Why track blood sugar?

Blood sugar tracking is important for anybody who is diagnosed with diabetes, whether type 1, type 2, or gestational diabetes. Your healthcare provider should let you know how often to test your blood sugar. The frequency of testing usually depends on the type of diabetes you have, and how much insulin you use.

Tracking your blood sugar helps you understand how different foods, medications, illness, and activities affect your levels. This allows you and your provider to develop the management plan that’s best-suited for you.

What do the numbers mean?

Blood sugar levels are represented as milligrams of sugar per deciliter of blood (mg/dL). The normal ranges of blood sugar are as follows:

• Before meals: 80 – 130 mg/dL
• Within 2 hours after meals: Less than 180 mg/dL

Everybody is different, and the American Diabetes Association recommends that healthy people under 60 aim for lower levels than these. You should speak with your healthcare provider about the ideal blood sugar levels for you.

Sources

CDC: https://www.cdc.gov/diabetes/managing/managing-blood-sugar/bloodglucosemonitoring.html

Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/blood-sugar/art-20046628

American Diabetes Association: https://www.diabetes.org/healthy-living/medication-treatments/blood-glucose-testing-and-control/checking-your-blood-glucose

How utilize mental health support

Having a support system in place can be a great way to make sure you’re ready for the inevitable ups and downs of life.

It doesn’t have to look like what you expect

Is there someone in your life you would feel comfortable sharing your struggles with? It doesn’t have to be the person you might feel you’re expected to turn to. Maybe the person who usually falls into the best friend category for you is a little high-strung, and opening up the question of mental health support with that person feels harder than not asking for help at all right now. That’s okay, and it doesn’t mean that person isn’t important to you. There may be someone else in your life who is a better listener, or someone who has more time for you. Maybe it’s a casual friend that can help you the most right now. You can try to turn that casual friendship into a more serious one by opening up, and sometimes this is a great opportunity.

Get specific

Asking for help is hard, and getting too specific about what kind of help you need can feel even harder, but even the people in your life who know you best can’t read your mind. If you’re having a hard time, and thinking you’ll do better reaching out and asking for help, sitting down and making a short list of exactly what might help you out – anything from a more general “please don’t ask me about,” a certain subject, “I’ll tell you when I’m ready,” to the more specific, “I need to take a break from cooking at night until things quiet down at work” – can help whoever it is you’re asking for help figure out the best way to support you.

Give a little to get a little

The strongest support system is one that’s mutually supportive. This can be tricky in moments when you’re the person who needs help, but it’s important to remember that by sharing vulnerability, you are offering friends, family, and others the chance to feel more open to sharing their own vulnerabilities or insecurities. Maybe you have that one friend who acts like a superhero, and always seems to be completely on top of things, even when their life is full of challenges and changes. It can be hard to feel comfortable sharing when you’re having trouble with a friend like that – but if you hide it every time you’re having trouble, they may feel the same way about you.

Asking for help can feel selfish, but everyone needs help at some point. If you make a point of reminding the people in your life that you’re committed to being there for them in the best way you can when it’s their turn, you’re offering the chance to deepen your relationship. Actively listening to what’s going on in the lives of the people in your support network, and doing your best to offer the kind of support they need isn’t just offering that chance, it’s taking an active part in maintaining and developing that relationship.

Think outside the box

Your support system doesn’t have to just consist of people you already know. For one thing, depending on why or how you’re starting to feel overwhelmed, talking to a therapist or looking for a support group can be a great place to get started, especially if you’re not sure how to bring the subject up with the people in your life already. Taking a step like this can make whatever you’re coping with feel more real – and sometimes that’s exactly what you need, as a reminder that your feelings are valid.

You also don’t need to talk to everyone in your life about everything that’s going on in your life. If opening up a big conversation about how you’re feeling seems out of reach, try just asking for help in a simple way. A friend may be willing to help you out if you ask them to carpool to get your toddler to dance class. Your sister may be perfectly happy to take the reins on planning the next family event.

