Common discomforts in pregnancy  Abdominal cramping - The ligaments that support the growing uterus are stretching. It is common to have cramping as the uterus grows.  In the second and third trimester, Braxton-Hicks become more common. Rx: Try a heating pad, rest or Tylenol. Call for severe pain, bleeding or regular contractions.  Allergies - The hormonal changes can increase nasal sensitivity. Rx -Avoid allergens such as mold, dust and pets. Rx – Antihistamines and nasal sprays are effective for allergies. Claritin is OTC and does not cause drowsiness. A humidifier in the bedroom may help.  Backache - The increasing uterus size causes a shift in the center of gravity and posture. Rx – A heating pad, ice or Tylenol may be helpful. Avoid lifting, bending, and high-heeled shoes. Wear a supportive bra.  Try stretching, pelvic rocking, or wearing an external abdominal binder. Physical therapy or a massage may also help.  Bleeding gums - The high level of estrogen increases gum sensitivity. Rx - Practice good oral hygiene. Use a soft toothbrush & floss regularly. Try warm saline mouthwashes. Increase Vitamin C.  Braxton-Hicks – Irregular contractions of the uterus in preparation for labor. Rx - Rest on your left side and drink lots of fluid. Keep your bladder empty. Braxton-Hicks do not usually signify labor is going to start. Call if the contractions become regular and intense and you are less than 34 weeks pregnant.  Breast pain - The increased hormone levels cause a thickening of the fat layer & stimulate the developing milk ducts. Rx - Avoid caffeine, and use Vitamin E 800 IU. Wear a supportive bra.  Carpal Tunnel Syndrome – Fluid retention causes compression of the ulnar nerve in the wrist resulting in numbness in the hands. Rx - Wear a wrist splint while sleeping. The numbness usually disappears about 6-8 weeks post-partum.  Chloasma/Linea Nigra Skin Changes - Estrogen & progesterone hormones have melanocyte stimulating effects which cause the dark line on the abdomen and a facial rash. Rx - Avoid sun exposure and wear sunscreen.  Constipation - Progesterone relaxes the smooth muscle, decreasing peristalsis. Can also be caused by iron supplementation. Rx – Drink 8 glasses of water daily. Eat prunes and a high fiber diet. Increase your exercise. Use a stool softener such as Colace or Metamucil.  Diarrhea - Caused by hormonal changes affecting peristalsis. Frequently occurs during early labor. Rx  Drink liquids to avoid dehydration. Eat rice, bananas and toast. Avoid dairy.   Difficulty breathing - The enlarging uterus presses up against your diaphragm. Rx - Avoid restrictive clothing. Use pillows to elevate your back while sleeping.  Dizziness - The enlarged uterus compresses the vena cava. Also caused by nausea, vomiting and blood sugar fluctuations. May be caused by standing or sitting in the same position for a long period of time. Rx –Lay on your left side while sleeping. Eat frequent, small meals. Do not get up from sitting too quickly or take very hot showers.  Move your legs while standing in place to increase blood circulation. Try slower breathing.  Fatigue - Caused by a fall in the metabolic rate, hormone level changes and sleep disturbances. Rx - Take frequent rest periods. Avoid caffeine exercising before bed. Drink warm milk.  Flatulence - occurs from decreased gastric movement and intestinal pressure.  Rx - Avoid gas-forming foods, drinking through a straw, chewing gum or drinking carbonated beverages. Try Mylicon.  Headaches - Caused by stress, increased blood volume, low blood sugar, or hormone level changes. Rx – Rest, drink fluids, try relaxation techniques or massage. Use Tylenol.  Heartburn - Hormonal influence relaxes the cardiac sphincter and decreases gastric motility. Rx - Eat small, frequent meals. Avoid spicy foods.  Do not lie down after eating.  Try Maalox or MOM. Elevate the head of the bed when sleeping.  Hemorrhoids- Straining during bowel movements causes veins in rectum to become inflamed & swollen.  Rx - Eat a high fiber diet, bran, whole grains & fruit. Try frequent sitz baths, sitting on a rubber ring, Preparation H, Tucks, or Anusol HC.  