The Dangerous of late menopause

Menopause is a normal, natural part of the aging process for all women. It is marked as having occurred after 12 consecutive months without a menstrual period. The average age for menopause is approximately 51, but it may occur much earlier or much later.

Significance
Menopause marks the end of a woman's fertile, reproductive years. Women who experience late menopause may become pregnant in their 50s or 60s. These pregnancies are considered high risk for both the baby and the mother.

Considerations
Late menopause has been linked to increased risks of ovarian cancer, according to the National Ovarian Cancer Association. The risk for ovarian cancer is greatest for women between the ages of 60 and 70.

Function
During menopause, the body ceases production of certain hormones such as estrogen. A woman who experiences late menopause may have an increased risk for breast and uterine cancer as a result of her body's continued exposure to estrogen.

Effects
Undergoing late menopause appears to increase the risk of developing endometrial cancer, according to Penn State University's Milton S. Hershey Medical Center. The connection between late menopause and endometrial cancer is not clearly understood.

Benefits
While there are numerous detrimental effects of late menopause, according to DrMirken.com. There are also a number of benefits to late menopause including improved bone thickness, improved cardiovascular performance, enhanced mood and increased longevity of life.

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How to Use Acai Berry for Diet

Instructions

Step 1

If you have a health store near you, you can purchase fresh, frozen or dried Acai Berries if you can find them. Or you can purchase them in this form online. Since it is a nutrient-rich food, you can cook with it and add it to your favorite recipes. It works well as a cereal topping, in granola, smoothies, yogurt, on low-fat ice cream and in things like muffins and cookies (as long as they're low fat!).


Step 2

You can also find Acai in the form of a liquid extract. The benefit of taking Acai in this form is that the nutrients will be super concentrated. Also, if you live in a climate where Acai Berries don't grow, this can be a good way to get it as fresh and concentrated as possible.

Step 3

If you want, you can also take Acai in capsule form. Capsules are good if you want to take Acai as easily as possible and still receive the benefits. If you make it a part of your daily vitamin and mineral regimen it will be easier to take it consistently.


Tips & Warnings

*
Follow a healthy diet and exercise in order to use Acai for weight loss in the most beneficial way.
*
Contact your doctor to make sure it's OK for you to take Acai.
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G-Spot and Women's SexualHealth

Based on the definition of the Ministry of Health, it is known that the reproductive health situation is completely healthy and reproductive processes. Thus, reproductive health conditions not only free from disease, but how someone can have a sexual life in a safe and satisfying both before marriage and after marriage.

Hearing Women's Reproductive Anatomy

The tool itself is reproductive parts of our bodies that continue to function in offspring. Tools reproductive women with different means of male reproduction. In this article we will discuss more specific means of reproductive women.

Women's reproductive tool consists of two parts, namely the in and outside. Have a function in part as follows:
* Genitalia lips (labia mayora), the heartland periwigged, functions as a protector and keep the remains in the humid.
* Lips in the genitals (labia minora), the area that is not blond and has a network of fiber sensory very knowledgeable sensitive because it contains the end of the nerve.
* Vagina, the cavity between the means of reproduction and women in the outside.

The tools of the outer female reproductive function has the following:

* Vagina the outside, which is an exit for menstrual blood and a way out when the baby is born (are very flexible so that the baby can come out through the vagina).
* Neck womb (cervix), which is between the vagina and uterus.
* uterus, where cells that have been fertilized egg grows in the womb during pregnancy. When the egg is not fertilized, the eggs stick to the cell wall of the womb. Next womb wall thick exuviate ago and flow out in the form of blood. This is called menstruation.
* Line of eggs (falopii tuba), the two channels that are located next to the uterus and left kanana that serves as the womb cavity and ovary.
* Two ovary (ovarium), functional cells to produce eggs and hormones peremputan namely progesterone and estrogen. Above the influence of hormones, as many as one to two eggs cooked the cells of each month, then released to the uterus wall. Wall of the womb will be thick, which is actually useful as a place to nest after the egg cell fertilized.

So ... if signs of maturity means of reproduction of women? Women's reproductive maturity instruments marked by the occurrence of first menstruation, which is called menarche. Usually we take the children so that young people have grown adult, which began around the age of 8-12 years. When a woman has experienced menarche, that means the body already produces egg cells that can be fertilized by sperm produced by the body of men, and can cause pregnancy.

Position Women's G-Spot

In addition to reproductive tool before, you also need to identify one area that is often called the G-Spot. G-Spot (Grafenberg Spot) is now frequently discussed in various media. He said, the point G-Spot is a narrow space behind the pubis bone of women who, when left this will give awesome sensation.

Spot G-Spot can be found by inserting the fingers into the Vagina palm facing forward. With the touch and play with it, you can create multiple pairs of women orgasm. G Spot which has stimulated can also make a good time with the position doggy style or spooning.

OK... Seeing the body of knowledge of anatomy and reproductive tool, of course you can now prepare to enjoy a wonderful time together. Do not be afraid to try and pair explore body, because creativity is the element that is essential to develop intimate relationships that always passionate.
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Anorexia and Pregnancy Don't Mix, Docs Say

While most expectant mothers marvel at the site of their growing baby bumps, Maggie Baumann says she was "horrified."


"As my stomach began to grow, I remember being in the shower and my bump was sticking out and I looked down at my body and I thought, 'I don't even want to be in this body,'" said Baumann.

Baumann, a 48-year-old mother of two, says she struggled with an eating disorder during her pregnancies, a condition sometimes referred to as "pregorexia."

"I wasn't even thinking about the baby," said Baumann of her first daughter, Christine, who is now 23. "It wasn't that I didn't want the baby, it was just that I could not stand the sight of my body."

Baumann, who lives in Laguna Niguel, Calif., told ABCNews.com that she struggled with anorexia since her high school years, but that it worsened after she got married and began having children.

