Tag Archives: women

How to optimize your chances for a normal labor: a mind-body approach

Pregnancy_bellyoxytocin Oxytocin

In my obstetrics  practice, I have many patients that come in wanting to what they can do to optimize there chances for a normal labor and minimize the need for an induction of labor.  I really hope that you are not reading this at 39 weeks of pregnancy, because the truth is, you might be starting a little late, but better late than never.

When it comes to labor, my own midwife, she had a catch phrase that I have since adopted: “Baby comes out the same way it got in”…Yup, that’s right, SEX. And lots of it. Ob/Gyn physicians induce your labor with use of a drug called Pitocin. This is a drug that mimics the hormone your own body produces in labor, which is called “Oxytocin” (shown above). This hormone stimulates your uterus to contract. As the levels of Oxytocin go up, more and more oxytocin hormone receptors are made in your uterus and over time, your uterine muscle cells become more and more sensitive to this hormone and labor builds.

Guess what? This is the same hormone that you feel when you get a hug, have an orgasm, and just feel generally “warm and fuzzy”. Now there are a lot of other hormones and pain receptors activated at the same time in labor so labor is by no means meant to feel nice, but generally speaking there are ways to encourage oxytocin as you are approaching your due date.

While sex is one of the ways to increase Oxytocin, nipple stimulation is another, so if you don’t have a partner, no problem. Masturbation will release the same hormones as well. Now, I think I may know what you are thinking, “I don’t feel sexy…”, but who does when they are 9 months pregnant. Quite frankly, it doesn’t matter. Once you get started it won’t matter and you will end up enjoying yourself.

There is one more element to enticing a natural labor to come on and that is that if you are extremely stressed or anxious, your body is pumping out the anti-labor hormone, and that is Cortisol, or stress hormone. Babies don’t like to come out when this hormone is high. They think you are at war, or about to be eating by a tiger, which would not be a good time to be born. Therefore, stress reduction is very important near term. If you are extremely stressed and busy at work, you might want to start slowing it down. And don’t just use the time to put together baby furniture. Take some time for yourself and for relaxation. Some folks may need professional help to do this and that is fine too. In general, most can get some exercise (exercise burns cortisol), lots of rest (also reduces cortisol), and maybe get a massage from a prenatal provider (releases oxytocin). Basically, just do whatever makes you feel warm and fuzzy inside. Make the baby think it is coming out to a world of roses and sunshine.

© Regina Zopf MD 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Regina Zopf MD with appropriate and specific direction to the original content. Accessing this site means you agree to the disclaimer that can be read here.


Support @EWG’s creation of a new food database and get tips on avoiding chemicals in pregnancy

As a gynecologist, I really value the service that the Environmental Working Group provides for me and my patients. Several years back, they even worked directly with me to create a patient information sheet with how women can reduce their exposure risk to harmful chemicals when women are pregnant, breastfeeding, or trying to conceive. With diseases like Autism Spectrum Disorder and Cancer on the rise, and a poorly regulated chemical industry where harm must be shown before a chemical is taken out of public use, the importance of the work they do cannot be overstated to a public that is often left finding ways to protect itself. In situations like these, grassroots is the only way. This is why I am voluntarily supporting them without their solicitation and hope you will too. They have a great database called Skindeep where you can check out the health risks of the beauty products you use everyday. They also have databases on keeping a healthy home, healthy cleaning products and and sunscreen guide. Having a food database will be that much better for those of us want to know what we are putting into our bodies. After all, you are what you eat.

You can check out their website at EWG.org

Or donate $10 here to support the completion of the database:

Here is the patient information they gave me for protecting my pregnant patients as well if you want to use it for yourself or your patients:

The Environmental Working Group

Tips to Reduce Chemical Exposure in Pregnancy

Pollutants in a pregnant woman’s food, air, water or consumer products
can cross the placenta from her body to her child at the most vulnerable time of life. Follow these tips to reduce exposure to harmful chemicals.

