Womens Health

Women's Health Newsletters 4/18/99 - 5/30/99

 

 



Back to top











***** Woman's Diagnostic Cyber Newsletter *****
                  April 25, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. Menopause and perimenopause FAQs at Hotflash
2. Medical care and the elderly
3. Post tubal ligation syndrome
4. Software for health
5. How much vitamin C do you need?
6. Humor is healthy

Spread the word! Send a copy of this newsletter
to someone you know.

Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Menopause and perimenopause FAQs at Hotflash
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
For a fun web site that focuses on menopause and 
perimenopause and includes symptom charts, recipes 
favoring phytoestrogens, news, bookstore and 
marketplace, check out the FAQs and other menu 
selections from families-first.com and their 
"hotflash" section: 
(Peri)menopause FAQs

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Medical care and the elderly
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The following editorial, Geriatrics and the Limits 
of Modern Medicine, from the New England Journal 
of Medicine should be read by anyone over the age 
of 65 or who has elder parents or relatives they 
care for. It points out how the medicalization of 
medicine and the need to have diagnostic certainty 
can very much work against the medical tenet to 
relieve suffering. Sometimes we have to be careful 
of how much medical care can work against its 
original intent to "do no harm". 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Post tubal ligation syndrome
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Some women have menstrual irregularities and 
pelvic pain which develops in the years following 
a tubal ligation. Sometimes this is called 
post tubal ligation syndrome, 
but doctors are aware of studies showing that 
women whose husbands who have had vasectomy also 
develop these gynecologic problems at the same 
rate. After viewing a web site referenced on the 
message board that was dedicated to warning about 
the condition, it was apparent that a review of 
the literature was needed to prove them wrong. It 
ended up proving them correct, i.e., we need to 
inform women having tubals that there is the 
possibility of increased gynecologic problems 
afterwards. This weeks article looks at: 

Is there such an entity as post tubal ligation 
syndrome? 

Does the type of tubal ligation performed make a 
difference? 

Does the age at which a tubal is done make a 
difference? 

Are women who have tubal more likely to end up 
needing a hysterectomy? 

If I want to have a tubal ligation for 
sterilization, what outcomes can I expect? 

Is there a post tubal ligation syndrome?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Software for health
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The search engine, Lycos, has an excellent section 
on finding health related software that is 
available for download. Many of the programs are 
free or shareware; some are just demo programs 
enticing you to buy or register, but most of them 
seem very reasonably priced. 

They include many programs such as: 
diet, weight loss, moods, exercise, running, 
biorhythm, rest breaks, medical records, human 
body education, beauty remedies, diabetes, herbal 
therapies, phobia identification, cholesterol, 
pregnancy tracking, fertility assessment and many 
others. 

Each software package has an evaluation rating of 
1-5 stars. 
Lycos software download

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. How much vitamin C do you need?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Vitamin C helps keep bones, teeth, gums, 
ligaments, and blood vessels healthy. It also 
helps the body's response to infection and stress, 
and helps use iron efficiently. There is also 
moderate evidence that, as an antioxidant,  
Vitamin C helps prevent some cancers. Recently the 
revision by the Food and Nutrition Board of the 
National Academy of Sciences from a requirement of 
60 mg of Vitamin C a day to 100-200 mg a day 
requirement was published. Also, they warn that 
too much Vitamin C can be harmful and cause nausea 
and diarrhea. Therefore they recommend that 1000 
mg (1 gram) of Vitamin C a day is too excessive. 

Vitamin C recommendations

In order to get enough Vitamin C through diet, 5 
servings of fruit or vegetables are recommended 
daily. For some women, this may imply a pill 
supplement is needed. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Gender Gap
-=-=-=-=-=-=-

A little girl and a little boy were at day care 
one day. The girl approaches the boy and says, 

"Hey Tommy, want to play house?" 

He says, "Sure! What do you want me to do?"

The girl replies, "I want you to communicate your 
feelings." 