"I feared my pregnancy," said Baumann, who gained a normal 33 pounds during her first pregnancy. "I refused to buy maternity clothes and our neighbors didn't even know I was pregnant until the ninth month. I hid it well."

Kathleen Rasmussen, a committee chairwoman at the Institute of Medicine who said there has been virtually no research done on pregorexics, said it's not uncommon for expectant mothers to experience a range of emotions regarding their growing figure.

"Women have very different psychological reactions to pregnancy," said Rasmussen. "Some are just thrilled with their new body and the marvelous things it's doing and others are humiliated."

The Institute of Medicine recommends that women of normal weight gain 25 to 35 pounds during pregnancy, and that those mothers-to-be who are underweight when they become pregnant should gain 28 to 40 pounds.

Baumann says that it was during her second pregnancy when she gained a measly 3 pounds that she saw her anorexia worsen.

"When I got pregnant with Whitney, I was just petrified to go through the changing body thing again and was scared to lose control," said Baumann, referring to her younger daughter. "I remember that I lost my waist really quickly and thinking to myself, 'Here it goes again.'"

Pregorexia Can Hurt the Baby

Dr. Robert Zurawin, an associate professor at the department of obstetrics and gynecology at Houston's Baylor College of Medicine, said that expectant mothers' fear of gaining weight is all too common.

"Women who are pregorexic -- or don't eat when they're pregnant because they're afraid of gaining weight -- need to think about their baby," said Zurawin.

"There are so many fad diets out there with no carbs and women are so obsessed with body image that they don't want to gain weight during their pregnancy because they're afraid of not being able to lose it afterward," said Zurawin.

"Women think that if they starve themselves during pregnancy, they won't look bad when they're done," said Zurawin.

Zurawin added that maintaining a well-balanced diet -- and not exceeding your doctor's recommendations for exercise -- are important for pregnant women to keep in mind, more so than whether they fit into their favorite jeans.

"It boils down to an expectant mother putting the needs of her unborn baby first," said Zurawin.

"What we'd like women to know is that what you eat affects how well your baby grows and how healthy your baby is," echoed Rasmussen. "This is a time in your life where it's really, really important to eat appropriately."

Baumann began over-exercising to try and quell her growing belly. An hour and a half of cardio -- running, biking and even volleyball -- was typical for her up until she gave birth.

"My rigidity and control got really strong during my second pregnancy," she said. "I was so oblivious to my disorder."

According to the National Institute of Mental Health, an estimated 0.5 percent to 3.7 percent of females will suffer from anorexia during their lifetime and an estimated 1.1 percent to 4.2 percent will suffer from bulimia.

Even when Baumann almost miscarried Whitney at the beginning of her pregnancy, cutting out exercise and increasing her daily caloric intake was not an option.

Baumann said that while she always ate -- she had to in order to keep up with her exercise regimen -- she was sure she was burning more calories than she was consuming.

Believes Pregorexia Caused by Her Adoption

"Whitney is so lucky to be here and I can only say that now that I realize what I had done at the time, back then I was in such a different world," said Baumann. "You think that [nearly miscarrying your baby] would probably hit most women as a warning that they have to be careful, but for me, I just kept going on my little path."

Baumann carried Whitney to term, when she was born at just over 5 pounds. During the first few years of her life she suffered from seizures that doctors suspect were caused by poor nutrition in the womb. Later on, Whitney was diagnosed with Attention Deficit Hyperactivity Disorder, another complication Baumann wonders whether she caused by her poor pre-natal care.

According to Zurawin, Baumann's daughter could have been much worse off than she was.

"You can seriously harm your baby by dieting and over-exercising during pregnancy," he said.

"You're setting yourself up for a growth-retarded baby and down the line, a baby with psychical and mental disabilities," said Zurawin.

Soon after Baumann gave birth to her second daughter, the anorexia she didn't think could get any worse spiraled out of control.

"I would work out for at least three hours a day," said Baumann. "My feet would be bleeding as I was running but I kept going. I was like a machine.

"I lived by the beach and couldn't stop and look at the waves," she said. "I wouldn't let myself. I was this machine and I had to complete the task.

"Or if my family went to church, they would go in the car and I'd run, then I'd stand at the back all sweaty, and to me, that was not abnormal," she said.

Finally suffering from chest pain, Baumann went to the emergency room and after doctors told her that her organs were failing, checked into an in-patient treatment center in Arizona.

"I weighed about 111 pounds," said Baumann, who is 5' 8". "For me, I thought I weighed so much. My husband said I looked like a skeleton."

After more than 10 years of therapy, Baumann has now faced how her adoption at just 6 months old and the abortion she had in her early 20s may have contributed to her anorexia. Baumann's birth mother, who is deceased, also struggled with an eating disorder.

Today, Baumann maintains a healthy weight and lifestyle and is proud that both her daughters live similarly healthy lives.

"It was never my intent to hurt my babies," said Baumann. "I forgive myself for what I did, but I'll never forget what I did."
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How Should I Be Taking Care Of My Skin In My 20s And 30s, And What Kinds Of Issues Should I Be Thinking About?

Question: How should I be taking care of my skin in my 20s and 30s, and what kinds of issues should I be thinking about?

Answer: In your 20s, the most important thing is to really develop a good skin care regimen. The first thing you should start with is sunscreen every morning, either in a moisturizer or separate. An SPF 15 is best, and SPF only tells you UVB (ultraviolet B) so you want a broad-based UVA-UVB sunscreen in the morning.

In your 20s at night, you can use a moisturizer over the counter with a retinol product in it.

In your 30s, you want to continue this regimen, but you may consider adding a prescription retinoic acid like tretinoin -- and this is available from your dermatologist. And that just helps with the fine lines and wrinkles.

