Diet that includes vegetable protein may protect against early menopause

Diet that includes vegetable protein may protect against early menopause

Eating more vegetable protein may protect against early menopause: Study shows modest but significant lower risk in older women, linking diet menopause.Results of a new study from epidemiologists at the University of Massachusetts Amherst and Harvard T.H. Chan School of Public Health suggest that long-term diet that includes a high intake of vegetable protein from such foods as whole grains, soy and tofu, may protect women from early menopause and could prolong reproductive function. Diet menopause.

Consuming enriched pasta, dark bread and cold cereal were especially associated with lower risk, while they observed no similar relation to eating animal sources of protein.

“A better understanding of how dietary vegetable protein intake is associated with ovarian aging may identify ways for women to modify their risk of early onset menopause and associated health conditions,” write first author and then-graduate student Maegan Boutot, with her advisor, professor Elizabeth Bertone-Johnson. Details appear in the current early online edition of the American Journal of Epidemiology.

Early menopause, the cessation of ovarian function before age 45, affects about 10 percent of women and is associated with higher risk of cardiovascular disease, osteoporosis and early cognitive decline, the authors note. Few studies have evaluated how protein intake is associated with menopause timing, they add, and to their knowledge this is the first to look specifically at early menopause.

Boutot, Bertone-Johnson and colleagues in the School of Public Health and Health Sciences at UMass Amherst, with others, evaluated the relationship between diet and risk of early menopause among members of the Nurses’ Health Study II (NHS2), an ongoing prospective study of 116,000 women aged 25-42 when they entered it in 1989.

Participants were asked to report how often they ate a single serving of 131 foods, beverages and supplements over the previous year, from “never or less than once a month” to “6+ per day.” They observed that women consuming approximately 6.5 percent of their daily calories as vegetable protein had a significant 16 percent lower risk of early menopause compared to women whose intake was approximately 4 percent of calories.

Diet Menopause

For a woman with a 2,000 calorie per day diet, the authors explain, this is equal to three to four servings of such foods as enriched pasta, breakfast cereal, tofu and nuts, or about 32.5 grams a day. They adjusted for age, smoking, body mass index and other possible confounding factors.

Boutot and Bertone-Johnson add, “Though relatively few women in our study consumed very high levels of vegetable protein and our power for analyses of more extreme intake levels was limited, women consuming 9 or more percent of their calories from vegetable protein had a hazard ratio of 0.41 (95 percent confidence interval = 0.19-0.88)” compared to those eating less than 4 percent.

Others on the study team were from Brigham and Women’s Hospital and Harvard Medical School. The study was supported by a grant from NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development.

For the NHS2, follow-up questionnaires have assessed nurses’ lifestyle behaviors and medical conditions every two years. Nearly 90 percent have continued to participate in followup. Diet was assessed five times over the 20-year study, allowing the researchers to capture within-person variation in changes in food and nutrient intake over times, Boutot explains. Participants in the study contributed more than 1 million person-years of follow-up, during which 2,041 women experienced early menopause.

Boutot and Bertone-Johnson suggest that more prospective studies of their findings are warranted, including studies that compare soy-based and non-soy vegetable proteins.

Story Source:

Materials provided by University of Massachusetts at Amherst. Note: Content may be edited for style and length. University of Massachusetts at Amherst. “Eating more vegetable protein may protect against early menopause: Study shows modest but significant lower risk.” Read this article on ScienceDaily:  ScienceDaily, 26 June 2017. www.sciencedaily.com/releases/2017/06/170626093604.htm.


The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. Call for an appointment today: (707) 579-1102. Visit our website: www.womensobgynmed.com

Menstrual cycle has no impact on how a woman’s brain functions

Levels of estrogen, progesterone and testosterone in one's system have no impact on the working memory, cognitive bias or ability to pay attention to two things at once.A new study published in Frontiers in Behavioral Neuroscience is setting out to change the way we think about the menstrual cycle. While it’s often been assumed that anyone who’s menstruating isn’t working at top mental pitch, Professor Brigitte Leeners and her team of researchers have found evidence to suggest that that’s not the case. They examined three aspects of cognition across two menstrual cycles, and found that the levels of estrogen, progesterone and testosterone in your system have no impact on your working memory, cognitive bias or ability to pay attention to two things at once. While some hormones were associated with changes across one cycle in some of the women taking part, these effects didn’t repeat in the following cycle. Overall, none of the hormones the team studied had any replicable, consistent effect on study participants’ cognition.

