Women's Health Newsletters 4/18/99 - 5/30/99
***** Woman's Diagnostic Cyber Newsletter ***** April 25, 1999 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Menopause and perimenopause FAQs at Hotflash 2. Medical care and the elderly 3. Post tubal ligation syndrome 4. Software for health 5. How much vitamin C do you need? 6. Humor is healthy Spread the word! Send a copy of this newsletter to someone you know. Note: Some of the long URLs may not wrap as a hyperlink and you may need to cut and paste. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Menopause and perimenopause FAQs at Hotflash ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ For a fun web site that focuses on menopause and perimenopause and includes symptom charts, recipes favoring phytoestrogens, news, bookstore and marketplace, check out the FAQs and other menu selections from families-first.com and their "hotflash" section: (Peri)menopause FAQs ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Medical care and the elderly ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The following editorial, Geriatrics and the Limits of Modern Medicine, from the New England Journal of Medicine should be read by anyone over the age of 65 or who has elder parents or relatives they care for. It points out how the medicalization of medicine and the need to have diagnostic certainty can very much work against the medical tenet to relieve suffering. Sometimes we have to be careful of how much medical care can work against its original intent to "do no harm". ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Post tubal ligation syndrome ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Some women have menstrual irregularities and pelvic pain which develops in the years following a tubal ligation. Sometimes this is called post tubal ligation syndrome, but doctors are aware of studies showing that women whose husbands who have had vasectomy also develop these gynecologic problems at the same rate. After viewing a web site referenced on the message board that was dedicated to warning about the condition, it was apparent that a review of the literature was needed to prove them wrong. It ended up proving them correct, i.e., we need to inform women having tubals that there is the possibility of increased gynecologic problems afterwards. This weeks article looks at: Is there such an entity as post tubal ligation syndrome? Does the type of tubal ligation performed make a difference? Does the age at which a tubal is done make a difference? Are women who have tubal more likely to end up needing a hysterectomy? If I want to have a tubal ligation for sterilization, what outcomes can I expect? Is there a post tubal ligation syndrome? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Software for health ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The search engine, Lycos, has an excellent section on finding health related software that is available for download. Many of the programs are free or shareware; some are just demo programs enticing you to buy or register, but most of them seem very reasonably priced. They include many programs such as: diet, weight loss, moods, exercise, running, biorhythm, rest breaks, medical records, human body education, beauty remedies, diabetes, herbal therapies, phobia identification, cholesterol, pregnancy tracking, fertility assessment and many others. Each software package has an evaluation rating of 1-5 stars. Lycos software download ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. How much vitamin C do you need? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Vitamin C helps keep bones, teeth, gums, ligaments, and blood vessels healthy. It also helps the body's response to infection and stress, and helps use iron efficiently. There is also moderate evidence that, as an antioxidant, Vitamin C helps prevent some cancers. Recently the revision by the Food and Nutrition Board of the National Academy of Sciences from a requirement of 60 mg of Vitamin C a day to 100-200 mg a day requirement was published. Also, they warn that too much Vitamin C can be harmful and cause nausea and diarrhea. Therefore they recommend that 1000 mg (1 gram) of Vitamin C a day is too excessive. Vitamin C recommendations In order to get enough Vitamin C through diet, 5 servings of fruit or vegetables are recommended daily. For some women, this may imply a pill supplement is needed. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Gender Gap -=-=-=-=-=-=- A little girl and a little boy were at day care one day. The girl approaches the boy and says, "Hey Tommy, want to play house?" He says, "Sure! What do you want me to do?" The girl replies, "I want you to communicate your feelings." "Communicate my feelings?" said a bewildered Tommy. "I have no idea what that means." The little girl smirks and says, "Perfect. You can be the husband." Contributed by: MoodyFan ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. We will bring you accurate women's health answers again soon. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** May 2, 1999 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. PMS symptom tracking sheet 2. Pregnancy ultrasound normal and abnormal anatomy 3. Perinatal infections - when to check 4. Osteoporosis case conference 5. Soap and detergent health and safety 6. Humor is healthy Spread the word! Send a copy of this newsletter to someone you know. Note: Some of the long URLs may not wrap as a hyperlink and you may need to cut and paste. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. PMS symptom tracking sheet ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ At a site called Pamper Me Softly which sells progesterone cream for PMS symptoms, you can create a customized symptom calendar to track 3 of your worst symptoms over an entire cycle. These calendars are extremely important in the diagnosis of PMS. Once you see how your symptoms change over a month, it becomes very obvious whether there is true PMS symptoms in which there is a 50% rise in symptom intensity in the last one or two weeks of a cycle, or whether there are just many stressful days each month not in a hormonal pattern. Print out one of these tracking sheets, fill it out and bring it to your doctor for a more accurate diagnosis of whether you have PMS. Take the rest of the site with a grain of salt. There is very little evidence that progesterone cream is any better than placebo in treating PMS. Buyer beware! Symptom tracking calendar ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Pregnancy ultrasound normal and abnormal anatomy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If the doctor ever starts talking about pregnancy ultrasound results showing a fetal pole, blighted ovum, decidual sac, cystic hygroma, cornual pregnancy, vanishing twin or other abnormal finding, you may want to get into the detail of it by looking at ultrasound pictures at the Indiana Perinatal Network's Online Magazine. Normal and Abnormal pregnancy ultrasounds ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Perinatal infections - when to check ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ When you are pregnant, the doctor does lab tests for several possible infections you are sure you do not have. But have you wondered if they can cause problems for the baby. Should you get routinely tested for group B strep infection? Can vaginitis cause problems in the baby? If you have evidence of an HPV infection will the baby get infected. These are all subjects of this week's article at: Perinatal infections ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Osteoporosis case conference ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The Women's Health Center at the Journal of the American Medical Association has some physician case conferences in which they thoroughly discuss a topic using an actual woman's history. This case below discusses a woman who took estrogen therapy for about 3 years in her 50's and then discontinued it. She is at high risk because of a low weight, less than 165 lbs, age over 65 and the fact she did not take estrogen replacement. The discussion talks about the bone densitometry measurements, spinal xrays, dietary intake and lab studies. Any woman who is under 165 lbs., and either younger than age 50 and has never taken birth control pills or under age 65 and has not taken much hormone replacement should learn about osteoporosis. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Soap and detergent health and safety ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The Soap and Detergent Association has an informative site you may want ot check out. Did you know that: vegetables and fruits should washed with soap and water? Salmonella can survive on counter surfaces for 24 hours and even survive freezing. Antibacterial soaps (if FDA approved) can kill rhinovirus (cold virus), rotovirus (diarrhea in children), athlete's foot fungus and others in addition to salmonella. They have sections on: Managing Allergies and Asthma: A Consumer Cleaning Guide Clean and Safe - guide to safe and effective use of cleaning products Food Safety Cleaning Tips - to help the reduce risk of food borne illness Cleaning for Health - antibacterial products for extra protection against germs Some FAQs About Bacterial Resistance From Antibacterial Wash Products Soap and Detergent Association ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Womanly Truisms: 1. Life is an endless struggle full of frustrations and challenges, but eventually you find a hair stylist you like. 2. Perhaps you know why women over fifty don't have babies: They would put them down somewhere and forget where they left them. 3. Time may be a great healer, but it's also a lousy beautician. 4. Brain cells come and brain cells go, but fat cells live forever. 5. Life not only begins at forty, it begins to show. 6. If at first you don't succeed, see if the loser gets anything. 7. I had to give up jogging for my health. My thighs kept rubbing together and setting my pantyhose on fire. 8. Amazing! You just hang something in your closet for a while, and it shrinks two sizes. 9. It is bad to suppress laughter; it goes back down and spreads to your hips. 10. Age is important only if you're cheese or wine. 11. The only time a woman wishes she were a year older is when she is expecting a baby. 12. Freedom of the press means no-iron clothes. 13. Inside some of us is a thin person struggling to get out, but she can usually be sedated with a few pieces of chocolate cake. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. We will bring you accurate women's health answers again soon. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** May 9, 1999 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Hysterectomy pre and post op Q&As 2. Fight back food borne illnesses 3. Eating disorders 4. HPV DNA testing for ASCUS Paps 5. Midlife sexuality and women 6. Humor is healthy Spread the word! Send a copy of this newsletter to someone you know. Note: Some of the long URLs may not wrap as a hyperlink and you may need to cut and paste. