women's health Archives - Page 3 of 11

Weight Gain and Hormonal Contraceptives

Published on June 8, 2016

4299 views

Once upon a time, a 26-year-old woman went to her doctor and asked to be put on the new birth control pill that allowed women to only have four periods a year. She had seen it advertised on television. Four months later, 15 pounds heavier and suffering from mild depression, she returned to the doctor feeling miserable. The doctor told her the weight gain and depression were not from the pill because those were not side effects of hormonal birth control. This left the young woman feeling like it was her fault she had gained weight. Needless to say, that didn’t help with the depression. But she switched back to her original birth control pill and lived happily (but heavily) ever after. Well, until it gave her a stroke two years later.

I’ve written a lot about my stroke and about blood clots and birth control pills, but there are many other side effects from hormonal birth control. More often than not, we are told that these side effects do not exist; that they are all in our heads. Are they? Or are we simply being ignored and lied to?

What Does The Research Show?

When researching my thesis, I was interested in finding out what women knew about the risks associated with birth control pills. I created a survey based on a published study by researchers in this field. The original study outlined which side effects were and were not associated with birth control pills. The survey used in my thesis demonstrated the following:

“When the women were asked to select which risk factors were associated with birth control pills, most women, 76.7% of the 313 who answered the question, selected blood clots. Weight gain, which is not considered a health risk or even a side effect of birth control pills, was the selection most chosen (79.9%).”

The number one answer most women chose was weight gain, yet all the research I read said that weight gain was not a side effect of birth control pills. My own doctor had told me it wasn’t a side effect when I stood before her 15 pounds heavier after switching pills. Even as I wrote my thesis, I wondered how we could all be so wrong. Well, it turns out we weren’t. The pill can cause weight gain. And they knew it could, even back in 1970. The following is testimony from the Nelson Pill Hearings.

Dr. Francis Kane (page 6453): [In a Swedish study of 344 women] Of the 138 women who stopped using the medication, weight gain and emotional disturbances were the most frequently reported, 26.1 percent and 23.9 percent.

Dr. Louis Hellman (page 6203): My private patients… come off the pill because of a host of minor reactions. The most prevalent one is weight gain. The modern American girl just does not want to gain 5 or 10 pounds if she can help it.

What About Today’s Birth Control Pills?

I took another look at what I could find out about weight gain and hormonal contraception now. According to WebMD:

“When birth control pills were first sold in the early 1960s, they had very high levels of estrogen and progestin. Estrogen in high doses can cause weight gain due to increased appetite and fluid retention. So, 50 years ago they may indeed have caused weight gain in some women. Current birth control pills have much lower amounts of hormones. So weight gain is not likely to be a problem.”

Maybe larger doses of hormones cause more weight gain. But I don’t think that means that smaller doses cause none. And what about taking that smaller dose for a decade or more?

Most current medical information dismisses weight gain completely. On the Mayo Clinic website’s FAQ page for birth control pills it says:

“Do birth control pills cause weight gain? Many women think so. But studies have shown that the effect of the birth control pill on weight is small — if it exists at all.”

That’s right, ladies. Just like your menstrual cramps, weight gain on the pill probably doesn’t exist. But wait, the Mayo Clinic says there are studies that show hormonal contraceptives don’t cause weight gain. Where are these studies?

Inconclusive? Or Incorrect?

A recent meta-analysis (2014) conducted by Cochrane (an independent group that reviews randomized controlled trials and organizes medical research information) found the following:

Available evidence was insufficient to determine the effect of combination contraceptives on weight, but no large effect was evident. Trials to evaluate the link between combination contraceptives and weight change require a placebo or non-hormonal group to control for other factors, including changes in weight over time.

You mean to tell me in the 40+ years since the Nelson Pill Hearings we haven’t been able to conduct one conclusive study to determine how hormonal contraception affects weight? Perhaps it’s time to start asking why. All those studies that provided insufficient evidence, who funded them and who might stand to lose if they were conclusive? I don’t know for sure but I do know that one of the few things women fear as much as an unintended pregnancy is weight gain. Even the staunchest feminists among us often fret over our figures.

According to Naomi Wolfe’s The Beauty Myth, “thirty-three thousand American women told researchers that they would rather lose ten to fifteen pounds than achieve any other goal.” Setting aside how disturbing that is, we can easily see how the fact that hormonal birth control can cause weight gain might adversely affect the pharmaceutical industry’s bottom line (pardon the pun).

At the Nelson Pill Hearings, there were at least a half dozen experts–doctors specifically chosen to testify before Congress–that mentioned weight gain as a side effect of the birth control pill. Including ones who admittedly worked for the pharmaceutical industry. But now, nearly five decades later, the research is inconclusive. Doctors are telling patients that hormonal contraceptives are not responsible for weight gain, yet 80% of women surveyed thought that weight gain was a side effect. Like so much surrounding the pharmaceutical industry, something doesn’t add up here. And who is paying the difference? Women. Yet again we are being told that it’s all in our heads. Have you had experience gaining weight on hormonal birth control?

Further Testimony on Weight Gain

This testimony from the Nelson Pill Hearings just scratches the surface of the side effects caused by hormonal contraceptives. I’ll be expanding more on a lot of this testimony in future articles. But perhaps Dr. Victor Wynn explained most succinctly how these side effects manifest when he testified (page 6303):

When I say these changes occur, I mean they occur in everybody, more in some than in others, but no person entirely escapes from the metabolic influence of these compounds. It is merely that some manifest the changes more obviously than others.

Dr. Robert Kistner (page 6082): I tell her about the side effects plus a weight gain edema and I may even give her a prescription for this.

Dr. John Laragh (page 6165): We do not have any firm clues. But it does look as though those who accumulate salt and water and gain weight on the oral contraceptives might be especially vulnerable [to increased hypertension].

Dr. Francis Kane (page 6449): Complaints of moodiness, being cross and tired, alterations in sexual drive, weight gain, edema, and insomnia were commonest in the group using the estrogen-progestin group.

At the hearings, Dr. Herbert Ratner (page 6737) was asked by James Duffy, minority council:

Mr. Duffy: You use the word “disease” here. Disease to me seems to be a pretty strong word and I am just curious why you would consider weight change to be a disease?

Dr. Ratner: You realize that obesity is one of our major problems in this country.

Real Risk Study: Birth Control and Blood Clots

Lucine Health Sciences and Hormones Matter are conducting research to investigate the relationship between hormonal birth control and blood clots. If you or a loved one have suffered from a blood clot while using hormonal birth control, please consider participating. We are also looking for participants who have been using hormonal birth control for at least one year and have NOT had a blood clot, as well as women who have NEVER used hormonal birth control. For more information or to participate, click here.

