Medical News Today: What are the benefits of Epsom salt foot soaks?

Epsom salt foot soak: Benefits, how-to guide, and other soaks

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Medical News Today: Could this mechanism explain why sleepless nights affect gut health?

Gut inflammation and other conditions that involve the immune system are more common among people with irregular sleep patterns, including those who work night shifts. Now, new research in mice has uncovered a previously unknown mechanism that could help to explain the connection.
man asleep at his desk
New research finds a body clock mechanism that may explain the link between sleep patterns and gut health.

The mechanism concerns group 3 innate lymphoid cells (ILC3s). These immune cells have a strong role in controlling metabolism, inflammation, and other biological processes.

In a recent Nature paper, the scientists explain how they used mice to better understand the role of ILC3s in the gut.

“These cells,” says senior study author Henrique Veiga-Fernandes, Ph.D., “fulfill important functions in the gut — they fight infection, control the integrity of the gut epithelium, and instruct lipid absorption.”

Veiga-Fernandes works at the Champalimaud Centre for the Unknown, in Lisbon, Portugal. He leads a group that investigates communication at the cellular level between the nervous system and the immune system.

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Sleep pattern, health, and clock genes

“Sleep deprivation or altered sleep habits can have dramatic health consequences, resulting in a range of diseases that frequently have an immune component, such as bowel inflammatory conditions,” Veiga-Fernandes explains.

Research has shown that people who work shifts are more likely to develop certain long term health problems.

Those who work night shifts for a long time, for instance, have a higher risk of conditions such as ulcers, some cancers, metabolic illnesses, obesity, and gastrointestinal conditions.

“To understand why this happens,” Veiga-Fernandes continues, “we started by asking whether immune cells in the gut are influenced by the circadian clock.”

He and his colleagues found that ILC3s are particularly sensitive to changes in their clock genes, the genes that control rhythmic cell processes.

They also uncovered a circuit that links the circadian, or 24-hour, clock in the brain to ILC3s in the gut.

It appears that disruptions to this circuit, which senses changes in environmental light, can alter ILC3 clock genes. These genetic changes can impair the immune cells’ ability to regulate gut health.

The team demonstrated this effect by disrupting the 24-hour clock in the mice’s brains.

The authors write that “Surgically or genetically induced deregulation of brain rhythmicity led to disrupted circadian ILC3 oscillations, a deregulated microbiome, and altered lipid metabolism.”

Disrupting brain clock reduces gut ILC3s

Nearly all the cells in the body have clock genes that help them to follow a 24-hour cycle.

Clock genes tell cell machinery what the time is so that the body’s biology can prepare for cycle-sensitive activity, such as eating or sleeping.

While each cell’s clock genes can keep the time independently, they rely on the master clock in the brain to keep them synchronized.

In addition, because the brain’s clock circuitry is sensitive to external light, the connection with clock genes in the rest of the body helps to keep body functions in sync with day and night cycles.

The team found that disrupting the ILC3s’ clock genes dramatically reduced their presence in the gut.

“This resulted in severe inflammation, breaching of the gut barrier, and increased fat accumulation,” notes Veiga-Fernandes.

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Disrupted brain clock wipes destination code

Further investigation revealed the reason for the dramatic drop in ILC3s in the gut. It appears that disruption to the brain’s circadian circuit stops an important signal from reaching the ILC3 clock genes.

Loss of the signal affects a protein that tells the transient ILC3 cells where to migrate to. The protein works like a destination zip code in a satnav, and without the signal from the brain’s circadian circuit, it cannot set up the zip code.

Veiga-Fernandes says that he and his team are very excited by these results because they help to explain why people who are active at nighttime are more likely to have poorer gut health and experience inflammatory illnesses.

He suggests that the body has evolved so that during daylight, when feeding prevails, the circadian clock in the brain tells ILC3s to leave the gut. This reduces ILC3 activity in the gut, which boosts lipid metabolism.

However, reduction in ILC3 activity also leaves the gut vulnerable to damage. So, at night, when feeding does not prevail, the brain’s clock tells the ILC3s to go back into the gut and carry out defensive and repair tasks.

It [all has] to do with the fact that this specific neuro-immune axis is so well-regulated by the brain’s clock that any changes in our habits have an immediate impact on these important, ancient immune cells.”

Henrique Veiga-Fernandes, Ph.D.

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Medical News Today: Everything you need to know about hyaluronic acid

Hyaluronic acid is a substance that occurs naturally in the skin, eyes, and joints. Its primary function is to trap water inside tissue cells, keeping the eyes moist and the joints lubricated.

Hyaluronic acid also has many medical and commercial uses. It is available in a variety of forms, including:

  • dietary supplements
  • face creams
  • serums
  • eye drops
  • injections

In this article, learn more about the uses and benefits of hyaluronic acid, as well as the possible side effects and risks.

Uses and benefits

a woman applying hyaluronic acid to her face in the form of hyaluronic acid
Hyaluronic acid is available in the form of face creams, serums, and eye drops.

Some people use hyaluronic acid to promote skin health and fight signs of aging. It may help wounds heal, too.

Some doctors also use hyaluronic acid to relieve joint pain in people with arthritis.

The skin contains about half of the hyaluronic acid in the body. Hyaluronic acid binds to water molecules, which helps keep the skin hydrated and supple.

Levels of hyaluronic acid in the skin significantly decrease as people age, which can lead to dehydrated skin and wrinkles.

Taking hyaluronic acid or using cosmetic products that contain it may improve skin hydration and reduce signs of aging.

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Is it effective?

Researchers have looked at whether hyaluronic acid is effective for a range of uses:


The anti-aging effects of hyaluronic acid products may vary from person to person, depending on other factors that influence the skin, such as:

  • genetics
  • nutrition
  • smoking and alcohol consumption
  • pollution
  • sun exposure

In a 2017 study, researchers examined the anti-aging effects of hyaluronic acid supplements in 60 Japanese adults. The researchers randomly assigned the study participants to either a treatment or a placebo group.

The participants who ingested the hyaluronic acid supplements experienced a decrease in wrinkles and an improvement in skin condition compared with those in the placebo group.

However, the study involved only a small sample size. It also received funding from a company that produce hyaluronic acid supplements, which may have influenced the results.

