Tuesday, February 24, 2015

Over The Past Decade IUDs And Hormonal Implants Have Become Five Times As Popular

Dr. Enrique Jacome
A new Centers for Disease Control and Prevention report finds a shift in preferences for birth control among American women, who are increasingly opting for long-lasting reversible contraceptives.
Long-acting reversible contraceptives (LARCs) include intrauterine devices (IUDs) and subdermal hormonal implants. Although IUDs were used more commonly in the US during the 1970s, concerns over their safety prompted a decline in use of these devices.
Since then, however, IUDs have been redesigned with safety in mind, and the Centers for Disease Control and Prevention (CDC) report shows that there has been growing interest in IUDs and 5-year contraceptive implants - which were approved in 1990 - because these contraceptive methods are highly effective at preventing unintended pregnancies.
IUDs are placed inside the uterus, where they release hormones or copper to prevent pregnancies. The CDC say that the failure rate for IUDs is below 1%, making them more effective than the birth control pill, which - partly due to users sometimes forgetting to take the pill - has a failure rate of about 9%.
According to the CDC's National Center for Health Statistics (NCHS) data, the use of LARCs waned during 1982-88 and remained stable up until 2002, but it has increased nearly five-fold over the last decade.
Among women aged 15-44, use of LARCs has increased from 1.5% in 2002 to 7.2% during 2011-13. The data also show LARCs are most popular among women aged 25-34 - more than twice as many women in this age group used LARCs during 2011-13 as women in other age groups.
Women who have given birth at least once were also found to be more likely to use LARCs compared with women who have not previously given birth. The report also found that this difference has increased over time.
CDC report tracks divergence in LARC use by race

There has also been a divergence in LARC use by race over the past 30 years. LARC use tripled among non-Hispanic white women between 2002 and 2006-10 and quadrupled among non-Hispanic black women, but LARC use among Hispanic women declined by 10% during this period.
Between 2006-10 and 2011-13, LARC use increased by 30% among non-Hispanic black women, however, there was a much higher increase in use among Hispanic (129%) and non-Hispanic white (128%) women. According to the report, non-Hispanic white women have traditionally used LARCs at the lowest rate.
When informed about the range of contraceptive options available to them, women are more likely to opt for long-acting contraceptive methods over the oral contraceptive pill or transdermal patch, recent research has found.
Despite this, the birth control pill remains the most popular contraceptive, used by 16% of women in the US.
Leading gynecologists from the American Congress of Obstetricians and Gynecologists (ACOG) say that while women are increasingly taking up LARCs as contraceptive options, use is still relatively low in the US:
"In part, high unintended pregnancy rates in the US may be the result of relatively low use of long-acting reversible contraceptive methods, specifically the contraceptive implant and intrauterine devices."

Monday, February 2, 2015

Research Shows Girls Who Drink Sugary Drinks Every Day May Start Periods Early

Dr. Enrique Jacome
Consumption of sugar-sweetened beverages has been associated with increased risk of obesity and type 2 diabetes. Now, a new study finds girls who frequently drink such beverages are likely to start menstruation earlier than those who do not consume sugary drinks, potentially putting them at higher risk of breast cancer.
A girl drinking soda
The research team, led by Karin Michels, associate professor at Harvard Medical School in Boston, MA, publishes their findings in the journal Human Reproduction.
According to the Centers for Disease Control and Prevention (CDC), approximately half of the US population consumes sugary drinks on any given day, including around 60% of females aged 2-19 years.
Sugar-sweetened drinks have grown to be a major public health concern, with numerous studies associating the beverages with increased weight gain in children and adolescents. In October 2014, Medical News Today reported on a study that also linked sugary drink consumption to premature aging of immune cells.
This latest study, however, is the first to associate sugary drink consumption in girls with the age of first menstruation, or menarche.
To reach their findings, Prof. Michels and her team analyzed 5,583 girls aged 9-14 years who were a part of the Growing Up Today Study, which involves 16,875 children of participants from the Nurses Health Study II.
At study baseline in 1996, none of the girls had started menstruation. They were followed-up until 2001, by which point 159 girls (3% of the participants) had started menstruation.
At several points during the 5-year study period, the girls were required to complete a dietary questionnaire that disclosed their consumption of sugary drinks - drinks that contain added sugars like sucrose, glucose and corn syrup.
They were asked how often they consumed a serving of these drinks, such as one glass or can of soda or one glass, can or bottle of sweetened ice tea. To assess the effects of artificially and naturally sweetened drinks, the girls were also asked how often they consumed a serving of diet soda or fruit juice.
1.5 servings of sugary drinks a day linked to starting menstruation 2.7 months earlier

