Could Cannabis Lube Be the Secret to Enhanced Female Sexual Pleasure?

November 25, 2018

Cannabis Lubrication and Sexual Pleasure

 

Just when I thought I had finally become familiar with all the possible medical uses of cannabis, I came across a few articles touting the benefits of cannabis lube for female orgasm. 

 

Cannabis lubricants and other cannabis-infused sensual aids are on many women’s radars, not to mention going into their nightstand drawers.  But does cannabis really help with women’s sexual health and wellbeing?

 

Anecdotally, Women Say Cannabis Lube Can:

 

  • reduce their stress that, in turn, can facilitate more pleasure.
  • enhance their creativity which could translate to a willingness to try new things.
  • lower inhibitions to get them “out of their head.”
  • increase hormonal production that could ‘open up’ emotions such as passion.
  • ease discomfort and pain, particular during and post menopause.
  • enhance physical sensitivity and sensation and potentially increasing orgasms or orgasm intensity.

 

The Skinny On Cannabis Lube

 

  • It is just as much a relaxation aid as a sexual aid.
  • It takes 20-40 minutes to work.
  • Cannabis oil is an experience in itself. Sex isn’t required, but it certainly makes it better.
  • A lot of cannabis lube formulations should not be used in combination with latex. The oils in the product can cause latex to break down and render your protection useless.

The Basic Breakdown of How Cannabis Lube Works Its Magic:

Isolated Cannabis Bud for making cannabis lube

  1. The mucous membranes present in a woman’s genitals (and there are a lot) absorb the THC in the oil lubricant
  2. The cannabinoids act locally on the cannabinoid receptors.
  3. This causes the capillaries to dilate and increases blood flow to that area.  This causes the lower portion of your body to relax and increases blood flow to all parts of your vaginal.
  4. This enhanced circulation magnifies sensitivity and sensation.

 

Put all those things together and you’ve got a very enjoyable experience.

 

THC absorbed in the vagina technically should not make you feel ‘high’.

 

** Take careful note that if you are using an oil-based lube, they are not compatible with latex or polyisoprene condoms and can degrade any rubber-based sexual aids or accessories. While no substance introduced with condoms is 100% safe for the integrity of the condom material, some product websites claim they should be okay to use with lambskin, polyurethane, or nitrile condoms. 

 

Click Here to Learn More About Cannabis Lube

Boost Your Mood With Vitamin D

October 2, 2018

Do you get enough vitamin D?

 

There could be many warning signs or symptoms of vitamin D deficiency in your life or of someone you know.

 

It is essential to understand the importance of getting enough of this crucial vitamin.

 

 

Vitamin D Basics

Vitamin D is best known for building bones. However, this highly-potent vitamin is essential for overall brain and body health. Optimal vitamin D levels can help improve your mood, boost your overall brain function, and generally improve your wellbeing. Vitamin D may be involved in the healthy regulation of as many as 900 human genes.

 

Vitamin D is converted by the liver and kidney into a hormone that is so important to brain function its receptors can be found throughout the brain. Vitamin D plays a critical role in the brain’s early development, its ongoing maintenance, and in its functions to maintain healthy mood and many of the most basic cognitive functions including learning and making memories. 

 

Avoid Vitamin D Deficiency

Unfortunately, vitamin D deficiency is becoming more and more common, in part because we are spending more time indoors and using more sunscreen when having fun outdoors. Research suggests that 70% of all adults and 67% of children, aged 1-11, do not have adequate levels of vitamin D. Low levels of vitamin D have been associated with low mood, behavioral difficulties in children, and psychological difficulties in adults. Vitamin D supplementation is consistently linked to higher quality of life and better wellbeing with the passing of the years.

 

Recommended Daily Vitamin D

In the United States, the current recommended daily dose of vitamin D is 400 IU. However, most experts agree that this is well below the physiological needs of most individuals. Instead, it is suggested that all adults take at least 2000 IU of vitamin D daily – unless directed to take a higher dose by their healthcare provider. We all should get our blood vitamin D levels tested every 4-6 months and if necessary increase our daily intake to as much as 5000-10000 IU per day to ensure we achieve blood levels of at least 60 ng/mL.

Avoid taking vitamin D2 supplements since D2 can interfere with the actions of vitamin D3 which is the body’s natural vitamin D.

 

The Vitamin D Challenge

Getting necessary amounts of vitamin D can be challenging during the winter season in some parts of the country —typically from November to March—when there are fewer hours of sunlight and when the sun itself is less intense. This is particularly true if you live in the northern half of the United States. Due to colder temperatures and inclement weather, the tendency for many people is to stay inside where it is warm and hunker down for the winter. However, failure to get enough vitamin D, as well as exercise, can lead to health problems and other mental and physical difficulties. For individuals who struggle with low mood during the winter, the colder months can produce feelings of melancholy and desperation.

 

5 Tips for How to Get More Vitamin D In Your Life

1.  Alternate Light Source

Daily exposure to appropriate levels (even just 10-30 minutes per day) of direct sunlight can boost vitamin D3 levels which can help improve your mood. If you have a hard time getting enough natural light during the winter, consider buying a vitamin D lamp for your home or work desk. Though many artificial light boxes claim to do the job, make sure to purchase one that is as close as possible to the natural sunlight spectrum and proven to increase vitamin D levels.

2.  Go Somewhere Sunny

If getting sufficient levels of UVA (ultraviolet A) rays from the sun proves difficult during the winter months, especially if you live anywhere near the Great White North, consider saving up some money during the summer for a vacation to a sunny destination (the Caribbean, for instance) during the winter. This will make enduring the cold, dark months more bearable.

3.  Get Quality Sleep

Insufficient and inconsistent sleep can increase irritability, moodiness and poor judgment. To remain at the top of your game, it is recommended that you get between 7-9 hours of sleep each night. Getting appropriate levels of sunlight during the day, or adequate amounts of vitamin D from foods or supplements can also help maintain your body’s natural production of serotonin. In the evening, the brain naturally converts serotonin into melatonin, our main sleep hormone that improves our chance of getting a good night’s sleep.

4. Vitamin D-Rich Diet

Foods can be an important source of vitamin D. Examples of vitamin D-rich foods are fortified milk, eggs, mushrooms and fish (especially wild salmon, tuna, and mackerel). A 4-ounce portion of salmon can provide over 250% of your daily recommended allowance of vitamin D. Wild salmon contains about 988 IU of vitamin D per serving, while farmed salmon contains 250 IU, on average.

5.  Take Sunshine Supplements

When it comes to mood, the scientific evidence is clear – the higher your vitamin D levels, the more likely you are to feel happy rather than blue. A 2014 study showed that the positive effect of vitamin D3 on mood was clinically very substantial as compared to other options. Since it promotes healthy mood, vitamin D3, which is often referred to as the sunshine vitamin, can help you get through the doldrums of the winter season.

Diagnosing Thyroid Disorders – Is TSH Adequate?

July 26, 2018

Thyroid deficiency is a common disorder where there is inadequate cellular thyroid levels to meet the needs of the tissues. Typical symptoms include fatigue, weight gain, depression, cold extremities, muscle aches, headaches, decreased libido, weakness, cold intolerance, water retention, premenstrual syndrome (PMS) and dry skin. Low thyroid function can cause or contribute to the symptoms of many conditions.  Unfortunately, thyroid deficiency is often missed by standard thyroid testing. This is frequently the case with depression, hypercholesterolemia (high cholesterol), menstrual irregularities, infertility, PMS, chronic fatigue syndrome (CFS), fibromyalgia, fibrocystic breasts, polycystic ovary syndrome (PCOS), hyperhomocysteinuria (high homocystine), atherosclerosis, hypertension, obesity, diabetes and insulin resistance.

TSH traditionally has been thought to be the most sensitive marker of tissue levels of thyroid hormone.  Despite this traditional thinking, newer information suggests that a normal TSH does not necessarily indicate that a person’s tissue thyroid levels are adequate. In fact, a more thorough understanding of thyroid hormone physiology demonstrates how TSH is NOT an accurate marker of the body’s overall thyroid status.

It is certain that TSH inversely correlates with pituitary T3 levels.  However, physiologic stress, depression, insulin resistance and diabetes, aging, calorie deprivation (dieting), inflammation, PMS, chronic fatigue syndrome and fibromyalgia, obesity and numerous other conditions, are often associated with diminished cellular and tissue T3 levels – and increased reverse T3 levels. Thus, with physiologic or emotional stress, depression or inflammation, pituitary T3 levels do not correlate with T3 levels in the rest of the body.  As a result, TSH is not a reliable or sensitive marker of an individual’s true thyroid status.

 

Serum levels of thyroid hormones

TSH is merely a marker of pituitary levels of thyroid function and not of thyroid hormone levels in any other part of the body.  Only under ideal conditions of total health do pituitary thyroid hormone levels correlate with thyroid hormone levels in the rest of the body, making the TSH a poor indicator of the body’s overall thyroid status.  With the above-mentioned conditions, most individuals with diminished tissue levels of thyroid hormone will have a normal TSH.  In other words, the relationship between TSH and tissue thyroid hormone is lost in the presence of physiologic or emotional stress, depression, insulin resistance and diabetes, aging, calorie deprivation (dieting), inflammation, PMS, chronic fatigue syndrome and fibromyalgia, obesity and numerous other conditions. In the presence of such conditions, a normal TSH cannot be used as a reliable indictor that a person is euthyroid (normal thyroid) in the overwhelming majority of patients.

 

Value of Serum T4

In the presence of such conditions, T4 levels also are not a reliable indicator of adequate thyroid function.  These conditions lead to a suppression of the tissue’s ability to convert T4 into T3.  Furthermore, there is an increased conversion of T4 to reverse T3 – an inactive form of T3 (a thyroid inhibitor for all practical purposes). AlthoughT4 levels are important, as with the TSH, the serum T4 level is often misleading and an unreliable marker of the body’s overall thyroid status.

 

Current best method to diagnosis

With increasing knowledge of the complexities of thyroid function, it has become clear that TSH and T4 levels are not the reliable markers of tissue thyroid levels as once thought – especially with chronic physiologic or emotional stress, illness, inflammation, depression and aging. It is common for an individual with. normal TSH and T4 levels  to complain of symptoms consistent with reduced thyroid function.

