Medical News Today: What is bigeminy?

Bigeminy is the technical term for the sensation of the heart skipping a beat, which is also sometimes described as heart palpitations or fluttering.

While the heart does not literally skip a beat, it may feel that way. The reason is that the heart’s rhythm has become irregular and the movement of blood through it is different to what a person expects.

Most people will experience bigeminy at some point in their lives, and, mostly, it is not a cause for concern.

Learning more about bigeminy can help people understand their symptoms and understand when they may need to seek medical care.


Doctor pointing to arteries and aorta on model of human heart.
The cause of bigeminy may not always be clear, since there are many possible causes.

Palpitations that occur with bigeminy can have many causes, and it may not be possible to identify the cause.

One study of people treated for palpitations at a university medical center found:

  • 40 percent were caused by arrhythmia
  • 31 percent were due to anxiety or panic disorders
  • 16 percent had no identifiable causes
  • 6 percent were due to prescription, over-the-counter, or illegal drugs
  • 4 percent had non-cardiac causes
  • 3 percent had a cardiac cause other than arrhythmia

Experts might not always be able to say what causes each case of bigeminy, but the condition is linked to changes in the heart’s rhythm sparked by variations in the its electrical system.

Even though it is only the size of a fist, the human heart is an incredible rhythm machine. It beats 100,000 times a day and moves roughly 5 liters of blood throughout the body, a distance of almost 60,000 miles.

It does all this thanks to a rhythmic cycle of contraction and relaxation, which pumps blood through the four chambers of the heart.

This process is triggered by electrical impulses occurring 60–100 times a minute in a resting, healthy adult.

The characteristic sound of the heartbeat – lub-DUB, lub-DUB, lub-DUB – comes from the valves between the chambers opening and closing, as the blood circulates through the heart.

When the timing gets skewed, the rhythm gets skewed. The technical term for this is an arrhythmia, and there are many forms of it, including bigeminy.

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When bigeminy happens, it may feel as if the heart is skipping a beat or having palpitations. These unusual, early beats are also called ectopic contractions.

An individual may feel as if there is a pause between the beats of their heart.

It may feel like the heart is skipping a beat, but bigeminy is a kind of arrhythmia in which the heart beats too early, or prematurely.

If heart palpitations are accompanied by feeling faint, actually fainting, or dizziness, individuals should seek prompt medical care.

Diagnosis and when to see a doctor

Stressed man with headache in front of laptop.
To diagnose bigeminy, a doctor may enquire about a person’s stress levels and health conditions.

If bigeminy lasts for a long time, recurs, or someone has a personal or family history of heart disease, it is advisable to see a doctor to be diagnosed.

Doctors will ask someone about:

  • symptoms in their chest, such as palpitations
  • incidents of dizziness
  • heart issues, such as high blood pressure or previous arrhythmia
  • diabetes
  • thyroid problems
  • personal stress levels
  • exercise habits
  • use of tobacco
  • prescription drug use
  • use of supplements and over-the-counter drugs
  • consumption of caffeine and alcohol
  • use of cocaine and other illicit drugs

Doctors ask about these issues because they can all affect heart health. As heart problems may have a genetic link, doctors will also most likely take a detailed family health history.

A physical exam is important to diagnosing bigeminy, with doctors taking a close look at the condition of the heart. The first steps for this process involve:

  • taking pulse and blood pressure readings
  • listening to the heart rate and rhythm
  • checking for a heart murmur
  • looking for signs of heart failure, such as edema or swelling
  • checking thyroid health, and other possible causes of arrhythmia

The best way to examine the health of the heart’s rhythm section is with an electrocardiogram, also known as an ECG or EKG.

An ECG measures the timing and the level of the electrical waves passing through the heart and stimulating the different chambers to contract and relax.

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Treatment and lifestyle changes

Takeaway coffee cup surrounded by coffee beans.
Avoiding coffee, tea, and other drinks containing caffeine may help to treat bigeminy.

Bigeminy will not usually require complicated treatment and will frequently resolve on its own.

Medical experts have identified several substances as potential triggers for episodes of bigeminy. Limiting or avoiding intake of these can make it easier for the heart to keep a steady beat.

Potential substances and triggers to avoid include:

  • caffeine in coffee, tea, energy drinks, and some soft drinks
  • nicotine
  • alcohol
  • medications for seasonal allergies, asthma, and colds

High blood pressure may increase the likelihood of palpitations, which gives individuals with hypertension more reason to carefully manage their blood pressure.

Exercise may sometimes trigger episodes of bigeminy, so individuals who have had palpitations should use caution when starting or returning to fitness activities.

Doctors may prescribe drugs known as beta-blockers when bigeminy episodes are frequent and potentially serious.

In the rare cases of bigeminy that require more aggressive treatment, a surgical process known as catheter ablation may be used to treat heart tissue.


In most cases, when otherwise healthy people experience bigeminy, the symptoms go away on their own, and there is no need for treatment.

However, if episodes of bigeminy are frequent and severe, particularly if they are accompanied by dizziness and feeling faint, people should see a doctor for a thorough evaluation and treatment plan.

For those who already know they have heart disease, frequent episodes of bigeminy could be a sign that they are at increased risk for serious heart problems. These people should see their doctor to discuss adapting their treatment plans.