In your late 30s, to your skin care regimen, you can consider something like Botox, which treats the fine wrinkles of the forehead and around the eyes, to add to your regimen, as well as possibly laser treatments. And those can be discussed with your dermatologist.
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Young Women Report Abdominal Pain on Smoggy Days

Here's another reason to watch what you breathe: Young women in two Canadian cities were more likely to seek emergency-room help for abdominal pain on days with bad air pollution, a researcher reported here.

Rates of emergency department visits for abdominal pain with no specific cause increased by up to 10 percent on days with high levels of carbon monoxide, nitrogen dioxide and particulate pollution, according to Dr. Gilaad Kaplan of the University of Calgary.

Nearly two-thirds of the diagnoses were women, and more than half of them were ages 15 to 24. The researchers did not find increases in abdominal pain visits by men on high-pollution days, although they noticed upticks in male visits a day or two after days of heavy pollution.

Kaplan reported his findings at the Digestive Disease Week conference here over the weekend.

His group studied 10 years of emergency-room records from all hospitals in Edmonton, Alberta, as well as records from a single urban hospital in Montreal. All told, the group found 118,000 cases of patients discharged after seeking treatment for abdominal pain with no known cause.

Kaplan said his study was prompted by earlier observations that abdominal pain without a known cause is frequently associated with depression and headaches, which in turn can be exacerbated by air pollution.

He also said a study on mice from the 1970s had shown that high levels of common air pollutants reduced proper function of the digestive system, suggesting a possible mechanism underlying abdominal pain.

Although his study showed stomach pain was associated with high levels of three common kinds of pollution, there was no link with increased levels of two other major pollutants -- sulfur dioxide and fine particulates (smaller than 2.5 microns).

Strangely, the rate of stomach pain admissions actually seemed to decrease when ozone levels were high.

At a Sunday news briefing announcing the findings, Kaplan could provide no explanation for any of the associations -- positive or negative -- since the study was not designed to determine causality.

In Abdominal Pain, Ozone May Be a Culprit

But he noted that ground-level ozone was a different kind of pollutant than others positively correlated with abdominal pain emergency visits.

Carbon monoxide, nitrogen dioxide and particulates are all direct waste products from fossil fuel burning, he said. Ozone, on the other hand, results from a complex chemical process in the atmosphere involving nitrogen oxides, volatile organic compounds, heat and sunlight over time.

Dr. Marcia Cruz-Correa, a gastroenterologist at the University of Puerto Rico, said the study confirmed many physicians' impression that most cases of non-specific abdominal pain involve women.

"If we could actually find something that's a trigger for this unexplained abdominal pain, we could maybe provide guidance," said Cruz-Correa, who moderated the news briefing.

Confirmation of the findings could help inform policy for pollution control and for public health warnings involving people with respiratory diseases, she said.
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Pregnancy Weight-Gain Guidelines Updated to Reflect More Obese Moms

Obese women should only gain between 11 and 20 pounds when they become pregnant, according to updated guidelines from the Institute of Medicine.

The recommendation builds on the agency's earlier advice that overweight women gain 15 to 25 pounds, normal-weight women add 25 to 35 pounds, and underweight women pack on 28 to 40 pounds during pregnancy.

While the adjustments for the three existing weight categories were relatively subtle, the decision to add a separate category for obese women was necessary because both obesity and weight gain during pregnancy have both surged among women across the country, the authors of the report say.

Central to the guidelines are body mass index ranges. BMI, a ratio of weight to height, is a common formula used to measure obesity.

The new guidelines use BMI ranges set by the World Health Organization and the National Heart, Lung and Blood Institute; the 1990 guidelines instead used recommendations from Metropolitan Life Insurance tables. The new ranges are more conservative, with the underweight category starting at a BMI of 18.5 instead of 19.8.

"Because of the shift in BMI in the population towards more overweight and obese, those criteria have shifted now for the obese category," said Dr. Patrick Catalano, chair of obstetrics and gynecology and professor at Case Western Reserve University in Cleveland, Ohio. Catalano was part of the committee that developed the new guidelines.

"With the new criteria, we're just trying to be consistent with what everybody else is using," he said.

The guidelines are "not dramatically different from what was reported in 1990, but they are sort of progressive," said Dr. Michael Katz, senior vice president for research at the March of Dimes, which co-sponsored the study.

"They illustrate the substantial increase in obesity," Katz said.

While the guidelines are specifically intended for pregnant women, they may have implications as well for those hoping to get pregnant.

Catalano said it will be easier to achieve the new recommendations if women attempt to get within normal BMI range when they're trying to conceive. This will result in better outcomes for both mom and baby, he said, since it is "remarkably clear that pre-pregnancy BMI is an independent predictor of many adverse outcomes."

IOM Guidelines for Pregnancy Weight Gain May Encourage Some

Interventions in diet and exercise -- both before and during pregnancy -- will be essential in helping women meet the guidelines, especially those who are obese, he said.

"The idea is that it will require an effort by many people," Catalano said. "It's not just something that one health care provider during pregnancy can do. It includes a host of other people, including a nutritionist, dietician, and even an exercise physiologist."

Women's Health Experts Split on New Guidelines

Katz said the aims of the report are on target, but "the effects are very difficult to achieve."

"Here the motivation is stronger because [pregnant women] are strongly motivated to protect their child," he said. "But to have a concerted effort like this will be difficult."

While Katz said the new guidelines are more conservative than those of the past, others say they are not conservative enough.

"It's been well shown that such a patient can lose weight in pregnancy and still be fine," said Dr. Jacques Moritz of St. Luke's-Roosevelt Hospital in New York. "[The guidelines] are still concerned with small babies. That was a problem when women smoked and drank in pregnancy. Now it's just the opposite."

"Women don't need to eat for two but for 1.1," he said.

The authors of the new recommendations noted that good outcomes for both mother and child are achieved "within a range of weight gains." Also, different factors for individual women should be considered, they said.

