You need to exercise for about 60 minutes every day. Setting aside 60 minutes all at once each day is one way to get in enough exercise. If you wait until the end of the day to squeeze it in, you probably won’t exercise enough or at all. If you’re not active for 60 minutes straight, it’s okay to exercise for 10 or 20 minutes at a time throughout the day.
Different exercises
No matter what your shape – apple, pear, ruler, or hourglass – there's an exercise for you!
Pick exercises you like to do and choose a few different options so you don’t get bored.
Aim to exercise most days of the week. If you’re not very active right now, start slowly and work your way up to being active every day.
There are three levels of physical activity.
Light – not sweating; not breathing hard (slow walking, dancing)
Moderate – breaking a sweat; can talk but can’t sing (walking fast, dancing)
Vigorous – sweating, breathing hard, can’t talk or sing (running, swimming laps)
No matter what level you are exercising at, the activity can be one of two types.
3 Şubat 2008 Pazar
Minority Health
Even though minority women have many of the same health problems as White women, they are in poorer health. Minority women use fewer health services and suffer more from disease, disabilities, and early death. Many also face huge social, economic, and cultural barriers to having life-long good health. Also, because minority groups are diverse, even within each group, access to health care, health behaviors, and health status can vary widely. Please keep in mind that the information in this section doesn't include every health problem that women in these groups face. However, this section does address health issues of greater concern to each of the minority groups.
The U.S. Department of Health and Human Services (HHS) is working to help remove racial and ethnic disparities in health. HHS has several programs and resources devoted to improving the health of minority women, such as the Indian Women's Health Initiative and the Office of Minority and Women's Health in the National Center for Infectious Diseases.
The U.S. Department of Health and Human Services (HHS) is working to help remove racial and ethnic disparities in health. HHS has several programs and resources devoted to improving the health of minority women, such as the Indian Women's Health Initiative and the Office of Minority and Women's Health in the National Center for Infectious Diseases.
Mental Health
As we move through different stages in our lives, we enjoy and cherish happy times as well as face challenges. In fact, many of the things that bring us great joy and fulfillment, such as close relationships, a promotion, having a baby, or buying a home, also can cause stress on our mental health. At some point we also have to cope with traumatic life events such as dealing with a loved one's serious illness or death, a loss of a job, domestic violence or sexual assault. Changes in our physical health also affect our mental health. Changes in the body's hormone levels from pregnancy and childbirth, or from menopause, can cause depression, anxiety, irritability, and tearfulness. Depression also comes along with many illnesses such as cancer, heart disease, stroke, HIV, or autoimmune diseases.
We all feel worried, anxious or sad from time to time. But, a true mental health disorder makes it hard for a woman to function normally. Women suffer twice as often as men by most forms of depression and anxiety disorders, and nine times as often by eating disorders. While there are different mental health disorders, they all are real illnesses that can't be willed or wished away. You aren't at fault if you have one, and you should not suffer in silence. Be patient with yourself and reach out to others for help. These illnesses can be treated successfully so that you can get back to enjoying life — not only for yourself, but for your family too.
Here you will find information about mental health issues that affect women and links to the best organizations and publications on mental health.
We all feel worried, anxious or sad from time to time. But, a true mental health disorder makes it hard for a woman to function normally. Women suffer twice as often as men by most forms of depression and anxiety disorders, and nine times as often by eating disorders. While there are different mental health disorders, they all are real illnesses that can't be willed or wished away. You aren't at fault if you have one, and you should not suffer in silence. Be patient with yourself and reach out to others for help. These illnesses can be treated successfully so that you can get back to enjoying life — not only for yourself, but for your family too.
Here you will find information about mental health issues that affect women and links to the best organizations and publications on mental health.
Menstrual Cycle Disorders
Menstrual Cycle Disorders
For the most part, the menstrual cycle occurs predictably and without problems. However, when things don’t go right -- when you experience heavy or excessive bleeding, when your period doesn’t occur when expected, when you have physical or emotional symptoms during the weeks before you menstruation, or when you experience painful periods or other symptoms -- you may have a Menstrual Cycle Disorders.
For the most part, the menstrual cycle occurs predictably and without problems. However, when things don’t go right -- when you experience heavy or excessive bleeding, when your period doesn’t occur when expected, when you have physical or emotional symptoms during the weeks before you menstruation, or when you experience painful periods or other symptoms -- you may have a Menstrual Cycle Disorders.
Cold Comfort
Ok, are you ready for this cruel joke? Literally a few hours after I blogged on Sunday about how I was feeling recharged, I started getting sick. I guess I deserved it—sore throat, aches and pains and all. I woke up Monday morning feeling like a truck had hit me and looking like that zombie person you see on cold medicine commercials. Today I definitely took a turn for the better, meaning I ate more than toast for dinner, but my cough has been getting more consistent.
Fact: I haven’t made it into the shower the past two days, let alone to the gym.
Tomorrow I am going to focus on getting back to work, and Thursday, I’ll see how I feel about the gym. I went ahead and made an appointment with my trainer so that he could tell me how far to push—or not. I don’t want to get too far off track at the gym, but I know enough to let my body take the time it needs to recoup.
Fact: I haven’t made it into the shower the past two days, let alone to the gym.
Tomorrow I am going to focus on getting back to work, and Thursday, I’ll see how I feel about the gym. I went ahead and made an appointment with my trainer so that he could tell me how far to push—or not. I don’t want to get too far off track at the gym, but I know enough to let my body take the time it needs to recoup.
24 Ocak 2008 Perşembe
Cholesterol Diet
This type of cholesterol diet is needed because many people have the misconception that the amount of cholesterol that's in your bloodstream is directly related to your diet.
While a diet to lower cholesterol is one of the factors in influencing cholesterol, a lot of your blood cholesterol is manufactured by your liver.
Your liver produces cholesterol then it's carried throughout your body to your cells. The excess cholesterol is then carried back to the liver. If the excess cholesterol isn't used up, it can begin to stick to artery walls, which leads to cardiovascular disease.
Even though high cholesterol can cause serious health problems, your body still needs it to perform many different functions. It's needed to help build membranes, manufacture bile, and produce hormones. But again, too much is bad.
Since cholesterol produces fatty deposits in the arteries, it is one of the main causes of heart disease. High levels are also linked to mental impairment, high blood pressure and gall stones.
A lot of people don't fully appreciate how essential cholesterol is for good health. It is a non-soluble waxy substance which your body needs for making hormones, cell walls and nerve sheaths.
along with information on the dangerous effects of cholesterol drugs & Much More, has just been made available to the public.
"A Specific Diet To Lower CholesterolCan Indeed Help You In Lowering Cholesterol Naturally"When recommendations are given for a diet to lower your cholesterol the 'official line' is to emphasize the importance of reducing dietary fats and foods high in cholesterol in order for a diet to lower cholesterol to be effective.
This has been the approach to use with a diet to lower your cholesterol for the last couple of decades and as recent research clearly shows...it is totally the wrong one for a diet to lower cholesterol.
In fact, for as long as this has been the official stance heart disease has steadily increased.
While it is possible to reduce your cholesterol levels with a good a diet to lower your cholesterol, just eliminating fats and cholesterol will not do it! This is the reason that a diet to lower cholesterol that has been proven with long-time research, must be used.
Cutting eggs and butter out of a diet to lower cholesterol will have minimal impact on cholesterol levels. What is more important is that you stop eating margarine.
Also reduce your intake of refined and processed foods in a diet to lower your cholesterol, which are full of hydrogenated fats and oils as well as trans fats. These are MUCH more dangerous than the saturated fats in butter and eggs which your body can handle and indeed needs.
In fact, studies have clearly established that the low fat, low cholesterol diet for high cholesterol approach is a very dangerous one because it can lower HDL, the good cholesterol but only have minimal impact on LDL, the 'bad' cholesterol.
Cholesterol is transported around your body in two different forms.
One form is called LDL (low density) or the 'bad' or 'oxidized' cholesterol, and the other is HDL (high density) or the 'good' cholesterol.
LDL attaches itself to your artery wall and creates 'plaque' which can ultimately accumulate and create a blockage in your arteries resulting in a heart attack, or a stroke if some of the capillaries in your brain become blocked and parts of your brain are starved for blood.
Your LDL needs to be as low as possible.
HDL travels around in your bloodstream picking up excess cholesterol including LDL and taking it back to your liver for reprocessing. Sort of like a garbage collector!
Your HDL must be as high as possible to ensure superior health.
As a result of any general low cholesterol diet that may be available - your cholesterol situation can get worse.
If you are not already doing so start adding natural cholesterol lowering nutrients to your diet to lower cholesterol.
The lack of essential fatty acids in your diet to lower cholesterol is also a major factor in heart problems.
You can supplement your diet to lower cholesterol with a tablespoon of organic flax seed oil every day which is an excellent source of Omega 3 essential fatty acids.
Note: These essential fatty acids will NOT make you fat, but rather will help you lose weight.
For cooking use only 'Extra Virgin Olive Oil'. Studies have shown that this version can help lower LDL cholesterol and raise HDL but it MUST be the 'Extra Virgin' olive oil.
Ordinary virgin olive oil does not lower LDL cholesterol.
Also, use as much garlic as you can in your cooking. This has been shown to help lower cholesterol.
In addition take a quality natural cholesterol lowering supplement that contains genuine Policosanol which is an extract from sugar cane, (does not increase blood sugar levels) plus guggulipid which is a natural herb from India.
These substances alone have proven to be highly effective in numerous double blind, placebo clinical trials in lowering LDL and raising HDL.
They will outperform the cholesterol lowering statin drugs with no side effects, other than assisting in the normalization of weight.
"The Bottom Line OnAny Diet To Reduce Cholesterol"Every one over the age of 20 should be concerned about their cholesterol levels and start doing everything they can to lower their "bad" cholesterol by using the proper and proven low cholesterol diet.
But it's even more important to note that in addition to a good low cholesterol diet you should be taking a cholesterol formula that uses ingredients that have been proven conclusively to assist in lowering blood cholesterol.
A cholesterol formula to assist your diet to reduce cholesterol that uses ingredients that has been proven conclusively to help in lowering blood cholesterol should also contain substances that have been shown to assist in lowering both triglycerides and homocysteine.
Also included in your low cholesterol diet should be nutrients that help strengthen the heart muscles such as CoQ10.
To date only one company has an excellent formula that meets all of the requirements and more for cholesterol problems and to assist your your diet to lower cholesterol.
They have one of the strictest regulatory environments in the world for the manufacture of cholesterol dietary supplements, far exceeding U.S. FDA standards.
We've come to have faith in this brand of nutritional supplements and can confidently vouch for this product as being an excellent choice for your diet to lower cholesterol.
Make sure you take a high quality, daily vitamin mineral supplement. Vitamin E will help to improve your circulation, while vitamin C and vitamin B3 will help to lower your high levels.
It's widely accepted that this particular cholesterol product to add to your over-all diet to lower cholesterol, any low cholesterol recipe, etc. reflects the best possible blend for your high cholesterol and health concerns.
We've received only very positive feedback from the individuals who have already used it as part of their diet to lower cholesterol.
While a diet to lower cholesterol is one of the factors in influencing cholesterol, a lot of your blood cholesterol is manufactured by your liver.
Your liver produces cholesterol then it's carried throughout your body to your cells. The excess cholesterol is then carried back to the liver. If the excess cholesterol isn't used up, it can begin to stick to artery walls, which leads to cardiovascular disease.
Even though high cholesterol can cause serious health problems, your body still needs it to perform many different functions. It's needed to help build membranes, manufacture bile, and produce hormones. But again, too much is bad.
Since cholesterol produces fatty deposits in the arteries, it is one of the main causes of heart disease. High levels are also linked to mental impairment, high blood pressure and gall stones.
A lot of people don't fully appreciate how essential cholesterol is for good health. It is a non-soluble waxy substance which your body needs for making hormones, cell walls and nerve sheaths.
along with information on the dangerous effects of cholesterol drugs & Much More, has just been made available to the public.
"A Specific Diet To Lower CholesterolCan Indeed Help You In Lowering Cholesterol Naturally"When recommendations are given for a diet to lower your cholesterol the 'official line' is to emphasize the importance of reducing dietary fats and foods high in cholesterol in order for a diet to lower cholesterol to be effective.
This has been the approach to use with a diet to lower your cholesterol for the last couple of decades and as recent research clearly shows...it is totally the wrong one for a diet to lower cholesterol.
In fact, for as long as this has been the official stance heart disease has steadily increased.
While it is possible to reduce your cholesterol levels with a good a diet to lower your cholesterol, just eliminating fats and cholesterol will not do it! This is the reason that a diet to lower cholesterol that has been proven with long-time research, must be used.
Cutting eggs and butter out of a diet to lower cholesterol will have minimal impact on cholesterol levels. What is more important is that you stop eating margarine.
Also reduce your intake of refined and processed foods in a diet to lower your cholesterol, which are full of hydrogenated fats and oils as well as trans fats. These are MUCH more dangerous than the saturated fats in butter and eggs which your body can handle and indeed needs.
In fact, studies have clearly established that the low fat, low cholesterol diet for high cholesterol approach is a very dangerous one because it can lower HDL, the good cholesterol but only have minimal impact on LDL, the 'bad' cholesterol.
Cholesterol is transported around your body in two different forms.
One form is called LDL (low density) or the 'bad' or 'oxidized' cholesterol, and the other is HDL (high density) or the 'good' cholesterol.
LDL attaches itself to your artery wall and creates 'plaque' which can ultimately accumulate and create a blockage in your arteries resulting in a heart attack, or a stroke if some of the capillaries in your brain become blocked and parts of your brain are starved for blood.
Your LDL needs to be as low as possible.
HDL travels around in your bloodstream picking up excess cholesterol including LDL and taking it back to your liver for reprocessing. Sort of like a garbage collector!
Your HDL must be as high as possible to ensure superior health.
As a result of any general low cholesterol diet that may be available - your cholesterol situation can get worse.
If you are not already doing so start adding natural cholesterol lowering nutrients to your diet to lower cholesterol.
The lack of essential fatty acids in your diet to lower cholesterol is also a major factor in heart problems.
You can supplement your diet to lower cholesterol with a tablespoon of organic flax seed oil every day which is an excellent source of Omega 3 essential fatty acids.
Note: These essential fatty acids will NOT make you fat, but rather will help you lose weight.
For cooking use only 'Extra Virgin Olive Oil'. Studies have shown that this version can help lower LDL cholesterol and raise HDL but it MUST be the 'Extra Virgin' olive oil.
Ordinary virgin olive oil does not lower LDL cholesterol.
Also, use as much garlic as you can in your cooking. This has been shown to help lower cholesterol.
In addition take a quality natural cholesterol lowering supplement that contains genuine Policosanol which is an extract from sugar cane, (does not increase blood sugar levels) plus guggulipid which is a natural herb from India.
These substances alone have proven to be highly effective in numerous double blind, placebo clinical trials in lowering LDL and raising HDL.
They will outperform the cholesterol lowering statin drugs with no side effects, other than assisting in the normalization of weight.
"The Bottom Line OnAny Diet To Reduce Cholesterol"Every one over the age of 20 should be concerned about their cholesterol levels and start doing everything they can to lower their "bad" cholesterol by using the proper and proven low cholesterol diet.
But it's even more important to note that in addition to a good low cholesterol diet you should be taking a cholesterol formula that uses ingredients that have been proven conclusively to assist in lowering blood cholesterol.
A cholesterol formula to assist your diet to reduce cholesterol that uses ingredients that has been proven conclusively to help in lowering blood cholesterol should also contain substances that have been shown to assist in lowering both triglycerides and homocysteine.
Also included in your low cholesterol diet should be nutrients that help strengthen the heart muscles such as CoQ10.
To date only one company has an excellent formula that meets all of the requirements and more for cholesterol problems and to assist your your diet to lower cholesterol.
They have one of the strictest regulatory environments in the world for the manufacture of cholesterol dietary supplements, far exceeding U.S. FDA standards.
We've come to have faith in this brand of nutritional supplements and can confidently vouch for this product as being an excellent choice for your diet to lower cholesterol.
Make sure you take a high quality, daily vitamin mineral supplement. Vitamin E will help to improve your circulation, while vitamin C and vitamin B3 will help to lower your high levels.
It's widely accepted that this particular cholesterol product to add to your over-all diet to lower cholesterol, any low cholesterol recipe, etc. reflects the best possible blend for your high cholesterol and health concerns.
We've received only very positive feedback from the individuals who have already used it as part of their diet to lower cholesterol.
Yoga And Sex
"Yoga sex as it will be discussed on this page refers to how you can improve your sex life through yoga." This discussion does not concern using specific yoga sex positions.
Although many of the yoga positions explained on this page, and in our many articles about yoga located at the bottom of this page, can indeed be used to dramatically spice up your sex life!
When you improve your spiritual and physical self, through yoga or many other methods, you will without a doubt have a better sex life.
Now contrary to what many people believe, the true yoga practitioners are no more against the pleasures of sex than they are food even though some of the elder sages do live on a lofty spiritual plane where all aspects of yoga sex techniques have ceased to matter.
On the contrary, Yoga, being a philosophy singularly free of both Puritanism and hypocrisy, its disciples recognize the yoga sex urge for the healthy instinct it is and would consider any attempt at its suppression profoundly unhealthy.
In other words, yoga and sex do go together.
Suppression and denial of yoga sex improvements can lead only to physical upsets and mental harm. But the Yogis are steeped in the general Eastern attitude which is simply that sexual impulses, yoga sex etc., like any other natural urges, may be used to either good purpose or evil, depending on ourselves.
If yoga sex is made synonymous with physical love-the carnal side of deep and genuine emotion-it becomes a supremely meaningful and beautiful expression of the man-woman relationship, the ultimate union.
The Hindu believe that woman is the complementary part of man, a gift from heaven, man's soul companion and helpmate, and that union must be not only mental and spiritual, but physical.
Marriage is entered upon in an attitude of humility, with full recognition of its solemnity.
