Tag Archive for: Womens health

Women’s Health Week #3 – Contraception & Birth Control

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By Dr. Hadass Fuerst & Dr. Marissa Jacobs

Women’s Health Week is May 8 -14 and this year NOAH is highlighting three health issues that women should be familiar with and discuss with their provider any time of year.

NOAH recommends that everyone have a primary care provider (PCP) and a medical home. If you don’t have one or both of these, contact NOAH and establish a PCP who is right for you!

Contraception & Birth Control

Nearly 65% of all women between age 15 and 49 in the U.S. use some form of birth control. But the reasons why are more than pregnancy prevention. Learn more about the types and uses for contraception from two of NOAH’s family medicine providers, Dr. Hadass Fuerst and Dr. Marissa Jacobs.

Why use birth control?

Birth control reduces the chances of an unintended pregnancy when used correctly. But beyond that, many individuals use hormonal birth control to help regulate menstrual cycles, prevent ovarian cysts, regulate hormones, and reduce menstrual pain, Acne, and excessive body hair growth.

What are different contraception options?

You have options but talk to your PCP or OBGYN about what method is right for you. Here are the different types of birth control available:

  • “The Pill” – A daily pill that combines two hormones: estrogen and progesterone. Failure rate: 7%.
  • Progestin-Only Pill – Like “The Pill” above but only the hormone progesterone. Failure rate: 7%.
  • Implant (Nexplanon) – This is a small rod placed in the arm by your doctor that gives a continuous dose of progestin slowly over 3 years. Low failure rate: 0.1%.
  • IUD (Intrauterine Devices) – These small T-shaped devices are placed in the uterus by your doctor. There are two options:
    • Hormonal: Releases a small hormone dose each day and can last 3 to 6 years. Low failure rate: 0.1% – 0.4%.
    • Copper: Can stay in your uterus for up to 10 years. Low failure rate: 0.8%.
  • Injection/Shot – This is a progestin shot every three months. The biggest side effect of the injection is weight gain. Failure rate: 4%.
  • Patch – The patch placed on a person’s skin releases hormones. A new patch is put on each week for three weeks, with no patch during the fourth week. These can be difficult in hot climates because it doesn’t stick as well. Failure rate: 7%.
  • Vaginal Ring – The ring releases estrogen and progesterone. You wear the ring for three weeks and then remove it on the fourth week. Failure rate: 7%.
  • Other methods:
    • Diaphragm – 16% failure rate
    • Male condom – 18% failure rate
    • Female condom – 21% failure rate
    • Cervical cap – 23% failure rate
    • Sponge – 24% failure rate
    • Fertility based methods (tracking cycle days, basal body temperature) – 26% failure rate
    • Spermicide – 28% failure rate

How to pick the right form of birth control?

Remember that not everyone will respond the same way to every form of birth control. And not everyone has the same reason for needing birth control. Be sure to discuss with your provider any types of current or previous forms of birth control used and any side effects so together you will find the right form of birth control for you!

Women’s Health Week #2 – HPV Vaccine

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By Dr. Hadass Fuerst & Dr. Marissa Jacobs

Women’s Health Week kicks off on Mother’s Day every year. This year for Women’s Health Week from May 8 – 14, NOAH is highlighting three health issues that women should be familiar with and can discuss with their provider any time of year.

NOAH recommends that everyone have a primary care provider (PCP) and a medical home. If you don’t have one or both of these, contact NOAH and establish a PCP who is right for you!

HPV Vaccine

Vaccines save lives in many ways, but the HPV vaccine and the virus it prevents is a little different. Two of NOAH’s providers, Dr. Hadass Fuerst and Dr. Marissa Jacobs explain why.

What is the HPV Vaccine?

The HPV vaccine protects against the human papillomavirus (HPV). This is a sexually transmitted infection and is extremely common. Almost everyone will be exposed to HPV at some point in their lives. Typically, if you are exposed, your body will fight off the virus easily. But when that doesn’t happen, HPV can lead to cancer later in life. In fact, HPV is responsible for more than 95% of cervical cancer cases.

The two- or three-part HPV vaccine (depending on your age) is given to preteens and is covered by most insurance, including Medicaid/AHCCS. If you don’t have insurance, you can get the vaccine at no cost at NOAH through Vaccines for Children.

Why is this vaccine so important?

The HPV vaccine provides coverage for nine strains of HPV which are linked to cervical cancer, anal cancers, and mouth cancers. Getting this vaccine protects against HPV and decreases the risk of future cancer. HPV vaccine is essentially a cancer vaccine.

Why does this vaccine start at 11?  

HPV vaccines can start as young as age 9, but according to the American Cancer Society, preteens have the best immune response with this vaccine, and the vaccine works best when given before someone is exposed to the virus. If the vaccines don’t start until age 15, they will need three doses instead of two. Vaccines can be given up to age 26.

