GynoFiles

This hunger can be seemingly out of proportion to the consumption of food. It's regulated in many ways, one of which is through the hormone ghrelin is that affects your metabolism and makes you have both triggers feelings of hunger , and a change in what your body does with food. When ghrelin is triggered food intake increases, and you begin to store fat. When this happens your fertility will decrease. It's also released when we are stressed; although cortisol is one reason for this, ghrelin is part of the reason we want to eat when we feel emotional or under pressure. Neuroscientists at RMIT in Australia have reported how ghrelin affects fertility in mice. works in mice. These researchers found that when ghrelin is increased the ovary has fewer eggs in reserve. So having a balanced diet, and keeping your metabolism steady, it is very likely to actually be beneficial for fertility.

Smoothies, and very low calorie days are often healthy in the context of having a stable healthy diet. The goal is to be heart healthy. Have a reasonable body fat and a reasonable amount of muscle within your body type. Actually doing a very low calorie day for long stretches, is essentially dieting by starvation. Starvation or near starvation have been studied for over a century. The classic dietary experiments of Folin and Denis in 1915 were among the early advocates of such plans for very obese individuals. Later regimens championed by Strang-Evans had 660 calories per day and did little to significantly reduce the weight of the super obese weighing between 300 and 700 pounds. In these cases severe hormone abnormalities prohibit weight loss even with this low intake. Low calorie and very low calorie diets have been championed as a path to rapid weight loss, and for some who are merely overweight and modestly obese may benefit from such plans as a way to briefly get weight off. The...

Body composition has a very complex relationship between fat, hydration, muscle, and bone mass. The regulatory hormones that control each are integrally linked and seem to control how we gain or lose weight, how the weight is distributed, how fit we are, how much muscle we can build as we get older and many other aspects of our health. To help understand this complex relationships how fit you are is more accurately measured by body composition readings than BMI. Specifically knowing your relative skeletal muscle mass can determine if you have an appropriate amount of strength for your gender and age. Knowing your body fat, and the differential between your visceral fat and your overall fat percentage can help determine your overall leanness. It is important to be lean for thermoregulation.  Once it was thought that heavier women would have fewer hot flashes because of overall higher estrogen levels. Then the prevalent theories were that body fat functions as a natural 'sweater l...

We have talked, in women's health, a lot about the HPO: the endocrine system that communicates between the H: the hypothalamus, the P: the pituitary gland, and the O: the ovary. Generally speaking when we talk about 'hormone imbalance' the gynecologic endocrinologist means there is something off with this cycle of how the ovary talks to the brain. Now it has been realized that other endocrine systems have just such a channel of communication and how that works between the brain and the adipose tissue has  now been called the "brain-fat axis" and this is an important control of how your body uses energy, or decides to amass fat stores. It is now well-known that appetite-regulating peptides that were studied as neurotransmitters in the central nervous system can act both on the hypothalamus to regulate feeding behavior and also on the adipose tissue to modulate the storage of energy. Energy balance is thus partly controlled by factors that can alter both energ...

Is your waist healthy? Do you need to improve? You are picking out that old favorite team gear and now you noticed that you are unable to button your pants as easily? The first clue to your nutritional health is not necessarily your weight. Your weight may not even have fluctuated much, but there it is, the dreaded thicker waist. Just doing a bit less? Having too much wheat based carbs? Eating sugar and forgoing the right fats? Trying the turkey and chicken instead of burgers and steaks?Weight gain in the middle is not good.  As your waist to hip ratio rises, your get thicker in the middle and even if you can button your pants, it's that you are getting that muffin top look. Whether or not you have a good or even relatively healthy 'overweight' BMI, if you have too thick of a waist it is called central obesity,  as measured by waist circumference (men – greater than 40 inches [102 cm]; women – greater than 35 inches [89 cm]). Your BMI is a measurement of your w...

As we help women achieve and maintain a healthy BMI, we see too many people in the middle of a successful diet, suddenly struggling to maintain the pace of weight loss. Knowing the cause can help guide us to a solution. Hormones pay a role in the regulation of weight and food consumption. These are hormones that most of us do not discuss with our providers. But understanding these hormones will help explain why so many of us hit a roadblock when tying to lose weight. When you begin a diet you find that you lose weight, but as you go on watching your calories you find that weight loss slows, and in some cases that weight gain resumes. When we eat food, normally when we are not trying to gain or lose weight as we at the leptin hormone from our fat decreases, the ghrelin from the stomach increases, the hormones glucagon-like peptide-1, cholecystokinin, and peptide YY from our intestine, and insulin and amylin from the pancreases all decrease. Those effects help regulate the signal to r...

There are 5 FDA approved weight loss medications: orlistat , lorcaserin , naltrexone-buproprion , phnterimine-topiramate and liraglutide . There are not many research trials comparing these medications. In the June 2016 JAMA issue the medications were compared. The research trials are difficult to do because close to 40% of patients drop out, and thus it's very difficult to apply the groups to an individual patient. At Women's Health Practice we have many patients who have lost in the 30-80 pound range, and some have accomplished their weight loss in 6 months. Although individual patients can lose significant amounts of weight more than what is reported in these studies, as a group most research trials show that these medications help women, average age of 45, lose about 5% of weight over 52 weeks of weight management plan. The process is a slow and laborious, as many individuals need to lose significantly more than that to achieve a heart healthy weight.. However, this pace...

