Cervical Cancer Testing - A Woman's Annual Exam Is Needed At All Ages

Dr. Bev Blessing FNP, PHD

I ran across an interesting article on MSNBC about pap smear screening with a summary of recommendations by the American College of OB -GYN.  I think it does a nice job of clarifying how often women need to be screened for cervical cancer with a pap smear and HPV testing.  However, I did want to make a few comments. Most GYN practices are doing the HPV with the pap smear testing on women between 30-65 to establish the risk factors,  Prior to that age HPV is of little benefit, unless there are significant changes on the pap smear.  After 65, the risk for cervical cancer begins to decrease.  Those women with negative HPV and /or 3 negative pap smears, can have the pap smear less frequently.

However, the point that is not clear in the article is that the pap smear is not the whole story.  During the annual exam, the woman is generally evaluated for thyroid changes, breast changes, hormonal issues, vulvar changes, or lesions, vaginal discharges, uterine enlargement, irregular bleeding, and ovarian issues.  In addition, when indicated a rectal exam is performed, STD testing may be requested, and the list continues....   The bottom line, although the pap smear may not be needed as frequently, the annual exam is still needed at all the ages.  What specifically we check for is changes, based on risk factors. As providers, we are committed to keeping women healthy at every age!

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Study Shows Pregnant Women Can Prevent Excess Weight Gain With Simple Steps

Dr. Enrique Jacome MD

A new study reports that a low-cost healthy lifestyle program, including self-weighing weekly or monthly, by pregnant women with pre-existing overweight can prevent them from gaining too much weight during early pregnancy.

The researchers are presenting the results at The Endocrine Society's 93rd Annual Meeting in Boston. 

"Preventing excess weight gain in pregnancy is essential to the health of all mothers and their babies and can be achieved by increasing awareness [of weight during pregnancy] and by simple health messages, behavior change strategies, and regular monitoring of weight gain," said lead author Catherine Lombard, PhD, of the Monash University School of Public Health and Preventive Medicine, Melbourne, Australia.

"This weight-management strategy has the potential to reduce pregnancy complications, such as gestational diabetes, and birth complications," Lombard said.

The clinical trial consisted of more than 200 overweight women, recruited from a hospital-based clinic, who were less than 15 weeks pregnant. All women were at high risk of developing gestational diabetes (pregnancy-related diabetes) because of their age, weight, ethnicity, previous gestational diabetes or a family history of diabetes. They were randomly assigned to the intervention group (106 women) or control group (99 women).

At 14 weeks of pregnancy, both groups received health information emphasizing making small, healthy changes to eating and physical activity, such as walking and eating more fruit and vegetables. The intervention group also received information about how much weight they should gain during pregnancy, an instruction to weigh themselves weekly or monthly and frequent reminders by text messaging. The control group received no instruction or reminders to self-weigh. Both groups received standard prenatal care.

Measures included weight, frequency of self-weighing, physical activity and food intake at the beginning of the study and at 28 weeks of pregnancy. This is the time that routine testing for gestational diabetes occurs, according to Lombard.

At 28 weeks regular self-weighing was associated with significantly less pregnancy weight gain for intervention participants than for the control participants -- 12.6 pounds versus 15.7 pounds, respectively. Women in both groups who did not self-weigh gained a similar amount of weight: an average of 15.2 pounds.

"We conclude," Lombard said, "that self-weighing keeps women focused on their behavior. When it is paired with a simple self-management intervention to prevent excess weight gain, it has a significant impact on weight gain in high-risk pregnancies." 

The study was supported by a BRIDGES grant from the International Diabetes Federation.

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FDA to look at blood clot risk from drospirenone

Dr. Enrique Jacome MD

BANGALORE (Reuters) - The U.S. Food and Drug Administration (FDA) said it is reviewing results from two studies that showed there is a higher risk of blood clots in women taking birth control pills containing drospirenone.

The FDA said it is evaluating the conflicting results from these and earlier studies and reviewing the risks and benefits of drospirenone-containing birth control pills.

Bayer AG's best-selling birth control drugs, including Yaz and Yasmin, contain the compound.

The two studies looked at whether there is a higher risk of blood clots in women taking birth control pills containing drospirenone, when compared to similar women taking pills containing levonorgestrel.

The studies showed the risk of blood clots is reported to be up to 2 to 3 times greater than with levonorgestrel-containing pills.

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