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More Than One Baby

Pregnancy & Prenatal Care

Causes

Having more than one baby may happen more often if:

* There is a family history of it.

* The mother is taking medicine or having treatment to get pregnant.

* She is an older mother.

More than one baby can happen in two ways. The most common way is when two or more eggs are fertilized by two or more sperm. These babies can be either boys or girls. They may or may not look alike. They are called fraternal twins or triplets, etc.

Less common is when an egg is fertilized by a sperm as usual. Then, for some reason, the egg splits apart. Two or more babies grow. They are the same sex. Their hair, eyes, and skin will be the same color. They are called identical twins or triplets, etc.

In rare cases, the egg doesn’t split apart all the way. The twins stay joined together at the head or back. Or they may be joined at some other part of the body. They are called conjoined twins. Sometimes surgery can separate them after they are born. This can be very risky.

Signs

At first, a woman may not know she is carrying more than one baby. Her health care provider can usually tell within 8 weeks, though. Signs include:

* Severe nausea and vomiting

* The uterus is growing faster than usual.

* There are two or more heartbeats.

* An ultrasound picture of the uterus shows more than one baby.

Risks

The health care provider watches for risks that come with carrying more than one baby.

* Low iron and oxygen in mother’s blood.

* Less and less blood flows to the baby.

* High blood pressure and preeclampsia.

* Gestational diabetes.

* Difficult labor

* Preterm labor and preterm birth. Preterm birth happens 3 weeks or more before the due date.

* Low birth weights. A low birth weight is less than 5-1/2 pounds.

Some mothers can have a vaginal birth with more than one baby. Others may need a Cesarean section (C-section) for a safe delivery.

Questions to Ask

Self-Care / Prevention

* You will need more prenatal health care visits than with just one baby. You will need extra blood tests and blood pressure checks. Your provider will need to make sure each baby is doing well. Call your provider whenever you have questions during your pregnancy.

* Eat healthy foods.

* Eat smaller meals more often. This helps ease things as your growing uterus presses on your stomach.

* Take your prenatal vitamins (vitamin pills) every day. They should include iron and folic acid. They will supply other needed vitamins and minerals, too.

* Don’t smoke, drink alcohol, or take drugs.

* Exercise only with your health care provider’s consent. Women carrying more than one baby tire more easily. In later pregnancy, avoid any activity that takes a lot of energy. Avoid any activity that could injure you or your babies.

* Lie on your left side. This helps blood flow to the babies. It may help keep blood pressure down, too. It also makes you more comfortable. Don’t lie on your back.

* Reduce stress in your life. Stress can lead to early labor.

* Get enough sleep. Learn and use methods to relax.

* Follow your health care provider’s advice on rest during the day.

* Get help with daily tasks, like caring for other children. If you can, take time off from your job after the 24th week.

* Watch for signs of preterm labor. Your provider may have you wear an electronic monitor. It senses contractions of the uterus.

* Choose a well-equipped hospital. Do this with your health care provider’s help. The hospital should be well suited for births of more than one baby. Choose one with a neonatal intensive care unit (NICU). This has special staff and equipment for babies born too early.

© American Institute for Preventive Medicine

January 23, 2026
Mononucleosis (“Mono”)

Student Health

A common cause of fatigue in students is infectious mononucleosis, an acute viral disease.

Signs & Symptoms

* Fatigue.

* Fever.

* Sore throat.

* Swollen lymph gland in the neck area.

* Pain in the upper left abdominal area.

Symptoms usually last several weeks.

Causes

Epstein-Barr virus (EBV). This is spread from person to person through contact with saliva from a person recently infected with the disease. The saliva can be picked up from hand-to-hand contact, sharing eating utensils, and kissing, which is why “Mono” is called the “kissing disease.” Symptoms usually appear about 4 to 6 weeks after exposure.

Treatment

Rest is the mainstay of treatment. Avoiding heavy lifting and contact sports is necessary, because there is a risk of rupturing the spleen with “Mono.”

© American Institute for Preventive Medicine

January 23, 2026
Menstrual Cramps

Women’s Health

Menstrual cramps are also called painful periods. Most females have them at sometime during their lives.

Signs & Symptoms

* Pain or discomfort in the lower abdomen right before or with a menstrual period. The pain can range from mild to severe.

* The pain can occur with: A backache; fatigue; headache; diarrhea and/or vomiting.

* Symptoms can vary from month to month or year to year.

Causes

Menstrual cramps occur when muscles of the uterus squeeze the lining out. This is a part of normal menstruation. They occur often in females who have just begun to menstruate. They may go away or become less severe after a woman reaches her mid-twenties or gives birth. (Childbirth stretches the uterus.)

Menstrual cramps occur much less often in women who do not ovulate. In fact, birth control pills reduce painful periods in 70 percent to 80 percent of females who take them. When the birth control pill is stopped, the same level of pain returns.