That means the guidelines should be used "in concert with good clinical judgment as well as a discussion between the woman and her healthcare provider about diet and exercise," they said.

For example, a patient with a BMI of 30 can gain closer to the 20 pounds at the higher end of the range, said Dr. Laura Riley, medical director of labor and delivery at Massachusetts General Hospital in Boston. On the other hand, a pregnant woman with a BMI of 40 "should get closer to the 11 pounds," she said.

Riley said that the major issue behind the new report is that women need to pay closer attention to the guidelines during pregnancy.

Adherence to Pregnancy Weight Gain Guidelines Key

"Most women don't listen to the guidelines that were out in 1990," she said. "If they had listened to those guidelines, we would have better outcomes at this point."

The report also calls for further study of pregnancy in obese women, as well as the impacts of gestational weight gain on outcomes for mothers and babies.

More Guidelines for Special Cases

Other updates include:

Though there was not as much evidence as there was for singletons, the researchers made provisional guidelines for women giving birth to twins. Normal-weight women should gain 37 to 54 pounds, overweight women should gain 31 to 50 pounds, and obese women should gain 25 to 42 pounds when they're having twins. There was insufficient information for underweight women.

Shorter women don't need to gain toward the lower end of the range for their pre-pregnant BMI. The researchers said there was not sufficient evidence to continue to support this 1990 recommendation.

There is no continued support for women under 20 who become pregnant to gain on the lower end of their range, as younger adolescents often need to gain more to improve their chances of a healthy birth.
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Menopause: Hormones Can Help Memory and Lift Brain Fog

As Pam approached menopause, she thought she was losing her mind.

"Oh my god, it was horrible," said the 57-year-old from Glenwood Springs, N.Y. "I could not remember words. Even a word like 'cat' might not come to mind. I'd have to go through the alphabet to come up with the word. And words I'd spelled all my life, I'd think I spelled them wrong."

Recently, Pam, who did not want her last name used, enrolled in an introductory mortgage class hoping to learn to be a lender. A high-powered business consultant with experience in banking, she thought she'd pass the exam with flying colors.

"I was in the class for one day and I cannot tell you one thing I learned," she told ABCNew.com. "I walked out laughing because everyone else was getting it. It was like Greek to me.

"In the end, I didn't take the test. I said, 'Forget it, no way," said Pam. "It's very upsetting. Normally this would have come easily to me."

For Pam and millions of other women in their 40s and 50s, "brain fog" seems to roll in as their menstrual cycles wane. Many fear it will never lift, signally the end of their professional lives.

Research published this week in the journal Neurology confirms that women do, indeed, lose their intellectual edge in peri-menopause -- the five- or six-year period leading up to the last menstrual cycle. But the ability to learn rebounds in the later phases of menopause.

For four years, University of California Los Angeles (UCLA) researchers looked at 2,362 women between the ages of 42 and 52 who took tests to measure verbal memory, working memory and processing speed at four different points during menopause: pre-menopause, early peri-menopause, late peri-menopause and after menopause.
Early On Hormones Help Brain Function

The Study of Women's Health Across the Nation (SWAN), which is based at seven sites throughout the United States and is funded by the National Institute on Aging, concluded that women taking hormones before their last period improved their cognitive skills, but after that, the hormones had a detrimental effect.

"It looks like the time at which you take hormones matters," said Dr. Gail Greendale, head investigator for the SWAN study at UCLA.

When tested year after year, women in their 40s and 50s "get better each time," she said.

"There's a learning effect," Greendale told ABCNews.com. "But on the test of speed, we found that when you get to late peri-menopause, (learning) takes about an 80 percent hit.

"You're a little off your game," she said. "You're not forgetting your way to the grocery store, but you don't feel as sharp or fast on the uptake."

This latest research is significant because it may clear the way for women in the earliest phases of menopause -- when they are typically younger and at the height of their professional careers -- to safely take estrogen to give them their edge back.

Hormone replacement therapy was demonized after the 2002 Women's Health Initiative (WHI), which concluded that it increased risk for cancer and cardiovasular disease.

Since then fewer women are turning to hormone replacement therapy, according to doctors.

But comparing the two studies is "apples and oranges," according to Greendale.

The WHI iinvolved postmenopausal women 65 and over and was designed to test the effects of hormone therapy, diet modification, and calcium and vitamin D supplements on heart disease, fractures, and breast and colorectal cancer.

When compared to a placebo, estrogen plus progestin provided no protection against mild cognitive impairment and increased risk of dementia

But in the SWAN study, with much younger, peri-menopausal women, hormone therapy showed only positive cognitive benefits.

"At 50, many women are at the top of their careers and can't afford this," said Dr. Michelle P. Warren, director for the Center for Menopause, Hormonal Disorders at Columbia University Medical Center.

"For those two to five years when the symptoms are at their worst, we should treat these women," she told ABCNews.com.

But, she cautioned, women should weigh the risks versus benefits with the advice of their doctor.

Hormone Scare After Women's Health Initiative

"Women are scared to take hormones and doctors are scared to prescribe it," Warren said. "We have an issue that is very worrisome."

Menopause technically begins 12 months after a woman's final menstrual period when the ovaries no longer release eggs and there is decrease in the production of the sex hormones estrogen and progesterone.

But a whole array of bothersome symptoms can begin years earlier -- in peri-menopause -- as the woman's cycle transitions into menopause.

The process can begin in the 40s and accelerates until the early to mid 50s. Symptoms can include hot flashes, night sweats and fatigue, which, in combination with hormone fluctuations, can affect a woman's ability to concentrate and remember.

"My approach to this is if lose your job, your sanity or your husband, you do something about it," Warren said. "I see a lot of women about to lose their jobs because they cannot concentrate, they forget things or they are not sleeping. One of my patients had an auto accident. The consequences are very severe."

