Female Care

A. Lanzirotti, K. W. Jones, T. W. Clarkson, and P. Grandjean

Introduction

Recently a National Academy of Sciences expert panel has reviewed the human health risks from methyl mercury in fish. Specifically, they reviewed three epidemiological studies on children prenatally exposed to methyl mercury (MeHg) in seafood. One study is located in the Faeroe Islands in the North Atlantic on a population whose exposure to MeHg is from consumption of fish and pilot whale meat. A second study, completed over 15 years ago, was located in New Zealand on people largely consuming ocean fish. The third study is located in the Seychelles Islands in the Indian Ocean where MeHg exposure comes from consumption of fish and barracuda.

All three studies included hair levels as one measure of the body burden of MeHg. All three studies used the average hair levels during pregnancy in their regression analyses comparing mercury levels in the mother with developmental measures in the children. Two studies, the Faeroes and New Zealand found adverse effects on child development whereas the Rochester study in the Seychelles did not. There it was found that the children were developing well with no evidence of any adverse effect from MeHg.
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Acne is a disorder of the skin caused by inflammation of the skin glands and hair follicles. The cause of acne is not completely understood, yet some factors, which may contribute, include heredity, hormones & bacteria.

What are the signs and symptoms?

Defined by severity, there are two types:

• Mild Acne – (“whiteheads” and “blackheads”) is caused by a plug of dead skin cells and oil in the canal that contains the hair, under the surface of the skin. Because the plugs are underneath the skin surface, scrubbing will not get rid of them. In fact, rubbing the skin or using harsh or abrasive soaps can irritate the skin and make the acne worse. Mild acne does not usually leave permanent marks on the skin.

•  Moderate to Severe Acne – causes large bumps (nodules) and cysts, which may lead to permanent scarring of the skin. With early and consistent treatment, however, such scarring can often be prevented.

What is the treatment for acne?

The treatment varies and depends on the type of acne. Appropriate and regular skin care is the 1st step.

•  Using the tips of your fingers (no washcloth or sponge, etc.) wash your face and other affected areas with a mild soap such as Purpose, Basis or Neutrogena, or with alcohol-free cleansing cream. Pat dry (DO NOT RUB) with a soft towel.

•  Avoid moisturizers and cosmetics. If they must be used, choose an oil-free or water based “non-comedogenic” and “non-acneogenic” cosmetic.

Medications prescribed will depend on the type of acne you have. Topical medications and oral antibiotics may be used alone or together. A topical medication might be an antibiotic lotion or gel (Clindamycin, Erythromycin, Tetracycline, Doxycycline or Minocycline) or a liquid or cream containing Benzoyl Peroxide or Retin A.

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Do you suffer from severe PMS symptoms? Up to 85% of women experience PMS symptoms before their menstrual periods with up to 10% experiencing such severe symptoms that they’re forced to miss time from work. Symptoms of PMS range from mood swings and irritability to physical symptoms such as bloating, headache, and fatigue. Although an effective prescription treatment that relieves all of the symptoms of PMS has yet to be found, there’s mounting evidence to suggest that diet may play an important role in treating severe PMS symptoms. The symptoms of PMS and diet appear to be closely associated according to the National Association for Premenstrual Syndrome who has developed dietary guidelines for women who suffer from this condition. An association between PMS and diet is also supported by several studies showing improvement in PMS symptoms when a premenstrual diet is followed. Here are some dietary changes that may improve severe PMS symptoms:

Premenstrual diet: Increase your intake of calcium and vitamin D

Increasing your calcium intake may be one of the most effective ways to relieve the symptoms of severe PMS. According to a study published by investigators at the department of Public Health at the University of Massachusetts, women who have higher intakes of calcium and vitamin D have a lower risk of PMS. Several other studies have shown a similar association. Although a definitive dose hasn’t been established, supplementing with 1,000 units of calcium, and 800 units of vitamin D under the supervision of your doctor may offer some benefit if you suffer from severe PMS symptoms. An even better strategy is to get your vitamin D and calcium from natural sources via exposure to the sun at least 15 minutes three to four days per week and consuming foods high in calcium.

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If you’re a woman it can be annoying and embarrassing to find you’re growing unwanted hair in places such as the abdomen, chest, and face. Not only is unwanted hair unsightly, it can sometimes be indicative of an underlying medical problem. What causes unwanted hair in women and what can be done about it?

Unwanted hair in women is the product of a group of hormones known as androgens. These are the hormones that give men their “manly” characteristics such as a deep voice, muscle mass, and, sometimes, hair on the chest. The best known androgen is testosterone. Women also produce a certain amount of androgens, although usually not as much as men. If too much androgen is produced by a woman or if her body is unusually sensitive to the effects of androgens, it can cause dark hair to grow on places it wouldn’t normally grow, a condition known as hirsutism.

