HPV Vaccine can eliminate cervical cancer as a public health issue

HPV Prevention Protect your children, yourself & your partner

October 1-7, 2018 marked the second annual HPV (Human Papilloma Virus) Prevention Week in Canada. As Chair of this educational week, initiated by the Federation of Medical Women of Canada, we focused on the need for both education and awareness of this common virus and how we can prevent the cancers associated with persistence. What does that mean practically? Well, 75-80% of adults in North America will be exposed to HPV at some point in their life. Most of us clear the virus, the way we clear a common cold. But persistence of the virus has now been linked to 6 different cancers in men and women. The most common one is cervical cancer where HPV now accounts for more than 99% of cancers. And oral cancers (think of the Michael Douglas story) are rapidly increasing in men.

The good news?

We have a fabulous vaccine, now offered to all boys and girls in the school system throughout Canada, in every province and territory. However, we do not have 100% uptake of the vaccine. Some of our young people may not be protected.

And what about older men and women? Our national guideline says there is no upper age limit for use of the vaccine. If you are likely going to be exposed, a new partner for example, you should talk to your doctor about immunization.

How do we know vaccination is really worth it? Australia is the leading country in the world with respect to this vaccine. When they announced vaccination in the school system more than 10 years ago, their uptake was very high. And they started immunizing boys as well in their school system soon after girls. The result: they just announced that by 2028, they will be the first country in the world to have eliminated cervical cancer as a public health issue, with less than 4 cases per 100,000. And by 2066, they project less than 1 case per 100,000.

Eliminating cancer by vaccination against the virus responsible.
That is what this is all about. That is why we held a week of education. That is why we want to be the second country in the world to eliminate cervical cancer. That is why you should protect your kids, protect yourself, protect your partner. That is why you should talk to your doctor!

Disclaimer

The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

Healthy Aging: The NON-DIET SOLUTION

One of the areas that truly impacts aging is weight. Having a reasonable body mass index is a marker for predicting how well one will do in the next 10 years. And we know that summertime – a time of barbecues, drinking, sharing meals with friends and family and vacations – is an easy time to overindulge.

Dieting is defined as restricting oneself to small amounts of food, in order to lose weight. An estimated 45-million Americans spend $33 billion a year trying to lose those extra pounds. Yet, as many of us have experienced, the weight will almost inevitably come back and the whole cycle of food deprivation will begin again.

So the question is: if diets don’t always work, what does? The answer is to turn to a more balanced, realistic approach to losing weight and maintaining good health with nourishing foods, daily physical activity, positive thinking and smart lifestyle choices.

The not dieting trend was confirmed in a 2013 study produced by the NPD Group, an American research organization, which found that people were dieting less and that women were showing the biggest decline in dieting. According to the report, “In the past 10 years, the percentage of women on a diet has dropped by about 10 points. In 1992, 34 per cent of women told NPD they were on a diet; and in 2012, 23 per cent of women reported being on a diet.”

Contrast this with the fact that 57 per cent of adults said that they would like to lose 20 pounds and almost half said they need to change their diet to improve their health.

According to the NPD report:

• 55 per cent said eating healthy includes adding to, and taking out of, their diet;

• 25 per cent said “adding something to the diet” is healthy;

• 19 per cent said “taking something out” of the diet is healthy;

• 72 per cent said they eat reduced-fat foods;

• nearly 45 per cent eat foods with whole grains on a regular basis; and

• 24 per cent include organic foods and beverages in their diet.

Notice that there is no mention of restricting foods as a way to lose weight. So instead of dieting by depriving yourself of food, which usually is a joyless endeavour, try practicing the 80/20 rule: 80 per cent of the time, focus on eating clean, healthy foods; and 20 per cent of the time, you have the freedom to indulge as you please. This means that you don’t have to cut out all treats, you just have to be smart about it 80 per cent of the time.

READ: LESSONS FROM OUR MOTHERS

Research into the impact of diet and brain health confirmed this proposal. Researchers looking at the effects of the MIND diet – which basically entails eating lots of fruits, vegetables, nuts, seeds, some low-fat proteins and either grapes or a glass of wine per day – confirmed that even if you follow this diet most of the time, but not all of the time, it has a significant impact on brain health.

And that makes good sense. None of us can be perfect all the time. But we can make the effort to eat healthy, live healthy and make healthy choices 80 per cent of the time. 

Disclaimer

The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

Sex & Menopause Why Bother?

