Medical News Today: Hemifacial spasm: Symptoms, causes, and treatment

Hemifacial spasm is a condition in which the muscles contract in tics or twitches on one side of the face, usually the left. People do not have control over these spasms, and very often they continue even during sleep.

Hemifacial spasm is usually not painful and not considered a health hazard. In advanced cases, however, the eyes may remain squeezed shut for long enough to become dangerous when driving, for example.

Both men and women can develop these facial twitches, but women, especially middle-aged and older women, develop hemifacial spasm at about twice the rate of men. The condition is also somewhat more common in Asian people.

It is a rare condition, seen in approximately 11 out of 100,000 people.

In this article, we look at different types of hemifacial spasms, the symptoms that can occur, and what can be done about them.


human head silhouette showing facial nerve
Hemifacial spasm causes the muscles on one side of the face to contract.

Hemifacial spasm is different from other nerve and muscle conditions affecting the face because it tends to affect only one side of the face.

However, there are differences between what is considered typical for hemifacial spasm and other forms of the condition.

A study of 215 people being examined for hemifacial spasm found that:

  • 62 percent were most likely caused by a vein putting pressure on the facial nerve

  • 18 percent had tics that mimicked hemifacial spasm but were not actually examples of the disease

  • 11 percent were due to Bell’s Palsy

  • 6 percent were the result of injuries to the facial nerve

  • 2 percent were linked to hereditary causes

Fewer than 1 percent of cases were caused by direct damage to nerves or the brain’s circulatory system


The first sign of hemifacial spasm is usually a twitching in the muscles of the left eyelid. These spasms can be strong enough to pull the eye closed and cause tears to form.

If left untreated, the symptoms of hemifacial spasm can become more severe and affect more and more facial muscles. Twitches can affect the muscles of the mouth and pull it to one side.

Over time, all the muscles on one side of the face can be pulled into a permanent frown. Some individuals may develop spasms on both sides of the face.

Ear pain, a “clicking” in the ear, and changes in hearing can also be symptoms of this condition. Hearing loss also sometimes occurs.

Around 13 percent of people taking part in one study reported a loss of hearing. However, this hearing loss did not appear to relate to how serious their hemifacial spasm symptoms were.

Symptoms of hemifacial spasm usually develop when people are between 40 and 50 years of age.

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Causes and associated conditions

Hemifacial spasm is caused by irritation to the seventh cranial nerve. This nerve is known as the facial nerve and controls the muscles of the face. It also transmits information about the sense of taste from the tongue and sensations in the ear.

The most frequent source of irritation is a small artery pressing on the facial nerve near the brain stem. Other potential causes include:

  • a benign tumor or lesion pressing on the nerve

  • abnormal clusters of blood vessels at birth

  • nerve injury

Hereditary cases of hemifacial spasm have been identified, although they are not common.

In some cases, hemifacial spasm is the first symptom of multiple sclerosis or MS. When people have MS, their immune system attacks the central nervous system, which results in a wide variety of symptoms.

However, this is extremely rare, with scientific studies showing only 1-6 occasions out of several hundred cases in which MS was identified as the cause of a hemifacial spasm.

Although it is rare, doctors still need to check for MS as a possible cause when people under age 40 have a hemifacial spasm.


doctor looking at brain MRI scans
MRI and CT scans can be used to diagnose the cause of facial spasms.

Facial tics are the key sign of hemifacial spasm. Doctors will observe the person and take a medical history, noting how severe the twitches are and how long the person has had them.

The doctor will then use medical imaging tests to find out what is irritating the facial nerve and rule out the possibility of tumors or brain lesions being the cause. These tests may include:

  • magnetic resource imaging (MRI)

  • computed tomography (CT scan)

  • angiography (arteriography)

If imaging tests do not find tumors or lesions, doctors will likely assume that pressure from a blood vessel is causing the hemifacial spasm. These tests cannot always locate the blood vessel that is irritating the facial nerve, however, because the blood vessels are so small.

A hemifacial spasm can be confused with other movement disorders that affect the face. These include facial nerve tics and eyelid spasms. These two conditions affect different areas of the face, and not just one side, which helps doctors accurately diagnose this condition.


To date, researchers have not discovered any ways of preventing hemifacial spasms.

As the spasms are involuntary, the only way to prevent the onset of muscle twitches once the condition develops is through treatment.

Stress, fatigue, and anxiety have been shown to make the condition worse, so people trying to minimize their symptoms may want to try to avoid these triggers, where possible.

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The two main ways to treat hemifacial spasm are through injections or surgery.


Botulinum toxin (Botox) shots are used to paralyze the facial muscles and stop the twitching.

These treatments are helpful for 85 to 95 percent of people. The effects wear off after 3 to 6 months so users will need follow-up treatment on a regular basis.


man having botox injection to face
Botox shots may improve facial twitches for up to 6 months.

Although surgery is more involved and invasive, it also provides more permanent and immediate relief.

In a procedure known as microvascular decompression, a surgeon moves the irritating artery away from the facial nerve and places a pad on the nerve to protect it from future compression.

This surgery is reported to be effective 85 percent of the time. It is considered especially helpful for young people and those in the early stages of this condition.

This procedure does have some risk, with one study finding a 1.5 to 8 percent risk of hearing impairment due to this surgery.

Treatment with medication alone has not been found to be effective for this condition.


Stress caused by this condition’s uncontrollable twitches is one of the most important side effects of hemifacial spasm. However, as people can relieve their symptoms with injections or surgery, the outlook can be good.

It is important for people to seek treatment and take an active role in their care. Their condition is likely to get worse if it is left untreated, so they should be aware of all the treatment options available.

One study found that close to 50 percent of people treated by one team had to learn about the surgical option for hemifacial spasm through their own efforts.

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Medical News Today: Scalp psoriasis: Shampoos, home remedies, and causes

Scalp psoriasis is an immune system disorder that causes scaly, itchy, and often, painful scales on the scalp.

The symptoms can range from mild to severe, with the most serious ones causing baldness if left untreated.

A variety of scalp psoriasis home remedies and shampoos can reduce pain and itching, speed the healing process, and prevent hair loss.

Scalp psoriasis shampoos

tar soap
Tar soap may help to treat psoriasis of the scalp.

