Pain that starts 1 to 3 days before your period, peaks 24 hours after the onset of your period and subsides in 2 to 3 days Dull, continuous ache Pain that radiates to your lower back and thighs Some women also have: Nausea Loose stools Headache Dizziness When to see a doctor See your health care provider if: For many people, heavy bleeding during periods is associated with abdominal pain. Pelvic pain and cramping may begin before and extend several days into a menstrual period. This type of pain is most common in postmenopausal women and is experienced as tenderness, burning or pressure, usually affecting both breasts. Aim for at least150 minutes of exercise weeklyor 30 minutes each day of the week. Accessed April 1, 2020. bloody urine (particularly during menstruation). Jacobsen. A person should also see a healthcare provider about any of the following: The following home care strategies may help ease mild period symptoms: Some people track symptoms throughout their cycle, in a journal, for example. Endometriosis classification - The quest for the holy grail? The pain may be moderate or severe, and affects both breasts. Symptoms of sternum pain vary depending on the cause. (1999). If your problem is just with your actual sternum, you may feel better with rest, gentle stretching, and anti-inflammatory medications. If the pain is severe, you may need a steroid injection. During this period, doctors observe if there is any chest pain. Your doctor will check you regularly to see whether symptoms develop. There are 2 main types of mastalgia: Cyclical breast pain. Your diaphragm is the dome-shaped muscle beneath your lungs that helps you breathe. Mild episodes of chest pain resulting from heartburn, indigestion or physical changes can be brought under control by. The pain in the upper right abdominal quadrant lasts about three days, increasing over time and to a point where breathing hurts. Because this condition is so rare, your doctor may not recognize the symptoms either. Premenstrual dysphoric disorder (PMDD) is a much more severe form of premenstrual syndrome (PMS). Ice, over-the-counter pain medications, and, sometimes, prescription pain medications may relieve your sternum pain. Endometriosis of the diaphragm: Four cases treated with a combination of laparoscopy and thoracoscopy. When it happens frequently, it can be a sign of acid reflux. Investigate herbal treatments. other information we have about you. Pushing or pressure on the sternum is painful. Unfortunately, its not uncommon for women to get chest pains. It can be intense, and it may get worse when you breathe or cough. Many conditions can cause pain in the sternum, including injuries, pneumonia, bronchitis, and costochondritis. Dizziness and Headaches. Healthline Media does not provide medical advice, diagnosis, or treatment. Costochondritis is sometimes known as chest wall pain syndrome, costosternal syndrome or costosternal chondrodynia. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Atypical vs. typical chest pain: What are the differences? We look at the symptoms and treatment options. Mayo Clinic does not endorse companies or products. If you have costochondritis or a muscle strain, ask your doctor how long your symptoms might last, and how you can manage your symptoms. Heart attack-related chest pain tends to come on suddenly and doesnt go away on its own and as you can see from above, heart attacks can affect far more than your chest. (2016). A hormone called prostaglandin triggers muscle contractions in your . A person may experience costochondritis due to: Like fractures in other parts of the body, sternum fractures can cause a lot of pain. People may feel chest pain in different ways, and some do not experience typical symptoms. There is a lot of variability in periods amongst women but for the sake of basic understanding, periods usually start between the ages of 11 and 14 . 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). You may be wondering why your chest is hurting if you have pain on the right side or middle of your chest and whether its a sign of a heart attack. Menstrual cramps that aren't caused by another condition tend to lessen with age and often improve after giving birth. These, collectively, are known as premenstrual syndrome (PMS). This diaphragmatic type makes up only about 1.5 percent of all endometriosis cases. But even if youre unsure, if youre at higher risk for a heart attack, any chest pain deserves immediate attention. Learn. Conditions such as pneumonia, pleurisy and GERD can also cause pain in nearby tissue that people may mistake for sternum pain. "Inflammation can lead to increased cortisol . During your period, prostaglandins primarily stimulate contraction of your uterus resulting in pain in your lower abdomen and back. You should go to the ER immediately if you have any of the following: Pain in the sternum