HEALTH," Dr.

RICH AND COMPANY DISCUSS THE MAJOR HORMONAL MILESTONES IN A WOMAN'S LIFE.

AND ON THE NEXT MEDICAL STUDENT MINUTE, GRACY LIN EXPLAINS WHY YOU SHOULD THINK TWICE BEFORE LETTING PEOPLE KISS YOUR NEWBORN.

THAT'S COMING UP ON "CYCLE OF HEALTH."

DON'T GO AWAY HELLO, AND WELCOME TO "CYCLE OF HEALTH."

I'M YOUR HOST Dr.

RICH O'NEILL.

TONIGHT'S TOPIC WOMEN'S REPRODUCTIVE HEALTHCARE.

WOMEN'S UNIQUE BIOLOGY AND PHYSIOLOGY ARE FINALLY GETTING MORE SCIENTIFIC AND CLINICAL ATTENTION.

WITH US IN STUDIO TODAY TO DISCUSS KEY ISSUES RELATED TO PREGNANCY, CONTRACEPTION, INVITRO FEATHER LIZ INDICATION AND MENOPAUSE ARE Dr.

RENEE MESTAD, DIRECTOR OF WOMEN'S HEALTH SERVICES AND ASSOCIATE PROFESSOR AT UPSTATE MEDICAL UNIVERSITY.

AND Dr.

WENDY VITEK, BOSTON IVF SYRACUSE AND CLINICAL PROF OF OBG/YN UPSTATE.

AND CHELSEA CORINALDI EXTENDS OUR DISCUSSION TO WOMEN'S ASSOCIATED MENTAL HEALTH ISSUES.

SO, Dr.

MESTAD, I LOOKED AT YOUR WEBSITE AND I SAW YOU FOLKS COVER AN ENTIRE SPECTRUM OF REPRODUCTIVE HEALTH ISSUES.

>> SO I QUALIFY AS WE WOULD SAY A GENERAL OBSTETRICIAN-GYNECOLOGIST, SO I DELIVER BABIES, DO YOUR PAP SMEARS, TALK TO YOU ABOUT YOUR MENSTRUAL PERIODS IF THEY'RE TOO HEAVY OR IRREGULAR AS WELL AS HELPING MY PATIENTS TO PLAN THEIR FAMILIES SO THEY CAN OPTIMIZE THEIR HEALTH AND JUST THEIR SOCIAL WELL-BEING AS WELL PRIOR TO ACTUALLY STARTING A FAMILY.

SINCE 2009-2010 THE UNITED STATES BIRTH RATE HAS ACTUALLY GONE DOWN.

IT HAD BEEN GOING DOWN QUITE A BIT PRETTY STEADILY SINCE THE LATE 1980S, EARLY 1990S BUT ACCELERATED PARTICULARLY AMONG THE YOUNGER AGE GROUPS, THE TEENAGERS AND THE EARLY 20S.

I THINK COMPLEMENTS OF THE AFFORDABLE CARE ACT WHERE IT MADE CONTRACEPTION MORE ACCESSIBLE WITH THE INSURANCE PROVIDERS AND PROVIDERS WILLING TO GIVE THEM MORE RELIABLE METHODS TO YOUNGER WOMEN.

>> WE ARE GOING TO COME BACK TO THE AFFORDABLE CARE ACT.

BUT INTERESTINGLY, YOU ARE AT THE OTHER END OF THE FERTILITY WINDOW WITH THE PEOPLE YOU SEE.

TELL US ABOUT YOUR PRACTICE.

>> YES, SO I ALSO TRAINED AS AN OBSTETRICIAN-GYNECOLOGIST AND THEN I DID ADDITIONAL TRAINING IN REPRODUCTIVE ENDOCRINOLOGY AND FER FERTILITY WHICH FOCUSES ON HELPING PATIENTS CONCEIVE WHEN THEY ARE READY.

SO AS CONTRACEPTION HAS BECOME QUITE EFFECTIVE AND ACCESSIBLE, IT HAS PUSHED MORE AND MORE PATIENTS INTO HAVING CHILDREN IN THEIR 30S AND 40S AND THAT'S WHERE WE SOMETIMES COME IN TO HELP.