The researchers found that, on average, girls who consumed more than 1.5 servings of sugar-sweetened beverages started menstruation 2.7 months earlier than girls who consumed two or fewer servings of these drinks each week.
What is more, the team found that at any age between 9 and 18.5 years, girls who consumed more than 1.5 servings of sugary drinks each day were approximately 24% more likely to begin menstruation in the next month than girls who drank two or fewer servings each week.
Overall, girls who drank the most sugary drinks started menstruation aged 12.8 years, while those who drank the least began menstruation aged 13 years.
The team found no association between consumption of artificially and naturally sweetened drinks and age of first menstruation.
These results remained significant even after the researchers accounted for other factors that could influence the age of first menstruation, such as body mass index (BMI), birth weight, height physical activity, ethnicity/race, family composition and how often the girls ate dinner with their family.
Commenting on the findings, Prof. Michels says:

"Our study adds to increasing concern about the widespread consumption of sugar-sweetened drinks among children and adolescents in the US and elsewhere.

The main concern is about childhood obesity, but our study suggests that age of first menstruation occurred earlier, independently of body mass index, among girls with the highest consumption of drinks sweetened with added sugar. These findings are important in the context of earlier puberty onset among girls, which has been observed in developed countries and for which the reason is largely unknown."
The team notes sugary drinks have a higher glycemic index than naturally sweetened drinks, which can trigger a rise in insulin concentrations. An increase in insulin concentrations can lead to a rise in concentrations of sex hormones, which can cause earlier menstruation - a potential explanation for the team's findings.
Findings may indicate an increased risk of breast cancer

The researchers say their findings raise concern as earlier menstruation has been associated with increased risk of breast cancer. 
They say a 1-year decrease in age at first menstruation is estimated to raise the risk of breast cancer by 5%. "Thus, a 2.7-month decrease in age at menarche likely has a modest impact on breast cancer risk."
"The amount of sugar-sweetened beverages consumed by girls in our highest category of consumption, more than 1.5 servings per day, however, is likely low compared with consumption in certain other populations, in which we would expect an even more dramatic decrease in age at menarche," they add.
"Most importantly, the public health significance of sugar-sweetened beverage consumption at age at menarche, and possibly breast cancer, should not be overlooked, since, unlike most other predictors of menarche, sugar-sweetened beverage consumption can be modified."

Wednesday, January 28, 2015

Mouse Model Discovers Two Genes Behind The Most Severe Form Of Ovarian Cancer

Dr. Enrique Jacome
In a new study reported in the journal Nature Communications, cancer researchers describe how they developed a mouse model of a very aggressive ovarian cancer that accurately portrays the disease as it occurs in humans. The model has helped them identify two mutated genes whose interaction appears to trigger, then hasten, the development of the cancer.
The researchers, from the University of North Carolina (UNC) at Chapel Hill, hope their findings will open new avenues to better treatments and much-needed diagnostic screens.
Ovarian cancer affects the ovaries, the reproductive organs responsible for producing eggs and female hormones in women.
Ovarian cancer is hard to detect, because the symptoms - such as feeling bloated and experiencing changes in appetite - are often mistaken for other conditions. There is also no effective diagnostic screen for early detection of ovarian cancer.
When ovarian cancer is found early, it can be highly treatable, and the 5-year survival rate in such cases is over 90%. But unfortunately, only 1 in 5 cases are found early, leaving the majority of patients to learn that their cancer has spread, is at an advanced stage that is hard to treat and their prognosis is stark.
While the pace is slow, the situation is gradually improving. Thirty years ago, the survival rate for women diagnosed with ovarian cancer in the US was 10-20%. Nowadays, it is nearer 50%. 
According to the American Cancer Society (ACS), a woman's risk of getting ovarian cancer during her lifetime is about 1 in 75, and her lifetime chance of dying from the disease is about 1 in 100.
The ACS estimate that in 2015, about 21,290 women in the US will receive a new diagnosis of ovarian cancer and about 14,180 women will die from the disease.