In fact, one of the basic Hindu yoga sex writings, the Kama Sutra, is an elaborate treatise on the philosophy and etiquette of love, courtship and yoga sex behavior, both male and female, detailed in a manner which our best modern manuals on marriage techniques do not begin to approach.
Hindu temples are often decorated with phallic yoga sex representations which shock the traveler, but which to the worshippers have a deep spiritual significance. Because of this cultural attitude Oriental women share with their men an approach at the same time more natural and more sophisticated.
The Yogis, who teach that man's supreme goal is Self-realization, understand that such realization cannot be wholly achieved except through union with woman, his other half.
What one sex lacks the other provides.
Rigid denial of yoga sex is merely a superficial form of escape which is self-defeating. To live fully, with understanding, each human being must know something of the innermost depths of the mind of the other sex.
It is impossible to advance to complete understanding of Self, and of the world at large, while living in ignorance of the other half of mankind. Man and woman have been created for each other, not to exist in separate vacuums.
However, Self-realization may not be equated with self-indulgence. Therefore yoga sex teaches that much of our sex drive must also be sublimated, that is, channelled into other life drives, creative or otherwise useful and always constructive.
In this Yoga is not too different from the Freudian theory which claims that all our urges, including the life urge itself, are based in the libido.
The very symbol of Kundalini, remember, is the serpent; and the serpent is one of the basic and universal symbols of male sexuality, not only in Freudian language but throughout mythology and folklore everywhere.
This, according to some authorities, symbolizes yoga sex and the creative power wrongly used.
The Yogis themselves have learned how to transmute yoga sex energy into psychic channels. Thus it is never either actually suppressed or dissipated but rather transmuted.
Sometimes it is drawn to the solar plexus for utilizing in healthful physical exercise. Sometimes it is sent to the brain and toward the spirit. To the advanced Yoga sex expert it then brings poise, harmony, freedom from desire, lasting serenity, and finally a merging with the universal consciousness.
To us average individuals, control over this basic inner force may well mean a happier personal life.
The man and woman doesn't exist whose personal life is not closely related to an amazing sex life - through yoga sex or any other improvements.
Yoga offers many such solutions. In the first place, a number of the yoga exercises help sublimate a restless sex urge while others awaken a sluggish body. Restlessness becomes positive, creative energy which may then be properly utilized instead of merely bringing trouble.
Conversely, lack of interest in one's mate-and sometimes the free-floating hostility arising out of such feelings-slowly gives way to a warmer, more giving attitude.
Sex, as we all know, is not all there is to a good marriage but it is one of its cornerstones. A warm hearted partner mated with a cold, unresponsive one may be willing out of loyalty to put up with a physical starvation diet, but is bound to be adversely affected and sometimes even emotionally destroyed.
Or else, the marriage itself is destroyed when once the rejected partner, having had enough of indifference, turns elsewhere for affection.
The sexless person-not as rare as many imagine-is a kind of emotionally impoverished individual.
Yoga sex education frees the student of the straight-jacket of prudishness and of hostility. But long before such emotional growth has been achieved certain obvious changes may be brought about through the daily performance of the proper asanas and mudras.
As we have said so many times at various points in this discussion, there can be no underestimating of the interplay of the physical and the spiritual in the human makeup. Therefore putting your physical house in order will do wonders for you in other ways too.
Sluggish sex urges are often traceable to inadequately functioning endocrine glands and a resulting hormone deficiency. The gonads, or sex glands, would be the offenders here.
But the gonads, like the other endocrines, are themselves controlled by the pituitary gland which is known to secrete about a dozen hormones that stimulate the proper functioning of all the other seven pair.
It may very well be, therefore, that the sexually indifferent person's basic trouble lies in some malfunctioning of the pituitary, a condition which medicine would treat by means of expensive hormone injections or equally expensive pills. The yoga method, of course, is through exercise.
You will find that the Headstand or Sirshasana advanced yoga poses, found in other yoga articles on this site, if practiced regularly, will stimulate the pituitary gland by sending a vast flow of blood to the head as your body briefly defies the laws of gravity.
Thus stimulated, it will then immediately wake up the gonads, which will begin to respond by producing hormones of their own. Needless to say this is not the only beneficial result of the Headstand (its various therapeutic effects are detailed along with directions for executing it) but it happens to be the yoga effect which concerns us here.
But revitalizing the pituitary is not the only way to keep the gonads in top functioning condition. Exercises for both stimulating and sublimating the yoga sex instincts include the Stomach Lift or Uddiyana Bandha, the Plough or Halasana, the Fish Pose, Matsyasana and the Supine Pelvic Posture.
Keep in mind that each of these sample yoga exercises is beneficial in more ways than for sex.
By learning to do them you will be reaping fringe benefits, but their specific value here is revitalization of the gonad secretions, overcoming seminal weakness in men and ovarian disturbances in women.
In a short while the sex effects will become apparent and will doubtless surprise you: you will be rewarded not only by physical revitalization, but a sense of greater inner harmony.
Anxieties relating to yoga and your sexual activity in general will gradually vanish.
Learning how to sublimate the yoga urge is a way to develop spiritual strength. Directing the emotions toward goals of universal love means reaching out toward everything in this world that is alive and good.
Love like this of course transcends the limits of sexual emotion and those who are able to experience it come to know an inner happiness denied less understanding and compassionate natures.
The very last thing a Yogi would maintain is that one must rise above sex. On the contrary, Yoga teaches that it is desirable to rise by means of it to greater spiritual heights.
Properly used, sex is the greatest of gifts and none may despise its rich potentialities. Both sexes should therefore learn to accept themselves completely, man as man, woman as woman, while at the same time recognizing that each of us carries some of the qualities of the opposite sex within us.
Armed with this knowledge and understanding, using yoga as an adornment, it is then possible to glory in its possession, not stifle it.
Although many of the yoga positions explained on this page, and in our many articles about yoga located at the bottom of this page, can indeed be used to dramatically spice up your sex life!
When you improve your spiritual and physical self, through yoga or many other methods, you will without a doubt have a better sex life.
Now contrary to what many people believe, the true yoga practitioners are no more against the pleasures of sex than they are food even though some of the elder sages do live on a lofty spiritual plane where all aspects of yoga sex techniques have ceased to matter.
On the contrary, Yoga, being a philosophy singularly free of both Puritanism and hypocrisy, its disciples recognize the yoga sex urge for the healthy instinct it is and would consider any attempt at its suppression profoundly unhealthy.
In other words, yoga and sex do go together.
Suppression and denial of yoga sex improvements can lead only to physical upsets and mental harm. But the Yogis are steeped in the general Eastern attitude which is simply that sexual impulses, yoga sex etc., like any other natural urges, may be used to either good purpose or evil, depending on ourselves.
If yoga sex is made synonymous with physical love-the carnal side of deep and genuine emotion-it becomes a supremely meaningful and beautiful expression of the man-woman relationship, the ultimate union.
The Hindu believe that woman is the complementary part of man, a gift from heaven, man's soul companion and helpmate, and that union must be not only mental and spiritual, but physical.
Marriage is entered upon in an attitude of humility, with full recognition of its solemnity.
In fact, one of the basic Hindu yoga sex writings, the Kama Sutra, is an elaborate treatise on the philosophy and etiquette of love, courtship and yoga sex behavior, both male and female, detailed in a manner which our best modern manuals on marriage techniques do not begin to approach.
Hindu temples are often decorated with phallic yoga sex representations which shock the traveler, but which to the worshippers have a deep spiritual significance. Because of this cultural attitude Oriental women share with their men an approach at the same time more natural and more sophisticated.
The Yogis, who teach that man's supreme goal is Self-realization, understand that such realization cannot be wholly achieved except through union with woman, his other half.
What one sex lacks the other provides.
Rigid denial of yoga sex is merely a superficial form of escape which is self-defeating. To live fully, with understanding, each human being must know something of the innermost depths of the mind of the other sex.
It is impossible to advance to complete understanding of Self, and of the world at large, while living in ignorance of the other half of mankind. Man and woman have been created for each other, not to exist in separate vacuums.
However, Self-realization may not be equated with self-indulgence. Therefore yoga sex teaches that much of our sex drive must also be sublimated, that is, channelled into other life drives, creative or otherwise useful and always constructive.
In this Yoga is not too different from the Freudian theory which claims that all our urges, including the life urge itself, are based in the libido.
The very symbol of Kundalini, remember, is the serpent; and the serpent is one of the basic and universal symbols of male sexuality, not only in Freudian language but throughout mythology and folklore everywhere.
This, according to some authorities, symbolizes yoga sex and the creative power wrongly used.
The Yogis themselves have learned how to transmute yoga sex energy into psychic channels. Thus it is never either actually suppressed or dissipated but rather transmuted.
Sometimes it is drawn to the solar plexus for utilizing in healthful physical exercise. Sometimes it is sent to the brain and toward the spirit. To the advanced Yoga sex expert it then brings poise, harmony, freedom from desire, lasting serenity, and finally a merging with the universal consciousness.
To us average individuals, control over this basic inner force may well mean a happier personal life.
The man and woman doesn't exist whose personal life is not closely related to an amazing sex life - through yoga sex or any other improvements.
Yoga offers many such solutions. In the first place, a number of the yoga exercises help sublimate a restless sex urge while others awaken a sluggish body. Restlessness becomes positive, creative energy which may then be properly utilized instead of merely bringing trouble.
Conversely, lack of interest in one's mate-and sometimes the free-floating hostility arising out of such feelings-slowly gives way to a warmer, more giving attitude.
Sex, as we all know, is not all there is to a good marriage but it is one of its cornerstones. A warm hearted partner mated with a cold, unresponsive one may be willing out of loyalty to put up with a physical starvation diet, but is bound to be adversely affected and sometimes even emotionally destroyed.
Or else, the marriage itself is destroyed when once the rejected partner, having had enough of indifference, turns elsewhere for affection.
The sexless person-not as rare as many imagine-is a kind of emotionally impoverished individual.
Yoga sex education frees the student of the straight-jacket of prudishness and of hostility. But long before such emotional growth has been achieved certain obvious changes may be brought about through the daily performance of the proper asanas and mudras.
As we have said so many times at various points in this discussion, there can be no underestimating of the interplay of the physical and the spiritual in the human makeup. Therefore putting your physical house in order will do wonders for you in other ways too.
Sluggish sex urges are often traceable to inadequately functioning endocrine glands and a resulting hormone deficiency. The gonads, or sex glands, would be the offenders here.
But the gonads, like the other endocrines, are themselves controlled by the pituitary gland which is known to secrete about a dozen hormones that stimulate the proper functioning of all the other seven pair.
It may very well be, therefore, that the sexually indifferent person's basic trouble lies in some malfunctioning of the pituitary, a condition which medicine would treat by means of expensive hormone injections or equally expensive pills. The yoga method, of course, is through exercise.
You will find that the Headstand or Sirshasana advanced yoga poses, found in other yoga articles on this site, if practiced regularly, will stimulate the pituitary gland by sending a vast flow of blood to the head as your body briefly defies the laws of gravity.
Thus stimulated, it will then immediately wake up the gonads, which will begin to respond by producing hormones of their own. Needless to say this is not the only beneficial result of the Headstand (its various therapeutic effects are detailed along with directions for executing it) but it happens to be the yoga effect which concerns us here.
But revitalizing the pituitary is not the only way to keep the gonads in top functioning condition. Exercises for both stimulating and sublimating the yoga sex instincts include the Stomach Lift or Uddiyana Bandha, the Plough or Halasana, the Fish Pose, Matsyasana and the Supine Pelvic Posture.
Keep in mind that each of these sample yoga exercises is beneficial in more ways than for sex.
By learning to do them you will be reaping fringe benefits, but their specific value here is revitalization of the gonad secretions, overcoming seminal weakness in men and ovarian disturbances in women.
In a short while the sex effects will become apparent and will doubtless surprise you: you will be rewarded not only by physical revitalization, but a sense of greater inner harmony.
Anxieties relating to yoga and your sexual activity in general will gradually vanish.
Learning how to sublimate the yoga urge is a way to develop spiritual strength. Directing the emotions toward goals of universal love means reaching out toward everything in this world that is alive and good.
Love like this of course transcends the limits of sexual emotion and those who are able to experience it come to know an inner happiness denied less understanding and compassionate natures.
The very last thing a Yogi would maintain is that one must rise above sex. On the contrary, Yoga teaches that it is desirable to rise by means of it to greater spiritual heights.
Properly used, sex is the greatest of gifts and none may despise its rich potentialities. Both sexes should therefore learn to accept themselves completely, man as man, woman as woman, while at the same time recognizing that each of us carries some of the qualities of the opposite sex within us.
Armed with this knowledge and understanding, using yoga as an adornment, it is then possible to glory in its possession, not stifle it.
Birth Control Pills
More than 45 years since the U.S. Food and Drug Administration (FDA) approved "the pill" in 1960, it continues to be the most popular and one of the most effective forms of reversible birth control ever invented. According to the Johns Hopkins School of Public Health Population Information Program, more than 18 million US women rely on birth control pills, also called oral contraceptives, as their birth control method. Today, American women have more than 40 different oral contraceptive products from which to choose.
Unlike the original oral contraceptives used decades ago, low-dose forms with few health risks are the norm. Today's birth control pills (BCPs) even offer health benefits.
Despite the fact that they are safe for most women, however, BCPs do carry some health risks. For example, if you are over 35 and smoke or have certain medical conditions such as a history of blood clots or breast or endometrial cancer, your health care professional may advise against taking BCPs. Also, birth control pills do not protect you from sexually transmitted infections (STIs), including HIV (human immunodeficiency virus), the virus that causes AIDS.
In recent years, birth control pills have been changed to include less hormones, resulting in fewer side effects. In fact, all healthy women who don't smoke may use birth control pills, regardless of their age.
Unlike other forms of birth control sold over-the-counter, you need a health care professional's prescription to purchase BCPs and many health insurers cover their cost. The one exception is the emergency birth control pill Plan B, which was just approved for over-the-counter sale by the FDA. Plan B is expected to be available over the counter by the end of 2006.
How Birth Control Pills WorkAt the beginning of each menstrual cycle, estrogen levels begin to rise. Estrogen helps thicken the lining of the uterus (endometrium) to prepare for a fertilized egg. Once estrogen levels peak, about 14 days into the menstrual cycle, one of the ovaries releases an egg. This monthly release of an egg is called ovulation.
After ovulation, progesterone, another reproductive hormone, begins to rise. Over the next seven days, progesterone further prepares the endometrium for a fertilized egg. Conception occurs when a fertilized egg implants itself in the uterine lining.
If conception does not occur, both estrogen and progesterone levels drop, signaling the now thickened uterine lining to slough off or shed, and menstruation begins.
Birth control pills are a synthetic form of the hormones progesterone and estrogen. They prevent ovulation by maintaining more consistent hormone levels. Without a peak in estrogen, then, the ovary doesn't get the signal to release an egg. No egg means no possibility for fertilization and pregnancy. They also thicken cervical mucus so the sperm cannot reach the egg, and make the lining of the uterus unreceptive to the implantation of a fertilized egg.
Types of Birth Control PillsThe three most common types of birth control pills are:
1. Progestin-only pills (POP). This type of pill contains no estrogen. Called the progestin-only pill, or "mini-pill," it's ideal for breastfeeding women because estrogen reduces milk production. It's also ideal for women who cannot take estrogen. Progestin-only pills primarily work by thickening the cervical mucus, thereby preventing sperm from entering the uterus. To work effectively, they must be taken at a certain time every 24 hours.
Advantage of POPs:
decreased menstrual blood loss
decreased menstrual cramps and pain
can be used by breast-feeding women immediately after delivery
an option for women who cannot use estrogen, such as those who are over 35 and still smoke
easily reversible
Disadvantages:
irregular bleeding patterns, spotting or breakthrough bleeding
must be taken at the same time every day
do not protect against sexually transmitted infections; women at risk must use condoms
may be slightly less effective than combination oral contraceptives
Possible side effects:
amenorrhea (absence of a monthly period)
irregular bleeding
heavy bleeding
abdominal pain
headaches
Ask yourself the following questions to determine if POPs are the right choice for you:
Are you the type of person who can remember to take a pill at exactly the same time every day?
Will irregular bleeding or spotting bother you or interfere with intimacy?
Are you breastfeeding, but feel that you need contraception?
If you are at risk for sexually transmitted infections, will you use condoms for protection?
Do you need to avoid taking estrogen?
2. Combination pills. When you hear the term "birth control pill," it most often refers to oral contraceptives containing estrogen and progestin. Each pill in the pack contains a combination of these two hormones.
Monophasic pills. Each of the 21 active pills in one of these packs contains the same amount of estrogen and progestin. The other seven pills are placebos and contain no hormones; menstruation occurs while they are being taken. In September 2003, the Food and Drug Administration (FDA) approved a 91-day oral contraceptive regimen called Seasonale, in which you take a pill containing progestin and estrogen for 12 weeks (84 days), followed by one week of placebo tablets. If you use this product, you only menstruate about once every three months instead of once a month.
Multiphasic pills. Also called biphasic and triphasic, multiphasic oral contraceptives contain varied amounts of hormones and are designed to be taken at specific times throughout the entire pill-taking schedule. Multiphasic pills contain various levels of estrogen and progestin throughout the month. They were developed to reduce side effects of oral contraceptives, including breakthrough bleeding, spotting and amenorrhea, associated with higher levels of hormones.
Continuous use pill. In May 2007, the FDA approved Lybrel, first continuous use birth control pill. It is a multiphasic pill that comes in a 28-day pack and is designed to be taken continuously, with no break in between pill packets. That means you won't have a period. However, you may have some spotting or breakthrough bleeding, particularly when you first start using Lybrel.