is a complaint where we really need to consider every piece of evidence to feel confident making the right diagnosis. This type of pain may occur, the OWH explain, if the changes in hormone levels due to the menstrual cycle affect chemicals in the brain. However, research has shown that most women experience retrograde menstruation, and yet most women dont develop endometriosis. If you cant afford a trip to the spa, try a hot bath. In costochondritis, the costal cartilage that connects your ribs to your sternum becomes inflamed and creates moderate, localized chest pain. If you suffer from acid reflux, try using over-the-counter antacids containing calcium. Endometriosis is one of the most common reasons women develop adhesions unconnected to a previous surgery. Learn the difference between heartburn, acid reflux, and GERD here. By seeking early care and making positive lifestyle changes, you can improve your health and relieve pain. For example, endometriosis can cause fertility problems. In another study, 90% of women had chest pain, 30% had shortness of breath, and 7% coughed up blood. Sternum or chest bone pain that isnt from a minor injury, Pain radiating to your arms, jaw, or back, Shortness of breath, nausea, sweating, or, Pain related to a car accident or other traumatic injury, Over-the-counter anti-inflammatory or pain medications, Prescription medications like antibiotics or heart medications. She received her undergraduate degrees in Chemistry and Biology from Macalester College (2006) and graduated from the University of Kansas School of Medicine (2010). For example, a plant-based meal may bring significant relief. She practices community Emergency Medic Community Emergency Medicine Physician, Kansas City, Worsening pain with deep breathing or movement. You shouldnt ignore chest pain. A hiatal hernia occurs when the stomach moves past the diaphragm and into the chest. When endometriosis involves the diaphragm, it usually affects the right side. Certain foods and drinks, including spicy or fatty foods, alcohol, and coffee, can trigger heartburn. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. They will probably do a chest X-ray and an electrocardiogram (EKG), which will be normal if it's costochondritis. We obtained hourly information on the onset of symptomatic arrhythmia (including atrial fibrillation, atrial flutter, atrial and ventricular premature beats and supraventricular tachycardia) from the Chinese Cardiovascular Association Database Chest Pain Center (including 2025 . It is also important to note that any mood changes related to regular hormonal shifts can worsen symptoms of existing mental health conditions. In rare cases, it can lead to a collapsed lung. Download scientific diagram | The nomogram model used for discriminating AAS from NSTEMI with chest pain onset at 2 h. D-dimer/(ng/mL) >840 calculated as 840; fibrinogen (g/L) <2 calculated as . PubMedHealth. 760: Dysmenorrhea and endometriosis in the adolescent. (3) About half of women with Crohn's disease (a chronic inflammatory disease of the intestines) report that their bowel symptoms get far worse just before and during their periods(4). You also want to know how to ease your suffering. Try adoptingmindfulness meditation or yoga to break through pain and the build-up of stress. A week or longer each month, starting before a period and sometimes continuing through the menstrual cycle. Engaging in physical activity and meditation to de-stress. All rights reserved. Downloadable! This injury is caused by overuse or repetitive movement, an increase in activity level, or a sudden improper movement. You can learn more about how we ensure our content is accurate and current by reading our. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. Unbearable Period Cramps? All rights reserved. Often the best way to diagnose diaphragmatic endometriosis is with laparoscopy. There is a problem with reaching puberty before age 11. This includes a heart attack, pleurisy (a lung inflammation), and acid reflux. One important clue to watch for: The symptoms of this condition are typically worse around your period. painful or difficult urination. Laparoscopic treatment with laser CO2. However, this also can cause pain. Because this is the area where your torso connects to your arms, this joint works hard. Tylenol (Panadol) - when needed, medicine can provide some relief. Some women experience bloating, while others suffer severe cramps. 2023 Healthline Media UK Ltd, Brighton, UK. Cramping, uterine tenderness, or abdominal pain can also be a sign of placental abruption. Pneumonia can cause sharp chest pains, which a person may feel behind their sternum. . Costochondritis usually has no clear cause. Severe cases may need surgery to create a bypass around the blocked artery. Avoiding spicy foods that may irritate your stomach and throat. When in deep sleep, your muscles (as well as your tongue and other throat muscles) tend to . Smith RP, et al. This can lead to life threatening complications, such as: Having surgery to remove endometriosis within the diaphragm may reduce your risk for these complications. 