by Dawn Smith-PlinerCan you imagine waving good bye to your son as he gets on the school bus for his first day of school and never seeing him again? A parent’s worst fear–losing a child. Well, that is what happened …
Month: July 2012
Women Face Decision on Risks, Benefits of Hormone Therapy
For women of a certain age, there comes a moment of truth. The moment arrives after sleepless nights, a lot of sweat and maybe even some tears.
Inevitably, though, virtually all women must make a decision: Can I endure the symptoms of menopause or should I undertake hormone replacement therapy?
Oddly enough, there is no single — or simple — answer for all women. Your best friend may have the same symptoms or none. The same goes for your sister, and even your mother’s experience is of no help because menopause is a highly personalized condition. Treatments also vary depending on the severity of the symptoms and the person — some need a single hormone, others combinations of two hormones. Other medications also can help, including birth control pills, anti-anxiety drugs and even natural remedies.
“We have to talk about it,” said Dr. Nigel Delahunty of Greer Ob/Gyn. “We inform them of all the potential risks and see what they need and want.”
Delahunty has been practicing medicine for 17 years, and during that time the way to help women get through their menopausal years — in terms of the use and popularity of hormone replacement therapy (HRT) — has changed dramatically.
“It has fluctuated over time,” said Dr. Margery Gass, executive director of The North American Menopause Society based in Cleveland. “But what has remained the same is that estrogen has been effective in treating symptoms for more than 30 years.”
Doctor Shortage Likely to Worsen With Health Law
RIVERSIDE, Calif. — In the Inland Empire, an economically depressed region in Southern California, President Obama’s health care law is expected to extend insurance coverage to more than 300,000 people by 2014. But coverage will not necessarily translate into care: Local health experts doubt there will be enough doctors to meet the area’s needs. There are not enough now.
Other places around the country, including the Mississippi Delta, Detroit and suburban Phoenix, face similar problems. The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed. And that number will more than double by 2025, as the expansion of insurance coverage and the aging of baby boomers drive up demand for care. Even without the health care law, the shortfall of doctors in 2025 would still exceed 100,000.
Health experts, including many who support the law, say there is little that the government or the medical profession will be able to do to close the gap by 2014, when the law begins extending coverage to about 30 million Americans. It typically takes a decade to train a doctor.
The Possibility of Infertility Looms for Cancer Patient
Staff writer Andrea Torres chronicles her breast cancer experiences in Tropical Life.
A woman in her early 30s should not have to think about infertility. But breast cancer changes everything.
Doctors have highly recommended that I have a hysterectomy, surgery to remove the uterus, and a prophylactic oophorectomy, removal of my ovaries. Both would be a preemptive move against uterine and ovarian cancer, which can develop after breast cancer.
Thinking about it has been difficult, especially faced with a gynecological appointment this week. On Saturday, I had a crying episode that lasted hours. I haven’t had one in months. Three of my best friends, all males, tried to comfort me.
I called Lawrence Pena, 34, who has a 2-year-old girl named Ella. After he heard my trembling voice, he asked, “What happened?”
“I sat in the shower holding my stomach crying this morning,” I said. “I haven’t been able to stop the tears.”
He listened and said, “It’s going to be OK.” I was calm again. He talked for a bit. And then his phone died.
Although the surgery is common, I am scared. Every 10 minutes, 12 hysterectomies are performed in the United States, or about 600,000 in a year. And about one-tenth of 1 percent of those, about 660 women, die from complications.
Also, when the procedures are done before age 45, there is an increased mortality risk associated with cardiovascular disease, osteoporosis, a decline in psychological well-being, and neurologic and mental disorders, such as cognitive impairment, dementia and Parkinsonism, which is similar to Parkinson’s disease. Of course, there are others who don’t experience these issues.
Estrogen treatment may prevent some of these, but for some breast cancer patients, estrogen feeds tumors. To block estrogen, I am taking a chemoprevention drug called Tamoxifen for the next five years. The drug protects me from osteoporosis, but increases the risk of cancer in the uterus.
Even more concerning is that I inherited a genetic mutation known as BRCA2. This increases my risk for breast and ovarian cancer. Hence, my doctors’ recommendation to undergo a hysterectomy and remove my ovaries. Compounding this are uterine fibroids and some “abnormal cells” found in the uterus.
Some women, who are not as high risk, may have the option of undergoing regular pelvic exams, combined with ultrasounds and blood tests to monitor any possible irregularities in their uterus and ovaries.
Physical Function Poorer After Menopause
NEW YORK (Reuters Health) – As women go through menopause, they may see a decline in their ability to carry groceries, climb stairs and get other routine tasks done, a new study suggests.
Exactly why is not clear, though extra pounds and depression symptoms seemed to account for some of the link.
“There is something going on during menopause. There is definitely a connection between menopause and the physical limitations women perceive themselves as having,” said lead researcher Lisa Tseng, a medical student at the University of Pittsburgh.
According to Tseng, her findings suggest that the “physiological changes” of menopause play a role.