People with psoriasis do not necessarily need to use special shop-bought psoriasis shampoos.

It is possible to make psoriasis shampoo at home. Try mixing psoriasis-friendly ingredients, such as apple cider vinegar or tea tree oil, with your usual shampoo for a gentle homemade psoriasis remedy.

The best ingredients for treating scalp psoriasis include:

Salicylic acid

Salicylic acid is a medication that helps the skin peel. It may also remove psoriasis scales and help the body heal psoriasis patches faster. The higher the percentage of salicylic acid a product contains, the stronger it will be. People should try starting with a relatively weak form of salicylic acid and gradually increasing the strength based on their skin’s reaction.

Other acids

Some other acids, including glycolic acid and lactic acid, can help the skin peel. Much like salicylic acid, they can irritate the skin at higher concentrations. Start slowly, and work your way up to stronger formulas.


Ketoconazole is an antifungal ingredient that can also treat dry, scaly skin. Shampoos containing ketoconazole can help remove both dandruff and psoriasis scales. Because some people with scalp psoriasis also have fungal infections, ketoconazole is an especially useful ingredient that can protect the scalp from painful yeast infections.

Tar soaps and shampoos

Tar soap can help treat psoriasis of all kinds, including scalp psoriasis. Though researchers have spent more time studying coal tar, pine tar soaps and shampoos may also work. It is also possible to wash the scalp with tar soap. The soap has a strong, distinct smell, and can be irritating to skin, however. People should start with a low concentration and work up to more potent formulas but always check with a doctor on the maximum strength to use. 

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Scalp psoriasis home remedies

turmeric root and powder on a board
Studies suggest turmeric may help to reduce the inflammation associated with psoriasis.

The right home remedy can, however, complement medical treatment, improving the appearance of psoriasis lesions.

Home remedies that may help include:

  • Turmeric: Some research on rats suggests that turmeric can reduce the inflammation associated with psoriasis.

  • Apple cider vinegar: This has long been used as a natural disinfectant to prevent infections. It may also ease the pain of psoriasis lesions.

  • Rich oils, such as avocado or coconut oil: These oils may help psoriasis plaques appear less dry and scaly.

  • Tea tree oil: This can be helpful in the treatment of minor psoriasis lesions. Tea tree oil may help the scales disappear, and can ease pain and itching.

  • Omega-3 fatty acids: Foods containing these acids, such as fish oil and olive oil, may fight inflammation and treat psoriasis. Apply oil directly to the plaques, or eat a diet rich in Omega-3 fatty acids.

  • Oats or colloidal oatmeal: Oats can soothe irritated skin, and may help with very dry psoriasis skin plaques.

What is scalp psoriasis?

Scalp psoriasis
Psoriasis causes patchy, scaly skin and shampoos may help to reduce the itching.

Psoriasis is a group of autoimmune diseases that affect the skin. Autoimmune diseases cause the immune system to overreact. In the case of psoriasis, the over-activity causes skin cells to grow more quickly than normal, creating scales and lesions on the skin. The appearance of the lesions depends on the type of psoriasis.

The only type of psoriasis that affects the scalp, however, is plaque psoriasis.

The most common symptoms of scalp psoriasis include:

  • Scales on the scalp: These can be light and fine, or thick and crusty. The scales may be small or can cover the entire scalp.

  • Psoriasis plaques on other areas of the body: Scales can spread from the scalp, extending to the face or neck. They may also appear on distant parts of the body.

  • Hair changes: In more severe cases, hair loss, changes in hair texture, or patchy hair can develop.

How scalp psoriasis is different from other forms of psoriasis?

Scalp psoriasis is not distinct from other forms of psoriasis. In fact, at least half of people who have psoriasis develop psoriasis plaques on their scalp.

What causes scalp psoriasis?

For most people, something triggers the immune system to flare-up, causing psoriasis patches. Triggers vary from person to person, but some common triggers include:

Some people also notice that their psoriasis gets worse after eating certain foods, or as a result of allergies. Research has not yet conclusively proven that these factors can trigger psoriasis.

However, triggers alone do not cause psoriasis. People without a genetic risk for psoriasis will not develop psoriasis even when they are stressed, injure their skin, or get an infection.

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Scalp psoriasis outlook

While home remedies applied directly to the scalp can improve the appearance of psoriasis, they will not cure the underlying disease. The patches will keep coming back and may get worse with each flare-up.

Without treatment, psoriasis can cause serious medical problems such as heart disease. So people who experience symptoms of psoriasis on the scalp should see a doctor. Numerous treatments can slow the progress of the disease, and help people with psoriasis lead normal, healthy lives.

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Medical News Today: Is pneumonia contagious? Causes and transmission

Pneumonia is an infection of the lung tissue that can make it difficult to breathe due to inflammation, fluid, and pus. Viruses or bacteria, which are contagious, cause most forms of pneumonia.

Not all cases of pneumonia are contagious, however, and the period during which it can spread from one person to another depends on the cause of the infection.

Is pneumonia contagious?

Pneumonia refers to an infection in the lungs caused by certain germs, such as bacteria or viruses. When one person spreads germs that can cause pneumonia to someone else, the recipient can develop a range of respiratory infections, from mild cold symptoms to pneumonia.

A range of factors determine whether pneumonia is contagious:

Type of pneumonia

senior man in bed with the flu
Contagious viruses or bacteria cause most forms of pneumonia.

Most cases of pneumonia are due to the spread of bacteria and viruses. Bacteria are living organisms that respond to antibiotics. Viruses are tiny strands of protein and genetic material that cannot be treated with antibiotics. Both viruses and bacteria are contagious.

Pneumonia often develops after a person has had a different infection, such as a head cold. This makes a person more vulnerable to other types of infections. An infection that develops in the lungs is called pneumonia.

Some organisms are more likely to cause pneumonia than others. One common example is pneumococcal disease, a bacterial infection that can cause ear infections, sinus infections, infections of the brain and blood, and pneumonia.

Another type of bacteria called Mycoplasma pneumoniae can cause other forms of pneumonia. Mycoplasma bacteria are also contagious.

