certain types of epilepsy, seizures occur only during sleep.

Learn about the types of epilepsy, seizures during sleep, and nocturnal seizures in infants and children.

Part 2 of 6: Epilepsy

What Is Epilepsy?

The cells in your brain communicate via electrical signals to other areas of your brain, muscles, and nerves. Sometimes, though, the signals go haywire, sending too many or too few signals, and you have a seizure. If you have two or more seizures at least 24 hours apart, and they weren’t caused by a medical condition, you may have epilepsy.

Epilepsy is not a single disorder. There are many different kinds of epilepsy, and the condition is common. About 2.3 million Americans have epilepsy. You can get epilepsy at any time in life. However, new cases of epilepsy are most likely to be diagnosed in infants and children under age 10 and people over age 55.

As with epilepsy, there are many different kinds of seizures. They fall roughly into two categories: generalized seizures and partial seizures.

Generalized Seizures

A generalized seizure happens when abnormal electrical activity occurs in all areas of the cerebral cortex — the top layer of the brain associated with movement, thought, reasoning, and memory. Included in this category are:

Tonic-clonic (grand mal) seizures: These seizures include a stiffening of the body, jerking motions, and usually, loss of consciousness.

Absence (petit mal) seizures: Absence seizures are characterized by brief periods of staring and may include blinking the eyes or small movements in the hands and arms.

Partial Seizures

Partial seizures, also called focal or localized seizures, occur in particular part of the brain. The person experiencing them remains conscious but may not know the seizure is happening. Partial seizures can affect behavior, consciousness, and responsiveness. They also can include involuntary movements. 

Part 3 of 6: Sleep Seizures

Seizures That Occur While Sleeping

According to an article in Journal of Neurology, Neurosurgery & Psychiatry, if more than 90 percent of your seizures occur while you slumber, you are said to have sleep seizures. The article also notes that an estimated 7.5 percent to 45 percent of people who have epilepsy have some form of sleep seizures.

It’s believed that sleep seizures are triggered by changes in the electrical activity in your brain during the stages of sleeping and awakening. Most nocturnal seizures occur in stage 1 and stage 2, which are the stages of lighter sleep. Nocturnal seizures can also occur upon waking. Most often, nocturnal seizures are partial seizures.  

Nocturnal seizures are associated with certain types of epilepsy, including:

• juvenile myoclonic
• awakening grand mal
• benign rolandic (also called benign focal epilepsy of childhood)
• electrical status epilepticus of sleep
• Landau-Kleffner syndrome (LKS)
• frontal onset seizures 

Nocturnal seizures disrupt sleep, which affects concentration and performance at work or school. Also, unfortunately, lack of sleep is one of the most common triggers for seizures. Other triggers include stress and fever.

Part 4 of 6: In Children

Nocturnal Seizures in Infants and Young Children

Seizures and epilepsy are more common in infants and children than any other age group, according to an article in Neurology. Fortunately, when a child has epilepsy, it often doesn’t continue into adulthood.

Parents of new infants sometimes confuse a condition called benign neonatal sleep myoclonus with epilepsy. Infants experiencing myoclonus have involuntary jerking that often looks like a seizure. But an electroencephalogram (EEG) doesn’t show changes in the brain that are seen in epilepsy. Plus, myoclonus is rarely serious. For example, hiccups and jerking in sleep are forms of myoclonus.

Part 5 of 6: Diagnosis

Diagnosing Nocturnal Seizures

It can be tricky to diagnose nocturnal seizures because they occur during sleep, and you may not be aware of them. Also, nocturnal seizures can be confused with parasomnia, an umbrella term for a group of sleep disorders that include sleepwalking, teeth grinding, and restless leg syndrome.

Doctors evaluate a number of factors to diagnose epilepsy and determine the type. Factors include:

• the type of seizures you have
• the age when you began having seizures
• family history of epilepsy
• other medical conditions you may have 

To diagnose epilepsy, doctors may use:

• images of electrical activity in your brain recorded by an electroencephalogram (EEG) 
• the structure of your brain as shown in a computed tomography (CT) scan or magnetic resonance imaging (MRI)
• a record or diary of your seizure activity 

If you suspect that your infant or child is having nighttime seizures, consult with your doctor. You can monitor the child by:

• using a baby monitor
• watching for signs in the morning, such as unusual sleepiness, headache, and signs of drooling, vomiting or bed-wetting
• using a seizure monitor, which has features like a motion, noise, and moisture sensors

Part 6 of 6: Treatments

Treatments for Epilepsy

If you have nocturnal seizures, you most likely experience partial-onset seizures. According to researchers at the Indiana University School of Medicine, these seizures are normally well controlled by medication. Indeed, medication is the first-line treatment for epilepsy. Your doctor will help find the medication that works best for you or your child.