While there are limitations to all testing and there is no perfect test, obtaining TSH, free T4, free T3, reverse T3, and T3/reverse-T3 ratios can be helpful to obtain a more accurate evaluation of overall thyroid status – and these values may be useful to predict those individuals who may respond favorably to thyroid supplementation. Many symptomatic patients with normal TSH and T4 levels significantly benefit from thyroid replacement, often with significant improvement in fatigue, depression, diabetes, weight gain, PMS, fibromyalgia and numerous other chronic conditions.

With an understanding of thyroid physiology, it becomes clear why a large percentage of patients treated with T4 only preparations continue to be symptomatic. As discussed above, with any physiologic stress (emotional or physical), inflammation, depression, inflammation, aging or dieting, T4 to T3 conversion is reduced and T4 will be preferentially converted to reverse T3, which acts a competitive inhibitor of T3 (blocks T3 at the receptor), reduces metabolism, suppresses T4 to T3 conversion and blocks T4 and T3 uptake into the cell.

While a normal TSH cannot be used as a reliable indicator of global tissue thyroid effect, even a minimally elevated TSH (above 2) is a clear indication (except in unique situations) that the rest of the body is suffering from inadequate thyroid activity. Thus, treatment should likely be initiated in any symptomatic person with a TSH greater than 2. Additionally, many individuals will secrete a less bioactive TSH so for the same TSH level, a large percentage of individuals will have reduced stimulation of thyroid activity, further limiting the accuracy of TSH as a measure of overall thyroid status. Reduced bioactivity of TSH is not detected by current TSH assays used in clinical practice.

Due to the lack of correlation of TSH and tissue thyroid levels, a normal TSH should not be used as the sole reason to withhold treatment in a symptomatic patient. A symptomatic patient with an above average reverse T3 level and a below average free T3 (a general guideline being a free T3/reverse T3 ratio less than 2) should also be considered a candidate for thyroid supplementation. 

Growth Hormone – Are You Deficient?

June 1, 2018

The older you are, the harder it is to lose weight. You can eat right, exercise, and cut out sweets, but the scale doesn’t budge. Why? It has a lot to do with your hormones.

 

Hormones play an integral role in health and wellness. They promote growth within the body and influence metabolism, organ function, energy, and weight management. There are many factors that can interfere with hormone production, including aging. As people age, their body may not produce adequate levels of hormones. This creates havoc with your ability to maintain a healthy weight, slowing metabolism and energy levels. And hormone balance can begin to change as early as your 20s.

 

The good news is that you can rebalance your hormone levels with targeted therapies and can effectively manage hormone imbalance.

 

Growth hormone-releasing hormone is a hormone produced in an area of the brain called the hypothalamus. The main role of this hormone is to stimulate the pituitary gland to produce and release growth hormone. Growth hormone acts on virtually every tissue of the body. Growth hormone stimulates production of insulin-like growth factor from the liver and other organs, and this acts in the body to control metabolism and growth. In addition to its effect on growth hormone secretion, growth hormone-releasing hormone also affects sleep, food intake and memory.  

 

If your body produces too little growth hormone-releasing hormone, the production and release of growth hormone from the pituitary gland is impaired.  Adults with growth hormone deficiency may have a wide range of symptoms. The most important consequences of reduced growth hormone levels are changes in body structure (decreased muscle and bone mass and increased body fat), tiredness, being less lively and a poor health-related quality of life.  When these symptoms are severe, they can reduce people’s ability to function – both socially and professionally – and this can dramatically lower the quality of their lives. 

 

Other signs and symptoms include:

  • decrease in the amount of muscle bulk and strength
  • increase in the amount of fat in the body (especially around the waist)
  • abnormalities in the amount of ‘good’ and ‘bad’ cholesterol – this can lead to an increase in the risk of heart disease
  • abnormalities in the blood and in the circulation
  • osteoporosis
  • low energy levels and decreased stamina
  • impaired concentration and memory
  • sleep disturbances 

 

Sermorelin

Sermorelin is a bio-identical synthetic hormone peptide that may be used in conjunction with bio-identical hormone replacement therapy, various weight loss programs and erectile dysfunction treatment.  Sermorelin, a growth hormone-releasing hormone (GHRH), can enhance overall health and well-being by stimulating the production and release of hormones by the pituitary gland. This kick starts your metabolism so that your weight loss efforts are more effective!  It holds the potential to slow the effects of aging in humans by spurring growth of new tissue, muscles and synapses in the brain. It even has the potential to help patients think more clearly.  As you age, your body produces fewer hormones, a phenomenon that is considered one of the principal medical signs of aging. Sermorelin therapy encourages the body to naturally produce hormones. Sermorelin is different from many similar treatments, as it stimulates a natural process rather than requiring patients to directly add hormones to the system – this distinction makes our Sermorelin therapy much less likely to lead to complications.

 

While results may vary from patient to patient, studies have shown that Sermorelin anti-aging treatment can lead to a range of physical and mental benefits, such as:

  • Increased lean body mass
  • Fat reduction – improves the ability to burn fat
  • Improved energy
  • Increased vitality
  • Increased strength
  • Increased endurance
  • Accelerated wound healing – improved recovery and repair from injuries and inflammation
  • Better sleep quality
  • Improved bone density
  • Improved skin quality and higher collagen density
  • Regenerate nerve tissues
  • Strengthen the cardiovascular system
  • Strengthen the immune system
  • Improve cognition and memory
  • Increased sex drive

 

Patient Benefits Over Time

Benefits for patients on Sermorelin shown over the first eight weeks of protocol may include improvements in:

  • Week 1 Quality of sleep
  • Week 2 Recovery from workouts
  • Week 4 Mental clarity
  • Week 6 Skin elasticity
  • Week 8 Body composition

 

Tree of Life Medical is proud to announce Sermorelin for help with reduction of belly fat via lipolysis, boosting energy levels, increasing the skin’s elasticity, elevating endurance levels, promoting speed healing of wounds, ameliorating vision, and promoting deeper sleep. This formula can also strengthen libido in both men and women. Those who have experienced loss of libido are good candidates for therapy. In addition, people who are struggling to control their weight may find it easier to slim down with the help of this formulation.

 

An initial appointment will include a consultation to discuss your health history, your health goals, and review pertinent medical information. Blood tests may be required to determine levels of hormone imbalance and if Sermorelin is right for you.

The IUD – What You Need to Know

May 1, 2018

An IUD is a tiny device that is placed in the uterus to prevent pregnancy. It is long-term, reversible, and one of the most effective birth control methods available.  IUD stands for intrauterine device. It is a small piece of flexible plastic shaped like a T.

 

Types of IUDs

There are 5 different brands of IUDs that are FDA approved in the United States: ParaGard, Mirena, Kyleena, Liletta, and Skyla. These IUDs are divided into 2 types: copper-containing IUDs (ParaGard) and hormone-containing IUDs (Mirena, Kyleena, Liletta, and Skyla).

 

The ParaGard IUD does not have hormones. It is wrapped in copper, and it is effective for up to 12 years.  The Mirena, Kyleena, Liletta, and Skyla IUDs use the hormone progestin to prevent pregnancy. Progestin is very similar to the progesterone. Mirena and Kyleena are effective for up to 5 years. Liletta works for up to 4 years. Skyla works for up to 3 years.

 

How Does the IUD Work?

Both copper IUDs and hormonal IUDs prevent pregnancy by changing the way sperm moves so they can’t get to an egg. If sperm can’t make it to an egg, pregnancy can’t happen.

 

 

The ParaGard IUD uses copper to prevent pregnancy. Sperm is adversely affected by copper, so the ParaGard IUD makes it almost impossible for sperm to get to that egg.

 

 

The hormones in the Mirena, Kyleena, Liletta, and Skyla IUDs prevent pregnancy in two ways.  First, hormones thicken the cervical mucus, which blocks and traps the sperm.  Second, the hormones sometimes stop ovulation, which means there is no egg for a sperm to fertilize. No egg, no pregnancy.

 

 

One of the advantages of IUDs is that they last for years — but they are not permanent. If you decide to get pregnant or you just do not want to have your IUD anymore, it can quickly and easily be removed. You are able to get pregnant immediately after the IUD is removed.

 

IUDs For Emergency Contraception?

The ParaGard (copper) IUD works well as emergency contraception. If you have it placed within 120 hours (5 days) of unprotected sex, it is more than 99.9% effective. It is the most effective way to prevent pregnancy after sex.

 

IUD Effectiveness

IUDs are more than 99% effective. That means fewer than 1 out of 100 women who use an IUD will get pregnant each year. IUDs are effective because there is no chance for you to make a mistake. You cannot forget to take it (like the pill), or use it incorrectly (like condoms). And you are protected for 3-12 years, depending on which kind you get. Once your IUD is in place, you can pretty much forget about it until it expires – just keep track of your insertion and removal date.

 

Do IUDs protect against STDs?

No, IUDs do NOT protect against STDs.

 

Where Do I Get an IUD?

An IUD has to be put in by a healthcare provider.

 

The IUD Insertion

People usually feel slight cramping or pain when the IUD is placed. The pain can be worse for some, but it only lasts for a minute or two.  Some people feel dizzy during or right after the IUD is inserted. You might want to ask someone to come with you to the appointment so you don’t have to drive or go home alone, and to give yourself some time to relax afterward.

 

What To Expect After an IUD Insertion

Most people feel perfectly fine right after an IUD insertion – although some people need to take it easy for a while after the insertion. Heating pads and over-the-counter pain meds can help ease cramps.

 

You may have cramping and spotting after getting an IUD, but this almost always goes away within 6-8 weeks. Hormonal IUDs eventually make periods lighter and less crampy, and periods mights stop completely. Copper IUDs may make periods heavier and cramps worse. For some people, this goes away over time. There is a very small chance that your IUD could slip out of place. It can happen any time, but it is more common during the first 3 months. If your IUD falls out, you are NOT protected from pregnancy, so make sure to go see your doctor, and use condoms or another kind of birth control in the meantime.

 

How soon after getting an IUD can I have sex?

You can have sex as soon as you want after getting an IUD.

 

Who SHOULDN’T Get an IUD?

