Some medical societies are calling into question the annual pelvic exam, at least for those women who have no symptoms and are not pregnant. As you might expect, this topic is being hotly debated.
Those in favor of annual screening pelvic exams argue that sometimes there are abnormalities found in women who have no symptoms. Those opposed to the yearly exam counter that the pelvic exam is not helpful in detecting ovarian cancer or bacterial vaginosis, and was not associated with improved health outcomes or reduction of ovarian cancer mortality rates. They further point out that women can now screen themselves for the common sexually transmitted infections like chlamydia and gonorrhea in the privacy of their own homes.
Harms of testing included false positives, unnecessary surgical procedures, fear, anxiety, embarrassment, pain, and discomfort – particularly for women with a history of sexual violence and/or post-traumatic stress disorder.
Pelvic exams should be tailored to what is in the best interest of each individual woman. Most women do not need a pelvic exam every year but should be sure to see a healthcare provider if they have a new problem or concern. It is important to remember that screening for cervical cancer (with a pap smear, cervical cytology or high risk human papilloma virus test) is still recommended. That is a separate and important issue. The timing interval for cervical cancer screening depends on your age and the findings on your last pap smear.
Diet and exercise can keep prediabetes from turning into diabetes, but it also does much more for women. It also prevents heart disease and reduces deaths. These were findings of a very long (23 years!) study in Da Qing, China, of people who had prediabetes. A group of them went through a 6-year program of diet and exercise. For those who were overweight or obese, the diet was designed for weight loss, and those who were normal weight just reduced their simple carb and alcohol consumption. In the group that went through the program, only 73% had diabetes develop compared with 90% of those who just had standard medical care. The rates of diabetic eye disease were also significantly lower in those who participated in the intensive lifestyle change program. In addition, the number of deaths from heart disease and deaths overall were also lower—for women. After menopause, women with prediabetes are more prone to developing type 2 diabetes, but this study shows that women can stave it off and reap huge benefits as a result. Not only will they stave off diabetes but also heart disease, eye disease, and other killers. Women around the world can take advantage of this good news!
It may not be menopause that’s making you bark at your spouse. You may be getting angry just because you’re hungry. Researchers at Ohio State University measured couples’ blood sugar in the morning and at night and found low nighttime levels predicted who would lash out at a spouse that evening. Measuring just how angry took a creative approach. All the participants got a voodoo doll representing their spouse and 51 pins and were told to stick in pins each night in a way that showed their level of anger. The researchers found that the number of pins tracked with the blood sugar levels. In addition, with low blood sugar, the participants were also more likely to blast their spouse with loud sounds when they beat them at a competitive game. Eating something sweet can raise blood sugar quickly, so a little desert after dinner may not be a bad thing. But if that shot of sugar calms you down, avoid the blood sugar highs and lows by eating small, healthy snacks through the day, and keep fruit on hand, which can raise your blood sugar and give you some healthy fiber as well.
If you’re heading toward menopause and you have more bleeding than usual, you are not alone. Women often worry when that happens because they have heard that menstrual periods become less frequent and lighter during perimenopause. Some periods do, some don’t. The Study of Women’s Health Across the Nation (SWAN), that included 1,200 women ages 42 to 52, found that over the course of three years, 91% of the women had as many as three periods that lasted 10 days or more, and 78% had three or more days of heavy flow. This news can be reassuring, but it doesn’t mean you should keep quiet about noticeable bleeding changes, especially if you are overweight. Overweight women have a higher risk of uterine cancer (called endometrial cancer), and frequent or heavy bleeding can be a sign of cancer for any woman. Note also that the study said 3 long periods occurring over 3 years. If a woman is experiencing heavier and/or longer periods every month or bleeding frequently throughout the month, that should also be reported to your healthcare provider sooner rather than later.
A handful of nuts is a convenient snack -- here’s how to make the best of it by choosing the best types of nuts and the healthiest ways to eat them!
Just the Facts Most varieties of nuts are high in unsaturated fats, omega-3 fatty acids, fiber, vitamin E, plant sterols, and L-arginine. They’re also high in fat and calories (lowest in calories are almonds, cashews, pistachios, while highest in calories are macademia nuts and pecans). Almonds are the nuts highest in calcium.
For Heart Health Studies including the Adventist Study, the Iowa Women’s Health Study, the Nurses’ Health Study, and the Physicians’ Health Study have shown a consistent 30% to 50% lower risk of myocardial infarction, sudden cardiac death, and cardiovascular disease associated with eating nuts several times per week.
The best nuts for your heart are walnuts. They contain high amounts of alpha linoleic acid, which has been found to be as effective as olive oil in reducing inflammation and oxidation after a fatty meal, per a 2006 Spanish study. Eating nuts has also been shown to lower the low-density lipoprotein (LDL, or “bad”) cholesterol level in the blood and improve the health of the lining of your arteries.
Snacking Ideas Eat them raw or dry, not packaged or roasted in oil (nutrients can be destroyed by high roasting temperatures and oil used may be the unhealthy hydrogenated variety or high in omega-6 unhealthy fats.
Because of their high calorie content, you should use nuts as a substitute for saturated fats such as those in meats, eggs, and dairy. A serving is a small handful or 2 tablespoons of nut butter. And remember, you’ll cancel out the benefit of nuts if they’re covered with chocolate, sugar, or salt. Try snacking on them instead of chips -- or throw them on a salad for a little crunchiness.
The Peanut Addendum Peanuts are actually legumes, not nuts. But they are healthy in their own right -- high in folate, which is essential for brain development and may protect against cognitive decline.
So don’t forget to make this healthy food group part of your diet. That’d be nuts.
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JoAnn V. Pinkerton, MD, NCMP