Australian Women Seeking Vaginal Plastic Surgery

Many unmarried Australian women are seeking plastic surgery to improve the look of their vulva according to Dr. Colin Moore, a plastic surgeon who has been performing this kind of surgery for about 30 years.

Dental Care In Pregnancy Can Prevent Premature Labor

Gum disease has been found to cause heart disease because of the increased production of the C-Reactive Protein. The level of the C Reactive Protein decreases when the gum disease is treated. It is therefore interesting to find that a similar mechanism can affect the outcome of childbirth.

A recent study that appeared in the American Journal Of Obstetrics and Gynecology showed that gum disease can cause premature labor. Among 1020 pregnant women who were followed in pregnancy, 28.6% women with moderate to severe periodontal disease had preterm delivery as compared to 11.2% of women with no periodontal disease. The authors concluded that gum disease in pregnancy is a predictor of premature labor.

Hence dental care should not stop in pregnancy. It will be more prudent for women who want to get pregnant to see their dentist to give them a clean bill of dental health before they get pregnant.

Reference:

Offenbacher et al

Obst Gynec. 2006, 107:29-36

Hormone Replacement Therapy Linked To Ovarian Cancer.

Ovarian cancer is a deadly disease. Up till now there has not been any significant test to screen for the disease in its early stages. The recent finding from a British study that appeared in the Lancet is frightening since its use may have resulted in a thousand deaths since 1991. The study was from the million women study. 30% were current users of hormone replacement therapy and 20% were past users. Current users had 1-2 fold greater risk for ovarian cancer than never user. The highest risk was for serous tumors in women with epithelial cancer, with current users at 1.53 times the risk as never users. The consensus is that current advice to take estrogen replacement therapy will not change however women should take hormone replacement therapy for a short time.

Polycystic Ovarian Disease-A Common Health Hazard

Question:

I am a 28 year old married woman who has been trying to have a baby for the past 4 years. I have had 2 miscarriages within the first 6 to 8 weeks of my pregnancy. Recently my periods have become irregular and scanty, I am gaining weight at a fast rate. Over the past month I have gained 10 pounds of weight. I am growing hair on my chin and my belly wall. I also have zits on my face. It looks like I have a become a teenager all over again. What is going on with my body? Can I ever have a baby?

Answer:

You may have polycystic ovarian disease. I see many women your age with your symptoms. Most of them have polycystic ovarian disease. Your weight gain, increased hair growth, irregular bleeding and recurrent pregnancy loss are common in people with PCO.

The cause of polycystic ovarian disease is not known for sure. However, many people who are affected by the disease have increased male hormones which lead to insulin resistance. In the presence of adequate insulin levels the muscles for example cannot utilise the insulin available. The muscles need the insulin to help them use the blood sugar. The insulin resistance does not affect every tissue. Some tissues retain their sensitivity to the insulin while others like the muscles develop insulin resistance. The proteins that bind and carry the sex hormones decrease because they have been used to carry the excess male hormones floating in your body.The body compensates by increasing the production of more male hormones.

Women with PCO do not ovulate or if they ovulate they do so infrequently. They therefore have difficulty in getting pregnant. When they get pregnant they tend to have miscarriages, diabetes mellitus and high blood pressure.

I suggest you discuss your condition with your doctor. She may examine you and look for tell tale signs of PCO such as acne, increased facial and body hair, skin tags around your neck, velvety dark discoloration around your neck and under your breasts, increased hair on your anterior abdominal wall and your face, increased body mass index. She may do blood tests to exclude other diseases such as thyroid disease.

If you have polycystic ovarian disease, your doctor may give you metformin, which has been found to help treat PCO and decrease early pregnancy loss. If the metformin alone does not help you get pregnant, your doctor may add clomid. Your doctor may also give you the clomid alone without the metformin. You may have to stay on the metformin for at least 3 months when you get pregnant.

Your Obesity May be Genetic - Obesity Gene Discovered.

A recent article that appeared in the Journal, Science, showed the discovery of obesity gene. A UK research team, led by Dr Andrew Hattersley of Peninsula Medical School in Exeter, has discovered a gene variant that occurs in over half of people of European descent that they think helps to regulate the amount of fat in the body. Obesity is linked to diabetes mellitus. People with diabetes mellitus have a particular variant of an FTO gene which was also linked with increased body weight.

The variant making people fatter differed from the other version of the FTO gene by a single mutation in the DNA sequence. People with one copy of the "fat" FTO variant had 30% chance of being obese compared to people without the gene. Those carrying two copies of the variant had a 70% increased risk of being obese, and were on average 3kg (6.6lb) heavier than a similar person with no copies. This finding helps to understand why some people cannot loose weight in spite of all attempts to loose weight.

Cardio Pulmonary Resuscitation In Patients Who Have Had Recent Heart Attack. Is It Necessary?