Professor Leeners, team lead, said: “As a specialist in reproductive medicine and a psychotherapist, I deal with many women who have the impression that the menstrual cycle influences their well-being and cognitive performance.” Wondering if this anecdotal evidence could be scientifically proven — and questioning the methodology of many existing studies on the subject — the team set out to shed some light on this controversial topic.

The study published today uses a much larger sample than usual, and (unlike most similar studies) follows women across two consecutive menstrual cycles. The team, working from the Medical School Hannover and University Hospital Zürich, recruited 68 women to undergo detailed monitoring to investigate changes in three selected cognitive processes at different stages in the menstrual cycle. While analysis of the results from the first cycle suggested that cognitive bias and attention were affected, these results weren’t replicated in the second cycle. The team looked for differences in performance between individuals and changes in individuals’ performance over time, and found none.

Professor Leeners said, “The hormonal changes related to the menstrual cycle do not show any association with cognitive performance. Although there might be individual exceptions, women’s cognitive performance is in general not disturbed by hormonal changes occurring with the menstrual cycle.”

Professor Leeners cautions, however, that there’s more work to do. While this study represents a meaningful step forward, larger samples, bigger subsamples of women with hormone disorders, and further cognitive tests would provide a fuller picture of the way that the menstrual cycle affects the brain. In the meantime, Professor Leeners hopes her team’s work will start the long process of changing minds about menstruation.


Story Source:

Materials provided by Frontiers. Note: Content may be edited for style and length.


Journal Reference:

  1. Brigitte Leeners, Tillmann H. C. Kruger, Kirsten Geraedts, Enrico Tronci, Toni Mancini, Fabian Ille, Marcel Egli, Susanna Röblitz, Lanja Saleh, Katharina Spanaus, Cordula Schippert, Yuangyuang Zhang, Michael P. Hengartner. Lack of Associations between Female Hormone Levels and Visuospatial Working Memory, Divided Attention and Cognitive Bias across Two Consecutive Menstrual Cycles. Frontiers in Behavioral Neuroscience, 2017; 11 DOI: 10.3389/fnbeh.2017.00120

See this article on science daily:  Frontiers. “Menstruation doesn’t change how your brain works — period: Normonal changes during the menstrual cycle have no impact on aspects of cognition, study shows.” ScienceDaily. ScienceDaily, 4 July 2017. www.sciencedaily.com/releases/2017/07/170704093610.htm.

How to always look good at the beach with Laser Hair Removal

With the arrival of summer Dr. Lela Emad of Women’s OB/GYN Medical Group discusses the advantages offered by laser hair removal.

With a heatwave bearing down on Northern California pushing temperatures to the maximum, many people are heading to the beach or hanging out at the pool. Being swimsuit ready is easy with laser hair removal.

The process of summer waxing and constantly shaving unwanted hair, then repeat – and repeat again can be a burdensome routine when all you want to do is get out, dive in and cool off. There is a way to be swimsuit ready all summer long with laser hair removal.  “Traditional methods for removing hair like shaving, tweezing and waxing can be very cumbersome and time consuming for women,” explains Dr. Lela Emad of Women’s OB/GYN Medical Group in Santa Rosa. “Laser hair reduction offers a safe and very effective medical procedure to permanently terminate hair growth from unwanted areas.”

What is Laser Hair Reduction?

Laser hair removal is actually a medical procedure that employs an intense, pulsating beam of light to remove unwanted hair. A focused laser beam passes through the skin to penetrate and essentially vaporize individual hair follicles. The intense heat of the laser damages the hair follicle without harming surrounding skin and tissue. This process acts to inhibit future hair growth and although it may not completely guarantee permanent hair removal, over the course of a few treatments, it can provide an extended hair-free period. Periodic follow-up maintenance treatments are recommended as well.