Practice these daily routines to help with managing depression

Sometimes, it’s easy to be harder on yourself than you’d ever allow or want yourself to be with someone else, especially when you’re dealing with depression. When you feel like this, picking some of the people in your life who you love, and who love you, and trying to talk to yourself the way you’d want someone to talk to those people if they were having a hard time can be a good frame for speaking generously to yourself. Like “fake it till you make it,” the way people speak to themselves inside their heads can have a huge impact of the way they think about themselves, and the way they feel, and can easily turn into feedback loops of bad feelings. Making a point to speak to yourself kindly can help to pull you out of the loop of speaking unkindly to yourself in a way that you internalize and feel worse because of.

Some suggestions for dealing with depression – or even most of them – can feel too simple to make much difference, or so often-repeated that it can feel like they can’t possibly make a difference. It’s true that no single one of these strategies may bring an end to depression, but finding the combination that works for you, in conjunction with the type of treatment that works best with your body chemistry and lifestyle, can make a big difference in helping you start to feel better.

Get it out there

Writing in a journal can offer an outlet for getting emotions out without opening them to any judgement, and can give you a way to keep track of your thoughts and notice any patterns in them. For example, do certain thought-patterns seem to go along with more severe depressive symptoms? That’s good information to have, and so is any strategy you might notices for steering your thoughts in other directions.

For endorphins’ sake

Getting into a regular exercise schedule is one of the most common pieces of advice when it comes to managing depression, and in turn, it’s one of the most dismissed pieces of advice. It’s true that exercise isn’t a magic bullet for depression, but getting outside and moving around on a regular basis has a whole host of benefits that can contribute to starting to feeling better. Between the sun, the change of scenery, the endorphins, and the fresh air, anything from a walk around the block to training for a marathon can be a healthy part of managing depression.

Treatment

Depression is a medical condition, but there’s a lot of stigma around it. Some may mistakenly characterize it as a personal problem, and to be resistant to seeking out treatment from professionals. If depression is negatively affecting your quality of life, seek help. Medication, psychotherapy, or some combination of the two, can have a huge positive impact on your life. Just like with these informal strategies, finding the treatment plan that works well for you can take some trial and error, and figuring out how to be patient with yourself and your medical team will be an important part of the process.

Setting up a pattern

Having a strong routine in your life  can help you demonstrate to yourself what you’re capable of, especially when you’re having an especially hard time. It can help to keep self-care tasks from slipping during difficult episodes, and when depression does become severe enough to interfere with routines, having those routines set up to begin as a control can show how much is changing.

General physical health

A lack of physical health doesn’t cause depression, but it can certainly contribute to it. Making sure to eat a balanced diet, get enough sleep (but notice if you find yourself sleeping more and more often), avoiding alcohol and street drugs can help keep you in your best shape possible to combat depression.

Reach out

Often, during periods of strong depression, spending time with people can be one of the early things that gets cut out. Isolating yourself can create a feedback loop of bad feelings, though, whereas spending time with someone, even if the sound of that feels exhausting, can be a way to get out of your own head a bit. Making a point to reach out to people who feel restful or helpful to you during this time, instead of the people who may ask more from your energy reserves, can help to make social experiences during periods of depression more meaningful and positive.

Fake it till you make it

Sometimes, especially during a spell of depression, putting on a can-do attitude – even if it’s not how you feel – is a great way to get through a difficult or challenging day, from a huge family gathering to coordinating with an electrician or landlord over an unexpected wiring problem in your house, to a normal day of work at a time when you just don’t think you can do it. One of the reasons faking it till you make it works is that putting on an attitude can help to infect you with some of the feelings you’re putting on, but that benefit also comes with a caution. It’s also key for you to know and understand how you’re really feeling. Denial about depression can mean putting off making the changes that can help you feel better.

Other things to consider

Depression can make even the simplest tasks feel more challenging, and managing changes to your life, routine, and comfort zone when you’re experiencing depression can feel like an especially dangerous game. Making changes can help you feel out the shifts in your routine that can better support your changes in mood, attitude, and mental health, though. Dealing with depression means that you may be able to benefit from a certain amount of extra support, but by making changes in your own life, some of that support can come directly from you.

Signs of depression and when to talk to a doctor about it

Most people experience majority of the symptoms of depression at some point in their lives, to one degree or another, and it can be hard to tell which moods and feelings are symptoms of disorders which require treatment. For this reason, many people who do have depression or other mood disorders are diagnosed many years after noticing symptoms, or are never diagnosed or treated at all.