12% experience chest pain. Abdominal pain along with other symptoms, such as vomiting or diarrhea, might indicate a UTI or a gastrointestinal virus. In men, breast pain is most commonly caused by a condition called "gynecomastia" (guy-nuh-koh-MAS-tee-uh). Endometriosis awareness advocate Casey Berna spent years living with debilitating pain. Since womentend to downplay symptoms, they often go misdiagnosed. The pain associated with costochondritis usually: For chest pain, seek emergency medical attention to rule out life-threatening causes such as a heart attack. Substernal pain is discomfort occurring behind or below the sternum. Usually you feel pain when you push on the sides of your sternum. People with GERD should talk with their doctor about preventing further damage to this area. Had the horrific periods that went 18 days sometimes. We also describe treatment and recovery and provide tips for prevention. Costochondritis occurs most often in women older than 40. Heres what you need to know. Policy. While sternum pain is not usually serious, there are some causes of sternum pain that require immediate medical attention. I've seen a few posts on this but my pain is under rib cage on RHS and it's what I'd describe as a stitch but it's too painful to run or do anything too active. Some people have whats called silent heart attacks, where they dont experience any pain at all. Heart attacks are no joke in the U.S., they happen every 40 seconds, with about 805,000 heart attacks occurring every year. Heartburn is a brief burning pain in your throat, chest, or abdomen that is caused by stomach acid. A study in the Journal of Clinical Rheumatology found that 90% of people over the age of 60 have osteoarthritis in this joint, but not all have symptoms. If you suffer from muscle spasms, try massage or heat therapy. Last medically reviewed on April 1, 2021. Pain can occur in the chest, usually due to stretching the muscles. Chronic shoulder pain and diaphragmatic endometriosis. Menstrual cramps are a natural occurrence, but severe cramps can affect a person's quality of life. https://www.uptodate.com/contents/search. Abd pain no period: Check HCG, may be pregnancy ,gastritis-try ranitidine/prevecid-check for H pylori bacteria causing gastritis, , constipation-drink fluids 2-3 liter/da. Liver disease. If the endometriosis is in both your diaphragm and pelvis, you might need more than one surgery. The stories shared below are not written by Buoy employees. Tips include: Many people come to expect mild discomfort around the time of a period, and specific issues vary from person to person. Accessed April 1, 2020. Some women experience digestive upset with menstruation. Sternum pain can result from problems with muscles and bones near the sternum, as well as the sternum itself. Some people have genetic conditions that cause the sternum to sink into the chest or to jut forward, and this may cause pain. In some instances, the bone may produce cracking noises (sternum pain popping). So, decreased estrogen level and increased progesterone levels can cause heart palpitations. Menorrhagia is heavy or long-lasting menstrual bleeding. Kidney disease. pains in the stomach, side, or abdomen, possibly radiating to the back. If progesterone levels are high, it may affect on other parts of your body resulting in diarrhea, vomiting, nausea . Other conditions that may cause pain near the sternum include: Because these conditions may have overlapping symptoms, many people with pain in the sternum will need to be tested for a heart attack. Chest pain can occur with low blood pressure. Kaveh, M. (2018). Even if doctors determineyou dont have cardiovascular disease, you will at least rule out the possibility. Pushing or pressure on the sternum is painful. if youre at higher risk for a heart attack, Early Signs of a Heart Attack To Take Seriously, 3 Heart Attack Signs Women Shouldnt Ignore. People who are having a heart attack experience specific signs before the heart attack itself, whereas most sternum pain starts suddenly. Injuries or trauma can result in bruising these muscles, which may cause them to ache. Others endure panic attacks due to fluctuations in hormonal levels. Menstrual cramps (dysmenorrhea) are throbbing or cramping pains in the lower abdomen. Elsevier; 2022. https://www.clinicalkey.com. After ovulation and before the start of a period, many women experience a combination of physical and emotional symptoms. For example,if you suffer from acid reflux, hormonal changes during menstruation can increase symptoms. Treatment should begin as soon as possible after symptoms start, so call 9-1-1, if