Monthly Archives: May 2011

Warning signs of pregnancy-related diabetes

Warning signs of pregnancy-related diabetes


Diabetes stemming from pregnancy can cause a host of problems for baby and mother alike, including birth complications and a higher risk of developing the more serious type 2 diabetes later in life.

In a new study, researchers say they’ve identified a series of routine health measures that can help doctors predict years in advance which women will develop pregnancy-related diabetes, paving the way for lifestyle changes and other early prevention efforts. Continue reading Warning signs of pregnancy-related diabetes

Irregular periods in teens linked to health risks: study

Irregular periods in teens linked to health risks: study


Teenagers who have irregular periods are more likely to be overweight and obese and to have early warning signs of diabetes and heart disease than those with regular menstrual cycles, a study said.

While the link between irregular periods and heart disease and diabetes is well-established in older women, the findings, published in “Fertility and Sterility,” suggest that doctors might be able to identify this risk much earlier — and try to do something about it. Continue reading Irregular periods in teens linked to health risks: study

Menopause age related to when mom went through it

Menopause age related to when mom went through it

The age at which women go through menopause depends a lot on when their relatives did, according to new study findings.

Specifically, women whose mothers or sisters experienced menopause by age 45 were roughly 6 times more likely to do the same. Women who underwent menopause at a relatively late age – 54 or older – were also 6 times more likely to have seen the same thing happen to their mothers, and twice as likely to see it in their sisters. Continue reading Menopause age related to when mom went through it

Why your brain needs vacations

Why your brain needs vacations


Mary Kole loves her job, but she’s been feeling like she’s lost the line between “work” and “not work.”

A literary agent for children’s books in Brooklyn, New York, Kole works from home and checks in with clients electronically around the clock — sometimes writers will even call her in the middle of the night with an idea. Stepping outside isn’t exactly relaxing either. “In New York, it’s just subway, office, people, talking, yelling, honking, all the time,” she said. Continue reading Why your brain needs vacations

1 Million Kids With Asthma Wrongly Prescribed Antibiotics Yearly

1 Million Kids With Asthma Wrongly Prescribed Antibiotics Yearly

When should doctors prescribe antibiotics to treat asthma? “The answer in 2011 is that they shouldn’t,” says Ian M. Paul, M.D., associate professor of pediatrics at the College of Medicine at Penn. State. Yet Paul and his colleagues have found that doctors do – about a million times a year.

Their study, published online May 23 and in print in the June issue of Pediatrics, looked at more than 60 million cases where children across the U.S. visited their doctors or the emergency room for asthma treatment from 1998 to 2007. They found that antibiotics were prescribed inappropriately at as many as 1 in 6 of these visits.

Healthcare experts have long been concerned about the over-prescribing of antibiotics because it can lead to the evolution of bacteria that is antibiotic resistant. The only time children with asthma should receive antibiotics is if they have an additional diagnosis – maybe a bacterial infection such as pneumonia – where the drugs would be needed.

Based on this study, researchers couldn’t determine why exactly doctors ignore guidelines and prescribe antibiotics for asthma. But they did note that children who received systemic corticosteroids (indicating a more severe attack) to treat their asthma were also more likely to receive antibiotics. “I can surmise from that that those kids were sicker, and the doctor wanted to throw the kitchen sink at it,” says Paul. Also, because asthma and pneumonia share some signs and symptoms, it is possible doctors prescribe antibiotics when they aren’t certain of their diagnosis.

Surprisingly to Paul, this is less likely to happen in emergency departments than at the doctor’s office, though the study offers no clues as to why. But in either type of visit, discussion with the doctor is key. “We found that when the doctors spent the time to educate families about asthma, they were 50% less likely to prescribe antibiotics,” Paul says. So parents should ask a doctor prescribing antibiotics to their asthmatic child what the medication is supposed to treat. If the doctor seems uncertain about the diagnosis, it’s reasonable to ask about a 24-hour waiting period to see whether asthma medications help with your child’s symptoms. “It’s really about communication with your doctor,” Paul says. Either way, ultimately, you’ve got to trust your doctor, so make sure your doctor is someone you trust.

Post-baby weight gain raises diabetes risk in next pregnancy

Post-baby weight gain raises diabetes risk in next pregnancy


Women who gain weight after giving birth for the first time dramatically increase their risk of developing pregnancy-related diabetes during their second pregnancy, a new study suggests.

