Women's Health Newsletters 2/9/03- 4/20/03
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****** Woman's Health Newsletter *******
February 9, 2003
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
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1. Sleep loss is heart risky for women
2. High vitamin A intake and bone fractures
3. Reader submitted Q&A - Diagnosis of menopause
4. Optimizing male fertility
5. Health tip to share - Hypothermia
6. Humor is healthy
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1. Sleep loss is heart risky for women
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sleep may play a role in a woman's risk for heart
disease. At least that is the suggestion from a
recent study from Brigham and Women's Hospital in
the Archives of Internal Medicine.
The scientists analyzed data from the large
Nurse's Health Study encompassing over 70,000
women aged 45-65 at enrollment. They had asked the
nurses at the beginning of the study how much
sleep per night they were getting. Then they
compared that with the development of heart
disease and conditions over the follow up period
of 10 years.
They found that women reporting 5 or fewer hours
of sleep a night compared with women who had 7-8
hours of sleep had a risk ratio of 1.8 or an 80%
increase of coronary heart problems. Those getting
6 hours of sleep a night even had a 30% increased
risk.
Interestingly, sleeping too much, 9 hours a night
or more, was also found to be associated with a
40% increased risk of coronary heart events.
As we have mentioned before it is not safe to
assume that sleep is the cause of a cardiac event
effect. For example, anxiety and stress causing
insomnia (5 hours of sleep per night or less) or
depression causing fatigue (9 or more hours of
sleep) could very likely be the culprits causing
adverse cardiac events. If this were true than the
treatment is not sleeping pills but rather stress
reduction or depression treatment. There could
also be many other factors that are the cause of
less sleep and heart problems rather than just the
amount of sleep itself.
In either case, however, it makes sense to try to
examine why a person is sleeping less than the
ideal 6.5-8 hours of sleep a night. If this is a
sporadic problem, don't worry but if it is a
constant habit, try to make changes that allow
more sleep.
Skimping on Sleep Raises Heart Risk for Women
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2. High vitamin A intake may cause bone fractures
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Not all vitamins are beneficial. High levels of
vitamin A intake have been associated with bone
deformities in newborn babies and spontaneous bone
fractures in animals. Some studies have indicated
an increased risk of hip fracture and low bone
density in women with a high dietary intake of
vitamin A. However dietary intake studies where
investigators depend upon your recall of what you
ate recently are fraught with inaccuracies.
In order to see if vitamin A really is associated
with fractures in adults, scientists have to
measure Vitamin A levels in blood or a byproduct
of vitamin A and correlate that with fractures
over time. That would produce more conclusive
evidence if there is an association.
In the study below, investigators measured blood
retinol levels, a chemical byproduct of vitamin A
metabolism. The measurements were made in men at
entry into the study and then they were followed
for 30 years. The men with the highest retinol
levels had an overall bone fracture risk that was
7 times higher than the men with the lowest
levels.
Again, this is association and not proven cause
and effect. It does not mean for sure that taking
vitamin A supplements puts you at risk for more
fractures but it should remind us that too much of
anything may have a potential to be harmful.
Vitamin A and bone fractures
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3. Reader submitted Q&A - Diagnosis of menopause
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I would like to know how a doctor can assume
without doing any blood work to check levels that
you have 'gone thru menopause' and put you on HRT.
I am 51. I started having irregular cycles about 4
yrs ago that also began some hot flashes. My OBGYN
did the blood work, and suggested Lo Estrin
1/20(R), I am not taking it for birth control. I
had my tubes tied in '85. The hot flashes went
away; so did my periods and I have been on Lo
Estrin(R) with no problems almost 3 years. Now
every 6 months I have been getting the levels
checked about (into) 6 days of not taking the 21
pill regimen and the levels have been normal. Last
time checked (6 months ago), the FSH level was
12."
"Last week I go in for my yearly check up and she
says how long has it been with no period, I said
over a year, she replied well you're ready for HRT
(I lost my job 8 months ago and have no insurance
coverage at this time) so we bypassed the lab
work, but to me this seems like a very unethical
way to determine if I have gone thru menopause.
she would not refill my Lo Estrin(R) and gave me
about a year's supply of FemHRT."
"Is this a common practice for obgyn's to just
assume by looking at your face that you need HRT??
She told me it's the exact medicine as in the Lo
Estrin(R), just a smaller amount of estrogen. I
had no choice but to start taking it, but I am
very perplexed and confused especially with all
the controversy surrounding HRT. If its not time
for me to be taking this yet, what am I doing to
myself in the meantime?" - Suzie
You may be having a communication problem with
your Ob-Gyn. So I do not have the same problem,
let me restate what I think you said.
You have not had a menses for at least a year even
though you have been taking Lo Estrin (cyclically)
during all that time. Also as of about 6 months
ago your blood test did not measure that you were
menopausal. Now, the doctor has assumed you are
menopausal without doing a blood test and she
wants to switch you to HRT (a continuous
combination pill with estrogen and progestin
called FemHRT). You have no insurance coverage and
so are concerned about expenses. You did not say
whether you conveyed to the doctor your concern
over expenses but I suspect she knows if you do
not have insurance coverage. Finally, you are
concerned that her decision to assume you are
menopausal without having you undergo the expense
of another FSH test is 'unethical".
Also you sound concerned that HRT (FemHRT) might
be more dangerous to you than the Lo Estrin(R)
oral contraceptive.
If these statements are essentially the facts
here, I have the following comments:
I would guess that at age 51 and having had no
menses for a year on cyclical oral contraception
pills, it is about 90-95% probable that you are
menopausal even though 6 months ago you were not.
Since the doctor is probably concerned about you
having to spend money, I do not think it is
unethical to forego the FSH test and go straight
to HRT. Even if she is wrong, the treatment will
still help any hot flashes and give more constant
hormone levels than your body would do without
them.
