passing the drinks affects everyone's (breasts) differently

In the news is a lot of advice about what to do, and a bit about what not to do. Often the recommendations seem contrary. On one hand someone who smokes may have lower estrogen level, so thought to decrease breast cancer risk, but on the other hand, all the other bad effects of smoke seem to outweigh that supposed benefit and cause the smoker to have a greater breast cancer risk. Same too with alcohol. Recent studies indicated the more one drinks the more likely you will have a breast cancer recurrence,, but what if you are in a cardiac risk group, alcohol may decrease risk and provide what gynos call "cardioprotection." I'd say take up youga and lap swimming, you'll be better off. . And perhaps it's not just what you do that causes breast cancer, but causes your doc to not detect the breast cancer. For instance low dose hormone replacement therapy can still cause increased breast density, for up to 5 years after you stop, that can obscure a developing breast cancer. Best advice is individual advice, and when patients and their gynos want to talk, be sure to schedule the right sort of appointment, one with enough time to talk as we know that hormones, alcohol and even exercise affects everyone differently!

Take Birth Control Pills and Quit Peeing in your Pants?

Hormones control our bladders as well as our hearts and minds. And it's not just your hormones, it can be the hormones you ingest. Women who have bladder dysfunction can be any age, any weight, any genetic background, although there are multiple factors that contribute. And it's now been found that there's another non-contraceptive benefit to The Pill: Women of child-bearing age who use oral contraceptives face a lower risk of lower urinary tract dysfunction than women of similar ages who do not, say researchers from Sweden.
"Hormone intake in the form of oral contraceptives has the potential to positively influence bladder and urethral function," Dr. Daniel Altman from Karolinska Institutet Stockholm, Stockholm, Sweden told Reuters Health. This group has pretty much done what most gynos would call preliminary work. Rounding up twins, and studying them via the web they came to these conculsions. They were looing for various bladder disorders including stress incontinence...or leaking with coughing and sneezing...and urgency incontinence (or mixed incontinence, if they had both), overactive bladder...as in running to the bathroom all the time, or nocturia...getting up all night to pee. It was reported in the August issue of Fertility and Sterility, the investigators report that 8689 twins answered the call of the bladder, and their conclusions were that current use of oral contraceptives was associated with a 43% lower risk of stress urinary incontinence, a 48% lower risk of mixed urinary incontinence, and a 64% lower risk of urgency urinary incontinence. Not only that, but the twins were remarkably similar in their answers, reinforcing our belief that bladder behavior is in the genes!
When it comes to older women,  the investigators point out that there is only conflicting evidence on the effects of hormone intake on lower urinary tract symptoms in women who are past menopause. Some consensus reports have supported this approach, but findings from the Women's Health Initiative, for example, do not support the use of either hormone replacement therapy or oral contraceptives for treating urinary incontinence in older women. It is important to note, that is was a population based study. Sonot really a study specifically of women with overt disease. And it's not really known if women with an actual medical problem that needs treatment could for instance avoid treatment with other medications if she just got on The Pill and stayed on the pill. But it's a provative idea, and one that could be tried if you want suggestions of something you can try before you get on longer term medication.
Fertil Steril. 2009;92:428-433. Abstract

Pop Chug It or Chuck It?