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Medical News Today: What causes pain in the lower left abdomen?

Pain in the lower left abdomen is often no cause for concern, but it is still not something a person should ignore. Causes of pain in the lower left abdomen may be benign, such as gas pain, or can be more serious, as in the case of an infection.

People experiencing persistent or chronic pain in the lower abdomen should seek medical attention. Similarly, a sudden onset of severe pain in the lower left abdomen may require immediate medical care.

Causes of lower left abdomen pain

There are several possible causes of lower left abdomen pain. Some causes are more common and benign, while others can be serious and require medical attention.

1. Diverticulitis

Pain in lower left abdomen
Lower left abdomen pain can have many causes.

Diverticulitis is one of the most common causes of lower left abdominal pain. Diverticulitis occurs when diverticula (small pouches) in the intestinal wall become infected and inflamed.

Diverticula form in weak areas of the large intestine, which is often referred to as the colon.

Diverticula are present in many adults. As a person ages, the number of diverticula increases, making it more likely that one will tear or swell. As a result, diverticulitis tends to be more common in older adults, although younger people can still develop the condition.

Diverticulitis pain tends to increase while a person is eating or shortly after a meal.

Additional symptoms of diverticulitis may include:

  • tenderness in the abdomen
  • fever
  • nausea
  • vomiting
  • feeling bloated

2. Celiac disease

Celiac disease is a chronic condition that occurs in the digestive tract when a person cannot digest gluten. Gluten is a protein found in wheat and is present in several foods and healthcare products.

When a person has celiac disease, their immune system attacks portions of the intestine, causing a range of digestive problems and vitamin deficiencies.

Symptoms of celiac disease may include:

  • pressure and gas
  • bloating
  • pain in the abdomen
  • fatigue
  • weight loss
  • diarrhea

Children with undiagnosed celiac disease may also suffer from malnourishment and growth impediments as a result of the condition.

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3. Gas

Gas is often trapped in the digestive tract when a person swallows air while eating, as well as through natural digestion processes.

Typically, gas is not anything to worry about and will pass through either the rectum or esophagus. Gas that is temporarily trapped in the digestive tract can cause pain and discomfort until it moves out of the system.

Gas can be caused by:

  • digesting foods that are prone to releasing gas
  • swallowing air
  • smoking
  • chewing gum
  • overeating
  • undigested foods
  • bacteria

If the gas pain is frequent or accompanied by additional symptoms, a person may wish to speak to a doctor. Other symptoms include:

4. Lactose intolerance

A person who is lactose intolerant has trouble digesting milk and milk-based products, such as cheese and yogurt. This is because the person lacks sufficient amounts of an enzyme called lactase.

Lactase breaks down the lactose in milk, which consists of the simple sugars glucose and galactose.

various dairy products
Lactose intolerence may be a cause of lower left abdomen pain.

When a person has high levels of lactose in their bloodstream, they may develop symptoms associated with lactose intolerance. These symptoms include:

  • loose stool or diarrhea
  • pain in the abdomen
  • bloating
  • gas pain
  • nausea
  • a growling or rumbling stomach

5. Inflammatory bowel diseases

Crohn’s disease and ulcerative colitis are chronic conditions that can cause painful inflammation anywhere in the digestive tract.

Crohn’s disease is most common in the small intestine, and ulcerative colitis is most common in the colon.

It is still not known what causes Crohn’s disease or ulcerative colitis. The most common symptoms include pain in the abdomen and bloody diarrhea. It can also cause fever and unexplainable weight loss.

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6. Indigestion

Indigestion is caused by a buildup of acid after eating. For most people, indigestion pain occurs in the upper part of the abdomen. While rare, indigestion can occur in the lower part of the abdomen.

Typically, most cases of indigestion are mild. Symptoms of indigestion include a burning sensation, slight pain or discomfort, heartburn, bloating, or gas.

7. Shingles

Shingles is caused by the same virus that causes chickenpox. Once a person has had chickenpox, the virus stays dormant in the body for their entire life. Sometimes, the virus reappears, causing pain and a rash that wraps around one side of the abdomen.

Vaccines are available to help reduce the risk of a person developing the disease later in life.

Symptoms of shingles include:

  • pain when touched
  • itching
  • tenderness on the skin
  • rash
  • blisters that may break open and scar

A person may feel tenderness and itchiness on one area of the skin before the rash appears. They may also experience a fever or general malaise. Once the rash appears, the pain can be severe.

8. Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that a doctor may only diagnose once they have ruled out other probable causes of a person’s symptoms.

Symptoms of IBS may include:

  • abdominal pain
  • pressure
  • constipation or diarrhea
  • gas
  • bloating

9. Hernia

A hernia occurs when an organ or other body part pushes through the abdominal wall. Sometimes, a lump may appear in the midsection or near the groin.

There are different types of hernias that vary according to the underlying cause. Because hernias can cause additional problems, it is essential to see a doctor as soon as possible.

Some additional symptoms of hernia complications include:

  • pain when lifting an object
  • pressure
  • increasing pain
  • increasing size of a bulge
  • a general feeling of fullness

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10. Constipation

man sitting on the toilet using his phone
Constipation may be caused by a lack of exercise and a poor diet.

Constipation is when a person cannot pass a stool. Constipation is often caused by poor diet and lack of exercise. Improving diet and increasing exercise are two of the most effective treatments.