"Communicate my feelings?" said a bewildered 
Tommy. "I have no idea what that means." 

The little girl smirks and says, "Perfect. You can 
be the  husband." 

Contributed by: MoodyFan

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you 
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



Back to top



***** Woman's Diagnostic Cyber Newsletter *****
                 May 2, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. PMS symptom tracking sheet
2. Pregnancy ultrasound normal and abnormal anatomy
3. Perinatal infections - when to check
4. Osteoporosis case conference
5. Soap and detergent health and safety
6. Humor is healthy

Spread the word! Send a copy of this newsletter
to someone you know.

Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. PMS symptom tracking sheet
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
At a site called Pamper Me Softly which sells 
progesterone cream for PMS symptoms, you can 
create a customized symptom calendar to track 3 of 
your worst symptoms over  an entire cycle. These 
calendars are extremely important in the diagnosis 
of PMS. Once you see how your symptoms change over 
a month, it becomes very obvious whether there is 
true PMS symptoms in which there is a 50% rise in 
symptom intensity in the last one or two weeks of 
a cycle, or whether there are just many stressful 
days each month not in a hormonal pattern. Print 
out one of these tracking sheets, fill it out and 
bring it to your doctor for a more accurate 
diagnosis of whether you have PMS. 

Take the rest of the site with a grain of salt. 
There is very little evidence that progesterone 
cream is any better than placebo in treating PMS. 
Buyer beware! 

Symptom tracking calendar

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Pregnancy ultrasound normal and abnormal anatomy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

If the doctor ever starts talking about pregnancy 
ultrasound results showing a fetal pole, blighted 
ovum, decidual sac, cystic hygroma, cornual 
pregnancy, vanishing twin or other abnormal 
finding, you may want to get into the detail of it 
by looking at ultrasound pictures at the Indiana 
Perinatal Network's Online Magazine. 

Normal and Abnormal pregnancy ultrasounds

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Perinatal infections - when to check
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

When you are pregnant, the doctor does lab tests 
for several possible infections you are sure you 
do not have. But have you wondered if they can 
cause problems for the baby. Should you get 
routinely tested for group B strep infection? Can 
vaginitis cause problems in the baby? If you have 
evidence of an HPV infection will the baby get 
infected. These are all subjects of this week's  
article at: 

Perinatal infections

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Osteoporosis case conference
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

The Women's Health Center at the Journal of the 
American Medical Association has some physician 
case conferences in which they thoroughly discuss 
a topic using an actual woman's history. This case 
below discusses a woman who took estrogen therapy 
for about 3 years in her 50's and then 
discontinued it. She is at high risk because of a 
low weight, less than 165 lbs, age over 65 and the 
fact she did not take estrogen replacement. The 
discussion talks about the bone densitometry 
measurements, spinal xrays, dietary intake and lab 
studies. Any woman who is under 165 lbs., and 
either younger than age 50 and has never taken 
birth control pills or under age 65 and has not 
taken much hormone replacement should learn about 
osteoporosis. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Soap and detergent health and safety
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

The Soap and Detergent Association has an 
informative site you may want ot check out. Did 
you know that: vegetables and fruits should  
washed with soap and water? Salmonella can survive 
on counter surfaces for 24 hours and even survive 
freezing. Antibacterial soaps (if FDA approved) 
can kill rhinovirus (cold virus), rotovirus 
(diarrhea in children), athlete's foot fungus and 
others in addition to salmonella. 

They have sections on:
Managing Allergies and Asthma: A Consumer Cleaning 
Guide 

Clean and Safe - guide to safe and effective use 
of cleaning products 

Food Safety Cleaning Tips - to help the reduce 
risk of food borne illness 

Cleaning for Health - antibacterial products for 
extra protection against germs 

Some FAQs About Bacterial Resistance From 
Antibacterial Wash Products 

Soap and Detergent Association

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Womanly Truisms:

1.  Life is an endless struggle full of 
frustrations and challenges, but eventually you 
find a hair stylist you like. 

2.  Perhaps you know why women over fifty don't 
have babies: They would put them down somewhere 
and forget where they left them. 