Pop. Is it your favorite drink? What Would Your Doc Say? Should we take pop out of the schools? Refuse to advertise it? Refuse to sell it in stores? OK — both of those might go a bit far.
But physicians are perhaps wavering on their medical stance as to whether pop is harmful or not, and we now go so far to say that it might actually be good for you! Pop can be found in many a local school and other easily accessible vending machines in the wider CU area, so it’s time you and your health care provider have a heart to heart talk on this.
Sales of pop appear to not be flagging.  Aside from the perceived health hazards physicians propose when chatting with primary care physicians at Provena Covenant Medical Center in the doctor’s lounge over our morning coffee, perhaps a second look is warranted. Some people apparently get a fair amount of actual water from some pop consumption, others get caffeine benefits, others may actually be avoiding kidney stones, and others are able to cut calories through the consumption of a very low calorie beverage they actually enjoy. So could this add up to being a good thing, as opposed to the negative effects of the caffeine, the phosphorous, the salt, and the calories of sugared beverages?
The Argument that Pop is GOOD for you
Prevents kidney stones. According to The Journal of Urology online on April 19, 2010, Dr. Brian Eisner of the University of California San Francisco presented at the April meeting of the Urological Association and revealed the relatively shocking information that kidney stone (nephrolithiasis) patients might get some help in avoiding stone formation by drinking diet soda.
The proposed mechanism: In the study, researchers investigated the possible link between decreasing kidney stone formation and some pop. The diet versions of several popular citrus-flavored sodas — like 7Up, Sunkist and Sprite — contained a compound called citrate. Citrate, in turn, is known to inhibit the formation of calcium oxalate stones, the most common form of kidney stone.
Just to put this in a bit of medical perspective, there are multiple accepted theories regarding calcium stone formation. In many cases, stone formation occurs when normally dissolved substances, like calcium oxalate, become so overloaded in the urine they can no longer be dissolved in the urine and crystal formation (e.g., calcium oxalate crystal) occurs, and if lodged in the kidney, by some process of being stuck there, they grow large, and can no longer be passed through your urinary tract, but become stuck as a rock. Other factors are important: not enough urine, so normal levels of calcium and oxalate that should be dissolved instead precipitate out and lead to a cluster of crystals called a “stone.“ Too much calcium, too much oxalate, a high protein diet, low citrate, too much sugar, too much sodium, too little potassium high acidity in the urine from substances like Vitamin C, and medical conditions such as diabetes and obesity all affect whether you are going to have a stone. A common treatment for kidney stones is potassium citrate supplements; some of us just call these supplements lemonade (but watch the sugar!).
The pops mentioned above have phosphorus and citrate. Diet sodas contain small amounts of alkalis, and lowering the pH of the urine should help too. For more information on foods known to promote bladder health go to http://www.ic-network.com.
Caffeine. Our socially-acceptable stimulant, and while we sophisticatedly sip our caffeine in coffees and teas, kids get it in pop.
Caffeine is actually a xanthine alkaloid that gets metabolized in our liver to three main components known as dimethylxanthines: mainily paraxanthin, and theobromine and lastly theophylline. Each of these is further metabolized and secreted into the urine. So each caffeine containing product we consume has a variety of the chemical components that we think of collectively as caffeine. Thus the buzz has big variety to it, and therein, a lot of the appeal.
And the buzz keeps coming. Caffeine can persist in your system for at least 12 hours. And not just if you intended to drink a caffeinated beverage, most of us fail to realize how much caffeine we get from hidden sources. Some of the decaffeinated products have enough residual caffeine to keep a pretty hefty dose left in the drink, the sort of five to one ratio. And just to keep the dieters happy, diet pop has about the same amount of caffeine as sugary pop. So maybe you weren’t just happy because you dieted well, you were smiling the cup-o-jo smile.