Most people can use IUDs safely, but there are some conditions that make side effects or complications more likely. You may not be able to get an IUD if you:

  • have certain STD’s or pelvic infection
  • think you might be pregnant
  • have cervical cancer that has not been treated
  • have cancer of the uterus
  • have vaginal bleeding that is not your period
  • have had a pelvic infection after either childbirth or an abortion in the past 3 months

 

 

Additionally, you should not get a ParaGard IUD if you have a copper allergy or a bleeding disorder that makes it hard for your blood to clot.  Very rarely, the size or shape of someone’s uterus makes it hard to place an IUD correctly.

 

Risks of IUD

There are possible risks with an IUD, but serious problems are really rare.

 

The IUD can sometimes slip out of the uterus — it can come all the way out or just a little bit. If this happens, you can get pregnant. If the IUD only comes out part of the way, it has to be removed. It is possible — though extremely unlikely — to get pregnant even if the IUD is in the correct location. If you get pregnant with an IUD in place, there is an increased risk of ectopic pregnancy and other serious health problems.

 

It is possible to get an infection if bacteria get into the uterus when the IUD is inserted. If the infection is not treated, it may affect your chances of getting pregnant in the future.

 

When the IUD is inserted, it could push through the wall of the uterus. If this happens, you could need surgery to remove the IUD. This is very rare.

 

What Warning Signs Should I Know About?

Chances are that you will NOT have problems with your IUD. But it is important to pay attention to your body and how you feel after you get your IUD. Here are the warning signs to watch out for:

  • the length of your IUD string feels shorter or longer than previously
  • you can feel the hard plastic bottom of the IUD coming out through your cervix
  • you think you might be pregnant
  • you have bad cramping, pain, or soreness in your lower abdomen
  • there is recurrent pain or bleeding during sex
  • you get unexplained fever, chills, or have trouble breathing
  • your vaginal discharge is different than normal
  • you have vaginal bleeding that is heavier than usual

 

IUD and Breastfeeding?

Yes, it is safe to use the IUD while you’re breastfeeding.  It should not have any effect on how much milk you produce, and it will not hurt your baby. In fact, the IUD is a great method to use if yo a’re breastfeeding and you do not want to get pregnant.

 

IUD Side Effects

Some people have side effects after getting an IUD. They usually go away in about 3–6 months.  Side effects can include:

  • pain when the IUD is put in
  • cramping or backaches for a few days after the IUD is put in
  • spotting between periods
  • irregular periods
  • heavier periods and worse menstrual cramps (ParaGard)

 

 

Pain medicine can usually help with cramping. If the bleeding or cramping gets worse or does not get better, tell your healthcare provider immediately.

 

IUD Removal

Getting an IUD removed is quick and easy. A healthcare provider gently pulls on the string, and the IUD slips out. You may feel cramping for a minute as it comes out.  There is a small chance that your IUD will not come out easily. If this happens, your healthcare provider may use special instruments to remove it. Very rarely, surgery may be needed.

 

 

You can get your IUD taken out whenever you want. ParaGard should be replaced after 12 years.  Mirena and Kyleena should be replaced after 5 years.  Liletta should be replaced after 4 years.  Skyla should be replaced after 3 years.

 

You should feel completely normal after getting your IUD removed. You may have some spotting. Your period will go back to how it was before you got your IUD.

 

Your fertility goes back to normal right after your IUD is removed.  It is possible to get pregnant right away. If you get your IUD removed and you don’t want to get pregnant, use another method of birth control.

MTHFR Mutations

April 17, 2018

What Is MTHFR?

MTHFR is a gene that provides the body with instructions for making a certain enzyme called methylenetetrahydrofolate reductase. There are two main MTHFR mutations: C677T and A1298C. Mutations can occur on different locations of these genes and be inherited from one or both parents. Having one mutated allele is associated with increased risk of certain health problems, but having two increases the risk much more. An MTHFR mutation can change the way a person metabolizes and converts important nutrients from their diets into active vitamins, minerals and proteins. In some cases, although not all, changes in how this enzyme works can affect cholesterol levels, brain function, digestion, endocrine functions and more.

 

MTHFR mutations affect people differently. It is believed that 30-50% of all people may carry a mutation in the MTHFR gene. Around 14-20% of that population have severe effects that impact overall health more drastically. People with this mutation tend to develop certain diseases, including ADHD, Alzheimer’s, atherosclerosis autoimmune disorders, autism, more often than those without the mutation. There is still a lot to learn about what this type of mutation means for people who carry it. To date, there have been dozens of different health conditions tied to MTHFR mutations, although just because someone inherits this mutation does not mean that person will wind up experiencing any problems.

 

Treating MTHFR Symptoms

 

Consume More Natural Folate, Vitamin B6 and Vitamin B12

People with MTHFR mutations have a harder time converting folic acid into its useable form and actually experience worsened symptoms from taking supplements containing folic acid. Look for the bioavailable form of folate in supplements (called L-methylfolate) and consume plenty of foods with folate. Some high-folate foods include:

  • Beans and lentils
  • Leafy green vegetables like raw spinach
  • Asparagus
  • Romaine
  • Broccoli
  • Avocado
  • Bright-colored fruits, such as oranges and mangoes

 

People with a MTHFR mutation are also more likely to be low in vitamins B6 and B12.  You can get these vitamins from supplements or food sources. To get more B vitamins, focus on eating quality protein foods, organ meats, nuts, beans, nutritional yeast and raw/fermented dairy products.

 

Treat Digestive Problems, Like Leaky Gut and IBS

Digestive complaints are common among people with MTHFR mutations. Many things affect digestive health, including nutrient intake, inflammation, allergies, neurotransmitter levels and hormone levels. For people who are already prone to nutrient deficiencies, leaky gut can make problems worse by interfering with normal absorption and raising inflammation.

 

To improve digestive/gut health, the following dietary changes can be beneficial:

  • Reduce intake of inflammatory foods, such as gluten, added sugar, preservatives, synthetic chemicals, processed meats, conventional dairy, refined vegetable oils, trans fats and processed/enriched grains (which often include synthetic folic acid).
  • Increase intake of probiotic foods, which supply ‘good bacteria’ that aids in digestion.
  • Consume gut-friendly foods, including bone broth, organic vegetables and fruit, flaxseeds and chia seeds, and fresh vegetable juices.
  • Consume health fats only, like coconut oil or milk, olive oil, grass-fed meat, wild-caught fish, nuts, seeds, and avocado.

 

Reduce Anxiety and Depression

MTHFR mutations are tied to higher incidences of mental disorders, including anxiety, depression, bipolar disorder, schizophrenia and chronic fatigue. High levels of stress can make MTHFR mutation symptoms even worse. Tips for dealing with these conditions include:

  • Supplement with omega-3 fatty acids: reduces inflammation and beneficial for cognitive health
  • Practice natural stress relievers: meditation, journaling, spending time outside, giving back or volunteering, praying, etc.
  • Regular exercise
  • Use soothing essential oils, including lavender, chamomile, geranium, clary sage and rose
  • Eliminate recreational drugs and reducing alcohol intake

 

Protect Heart Health

Studies show that homocysteine levels tend to rise with age, smoking and use of certain drugs – so the first step is to focus on taking care of yourself as you get older and limiting use of harmful substances. Other tips for keeping your heart healthy include:

  • Eating a healthy diet, especially one with plenty of high fiber foods
  • Getting regular exercise and keeping your weight in a healthy range
  • Managing stress to prevent worsened inflammation
  • Consider the following supplements, which can help improve blood flow, cholesterol and blood pressure: magnesium, omega-3s, CoQ10, caretenoids and other antioxidants, selenium, and vitamins C, D and E. 

Discuss Your Medications With Your Doctor

Some medications can deplete folate levels or interfere with methylation. The following medication classes might make symptoms worse:

  • Antibiotics
  • Birth control pills
  • Hormone replacement therapy drugs
  • Anticonvulsants (like phenytoin and carbamazepine)
  • Antacids
  • NSAIDs
  • Antidepressants
  • Chemotherapy treatments
  • Cholesterol-lowering drugs

Boost Detoxification

Because reduced methylation contributes to poor elimination of heavy metals and toxins, take extra steps to help flush waste and accumulated chemicals from your body. Tips for improving your ability to detox include:

  • Consume fresh vegetable juices to increase antioxidant intake
  • Takie activated charcoal
  • Drink plenty of water and avoiding alcohol or tobacco
  • Dry brushing
  • Take detox baths
  • Exercise regularly
  • Use of saunas
  • Occasionally fast in a healthy way or use natural enemas
  • Only use natural beauty and household products that are free from chemicals

Get Enough Quality Sleep

Sleep disturbances are common among people with anxiety, hormonal disorders, autoimmune disorders, chronic pain and fatigue. Make it a priority to get 7-9 hours of sleep every night, sticking to a regular schedule as much as possible. To help you get better sleep, try natural sleep aids like:

  • Create a relaxing bedtime routine
  • Use essential oils
  • Stay off of electronic devices
  • Read something soothing
  • Cool your bedroom a bit

 

MTHFR Mutation Symptoms and Signs

Evidence exists that the following health problems are tied to one of two primary forms of genetic MTHFR mutation:

  • ADHD
  • Autism and other childhood learning developmental problems
  • Down syndrome
  • Depression and anxiety
  • Spina bifida
  • Schizophrenia
  • Bipolar disorder
  • Autoimmune disorders and thyroid disorders
  • Addictions (alcohol and drug dependence for example)
  • Chronic pain disorders
  • Migraines
  • Heart problems, including low HDL “good” cholesterol levels and high homocysteine levels
  • Hormonal problems and fertility problems, including miscarriages and PCOS
  • Pulmonary embolisms
  • Fibromyalgia
  • Diabetes
  • Chronic Fatigue Syndrome
  • Parkinson’s disease, other tremor disorders and Alzheimer’s Disease
  • Stroke
  • Digestive problems, including irritable bowel syndrome
  • Problems during pregnancy, including pre-eclampsia and postpartum depression. The severity and type of symptoms depends on the variant of the mutation, along with much how the ability to carry out methylation and make MTHFR enzymes is impacted. 