Advantages of combination pills:
reduces risk of ovarian cancer and endometrial cancer
prevents ectopic pregnancy (pregnancies that occur outside the uterus, usually in the fallopian tube)
decreases menstrual blood loss and pain and cramps
less severe premenstrual symptoms
more regular menstrual cycles
improves acne
prevents bone density loss in women who have attained their peak bone mass (generally women over 30)
less risk of ovarian cysts
improves excessive body hair, particularly on the face, a condition called hirsutism
improves endometriosis
improves symptoms of rheumatoid arthritis
beneficial effects on cholesterol (HDL and LDL)
decreases benign breast disease or breast cysts
reversible with quick return to fertility
treats the emotional and physical symptoms of premenstrual dysphoric disorder (PMDD), a severe form of PMS. Only one combination OC has been shown to be clinically effective for this use. It contains the progestin drospirenone and ethinyl estradiol, a form of estrogen.
Disadvantages:
could cause nausea, vomiting, headaches and/or spotting, particularly with the first few cycles
may lead to hypertension (less than one in 200 women)
may causes blood clots in a small percentage of users
may contribute to the formation of gallstones and rare benign liver tumors
Possible side effects:
nausea and vomiting
headaches
irregular bleeding
weight gain or weight loss due to changes in eating habits
breast tenderness
increased breast size
Ask yourself the following questions to determine if combined birth control pills are a good option for you:
Are you the type of person who can remember to take a pill every day?
If you are at risk for sexually transmitted infections, will you use condoms?
Do you need relief from endometriosis, severe menstrual pain or anemia?
If you still smoke, are you under 35?
If breastfeeding, is your baby six months or older?
Do you have high blood pressure?
Have you done well with combination pills in the past?
3. Emergency contraceptive pills (ECP). ECPs are not intended to be used regularly as a contraceptive. They are designed to prevent pregnancy after unprotected sex (when standard contraceptives fail or no method was used). The FDA has approved one emergency contraception pill called Plan B, which contains the progestin levonorgestrel. And women over 18 will soon be able to buy Plan B without a prescription—probably by the end of 2006—due to recent OTC approval by the FDA. Plan B will be available behind pharmacy counters to ensure that women who purchase it are 18 or over. In addition, certain regular oral contraceptive pill packs can be used for emergency contraception if you take several pills at the same time (the exact quantity depends on the brand), with guidance from your health care professional.
While the Plan B label calls for a two-dose regimen, with the first dose taken within 72 hours of unprotected sex and the second 12 hours later, studies find that both pills can be taken at the same time, and that Plan B is effective up to 120 hours after unprotected intercourse.
To learn more about how ECPs work and how to get them, ask your health care professional or pharmacist. Or visit the Internet site for emergency contraception operated by Association of Reproductive Health Professionals and the Office of Population Research at Princeton University (www.not-2-late.com or ec.princeton.edu). Emergency contraception used to be available by prescription only, although the FDA has just approved Plan B without a prescription, which is expected to be available over the counter by the end of 2006.
Advantages of ECP:
reduces the chance of unintended pregnancy
can be obtained easily—Plan B will soon be available over the counter for women 18 and over
can be obtained in advance and kept handy in case of an emergency such as condom breakage, missed oral contraceptives, late contraceptive injections or forced sex
Disadvantages:
timing, because you must take the first dose within 120 hour of having unprotected sex. The sooner you take them after unprotected intercourse, the more effective they are. That's why it's a good idea to have a prescription or a supply of emergency contraceptive pills available should the need arise.
Possible side effects:
nausea, vomiting, dizziness, fatigue and headache
an earlier next period, or, in rare instances, a later next period
heavier or lighter menstrual bleeding
breast tenderness
abdominal pain
Ask yourself the following questions to determine if you should have ECPs on hand or know where to find them:
Have you ever made love unexpectedly?
Have you ever been forced to have sex?
Has a partner had a condom break, slip or come off?
Have you ever forgotten to take several birth control pills?
Have you expected your partner to pull out before ejaculation, but he didn't?
Has your diaphragm slipped?
Have you been late for your Depo-provera or Lunelle shot and had unprotected sex?
Health benefits, risks and other medical issues about birth control pillsBirth control pills provide certain health benefits in addition to preventing pregnancy. Before you start taking oral contraceptives, discuss the health benefits and risks associated with them with a health care professional. Like any other medication, birth control pills can also cause side effects; they may interact with other medications you may take; or they may not be a good choice for you because of your personal health history. Benefits and risks associated with birth control pills are listed below:
BenefitsPrevent pregnancy. First and foremost, birth control pills are one of the most effective forms of reversible birth control. If used correctly, the odds are that only five in 1,000 women is likely to get pregnant in the first year of use.
Improve your menstrual cycle. Birth control pills can improve your menstrual cycle in at least for ways, including:
less bleeding during periods; one product is designed to eliminate your periods entirely
more regular and consistent menstrual cycle patterns
relief from pelvic pain during menstruation
relief from primarily mood-related symptoms of premenstrual dysphoric disorder (PMDD), a condition that causes many of the same symptoms as PMS, but with more intensity. A combination oral contraceptive containing drospirenone, a progestin, and ethinyl estradiol, a form of estrogen, was recently approved by the FDA. Known as "YAZ," this OC was shown to be clinically effective both for the prevention of pregnancy and for the emotional and physical symptoms of PMDD.
Prevent cancer. Birth control pills have been shown to protect women from ovarian and uterine cancer, and possibly from colorectal cancer.
Improve bone density. Some studies have shown that it's possible that bone density improves while taking birth control pills. However, it has not been shown that BCPs make a difference in reducing bone fractures.
Protect you from ovarian cysts. If you take BCPs, you may have about one-fifth less risk for developing ovarian cysts than women using nonhormonal methods of contraception, such as diaphragms or condoms. Women using low-dose pills (20 mcg of estrogen) or multiphasic pills may not get the same benefit.
RisksHeart attack. The chances of BCPs contributing to a heart attack are small (less than three additional heart attacks per million American women per year) unless you smoke. Studies have shown that smoking dramatically increases the risk of heart attack in women age 35 years or older, which is why BCPs are generally not prescribed to women in this age group who smoke. The American College of Obstetricians and Gynecologists (ACOG) notes that POPs may be appropriate for women with coronary artery disease, congestive heart failure or cerebrovascular disease. However, combined pills are not recommended for these women.
Ischemic stroke. There is a small, but significant increase in ischemic stroke risk when using birth control pills. This was a particular concern with early oral contraceptives that contained higher doses of estrogen, but newer preparations containing less estrogen are associated with a lower risk of stroke. In otherwise healthy young women (non-smokers without persistent high blood pressure), the risk is low.
Migraines and stroke. Women who take oral contraceptive and have a history of migraines have an increased risk of stroke compared to nonusers with a history of migraine. Your risk is greatest if you have migraines with "aura"--neurologic symptoms related to vision, such as blurred vision, temporary loss of vision or seeing flashing lights or zigzag lines. As a result, both the American College of Obstetricians and Gynecologists (ACOG) and the World Health Organization (WHO) have concluded that for women over age 35 who get migraines, the risks of BCPs use usually outweigh the benefits.
Venous thromboembolism (VTE). This rare condition causes clots to form in your blood vessels and can cause symptoms including pain, swelling, and varicose veins, and may block the flow of blood. The risk may vary with the type of progestin used in the pill.
Worsen severe diabetes. The estrogen in birth control pills may increase glucose levels while decreasing the body's insulin response, while the progestin in the pills may encourage overproduction of insulin. Use of birth control pills by diabetic women should be limited to those who do not smoke, are younger than 35 and are otherwise healthy with no evidence of persistent high blood pressure, kidney disease, vision problems or other vascular disease.
Possible acceleration of gallbladder disease. Estrogen may cause bile to become oversaturated with cholesterol, which can lead to gallstones.
No decreased risk of sexually transmitted infections. Birth control pills do not protect against sexually transmitted infections (STIs). But women who use birth control pills are less likely to develop symptomatic pelvic inflammatory disease (PID), which is an infection of the uterus, fallopian tubes or other reproductive organs. PID is a complication of STIs, especially chlamydia or gonorrhea, and may make you to infertile or cause chronic pain. If you are at risk for contracting an STI, you should consider also using condoms.
Lupus/sickle cell anemia. The American College of Obstetricians and Gynecologists notes that birth control injections or implants are safer alternatives than birth control pills in women with these health conditions.
Possible drug interactionsSome drugs can reduce the effectiveness of oral contraceptives. Likewise, oral contraceptives can interfere with the effects of some drugs.
These include:
Seizure medications: phenytoin, carbamazepine, primidone, ethosuximide, methylphenobarbital, paramethadione, phenobarbital, topiramate
Tuberculosis medication rifampin
Antifungal drug griseofulvin
Anti-anxiety drugs containing benzodiazepine
Corticosteroids
Bronchodilators such as theophylline
St. John's wort
If you take any medication either on a short- or long-term basis, be sure to ask your health care professional or pharmacist about possible interactions with birth control pills, and how you should avoid or manage them.
For example, you may need to use an additional contraceptive (such as condoms) as a backup contraceptive method, or take a higher or lower-dose pill formulation.
Unlike the original oral contraceptives used decades ago, low-dose forms with few health risks are the norm. Today's birth control pills (BCPs) even offer health benefits.
Despite the fact that they are safe for most women, however, BCPs do carry some health risks. For example, if you are over 35 and smoke or have certain medical conditions such as a history of blood clots or breast or endometrial cancer, your health care professional may advise against taking BCPs. Also, birth control pills do not protect you from sexually transmitted infections (STIs), including HIV (human immunodeficiency virus), the virus that causes AIDS.
In recent years, birth control pills have been changed to include less hormones, resulting in fewer side effects. In fact, all healthy women who don't smoke may use birth control pills, regardless of their age.
Unlike other forms of birth control sold over-the-counter, you need a health care professional's prescription to purchase BCPs and many health insurers cover their cost. The one exception is the emergency birth control pill Plan B, which was just approved for over-the-counter sale by the FDA. Plan B is expected to be available over the counter by the end of 2006.
How Birth Control Pills WorkAt the beginning of each menstrual cycle, estrogen levels begin to rise. Estrogen helps thicken the lining of the uterus (endometrium) to prepare for a fertilized egg. Once estrogen levels peak, about 14 days into the menstrual cycle, one of the ovaries releases an egg. This monthly release of an egg is called ovulation.
After ovulation, progesterone, another reproductive hormone, begins to rise. Over the next seven days, progesterone further prepares the endometrium for a fertilized egg. Conception occurs when a fertilized egg implants itself in the uterine lining.
If conception does not occur, both estrogen and progesterone levels drop, signaling the now thickened uterine lining to slough off or shed, and menstruation begins.
Birth control pills are a synthetic form of the hormones progesterone and estrogen. They prevent ovulation by maintaining more consistent hormone levels. Without a peak in estrogen, then, the ovary doesn't get the signal to release an egg. No egg means no possibility for fertilization and pregnancy. They also thicken cervical mucus so the sperm cannot reach the egg, and make the lining of the uterus unreceptive to the implantation of a fertilized egg.
Types of Birth Control PillsThe three most common types of birth control pills are:
1. Progestin-only pills (POP). This type of pill contains no estrogen. Called the progestin-only pill, or "mini-pill," it's ideal for breastfeeding women because estrogen reduces milk production. It's also ideal for women who cannot take estrogen. Progestin-only pills primarily work by thickening the cervical mucus, thereby preventing sperm from entering the uterus. To work effectively, they must be taken at a certain time every 24 hours.
Advantage of POPs:
decreased menstrual blood loss
decreased menstrual cramps and pain
can be used by breast-feeding women immediately after delivery
an option for women who cannot use estrogen, such as those who are over 35 and still smoke
easily reversible
Disadvantages:
irregular bleeding patterns, spotting or breakthrough bleeding
must be taken at the same time every day
do not protect against sexually transmitted infections; women at risk must use condoms
may be slightly less effective than combination oral contraceptives
Possible side effects:
amenorrhea (absence of a monthly period)
irregular bleeding
heavy bleeding
abdominal pain
headaches
Ask yourself the following questions to determine if POPs are the right choice for you:
Are you the type of person who can remember to take a pill at exactly the same time every day?
Will irregular bleeding or spotting bother you or interfere with intimacy?
Are you breastfeeding, but feel that you need contraception?
If you are at risk for sexually transmitted infections, will you use condoms for protection?
Do you need to avoid taking estrogen?
2. Combination pills. When you hear the term "birth control pill," it most often refers to oral contraceptives containing estrogen and progestin. Each pill in the pack contains a combination of these two hormones.
Monophasic pills. Each of the 21 active pills in one of these packs contains the same amount of estrogen and progestin. The other seven pills are placebos and contain no hormones; menstruation occurs while they are being taken. In September 2003, the Food and Drug Administration (FDA) approved a 91-day oral contraceptive regimen called Seasonale, in which you take a pill containing progestin and estrogen for 12 weeks (84 days), followed by one week of placebo tablets. If you use this product, you only menstruate about once every three months instead of once a month.
Multiphasic pills. Also called biphasic and triphasic, multiphasic oral contraceptives contain varied amounts of hormones and are designed to be taken at specific times throughout the entire pill-taking schedule. Multiphasic pills contain various levels of estrogen and progestin throughout the month. They were developed to reduce side effects of oral contraceptives, including breakthrough bleeding, spotting and amenorrhea, associated with higher levels of hormones.
Continuous use pill. In May 2007, the FDA approved Lybrel, first continuous use birth control pill. It is a multiphasic pill that comes in a 28-day pack and is designed to be taken continuously, with no break in between pill packets. That means you won't have a period. However, you may have some spotting or breakthrough bleeding, particularly when you first start using Lybrel.
Advantages of combination pills:
reduces risk of ovarian cancer and endometrial cancer
prevents ectopic pregnancy (pregnancies that occur outside the uterus, usually in the fallopian tube)
decreases menstrual blood loss and pain and cramps
less severe premenstrual symptoms
more regular menstrual cycles
improves acne
prevents bone density loss in women who have attained their peak bone mass (generally women over 30)
less risk of ovarian cysts
improves excessive body hair, particularly on the face, a condition called hirsutism
improves endometriosis
improves symptoms of rheumatoid arthritis
beneficial effects on cholesterol (HDL and LDL)
decreases benign breast disease or breast cysts
reversible with quick return to fertility
treats the emotional and physical symptoms of premenstrual dysphoric disorder (PMDD), a severe form of PMS. Only one combination OC has been shown to be clinically effective for this use. It contains the progestin drospirenone and ethinyl estradiol, a form of estrogen.
Disadvantages:
could cause nausea, vomiting, headaches and/or spotting, particularly with the first few cycles
may lead to hypertension (less than one in 200 women)
may causes blood clots in a small percentage of users
may contribute to the formation of gallstones and rare benign liver tumors
Possible side effects:
nausea and vomiting
headaches
irregular bleeding
weight gain or weight loss due to changes in eating habits
breast tenderness
increased breast size
Ask yourself the following questions to determine if combined birth control pills are a good option for you:
Are you the type of person who can remember to take a pill every day?
If you are at risk for sexually transmitted infections, will you use condoms?
Do you need relief from endometriosis, severe menstrual pain or anemia?
If you still smoke, are you under 35?
If breastfeeding, is your baby six months or older?
Do you have high blood pressure?
Have you done well with combination pills in the past?
3. Emergency contraceptive pills (ECP). ECPs are not intended to be used regularly as a contraceptive. They are designed to prevent pregnancy after unprotected sex (when standard contraceptives fail or no method was used). The FDA has approved one emergency contraception pill called Plan B, which contains the progestin levonorgestrel. And women over 18 will soon be able to buy Plan B without a prescription—probably by the end of 2006—due to recent OTC approval by the FDA. Plan B will be available behind pharmacy counters to ensure that women who purchase it are 18 or over. In addition, certain regular oral contraceptive pill packs can be used for emergency contraception if you take several pills at the same time (the exact quantity depends on the brand), with guidance from your health care professional.
While the Plan B label calls for a two-dose regimen, with the first dose taken within 72 hours of unprotected sex and the second 12 hours later, studies find that both pills can be taken at the same time, and that Plan B is effective up to 120 hours after unprotected intercourse.
To learn more about how ECPs work and how to get them, ask your health care professional or pharmacist. Or visit the Internet site for emergency contraception operated by Association of Reproductive Health Professionals and the Office of Population Research at Princeton University (www.not-2-late.com or ec.princeton.edu). Emergency contraception used to be available by prescription only, although the FDA has just approved Plan B without a prescription, which is expected to be available over the counter by the end of 2006.
Advantages of ECP:
reduces the chance of unintended pregnancy
can be obtained easily—Plan B will soon be available over the counter for women 18 and over
can be obtained in advance and kept handy in case of an emergency such as condom breakage, missed oral contraceptives, late contraceptive injections or forced sex
Disadvantages:
timing, because you must take the first dose within 120 hour of having unprotected sex. The sooner you take them after unprotected intercourse, the more effective they are. That's why it's a good idea to have a prescription or a supply of emergency contraceptive pills available should the need arise.
Possible side effects:
nausea, vomiting, dizziness, fatigue and headache
an earlier next period, or, in rare instances, a later next period
heavier or lighter menstrual bleeding
breast tenderness
abdominal pain
Ask yourself the following questions to determine if you should have ECPs on hand or know where to find them:
Have you ever made love unexpectedly?
Have you ever been forced to have sex?
Has a partner had a condom break, slip or come off?
Have you ever forgotten to take several birth control pills?
Have you expected your partner to pull out before ejaculation, but he didn't?
Has your diaphragm slipped?
Have you been late for your Depo-provera or Lunelle shot and had unprotected sex?
Health benefits, risks and other medical issues about birth control pillsBirth control pills provide certain health benefits in addition to preventing pregnancy. Before you start taking oral contraceptives, discuss the health benefits and risks associated with them with a health care professional. Like any other medication, birth control pills can also cause side effects; they may interact with other medications you may take; or they may not be a good choice for you because of your personal health history. Benefits and risks associated with birth control pills are listed below:
BenefitsPrevent pregnancy. First and foremost, birth control pills are one of the most effective forms of reversible birth control. If used correctly, the odds are that only five in 1,000 women is likely to get pregnant in the first year of use.
