Another point to be made here is that there are people who have been given the diagnoses of herpes and make a conscience choice not to tell their partners, usually because they are afraid of losing someone they love or really like.  Here are some reasons that I’ve heard: “It’s not like it’s life threatening”,  ”I’ve never had an outbreak and don’t think that I will” or “I just can’t tell him (or her)”.  Before you weigh in, here are a few facts from the CDC that you should know:

*Eighty one percent (8 out of 10!) of people who have herpes DO NOT KNOW.

*Of blacks between the ages of 40-49, fifty six percent, that’s more than half, of this population have herpes!  For whites in the same age range, 20% have herpes and for Mexicans, 20% have herpes.

The number of sex partners matter.  Yesterday, I met an 18 year woman who had already slept with eight men.

* One third of blacks who have had sex with 2 to 4 partners have herpes.  How many does it take before you are considered a “playa” or a “diva”?  For whites and Mexicans who have had sex with more than two to four partners, only 9% and 13% will have herpes, respectively.

*By the time you get to 10 partners, 49% of blacks will have herpes; for whites who have slept with more than 10 partners, 22% will have herpes and for Mexicans who have slept with more than 10 partners, 13% will have herpes.

I could go on, but I think you get the picture.  Herpes is prevalent.  Hooking up is ‘in’ and asking direct questions about another’s sexual exposure and history of sexually transmitted diseases has gone out of style.  More women than men have herpes because it’s easier for men to transmit the virus to women.  And if you are a black woman, what should you do, rinse the penis with bleach before you have your fun?  Not that this would help.  And, as a side note, infection with Herpes type-2 makes you more susceptible to acquiring HIV.

Herpes is such an emotional issue, more than a physical one, for many.  But, getting tested, both you and your intended partner, and being open to full disclosure is one reasonable approach, in my humble opinion. At least with knowledge of the infection you can try to avoid spreading it to others, especially if that other is someone you really care about. If you have herpes, use of a condom can provide moderate, not complete, protection for your partner.  Also, talk to you doctor about suppressive therapy, drugs like Valtrex, Acyclovir and Famvir are used to reduce the chances that you will transmit the virus to someone who does not have it and reduce the number of painful outbreaks you have to suffer through.  Lastly, avoid having sex if a lesion is present or if you feel and outbreak coming on.

There it is.  Spread the word!  I’d love to hear what you guys think about this topic.  Please comment or click on Forums (top right hand corner) and start a discussion.

Over 200,000 people were diagnosed with lung cancer in 2008.  Ninety percent of them were smokers.  About 35% of men and 22% of women who live in the United States are smokers.  And, one in ten lifelong smokers will develop lung cancer.  This is bad.  People who continue to smoke after they have been diagnosed with lung cancer do not respond to treatment as well as those who quit.  Bad.  And, unfortunately, 4 out of 25 cases of lung cancer are due to second hand smoke.  Really bad.  Even worse, children of smokers tend to become smokers and are twice as likely to develop lung cancer as adults.

Stop smoking and one can reduce the risk of getting lung cancer by up to 50%.  The best!  Diets rich in fruits and vegetables, i.e. lots of antioxidants, may help to protect the lungs.  Good. Cigarette for cigarette, the Harvard Alumni Health Study showed that exercise could reduce the risk of lung cancer, a drop of 39% for the men who did strenuous exercise on a regular basis. Great!

Ladies, you, and the men in your lives, should stop smoking.  I’ll admit, I’ve puffed on a couple of Marlboro lights while I sipped cocktails.  Think Sarah Jessica Parker in “Sex in the City”, when she was still a smoker.  Then I noticed tiny wrinkles around my eyes—the damage to small blood vessels leads to premature aging–I was all too happy to pay for facials instead.  Shear panic was my antidote.  Dig deep and find yours.  My father had friends who were always bumming cigarettes. So he stopped, cold turkey, out of spite.

Spread the word! Happy Father’s Day.

For those who prefer the au natural approach, here is some information on one of the most popular alternative supplements: black cohosh.

Black cohosh is an herb.  For the budding botanists, it is also called Actaea racemosa or Cimicifuga racemosa.  The Native American Indians called it something else altogether but, the most common formulation is Remifemin.  Remifemin is available over the counter and is usually taken twice daily.  It is regulated as a dietary supplement, not a drug; therefore it is not subject to the same stringent testing as your Tylenol, for example.  Does it work?  Not all the studies agree, but most reported a definite reduction in hot flashes, night sweats and irritability.  It absolutely will not help with vaginal dryness.  The American College of Obstetricians and Gynecologists states that black cohosh may be helpful if used for up to six months.  The University of Pennsylvania School of Medicine, sponsored by the National Institute of Health, studied women in the Philadelphia area with breast cancer who used black cohosh.  They found that black cohosh had a protective effect against breast cancer!  More studies have to be done but this was exciting.

Side effects: stomach cramps and a few reports of liver damage.  One should definitely stop using this supplement if these symptoms develop.  Keep in mind, there are no long-term studies (at least five years) on black cohosh.  Given what we know about black cohosh, when my patients ask for advice about what they can do besides take hormones or antidepressants, I answer, “Eat right, exercise, throw out the cigarettes and try black cohosh.”

There you have it.  Now spread the word!

Stay tuned.  Don’t miss!  More to come on The Big M…..

Now that we have clearer understanding of how HPV (human papillomavirus) affects the cervix at different points in women’s lives, we can now target certain women while reducing the number of procedures that we do on others.