Menstrual cramps can be due to other problems. Examples are fibroids, endometriosis, ovarian cysts, and rarely, cancer. Having an intrauterine device (IUD), especially if you’ve never been pregnant, can also cause menstrual cramps, except with the Progestasert® IUD. It releases a small amount of progesterone into the uterus. This lessens cramps and lightens menstrual flow.

Treatment

Self-care measures treat most cases of menstrual cramps. If not, a doctor can diagnose the cause and prescribe treatment.

Questions to Ask

Self-Care / Prevention

* Take an over- the-counter pain reliever, such as ibuprofen, naproxen sodium, or aspirin. These nonsteroidal anti-inflammatory drugs (NSAIDS) relieve pain and inhibit the release of prostaglandins. Acetaminophen will help with pain, too. Most over-the-counter menstrual discomfort products contain acetaminophen. Read labels. {Note: Do not give aspirin or any medication with salicylates to anyone 19 years of age or younger due to its link with Reye’s Syndrome.}

* Hold a heating pad or hot-water bottle on your abdomen or lower back.

* Take a warm bath.

* Gently massage your abdomen.

* Do mild exercises. Stretch. Do yoga. Walk. Bicycle.

* When you can, lie on your back. Support your knees with a pillow.

* Get plenty of rest. Limit stress as your period nears.

* Consider using birth control pills or the Progestasert® IUD. These lessen menstrual cramps.

If you still feel pain after using self-care measures, call your doctor.

Resources

National Women’s Health Information Center

www.womenshealth.gov

© American Institute for Preventive Medicine

January 23, 2026
Men’s Health

Men’s Health

Common reasons men give for not seeing a doctor or getting health screenings are, “I feel fine” and “I’m afraid of what the doctor will find.”

Don’t wait until you get sick to find a doctor. It is better to prevent a health problem than to get it. The next best thing is to detect and treat an illness early.

Testicular cancer is very curable, especially when it is found and treated in its early stages. Do a testicular self-exam monthly.

Erectile dysfunction is usually caused by blood vessel diseases, diabetes, and other physical problems.

An enlarged prostate gland is common. Signs of this are the need to pass urine more often, especially at night and delay in onset and/or slow stream of urine flow. If you have these signs, see your doctor. They can also be signs of a prostate infection or prostate cancer.

Discuss prostate cancer screening with your doctor if you are a male aged 50 to 69; starting at 45 if you are an African American male; 40 and older if you have a family history of prostate cancer.

Though rare, men can get breast cancer.

© American Institute for Preventive Medicine

January 23, 2026
Menopause

Women’s Health

Menopause occurs when menstrual periods have stopped for one whole year. It is also called “the change of life.” In general, this occurs between the ages of 45 and 55. It can, though, occur as early as age 35 or as late as age 65. It can also result when both ovaries are removed by surgery.

Signs & Symptoms

Signs and symptoms usually span 1 to 2 or more years. This is called peri-menopause. Symptoms vary from woman to woman. They result from hormone changes, the aging process itself, fatigue, and stress.

Physical Signs and Symptoms

* Hot flashes. These are sudden waves of heat that can start in the waist or chest and work their way to the neck and face and sometimes the rest of the body. They can occur as often as every 90 minutes. Each one can last from 15 seconds to 30 minutes; 5 minutes is average. Seventy-five to 80% of women going through menopause have hot flashes. Some women are more bothered by them than others. Sometimes heart palpitations come with hot flashes.

* Vaginal dryness. The vaginal wall also becomes thinner. These problems can make sex painful or uncomfortable. Irritation can increase the risk for infection.

* Loss of bladder tone. This can result in stress incontinence (leaking urine when you cough, sneeze, laugh, or exercise).

* Headaches.

* Dizziness.

* The skin is more likely to wrinkle.

* Hair grows on the face, but thins at the temples.

* Muscles lose some strength and tone.

* Bones become more brittle. This increases the risk for osteoporosis.

* Irregular periods:

– Bleeding can occur between periods. This is the most common bleeding pattern in peri-menopause.

– Periods get shorter and lighter for 2 or more years.

– Periods can stop for a few months and then start up again and are more widely spaced.

– Periods occur with heavy bleeding and/or the passage of many small or large blood clots.

Emotional Signs and Symptoms

* Irritability.

* Mood changes.

* Lack of concentration. Memory problems.

* Tension, anxiety, depression.

* Insomnia. Hot flashes can interrupt sleep.

Causes

Hormone changes that come with aging cause menopause. The body makes less estrogen and progesterone.

Treatment

Self-care may be all that is needed. Just estrogen can be prescribed. This is estrogen therapy (ET). Estrogen plus progestogen can be prescribed. This is called EPT. The term hormone therapy (HT) is used for both ET and EPT. Hormone therapy helps protect against osteoporosis, but has health risks. Each women should discuss the benefits and risks of HT and non-estrogen treatments with her doctor.