She wants to get you on LOWER doses of hormone
treatment by switching to HRT instead of an oral
contraceptive. I would think you would want to do
that too since you are concerned about adverse
effects from HRT. She is correct in that the
individual components of LoEstrin(R) and FemHRT
are identical. Both have 1 mg of norithindrone
acetate, while FemHRT(R) has only 5 mcg of ethinyl
estradiol versus LoEstrin(R) which has 20 mcg.
Thus she is decreasing your estrogen dose to one
fourth of what it was.
Actually I do not think there are excessive risks
to HRT at all and the benefits outweigh any small
risks as I have expressed many times in this
newsletter. However, any risks that HRT have are
very likely to be LESS than the risks of taking
the higher estrogen and progestin dose birth
control pills such as Lo Estrin(R). We feel
perimenopausal treatment of hot flashes with low
dose oral contraceptives are still low enough in
risk to be safe even though they would be a
smidgen more risky due to the slightly higher
hormone doses than HRT.
I would agree with continuing the HRT instead of
the Lo Estrin(R) whether you are menopausal or
still perimenopausal. I think it makes more sense,
all things considered. If you are not sure this is
the best course of action, just call the office
and ask if you can have an FSH test or order an
at-home Menopause Test kit although you will need
to pay yourself for either one.
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4. Optimizing male fertility
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Male factors such as sperm count, sperm motility
and normality of sperm function actually play a
large role in producing infertility, up to 40%.
Both men and women want to know what can be done
to make sure the male sperm component is as
healthy as possible when trying to conceive.
The first step for a male is to have a medical
sperm analysis performed to make sure there are no
major problems in count, movement and shape. If
there are abnormalities, there may be medicines or
procedures that the doctor can order to improve
those parameters.
There are some Don'ts' and Do's for men to further
optimize sperm health:
Don't subject the testicles to long periods of
heat. Prolonged heat such as that from an hour in
a sauna, steam room or hot tub can lower sperm
count and motility.
Don't drink more than one or two drinks of alcohol
a day. Alcohol also affects sperm counts.
Don't take illicit drugs. Marijuana decreases
sperm count, movement and increases the number of
abnormal sperm. Cocaine can cause difficulty with
having an erection and amphetamines decrease
libido.
Don't smoke. Smoking over a pack of cigarettes a
day can cause abnormal sperm shapes and slow
movement.
Avoid exposure to toxic chemicals. Many chemicals
in standard cleaners, paints, pesticides,
herbicides, glues and anything with heavy metals
such as mercury, lead, arsenic, nickel, cadmium
and others can be toxic to sperm production if
they accumulate in the body.
Some other things a man should consider are to eat
healthy and avoid stress because stress alters
hormone levels which are needed for sperm
production.
Sperm smarts: Optimizing fertility
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5. Health tip to share - Hypothermia
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Cold weather for an extended period of time puts a
person at risk for hypothermia or low body
temperature. This is especially true for older
adults who may be trying to save on heat in their
home. Hypothermia can be serious and affect muscle
performance. It becomes serious when you observe
the "'umbles' -- stumbles, mumbles, fumbles and
grumbles."
If you observe someone, especially an elderly
person, with the above, blundering behavior, check
their oral temperature. If it is lower than 96 deg
F, get them wrapped in a blanket and to a health
facility.
If you have discovered ways of coping with a
disease or condition and it works for you, please
share it with us:
Health tip suggestion form
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6. Humor is healthy
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For thousands of years, men have tried to
understand the rules when dealing with women.
Finally, this merit/demerit guide will help men
understand just how it works. Give it to your
favorite man to promote understanding.
Merit - Demerit Guide
In the world of romance, one single rule applies:
Make the woman happy and you get points. Do
something she dislikes and points are subtracted.
You don't get any points for doing something that
she expects. Sorry, that's the way the game is
played. Here is a guide to the points system:
SIMPLE DUTIES
You make the bed +1
You make the bed, but forget to add the decorative
pillows -1
You throw the bedspread over rumpled sheets -2
You leave the toilet seat up -5
You replace the toilet paper roll when empty +5
When the toilet paper roll is empty, you resort to
Kleenex -1
When the Kleenex runs out you use the next
bathroom -2
You go out to buy her extra-light panty liners
with wings +5
- in the rain +8
- but return with beer -1
- and no pads -25
You check out a suspicious noise at night +1
You check out a suspicious noise and it is
nothing 0
You check out a suspicious noise and it is
something +5
You pummel it with a six iron +10
It's her cat -40
AT THE PARTY
You stay by her side the entire party 0
You stay by her side for a while, then leave to
chat with a school drinking buddy -2
- named Tiffany -5
Tiffany is a dancer! -10
- with breast implants -20
HER BIRTHDAY
You remember her birthday +1
You buy a card and flowers +2
You take her out to dinner +5
You take her out to dinner and it's not a sports
bar +5
Okay, it is a sports bar -20
And it's all-you-can-eat night -30
It's a sports bar, its all-you-can-eat night, and
your face is painted the colors of your favorite
team -35
A NIGHT OUT WITH THE BOYS
Go with a pal 0
The pal is happily married +1
The pal is single -10
He drives a Ferrari -20
- with a personalized license plate (GR8 NBED) -25
A NIGHT OUT WITH HER
You take her to a movie +2
You take her to a movie she likes +5
You take her to a movie you hate +8
You take her to a movie you like -5
- it's called Death Cop III -10
- which features Cyborgs that eat humans -11
You lied and said it was a foreign film about
orphans -15
YOUR PHYSIQUE
You develop a noticeable pot belly -15
You develop a noticeable pot belly & exercise to
get rid of it +10
You develop a noticeable pot belly and resort to
loose jeans and baggy Hawaiian shirts -30
You say, "It doesn't matter, you have one too."
-1000
THE BIG QUESTION
She asks, "Does this dress make me ! look fat?"
