Category: Health x Body

Sudden weight gain. Three words few people want to hear. And yet, there you are. You’ve stepped on the scale, and seemingly out of nowhere, your weight has skyrocketed.
If you haven’t eaten a Thanksgiving-sized meal or recently found out you’re pregnant, a sudden weight gain can send you into a tailspin, wondering exactly what the heck is going on with your body. Are you getting sick? Is your thyroid acting up? Is it cancer? Or are you absolutely fine and just need to refocus on your fitness?
That depends on how much weight you’ve gained and how fast, says Susan Besser, MD, a primary care physician with Overlea Personal Physicians and a physician certified in treatment of obesity through the American Board of Obesity Medicine. Most of us gain a few pounds every now and then, whether it’s because we’ve been spending a lot more time sitting or we’ve been under the weather.
Weight gain isn’t typically a problem unless it’s sudden, Besser says, but even then, a pound or two is considered well within the range of normal.
It’s when you’ve gained at least 10 pounds in as little as a week that Besser says she starts to get concerned. She’s quick to point out that it’s not just the weight gain itself but other symptoms that tend to coincide with sudden weight gain, such as obvious swelling of the legs, sudden shortness of breath, or chest pain.
“These things all suggest a systemic illness,” Besser explains. “Alternatively, many chronic health problems don’t cause sudden weight gain but slow, steady unexplained gain.”
If you’ve had sudden weight gain like the type Besser has described, here’s what the experts say could be going on (and what to do about it).

Causes of Sudden Weight Gain

Medicine

If you’ve had a change in medicine recently, and your weight has increased suddenly, a call to your pharmacist might be in order.
There are a range of drugs that can cause varying degrees of weight gain, says Julie Cantrell, MD, lead physician at OhioHealth Medical Weight Management. Some may cause sudden weight gain, while some may cause the body to pack on weight more slowly, albeit still significantly.
One of the worst offenders is prednisone, a steroid used to fight inflammation in patients with everything from asthma to lupus to psoriasis. Known for giving patients a “moon face” because of swelling, prednisone and similar steroids cause both fluid retention and an increased appetite, Cantrell says. Together, these symptoms can cause the numbers on the scale to climb, and for folks who have a chronic disease that requires extended steroid usage, weight management can be a significant challenge.
Antidepressants make the list too, in large part because they affect many of the different hunger hormones, Cantrell says. In particular, Paxil is known for its effect on hunger and resulting weight gain.
Other drugs that can cause a fluctuation in weight include anticonvulsants, beta blockers, diabetes medications, antipsychotics, and heart medications, although Cantrell notes that typically gains are slow rather than sudden.

Heart and/or Kidney Disease

The medications used to treat heart disease aren’t the only trigger of weight gain. Heart disease itself, along with kidney disease, can also cause a spike when you step on the scale.
That’s because congestive heart failure and renal failure both result in “significant water retention,” Besser says.
If you don’t have a medication to blame, and you’ve noted sudden weight gain, the risk of heart or kidney disease is a reason to call your doctor ASAP.
“Increased weight due to heart or kidney disease could be life threatening,” Besser warns, not because of the weight itself but because of the underlying disease.

Thyroid

When patients show up in Cantrell’s office complaining of weight gain, they often hope it’s a malfunctioning thyroid, she says, “because then we can fix it!”
Some 12 percent of Americans will develop a thyroid disorder during their lifetime, according to the American Thyroid Association, but up to 60 percent of Americans with a malfunctioning thyroid never know it.
For those who have hypothyroidism, meaning the thyroid gland is not producing enough hormones, weight gain can be a problem, along with fatigue, depression, and forgetfulness.
“The thyroid is like the body’s gas pedal, determining how many calories we burn at rest,” explains Jacob Teitelbaum, MD, author of the Beat Sugar Addiction NOW! series. “For most of us, that plays a much larger effect than exercise on weight.”
Treatment of hypothyroidism with synthetic hormones will typically help reverse weight gain.

Cushing’s Disease

Although it’s considered a rare condition, Cushing’s disease, or Cushing’s syndrome, can sometimes be the culprit of sudden weight gain. Most common in adults aged anywhere from 20 to 50, Cushing’s is an illness that results in excessive levels of cortisol, an adrenal stress hormone.
“This triggers insulin resistance and marked fat deposition,” Teitelbaum explains. That means fat won’t be spread evenly across the body; instead it’s often deposited in spots on the upper body such as around the neck, while legs and arms may remain thin.
Treatment for Cushing’s disease is dependent on the cause, as some cases of the condition are familial (meaning it was passed down through your genes), while others can actually be caused by medications such as the steroids described earlier.

Cancer

It may be a major fear for most of us when we note body changes, but this is one that can typically be written off when it comes to a sudden weight gain, says Avram Abramowitz, MD, a board-certified oncologist and hematologist with Queens Medical Associates.
Typically, cancer will cause weight loss rather than weight gain.
“The way cancer works is that tumors produce their own chemistry, which interferes with the body’s ability to use the nutrition intake. Whether people eat a lot or a little, well or poorly, is almost irrelevant when cancer takes over the body,” Abramowitz notes. “Their ability to use nutrients is subsumed by the behavior of the cancer.”
The only time cancer may cause weight gain, he adds, is at the end stage. Called ascites, this weight gain is actually a filling of the body with fluid, but other symptoms are apparent long before this point.

Pregnancy Complications

Most women gain steady weight while pregnant, and according to Nancy P. Rahnama, MD, a bariatric physician, as long as the weight gain isn’t sudden, it’s normal.
“General progression of weight gain will vary, but an average of four pounds a month is considered normal as long as the mother stays within the appropriate range,” Rahnama says.
It’s when you see sudden weight gain that you should have a talk with your doctor or midwife.  
“Any more weight gain may be suggestive of gestational diabetes, which can be detrimental to the baby and the mother,” Rahnama says.
Preeclampsia, HELLP syndrome, and other hypertensive disorders that are singular to pregnancy can also cause sudden weight gain in much the same way that kidney and heart disease can cause a weight spike in a non-pregnant woman. According to the Preeclampsia Foundation, “Damaged blood vessels allow more water to leak into and stay in your body’s tissue and not to pass through the kidneys to be excreted.”

Mental Health Issues

Although typically people suffering from depression or a binge eating disorder see slow weight gain rather than sudden weight gain, as lack of energy and increased appetite cause the body to build fat, stepping on the scale and seeing a big jump can be a sign of a mental health issue.
Sometimes, Cantrell says, the weight gain was gradual but seems sudden because “we put our heads in the sand.”