Some symptoms of constipation include:

  • straining when passing stool
  • needing to apply pressure to the abdomen to help push out a stool
  • a lumpy or very hard stool
  • feeling like the rectum is blocked
  • feeling like not all the stool has passed
  • having fewer than three bowel movements in a week

11. Kidney stones

Most stones are formed from calcium buildup and can form in either the right or left kidney. A person may develop a kidney stone and not realize they have it until it causes problems, such as blocking part of the kidney, or causing great pain as it is passed.

Typical symptoms of kidney stones include:

  • abdominal pain
  • pain when urinating
  • nausea or vomiting
  • blood in the urine
  • fever
  • frequent urination

12. Intestinal obstruction

When something blocks the intestine, food cannot pass through the digestive tract. This results in a painful back-up that needs immediate medical attention.

Intestinal obstructions are more common in older adults and are typically caused by other conditions, such as diverticulitis or colon cancer.

Common symptoms of an intestinal obstruction include:

  • abdominal pain
  • inability to pass stool
  • distention
  • vomiting
  • constipation

When to see a doctor

It is important to see a doctor for abdominal pain whenever it is unexplainable or is accompanied by additional symptoms. Persistent or chronic pain should be examined to rule out any serious underlying causes.

A doctor can diagnose the cause of the pain and develop a treatment plan that will address the underlying cause of lower left abdominal pain.


In many cases, a person is not likely to experience any lasting effects from abdominal pain.

If the abdominal pain is caused by a chronic condition, such as Crohn’s disease or celiac disease, a doctor can help a person develop a treatment plan to improve their symptoms in the long-term.

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Medical News Today: What you need to know about pancolitis

Pancolitis is a form of ulcerative colitis that affects the entire large intestine or bowel. It is a type of inflammatory bowel disease.

Its full name is pan-ulcerative colitis and is also sometimes known as total colitis or universal colitis.

Pancolitis is a chronic condition, meaning it develops over a long period and there is currently no known cure.

Overview of ulcerative colitis

Image of the colon - pancolitis
Pancolitis affects the large intestine or bowel.

Ulcerative colitis is a chronic autoimmune disease that affects the colon. At the end of the colon is the rectum, which stores feces before it leaves the body.

In ulcerative colitis, small ulcers can develop on the colon, producing pus and mucus. In turn, this can lead to abdominal discomfort, diarrhea, and rectal bleeding.

Experts estimate that around 20 percent of people who have ulcerative colitis will have pancolitis.

Other types of ulcerative colitis include:

  • proctitis
  • proctosigmoiditis
  • left-sided colitis


The main symptoms of pancolitis are:

  • recurring diarrhea, which can contain blood, mucus, or pus
  • abdominal pain and cramps
  • an urgent need to empty the bowels

Other typical symptoms of pancolitis can include:

  • tenesmus — the need to pass stools even when there is nothing in the bowel
  • fatigue, or extreme tiredness
  • weight loss
  • loss of appetite
  • fever
  • night sweats


If a person has not experienced symptoms of pancolitis for a significant period and then they suddenly return, it is known as a flare-up or relapse.

During a flare-up, a person can also experience symptoms elsewhere in the body:

  • painful and swollen joints
  • ulcers in the mouth
  • red, painful, and swollen skin
  • irritated and red eyes
  • shortness of breath
  • fast or irregular heartbeat
  • high temperature
  • bloody stools

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Stress may lead to pancolitis
Unknown triggers such as diet, bacteria, and stress may lead to the development of ulcerative colitis.

Ulcerative colitis is a type of inflammatory bowel disease. It is an autoimmune condition, which means that instead of defending the body against infection, the immune system goes wrong and instead attacks healthy tissue.

The exact cause of ulcerative colitis is not known, but scientists think that a combination of factors leads to the development of the disease.

The different factors include:

  • a genetic predisposition, which the person is born with
  • an abnormal reaction from the digestive system to bacteria in the intestine
  • unknown triggers, such as viruses, bacteria, stress, or diet
  • abnormal immune response

While people of any age can develop pancolitis, it is more commonly diagnosed in those aged between 15 and 25 years old.

Both men and women are equally affected.

Diagnosis and when to see a doctor

When diagnosing pancolitis, the doctor will ask the individual about their symptoms, general health, and medical history.

The doctor might also conduct a physical examination and take stool and blood samples to check for signs of infection and inflammation, among other things.

If the doctor is concerned that a person may have any form of inflammatory bowel disease, then they may refer the individual for further tests, including:

  • Blood tests to look at cell counts and inflammatory markers.
  • X-ray or computerized tomography (CT) scan to rule out serious complications within the abdomen if there are other concerning signs or symptoms.
  • Colonoscopy — a flexible tube containing a camera, called a colonoscope — to examine the colon. During a colonoscopy, the surgeon may take a biopsy. The colon needs to be emptied before a colonoscopy. The procedure takes around 30 minutes and can be uncomfortable.

What are the treatment options?

Treatment for pancolitis will depend on how severe the condition is and how badly the symptoms are affecting the person’s life.

While there is no known cure, the two main aims of treatment are to reduce symptoms until they are gone, known as remission, and then to maintain remission.

The two types of treatment currently available for pancolitis are medication and surgery.


