Women’s health issues

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Postpartum Anemia May be Avoided with Iron Supplements

Thursday, June 7th, 2012

Most women know that because of their menstrual cycle, it’s a good idea to take iron supplements to replenish the minerals lost during that time of month.  Otherwise, their deficiency could lead to anemia as well as other symptoms.  What women should also realize though is that iron deficiency is a big factor in causing postpartum anemia as well.

When you give birth, you are immediately thrown into a chaotic new schedule, added responsibility, and the constant task of taking care of a very fragile new human being.  Of course, as the child’s mother, you no doubt find great joy in this responsibility, but that doesn’t make it any less exhausting.  If your iron levels after giving birth aren’t where they should be, that exhaustion can be a lot worse.  Iron deficiency can cause people to feel exhausted, to have low endurance for physical activities, to struggle with short-term memory, to find themselves unable to focus, and to feel depressed and irritable.  When a mother gives birth, it puts a lot of stress on her body, which can cause imbalances and a decrease in iron levels in particular.  This is why it’s so important for women to maintain a very different diet when they are pregnant, about to give birth, and breastfeeding.  A study in the Journal of Obstetric, Gynecologic, & Neonatal Nursing states very clearly that, “the increased iron requirements of pregnancy cannot be met by the typical US diet or the iron stores of most women. Therefore, if women are left unsupplemented during pregnancy, they bear a considerable risk of developing iron deficiency,” which in turn increases their risk of postpartum anemia.  Other factors that can increase that risk include short intervals between pregnancies, because they don’t allow a woman’s body time enough to recover, and cesarean deliveries, which usually include more blood loss.

If you’ve ever been through a pregnancy, you know just how much it takes out of you.  This can make it difficult to determine whether you are just “new mom tired” or medically ill tired.  This is why it is imperative that you keep your physician as up to date as possible when it comes to exactly how you are feeling, whether physically, mentally, or emotionally.  This way, you can work together to make sure your vitamins and minerals stay balanced, along with your overall well-being.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

Fattening Foods Give Women Yet another Reason to Cut Down

Monday, June 4th, 2012

As if we need another reason to feel guilty about those fattening foods we love so much, women now need to be concerned about how those kinds of foods can impact their mental health.  While we already know that fattening foods can cause obesity, increase the risk of heart disease, and even bring on diabetes, studies now indicate the type of fat found in those foods also slows our cognitive functions.

Over 6000 women participated in the Women’s Health Study at Brigham and Women’s Hospital.  Researchers overseeing the study took surveys about the types of foods they ate and with what frequency before and after the study.  They also performed cognitive function tests at the beginning of the study, after two years, and then again when the study was finished after four total years.   What they found was that certain foods impacted how fast cognitive decline happened.  Olivia Okereke, a doctor from the Department of Psychiatry reported that, “when looking at changes in cognitive function, what we found is that the total amount of fat intake did not really matter, but the type of fat did.”  Their results showed that women who ate a lot of foods high in saturated fats had a cognitive decline much more significant than those who ate foods high in monounsaturated fats or who had less fat in their diet altogether.  In other words, those who ate foods with animal fats, like red meat, dairy products, and butter, were less likely to maintain a sharp mind compared to those who ate plant fats, like avocado and olive oil.

Although this study is revealing, you won’t find me giving up my favorite ice cream or opting out of that nice juicy steak once in a while, and that’s ok.  By simply reducing how often we eat foods like this or replacing their saturated fat ingredients with monounsaturated fats, we can do a lot to keep our minds sharp and our bodies fit.  I guess it’s finally time to try that olive oil ice cream I’ve been hearing about!

 

– Yvonne S. Thornton, M. D., M. P. H.

 

Sleep Yourself Thin

Thursday, May 31st, 2012

When you are a parent, you do not always get a lot of opportunity for sleeping.  You do not get a lot of time for yourself in general really.  You have work to take care of, children to manage, and somewhere in there, a body to consider.  The fact is though, with our busy American lifestyles, the health of our bodies simply seems to take a back seat.  Unfortunately, this has caused many of us to become overweight, or even worse, obese and diabetic.  A recent study shows though, that if we could all just find enough regular time to sleep, we might be able to stay slimmer and healthier in general.