When to Call the Doctor

Whatever may be to blame for sudden weight gain, doctors advise against self-diagnosing in favor of a call to your physician.
“Inappropriate weight gain without an obvious cause that is consecutive should be evaluated,” Rahnama stresses. “When this weight gain is associated with other symptoms, such as fatigue, depression, hair loss, change in skin texture, or a lack of menstruation, the evaluation should be done sooner than later.”

When Amanda LaFleur quotes the PMDD statistics for America, she quickly adds an asterisk.
The medical community estimates 3 to 8 percent of cisgender women of reproductive age have premenstrual dysphoric disorder (PMDD). But that figure may be a wild underestimation of the number of cisgender women, transgender men, and non-binary folks who do battle with the condition every month, says LaFleur, who is the co-founder and executive director of the Gia Allemand Foundation, a non-profit focused on reducing the stigma and raising awareness of reproductive mood disorders, suicidality, and depression.
The foundation is named for Gia Allemand, an actress whose death by suicide rocked the country, her family, and her friends in 2013. Allemand had been diagnosed with PMDD before her death, putting her in that 3 to 8 percent. But PMDD is a condition that many folks don’t realize exists at all, and misdiagnosis is rampant, LaFleur says.
So what is PMDD? And why is it so hard for those who have it to find help? We asked the experts to shed a little light on the mental health condition and how to get treatment if you need it.

What is PMDD?

Most people have heard of PMS or premenstrual syndrome, the symptoms that crop up anywhere from a week to a few days before your period starts. You may feel bloated, have cramps, and even have some mood swings.
PMDD is not PMS. At least not exactly.
Someone with premenstrual dysphoric disorder may have some of those symptoms, and they will show up in the week prior to menses, but PMDD is both more severe and more debilitating, says Cindy Basinski, MD, an OB-GYN from Newburgh, Indiana.
“The symptoms experienced are more severe in PMDD as they affect the ability of a woman to perform normal daily activities,” Basinski explains. And while as many as 80 percent of women experience PMS on a regular basis, PMDD is considerably more rare.  
What sets the two apart?
PMDD is characterized by five or more of the following symptoms, says Nicole B. Washington, DO, a board-certified psychiatrist from Broken Arrow, Oklahoma, and chief medical officer at Elocin Psychiatric Services:

• Mood swings
• Sudden sadness
• Increased sensitivity to rejection
• Anger or irritability
• Depressed mood
• Sense of hopelessness
• Self-critical thoughts
• Tension
• Anxiety or feeling on edge
• Impaired concentration
• Change in appetite or food cravings
• Decreased interest in usual activities
• Low energy
• Feeling out of control
• Breast tenderness
• Bloating
• Aching joints or muscles
• Impaired sleep

The symptoms typically disappear as soon as the period starts or within a day or two of the first sign of blood—only to return again a month later.
Exactly why PMDD happens to some people and not others isn’t fully understood in the medical community, although Washington says it’s thought to be triggered by changes in sex hormones during what is known as the luteal phase of the menstrual cycle.
“This only occurs in susceptible women, but what we don’t really know is what makes one woman susceptible over another,” Washington says.
That’s not for lack of trying by scientists. The more awareness there is of PMDD, the more researchers are trying to suss out what happens to patients in the days and weeks before their period. A National Institutes of Health (NIH) study released in 2017 seems to have keyed in on one of the major components: a hormone susceptibility that only PMDD sufferers have. The scientists said their findings indicate molecular differences detectable in the cells of those with PMDD.
“We found dysregulated expression in a suspect gene complex, which adds to evidence that PMDD is a disorder of cellular response to estrogen and progesterone,” Peter Schmidt, MD, of the NIH’s Behavioral Endocrinology Branch, said in an NIH press release. “Learning more about the role of this gene complex holds hope for improved treatment of such prevalent reproductive endocrine-related mood disorders.”

Getting a PMDD Diagnosis

The path to diagnosis should be simple enough. PMDD is in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), the official guide of the American Psychiatric Association.
But Washington says the frequency of misdiagnosis comes down to issues on both the patient’s and the provider’s part.
“[The patient] may not be thinking that happens around that time of the month,” Washington says, “And the provider may not think to ask.”
In part, LaFleur blames this on a profound lack of understanding of how PMDD differs from PMS. People who struggle in the run-up to their menstrual cycle often doubt themselves, she says, even blaming themselves for not being able to pull themselves up by their bootstraps and muddle through a time of the month that’s hard on just about every person in their shoes.
“So many go through life thinking, ‘Oh, everyone goes through PMS, I’m just being dramatic’,” LaFleur says. In reality, a PMDD sufferer isn’t “just” going through PMS. While timing is the same, the symptoms are far more troublesome. That’s one of the cornerstones of PMDD itself: Symptoms have to interfere with life in order for the diagnosis to be made.
But the condition isn’t talked about very often—not nearly as much as PMS, which most Americans have heard of.
“It has the double stigma of the female problem of menstruation, which isn’t talked about because people think ‘ew, icky, blood, we don’t want to talk about that,’ and then you have the stigma of mental health on top of it,” LaFleur says of PMDD.
Even within the medical community, PMDD patients face stigma. As recently as 2002, the American Psychological Association ran an article in which some psychiatrists and psychologists said PMDD should not be classified as a mental illness at all.
Add to that the fact that some PMDD symptoms can crop up with other mental illnesses, and it’s no wonder there are misdiagnoses, Washington says.
In particular, LaFleur sees a number of patients who say they were first diagnosed with either borderline personality disorder or bipolar disorder before it was finally ascertained that they were experiencing PMDD.
Why?
According to Washington, borderline personality disorder is characterized by mood swings and extreme reactivity. Both are traits that crop up in PMDD sufferers. The difference? Personality disorders are what the medical community calls pervasive, meaning they are there all the time, rather than showing up only cyclically, as PMDD does.
Similarly, bipolar disorder is characterized by extreme mood changes that limit daily functioning—a symptom that can crop up with PMDD—but bipolar disorder is not related to the menstrual cycle.
Narrowing down the correct diagnosis can take time. Patients often don’t even recognize the tie to their menstrual cycle or have repressed it because of the fear that they’re blowing “normal” PMS out of proportion.
Washington says she encourages her patients to begin keeping a diary with their symptoms over a course of several months. She asks them to include important dates, especially the start and end of their periods, so she can see if there’s a link between the mental health component and a patient’s menstrual cycle.
Getting a patient the right diagnosis is crucial for myriad reasons.
First, treating someone for the wrong condition means putting them through unnecessary treatments, Washington says. The medicines used to treat bipolar disorder and borderline personality disorder are different from those used for PMDD, and getting the appropriate treatment right away spares someone having to deal with taking the wrong medication.
What’s more, getting the right treatment can help someone get their life back on track.
The Gia Allemand Foundation estimates that 15 percent of PMDD sufferers will attempt suicide, a shockingly high number that can be lowered by treatment.
Even for those who don’t face suicidal thoughts, the effects of PMDD can be life altering.
Carol (who has asked for her name to be changed) remembers the day she slapped her son in the face. It was the day before she called her counselor and asked for help.
“He was 3, and I thought he was trying to manipulate me,” Carol recalls. Now she realizes she was wrong to hit her child and to put that sort of burden on his shoulders, but at the time, she had no name for her feelings or means to control them.
Having one out-of-control moment that serves as a tipping point and sends them seeking help is common for PMDD sufferers.
“I can think of people who have been hospitalized, who have had marital problems, who have lost their jobs because they snapped at work,” Washington says—all this because they were experiencing untreated PMDD.
In Carol’s case, she’d always been susceptible to mood swings related to her hormones, but she says it wasn’t something her mother had ever talked to her about.
“We never really discussed that kind of stuff in my house,” she recalls.
When she went to find help, the counselor at first thought Carol was in a bad place in her marriage. But by the end of their second session, the counselor had pinpointed a problem related to her menstrual cycle.
“She said, ‘OK, now I see what is going on. I would like you to go see this gynecologist. She should be able to help you out,’” Carol recalls. She went to the OB-GYN, who directed her to keep a diary much like Washington’s patients, and then began treatment.