There are now hundreds of brands of caffeinated beverages, most of them pops. According to Dr. Kennedy-Hagan, RD, LDN from Eastern Illinois University not all pops are high in caffeine. In fact “A 12oz can of 7Up, Sprite, Mug Root Beer or Fanta soda, either sweetened or diet, contains no caffeine. Other popular sodas, such as various varieties of Coca-Cola, Pepsi and Mountain Dew range from 35-54 mg caffeine per 12 oz serving. Consuming one can per day is minimal, but the caffeine in a 6-pack would add up if consumed throughout the day.“ Which may be a good thing as medical studies show that pop in the range of 100-150 mg consumption will show improved attention, mood, psychomotor performance, and working memory. Although these studies have been done in adults, and they never really study withdrawal symptoms on top of the symptoms of the initial focus!
Coffee can ward off diabetes, but apparently you have to drink 6 or more cups a day, so you do have to be committed. But, it may not be the caffeine itself in this case that is the important ingredient, The women in one retrospective study of almost 30,000 people showed that decaffeinated drinkers were even less likely to get diabetes. Or perhaps it’s some of the other beneficial properties of drinks like coffee and tea which contain a significant number of anti-oxidants such as polyphenols (caffeic acid and chlorogenic acid), catechins, and flavonoids. The polyphenols are known to raise homocysteine, and these anti-oxidants freely drip through your fancy filters, so fuss away with preparation, you won’t be ruining your coffee’s benefits. And a new rat study showed that the liver is detoxified by glutathione S-transferase which is an enzyme found in coffee. So all that avoidance of coffee during your ‘cleanses’, and now you find out it was good for your liver all along!
And the most perplexing new data to me, as a physician, is the new study showing the cancer fighting ability of coffee’s antioxidant components which apparently can increase DNA repair and promote more tumor suppressor proteins! Pop, as opposed to coffee and tea, doesn’t have any of these.
And don’t panic if you do use caffeine for fighting fatigue and find you have now been instructed to stay off: iron, B vitamins, decreased smoking, increased exercise, and increased sex all fight fatigue. So dilute your pop with some vitamin water and you may be on your way to a caffeine free energized life.
The Argument that Pop is BAD for you
The Bad effects of caffeine, are not as numerous as the good effects, non-regular drinkers of coffee can have a brief increased blood pressure after coffee consumption. But this may be due to other compounds in coffee that activate the sympathetic system and thus is not likely to happen when you swig a pop with caffeine. And if you are struggling with your blood cholesterol know that the diterpenoids in unfiltered coffee can raise plasma bad (LDL) cholesterol and lower god (HDL) cholesterol.
Read the labels and try to figure out which artificial sweeteners you are getting exposed to in your favorite pop. Aspartamine (NutraSweet®), a dipeptide, is a low calorie artificial sweetener that is 180 times sweeter than sucrose… and now seems to be in just too many foods to be healthy for us, if you use the “a good diet is a varied diet” mantra. Newly in some drinks is Sucralose, known commercially as Splenda, and it tastes less artificial but not less of a synthetic lab generated sweetener.
Waistline effects: In the e-Alert “Junk in the Trunk” (8/7/07), I told you about a study that followed health records for more than 6,000 soda drinkers for four years. Subjects who drank one or more sodas each day were nearly 45 percent more likely to develop obesity, increased waist circumference, impaired fasting glucose, higher blood pressure, high triglycerides, and higher LDL cholesterol. The really surprising result from that study was that it showed over-drinkers of pop had identical weight gain whether they consumed sugar laden or diet soda. And that weight gain is not only bad for your look; it potentially harms mood, memory, and the effectiveness of contraception pills.
Phosphorous So What’s your verdict? Restrict pop? Start drinking more? Switch to tea or coffee? So many good choices! And what about pop access for the kiddies? At the local high schools: Centennial High School, Central High School, Mahomet, St. Thomas Moore, and Judah Christian High school only have said they have machines with only water and juice in them, no pop at all. However, with the right change you can guzzle pop during lunch at Urbana or St. Joseph High Schools (unless you push the juice or water buttons!).
Like all things at the end of the day, it’s all relative. Goldilocks had it right, too much or too little, never probably a good solution. Kennedy-Hagan says that “Moderation and balance are important to good health and longevity. It is up to you to pay attention to your body and the choices that you make so that you can enjoy life.“ If you want to analyze your pop consumption in light of your whole diet the researchers at the U of I have a good tool for you to use. You can access the Nutrition Analysis Tool at the University of Illinois.

