The Christian Woman's Complete Guide to Health: Everything You Need to Know About You! Adolescence to Menopause and Everything in Between

This book on women’s health is a must-read for every young woman entering adulthood. Although it is impossible to cover everything in one book you would want a young girl to know, Dr. Farhart and Dr. King have done an excellent job in covering the most important issues. I would recommend this book for women of all ages. They will find this book enlightening and full of good practical information.

—DON COLBERT, MD

New York Times best-selling author, speaker, and practicing physician

The Christian Woman’s Complete Guide to Health is many years overdue. What a blessing to the young generation, a woman’s handbook that will carry you through every phase of being a woman. I have floundered my way through most of these and still have a lot of questions. Now I have a source for the healthy answers, knowing they are with the knowledge from the Word of God.

—ELIZABETH TRAVIS

Wife of country music star Randy Travis

In a world of ever-changing values, godly principles have remained true. Societal pressures on our daughters to compromise those values have never been stronger. As a board certified OB/GYN and proud father of two daughters, I am pleased to see a resource covering the time from puberty to menopause that extols those godly standards. Godly decisions made in adolescence will benefit future relationships and fertility, as well as both physical and spiritual well-being. For you were bought at a price; therefore glorify God in your body and your spirit, which are God’s (1 Cor. 6:20, NKJV).

—WILLIAM R. LILE JR., MD, FACOG

Founder, ProLifeDoc.org

Thank you, Dr. Farhart and Dr. King, for equipping and empowering women to manage their health! This book is like a private consultation, filled with wisdom and understanding for the issues, decisions, and struggles women face throughout their lives. What a marvelous resource for the women we are and for the women we mentor.

—DONDI SCUMACI

International speaker and author of Designed for Success: Ten Commandments

for Women in the Workplace

As a specialist in teen issues and sex education, I believe that young ladies need facts to build a strong foundation in health and wellness. Dr. Scott Farhart and Dr. Elizabeth King’s book offers just that. It empowers young ladies to take responsibility for their own health with solid biblical instruction.

—GABE SALAZAR

Youth motivational speaker and teen sex educator

THE

Christian Woman’s

Complete

Guide to

HEALTH

SCOTT FARHART, MD

ELIZABETH KING, MD

Most STRANG COMMUNICATIONS/CHARISMA HOUSE/CHRISTIAN LIFE/EXCEL BOOKS/FRONTLINE/REALMS/SILOAM products are available at special quantity discounts for bulk purchase for sales promotions, premiums, fund-raising, and educational needs. For details, write Strang Communications/Charisma House/ Christian Life/Excel Books/FrontLine/Realms/Siloam, 600 Rinehart Road, Lake Mary, Florida 32746, or telephone (407) 333-0600

THE CHRISTIAN WOMAN’S COMPLETE GUIDE TO HEALTH

   by Scott Farhart, MD, and Elizabeth King, MD

Published by Siloam

A Strang Company

600 Rinehart Road

Lake Mary, Florida 32746

www.strangdirect.com

This book or parts thereof may not be reproduced in any form, stored in a retrieval system or transmitted in any form by any means—electronic, mechanical, photocopy, recording or otherwise—without prior written permission of the publisher, except as provided by United States of America copyright law.

Unless otherwise noted, all Scripture quotations are from the Holy Bible, New International Version. Copyright © 1973, 1978, 1984, International Bible Society. Used by permission.

Scripture quotations marked KJV are from the King James Version of the Bible.

Scripture quotations marked NKJV are from the New King James Version of the Bible. Copyright © 1979, 1980, 1982 by Thomas Nelson, Inc., publishers. Used by permission.

Scripture quotations marked NLT are from the Holy Bible, New Living Translation, copyright © 1996. Used by permission of Tyndale House Publishers, Inc., Wheaton, IL 60189. All rights reserved.

Design Director: Bill Johnson

Cover Designer: Judith McKittrick

Author Photograph: © Paul Wharton

Copyright © 2008 by Scott Farhart, MD, and Elizabeth King, MD

All rights reserved

Library of Congress Cataloging-in-Publication Data:

Farhart, Scott, 1959-

   The Christian woman’s complete guide to health / Scott Farhart, Elizabeth King.

      p. cm.

   ISBN 978-1-59979-207-1

  1. Women--Health and hygiene. 2. Women--Health and hygiene--Religious aspects--Christianity. I. King, Elizabeth. II. Title.

