Women’s health issues

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Heart Attack Risk Peaks after Sex or Exercise – Especially if Activity Is Sporadic

Monday, September 9th, 2013

It’s common knowledge these days that regular exercise and an active sex life are heart-healthy. But have you ever wondered whether all that huffing and puffing was stressing your heart rather than strengthening it? That’s exactly what a recent study aimed to answer. Doctors have known for a long time that physical or psychological stress can trigger heart attacks, but how does this reconcile with the conventional wisdom that exercise is actually good for your heart?

Turns out, both assertions are correct. The risk of a heart attack does indeed rise immediately following strenuous exercise or sex, but only for an hour or so, and only if you do not engage in these activities on a regular basis.

Researchers found that any physical exertion, such as having sex, running, or climbing stairs, raised heart attack risk 3.5 times higher than during periods of rest. During sex, the risk is 2.7 times higher. The risk of dying from a heart attack is five times greater immediately following physical exertion than when you are resting.

However, you should not misinterpret these findings to mean that you should not exercise. The risk is still transient and very low, while the overall benefits of exercise remain compelling. The temporary risk of heart attack after exercise is limited to a one- to two-hour window, while the cumulative benefits of exercise can actually reduce your overall risk of having a heart-related episode. And, the more regularly you exercise (or have sex), the less elevated your risk is after each period of exertion.

It may seem strange to think that activities that pose short-term risks after each occurrence are actually healthy when cumulative effects are measured, but that is the case with exercise, sex, and heart disease. Keep in mind that regular exercisers experienced a smaller increase in risk after these behaviors. For every additional episode of physical activity a person implemented each week, heart attack risk dropped by 45%.

The bottom line is that if you are not a regular exerciser, you should be. Most of us experience occasional bouts of physical activity. You can attenuate your risk of heart attack following workouts by making sure they occur more often. Start your exercise routine gradually to avoid raising your heart attack risk as much as possible. Keep in mind that if you have been completely sedentary, even climbing a flight of stairs could qualify as enough physical activity to raise your heart attack risk.

For these reasons, starting an exercise program under a doctor’s supervision is vital. As you get into a routine of working out and your body becomes accustomed to the activity, your risk of having an exercise-induced heart attack drops more and more. Make the effort to get at least a moderate amount of exercise daily so that your heart is healthier and your sex life is safer – and better.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Women's health issues | No Responses »
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Natural (and Not-so Natural) Ways to Ease PMS Symptoms

Thursday, August 29th, 2013

Any woman who has ever had premenstrual syndrome knows that it is real. It may range from barely noticeable to debilitating, and it changes from woman to woman and from month to month in the same woman. But for women who have come to expect it and live with it for a week or so every month, it is a significant challenge. And it doesn’t help when many people seem to believe it’s “all in your head.”

In my book, Inside Information for Women, I explained that PMS is the body’s response to excess hormones after ovulation if the egg is not fertilized. Different women’s bodies respond to these hormones differently, so the symptoms of PMS can vary greatly, but they may include bloating, acne, breast tenderness, fatigue, and volatile emotions, among other things.  Less commonly, PMS symptoms may become so severe that they interfere with a woman’s daily life – for example, her job or relationships. Women with preexisting psychological disorders seem to be more susceptible to this severe form of PMS, known as premenstrual dysphoric disorder (PMDD).

Fortunately, there are things you can try to alleviate your symptoms. There is no one-size-fits-all PMS remedy, so there will probably be some trial and error involved. Different women respond to different approaches, so be patient and figure out what works for you. Some things that might help are:

  • Getting enough sleep – at least 7 ½ hours a night will eliminate the added stress of being tired and help your body and mind function at their most efficient
  • Meditation and/or relaxation – to promote feelings of relaxation and well-being and relieve stress
  • Altering your diet – try eliminating refined sugar, caffeine, or alcohol to see if it has a positive effect on your symptoms
  • Working regular exercise into your routine – it doesn’t take much to enhance your heart health and make you feel stronger and more energized

But what about when these measures aren’t enough? What if you are one of the unlucky women who responds to the monthly hormonal surge in a more severe way? Ask your doctor about trying an antidepressant.  Studies show some success with SSRIs (selective serotonin reuptake inhibitors), for PMDD, with continuous use having the best effect.