New mouse model depicts aggressive ovarian cancer just as it presents in humans

The senior author of the new study is Terry Magnuson, the Sarah Graham Kenan Professor and chair of UNC's Department of Genetics. He says the new model portrays an extremely aggressive form of ovarian cancer - ovarian clear cell carcinoma - just as it presents in women.
Not all mouse models of human conditions are able to portray them as accurately as they occur in humans. But the model that Prof. Magnuson and colleagues have developed is based on genetic mutations found in human cancer samples.
Prof. Magnuson says they used the mouse model to show how mutations in two genes - ARID1A and PIK3CA - interacted to trigger the aggressive ovarian cancer:
"When ARID1A is less active than normal and PIK3CA is overactive, the result is ovarian clear cell carcinoma 100% of the time in our model."
The team was also able to use the mouse model to show that BKM120, a drug that suppresses PI3 kinases - proteins that are involved in cancer cell growth, survival and proliferation - directly inhibited ovarian tumor growth and significantly prolonged the lives of mice.
BKM120 is currently undergoing human trials for the treatment of other cancers.

Two gene mutations interact to trigger aggressive ovarian tumor formation and growth

The study arose from previous work that found the ARID1A gene was highly mutated in several types of tumor, including ovarian clear cell carcinoma. But that work also found deleting the gene in mice did not trigger tumor formation or growth.
This is how the UNC team found the gene needed to interact with another gene, as Dr. Ronald Chandler, a postdoctoral fellow in Prof. Magnuson's lab, explains:
"We found that the mice needed an additional mutation in the PIK3CA gene, which acts like a catalyst of a cellular pathway important for cell growth. Too little expression of ARID1A and too much expression of PIK3CA is the perfect storm; the mice always get ovarian clear cell carcinoma. This pair of genes is really important for tumorigenesis."
Dr. Chandler says their research also "shows why we see mutations of both ARID1A and PIK3CA in various cancers, such as endometrial and gastric cancers."
The team also discovered that ARID1A and PIC3CA mutations were involved in overproduction of a protein that helps trigger inflammation. They say they do not know if inflammation causes ovarian clear cell carcinoma, but they do know it is important for tumor cell growth.
Speaking about the protein - Interleukin-6, or IL-6 - Prof. Magnuson says: "We think that IL-6 contributes to ovarian clear cell carcinoma and could lead to death. You really don't want this cytokine circulating in your body."
He suggests when they treated tumor cells with an antibody that targets IL-6, it inhibited cancer cell growth, so perhaps reducing levels of IL-6 could help patients, he adds.

The potential for new ways to diagnose ovarian cancer

The researchers say that while their work will help identify better treatment targets, it may also lead to new ways of diagnosing ovarian cancer.
Dr. Chandler says maybe they could find a biomarker that could be used to screen women. Perhaps there is a cell surface protein "downstream of ARID1A," he suggests, adding that:
"Right now, by the time women find out they have ovarian clear cell carcinoma, it's usually too late. If we can find it earlier, we'll have much better luck successfully treating patients."
The study was funded by the National Institutes of Health, with additional support from the ACS and the Ovarian Cancer Research Fund.
In March 2014, Medical News Today learned how scientists achieved another breakthrough by finding the genetic cause of a rare, aggressive ovarian cancer that most often strikes girls and young women. 
In that study - which used groundbreaking genomic techniques - the international team found several strong links between a mutation in the SMARCA4 gene and a large majority of patients with small cell carcinoma of the ovary, hypercalcemic type (SCCOHT).