Right now, nearly two-thirds of Americans are overweight or obese.  Even more concerning is how many of these people are progressing into diabetes.  The CDC cites diabetes as a health issue for 8.3% of Americans and a whopping 79 million show signs of prediabetes.  While poor diet and little to no exercise are obvious causes for such an epidemic, stress and sleep schedules also play a role.   A recent study by researchers at the Brigham and Women’s Hospital and the Harvard Medical School in Boston found that “lack of sleep or disrupted sleep patterns…may lead to an increased risk of diabetes and obesity.”  The study involved tracking the effects of disrupted sleep routines in participants by shifting their sleeping time from 10 hours a night, to just 5.6 hours per 24 hour period.  This sleep restriction and pattern disruption caused 32% of participants to have decreased insulin secretion when they ate and lower metabolic rates, which led to high blood sugar levels bordering on pre-diabetic.  If they had continued the study for a year, they estimated that these levels could have caused them to gain about 12.5 additional pounds of body weight in one year.  When you add these conclusions to the hectic lifestyle of working American parents, it is no wonder so many are struggling with their weight.

When we are young, we spend a lot of time fighting our parents over daily naps and early bed times, but once we grow up, we find it even harder to put ourselves to bed.  Perhaps this study will help us hardworking adults realize that it is no use staying up all night stressing about our busy lives, if it only gives us fewer nights to live.

 

– Yvonne S. Thornton, M. D., M. P. H.

Exercise Beats Cancer

Thursday, May 24th, 2012

With more than 40% of Americans diagnosed with cancer in their lifetimes, it’s highly likely that you or someone you know has experienced cancer.  For this reason, we have put a lot of effort into finding cures and treatments for this devastating disease, and now, we are finally seeing some glimmer of hope in the statistics, especially in terms of prevention.  It seems that an active lifestyle, a healthy weight, and a smart diet can do a lot to reduce the risk of cancer.

According to the American Institute for Cancer Research, 1/3 of cancers can actually be prevented if Americans were to commit to being physically active every day for at least 30 minutes, if they were to maintain a healthy weight throughout their lives, and if their diet would include mostly plant foods, limited red meat, and as little processed meat as possible.  If that’s not enough motivation to live a healthy, balanced lifestyle, I don’t know what is!  Unfortunately, the American diet is packed with processed meats and other unhealthy foods and our culture is getting less active by the generation.  Hopefully, these statistics are enough to create a paradigm shift and force Americans to look at the long-term effects of their choices.

For those of us in our middle-aged years already, much of the damage has already been done, but that doesn’t mean we can’t turn it around.  In fact, a recent study in the Journal of the National Cancer Institute revealed that physical activity was linked to lower rates of breast and colon cancer deaths.  They found that cancer survivors, particularly breast cancer survivors, enjoyed longer lives when they exercised regularly, as compared to those who did not.  Exercise was also found to prevent reoccurring cancers. They believe the results stem from the way regular exercise effects insulin levels, inflammation, and immunity, but more studies are planned to better understand these recent results.

Between our American lifestyle, family histories, and the sheer prevalence of the disease, our risk factors for cancer only seem to be going up.  Now that we know that simply being healthy is just one way to reduce our risk though, maybe we can finally commit to getting out there and getting active.  How many more reasons do we need to take care of ourselves.

– Yvonne S. Thornton, M. D., M. P. H.

 

 

A Family History of Heart Disease Doesn’t Have to Be Your Future

Monday, May 21st, 2012

Heart disease is a growing problem in America.  It is the leading cause of death in both men and women, and is even more of a problem for African Americans.  For many Americans the tendency towards heart disease runs in the family, and with their fast food addiction and sedentary lifestyles, the risk only increases.  Just because you may have a history of heart disease in your family though, doesn’t mean it’s a fate you have to suffer.

Jennifer Sedbrook, an OSF Cardiovascular Service Line Leader, says that “We can control all but two of the factors that affect heart disease; family history and age.”  OSF (Order of St. Francis) Healthcare is a nonprofit Catholic health care corporation that operates a medical group, hospital system, health plan, and other health care facilities in Illinois and Michigan.  According to OSF, There are other important factors which can also increase our risk though, and those include our BMI, or body mass index, blood pressure, cholesterol, and weight.  It’s important to be aware of your body and to know each of these numbers, so that if there is a change, you can alert your doctor.  Additionally, if you know your body mass index and, consequently, weight are not where they should be, you can be proactive.  By eating healthy and committing to a regular exercise routine, you can drastically reduce your risk of heart disease.  This, along with controlling the amount of stress in your life, will decrease your cholesterol and blood pressure.

