Health Wellness Fitness » Women’s Health Fitness

Finding A Breast Lump

Mark — Tue, 09 Dec 2008 14:28:18 +0000

One of the most common woman’s health issues that plague women are breast lumps. Finding a lump can be traumatizing. A lot of women feel that their breasts are what make them a beautiful woman and can’t bear the thought of losing their breast(s) should the lump turn out to be the sign of something serious.

There are many causes of breast lumps. Some of these causes are harmless, while others can be painful and/or dangerous.

One common cause of a breast lump is infection. An infections of the breast are known as mastitis and is especially common in women who are breastfeeding. When the skin of the nipple (areola) is injured or cracked, such as occurs with nursing, bacteria can enter the wound and cause infections. In a breastfeeding woman, a hard area commonly thought of a clogged milk duct will form. Sometimes, certain treatments can prevent the painful, hard area from developing into an actual breast infection (mastitis). Infections can either be a deep pocket of pus, in which the infection looks like it is growing down into the breast (an abscess), or a wider area of skin redness that spreads out (cellulitis). Body piercing in the nipple area increases the risk of breast infections that may be particularly difficult to treat.

Another cause of breast lumps is injury. If a breast is injured by trauma, tiny blood vessels can rupture to cause an area of localized bleeding (hematoma) that can be felt as a lump. Trauma to the breast can damage the fat cells in the breast tissue, a condition called fat necrosis which can also form a lump in the breast.

Third, there are non-cancerous growths such as Fibroadenomas or cysts. Fibroadenomas growths most commonly occur in women 30 to 35 years old. They are solid, firm tumors that are usually painless or only slightly tender. They sometimes grow quickly in teenagers or during pregnancy. Breast cysts are fluid-filled, tiny sacs within the breast tissue and are benign. They are very common, especially over the age of 35. These cysts often vary in size during the menstrual cycle and may be tender.

Last, the most dreaded cause- cancer. Breast cancer usually causes no pain in the breast. Although women often worry about breast pain, most women with breast pain do not have breast cancer. Only about 6% of women with breast cancer have breast pain as their first sign of cancer.

Nipple discharge that occurs without the nipple being touched can be caused by benign (non-cancerous) growths. Examples of these growths are intraductal papillomas (non-cancerous growths that protrude into the milk ducts) and dilated areas of milk ducts (ductal ectasia). Nipple discharge can also be caused by cancer of the breast tissue. Because nipple discharge can be a sign of cancer, it needs to be evaluated by a doctor.

Skin changes on the breast, including redness and warmth, can sometimes be a sign of breast cancer. A form of breast cancer that commonly causes these signs of inflammation is Paget’s disease of the breast. Most inflammation or rashes on the breast are not due to cancer. They may be caused by benign problems such as nipple eczema or a fungus infection. Still, any breast rashes should be evaluated by a doctor. Areas that are especially scaly and red, particularly if they are persistent, or if there is also nipple discharge, are often sampled (biopsied) to rule out cancer.

In conclusion, woman’s health issues such as breast lumps are not to be taken lightly. Should you find a lump in your breast, it is best to seek medical attention immediately to rule out the possibility of it being the sign of something life threatening like cancer.

Technorati Tags: Breast, breast cancer, cancer, Conditions and Diseases, Health, Nipple, Nipple discharge, Women's Health

Pregnancy And What To Expect

Aurel Radulescu — Sat, 13 Sep 2008 08:00:15 +0000

Image by fahrenheit45one via Flickr

There are no two pregnancies that are alike so, while it is difficult to say exactly how each will progress, there are certain factors that are common among all women going through pregnancy. Quite often, early symptoms of pregnancy will appear and prompt the soon-to-be mom to purchase a home pregnancy test. These can be found at virtually every retail and/or grocery store. It is important to remember that pregnancy tests, while designed to be accurate, are sometimes wrong. Regardless of the result, it is recommended that women experiencing pregnancy symptoms should schedule an appointment with a health care professional who will accurately test for pregnancy.

Among the pregnancy symptoms that most women experience are heightened sensitivity to certain smells and/or food, exhaustion, recurring morning sickness and mood swings. During the entire pregnancy, it is very important that the woman participate in a healthy lifestyle. Among other things, this would include not smoking or being near secondhand smoke, avoid drinking alcohol, etc. In addition, the mom-to-be should drink plenty of milk and eat healthy foods. This will help to promote good development for the child and will be a healthy start for him/her.