The four main forms of medication given to treat pancolitis are:

  • Aminosalicylates (ASAs) to reduce inflammation. The medicine is available as a tablet or capsule, as a suppository in the rectum, or through an enema. It is prescribed for mild or moderate cases and rarely has side effects.
  • Corticosteroids also used to reduce inflammation. This powerful medicine can be administered orally, as a suppository, or through an enema. Not used as long-term treatment, as corticosteroids can cause serious side effects, such as osteoporosis and cataracts.
  • Immunomodulators to reduce the activity of the immune system. They can be taken as a tablet to treat mild or moderate flare-ups. Immunomodulators can make some people vulnerable to infection and prone to anemia.
  • Biologics target specific components of the immune system involved in inflammation. People take biologics via an intravenous (IV) infusion or injection.


surgeons working on a patient
A treatment option for pancolitis may be surgery, which should be carefully considered.

If flare-ups are having a serious impact on a person’s quality of life, or the person is not responding to medications, then surgery is an option.

Surgery usually involves removal of the colon entirely, which means there is no chance of any form of ulcerative colitis returning.

However, anyone thinking about having this surgery must consider the consequences very seriously.

Once the colon has been removed, waste will instead leave the body from the small intestine via a hole in the abdomen. The waste passes into a special bag, known as an ileostomy.

A second surgery may then be performed at a later time to create an internal pouch called an ileoanal pouch. This pouch connects the small intestine to the anus, allowing stools to pass normally,

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There can be some very serious complications associated with pancolitis:

  • Cancer: The longer a person has had pancolitis, the greater the risk of developing bowel cancer.
  • Toxic megacolon: When inflammation is very severe, and the colon dilates in size. Symptoms include; fever, abdominal pain, dehydration, malnutrition, and colonic rupture. This is a surgical emergency.
  • Anemia: Lack of iron in the blood, caused by blood loss from the condition.
  • Fulminant colitis: A rare and severe form of pancolitis. Symptoms include; dehydration, severe abdominal pain, diarrhea with blood, and shock.


Pancolitis is a chronic condition with no cure and people living with it can experience significant practical and emotional issues.

When someone is having a flare-up, they may have to limit or change their activities. However, during periods of remission most people can lead a normal and healthy life.

Pancolitis can affect relationships and work, but talking to and seeking emotional support from family, friends, and healthcare professionals can help.

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Medical News Today: What can you do to make your nails grow faster?

Fingernails provide more than just a surface to paint. They protect the fingers, make it easier to grab things, and are a convenient way to scratch an itch.

Having longer, healthier fingernails can make the hands look better, and make it easier to type, play a musical instrument, or perform daily tasks.

Nail growth remedies will not typically make the nails grow faster. Instead, they prevent the nails from breaking, helping them look healthier and grow longer.

How fingernails grow

Woman's hands with manicured nails folded over white towel.
A healthy nail bed will ensure the nail plate itself grows properly.

Understanding how the nails grow can make it easier to make lifestyle changes that support nail health.

Nail plate

The hard part of the nail is called the nail plate. The nail plate, much like hair, is made primarily from a protein called keratin.

The nail plate is not made of living tissue, so it is not possible to improve the health of the nail plate. While it is possible to prevent breakage of the nail plate, nail health begins in the nail bed.

Nail bed

The nail bed is the tissue underneath the nail. If the nail breaks off below the fingertip, the nail bed can be exposed. This painful experience makes it clear that the nail bed is living tissue.

At the base of the nail is a structure called the nail matrix, which is where growth begins.

Long-term approaches to nail health support the body to keep the nail and surrounding skin healthy, enabling the nails to grow longer and stronger.

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Myths about nail growth

The nail tissue is already dead by the time it is long enough to be painted, so painting will not affect growth.

It is also a myth that applying vitamins directly to the nails can help them grow. These remedies are unlikely to help. At best, they strengthen the nail and prevent it from breaking.

No specific nail polish, such as a gel or powder, can improve nail health. In fact, some products, particularly those that require harsh methods for removal, can even destroy nail health. The acetone used to remove gel nails can weaken nails despite the gel polish making them look strong and healthy.

Diet and nail health

Dried fruits and nuts in a wooden bowl, including raisins, sultanas, almonds, and hazelnuts.
Dried fruits and nuts contain iron and protein, which may support the health growth of nails.

Like the rest of the body, the nails need a balanced diet to grow, including protein, water, fruits, vegetables, and a wide array of vitamins and minerals.

People who do not get enough iron, for instance, may have brittle nails, or nails with dents. Protein deficiency may cause ridges in the nails.

Some specific diet changes can strengthen the nails and promote growth. Those include:


Some over-the-counter nail supplements contain calcium. Some people think that because calcium strengthens the bones, it might also strengthen the nails.

Some research has found that postmenopausal women with a condition called osteoporosis—which is often due to inadequate calcium intake—experience nail changes.

However, few studies have definitively proven whether or not calcium improves nail health. People at risk of calcium deficiency should consider supplementing their diet with this essential mineral.


As the nails are made of protein, some people think that not including enough protein in the diet may affect nail health.

To increase the amount of protein in the diet, choose lean meats, such as chicken, and fish. Vegetarian sources of protein include lentils, peanuts, nuts, and dairy products, such as cheese and milk.