Unwanted hair in women is not always a sign of a medical problem. Sometimes there’s a genetic basis for excessive body hair. Some medications can also cause hirsutism, including steroid based medications, as well as certain anti-seizure and anti-hypertensive medications. Your doctor should be able to tell you if the medications you’re on may be contributing to the problem.

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Menopause is a time of change and new opportunity. It can also be a time of challenge as the sweats and hot flashes so commonly experienced by women during this phase in their life must be dealt with. As more women choose to forgo hormonal therapy and face menopause naturally, nonprescription remedies are needed to help women get through this time comfortably. A natural hot flash remedy that has recently been studied is the use of acupuncture for treatment of sweating and hot flashes. Is acupuncture good for menopausal symptoms?

A study recently published in the medical journal Menopause looked at the role acupuncture may play in relieving the sweating and hot flashes associated with menopause. Postmenopausal women with symptoms of sweating and hot flashes were randomized to three treatment groups. One group received standard care, but no acupuncture. The second group received sham acupuncture in which they thought they were receiving acupuncture but only shallow needling was used. A third group received traditional Chinese medicine acupuncture. After two months of twice weekly therapy, the frequency of sweating and hot flashes experienced by the women were quantified. The results? The group receiving the sham acupuncture as well as the group receiving actual acupuncture both had a reduction in the frequency of sweating and hot flashes. In contrast, the usual care group did not.

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By Marie McCarren (author of american Diabetes association Guide To insulin & Type 2 Diabetes. She lives in Arnold, Md.)

There are now six classes of diabetes pills and several combination oral meds. Each has a different way of helping you control your diabetes.

About 90 percent of diabetes in the U.S. is the type 2 form, which occurs in most people after the age of 40.  Type 2 diabetes is increasing in young people, especially among those who are overweight, physically inactive, or have a family history of diabetes. Obesity is a major risk factor for diabetes. Upper-body obesity is a stronger risk factor for type 2 diabetes than excess weight below the waist. Regular physical activity can protect against type 2 diabetes, while a lack of exercise is a risk factor for developing diabetes.

if you’re a typical person with type 2, your blood glucose levels are high because you have:

# a pancreas that doesn’t make enough insulin to control your blood glucose
# a liver that releases glucose inappropriately
# muscle cells that don’t easily take in glucose
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If you are overweight, you are at risk for diabetes. And if you are a woman, you should know that diabetes can affect you differently than a man, particularly your heart.

Diabetes is on the rise, both in men and women, young and old. Some 16 million Americans have diabetes, about one-third of whom do not know it. More people than ever before are developing type 2 diabetes, mainly because of obesity and inactivity, the two major risk factors for this type of diabetes. Most women with diabetes have type 2 diabetes, which is more common in older people. Women who develop diabetes during pregnancy, known as gestational diabetes, are at increased risk of developing type 2 diabetes later in life.

Diabetes can lead to blindness, kidney failure, nerve damage that can result in foot or leg amputation, heart disease, and stroke . Special attention must be paid to this public health problem, particularly in women.

Did You Know That…

# About 90 percent of diabetes in the U.S. is the type 2 form, which occurs in most people after the age of 40.
# Type 2 diabetes is increasing in young people, especially among those who are overweight, physically inactive, or have a family history of diabetes.
# Obesity is a major risk factor for diabetes. Upper-body obesity is a stronger risk factor for type 2 diabetes than excess weight below the waist.
# Regular physical activity can protect against type 2 diabetes, while a lack of exercise is a risk factor for developing diabetes.

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In history, menopause and aging have not always been viewed negatively.  Women often greeted the absence of their period gladly; welcoming a time when they would be free of the burden of childbearing, their time and energy liberated for new things.  Many cultures have revered wise old women. They were sought out for healing or guidance. Not so in our times.  Now it is a put down to call something an old wives tale! It’s a way of saying that something is false, frivolous, or foolish.

First of all, are you really in menopause?  Menopause is defined as the end of your period.  For several years before that happens you will likely experience symptoms of perimenopause, which is the time when your hormones start wildly fluctuating, and your period becomes irregular.  Kind of like being a teenager again, only with wrinkles.

In modern culture menopause is viewed as a medical condition which can be treated.  Current treatments often include hormone replacement therapy, or HRT.   HRT can ease symptoms of menopause such as irritability, anxiety, memory loss, or skin or hair changes.  HRT has also been connected with reduced risk of heart disease and osteoporosis; and can help if you experience vaginal dryness or loss of sexual desire.  But there are risks that have been associated with HRT too.  Some studies have shown a connection to breast cancer, blood clots, high blood pressure and gall bladder disease.  The trend these days is to use HRT for a short focused period of treatment, rather than a long term one, to address the most bothersome and persistent symptoms of menopause, the ones you really cannot live with.