3.  Time may be a great healer, but it's also a 
lousy beautician. 

4.  Brain cells come and brain cells go, but fat 
cells live forever. 

5.  Life not only begins at forty, it begins to 
show. 

6.  If at first you don't succeed, see if the 
loser gets anything. 

7.  I had to give up jogging for my health. My 
thighs kept rubbing together and setting my 
pantyhose on fire. 

8.  Amazing! You just hang something in your 
closet for a while, and it shrinks two sizes. 

9.  It is bad to suppress laughter; it goes back 
down and spreads to your hips. 

10. Age is important only if you're cheese or 
wine. 

11. The only time a woman wishes she were a year 
older is when she is expecting a baby. 

12. Freedom of the press means no-iron clothes. 

13. Inside some of us is a thin person struggling 
to get out, but she can usually be sedated with a 
few pieces of chocolate cake. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you 
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



Back to top


***** Woman's Diagnostic Cyber Newsletter *****
                  May 9, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. Hysterectomy pre and post op Q&As
2. Fight back food borne illnesses 
3. Eating disorders
4. HPV DNA testing for ASCUS Paps
5. Midlife sexuality and women
6. Humor is healthy

Spread the word! Send a copy of this newsletter
to someone you know.

Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Hysterectomy pre and post op Q&As
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Hystersisters is a member site formed by women who 
are or have been in different stages of having a 
hysterectomy. Their frequently asked questions 
(FAQs)  section contains answers to many practical 
questions such as will I have nausea after the 
surgery, how many stitches, when can I restart 
intercourse and many other preop and postop 
questions. 

Preop and post op lists about hysterectomies

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Fight back food borne illnesses 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

The General Accounting Office in a 1996 report, 
stated that there are between 6.5 million and 81 
million cases of food borne illness a year. The 
Center for Disease Control (CDC) lists four 
bacterial pathogens - E. coli O157:H7, Salmonella 
Enteritidis, Listeria monocytogenes and 
Campylobacter jejuni - as the ones of greatest 
concern. Also of concern to CDC are other 
bacterial pathogens, such as Vibrio vulnificus and 
Yersinia enterocolitica, Clostridium perfringens 
and Staphylococcus aureus. 

Infection experts also report that many of the 
intestinal illnesses we commonly referred to as 
stomach flu are actually caused by foodbornee 
pathogens. People do not associate these illnesses 
with food because the onset of symptoms often 
occurs two or more days after the contaminated 
food was eaten. 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Eating disorders
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Have you ever worried about a friend who seems to 
never eat much, who thinks she's overweight when 
in fact she looks quite slim? Eating disorders 
such as anorexia nervosa, bulimia nervosa and 
binge-eating can go undiagnosed in many instances. 
It can cause medical problems that masquerade as 
other illnesses. If you want to be able to 
recognize this enigmatic set of disorders, take a 
look at: 

Eating disorders and medical symptoms

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. HPV DNA testing for ASCUS Paps
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

An interesting article in the Journal of the 
American Medical Association (JAMA), entitled 
Identifying women with cervical neoplasia: Using 
human papillomavirus DNA testing for equivocal 
papanicolaou results, suggests that ASCUS Pap 
smears should have HPV DNA testing rather than 
repeat Paps. 

Only about 5-10% of ASCUS (atypical cells of 
undetermined significance) Paps actually ever show 
a high grade dysplasia on further testing. That is 
why women are cautioned to have repeat Paps done 
because a repeat Pap will pick up about 75% of 
those ASCUS Paps that actually have high grade 
dysplasia. 

