Every year there are 400,000 Canadian women who receive news that their Pap test results are not normal. The voice of women physicians, The Federation of Medical Women of Canada ( wants to change that. This month they are launching an awareness campaign aimed at physicians to urge their female patients to have a PAP test. #endcancer
Cervical cancer is the 4th most common reproductive cancer in Canadian women today.
This year, 1500 women will be diagnosed with cervical cancer and sadly 380 women will die. Cervical cancer is a malignant tumour that starts in the cells of the cervix. Malignant means that it can spread, or metastasize, to other parts of the body. Cells in the cervix sometimes change and no longer grow or behave normally. Changes to cells of the cervix can also cause precancerous conditions. This means that these cells are not yet cancer, but there is a chance that these abnormal cells might become cancerous if not treated. Most women with precancerous changes of the cervix are successfully treated and don’t develop cancer. *
Cervical Cancer is Preventable!
Most cervical cancers are diagnosed in women who have never been screened or have not been screened regularly. Screening is the only way to detect the early changes that might lead to cervical cancer.  I can’t emphasize enough how important is to have a PAP test. In Ontario PAP tests are recommended at the age of 21, if the individual has ever been sexually active. If the test is normal, then screening should be done every three years.
HPV and Cervical Cancer can be prevented with vaccines.
Another way to protect against cancer is to get vaccinated against HPV, the Human Papillomavirus. It is the most common sexually transmitted infection with more than 40 types of HPV contracted through sexual intercourse, genital skin-to-skin contact and oral sex. They can infect the genital areas of men and women, including the penis, vulva, vagina, cervix, rectum and anus.
There are millions of women in Canada who still do not get regular PAP tests and/or a HPV vaccination.We are fortunate in Canada to have access to government-funded healthcare. Prevention is the best way to reduce your chances of facing a serious illness.

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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.

Brain Drain and Menopause: Reality or Myth ?

shutterstock_57740512Is there such a thing as Brain Drain and Menopause?
Research shows that the female sex hormone, estrogen, plays a key role in brain function. Estrogen declines during menopause, but that doesn’t mean your brain function will decline along with it. Although estrogen produced by our bodies helps the brain function, there’s no clear clinical evidence to support the notion that the brains of women after menopause don’t work as well as they did in the past.  What we are learning is the difference between changes with menopause and normal age-related changes in function.
Often, postmenopausal women do have memory slips or difficulty concentrating. However, research suggests a variety of potential underlying causes. These include disturbed sleep, extra stress, or depression. If you’re awakened by night sweats several times during the night, that’s often enough to interfere with your ability to concentrate or remember details for the next days’ meeting.

Should hot flashes be the reason for your insomnia and the fuzzy thinking and memory glitches that follow a sleepless night, try reducing their hold on you with some lifestyle changes. Exercising daily is linked to a lower incidence of hot flashes. And some products designed to lower your temperature, such as the menopod, may be helpful. And if you’re a smoker, this may be the motivation you need to finally quit: Women who smoke have more intense and more frequent hot flashes than nonsmoking women.
If you think you might be depressed, which can cause difficulty concentrating, make an appointment with your doctor. Menopausal hormone fluctuations can be linked to depression in some women. Feeling occasional sadness isn’t the same as being depressed.
If your stress level is noticeably high, you may be able to control and reframe your intensity by practicing some form of relaxation. One of the simplest ways to combat stress is deep breathing. Meditation, yoga, tai chi, or gentle stretching are also good ways to reduce stress. If stress, memory slips, or other menopausal symptoms continue to bother you, consult your doctor. The key is to take action that will let you feel more in control.
Now what was I saying?

#woman #brainhealth #healthy #menopause

Chilling hot flashes? You might want to check out the Menopod. ( It contains a cooling technology inside the device. There are no fans or moving parts. When you turn the power on, it instantly drops to a cool temperature) so that you can discreetly place it on the back of your neck to stop the hot flash.

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.

Travel alerts internationally for polio and measles outbreaks this summer. Check your vaccinations before traveling


Travel alerts for polio worldwide & the resurgence of measles outbreaks in Canada, Europe and Africa, highlight the need for Canadians to get vaccinated before traveling to affected areas. Measles is a virus that can affect anyone and is highly contagious for individuals that have not previously had measles, or have not been vaccinated.