Many people do not like to give mouth to mouth resuscitation to a stranger who has had a heart attack. A recent article in the Lancet, a British Medical Journal claims that mouth to mouth resuscitation is not necessary in heart attack victims because their blood contains enough oxygen to sustain them for several minutes until the heart recovers. Chest compressions are far better than rescue breathing which requires regular pauses in the chest compressions.

The authors believe the benefit from continuous chest compressions far outweighs that from so-called "rescue breathing", which necessitates regular pauses in the compressions. Studies show less than a third of people who collapse in public are helped by people because of the “yuk” factor. If people realize that they don’t have to give mouth to mouth resuscitation they will be more willing to help a heart attack victim. On the other hand near drowning patients will need chest compression and mouth to mouth resuscitation

"The forward blood flow that you get from pumping on the chest is so marginal that if you stop for anything it's bad for the brain," Gordon Ewy

Reference:

The Lancet 2007; 369:920-926

DOI:10.1016/S0140-6736(07)60451-6

Articles

Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study

SOS-KANTO study group

Maternal Fish Consumption in Pregnancy Provides “Brain Food” For Baby’s Brain

"Seafood is the main food source of omega-3 fatty acids, which are essential for optimum neural development. However, in 2004, the FDA and the Environmental Protection Agency advised women who were pregnant or might become pregnant to limit seafood intake during pregnancy to 340 g per week (less than three portions) to avoid exposure to trace amounts of neurotoxins, especially methylmercury"

Judith Groch

Many of my patients are afraid of eating fish because of the fear that they will ingest too much mercury to affect the developing baby's brain. This deprives them of the Omega 3 Acid that is good for the development of the baby's brain. It is therefore very encouraging that a recent Lancet article summarized in Medpage Today, showed evidence to the contrary. According to many pregnant women, this is serious enough for them not to eat fish in pregnancy.

"A U.S. survey showed that two-thirds of Americans believe that 1,000 to 100,000 U.S. children are poisoned by mercury from eating fish every year. In fact, Drs. Myers and Davidson said that there has never been even one child with prenatal mercury poisoning from consuming fish documented outside Japan." Judith Groch

Joseph Hibbeln, MD of the National Institute of Alcoholic Abuse and Alcoholism and colleagues, showed that:

"After adjustment, maternal seafood intake during pregnancy of less than 340 g per week was associated with an increased risk at age eight years of the child being in the lowest quartile for verbal IQ (no seafood consumption, odds ratio [OR] 1.48, 95% CI 1.16-1.90; some seafood, 1.09, CI 0.92-1.29; overall trend, P=0.004), compared with mothers who consumed more than 340 g per week. At seven years, low maternal seafood intake was also associated with an increased risk of suboptimum outcomes for prosocial behavior 1.44 (CI 1.05-1.97) for no seafood consumption versus more than 340 g/week. Overall, the investigators said, the higher the maternal seafood intake, the less likely the infant was to have a poor score. At ages up to 3.5 years, scores were also lower for fine-motor skills, communication, and social development, they reported. Maternal seafood consumption reached a mean of 235 g a week, resulting in estimated weekly intakes of zero to 15.6 g, and a mean intake of 1.06 g of omega-3 fatty acids a week. " Judith Groch

Hence it is important that pregnant women know that fish, the major source of Omega 3 Acid is important for the development of the baby's brain. The benefits far outweigh the risks of Mercury poisoning from seafood. A risk largely attributed to fatty fish.

"Additional source: The Lancet

Source reference:

Hibbeln, JR, et al "Maternal seafood consumption in pregnancy and neurodevelopmental outcome in childhood (ALSPAC study): an observational cohort study" Lancet 2007; 369: 578-585. "



"Additional source: The Lancet

Source reference:

Myers, GJ, Davidson PW "Maternal fish consumption benefits children's development" Lancet 2007; 369: 537-539."

Cancer Of The Ovary-Screening Test for Women Is In The Horizon

Ovarian cancer is one of the most difficult cancers to diagnose in its early stages. It does not have any specific symptoms and most patients are diagnosed in the advanced stages when the results of treatment are poor. On the other hand when they are diagnosed in its early stage the five year survival rate is about 90% as compared to 20% in the late stage.

Up till now there have not been any significant screening tests such as Pap smear to screen for cervical cancer. According to Alisa Leisa, MD of Yale University, a highly sensitive blood test comprising of six biological markers can be used to detect the disease in its early stages. The positive predictive value is 93% in the test population and a negative predictive value of 99.2%. Yale University is currently enrolling women at high risk of ovarian cancer and healthy controls.

Is Testosterone Too Much of a Good Thing for Women’s Health?

I see many women in my office complaining of decreased libido. Most of these women are in the middle age with its change in hormones and life's uncertainties. In our world we are used to taking medications for anything that bothers us. Many life changes can decrease women's desire for sex. However, tell the modern woman that her stress from the fear of loosing her job is causing her decreased libido and she will seek another physician who would be prepared to slap the testosterone patch on her without much protest. A recent article in the Star Tribune shows that testosterone is not a panacea for women suffering from decreased libido.