Mar
28
Early Menopause?
Filed Under Women's Health News
The absence of menstrual periods for a minimum of one year is the hallmark of menopause. Premature ovarian failure (POF) is the term usually used to describe women entering menopause before the age of 40. Surprisingly, about 25% of these women may ovulate and some even conceive after the diagnosis is made, so some specialists suggest that it may be more appropriate to refer to this as “primary ovarian insufficiency”.
Semantics aside, 5–10% of women who complain of absent or irregular periods, or infertility have POF. Many display intermittent or persistent symptoms of estrogen deficiency (hot flushes, night sweats, emotional lability, and painful sex due to vaginal dryness).
In general, evaluation is warranted for any young woman with fewer than nine menstrual periods per year or missing three or more consecutive menstrual cycles. Once excluding pregnancy, measurements of hormones FSH TSH and prolactin levels are indicated. If the FSH is significantly elevated above 30 it should be repeated with an estrogen level (decreased below 50) to prove POF.
Since autoimmune disease is the most frequent cause of POF, screening for other types like thyroid abnormalities and diabetes should also be performed. Periodic bone density testing will assess for early bone loss that these women are at risk of developing.
Hormone therapy addresses symptoms such as hot flushes, night sweats, vaginal dryness, and also slows bone loss (The findings of the Women’s Health Initiative study do not apply to women with POF). It is important to remember that young women with diminished ovarian function typically require more estrogen than do postmenopausal women to alleviate similar symptoms. Although combination oral contraceptives (OCs) provide higher levels of estrogens then are required, OCs may be more emotionally acceptable and simplify compliance. Additionally, 1,200 to 1,500 mg of calcium each day, preferably with added vitamin D, is recommended for bone health.
Finally these women often need emotional support and resources such as the International Premature Ovarian Failure Association (www.POFsupport.org) or Rachel’s Well (www.rachelswell.com). Additonally abundant general menopause information on our webiste.
Wishing you good health,
Women’s Health Specialists
2299 Mowry Avenue, Suite #3C
Fremont, CA 94538
510.796.7057
www.WomensHealthFremont.com
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Feb
14
Pelvic floor disorders, including urinary and fecal incontinence as well as prolapse, affect 1 in 4 non‑pregnant women. Not surprisingly, the incidence increases with age from 10% in their 20’s to almost 50% in their 80’s, and also with bodyweight. Specifically, 1 in 6 women report concerns about bladder control. A recent study reported that incontinent women spend on average $900 per year on protective pads or laundry. Yet, most afflicted women remain silent because of embarrassment.
Kegel exercises are the foundation of most pelvic floor rehabilitation programs for incontinence, yet are challenging for women to perform long term. 
Over the past decade, synthetic urethral slings have become the gold standard for surgical correction of stress urinary incontinence (SUI), which is when a person loses urines with activities like coughing, sneezing, laughing, or lifting. Because these outpatient, minimally invasive procedures improve or resolve over 85% of cases and allow women to return to regular activities in just a few days, they have become very appealing solutions for women, whether busy mothers or elderly adults.
Alternatively, Renessa is an office-based treatment that shrinks the collagen around the urethra for women with SUI. It is an excellent solution for women who have not finished having babies or wish to avoid the operating room. Afterwards, over half the women report a 50% reduction in the number of incontinent episodes, and 45% are dry on pad testing.
An abundance of over active bladder (OAB) medications are now available to treat the most common cause of urinary incontinence. These women classically experience leakage after urgency or without exertion as is typical of SUI. Helping women understand reasonable goals, like improvement by an objective measure, such as discipline use of a one-week bladder diary (70% in one study), and empowering them about dose escalation during the first month of treatment; have been shown to improve compliance with continuing with these medications.
Finally, a woman tolerating prolapse symptoms, such as a bulge in her vagina, or difficulty voiding or defecating; may be interested to learn that a pessary or vaginal reconstructive procedure are solutions. The success rate and durability are significantly enhanced by using synthetic grafts that work like a hammock to support the bladder.
However little can be done to improve a women’s quality of life until a she voices her concerns about these embarrassing problems to her doctor.
Wishing you good health,
Women’s Health Specialists
2299 Mowry Avenue, Suite #3C
Fremont, CA 94538
510.796.7057
www.WomensHealthFremont.com
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Jan
22
Extra H1N1 Vaccine
Filed Under Practice News
Good News!
We have received extra H1N1 vaccine and can now expand vaccination to all established Women’s Health Specialists’ patients and adults in their household; ages over 18 years old who desire it. New patients may also conveniently receive the vaccine at the time of their annual well women exam. People under 50 appear to be more vulnerable to this flu strain.
We anticipate significant interest in the H1N1 vaccine. In order to keep our phones free for our regular appointments and questions, we are asking you to submit vaccination requests exclusively online at our website WomensHealthFremont.com (Please do not phone our office). You will then be contacted within 1-2 business days by our staff to schedule your appointment.
For more information about the H1N1 Flu web recommend the CDC website.
Wishing you good health!
Women’s Health Specialists
2299 Mowry Avenue, Suite #3C
Fremont, CA 94538
510.796.7057
www.WomensHealthFremont.com
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