Once a woman is confirmed with pregnancy, the next step is shopping for maternity clothes. There is generally a maternity section of every store, but many women simply wear oversized shirts and comfortable elastic waist pants. Preparing for a new baby will include shopping for nursery items, including a rocking chair, bassinet, baby blankets, clothes and toys. If there are plans to convert any room in the house into a nursery, it’s best to start early. It’s also very important that the mom-to-be not be near any paint or harmful products that may cause her, or her unborn child, any problems.

During the nine months of pregnancy, women will go through a lot of changes – both physically and mentally. Mood swings will become more intense and there may be frequent trips to the bathroom as the pregnancy progresses and the growing child begins to press more heavily on the bladder. After the baby is born, the woman will likely have a desire to lose her pregnancy weight. Immediately following birth, it may be a good idea to rest before starting on any exercise program. A licensed medical doctor will be able to prescribe a timeline for such things as physical activity, which will greatly be determined by the mom’s overall health.

This article is to be used for informational purposes only. It is not designed to be used in conjunction with, or in place of, professional medical advice. Any woman who believes she may be experiencing pregnancy symptoms, or has reason to believe that she may be pregnant, should consult a licensed medical physician for proper testing and determination.

Find more about Chinese pregnancy calendar, Chinese gender chart and EPT pregnancy test and many other pregnancy resources on CareJournal.org

Tags: pregnancy, health, home pregnancy test, early symptoms of pregnancy, pregnancy symptoms, pregnancy tests

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Early Pregnancy Test

Mark — Fri, 05 Sep 2008 17:00:54 +0000

Image via Wikipedia

There are milestones in some individual’s lives. Some times they are intentional and at other times accidental. Parenthood could definitely be considered to be one of these markers in life and it is often useful to know as soon as possible. The answer is to turn to an early pregnancy test.

There are things that go on in a woman’s body if she is pregnant. Many women and health officials use these tell-tale signs to give them some indication of what a problem might be. For example: a woman walks into the doctor’s office and is complaining about nausea. The first thing the health professional wants to know is when the last period occurred. Why? Nausea is an early sign in many pregnancies.

For some people the idea of leaving something up to chance is not a gamble they are willing to take. These are couples who want to know when the best possible chance is for reproduction to occur. That is where ovulation kits come in way before the pregnancy test. A pregnancy test monitors the HCG hormone in a woman’s body. When reproduction occurs the hormone levels go up. An early pregnancy test has become 99% accurate but that accuracy rate is for after the first missed period. The chances for detection are slimmer before.

The ovulation kits monitor a woman’s natural temperature and hormone levels throughout the month. By charting her temperatures and readings from the kit, she is able to observe when her egg is released from her ovary. This means that there is a higher chance for the sperm to fertilize the egg. Once the average temperatures and hormones have been charted by ovulation kits or ovulation tests, the rest is up to the sperm finding the egg and implantation to occur. The fertilized egg then moves to the uterus and becomes implanted.

The early pregnancy test cannot determine when implantation of the fertilized egg occurs but it can be used once the early signs begin showing. Tender breasts, nausea and a missed period are all symptoms of pregnancy. Her body is preparing for the nine months ahead in which she will nourish her child as it develops and grows. Conception is just the beginning and the fetus will develop at a tremendous rate from that point on.

An early pregnancy test can not detect a pregnancy if the woman’s HCG hormone is not high enough. She may know she is pregnant but the test may give a negative. It is for this reason that doctors and health professionals advise waiting until the first missed period before attempting a pregnancy test. It may seem like torture having to wait but it is better for the test results to be more accurate.

Tags: conception, early pregnancy test, ovulation, ovulation kits, reproduction

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After Birth Belly

Mark — Thu, 14 Aug 2008 09:00:54 +0000

photo credit: moonsheep

Pregnancy and childbirth are wonderful events that leave a lasting impression in the life the mother and father. And the mother often has an extra gift after the birth of her child. The changes in her body that were so welcome as the baby was growing and developing have now left changes to hips, feet, breasts and belly that can take up to one year return to pre-pregnancy status.

And even at one year there is the chance that the pelvis will continue to be just a bit wider, feet just a bit wider and breasts just a bit larger. But the physical change that most women struggle with is their belly after child birth.

