GynoFiles

The fact of the matter is, your weight and your waist size does matter. So measuring your waist and making sure you reduce your abdominal fat will improve your health. Some gynos will quote the left hand washes the right, others will refer to the chicken and the egg problem, and still others will refer to hand in glove. Whatever your metaphor is the message is simple: cardiovascular factors and obesity are linked in exactly that way. The importance of obesity as a heart risk factor was demonstrated in the prospective cohort Nurses' Health Study of over 115,000 middle-aged women.  Body weight and death rates are directly related, so the message is slim that waistline.  Your waistline is the critical factor and those who have the so called apple shape of abdominal obesity (waist-hip ratio of above 0.9) are more likely to suffer from severe medical complications of heart disease. In a recent report in  Managed Healthcare Executive they point out that the increase in risk ...

Enjoy whatever your grillmaster,  pizza wizard,  or master chef is serving up this holiday season do enjoy, but realize that there will be some catch up to that feasting: so after enjoying come on in to Women's Health Practice for a three part plan to fit in your best holiday wear by, the next holiday. We especially are going to target the weight we carry in the midline, no matter what your overall BMI and weight is. 1. Customize the Calorie count. 2. Understand the risks and benefits of weight distribution based on your own health 2. Contour Revision, that may mean diet medications or other nutritional strategies. And there are treatments such as Coolsculpting that help. 3. Normalize Your Hormones. Lots of us use our clothes to tell us what size we want to be, and that's not a terrible way to do it. To be even more scientific you can calculate that waist to hip ratio and you should be below .80 . You need to have a realistic approach to calories and the content of yo...

WHO lists the leading causes of death in women , and shows us how developed and underdeveloped nations differ.  It varies from country to country, and there are some shockers, in England, it's dementia that kills the most women! The rates differ by states as well . The National Center for Health Statistics last released data on what women, per age group, die of in 2004. The provisional data for 2011 is now available for comparisons on line. http://www.cdc.gov/nchs/fastats/deaths.htm In the last tabulation if you were between 19 and 64 years old you are most likely to diet of malignant neoplasms. If you are 65 years or older you are most likely to die of diseases of the heart . If you are younger than age 19 then you are most likely to die of an accident or unintentional injury. They do list the top ten conditions that cause mortality in women, it's interesting to browse and think about what health screenings could help you prevent these conditions. Although not a...

Females can have excess fine hair, on their trunk or their arms and legs that is genetic; or they can have the excess hair of virilization. The best way to measure the amount of hair you have on your body is to grade 9 body areas with scores of 0 to 4. Those who score low have no excess hair problems, those who score very high, closer to 36 have significant excess hair. The Body areas are 1. Upper lip, 2. Chin, 3.Chest and breast area, 4. mid abdomen, 5. Lower abdomen, 6. arms, 7. legs, 8. Upper back, 9. Lower back and buttock area. Now these hair scores may or may not correlate with abnormal hormones, irregular periods, and/or infertility. But for those with changing scores, or abnormal scores, a gyno discussion may be in order.

Are you a planner? Do you want to plan when you will have your next baby? Science and superstition can help you plan! Most of us think that we have sex for the holidays with a bit more abandon, so lots of babies born in the fall. But a new study says, maybe there is something else to the seasonal birthday phenomenon. Almost 6500 semen samples were collected in Israel to try to answer the question of seasonal birth patterns.In the animal world seasonal birthing is very common, so they reasoned it might be with humans too. I have always told patients that bursts of sex: 9 months after New Year's Eve, ( months after the New York City Blackout....translates into more babies born with identical birth dates. But in analyzing sperm counts by season, it turns out in the study by Eliahu Levitas and co-workers, men produce their best swimming sperm in the winter. And there was a low of fast swimming sperm in the summer, which improved by fall, and was best in the winter. So apparently the...

How long do we live?   Expectancy is to 80.4  (US data 2004), and some are now saying 80.8 as of 2013. Was 48.3 in 1900. So the group of us is getting older. Now the longevity experts would tell us that the oldest among us hasn't really gotten older. The top dog in longevity: Maybe 1113, or 122, the data keeping back then, and from where, not so good. And who should we ask if we want to live really long, your doctor, right? Maybe not. I looked in UpToDate, the hot shot "medical encyclopedia"...and it is good for lots of stuff, longevity...no such place or topic to look up. I can check on how to make someone with a particular cancer survive longer, or with hypertension, you get the idea. Eventually, apparently living longer is treating what you have better. With rats we can do experiments and see which rat lives the longest, apparently that just has not been ok with human research, so extrapolation. First we do have to kick what kills us off early. Living longer world...

