Understanding endometriosis

March is Endometriosis Awareness Month, which makes it a good time to talk about this little understood but serious medical condition.

Endometriosis is a condition where endometrial tissue that normally lines the inside of the uterus, grows outside the uterus and attaches to other organs in the abdominal cavity, such as the ovaries and fallopian tubes. Endometriosis is a progressive disease that tends to get worse over time and can recur after treatment. Symptoms include painful menstrual periods, abnormal menstrual bleeding, pain during or after sexual intercourse, and infertility. The cause of endometriosis is unknown, though there are a few theories that suggest possible causes.

Based on the stage of endometriosis, your physician will determine the best treatment plan for you, which may include medication, surgery or a combination of both. Dr. Ziegler is an expert in laparoscopic laser surgery, which minimizes adhesion due to a surgical procedure. Laser ablation is associated with a success rate of greater than 70% pain relief and improved fertility.

If you’d like to learn more, call us today for a free phone consultation, or contact us online. 

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Does folic acid really prevent birth defects?

It sure does. Serious birth defects of the brain and spine called neural tube defects have fallen 35 percent in the United States since mandatory folic acid fortification of enriched grain products was introduced in 1998, according to the U.S. Centers for Disease Control and Prevention.

That decrease means 1,300 fewer babies are born annually with neural tube defects such as spina bifida, the most common neural tube defect, which in severe cases can cause partial or complete paralysis of the parts of the body below the waist.

The agency says all women of childbearing age—even if they’re not planning to get pregnant—need to get 400 micrograms of folic acid daily from fortified foods, supplements or both, and to eat foods high in folic acid. “All women capable of having a baby should be taking a multivitamin containing folic acid every day,” obstetrician-gynecologist and geneticist Siobhan Dolan, M.D., co-author of the March of Dimes book Healthy Mom, Healthy Baby: The Ultimate Pregnancy Guide, says in a news release from the organization.

“It’s also good to eat foods that contain folate, the natural form of folic acid, including lentils, green leafy vegetables, black beans and orange juice, as well as foods fortified with folic acid, such as bread and pasta, and enriched cereals,” Dr. Dolan adds.

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‘Tight’ BP control better for mom and baby

When pregnant women have high blood pressure, intensive treatment doesn’t seem to affect their babies, but may lower the odds that moms will develop severely high blood pressure. That’s the conclusion of a clinical trial reported in the Jan. 29 issue of the New England Journal of Medicine.

The findings are based on nearly 1,000 pregnant women from 16 different countries who had high blood pressure. Half were randomly assigned to “tight” blood pressure control, and half to “less tight.” Treatment involved regular blood pressure checks and, for most women, medication, with the dose adjusted when needed. In the end, researchers found no differences in how the two groups fared, except for one: Almost 41 percent of women under looser blood-pressure control eventually developed severe high blood pressure (a reading of 160/110 mm Hg or higher), while just 27.5 percent of women on the tighter regimen developed severe high blood pressure.

Some experts worry that lowering a pregnant woman’s blood pressure too much could reduce blood flow to the placenta and impair fetal growth. Some studies have found that to be a risk. But in this trial, the degree of blood-pressure control did not affect a woman’s risk of pregnancy loss or of having a baby who needed a stay in the newborn intensive care unit.

High blood pressure, or hypertension, is the most common medical condition of pregnancy, affecting about 10 percent of pregnant women. Some women go into pregnancy with the condition, but many more develop pregnancy-induced hypertension, which tends to arise after the 20th week.

Be sure to discuss these findings with your doctor, especially if you have high blood pressure before getting pregnant.

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Early menopause linked to chemicals

Extensive exposure to common chemicals appears to be linked to an earlier start of menopause, a new study suggests. Researchers found that menopause typically begins two to four years earlier in women whose bodies have high levels of certain chemicals found in household items, personal care products, plastics and the environment, compared with women with lower levels of the chemicals.