Another one of her patients was a lawyer in court presenting her arguments "when she drew a blank," Warren said. "Then she went to get her papers and couldn't find them. It was the most embarrassing thing in her life."

But the good news, according to the UCLA study, is that cognitive function rebounds once women reach menopause, though there is still a debate on what the longterm effects on brain function are.

"As long as there are hot sweats, the theory is that the neurons are sensitive to estrogen, but once you are more than five years out of menopause there is no benefit and, particularly as the brain ages, estrogen leads to deterioration," said JoAnn V. Pinkerton, president of the North American Menopause Society and director of the Mid-life Health Center at University of Virginia.

Hormone Replacement Controversy

As far as the long-term effects of hormones on cognition, "there isn't a clear answer," according to Pinkerton.

"If you look at older women, you get mixed reports that estrogen prevents and increases Alzheimer's disease," she told ABCNews.com. "But it appears there is a critical window."

While the 2002 heart study showed "who shouldn't get estrogen" -- those over 60 -- newer research is pointing to a "critical window" in the stages of menopause when women can benefit from the hormone, according to Pinkerton.

A 2008 study on mice at Yale University suggested that estrogen has a beneficial effect on younger, healthy neurons, but a detrimental one on aging neurons, "perhaps even speeding up dementia," she said.

The new spin on estrogen is likely to be heartening news for women at the pinnacle of their careers, but disabled by brain fog. And even in the absence of any hormone, the memory eventually rebounds.

"I was in the thick of it," said Anita Mahaffey, a 51-year-old San Diego mother of three, who runs her own business, selling pajamas made of moisture-drawing fabric for menopausal women.

"I used to remember everything -- every little detail," she told ABCNews.com. "I could tell you every number in the spreadsheet and tell you the bottom line. Now, if I don't write everything down right away or it doesn't get done.

"I scared myself so much I thought there was something wrong," said Mahaffey, who enrolled in a university study on memory. But she said tests proved her memory was "100 percent better than most people," so the evaluators sent her packing.

"I do think it's difficult," she said. "And like any muscle, if you don't use it, you lose it. I started doing Sudoko puzzles."
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Spare the Ovaries! What Women Should Ask Before a Hysterectomy

Far too many women, even young women, have their perfectly healthy ovaries removed at the time of a hysterectomy.

Doctors long recommended this to prevent ovarian cancer later in life. Although many doctors claim that this practice rarely happens today, the statistics say otherwise.

Of the 600,000 hysterectomies each year for non-cancerous causes, half of all women have their ovaries removed at the same time -- and many of these women have many years to go before menopause.

So, it seems that the practice of removing healthy ovaries at the time of hysterectomy has continued, despite years of evidence suggesting that ovaries are complicated hormone powerhouses, even in the time approaching and during menopause.

Our ovaries influence all aspects of our health and sense of well-being. Unfortunately, too many doctors feel that taking estrogen pills or an estrogen patch will work just fine, and there is really no big loss to having the ovaries removed.

However, taking estrogen as a substitute for young healthy ovaries hardly takes the place of what our healthy ovaries produce.

I remember the stories of many young -- and even not-so-young -- women describing how awful they felt following surgery when their ovaries were removed and how difficult it was to get the right balance of hormones. They all complained of low energy, reduced libido and not feeling quite right.

Even when I came up with a regimen that helped relieve many of their symptoms, they complained that they still were not feeling themselves.

Ovarian cancer is fairly uncommon, accounting for about 3 percent of all cancers and only 1 percent of all deaths in women. But it is difficult to detect and treat, so understandably, many women go along with their doctors and agree to have their healthy ovaries removed. What women don't consider are the potential health risks to having their ovaries removed.

A study published in the May 2009 issue of the journal Obstetrics & Gynecology, from the famous Nurses' Health Study, found what research has long shown us: Surgical removal of perfectly healthy ovaries is associated with a number of health risks, especially for young women.

But the increased risk of death found by the researchers surprised me. The overall risk of death was increased by 40 percent, and the risk of heart attack and stroke increased by 50 percent in women with removal of ovaries before age 50, especially if they didn't take hormones after surgery. In this study, all women, even older women, benefited from keeping their ovaries.

Ovary Removal During Hysterectomy a Disturbing Trend

The findings in this study are a big concern because far too many women elect to have their healthy ovaries removed during a hysterectomy, and many of these women are hesitant to take hormones because of the tremendous media scare against hormones.

Women in their 30s and 40s have a greatly increased risk of heart disease, osteoporosis and even stroke if they have their ovaries removed prematurely. Taking estrogen replacement after surgery will help reduce this risk, but hormones probably don't remove the risk altogether.

The good news, however, is that for women who choose to take estrogen when they have their uterus removed, there is no need to take progesterone as they no longer have a uterine lining at risk for cancer. Synthetic progesterone called progestins, such as Provera, often are prescribed to women with a uterus who are taking estrogen to balance out the estrogen and to prevent a buildup of the uterine lining. Without progesterone to balance out the effects on the lining, unchecked estrogen could eventually lead to uterine cancer.

I think all women need to be informed of their choices and apprised of the risks (there are many) and benefits (there are very few) of such a practice before they go under the knife. Expressing your concerns and wishes to your surgeon in advance will help your surgeon make the best decision for you -- and will more often than not mean you will wake up with your ovaries still intact.

What to Discuss With Your Surgeon Before Hysterectomy

I suggest four things you should ask your doctor before you have a hysterectomy.

1) Can I avoid a hysterectomy?
Many women who undergo a hysterectomy could have their medical conditions, such as heavy bleeding and fibroids, treated without surgery. Don't be afraid to ask if you should have a second opinion.

2) Can I have minimally invasive laparoscopy or robotic hysterectomy?
The recovery time after minimally invasive surgery is much quicker, and instead of a large incision you end up with a few tiny incisions.