Ann Ripsom, one woman in a family of 7 siblings, has lowered her own risk factors by quitting smoking, joining Weight Watchers, and getting regular check-ups with her doctor.  She decided to get involved with the OSF Women’s Heart Ambassadors after losing three of her brothers to heart disease.  Three of her other siblings have also suffered from major heart issues.  Despite such an intense family history of heart problems, Ann does not show signs of the disease and is working to help others decrease their factors too.  She says that the most important thing to do is to take control of your risk factors and do not ignore signs your body may be giving you. In addition, people need to know the various symptoms of a heart attack, which can include chest pain, jaw pain, pain in either arm, nausea, sweating, disorientation, and fatigue.

More than 616,000 people died of heart disease in 2008 alone.  That accounted for 25% of the deaths in America that year.  By becoming educated about your risk factors, these kinds of deaths can be prevented.  Knowing this information and taking steps toward prevention is the most important thing you can do.  So find out what your numbers are, start eating healthy, and above all, get active.  Don’t let your family’s history determine your future.

– Yvonne S. Thornton, M. D., M. P. H.

 

 

 

Don’t Want Kids? Why Haven’t You Told Your OB/GYN?

Monday, May 14th, 2012

Back in my mother’s day, women were expected to grow up and raise a family.  Nowadays though, modern women view having kids as more of an option.  In fact, more and more often women are choosing to forgo the family experience in exchange for a demanding or prestigious career.  There is no longer a societal stigma for not having children.  It is truly a choice.  Oprah Winfrey, two recently-appointed female Supreme Court Justices, Condolezza Rice, and even our Surgeon General are childless.  While I can say firsthand that it is possible to have both a career and children, I can certainly relate to the ambitious young women out there who want different achievements than those of their mothers’ generation.  While these young women may have decided beyond a doubt that they don’t want children, for some reason, they’re not sharing this information with their OB/GYNs.

Many people see OB/GYNs as physicians who perform annual exams or take care of matters concerning pregnancy.  While these are important parts of our job, they’re not the sole aspects.  We are here to provide support and advice when it comes to a variety of women’s health issues.  Just because you’ve decided not to have kids, doesn’t mean we don’t have anything more to tell you.  In fact, OB/GYNs can give you valuable information concerning your permanent birth control options.  Although so many women are opting out of pregnancy, they continue to use contraception methods that are temporary, not always effective, and sometimes, risky to their health.  With average use, condoms have a failure rate of 17.4 percent and the pill has an 8.7 percent failure rate.  In addition to the pregnancy risk, hormonal birth control increases a woman’s risk for blood clots, strokes and heart attacks.  Yet, those who don’t want kids or those who don’t want any more kids, continue to take the risk.

As stated in my women’s health book, “Inside Information for Women”, the most common form of contraception among couples is sterilization.  While most have heard about invasive procedures like vasectomies and tubal ligations, only 12 percent were aware that other options existed.  Because, in the final analysis, whoever carries the child is the one who is going to be the one most concerned about birth control, it is more usually the female partner rather than her mate who elects sterilization. There is more than one type of sterilization for women though, including sealing fallopian tubes using an instrument with an electrical current, closing them with clips, clamps, or rings.  A new method of sterilization (Essure®) involves inserting spring-like coils into the tubes through the cervix around which tissue grows to block the tubes.  President of AAGL and practicing OB/GYN, Dr. Linda Bradley believes that more women would choose a permanent method if they were simply more educated on the matter.  She cites the insert procedure (Essure®) as being 99.8 percent effective and a lot less invasive than a tubal ligation.  She notes the insert method, for instance, as being a “non-surgical permanent birth control procedure [that] offers women the option of no incisions, no hormones, no general anesthesia and no slowing down to recover.”  It’s a fairly new procedure, just ten years old, but it is gaining in popularity among those who have learned about it.

Wherever you are in your reproductive plans, it’s important to share them with your OB/GYN.  They can give you information you may not have considered, guide you in your decision making, and help you make the healthiest and most informed choice regarding your reproductive health.  The next time you and your loved one debate over who should get that permanent birth control procedure, include your OB/GYN in the conversation.

– Yvonne S. Thornton, M. D., M. P. H.

WHAT’S WRONG WITH THIS PICTURE?