Another small study found that hyaluronic acid may improve skin elasticity and reduce skin roughness in as little as 2–8 weeks.

In a 2016 German study, researchers compared the anti-aging effects of four different face creams containing hyaluronic acid. The researchers observed increased skin tightness and a 10–20% reduction in wrinkle depth in all 20 participants.

Many cosmetic brands claim that their hyaluronic acid products can reverse signs of aging. However, most over-the-counter products contain hyaluronic acid molecules that are too large to pass through the outer layer of skin cells, according to a 2015 review article.

Wound healing

Sporty woman treating her foot with a cream.
Hyaluronic acid may help with wound healing by promoting skin hydration.

Hyaluronic acid not only promotes skin hydration, but it also plays a crucial role in wound healing.

According to a 2016 review article, hyaluronic acid speeds up wound healing by controlling inflammation and redirecting blood vessels to areas of damaged skin.

In a study from the same year, researchers observed that hyaluronic acid helped diabetic foot ulcers heal more quickly compared with standard wound dressing materials.

In a 2019 animal study, researchers applied a biodegradable gel containing hyaluronic acid and poloxamer to skin wounds. The gel promoted wound healing by preventing bacterial infections and moisturizing the wound.

Relieving joint pain

Synovial fluid lubricates and cushions the joints. This fluid contains hyaluronic acid.

Over time, the hyaluronic acid in synovial fluid breaks down, which contributes to joint pain and stiffness, according to the Arthritis Foundation.

Doctors can use hyaluronic acid injections to treat people who have osteoarthritis.

Although hyaluronic acid injections can relieve osteoarthritis-related pain, it takes an average of 5 weeks before people experience the full benefits.

Usually, people need multiple injections before they notice significant pain relief, according to some research. However, receiving five or more injections may increase the risk of adverse effects.

The findings of a 2017 study suggest that combining hyaluronic acid injections with anti-inflammatory medications increases their effectiveness in relieving pain.

Side effects

In general, hyaluronic acid supplements, topical products, and injections appear to be safe when people follow the instructions on how to use them.

However, hyaluronic acid may produce adverse side effects and allergic reactions in some people. A person should always do a test patch before they start using a new skin product.

People who receive injections containing hyaluronic acid may experience the following side effects, which should clear up within a week:

  • pain
  • redness
  • itching
  • swelling
  • bruising

These side effects are most likely to occur as a result of the injection process rather than the hyaluronic acid solution itself.


young male patient speaking with female doctor in her office
A person should talk to a doctor about any interactions hyaluronic acid may have with existing medications.

As the body naturally produces hyaluronic acid, this substance rarely causes severe side effects or allergic reactions.

However, people who have a history of severe allergic reactions, such as anaphylaxis, should be cautious when using hyaluronic acid.

Its effects during pregnancy and while breastfeeding remain unknown, so women may want to avoid taking hyaluronic acid supplements during these times.

In general, people should talk to a doctor before trying a new supplement, especially if they:

  • take a prescription medication
  • are receiving treatment for an illness
  • have a chronic health condition

People can always speak with a doctor about whether hyaluronic acid is right for them.


Hyaluronic acid is a naturally occurring substance that helps retain moisture in the skin and eyes and lubricates the joints.

It also plays a crucial role in wound healing by controlling inflammation and redirecting blood flow to damaged tissue.

Hyaluronic acid levels decrease as people age, and this may contribute both to the physical signs of aging, such as the appearance of wrinkles, and to age-related conditions, including osteoarthritis.

Although hyaluronic acid is present in numerous cosmetic and medical products, its effects can vary from person to person.

People can purchase hyaluronic acid at a pharmacy or ask their doctor about medical products containing this substance. Some products are also available to buy online.

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Medical News Today: What are nootropics (smart drugs)?

Nootropics, or “smart drugs,” are a class of substances that can boost brain performance. They are sometimes called cognition enhancers or memory enhancing substances.

Prescription nootropics are medications that have stimulant effects. They can counteract the symptoms of medical conditions such as attention deficit hyperactivity disorder (ADHD), narcolepsy, or Alzheimer’s disease.

Nonprescription substances that can enhance brain performance or focus — such as caffeine and creatine — are also considered nootropics. They do not treat diseases but may have some effects on thinking, memory, or other mental functions.

This article looks at prescription and nonprescription smart drugs, including their uses, side effects, and safety warnings.

Prescription nootropics

a woman taking nootropics at her desk.
A person may take a nootropic to treat ADHD, narcolepsy, or dementia.

A doctor may prescribe a nootropic to treat a medical condition. Usually, the drug is a type of stimulant, such as an amphetamine, that can help treat ADHD, narcolepsy, dementia, or a similar condition.

Prescription nootropics include:

  • modafinil (Provigil), a stimulant that addresses the sudden drowsiness of narcolepsy
  • Adderall, which contains amphetamines to treat ADHD
  • methylphenidate (Ritalin), a stimulant that can manage symptoms of narcolepsy and ADHD
  • memantine (Axura), which treats symptoms of Alzheimer’s disease

While these can be effective in treating specific medical conditions, a person should not take them without a prescription.

Like any prescription medications, they carry risks of side effects and interactions, and a person should only take them under a doctor’s care.

Common side effects of prescription nootropics include:

Some evidence suggests that people who use prescription nootropics to improve brain function have a higher risk of impulsive behaviors, such as risky sexual practices.

Healthcare providers should work closely with people taking prescription nootropics to manage any side effects and monitor their condition.

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Over-the-counter nootropics

The term “nootropic” can also refer to natural or synthetic supplements that boost mental performance. The following sections discuss nootropics that do not require a prescription.


Many people consume beverages that contain caffeine, such as coffee or tea, because of their stimulant effects. Studies suggest that caffeine is safe for most people in moderate amounts.

Having a regular cup of coffee or tea may be a good way to boost mental focus. However, extreme amounts of caffeine may not be safe.

The Food and Drug Administration (FDA) recommend that people consume no more than 400 milligrams (mg) of caffeine a day. This is the amount in 4–5 cups of coffee.

Caffeine pills and powders can contain extremely high amounts of the stimulant. Taking them can lead to a caffeine overdose and even death, in rare cases.

Women who are pregnant or may become pregnant may need to limit or avoid caffeine intake. Studies have found that consuming 4 or more servings of caffeine a day is linked to a higher risk of pregnancy loss.