As long as measles is affecting children in other parts of the world, Canada will be affected as well. That’s why it’s extremely important for parents to ensure their children are vaccinated twice. Once when they are 12-15 months old, and again when they are 4-6 years old. Adults born before 1970 are likely immune, and everyone else needs to check their records. Polio, which has been eliminated from most countries, continues to occur in some areas of the world. The Public Health Agency of Canada recommends that travelers get vaccinated against polio when going to countries where polio has not been eliminated: Pakistan, Afghanistan, Nigeria, Cameroon, Equatorial Guinea, Ethiopia, Syria, and Iraq.  As for polio, our travel clinics have been busy answering questions from travelers about getting the vaccine even when not travelling in affected areas.  My advice is to have one shot for polio, called IPV as an adult, if you have not already done so.
Measles is a respiratory disease caused by a virus of the same name. It causes fever, runny nose and a characteristic rash all over the body. Most people recover, but the infection is fatal between one and three of every 1,000 cases. Polio is a contagious disease. It is spread from person to person through contaminated food and water. Polio can attack the central nervous system and destroy the nerve cells that activate muscles, which may cause paralysis and death.
So please check your vaccinations before travelling this summer.

#travel #summer #healthy

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.


Flu Season is here!!!

   Flu HRPA email blast (4)                    

      Ontario has already documented a few cases of flu and the vaccine is HERE

      Influenza vaccines authorized for use in Canada are safe and associated with minimal side effects and can be administered to anyone over 6months of age. *We know that between 10% and 20% of all Canadians will get the flu this winter.  And for some of us it can be severe, life threatening and perhaps even life ending. About 4000 Canadians die every year of flu and related complications. Generally the very young and the very old are most at risk, but we know pregnant women, children under 5, those with asthma, COPD, heart disease and diabetes are also at significant risk compared to the general population.  And even if you personally are not a high risk individual, chances are you will spread this easily to others in your family or community who are at greater risk.  You need to protect yourself and others!
Does the flu shot eliminate every case of flu? NO.  But if you have been immunized, but still get the flu, chances are it will be much less severe than if you were unprotected.  So you are less likely to need the emergency room and in- hospital treatment.  And that’s what it’s all about.  We can’t avoid every case of influenza, but we can decrease our chance of a serious episode!

      I can’t emphasize enough how important it is to get a flu shot.  I have taken mine, immunized my family, my staff and my coworkers!  Have you had yours?

      Aside from having flu shot,  here are everyday preventative measure to protect you from colds and flu

Top ways to fight the flu*
Wash your hands with soap and water
Avoid touching your eyes, nose and mouth as germs spread this way
Sneeze into your arm or sleeve
After or blowing your nose with a tissue, throw away the tissue and wash your hands.
Stay home and avoid crowds if you feel sick

*Health Canada, Flu Watch

Losing weight the successful way


As a family physician, I am often asked, what is the best diet to lose weight. The answer is that all of the well known popular diets whether it’s low fat, low-carb or high fiber is all pretty similar.  The most important part is not the diet or weight loss plan you choose, but sticking to it.  We have a hard time over a sustained period of time staying motivated and following a plan.  Ashley Grachnik, RD, CDE, a Registered Dietitian and Certified Diabetes Educator recommends these five strategies to lose weight successfully.

Losing Weight – the Successful Way

How do I lose weight and actually keep it off this time?” 

As a Registered Dietitian focusing on Diabetes prevention and management I get this question
all the time.  I see patients who have tried every diet and weight loss trick in the book.  Most of the time they are able to lose some weight but eventually, and inevitably it seems, the weight creeps back on.  This usually happens because of extreme short term changes like cutting outentire food groups which are not sustainable in the long run.  Most people know they should be eating balanced, healthy meals but they don’t always
recognize other behaviour changes that can help with long term success.  So here are my suggestions for healthy eating and changing food behaviours, not dieting.  Healthy eating nourishes the body, prevents diseases and keeps you at a healthy body weight while healthy food behaviours set you up for
success.  You want long term success? Read on…

  1. Change your relationship with food

Food is not your friend or your enemy.  Food should not comfort you when you’re sad, relieve your stress when it’s been a tough day or reward you when you’ve done something good.  Food is your body’s nourishment, just like air and water.  So what does your body really need to be sustained? – Healthy carbohydrates, fat, protein, vitamins and minerals.  When you’re emotional – sad, happy, stressed, angry, tired – find something else to do about it that doesn’t involve the kitchen or the drive thru.  I know this is easier said than done but starting to identify those times when you turn to food as emotional comfort or reward is the first step to changing your relationship with food.  To help you, write down a list of all the things you enjoy doing that doesn’t involve food.  Put that list on the fridge or cabinet and when you’re about to reach for food that list is in your face reminding you to turn around and try something else other than eating.

  1. Find support

Changing your habits is difficult but it’s easier when you have people in your corner cheering you on.  You don’t need the food police, that is not supportive, you need friends or family who will encourage you through your journey without judging your setbacks.  And there will be set backs.  If you’re not comfortable talking to your friends or family I suggest turning to the online community.  I’m not talking about joining a diet club online as you might get a lot of misinformation about what healthy eating really means.  I’m mean a chat room or blog about the challenges you face trying to eat healthy and stay on track.  So many people around you are trying to do the same thing as you and you can easily support each other through the tough hurdles of healthy eating and weight loss.