How to Deal With PMDD

In Carol’s case, treatment was a combination of birth control pills (meant to control her cycle to reduce hormonal ebbs and flows) and a prescription for a selective serotonin reuptake inhibitors (SSRIs), a medication typically used to treat depression.
It hasn’t cured her of PMDD, but it has curbed her symptoms immensely.
“My guys are fully aware of my meds, my freakouts, everything,” she says of her sons and husband. “I make sure they understand that it is my issue and overreaction and not them. I always explain how I was out of line. Sometimes I don’t say I am sorry because I don’t want them to feel as if they have to accept my apology. But I explain that my behavior was out of line.”
The medicine has enabled her to live with her PMDD without it massively impacting her life.
For some patients, more conservative PMDD treatments do work and work well, Basinski says; those can include increasing exercise, meditation, reduction of salt and sugar intake, and getting more rest. Some over-the-counter options, such as black cohosh and St. John’s wort, are also available, but data varies on their success in treatment.
For many patients, however, medication is required up until the beginning of menopause. Typically that means birth control in the form of oral contraceptive pills or hormone injections (such as the Depo-Provera shot) to regulate hormone levels, Basinski says, while some may opt for Mirena, an IUD that includes a hormonal component.  
Some doctors may add an SSRI to the mix as well as or instead of the birth control pill. But unlike those taken by depression sufferers, sometimes the SSRI will be given only during the luteal phase of the cycle, says Lisa Valle, DO, an OB-GYN at Providence Saint John’s Health Center in Santa Monica, California.
For some people, like LaFleur, the next step is surgery. She opted for a full oophorectomy and hysterectomy several years ago, allowing doctors to remove much of her reproductive system, including her uterus and ovaries. This stopped her periods and the hormonal shifts that come with a menstrual cycle, ending her fight with PMDD.
It’s a drastic move, and one that LaFleur acknowledges is not appropriate for many people. It puts an end to any chances of carrying a baby and sends the body into menopause early in life.
But ending her own personal battle with PMDD has empowered LaFleur to fight for more cisgender women, transgender men, and non-binary folks in her position.
“I want them to know it’s not about mental strength. It’s not about willpower. You didn’t do anything wrong to have this happen to you,” she says.
And there is help out there. Beyond the treatment options, the Gia Allemand Foundation offers online support through its website, along with symptom trackers and other tools for PMDD sufferers.

Gender-fluid. Genderqueer. Non-binary. Gender non-conforming. The language of gender is changing, and it’s doing it faster than you can say LGBTQIA.
Whether your best friend has just asked that you start referring to them as “they,” or your child has come home and shyly asked if it’s okay that they don’t really “feel” like a boy or a girl, it can be hard to know what to say and when to say it.
That hesitancy and confusion is absolutely normal, says Joel Baum, senior director of professional development at Gender Spectrum, a San Francisco area non-profit dedicated to creating a more gender-inclusive world for kids and adults alike.
“Gender hasn’t changed that much,” Baum says, “But we’re understanding it differently.”
And that understanding has brought along with it what Baum calls a “language explosion,” with a host of new terms that many people are struggling to understand. Sometimes they’re trying to figure out if those terms are right for themselves or an appropriate way to describe their own gender identity. Sometimes they’re trying to understand the terms used by friends, family members, or their kids, hoping to say the right thing and not be offensive or cruel.
What matters most, Baum says, isn’t the words you use at the outset but the ability to be open to hearing from others what their chosen terms mean and to be able to change.
“A big part of the work around this is becoming more comfortable with not knowing and being able to ask,” Baum says.
So what is gender-fluid? And how about non-binary, genderqueer, or gender non-conforming, for that matter?

Gender-fluid is just one term.

If you go by its dictionary definition, gender-fluid refers to “a person whose gender identity or gender expression is not fixed and shifts over time or depending on the situation.” That fluidity doesn’t mean that people can’t make up their minds. But it does mean that their identity is not constrained to just one binary, such as boy or girl.
Non-binary and genderqueer, on the other hand, are defined by GLAAD as “terms used by some people who experience their gender identity and/or gender expression as falling outside the categories of man and woman. They may define their gender as falling somewhere in between man and woman, or they may define it as wholly different from these terms.”
GLAAD defines gender non-conforming as “a term used to describe some people whose gender expression is different from conventional expectations of masculinity and femininity.”
So do they all mean the same thing?
Not at all, says Ellen Kahn, director of the Children Youth and Families Program at the Human Rights Campaign Foundation.
“Most of us are familiar with a binary, with male and female,” Kahn says. “We know folks who are transgender and binary too. Jazz Jennings is a binary person; she expresses herself as female, she identifies herself as female. Chaz Bono likewise is binary. He identifies as male.”
But for many people, the constraints of the binary are just that: constraining.
“In the middle range of binary there is a range of experiences,” Kahn notes.
That’s where these other terms come into play for people. They are words that have evolved in our language to allow people to give a descriptor for their gender identity. And just as each person’s identity is extremely personal, so too is their relationship to the words they use to identify themselves.
While “gender-fluid” is in the non-binary experience, the actual lived experience of folks who identify as gender-fluid or non-binary or genderqueer or gender non-conforming can all differ in qualitative ways, Kahn says.
In a forthcoming Human Rights Campaign survey of LGTBQ teens, Kahn says the kids were given the chance to describe their own identity in their own words. The responses included at least 50 different terms the kids used to identify themselves. And not a single one of those kids was “wrong” for using a different word.
“I’m surprised and intrigued at how the language is evolving,” Kahn says. “Young people don’t feel confined, don’t feel constrained. You can be free to be who you are.”