L-theanine is an amino acid that occurs in black and green teas. People can also take l-theanine supplements.

A 2016 review reported that l-theanine may increase alpha waves in the brain. Alpha waves may contribute to a relaxed yet alert mental state.

L-theanine may work well when paired with caffeine. Some evidence suggests that this combination helps boost cognitive performance and alertness. Anyone looking to consume l-theanine in tea should keep the FDA’s caffeine guidelines in mind.

There are no dosage guidelines for l-theanine, but many supplements recommend taking 100–400 mg per day.

Omega-3 fatty acids

person at desk holding omega 3 supplements in palm
Studies have shown that omega-3 fatty acids are important to fight against brain aging.

Omega-3 fatty acids are among the most well-known and well-studied mental enhancers.

These polyunsaturated fats are found in fatty fish and fish oil supplements. This type of fat is important for brain health, and a person must get it from their diet.

Omega-3s help build membranes around the body’s cells, including the neurons. These fats are important for repairing and renewing brain cells.

A 2015 review found that omega-3 fatty acids protect against brain aging. Other research has concluded that omega-3s are important for brain and nervous system function.

However, a large analysis found “no benefit for cognitive function with omega‐3 [polyunsaturated fatty acids] supplementation among cognitively healthy older people.” The authors recommend further long term studies.

A person can get omega-3 supplements in various forms, including fish oil, krill oil, and algal oil.

These supplements carry a low risk of side effects when a person takes them as directed, but they may interact with medications that affect blood clotting. Ask a doctor before taking them.


Racetams are synthetic compounds that can affect neurotransmitters in the brain. Some nootropic racetams include:

  • piracetam
  • pramiracetam
  • phenylpiracetam
  • aniracetam

A study conducted in rats suggests that piracetam may have neuroprotective effects.

One review states that “Some of the studies suggested there may be some benefit from piracetam, but, overall, the evidence is not consistent or positive enough to support its use for dementia or cognitive impairment.” Confirming this will require more research.

There is no set dosage for racetams, so a person should follow instructions and consult a healthcare provider. Overall, studies have no found adverse effects of taking racetams as directed.

Ginkgo biloba

Ginkgo biloba is a tree native to China, Japan, and Korea. Its leaves are available as an herbal supplement.

A 2016 study found that gingko biloba is “potentially beneficial” for improving brain function, but confirming this will require more research.

Ginkgo biloba may help with dementia symptoms, according to one review, which reported the effects occurring in people who took more than 200 mg per day for at least 5 months.

However, the review’s authors note that more research is needed. Also, with prescription nootropics available, ginkgo biloba may not be the most safe or effective option.

Panax ginseng

Panax ginseng is a perennial shrub that grows in China and parts of Siberia. People use its roots for medicinal purposes.

People should not confuse Panax ginseng with other types of ginseng, such as Siberian or American varieties. These are different plants with different uses.

A 2018 review reports that Panax ginseng may help prevent certain brain diseases, including Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease. It also may help with brain recovery after a stroke.

Panax ginseng interacts with many medications, so consult a doctor before taking it. A typical dosage for mental function is 100–600 mg once or twice a day.


Some evidence suggests that Rhodiola rosea L., also known as rhodiola or roseroot, can help with cognitive ability.

One review reported that rhodiola may have neuroprotective effects and may help treat neurodegenerative diseases.

Another review found that rhodiola helped regulate neurotransmitters in the brain, having a positive effect on mood.

Rhodiola capsules have varying strengths. Usually, a person takes a capsule once or twice daily.


Creatine is an amino acid, which is a building block of protein. This supplement is popular among athletes because it may help improve exercise performance. It may also have some effects on mental ability.

A 2018 review found that taking creatine appears to help with short term memory and reasoning. Whether it helps the brain in other ways is unclear.

The International Society of Sports Nutrition report that creatine supplementation of up to 30 grams per day is safe for healthy people to take for 5 years.

Another 2018 review notes that there has been limited research into whether this supplement is safe and effective for adolescent athletes.

Do nootropics work?

Some small studies show that some nootropic supplements can affect the brain. But there is a lack of evidence from large, controlled studies to show that some of these supplements consistently work and are completely safe.

Because of the lack of research, experts cannot say with certainty that over-the-counter nootropics improve thinking or brain function — or that everyone can safely use them.

For example, one report on cognitive enhancers found that there is not enough evidence to indicate that they are safe and effective for healthy people. The researchers also point to ethical concerns.

However, there is evidence that omega-3 fatty acids can benefit the brain and overall health. In addition, caffeine can improve mental focus in the short term.

Notes on the safety of nootropics

doctor and patient in office discussing adrenal cancer
A person should talk to a doctor about any interactions supplements may have with existing medications.

As with any supplement, there is a risk of side effects and interactions with medications. People should speak with their doctors about the safety of any supplement before taking it.

Also, some supplements may not contain what their labels say. A study of rhodiola products, for example, found that some contain contaminants or other ingredients not listed on the label.

For this reason, it is important to only purchase supplements from reputable companies that undergo independent testing.

Buying nootropics

A prescription is necessary for some nootropics, such as Provigil and Adderall. Over-the-counter nootropics are available in some supermarkets and drug stores, or people can choose between brands online:

Not all of these supplements are recommended by healthcare providers and some may interact with medications. Always speak to a doctor before trying a supplement.


Many doctors agree that the best way to boost brain function is to get adequate sleep, exercise regularly, eat a healthy diet, and manage stress.

For people who want to boost their cognitive function, nootropic supplements may help, in some cases. Anyone interested in trying a nootropic should consult a healthcare professional about the best options.

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Medical News Today: What to know about nitric oxide supplements

Nitric oxide is a compound in the body that causes blood vessels to widen and stimulates the release of certain hormones, such as insulin and human growth hormone.

Nitric oxide supplements are a category of supplements that includes L-citrulline and L-arginine. Researchers have performed multiple clinical trials related to nitric oxide supplements and their effectiveness, often with mixed results.

This article will examine how nitric oxide works in the body and some of the reported health benefits and risks of nitric oxide supplementation.

How they work in the body

a woman holding two Nitric oxide supplements in her hand.
Nitric oxide supplements may relax or widen blood vessels.

The two most common nitric oxide supplements are L-arginine and L-citrulline.

