REPOST: Prime Time: The Angelina Conundrum

How did Angelina Jolie changed a lot of women's perception about preventive double mastectomy? Read about it from this MedPageToday.com article:

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Angelina Jolie has been very public about her choice to undergo a preventive double mastectomy. Her very honest, and descriptive opinion piece in the New York Timesthis past May even outlined the risk factors unique to her physiology and genetic makeup, which prompted her actions.

Many oncologists and genetic specialists believe that Jolie made a well-educated decision under the guidance of competent medical counsel. Jolie tested positive for mutations in her BRCA1 gene and her biological mother fought breast cancer for a decade before passing at the age of 56.

These combined risk factors gave her an estimated 87% chance, at the highest end of the range, of developing breast cancer, which was reduced to 5% post mastectomy.

But, as it turns out, most people have completely missed out on the medically relevant details, Dina L.G. Borzekowski, EdD, of Johns Hopkins School of Public Health, and colleagues reported online in Genetics in Medicine.

Borzekowski and colleagues surveyed 2,572 adults, men and women, across the nation about their awareness and understanding of Jolie's health and breast cancer risks, as well as hypothetical questions about how they would handle a similar situation.

After assessing the surveys, the researchers found that three out of four responders knew of Jolie's surgery, but fewer than 10% had an accurate understanding of what Jolie's risk factors actually were for developing breast cancer in relation to women who do not have BRCA1gene mutations.

Nearly half of all responders were able to recall Jolie's estimated risk for breast cancer prior to her surgery. And 57% of the women said they would also have had a prophylactic double mastectomy if they tested positive for a BRCA gene mutation.

"Awareness of the Angelina Jolie story was not associated with improved understanding .... In fact, among those who followed the story, women were less accurate than men, almost always overestimating the contribution of the BRCA mutation to breast cancer and the average women's lifetime risk of breast cancer," Borzekowski and colleagues wrote.

In conclusion, Borzekowski and colleagues noted that celebrities may have the capacity to heighten awareness of a particular health issue, but that those messages should be sandwiched between useful and purposeful communications to help the public understand exactly what is going on in these individual cases.

Without purposeful communication to put individual cases in public context, the "Couric Effect" may spike misplaced health concerns, and therefore unnecessary screenings for low-risk individuals.

In 2000, Katie Couric underwent an on-air colonoscopy, after her husband died from colon cancer. Researchers at the University of Michigan did a population-based observational study on increases in colonoscopy screenings in the general public. Overall, a 20% increase, and in women alone, a 4% increase, in colonoscopies occurred during the 9 months following Couric's televised event.

For years now, researchers have been reporting on overscreening; it's expensive, invasive, and stressful.

Even 8% of responders to Borzekowski's survey said they had increased anxiety for several weeks after hearing about Jolie. Although no uptick in mammograms were reported by survey participants, 9% said they felt more motivated to get the mammogram they had been putting off.

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More about women's health can be access on this Louise Habash blog site.

REPOST: Drinking Milk in Pregnancy May Lead to Taller Children

According to a new study published in this New York Times article, pregnant women who drink milk will most likely to have taller offspring compared to those who don't.

A new study suggests that the amount of milk a woman drinks during pregnancy may affect the adult height of her offspring.

Researchers followed 685 Danish mother-child pairs in a prospective study over 20 years, tracking milk consumption during pregnancy and the height of the offspring at birth and age 20. The study was published online Sept. 4 in The European Journal of Clinical Nutrition.

After adjusting for the mother’s height, age, body mass index and many other factors, they found that mothers who drank more than five ounces of milk a day — almost all drank low-fat milk — had bigger babies, on average, than those who drank less. This, the authors write, confirms the results of previous studies.

By age 20, children with mothers who drank more than five ounces of milk a day during pregnancy were, on average, almost a half-inch taller. They also had an average of 8 percent higher blood levels of IGF-1, or insulin-like growth factor, which promotes bone growth. But these trends did not achieve statistical significance.

“There aren’t many prenatal dietary or environmental factors identified that explain growth in children,” said Thorhallur Halldorsson, a researcher at Center for Fetal Programming at the State Serum Institute in Copenhagen. “Milk drinking may be one. It does increase weight and length at birth, and there’s a possibility that this actually tracks into adult life.”

Learn what you need to know during pregnancy by reading articles on this Dr. Louise Habash blog site. 

