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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.

Posted in Menstruation, Women's health issues | No Responses »
Tags: calcium, menstruation, PMS, premenstrual syndrome, women's health

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.

Posted in Menstruation, Women's health issues | No Responses »
Tags: birth control, contraception, hormones, menstruation, women's health

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.

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Tags: depression, seasonal affective disorder, women's health

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.

Posted in Women's health news | No Responses »
Tags: folate, nutrition, women's health

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.

Posted in Women's health issues | No Responses »
Tags: cervical cancer, HPV, Human Papillomavirus, women's health

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.

Posted in Women's health issues | No Responses »
Tags: HPV, sexual health, women's health

What to Do about Bloating during Menstruation

Thursday, November 29th, 2012

Especially for women trying to lose weight through diet and exercise, fluid retention during each menstrual cycle can be especially disheartening. More commonly known as “bloating”, fluid retention will make your favorite jeans too tight and will make the numbers on the scale creep up more than you’d expect. Luckily, bloating is no indication of your actual weight, and it’s quite literally excess water in your body that has been stored between layers of tissue. During your period, your body holds on to this water because of hormonal changes and minor swelling of the tissue. It is extremely common during menstruation, but it can be even more inconvenient than the usual cramps and back pain.

The only way to ensure that your bloating won’t get in the way of any major events is to plan those events around your period. You won’t want to try squeezing your bloated belly into your wedding dress or honeymoon bikini on the big day, but you’ll probably have planned your wedding around your period anyway. However, if you need to deal with bloating for one reason or another, there are some home remedies you could try to ease the discomfort.

First, make sure you eat a healthy and balanced diet during menstruation. Cut back on salt and sodium, as these will make your body retain even more water. Eat more vegetables and less fat and sweets to keep the fluids in your body moving properly through you. Next, exercise through your menstrual cycle. Not only will this ease any cramps you might have, but it will also help you sweat out the excess water trapped in your tissues. Although it seems counterintuitive, make sure you drink plenty of water. Proper hydration will keep the rest of your system working properly, so that when your period is finally over, the bloating will subside quickly and without incident.

Bloating is the modern woman’s worst nightmare. Months of exercise and healthy eating seem to go down the drain as menstruation begins and your designer jeans won’t even make it to your waist. Luckily, the home remedies listed will help relieve the fluid retention somewhat. Until the relief kicks in, there’s no shame in sweatpants.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Women's health issues | No Responses »
Tags: bloating, menstruation, women's health

Should You Stop Smoking to Start Birth Control?

Monday, November 26th, 2012

You already know that smoking is bad for your health. If you’re a smoker, you’re already making the choice to ignore certain health warnings that could significantly alter your health for the rest of your life, and that’s a choice that no one else can make for you. My telling you about all of the risks associated with smoking cigarettes would be a waste of time. However, I do feel it’s important that you know the increased risks associated with oral contraceptives for women who are smokers.

For the most part, modern oral contraceptives are safe. Even problems that have been tied to birth control for decades are now less common as the medicine improves and doctors work towards making the pill safer and with fewer side effects. However, by smoking while taking contraceptives, you’re increasing your risk for complications in multiple ways. Blood clots and stroke are both much more common in women taking birth control and smoking, especially in women who are 35 years old or older. In fact, there is a ten-fold increase of death attributed to cardiovascular disease and the use of oral contraceptives in women who smoked above the age of 35 years. [Link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1756661/]

The biggest risk for women who are smoking while on the pill is any cardiovascular complication and you’re increasing your risk by simultaneously restricting your blood vessels with the tobacco. The exact mechanism is not known as to the etiology of the increased risk, but according to a recent study, the risk of death due to such complications is low for women under 35 years old. Women who smoke while taking birth control are at a higher risk for heart attacks, high blood pressure, and increased blood vessel tension.

I’m not going to tell you to stop smoking, though as a physician, I certainly think you should. However, I urge you to take a closer look at the risks and benefits when it comes to combining your birth control with tobacco. If you feel that you need to continue smoking while taking your oral contraceptives, consider looking other types of birth control that don’t use hormones, such as an intrauterine device or even the old tried and true diaphragm.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Contraception (birth control) | No Responses »
Tags: cardiovascular health, contraception, smoking, women's health

How Kegel Exercises Can Help You Long after Birth

Thursday, November 22nd, 2012

Of course you’ve heard about Kegel exercises before. In fact, you probably did some of your own when you were pregnant. When you perform Kegel exercises, you strengthen the floor of your pelvis, which is an excellent way to prepare your body for birth and push more effectively in the delivery room when the big day finally arrives. Believe it or not though, Kegel exercises can be helpful even if you’re not planning on giving birth any time soon. Actually, they’re extremely helpful for women going into menopause. Studies show that Kegel exercises are a great way to prevent incontinence.