THE DEFINITION OF INFERTILITY IS TRYING TO CONCEIVE FOR AT LEAST A YEAR WITHOUT SUCCESS IF THE FEMALE PARTNER IS UNDER AGE 35, OR SIX MONTHS IF OVER AGE 35 AND THE DIFFERENCE IN TIME COURSE IS BECAUSE THE EGG NUMBER AND QUALITY CHANGES WITH AGE.

WE WANT TO HELP PATIENTS ACCESS CARE SOONER WHEN THEY'RE IN THEIR LATE 30S AND EARLY 40S BECAUSE WE CAN BE MORE EFFECTIVE.

>> WHAT PERCENTAGE OF WOMEN HAVE DIFFICULTY CONCEIVING?

>> GREAT QUESTION.

SO IT'S SURPRISINGLY COMMON.

IT'S ONE IN EIGHT COUPLES NEED FERTILITY ASSISTANCE.

AND THAT'S SIMILAR TO THE RATE OF BREAST CANCER.

SO IT'S OFTEN NOT TALKED ABOUT OPENLY, THOUGH.

I THINK THERE IS MORE AND MORE OPEN DISCUSSION HAPPENING, THANKS TO INDIVIDUALS LIKE YOU WHO ARE PROMOTING THESE IMPORTANT CONVERSATIONS FOR OUR PATIENTS.

>> SO WOMEN EARLY ON IN THEIR LIVES ARE USING CONTRACEPTION AND THEN THEY FIND THEMSELVES LATER ON... >> MAYBE NEED BE NEEDING SOME HELP.

>> TELL US ABOUT CONTRACEPTION.

>> I WANT TO GET THROUGH WHAT YOU MENTIONED WOMEN USING IT EARLIER IN THEIR LIFETIME AND THEN NEEDING HELP TOWARDS THE END OF THEIR REPRODUCTIVE LIFESPAN.

THERE IS A COMMON MYTH THAT PORTRAYS CONTRACEPTION AS A DEVICE THAT RUINS OUR FERTILITY; THAT MAKES IT MORE DIFFICULT FOR WOMEN TO BECOME PREGNANT WHEN THEY WANT TO.

WHAT THEY'RE FAILING TO BRING INTO THIS IDEA IS THAT WOMEN AGE AND AS THEY AGE, WHILE THEY'RE TAKING CONTRACEPTION, THEIR FERTILITY STARTS TO DECLINE.

>> SO IT'S NOT THE CONTRACEPTION ITSELF.

>> CORRECT.

>> WE ARE JUST GETTING OLDER.

>> AND THAT'S INEVITABLE.

IDEALLY.

>> RIGHT.

>> SO A WOMAN STARTS HER BIRTH CONTROL PILLS IN HER EARLY 20s AND GETS THROUGH HER SCHOOLING, GETS INTO A GOOD JOB, HAS GOOD INSURANCE, MEETS A GOOD PARTNER AND AT 33 OR 34 DECIDES TO STOP HER PILLS AND TRY FOR A BABY AND FINDS IT MORE DIFFICULT.

AND OFTEN IT GETS BLAMED ON THE LONG-TERM USE OF BIRTH CONTROL PILLS.

IT'S ACTUALLY THAT SHE IS 33 OR 34 YEARS OLD.

>> BIOLOGY.

>> SO THAT'S WHEN YOU START TO SEE FOLKS POP UP IN YOUR OFFICE.

>> RIGHT.

SO THE GROUP WITH THE HIGHEST BIRTH RATE CURRENTLY IS IN THE UNITED STATES ARE WOMEN IN THEIR 30S, EARLY 30S.

>> THE HIGHEST BIRTH RATE ARE WOMEN IN THEIR 30S.

>> YES.

>> IT USED TO BE LIKE EARLY 20s.

YOU WERE AN OLD MAID IF YOU DIDN'T GET MARRIED... RIGHT.

>> OUR PEAK FERTILITY IS IN FACT IN OUR 20s.

BUT WITH SOME OF THE SOCIETAL CHANGES THAT WE COVERED, MORE AND MORE DELAYING THE START OR EXPANSION OF THEIR FAMILY INTO THEIR EARLY 30S.

AND, AGAIN, JUST TO REITERATE THE SUCCESS OF CONTRACEPTION, TEEN BIRTH RATE IS AT AN ALL TIME LOW.

AND THE GROUP WITH THE FASTEST INYEARS IN THEIR BIRTH RATE IS WOMEN OVER 40.

>> TEENS VERY LOW BIRTH RATE, ALL TIME LOW.