Biotin is a B-complex vitamin that proponents say can promote healthy hair and nail growth. Biotin may strengthen brittle nails, preventing them from breaking, but there is little evidence that biotin supplements will help the nails grow faster.

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Home remedies

The following home remedies might improve nail health and protect against breakage. These remedies will not make the nails grow faster but may help improve the overall health of nails for optimum growth rates:

Preventing and treating dry skin

Woman applying moisturizing cream or lotion to her hands.
Applying moisturizer to the hands and the skin around the nails may help to encourage healthy nail growth.

Dry skin often means dry nails. Very dry skin can even crack open and bleed, exposing the nails to fungal and bacterial infections.

When the skin surrounding the nail bed or nail matrix is dry, it may even damage the nails as they grow.

Keep hands and nails moisturized during the winter months. Apply lotion after washing hands. People who have eczema should choose eczema-friendly creams that are highly moisturizing.

Keeping the nails dry

Water can weaken the nails, making them soft and brittle. Keep the nails dry by toweling off after swimming or showering.

When washing dishes, clothes, the bathroom, the kitchen floor, the car, or anything else wear gloves to prevent water or cleaning products from sitting on top of the nails.

Filing and grooming the nails

Keeping the nails filed in a natural shape—slightly rounded or squared—can prevent nails from snagging and breaking.

Good nail grooming may also discourage biting and picking.


Medical conditions such as diabetes can reduce circulation to the nails, making them weaker.

While this is more likely to affect the toenails than the fingernails, gentle massage can promote circulation to the nails, offsetting the effects of diabetes and other circulatory issues.

Protecting the cuticles

The cuticles are thin pieces of skin that protect the nail matrix. Cutting them very short can expose the nail matrix or nail bed, damaging the nails and causing infections.

Instead, keep the cuticles moisturized. Do not cut them.

Be cautious about manicures

Some nail salons are sources of nail infections. Aggressive manicure techniques, such as cutting the cuticles very short, can allow bacteria to enter the nail bed and weaken the nails.

Take personal tools to the nail salon, and check a salon’s reputation by reading reviews. If something hurts, ask the technician to stop. Manicures should not be painful.

Avoid harsh polish removers

Acetone polish remover can dry and weaken the nails. Avoid using it, and steer clear of nail polishes that require its use.

If acetone is the only option, avoid soaking the nails in acetone. Instead, rub them with the polish remover, then thoroughly wash and moisturize the hands.

Manage medical conditions

Medical conditions such as diabetes and psoriasis can affect the skin and nails. Instead of treating the nails, address the problem at its source by following a doctor’s treatment recommendations.

If symptoms change or get worse, or if someone has a chronic disease accompanied by nail problems, see a doctor.


The nails can provide an early warning sign to some health problems, such as nutritional deficiencies and diabetes.

If home remedies do not improve the look of the nails, talk to a dermatologist. Treatment for an underlying condition might be the path to better nails.

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Medical News Today: Fertility treatment: Vitamin D may influence success rate

Pregnant woman in the sun
Vitamin D is produced in response to sunlight, but what is its role in fertility?
A new meta-analysis has concluded that there is a relationship between a woman’s vitamin D status and the success rate of assisted reproduction therapy.

Infertility is a common and distressing issue, and it affects an estimated 6.1 million couples in the United States. That’s around 10 percent of all couples of childbearing age.

Over the years, assisted reproduction therapy (ART) — including in vitro fertilization (IVF) and fertility medication — has become much more widespread and its success rates have increased.

As an example, depending on the woman’s age and the clinic involved, success rates of IVF in the U.S. range from 13–43 percent.

An initial uptick in ART success rates was thanks to improved methods of picking out embryos with the highest chances of survival. But more recently, success rates have started to stagnate.

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Vitamin D and reproduction

Researchers believe that there is room for improvement in ART success rates. A range of potential factors are being explored, and some scientists have turned their attention to the potential role of vitamin D.

The vast majority of our vitamin D supply is generated in our skin after exposure to sunlight. This means that individuals who live in colder or darker environments are more susceptible to lower vitamin D levels, as are people with darker skin, those who regularly wear clothes covering the majority of their skin, and those who rarely go outside.

A link between vitamin D and fertility has been theorized based on a number of observations. For instance, vitamin D receptors and enzymes have been found in the endometrium. Also, in animal studies, vitamin D deficiency causes poorer fertility and reduced function of the reproductive organs.

In humans, vitamin D deficiency has been shown to increase the risk of preeclampsia, pregnancy-induced hypertension, gestational diabetes, and lower birth weight.

Researchers from the University of Birmingham and Birmingham Women’s and Children’s National Health Service (NHS) Foundation Trust, both in the United Kingdom, decided to take a look at existing data to probe the links further.

They carried out a meta-analysis, reopening 11 studies including 2,700 women undergoing ART. Their findings are published this week in the journal Human Reproduction.

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Vitamin D deficiency and lower success rates

The featured studies involved women undergoing IVF or intracytoplasmic sperm injection, frozen embryo transfer, or both.

All the participants’ vitamin D levels were checked by blood test. Vitamin D concentrations of more than 75 nanomoles per liter of blood were considered as sufficient, under 75 nanomoles per liter of blood as insufficient, and under 50 nanomoles per liter of blood as deficient.