3) Can I keep my ovaries?
Always talk over the risks and benefits of keeping your ovaries. Only women with a strong family history of ovarian cancer or women who know they carry the BRCA1 or BRCA2 gene mutations that greatly increase their risk of ovarian and breast cancer should strongly consider having their ovaries removed.

4) Can I begin estrogen in the form of a patch during or immediately after surgery?
Women, especially young women, who have their ovaries removed often experience disabling hot flashes soon after surgery. Taking estrogen will help considerably, although finding the right dose of estrogen can take some time. Ask about testosterone cream if estrogen does not completely relieve your symptoms, especially if you experience low libido after the surgery.
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Mom's Exercise Helps Baby's Heart

It's natural that a woman might be skeptical about exercising while she's pregnant. So many changes are occurring in her body, it makes sense to have second thoughts about whether exercise might harm her or her unborn child.

But it turns out that a thoughtful exercise program is good for both mother and child, according to medical experts.

"We know that women who exercise during pregnancy have less chance of developing certain conditions like gestational diabetes," said Dr. Raul Artal, chairman of obstetrics, gynecology and women's health for the Saint Louis University School of Medicine. "Not only that, exercise maintains musculoskeletal fitness. Women can cope with the anatomical and physiological changes of pregnancy better when they're in good shape. They also tolerate labor better and recover more quickly from delivery."

The baby also benefits. One study found that when an expectant mother works out, her fetus reaps cardiac benefits in the form of lower fetal heart rates.

The American College of Obstetricians and Gynecologists recommends that pregnant women do at least 30 minutes of moderate exercise a day most days of the week. First, though, all women should consult a doctor to make sure it's OK.

When choosing what sort of exercise to pursue, a woman should take into account the shape she was in before becoming pregnant, said Dr. Thomas Wang, a family practitioner for Kaiser Permanente in San Diego.

"A lot of things depend on the level of fitness they had before," Wang said. A mom-to-be should pursue activities that will provide a good level of exertion without testing the limits of her body's current conditioning. If she's just starting a fitness program to improve her health during pregnancy, she should start out slowly and be careful not to overexert herself.

But there are certain activities that should at least be undertaken with caution, if not avoided altogether. Pregnant women, for instance, should not go scuba diving, as that activity exposes the fetus to a risk of developing decompression sickness, also known as the bends.

Women also should think twice before engaging in activities where the risk of falling is higher, such as gymnastics, horseback riding, downhill skiing and high-intensity racquet sports. And they should avoid contact sports such as ice hockey, soccer and basketball.

"Anything that involves impact or the chance of abdominal trauma, they should try to avoid," Wang explained.

Exercise that's perfectly safe for expectant mothers includes Kegel exercises, swimming, walking, light dancing and yoga. Riding a stationary bicycle or working out on aerobic gym equipment -- elliptical or stair-climbing machines, for instance -- is also fairly safe, as long as care is taken to prevent a fall.

Most pregnant women also can take part in jogging, running and aerobics, especially if those were exercises they regularly performed before pregnancy.

Pregnant women who are doing weight training should emphasize improving their muscle tone, particularly in the upper body and abdominal area, according to the American Pregnancy Association. They should avoid lifting weights above their heads and performing exercises that strain the lower back muscles.

"There have been some studies that show heavy lifting causes a temporary drop in the baby's heart rate," Wang said. "It usually corrects pretty quickly, but they might want to be careful."

Other things to keep in mind if exercising while pregnant:

* Avoid exercising to the point of exhaustion or breathlessness, as that could affect the oxygen supply to the fetus.

* Avoid overheating, which can affect the baby's development. Don't exercise in hot weather.

* During the second and third trimesters, avoid exercise that involves lying flat on your back as this decreases blood flow to the womb.

Though that might seem like a lot of cautions for something that's supposed to be safe, doctors insist that women can and should engage in a well-thought-out fitness program during their pregnancy.

"By and large, if there are no medical complications of pregnancy, women can continue engaging in the same type of activities," Artal said. "Women should be encouraged to continue living an active lifestyle."
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The Pill May Limit Muscle Gains in Women

FRIDAY, April 17 (HealthDay News) -- Lower hormone levels in women who exercise regularly and take birth-control pills may result in less muscle mass increases, a new study suggests.

But the muscle-mass differences between women taking "the pill" and those not taking the pill did not affect performance.

At this point, the finding, from a study scheduled for presentation Friday at the annual meeting of the American Physiological Society in New Orleans, is no reason to stop taking oral contraceptives, experts said.

"It is premature to say anything conclusively at this point," said study lead author Chang Woock Lee, a doctoral candidate in the department of health and kinesiology at Texas A&M University, College Station. "Vigorous future studies with more stringent control and clever design will be definitely needed to confirm the results and/or elucidate the underlying mechanism conclusively."

Others agreed.
"It's just one small, a very small, group of women. If you think of how many women actually are on the pill, how significant is the difference in terms of patients noticing anything or even an actual health effect?" said Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City. "This might make a difference for a high-performance athlete in a competition, but, for your normal patients who have a healthy exercise routine, this might not make a difference."

"I don't disagree with the statistical significance, but the clinical significance is very questionable," added Dr. Amanda Weiss-Kelly, director of pediatric sports medicine at Rainbow Babies & Children's Hospital, part of University Hospitals Case Medical Center in Cleveland. "The difference didn't translate into improvement in performance," she added.

There is some existing research into the effect of oral contraceptives on body composition, Weiss-Kelly said, but most studies have been small, and results have been conflicting.

The authors of the new research studied two groups of 18- to 31-year-old women: 34 who were on the pill and 39 not on the pill. All were active and healthy and took part in a 10-week resistance-exercising training program (three times a week) as well as analysis of their body composition both before and after the program.

Women not taking oral contraceptives gained more than 60 percent more muscle mass than those on the pill.