   RA778.F36 2008

   613’.04244--dc22

2008018858

People and incidents in this book are composites created by the authors from their experiences as medical doctors. Names and details of the stories have been changed, and any similarity between the names and stories of individuals described in this book to individuals known to readers is purely coincidental.

Neither the publisher nor the authors are engaged in rendering professional advice or services to the individual reader. The ideas, procedures, and suggestions in this book are not intended as a substitute for consulting with your physician. All matters regarding your health require medical supervision. Neither the author nor the publisher shall be liable or responsible for any loss or damage allegedly arising from any information or suggestion in this book.

While the authors have made every effort to provide accurate telephone numbers and Internet addresses at the time of publication, neither the publisher nor the authors assume any responsibility for errors or for changes that occur after publication.

EISBN: 978-1-59979-799-1

We would like to dedicate this book to our patients

at Northeast OB/GYN Associates, whose lives have

instructed and inspired us.

Acknowledgments

WE WOULD LIKE TO THANK ALL THOSE WHO MADE THIS PROJECT POSSIBLE. First and foremost, we want to thank our spouses, Sandy Farhart and Dr. Aaron King, for their sacrifices while we toiled away at our computers. This book is as much theirs as it is ours. To our children, Jordan and Jared Farhart and Daniel King, for giving up time with us while we completed this book: thank you, and we love you.

We are grateful to Pastor John and Diana Hagee for their unwavering support of us, and to the production staff at John Hagee Ministries for their tremendous help with our promotional spots. Our appreciation goes to the Siloam and Strang groups for helping make this book a reality for the body of Christ, specifically to Debbie Marrie and Lillian McAnally, who faithfully guided this book with their considerable managerial and editorial skills.

Our thanks to those who have endorsed this book: Dr. Don Colbert, Elizabeth Travis, Gabe Salazar, Dondi Scumaci, and Dr. William R. Lile Jr. Your encouragement is greatly appreciated. Thanks also to Niky Scragg and Nucleus Medical Art for their fine illustrations, and to Dr. Francisco Arredondo and Dr. John Pilcher for lending us their charts on fertility and body mass index, respectively. Thanks also to Ethicon for the use of their Gynecare TVT-OT illustration. A special thanks to a woman known only as Jilly who let us share her Web site on post-abortion stress syndrome.

Finally, we would like to thank the physicians and staff at Northeast OB/GYN Associates for creating such a rewarding and fulfilling place to work. It is a joy to come to the office each day where a group of dedicated people allow us to do what we love best.

Contents

List of Abbreviations

Foreword by Diana Hagee

Introduction

Section 1

Puberty: Your Changing Body

1 Woman as Designed by God

2 Body Image

3 Sex and Teens

Section 2

The Healthy Woman

4 Your Gynecologist and You

5 Emotional Health

6 Diet and Exercise

Section 3

Sex and the Single Woman

7 Dating and Sex

8 Sexually Transmitted Diseases

9 STD Prevention

10 Abortion

11 Post-Abortion Recovery

Section 4

The Married Woman

12 The Wedding Night

13 Methods of Birth Control

14 Sacred Sex

15 Female Sexual Drive

Section 5

Congratulations! You’re Going to Be a Mother

16 When You’re Ready for a Baby

17 Infertility: Causes and Treatments

18 The First Trimester

19 The Second Trimester

20 The Third Trimester

21 Childbirth

22 The Postpartum Mother

23 The Life of a Perimenopausal Soccer Mom

Section 6

Living Life at Midlife and Beyond

24 Everything Menopause

25 Surgery 101

26 Life Beyond Forty: Maintaining Your Health

27 Women and Cancer

28 Aging and Intimacy

Notes

Glossary

List of Abbreviations

Below is a list of abbreviations commonly used in this book.

ACOG: American College of Obstetricians and Gynecologists

AIDS: acquired immunodeficiency syndrome

AMA: American Medical Association

CDC: The Centers for Disease Control and Prevention

FDA: Food and Drug Administration

HIV: human immunodeficiency virus

HPV: human papillomavirus

HRT: hormone replacement therapy

JAMA: Journal of the American Medical Association

NIH: The National Institutes of Health

NIAID: The National Institute of Allergy and Infectious Diseases

NSAID: nonsteroidal anti-inflammatory drug

OB/GYN: obstetrician/gynecologist

PAS: Post-Abortion Syndrome

PASS: Post-Abortion Stress Syndrome

PID: pelvic inflammatory disease

PMDD: premenstrual dysphoric disorder

PMS: premenstrual syndrome

STD: sexually transmitted disease

Foreword

WITH THE ENDLESS NUMBER OF TITLES ON THE SHELVES OF BOOKSTORES everywhere, what makes this book on health different from all other books? Why should you read this book? Allow me to explain.

