Can a cortisone shot affect your period - Corticosteroids can help reduce inflammation.

 
Systemic effects of. . Can a cortisone shot affect your period

The effects of your shot can last up to several months before it wears off. They can also cause changes in peoples mood you may feel very high or very low. Do cortisone shots cause weight gain While cortisone can increase appetite and weight, we only see this effect when taking high doses of tablets for many weeks. However, a change in your periods can be due to another cause. Web. Yes, the menstrual cycle can stop after a cortisone injection. Log In My Account aw. Aug 24, 2007 Cortisone injections can affect the menstrual cycle. May 20, 2021 Cortisone shots commonly cause a temporary flare in pain and inflammation for up to 48 hours after the injection. The body needs cortisol to power through demanding situations, whether it&x27;s dealing with hectic schedules and. While steroids are a commonly prescribed treatment, they must betaken with caution as they can also produce certain side effects that can affectyoureyes and vision. The steroid injections we. In some cases, steroid injections can temporarily change a woman&39;s menstrual cycle. The one caveat to this general rule is seen in insulin-dependent diabetics; although uncommon, cortisone injections can sometimes. The beneficial effects may last for days or months. According to CostHelper, the cost of a cortisone injection ranges between 25 and 300, depending on the area of injection on the body, the city and state in which the injection is administered and whether or not the patient has health insu. However, the length of time for pain relief varies and can take days or weeks. Many woman have reported a period that are prolonged and heavier than usual. Learn how we can help. 3 aug. Web. Generally, a cortisone shot can suppress pain for anywhere from six weeks to six months. If a patient is receiving cortisone or any steroid injections for a lengthy period, they will. Most participants were exposed to endocrine-disrupting chemical pesticides, a type of pesticide known to cause menstrual irregularities. Cortisone shots are very safe, and side effects tend to be rare and minor. By Mayo Clinic Staff Request an Appointment at Mayo Clinic Doctors & Departments May 20, 2021 Show references. A cortisone shot is typically not very painful but can cause a temporary surge of pain and inflammation that maylast up to 48 hours. Antidepressants are not said to adversely affect your menstrual cycle. Cortisone shots are very safe, and side effects tend to be rare and minor. Antidepressants are not said to adversely affect your menstrual cycle. It must be noted that cortisone shots could temporarily cause a pain flare up to 48 hours after the. There are six types of medication used to treat heavy menstrual bleeding. Generally, a cortisone shot can help with pain suppression for six weeks to six months. Many woman have reported a period that are prolonged and heavier than usual. Steroid injections can cause increased bleeding that stops after a few days, or they can trigger a period than lasts for several weeks instead of just several days. May 19, 2021 Cortisone shots can be effective in treating a wide variety of conditions, but they can have adverse effects. Results Among 8166 epidural steroid. They believe the cortisone shots are to blame, but said the periods should return to normal within two months of the last injection. It may even hasten the need for total hip and knee replacements. It happens to me every time I get a shot, there&x27;s quite a few side effects, but to me well worth it. Generally, a cortisone shot can help with pain suppression for six weeks to six months. However, steroids can also be prescribed for longer periods of time to treat certain inflammatory disorders, autoimmune disorders, and organ transplants. How long does cortisone stay in your system Generally, any cortisone injection will have an effect on the body. Generally, a cortisone shot can help with pain suppression for six weeks to six months. Your story illustrates that such medications can affect the entire body, including the nervous system. In general, an antibiotic should not delay your period. According to Mayo Clinic, joint infection, nerve damage, tendon weakening or rupture and temporary pain or inflammation can all be negative side effects of a cortisone shot. Log In My Account wv. This may be more likely if you have a history of mood disturbance. Aug 2, 2019 Can cortisone injection affect period Steroid injections can sometimes cause temporary changes to womens periods. Nerve damage. For women found to have bleeding, medical records review was performed to examine menopausal status and bleeding evaluation outcomes. Corticosteroids can affect many of the bodily systems, including the thyroid gland and adrenals. Sep 12, 2022 In some cases, one or several cortisone shots can cure a condition, particularly those that affect the hand and wrist, Dr. How long do I have to wait after the cortisone shot to have surgery to not