EXPERT
Dr. Ban Al-Karaghouli
OB-GYN (Obstetrician-Gynecologist)
- Commerce, MI
- October 6 University – College of Medicine / EGYPT
- Accepting new patients
Intimacy and Menopause: Reclaiming Connection in a New Season of Life
Menopause is often framed as an ending, the final chapter of fertility, a hormonal shutdown, the signal that a woman is aging. But what if we reframed menopause not as a loss,...
Is it safe to have a flu shot while pregnant?
Here is Why It's Safe and Important:
The inactivated flu vaccine (the standard flu shot) is safe during any trimester of pregnancy.
Getting vaccinated helps protect both you and your baby:
Pregnant people are at higher risk for severe flu illness and complications like pneumonia.
The antibodies you develop will also pass to your baby, helping protect them in their first few months of life when they can’t be vaccinated yet.
Be sure to get the injectable flu shot, not the nasal spray (which is a live vaccine and not recommended during pregnancy).
Common side effects are mild and may include arm soreness, fatigue, or low-grade fever, but serious side effects are extremely rare.
Studies show that babies born to people who were vaccinated during pregnancy have lower rates of flu-related hospitalization in the first 6 months of life.
I hope this was helpful! I fully support you getting the flu shot, and you're doing a great job protecting both your health and your baby’s. Please don’t hesitate to reach out if you have any more questions.
birth control and iron supplements
Here’s the short answer:
Iron supplements do not reduce the effectiveness of birth control pills.
You can safely take both together.
Here's what you should know:
Iron (including slow-release forms) is a mineral, not a hormone or enzyme inducer, so it doesn’t interfere with the hormones in birth control pills.
The confusion online usually comes from people wondering about general absorption issues but this is more about when you take the pills, not about effectiveness.
Helpful Tips:
To improve iron absorption, take your supplement:
With vitamin C (like orange juice)
On an empty stomach, if your stomach tolerates it
Avoid taking iron at the exact same time as your birth control if it causes nausea, but that’s more about comfort—not about drug interaction
It’s totally fine to space them out (e.g., birth control in the morning, iron at night)
Bottom Line:
You’re good to go, your iron supplement won’t interfere with your birth control. If you start feeling any side effects (constipation, nausea), you can switch formulations or timing, but there’s no effect on protection.
I hope this was helpful! Please don’t hesitate to reach out anytime.
What vitamin supplements can I take during the third trimester?
Here’s a breakdown of what supplements are typically recommended in the third trimester, in addition to your daily prenatal vitamin:
Core Supplements (Usually Included in a Good Prenatal Vitamin):
Folic Acid (400–800 mcg/day)
Still important in the third trimester to support red blood cell production and reduce risk of anemia.
Iron (27–60 mg/day)
Often increased in the third trimester to prevent or treat anemia. Many women need additional iron at this stage, especially if they’re fatigued or have low hemoglobin.
Calcium (1000–1300 mg/day)
Helps with fetal bone development and prevents your body from pulling calcium from your bones.
Take calcium separately from iron, since they compete for absorption.
Vitamin D3 (600–2000 IU/day)
Supports calcium absorption and fetal bone and immune system development. Many women benefit from extra Vitamin D, especially if they have limited sun exposure.
DHA (Omega-3 fatty acids) – 200–300 mg/day
Important for baby’s brain and eye development. Not all prenatal vitamins include DHA, so check your label. If not included, a separate fish oil or algae-based supplement is often recommended.
Optional or Situational Supplements
Magnesium – for leg cramps or sleep support
Vitamin B6 – can help with nausea or fatigue
Probiotics – may support digestion and gut health, especially if you’re taking iron
Fiber supplements (like psyllium or Benefiber) – if you’re struggling with constipation
What to Avoid:
High-dose Vitamin A (especially retinol form)
Herbal supplements unless cleared by your OB (some are unsafe in pregnancy)
Always choose third-party tested supplements and run any new products by your OB-GYN or midwife to ensure they fit your specific needs.