L-arginine is an amino acid, or a protein building block, naturally found in red meat, dairy products, poultry, and fish. Manufacturers produce it in a laboratory as a pill, powder, or cream.

L-citrulline is also an amino acid found in meat, nuts, legumes, and watermelon. Manufacturers can also make L-citrulline in a laboratory and package it as a pill or powder.

Without taking nitric oxide supplements, a person typically consumes about 5 grams (g) of L-arginine per day, according to an article in The Journal of Nutrition. The body converts this into nitric oxide for use in various body functions.

Some scientists believe that nitric oxide in the body relaxes or widens blood vessels. Some medications, such as Viagra harness the nitric oxide pathway to promote blood vessel widening and improve blood flow to the penis to enhance erections.

Many people think that taking nitric oxide supplements will enhance blood flow in the body to improve performance in sports, promote healing, enhance heart health, and provide many other potential benefits.

While there are many potential uses and benefits for nitric oxide supplements, there is not a lot of research to support some of the claims.

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Researched benefits

This is what the science says about the benefits of taking nitric oxide:

Improves heart health

According to an article published in the journal Biochemical and Biophysical Research Communications, taking nitric oxide supplements offers several heart boosting effects. These include reducing arterial stiffness, reducing blood pressure, and improving carotid artery blood flow. However, it is important to note that the researchers studied animals, not humans, to find these effects.

Enhancing exercise and recovery

a man who knows how to increase bone density through strength training
A person may take nitric oxide supplements to improve athletic performance.

Researchers theorize that taking nitric oxide supplements could enhance the delivery of oxygen to muscles. This could potentially improve athletic performance and reduce soreness after a workout.

According to an article in the journal Sports Medicine, studies have shown that taking nitric oxide supplements may enhance tolerance to exercise. However, this only applies to those who did not exercise regularly or only exercised at a moderate rate.

The research has not shown that nitric oxide supplements can help elite athletes. Researchers carried out these studies on young males, so they do not know how nitric oxide supplements may affect older people and females.

Reducing erectile dysfunction

Because nitric oxide supplements enhance blood flow, researchers have conducted studies to determine if it could enhance blood flow for people with erectile dysfunction (ED).

According to an article in the journal Future Science OA, some studies have shown taking nitric oxide may reduce ED in those with mild to moderate ED.

Reducing high blood pressure in pregnancy

Preeclampsia, which is a form of high blood pressure that can occur in pregnancy, can be dangerous for both the woman and baby.

A 2005 study in the European Journal of Clinical Investigation found that pregnant women who took L-arginine supplements for a prolonged period had lower blood pressure readings than pregnant women who did not take L-arginine.

Although researchers need to conduct more studies, the results are promising for women struggling with high blood pressure in pregnancy.

Future research

These are just some examples of more extensive studies that examined the effectiveness of nitric oxide.

However, there are no studies that establish how much nitric oxide supplements people should take to achieve the same results as the study participants did.

Other reported benefits

People take nitric oxide for a variety of reasons, many of which do not have any scientific research to support them.

Some of the reported benefits of nitric oxide supplements include:

  • enhancing weight loss
  • improving lung function in those with cystic fibrosis
  • treating altitude sickness
  • improving recovery after major trauma or injury
  • preventing the common cold
  • reducing the side effects of memory loss
  • healing diabetic foot ulcers

Most of these benefits are anecdotal, meaning that people may have reported a benefit, but there is no proof backed up by a scientific study.


woman speaking to a female doctor
A person should talk to a doctor about any interactions nitric oxide supplements may have with existing medications.

For most people, taking nitric oxide supplements does not cause side effects. When side effects do occur, they are often mild and may include:

However, some people should not take the supplements because of the risk of potential side effects. These include people with:

  • Cirrhosis: People with cirrhosis, or liver scarring, should take nitric oxide cautiously as it could worsen liver function.
  • Guanidinoacetate methyltransferase deficiency: This is a rare genetic condition where a person lacks an enzyme that converts arginine into creatine, which is a waste product. As a result, people with this deficiency should not take nitric oxide supplements.
  • Low blood pressure: If a person already has low blood pressure, they should not take nitric oxide supplements due to the risk that it might lower blood pressure further. Doctors will recommend that anyone taking nitric oxide supplements stops doing so before undergoing surgery.

Doctors also have some concerns that taking nitric oxide supplements could make some conditions worse. These include kidney disease, herpes, and after a person has had a heart attack.

A study published in 2006 in JAMA found that people taking L-arginine after a heart attack had a higher chance of death, experiencing a repeat heart attack, and being hospitalized than people who did not.

This article does not give a comprehensive list of potential conditions where a person should not take nitric oxide supplements.

The supplements may also interfere with medications, such as those for diabetes and high blood pressure. Anyone thinking about taking nitric oxide supplements should talk to their doctor first to ensure they will not interfere with existing conditions or any other medications they are taking.


Nitric oxide supplements have been available for decades, but as there is little scientific evidence to back up their use for specific health benefits, doctors do not routinely recommend them.

Instead, doctors may prefer to recommend lifestyle modifications or medications that scientists have proven to treat medical conditions effectively.

Nitric oxide supplements do not cause many side effects in most people, so some people might choose to try them. However, individuals should make sure that they do not have specific medical conditions that nitric oxide could harm.

A person should always talk to their doctor before taking nitric oxide or any other supplement to make sure they are making a safe, healthful choice.

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Medical News Today: Cervical effacement and how to measure it

Cervical effacement refers to the shortening and thinning of the cervix. It is part of the process that helps the cervix prepare for a vaginal delivery.

The cervix connects the lower portion of the uterus to the vagina. Normally, the cervix is around 2.5 centimeters (cm) and is firm and closed.

In preparation for childbirth, the cervix must thin and open up to allow the fetus to pass from the uterus through the vagina.

In this article, we look at cervical effacement, including how it relates to dilation and how to measure it.

What is cervical effacement?

a pregnant woman who may be undergoing Cervical effacement
The cervix must thin and open up to prepare for childbirth.

Cervical effacement is the shortening and thinning of the cervix. This helps the cervix prepare for a vaginal delivery.

During the later stages of pregnancy, the fetus’s head drops into the pelvis, pushing it against the cervix. This process stretches the cervix, causing it to thin and shorten.

