December, 2012 browsing by month


Do Failed Emergency Contraceptive Result in Birth Defects?

Monday, December 31st, 2012

As I’ve discussed before, emergency contraceptives should never serve as your main form of birth control. In certain circumstances, the morning after pill is perfectly acceptable. Maybe your usual form of birth control didn’t work, or maybe your sexual encounter was unplanned, or—worse yet—unwanted. Occasional use of emergency contraceptives such as the Plan B pill is fine, especially if it will prevent the birth of a baby that cannot be properly cared for. However, these pills are not always 100% effective in preventing pregnancy. If you took an emergency contraceptive but still got pregnant, you’re probably wondering how the hormones might negatively affect your baby’s health.

Luckily, the creators of the emergency contraceptive already thought of that, and they are designed in a way that will not harm a developing baby should the hormones be ineffective at preventing pregnancy. One study in particular showed that emergency contraceptives had absolutely no effect on the likelihood that a woman would have an ectopic pregnancy. Ectopic pregnancies are extremely dangerous for the woman having it, and most are aborted so that the mother can live through them. They occur when the fetus is growing outside the uterus. If you took an emergency contraceptive and it failed, you are just as likely to have a normal, healthy baby as if you hadn’t taken anything at all. Preventing pregnancy with an emergency contraceptive is just as safe as preventing it with regular birth control, even though “morning after” pills such as Plan B give you twice the amount of hormones as a high dose birth control pill.

While you’ll have a perfectly safe pregnancy if an emergency contraceptive fails, you should absolutely never rely on it as your only birth control. If you know that you are going to be having sex, you should already be on birth control to prevent pregnancy. On top of that, you should be using a condom if you aren’t sure of the sexual history of your partner. Doctors aren’t entirely sure what the long-term effects of high doses of hormones are, so taking pills like Plan B regularly could easily lead to blood clots or strokes. If you need to take an emergency contraceptive in a true emergency, rest assured that it will probably work. If it doesn’t, you’ll soon be the mother of a healthy new baby.

 – Yvonne S. Thornton, M. D., M. P. H.


Calcium Will Ease the Pains of PMS

Thursday, December 27th, 2012

It’s almost that time of the month. Your skinny jeans don’t fit, you’re crying about the dishes in the sink, and chocolate is all you want for dinner. Premenstrual syndrome (PMS) affects at least 85% of all women in some way. Some don’t have the same symptoms as others, but many women will have at least one as part of their cycle. You might get acne, tender breasts, fatigue, bloating, cravings, muscle pain, trouble with memory, irritability, mood swings, and anxiety all at once. In many ways, these symptoms interfere with everyday life by making even the most simple and mundane tasks more difficult. The fatigue can feel paralyzing, and the mood swings can make you feel like a monster. Even the most casual conversations can turn into fights or tear-jerkers.

For women who are predisposed to it, PMS is impossible to avoid. Sometimes, contraceptives can ease the symptoms, but other times they actually become much worse. There are also a few easy remedies you can try to ease symptoms, such as exercise and diet adjustment. By exercising, you release much of the tension and stress built up in your body, which will make each problem seem a lot less intense. Avoiding junk food and alcohol can also make symptoms fade away faster, but this only works for some women. However, there is one easy treatment for PMS that has been repeatedly proven to work in a clinical setting. An increased intake of calcium will help ease the symptoms of PMS. In the study, women who increased their intake by 1200-1600 mg every day had significantly less symptoms than before they began the supplementation.

Always consult with your doctor before making any changes to your diet, but increasing the amount of calcium you eat while you are experiencing PMS is easy. You don’t even need to pay for the supplements if you try adding more calcium-rich foods to your diet. Milk, yogurt, beans, tofu, kale, spinach, and orange juice are all excellent sources of calcium. When that time of the month rolls around and you feel too bloated to function and too emotional to face your friends, stock up on calcium rich foods to get over your PMS before it gets the best of you.

 – Yvonne S. Thornton, M. D., M. P. H.

Merry Christmas and Happy Holidays to All!

Tuesday, December 25th, 2012

I would like to take this opportunity to express my gratitude and thank you for reading and joining in the discussion on this blog since it’s inception. Words cannot express how grateful I am that I have such a supportive and engaging group of readers.

I want to wish you all the merriest of Christmases and wish all the best for each and every one of you both now and through the new year.

– Yvonne S. Thornton, M. D., M. P. H.

What Causes Breakthrough Bleeding?