>> 30S PEAK.

>> MOST WOMEN HAVING BABIES.

>> AND 40S RISING.

>> THAT'S A HUGE SHIFT.

WHAT ARE THE CONTRACEPTIVE METHOD IS THE WOMEN IN THEIR LATE TEENS EARLY 30S USING?

>> FORTUNATELY IN THE UNITED STATES WE HAVE A WIDE VARIETY OF METHODS THAT ARE AVAILABLE.

STARTING WITH THE METHODS THAT YOU CAN JUST GET OVER THE COUNTER WITHOUT NEEDING A PRESCRIPTION, WITHOUT NEEDING, YOU KNOW, A HEALTHCARE VISIT, THERE IS THE CONDOMS THAT CONTINUE TO BE VERY POPULAR WITH PRETTY MUCH ALL POPULATIONS, AGED POPULATIONS BECAUSE THEY CAN BE BOUGHT AS NEEDED.

AND THEY ALSO HELP TO PREVENT VARIETY OF SEXUALLY TRANSMITTED INFECTIONS.

AND THEN YOU MOVE INTO THE OTHER METHODS THAT REQUIRE SOME KIND OF A PRESCRIPTION, THAT INCLUDES BIRTH CONTROL PILLS WHICH CONTINUE TO BE THE MOST POPULAR METHOD OF CONTRACEPTION MAINLY BECAUSE THEY HAVE BEEN AROUND THE LONGEST.

AND EVERYBODY HAS KNOWN SOMEBODY WHO HAS BEEN ON THE PILL.

YOU KNOW, THEIR MOTHER, THEIR SISTER, AT THIS POINT, MY MOTHER, WHO IS IN HER 70S WAS THE FIRST GENERATION OF BIRTH CONTROL USERS.

SO THAT'S JUST THE BEST KNOWN, I THINK, PROBABLY THE BEST TRUSTED.

>> IS THERE ANYTHING NEW?

ANY NEW THINGS?

>> WE HAVE, FORTUNATELY, HAVE SEVERAL LONG ACTING REVERSIBLE CONTRACEPTIVES THAT ARE AVAILABLE NOW.

AND THEY USED TO BE RESTRICTED TO YOUNG, YOUNG WOMEN OR TEENAGERS.

NOW THEY'RE AVAILABLE TO EVERYBODY OF ALL AGES.

>> LONG ACTING REVERSIBLE CONTRACEPTIVE LARC.

>> YES.

>> WHICH IS MUCH EASIER TO SAY.

>> IT IS.

>> SO THAT INCLUDES YOUR INTRAUTERINE DEVICES, IUDS AND YOUR SUBDERMAL CONTRACEPTIVE I AM PLANTS WHICH FIT UNDERNEATH THE PATIENT'S SKIN VERY SUPERFICIALLY.

>> HOW LONG DO THEY LAST?

ARE THEY EFFECTIVE FOR HOW LONG.

>> THREE YEARS TO 10 YEARS.

DEPENDING ON WHAT KIND THE PATIENT ACQUIRES.

SO WE HAVE SEVERAL THAT HAVE HORMONE IN THEM THAT HELP TO ALSO DECREASE MENSTRUAL BLEEDING SO THEY'RE FANTASTIC FOR PATIENTS WITH LONG PERIODS OR HEAVY ARE USING THEM TO PROTECT THEIR ABILITY TO HAVE A BABY LATER ON?

TO HAVE VIABLE EGGS?

>> GREAT QUESTION.

SO IF SOMEONE ANTICIPATES LIKE DELAYING THE START OF THEIR FAMILY, IN THEIR 20s AND EARLY 30S, WE CAN CONSIDER UNDERGOING THE FIRST STEPS OF IVF, WHICH INVOLVE STIMULATING THE OVARIES TO PRODUCE EGGS AND THOSE EGGS CAN BE FROZEN.

AT A LATER DATE... >> THERE ARE MEDICATIONS FOR THAT?

>> THERE ARE MEDICATIONS TO STIMULATE THE OVARIES AND THEY HAVE BECOME QUITE SAFE AND BETTER TOLERATED.

THE PROCEDURE TO RETRIEVE OR REMOVE THE EGGS FROM THE BODY IS ALSO QUITE SAFE AND IT'S DONE UNDER SEDATION SO THAT WAY THE PATIENT IS COMFORTABLE.

