Friday, February 12, 2016

Prevention Breakthrough Targeting Sexually Transmitted HIV in Women

Condoms have been the primary defense against sexually transmitted diseases. Spermacide has also been shown to have protection, if used in the right amount and frequently enough, to achieve an effective concentration to be able to kill bacteria and viruses before they can infect a woman. And gradually we have seen other products being developed that would be both spermacidal (kill sperm) and microbicidal (kill bacteria). Two research studies on a vaginal ring that would contain a medication that would be able to inactivate the HIV virus are underway. The
trial is called ASPIRE   A Study to Prevent Infection with a Ring for Extended Use with investigator Jared Baeten, MD, from the University of Washington in Seattle with his team, and  Annalene Nel, MD,head of the international branch of the study in South Africa called the International Partnership for Microbicides. This medication is not a contraceptive and would have to be used with a contraceptive, and is not thought to provide levels of medication that would prevent other methods of HIV transmission. Getting appropriate STI testing and early intervention is still our best strategy for staying healthy, so if you have a new partner, or your partner has a new partner, please see your physician for evaluation.

Voluminous or Not-so-Voluminous Varicose Veins, but still bothersome!

Varicose veins are a hassle.

The picture on the upper right was taken of a 34 year old woman, at 38 weeks pregnant. She sent us this photo of her varicose veins that seemed to appear during pregnancy. The picture on the bottom right is the same woman, taken a week after she delivered. The veins have largely gone away.

Pregnancy Can Cause Varicose Veins

Pregnant moms often notice the appearance of varicose veins for the first time. These veins are at their worst during the pregnancy, and as the picture shows the delivery of the baby eases off the vascular pressure in the post partum period of time when the dramatic cardiovascular changes of pregnancy begin to resolve. Varicose and spider veins in pregnancy will shrink post partum, but some will not resolve and perhaps benefit from therapy. The reasons for the appearance of varicosities are complex. Natural twists and turns of veins, veins that carry additional blood flow, slowed flow through blood vessels, poor valves within the veins, and obstruction because of blood clots are reasons that a woman might develop varicose veins. During pregnancy all these conditions occur, the body’s blood volume increases by half again during pregnancy to handle the nutritional needs of both mom and baby demand that extra blood flow carry nutrients. The pressure of the growing baby on return flow is a relative ‘obstruction.’ The body, mediated by the hormonal changes as the pregnancy progresses, handles the extra blood flow in many ways heart makes changes, it expands, it beats faster, and overall blood pressure drops so that blood vessels can accommodate extra flow being pumped through, and often a few of the veins will be come, in medical terms, less competent, and flow bubbles out and produces the veins that bulge. Spider veins are those that are tiny, and weblike. Superficial varicose veins are larger, even bulging veins, and their larger size and greater potential for complications. As a strategy: first be patient, some veins may resolve to the point they no longer cause pain or trouble, and can, with exercise, support hose, weight control, and nutrition, be ready to withstand the next baby round. #varicoseveins #pregnancy #spiderveins

Top Ten Reasons To Eat Chocolate on Valentine Date Night, and More!

