Certified Nurse-Midwives (CNMs) are specially trained in providing healthcare to pregnant women from conception through labor and delivery. Many women opt to have a CNM serve as their primary healthcare providers during pregnancy. Maximizing the birth experience and the health of newborns and their mothers is our practice’s primary goal for pregnant patients. Achieving this goal requires expert knowledge about the gestation period and birthing process, as well as heightened empathy between providers and their patients.
Women’s OB/GYN Medical Group’s experienced CNMs offer expertise and tender care guidance to women during their childbearing years. Our CNMs understand that delivery preferences are extremely important and personal to expecting mothers, and that they can also be difficult for some women to determine. To ensure that our patients have the best possible experience during their pregnancies, our CNMs are especially attentive to pregnant mothers’ personal philosophies on giving birth and general reproductive health.
Our CNMs work in close collaboration with OB/GYN doctors, and serve as the primary health resource for pregnant women whom prefer to involve a midwife in their pregnancies. What to expect from your Certified Nurse-Midwife at Women’s OB/GYN Medical Group during your pregnancy:
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
In her recent doctoral dissertation, researcher Sanna Heikkinen from the University of Helsinki and Finnish Cancer Registry evaluates the contribution of the use of hormonal contraceptives and hair dyes to the spectrum of breast cancer risk factors.
The analysis included self-reported survey data from 8000 breast cancer patients and 20,000 controls from Finland.
According to the results, use of hormonal intrauterine device was associated with 52% increased risk of breast cancer in post-menopausal women, when compared to women who had used copper intrauterine device.
The use of other hormonal contraceptives was, by contrast, associated with 32% higher breast cancer risk among younger women under 50 when compared to women who did not use hormonal contraceptives.
There was also a 23% observed increase in the risk of breast cancer among women who dyed their hair compared to those who didn’t.
To confirm the roles of these factors, further research on the effects of hormonal contraceptives, most specifically hormonal intrauterine device, and hair dyes is needed with other populations and a prospective study design.
“The biggest risk factor in breast cancer is high age, and known lifestyle-related risk factors include late age at first birth, small number of children, high alcohol consumption, and sedentary lifestyle,” Heikkinen stresses.
Many of these factors have become significantly more common in Western countries, including Finland, during the last decades.
In her research, Heikkinen also investigated the amount of opportunistic mammography, which was found to be very common. More than 60% of responders reported having had a mammography before the screening age of 50.
“Women should be more extensively informed of the harms of opportunistic mammography, such as accumulating radiation burden and the potential consequences of false positive or negative findings,” Heikkinen says.
Read this article on Science Daily:
University of Helsinki. “Hormonal contraceptives and hair dyes increase breast cancer risk.” ScienceDaily. ScienceDaily, 9 March 2017. <www.sciencedaily.com/releases/2017/03/170309120440.htm>.
If you’re in menopause before the age of 40, you have a higher fracture risk. That fact has already been proven by the Women’s Health Initiative (WHI) clinical trials. Now a new study evaluating the same WHI data further concludes that, even with calcium and vitamin D supplements, your risk of fracture is still higher. The study is being published online in Menopause, the journal of The North American Menopause Society (NAMS).
For years, calcium and vitamin D have been touted for their abilities to increase bone mineral density. Hormone therapy is also recognized for its ability to help ward off osteoporosis. That’s what prompted this latest study to evaluate the effectiveness of calcium, vitamin D, and/or hormones in offsetting the higher fracture risks for women experiencing early menopause. Based on an evaluation of nearly 22,000 women included in the WHI trials, women aged younger than 40 years already in menopause had significantly higher risks for fracture than women who experienced menopause between the ages of 40 and 49 or after 50, regardless of treatment intervention.
Although the findings are disappointing for women experiencing an early onset of menopause, the study did open the door to a number of questions and possibilities. For example, women with early menopause are candidates for hormone therapy until at least the average age of menopause (52 years) to reduce the risks of heart disease, osteoporosis, and cognitive and mood changes. It is possible that earlier initiation of treatment for those with early menopause with calcium, vitamin D, or hormones; more appropriate dosing of young women, longer duration of treatment; or longer duration of follow-up could provide better bone protection and ultimately reduce fracture risk.