The procedure is extremely precise and takes only a few minutes to remove hair from small areas, such as the upper lip or chin, and about an hour to treat larger areas, such as the back or legs. Laser hair reduction may require up to five sessions for optimal outcomes, and when performed properly, the procedure successfully terminates hair growth from treated areas in the vast majority of (up to 90%) of women.

Does it work for everyone?

Although anyone can undergo laser hair removal, best results depend on a person’s hair color and skin type. For example, people who have light skin and dark hair have the best results overall due to how the laser beam targets the pigment (melanin) in the hair. Advances in technology over recent years have made laser hair removal an option even for people who have darker skin.

Laser hair removal isn’t always as effective for hair colors such as white, gray, blond or even red because it’s more difficult for the laser to target that range of color,” said Dr. Emad. “Although people with lighter color hair will see results, it may not be as obvious as those with darker hair color.”

While laser hair reduction is fast and easy for patients, it is still a medical procedure that requires an experienced technician to ensure it is performed safely and effectively. The physicians at Women’s OB/GYN Medical Group carry years of experience in performing laser hair reduction and they take care to attend to any discomfort or bad reactions patients may have to the procedure.

Best outcomes for laser hair removal

Laser hair removal leaves skin smooth and soft on the underarms, legs and arms, hands, back, face, bikini area. The results are always immediate and quite lasting. And since hair follicles are essentially transformed by laser light, hair typically will not grow back as quickly as prior to the treatment and occasional touch-ups are recommended to keep the skin smooth and hair-free.

“Patients who have experienced laser technology for hair removal tend to feel better about the look of their skin, and many report experiencing an improvement in body image that gives a boost of confidence,” says Dr. Email. “Above all else, patients appreciate the convenience it provides to the grooming routine.”

About Women’s OB/GYN Laser Hair Removal

Women’s OB/GYN physicians also offer expert advice and products for general skin care and treatment. Call (707) 579-1102 to schedule an appointment and for more information about laser hair reduction and skin care offered by the group. Visit the website to learn more.

Body Image Improves After Just 30-minutes of Exercise

Just one 30-minute bout of exercise makes women feel stronger and thinner, according to a new study. And the positive effect lasts well beyond the activity itself, which may be good news for women concerned about their body image.Just one 30-minute bout of exercise makes women feel stronger and thinner, according to a new UBC study. And the positive effect lasts well beyond the activity itself, which may be good news for women concerned about their body image.

“Women, in general, have a tendency to feel negatively about their bodies,” says study senior author Kathleen Martin Ginis, professor in UBC Okanagan’s School of Health and Exercise Sciences. “This is a concern because poor body image can have harmful implications for a woman’s psychological and physical health including increased risk for low self-esteem, depression and for eating disorders. This study indicates exercise can have an immediate positive effect.”

Martin Ginis, along with her graduate student Lauren Salci, compared the body image and physical perceptions of women who completed 30 minutes of moderate aerobic exercise with those who sat and read. Women in the exercise group had significant improvements in their body image compared to those who didn’t exercise. This positive effect lasted at least 20 minutes post-exercise. The research team further established that this effect was not due to a change in the women’s mood, rather it was linked to perceiving themselves as stronger and thinner.

“We all have those days when we don’t feel great about our bodies,” says Martin Ginis. “This study and our previous research shows one way to feel better, is to get going and exercise. The effects can be immediate.”

Martin Ginis sees this study as a gateway to developing maximally effective body image-enhancing exercise interventions.

According to the National Institutes of Health, nearly one half of North American women experience some degree of body image dissatisfaction and this has become more prevalent over the last three decades.

“We think that the feelings of strength and empowerment women achieve post exercise, stimulate an improved internal dialogue,” says Martin Ginis. “This in turn should generate positive thoughts and feelings about their bodies which may replace the all too common negative ones.”

Story Source:

Materials provided by University of British Columbia Okanagan campus. Note: Content may be edited for style and length.

Breastfeeding after a C-section may help manage pain

Breastfeeding after a cesarean section (C-section) may help manage pain, with mothers who breastfed their babies for at least 2 months after the operation three times less likely to experience persistent pain compared to those who breastfed for less than 2 months, according to new research being presented at this year’s Euroanaesthesia Congress in Geneva (3-5 June).

