Painkillers in Pregnancy May Harm Son’s Fertility, Study Suggests

THURSDAY, Nov. 11 (HealthDay News) — Pregnant women who use mild painkillers may boost the risk that their male children will grow up to be infertile, a new European study suggests.

Commenting on the study, a U.S. researcher said the findings are weak, although he thinks pregnant women should be careful around painkillers, including aspirin, ibuprofen and acetaminophen, for another reason: miscarriages.

The European study, which included 834 women in Denmark and 1,463 in Finland, found that women who combined more than one mild painkiller at the same time were seven times more likely to give birth to sons with undescended testicles compared to women who took no painkillers.

In particular, the second trimester seemed to be the most vulnerable time, with any use of mild painkillers during that time period more than doubling the risk, the study authors noted in a news release from the European Society of Human Reproduction and Embryology.

Combining more than one painkiller during the second trimester increased the risk 16-fold, the investigators reported in the study published online Nov. 8 in the journal Human Reproduction.

It appears that it is becoming more common for males to have undescended testicles, particularly in Denmark, where the incidence has increased from 1.8 percent in 1959-1961 to 8.5 percent in 1997-2001, the study authors noted. The condition is thought to boost the risk of infertility and testicular cancer later in life. However, many males with undescended testicles grow up without these problems, they added.

In support of the findings, a study in rats by researchers from France and Denmark found that painkillers disrupt the endocrine system, changing the way the body produces testosterone.

“If exposure to endocrine disruptors is the mechanism behind the increasing reproductive problems among young men in the Western world, this research suggests that particular attention should be paid to the use of mild analgesics during pregnancy, as this could be a major reason for the problems,” research leader Dr. Henrik Leffers, a senior scientist at Rigshospitalet in Copenhagen Denmark, said in the news release.

“Women may want to try to reduce their analgesic use during pregnancy,” Leffers added. “However, as biologists this is not something we can advise women about. So we recommend that pregnant women seek advice from their physician before using mild analgesics and in general follow the advice to use as little medicine during pregnancy as possible.”

Commenting on the study findings, Dr. De-Kun Li, a senior research scientist at the Kaiser Foundation Research Institute in Oakland, Calif., said women should be cautious about painkillers during pregnancy because their use around conception has been linked to miscarriages. But Li said the new research is “relatively weak” for several reasons.

For one, Li said, the results from the two countries (Finland and Denmark) are inconsistent, and the condition in question — undescended testicles, also known as cryptorchidism — “is a tricky condition to determine.”

“Many boys can have undescended testicles at birth and then the condition will disappear [by] 1 year of age,” Li said. “Therefore, there is controversy over which cases should be really considered as cryptorchidism. Most studies only included those cases who remained cryptorchidism at age 1. But this study appeared to include all cases at birth. This raised the question whether those are real cases.”

Flu Vaccine recommended during Pregnancy

Yearly Flu vaccine is highly encouraged for all pregnant women. A recent study revealed that women who were vaccinated in the second or third trimester of pregnancy, their babies were significantly less likely to get the flu, and the babies’ blood showed evidence of antibodies to the flu. This study adds to the literature that vaccination in pregnancy is a “two for” because of the protection that it affords to infants younger than 6 months old who are vulnerable to influenza but not eligible for immunization. Please also note flu vaccination takes two weeks to become effective and lasts from six to eight months. Vaccination is safe in any trimester.

Serious complications including respiratory failure requiring ICU admission and maternal death are much more common in pregnancy due to generalized immune system suppression. If you recall last year’s HIN1 pandemic you should remember the numerous deaths that resulted and the much greater incidence in pregnant women than the general population.

Rest assured this year’s flu vaccine already includes HIN1 and cannot give you the flu as there is no live flu virus in the injectable form recommended during pregnancy. Any muscle aches or pains that patients claim have occurred after the injection are nothing compared to actually contracting the flu.

Get the flu vaccine during pregnancy… it’s not just for you but for your unborn and newborn baby too!

Doctor Jonathan Weinstein, an Ob-Gyn physician in Frisco, TX cares for patients that come from Frisco, Plano, McKinney, Allen and surrounding cities for all their obstetrical and gynecological needs.

Pregnancy-Related Weight Gain Higher Among Low-Income Minority Women

A new study by the Yale School of Public Health finds that excessive weight gain during pregnancy and inadequate postpartum weight loss are particularly prevalent among low-income, ethnic minority women. The study appears online in the journal American Journal of Obstetrics & Gynecology.

Patterns like this have important public health implications, including reduced growth for the fetus and greater likelihood of preterm delivery and injury during birth. Mothers who retain weight after giving birth are more likely than their peers to develop a range of serious health conditions, including cardiovascular disease, hypertension and diabetes.

The study followed 427 women (ranging in age from 14 to 25 years old) during their pregnancy through to 12 months postpartum. The researchers found that 62 percent of the women— particularly those who were already overweight or obese—exceeded the maximum recommended weight gain. Only 22 percent of the women gained weight within recommended guidelines.

Postpartum, the study found that one-third of the participants had a higher body mass index (BMI) one year after giving birth and that 68 percent were either overweight or obese. The study also found a noticeable shift toward obesity. Five percent of the women classified as having normal weight and 53 percent of those classified as overweight before pregnancy were classified as obese one-year postpartum. The authors note that a shift in body mass index that is seen after just one pregnancy is likely to be compounded with future pregnancies.

