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Further Proof that What You Drink Can Affect Your Urinary Health

Thursday, July 11th, 2013

Urinary health is a bit of a tricky subject for some women to discuss, but it can be one of the biggest issues that many women face throughout their lives. Most women will endure issues such as Urinary Tract Infections (UTIs) or urinary incontinence at some point during their lives, and it is important for women to have a healthy dialogue with their doctor about the ways that they can prevent and treat problems such as UTIs when they occur.

There has long been a consensus among doctors that the amount of fluid intake that a woman has day-to-day, can affect the healthy of her bladder, kidneys, and urinary tract. One of the most important things that a woman can do to maintain her health is to be certain that she is drinking the recommended amount of water throughout the day. However, a new study is showing that the types of fluids a woman takes into her body plays as important of a role in preventing and treating UTIs as the amount of fluid that she drinks.

Caffeine and drinks high in sugar such as sodas are one of the biggest risk factors for both men and women for experiencing urgency symptoms and UTI symptoms. This is in addition to the elevated risks of obesity and diabetes that come with drinking sugary sodas. On the other hand, certain types of fruit juices such as orange and grapefruit may reduce the symptoms of UTIs. In this observational study, the ingestion of citrus juices had a weak link for significance regarding an actual improvement in lower urinary tract infections or the prevention of a urinary tract infections. Citrus juice ingestion showed more promise in men compared to women. Recent studies have also debunked the idea of drinking cranberry juice to prevent urinary tract infections. The best way to reduce the risk of urinary tract infections is to drink more water and refrain from sexual intercourse. Simple advice, but difficult to follow.

None of this is surprising news for doctors, many of whom have been recommending that women with a history of UTIs avoid caffeinated drinks and sodas, while increasing their water intake, for years. What is probably more surprising is the number of women who still do not know about the effects that caffeine and sugar consumption can have not just on their weight, but on other aspects of their health. This is a clear indicator that more women need to be open about any UTI problems that they may be experiencing so that they can have an open and honest discussion with their doctor about their urinary health. There is nothing to be shy about in this case, especially when such simple measures can be taken to ensure your health.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Women's health issues | No Responses »
Tags: obesity, urinary health, UTIs, women's health

Not Receiving Influenza Vaccinations Increases Infant Mortality

Monday, July 8th, 2013

There has been a lot of talk about vaccinations in the past several years, and the camp of people on the side of going vaccination-free is getting bigger every year. That is something that frightens me as a doctor, as vaccinations are the single most effective way to prevent disease, not just among individuals but also among the general population, known as herd immunity. Vaccination acts as a “firewall” in the spread of disease. In herd immunity, the more folks that are vaccinated against a contagious disease, the less likely a single individual will become infected.

However, part of being a doctor is a willingness to look at all the evidence as it is presented to you. As the debate about vaccinations continues, an increasing number of researchers are looking at the effects that vaccinations have on individuals, and whether they have the potential to do more harm than good among certain groups.

Pregnant women are a group of major concern. There are a lot of steps and preventative measures that a woman must take in order to maintain the health of her child while she is pregnant, and vaccinations have always been recommended to prevent the devastating effects of the Influenza virus. Doctors in one study have conducted research on pregnant women and the influenza virus, as well as the mortality rates in the infants of those that choose not to be vaccinated. While vaccinations against the Influenza virus pose no significant threat to women or to their unborn children, women who go without the vaccination show much higher rates of infection, and those that were infected show much higher rates of fetal mortality. Another vaccine, known as Tdap, for tetanus, diptheria and pertussis (whooping cough), should be administered to all pregnant women in their third trimester (27 weeks to 36 weeks) in order to maximize the maternal antibody response and passive antibodies that will protect the newborn.