C-sections account for around a quarter of all births in the UK, USA, and Canada. Chronic pain (lasting for more than 3 months) after C-section affects around 1 in 5 mothers. It is widely accepted that breast milk is the most important and appropriate nutrition in early life, and WHO, the UK Department of Health, and US Department of Health and Human Services all recommend exclusive breastfeeding up to 6 months of age. But until now, little has been known about the effect of breastfeeding on a mother’s experience of chronic pain after C-section.

The study, by Dr Carmen Alicia Vargas Berenjeno and colleagues from the Hospital Universitario Nuestra Señora de Valme in Sevilla, Spain, included 185 mothers who underwent a C-section at the hospital between January 2015 and December 2016. Mothers were interviewed about breastfeeding patterns and the level of chronic pain at the surgical site in the first 24 and 72 hours after C-section, and again 4 months later. The researchers also looked at the effect of other variables on chronic pain including surgical technique, pain in the first 24-72 hours, maternal education and occupation, and anxiety during breastfeeding.

Almost all (87%) of the mothers in the study breastfed their babies, with over half (58%) reporting breastfeeding for two months or longer. Findings showed that around 1 in 4 (23%) of the mothers who breastfed for two months or less still experienced chronic pain in the surgical site 4 months post-op compared to just 8% of those who breastfed for 2 months or longer. These differences were notable even after adjusting for the mother’s age. Further analysis showed that mothers with a university education were much less likely to experience persistent pain compared to those who were less well educated. The researchers also found that over half (54%) of mothers who breastfed reported suffering from anxiety.

The authors conclude: “These preliminary results suggest that breastfeeding for more than 2 months protects against chronic post-cesarean pain, with a three-fold increase in the risk of chronic pain if breastfeeding is only maintained for 2 months or less. Our study provides another good reason to encourage women to breastfeed. It’s possible that anxiety during breastfeeding could influence the likelihood of pain at the surgical site 4 months after the operation.”

The authors are currently analyzing additional data from women interviewed between November 2016 to January 2017, which, when combined with data from all the other women, shows that anxiety is associated with chronic post Cesarean pain in a statistically significant way.


Story Source:

Materials provided by ESA (European Society of Anaesthesiology). Note: Content may be edited for style and length.


Read this article on Science Daily: (European Society of Anaesthesiology). “Breastfeeding may protect against chronic pain after Caesarean section.” ScienceDaily. ScienceDaily, 4 June 2017. www.sciencedaily.com/releases/2017/06/170604115807.htm

Sunscreen use now implicated in widespread vitamin D deficiency

Results from a clinical review find nearly 1 billion people worldwide may have deficient or insufficient levels of vitamin D due to chronic disease and inadequate sun exposure related to sunscreen use.

Results from a clinical review published in The Journal of the American Osteopathic Association find nearly 1 billion people worldwide may have deficient or insufficient levels of vitamin D due to chronic disease and inadequate sun exposure related to sunscreen use.

The study also found that 95 percent of African American adults may have vitamin D deficiency or insufficiency. Vitamin D variations among races are attributed to differences in skin pigmentation.

“People are spending less time outside and, when they do go out, they’re typically wearing sunscreen, which essentially nullifies the body’s ability to produce vitamin D,” said Kim Pfotenhauer, DO, assistant professor at Touro University and a researcher on this study. “While we want people to protect themselves against skin cancer, there are healthy, moderate levels of unprotected sun exposure that can be very helpful in boosting vitamin D.”

Dr. Pfotenhauer also said chronic diseases like Type 2 Diabetes and those related to malabsorption, including kidney disease, Crohn’s and celiac disease greatly inhibit the body’s ability to metabolize vitamin D from food sources.

Considered a hormone rather than a vitamin, vitamin D is produced when skin is exposed to sunlight. Vitamin D receptors are found in virtually every cell in the human body. As a result, it plays a wide role in the body’s functions, including cell growth modulation, neuromuscular and immune function and inflammation reduction.