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Hysterectomy pre and post op Q&As ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Hystersisters is a member site formed by women who are or have been in different stages of having a hysterectomy. Their frequently asked questions (FAQs) section contains answers to many practical questions such as will I have nausea after the surgery, how many stitches, when can I restart intercourse and many other preop and postop questions. Preop and post op lists about hysterectomies ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Fight back food borne illnesses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The General Accounting Office in a 1996 report, stated that there are between 6.5 million and 81 million cases of food borne illness a year. The Center for Disease Control (CDC) lists four bacterial pathogens - E. coli O157:H7, Salmonella Enteritidis, Listeria monocytogenes and Campylobacter jejuni - as the ones of greatest concern. Also of concern to CDC are other bacterial pathogens, such as Vibrio vulnificus and Yersinia enterocolitica, Clostridium perfringens and Staphylococcus aureus. Infection experts also report that many of the intestinal illnesses we commonly referred to as stomach flu are actually caused by foodbornee pathogens. People do not associate these illnesses with food because the onset of symptoms often occurs two or more days after the contaminated food was eaten. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Eating disorders ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Have you ever worried about a friend who seems to never eat much, who thinks she's overweight when in fact she looks quite slim? Eating disorders such as anorexia nervosa, bulimia nervosa and binge-eating can go undiagnosed in many instances. It can cause medical problems that masquerade as other illnesses. If you want to be able to recognize this enigmatic set of disorders, take a look at: Eating disorders and medical symptoms ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. HPV DNA testing for ASCUS Paps ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ An interesting article in the Journal of the American Medical Association (JAMA), entitled Identifying women with cervical neoplasia: Using human papillomavirus DNA testing for equivocal papanicolaou results, suggests that ASCUS Pap smears should have HPV DNA testing rather than repeat Paps. Only about 5-10% of ASCUS (atypical cells of undetermined significance) Paps actually ever show a high grade dysplasia on further testing. That is why women are cautioned to have repeat Paps done because a repeat Pap will pick up about 75% of those ASCUS Paps that actually have high grade dysplasia. In this study below, 6.7% of women with ASCUS Paps had a high grade squamous lesion on colposcopy. An HPV DNA test picked up almost 90% of those high grade lesions. The advantage of a strategy such as this is that the HPV DNA testing can be performed on the same specimen as the original Pap if it was a thin prep Pap smear. Keep in mind the thin prep Pap is more expensive and it is not in common use, but this may be a promising new diagnostic approach to eliminate excessive worry about abnormal Paps and maybe even unnecessary procedures. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Midlife sexuality and women ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ For a practical article on adjusting to menopausal changes that affect sexuality, sexual response and desire, and vaginal dryness and comfort with intercourse, go the the Mayo Clinic site: Midlife and sexuality ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ One day, a painter found himself short of help and went to the unemployment office to hire someone for the day. When he arrived, they didn't have any painters available, but they did have a gynecologist there. He reluctantly took him along to help. A couple of weeks later, the painter returned to the unemployment office needing temporary help again. This time there were two painters there, but instead he asked for the gynecologist again. The clerk asked, "Why do you want a gynecologist when we have two professional painters you can take right now?" He said, "Two weeks ago when I hired the gynecologist, we arrived at the house and it was locked with nobody home. But I'll be damned if that gynecologist didn't stick his hand through the mail slot and paint the whole house!" ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. We will bring you accurate women's health answers again soon. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** May 16, 1999 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Fertility charting primer 2. Is an annual physical exam really necessary? 3. Basic evaluation for urinary leakage 4. Teenwire 5. Home test kit for Hepatitis C coming available 6. Humor is healthy Spread the word! Send a copy of this newsletter to someone you know. Note: Some of the long URLs may not wrap as a hyperlink and you may need to cut and paste. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Fertility charting primer ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did you know that you may ovulate as early as Day 8 or as late as Day 22 of your cycle -- not necessarily always on Day 14? For women trying to conceive, a set of basic instructions for how to chart a basal body temperature and record cervical mucous changes can be handy. BBT charting can also be used for contraception by using the luteal phase after ovulation as a safe time to have intercourse. Fertility friend online also has a free demo for one month of BBT charting. Check out: Fertility charting ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Is an annual physical exam really necessary? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ In the changing medical care environment everything gets questioned. This article below asserts that there is no scientific evidence that supports an annual physical exam as beneficial in theasymptomaticc person. There are apparently several studies showing no significant, previously unknown disease detection from annual physical exams. In fact most who have studied this say that doctors should only focus on screening for high-risk behaviors with minimal reliance on physical examination findings except for blood pressure, weight, and breast examination. Look at this and see what you think. Annual physical exam discussion ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Basic evaluation for urinary leakage ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Many women are embarrassed to go to the doctor to be checked out for a problem of leaking urine. Part of the problem is that they do not know what to expect. This article includes: Can I tell from my symptoms, i.e., when and how I lose urine, what type of incontinence I have? What are some of the risk factors for developing urine leakage? What does the doctor check for on examination? Will I have to have a catheter put in my bladder? What tests other than the physical and pelvic exam will I need to have? Incontinence evaluation ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Teenwire ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The Planned Parenthood Federation of America has created a site for teens to view and ask sexuality and relationship information. Did you ever have to go to the local Kroger store as a teen to get a pregnancy test because your period was late and your boyfriend had touched your genital area? Just running the test is anxiety provoking and knowing how other teens feel when doing it can ease the stress level. While your teenage daughter would certainly come to you if she were concerned about the possibility of pregnancy (NOT), maybe her girlfriend does not have that relationship with her parents. You can help by pointing her to a site that has a list of nearby Planned Parenthood Clinics to see about a pregnancy test for example. Teenwire.com ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Home test kit for Hepatitis C coming available ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The FDA has announced approval of a home test kit for hepatitis C in which blood is collected at home and the test sent to a centralized lab. There it is treated with an anonymous number that you choose so you can call and get results. It functions very much like the home HIV test kit that we have at the Woman's Diagnostic Cuber Store. Individuals at high-risk for contracting hepatitis C include anyone who: Abused IV drugs (or inhaled cocaine); Received a tattoo or body piercing; Is a healthcare worker exposed to blood or blood products; Was stuck with a possibly infected needle; Received blood transfusions or blood products before 1992 (when the blood supply could be reliably screened for HCV); Had hemodialysis before 1992; Received a transplant before 1992; Has hemophilia or a similar bleeding disorder; Had sex with multiple partners; Had sex with anyone with hepatitis (or HIV or another sexually transmitted disease) Hepatitis C home test kit As soon as this test is shipped, we should be carrying it at: Woman's Diagnostic Cyber Store ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ A Veterinarian was feeling ill and went to see his doctor. The doctor asked him all the usual questions, about symptoms, how long had they been occurring, etc., when he interrupted him: "Hey look, I'm a vet - I don't need to ask my patients these kind of questions: I can tell what's wrong just by looking." He then smugly added, "Why can't you?" The doctor nodded, stood back, looked him up and down, quickly wrote out a prescription, handed it to him and said, "There you are. Of course, if that doesn't work, we'll have to have you put to sleep." ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. We will bring you accurate women's health answers again soon. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** May 23, 1999 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. ERT in women with previous breast cancer 2. Early postpartum discharges cause distress 3. Testosterone supplementation during menopause 4. Mitral valve prolapse in women - what is it? 5. What causes headaches? 6. Humor is healthy Spread the word! Send a copy of this newsletter to someone you know. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. ERT in women with previous breast cancer ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This is the first report I have seen of women who were allowed to have estrogen replacement therapy after having localized breast cancer. 