Watch out for these symptoms and signs of depression

There are a wide range of symptoms of depression, and some of them are physical, which can make it easier for some people to figure out how and when to reach out and ask for help. Both physical and emotional symptoms may be signs of depression if they last for two weeks or longer. Physical symptoms of depression include:

• Changes in sleep, whether that’s sleeping more often than usual, or insomnia
• A loss of appetite, or increased craving for food, causing either over- or under-eating
• A loss of sex drive
• Tiredness or lack of energy
• Aches and pains or headaches with no obvious cause

The emotional effects of depression can vary widely, from a consistent level of negative feelings all the way to feeling suicidal or hopeless. Emotional symptoms of depression can include:

• Feelings of sadness, hopelessness or feeling on the edge of tears
• Anger, irritability, or frustration, especially anger or frustration that feels excessive to events
• A loss of interest or pleasure in favorite things or interests
• Slowed thoughts, speaking and movements
• Agitation, twitchiness or restlessness
• Feelings of guilt, inability to let go of past mistakes or blame
• Thoughts of death or suicide

Thoughts of suicide should be treated as a medical emergency and you should go to your local emergency room right away.

Depression can be caused and set off by different things at different times. Sometimes depression is triggered  more by life events and stressors. Other times, it’s more determined by brain chemistry, regardless of life and stressors. Often, it’s some combination of the two. In any case, when depression affects your life, reaching out to a healthcare provider  for treatment and support is one of the best ways to start to work towards recovery.

Talking to your provider

Depression is a serious condition, and not something that one snaps out of by force of will. The earlier treatment starts, the faster and more effectively one can begin to start feeling better.

Primary care providers tend to be the first line of defense against depression. Starting the conversation about your mental health with the healthcare provider you’re the most comfortable with is never a bad idea, but it’s also good to remember that most PCPs don’t specialize in mental health treatment, and mental health providers like psychiatrists can be fantastic resources as you start to figure out what your needs around treatment are.

Your mental and physical health is a series of connections working together to keep you going. At the center of it is our heart. Maintaining your heart health is crucial to your wellbeing. Understanding how the heart functions, its role and the risk factors you may face are key to getting on the path toward keeping it as healthy as possible.

How your heart works with the rest of your body

The heart is a muscle that works in connection with the rest of the body through the circulatory system. As the heart pumps blood throughout the body’s circulatory system, it operates in a coordinated effort with the lungs (pulmonary circulation) to exchange carbon dioxide for oxygen and with the rest of the body (systemic circulation) to deliver oxygen-rich blood.

Our heartbeat is the heart’s rhythmic contractions, regulated by electrical impulses. These contractions ensure continuous blood flow, support bodily functions and maintain stable body function. The heart speeds up in response to movement, physical activity and hormone signals to meet the body’s demands.

Heart health’s connection to family history

Family history can significantly impact heart health. Genetic predisposition can increase the risk of many cardiovascular diseases, including coronary artery disease, high blood pressure, and congenital heart defects. 

Genetics also have a role in terms of high cholesterol and increasing your risk of developing diabetes- both of which are risk factors for heart disease. While you can’t change your genetics, awareness of your family history can guide preventive measures, lifestyle choices, and early screenings to mitigate these risks.

Cardiovascular health and its unique effects on women

Cardiovascular health can affect women uniquely due to several factors. Women may experience different heart attack symptoms than men, such as nausea, dizziness, and back or jaw pain. Also, pregnancy, reproductive conditions, mental health and hormonal factors increase the risk of heart disease among women.

Reproductive health and the heart

In many ways, pregnancy is like a stress test for the heart, as many signs of heart disease show up during pregnancy or in the postpartum period, including:

• Preeclampsia greatly raises the risk of developing hypertension and/or diabetes later in life. It also increases the risk of a stroke.
• A gestational diabetes diagnosis raises the lifetime risk of developing diabetes. About 50% of women with gestational diabetes develop type 2 diabetes.