 Medical science now has begun to recommend limited fasting. We used to call days of higher calories 'cheating days' and days of lower calories the days we 'stick on our diet.' Even normal weight women have been heard to echo this sentiment. Some diet advice cautions that these higher calorie days might lead to more and more meals of unhealthy foods and even binge eating. But Krista Varady, a nutritionist for University of Illinois-Chicago, found that with the process of varying caloric intake, the very low calorie diet days help overall reduce calories. Long term health studies seem to indicate that fasting bouts can slow aging, reduce the risk of cancers, and reduce the risk of diabetes .You should work with your gyno on what your consumption should be. Although it would be safe to not eat at all on fast days, everyone should  keep up water consumption, and eating about 600-700 calories on those days would trigger the physiologic effects you are looking for. Feast...

 Hormonal contraception provides ovulation suppression and eventually this correlates with overall hormone control and normalizing the menstrual cycle. Knowing that these methods are extremely effective, 'will I gain weight' remains the top question women ask their gyno before selecting a contraceptive. The issue of weight gain on contraceptives is complicated by the fact that many young women are beginning on hormonal contraception as they give up sports and physical activities for extra studying in college or as they start a new job that likely is more sedentary with travel or just desk time required. But contraception might have the ability to affect weight, affect weight gain, affect weight loss and cause fluid shifts that ultimately shouldn't alter the scale. In general we counsel patients that neither oral contraceptive, patches, rings, medicated IUDs, nor Nexplanons should cause weight gain. DMPA (you may know this as Depo Provera) is associated with 10-15 po...

Since a new CDC repor t looked at whether US pregnant women's weight gain and found too many women are not hitting recommended amounts, the question remains what should you do about it? The answer lies in a combination of recommendations. You need to start with your provider and get in mind the normal weight recommendations. The CDC article reviews them:Gain 28-40 if you are underweight, and 25-35 if normal weight, 15-25 if you are overweight and 11-20 if you begin pregnancy with a diagnosis of obesity. This is based on pre-pregnancy BMI. Then discuss with your provider: what is your metabolism really like: do you gain easily, have you recently been on a diet, are pregnancy nutrition requirements going to be difficult for you to eat as they are so different from your normal way of eating. Have you ever been a calorie counter? Did you have to recently give up smoking? Be realistic and discuss a plan with your birth provider so that you can tackle these issues together. For some it ...

If we could understand obesity, we may be able to cure it. The causes are complex Maybe the fault is not in our stars, but in our "starts" as a new a rticle about obesity due to fetal diet implies.  The obese in the world outnumber the hungry in the world. In 2006 the International Congress on Obesity found there were 1 billion obese individual in the world and 'only 600 million' hungry in the world. The numbers now are closer to 2.1 billion obese and 800 million hungry. With the current thinking that in 'large part' we get fat, merely because we can, food is abundant. Tackling the problem, regardless of the causes, according to the Institute of Medicine , the solution will be multifactorial. Under normal physiological situations we have all of our fat cells and enlargement of these existing adipocytes is the cause of fat weight gain. But under conditions of severe obesity, you have probably generated new fact cells. Those fat cells manage to generate hormo...

We just can't get to sleep, and the scientific statistics prove it. This is not good news as those with poor sleep have much poorer health and a shorter life span as well. To try to over come this we take sleeping pills! At any given time millions of adults in the United States — or 8.6 million — report taking prescription sleeping aids, according to a new report released by the Centers for Disease Control and Prevention (CDC). The rates are creeping towards 10% of those 80 and above taking sleep medicine, and it's mostly the women who are taking them. As a gyno I do not want the patients taking medication unless they need to, but what is more disturbing is that over 50% of adults report poor sleep, so we need to think about the things we can do to improve sleep. There is another culprit which is robbing us of sleep and that would be shift work. Those with shift that rotate or those that take night shifts have a lot worse sleep. Maybe its just living a in city that is the ...

Physicians and health care providers have finally learned that obesity is a disease to be attacked through a multi-front Napoleonic approach. Life style changes, nutrition strategies, and medical strategies have all been tried, true and remain a critical component. The newest front on the battle field is an electronic implantable device . It is for the morbidly obese patient, and the FDA has cleared it for individuals who have already embarked on some weight loss using the previously available strategies According to the US News and World Report, DASH diet out does all the other s.At Women's Health Practice, we see that all diets work, but that your food desires, lifestyle, current health, and genetics will determine whether you will have success, so as with all things: customize your plan. As for what medication will help you get ready to qualify for the implant, if you will ever qualify? And then for the stubborn pockets of fat that won't go away, would you consider Cool S...