“This study highlights the need for healthcare providers to take into consideration a woman’s age at menopause onset when evaluating patients for fracture risk,” says Dr. JoAnn Pinkerton, NAMS executive director. “Women at risk for bone loss need 1,200 mg of calcium per day, with adequate vitamin D, and encouraged to get as much as possible through diet due to concern that too much supplemental calcium may increase atherosclerotic plaque in women. Women with early menopause should discuss whether they are candidates for hormone therapy with their providers, appropriate amount of calcium, vitamin D and hormones.”
A new study has found that women have better brainpower after menopause if they had their last baby after age 35, used hormonal contraceptives for more than 10 years or began their menstrual cycle before turning 13.
This is the first study to investigate the association between age at last pregnancy, which can be a marker of a later surge of pregnancy-related hormones, and cognitive function in later life, said Roksana Karim, lead author of the study and assistant professor of clinical preventive medicine at the Keck School of Medicine of USC.
“Based on the findings, we would certainly not recommend that women wait until they’re 35 to close their family, but the study provides strong evidence that there is a positive association between later age at last pregnancy and late-life cognition.”
Postmenopausal women who had their last pregnancy after 35 had better verbal memory. Those who had their first pregnancy when they were 24 or older had significantly better executive function, which includes attention control, working memory, reasoning and problem solving.
The main hormones at play are estrogen and progesterone. In animal studies, estrogen has a beneficial impact on brain chemistry, function and structure; progesterone is linked with growth and development of brain tissue, Karim said.
The study, published this month in the Journal of the American Geriatrics Society, includes 830 women who, on average, were 60 years old. The data was adjusted for age, race and ethnicity, income and education.
Participants were given a series of tests that included assessments of verbal memory (remembering a list of words or retelling a story after some distraction), psychomotor speed, attention and concentration, planning, visual perception and memory.
Previous research has shown that many women experience brainpower and memory declines in their postmenopausal years. An outpouring of estrogen and progesterone, especially in later life, appears to be beneficial, Karim said.
The study found that other reproductive events were also important to later life cognition. More time between first and last period — longer reproductive life — proved valuable for executive function.
“Starting your period early means you have higher levels of the female sex hormone being produced by the ovaries,” Karim said. “Girls are receiving the optimal levels early, so it’s possible that their brain structures are better developed compared to those who are exposed to estrogen levels associated with menstrual cycles at a later age.”
Use of the pill or other hormonal contraceptives for at least 10 years was beneficial for verbal memory and critical thinking ability.
“Oral contraceptives maintain and sustain a stable level of sex hormones in our blood stream,” Karim said. “Stable is good.”
Women who didn’t carry their pregnancy to term and those who gave birth to two children had better overall cognitive ability, verbal memory and executive function when compared to women who had only one full-term pregnancy.
“The finding that even incomplete pregnancies are beneficial was novel and surprising,” said Wendy Mack, the study’s senior author and professor of preventive medicine at the Keck School of Medicine. “In general, our findings are intriguing and are supported by other clinical studies and animal studies.”
In humans, however, previous studies have shown that “pregnancy brain” exists, meaning researchers found that pregnant women have poorer verbal memory, word fluency and word-list learning when compared to non-pregnant women.
“The issue is the human studies haven’t followed women for the long term,” Mack said. “They just looked at women during pregnancy. We are not sure if we can expect to detect a positive estrogen effect at that point, as the many bodily changes and psycho-social stressors during pregnancy also can impact women’s cognitive and emotional functions.”
The research was supported by the National Institutes of Health and included data from two clinical trials: Women’s Isoflavone Soy Health and Early vs. Late Intervention Trial of Estradiol.