It is not the truth that will set you free, but the knowledge of the truth that will set you free. The truth about women’s health issues has been available since the beginning of time; however, this truth has been clouded by the fallacies of a humanistic world. When searching for fundamental knowledge, women need not be driven by fear, old wives’ tales, or political correctness. The time has come for the Christian woman to liberate herself from the secular world and obtain knowledge concerning her body from balanced, reliable, and godly sources.

Christian women must not be intimidated to search out the truth. We must become proactive when caring for our bodies. I have exciting news! The Christian Woman’s Complete Guide to Health is the tool that will help you accomplish your search. We ought to seek out knowledge from a multitude of godly counsel. The authors of this vital health guide book, Doctors Scott Farhart and Elizabeth King, are wise vessels who have dedicated their life’s work to bring healing to the thousands of women they serve within their practice.

Dr. Farhart continually strives to attain a deeper knowledge of his profession, bringing healing to those he serves through his expertise and through prayer. I know him to be one of the most compassionate advocates of women’s health care. Pastor Hagee and I also have confidence in him to teach thousands in our congregation and the tens of thousands that comprise our television ministry outreach throughout the world.

I have the privilege of knowing Scott Farhart first as a man of God who has devoted himself to serving in church leadership for the past thirteen years. Second, I know him as my brother-in-law, a man lovingly committed to my beloved sister and their children for nearly twenty-five years. Third, Scott is my doctor. He is an outstanding physician who has served as the chief of staff for one of San Antonio’s foremost hospitals, and I trust him to direct my path in making wise choices regarding my health. He is also the doctor for three of our children and has delivered five of our grandchildren!

Dr. Elizabeth King is the wife of a physician and a mother of a toddler. She knows what concerns women from firsthand experience. She also delivered our youngest grandson, Will, this past year. She gave our son and daughter-in-law guidance during a complicated pregnancy, and for that she has our eternal gratitude.

Our children have placed their utmost faith in these fine physicians to bring our grandchildren into this world, and that, dear friend, is the highest endorsement I can give the authors of this book.

Our lives are but a vapor in the span of eternity; it is time for us to live life to the fullest, with wisdom, joy, and good health. A Christian Woman’s Complete Guide to Health is different from all other health books in that it will be a torch of truth that will light your path on your journey to becoming a better you.

—DIANA HAGEE

Wife of Pastor John Hagee and

chief of staff of John Hagee Ministries

Introduction

WHEN WE FIRST THOUGHT OF WRITING A WOMEN’S HEALTH BOOK, WE looked at the available resources for Christian women on the market today. Most came from an academic perspective that emphasize secular humanism with a liberal bias toward women’s health. Chapters were often included on such topics like lesbian health and abortion as birth control. While the scientific information was generally sound, many Christian women would not want to navigate through the liberal opinions and secular advice that permeated most of the text.

What we hope to bring to you is a medically accurate and spiritually sound resource your whole family can use. The sections are purposely arranged so each generation can find the information they need. Each phase of a woman’s life is represented: from puberty to singlehood, from womanhood to motherhood to senior adulthood. Undoubtedly some of you will find that certain phases in your life may overlap. For example, you may be raising children at the same time you are going through menopause.

While there are specific sections for reference, information important to all women is found in every chapter. This book is meant to be a resource you can use to find the answers you need in every situation you will face. We hope that mothers and daughters, grandmothers and granddaughters can find within these pages medical information from a trusted source.

Between the two of us, we have practiced obstetrics and gynecology for over thirty years and have treated several thousand women of all ages. Within the day-to-day practice of our medical profession, we regularly address the subjects we have placed in this book. The latest research and medical opinion are tempered with a solid knowledge of the Word of God. Where there are differences of opinion within the medical community, we have acknowledged it and given our own opinion as well. Where there are areas of controversy, we have addressed the various factions and given enough information for you to form your own opinion. In areas where Christians may disagree, we present the facts to you so that you can take ownership of your health-care decisions.

As you read this book, we want you to feel as if you are having a personal consultation with us. If you are having a difficult time finding sound, biblically based medical advice from a pro-life OB/GYN in your community, we hope to serve as a medical resource to many of your questions. However, we are not a substitute for your own physician who has the benefit of direct contact with you and the ability to run specific tests to determine what is best for you. This book could serve as a starting point to gather the information you need to ask your physician important questions and make informed decisions about your health care.