Basically, get to know your own body. If you are having trouble with PMS, start with the above suggestions. You can even try keeping a journal of what you tried and how you felt during a given month. Maybe you will notice a trend and find an effective plan for handling your individual PMS. If not, there are effective medicines available.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Menstruation, Women's health issues | No Responses »
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Two Most Common Vaginal Infections Can Masquerade as Each Other

Thursday, August 22nd, 2013

At one time or another most women experience some type of vaginal infection. The vast majority of these are easily treatable and no big deal – if they are diagnosed correctly. There is a lot of information on the Internet and today, more than ever, people are diagnosing and treating themselves without consulting a health professional.

The top two vaginal infections are an example of why this is almost never a good idea. Bacterial vaginosis (BV) and yeast infections plague most women sooner or later. It is not typically possible to pinpoint exactly what causes BV, but it is known that having multiple sex partners, smoking, and douching all increase a woman’s chances of developing it. Yeast infections are generally caused by either douching, using antibiotics, or having diabetes, and being pregnant also makes a woman more susceptible.

These two infections can mimic each other’s symptoms and can sometimes be indistinguishable from each other without the proper tests. But they require completely different treatments. BV is caused by an overgrowth of harmful bacteria in the vagina and requires treatment with an antibiotic. Yeast infections are caused by fungi, and require antifungal medications to treat them. Antibiotics will have no effect on a yeast infection (except, possibly, to cause it or make it worse) and vice versa. So while you use the wrong medication, you are enduring discomfort for a much longer time than necessary and taking risks with your health.

While these two infections each have their own trademark symptoms (BV is more likely to produce a fishy odor; a yeast infection is more likely to produce a “cottage cheese” discharge), the symptoms can differ from woman to woman and day to day. And both infections can cause intense itching, pain (during intercourse or otherwise), redness, and burning during urination. You can get an idea of what your infection may be by evaluating the symptoms, but only a laboratory examination of the discharge (under a microscope, known as a wet mount) can confirm it.  Often, it is reported as an ancillary finding on a Pap test.

And confirming is extremely important, because if you are treating the wrong infection, you are wasting your time and money and possibly harming your health. Most cases of bacterial vaginosis do not spontaneously resolve, and bacterial vaginosis has been associated with both preterm births and cervical cancer.   For more information on this topic, read my healthbook “Inside Information for Women”.

Finally, evaluation by a doctor is important because it could be neither of these common infections; it could be something more serious or something requiring a different treatment, like an STI (sexually transmitted infection). So check with your doctor any time you have unusual vaginal symptoms to be sure you are properly diagnosed and using an effective treatment.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Women's health issues | No Responses »
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Teachers Required to Give Students False Information

Monday, August 12th, 2013

In a prime example of why parents must stay informed about their children’s school curriculum, North Carolina governor Pat McCrory signed a bill in July requiring that middle school students must be taught that abortion is a preventable cause of preterm births. Incidentally, this comes after McCrory’s promise not to sign any bills regarding abortion, period. But McCrory did not act alone; 73 state senators agreed that it was okay to give students erroneous information in the classroom.

I realize that this is a hot button issue for many, but let’s focus on the real issue here: middle school teachers required by law to lie to students. Is lie too strong a word? Absolutely not, and here’s why: There is no scientific evidence that abortions cause preterm labor. Let me say that again. There is no scientific evidence to support the idea that abortion causes preterm labor. This seems to be just another thinly disguised attempt to limit women’s ability to make choices for their own lives.

Proponents of the bill point to recent studies that show a limited risk of preterm births following abortions, but these studies and the recommendations made based on them are flawed. For one, they did not distinguish between successful medical abortions and those requiring surgery. In addition, they did not distinguish between induced and spontaneous abortions. Furthermore, legislators ignore the fact that the studies showed no increase at all in preterm births after abortions from 2000 onward, a fact probably contributable to modernized abortion methods.