  1. There is no such thing as will power

I truly believe that will power doesn’t exist.  Or if it does it is finite and runs out way too quickly.  So rather than have all sorts of temptations easily accessible to the point you have to fight with yourself NOT to give in, why not set yourself up for success?  Create an environment where you don’t have to fight, where all your choices are easy and healthy.  That means there is no ice cream in the freezer, chips in the cabinet, or pop in the fridge.  When you open anything in your kitchen it is healthy.  Involve your family too – make the house a haven for health and everyone at home will reap the benefits.

Another challenge against “will power” is eating out.  If you’re going to someone’s house for dinner bring a salad, veggie platter or fruit salad so you know at least one option will be healthy.  Don’t go to an all you can eat buffet.  Choose, instead, to go to a restaurant where you know there are healthy choices on the menu or you can ask for healthy substitutions.  Study the menu online or call ahead before you go to ask questions about how dishes are prepared and what kinds of substitutions are possible.  Bottom line: healthy choices are only as hard as you make them.

  1. Enjoy a treat every once in a while!

If it’s your birthday, have some birthday cake.  If you’re at a wedding, have some wedding cake.  Don’t be that person who is on a diet so you can’t ever eat anything unhealthy until you’ve reached your weight goal so you can completely fall off the wagon and indulge in excess.  Allow yourself little treats now and then.  If you’ve been eating healthy and exercising then there is nothing to feel guilty about when you treat yourself to some birthday cake.  Notice I’m using the word “treat” and not “cheat” – this goes back to point number 1 and having a healthy relationship with food.  If you consider food just what it is, then a treat now and then isn’t a negative.  Relax and enjoy and don’t feel guilty.  And if you really want to ensure a little treat won’t be a big set back for you then plan some extra exercise that day before or after the birthday party or wedding.

  1. Make your health your number 1 priority

Yes, healthy living (eating and activity) takes time and planning.  Far too often the excuse for running to a drive thru or skipping the gym is that you just didn’t have time.  If you don’t make time for your health now, you’re going to have to make time for illness later.  And health is a much better thing to make time for.  So re-prioritize.  Take a careful look at everything you do in the day and shift around the importance.  Grocery shopping for healthy food, time to cook and prepare healthy food, and time for some physical activity should be top on the list.  If you find time to sit in front of the TV or computer at all in the day, those activities should move lower than your health on the priority list.  Or if you’re too tired at the end of the day then take a good look at what you do in the beginning of the day and move your health to the start.  No better time to focus on your health then today, so what are you going to do today that is healthy?

Vaginal atrophy affects more than 2 million post-menopausal Canadian women

shutterstock_84108826But intimacy does not need to be sacrificed

Vaginal atrophy (VA) is a common but treatable condition affecting post -menopausal women.  VA is where the vaginal walls become thin, fragile and inflamed due to the reduction of estrogen that naturally occurs during menopause***.

Symptoms of vaginal atrophy include: burning, itching, dryness, irritation and painful intercourse.

According to a recent study, not only is VA causing physical discomfort, but it’s also causing emotional distance between couples because of the difficulty women are having discussing it with their partners.


The CLOSER study *,  a study that surveyed more than 1,000 Canadian post-menopausal women and male partners of post-menopausal women, and showed couples are feeling the impact.


·       Sixty-six per cent of post-menopausal women avoid sexual intimacy fearing it is too painful

·       Sixty-three per cent of women avoid sexual intimacy due to a general loss of libido

·       Canadian women are among the most likely to agree that due to VA sex is less satisfying

·       One fifth of women feel VA has made them emotionally distant from their partner

·       Forty-four per cent of women say VA makes them feel old

·       Sixty-eight per cent of men surveyed say they have sex less often because of VA

·       Thirty per cent of men say sex is less satisfying for them personally

·       Twenty-six per cent of Canadian men say they have stopped having sex altogether

Fortunately today there are treatment options

Treating the symptoms:
Many women self-treat using over-the-counter lubricants and moisturizers, which may provide temporary relief of symptoms but do not treat the underlying condition.

Treating the underlying condition
Local Estrogen Therapy (LET) treats the underlying condition.As a result of LET, one third of Canadian women according to the CLOSER Study ** agreed their sex life had improved and that they felt more optimistic about the future of their sex life.

According to the Society of Obstetricians and Gynecologists of Canada (SOGC), effective treatment options are available for VA, with local estrogen therapy being a standard of care.