your pain could be heart related. Heartburn can also be caused by a hiatal hernia, which happens when part of the stomach slips through a hole in the diaphragm (the muscle that separates the chest from the abdomen). irregular or slow heart rate. That doesnt necessarily mean theres no cause for alarm, but there are ways to exclude a heart attack if youre not at high risk for having one. You can learn more about how we ensure our content is accurate and current by reading our. Inflammation to these tissues is pleurisy. Stop if your chest discomfort increases with exercise and seek medical attention this could indicate a cardiovascular problem. Rest, ice, and over-the-counter pain medications can relieve muscle strain. A heart attack means the blood flow to your heart has been cut off. (2009). 10% experience pain and/or bleeding during or after sexual intercourse. Some people experience no symptoms. What is pectus carinatum and can it be treated? Dysmenorrhea. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. In the U.S., heart disease remains the number one killer of women. Can diet help improve depression symptoms? Because costochondritis feels so much like more serious causes of sternum pain, you should see a doctor. (2006). Buoy does not endorse any of the information in these stories. (2018). Some of the most common causes of sternum and substernal pain are: Costochondritis is inflammation of the cartilage between the sternum and ribs. Hormonal treatments include: Your doctor may also recommend over-the-counter (OTC) or prescription nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) or naproxen (Aleve), to manage pain. Pain caused by costochondritis might mimic that of a heart attack or other heart conditions. I too am experiencing gall bladder symptoms during my period. Heavy bleeding Period blood volume varies from woman to woman. 2. When the sphincter doesnt close tightly or opens too frequently, stomach acid or food can travel out of the stomach back into the esophagus. DOI: ncbi.nlm.nih.gov/pmc/articles/PMC6018178/#B1, ncbi.nlm.nih.gov/pmc/articles/PMC4842236/, What to Eat and What to Avoid If You Have Endometriosis. Subscribers get even more tailored tips and deets delivered directly to their inboxes! Many conditions can cause pain in the sternum, including injuries, pneumonia, bronchitis, and costochondritis. This type of endometriosis may not cause symptoms. Heres what you need to know about chest pains and how to relieve your agony. You should never put too much value into location because you could lose functioning heart muscle the longer you wait to figure out whats causing your pain.. Small samples of tissue, called biopsies, are usually collected and sent to the lab so they can be examined under a microscope. This can help a person learn what to expect, plan accordingly, and spot any abnormalities. In: Essentials of Physical Medicine and Rehabilitation. MNT is the registered trade mark of Healthline Media. Symptoms of a hiatal hernia include: People with substernal pain and symptoms of a hiatal hernia should see a doctor for prompt treatment. This pain usually occurs around the time of your period. DOI: Rousset P, et al. It causes a wide range of symptoms before and sometimes during a period, which may include dizziness . Aloe vera gel - can provide some relief, especially if you keep it in the fridge. This content does not have an Arabic version. Breast/chest pain is a common premenstrual symptom, typically occurring in the 5-10 days before the start of your period. Nezhat C, et al. Pain behind the sternum (retrosternal pain) is often associated with cardiac conditions, however, the more common causes are related to acid reflux and related gastrointestinal conditions.Rarely, retrosternal pain may be a consequence of referred pain from neighboring structures, especially those in the abdominal cavity as is seen with gastritis, peptic ulcer, gallstones . But if there are other issues, you might need prescription medications, joint injections, or surgery. If its painful or causes complications, you can have surgery to remove the tissue. Stay hydrated - drink water regularly. It is caused by a blood clot that travels from a fatty buildup (plaque), inside the artery. You can also modify your diet to calm acid. 5. You can learn more about how we ensure our content is accurate and current by reading our. Due to the direct connection between the two structures, injuries to the collarbone may cause pain in the sternum area. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider. Oftentimes, its an unrelenting intense pressure or heaviness and not a distinct pain.. However, a hiatal hernia can affect the chest area and cause substernal pain. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. Pelvic inflammatory disease (PID). The pain may extend to the upper and outer portions of the breast, the armpit, and the arm. COVID-19: Check your symptoms and find the right care. Tested for covid lots of times. You shouldn't ignore chest pain. According to the Centers for Disease Control and Prevention (CDC), people have heavy bleeding if they: have a period that lasts longer. Up to 50 percent of people with endometriosis experience difficulties getting pregnant. Lower your stress level by exercising, soaking in a tub, or doing simple breathing exercises. Smith RP, et al. It can then contribute to period pain, which means that cramps occurs in the uterus With our breathing we can either enhance or reduce the pain. Last medically reviewed on June 30, 2020, Menstruation is a natural effect of the production of an egg in the ovaries. Although there is no cure, various treatments can manage the symptoms and help prevent migraine episodes. They mayperform a D-Dimer testto rule out a blood clot, or a CAT scan to check your lungs. However, in case of persistent pain in sternum bone, contact your doctor immediately. Answer It is most likely that the pain you are experiencing is related to muscles in your chest wall. It happens as you age, but it might occur earlier if you had a previous injury in that area. Costochondritis is inflammation of the cartilage that links your ribs to your sternum. Periods can cause uncomfortable symptoms such as cramps, mood changes, and breast tenderness. Pain in the chest can cause anxiety. You can find relief with hormone-replacement therapy if you suffer from this type of chest pain, but it requires monitoring by a physician. Spotting, or any vaginal bleeding between periods, could indicate a condition such as: In rare cases, vaginal bleeding between periods or after menopause could be a sign of uterine, cervical, or ovarian cancer. Collarbone trauma may affect its connection to the sternum and the surrounding musculature. Costochondritis most commonly affects the upper ribs on the left-hand side of your body. Accessed Jan. 20, 2022. 2023 Body + Mind Magazine, All rights reserved. Here are possible reasons you feel dizzy spell during your period. Heavy menstrual bleeding is a symptom associated with various conditions, including bleeding disorders and non-bleeding disorders. When Aunt Flo flies in for her monthly visit, you expect certain symptoms. You can have pain in this area because of infection, inflammation, injury, or the breakdown of cartilage affecting the sternum itself. DOI: Redwine DB. Symptoms Alongside discomfort and stiffness, diaphragmatic endometriosis primarily causes pain, which usually becomes worse at certain times of the menstrual cycle. Anyone with one or more of the 12 symptoms below should speak with a doctor. https://www.uptodate.com/contents/search. Costochondritis. If diarrhea is severe or an unusual period symptom, speak to a doctor. 2023 Healthline Media LLC. But those who do experience pain during a heart attack can feel it anywhere in their chest, typically across an area roughly the size of their fist or larger. In many cases, the cause is unknown, but it is sometimes related to exercise or a recent illness. Chest pain can be caused by more than just heart attacks. The pain may come from the breast. But because the symptoms of chest bone pain are so similar to other causes of chest pain, you might need to have tests to check for heart attack and other serious conditions. "By that time, you'll generally be strong enough to get back to normal activities, such as driving," Dr. Tong says. To provide you with the most relevant and helpful information, and understand which The answer, says cardiologistCurtis Rimmerman, MD, is knowing that your pain is sudden, persistent and not pinpointed to one location. Cyclical pain may worsen during perimenopause, when hormones can surge and drop erratically, and linger into menopause, especially in women who use oral contraceptives or hormone therapy. by . But you might experience pain in these areas: This pain usually occurs around the time of your period. These muscles can become strained or fatigued, usually with exercise but also sometimes just by position during sleep or throughout the day. Your pain gets worse or better when you reposition your body. Menorrhagia is heavy or long-lasting menstrual bleeding. Sign up for our newsletter to get the latest in health and wellness tips. Uterine fibroids are commonly found in a lot of women without any obvious symptoms. Aromatherapy may also help reduce stress, which in turn can minimize your breast pain. Irregular periods can point to an underlying condition, such as: Roughly 4 in 10 females experience a migraine headache at some point, and about half of the time, the headache occurs during a period. Read More Created for people with ongoing healthcare needs but benefits everyone. Seatbelts save lives in car accidents, but they cross over the sternum, which can fracture it in a high-impact crash. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. Frontera WR, et al. pain and cramps before and during your periods, heavy bleeding during or in between periods, gonadotropin-releasing hormone (GnRH) agonists or antagonists, danazol (Danocrine), now less commonly used. information submitted for this request. Pain during inspiration would be expected in the presence of a rib or sternal fracture, along with painful chest and upper extremity movements and pain on palpation and/or gentle percussion. These may require lifestyle adjustments, home care, or professional treatment. This combination can make it especially hard to function. hives, itching, skin rash. But if you are very uncomfortable, ice and anti-inflammatory medication can help. Mild cramping in the abdomen can be an uncomfortable but expected part of the menstrual cycle. It may also radiate to the underarm and it is often accompanied by swelling, breast fullness, or lumpiness that becomes more pronounced during the two weeks leading up to your period. We use cookies to ensure that we give you the best experience on our website. Being able to spot the early signs means that prompt treatment can be sought. Merck Manual Professional Version. https://www.uptodate.com/contents/search. irregular or heavy menstruation, painful urination, or. New treatment approaches are continually becoming available. But, while some causes are severe, such as heart attacks, many of the potential causes are less worrisome. https://www.ncbi.nlm.nih.gov/books/NBK279324/. Most (7 of 11, 64%) presented with ST-segment elevation MI at The majority (7 of 11, 64%) had left anterior descending coronary artery SCAD. The medical term for pain during periods is dysmenorrhea, and cramping is often a cause of this pain. It's the most common cause of chest bone pain. Anatomy of Sternum Area But in more severe cases, you may need physical therapy or surgery. It can cause a range of effects across the body and its systems. Learn more about the atypical symptoms of chest pain here. This test consists of sensors placed on your skin. Ceccaroni M, et al. The medical term for these air sacs is alveoli. For relief, try supportive bras, warm or cold compresses, massage, medications, diet changes, and/or meditation. All rights reserved. having irregular periods. Middle sternum area. Clavicle fracture (broken collarbone). The sternum pain is a characteristically bruised or sharp pain in sternum area. WebMD, meanwhile, confirmed that some women may have chest pains "at times of the month when less estrogen is circulating in their bloodstreams" e.g. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, Centers for Disease Control and Prevention (CDC), https://www.hopkinsmedicine.org/health/conditions-and-diseases/breast-pain-10-reasons-your-breasts-may-hurt, https://www.acog.org/patient-resources/faqs/gynecologic-problems/dysmenorrhea-painful-periods, https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html, https://www.plannedparenthood.org/learn/health-and-wellness/menstruation/how-do-i-know-if-my-menstrual-cycle-normal, https://www.womenshealth.gov/menstrual-cycle, https://youngwomenshealth.org/2013/08/22/painful-periods/, https://www.cdc.gov/std/pid/stdfact-pid.htm, https://www.womenshealth.gov/menstrual-cycle/period-problems, https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome, https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome/premenstrual-dysphoric-disorder-pmdd, https://www.womenshealth.gov/menstrual-cycle/your-menstrual-cycle#3, Gut microbiome appears to fluctuate throughout the day and across seasons, One-hour endoscopic procedure could eliminate the need for insulin for type 2 diabetes, New clues to slow aging? If the cause is temporary, a persons period may return as usual the next month. If you are throwing up during period, it could be due to a uterine fibroid located within your womb. It's a severe and chronic medical condition that requires attention and treatment. If any severe symptom occurs during a period, or if a period has any unusual features, it is a good idea to see a doctor. Other causes: Heavy bleeding can be pregnancy-related, in the event of ectopic pregnancy or miscarriage. People who believe they may have a sternum fracture should seek immediate medical attention in case of additional damage to the heart and lungs. Mild symptoms can often be expected, but anyone with severe or unusual symptoms should receive medical attention. Self-Care Some tips can relieve your breast pain during your menstrual period: De-stress. It hurts so bad that I begin to hyperventalate and eventually have an anixity attack. Eating 2-3 hours before you go to sleep and. Pelvic inflammatory disease can scar your fallopian tubes, increasing the risk of a fertilized egg implanting outside of your uterus (ectopic pregnancy).

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