Ask, don’t tell.

Some people may identify as gender-fluid, some as non-binary, and so on. What’s important, Kahn says, is to be open to allowing people to describe their own identity to you.
Part of that is asking someone their preferred pronouns. While many who identify as gender-fluid or non-binary identify as “they” rather than using “he” or “she,” pronoun usage is again very personal.
For Sula Malina, the decision to ask friends and family to call them “they” was years in the making. Malina, who works as a children, youth, and families coordinator at the Human Rights Campaign Foundation, came out as queer as a teenager.
At the time, Malina says they began to dress in a manner largely associated with masculinity in our society, and eventually began binding, a technique wherein fabric is used to minimize the appearance of breasts. When they applied to college, Malina did so identifying as a cisgender female.
But their understanding of their identity was already shifting, and that shift became more pronounced at college.
“There was a lot of grappling with whether I was more transmasculine,” Malina says. And yet, they were very aware that they did not have the experience of the many transgender people who knew they were a gender other than the one assigned at birth from an early age.
“I don’t think it’s inaccurate to have identified as a girl growing up,” Malina says.
But after top surgery to remove their breasts, Malina says they found that acknowledgement of their masculine side made them all the more comfortable exploring their feminine side. Eventually, Malina came out to friends and family as non-binary.
“There’s something that was really empowering about it,” they recall. “It’s who I am, and it also aligns with what I stand for.”
The relationship to one’s identity can be difficult to explain to people who are cisgender, Malina says, because there is no correlating experience.
“With sexual orientation, there’s an analogy. Just as you love a boy, for example, you can say I love a girl. But with gender there isn’t an analogous experience,” Malina says.
While gender identity is not a choice, it’s often something people have to think about and come to an understanding of, if only because society is still very much built on a binary system, wherein children are assigned “boy” or “girl” in the delivery room.
When someone comes out to you about their gender identity, be it as gender-fluid, non-binary, genderqueer, or using any other term, the fear of making a misstep is often there.
This is where you should give yourself a break … at least to a point, Malina says.
“I think people are stressed about definitions,” they said. “But it’s very complicated and yet in some way very simple. The real skill and real gain when you are developing ally skills is to ask people about their experience.”

Don’t force disclosure.

So asking is okay. What’s not okay?
Forcing someone to disclose their gender identity is never okay. While it’s becoming more common in college and business settings to ask people to identify themselves and their pronouns, that has to be done with safety measures in place, Malina says.
It’s not okay to simply go around the room and make everyone share their name and pronouns because that can force folks who identify as non-binary to out themselves in spaces that may not be friendly to people who don’t identify as “male” or “female.”
Instead, Malina suggests a one-on-one conversation where you give someone the choice to share their identity. Doing it that way lets the person know they’re in a safe space and that their identity is respected.
It’s also not okay to make dismissive statements about gender identity, Baum says, casting it as a choice or phase.
“If you’re dismissing another person’s experience, that’s really arrogant,” he notes. Worse, for those who are opening up about their gender identity, having people dismiss their experience can be downright dehumanizing.
“Suddenly it’s not just ‘I’m a different kind of kid,’ it’s ‘I’m a sick kid,’” Baum says. That can have devastating effects. Suicide rates for the transgender and gender non-conforming population exceed the national average, and a study by the Williams Institute found that as much as 57 percent of people in this demographic have experienced families who refuse to speak to them, and 69 percent have experienced homelessness.
It’s something Malina tries to explain to people who are grappling with how to be good allies. Malina’s mom, a gender studies major in college and an educated woman who supported her child’s transition, struggled with the transition to “they/them” pronouns because grammar rules had been ingrained in her head dictating the use of these terms only in reference to multiple people.
But she called Malina one day and said, “Every time I think about how hard it is for me to use they/them pronouns, I think about how hard it is for non-binary people to exist.”
For allies who are struggling with the transition, Malina puts it this way: “Maybe you can’t end trans-violence, but you can certainly use someone’s pronouns!”
One final note from the experts? It’s also important to understand that gender identity and sexual orientation are not synonymous.
Coming out as gender-fluid, non-binary, or any other term beyond “male” or “female” does not equate with being gay or lesbian. Again, it’s important to have open communication with someone and to let them lead you.
People can identify themselves in many different ways, and the words they choose to do so are important. More important, however, are the humans behind the words and the efforts taken to understand their experiences.
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As a tea lover, I frequent health stores often, looking for new and delicious flavors. Recently, when I bought a box of rose tea, the cashier told me the tea contains adaptogens. Adaptogens? I thought. What are adaptogens?
Being a fairly skeptical person, I suspected it was just another meaningless buzzword that was created to market health foods. But when I began my research, I found out that adaptogens have been used for their anti-stress properties in traditional Ayurvedic medicine for centuries. While more studies on adaptogens are needed, the existing evidence on their chemical properties is very encouraging.
Here’s what you need to know about using adaptogens.

What are adaptogens?

Adaptogens is a term used to refer to plants that have an anti-stress affect on the body. They affect the central nervous system, and can have either a stimulating or a relaxing effect.
“Adaptogens are typically herbs or other plants that help the body handle stress. They act on the body’s production of the stress hormone, cortisol,” explains Sunny Brigham, MS, CNS, a board-certified clinical and integrative nutrition specialist. Brigham uses adaptogens with clients who experience anxiety and stress-related fatigue, as well as stress-induced irritable bowel syndrome (IBS).
While adaptogens are definitely trending at the moment, they’ve been used for a very long time in traditional Ayurvedic medicine. The first modern scientific trials on adaptogens were conducted during World War II in the Soviet Union, where researchers focused on whether adaptogens could help increase the stamina of military personnel. Over the next few decades, adaptogens became widely used by the USSR, where they played a part in the space exploration program, the Olympic games, and the Arctic and Antarctic expeditions.
Since then, adaptogens have become popular in the West, too, especially among natural healthcare practitioners.

What types of adaptogens are there?

There are many different adaptogens out there, and while all of them are associated with soothing stress, they all have their own particular benefits and drawbacks.
Fortunately, most of them are safe—but it’s still important that you speak to a qualified healthcare provider before you take them. Even though adaptogens can be bought without a prescription, they can interfere with the medications you’re currently taking, Brigham points out.
“Adaptogens are fairly safe but some [like rhodiola and ginseng] can be stimulating and should not be taken in the evening.” She goes on to say, “Others can interact with medications, such as ginseng. It’s important that individuals investigate their medication interactions before taking any herbal supplements.”