Compared with women of similar height who maintain their weight, a 5-foot-4 woman who gains roughly 12 to 17 pounds after giving birth more than doubles her odds of developing diabetes during her second pregnancy, the study found. If she gains 18 pounds or more, she more than triples her odds.

(The study used body mass index, a ratio of height to weight, so problematic weight gain will vary according to a woman’s height.)

Diabetes diagnosed during pregnancy, known as gestational diabetes, is influenced by hormonal changes and normal weight gain and usually goes away after the baby is born.

It can lead to birth complications, however, and it also increases a woman’s risk of developing type 2 diabetes later in life. In addition, it makes the baby more prone to diabetes and obesity as he grows up.

The findings underscore how important it is for women to lose their baby weight and keep postpartum weight gain to a minimum, the researchers say. This applies especially to those who are overweight or obese at the start of their first pregnancy.

The overweight women in the study who lost weight post-birth substantially lowered their risk of gestational diabetes compared with those who maintained their weight.

“We acknowledge that this is not an easy thing to do,” says the lead author of the study, Samantha F. Ehrlich, a researcher at Kaiser Permanente, in Oakland, California. “It’s quite common for women to gain weight.”

The study, which appears in the June issue of the journal Obstetrics & Gynecology, included 22,351 ethnically diverse women who were members of the Kaiser Permanente health plan in Northern California. The overall rate of gestational diabetes during the women’s first pregnancy was 4.6%, and during the second it was 5.2%.

Less than 10% of the women in the study lost weight between pregnancies, which isn’t surprising given the new stresses and responsibilities that come with a newborn.

Having a baby causes a host of changes to a mother’s life and lifestyle that can influence her eating patterns, exercise habits, and work-family balance, says Truls Ostbye, M.D., a professor at Duke University Medical Center, in Durham, North Carolina, who studies postpartum obesity but was not involved in the current research.

“Many of these changes make it hard to return to a healthy weight,” he says. “But the period can also be seen as a teachable moment for positive change. [It] can be time when the mother — and the rest of the family — can refocus on a healthy lifestyle and set the new baby on a lifelong healthy trajectory.”

Pregnant women should walk regularly (with or without a stroller), keep snacking to a minimum, and avoid soda and other sugary drinks, Ostbye says. Breast-feeding can also make it easier for women to shed pregnancy pounds.

Women who breast-feed their babies for at least six months are more likely to achieve a healthy weight after pregnancy, Ostbye adds. Ehrlich and her colleagues are currently studying a weight-loss program, which includes weekly telephone coaching sessions, specifically tailored to help women with infants exercise and eat well.

“We believe that something that’s based on the telephone or a website would be easier for new moms to do than having to go somewhere to have classes,” she says.

How to Stop Incontinence From Sabotaging Your Sex Life

How to Stop Incontinence From Sabotaging Your Sex Life


It’s bad enough worrying about whether you’re going to make it to the bathroom on time to avoid an accident. But worrying about leakage during sex — that can really bring you down. If incontinence is sabotaging your sex life, at least you’re in good company. According to the American Foundation for Urologic Disease (AFUD), one in three women with stress incontinence avoids sexual intimacy because of fear of leakage during intercourse or orgasm.

5 Ways to Fix a Leaky Bladder Without Surgery

But don’t despair: Here’s a seven-step plan for coping with incontinence and getting your sex life back on track.

1. Prepare for sex.

One thing to take into account is when during sex you’re more likely to leak: If you have stress incontinence, you’re more likely to leak with penetration due to pressure on the bladder. If you have urge incontinence, you’re more likely to leak during orgasm. (Since women’s orgasms often don’t happen during intercourse, you can prepare for that moment separately.)

Either way, there are lots of things you can do to decrease the likelihood of involuntary leakage during sex while you’re working on a longer-term solution. You’ll need to experiment to see which of these makes a difference for you:

  • Avoid coffee or tea for several hours prior to sex.
  • Drink plenty of water well before having sex, but don’t drink any fluids for an hour before sex.
  • Practice “double voiding” prior to sex: Go the bathroom, then fully relax the bladder (some people recommend massaging the abdomen) and go again.
  • Put towels down, so you’re not worrying about linens if you do leak.
  • Don’t be shy about taking a “bathroom break” during sex. For women with urge incontinence, taking a bathroom break between foreplay and intercourse or between intercourse and “after-play” can make sex much more relaxing.
2. Talk about it.