You hesitate in responding -10
You reply, "Where?" -35
You reply, "No, I think it's your butt" -100
Any other response -20
COMMUNICATION
When she wants to talk about a problem, you
listen, displaying a concerned expression +1
You listen, for over 30 minutes +5
You relate to her problem and share a similar
experience +50
Your mind wanders to sports and you suddenly hear
her saying "Well, what do you think I should do?"
-100
IT'S THAT TIME OF MONTH
You talk -100
You don't talk -150
You spend time with her -200
You don't spend time with her -500
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That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
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****** Woman's Health Newsletter *******
February 23, 2003
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
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1. Topical creams versus pills for athlete's foot
2. Stress at work - Control it
3. Reader submitted Q&A - Hot flashes
4. Celiac disease and bowel reaction to dietary glutens
5. Health tip to share - Allergy skin test interference
6. Humor is healthy
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1. Topical creams versus pills for athlete's foot
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Can foot and toenail fungus be treated with over-
the-counter creams or is it better to use
prescription medicine? To answer this we need to
look at studies in the literature that compare
various treatments to see how successful they are.
From the Bandolier Internet journal about health
care that reviews evidenced-based medicine
articles, we can see the efficacy of various
treatments.
Topical azole creams such as clotrimazole
(Lotrimin(R), Mycelex(R)), and miconazole used for
about 4-6 weeks are about 85% effective at curing
the fungus.
Creams with topical allylamines (Lamisil (R)
creams sprays) are about 75% successful in curing
foot and nail fungus.
Topical undecanoates (Tinactin (R))are about 67%
successful.
By prescription, terbinafine (Lamisil® tablets)
250 mg was over 80% effective and fluconazole
(Diflucan (R)) about 90% effective although the
studies are small.
This means that topical anti-fungal creams such as
Mycelex(R) that you can buy without a prescription
are about as effective as prescription pills that
you have to visit the doctor to get. It certainly
is worth trying to treat foot fungus yourself
before seeking medical attention. If that doesn't
work, then a prescription for tablets may be the
next step.
Topical and oral treatments for foot fungal infections
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2. Stress at work - Control it
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Stress usually comes from one of three areas: at
work, from family or relatives or from self-
imposed expectations. For many women, work is a
major source of stress. Here are some tips from
Mayo Clinic to reduce stress from the workplace.
1. Determine your priorities. You cannot do
everything. Time for family, time for exercise,
time to eat in a relaxed mode, desire to have a
house absolutely spotless, need for overtime pay,
employer assigned tasks that require work beyond
normal hours, time for sleep and many other
activities compete for your limited time. Rank
what is important to you so that if two of the
activities compete for your limited time, assign
which one takes precedence and give up your
concern over having to let go the other activity.
2. Schedule time for renewal. Each day, set aside
time to relax. Even at work there should be break
time or lunch time that you can grab a moment to
do something to stress bust.
3. Take advantage of a workplace wellness program
if available.
4. Talk with your supervisor. Whether you have a
health problem, a child care problem, a co-worker
problem or even unrealistic expectations from the
supervisor him/herself, sit down and try to
discuss these concerns with the supervisor when
you are not stressed out. Do not be afraid to
bring up issues as long as you sound like you want
to constructively work to overcome these problems
in a way that everyone would benefit from.
5. Keep stress in check. When you feel stress
getting the upper hand, make a renewed effort to
start or resume a stress-busting activity. It will
help your work performance. You may be able to do
this by:
change your health habits
get more sleep (7-8 hours)
practice stress management techniques at work
build your skills to listen better and manager
your time more efficiently
develop a support system of friends or co-workers
draw the line between your job and your home life
Finally, you may have to consider a different job.
Sometimes you cannot change your reaction to work
related issues or outlast a supervisor who is
unreasonable. Then it is time to strongly consider
finding a new job.
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3. Reader submitted Q&A - Hot flashes
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"I quit taking my Estratest(R). Didn't feel the
need to take it any more. Didn't make me feel any
different. Still had hot flashes."
"I'm 39 yrs.old and had a total hysterectomy at 37
yrs.old. What do you think I should do, the hot
flashes are driving me crazy." - P.R.
Estratest (R) has both estrogen (estradiol) and
testosterone in it. The estrogen component is
expected to help reduce hot flashes whereas the
testosterone may help sexual desire but not the
hot flashes very much. There are three main
reasons that the medicine may not be helping you:
1) The dose of estrogen may be too low. Women who
have a surgical menopause often require more
estrogen than women who undergo natural menopause
at a later age. Usually a full strength
Estratest(R) would be enough replacement but
sometimes not.
2) You may not be absorbing the full amount of
medicine into your blood stream from the stomach
and gastrointestinal tract. Different people have
different levels of enzymes in the GI tract which
aid or hinder absorption of hormones.
3) The hot flashes may be triggered by causes
other than hormone deficiency such as stress,
foods, heat sources, other medications or other
medical conditions such as chronic infections,
thyroid disease etc.
The best way to eliminate the 3rd item (other
cause) is to get blood levels of estrogen drawn
(serum estradiol) on a day when you have taken the
Estratest(R) earlier. The blood estradiol level
should be between 50-100 pg/ml. If it is, then you
are absorbing the medication and it is very likely
that hot flashes are from some other cause than
estrogen deficiency.
If the level is lower than 50 pg/ml, then you are
not absorbing the pill. You may want to ask your
doctor to change you to a different estrogen pill.
Usually conjugated estrogens absorb better than
natural micronized estradiol. If that still does
not work, try a skin patch with estrogen and have
the blood levels checked. It would be highly
unusual that your levels could not be brought into
a normal postmenopausal replacement range with a
skin patch but if not, every 4 week injections of
estrogen at the doctor's office are still an
option although the very last choice in my
opinion.
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4. Celiac disease and bowel reaction to dietary glutens
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Celiac disease is an inflammatory condition of the
bowel in which the ingestion of gluten-containing
grains (wheat, barley, and rye) produces an immune
response in genetically susceptible individuals.
The inflammation from the immune response causes
recurrent diarrhea, constipation and abdominal
pain.