Menopause is a process, not an event. Menopause is not a disease, does not always need treatment, and does not get “cured.” Rather it is a time of transition, with lots of changes in a woman’s body, not unlike the changes we understand as normal during puberty. It begins with a decline in estrogen production that ultimately results in cessation of ovulation, but a woman’s last period is by no means the end of the process. There are many adjustments that continue over time

A very, very common experience of menopausal and post-menopausal women is a major change in their libido, which, like other symptoms of menopause, results from the lack of estrogen. Women often tell me they have less interest in sex, they don’t feel the same,  don’t function the same, and they may think, “It’s all over for me.”

I think it is very important when you look at something like the Masters and Johnson model of sexual function, which envisions a start, a peak, and a finish to sexual activity, that you realize that process may be true in younger women and it may be true in men, but it is not true in menopausal women. Interestingly, a Vancouver-based researcher named Rosemary Basson proposed a different reality, one that has become well accepted in the medical community. Based on her research, first published in 2001, she has created a schematic diagram illustrating sexual function in women as they age, and that diagram portrays sexual experience not as a line with a start and a finish but rather as a circle.

Her research shows that, with menopause, women often lose interest in initiating sexual activity; however, if they are intimate, if they are close with their partner and the partner begins sexual activity, they can derive pleasure from it. I think her model is much more accurate regarding how women function because I know that a lot of the women in my practice feel this way. But many women, because they have lost interest in initiating sexual activity, and because the idea of sex doesn’t have the same appeal, often say, “No way. Why bother?”

It’s Not Just You

When I talk to women in my practice about sexual issues they often respond with a huge sigh of relief. Women tend to think it’s a completely personal problem; they think it is just about them or about their partner or their relationship. So, it is extremely reassuring for them to learn about Basson’s research. They say things like, “Oh! You mean it’s not just me?” And they begin to see possibilities for maintaining and deepening their relationship, possibilities they thought no longer existed for them. And so I do encourage women to maintain intimacy, to maintain closeness, and to allow themselves to continue to be involved sexually with their partner, because generally once they start and once they get involved they can go through that circle and to derive pleasure from the activity itself and satisfaction from the ongoing intimacy.

One menopausal symptom that does not go away with time is the genitourinary syndrome of menopause. That term may sound off-putting, but it is more medically accurate—and perhaps less alarming—than the name that was previously used: vaginal atrophy. So, what is it? Because of lack of estrogen the vagina gets dryer and the back wall of the bladder loses its estrogen support. This results in vaginal symptoms like dryness, burning, and itching; it also causes bladder symptoms such as loss of control and results in an increased risk of bladder infections.

Don’t get me wrong: estrogen is not a panacea; it does not solve everything. Adding back estrogen does not necessarily replace lost interest or replace the physiological response so that it is the same as when you were 30. But adding back estrogen can lubricate and make you more comfortable, and for many women, it is discomfort that convinces them they are past the time when sex can be good, can be enjoyable for them.

In Chapter 5 of my book, A Woman’s Guide to Healthy Aging- 7 Proven Ways to Keep You Vibrant, Happy & Strong, I go into a great deal of detail about hormone treatments and various options.

Disclaimer

The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or healthcare provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

 

Optimal Aging Means Good Brain Health, Especially for Women

Optimal Aging Means Good Brain Health, Especially For Women

Women’s Brain Health Initiative

WBHI Logo

Women’s Brain Health & Why Grey Matter Now Matters

Women suffer from depression, stroke and dementia twice as much as men and an astounding 70% of new Alzheimer’s patients will be women. Yet research still focuses on men. We want to correct this research bias.

Women’s Brain Health Initiative creates education programs and funds research to combat
brain-aging diseases that affect women.

Thanks in large part to the work of the Women’s Brain Health Initiative (WBHI), science is now paying a lot of attention to women’s brain health. WBHI is a partner of the
Canadian Consortium on Neurodegeneration and Aging, which is an umbrella group that oversees all the brain research that is happening in Canada. Because of its significant funding clout, WBHI has been able to ensure that every participant group—in all brain research undertaken in Canada—includes enough women to matter. What do I mean by “enough women to matter”? I mean that there have to be enough women in each study to be statistically significant, so the research conclusions of the study apply to women, not just to men.

WBHI has been able to make sex & gender part of core research in Canada

And it is not that women are a priority only in the research today that is being done today. Governments come and go, and researchers’ interests shift, and those changes can also alter research priorities. But WBHI has been able to make sex and gender—and therefore women—part of the core value of all the brain research that is going on. And core values are impervious to the fickle winds of change. We may not know today why more women than men suffer from Alzheimer’s, but because of the inclusion of women as a core value in research we will know at some point in the future.

In fact, there is a lot of research going on now to discover ways to identify cognitive decline earlier in women. This includes research on issues around Alzheimer’s disease, which is now being recognized as “a woman’s disease” because so many more women than men suffer from it, as mentioned above. Drug development is another important area of research because the drugs we currently have for treating brain problems may not work as effectively in women as they do in men.