No, this probably isn’t an easy topic to bring up with your partner. But isn’t it worth a few minutes of blushing if the payoff is returning to your previously joyous sex life? You might start by mentioning that you’ve been to the doctor to get help with a problem you’re really embarrassed to discuss. Tell your partner how much you miss your formerly great sex life together, and let him know that your reluctance hasn’t been because of lack of interest but because of fear of leakage and embarrassment.

You may be pleasantly surprised by your partner’s supportive reaction; it’s likely that the problem isn’t nearly the issue for him you’ve been thinking it is. After all, men have aging-related issues that affect their sexual performance, too. Your guy is probably all too familiar with the fear and shame that can accompany age-related changes affecting sex. If talking privately isn’t solving your sexual issues, working with a couples counselor or sex therapist can make it easier to talk about difficult topics.

3. Experiment with new sex positions.

Now this one your partner should have no trouble getting on board with. Here are some options to try:

  • Rear entry. When he stands or kneels behind you, it puts less pressure on the bladder and urethra.
  • Side entry. Another position that prevents his weight from being on your abdomen and relieves pressure.
  • Woman on top. When you’re on top, it’s easier to control the depth of penetration and to work those deep pelvic muscles you’ll want to strengthen.
4. See a specialist.

Ask your doctor for a referral to a urologist who specializes in incontinence. This isn’t an easy topic to bring up, but knowing how common it is might make it easier. Experts estimate that nearly one out of three women over age 40 struggle with incontinence at some point, but only 20 percent of them seek help. Wouldn’t you rather find a solution than remain a silent sufferer? Specify that you’d like a recommendation for someone who keeps up with recent research and training and is familiar with newer, more experimental therapies, such as biofeedback.

If you have any friends with whom you’d feel comfortable discussing this issue, ask if they’ve found a doctor they like. Personal referrals are a great way to find specialists who “get it.” Some hospitals and medical centers have specialized bladder health clinics where you’re likely to get up-to-the-minute expertise.

5. Strengthen your muscles with pelvic floor therapy.

Working with a physical therapist, you can rebuild strength in the deep abdominal muscles that support the bladder, using a program of exercises known as Kegels. (Many women try doing pelvic floor exercises on their own and don’t get the full benefit because they’re not doing them correctly.) Working with a pelvic floor therapist (PFT) with specialized training has been shown to increase the effectiveness of Kegels; one study found that when women worked with a PFT, 80 percent were able to control their incontinence.

Two additional techniques can boost the effectiveness of pelvic floor therapy:

  • Biofeedback. Computers attached to sensors can help you and your physical therapist know which muscles you’re working, measure muscle strength, and check whether you’re doing pelvic floor exercises correctly. Kegels can have the additional benefit of strengthening the muscles in the vaginal wall, so you and your partner may notice a sexual benefit as well. Interestingly, sex is great for the Kegel muscles, so as your revitalize your sex life, you may strengthen your bladder control as well.
  • Electrical stimulation. Some clinics offer electrical stimulation (also called pelvic floor muscle electrical stimulation, or PFES) in combination with biofeedback for people with severely weakened pelvic floor muscles. A low-grade electric current causes the muscles to involuntarily contract so patients can experience what that contraction feels like, learn to replicate it themselves, and regain muscle control.
6. Practice bladder control.

Your urologist can work with you on a process known as “bladder retraining,” which involves determining your natural pattern of urination, then setting up and following a fixed schedule of timed toilet trips, whether you feel like going or not. When you feel the need to go between intervals, you buy time by using urge-suppression techniques such as Kegels, distraction, and relaxation. You’ll also learn techniques, such as double voiding, to completely empty your bladder when you go. Over time you’ll work to increase the intervals between bathroom trips and the amount of liquid your bladder can hold.

7. Try medication.

Many doctors consider medication for incontinence a last resort, but if you’ve tried bladder retraining and pelvic floor exercises, and incontinence is still seriously impacting your sexual relationship, then medication is a smart next step. There are a number of drugs classed as anticholinergics and antispasmodics that block the signal that triggers involuntary contractions of the bladder. Some of the most popular are Detrol, Enablex, Sanctura, Ditropan, Toviaz, Vesicare, and generics containing the active ingredient oxybutynin.

