Yoga Hive Philly

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YOGA HIVE Philly's mission is to increase awareness throughout our community of the powerful benefits associated with regular yoga practice. YOGA HIVE Philly offers a warm and welcoming environment to our students, allowing them to learn yoga at their own pace and feel comfortable on their yoga journey. At The Hive, we welcome beginners and first-timers, while also offering a variety of challenging classes for the more experienced yogi. The Hive offers something for everyone; our classes range in difficulty and are always updating and expanding to accommodate your practice.

Yoga has no end: we will never be perfect yogis and there is always room for continuous improvement and progress. The practice of yoga has always represented hope, transition, and growth. The benefits of yoga are boundless and the possibilities of practice are endless. At YOGA HIVE Philly, our founders know first hand the transformative power of regular yoga practice. Welcome to your healing journey!

1914 E. Passyunk Ave
Philadelphia, PA

Endometriosis: Everything You Need to Know

By: Reproductive Medical Associates

If you don't have endometriosis, you've probably heard of it – it affects about one in ten women of reproductive age. Although the condition's two main symptoms are pelvic pain and infertility, both are treatable, and women with endometriosis often go on to have healthy pregnancies.

If you are having pelvic pain or trouble getting pregnant then you should schedule an appointment with your practitioner and we can refer you, if necessary, to a specialist.

What is endometriosis?

Endometriosis is a condition where cells from the endometrial lining implant and grow outside of the uterus (including on the ovaries, the pelvic cavity and the fallopian tubes), causing inflammation and scar tissue that can lead to pelvic pain and infertility.

What are the causes of endometriosis?

There are several potential causes, including:

• Retrograde menstruation: During menstruation, while most of the blood and tissue flows out of the vagina, a small amount of blood and tissue travels up backwards through the uterus and fallopian tubes and into the pelvic cavity. In most women, the immune system gets rid of that blood and tissue. By contrast, the immune system of women with endometriosis is unable to fully eliminate the backflow. Therefore, tissue from the uterine cavity is able to stick to and invade areas outside of the uterus. This is the most common cause of endometriosis.

• Blood or lymphatic system spread: endometrial cells can spread to other parts of the body (the pelvic cavity in particular) through blood.

• Coelomic Metaplasia: in this case, cells in other parts of the body unrelated to the uterus turn into endometrial cells.

What are the symptoms?

Pelvic masses, pelvic pain and infertility are the main symptoms of endometriosis. All of them can be treated, but not necessarily at the same time. In some cases, women with endometriosis have no symptoms at all and are diagnosed only after they seek a reproductive endocrinologist's help in getting pregnant.

How is the condition diagnosed?

While checking for symptoms and performing a physical exam is an important first step, the only real way to diagnose endometriosis is through a biopsy obtained during surgery. There is no blood test for endometriosis.

How is endometriosis treated?

When treating endometriosis, it is important to first identify whether a patient is mainly concerned with addressing her pain or treating infertility. It is not always possible to simultaneously relieve a patient's pain and also help her to become pregnant. If a woman is not looking to conceive and just wants to alleviate her pain, over the counter pain killers like Advil or Motrin, as well as hormonal treatments like birth control pills or the Mirena IUD, can help.

Patients whose main concern is pregnancy will likely require treatment with fertility medications and either artificial insemination or in vitro fertilization (IVF). IVF is the most effective treatment for infertility in patients with endometriosis because it bypasses pelvic scar tissue and enables the sperm and egg to meet in a controlled environment. However, even in IVF, women with endometriosis have slightly lower pregnancy rates than other individuals with infertility.

So I can get pregnant if I have endometriosis?

Yes, you read that right! You might need a little help through IVF, but you can get pregnant.

Mammograms: What to Know Before You Go

By: Allison Andrews, WHNP

At what age should I get my first Mammogram?

Women with an average risk of breast cancer should undergo regular, annual screening mammography beginning at age 45 years, with women having an opportunity to choose to begin annual screening as early as age 40; women 55 years and older should transition to screening every other year.

What is a Mammogram?