Past research has indicated that metabolic function is critical for women to prevent cardiovascular disease and type II diabetes after they reach menopause. Now, according to new research from the University of Missouri, minimal exercise may be all it takes for postmenopausal women to better regulate insulin, maintain metabolic function and help prevent significant weight gain. These findings suggest that women can take a proactive approach and may not need to increase their physical activity dramatically to see significant benefits from exercise.
“Diseases and weight gain associated with metabolic dysfunction skyrocket after menopause,” said Vicki Vieira-Potter, assistant professor of nutrition and exercise physiology at MU. “The intent of this research was to determine what role exercise plays in protecting women, specifically less-active women, metabolically as they go through menopause.”
Vieira-Potter’s research team compared how exercise training maintained metabolic function in sedentary rats versus highly active rats. The rats were provided a running wheel which they could use as much or as little as they wanted. The sedentary rats only ran 1/5th of the distance as the highly active rats did; yet, the limited physical activity still maintained their metabolic function and normalized insulin levels. Moreover, the previously sedentary rats saw a 50 percent reduction in their fat tissue as a result of that small amount of exercise.
“These findings suggest that any physical activity, even just a small amount, can do wonders in terms of maintaining metabolic function,” Vieira-Potter said. “This is significant for postmenopausal women as they deal with weight gain associated with menopause as well as the increased risk for disease.”
Vieira-Potter says sedentary women can be proactive as they enter menopause by:
• Going on regular walks with friends;
• Taking the stairs rather than the elevator;
• Joining beginners’ fitness programs;
• Monitoring physical activity through use of fitness trackers.
Hot flashes — the bane of existence for many women during menopause — can be reduced in frequency by almost half for about 50 percent of women over eight weeks of acupuncture treatment, according to scientists at Wake Forest Baptist Medical Center.
In a study published in the Sept. 28 issue of the journal Menopause, scientists reported that about half the women in the study reduced the frequency of hot flashes, while half did not.”Women bothered by hot flashes and night sweats may want to give acupuncture a try as a relatively low-cost, low-risk treatment,” said Nancy Avis, Ph.D., lead author of the study and professor of Public Health Sciences at Wake Forest School of Medicine, a part of Wake Forest Baptist. “Women will know pretty quickly if acupuncture will work for them. Women who had a reduction in their hot flashes saw a benefit beginning after about three to four weeks of weekly treatments.
“The National Institutes of Health-funded study was designed to examine different patterns of responses to acupuncture. Participants included 209 perimenopausal and postmenopausal women ages 45 to 60 who had on average at least four hot flashes or night sweats per day. Women were randomized to receive up to 20 acupuncture treatments within six months or to a control group.
Of the 170 women who received acupuncture, a small group of women (11.9 percent) had an 85 percent reduction in hot flashes by the eighth week of the study, Avis said. Forty-seven percent of the study group reported a 47 percent reduction over this same time frame. However, 37 percent showed only a minimal reduction of 9.6 percent in frequency of hot flashes, while 4 percent reported a 100 percent increase in hot flashes.
“We had hoped to identify some of the characteristics of the women who benefitted from acupuncture, but like so many treatments, we could not really tell ahead of time who would benefit,” Avis said.
“Acupuncture reduces hot flashes for half of women, study finds.” ScienceDaily. ScienceDaily, 28 September 2016. www.sciencedaily.com/releases/2016/09/160928141719.htm
Sonoma County physicians Lela Emad, Amita Kachru and Susan Logan of NCMA Women’s OB/GYN Medical Group were recently chosen as among the top Obstetrics and Gynecology doctors by Sonoma Magazine’s Top Doctors survey.
Sonoma Magazine’s Top Doctor survey was sent out to local doctors who were then asked which medical specialist they would most often recommend to a loved one, and 327 professionals emerged as top docs in 50 categories of medicine. Among their physician peers Dr. Emad, Dr. Kachru and Dr. Logan ranked at the top for go-to OB/GYN specialists, supporting what the many patients who routinely benefit from the expertise and outstanding professional services of these fine OB/GYN specialists already know. “I am so thankful to work with such a wonderful dedicated team and we are all deeply honored to be recognized for the exceptional dedication I know my team provides every day for every patient,” says Dr. Emad. “Thank you, Sonoma County.”