Friday, May 11th, 2012

2012 -- The All-Male Leadership of ACOG

I just returned from the 60th Annual Clinical meeting of ACOG (Women’s Health Physicians).  I can’t explain it, but after being a member for over 30 years, it bothered me to no end to see ALL men on the dais as representatives of women’s health as if women couldn’t make policy about their own health.  When I was a resident, 95% of obstetricians were male.  Now, women comprise over 46% of practicing obstetricians and almost 80% of the OB/GYN resident physicians, YET all you see in the  governing body and officers (who set policy for the care of women) are 12 elderly Caucasian males.   Their very presence as leaders do not reflect the diversity of the ACOG membership today, yet there they are. No Blacks, No women, No minorities.  It’s as if ACOG were stuck in a time warp of 60 years ago!!  Since 1951, there have been only two female Presidents of the College and the last one was almost twenty years ago!  It seems so anachronistic and so wrong.

The male obstetricians have had the power to dictate and oversee women’s health for decades and it appears that they are NOT relinquishing it to any female any time soon; even if it pertains to women’s health!! It is a shame that in the 21st century, no one at ACOG (American College of Obstetricians and Gynecologists) is reaching out for inclusion of women and minorities in its upper echelons.  A picture is worth a thousand words.

– Yvonne S. Thornton, M. D., M. P. H.

Introduction of ACOG’s leadership

Are Cesareans the Lazy Way Out?

Thursday, May 10th, 2012

The process of giving birth has certainly evolved over the years.  Women can now opt for an assortment of painkillers, choose to do a home birth, and even substitute doctors for midwives.  The most recent trend though, seems to be cesarean deliveries.  Instead of enduring hours of labor, being coached by the doctor, and toughing out a natural, vaginal birth, babies are getting the quick way out.  Is this increase because of concerns for the mother’s or child’s health, or simply because obstetricians are looking for the lazy way out?

Right now, one out of every three births happens through cesareanIn 1965, only 4.5% of births were cesareans.  Why the big increase?  Unfortunately, it’s not a result of medical need.  Instead, 29% of Obstetricians polled in a survey said, “they were performing more Caesareans because they feared lawsuits.”  (Some other physicians, myself included, happen to be of the mindset that it is more about convenience, on both the parent and physician side, than anything else. It takes serious stamina to stand by and coach a woman through thirty hours of difficult labor. And I do it because I love my job. I am a warhorse, and I am there for my patients.) Because they’re concerned about being held responsible for potential harm to the baby from vaginal labor and deliveries, they would rather opt for cesarean deliveries.  While this kind of labor may be quicker, it is by no means safer.  A cesarean is an invasive surgery that is actually more likely than a vaginal birth to pose a risk for complications that might, “put the mother back in the hospital and the infant in an intensive-care unit.”  Some hospitals are not giving moms all the information.  Instead, they offer the cesarean as a casual choice in order to skip providing long-term labor support, to get through the labor as quickly as possible, and to avoid malpractice claims.  Cesareans are also much more expensive, consequently, making hospitals more money.  While there are women who do need cesareans for valid medical reasons such as breech for first-time Mom’s, high-order multiple births in one delivery, cephalopelvic disproportion (the baby’s too large for Mom’s pelvis) or eminent danger to the mother (such as hemorrhage) or fetus (sudden abnormal heart rate), these do not make up nearly enough of the more than 30% cesarean rate.  That means that the majority of cesareans are happening because obstetricians are choosing them, not mothers.  If Mother Nature wanted our babes to be born by Cesarean, she would have put a zipper on our abdomens.  The consequence of this increase in Cesarean births (some by maternal request) is the increase in maternal death and Cesarean hysterectomies in subsequent pregnancies due to hemorrhage caused by abnormal placental location and uterine rupture.

This is why it’s so important to become as informed as possible about child birth before making any decisions.  Make sure you have a caring, ethical obstetrician who is willing to give you all the information you need to make the safest choice for you and your child.  If they recommend a cesarean, ask them about their reasons and whether or not it is medically necessary.  Remember, it is your body, your baby, and your choice.

— Yvonne S. Thornton, M. D., M. P. H.

Early Menopause is Bad News for Women and Their Bones

Monday, May 7th, 2012

Let’s face it.  None of us looks forward to getting old, but we try to do it with as much grace as possible.  For some women though, menopause, a hormonal change that should come later in life, comes sooner than expected.  Instead of dealing with hot flashes, night sweats, mood swings and all the other symptoms of menopause in their 50s, they’re facing it in their 40s or even younger.  And as if early menopause isn’t bad enough, studies now show that it increases their risk for osteoporosis and even shortens their life expectancy.