39 women took estrogens and 280 did not. One woman of the 39 (2.5%) developed recurrent breast cancer 27 months after starting ERT and 72 months after the initial diagnosis of breast cancer. Fourteen women of the 280 controls (5%) developed another breast cancer on average 139.5 months after initial diagnosis. While this study does not absolutely prove that estrogen replacement after breast cancer is safe, it certainly is very encouraging to conduct further studies because of the severe estrogen deficiency symptoms that many breast cancer survivors have. From the Journal of Clinical Oncology: ERT after breast cancer ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Early postpartum discharges cause distress ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Drive thru deliveries in which women are discharged within 24 hours of having a baby have come under scrutiny because many women do not feel they are ready to go home from the hospital so soon. This study reported in the Archives of Family Medicine found that women who were discharged in 24 hours compared to those who were allowed to stay 48 hours more fatigue (49% vs 29%) more morbidity in the newborns (31% vs 16%) more pediatric visits (96 vs 54 per 100 newborns) were less likely to start breast-feeding (64% vs 77%) more likely to stop breast feeding prematurely (14% vs 8%) Hopefully studies like this will encourage more health plans to allow women to stay at least 48 hours after delivery. Early postpartum discharge ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Testosterone supplementation during menopause ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Can testosterone help menopause symptoms without causing hair growth, voice changing or excessive aggressiveness? It does have its benefits for menopausal symptoms of fatigue, libido, concentration and well-being but taking testosterone supplementation needs a careful titration to your own body. See the weekly article at: Testosterone during menopause ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Mitral valve prolapse in women - what is it? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ You may or may not be familiar with a medical term called mitral valve prolapse but many women have this diagnosis. It can sometimes explain heart racing or skipping beats (palpitations) dizziness, fainting or even chest pains. It is more of a condition than a disease in that women with mitral valve prolapse do not have a shortened life span or die because of it, but since it gives heart symptoms, it can be a very frightening condition. For a good explanation of what mitral valve prolapse is, visit WebMD.com: Mitral valve prolapse in women ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. What causes headaches? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did you know that sinus infections rarely cause chronic headaches? At the American Council for Headache Education, achenet.org, there is a great supply of resources and explanations for what causes headaches. If you are not sure whether that nagging headache is a migraine, "tension-type headache," cluster headache, a transformed or "progressed" migraine (this was a new one for me!), a rebound headache or one from TMJ syndrome, then visit: What causes headaches? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ A lady goes to the doctor to see about getting a facelift. "Well," says the doctor, "I can do the facelift, and then you'll have to come back in six months for another follow-up procedure." "Oh, no." the woman replies. "I want it all done in one shot. I don't want to have to come back." The doctor thinks for a second, then offers, "There is a new procedure where we put a screw in the top of your head. Then anytime you see wrinkles appearing, you just give it a little turn, which pulls the skin up and they disappear." "That's what I want!" exclaims the lady. "Let's do that." Six months later the lady charges into the doctor's office. "Well, how's the procedure holding up?" the doctor asks. "Terrible!" the lady bellows. "It's the worst mistake I've ever made!" "What's wrong?" asks the doctor. "Just look at these bags under my eyes!" she hollers. "Lady," the doctor reports, "those aren't bags, those are your breasts, and if you don't leave that screw alone, you're going to have a beard!" ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. We will bring you accurate women's health answers again soon. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
***** Woman's Diagnostic Cyber Newsletter ***** May 30, 1999 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This week from Woman's Diagnostic Cyber ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Common simple emergencies 2. Sexual desire in the third age 3. Evaluation of excessive hair growth (hirsutism) 4. Traffic accidents and sedatives/antipsychotics 5. Age at menopause and heart disease risk 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. Common simple emergencies ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Have you ever run into a situation where someone gets a foreign body in the eye or a child has something stuck up a nose? What about an avulsed tooth, a neck muscle strain, a foreign body beneath a nail or a ring you cannot remove? Although written for doctors as to how to handle some of these emergencies and others, you may find the descriptions and treatments useful in a "pinch". Emergency situations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Sexual desire in the third age ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Thirdage.com is a site devoted to a specific age group, i.e., that age between young and old. In other