risk infection Also, I take 500 mg turmeric, a multivitamin, 2400 mg vitamin D and 1200 (900 mg omega 3) mg fish oil. They could be mild or severe. Yes, the menstrual cycle can stop after a cortisone injection. However, cortisone can also trigger acute pancreatitis. Web. Menstrual changes; Water retention; In rare instances, pain that actually increases for several days after the procedure. Can cortisone injection affect period Steroid injections can sometimes cause temporary changes to womens periods. There are six types of medication used to treat heavy menstrual bleeding. Web. It is not uncommon to occasionally miss a period, . Cortisone injections can affect the menstrual cycle. Those who get multiple injections are at particularly high risk for continuing damage. Cortisone can weaken the immune system. What are cortisone shots Cortisone shots are injections of medicine that ease pain and swelling in different parts of the body. How do steroid injections affect menstrual cycle Steroid injections can sometimes cause temporary changes to women&39;s periods. Diane Minich agrees View 1 more answer. First period in 5 years Although not mentioned anywhere as a side effect I&39;ve been told that having steroid injections can affect menstrual cycles. Your child&39;s growth could be affected by long-term use or high doses of steroid treatment andor their bones may become thinner. Log In My Account wv. NSG 6440Predictor test Typed Pre-Predictor 1) A 15 years old high school student with a mild sore throat and low-grade fever that has persisted for about 3 weeks. Taking the medication with food can help prevent stomach ulcers. Dec 27, 2022 Once the inflammation goes away, the pain will get better. In the study, he uncovered that cortisone shots may be associated with complications that can potentially accelerate the destruction of the joint. Depending on the condition, a person may need more than one injection. Web. Your story illustrates that such medications can affect the entire body, including the nervous system. Skin issues, including dryness, thinness, acne, dry skin, and red or purple blotches. I contacted my pain management doc, and she said this is a common side effect. Potential side effects of cortisone shots increase with larger doses and repeated use. Web. Can a cortisone shot bring on your period Steroid injections can sometimes cause temporary changes to womens periods. However, cortisone can also trigger acute pancreatitis. Hypothyroidism and cortisone injection. Taking higher-dose steroids then tapering to a lower dose is less likely to cause cataracts than taking a lower steroid dose over a longer period of time, according to the American Academy of. Indeed, some cortisone shots may last for several months. First period in 5 years Although not mentioned anywhere as a side effect I&39;ve been told that having steroid injections can affect menstrual cycles. Though it depends on your condition, your doctor will likely limit how often you get a cortisone shot to every 6 weeks. Fatigue and trouble sleeping. Created for people with ongoing healthcare needs but benefits everyone. High blood pressure. The effect can last several weeks or more. After that, your pain and inflammation of the affected joint should decrease, and can last up to several months. ub; ay. Joint infection. Web. Sep 12, 2022 In some cases, one or several cortisone shots can cure a condition, particularly those that affect the hand and wrist, Dr. Cortisone shots reduce inflammation, a common cause of joint and tendon pain. Fatigue and trouble sleeping. Joint infection. Injections can be helpful in treating conditions like tendinitis or bursitis. Web. Rarely, they can have side effects such as Infection Allergic reactions Bleeding Ruptured tendon Changes in skin color Fatigue Mood changes If you get too many injections in the same area,. According to the Mayo Clinic, people who receive cortisone shots in the back should expect to protect their backs and the injection area by avoiding heavy lifting and other activities that might cause strain. 5 iul. Whether your period is irregular or missing altogether,. Web. Corticosteroid shots, also known as cortisone shots, can be a great. Skin issues, including dryness, thinness, acne, dry skin, and red or purple blotches. Some people also experience hiccups. A side effect of this injection can be irregular or missed menstrual periods. Mood swings and disturbances. How do steroid injections affect menstrual cycle Steroid injections can sometimes cause temporary changes to women&39;s periods. They can also cause changes in people&39;s mood you may feel very high or very low. 4 What Can Cause Pain After a Steroid Shot Skin Color Changes. Cortisone shots can be effective in treating a wide variety of conditions, but they can have adverse effects. May 19, 2021 The effects of cortisone shots can last for more than a month. Created for people with ongoing healthcare needs but benefits everyone. Before I could begin the medication . Steroid injections can be given by your doctor (GP or specialist). It&39;s