A mammogram is a form of radiology imaging that is used to find changes in breast tissue. Conventional digital imaging typically gives the radiologist one look at overlapping breast tissues, but 3D mammography tomosynthesis takes pictures of the breast from all different angels providing a clear, accurate view.

Always let your provider or technologist know if you have any breast changes or concerns. Also, review any medical history that could affect your breast cancer risk such as; surgery, hormone use, breast cancer in your family, or if you have had breast cancer before.

Before getting any type of imaging, it is important to tell your technologist if you are breastfeeding or if you think you might be pregnant.

Where do I go for a mammogram?

It is important to find a clinic that specializes in mammograms as they meet FDA standards of health and safety. You want to try and go to the same facility every time so that your mammograms can easily be compared from year to year. If you need to switch facilities, bring a list of the places and dates of previous mammograms, biopsies or consultations.

What to wear during a mammogram?

Arrive at your appointment wearing a two-piece outfit, as you will have to remove your shirt for the exam. Do not apply any deodorants, powder, ointment, or lotions the day of your mammogram.

What to expect during a mammogram?

You will have to undress above the waist to get a mammogram and you will be given a wrap to wear. A technologist will position your breasts for the mammogram. To get a high quality pictures, your breast must be flattened between two plates. The whole procedure takes about twenty minutes, the actual compression only lasts for a few seconds. Most women feel discomfort when your breasts are compressed, and for some women it can be painful. It is important to tell your technologist if you are in a lot of pain.

What to expect if I need a diagnostic mammogram?

First it is important to note that a diagnostic mammogram is often done if a woman has breast changes/concerns or if a change is seen on a routine mammogram. During a diagnostic mammogram more pictures are taken with a focus on the area of concern. Your images are then immediately reviewed by the radiologist so that more imaging or consultations can be done if needed.

How will I get my mammogram results?

A full report of the results of your mammogram will be sent to your health care provider as well as mailed to all women. If you have any questions about your mammogram, please do not hesitate to call or schedule an appointment.

What Will It Be, City Or Country?

By: Dr. Maria Mazzotti

Even though I am a city girl at heart, I have to admit there are some good things about living in the country.  I grew up in the suburbs (my parents hated the city) and once I went to college in the city, I never left.  The biggest thing I miss is sitting outside in the summer, staring up at the sky and listening to the sounds of nature.  But this isn’t about me - so I would like to present the pros and cons of city vs suburban living.

City life provides more options for anything you need at a moment’s notice. This can be a great thing, unless you have a hard time making decisions.  The city offers multiple choices for essential things like different health systems as well as less important things that only seem essential like coffee shops.  Sometimes finding alternative foods when you have food allergies/sensitivities may be more cumbersome in the country - while it is easier to find local produce in the country. However you may be lucky enough to have access to an open market in the city where you can get locally grown products.  

The landscape of where you live does not discriminate on the types of sicknesses you can catch. Believe it or not, you can still get Lyme disease in a city.  On the other hand, if you need medication or help from a neighbor, these things are more accessible in the city.  Frequently there are fewer choices for medical specialists in the country and patients may need to travel further to get better care.  Equally you can spend a lot of time in a car travelling from one point of the city to another or from one town to the next.  Pick your poison.

Typically the city offers more resources in every category - whether you are considering a psychotherapist, yoga studio or the best French bakery.  Often times the hours are more flexible/longer in a city which makes it more accommodating for working people.  But sometimes, because people are more likely to know each other better in the country, people may be more likely to be to help out.  Have you ever tried stopping someone in the city to ask for help or ask a question?

One big advantage to living in the country would be larger living spaces and more green space.  This allows for kids, adults, pets and dogs to roam around.  Generally the trend is that you get more bang for your buck when it comes to housing.  The space that the country provides creates a lot of possibilities for your property, like a pool! Who doesn’t love that in the summer?

There are more employment options in the city, but often times the employer is more likely to be larger in size which has its own set of pros and cons.  On the flip side, sometimes in a smaller entity, it may be easier to communicate and achieve your task.  You can get lost in a large group, but smaller employment groups may be stifling.  