Improve your menstrual cycle. Birth control pills can improve your menstrual cycle in at least for ways, including:
less bleeding during periods; one product is designed to eliminate your periods entirely
more regular and consistent menstrual cycle patterns
relief from pelvic pain during menstruation
relief from primarily mood-related symptoms of premenstrual dysphoric disorder (PMDD), a condition that causes many of the same symptoms as PMS, but with more intensity. A combination oral contraceptive containing drospirenone, a progestin, and ethinyl estradiol, a form of estrogen, was recently approved by the FDA. Known as "YAZ," this OC was shown to be clinically effective both for the prevention of pregnancy and for the emotional and physical symptoms of PMDD.
Prevent cancer. Birth control pills have been shown to protect women from ovarian and uterine cancer, and possibly from colorectal cancer.
Improve bone density. Some studies have shown that it's possible that bone density improves while taking birth control pills. However, it has not been shown that BCPs make a difference in reducing bone fractures.
Protect you from ovarian cysts. If you take BCPs, you may have about one-fifth less risk for developing ovarian cysts than women using nonhormonal methods of contraception, such as diaphragms or condoms. Women using low-dose pills (20 mcg of estrogen) or multiphasic pills may not get the same benefit.
RisksHeart attack. The chances of BCPs contributing to a heart attack are small (less than three additional heart attacks per million American women per year) unless you smoke. Studies have shown that smoking dramatically increases the risk of heart attack in women age 35 years or older, which is why BCPs are generally not prescribed to women in this age group who smoke. The American College of Obstetricians and Gynecologists (ACOG) notes that POPs may be appropriate for women with coronary artery disease, congestive heart failure or cerebrovascular disease. However, combined pills are not recommended for these women.
Ischemic stroke. There is a small, but significant increase in ischemic stroke risk when using birth control pills. This was a particular concern with early oral contraceptives that contained higher doses of estrogen, but newer preparations containing less estrogen are associated with a lower risk of stroke. In otherwise healthy young women (non-smokers without persistent high blood pressure), the risk is low.
Migraines and stroke. Women who take oral contraceptive and have a history of migraines have an increased risk of stroke compared to nonusers with a history of migraine. Your risk is greatest if you have migraines with "aura"--neurologic symptoms related to vision, such as blurred vision, temporary loss of vision or seeing flashing lights or zigzag lines. As a result, both the American College of Obstetricians and Gynecologists (ACOG) and the World Health Organization (WHO) have concluded that for women over age 35 who get migraines, the risks of BCPs use usually outweigh the benefits.
Venous thromboembolism (VTE). This rare condition causes clots to form in your blood vessels and can cause symptoms including pain, swelling, and varicose veins, and may block the flow of blood. The risk may vary with the type of progestin used in the pill.
Worsen severe diabetes. The estrogen in birth control pills may increase glucose levels while decreasing the body's insulin response, while the progestin in the pills may encourage overproduction of insulin. Use of birth control pills by diabetic women should be limited to those who do not smoke, are younger than 35 and are otherwise healthy with no evidence of persistent high blood pressure, kidney disease, vision problems or other vascular disease.
Possible acceleration of gallbladder disease. Estrogen may cause bile to become oversaturated with cholesterol, which can lead to gallstones.
No decreased risk of sexually transmitted infections. Birth control pills do not protect against sexually transmitted infections (STIs). But women who use birth control pills are less likely to develop symptomatic pelvic inflammatory disease (PID), which is an infection of the uterus, fallopian tubes or other reproductive organs. PID is a complication of STIs, especially chlamydia or gonorrhea, and may make you to infertile or cause chronic pain. If you are at risk for contracting an STI, you should consider also using condoms.
Lupus/sickle cell anemia. The American College of Obstetricians and Gynecologists notes that birth control injections or implants are safer alternatives than birth control pills in women with these health conditions.
Possible drug interactionsSome drugs can reduce the effectiveness of oral contraceptives. Likewise, oral contraceptives can interfere with the effects of some drugs.
These include:
Seizure medications: phenytoin, carbamazepine, primidone, ethosuximide, methylphenobarbital, paramethadione, phenobarbital, topiramate
Tuberculosis medication rifampin
Antifungal drug griseofulvin
Anti-anxiety drugs containing benzodiazepine
Corticosteroids
Bronchodilators such as theophylline
St. John's wort
If you take any medication either on a short- or long-term basis, be sure to ask your health care professional or pharmacist about possible interactions with birth control pills, and how you should avoid or manage them.
For example, you may need to use an additional contraceptive (such as condoms) as a backup contraceptive method, or take a higher or lower-dose pill formulation.
Bipolar Disorder
Bipolar disorder is one of the most distinct and dramatic of mental illnesses. It is characterized by intense episodes of elation or irritability and despair, with any combination of mood experiences in between, including periods of normal moods. Mood changes are accompanied by changes in behavior, such as altered patterns of sleep and activity. According to the National Institute of Mental Health, about 5.7 million Americans, or 2.6 percent of the population, have bipolar disorder in a given year. It is less common than other forms of depression, such as major depression, also called 'unipolar' disorder, or simply, "depression."
The classic form of bipolar disorder, which involves recurrent episodes of mania and depression, is called bipolar I disorder. Some people, however, never develop severe mania but instead experience milder episodes, called hypomania, that alternate with depression; this form of the illness is called bipolar II disorder.
Studies show that men and women are equally likely to develop bipolar disorder; however, there is some evidence that women may have more depressive and fewer manic episodes than men with the illness. Women seem to have "mixed states" (mania or hypomania occurring at the same time as depression) more often than men. Also, women are more likely to have the rapid cycling form of the disease, which is characterized by four or more episodes of depression, mania or hypomania a year, and may be more resistant to standard treatments. Women are also more likely to have bipolar II disorder.
The symptoms of bipolar disorder can be severe and life threatening. Bipolar disease is not curable. However, medication can help many people achieve remission of symptoms. Treatment and maintenance of this disorder is necessary throughout a person's life once bipolar disorder is diagnosed.
Like some other illnesses that require life-long treatment, bipolar disorder poses unique medical challenges for women with the disorder who are considering pregnancy. According to the National Alliance on Mental Illness, pregnant women and new mothers with bipolar disorder have seven times the risk of hospitalization and two times the risk of a recurrent episode compared to women who are not pregnant or who have not recently delivered.
So a woman with bipolar disorder who wants to become pregnant should discuss her treatment options with her health care team prior to conception, if possible, or as early in her pregnancy as possible. Concerns exist about the potential, harmful effects mood-stabilizing medications used to treat bipolar disorder may have on the developing fetus and the nursing infant.
The classic form of bipolar disorder, which involves recurrent episodes of mania and depression, is called bipolar I disorder. Some people, however, never develop severe mania but instead experience milder episodes, called hypomania, that alternate with depression; this form of the illness is called bipolar II disorder.
Studies show that men and women are equally likely to develop bipolar disorder; however, there is some evidence that women may have more depressive and fewer manic episodes than men with the illness. Women seem to have "mixed states" (mania or hypomania occurring at the same time as depression) more often than men. Also, women are more likely to have the rapid cycling form of the disease, which is characterized by four or more episodes of depression, mania or hypomania a year, and may be more resistant to standard treatments. Women are also more likely to have bipolar II disorder.
The symptoms of bipolar disorder can be severe and life threatening. Bipolar disease is not curable. However, medication can help many people achieve remission of symptoms. Treatment and maintenance of this disorder is necessary throughout a person's life once bipolar disorder is diagnosed.
Like some other illnesses that require life-long treatment, bipolar disorder poses unique medical challenges for women with the disorder who are considering pregnancy. According to the National Alliance on Mental Illness, pregnant women and new mothers with bipolar disorder have seven times the risk of hospitalization and two times the risk of a recurrent episode compared to women who are not pregnant or who have not recently delivered.
So a woman with bipolar disorder who wants to become pregnant should discuss her treatment options with her health care team prior to conception, if possible, or as early in her pregnancy as possible. Concerns exist about the potential, harmful effects mood-stabilizing medications used to treat bipolar disorder may have on the developing fetus and the nursing infant.
Biofeedback
Biofeedback is a therapeutic technique that teaches you how to control physical responses, such as breathing, muscle tension, hand temperature, heart rate, blood pressure and brain activity that are not normally controlled voluntarily. This control is achieved by learning how to focus on and modify signals from your body. Biofeedback may be used to help people change the way their bodies respond to a variety of conditions, including chronic pain, stress and anxiety, to name a few. The skill typically is taught by a health care professional with expertise in the techniques and uses a handful of clinical, noninvasive instruments. Once you understand how the technique is applied, and after some practice, it is usually possible to use the skill independently.
To understand biofeedback, think of a thermometer-an external device that measures a physiological change. Biofeedback uses electronic or electromechanical instruments to monitor, measure, process and feed back information about blood pressure, muscle tension, heart rate, brain waves and other physiological functions.
Audio and/or visual feedback signals reflect this activity. This gives you greater awareness and voluntary control: First you learn to control the external signal and, eventually, you learn to recognize and use internal cues.
Biofeedback is a relatively recent approach, first developed in the 1940s. The term came into use around 1969 to describe procedures that trained research subjects to alter brain activity, blood pressure, muscle tension, heart rate and other "involuntary" bodily functions. The goal is to train you, primarily through relaxation techniques, to control physiological reactions that aren't working properly.
At first, biofeedback was viewed with skepticism, but it has been increasingly accepted by mainstream health care professionals and insurers. In the last 30 years, scientists have been exploring the mind/body connection. More acceptance and widespread use of biofeedback therapy has resulted.
Roughly half a million people have tried the technique, usually in conjunction with other therapies. Studies indicate that it is an effective therapy, and it is supported by the National Institutes of Health (NIH).
Biofeedback is most helpful for conditions involving muscle tension. It's a particularly useful therapy for reducing stress and anxiety, and the NIH has approved its use in the treatment of chronic pain and insomnia. Biofeedback can be used as both a primary and secondary treatment. Secondary treatments are used in conjunction with traditional medicine. In these cases, biofeedback would be used to deal with the trauma or fear of having a disease like cancer, pain associated with the condition and for the nausea from chemotherapy. Biofeedback is a secondary treatment for diseases like multiple sclerosis, Crohn's disease and other conditions that are not considered curable by biofeedback, although some symptoms of these conditions can be alleviated with this therapy.
There are at least 150 applications for biofeedback, and the list continues to grow. Below are the most common uses:
addiction to alcohol, tobacco and other drugs
anxiety disorders
asthma
attention deficit disorder
bruxism (teeth grinding)
cardiac arrhythmia (abnormalities in heartbeat)
chronic fatigue syndrome
chronic pain
circulatory problems (such as Raynaud's phenomenon)
concentration improvement for education and meditation
control of brain waves for spiritual development and inner tranquility
diabetes
epilepsy
fecal incontinence
fibromyalgia
headaches (including migraines)
high blood pressure
insomnia
irritable bowel syndrome and other digestive disorders
jaw pain and dysfunction (including temporomandibular joint syndrome)
menopausal symptoms
menstrual cramps
migraine headaches
mild depression
nausea and motion sickness
neuromuscular re-education
paralysis, spinal cord injury and other movement disorders
premenstrual syndrome
stress
torticollis (neck muscles contract involuntarily, causing the head to turn)
Tourette's syndrome
urinary incontinence
vulvovaginal pain
New applications are being developed regularly. Perhaps most closely associated with stress reduction, biofeedback has also been shown to be effective for insomnia and chronic pain (including arthritis, muscle spasms and headaches). It has been shown to help those with Raynaud's disease (periodic loss of circulation in the fingers and/or feet). It is used to reduce tension, fatigue and anxiety; alleviate depression; and even help overcome alcoholism and drug addiction. It's also been used successfully for digestive disorders (such as difficulty swallowing, ulcers, irritable bowel syndrome and acidity), blood-pressure problems and paralysis. In addition, it's been used for retraining and strengthening muscles after an accident, surgery or stroke.
Motion sickness is one of the newest applications. NASA used biofeedback to help astronauts deal with space sickness, and now the space agency's techniques are being used to help others who suffer from nausea, vomiting and motion sickness.
A particular type of biofeedback, called electroencephalographic (EEG) biofeedback, or neurotherapy, is used for a variety of conditions, including reducing hyperactivity and attention deficit hyperactivity disorder. Through neurotherapy, you learn to pay attention to brainwave activity and ultimately control it. However, the science surrounding the use of biofeedback for ADHD is still inconclusive, and you should be cautious about pursuing biofeedback for this condition.
Unlike many other approaches to health care, biofeedback puts you in charge. It requires you to learn from the signals your body sends and make changes accordingly. It even involves practice at home. And after you finish your biofeedback sessions, you need to use what you learned on a regular basis. You will use it, of course, to affect the condition. Daily practice, even when your symptoms responding to treatment, reinforces your skills. Depending on the condition you're trying to affect, your practice period may range from a couple of minutes intermittently during the day to half-hour sessions. You might focus on a particular muscle group, a hand-warming technique or on some other technique specific to your needs.
Biofeedback and HypnosisMany health professionals use both hypnosis and biofeedback, often together. In fact, it is impossible to teach biofeedback without also teaching a type of self hypnosis exercise, such as imagery-relaxation, progressive relaxation, or imagery change.
One benefit from using the combination of hypnotherapy and biofeedback is that the participant recognizes quickly that by changing his/her thinking he/she is changing physiologic responses. This encourages mental practice toward the goal of making a desired physiologic change permanent.
To understand biofeedback, think of a thermometer-an external device that measures a physiological change. Biofeedback uses electronic or electromechanical instruments to monitor, measure, process and feed back information about blood pressure, muscle tension, heart rate, brain waves and other physiological functions.
Audio and/or visual feedback signals reflect this activity. This gives you greater awareness and voluntary control: First you learn to control the external signal and, eventually, you learn to recognize and use internal cues.
Biofeedback is a relatively recent approach, first developed in the 1940s. The term came into use around 1969 to describe procedures that trained research subjects to alter brain activity, blood pressure, muscle tension, heart rate and other "involuntary" bodily functions. The goal is to train you, primarily through relaxation techniques, to control physiological reactions that aren't working properly.
At first, biofeedback was viewed with skepticism, but it has been increasingly accepted by mainstream health care professionals and insurers. In the last 30 years, scientists have been exploring the mind/body connection. More acceptance and widespread use of biofeedback therapy has resulted.
Roughly half a million people have tried the technique, usually in conjunction with other therapies. Studies indicate that it is an effective therapy, and it is supported by the National Institutes of Health (NIH).
Biofeedback is most helpful for conditions involving muscle tension. It's a particularly useful therapy for reducing stress and anxiety, and the NIH has approved its use in the treatment of chronic pain and insomnia. Biofeedback can be used as both a primary and secondary treatment. Secondary treatments are used in conjunction with traditional medicine. In these cases, biofeedback would be used to deal with the trauma or fear of having a disease like cancer, pain associated with the condition and for the nausea from chemotherapy. Biofeedback is a secondary treatment for diseases like multiple sclerosis, Crohn's disease and other conditions that are not considered curable by biofeedback, although some symptoms of these conditions can be alleviated with this therapy.
There are at least 150 applications for biofeedback, and the list continues to grow. Below are the most common uses:
addiction to alcohol, tobacco and other drugs
anxiety disorders
asthma
attention deficit disorder
bruxism (teeth grinding)
cardiac arrhythmia (abnormalities in heartbeat)
chronic fatigue syndrome
chronic pain
circulatory problems (such as Raynaud's phenomenon)
concentration improvement for education and meditation
control of brain waves for spiritual development and inner tranquility
diabetes
epilepsy
fecal incontinence
fibromyalgia
headaches (including migraines)
high blood pressure
insomnia
irritable bowel syndrome and other digestive disorders
jaw pain and dysfunction (including temporomandibular joint syndrome)
menopausal symptoms
menstrual cramps
migraine headaches
mild depression
nausea and motion sickness
neuromuscular re-education
paralysis, spinal cord injury and other movement disorders
premenstrual syndrome
stress
torticollis (neck muscles contract involuntarily, causing the head to turn)
Tourette's syndrome
urinary incontinence
vulvovaginal pain
New applications are being developed regularly. Perhaps most closely associated with stress reduction, biofeedback has also been shown to be effective for insomnia and chronic pain (including arthritis, muscle spasms and headaches). It has been shown to help those with Raynaud's disease (periodic loss of circulation in the fingers and/or feet). It is used to reduce tension, fatigue and anxiety; alleviate depression; and even help overcome alcoholism and drug addiction. It's also been used successfully for digestive disorders (such as difficulty swallowing, ulcers, irritable bowel syndrome and acidity), blood-pressure problems and paralysis. In addition, it's been used for retraining and strengthening muscles after an accident, surgery or stroke.
Motion sickness is one of the newest applications. NASA used biofeedback to help astronauts deal with space sickness, and now the space agency's techniques are being used to help others who suffer from nausea, vomiting and motion sickness.
A particular type of biofeedback, called electroencephalographic (EEG) biofeedback, or neurotherapy, is used for a variety of conditions, including reducing hyperactivity and attention deficit hyperactivity disorder. Through neurotherapy, you learn to pay attention to brainwave activity and ultimately control it. However, the science surrounding the use of biofeedback for ADHD is still inconclusive, and you should be cautious about pursuing biofeedback for this condition.
Unlike many other approaches to health care, biofeedback puts you in charge. It requires you to learn from the signals your body sends and make changes accordingly. It even involves practice at home. And after you finish your biofeedback sessions, you need to use what you learned on a regular basis. You will use it, of course, to affect the condition. Daily practice, even when your symptoms responding to treatment, reinforces your skills. Depending on the condition you're trying to affect, your practice period may range from a couple of minutes intermittently during the day to half-hour sessions. You might focus on a particular muscle group, a hand-warming technique or on some other technique specific to your needs.