The influenza virus or the flu is a common cause of viral pneumonia. The virus spreads easily from person to person, causing a range of symptoms and conditions.

Less common causes of pneumonia include:

  • inhaling food particles or contents from the intestinal tract

  • some fungi

These forms of pneumonia are not contagious.

Length of infection

In most cases, infections are contagious for a few days before symptoms appear and for a few days after. The exact length of time a person is contagious depends on the type of microorganism causing the infection.

Some forms of pneumonia, such as pneumonia caused by mycoplasma, remain contagious for several weeks. If a person has pneumonia, they should speak to a doctor about how long the infection will be contagious.

Pneumonia treatment

People with bacterial pneumonia will usually be prescribed antibiotics that stop the infection from progressing. Pneumonia will usually stop being contagious a day or two after treatment begins.

A person is also considered contagious during a fever, so it is best to stay home from work or school until the fever is gone.

People who have been vaccinated against infections that can cause pneumonia, such as pneumococcal bacteria, are usually immune to those specific germs. Getting the vaccination can help prevent this type of infection from developing.

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Risk factors

senior hand holding a babies hand
Older people and very young children may have weaker immune systems, which means they may be more likely to get pneumonia.

Although anyone can get pneumonia, some people are at greater risk. Pneumonia occurs when an infection develops within the lungs. It can cause complications with breathing and spread to other parts of the body such as the bloodstream.

People who are more likely to get pneumonia include:

  • very young children and babies whose immune systems are not fully developed

  • older people with weakened immune systems

  • pregnant women

  • people taking medications that suppress the immune system

  • people with diseases that weaken the immune system, such as cancer, HIV, and AIDS

  • people with autoimmune diseases, such as rheumatoid arthritis

  • people with lung and respiratory conditions, such as chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), and asthma

People at risk of pneumonia need to be especially cautious around people who have recently had pneumonia or another respiratory infection.


Pneumonia is transmitted when germs from the body of someone with pneumonia spread to another person. This can happen in a variety of ways, including:

  • Inhaling the infection. This can occur when a person with pneumonia coughs or sneezes and another person inhales the infected particles. This is more likely between people in close contact with each other, such as parents and children, or in poorly ventilated spaces, such as airplanes.

  • Through the mouth or eyes. This can happen when a person touches a surface that an infected person has coughed or sneezed on. When a person with an infection coughs into their hand and then shakes another person’s hand, the second person can become infected if they touch their mouth or eyes without washing their hands.

Food particles and irritants from the intestinal tract can also cause pneumonia. This is called aspiration pneumonia and can occur when a person accidentally inhales these substances.

Aspiration pneumonia usually happens in people who have trouble swallowing, such as someone having a diagnosis of a stroke or other central nervous system conditions, such as Parkinson’s disease

Fungal pneumonia typically develops when people inhale microscopic particles of fungus from the environment. People with weakened immune systems are more likely to develop this type of pneumonia.

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breaking a cigarette in half
Quitting smoking may help to prevent pneumonia.

A number of strategies can prevent the spread of pneumonia. The single most effective way to prevent the spread of viruses and bacteria is with frequent hand-washing, especially during the colder months.

People should wash their hands before eating, after using the bathroom, after touching someone else, before visiting people vulnerable to pneumonia, and upon returning home after going out in public.

Other strategies to prevent pneumonia include:

  • staying up-to-date on all vaccinations, as well as getting a flu shot and pneumococcal pneumonia vaccination annually

  • quitting smoking, since smoking makes the lungs more vulnerable to infection and affects the body’s immune system

  • managing any chronic medical conditions, especially those that affect the immune system or lungs

  • staying home from school or work when ill or with a fever

Protecting vulnerable people from pneumonia

Most people recover from pneumonia without any lasting effects. In vulnerable people, pneumonia can be fatal. Worldwide, pneumonia accounts for 16 percent of deaths in children under 5. Older people and those with a weakened immune system are also more likely to experience serious complications.

Older people, people with serious illnesses, parents of newborns, and caregivers to sick people should make sure all visitors wash their hands. It is best that people with symptoms of a respiratory illness or fever do not visit a vulnerable person until their symptoms are gone.

Other strategies that can reduce the risk include:

  • washing hands before eating, after touching people, and after going out in public

  • disinfecting all surfaces in the home, particularly if someone has recently been sick

  • keeping up-to-date on all vaccinations, especially any household members around infants who are too young to be vaccinated

  • avoiding locations with inadequate air filtration during cold and flu season

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Pneumonia killed more than 50,000 people in the United States in 2014. Despite this, around two-thirds of older adults do not get the recommended pneumococcal pneumonia vaccination to prevent pneumonia.

Pneumonia can be prevented, particularly in people who do not have chronic lung diseases. By avoiding sick people, staying home when ill, washing hands, and adopting basic health measures, such as getting vaccinated, it is possible to prevent this potentially fatal illness.

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Medical News Today: Period bloating: Seven tips for relief

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Medical News Today: Natural protein may help to prevent blindness

an older man with a poor eye
Researchers have found that a naturally occurring protein helps to protect the retina against glaucoma.
Scientists may be on the brink of a new strategy to prevent blindness, after discovering a naturally occurring protein that protects the eye from one of the leading causes: glaucoma.

Glaucoma is an umbrella term for a number of diseases that damage the optic nerve, which is the cluster of nerve fibers that links the retina – the light-sensitive tissue that lines the back of the eye – to the brain.

Optic nerve damage disrupts the transmission of visual signals to the brain, which can result in vision loss and blindness.

Glaucoma is most commonly caused by a buildup of eye pressure, which can damage the optic nerve. However, the precise mechanisms by which optic nerve damage occurs have been unclear, but researchers from Macquarie University in Australia may have shed some light.

The team found that a protein called neuroserpin plays a key role in retinal health, but that this protein is inactivated in glaucoma. They suggest that their findings may lead to much-needed strategies to prevent and treat the disease.

Lead study author Dr. Vivek Gupta, of the Faculty of Medicine and Health Sciences at Macquarie University, and colleagues recently published their results in the journal Scientific Reports.

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Neuroserpin and glaucoma

Neuroserpin is already established as a protein that blocks the activity of an enzyme called plasmin, protecting neurons, or nerve cells, against plasmin-induced damage.

