Ask Pat

If the condom is a spermicidal condom, the sperm are quickly inactivated. In one study, the percentage of mobile sperm in spermicidal condoms was 10.3% at 30 seconds, 4.3% at 60 seconds, and 1.5% at 120 seconds after ejaculation. In regular condoms, the percentage of mobile sperm was 55.5% at 30 seconds, 52.3% at 30 seconds, 52.3% at 60 seconds, and 50.2% at 120 seconds.

If hot tubs and swimming pools are properly maintained using chlorine and other chemicals, it is unlikely that semen, even if it did leak out of condoms, would remain "viable", meaning it is unlikely it would be able to live in that environment. However, nothing is ever completely impossible, so Pat would never say there is not any possibility of this happening. It would be a most unlikely scenario, though.

What is the liver? The liver is an organ located on the right side of the body underneath the lower ribcage. It is connected to gallbladder and is involved in the absorption of fats and fat-soluble vitamins. Blood carrying contents of the stomach and intestines flows directly to the liver, because the liver has a large role in protecting the body from harmful substances. The liver is also integral to countless other metabolic processes. It produces more proteins than any other organ in the body. What exactly does the liver do? The liver: Stores and Mobilizes Energy Controls Blood Sugar (Glucose) Regulates Glycogen Regulates Fat Storage Aids Digestion Produces Bile Regulates Blood Clotting Manufactures Clotting Factors Other Blood Proteins (During gestation the liver, forms blood in place of bone marrow.) Produces Several (Non-Reproductive) Hormones Manufactures Cholesterol (a certain amount of cholesterol is beneficial) Filters Blood Eliminates Bacteria Detoxifies Poisons Externally-Derived Poisons Alcohol Byproducts of Metabolism Bilirubin Breaks down Drugs Produces Vitamins Vitamin D Stores Minerals Iron Produces Essential Immune System Factors Monitors, as Well as Manufactures, Countless other Blood Proteins, to Maintain the Proper Levels of Numerous Chemicals in the Body

Pat has a few thoughts on your situation. First, it sounds like you are doing a good job of maintaining an active lifestyle and being aware of what you eat. The key to maintaining your weight is matching the calories taken in, with the calories used by your body. Calories are taken in through food and beverages and calories are used through a combination of your body's resting metabolic rate (metabolism) and the amount of activity/ exercise you do. Because I'm not sure of your exact diet, it is difficult to know if your weight gain is due more to decreased exercise or increased calorie consumption. In order to lose weight, you must eat fewer calories than you are expending through resting metabolism and activity. Resting metabolism is about 65-75% of your overall energy expenditure and typically ranges from about 1200-1800 calories per day depending on height, weight, and body composition (how much muscle mass vs. fat mass you have). We can't change resting metabolism substantially, but the amount of calories we expend exercising can vary drastically. The number of calories you "burn" during exercise varies with the intensity (how hard your body is working), frequency (how often you're exercising), and duration (how long you're exercising). You can maximize calorie expenditure by increasing intensity to the point where you're breaking a sweat and are breathing hard, increasing frequency of cardiovascular workouts to 3-4 times per week, and increasing duration to 45-60 minutes per session. Instead of doing aerobics twice a week, try cardiovascular exercise you do to challenge your muscles and "spice things up." Consider swimming, walking/ jogging, and hiking, cycling outdoors or on the stationary bike, or using the elliptical trainers. It's not so important which activities you do, but that you find some that fit into your schedule and that you enjoy! It's great that you're already strength training too. You might see better results if you lifted slightly heavier weights (challenging after 10 repetitions) 3 times a week rather than lightweights every day. Make sure to progressively increase the weight as you become stronger and it becomes too easy! As important as exercise is for health, it is also essential to look at your diet. You should monitor your diet to make sure that it is well balanced with plenty of fruits, vegetables, whole grains, lean meats, low-fat dairy products, and beans and minimal amount of fats and sweets. Watch out for extra calories that can sneak into the diet such as in sodas, fruit juices and drinks, coffee drinks, and condiments like cream cheese, sour cream, mayonnaise, butter, or salad dressings. 1 ladle-full of salad dressing at a salad bar can add 300 calories and 30 grams of fat! It is important to not skip any meals and allow yourself healthy snacks (such as granola bars, baby carrots, piece of fruit, cereal, yogurt) in between meals in order to maintain your energy levels and to prevent getting to hungry, which can lead to over-eating and less healthy food choices. You might consider consulting with a registered dietitian who can give you more individualized nutrition information and help you set and achieves nutrition goals. Finally, the medicine you are taking right now may also affect appetite. One of the known side effects of these drugs is actually a decreased appetite. However, these drugs can affect everyone differently and it would be best to consult your physician about the combination of the two and the side effects when taken together.

Birth control pills can cause some breast enlargement. Also some breast tenderness. If this is a problem for you see your doctor. Changing your pill will probably help.

All breasts are different. The size and shape of your breasts are determined by heredity, body size, fat distribution, etc. The shape of your breast will probably change as you get older, but even if they don't, try not to compare yourself to other people.

