April, 2013

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Can A Low-Dose Birth Control Help Control PMS?

Monday, April 29th, 2013

Being a woman is tough, especially when you have to deal with the monthly effects of premenstrual syndrome. PMS can have a range of effects, as every woman knows, and while for some it may be nothing more than a minor annoyance, for others it can be pretty difficult to get up and go while they’re dealing with symptoms such as moodiness, aches, pains, and bloating. I understand that, and part of my job is making sure that women have all the resources they need so they can live healthy, comfortable lives, no matter what their bodies are putting them through.

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.

Know the Facts When Making the Decision to Breastfeed

Thursday, April 25th, 2013

There is not a doctor out there who will deny there are some definite benefits to breastfeeding. Both mother and baby experience these benefits, which range from helping mom to lose some of her baby weight to helping your infant gain greater immunity to childhood diseases. But when my patients ask me whether or not they should breastfeed after they give birth, the last thing I want to do is bully them, or use scare tactics to pressure them into breastfeeding if they don’t think that it is the best option for them.

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.

Traditional Methods are Still the Best When Looking for a Diagnosis

Monday, April 22nd, 2013

Too many patients walk into my office looking for a quick fix for their problems. And why shouldn’t they expect a cure as quickly as possible? Nobody wants to feel sick, or live with unexplained symptoms. Nobody wants to worry that they have something seriously wrong with their bodies. However, all too often the patient’s idea of a “quick fix” is extensive testing and diagnostics. They see these highly advanced medical tools and think they’re a miracle tool that’s going to fix all of their problems. What these patients aren’t considering is that the best tool of all isn’t one that uses radio waves, computers, and high-tech imaging to get to the source of the problem.

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.

Are Hormones Giving You Breast Cancer?

Thursday, April 18th, 2013

When we are young and fertile, we take hormones for birth control.  As we age and go through menopause, we take hormones to control our bodies in other ways.  It seems as women, we are never happy with the natural course our bodies take, and so we constantly manipulate them with hormones. Although for most of us this method works, there are side effects, and sometimes, they can be deadly.

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.


Are Your Vitamins Contributing to Your Life or Death?

Monday, April 15th, 2013

Remember the good old days of Flintstones vitamins?  We were taught to take one every day so we could grow up strong.  Most of us continued that practice into adulthood, though the types of vitamins and supplements we use have changed considerably from the fruity, chalky prehistoric characters we were used to.  Although your doctor may prescribe supplements and although commercials suggest their vitamins can improve your health, they can actually be detrimental to your health, especially in older women.

It is important to make sure you’re getting all of the vitamins and minerals your body needs to function properly.  However, as we age, our body chemistry changes, which means the types of vitamins and minerals we need most will change as well.  More than 38,000 women were the subject of an Iowa Women’s Health Study concerning vitamin and mineral supplements.  Their results showed that most supplements had no obvious affect, but there were a few that actually increased the mortality rate in older women.  The culprits included Vitamin B6, folic acid, iron, magnesium, zinc, and copper.  Specifically, Iron seemed to be the most dangerous, with 15% of study participants who used it regularly dyeing.  Calcium, on the other hand, seemed to have the opposite effect, meaning it actually decreased the mortality rate.

Although this information may seem frightening, it’s important to put it into context.  Women in particular need Iron, so you never want to cut it out of your regimen completely.  That said, it’s better to get in the form of red meat and green leafy vegetables than in a vitamin.  The same is true of pretty much all supplements.  Your body will do a much better job of processing and using vitamins and minerals that are in food form.  Vitamins, when used on top of your usual diet, will easily put your system out of balance, which is what leads to dangerous levels of one or the other.  Likewise with Calcium, although it is important in the fight against osteoporosis, supplements can be dangerous when not taken in moderation or without the coinciding vitamins your body needs to process it.  In short, unless your physician recommends it, stick to a balanced diet and forget the vitamin supplements.

– Yvonne S. Thornton, M. D., M. P. H.

It’s Ok to Be a Big, Beautiful, Black Woman in America

Thursday, April 11th, 2013

Although historically, eating disorders like Bulimia and Anorexia have been found to be more prominent among women of European descent, our American culture continues to evolve.  While the added diversity this brings can be a good thing, it also means we share some of the negative aspects of our heritages as well.

The Journal of Counseling Psychology published a study meant to find out if African-American women now suffered from eating disorders as much as Caucasian women.  They also wanted to find out if the sources behind those disorders were similar.  The study did show that eating disorders among African-American women are on the rise, and this is mostly due to the internalization of societal beauty ideals.  In other words, as more and more wafer-thin models and actresses of African-American descent are spotlighted in the media, more of the public ideal as to what makes a beautiful African-American woman is biased in that direction.  In fact, concern over body image due to societal beauty ideals had a 79% correlation with eating disorders in African-American women.

It’s sad to me, that even though more cultures and ethnicities are being accepted in the American way of life, new types of beauty are not part of that incorporation.  Instead, the media seems to reduce them all down to one, predictable body type.  Yes, they are showing a more diverse range of races on TVs these days, but only those that fit into the Hollywood body stereotype.  It’s up to the public to call for movies, shows, and music that proudly display real people.  Only then will producers realize that it’s ok to be a big, beautiful, black woman in America.  In fact, there are many types of people out there who can help Hollywood create more dynamic and engaging media simply by being themselves, and this, in turn, will help form a healthier society.

– Yvonne S. Thornton, M. D., M. P. H.