The Hidden Heart Disease Risk Factor: High Homocysteine

by Susan Rex Ryan

Published on February 19, 2016

7130 views

You may unknowingly have a ticking time bomb for heart disease flowing through your body. Right now. And you haven’t been told about it. Until now. Naturally produced in your body, a chemical substance called homocysteine often becomes elevated due to age, diet, and genetic disposition. If your homocysteine is high, you are at an increased risk of developing heart disease including heart attacks, coronary artery diseases, and strokes.

Staggering Mortality Rates

Heart disease is the number one cause of death worldwide. More than 17 million people—nine million of whom are women–die annually from heart disease.

In the United States heart disease ranks as the top killer of women. More than 500 American females die daily from heart disease. Furthermore, heart disease deaths in American women under the age of 55 continue to rise, according to a study published in the June 2013 issue of the journal Global Heart.

Why are so many people dying from heart disease? We have been educated to believe high blood pressure, high LDL cholesterol, and smoking are the primary causal culprits in causing heart disease. Physical inactivity, obesity, and excessive alcohol use also are attributed as risk factors for heart disease. But we hear little information about homocysteine as an independent factor for heart disease.

What is Homocysteine?

Homocysteine is an amino acid (a building block of protein) naturally produced in the body from a byproduct of another amino acid called methionine. Healthy amounts of homocysteine are vital in protein metabolism. However, homocysteine levels must be carefully balanced by adequate quantities of specific B vitamins.

Ideally, about half of homocysteine is recycled back into methionine (remethylation), and the other half is converted into a beneficial amino acid called cysteine (transsulfuration). This bifurcated process is dependent on specific B vitamins. Remethylation cannot occur without folate (vitamin B9) and vitamin B12. Transsulfuration cannot happen without vitamin B6. If these B vitamins are deficient, dangerous levels of homocysteine can accumulate in the body and damage the lining of the arteries, often causing heart disease.

Homocysteine Matters

In the late 1960s, Kilmer S. McCully, M.D., a young pathologist at Harvard University School of Medicine, reviewed a number of pathological findings of cases as far back as 1933 that involved young children with a genetic disorder who perished from atherosclerosis (hardening of the arteries). He discovered that elevated homocysteine damages arterial lining, causing arterosclerosis. Dr. McCully concluded that elevated homocysteine from a high animal-protein diet, more so than fats and cholesterol, was the primary cause of heart disease.

McCully subsequently published his ground-breaking conclusion in a 1969 issue of the American Journal of Pathology. By purporting such an unorthodox theory, he committed medical heresy.(1) Harvard denied him tenure, effectively firing him. Undeterred, he forged ahead, conducting research on homocysteine. He still practices medicine in the United States today.

Thanks to Dr. McCully’s tenacious efforts over the past four decades, a plethora of studies supporting his theory have been published. Landmark studies from the mid-1990s contributed to mainstream medicine’s eventual, yet delicate, embrace of the fact that high homocysteine is significant risk factor for heart disease. This research includes:

As part of the acclaimed Framingham Heart Study, researchers from Tufts University examined 418 men and 623 women, ages 67 to 96 years, to study their homocysteine blood plasma levels as well as their vitamin intake including folate, vitamin B12, and vitamin B6. The Tuft research team concluded that people with homocysteine levels greater than 11.4 µmol/L have a significant risk of having a heart attack. These findings were published in the February 2, 1995 edition of the New England Journal of Medicine.

The results of a study conducted by The European Concerted Action Project, a consortium of doctors and researchers from 19 medical centers in nine European countries, clinched the theory that Dr. McCully asserted almost two decades prior. By comparing 750 people under the age of 60 with blockages in their coronary arteries with 800 healthy persons also under 60 years old, the Project team determined that an elevated homocysteine score posed as great a risk as smoking or high cholesterol. Furthermore, people with the highest homocysteine levels had twice the risk of developing heart disease. Finally, the consortium discovered that those people who took folate, B12, and B6 supplements had a risk factor of about 66 percent less than those subjects who did not take the B vitamin supplements. The findings were published in the June 11, 1997 issue of the Journal of the American Medical Association.

What is a Healthy Homocysteine Level?

Homocysteine levels are easily evaluated by a simple test of blood plasma. Heath care practitioners can order a homocysteine test. But guess what? We are not routinely tested for homocysteine. In fact, I never had been tested for this important amino acid until I recently requested the test from my primary care physician. (Read on for my homocysteine score.)

To further exacerbate the issue of homocysteine evaluation, many clinical testing laboratories consider a healthy homocysteine value between 5 and up to 15 µmol/L. However, the upper limit of this range is highly misleading. A score of 6 µmol/L or less is optimal for homocysteine. Medical research has indicated that readings greater than 9 µmol/L indicate an increased risk for heart disease.

Reducing Homocysteine

The good news is that elevated homocysteine levels can be decreased by consuming adequate amounts of the B vitamins folate, B12, and B6. Although the daily dosage of these vitamins is dependent upon your homocysteine score, I offer general guidelines.

Foods rich in folate include wheat germ, lentils, sunflower seeds, spinach, broccoli, and romaine lettuce. If you are considering a supplement, note that “folate” is natural and “folic acid” is synthetic. Consider taking a daily 400-mcg folate capsule containing L-5-MTHF. (2)
The best food sources of vitamin B12 include sardines, oysters, cottage cheese, and tuna. When supplementing with B12, please ensure the B12 is methylcobalamin (methylB12). Many B12 supplements contain cyanocobalamin; yes, it contains a cyanide molecule. Consider taking 10,000 mcg daily of methylB12.
Fish and lean meats are excellent sources of vitamin B6 (pyridoxine). Consider taking a 25-mg B6 supplement.

You may recall that the amino acid methionine produces homocysteine. Too much methionine translates to excessive homocysteine. As animal protein is highly rich in methionine, it is wise to not overload animal protein consumption if the three major B vitamins are deficient.

Stunning Health Statistics

The scope of this article is limited to a brief discussion of elevated homocysteine as an independent risk factor for heart disease. However, I must tell you that homocysteine levels also affect the risk for developing a wide range of other serious medical conditions including cancer, diabetes, thyroid disorders, and Alzheimer’s disease. Let’s take a broad look at statistics.

Nestled in the spectacular western fjords of Norway, the University of Bergen houses one of the world’s leading homocysteine research centers. Since the 1990s, Bergen’s researchers have published dozens of papers reporting their homocysteine findings conducted during the University’s population-based Hordaland Homocysteine Study.

Having measured the homocysteine levels of 4,766 Norwegian men and women in their 60s a decade ago and then recorded those who lived and died, the researchers discovered that a 5-point decrease in homocysteine scores predicted, inter alia, a 50 percent reduced risk of death from cardiovascular disease as well as a 104 percent decreased risk of mortality from any disease or medical condition other than heart disease or cancer!

Are You Homocysteine Healthy?

It is not too early or too late to learn your homocysteine score. At the age of 60 and with a family history of heart disease, I requested a baseline homocysteine blood plasma test from my doctor. My score was an optimal 6µmol/L, a value that is most common in preteens! I attribute my homocysteine health score to feeding my body the folate, B12, and B6 it needs to maintain a balanced level of homocysteine.

