When estrogen is in the body, one of the effects of estrogen is to ...
A recent study addressed the outcomes of pregnancy in women with MS who were taking fingolimod (Gilenya). Of 66 pregnancies on the medication, 41 attempted to carry the pregnancy to term. 26 of the 41 had healthy newborns. There were, 9 miscarriages, 24 elective abortion, 4 ongoing pregnancies and 1 with an unknown outcome. Of the elective abortions, four were for fetal malformations. There were 5 cases with abnormal fetal development in the 66 pregnancies. Poor fetal outcomes were found in 14.6% of the pregnancies. This contrasts with a 3% rate of poor outcomes for most pregnancies.
This paper highlights the importance of care in planning pregnancies in MS. It is now known that women with MS have ...
Swedish Cancer Institute has changed the way early stage breast cancer patients are cared for by adopting new surgical margin guidelines. These guidelines will reduce the need for taking women back to the operating room if cancer cells are found at or near the specimen edge, also known as the margin. Following extensive review of the data, this new guideline was established by breast experts from the Society of Surgical Oncology and the American Society of Radiation Oncology and has been endorsed by the American Society of Breast Surgeons and the American Society of Clinical Oncology.
Many women with early stage invasive breast cancer opt for breast conserving surgery, known as lumpectomy or partial mastectomy. For 20-25% of these patients, a second surgery or re-excision was performed because the margin was not considered adequate based on previous practice guidelines. The latest peer reviewed evidence shows disease control is excellent when surgery is combined with whole breast radiation with or without hormonal therapy and/or chemotherapy, regardless of the margin width.
The Swedish Cancer Institute’s multidisciplinary breast cancer team reviewed and approved these guidelines for our program. We believe by reducing the need ...
Labor pain is due to contractions of the muscles of the uterus and by pressure on the cervix. This can feel like strong cramping in the abdomen, groin, and back. Some women experience pain in their sides or thighs as well. Women can also feel pressure on the bladder and bowels by the baby's head and the stretching of the birth canal and vagina. Some find the hardest part is not the contraction itself, but the fact that the contractions keep coming.
One of the best ways to alleviate fears for women is to learn about the available strategies for coping with pain. There are both medical and non-medical tools that may be a good match for you.
While you are deciding, think about what appeals to you most. Ask your health care provider these questions:
Emergency birth control has been available for many years, starting with medicine approaches that were not approved by the Food and Drug Administration. In 1999, Plan B, levonorgestrel pills taken by mouth, was approved for use by prescription and in 2006 was approved without prescription for women 18 years old and over. It was approved for those 17 and older in 2009 without prescription. In late February, 2014, FDA approved over the counter sales of generic emergency contraceptives without proof of age.
In order to get the most out of your appointment here are some simple tips:
1. Come prepared!
- Bring a list of your medications; this can help us be sure that anything we prescribe will be safe for you. Your problem may also be related to your medication – for example, blood thinners can cause heavy periods.
- Know your family history. Things that are important for OB/GYNs to know include family member with blood clots, recurrent (more than 3) miscarriages, family members with cancer of the breast, ovary, uterus or colon (bowel.) It is also helpful to know the age they were diagnosed.
- Bring a list of questions! The more you ask, the more you’ll know. We want our patients to be well informed so that we can help you make the right treatment plan for you. Also, there may not be time to go over everything in one appointment so make sure you start with what is important to you.
- Trust me, we have seen and heard everything and there is very little than can shock us! It is important that you are open and honest so that we can make sure we understand exactly what is going on to come up with the right diagnosis.
- It is likely that ...
A Canadian medical research study has recently been published questioning the value of doing screening mammograms on women in their forties. The article has spurred controversy because the results contradict multiple other similar research studies which showed that women in that age group who get regular mammograms actually are spared death from breast cancer more often that women who are not invited to screening.
Some problems with the methods of Canadian study, published in the journal BMJ, were pointed out by a scientist at the University of Washington, Judith Malmgren, who has worked with Swedish Medical Center doctors to see how women in their forties have fared in our system. Click here to read Dr. Malmgren’s letter to the editor of BMJ.
There are two ironic features to the Canadian study. First, the authors say it is okay for women to not get screening starting in their forties “when adjuvant therapy for breast cancer is readily available.” This means that it is okay to diagnose breast cancer later because you can mop up bigger and more advanced cancers with treatment like chemotherapy, radiation and bigger surgery. But at Swedish, we do not think that many women prefer more severe therapy rather than earlier detection.