Both males and females need the HPV vaccine because it protects you and your partners from getting or passing the virus. It also prevents genital warts and some cancers which both males and females can get.

What if you are 26 years and older?

The vaccine is now approved up to age 45, but it is less effective after age 18. Discuss this with your doctor if you are interested. Most sexually active adults have been exposed to some, but probably not all, strains of HPV. If you haven’t received the vaccine and are over 26, the best way to prevent these types of cancers is regular physicals and screenings with your PCP.

Cool Down! A New Dietary Treatment for Menopause

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By Daniel Davis, MD | Internal Medicine

A study published by the North American Menopause Society found a plant-based diet rich in soy reduces moderate-to-severe hot flashes by 84%. During the study, nearly 60% of women became totally free of moderate-to-severe hot flashes. Overall hot flashes (including mild ones) decreased by 79%.

What does this all mean for diet and menopause? We dive in with Dr. Daniel Davis.

What are hot flashes?

Hot flashes are one of the most common symptoms of menopause with about 80% of American women experiencing them. Hot flashes can be mild or serious enough to impact your day-to-day life. The feeling is usually a flushing warmth or heat in the upper body and face.

Traditional treatment for hot flashes

Most women with mild hot flashes can treat them with small changes: fans, air conditioning, dressing in layers, and avoiding things like spicy foods and stress. For serious hot flashes, women for a long time were given estrogen (a group of hormones in women) therapy. Now we know that these treatments increase the risk of some cancers, blood clots, heart attacks, and strokes! After learning this, many providers began treating serious hot flashes with other medicines like anti-depressants. Diet wasn’t considered in most patient’s treatment plans.

But that changed in March of 2021 when a study in the American Journal of Menopause showed diet might play an important role in menopause and hot flashes.

How does diet impact menopause?

Scientists have known for a long time that not all women have hot flashes like American women, particularly those countries not following a western/American diet. In countries like Japan and other parts of Asia, only about 15% of women develop hot flashes compared to 80% of American women!

While researchers are still figuring out why 65% more American women have hot flashes compared to Japan, diet is top of mind. People living in Asian countries usually eat less animal products (meat, dairy), eat more vegetables, and have other differences.

How did the study work?

The March 2021 study looked at women all experiencing the same hot flash symptoms, and randomly put them in two groups and watched they symptoms:

  • Group #1 – Dietary Changes – low fat vegan diet
  • Group #2 – No Dietary Changes – known as the control group

Women in group #1 with the vegan diet saw a 79% decrease in all hot flashes. Women in group #2 had a 49% decrease.

For severe hot flashes – the kind that disrupt daily life – women in group #1 had a decrease of 84%, while women in group #2 saw severe hot flashes decrease 42%. When it came to less severe hot flashes (mild or moderate), 59% of the women on the vegan diet in group #1 said they didn’t have ANY!

The vegan diet group also lost a significant amount of weight and had other health improvements compared with group #2 that did not change their diet.

What does this mean about estrogen, diet, and menopause?

Estrogen is still an important factor for menopause and hot flashes. But doctors and researchers want safer ways to replace estrogen. One way is diet.

Luckily most plant foods – like soybeans and tofu – have estrogen-like nutrients that help during menopause. What’s even more exciting is that these foods have health benefits, like decreasing the risk of breast, prostate, ovarian, and uterine cancer.

People concerned about children or males consuming estrogen don’t need to be. There isn’t a hormonal effect on men or on children’s normal development from foods. Most people can and should consume soy. If someone has a soy allergy, which is rare, they should not treat hot flashes with soy foods.

What about estrogen supplements for menopause?

I recommend against consuming phytoestrogen supplements (plant-based estrogen-like pill). Herbal supplements in the USA often contain ingredients not on the label and they aren’t regulated by any government agency, so we really don’t know what is in them or if they provide any benefits. Additionally, not all plant-based estrogen-like nutrient pills are the same. Some have potentially risky plant estrogens being sold as safe supplements.

What does Dr. Davis recommend?

As a doctor, I recommend you talk to your primary care provider or registered dietician if you are working with one before making any major changes to your diet. If you want to make an appointment with a dietician, NOAH’s has a team of registered dieticians here.

Plant based diets, like a vegan diet, can have a lot of health benefits and a well-planned vegan diet is good for anyone according to the American Dietetics Association. Eating a plant-based diet can also prevent and be part of a treatment plan for diabetes, heart disease, hypertension, cancer, and obesity.

What now?

This study shows that diet can have a tremendous impact on menopausal symptoms. The vegan diet in this study is safe and could lead to many other benefits. Ask your medical provider or dietician if you can give it a try.

You can read more about this study here, and find the full scientific paper free here.