Tuesday, January 6, 2015

The Health Benefits Of Iron

Dr. Enrique Jacome
Iron deficiency anemia is the world's most common nutritional deficiency disease and is most prevalent among children and women of childbearing age. Anemia develops due to an inadequate amount of iron in the diet or poor iron absorption.

Iron deficiencies can be caused or exacerbated by injury, blood loss, hemorrhage or gastrointestinal diseases that impair iron absorption. Inadequate intake of folate, protein and vitamin C can also contribute to iron deficiency.

MNT Knowledge Center feature is part of a collection of articles on the health benefits of popular vitamins and minerals. It provides an in-depth look at recommended intake of iron, its possible health benefits, foods high in iron and any potential health risks of consuming iron. 

Recommended intake
The Recommended Daily Allowance (RDA) for iron depends on age and gender. 
Children:
  • 1-3 years - 7 milligrams 
  • 4-8 years - 10 milligrams.
Males:
  • 9-13 years - 8 milligrams
  • 14-18 years - 11 milligrams
  • 19 years and older - 8 milligrams.
Females:
  • 9-13 years - 8 milligrams
  • 14-18 years - 15 milligrams
  • 19-50 years - 18 milligrams
  • 51 years and older - 8 milligrams.
Pregnancy:
  • 27 milligrams.
An estimated 8 million women of childbearing age in the US suffer from iron deficiency severe enough to cause anemia. Iron deficiency during pregnancy may raise the risk for preterm delivery.
Iron supplements are available, but it is best to obtain any vitamin or mineral through food first. It is not the individual vitamin or mineral alone that make certain foods an important part of our diet, but the synergy of the foods nutrients working together. It has been proven time and again that isolating certain nutrients in supplement form will not provide the same health benefits as consuming the nutrient from a whole food. First focus on obtaining your daily iron requirement from foods then use supplements as a backup.

Possible health benefits of consuming iron

Iron deficiency can cause many health problems. Common difficulties associated include delayed cognitive function, poor exercise performance and lowered immune function. In children, iron deficiency anemia can cause psychomotor and cognitive abnormalities resulting in future learning difficulties.

Healthy pregnancy

Low iron intakes increase a woman's risk of premature birth and the risk of her infant having low birth weight, low iron stores and impaired cognitive or behavioral development.

More energy

Not getting enough iron in your diet can affect how efficiently your body uses energy. Iron carries oxygen to the muscles and brain and is crucial for both mental and physical performance. Low iron levels may result in a lack of focus, and an increase in irritability. 

Better athletic performance

Iron deficiency is more common among athletes, especially young female athletes, than sedentary individuals. Iron deficiency in athletes decreases athletic performance and weakens immune systems. A lack in hemoglobin iron can greatly reduce physical work performance via a decrease in oxygen transport to exercising muscle. 

Foods high in iron

Iron has a low bioavailability, meaning that it has poor absorption within the small intestine and low retention in the body, decreasing its availability for use. The efficiency of absorption depends on the source of iron, foods consumed with the iron, and overall iron status of the person. In many countries, wheat products and infant formulas are fortified with iron.
There are two types of dietary iron - heme and non-heme. Most animal products and seafood contain heme iron, which is easier to absorb than non-heme. Non-heme iron sources include beans, nuts, vegetables and fortified grains. The recommended iron intake for vegetarians is 1.8 times higher than for those who eat meat in order to make up for the lower absorption level from plant-based foods.
Proton pump inhibitors (lansoprazole [Prevacid®] and omeprazole [Prilosec®]) used to reduce the acidity of stomach contents can inhibit the absorption of iron. The polyphenols and tannins in coffee and tea also decrease non-heme iron absorption. Eating foods that are high in vitamin C, on the other hand, help to increase iron absorption.
clams tomatoes and shrimp
Clams contain a significant 24 mg of iron per 3 oz.
  • Clams, canned, 3 oz: 24 milligrams
  • Cereal, fortified, one serving: 1-22 milligrams
  • White beans, canned, 1 cup: 8 milligrams
  • Chocolate, dark, 45-69% cacao, 3 oz: 7 milligrams
  • Oysters, cooked, 3 oz: 6 milligrams
  • Spinach, cooked, 1 cup: 6 milligrams
  • Beef liver, 3 oz: 5 milligrams
  • Blueberries, frozen, ½ cup: 5 milligrams
  • Lentils, boiled and drained, ½ cup: 3 milligrams
  • Tofu, firm, ½ cup: 3 milligrams
  • Chickpeas, boiled and drained, ½ cup: 2 milligrams
  • Tomatoes, canned, stewed, ½ cup: 2 milligrams
  • Ground beef, lean, 3 oz: 2 milligrams
  • Potato, baked, medium: 2 milligrams
  • Cashew nuts, roasted, 1 oz: 2 milligrams
  • Egg, 1 large: 1 milligram.1,2
Potential health risks of consuming iron