Swedish researchers from Skane University Hospital in Malmo conducted a study of almost 400 women over the course of just under 30 years.  They found that of the women who started menopause before the age of 47, 56 percent developed osteoporosis compared to just 30 percent in the women who started menopause later in life.  Women suffering from osteoporosis are at greater risk for bone fractures, bone pain, and loss of height due to bone loss.  Their findings also showed that women who had undergone early menopause had a greater risk of fragility fracture and death with a rate 17 percent higher than the women with later menopause.  The rate of fractures in women with early menopause was 44% compared to 31% in those women who entered menopause later.

The cause of early menopause is not yet clear, though there seems to be a link between it and premature ovarian failure, hysterectomies, chemotherapy, and possibly even stress.  Premature ovarian failure has been associated with Fragile X syndrome, so there may be a genetic link. Unfortunately, preventing and reversing early menopause is not yet possible, but there are ways to decrease your risk of osteoporosis.  The bone masses of most women peaks in their 20s.  You can increase yours by getting plenty of calcium, vitamin D and exercise.  A balanced diet and thirty minutes of weight training or other moderate exercise every day can make big difference when it comes to your bone health.

The association found between early menopause, osteoporosis, and death is causing some to call for more studies to determine a more definite correlation. The higher mortality rate in women with early menopause does need further study in order to address the confounding variables, such lifestyle, medications and smoking.  In the meantime, we should take the results as a warning to take care of our bodies, particularly our bones, as early as possible.

— Yvonne S. Thornton, M. D., M. P. H.

Women Are Enduring More and So Are Their Hearts

Thursday, May 3rd, 2012

There was a time, when women stayed home to care for the children, did not vote, and did not make money of their own.  Luckily, we’ve since achieved a sense of equality as citizens.  Unfortunately, that equality has not come without a price.  As modern day women, we work just as hard as men, but on average, still earn less.  We parent just as much as men, and often as not, more because it is ingrained in us to try and be that Hallmark mom, but still must bear the burden of pregnancy.  We deal with the emotional, physical, and economic stresses just as much as men, but now, studies show that our hearts do not get as much help during these stressful times.

Researchers at Penn State conducted a study to find out how the heart and blood pressure of men and women differed when presented with mental stress.  All subjects were given the same problems and were monitored carefully to see how they dealt with the pressure.  The hearts of both men and women started working harder as the stress mounted, as was expected.  The amount of blood flow to the heart increased in men in order to make up for the extra work, but it did not increase in women.  This was a surprising discovery.  Professor Chester Ray, who led the study, believes this “shows women may be more susceptible to experiencing a cardiac event with mental stress compared to men.”  With heart attacks being much more common in women than in men, their results are helping doctors understand why.  Hopefully, these findings will encourage more women to seek a doctor’s advice when they feel stress that seems to be affecting their heart.

What does this boil down to? It boils down to the fact that women need to begin to realize that they need to demand the help that they deserve and need. We simply cannot be everything to everyone all of the time. We need to set priorities, and stick to them. My new memoir, “Something to Prove” chronicles my life as a woman who balances career, home and family; hopefully serving as a roadmap for other adventurous women.  Different times in our lives call for different priorities. Being a harried mother may be just as stressful as meeting an office deadline or being the sole caretaker of infirm parents or performing difficult surgery.  We are not superwomen, though if you look at what a majority of women accomplish on a day-to-day basis, we might as well be; even without the additional pressure that put on ourselves trying to “do it all”. All women who have children have one job, if she works outside the home, then she has two jobs, and if you are also cook, cleaner, and overall the “go-to” person, you might just have three jobs. And this is considered normal… It’s no wonder women are stressed.   

Although psychological studies have shown that women feel they are “expected to possess many diverse traits and behaviors, such as being both competitive and nurturing, compliant and assertive, and to appear in control without any signs of vulnerability,” they need to realize these expectations contradict themselves and are simply not realistic.  If your lifestyle has caused you to deal with inordinate amounts of stress, your mental, emotional, and physical health will suffer if you don’t make a change.  A study at the Chinese University of Hong Kong found that women who had more satisfying jobs and home lives were less likely to develop as much mental stress, even though they had the same amount of responsibilities as others.  I love ballroom dancing and I twirl around the dance floor each week with a cha-cha or tango in order to de-stress and have a creative outlet.  In other words, find something that you love doing and it won’t take quite as much of a toll on your health.  With this in mind, you can still be a modern day woman and take on numerous responsibilities, but you shouldn’t be afraid to ask for help when you need it.  As a physician, author, wife, and mother, I know that finding this balance can be difficult, but your heart is worth it.

— Yvonne S. Thornton, M. D., M. P. H.