While once thought to be a rare disease, recent
studies show it is more common than doctors
expect. Since blood tests have been developed that
can detect this condition,
Celiac disease test kit
more attention has been paid to this as a cause of
frequent bowel symptoms.
The study below as reported in the Archives of
Internal Medicine looked at different groups of
people across the U.S. to see how common this
disease is. They found:
in individuals who have a parent, sibling or child
with celiac disease, the risk was 1 in 22
in individuals who have an aunt, uncle,
grandparent, niece or nephew with celiac
disease, the risk was 1 in 39
in individuals who are having bowel symptoms, the
risk is 1 in 56
in individuals who are asymptomatic and so not
have a family history of celiac disease, the
risk is 1 in 133.
This prevalence is more frequent than most doctors
have previously thought and it turns this
condition from a rare one to something that should
be looked for more commonly. If you or someone you
know is suffering from frequent bowel problems or
has gastrointestinal intolerance to pasta, breads,
cereals and so forth, you may want to seek out
testing for celiac disease.
Celiac disease prevalence
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5. Health tip to share - allergy skin test interference
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you are going to have an allergy skin test
performed to determine what allergies you may
have, certain medications can interfere with the
test. Anti-histamines should not be taken before
allergy testing as well as antidepressants or
heartburn medications. Be sure to let your doctor
know what meds you are taking.
If you have discovered ways of coping with a
disease or condition and it works for you, please
share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Grave Humor"
On the grave of Ezekial Aikle in East Dalhousie
Cemetery, Nova Scotia:
Here lies
Ezekial Aikle
Age 102
The Good
Die Young.
In a London, England cemetery:
Ann Mann
Here lies Ann Mann,
Who lived an old maid
But died an old Mann.
Dec. 8, 1767
In a Ribbesford, England, cemetery:
Anna Wallace
The children of Israel wanted bread
And the Lord sent them manna,
Old clerk Wallace wanted a wife,
And the Devil sent him Anna.
Playing with names in a Ruidoso, New Mexico,
cemetery:
Here lies
Johnny Yeast
Pardon me
For not rising.
Memory of an accident in a Uniontown,
Pennsylvania cemetery:
Here lies the body
of Jonathan Blake
Stepped on the gas
Instead of the brake.
In a Silver City, Nevada, cemetery:
Here lays Butch,
We planted him raw.
He was quick on the trigger,
But slow on the draw.
A widow wrote this epitaph in a Vermont cemetery:
Sacred to the memory of
my husband John Barnes
who died January 3, 1803
His comely young widow, aged 23, has
many qualifications of a good wife, and
yearns to be comforted.
A lawyer's epitaph in England:
Sir John Strange
Here lies an honest lawyer,
And that is Strange.
Someone determined to be anonymous in
Stowe, Vermont:
I was somebody.
Who, is no business
Of yours.
Lester Moore was a Wells, Fargo Co. station
agent for Naco, Arizona in the cowboy days
of the 1880s. He's buried in the Boot Hill
Cemetery in Tombstone, Arizona:
Here lies Lester Moore
Four slugs from a .44
No Les No More.
In a Georgia cemetery:
"I told you I was sick!"
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Health Newsletter *******
March 9, 2003
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Dietary fat intake affects hormone levels
2. Sinus treatment with saline nasal spray
3. Reader submitted Q&A - Vulvar burning/dystrophy
4. Sexual Health
5. Health tip to share - Allergic rhinitis
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Dietary fat intake affects hormone levels
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
You would think from the popular press that
cholesterol is entirely bad, bad, bad. Actually,
however, dietary fats containing cholesterol are
absorbed into the blood stream when you eat them
and then the cholesterol is used as a building
block for many hormones that are essential to the
functioning of the body.
It is an interesting concept as to whether eating
more fats would result in higher hormone levels.
The body usually stores excess cholesterol as fat
but it is possible that some excess fat goes into
producing more hormones also. Investigators from
Philadelphia looked at this premise in a group of
teenage girls who had to be on a low fat diet and
compared them to teens on a regular diet. They
then measured estrogen, progesterone and
testosterone blood levels at 1, 3 and 5 years of
the dietary study.
They found that estrogen and progesterone levels
were lower in the teen girls on the low fat diet
while their testosterone levels were higher. The
levels were 25-50% different which is quite a
large change considering.
This implies either that restricting fat in the
diet lowers female reproductive hormone levels or
that high fat diets increase hormone levels. The
investigators are trying to make the case that
dietary modification may be able to reduce your
risk for breast cancer by lowering estrogen
levels. I am not sure you can make that leap of
logic but it is interesting how dietary fat may
alter the estrogen levels by an amount that could
affect menstrual bleeding and other reproductive
conditions.
Dietary fat intake affects hormone levels
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Sinus treatment with saline nasal spray
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many individuals suffer from chronic sinusitis.
They have yellowish green drainage when they blow
their nose along with a constant head congestion
fullness. Most of the time treatment includes
antibiotics to fight off the bacteria that cause
the infection in the first place.
There have not been many studies about what to do
to prevent sinus infection flare-ups. The study
below looked at the use of a daily hypertonic
saline (salt water) spray irrigation to reduce
sinusitis recurrences. The principle behind
hypertonic saline is that the extra salt draws
some of the fluid out of the skin lining the nasal
passages. Thus it reduces edema (swelling) around
the sinus openings that may have been blocking
normal sinus mucous drainage and predisposing to
infection.
Seventy six subjects were tested with half using
hypertonic saline irrigation on a daily basis and
half not using any routine spray. The study group
had a 57% improvement with less episodes of
antibiotic and nasal spray use and fewer days of
symptoms.
They concluded that daily irrigation with
hypertonic saline which is an over-the-counter
product, is an effective strategy to reduce the
frequency of sinusitis.
Sinus treatment with saline nasal spray
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Vulvar burning/dystrophy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am a married female suffering from what my
gynecologist said is called vulvar dystrophy.