The city comes with a lot of action. Entertainment, culture and groundbreaking events are more likely to occur in the city.  For someone that does not like crowds, traffic or noise, the city may not be for them.  Violence tends to be more prominent in cities. Some upkeep is questionable -  having tripped and fractured my elbow three years ago, I would always be aware of uneven payments when walking around on any side walk, especially in Philadelphia.  

With more cars, buses and trucks come more pollution.  When it is windy/cold the city may be a few degrees warmer and less likely to have roads covered in snow.  Smaller city streets make it harder to clear away snow when there is a large accumulation.  Parking can be a challenge in the city.  City dwellers do tend to walk a lot in comparison to people living in the county, but at times whether it is for work or a consequence of where someone is living, people in the country may need to walk more to get somewhere on their property or to get to work if they do not own a car.  

It is difficult deciding where to live when you are just taking yourself into consideration and the variables grow exponentially when making the right decision for a spouse or family.  There are a lot of things to consider when choosing where to call home. Some are lucky enough to live close to the comforts of a city with the positive attributes of residing in the country.  The best option is what fits best for the individual or family. 

Signs You Are Overworking Yourself

By: Dr. Rupa Natarajan

It's summer, the weather is (mostly) beautiful, but you're too tired or stressed out to enjoy it. Sound familiar? Fatigue that is unremitting, mood swings or depressed/anxious mood, changes in appetite, and feelings of detachment can all be signs that you are working too hard, and on the pathway to burnout. Other symptoms can include memory and concentration impairment, dizziness, frequent illnesses (or an illness that persists), palpitations, headaches, chest pain, gastrointestinal distress, labile/angry mood, and lack of productivity/motivation. If you have the above symptoms, it is important to get checked out by your medical provider, but you may also need to reconsider whether or not you are overburdened by demands of work and home.
Why does this matter? Long term stress and burnout (which is now recognized as a medical condition) can put you at risk of increased health problems, such as obesity or malnutrition, anxiety, depression, heart disease, chronic insomnia, and digestive problems, to name a few! Burnout is not just due to working too hard or too many hours. It can happen when the demands of your job/day overwhelm your body's capacity to handle stress.

Why does this happen? When your body initially encounters a stressful event, your senses send signals to a part of your brain called the amygdala, which plays a role in processing of memory, emotions, and decision making. A condition called "amygdala hijack" can occur in times of increased stress, where your amygdala is constantly activated rather than calmed by your prefrontal cortex, causing a cascade of biochemical triggers that lead to the release of stress hormones cortisol and adrenaline (fight or flight response). Instead of your body regulating its response to stress, it learns to exist in a hyper stressful state, putting your overall health at risk. In studies, individuals who identified as burned out were noted to have enlarged amygdalae, demonstrating that chronic stress leaves a mark on your brain and can restructure how you cognitively function.

Can this be reversed? Early evidence suggests yes, but the best treatment is always prevention. Make sure you try to take time out for yourself whenever possible- whether it is healthy habits such as yoga, cardiovascular exercise, meditation, and eating fresh fruits/vegetables. If you cannot reduce your work hours, mitigating your stress at work and concentrating on the parts of your job that bring you pleasure (or looking for a new job) can be helpful. Speaking to a therapist, or to a career coach can also be ways you take time out for yourself and recharge. Aiming for a regular routine or sleep pattern nightly can be helpful, and exercise/meditation/decreased caffeine intake can support this as well.
We look forward to supporting you on your journey to health, and encourage you to talk to your provider more at your next visit about ways to reduce burnout.

Understanding Infertility: Polycystic Ovary Syndrome (PCOS)

When it comes to female infertility, one of the most common causes is polycystic ovary syndrome (PCOS), which can prevent women from ovulating. The good news is that there are ways to spur ovulation in women with PCOS, and achieve a healthy pregnancy and baby.

Dr. Jackie Gutmann, a reproductive endocrinologist at Reproductive Medicine Associates of Philadelphia and Central Pennsylvania, see patients with PCOS and helps them start their families. She answered some of our questions about PCOS.