Symptoms for insufficient or deficient vitamin D include muscle weakness and bone fractures. People exhibiting these symptoms or who have chronic diseases known to decrease vitamin D, should have their levels checked and, if found to be low, discuss treatment options. However, universal screening is likely neither necessary nor prudent absent significant symptoms or chronic disease.

Increasing and maintaining healthy vitamin D levels can be as easy as spending 5-30 minutes in midday sun twice per week. The appropriate time depends on a person’s geographic location and skin pigmentation — lighter skin synthesizes more vitamin D than darker skin. It is important to forgo sunscreen during these sessions because SPF 15 or greater decreases vitamin D3 production by 99 percent.

“You don’t need to go sunbathing at the beach to get the benefits,” said Dr. Pfotenhauer. “A simple walk with arms and legs exposed is enough for most people.”

Food sources such as milk, breakfast cereals, and Portobello mushrooms are also fortified with vitamin D. Dr. Pfotenhauer said supplements are a good option, as they are effective and pose few risks, provided they are taken as directed and a physician is consulted beforehand.

Research is ongoing to determine whether vitamin D deficiency has a role in multiple sclerosis, autoimmune disorders, infections, respiratory disease, cardiometabolic disease, cancer, and fracture risk.

“Science has been trying to find a one-to-one correspondence between vitamin D levels and specific diseases,” said Dr. Pfotenhauer. “Given vitamin D’s ubiquitous role in the body, I believe sufficient vitamin D is more about overall health. Our job as osteopathic physicians is to recognize those patients that need to be tested and treat them accordingly.”

Currently, insufficiency is defined as between 21 and 30 ng/ml and deficiency is considered below 20ng/ml by the Endocrine Society.


Story Source: Materials provided by American Osteopathic Association. Note: Content may be edited for style and length.

Read this article on Science Daily: American Osteopathic Association. “Widespread vitamin D deficiency likely due to sunscreen use, increase of chronic diseases, review finds.” ScienceDaily. ScienceDaily, 1 May 2017. www.sciencedaily.com/releases/2017/05/170501102258.htm.

May is the Month for Women – A good time to focus on Women’s Health

In honor of Mother’s Day and National Women’s Health Week Dr. Lela Emad of Women’s OB/GYN Medical Group offers timely insights for staying healthy.

With the goal of empowering women to make health a priority, the U.S. Department of Health and Human Services Office celebrates National Women’s Health Week beginning on May 14th – which is also Mother’s Day. This weeklong event is offered to encourage women to take steps to improve health with a focus on annual screenings, lifestyle choices and prevention.

“It is certainly important for women to be vigilant about testing for conditions that are most successfully treated when caught early, including breast cancer and colon cancer. And, another good way to stay healthy is to have routine check-ups to screen for the basic health concerns,” says Dr. Lela Emad obstetrician & gynecologist. “Heart disease is still the top killer of women in the U.S. therefore it is equally important for women to monitor blood pressure, cholesterol levels and to be aware of any potential for diabetes.”

Life expectancy in the U.S. for women now averages a full eight decades – barring accidents or major health issues. With all that living to look forward to, it’s a good idea to adopt healthy habits as early in life as possible. A look at the trends to better health reveals that there are some very simple ways to optimize health, and make life worth living.

Schedule an Appointment

One important step consists of scheduling a visit to a healthcare provider for a well-woman checkup that includes preventive screenings. Health professionals recommend adolescent girls and women start routine, annual gynecologic visits around the age of 14 unless otherwise indicated by their general practitioners. These important checkups give women an opportunity to discuss both gynecologic and general health concerns. This type of screening can include the following:

  • Blood pressure, Height, Weight
  • Lipid Panel (cholesterol and triglycerides)
  • Breast Cancer Screening
  • Cervical Cancer Screening
  • A hemoglobin test, an indicator for anemic
  • Pap & HPV tests

Exercise – Be more active!

Sitting for prolonged periods at a desk or in front of the computer may be a necessity for many a woman’s livelihood, but it’s not good for the body. Research shows that women who sit for more than six hours a day have a 40 percent higher risk of dying from any cause when compared to women who sit for fewer than three hours—regardless of their fitness levels.

Exercise is hands-down the best thing both men and women can do to improve health. And the best way to get fit and stay fit is to get moving. Exercise increases energy and releases endorphins—which in turn increases a person’s happiness quotient. Several recent studies indicate that staying active is associated with a longer life expectancy.