Here’s a brief guide to different types of adaptogens:

Ashwagandha

Ashwagandha, also known as Withania somnifera, is probably one of the more well-known and well-studied adaptogens. “Ashwagandha is best used for minor nervousness or anxiety related to increased stress. It may also be helpful with increasing concentration levels and boosting the immune system,” Brigham says. “Ashwagandha should not be used in pregnant or lactating women as it can have a mild sedative effect.” A review of human trials shows that ashwagandha is probably effective at regulating stress, but further studies are needed. Studies also suggest that the herb may have anti-inflammatory and antioxidant effects in addition to its anti-stress properties.

Cordyceps Mushrooms

Cordyceps mushrooms are particularly good for boosting the immune system, Brigham explains. “There is insufficient information available to determine if cordyceps are okay to be used in pregnancy. With this information, I probably would not use them in pregnant or lactating women.”
Brigham also says that she wouldn’t use cordyceps on people using blood thinning medication or those with immune disorders. “There is some evidence, in animal studies, that show cordyceps inhibit platelet aggregation, the clumping together of platelets to form blood clots around wounds,” Brigham explains. “If someone is on a blood thinning medication, taking cordyceps could cause further blood thinning and increase the chances of bleeding.”

Eleuthero

Joseph Feuerstein, MD, associate professor of clinical medicine at Columbia University and director of integrative medicine at Stamford Hospital, says eleuthero is good for fatigue related to excess exercise, so he recommends it to his active patients. “Eleuthero seems to be okay in pregnant women but should be used with caution in those with hypertension,” he adds.

Ginseng

“Ginseng can be slightly stimulating to help combat stress-related fatigue,” Brigham says. “It can also be used to help boost the immune system.” Ginseng seems to be safe for pregnant women. Studies have also suggested that ginseng improves male sexual functioning.

Holy Basil

Also known as tulsi, holy basil has a mildly stimulating effect, says Brigham. This means it can be used to help combat stress-related fatigue. There’s a fair amount of scientific evidence to show that tulsi does, indeed, reduce stress. While Brigham says it’s fairly safe to use, it shouldn’t be used if you’re pregnant or lactating.

Passionflower

While many adaptogens are stimulating and shouldn’t be taken in the evening, passionflower has a very calming effect and thus can be taken before sleep, says Brigham. “Passionflower helps the hamster get off the wheel so our brains can relax and we can sleep,” she explains.

Reishi

Much like cordyceps in function, reishi is good for boosting the immune system, Brigham explains. Again, she cautions people against using it if they’re on blood thinning medication.

Rhodiola

Feuerstein says that he uses rhodiola to help with fatigue associated with low mood. Studies have shown that rhodiola might be effective at reducing symptoms of depression and easing mental fatigue, but those trials were small and more evidence is needed. Brigham notes that rhodiola should be avoided by people who have high blood pressure, nervous system disorders, or sleep issues. Brigham also says she wouldn’t give rhodiola to pregnant people.

Schisandra

Schisandra, while an adaptogen, is most commonly used to support the liver and digestive system, as it can reduce diarrhea. However, it can cause digestive issues in some people, Brigham explains. Namely, it can cause acid reflux, heartburn, and stomach pain.
Feuerstein emphasizes that you should consult a medical practitioner before using any adaptogen. “Much of the time, use of adaptogens is based on clinical experience of the practitioner,” he says. “It is important that you use them under the guidance of a medical professional so you get the right dose of the right herb made by a pharmaceutical-grade manufacturer to ensure quality and purity.”
While adaptogens are fairly safe and easy to obtain without a prescription, Brigham also notes that she wouldn’t give them to children. “They are pretty safe and many people use them. Kids are under more stress in school today than we ever were,” she notes. “I’d prefer, though, to teach them stress reduction techniques and proper sleep habits so they don’t need adaptogens.”

Is there a lack of scientific evidence on adaptogens?

While the scientific evidence on adaptogens is very encouraging, it’s also limited. You’ll notice that many of the herbs outlined by Brigham and Feuerstein need to be studied more to confirm their effectiveness.
Feuerstein agrees that there’s not enough evidence out there when it comes to adaptogens. Part of the reason is because studies into medicinal herbs aren’t well funded, he says, which means that the trials which have been done—although promising—are quite small.
“I do believe there is a lack of quality trials in reference to herbs today,” Brigham says. “There’s also a lack of peer-reviewed sources as well.” However, Brigham remains optimistic about the effects of adaptogens given the fact that they’ve been used by humans for centuries, and given her personal and professional experience with adaptogens.

How can I integrate adaptogens into my diet?

Adaptogens often come in form of tinctures, teas, or pills. They could also be eaten: For example, I use passionflower in my smoothies. Brigham says that most people don’t enjoy tinctures because they have an unpleasant taste, so many people opt for teas or pills instead. “Teas are great because you can make a combination of various adaptogens from bulk herbs,” she says. “The same can be said for pills. Most pill-form adaptogens are blends.”
Feuerstein says that he generally uses standardized herbal extracts in pill form to ensure quality. The clinical studies that are available use high doses, and those doses would be too high to add to a food or tea, he explains.
While your healthcare practitioner should be able to recommend a reputable brand, there are some great brands you can look out for, says Brigham. “My favorite sources for quality herbs or adaptogens are Gaia Herbs, Mountain Rose Herbs, Frontier Co-op, Oregon’s Wild Harvest, and Pacific Botanicals. There are ready-made supplements available as well, but the purchaser should ensure the source of the herbs [in them] is from a quality source,” says Brigham.
While there is a need for more scientific evidence, adaptogens might be worth trying if you struggle with stress, anxiety, and fatigue. Consider speaking to an integrative medical specialist if you’d like to use them: They’ll be able to ensure that you’re taking them safely, and they’ll help you choose the best kinds of adaptogens for your specific health concerns.

Before I became an egg donor, I had a lot of questions about the process: What does egg donation entail? Are there any long-term health effects of donating your eggs? What should I know before I donate?
I googled it, but unfortunately there’s a lot of confusion and misinformation out there. This is probably because egg donation is often stigmatized. I read a lot of information online, but I wanted to know more. After all, it was a big decision.
I wanted to hear about egg donation from real donors—not just fertility specialists and egg donation agencies. Unfortunately, because of all the moralizing that surrounds egg donation, few egg donors really talk about their experiences.
So here I am, a three-time egg donor, telling you about my personal experience with egg donation as well as the scientific research behind the process. If you’re considering egg donation—or want to understand what the process is like for a donor—read on to find out what you need to know.

Who can become an egg donor?

