What to know about spotting in early pregnancy

Spotting in early pregnancy is common for many women and usually not a cause for concern. However, in some instances, it may occur as a symptom of a pregnancy complication.

About a quarter of pregnant women experience bleeding during the first trimester. Although bleeding is a possible sign of early pregnancy loss, it does not mean that this will happen. Several other conditions and factors, including normal hormonal shifts, may cause spotting in early pregnancy.

Causes

The most common causes of spotting in early pregnancy include:

Subchorionic hematoma

A subchorionic hematoma is sometimes called subchorionic hemorrhage. This happens when blood builds up near the chorion, which is the fetal membrane next to the placenta. The bleeding may also appear between the uterus and the placenta.

Subchorionic hematoma is a common pregnancy complication with various studies estimating the prevalence between 1.3% and 62% among different groups of pregnant women.

A subchorionic hematoma is not a pregnancy loss. Many pregnant women with this type of bleeding have no further complications during their pregnancy.

A 2012 meta-analysis of nine research studies concluded that there was a link between subchorionic hemorrhage and higher risk of pregnancy loss and preterm labor.

However, a 2013 observational study of 1,115 women that included 142 with a subchorionic hematoma found no significant increase in the risk of pregnancy complications.

Ectopic pregnancy

In an ectopic pregnancy, a fertilized egg implants outside of the uterus, often in the fallopian tubes. A woman may still have pregnancy symptoms or get a positive pregnancy test. The pregnancy, however, cannot survive. If it continues to grow, it can rupture and cause life threatening bleeding or a dangerous infection.

An ectopic pregnancy can cause spotting as the pregnancy grows. If the pregnancy ruptures, it can cause life threatening internal bleeding that may get progressively heavier over several hours.

Cervical irritation

The cervix, the doughnut-shaped entry to the uterus, increases its blood supply during pregnancy. This means it is more likely to bleed from irritation, such as after sex or a pelvic exam. Light spotting after any form of vaginal penetration is a possible sign of cervical bleeding.

Cervical bleeding is not dangerous and usually stops on its own within a few hours. The blood is typically red or brown, and the bleeding minimal.

Very rarely, a serious injury to the cervix, such as from an assault or trauma, might cause more severe cervical bleeding. These injuries can cause infections and other serious complications. It is important to see a doctor following any traumatic injury to the cervix or vagina.

Pregnancy loss

For many pregnant women, bleeding triggers fears of pregnancy loss. A 2010 study of 4,539 pregnant women found that 26.7% experienced bleeding at some point during their pregnancies, but only 12% had a pregnancy loss. These figures suggest that less than half of people who bleed during pregnancy have a pregnancy loss.

About two-thirds of people who do have a pregnancy loss report bleeding. As such, bleeding is a symptom that a pregnant person should not ignore. Any pregnant woman who has concerns about their pregnancy should speak to a doctor about risk factors and how to minimize them.

Hormonal shifts

Around the 7th week of pregnancy, a luteal-placental shift happens. This is when the placenta develops enough to begin producing hormones that sustain the pregnancy. Before this change, the corpus luteum — a group of cells that forms during ovulation — produces pregnancy hormones.

This hormonal change sometimes triggers a temporary drop in the hormone progesterone. This shift may cause spotting, or even bleeding as heavy as a period. As long as the placenta begins producing enough progesterone, the pregnancy can safely continue, and a woman will not have a pregnancy loss.

Diagnosis

A doctor or other healthcare provider may do numerous tests to diagnose bleeding. These may include:

Ultrasound

A doctor may order an ultrasound to help diagnose a subchorionic hematoma.

An ultrasound can diagnose a subchorionic hematoma. It can also tell a healthcare provider the location of the pregnancy, helping in the detection of an ectopic pregnancy.

After about the 6th week of pregnancy, an ultrasound can measure the viability of the pregnancy. If the embryo is growing correctly, and there is a sufficiently strong heartbeat, this suggests that the pregnancy will continue and the risk of pregnancy loss is low.

An ultrasound can also examine other pelvic organs to check for causes of bleeding. For example, an ovarian cyst may cause bleeding.

Blood tests

Blood tests can measure levels of the pregnancy hormone hCG. Low hCG may suggest that a pregnancy is not developing correctly or is in its early stages.

Some healthcare providers also check progesterone levels. Low progesterone may cause temporary bleeding, while very low progesterone may be a sign of an abnormal pregnancy.

Is it normal?

While many women who experience bleeding have healthy pregnancies, it is important never to treat bleeding as usual. Bleeding can be a critical symptom of several pregnancy-related symptoms, and prompt treatment for conditions such as ectopic pregnancy can save lives.

Implantation bleeding

Implantation happens when a fertilized egg embeds in the lining of the uterus. This marks the beginning of pregnancy. Some women notice spotting shortly after implantation. However, the body does not begin producing hCG until after implantation.

A woman is not pregnant until after implantation, and a pregnancy test cannot usually detect pregnancy until several days after implantation. So, bleeding that appears after a woman already knows she is pregnant is not implantation bleeding.

Implantation bleeding is usually brown. Some women may mistake the bleeding for their monthly period because it usually occurs around the time a woman expects her period.

The flow of implantation bleeding is often lighter and shorter than a period, so women who experience unusual bleeding after having sex should consider the possibility of pregnancy.

When to see a doctor

Speak to a doctor about any bleeding early in pregnancy. While the bleeding may be harmless, it is impossible to diagnose its cause without blood work, an ultrasound, or other diagnostic tests.

Bleeding from a ruptured ectopic pregnancy can endanger the life of the mother. While many pregnancy losses pass on their own, some require treatment to prevent excessive bleeding and infection.

Prompt medical care can be lifesaving. Even when there is no serious problem, the right care can offer peace of mind.

If a pregnant woman experiencing spotting has Rh-negative blood, a doctor may prescribe RhoGAM. This treatment can help prevent a condition known as erythroblastosis fetalis.

If a woman experiences light bleeding at any time, they should contact a midwife, doctor, or another healthcare provider.

A woman should visit an emergency room if:

  • they develop a fever
  • bleeding gets heavier over several hours
  • bleeding is heavy, similar to a period
  • there are large clots in the blood
  • they have cramps
  • there is severe pain in the abdomen
  • they feel dizzy or light-headed

Summary

Many women panic when they bleed during pregnancy, especially if they have a previous history of miscarriage. Seeking prompt care is the fastest way to ease anxiety and get clear answers.

It is not advisable for people to try to self-diagnose bleeding or assume that bleeding means a pregnancy loss. A few quick tests can usually diagnose the cause, and prompt treatment can prevent possible complications.

Sleeping for less than 6 hours each night could put people with diabetes or hypertension at a higher risk of premature death.

A new study analyzing the data of more than 1,600 adults found that people with hypertension or type 2 diabetes had a higher risk of death from stroke or heart disease if they slept for less than 6 hours per night.