Questions to Ask

Self-Care / Prevention

For Hot Flashes

* Wear lightweight clothes made of natural fibers, such as cotton.

* Limit or avoid alcohol. Limit caffeine.

* Have cool drinks, especially water, when you feel a hot flash coming on and before and after you exercise. Avoid hot drinks.

* Keep cool. Open a window. Lower the thermostat when the heat is on. Use air conditioning and/or fans. Carry a small fan with you.

* Try to relax when you get a hot flash. Getting stressed out over one only makes it worse.

* Use relaxation techniques, such as meditation, biofeedback or yoga.

* Follow your doctor’s advice for taking herbal products, such as black cohosh; vitamin supplements; over-the-counter menopause aids; and soy products.

* If you suffer from night sweats (hot flashes that occur as you sleep):

– Wear loose fitting cotton nightwear. Have changes of nightwear ready.

– Sleep with only a top sheet, not blankets.

– Keep the room cool.

For Vaginal Dryness and Painful Sex

* Don’t use deodorant soaps or scented products in the vaginal area.

* Use a water soluble lubricant, such as K-Y Liquid®, Replens®, etc. These make penetration easier during sex. Avoid oils or petroleum-based products. These promote infection.

* Ask your doctor about the benefits and risks of using estrogen (pills, patches, vaginal cream, or rings).

* Stay sexually active. Having sex often may lessen the chance of having the vagina constrict. It also helps to maintain natural lubrication and pelvic muscle tone. Reaching orgasm with a partner or alone gives these benefits.

* If you can, avoid using antihistamines. They dry mucus membranes in the body.

For Emotional Symptoms

* Exercise regularly. This helps maintain hormonal balance.

* Talk to other women who have gone through or are going through menopause.

* Avoid stress as much as you can.

* To deal with stress, use relaxation techniques. Examples are meditation, yoga, listening to soft music, and massages.

* Eat healthy. Take vitamins and minerals, as advised.

Resources

National Women’s Health Information Center

www.womenshealth.gov

North American Menopause Society (NAMS)

www.menopause.org

© American Institute for Preventive Medicine

January 23, 2026
Men Need Calcium, Too

Men’s Health

Much has been written about the importance of calcium for women’s health, but men need calcium, too. Although osteoporosis is more prevalent in women, it can strike men. And studies have suggested that calcium may play some role in controlling blood pressure for some people-something worth asking your physician about.

In addition to eating foods high in calcium-like fat-free or low-fat milk, cheese, and yogurt-you can protect your bones by performing a weight- bearing exercise like walking regularly, by avoiding over-consumption of alcohol, and by getting adequate vitamin D (from either fortified milk or sunshine).

Medications like corticosteroids or Dilantin can interfere with calcium absorption, so if you’re taking these medications, find out if you should also take a calcium supplement.

© American Institute for Preventive Medicine

January 23, 2026
Memory Loss

Brain & Nervous System

With short-term memory loss, you can’t recall things learned in the past seconds to minutes. With long-term memory loss, you forget things learned in the distant past, such as in childhood. It is normal to have some memory loss as you age. It is common to forget where you put your eyeglasses or keys. You may have a hard time recalling the name of a person or place, and say, “It is on the tip of my tongue.” This memory loss is temporary and not severe. When it persists or interferes with your daily life, it can be a sign of a problem.

Signs & Symptoms

Signs and symptoms of serious memory loss, such as amnesia, depend on the cause. The memory loss can be partial or complete. It can occur for a short time or persist. It can also come on suddenly or slowly.

Causes

Other than the normal memory loss that comes with aging, causes include:

* Depression.

* Excess alcohol. Drug use.

* Side effects of some medicines.

* Alzheimer’s disease and other forms of dementia. Dementias result in a decline of all areas of mental ability. This includes learning, problem solving, language, behaviors, and memory loss.

* Mild cognitive impairment. This is a medical illness. With this, people have abnormal memory for their age and education. They have a harder time learning new information or recalling things.

* Posttraumatic stress disorder.

* Seizures. Head trauma.

* Stroke.

* Brain infections or tumors.

Treatment

Memory loss that persists, is severe, or that interferes with daily life needs a medical diagnosis. When another problem is the cause and is treated with success, memory loss improves. For other causes, such as Alzheimer’s disease, there is no cure. The goal is to treat symptoms and provide safety and comfort.

Questions to Ask

Self-Care / Prevention

To Help Prevent Memory Loss

* Keep the brain active. Read, do puzzles, etc.

* Eat a balanced diet. Take vitamins and minerals, as advised by your doctor.

* Get regular exercise.

* Protect the head from injury.

* Follow tips under Prevention for Stroke (Brain Attack).