Monday, December 24th, 2012

Vaginal bleeding outside the schedule of your normal menstrual cycle is always disconcerting. Many women feel a rush of panic when they notice blood on their underwear during a random trip to the bathroom, and rightfully so. Bleeding is usually a sign that something is wrong with us internally. If you’re not on birth control, you should see your physician immediately to make sure nothing is wrong and also to receive a pregnancy test. If you’re bleeding randomly and you are on oral birth control medication, this is probably breakthrough bleeding or spotting. Though it’s frightening, it’s actually not something you should be overly concerned about. It’s common, and it’s a harmless side effect of contraception. Of course, it will still be a surprise when you notice it, so learning the cause might help you feel less worried when you do notice a bit of abnormal bleeding while taking contraception.  As always, with breakthrough bleeding, abstinence or an alternate form of contraception is in order.

Studies show that breakthrough bleeding on contraceptives is caused by the hormones they produce, such as lower dose progestins, which are forms of synthethic progesterone. Since the 1960s , the estrogen dose in oral contraceptive has decreased from more than 150 mcg of ethinyl estradiol to 35 mcg or less. The reduction in dose of the hormone has reduced the incidence of venous thrombosis and clots but also increased the incidence of breakthrough bleeding because of the lower dosage.  Without enough hormone to stabilize the lining of the uterus, the lining prematurely sheds causing breakthrough bleeding (metrorrhagia).  Progesterone-only implants and vaginal rings particularly have an increase in the prevalence of breathrough bleeding, specifically with the active component of etonorgestrel.  To solve this problem, many women find it helpful to go on a different type of contraceptive with a different ratio of hormones to see if their body might react differently.

If you do notice large amounts of blood outside of your normal menstrual cycle, you need to contact your  gynecologist. Though it might be normal spotting caused by your birth control, there is also a chance that it could be a sign of something more serious, or even pregnancy. If you find out it is in fact caused by your contraception, speak with your gynecologist who may switch brands, doses or types of hormonal contraception. In addition to making you worry, spotting and breakthrough bleeding is extremely inconvenient, so the sooner you solve the problem the better off you’ll be.

You can read more about abnormal bleeding and contraception in my women’s health book, INSIDE INFORMATION FOR WOMEN, now in paperback.

 – Yvonne S. Thornton, M. D., M. P. H.


Blue Christmas is an Annual Reality for Some

Thursday, December 20th, 2012

Unfortunately, Elvis isn’t the only one who has experienced a “Blue Christmas.”  Depression during the holiday season is actually very common.  Although people can be depressed any time of year, we are often more aware of it during the holidays, because the festive season causes us to notice how non-festive our lives are.

Most of us would love for our holidays to be filled with joy, but making it happen can be stressful in itself.  There are so many factors to consider this time of year that it can be difficult to pin down the actual cause of someone’s holiday blues.  Depression can stem from financial constraints, stress from over-scheduling, frustration due to the inability to spend time with family, or, conversely, anxiety due to spending too much time with family.  High expectations and fatigue can also greatly contribute to holiday depression.  With all of the tasks that need to be accomplished before our dinners, present-openings, and get-togethers, stress can be at an all-time high.  On the other hand, for those who are removed from family and friends either due to distance or death, this time of year can be particularly lonely.  For still others, the time after Christmas is the most depressing, because of the letdown after all of the excitement and activities.  The most common cause of depression during the winter though, is Seasonal Affective Disorder, known appropriately as SAD.  As you probably already know, SAD is caused by the limited amount of sunlight the body receives during these short days.  Feeling sad isn’t the only symptom of depression either.  This emotional disturbance can cause severe anxiety, overeating or loss of appetite, insomnia or excessive sleeping, and in some, even physical pain.  How depression manifests itself varies by the individual.

Luckily, depression during the holidays is normally temporary.  However, if your depression lasts for several weeks or longer, it could be considered clinical depression.  In which case, you should visit your physician to discuss treatment.  There are a variety of treatments, and the one your doctor chooses for you will depend on the cause of your depression.  For instance, for SAD, light therapy can be very effective.  For more severe forms of depression, such as PTSD, long-term therapy from a qualified counselor may be needed.

 – Yvonne S. Thornton, M. D., M. P. H.



When it Comes to Your Salad, Be Picky

Monday, December 17th, 2012

If I lectured you about the importance of adding more salad to your diet, I’d be wasting my time. We all know that fresh vegetables are extremely important to a healthy diet, and women especially will benefit from the nutrients present in the veggies common to salad. If you’re eating a healthy diet, you probably try to add salad to your daily diet by eating one for lunch or dinner on a regular basis. Though they can taste boring when not prepared well, it’s no secret that they are one of the healthiest meals a woman can consume. However, next time you’re making your salad, consider the difference between Iceberg and Romaine lettuce.