Originally on Smile Politely

STI screening

What do you think of when you think about a potential partner?
“N-i-c-e! Who’s that one with?“ and, after conversation, “C-l-e-v-e-r!  I can’t wait to spend some alone time with him.“
Maybe you are looking for someone to show you around the secrets of the Morrow Plots, tell you the relative microprocessing speed of Deep Blue, and explain why Arimaa is still epic. However, as a gyno, I’m mainly concerned about sexual health, as well as intellectual health.
And frankly, without both, nope, there’s no staying together.
So, before you get that alone time with your partner and get out a large magnifying glass to examine your relationship and where it is going, there should be a frank discussion about sexual histories and sexual health. Although you want to trust the person that you are spending time with, you need to consider the fact that many people aren’t completely open and honest about their sex lives.
Relationships shouldn’t be a prix fixe menu; we should have choices, and realistically know about what we are being exposed to potentially. When it comes to STDs, you or your partner may both appear to be symptom free and believe yourselves to be so.
So, here are some heartwarming statistics straight from the CDC: only 1 out of 10 individuals infected with Herpes has been formally diagnosed and know they are infected, and only 25% of all Chlamydia carriers have any symptoms at all. Unless you both get tested, you may never know if one of you has an STD.
The rate of STDs is climbing; in the U.S. alone, there are 40 million Human Papilloma Virus (HPV) infections and over 1 million Chlamydia Trachomatis infections. Did you know that, in 2008 (most recent year for available state statistics), the State of Illinois ranked 8th in the United States for the rate of Gonorrhea infections? According to the CDC, our state reported 20,674 Gonorrhea cases resulting in a rate of 160.9 per 100,000, well above the national average rate of 111.6. Illinois also ranked 9th out of all states for rate of infection for Chlamydia, beating out California, which has almost 3 times the population! Sun Tzu, a famous warrior, taught me this gyno perspective: “Know thy enemy.“
Here are the 2008 statistics for Champaign County and nearby/comparable counties as reported by the Illinois Department of Public Health:
Rate per 100,000
County           Population           STD Type                   Cases Reported           Population
Champaign 195,671 Chlamydia 1259 700.7

• Gonorrhea 317 176.4
• Primary & Secondary Syphilis 5 2.8
• HIV                             21

McLean 167,699 Chlamydia 665 442.1

• Gonorrhea 212 140.9
• Primary & Secondary Syphilis 1 0.7
• HIV                             7

Macon 108,204 Chlamydia 708 617.2

• Gonorrhea 318 277.2
• Primary & Secondary Syphilis 2 1.7
• HIV                             4

Vermillion 80,067 Chlamydia 496 591.0

• Gonorrhea 218 259.8
• Primary & Secondary Syphilis 0 0
• HIV                             8

These figures show us that sexual contact is potentially risky, that sex can be safer, and that it is extremely important for everyone to take control of his or her sexual health. Here are some disturbing results from a new study by Dr. Heather Royer of the University of Wisconsin, Madison: 41% of women aged 18–24 assumed that STD testing includes screening for all STDs; 81% of participants would rather not go to their family doctor for STD testing, and many of these women assumed that they were being tested for STDs when their health care provider performed a Pap smear.
Here’s the issue, if you thought you were given a clean bill of health just because you were told you ‘passed your pap test’, but in fact were never tested, you could unwittingly be part of this undying epidemic.
The best advice for couples: test before any sexual contact or as soon as possible after you start to have sex. Exactly when to test is a discussion you may want to tackle with your own health care provider. Repeat testing at a later time is advised as well because you won’t necessarily test positive the morning after; that is a project for a couple of weeks later. For HIV, you might need a test a few weeks later just to be sure.
According to the CDC, sexually active women, age 25 or older, should be tested for Chlamydia every year, and sexually active men and women who are not in a long-term, mutually monogamous relationship should get annual HIV testing, a Hepatitis B vaccination, and Chlamydia testing as recommended by their healthcare provider. All men who have sex with men should get vaccinations for Hepatitis A & B along with annual tests for HIV, Syphilis, Chlamydia, and Gonorrhea. While female to female transmission is less likely, female bisexuality is common, and therefore infections introduced into the relationship are so common to make the recommendations applicable to this population as well. The American College of Obstetricians and Gynecologists recommends getting an HIV test every time you have a new partner. Of course, talk candidly to your doctor about your sexual history, signs, and symptoms, so you can both decide on the best course of action for you. Remember, always be specific in all your requests to your doctor and ask tons of questions to be sure you are getting the proper care and treatment.
You have several alternatives for STD testing sites in Champaign County:

1. Champaign Urbana Public Health District, Champaign Office / http://www.c-uphd.org/std-clinic.html / 201 W. Kenyon Rd., Champaign         Hours: Monday 4:00 - 5:30 p.m. (Men’s clinic) / (217) 239-7827         Tuesday 1:00 - 5:00 p.m. / Thursdays 9:00 am - 11 a.m. and 1:00 - 3:00 p.m.  Cost: Determined at visit, but no one will be refused services because of inability to pay. Additional services may incur additional costs. Blood test for genital herpes (for people with no symptoms) = $7
2. Frances Nelson Health Center / 1306 Carver Drive, Champaign         Hours:  Mon, Wed, Fri 9:00am-5:00pm / (217) 356-1558                             Tuesday and Thursday 1:00pm-8:30pm / Cost: Determined at visit and based on income/insurance/Medicaid.
3. Women’s Health Practice / 2125 S. Neil Street, Champaign         Hours: Monday-Friday 8:00am-5:00pm / (217) 356-3736 / Cost: Most major health insurance accepted.  See if they are running a clinical trial; you may qualify for free testing. (Full disclosure: Dr. Trupin runs Women’s Health Practice)
4. Planned Parenthood / 302 E. Stoughton Street, Champaign / Call 217-359-8022 or visit www.ppil.org to schedule an appointment (Ed. note: We apologize for the oversight, per Beth’s comment below.)
5. Schedule an appointment with your OB/GYN or your general practice doctor. Specifically ask for testing and specify what tests are needed / Cost: Dependent upon your physician and health insurance accepted.
6. Anonymous STD Testing Centers Do a search on the internet for these centers / Cost: Dependent on the company / For more information and specific disease state questions: American Social Health Association / http://www.ashastd.org/

Whether you are in a new or established relationship, everyone knows that communication, honesty, and trust are as key to keeping a relationship going as that perfect chili recipe, a re-enactment of Kasparov’s last win against Deep Blue, or love of the Illini. There is no better way to show your commitment than for you and your partner to talk about sex, talk about your future sex, and be screened! For then you will truly complete the teaching of Sun Tzu, who said “know thy enemy,“ for the wisdom is not complete until you, “know thyself.“
So, instead of lunch and a movie, make it lunch and a screening…for STDs!

L

First posted in Culture section of Smile Politely, 5/26/2010 

A pulse a day keeps the doctor away

Tofu is made from soy much like we make cheese from milk. Tofu is essentially the coagulation of soy milk. Since it takes some treatment to get the right consistency it actually often contines fairly high levels of calcium and magnesium to it’s already high content of protein and significant amounts of iron. I used to profess that a pulse a day would keep the doctor away. However, what it isn’t is a pulse, as this term is reserved for beans used in their dried form, although soybeans are legumes, they are primarily harvested for oil, so the pulse term isn’t really correct.

Is the baby bed ready?

Trying to figure out if the uterus is ready for implantation of the embryo should it manage all those negotiations and show up to implant has been tricky business. Pelvic examinations, pap smears and just the normal cycles of a woman can show that a lot is working well. But ultrasound, saline infusion sonography, and x-ray aided dye studies also help. An even better look at the uterus can be performed with hysteroscopy to actually look inside the uterus. Polyps and small fibroids are definitely an impediment to an approaching embryo looking for a docking spot. An infertility treatment cycle depending on exactly how it is planned can be arduous. So the bed better be made if company is coming. And if things aren’t what they should be, and you’ve gone through all the tests above, you can use ovarian clues to whether enough hormone is around to get that lining nice and lush.. We can look at the estrogen levels, both early and later in the cycle. If they rise quickly to over 150 pmol/l on day three there is a good chance of pregnancy.

DMPA and Weight Gain?

Plenty of time in the lengthy list of explanations, pricing, alternatives, fall back instructions, finally is the possible side effect of WEIGHT GAIN mentioned when discussing most hormonal contraception. But does it come with a set of barbells to tell you to get busy? No. But it could, or should, or at least a diet plan to follow. A group of researchers at the Carolinas Medical Center in Charlotte NC have discovered that even thirty minutes of education by a dietician right before that first Depo-Provera shot actually led to a bit less weight gain than no counseling at all. But the disturbing news: yes, both groups did gain some weight. Now I want to know what sort of weight? Fat? Waist weight? Weight of going off to college?