REPOST: Article sheds light on the link between depression and poor parenting

How does depression affect parenting? This article from MedicalNewsToday.com discusses this subject. 

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An article by researchers at the University of Exeter has shed light on the link between depression and poor parenting. The article identifies the symptoms of depression that are likely to cause difficulties with parenting. The findings could lead to more effective interventions to prevent depression and other psychological disorders from being passed from parent to child.

Although the link between depression and poor parenting has previously been identified, this is the first time that researchers have brought together multiple studies in order to identify the reasons behind the parenting difficulties.

The editorial, published in the journal Psychological Medicine, indicates that parents who experience depression might be emotionally unavailable and as a consequence feel shame and guilt towards their parenting role.

The work also indicates that problems with memory - a symptom of depression - may affect a parent's ability to set goals for their child at the appropriate developmental stage.

In the weeks after birth a mother's interaction with her child leads to structural changes in the brain which helps her respond to the needs of the infant. These changes may also occur in fathers. If depressed parents have not had optimal and frequent interactions with their newborns they may not develop these brain changes, resulting in parenting difficulties that can ultimately lead to a child with behavioural problems.

Dr Lamprini Psychogiou from the University of Exeter said: "We have looked at a wide range of research studies and identified multiple factors that link depression in adults to difficulties in their parenting role.

"This work will help identify areas in which future research is necessary in order to develop interventions that will prevent mental health issues from being transmitted from one generation to the next. We hope that this will go some way towards helping both depressed parents and their children."

Future research will test the mechanisms that link depression in adults with the difficulties they may have with parenting. An improved understanding of these processes will aid the development of more specific and potentially more effective treatments.

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Read interesting articles about motherhood and femininity from this blog by Dr. Louise Habash.

REPOST: Breast health linked to eating peanut butter and nuts

Does eating peanut butter beneficial to women? Read about the new study linking peanut butter and nuts to breast health from this Medical News Today article. 

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By eating more peanut butter during their high school years, girls could be improving their breast health in adulthood, according to a US study published recently in the journal Breast Cancer Research and Treatment.

Dr. Graham Colditz, of Washington University School of Medicine in St. Louis, and colleagues found that girls aged 9 to 15 who ate peanut butter and nuts twice a week were 39% less likely to develop benign breast disease by the age of 30 than girls who did not.

Benign breast disease includes lumps or tender spots that turn out to be fibrous tissue and/or cysts, as well as other conditions like hyperplasia, an overgrowth of the cells that line the ducts in the glandular breast tissue.

Although benign breast disease is not cancerous, it can raise the risk of developing breast cancer later in life.

Dr. Colditz, associate director for cancer prevention and control at the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, says:

"These findings suggest that peanut butter could help reduce the risk of breast cancer in women."

For their study, he and his colleagues looked at health data on over 9,000 American schoolgirls recruited to The Growing Up Today Study between 1996 and 2001. This included detailed information about food consumption as captured in food frequency questionnaires that the girls filled in on enrollment.

The data also included reports from the girls between 2005 and 2010, when they were 18 to 30 years old, that indicated whether they had ever been diagnosed with biopsy-confirmed benign breast disease.

When they compared the two sets of data, the researchers found that participants who had eaten peanut butter or nuts twice a week were 39% less likely than peers who never ate those foods to receive a diagnosis for benign breast disease.

The data suggest pulse foods - soy and other beans and lentils - and corn may also be linked to reduced risk of benign breast disease, but because they did not feature as much in the diets of these girls, the evidence was not so strong.

The researchers also note that:

"Girls with a family history of breast cancer had significantly lower risk if they consumed these foods or vegetable fat."

And they concluded that "consumption of vegetable protein, fat, peanut butter, or nuts by older girls may help reduce their risk of BBD [benign breast disease] as young women."

This is not the first study to tie diets rich in vegetable fats - such as those present in peanut butter, nuts and pulse foods - to a lower risk for benign breast disease. But it is the first to find the evidence by comparing data captured during adolescence with followed-up cases of diagnosed disease, as opposed to asking young women to recall what they ate when they were in high school.

Dr. Colditz says girls would do well to eat more peanut butter and nuts and consume less junk foods and sugary drinks, especially in view of the rise in obesity.