Your level will not only predict your risk for heart and other serious diseases but it will help you understand how you can add energy and vitality to your life. Based on your homocysteine score, you can supplement with the necessary foods and/or dietary supplements that are readily available in retail and online outlets. And enjoy the benefits of being homocysteine healthy! I am glad than I am.

Footnote 1: Natural vitamins cannot be patented. Therefore, manufacturing and selling vitamins is far less lucrative than, for example, statins (cholesterol-lowing drugs.)

Footnote 2: The enzyme MTHFR (methylenetetrahydrofolate reductase) helps to facilitate the conversion process of remethylation.

Author’s Note: I wrote this overview to promote awareness of the potential heart disease risks associated with high homocysteine plasma levels. I briefly touched on the adverse effect of elevated homocysteine on the development of other serious medical conditions. If you are interested in learning more about homocysteine, I suggest reading: The H Factor Solution by James Braly, M.D. and Patrick Holford and/or The Homocysteine Revolution by Kilmer McCully, M.D.

Editor’s Note: Susan Rex Ryan is the author of the Mom’s Choice Award®-winning book Defend Your Life about the extensive health benefits of vitamin D. For additional information about vitamin D, check out our series of Sue’s articles, and visit her blog at smilinsuepubs.com.

This article was published previously on Hormones Matter in June 2014.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

Maternal Vitamin D: Pregnancy and Beyond

by Susan Rex Ryan

Published on December 16, 2015

7633 views

Researching the role of vitamin D in pregnancy for this article, I unexpectedly blew inches of virtual dust from a page of medical correspondence published almost seven decades ago. With keen interest I read “Vitamin-D Requirements in Pregnancy,” published in a 1947 edition of the British Medical Journal. The author Edgar Obermer, MD asserted the necessity for English pregnant women to supplement with robust daily doses of vitamin D.

Perhaps Dr. Obermer was ahead of his time, or today we are behind in understanding the power of vitamin D. I think both are true. Nonetheless, his assertion about relatively high maternal vitamin D doses accentuates vitamin D’s importance during pregnancy. Today pregnant women typically supplement with prenatal vitamins, most of which only contain enough vitamin D to prevent rickets.

Unfortunately, taking prenatal vitamins without supplementing with extra vitamin D provides expectant mothers with a false sense of health for their babies and themselves. In this article, I address vitamin D’s role in pregnancy, recent evidence supporting the positive effect of vitamin D on expectant moms and their babies, and vitamin D supplementation guidelines for pregnant and lactating women and their infants.

A Healthy Pregnancy

Many people may not realize that vitamin D is actually a steroid hormone produced in our body. We manufacture vitamin D when we take a quality vitamin D3 supplement, expose our skin to optimal sunlight, or consume lots of wild-caught fatty fish or vitamin D3-fortified foods.

The female reproductive system comprises billions of cells. Every cell in the female reproductive system contains genetic codes as well as a receptor to receive vitamin D. Cells in the female reproductive system (including the ovaries, fallopian tubes, uterus, placenta, decidua, vagina, and breasts) are replete with vitamin D receptors.

When we have ample amounts of activated vitamin D in our cells, the vitamin D binds with its receptor to regulate genes in our reproductive system. For example, the vitamin D pathway genes affect in utero fetal development. Conversely, when the female reproductive system lacks activated vitamin D, genes essential to a smooth pregnancy and sound fetal health are not expressed.

Mom Needs Nutrients for her Health

Vitamin D is vital to a pregnant women’s health. An expectant mom with adequate vitamin D levels may enjoy a reduced risk of pregnancy complications including preeclampsia, gestational diabetes mellitus, Caesarian section, and preterm birth. However, low vitamin D blood serum levels are common in pregnant women.

The recent findings of a Canadian study published in the December 2014 edition of the journal Current Opinion in Obstetrics and Gynecology once again accentuate the importance of vitamin D to maternal health. Lead researcher Shu-Qin Wei, MD, PhD examined scientific evidence of the role of maternal vitamin D on pregnancy outcomes. Focusing on studies published between January 1, 2013 and July 1, 2014, she concluded: “Recent evidence supports that low maternal vitamin D status is associated with an increased risk of adverse pregnancy outcomes. Interventional studies demonstrate that vitamin D supplementation during pregnancy optimizes maternal and neonatal vitamin D status.”

A Seed for Healthier Babies

Vitamin D is vital to fetal bone and cell development. Medical research suggests some seeds for disease are sown before birth. Low vitamin D during pregnancy may be one of those seeds. Babies born to mothers with a vitamin D deficiency are more likely to develop a number of medical conditions including asthma; autism; soft bones (rickets, craniotabes); brain disorders; cardiovascular malformation; and type 1 diabetes mellitus.

A new study highlights the benefit of vitamin D to fetal skeletal development. Dutch researchers explored the effect of vitamin D supplementation during pregnancy and early infancy on skull formations. The scientists recommended that women in their last trimester and early infants take a daily vitamin D dose of 400 international units ((IU) albeit a small amount). The research team found that non-adherence to their recommendations for vitamin D supplementation by pregnant mums and infants is linked to an increased risk of skull deformities in babies at 2 to 4 months of age. This study was published in a November 2014 issue of the journal Maternal & Child Nutrition.

Labor, Lactation, and Early Infant Life

Vitamin D also plays a beneficial role regarding labor pain, breastfeeding, and early infant health.

Labor. The benefits of maternal vitamin D have recently been extended to decreased labor pain. In October 2014, Andrew W. Geller, MD, a physician anesthesiologist at Cedars-Sinai Medical Center in Los Angeles, presented a study about vitamin D‘s effect on labor pain to the American Society of Anesthesiologists’ annual meeting. Dr. Geller and colleagues measured the vitamin D levels of 93 pregnant women prior to delivery. All of the patients requested an epidural for pain during labor. The research team then measured the doses of pain medication required by each woman during labor. They compared the quantity of pain medicine consumed by women with higher vitamin D levels with those with lower vitamin D status. The patients with lower vitamin D levels used more pain drugs than those women who enjoyed higher vitamin D status. Dr. Geller concluded that “prevention and treatment of low vitamin D levels in pregnant women may have a significant impact on decreasing labor pain in millions of women every year.”

Lactation. Nature intended for newborns to obtain their nutrients, including vitamin D, from breast milk. Breastfeeding provides babies with the vitamins and minerals required for healthy development. That’s why it is imperative that lactating mums supplement daily with adequate vitamin D. Vitamin D supplementation guidelines are discussed in the next section of this article.

Early Life. Vitamin D is important to all stages of life including neonatal. The growth and development of an infant is associated with the vitamin D intake during pregnancy.

Recent research from the University of Southampton in the United Kingdom suggests that young children are likely to develop stronger muscles when their mums enjoyed a higher level of vitamin D during pregnancy.