“Rates of overweight and obesity have increased dramatically in the United States and abroad. For childbearing women, obesity and excessive weight gain can result in serious adverse health outcomes for both mother and baby,” said Jeannette Ickovics, a professor at the School of Public Health and the paper’s senior author. “Pregnancy is a pivotal point for weight management. To promote good health, we must consider pregnancy a ‘window of opportunity’ for interventions to improve weight management and reduce the shift towards obesity.”

The Institute of Medicine released guidelines in 2009 on healthy levels of weight gain for pregnant women. They recommend that women who are considered underweight at the onset of their pregnancy gain no more than 40 pounds; that woman who are overweight gain no more than 25 pounds; and that women who are obese limit their overall weight gain to 20 pounds.

Other authors include Trace Kershaw, an associate professor at the School of Public Health; Bonnie E. Gould Rothberg, an associate research scientist in the Department of Pathology; Urania Magriples, an associate professor in the Department of Obstetrics and Gynecology; and Sharon Schindler Rising, executive director of the Centering Healthcare Institute in Cheshire, Conn.

Hologic Encourages Health Professionals to Get the Facts About Women’s Imaging at RSNA 2010

Hologic Technologies Help Bring Imaging Excellence and Clinical Confidence to Hospitals and Imaging Centers Across the World

BEDFORD, Mass., Nov. 10, 2010 /PRNewswire-FirstCall/ — Hologic, Inc. (Hologic or the Company) (Nasdaq: HOLX), a leading developer, manufacturer and supplier of premium diagnostics products, medical imaging systems and surgical products dedicated to serving the healthcare needs of women, will focus on products that are the future of women’s imaging at the Radiological Society of North America (RSNA) meeting at McCormick Place in Chicago, November 28 through December 2, 2010.

Hologic offers clinicians the tools they need to spot, diagnosis and treat cancer or detect osteoporosis while they can still do something about it and the ability to treat a woman at every stage of her life, not just the disease. Over the years radiologists, surgeons, and radiation oncologists have come to rely on Hologic solutions and have made Hologic a leader in digital mammography, breast magnetic resonance imaging (MRI), breast biopsy, accelerated partial breast irradiation and osteoporosis assessment.

With a footprint of 16,000 sq. ft. (1,500 sq. meters) in the South Building of McCormick Place, the Hologic RSNA exhibit ranks 5th in overall size of the 706 booths at this year’s meeting. Sixty thousand professionals are expected to attend RSNA 2010, where 4,200 scientific papers and educational exhibits, and 300 refresher courses will be presented.

Breast Screening and Diagnostic Systems

The November FDA Mammography Quality Standards Act (MQSA) scorecard reports that over 70% of the 8,643 breast imaging sites in the U.S. now have at least one digital mammography system. The Hologic Selenia® system leads the industry in U.S. system installs with more than all the other digital mammography vendors combined.

The power of digital imaging creates new possibilities that will enable us to see cancers earlier than ever before. One area that is expected to deliver on this promise is digital breast tomosynthesis. The Selenia® Dimensions® three-dimensional (3D) breast tomosynthesis system directly addresses the primary limitations of 2D digital alone mammography — the superimposition of normal breast tissue.

Launched in Europe in September 2008, Selenia Dimensions breast tomosynthesis is poised to revolutionize how breast cancer is detected. It delivers the exquisite 2D images the industry has come to expect from Hologic and, for the first time ever, allows radiologists to offer their patients a conventional digital mammogram and a tomosynthesis exam — all under one compression, in just seconds.

Hologic has commercial breast tomosynthesis systems installed in over two dozen countries including Canada and Mexico. In September the Radiological Devices Panel of the U.S. Food and Drug Administration (FDA) voted unanimously that Hologic demonstrated both the effectiveness and safety of the Selenia Dimensions system. The Panel also voted in favor that the benefits of this new technology outweigh the risks.

In 2010 Hologic and Barco, a global display and visualization provider, are working with the RSNA organization to deliver a series of hands-on digital mammography and breast tomosynthesis workshops during the weeklong meeting. Five hundred radiologists will benefit from this highly popular self-assessment educational workshop. Registration information may be found on the RSNA website.

Breast MRI

With the acquisition of Sentinelle™ Medical Inc. Hologic adds a suite of breast MRI tools to its best-in-class women’s health portfolio. The company believes MRI is an important standard of care in breast screening for women indicated as having a high risk of developing breast cancer.

The Sentinelle Breast MRI coil comes in two configurations: A design award-winning patient stretcher with integrated breast MRI coils, and a tabletop configuration leveraging the same open access features of the patient stretcher. Both patient support configurations are designed to provide greater access for positioning and intervention, optimal patient comfort and improved workflow. The innovative combination of the Sentinelle breast MRI coil’s unique patient support and patented Variable Coil Geometry™ feature offers technological advances not available in traditional tabletop coils. Unlike competitive breast coils, the Sentinelle Variable Coil Geometry feature allows for the diagnostic coils and biopsy grid positioning to be customized to each patient. This innovation has the potential to improve image quality, decrease set up time, increase patient accommodation and improve access to lesions for biopsy.

The Sentinelle Aegis™ Breast imaging and interventional software is a dedicated plug-in for the Aegis platform software. It offers powerful real-time 4D (3D + time) image processing, combining speed, flexibility, and dedicated breast MRI algorithms. With advanced hanging protocols and dynamic real-time processing, Aegis Breast software is a state-of the-art platform for breast MRI visualization and interventional guidance to multiple targets.