Firstly, you’re probably wondering whether you fit the criteria for donation.
Generally speaking, egg donors are between the age of 18 and 35, although this can vary depending on the clinic you want to work with. You have to have a low chance of passing on genetic diseases. In addition to fitting specified health criteria, a potential donor will also have to undergo a scan and blood tests to ensure they’re qualified to donate.
If you have certain reproductive conditions, like endometriosis, it might not be advisable to donate eggs, even if a clinic would allow you to do so. “For women with endometriosis, there is evidence that ovarian reserve may be lower and procedural risks slightly higher if they have ovarian cysts,” says Rashmi Kudesia, MD of CCRM. Kudesia is board-certified in reproductive endocrinology and infertility by the American Board of Obstetricians and Gynecologists.
If you check all the boxes for becoming an egg donor, remember that certain characteristics—like having an education beyond high school, such as a college degree—can also make you more appealing to prospective recipients. Fitting the criteria is one thing, but you’ll still need to be matched to potential parents. This can take a while after you sign up and depends on how many potential parents the agency works with and your personal characteristics. It took me around eight months to be matched.

What exactly happens during the egg donation process?

Once a potential donor applies—either with a clinic or an egg donation agency—they wait to be matched with potential recipients (also known as intending parents or IPs). Once matched, the donors will undergo some blood tests and scans, says Kelly Rodgers, a five-time egg donor and egg-donation coordinator with Extraordinary Conceptions. The screening process involves a trans-vaginal ultrasound and a follicular count. The follicles are the small sacs in the ovaries where the eggs develop, and it’s important that donors have a healthy number of follicles—a number that needs to be determined by a donor and their healthcare provider.
If all is well, Rodgers says, contracts will be drafted and signed. The donor will go on to have hormone injections once a day for the next 10 days, give or take, with the dosage depending on their personal biology and determined by a fertility specialist.
“These medications are typically self-administered—which is not as hard as it sounds—via very skinny needles right under the skin, typically in the lower abdomen or outer thigh,” Kudesia explains. The medication contains synthetic versions of naturally occurring hormones called follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are used by the body to promote ovulation during the menstrual cycle.
“While on medications, donors will have a handful of monitoring appointments to see how her body is responding to the the medication and, if necessary, travel to the intended parent’s clinic for about seven to 10 days leading up to the egg retrieval,” Rodgers says. This could include more trans-vaginal ultrasounds and blood tests. The scans will help fertility specialists determine when to schedule the retrieval, which is also known as an egg pick-up. The retrieval is a non-invasive surgery, meaning it doesn’t involve cutting into your body. Instead, an implement is inserted through the vagina and a needle enters the ovary. The eggs are retrieved through this needle. You’ll either be under general anesthetic or a deep sedation, so you aren’t able to feel anything during the retrieval.
There might be a mild discomfort when you wake up, but generally it isn’t painful. You should be discharged on the same day, after which you should go home and rest. You’ll get your period within the next ten days after the retrieval. After this, you’ll probably be more fertile than usual. Following one full menstrual cycle, your fertility will be back to normal according to Rodgers.
After your retrieval, the donated eggs will be fertilized and placed in either a surrogate’s uterus or the uterus of the female IP.

What are the short-term health effects of egg donation?

The most concerning issue when it comes to egg donation is ovarian hyperstimulation syndrome, or OHSS. It occurs when the medication used to facilitate egg retrieval elevates your estrogen levels, says Kudesia. “Because these levels induce water to be drawn out of your bloodstream into the abdomen, severe OHSS can cause bloating and swelling, nausea and vomiting, low urine output, and a risk of blood clots,” she explains. In some severe cases, the donor might have to be hospitalized and given IV fluids. They might also need excess abdominal fluids to be removed.
Kudesia points out that egg donors only have a 1 to 2 percent chance of developing a serious case of OHSS. “Though anyone who has a robust response to ovarian stimulation may have a few rough days around the time of their egg retrieval, it is quite rare to see a severe OHSS case these days,” she notes.

How can egg donation impact my future fertility? Can it impact my health?

Here’s where things become a bit more controversial: While many experts deem egg donation to be safe judging from the current research, many donors would like more long-term studies on egg donation. Many donors go on to have their own children, but at present there aren’t any long-term studies that have monitored the impacts of egg donation on donor health.
Raquel Cool, co-founder of We Are Egg Donors, a global forum for egg donors, is one of the people advocating for more studies. Cool is currently working on a book compiling personal accounts from donors as well as data on their retrievals. “We are big advocates for more research on donor health,” she says. “We’d like more transparency on how eggs are retrieved, how many overstimulate and to what extent of severity, and finally, how egg donation impacts our health down the line. There have been no long-term studies on donor health outcomes.”
On the other hand, Kudesia feels the research that’s currently available is a firm enough indicator that there aren’t any long-term effects of donation. “Though we do not have registries or long-term cohort studies to specifically report on egg donors, we nonetheless have a lot of scientific data from which to extrapolate long-term effects,” she says. Kudesia points out that the egg donation process mirrors the first half of an IVF cycle. It involves the same medication and retrieval process as IVF patients undergo, and IVF has been around since the ’70s, which is one of the reasons she considers egg donation to be safe.
“Multiple scientific papers, following tens of thousands of women for up to 30 years after IVF, have established the long-term safety of the procedure for moms and babies,” she says. Those studies haven’t found any long-term risks of ovarian or breast cancer, for example, Kudesia says
The studies that look specifically at egg donors also haven’t found any risks of egg donation, Kudesia says. “I would echo the statement of the American Society for Reproductive Medicine, which is that though there is no evidence of long-term risk.” She goes on to say, “Prudence suggests that women be informed of the possible risks, and limit the number of times they donate to six cycles.” She adds that fertility clinics must take precautions to avoid OHSS. “Though I would be thrilled to see more specific literature on this topic, what exists is very reassuring to me for women and clinics following the guidelines.”
Before donating, it’s important not only to understand the research or lack of research on the long-term medical effects of donation, but also the emotional impact it may have on you as a donor.

What are the emotional impacts of being an egg donor?

Many potential donors are curious about how egg donation will affect them on an emotional level. Of course, this is a difficult question to answer because the process affects everyone differently.
Kudesia states that donors need to be mentally prepared to donate their eggs. “All donors meet with a mental health professional to make sure they’ve thought through the possible ramifications of possibly having genetic offspring out in the world,” she explains. “If, after that discussion, you have any reservations at all, I would not recommend donating.”
My personal experience with egg donation has been emotionally rewarding. I’ve never regretted my choice, and I feel great about my decision to donate. However, not everyone has the same experience.
Some people experience remorse about not having a relationship with their offspring, for example. You might not get pregnant with or birth the child, but in terms of DNA, the child is biologically yours. In that sense, it can be difficult to know they exist without being able to contact them. Most donors I know, myself included, aren’t bothered by this, but it’s something you have to consider before donating.
Another aspect to consider is whether you’d want an open, semi-open, or totally anonymous donation. Certain clinics and egg donation agencies only facilitate anonymous donations, while others facilitate open donations, semi-open donations, or a mixture of the two. This is usually stated quite clearly on their websites. Personally, I’ve done one anonymous donation and two open donations, where I’m still in contact with the recipient families.