Biofeedback and HypnosisMany health professionals use both hypnosis and biofeedback, often together. In fact, it is impossible to teach biofeedback without also teaching a type of self hypnosis exercise, such as imagery-relaxation, progressive relaxation, or imagery change.
One benefit from using the combination of hypnotherapy and biofeedback is that the participant recognizes quickly that by changing his/her thinking he/she is changing physiologic responses. This encourages mental practice toward the goal of making a desired physiologic change permanent.
Bacterial Vaginosis
Bacterial vaginosis (BV) is the most common of three vaginal infections that fall under the category known as vaginitis. The other two infections are trichomoniasis, a sexually transmitted disease, and the fungal infection commonly known as a yeast infection.
BV is the least understood and most often ignored or misdiagnosed of these conditions. However, it is gaining more attention as more research shows that untreated BV can lead to significant health complications, including premature delivery, postpartum infections, clinically apparent and subclinical pelvic inflammatory disease (PID), post-surgical complications (after abortion, hysterectomy, cesarean section and other reproductive procedures), increased vulnerability to HIV infection and, possibly, infertility. As many as one-third of pregnant women in the United States have BV.
BV is not considered a sexually transmitted disease. Although it is less common in women who have never had sex, there is evidence that it could be linked to having a new sex partner or multiple sex partners. Also, douching appears to increase the risk of developing BV.
BV has gone by different names in the past, including non-specific vaginitis and Gardnerella vaginalis vaginitis. BV is a lot simpler to remember but there is nothing simple about this condition and it is not harmless, as was once believed.
BV is actually a syndrome resulting from an imbalance in the different types of bacteria in the vagina (also called vaginal "flora"). A healthy vagina has numerous organisms that naturally live there. The vast majority--about 95 percent--belong to a type of bacteria called lactobacillus.
There are several different kinds of lactobacillus, at least one of which is responsible for keeping the vagina's pH at normal levels. When these levels become unbalanced, the certain microorganisms may overtake the normal flora leading to a low-grade infection that often produces an abnormal vaginal discharge.
BV is the least understood and most often ignored or misdiagnosed of these conditions. However, it is gaining more attention as more research shows that untreated BV can lead to significant health complications, including premature delivery, postpartum infections, clinically apparent and subclinical pelvic inflammatory disease (PID), post-surgical complications (after abortion, hysterectomy, cesarean section and other reproductive procedures), increased vulnerability to HIV infection and, possibly, infertility. As many as one-third of pregnant women in the United States have BV.
BV is not considered a sexually transmitted disease. Although it is less common in women who have never had sex, there is evidence that it could be linked to having a new sex partner or multiple sex partners. Also, douching appears to increase the risk of developing BV.
BV has gone by different names in the past, including non-specific vaginitis and Gardnerella vaginalis vaginitis. BV is a lot simpler to remember but there is nothing simple about this condition and it is not harmless, as was once believed.
BV is actually a syndrome resulting from an imbalance in the different types of bacteria in the vagina (also called vaginal "flora"). A healthy vagina has numerous organisms that naturally live there. The vast majority--about 95 percent--belong to a type of bacteria called lactobacillus.
There are several different kinds of lactobacillus, at least one of which is responsible for keeping the vagina's pH at normal levels. When these levels become unbalanced, the certain microorganisms may overtake the normal flora leading to a low-grade infection that often produces an abnormal vaginal discharge.
Attention Deficit Hyperactivity Disorder
Experts suggest that attention deficit hyperactivity disorder (ADHD) affects an estimated 5 to 8 percent of school-aged children and one to seven percent of adults. ADHD interferes with your ability to regulate activity (hyperactivity), control some behaviors (impulsivity) and focus on tasks (inattention). When the hyperactivity is not present, the condition is sometimes called Attention Deficit Disorder (ADD), although the more current term is ADHD-Inattentive type. As many as two-thirds of children with ADHD will continue to face major challenges caused by the disorder as adults, according to the Attention Deficit Disorder Association (ADDA).
By current estimates, about three times more boys than girls are affected by ADHD, but that gap appears to close across development, with the ratio evening out in adulthood.
Overall, women and girls may have fewer of the typical symptoms associated with ADHD in boys, but once a diagnosis is made, the symptoms are fairly similar. Still, sex differences exist. For example, girls with ADHD may be more likely to be shy rather than hyperactive. They tend to be less defiant and more compliant than boys and men with the condition. Like boys and men with ADHD, however, women with the condition may also have difficulty completing tasks and remaining organized. Instead of being tested for ADHD, they're often dismissed as flighty or spacey.
Thus, because girls are less likely to disrupt class—the kind of behavior that often brings boys with the condition to medical professionals' attention—girls are less likely to get diagnosed with ADHD. Consequently, many girls and women do not get the help they need. Often, girls' self-esteem suffers as they encounter academic problems in school. They may have difficulty with interpersonal relationships as well as social challenges. These secondary difficulties may result in depression, anxiety disorders, problems sleeping and substance abuse.
Once diagnosed, however, many women recall painful or difficult childhood experiences in school that were likely caused by ADHD but attributed at the time to other causes, such as laziness or lack of ability. This can lead to significant emotional or psychological problems.
Causes of ADHDAlthough no one knows for sure what causes ADHD, the condition does run in families, suggesting a strong genetic component. In fact, ADHD is among the most recognized genetic-based disorders in psychiatry. Overall, if a parent has the disorder, there is up to a 40 percent chance that a child will have it. Studies show that if a child has ADHD, there is about a 25 percent chance that one of his or her close relatives will also have the condition. For identical twins, there is a strong chance the other twin has it. This "family resemblance" appears due more to genetic than social factors. Many researchers around the world are now investigating various genes that may contribute to the development of ADHD in families.
A smaller percentage of cases of ADHD are due to environmental causes, including prenatal use of alcohol, tobacco and cocaine, and exposure to lead, which can alter brain development in the fetus. Low birthweight can also lead to ADHD symptoms. Additionally, some postnatal problems, such as chronic low levels of lead or severe head trauma, can result in ADHD.
For years, ADHD was thought to be a disruptive behavior disorder that most experts intuitively believed involved some brain abnormality. With the development of more sophisticated brain scanning techniques, it is now known that people with ADHD do have anatomical differences in their brains, as well as differences in the biochemical balance that controls everything from mood to impulses.
For instance, imaging studies like MRIs show that some areas of the brain in children with ADHD are smaller, or have structural abnormalities, compared to those without the condition.
Another biological component of ADHD has to do with levels of two key neurotransmitters in the brain: norepinephrine and its precursor, dopamine. Both are major neurochemicals responsible for transmission of nerve impulses throughout the brain, and both are thought to be essential in regulating impulse control, organization and attention.
Those with ADHD generally may have increased levels of a transporter protein that reduces the amount of dopamine transmitted between neurons, leading to a dopamine (and thus norepinephrine) deficiency.
Medications like methylphenidate HCL (Ritalin and Concerta) and other stimulants work directly on this mechanism, making more dopamine available for transmission by blocking those proteins, while the newest and first non-stimulant ADHD drug, atomoxetine (Strattera), works on the norepinephrine pathway.
ADHD is not caused by many environmental triggers commonly believed to be associated with the disorder, such as:
too much TV
food allergies
eating too much sugar
poor home life
poor teaching and/or schools
permissive parenting
Still, it is essential to realize that the home environment and the school setting are extremely important in managing ADHD.
By current estimates, about three times more boys than girls are affected by ADHD, but that gap appears to close across development, with the ratio evening out in adulthood.
Overall, women and girls may have fewer of the typical symptoms associated with ADHD in boys, but once a diagnosis is made, the symptoms are fairly similar. Still, sex differences exist. For example, girls with ADHD may be more likely to be shy rather than hyperactive. They tend to be less defiant and more compliant than boys and men with the condition. Like boys and men with ADHD, however, women with the condition may also have difficulty completing tasks and remaining organized. Instead of being tested for ADHD, they're often dismissed as flighty or spacey.
Thus, because girls are less likely to disrupt class—the kind of behavior that often brings boys with the condition to medical professionals' attention—girls are less likely to get diagnosed with ADHD. Consequently, many girls and women do not get the help they need. Often, girls' self-esteem suffers as they encounter academic problems in school. They may have difficulty with interpersonal relationships as well as social challenges. These secondary difficulties may result in depression, anxiety disorders, problems sleeping and substance abuse.
Once diagnosed, however, many women recall painful or difficult childhood experiences in school that were likely caused by ADHD but attributed at the time to other causes, such as laziness or lack of ability. This can lead to significant emotional or psychological problems.
Causes of ADHDAlthough no one knows for sure what causes ADHD, the condition does run in families, suggesting a strong genetic component. In fact, ADHD is among the most recognized genetic-based disorders in psychiatry. Overall, if a parent has the disorder, there is up to a 40 percent chance that a child will have it. Studies show that if a child has ADHD, there is about a 25 percent chance that one of his or her close relatives will also have the condition. For identical twins, there is a strong chance the other twin has it. This "family resemblance" appears due more to genetic than social factors. Many researchers around the world are now investigating various genes that may contribute to the development of ADHD in families.
A smaller percentage of cases of ADHD are due to environmental causes, including prenatal use of alcohol, tobacco and cocaine, and exposure to lead, which can alter brain development in the fetus. Low birthweight can also lead to ADHD symptoms. Additionally, some postnatal problems, such as chronic low levels of lead or severe head trauma, can result in ADHD.
For years, ADHD was thought to be a disruptive behavior disorder that most experts intuitively believed involved some brain abnormality. With the development of more sophisticated brain scanning techniques, it is now known that people with ADHD do have anatomical differences in their brains, as well as differences in the biochemical balance that controls everything from mood to impulses.
For instance, imaging studies like MRIs show that some areas of the brain in children with ADHD are smaller, or have structural abnormalities, compared to those without the condition.
Another biological component of ADHD has to do with levels of two key neurotransmitters in the brain: norepinephrine and its precursor, dopamine. Both are major neurochemicals responsible for transmission of nerve impulses throughout the brain, and both are thought to be essential in regulating impulse control, organization and attention.
Those with ADHD generally may have increased levels of a transporter protein that reduces the amount of dopamine transmitted between neurons, leading to a dopamine (and thus norepinephrine) deficiency.
Medications like methylphenidate HCL (Ritalin and Concerta) and other stimulants work directly on this mechanism, making more dopamine available for transmission by blocking those proteins, while the newest and first non-stimulant ADHD drug, atomoxetine (Strattera), works on the norepinephrine pathway.
ADHD is not caused by many environmental triggers commonly believed to be associated with the disorder, such as:
too much TV
food allergies
eating too much sugar
poor home life
poor teaching and/or schools
permissive parenting
Still, it is essential to realize that the home environment and the school setting are extremely important in managing ADHD.
Atherosclerosis
Diseases caused by atherosclerosis are the leading cause of illness and death for both men and women in the U.S, according to the National Heart, Lung, and Blood Institute. Although breast cancer is often the illness most feared by women, the disease affects one out of nine women over the lifetime, compared to coronary heart disease, which affects one out of every two women over the lifetime. Atherosclerosis is often the first stage of coronary heart disease (CHD).
Often referred to as "hardening of the arteries," atherosclerosis occurs when your arteries narrow and become less flexible. This happens when cholesterol, fatty substances, cell waste products, calcium and fibrin—collectively called plaque—collect on the inner walls. The arteries respond to the buildup by becoming inflamed, which, in turn, results in the formation of scar tissue and the collection of other cells in the affected areas, further narrowing the artery.
Atherosclerosis can affect medium and large arteries anywhere in your body. If someone has atherosclerosis in one part of their body, they typically will also have atherosclerosis in other parts of their bodies. Atherosclerosis restricts blood flow, thus limiting the amount of oxygen available to your organs. When blood flow to the heart is reduced, for instance, chest pain, or angina, may result. Similarly, when blood flow to the arteries in the legs are reduced, leg pain called claudication may result.
As the disease progresses, atherosclerosis can completely clog arteries, cutting off blood flow. This usually happens suddenly when a blood clot forms in the damaged arteries on top of the atherosclerosis. This is especially dangerous in arteries near the brain, heart or other vital organs. If blood flow to the heart is nearly or completely blocked, a heart attack results and muscle cells in the heart die. The result is permanent heart damage. Similarly, if blood flow is abruptly cut off to the brain, this can cause a stroke, which may also result in permanent brain damage. And if blood flow is abruptly cut off to the legs, the leg may have to be amputated. Thus atherosclerosis can lead to serious life-threatening complications if not addressed early through prevention and early treatment.
Atherosclerotic plaques have a cholesterol- or lipid-rich core covered by a fibrous cap. If this cap ruptures, it exposes this lipid-rich core to blood. The sticky core attracts platelets, forming a blood clot, called a thrombus, at the site. This clot can completely clog the artery and cut off blood flow.
More mature plaques (stable plaques) have a thick fibrous cap, which is less likely to rupture. Softer, fattier plaques (unstable plaques) have a weaker cap and are more likely to rupture.
Two thirds of sudden total or near total blockage (called an occlusion) develops in arteries that were less than 50 percent narrowed, and 97 percent of plaque rupture occurs in arteries with less than 70 percent narrowing.
So the degree of narrowing in a particular artery does not necessarily predict complete blockage in that same artery.
Tighter or narrower arteries may cause angina, but are not necessarily more likely to rupture. However, the total amount of plaque or atherosclerosis in all your arteries predicts your risk of a heart attack.
We don't know what causes plaque to begin building up in arteries. Some experts think plaque begins to accumulate in places where the inner layer of an artery is damaged.
The specific arteries most at risk for atherosclerosis-induced blockage are those going to your brain (carotid), heart (coronary) and legs (femoral or iliac). Atherosclerosis in the legs is the most common form of peripheral arterial disease (PAD) and can lead to intermittent claudication—severe pain, aching or cramping when walking, numbness, reduced circulation, and if left untreated, gangrene (death of tissue).
While atherosclerosis is typically a disease that progresses gradually—sometimes even starting in childhood—you are most at risk when arterial blockage builds up quickly, completely closing off an entire artery. This can happen if the plaque ruptures.
Risk Factors for Atherosclerosis:Over the last two decades, researchers have identified many risk factors for developing cardiovascular diseases. They include:
Elevated cholesterol levels (both total cholesterol and LDL ("bad") cholesterol)
Elevated triglyceride levels
High blood pressure hypertension
Cigarette smoke
Low HDL cholesterol (the "good" cholesterol that clears away artery-clogging LDL cholesterol—the "bad" cholesterol)
Diabetes (elevated blood sugar)
Advanced age
High cholesterolMore than half of women over age 55 need to lower their blood cholesterol, and a quarter of all American women have blood cholesterol levels high enough to pose a serious risk for coronary heart disease-a result of atherosclerosis.
Cholesterol begins collecting in the walls of the arteries at an early age. In fact, the earliest type of arterial lesion, the "fatty streak," is present even in young children.
According to the National Cholesterol Education Program (NCEP), elevated LDL cholesterol is a major cause of coronary heart disease. That's why the NCEP panel recommends aggressive treatment. Treatment may include lifestyle changes, such as exercising more and reducing the amount of saturated fat in your diet, and medication. A combination of approaches is typically recommended.
Other lipid abnormalities, such as elevated triglycerides or low HDL (the good cholesterol), are also associated with increased cardiovascular risk.
Cigarette smokingSmoking accelerates the development of atherosclerosis, increases blood pressure and restricts the amount of oxygen the blood supplies to the body. Quitting smoking dramatically and immediately lowers the risk of a heart attack and also reduces the risk of a second heart attack in people who have already had one.
DiabetesHaving diabetes poses as great a risk for having a heart attack in 10 years as heart disease itself, according to NHLBI. In fact, cardiovascular disease is the leading cause of diabetes-related deaths. People with diabetes who have not yet had a heart attack have the same risk of future heart attack as someone with known coronary heart disease. Because their risk of heart attack is so high, NHLBI recommends that people with diabetes be treated aggressively with LDL cholesterol lowering medication and carefully manage their blood sugar to reduce their cardiovascular risk.
AgeGenerally, women over age 55 and men over age 45 are at greatest risk for developing atherosclerosis. The risk of cardiovascular events increases with age.
Global Risk Factor AssessmentThe Framingham Risk Score is a useful, office-based risk prediction model. It assigns a point score for each major risk factor to predict your 10-year risk of developing future cardiovascular events. You can estimate your own 10-year risk at: http://hp2010.nhlbihin.net
If you have more than a 20 percent risk of future cardiac events over the next 10 years, you should be treated very aggressively, the same as someone with known heart disease. Intermediate risk individuals with scores between 10 percent and 20 percent should have further risk evaluation. Low-risk individuals with scores of less than 10 percent usually don't need drug therapy, but should make lifestyle changes such as diet and exercise, which are recommended for everyone.
Other risk factors for coronary heart disease include:A family history of early heart disease
Obesity
Metabolic syndrome
Physical inactivity and sedentary lifestyle
Postmenopausal status
High levels of homocysteine
Family HistoryEven though it is not included in the Framingham Risk Score, family history is one of the biggest risk factors overall for atherosclerosis. Your risk is greater if your father or brother was diagnosed before age 55, if your mother or sister was diagnosed before age 65, or if you have a sibling with early coronary disease.
ObesityOverweight women are much more likely to develop heart-related problems, even if they have no other risk factors. Excess body weight in women is linked with coronary heart disease, stroke, congestive heart failure and death from heart-related causes.
InactivityNot exercising contributes directly to heart-related problems and increases the likelihood that you'll develop other risk factors, such as high blood pressure and diabetes.
Metabolic SyndromeThis deadly quartet of abdominal obesity, high blood pressure, glucose intolerance (or pre-diabetes) and abnormal cholesterol is associated with a markedly increased risk of cardiovascular disease.
HomocysteineHomocysteine is an amino acid normally found in the body. Studies suggest that high blood levels of this substance may increase the risk of heart disease, stroke and peripheral vascular disease.
StressAlthough stress has been implicated in the development of atherosclerosis, its exact relationship to heart disease has not been determined. Regular exercise can reduce stress and improve your mood.