Risk factors for heart disease

Many risk factors can increase the likelihood of developing heart disease, including:

• Lifestyle factors: Smoking, physical inactivity, unhealthy diet, and excessive alcohol use.
• Health conditions such as high blood pressure, high cholesterol, diabetes, obesity, and chronic kidney disease.
• Genetic factors: family history of heart disease, especially at an early age
• Age: the risk of developing heart disease increases with age.
• Gender: Men are generally at higher risk at a younger age, but the risk for women increases and can surpass that of men after menopause.
• Ethnicity: Certain groups are at higher risk, such as African Americans, who have a higher risk of high blood pressure and South Asians, who have a higher risk for heart disease. 

Understanding these aspects of heart health is crucial for helping you manage your health. Preventive care such as regular check-ups, a health-focused lifestyle, and managing risk factors can help maintain heart health and prevent cardiovascular diseases.

Reviewed by the Ovia Health Clinical Team

Read more

Connective Matters: Heart Health | Steps Towards Preventive Care

Sources:

• National Heart Lung and Blood Institute (NHLBI). How the Heart Works: The Heart. https://www.nhlbi.nih.gov/health/heart
• Center for Disease Control (CDC). Prevent Heart Disease. cdc.gov. March 21, 2023 https://www.cdc.gov/heartdisease/prevention.htm#:~:text=Eating%20foods%20high%20in%20fiber,prevent%20or%20help%20control%20diabetes.
• American College of Obstetricians and Gynecologists (ACOG). Heart Health for Women. acog.org. https://www.acog.org/womens-health/faqs/heart-health-for-women#:~:text=Lack%20of%20physical%20activity%20can,of%20heart%20disease%20and%20stroke
• The Mayo Clinic. “Strategies to prevent heart disease”. www.mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease-prevention/art-20046502

Your health is important to your body’s ability to function and keep you going daily. Your heart, the center of your cardiovascular system, is crucial in maintaining your overall health. Unfortunately, in the United States, heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups. More than one in three women is living with some form of heart disease.

Taking preventive measures is essential to maintaining good heart function and another act of self-care from which we can all benefit. Below are steps towards preventive care to help support your heart health.

Stay informed and proactive in your healthcare

Preventive care can begin the next time you meet with your healthcare provider. Have a shared discussion about the factors that can contribute to your heart’s health.

• Monitor blood pressure, cholesterol levels, and diabetes screenings to catch any potential problems early.
• Early detection and management of elevated blood pressure, high cholesterol, and diabetes can prevent heart disease or its complications.
• Know your family history of heart disease and discuss it with your healthcare provider to personalize your prevention plan. 
• Follow your healthcare provider’s advice, including taking prescribed medications as directed to manage conditions affecting heart health.

Adopt a heart-healthy diet

Eating nourishes us, gives us energy and generally tastes delicious. Taking a heart-healthy approach to food can provide a better defense against cardiovascular issues.

• Eat plenty of fruits, vegetables, whole grains, and lean proteins to provide essential nutrients for heart health.
• Limit saturated fats, trans fats, cholesterol, sodium, and added sugars to reduce the risk of heart disease.
• Incorporate healthy fats from sources like fish, avocados, nuts, and olive oil, which can help improve blood cholesterol levels.

Maintain a healthy weight

• Balance calorie intake with physical activity to prevent obesity, a significant risk factor for heart disease.
• Be aware of your body mass index (BMI) and waist circumference as healthy weight and risk indicators.

Engage in regular physical activity

Anywhere from 10 to 20 minutes of activity and exercise daily can get your heart pumping and your body moving. And your heart will love it.

• Exercise helps control weight and reduces blood pressure, cholesterol levels, and the risk of type 2 diabetes, all of which are risk factors for heart disease.
• Aim for at least 150 minutes of moderate aerobic exercise or 75 minutes of vigorous exercise per week. 
• Add muscle-strengthening activities two or more days per week as recommended by health authorities to support your heart health.

Avoid smoking and limit alcohol consumption

Cigarette smoking and excessive drinking of alcoholic beverages can lead to many health issues, including certain heart diseases.

• Stopping cessation significantly reduces the risk of heart disease by improving heart function and blood circulation.
• Limit alcohol intake to moderate levels (up to one drink a day for women and up to two drinks a day for men) to avoid high blood pressure and other heart risks that arise due to excessive drinking.