Type 2 diabetes and hypertension (high blood pressure) are two very common health conditions around the world.

While there are tried and true ways of managing them, these conditions can increase a person’s risk of developing heart disease and experiencing a stroke.

Recently, a study that featured in the Journal of the American Heart Association found that one factor — sleep — may play a significant role for people with these health conditions.

“Our study suggests that achieving normal sleep may be protective for some people with these health conditions and risks,” says lead author Julio Fernandez-Mendoza, Ph.D., from the Pennsylvania State College of Medicine in Hershey.

“However,” he cautions, “further research is needed to examine whether improving and increasing sleep through medical or behavioral therapies can reduce risk of early death.”

Is short sleep duration ‘a useful risk factor?’

In the new study, Fernandez-Mendoza and team analyzed the data of 1,654 participants — 52.5% of whom were women — between the ages of 20 and 74 years. All of the participants had enrolled in the Penn State Adult Cohort.

The researchers split the participants into two categories according to cardiometabolic risk. The participants in one group had stage 2 hypertension or type 2 diabetes, while those in the other group had received a diagnosis of or treatment for heart disease or stroke.

Moreover, the researchers had access to data regarding the participants’ sleep duration, as this cohort had agreed to a 1-night evaluation in a sleep laboratory between 1991 and 1998. They also had access to death records and associated documentation for the years from 1992 through to 2016.

The team’s analysis revealed that of the 512 people who had died by 2016, about two-fifths had died because of causes relating to heart disease or stroke, while close to one-quarter had died following a cancer diagnosis.

What caught the investigators’ attention was the fact that among individuals who had hypertension or type 2 diabetes, the risk of death due to heart disease or stroke was two times higher in those who slept for less than 6 hours per night than in those who slept for 6 hours or more.

For the individuals with one of these two health conditions who slept for longer, the increased risk of premature death was not significant.

Additionally, participants in the heart disease and stroke group who slept for less than 6 hours a night had almost three times the risk of dying from cancer-related causes.

“Short sleep duration should be included as a useful risk factor to predict the long term outcomes of people with these health conditions and as a target of primary and specialized clinical practices.

Julio Fernandez-Mendoza, Ph.D.

“I’d like to see policy changes so that sleep consultations and sleep studies become a more integral part of our healthcare systems. Better identification of people with specific sleep issues would potentially lead to improved prevention, more complete treatment approaches, better long term outcomes, and less healthcare usage,” suggests Fernandez-Mendoza.

While this research adds to the evidence that sleep plays a crucial role in the maintenance of health and well-being, the study authors do admit that their current analysis has some limitations.

The chief limitation, they note, is the fact that they only had access to data on the duration of a single night’s sleep.

As this data came from laboratory observations, they caution that there is a possibility that the participants’ normal sleep patterns may have been different than usual because they were in an unfamiliar environment.

“Nevertheless, the associations found for those other clustered non‐[cardiovascular and cerebrovascular disease] causes of death had the expected [hazard ratios] and provided confidence about the reliability and validity of our findings,” the authors argue in their study paper.

How plant based diets can help people with rheumatoid arthritis

Many recent studies have highlighted the health benefits that a plant based diet can bring. Now, a new review explains just why it can be helpful for people living with rheumatoid arthritis.

Rheumatoid arthritis — a chronic autoimmune condition that causes pain and stiffness in the joints — has a prevalence of between 0.3% and 1% among the world’s population, according to the World Health Organization (WHO).

The condition can become so debilitating as to stop people from continuing in full time work. As the WHO also note, within only 10 years from disease onset, at least 50% of individuals with rheumatoid arthritis in high income countries become “unable to hold down a full time job.”

Doctors usually prescribe a range of drugs and lifestyle adjustments to help people manage their rheumatoid arthritis and make disability less likely. Management strategies that healthcare providers might advise include increased physical activity and weight loss.

Now, a new review appearing in the journal Frontiers in Nutrition shows that following a plant based diet can be a useful intervention when it comes to coping with this condition, as it triggers some helpful biological changes.

‘Symptoms may improve or even disappear’

The review — conducted by specialists from the Physicians Committee for Responsible Medicine in Washington, DC — looked at recent studies that observed the impact of diet on biological mechanisms that are important in rheumatoid arthritis.

It concluded that plant based diets lead to specific changes that can help relieve the symptoms of this condition.

One key way in which plant based diets can be helpful is by reducing levels of inflammation. The review authors cite a study from 2015 that showed participants who ate a plant based diet for 2 months had lower inflammation than those who ate a diet that was high in fat and featured more animal products.

The team also notes that additional research has found an association between adherence to diets high in fat and processed meat and a rise in markers of inflammation. One of these markers is C-reactive protein, a protein present in the blood, and one which reacts to inflammation.

On the other hand, following plant based diets or diets that have a high content of fiber has an association with lower levels of C-reactive protein.

Another study that the review looked at was a randomized clinical trial showing that, after following a low fat vegan diet for 4 weeks, individuals with moderate-to-severe rheumatoid arthritis saw significant improvements in symptoms, including joint pain and stiffness, tenderness, and swelling.

People with rheumatoid arthritis can also benefit from losing extra weight. According to evidence from a 2018 study, overweight individuals with rheumatoid arthritis who shed in excess of 5 kilograms were three times more likely to have improvements in their symptoms compared to those who lost less weight.

The review authors explain that vegetarian and vegan diets appear to help people lose weight, more so than any other diet types.

Finally, the researchers explain that plant based diets also seem to promote a healthy gut environment, since many of these diets are high in fiber, which, as studies have shown, influences the composition of the gut microbiome.

Specifically, plant based diets seem to increase bacterial diversity in the gut, which could help people with rheumatoid arthritis, precisely because they tend to lack bacterial diversity.

The investigators who conducted the review suggest there is a need for further research into the benefits that plant based diets may afford to people with inflammatory autoimmune conditions, as well as their underlying mechanisms.

However, they note that, so far, the emerging evidence suggests that eating more fruits, vegetables, whole grains, and legumes could make a real difference for people with rheumatoid arthritis.

“A plant based diet comprised of fruits, vegetables, grains, and legumes may be tremendously helpful for those with rheumatoid arthritis. This study offers hope that with a simple menu change, joint pain, swelling, and other painful symptoms may improve or even disappear.”

Study co-author Dr. Hana Kahleova

A complex relationship between Alcohol & Dementia

Although alcohol has been popular for millennia, and dementia is increasingly prevalent, scientists are yet to understand the relationship between the two. A recent study sets out for answers.

With dementia predicted to affect 13.9 million adults in the United States by 2060, understanding why these conditions develop is more urgent than ever.

Scientists have uncovered certain factors that increase the risk of developing dementia. Some, such as advancing age, cannot be prevented. However, it is possible to avoid other potential risk factors, such as smoking tobacco.

It is essential to identify modifiable risk factors as understanding these could help prevent or delay the onset of dementia.