Causes and Risk Factors of MTHFR Mutation

The main reason that MTHFR mutations cause health problems is due to disruptions in the normal process of methylation. Under normal circumstances, MTHFR:

  • Facilitates methylation, which is a metabolic process that switches genes on and off and repairs DNA. Methylation also affects nutrient conversions through enzyme interactions.
  • Forms proteins by converting amino acids.
  • Converts the amino acid homocysteine into methionine. This helps keep cholesterol levels balanced and is important for cardiovascular health. Elevated homocysteine levels put someone at a greater risk for heart attacks, strokes and other problems.
  • Carries out chemical reactions that help the body process folate (also called vitamin B9). This is done by converting one form of the methylenetetrahydrofolate molecule into another active form called 5-methyltetrahydrofolate. Folate/vitamin B9 is required for numerous critical bodily functions, so the inability for the body to make and use enough can affect everything from cognitive health to digestion.
  • Methylation is also tied to detoxification because it helps eliminate heavy metals and toxins through the GI tract.
  • Methylation also helps with the production of neurotransmitters and hormones. Deficiencies in these neurotransmitters can affects things like mood, motivation, sleep, sex drive, appetite and digestive functions. Abnormal levels of neurotransmitters are tied to ADHD, depression, anxiety, IBS and insomnia.
  • In order for methylation to take place, the body requires an amino acid called SAMe. SAMe helps regulate more than 200 different enzyme interactions, and without it methylation stops.

 

Whether you carry the MTHFR C677T or MTHFR A1298C mutation determines if you’re more likely to suffer from certain diseases than others.

  • MTHFR C677T mutations are tied to cardiovascular problems, elevated homocysteine, stroke, migraines, miscarriages and neural tube defects. Some studies suggest that people with two C677T gene mutations have about a 16 percent higher chance of developing coronary heart disease compared to people without these mutations.
  • MTHFR A1298C are tied to higher levels of fibromyalgia, IBS, fatigue, chronic pain, schizophrenia and mood-related problems. This is especially true if you’ve inherited the mutation from both parents or have both forms of MTHFR mutations.

 

Testing and Diagnosing MTHFR Mutations

Many people have no idea that they carry an MTHFR mutation gene that contributes to their symptoms. If you suspect you might be affected by an MTHFR mutation, consider having a genetic test performed. Other tests that can help confirm a mutation include heavy metal tests, urine tests, homocysteine level tests, folic acid tests, leaky gut testing and hormone level testing.

 

Because it is a problem related to an inherited gene, there is no way to ‘cure’ an MTHFR mutation — however lifestyle changes and natural treatments can help manage symptoms.

Polycystic Ovarian Syndrome

March 30, 2018

Polycystic ovarian syndrome (PCOS) is a common health problem caused by an imbalance of reproductive hormones. The hormonal imbalance creates problems in the ovaries. The ovaries make egg that are released each month. With PCOS, eggs may not develop or may not be released during ovulation. Five to ten percent of reproductive aged women have PCOS.  Most often, women find out they have PCOS in their 20’s and 30’s when they have problems getting pregnant – but PCOS can happen at any age after puberty.  Women of all races and ethnicities are at risk for PCOS.  Your risk for PCOS may be higher if you are obese or if you have a mother, sister, or aunt with PCOS.

Conditions Associated With PCOS

  • Diabetes. More than half of women with PCOS will have diabetes or pre-diabetes  before age 40.
  • High blood pressure. Women with PCOS are at greater risk of having high blood pressure compared to women without PCOS. High blood pressure is a leading cause of heart disease and stroke.
  • Unhealthy cholesterol. Women with PCOS often have higher levels of LDL (bad) cholesterol and low levels of HDL (good) cholesterol. High cholesterol raises your risk for heart disease and stroke.
  • Sleep apnea – momentary and repeated interuptions in breathing that disrupt sleep. Many women with PCOS are overweight or obese, which can cause sleep apnea. Sleep apnea raises your risk for heart disease and diabetes.
  • Depression and anxiety. Depression and anxiety are common among women with PCOS.
  • Endometrial cancer. Problems with ovulation, obesity, insulin resistance, and diabetes (all common in women with PCOS) increase the risk of developing cancer of the endometrium (lining of the uterus).

Symptoms of PCOS?

PCOS has many signs and symptoms, some of which may not seem to be related:

  • Menstrual irregularities:
    • No menstrual periods—called amenorrhea
    • Frequently missed periods—called oligomenorrhea
    • Heavy periods
    • Bleeding but no ovulation—called anovulatory periods
  • Infertility
  • Pelvic pain
  • Excess hair growth on the face, chest, stomach, or thighs—called hirsutism
  • Severe, late-onset, or persistent acne that does not respond well to usual treatments
  • Obesity, weight gain, or trouble losing weight, especially around the waist
  • Oily skin
  • Patches of thickened, dark, velvety skin—a condition called acanthosis nigricans

Because many women don’t consider problems such as oily skin, extra hair growth, or acne to be symptoms of a serious health condition, they may not mention these things to their doctor. As a result, many women aren’t diagnosed with PCOS until they have trouble getting pregnant or if they have abnormal periods or missed periods.

Although PCOS is a leading cause of infertility, many women with PCOS can and do get pregnant. Pregnant women who have PCOS, however, are at higher risk for certain problems, such as miscarriage.

Causes of PCOS?

The exact cause of PCOS is unknown. Most experts think that several factors, including genetics, play a role:

  • High levels of androgens. Androgens are sometimes called ‘male hormones’, although all women make small amounts of androgens. Androgens control the development of male traits, such as male-pattern baldness. Women with PCOS have more androgens than normal. Estrogens are also called ‘female hormones’. Higher than normal androgen levels in women can prevent the ovaries from releasing eggs (ovulation) and can cause extra hair growth and acne, two signs of PCOS.
  • High levels of insulin. Insulin is a hormone that controls how the food you eat is changed into energy. Insulin resistance is when the body’s cells do not respond normally to insulin. As a result, your insulin blood levels become higher than normal. Many women with PCOS have insulin resistance, especially those who are overweight or obese, have unhealthy eating habits, do not get enough physical activity, and have a family history of diabetes (usually type 2 diabetes). Over time, insulin resistance can lead to type 2 diabetes.

Polycystic ovarian syndrome (PCOS) is the leading cause of infertility in reproductive age women. Lack of ovulation is generally assumed to be the cause after other anatomic, hormonal, and male factor causes are ruled out.

Diagnosing PCOS

Because there is currently no universal definition of PCOS, different expert groups use different criteria to diagnose the condition. All the groups look for the following three features:

  1. Menstrual irregularities, such as light periods or skipped periods, that result from long-term absence of ovulation (the process that releases a mature egg from the ovary).
  2. High levels of androgens that do not result from other causes or conditions, or signs of high androgens, such as excess body or facial hair.
  3. Multiple cysts of a specific size on one or both of the ovaries as detected by ultrasound.

Having one or more of these features could lead to a diagnosis of PCOS. If your medical history suggests that you might have PCOS, we will rule out other conditions that may cause similar symptoms.

Some of these conditions include:
  • Excess hormone production by the adrenal glands, called adrenal hyperplasia
  • Problems with the function of the thyroid gland
  • Excess production of the hormone prolactin by the pituitary gland, called hyperprolactinemia

After ruling out other conditions and before making a diagnosis of PCOS, we will also:

  • Take a full personal and family history because PCOS tends to run in families.
  • Conduct a complete physical exam. We will look for extra hair growth, acne, and other signs of high levels of the hormone androgen. We will take your blood pressure, measure your waist, and calculate your body mass index, a measure of your body fat based on your height and weight.
  • Take blood samples. Blood tests will include levels of androgens, cholesterol, and sugar in your blood.
  • Do a pelvic exam or ultrasound to check your ovaries.

Treatment For PCOS

  • Losing weight. Changing your lifestyle like having fewer sugary drinks and hog-calorie desserts to help control your weight, exercising each day and avoiding smoking.  These healthy eating habits and regular physical activity can help relieve PCOS-related symptoms. Losing weight may help to lower your blood glucose levels, improve the way your body uses insulin, and help your hormones reach normal levels. Even a 10% loss in body weight (for example, a 150-pound woman losing 15 pounds) can help make your menstrual cycle more regular and improve your chances of getting pregnant.  Consider counseling with a registered dietitian to help you choose healthy foods and lose weight if you are overweight or obese.
  • Removing unwanted facial/body hair. You can try facial hair removal creams, laser hair removal, waxing, or electrolysis to remove excess hair. You can find hair removal creams and products at drugstores. Procedures like laser hair removal or electrolysis must be done by a doctor and may not be covered by health insurance.
  • Slowing hair growth. A prescription skin treatment (eflornithine HCl cream) can help slow down the growth rate of new hair in unwanted places.
  • Medications.  Medicines that contain estrogen and progesterone such as birth control pills, a vaginal ring, or a skin patch; medicines to help your body use insulin better, such as Metformin (for pre-diabetes or diabetes); and/or acne medicine.

Coping With PCOS

Seeing a doctor who knows about PCOS is the first step. Choose a doctor who specializes in hormone problems or a doctor who specializes in women’s health. Remember that the sooner you get help for your PCOS, the sooner you could lower your risk for related health problems such as diabetes. Your doctor can help you find ways to feel better about your appearance. For example, you can ask your doctor about the best way to remove unwanted facial hair. If you feel worried or depressed, ask your parents or your doctor where to go for counseling. You can also go to a support group to talk with others who have PCOS.

Abnormal Uterine Bleeding in Adolescents

March 11, 2018

A female’s first menstrual cycle is an important event during adolescence. For most girls, it marks completion of puberty and the onset of reproductive capability. Menstrual problems are common during adolescence and can last 2-5 years after their first period.

 

Menstrual irregularities are a common gynecologic problem, especially in adolescents. Abnormal uterine bleeding is any form of bleeding that is irregular in amount, duration, or frequency. It can be characterized by excessive uterine bleeding that occurs regularly, by heavy bleeding at irregular times, or a combination of both. It can also be intermittent bleeding or sparse cyclical bleeding. Often the bleeding is not serious, but it can be annoying and disrupt life. The term ‘dysfunctional uterine bleeding’ is a subset of abnormal uterine bleeding and is defined as excessive, prolonged, or unpatterned bleeding from the uterus without an organic cause,  The term is frequently used synonymously with anovulatory bleeding (irregular bleeding resulting from the absence of ovulation). In adolescents, up to 95% of abnormal uterine bleeding is ‘dysfunctional uterine bleeding’. However, because ‘dysfunctional uterine bleeding’ is a diagnosis of exclusion, other potential causes of abnormal bleeding must be considered and excluded.

