Not surprisingly, one of the most important factors used by women in determining their method of birth control is its ease of use. The birth control pill can be notoriously difficult for some women to keep track of. It must be administered at the same time, every day, to be effective. That is why an increasing number of women are turning to other contraceptive methods, such as IUDs, to prevent pregnancy.

However, as a doctor I feel it’s my duty to urge women to think a little bit more about what contraception is best for them. There are a number of other factors besides ease of use to consider when choosing a method of birth control, from the permanence of the method you want to use to biological issues which may play a huge role in determining the efficacy of your chosen method. For example, an IUD may be best suited for a woman who has already had children and is looking for a more long-term solution to prevent pregnancy. Before making a decision about your birth control, be certain you engage in a dialogue with your doctor to determine what solution is best for you. There are so many options out there that it is easy in this day and age to find something tailored to your individual needs.

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

For patients, there is a real fear associated with mammograms. They can be uncomfortable, and there are always stories getting out about false diagnoses of breast cancer being made. In fact, it is likely that a lot of women will need to undergo a biopsy to determine whether a spot found in a mammogram is cancerous or not—however, the benefits of a potential diagnosis early on, before cancer has a chance to grow and spread, far outweighs the potential downside of having to undergo a biopsy when no cancer is present.

In addition, there are unfortunately still many women out there who treat the age of 70 as a magical cut-off point when they no longer need breast cancer screenings. However, most women who get breast cancer are over 50, and a large number of these are over 70. Senior women are not being told how important it is to receive a regular mammogram, as this study indicates.  A large number of younger women are also unaware of the importance of checking their breasts regularly with home examinations. It is important for women of all ages to be aware of the fact that they are at risk, no matter what their age, background, or current health.

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

However, there are still a lot of problems when it comes to awareness. One of those issues is the fact that the segment of the population that is most likely to be diagnosed with it is the segment least likely to be knowledgeable about the subject. In this study, which identified women positively diagnosed with postpartum depression as well as the demographics of affected women, it was revealed that women positive with a diagnosis were more likely to be younger, African American, and to be in a lower income bracket.

In addition, most of the women who were found to have postpartum depression were also found to have a comorbid generalized anxiety disorder. That means that many instances of depression may also dismissed as common anxiety, or the typical concerns of a new mother. It is important to correctly identify depression, as it can have an immense effect on both mother and baby in the period after birth. In fact, many women will suffer depression for years afterward. In this study alone, 14 percent of the women in the study were positively diagnosed.

Women should be informed about postpartum depression and its effects, and they should know that it is a common problem after pregnancy. Of course, postpartum depression is just one of the many issues that a woman might face regarding pregnancy and childbirth—my mission in life is to inform women of all ages and races of what is going on with their bodies, and in my book, “Inside Information for Women”, I discuss pregnancy and childbirth in detail, in the hopes that more women will go through the process with the knowledge that they need to remain safe, healthy, and happy throughout their pregnancy and well afterwards.

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

For many young women, the second question they ask after determining their prognosis is what effect their cancer will have on their future ability to start a family. Fortunately, advances in science over the past few decades have made it entirely possible for a woman to preserve her fertility after a cancer diagnosis. There are many options available for women who want to start a family after they have recovered from their illness. However, it is important to note that many of these options must be pursued early on in a cancer diagnosis—especially if the woman is choosing to freeze her eggs for future in vitro fertilization use.

Many women may see egg freezing as their only choice, and will not want to pursue this avenue when undergoing cancer treatment—this may leave them feeling as if they might never have the chance to start a family. This study shows that most women believe egg and embryo banking is their only option. This is most certainly not the case. Women who are concerned about their potential for reproduction should talk with their doctors and learn all the options before they give it up for a lost cause. There are many mothers out there who have had their children after surviving this horrible disease. I invite people to read my book, “Inside Information For Women”, for more information on the effects of breast and other cancers on the female body.