Built on the Aegis software platform, the Sentinelle Navigation system offers a multi-modality approach to correlated image viewing and device guidance. The Navigation system simultaneously displays real time ultrasound images with corresponding images from previously acquired 3D DICOM datasets. Leveraging the increased sensitivity and specificity of MRI, CT or PET images with ultrasound has the potential to yield more dependable results.

Diagnostic Workstations

With the most popular diagnostic workstation on the market today Hologic is ideally positioned to address some of the toughest challenges — controlling costs, increasing productivity and improving quality. Hologic SecurView® diagnostic workstations lead the industry in the transition from analog to a digital environment. Our ImageChecker® CAD system delivers proven performance and has been the leading CAD technology for more than a decade.

Until recently, consistent assessment of breast composition was hampered by widely differing technical factors and the subjectiveness of the reviewer. The Quantra® volumetric assessment tool is a break-through technology designed to estimate volumes in the breast and calculate the volumetric fraction of fibroglandular tissue. The Quantra tool uses details of the x-ray imaging chain to quantify fibroglandular tissue in the breast. Quantra software aggregates volumetric measurements from each view in a study into a simple, concise assessment for each breast.

Breast Biopsy Solutions

If a suspicious lesion is detected, Hologic supports the next clinical steps — biopsy and intervention. RSNA attendees are invited to discover the many ways Hologic can help deliver compassionate, clinically effective alternatives to open surgical breast biopsy. From our ATEC®, Eviva® and Celero® breast biopsy devices to our new Eviva upright biopsy system and our ergonomically engineered MultiCare® Platinum breast biopsy table with the latest in patient comfort features, we bring more compassionate care to healthcare providers the world over. New this year, we are featuring our work in progress, the Abrivo™ breast biopsy device and Affirm™ breast biopsy guidance system. The Affirm stereotactic-guided biopsy device is specifically designed for the Selenia Dimensions system. Each Hologic breast biopsy solution is designed to improve precision and increase control while collecting the best possible tissue samples.

The SecurMark® family of biopsy site markers now offers three new distinct shapes. The SecurMark biopsy site markers are comprised of two components; one is a bio-absorbable suture-like netting material and the other is a permanent bio-compatible titanium or stainless steel marker. In addition, the Hologic biopsy site marker family includes TriMark® and CeleroMark™ markers.

Should cancer be detected in its early stages, many women are candidates for the Hologic MammoSite® radiation therapy system, a unique and welcomed clinical option, and a patient-friendly alternative to traditional whole breast radiation. The November 2010 release of five-year results from the American Society of Breast Surgeons (ASBS) MammoSite® Breast Brachytherapy Registry Trial was a significant milestone for MammoSite and adds further clinical support for the use of accelerated partial breast irradiation in appropriate patients.

Patient Comfort

For added comfort, the MammoPad® breast cushion is designed to offer a softer, warmer mammogram to help ease a patient’s fear of mammography-associated pain, allowing the technologist to obtain more of the chest wall in the image and ensure even compression of the breast. The MammoPad cushion, which can be used with both digital and analog mammography, is radiolucent and does not require additional dose. New this year is a change in color for MammoPad to pink. The new color of MammoPad not only brings a more aesthetically pleasing look, but also a potentially greater influence on a patient’s ability to relax.

Bone Health

For many years Hologic has set the gold standard in osteoporosis assessment. Now we are expanding our solutions to address the continuum of skeletal health care, from prevention to intervention. Just as we are leading the way in women’s health imaging solutions, we are raising the bar in skeletal health imaging.

Discovery™, our most advanced QDR™ series bone densitometer, offers exquisite imaging and rapid assessment of the most important risk factors for osteoporotic fracture: bone density and vertebral fracture. Hologic’s OnePass™ single sweep linear scanning enables superior image quality and unparalleled precision in just seconds.

Hologic was the first manufacturer to receive FDA clearance for the new World Health Organization FRAX® 10-year fracture risk calculator. While the T-score remains the standard for diagnosing osteoporosis, the FRAX calculator breaks new ground enabling healthcare providers to identify patients with a high risk of experiencing bone fractures within a period of 10 years. By combining 11 of the highest risk factors, including age, personal, and family history of fractures, country-specific life expectancy and country-specific fracture data, the FRAX calculator identifies patients who are at high risk of fracture but would not be candidates for preventative therapy using the traditional T-score.

At RSNA 2010 Hologic will highlight Advanced Body Composition™ assessment software — commercial in Europe and awaiting FDA clearance in the U.S. The Advanced Body Composition Assessment feature on Discovery combines rapid acquisition of the total body with comprehensive reporting and the new National Health and Nutrition Examination Survey (NHANES) reference data. The new color displays of fat and lean distribution combined with the new trending report are valuable tools for the clinician.

The Fluoroscan® InSight system is the original and most sought after mini C-arm system on the market. Now the new Fluoroscan InSight mini C-arm is more versatile, efficient and cost effective than ever before. Designed specifically for orthopedic and other extremity surgeons, the Fluoroscan InSight system is designed to offer maneuverability, high definition (HD), low-dose fluoroscopy images, and automated adjustments that deliver the optimum image every time, for every patient.