Measurement of effacement is usually in percentages. For example, when the cervix is 100% effaced, it means that it is completely thinned and shortened.

An alternative is to measure the length in cm. As the cervix effaces, it becomes shorter.

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How effacement relates to dilation

As well as needing to thin and shorten, the cervix also needs to open up, or dilate, to prepare for vaginal delivery.

When the cervix opens up by 10 cm, doctors consider it considered “fully dilated.”

Full dilation and 100% effacement both need to occur for the fetus to be able to pass through the birth canal. The process of dilation and effacement is called cervical ripening.

a diagram showing the different stages of cervical effacement. Image credit: logika600's /
Image credit: logika600’s /


Certain signs and symptoms may indicate that cervical effacement has begun. These symptoms may include:

Passing of the mucus plug

During pregnancy, the mucus plug seals the opening of the cervix. This prevents bacteria from entering the uterus.

Cervical changes, including dilation and effacement, cause movement or loss of the mucus plug. However, not all pregnant women will notice this.

Bloody show

As effacement nears, tiny blood vessels near the cervix may rupture. This can cause a small amount of spotting known as bloody show.

This may occur with loss of the mucus plug or on its own.

Pelvic pain

Cervical effacement often occurs after the head of the fetus drops lower into the pelvis. This may cause pain, as the head puts pressure on the woman’s pelvic ligaments.

The pain may vary. For example, it may cause a dull ache or intermittent sharp pain. However, some women may not feel any discomfort at all.


Contractions involve the tightening and relaxing of the uterus to help cervical dilation and effacement.

Contractions can vary in severity and frequency. Usually, the more regular, frequent, and strong they are, the closer the woman is to delivery.

Braxton–Hicks contractions may occur during the second or third trimester of pregnancy. These are known as false labor, as they do not lead to delivery.

Braxton–Hicks contractions are less regular than true labor contractions and are often milder. According to March of Dimes, Braxton–Hicks contractions may play a role in cervical effacement.

How to measure

A healthcare professional often performs a pelvic exam to measure cervical effacement. Wearing a surgical glove, they will insert two fingers into the vagina and feel for dilation, effacement, and the position of the cervix.

Pregnant women can check their own cervix, but if they are not familiar with how it felt before pregnancy, it may be difficult to recognize the changes. A self-check of the cervix is not a substitute for a cervical exam by a healthcare professional, however.

In some cases, a doctor may recommend a transvaginal ultrasound to measure cervical thickness and length, as this method is likely more accurate.


The amount of time it takes for complete cervical effacement during labor varies greatly. Some women may reach 100% effacement within a few hours. For others, cervical effacement may occur slowly over several weeks.

The same applies to dilation. It is not uncommon for a woman to be 1–2 cm dilated a couple of weeks before going into labor.

Although they may occur at different speeds, cervical effacement and dilation can go hand in hand. A study in the American Journal of Obstetrics & Gynecology involved 7,407 pregnant women.

The researchers analyzed how fast effacement occurred in relation to dilation. The results indicated that by 8 cm dilated, 95% of the women had complete cervical effacement.

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Is it a sign that labor is near?

constipation in pregnancy doctor
Healthcare providers may monitor the length and thickness of the cervix to determine pregnancy duration.

Cervical effacement can start a few weeks before labor. Once a woman’s cervix is fully effaced, delivery is likely to be close.

The length and thickness of the cervix at different stages of pregnancy can also provide useful insight for healthcare providers.

For example, the length of the cervix at mid-pregnancy may give a clue as to pregnancy duration. A pregnancy longer than 41 weeks can raise the risk of complications for both the woman and the fetus.

Assessing which women have a high risk of a prolonged pregnancy allows healthcare providers to determine the necessity of labor induction.


Cervical effacement refers to the stretching, thinning, and shortening of the cervix in preparation for vaginal childbirth.

Along with effacement, cervical dilation must also occur to allow vaginal delivery. Typically, healthcare providers measure effacement in percentages or by the length of the cervix that remains.

Symptoms such as the loss of the mucus plug and pelvic pain may indicate that cervical effacement has begun. The rate of complete effacement varies from woman to woman.

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Medical News Today: What causes itching after sex?

Genital itching after sex can sometimes be due to dry skin or a lack of lubrication around the genital area. In cases where itching persists, this symptom could be a sign of an infection, allergic reaction, or sexually transmitted infection (STI).

In this article, we look at the possible causes of genital itching in females and males and discuss the treatment options.

Causes in males and females

Some causes of genital itching after sex are the same, regardless of biological sex. Some of the symptoms, however, can differ. Below, we discuss allergies and infections that can affect both males and females.

Latex allergy

a man and woman in a bedroom with a condom that may cause Itching after sex
A latex allergy may be the cause of itching after sex.

A latex allergy means that the immune system reacts strongly to any product containing latex. Latex condoms or lubricants that contain latex can cause uncomfortable symptoms in people with a latex allergy. These symptoms can include itching, redness, and swelling around the genital area after sexual activity.

People can try using latex free condoms and lubricants to see whether this relieves their symptoms.

Latex can cause three different allergic reactions:

Contact dermatitis

When latex triggers contact dermatitis, the reaction may not occur until 12–36 hours after contact with the skin. Symptoms can include:

  • itching
  • redness and irritation
  • skin appearing scaly

Immediate allergic reaction

This type of reaction happens in people who have become sensitive to latex through previous exposure to it. Coming into contact with latex again triggers a response from the immune system, and people may experience:


In some cases, latex can cause anaphylaxis, which is a very severe allergic reaction. If a person notices any signs of anaphylaxis, they should seek immediate medical attention or call 911 or the local emergency number.


STIs often do not produce any symptoms, but they can sometimes cause vaginal or penile itching. This itching and any other symptoms, which depend on the type of STI, may take several days to appear.

Common STIs that can cause itching include chlamydia, herpes, and gonorrhea.

Symptoms of STIs in females can include:

Symptoms of STIs in males can include:

  • unusual discharge from the penis, which may be yellow, green, or white
  • pain when urinating
  • in some cases, swollen or painful testicles
  • sores or warts around the genitals or mouth
  • flu-like symptoms
  • pain in the rectum

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Causes in females

As we discussed above, itching around the vulva or vagina after sex can be due to allergic reactions or STIs. Vaginal dryness, a vaginal infection, or sperm allergy can also cause genital itching specific to females. We look at these causes in more detail below.