LET comes in several forms, we have several options in Canada

Vaginal estrogen tablet. Vaginal estrogen cream. Vaginal estrogen ring. Which one is right for you? There are different advantages, ease of use and decisions for women…so talk to your doctor! Healthcare professionals are a primary source of information and together with women, their partners and their doctors can find a solution.

** Clarifying vaginal atrophy’s impact On SEX and Relationships (CLOSER). European Menopause and Andropause Society (EMAS) Annual Congress, March 2012.

***Mayo Clinic: Vaginal Atrophy Definition. Available at: Last accessed June 2013

Boning up on Bone Health. Why diet & exercise are important in preventing Osteoporosis


Part Two. *

Bone is a living tissue that is constantly renewed through a process in which old bone is removed and replaced by new bone. Cells called osteoclasts erode the bone, creating small cavities; bone-forming cells called osteoblasts then fill in the cavities with new bone. This is nature’s way of restoring bones and keeping them healthy.

In younger people with healthy bones, the osteoclasts and osteoblasts work together, maintaining healthy bones. However, after our mid-30s the process is not as efficient, and we begin to gradually lose bone. In someone with osteoporosis, bone loss occurs more rapidly, causing the bones to become thinner and weaker over time. If you have osteoporosis, you have already lost a significant amount of bone and may continue to do so unless you receive medication.  Over 80% of all fractures in people 50+ are caused by osteoporosis.

That’s why diet and exercise is recommended as part of an overall healthy approach to preventing osteoporosis.

 We need to emphasize the importance of regular weight-bearing exercise for bone health. Weight bearing exercise, where you use your body weight in activities such as walking, running and weight lifting will help your bones become denser. The result is that you develop more bone material, and your bones become denser. Brisk walking, dancing, tennis, and yoga have all been shown to help your bones.

It will also help your balance and strength, which could help to prevent falls


  • Calcium is the cornerstone of strong bones. Adults up to age 50 need 1,000 milligrams per day. Beginning at age 51, women need 1,200 milligrams every day, and when men hit 71, they need to hit that mark, too. The pop star of calcium sources is undoubtedly milk. A single, 8-ounce cup of milk, whether skim, low-fat, or whole, has 300 milligrams of calcium.
  • Not a milk drinker? A cup of yogurt has at least as much calcium as an 8-ounce cup of milk. And 1 ounce of Swiss cheese has nearly as much. Even if you’re lactose intolerant, yogurt and hard cheeses are low in lactose. Or try dairy products that are lactose-reduced or lactose-free. Removing lactose from milk and dairy foods does not affect the calcium content
  • You might be surprised to learn that calcium is plentiful in many vegetables. Go for dark leafy greens such as Bok Choy, Chinese cabbage, and kale. If dairy products, sardines, and leafy greens leave you cold, consider eating fortified foods. These are products that do not naturally contain calcium but have been enhanced with varying amounts of the essential mineral.
  • Breakfast foods are a great start — fortified orange juice has up to 240 milligrams of calcium, and fortified cereals deliver up to 1,000 milligrams per cup. Check the nutritional label for the exact amount.
  • Half a cup of calcium-enriched tofu has as much as 861 milligrams of calcium, but calcium is not the only mineral that gives bones a leg up. New research suggests plant-based chemicals called isoflavones strengthen bone density as well. Isoflavones are plentiful in soy foods, such as tofu, and seem to have an estrogen-like effect on the body. For some women, this is a positive side effect, while others may choose to limit their intake
  • Salmon and other types of fatty fish offer an array of bone-boosting nutrients. They contain calcium as well as vitamin D, which aid in calcium absorption. They’re also high in omega-3 fatty acids, important as antioxidants in the body

 Calcium Supplements

Supplements are an easy way to boost your calcium intake, but some reports suggest you may not need them. If you’re already getting enough calcium from food, taking more in pill form won’t contribute to bone health. Experts say there’s little benefit in getting more than 2,000 milligrams of calcium per day, and too much can lead to kidney stones. For the best absorption, take no more than 500 milligrams at one time. Some calcium supplements, such as calcium carbonate, are better absorbed if taken with meals; however, calcium citrate can be taken anytime

Vitamin D



Vitamin D helps the body absorb calcium and store calcium from the foods we eat. Our bodies can produce vitamin D when we are exposed to sunlight. However, during the winter months, most Canadians do not get enough sun exposure to produce adequate amounts of vitamin D, nor do we get enough vitamin D through our dietary intake. However, Vitamin D intake can be enhanced through dietary sources and supplements.  It is important to continue to take Vitamin D, even in the summer months, as we tend to wear sunblock that limits the absorption of vitamin D.

Osteoporosis Canada recommends the following intake of vitamin D (total intake through diet and supplementation) on a daily basis.  For people age 19-50; 400-1,000 IU, and for those of us over the age of fifty; 800-2,000 IU’s.

* Source –