Wednesday, August 18, 2004

Female Domys

It's staggering how many health dogmas and myths (domys) women have to put up with, just because they're women. [Domys? Did you just make up a word, and pluralized it? Ed. Yes, yes I did.] Three of the most entrenched ones are:

- Painful and inconvenient menstrual periods are an integral part of being a woman.

- Women must feel excruciating pain during childbirth!

- Pregnancy and nausea and vomiting go hand-in-hand.

No, no, and no! None of these harmful domys are true, and it's high time we get rid of them. My book informs women about the first domy. Thankfully, most physicians are doing their part in combating the second one, by being aware of, and informing women about pain management options during delivery. [Unlike the majority of TV executives who find it perfectly acceptable, not to mention amusing, to depict a woman squirming in pain while giving birth!] So, let's spend a little time today deconstructing the nausea and vomiting of pregnancy (NVP) domy.

The prevalence of NVP is 70% to 85% (about 50% of women have both nausea and vomiting; 25% have nausea only). About 35% of pregnant women have NVP severe enough to disrupt their daily routine. As many as 50% of these women are not offered treatment for their condition. The most severe form of NVP, hyperemesis gravidarum, requires hospitalization. This condition is seen in 3 to 20 of every 1,000 pregnancies. NVP usually present before the 10th week; about 30% of pregnant women can expect it to go away before 10 weeks, in about 30% of women it will resolve between 10-12 weeks, and in another 30% of women by 12-16 weeks.

The physical discomfort experienced by pregnant women with NVP (even at milder levels of severity) is similar in intensity and character to the nausea and vomiting induced by cancer chemotherapy.

What helps with NVP? Although not well supported by studies, lifestyle changes might help--avoiding foods and activities that worsen the NVP; small, frequent meals; protein liquid meals. Also, there are alternative remedies, like ginger (250 mg by mouth 3-4 times a day), and acupuncture. Moving on to drugs, studies found that multivitamins can help reduce the severity of NVP. If none of these work, or if you don't want to try them, you have very good alternatives available: vitamin B6 (pyridoxine) and Bendectin (only if you live outside the U.S., otherwise you have to improvise). [And while we're on the subject of availability: Avoid thinking of the multi-millionaire lawyers who file frivolous lawsuits while you're vomiting; it may aggravate your condition.]

Vitamin B6 (10 to 25 mg every eight hours) should significantly reduce the vomiting. If this doesn't work, the next step is Diclectin (available only outside the U.S.). In the U.S., the equivalent drug Bendectin was voluntarily withdrawn from the market in 1982 because of greedy lawyers. [For the full story, in the article I linked to, look under Bendectin: The sad saga of a useful drug, or click here (pdf file).]

One tablet of Bendectin had 10 mg each of vitamin B6 and doxylamine. Approximately the same amount of doxylamine (12.5 mg) can be found in half a tablet of the OTC drug Unisom. So, if vitamin B6 alone doesn't help, half a Unisom tablet can be added; that is half a tablet every eight hours. (Only Unisom in tablet from works; the gel caps have a different active ingredient.)

Other drugs used, for more severe cases and hospitalized patients, are: Phenergan, Dramamine, Reglan, Tigan, Zofran, and Medrol.

Bottom line: feeling nauseous and vomiting during your pregnancy is not a "must-have" experience. Treatment is available; ask for it! And, as always, verify everything you read here with your own health care professional.

Creative bonus, since I'm in a slogan-y kind of mood: Know More, Live Better. Just Say No to Domys!


At 6:56 PM, Blogger bitchphd said...

Oh wow. Thanks for this. I got very tired of throwing up last time (7 months of it, ugh). I'll try the B6 when I get myself knocked up again...

At 10:20 PM, Anonymous Anonymous said...

I wish I would have known more of this 11 years ago when I had my son. I basically was naseuous and throwing up the entire 9 months. I had b-6 IV's twice, which only provided minimum relief, diet changes didn't make much difference as I had no appetite to begin with. For the only time in my life, doctors were worried about my weight LOSS. Yet somehow I managed to deliver a perfectly healthy (if sunnyside up!!:) little boy, who one would not ever believe, if looking at him now, ever had a health problem in his life.

Holly my blog is located at I have a blogger account, but never use it.

At 12:25 AM, Anonymous Anonymous said...

With my last pregnancy I was so sick, vomiting at least 5 times a day. I tried everything, and mean EVERYTHING. The thing that helped me not be so sick? Doxylamine and vitamin B6. It made my life so much better. I highly recommend it if nothing else works.


Post a Comment

<< Home