Tag Archives: Women’s Health Week

An ancient imaging system proves to be an amazing cure for infertility!

Towards the end of the work week, Medical News Today revealed a story that looks like a miracle and something out of science fiction simultaneously. Infertility is a huge problem, with expensive, whose treatments are temperamental to say the least, fraught with emotional travails for families and other complicating issues.

And now, a single study appears to upend the problems and probably offer a simple, cost effective solution that will beat infertility right out of the cliched ball park! It is probably imprudent to get so excited, but it is hardly resistible.

Old techniques have gotten a second look in the past. Some of these techniques were trial and error prone, and many times the underlying science has not been understood. Renal Denervation is one such technique. With a surprising and incredible purchase of Ardian by Medtronic, it caused a frenzy, only to be let down by a poorly designed clinical trials. I have seen similar comebacks on old studies that controlled the Over Active Bladder condition. Therefore, one should look at any revivals of old techniques with ample caution.

Interesting Coincidences

Dr. Ben Mol, a Professor at Australia who spearheaded the study into an age old imaging technique as a possible treatment, appears to have been conceived as a result of this imaging treatment and has a younger brother! It seems remarkable that he started research intot his technique even before being made aware of his own history and relationship with the technique. Please refer to the MNT link below for more on this.

The Technique – Hysterosalpingography (HSG)

The technique, whose name is a mouthful, simply refers to imaging of the hystero, the uterus and salpingo, the fallopian tube. It was first carried out exactly 100 years ago, in 2017, just a few years after X-rays came into existence.

The procedure itself is a dye test, performed under X-ray. Water or oil are used to flush the Fallopian tubes. It is the flushing that appears to have aided fertility. In view of this notion, Dr. Ben Mol and others led a study with 1119 women, that produced interesting results.

The Study

The study, titled H2Oil was held in Netherlands, and as mentioned before, recruiting 1119 women, approximately half received HSG with oil, and as MNT put it, Lipidoil Ultra-Fluid, an iodized solution of fatty acids derived from poppy seeds.

The other half received HSG with water.

The Results

Nearly 40% of the women in the oil group, and 29% in the water group all conceived within 6 months. This is an amazing result. It shows immense promise.

Of course, more needs to be known, as I mentioned before. An underlying understanding of science, safety of flushing fallopian tubes and other important, fundamental considerations remain. However, for women and families struggling with infertility, this study shows great promise.

References: 

  1. The MNT Article: http://www.medicalnewstoday.com/articles/317532.php
  2. The NEJM Publication: http://www.nejm.org/doi/10.1056/NEJMoa1612337
  3. Image Courtesy, Pexels: https://www.pexels.com/photo/close-up-of-hands-holding-baby-feet-325690/

Hand Osteoarthritis risk higher in women

Medscape reported on a study published on May 8 in the Journal, Arthritis and Rheumatology, that examined data collected from 1999 to 2010 to arrive at a risk prediction for women, with respect to osteoarthritis of the hand.

The Study

The study appears to be a retrospective evaluation of over 2000 people over the age of 45, in North Carolina. They used self-reports of arthritic symptoms and the participants’ X-ray imagery of the hands.

Results

For the overall population, the risk for osteoarthritis in at least one had by the age of 85, is about 39.8%

Caucasians had a higher risk of 41% and African Americans 29%. I assume here that the sub-populations were equivalent or adjusted for.

Obesity ups the risk to 47%, compared to 36% among the non-obese.

In women, the risk is 47% as opposed to men, where it is 25%.

Pain

Pain is one of the key effects of osteoarthritis. The more people use their hands, the more the pain related to osteoarthritis of the hand. This makes day to day activities challenging and a huge burden on Quality of Life.

Fighting Back

As the medscape article rightfully points out, physical therapy, occupational therapy and other precautions can help women (and men) in preparing themselves for this condition, as life spans increase and we await more permanent cures (such as gene therapies, etc).

References:

  1. The medscape article: http://www.medscape.com/viewarticle/879943
  2. The publication summary: http://onlinelibrary.wiley.com/doi/10.1002/art.40097/abstract
  3. The Arthritis Foundation on Osteoarthritis: http://www.arthritis.org/about-arthritis/types/osteoarthritis/
  4. Image Courtesy, Pexels: https://www.pexels.com/photo/silhouette-woman-hand-holding-heart-shape-against-orange-sky-256809/

Total Body Fat Vs. Belly Fat in Breast Cancer Risk

I came across this very interesting study through a Medical News Today article (link below). The paper manuscript itself is free, but comes across as a little difficult to read on the downloadable PDF version , because of the way it appears to be output by the journal. However, it is always good to be able to access the full paper, and not simply the summary.