Post-menopausal statusA woman's risk of developing atherosclerosis and heart disease increases once she reaches menopause. Prior to menopause, women are mainly protected from heart disease by estrogen, the reproductive hormone produced by the ovaries. This protection is why women tend to develop heart disease 10 years after men. However this 10-year protection is not seen in women who smoke or those with diabetes.
Among its many roles, estrogen helps keep arteries free from plaque by improving the ratio of LDL (low-density lipoprotein) and HDL (high-density lipoprotein) cholesterol. It also increases the amount of HDL cholesterol, which helps clear arteries of LDL cholesterol—the kind that most contributes to plaque build up.
Estrogen also helps keep the lining of your blood vessels strong and pliable, which helps reduce your risk of atherosclerosis. Despite the theoretical benefits of estrogen, replacing natural estrogen hormones with drugs after menopause is not an effective way to prevent heart disease, and may even be harmful.
Symptoms of Atherosclerosis:Often, you will experience no symptoms of atherosclerosis until the disease has progressed significantly. However, there are some conditions that may suggest atherosclerosis is present, although these conditions may also happen for other reasons.
Angina. If clogged arteries prevent enough oxygen-carrying blood from reaching your heart, the heart may respond with pain called angina pectoris. Episodes of angina occur when the heart's need for oxygen increases beyond the oxygen available from the blood nourishing the heart. Silent angina occurs when the same inadequate blood supply causes no symptoms.
Physical exertion is the most common trigger for angina. Other triggers can be emotional stress, extreme cold or heat, heavy meals, alcohol and cigarette smoking. The pain is a pressing or squeezing pain, usually felt in the chest or sometimes in the shoulders, arms, neck, jaws or back.
Angina suggests that coronary heart disease exists. People with angina have an increased risk of heart attack compared with those who have no symptoms. When the pattern of angina changes—if episodes become more frequent, last longer or occur without exercise—your risk of heart attack in subsequent days or weeks is much higher and you should see your health care professional immediately.
If you have angina, learn its pattern—what causes an angina attack, what it feels like, how long episodes usually last and whether medication relieves the attack. Angina is usually relieved in a few minutes by resting or taking prescribed angina medicine, such as nitroglycerin.
Episodes of angina seldom cause permanent damage to heart muscle.
Heart attack pain may be similar to angina, but the symptoms of angina quickly disappear with rest. Heart attack pain, however, usually persists despite resting or taking nitroglycerin and should be evaluated immediately. Like angina, heart attack pain can be a pressure or tightness in chest, arms, back or neck. Often symptoms include shortness of breath, sweating, nausea, vomiting, indigestion or dizziness. Women, especially those with diabetes, may not have the typical symptoms of chest pain like men, but other symptoms such as shortness of breath or indigestion. A heart attack is an emergency. A delay in treatment could mean more of the heart muscle tissue is permanently damaged. If you think you're having a heart attack, take an aspirin (which reduces blood clotting) and get medical help immediately.
Cardiac arrhythmias. These occur when the heart momentarily beats too fast or beats irregularly. Chest pain, dizziness and shortness of breath are symptoms of cardiac arrhythmias. Atherosclerosis is one cause of rapid or irregular heartbeat; however, it can also be caused by angina, valvular heart disease, blood clots, thyroid abnormalities, electrolyte imbalance or previous heart damage. Arrhythmias may be frequent or infrequent.
Silent ischemia. Sometimes atherosclerosis causes no symptoms. Silent ischemia is a condition caused by atherosclerosis, but isn't associated with the chest pain or other symptoms common to other types of heart conditions. This condition occurs when arteries with atherosclerosis can't deliver enough blood to the heart. An electrocardiogram (EKG or ECG), a measurement of electrical impulses produced by the heart, may indicate silent ischemia. However, unless you know your risks for heart disease and decide, with the advice of your health care professional, that you need a heart checkup, you may never know you have ischemia. People with diabetes are especially at risk for this condition.
Intermittent claudication. This leg disorder predominantly affects elderly people. It causes severe pain, aching or cramping in the legs when you walk due to atherosclerosis in the major arteries that supply blood to the legs (femoral and iliac). Severe cases of peripheral arterial disease can lead to gangrene and amputation.
Transient ischemic attack (TIA). If you experience a sudden onset of weakness or numbness on one side of your face, arm, or leg, or an inability to talk or find words, or lose vision in one eye, you may be having a mini-stroke or TIA. Neurological symptoms that last less than 24 hours are called TIAs, where as symptoms that persist for longer periods are classified as strokes.
They are often the result of atherosclerosis in the arteries that supply blood to the brain, such as the carotid arteries. This is very serious. If you experience these symptoms, seek medical attention immediately. This is the brain's equivalent of a "heart attack," during which the brain is deprived of oxygen-carrying blood supply. Any delay in medical treatment may permanently damage your brain.
Often referred to as "hardening of the arteries," atherosclerosis occurs when your arteries narrow and become less flexible. This happens when cholesterol, fatty substances, cell waste products, calcium and fibrin—collectively called plaque—collect on the inner walls. The arteries respond to the buildup by becoming inflamed, which, in turn, results in the formation of scar tissue and the collection of other cells in the affected areas, further narrowing the artery.
Atherosclerosis can affect medium and large arteries anywhere in your body. If someone has atherosclerosis in one part of their body, they typically will also have atherosclerosis in other parts of their bodies. Atherosclerosis restricts blood flow, thus limiting the amount of oxygen available to your organs. When blood flow to the heart is reduced, for instance, chest pain, or angina, may result. Similarly, when blood flow to the arteries in the legs are reduced, leg pain called claudication may result.
As the disease progresses, atherosclerosis can completely clog arteries, cutting off blood flow. This usually happens suddenly when a blood clot forms in the damaged arteries on top of the atherosclerosis. This is especially dangerous in arteries near the brain, heart or other vital organs. If blood flow to the heart is nearly or completely blocked, a heart attack results and muscle cells in the heart die. The result is permanent heart damage. Similarly, if blood flow is abruptly cut off to the brain, this can cause a stroke, which may also result in permanent brain damage. And if blood flow is abruptly cut off to the legs, the leg may have to be amputated. Thus atherosclerosis can lead to serious life-threatening complications if not addressed early through prevention and early treatment.
Atherosclerotic plaques have a cholesterol- or lipid-rich core covered by a fibrous cap. If this cap ruptures, it exposes this lipid-rich core to blood. The sticky core attracts platelets, forming a blood clot, called a thrombus, at the site. This clot can completely clog the artery and cut off blood flow.
More mature plaques (stable plaques) have a thick fibrous cap, which is less likely to rupture. Softer, fattier plaques (unstable plaques) have a weaker cap and are more likely to rupture.
Two thirds of sudden total or near total blockage (called an occlusion) develops in arteries that were less than 50 percent narrowed, and 97 percent of plaque rupture occurs in arteries with less than 70 percent narrowing.
So the degree of narrowing in a particular artery does not necessarily predict complete blockage in that same artery.
Tighter or narrower arteries may cause angina, but are not necessarily more likely to rupture. However, the total amount of plaque or atherosclerosis in all your arteries predicts your risk of a heart attack.
We don't know what causes plaque to begin building up in arteries. Some experts think plaque begins to accumulate in places where the inner layer of an artery is damaged.
The specific arteries most at risk for atherosclerosis-induced blockage are those going to your brain (carotid), heart (coronary) and legs (femoral or iliac). Atherosclerosis in the legs is the most common form of peripheral arterial disease (PAD) and can lead to intermittent claudication—severe pain, aching or cramping when walking, numbness, reduced circulation, and if left untreated, gangrene (death of tissue).
While atherosclerosis is typically a disease that progresses gradually—sometimes even starting in childhood—you are most at risk when arterial blockage builds up quickly, completely closing off an entire artery. This can happen if the plaque ruptures.
Risk Factors for Atherosclerosis:Over the last two decades, researchers have identified many risk factors for developing cardiovascular diseases. They include:
Elevated cholesterol levels (both total cholesterol and LDL ("bad") cholesterol)
Elevated triglyceride levels
High blood pressure hypertension
Cigarette smoke
Low HDL cholesterol (the "good" cholesterol that clears away artery-clogging LDL cholesterol—the "bad" cholesterol)
Diabetes (elevated blood sugar)
Advanced age
High cholesterolMore than half of women over age 55 need to lower their blood cholesterol, and a quarter of all American women have blood cholesterol levels high enough to pose a serious risk for coronary heart disease-a result of atherosclerosis.
Cholesterol begins collecting in the walls of the arteries at an early age. In fact, the earliest type of arterial lesion, the "fatty streak," is present even in young children.
According to the National Cholesterol Education Program (NCEP), elevated LDL cholesterol is a major cause of coronary heart disease. That's why the NCEP panel recommends aggressive treatment. Treatment may include lifestyle changes, such as exercising more and reducing the amount of saturated fat in your diet, and medication. A combination of approaches is typically recommended.
Other lipid abnormalities, such as elevated triglycerides or low HDL (the good cholesterol), are also associated with increased cardiovascular risk.
Cigarette smokingSmoking accelerates the development of atherosclerosis, increases blood pressure and restricts the amount of oxygen the blood supplies to the body. Quitting smoking dramatically and immediately lowers the risk of a heart attack and also reduces the risk of a second heart attack in people who have already had one.
DiabetesHaving diabetes poses as great a risk for having a heart attack in 10 years as heart disease itself, according to NHLBI. In fact, cardiovascular disease is the leading cause of diabetes-related deaths. People with diabetes who have not yet had a heart attack have the same risk of future heart attack as someone with known coronary heart disease. Because their risk of heart attack is so high, NHLBI recommends that people with diabetes be treated aggressively with LDL cholesterol lowering medication and carefully manage their blood sugar to reduce their cardiovascular risk.
AgeGenerally, women over age 55 and men over age 45 are at greatest risk for developing atherosclerosis. The risk of cardiovascular events increases with age.
Global Risk Factor AssessmentThe Framingham Risk Score is a useful, office-based risk prediction model. It assigns a point score for each major risk factor to predict your 10-year risk of developing future cardiovascular events. You can estimate your own 10-year risk at: http://hp2010.nhlbihin.net
If you have more than a 20 percent risk of future cardiac events over the next 10 years, you should be treated very aggressively, the same as someone with known heart disease. Intermediate risk individuals with scores between 10 percent and 20 percent should have further risk evaluation. Low-risk individuals with scores of less than 10 percent usually don't need drug therapy, but should make lifestyle changes such as diet and exercise, which are recommended for everyone.
Other risk factors for coronary heart disease include:A family history of early heart disease
Obesity
Metabolic syndrome
Physical inactivity and sedentary lifestyle
Postmenopausal status
High levels of homocysteine
Family HistoryEven though it is not included in the Framingham Risk Score, family history is one of the biggest risk factors overall for atherosclerosis. Your risk is greater if your father or brother was diagnosed before age 55, if your mother or sister was diagnosed before age 65, or if you have a sibling with early coronary disease.
ObesityOverweight women are much more likely to develop heart-related problems, even if they have no other risk factors. Excess body weight in women is linked with coronary heart disease, stroke, congestive heart failure and death from heart-related causes.
InactivityNot exercising contributes directly to heart-related problems and increases the likelihood that you'll develop other risk factors, such as high blood pressure and diabetes.
Metabolic SyndromeThis deadly quartet of abdominal obesity, high blood pressure, glucose intolerance (or pre-diabetes) and abnormal cholesterol is associated with a markedly increased risk of cardiovascular disease.
HomocysteineHomocysteine is an amino acid normally found in the body. Studies suggest that high blood levels of this substance may increase the risk of heart disease, stroke and peripheral vascular disease.
StressAlthough stress has been implicated in the development of atherosclerosis, its exact relationship to heart disease has not been determined. Regular exercise can reduce stress and improve your mood.
Post-menopausal statusA woman's risk of developing atherosclerosis and heart disease increases once she reaches menopause. Prior to menopause, women are mainly protected from heart disease by estrogen, the reproductive hormone produced by the ovaries. This protection is why women tend to develop heart disease 10 years after men. However this 10-year protection is not seen in women who smoke or those with diabetes.
Among its many roles, estrogen helps keep arteries free from plaque by improving the ratio of LDL (low-density lipoprotein) and HDL (high-density lipoprotein) cholesterol. It also increases the amount of HDL cholesterol, which helps clear arteries of LDL cholesterol—the kind that most contributes to plaque build up.
Estrogen also helps keep the lining of your blood vessels strong and pliable, which helps reduce your risk of atherosclerosis. Despite the theoretical benefits of estrogen, replacing natural estrogen hormones with drugs after menopause is not an effective way to prevent heart disease, and may even be harmful.
Symptoms of Atherosclerosis:Often, you will experience no symptoms of atherosclerosis until the disease has progressed significantly. However, there are some conditions that may suggest atherosclerosis is present, although these conditions may also happen for other reasons.
Angina. If clogged arteries prevent enough oxygen-carrying blood from reaching your heart, the heart may respond with pain called angina pectoris. Episodes of angina occur when the heart's need for oxygen increases beyond the oxygen available from the blood nourishing the heart. Silent angina occurs when the same inadequate blood supply causes no symptoms.
Physical exertion is the most common trigger for angina. Other triggers can be emotional stress, extreme cold or heat, heavy meals, alcohol and cigarette smoking. The pain is a pressing or squeezing pain, usually felt in the chest or sometimes in the shoulders, arms, neck, jaws or back.
Angina suggests that coronary heart disease exists. People with angina have an increased risk of heart attack compared with those who have no symptoms. When the pattern of angina changes—if episodes become more frequent, last longer or occur without exercise—your risk of heart attack in subsequent days or weeks is much higher and you should see your health care professional immediately.
If you have angina, learn its pattern—what causes an angina attack, what it feels like, how long episodes usually last and whether medication relieves the attack. Angina is usually relieved in a few minutes by resting or taking prescribed angina medicine, such as nitroglycerin.
Episodes of angina seldom cause permanent damage to heart muscle.
Heart attack pain may be similar to angina, but the symptoms of angina quickly disappear with rest. Heart attack pain, however, usually persists despite resting or taking nitroglycerin and should be evaluated immediately. Like angina, heart attack pain can be a pressure or tightness in chest, arms, back or neck. Often symptoms include shortness of breath, sweating, nausea, vomiting, indigestion or dizziness. Women, especially those with diabetes, may not have the typical symptoms of chest pain like men, but other symptoms such as shortness of breath or indigestion. A heart attack is an emergency. A delay in treatment could mean more of the heart muscle tissue is permanently damaged. If you think you're having a heart attack, take an aspirin (which reduces blood clotting) and get medical help immediately.
Cardiac arrhythmias. These occur when the heart momentarily beats too fast or beats irregularly. Chest pain, dizziness and shortness of breath are symptoms of cardiac arrhythmias. Atherosclerosis is one cause of rapid or irregular heartbeat; however, it can also be caused by angina, valvular heart disease, blood clots, thyroid abnormalities, electrolyte imbalance or previous heart damage. Arrhythmias may be frequent or infrequent.
Silent ischemia. Sometimes atherosclerosis causes no symptoms. Silent ischemia is a condition caused by atherosclerosis, but isn't associated with the chest pain or other symptoms common to other types of heart conditions. This condition occurs when arteries with atherosclerosis can't deliver enough blood to the heart. An electrocardiogram (EKG or ECG), a measurement of electrical impulses produced by the heart, may indicate silent ischemia. However, unless you know your risks for heart disease and decide, with the advice of your health care professional, that you need a heart checkup, you may never know you have ischemia. People with diabetes are especially at risk for this condition.
Intermittent claudication. This leg disorder predominantly affects elderly people. It causes severe pain, aching or cramping in the legs when you walk due to atherosclerosis in the major arteries that supply blood to the legs (femoral and iliac). Severe cases of peripheral arterial disease can lead to gangrene and amputation.
Transient ischemic attack (TIA). If you experience a sudden onset of weakness or numbness on one side of your face, arm, or leg, or an inability to talk or find words, or lose vision in one eye, you may be having a mini-stroke or TIA. Neurological symptoms that last less than 24 hours are called TIAs, where as symptoms that persist for longer periods are classified as strokes.
They are often the result of atherosclerosis in the arteries that supply blood to the brain, such as the carotid arteries. This is very serious. If you experience these symptoms, seek medical attention immediately. This is the brain's equivalent of a "heart attack," during which the brain is deprived of oxygen-carrying blood supply. Any delay in medical treatment may permanently damage your brain.
Anxiety Disorders
An anxiety disorder is an excessive or inappropriate response to stress that leaves you with feelings of apprehension, uncertainty and fear. It can paralyze you into inaction or withdrawal. An anxiety disorder isn't just a case of "nerves." According to the Anxiety Disorders Association of America (ADAA), an estimated 40 million Americans, or 18 percent of the population, experience this illness. It is the most common psychiatric condition in the U.S. and costs an estimated $42 billion per year.
Anxiety is expressed physically through a series of responses such as:
a rise in blood pressure
a fast heart rate
rapid breathing
an increase in muscle tension
a decrease in intestinal blood flow, sometimes resulting in nausea or diarrhea
Without treatment, an anxiety disorder can significantly disrupt your life because symptoms usually become progressively worse. Tormented by panic attacks, irrational thoughts and fears, compulsive behaviors or rituals, flashbacks, nightmares or countless frightening physical symptoms, people with anxiety disorders rely heavily on emergency departments and other medical services to address their symptoms.
Their work, family and social lives are disrupted, and some even become housebound. Many individuals who suffer from this disorder have other mental disorders such as depression or substance abuse.
Fortunately, treatment for anxiety disorders is, in general, very effective. Early diagnosis may aid early recovery, prevent the disorder from becoming worse and possibly prevent the disorder from developing into depression. Yet, because of a widespread lack of understanding and the stigma associated with anxiety disorders, only about one third of those who experience them are diagnosed and receive treatment.