Recently, researchers designed a study to look for links between dementia and alcohol consumption in older adults. They published their findings in JAMA Network Open.

What do we already know?

Perhaps surprisingly, as the authors explain, “we know little about the independent associations of quantity and frequency of alcohol consumption with dementia risk.”

Although some studies have investigated alcohol and dementia more broadly, there are still substantial gaps in our understanding. For instance, in an earlier study, researchers calculated alcohol consumption as a daily average across each year.

Using a daily average in this way misses the nuances of alcohol quantity and frequency.

This is an important point. For example, drinking 7 glasses of beer on 1 day each week is likely to have a different impact than drinking 1 glass of beer each night, every day of the week; although the quantity consumed is the same.

The authors of another study concluded that binge drinking in midlife increases the risk of dementia. However, it is still not clear whether regularly drinking smaller amounts of alcohol has the same effect.

Other studies muddy the water further by looking at the links between alcohol, dementia risk, and the presence of apolipoprotein E4 (APOE E4). This gene variant has associations with an increased risk of developing Alzheimer’s.

An earlier study concluded that alcohol consumption increases the risk of dementia and that people with the APOE E4 variant have a higher chance of developing dementia.

Another unknown is how alcohol influences dementia risk for individuals with mild cognitive impairment (MCI). Scientists consider MCI to be the stage between normal age-related cognitive decline and dementia.

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Alcohol and dementia data

To investigate, the scientists delved into an existing dataset, extracting the information from 3,021 participants, with an average age of 72.

The Ginkgo Evaluation of Memory Study from 2000–2008 supplied the data.

At the beginning of the study, participants provided information about the amount of alcohol they consumed, how often they drank, and what types of drinks they consumed — beer, wine, or liquor.

According to the authors, at the start of the study, each participant went through “a comprehensive neuropsychological battery of 10 tests.” These assessed a range of cognitive functions, and participants completed the tests every 6 months.

Scientists isolated DNA from blood samples to identify carriers of the APOE E4 variant.

Alongside genetic data and details about alcohol use, the scientists also collated information about blood pressure, body weight, height, history of heart disease, and smoking status. They also asked questions to estimate how regularly each participant was involved in social interactions.

Many gaps remain

Of the 3,021 participants, 2,548 did not have MCI, and 473 did have MCI. Over approximately 6 years of follow-up, 512 participants received a diagnosis of dementia.

The authors found that, among those without MCI, no amount of alcohol consumption increased dementia risk compared with those who drank less than one drink per week.

When they analyzed the group of individuals with MCI, it was a similar story; there was no statistically significant difference.

However, dementia risk appeared to be highest for the individuals with MCI who drank 14 drinks per week compared with those who drank less than one drink each week — a relative risk increase of 72%.

The authors also note some differences associated with drinking patterns:

“Daily low-quantity drinking was associated with lower dementia risk than infrequent higher-quantity drinking among participants without MCI at baseline.”

Although the authors are keen to underline the negative impacts of excessive drinking on brain health and health in general, they also note that:

“Our findings provide some reassurance that alcohol consumed within recommended limits was not associated with an increased risk of dementia among older adults with normal baseline cognition.”

When the researchers investigated the potential impact of APOE E4, they found no significant effect, which mirrors several previous studies. The authors theorize that the lack of effect might be because the association is more pronounced in younger populations; they call for further investigation.

In conclusion, the current study provides few solid answers. It confirms, however, that the relationship between alcohol and dementia is complex and likely to require a great deal more research.

Memory impairment in ARD correlates best with lesions of the thalamus. Atrophy of the mamillary bodies is specific for Wernicke’s Encephalopathy (WE) Diagnosis is clinical, not radiological.

Link found between chronic headache and back pain

A review of 14 studies found that people with persistent headache or back pain were twice as likely to experience the other disorder as well.

Chronic headaches and persistent back pain are both debilitating conditions. New findings suggest a link between the two, potentially charting a new course for more effective treatment.

Chronic headaches and back pain both appear in the top five causes of years lived with disability. Healthcare professionals often treat the conditions separately, but there is a theory that in some people, they appear together. Therefore, treating both as one disorder may provide better results.

Up to 4% of individuals in the global adult population have headaches on 15 or more days of every month, according to the World Health Organization (WHO).

Meanwhile, about 80% of adults experience low back pain at least once in their lifetime, according to the National Institute of Neurological Disorders and Stroke, and approximately 20% of these people go on to develop chronic low back pain.

In 2013, a German study found a link between low back pain and both chronic migraine and chronic tension-type headaches.

Now, researchers from the University of Warwick, United Kingdom, appear to have found an even stronger association.

Double the odds

Appearing in the Journal of Headache and Pain, their review involved 14 studies with a range of sample sizes. The smallest study included 88 participants, while the largest involved 404,206 individuals.

One type of headache and a particular back pain disorder were the focus: chronic headaches and persistent low back pain. The team notes the definitions of these conditions, describing the former as headaches that occur on the majority of days for a minimum of 3 months and the latter as pain “between the bottom of the rib cage and the buttock creases” for the same period.

The review found that all the studies shared a similar positive association between the two conditions. However, the odds of experiencing both conditions varied widely between the studies from less than twice as likely to eight times as likely.

This meant that the researchers were unable to pool the data in a combined statistical analysis. However, Prof. Martin Underwood notes, “[i]n most of the studies, we found that the odds were about double — either way, you’re about twice as likely to have headaches or chronic low back pain in the presence of the other.”

For people experiencing migraine ⁠— the third most prevalent illness in the world ⁠— the link was even stronger.

A few limitations exist, namely that inconsistent study designs and populations and varying definitions of the disorders may have weakened the quality of the results.

Still, the findings are “very interesting,” notes Prof. Martin Underwood, from Warwick Medical School, “because typically these have been looked at as separate disorders and then managed by different people.”

“But this makes you think that there might be, at least for some people, some commonality in what is causing the problem.”

Combining treatments

The researchers are not yet sure of the potential shared cause, but they have some theories. One, explains Prof. Underwood, is that there may be “an underpinning biological relationship” in some people with headaches and back pain.

“There may be something in the relationship between how people react to the pain,” he says, “making some people more sensitive to both the physical causes of the headache, particularly migraine, and the physical causes in the back, and how the body reacts to that and how you become disabled by it.”

Such a cause could be a target for treatment. In fact, the team thinks that a joint approach may be best.

Right now, drugs are available to treat chronic headaches. Some people try a range of holistic remedies too. Back pain, meanwhile, may require a combination of exercise and psychological therapy.

Ensuring that people with both disorders receive appropriate support and management techniques could well help their quality of life. A combined treatment method could also provide a financial benefit by reducing the number of medication prescriptions.

“There is a need for doctors and other healthcare professionals to think that when treating one issue, [they should] ask about the other and tailor the treatment accordingly.”

Prof. Martin Underwood

“For future research, there’s probably work that needs to be done to understand what the underlying mechanisms behind this relationship are,” he adds.