Exercise doesn’t need to be drudgery, a good way to incorporate a routine that endures the test of time is to choose activities that are fun. Simply going for a 20-minute walk with a friend is extremely beneficial to overall healthfulness. Just 2.5 hours weekly (about 20 minutes a day) of moderate aerobic exercise such as walking provides all the major health benefits a body needs to stay healthy.

Eating for Life

Research proves that eating more fresh vegetables is one of the simplest way to improve overall healthfulness. A vegetable-rich diet can help protect the body from arthritis, heart disease, stroke, dementia and a variety of cancers – and it might also slow down the aging process. In fact, one study found that people who consume at least seven portions of fresh vegetables and fruit each day have as much as 42 percent lower risk of dying from any cause, compared to those who eat one portion or less.

Breast Health

Routine breast exams and general awareness of how to maintain breast health are important elements in maintaining a healthy lifestyle for women. Screening methods such as regular self-breast exams, breast checks during routine gynecologic exams, and screening mammographies can all help to detect breast problems early-on.

For National Women’s Health Week, the office of Women’s Health US Dept. of Health & Human Services also recommends that women pay attention to mental health, get plenty of sleep and take steps every day to manage stress. And, of course avoid unhealthy behaviors, such as smoking, texting while driving, and not wearing a seatbelt or bicycle helmet.

About Women’s OBGYN Medical Group

The provider team of expert OB/GYN physicians, certified nurse midwives, family nurse practitioners, and medical assistants provides unmatched care to patients in our region. As women proudly serving women, we understand the needs and expectations of our patients. For more information call (707) 579-1102 or visit the Women’s OB/GYN website.

Low-dose aspirin may be powerful cancer fighting tool for women

The use of low-dose aspirin (81 mg) reduces the risk of breast cancer in women, a new study concludes. Researchers saw an overall 16 percent lower risk of breast cancer in women who reported using low-dose aspirin at least three times per week.

A City of Hope-led study found that the use of low-dose aspirin (81mg) reduces the risk of breast cancer in women who are part of the California’s Teacher’s Study. This study — which is the first to suggest that the reduction in risk occurs for low-dose aspirin — was proposed by City of Hope’s Leslie Bernstein, Ph.D., professor and director of the Division of Biomarkers of Early Detection and Prevention, and published online in the journal, Breast Cancer Research.

Bernstein and her colleagues saw an overall 16 percent lower risk of breast cancer in women who reported using low-dose aspirin at least three times per week. Such regular use of low-dose aspirin reduced the risk by 20 percent of estrogen or progesterone receptor positive, HER2 negative breast cancer, which is the most common breast cancer subtype.

“The study found an interesting protective association between low-dose aspirin and breast cancer,” said lead author Christina A. Clarke, Ph.D., M.P.H., from the Cancer Prevention Institute of California. “We did not by and large find associations with the other pain medications like ibuprofen and acetaminophen. We also did not find associations with regular aspirin since this type of medication is taken sporadically for headaches or other pain, and not daily for prevention of cardiovascular disease.”

This study differed from other studies that have looked at aspirin and cancer risk because it focused on the dose levels of the aspirin women had taken and tracked the frequency of the use of low-dose aspirin as opposed to regular aspirin. It was also able to look in detail at subtypes of breast cancer.

“We already knew that aspirin is a weak aromatase inhibitor and we treat women with breast cancer with stronger aromatase inhibitors since they reduce the amount of estrogen postmenopausal women have circulating in their blood,” said Bernstein. “We thought that if aspirin can inhibit aromatase, it ought to reduce the likelihood that breast cancer would develop and it could also be an effective way to improve breast cancer patients’ prognosis once they no longer take the more potent aromatase inhibitors.” Bernstein added, “Aspirin also reduces inflammation, which may be another mechanism by which aspirin taken regularly can lower risk of breast cancer developing or recurring.”