IT TAKES ABOUT TWO WEEKS TO BANK EGGS AND THEY CAN BE FROZEN INDEFINITELY.

THEY DON'T HAVE A SHELF LIFE.

SO MONTHS, YEARS, DECADES LATER, EGGS CAN BE THAWED, FERTILIZED, EMBRYOS CREATED AND THEN TRANSFERRED TO THE PATIENT SO SHE CAN CARRY A BABY THAT IS HER OWN BIOLOGY FROM HER OWN EGG.

>> SO YOU MIGHT BE ON THE SHELF BUT YOUR EGGS ARE GOOD TO GO?

>> YES, IF THEY'RE FROZEN.

>> FOR A LONG TIME.

SO THAT'S GREAT NEWS.

SO PEOPLE CAN BANK THEIR EGGS AND THEN MAKE USE OF THEM LATER ON.

>> LATER.

IF NEEDED.

>> ANYTHING ELSE?

WHAT ABOUT OTHER POSSIBLE WAYS OF DEALING WITH INFERTILITY EARLY 30S, LATE 30S, 40S.

WHAT IS POSSIBLE?

>> SO WE ALWAYS START WITH A COMPREHENSIVE ASSESSMENT TO UNDERSTAND THE FACTORS.

SOME WOMEN NEED JUST LIFESTYLE SUPPORT THAT CAN HELP RESTORE THEIR NATURAL FERTILITY.

SOME NEED ORAL FERTILITY MEDICATIONS THAT HELP WITH OVULATION.

>> THIS IS DURING THE 30S OR WHATEVER.

>> YEAH.

>> THE PERI MENOPAUSE PHASE?

>> PERI MENOPAUSE CAN, IN SOME WOMEN START IN THEIR 30S BUT MORE OFTEN IT'S IN OUR 40S.

THE DEFINITION OF MENOPAUSE IS ONE YEAR WITHOUT A MEN MENSTRUAL CYCLE.

TYPICALLY THE AVERAGE AGE IN THE UNITED STATES IS AROUND 51.

BUT THE SYMPTOMS LEADING UP TO MENOPAUSE CALLED THE PERI MEN MENOPAUSAL TRANSITION CAN START FIVE TO EIGHT YEARS PRIOR TO THE FINAL MENSTRUAL PERIOD.

SO SOME WOMEN FIND THEMSELVES IN A CHALLENGING SITUATION WHERE THEY'RE STARTING THEIR FAMILIES IN THEIR 40S WHEN THEY'RE IN PERI MENOPAUSE.

AND WHILE WE KNOW WHICH HORMONES TO SUPPORT SO THAT A WOMAN CAN CARRY A PREGNANCY SAFELY IN HER 40S, WE ARE LIMITED BY THE NUMBER AND QUALITY OF EGGS.

SO THAT'S WHERE HAVING THOSE FROZEN EGGS CAN COME INTO BE HELPFUL TO ESTABLISH PREGNANCY IN OUR MID 40S.

OR THERE IS AN ALTERNATIVE CALLED DONOR EGGS.

JUST LIKE SOMEBODY CAN DONATE BLOOD, YOUNG WOMEN CAN CHOOSE TO DONATE EGGS.

THEY UNDERGO THE FIRST PART OF IVF.

THEIR EGGS ARE FROZEN AND WOMEN IN THEIR 40S WHO ARE INTERESTED IN HAVING A PREGNANCY BUT NO LONGER HAVE EGGS, CAN PURCHASE EGGS THAT ARE THEN FERTILIZED AND EMBRYOS CREATED.

THE WOMAN CARRIES THAT PREGNANCY.

IT'S HER CHILD.

IT'S NOT AN ADOPTION.

AND SHE ALSO HAS THE OPPORTUNITY TO NOT ONLY EXPERIENCE PREGNANCY AND CHILD BIRTH BUT POTENTIALLY LACTATION.

>> Dr.

MESTAD, I IMAGINE THIS DISCUSSION IS PART OF WHAT YOU HAVE WITH YOUR CLIENTS EARLY ON IN THEIR LIVES, WHEN THEY'RE CONSIDERING CONTRACEPTION.

ARE THESE THE KINDS OF THINGS THAT COME UP AS YOU ARE TALKING ABOUT PLANNING AHEAD?

>> YES.

SO, THE FIRST QUESTION IS ALWAYS WHAT IS YOUR PLAN FOR YOUR FAMILY?