Insomnia - Caused by anxiety &/or being uncomfortable.  Rx - Try a warm bath, relaxation techniques, & a body pillow. Avoid caffeine. Benadryl causes fatigue and is commonly used to help with insomnia.  Itching - Changes in the hormone levels. Rx - Try an Aveeno bath, moisturizing lotion and drink fluids.  Try Benadryl cream or Calamine lotion.  Leg cramps - The uterus puts pressure on pelvic blood vessels causing decreased circulation to the lower extremity muscles. Rx - Straighten the affected leg & point heel. Try leg elevation several times daily, stretching and a diet high in calcium & magnesium. Try using a heating pad, hot water bottle or a warm bath.  Mood swings - Occur from constant fluctuation of hormone levels, fatigue and stress. Rx - Make time for yourself, rest, and exercise. Consider yoga.  Nasal congestion -   The hormone changes increase nasal mucosa sensitivity. Rapid breathing increases the dryness in the nasal passages. Rx - Use a humidifier, drink fluids, and try saline nasal sprays.   Nausea/Vomiting -   Occurs from changing hormone levels, slowed peristalsis, stretching of the internal organs and the enlarging uterus putting pressure on the stomach. Rx - Avoid spicy, greasy foods. Eat small, frequent meals. Drink tea and liquids between meals. Keep crackers, popcorn, or toast at bedside.  Try lemon juice or drops, Vitamin B6 50-100mg with ½ a Unisom tablet. May use OTC acupressure wrist bands.  Nose bleeds - The high estrogen levels increase nasal sensitivity and by dry air. Rx - Loosen the clothing around your neck. Sit with head tilted forward & pinch your nostrils for 10- 15 minutes. Avoid overheated, dry air and excessive exertion.  Blow your nose gently. Use a humidifier while sleeping. Use Vaseline on the nasal passages to keep them moist. Try a nasal decongestant to shrink the swollen vessels.  Pain with intercourse - Occurs from pelvic & vaginal congestion, uterus enlargement or anxiety. Rx - Try changing positions, adding lubrication, increased foreplay, and more communication.                                                                       Round ligament pain - The ligaments that support the enlarging uterus are stretching. Rx - Flex your knees to your abdomen. Try warm baths, a heating pad, exercise, or sleeping with a body pillow.  Stretch marks - The skin stretches to accommodate the enlarging uterus. Rx - Apply lotion with Vitamin E & aloe vera daily. The marks usually fade after delivery.  Swollen hands/feet -   The water retention impairs the circulation and increases pressure in the extremities while standing.  Rx - Avoid restrictive clothes, long periods of standing, excessive sugar, carbohydrate and fat intake. Elevate legs throughout the day. Wear support hose.  Increase your exercise and water intake.    Tender breasts - Wear a support bra.   Urinary frequency - The heavy weight of the uterus puts pressure on the bladder. Rx - Drink fewer fluids before bed. Wear easily removable clothing.  Urinary Tract Infection – Due to relaxation of the sphincters in the perineum and slower peristalsis in the urinary system. Rx - Drink more fluids and consider cranberry juice or cranberry tablets. Use Vitamin C tablets. After urination, wipe from front to back. Urinate after intercourse.  Call our office if you suspect an infection.  Vaginal discharge - Estrogen causes increased cervical mucous formation. Rx - Wear cotton underwear and pantiliners.  Call if odor, persistent itch, changes in color or consistency.  Avoid pantyhose, girdles, and tight pants. Try an OTC yeast medication if symptomatic of yeast.  Varicosities - May be hereditary.  Caused by impaired circulation, pressure of the uterus on the circulatory system, and hormonal effects on veins. Rx - Avoid restrictive clothing, long periods of standing, and crossing legs at the knees. Elevate legs and wear support hose. Take rest periods and walk more.  Yeast infection - Caused by a change in vaginal flora because of hormone fluctuations.   Rx -Use good hygiene. Wear cotton underwear. Use a hairdryer vaginally after showering. Try an OTC yeast medication.