also possible for you to feel very low or extremely . It must be noted that cortisone shots could temporarily cause a pain flare up to 48 hours after the. Can cortisone injection affect period Steroid injections can sometimes cause temporary changes to womens periods. Mood swings and disturbances. They can also cause changes in peoples mood you may feel very high or very low. Log In My Account wv. May 29, 2013 Steroid injection 2 weeks ago. Despite the effectiveness of cortisone, it can come with some. Evidence was found that triamcinolone acetonide (TA) influenced menstruation after intramuscular application,9-13 but no literature was found about disturbance of the menstrual pattern after intra-articular or periarticular corticosteroid injections and because knowledge of the possible side effect is important for medical practice it was decided to investigate this phenomenon. Anticoagulation drugs Warfarin and pain killers might enhance the flow and also intensity of bleeding. A magnifying glass. However, this effect is small and only lasts for 3-4 weeks. Pain relief can take a few days to a few weeks, depending on how long it takes for the inflammation to settle. However, this effect is small and only lasts for 3-4 weeks. Cortisone is a type of steroid; it decreases pain by decreasing the inflammation. Systemic effects of. Results Among 8166 epidural steroid. 9 oct. Allergic reactions. Long-term, repeated administration of cortisone shots can be particularly problematic, as frequent injections in the same joint can damage it, as well as the surrounding soft tissue. i did, however, also see my ob-gyn, who did an ultrasound and ordered blood tests. Web. There is no way around it. 6 aug. Rather, it reduces inflammation which, in turn, decreases pain. Fatigue and trouble sleeping. More serious chronic side effects include diabetes and Cushing&x27;s disease. 22 feb. Web. Weight Gain And Swelling. Steroid injections can cause increased bleeding that stops after a few days, or they can trigger a period than lasts for several weeks instead of just several days. 6 iun. There are many reasons that periods can be irregular, or absent. Increased appetite, weight gain, and water retention. A local anaesthetic may also be given. However, the length of time for pain relief varies and can take days or weeks. Web. A side. Don&39;t use heating. Can a cortisone shot bring on your period Steroid injections can sometimes cause temporary changes to womens periods. Flushing of the skin. Menstruations can be . Antipsychotics such as risperidone may increase levels of the hormone prolactin and lead to lack of. Side effects can vary from person to person. This blend is typically injected around inflamed. Conclusion Epidural steroid injections are associated with subsequent abnormal vaginal bleeding for both premenopausal and postmenopausal women. If a patient is receiving cortisone or any steroid injections for a lengthy period, they will. The main reason The steroids could weaken her response to the vaccine, making it less. Fatigue and trouble sleeping. By Mayo Clinic Staff Request an Appointment at Mayo Clinic Doctors & Departments May 20, 2021 Show references. Yes but Using your pills to delay your period 2 months in a row is safe but may not work as well the second month. Web. This may be more likely if you have a history of mood disturbance. Some patients react to the injection with what is called a cortisone flare. Pain relief can take a few days to a few weeks, depending on how long it takes for the inflammation to settle. High Blood Pressure The drugs can also cause an elevation in blood pressure, which is a risk factor for heart disease and stroke. For instance, if you received a cortisone shot in your shoulder, avoid heavy lifting. is it a side affect to the depo birth control shot to have a period and still spot the whole. Your body naturally makes its own cortisone when your body is under. Death of nearby bone. 1-8 This may cause systemic effects. Pain and Cortisone Flare Reaction Some people have discomfort after the shot and may experience an increase in pain 24 to 48 hours after being treated. Skin issues, including dryness, thinness, acne, dry skin, and red or purple blotches. 31 mar. Steroid injectioniontophoresis showed significant improvement in the short term (1 month). Can a cortisone shot affect your period. Nevertheless, this impact is small as well as just lasts for 3-4 weeks. Log In My Account wv. In fact, they are increasingly being used to treat severe cases of PMT (that&x27;s pre-menstrual tension, otherwise known as. Mar 20, 2021 Can cortisone shots affect your periods Yes. For women found to have bleeding, medical records review was performed to examine menopausal status and bleeding evaluation outcomes. These shots consist of a synthetic version of the cortisone hormone that a. It may even hasten the need for total hip and knee replacements. All participants were older than 50 years. However, we often say you should leave about a week before an event for the cortisone shot to work. Though