You will find anecdotes interspersed throughout the book. While we have taken great care to obscure patients’ identities, most of you will encounter each of these situations at some point in your lives. You may even identify with the struggles these women have faced. If not you, then someone you know will need this advice. As you mentor the next generation of godly women, stay informed of the latest medical information.

We have included additional features such as:

• Mom Never Told Me!

• It’s in the Word (biblical examples)

• Did You Know?

When you see the following symbols, you will find:

Finally, understand that we cannot possibly place all of the information regarding women’s health into one book. The resources we have used are listed with each chapter to allow you to further explore the information for yourself. The Internet has been of great benefit in helping everyone access information at home. But be careful to stay with respected medical Web sites and away from sites that are written by laymen. Otherwise, you may become victims of their own hidden agendas.

It is our hope that this resource book is one you will recommend to your friends and neighbors, your women’s groups, and your churches. We are here to serve you as you seek the truth about God’s most precious creation: women!

—SCOTT FARHART, MD, and ELIZABETH KING, MD

SECTION 1

PUBERTY: YOUR CHANGING BODY

Chapter 1

WOMAN AS DESIGNED BY GOD

WHEN GOD DESIGNED WOMAN, HE CREATED SOMEONE VERY SPECIAL. Developing from a girl to a woman, however, is complex and filled with ups and downs. Most young women deal with painful periods each month, as in the case of one of our patients, Sarah.

The summer before heading off to college, seventeen-year-old Sarah came to the office for her first gynecological exam. Her periods were regular, but she was suffering from severe pain the first two days of her menstrual cycle. The pain was so bad that not even over-the-counter pain medications provided much relief. The only way she could get some relief was to climb into bed, apply a heating pad to her lower abdominal area, and assume the fetal position. She missed many days and events during her senior year in high school because the pain was so excruciating. Now she would be attending college, and she was afraid her painful periods would affect her class attendance and social events with friends.

We placed her on a low-dose birth control pill to decrease the severity of menstrual cramping. Over the Thanksgiving break, she came back to the office and was happy to report she did not have to miss any classes or sorority events. Her period was significantly lighter and her cramping was minimal. She was able to enjoy her life away from home during her freshman year in college.

Overview of Female Anatomy

From the very beginning, we read that women are unique creations:

The Lord God made a woman from the rib he had taken out of the man, and he brought her to the man. The man said, This is now bone of my bones, and flesh of my flesh; she shall be called ‘woman,’ for she was taken out of man.

—Genesis 2:22–23

Though the Bible states that females are formed from males, a developing fetus will automatically take a female form if not influenced early on by the male hormone testosterone. It is testosterone that closes the vagina, makes the labia turn into a scrotum, and elongates the clitoris to form a penis. Without it, a normal-appearing female will be formed, complete with breast development and a vagina, even if that person has the chromosomes of a male. So being female is no accident or mistake.

Illustration copyright © 2008 Nucleus Medical Art. All rights reserved. www.nucleusinc.com.

Your ovaries

The ovaries are the dominant organs in women. Nearly all of the sex hormones come from the ovaries, and they hold the key to much of what it means to be female. These almond-sized oval structures are located on each side of the uterus. They produce the female sex hormones estrogen and progesterone, and they store all of the eggs needed for later reproduction. Each month, dozens of eggs compete with each other to select the one egg that will be released for fertilization in a process called ovulation. In a complex interaction between the brain and the ovaries, one dominant egg reaches maturity and is released into the pelvic cavity where the fallopian tube takes it into itself. There, one of the waiting sperm fertilizes it. The resulting new embryo journeys into the uterus to begin its new life. The ovaries make a hormone called estrogen. From the onset of puberty to menopause, the ovaries produce this hormone daily. It’s what keeps the female voice high, develops breasts, changes the shape of the pelvic bones to accommodate pregnancy, and grows a uterine lining for later use in reproduction. This hormone has been found to interact with almost every organ of the body in a powerful way. It causes calcium to bind to bone (the loss of estrogen is the primary cause of osteoporosis in women). It increases the good cholesterol and lowers the bad cholesterol, delaying the onset of heart attack and stroke in women compared to men. And this doesn’t mention the effects on the brain!

