Instruct: Given a question, retrieve relevant passages that answer the question.
Query: Is spotting on the mini pill normal?
In some women, menstrual spotting between periods occurs as a normal and harmless part of ovulation. Some women experience acute mid-cycle abdominal pain around the time of ovulation (sometimes referred to by the German term for this phenomenon, "mittelschmerz"). This may also occur at the same time as menstrual spotting. The term breakthrough bleeding or breakthrough spotting is usually used for women using hormonal contraceptives, such as IUDs or oral contraceptives, in which it refers to bleeding or spotting between any expected withdrawal bleedings, or bleeding or spotting at any time if none is expected. If spotting continues beyond the first three cycles of oral contraceptive use, a woman should have her prescription changed to a pill containing either more estrogen or more progesterone.
"L. minor" is a solitary species and like most other praying mantises will only come together to mate. Mating times for this species are highly dependent upon weather conditions and prey availability. Typically females are most likely to accept a mate and have a successful clutch two weeks after their last molt.
The mechanism of action of progestin only contraceptives depends on the progestin activity and dose. Intermediate dose progestin-only contraceptives, like Nexplanon or Implanon (and the progestin-only pill Cerazette) allow some follicular development but inhibit ovulation in almost all cycles as the primary mechanism of action. Ovulation was not observed in studies of Implanon in the first two years of use and only rarely in the third year with no pregnancies. A secondary mechanism of action is the progestogenic increase in cervical mucus viscosity which inhibits sperm penetration. Hormonal contraceptives also have effects on the endometrium that theoretically could affect implantation, however no scientific evidence indicates that prevention of implantation actually results from their use.
Elevated serum follicle stimulating hormone (FSH) level measured on day three of the menstrual cycle. (First day of period flow is counted as day one. Spotting is not considered start of period.) If a lower value occurs from later testing, the highest value is considered the most predictive. FSH assays can differ somewhat so reference ranges as to what is normal, premenopausal or menopausal should be based on ranges provided by the laboratory doing the testing. Estradiol (E2) should also be measured as women who ovulate early may have elevated E2 levels above 80 pg/mL (due to early follicle recruitment, possibly due to a low serum inhibin B level) which will mask an elevated FSH level and give a false negative result.
Progestins in birth control pills are sometimes grouped by generation. While the 19-nortestosterone progestins are consistently grouped into generations, the pregnane progestins that are or have been used in birth control pills are typically omitted from such classifications or are grouped simply as "miscellaneous" or "pregnanes". In any case, CPA has been described as a "first-generation" progestin similarly to closely related progestins like chlormadinone acetate, medroxyprogesterone acetate, and megestrol acetate.
"Eumenorrhea" denotes normal, regular menstruation that lasts for a few days (usually 3 to 5 days, but anywhere from 2 to 7 days is considered normal). The average blood loss during menstruation is 35 milliliters with 10–80 ml considered normal. Women who experience Menorrhagia are more susceptible to iron deficiency than the average person. An enzyme called plasmin inhibits clotting in the menstrual fluid.
During the subacute postpartum period, psychological disorders may emerge. Among these are postpartum depression, posttraumatic stress disorder, and in rare cases, puerperal psychosis. Postpartum mental illness can affect both mothers and fathers, and is not uncommon. Early detection and adequate treatment is required. Approximately 25% – 85% of postpartum women will experience the "blues" for a few days. Between 7% and 17% may experience clinical depression, with a higher risk among those women with a history of clinical depression. Prevalence of PTSD following normal childbirth (excluding stillbirth or major complications) is estimated to be between 2.8 and 5.6% at 6 weeks postpartum.
Zopiclone, as traditionally sold worldwide, is a racemic mixture of two stereoisomers, only one of which is active. In 2005, the pharmaceutical company Sepracor of Marlborough, Massachusetts began marketing the active stereoisomer eszopiclone under the name Lunesta in the United States. This had the consequence of placing what is a generic drug in most of the world under patent control in the United States. Generic forms of Lunesta have since become available in the United States. Zopiclone is currently available off-patent in a number of European countries, as well as Brazil, Canada, and Hong Kong. The eszopiclone/zopiclone difference is in the dosage—the strongest eszopiclone derivative dosage contains 3 mg of the therapeutic stereoisomer, whereas the highest zopiclone dosage (10 mg) contains 5 mg of the active stereoisomer. The two agents have not yet been studied in head-to-head clinical trials to determine the existence of any potential clinical differences (efficacy, side effects, developing dependence on the drug, safety, etc.).
Xenoestrogens are clinically significant because they can mimic the effects of endogenous estrogen and thus have been implicated in precocious puberty and other disorders of the reproductive system.