Funds from the Breast Cancer Research Foundation and the National Institutes of Health (NIH) helped finance the study.

Another study published recently in the journal BMC Medicine also suggests eating nuts may cut risk of death from cancer and heart disease.

Written by Catharine Paddock PhD

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Dr. Louise Habash helps women in taking care of their health and femininity. For more about her, visit this Facebook page.

REPOST: Many Women Victims of ‘Contraceptive Sabotage,’ Experts Say

Many adolescent girls and women have male partners who intentionally sabotage their contraception, or forced them into having unwanted pregnancies or abortions. This Health.com article shares that women should be screened to detect signs of this form of sexual coercion. 

Image Source: .health.com

WEDNESDAY, Jan. 23 (HealthDay News) — Obstetricians and gynecologists should screen women and teens for signs that their partner is sabotaging their birth control, forcing them to have unprotected sex or otherwise trying to control their reproductive choices, says a leading group of U.S. doctors.

The American College of Obstetricians and Gynecologists (ACOG) lays out guidelines for detecting sexual and reproductive “coercion” — which it calls an under-recognized form of violence against women — in the February issue of the journal Obstetrics & Gynecology.

“Most ob/gyns are probably unfamiliar with sexual and reproductive coercion as an entity and probably don’t ask about it,” said Dr. Eve Espey, chairwoman of the ACOG’s Committee on Health Care for Underserved Women.

The abuse includes hiding or destroying a woman’s birth control method of choice; poking holes in a condom or removing it during sex; coercing a woman to carry out or end a pregnancy against her will through violence or threats; and intentionally exposing her to a sexually transmitted disease.

It’s not clear how common this type of abuse is, Espey said. One study of teenagers on public assistance found that of those who said they were victims of any type of domestic violence, two-thirds said it included birth-control sabotage.

“It’s hard to determine the prevalence of this form of abuse, and it’s understood that most [domestic] violence is under-reported,” Espey said.

A 2011 government survey found that one in four U.S. women has been physically abused by a partner.

“Given how prevalent [domestic] violence is, reproductive coercion is probably not uncommon,” Espey said.

Rita Smith, executive director of the National Coalition Against Domestic Violence, praised the ACOG’s move. Encouraging doctors to regularly ask women about such abuse is “a great addition to women’s health care needs,” Smith said.

“Chronic health care issues can be avoided, and women can manage the needs of their families and themselves much better if their reproductive decisions are not interfered with by an abuser,” Smith said.

The ACOG said doctors should ask women about potential reproductive coercion when they screen for domestic violence in general — something ob/gyns already know to ask about, Espey said.

Futures Without Violence, a nonprofit organization based in San Francisco, has developed wallet-sized “safety cards” with information on reproductive coercion that doctors can give to women. Doctors also can use those cards as a starting point for talking to their patients, said Rebecca Levenson, a senior policy analyst at Futures Without Violence.

The term “reproductive coercion” was coined several years ago after researchers began recognizing it as a distinct form of violence that some women suffer independent of other types of abuse, Levenson explained.

She said the ACOG is on the “cutting edge” in making its new recommendations, and it is important for ob/gyns to specifically ask about reproductive coercion because they can help women directly.

Espey agreed. Giving a woman a birth-control method that is not obvious to her abuser is one way.

“For example, an IUD with the strings cut off would protect against pregnancy but would not be felt by the partner during intercourse,” Espey explained.

IUDs, or intrauterine devices, are implanted in the uterus, where they release small amounts of either copper or the hormone progestin to prevent pregnancy. Espey said the copper IUD might be preferable for women who are victims of abuse because they do not usually keep a woman from menstruating, and some abusers monitor their partner’s periods.

Espey said the takeaway for women is that they have the right to decide whether and when to have children, and what to do about an unplanned pregnancy.

“Most women involve their partners in these decisions, but in some circumstances, it is unsafe to do so,” Espey said. “If a woman feels that she is experiencing reproductive coercion, there is help.”


Louise Habash is knowledgeable on the specific healthcare needs of women. Follow this Twitter page for more updates.

REPOST: Thyroid Disorders Tied to Complications in Pregnancy

Undiagnosed and untreated thyroid disease can be a cause for a more complicated pregnancy according to this Health.com article.

Image Source: news.health.com

WEDNESDAY, May 29 (HealthDay News) — Pregnant women with thyroid disorders are at greater risk for premature delivery and other pregnancy complications, a new study indicates.