Manage stress

Stress can affect your health in many ways, so look for ways to address and manage it. Managing stress can help reduce behaviors and factors that increase heart disease risk, like high blood pressure and cholesterol levels, physical inactivity, and overeating.

• Engage in stress-reducing activities such as meditation, deep breathing, and physical activity.
• Speak to your healthcare provider about managing your mental health as well as studies show that your mental health can also affect your heart’s function.

Sleep well

Sleep recharges your body, so working towards better sleep is another great way to support healthy heart function.

• Aim for 7-9 hours of quality sleep per night, as poor sleep can increase the risk of high blood pressure, obesity, and diabetes.
• Establish a regular sleep schedule and a relaxing bedtime routine to improve sleep quality.

Taking these preventive measures can significantly reduce the risk of developing heart disease. It’s about creating a balanced lifestyle that supports heart health and overall wellbeing. 

Reviewed by the Ovia Health Clinical Team

Read more

Connective Matters: About Your Heart

Sources

Center for Disease Control (CDC). Prevent Heart Disease. cdc.gov. March 21, 2023 https://www.cdc.gov/heartdisease/prevention.htm#:~:text=Eating%20foods%20high%20in%20fiber,prevent%20or%20help%20control%20diabetes.

American College of Obstetricians and Gynecologists (ACOG). Heart Health for Women. acog.org. https://www.acog.org/womens-health/faqs/heart-health-for-women#:~:text=Lack%20of%20physical%20activity%20can,of%20heart%20disease%20and%20stroke

The Mayo Clinic. “Strategies to prevent heart disease”. www.mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease-prevention/art-20046502

According to the American Thyroid Association, over 12% of the American population will develop a thyroid condition in their lifetime, but many may be unaware of their condition. Some people are born with a poorly developed or poorly functioning thyroid. Others develop thyroid disorders later in life due to autoimmune dysfunction, cancer, or damage to the thyroid from medications, radiation, or surgery. Thyroid conditions can also develop with no clear cause. These conditions can impact anyone, but they are most common in women. So what should you look out for?

Some signs and symptoms of hyperthyroid (too much thyroid gland activity) include:

• Agitation, anxiety, or irritability
• Feeling restless, fidgety, or hyperactive
• Fast heartbeat, pounding heart, or palpitations
• Sweating and sensitivity to heat
• Insomnia
• Weight loss
• More frequent bowel movements
• Irregular periods in women

Some signs and symptoms of hypothyroidism (not enough thyroid gland activity) include:

• Fatigue
• Depression
• Slow heart rate
• Feeling cold
• Dry skin and hair
• Weight gain
• Constipation
• Irregular periods in women

Some signs of thyroid cancer can include:

• Lumps or bumps on the front of the neck
• Changes in the voice or hoarseness
• Trouble swallowing or breathing
• Persistent cough without another cause

Anyone with concerning signs and symptoms should discuss them with their primary healthcare provider and consider blood tests of thyroid function.

Routine screening: if I don’t have any worrying signs or symptoms, should I still get a thyroid test?

In general, routinely testing the thyroid function of all adults is not standard. That’s because there’s no evidence that testing everyone has any benefit. However, for those with symptoms or with certain risk factors, testing may be beneficial and is encouraged. Risk factors can include having any of the following: an autoimmune disorder, a history of goiter, a family history of thyroid disease, previous radiation treatment, or taking medications that could affect the thyroid.

Is there anything I can do to protect or support my thyroid?

Many things that are good for your overall health are also good for your thyroid. For example, eating a nutritious, well-balanced diet that’s high in whole foods and low in processed foods is one helpful step. One particularly important nutrient for thyroid health is iodine, which is naturally found in most kinds of seafood and animal proteins. In the US, most of us get enough iodine from our diet, but you can also support your iodine intake by using iodized salt, which can be especially important for vegetarians and vegans.

Reviewed the Ovia Clinical Team

Source: General Information, Thyroid, American Thyroid Association. American Thyroid Association. Jan 2024. https://www.thyroid.org/media-main/press-room/

Many studies have shown that physical activity is linked with lower breast cancer risk. The American Cancer Society recommends that adults get at least 150 to 300 minutes of moderate-intensity or 75 to 150 minutes of vigorous-intensity activity each week. A combination of these activities spread throughout the week would be ideal.

