Doc: Another solution for early pregnancy vomiting
Dear Dr. Roach: Thank you for addressing the question regarding early pregnancy emesis (vomiting). However, I believe your column could help women who suffer from hyperemesis by further explaining that although dangerous and perhaps seemingly intolerable, there are solutions for those with great resolve and good info. I’m mother to two adults now (22 and 19), thanks I’m sure in large part due to a sister who was a registered dietician interning at a research hospital in Baltimore where trial practices were being done on hyperemesis gravidarum patients, and an accommodating obstetrician who otherwise had run out of ideas. Until my sister suggested tube feeding at a very slow drip, the only solution for treating my case was what you hinted at: a constant cycle of IV rehydration.
Dear R.F.: I thank you for writing. Mild cases of vomiting in pregnancy usually can be treated with the remedies I mentioned in my previous column, but severe and recalcitrant cases require more-aggressive regimens. In very severe cases, patients may require admission to the hospital. Intravenous medicines, too dangerous to be given at home, may be necessary.
The treatment you mention, tube feeding (usually by a nasogastric tube), sometimes can help treat the vomiting. Feeding the patient by stomach is preferable to intravenous feeding, which has a much higher risk of complications, including infection and blood clotting. In most cases, symptoms improve dramatically between week 16 and week 20 of gestation.
Dr. Roach Writes: A recent column on low female libido continues to generate additional letters. I got letters from women who were treated with testosterone (sometimes with female hormones), and these women reported excellent results. A gynecologist, Dr. Kathy Maupin, sent me her book on testosterone treatment in women, along with her observation that 95 percent of her patients fully recover when treated. The published studies on testosterone treatment in women have mostly shown benefit, though not to the remarkable degree Dr. Maupin reports. Further, the Food and Drug Administration hasn’t OK’d any testosterone product for women. Nonetheless, testosterone replacement remains an option for treatment of low libido in women.
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