In recent years, a number of different anxiety disorders have been categorized:
Generalized anxiety disorder (GAD), which affects about 6.8 million Americans (3.1 percent), and it affects twice as many women as men. GAD is characterized by at least six months of a more-or-less constant state of tension or worry not related to any event. If you suffer from GAD, you may always expect a catastrophe to happen. Though you may know your feelings are unrealistic, you cannot control them. The worries that accompany GAD are non-specific and are not as obsessive as the thoughts and worries experienced with obsessive-compulsive disorder. However, more than half the people who suffer from GAD also have another anxiety disorder or depression.
Panic attacks. While GAD is long-lasting and low-grade, panic attacks develop abruptly and generally reach a peak within 10 minutes. They develop without warning and are not necessarily related to any specific event. The word anxiety is derived from the Latin angere, which means to choke or strangle, and many women who suffer from panic attacks report the physical sensation of their throat tightening, cutting off their breath. This physical sensation can lead to additional anxious feelings.
Panic disorder, defined as repeated panic attacks or worry about such attacks, affects about six million Americans (2.7 percent). It typically strikes in young adulthood—before age 24 in roughly half of cases. Women are twice as likely as men to develop panic disorder. People with panic disorder may also suffer from depression; in addition, 30 percent of those with panic disorder abuse alcohol and 17 percent abuse drugs such as cocaine and marijuana. About one-third of people with panic disorder develop agoraphobia, an illness in which they become afraid of being in any place or situation where escape might be difficult or help unavailable if they have a panic attack. So they often won't leave their home.
Phobias are irrational, involuntary and include overwhelming fears that lead a person to avoid common objects, events or situations, or become excessively anxious as they approach them. While they vary in severity, in some cases the anxiety associated with the feared object or situation can be incapacitating. Most people who suffer from phobias are aware of the irrationality of their fear, and many avoid certain objects or situations or endure intense anxiety. Specific phobias are among the most common medical disorders.
There are three types of phobias: specific, social and agoraphobia. Specific phobias include fear of animals, heights (acrophobia), air travel (pterygophobia), water, confined spaces (claustrophobia), bridges or other things.
Social phobias, also known as Social Anxiety Disorder (SAD), is caused by a fear of being embarrassed in a social situation, or publicly scrutinized and humiliated. Social phobia is often accompanied by depression and may lead to alcohol or other drug abuse. About 6.8 percent of Americans or 15 million people, have social phobia. Social phobia is equally common among women and men. The disorder typically begins in childhood or early adolescence and rarely develops after age 25.
Agoraphobia is caused by a fear of having a panic attack in public. This fear is so great that it may lead a person to avoid public spaces. About one-third of people with panic disorder develop agoraphobia, which has been somewhat misleadingly described as fear of open spaces—the term having been derived from the Greek word agora, meaning marketplace.
Obsessive-compulsive disorder (OCD) is characterized by recurrent, persistent and intrusive thoughts, images or impulses that cause anxiety. These mental images or ideas are called obsessions. The person tries to control these obsessions or keep her fears from being realized by performing repetitive behaviors called compulsions.
The compulsions are often rigid and must be performed in a certain time-consuming order. Although adults with OCD know these rituals are excessive, they cannot stop doing them in spite of strenuous efforts to ignore or suppress the thoughts or actions. Repeated hand washing, re-ordering of belongings, re-checking objects in one's house, or silently repeating words, numbers or prayers are examples of compulsions. More than half of OCD sufferers have obsessive thoughts without ritualistic behavior. About one percent of the U.S. population, approximately 2.2 million Americans, has OCD. One third of adults affected with OCD had their first symptoms in childhood. OCD affects men and women with equal frequency.
OCD should not be confused with obsessive-compulsive personality, which defines certain character traits such as being a perfectionist, excessively conscientious, morally rigid and preoccupied with rules and order. These traits do not necessarily occur in people with OCD.
Post-traumatic stress disorder (PTSD) involves exposure to an extremely stressful event. About 3.5 percent of the population, or seven million people, suffer from PTSD. Trauma such as a rape, childhood sexual abuse, military combat or war-related incidents and natural disasters during which you experienced intense fear, helplessness and horror are common causes of PTSD. Rape is the most common trigger of PTSD—65 percent of men and 45.9 percent of women who are raped develop the disorder.
Although anxiety is a normal human response to stress, health care professionals and researchers don't know why some people have severe anxiety or panic in response to everyday situations. They do have several theories, however. Among the possible causes of anxiety disorders:
A biological tendency toward anxiety, including greater sensitivity to the effects of hormones released during anxiety, such as adrenaline; or an imbalance of certain substances called neurotransmitters (chemical messengers in the brain)
A chemical hypersensitivity that triggers a panic attack after exposure to caffeine
Genetic factors. About 20 to 25 percent of close relatives of people with panic disorder or obsessive-compulsive disorder experience these disorders themselves. Researchers have identified a gene associated with people with certain personality traits, such as anxiety, anger, hostility, impulsiveness, pessimism and depression; the gene produces reduced amounts of a protein that transports serotonin, an important neurotransmitter for maintaining positive emotions
Family background, such as an early childhood conflict or trauma, or "learned" fears or phobias
Stressful events and an exaggerated negative interpretation of them
Other illnesses or medications can cause symptoms of an anxiety disorder
While anxiety disorders can strike anyone of any age, gender or socioeconomic background, they most often begin in young adulthood. They often start mildly and progress, although GAD appears to be the most common form of anxiety in older ages. In addition, except for OCD, anxiety disorders strike women at twice the rate of men.
Anxiety is expressed physically through a series of responses such as:
a rise in blood pressure
a fast heart rate
rapid breathing
an increase in muscle tension
a decrease in intestinal blood flow, sometimes resulting in nausea or diarrhea
Without treatment, an anxiety disorder can significantly disrupt your life because symptoms usually become progressively worse. Tormented by panic attacks, irrational thoughts and fears, compulsive behaviors or rituals, flashbacks, nightmares or countless frightening physical symptoms, people with anxiety disorders rely heavily on emergency departments and other medical services to address their symptoms.
Their work, family and social lives are disrupted, and some even become housebound. Many individuals who suffer from this disorder have other mental disorders such as depression or substance abuse.
Fortunately, treatment for anxiety disorders is, in general, very effective. Early diagnosis may aid early recovery, prevent the disorder from becoming worse and possibly prevent the disorder from developing into depression. Yet, because of a widespread lack of understanding and the stigma associated with anxiety disorders, only about one third of those who experience them are diagnosed and receive treatment.
In recent years, a number of different anxiety disorders have been categorized:
Generalized anxiety disorder (GAD), which affects about 6.8 million Americans (3.1 percent), and it affects twice as many women as men. GAD is characterized by at least six months of a more-or-less constant state of tension or worry not related to any event. If you suffer from GAD, you may always expect a catastrophe to happen. Though you may know your feelings are unrealistic, you cannot control them. The worries that accompany GAD are non-specific and are not as obsessive as the thoughts and worries experienced with obsessive-compulsive disorder. However, more than half the people who suffer from GAD also have another anxiety disorder or depression.
Panic attacks. While GAD is long-lasting and low-grade, panic attacks develop abruptly and generally reach a peak within 10 minutes. They develop without warning and are not necessarily related to any specific event. The word anxiety is derived from the Latin angere, which means to choke or strangle, and many women who suffer from panic attacks report the physical sensation of their throat tightening, cutting off their breath. This physical sensation can lead to additional anxious feelings.
Panic disorder, defined as repeated panic attacks or worry about such attacks, affects about six million Americans (2.7 percent). It typically strikes in young adulthood—before age 24 in roughly half of cases. Women are twice as likely as men to develop panic disorder. People with panic disorder may also suffer from depression; in addition, 30 percent of those with panic disorder abuse alcohol and 17 percent abuse drugs such as cocaine and marijuana. About one-third of people with panic disorder develop agoraphobia, an illness in which they become afraid of being in any place or situation where escape might be difficult or help unavailable if they have a panic attack. So they often won't leave their home.
Phobias are irrational, involuntary and include overwhelming fears that lead a person to avoid common objects, events or situations, or become excessively anxious as they approach them. While they vary in severity, in some cases the anxiety associated with the feared object or situation can be incapacitating. Most people who suffer from phobias are aware of the irrationality of their fear, and many avoid certain objects or situations or endure intense anxiety. Specific phobias are among the most common medical disorders.
There are three types of phobias: specific, social and agoraphobia. Specific phobias include fear of animals, heights (acrophobia), air travel (pterygophobia), water, confined spaces (claustrophobia), bridges or other things.
Social phobias, also known as Social Anxiety Disorder (SAD), is caused by a fear of being embarrassed in a social situation, or publicly scrutinized and humiliated. Social phobia is often accompanied by depression and may lead to alcohol or other drug abuse. About 6.8 percent of Americans or 15 million people, have social phobia. Social phobia is equally common among women and men. The disorder typically begins in childhood or early adolescence and rarely develops after age 25.
Agoraphobia is caused by a fear of having a panic attack in public. This fear is so great that it may lead a person to avoid public spaces. About one-third of people with panic disorder develop agoraphobia, which has been somewhat misleadingly described as fear of open spaces—the term having been derived from the Greek word agora, meaning marketplace.
Obsessive-compulsive disorder (OCD) is characterized by recurrent, persistent and intrusive thoughts, images or impulses that cause anxiety. These mental images or ideas are called obsessions. The person tries to control these obsessions or keep her fears from being realized by performing repetitive behaviors called compulsions.
The compulsions are often rigid and must be performed in a certain time-consuming order. Although adults with OCD know these rituals are excessive, they cannot stop doing them in spite of strenuous efforts to ignore or suppress the thoughts or actions. Repeated hand washing, re-ordering of belongings, re-checking objects in one's house, or silently repeating words, numbers or prayers are examples of compulsions. More than half of OCD sufferers have obsessive thoughts without ritualistic behavior. About one percent of the U.S. population, approximately 2.2 million Americans, has OCD. One third of adults affected with OCD had their first symptoms in childhood. OCD affects men and women with equal frequency.
OCD should not be confused with obsessive-compulsive personality, which defines certain character traits such as being a perfectionist, excessively conscientious, morally rigid and preoccupied with rules and order. These traits do not necessarily occur in people with OCD.
Post-traumatic stress disorder (PTSD) involves exposure to an extremely stressful event. About 3.5 percent of the population, or seven million people, suffer from PTSD. Trauma such as a rape, childhood sexual abuse, military combat or war-related incidents and natural disasters during which you experienced intense fear, helplessness and horror are common causes of PTSD. Rape is the most common trigger of PTSD—65 percent of men and 45.9 percent of women who are raped develop the disorder.
Although anxiety is a normal human response to stress, health care professionals and researchers don't know why some people have severe anxiety or panic in response to everyday situations. They do have several theories, however. Among the possible causes of anxiety disorders:
A biological tendency toward anxiety, including greater sensitivity to the effects of hormones released during anxiety, such as adrenaline; or an imbalance of certain substances called neurotransmitters (chemical messengers in the brain)
A chemical hypersensitivity that triggers a panic attack after exposure to caffeine
Genetic factors. About 20 to 25 percent of close relatives of people with panic disorder or obsessive-compulsive disorder experience these disorders themselves. Researchers have identified a gene associated with people with certain personality traits, such as anxiety, anger, hostility, impulsiveness, pessimism and depression; the gene produces reduced amounts of a protein that transports serotonin, an important neurotransmitter for maintaining positive emotions
Family background, such as an early childhood conflict or trauma, or "learned" fears or phobias
Stressful events and an exaggerated negative interpretation of them
Other illnesses or medications can cause symptoms of an anxiety disorder
While anxiety disorders can strike anyone of any age, gender or socioeconomic background, they most often begin in young adulthood. They often start mildly and progress, although GAD appears to be the most common form of anxiety in older ages. In addition, except for OCD, anxiety disorders strike women at twice the rate of men.
Androgen
Androgens may be called "male hormones," but don't let the name fool you. Both men's and women's bodies produce androgens, just in differing amounts. In fact, androgens have more than 200 actions in women.
The principal androgens are testosterone and androstenedione. They are, of course, present in much higher levels in men and play an important role in male traits and reproductive activity. Other androgens include dihydrotestosterone (DHT), androstenedione, dehydroepiandrosterone (DHEA) and DHEA sulfate.
In a woman's body, one of the main purposes of androgens is to be converted into the female hormone estrogen.
In women, androgens are produced in the ovaries, adrenal glands and fat cells. In fact, women may produce too much or too little of these hormones -- disorders of androgen excess and deficiency affect an estimated 5 to 10 percent of women and are among the more common hormonal disorders in women.
In women, androgens play a key role in the hormonal cascade that kick starts puberty, stimulating hair growth in the pubic and underarm areas. Additionally, these hormones are believed to regulate the function of many organs, including the reproductive tract, bone, kidneys, liver and muscle. In adult women, androgens are necessary for estrogen synthesis and have been shown to play a key role in the prevention of bone loss as well as sexual desire and satisfaction. They also regulate body function before, during and after menopause.
According to "Medical Guidelines For Clinical Practice For the Diagnosis and Treatment of Hyperandrogenic Disorders," issued in 2001 by the American Association of Clinical Endocrinologists, excess amounts of androgens can pose a problem, resulting in such "virilizing effects" as acne, hirsutism (excess hair growth in "inappropriate" places, like the chin or upper lip) and thinning hair.
Many women with high levels of a form of testosterone called "free" testosterone have polycystic ovary syndrome (PCOS), characterized by irregular or absent menstrual periods, infertility, blood sugar disorders, and, in some cases, symptoms like acne and excess hair growth. Left untreated, high levels of androgens, regardless of whether a woman has PCOS or not, can lead to serious health consequences, such as insulin resistance and diabetes, high cholesterol, high blood pressure and heart disease.
In addition to PCOS, other causes of high androgen levels (called hyperandrogenism) include, congenital adrenal hyperplasia (a genetic disorder affecting the adrenal glands that afflicts about one in 14,000 women) and other adrenal abnormalities, and ovarian or adrenal tumors. Medications such as anabolic steroids can also cause hyperandrogenic symptoms.
Low androgen levels can be a problem as well, producing effects such as low libido (interest or desire in sex), fatigue, decreased sense of well being and increased susceptibility to bone disease. Because symptoms like flagging desire and general malaise have a variety of causes, androgen deficiency, like hyperandrogenism, often goes undiagnosed.
Low androgen levels may affect women at any age, but most commonly occur during the transition to menopause, or "perimenopause," a term used to describe the two years just prior to and just after the last menstrual flow when menopausal symptoms are most common. . Androgen levels begin dropping in a woman's twenties, however; by the time she reaches menopause, they have declined 50 percent or more from their peak as androgen production declines in the adrenal glands and the midcycle ovarian boost evaporates.
Combination estrogen/testosterone medications are available for women in both oral and injected formulations. Small studies find they are effective in boosting libido, energy and well being in women with androgen deficiencies, as well as providing added protection against bone loss. Current research continues on a testosterone-only patch for women to help with libido issues in women who have had their ovaries surgically removed. More research is needed to determine safe and effective dosages without side effects for women.
Testosterone is also an effective treatment for AIDS-related wasting, and is undergoing studies for treating premenstrual syndrome (PMS) and autoimmune diseases. Women with PMS may have below-normal levels of testosterone throughout the menstrual cycle, suggesting a supplement may help.
The principal androgens are testosterone and androstenedione. They are, of course, present in much higher levels in men and play an important role in male traits and reproductive activity. Other androgens include dihydrotestosterone (DHT), androstenedione, dehydroepiandrosterone (DHEA) and DHEA sulfate.
In a woman's body, one of the main purposes of androgens is to be converted into the female hormone estrogen.
In women, androgens are produced in the ovaries, adrenal glands and fat cells. In fact, women may produce too much or too little of these hormones -- disorders of androgen excess and deficiency affect an estimated 5 to 10 percent of women and are among the more common hormonal disorders in women.
In women, androgens play a key role in the hormonal cascade that kick starts puberty, stimulating hair growth in the pubic and underarm areas. Additionally, these hormones are believed to regulate the function of many organs, including the reproductive tract, bone, kidneys, liver and muscle. In adult women, androgens are necessary for estrogen synthesis and have been shown to play a key role in the prevention of bone loss as well as sexual desire and satisfaction. They also regulate body function before, during and after menopause.
According to "Medical Guidelines For Clinical Practice For the Diagnosis and Treatment of Hyperandrogenic Disorders," issued in 2001 by the American Association of Clinical Endocrinologists, excess amounts of androgens can pose a problem, resulting in such "virilizing effects" as acne, hirsutism (excess hair growth in "inappropriate" places, like the chin or upper lip) and thinning hair.
Many women with high levels of a form of testosterone called "free" testosterone have polycystic ovary syndrome (PCOS), characterized by irregular or absent menstrual periods, infertility, blood sugar disorders, and, in some cases, symptoms like acne and excess hair growth. Left untreated, high levels of androgens, regardless of whether a woman has PCOS or not, can lead to serious health consequences, such as insulin resistance and diabetes, high cholesterol, high blood pressure and heart disease.
In addition to PCOS, other causes of high androgen levels (called hyperandrogenism) include, congenital adrenal hyperplasia (a genetic disorder affecting the adrenal glands that afflicts about one in 14,000 women) and other adrenal abnormalities, and ovarian or adrenal tumors. Medications such as anabolic steroids can also cause hyperandrogenic symptoms.
Low androgen levels can be a problem as well, producing effects such as low libido (interest or desire in sex), fatigue, decreased sense of well being and increased susceptibility to bone disease. Because symptoms like flagging desire and general malaise have a variety of causes, androgen deficiency, like hyperandrogenism, often goes undiagnosed.
Low androgen levels may affect women at any age, but most commonly occur during the transition to menopause, or "perimenopause," a term used to describe the two years just prior to and just after the last menstrual flow when menopausal symptoms are most common. . Androgen levels begin dropping in a woman's twenties, however; by the time she reaches menopause, they have declined 50 percent or more from their peak as androgen production declines in the adrenal glands and the midcycle ovarian boost evaporates.