words, babyboomers in the 40's 50's and 60's. There is an interesting set of articles about "peak sex" or how sexual desire seems to change as we age. Not all of the articles are great but the ones below are worth looking at: Still Sexy After All These Years Sexual Desire: Who Wants to Want? SexQuiz: Where Did My Sex Drive Go? Peak sex in your third age ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Evaluation of excessive hair growth (hirsutism) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If women have coarse dark hairs on their arms and legs, that is usually due to genetics or their ethnic background. If the increased growth is in the midline such as the chin or face or the pubic hair up toward the navel, then that is called hirsutism and may be due to excessive male hormone like substances in the blood. Sometimes the ovary may be producing too much testosterone and sometimes the adrenal gland may be over producing androgens. If your doctor says the hormone levels are normal but you still want to reduce excess hair growth, there are things that can be done. See our article at: Evaluation of excessive hair growth ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Traffic accidents and sedatives/antipsychotics ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ At the journal club of the American College of Physicians, a discussion of an article that shows an increased association of first traffic accidents with the use of certain medications caught my interest. There was an increased risk with the use of benzodiazepines (Ativan, Halcion, Klonepin, Librium, Restoril, Serax, Tranxene, Valium, Xanax) but not with tricyclic antidepressants, (Elavil, Etrafon, Limbritrol, Norpramin, Pamelor, Sinequan, Tofranil, Triavil) or with selective serotonin-reuptake inhibitors [SSRIs] such as Paxil, Prozac, Zoloft. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Age at menopause and heart disease risk ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ For a while it has been suspected that earlier menopause (natural) is a risk factor for cardiovascular disease. In the study below reported in the Archives of Internal Medicine, the authors looked at the large nurses' health study (35,616 naturally postmenopausal women who never used estrogen replacement therapy) and indeed found that the earlier the age of menopause, the more the risk for cardiovascular disease. Interestingly there was no increased risk of thrombotic or hemorrhagic stroke with earlier menopause. If menopause was less than age 40 or age 40-45, the risk ratios were 1.53 and 1.42 compared to menopause at age 55. Age at menopause and heart disease risk ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Note: Because I live in the South, I think I can safely send out this joke! Advice for Yankees Moving South 1. Save all manner of bacon grease. You will be instructed later how to use it. 2. If you forget a Southerner's name, refer to him (or her) as "Bubba." You have a 75% chance of being right. 3. Just because you can drive on snow and ice does not mean we can. Stay home the two days of the year it snows. 4. If you do run your car into a ditch, don't panic. Four men in the cab of a four wheel drive with a 12-pack of beer and a tow chain will be along shortly. Don't try to help them. Just stay out of their way. This is what they live for. 5. Don't be surprised to find movie rentals and bait in the same store. 6. Do not buy food at the movie store. 7. If it can't be fried in bacon grease, it ain't worth cooking, let alone eating. 8. Remember: "Y'all" is singular. "All y'all" is plural. "All y'all's" is plural possessive. 9. Get used to hearing, "You ain't from around here, are you?" 10. Don't be worried that you don't understand anyone. They don't understand you either. 11. The proper pronunciation you learned in school is no longer proper. 12. Be advised: The "He needed killin'" defense is valid here. 13. If attending a funeral in the South, remember, we stay until the last shovel of dirt is thrown on and the tent is torn down. 14. If you hear a Southerner exclaim, "Hey, y'all, watch this!" stay out of his way. These are likely the last words he will ever say. 15. Most Southerners do not use turn signals, and they ignore those who do. In fact, if you see a signal blinking on a car with a Southern license plate, you may rest assured that it was on when the car was purchased. 16. Northerners can be identified by the spit on the inside of their car's windshield that comes from yelling at other drivers. 17. Satellite dishes are very popular in the South. When you purchase one it is to be positioned directly in front of your trailer. This is logical bearing in mind that the dish cost considerably more than the trailer and should, therefore, be displayed. 18. Tornadoes and Southerners going through a divorce have a lot in common. In either case, you know someone is going to lose a trailer. 19. Florida is not considered a Southern State. There are far more Yankees than Southerners living there. 20. If you are cursing the person driving 15 mph in a 55 mph zone, directly in the middle of the road, remember, many folks learned to drive on a model of vehicle known as John Deere, and this is the proper speed and lane position for the vehicle. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. We will bring you accurate women's health answers again soon. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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