For their study, Dr. Gupta and colleagues set out to determine how neuroserpin and plasmin are affected by glaucoma.

The researchers came to their findings by analyzing retinal cells derived from humans with and without glaucoma, as well as retinas from rat models of the disease.

The analysis revealed that neuroserpin is deactivated in response to oxidative stress, which can be triggered by environmental factors such as air pollution.

Oxidative stress is an imbalance between the production of reactive oxygen species (ROS) – which are molecules that can damage cell structures – and the body’s ability to offset their harmful effects.

Interestingly, the researchers found that neuroserpin was inactive in retinal cells from glaucoma patients and in the retinas of glaucoma rat models, which prevented the protein from inhibiting plasmin activity.

“Over a long period of time,” explains Dr. Gupta, “increased enzyme activity gradually digests the eye tissue and promotes cell death causing the adverse effects associated with glaucoma.”

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‘Breakthrough findings’

It is estimated that glaucoma affects around 2.2 million adults aged 40 and older in the United States, and it is one of the country’s leading causes of vision loss and blindness.

There is currently no cure for glaucoma, but there are treatments that can help to slow progression of the disease if it is detected early enough.

Dr. Gupta and team hope that their findings will open the door to new strategies that could help to prevent or treat glaucoma.

“Ophthalmologists and vision scientists have always wondered what damages the optic nerve in the back of the eyes, which is widely observed in glaucoma,” notes study co-author Dr. Mehdi Mirzaei, of the Department of Chemistry and Biomolecular Sciences at Macquarie University.

“The breakthrough findings of this study,” he adds, “help us understand the disease mechanism and answer a key question that has eluded scientists for several years.”

This long-term collaborative study has opened up a completely new line of investigation in glaucoma research that will lead to new treatment avenues for the disease.”

Dr. Vivek Gupta

In future studies, the team plans to investigate whether or not antioxidants – which are molecules that help to prevent cell damage caused by ROS – could be an effective treatment for glaucoma.

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Medical News Today: Hammer toe surgery: What to expect

A hammer toe is a potentially painful deformity of the second, third, or fourth toes, where the toe bends upward at the joint, resembling a hammer.

When a hammer toe causes pain, and other treatments fail, surgery may be the only option for correcting the joint.

What is hammer toe?

Hammer toe on both feet
Hammer toe is when the toe bends upwards at the joint.

A hammer toe causes the toe to bend at the first joint, which is called the proximal interphalangeal joint. The problem usually begins with a muscle imbalance.

When a muscle gets too weak, it can put pressure on the tendons of the toe. This can eventually cause the joint to become deformed. People with hammer toe may also develop corns or calluses at the top of the joint from the toe rubbing on poorly fitted shoes.

Wearing ill-fitting or pointy-toed shoes is one of the most common causes of a hammer toe. High heels can also cause the condition, because the heel pushes the front of the foot down, forward, and against the shoe. Over time, the toe muscles grow weaker and are no longer able to straighten the toe.

Certain risk factors increase the likelihood of developing hammer toe. People with unusually long toe bones, a history of toe injuries, and rheumatoid arthritis are more at risk of developing hammer toe.

The type of hammer toe determines treatment options. There are two distinct types:

Flexible hammer toe

In the early stages, the joint is still movable. It is possible to treat flexible hammer toe without surgery, often by simply switching to better shoes.

A person can reduce the symptoms of a flexible hammer toe by avoiding high heels and wearing loose shoes that are at least a half-inch longer than the longest toe.

Toe-strengthening exercises, such as picking items up off the floor with the toes, may also help. Ice packs to reduce pain and swelling can help with pain and inflammation. A doctor may also recommend putting a pad over the joint to prevent it from rubbing against shoes.

Rigid hammer toe

A rigid hammer toe means the joint is no longer movable. Home treatment and better shoes may offer temporary relief from the pain, and a doctor may recommend trying a custom orthotic device before surgery. If that fails, surgery might be the only option.

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Types of hammer toe surgery

surgeons gloves
Surgery for hammer toe may be recommended when there is no other underlying condition.

Hammer toe surgery can be highly effective in people for whom the primary or only issue is hammer toe.

But when an underlying condition such as rheumatoid arthritis causes a hammer toe, doctors may recommend treating that condition first.

Surgical options for hammer toe include:

Tendon transfer

A tendon transfer pulls the toe into the correct position and often works well for a flexible hammer toe.

Tendons attach muscle to bone. During a tendon transfer, the surgeon pulls a tendon near the hammer toe across the top of the joint. This pulls the toe into a straighter position, compensating for muscle weaknesses and improving the toe’s appearance. It should also reduce pain.

Joint resection

Joint resection can help with a fixed hammer toe. For this surgery, a doctor cuts ligaments and tendons to help straighten the toe and may also remove a portion of the bone.

To keep the toe in place, the surgeon may insert temporary pins. These pins can be removed a few weeks after the surgery.


A fusion procedure can reduce the severity of a fixed hammer toe. In this procedure, the surgeon removes portions of the joint to allow bones to grow together. This straightens the toe and can help reduce pain.

A surgeon will cut tendons and ligaments, as well as the ends of the bones. Then, the surgeon will use pins to help keep the joint in place. The pins remain in place to allow the bones to grow together and are removed after the joint has fused.


In rare cases where a person experiences severe pain from a hammer toe and no other treatment works, a podiatrist or orthopedic surgeon might recommend removing the toe. This is called amputation.

A 2005 study of 12 older adults who had toes amputated found that the procedure could alleviate pain, and people were typically very satisfied with surgical outcomes.

Removing a toe can change the way a person balances on their foot. It also permanently changes the foot’s appearance and can be riskier and harder to recover from than some other surgeries.

What to expect

signs outside of an outpatient building
Depending on the type of surgery, hammer toe surgery is often performed on an outpatient basis.

Hammer toe surgery is primarily done on an outpatient basis. This means a person may go home the same day the surgery is performed.

Surgery can often be done with a local anesthetic that only numbs the toe, so the person remains awake during the operation. This can shorten recovery time and avoid the rare complications that sometimes accompany general anesthesia.

Hammer toe surgery can also be done under general anesthesia. People should discuss the risks and benefits of each option.