The analysis showed that procedures in women with adequate vitamin D levels were one third more likely to lead to live births than in women who were deficient.

When the researchers looked at positive pregnancy tests and clinical pregnancies — that is, where a heartbeat can be detected — rather than live births, the results were similar.

When compared with women who had insufficient vitamin D concentrations, those with sufficient amounts were 46 percent more likely to have a clinical pregnancy, and 34 percent more likely to have a positive pregnancy test result.

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The analysis showed no associations between miscarriage and vitamin D concentrations.

One startling finding was the high prevalence of vitamin D deficiency among these women. We found that only 26 percent of women in the studies had sufficient concentrations of vitamin D; 35 percent had deficient concentrations, and 45 percent had insufficient concentrations.”

Study co-author Dr. Ioannis Gallos

The researchers are quick to explain the study’s limitations. Team leader Dr. Justin Chu says, “Although an association has been identified, the beneficial effect of correction of vitamin D deficiency or insufficiency needs to be tested by performing a clinical trial.”

He also adds an important note of caution. “In the meantime,” he says, “women who want to achieve a successful pregnancy should not rush off to their local pharmacy to buy vitamin D supplements until we know more about its effects.”

“It is possible to overdose on vitamin D and this can lead to too much calcium building up in the body, which can weaken bones and damage the heart and kidneys,” he explains.

This current analysis backs up the theory that vitamin D plays an important role in fertilization and pregnancy. Its exact role is still not understood, and the optimum blood concentrations are not yet known. However, testing for vitamin D is relatively simple and cost-effective, so further studies are sure to follow.

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Medical News Today: What are the best birth control pills for PCOS

Polycystic ovary syndrome is a hormone disorder that causes numerous symptoms, including infertility. Hormonal birth control that contains both estrogen and progestin can help rebalance the hormones, alleviating many of the symptoms.

Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects 1 in 10 women of childbearing age. The endocrine system consists of glands that secrete and regulate hormones, such as testosterone and estrogen.

Women with PCOS have a hormonal imbalance that causes unusually high levels of male sex hormones. This imbalance changes the way the ovaries function and can cause them to develop many small cysts.

Women with PCOS may also not ovulate or do so infrequently. PCOS is a leading cause of infertility.

What are the symptoms?

various birth control pills
Hormonal birth control pills are safe but they may present some risks.

Some of the symptoms of PCOS include:

Symptoms vary and may be mild or so severe that they disrupt a woman’s life.

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How birth control can affect PCOS

With treatment, the symptoms can be managed and may disappear.

Hormonal birth control is considered to be combination birth control when it contains two hormones. These hormones are usually estrogen, and a synthetic form of progesterone called progestin.

These combination pills can also regulate some hormonal imbalances, by increasing a woman’s estrogen levels and decreasing the amount of testosterone her body produces.

Due to combination birth control pills containing two hormones that can adjust hormone issues, they are the preferred choice for many prescribing doctors.

However, not all women can safely take combination pills. Hormonal birth control pills are safe, but they do present some risks including:

  • A greater risk of diabetes: This is a consideration for women with PCOS who are already at risk for diabetes.
  • A risk of cardiovascular issues: Including dangerous blood clots in the legs. Women with PCOS who are obese may have an elevated risk. If they smoke, the risk rises.
  • Weight gain: Some evidence suggests that birth control pills can cause weight gain, but other studies disagree. Women who are already obese may be reluctant to take birth control pills. Weight gain can make the symptoms of PCOS worse.

For some women, a pill known as the minipill may be a better choice. Minipills contain just one hormone, progestin. They are less likely to cause side effects than combination pills. However, when they do cause side effects, these can be the same.

Best birth control pills for PCOS

Combination birth control pills all work the same way. They prevent the ovaries from releasing an egg and so prevent pregnancy. They also thicken the mucus of the cervix. If the ovaries were to release an egg, this thickened mucus could prevent pregnancy.

The same hormones that prevent ovulation can also keep male hormone levels low and raise female hormone levels. Combination pills for PCOS include:

Lady being handed birth control pills by a pharmacist
The hormones that prevent ovulation in combination birth control pills, may also raise female hormone levels.
  • Alesse
  • April
  • Aranelle
  • Aviane
  • Enpresse
  • Estrostep
  • Lessina
  • Levlen
  • Levlite
  • Levora
  • Loestrin
  • Mircette
  • Natazia
  • Nordette
  • Lo/Orval
  • Ortho-Novum
  • Ortho Tri-Cyclen
  • Yasmin
  • Yaz

Some pills, such as Loestrin, have lower estrogen levels. These low estrogen levels can reduce the severity of some side effects but may also be less effective against symptoms of PCOS.

Someone with PCOS should talk to a doctor about the right amount of estrogen based on their symptoms and other risk factors.

Pills for painful periods

Women who get some relief from combination pills but who continue to experience painful or heavy periods may wish to switch to a pill that causes them to be less frequent.

The following pills can make a woman have less frequent periods:

  • Lybrel
  • Seasonique
  • Seasonale


Women who develop unpleasant side effects from taking a combination pill may wish to switch to a minipill. In some cases, doctors recommend that women try a minipill first.

Women who smoke, who have a history of cardiovascular problems, who are very overweight, or who are diabetic may have fewer side effects with a progestin-only pill.