As part of the study, researchers analyzed data recorded in questionnaires submitted by 57,164 women in the California’s Teacher’s Study. In 2005, participants answered questions regarding family history of cancer and other conditions, use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDS), menstrual and reproductive history, use of hormones, weight and height, living environment, diet, alcohol use and physical activity. In the ensuing years before 2013, 1,457 of these participants developed invasive breast cancer.

The team of researchers chose to focus on low-dose “baby” aspirin, because not only is it inexpensive and readily available as potential means of prevention, but because there are already a lot of people already taking it for prevention of other diseases such as heart disease and even colon cancer.

Now that we have some data separating low-dose from higher-dose aspirin, more detailed research can be undertaken to understand the full value of low-dose aspirin for breast cancer prevention,” said Clarke.”


Story Source:

Materials provided by City of Hope. Note: Content may be edited for style and length.


Journal Reference:

  1. Christina A. Clarke, Alison J. Canchola, Lisa M. Moy, Susan L. Neuhausen, Nadia T. Chung, James V. Lacey, Leslie Bernstein. Regular and low-dose aspirin, other non-steroidal anti-inflammatory medications and prospective risk of HER2-defined breast cancer: the California Teachers Study. Breast Cancer Research, 2017; 19 (1) DOI: 10.1186/s13058-017-0840-7

 

Read this article on science daily:  “Regular use of aspirin can lower risk of breast cancer for women: A new study identifies low-dose aspirin as a potential cancer prevention tool.” ScienceDaily. ScienceDaily, 1 May 2017. www.sciencedaily.com/releases/2017/05/170501131759.htm.

Good outcomes for older women who give birth at home or in a birth center

Women with some characteristics commonly thought to increase pregnancy risks — being over age 35; being overweight; and in some cases, having a vaginal birth after a cesarean section — tend to have good outcomes when they give birth at home or in a birth center, a new assessment has found.

However, women with some other risk factors, a breech baby and some other cases of vaginal birth after cesarean or VBAC, may face an increased risk of poor outcomes for themselves or their babies, researchers at Oregon State University have found. The study is believed to be the first to examine these risks and the outcomes. About 2 percent of all births in the U.S., and about 4 percent in Oregon, occur at home or in a birth center, rather than in a hospital setting. Generally, women who are considered “low-risk” are good candidates for home or birth center births, also referred to as community births, if they are attended by a midwife or other trained provider and timely access to a hospital is available.

However, there is little agreement among health providers on what should be considered low- or high-risk, and some women choose to have a community birth despite potential risks, said Marit Bovbjerg, a clinical assistant professor of epidemiology at Oregon State University and lead author of the study.

Medical ethics and the tenets of maternal autonomy dictate that women be allowed to decide where and how they wish to give birth. That’s why it’s important to have as much information as possible about potential risks, said Bovbjerg, who works in the College of Public Health and Human Sciences at OSU.

There are also risks associated with hospital births, such as increased interventions, which means there aren’t always clear answers when it comes to determining the best and safest place to give birth, said Melissa Cheyney, a medical anthropologist and associate professor in OSU’s College of Liberal Arts.

The goal of the research was to better understand the outcomes for women and babies with some of the most common pregnancy risk factors, to see how those risk factors affected outcomes.

“There’s a middle or gray area, in terms of risk, where the risk associated with community birth is only slightly elevated relative to a completely low-risk sample,” Cheyney said. “We’re trying to get more information about births that fall in that middle zone so that clinicians and pregnant women can have the best evidence available when deciding where to give birth.”

The findings were published recently in the journal Birth. Other co-authors are Jennifer Brown of University of California, Davis; and Kim J. Cox and Lawrence Leeman of the University of New Mexico. Using birth outcome data collected by the Midwives Alliance of North America Statistics Project, commonly referred to as MANA Stats, the researchers analyzed more than 47,000 midwife-attended community births.

They looked specifically at the independent contributions to birth outcomes of 10 common risk factors: primiparity, or giving birth for the first time; advanced maternal age, or mother over age 35; obesity; gestational diabetes; preeclampsia; post-term pregnancy, or more than 42 weeks gestation; twins; breech presentation; history of both cesarean and vaginal birth; and history of only cesarean birth.

The last two groups are both considered VBACs and hospital policies and state regulations for midwifery practice usually make no distinction between the two types. However, the researchers found a clear distinction between the two groups in terms of community birth outcomes.