The connection between vitamin D levels and muscle strength has been well-established by the scientific community. However, the Southampton study, published in the January 2014 issue of the Journal of Clinical Endocrinology and Metabolism, marks the first time that the relationship between maternal vitamin D status during pregnancy and the muscle development and strength in offspring was examined.

Led by Nicholas Harvey, PhD, the researchers measured the vitamin D levels in 678 mothers from the Southampton Women’s Survey in their later stages of pregnancy. Four years after the babies were born, the Southampton team measured their hand-grip strength and muscle mass. The researchers found that the higher the levels of vitamin D in the mother, the higher the grip strength of her child. A secondary finding addressed a lesser connection between maternal vitamin D and the child’s muscle mass. The Southampton study’s outcome suggests more far-reaching health benefits. Dr. Harvey commented,

“These associations between maternal vitamin D and offspring muscle strength may well have consequences for later health; muscle strength peaks in young adulthood before declining in older age and low grip strength in adulthood has been associated with poor health outcomes including diabetes, falls, and fractures. It is likely that the greater muscle strength observed at four years of age in children born to mothers with higher vitamin D levels will track into adulthood, and so potentially help to reduce the burden of illness associated with loss of muscle mass in old age.”

Supplementation Guidelines for Mum and her Newborn

The importance of vitamin D supplementation cannot be overstated for the health of mothers and their infants.

British nutrition expert Sara Patience, author of the new book Easy Weaning, stated, “It’s important for mums to understand that their baby will be born with the same vitamin D status as themselves, therefore, if mum is vitamin D deficient during pregnancy, baby will be too. Women, who are pregnant, or planning to become pregnant, should ensure they are vitamin D sufficient, not only to protect their own health, but also to protect the health of their baby.”

The most effective source of vitamin D3 (cholecalciferol) is an oil-based soft gel or liquid supplement. Vitamin D3 supplements (usually measured in international units) are available over-the-counter in retail and online stores. Beware of vitamin D prescriptions as most contain vitamin D2 (ergocalciferol) that is much less effective than vitamin D3.

How much vitamin D a pregnant woman (or anyone, for that matter) needs continues to be a topic of debate.

First, let’s consider Dr. Obermer’s surprising recommendation in 1947. Remarking that the subject of vitamin D supplementation in pregnancy “is a difficult and complex one,” he concludes, “In a climate like that of England every pregnant woman should be given a supplement of vitamin D in doses of not less than 10,000 i.u. per day in the first 7 months, and 20,000 i.u. during the 8th and 9th months.” (Note: England’s distance from the equator denies its residents from enjoying optimal sun light exposure during the majority of the year.)

Second, a few noted organizations recommend daily intake of vitamin D for pregnant women as follows:

Vitamin D Council: 4,000-6,000 IU (Upper limit: 10,000 IU)
Endocrine Society: 1,500-2,000 IU (Upper limit: 10,000 IU)
Institute of Medicine (IOM): 600 IU (Upper limit: 4,000 IU)

It is interesting (and refreshing) to note that the Vitamin D Council and the Endocrine Society’s “upper limit” recommendations almost mirror those of Dr. Obermer’s. Please note that the IOM’s Food and Nutrition Board’s controversial recommendations, announced four years ago, were largely based on nutritional requirements for bone health. Most vitamin D experts agree that the IOM’s guidelines are woefully low with regard to vitamin D and way too high concerning calcium. Moreover, the intake of magnesium and vitamin K2 (vitamin D co-factors) was not addressed by this IOM panel.

According to the Vitamin D Council, if you are lactating and taking 6,000 IU of vitamin D daily, your breast milk should have enough vitamin D for your baby. If you are taking less than 5,000 IU of vitamin D a day, you should give your baby a daily vitamin D supplement (quality vitamin D3 drops are widely available).

Daily supplementation guidelines for babies include:

Vitamin D Council: 1,000 IU (Upper limit: 2,000 IU)
Endocrine Society: 400-1,000 IU (Upper limit: 2,000 IU)
Institute of Medicine: 400 IU (Upper limit: 1,000-1,500 IU)

Why risk pregnancy and neonatal complications? Vitamin D supplementation is a safe, inexpensive, and effective approach to a smooth pregnancy and birth of a healthy baby.

**This article is a companion post to “Improving Male and Female Fertility with Vitamin D”.

Editor’s Note: Susan Rex Ryan is an award-winning author who is dedicated to vitamin D awareness. Her extensive collection of health articles can be found on Hormones Matter as well as on her blog at smilinsuepubs.com Follow Sue on FB “Susan Rex Ryan” and Twitter @vitD3sue.

This post was published previously in December 2014.

Listening to Patients – A New Opportunity for Medical Science

by Chandler Marrs, PhD

Published on August 10, 2015

3508 views

Over the last several weeks I have been struck by the growing chasms in modern medicine. I see battles between physicians and patients, physicians and technology, physicians and bureaucracy and between the entire healthcare industry and health itself. The chasms are particularly deep in women’s health where so often serious health issues are written off as psychosomatic or with medication safety and efficacy where obvious side-effects are routinely discounted as not possible despite clinical and biochemical evidence to the contrary. Why is the physician not listening to patients? Why is he so quick to discount their suffering and attribute it elsewhere?

And then it occurred to me, within the doctor-patient relationship there has never been an impetus for the physician to listen to patients. The structure of modern medicine was built upon a presumption of physician authority and expertise that involved not listening but seeing. So what began as a post about listening to patients versus patient engagement (what the heck does patient engagement mean anyway), has evolved into a commentary on the eroding power of the physician and medical science in modern healthcare. Interestingly enough, I think the changes in modern medicine may finally permit, if not demand, listening to patients. Let me explain.

Listening to Patients: A Lost Art that Never Was

Historically, listening to patients has had, at best, a tenuous position in medicine. Some would argue that it was supplanted long ago by the physician’s all-knowing clinical gaze. The clinical gaze, a term used by French philosopher, Michel Foucault, is the ability to see correctly what is unseen, to bring to light and then describe the hidden truth of disease. It was what allowed the physician to penetrate the illusions of the non-scientific engendered by previous generations (16^th – 18^th century medicine) and to see the truth of the disease by correctly perceiving the signs and symptoms. The physician’s power of observation, his clinical gaze, aided by technology, gave him a vantage point inaccessible by mere mortals, and thus, incontrovertible.

The clinical gaze anchored modern medicine in a way that no other concept could. It brought with it the power to see truth, but also, to define it. No matter how potentially relevant to disease diagnosis, the patient’s truth or story could never replace the physician’s truth – the truth that was accessible only by him and through the all-knowing clinical gaze.

And so it was for most of the last century and a half, the physician was the arbiter of what was valid, of what could be seen and of what could be known about health and disease. The patient was no more than a body; living or dead, it did not matter. It was the job of the physician to perceive correctly what the body (not necessarily the patient) was showing him and then classify, communicate, and finally, treat appropriately.