it depends on your condition, your doctor will likely limit how often you get a cortisone shot to every 6 weeks. Joint infection. Long-term, repeated administration of cortisone shots can be particularly problematic, as frequent injections in the same joint can damage it, as well as the surrounding soft tissue. Web. For women found to have bleeding, medical records review was performed to examine menopausal status and bleeding evaluation outcomes. Does a cortisone shot affect the whole body Cortisone shots can be used to treat inflammation of small areas of the body, like inflammation of a specific joint or tendon. However, in some cases, a cortisone shot while pregnant is useful. Joint infection. How long does cortisone stay in your system Generally, any cortisone injection will have an effect on the body. I have had tablets before with no problems. It must be noted that cortisone shots could temporarily cause a pain flare up to 48 hours after the. Also, your period may recur earlier than usual. 8k views Reviewed >2 years ago Thank Dr. Skin issues, including dryness, thinness, acne, dry skin, and red or purple blotches. Also when your hip pain is relieved you may find your back and other body parts feel better because you are not trying to compensate for the hip pain. Yes, cortisone shots can mess up your cycle. This may be more likely if you have a history of mood disturbance. Web. This can cause a brief period of pain that is worse than before the shot. Since steroids can decrease your. 29 sept. Web. Ruptured tendon. They can also cause changes in peoples mood you may feel very high or very low. Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. Normally, any type of cortisone shot will certainly affect the body. Typically, a patient is only given two to three injections a year to avoid any negative side effects. Bc my rheumatologist said it was a very low risk, I am past the week where it would impact anyway, and she has said she has seen many patients take it the whole pregnancy with healthy babies. Cortisone is a type of medication called a corticosteroid. I have had tablets before with no problems. Diane Minich agrees View 1 more answer. Temporary flare of pain and inflammation in the joint. According to the National Institutes of Health, the side effects from cortisone shots include Dizziness or headaches. If a patient is receiving cortisone or any steroid injections for a lengthy period, they will. Cortisone provides pain relief by reducing inflammation. low sperm count. Some people also experience hiccups. The steroid injections we. Web. Anticoagulation drugs Warfarin and pain killers might enhance the flow and also intensity of bleeding. Indeed, some cortisone shots may last for several months. but the time when it could be waning is the time your Hydroxy should be doing its thing. type of steroid medication. So, discuss whether you can have another one with a doctor if the effects are wearing off. Our answer is yes Delay the flu shot until three days after your wife finishes her prescription. com adds that the most common side effect is called cortison. Will a single steroid injection into your knee, shoulder, hip, or elbow affect your immune system Maybe. Cortisone injections often lead to a temporary increase in inflammation and pain. Indeed, some cortisone shots may last for several months. However, a change in your periods can be due to another cause. Web. Web. Those who get multiple injections are at particularly high risk for continuing damage. 31 mar. I contacted my pain management doc, and she said this is a common side effect. Because the injection contains only a small amount of cortisone, and it is injected locally, cortisone generally does not affect other parts of the body. Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. They could be mild or severe. Since steroids can decrease your. In addition to pain, side effects can include flushing of the face loss of fat where the injection was given, which may cause permanent dimples paler skin where the injection was given,. Generally, a cortisone shot can help with pain suppression for six weeks to six months. A side. According to the Mayo Clinic, complications of cortisone shots can include (iv) Joint infection. This is not a complete list of side effects and others may occur. And while cortisone shots are often used to relieve arthritis symptoms in old, creaky. Also when your hip pain is relieved you may find your back and other body parts feel better because you are not trying to compensate for the hip pain. I have had tablets before with no problems. to xc. While steroids are a commonly prescribed treatment, they must be taken with caution as they can also produce certain side effects that can affect your eyes and vision. Web. My doctor also prescribed Medroxyprogesterone to stop the bleeding and also suggested an IUD going forward. 6 iun. What to expect after cervical epidural steroid. According to the Cleveland Clinic, it may take up to seven days before the body responds to a corticosteroid injection. May 20, 2021 Cortisone shots commonly cause a temporary flare in pain and inflammation for up to 48 hours after the injection. "But for conditions that affect the knees,. We&39;ll see. While steroids are a commonly prescribed treatment, they must betaken with caution as they can also produce certain side effects that can affectyoureyes and vision. i did, however, also see my ob-gyn, who did an ultrasound and ordered blood tests. In general, an antibiotic should not delay your period. Web. Cortisone shots reduce inflammation, a common cause of joint and tendon pain. If taken at high doses or for a prolonged period, this treatment can have a number of side effects, including osteoporosis (thinning of the . hot giy jerking off, married at first sight chapter 171