Man having a back pain over gray background

Onion & Garlic Vs Breast Cancer

Onions and garlic may protect against breast cancer

New research examines the consumption of onion and garlic among women in Puerto Rico and suggests that the vegetables can significantly reduce the risk of breast cancer.

Onions and garlic are part of the allium genus, along with leeks, chives, and hundreds of other species.

Rich in flavor, with a strong, pungent kick, these “feisty” vegetables may also be able to fight off diseases, such as diabetes, heart disease, and cancer, according to emerging evidence.

In regards to cancer, several studies have specifically explored the links between onion and garlic consumption and the risk of colorectal, stomach, and prostate cancers.

Overall, these studies have found that the more of these vegetables that people consume, the lower their risk of developing these cancers.

However, less extensive research has gone into the link with breast cancer, say researchers led by Gauri Desai, a doctoral candidate in epidemiology at the University at Buffalo (UB), part of The State University of New York.

So, Desai and the team set out to investigate this topic further, looking at a population of women in Puerto Rico. The reasons for choosing this population were twofold. Firstly, “Puerto Rico has lower breast cancer rates, compared to the mainland [United States], which makes it an important population to study,” explains Desai.

Secondly, a condiment called “sofrito,” which consists largely of garlic and onion, is a traditional Puerto Rican sauce that is widely consumed across the island.

The researchers published the results of their findings in the journal Nutrition and Cancer.

Studying onions, garlic, and cancer risk

Desai and the team used hospital and clinic records to identify 314 women aged between 30 and 79 who had breast cancer between 2008 and 2014. The researchers also included 346 control participants who were matched based on age and residential area.

nonmelanoma skin cancer. The researchers used a food frequency questionnaire to enquire about dietary patterns and total onion and garlic intake, which included sofrito consumption.

The team employed unconditional logistic regression to examine the association between onion and garlic intake and breast cancer occurrence, adjusting for factors such as age, education, family history, body mass index, smoking status, and others.

Sofrito linked to 67% lower breast cancer risk

The researchers found an inverse association between moderate and high total onion and garlic consumption and breast cancer cases, compared with low consumption of these vegetables.

Their findings were consistent after the researchers had stratified the results according to menopausal status, suggesting that “High onion and garlic consumption is protective against breast cancer in [the studied] population.”

Specifically, the authors write, “Sofrito intake, when examined alone, was inversely associated with breast cancer; for those consuming sofrito more than once/day, there was a 67% decrease in risk, compared to never consumers.”

“We found that among Puerto Rican women, the combined intake of onion and garlic, as well as sofrito, was associated with a reduced risk of breast cancer.”

Gauri Desai

“Studying Puerto Rican women who consume a lot of onions and garlic as sofrito was unique,” Desai adds, referring to one strength of the research.

Why might onions, garlic lower cancer risk?

Study co-author Jo Freudenheim, Ph.D., chair of epidemiology and environmental health at UB, also comments on the uniqueness of the study, saying, “There is very little research on breast cancer in Puerto Rico.”

“This study was a collaboration between my colleagues here at UB and at the University of Puerto Rico to help us understand why rates there are lower than in the rest of the U.S., and why rates there are continuing to increase, while they are decreasing in the rest of the [U.S.].”

Although the study was observational and cannot explain the mechanisms behind the findings, the researchers suspect that the flavonols and organosulfur compounds abundant in onions and garlic may be responsible for the anticancer effects.

In particular, the S-allylcysteine, diallyl disulfide, and diallyl sulfide in garlic and the alk(en)yl cysteine sulphoxides in onions have shown “anticarcinogenic properties in humans, as well as in experimental animal studies,” says Dr. Lina Mu, an associate professor of epidemiology and environmental health at UB and the study’s senior author.

Some study limitations

However, the authors also recognize some limitations to their research. For instance, they write, “The size of the study was small, particularly for analyses stratified on menopausal status.”

Secondly, the number of people who had never consumed garlic or onion was too small to use as a reference group. Therefore, the low exposure group still consumed some onion and garlic.

For this reason, say the researchers, the results “may have underestimated the true association between garlic and onion intake and breast cancer.”

“Furthermore, there is not a standardized recipe for sofrito, a condiment which is frequently homemade and therefore varies at least somewhat in recipe from person to person,” add the authors. “Hence, we were also not able to estimate the amount of onion and garlic in sofrito.”

“Although the recipe for sofrito varies to some extent, other ingredients, such as bell peppers, tomatoes, cilantro, and black pepper are usually added. Since we did not adjust our models for these ingredients, we cannot be sure that our results were due to the sole effect of onions and garlic.”

KNOW YOUR HEART. 10 facts about the Cardiovascular system…

The cardiovascular system carries blood and nutrients to the cells of the body. The function of this system has effects on other parts of the body. A nursing student has many facts to learn about the cardiovascular system. Therefore, this article below will start you off with a list of 10 facts about the cardiovascular system that every nursing student should know.

The cardiovascular system or circulatory system consists of the heart, blood and blood vessels. The heart is the pump of the system and sits in the thoracic cavity. The heart sits predominately on the left side. Therefore, approximately two-thirds of the heart is to the left side of the sternum. The blood is a connective tissue. It is the fluid component of the system. The blood is transported to the cells via a network of passageways call the blood vessels.

There are 3 major layers of the heart. The layers are the endocardium, myocardium and the pericardium. The endocardium lines the inner chambers of the heart and the valves. The myocardium makes up the heart wall. The pericardium is the container of the heart. This triple-walled layer protects the heart. Also, the pericardium contains a fibrous layer and a serous layer. The serous layer has two separate layers. These layers are the parietal and visceral layers.

Below is a list of 10 facts about the cardiovascular system that every nursing student should know to help build a foundation of knowledge of the cardiovascular system.

Fact #1: The Cardiovascular System Is A Closed System.

The cardiovascular system is a closed system and also a system which is under pressure. This means if there is a leak in a large vessel it does not drip it sprays, especially a leak on the arterial side.

Therefore, when small leaks occur the system has a method of stopping these leaks. Hemostasis is the system within the blood that stops these leaks. Hemostasis is defined as the stoppage of blood. This system is constantly in action sealing small insults to the system.

Substances contained in the blood assist the process of hemostasis. The blood contains calcium ions and plasma proteins that cause coagulation or clotting within seconds of an injury. These plasma proteins are your clotting factors. (e.g. prothrombin and vitamin K)

Fact #2: The Heart Has Four Chambers.

The heart has four chambers: the right and left atria and the right and left ventricles. The right atrium and right ventricle receive deoxygenated blood from the body. The left atrium and left ventricle receive oxygenated blood from the lungs.

The atria of the heart are mostly reservoirs. The atria only contribute “atrial kick” to the cardiac cycle. Atrial kick or atrial contraction contributes approximately 20% of the volume to ventricular filling.

The ventricles make up the majority of the heart. The ventricles of the heart receive blood from the atrium. They eject blood into the pulmonary system (lungs) and to the systemic circulation (body).