In fact, David Grimes, a North Carolina professor of obstetrics and gynecology, called the bill “state sponsored ideology,” and pointed out that “the World Health Organization, the CDC, the American College of Obstetrics and Gynecologists, the American Academy of Pediatrics… and the American Public Health Association have all concluded that abortion does not cause prematurity.”

So why would these legislators support this bill? Do they have their own agendas, or do they just not understand the facts? Who knows – just do your part by staying informed, thinking for yourself, and getting your facts from the experts, not the politicians. Have a conversation with your middle school kids about this and other sex education topics. Don’t leave it to the schools.

To close, let me be crystal clear on this. This issue has nothing to do with how anyone may feel about abortion. It has only to do with the integrity of our schools’ curriculum being compromised by untruth. Be the voice of accuracy at home. Teach your kids how to find reliable information. You are free to teach your children about your moral beliefs. But at least tell the truth about the facts so that they are free to develop their own morals and form their own conclusions based in reality, not folklore.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Contraception (birth control), Women's health issues | 1 Response »
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Your Shoes Could Be Hurting Your Health

Thursday, August 8th, 2013

It’s no secret by now that high heels are harmful to your health. You are probably aware that wearing high heels can increase your risk of falling or developing foot, leg, or back problems due to the pressure exerted on various parts of the foot and the misalignment of your ankles, hips, and spine. You probably already know that you should limit high heels to no more than two inches and avoid tight, pointy-toed shoes.

But did you know that your beloved flip-flops are just as bad?

Flip-flops literally expose your feet to a whole host of potential problems. From relatively benign issues like cold feet or stubbed toes to more serious injuries like cuts or broken bones, there are many problems which are completely avoidable by wearing protective and supportive shoes.

As if the potential for injury weren’t enough, researchers now suspect that flip-flops may prevent you from being as fit as you could be. When you wear flip-flops, you are forced to bunch your toes up to hold them on your feet. This prevents your arch from flexing naturally, which alters the way you walk. Think of this as a ripple effect, where you grip your shoes with your toes, which prevents you from flexing your arch, which prevents you from “pushing off” from each step strongly enough, which forces you to compensate with your hips, which puts more stress on your knees. The result is an unnatural gait that does not fully engage all the muscles in your legs and backside that walking should engage.

So think twice before wearing those flip-flops out to run errands or to the office (if you are lucky enough to work in that kind of office!). Flip-flops are great for occasional wear – to the pool or the beach – but not for hours on end, day after day. Your day-to-day shoes should be supportive and ergonomically correct. If you want to wear an open shoe like a sandal, at least make sure it has a strap that wraps around your ankle so that you aren’t tensing those toes up to hold the shoe on.

You should be aware that, with their lack of arch support, ballet flats do not fare much better under scrutiny than flip-flops. Incidentally, research shows no additional benefit from wearing “toning” sneakers; regular walking or running shoes will do just fine for exercise, and any comfortable, well-fitting shoes with good arch support are fine for daily wear.

– Yvonne S. Thornton, M. D., M. P. H.

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Researchers Suggesting There is No “One-Size-Fits-All” Approach to Breast Screenings

Monday, July 29th, 2013

Mammograms are universally accepted as the most effective way of screening for breast cancer; however, is this really true? Many women may be surprised to learn that there is more than one method for detecting potentially life-threatening masses in the breasts, and these varying procedures are being used in an increasing number of women in the population.  This is not to say that mammograms are not important or valuable as a detection tool in screening for breast cancers – however, in many cases it may not be effective when used alone, and as new screening technologies are developed and become more widespread an increasing number of women will need to work with their doctors to develop a more personalized approach to breast screenings.