What is PCOS?
Reproductive hormones are abnormally regulated in women with PCOS. In a perfect world, the hypothalamus, pituitary gland and ovaries all work together each month to grow follicles, stimulate one of them and release one egg from that stimulated follicle. In women with PCOS, several follicles are stimulated but none mature enough to ovulate, so there is no release of an egg and no chance to get pregnant.

Why do some women get PCOS and others don't?
We know genetics play a large role in who develops PCOS – first degree relatives of women with PCOS (mothers and sisters) have up to a 30-50 percent chance of developing the condition. There are also others theories about the cause of PCOS, such as the effect of the in-utero environment on the risk of developing PCOS later in life.

What are the symptoms of PCOS?
• Irregular periods or a loss of menstruation entirely
• Acne and abnormal hair growth (on the face, chest, or abdomen)
• Obesity, difficulty losing or maintaining weight, and type 2 diabetes
• Infertility
• Anxiety, depression and eating disorders

How is PCOS diagnosed?
Because irregular cycles are a common symptom of PCOS, a doctor will ask about a woman's menstrual cycle history and look for symptoms like acne, hair growth or difficulty losing weight. During a physical exam, the woman's vital signs, including height, weight and a calculation of Body Mass Index (BMI) are important to determine. A transvaginal ultrasound will help doctors see whether the patient has ovarian features of PCOS. Then, the doctor will take blood tests to examine her levels of FSH, LH, estrogen, testosterone, AMH and to screen for insulin resistance.

How is PCOS treated in women who want to conceive?
The first line of treatment for women with PCOS is lifestyle modification. Modest weight loss and increase in lean muscle mass can have huge impacts on the abnormal hormone regulation seen in women with PCOS. For many women trying to conceive, medications are needed. The goal of treatment is to correct ovulation. A woman may be prescribed Clomid, an ovulation inducing medication that indirectly promotes the production of FSH and the growth and release of a mature egg. Another medication commonly used to induce ovulation in women with PCOS is Letrozole. After ovulation is induced with Clomid or Letrozole, the doctor may recommend timed intercourse or intrauterine insemination (IUI). In vitro fertilization (IVF) is another excellent treatment for women with PCOS and has superior success rates.

The Importance Of Breastfeeding Around The World

By: Dana Shanis, MD

Breastfeeding has many benefits to both mother and child, benefits that have been well studied and consistently shown for decades. Babies who are breastfed have lower rates of respiratory illnesses, gastrointestinal and ear infections, as well as lower rates of allergies, SIDS, diabetes and many other illnesses that can impact their life-long health. Breastfeeding mothers also experience health benefits, from decreased postpartum bleeding and depression to long term decreases in diabetes and breast cancer.

While infant formula has been improved over the years and offers an alternative for women who are unable or choose not to breastfeed, even in the best circumstances it has disadvantages. Formula is expensive and can cost families several thousand dollars a year in direct costs. Increased illnesses in formula fed babies also result in higher healthcare costs and loss of wages for parents who have to miss work to take care of their child. By increasing breastfeeding to optimal rates in the US, up to $13 billion a year could be saved on these indirect costs, according to analyses by the U.S. Department of Agriculture, Food Assistance and Nutrition Research. As a result of the importance of health and economic benefits, the American Academy of Pediatrics urges that breastfeeding be viewed as "a public health issue and not only a lifestyle choice".

The impact of formula feeding on poor and developing countries can be even more profound than what is seen in the United States. Many women in these countries are malnourished and falsely believe they would be unable to produce milk with adequate nutrition for their children. Aggressive marketing by the formula industry, a multi-billion dollar industry, often focuses on poor areas and promotes this and other inaccurate information about the benefits of formula. This misinformation can be particularly dangerous as many of these women do not have access to clean water to mix with the formula, resulting in higher rates of water-borne illnesses in these areas. Due to the high cost, many women end up diluting the formula to extend its use, which also results in higher rates of illness and even death. A 2016 series in The Lancet journal estimated that worldwide 800,000 formula-fed infants a year could be saved by breastfeeding, mostly due to reducing rates of diarrhea, respiratory infections and malnutrition from formula dilution.