If a person is squeamish, does not want to see the procedure, or has a phobia of knives or needles, they might prefer general anesthesia. People with a history of bad reactions to general anesthesia or who want the shortest possible recovery time might prefer a local anesthetic.

Before surgery, a doctor will likely perform blood work and ask the person about their medical history. Some people will receive intravenous (IV) medication before or during surgery. An IV can be used to administer anesthesia or to provide a drug that helps a person feel relaxed while awake.

Under local anesthetic, a person will not be able to feel the procedure itself, but they may feel pressure or pulling. The surgery should not hurt.

After surgery, a person will typically feel some pain in the toe and must have someone drive them home. Those who choose general anesthesia may not be allowed to eat before surgery.

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Following surgery, most people experience swelling, which can last up to a year. It may be necessary to wear a special shoe or a shoe insert to support the toe following the procedure.

A person will need to avoid putting weight on the foot for several weeks. Elevating the foot can speed up healing and reduce pain.

As the toe heals, walking can be difficult and painful, so a person may need a cane or crutches for a few weeks. They may also be unable to drive for several weeks.

A few weeks after surgery, the doctor will remove any stitches or pins. The incision will probably leave a scar.

Exercises to improve strength in the toe and foot muscles may help the toe heal. These exercises can also prevent hammer toe from coming back.

A person with a history of hammer toe is at risk of developing it again, even after surgery, so it is important to wear comfortable shoes that fit and to follow a doctor’s recommendations for protecting the joint.


Hammer toe can be unsightly and painful, but it does not always require surgery. Home treatment, including changing shoes and toe exercises, often work.

An orthopedic surgeon or podiatrist can help a person correct the problem before surgery becomes necessary, so anyone experiencing symptoms of hammer toe should speak to their doctor before allowing it to get worse.

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Medical News Today: How does oxytocin control the brain’s social reward circuit?

oxytocin definition
Oxytocin, the “love hormone,” is a key factor of our social abilities, but not much is known about the mechanisms in which this hormone is involved. 
Although several studies have pointed to oxytocin, or the “love hormone,” as an important factor in promoting sociability, the mechanisms behind this remain unknown. Researchers from Stanford University have now looked into how oxytocin regulates the social reward mechanism in the brain.

Oxytocin, which is sometimes referred to as the “love hormone,” is a hormone and neuropeptide – or neurotransmitter, carrying information through the central nervous system – involved in sociability and sexual interaction. It also plays a role in facilitating biological processes related to childbirth, and bonding with the newborn baby.

Oxytocin is mainly produced in a brain region called the paraventricular nucleus, which is located in the hypothalamus. The hypothalamus is involved in various metabolic processes, including regulating body temperature, determining states of hunger and thirst, and some social behaviors, such as attachment.

Recently, much has been made of oxytocin’s role in promoting social behaviors, especially with a view to harnessing its potential in managing conditions such as autism, which impairs social interaction.

Medical News Today, for instance, have recently covered a study suggesting that the hormone could improve sociability in some children with autism.

Now, a new study conducted by Dr. Robert Malenka and a team of researchers from the Stanford University School of Medicine in California now looks at the mechanism behind the social reward system of the brain, pinpointing oxytocin’s role in this process.

“[D]eficits in social behavior [due to brain disorders such as autism] profoundly affect […] quality of life,” Dr. Malenka told MNT, “and thus it is critical to understand the underlying abnormalities in brain function that cause [them].”

He continued, saying, “The findings in this paper suggest that one factor contributing to social behavior deficits may be abnormal modulation of the brain’s reward circuitry by oxytocin.”

A paper detailing the researchers’ findings has been published in the journal Science.

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The brain’s reward mechanism

In the brain, a region called the ventral tegmental area (VTA) communicates with the nucleus accumbens to regulate the system’s reward response, which is a circuit telling us that certain activities – such as eating, drinking, and sex – are pleasurable.

Thus, they “encourage” us to keep performing them. This reward mechanism is, in part, what ensures that we thrive and keep on reproducing.

The nerve cells that make up the VTA secrete dopamine, another neurotransmitter, which regulates the sensation of pleasure. Dopamine released in the brain makes us feel good when we perform activities correlated with survival, but abnormal levels of this neurotransmitter have also been linked to addiction and substance abuse.

Dr. Malenka and team were interested in understanding why dopamine is sometimes released abnormally, causing undesirable effects, and what other factors are implicated in the complex reward response mechanism of the brain.

Oxytocin impacted dopamine neurons

Since the reward circuit of mice is similar to that of humans, the researchers used the rodent model to study the mechanism’s intricacies in more detail.

In a previous study on mice conducted by Dr. Malenka and colleagues, it became apparent that oxytocin plays an important role in determining social reward responses alongside dopamine. However, it remained unclear exactly how oxytocin impacted the functioning of this circuit.

Now, the researchers reveal that the paraventricular nucleus releases oxytocin in the VTA, which is crucial for promoting prosocial behaviors. Conversely, when the release of oxytocin into the VTA is inhibited, social interaction is impaired.

Dr. Malenka and team noted that oxytocin released in the VTA stimulates a group of neurons called “dopamine neurons,” which function via dopamine signaling. Moreover, while inhibiting the release of oxytocin in that region of the brain did impact sociability negatively, it did not stop the animals’ taste for pleasure-inducing drugs such as cocaine.

This is possibly the first study to confirm the existence of this mechanism, showing that oxytocin directly affects dopamine neurons in the VTA.

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Crucial ‘to understand how oxytocin works’

Dr. Malenka told MNT that the study “use[d] a sophisticated collection of methods to provide a brain mechanism that explains why social interactions are often pleasant and rewarding.”

But he also pointed out that the main limitation it faced was the reliance on the mouse model, which may lead to some inaccuracies.

“The limitations,” he explained, “are that the work was done in mice and therefore, of course, we do not know whether the same mechanisms happen in the human brain (although we think it is likely). We also use very simple behavioral assays in the mice and have to make the assumption that the social interactions we studied were ‘rewarding’.”

In the future, added Dr. Malenka, “We need to figure out experiments to do in people that will allow us to test whether the same mechanisms occur in the human brain and contribute to the good feeling we have when we have pleasant social interactions with our friends.”