It took nine months to stretch the skin, muscle and connective tissue so that baby could grow to 5-7 pounds in weight, plus a 2 pound placenta and the extra fat and blood needed to supply nutrients to the infant.

Now mom is faced with a belly that jiggles and moves all on its own! But relax – the stomach you see immediately after childbirth isn’t the belly that you’ll be enjoying in just a few short months.

In fact it will only be a week or two and you’ll notice a large change. Although not the belly you had pre-pregnancy it will start to regain some tone and the jiggle and wiggle will be decreasing gradually.

Many women never regain the tight abs they had before getting pregnant, especially if a first pregnancy happens in the 30’s or if you are contemplating your navel after your third or fourth birth. But with time, patience and a bit of work you can achieve and enjoy a belly after child birth that anyone would be proud to show off.

And the work is simple, doesn’t require lots of heart pounding sweating miles running on the roads or even lifting Olympian type weights at the gym. Rather you can achieve a pre-pregnancy belly using simple equipment at home in just minutes each day. And those minutes will also help you to achieve a healthier lifestyle and have more energy to deal with your new infant each day.

After your six week appointment with your obstetrician they will probably release you to do light exercise and workouts. Ask when you’ll be able to exercise your abdominal muscles.

Your best option, at least when your baby is young, is to use an exercise ball or Swiss ball, at home. These are the large blow up balls that are available in department stores. An exercise ball that fits you appropriately should let you place your feet on the ground with your knees at 90 degrees or less. You can use the ball to help improve your core abdominal strength just by bouncing and moving around on the ball.

Another option to use, (that can be done throughout the day), are both abdominal muscle tightening and/or kegel exercises. While sitting in the car, rocking the baby or watching television you can employ both of these options to improve the muscle tone in the stomach.

While these exercises will help to tone the belly and improve the strength of the muscles they won’t help to decrease the fat over the belly. Spot toning will happen but spot weight loss will not. To get those great new abs visible you’ll also have to lose some of the extra weight from the pregnancy.

Tags: belly, pregnancy and childbirth, pregnancy belly

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How Red Wine May Help Prevent Breast Cancer

Mark — Wed, 09 Jul 2008 17:03:44 +0000

photo credit: uLe @ Dortmund

Red wine may help prevent breast cancer new research shows. A team of researchers from the University of Nebraska has found that in the test tube studies in relation to breast cancer and estrogen, resveratrol which is an antioxidant found in red wine, blueberries, cranberries, red and purple grape juice, peanuts, and which is also available as a supplement, keeps estrogen from causing breast cancer in their test-tube research.

One of the major risks to breast cancer is continued and prolonged exposure to estrogen because interactions take place between estrogen and estrogen receptors in breast cancer cells.

In a woman’s body when the body’s system for keeping estrogen in balance becomes erratic, toxic compounds called estrogen metabolites begin to appear. DNA in breast cells in the act with these estrogen metabolites causing the growth of tumours.

Now the team of researchers at the University of Nebraska headed by Eleanor G. Rogan, PhD, have found that the antioxidant Resveratrol frustrates the formation of the toxic compounds and tends to block interactions between the cellular DNA and between the toxic compounds themselves.

Perhaps equally as important it has also been found that the resveratrol helps to increase the production of an enzyme which destroys the estrogen metabolites. In other words a resveratrol helps stop the first steps in the process leading to breast cancer.

Additionally the results were achieved with low levels of resveratrol.

While this research shows promising results from test-tube experiments and breast cells actually grown in a laboratory, further research is still needed. However these are promising results indeed towards the progress to eradicate breast cancer.

Tags: resveratrol, red wine, antioxidants, breast cancer

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Post Ironing Stress Disorder

Mark — Fri, 27 Jun 2008 12:53:43 +0000

photo credit: The BrassPotato

Post Ironing Stress Disorder or PISD was first diagnosed back in the 1950’s by general practitioners who were seeing more and more housewives across Europe and America complaining of symptoms of tiredness and exhaustion while managing large families.

Let’s face it, no one enjoys ironing especially when you have to fold all of the clothes afterwards. The term PISD quickly became slang ‘pissed’, and hence the origin of the term ‘Pissed Off’.

Hey, I’m taking the Mickey, but I bet I was beginning to take you in.