1.  Chocolate reduces blood pressure. The flavonoids found in cocoa help in the control of the arterial tension, by increasing the amount of nitric oxide in the blood. Studies showed that dark chocolate, for many, is as effective at lowering blood pressure the antihypertensive drugs are.
2. Dark chocolate can decrease by 50% the risk of a heart attack, coronary disease by 10%, and premature death by 8%. Planning sex on Date Night? Here's something that can help!
3. Chocolate improves blood circulation to the brain for two to three hours after you eaten chocolate. The flavonoids in chocolate dilate the blood vessels in the brain, allowing a larger blood flow (implicit of oxygen). This way, the brain fights off exhaustion, insomnia, improving memory and learning, all good for the lively date night. Cocoa that retains thehighest level of these naturally occurring chemicals within chocolate called flavonoids, which are abundant in fresh cocoa, could help maintain the normal functioning of the brain and could be used for future therapies against cognitive decline and dementia, so date night conversation is improved.
4. Chocolate gets us a good mood. Phenylethylamine, a neuronal disinhibitor released by the brain, is also found in chocolate, and induces a stage of euphoria and excitation during the sexual prelude, by turning on the brain's pleasure nuclei. This molecule increases the feeling of excitement, giddiness and boosts the sex drive; consequently, it gives you more or less the same sensation that the alcohol does, but without the secondary effects of the latter. (you know what they say... 'Flowers or chocolate to your girl!').Anyone knows the "I feel good" sensation induced by chocolate. Chocolate treats do not typically  contain serotonin, one of the the "happiness"molecules , but tryptophan, a serotonin precursor, that the brain can transform into serotonin is often in chocolate.High serotonin levels stimulate the release of endorphins. Actually, what the antidepressant drugs do is simply increase the brain's serotonin levels, since low levels of serotonin induce depression.
5Chocolate increases energy by increaseing the quantity of sugar in your blood, due to the above-mentioned flavonoids. Chocolate helps the process of sugar metabolism, and dark chocolate helps reduce the risk of developing diabetes.
6. Chocolate fights off chronic fatigue. Eating 50 grams of chocolate (85 % cacao) daily decreases the symptoms of this disease.
7. Chocolate increases "good" cholesterol and lowers the "bad" one, due to the antioxidants, similar to those found in fruits, vegetables, tea and wine.
8. Chocolate can also be a remedy against coughing. A chemical from cocoa can be more efficient against coughing than many medicines are, and it doesn't have the adverse effects that the latter have.
9. Chocolate enhanced improved circulation induced by flavonoids also boost...erection! So ….what will it be: Viagra or chocolate?
10. Many chocolates contains iron. That's why it is recommended for pregnant women. Chocolate is also abundant in magnesium, proven to ease pre-menstrual symptoms (PMS). The calcium in milk induces the same effect, so milk chocolate could ensure the men's peace and relaxation in certain... 'special moments'.
11. Just like coffee, most chocolates contains caffeine too. Another reason to be energetic on a date!
12. The researches showed that chocolate consumers live almost one year more than those who do not eat chocolate. Ok, this means lots more dates, a bit more long term than just this valentine date nitght!
13. Studies have shown that chocolate impedes cell deterioration and cancer.
14. Chocolate improves your smile, again longer term project! The bitterest chemical found in chocolate, theobromine, an alkaloid similar to caffeine, was found to fight off tooth decay, being more efficient than the fluoride in strengthening the crystalline structure of teeth against erosion by acid-producing bacteria (linked to tooth decay).

Wednesday, February 10, 2016

Hers and His: Aspirin

Our physiology varies, and what lies in our genetics makes some medical advice better than other medical advice. No where has that been more true than with aspirin as a prevention strategy. The risk of stoke goes up with menopause, women have fewer strokes prior to menopause than men, after menopause they have more. 

According to the study Risk of stroke in women may come down to a compound the body produces from estrogen known as 2-methoxyestradiol (2-ME).  The 2-ME theory shows how that compound preserves the brain after strokes, although over activity of the compound can be an issue too. Furthermore, the compound's therapeutic potential may extend beyond treating stroke in women to healing brain injuries in men, a new study in the American Journal of Physiology Endocrinology and Metabolism reports.
Women and men differ in their aspirin benefits, but both could potentially benefit making that hers and his aspirin bottle worth sharing (after personal consultation) after all. The newest data shows that breast cancer patients who take aspirin have fewer recurrences, although it may be the best in overweight breast cancer patients. Although there are lots of things that prevent breast cancer and you have to take advice in context of other recommendations. And we know that women can get lower ovarian cancer if they take aspirin. colon. The story on heart attack and stroke prevention still favors aspirin for men and not necessarily for women. These recommendations are also well studied based on your genetics and what your body does to metabolize aspirin. The both could benefit from aspirin as colon cancer protection. And as for the original indications for aspirin: headaches, pains, and fevers: well men and women both get those as well!


