Friday, April 29, 2011

Really? Shocking news!

study came out that shows that hungover surgeons are more likely to make mistakes.

"Surgeons who drink to excess the night before they operate are more likely to make errors the next day, even as late as four in the afternoon, according to a novel experiment described in a recent Irish study."

Yes, this news is shocking. You might be taken aback to learn that if doctors that boozed it up the night before a surgery are going to flub more than those that stayed home.  Next time you are about to go under the knife, ask your surgeon what they did the night before!

Thursday, April 28, 2011

Not all itchies are the same

You have an itch down there and things seems a little funky. Before you go rushing over to Duane Reade or Walgreens to go buy your Monistat and yogurt, think again! It may not be a yeast infection (YI) causing that icky vagicky, but BV - bacterial vaginosis (yeah, that sounds appealing).

Your lady parts actually have quite a bit of microorganisms that help keep the place clean and happy with yeast and bacteria playing a balancing act of sorts. Sometimes yeast overpowers the bacteria (which is why you sometimes get YI after taking antibiotics), and sometimes the bacteria wins. Treating BV as if it is a YI can in fact make things worse, and make the whole horrid uncomfortable process even longer.

So, if you are feeling like the lady parts down there aren't happy, and it isn't CLEARLY a YI, make an appointment with your doc to get a culture done and have things checked out. It may take a day or two longer for you to figure things out, but in the long run you will save yourself, and your lady parts, a lot of unpleasantness.

Wednesday, April 27, 2011

Speaking of itchies...

On a rather unrelated topic, my friend recommended I blog about my magical eczema cure. Yes, totally different kind of itchy, but for those with eczema, you know that itch is one of the most unbearable of which no scratch is good enough.

What is my cure, you ask? First off, you gotta moisturize and moisturize good. I am a big fan of Aveeno Baby Soothing Relief, and Cerave Cream, but as I have been trying to go more "natural", I've been using this and it has been working alright. 

Secondly, and this is important, Tamanu oil. What is this magical oil you ask? Well I call it magical Tahiti Oil since is pretty much a cure all for anything skin related and it is from Tahiti. This stuff is really amazing - it is good for anything from insect bites to acne scars with its anti-inflammatory, anti-neuralgic, and antioxidant properties. My friend gave this to me, and after my derm doc was running out of prescribing options, I decide to give this a try. People, it was a dermatological miracle!! Eczema gone!

So, if you are have itchy scratchy skin as a result of pretty much anything, check this stuff out - you can buy it online at a bunch of different natural online retailers. 

Tuesday, April 26, 2011

Natural Cures for the Itchies

Getting the itchies in the lady parts is no fun. For anyone who has had a yeast infection, you know the joys of having your vagina throw a temper tantrum. So, what to do about it? This question comes up quite frequently in online communities (such as vagina pagina, my personal fave), and many people rave about natural medicines such as garlic and yogurt suppositories. Yes ladies, I mean sticking yogurt and/or garlic up your hoo-ha.

Clearly intrigued, I decided to see if there was any studies on the topic. After scouring PubMed for academic papers on natural remedies for yeast infections, I have learned that there is very little data out there. Mice studies have shown that garlic is an effective treatment for yeast infections, and yogurt has long been known as a helpful probiotic (although again, no study has actually conclusively shown this). But as to whether or not you should use the natural remedies instead of going to the pharmacy and grabbing a monistat or calling your doc for a diflucan, well, the jury is still out.

Many have said that the yogurt suppositories may help, and certainly cannot harm, so that may be worth giving a try. Garlic may actually irritate (ow!), so that may be something to be weary of (apparently you are supposed to peel but not nick the garlic and then use a gauze wrapping before inserting).

Personally, I'm not so into sticking useful cooking items into my lady parts, but hey, that's just me. Anyone have any tried and true remedies?

Monday, April 25, 2011

To screen or not to screen: What to do about ovarian cancer

Not to long ago, my sister-in-law recommended that I ask my lady parts doc to do a blood test for ovarian cancer. What is this test you ask, and why haven't you heard of it? Well, it tests for elevated levels of CA-125, a cancer antigen that is found at higher levels in tumor cells than in higher cells of the body, particularly in ovarian cancer cells. A blood test that can easily measure if you have ovarian cancer cells - sounds like pure genius! Armed with my newly enhanced cancer epidemiology reading skills (one of the perks of having a bagillion degrees), I decided to find out what the deal is with this test, and whether or not I should be getting annoyed at my lady parts doc for not mentioning it.

Turns out, this test, while recommended for those with known ovarian cancer as a means of monitoring, it is a little controversial for screening for us regular gals. Much of this has to do with the sensitivity and specificity of the test - it's ability to find and rule out cancer. So, not everyone with high CA-125 will have ovarian cancer, nor will all those with ovarian cancer have high CA-125. High CA-125 levels are also associated with endometriosis, uterine fibroids, or even regular ol' menstruation.

What's a girl to do? If you know that you are at a higher risk for ovarian cancer (family history, positive BRCA gene), then yeah, go ahead and ask your lady parts doc about getting a test done. Otherwise, the jury is still out about the usefulness in using the CA-125 test as a regular screening tool for ovarian cancer. There are some large screening studies being conducted as we speak, but results will not be in until 2012 - I'll keep you posted as to what they conclude.

Thursday, April 21, 2011

IUDs: Facts and Fictions

As one lovely reader pointed out, IUDs are a wonderful form of birth control that is often overlooked in this country. In fact, worldwide, they are the most common form of contraception. So I thought I would take this opportunity to give some facts and clear up some fictions about IUDs.