Award Winning Service

Hologic’s commitment to supporting customers does not end once a product is delivered. We are committed to delivering the highest quality products and service, acting with the utmost integrity and not just meeting, but exceeding customer expectations. How are we doing?

The recently released 2010 IMV ServiceTrak™ Imaging for X-Ray Mammography Systems report notes that Hologic service out-scored the industry average in 25 of the 39 service attributes measured, is top-rated for 22 attributes, and achieved a rating at or above 5.0 (“very good”) on all 30 of the ratings attributes. Of particular note, Hologic scored highest on the reliability of our detectors, probability of repurchase, our ability to drive industry standards, and our image quality. Additionally, it was the 3rd year in a row that Hologic was rated highest in overall manufacturer performance and overall system performance.

On the journey from images to answers, Hologic offers the finest screening, compassionate diagnosis, and confident treatment solutions for women — every step of the way.

About Hologic, Inc.

Hologic, Inc. is a leading developer, manufacturer and supplier of premium diagnostics products, medical imaging systems and surgical products dedicated to serving the healthcare needs of women. Hologic’s core business units are focused on breast health, diagnostics, GYN surgical, and skeletal health. Hologic provides a comprehensive suite of technologies with products for mammography and breast biopsy, breast magnetic resonance imaging, radiation treatment for early-stage breast cancer, cervical cancer screening, treatment for menorrhagia, permanent contraception, osteoporosis assessment, preterm birth risk assessment, mini C-arm for extremity imaging and molecular diagnostic products including HPV and reagents for a variety of DNA and RNA analysis applications. For more information, visit www.hologic.com.

Hologic, Advanced Body Composition, Aegis, Affirm, ATEC, CeleroMark, Dimensions, Discovery, Eviva, Fluoroscan, ImageChecker, InSight, MammoPad, MammoSite, OnePass, QDR, Quantra, SecurMark, SecurView, Selenia, Sentinelle TriMark, Variable Coil Geometry and associated logos are trademarks and/or registered trademarks of Hologic, Inc. and/or its subsidiaries in the United States and/or other countries. FRAX is a trademark of the World Health Organization.

Forward Looking Statement Disclaimer

This News Release contains forward-looking information that involves risks and uncertainties, including statements about Hologic’s plans, objectives, expectations and intentions. Such statements include, without limitation, statements regarding the expected performance and benefits of Hologic products and products under development. There is no guarantee that such products will achieve benefits described herein and that such benefits will replicated in particular manner with respect to an individual patient as the actual effect of the use of the these products can only be determined on a case-by-case basis depending on the particular circumstances and patient in question. These forward-looking statements are subject to known and unknown risks and uncertainties that could cause actual results to differ materially from those anticipated. Factors that could cause actual results to materially differ include, without limitation: risks inherent in the development of new products and the enhancement of existing products, including technical and regulatory risks, such as the ability to obtain FDA approval or clearances to market products developed, cost overruns and delays; the risk that newly introduced products may contain undetected errors or defects or otherwise not perform as anticipated; Hologic’s ability to predict accurately the demand for its products and to develop strategies to address its markets successfully; technical innovations that could render products marketed or under development by Hologic obsolete; competition; and reimbursement policies for the use of Hologic’s products. Other factors that could adversely affect Hologic’s business and prospects are described in Hologic’s filings with the Securities and Exchange Commission. Hologic expressly disclaims any obligation or undertaking to release publicly any updates or revisions to any such statements to reflect any change in Hologic’s expectations or any change in events, conditions or circumstances on which any such statement is based.

Child Abuse Linked to Increased Risk for Type 2 Diabetes in Adults

November 10, 2010 — Women who experience physical or sexual abuse as children or adolescents are at significantly increased risk of developing type 2 diabetes, a large, longitudinal cohort study suggests. Furthermore, investigators found there is a dose response relationship such that the more severe the abuse, the greater the risk.

The latest findings from the Nurses Health Study II show moderate or severe physical abuse was associated with a 26% to 54% higher risk for diabetes in adulthood. Unwanted sexual touching was associated with a 16% higher risk for the disease. Forced sexual activity before adulthood carried a 34% increased risk if it occurred once and but carried a 69% greater risk if it occurred more frequently.

“Although there was no evidence of a multiplicative, synergistic impact of experiencing both physical and sexual abuse, women who experienced both types of abuse had higher absolute risks of diabetes than expected from physical or sexual abuse alone.

“Girls who experience both types of abuse may suffer more severe abuse, more emotionally damaging abuse, or more chronic abuse than girls who experienced abuse of one type,” the researchers, led by Janet Rich-Edwards, ScD, director of developmental epidemiology at the Conners Center for Women’s Health, Brigham and Women’s Hospital, Boston, Massachusetts, write.

The study was published online November 9 in the American Journal of Preventive Medicine.

According to investigators there is a considerable amount of research examining the psychological sequelae of childhood abuse but few studies examining lifelong physical consequences, with 1 exception.

The researchers note that there has been a consistently reported link between child abuse and adult obesity and evidence indicating that child abuse leads to overweight.

The study authors add that because obesity is a major risk factor for type 2 diabetes, it may be that early abuse may lead to the disease via this pathway. They also note that experimental and observational research suggests that “early trauma may cause lasting dysregulated stress responsivity, which may link child abuse with diabetes through physiologic pathways independent of adiposity.”