Truthfully I do not like ironing and folding clothes myself, so about a year ago I found a wonderful solution. I only iron when I need something to wear, and as for folding clothes, towels, etc, I made myself a speed clothes folder so all my items were folded quickly and uniformly usually within five seconds for each item.

Here are photographs of what it does (folds clothes quickly within five seconds), and what it is made from, (an egg box from a supermarket). The item of clothing is not ironed in these photographs, however if it was the resulting uniform neat pile of clothes would resemble a shop shelf.

The measurements of the pieces are:

1 x 33cm x 72cm (base)
2 x 25cm x 72cm (sides)
1 x 25cm x 36cm (flipper)
The flipper is aligned centrally on the base on the bottom edge.

It’s possible you may not have come across this idea before, but it is actually a well known idea that has been around for many years. There are plenty of similar examples across the internet. It will save you a lot of personal stress with laundry.

Tags: pissed, pissed off, clothes folding, folding clothes, clothes folder

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The Causes of Menopause in Women

Mark — Tue, 24 Jun 2008 14:26:21 +0000

photo credit: Ed Yourdon

The causes of menopause are either physiological or pathological. The physiological cause simply means that for a woman that her body is starting to go through the process of menopause for a natural reason which is quite normal. On the other hand a pathological cause means that a woman is starting to go through the process of menopause due to a medical condition which has led to a loss of ovarian function.

This loss of ovarian function prematurely pushes a woman’s body into menopause as hormonal support is gradually withdrawn from the body. Hormones control the initial development and release of the egg as well as initiating changes in the uterus to support a pregnancy such as building up a supply of blood. Additionally hormones aid in keeping collagen and elastin present in the skin as well as supporting physical and physiological processes which happen each month.

Pathological factors which can prematurely hasten menopause are conditions such as, extreme emotional stress, malnutrition, debilitation, reproductive tract tumours, a surgical procedure such as hysterectomy, radiation treatment and chemotherapy, or any other surgical procedure that can cause a loss of blood supply to the ovaries.

Once the ovarian function declines and the woman’s body reduces the natural functions surrounding ovulation then she is thrown first into peri menopausal, or pre menopause symptoms and then into menopause itself.

In normal physiological menopause the decline in function with the ovaries and symptoms of menopause are usually due to age. As the hormonal levels decrease the woman finds out her menstrual cycles become unpredictable, may last longer or shorter, and may be lighter or heavier than usual. These are menopause symptoms and the first signs of the start of approaching menopause.

Naturally these menopausal symptoms can bring an onset of depression, so if you are suffering from the above symptoms and some associated depression you may find menopause relief psychological support from a group of people suffering the same symptoms, helpful.

The first stage as I previously mentioned is peri menopause. There are actually three stages and the process is gradual and permanent. Peri menopause is the stage when you experience hot flushes and your menstrual cycle goes a bit pear shaped. The stage lasts for several years until the ovaries actually stop releasing eggs. During the last couple of years of the process there is a sudden decrease in estrogen.

In the second stage, which is actually menopause itself, is when a woman has her final menstrual period. Once this has happened for 12 consecutive months the normal diagnosis is menopause.

The latter stage is called post menopause. These are at the years following the diagnosis of menopause. By this time the hot flushes and depression should be well past, however they are are risks for women associated with the loss of estrogen during these years and they should seek regular medical consultation with their general practitioners. One condition which seems to affect women more than men is osteoporosis.

One word of warning though for a woman who starts to experience the symptoms of premature menopause before they are 39. If this applies to you be sure to be fully evaluated by your physician, in case there are any potential medical conditions that are causing the early onset of symptoms.

For further information and help with menopause symptoms click here.

Tags: menopause, pre menopause, premature menopause, peri menopause, post menopause, menopause symptoms, menopausal symptoms, pre menopause symptoms, early menopause symptoms, early signs of menopause, premature menopause symptoms, signs of menopause, symptoms of menopause, peri menopausal symptoms

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Recognising Postpartum Depression

Mark — Thu, 03 Apr 2008 20:10:53 +0000

Postpartum depression is ‘baby blues’. It is a condition of depression which occurs after the birth of a new child, and it usually throws a woman’s life into significant upheaval.