The results are not surprising to doctors, but they are worrying when you take into consideration the fact that this year, many women will choose not to be vaccinated, and will choose not to vaccinate their children. While many trends are silly but otherwise harmless, this “popular” trend could be absolutely devastating. There are certain vaccinations that should not be performed during pregnancy, such as measles, mumps and rubella (MMR), varicella (chickenpox), zoster (shingles), anthrax, BCG (tuberculosis), Japanese encephalitis, typhoid, yellow fever and smallpox, but women should trust their doctors to guide them in the right direction when it comes to making these decisions about the necessary vaccinations. Choosing to vaccinate against Influenza, even while pregnant, poses virtually no risks. Choosing not to vaccinate could be a big mistake.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Fertility & Infertility | No Responses »
Tags: influenza, Pregnancy, vaccinations, women's health

Reproductive Science Helps Women With HIV-Positive Partners Give Birth

Thursday, July 4th, 2013

Although sexually transmitted diseases are a very serious matter no matter what an individual is facing, HIV is perhaps the most frightening diagnosis for many individuals. Even with vastly improved life-expectancy rates, there are a number of concerns that individuals and those who have HIV-positive partners face throughout their lives. One of the biggest concerns for those who have HIV is whether or not they will have the opportunity to conceive children.

It is absolutely imperative that among couples in which one partner is infected with HIV and the other is not that protection is used whenever intercourse occurs. This means that a couple in which one partner has HIV cannot conceive naturally—at least, not in a responsible manner. However, studies in reproductive medicine have investigated whether or not the sperm of men that have been infected with HIV can successfully impregnate women while still leaving both mother and child HIV-free.

It sounds like a scary and risky procedure, and there has certainly been a lot of debate over whether these kinds of studies are wise. However, this study has shown that there does not seem to be a risk of infection in cases where the male sperm has been “washed” and the woman has been artificially impregnated. This is intriguing news not only for researchers that study the mechanics of HIV, but also for doctors who specialize in reproductive help. It means that there seem to be more options for couples in which at least one partner is infected. Unfortunately, pregnancy among HIV-infected women can still be dangerous, as the virus can transmit to the infant either during pregnancy or childbirth, and much more needs to be done to determine the possibilities for couples during these cases.

Overall, it is intriguing news and it will certainly continue to raise a lot of questions for those that specialize in women’s health and reproductive medicine. However, it is imperative for any couples in which one partner is infected with HIV to realize that it is necessary to seek medical advice when the issue of conception comes up. Even if the possibility for a safe pregnancy is there, it is better to seek the advice of professionals and to avoid any potential infection. Childbirth is a wonderful and a beautiful experience, but currently the best option for these couples is still to seek alternate methods to become parents.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Women's health issues | No Responses »
Tags: Pregnancy, reproductive medicine, sexually transmitted diseases, women's health

Obesity A Major Cause of Death for Women that Survive Cancer

Monday, July 1st, 2013

A diagnosis of cancer can put a person’s entire life on hold. Fortunately, treatments for cancer, and especially for women’s cancers, are becoming increasingly better at helping women prolong their lives and even enter into remission. This is wonderful news for both doctors and patients that have to deal with this horrible and tragic disease. However, as the rate of women who survive cancer increases, alarming statistics about what can happen after surviving this disease are coming to light.

It has been suggested that one of the main killers for women that survive cancer is obesity. Hormonal changes in women who have received oophorectomies can severely impact their ability to maintain a healthy weight, and in some cases can cause women who have never had weight problems to face weight gain. Additionally, many medicines such as steroids that are used to treat cancer can cause weight gain. This does not even begin to take into account the many emotional and mood changes faced by women who have survived cancer, which can also be a major contributor to weight gain.

So what can a doctor such as myself do about it? How can those who have survived cancer move on with their lives and continue to preserve their health? One study suggests that it is extremely important for those who have been diagnosed with cancer and those who have entered remission to discuss the problem of obesity and how it can factor into a woman’s health after she has begun to recover from such a devastating disease. It is also important for women who have survived cancer to seek the support of other survivors that may be able to help them understand what they face after remission and recovery.