WHAT DO YOU WANT TO ACHIEVE IN THE NEXT YEAR?

WHAT DO YOU WANT TO ACHIEVE IN THE NEXT FIVE YEARS?

AND DOWN THE LINE.

SO THAT WE CAN HELP FACILITATE OUR PATIENTS' GOALS IN THE FAMILY WHETHER THEY DON'T EVER WANT TO HAVE CHILDREN OR THEY PLAN TO HAVE EIGHT OR NINE CHILDREN.

>> FITTING THAT IN WITH A CAREER PERHAPS.

>> EXACTLY.

AND YOU KNOW, SO THAT GOES WITH OUR COUNSELING AS TO WHAT KIND OF CONTRACEPTIVE METHODS TO BE MOST AGREEABLE.

I DON'T WANT TO REALLY RECOMMEND AN EIGHT-YEAR IUD FOR A PATIENT WHO PLANS TO TRY TO GET PREGNANT IN SIX MONTHS.

>> THAT DOESN'T MAKE SENSE.

>> RIGHT.

>> DO THE MATH, RIGHT?

>> EXACTLY.

IT'S A LOT OF MONEY AND VERY UNCOMFORTABLE FOR SOMETHING YOU ARE GOING TO REMOVE IN A FEW MONTHS.

WE WOULD LEAN TOWARD THE SHORTER METHOD LIKE THE PILL, PATCH OR THE RING.

SOMETHING LIKE THAT.

>> I REMEMBER WHEN WE WERE TALKING ABOUT DOING THIS SHOW, YOU TOLD ME ABOUT ONE OF YOUR PROFESSORS IN MEDICAL SCHOOL, ASKED YOUR CLASS, THE WOMEN IN YOUR CLASS WHY-- TELL US THAT STORY.

>> SO MY FIRST YEAR OF MEDICAL SCHOOL AND ONE OF THE PROFESSORS BROUGHT UP THE POINT THAT THERE WERE VERY FEW WOMEN IN NEUROSURGERY BECAUSE IT'S A SEVEN YEAR RESIDENCY.

>> SEVEN YEARS AFTER MEDICAL SCHOOL.

11 YEARS ALL TOGETHER.

>> YOU ARE LOOKING AT EARLY TO MID 30S AT THAT POINT.

AND THE RESPONSE WAS BECAUSE WE WANT TO BE BEFORE OUR EGGS SHRIVEL UP.

>> SOME WOMEN IN THE CLASS... >> AND THAT WAS THE GENERAL CONSENSUS AMONG US THAT WE, AS FUTURE PHYSICIANS, ALSO WANTED TO HAVE A FAMILY.

WE WANTED TO BE ABLE TO HAVE THE TIME BECAUSE RESIDENCY AT THAT TIME WAS EASILY 100 HOURS A WEEK ON YOUR FEET A LOT.

SO NOT REALLY CONDUCIVE TO PREGNANCY.

PEOPLE DID IT.

>> YOU DON'T WANT TO HAVE ANYTHING TO DO WITH A MAN WHEN YOU GET HOME.

YOU ARE EXHAUSTED.

>> YOU ARE UNCONSCIOUS BASICALLY.

>> I'M GOING TO BED, BUT NOT WITH YOU.

GOODBYE.

[LAUGHTER] >> EXACTLY.

BUT ALSO THE EGG BANKING WASN'T AN OPTION BACK IN THE 90s.

WHEN I WAS IN SCHOOL.

SO THAT'S WHY IT'S SUCH A WONDERFUL RESOURCE THAT WE ARE STARTING TO HAVE MORE READILY AVAILABLE.

INSURANCE COMPANIES ARE STARTING TO PROMOTE IT.

EVEN OUR FEDERAL GOVERNMENT IS LOOKING TO PROMOTE IT AS WELL.

>> AND THE AFFORDABLE CARE ACT, I UNDERSTAND, MADE A LOT OF THINGS AVAILABLE TO WOMEN THAT WEREN'T AVAILABLE BEFORE.

>> YES.

>> WHICH IS WONDERFUL.

ANY LAST WORDS?

WE HAVE 15 SECONDS.

ANY 15-SECOND WORDS FOR YOU?

>> I WOULD SAY IT'S GREAT TO PARTNER WITH YOUR HEALTHCARE PROVIDERS, PARTICULARLY YOUR OBG/YNS TO VERY THESE DISCUSSIONS.