 

You may have abnormal uterine bleeding if you have one or more of the following symptoms:

  • You get your period more often than every 21 days or farther apart than 35 days. A normal adult menstrual cycle is 21 to 35 days long. A normal teen cycle is 21 to 45 days.
  • Your period lasts longer than 7 days (normally 4 to 6 days).
  • Your bleeding is heavier than normal.

(If you are passing blood clots and soaking through your usual pads or tampons each hour for 2 or more hours, your bleeding is considered severe and you should call your doctor.)

 

The normal menstrual cycle usually consists of an average interval of 28 days (± 6 days) with a average duration of 4 days (±2-3 days). Normal blood loss is approximately 30 mL per cycle, with an upper limit of 60-80 mL. The average age of a first period in the United States is 12.8 years, with the range from 9-18 years.

 

The normal menstrual cycle is divided into three phases. In the first phase, a group of eggs are stimulated to grow in the ovaries, from which one dominant follicle (egg) is selected. The dominant follicle produces increasing amounts of estrogen. Estrogen stimulates the uterine lining to proliferate and develop progesterone receptors. When estrogen reaches a certain sustained level, a surge of hormone is released from the pituitary, causing the dominant follicle to ovulate:  the second stage of the menstrual cycle. Progesterone halts uterine lining growth and stabilizes the lining, which is the third phase. In the absence of conception, there is a rapid decline in estrogen and progesterone. The endometrium collapses and sheds as menstruation occurs, approximately 14 days after ovulation. Menstrual flow stops as a result of the combined effect of prolonged vasoconstriction, tissue collapse, vascular stasis, and estrogen-induced “healing”.

 

In summary, with normal ovulation, there is regular cyclical production of estradiol, initiating ovarian follicular growth and uterine proliferation. Following ovulation, the production of progesterone stabilizes the uterine lining. Without ovulation and subsequent progesterone production, a state of “unopposed” continuous estrogen secretion occurs. This stimulates abnormal uterine lining growth without adequate structural support. The consequence is spontaneous sloughing of the endometrium and unpredictable bleeding. In anovulatory cycles, the estrogen levels can either be high or low. With chronic high levels, there is intermittent heavy bleeding, and chronically low levels may result in prolonged light bleeding.[5]

 

Abnormal uterine bleeding in adolescents is defined as excessive bleeding occurring between menarche (first period) and 19 years of age. During the first 12–18 months after the onset of menstruation, immaturity of the hypothalamic-pituitary axis.  This means that the communication system between the brain, the ovaries and the uterus is immature and not yet communicating properly.  It is believed that this ‘miscommunication’ results in an inconsistent ‘positive feedback’ response, wherein sustained elevations of estrogen occur – which causes progesterone disregulation and prevents ovulation.  The lack of ovulation (called anovulation) is the most common cause of abnormal uterine bleeding during early adolescence. By the third year after menarche, about 75% of menstrual cycles are 21–34 days long, regardless of age at menarche.  The maturation of the hypothalamic-pituitary-ovarian axis occurs slowly in the first 18-24 months after menarche in the adolescent female. Anovulatory cycles may last up to 5 years.

 

Besides physiologic causes, anovulation can also have organic pathologic causes. These include hyperandrogenic states (e.g., polycystic ovary syndrome [PCOS]), hypothalamic dysfunction (e.g., anorexia nervosa and excessive exercise), endocrinopathies, and premature ovarian failure. Occasionally, the bleeding is caused by an anatomic cause (e.g., polyps or fibroids), although this is very rare in adolescents.

 

Girls and adolescents with more than 45 days between menstrual cycles, less than 21 days between menses, bleeding lasting longer than 7 days, having a single episode of 3 months between bleeding, or changing sanitary products more often than every 1-2 hours should undergo an evaluation. Regardless of reported sexual history, it is imperative to rule out pregnancy, sexual trauma, and sexually transmitted infections. Patients should be evaluated for endocrine disorders (such as thyroid disease), stress and eating disorders, and polycystic ovary syndrome (PCOS).

 

Differential Diagnosis of Abnormal Uterine Bleeding in Adolescents

 

Although the majority of adolescents with abnormal bleeding have anovulation due to age, dysfunctional vaginal bleeding is a diagnosis of exclusion.

 

Coagulation Disorder

Blood loss in the normal menstrual cycle is self-limited due to the action of platelets and fibrin. Individuals with thrombocytopenia or coagulation deficiency may have excessive menstrual bleeding.The most common coagulation disorders include thrombocytopenia, due to idiopathic thrombocytopenic purpura (ITP), von Willebrand’s disease, which affects up to 1% of the population, and platelet function defects. Of the adolescents presenting with severe menorrhagia or hemoglobin less than 10 g/dL, 25% were found to have a coagulation disorder. In those presenting with menorrhagia at the first menses, 50% were found to have a coagulation disorder.

 

Pregnancy Complications

The possibility of pregnancy should be considered in any adolescent with abnormal bleeding, and a pregnancy test is mandatory even if the client denies sexual intercourse. Any bleeding in early pregnancy should lead to suspicion of miscarriage or ectopic pregnancy.

 

Reproductive Tract Pathology

Any trauma, infection, or neoplasm can cause abnormal uterine bleeding. Infections, such as chlamydia or pelvic inflammatory disease (PID), may present with abnormal bleeding. Vaginal trauma or a foreign body may cause bleeding that might be assumed by the adolescent to be uterine in origin. Women with a foreign body in the vagina generally present with a bloody, odorous discharge. Cervical polyps, cervical carcinoma, and cervical inflammation can cause bleeding. Cervical cancer is fairly rare in adolescents but may be encountered in those who had sexual experiences at a very early age (including those with a history of sexual abuse). Ovarian estrogen-producing tumors need to be excluded in the adolescent with very heavy persistent bleeding. Finally, although rare, uterine pathology, such as polyps and fibroids, may lead to abnormal bleeding.

 

Endocrinopathies

The most common endocrine disorder to cause abnormal bleeding is thyroid disease. In general, hypothyroidism presents with hypermenorrhea, and hyperthyroidism presents with hypomenorrhea. Hyperprolactinemia caused by a prolactinoma or certain medications, such as neuroleptics, can also cause anovulation and abnormal uterine bleeding. PCOS is underdiagnosed in adolescents and should be suspected in obese teens with hirsutism, acne, and continued irregular cycles. There is some recent evidence that PCOS is more common in women with epilepsy. Other diseases to consider are congenital adrenal hyperplasia, Cushing syndrome, hepatic dysfunction, and adrenal insufficiency.

 

Others Causes

Other causes of abnormal uterine bleeding in adolescents are eating disorders, stress, excessive exercise, and weight loss. In addition, common medications, which increase the cytochrome P450 enzymatic processes in the liver, may induce the more rapid metabolism of steroid hormones, thereby decreasing their bioavailability and result in abnormal uterine bleeding that is secondary to a relative insufficiency of estrogen or progesterone (e.g., anti-seizure medications).

 

Evaluation and Management of Abnormal Uterine Bleeding in Adolescents

 

Laboratory testing should initially include an assessment of urine or serum β-hCG, a complete blood count with platelets, and TSH. Other testing should be performed based on the history and physical examination, and may include androgen levels (free or total testosterone) and prolactin. Adolescents with abnormal uterine bleeding can have a concomitant bleeding disorder. Von Willebrand disease is the most common bleeding disorder in women. Approximately one quarter of adolescents who require hospitalization or blood transfusion may have a coagulopathy. Anemia on initial evaluation should trigger further testing for a bleeding disorder including PT, PTT, and a Von Willebrand panel.

 

The goal of therapy is to decrease excessive bleeding, prevent its recurrence, and improve quality of life. A trial of combined oral contraceptives can serve as a diagnostic and therapeutic approach to the workup of abnormal bleeding in adolescents. In addition to regulating menstrual flow and providing contraception, combined oral contraceptives can provide relief of associated dysmenorrhea, acne/hirsutism, and premenstrual syndrome, prevent menstrual migraine, and potentially reduce pelvic pain associated with endometriosis. In patients who cannot use estrogen due to other existing medical conditions, Depo-Provera or a progesterone-containing IUD can also reliably provide relief for abnormal bleeding, with a substantial proportion of users achieving amenorrhea within 6 months. Rarely, incessant bleeding can become a medical emergency that requires hospitalization and more intense evaluation including a pelvic exam, ultrasound, and treatment including intravenous estrogen, fibrinolytics, and in rare cases, surgical intervention.

 

Consider coming in for evaluation if you have had irregular vaginal bleeding for three or more menstrual cycles, or if your symptoms are affecting your daily life. There are many things we can do to treat abnormal uterine bleeding. Some are meant to return the menstrual cycle to normal. Others are used to reduce bleeding or to stop monthly periods. Each treatment works for some women but not others. We will discuss all the options and find a treatment that is right for you.

 

Differential Diagnosis of Abnormal Uterine Bleeding in Adolescents

  • Immaturity of the HPO axis
  • Coagulation disorders

  Idiopathic thrombocytopenic purpura (ITP)

  Von Willebrand’s disease

  Platelet function defect

  • Pregnancy complications

  Abortion (complete, incomplete, missed)

  Ectopic pregnancy

  Trophoblastic disease

  • Genital tract infection

  Vaginitis

  Cervicitis

  Vaginal foreign body

  Salpingo-oophoritis

  Endometritis

  • Endocrinopathies

  Polycystic ovary disease

  Hyperprolactinemia

  Thyroid or adrenal abnormalities

  Premature ovarian failure

  Hypothalamic dysfunction

  Anorexia, stress, excessive exercise

  • Benign lesions of the genital tract

  Cervical polyp

  Vaginal adenosis

  Endometriosis

  Uterine fibroid

  • Iatrogenic: drugs or hormones
  • Trauma
  • Malignant lesions of the genital tract

Vaginal carcinoma

 Cervical carcinoma

  Uterine carcinoma

  Ovarian tumors

What You Need To Know About Thyroid Disease

January 10, 2018

The thyroid gland is a small, gland located in the base of the neck. It plays a huge role in our body, influencing the function of many of the body’s most important organs, including the heart, brain, liver, kidneys and skin.