There were other changes noted in participants on the pill, including reduced concentrations of the hormone DHEA, which Lee explained, is an anabolic hormone and therefore builds muscle.

But some of these changes would be expected in women taking contraceptives, Weiss-Kelly said.
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Drink for Your Heart but Abstain for Cancer?

The latest piece of evidence on the risks of drinking alcohol comes from researchers at Oxford University who studied more than 1.2 million women in the United Kingdom. They found that drinking alcohol may account for about 13 percent of all breast , liver, rectal and upper digestive tract cancers in women.

More shocking, even small amounts of alcohol seemed to increase the cancer risk. When compared with women who drank two or fewer alcoholic beverages per week, those drinking up to six alcoholic beverages had a 2 percent greater risk for cancer in general; those consuming between seven and 14 drinks per week had a 5 percent increased risk for cancer; and those consuming 15 or more per week had a 15 percent increased risk for cancer.

Using these findings, Dr. Michael Lauer, director of the Division of Prevention and Population Sciences at the National Heart, Lung, and Blood Institute in Bethesda, Md., wrote in the study's editorial that "there is no level of alcohol consumption that can be considered safe."

But with all we've heard in the past about the supposed health benefits of alcohol, can this really be the case?

Most experts say no.

"The editorialists … seem to be rather extreme in their views," said Dr. Charles Poole, associate professor of epidemiology in the Gillings School of Global Public Health at the University of North Carolina. "I have seldom seen such a one-sided dismissal of the hypothesis that moderate alcohol use may have cardiovascular benefits."

Alcohol for a Healthy Heart?

A study published in the British Medical Journal in May 2006 found that women who drank alcohol at least one day a week had about a 35 percent lower risk of coronary heart disease than women who drank alcohol less than once a week. For men, however, those who drank daily saw the largest reduction in risk when compared with nondrinkers -- about 41 percent.

The Fine Line Between Health and Illness

But it seems that the quantity of alcohol consumption plays a big role in whether you will see the risks or the benefits of a good buzz.

A meta-analysis (or overview of old studies) published in the Journal of the American Medical Association in 2003 found that light to moderate alcohol consumption could lower the risk for stroke, while heavy alcohol consumption raised the stroke risk.

Researchers found that those who consumed more than about 60 grams of alcohol per day, or about five drinks, had a 64 percent increase in overall stroke risk. But those who drank 12 grams of alcohol per day, or about one drink, experienced an 83 percent decrease in overall stroke risk.

Based on the body of available evidence on the benefits and risks of alcohol consumption, the American Cancer Society recommends that drinkers limit intake to one drink per day for women and two drinks per day for men.

Drink for Your Heart, or Stop Drinking for the Cancer Risk?

For some, this decision to start drinking for the heart benefits or stop drinking because of the increased cancer risk should be based on personal medical history.

"In light of the findings from [this study], women who are concerned about their cancer risk versus their risk of cardiovascular disease might want to discuss the potential risks and benefits of even low alcohol intake with their health care providers," said Susan Gapstur, associate director of Cancer Prevention and Control within the Robert H. Lurie Comprehensive Cancer Center at Northwestern University in Chicago.

And for those with a history of certain diseases such as breast cancer, experts said the heart-protective benefits of alcohol might not outweigh the overall increase in cancer risk caused by drinking.

"I think women at high breast cancer risk due to strong family history, or due to their own personal history, might be better off if they were to restrict alcohol intake to under one drink per day on average," said Dr. Tim Byers, associate dean of the Colorado School of Public Health at the University of Colorado at Denver.

The End Result: Alcohol's Effect on Life Expectancy

But for those whose personal history offers no added risk for alcohol consumption, taking a look at the overall life expectancy of alcohol drinkers might help to sway one's decision on whether the buzz is really worth it.

A study published in the journal Epidemiology in November 1998 found that light to moderate drinkers had the lowest risk of death compared with nondrinkers. Those who drank between one and seven alcoholic beverages a week experienced a 20 percent reduction in overall mortality.

When the researchers looked more closely at why light to moderate alcohol drinkers had less risk of death, they found that this group experienced a reduction in death from heart disease, thereby suggesting that the moderate alcohol consumption could have some protective benefits for the heart.

The Final Word on Alcohol

Based on the many studies finding that moderate alcohol consumption can have a heart-protective benefit, many experts said that moderate drinkers should not worry about this latest research finding an increased risk in cancer.

"A small decrease in [cardiovascular] risk more than compensates for an increased risk of rare cancers," said Dr. Alan Kristal, member and associate head of the Cancer Prevention Program at the Fred Hutchinson Cancer Research Center in Seattle. "You have to die of something, and no doubt how you live affects what you die [from], but not 'if' and maybe not 'when.'"
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Pregnancy No Hindrance to Breast Cancer Treatment, Study Says

Pregnant Women Can Get Chemo; Early Detection Still Lags.

That was when she found out she was pregnant. But it was also in April 2007 that she learned she had breast cancer.

"It definitely was not expected," Sanchez recalled. "It was scary -- it was very, very scary, actually."

She had noticed the lump in her breast herself, and by the time a doctor examined it, it had developed into stage 2 breast cancer. To delay treatment would put her life at risk. But doctors at the time told her that to go forward with chemotherapy could pose a health threat for the baby growing inside her.

"My gynecologist at the time, she told me that I was not going to be able to keep the baby," she said.

Sanchez is not alone. Dr. George Perkins, an associate professor in the M.D. Anderson Cancer Center's Department of Radiation Oncology, said a growing number of women face a breast cancer diagnosis while pregnant.

"In the midst of this joyous occasion is the somber news that there might not be hope for them," he said. "Usually ... they have been told that the only way they can receive treatment is through the termination of their pregnancy."

But mounting evidence suggests that women in this situation do not necessarily have to decide between their own health and their baby's survival. The latest study to suggest this, which Perkins co-authored, was published today in the current issue of the journal Cancer.