Low-Income Equals High-Energy Diets Equals Low-Nutritional Value

Monday, April 8th, 2013

When you’re in an income rate, it seems like you just can’t win sometimes.  You have to live somewhere cheap, which usually means a bad neighborhood.  You have to cut corners, which usually means paying bills late and accruing late fees.  Also, you have to make the most of your grocery list, which means cheap food that isn’t necessarily good for you.  Unfortunately, health becomes a low priority when people are struggling to make ends meet, and a balanced diet is almost always the first thing that gets cut.

A study by the University of California and the Western Human Nutrition Research Center set out to determine if low-cost diets were affecting the quality of nutrition in low-income households.  It’s not too surprising that their results showed a positive correlation.  Specifically, they found that low-income women who bought low-cost foods had a diet that was energy dense but low on nutrition.  In other words, they bought a lot of carbs, quick prepackaged meals, and not too many fresh vegetables or meats.  The cost was inversely proportional to energy, meaning the more they spent, the lower energy and more nutritional their foods.  Consequently, those trying to save money and not spend much had diets severely lacking in the protein, fats, vitamins, and minerals they needed.

Because of the study, the research center is calling on the US Department of Agriculture to create policies that would make it easier for low-income families to buy nutritious foods.  In the meantime, these families are going to have to get creative with the way they get their next meal.  I’m a big supporter of community and backyard gardens, though I know not everyone has the time to maintain one.  Also, there are a plethora of coupons online these days, so put the kids to work planting veggies and hunting down discounts, and you’ll be a lot healthier in the long run.

– Yvonne S. Thornton, M. D., M. P. H.

A Cesarean Delivery Will Not Lower Your Chances for Incontinence

Thursday, April 4th, 2013

Obviously, childbirth can really do a number on a woman’s lower body. While we have all dreamed of the day we become mothers since we were little girls, we have also all feared it. Both women and men alike understand the pain and discomfort of childbirth. Some of that discomfort can even last beyond the pregnancy itself. Many women report incontinence after they’ve delivered a baby. Whether it’s a long bathroom line or a hearty laugh, you might find yourself darting to the nearest empty stall in horror as you realize you don’t have the bladder control you used to. It’s a common misconception that women who opt for Cesarean delivery are impervious to incontinence postpartum. Believe it or not, studies show that the mode of delivery actually has no influence on whether or not a woman will experience incontinence after she gives birth.

You’re probably wondering what causes incontinence postpartum then since the mode of delivery has no effect. If you are having bladder control problems after you give birth, it’s more likely a result of your age. Older women are more susceptible to incontinence to begin with, so childbirth will only bring it on sooner. Also, genes play a role. If your own mother was incontinent postpartum, there’s a better chance you will be also. Finally, your lifestyle might also play a role. Women who maintain a healthy weight and exercise regularly become incontinent less often. By avoiding those fatty pregnancy temptations and resisting the urge to become a couch potato during your gestation, you will be preventing incontinence.

If you’re thinking about having a Cesarean for health reasons, don’t let the potential for incontinence sway you. You have just as great a chance of becoming incontinent from a Cesarean delivery as you would from giving birth vaginally. Make other adjustments in your pregnancy if you are hoping to avoid incontinence. Stay healthy, plan the age at which you conceive wisely, and talk to your family members about their own incontinence postpartum to determine whether or not genes might play a role. While incontinence is embarrassing, it is temporary for many new moms who struggle with it for the first time.


– Yvonne S. Thornton, M. D., M. P. H.

How Exercise Can Cure the Postpartum Blues

Monday, April 1st, 2013

There’s no way around it. Exercise is an effective solution for many of life’s common problems. Many women are constantly trying to find shortcut answers to their ailments, but there is really no alternative for a good old-fashioned workout. Obesity isn’t the only thing that exercise can reverse. Many experts agree that physical activity is an excellent solution for people who are struggling with depression. Since exercise releases endorphins into the brain, it can raise the spirits against all odds. Therefore, it’s no surprise that studies show exercise is a suitable cure for postpartum depression.

Don’t be ashamed if you’re feeling depressed after you give birth. It’s a common problem, and the reasons are clinical. Many of my patients worry that they are already being insufficient parents by feeling unhappy in their first few weeks of motherhood. Let your doctor know right away if you’re having these feelings, especially if they are severe. Once you’re on a treatment plan and are getting help for the problem, you should begin exercising regularly.

Postpartum depression is sometimes simply a misconception of the most common postpartum symptoms. Fatigue, trouble sleeping, a lack of concentration, and irritability are all likely after you’ve given birth. Since these are common signs of depression, you might assume it’s such. Since exercise will give you more energy, help you sleep better, and relieve some negative feelings, it is an easy cure. Additionally, many new moms say that their postpartum depression is partly a result of the isolation they feel when they are at home all day with the baby. Especially after a busy, working lifestyle, the schedule of a stay at home mom can be saddening. Exercise will not only offer a burst of endorphins, but it will also give you an opportunity to spend time with other women in your area at the gym or on the local track.

Postpartum depression can hit even the most excitable new moms, so don’t be surprised if you’re feeling the new baby blues in the weeks following your labor. While you should certainly follow whatever treatment plan your doctor recommends, you should also try getting into an exercise routine. It will improve your mood more than you might think, and the alone time itself will help you clear your head and find your happy place once again.

– Yvonne S. Thornton, M. D., M. P. H.