The tolerable upper intake level for iron is between 40-45 milligrams. Adults with healthy functioning gastrointestinal systems have a very low risk of iron overload from dietary sources. 
Taking iron supplements of 20 milligrams or more on a frequent basis can cause nausea, vomiting and stomach pain, especially if the supplement is not taken with food. In severe cases, iron overdoses can lead to organ failure, coma, seizure, and even death.
Some studies have suggested that excessive iron intake can increase the risk of coronary heart disease and cancer.
Iron supplements can interact with several medications, including levodopa (used to treat restless leg syndrome and Parkinson's) and levothyroxine (used to treat hypothyroidism, goiter, and thyroid cancer). 
It is the total diet or overall eating pattern that is most important in disease prevention and achieving good health. It is better to eat a diet with a variety than to concentrate on individual nutrients as the key to good health.

Monday, December 29, 2014

5 Health Resolutions For Women To Keep In 2015

Dr. Enrique Jacome
For many women, the path to good health is not an easy one, with plenty of roadblocks along the way. Procrastination, family obligations, work demands, and lack of time and energy are a few culprits that can stop the best of health resolutions in their tracks. 

To help women in their quest for better living, here are five resolutions to improve physical and mental well-being. If you've made attempts at sounder mind and body before, don't get discouraged. This is just another wonderful chance for you to make it happen:

New Year's Resolution No. 1: Eat, but Don't Pig Out

When women resolve to lose weight, they are often black and white about it, says Bonnie Taub-Dix, spokeswoman for the American Dietetic Association. She says women tend to want to cut out major food groups, telling themselves they cannot have any candy, dessert, or carbohydrates.

"It's a setup for failure, because by the time mid-January comes around, those resolutions are already in line for the next new year," says Taub-Dix. "It would be a much wiser decision to say, for example, 'I'm going to cut back on desserts.' Maybe pick a Saturday to have dessert." Instead of deprivation, practice moderation during the holidays.

The reduction approach is much more realistic than the all-or-nothing technique, which labels foods as "good" or "bad." When people see certain edibles as "bad," they can end up obsessing about it. Or they may see dieting as punishment for a year of unhealthy eating. Concentrate on getting adequate servings of whole grains, calcium, fiber, fruits and vegetables. This can be as easy as having a high-fiber cereal with milk and a banana.
Slashing entire food groups from the diet often backfires, because food is good and is one of the pleasures in life, says Taub-Dix. "There's no reason why we shouldn't enjoy food just because we're over the weight that we should be." "Don't wait until the new year to have better eating habits, says Taub-Dix. "It should be a whole year's resolution, not a New Year's resolution."

