Hormone Therapy, Smoking, Drinking, Douching, Eating Grapefruit, Are these Things Good For Us or Not: Sometimes Medical Advice Seems Contradictory!

We all expect hemlines to rise and fall, and last year’s fashion foible to be this year’s hip take on the best dressed list. But doctor’s advice, we just don’t expect the 180 degree change of advice from check up to check up! What was once prohibited may now be advised and we just do not expect last year’s good advice to be told the complete opposite that it is now thought of as bad advice.
Nor do us doctors feel like we can always trust the advice of the day. Sometimes the newest health news seems so unfounded in its credibility we hate to even publicize it. Estrogen was once supposed to prevent heart and cardiovascular disease (CVD); however in 2001 vast numbers of women were pulled off their therapy as a study claimed there was harm to the heart not benefit. Now in 2006 a re-analysis of the very same data said that there was only harm for much older women and in fact younger women did derive the heart benefit we had been touting (but to be safe don’t prescribe for that anyway).

Another of the newest shocking news in gynecology are studies showing the benefits of douching! It has always been postulated that douching could push bacteria up past the sterile barrier of the cervix into the uterus. So a new study was undertaken to see if in fact those who douched would have more infections and premature births. But the opposite was true, in those who douched (up to three times a week) prior to pregnancy had fewer preterm births. Intriguing, and probably warrants more investigation before making this a recommendation.

 In the column of shocking neurological news: smoking reduced the risks of Parkinson’s Disease. Exactly what in tobacco leaves themselves might be neuron protective is not yet known. It is thought that this will not be something that is an effect from the combustion of the leaves. Smoking known to be anti-estrogenic, it both lowers premenopausal estrogen level and promotes an earlier menopause. This anti-estrogenic effect of smoking is slightly protective against uterine cancer and was thought to be possibly protective against breast cancer, which was even shown in some studies. Now it is thought that smoking doesn’t increase some women's chance of getting breast cancer, and the smokers, while not getting the most invasive or extensive breast cancers were more likely to die, probably due to other factors that make smoking not healthy. And behavioral studies of breast cancer patients show that if you have a fighting spirit your more likely to be successful in treatment and those who kept smoking through their treatment had a better psychological profile, so current advice, yes, do quit, but might be ok to wait until breast cancer treatment is over.

 Do you pick up that glass of wine, does it have to be a glass of red wine? Regular modest alcohol consumption has been reported to lower heart attack and heart failure rates, decrease strokes, decrease risks for diabetes, osteoporosis and dementia.

The newest finding is that three glasses of the red wine reduced precancerous colon polyps. Other areas to find good advice on colon cancer is at this site: Oncologystat It is thought to be due to reservatrol found in grapes and red wine in particular. The reservatrol might have the effect of dilating the blood vessels, and thinning the blood to prevent clotting. Crossing over from light to moderate to higher consumption has known negative effects on multiple aspects of our health, the least of which is the effects on the heart, the GI system, and our mental well being. Even some studies of light alcohol consumption have shown increased risks of breast cancer. So, exert caution when following a doctor’s advice to drink red wine. Other “good advice” to perhaps avoid? Correction of anemia past a certain point. Excess Vitamin E (past 400 IU daily) can actually increase your risk of dying rather than preventing dying of heart disease. Don’t completely eliminate salt, those with too little salt actually had an increased risk of heart attacks compared to those with a normal amount of sodium each day (about 2 grams/day). But then reservatol data in 2015 says that perhaps it's not the reservatrol that is the antioxidant in dark chocolate, berries and red wine?

Daily grapefruit was touted to lower appetite thus decreasing weight while increasing daily vitamin C, but now has been found to have a compound called furanocoumarin that can negatively interact with many medications. And ultimately when does the 180 become a 180? Do we follow the advice, or wait until the advice is contradicted: again? Obviously you and your gyno have to gab! With the first article published, or a bit more validation over time? Most physicians like the initial study to be corroborated. I like to view that first piece of information as another piece of the puzzle to be sorted. But an apple a day: Still good advice, enjoy one right away! First written for the News Gazette Health Magazine, Updated 9/9/11.

And then the newest info is that hormone therapy in menopause, either estrogen only, or progesterone and estrogen have been linked to increased risks of ovarian cancer, although combination therapy protects against uterine cancer, and estrogen alone protects against breast cancer.

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