I use this example with my patients to explain the role of the thyroid gland:

Think of your thyroid as a car engine that controls how your body functions. An engine produces the necessary energy for a car to operate in a certain manner. In the same way, the thyroid gland produces enough thyroid hormone to prompt your body to perform functions in a certain manner. Just as a car cannot produce energy without gas, your thyroid needs fuel to produce thyroid hormone. Your thyroid’s fuel is iodine. The thyroid extracts iodine from the bloodstream and uses it to make two thyroid hormones: T4 (contains four iodine atoms) and T3 (contains three iodine atoms). T3 is made from T4 when one iodine is removed, a conversion that occurs mostly outside the thyroid in organs and tissues where T3 is the primary thyroid hormone that is used. When T4 is produced, it is stored within the thyroid as a reserve for later use. A small amount of T3 is also produced and stored in the thyroid. When your body needs thyroid hormone, it is secreted into your bloodstream in quantities set to meet the needs of your cells. Your car engine produces energy, but you tell it how fast to go by stepping on the accelerator. The thyroid gets its instruction from the pituitary gland, which is located in your brain. These instructions come in the form of thyroid-stimulating hormone (TSH). TSH levels rise or fall depending on whether enough thyroid hormone is produced to meet your body’s needs. Higher levels of TSH prompt the thyroid to produce more thyroid hormone. Conversely, low TSH levels signal the thyroid to slow down production.

When Things Go Wrong

Normally, the thyroid produces just the right amount of hormone to keep your body running smoothly. TSH levels remain fairly constant. But even the best systems are subject to interference. When outside influences such as disease, damage to the thyroid or certain medicines inhibit proper communication, your thyroid might not produce enough hormone. This slows down all of your body’s functions – known as hypothyroidism or underactive thyroid. I like to use the term ‘suboptimal’ thyroid function.  Your thyroid could also produce too much hormone which would send your systems into overdrive, a condition called hyperthyroidism or overactive thyroid.  I like to use the term overactive thyroid.  When considering thyroid disease, doctors ask two main questions: First, is the thyroid gland inappropriately producing an abnormal amount of thyroid hormone? And second, is there a structural change in the thyroid, such as a lump (a nodule) or an enlargement (a goiter)? Though one of these characteristics does not necessarily imply that the other is present nor do they diagnose hypo- or hyperthyroidism.

 

Out of Gas

Sometimes the thyroid can’t meet your body’s demands for thyroid hormone, even though TSH levels increase. As your body slows down, you may feel cold, tired and even depressed. You may gain weight, even though you’re eating less and exercising. There could be a number of reasons why your thyroid is not performing well. For example, if your body isn’t getting enough iodine, your thyroid can’t make enough thyroid hormone, but it will try to respond to rising TSH levels by working harder and harder anyway.

Causes of Hypothyroidism
  • Autoimmune thyroiditis:  When your thyroid comes under attack by your body’s immune system. Normally, antibodies protect you from infection or inflammation. But in this condition, called Hashimoto’s thyroiditis, your antibodies mistake your thyroid for a foreign invader. Hashimoto’s generally involves the presence of two types of antibodies called antithyroid peroxidase (anti-TPO) and antithyroglobulin (anti-TG) antibodies. These antibodies lead to destruction of the thyroid by the immune system. Hashimoto’s thyroiditis results from an abnormal immune response are called autoimmune diseases. Hashimoto’s thyroiditis is only one form of thyroiditis —an inflammation of the thyroid—that causes hypothyroidism.  Other autoimmune diseases may be associated with this disorder, and additional family members may also be affected.
  • Central or pituitary hypothyroidism:  Any destructive disease of the pituitary gland or hypothalamus, which sits just above the pituitary gland, may cause damage to the cells that secrete TSH, which stimulates the thyroid to produce normal amounts of thyroid hormone. This is a rare cause of hypothyroidism.
  • Congenital hypothyroidism: An infant may be born with an inadequate amount of thyroid tissue or an enzyme defect that does not allow normal thyroid hormone production. If this condition is not treated promptly, physical stunting and/or mental damage may develop.
  • Medications: Lithium, high doses of iodine and Amiodarone, for example.
  • Postpartum thyroiditis: 5-10% of women develop mild to moderate hyperthyroidism within months of giving birth. Hyperthyroidism in this condition usually lasts for approximately 1-2 months. It is often followed by several months of hypothyroidism.  Most women will eventually recover normal thyroid function. In some cases, however, the thyroid gland does not heal, so the hypothyroidism becomes permanent and requires lifelong thyroid hormone replacement. This condition may recur in subsequent pregnancies.
  • Radioactive iodine treatment: Hypothyroidism frequently develops as a desired therapeutic goal after the use of radioactive iodine treatment for hyperthyroidism.
  • Silent Thyroiditis: This condition appears to be the same as postpartum thyroiditis but not related to pregnancy.
  • Subacute thyroiditis: This condition may follow a viral infection and is characterized by painful thyroid gland enlargement and inflammation, which results in the release of large amounts of thyroid hormone into the blood. This condition usually resolves spontaneously. The thyroid usually heals itself over several months.
  • Thyroid surgery: Hypothyroidism may be related to surgery on the thyroid gland, especially if most of the thyroid has been removed.
Signs & Symptoms of Hypothyroidism

In its earliest stage, hypothyroidism may cause few symptoms, since the body has the ability to partially compensate for a failing thyroid gland by increasing the stimulation to it, much like pressing down on the accelerator when climbing a hill to keep the car going the same speed. As thyroid hormone production decreases and the body’s metabolism slows, a variety of features may result.

  • Pervasive fatigue
  • Drowsiness
  • Forgetfulness
  • Difficulty with learning
  • Dry, brittle hair and nails
  • Dry, itchy skin
  • Puffy face
  • Constipation
  • Sore muscles
  • Weight gain and fluid retention
  • Heavy and/or irregular menstrual flow
  • Increased frequency of miscarriages
  • Increased sensitivity to many medications
Diagnosing Hypothyroidism

Characteristic symptoms and physical signs  can signal hypothyroidism. However, the condition may develop so slowly that many patients do not realize that their body has changed, so it is critically important to perform diagnostic laboratory tests to confirm the diagnosis and to determine the cause of hypothyroidism.

Treating Hypothyroidism

Hypothyroidism is generally treated with a daily medication. There are multiple types of thyroid medication.  Not everyone respond the same to each medication, and not every medication is appropriate for a particular type of thyroid disease  An experienced physician can prescribe the correct form and dosage to return the thyroid balance to normal. Thyroid hormone acts very slowly in some parts of the body, so it may take several months after treatment for some features to improve.

It is extremely important that women planning to become pregnant are kept well adjusted, since hypothyroidism can affect the development of the baby. During pregnancy, thyroid hormone replacement requirements often change, so more frequent monitoring is necessary. Various medications and supplements (particularly iron) may affect the absorption of thyroid hormone; therefore, the levels may need more frequent monitoring during illness or change in medication and supplements. Thyroid hormone is critical for normal brain development in babies.

Since most cases of hypothyroidism are permanent and often progressive, it is usually necessary to treat this condition throughout one’s lifetime. Periodic monitoring of laboratory levels and clinical status are necessary to ensure that the proper dose is being given, since medication doses may have to be adjusted from time to time. Optimal adjustment of thyroid hormone dosage is critical, since the body is very sensitive to even small changes in thyroid hormone levels.

 

Revved Up – Hyperthyroidism

Hyperthyroidism develops when the body is exposed to excessive amounts of thyroid hormone. This disorder occurs in almost one percent of all Americans and affects women five to 10 times more often than men. In its mildest form, hyperthyroidism may not cause recognizable symptoms. More often, however, the symptoms are discomforting, disabling or even life-threatening.

Causes of Hyperthyroidism
  • Graves’ Disease: Graves’ disease is an autoimmune disorder that frequently results in thyroid enlargement and hyperthyroidism. In some patients, swelling of the muscles and other tissues around the eyes may develop. This is characterized by swollen, bulging, red eyes; widely open eyelids; and double vision. In its most severe form, diminished visual acuity may be present. As with Hashimoto’s thyroiditis, antibodies attack the thyroid, but in this case they stimulate the thyroid to overproduce thyroid hormone. The antibodies present in Graves’ disease are generally thyrotropin receptor antibodies (TRAb), including one kind known as thyroid-stimulating immunoglobulins (TSIs). They work by mimicking TSH, attaching to the TSH receptor on the thyroid gland and confusing the thyroid into producing too much hormone. Like other autoimmune diseases, this condition tends to affect multiple family members. It is much more common in women than in men and tends to occur in younger patients.
  • Postpartum Thyroiditis: 5-10% of women develop mild to moderate hyperthyroidism within months of giving birth. Hyperthyroidism in this condition usually lasts for 1-2 months. It is often followed by several months of hypothyroidism, but most women will eventually recover normal thyroid function. In some cases, however, the thyroid gland does not heal, so the hypothyroidism becomes permanent and requires lifelong thyroid hormone replacement. This condition may occur again with subsequent pregnancies.
  • Silent Thyroiditis: Transient (temporary) hyperthyroidism can be caused by silent thyroiditis, a condition similar to postpartum thyroiditis, but is not related to pregnancy. It is not accompanied by a painful thyroid gland.
  • Subacute Thyroiditis: This condition may follow a viral infection and is characterized by painful thyroid gland enlargement and inflammation, which results in the release of large amounts of thyroid hormones into the blood. This condition usually resolves spontaneously over several months, but often not before a temporary period of low thyroid hormone production occurs.
  • Toxic Multinodular Goiter: Multiple nodules in the thyroid can produce excess thyroid hormone, causing hyperthyroidism. Typically diagnosed in patients over the age of 50, this disorder is more likely to affect heart rhythm. In many cases, the person has had the goiter for many years before it becomes overactive.
  • Toxic Nodule: A single nodule or lump in the thyroid can produce more thyroid hormone than the body requires and lead to hyperthyroidism.
  • Excessive Iodine Ingestion: Various sources of high iodine concentrations, such as kelp tablets, some expectorants, amiodarone and x-ray dyes may occasionally cause hyperthyroidism in patients who are prone to it.
  • Overmedication with thyroid hormone: Patients who receive excessive thyroxine replacement treatment can develop hyperthyroidism. They should have their thyroid hormone dosage evaluated routinely and should NEVER give themselves “extra” doses.