On DMPA, be Sure to Drink Your Milk!

Milk isn't the only way to get calcium into your bones, but if you are on DMPA you may want to look at the calcium and vitamin D and exercise plan you have for bone health. Although we've had many studies over the years showing that long term vitamin D use lowers bone thickness, there wasn't much data linking that to greater fracture risks, although the FDA did put a Black Box warning out about the risk of long use of DMPA and possible bone health. We know breast feeding our babies lowers bone thickness to about the same degree, but we don't want to stop breast feeding the babies! And both DMPA and breast feeders, when they stop did re-gain lost bone, although after two years off of DMPA most users for over 5 years had not quite gotten back to their baseline bone status. A study by Cromer and her colleagues in Cleveland, Ohio, reported in 2005, did show in teens however, usually gain that lost bone by 12 months.  It is now been shown, through a retrospective study, by  Dr. Christoph R. Meier of University Hospital Basel in Switzerland and his colleagues and then August 4th in the Journal of Clinical Endocrinology and Metabolism online, that there was an increased fracture risk in women using DMPA. The degree of fracture was very significant, and there haven’t been many studies to compare this one too. The researchers showed that looking at this group of 17,000+ UK  women with fractures and over 70,000 that had not had fractures and found that 1,300, or about 8%, sustained fractures during 26 years of follow-up. Based on this figure, and the new findings, a woman using Depo Provera for at least 30 months would have a 12% likelihood of breaking a bone over the next couple of decades. Reminding people that in 2004, the U.S. Food and Drug Administration and Pfizer, the company that makes Depo Provera, added this black box warning to the drug's labeling stating that use of the contraceptive can lead to loss of calcium in the bones, and that greater loss occurs with longer use. The label advises women against using the drug for longer than two years, stating that they should do so "only if other birth control methods are inadequate." So if you are on DMPA, beyond dairy, don't forget those green leafy veggies! Come to see your gyno for your bone health and best contraceptive choices!

A pill for the healthy

Yes, sort of like a vitamin. Too long going to the doc meant getting treated while sick. Gynos were ahead of the curve in that doc visits often at least introduced, in a mass market kind of way, the idea of screening for sickness with the pap test and bring out prenatal care which was pretty much only focused on high blood pressure in pregnancy at the get go. However, most doc visits are aimed at treating the sick, with a mere nod to the concept of staying well or making you a whole lot better. A wellness visit for women actually focuses on screening for disease, and still needs just a bit of a tweak more to focus on actually making you better. Show up at a normal weight and no obvious medical condition, no one will ever question your diet. Have a low blood pressure at your check up, were you ever told how to keep it there? Probably you have been told your health care provider to avoid secondhand smoke, perhaps a quick reminder about seat belts, wearing sun screen and using condoms. All designed to prevent illness, not to make you “even healthier.” And my favorite be healthier advice best nod to keeping you healthy beyond just exercising,…encourage sex (yes, for adults sex can be extremely healthy). In gynecology we have long touted the non-contraceptive health benefits of taking oral contraceptives, it specifically suppresses both ovulation and the uterine lining tissue, raising the blood counts and improving bone density even in the healthiest of users. But how about taking this one step further, requiring anyone without contraindications to take at least 10 or twenty years of oral contraceptives? This strategy has been estimated to eliminate 80% of all ovarian cancers. And going even farther to ward off disease would be to use pills to ward off high blood pressure and heart disease all together. In Europe there has been the crusade actually brought by a Kiwi, that crusade was that of the of the “polypill”. Using a pill to treat the entire healthy population, to help ward off disease would indeed be rather radical.