Could I be paid for egg donation?

According to international law, you’re not allowed to sell your eggs because they’re bodily tissues, but you can be compensated for your time since you might lose out on other forms of income while donating. More often than not, you’ll have to take time off work or studying and your personal life to become an egg donor.
Rodgers notes that the time commitment is something every donor needs to understand. “While the donation itself, in which you are on medication and undergoing the egg retrieval, is roughly two weeks, the medical screening process and legal contract finalization can add approximately six weeks time.” If you travel overseas to donate, as I did, it can be even more time-consuming.
In addition to compensation, you shouldn’t be expected to pay any medical expenses associated with the donation as those should be covered by the egg recipients. This usually includes covering any emergency expenses in case you have any health complications, like OHSS. Your contract should include the exact details of what is covered by the agency or recipients. If an agency asks for any money up front, be wary.
Also note that in some places, including the U.S., you might be taxed on any funds you receive in compensation for donating. In other places, like Australia, donors aren’t usually compensated at all according to Cool. If you’re curious about compensation, speak directly to the agency or clinic you’d like to sign with.

How do I know which egg donation agency or clinic to sign with?

While many agencies and clinics genuinely care about their egg donors, others might not treat their donors well. This is why it’s important to do a background check before signing up.
Cool notes that according to accounts by donors shared on We Are Egg Donors, there is a notable difference between the way donors in the U.S. are treated compared to donors in other countries. “Unfortunately, in the U.S. we see more instances in which higher numbers of eggs are retrieved, more cases of OHSS, greater challenges with withdrawing consent, and women feeling like they are being treated more like a number than a patient,” Cool says.
Your chances of getting OHSS are higher if more eggs are retrieved, since a higher egg count is usually associated with a higher amount of follicle-stimulating medication. As such, a clinic might overstimulate donors to get more eggs—at the price of the donor’s health. “High numbers are becoming so normalized within the industry that we see experienced donors rejected for subsequent cycles, or questioned about their medical records because they are considered ‘low producers’—yet their past cycle figures are between five and 20 [eggs], which is considered a safe and optimal range,” Cool says.
“Some clinics offer their clients (that is, the egg recipients) a cost savings option: a ‘shared cycle,’ in which a donor is stimulated to produce eggs—in one cycle—for two or three recipients rather than one,” Cool explains. This incentivizes clinics to over-stimulate donors so that they can collect more eggs for each of their clients. This is why carefully vetting agencies and clinics is important.
“I would do my best to vet agencies or clinics through word of mouth or reviews,” says Kudesia. “A clinic is perhaps the easier setup to vet, as all success rates are publicly reported and available online. Picking a clinic with high volume and success rates might help ensure that their methods prioritize patient safety and experience rather than trying to maximize egg number at any cost,” she adds. Kudesia also suggests you discuss the process with the agency or clinic before signing up, including the strategies they use to minimize your chances of getting OHSS. “Getting detailed, compassionate answers to these questions would be reassuring. Being rushed or pushed into donating should be immediate red flags,” she says.
When I donated my eggs, I was very well prepared: I researched a lot beforehand, I asked plenty of questions, and I thought about the emotional impact of donating before I did it. For those reasons, I felt confident in my decision and the people caring for me during the retrieval procedures.
Your generosity as an egg donor can mean the world to someone who wants to start a family, but it’s important that you’re well informed about the entire process before you start this journey.
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Ellen (name changed by request) was just 19 years old when she was rushed to the emergency room. The problem? Excruciating pain during sex. The diagnosis was human papillomavirus (HPV), which had created abnormalities in Ellen’s vagina, resulting in pain—and later a diagnosis of cancer.
“I was young. I felt this awful fear,” Ellen tells HealthyWay. “Who would want to be with me? How do you tell someone that you are a carrier for an STD? I had a lot of guilt and disgust.”
It’s true that HPV is a sexually transmitted infection or STI (a term that’s replaced the phrase sexually transmitted disease or STD in medical circles in recent years), and with it has come an unfortunate stigma for the women and men who are diagnosed.
But while cancer and other complications from HPV are real, the truth is, being sexually active in America means your chances of coming in contact with HPV are sky high. It’s almost guaranteed that sexually active Americans will encounter this common STI at some time in their lives.
Sounds like an exaggeration, right? One virus can’t possibly be so prevalent that nearly everyone will be exposed to it at one point or another. Guess again.
The Centers for Disease Control and Prevention (CDC) has labeled HPV as the “most common sexually transmitted infection in the United States.” CDC literature even goes so far as to state that “HPV is so common that nearly all sexually active men and women get the virus at some point in their lives.” Every day, approximately 14,000 individuals ages 13 to 24 are infected with HPV, and every year, more than 30,000 cases of cancer are tied to human papillomavirus.
With 40 distinct types, human papillomavirus isn’t just prevalent. This STI is also wildly contagious, which is why at any given time an estimated 42.5 percent of Americans in the 18 to 59 age range are walking around with a case of HPV.
“Other than abstinence, there is no reliable way to prevent transmission,” says Steven Vasilev, MD, a gynecologic oncologist and medical director of integrative gynecologic oncology at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, California. He tells HealthyWay that “A condom will not help prevent transmission, because the virus can be present on multiple genital areas, not just the penis. Other than vaccination at an early age, before exposure to the virus, there is no reliable medical way to prevent spread.”
For Ellen, HPV came with a sexual assault when she was just a tween. For hundreds of thousands more Americans, HPV can come at any time as a result of a sexual encounter, be it one that’s consensual or not.
Because it’s so contagious, the risk is high. But with warnings that some types of HPV (although not all) can cause cancer and it’s nearly impossible to avoid, how worried should you be about HPV? And is there anything you can do to protect yourself or your family?
We asked the experts to weigh in on the real deal with this STI.

What is HPV, anyway?