Stroke Awareness Month

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Do you know the signs of a stroke? The sooner someone with a stroke gets help, the better. People who are treated during the first few hours have a better chance of survival and less chance of having permanent disabilities from the stroke.

Signs of a Stroke

Knowing the signs can save a life. It happens every day. The signs are organized to the memorable acronym F.A.S.T.

F – Face drooping. The face can be drooping on one side or be numb. If you are unsure, ask the person to smile.

A – Arm weakness. Can the person raise both arms? Are they both the same height? Does one arm droop?

S – Speech problems. A speech issue could be the person having slurred speech, trouble talking, or is hard to understand.

T – Time to call! If the person is showing ANY of these symptoms, it is time to call 9-1-1 and get them to the hospital immediately.

These are not the only symptoms of a stroke, but they are the best immediate way to recognize one. Other signs that someone may be suffering from a stroke include numbness especially on one side of the body, confusion or trouble understanding things, vision trouble, dizziness and trouble walking, and a severe headache that comes on suddenly.

Risk Factors

There are things that make you or someone in your life at a higher risk of stroke. These risks include high blood pressure, smoking, diabetes, obesity, low physical activity, high cholesterol, heart disease, and having a previous stroke. Working with your healthcare team to improve some of these areas can reduce your risk of having a stroke.

Other risks are out of your control but knowing them is important to your ongoing medical care and wellness. Some of these factors are include gender because women have more strokes than men, age as risk increases with age, race, and family history.

Knowing your risk factors will help you manage your risk so talk to your NOAH provider today if you have any questions or concerns.

Stroke is one of the top causes of death and disability in America, so knowing the signs and what to do can save a life. Every minute counts during, so act F.A.S.T.!

March is Endometriosis Awareness Month

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Test your knowledge

An estimated 11 percent, or nearly 7 million women in the U.S. have endometriosis.

That’s more than the number of women who suffer from asthma (9.8%), more than the number of women who suffer from heart disease (6.2%), and it is just slightly less than the number of women who will develop breast cancer during her lifetime (13%).

It effects a lot of women every day.

Endometriosis is a health condition that involves tissue that typically grows in the uterus or womb but begins to grow where it shouldn’t. When this happens, it can cause pain, digestive problems, and even infertility. It can happen to any female, but it is more common in women who are in their 30s and 40s.

Signs and symptoms

The pain women feel is the most common symptom of endometriosis. However, the pain is different for different women, including:

  • Pain in the lower back and pelvis that doesn’t go away
  • Painful menstrual cramps
  • Intense discomfort in the intestines or during bowel movements
  • Pain after or during sex

It is important to know that how intense or severe the pain is, doesn’t matter. People with mild pain could have a more advanced case of endometriosis. The pain can also increase over time.

Treatment and prevention

After a doctor does a full exam and diagnoses a patient with endometriosis, there are a few different types of treatment options to discuss.

Medication – Some medications will likely include hormones, usually a hormonal birth control pill or implant, as a starting point. Hormones aren’t a permanent solution but will typically provide some relief of the pain and reduce the additional growth of endometriosis.

Surgery – If medicine isn’t helping, your endometriosis is severe, or you can’t get pregnant, your doctor may suggest surgery. You will likely start hormone medication after the surgery if not trying to get pregnant.

Other treatments – Over the counter pain medicine like acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) can help with discomfort. Some women have relief with other things like acupuncture and herbal supplements, but there is no research or proof that these things provide consistent relief.

There is good news and bad news about preventing endometriosis. The bad news is you can’t prevent it. The good news is that there are a number of things you can do to decrease your odds of developing it. Because endometriosis is tissue that grows with increases of the hormone estrogen, the goal is to keep that level low with:

  • Regular exercise which helps reduce body fat, which then reduces estrogen.
  • Reducing or eliminating caffeine because it can increase estrogen levels.
  • Opting for a low-dose hormonal birth control pill, patch, or ring.
  • Reducing or eliminating alcohol because more than one drink per day can rise your estrogen levels.

Pregnancy and endometriosis

How endometriosis affects a woman’s ability to get pregnant isn’t fully known. But many women – as many as half – with fertility problems had endometriosis. The good news is that many women can still get pregnant! Each patient is different, and every patient’s doctor will recommend the best approach.

Having a medical home with consistent medical exams and conversations with a comprehensive medical team is the best approach. NOAH’s providers work with patients of all ages and health backgrounds. Learn more and make an appointment today.

Understanding Thyroid Disease

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The thyroid is a very important organ that – frankly – doesn’t get the attention it deserves, until something goes wrong, like getting diagnosed with thyroid disease. Here at NOAH, we want to turn our focus here for Thyroid Awareness Month.

What is the thyroid?

The thyroid is a small, butterfly-shaped organ in the front of your neck that wraps around your trachea (throat or windpipe). Its job is to create and release important substances to help your body function. In the case of the thyroid, its job is to release hormones that control your metabolism.