Iceberg lettuce does not totally lack vitamins and nutrients, but it is far less healthy when compared to romaine lettuce. If you’re trying to get as many nutrients as possible from your salad, always choose Romaine, because many of the vitamins in the vegetable are essential to the health of the female body. Romaine lettuce contains high levels of folate, which are especially important prior to conception and during pregnancy. A deficiency can cause fatigue and confusion. Some studies have shown that  women who eat more folate are less likely to get certain neurological diseases such as Alzheimer’s. Romaine also contains much more fiber, carotenoids, and vitamin C than iceberg lettuce.

As a general rule of thumb, always choose vegetables that are dark in their color. Romaine is slightly darker than iceberg lettuce, which is a good indication that it is richer in the essential vitamins and nutrients you need. With that said, romaine is a better choice across the board for all women trying to maintain a healthy diet. If you’re really looking to make a power-packed salad, kale would be an even better choice.  One cup of kale has more calcium than one cup of cottage cheese.  Go Figure!

Hitting the salad bar is definitely a step in the right direction, but you can improve your health even more by choosing the right lettuce to make sure you’re getting as many nutrients as possible. Without these nutrients, your body will degrade more quickly and you’ll feel the effects of old age sooner rather than later. Weight loss and exercise will also be more difficult, so be picky when you’re at the salad bar.

 – Yvonne S. Thornton, M. D., M. P. H.


Vitamin D Helps Prevent Breast Cancer in Black Women

Thursday, December 13th, 2012

As if breast cancer wasn’t frightening and deadly enough, research shows that black women are 41% more likely to die from it. Though they are less likely to get it in the first place, the results are more often fatal when they do. Of course, no one wants to get breast cancer. No matter your race or background, it’s extremely dangerous. However, these findings should be a wake up call for black women to be especially diligent in being tested for breast cancer early on and also to take as many preventative measures as possible. Believe it or not, increased exposure to vitamin D will help.

A recent study explored the link between vitamin D and breast cancer in black women.  According to this case-control study, for black women, it is more difficult for the body to extract vitamin D from its most natural source—sunlight—because the pigmentation in the skin prevents it. However, the results of the study showed that women who had more vitamin D in their systems from external sources were less likely to get breast cancer. External sources include both sunlight and vitamin supplements. Though vitamin D is produced in the body sometimes, that type of vitamin is not the one that protects against breast cancer.  I am somewhat skeptical of this study because it does not consider any confounding variables, such as genetic predisposition and health care disparities in the management of breast cancer in Black women.  The patients were from the Northeast and there were no patients from the Caribbean or southern locales.  However, it is a start and a randomized clinical trial needs to be conducted to confirm their results in African-American women in the Sun Belt compared to those living in areas with less daily sunlight.

If you are of African American descent, it’s important that you start getting mammograms, as recommended, i.e., every one –two years between age 40 and 49 and then annually at 50 years of age.  Early detection is the best way to save yourself from the disease.  Too much sun exposure can be dangerous for the skin, but you should find out how much will allow vitamin D to be processed and utilized in cancer prevention. A supplement containing the vitamin is another good way to reap the benefits of it, and many women’s vitamins do contain small amounts.

In many cases, breast cancer is totally unpredictable and random. It might strike you no matter how you live your life. However, we should consider the results of this study because even if it doesn’t help, it certainly can’t hurt.

– Yvonne S. Thornton, M. D., M. P. H.

You’ve Been Diagnosed with HPV. Now What?

Monday, December 10th, 2012

Have you gotten your HPV vaccination yet? If not, go get one now. HPV, or the human papillomavirus, is the single most common cause of cervical cancer in women. In many cases, women don’t even realize that they have HPV. For that reason, it’s important that every sexually active person is vaccinated because it is technically an STD (sexually transmitted disease) transmitted through intercourse. The HPV vaccination is simple, especially compared with the possible consequences of cancer treatment without it.  As stated in a prior blog in 2009, the benefits of being vaccinated against HPV far outweigh the small potential dangers.  If you are between 9 and 26, you should seriously consider getting the vaccination.

If you’ve been diagnosed with HPV, you’re probably wondering what happens next. It is too late to get vaccinated at this point, but it’s important that you understand how high your risk for getting cancer is. Though HPV (depending on its type) causes cancer in many instances, it is not to say that you’ll get it for certain. Many high-risk HPV infections simply go away on their own without leaving anything more than a few cell abnormalities. This spontaneous clearance of the virus usually occurs in women who are younger than 30 years of age.  It’s also important that you understand ways to decrease your risk once you’re diagnosed with HPV. Smoking and poor oral hygiene have both been linked to increase cancer risk following an HPV diagnosis, so it’s important that you take proper preventative measures.