Researchers caution that these complications could have both short-term and long-term health consequences for women and their babies. Thyroid disease occurs when the thyroid gland — located at the front of the neck — doesn’t supply the proper amount of hormones needed by the body.

“In the United States, at least 80,000 pregnant women each year have thyroid diseases,” study lead author, Dr. Tuija Mannisto, of the U.S. National Institute of Child Health and Human Development (NICHD), said in a news release from the Endocrine Society.

“These women are at increased risk of having serious adverse pregnancy outcomes, including hypertension and preterm birth. They also have a higher rate of labor inductions and other birth interventions,” Mannisto explained.

In conducting the study, the researchers examined medical records from more than 223,000 pregnancies. The investigators found that women with thyroid conditions were more likely to develop preeclampsia, a complication marked by protein in the urine and a sharp rise in blood pressure during pregnancy. These women were also admitted to the intensive care unit more often, were more likely to develop gestational diabetes and had a higher rate of cesarean deliveries.

“Women need appropriate thyroid hormone levels to support a healthy pregnancy, so it is very important to carefully monitor expecting mothers who have thyroid diseases,” said one of the study’s authors, Pauline Mendola, from the NICHD. “We also need more research to identify ways to reduce the risks these women currently face.”

Although the study found an association between having a thyroid condition and higher risk of pregnancy complications, it did not establish a cause-and-effect relationship.

Do you want to have a healthy pregnancy? Follow Dr. Louise Habash's Twitter page to learn how to keep you and your baby safe.

Complicated but not hopeless: Having a bouncing baby despite diabetes

As a doctor, I always tell the truth to my patients no matter how dismaying it may be. Women don’t go out of Dr. Louise Habash’s clinic with false hopes. Inasmuch as I hate relaying bad news to my patients, I feel exultant when I tell them good ones such as the fact that diabetes during pregnancy may be complicated, but is not a hopeless case.

Image Source: diabetesmine.com

Most pregnant women with diabetes may feel disheartened by their medical condition especially because of its possible effects, which include:

- Fetal growth restriction or acceleration

- Risk of giving birth to large babies, which may cause difficulty in delivery, which in turn often leads to the C-section

- The baby’s risk for developing congenital abnormalities

- Miscarriage

- Stillbirth

Opportunely, these risks can be prevented. To give birth to a healthy baby despite diabetes, I advise women to monitor their blood sugar level regularly. The fluctuation of blood sugar level necessitates them to undergo frequent tests to prevent it from becoming too low, leading to hypoglycemia, or too high, resulting to gestational diabetes.

Image Source: babble.com

However, as I always tell my patients, frequent blood tests will be in vain if they don’t watch what they eat. Besides, even those without diabetes are advised to keep an eye on their weight, making this step more of an imperative for them. NHS.uk furthers that dieting can control gestational diabetes. Consulting a dietician is an option for women who are not sure of what they can eat to keep their blood sugar stable.

Image Source: modernmom.com

Stopping diabetes treatment is out of the question during pregnancy, though, it will definitely be adjusted according to the soon-to-be moms’ needs and condition. Sufficient intake of folic acid is also a must during pregnancy as it prevents birth defects.

Aside from having the tests that patients undergo to monitor their blood sugar, they are also advised to undergo an ultrasound scan such as the fetal echocardiogram to observe the development of the baby’s heart, and sometimes even a congenital anomaly scan to determine fetal malformations.

Yes, being pregnant while suffering from diabetes entails expending twice the effort, but it will be all worth it once the bundle of joy has been brought to the world safe and healthy.

Image Source: thetreatmentfordiabetes.com

More topics on childbirth can be accessed on this Louise Habash blog site.

REPOST: Ectopic pregnancy treatments preserve fertility

According to a recent study revealed in this New York Times article, women should be reassured that  treatments for ectopic pregnancy will not affect their ability to become pregnant in the future.

Each of the three main treatments for ectopic pregnancy — a condition in which a fetus develops outside the uterus, often in the fallopian tube — appears to be equally effective in preserving a women’s ability to become pregnant in the future, a new study found.

Ectopic pregnancies can be ended by administration of a drug, methotrexate; conservative surgery that preserves the fallopian tube; or radical surgery that removes it. Methotrexate may be used alone or combined with surgery.