Combination and progestin-only pills are highly effective at preventing pregnancy. At typical usage rates, which are the imperfect way most women use these pills, they are about 91 percent effective.

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Non-pill options for PCOS

copper iud device used for birth control
A non-pill alternative to birth control may be an intrauterine device (IUD).

Birth control pills are not for everyone, as some women find it inconvenient to take a pill every day. Non-pill combination options that blend progestin with estrogen tend to be the most effective. Progestin-only options may pose fewer risks and side effects.

The non-pill alternatives to birth control for PCOS include:

  • Birth control injection: This injects the hormone progestin into a woman’s body every three months. At typical usage rates, it is 94 percent effective at preventing pregnancy.
  • Birth control patch: This is applied to the skin and releases both estrogen and progestin into the bloodstream. With typical usage, it is about 91 percent effective at preventing pregnancy. In women over 98 pounds, it may be less effective.
  • Birth control ring: This is worn inside the vagina, where it releases progestin and estrogen. It is 91 percent effective with typical use.
  • Birth control implant: This is a small rod that a doctor inserts under the skin. It releases progestin only and can prevent pregnancy for three years or longer. At typical usage, it is more than 99 percent effective.
  • Intrauterine device (IUD): This device is inserted into the uterus by a doctor and releases the hormone progestin. It is more than 99 percent effective with typical use. Another IUD contains copper only and does not release hormones or help with symptoms of PCOS.

Non-hormonal birth control options, such as condoms, natural family planning, or diaphragms, will not help with symptoms of PCOS. Also, women who want to become pregnant must try another type of treatment.


Hormonal birth control can help with PCOS symptoms, but it is not the only option. Lifestyle changes, such as losing weight and exercising more, may help.

Some women also try supplements or special diets. Some other drugs, such as Metformin, may help when birth control does not work.

And for women trying to become pregnant, the medication Clomid can encourage the body to ovulate.

Women with PCOS should talk to their doctors about their symptoms, and their treatment aims to arrive at a comprehensive treatment strategy. A woman can ask a doctor to refer her to a specialist for further advice.

Birth control can be a part of a strategy for dealing with PCOS, but it does not have to be the only option.

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Medical News Today: ‘Good’ cholesterol not so good at preventing heart disease

cholesterol sign
The precise interplay between the ‘good’ and the ‘bad’ kinds of cholesterol, as well as their impact on heart disease, have yet to be unraveled.
It is a widely held belief that we should keep levels of the “bad” cholesterol in check, while “good” cholesterol should be high in order to protect against heart disease and other cardiovascular conditions. But new research challenges this belief.

High-density lipoprotein (HDL) cholesterol “is ‘good’ cholesterol,” write the American Heart Association (AHA). “Think of it as the ‘healthy’ cholesterol, so higher levels are better,” they add.

In light of this widely accepted belief, an increasing number of studies have been trying out various therapeutic ways to increase HDL cholesterol levels.

The hope has also been that testing such different therapies may also shed some light on the mechanisms by which HDL seemingly prevents heart disease. Such mechanisms are still unclear, as most of the belief that HDL protects against heart disease rests on observational evidence.

One such therapeutic strategy has been to block the activity of a protein called cholesterol ester transfer protein (CETP).

But now a new study, published in the journal JAMA Cardiology, shows that raising levels of the so-called good cholesterol by blocking this protein does not do much to protect against heart disease.

The research was largely genetic — analyzing the genetic variants of more than 150,000 adults in China — and it was led by a team from University of Oxford in the United Kingdom in collaboration with scientists at the Peking University and Chinese Academy of Medical Sciences, both in Beijing, China.

The lead author of the paper is Dr. Iona Millwood, from the Nuffield Department of Population Health at the University of Oxford.

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Studying the effect of blocking CETP

The CETP protein is tasked with transferring HDL cholesterol to certain lipoproteins in exchange for triglycerides, which are a type of fat found in the blood.

As Dr. Millwood and her colleagues explain, certain genetic variants can have the same effect on the CETP protein as a drug would.

Therefore, the team analyzed the CETP-altering genetic variants of 151,217 individuals in order to evaluate the potential benefits and risks of using a CETP-inhibiting treatment.

The participants were clinically followed for more than 10 years. By the end of this period, more than 5,700 of them had developed coronary heart disease, and more than 20,000 had had a stroke.

Dr. Millwood and colleagues found that a higher number of CETP genetic variants did increase levels of HDL cholesterol, but it did not lower the risk of coronary heart disease and stroke.

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Additionally, the research did not find any effect on the risk of atherosclerosis or other diseases, such as diabetes and kidney disease. The study’s lead author summarizes the findings.

Our research has helped clarify the role of different types of cholesterol, and suggests that raising levels of HDL [cholesterol] by blocking CETP activity, without also lowering LDL [cholesterol], does not confer any major benefits for cardiovascular disease.”

Dr. Iona Millwood

Study co-author Zhengming Chen, a professor at the University of Oxford, adds, “This study demonstrates the value of large prospective biobank studies with genetic data linked to health records, carried out in diverse global populations, to predict the potential benefits or harms of new drug treatments.”

The researchers are planning to use the same genetic approach to elucidate the potential effects of other drug targets.