In recent years, timed release once-a-day versions of these drugs have become popular. But if incontinence during sex and exercise is your primary concern, ask your doctor whether it’s more effective to take an older, multidose formula. Some women say taking one dose of a multiple-dose drug just prior to sex works better than one dose a day

What You Can Do to Prevent Urinary Tract Infections

What You Can Do to Prevent Urinary Tract Infections


As women, most of us will get a urinary tract infection (UTI) at some point in our lives. Some women will get many. But there are steps that you can take to help prevent the majority of UTIs.

UTIs explained

UTIs are bacterial infections that occur in the body’s system that produces and excretes urine.  Sometimes referred to as bladder infections or cystitis, the primary symptoms are painful and frequent urination. In more serious cases, UTIs can extend up into the kidneys, called Pyelonephritis. Infections in the kidneys can produce back pain in the area known as the flank. Some infections lead to bleeding in the bladder and produce a condition known as hemorrhagic cystitis. Left untreated, UTIs can be damaging and dangerous.

Women are more prone to UTIs than men because the tube that carries urine from the bladder to the outside (the urethra) is shorter in women. So it’s easier for bacteria to get to the bladder. Anything that pushes bacteria up toward the bladder (the holding area for urine) makes a UTI more likely. So, it makes sense that anything that pushes the bacteria away from the bladder will make a UTI less likely.

Common causes of UTIs

  • Some common things that lead to increased bladder infections are wiping from back to front (after a bowel movement), having sex, and not drinking enough fluids:
  • Wiping from back to front pulls the bacteria from the rectal area up to the urethra where it makes a quick trip into the bladder.
  • Having sex causes bacteria to be pushed to the urethra, which then travels into the bladder.
  • Not drinking enough fluids can also cause a problem. Adequate fluid intake ensures that the bacteria is diluted and washed away from the bladder.

Three things you can do

  1. Always wipe front to back. Girls should learn this at a young age and it should become a life-long habit.
  2. After having sex, be sure to go urinate. The process of urination will wash away the bacteria that have been pushed up to your urethra during sex.
  3. Always drink plenty of water every day. Water will filter right into the bladder and effectively wash away all of that bacteria. Also helpful, cranberry juice is the one juice that will remain acidic as it filters into the bladder. Because of its acidic nature, cranberry juice is unfriendly to the bacteria and can be helpful in keeping infections away. And, it’s also important to know that caffeinated beverages are not helpful–they will often dehydrate you and create more bladder infection issues.

If despite these precautions, you still do get a bladder infection, see your healthcare provider and get treated quickly. It is important to treat the infection early before it spreads to the kidneys and becomes a damaging, dangerous infection

When Two Worlds Collide: Menopause and Skincare

When Two Worlds Collide: Menopause and Skincare


Perhaps with the exception of puberty, there is no more challenging time for your skin than when you go through menopause. Like opposing forces of nature, your skin must battle against both breakouts and wrinkles, giving you definite obstacles when it comes to choosing treatments and products to keep you looking your best.

As you may have guessed, hormonal shifts that play a major role in your skin changes. Surges of testosterone cause acne, not only on the face but anywhere else, including the back and chest. Stress also creates precursors to hormones, which serve to increase breakouts.

The same hormonal shifts that are giving you prepubescent skin issues are working on the other side of the spectrum to break down your collagen and elastin and thin the dermis, leading to fine lines and wrinkles. Women going through this time in their life may also notice their skin lacks luster and radiance and becomes looser than before. On another note, many women also experience hair and nail changes. Nails become more brittle, while hair may thin and lack vitality.

So, what’s a woman to do? While this may seem almost hopeless, there are several things you can do to restore balance to your body and your skin.

Yes, this seems like the cure-all to everything, but exercise is critical. All women 35 and older need to exercise 20 to 30 minutes a day. Exercise increases your circulation and gets oxygen to your tissues. Not only will you feel better, but your skin will also thank you.

Again, a tool in your arsenal is the food you eat. Approximately 30 percent the calories you consume should be from carbohydrates, and of those carbohydrates, the majority should come from fresh fruits and vegetables high in vitamins and minerals. Make it a goal to have a streamed green vegetable with at least one meal. Forty percent of your diet should be in the form of lean protein, and 30 percent from healthy fats. Keeping salt to a minimum is also important for fluid retention.