Symptoms often include frequent urination, increased thirst and increased appetite. . Can a cortisone shot affect your period

Web. . Can a cortisone shot affect your period peezy detroit rapper age

Fatigue and trouble sleeping. Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. A side. Generally, a cortisone shot can help with pain suppression for six weeks to six months. Web. Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. Web. Cortisone injections often lead to a temporary increase in inflammation and pain. The individual may also notice pain associated with cartilage softening at the injection site. The main reason The steroids could weaken her response to the vaccine, making it less. Mood Changes Steroid injections can also cause changes in mood and behavior, including irritability and depression. For this reason, many doctors limit injections to once every 3 months for a specific joint, and 6 times a year for the entire body. According to CostHelper, the cost of a cortisone injection ranges between 25 and 300, depending on the area of injection on the body, the city and state in which the injection is administered and whether or not the patient has health insu. Rarely, they can have side effects such as Infection Allergic reactions Bleeding Ruptured tendon Changes in skin color Fatigue Mood changes If you get too many injections in the same area,. Systemic effects of. Inflammation usually improves within a few days. Mary David answered. 21 ian. Web. Local corticosteroid injection to the shoulder can create a significant,. May 29, 2013 Steroid injection 2 weeks ago. Doctors use these drugs to treat inflammation (swelling) caused by injury and illness. You may experience periods that are irregular, heavier, lighter, prolonged, shortened, delayed, or skipped entirely. Web. This helps relieve pain immediately and lasts for 3 to 4 hours while the cortisone is beginning to take effect. ATI Nursing Care of Children Proctored exam (answered) review guide updated Nov 2022. "But for conditions that affect the knees,. Specializes in Obstetrics and Gynecology. Even worse, research has shown that for every cortisone injection your risk of bone fracture due to. Hope this helps. Steroid injection 2 weeks ago. Steroid injectioniontophoresis showed significant improvement in the short term (1 month). According to the Mayo Clinic, people who receive cortisone shots in the back should expect to protect their backs and the injection area by avoiding heavy lifting and other activities that might cause strain. Web. Some patients react to the injection with what is called a cortisone flare. They can also cause changes in people&39;s mood you may feel very high or very low. If left untreated, diabetes can cause many health complications. They could be mild or severe. Web. "We&x27;ve been telling patients that even if these injections don&x27;t relieve your pain, they&x27;re not going to hurt you," Dr. Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. Death of nearby bone. 4 What Can Cause Pain After a Steroid Shot Skin Color Changes. Taking higher-dose steroids then tapering to a lower dose is less likely to cause cataracts than taking a lower steroid dose over a longer period of time, according to the American Academy of. Another negative side effect of cortisone injections is, unfortunately, weight gain and abdominal swelling. Cortisone injections can provide rapid and lasting pain relief for. Web. if you are stressed about your heart rate or other issues, this will increase your heart rate. They can also cause changes in people&39;s mood you may feel very high or very low. They can also cause changes in people&39;s mood you may feel very high or very low. Corticosteroid shots, also known as cortisone shots, can be a great. A magnifying glass. Web. 1-8 This may cause systemic effects. If a patient is receiving cortisone or any steroid injections for a lengthy period, they will more than likely experience weight gain and bloating. Cortisone shots reduce inflammation, a common cause of joint and tendon pain. You should be able to go home soon after the injection. Mood swings and disturbances. If a patient is receiving cortisone or any steroid injections for a lengthy period, they will more than likely experience weight gain and bloating. Anticoagulation drugs Warfarin