A woman’s body composition, for example, tends to change – with an increase in fat and decrease in muscle mass. And with the decline in estrogen levels, bone mass dips as well.
Men also lose muscle mass and strength as they age. But studies have found that women’s strength decline seems to speed up around menopause.
The bottom line for women is to stay physically active as they age, according to Dr. Timothy Church, who was not involved in the new study.
And that should include aerobic exercise and strength training to help hang on to your muscle mass, said Church, a researcher at Pennington Biomedical Research Center in Baton Rouge, Louisiana.
37% of Births Between 2006 and 2010 Were Unplanned
Over a third of women giving birth in the U.S. are having babies they did not plan to have. Between 2006 and 2010 37.1 percent of women had unintended births in the United States, according to a report from the National Center for Health Statistics. That’s up from 1995 where 30.6 percent were unintended and 2002 where 34.9 were.
The data was gleaned from interviews with 12,279 women between the ages of 15 and 44 in the given time frame and the report only takes into account pregnancies “ending in live birth.” Of women who did not use contraception and had an unintended birth a majority — 35.9 percent — did not think they could get pregnant.
The IUD: What Does Your Doc Know That You Don’t?
Few U.S. women choose intrauterine devices, or IUDs, for contraception — a recent study found they rank No. 5 in use, behind oral contraceptives, tubal ligation, condoms and vasectomies.
But IUD use is much more common among one group of women: gynecologists. According to a poll released by the American College of Obstetricians and Gynecologists (ACOG), use of IUDs by female ob-gyns is three times greater than that of the general public.
If the women who are, presumably, the most knowledgeable about reproductive health are choosing IUDs more often than the rest of us, then what is it our gynecologists know that most women don’t?
Why gynecologists love IUDs
IUDs are an excellent birth control option because they are effective, safe and easy to use, said Dr. Sara Pentlicky, a gynecologist and family planning specialist at the University of Pennsylvania.
While some women can’t use estrogen-containing birth control because of health issues, “there are very few women who can’t use an IUD,” Pentlicky said. She estimated that 80 percent of the female doctors in her practice use IUDs for their own contraception.
IUDs have to be inserted by a doctor, but once in place, they are effective immediately and can protect against pregnancy for five to 12 years, depending on the type.
Unlike birth control pills, which require that users remember to take them on a daily basis, IUDs need little to no maintenance. They are nearly 99 percent effective, according to a study published in May in the New England Journal of Medicine.
IUDs also differ from birth control pills in that women have a greater chance of becoming pregnant immediately after stopping use.
In the U.S., there are two IUDs available — ParaGard, a copper, hormone-free device that can protect against pregnancy for up to 12 years, and Mirena, which releases small amounts of a synthetic progestin hormone and can be effective for up to 5 years.
“With ParaGard, you don’t actually stop ovulating like you do with the pill, so when I take it out, you should be able to get pregnant the next month without any trouble,” Pentlicky said.
How Millennial Women and Their Eggs Can Have It All
I’m sitting across the desk from my neurologist, Dr. Gayatri Devi, the Director of the New York Memory Services, a Clinical Associate Professor at New York University School of Medicine, President of the National Council on Women’s Health and author of The Calm Brain.
Me: Twenty years ago I was diagnosed as being infertile and underwent five years of infertility treatment. It was a physical and emotional roller coaster. Daily doctor visits. Blood tests and hormones that I never knew existed were injected into my body. Every month I would pray and hope to hear, “You’re pregnant.” Every month I spent thousands of dollars to get a ticket for this ride (insurance didn’t cover infertility treatment). I look back and realize it was like I was possessed. Or maybe it was more like I was in infertility jail – I couldn’t get out, not even for good behavior. My mantra was, “Just one more month.” I thought it was like other things in life that worked for me – try harder and I’ll succeed.
Dr. Devi: How old were you?
Me: 34-39 years old.
Dr. Devi: Were you ever pregnant?
Me: Yes, when I was in my 20s. I had a miscarriage.
Dr. Devi: You are not infertile. In your mid to late 30s, you were trying to get pregnant at a less than optimal time in a women’s reproductive cycle. The reality is that you could have been very fertile in your 20s. You could have had babies every year in your 20s. But in your mid to late 30s, you were trying to conceive when timing wasn’t on your side.
Then Dr. Devi said something that made me really think: “We use technology for everything else in life, why not embrace technology to give women child-bearing strategies and choices?”
What does she mean by that? Freezing eggs when women are most fertile – in their 20s, not their 30s. According to the Reproductive Biology Associates: “Fertility in women is greatest when they are between 20 and 28 years of age. By the age of 35, a woman’s chance of conceiving per month is decreased by half. By age 45, the natural fertility rate per month is reduced to only 1%.”
Forward on Safer Chemicals, One Way or the Other
By Andy Igrejas, Campaign Director for Safer Chemicals, Healthy Families
Wednesday’s successful Senate vote on the Safe Chemicals Act was an important milestone by any measure. It was the first vote on a comprehensive overhaul …
The Challenge of Waiting When You Are Infertile
by Iris Waichler, …