Vaginal dryness

a woman on the toilet with slippers on
A person with vaginal dryness may also experience a more frequent need to urinate.

Vaginal dryness can cause itchiness and pain in or around the vagina during or after sex. People may also have:

Changes in hormone levels can create vaginal dryness. People may experience this if they:

Using scented products in the vagina or douching can also cause vaginal dryness. Sometimes, vaginal dryness may be a sign of an underlying health condition, such as diabetes or Sjogren’s syndrome.

Vaginal infections

Sexual intercourse can sometimes cause an imbalance in the pH balance and bacteria in the vagina. This imbalance can cause a yeast or bacterial infection.

A yeast infection occurs when there is an overgrowth of a fungus called Candida. People may also refer to it as vaginal thrush, vulvovaginal thrust, or candidiasis.

Along with itching, a vaginal yeast infection can cause:

  • painful urination
  • redness and swelling of the vagina and the area around the vulva
  • a burning sensation
  • painful sex, also called dyspareunia
  • thick, white, odorless discharge that looks like cottage cheese

Learn more about yeast infections after sex here.

Bacterial infections arise from an overgrowth of bacteria. Bacterial vaginosis is a common vaginal bacterial infection, which can cause:

  • vaginal itching
  • a fish-like odor from the vagina
  • grey or white discharge

Sperm allergy

Sperm allergy mostly affects women and is also called semen allergy or seminal plasma hypersensitivity.

An allergy to the proteins present in semen can affect any part of the body that has contact with semen, including the vagina, skin, and mouth. It typically causes symptoms to develop within 10–30 minutes of the bodily contact.

In addition to itching genitals, sperm allergy can cause:

  • redness
  • swelling
  • a burning sensation
  • pain

In more severe cases, people can also experience anaphylaxis from a sperm allergy.

Causes in males

As we mentioned earlier in the article, itching around the penis or testicles after sex can arise due to allergic reactions or STIs. Although it is uncommon, males may also develop thrush from sexual activity. A reaction to spermicide can also lead to genital itching. We look at these causes in more detail in the following sections.

Male candidiasis

Although yeast infections are less common in males than in females, males can also get thrush. Thrush can cause genital itching, and it has an association with sexual activity.

In males, thrush is sometimes called male candidiasis. It can affect the head of the penis and the foreskin, causing itching, soreness, and swelling. It sometimes also produces a thick, white, lumpy discharge.

Thrush can occur in males with a sexual partner who has vaginal candidiasis and in those with diabetes.

Read about thrush in men.

A reaction to spermicides

A reaction to spermicides is more common in males, but it can also affect females. Substances in spermicides can cause sensitivity or allergic reactions that can create an itching sensation around the genitals. Nonoxynol-9 is a chemical in spermicides that can irritate the genitals.

Irritation to the genitals can increase the risk of infections, including HIV and other STIs, entering the body.

Treatment and relief

Using a condom can prevent an allergic reaction to sperm. People can also receive treatment for a sperm allergy. A doctor or allergist will place some diluted semen into the vagina and then gradually increase the amount to allow the body to develop a tolerance.

For people with a sperm or latex allergy, a doctor may prescribe an epinephrine auto-injector, known as an EpiPen, in case of a severe allergic reaction.

If people have vaginal dryness, they can use a vaginal moisturizer. It is important to use a moisturizer that manufacturers designed specifically for this purpose and avoid putting any other lotions into the vagina.

Foreplay may increase arousal during sex, which may help reduce vaginal dryness.

If itching is due to a vaginal infection, a doctor may prescribe antifungal or antibiotic medication to treat the infection.

Learn about home remedies for yeast infections and home remedies for bacterial vaginosis.

Anyone who thinks that they might have an STI should see a doctor, who will be able to diagnose the infection and provide medication to treat it.


home remedies for diarrhea imodium
Changing spermicides or switching to another form of birth control may help prevent itching after sex.

People may be able to help prevent an itching sensation after sex by doing the following:

  • avoiding douching
  • using nonlatex condoms if latex causes irritation
  • using a water based lubricant before having sex
  • changing spermicides or switching to another form of birth control

Stopping using other irritants that can cause itching of the genitals may also help. Try avoiding:

  • vaginal deodorants or sprays
  • scented sanitary products
  • the use of perfumed soaps and chemical bathing products around the genitals

People can wash their genitals with mild soap and warm water to keep them clean. Females can wash the vulva and avoid washing inside the vagina.

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Itching genitals after sex can be normal, and this symptom is often no cause for concern if it goes away shortly. However, if itching continues, it may be a sign of an allergy or infection.

A person should see their doctor if the itching does not go away or if they notice any unusual symptoms alongside it, such as:

  • unexpected bleeding
  • unusual discharge
  • warts or sores around the genitals or mouth
  • redness or swelling
  • pain during sex or urination

If people have symptoms of a severe allergic reaction, they should seek medical help immediately.

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Medical News Today: What are the effects of black mold exposure?

Despite the commonly held belief that black mold exposure is a serious health concern, no convincing research suggests that exposure to this type of mold causes conditions such as cancer or lung disease.

Mold is a type of fungus. It is present almost everywhere, including the air. In general, normal amounts of mold in the environment do not pose a substantial health risk to healthy people with regular immune system function.

There is no single type of mold called “black mold” — many molds are black. When people use the term, they may be referring to a type called Stachybotrys chartarum (S. chartarum), also known as Stachybotrys atra.

There is no scientific evidence to suggest that exposure to S. chartarum is more dangerous than exposure to any other type of mold.

However, some people may be more sensitive to mold spores than others, and they may develop respiratory symptoms after inhaling even a small number of spores. In large quantities, mold spores can cause ill health in almost anyone.

Therefore, people should remove any mold growth in the home and take steps to prevent it from growing back.

In this article, we look at some facts and myths surrounding black mold exposure. We also describe ways to remove and prevent mold growth in the home.

How dangerous is black mold to health?

Some molds can release mycotoxins.
Some molds can release mycotoxins.

There is a commonly held belief that black mold — sometimes called toxic mold — can cause severe health problems because it releases mycotoxins. Mycotoxins are toxic substances that a fungus produces.