There are many alternative and natural therapies to try if you feel you need help calming the beast.  The first time you feel like Krakatoa getting ready to blow; that you feel puffy, flushed faced and damp, and everyone else looks slender and cool as a cuke; or that you’re jotting your name down and you have to pause for a moment,  to think what it is; you may decide it’s time to explore your options.  It’s actually a great time to think of the wisdom passed on by our ancestors. Our great grandmothers learned about beneficial plants at grandmother’s knee.  Today we can go to the bookstore, health food store, or the internet to find healthy products that are good for menopausal symptoms.

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Joanne M. Friedman

Forget what your mother taught you.  When my mother reached “that certain age”, the whole family held its collective breath.  I have no idea whether she endured hot flashes or vaginal dryness—not the sort of thing we talked about over dinner in the ‘50’s.  The mood swings, obvious aberrations in an otherwise calm view of life, were blamed on us kids who couldn’t seem to avoid enraging her at one moment and bringing her to sappy tears the next.  If there was medication available, she wasn’t taking it.

Skip forward to the turn of the New Millennium, and it was my turn.  But the calendar wasn’t the only place a big change could be seen.  Boomer women began flashing hot and cold all over the country.  Information on peri-menopause and the real deal was everywhere.  Gail Sheehy turned her talents from tracking the basic life changes in Passages to taking a round shot at “The Change” in The Silent Passage, and I got the full benefit of the new openness on a closed subject.  Not only was there ample coverage of the physiological basics available everywhere, but there were ways to help one round the bend with style and without alienating adults and frightening children.

Perhaps the most important tidbit we learned was that menopause is the end of only one (not very popular) part of the overall process of our lives.  Where my older acquaintances fluttered handkerchiefs over their sweaty chests and whimpered about not being “real women” as their reproductive powers dwindled, my generation wrapped those hankies around our heads and went bicycling.  For us the advent of goodies like HRT (hormone replacement therapy), hormone-infused suppositories, and high-tech lubricants were just what the doctor ordered to ward off the discomfort of thinning vaginal tissues and those exciting mood swings.

Some of us lucky ones responded well to herbal treatments.  I was not prone to serious hot flashes, but the mood swings were enough to send co-workers into duck-and-cover under their desks.  Though not everyone responds to all herbals, I got by with regular doses of St. Johns’ Wort and a growing appreciation of the calming effects of yoga.  Suddenly life was good.  Better than good, life was great!  The down side to menopause—the loss of reproductive viability—becomes a huge plus when the other issues are kept at bay.  Wait a bit and worries about pregnancy become a thing of the past, opening the door to excellent times.  Apply creams and ointments judiciously, and take targeted multi-vitamins, and you’ll find there’s a whole new life around that bend.

Add to the mix one of the largest psychological effects of aging—the ability to cease caring what other people think while simultaneously becoming sensitive to and totally involved in the community at large—and you’ve got one heady experience.

Only one caveat needs to be addressed.  It is far too easy to enjoy the post-menopause years too much, to become insufferable to your friends and family as you boldly go where you never before thought you could.  Apply the freedom confidently but with a light hand and keep up with regular physical checkups to avoid being flattened by a mid-life ailment.  High blood pressure comes with the package for many women, but it’s usually easily controlled by diet, medication and exercise.  Cholesterol levels can fluctuate widely and bone density can suffer.  Heart disease can rear its ugly head.  Again, lifestyle changes will help greatly, but the care of a caring physician is vital to the process.

With a little careful management, peri- and post-menopause can shift from “that time” to Your Time in no time.

You’re not crazy! You’re not dying! You’re a woman! Menopause is one of those evil words women pretend not to hear. While menopause is a natural process for the female body, it typically gets a bad rap. The good news is that no one is alone. Menopause happens to every woman on the face of the earth. It simply signals the end of fertility, not the end of energy or vibrance. In order to come to terms with menopause, it is important to understand what the big fuss is all about.

Physical Changes

Menopause usually comes with a set of physical symptoms. While it would be nice to just merrily skip through the change of life without a hitch, it simply isn’t realistic. With menopause comes some unwelcome physical changes. Among those include night sweats and hot flashes, vaginal dryness, sleep irregularity, thinning hair, weight gain, diminishing bone density, decreased sexual appetite, and drying skin. It sounds pleasant right? Fortunately, it’s not all gloom and doom. Some women find it quite liberating to be able to have intercourse without the use of birth control.

Emotional Changes

Emotional changes also take place during menopause. Things such as mood swings, anxiety, and a feeling of loss may be directly related to hormone shifts. These changes, however, may also be directly related to the physical changes associated with menopause. For instance, anxiety may be caused by a lack of sleep. There aren’t many people who could get through a sleepless night without a mood shift.

Perimenopause

Women can experience menopause symptoms as much as 8 years before the end of fertility. It is just the body’s ways of making the transition into menopause. This is called perimenopause. During this time menstrual cycles tend to be irregular. Some women even experience hot flashes. Isn’t it great to be a woman!

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