About the Women’s OB/GYN Medical Group
With a team made up of compassionate, expert doctors, midwives, nurses and medical assistants aimed at providing unmatched care to patients, the Women’s OB/GYN Medical Group offers a full range of obstetrics and gynecology services to women in the North Bay region. “Putting our patient’s health at our priority, our goal has always been to meet the healthcare needs of women in a comfortable environment, close to home,” says Dr. Emad. “This is something we’ve been doing for more than 25 years.”
Services offered include;
Women’s OB/GYN Medical Group’s staff of physicians include; Lela Emad, MD, Shazah Khawaja, MD, Amita Kachru, MD, and Susan Logan, MD. Together, these doctors share a unique whole-body approach to medicine as they strive to find the underlying causes of a woman’s health problems, rather than simply treating the symptoms. The team of health professionals at Women’s OB/GYN is committed to both alleviating short-term ailments and maximizing long-term health. The practice partnered with Northern California Medical Associates (NCMA) in 2014 to strengthen its network of experienced healthcare providers, directly benefitting patient access to healthcare specialists in the area.
“The theme of our care is ‘women proudly serving women’,” explains Dr. Emad. “As women we understand the needs and expectations of our patients, and we strive to provide each patient with the best experience possible.”
Meet the Women’s OB/GYN Medical Team
Dr. Lela Emad is a compassionate, experienced OB/GYN certified by the American Board of Obstetrics and Gynecology specializing in general women’s health as well as the diagnosis and treatment (surgical and non-surgical) of a full-spectrum of gynecological disorders. Dr. Emad serves as the OB/GYN Department Chair at Santa Rosa Memorial Hospital, a close affiliate of Women’s OB/GYN. A true fan of northern California, Dr. Emad opened her private practice in 1990 at Women’s OB/GYN Medical Group in Santa Rosa, where she has devotedly served Sonoma County women ever since. After 25 years of experience, Dr. Emad continues to receive great satisfaction from helping patients overcome gynecologic health problems and to meet their long-term lifestyle and healthcare goals.
Dr. Susan C. Logan is a respected, caring OB/GYN certified by the American Board of Obstetrics and Gynecology. Dr. Logan has been a part of Women’s OB/GYN Medical Group since 1993, and has played an integral role in building the practice with Dr. Emad. She also serves as Antepartum Testing Medical Director at Santa Rosa Memorial Hospital, as well as the Medical Director of the Sweet Success Program.
Dr. Amita Kachru is a board certified OB/GYN with specialty interest in Adolescent Gynecology and Teen Pregnancy. Dr. Kachru began her private practice with Women’s OB/GYN Medical Group in 2008, and has become an invaluable member of our care team since then. Dr. Kachru’s diverse educational and professional backgrounds have played a vital role in shaping her interest and expertise in general women’s health, adolescent gynecology, and teen pregnancy.
Dr. Shazah Khawaja is a conscientious OB/GYN certified by the American Board of Obstetricians and Gynecologists. Throughout her career, Dr. Khawaja has focused her energy on developing strong skills in minimally invasive laparoscopic surgery, uro-gynecological procedures, as well as educating women on nutrition, exercise and general health awareness. Dr. Khawaja’s care philosophy perfectly realizes the whole-body approach to women’s healthcare, and the Women’s OB/GYN Medical Group is proud to have her on the team.
The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. To learn more about these fine physicians and the many services provided by the Women’s OB/GYN Medical Group visit the website. Call for an appointment at (707) 579-1102.
Most women will get hot flashes or night sweats at some point in life. However, when these symptoms occur and how long they last can vary dramatically among women. New findings show that women fit into four distinct groups when it comes to getting hot flashes and night sweats, with potential ramifications for therapy and prevention of future health conditions, according to the research led by the University of Pittsburgh Graduate School of Public Health.
The epidemiological investigation followed hundreds of women for an average of 15 years and identified characteristics that predisposed them to certain trajectories for getting hot flashes and night sweats–collectively known as “vasomotor symptoms.” The findings are published in Menopause: The Journal of the North American Menopause Society and were funded by the National Institutes of Health.