THEY'RE THE KEY ADVOCATE AND GUIDE FOR YOUR REPRODUCTIVE HEALTH AND WHEN NEEDED THEY WILL REFER TO SUBSPECIALISTS LIKE MYSELF TO HELP OUT SO YOU CAN COMPLETE YOUR FAMILY WHEN YOU WANT TO AND SAFELY.

>> TERRIFIC.

I UNDERSTAND THERE IS A WEBSITE WORLD HEALTH ORGANIZATION THAT PROVIDES A LOT OF THIS INFORMATION.

>> A LOT OF INFORMATION ABOUT MEDICAL ELIGIBILITY CRITERIA ABOUT WHAT METHODS ARE SAFEST FOR... >> WE WILL PUT THAT ON OUR WEBSITE FOR PEOPLE WHO ARE INTERESTED.

THANK YOU VERY MUCH AND OUR "CYCLE OF HEALTH" TEAM AND I SAT DOWN WITH Dr.

CHELSEA CORINALDI, AN UPSTATE PSYCHIATRY RESIDENT TO DISCUSS RELATED WOMEN'S MENTAL HEALTH ISSUES.

LET'S TAKE A LOOK.

HOW DOES GETTING PREEING-- HOW DOES GETTING PREGNANT OR HAVING A BABY AFFECT A WOMAN'S MENTAL HEALTH.

>> THAT'S A GOOD QUESTION.

WHEN WOMEN ARE PLANNING TO BECOME PREGNANT, ESPECIALLY, YOU KNOW, PRE-CONTRACEPTION DURING PREGNANCY AND AFTER PREGNANCY, WE ENCOURAGE THEM TO COME UP WITH A PLAN.

WE HAVE THINGS LIKE CBT, COGNITIVE BEHAVIORAL THERAPY AND INTERPERSONAL THERAPY AND THESE HELP TO ADJUST THE ROLE OF BEING A MOTHER.

>> BIG ROLE SHIFT THERE.

>> BIG ROLE SHIFT.

WHEN WE ARE THINKING ABOUT BECOMING PREGNANT, WE HAVE TO THINK ABOUT, YOU KNOW, WHO OUR SUPPORTS ARE.

WHAT IS OUR PRECONTRACEPTION PLAN, POST-PARTUM PLAN.

WHO IS GOING TO BE IN THE HOUSEHOLD HELPING OUT?

HOW ARE YOU GOING TO GET SLEEP?

THOSE ARE THINGS WE GO OVER WITH OUR PATIENTS TO SEE HOW ARE THEY GOING TO MANAGE.

OXYTOCIN IS LIKE THE BONDING HORMONE AND STRESS NEGATIVELY AFFECTS THAT.

STRESS LEVELS RELATED TO ANXIETY, DEPRESSION, CAN AFFECT CORTISOL WHICH CAN AFFECT OXYTOCIN AND MILK LET DOWN.

WHEN A MOTHER IS TRYING TO LATCH WITH BABY, THAT CAN AFFECT MAYBE HER PATIENCE WHEN SHE IS TRYING TO BREAST FEED.

>> YOU ARE SUGGESTING THAT A WOMAN THINK ABOUT THOSE THINGS, MAYBE EVEN BEFORE SHE IS GETTING PREGNANT.

>> YEAH, THAT'S THE HOPE.

BUT AS WE KNOW, ABOUT 50% OF PREGNANCIES ARE UNPLANNED.

>> UNPLANNED, WOW.

>> YEAH SO THAT CAN LEAD TO A LOT OF STRESS ITSELF.

SO IT'S HELPFUL DURING THAT PERIOD TO TRY AND PLAN AROUND WHAT STRESSES YOU ARE EXPECTING.

>> ALL THE BIG THINGS.

>> ALL THE BIG THINGS.

>> BABIES CHANGE ALL OF THAT STUFF.

>> THEY DO.

BABY CHANGES EVERYTHING.

>> WHAT PERCENTAGE OF WOMEN HAVE A MENTAL HEALTH ISSUE DURING PREGNANCY OR POST-PARTUM?

>> WE DON'T HAVE EXACT NUMBERS FOR HOW MANY WOMEN HAVE MENTAL HEALTH ISSUES DURING PREGNANCY.

FOR WOMEN THAT ARE IN THE POST-PARTUM PERIOD, 70 TO 80% OF WOMEN HAVE POST-PARTUM BLUES.

