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For females with primary amenorrhoea but who have secondary sexual characteristics, pelvic ultrasound is indicated.
Primary amenorrhoea in females with no secondary sexual characteristics may also be caused by hypergonadotropic (i.e.
Secondary amenorrhoea is defined as a lack of menses for six months in a non-pregnant patient who was previously menstruating. FSH, TSH and prolactin measurements will help identify most causes of secondary amenorrhoea. Pregnancy should be first excluded by either urine pregnancy test or a serum hCG, rather than relying solely on history. Results can often be difficult to interpret (Table 1) therefore review or advice from a relevant specialist may be appropriate. In the past, the diagnosis of PCOS was often based upon the finding of an elevated ratio of LH to FSH in serum. Depending upon the history, clinical exam and initial evaluations, a second tier of laboratory testing may be appropriate. A full history and clinical examination, including sexual history and relationship factors is important.
Except in limited specialist settings, androgen levels are not helpful when evaluating the cause of a sexual problem.
The Body Mass Index (BMI) value of an individual is a number that is calculated using their weight and height.
Although BMI does not measure body fat directly, research has shown that an individual's BMI level correlates to direct measures of body fat. In many cases, the Body Mass Index approach can be considered a viable alternative to direct measurements of body fat.
For example, a person may have a high BMI, but in order to determine if the excess weight represents a health risk, a medical professional would need to perform additional tests. Within the metric system, the formula for BMI is [weight in kilograms] divided by [height in meters squared]. Within the American Standard system, calculate BMI by dividing [weight in pounds (lbs)] by [height in inches (in) squared] and multiplying by a conversion factor of 703.
Once an individual has calculated their BMI value, they can reference Table #1, below, to determine whether their BMI value is within the ideal weight range.
Note: Table #1 and Table #2 are to be used only by male and female adults 20 years of age and older. The correlation between the BMI number and an individual's level of body fat is fairly strong. At the same BMI level, older individuals tend to have a higher level of body fat than younger adults.


Athletes may have a high BMI value due to their elevated level of lean muscle mass, which weighs more than fat. It's also important to remember that an individual's BMI value is only one factor related to risk for disease. The individual's waist circumference (abdominal fat is a predictor of an individual's risk level for obesity-related diseases). Although the BMI value is calculated the same way for children, adolescents and adults, the criteria used to interpret the results of the BMI value for children and adolescents are different from those used for adults. The Centers for Disease Control and Prevention (CDC) have compiled BMI charts that take into account these differences and facilitate the translation of the BMI value into a percentile. After the BMI value has been calculated for a child or an adolescent, the BMI value is plotted on the CDC BMI age growth chart (for either girls or boys) to obtain a percentile ranking. Table #3 represents the CDC BMI weight status categories and the corresponding percentiles used for both children and adolescents. BMI values are used as screening tools to identify potential weight concerns for children and adolescents. The standard BMI formulas used earlier in this article for adults can be used for children and adolescents of both sexes.
To determine the appropriate weight range for a given child or adolescent, Table #4 or #5 will need to be used in conjunction with Table #3. The BMI method of determining an individual's optimum weight has proven to be fairly reliable and accurate throughout the years. It is recommended that each individual determine their optimum weight via the alternative methods provided within this section of our website. The BMI value for an individual can be a useful tool in determining whether the individual is underweight, overweight, or within the medically approved weight range for their height.
The BMI approach to determining your optimum weight is similar to underwater weighing and dual energy x-ray absorptiometry (DXA). Calculating one’s BMI level is inexpensive, easy to perform, and a quick way to determine whether an individual’s weight is appropriate for their height.
Under this scenario, the medical professional may suggest performing a skinfold caliper test and reviewing the individual's diet, level of physical activity, family history, and possibly a whole host of additional health screenings.
Since height is commonly measured in centimeters, divide the height (in centimeters) by 100 to obtain height in meters. Table #2 can be used to determine an individual's BMI value without performing any mathematical computations. For children and adolescents, BMI value is not only age-specific, but sex-specific as well. Percentiles are the most commonly used indicators to assess the size and growth patterns of individual children in the United States.


The CDC and the American Academy of Pediatrics (AAP) recommend the use of the BMI approach to screen for overweight and obesity in children beginning at 2 years of age.
Once the BMI value has been calculated for a child or an adolescent, the value can then be applied to either Table #4 or Table #5, depending on whether the child or adolescent is a male or a female. For example, for a boy that is 10 years of age and has a BMI value of 23, using Table #4 shows that the individual is above the 95th percentile. It is now necessary to reference Table #3 and choose the weight category that applies to the equal to or greater than the 95th percentile.
As stated earlier in this article, there are a few instances in which the BMI method fails to accurately depict the optimum weight for an individual (e.g. Once the optimum weight levels have been determined using the alternative methods, it is recommended that you compare the results to evaluate the similarities and differences.
Furthermore, the Body Mass Index technique is used as a screening tool to identify possible weight concerns for adults. Table #1 represents a BMI scale that is specifically designed for adult men and women only.
The Y-axis represents the height of an individual, and the X-axis depicts an individual's weight. The first step is to identify your height on the Y-axis. However, for children and adolescents, the interpretation of their BMI values are both age and sex-specific. The percentile value represents the position of the child's BMI value relative to children of the same sex and age.
For children and adolescents, the BMI approach can be used to screen for obese, overweight, healthy weight or underweight conditions. Table #4 is designed to be used for a male child or adolescent, while Table #5 is designed to be used for a female child or adolescent. Children and adolescents will utilize an alternative scale, discussed later in this article. Thereafter, simply move to the right until you are under your specific weight. The intersection of your height and your weight will represent your BMI value. However, as long as the conditions applicable to creating the inaccuracies in the BMI results are not present, this method will prove to be a reasonable benchmark for determining an individual's optimum weight level.
For instance, a child or adolescent may have a high BMI value for their age and sex, but to determine if excess fat is a problem, a medical professional will need to perform additional tests. These tests typically include skinfold thickness measurements, evaluations of diet, physical activity and family history, and any other appropriate health screenings.



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