According to investigators, earlier studies examining childhood trauma and diabetes have been limited by small sample sizes, cross-sectional design, unvalidated or nonspecific metabolic outcomes, or cursory assessments of abuse history.

To examine the extent to which child physical or sexual abuse is associated with type 2 diabetes, the researchers examined data from 67,853 women participating in the Nurses’ Health Study II.

Established in 1989, the cohort has been followed by biennial mailed questionnaires asking about risk factors and disease incidence. In 2001 a Violence Questionnaire was sent to 91,297 study participants and 67,853 individuals responded. The investigators then examined reported lifetime abuse in 2001 and corresponding risk for diabetes from 1989 through 2005.

More than half (54%) of participants reported mild to severe physical abuse as a child or teen and 34% reported experiencing sexual abuse. Adjusted analyses revealed that compared with women who reported no physical abuse, the hazard ratios (HRs) were 1.03 (95% confidence interval [CI], 0.91 – 1.17) for mild physical abuse, 1.26 (95% CI, 1.14 – 1.40) for moderate physical abuse, and 1.54 (95% CI, 1.34 – 1.77) for severe physical abuse.

Compared with women who reported no childhood or adolescent sexual abuse, the HRs were 1.16 (95% CI, 1.05 – 1.29) for unwanted sexual touching, 1.34 (95% CI, 1.13 – 1.59) for a single episode of forced sexual activity, and 1.69 (95% CI, 1.45 – 1.97) for repeated forced sex.

“The more severe the reported abuse, the higher the woman’s risk of developing type 2 diabetes as an adult,” Dr. Rich-Edwards said in a statement.

The investigators report that adult body mass index accounted for 60% of the association of child and adolescent physical abuse and 64% of the association of sexual abuse with diabetes.

“Interpersonal violence is a prevalent and understudied threat to women’s health,” said Dr. Rich-Edwards. “Since child abuse predicts later obesity, and obesity is one of the primary causes of chronic disease, our study demonstrates just one of many potential health risks associated with childhood abuse.”

The investigators note that there is a need for further investigation of potential associations between abuse of girls and women with health.

Statin use did not reduce colon cancer in postmenopausal women

PHILDELPHIA — A prospective analysis of the Women’s Health Initiative showed that statins had no chemopreventive effect for women aged 50 to 79 years.

Michael S. Simon, MD, professor of oncology at Wayne State University’s Barbara Ann Karmanos Cancer Institute, in Detroit, presented the results during the Ninth Annual AACR Frontiers in Cancer Prevention Research. Researchers sought to confirm results from earlier case-control studies showing a moderate reduction in colorectal cancer risk associated with 3-hydroxy-3-methylglutaryl coenzyme A inhibitors. Simon said, however, that there was no correlation between reduction in colon cancer risk and type of statin used, statin potency or use of other lipid-lowering medications.

“While biologically plausible, there was no significant reduction in risk for colorectal cancer among users of statins among postmenopausal women in the Women’s Health Initiative cohort,” Simon said.

The study included 159,219 women who participated in the Women’s Health Initiative. Participants were asked to bring all current medications to their screening interviews, and information on statin use and other lipid-lowering medications was entered into a database. That information was updated at 1 year and at 3 years.

Researchers collected further information on colorectal cancer risk factors through both patient-administered and staff-administered questionnaires.

Simon said 7.6% of women in the cohort reported using statins.

At an average follow-up of 10.7 years, 2,000 patients had been diagnosed with colorectal cancer. The annualized rate of colorectal cancer was 0.13% among statin users and 0.12% among nonusers (HR=0.99; 95% CI, 0.83-1.20).

Researchers did not observe a reduction in risk for colorectal cancer by duration of statin use whether patients used the drugs for less than 1 year (HR= 0.91; 95% CI, 0.66-1.27), 1 to 3 years (HR=1.28; 95% CI, 0.97-1.68) or more than 3 years (HR=0.79; 95% CI, 0.56-1.11).

Additionally, there was no relationship between statin use and tumor location or clinical features. – by Jason Harris

Weaning Yourself Off An Antidepressant

(HealthNewsDigest.com) – BOSTON—Taking an antidepressant can be a godsend when depression robs you of joy. But once you are feeling better, you may start thinking about going off the drug. First, talk to your physician or therapist to make sure you aren’t at risk of falling back into depression. Then slowly lower the dose, reports the November 2010 issue of Harvard Women’s Health Watch.

Suddenly stopping an antidepressant can cause a number of physical and emotional problems that include nausea, vomiting, dizziness, sweating or flushing, sleep disturbances, tremors, irritability, or strange sensations. The best way to minimize or prevent these problems is by gradually lowering the dose (tapering off) over weeks to months. Sometimes this process involves substituting other medications for the one you are quitting.

Harvard Women’s Health Watch notes that if you’re thinking about stopping antidepressants, you should consider the following:

Take your time. Depression can return if you stop taking an antidepressant too soon. Clinicians generally recommend sticking with the drug for six to nine months before considering going off it. Before stopping, you should feel confident that you’re functioning well and that your life circumstances are stable.

Make a plan. Going off an antidepressant usually involves reducing your dose in increments, allowing two to six weeks—or more—between dose reductions. Your clinician can instruct you in tapering your dose and can prescribe pills of the appropriate dosage for making the change. Other techniques for dose tapering include pill cutting and using a liquid antidepressant formulation.