Some research suggests that mycotoxins from S. chartarum have a link to serious health problems in people who live in contaminated buildings.

One such health concern is mycotoxicosis — mold poisoning. Others include:

To date, there is no proof that inhaling mold spores causes these symptoms.

Mold exposure can cause other symptoms, however. According to the Florida Department of Health, it can cause the following types of health problems:

Allergy and irritation

People with allergies may be more sensitive to mold than others. If they come into contact with mold, they may experience symptoms, such as:

Severe mold allergies cause more severe symptoms, including shortness of breath.

Mold exposure may also worsen asthma or lung problems in people with preexisting lung conditions.

A 2012 study found that infants and young children exposed to mold in the home had an increased risk of developing asthma by the age of 7. The research examined 289 homes and 36 types of mold.

However, S. chartarum was not among the three types of mold most strongly associated with asthma development.

Research published in 2004 by the Institute of Medicine (IOM) indicates that spending time in damp indoor spaces is related to respiratory symptoms, including those of asthma.


For most people with healthy immune systems, molds are not a problem.

However, people with weakened immune systems — such as those with uncontrolled HIV, transplant patients, or people undergoing cancer treatment — are at risk of fungal infections.

Toxic effects

Some people believe that black mold is particularly dangerous because it releases mycotoxins. However, the fact is that all molds are capable of producing mycotoxins. Just because mold is present does not mean that it is producing these toxins.

Most cases of mycotoxicosis result from eating moldy food, rather than from inhaling fungal spores in the home or outdoors. The evidence does not indicate that inhaling or touching mold can cause mycotoxicosis.

The IOM’s 2004 report was unable to back up claims that issues such as fatigue, lung disease, or cancer result from mold exposure.

The Centers for Disease Control and Prevention (CDC) state that there are very few reports of unique or rare health conditions resulting from mold in the home.


It appears that many types of indoor mold — not just black mold — may cause health problems in some people, but not in everyone.

Long term exposure to mold in the home, however, may be unhealthy for anyone.

People who are most at risk of the symptoms of mold exposure are:

  • infants and children
  • older adults
  • people with allergies or asthma
  • people with weakened immune systems

The main health concerns seem to relate to allergies and irritation, which typically cause respiratory symptoms.

People with weakened immune systems may also have a risk of fungal infection.

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A person who suspects they may have a mold allergy should speak to a doctor.
A person who suspects they may have a mold allergy should speak to a doctor.

A doctor may diagnose a mold allergy based on a person’s symptoms and their medical and family histories. They may also perform tests, including:

  • a skin prick test, to check for reactions to common allergens
  • blood tests, to measure the immune system’s response to mold and to check for allergies to specific types of mold

To diagnose a systemic fungal infection in someone with a weakened immune system, a doctor may take a blood sample. In some cases, further testing may be necessary.


Treatment for a mold allergy is similar to treatment for other types of inhaled allergies. Options include:

  • avoiding the allergen whenever possible
  • a nasal rinse, to flush mold spores out of the nose
  • antihistamines, to stop a runny nose, sneezing, and itchiness
  • decongestant nasal sprays, a short term remedy for congestion
  • nasal corticosteroids, to reduce inflammation
  • oral decongestants, to reduce congestion

For a long term solution, a doctor may recommend immunotherapy. This involves getting a series of allergy shots over a few years.

Immunotherapy can be highly effective, but it is only suitable for certain types of mold allergy.

Getting rid of mold

Individuals should treat all molds the same when it comes to removing them from the home.

To do this:

  • Remove visible mold growth from hard surfaces with a commercial mold removal product, hot soapy water, or a mixture of 1 cup of bleach per gallon of water.
  • Remove and discard soft or porous materials — such as carpets, insulation, or wallboard — that show signs of mold.
  • Contact a professional if there is extensive mold growth in the home or if allergic reactions occur when cleaning moldy surfaces.


Thoroughly removing mold can help with long-term relief from allergic symptoms.
Thoroughly removing mold can help with long term relief from allergic symptoms.

Mold thrives in damp and humid environments.

The most effective way to prevent mold growth is to monitor the humidity level in the home. It should be no higher than 50% throughout the day.

Check the humidity level regularly, as it can change every few hours.

Use a dehumidifier if necessary, especially during humid months.

To prevent mold, a person can also take the following steps:

  • Regularly inspect the building for signs of water damage and mold.
  • Clean the bathroom regularly and tackle mold and mildew as soon as it appears.
  • Use exhaust fans in the kitchen and bathroom or open windows to improve ventilation.
  • Install an air conditioner with a high efficiency particulate air filter — better known as a HEPA filter — to remove mold spores from the air.
  • Add mold inhibitors to paints to stop mold growth on walls and ceilings.
  • Avoid using carpet in the kitchen, basement, or bathroom.
  • Recycle old books and newspapers, as these can become moldy quickly if they get damp.
  • Deal with any flooding promptly by drying out soft furnishings and cleaning wet items with commercial products.
  • Dispose of flood-damaged carpets.

To prevent or reduce the symptoms of a mold allergy:

  • Close the windows at night, as there are more airborne mold spores during the cool, damp nighttime hours.
  • Wear a dust mask while gardening.
  • Stay indoors after a rainstorm, in damp weather, and other times when the mold count is high.

Also, use proper safety equipment when cleaning up mold in an industrial setting or after a natural disaster.

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Based on current research, black mold exposure is no more dangerous than any other type of mold exposure.

It is impossible to avoid exposure to mold — the spores are almost everywhere around us.

In high amounts or in people with allergies, exposure to any mold may cause allergy symptoms. In people with underlying health conditions, it may lead to more serious complications.

Regardless of the type of mold, it is important to remove it from the home for hygiene and health reasons.

Anyone with concerns about the effects of mold on their health should speak to a doctor.

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Medical News Today: Causes of high blood pressure and a low pulse

High blood pressure and a low pulse: What it means

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Medical News Today: What is hoarding disorder?

Hoarding disorder is a condition that makes it difficult for people to throw things away, regardless of their value. There are a range of treatment options available.

Hoarding disorder can have a significant negative emotional, social, financial, and legal impact.

This article provides important information about hoarding disorder, including the symptoms, causes, and treatment options.


a man looking depressed because he has Hoarding disorder
A person with hoarding disorder may also experience disorganization, indecisiveness, and distractibility.