Avoid or limit alcohol

Alcohol increases risk of breast cancer. Even drinking small amounts of alcohol has been linked with an increase in risk. It is best not to drink alcohol at all. For women who do drink, they should have no more than 1 alcoholic drink a day. A drink is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits (hard liquor).

Breastfeed if possible

Mothers who breastfed are less likely to get breast cancer. Mothers who breastfed for a lifetime total of more than two years get the most benefit.

Limit hormone therapy

Postmenopausal hormone therapy can increase the risk of breast cancer. If you must take hormones to manage menopausal symptoms, try to use the lowest dose that works for you and for the shortest time.

Know and explore your options

If breast cancer runs in your family, talk to your doctor about considering genetic counseling and testing. Testing will show if you have an inherited gene mutation that increases your risk of breast cancer. If genetic test results show you a gene mutation, you can consider drugs that can lower your risk or surgery.

Reviewed by the Ovia Health Clinical Team

Let’s start with the basics, how often should someone be STI tested? Can you tell us a little more about what exactly to expect?

The guidelines are that everyone who is under 25 and sexually active should be tested at least once a year for gonorrhea and chlamydia. Many STIs can be asymptomatic (particularly in women), so it’s important to make testing part of your annual care. Every annual preventive visit should include a conversation about STIs. Certain people may be at higher risk and require more frequent screening. 

Women 25 years and older with risk factors such as new or multiple sex partners or a sex partner who has an STI should also be tested for gonorrhea and chlamydia every year.

All adults and adolescents from ages 13 to 64 should be tested at least once for HIV.

Everyone who is pregnant should be tested for syphilis, HIV, hepatitis B, and hepatitis C starting early in pregnancy. Those at risk for infection should also be tested for chlamydia and gonorrhea starting early in pregnancy. Repeat testing may be needed in some cases.

Are there other options for testing besides at a primary care visit?

Yes. Urgent care is an option, as are retail health clinics, community clinics and OB/GYN providers. Home tests are also available.

Can you tell us more about specific STIs and how they’re tested for?

Gonorrhea and chlamydia are tested with a urine sample, a cervical sample, or a swab. 

HIV, hepatitis, and syphilis can be tested for with blood tests. 

We’ll test for herpes (HSV1 and HSV2) with a swab of the lesion if you have symptoms. 

What are your recommended best safe sex practices with a new sexual partner?

It’s great if both people can discuss STI testing before they forgo using barrier methods like condoms. This way you know where you’re starting out. 

And what if someone doesn’t feel comfortable having those conversations with a new or more casual partner?

These can be hard conversations, especially early on in a relationship. 

To start off, everyone can empower themselves and at least get testing for themselves. These conversations can certainly sometimes put pressure on relationships about the future of the relationship or expectations around monogamy. If you’re not there yet, that’s a good reason to continue using other methods to protect yourself. Then when you both feel comfortable you can test again. 

What are some common symptoms of STIs to pay attention to? 

Women and people with uteruses will typically experience symptoms like pain with urination, vaginal discharge, and painful bumps or sores. 

Gonorrhea can also infect the throat, this can be asymptomatic or cause a sore throat. 

HIV can look like an acute illness with viral symptoms — think swollen lymph nodes and a fever. These symptoms are often missed because they can be mistaken for another type of virus. 

Can you get an STI from oral sex?

Yes. We commonly see gonorrhea which can present as a very painful sore throat. The good thing is that providers are more informed and educated about this symptom as a potential sign of an STI, so they should be taking a swab and testing. 

Herpes (HSV) is often spread during oral sex as well.

Which STIs are treatable vs. curable?

Gonorrhea, chlamydia, trichomonas, and syphilis are all curable. We give medication and we may recommend a test for cure. HIV, as we know, is a chronic infection, which is treatable and we have great therapies and treatments, but it requires lifelong treatment and monitoring. 

An initial outbreak of HSV is treated with a high dose of an antiviral treatment, which shortens the amount of time a person is symptomatic, and most likely the time they’re infectious as well. And then depending on how often a person has outbreaks, we may recommend that they go on suppressive therapy, which is a daily antiviral medication. This can be a lifelong medication.