From Medicine to Healthcare and the Physician’s Diminishing Autonomy

Despite the inherent tension between the patient’s experience of his or her disease and the physician’s discovery and classification of that disease, the interaction was private, between the physician and the patient. The degree to which the physician listened or did not listen to the patient, the correctness of the physician’s diagnosis and subsequent treatment decisions occurred within the confines of his practice. So long as the interaction was private, the physician remained the arbiter of disease; the clinical gaze his power and the patient his subject.

When the private became public, gradually at first (third party payer systems, pharmaceutical marketing) and then explosively, (the Internet), the clinical gaze, the lens through which disease was defined, refocused away from the patient and the disease itself and toward the economics.

The Interlopers

Managed care and third party payer systems unlocked the sacred space between the physician and the patient. The economics of his treatment decisions increasingly bore more weight than the accuracy or the clinical outcomes. The economic principles of the new managed care systems were skewed divergently. On the one hand, managed care demanded efficiencies of scale in the allotment of care – more patients, less time – but on the other hand, and simultaneously, rewarded physicians and other healthcare providers with fees for services instead of positive outcomes efficiently managed. The macroeconomic principles guiding healthcare decision-making, skewed and untenable as they were, gave the physician a modicum of authority. Even though managed care infiltrated every aspect of the doctor-patient relationship, it was still the physician who defined the disease. The clinical gaze remained somewhat intact.

That was until the pharmaceutical industry caught on and the definition of disease not only miraculously began to fit the latest, greatest drug, but also fit managed care payer guidelines. Some would argue that late 20^th century diseases and discovery emerged, not from the plight of human suffering, and certainly not from the powers of observation that once guided the physician’s clinical gaze, but by profit.

The physician, who at once held the power to see and define medical science, is now buried beneath a heap of competing and conflicting interests that are only cursorily related to the practice of medicine. There is no clinical gaze; no medical decision-making that rests solely upon his shoulders or within the space of the doctor-patient encounter.

And Then Came the Internet

The same technological advancements of the latter half of the 20^th century that allowed the physician to see more, also allowed others to see what he was seeing and to communicate those insights broadly. Once that private and controlled perception became public, the physician and the all-knowing clinical gaze, no longer wielded the same power it once did.

The primacy and indeed the privacy of what was once a sacred relationship between the doctor and the patient, was overrun by a ‘system’ of disease economics; one that no longer can be considered medicine, healthcare or even what those in those in anti-modern medicine movement call disease care. Instead, we have a ‘health’ economics built on a false precipice of industrialized, factory, efficiency and underlain with a bastardized model of free market capitalism – moral hazard. Indeed, the creative billing seen in the healthcare industry makes the financial derivatives scandals of recent history look downright tame by comparison.

Business Innovation Disguised as Medical Innovation

Nowhere in the current model is there room for listening to patients, for relationship, for health, for ethics or even for medicine itself. Arguably, the possibility for medical discovery, the kind that breaks paradigms and catapults the science forward, is also stifled in favor high profit blockbusters that are no more effective than the last one, gadgets that often fail to deliver measurable improvements in care but sure are fun to play with, and ever intrusive services that make healthcare more cost-effective – well, not really.

Business innovations designed to enhance spread sheets and enhance patient engagement do neither. Indeed, patient engagement is no more than a meaningless euphemism for medication compliance. If we can only engage the patient more effectively through this application or that, then we will ________ (insert promise), save healthcare, reduce costs, reduce hospital visits, save time. What patient engagement applications are really promising is to save the world from the pitifully unengaged or disengaged, burdensome, non-compliant patient. There is no doctor-patient relationship and can be no relationship within this model. Both the doctor and the patient are cogs.

From this perspective, it is no wonder that physicians lash out against patient empowerment, against electronic health records and other healthcare innovation. Each is a very real threat to an already diminished autonomy.

From Healthcare Back to Medicine: Listening to Patients Revisited

In spite of all the negatives of the entrenched medical-industrial complex (I hate that phrase, but it seems appropriate), there is hope. It rests not with ‘healthcare innovation’ that inevitably promises high returns, nor does it rest with the next great blockbuster drug. Rather, the survival of medical science rests within the space of the doctor-patient relationship. It is there, that when disengaged from the multitudes of competing interests, within that private moment, that the physician can unlock the next phase of medicine, the next great discoveries. It is there that he can listen to his patients.

The Necessary End of the Clinical Gaze

The clinical gaze as a power structure served its purpose in catapulting medicine from mystery and myth, but it was one-sided. It considered disease from an idiosyncratic lens solely within the physician’s control. This was both its strength and its downfall. Without feedback or resistance, it was easy for managed care and the pharmaceutical industry to invade this space and usurp the physician’s authority. All that was necessary was to learn the taxonomies and then redefine them to fit the economic needs of the vendors. New diseases, new drugs were viewed as medical advancements. Technology that standardized diagnostic criteria (or arguably loosened it so that most conditions would fit easily within many payer accepted categories), all but eliminated the need for the physician’s skills.

Had the internet not come along and opened the communication channels among patients, no one would be the wiser. With the internet, patients have become empowered and are rather loudly proclaiming their stake in this conversation. Patients search Dr. Google for diagnostic and treatment options, some sound, some not. They have formed groups and societies geared toward furthering education, research and strengthening their voices. Physicians have hereto ignored or chastised patients, lashing out against their new found empowerment, as if it were the patients and not the industry vendors, who displaced his vaulted position and redefined his diagnostic capabilities. No, it was not the patients who did this, but it is the patients who offer the physician a way back towards medical science – not the all-knowing, indisputable medical science of yesteryear, but the dynamic relational medical science of the next generation.

Listening to Patients as a Way Forward

Listening to patients provides the context and connections that can move medicine beyond an outdated and thoroughly usurped taxonomy of signs and symptoms that serves only to name and to limit or contain disease within an appropriately defined diagnostic category, to a space that can connect the larger patterns and the associations among diseases, health and environment. Physicians can lead this charge but only if and when they begin listening to their patients. It is the patients, not the industry, that hold the keys to the myriad of intractable diseases that plague modernity. Listening to patients, not patient engagement, but listening and trusting the truth of the patient’s experience of his or her disease, is the missing piece of the next great medical revolution.

This article was published previously in May 2013.

The Match Game of Healthcare That Works: Understanding Insurance

by Deb Andelt, JD

Published on March 4, 2015

2281 views

Understand What Insurance Is and Is Not

Finding healthcare resources – people, treatments, care – is a match game. Your quest is to find resources to partner with you to feel better, heal and experience the life you want to live.

Reading “match game,” the vision that probably came to mind involves perusing a list of “providers” your insurance company included in a thick volume of paperwork. Or maybe you wish you at least had an opportunity to have access to such a list. You see lists organized by “specialty” (which you may or may not understand) and geography; and you hope you can find someone with solutions for your needs – someone to help you feel better – from this paltry information.