The right side of the heart (ventricle) pumps against a low-pressure system (pulmonary circulation) and the left side of the heart (ventricle) pumps against a high-pressure system (systemic circulation). The left ventricle works harder than all the other chambers because it has to pump against the high pressure of the systemic circulation.

Fact #3: The Heart Has Four Valves.

The right side of the heart contains the tricuspid and pulmonary valves. The left side of the heart contains the bicuspid (mitral) and aortic valves.

The tricuspid and bicuspid (mitral) valves separate the atrium and ventricles.  These valves are also called the atrioventricular or AV valves.  As you would guess the tricuspid valve had three cusps or leaflets and the bicuspid valve has two cusps or leaflets.

The pulmonary valve opens to the pulmonary circulation and the lungs. The aortic valve opens to the systemic circulation. These valves are also called the semilunar valves because of their shape. The pulmonary and aortic valve each has three cusps or leaflets that are shaped like a half moon.

The “Lub-Dub” sound you hear with your stethoscope is the closing of the heart valves. The heart sound S1 is the closure of the tricuspid and bicuspid (mitral) valves. The heart sound S2 is the closure of the pulmonary and aortic valves.

Fact #4: The Heart Valves Operate Due To A Pressure System.

The valves of the heart open and close due to pressure within the system. During the cardiac cycle, the atria fill with blood. As the atria fill, the pressure in the atria eventually exceeds the pressure in the ventricles. When this happens the tricuspid and bicuspid (mitral) valves open and blood flows into the ventricles.

As blood flows into the ventricles the pressure begins to rise. Eventually, the pressure in the ventricles exceeds the pressure in the atria. This pressure that builds up in the ventricles is attributed to filling volumes of the ventricles. At this time the pulmonary valve and aortic valves close.

Following the isovolumetric contraction of the ventricles, the pulmonary and aortic valves open. Then, blood is ejected into the pulmonary circulation and systemic circulation.

Both the left and right atria fill at the same time and both the left and right ventricles fill at the same time.

Fact #5: Blood Vessels Are The Vascular Portion Of The Cardiovascular System.

Blood vessels include arteries and veins. When the blood leaves the heart it flows into the arteries. Arteries carry oxygenated blood from the heart to systemic circulation. The arteries divide into the smaller arterioles. Next, the arterioles divide into the even smaller capillary network on the arterial side. This arterial capillary network feeds the cells.

The veins divide into smaller venules. The venules divide into the smaller capillary network of the veins. Starting at the capillary network, the capillaries on the vein side pick up carbon dioxide and waste products which travel to the venules and then to the veins and back to the heart.

Blood flows from the heart to the arteries to the arterioles to the arterial capillary network. Then blood moves from the vein capillary network to the venules to the veins and back to the heart.

Fact #6: Blood Vessels Can Constrict And Dilate Having An Effect On Blood Pressure.

The sympathetic nervous system controls the blood vessels. Blood vessels have the ability to constrict or dilate with signals from the sympathetic nervous system.

Vasoconstriction and vasodilation occur when the blood vessels dilate and constrict. Vasoconstriction causes a decrease in the inner diameter of the blood vessel. Vasodilation causes an increase in the inner diameter of the blood vessel.

Blood vessels have an effect on blood pressure.

Remember, blood pressure is the measure of the pressure exerted on the walls of the blood vessel. The greater the pressure within the blood vessel the higher the blood pressure measurement. The lower the pressure within the blood vessel the lower the blood pressure measurement. The systolic pressure is the maximum pressure against the wall of the blood vessel and the diastolic pressure is the recoil.

A change in the diameter of the blood vessels causes changes in the blood pressure. When the blood vessels constrict (vasoconstriction), the blood pressure is higher. This is because the decrease in the diameter of the blood vessel increases the pressure exerted on the lumen. When the blood vessels dilate (vasodilation), the blood pressure is lower. This is because the increase in the diameter of the blood vessel decreases the pressure exerted on the lumen.

Fact #7: The Ventricles Contract Due To Electrical Pathways.

The ventricles contract due to the cardiac conduction system (electrical pathways). The cardiac conduction system consists of the SA or sinoatrial node, the AV or atrioventricular node, the bundle of HIS, the right bundle branch, the left bundle branch and the Purkinje fibers.

The SA node is known as the pacemaker of the heart. It is located on the wall of the right atrium near the entrance to the superior vena cava. The AV node receives electrical impulses from the SA node and transfers them to the bundle of HIS. The bundle of HIS divides into the left and right bundle branch. Impulses travel to each bundle branch down the septum to the Purkinje fibers. The Purkinje fibers innervate the ventricles. The atria of the heart contract before the ventricles.

Fact #8: The Cardiac Cycle Consist of Diastole and Systole.

First of all, the cardiac cycle consists of phases called diastole and systole. These terms should not be confused with the terms diastolic and systolic which refer to blood pressure. These terms are related but not the same. Also, when we talk about diastole and systole we are referring to the ventricles. (e.g. ventricular diastole, ventricular systole)

During systole, when the heart contracts, blood is ejected from the ventricles.  The right ventricle ejects blood into the pulmonary circulation (lung) and left ventricle ejects blood into the systemic circulation (body).

During diastole, the heart is at rest and the ventricles are filling. When you think of diastole think of Die, Done, Doing nothing (but filling-ventricular filling) and systole is the opposite.

Fact #9: The Cardiac Cycle Moves Blood Through The Heart.

The phases of the cardiac cycle are diastole and systole. Diastole is divided into early, mid, and late diastole. Systole is divided into early and late systole. Remember, when you think of diastole and systole, think of ventricular diastole and systole. Let’s take a quick walk through diastole and systole. It is easier to begin at diastole.

Early Diastole

Early diastole begins following the closure of the pulmonary and aortic. The tricuspid and bicuspid (mitral) valves are open. During early diastole, the ventricles are rapidly filling. The pressure in the ventricles is beginning to increase.

Mid Diastole

During mid-diastole, the ventricles continue filling but slower. The pressure in the ventricles continues to rise but they still have not exceeded the pressure in the atria. The tricuspid and bicuspid (mitral) valves are still open. The pulmonary and aortic valves close.

Late Diastole

During late diastole, the atrium contract to finish emptying. The atrial contraction is the “atrial kick”. This accounts for approximately 20% of ventricular filling.

Early Systole

At the beginning of early systole, the pressure in the ventricles is greater than the pressure in the atrium. At this time you have an isovolumetric contraction. The ventricular filling and the isovolumetric contraction causes the tricuspid and bicuspid (mitral) to close. This causes the “Lub” sound. The “Lub” is the S1 heart sound.

Late Systole

During late systole, you have ventricular ejection.  The blood is ejected into the pulmonary circulation and systemic circulation when the pulmonary and aortic valves are opened. The blood is ejected by the ventricles fast at first then the blood flow slows.