Lifestyle Choices Can Affect Brain Health

The current research also includes a focus on lifestyles choices. We know some of the things that can contribute to cognitive difficulties in old age, and many of them are things we can control. For instance, we know we can alter smoking, diet, exercise, stress, blood pressure, and blood sugar levels—all of which can have a big impact on cognitive health, or to put it another way, on cognitive decline. As with any research, there is always the possibility of unexpected results. For instance, one study showed that the most important decade of life to impact brain health through exercise is your 20s. That’s right, exercise in your 20s makes the biggest difference to your brain 50 years later! So, realistically, you are never too young to start thinking about your brain and how to keep it healthy.

WBHI Celebrates 5 years 

I have been fortunate to be a member on the board of the directors of the Women’s Brain Health Initiative founded by Lynn Posluns five years ago.  The  www.wbhi.org website has the most comprehensive information on women and brain health including research, events and healthy aging tips plus ways to get involved.  I urge you to take a few moments and visit their site.

On May 10, WBHI will be celebrating its 5th Anniversary and honouring the individuals, including myself as a Catalyst who have been involved in helping make Women’s Brains Matter.  6pm-9 pm at the Gardiner Museum. Tickets for $60 can be purchased on the WBHI site under events. 

Disclaimer

The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

Boning Up on Bone Health for Healthy Aging

Why Bone Health is Important for Healthy Aging

What do we need to ensure we all age well and do so in a healthy vibrant way?
How can we be the architects of our future, not the victims. Aging and wellness are popular topics in magazine and talk shows, but we need to be clear about what is evidence based as opposed to trendy, what has true merit, rather than anecdotal stories.

The number one event that is common to both men and women over the age of 50 is the risk and the likelihood of fracture. Slipping and falling is very, very common, but not everyone fractures. Some people will bounce and NOT break. What is the secret? How can we have strong robust bones?

Essential Vitamins

Well, bone health starts for us all when we are young. We need calcium and Vitamin D. No, I don’t work for the Milk Marketing Board of Canada, but in truth, they ae quite right. Calcium is essential and is absorbed by the body from milk, cheese and yogurt, much more efficiently than from tablets. For people over the age of 50, Osteoporosis Canada, out guideline body says we need 1200 mg per day. That is 3-4 servings of dairy. Yes, we can get some calcium from broccoli and from almonds and salmon, etc., but dairy products pack the biggest punch. Vitamin D is from the sun. See any of that lately? Even in the summer, when we do see sun, the sunblock we use to prevent skin cancer, blocks out the vitamin D absorption, so we need 1000-2000iu (international units) as adults over 50.

Our children should be having milk and calcium containing products and vitamin D. And you know our grandmothers and great-grandmothers fed us cod liver oil! They were right.

What does this mean. Our bones will be stronger and more able to stand the expected slow loss of bone with age.

What Bone Density Tests Tell You

By age 65 everyone, men and women need a bone density test. This tells us how much bone we have, the quantity of bone. It does not tell us, the quality of that bone. Bone quality is not as easily measured but we do know any fracture past age 40 should be evaluated to determine if it was a fragility fracture or a traumatic fracture. If you are hit by a truck, any fracture is traumatic. If you step of the curb, a fall from your standing height or 1-3 steps higher, that is generally a fragility fracture. And a fragility fracture is a predictor of weak bones, risk of hip fractures. A fracture is the event that warns us that our bone quality is not ideal.

Evaluate Your Risk

It is reasonable to evaluate your risk, whether you have fractured since age 40, whether your parent had a hip fracture, what drugs you may be on that can have an effect on bone, what underlying diseases, such as rheumatoid arthritis that may impact bone health. By focusing on bone health, you may be doing great, or you may need some intervention, but the goal remains the same for you and your doctor:  maintain your activity, independence and ability to age in a healthy way for years to come.

Disclaimer

The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

Get Cooking to Manage Your Weight

If you are like many busy modern women, you probably have the local pizza place on your speed dial. But delivery pizza—or even frozen pizza—is high in fat and sodium and often lacks fibre. You can make a healthier, portion-controlled version quickly and easily. I call it the Pita Pizza. Use a 6-inch whole-grain pita as your crust, add a low-sodium pizza sauce, lightly sprinkle on some low-fat mozzarella, and top it with your favourite veggies. Pop it in the oven or toaster until the cheese melts, and you’re done—in way less time than it takes for a delivery! And you can save even more time by buying pre-cut, washed veggies. You can control the portion by eating only one, and you can control the fat by limiting the amount of cheese and using more veggies.