Eat Right

Fruits and veggies – Eat plenty of fresh fruits and vegetables. Buy organic when you can to reduce your pesticide consumption. Check out EWG’s Shopper’s Guide to Pesticides in Produce, especially the Dirty Dozen list of high-pesticide fruits and vegetables. http://www.ewg.org/foodnews/

Meat and dairy – Eat low-fat dairy, lean meat, and meatless protein-rich foods to reduce exposures to pollutants that build up in animal fat. Choose brands without added antibiotics and growth hormones when possible.

Ditch the can – Choose fresh food over canned, packaged and processed food to avoid bisphenol A, a synthetic estrogen, and other artificial additives and package coatings that can leach into food. Read labels to find foods with natural ingredients and lower sugar, sodium and trans fats.

Safe seafood – Choose low-mercury fish such as salmon, tilapia and pollock, rather than higher-mercury tuna and swordfish. Mercury is a potent neurotoxin that can damage the developing brain and nervous system.

Iodine – Use iodized salt for home cooking. It counters perchlorate and other chemicals that can disrupt the thyroid’s growth hormones critical to a baby’s development.

Storing and cooking – Store food in glass containers. Don’t microwave in plastic, since plastics additives can migrate into your food.
Drink plenty of SAFE water
What’s in your water – Get your water quality report from EWG.org or your local utility. Test your water for lead.
The District of Columbia and Maryland have some of the highest levels of trihalomethanes in the country. This has been linked to miscarriages and birth defects – such as low birth weight, small body length, small head circumference and neural tube defects. This can be removed by using a carbon filter or by boiling your water.
Filtered tap water – Skip bottled water, which costs more and isn’t necessarily better. Filter your tap water instead.

Filter choices – Choose a filter that’s certified to take out your water’s pollutants. Carbon filters are affordable and remove lead and toxic chemicals created by treatment processes at municipal water utilities. Reverse osmosis filters cost more but take out substances that carbon can’t, like arsenic, chromium and perchlorate.

Reuseable Containers – Drink from stainless steel or BPA-free plastic containers when you’re on the go, and check out EWG’s Safe Drinking Water Guide for more tips. http://www.ewg.org/BottledWater/Bottled-Water-Quality-Investigation/Safe-Drinking-Water-Guide

Choose Better Products, Avoid Chemical Heavy Chores

Cosmetics – Cut out non-essential personal care products. Choose fragrance-free productswith the fewest ingredients possible. Find safer products in EWG’s Skin Deep Cosmetics Database. http://www.ewg.org/skindeep/

Clothing – Wash maternity clothes before wearing. Clothing is often coated in the factory with chemical treatments.

Green cleaning – Leave shoes at the door to avoid tracking dirt and dust-bound pollutants into your house. Clean with fragrance-free brands. Don’t use unneeded, harsh and caustic products, such as bleach discs for toilet bowls, air fresheners (open a window instead), harsh oven cleaner (use baking soda) or drain cleaners (use a drain snake). Use a wet mop and a HEPA-filter vacuum cleaner to avoid breathing in dust.

remodeling – Avoid remodeling if your house was built before 1978, when lead house paint was banned. Dust from sanding old paint is a common source of lead exposure. If others do the work, make sure they wet-sand chipped areas.

Pumping gas – Don’t breathe gasoline fumes. Ask your partner to fill the gas tank, or use full service.

For more information visit:



A gynecologist’s favorite gut bug and probiotic: Lactobacillus rhamnosus

I’ve said it! My favorite bug is L. rhamnosus. I know it sounds crazy, but just looking at the image of them makes me happy. WHY?!

l rhamnosus

If you haven’t heard the news the bugs, or microbes, that colonize our bodies are amazing. There are over 10,000 strains of these microorganisms that make up almost 5 lbs of our body weight. More and more data continues to emerge related to the bugs that inhabit our bodies and the amazing health benefits they provide, not just for the body, but as it turns out, for the mind as well.  We each have our own unique “fingerprint” of these bugs that is likely determined by our mothers vagina, but also, can be influenced by our own diet and lifestyle, and in some cases by taking probiotics. So why do I have a favorite?