This puts us back to the beginning of early diastole in which the pulmonary and aortic valves close and the tricuspid and mitral valves are open. When the pulmonary and aortic valves close they make the “Dub” sound. The “Dub” is the S2 heart sound. The ventricles are filling during this period.

So, between S1 and S2 you have systole. Between the S2 and the next S1, you have diastole.

Fact #10: There Is A Relationship Between The Cardiac Cycle And Blood Flow.

First of all, the cardiac cycle and blood flow through the heart are very similar. If you understand one you will understand the other. With the cardiac cycle, we move from the top to the bottom (atria to ventricles). With blood flow through the heart, we will move from the right to the left.

Right Atrium

On the venous or return side, deoxygenated blood travel from the venous capillary beds to the venule. Blood continues to travel to the large veins called the superior vena cava and the inferior vena cava. These veins transport blood from the top and bottom of the body. They return blood to the right side of the heart into the right atrium. Then, the right atrium fills causing increased pressure that is eventually greater than the pressure in the right ventricle. This places pressure on the tricuspid valve.

Right Ventricle

The pressure continues to rise until it is greater in the right atrium and causes the tricuspid valve to open. The right ventricle begins to fill. The right atrium contracts causing the final filling of the right ventricle.

As a result of electrical stimulation, the right ventricle contracts. The tricuspid valve closes. The right ventricle ejects blood causing the pulmonary valve to open. Blood enters the pulmonary circulation and moves to the lungs via the pulmonary artery. The blood travels through the capillary bed of the lung. After the blood is oxygenated it returns to the left side of the heart.

Left Atrium

On the left side of the heart, blood travels from the lung to the left atrium via the pulmonary vein. The left atrium begins to fill causing the pressure to increase in the left atrium. The increased pressure is eventually greater in the left atrium producing pressure on the bicuspid (mitral) valve.

Note: If you note above, the pulmonary artery carries deoxygenated blood to the lungs and the pulmonary veins carry oxygenated blood to the left atrium. The pulmonary artery is the only artery in the body that carries deoxygenated blood and the pulmonary vein is the only vein in the body that carries oxygenated blood.

Left Ventricle

The pressure continues to rise until it is greater in the left atrium than the left ventricle and causes the bicuspid (mitral) valve to open. The left ventricle begins to fill. The left atrium contracts causing the final filling of the left ventricle.

Again due to the electrical stimulation, the left ventricle contracts. The bicuspid (mitral) valve closes and the aortic valve opens ejecting blood into the systemic circulation via the aorta. The blood travels throughout the body via the arteries, arterioles to the capillary bed where the process continues.

In conclusion, the list of 10 facts about the cardiovascular system above is by no means all-inclusive. Hopefully, this list will help build a foundation useful in studying the cardiovascular system. Hence, these simple facts will give you a greater understanding of not only how the system works but how it can affect other parts of the body.

Physical fitness may help prevent depression, anxiety

Although there is evidence that exercise can boost mental health, scientists know less about whether physical fitness can prevent the onset of mental health conditions. A recent systematic review and meta-analysis take a closer look.

Common mental health problems, such as depression and anxiety, are a growing global issue.

They reduce overall wellbeing and life satisfaction, but they may also increase the risk of cardiovascular disease and increase mortality risk.

Although talking therapies and medication can help in many instances, they do not help everyone.

An issue as substantial as mental health needs an effective public health strategy; stopping mental health issues before they begin would, of course, be ideal.

Researchers are focused on unraveling the myriad of factors that increase the risk of developing mental health conditions. Although it is not possible to alter some of these factors, such as genetics, it is possible to modify some lifestyle factors, including diet and physical activity.

Scientists are keen to identify which modifiable factors might have the most significant impact on mental health. Some researchers are looking to physical fitness.

Fitness and mental health

The authors of a recent study investigated whether cardiorespiratory fitness might be an effective intervention. Cardiorespiratory fitness is a measure of the cardiovascular and respiratory systems’ capacity to supply oxygen to the body during exercise.

They recently published the results of their analysis in the Journal of Affective Disorders.

The authors explain how previous studies “have found that low physical activity is associated with a greater incidence of common mental health disorders.” However, few studies have investigated whether cardiorespiratory fitness is directly related to mental health risk.

Medical News Today spoke with the lead author of the study Aaron Kandola, from University College London in the United Kingdom. We asked him why so few studies have looked at this question.

One reason, he said, is that cardiorespiratory fitness “can be expensive and impractical to measure, particularly in large groups of people.” He explains how it needs to be “measured with structured exercise tests that require the use of specialized equipment in a controlled environment.”

A small pool of studies

To investigate, the researchers hunted down studies that looked at how fitness interacts with mental health risk.

They only included papers that used a prospective study design. This means that at the beginning of the studies, none of the participants had mental health conditions, and researchers observed them for a time to see if any mental health issues arose.

All experiments assessed cardiorespiratory fitness and either depression or anxiety.

In total, the researchers only identified seven studies to include in their qualitative synthesis and four that they could enter into their meta-analysis.

Their analysis of the latter four studies — which included 27,733,154 person-years of data — produced significant results. The authors write:

We found that low [cardiorespiratory fitness] and medium [cardiorespiratory fitness] are associated with a 47% and 23% greater risk of […] common mental health disorders, compared with high [cardiorespiratory fitness].”

They also found evidence of a dose-dependent relationship between fitness and common mental health conditions. The authors explain that “[i]ncremental increases in [the cardiorespiratory fitness] group were associated with proportional decreases in associated risk of new onset common mental health disorders.”

The results were in line with the researchers’ expectations. As Kandola told MNT, “exercise is the biggest determinant of cardiorespiratory fitness,” and scientists have already uncovered “the benefits of exercise for common mental health disorders.”

However, he explained that they “were surprised at the lack of research in this area.” He hopes that their study will “help to draw more attention to it.”

Kandola plans to continue exploring this avenue. He told MNT that the team is “currently working on several other studies to further investigate the impact of exercise and fitness on mental health across the lifespan, and to identify possible mechanisms that underlie this relationship.”

Prostate cancer in detail


Prostate cancer affects the prostate gland, the gland that produces some of the fluid in semen and plays a role in urine control in men.

The prostate gland is located below the bladder and in front of the rectum.

In the United States (U.S.), it is the most common cancer in men, but it is also treatable if found in the early stages.

In 2017, the American Cancer Society predicts that there will be around 161,360 new diagnoses of prostate cancer, and that around 26,730 fatalities will occur because of it.

Regular testing is crucial as the cancer needs to be diagnosed before metastasis.

Fast facts on prostate cancer:

Here are some key points about the prostate cancer. More detail is in the main article.

  • The prostate gland is part of the male reproductive system.
  • Prostate cancer is the most common cancer in men.
  • It is treatable if diagnosed early, before it spreads.
  • If symptoms appear, they include problems with urination.
  • Regular screening Is the best way to detect it in good time.