In this study, published in the journal PLoS One, the investigators analyzed blood and urine samples from more than 1,400 menopausal women, averaging 61 years of age, to determine their exposure to 111 mostly man-made chemicals. They identified 15 chemicals—nine (now banned) PCBs, three pesticides, two forms of plastics chemicals called phthalates, and the toxin furan—that were significantly associated with an earlier start of menopause and that may have harmful effects on ovarian function.

Along with reducing fertility, a decline in ovarian function can lead to earlier development of heart disease, osteoporosis and other health problems, the researchers said. Prior research has also linked the chemicals with some cancers, early puberty and metabolic syndrome. Metabolic syndrome refers to a group of health conditions that together increase the risk of heart disease, stroke and diabetes.

Although some of these chemicals are in the soil, water and air and beyond our control, the researchers said, certain precautions with day-to-day use of chemicals and plastics in household products might reduce exposure. For example, microwave food in glass or paper containers instead of in plastic, and learn more about the ingredients in cosmetics, personal-care products and food packaging, they suggested.

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Keep tabs on thyroid health

A new study supports the notion that thyroid disorders can cause significant reproductive problems for women. The report’s authors believe that testing for thyroid disease should be considered for women who have fertility problems and repeated early pregnancy loss.

The research, published Jan. 23 in The Obstetrician & Gynaecologist, found that 2.3 percent of women with fertility problems had an overactive thyroid (hyperthyroidism), compared with 1.5 percent of those in the general population. The condition is also linked with menstrual irregularity, the researchers said.

The thyroid produces hormones that play key roles in growth and development. According to the researchers, changes in thyroid function can have a major effect on reproductive function before, during and after conception. The researchers also noted that thyroid disease is associated with an increased risk of problems during pregnancy, including miscarriage, preeclampsia, poor fetal growth, premature birth and stillbirth.

However, with appropriate screening and prompt management, these risks can be significantly reduced, the authors said. The current recommendation by the American Congress of Obstetricians and Gynecologists is to start screening at age 35. Ask your doctor if thyroid screening is appropriate.

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De-stress for baby’s success

Stress has long been linked to many health problems, and fetal development can now be added to that list, according to a study published in the Journal of Physiology.

To test whether high stress levels in pregnant mice had an impact on their offspring, pregnant mice received a natural stress hormone at different times during pregnancy. Researchers found that increased levels of stress hormones caused the mother to eat more but reduced the ability of the placenta to transport glucose to her fetus.

The researchers believe that this may affect the combination of nutrients received by the fetus and, in turn, the long-term metabolic health. The study found that, when under stress, certain genes in the placenta were modified, including one in the placenta that is believed to regulate nutrients and oxygen uptake in other body tissues.

If you are feeling stressed while pregnant, work with your doctor to find ways to de-stress, including meditation, exercise, proper sleep and other healthful choices.

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Should pregnant women eat fish?

Yes, say new findings in the American Journal of Clinical Nutrition. Research in the Seychelles provides evidence that the benefits of fish consumption on prenatal development may offset the risks associated with mercury exposure. In fact, the new study suggests that the nutrients found in fish have properties that protect the brain from the potential toxic effects of the chemical.

Three decades of research in the Seychelles have consistently shown that high levels of fish consumption by pregnant mothers—an average of 12 meals per week—do not produce developmental problems in their children. Researchers have previously believed that the developmental benefits of nutrients in fish were greater than the possible harmful effects of mercury also found in fish. However, the new research indicates that this relation is far more complex and that compounds in fish, specifically polyunsaturated fatty acids (PUFA), may also actively counteract the damage that mercury causes in the brain.

The new study comes as the U.S. Food and Drug Administration and international agencies are in the process of revisiting fish consumption advisories to better reflect the health benefits of nutrients found in fish. The FDA’s current guidance, which recommends that pregnant women limit their consumption of certain fish to twice a week, was established because of the known risk of high-level mercury exposure on childhood development. Stay tuned for new guidelines.