The premise

Among several risk factors, body fat is a breast cancer risk. There apparently have been contentions about where specific biomarkers that indicate breast cancer are produced, with some previous studies. This study has shown that overall weight loss is more beneficial in terms of breast cancer biomarker production reduction, rather than focusing on belly fat alone.

The current study

The current study is limited to post-menopausal women. Conducted in the Netherlands, 243 overweight women were recruited. They lost 5 – 6kg over a period of 16 weeks. A set of biomarkers, indicative of sex hormones, leptin and inflammation were compared before and after the weight loss. The fat changes themselves were measured using X-ray and MRI scans.

The latter appears to be important. The MNT article includes a statement that this study is different than previous ones that used waist measurements. I can see this being quite an important difference. X-rays and MRI scans definitely appear to be more fastidious methods of assessing fat changes, specific to a body region.

Results

Increased belly fat, according to Dr. Evelyn Monninkhof, the lead in the study indicates, increases the risk for several chronic diseases, independent of total body fat. She indicates however, that sex hormones, are more affected by total body fat and not just localized fat, as concluded from the study.

She also points that their next steps is to look at how to reduce levels of total fat and abdominal fat. This said, it appears that women, especially those postmenopausal and those approaching menopause can benefit from exercise and nutritional changes that lead to total fat loss, and hopefully, abdominal fat loss along the way. It is always important to contact licensed medical and/or nutritional professionals when considering exercise and/or dietary changes.

References:

  1. The MNT Article: http://www.medicalnewstoday.com/releases/317498.php
  2. The Endocrinology Paper: http://erc.endocrinology-journals.org/content/early/2017/05/16/ERC-16-0490.abstract?sid=9f3c9977-0e81-4583-bdf5-07b3f182f911
  3. Image Courtesy, Pexels: https://www.pexels.com/photo/woman-with-umbrella-on-beach-247304/

Obesity is a risk factor for IUD Expulsions

This is National Women’s Health Week. I am trying to highlight key health-related news all week. This night’s post also comes from the latest ACOG 2017 meeting from last week.

Obesity

Obesity is already a risk factor for various health conditions, such as diabetes, cardiovascular diseases and so on. For long term, reversible contraception, it is recommended that obese women opt for IUD over oral pills or patches, as the chances of venous thromboembolism is higher in obese and overweight women, than in women of normal weight. Please see referenced link below. It is an earlier paper by the same lead author/group as the current one, coming from Hawaii.

Weight classification, takes women and men from underweight to normal weight, overweight and obese. Within obesity, depending on waist size, the classification goes from Class I to Class III, representing extreme obesity. I have attached an NIH reference for your convenience.

It appears that in women with Class III obesity, IUDs can shift inside the uterus, also commonly termed IUD expulsion, at a higher rate than in women of other weight classes. This was the focus of the presentation at ACOG last week.

The current study

A retrospective cohort study, in Hawaii, with access to a diverse population including approximately a third each of Asian women and Native Pacific Islanders, has shown that obese women with Class III obesity have a risk, that is 3.06 times other women. Read other details in the paper summary and the article linked below.

Theories

The study itself was only performed, retrospectively to titrate risks. Some theories have been presented by the authors.

Placement itself might pose difficulties because of obesity.

Another risk of obesity is heavy menstrual bleeding, and therefore, IUD expulsions might be encouraged.

The authors however continue to encourage the use of IUDs in all women, regardless of body weight, as the benefits outweigh risks.

Conclusion

While on one end, further studies are needed, and will likelihood indicate why IUD expulsions occur at a higher rate in obese women, women should not stop opting for IUDs.

Additional studies that describe the causes for IUD expulsion might indicate that it is solely not a function of obesity, and it has already been shown that obesity is but one risk factor for expulsion.

Knowing why IUDs dislodge or move would make for better IUD design! 

Until the reasons are known and designs could be potentially improved, for the long term, women should focus on efforts that help them lose weight, in a healthy and practical manner.

References:

  1. ACOG Presentation Summary: http://mobile.journals.lww.com/greenjournal/Abstract/2017/05001/Levonorgestrel_Intrauterine_Device_Complications.235.aspx
  2. A previous article by the same group: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4642497/
  3. The mdedge article http://www.mdedge.com/clinicalendocrinologynews/article/137744/gynecology/beware-hormonal-iud-expulsion-obese-women?channel=261&utm_source=News_CEN_eNL_051317_F&utm_medium=email&utm_content=Are%20some%20obese%20women%20having%20issues%20with%20IUDs?
  4. NIH Weight Classification: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi_dis.htm
  5. Some information on IUD Expulsion and what to do: http://www.healthline.com/health/birth-control/iud-fell-out#5
  6. Retrospective Cohort Studies: https://en.wikipedia.org/wiki/Retrospective_cohort_study
  7. Image Courtesy, Pexels: https://www.pexels.com/photo/backlit-beach-dawn-dusk-227674/