 

Signs & Symptoms of Hyperthyroidism

When hyperthyroidism develops, a goiter (enlargement of the thyroid) is usually (but not always) present and may be associated with some or many of the following features:

  • Fast heart rate, often more than 100 beats per minute
  • Becoming anxious, irritable, argumentative
  • Trembling hand
  •  Weight loss, despite eating the same amount or even more than usua
  •  Intolerance of warm temperatures and increased likelihood to perspire
  • Loss of scalp hair
  • Tendency of fingernails to separate from the nail bed
  • Muscle weakness, especially of the upper arms and thighs
  • Loose and frequent bowel movements
  • Smooth skin
  • Change in menstrual pattern
  • Increased likelihood for miscarriage
  • Prominent “stare” of the eyes
  • Protrusion of the eyes, with or without double vision (in patients with Graves’ disease)
  •  Irregular heart rhythm, especially in patients older than 60 years of age
  • Accelerated loss of calcium from bones, which increases the risk of osteoporosis and fractures

 

Diagnosing Hyperthyroidism

Characteristic symptoms and physical signs of the disease can be detected by a trained physician. In addition, tests can be used to confirm the diagnosis and to determine the cause.

 

Treating Hyperthyroidism

Antithyroid Drugs

Two drugs are available for treating hyperthyroidism: propylthiouracil (PTU) and methimazole. Except for early pregnancy, methimazole is preferred. These medications control hyperthyroidism by slowing thyroid hormone production. They may take several months to normalize thyroid hormone levels.

 

Radioactive Iodine Treatment

Iodine is an essential in the production of thyroid hormone. Each molecule of thyroid hormone contains either four (T4) or three (T3) molecules of iodine. Since most overactive thyroid glands are hungry for iodine, it was discovered that the thyroid could be “tricked” into destroying itself by feeding it radioactive iodine. The radioactive iodine is given by mouth, usually in capsule form. Maximal benefit is usually noted within 3-6 months.  Most physicians strive to completely destroy the thyroid gland with a single dose of radioiodine. This results in the intentional development of an underactive thyroid state (hypothyroidism), which is easily, predictably and inexpensively corrected by lifelong daily use of oral thyroid hormone replacement therapy.
Thousands of patients have received radioiodine treatment. The treatment is a very safe, simple and reliably effective. Because of this, it is considered by most thyroid specialists to be the treatment of choice for hyperthyroidism cases caused by overproduction of thyroid hormone.

 

Surgical Removal of the Thyroid

Although seldom used now as the preferred treatment for hyperthyroidism, surgically removing most(or all) of the thyroid gland may be recommended in certain situations. Surgery usually leads to permanent hypothyroidism and lifelong thyroid hormone replacement therapy.

 

Other Treatments

A drug from the class of beta-adrenergic blocking agents (which decrease the effects of excess thyroid hormone) can temporarily control hyperthyroid symptoms until other therapies take effect. In cases where hyperthyroidism is caused by thyroiditis or excessive ingestion of either iodine or thyroid hormone, this may be the only type of treatment required. Also,  iodine drops are prescribed when hyperthyroidism is severe or prior to undergoing surgery for Graves’ disease.

 

How common is thyroid disease?

Thyroid disease is more common than diabetes or heart disease. As many as 30 million Americans are affected by thyroid disease – and more than half of those people remain undiagnosed. Women are five times more likely than men to suffer from hypothyroidism.

 

How important is my thyroid in my overall well-being?

The thyroid gland produces thyroid hormone, which controls virtually every cell, tissue and organ in the body. Untreated thyroid disease may lead to elevated cholesterol levels and subsequent heart disease, as well as infertility and osteoporosis. Research also shows that there is a strong genetic link between thyroid disease and other autoimmune diseases, including types of diabetes, arthritis and anemia. Simply put, if your thyroid gland isn’t working properly, neither are you.

 

How do you know if you have a thyroid problem?

First, you must recognize the symptoms and risk factors of thyroid disease. Since many symptoms may be hidden or mimic other diseases and conditions, the best way to know for sure is to ask your doctor.

 

What are some of the reasons to consider a thyroid evaluation?

  • Family history:  If you have a first-degree relative (a parent, sibling or child) with thyroid disease, you would benefit from thyroid evaluation. Women are much more likely to be thyroid patients than men; however, the gene pool runs through both.
  • Prescription medications: If you are taking Lithium or Amiodarone, you should consider a thyroid evaluation.
  • Radiation therapy to the head or neck: If you have had any of the following radiation therapies, you should consider a thyroid evaluation: radiation therapy for tonsils, radiation therapy for an enlarged thymus, or radiation therapy for acne.
  • Chernobyl: If you lived near Chernobyl at the time of the 1986 nuclear accident, you should consider a thyroid evaluation.

 

Thyroid Nodules

A thyroid nodule is a lump in or on the thyroid gland. Thyroid nodules are common, but are usually not diagnosed. They are detected in about 6% percent of women and 1-2% of men. They are 10 times as common in older people. Sometimes several nodules will develop in the same person. Any time a lump is discovered in thyroid tissue, the possibility of malignancy (cancer) must be considered. Fortunately, the vast majority of thyroid nodules are benign (not cancerous).

 

Causes

Nodules can be caused by a simple overgrowth of “normal” thyroid tissue, fluid-filled cysts, inflammation (thyroiditis), or a tumor (either benign or cancerous).

 

Signs & Symptoms

Most patients with thyroid nodules have no symptoms. Many are found by chance on a routine physical exam or an imaging study of the neck done for unrelated reasons. A substantial number of nodules are first noticed by patients or those they know who see a lump in the front portion of the neck, which may or may not cause symptoms, such as a vague pressure sensation or discomfort when swallowing. Finding a lump in the neck should be brought to the attention of your physician, even in the absence of symptoms.

 

Diagnosis
  • Thyroid Scan: A  picture of the thyroid gland taken after a small dose of a radioactive isotope has been injected or swallowed. The scan tells whether the nodule is hyperfunctioning (a “hot” nodule), or taking up more radioactivity than normal thyroid tissue does; taking up the same amount as normal tissue (a “warm” nodule); or taking up less (a “cold” nodule). Because cancer is rarely found in hot nodules, a scan showing a hot nodule eliminates the need for fine needle biopsy. If a hot nodule causes hyperthyroidism, it can be treated with radioiodine or surgery.
  • Thyroid needle biopsy: A very thin needle takes a small sample of tissue from the nodule.  This is a simple procedure performed in the physician’s office and patients can usually return to work or home afterward. A thyroid needle biopsy will provide sufficient information on which to base a treatment decision more than 75% of the time, eliminating the need for additional diagnostic studies. Use of fine needle biopsy has reduced the number of patients who have undergone unnecessary operations for benign nodules. However, about 10-20% of biopsy specimens are interpreted as inconclusive or inadequate – uncertain whether the nodule is cancerous or benign. In such cases, a physician who is experienced with thyroid disease can use other criteria to make a decision about whether or not to operate. The fine needle biopsy can be repeated in patients whose initial attempt failed to yield enough material to make a diagnosis. Many physicians use thyroid ultrasonography (ultrasound) to guide the needle’s placement.
  • Thyroid ultrasonography: Obtaining pictures of the thyroid gland by using high-frequency sound waves to create detailed images of the thyroid. It can visualize nodules as small as 2-3 millimeters. Ultrasound distinguishes thyroid cysts (fluid-filled nodules) from solid nodules and help physicians identify nodules that are more likely to be cancerous. Thyroid ultrasonography is also utilized for guidance of a fine needle for aspirating thyroid nodules. Ultrasound guidance allows biopsy samples to be obtained from the solid portion of those nodules that are both solid and cystic, and it avoids getting a specimen from the surrounding normal thyroid tissue if the nodule is small. Even when a thyroid biopsy sample is reported as benign, the size of the nodule should be monitored. A thyroid ultrasound examination provides an objective and precise method for detection of a change in the size of the nodule. A nodule with a benign biopsy that is stable or decreasing in size is unlikely to be malignant or require surgical treatment.
Treatment

Most patients who appear to have benign nodules require no specific treatment and can be followed by their physician. Some physicians prescribe thyroid medications with hopes of preventing nodule growth or reducing the size of cold nodules, while radioiodine may be used to treat hot nodules. If cancer is suspected, surgical treatment is recommended. The primary goal of therapy is to remove all thyroid nodules that are cancerous and, if malignancy is confirmed, remove the rest of the thyroid gland along with any abnormal lymph nodes. If surgery is not recommended, it is important to have regular follow-up of the nodule.

 

Cervical Cancer Awareness

January 1, 2018

January is Cervical Cancer Awareness Month!!

Cervical cancer was once one of the most common causes of cancer death for American women. Over the last 30 years, the cervical cancer death rate has gone down by more than 50%. The main reason for this change is the increased use of screening tests. Screening can find changes in the cervix before cancer develops. It can also find cervical cancer early – when it’s small, has not spread, and is easiest to cure. Another way to help prevent cervical cancer in the future is to have children vaccinated against human papilloma virus (HPV), which causes most cases of cervical cancer.

What Is Cervical Cancer?

Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas of the body. Cervical cancer starts in the cells lining the cervix — the lower part of the uterus (womb). This is sometimes called the uterine cervix. The fetus grows in the body of the uterus (the upper part). The cervix connects the body of the uterus to the vagina (birth canal). The cervix has two different parts and is covered with two different types of cells.

  • The part of the cervix closest to the body of the uterus is called the endocervix and is covered with glandular cells.
  •  The part next to the vagina is the exocervix (or ectocervix) and is covered in squamous cells.

 

These two cell types meet at a place called the transformation zone. The exact location of the transformation zone changes as you get older and if you give birth.  Most cervical cancers begin in the cells in the transformation zone. These cells do not suddenly change into cancer. Instead, the normal cells of the cervix first gradually develop pre-cancerous changes that turn into cancer. Doctors use several terms to describe these pre-cancerous changes, including cervical intraepithelial neoplasia (CIN), squamous intraepithelial lesion (SIL), and dysplasia. These changes can be detected by the Pap test and treated to prevent cancer from developing.

 

Although cervical cancers start from cells with pre-cancerous changes (pre-cancers), only some of the women with pre-cancers of the cervix will develop cancer. It usually takes several years for cervical pre-cancer to change to cervical cancer, but it also can happen in less than a year. For most women, pre-cancerous cells will go away without any treatment. Still, in some women pre-cancers turn into true (invasive) cancers. Treating all cervical pre-cancers can prevent almost all cervical cancers.

 

What Are the Types of Cervical Cancer?