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New concerns about PCOS

Women with polycystic ovary syndrome (PCOS), which can cause infertility, are at increased risk for a number of serious health problems, new research suggests.

“PCOS has profound implications for a women’s reproductive health, as well as her long-term risk of chronic illness,” wrote study author Dr. Roger Hart, of the University of Western Australia and Fertility Specialists of Western Australia, both in Perth.

PCOS is the most common hormone disorder in women of reproductive age. The condition causes an imbalance of hormones, resulting in excess weight, irregular periods, infertility and an overgrowth of body and facial hair. As many as 5 million American women have the condition, according to the U.S. Office on Women’s Health.

For the study, published Jan. 27 in the Journal of Clinical Endocrinology & Metabolism, researchers analyzed data from more than 2,500 Australian women. They were aged 15 and older, and all had been diagnosed with PCOS between 1997 and 2011. Compared with those without the condition, women with PCOS had a higher risk of hospitalization. Conditions included heart disease, diabetes, asthma, musculoskeletal disorders, mental health conditions such as depression, stress and anxiety, and cancer of the lining of the uterus, according to the study authors.

Women with PCOS were also more likely to have gynecological issues. These included miscarriages, ectopic pregnancies, irregular menstrual periods and endometriosis, the study found.

The Endocrine Society, which publishes the journal this study appears in, has issued clinical guidelines that recommend all women and teens diagnosed with PCOS be screened for heart disease risk factors and diabetes. Be sure to talk to your doctor about these important findings.

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More kudos for vitamin D

Vitamin D is essential for calcium absorption and metabolism. And it has long been known that having high levels of vitamin D during pregnancy is critical to promoting healthy fetal skeletal growth.

A new study shows just how important that is. In newborns and young children, vitamin D deficiency, especially when accompanied by low calcium levels, can cause unexpected death.

Vitamin D deficiency is directly associated with rickets, which is the failure of growing bone and cartilage to mineralize. This condition can cause premature death in small children. Other studies suggest there is also a correlation between vitamin D deficiency and early childhood asthma, multiple infections and bone fractures.

The article—“Does Low Vitamin D Have a Role in Pediatric Morbidity and Mortality?”—in the journal Pediatric and Developmental Pathology presents data from 2009 to 2012, examining 183 cases of death in children between the ages of 2 days and 10 years.

Vitamin D status was known and examined in 51 of these cases. All but one had insufficient or deficient levels.

Receiving the right amount of vitamin D begins in the womb and continues through birth and development. After birth, the major source of vitamin D is through skin exposure, so spending an adequate amount of time outdoors in the sunshine is essential.

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Study: Fertility treatments producing healthier children

Great news for those considering fertility treatment: A recent study has found that the health of children born with the help of fertility treatments has improved substantially over the past 20 years.

Fewer babies are being born prematurely or with low birth weight. There are also fewer stillbirths or deaths within the first year of life, researchers in Denmark found. The study was published in the journal Human Reproduction.

The researchers reviewed the health outcomes of more than 62,000 single babies and nearly 30,000 twins born with the help of assisted reproductive technology (ART). The babies were born in Denmark, Finland, Norway or Sweden between 1988 and 2007. These children were compared with more than 350,000 singletons and about 123,000 twins born without the help of advanced fertility treatments in those countries during the same years.

Over the study period, the researchers discovered that fewer singleton babies conceived through fertility treatments were born with a low birth weight of about 5.5 pounds or very low birth weight (about 3 pounds). They also found that the rates for stillbirths and deaths within the first year of life dropped for both singletons and twins conceived through ART.

“These findings show convincingly that while there has been a considerable increase in assisted reproduction cycles over the past 20 years, this has been accompanied by a significant improvement in health outcomes for these babies, particularly for singleton babies,” the researchers said.

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