South African Fertility Dolls Endometriosis has been stated to be a "modern disease." It is a condition in which tissue from the lining of the uterus implants or sprouts and grows in the interior of the abdomen. It takes a surgery to make a firm diagnosis and tracking the disease is as difficult, as it takes a follow up surgery to figure out if it has been adequate treated. From being a rare condition in the early 1980s we now think there are 8.5 million women with endometriosis in the US today,  that means we have about 350,000 women in Illinois with the condition. Many women do not know they have the entity of endometriosis. The government does track some statistics for endometriosis . We know that non-hispanic white women are most at risk; and there is a genetic link as well. Women with red hair, women who are tall, women who have had melanoma are all more at risk for endometriosis. The most alarming statistic regarding endometriosis is that we are seeing more advance...

UNCC Gardens I like sayings and numbers and acronyms to help me remember, but of course there are exceptions. We used to say: clinical gyno exams once a year "1" and mammograms once a year "1" pap smears once a year "1" and now we still say see your gyno for a clinical exam once a year "1" but consider mammograms every two years "2" and then get the pap smear every three years (some can go to 5 if you are having HPV testing that is negative) so the "3". Of course these recommendations do not apply if you have had prior disease or are being followed for a specific treatment or have other reasons for being more high risk, for that plan you need to speak privately with your gyno. I see too many healthy women not complying with recommedations and they often seem to be doing a "3, 3, 3" meaning if they didn't get a pap they didn't get a gyno exam annually, but are spacing all exams out too fare; and of course...

I have always liked the idea of fluoridating water, as we do have much better teeth than the Europeans who don't.As a gyno I had always told women to be sure to get their calcium in their diet, but calcium began cropping up everywhere in the foods. And then we had to remind pregnant women or women planning pregnancy to take folic acid. But foods are fortified with these as well. And few people will be worse for wear. An extra kidney stone  or two to the woman not looking at labels and taking full supplements of calcium besides, an older individual rarely with B12 problems because of the extra folate in foods. But don't stop paying attention. Just when you were struggling to get in enough oatmeal and salmon to lower your cholesterol, unbeknown to us, foods have started to get supplemented with the plant stanols and sterols that lower our blood lipids. Actually a study that is aging now, about 15 years ago, showed that using stanol-fortified margarine can lower your LDL by abo...

Cardio C Reactive Protein or CRP to some of you or C-CRP to some of you should be less than 1 (mg/L) or is sort of ok to be between 1 and 3. But should not be greater than 3 or ou may be at risk for heart disease. Taking estrogen, although if given right as you pass through menopause, will, pretty much universally, increase your C-CRP number, by about 1, so that means you move from low risk to moderate risk or from moderate risk to high risk depending upon your starting numbers. And the WHI study does say that it's pretty predictable that you will have heart events if you have those high numbers. I say, exercise, diet, weight, weight fluctuations, where your weight is, whether you take lipid lowering medicines, whether you take aspirin, and a few other factors do affect the overall risk of actual heart events. There's more than on way to 'skin the_____" (I just cannot type it)...anyway. Knowledge is power, and I do believe that we should check our levels whenever...

"Clean your plate." "Drink your milk." Darn, again, mom's advice was right! Did you ever hear her say, fill your stomach full of a bunch of pills? No, so when you want good nutrition, the first step, particularly if trying to lose weight is to pack your diet full of nutrients. When asked for the type of pills to supplement with, I try to tell patients: my best advice is to get your nutrition from food. But if there are foods you avoid, or a day of particularly poor nutrition, or a particularly strict diet in attempt to weight loss, yes, you may indeed need to add in some supplements. We also live in the north, and local food isn't possible all year long, we have to have our food shipped, which means picking early. A new study that is getting a lot of talk on many sites and being reviewed by the NIH Office of Dietary Supplements is saying that the escalating recommendations regarding both the dietary levels and the blood levels of Vitamin D are not back...

Chocolate Brownie Treat The Gyno Gab 1,2,3 of basic health:  The apple (representing that basic healthful and small diet), relatively high in nutrients, high in fiber, high in water, and of course low in calories. The two exercise principles: 30 minutes a day, every day, and then for the pelvic floor: three sets a day of about 10 maximum pelvic floor muscle contractions per day.Very simple procedures to incorporate into your daily diet. And of course, rare, warm from the oven homemade treats! Do that for awhile and then we can gab about  the stretching, your cholesterol, your blood pressure, and your sun screen in the next lesson! In lesson three: we'll get to the stress reduction, the improvement in sex, and yes, the gyno tests like pap ,HPV tests, Halo breast tests, blood work, and mammograms!

Testosterone testing is very useful for gynos, and you may want to gab with yours to see if you need this hormone checked. But getting the right test, and an accurate test is very important. The Testosterone Tests were Toppled in 2011. Laboratories changed the way they reported tests, and they had to change how they interpreted the results. Results of Testosterone Tests called into question by the endocrine society  and then the tests have been improved. All patients need to understand that all testing has flaws, but with hormones it's often difficult to get a test that your gyno can use. Times of day, part of the menstrual cycle, are just two of the obvious sources of error to testosterone testing. Then there is the fact that physicians have not been able to decide what level is a normal blood level of testosterone. It may not even be so simple as what is normal per decade of life, but may be what is normal for a certain ethnicity.  But there is more to it t...