Why is the thyroid important?

The thyroid has an important job to do – regulating your metabolism. Your metabolism is how your body turns food into energy. When your thyroid is working correctly, you don’t think about it. It adjusts the amount of hormones it releases to meet what your body needs. Then, the thyroid creates more hormones and continues the process. Pretty nice.

But like with many things, we don’t notice or appreciate it when it works correctly. However, when the thyroid has trouble doing its job, the results can be serious.

What happens when the thyroid doesn’t work correctly?

Thyroid disease can be caused by two different types of problems with the thyroid: making too much hormones or making too little.

  • Hyperthyroidism is when your thyroid makes too much of the hormones needed to regulate your metabolism. Then, your body uses the hormones too quickly. It can cause people to feel anxious, lose weight too quickly, have trouble sleeping, and make your heart beat faster.
  • Hypothyroidism is when your thyroid doesn’t make enough of the hormones needed to regulate your metabolism. With too little hormone, you can also feel overly tired, gain weight, experience forgetfulness, and feel discomfort with cold temperatures.

Both are serious medical conditions and should be diagnosed and treated by your medical provider.

How do you get thyroid disease?

The risks for thyroid disease are broad and it effects around 20 million Americans. It can be genetic and passed down from family members, but other risk factors include having another medical condition. It’s worth noting that while anyone can have thyroid disease, women are five times more likely to be diagnosed than men, and people age 60 and older are also at a higher risk.

Are there diagnoses and treatments?

Because the signs and symptoms for thyroid disease can look like other illnesses, it is important to talk with your doctor if you have any new symptoms. Your medical provider will do physical exams and most likely blood tests to confirm a thyroid condition.

Treatments will depend on what type of thyroid disease you have and how serious it is. Most patients are prescribed medications.

Many people live healthy, normal lives with thyroid disease, but this thyroid awareness month it is important to learn all about it for yourself and for others. Working with your medical provider and integrated care team at NOAH will make it easier to navigate this or any other health concern or diagnosis.

Understanding & Preventing Some Birth Defects

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By Dr. Lindy Truong

Birth defects are not uncommon. Every year, one out of every 33 babies is born with some kind of birth defect ranging from minor, to those with life-long challenges. Some are preventable, and many can be managed better with proper care and support from a medical team.

There are, however, some factors that increase the risk of having a baby with a birth defect. January is National Birth Defects Prevention Month, so here are ways to increase the chance of having a healthy baby. This year’s theme is “Best for you. Best for baby.”

Healthy Moms for Healthy Babies

One of the most important steps a patient can take to having a healthy baby is to make sure they are healthy themselves prior to getting pregnant and throughout pregnancy. One of the most important ways to do that is to maintain a healthy weight before becoming pregnant, since women will gain weight during pregnancy. Babies born to obese women have an increased risk of having birth defects, such as heart and spinal cord defects.

Folic Acid During Pregnancy

Folic acid plays a big role in a baby’s development during pregnancy. Women who are pregnant or might become pregnant should try to have 400 micrograms of folic acid every day. In early development, folic acid helps form the neural tube—a structure that begins forming in the first 3 to 4 weeks after conception. Later, the neural tube becomes the brain and spinal cord. Folic acid is important in preventing birth defects that affect the baby’s brain (anencephaly) and spine (spina bifida).

Prenatal Care

Starting prenatal care as early as possible during a pregnancy has shown to increase healthy, full-term deliveries. If someone is pregnant, they should start prenatal care as soon as they think they might be pregnant. It will be important to continue all prenatal appointments throughout the pregnancy. These appointments ensure that both baby and mom are healthy, monitor any medications because some can cause birth defects, and so much more.

Preventative Health

Being current on vaccinations is important to protecting both mother and baby. The two most important vaccines to have during pregnancy are the Flu and Tdap (tetanus, diphtheria, and pertussis a.k.a. whooping cough) vaccines. When mothers get these vaccines during pregnancy, it also protects them from the flu and whooping cough for a short period post-delivery as well!

What to Avoid

Last, but not least, it is very important to avoid substances like alcohol, smoking, and recreational drugs. These can seriously increase the risk for birth defects. Drinking any alcohol during pregnancy can increase the risk of fetal alcohol syndrome and defects. Smoking and recreational drugs similarly increases the risk that the baby will be born smaller and with birth defects.

Expecting a baby can leave the parents with many questions, which is why having a trusted medical home for you and your baby is so important. If you plan to get pregnant, take care of yourself and do what is best for you, because it is also what is best for the baby.

You can schedule a preconception visit with your healthcare provider before you even become pregnant, which is a good place to start. Being healthy before pregnancy sets a good foundation for a healthy pregnancy. Continue with regular prenatal visits for close monitoring along the way. These are simple yet important things one should do to prevent birth defects in their baby.