and pain killers might enhance the flow and also intensity of bleeding. Nevertheless, this impact is small as well as just lasts for 3-4 weeks. For instance, if you received a cortisone shot in your shoulder, avoid heavy lifting. Weight Gain And Swelling. They can also cause changes in peoples mood you may feel very high or very low. However, this effect is small and only lasts for 3-4 weeks. Men have reported on occasion that they had decreased libido andor erectile dysfunction during corticosteroid therapy. Jan 4, 2019 Cortisone Cortisone injections can disrupt the complex hormonal regulation of the menstrual cycle, resulting in abnormality. I know having a . For this reason, many doctors limit injections to once every 3 months for a specific joint, and 6 times a year for the entire body. Any kind of pain, whether from injury, headache or conditions such as arthritis, can interfere with your daily life. Will a single steroid injection into your knee, shoulder, hip, or elbow affect your immune system Maybe. Web. I contacted my pain management doc, and she said this is a common side effect. Oct 5, 2020 The progress of drug-induced pancreatitis is usually chronic. My blood pressure gradually went down over about a 3 - 4 week period. Web. 125 twice a day (terrible bradycardia and hypotension happened), my PCP had decided that I had strained my chest wall muscle and he gave me a steroid shot and some hydrocodone. However, this effect is small and only lasts for 3-4 weeks. Doctors use these drugs to treat inflammation (swelling) caused by injury and illness. Some people also experience hiccups. Web. Web. Taking it earlier in the day can help avoid sleep problems. However, this effect is small and only lasts for 3-4 weeks. sm Fiction Writing. The pain and inflammation will decrease over time, and the. This may be more likely if you have a history of mood disturbance. These may include a little swelling, tenderness, pain, itching, or redness around the area where the injection was given. Web. Can a cortisone shot affect your period. Tendon weakening or tendon rupture. This provides immediate pain relief that lasts a few hours. No data has been . Cortisone injections often lead to a temporary increase in inflammation and pain. Web. Though it depends on your condition, your doctor will likely limit how often you get a cortisone shot to. 9 oct. Our answer is yes Delay the flu shot until three days after your wife finishes her prescription. Mood Changes Steroid injections can also cause changes in mood and behavior, including irritability and depression. We&39;ll see. Corticosteroids Can Cause Or Worsen Hypothyroidism. First period in 5 years Although not mentioned anywhere as a side effect I&39;ve been told that having steroid injections can affect menstrual cycles. Aug 12, 2022 The effects of your shot can last up to several months before it wears off. Menstruations can be longer or shorter than usual. Web. Web. Cortisone injections can help many people, they can also provide potential harm to others. We&39;ll see. Fatigue and trouble sleeping. In our practice, a few patients have complained of abundant menstruation after local injection of corticosteroids. Acute complications can include diabetic ketoacidosis, hyperosmolar. Feb 1, 2023 What Happens When You Get a Cortisone Injection A cortisone shot is typically not very painful but can cause a temporary surge of pain and inflammation that may last up to 48 hours. The shots may be doing more harm than good. Cortisone is a type of medication called a corticosteroid. These shots consist of a synthetic version of the cortisone hormone that a. ATI Nursing Care of Children Proctored exam (answered) review guide updated Nov 2022. Cortisone is a type of medication called a corticosteroid. Steroid injection 2 weeks ago. Fatigue and trouble sleeping. Oct 5, 2020 The progress of drug-induced pancreatitis is usually chronic. Do steroid shots really work Corticosteroid injection treatments can lead to two to three. The pain and inflammation will decrease over time, and the. Jan 25, 2023 Youll stay for a short period of time after the procedure for monitoring. The body needs cortisol to power through demanding situations, whether it&x27;s dealing with hectic schedules and. Web. Injections can be helpful in treating conditions like tendinitis or bursitis. A side effect of this injection can be irregular or missed menstrual periods. However, this effect is small and only lasts for 3-4 weeks. Rarely, they can have side effects such as Infection. Common Side Effects of Cortisone Shots in Dogs and Cats. Web. While steroids are a commonly prescribed treatment, they must be taken with caution as they can also produce certain side effects that can affect your eyes and vision. Web. Steroid use for over two weeks can decrease the ability of your body to respond. The one caveat to this general rule is seen in insulin-dependent diabetics; although uncommon, cortisone injections can sometimes. However, cortisone can also trigger acute pancreatitis. . evan lamicella onlyfans twitter