In 1981, the World Health Organization voted 118 to 1 adopt a non-binding resolution promoting the dissemination of accurate information on breastfeeding worldwide, as well as restrictions on inaccurate formula advertising and direct marketing and kickbacks to health providers. 130 countries have adopted the ban on the promotion of formula, and in countries where these laws are enforced, such as Brazil, the rates of breastfeeding are typically higher than those that do not. During the World Health Assembly (WHA) each year, this resolution has been reaffirmed and in 2016, the United States, under Obama, supported strengthening the resolution. Despite these efforts, in the past year alone, more than 800 violations of these practices have been noted by formula companies around the world. Funding for formula industry lobbyists has also remained high, with one company, Abbott Pharmaceuticals (makers of Similac and other formulas), spending more than $790,000 on lobbying efforts, including contributions to President Trump’s inauguration ceremonies. In the most recent WHA, our president sided with the formula industry in trying to oppose the existing regulations that would limit the negative effects of inaccurate formula advertising and direct marketing to healthcare providers. The US administration went as far as threatening the US contribution to funding for WHO to oppose this resolution.

Whether or not to breastfeed is a decision that each woman needs to make for herself and her family. Providing accurate information on options, as well as support for the challenges that new mothers will experience is the best way to optimize the health of future generations.

Infertility FAQ

An article from RMA Philadelphia

What is infertility?

Infertility is defined as the inability to get pregnant after six months of trying for women aged 35 or older and after one year of trying for women under the age of 35. Women who have been pregnant previously and have been trying for six months also fall into this category.

When is it time to see a doctor?

If the above definition of infertility describes your situation, it may be time to see a reproductive endocrinologist. Women with a history of irregular periods, endometriosis, pelvic surgery or infection, as well as previous radiation or chemotherapy should not wait 6-12 months prior to seeking care from a fertility specialist. In addition, men with a history of testicular cancer, radiation or chemotherapy, as well as other medical conditions, should seek evaluation.

What happens at that first patient visit?

You’ll meet with your reproductive endocrinologist, who will ask about your medical and family history, as well as how long you’ve been trying to conceive.

The doctor will perform a pelvic exam and vaginal ultrasound to evaluate your uterus and ovaries, and tell you about additional testing, such as blood work, a semen analysis and a procedure to assess your fallopian tubes.

If you decide to pursue evaluation, you can have your testing completed within four weeks of your first visit, at which point you will meet with your doctor again to design a plan for you.

That plan could include using medication to boost ovulation coupled with Intrauterine Insemination (IUI) or require a more high-tech approach like In Vitro Fertilization (IVF).

Are my chances of getting pregnant good?

It depends on your age, your specific situation and the clinic you choose, but women can feel confident going to a successful fertility clinic, especially because major advances in technology and science have improved success rates and lessened risk.

I’m seeing older celebrities getting pregnant – why should I worry?

While doctors are getting better at helping infertile women get pregnant, the time on the biological clock has not changed: at 35 years of age, a woman’s fertility begins to significantly decline, and it gets harder to get pregnant. The risk of miscarriage also increases. So while celebrities are having babies at an older age, it’s unclear whether those babies came from eggs or embryos that they froze when they were younger, or from donor eggs. While it is possible for women in their 40s to conceive naturally or through IVF using their own eggs, is it is uncommon.

I’m ready to talk to a specialist now. What’s next?

Congratulations on taking a proactive step to begin your family. The doctors at Reproductive Medicine Associates of Philadelphia are here to help. Begin your fertility journey by making an appointment today: 855.762.4672 or visit


What is the difference between ThermiVa and O-Shot?

By: Allison Andrews, WHNP

What is the ThermiVa®?

ThermiVa® is a non-surgical, safe and effective procedure that uses radiofrequency heat to tighten loose, sagging skin and increase blood flow and nerve sensitivity in the vaginal area. 