I am unaware of any medication hormone supplement or herb that will change the size or shape of your breasts. There are certainly products on the market that may make this claim, however, I would be highly suspicious and would waste my money elsewhere. If you have further questions or concerns about this, please feel free to make an appointment with your provider.

I am unaware of any medications or other interventions, with the exception of surgical implants, that enlarge the size of the breasts dependably. Some women find that with weight gain, use of hormone types of birth control, or with pregnancy the breasts enlarge, but that may or may not be a temporary situation. Again, with the exception of surgical placement of implants, I don't know of anything that reliably works to change the size or shape of the breasts. I would encourage you, if you are having concerns about the size of your breasts, to make an appointment and discuss this with a provider, because it may be the easiest thing to change is our attitude about the size of our breasts versus the actual size of our breasts. Please understand that the function of the human breast (mammary gland), which is a prerequisite of being in the group of animals known as mammals, who feed our young with milk produced in the breast. The function of the mammary glands is unaffected by the size of the breasts. However, again, if you have questions or concerns, please make an appointment with a provider and we can discuss this further.

I am personally unaware of any sort of exercise that would make the breasts themselves bigger. However, underlying the breast tissue itself are the pectoral muscles, so anything that would increase the size of them might give the appearance of enlarged breasts. I am unaware of any upper arm exercises, if they don't involve the pectoral muscles having any effect visually or actually. The breasts are not muscular tissue; therefore, conditioning of any sort will not really change their size. Please feel free to make an appointment with your provider if you have any further questions.

Breast tenderness before your menstrual cycle is normal. Breast tenderness can also be caused by birth control pills, so tenderness is not always a sign of problems. Thickening in your breasts can be due to fibrocystic breast disease-a benign condition that can often cause tenderness. If you are concerned, see your health care provider for a breast check.

Because there is usually not a medical reason for this surgery, breast enlargement is considered a cosmetic procedure and is not covered by medical insurance. For this reason bankruptcy can be a risk, in addition to any physical risk! The most frequent complications after breast enlargement surgery include loss of nipple sensation and bleeding. Numbness of the nipple may recede with time, but often the condition is permanent. Bleeding can lead to a buildup of blood that needs to be drained to avoid infection. Infection often requires temporary removal of the implant and its replacement weeks or even months later. Infections can occur well after surgery has been completed, perhaps triggered by an infection elsewhere in the body or even by dental work. All women form some degree of scar tissue around implants. Scars can become firm and may make the breast appear more globular or higher. Tight, firm scars resulting from scar shrinkage, called capsules, can be painful and may need to be released externally by applying pressure or internally by surgically cutting the capsule. Some physicians believe that oral administration of vitamin E may decrease the risk of this firm scar. Capsules are less likely when implants are placed under the breast muscle. However, implants placed this way often are high in the breast. With vigorous arm motion, these implants move toward the shoulder, which troubles some women. Augmented breasts are difficult to study with mammography. Excessive compression during a mammogram may cause implant rupture. Pat always tries to encourage women to appreciate their bodies women are not their cup size! We live in a society that puts undo pressure on women to look and act a certain way that is unrealistic for 98% of them women can choose to buy into this or learn to appreciate their entire package as being attractive, smart, and worthy just as they are. It is important to look at all the risks and benefits if you are seriously considering this procedure. You should ask other women who have implants if you can see what their breasts look like not in clothes. You may or may not like the appearance of the actual augmented breasts.

The most common reasons for breast enlargement in someone your age would be: Pregnancy and lactation Weight gain Medications Diet (caffeine and chocolate) Upper body strengthening (i.e. Nautilus) Breast lumps or fibrocystic changes In addition, cyclical changes in breast size occur in women of all ages with swelling most common prior to menses. Breast enlargement that is associated with breast discharge needs a medical evaluation to rule out more serious problems. Certainly many women notice changes in their breasts all throughout their lives with fluctuations in size as a part of that. If you have further questions, Pat would suggest that you make an appointment with a health care provider.

At the Women's clinic we teach patients in exams to do breast self-exams and we're definitely available to ask questions by appointment. We also do outreach to teach breast self exams to promote early detection. If you would like to see some more information on breast cancer, Pat has written about it as a previous hot topic. Just click on the icon marked hot topics on the menu at the bottom of every Ask Pat screen, or click on the hot topics tab at the top of every Ask Pat screen. Once you are there, you can click on the link marked breast cancer to your left. You may also call the Women's clinic at 491-1754 if you would like to speak to a provider about it.

Inverted nipples (either or both) are not unusual. Pat is unaware of any link between inverted nipples and breast cancer. The only time inverted nipples are significant is when women are planning to breast feed, in which case there are methods during a pregnancy that can help them be everted.

There are several methods for causing your breasts to be enlarged which do not include surgery or drugs, including things like some natural hormones that can be purchased at a health food store or at some other type of homeopathic medicine outlet. In addition, you do not have to push weights in order to make the muscles under your breasts larger. You can exercise your upper arms and such when you are studying or watching television. It does not require a great deal of time to do that. In addition to that, there are a number of padded bras that might make them look bigger without doing anything at all.