Discussing the other factor surrounding a diagnosis of cancer can be just as important as discussing the disease itself. Whether an individual is a doctor, a patient, or even a close friend or family member of the person who is recovering, the “what comes next” dialogue is an essential part of preparing for a woman’s long-term health prospects. Women should not be surviving cancer only to face further health complications, especially if steps can be taken early on to prevent these issues. Whether it is due to hormonal fluctuations, medication, or an issue such as depression, weight gain can be prevented. The entire community needs to work together to put an end to this growing problem.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Women's health issues, Women's health news | No Responses »
Tags: cancer, oncology, weight gain, women's health

Among Women, Sexual Satisfaction Only Increases With Age

Thursday, June 27th, 2013

Let’s talk about sex! While sexual activity, and sexual desire for that matter, is usually thought of to be a younger woman’s game, an increasing amount of attention is being given to older women and their sexuality. It has been commonly thought for years that a woman peaks sexually around the age of 30 to 40, and after that experiences a steady decline in her sexual performance and desire until she hits menopause. However, according to some new studies, that might not necessarily be the case. In fact, some studies are showing that as opposed to the more commonly held opinion that older women simply aren’t interested in sex, sexual desire actually increases with age.

But how is that possible? Isn’t sex all just a “hormone” thing? If that were the case, then it would certainly be true that sexual desire may drop among women who are experiencing menopause, or among women who were post-menopausal. However, the study cites a few different reasons as the main cause of rising sexual desire in older women. Older women do not have the same concerns as their younger counterparts. They do not have to worry about birth control or potential pregnancies, and more often than not older women are having sex with life-long partners, a fact that greatly reduces the potential risk of STDs. It should also be taken into consideration that women with life partners are more likely to have an emotional connection with the object of their sexual desire. That emotional connection leads to greater sexual satisfaction when they do engage with their partners.

It is true that as women get older, they tend to have less sex. It is also true that they may experience a lack of lubrication. These are not necessarily factors for decreased sexual satisfaction. In the study, it was found that the act of intercourse was not necessarily the most important way for older women to achieve satisfaction, and other forms of gratification were just as, if not more, important to them than intercourse.

So what does that mean for women? Well, for one thing, it is further proof that growing older does not mean that women have to “throw in the towel” on their sex lives. Women that are not sexually satisfied, that are experiencing pain or discomfort during sex, or who are having any other sex related issues should not just assume it is a natural byproduct of aging. Always speak with your doctor to determine whether or not there is anything that can be done to help you enjoy a happy, healthy sex life, whether you are twenty or eighty.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Women's health issues | 1 Response »
Tags: aging, intercourse, sexuality, women's health

Talking With Your Doctor About Sexuality During Pregnancy

Thursday, June 13th, 2013

Pregnancy can be a wonderful experience, but it can also provoke a lot of mixed emotions in women. From joy to depression and anxiety, and just about everything in between, women will likely experience a full range of emotions. Their mental state is also not helped by the hormonal shifts that are taking place inside their bodies as they prepare for pregnancy and birth.

One of the most common complaints among pregnant women is the shift they experience in their sexual desire. It is hard to predict the shifts that will occur—some women may experience heightened sexual urges, while others may experience a drop or a complete lack of sexual interesting altogether. Some studies have shown a tendency for sexual practices to drop trimester by trimester, with an overwhelming majority of women not having sex in their last trimesters. Among the reasons for this seem to be concern in both men and women that sex could potentially complicate the pregnancy or cause harm to the unborn child.

It is up to the woman to decide whether or not she has an interest in sex. However, women should not feel as if they have to suppress their sexuality just because they are pregnant. It is imperative for women to open a dialogue with their doctors and to feel comfortable discussing sexual issues with her doctor. This can vastly help improve her understanding of what is and is not harmful during pregnancy, and can do much to reduce her anxieties.

Many women have a healthy and natural sex drive throughout their pregnancies, and some may even report an increase in sexual interest toward their second and third trimesters. They should not avoid sexual intercourse simply because they feel that it might do harm to their pregnancy. By speaking with their doctors, they can learn whether or not there are any real risks related to sexual activity, and in many cases they will realize their anxieties are unwarranted.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Pregnancy | No Responses »
Tags: obstetrics, Pregnancy, sexuality, women's health

Angelina Jolie News Raises BRCA Awareness

Monday, June 10th, 2013

Celebrity gossip is usually centered on unimportant things, and as busy as I am I rarely pay attention to any of it. However, I was forced to take pause with the recent news of Angelina Jolie’s double mastectomy, which she decided to undergo after making discovery that she was a carrier of the BRCA1 gene. For once, celebrity gossip might be doing more good than harm. In the past few weeks, talk about the BRCA 1 and 2 genes has gained a lot of momentum.