When the egg is released in the middle of the menstrual cycle, a second hormone, called progesterone, is made. Its principle job is to prepare the uterine lining to receive an embryo. Without this preparation, the embryo would float by and fall out of the cervix, never implanting and never causing pregnancy. If an embryo does not implant and signal its existence to the ovary, the progesterone levels will fall and the uterine lining will tear away, beginning the familiar process of menstruation.

Illustration copyright © 2008 Nucleus Medical Art. All rights reserved. www.nucleusinc.com.

Your uterus

The uterus, commonly referred to as the womb, is the place where the embryo develops into the fetus and then is delivered by a series of contractions as a live baby. The end of the uterus that protrudes into the vagina is the cervix. While the uterus and cervix have different functions and different cellular makeup, they essentially blend together into one organ. Think of them as the uterus being the house and the cervix being the door to that house. The uterus is primarily muscular in nature, responsible for menstrual cramps that shed the old lining, making a place for the placenta to attach during pregnancy, and causing labor contractions during delivery. Damage to the cervix from surgical procedures to correct abnormal Pap smears, or from past abortions, can weaken its ability to hold a pregnancy to term and cause loss of the fetus. When a woman is not pregnant, the cervix is a source of lubrication for intercourse. It also releases its own unique secretions during the fertile phase of each cycle that nourish the sperm and aid their passage into the uterus.

Your fallopian tubes

Attached to the upper sides of the uterus are the fallopian tubes that bring egg and sperm together and transport the created embryo to the uterus. The fallopian tubes are among the most delicate of the female organs and vitally important. Scarring of the tubes from previous infection is a common cause of infertility, which is a topic for another chapter.

Your vagina

The vagina is a three- to four-inch muscular tube leading from the cervix to the outer labial opening. It is lined by cells that secrete lubrication to aid in intercourse and is capable of expanding during sexual excitement to hold the erect penis. The vagina is able to accommodate any size penis, and a fully developed baby can journey through it during birth. It is surrounded by the bladder above and the rectum below. Childbirth injuries to the vaginal walls, as well as aging of the muscles, can cause the uterus, bladder, and/or rectum to fall into it, as we will discuss in a later chapter. While the vagina is the main location of intercourse and is capable of feeling its own unique sensations, it is not the primary place where a woman experiences the pleasure of intercourse—that is left to the clitoris.

Illustration copyright © 2008 Nucleus Medical Art. All rights reserved. www.nucleusinc.com.

Your clitoris

The clitoris is the most sensitive receiver of sexual pleasure in a woman’s body. Its counterpart in men is the head of the penis. The clitoris is filled with sensitive nerves that transmit pleasurable sensations. It is also capable of an erection, and when erect, it protrudes from under a hood of skin formed by the joining of the tops of the labia (or lips). During intercourse, the inward thrusting of the penis pulls on the labia, and the hood of the clitoris rubs against it, causing sensation to be transmitted to the clitoris. With enough sensation, a woman will achieve orgasm.

What Is Puberty?

Puberty is the physical, emotional, and sexual transition from childhood to adulthood. This transition occurs gradually and contains a series of well-defined events and milestones. The brain contains two structures—the hypothalamus and pituitary gland—that are responsible for turning on and regulating the secretion of hormones from the ovaries in women (the gonads). This is referred to as the hypothalamic-pituitary-gonadal axis and is initially active in the fetus and during the first few years following birth. It then becomes inactive until the onset of pubertal development. At approximately age eight, the adrenal glands send a signal that turns on the gonadal sex hormone production approximately two years later. The process of pubertal development requires approximately four years to achieve full sexual maturation. This process takes place in an orderly fashion of breast development, pubic hair growth, menstruation, and growth spurts.

Three critical elements that play a role in the timing of a girl’s sexual maturation are adequate body fat, adequate sleep, and vision. Without adequate body fat, the body cannot turn on the developmental process. This is a protective mechanism because a woman’s body cannot support a pregnancy without a certain amount of reserve. This is why you will notice that as you approach puberty you gain weight, often in new places. Girls begin to develop hips, and their proportion of overall body fat increases. Likewise, puberty is delayed in girls who participate in strenuous exercise before puberty. Adequate sleep is also important in hormone signaling and production. During the sleep cycles in puberty, there is an increased secretion of both follicle-stimulating hormone and luteinizing hormone (two hormones produced in the brain to stimulate the ovaries). Visual exposure to sunlight is necessary for sexual development. Blind children have delayed puberty, and pituitary hormone secretion is suppressed in hibernating animals.