Research on the mechanisms behind the reward circuit, and the role that oxytocin plays in them, is important – especially given this hormone’s potential to substantially affect social behavior.

[O]xytocin is being tested as a potential therapeutic agent in the treatment of individuals with autism and other brain disorders which exhibit social behavior deficits. It is therefore important to understand how oxytocin works in the brain to mediate its potential therapeutic effects.”

Dr. Robert Malenka

Going forward, he hopes that his team may be able to delve even deeper into the mysteries of the social reward response in the brain.

“We need to learn more about the detailed molecular mechanisms by which oxytocin modulates reward circuitry and dopamine neuron activity,” he concluded.

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Medical News Today: Retrolisthesis: Types, causes, and symptoms

Retrolisthesis is an uncommon joint dysfunction that occurs when a single vertebra in the back slips backward along or underneath a disc.

Retrolisthesis is the opposite of spondylolisthesis, which occurs when a vertebra slips forward. Retrolisthesis occurs in the neck and shoulder area, known as the cervical spine, or the lower back, known as the lumbar spine.

Retrolisthesis occurs less often in the center area of the spine or the thoracic spine, although it is possible.

Types of retrolisthesis

Model of the vertebrae in the spine.
Retrolisthesis affects the vertebra in the spine.

There are three types of retrolisthesis:

  • Complete retrolisthesis occurs when one vertebra moves backward in relation to the one above and below it.

  • Partial retrolisthesis involves one vertebra moving backward toward either the one above or below it.

  • Staircase retrolisthesis happens when one vertebra moves backward from the ones above it and ahead of the ones below it.


Retrolisthesis happens when the space between the vertebrae decreases. Sometimes this happens if the discs between the vertebrae shrink. Scientists are not entirely sure what makes the discs and space between the vertebrae decrease.

However, they suspect the following factors may cause this shrinkage and lead to retrolisthesis:

  • degenerative spinal problems

  • arthritis

  • congenital disabilities

  • injuries to or near the spine

  • weak abdominal muscles and muscles around the spine

  • blood or bone infections

  • osteoporosis

  • nutritional deficiencies

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Symptoms of retrolisthesis vary from person to person and range from mild to severe. Symptoms may include any combination of the following:

  • back pain

  • discomfort in one specific area of the back

  • limited range of motion

  • pain in the area of dislocation

  • sharp pinching pain

  • a bulge in the spine

Symptoms may extend beyond the back. Some people experience numbness or tingling in some of their extremities, including:

  • buttocks

  • thighs

  • arms

  • hips

  • legs

  • shoulders

  • neck


X-ray of vertebrae in the neck affected by Retrolisthesis. <br>Image credit: James Heilman, MD, (2012, March 26.)</br>
An X-ray may be required to diagnose retrolisthesis.
Image credit: James Heilman, MD, (2012, March 26.)

A doctor will start by reviewing a person’s general health and the symptoms the person is experiencing. After the examination, if a doctor suspects retrolisthesis, they may recommend a lateral X-ray. A lateral X-ray is taken when the person is standing up because it is impossible to identify retrolisthesis if the person is lying down.

A doctor will examine the X-ray, likely drawing several lines on it to compare the positions of the vertebrae and measure how far the vertebrae has slipped out of position. Any slippage over 2 millimeters is considered an indication of retrolisthesis.

The X-ray can also outline any other symptoms that may indicate whether a person has retrolisthesis. Some additional signs may include:

  • hardened arteries around the vertebrae

  • shorter disc heights

  • bone spurs

  • gas trapped between vertebrae

Treatment options

Many different techniques and methods are available to treat retrolisthesis, but these depend on the severity of the retrolisthesis and other areas of concern around the site of the slippage.

Nonsurgical methods may include:

  • physical therapy to help increase strength in the back and abdominal muscles

  • targeted spin strengthening exercises

  • massages designed to improve circulation and help with muscle tone

  • applying heat to the area

  • low-level electric currents (microcurrent therapy) that reduce swelling, pain, and inflammation

  • pain medication, such as ibuprofen or aspirin

Doctors do not usually consider surgery as a treatment option. Surgery is usually only performed to treat retrolisthesis as a last resort if the other non-surgical methods are not working.

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Lifestyle remedies for retrolisthesis

Leafy green vegetables, including cabbage, lettuce, spinach, kale, and greens.
Eating a diet rich in vitamins and minerals may help to treat retrolisthesis. Including green leafy vegetables such as spinach is recommended.

A person with retrolisthesis should talk to their doctor about ways to improve their nutritional intake. Eating nutrient-rich foods can help the body heal naturally over time and promote bone and joint health. Some nutrients and foods to include in a diet include:

  • vitamin A, found in spinach and carrots

  • vitamin C, found in lemons and oranges

  • vitamin D, found in milk, fortified cereals, and bread

  • calcium, found in dairy products and green, leafy vegetables

  • copper, found in peanut butter, nuts, and leafy vegetables

  • zinc, found in nuts and pork

  • proteins, found in nuts, meats, fish, and poultry

In conjunction with dietary changes, a person could consider an exercise routine that may help with recovery. Exercising will improve a person’s flexibility, mobility, and strength and help reduce pain from the slipped disc. Some common exercises that may help include:

  • walking

  • pilates

  • yoga

  • crunches performed on an exercise ball

  • hip exercises

  • back exercises

Diet and exercise have an additional benefit. For people who are overweight or heavier, both exercise and diet can help reduce excess weight. The reduced weight will help alleviate some of the pain as there is less strain put on the back and neck.

Can it be prevented?

Retrolisthesis is not always preventable. For example, a person may experience an injury that causes the back to slip out of alignment. For others, retrolisthesis may be caused by genetic factors.

For most people, following some of these basic tips can help prevent retrolisthesis:

  • maintaining good posture while sitting and standing

  • participating in yoga, pilates, or other core strengthening classes and routines

  • avoiding straining the back with excessive weight

  • stopping smoking, as it can lead to joint damage

  • strengthening the lower core muscles through regular exercise

  • eating a balanced diet


People can prevent retrolisthesis from occurring by taking proper care of their back with regular exercise, a balanced diet, and avoiding activities that may cause injuries.