For many gynecologists and the women they care for, recurrent BV is a pain in the neck to treat. This is why early in my career, I began to do some research to see how I could better serve my patients. When it comes to recurrent BV, I have had many patients benefit from the simple addition of the strain of Lactobacillus rhamnosus. It turns out that a healthy vaginal flora provides a microenvironment that is not very pleasant for nasty bacteria that can cause a yucky fishy odor and a thin vaginal discharge. This study, published in the journal of Immunology and Medical Microbiology showed that in a randomized, controlled trial, oral L. rhamnosus not only colonized the vagina, it also prevented BV and candida colonization of the vagina. Many of my patients that were coming back to me for recurrent BV swear by this probiotic. Some are even able to treat themselves without the help of antibiotics by taking it when they start to feel some discomfort or discharge.

But wait…there’s another reason why I like this bug for women and it involves weight loss. A large study showed that babies that are delivered by cesarean section and or are formula fed suffer higher rates of adult obesity. It is thought to be due to the lack of healthy flora that babies born through the vagina get. Recently after noticing my own weight gain following treatment with broad spectrum antibiotics, I remembered the studies about obesity and cesarean section. I decided to look into which strains might be beneficial for weight loss. And I found this study. They randomly gave L. rhamnosus or a placebo pill to men and women that were attempting to lose weight with the exact same diet and exercise regimen. They found that the women dieters (BUT NOT THE MEN!!!) using the L. rhamnosus lost twice as much weight as those taking the fake pill. Keep in mind, the study was funded by Nestle so potential bias could exist however the double blind design does minimize potential bias. Keep in mind…you still have to exercise and eat right!!! But the addition of the probiotic should give you an extra boost. It worked for me!

Still more and perhaps most interesting, there was a neurobiology study looking at depression behaviors in in mice taking L. rhamnosus versus not taking it. What they found was that mice that were given the L. rhamnosus (JB-1) strain had significantly lower levels of the stress-induced hormone corticosterone and exhibited less anxiety- and depression-related behavior. It was thought to be driven by the vagus nerve and effects of GABA receptor expression. So how’s that for mind-body. Perhaps we should really be talking about mind-body-bug.

Hopefully this will convince you that your own microbiome can protect you and explains why as a gynecologist, L. rhamnosus is my favorite bug. Here are some natural ways you can promote your body’s own beneficial flora:

Diet high in fiber



Plant based diet

So there you have it, the reasons why my favorite gut bug is L.rhamnosus.

For more on the microbiome, check out this TEDx Talk on YouTube.

Or this talk by Stanford Immunology Professor David Relman

If you want to try a supplement, here are some products that have the L. rhamnosus strain, but there are many out there that will work, you just have to look for it on the side of the probiotic bottle where they have the strains listed. Try to buy from a reputable company however so you can ensure you are getting active strains.

© Regina Zopf MD 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Regina Zopf MD with appropriate and specific direction to the original content. Accessing this site means you agree to the disclaimer that can be read here.

Dieters? Go ahead, INDULGE! but do it mindfully

With all of the varied diets that are promoted all over the place, what’s a woman that wants to stay healthy to do?

So by now, most of us know we shouldn’t “diet”. It is really about making healthy food choices that become a part of our everyday life and habits. Does that mean you can’t sneak a sweet treat every now and again? ABSOLUTELY NOT. But if you do, be sure to fully indulge. Here is a great posting on NPR from yesterday. When folks were given the same exact 300 calorie delicious milkshake, one was labeled low calorie, fat free, and guilt free, while the other was labeled with exactly what it was, 300 calories. Well what happened next was yet another window into the mind body connection and the miriad of ways that what we believe can actually affect how our body responds the food we put into our bodies! The folks that drank the mislabeled “healthy milkshake” secreted more Ghrelin. This hormone basically makes you think you are hungry and leads you to seek out more “satisfying foods”. But wait…there’s more, it also slows your metabolism, making it harder to burn calories and easier to gain fat and store sugars.


So what does this mean? It means, fully enjoy in your food. Eat mindfully and indulge in your food. Even if it is healthy food. When you are mindfully eating, enjoying your food and the way it is nourishing your body, your mind is sending out all the right hormones to satisfy your hunger. If on the other hand, you are restricting your diet with health foods you really don’t want, you may actually be shooting yourself in the foot.