I hope this information was helpful. I wish you the best. Please don’t hesitate to reach out anytime!
What foods to avoid when breastfeeding?
In general, you don’t need to follow a highly restrictive diet while nursing, but there are a few foods and substances to watch or limit because they can affect your baby through breast milk or impact your own comfort.
Foods & Substances to Limit or Avoid While Breastfeeding:
1. Alcohol
Occasional, moderate alcohol is okay with timing—wait at least 2–3 hours per drink before nursing.
No need to “pump and dump” unless you're nursing sooner than that.
If you feel sober, your milk is likely clear of alcohol.
2. Caffeine (Coffee, Tea, Soda, Chocolate)
Safe in moderation—limit to ~300 mg/day (about 2–3 small cups of coffee).
Too much can lead to fussiness or poor sleep in sensitive babies.
3. High-mercury fish
Avoid fish like shark, swordfish, king mackerel, and tilefish.
Opt for low-mercury options like salmon, sardines, cod, and shrimp—great for omega-3s!
4. Certain herbal supplements or teas
Herbs like fenugreek, licorice root, and ginseng may affect milk supply or baby’s digestion.
Always check with your provider before using herbal products.
5. Highly processed or spicy foods (only if baby reacts)
Some babies are sensitive to spicy, gas-producing, or acidic foods (like cabbage, onions, tomatoes), but most are not.
There's no need to avoid these preemptively only if you notice a pattern of fussiness or gas after certain meals.
6. Allergens (only in special cases)
Dairy, soy, or eggs can rarely cause reactions (eczema, blood in stool, colic) in sensitive babies.
Only consider an elimination diet under provider guidance if your baby has symptoms.
What to Focus On Instead:
Stay hydrated , drink to thirst, especially during and after nursing.
Eat a balanced, nutrient-dense diet: protein, whole grains, healthy fats, fruits, and veggies.
Consider continuing your prenatal vitamin or switching to a postnatal supplement while breastfeeding.
Bottom Line:
There’s no perfect “breastfeeding diet”, and most foods are safe unless your baby reacts to something. Enjoy a varied, healthy diet, keep an eye on baby’s cues, and don’t stress over occasional indulgences.
I hope this was helpful. I wish you and your baby the best—please don’t hesitate to reach out anytime!
Could I be pregnant?
Can You Get Pregnant From Sperm on the Thigh or Clothing?
No — pregnancy cannot occur from sperm on the outer thigh, bikini line, or clothing like shorts, especially if:
There was no direct genital-to-genital contact
There was no penetration
The semen was on clothing, not inside the vagina
Even if there was semen near the vaginal area, sperm cannot travel through clothing or from skin to the vagina in this scenario.
What About the Period You Got Afterward?
If you had a normal period, that’s the most reliable sign that you’re not pregnant
Implantation bleeding, which some people confuse with a period, is usually:
Light spotting (not a full flow)
Lasts 1–2 days at most
Occurs around 6–12 days after actual intercourse (not just contact)
What About the Weird Dreams or Symptoms?
Anxiety and stress (especially around fear of pregnancy) can trigger vivid dreams, changes in sleep, and even mild physical symptoms like nausea or fatigue
These are not reliable indicators of pregnancy without actual risk or a missed period
Bottom Line:
From what you described — no penetration, sperm only on your shorts/thigh, period afterward — there is no realistic chance of pregnancy.
You're doing the right thing by asking and being careful. If you're ever unsure or feeling anxious regularly after these types of encounters, it might be worth talking to a healthcare provider about birth control options or how to feel more in control during intimate situations.
Would you like a simple guide on what does and doesn’t pose a pregnancy risk?
What vitamins to avoid during the second trimester?
Vitamins & Supplements to Avoid or Limit in the Second Trimester
1. Vitamin A (Retinol) – in high doses
Why: High doses of preformed vitamin A (retinol, found in some acne treatments and liver supplements) can be teratogenic (cause birth defects).
Safe form: Beta-carotene (the plant-based version) is safe; most prenatals use this.