Perkins, lead study author Dr. Beth Beadle and colleagues at M.D. Anderson studied 652 breast cancer patients. What they found was that there was no difference in the odds of surviving 10 years -- widely considered as the point at which a woman can be considered cured of breast cancer -- between the women who were not pregnant during or slightly before their diagnosis and those who were.

The primary difference in treatment, Perkins said, was that pregnant women should not undergo chemotherapy during the first trimester, as this is the time when the baby's organs are forming and they are particularly vulnerable. But past studies have shown that when chemo begins in the second or third trimester, the children that are born are just as healthy as babies born to mothers without breast cancer -- and their mothers have the same chance of survival as their breast cancer-free counterparts.

Perkins said that this is good news for those women who find themselves in a situation similar to Sanchez's.

"The overall outcome of the newborn child, as well as the mother, can be taken into account [during treatment]," he said.

'Minimal Harm to Baby' From Chemo Later in Pregnancy

Dr. Eva Singletary, associate director of M.D. Anderson's Nellie B. Connally Breast Center, said in an interview with ABC News' OnCall+ Breast Cancer resource site that it is true that women who are further along in their pregnancies can take advantage of chemotherapy.

"In the second and third trimester, we can use chemotherapy very successfully with minimal harm to the baby," Singletary said.

But, she added, if a woman already has a breast cancer diagnosis, it is still wise for her to avoid getting pregnant because of how it could possibly complicate treatment.

"[I]t is important to use birth control, because chemotherapy can have harmful side effects to the fetus in the first trimester," she said. "However, in the second and third trimester, we can use chemotherapy very successfully with minimal harm to the baby.

Diagnosis During Pregnancy Becoming More Common

According to statistics from the American Cancer Society, breast cancer associated with pregnancy is rare, but it does happen in about one in 3,500 pregnancies.

And current trends suggest that this rate could be on the rise.

"We are noticing that we are seeing more patients being diagnosed with breast cancer during pregnancy," Perkins said.

The primary reason for this is that pregnant women, on average, are getting older. In 1982, the median age of a pregnant woman was 26.0 years; in 2002, this figure stood at 27.4 years.

"As the age at which child birth increases for women due to career goals and other reasons, we are expecting the incidence to increase," Perkins said. "We receive several phone calls a month from women who have been diagnosed with breast cancer and who are pregnant who have been told that overall they have an abysmal diagnosis."

When Cancer Goes Undetected

While the new study has good news to offer women who require breast cancer treatment while pregnant, it also exposes a disturbing fact -- pregnant women with breast cancer tend to be diagnosed later than those who are not pregnant. This means that by the time their cancers are found, they are generally worse.

"Women who present with breast cancer while pregnant on average have more advanced disease," Perkins said. "This represents a phenomenon of delayed diagnosis. In many cases they don't find out that they have breast cancer until after delivery."

Part of the problem is the fact that pregnant women naturally experience changes in the breast. These expected changes may mask breast cancer symptoms, making detection less likely by both these women and their doctors.

"The natural tendency is to say that this is a benign process, and that we don't have to be concerned about it," Perkins said.

But Perkins added that he remains hopeful that as more evidence comes out that pregnant women have little to fear from cancer treatment, more will have stories similar to Sanchez's. On Nov. 26, 2007, her baby, Isabella, was born. And Sanchez said that thus far, her daughter is meeting all of the normal benchmarks for children her age.

As for her own health, Sanchez is looking forward to this June, when it will be a year since she was declared cancer-free.

"I don't really feel like a survivor yet, but everything looks good so far," she said.
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Study Examines Moms' C-Section Complications

As the rate of cesarean deliveries in the USA has risen, so has the rate of rare but severe complications in mothers, researchers report today.

With more than a million performed annually, C-section is the country's most common operation. In 2006, the most recent year available, 31.1 percent of all U.S. births were C-sections, up 50 percent from 1998. While a number of studies have focused on C-sections' effects on newborns, few have looked at the effects on moms.

The new study, by government researchers, examined the rate of severe complications in women who delivered in U.S. hospitals in two time periods: 1998-99 vs. 2004-05.

They found a 90 percent increase in blood transfusions and a 50 percent increase in pulmonary embolisms, or blood clots in the lungs. They also found about a 20 percent increase in rates of kidney failure, respiratory distress syndrome, shock and the need for a ventilator.

While the study doesn't prove that C-sections cause complications, tracking those complications could be useful, says co-author Susan Meikle, a medical officer at the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

The actual number of deliveries with at least one complication was 0.64 percent in 1998-99 and 0.81 percent in 2004-05. "Even though the absolute numbers are low, the rates are increasing. ... We could do a better job at tracking these complications," says Meikle, an obstetrician. "There may be short-term trade-offs and long-term trade-offs (depending on mode of delivery). We don't know that yet."

Although the average age of women giving birth has been rising, that didn't seem to play a big role in the complication rates, the researchers write in the Journal of Obstetrics & Gynecology. But they found that the rising cesarean rate seemed to explain the hikes in kidney failure, respiratory distress syndrome and ventilation. The rise in C-sections only partially contributed to increases in shock, pulmonary embolisms and transfusions.

The authors lacked information about race and whether the women were overweight, both of which could impact the risk of complications. They also didn't know why C-sections were performed and whether moms who had them were sick beforehand.

The study used the largest U.S. inpatient care database, which in 2005 sampled hospitals from 37 states, constituting about 90 percent of hospital discharges in the country.

Michael Kramer, scientific director of the Canadian counterpart of Meikle's institute, notes that in some cases, a complication might have triggered a C-section, not vice-versa. Still, says Kramer, co-author of a 2007 report that found more severe maternal complications in planned C-sections than in vaginal deliveries, doctors tend to underestimate C-section risks.
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