This means that I have a part of the vagina always
burning to the extent that my husband cannot even
touch me let alone intercourse. This has happened
after total hysterectomy 10 years ago and after
taking HRT which I have stopped taking. My
gynecologist told me that the only cure is by
surgery but it may not be a total success. Is it
not possible that in these modern times and age
there is no other cure? - J.M.
I doubt very much whether the condition you
describe was caused by either the hysterectomy or
the hormone replacement therapy or lack of it. If
it were, we would see a much higher incidence of
the problem.
What you describe is vulvodynia or "painful
vulva". Sometimes it is due to vulvar dystrophy
which is a skin change that may or may not produce
pain. Sometimes you hear about a disease or
condition called vulvar vestibulitis. You may
wonder when a painful, burning vulva is vulvar
vestibulitis, vulvar dystrophy or when it is just
a symptom of some other condition such as candida
vaginitis, genital herpes infections, vaginismus
(spasm of the vaginal opening muscle), allergic or
irritant reactions or one of many other less
frequent but possible causes. Your doctor has
hopefully narrowed it down from some of these
other etiologies.
Assuming your condition is vulvar dystrophy
causing the pain, I think it is safe to say that
even in these modern times the treatments for this
are not universally successful. Surgery may only
be 60-80% successful but none of the other
treatments such as steroid injections or
ointments, nitroglycerin paste, capsaician
(chemical from hot peppers), dietary
interventions, muscle relaxation training,
biofeedback therapy, and electrical stimulation
are any more successful; often they are less.
I cannot tell you if surgery is the right answer
for you. For my own part, I lean more and more
toward surgery to treat this if it has been a long
term problem for two or more years and the woman
has tried some of the other treatments
unsuccessfully. We are always looking for newer
successful treatments for this uncommon but very
perplexing and debilitating problem.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Sexual Health
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sex is enjoyable but it can also be stressful.
Many couples wonder if their sexual activity and
frequency is normal. There is a very wide range of
normal, however, and it does not really matter if
one couple's frequency of intercourse or specific
sexual behavior is the same as that of another
couple as long as both partners are satisfied and
comfortable with the relationship.
There actually is no definition of normal sexual
behavior and no exact norms to fit into. Frequency
of sexual intercourse might be normal at once a
year, once a month, once a week or once or several
times a day, as long as both partners are
satisfied. If one partner has a significantly
different level of sexual desire than the other,
then it becomes a problem.
If there is a large difference in sexual desire in
a couple, concerns are raised and both people may
feel unloved. There are things that can be done
even when the levels of desire are greatly
different. A therapist may need to be involved and
you might be interested in the comments via the
link below of one of Mayo Clinic's psychologists
about this problem.
What happens if one partner considers a certain
sexual activity that the other partner requests,
as repulsive? How do you reconcile widely
different behavior desires? The activities need to
be negotiated and that is where the help of a
therapist may come in. There can be difference
among partners, some of which are negotiable and
some of which are not. It often takes a third
party to sound out and iron out the different
concerns.
In order to function normally with regard to
sexual arousal, the following conditions are
needed:
partners need to have a feeling of self-confidence
they need to be free from anxiety
they must have arousing mental AND physical
stimulation
they must have ability to focus attention on
sexually arousing thoughts or behavior (free
from distractions)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Allergic rhinitis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am almost 70 years of age and suffer with runny
nose and eyes watering in the summer when pollen
starts to appear. I used to take Claritin (R)
and it worked well, but I developed stomach
problems. Other medications made me very sleepy.
I started wearing an over-the-nose painting mask
that you can purchase at Walmart or other places.
Now I do not suffer from the runny nose and watery
eyes. As soon as I'm out the door, on goes the
mask. I live in the country so I don't care if I
do look weird. If I suffered enough and lived in
the city, I'd wear it anyway." - Marian
If you have discovered ways of coping with a
disease or condition and it works for you, please
share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
First mammogram practice exercises
Many women are afraid of their first mammogram,
but there's no need to worry. By taking a few
minutes each day for a week preceding the exam,
and doing the following practice exercises, you
will be totally prepared. And you can do this
right in your own home!
Exercise 1:
Open your refrigerator door and insert one breast
between the door and the main box. Have one of
your strongest friends slam the door shut and lean
on the door for good measure. Hold that position
for five seconds (while you hold your breath).
Repeat again, in case the first time wasn't
effective enough.
Exercise 2:
Visit your garage at 3 am when the temperature of
the cement floor is just perfect. Take off your
clothes and lie comfortably on the floor with one
breast wedged under the rear tire of the car. Ask
a friend to slowly back the car up until your
breast is sufficiently flattened and chilled.
Turn over and repeat for the other breast.
Exercise 3:
Freeze two metal bookends overnight. Strip to the
waist. Invite a stranger into the room. Press
the bookends against one of your breasts. Smash
the bookends together as hard as you can. Set an
appointment with the stranger to meet next week
and do it again!!
CONGRATULATIONS!
Now you have nothing at all to worry about when
you go for your Mammogram!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Health Newsletter *******
March 23, 2003
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Do vitamin supplements help prevent infections?
2. Accidental loss of stool
3. Reader submitted Q&A - Postoperative back pain
4. Vitamins E and C to prevent vascular disease
5. Health tip to share - Vulvar burning
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Do vitamin supplements help prevent infections?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many people who take vitamin supplements do so to
prevent common infections such as colds, flu,
bronchitis, GI upset and other minor but annoying
infections. While vitamin supplements have been
studied as preventatives for many different
illnesses and conditions such as cancer and heart
disease, they have not been looked at very much
for their ability to prevent common infections.
A recent study conducted in North Carolina and
reported in the Annals of Internal Medicine,
looked at infection rates among 158 individuals
who took multivitamin and mineral supplements
versus a placebo that contained only vitamin B12,
B2, calcium and magnesium.
Participants who had adult onset diabetes had
lower infection rates when taking the multivitamin
then did those taking the placebo (17% vs 93%).