Cervical cancers and cervical pre-cancers are classified by how they look under a microscope. The main types of cervical cancers are squamous cell carcinoma and adenocarcinoma.

  • Most (up to 9 out of 10) cervical cancers are squamous cell carcinomas. These cancers develop from cells in the exocervix and the cancer cells have features of squamous cells under the microscope. Squamous cell carcinomas most often begin in the transformation zone (where the exocervix joins the endocervix).
  • Most of the other cervical cancers are adenocarcinomas. Adenocarcinomas are cancers that develop from gland cells. Cervical adenocarcinoma develops from the mucus-producing gland cells of the endocervix. Cervical adenocarcinomas seem to have become more common in the past 20 to 30 years.
  • Less commonly, cervical cancers have features of both squamous cell carcinomas and adenocarcinomas. These are called adenosquamous carcinomas or mixed carcinomas.

 

Although almost all cervical cancers are either squamous cell carcinomas or adenocarcinomas, other types of cancer also can develop in the cervix. These other types, such as melanoma, sarcoma and lymphoma occur more commonly in other parts of the body.

 

What Are the Risk Factors for Cervical Cancer?

A risk factor is anything that changes your chance of getting a disease such as cancer. Different cancers have different risk factors. For example, exposing skin to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for many cancers. But having a risk factor, or even several, does not mean that you will get the disease.

 

Several risk factors increase your chance of developing cervical cancer. Women without any of these risk factors rarely develop cervical cancer. Although these risk factors increase the odds of developing cervical cancer, many women with these risks do not develop this disease. When a woman develops cervical cancer or pre-cancerous changes, it might not be possible to say that a particular risk factor was the cause.

 

In thinking about risk factors, it helps to focus on those you can change or avoid (like smoking or human papillomavirus infection), rather than those you cannot (such as your age and family history). However, it is still important to know about risk factors that cannot be changed, because it’s even more important for women who have these factors to get regular Pap tests to detect cervical cancer early.

 

Cervical Cancer Risk Factors Include:

Human Papillomavirus (HPV) Infection

Infection by the human papillomavirus (HPV) is the most important risk factor for cervical cancer. HPV is a group of more than 150 related viruses. Some of them cause a type of growth called papillomas, which are more commonly known as warts .

  • HPV can infect cells on the surface of the skin, and those lining the genitals, anus, mouth and throat, but not the blood or internal organs such as the heart or lungs.
  • HPV can spread from one person to another during skin-to-skin contact. One way HPV spreads is through sexual activity, including vaginal, anal, and even oral sex.
  • Different types of HPV cause warts on different parts of the body. Some cause common warts on the hands and feet; others tend to cause warts on the lips or tongue.

Certain types of HPV may cause warts on or around the female and male genital organs and in the anal area. These are called low-risk types of HPV because they are seldom linked to cancer.

Other types of HPV are called high-risk types because they are strongly linked to cancers, including cancer of the cervix, vulva and vagina in women, penile cancer in men, and cancers of the anus, mouth and throat in both men and women.

Infection with HPV is common, and in most people the body can clear the infection by itself. Sometimes, however, the infection does not go away and becomes chronic. Chronic infection, especially when it is caused by certain high-risk HPV types, can eventually cause certain cancers, such as cervical cancer.

Although there is currently no cure for HPV infection, there are ways to treat the warts and abnormal cell growth that HPV causes.

Smoking

When someone smokes, they and those around them are exposed to many cancer-causing chemicals that affect organs other than the lungs. These harmful substances are absorbed through the lungs and carried in the bloodstream throughout the body.

Women who smoke are about twice as likely as non-smokers to get cervical cancer. Tobacco by-products have been found in the cervical mucus of women who smoke. Researchers believe that these substances damage the DNA of cervix cells and may contribute to the development of cervical cancer. Smoking also makes the immune system less effective in fighting HPV infections.

Having a Weakened Immune System

Human immunodeficiency virus (HIV), the virus that causes AIDS, damages a woman’s immune system and puts them at higher risk for HPV infections.
The immune system is important in destroying cancer cells and slowing their growth and spread. In women with HIV, a cervical pre-cancer might develop into an invasive cancer faster than it normally would.

Another group of women at risk for cervical cancer are those taking drugs to suppress their immune response, such as those being treated for an autoimmune disease (in which the immune system sees the body’s own tissues as foreign and attacks them, as it would a germ) or those who have had an organ transplant .

Chlamydia Infection

Chlamydia is a relatively common kind of bacteria that can infect the reproductive system. It is spread by sexual contact. Chlamydia infection can cause pelvic inflammation, leading to infertility.

Some studies have seen a higher risk of cervical cancer in women whose blood tests and cervical mucus showed evidence of past or current chlamydia infection.  Women who are infected with chlamydia often have no symptoms. In fact, they may not know that they are infected at all unless they are tested for chlamydia during a pelvic exam.

A Diet Low in Fruits and Vegetables

Women whose diets don’t include enough fruits and vegetables may be at increased risk for cervical cancer.

Being Overweight

Overweight women are more likely to develop adenocarcinoma of the cervix.

Long-Term Use of Oral Contraceptives Pills

There is evidence that taking oral contraceptives (OCPs) for a long time increases the risk of cancer of the cervix. Research suggests that the risk of cervical cancer goes up the longer a woman takes OCPs, but the risk goes back down again after the OCPs are stopped, and returns to normal about 10 years after stopping.

Intrauterine Device (IUD) Use

Some research suggests that women who had ever used an intrauterine device (IUD) had a lower risk of cervical cancer. The effect on risk was seen even in women who had an IUD for less than a year, and the protective effect remained after the IUDs were removed.

Using an IUD might also lower the risk of endometrial (uterine) cancer. However, IUDs do have some risks. A woman interested in using an IUD should first discuss the possible risks and benefits with her doctor. Also, a woman with multiple sexual partners should use condoms to lower her risk of sexually transmitted illnesses no matter what other form of contraception she uses.

Having Multiple Full-Term Pregnancies

Women who have had 3 or more full-term pregnancies have an increased risk of developing cervical cancer. No one really knows why this is true. Also, studies have pointed to hormonal changes during pregnancy as possibly making women more susceptible to HPV infection or cancer growth. Another thought is that pregnant women might have weaker immune systems, allowing for HPV infection and cancer growth.

Being Younger than 17 at Your First Full-Term Pregnancy

Women who were younger than 17 years when they had their first full-term pregnancy are almost 2 times more likely to get cervical cancer later in life than women who waited to get pregnant until they were 25 years or older.

Economic Status

Many low-income women do not have easy access to adequate health care services, including Pap tests. This means they may not get screened or treated for cervical pre-cancers.

Diethylstilbestrol (DES)

DES is a hormonal drug that was given to some women between 1940 and 1971 to prevent miscarriage. Women whose mothers took DES (when pregnant with them) develop clear-cell adenocarcinoma of the vagina or cervix more often than would normally be expected. These types of cancer are extremely rare in women who haven’t been exposed to DES. There is about 1 case of vaginal or cervical clear-cell adenocarcinoma in every 1,000 women whose mothers took DES during pregnancy. This means that about 99.9% of “DES daughters” do not develop these cancers.

DES-related clear cell adenocarcinoma is more common in the vagina than the cervix. The risk appears to be greatest in women whose mothers took the drug during their first 16 weeks of pregnancy. The average age of women diagnosed with DES-related clear-cell adenocarcinoma is 19 years. Since the use of DES during pregnancy was stopped by the FDA in 1971, even the youngest DES daughters are older than 40 − past the age of highest risk. Still, there is no age cut-off when these women are felt to be safe from DES-related cancer. Doctors do not know exactly how long these women will remain at risk.
DES daughters may also be at increased risk of developing squamous cell cancers and pre-cancers of the cervix linked to HPV.

Having a Family History of Cervical Cancer

Cervical cancer may run in some families . If your mother or sister had cervical cancer, your chances of developing the disease are higher than if no one in the family had it. Some researchers suspect that some instances of this familial tendency are caused by an inherited condition that makes some women less able to fight off HPV infection than others. In other instances, women in the same family as a patient already diagnosed could be more likely to have one or more of the other non-genetic risk factors previously described in this section.

Do We Know What Causes Cervical Cancer?

In recent years, there has been a lot of progress in understanding what happens in cells of the cervix when cancer develops. The development of normal human cells mostly depends on the information contained in the cells’ DNA. DNA is the chemical in our cells that makes up our genes, which control how our cells work. We look like our parents because they are the source of our DNA. But DNA affects more than just how we look.

 

Some genes control when cells grow, divide, and die:·

  • Genes that help cells grow, divide, and stay alive are called oncogenes.
  • Genes that help keep cell growth under control or make cells die at the right time are called tumor suppressor genes.

 

Cancers can be caused by DNA mutations (gene defects) that turn on oncogenes or turn off tumor suppressor genes.

 

HPV cause the production of two proteins known as E6 and E7 which turn off some tumor suppressor genes. This may allow the cervical lining cells to grow too much and to develop changes in additional genes, which in some cases will lead to cancer.

 

But HPV is not the only cause of cervical cancer. Most women with HPV don’t get cervical cancer, and certain other risk factors, like smoking and HIV infection, influence which women exposed to HPV are more likely to develop cervical cancer.

Can Cervical Cancer Be Prevented?

The most common form of cervical cancer starts with pre-cancerous changes and there are ways to stop this disease from developing. The first way is to find and treat pre-cancers before they become true cancers, and the second is to prevent the pre-cancers.

 

Finding cervical pre-cancers

A well-proven way to prevent cervical cancer is to have testing (screening) to find pre-cancers before they can turn into invasive cancer. The Pap test (or Pap smear) and the HPV test are used for this. If a pre-cancer is found it can be treated, stopping cervical cancer before it really starts. Most invasive cervical cancers are found in women who have not had regular Pap tests.

 

The Pap test is a procedure used to collect cells from the cervix so that they can be looked at under a microscope to find cancer and pre-cancer. These cells can also be used for HPV testing. A Pap test can be done during a pelvic exam, but not all pelvic exams include a Pap test.

 

An HPV test can be done on the same sample of cells collected from the Pap test.

 

Things to do to prevent pre-cancers:

  • Get an HPV vaccine
  • Test for HPV
  • Do not smoke
  • Use condoms

 

For more information visit the American College of Obstetricians and Gynecologists website.