A woman may describe emotional feelings of being blue, unhappy, miserable, sad, exhausted, have a headache, irritable, feel a sense of inadequacy, or just simply feel more down than usual. It’s not a temporary feeling, but a true clinical depression that interferes with the woman’s life over a period of time immediately following the birth of the child.

The attack of depression can come in varying degrees ranging from mild or moderate depression, to very severe. Any woman experiencing these symptoms should see a physician or psychologist, who will help determine what treatments will be used to alleviate the symptoms.

It can be distressing to feel happy, one minute and to begin crying the next. Usually the depression also manifests in a loss of appetite and a loss of sleep. Of course this tends to be a vicious circle, which aggravates the depression.

The most common form of baby blues usually lasts no more than 3, 4 days after the birth. During this time, it is beneficial, if there is someone else in the house to help get over this period. Another female who can help with the meal preparation and just be there for the new mother to speak with can be very helpful. It can also help the new mother make it quicker recovery.

The more moderate form of postpartum depression may appear several weeks after the delivery, and is a more severe type of depression. This is the form of baby blues were a woman experiences symptoms of constant fatigue, emotional numbness, perhaps a feeling of failure, impaired thinking or lot of concentration, severe mood swings, excessive emotional concern for the baby, and perhaps a loss of interaction with family and friends.

Even more severe is postpartum psychosis, a condition of severe postpartum depression, which is thankfully rare. Again, it develops within the first six weeks after delivery. This is the very extremely depressive condition were women feel or experience a fear of harming themselves or their baby. They may experience confusion, disorientation, hallucinations, delusions, and even paranoia.

There may be a number of medical reasons for the onset of postpartum depression. A further stressful life event, hormonal changes, or even a death in the family can all cause the onset of the condition even as late as one year after the birth.

The new parent’s immediate family circle should be aware that there is always this chance that the condition may develop, so for the first year, they should really be watching out for these signs. Most people assume once the first few weeks have passed, everything is great. Not so. The condition should always be watched for so that early treatment can lead to a quicker recovery and less emotional stress and pain for the new mother involved.

Some women will have a hard time admitting their feelings because they feel they are letting their husband or family down, and they feel it is somehow their own fault. They feel they should be happy with their beautiful new baby, but because they aren’t, they feel very guilty and worry that they may be seen as an unfit mother. They may even beg you not to call the doctor, but to let them sort it out themselves.

This is why early recognition and treatment is essential, and husbands especially need to be aware of the background of postpartum depression. If you think you are suffering from this, or if you are a husband who thinks his wife may be suffering from this condition, please seek advice from a doctor or midwife immediately.

Tags: postpartum depression, postpartum psychosis, baby blues

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Pre Menopause – How To Recognize Pre Menopause Symptoms

Mark — Fri, 14 Mar 2008 10:08:52 +0000

by Dean Caporella

When experiencing pre menopause symptoms keep in mind that these are simply the lead up process to full menopause.

Menopause basically means a women stops her menses or menstrual flow. It’s a time of change and while the symptoms associated with it can be uncomfortable, research indicates women who embrace this as a new beginning in their lives tend to have a better mental disposition and thus, handle it much better.

Pre Menopause Symptoms

Nature is amazing in many respects and pre menopause symptoms are simply a way of easing a woman into full menopause. You’ve got to understand that if a woman went from normal straight to menopause in one fell swoop then there is every likelihood she could end up in a mental institution.

Pre menopause symptoms are the body’s way of easing a woman into menopause and the change is usually a slow one. The time it takes can vary considerably but ten years is common.

Let’s take a look at some of the symptoms of peri menopause. It’s also important to understand that just because you are experiencing these symptoms it doesn’t always mean they are menopause-related.

In fact, don’t just ignore them and put them down to menopause. See your doctor because they may well be associated with other conditions of a more sinister nature. Your doctor is best placed to determine exactly what they are related two. Here are some symptoms to take note of:

- irregular periods
- hot flashes
- mood swings
- migraine headaches
- weight gain despite the fact you follow a sensible diet and exercise regularly
- night sweats
- insomnia
- joints which ache regularly
- vaginal dryness
- skin irritations or dry skin
- depression
- libido issues or lack of sex drive

The symptoms of pre menopause can start as early as the thirties. This may come as a surprise to most women but the truth is, handling them has a lot to do with your mental preparation.