What are the benefits of the ThermiVa®?

Ø  Vaginal and labial laxity 

Ø  Vaginal dryness

Ø  Urinary incontinence and overactive bladder

Ø  Painful sex 

How is it performed?
During the procedure, a small wand is slowly moved over the areas of concern, gradually heating the tissue.  The procedure takes less than an hour, during which most women report feeling only a warm sensation and no pain.  There is no down time once completed, women can return to exercise and sexual activity immediately. 

What is the O-Shot®?
The O-Shot® is a non-surgical, minimally invasive procedure that can help improve a woman’s sexual desire and orgasm, decrease urinary incontinence and treat a chronic skin condition called lichen sclerosus.   Up to half of women experience low sexual desire and many others experience issues with arousal, lubrication and orgasm.  The O-Shot® uses platelet-rich plasma (PRP) that contains growth factors from the woman’s own blood, and is injected into the clitoris and vaginal wall.  This increases the blood flow, nerve sensitivity and collagen formation in the area, leading to improved sexual function.

What are the benefits of the O-Shot®?
This injection can increase a woman’s sexual desire and arousal, as well as improve the number or quality of her orgasms.  In addition, this procedure can help with

Ø  Leaking urine

Ø  Painful sex

Ø  Vaginal dryness

Ø  Decrease symptoms and long-term consequences of lichen sclerosus

How is it performed?

Blood is drawn from the patient and then using a special double-spin process the red blood cells are removed, leaving the plasma which is full of growth factors.  Numbing cream is then placed onto the areas that will be injected, and a lidocaine injection is performed to ensure there is minimal to no discomfort during the procedure.  The PRP is then injected into the clitoris and vaginal wall.  The procedure takes less than an hour.  

If you would like to learn more about these procedures, schedule a consultation with one of our Women’s Health providers.

Hosting a Healthy Independence Day Party

By: Beth Auguste MS, RDN, CSOWM

Summertime is party time. We often associate summertime with beach trips, cookouts, and, less than healthy food and beverage choices. The biggest cookout of all, Independence Day, is quickly approaching. Feel your best this 4th of July by using some of these tips to healthify your holiday:

1. Make burgers with grass fed beef -

Grass fed beef does not increase cholesterol in the same way as traditional grain fed beef. Eating grass fed beef can benefit your body by increasing circulating omega-3 fatty acids (aka good, anti-inflammatory fats), introducing vitamin A and E precursors, and providing cancer fighting antioxidants.

2. Offer options for hydration -

Fruit, fruit and more fruit. Your body gets 20% of it’s hydration from food and fruit is a big source! In addition to sliced watermelon, make a fruit salad with berries and dress it up with lime and honey. Offer a third fruit option in the form of a Fourth of July themed infused water. Fill your punch bowl the day before the party with club soda, strawberries, blueberries and mint leaves and leave overnight to maximize flavor. Lastly, don’t forget to make water generally available, throw some bottles in to your beer and soda coolers.

3. Do the cafeteria trick and put the salad at the front of the buffet-

Food service organizations are good at influencing customer behavior. They put the salad at the front of buffets because they know that patrons will take the largest serving from the first food they encounter. These organizations want to trick you in to filling your plate with the cheapest food item so that they can save money. As a party host, you can use this concept to trick your guests (and yourself) in to eating more of the healthy stuff!

4. Create a space for physical activity -

If you want your guests to have a great time at your party, get them moving. Physical activity after eating can lift endorphins (more energy!) and can help stabilize blood sugar to avoid that ‘crash’ feeling. Set up lawn games or play some dance music to inspire guests to get their bodies in motion.

5. Attending a party as a guest? Be the person who brings the healthy thing-

Don’t worry, somebody else will show up with the chips and dessert. Party goers will thank you for your nutritious addition. Try making a mayo-free Russian style coleslaw with a vinegar base.

There is always an event around the corner that will challenge your healthy diet goals. Don’t wait to get started, just incorporate some healthiness in to the unhealthy fun and it won’t be so hard to get back on track after the party is over

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