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

My son and his beautiful bride

The wedding was an incredible event, and it was the perfect way to celebrate the union not just of my son and his bride, but also of our two families. I had a blast, and it is certainly an event that I will remember for the rest of my life.  I can’t wait to see what comes next for my son and my daughter-in-law. Marriage is a blessing, filled with a lot of hard work, obstacles, and joys, and I know that they will meet any and all challenges they face head-on.

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

This is simply astonishing to me. When did the most important part of a woman’s pregnancy become how much weight she is putting on? As if our society’s standards of beauty weren’t bad enough, now we have to go and turn those “skinny at all costs” ideas on expectant mothers? The simple fact is normal-sized women are supposed to put on weight during pregnancy. Obese women have other recommendations for pregnancy weight gain. Studies show that the average woman should gain at least 25 to 35 pounds while pregnant.  Actually, the ideal weight gain should be closer to 11 kg or about 22 pounds.  This obsession with weight has led to a condition known as “pregorexia”, which is a rare condition, but becoming more common, which pertains to a woman’s drive to control pregnancy weight gain through extreme dieting and exercise.  This is an eating disorder and it shouldn’t be when it comes to women who are pregnant.  It is an outgrowth of all of this idiotic media focus on appearance and body images that average women strive to resemble celebrities.

When our society starts shaming women for gaining weight during their pregnancy, or suggesting that women are unhappy because of a few extra pounds they’ve put on, it can do a lot of damage to mothers and children. Are we creating a culture of women who are asking their doctors no, “What can I do to keep my baby healthy?” but “How can I make sure I don’t gain too much weight while I’m pregnant?” I’ve already made it known what I think about our culture and its standards of beauty. The fact that people in our society would rather focus on thinness rather than on the health of expectant mothers and their children is unbelievable.  On the other hand, the guidelines for weight gain in the average women should not be ignored.  Women who gain 50-100 pounds during their pregnancy are also putting their pregnancy and unborn child at increased risk for preeclampsia, diabetes and caesarean birth.

When the appropriate weight gain is achieved in the normal-sized patient, women  who are pregnant should not be ashamed of the weight they’ve gained—every pound that they put on should be worn as a badge of honor, as its proof that they are nourishing a happy and healthy infant with their bodies. When I see a woman who cares more about the health of her child than her dress size, I applaud them for having the courage to do what’s right and to stand up to the standards of our crazy society.

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

While birth control and other drugs been used for years to deal with the more serious symptoms of more severe cases of PMS, or even premenstrual dysphoric disorder, (PMDD), both women and physicians hesitate to give full doses of birth control to women who don’t need or want it. The birth control pill comes with a lot of side effects, as any woman who has taken it knows, and this can cause a lot of concerns for women who are already dealing with the effects of PMS. Fortunately, low-dose birth control can do a lot to regulate your menstrual cycle, and it comes with far fewer side effects than its more estrogen-heavy counterpart. Studies show that it can also help to alleviate the symptoms of PMS, so it may be an option for women who are trying to deal with the worst symptoms of their oncoming menstrual cycle.

If you think your PMS symptoms are bad enough to warrant medical intervention, make sure you bring it up during your next appointment with your doctor. It’s important to have a dialogue with the person in charge of your health about what is going on with your body, and what can be done to make you more comfortable, and your life a little easier. It’s also important to trust your doctor’s judgment when it comes to low-dose birth control, or any other form of treatment. They will know what is best for your body, and can talk you through your options.

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

Perhaps it’s just me, but I think these decisions are best left to the mother. It is not my job as a doctor to make those decisions for you. However, it is my job to make sure that you have the facts, and all the facts, before you decide either way. A lot of women might not know just how many benefits there are to breastfeeding, but on the contrary, a lot of women may have heard information that is just plain false. For example, plenty of people trying to push breastfeeding on young mothers will tell them that mother’s milk can prevent obesity later in life, but studies show that this is not the case at all.