Individuals who did not have adult onset diabetes
had no differences in infection rates according to
whether they took multivitamins (59%) or did not
(60%).
The purpose of this study was "to assess the
effect of a typical 'one-a-day' multivitamin and
mineral supplement on infection rate and perceived
quality of life in a fairly broad sample of
relatively healthy adults." Basically, they found
no difference between the treatment and placebo
groups in physical and mental health measures of
quality of life. Thus, it seems that multivitamin
and mineral supplements do not increase health or
energy levels any more than placebos do unless you
have a condition like diabetes which makes you
more susceptible to infections.
Do vitamin supplements help prevent infections?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Accidental loss of stool
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The inability to control stool and prevent any
"leaking" of both fecal material or bowel gas is
called fecal, rectal or anal incontinence. It is a
very socially debilitating condition. It can be
just a small amount of "leakage" or it can range
to total loss of bowel movement control.
Most people never have this problem unless they
develop a severe case of diarrhea. It is more
common in women after childbirth and in adults
over the age of 65 who have some muscle or nerve
weakness of the anal sphincter muscle.
Causes of fecal incontinence include:
constipation with impaction
irritable bowel syndrome, chronic diarrhea
multiple sclerosis
diabetes
strokes
spinal column trauma or arthritic disc problems
injury from childbirth
rectal irradiation or surgery
Crohn's or any inflammatory bowel disease
Alzheimer's and other dementias
Diagnosis of the cause of fecal incontinence
involves ruling in or out any of the above
diseases. If a bowel condition or diet is the
cause, treatment is directed at controlling the
diarrhea or constipation process. This may be
through both diet control and medications.
If any muscle weakness or injury is the primary
problem, sacral nerve stimulation and biofeedback
may be used to strengthen the internal and
external anal sphincter muscles. The nerve
stimulation produces muscle contractions which in
turn gives a person more voluntary muscle control.
Permanent nerve damage from something such as a
stroke, long standing diabetes, multiple sclerosis
or Alzheimer's is much more difficult to treat.
Sometimes it requires a colostomy so that stool
soiling does not break down the skin and cause
ulcerative infections.
If the external anal sphincter is damaged with
childbirth or other rectal surgery it can
sometimes be either surgically fixed using
existing muscle tissue or an artificial anal
sphincter muscle may be inserted in the anus.
Be sure to see your doctor if there is any
difficulty holding stool or bowel gas. You may
need a referral to a bowel specialist but your
physician can direct you to the specialist most
likely to help you.
Incontinence of stool
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Postoperative back pain
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I had my uterus removed over a year ago due to a
9 cm cyst that was attached to it. I also had
endometriosis on my right ovary that was
cauterized during surgery. While I am pain free in
the menstrual and ovulation process, I have
developed intense low back pain. My massage
therapist and chiropractor both agree it is due to
the groin muscle or iliopsoas muscle being
extremely tight! I had the surgery through my
belly button and vagina, not through the abdomen.
I have been told that I have scar tissue as well.
Is there anything that can be done to alleviate
the constant visits and expense to these
therapists? I have tried all the stretching
techniques but everyday I am still in constant
pain...Help!" - Susan
Post-operative low back pain is an often
underestimated complication of any surgery, not
only hysterectomies. Some doctors try to ignore it
while others admit it is a complication but they
are unable to determine the causes. Some guess at
the cause as inflammation around the muscles and
nerves of the back and pelvis caused by the
surgery itself while others think it just has to
do with injury from lying on the hard operating
room tables for a couple of hours followed by
hospital mattress support (poor) for a few days
that is different than one is used to on their
home bed.
One study from Great Britain looked at women who
had hysterectomies and found that the overall low
back pain incidence following hysterectomy was
about 15-18% and lasted on the average for 7
months after surgery. They also looked at whether
it made a difference in the rate of low back pain
whether a women had the surgery with the legs
elevated like a pelvic exam is done (lithotomy) or
whether the legs are flat with the body (supine)
during the surgical procedure. There was not much
difference in the incidence of postoperative low
back pain (14% lithotomy, 20% supine) although the
supine position was slightly worse.
Another study found that the rate of low back pain
was less if the surgery was less than 40 minutes
and if patients were made to walk and sit up
sooner after the surgery than if they were allowed
to lie in bed for a prolonged time.
Keep in mind that at any one time, between 14% and
42% of all adults will admit to having some degree
of back pain. It is a common problem that is often
coincidental with the surgery rather than caused
from it.
Unfortunately, knowing that low back pain can be
associated with surgery is not any help in
treating it. Basically you have to have x ray
studies such as an MRI to rule out any spinal
abnormality that may be contributing to the pain
and you need a good exam to make sure what nerves
or muscles are involved. If you have not had an
MRI study of the pelvis and lumbar spine, that
would be the next step. It sounds as though you
have been through this part already and the pain
has been determined as associated with the
iliopsoas muscle.
I am sorry I cannot give you any tips for
improving the low back pain. That is best left up
to the orthopedic and physical therapy specialists
along with your treatments from the massage
therapist and chiropractor.
Be sure if you have any problem with being
overweight that you are dieting to lose at least
15 pounds or 10% of your body weight. It will make
a significant difference in the low back pain.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Vitamins E and C to prevent vascular disease
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Vitamin supplements of E (136 IU) and slow-release
C (250 mg) have previously been reported to slow
the progression of atherosclerotic heart disease
and heart attacks in individuals with elevated
cholesterol. Unfortunately at 3 years of the main
Finnish study looking at this, the reduction was
only significant in men but not women.
The investigators have now updated their results
with a six year follow up. They continue find a
significant reduction in atherosclerosis in men
but in women, the reduction of only 14% was not
significant.
Vitamin E and Vitamin C to prevent atherosclerosis progression
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Vulvar burning
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"This comment is for the woman who was suffering
from vulva burning. I am post menopausal and was
suffering from that problem also. It was due to
the lack of estrogen and it was awful. Taking
estrogen by mouth did not agree with me and I was
leary with all the bad press on estrogen. My GYN
gave me estrogen suppositories called Vagifem(R).