Seek support. Stay in touch with your clinician as you go through the process. Let her or him know about any physical or emotional symptoms you are having, and check in one month after you’ve stopped.

Harvard Women’s Health Watch is available from Harvard Health Publications (www.health.harvard.edu

8 Ways the Election Will Change Women’s Health & Reproductive Rights

Now that the dust has settled a bit since Tuesday’s midterm election, every talking head on TV and writer in the blogosphere can’t help but take a stab at the answer to two big words: “What now?” There’s no doubt the election’s results will affect the future of our country … and the future of American women’s health. Daunting, I know.

Here, eight major shake-ups, take-downs, and potential changes on the horizon …

1. Birth Control & Abortion Ban. Defeated

In Colorado, the so-called “personhood” amendment was voted down by a large margin—72 to 28. The amendment would have mandated that a fertilized egg have the same rights as a born human from the moment of conception. In other words, if it had passed, it would have outlawed abortion (even in cases of rape or incest), emergency contraception, hormonal contraception (like the NuvaRing, Depo-Provera, Mirena IUD, etc. which alter the lining of the uterine wall to make it inhospitable to fertilized eggs), and even medical care that could potentially harm the fetus.

2. The “Rape Comment” Republican. Defeated.

Colorado also did not elect Ken Buck, the unsuccessful Republican challenger for U.S. Senate. This is the guy who accused a rape victim of “buyer’s remorse.”

3. Abortion Tax Proponent. Elected.

House Speaker John Boehner & Co. has promised to push the new “Stupak on Steroids” bill, which would ban coverage of abortion in the new health care system and impose a tax on Americans with private insurance plans that include abortion coverage. (That’s 87% of private plans.) Boehner is one of more than 180 current House members who are co-sponsors of this legislation.

4. Healthcare Reform Hating Governors. Elected.

The recently picked up GOP governorships will likely impede the Affordable Care Act (known to some as “Obamacare”) at the state level. The federal statute for healthcare reform leaves a lot up to state government (like setting up a process by which to review “unreasonable” premium hikes and creating state-level insurance exchanges). But the GOP governors, who are now at the helm of more than 30 states, could introduce officials who favor a lax regulatory regime, which would undermine the law early on.

5. (Several) Pro-Life Candidates. Defeated.

In Washington, Nevada, California, Louisiana, Rhode Island, Hawaii, and Delaware, pro-choice candidates beat out pro-life, not-very-femme-friendly ones—one who even argued that rape victims ought to “turn lemons into lemonade.”

6. The Anti-Masturbation Candidate. Defeated.

Speaking of Delaware … Christine O’Donnell lost her bid for Senator, and therefore will not be able to introduce anti-masturbation legislation.

7. Healthcare Reform Hating Congressmen. Elected.

The new GOP majority in the House of Representatives promised that they will go to great lengths—potentially even shutting down government—to overturn healthcare reform, which currently aims to widen women’s access to birth control and prenatal care services.

8. Abstinence-Only Supporters. Elected.

The newly elected Republican representatives want to revive the failed, Bush-era “abstinence-only” programs that emphasize waiting until marriage while excluding discussion of birth control and safe sex.

What do you believe were the biggest victories and defeats for women’s health in this election?

Planned Parenthood president blasts Buck on women’s issues

Planned Parenthood’s Cecile Richards, on a U.S. tour backing pro-choice candidates, called out Republican U.S. Senate hopeful Ken Buck as having extreme views not consistent with Colorado values. But she said voter turnout, not a shift in those values, would determine the outcome of today’s election. Buck’s campaign today dismissed Richards’ comments and said she was just dishing dirt for the Democratic machine.

Richards, president of the Planned Parenthood Federation of America and Planned Parenthood Action Fund, said the turnout of women voters could be the deciding factor in Colorado’s race for U.S. Senate, where she says women are frightened of Buck’s views on women’s health. Her organization supports incumbent Democratic Sen. Michael Bennet.

“Ken Buck is really out of touch with where I think mainstream voters are,” Richards said.
“If he is elected, and this is a very competitive race as you know, I think that voters are going to be surprised on just how extreme he is on women’s health and women’s rights.”

Pointing to Buck’s opposition to abortion in cases including rape and incest, Richards said Colorado is a moderate state. “This is a pro-choice state. It is one I don’t think is going to be very sympathetic at all to elected officials that want to overturn Roe.”

The Buck campaign, however, rejected the comments of Richards as coming straight out of the Democratic playbook.

“[Richards] and the Democrat machine have tried everything they could to tear down Ken Buck, and the latest independent polls show Ken Buck leading,” said Buck campaign spokesman Owen Loftus. “Our internal polls show Ken Buck as leading. They are trying to throw this mud and it is just not working.”

A Public Policy Polling survey conducted Sunday showed Buck up one point on Bennet 49-48.

Richards said that Planned Parenthood Action Fund is working actively to turn out the vote for Bennet in today’s race. She said they are targeting a list of 50,000 supporters, many of whom are swing voters, to get out the message about Buck’s positions on women’s health. She said they are backing Bennet because he has been a strong advocate for women’s health issues in the Senate.

“I think that he stands a very good chance of winning, and it is all down to turnout. Every poll I have looked at in this race is razor thin.”

Loftus said voter turnout was working in the GOP’s favor. “The Secretary of State just released new numbers; Republicans now have a 70,000 edge over Democrats in the early vote.”