Tuesday, February 9, 2016

Bipolar Disorder in Pregnancy

The trailer of Touched With Fire #touchedwithfire was just released! In this movie, Katie Homes #katiehomes plays the role of a 37 year old who has bipolar disorder. Bipolar disorder has both manic and hypomanic episodes. You can find a very specific definition of bipolar disorder at APA.
Bipolar disease affects approximately 5.5 million americans. Using this statistic, we know there are bound to be a number of women affected by bipolar who may want to become or are already pregnant. Many pregnant women assume they can't take a medicine. Here is a statistic from the ACOG bulliten, "psychotropic drugs are taken by 21 - 35 percent of pregnant patients." If you are diagnosed with or suspect you have bipolar disorder, it is time to talk to your birth provider about what medication is or isn't safe to take during pregnancy. Gyno's applaud Katie Homes and the producers of Touched with Fire for bringing this disease to the forefront. #bipolar #pregnancy #medicationinpregnancy

Eat Yourself Into Labor? Not Very Scientific, But Here's What They Say

Its #NationalPizzaDay! Are you close to your due date?! When in your due date? #40weeks

The first thing you get told when your gyno confirms your pregnancy is a due date. And most happy moms are dutifully repeating that date to all they ask! And just how reliable is that "due date" and how likely is that your baby will actually come on time? We've already discussed that obstetricians like to think in pregnancy weeks, and not really days at all. Human pregnancies typically last 280 days or 9 and 1/3 months. But many human pregnancies are delivered after that time, yet we still use the 280 days. For those that bet, ultrasound dates a few days later than the last period due date, so some say if you are a betting woman use 283 days. If we know very precisely when conception was, for instance and IVF pregnancy, then we can add on those 280 days and it's a very reliable prediction. And we then term that due date your EDC or EDD, estimated dates of confinement (old school term) or estimated date of delivery (sounds much better!). But studies done in the early 1900s based on menstrual dates said that really only 1/20 births occur on the due date. And more recent studies have only improved just a bit on that prediction. 10% are actually born premature, and over half are delivered in their due week. Quickening is the date the mom feels movement, and prior to ultrasounds, in cases of unknown menstrual dates, that was the date the due day was reckoned from. And new moms feel that about 20 weeks in, experienced moms quicken about 4 weeks earlier at 16 weeks.  Once you get closer to that assigned day there are signs that the day is near or slightly farther, like the opening of your cervix or any contractions you are feeling. It's always just a bit of a mystery as to whether the baby will come on time, and most of us moms sort of enjoy that thrill of the unknown. For those who want a natural nudge, it's always been said that eggplant, balsamic vinegar, and anything spicy are the foods that trigger labor, although there has never been any scientific proof for that.For the newest research on the due date ACOG has just released the newest guidelines for establishing that due date.

So, since it is National Pizza day, maybe add #eggplant, #balsamicvinegar, and #redpepper if you are close to your due date and looking to #bringonlabor!