People diagnosed with retrolisthesis often make a full recovery after following the treatment plan put in place by their doctor. Sometimes, surgery may be required to help the person heal.

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Medical News Today: Head cold: Symptoms and home remedies

A head cold or common cold is a viral infection of the nose and throat. It is usually a mild illness, but its symptoms can have a significant impact on everyday activities.

According to the Centers for Disease Control and Prevention (CDC), the average adult experiences two to three colds every year, and children may experience more.

This article looks at the symptoms of a head cold as well as a range of home remedies available to help manage its symptoms.

What is a head cold?

sick lady in bed blowing her nose
A head cold may resemble other similar conditions but differs due to the location of the symptoms.

Head colds can closely resemble other conditions, including chest colds and sinus infections. However, there are some significant differences.

A head cold occurs when a viral infection causes symptoms primarily in the head, such as a stuffy nose or a headache. It differs from a chest cold because of the location of the symptoms. Chest colds cause symptoms including chest congestion and coughing.

Sinus infections share many of the same symptoms as head colds, but their causes are usually different. Sinus infections are mostly caused by bacterial infections, although sometimes a sinus infection can be caused by a virus.


Several types of viruses can cause a head cold, including:

Head colds are transmitted when an infected person sneezes or coughs, projecting droplets infected with the virus into the air or onto people around them.

It is possible to catch a head cold by coming into contact with surfaces or things that someone with the virus previously touched. The virus can enter the body through a person’s eyes, mouth, or nose.

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Risk factors

Although anyone can get a head cold, and most people will experience many colds in their lifetime, some factors increase the risk of getting sick. These include:

  • having a weakened immune system

  • being under the age of 6

  • smoking

  • the season, as colds are more common in fall and winter

  • exposure to other people with head colds, particularly schoolchildren


Symptoms of a head cold begin to appear within 3 days of exposure to rhinovirus or another cold-causing virus. These signs and symptoms vary between individuals and include:

sick in bed with a sore thoat
Symptoms of a head cold may include a runny nose, sneezing, and a sore throat.

  • malaise, or a general feeling of being unwell

  • sore throat

  • cough

  • runny nose

  • stuffy nose

  • sneezing

  • congestion

  • body aches

  • headache

  • low-grade fever

  • fatigue

Most people recover from a head cold in 7-10 days, but symptoms may last longer in some cases.


Most people will recover from a head cold without experiencing any complications. When complications do arise, they include:

  • Asthma attack: In those with asthma, a cold may trigger an asthma attack.

  • Acute sinusitis: A head cold that does not resolve can eventually contribute to inflammation and infection of the sinuses, a condition known as sinusitis.

  • Ear infection (otitis media): If the virus gets into the area behind the eardrum, it can lead to earaches and a green or yellow discharge from the nose.

  • Other infections: Some people, especially children and individuals with weakened immune systems, can develop secondary infections following a head cold. Typical secondary infections associated with a head cold include strep throat, pneumonia, and croup, which a doctor must treat.

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Home remedies for a head cold

As a head cold is caused by a viral infection, antibiotics are not an effective treatment. Instead, treatment aims to manage the symptoms and reduce discomfort.

Some common home remedies for a head cold include:

  • Rest: Resting helps the body heal. Staying home from work or school also reduces the risk of transmitting the virus to others.

  • Hydration: Staying hydrated helps loosen congestion in the nose and sinuses while soothing the throat. Water and diluted juice are good options to stay hydrated. Warm liquids, such as teas, broths, and soups, may be especially beneficial. A person should avoid caffeine and alcohol until fully recovered.

  • Saltwater gargle: To soothe a sore throat, a person can mix a 1/2 teaspoon of salt with 8 ounces of warm water and use as a gargle.

  • Pain relievers: A headache, sore throat, and fever may be relieved with over-the-counter medications, such as acetaminophen or ibuprofen. Always follow the instructions on the packet, especially if giving medications to children.

  • Vaporizers or humidifiers: These devices help add moisture to the air, which may ease coughing and congestion. Using a vaporizer or humidifier at night might encourage a good night’s sleep. Vaporizers and humidifiers should be cleaned daily to discourage the growth of microbes and mold.

  • Nasal sprays: Saline nasal sprays can loosen mucus in the nose and are suitable for use by both children and adults. Adults may use decongestant nasal sprays for 3 to 5 days. However, people should avoid prolonged use of decongestant sprays.

  • Supplements: Many people take supplements to prevent or treat a head cold. The most popular supplements used include vitamin C, Echinacea, and zinc. However, there is limited evidence on whether taking supplements reduces symptoms.


Man sneezing into a tissue
Sneezing and coughing into tissues may help to prevent the spread of germs.

It is not possible to vaccinate against a head cold, but the following steps may help reduce the risk of getting a cold virus:

  • Avoid contact with infected people. Maintain a distance with anyone who has a head cold to reduce the risk of catching the virus.

  • Wash hands regularly. Thoroughly cleaning the hands with soap and hot water reduces transmission of the virus. An alcohol-based hand sanitizer is also effective.

  • Avoid sharing items. To prevent exposure to cold germs, try not to share cups or utensils with others.

  • Use disinfectant when family members are sick. Kitchen countertops and bathroom fittings should be cleaned with disinfectant when a family member is sick. Also, it is important to clean children’s toys regularly.

  • Sneeze or cough into tissues. Using tissues prevents germs spreading through the air. Throw away used tissues immediately and always wash hands after sneezing and coughing.

  • Maintain a healthy lifestyle. Eating a balanced diet, engaging in regular physical activity, reducing stress, and getting an adequate amount of sleep can help the immune system fight off an illness.

  • Teach children good hygiene practices. Ask children to sneeze or cough into a tissue, or the bend of their elbow, so they cover their mouths without using their hands. Encourage children to wash their hands thoroughly on a regular basis.