According to a new report in the June issue of the American Journal of Medicine, for many years, mammography has been the sole imaging test recommended for breast cancer screening, and remains the only test proven to reduce breast cancer-related mortality. However, the widespread application of mammography in population-based screening remains controversial, owing to decreased sensitivity in women with dense breast tissue, radiation concerns, and a high rate of false-positive studies, leading to excessive breast biopsies.  Those who image the breasts are adapting to these challenges with the development of new technologies. Low-dose mammography can reduce radiation risk to the breast. Contrast-enhanced mammography can evaluate blood flow in the breast, similar to MRI. Tomosynthesis produces multiple mammographic slices through the breast, similar to computerized tomography (CT scan), and has significant potential to lower recall rates and increase specificity.

The article goes on to say that both whole-breast ultrasound and MRI have been shown to detect additional cancers in certain high-risk populations and will likely be increasingly used in screening women with dense breasts. MRI studies are very expensive and have a high false positive rate, i.e., they have difficulty in identifying a negative on the image as a true negative (without disease) in the patient.  However, a decrease in mortality has not been proven using these modalities.  Molecular imaging in the form of BSGI and PEM of the breast is widely available. Positron emission mammography (PEM) and breast-specific gamma imaging (BSGI) use molecular imaging to increase specificity in cancer detection by demonstrating increased metabolic activity.  However,  due to relatively large whole-body radiation doses (equivalent to 20-30 mammograms), they are not currently suitable for annual screening.

The reason that the same method will not work with every woman is because every woman’s body is different. Variations in the structure of a woman’s breast, the density of her breast tissue, or even the existence of implants may affect the ability of the standard mammogram to fully detect any underlying lumps or irregularities in her breast tissue. Simply put, every woman’s breasts are different, and so too must the screening for every woman be different.

While these advances are encouraging, it is improbable that any of the new technologies will replace mammography for population-based screening programs, because all have significant limitations.  Furthermore, given the heterogeneity of the human population, a “perfect” imaging technology for breast cancer screening will likely never be found.  However, women who feel as if they have different needs should consult with their doctor and ask whether or not there may be special considerations they should make as a part of screening for cancers. However, ultimately the main thing that older women should do is to continue receiving their mammograms regularly as well as younger women (less than 35 years of age) conducting breast self-examinations on a regular basis within the comfort of their own home. In coming years it is likely that the plan of action for women will begin to change depending on individual women’s needs, but the existence of different technologies is still no substitute for the screening methods that are commonly accepted and readily available.

– Yvonne S. Thornton, M. D., M. P. H.

Posted in General health news, Women's health issues | No Responses »
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Talking About Depression With Your Ob-Gyn

Thursday, July 25th, 2013

Depression is one of the most serious and prevalent disorders affecting women in the present day. It is also one of the most underreported disorders affecting women, and the number of those affected by it is increasing every year. Depression affects women of all age ranges and social statuses, and it affects those in poor health as well as those who are seemingly in perfect condition. With depression being so common, and affecting so many, it would seem that Ob-Gyn’s regularly diagnosis this problem in women. However, studies are suggesting that doctors miss a diagnosis of depression in as much as sixty percent of their patients.

Whether the women had a preexisting diagnosis of depression, reported suffering from psychological distress, or simply felt as if they might be depressed, their depression consistently went undiagnosed throughout visits with their Ob-Gyn. The most common signs recognized by doctors included physical manifestations of the disorder, such as weight gains and losses as well as reported insomnia.

Those that did receive a diagnosis were primarily women who were under twelve months postpartum, those under thirty-five years of age, and women who were seeing their Ob-Gyn either to discuss their depression symptoms or as part of a regular checkup. The most common visits in which the depression went unnoticed were visits in which the woman had scheduled an appointment to discuss an existing complaint.

This raises the all-important question—why do so many doctors miss depression diagnoses? There are likely a number of factors, ranging from the feeling of suffers that they are not in need of help to a reluctance to discuss any issues that are not “medical” with a medical practitioner. However, it is important for women to realize that depression is a medical issue, and it is one that can severely impact them throughout their lives—and it can even impact their health directly. Recognize that your mental state is just as important to report as your physical state and, most importantly, persistent feelings of sadness, loneliness, and lack of interest in one’s life are not feelings that must simply be “dealt with”.  Your doctor can help.

– Yvonne S. Thornton, M. D., M. P. H.

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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.

 

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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 »
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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 »
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