Monday, February 8, 2016

Over Active Bladder Cure With Antibiotics

Overactive Bladder (OAB) is an idiopathic syndrome, there is no known cause. Generally the most common symptom is an overwhelming urge to run to the bathroom. Too often that urge is 'inappropriate' meaning that there is no urine in the bladder. The cure has escaped us and in a study published in June 2015 issue of OBSTETRICS AND GYNECOLOGY by Reynolds and colleagues showed that most drug therapies are only modestly successful and rarely resolve all the symptoms. So a new solution was proposed that seems contrary to medical logic Just when we see doctors and patients calling for less antibiotic use in general a team from Scotland has a new idea to cure the medical condition of running to the bathroom too frequently: More Antibiotics! This group, reporting from  Glasgow, Scotland at the 41st annual meeting of the .International Continence Society came up with a novel idea that a group of patients with Overactive bladders and white blood cells in their urine probably had a degree of inflammation going on in their bladder accounting for the symptoms. In fact  Dr. Kiren Gill, of University College London, UK, told Reuters Health. "We think about half of patients with OAB may have bacteria in their urine." The team looked at groups with antibiotic treatment alone, verses treatment with antibiotics and the commonly used overactive bladder medicines, or just the medical treatment group alone and these did not receive antibiotics.The success rates of cure in these groups was an outstandingly good 75-85%. The group also took very seriously the issue that surely pops into our minds first which is: could this strategy cause resistance to antibiotics that are important for serious infection. They went on to say that they did over 65,000 cultures and couldn't find any undue antibiotic resistance in patients who had received antibiotic. They felt that this was because there really wasn't' too much infection, just a few bacteria, so not enough bacteria growing in rapid secession that would be the potential victims of antibiotic resistance. So the next time you run out of treatment options, this is something to consider, but most of us think there are other better ways of treating this condition that this which seems drastic. What do you think? Would you do his treatment? You may want to gab with your gyno about it, prehaps she has other solutions such as Urgent PC OAB therapy.

Sunday, February 7, 2016

PCOS Leads To Risks In Pregnancy: Planning Needed

The doctors Stein and Leventhatal in 1935 discovered why some women had big cysts on their ovaries, extra hair growth and troubles getting pregnant. And though we recognize their work as the beginning, their name long left the condition of Polycystic Ovaries. After it was called Stein and Leventhal's disease this has been called a disease, a condition and now a syndrome, PCOS or Polycystic Ovarian Syndrome. It begins in teen years, at which time it may mean some acne and  occasional irregular cycles. The most common issue with getting pregnant is chronic anovulation which leads to patients not getting pregnant.Now it has been shown in a publication by Doherty in the journal of OBSTETRICS AND GYNECOLOGY that women with PCOS have increased risks of preeclampsia, gestational diabetes, preterm delivery, and cesarean delivery. Sadly there has not been increased rates of any congenital birth defect, and increased rates of hospitalization for the child that persists into adolescence. Generally it is thought that the overall metabolism disorder leads to changes in the placenta and in term changes in the vascular system of the developing fetus in pregnancy. Attempts to control both the metabolism: good sugar control and normalize insulin levels, the weight, and the levels of blood inflammation should help to off set those effects. See your gyno to discuss how you can plan your pregnancy for the best health.

Saturday, February 6, 2016

PCOS Is Now Thought to Affect 14% of All Women

Only about 40% of women with irregular periods have PCOS. The definition has been changed, and simplified, so that you only need two out of the follow features: chronically not ovulating, presence of polycystic ovaries on ultrasound, and or clinical evidence of androgen excess so that now 14% of all women can meet the definition and in fact many women with perfectly regular menstrual periods are surprised to learn upon visiting their gynos that they are newly classified with an important condition that can have fertility and  life long health consequences.  If you’ve got to shave your chin regularly, you may just have that sort of genetics, and on the other hand your ovaries may be producing too much testosterone, or one of the other boy hormones that emanate from the ovary or the adrenal gland. The most common symptom of PCOS is hyperandrogenism (too much male hormone), chronic anovulation (skipped periods due to not popping an ovarian egg), many are overweight (7 out of 10) and finally either diabetic or pre-diabetic (again 7 out of 10), insulin resistance (you have it but it won’t work like it’s supposed to with your metabolism) and compensatory hperinsulinemia (the pancreas cranks out extra) are also features. And many have ovaries seen on ultrasound with a “string of pearls” look…little cysts all lined up around the edge as seen when looking with the ultrasound. Not only should there be these extra cysts, but the overall ovarian volume should be greater than 10 to the 3.