Limit: Avoid more than 10,000 IU (3,000 mcg RAE) of vitamin A daily from all sources.
2. Vitamin E (in large doses)
Why: Some studies suggest high-dose vitamin E may be associated with increased risk of abdominal pain and premature rupture of membranes.
Limit: Stick to what’s in your prenatal unless your provider specifically recommends more.
3. Herbal supplements or "natural" vitamins not studied in pregnancy
Why: Many herbal products (like dong quai, black cohosh, ginseng, or vitex) can interfere with hormones or uterine function.
Caution: Always ask your provider before starting any herbal or non-standard supplements.
4. High-dose Iron (unless prescribed)
Why: Too much iron can cause constipation, nausea, and interfere with absorption of other nutrients.
Note: Most prenatals have the right amount (27 mg); don’t add more unless you're anemic and your doctor recommends it.
5. Vitamin B6/B12 in megadoses
Why: While B6 is often used for nausea, very high doses (>100 mg/day) can cause nerve problems. B12 is generally safe, but don’t exceed mega-doses without supervision.
What You Should Be Taking in the Second Trimester:
A high-quality prenatal vitamin with:
Folate (L-methylfolate or folic acid) – 400–800 mcg
Iron – ~27 mg
Calcium + magnesium – for bone and muscle support
Vitamin D3 – 1000–2000 IU daily
DHA (omega-3) – 200–300 mg for fetal brain and eye development
Choline – ideally 250–350 mg/day for neural development (may need separate supplement)
Pregnancy
Can You Get Pregnant From What You Described?
Technically, yes — there is a small chance of pregnancy, though it’s lower than with intercourse or ejaculation inside the vagina, but it’s not zero.
Here’s why:
Sperm can survive up to 5 days in the female reproductive tract if conditions are right (like during ovulation).
If semen was transferred directly from your fingers into the vagina, motile sperm could still reach the cervix.
If this happened 3 days before ovulation, that's within the fertile window — which increases the chance of pregnancy.
What About the Pinkish Ovulation Discharge?
Light pink or clear discharge with a pink tinge around ovulation is common and usually due to a brief drop in estrogen — not a sign of pregnancy or a problem.
So it’s not necessarily a red flag, and could just mean your body’s doing what it should.
What Should You Do Now?
You can take a pregnancy test around 10–14 days after ovulation if your period doesn’t come as expected.
If you’re not ready for pregnancy and don’t want to worry about “what if” situations, this could be a good time to talk about birth control options that feel right for you.
Bottom Line:
There is a small chance of pregnancy from what you described — but it’s not the most efficient way for sperm to reach the egg.
If you’re ovulating and the semen was fresh, it’s possible.
It’s completely fair to feel anxious — you’re not overreacting by asking.
Are there any imaging procedures that are safe for me and my baby?
Here’s a breakdown of what’s safe and when:
Safe Imaging Procedures During Pregnancy:
1. Ultrasound (US)
Safest and most commonly used imaging during pregnancy.
No radiation — uses sound waves.
Used to check baby’s growth, placenta, cervix, and sometimes maternal organs (kidneys, gallbladder, etc.)
2. MRI (Magnetic Resonance Imaging)
Also very safe in pregnancy — no radiation.
Especially helpful for evaluating soft tissues, spine, brain, abdomen, or pelvis in the mother.
MRI without contrast (no gadolinium) is preferred unless absolutely necessary.
Imaging That Uses Radiation (Use with Caution):
X-rays
Can be done safely if needed (especially extremities like arms or teeth).
Shielding the abdomen is essential.
Used only when the benefit outweighs the small risk.
CT Scans
Not the first choice, but may be used in urgent situations (like for appendicitis, trauma, or blood clots).
Uses more radiation, so providers weigh risks carefully.
CT of the chest or head exposes the baby to very little radiation.
Important Tips:
Always tell imaging staff you’re pregnant
Your doctor will choose the lowest-risk method that still gives the info needed
Don’t delay important imaging if it’s needed — the risk of missing a diagnosis is often higher than the imaging risk itself