The study, published in the journal Human Reproduction, included 406 women with ectopic pregnancies, of whom 298 subsequently tried to become pregnant. In one part of the study, appropriate cases were randomly assigned to receive either conservative surgery and methotrexate or methotrexate alone. In another, women who required surgery were assigned to either conservative or radical surgery.

Within two years, 67 percent of the women who had the drug alone became pregnant again, compared with 71 percent of those who had the medicine and conservative surgery. In the other group, pregnancy rates were 70 percent after conservative surgery with methotrexate, compared with 64 percent after radical surgery. None of these differences was statistically significant.

“The message is that women should be reassured that removing the fallopian tube does not affect future fertility,” said an author of the study, Dr. Perrine Capmas, an obstetrician at Bicêtre Hospital in Le Kremlin-Bicêtre, near Paris. “It’s important to take into account other factors — the woman’s preference, for example — because fertility will be the same whatever treatment is used.”


Louise Habash is a maternal-fetal specialist in Houston, Texas. More questions about your pregnancy can be answered by visiting this Facebook page.

Not planning to get pregnant? You still need folic acid

Many of my patients would say: “Dr. Louise Habash, I never planned to get pregnant.”

But they do get pregnant.

Image Source: tgblankenship.blogspot.com

You might be one, among many, who keeps pregnancy on the sidelines, but this is not a reason for you to forego taking folic acid every day. The US Department of Health lists these reasons why you should consider having folic acid supplements:

• A lot of pregnancies in the country are not planned. Because of this, all women who are capable of getting pregnant need to take at least 400 mcg of folic acid daily.

Image Source: mnn.com

• Birth defects of the brain and spine occur during the early stages of pregnancy. It could happen even before you are aware that you are pregnant.

• It might be too late to prevent the occurrence of birth defects by the time you find out that you are pregnant.

The US National Institutes of Health (NIH) explains that folic acid is a B vitamin which helps the body make healthy new cells. Everyone needs folic acid, especially women who may get pregnant. Taking this supplement helps prevent birth defects in babies. NIH also suggests getting your daily dose of this B vitamin from leafy green vegetables, fruits, nuts, cereals, enriched bread, and dried beans. However, if these food sources don’t reach the daily recommended dose of folic acid, it’s best to take dietary supplements.

So if you’re at a child bearing age, even if you are not able to plan your pregnancy or don’t want to get pregnant yet, taking this vital nutrient is crucial. It’s one of the most effective ways to ensure that you’ll have a healthy baby.

Image Source: weemade.com

Access my Facebook page for more on having a healthy pregnancy.

REPOST: Few Americans have 'healthy' hearts

In health news, Fox News reveals the estimated percentage of Americans who actually have healthy hearts.

Image Source: a57.foxnews.com

Just 3 percent of Americans have optimal heart health, while 10 percent have poor heart health, according to a new report from the American Heart Association.

The District of Columbia has the highest percentage of people with ideal heart health , at 6.9 percent, followed by Vermont, at 5.5 percent, and Virginia, at 5 percent. The states with the lowest percentage of people in ideal heart health are Oklahoma, at 1.2 percent, and West Virginia and Mississippi, both at 1.5 percent.

The findings are based on a 2009 survey of more than 350,000 Americans that collected information on seven indicators of heart health.

People were considered to have optimal heart health if they met the following criteria: They did not have high blood pressure,high cholesterol or diabetes; they were not overweight, underweight or obese; they did not smoke; they did at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity a week; and they ate five or more servings of fruits and vegetables a day.

The maximum score was 7, and the average was 4.4. [See 7 Ways to Lower Your Risk of Heart Disease .] In general, people living in New England and western states had higher percentages of people with ideal heart health than did people hailing from southern states.

The findings show that the heart health of Americans varies dramatically by state, the researchers said. The study estimates could be used to help states set goals for improving heart health in their areas, they said.

The study excluded people with coronary heart disease (CHD) and stroke because risk factors for heart disease in this population differ from those in people who don’t have a history of CHD or stroke. The findings were based on people's self-reports. As a result, the study could have overestimated the percentage of people in ideal heart health if individuals didn't know they had a certain condition.

The study is published Dec. 19 in the Journal of the American Heart Association.

Louise Habash is a Texas-based obstetrician. To know know more about her, visit this Facebook page.