Mood changes are very common during pubertal development and may lead to periods of depression or violent outbursts. Although this can be difficult for both adolescents and their parents, be reassured that these mood changes disappear with time.

Illustration copyright © 2008 Nucleus Medical Art. All rights reserved. www.nucleusinc.com.

Development of breasts and body hair

The initial sign of breast development is a darkening of the areola (pigmented skin around the nipple). The breast tissue underneath it will begin to grow into a mound, which is commonly referred to as a breast bud. Shortly thereafter, pubic hair will start to develop. It will initially be a few long, downy, slightly darkened hairs. Breast development continues past the edge of the areola. Girls will also develop darker hair in the axillary region (armpit). The pubic hair then begins to darken, increase in amount, and become coarser. At this stage it is confined to the labia majora (the outer lips of the vagina) and mons pubis (the raised fatty area above the labia). It will then begin to spread to the inner thighs. Around this time, most girls will get their first period (menarche). Breast development continues past the areola mound and the breast takes on a rounder shape. The breasts may have initially grown at different rates, with one larger than the other, but they should eventually even out.

Menstruation

About a year following initial breast development, most girls will get their first period. This occurs on average at age twelve, but it can begin as early as age nine or ten, or late into the teen years. As stated earlier, the hormones estrogen and progesterone regulate the menstrual cycle. When a pregnancy does not occur, the uterine lining is shed. This monthly process is commonly known as your period.

On average, the menstrual cycle is twenty-eight days, with some girls bleeding for only three to four days, while others will experience bleeding for five to seven days. When you first start having menstrual cycles they may be erratic, sometimes occurring twice in one month and skipping a month at other times. Your body usually just needs time to get used to the new signals it is receiving. If erratic cycles persist beyond the first year, you should consult a doctor for evaluation.

The menstrual cycle is divided into three phases. The first stage is marked by the first day of bleeding (referred to as Day 1 of your menstrual cycle) when your body sheds blood and the endometrium (or lining of the uterus). Many women will develop problems with this stage, such as dysmenorrhea (painful periods) and/or menorrhagia (heavy periods), which we will discuss in detail later on.

The second stage of the menstrual cycle is the follicular/proliferative phase. The pituitary gland releases a hormone, FSH (follicle-stimulating hormone), which in turn stimulates the ovary to develop a follicle (egg sac).

This follicle contains an ovum (egg), which matures during this phase. FSH also stimulates the ovary to produce estrogen. The increasing amounts of estrogen cause the endometrium to grow and reach its maximal thickness at the time of ovulation.

MY GIRL CARE KIT

A girl’s first period is a rite of passage as she moves from puberty to womanhood. It can be an exciting time, but it can also be an awkward stage in a girl’s life—not quite a little girl, not quite a woman. Aside from talking to a trusted Christian woman, a simple emergency care kit can make most girls feel at ease.

Find a nice toiletry or cosmetic bag (something discreet that will easily fit in a backpack or purse), and fill it with things needed for the first period. Here is a sample list, but you can create your own.

• A small calendar (to keep track of menstrual cycles)

• 1 sanitary pad and 1 panty liner

• Feminine disposable wipes

• Antibacterial hand wipes

• A small note of encouragement with a favorite Bible verse

• Two to three chocolate kisses (what girl doesn’t love—and need!—chocolate at this time)

• The phone number or e-mail address of a trusted Christian woman to answer questions and offer support

The third stage of the menstrual cycle is the luteal/secretory stage. This is marked by the production of LH (luteinizing hormone) in the brain, which triggers the release of the egg (ovulation). Some women can actually feel when they ovulate, sensing a twinge of pain on one side or the other. The empty follicle becomes a sac known as the corpus luteum. This sac grows in response to LH and begins to secrete progesterone, causing the endometrium to convert from a proliferative state to a secretory state. The endometrial glands contain fluid that will support a developing embryo should pregnancy occur. If pregnancy does not occur, the corpus luteum begins to deteriorate, progesterone levels fall, and the lining of the uterus is shed. Estrogen levels fall along with progesterone, and this drop in hormones signals the body to start the process over again.

When a girl first starts having her period, she may wonder about using a pad versus a tampon. It is really a matter of preference and comfort. There are certain instances when wearing a pad is not feasible, such as going swimming.

Anyone can use a tampon, even virgins. You can use a tampon during your very first cycle if you wish. It is important to remember to change your tampon regularly, however, because you can develop a condition called toxic shock