When to see a doctor

Adults should consult their doctor if they experience any of the following symptoms:

  • shortness of breath

  • wheezing

  • a severe headache, sore throat, cough, or sinus pain

  • fever that persists beyond 5 days

Children should receive urgent medical treatment if they have:

  • wheezing

  • a severe headache, sore throat, cough, or sinus pain

  • symptoms that do not improve or get worse

  • earache

  • drowsiness

  • loss of appetite

  • fever of 100.4°F in infants under 12 weeks

  • fever for more than 2 days in children of any age

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Although there is no cure for a head cold, there are several home remedies that can help manage symptoms and reduce discomfort. To avoid getting a cold, a person can take steps to limit exposure to cold-causing viruses.

People with a head cold can expect to recover within 7-10 days. Individuals who experience severe or persistent head cold symptoms should see their doctor.

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Medical News Today: Birth control and yeast infections: What’s the link?

Yeast infections are caused by an overgrowth of yeast, also known as candidiasis, in the vagina. Candida is the organism that causes a yeast infection.

Candida normally exists in the vagina in small amounts, but sometimes it can overgrow, which causes the symptoms of a yeast infection.

One common risk factor for getting a yeast infection is the type of birth control a woman is using. In this article, we look at why certain types of birth control increase the risk of a yeast infection, as well as treatment and prevention.

Yeast infections and birth control

Various packets of birth control pills stacked on top of each other.
Hormonal birth control pills may affect the natural hormonal balance in the body, making it easier for yeast to grow.

It is important to realize that using birth control does not cause a woman to get a yeast infection. Instead, it may change the environment of the vagina so that she is more likely to get one.

Hormonal birth control

Hormonal birth control contains either a combination of estrogen and progestin (a synthetic version of progesterone) or progestin alone. Taking these hormones can disrupt the body’s natural hormonal balance and can help yeast to grow.

It is believed that the estrogen in birth control pills, patches, and rings can cause the vagina to produce more sugars. These sugars feed the yeast already living in the vagina, causing overgrowth.

Barrier birth control

Physical and barrier forms of contraception can also cause yeast overgrowth.

Spermicidal jellies and creams can alter the balance of bacteria living in the vagina, which make it easier for yeast to grow. Also, using jellies or creams can create a moist environment that allows candida to grow faster.

Vaginal sponges, diaphragms, intrauterine devices (IUDs), and other devices that sit in the vagina may also promote the risk for growth and infection.

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Other risk factors for yeast infections

Pregnant woman sitting cross legged on a bed, holding her belly.
Various factors may affect the growth of yeast, including pregnancy, diabetes, and some antibiotics.

In addition to a woman’s birth control choices, there are other reasons why candida would overgrow:

  • Certain antibiotics: Antibiotics kill harmful bacteria in the body, but they can also kill the healthy bacteria living in the vagina that help to maintain normal yeast levels.

  • Uncontrolled blood sugar levels: Yeast tends to thrive in high-sugar environments, so a person with undiagnosed or poorly controlled diabetes is at higher risk.

  • Poor immune system: Someone with a weak immune system may have difficulty controlling large amounts of bacteria or yeast.

  • Pregnancy: Pregnancy causes a high-estrogen environment, in a similar way to someone who is taking high-estrogen birth control or hormone replacement therapy. This can increase the risk of a yeast infection.

  • Sexual activity: Even though sexual activity does not cause a yeast infection, it can help to spread an infection between partners.

Symptoms of a yeast infection

Most women are familiar with the symptoms of yeast infections; according to The National Women’s Health Resource Center, nearly 75 percent of all women will experience at least one yeast infection in their lifetime.

Symptoms can include:

  • vaginal itching and discomfort

  • white vaginal discharge similar in consistency to cottage cheese

  • burning around the vaginal opening

  • pain or dryness during sex

  • redness or swelling of the external vagina and vulva

These symptoms can sometimes resemble other vaginal infections, so it is important for a woman to see her doctor, especially if she has never had a yeast infection before. The doctor can confirm that it is not a more serious infection.

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Most yeast infections are easily treated with over-the-counter medicines. Pills and anti-fungal creams are available in many different preparations, so it is important to follow the instructions on the packaging and speak with a pharmacist if necessary.

Clotrimazole and miconazole are usually very effective for a simple yeast infection.

Anyone with a yeast infection should abstain from sexual intercourse during treatment to prevent passing it to their partner.

Also, some medications for yeast infections can weaken forms of birth control, including latex condoms and diaphragms.

When to see a doctor

Women sitting on examination table, speaking with gynecologist.
A woman should see their doctor if the yeast infection does not go away after using over-the-counter medication.

If over-the-counter treatments are ineffective or if a person has multiple yeast infections in a year, they should visit their doctor for an evaluation.

The doctor may suggest diagnostic testing to be sure that candida overgrowth is causing the symptoms.

Doctors may prescribe an oral medication called fluconazole (Diflucan) to help get rid of the infection. A doctor may also suggest a stronger or longer course of the topical medications, if necessary.

If a yeast infection is not causing the symptoms, a doctor can prescribe the appropriate treatment.

For recurrent yeast infections, the doctor may suggest a maintenance program. This may include a weekly dose of either oral or vaginal antifungal medications.

If the doctor suspects that a woman’s birth control is contributing to her recurrent yeast infections, the doctor can prescribe an alternative type of birth control or help her find a better option. 

Options may include a non-hormonal form of birth control or one with a lower dose of hormones.

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Preventing yeast infections

In addition to changing the type of birth control, there are other things a woman can do to lower the risk of getting yeast infections. These include:

  • wearing cotton underwear

  • wearing loose-fitting pants, shorts, or skirts

  • avoiding tight underwear or pantyhose

  • keeping the vaginal area clean and dry

  • changing out of wet workout clothing or swimsuits immediately

  • avoiding hot tubs

  • avoiding unnecessary antibiotics

  • limiting sugar

  • using natural soaps and laundry detergents

  • avoiding regular use of panty liners unless necessary

  • always wiping from front to back after using the bathroom

A woman who gets frequent yeast infections should keep a record of possible triggers, such as antibiotics or chemical soaps. If she can identify what is causing the symptoms, it can be easier to avoid it.


Most women will get a vaginal yeast infection at some point in their life. Certain forms of birth control can increase a woman’s risk of getting a yeast infection or make it more likely that she will get recurrent infections.

If a woman or her doctor suspects her birth control is affecting her vaginal health, switching the brand or type of birth control can help to reduce the risk for further yeast infections.

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