As we get older, our ability to hold in urine when we really have to go lessens. It’s simply a part of aging, and it usually comes on during menopause. Whether you’re having a laughing fit with the girls over brunch or rushing to the bathroom at a crowded sports game, you just won’t be able to hold it in like you used to. It’s common and nothing to be ashamed of, but regular Kegel exercises will improve your ability to hold it until you find a bathroom.

Your physician can help you learn how to do Kegel exercises if you’ve never done them before, but once you get the hang of it you’ll be able to do them anywhere. Your daily Kegel routine will involve contracting and relaxing the muscles for a short period of time every day. As stated in my women’s health book, Inside Information for Women, it takes about one to two hundred repetitions a day in divided segments of twenty at a time. It’s important that you don’t do your Kegel exercises while urinating though, as this could lead to a urinary tract infection. Never interrupt the flow of urine once it begins. These exercises are especially helpful in obese women who have reached menopause and are experiencing incontinence.

It makes sense that Kegel exercises can help you better control the flow of your bladder. Just like any other muscular exercise, you will become stronger over time and have more control in general. The best part about the exercises is that you don’t need a gym or even privacy to do them. They are extremely discrete, so you could even do your routine at your desk or anywhere else you can sit comfortably. Of course, speak with your physician if your incontinence is seriously affecting your daily routine, but if it’s only a minor inconvenience, Kegel exercises might be the only treatment you need.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Women's health issues | No Responses »
Tags: incontinence, Kegel exercises, Menopause, women's health

Stopping UTI’s before They Start

Monday, November 19th, 2012

I could tell you that urinary tract infections (UTI’s) are common in women all over the world, but it would be an understatement. The fact is, they are extremely common, and few women make it to age forty never having experienced one. They’re relatively easy to treat and harmless when taken care of early, but they’re also inconvenient and uncomfortable. Treating them is as easy as taking abstinence from intercourse. If caught early enough, your gynecologist might even simply prescribe more water. However, most women don’t catch their UTI’s until they feel the symptoms of burning and frequent urination. By that point, antibiotics are usually necessary.

That means treatment requires a quick trip to the doctor and a prescription. However, to make your life even easier, you should try to prevent UTI’s before they even start. Some women are more susceptible to UTI’s than others because their urinary tract is short or shaped in a way that traps bacteria. If you get them often, you need to be even more diligent in taking the proper steps to prevent them. UTI’s will clear up easily with treatment, but without treatment they could creep up your system and turn into a kidney infection (pyelonephritis), which could eventually kill you. A UTI will require antibiotics, but a kidney infection could require hospitalization.

The easiest and most beneficial way to prevent UTI’s is to drink plenty of water. You should be drinking at least eight glasses a day already, and getting that recommended amount will help flush out any bacteria that might get caught in your bladder. While it has long been believed that cranberry juice can help prevent all-too-common bladder and kidney infections, a new study from the well-respected Cochrane Library says its unlikely to do any good. (http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001321.pub5/abstract) Taking proper measures to keep your bladder free from bacteria is also important. Always remember as well to wipe from front to back, and urinate after intercourse to flush out bacteria that made its way into your system. Of course, good personal hygiene in the shower helps, and you should always wear clean, cotton underwear that keep those germ-sensitive areas covered. Recent studies have concluded that the best way to prevent uncomplicated urinary tract infections is to abstain from sexual intercourse (link to New England of Medicine). However, being the healthy females that we are, intercourse is a fact of life and refraining from intimacy may be a price to big to pay for not having a urinary tract infection.

Urinary tract infections are inconvenient and sometimes painful. They’re extremely common, but by practicing good health and hygiene you’ll increase your chances of avoiding them. Even if you feel like one might be coming on, plenty of fluids, short hiatus from intercourse can ward it off before you even call the doctor.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Women's health issues | No Responses »
Tags: urinary tract infection, UTI, women's health