In this study below, 6.7% of women with ASCUS Paps 
had a high grade squamous lesion on colposcopy. An 
HPV DNA test picked up almost 90% of those high 
grade lesions. The advantage of a strategy such as 
this is that the HPV DNA testing can be performed 
on the same specimen as the original Pap if it was 
a thin prep Pap smear. Keep in mind the thin prep 
Pap is more expensive and it is not in common use, 
but this may be a promising new diagnostic 
approach to eliminate excessive worry about 
abnormal Paps and maybe even unnecessary 
procedures. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Midlife sexuality and women
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

For a practical article on adjusting to menopausal 
changes that affect sexuality, sexual response and 
desire, and vaginal dryness and comfort with 
intercourse, go the the Mayo Clinic site: 

Midlife and sexuality

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

One day, a painter found himself short of help and 
went to the unemployment office to hire someone 
for the day. When he arrived, they didn't have any 
painters available, but they did have a 
gynecologist there. He reluctantly took him along 
to help. 

A couple of weeks later, the painter returned to 
the unemployment office needing temporary help 
again. This time there were two painters there, 
but instead he asked for the gynecologist again. 


The clerk asked, "Why do you want a gynecologist 
when we have two professional painters you can 
take right now?" 

He said, "Two weeks ago when I hired the 
gynecologist, we arrived at the house and it was 
locked with nobody home. But I'll be damned if 
that gynecologist didn't stick his hand through 
the mail slot and paint the whole house!" 


~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you 
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



Back to top


***** Woman's Diagnostic Cyber Newsletter *****
                  May 16, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. Fertility charting primer
2. Is an annual physical exam really necessary? 
3. Basic evaluation for urinary leakage
4. Teenwire
5. Home test kit for Hepatitis C coming available
6. Humor is healthy

Spread the word! Send a copy of this newsletter
to someone you know.

Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Fertility charting primer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did you know that you may ovulate as early as Day 
8 or as late as Day 22 of your cycle -- not 
necessarily always on Day 14? For women trying to 
conceive, a set of basic instructions for how to 
chart a basal body temperature and record cervical 
mucous changes can be handy. BBT charting can also 
be used for contraception by using the luteal 
phase after ovulation as a safe time to have 
intercourse. 

Fertility friend online also has a free demo for 
one month of BBT charting. Check out: 

Fertility charting

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Is an annual physical exam really necessary?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

In the changing medical care environment 
everything gets questioned. This article below 
asserts that there is no scientific evidence that 
supports an annual physical exam as beneficial in 
theasymptomaticc person. 

There are apparently several studies showing no 
significant, previously unknown disease detection 
from annual physical exams. In fact most who have 
studied this say that doctors should only focus on 
screening for high-risk behaviors with minimal 
reliance on physical examination findings except 
for blood pressure, weight, and breast 
examination. 

Look at this and see what you think.

Annual physical exam discussion

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Basic evaluation for urinary leakage
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Many women are embarrassed to go to the doctor to 
be checked out for a problem of leaking urine. 
Part of the problem is that they do not know what 
to expect. This article includes: 

Can I tell from my symptoms, i.e., when and how I 
lose urine, what type of incontinence I have? 

What are some of the risk factors for developing 
urine leakage? 

What does the doctor check for on examination? 

Will I have to have a catheter put in my bladder? 

What tests other than the physical and pelvic exam 
will I need to have? 

Incontinence evaluation

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Teenwire
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

The Planned Parenthood Federation of America has 
created a site for teens to view and ask sexuality 
and relationship information. Did you ever have to 
go to the local Kroger store as a teen to get a 
pregnancy test because your period was late and 
your boyfriend had touched your genital area? Just 
running the test is anxiety provoking and knowing 
how other teens feel when doing it can ease the 
stress level. 

While your teenage daughter would certainly come 
to you if she were concerned about the possibility 
of pregnancy (NOT), maybe her girlfriend does not 
have that relationship with her parents. You can 
help by pointing her to a site that has a list of 
nearby Planned Parenthood Clinics to see about a 
pregnancy test for example. 