New Year's Resolution No. 2: Jump Outside the Box
Many women who resolve to become more physically active think of going to the gym. They tend to hit the aerobic machines or join group exercise classes. They may get discouraged easily because they don't achieve desired weight loss or muscle tone in a certain time frame. They may quit because of lack of time, energy, or money. Or, they may tire of the gym atmosphere.
There are dozens of reasons why the best of workout intentions fall by the wayside come February. Yet they don't have to end up that way if you're willing to step outside of a certain mode of thinking -- that exercise has to be done a certain way, at a certain place, at a certain time, and for a certain amount of time.
"Sometimes people have this 'all or none' mentality and they're so gung-ho and so excited when they set the resolution that they judge themselves too harshly if they don't perfectly adhere to what they've established," says Cedric Bryant, PhD, chief exercise physiologist for the American Council on Exercise.
He says many people make resolutions that are either unrealistic or too vague. A woman, for instance, may resolve to lose 10 pounds in two weeks. If she doesn't see desired results, she becomes discouraged and gives up.
It's better to set fitness goals that are realistic, achievable, and well defined. For example, a woman may strive to lose one to two pounds per week by exercising three to four times per week and holding off on seconds at the dinner table.
While the trend is changing, too many women don't do valuable resistance training, says Bryant. According to the Mayo Clinic, enhanced muscle mass can not only help better manage weight, it can also improve endurance, maintain the flexibility of joints, and reverse age-related declines in strength, bone density, and muscle mass.
Even very busy women can do resistance training and aerobic exercise, as they do not necessarily require a visit to a fitness center. "If you can't get to the gym, what can you do today to be more active?" asks Saralyn Mark, MD, senior medical adviser for the Office on Women's Health in the U.S. Department of Health and Human Services. "Can it be walking a little bit further in the parking lot, and using the stairs, or raking your leaves?"
"There's a lot you can do with just what is around you," says Mark. "The best part is that you don't have to get into a fancy gym outfit. You can be comfortable and you can do it while you're watching the news."

New Year's Resolution No. 3: Guard Against the Bone Thief 
"A lot of women feel that when they're not babies anymore, they don't have to worry about their bones, but it's quite the contrary," says Taub-Dix. "Watching calcium in your diet even as a young child or teen is very important, because that is the setup for what your bones may look like later on in life."
Osteoporosis, a bone-thinning disease, is major public health threat for 44 million Americans, 80% of whom are women, according to the National Institute of Health Osteoporosis and Related Bone Diseases. One out of every two women over 50 years old will have an osteoporosis-related fracture in her lifetime.
To help prevent osteoporosis, Taub-Dix suggests getting at least three servings of dairy a day. Healthy sources of dairy include skim milk, low-fat cheeses, and yogurt. There are also nondairy options for calcium, such as canned salmon with bones, dark green vegetables, dried beans, and calcium-fortified juices and cereals. Calcium supplements can also help women meet their recommended daily intake.
Adequate intakes of calcium for women:
  • From age 11 to 24, between 1,200 and 1,500 milligrams daily
  • From age 25 to 50, 1,000 milligrams daily
  • For postmenopausal women 1,000-1,500 milligrams daily if on menopausal hormone therapy
  • For pregnant and breastfeeding women, 1,200-1,500 milligrams daily

Women also should be aware that without vitamin D, calcium absorption is reduced.  This vitamin is found in some foods sources including fatty fish, fish liver oil, and diary products that are fortified with vitamin D. An adequate intake of vitamin D for adults ranges from 200-600 international units a day.
Weight-bearing exercises, which use gravity to put pressure on the bones, can also help strengthen bones. Examples include walking, running, aerobics, and dancing. Resistance-training exercises are also valuable as they help enhance muscle mass and bone strength.
Be aware that certain foods and medications may help weaken bones. There is some evidence that soda drinking can contribute to bone loss, primarily because many soda drinkers tend not to drink milk. Research also shows nicotine can slow down bone cell production and cause faster bone loss.
"It's important that you talk with your doctor about how much calcium you get in your diet, whether you smoke cigarettes, your family history, whether you've been on Depo-Provera, or you've had a history of other diseases that have required you to be on steroids or thyroid medications," says Mark.
The FDA recently issued a strong warning about potential bone density loss with use of the contraceptive Depo-Provera. Use of steroids and an overactive thyroid have also been associated with weak and thinning bones.