People with hoarding disorder may find it difficult or stressful to throw away items that others view as worthless or of little value.

Unlike collectors — who choose to collect a specific type of item — people with hoarding disorder tend to acquire various items. These may include piles of clothes, old magazines, food wrappers, and childhood trinkets.

Over time, they may run out of room to store these things, so they may have to display their belongings chaotically.

Some people with hoarding disorder might even start to acquire living things, including companion or farm animals. This can endanger both human and animal welfare due to factors such as overcrowding, unhygienic conditions, and a possible lack of veterinary care.

Other symptoms that people with hoarding disorder may experience include:

  • emotional distress, such as being overwhelmed or embarrassed by their possessions or living situation
  • suspicion or fear of other people touching their items
  • obsessive fears and actions, such as checking trashcans for discarded items or a fear of needing an item in the future
  • feeling responsible for objects, and sometimes thinking of inanimate objects as having feelings

People with hoarding disorder also tend to experience associated issues with:

  • indecisiveness
  • disorganization
  • distractibility
  • procrastination

Typically, the symptoms of hoarding disorder will begin during a person’s early teenage years, with the average age of onset being 13 years old.


Hoarding disorder can result in a range of negative emotional, social, physical, financial, and even legal complications.

For example, clutter may overrun someone’s home, blocking access to important living, cooking, and working spaces.

Other common complications or consequences associated with hoarding disorder include:

  • difficulty functioning in daily activities
  • poor hygiene
  • poor diet or nutrition
  • living in unsafe environments, with factors such as tripping hazards, fire hazards, or large piles of items that may collapse
  • strained or severed marital, family, or friend relationships
  • social isolation and loneliness
  • lost work or employment
  • debt
  • reluctance to let others into their home
  • financial difficulties
  • legal problems, such as those involving child custody and animal welfare
  • lost property value or eviction

As well as these complications and consequences, people with hoarding disorder may also experience mental health conditions such as:

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a woman receiving psychiatry for hoarding disorder
CBT is one possible treatment for hoarding disorder.

With the right treatment, most people with hoarding disorder can reduce their major symptoms and the risk of complications.

Healthcare professionals tend to treat hoarding disorder using a type of therapy called cognitive behavioral therapy (CBT).

During CBT sessions for hoarding disorder, a mental health professional will gradually teach people how to part with unnecessary items less stressfully.

CBT can also help a person improve relaxation, organization, and decision making skills. This can help with future management of hoarding behaviors.

In some cases, medication may also play a role in treatment. This is particularly the case when hoarding disorder is related to other conditions that respond well to medication, such as severe anxiety or depression.

Causes and risk factors

Researchers do not yet know why people develop hoarding disorder.

Usually, people with hoarding disorder are driven to obtain and keep items that:

  • they believe may become useful or valuable in the future
  • are free or are more affordable than usual
  • have perceived sentimental value
  • seem irreplaceable, unique, or perfect (often only to them)
  • are a reminder of an important memory of a person, place, time, or event that the person fears they will forget

Surrounding themselves with these items may also comfort the person.

Although researchers are not certain what causes people to develop hoarding disorder, several risk factors seem capable of triggering or worsening the symptoms. These include:

  • a family history of the condition
  • brain injuries
  • very stressful events, such as severe illness or the loss of a loved one
  • differences in brain function and neuropsychological performance unique from people with other conditions, such as obsessive-compulsive disorder (OCD)

Hoarding disorder can also be a symptom of another condition, most commonly:

Less commonly, hoarding disorder is also associated with:


Diagnosing hoarding disorder can be difficult, as many people with the condition are not willing to admit that they have it or are unwilling to seek treatment, often for fear of losing their belongings.

To diagnose someone with hoarding disorder, a psychiatrist will usually ask the person some questions about themselves, their belongings, and their homes. Common questions include:

  • How hard or stressful is it to get rid of (sell, give away, recycle) things that other people seem to discard easily?
  • How hard is it to use rooms and surfaces at home because of clutter?
  • How hard is it to organize things or decide where they should go?
  • To what extent do items or clutter impact overall daily functioning?
  • Does clutter impact work, school, social, or family obligations or relationships?
  • How common are fears about other people touching, using, or destroying belongings?

The doctor may also ask to see pictures of the person’s major living areas or ask to visit it themselves to better assess the extent or impact of their symptoms.

For a diagnosis of hoarding disorder, someone will need to display:

  • long term problems with getting rid of possessions, regardless of their value
  • significant distress tied to losing items
  • items that block, fill, or clutter primary living spaces and prevent proper use

For an accurate diagnosis, a psychiatrist will also need to make sure that hoarding disorder is not a symptom of another condition.

How common is it?

According to the American Psychiatric Association, around 2–6% of the population of the United States has hoarding disorder.

Some research suggests that hoarding disorder is more common among males than females.

When to see a doctor

People with symptoms of hoarding disorder should try to talk to a doctor, particularly if these symptoms:

  • are severe, chronic, or accompanied by other symptoms
  • interfere with everyday activities, such as cleaning, cooking, bathing, working, or attending school
  • cause significant interpersonal problems
  • cause severe anxiety or embarrassment
  • have made living environments unsafe or unhealthful

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How to help someone with hoarding disorder

a daughter gently touches her mother shoulder
It may be beneficial to have a loved one accompany a person to their first mental health meeting.

Family members or friends may want to meet with a doctor or mental health professional to learn how to broach the topic of diagnosis and treatment with someone they suspect has hoarding disorder.

Loved ones may also want to accompany someone to their first mental health meeting to make them feel more comfortable.

Having someone else attend early mental health appointments may also help give the doctor a better perspective of the person’s habits, home, and interpersonal relationships.

It is also worth noting that community public health agencies may have programs and services dedicated to helping people with hoarding disorder.

In extreme cases, local state or governmental authorities and agencies may need to become involved in someone’s treatment, such as to provide child or animal welfare services.


Early recognition, diagnosis, and treatment usually increase the likelihood that someone with hoarding disorder can reduce the severity of their symptoms.

Untreated hoarding disorder is likely to become chronic, often getting more severe over time.

People with signs of hoarding disorder should try to speak to a doctor or mental health professional as soon as possible.

People who think that someone they know may have hoarding disorder should consider contacting a mental health professional to learn how to help the person seek treatment.

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