Teenwire.com

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Home test kit for Hepatitis C coming available
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

The FDA has announced approval of a home test kit 
for hepatitis C in which  blood is collected at 
home and the test sent to a centralized lab. There 
it is treated with an anonymous number that you 
choose so you can call and get results. It 
functions very much like the home HIV test kit 
that we have at the Woman's Diagnostic Cuber 
Store. 

Individuals at high-risk for contracting hepatitis 
C include anyone who: 

Abused IV drugs (or inhaled cocaine); 

Received a tattoo or body piercing; 

Is a healthcare worker exposed to blood or blood 
products; 

Was stuck with a possibly infected needle; 

Received blood transfusions or blood products 
before 1992 (when the blood supply could be 
reliably screened for HCV); 

Had hemodialysis before 1992; 

Received a transplant before 1992; 

Has hemophilia or a similar bleeding disorder; 

Had sex with multiple partners; 

Had sex with anyone with hepatitis (or HIV or 
another sexually transmitted disease) 

Hepatitis C home test kit

As soon as this test is shipped, we should be 
carrying it at: 

Woman's Diagnostic Cyber Store

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

A Veterinarian was feeling ill and went to see his 
doctor.  

The doctor asked him all the usual questions, 
about symptoms, how long had they been occurring, 
etc., when he interrupted him: 

"Hey look, I'm a vet - I don't need to ask my 
patients these kind of questions: I can tell 
what's wrong just by looking."  

He then smugly added, "Why can't you?" 

The doctor nodded, stood back, looked him up and 
down, quickly wrote out a prescription, handed it 
to him and said,  

"There you are.  Of course, if that doesn't work, 
we'll have to have you put to sleep." 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you 
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



Back to top


***** Woman's Diagnostic Cyber Newsletter *****
                  May 23, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. ERT in  women with previous breast cancer
2. Early postpartum discharges cause distress 
3. Testosterone supplementation during menopause
4. Mitral valve prolapse in women - what is it?
5. What causes headaches?
6. Humor is healthy

Spread the word! Send a copy of this newsletter
to someone you know.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. ERT in  women with previous breast cancer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

This is the first report I have seen of women who 
were allowed to have estrogen replacement therapy 
after having localized breast cancer. 39 women 
took estrogens and 280 did not. One woman of the 
39 (2.5%) developed recurrent breast cancer 27 
months after starting ERT and 72 months after the 
initial diagnosis of breast cancer. Fourteen women 
of the 280 controls (5%) developed another breast 
cancer on average 139.5 months after initial 
diagnosis. While this study does not absolutely 
prove that estrogen replacement after breast 
cancer is safe, it certainly is very encouraging 
to conduct further studies because of the severe 
estrogen deficiency symptoms that many breast 
cancer survivors have. 

From the Journal of Clinical Oncology:

ERT after breast cancer

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Early postpartum discharges cause distress
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Drive thru deliveries in which women are 
discharged within 24 hours of having a baby have 
come under scrutiny because many women do not feel 
they are ready to go home from the hospital so 
soon. This study reported in the Archives of 
Family Medicine found that women who were 
discharged in 24 hours compared to those who were 
allowed to stay 48 hours 

more fatigue (49% vs 29%)
more morbidity in the newborns (31% vs 16%)
more pediatric visits (96 vs 54 per 100 newborns)
were less likely to start breast-feeding (64% vs 77%) 
more likely to stop breast feeding prematurely (14% vs 8%)

Hopefully studies like this will encourage more 
health plans to allow women to stay at least 48 
hours after delivery. 

