Answers to women's health concerns

Question: You hear so much about what you can and cannot eat when you are pregnant. What's really the truth about what you are supposed to be eating or not eating?

Nutrition in Pregnancy:

  • Consume meats, fish, poultry that are fully cooked
  • Only eat pasteurized dairy products
  • Wash fresh fruits and vegetables well before consumption

Excessive mercury exposure is associated with central nervous system damage in a fetus.

Eat 12 ounces or less a week of fish/shellfish low in mercury:

  • Canned light tuna
  • Salmon
  • Shrimp
  • Catfish

Eat 6 ounces or less of tuna steak a week

Avoid fish high in mercury: swordfish, shark, tilefish, king mackerel

EPA website lists mercury levels of various fish:


  • Great source of protein and calcium in pregnancy
  • Unpasteurized cheeses should be avoided as they may contain bacteria called Listeria. Infection with listeria during pregnancy may cause miscarriage, stillbirth, premature delivery, or mental retardation in an affected fetus.
  • Hard cheeses, processed cheeses, cottage cheese, cream cheese are safe
  • Soft cheeses such as feta, brie, Camembert, Roquefort, blue-veined, queso blanco, queso fresco or Panela should be avoided unless the cheese is labeled as made with pasteurized milk


  • Avoid food that may contain raw or lightly cooked eggs:
  • Home-made or fresh Caesar salad dressing, béarnaise sauce, hollandaise sauce, aioli, mayonnaise
  • Raw cookie dough, batter, or fillings
  • Homemade ice cream
  • Commercially made salad dressings, mayonnaise, and sauces use pasteurized eggs that are safe to eat

Question: What is the biggest difference between the hormone replacement therapy that is out now to the holistic, homeopathic, natural medications that are out there for relieving the symptoms of menopause?

Postmenopausal Hormone Therapy Alternatives:

  • The research available supporting the use of complementary and alternative treatments for night sweats and hot flashes associated with menopause is limited and it is unclear if these treatments are safe and/or effective.
  • Phytoestrogens (soy, legumes, flaxseed, red clover)
  • Acupuncture
  • Vitamin E
  • Black Cohosh
  • Ginseng
  • Dong quai
  • Wild yam
  • Evening primrose oil
  • These treatments should be used with caution, especially in women with estrogen-dependent cancers (such as certain types of breast cancer)
  • Several non-hormonal treatments have been shown to be effective in the treatment of hot flashes and night sweats, including SSRI's, SNRI's, clonidine, and gabapentin

Question: Is it true that birth control lowers the sex libido?

Birth Control Pills and Libido:

  • There is a link between lowered sexual desire, decreased vaginal lubrication, pain with intercourse and oral contraceptives (birth control pills)
  • This may be due to lowered circulating testosterone levels
  • This does not occur in all women taking the pill
  • Vaginal dryness and pain during intercourse may be improved with over the counter lubricants
  • Talk to your doctor about changes in sexual function that occur after the pill is started

About Dr. Leah Millheiser
Dr. Millheiser oversees the Female Sexual Medicine Program, which is available to women of all ages in the discreet surroundings of our Stanford Hospital office. This clinic provides treatment for the following disorders: decreased libido; decreased arousal; anorgasmia; dyspareunia and vaginismus. We take a multidisciplinary approach to female sexual medicine, working in conjunction with a licensed sex therapist, pelvic floor physical therapist, as well as alternative health practitioners.

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