Menopause is the permanent cessation of menstruation resulting from loss of ovarian follicular activity. Menopause can be divided into early and late transition periods, also known as perimenopause and postmenopause. Each stage is marked by changes in hormonal patterns, which can induce menopausal symptoms. It is possible to induce menopause prematurely by surgically removing the ovary or ovaries (oophorectomy). This is often done as a consequence of ovarian failure, such as ovarian or uterine cancers. The most common side effects of the menopausal transition are: lack of sexual desire or libido, lack of sexual arousal, and vaginal dryness. The modification of women’s physiology can lead to changes in her sexual response, the development of sexual dysfunctions, and changes in her levels of sexual desire.
Dexmethylphenidate has a 4–6 hour duration of effect (a long-acting formulation, Focalin XR, which spans 12 hours is also available and has been shown to be as effective as -TMP (threo-methylphenidate) XR (extended release) (Concerta, Ritalin LA), with flexible dosing and good tolerability.) It has also been demonstrated to reduce ADHD symptoms in both children and adults. d-MPH has a similar side-effect profile to MPH and can be administered without regard to food intake.
Females of most mammal species advertise fertility to males with visual behavioral cues, pheromones, or both. This period of advertised fertility is known as "oestrus", "estrus" or "heat". In species that experience estrus, females are generally only receptive to copulation while they are in heat (dolphins are an exception). In the estrous cycles of most placental mammals, if no fertilization takes place, the uterus reabsorbs the endometrium. This breakdown of the endometrium without vaginal discharge is sometimes called "covert menstruation". Overt menstruation (where there is blood flow from the vagina) occurs primarily in humans and close evolutionary relatives such as chimpanzees. Some species, such as domestic dogs, experience small amounts of vaginal bleeding while approaching heat; this discharge has a different physiologic cause than menstruation.
In the past, the term PCS was also used to refer to immediate physical symptoms or post-concussive symptoms following a minor TBI or concussion. The severity of these symptoms typically decreases rapidly. In addition, the nature of the symptoms may change over time: acute symptoms are most commonly of a physical nature, while persisting symptoms tend to be predominantly psychological. Symptoms such as noise sensitivity, problems with concentration and memory, irritability, depression, and anxiety may be called 'late symptoms' because they generally do not occur immediately after the injury, but rather in the days or weeks after the injury. Nausea and drowsiness commonly occur acutely following concussion. Headache and dizziness occur immediately after the injury, but also can be long lasting.
Maternity blues, also known as baby blues and postpartum blues, is a transient condition that 75-80% of mothers could experience shortly after childbirth with a wide variety of symptoms which generally involve mood lability, tearfulness, and some mild anxiety and depressive symptoms. Baby blues is not postpartum depression, unless it is abnormally severe.After the placenta is delivered, the placental "hormone factory" shuts down causing radical changes in hormone levels, and the woman can suffer symptoms due to withdrawal from the high pregnancy levels of estrogen, progesterone and endorphins. Combined with this shift in hormone levels is the physical, mental and emotional exhaustion - as well as sleep deprivation typical of parenting a newborn. All of these factors contribute to the condition.
CD with "classic symptoms", which include gastrointestinal manifestations such as chronic diarrhea and bloating, malabsorption of certain vitamins and minerals, loss of appetite, impaired growth and even bone pain, is currently the least common presentation form of the disease and affects predominantly to small children generally younger than two years of age.
As the sodium salt, sodium estradiol sulfate, E2S is present as a minor constituent (0.9%) of conjugated equine estrogens (CEEs), or Premarin. It effectively functions as a prodrug to estradiol in this preparation, similarly to E1S. E2S is also formed as a metabolite of estradiol, as well as of estrone and E1S. Aside from its presence in CEEs, E2S is not available as a commercial pharmaceutical drug.
Although the goal of the program is to prevent pregnancies of women who take the drug, male patients must also participate in anti-pregnancy restrictions, primarily due to fears that male isotretinoin users might share their prescriptions with females without their physicians' knowledge. There has been no link to birth defects from Accutane associated with males using the drug, though male sexual dysfunction has been suggested by one study. As this has not been conclusively proven, this is not acknowledged as a side effect in the official literature accompanying the medication.
Whereas some men may have refractory periods of 15 minutes or more, some men are able to experience sexual arousal immediately after ejaculation. A short recovery period may allow partners to continue sexual play relatively uninterrupted by ejaculation. Some men may experience their penis becoming hypersensitive to stimulation after ejaculation, which can make sexual stimulation unpleasant even while they may be sexually aroused.