EFFECTS OF BREAST CANCER RADIATION ON THE BODY

Emotional Distress

Underarm Hair Loss

Marking

Nerve Damage

Heart Damage

Skin Irritation

Fatigue

Skin Discoloration

Arm Swelling

Fractured Rib

Effects of Breast Cancer Radiation on the Body

Radiation therapy uses high-powered X-rays to kill cancer cells. It’s a type of targeted therapy often used in breast cancer treatment. The radiation may be aimed at the tumor site, the lymph nodes, or the chest wall. 

It attempts to stop 

cancer from spreading, or decrease the risk of recurrence.

External radiation treatment is typically given five times per week, for five to seven weeks. 

A newer approach gives larger doses of radiation over three weeks (accelerated breast irradiation). 

Most people tolerate radiation therapy well.

Your doctor may recommend internal radiation (brachytherapy). 

This is a procedure in which tiny pieces of radioactive material are placed around the tumor site. 

Total treatment time can range from hours to about a week. There are fewer short-term side effects 

with targeted therapy, and it spares healthy tissue. According to BreastCancer.org, 

the long-term side effects of this method are not yet known.

Short-Term Side Effects of Breast Cancer Radiation

The most common side effect of radiation therapy is skin irritation in the targeted area. 

After the first few treatments, your skin may feel sensitive and begin to turn pink.

 It may eventually begin to look and feel like a sunburn, with itching, peeling, or 

blistering. Soreness and tenderness are common. Any irritation may get worse as treatment continues. 

However, you can expect it to get better in the weeks following your final treatment.

You may lose underarm hair if the radiation was targeted to your underarm area. You might also 

perspire less under that arm. These side effects are usually temporary.

Many women undergoing breast cancer radiation experience growing fatigue as the weeks go by. 

Fatigue almost always begins to clear up within a few weeks of the last treatment.

Because it’s administered daily over many weeks, conventional external beam radiation therapy 

is a huge time commitment. The process can interfere with work and family responsibilities, 

especially if you lack transportation or don’t live close to a treatment facility.

You should plan on being there for 30 minutes to an hour, even though the actual treatment 

only takes about 10 minutes. Getting in position takes time and precision. The hectic daily

 schedule may cause you emotional upset, stress, or anxiety.

Long-Term Side Effects

Because radiation is targeted to a specific area of your body, your radiation team will 

spend a lot of time on “marking” prior to your first treatment. That is, they’ll take 

careful measurements to check and double-check that the radiation will hit the correct 

area and nothing else. Then they’ll make small ink marks on your skin to use as a guide for future

 treatments. These marks are typically tattooed onto your skin permanently.

It could take months or years for skin to return to normal color if it gets significantly darker at

 the site of radiation. In some cases, minor discoloration may be permanent, or skin may appear 

thicker or firmer. Skin sensitivity or tenderness can sometimes last for months.

Radiation can cause some nerve damage resulting in numbness and pain. Radiation therapy can limit your reconstruction options or your ability to breastfeed. These are risks you should discuss with your doctor before you begin treatment.

Rare Side Effects

If you had lymph nodes removed before getting radiation, you’re at increased 

risk of a blockage of the lymph system (lymphedema). This can cause swelling 

of the arm where the nodes were removed.

Other rare complications include:

• fractured rib due to weakened rib cage
• inflamed lung tissue
• heart damage when radiation is given on the left side of the chest
• secondary cancer caused by radiation

Tell your doctor if you’re experiencing shortness of breath, trouble swallowing, or chest pain.

Dealing with Breast Cancer Radiation Side Effects

You can’t necessarily avoid side effects of radiation therapy, but there are some things 

you can do to minimize them.

Wear loose-fitting clothing if you’re experiencing skin irritation. If you wear a bra, choose one 

without underwire.

Ask your doctor if there are special products you should use on your skin while bathing.

 Check with your medical team before using ointments or creams on the treated area. 

Try not to rub or scratch the area, and avoid ice packs and heating pads.

Fight fatigue by getting plenty of rest. Give your body the nutrition it needs to repair itself. 

Report any side effects to your radiation oncologist.

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