Early postpartum discharge

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Testosterone supplementation during menopause
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Can testosterone help menopause symptoms without 
causing hair growth, voice changing or excessive 
aggressiveness? It does have its benefits for 
menopausal symptoms of fatigue, libido, 
concentration and well-being but taking 
testosterone supplementation needs a careful 
titration to your own body. See the weekly article 
at: 

Testosterone during menopause

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Mitral valve prolapse in women - what is it?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

You may or may not be familiar with a medical term 
called mitral valve prolapse but many women have 
this diagnosis. It can sometimes explain heart 
racing or skipping beats (palpitations) dizziness, 
fainting or even chest pains. It is more of a 
condition than a disease in that women with mitral 
valve prolapse do not have a shortened life span or 
die because of it, but since it gives heart 
symptoms, it can be a very frightening condition. 
For a good explanation of what mitral valve 
prolapse is, visit WebMD.com: 
Mitral valve prolapse in women

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. What causes headaches?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Did you know that sinus infections rarely cause 
chronic headaches? At the American Council for 
Headache Education, achenet.org, there is a great 
supply of resources and explanations for what 
causes headaches. If you are not sure whether that 
nagging headache is a migraine, "tension-type 
headache," cluster headache, a transformed or 
"progressed" migraine (this was a new one for 
me!), a rebound headache or one from TMJ syndrome, 
then visit: 

What causes headaches?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

A lady goes to the doctor to see about getting a 
facelift. "Well," says the doctor, "I can do the 
facelift, and then you'll have to come back in six 
months for another follow-up procedure." 

"Oh, no." the woman replies. "I want it all done 
in one shot.  I don't want to have to come back."  

The doctor thinks for a second, then offers, 
"There is a new procedure where we put a screw in 
the top of your head. Then anytime you see 
wrinkles appearing, you just give it a little 
turn, which pulls the skin up and they disappear." 

"That's what I want!" exclaims the lady. "Let's do 
that." 

Six months later the lady charges into the 
doctor's office. "Well, how's the procedure 
holding up?" the doctor asks. 

"Terrible!" the lady bellows. "It's the worst 
mistake I've ever made!" 

"What's wrong?" asks the doctor.  

"Just look at these bags under my eyes!" she 
hollers. 

"Lady," the doctor reports, "those aren't bags, 
those are your breasts, and if you don't leave that 
screw alone, you're going to have a beard!" 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you 
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



Back to top


***** Woman's Diagnostic Cyber Newsletter *****
                 May 30, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. Common simple emergencies
2. Sexual desire in the third age 
3. Evaluation of excessive hair growth (hirsutism)
4. Traffic accidents and sedatives/antipsychotics
5. Age at menopause and heart disease risk
6. Humor is healthy

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Common simple emergencies
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Have you ever run into a situation where someone 
gets a foreign body in the eye or a child has 
something stuck up a nose? What about an avulsed 
tooth, a neck muscle strain, a foreign body beneath 
a nail or a ring you cannot remove? Although 
written for doctors as to how to handle some of 
these emergencies and others, you may find the 
descriptions and treatments useful in a "pinch". 

Emergency situations

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Sexual desire in the third age
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Thirdage.com is a site devoted to a specific age 
group, i.e., that age between young and old. In 
other words, babyboomers in the 40's 50's and 
60's. There is an interesting set of articles 
about "peak sex" or how sexual desire seems to 
change as we age. 

Not all of the articles are great but the ones 
below are worth looking at: 

Still Sexy After All These Years
Sexual Desire: Who Wants to Want?
SexQuiz: Where Did My Sex Drive Go?

Peak sex in your third age

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Evaluation of excessive hair growth (hirsutism)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

If women have coarse dark hairs on their arms and 
legs, that is usually due to genetics or their 
ethnic background. If the increased growth is in 
the midline such as the chin or face or the pubic 
hair up toward the navel, then that is called 
hirsutism and may be due to excessive male hormone 
like substances in the blood. Sometimes the ovary 
may be producing too much testosterone and 
sometimes the adrenal gland may be over producing 
androgens. If your doctor says the hormone levels 
are normal but you still want to reduce excess 
hair growth, there are things that can be done. 