Symptoms

There are usually no symptoms during the early stages of prostate cancer. However, if symptoms do appear, they usually involve one or more of the following:

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  • frequent urges to urinate, including at night
  • difficulty commencing and maintaining urination
  • blood in the urine
  • painful urination and, less commonly, ejaculation
  • difficulty achieving or maintaining an erection may be difficult

Advanced prostate cancer can involve the following symptoms:

  • bone pain, often in the spine, femur, pelvis, or ribs
  • bone fractures

If the cancer spreads to the spine and compresses the spinal cord, there may be:

  • leg weakness
  • urinary incontinence
  • fecal incontinence

Treatment

Treatment is different for early and advanced prostate cancers.

Early stage prostate cancer

If the cancer is small and localized, it is usually managed by one of the following treatments:

Watchful waiting or monitoring: PSA blood levels are regularly checked, but there is no immediate action. The risk of side-effects sometimes outweighs the need for immediate treatment for this slow-developing cancer.

Radical prostatectomy: The prostate is surgically removed. Traditional surgery requires a hospital stay of up to 10 days, with a recovery time of up to 3 months. Robotic keyhole surgery involves a shorter hospitalization and recovery period, but it can be more expensive. Patients should speak to their insurer about coverage.

Brachytherapy: Radioactive seeds are implanted into the prostate to deliver targeted radiation treatment.

Conformal radiation therapy: Radiation beams are shaped so that the region where they overlap is as close to the same shape as the organ or region that requires treatment. This minimizes healthy tissue exposure to radiation.

Intensity modulated radiation therapy: Beams with variable intensity are used. This is an advanced form of conformal radiation therapy.

In the early stages, patients may receive radiation therapy combined with hormone therapy for 4 to 6 months.

Treatment recommendations depend on individual cases. The patient should discuss all available options with their urologist or oncologist.

Advanced prostate cancer

Advanced cancer is more aggressive and will have spread further throughout the body.

Chemotherapy may be recommended, as it can kill cancer cells around the body.

Androgen deprivation therapy (ADT), or androgen suppression therapy, is a hormone treatment that reduces the effect of androgen. Androgens are male hormones that can stimulate cancer growth. ADT can slow down and even stop cancer growth by reducing androgen levels.

The patient will likely need long-term hormone therapy.

Even if the hormone therapy stops working after a while, there may be other options. Participation in clinical trials is one option that a patient may wish to discuss with the doctor.

Radical prostatectomy is not currently an option for advanced cases, as it does not treat the cancer that has spread to other parts of the body.

Fertility

As the prostate is directly involved with sexual reproduction, removing it affects semen production and fertility.

Radiation therapy affects the prostate tissue and often reduces the ability to father children. The sperm can be damaged and the semen insufficient for transporting sperm.

Non-surgical options, too, can severely inhibit a man’s reproductive capacity.

Options for preserving these functions can include donating to a sperm bank before surgery, or having sperm extracted directly from the testicles for artificial insemination into an egg. However, the success of these options is never guaranteed.

Patients with prostate cancer can speak to a fertility doctor if they still intend to father children.

What causes prostate cancer?

The prostate is a walnut-sized exocrine gland. This means that its fluids and secretions are intended for use outside of the body.

The prostate produces the fluid that nourishes and transports sperm on their journey to fuse with a female ovum, or egg, and produce human life. The prostate contracts and forces these fluids out during orgasm.

The protein excreted by the prostate, prostate-specific antigen (PSA), helps semen retain its liquid state. An excess of this protein in the blood is one of the first signs of prostate cancer.

The urethra is tube through which sperm and urine exit the body. It also passes through the prostate.

As such, the prostate is also responsible for urine control. It can tighten and restrict the flow of urine through the urethra using thousands of tiny muscle fibers.

How does it start?

It usually starts in the glandular cells. This is known as adenocarcinoma. Tiny changes occur in the shape and size of the prostate gland cells, known as prostatic intraepithelial neoplasia (PIN). This tends to happen slowly and does not show symptoms until further into the progression.

Nearly 50 percent of all men over the age of 50 years have PIN. High-grade PIN is considered pre-cancerous, and it requires further investigation. Low-grade PIN is not a cause for concern.

Prostate cancer can be successfully treated if it is diagnosed before metastasis, but if it spreads, it is more dangerous. It most commonly spreads to the bones.

Stages

Staging takes into account the size and extent of the tumor and the scale of the metastasis (whether it has traveled to other organs and tissues).

At Stage 0, the tumor has neither spread from the prostate gland nor invaded deeply into it. At Stage 4, the cancer has spread to distant sites and organs.

Diagnosis

A doctor will carry out a physical examination and enquire about any ongoing medical history. If the patient has symptoms, or if a routine blood test shows abnormally high PSA levels, further examinations may be requested.

Tests may include:

  • a digital rectal examination (DRE), in which a doctor will manually check for any abnormalities of the prostate with their finger
  • a biomarker test checking the blood, urine, or body tissues of a person with cancer for chemicals unique to individuals with cancer

If these tests show abnormal results, further tests will include:

  • a PCA3 test examining the urine for the PCA3 gene only found in prostate cancer cells
  • a transrectal ultrasound scan providing imaging of the affected region using a probe that emits sounds
  • a biopsy, or the removal of 12 to 14 small pieces of tissue from several areas of the prostate for examination under a microscope

These will help confirm the stage of the cancer, whether it has spread, and what treatment is appropriate.

To track any spread, or metastasis, doctors may use a bone, CT scan, or MRI scan.

Outlook

If the disease is found before it spreads to other organs in a process known as metastasis, the 5-year survival rate is 99 percent. After fifteen years, this decreases to 96 percent. Once the cancer metastasizes, or spreads, the 5-year survival rate is 29 percent.

Regular screening can help detect prostate cancer while it is still treatable.

Risk factors

The exact cause of prostate cancer is unclear, but there are many possible risk factors.

Age

Prostate cancer is rare among men under the age of 45 years, but more common after the age of 50 years.

Geography

Prostate cancer occurs most frequently in North America, northwestern Europe, on the Caribbean islands, and in Australia. The reasons remain unclear.

Genetic factors

Certain genetic and ethnic groups have an increased risk of prostate cancer.

In the U.S., prostate cancer is at least 60 percent more common and 2 to 3 times more deadly among black men than non-Hispanic white men.

A man also has a much higher risk of developing cancer if his identical twin has it, and a man whose brother or father had prostate cancer has twice the risk of developing it compared to other men. Having a brother who has or has had prostate cancer is more of a genetic risk than having a father with the disease.

Diet

Studies have suggested that a diet high in red meat or high-fat dairy products may increase a person’s chances of developing prostate cancer, but the link is neither confirmed nor clear.

Medication

Some research has suggested that non-steroidal anti-inflammatory drug (NSAID) use may reduce the risk of prostate cancer. Others have linked NSAID use with a higher risk of death from the disease. This is a controversial area, and results have not been confirmed.