An increasing number of women are realizing how important it is to receive this screening procedure, especially if they have a family history of breast and ovarian cancers. Many women had certainly not heard about BRCA 1 and 2 screenings until Jolie’s frank discussion of the issue—something which is astonishing, as studies have already shown that testing for the BRCA gene increases awareness in women, leading them to higher rates of surveillance with regular self-checks and mammograms, as well as to a higher rate of preventative operations to reduce their cancer risks, such as Jolie’s double-mastectomy.

In short, the Angelina Jolie story is one piece of celebrity news that I can get behind. It might be a little distressing to think that some women are only learning about such an important topic through gossip magazines, rather than through their doctors, but sometimes it is best to appreciate any help you can get. In this case, if a larger number of women receive genetic testing to determine whether or not they are a carrier of the BRCA 1 or 2 gene as a result of a celebrity news story, then at least it can be said that perhaps our celebrity culture has done something right for once.

Angeline Jolie should, of course, be commended for her strength in speaking so publicly about such an important issue. The fact that she was willing to open up about her experiences in hopes of raising awareness may help many women prevent breast and ovarian cancers.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Women's health issues | No Responses »
Tags: Breast cancer, mammogram, testing, women's health

How Does “Bedside Manner” Affect Patient Pain?

Thursday, June 6th, 2013

You’ve probably heard somebody talk about a doctor’s “bedside manner”. It can be fun to watch television shows such as House, M.D., where the doctor is not-so-nice to his patients, but there is a very real reason that doctors like this are often not successful in the real world, and why part of a doctor’s medical training includes learning how to communicate with their patients and treat them appropriately, especially after a major medical event such as childbirth or surgery.

While you can guess that the way a doctor interacts with their patient can affect their psychological well-being, you might not have considered the fact that the same interaction can influence the patient’s perception of pain. In fact, one study has shown that discussing pain with patients who have had a Caesarean childbirth adversely affects their perception of pain, and can actually make them feel worse. This raises several important for both doctors and patients as they consider what it means to have a good “bedside manner”.

There are two ways to quantitate the perception of pain. One is a numerical scale (http://pain.about.com/od/testingdiagnosis/ig/pain-scales/Numerical-Scale.htm) and the other is a visual analog pain scale, also known as the FACES or Wong-Baker scale (http://pain.about.com/od/testingdiagnosis/ig/pain-scales/Wong-Baker.htm), These pain scales allow the physician or nurse to get a better idea of the extent of the patient’s discomfort. Still, even with these pain scales, some doctors still will act like “House”.

Talking about pain is also a complex issue because it forces both doctors and patients to consider how they will manage pain and discomfort after surgery or childbirth. On the one hand, it is important for the doctor to know that their patient is feeling all right, and that there are no potential complications that need to be addressed. Some patients, especially those who have never undergone major surgery before, may feel that certain types of pain are “natural” and will not speak about these issues with their doctor. However, if asking about pain leads to negative effects, it important for doctors to choose their wording carefully in order to acquire the information they need while still aiding in their patient’s comfort.

It is always important for patients to have a doctor whom they feel that they can trust—who they already know through interacting with them has a bedside manner that meets their needs. This is especially important for women who are preparing to give birth, as they will want to heal as quickly as possible so they can begin to care for their newborns.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Women's health issues | No Responses »
Tags: Caesarean Section, Childbirth & delivery, Pregnancy, women's health

The Risk of Cellulitis and Infections After Hysterectomies

Monday, June 3rd, 2013

There is no doubt that a hysterectomy can be a traumatic experience for women. In fact, it is one of the most invasive surgeries that most women will face over the course of their lives. The immediate effects of a hysterectomy are far reaching. The psychological effects of a hysterectomy can be devastating. Even women who do not plan on having any more children may experience difficulty coping with this kind of surgery.

