MILL CREEK, WASH., Feb. 19, 2013 – If heavy periods are interfering with your daily activities, you’re not alone. It is estimated that one in five women deal with this problem every month. The good news is that there is a wide range of treatment options that can reduce or eliminate those symptoms and get women back to their regular activities.
Self breast exams: to do or not to do?
Remember when there were monthly emails you could sign up for to remind you and your friends to do your self breast exams at home? Remember seeing the news anchors talking about their monthly self breast exams in an attempt to remind you to do your breast “due diligence?” What happened to self breast exams and are they still important?
Initially, self breast exams were recommended as a screening tool to help early detection of breast cancer. Unfortunately long-term studies have not confirmed that they actually live up to their hype. Two large studies looking at over 200,000 women in both Russia and China didn’t show any difference in breast cancer mortality after 15 years between the women who were performing routine self exams and those who were not. In fact, the women that were practicing self exams found more lumps and underwent more biopsies for benign reasons. Reviews of several other studies failed to show a benefit of regular breast self-examinations including no benefit of early diagnosis, or reductions in deaths or stage at diagnosis. Hence in 2009, the US Preventative Services Task Force advised that clinicians no longer recommend routine self breast examination as a screening tool for breast cancer detection.
Even though you don’t need to be doing a monthly self exam, you should...
You may have many questions when you find out that you are pregnant, but some of the most common concerns revolve around nutrition and food safety. These are some basic guidelines from the American College of Obstetricians and Gynecologists to get you started. As always, your situation may be different and so always discuss specifics with your provider.
How much weight should I gain?
This depends on your pre-pregnancy BMI (body mass index - a calculation from your height and weight). In general, however, if your pre-pregnancy weight is normal you should gain between 25 to 35 pounds. Most women stay within this goal with an increase of only 300 extra calories a day (equal to about 2 tablespoons of peanut butter and one slice of whole wheat bread). If you are underweight, however, you may need to gain more weight, and if you are overweight, less. Your doctor can help you to come up with a specific weight goal.
What foods can't I eat?
Alcohol, of course, is not recommended in pregnancy, but there are other restrictions. Other foods can put you at risk for listeriosis, a bacterial infection that causes miscarriage and stillbirth. Unpasteurized milk and cheese can put you at risk, as can raw or undercooked shellfish, meat, or poultry. Deli meats and hotdogs are okay if they are heated until they are steaming hot.
What about fish?
That depends on the fish! Certain large fish may contain too much mercury to be safely eaten in pregnancy. High levels of mercury exposure in pregnancy may lead to nervous system damage in the unborn child. If you are pregnant you should avoid eating Shark, Tilefish, Swordfish, and King Mackerel and limit your intake of albacore tuna to 6 ounces a week.
You may eat fish and shellfish that are lower in mercury, but no more than 12 ounces a week. If you want to eat fish caught by family or friends from local waterways check for local advisories first, and do not eat more than 6 ounces.
Do I need to take extra vitamins or supplements?
It is important to take ...
Symptoms associated with menopause have been treated with estrogen and progesterone for many years. When I went into private practice in 1986, we had been taught that hormones given to postmenopausal women were protective. We prescribed them widely, like they were vitamins. If menses stopped, the next thing to do was to take hormone replacement therapy. We asked patients to let us know when their menses stopped so that we could administer hormone therapy promptly.
Today we have concerns about hormone therapy. The Women’s Health Initiative was a large study that collected data on the incidence of heart disease, stroke, cancer and bone fracture in women taking hormones as compared with women who did not take hormones in menopause. In 2002, a large portion of the study was discontinued because it appeared that women taking estrogen and progesterone were at increased risk for heart disease, stroke and breast cancer.
In 2002 many women went off of hormone therapy and many physicians stopped prescribing it. In the months that followed, many women found that they had symptoms of menopause that interfered with their lives. The consumer media began reporting on natural and bio-identical hormones. Claims surfaced of superior safety.
What are natural hormones?
Robotic surgery - the term implies some futuristic concept, a la the “Jetsons” or Isaac Asimov. As someone who was a science fiction fan growing up, I never thought I’d actually spend every day of my professional life answering this question.
As a gynecologic oncology surgeon, this is a question I now ask myself every time I pick up a patient’s chart. And the answer more times than not is YES! Why?