There has also been some investigation into whether statins might slow the progression of prostate cancer. One 2016 study concluded that results were “weak and inconsistent.”

Obesity

It is often believed that obesity is linked to the development of prostate cancer, but the American Cancer Society maintains that there is no clear link.

Some studies have found that obesity increases the risk of death in advanced cancers. Studies have also concluded that obesity decreases the risk that a cancer will be low-grade if it does occur.

Agent Orange

Exposure to Agent Orange, a chemical weapon used in the Vietnam war, may possibly be linked to the development of more aggressive types of cancer, but the extent of this has not been confirmed.

What to know about blood in urine (hematuria) in females


Hematuria refers to the presence of blood in the urine. Some causes are specific to, or more likely to affect, females.

Blood in the urine is often due to infections, kidney problems, or injuries.

In this article, we discuss the possible causes of blood in the urine in females. We also discuss when to visit a doctor, diagnosis, treatment options, and what blood in the urine can mean for children.

Causes

Hematuria can occur when part of the urinary tract, which includes the kidneys, bladder, and ureters, sustains damage or becomes irritated.

However, blood that appears in the urine does not always come from the urinary tract. In females, blood from the vagina, cervix, or uterus may appear in the urine, giving the false appearance of hematuria.

Types of hematuria include:

  • Gross hematuria, where a person can see blood in their urine. The urine can appear pink, red, or brown.
  • Microscopic hematuria, in which the urine contains trace amounts of blood that are invisible to the naked eye. Microscopic hematuria accounts for 13% to 20% of urology referrals.

Causes of blood in the urine in females can include:

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Urinary tract infections

Females have a higher risk of developing urinary tract infections (UTIs) due to the location of their urethras.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), at least 40–60% of women experience a UTI in their lifetime.

UTIs occur when bacteria from the bowels enter the urethra, the tube that carries urine out of the body. A UTI can travel up the urethra and infect the ureters, kidneys, or bladder.

A UTI can cause people to feel a frequent and urgent need to urinate.

Other symptoms of a UTI can include:

  • painful urination
  • cloudy or foul-smelling urine
  • blood in the urine
  • pressure or pain in the lower back, abdomen, or pelvic area

Stones

Excess minerals can form hard deposits or stones in the bladder and kidneys.

Stones may tear or scratch the lining of the urinary tract and its associated organs. Blood from these tears can mix with the urine, resulting in either gross or microscopic hematuria.

Stones in the urinary tract can cause the following symptoms, according to the NIDDK:

  • pink, red, or brown urine
  • frequent urination
  • incontinence, or involuntary urination
  • painful urination
  • cloudy or foul-smelling urine

The following factors may increase a person’s risk of developing stones, according to the Urology Care Foundation:

  • dehydration
  • consuming large quantities of salt
  • gastrointestinal conditions, such as Crohn’s disease or ulcerative colitis
  • thyroid problems
  • being overweight or having obesity

Endometriosis

Blood in the urine that accompanies severe lower back pain may indicate endometriosis, a common health condition that occurs in more than 11% of adolescent and adult females in the United States.

Endometriosis occurs when tissue similar to the endometrium — the lining of the uterus — grows in areas of the body outside of the uterus.

Although endometriosis can affect any part of the body, the Office on Women’s Health state that it commonly involves the following areas:

  • outer lining of the uterus
  • ovaries
  • fallopian tubes

Without treatment, endometriosis can affect fertility.

Cancer

Although it does so less commonly than infections and stones, cancer of the kidney or bladder can also cause hematuria.

The urine may contain blood one day and appear clear the next. A person should not wait for the blood to reappear before contacting a doctor.

Bladder cancer can cause a person to urinate more or less frequently. Kidney cancer does not typically affect a person’s urination habits, but it can cause lower back pain.

Diagnosis

Treating blood in the urine requires an accurate diagnosis of the underlying cause. A doctor may start the diagnosis process by reviewing a person’s medical and family history for any contributing risk factors.

They are likely to ask females when their last menstrual period occurred. The presence of menstrual blood in the urine can result in a false positive hematuria diagnosis.

Doctors use the following tools to diagnose blood in the urine:

Pelvic exam

During a pelvic exam, a doctor will assess the condition of the female reproductive organs, including the:

  • vulva
  • vagina
  • cervix
  • uterus
  • ovaries

Depending on the reason for the evaluation, the doctor may examine the bladder and rectum as well.

Urinalysis

A urinalysis tests for protein, blood cells, and waste products in the urine. It can identify a range of medical conditions that affect the urinary tract, such as kidney disease and UTIs.

Imaging tests

Imaging tests can detect stones, endometriosis growths, and cysts in the urinary tract and pelvis.

Imaging tests can include:

  • ultrasound tests
  • MRI scans
  • CT scans
  • cystoscopy

When to see a doctor

People should not wait to see a doctor if they notice blood in their urine. They should speak with a doctor even if the blood clears on its own.

Females should speak with their doctor if they see blood in their urine outside of their regular menstrual period, especially if it occurs alongside the following symptoms:

  • severe pain in the lower back, intestines, or pelvis
  • gastrointestinal problems, such as constipation, diarrhea, or nausea
  • painful urination
  • cloudy or abnormally colored urine
  • foul-smelling urine
  • fever
  • chills
  • fatigue

Blood in urine in children

UTIs, stones, injuries, and some inherited diseases, such as polycystic kidney disease, can cause hematuria in children. In general, hematuria will not cause further complications in children. It may resolve on its own without treatment.

However, parents or caregivers should still take the child to see a doctor.

In most cases, a doctor will use a physical exam and urinalysis results to diagnose the underlying cause of hematuria in a child.

The presence of blood and protein in the urine may indicate an issue relating to the kidneys. In this case, it may be best to take the child to see a nephrologist, a healthcare professional who specializes in treating kidney conditions.

Treatment

Treatments for hematuria will address the underlying cause.

UTIs

A doctor may prescribe a course of antibiotics to treat hematuria that is due to a bacterial UTI.

Stones

People who have kidney stones can expect an improvement in their symptoms after they pass the stone. Large stones may require either medication, a special procedure to break the stone into smaller pieces, or surgical removal to relieve the symptoms.

Cancers

If a doctor finds that a person has kidney or bladder cancer, they will usually refer the individual to an oncologist, a healthcare professional who specializes in treating people who have cancer.

Treatment options for kidney and bladder cancer include surgery, chemotherapy, and radiation. Treatment programs will vary from person to person, depending on the stage of cancer and whether it involves other organs.

Summary

A doctor can help diagnose the cause of blood in the urine. Some causes, such as endometriosis, are specific to females, and females are more likely than males to experience UTIs.

The treatment for blood in the urine will depend on the cause.

Treating UTIs usually involves antibiotic therapy. Stones in the urinary tract can pass on their own without treatment. Large stones may require medication to break them up or surgical removal.

People should contact their doctor if they experience severe symptoms that interfere with their daily lives.