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Medical News Today: Why do colds and flu strike in winter?

woman with a cold
Most of us get at least two colds per year, but why?
The cold and flu season is starting to rear its ugly head and we can’t seem to get away from the coughing and sneezing. But why are we prone to get the sniffles during winter?

Viral infections that cause the common cold or the flu are a nuisance. According to the Centers for Disease Control and Prevention (CDC), “Common colds are the main reason that children miss school and adults miss work” each year.

While most colds tend to go away by themselves, every year, the flu kills an estimated 250,000 to 500,000 people worldwide.

So, what do scientists know about how plummeting temperatures allow these viruses to spread like wildfire?

Common cold vs. flu

First, we need to distinguish between the common cold and the flu, because the viruses that cause these do not necessarily behave in the same way.

Most of the time, the common cold manifests with a trilogy of symptoms: sore throat, blocked nose, and cough. There are more than 200 viruses that can cause the common cold, but rhinoviruses are by the far the most common culprits.

Interestingly, around a quarter of people infected with a common cold virus are lucky enough not to experience any symptoms at all.

The flu is caused by the influenza virus, of which there are three types: influenza A, influenza B, and influenza C. Common colds and flu share many symptoms, but an infection with influenza often also manifests with a high temperature, aching, and cold sweats or shivers — a good way to tell the two apart.

So, now that we know the difference between the common cold and the flu, let’s look at when we tend to fall prey to these viruses.

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Seasonal patterns

The CDC monitor flu activity closely. Influenza can occur at any time of year, but most cases follow a relatively predictable seasonal pattern.

The first signs of influenza activity usually start around October, according to the CDC, and often peak at the height of winter. But some years, flu outbreaks can stick around and last until May.

The peak month for flu activity in the seasons spanning 1982–1983 to 2015–2016 was February, followed by December, March, and January.

Other temperate locations across the globe see similar patterns, with cold temperatures and low humidity cited as the prime factors, a 2013 analysis showed. The same can’t be said for tropical areas, however.

There, you might see outbreaks during rainy, humid months, or relatively consistent levels of flu cases all year round.

If this seems counterintuitive to you, you are not alone. While influenza data do support such a link, scientists don’t fully understand how viruses are able to exert their maximum damage at both low and high temperature and humidity extremes.

There are several theories, however, ranging from the cold affecting how viruses behave and how well our immune system copes with infections, to more time spent in crowded places and less exposure to sunlight.

Cold air affects our first line of defense

Common cold and flu viruses try to gain entry into our bodies through our noses. Luckily, our nasal lining has sophisticated defense mechanisms against these microbial intruders.

Our noses constantly secret mucus. Viruses become trapped in the sticky snot, which is perpetually moved by tiny hairs called cilia that line our nasal passages. We swallow the whole lot and our stomach acids neutralize the microbes.

But cold air cools the nasal passage and slows down mucus clearance. Viruses can now stick around for longer, trying to dig through the snot to break into our body.

Once a virus has penetrated this defense mechanism, the immune system takes control of fighting off the intruder. Phagocytes, which are specialized immune cells, engulf and digest viruses. But cold air has also been linked to a decrease in this activity.

Rhinoviruses actually prefer colder temperatures, making it difficult not to succumb to the common cold once the thermometer plummets. At a normal body temperature, these viruses are more likely to commit cell suicide, or apoptosis, or to encounter enzymes that make short work of them, a 2016 study showed.

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Vitamin D and ‘spending time indoors’ myths

During winter, levels of ultaviolet radiation are much lower than in summer. This has a direct effect on how much vitamin D our bodies can make. Vitamin D has been shown to be involved in making an antimicrobial molecule, which has been shown to limit how well the influenza virus can replicate in laboratory studies.

Consequently, some believe that taking vitamin D supplements during the winter months can keep flu at bay. The findings of a clinical trial published in 2010 showed that school children who took vitamin D-3 daily had a reduced risk of developing influenza A flu infection.

However, the results of a further clinical trial — published earlier this year — found that high levels of vitamin D supplementation had no effect. So, the jury is still out on the effects of vitamin D.

Another reason commonly cited to contribute to cold and flu infections in the fall and winter months is that we spend more time indoors once the weather is less hospitable.

This is thought to have two effects: crowded spaces help viruses to spread from person to person and central heating causes a drop in air humidity, which — as we’ve already seen — is linked to influenza outbreaks.

However, many of us live our lives in crowded spaces all year round, and in isolation, this theory cannot explain flu rates. Instead, some scientists believe that temperature, humidity, travel, and crowding all contribute to the overall risk of virus transmission.

With many people scheduled to travel over the upcoming Thanksgiving weekend, we predict that the sniffles will be making the rounds in the aftermath of the festivities.

But is there anything that you can do to protect yourself?

How to stave off viruses and treat symptoms

Your chances of catching a cold this winter are very high. In fact, the CDC estimate that adults have two to three colds each year.

The best way to protect yourself is by washing your hands with soap and water frequently, avoiding touching your eyes, nose, and mouth, and staying away from people who are already infected.

These rules also apply to influenza. The CDC recommend a yearly flu shot as the best way of preventing infection.

However, should you fall prey to a winter virus, here are eight home remedies to consider to help ease your symptoms.

You should always contact your doctor if you have a high temperature that doesn’t go away, your symptoms persist, get worse, or are unusual, or if you have any chest pain.

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