Why is this important to me? Because I don’t think that any woman should be shamed for making the decision not to breastfeed if she doesn’t think that option is right for her. And there are plenty of women who have good reasons not to, whether they produce low amounts of milk, they need to return to work or take care of the rest of the family, or the process is just too painful for them. This is an important choice to make—possibly the most important choice that new parents will make in the first months of their child’s life. I want people to be informed about every option that they have, and will always encourage those who are uncertain about that choice to know everything they can, and to get their information from a source that isn’t trying to push some sort of an agenda. Let’s face it—parenthood is hard. You need information to make the right decisions. And there is absolutely nothing wrong with formula feeding. Unlike the milk from breastfeeding, which is deficient in Vitamin D and iron, formula feeding has enhanced those vital nutrients and there is also a quantitative check on just how much your baby is receiving in milk.  There are NO randomized clinical studies or trials (Level I) that have compared exclusive breastfeeding with formula feeding.  Therefore, the recommendations made are not based on evidence-based medicine.  Breastfeeding sounds good, so it must be good and sound.  With breastfeeding, that may not be the case.  Each mother has to decide what is best for her family, her baby and her self.  A panel of “experts” cannot recommend a course of action based on what “sounds” good without definitive outcomes of the two modes of management.  This has not been done when it comes to comparing breastfeeding to formula feeding.  Only observational studies exist and they are not the appropriate study design upon which to make decisions about such an important aspect of infant nutrition. The goal is to give your child the nutrition that he or she needs in order to grow.

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

The simple fact is, expecting high-tech diagnostics to get to the root of your medical issue could do more harm than good. Studies show that time is a factor in getting treatment for your problems, and a doctor can diagnose your problem far quicker than any machine. The first order of business for any doctor in treating their patient is determining whether or not they think an issue is serious enough to warrant extensive testing, which can be time-consuming and expensive. In most cases, an issue can be simply taken care of if you just trust your doctor’s gut instinct about what’s causing the problem and follow the course of treatment they lay out for you.

The fact that it can take a little time, and a handful of visits, to get to the root of the problem is a good thing. It may not seem that way if you’re experiencing headaches, nausea, or painful menstruation, but waiting it out and letting the doctor diagnose you with traditional methods has a lot of benefits. I’ve seen many patients come in thinking they had a serious illness, only to have the issue resolve itself with time, and patients whose problems persist are much easier to diagnose and treat when we stick it out and develop a detailed profile of their illness. There are times, of course, when us doctors get stuck. That’s when we’ll refer you to a specialist for high-tech testing. Just remember, no matter how fancy those machines may seem, the best resource you have for your health is the store of information and experienced located in your doctor’s brain.

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

If you’ve been involved in any kind of female hormone therapy, you know that the two main ingredients are estrogen and progestin.  This kind of treatment can balance older women out so they don’t have to deal with hot flashes, mood swings, and other symptoms of menopause, but it can also lead to dangerous imbalances that lead to illnesses like cancer.  An observational study by the Los Angeles Biomedical Research Institute found that women who initiated hormone therapy involving estrogen plus progestin has a higher incidence of breast cancer than in women who did not use such therapies.  Additionally, they found that the closer to menopause hormone therapy was used, the higher the risk.  Estrogen plus progestin also increased the mortality rate in women who developed breast cancer.

If menopause is making you miserable, obviously you need to find some form of relief.  Instead of jumping into hormone therapy though, talk to your physician about all of your options.  There are many lifestyle changes you can make to reduce your symptoms that have to do with diet, exercise, and routines.  For instance, hot flashes may be reduced by avoiding spicy foods, caffeine, and alcohol.  Sleeplessness may be remedied by regular workouts, a strict sleep schedule, and stress reduction.  Mood swings could be controlled by the same diet and exercise strategies or even therapy.  Your physician may also be able to administer less extreme medications for only your most severe symptoms instead of taking the wide-scale approach of hormone therapy.

For women who absolutely must go on a hormone therapy regimen that involves estrogen plus progestin, make sure you start out on the lowest dose possible.  Your physician can always increase it if needed, but there’s no sense getting more than you need.  Also, as soon as symptoms are under control and hormone therapy is no longer needed, get off of it.

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