The Traditional Match Game: The Insurance Company Sets the Playing Field For “Health”

Health insurance is not healthcare. Insurance is business. Health insurance is a payment system.

In the framework of the traditional match game, the insurance company sets the rules with four basic things: 1) a list of “providers” – people who meet the company’s contractual requirements; 2) a list of acceptable services (your “benefits”) the providers can offer for certain ailments; 3) acceptable fees for such services; and finally 4) a means to parse the payment/cost burden. This is so familiar that perhaps we didn’t even question this until prices sky rocketed and services diminished.

Playing the well-being match game within this familiar framework puts the insurance corporation in a position of power. Playing the match game this way immediately puts a corporation, a payment system, in control of your well-being. Through their contractual relationships they determine what constitutes health, who is allowed to serve your needs, and what treatments or medications are acceptable. Insurance companies narrow the field of possibilities and choices for your path to well-being.

By engaging in this match game we’ve been attempting to attain well-being from a system in which the rules have been set by companies that are focused on payment and profit. Pause and think about that for a moment. We have been lulled into looking to a payment system as a means to experience vitality.

You may have had very good success with this structure. While this may work well for some, and may work some times; for many it is a challenge to find care that works. That challenge can take a further toll on health.

In this traditional match game it is very difficult to insert your personal needs, values, and beliefs about health and well-being into the framework of a payment system. It can be a challenge to find the right partner in healing, the right practitioner, who supports your personal journey to live your best life.

Time To Shift the Paradigm

If it doesn’t work for many, if not most, people to look to a payment system as a means to experience well-being, what do we do? It requires a change in the fundamental nature of the match game. In the next article we’ll explore this shift. It begins with identifying your personal concept of the essence of health, well-being and healing. This will vary for each person, and can vary over time. This shift puts each person back into control of their health.

About the author: Deb is co-owner of Experience In Motion, which equips organizations with tools to curate meaningful experiences for customers and employees. Deb’s personal journey from decay to well-being inspired an emphasis in improving healthcare experiences for patients and practitioners by focusing on experiences that heal and self-caring as a way of organizational being. www.experienceinmotion.net.

Note: This is part of an ongoing series to equip you with a process, a path, to identify and experience healthcare that works for you. Other articles in this series are:

The heart of healthcare that works: know your personal worldview of health

Find your Inner Chris Columbus

Women Are Less Satisfied with Health Care Than Men – Why?

by Elena Perez

Published on January 29, 2015

2834 views

The New York Times reported that women are less satisfied with their health care than men, citing a study from Health Services Research.

Researchers could see an overall difference between men’s and women’s views, but these differences were even more prominent for particular questions. One question asked patients if they felt they received sufficient information for the medications they were prescribed, and the other question asked whether patients were satisfied with the cleanliness of the hospital.

In both cases, women were less satisfied with health care than men – significantly so. Now the question is, Why?

Perhaps women have just been paying attention to the news. Dr. Mark Hyman explains in the Huffington Post that postmenopausal women are being prescribed cholesterol-lowering medication that increases their chances of getting diabetes – by 71%.

This isn’t the only instance in which women’s health needs were overlooked:

Premarin was prescribed to postmenopausal women to prevent heart disease, but it increased their chances of having a heart attack.
Studies have found increased osteoporosis in postmenopausal women prescribed osteoporosis medication.
Women are prescribed medicine as though they’re men, yet they are more likely than men to have irregular heartbeats due to prescription cocktails.
Many doctors don’t realize that pain medication does not have the same impact on women as it does on men. Experiments show Ibuprofen did not reduce pain for women.
In fact, the Society for Women’s Health Research and Medco Health Solutions, Inc. presented a study that showed women are prescribed more medication than men, yet they are less likely than men to get the appropriate drug for their needs.
The Center for the Study of Sex Differences at Georgetown University in Washington, D.C. explains that your gender can significantly impact how your disease should be diagnosed and treated. Yet the FDA only required that women be included in drug research since 1993.

No wonder women are less satisfied with their health care than men.

Women Are Less Satisfied with Health Care Provider’s Cleanliness

As it turns out, women’s immune systems are more resilient than men’s. Even so, women are more susceptible to certain illnesses and diseases than men are. Some experts suggest a woman’s stronger immune system is the cause for her susceptibility to autoimmune disorders, but the reasons remain unclear.

Sharyn Clough, a philosopher of science at Oregon State University, explained on NPR how society’s emphasis on a girl’s cleanliness could impact her susceptibility to diseases when she gets older, since she may not be exposed to the same bacteria as young boys.

While this may, or may not, be the case, it makes sense for a woman to be more aware of the cleanliness of her environment if she was raised to do so. It is even more reasonable for a woman to consider the cleanliness of her surroundings if she is more susceptible to disease – especially when she is in an institution that treats the sick.

It’s important that health care providers know that women are less satisfied with their health care than men. Voicing our opinions raises awareness, and these industries don’t want to lose half of their market.

It’s entirely possible that women are less satisfied with health care than men because women pay more for health insurance than men – health care that seems to be specifically geared toward the needs of men, not women.

This post was published previously in April 2012.

Migraines and Hormones: Behind the Curtain

by Angela A Stanton, PhD

Published on December 15, 2014

7194 views

Before puberty, migraines are three times more frequent in males than in females but after puberty the tides turn and females are more likely to suffer from migraines than males. An Oxford study found that females are twice as likely to have migraines and that

“brains are deferentially affected by migraine in females compared with males. Furthermore, the results also support the notion that sex differences involve both brain structure as well as functional circuits, in that emotional circuitry compared with sensory processing appears involved to a greater degree in female than male migraineurs.”

The overwhelming belief is that the connection is clear: the hormones kick in for women at puberty and that must be the reason. This begs the questions: 1) Do males have the same hormonal problems before puberty as females do after puberty? If hormones are at root of the problems, then there must be some similarities, right? 2) If female hormones are responsible for migraines, do all females have migraines when they reach puberty? 3) Do migraines cease when hormones stop changing after menopause? 4) What about pregnancy or postpartum, how do hormones impact women then? And finally, 5) Do men stop having migraines after puberty?

Some of the answers to these questions will surprise you and may make you wonder if hormones have anything to do with migraines at all. In this post, I show you that while there are some connections between hormones and migraine they might not be the primary drivers of migraine. The relationship between hormones and migraine is not in the presence of hormonal changes but what those changes require in terms of brain energy, the lack of which causes migraines.

First, I would like to respond in quick the five questions I asked earlier: 1) Do males have the same hormonal problems before puberty as females do after puberty that causes them migraines? The answer to this is no. 2) If female hormones are responsible for migraines, do all females have migraines when they reach puberty? The answer to this also is no. 3) Do migraines stop after menopause? Many women have more migraines and some even start migraines in their menopause, so the answer is no. 4) Do migraine increase or decrease during pregnancy or postpartum? The answer is no during pregnancy, but yes postpartum. 5) Do men stop having migraines after puberty? No they do not.