>> SHOCKING.

>> SO THE PHYSIOLOGY BEHIND THAT IS THAT ESTROGEN AND PROGESTERONE HAVE A PRECIPITOUS DROP.

>> HORMONES.

>> YES, HORMONES.

SO THOSE ARE ELEVATED THROUGHOUT PREGNANCY, PROGESTERONE TO MAINTAIN THE PLACENTA.

ESTROGEN IS IMPORTANT IN SEROTONIN MAINTENANCE AND PRODUCTION.

WHEN THOSE TWO DROP OFF, YOU MIGHT SEE SOME INCREASED ANXIETY, INCREASED DEPRESSED MOOD.

AND SO IT'S NORMAL FOR PEOPLE TO HAVE BABY BLUES.

BUT THEN ABOUT 20% OF WOMEN IN THE POST-PARTUM PERIOD MIGHT GO INTO POST-PARTUM DEPRESSION.

>> SO IF A WOMAN IS HAVING MENTAL HEALTH STRUGGLES POST-PARTUM AFTER SHE DELIVERS, ARE THERE TREATMENTS AVAILABLE?

>> FOR ANXIETY AND DEPRESSION SPECIFICALLY WE CAN USE AN SSRI OR SSNI, AND THEN THERE ARE UNIQUE MEDICATIONS APPROVED FOR POST-PARTUM DEPRESSION.

A ONE AND DONE.

>> ONE AND DONE MEANS?

>> YOU JUST USE IT ONE TIME FOR THAT PERIOD.

SO YOU CAN USE IT UP TO 12 MONTHS POST-PARTUM.

>> OKAY.

>> AND YOU CAN USE IT FOR EACH PREGNANCY BUT THEN AGAIN JUST ONCE.

AND ESSENTIALLY IT HELPS TO REESTABLISH ALLOPREGENOLONE WHICH IS AN OFF SHOOT OF PROGESTERONE.

>> AND THAT REESTABLISHES THE LEVEL.

>> YES.

>> I WANT TO START OFF BY SAYING ANY PREGNANCY CARRIES A BACKGROUND RISK OF 3 TO 5% FOR BURTSDZ DETECTS AND FROM STUDIES, WE KNOW THAT THERE IS A 1 TO 2% INCREASE.

>> SO VERY SLIGHT INCREASE.

>> THE OTHER SIDE OF THAT IS IF YOU ARE NOT TREATING PERINATAL MOOD AND ANXIETY, THAT CAN AFFECT BIRDS RATE, PRETERM LABOR, UNPLANNED C-SECTION AND WE KNOW ONE OF THE LEADING CAUSE OF MATERNAL DEATH IS SUICIDE.

SO THAT IS ABOUT 25% BASED ON 2017-2019 DATA FROM THE CDC.

>> IF A WOMAN IS CONSIDERING STARTING MEDICATION OR STOPPING MEDICATION, OBVIOUSLY THEY SHOULD TALK TO THEIR DOCTOR.

ARE THERE OTHER RESOURCES AVAILABLE?

>> YEAH, SO I WOULD LIKE TO PLUG A RESOURCE CALLED MOTHER TO BABY.ORG AND THEY HAVE SOME FACT SHEETS THAT INCLUDE DIFFERENT MEDICATIONS.

ALL THE SSRIS ARE ON THERE AND THEY CAN TELL WITH YOU BREAST FEEDING RISK, BIRTH DEFECT RISK.

WHAT YOU MIGHT BE ABLE TO TALK ABOUT WITH YOUR DOCTOR.

I FIND IT TO BE A VERY HELPFUL RESOURCE TO SHARE WITH MY PATIENCES.

>> Dr.

CHELSEA CORINALDI THANK YOU VERY MUCH FOR BEING WITH US.

>> THANK YOU.

>> AND BEFORE WE WRAP OUR SHOW TODAY, IT'S TIME FOR OUR MEDICAL STUDENT MINUTE.

MISS GRACY LIN EXPLAINS WHY YOU SHOULD THINK TWICE BEFORE SETTING PEOPLE KISS YOUR NEWBORN.

NO, THEY ARE SO SMOOCHABLE.

LET'S TAKE A LOOK.

>> HI ALL.

I'M GRACY LIN, A FOURTH YEAR MEDICAL STUDENT.