It's October And We Wear Pink Because We Fear What Pink Implies. It's October and We Fear What Pink Means: Breast Cancer. But in spite of the seriousness of the breast cancer issue we need to continually remember that as women we are more at risk for cardiac disease. We are at risk, we don't always get tested for it, and we aren't always tested properly for it. Now this is a huge topic, and we will be gabbing about this for decades to come in lots of posts, and stories of how women had just the softest of symptoms and were not diagnosed are rampant out there. But now the gynecologists have something to say about getting your heart tested: by way of: Your Ovaries! Turns out if you go through premature menopause you are at risk for cardiovascular disease. And that happens to be something that we can test for. Estrogen protects the hearts of young women. And if you still have estrogen, and as a side note are doing your best to not have completely blocked up your veins an...

Check your pulse. What is it? What was it last year, and ten years ago? High heart rates can be due to a number of factors, nerves, sure, that's part of "the jitters." But it may not just mean you are overweight, and out of shape, yes, it means that too...but it might mean a serious health concern. The National Institute of Health has decided to study the beating of the heart. And heart rates over 80 (what was yours? check again) may mean poor health according to the ARIC study . And for the first time they looked at the consequences of an abnormal heart rate on your kidneys. Higher than normal heart rates don't help the kidneys either. Women may in fact have lower heart rates than men, but the general cut off for 80 is right now used for both women and men. So if you need to think about why your heart rate may be abnormal, go see your gyno.

Do you hate to stand on the scales? When it comes to checking weight, it's not always the amount of weight on the scales, as everyone knows. And it's not just whether you fit into your jeans. It's exactly how fat you are. We've written a lot about fat distribution, and we've written about getting that fat rearranged, but everyone knows as long as they don't look fat, they are fine, right? Of course wrong. So When you go to the doctor's office are they measuring the right things? How about waist to hip ratios? That will at least tell you whether you are a pear or an apple. But how about the old fashioned calipers to grab your flabby parts. The American Bariatric Society endorses some criteria for obesity, that we are used to and a physician Dr. Eric Braverman, who is associated with Weill Cornell neurologic surgery department, but also seems to support some non-substantiated alternative therapies on his website, has reported that a study by his PATH Resea...

Why me? Is it my diet? Or perhaps the metabolism or delicate hormone imbalances that cause one to be healthy and the other to have endometriosis. Certainly not all factors are worked out. Apparently takes about 60 pg/ml of estrogen, in terms of blood level, and is why if you are menopausal, or menopausal and on minimal Estrogen Replacement therapy, odds are good that your endometriosis will die out. And when we treat with Lupron (gonadotrophin releasing agent) the levels of estrogen at which treatment is most effective are in the 20 to 40 pg/mL levels. And it takes more than that to feed an implant. It takes growth factors. Some of these endometrois inciting growth factors are elaborated in the macrophages. So once the implants are located in the abdomen through reflus seeding of menstrual debris, it's possible that their very presence sets off a casade of events that enhances more endometriosis.

Almost 1/3 women are birthed by surgery in the US today, and lots of factors go into this statistic. Of course if you are pregnant, sit down with your gyno and a good birth plan and then ask some individual probing questions. What would be the safest birth for your baby and for you?  But it's pretty interesting reading to go over the  National Vital Statistic Report of Births and you can learn a lot. For instance we have many fewer teen births, but the rate of C-sections has soared in just the past 10 years. For awhile we used to blame the introduction of fetal monitoring as a factor in the increased rate, but monitoring came into virtually universal use over three decades ago. Furthermore, year after year, rates vary by state, with some states consistantly having high rates and some with consistently lower. One table I looked at had has Mississippi running the highest rate of C-section and Utah the lowest. So what would you do to get a vaginal birth? Eat less? Change gy...

Did you have a new year's resolution to become fit? Well, maybe you need to figure out just how fit you are, you know, a baseline. then you can build on your baseline fitness and improve. I myself love numbers, and signs on my bathroom mirror door, goal messages on my phone, stickers that say you're a star in my planners, great help too. But numbers can be obtained for more than just your weight, your BMI, or your waist measurement. Numbers can be obtained for many vitamin levels, for your insulin resistance, for your blood levels of inflammation, for your fat and carb metabolism. All these numbers will help you determine just how fit you are. You want to know all of these numbers and your gyno can help you interpret them. Recently a study from researchers out of the University of Iowa and the University of California at Davis who were studying soy and bone health found out some very interesting facts about Vitamin D . Those with better Vitamin D levels were more fit overal...