* Don’t smoke or use illegal drugs. Limit alcohol.

* Manage stress.

* Get regular eye exams. Get your hearing checked. If needed, wear eyeglasses and/or a hearing aid.

To Help Remember Things

* Follow a routine for daily and weekly activities.

* Listen carefully. Link newly learned things to past memories.

* Repeat what you want to remember out loud. Write it down if you need to.

* Keep track of important things to do, phone numbers, etc. Use a calendar, planner, PDA, etc.

* Set up a system to remind you of daily medications to take, bills to pay, appointments to keep, etc.

* Put your keys, eyeglasses, etc. in the same place.

© American Institute for Preventive Medicine

January 23, 2026
Get Vaccines To Prevent Measles

Skin Conditions

In January 2015, CDC issued a health advisory to notify public health departments and healthcare facilities about a multi-state outbreak of measles. The outbreak started at Disneyland in Dec., 2014. During that entire year, the CDC reported a record number of measles in the U.S. with 644 cases from 27 states. This is the greatest number of cases since measles was eliminated in the U.S. in 2000.

Why the rise in measles?

* The majority of the people who got measles did not receive vaccines.

* Measles is still common in many parts of the world including some countries in Europe, Asia, the Pacific, and Africa.

* Travelers with measles continue to bring the disease into the U.S.

Measles is a highly contagious respiratory disease caused by a virus. Coughs and sneezes spread the virus through the air. Measles starts with a fever, runny nose, cough, red eyes, and sore throat. A rash that spreads all over the body follows. About three out of 10 people who get measles will develop one or more serious problems including pneumonia, ear infections, or diarrhea. These problems are more common in adults and young children.

Guidelines for measles vaccines

Children should get 2 doses of measles, mumps, and rubella (MMR) vaccine:

* First Dose: 12-15 months of age. Some infants younger than 12 months should get a dose of MMR if they are traveling out of the country.

* Second Dose: 4-6 years of age

* If not given at these times, a two-dose series is needed for all school-age children and adolescents.

Adults born after 1956 should get at least one dose of MMR vaccine, unless they can show that they have either been vaccinated or had all three diseases.

© American Institute for Preventive Medicine

January 23, 2026
Make The Most Of Mealtime

Mature Health: Over Age 50

Mealtime is something to look forward to. But for some older adults, especially men living alone, preparing meals can be both awkward and troublesome. This can lead to the “tea and toast” syndrome of skipped or unbalanced meals. Hit-or-miss eating habits can, in turn, lead to loss of energy and malnutrition. Coupled with the fact that older adults often need more calcium than other folks (for strong bones), more fiber (to prevent constipation), and adequate supplies of other important dietary components, poor meal habits can directly affect your health.

Here are a few hints to make preparing meals and eating meals more pleasant and convenient.

* Make a list before you shop for food. Include fish, poultry, lean meats, nonfat dairy products, whole-grain breads and cereals, fresh fruits and vegetables.

* When you shop for meat or produce, ask a store clerk to cut or repackage large quantities into smaller single- or double-serving portions.

* Take advantage of salad bars in supermarkets. They’re a convenient way to incorporate fresh vegetables into your diet.

* Buy some back-up supplies of nutritious foods-like tuna canned in water or low-salt soups-for days when you don’t have the time or inclination to cook a full meal from scratch.

* Read labels. Avoid foods high in fat, salt, and sugar. These ingredients contribute to many of the chronic health problems that affect people after age 40.

* Prepare double portions of main dishes, so you can reheat leftovers a day or two later.

* Share shopping, meal preparation, and meals with a friend or neighbor.

© American Institute for Preventive Medicine

January 23, 2026
Managing Male Menopause

Men’s Health

You never heard of male menopause? It’s a term used to describe the emotional reactions men sometimes have in response to mid-life transitions. Between the ages of 40 and 60, some men begin to feel edgy and dissatisfied, overwhelmed by their obligations, and pessimistic about their futures.

Typical symptoms include:

* Insomnia.

* Sexual problems.

* Increased dissatisfaction with work, marriage, and family life.

* Preoccupation with the past, or worries about illness and death.

* Abuse of alcohol, drugs, or both.

* Impulsive behavior, or taking unnecessary or dangerous risks.

These feelings and behaviors are often triggered by changes, such as children moving away from home or other typical mid-life events.

To cope with mid-life change:

* Don’t make radical or impulsive changes, like trading in an economical sedan for a luxury European sports car, or suddenly deciding you want a divorce.

* Don’t use alcohol, drugs, or casual sex to escape or lessen the impact of change.

* Do share your fears and concerns with your family, and seek professional counseling if your troubles seem to be more than you can handle.

* Do cultivate skills and interests you’d enjoy but never took the time to pursue.

© American Institute for Preventive Medicine

January 23, 2026