DID YOU KNOW IT CAN BE DANGEROUS TO LET FRIENDS AND FAMILIES KISS YOUR NEW BABY.

A BABY'S IMMUNE SYSTEM IS NOT FULLY DEVELOPED, ESPECIALLY IN THE FIRST THREE MONTHS.

THIS MEANS THAT THEY HAVE A MUCH HIGHER CHANCE OF CATCHING AN INFECTION AND BEING UNABLE TO FIGHT IT OFF.

ONE SUCH EXAMPLE IS THE HERPES SIMPLEX VIRUS WHICH OFTEN PRESENT AS COLD SORES BUT MAY BE ASYMPTOMATIC AND CAN BE TRANSMITTED THROUGH A SEEMINGLY BENIGN KISS.

EARLY SIGNS FOR BABY IS IRRITABILITY, HIGH FEVERS, RASHES ON THEIR SKIN, INSIDE THEIR MOUTH.

TRAMMINGALLY THIS CAN LEAD TO ORGAN FAILURE AND BRAIN DAMAGE.

SO, NEXT TIME A SMOOCHY PERSON TRIES TO GIVE YOUR BABY A KISS, LET THEM KNOW YOUR BABY'S IMMUNE SYSTEM IS STILL DEVELOPING AND THEY CAN GIVE SOME LOVING CUDDLES INSTEAD.

I'M MEDICAL STUDENT GRACY LIN.

>> THAT'S ABOUT ALL THE TIME WE HAVE.

I WANT TO THANK OUR GUESTS Dr.

RENEE MESTAD, MEDICAL DIRECTOR OF WOMEN HEALTH SERVICES AT UPSTATE MEDICAL UNIVERSITY AND Dr.

WENDY VITEK, MEDICAL DIRECTOR AT BOSTON IVF SYRACUSE AND Dr.

CHELSEA CORINALDI, PSYCHIATRY RESIDENT, ALSO AT UPSTATE.

TO HEAR OUR COMPANION COMMUNITY FM RADIO SHOW, CHECK UP FROM THE NECK UP, VISIT WCNY.ORG/COMMUNITYFM.

I'M HOPING TO GET THESE LADIES ON THE SHOW AND IF YOU WOULD LIKE TO REVISIT THIS EPISODE AND PAST SEASONS VISIT WCNY.ORG/"CYCLE OF HEALTH."

OR MY WEBSITE, Dr.

NECKUP.ORG.

FOR CYCLE PSYCH, I'M PSYCHOLOGIST Dr.

RICH O'NEILL.

Dr.

NECK-UP.

WE'LL SEE YOU NEXT WEEK.

>> NEXT WEEK ON "CYCLE OF HEALTH," Dr.

RICH AND COMPANY TAKE A CLOSER LOOK AT VISION HEALTH.

WE DISCUSS THE WARNING SIGNS OF VISION LOSS AND NOT JUST GETTING DIAGNOSED, BUT UNDERSTANDING YOUR PROGNOSIS AND HOW TO FIND THE CARE AND SERVICES YOU NEED.

>> A YEARLY VISION EXAM.

THAT'S THE NUMBER ONE THING.

>> SOONER THE BETTER.

>> AND OAT NEXT MEDICAL STUDENT MINUTE, SCHUYLER CONCERNER SHARES HOW DOCTORS CAN PERSONALIZE TREATMENTS TO CONTROL YOUR PAIN.

THAT'S COMING UP ON "CYCLE OF HEALTH."

>> THIS PROGRAM IS BROUGHT TO YOU BY THE MEMBERS OF WCNY.

THANK YOU.

CANCER, IT'S NOT JUST A DIAGNOSIS.

IT'S A COMPLEX OPPONENT, ONE THAT CAN ALTER THE COURSE OF YOUR LIFE, EVERY MOVE, EVERY DECISION HOLDS TREMENDOUS WEIGHT.

ST.

JOSEPH'S HEALTH HAS PARTNERED WITH ROSWELL PARK, THE REGION'S ONLY DESIGNATED COMPREHENSIVE CANCER CENTER TO OFFER YOU ACCESS TO PERSONALIZED THERAPIES AND LEADING ONCOLOGISTS RIGHT IN OUR COMMUNITY.

AMONG THE MANY MOVES YOU CAN MAKE, THIS ONE HOLDS THE POWER TO CHANGE YOUR LIFE FOR THE BETTER.