Metabolism loosely defined is how we burn food for fuel. There are rare causes of diseases of our metabolism that occur in about 1/100,000 individuals and are usually diagnosed at birth. These disorders are usually single enzymes that won't allow for certain nutrients to be accessed from food. In other conditions there are foods that just cannot be processed so that their by products accumulate in dangerous levels, but none of these conditions typically are the cause of being overweight or obese. What we believe about our metabolism is filled with myt h, hopeful thinking and urban lore. We run on a lot of sugar, or more specifically the sugar glucose. And this is regulated by our thyroid gland and our insulin. Glucose is either ingested, made in the body, or obtained from the breakdown of bigger carbohydrate molecules such as glycogen. This then controls what we burn and what we store. And, if stored food, what form is it going to be stored in. For instance will you store it as ...

Gynos have heard patients complaining about weight gain in menopause for years. The amount of weight women gain when menopausal had not yet been quantified, and more importantly the reasons have not been agreed upon by experts. Factors such as slowing of metabolism with advancing age, the lack of sleep by women with hot flashes, the inability to exercise well due to arthritis and loss of vertebral flexibility due to degenerative disc disease, and finally the dramatically changing hormones. In a study sponsored by NIH it has been confirmed that the hormonal shifts in menopause predispose women to gain of belly fat as well as at least a ten pound weight gain. The weight of menopause then increases cardiovascular disease and pre-diabetic states. The physiology of fat changes towards fat accumulation, and only active dieting and exercise can reverse these otherwise inevitable pounds around your waist. At Women's Health Practice we say that weight management and more complete kn...

If you had diabetes when pregnant, you likely got to stop your medications and intense regimen of blood sugar checking almost as soon as your baby was born. And if you keep up your diabetic diet, exercise, and especially if you breastfed you were likely to not to be diabetic in  those early days. But only testing can determine if you have a normal blood sugar or not. The current recommendation is to get tested at the time of your post partum visit, and your physician may recommend a 2 hour sugar tolerance test (GTT). This more rigid testing is finding that about one in three women who are tested right at that 6 week check up will still have diabetes. And current studies are showing about half of all those who had diabetes in pregnancy will become diabetic in later life. Some gynos will not test until about 3 months out, and most will recommend testing again as your baby turns 3, to see if you are a diabetic. There are a number of ways to test once you have had a baby, but having...

The waistline is one of the most important gauges of our overall health, fitness, and how we perceive our body. To reach optimum weight overall nutrition is important, but spot reduction of the waistline is often named the number one concern of those trying hard to be physically fit an an ideal weight. Nutrition and lifestyle and now the very effective aid CoolSculpting work hand in hand to shape you.. And the American classic pop is an example of empty calories, that may not just be 'empty' of nutrition, but they may contribute to weight gain, weight retention, and the overall rates of obesity. And since half of all Americans consume soda daily, we feel obliged to give you the skinny on why you need to move that pop to the guilty pleasure list rather than have it be a daily food group! The soda you are drinking may have caffeine, it may have chemicals and phosphorus to make it fizzy, and it may have sugars or sweeteners. of This is why at Women's Health Practice , Hada...

Pondering the Middle during Vyaghrasana. The Tiger pose and the Tiger Stretch awake our muscles in the morning like awaking aTiger in the jungle. There are three aspects to every successful exercise plan: get your heart rate up, use your muscles and stretch. Yoga can help you with all of these things. It's good for the young, the old, the menstruating, those in need of balance, too many virtues to even list! Nothing like the Tiger Pose and Stretch to make me ponder the role of middle weight gain, some of us get this middle budge from genetic predisposition, others as we age, and in others its a consequence of the hormone lack in the menopausal female. Metabolism slows with aging because of many factors including inactivity (keep posing!) pancreatic insulin production slowing, but enough of that Gyno Gab Gals want to know how to reverse this. Our skeletal muscle is the primary tissue that if told to by insulin can grab the sugar molecule glucose and metabolize it: if not, grabbed b...

Are your hormones able to keep your waistline under control? You do weights, you run, you swim, and the scale doesn't budge and you still have more fat mass than you want to for your weight. Make sure you really include resistance training.Leptin is the hormone produced by our body, that causes weight loss. It itself does produce weight loss independently, just by normal to high levels being secreted, but it also causes weight loss by decreasing your food intake. Higher leptin levels cause (in animal studies) less food intake, and we don't actually know how well this works in people. We are quickly finding out. The blood levels can be measured, and at Women's Health Practice we wouldn't measure these for routine dieters, but when there is no progress with normal weight loss strategies, we begin to look to hormonal causes. Leptin also will increase your weight loos by changing your body temperature, specifically, leptin will decrease your heat production so that you ...

Varicose Veins With Ankle Swelling If you have had fertility treatments in your past, you probably do need closer follow up than routine gynecologic care. The reason you need closer follow up is that the side effects of treatment, and the reasons you were infertile may lead to gynecologic problems and medical health issues in later life. Here we suggest the topics to investigate with your gyno. Each infertile woman may have concerns in some or all of these in our list, but consulting with your health provider is important to see if you had special aspects of your case. The guidelines regarding future care from organizations do vary depending on the following factors: what treatments you received, did you successfully achieve pregnancy, did you breastfeed, your weight, your genetics, and your nutrition. If you had endometriosis syndrome you may need follow up as it is a chronic and recurring disease. But these are some of the post fertility treatment considerations we have at Wome...