After a number of years of being on antiviral medication, most people have very low rates of outbreaks. I say that because when people are told that they have HSV, it can be very upsetting. They might be worried about navigating conversations with sexual partners given some stigma that’s still lingering around HSV. People also worry that they might pass it on if they’re pregnant. But we have great medication that is safe and generally has minimal side effects, so most people can go back to living a normal life. We do recommend that they tell new sexual partners. 

Any tips for how to have these conversations with a partner?

HSV is transmitted through skin contact. And we know that there can be transmission of HSV even when a person doesn’t have an outbreak or an outbreak that’s visible to them. This is particularly true right before they have an outbreak, when there can be a high level of virus. And condoms don’t protect anyone 100%. 

These conversations can be hard with a new casual partner before you have any sexual contact. You might say, “I just wanted to let you know that I tested positive for HSV [X] years ago. I’m on suppressive therapy, which reduces the risk, but I just wanted to let you know.” 

Because it’s such a common virus, many people are in this situation, so hopefully the conversation is met with kindness and appreciation that you disclosed it.

HIV can be a more challenging conversation, but it’s similar in many ways. This is a conversation to have earlier rather than later. In relationships with two people who have discordant HIV infection, the partner who is not HIV positive often chooses to go on PrEP therapy to prevent their chance of being infected. Also, here condoms are very effective, because HIV is not transmitted through the skin. 

There is a lot less stigma than there used to be, but these conversations can be hard.

How long should someone be on suppressive therapy before it kicks in?

Those who are HIV positive need to wait until they’re controlled before having sexual contact. Their HIV specialist or internist will help them manage their treatment plan. 

And for other STIs, how should we think about testing timelines? 

If you were sexually active with a new partner recently, your current testing might not reflect your status. It’s good to get tested when you haven’t been with anyone else for 6 weeks, so waiting until you’re 6 weeks or so into a relationship can make sense. This is because it can take 6 weeks for the body to mount an antibody response to the virus so that it can be detected in blood work. 

Certain STIs have recommendations for follow up — in those cases, we recommend that people get tested for cure to make sure they’re fully treated. If both partners are positive for an STI, both should be treated at the same time and there should be no sexual contact during treatment to prevent transmission back and forth.

Any tips if you don’t feel comfortable talking to your provider about sexual health?

There are on-demand tests that you can use, which can be a great option. You can also email or message your provider to ask for certain tests/labs if you don’t feel you can ask in person. We like to minimize barriers for testing for important health issues.

Read more

• 5 Things you should have learned in sex ed class
• The complete glossary on sexually transmitted infections

While medicine may have expanded fertility options, it can feel like there are so many more decisions to make about when to start a family or how to preserve fertility. If you’re wondering: should I freeze my eggs? you’ve come to the right place. Make sense of egg freezing and why it might be an option to consider.

What Is egg freezing?

Known in official medical circles as mature oocyte cryopreservation (OC), egg freezing is the process by which a doctor takes eggs (oocytes) from your ovaries. These eggs can then be frozen and stored until you decide you’re ready to use them. At that point they are thawed, mixed with sperm in a laboratory, and re-inserted into your uterus (womb) through your cervix, hopefully leading to pregnancy.

Who’s freezing their eggs in the U.S.?

Nationally, the number of egg freezing cycles increases every year. The Center for Disease Control (CDC) reports there were more than 22,000 egg freezing cycles in 2019, up from around 18,000 in 2018 and 14,500 in 2017.

• It’s becoming more common for people under the age of 35 years to preserve their fertility through egg freezing.
• White patients freeze their eggs more than people of color, although more minority groups are freezing their eggs, especially Asian women.
• University-educated or professional people are more likely to pursue elective egg freezing.

Why might you want to freeze your eggs?