New Year's Resolution No. 4: Take Health Exams and Get an "A" for Good Health


An osteoporosis screening test is ideal for all women aged 65 or older, or for younger women with one or more risk factor. It is also important to get tested if this problem runs in your family.
There are other important health exams for women, and the optimal benefits usually correspond with certain age groups. Mammograms, for example, screen for breast cancer, a disease with a risk that increases after age 40. Consequently, the Task Force recommends that mammograms be performed every one or two years beginning at 40.
Pap smears, which screen for cervical cancer, are recommended to start within three years of onset of sexual activity or at 21 years old, whichever comes first, and to continue screening at least every three years. Also, discuss with your doctor the new HPV vaccine, which helps reduce your risk of cervical cancer.
Starting at 50, testing for colorectal cancer is also important. The disease more often strikes older men and women.
Other important areas of screening for women include blood pressure, cholesterol, diabetes, depression, and sexually transmitted diseases.
There are risks to every exam, including the possibility of an inaccurate report. Overall, though, experts say they play an invaluable role in good health. "Screenings can't prevent anything, but they can make treatment more effective," says Cindy Pearson, executive director of the National Women's Health Network.

New Year's Resolution No. 5: Move Center Stage

Women are well-known caretakers and jugglers of several tasks at once. With responsibilities concerning home, work, and children, there just aren't enough hours to do all that needs done. The result: many women feel frazzled, frustrated, and forlorn.
The mere thought of taking time to take care of themselves sends ripples of guilt through many women. Where does one find the time for self-care?
Make the time, says Mark. Research shows stress can wreak havoc on health. It's not unusual for the stressed to have stomachaches, diarrhea, increased appetite, and weight gain. Constant stress can also compromise the immune system, making people more vulnerable to colds and other infections. The pressure can also aggravate illnesses, produce anxiety and depression, disrupt valuable sleep, decrease sex drive, and raise blood pressure.
The list of negative consequences goes on and on. But women do not have to be victims, or they can try to change unpleasant situations.
Peter A. Wish, PhD, a psychologist in Sarasota, Fla., suggests identifying stresses, prioritizing them according to importance, and then tackling them one at a time. He recommends starting with an easy objective, and then moving on to another minigoal. "It starts with something that you can be successful at, and nothing succeeds like success," he says. "It reinforces you to keep going."
If a woman is not able to accomplish everything on her list, Wish says not to fret. "The probability is that [women] won't be able to accomplish everything, and therefore, they shouldn't be too hard on themselves."
With the to-do list never ending, there's no better time than today to find time to do something for yourself, even if it's just for 10 minutes. The ideas vary with individual tastes, but some women have found doing simple things, such as walking, exercising, talking to a friend, soaking in the tub, or meditation to be highly enjoyable and relaxing.
So this new year, think of what's important to you, make your resolutions, and vow to make this the beginning of If a woman is not able to accomplish everything on her list, Wish says not to fret. "The probability is that [women] won't be able to accomplish everything, and therefore, they shouldn't be too hard on themselves."

With the to-do list never ending, there's no better time than today to find time to do something for yourself, even if it's just for 10 minutes. The ideas vary with individual tastes, but some women have found doing simple things, such as walking, exercising, talking to a friend, soaking in the tub, or meditation to be highly enjoyable and relaxing.

Saturday, December 27, 2014

Analysis Shows Tamoxifen Has Reduced Breast Cancer Rates By 1/3

Dr. Enrique Jacome
A new analysis published in The Lancet Oncology finds that, for the last 20 years, the preventive effects of the breast cancer drug tamoxifen have remained constant, having reduced breast cancer rates by almost a third.
"Tamoxifen is a well-established and effective treatment for certain breast cancers, but we now have evidence of its very long-term preventive benefits," says lead author Prof. Jack Cuzick, head of the Centre for Cancer Prevention at Queen Mary University of London, UK. 
"The preventive effect of tamoxifen is highly significant with a reduction in breast cancer rates of around a third," he adds. 
The new analysis expanded upon the International Breast Cancer Intervention Study (IBIS-I), which weighed the long-term risks and benefits of taking tamoxifen to prevent breast cancer in women considered to be at high risk. The IBIS-I participants were 7,154 pre- and post-menopausal women aged between 35 and 70 - most of them had a family history of breast cancer.
In IBIS-I, the women were randomized to receive either 20 mg of tamoxifen or a placebo every day for 5 years. The health of all participants was monitored after treatment was completed, with an average follow-up time of 16 years (the maximum follow-up was at 22 years).
In the extended analysis, which was presented at the San Antonio Breast Cancer Symposium, it is revealed that 251 women in the tamoxifen group and 350 women in the placebo group developed breast cancer. This works out as a reduced rate of breast cancer in the tamoxifen group of 29%.
The estimated risk of developing breast cancer after 20 years of follow-up was found to be 8% among the tamoxifen group, compared with 12% in the placebo group.