This is one of the reasons education on pre menopause symptoms is not so much about how to treat them but more about preparing for them by simply understanding what they are and why they are occurring.

Too many women wait to the very last minute to even learn about menopause and how it can affect many facets of their lives. Your education, despite the fact the big “M” gives an impression of aging, should begin very early.

Want to know how to effectively prepare for the symptoms of menopause and save yourself unnecessary stress? Plus, get the latest menopause related news and reviews.

Article Source: http://EzineArticles.com/?expert=Dean_Caporella

Tags: menopause, menopause symptoms

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Acupuncture And Infertility

Mark — Thu, 21 Feb 2008 21:05:13 +0000

Acupuncture assists success of IVF fertility treatments

8 February, 2008

The British Acupuncture Council (BAcC) has welcomed the preliminary results of a recent international study published today in the British Medical Journal which found that acupuncture given with embryo transfer can improve rates of pregnancy by 65% in women undergoing in vitro fertilisation (IVF).

Head of the British Acupuncture Council Research Committee, Professor Nicky Robinson said: The recent systematic review and meta-analysis of 7 trials, involved 1,336 women undergoing IVF.

“This study suggests that when acupuncture given in conjunction with embryo transfer increases the chance of women becoming pregnant by 65%, in comparison to sham acupuncture or no additional treatment. What this means is that 10 women would need to be treated with acupuncture to bring about one additional pregnancy.”

“It confirms what many of our practitioners and their patients have found, namely that acupuncture can be helpful in this area.”

”At the BAcC, we recognise that our practitioners are treating more and more women for a wide range of fertility issues, including menstrual irregularities and the inability to conceive and our research committee has a comprehensive research study underway, analysing the member’s practice of fertility related conditions.”

The researchers at the University of Maryland School of Medicine and VU University Amsterdam set out to determine whether acupuncture given with embryo transfer improves the rates of pregnancy and live birth among women undergoing IVF.

Acupuncture is a form of oriental therapy and fertility focused acupuncture treatment can help to increase blood flow to the reproductive organs, balance hormone levels, regulate the menstrual cycle and help improve the lining of the uterus and quality of eggs released.

Acupuncture is thought to aid fertility treatments by being able to:

regulate the menstrual cycle and promote regular ovulation
regulate the hormones to produce a larger number of follicles
improve the functions of ovaries to produce better quality eggs
enhance the vitality of sperm
relieve the side effects of drugs used in IVF
increase the thickness of the uterine lining so to encourage successful implantation.

As with all health care treatments, it’s important to find a registered and qualified practitioner. To find a practitioner in your area call the British Acupuncture Council on 020 8735 0400 or visit www.acupuncture.org.uk

BAcC practitioners are available for interview, expert comment
and case histories.

For further press information please contact:

Mandate Communications
Tel: 0207 836 4279

About the BAcC:

The British Acupuncture Council (BAcC) has a membership of over 2,800 professionally qualified acupuncturists. It is the UK’s largest professional body for the practice of acupuncture.

BAcC members practise a traditional, holistic style of acupuncture diagnosis and treatment based on a system developed and refined over 2,000 years. To achieve BAcC membership, practitioners must first undertake extensive training in traditional acupuncture (minimum three years full-time or part-time equivalent), which includes physiology, anatomy and other biomedical sciences appropriate to the practice of acupuncture.

What is acupuncture?

Acupuncture is an Oriental therapy that aims to improve the overall wellbeing of the patient, rather than treating specific symptoms in isolation. Traditional Chinese philosophy states that our health is dependent on the body’s motivating energy – known as Qi – moving in a smooth and balanced way through a series of meridians (channels) beneath the skin.

For any number of reasons, Qi may become unbalanced and lead to illness. By inserting fine needles into the channels of energy or Qi, an acupuncturist can stimulate the body’s own healing response and help restore its natural balance.

Technorati Tags: acupuncture, fertility, In vitro fertilisation, infertility, pregnancy

Health Wellness Fitness » Women’s Health Fitness

Finding A Breast Lump

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Pregnancy And What To Expect

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Early Pregnancy Test

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After Birth Belly

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How Red Wine May Help Prevent Breast Cancer

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Post Ironing Stress Disorder

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The Causes of Menopause in Women

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Recognising Postpartum Depression

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Pre Menopause – How To Recognize Pre Menopause Symptoms

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Acupuncture And Infertility

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