How Many Paps and Where To Have Them

HPV probably never goes away. So if you have had paps that wax and wane: they are good, they are bad: don't get out the frying pan and chase anyone out the door. It's probably a reactivation of prior disease. Disease which we thought our immune system could resolve, probably just goes into latency. And if a woman has HPV disease she may have a 'field effect' meaning that the entire area: your vagina, your vulva, your urethra, and your anorectal areas may all be affected.  There has been an increase in anal cancers in the US. Mostly these are individuals that are already immunodeficient, and on medication. So regular anal pap testing can be done. If your pap is abnormal then you need an anoscopy(microscopic look at the anal area) exam.  So after offering cervical paps since the 1950s, we added the Halo Breast pap a few years ago, now an anal pap. We want to be more aggressive once we do a pap and go on to the colposcopy to see what the lesion really is. However in pregnancy, the newest guideline is to manage early abnormal pap tests (ASCUS, LGSIL) expectantly, as the pregnant state actually gives most women a bit of an immune boost.

As Time Passes Has Your HPV Case Resolved?

At 3, 6, 12, 18 and 24 months Dr. Woo Dae Kang and researchers at the Chonnmam National Univeristy looked at women with high grade cervical dysplasia after LEEP and looked at the Human Papilloma Virus (HPV) viral persistance. Up to 30% have peristant disease of some nature, and understanding whethether the condition has been resolved has been a challenge for patients and their clinicians. The group used their very sensitive HPV chip test and have determined that for women who continue to test + for High Risk HPV types have about 44+% chance of recurrance. Especially important were women who had persistance of HPV type 16 or 18. These tests are now available and can be requested from your provider.

How 'Green' are Your (STI treatments)?

Ever hear of EPT? I think the EPT initials have been used a lot in the gyno world, but one very green way of stopping STI's in their tracks is to get your partners treated before they are event tested! That has become known as EPT accorting to the CDC . So that there is no delay in treatment, no extra paperwork, no extra q-tips,  but most importantly, no extra STI spread! So, if you happent to test positive for an STI, get your partners notified and EPTed! Any Questions? Call your gyno!

Quebecers Rally Again for Asprin Use

Two persistent problems of pregnancy have plagued parturants perpetually. Preeclampsia and Growth Restriction, primarily in primagravidas.The problem seems to lie in the placenta. The actual causes of these conditions remains an enigma. We have struggled for years with the cause. Some suggesting a worm could actually cause preeclampsia. One thing is for sure, the placenta is the 9 month baby bottle, and if the nutrients cannot pass, the baby cannot grow. So it stands to reason any treatment that can free flow the passage of nutrients through clogged vessels will help feed the baby. This has been looked at inconclusively many times before. But in the recent Obstetrics and Gynecology publication there was a definite reduction in the rates of these two serious problems of pregnancy with daily low dose aspirin. The research group from Quebec studied a high risk population. If you are low risk, then treatment may incur risks that you wouldn't need to prevent a condition you are unlikely to get, so do not try this without physician supervision! And the supervision began very early for many, it even began during infertility treatment, for others the treatments began in the first trimester. But one thing is always clear in pregnancy. Prenatal care is vital to your health, and when symptoms change, see your physician.

Gyno Gab: post-endometrial ablation syndrome

Gyno Gab: post-endometrial ablation syndrome
http://www.womenshealthpractice.com

Eradicate Yeast, Eradicate Bv, Eradicate STIs

Eradicate yeast and bacteria by the microwave route, at least from you unmentionables. Yes even the underwear, pop them in the Amana. 30 seconds for dry and one to 3 minutes for wet. But beyond that more needs to be done. Condoms help, and we know that spermicides even do help to reduce the risk of STI acquisition through a bit of bactericidal and viracidal properties, but beyond that we need to take more dramatic action. WE need better microbicial agents to use a the time of IC. Trials are going on in the world, read about them. STI Prevention Research

A Different Sort of Itch, Still Get Checked

Not all STIs have vaginal symptoms. Some present with rectal symptoms. Most often I diagnose HPV in the rectal or anal area, but actually, those cases are typically not symptomatic, those cases are typically found on examinations, often just routine examinations. But individuals with rectal irritation, itching, discomfort (proctitis) may in fact have GC, CT, a form of CT called LGV, syphilis or Herpes (HSV). All these conditions can be tested for. So if you have a different sort of itch, be sure and see your gyno for appropriate testing. These conditions can be cured and are important to know about. And making sure we get this done has been a part of the Healty People 2010 objectives and has been retained in the Health People 2020 objectives that are now closed for comments, but can be read on line.