The insulin excess in a woman's body is probably in large part responsible  of the extra hair. The insulin stimulates the cells of the ovary to produce more male hormones. These extra male hormones right in the ovary mess up ovulation. Insulin can also suppress the liver substance SHBG (sex hormone binding globulin) which is supposed to bind male hormones and keep them inactive and there for in check. So the more deranged your metabolism is, the heavier you get, the worse your PCOS gets. So how to fix: well to some extent there is no fix, it’s in your genes, but it can be controlled. Control anything and everything diet: lower bad LDL cholesterol, lower the blood fat triglyceride, exercise and increase good HDL cholesterol, and changing the biology of your blood fats so you change your cholesterol particle sizes and numbers of particles. Overall weight is related to how serious your PCOS is, slim by even 5%, control the sugar and use diabetic drugs like metformin if you need to. But watch for side effects of the medications used to control insulin and blood sugar. metformin can have its negative side, it can lower vitamin B12 levels (side effects of low B12 levels might include numbness, other odd neurologic symptoms such as memory loss and behavior changes). Oral contraceptives can suppress the boy hormones of the ovary, so that’s a good bet that it will be recommended as a possible solution by your gyno. help them when they want to get pregnant, there's a lot to gab about here!
The fix for PCOS is not simple, and the more we learn, the more we know that we have to follow our PCOS patients closely, check their sugars, scan their gall bladders, check their hormone levels, discuss contraception carefully, help them control their weight, and

Friday, February 5, 2016

Hormones and Your Waist

Have you noticed that you are unable to button your pants as easily? Your wait may not even have fluctuated much, but there it is, the dreaded thicker waist. Just doing a bit less? Trying the turkey and chicken instead of burgers and steaks? As your waist to hip ratio rises, your get thicker in the middle and even if you can button your pants, it's that you are getting that muffin top look. Weather or not you have a good or even relatively healthy 'overweight' BMI, if you have too thick of a waist it is called central obesity,  as measured by waist circumference (men – greater than 40 inches [102 cm]; women – greater than 35 inches [89 cm]).  Hormones are actually not a factor in drug induced weight gain, but they are a factor as we age and perimenopause induces side effects such as poor sleep, fatigue, and change in fat to muscle ratio in our body. Some French Canadians have came up with a solution. Subtle impairment to the metabolism seems to be the blame, more than the specific place you are in menopause. At Women's Health Practice we have blood panel testing that will give you more in depth information regarding your cholesterol as well as information regarding your insulin levels and your ability to process sugar. Call or email to schedule your appointment today!
. In a report in Menopause in the winter of 2010, Dr. Andre Lemay and co-workers discovered that abdominal fat that menopausal women report also is related to increased triglycerides and decreased high density lipoprotein cholesterol, even fasting insulin levels were noted to be elevated in this group of women. In essence these women became pre-diabetics. For most of our women prediabetes is measure by Hba1c of greater than 5.6 and less than 6.5. And before any of the formal definitions of diabetes were met, a large percent of  women with the abnormal Hba1c levels were found to have insulin resistance. Fasting insulin is an quick and accurate way to measure insulin resistance and can be used to have a positive intervention on your diet. It may mean taking diabetes medication, exercising more, exercising differently, controlling your hormones, and eating a fairly strict diabetic diet, but if the biologic basis is right, then this is a solution that has evaded patients and doctors for decades!

For more information read Menopause, Make Peace With Change.This book is about the menopausal transition focusing on changing menstrual cycles, changing hormonal levels, and menopausal changes in sexuality. Written by a female physician for women to help them understand how they can achieve the best health, beauty and vigor through understanding and managing the menopausal transition. It is a must read for women who proactively want to understand the discussion about menopause, normal changes versus medical conditions, the use of medications, and answers to questions they may have regarding health decisions they will need to make.

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Vaginal Contraceptive Ring

If you are a female between the ages of 18 and 35 you may be eligible for a contraceptive ring investigational contraceptive medication study. Qualified participants will receive study-related medical evaluations and care at no cost. If interested, please call 217-356-3736.

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