Short for human papillomavirus, HPV is a virus, just as its name would imply. That means it’s a microscopic organism that replicates inside the cells of a host organism. According to Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, human papillomavirus chooses mucosal surfaces as host and tends to live in or on the vagina, penis, anus, and/or mouth, which is where it spreads from person to person via sexual contact.
That means HPV infection can be genital, anal, or oral, depending on the mode of sexual contact, Adalja says. In other words? Oral sex, anal sex, and any other form of genital-to-genital contact can spread HPV. So unlike with pregnancy, simply avoiding sex that puts a cisgender male’s penis in contact with that of a cisgender female will not keep someone safe. Even the use of condoms in those cases can still do little to prevent transmission, as HPV lives in the area around the vagina and anus, not just inside.
Because there are 40 different types of HPV, what happens next depends on what kind you’ve contracted. Most types will cure themselves, passing through the body in six to 12 months without ever showing any symptoms, Vasilev says. But it’s not always that simple.
“Sexual activity timing could be such that the infection is passed back and forth between a monogamous couple for a prolonged period of time,” Vasilev says. What’s more, certain types of HPV can cause complications—some as serious as cancer.

Low-Risk HPV

Most types of HPV are what’s termed “low risk” by doctors. That doesn’t mean it won’t cause problems in your life, but it does mean it’s unlikely to cause cancer.
Low-risk HPV includes the types that cause warts or, as they’re known in medical circles, papillomas (hence the name), says Gerald J. Botko, DMD, a master of the Academy of General Dentistry and dentist chief of service at VA Miami Healthcare System. These warts typically crop up in the genitals and anus of men and women, although women may also have small cauliflower-type growths on the cervix and/or vagina, and oral warts are a possibility. The warts are usually painless but cause some irritation, itching, or burning, Botko continues. Low-risk genital HPV typically goes away on its own without treatment.
“In oral HPV infections, the warts colonize in the back of the mouth (throat), including the tongue, base, and tonsils,” Botko explains. In those cases, contagious lesions found in the gingiva (gums) and palate typically have to be excised surgically for a cure, although sometimes oral HPV can go away on its own as well.
Low-risk HPV can also cause wart-like lesions called condylomas. Again, these can be found on the genitals or in the mouth (the latter from oral–genital contact). Condylomas can cause disfigurement and are difficult to treat, Botko says.
Although low-risk HPV types 6 and 11 cause 90 percent of genital warts, they are still termed low risk because they rarely cause cancer, Botko says.

High-Risk HPV

About a dozen of the 40 types of HPV are considered high risk, but there are just a few that have been linked to cancer. Despite that bit of good news, it turns out that 79 percent of the cancers of the vaginal region, anal region, and mouth are caused by HPV. Researchers have tied most of those back to human papillomavirus types 16 and 18. According to the National Cancer Institute, the most common types are:

• Cervical cancer: Types 16 and 18 are responsible for about 70 percent of all cases of cervical cancer.
• Anal cancer: Approximately 95 percent of anal cancers are caused by HPV, most by type 16.
• Oropharyngeal cancers (which includes cancers of the middle part of the throat, including the soft palate, the base of the tongue, and the tonsils): Approximately 70 percent of oropharyngeal cancers are caused by HPV, more than half by type 16.
• Vaginal cancer: About 65 percent of cases are caused by HPV, most by type 16.
• Vulvar cancer: Approximately half of all vulvar cancers are linked to HPV, most caused by type 16.
• Penile cancer: More than a third of all penile cancers are caused by HPV, most by type 16.

Unfortunately, high-risk HPV tends to be silent, says Renée Volny Darko, DO, an OB-GYN and founder and CEO of Pre-med Strategies, Inc. That means there aren’t signs that scream “I have HPV,” such as pain or itching. Typically, the first sign of infection will be a precancerous lesion—or cancer itself.

Finding HPV Before It Turns to Cancer

Because HPV doesn’t have symptoms until it causes a disease such as genital warts or cancer, most people don’t show up in a doctor’s office complaining that they have an issue. Men can’t currently be tested for HPV, as no such test exists. With women, however, testing can be done at your annual exam to determine if you have HPV.
Although it can’t be picked up via a regular Pap smear, Darko says HPV can be tested from the same sample collected for your Pap smear.
Confused?
“A Pap smear is looking at cells of the cervix under a microscope to determine if they are normal or abnormal,” Darko explains. “HPV can be hiding in cervical cells. Another test can be done on that same sample of cervical cells to determine if HPV is present in the cells.”
If HPV types that are considered low or high risk are noted, your doctor will advise you on the next steps. For example, those tied to cancer may indicate you should have more frequent screenings to ensure that no such cancer has developed.

Preventing HPV Before It Starts

So nothing prevents HPV, right? Sticking to oral or anal sex, condoms—none of that will keep you safe?
Yes and no. Some HPV cases simply can’t be avoided, save for complete abstinence, but Darko says, “HPV vaccine is the next best line of prevention against several types of HPV.”
For children and women under the age of 26, there is now a trio of options out there to prevent the highest-risk forms of human papillomavirus. Gardasil and Cervarix have both been found to help prevent HPV type 16 and 18 infection. Gardasil 9, a more recent vaccine, prevents types 6, 11, 16, 18, 31, 33, 45, 52, and 58.
The vaccine can be given up until age 26, even if you’ve already been sexually active. If you’re pregnant, it’s best to put off the vaccination, says Lara Millar, MD, a radiation oncologist with the Eastern Virginia Medical School, as there’s not enough research on the safety of the vaccine for pregnant women. If you’re afraid you may contract HPV in the meantime and put your baby at risk, Millar says transmission from mother to child can happen but is extremely uncommon.
If at all possible, it’s recommended that you get the HPV vaccine well before pregnancy—and even before having sex.
Darko advocates that parents in particular talk to their children’s pediatrician about it earlier rather than later, no matter how uncomfortable it is to think of their child one day encountering an STI.
“The vaccine is most protective when it is given before the first sexual encounter. So it is recommended for males and females as early as age 11 years,” she says.
Kids who get a dose of the vaccine typically only need one follow-up shot, whereas older women and men who opt for vaccination may require three doses to be fully vaccinated.

Is it worth it?

Consider this: Since the U.S. Food and Drug Administration’s approval of vaccination for human papillomavirus more than a decade ago, doctors have seen a reduction in infection rates. Six years after the vaccine’s approval, a study of infection rates for the four most common high-risk types of HPV showed a 64 percent decrease among females age 14 to 19 years and a 34 percent decrease among those age 20 to 24 years.
It’s also worth using condoms and dental dams regardless of whether you’ve gotten the shot, Darko says. Although they are not 100 percent effective in preventing HPV, contraceptives like these can prevent other STIs (and pregnancy). And if the HPV infection is living inside the vagina or anus or on the penis (rather than outside on labial tissue or near the penis), that coverage may indeed make a difference.
One final note of relief? Although the internet is rife with myths on how HPV is spread, the American Cancer Society assures women and men both that they cannot contract human papillomavirus via a dirty toilet seat, by swimming in a pool or hot tub, or by simply being unclean.