Here in the U.S., women can use either of two types of IUD: one contains copper (aka, Paragard, and the other contains the hormone progesterone (aka, Mirena). Basically, a medical professional (can't do this at home!) inserts the device into the uterus, and the IUD prevents pregnancy mostly by keeping a woman’s egg and a man’s sperm from meeting, and make it harder for an egg to reach or attach to the uterus. With the copper IUD, the copper disrupts sperm movement (hello paralyzed swimmers). The hormone in the Mirena helps block sperm from getting into the uterus (like a super sperm shield).

Ladies, IUDs are uber effective! As in, other than abstinence and tubal ligation, pretty much the most effective form of contraception if placed properly.

So why isn't everyone on the IUD bandwagon? Good question!

Back in the 70s, there was a giant hubabaloo around the Dalkon Shield IUD, including infertility, uterine perforation, and death. Oh yeah, shiz hit the fan around IUDs, and women started going into a panic. They took the Dalkon off the market, but people in the US have been freaked out about IUDs since. For many years, women were strongly cautioned against getting an IUD if they wanted to have children later, and doctors often refused to provide IUDs to childless women due to fears about infertility (this in fact, happened to me) .We need to remember that back then medical devices were not regulated as they are now, so we can rest assured that the IUDs on the market today are heavily studied and kept track of.

There are of course, some downside of using IUDs. First, they are not so fun have inserted, especially if you have never given birth. Second, you risk developing PID (pelvic inflammatory disease), and infection that can cause infertility. Now, this risk is VERY low (although higher if you have and STI), but it is something that you actually need to be aware of and go to the doctor at the first sign of something being wrong (we all too often gloss over our symptoms and pain). Third, with the copper IUD, periods tend to be heavier, while on Mirena, they are lighter but you are using hormones. And fourth, you can't just yank it out yourself, you have to go to a medical practitioner to have it removed.

Here is a great resource about IUDs : IUD facts

So, if you are sick of popping pills with all their hormones and aren't ready to have babies just yet (or have any more), give your lady parts doc a shout out about IUDs.

Wednesday, April 20, 2011

Ovulation Situation

It is often thought that if you are on birth control that you will DEFINITELY not be ovulating. While most women do not ovulate while taking hormonal contraception, there is such thing as "breakthrough ovulation" - my lady parts doc said that this occurs in up to 30% of women.

Fear not though! There is no need to have a freak out session if you  feel that "ow, what the hell was that " cramp mid-cycle if you are on BC, since the hormones you are taking have other back ups to prevent pregnancy (e.g. funky cervical mucus and inhospitable uterine lining). 

Saturday, April 16, 2011

Birthcontrol while breastfeeding

I recently received an email from my dear friend who had recently given birth (to the most adorable child, might I add) asking for advice on what she should use for birth control while she was still breastfeeding:
"IUDs: mirena vs. copper T. Or birth control pill with only progesterone (mini-pill)??"

After a little contemplation, I gave her my thoughts:

So, the mini-pill is 85% effective, so that is something to think about. This is a common option for women while breast feeding, but again, not as effective as other forms of BC. Some women are also sensitive to progesterone, so taking that without the estrogen to balance you may be hormonally difficult.

As for IUDs, they are apparently quite painful when inserted (my friend said that having the IUD put in was more painful than childbirth), and there is always the risk of PID (pelvic inflammatory disease). I would probably have this put in if a)god forbid something happens, you would be ok with just one child, and b) you know you want SEVERAL years between pregnancies. Otherwise, just too painful. As far as IUDs, I would probably stick with Mirena, since apparently periods tend to be more painful and heavier with the copper.

Breastfeeding is also a method of birth control if you are doing it continuously and haven't gotten your period yet.

Things to consider:
How long do you want to breastfeed for? If it is a couple months, you mayjust want to suck it up and use condoms.
How long do you want between kiddos?

Here is a chart that I think is helpful:
Planned Parenthood Birth Control Chart

There is no clear and easy answer to this, so it really is just a balancing of priorities.

Monday, April 4, 2011

Checking that all the parts are working

It is often asked how often do we REALLY need to see the OB/GYN if we aren't having any pressing issues. For me, even though I adored my lady parts doc, the schlep and hassle of dealing with what is often a 15 minute appointment would often cause the visit to be shoved down on my to-do list. It's not like having a giant metal device crammed in your vajayjay and being felt up in an exam room is the most pleasurable of experiences (although if it is, more power to you!).

Nevertheless, there are some important reasons to suck it up and get your coochie checked yearly:

  • If you are having sex, probably should make sure that you STI free. Even if you are in what you think is a monogamous relationship, a little blood work and swab is important to make 100% certain that no one is bringing cooties to the bedroom.

  • Pap smear - Cervical cancer is bad. And since the cells that line the cervix are more prone to grow funky, this is important to get done yearly. Also, if you have HPV (pretty common infection in the prevaccine days), this is uber important to get done on a regular basis.

  • Getting the boobies checked is important, especially if you aren't so good at doing a self breast exam and if you have cystic or lumpy breasts that make it difficult to really know what is going on in there.

  • For prescriptions for lady parts stuff like birth control, you do need to go to the doc, and it is good to check in and see how you are doing on these meds. There are always new options and choices and research, so discussing these things with your doctor are good, especially if you are less than thrilled with how you are feeling.

Of course, if you have anything itchy, hurty, scratchy, smelly, or icky going on down there, make an appointment asap! I found this little chart from that is VERY helpful to remind you what you should be asking and thinking about before you go to the lady parts doc: Yearly visit talking points So for all of you that have been slacking on visiting the lady parts doc, have this little blog post be a reminder and go and make an appointment today!

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