In some ways, your HPV diagnosis is a perfect way for your doctors to more closely monitor your risk of developing cervical cancer. Many women who have cervical cancer can go years without even knowing that the cells are developing. It is a silent progression from a precancerous lesion to full-blown cervical cancer.  After your HPV diagnosis, doctors will know to check for cervical and anal cancer regularly. If they notice a tumor, they can take action quickly, which is the best way for you to beat it. It can take up to twenty years for cancer cells to develop after an initial HPV infection, so regular screening is necessary. Even if a tumor forms, you still have very good chance that it is not even cancerous.

You might be devastated when you first learn that you’ve contracted HPV. However, depending your age, it may resolve or it may persist.  If it does persist, then it certainly increases your risk for cervical cancer.  However, it does not necessarily mean that you will get it for sure. Stay on top of your regular screenings and stay positive.

Read more about HPV and cervical cancer in my newly updated health book, INSIDE INFORMATION FOR WOMEN.

– Yvonne S. Thornton, M. D., M. P. H.


How Endometriosis Might affect Your Fertility

Thursday, December 6th, 2012

When you’re trying to get pregnant to become a mom for the first time, you feel as though you won’t let anything get in your way. You’ll stick to a proper diet, you’ll avoid alcohol, and you’ll time conception carefully so that ovulation lines up with each attempt. However, past conditions can sometimes affect your ability to conceive. Endometriosis is one such condition, and women who have had it in the past often have a difficult time getting pregnant, even if they’ve undergone surgical procedures to reverse the effects of the condition. Endometriosis is, in fact, the most common cause of infertility in women over 25 years of age.

If you’ve had endometriosis at any point in your past, you might have undergone laparoscopic surgery to remove the excess tissue that causes the condition. Depending on the severity and the stage of endometriosis, even if all excess tissue has been removed, your ovarian reserve may be significantly lower than that of a woman who has never had the condition. While this won’t necessarily cause infertility, it will certainly make conception more difficult. Conception is partly up to chance as it is, so a limited ovarian supply will make the process much more difficult.

If you’ve had endometriosis and you’re trying to get pregnant, talk to your physician, preferable a reproductive endocrinologist, about fertility treatment options.  With the right combination of treatments, you’ll be able to conceive, though it might take you longer than the average woman. .  In vitro fertilization is a viable alternative in those women who are infertile by virture of  having severe endometriosis.  As long as you and your partner are both committed to making serious attempts though, you can become pregnant even after going through surgery for endometriosis. Since the condition directly affects the reproductive system in women, it’s impossible to tell just what effect it might have on fertility without close evaluation by a trained reproductive endocrinologist.

If you’re hoping to be a mom someday soon, endometriosis can be a major road block. However, by following your doctor’s advice and staying committed to a fertility treatment plan, you can increase your chances of becoming pregnant despite the setbacks of the condition.   For more information about endometriosis, read my women’s health book, “Inside Information for Women”.

-Yvonne S. Thornton, M.D., M.P.H

Sex, Lies, and HPV

Monday, December 3rd, 2012

All women have the right to keep their sex lives a secret and only share details with an intimate crowd of friends and partners. However, you might be surprised when your gynecologist asks for details about your first sexual experience. He or she might ask what age you had your first sexual partner and even what type of intercourse occurred. While you might be hesitant to share the details at first, it’s actually extremely important that you’re as honest as possible. Your gynecologist needs to know the details because recent studies have linked the age of your first intercourse with the likelihood that you’ll contract the human papillomavirus (HPV).  HPV has been found to be a precursor and is linked to cervical cancer.

In many cases, women who had sexual intercourse for the first time at a young age contracted HPV later in life. Even if you don’t have HPV now, your sexual history will help your gynecologist decide which types of infections and viruses to look out for.  Also, he or she may recommend being vaccinated against HPV with the Quadrivalent vaccine (Gardisil). The reasoning behind the connection between sexual history and HPV is partly because of sexual choices. There is a good chance that someone who had sex early on will have had more sexual partners than other adults, which will directly increase her likelihood of contracting HPV. Your gynecologist will also ask if you ever had any non-consensual sex, because the types of partners you’ve had and their health will also contribute to whether or not you’ll get HPV.

When your physician asks about your early sexual history, don’t worry about being judged. The best thing you can do for your own health is to be honest and share any detail you can remember. It might seem strange sharing such information with a stranger, but rest assured that she will keep the information confidential and within the walls of the office. If you’re concerned about your gynecologist’s honesty and you don’t trust that the information will remain private, it’s time to start looking for a new one. Your health is paramount, and you should feel comfortable sharing any information that will make for a more accurate diagnosis.

-Yvonne S. Thornton, M.D.,M.P.H.