Women taking tamoxifen 'at increased risk for endometrial cancer'

The women who took tamoxifen were at increased risk of endometrial cancer. This cancer - which is a known side effect of tamoxifen - was 3.8 times more common in the tamoxifen group during treatment, though the researchers found no increased risk in the follow-up period. Five women in the tamoxifen group died from endometrial cancer.
The researchers did not find a significant reduction in deaths specific to breast cancer following treatment with tamoxifen. Deaths from other causes were similar across both groups.
The extended IBIS-I analysis follows the first results of the IBIS-II trial, which were released last year. That trial reported that taking the aromatase inhibitor anastrozole for a period of 5 years reduced the risk of breast cancer among post-menopausal, high-risk women by 53%, compared with women who took a placebo.
Prof. Cuzick says of the team's findings:
"We hope these results will stimulate more women, particularly younger women, to consider treatment options for breast cancer prevention if they have a family history of the disease or other major risk factors."
Breast cancer is the most common cancer in women, with an estimated 1.6 million cases per year worldwide. However, Prof. Cuzick says there has been a clear and continuing reduction in breast cancer rates, although there has not yet been a reduction in breast cancer deaths.
"We will need to continue monitoring these women for a further decade to get a clearer picture of the impact of tamoxifen on death rates," he says. "Some of the side effects of tamoxifen are also cause for concern and need continued monitoring - specifically the increased occurrence of endometrial cancer."

Thursday, December 11, 2014

Researchers Identify Factors That May Boost Success Of Artificial Insemination

Dr. Enrique Jacome
During in vitro fertilization, uterine contractions can reduce a woman's chance of becoming pregnant. A new study published in the journal Fertility and Sterility, however, finds the opposite is true during artificial insemination.

Lead researcher Manuel Fernández and his team, from the Valencia Infertility Institute in Spain, found that the more uterine contractions women have per minute during artificial insemination, the more likely it is that the procedure will be successful.

Artificial insemination, also referred to as intrauterine insemination (IUI), involves directly inserting sperm into a woman's uterus during ovulation. The aim of this procedure is to boost the chance of fertilization by increasing the number of sperm that reach the fallopian tubes.

IUI is a much cheaper and simpler form of fertility treatment than in vitro fertilization (IVF), which is why it is the most widely used procedure. But the research team note that the success rate of IUI is lower than more complex fertility treatment and, as such, the procedure has lagged in terms of development in recent years.

In their study, Fernández and his team set out to find factors that may improve the success of IUI.


Success of IUI influenced by uterine contractions, follicular rupture

The researchers analyzed data of 610 women who underwent IUI with either a partner's sperm or a donor's sperm between 2005 and 2010.

Results of the analysis revealed that the number of uterine contractions a woman has each minute during artificial insemination is positively linked to the number of live births. "When the number of contractions is high, the rates of pregnancy and live births are also notably elevated," explains Fernández.

The team also found that the timing of insemination appeared to be an important influence on its success, with significant improvement seen when the procedure was conducted the same day as follicular rupture - the release of oocytes, or eggs.

Other factors that appear to affect the success of IUI - independent of live births - include whether a woman is inseminated with sperm from a partner or donor, maternal age and the number of follicles.

Taking all these factors into account, the team says IUI could offer a 15-20% success rate per cycle with a partner's sperm and a 25% success rate per cycle with a donor's sperm.

Commenting on their findings, Fernández says:"If we manage to improve artificial insemination success rates using this and other studies, we would be contributing to an important advance, given that this is currently the most accessible and widely used treatment."

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