It is not obvious that the cause of migraines must have anything to do with female monthly cycles and their associated hormones. Given also that many women have migraines after puberty, we are safe to assume that some other factors may play a role. It would be hard to envision a world full of children in which our evolutionary road took women to necessarily experience migraines with their menstrual cycles. So what is the connection to hormones; how do women end up with migraines; and why?

Rather than listing all the hormones that activate throughout the monthly cycle of a woman, let’s take a look at what is happening in the body of that woman backstage, during the hormonal changes. First, in a small review I cover in a few sentences what a migraine is.

Migraine is a collection of symptoms that have an underlying physiological mechanism based on chemical (ionic) imbalance in the brain. Migraine is a neurovascular event that Dr. Charles at UCLA called “spectacular neuro-physiological event” that changes the neurophysiology or chemistry of the brain itself. This can be seen using fMRI technology where oxygenation of brain regions shows where activity occurs during migraine—albeit this does not show why it occurs. The same article also suggests that though medications are available to treat the pain associated with migraines, half the sufferers do not receive any pain relief benefit from the drugs. I find this statement alone interesting because if migraine was truly understood, the pain medication would work for all. This clearly is not the case. To understand what is happening, we must think out of the box and leave behind the hormonal theory of migraines.

Moving Beyond the Hormone Migraine Theory

We now visit the female body all through a month. Let’s start two days after her menstrual cycle has ended. As female, we feel great, no pain, no bleeding, life is awesome. But what we don’t see works hard in the background using up important energy: the brain. Our hormonal changes are happening every moment of the day only we don’t feel it—hormonal changes are directed by the brain. Because we don’t feel the changes, we are ill-prepared for the inevitable day when it reaches a threshold point of not enough brain energy and the migraine starts. This typically happens 2-4 days prior to menses. I do not think migraines are caused by hormones, but rather they are triggered by the lack of energy available to the brain as the hormones cycle. When the brain runs out of energy, a wave of cortical depression begins in some part of the brain. This is what we feel as a migraine.

What actually happens that uses all that energy? After the menstrual cycle is over, the female body immediately prepares for the next menstrual cycle. There is no downtime for rest. The brain turns off one group of hormones and turns on others thereby manipulating how women see the world prior to and during estrus (fertile time). After a menstrual cycle is over, the brain turns on the estrogen to do a few things:

Prepare the uterus with a new fertile lining to accept the fertilized egg should one arrive and start a new life.
In order to make such fertilized egg happen, the egg must be prepared in the ovaries so hormones initiate the ripening of a new egg.
The woman’s body goes through amazing visible changes at this time of the month. If she had pimples, they magically disappear. If she was bloated, her bloating goes away. Her face becomes the most symmetrical it possibly can; the more symmetrical the more sexually appealing she becomes to the opposite sex.
She becomes extremely attracted to high testosterone males requiring her pheromones to change and to be able to sense a high testosterone pheromone male’s presence. This high testosterone attraction changes after estrus to attraction to low testosterone males for the safety of the child, should mating end in a baby.

With all this activity going on in the female body that she cannot feel, she is in danger of exceeding the threshold of brain energy-shortage without prior notice or preparation. The cost of all of these activities behind the curtains in the female body is very high in terms of brain energy and hydration. These are sex-hormonal functions that only exist for a certain period of time during the female life. Females are known to be born with all of their eggs they will ever ripen for possible babies. Only these eggs are not “ripe” at birth. Every month one egg ripens in one of two ovaries (sometimes in both and sometimes in none). This egg breaks out of the ovary and starts its journey down the ovarian tube where it either gets fertilized by a sperm or not. If the egg is fertilized, it attaches to the wall of the uterus lining—later to become the placenta of the baby—and a new life cycle begins in the mother-to-be. If however there is no sperm able to penetrate the egg, while it descends in the ovarian tube, the egg will have to be cleared from the uterus together with the nutritious blood vessel rich lining created. This happens with the menstrual bleeding. This we can see and feel.

My Theory: Why Hormone Changes are not the Cause of Migraines

As shown earlier, migraines are not equally present in everyone’s life. Other factors, such as genetic predisposition to sensory organ hyper sensitivities (SOHS) that require more energy, may be the cause. Recent research hints at ionic balance (meaning energy available for use) is crucial in maintaining optimal function and the slightest imbalance can cause major problems (Wei et al.).

When the body is tasked with demanding activities the cells responsible for completing those extra tasks are doing extra chores and need extra energy. The brain regulates the creation of extra hormones for the menstrual cycle. The brain manages the clearing of the uterus after the fertile layer was not used.

By the third day after the cycle, the brain is ordering an egg to ripen—this takes extra energy. This is a once a month event. The brain must have extra energy to complete this task. Ever tried to run a marathon on empty or run your car the extra mile without fuel in your tank? Not possible. Something must break. The brain is the logical one for those who are predisposed to SOHS. If their brain runs out of energy, the neurons cannot generate voltage and stop creating neurotransmitters that instruct the production of hormones in the body. This leads to cortical depression and migraine.

Migraine during Pregnancy

Hands up: how many of you had migraines during pregnancy? Up to 75% of migraineurs do not have migraines during pregnancy. Why you may ask? There is more than one reason for this. The first and most important reason is that while the mom-to-be is pregnant, she has no menstrual cycles so the brain has no monthly cyclical job and it need not use extra energy. Even if the pregnancy comes with a menstrual flow here and there—as it sometimes happens—there is no egg that ripens and there is no uterus layer to remove. It is only a bit of bleeding but no extra energy was needed by the brain for this menstrual flow.

The second important factor is that during pregnancy the mom-to-be seems is more cognizant of what her and her baby-to-be needs. She eat more, tends to eat what she craves and is less likely to be good-looking-body conscious during this time. Pickles with ice cream are famous cravings of women. All the nutrients the brain craves for re-creating energy and feed the brain to prevent migraines: salt, calcium, magnesium, and fat that converts to sugar in the brain.

Migraine during Postpartum

After giving birth nearly, nearly all women immediately revert to eating for a good looking body, lose all the baby fat, and get back into the size zero genes. They stop eating brain-healthy after pregnancy (they never realized they ate brain healthy the first place). Nearly all women return to their migraines postpartum as they return to their old dietary habits.

Post-Menopausal and Menopausal Migraines

We are often told that after we enter menopause or are post-menopausal, our migraines will disappear. Yet, I talk to many women, who have more migraines after their fertile period of life has passed. I am one of those women who experienced more migraines in menopause than in early life. Thus, being no longer fertile, no longer ‘hormonal’ does not mean that we become migraine free; further pointing to the lack of connection of migraines to hormonal fluctuations. In menopause, many women are still very body conscious and watch their dress size more than their health. Others, however, recognize the value of a body supporting diet that may not create a body to fit into such small jeans but may be healthier for an older woman. This second group probably stops experiencing migraines (like I did) whereas the first group remains dehydrated and lacks brain nutrition to work those SOHS brains. They end up continuing their migraines as they had them before.