People choose to press pause on becoming a parent or growing their family for many reasons. Elective egg freezing is now safer, more affordable, and more common. Some of the reasons people give for choosing electively to freeze their eggs include:

• Not being in a relationship with a partner they want to parent with 
• Wanting to be financially stable before starting a family
• Working in a demanding career where being pregnant could come at a professional cost
• Having access to employer-subsidized egg freezing benefits

Other people may turn to egg freezing because they have a medical condition that threatens their future fertility. One out of five women in one study reported choosing egg freezing because of underlying health conditions. Women and their health care providers may consider egg freezing if they:

• Have a condition impacting fertility such as sickle cell anemia, autoimmune diseases such as lupus, or premature ovarian failure
• Have a cancer diagnosis or other illness and need to receive chemotherapy or radiation that could harm their ovaries

Egg freezing also helps LGBTQ+ people keep their parenting options open. Gender-affirming surgery or medical treatments can limit fertility so some transgender men choose egg freezing before beginning their transition.

When should I freeze my eggs?

According to the American Society of Reproductive Medicine (ASRM), elective egg freezing is most successful for women younger than 38 years. The more eggs you can harvest and freeze, the better your chances for pregnancy down the road. As you get older, it gets harder to harvest enough high-quality eggs. Here’s what the science tells us:

• Egg quality peaks between 16 and 28 years old
• Women in their mid-reproductive years (29 to 37 years old) produce enough high-quality eggs to make egg freezing cost effective
• People who freeze their eggs before age 34 have the highest overall live birth rates.
• One 2015 study found that the biggest difference in live birth rates between people who did and didn’t freeze their eggs was at age 37. At younger ages, the differences in live birth rates in people who did and did not freeze their eggs were smaller.
• There is little benefit (no comparative increase in the number of live births) for women ages 25-30 to freeze their eggs

From a straight biological perspective, the younger you are when you freeze your eggs, the better your chances for good egg quality and number harvested.

Egg freezing and deciding what’s right for you

Decisions about fertility and parenting are individual and personal — egg freezing is no different. It can be helpful to think of egg freezing as an insurance plan rather than a guarantee for a baby. It is a way to increase your chances of being able to be a parent, without being limited by your biological clock or life circumstances. That said, it can be very expensive and so is not a good option for everyone.

Reviewed by the Ovia Health Clinical Team

Read more:

• Egg freezing step by step
• Egg freezing FAQ

Sources 

• Katler QS, Shandley LM, Hipp HS, Kawwass JF. National egg-freezing trends: cycle and patient characteristics with a focus on race/ethnicity. Fertil Steril. 2021 Aug;116(2):528-537. doi: 10.1016/j.fertnstert.2021.02.032. Epub 2021 Mar 30. PMID: 33795141.
• Inhorn MC, Birenbaum-Carmeli D, Birger J, Westphal LM, Doyle J, Gleicher N, Meirow D, Dirnfeld M, Seidman D, Kahane A, Patrizio P. Elective egg freezing and its underlying socio-demography: a binational analysis with global implications. Reprod Biol Endocrinol. 2018 Jul 23;16(1):70. doi: 10.1186/s12958-018-0389-z. PMID: 30037349; PMCID: PMC6056999.
• Mayo Clinic Staff. “Egg Freezing.” Mayo Clinic. Mayo Foundation for Medical Education and Research. April 23, 2021. https://www.mayoclinic.org/tests-procedures/egg-freezing/about/pac-20384556. 

• “Assisted Reproductive Technology (ART) National Data.” Centers for Disease Control and Prevention (CDC). CDC. 2019. https://nccd.cdc.gov/drh_art/rdPage.aspx?rdReport=DRH_ART.ClinicInfo&ClinicId=31&ShowNational=0. 
• Kylie Baldwin, Lorraine Culley, Nicky Hudson & Helene Mitchell (2019) Running out of time: exploring women’s motivations for social egg freezing, Journal of Psychosomatic Obstetrics & Gynecology, 40:2, 166-173, DOI: 10.1080/0167482X.2018.1460352
• Amato, Paula. “Fertility Options for Transgender Persons.” UCSF Transgender Care. University of California, San Francisco. June 17, 2016. https://transcare.ucsf.edu/guidelines/fertility. 
• “Can I Freeze My Eggs to Use Later If I’m Not Sick?” ReproductiveFacts.org. American Society for Reproductive Medicine. 2014. https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/can-i-freeze-my-eggs-to-use-later-if-im-not-sick/. 
• Mesen, Tolga B et al. “Optimal timing for elective egg freezing.” Fertility and sterility vol. 103,6 (2015): 1551-6.e1-4. doi:10.1016/j.fertnstert.2015.03.002