See our article at:

Evaluation of excessive hair growth

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Traffic accidents and sedatives/antipsychotics
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

At the journal club of the American College of 
Physicians, a discussion of an article that shows 
an increased association of first traffic 
accidents with the use of certain medications 
caught my interest. There was an increased risk 
with the use of benzodiazepines (Ativan, Halcion, 
Klonepin, Librium, Restoril, Serax, Tranxene, 
Valium, Xanax) but not with tricyclic 
antidepressants, (Elavil, Etrafon, Limbritrol, 
Norpramin, Pamelor, Sinequan, Tofranil, Triavil) 
or with selective serotonin-reuptake inhibitors 
[SSRIs] such as Paxil, Prozac, Zoloft. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Age at menopause and heart disease risk
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

For a while it has been suspected that earlier 
menopause (natural) is a risk factor for 
cardiovascular disease. In the study below 
reported in the Archives of Internal Medicine, the 
authors looked at the large nurses' health study 
(35,616 naturally postmenopausal women who never 
used estrogen replacement therapy) and indeed 
found that the earlier the age of menopause, the 
more the risk for cardiovascular disease. 
Interestingly there was no increased risk of 
thrombotic or hemorrhagic stroke with earlier 
menopause. 

If menopause was less than age 40 or age 40-45, 
the risk ratios were 1.53 and 1.42 compared to 
menopause at age 55. 

Age at menopause and heart disease risk

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Note: Because I live in the South, I think I can 
safely send out this joke! 

Advice for Yankees Moving South

1. Save all manner of bacon grease. You will be 
instructed later how to use it. 

2. If you forget a Southerner's name, refer to him 
(or her) as "Bubba." You have a 75% chance of 
being right. 

3. Just because you can drive on snow and ice does 
not mean we can. Stay home the two days of the 
year it snows. 

4. If you do run your car into a ditch, don't 
panic. Four men in the cab of a four wheel drive 
with a 12-pack of beer and a tow chain will be 
along shortly. Don't try to help them. Just stay 
out of their way. This is what they live for. 

5. Don't be surprised to find movie rentals and 
bait in the same store. 

6. Do not buy food at the movie store.

7. If it can't be fried in bacon grease, it ain't 
worth cooking, let alone eating. 

8. Remember: "Y'all" is singular. "All y'all" is 
plural. "All y'all's" is plural possessive. 

9. Get used to hearing, "You ain't from around 
here, are you?" 

10. Don't be worried that you don't understand 
anyone. They don't understand you either. 

11. The proper pronunciation you learned in school 
is no longer proper. 

12. Be advised: The "He needed killin'" defense is 
valid here. 

13. If attending a funeral in the South, remember, 
we stay until the last shovel of dirt is thrown on 
and the tent is torn down. 

14. If you hear a Southerner exclaim, "Hey, y'all, 
watch this!" stay out of his way. These are likely 
the last words he will ever say. 

15. Most Southerners do not use turn signals, and 
they ignore those who do. In fact, if you see a 
signal blinking on a car with a Southern license 
plate, you may rest assured that it was on when 
the car was purchased. 

16. Northerners can be identified by the spit on 
the inside of their car's windshield that comes 
from yelling at other drivers. 

17. Satellite dishes are very popular in the 
South. When you purchase one it is to be 
positioned directly in front of your trailer. This 
is logical bearing in mind that the dish cost 
considerably more than the trailer and should, 
therefore, be displayed. 

18. Tornadoes and Southerners going through a 
divorce have a lot in common. In either case, you 
know someone is going to lose a trailer. 

19. Florida is not considered a Southern State. 
There are far more Yankees than Southerners living 
there. 

20. If you are cursing the person driving 15 mph 
in a 55 mph zone, directly in the middle of the 
road, remember, many folks learned to drive on a 
model of vehicle known as John Deere, and this is 
the proper speed and lane position for the 
vehicle. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you 
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



Back to top

Login to comment
(0 Comments)

Post a comment