Middle-of-the-night insomnia is often treated with medication, although currently Intermezzo (zolpidem tartrate sublingual tablets) is the only Food and Drug Administration-approved medication specifically for treating MOTN awakening. Because most medications usually require 6–8 hours of sleep to avoid lingering effects the next day, these are often used every night at bedtime to prevent awakenings. Medication may not be prescribed in some cases, especially if the cause turns out to be the patient ingesting too much fluid during the day or just before they go to sleep.
Menopause typically occurs between 49 and 52 years of age. The majority of women have their last period between the ages of 48 and 55. The average age of the last period in the United States is 51 years, in the United Kingdom is 52 years, in Ireland is 50 years and in Australia is 51 years. In India and the Philippines, the median age of natural menopause is considerably earlier, at 44 years. The menopausal transition or perimenopause leading up to menopause usually lasts 7 years (sometimes as long as 14 years).
Menstruation, also known as a period or monthly, is the regular discharge of blood and mucosal tissue (known as menses) from the inner lining of the uterus through the vagina. The first period usually begins between twelve and fifteen years of age, a point in time known as menarche. However, periods may occasionally start as young as eight years old and still be considered normal. The average age of the first period is generally later in the developing world, and earlier in the developed world. The typical length of time between the first day of one period and the first day of the next is 21 to 45 days in young women, and 21 to 31 days in adults (an average of 28 days). Bleeding usually lasts around 2 to 7 days. Menstruation stops occurring after menopause, which usually occurs between 45 and 55 years of age. Periods also stop during pregnancy and typically do not resume during the initial months of breastfeeding.
Up to 80% of women report having some symptoms prior to menstruation. Common signs and symptoms include acne, tender breasts, bloating, feeling tired, irritability, and mood changes. These may interfere with normal life, therefore qualifying as premenstrual syndrome, in 20 to 30% of women. In 3 to 8%, symptoms are severe.
A lack of periods, known as amenorrhea, is when periods do not occur by age 15 or have not occurred in 90 days. Other problems with the menstrual cycle include painful periods and abnormal bleeding such as bleeding between periods or heavy bleeding. Menstruation in other animals occur in primates (apes and monkeys).
The menstrual cycle occurs due to the rise and fall of hormones. This cycle results in the thickening of the lining of the uterus, and the growth of an egg, (which is required for pregnancy). The egg is released from an ovary around day fourteen in the cycle; the thickened lining of the uterus provides nutrients to an embryo after implantation. If pregnancy does not occur, the lining is released in what is known as menstruation.
Recent exhibitions at Tensta konsthall include
• “Abstract Possible: The Stockholm Synergies,” with Doug Ashford, Claire Barclay, Goldin+Senneby, Wade Guyton, Mai-Thu Perret, Walid Raad, and Haegue Yang, among others
• “Kami, Khokha, Bert and Ernie: World Heritage” by Hinrich Sachs
• “Doing what you want: Marie-Louise Ekman accompanied by Sister Corita Kent, Mladen Stilinović, and Martha Wilson” 
• “The Society without qualities” with Sören Andreasen, Ane Hjort Guttu, Sture Johannesson, Sharon Lockhardt, and Palle Nielsen (part of “The new model” and curated by Lars Bang Larsen)
• “Working With…” by Zak Kyes
• “We are continuing BBDG” with Bernd Krauss
• “Two Archives” by Babak Afrassiabi and Nasrin Tabatabai
"We designed the building from the inside out, not the outside in,” said Loretta H. Cockrum, Foram’s founder, chairman and CEO. “We wanted the most efficient office building ever designed, with no wasted space or wasted energy. This is a building of the future more than a building of the present. A lot of love has gone into that building, and a lot of pride."
Progestogen-only contraceptive pills (sometimes called the 'mini pill') are taken continuously without a 7-day span of using placebo pills, and therefore menstrual periods are less likely to occur than with the combined pill with placebo pills. However, disturbance of the menstrual cycle is common with the mini-pill; 1/3-1/2 of women taking it will experience prolonged periods, and up to 70% experience break-through bleeding (metrorrhagia). Irregular and prolonged bleeding is the most common reason that women discontinue using the mini pill.
Use of combined estrogen and progesterone eliminates the normal endogenous hormonal cycling and gradually produces atrophy of the endometrial glands. This is because the dosage of estrogen in the OCs pills is much lower than the quantity produced naturally by the ovaries. Higher quantities produced by the ovaries induce proliferation, but low levels supplied by the pills produce atrophy but are sufficient to inhibit the endogenous secretion of the gonadotropins.
The exact chain of events that lead from an atrophic endometrium to the spotting between menses is not explained by the text. This condition may be corrected by using a pill with a higher estrogen (which will stimulate further proliferation of the endometrium) or lower progestin content (which will reduce its stability).