He said it would treat the problem, but was not
systemic. I only needed to insert one once every
10 days although the doctor prescribed once or
twice a week. I gradually went down to once a
month and now I have not needed one for several
months. When I feel the irritation and burning
starting again, I use one of the suppositories.
Also, for women suffering from menopause symptoms,
especially hot flashes, Effexor(R) is wonderful. I
was in the constant state of hot flashes and when
I started taking Effexor(R) for anxiety attacks all
my menopause discomforts vanished along with the
anxiety attacks. I hope these tips help other
women." - CLF
If you have discovered ways of coping with a
disease or condition and it works for you, please
share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Of Cats and Dogs... Maybe"
If you want someone who will bring you the paper
without first tearing it apart to remove the
sports section ...buy a dog.
If you want someone willing to make a fool of
himself simply over the joy of seeing you ...buy a
dog.
If you want someone who will eat whatever you put
in front of him and never says its not quite as
good as his mother made it ...buy a dog.
If you want someone always willing to go out, at
any hour, for as long and wherever you want ...buy
a dog.
If you want someone to scare away burglars,
without a lethal weapon which terrifies you and
endangers the lives of your family and all the
neighbors ..buy a dog.
If you want someone who will never touch the
remote, doesn't care about football, and can sit
next to you and watch a romantic movie ...buy a
dog.
If you want someone who is content to get up on
your bed just to warm your feet and whom you can
push off if he snores ...buy a dog.
If you want someone who never criticizes what you
do, doesn't care if you are pretty or ugly, fat or
thin, young or old, who acts as if every word you
say is especially worthy of listening to, and
loves you unconditionally, perpetually ..buy a
dog.
But on the other hand, if you want someone who
will never come when you call, ignores you totally
when you come home, leaves hair all over the
place, walks all over you, runs around all night,
only comes home to eat and sleep, and acts as if
your entire existence is solely to ensure his
happiness, then my friend --- Buy a cat.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Health Newsletter *******
April 6, 2003
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Severe acute respiratory syndrome (SARS)
2. Blood mercury levels in women and children
3. Reader submitted Q&A - Brittle fingernails
4. Diagnosis of overactive bladder
5. Health tip to share - Vitex for perimenopause
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Severe acute respiratory syndrome
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Severe acute respiratory syndrome (SARS) is the
name given to a recent form of illness
characterized by fever over 100.4F (38.0C), cough,
shortness of breath and extreme tiredness. The
difference between this condition and a serious
cold or flu is that the illness can cause death or
a pneumonia that requires hospitalization.
The current suspected agent that causes this is a
coronavirus that has mutated from the same family
of coronaviruses that produce common colds and
respiratory tract infections. A large outbreak of
this disease started in China and apparently has
spread from there via travellers.
The infection is spread by being in the near
vicinity (10 feet or less) of someone with the
virus who is coughing and sneezing. The symptoms
start about 2-7 days after exposure. In addition,
you have to have been exposed to someone who
recently travelled to Asia before doctors worry
that you may have this severe form of illness and
not just a common cold or respiratory infection.
Hopefully we will see more and more people wearing
paper face masks when they have colds to prevent
spreading even the common cold virus. Because of
SARS, there are also some travel restrictions and
warnings especially when going to Hong Kong and
China as well as other Asian countries. Be sure to
check on this if you are taking a trip to the far
East.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Blood mercury levels in women and children
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If the toxic metal mercury accumulates in a
person's body, it can produce symptoms such as
fatigue, memory loss, confusion, tremors, metallic
tastes and hair loss. Usually mercury levels in
blood are below 5 parts per billion but those
individuals who eat fish that have high mercury
levels from feeding in mercury contaminated water
will have higher blood levels themselves.
A recent study looked at 1250 children aged 1 to 5
years and 2314 women aged 16 to 49 years and
checked their blood levels of mercury. They found
mercury levels almost 3 times higher in women than
in children and it was highest in women (4 times)
that had eaten fish 3 or more times in the
previous 30 days. Approximately 8% of all the
women tested had elevated levels.
This study did not correlate blood mercury levels
with symptoms, but other studies have shown that
blood mercury levels above the Environmental
Protection Agency's limits of 5.8 ug/L is
associated with many of above symptoms. There is a
home test that can screen for elevated levels of
many of the toxic metals:
Mineral Check home mineral analysis
Blood mercury levels in women and children
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Brittle fingernails
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have two nails that keep splitting (in the
middle) of the nail. It is on the fourth finger of
both hands. It is very annoying because it causes
those nails to snag on everything I touch. What is
causing this and what can I do to prevent this
from happening? Is there any supplement that I can
take to help this condition? I already take a
daily vitamin supplement each day. Thank you for
any suggestions that you can give me." - SAE
This is not a topic I am very familiar with so I
have had to hit the books and journal articles to
see what dermatologists have said about this
problem.
Basically what you are describing are "brittle"
fingernails or a condition the dermatologists call
"onychoschizia". Approximately 20% of women have
this problem and it is aggravated by dehydration
of the nails from frequent washing and drying the
hands. In addition to repeated exposure to water,
it can also be associated with Working with
household cleaners, overuse of nail polish
remover, and certain sports and outdoor
activities.
Some people have attributed zinc deficiencies and
thyroid abnormalities to producing brittle nails
but the only hard evidence I could find was that
individuals with hematologic abnormalities
(anemia, iron deficiency) have a higher incidence
of this problem. Therefore make sure your doctor
checks you out for anemia with a complete blood
count to make sure there is not any problem there.
Treatment is to minimize exposure of the hands and
nails to repeated washing, cleansers and nail
polish remover. Also, the B vitamin, biotin, 2.5
mg a day, has been described as helpful in
restoring nail hardness after about 3-5 months of
use.