Combination estrogen/testosterone medications are available for women in both oral and injected formulations. Small studies find they are effective in boosting libido, energy and well being in women with androgen deficiencies, as well as providing added protection against bone loss. Current research continues on a testosterone-only patch for women to help with libido issues in women who have had their ovaries surgically removed. More research is needed to determine safe and effective dosages without side effects for women.
Testosterone is also an effective treatment for AIDS-related wasting, and is undergoing studies for treating premenstrual syndrome (PMS) and autoimmune diseases. Women with PMS may have below-normal levels of testosterone throughout the menstrual cycle, suggesting a supplement may help.
Allergies
It's hard to believe that items as unrelated as shellfish, pollen, animals, bee venom, peanuts and mold can all potentially lead to the same type of problem. What these substances have in common is that they are common allergens-they cause allergic reactions in some people.With so many substances potentially causing so many problems, it's no wonder allergic diseases are among the major causes of illness and disability in the U.S., and the sixth leading cause of chronic disease in the U.S. Allergies affect as many as 60 million Americans, or one in every five adults and children, and are as common in women as in men. Thirty-five million people suffer from upper respiratory symptoms that are allergic reactions to airborne pollen; up to 10 million Americans are allergic to cats; and two million develop severe allergic reactions to insect stings. Food allergies are less common; and while about one out of three people say they have a food allergy, only about three percent to eight percent of children younger than three years old, and one percent of adults have true allergic reactions to foods. Unfortunately, about 200 deaths per year are attributed to food allergies.An allergy is a reaction of a person's immune system to a normally harmless substance, one that doesn't cause problems for most people. In the allergic woman, the offending substance causes the immune system-which functions as the body's defense against invading agents such as bacteria and viruses-to respond to a "false alarm." Her immune system treats the allergen as an invader by generating large amounts of a type of antibody-a disease-fighting protein known as IgE-that attaches to the body's tissue and blood cells. The cells are then triggered to release powerful inflammatory chemicals like histamine, cytokines and leukotrienes. These chemicals act on tissues in various parts of the body, such as the respiratory system, and cause the symptoms of the allergy.Allergies can be more than just bothersome. While some allergies cause symptoms of rhinitis like sneezing, runny nose and watery eyes; skin irritations like itching and hives or eczema; or gastrointestinal distress; in some people, the allergic response can lead to anaphylaxis or anaphylactic shock-a sudden and sometimes deadly drop in blood pressure. Anaphylactic shock can potentially stop the heart or lead to complete closure of air passages, causing death by suffocation.Allergies that result in respiratory symptoms can be caused by pollens, molds and fungi, dust or dust mites, animals, medications, foods, latex and other substances. Food allergies, which can cause a wide variety of symptoms, are most commonly caused by shellfish and other fish, peanuts and other nuts, wheat, soy, dairy and eggs. Contact allergies, or allergic reactions caused by a person's skin coming in contact with a substance, are most usually caused by, nickel, polishes, rugs, fabric softeners, deodorants, cosmetics, perfumes, preservatives, dyes, and foam insulation. And don't forget plants like poison ivy, poison oak and sumac. There is a compound in these plants that can cause severe skin reactions in people who are allergic-up to 85 percent of Americans.Allergies have a genetic component. If one parent has allergies, chances are one in three that each child will have an allergy. If both parents have allergies, it is much more likely (seven in 10) that their children will have allergies. Adults usually do not lose their allergies, but children can sometimes outgrow them. In addition, while people are born with a genetic predisposition to allergies, sometimes they don't develop them until well into adulthood. Exactly what turns these genes on and when remains a bit of a mystery. Some researchers speculate that the more you are exposed to a potential allergen, the more antibodies to that allergen you can build up, until finally one day, they are released in an allergic reaction. Once you become "sensitized," you're going to get recurring symptoms every time you are exposed to the allergen.
Acupuncture
Acupuncture is an important component of Traditional Oriental Medicine (TOM) that involves the insertion of thin needles at specific points (acupoints), which are primarily located along meridians. The TOM theory of acupuncture is based in part on the premise that there are patterns of energy flow composed of Qi (pronounced chee) throughout the body. This energy flow is required for good health; blockages in Qi lead to pain and ill health. (All traditional oriental medicine practices are focused on improving the flow and balance of Qi.) Thus, according to TOM practitioners, the use of acupuncture stimulates certain points in the energy channels, restoring (or maintaining) a healthy flow and balance. TOM practitioners use acupuncture to treat and prevent a range of conditions and illnesses, even colds and flu. In the U.S., one of its most common uses is to relieve pain, but it is also used for a host of other conditions ranging from ear, nose and throat disease to neurological and respiratory problems and even depression. Acupuncture may be the only intervention used, or it may be used in conjunction with other Oriental therapies such as herbs, or with more conventional therapies.
Acupuncture as a therapeutic intervention is widely practiced in the United States. An estimated 15 million Americans have undergone acupuncture, and about five million undergo the treatment each year. People may find the procedure painless, although some points in some patients may be quite sensitive. Depending on your practitioner, the needles may be twirled or warmed.
There are many state acupuncture organizations, and many states also have acupuncture regulations and codes. Almost every state has a State Acupuncture Board, and there are more than 50 accredited schools of acupuncture in the U.S.
Widely practiced around the world, especially in Asia (the practice originated in China) and Europe, acupuncture didn't gain a notable following in the U.S. until the 1970s, after President Richard Nixon's visit to the People's Republic of China. James Reston, a member of the press corps accompanying Nixon, also piqued public interest when he wrote about how physicians in Beijing eased his post-surgery abdominal pain with needles. Acupuncture has been gaining popularity in the U.S. ever since.
The National Institutes of Health (NIH) has given a big boost to acupuncture, holding that it is safe and, for some conditions, proven effective. The NIH has funded a variety of research projects relating to the safety and effectiveness of acupuncture. (See the "Research" section of this report.) An NIH panel found that acupuncture can relieve nausea associated with chemotherapy, anesthesia or pregnancy and lessen the pain from dental surgery. There's also evidence supporting it as an effective way to treat headaches, menstrual cramps, tennis elbow, fibromyalgia, low back pain and arthritis. Acupuncture also may be used for carpal tunnel syndrome, asthma, addiction, myofascial pain and for rehabilitation following stroke. More recent evidence suggests that hypertension and certain cardiovascular diseases can be improved by treatment with acupuncture, according to a June 2000 workshop sponsored by the NIH on complementary and alternative medicine in cardiovascular, lung and blood research.
The World Health Organization (WHO), using different criteria, has recognized acupuncture as an appropriate treatment for more than 40 conditions, including certain digestive, respiratory, neurological, muscular, urinary, menstrual and reproductive disorders.
The way acupuncture is practiced here, for the most part, is different from how it is currently practiced in China. "Medical acupuncture" refers to acupuncture practiced by a Western physician. Physicians as well as non-physicians who are licensed to practice acupuncture (LACs) will often use a variety of styles of acupuncture. The most common style taught in American schools is called Traditional Chinese Medicine (TCM) acupuncture, but five element, auricular, and neuro-anatomical acupuncture are also widely used.
Scientists are finding it hard to reconcile the traditional explanation of how acupuncture works with standard Western medical models. Although several studies have documented acupuncture's efficacy and effectiveness, much remains to be learned about the mechanisms of action from a Western perspective.
Human and animal studies show that acupuncture can generate various biological responses-some close to the insertion point and others at a distance. It is well established that acupuncture stimulates the release of naturally occurring chemicals and hormones, especially endorphins. Endorphins can change the experience of pain, influence the body's self-regulating systems, and. promote physical and emotional well-being. Research has shown that several types of opioids may be released into the central nervous system during acupuncture treatment, thereby reducing pain.
Associated mechanisms are also at work:
Electromagnetic signals: Evidence suggests that acupuncture points are strategic conductors of electromagnetic signals. It is possible that electromagnetic signals can work outside of standard nerve conducted functions.
Brain blood flow: Studies indicate that acupuncture clearly affects blood flow to centers of the brain and the central nervous system related to sensation and involuntary body functions, such as immune reactions and the regulation of blood pressure, blood flow, oxygenation and body temperature. Specific activation of certain brain regions, including some of the pain perception centers (such as the limbic area and hypothalamus) can be demonstrated during the application of acupuncture.
Ultimately, scientists don't know exactly which mechanisms make acupuncture effective; more research is needed. It is often believed that to get the best results, treatments need to be individualized. That's one of many reasons acupuncture is more difficult to research than a standard pharmaceutical medication.
Acupuncture as a therapeutic intervention is widely practiced in the United States. An estimated 15 million Americans have undergone acupuncture, and about five million undergo the treatment each year. People may find the procedure painless, although some points in some patients may be quite sensitive. Depending on your practitioner, the needles may be twirled or warmed.
There are many state acupuncture organizations, and many states also have acupuncture regulations and codes. Almost every state has a State Acupuncture Board, and there are more than 50 accredited schools of acupuncture in the U.S.
Widely practiced around the world, especially in Asia (the practice originated in China) and Europe, acupuncture didn't gain a notable following in the U.S. until the 1970s, after President Richard Nixon's visit to the People's Republic of China. James Reston, a member of the press corps accompanying Nixon, also piqued public interest when he wrote about how physicians in Beijing eased his post-surgery abdominal pain with needles. Acupuncture has been gaining popularity in the U.S. ever since.
The National Institutes of Health (NIH) has given a big boost to acupuncture, holding that it is safe and, for some conditions, proven effective. The NIH has funded a variety of research projects relating to the safety and effectiveness of acupuncture. (See the "Research" section of this report.) An NIH panel found that acupuncture can relieve nausea associated with chemotherapy, anesthesia or pregnancy and lessen the pain from dental surgery. There's also evidence supporting it as an effective way to treat headaches, menstrual cramps, tennis elbow, fibromyalgia, low back pain and arthritis. Acupuncture also may be used for carpal tunnel syndrome, asthma, addiction, myofascial pain and for rehabilitation following stroke. More recent evidence suggests that hypertension and certain cardiovascular diseases can be improved by treatment with acupuncture, according to a June 2000 workshop sponsored by the NIH on complementary and alternative medicine in cardiovascular, lung and blood research.
The World Health Organization (WHO), using different criteria, has recognized acupuncture as an appropriate treatment for more than 40 conditions, including certain digestive, respiratory, neurological, muscular, urinary, menstrual and reproductive disorders.
The way acupuncture is practiced here, for the most part, is different from how it is currently practiced in China. "Medical acupuncture" refers to acupuncture practiced by a Western physician. Physicians as well as non-physicians who are licensed to practice acupuncture (LACs) will often use a variety of styles of acupuncture. The most common style taught in American schools is called Traditional Chinese Medicine (TCM) acupuncture, but five element, auricular, and neuro-anatomical acupuncture are also widely used.
Scientists are finding it hard to reconcile the traditional explanation of how acupuncture works with standard Western medical models. Although several studies have documented acupuncture's efficacy and effectiveness, much remains to be learned about the mechanisms of action from a Western perspective.
Human and animal studies show that acupuncture can generate various biological responses-some close to the insertion point and others at a distance. It is well established that acupuncture stimulates the release of naturally occurring chemicals and hormones, especially endorphins. Endorphins can change the experience of pain, influence the body's self-regulating systems, and. promote physical and emotional well-being. Research has shown that several types of opioids may be released into the central nervous system during acupuncture treatment, thereby reducing pain.
Associated mechanisms are also at work:
Electromagnetic signals: Evidence suggests that acupuncture points are strategic conductors of electromagnetic signals. It is possible that electromagnetic signals can work outside of standard nerve conducted functions.
Brain blood flow: Studies indicate that acupuncture clearly affects blood flow to centers of the brain and the central nervous system related to sensation and involuntary body functions, such as immune reactions and the regulation of blood pressure, blood flow, oxygenation and body temperature. Specific activation of certain brain regions, including some of the pain perception centers (such as the limbic area and hypothalamus) can be demonstrated during the application of acupuncture.
Ultimately, scientists don't know exactly which mechanisms make acupuncture effective; more research is needed. It is often believed that to get the best results, treatments need to be individualized. That's one of many reasons acupuncture is more difficult to research than a standard pharmaceutical medication.
Abortion Ab
Expulsion from the uterus of an embryo or fetus before viability (20 weeks' gestation [18 weeks after fertilization] or fetal weight less than 500 g). A distinction made between abortion and premature birth is that premature infants are those born after the stage of viability but before 37 weeks' gestation. Abortion may be either spontaneous (occurring from natural causes) or induced (artificially or therapeutically).
The arrest of any action or process before its normal completion.
The arrest of any action or process before its normal completion.
23 Ocak 2008 Çarşamba
Infant fever
Fevers are fact of life for most children. In most cases they are nothing to worry about, but it is important to monitor the symptoms closely and to seek medical advice if they persist.
What is a fever?
Fever has been defined as a body temperature elevated to at least 1F above the 'normal' of 98.6F (37.0C).
A baby's temperature normally varies by as much as 2F, depending on the temperature of his surroundings, clothing worn, degree of stress, level of activity or time of day.
What prompts a fever?
In most cases a fever is the body's reaction to an acute viral or bacterial infection. Raising the temperature helps create an inhospitable environment for viral or bacterial invaders, it also stimulates the production of disease-fighting white blood cells.
Why are babies prone to fevers?
The body's temperature control system is not well developed in babies.
Infant and childhood fevers can be caused by a number of different factors including:
Overexertion
Dehydration
Mosquito bites
Bee stings
Allergic reactions
Viral or bacteria infections
What are the symptoms?
Typical symptoms of a fever include coughing, aches or pains, an inability to sleep and shivering.
Other symptoms include poor appetite, lethargy and prolonged irritability.
In some cases breathing may be difficult.
What are the treatments?
Dehydration is a risk for infants, and a feverish baby should always be given lots of fluids.
A child with a temperature of less than 102F (38.8C) does not always require immediate medical attention. The child should be observed, and help sought if the symptoms appear to get worse, or the fever does not subside within 24 hours.
A child with a temperature of 102F or higher should be given paracetamol. A doctor or pharmacist should be consulted for a recommended dose.
A doctor's advice should always be sought for a child whose temperature is 104F (40C) or higher.
Children should not be given aspirin. Several studies link aspirin use in children with Reye's Syndrome a severe illness that often is fatal.
Are there danger signs?
Certain symptoms, when combined with a fever, warrant an immediate call to the doctor. These include:
Red spots on the skin, sensitive eyes and runny nose (measles)
Red, itchy spots (chicken pox)
Stiffness in the neck or headache (a sign of a more severe infection)
Febrile seizures
Occasionally, a child with a fever will have a seizure. This is called a febrile seizure, and it demands immediate attention from a doctor.
The seizures do not seem to be related to the height of the fever, or to the rapidity with which it rises, but a small number of children seem to be predisposed to attacks.
About 50% of the children who suffer one febrile seizure will go on to have another one. About 33% will have a third one.
While waiting for a doctor to arrive, it is important to follow basic instructions:
Keep the child upright and make sure they are breathing well
Stay with the child and talk reassuringly
Watch for changes in breathing, and make sure that the airways are kept open
Clear the area to prevent injury
Do not restrain as this can cause additional injury
Try placing a soft pillow or blanket under the child's head
Loosen clothing to prevent injury and ease discomfort
If vomiting occurs, turn the head to the side so there is no risk of his choking on inhaled vomit
What is a fever?
Fever has been defined as a body temperature elevated to at least 1F above the 'normal' of 98.6F (37.0C).
A baby's temperature normally varies by as much as 2F, depending on the temperature of his surroundings, clothing worn, degree of stress, level of activity or time of day.
What prompts a fever?
In most cases a fever is the body's reaction to an acute viral or bacterial infection. Raising the temperature helps create an inhospitable environment for viral or bacterial invaders, it also stimulates the production of disease-fighting white blood cells.
Why are babies prone to fevers?
The body's temperature control system is not well developed in babies.
Infant and childhood fevers can be caused by a number of different factors including:
Overexertion
Dehydration
Mosquito bites
Bee stings
Allergic reactions
Viral or bacteria infections
What are the symptoms?
Typical symptoms of a fever include coughing, aches or pains, an inability to sleep and shivering.
Other symptoms include poor appetite, lethargy and prolonged irritability.
In some cases breathing may be difficult.
What are the treatments?
Dehydration is a risk for infants, and a feverish baby should always be given lots of fluids.
A child with a temperature of less than 102F (38.8C) does not always require immediate medical attention. The child should be observed, and help sought if the symptoms appear to get worse, or the fever does not subside within 24 hours.
A child with a temperature of 102F or higher should be given paracetamol. A doctor or pharmacist should be consulted for a recommended dose.
A doctor's advice should always be sought for a child whose temperature is 104F (40C) or higher.
Children should not be given aspirin. Several studies link aspirin use in children with Reye's Syndrome a severe illness that often is fatal.
Are there danger signs?
Certain symptoms, when combined with a fever, warrant an immediate call to the doctor. These include:
Red spots on the skin, sensitive eyes and runny nose (measles)
Red, itchy spots (chicken pox)
Stiffness in the neck or headache (a sign of a more severe infection)
Febrile seizures
Occasionally, a child with a fever will have a seizure. This is called a febrile seizure, and it demands immediate attention from a doctor.
The seizures do not seem to be related to the height of the fever, or to the rapidity with which it rises, but a small number of children seem to be predisposed to attacks.
About 50% of the children who suffer one febrile seizure will go on to have another one. About 33% will have a third one.
While waiting for a doctor to arrive, it is important to follow basic instructions:
Keep the child upright and make sure they are breathing well
Stay with the child and talk reassuringly
Watch for changes in breathing, and make sure that the airways are kept open
Clear the area to prevent injury
Do not restrain as this can cause additional injury
Try placing a soft pillow or blanket under the child's head
Loosen clothing to prevent injury and ease discomfort
If vomiting occurs, turn the head to the side so there is no risk of his choking on inhaled vomit
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