Tag Archive for: women's health

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

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!

Cool Down! A New Dietary Treatment for Menopause

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.

Understand Gynecological Cancer

By Dr. Monica Mansour | Family Medicine Residency

September was gynecologic cancer awareness month, but it is always a good time to learn about these diseases. There are five main types to be aware of: cervical, ovarian, uterine/endometrial, vaginal, and vulvar cancer. According to the American Cancer Society, in 2021 an estimated 110,000 women will be diagnosed with one of these cancers and approximately 32,500 may die from them.

Steps to lower your risk of gynecological cancer:

  • Practice safe sex. Use condoms and ensure you and your partner(s) are routinely getting checked out for sexually transmitted infections.
  • Avoid smoking cigarettes. Cigarette smoking increases your risk of cervical, ovarian, vaginal, and vulvar cancers. Talk to your doctor if you need help quitting.
  • Get your HPV vaccine. Males and females aged 9-45 years may qualify for it. The vaccine helps reduce the spread of the human papilloma virus which causes abnormal pap smears in females, as well as cervical, vaginal, and vulvar cancers. The HPV virus can also cause cancers of the head, neck, and anus.
  • Talk with your doctor about your medical history. When you started your period, if you have ever been pregnant, if you had fertility issues, or have a history of endometriosis or polycystic ovarian syndrome. These and other facts will help you and your doctor come up with a plan that is right for you.
  • Know your family history. Risk for developing ovarian or uterine/endometrial cancer is higher in people who have a family history of these cancers. A family history of breast cancer, and any other cancer, is also important to share with your doctor.
  • Be aware of your body and talk to your doctor about new changes that don’t feel right to you. Irregular vaginal bleeding or bleeding after sex, pelvic pain or bloating, sores or lumps of the vagina are some symptoms that you should get checked out.
  • Unfortunately, many gynecological cancers do NOT have symptoms. Talk with your doctor to determine how often you need a pap smear and don’t skip out on your annual exams. This is a great time for you and your doctor to check in with each other.

Schedule an appointment today with a NOAH provider to discuss your health history, family health, questions, or concerns, and get any needed tests or screenings scheduled. Prevention and early detection are the best ways to keep you and loved ones safe from gynecological cancer.