I remember as a child my mother saying that Knox
gelatine, at that time used for desserts and jams,
was very helpful to produce good nails. Knox
orange-flavored gelatine is still available in the
drug and grocery stores and it contains 0.3 mg of
biotin along with vitamins C, B3 and B6. It is
used now primarily as a supplement for nail health
and the gelatine may work in addition to the
biotin for nail health.
Thanks for asking this question. I learned a lot
about a common problem from trying to answer it!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Diagnosis of overactive bladder
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Overactive bladder is a relatively new diagnostic
term which as been coined or at least popularized
in the last decade by a pharmaceutical company
that developed a treatment for urinary frequency,
urinary urgency and urge urinary incontinence.
Most of these urgency, frequency symptoms are
thought to be associated with measurable bladder
contractions called uninhibited bladder detrusor
muscle contractions or "bladder spasms". These
contractions are discovered and measured on a
bladder test called a cystometrogram.
In a recent study from the United Kingdom of over
800 women who had symptoms consistent with
overactive bladder, only about half of them had
these uninhibited bladder contractions measurable
on the cystometrogram study. Also, in the all the
women who did have uninhibited contractions on
cystometrogram, only about 2/3's of them had
"overactive" bladder symptoms.
These results indicate that you do not have to
have uninhibited bladder contractions to make the
diagnosis of overactive bladder, but the authors
still recommend the cystometrogram because there
may end up being a difference in the treatment for
women with overactive bladder that have
uninhibited bladder contractions versus those that
do not.
Overactive bladder
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Vitex for perimenopause
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I'm an over 40 woman who may be perimenopausal. I
started having night sweats over the past year and
just recently 'hot flashes'. My doctor has not
issued a hormone test to determine if I'm in fact,
menopausal --- maybe because I have hope that I
may still become pregnant. I recently saw a
broadcast that featured an older couple who'd had
their first child. The new mom attributes it to an
herbal supplement called 'Fertility Blend'. I've
since ordered and am taking the supplement. To my
delight, the night sweats have ceased and so have
the 'hot flashes'. I believe one important herbal
ingredient is largely responsible -- VITEX or
Vitex Berry. The 'Blend' is also rich in Folate
and B vitamins. I am not 'new' to herbs and herbal
remedies. VITEX has long been recommended by
herbalists to treat women's health...from cervical
dysplasia to menopause. I'm not pregnant --- yet,
but I'm hopeful and pleased with the results of
the 'Blend'. I think the supplement is helpful,
even for women who feel they've passed their
child-bearing years." - Tami
If you have discovered ways of coping with a
disease or condition and it works for you, please
share it with us:
Health tip suggestion form
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"The Rules of Chocolate"
Q: Why is there no such organization as
Chocoholics Anonymous?
A: Because no one wants to quit.
Q: Is there life without chocolate?
A: We don't know. No one dared to
attempt it yet.
If you've got melted chocolate all over your
hands, you are eating it too slowly.
Chocolate covered raisins, cherries, orange
slices & strawberries all count as fruit, so eat
as many as you want.
The problem: How to get 2 pounds of chocolate
home from the store in a hot car.
The solution:
Eat it in the parking lot.
Diet tip: Eat a chocolate bar before each meal.
It'll take the edge off your appetite, and you'll
eat less.
If calories are an issue, store your chocolate on
top of the fridge. Calories are afraid of
heights, and they will jump out of the chocolate
to protect themselves.
If I eat equal amounts of dark chocolate and white
chocolate, is that a balanced diet? Don't they
actually counteract each other?
Money talks. Chocolate sings. Beautifully.
Chocolate has many preservatives. Preservatives
make you look younger. Therefore, you need to eat
more chocolate.
Put "eat chocolate" at the top of your list of
things to do today. That way, at least you'll get
one thing done.
A nice box of chocolates can provide your total
daily intake of calories in one place. Now, isn't
that handy?
If you can't eat all your chocolate, it will keep
in the freezer. But if you can't eat all your
chocolate, what's wrong with you?
If not for chocolate, there would be no need for
control top pantyhose. An entire garment industry
would be devastated. You can't let that happen,
can you?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
****** Woman's Health Newsletter *******
April 20, 2003
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Should you be screened for diabetes?
2. How aging affects your driving
3. Reader submitted Q&A - Progesterone cream
4. Organic food standards
5. Health tip to share - Hot flashes
6. Humor is healthy
If you wish to change this newsletter from
TEXT style to HTML style for subsequent
newsletters, go to the very bottom of this
page and choose the "Update your profile" link.
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Should you be screened for diabetes?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
When should you ask your doctor to order a test
for diabetes? Many people ask to have testing if
they have a family history of diabetes or if they
want a general checkup prior to starting a weight
reduction diet. The whole question is whether
detecting diabetes early before a person has
symptoms helps reduce any long term disability
that diabetes can produce. The answer to that is
probably "no" but there are some exceptions.
There are two major types of diabetes: juvenile
onset which requires insulin shots because the
pancreas does not make any insulin, and adult
onset (Type 2) in which the pancreas makes insulin
but the body is unable to use it normally. For the
most part, juvenile diabetes is discovered before
the age of 20 and adult onset diabetes after the
age of 20 although this is not a hard and fast
rule. Juvenile onset diabetes is treated with
insulin while adult onset diabetes is treated with
diet and oral hypoglycemic medications.
Symptoms of diabetes are excessive thirst,
fatigue, weight loss and frequent urination. If
you have any of those symptoms, you should asked
to be checked for diabetes or take one of the
Hemoglobin A1c Home Test Kits.
The U.S. Preventive Services Task Force looked at
whether screening for diabetes in the absence of
symptoms had any benefit to discovering the
disease early. They found that only in patients
with high blood pressure or with elevated
cholesterol did the early testing make a
difference. Therefore individuals who have
hypertension or high cholesterol levels should
periodically be screened for diabetes even though
they do not have symptoms.
Screening for diabetes mellitus
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