This is just one example of how you can make healthier versions of your favourite take-out or restaurant choices at home. If you are looking for resources on healthy meal planning, you might consider cookbooks by Lucy Waverman, Bonnie Stern, and Rose Reisman.

Disclaimer
The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

 

Alcohol Consumption-How much is OK?

How Much Alcohol Consumption is OK?

The reality for alcohol consumption and women is significant. Any more than 7-9 drinks per week for women can lead to breast cancer. I am not an abolitionist.  I do advocate drinking moderately. There is some evidence that moderate drinkers and those who drink just a little have a somewhat lower risk of heart disease and stroke than those that do not drink at all or who drink excessively.  And some of the newer data is looking at whether any amount is a risk.

Here is my take on the current guidelines.

So, what exactly is moderate drinking?

The Heart and Stroke Foundation defines moderate drinking for women as two drinks a day most days to a weekly maximum of ten; for men, its three drinks a day to a weekly maximum of 15.I have to smile when some of my patients try to demonstrate that they drink only moderately by saying they and their husband split a bottle of wine at dinner every evening. I smile only because few people really understand the word ‘moderate’ as it applies to alcohol.Half a bottle of wine is not quite within the bounds of ‘moderate.’ It’s actually two and a half glasses of wine, not two glasses!

The extra half glass of wine can add up.  In fact, it might be wise to limit your consumption of alcohol to considerably below the weekly maximum of 10 drinks.

As I said, I am not an abolitionist, but I will ask you to be careful with your alcohol consumption. Review what you are actually doing when you drink, tally how much you drink in a week—including the weekend bar-b-que and girls’ night out-and please make sure that your glass is not keg-sized. A serving of wine, for example is considered to be 4 ounces, not 6 or 9!

I know for me, I would rather have one or two servings when out for dinner, and that’s OK, as I generally am out for dinner once or twice a week, not nightly. So as we approach the holidays and parties, plan ahead, consider having a spritzer with only 2 ounces of wine, or having most nights with none, so you can have 2drinks at that party and enjoy.

Disclaimer

The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

Obesity 2x higher than in 1981

Obesity rates for both men and women are about twice as high today as they were in 1981. In Canada, approximately 25 percent of adults are obese. Along with its growing prevalence, obesity is also becoming more severe, and the research shows that overall fitness levels are decreasing as the incidence of obesity rises. If we include statistics on overweight along with statistics on obesity we find that 67 percent of Canadian men and 54 percent of Canadian women aged 18 to 79 are overweight or obese, according to results from the Canadian Health Measures Survey (2009-2011).

A study published in the New England Journal of Medicine looked at obesity among American adults and found that obesity rates increased by approximately 50 percent through the 1980s and 1990s after having been relatively stable in the 1960s and 1970s. That was likely the start of it all. An article in the Journal of the American Medical Association (April 4, 2016) found that age-adjusted death rates in 2015 increased significantly from the year before; causes of death related to obesity were a major factor in the increase.

Life Expectancy Decreases

The same article points out that life expectancy in the U.S. increased consistently between 1961 and 1983, but between 1983 and 1999 life expectancy decreased for men and for women in U.S. counties where obesity was prevalent. The article states that “in addition to the health-related effects, the economic effects of obesity-related disease are substantial and predicted to worsen.” So, yes; I think we can conclude that there really is an obesity epidemic. And not just in the U.S.

But what exactly do we mean by obesity? Obesity refers to excessive weight for your height and body frame, based on Body Mass Index (BMI) guidelines. (You can use the BMI chart in the Appendix to calculate your own BMI.) This is a useful tool, but it has its drawbacks. For instance, it is based on the ratio of a person’s weight in kilograms divided by their height in meters squared, but it does not take into account how much of their weight comes from fat and how much from muscle. Because muscle weighs more than fat, people who are muscular may have a higher BMI and still be in excellent health.

If we don’t know the fat/muscle breakdown, another—and perhaps even more useful—way to measure obesity is to look at waist circumference. For women, a healthy waist circumference should be no more than 90 centimeters (35 inches). Healthy waist size varies, of course, based on a number of factors, including a woman’s height and bone structure, and even ethnicity: as a rule, for Asian women it should be no more than 80 centimeters (31.5 inches).

Waist circumference is a helpful health indicator because it correlates more closely with a number of health risks than either weight or BMI alone. And it turns out that the old apple or pear comparison is accurate. If we look at two women who are the same height and who are equally overweight, and one carries most of the excess weight in her hip area while the other carries it mostly in her protruding belly, we find that the second woman is more at risk than the first not only for heart disease but also for diabetes and other metabolic conditions.

Disclaimer

The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.