You can try mindful eating on your own the next time you eat. If you have a grape handy, it is always fun to try with that. Take a quiet moment to savor a grape in a way you never have. Slow down. Pick up the grape. Feel it in your fingers, note how it feels or any thoughts you may be having about eating the grape. Place the grape in your mouth. Notice any sensations on your tongue. Slowly bite into the grape and feel the texture, the pressure on your teeth. Feels the juicy sweetness that bursts onto your tongue as you bite into the grape. Take your time as you savor the flavors and aromas. Notice how you feel while you are eating the grape. Note: You can try this with any food.

Want to try a free webinar on mindful eating? Check out the Center for Mindful Eating. They have a webinar coming up on April 24, 2014. For further reading, check out a NY Times article on mindful eating to avoid binging here.

Mother Nature’s Network author and registered dietitian Jenni Grover recommends these 5 tips for mindful eating:

  1. Eat Slower
  2. Savor the Silence
  3. Shut off the phone and TV
  4. Pay attention to flavor
  5. Know your food

You can read more about these tips from the original blog post here.

Exercise: A must for mind-body health

We all know those fitness people we encounter in our lives who are happy, healthy and glowing. They definitely have the best career because they are getting paid to do what they love and getting paid to move. They are definitely my happiest patients. (We all know them and secretly love to hate them)!  But they’re not dumb for choosing that lifestyle…You do not need to quit your career and become a personal trainer to feel great. You do, however, need to move.
The most important thing to actually exercise is your personal motivation and drive to do it. Making the commitment to yourself on a deep level has to be the starting point. It might help to reframe why you are exercising. The payoffs from exercise are slow to come. It does not give you the same instant gratification that you get from say, eating some chocolate ice cream or having a glass of wine while you snuggle up to your favorite (dramedy, sit com, game show,…) on the couch. Therefore, if you are doing for a specific goal, like fitting into a pair of jeans, or even for losing weight, you might feel dejected and disappointed in your progress. Instead, it might be helpful to focus on a desire to do it for long term health and wellness, ie. Sticking around a bit longer to have time with the ones you love, having more energy to function in your daily life, or feeling well enough to enjoy that retirement you have been working so hard for.  Making the choice for something positive you really, really want!
I find that my patients who are able to exercise every day have made it a part of their daily routine.
If you don’t do it, you won’t do it.Here, self-awareness is key. Observing your daily actions and mindfully deciding where you can actually fit your exercise in, what you actually need to accomplish it, and what some barriers to doing it might be. Then taking the time to make a plan and commit to it. Also, find something you love to do for exercise. If you love it, you are much more likely to do it. If you can’t do it for one day, or even one week, it is okay, don’t let this drag you down into the guilt cycle and into stopping altogether, just ask yourself again what might be getting in your way and make your choices. We all fall off the horse sometimes, and let’s face it, the hardest thing to change is habits. But it CAN be done!
The benefits of exercise are far reaching and the importance to mind body health cannot be overstated. It has to be a part of your life or you will never achieve balance in your mind body health. It does not need to be much. Just 30 minutes out of 24 hours, but the more you can do, the better.
Remember to combine strength training and aerobic activity to reap the full benefits.
Here is a list of what exercise can do for your mind body health:
  • Burns the stress hormone “cortisol” and is crucial for hormone balance.
  • Can help to keep your period regular and less painful
  • Increases will power and motivation
  • Decreases blood pressure and improves digestion of sugar
  • It can improve your symptoms around your menstrual cycle, decreasing bleeding and pain
  • It improves sleep patterns
  • Builds bones and improves posture with long term prevention from osteoporosis
  • Trims your waist line reducing your long term risk of diabetes heart disease and all those other chronic diseases that lead to sudden death prematurely
  • Silver lining? Eventually it gives you that svelte figure you’ve been hoping for, but I strongly precaution against doing exercise for physical appearance and instead focus on accepting yourself just as beautiful as you already are.

Here are some links for excellent free exercise resources that you can do at home, FOR FREE!

Site Homehttp://www.fitnessblender.com 


Lionsgate BeFithttps://www.youtube.com/user/BeFit?feature=watch


© Regina Zopf MD 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Regina Zopf MD with appropriate and specific direction to the original content.