The Colorado Secretary of State’s Office reporting Monday that with just over a million ballots cast, 48 percent of active Democrats, 52 percent of Republicans and 34 percent of unaffiliated voters have already voted for their candidates.

Richards said her organization was not going to let up on getting out the vote until the last polling station is closed at 7 p.m.

“Through the Planned Parenthood Action Fund we have sent a lot of mail, a lot of phoning to our supporters. Really just to educate women on how extreme Ken Buck is. If women get out to vote, certainly the majority of them will vote for Sen. Bennet.”

Richards said that politicians and analysts had initially downplayed the role women’s health issues would play in the election, instead pointing to jobs, the economy and debt as the vote drivers. However, she said that since September, as the drive to get women’s votes began, polling has shown politicians that women’s issues matter.

“You are not seeing people who take extreme positions, such as Ken Buck, advertising proudly and loudly their positions against Roe and reproductive health care,” Richards said. “So for [Colorado Constitution Party gubernatorial candidate] Mr. [Tom] Tancredo, for Ken Buck, if they were to get elected, it would be despite their position on choice.”

Loftus said that it is no illusion that Coloradans are focused on the economy in this year’s election. He said despite opposition attacks on Buck, the Weld County D.A. would be focused on the fiscal issues if he is elected to office.

“Coloradans know Ken Buck is going into Washington to fix the economy, create jobs, and get Washington spending under control,” Loftus said.

Sexism remains a problem for women seeking office

NEW YORK — Even with many high-profile female candidates, the just-ended campaign was rife with sexism ranging from snarky fashion critiques to sexual innuendo. And when all the ballots are counted, women may hold fewer seats in the new Congress than the outgoing one.

“It looks as if we’re going backward rather than forward,” Siobhan Bennett, president of the Women’s Campaign Forum Foundation, said at a teleconference Thursday discussing the prevalence of political sexism.

Two years after Hillary Rodham Clinton nearly captured the Democratic presidential nomination and Sarah Palin was the Republican vice presidential nominee, female candidates dealt with comments about their hair and seamy, anonymous Web postings. Speaker Nancy Pelosi – second in the presidential line of succession – was widely vilified by Republican candidates in ways that often seemed gender-specific.

Bennett said the prospect of sexist attacks deterred many women from running for office and was a reason why scores of other countries have a higher proportion of women in their national legislatures than the U.S., which remains at 17 percent.

Depending on the outcome of a few undecided races, women will at best hold even in the Senate with 17 seats, and could lose one or two of their 73 seats in the House. That would be the first such decline since 1978.

“Going backward is unacceptable,” said Erin Vilardi of the White House Project, a nonpartisan group dedicated to recruiting women to run for office.

She said there was a growing pipeline of potential female candidates eager to run at the local level, and she faulted both major parties for inadequate efforts to identify and support them.

Earlier in the campaign, there was widespread buzz that this would be “The Year of the Woman” – notably on the Republican side with the Senate candidacies of Carly Fiorina in California, Linda McMahon in Connecticut, Christine O’Donnell in Delaware and Kelly Ayotte in New Hampshire.

Of the four, only Ayotte won. She will become the lone woman in the Senate opposed to broad-based abortion rights.

On the House side, the GOP fared better, adding at least eight new female members. But those gains were offset by defeats of at least nine incumbent Democratic women.

The number of female governors will remain at six, including three new Republicans: Susana Martinez in New Mexico, Mary Fallin in Oklahoma and Nikki Haley in South Carolina.

The outcome spells the end of Pelosi’s four-year stint as the first female speaker of the House -the highest-ranking elected woman in U.S. history.

Women’s groups monitoring campaign sexism felt that some of the GOP attacks on Pelosi were misogynistic and were irked that conservative commentator Rush Limbaugh played “Ding-Dong! The Witch is Dead” on his radio show Wednesday to celebrate Pelosi’s impending demotion.

Three groups supporting an expanded political role for women teamed up in recent months with an initiative called “Name It, Change It,” – intended to swiftly protest instances of perceived political sexism that surfaced during the campaign.

On Thursday, the New York-based Women’s Media Center and its partners announced “awards” for what they considered the most flagrant examples in the media.

Among those cited were the gossip blog Gawker, for running a tawdry anonymous posting from a man claiming a brief romantic encounter with Christine O’Donnell several years ago, and the Boston Herald, for a column in which a minor party candidate’s hair was likened to a Brillo pad.

Joining the teleconference was Krystal Ball, the losing Democratic candidate in a race for a U.S. House seat in Virginia. In mid-campaign, she had to deal with the fallout of an Internet-posted photo showing her in a suggestive outfit and pose at a costume party six years ago.

Ball sought advice from “Name It, Change It” on how to respond, and forcefully defended herself against what she said was a smear campaign. Though she lost, she said her decision to denounce the tactic as sexist helped her gain votes.

“There’s no question in my mind that calling this out was the right thing to do,” she said, expressing hope that other women wouldn’t be deterred from running for office out of fear of being embarrassed by comparable tactics.

The issue of sexism has cropped up regularly in recent elections. In 2008, for example, both Clinton and Palin were critiqued for dress and demeanor in ways that seemed belittling to women.

“When you attack one woman in this way, you attack all women in this way,” said Bennett, who depicted political sexism as a bipartisan problem.

She said seemingly mild sexism – commentary on clothes, makeup and cleavage – can be as damaging to a female candidate’s credibility as sharper attacks.