The magic elixir comes into play once again. Drinking your eight glasses of water per day will flush your system and help your skin reclaim its glow. Mineral water is best.

As important as what goes into your body is what goes on your body. Choosing a skincare regimen that is right for you is vital. Look for products that use pharmaceutical-grade ingredients.

During this time, women must exfoliate the skin using a gentle polish. Exfoliating invigorates the skin, removes dry, dead skin cells, promotes collagen production and brings oxygen to the skin.

Proper cleansing rids the skin of debris, preparing it for the rest of your skincare regimen.

Specific treatments designed for your skin type should definitely be part of your routine. Always make sure you treat your skin with some sort of
antioxidant. All antioxidants are anti-aging, and they act to protect your skin. Vitamin A (retinoids), vitamin C, green tea and resveratrol are among the top antioxidants.

During menopause, the skin often becomes dry. The use of a proper moisturizer will help with water loss and seal the skin

The use of a broad-spectrum SPF is a must in all skincare regimens.

Menopause is a multifaceted issue for all women. Remember to add a dermatologist to your team of experts when choosing what treatments work best for you.

Lowering Stress Improves Fertility Treatment

Lowering Stress Improves Fertility Treatment


Women undergoing certain infertility treatments are more likely to become pregnant if they take part in a simultaneous stress reduction program, new research shows.

The finding, published in the journal Fertility and Sterility, raises new and controversial questions about the role that stress may play in infertility.

The issue is a delicate one because historically, doctors often laid the blame for a couple’s inability to conceive on psychological and emotional issues in one or both partners. But research shows that most infertility is the result of physical problems in a man’s or woman’s reproductive system, and psychological factors are rarely the primary cause.

“It’s an extremely sensitive topic for couples,’’ said Alice D. Domar, a psychologist at Beth Israel Deaconess Medical Center in Boston and director of mind-body services at Boston IVF, a large fertility center. “The most common, unwelcome piece of advice to couples is ‘just relax and you’ll get pregnant.’ ”

Even so, a diagnosis of infertility can cause considerable stress and sadness, and patients often report high levels of depression and anxiety. Some studies have compared the stress of infertility to that experienced by patients with cancer or heart disease.

To assess the effects of high levels of stress, researchers are studying whether stress may make the body a less hospitable place for a pregnancy and somehow interfere with the success of fertility treatments. Many large infertility programs offer individual and couples counseling to help men and women cope with the diagnosis and treatment, but it’s not known if any particular type or duration of treatment may affect success rates.

To find out, Dr. Domar and colleagues recruited 100 Boston women under 40 who were taking part in in vitro fertilization, or I.V.F., in which embryos formed in test tubes are implanted in a woman’s body to help her become pregnant.

The women were randomized to a control group that received only the fertility treatment or a group that received fertility treatment as well as a 10-week stress management program that focused on cognitive behavioral therapy, relaxation training and social support.

Researchers tracked the groups through two I.V.F. cycles. In the first cycle, there were no differences in conception rates between the groups. Dr. Domar said that only about half of the women in the mind-body treatment group had begun the program, and those who had started had completed only a few sessions.

In the second cycle, most of the patients had attended at least five mind-body sessions. At that point, 52 percent of the women participating in the stress reduction program had become pregnant, compared with 20 percent in the control group.

“It’s not that it’s all in your mind,’’ Dr. Domar said. “If you’re really stressed out and depressed, the body seems to sense that’s not a good time to get pregnant. There’s something about practicing relaxation techniques or being with other women who understand what you’re going through, probably a combination of everything, that makes a difference. It isn’t just about relaxing.”

The mind-body program includes an exercise called “cognitive restructuring,” in which women are asked to share recurring negative thoughts. Common thoughts include “I’m never going to be happy unless I have a baby,’’ or “It’s my fault for waiting too long.”

Through a series of exercises, the patients are taught to replace the negative feeling with a more positive but still realistic thought — for example, “I’m doing everything I can to have a healthy baby.’’

“For a lot of patients, cognitive restructuring is a huge breakthrough,’’ said Dr. Domar. “Helping them tap into the hope they have is a really powerful thing, and you wouldn’t do an I.V.F. cycle unless part of you believed it would work.’’