Women who delivered vaginally after a previous cesarean and also had a history of previous vaginal birth had better outcomes even than those women giving birth for the first time. On the other hand, women who had never given birth to a child vaginally had an increased risk of poor outcomes in community birth settings.

“That finding suggests that current policies that universally discourage VBAC should be revisited, as the evidence does not support them,” Bovbjerg said. “Women who in the past have successfully delivered vaginally seem to do just fine the next time around, even if they have also had a previous C-section. That’s really important because some medical groups totally oppose VBACs, even in hospital settings, and many hospitals don’t offer the option of a VBAC at all.”

Researchers also found that women whose babies were in breech position had the highest rate of adverse outcome when giving birth at home or in a birth center.

There was only a slight increase in poor outcomes for women over age 35, or women who were overweight or obese, compared to those without those risk factors. In some categories, there were not enough births in the data set to properly evaluate a risk’s impact, such as with gestational diabetes and preeclampsia.

“As is appropriate, women who face high complication risks such as preeclampsia tend to plan for and choose a hospital birth, rather than a community birth,” Bovbjerg said. “But even for these women, it’s important to remember that they can choose a community birth if their faith, culture or other considerations dictate that is the best choice for them.”

The researchers emphasized that the new information about risks and outcomes can serve as an important tool in decision-making for families making very personal choices about where to give birth. “These findings help us to put information and evidence, rather than fear, at the center of discussions around informed, shared decision-making between expectant families and their health care providers,” Cheyney said.

Researchers next plan to examine how the healthcare culture and standards of care in different locations within the U.S. affect outcomes of home and birthing center deliveries.


Story Source:

Materials provided by Oregon State University. Note: Content may be edited for style and length.


Journal Reference:

  1. Marit L. Bovbjerg, Melissa Cheyney, Jennifer Brown, Kim J. Cox, Lawrence Leeman. Perspectives on risk: Assessment of risk profiles and outcomes among women planning community birth in the United States. Birth, 2017; DOI: 10.1111/birt.12288

Read this article on Science Daily: www.sciencedaily.com/releases/2017/04/170413154439.htm.

Could hot flashes indicate risk of heart disease?

Study shows younger midlife women with hot flashes more likely to have poor vascular function

Hot flashes, one of the most common symptoms of menopause, have already been shown to interfere with a woman’s overall quality of life. A new study shows that, particularly for younger midlife women (age 40-53 years), frequent hot flashes may also signal emerging vascular dysfunction that can lead to heart disease. The study outcomes are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

The study involving 272 nonsmoking women aged 40 to 60 years is the first to test the relationship between physiologically assessed hot flashes and endothelial cell (the inner lining of the blood vessels) function. The effect of hot flashes on the ability of blood vessels to dilate was documented only in the younger fertile of women in the sample. There was no association observed in the older women (age 54-60 years), indicating that early occurring hot flashes may be those most relevant to heart disease risk. The associations were independent of other heart disease risk factors.

Cardiovascular disease is the leading cause of death in women. The results from the study, “Physiologically assessed hot flashes and endothelial function among midlife women,” may offer valuable information for healthcare providers working to assess the risk of heart disease in their menopausal patients. Hot flashes are reported by 70% of women, with approximately one-third of them describing them as frequent or severe. Newer data indicate that hot flashes often start earlier than previously thought — possibly during the late reproductive years — and persist for a decade or more. “Hot flashes are not just a nuisance. They have been linked to cardiovascular, bone, and brain health,” says Dr. JoAnn Pinkerton, executive director of NAMS. “In this study, physiologically measured hot flashes appear linked to cardiovascular changes occurring early during the menopause transition.”

 


 

Story Source:Materials provided by The North American Menopause Society (NAMS). Note: Content may be edited for style and length.

Journal Reference:

Rebecca C. Thurston, Yuefang Chang, Emma Barinas-Mitchell, J. Richard Jennings, Roland von Känel, Doug P. Landsittel, Karen A. Matthews. Physiologically assessed hot flashes and endothelial function among midlife women. Menopause, 2017; 1 DOI: 10.1097/GME.0000000000000857