Of course, we already know from my previous posts that migraines are genetic so not everyone abusing her body will end up as migraineur. To be migraine free, everyone, male or female, must follow the rules of brain fuel.

Fuel for Migraines (Hormonal or Not)

What exactly is the fuel for migraines of any kind? I am leading you back to the first post on migraine that tells you what nutrition the brain needs to return to energy and fuel-filled comfortable homeostasis. The brain works on electricity, which requires specific charge differences inside and outside the cell’s membrane. This voltage is created by salt (sodium and chloride) in ample supply. Sodium also retains water inside the cells for hydrations and opens the sodium-potassium gate to allow nutritional exchange. I am also linking you back to the second post on migraines that explains the anatomy of migraines and what actually happens when the brain in not in homeostasis. How a migraine starts is now visible in fMRI. If you follow the posts I linked to and read the book on how to prevent and fight migraines, chances are, you may never have to face another migraine in your life.

Sources:

Fighting the Migraine Epidemic; A complete Guide. An Insider’s View by Angela A. Stanton, Ph.D. Authorhouse, February 2014. https://www.amazon.com/Fighting-Migraine-Epidemic-Complete-Migraines/dp/154697637X/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=1518636023&sr=8-1
Why Women Suffer More Migraines Than Men by Patty Neighmond, NOR April 16, 2012 3:17 AM ET http://www.npr.org/blogs/health/2012/04/16/150525391/why-women-suffer-more-migraines-than-men
Her versus his migraine: multiple sex differences in brain function and structure by Maleki et al. BRAIN. 2012: 135; 2546–2559, http://brain.oxfordjournals.org/content/brain/135/8/2546.full.pdf
Hormones & desire Hormones associated with the menstrual cycle appear to drive sexual attraction more than we know. American Psychological Association By Bridget Murray Law. March 2011, Vol 42, No. 3 Print version: page 44 http://www.apa.org/monitor/2011/03/hormones.aspx
Human Oestrus by Steven W Gangestad, Randy Thornhill. The Royal Society, Proceedings B May 2008 http://rspb.royalsocietypublishing.org/content/275/1638/991
Ovulating Women are STRIPPING Men of their Money. Cal Poly Bio 502 class lecture notes article. A blog about human evolution, economics, and sexual physiology. Why do strippers make more money at different times of the month? By Hayley Chilton http://physiologizing.blogspot.com/2013/01/ovulating-women-are-stripping-men-of.html
Migraine and Children. Migraine Research Foundation http://www.migraineresearchfoundation.org/Migraine%20in%20Children.html
Prevalence and Burden of Migraine in the United States: Data From the American Migraine Study II; Richard B. Lipton, MD; Walter F. Stewart, MPH, PhD; Seymour Diamond, MD; Merle L. Diamond, MD; Michael Reed, PhD. Journal Headache; 646:657
Population-based survey in 2,600 women. Karli et al., The Journal of Headache and Pain October 2012, Volume 13, Issue 7, pp 557-565 http://link.springer.com/article/10.1007%2Fs10194-012-0475-0
Multisensory Integration in Migraine Todd J. Schwedt, MD, MSCI. Curr Opin Neurol. Jun 2013; 26(3): 248–253
Unification of Neuronal Spikes, Seizures, and Spreading Depression. Wei et al., The Journal of Neuroscience, August 27, 2014 • 34(35):11733–11743 • 11733

Quick News: HRT, Gallstones and Gallbladder Disease

by Chandler Marrs, PhD

Published on October 23, 2014

6124 views

Hormone replacement therapy or HRT, used by millions of women worldwide to minimize the severity of menopausal symptoms, is associated with increased risk of gallbladder disease necessitating surgery to remove the gallbladder. A recently published, very large (+70,000 women), longitudinal study assessed the risk for gallstones, gallbladder disease and gallbladder removal in women who used synthetic HRT medications either in patch or oral form.

The researchers found a significant increase in cholecystectomy – the surgical removal of the gallbladder as a result of complications related to gallstones in the women who used synthetic HRTs. The risk was was so high that researchers estimated that over five years, 1 in every 150 women who use HRT would require a surgery.

Over five years, about one cholecystectomy in excess would be expected in every 150 women using oral estrogen therapy without a progestagen, compared with women not exposed to menopausal hormone therapy.
Dr. Antoine Racine of South Paris University, study author

The study also showed that using oral, estrogen only HRT, as is more common in the US and UK than in France where the study was conducted, poses a greater risk for gallbladder disease than the either oral HRT with a progestogen or the transdermal HRT patch. Indeed, the transdermal and gel HRT formulas showed little increase in expected numbers of cholecystectomy. It should be noted that the increased gallbladder disease is in addition to the already well-documented increases in heart disease, stroke, breast cancer and blood clots. It may be time to reconsider synthetic HRT therapies and look toward more natural treatment options.

women's health - Page 3

What Does The Research Show?

What About Today’s Birth Control Pills?

Inconclusive? Or Incorrect?

Further Testimony on Weight Gain

Real Risk Study: Birth Control and Blood Clots

Related posts:

You might be interested in

Staggering Mortality Rates

What is Homocysteine?

Homocysteine Matters

What is a Healthy Homocysteine Level?

Reducing Homocysteine

Stunning Health Statistics

Are You Homocysteine Healthy?

We Need Your Help

Related posts:

You might be interested in

A Healthy Pregnancy

Mom Needs Nutrients for her Health

A Seed for Healthier Babies

Labor, Lactation, and Early Infant Life

Supplementation Guidelines for Mum and her Newborn

Related posts:

You might be interested in

Listening to Patients: A Lost Art that Never Was

From Medicine to Healthcare and the Physician’s Diminishing Autonomy

The Interlopers

And Then Came the Internet

Business Innovation Disguised as Medical Innovation

From Healthcare Back to Medicine: Listening to Patients Revisited

The Necessary End of the Clinical Gaze

Listening to Patients as a Way Forward

Related posts:

You might be interested in

Understand What Insurance Is and Is Not

The Traditional Match Game: The Insurance Company Sets the Playing Field For “Health”

Time To Shift the Paradigm

Related posts:

You might be interested in

Women Are Less Satisfied with Health Care Provider’s Cleanliness

Related posts:

You might be interested in

Moving Beyond the Hormone Migraine Theory

My Theory: Why Hormone Changes are not the Cause of Migraines

Migraine during Pregnancy

Migraine during Postpartum

Post-Menopausal and Menopausal Migraines

Fuel for Migraines (Hormonal or Not)

Sources:

Related posts:

You might be interested in

Related posts:

You might be interested in