“Most women get vasomotor symptoms, and we used to think these symptoms lasted from three to five years, right around the time of the final menstrual period,” said senior author Rebecca Thurston, Ph.D., a professor in Pitt’s Department of Psychiatry and an epidemiologist at Pitt Public Health. “We now know that these symptoms persist for far longer–typically seven to 10 years–and occur at different times for different women. This is strong evidence that we need to further investigate the underlying physiological causes of vasomotor symptoms and their link to potentially preventable health conditions.”
Hot flashes and night sweats involve a sudden flush of feverish heat and are linked to menopause, the time when a woman’s menstrual period stops.
Dr. Thurston and her colleagues followed 1,455 women enrolled in the Study of Women’s Health Across the Nation (SWAN) who had not yet gone through menopause when they enrolled. The women lived in Pittsburgh, Boston, Detroit, Chicago, Los Angeles, Oakland, Calif., or Newark, N.J., and were not on hormone therapy, nor did they have a hysterectomy. Each year, the women reported their vasomotor symptoms, along with receiving a clinical examination and sometimes a blood test.
The researchers found that the women could be relatively equally divided into four distinct trajectories for vasomotor symptoms as they went through menopause transition, and that certain characteristics were more common in different categories:
Hormonal fluctuations were correlated with vasomotor symptoms but were not perfectly consistent, indicating that they did not fully account for the symptoms.
“It’s fascinating that we can distinguish these unique patterns and then pinpoint specific characteristics associated with each of these trajectories,” said co-author Maria M. Brooks, Ph.D., professor of epidemiology and associate professor of biostatistics at Pitt Public Health, and principal investigator of the coordinating center for SWAN. “When we see patterns like this, it indicates that there’s something going on beyond hot flashes and night sweats being a passing nuisance. Depending on which category a woman falls into, there may be important implications regarding her health.”
In a different, recent study, Dr. Thurston found evidence that some of these trajectories were associated with risk factors for cardiovascular disease.
“At this point, we can’t completely untangle any causal relationship between vasomotor symptoms and health outcomes or suggest preventative measures for vasomotor symptoms without further study,” said Dr. Thurston. “But women and their doctors can use these findings now to help them get a better idea what they’re likely to experience as they go through menopause and to plan the best ways to manage their symptoms.”
Read online: ScienceDaily, 13 July 2016. www.sciencedaily.com/releases/2016/07/160713152157.htm.
The above post is reprinted from materials provided by University of Pittsburgh Schools of the Health Sciences. Note: Content may be edited for style and length.
We say it all the time, and just chalk things up. Hey, that’s how it goes, right?
Most of us have lived our lives believing that certain things just happen… that they are meant to be… that we’re powerless to stop or change them.
Getting old is one of those things. Now, I know that technically, we actually do get older in years. But conventional doctors have groomed you to accept that “diseases of aging” is a real thing. That a deteriorating mind and body is inevitable.
But what if the opposite were true? What if aging is a hoax, and diseases are causing it?
I’ve read and had conversations with many doctors of natural medicine who say there’s nothing natural about the aging process.
This is going to eventually turn medicine on it’s head.
But until then, people who believe aging is bogus are going to get labeled “quacks” and worse. At the same time, there are those among us who believe every word in the Bible, but don’t want to consider that Abraham’s wife, Sarah, could have really lived to be 127.
But I do, and here’s why…
For women, we think of menopause as perhaps the most significant marker of aging. It’s that stage in life that signifies the end of our reproductive cycle… that “natural” biological process that ends fertility… and the beginning of old age.
It’s soon after and sometimes during menopause that the flood gates open to heart disease, osteoporosis, weight gain, loss of vitality and energy — all of the diseases and conditions we accept as yet another step in this journey of so-called natural aging.
But researchers have found the opposite to be true…
In fact, the results of not one but two studies, found that lack of sleep and the symptoms of menopause cause women to age faster — not the other way around.