Unfortunately, there are other risks associated with hysterectomies, and these risks can make it even more frightening for some women who are facing the surgery. Cellulitis and SSIs (surgical site infections), can cause complications after surgery for women. These issues can delay healing time, and can lead to other psychological effects as women cope with the cellulitis or SSI in addition to the effects of the surgery.

Many women may want to know if they are at risk for these kinds of issues after surgery. There are in fact multiple risk factors, as this study shows, which can include pulmonary disease, obesity, and even the lack of private insurance. This may be concerning for some women as they go into their surgery. Even the operating room environment in this study played a major role in whether a patient develops cellulitis (inflammation just below the skin) and a wound infection in the hospital (nosocomial). One of my pet peeves is the wearing of O. R. scrubs as a fashion statement. O. R. scrub attire was designed to decrease the possibility of outside contamination and not bringing it into the Operating Room. Yet, today, you see doctors and O. R. personnel (as well as the housekeeping personnel) wearing their “scrubs” to the food trucks outside of the hospital, wearing them home, walking and running in the street, sleeping in them. All the while knowing that these filthy O. R. scrubs are vectors for disease and infection. But, because everyone today is more casual, the patient has to suffer with a nosocomial infection (an infection contracted from the hospital) and needs to be treated with antibiotics or in some instances pay the ultimate price of an overwhelming, untreatable infection (such as MRSA) because someone was too lazy to change their O. R. scrubs before leaving the hospital. Dr. Oz and other TV reality show doctors have set this unfortunate precedent by wearing their scrubs on TV, as if to make a statement that they are “real” doctors. “Real” surgeons do not wear their scrub attire outside of the operating room, unless they are covered up with a buttoned, long, white coat. So, the next time you see your doctor wearing scrubs outside of the Operating Room, you should call them on it.

Fortunately, the study also shows that certain precautions, such as pre-operative showers, antibiotic prophylaxis and better surgical techniques and a better operating room environment (personnel and instrumentation) can help prevent SSIs and cellulitis. It is important to figure out new ways to speed up the healing process in order to help women who have had these surgeries move on as quickly as possible—for many women, this will be one of the most traumatic experiences that they will ever go through.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Women's health issues | No Responses »
Tags: hysterectomy, surgery, women's health

Better Knowledge of Symptoms Leads Gynecological Cancer Survivors to Seek Treatment

Thursday, May 30th, 2013

Though your doctor can provide much in the way of education about your health, the burden of determining whether or not a symptom is in need of treatment or diagnosis can fall into the hands of the patient. However, this can be a catch-22—self-diagnosis via Internet message boards and medical sites can be just as detrimental to a woman’s health as ignoring her symptoms completely, especially if she makes her own decisions about her care or treatment without consulting with her doctor. This leads to a problem that many doctors are finding it difficult to solve.

We want patients to be informed about their bodies and their health; however, we don’t want our patients to think that self-diagnosis is the way to go when it comes to caring for their bodies long-term. It is important to consider how women use message boards and medical websites to supplement their own understanding about their health. One study done on women in Japan showed that gynecological cancer survivors were more likely to seek treatment after searching online and connecting with others who had those same symptoms.

This proves that the Internet can be a great tool for assessing whether or not a symptom is normal—after all, it can be easy to dismiss something as natural without taking into account that it very well may not be. What seems to be a minor issue can easily be a symptom of something much greater. When women use the technology at their disposal to educate themselves about their health and use that education to open a dialogue with their doctor about whether or not they are in need of diagnostics or treatment, they are taking a proactive step toward bettering their health. Every woman should be aware of the importance of educating themselves about their bodies—but it is just as important that women realize self-diagnosis can be dangerous. Part of educating yourself is understanding that you are learning to communicate with your doctor, and aren’t trying to play “doctor” yourself.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Women's health issues | No Responses »
Tags: cancer, health education, symptoms, women's health