“Women can fight back,” she said. “As soon as a woman says, ‘That’s sexist, that’s off-base,’ voters go, ‘That’s right.’”

For many politically engaged women, possible bipartisan solidarity against sexism is overshadowed by the bitter divide over abortion. On both sides of that debate, prominent women have been busy since the election tallying the huge increase – several dozen seats – in the number of abortion opponents in the House.

Bennett said women should not let the abortion divide impede the broader goal of getting more women – liberal or conservative – into Congress.

“You elect any woman, of either party, and you have a harder-working woman … a leader who will be paying more attention to education, to quality of life,” she said. “Having more women in elective office is essential to the long-term health of our nation.”

Mobile mammography unit travels to ensure women’s health

FLORENCE, SC (WMBF) – The McLeod Mobile Mammography Unit takes digital mammogram screenings to women at health care facilities, businesses, industries, and health fairs to reach those women who do not undergo a mammogram for lack of time, awareness, and access. The unit provides a convenient, comfortable, and private setting in which women can undergo a screening mammogram.

Upcoming visits include:McLeod Family Practice Timmonsville (755 E. Smith Street, Timmonsville) Tuesday, November 2, 2010, 8:30 a.m. – 4:00 p.m.
Pee Dee Active Day Center (2120 Enterprise Drive, Florence) Monday, November 8, 2010, 9:00 a.m. – 4:00 p.m.
Schofield ACE Hardware (155 S. Cashua Drive, Florence) Wednesday, November 17, 2010, 9:00 a.m. – 4:00 p.m.
McLeod Family Medicine Johnsonville (355 South Georgetown Highway, Johnsonville) Thursday, November 18, 2010, 8:30 a.m. – 4:00 p.m.
Pate Medical Associates (116 Hospital Square, Bishopville) Monday, November 29, 2010, 8:30 a.m. – 3:45 p.m.

Any woman who meets certain conditions and criteria is able to have a screening mammogram performed on the mobile unit. No physician order is required for a screening mammogram, but each woman must have a referring physician to receive the mammogram results.

This procedure will also require insurance or a method of payment as normal screening mammogram charges apply (no cash please). Medicaid, Medicare, and Best Chance Network are accepted. Generally, women should be 40 years of age or older and must not have had a screening mammogram performed in the past 12 months for most insurance coverage.

Strengthen pelvic floor muscles to ease common women’s health issues

A variety of problems, including incontinence, constipation and prolapse can be traced to the pelvic floor muscles — a group of muscles inside the pelvis that many women don’t even know they have.

The pelvic floor muscles connect the bony structure at the bottom of the pelvis. These muscles help to keep the bladder, uterus and rectum in place. The urethra, anus and vagina all exit through and are supported by the pelvic floor muscles, said Maggie Coffman, clinical nurse specialist at Benefis Medical Group Urology.

The pelvic floor muscles have so much influence on so many systems, she said. And keeping those muscles healthy at every age is important.

This critical muscle group contributes to the physical sensations during orgasm and maintains vaginal tone, she said.

Many women have a good understanding of their organs but don’t understand that organs and muscles can affect each other, said Coffman, who specializes in pelvic floor dysfunction.

What appears to be a problem with the bladder, for example incontinence, might actually be an issue of the pelvic floor muscles.

Patients often find themselves at Coffman’s office after being referred by a urologist or another specialist who thinks that whatever problem they’re having, whether its urinary leakage or sexual dysfunction, stems from pelvic floor issues.

Some pelvic problems are related to the pelvic floor muscles and might not require surgery to fix, Coffman said. For example, women who are experiencing urinary leakage might need to strengthen their pelvic floor muscles. Patients who have a hard time urinating may also need to learn to relax those muscles

“With those patients, the muscles are too tight,” Coffman said.

Coffman often works with women to teach them how to exercise these muscles.

“Most women have heard of Kegels,” Coffman said.

Women often are told to do the exercises, which involve contracting and relaxing the pelvic floor muscles, during pregnancy to help with childbirth.

While many people have heard of Kegel exercises, named after Dr. Arnold Kegel who played a role in discovering the pelvic floor muscles, many people do them incorrectly.

“They’re actually hard to do correctly,” she said.

Many women have a hard time finding their pelvic floor muscles. Often patients squeeze their abs, legs or butt and think it’s the pelvic floor. For women who have pelvic floor weakness or spasms, they can be even harder to find.

“Weak muscles are hard to isolate, and it’s hard to make it do something,” Coffman said.

Many women have heard that a good way to do Kegel exercises is to start and stop their urinations. That’s actually not effective, Coffman said. That’s a good technique to help find the pelvic floor muscles, but actually can lead to urination problems.

Instead women should isolate and contract their pelvic floor muscles and hold up to 10 seconds, followed by complete relaxation for 10 seconds. Repeat to the point of muscle fatigue, which is usually 20 to 30 cycles, said Dr. Rollin Bearss, urologist at Benefis Medical Group Urology. Fatiguing the muscles helps strengthen them.

Women should work on strengthening their pelvic floor muscles before they develop problems, he said. Like other muscles, it’s easier to keep them toned when you work at it constantly, rather than letting them get out of shape and then trying to get them back into shape.

“By keeping your pelvic floor strong and healthy, you can help prevent certain types of bladder control problems and other common pelvic health issues,” Coffman said.