Every year, millions of women are infected with HPV in the United States — but relatively VERY FEW actually develop cervical cancer.

HPV is the most common sexually transmitted virus. It’s spread through sexual intercourse.  But know that it is easily spread through skin-to-skin contact, so penetration during sex is not required to get HPV.  Infection with HPV peaks between ages 16 and 24.  This is the time when most women are exposed to HPV, which is often when they become sexually active.

Young women who are sexually active are very likely to have HPV. A study done on a college campus documented that 60 to70% of the young women tested had HPV. But, nearly 90% of all young women who have HPV will clear the virus within two years without any additional tests or procedures.

This is why women younger than 21 do not need a Pap or HPV test, even if they are sexually active.  This is not a free ticket to get out of going to your gynecologist.  Preventing unwanted pregnancy and screening for sexually transmitted diseases, like chlamydia (cla-mid-i-a) is essential at this age.

Also, consider getting immunized against the most common types of HPV.  Gardasil, a vaccine approved for females ages 9 to 26, has been shown to reduce the occurrence of moderate and severe abnormal changes in the cervix caused by HPV.

For those of us who are not so young anymore, here is another scenario: “I’ve been in a stable relationship for many years and my paps have been normal.  How did I get HPV? Is my partner cheating?”

What’s not commonly known is that some women get HPV in their younger years but never completely eradicate the virus from the body.  HPV peaks again in the 30s; women in this age group are the best candidates for the HPV test.

Testing for HPV, in addition to Pap tests, has improved the ability to pick up abnormal cells 8 to 12 years before they become cancerous.

An HPV test is usually done every 6 to 12 months for women:

1. who have had an abnormal Pap smear,

2. who have had a LEEP or Cone biopsy (two procedures that remove abnormal cells from the cervix)

3. or in women 30 and over who wish to have less frequent smears.

Also:

4. It’s possible to have HPV and have a normal Pap smear. In this situation, it’s important to have a Pap             smear and HPV test done at least once each year.

5. If you are a healthy women over age 30 who have a negative HPV test and a normal Pap smear do not           need another Pap smear for two to three years.

Remember, however, that annual gynecological exams are still necessary since they examine overall breast and gyn health. Talk with your doctor about how often you should have Pap smears.

We can live healthfully with HPV, as long as it doesn’t cause worrisome changes in the cervix.

There you have it. Now spread the word!

AIDS (Acquired Immunodeficiency Syndrome) was first reported in 1981.  Two years later, scientists were able to find the cause of this disease: HIV  (Human Immunodeficiency Virus).  The infection has touched lives in every part of the world.  Countries in regions of the world with little resource: Sub-Saharan African, the Caribbean and Asia, have seen millions of their citizens die from this disease.  HIV in contracted by contact with infected blood and body fluids.  The virus then attacks the immune system, leaving the body unable to defend itself against infections that might otherwise be effectively eliminated.

Recently, there has been a flurry of discussions about the number of single professional black women, of whom, 45% will never marry.  With so many women spending an extended amount of time “out there”, I thought it prudent to bring up the topic of safer sex.  Nice guys, guys with good hygiene, hard workers, men who love children, professional men and men who always smell nice, can be infected with HIV.  While you’re looking for Mr. Right, take steps to protect yourself: use condoms, ask about their sexual history, limit the number of sexual partners and get tested.  The very act of getting an HIV test is a reminder to be vigilant about protecting yourself.  It’s amazing how many women chose not use condoms based on how they feel instead of acting on facts.

Since the isolation of the virus, scientists have worked hard to discover ways to treat people with HIV/AIDS.  There is no cure and a vaccine is far in the horizon.  Prevention should be the goal but early discovery of one’s infection, will lend itself to early treatment and to a longer and better quality of life. Women who are HIV positive should take steps to prevent pregnancy or at least seek early prenatal care to reduce the risk of passing the virus to the child.  Without treatment, one in every four (25%) of babies born to HIV positive mothers will become HIV positive.  With early detection and treatment, the risk of passing the virus to the child can be reduced to less than 2%.  Mothers who are HIV positive should not breastfeed.

There it is!  Now spread the word.

I chose this topic because recently I had several patients who were diagnosed with this syndrome and most of them had no idea of what this disease meant for them or for their unborn child.

Simply, Preeclampsia is a type of high blood pressure that affects pregnancy.  It is diagnosed when there is both an increase in the mother’s blood pressure and when a certain amount of protein is found in the urine.

We don’t know what causes preeclampsia and we have not found a way to prevent it.  But, we do know that certain women are more prone to developing this disorder. Here are some of the top risk factors: women having their first baby, those who have had preeclampsia in a previous pregnancy and those with a family history of preeclampsia.  Some other really important risk factors include: women who are obese, those who were diagnosed with high blood pressure before they became pregnant (or who were diagnosed in the beginning of the pregnancy), women who have kidney disease, those carrying two or more babies and those who are genetically prone to develop blood clots.

Preclampsia can damage the placenta which in turn results in a baby who does not grow well in the uterus.  It can also cause low amniotic fluid levels.  More devastating is when the placenta pulls away from its attachment (abruptio placenta) leading to bleeding, the need for an emergency Caesarean section or worse, fetal death.  For the mother, the most serious outcomes are bleeding, liver damage, stroke and seizures.

If the baby is premature and the condition is mild, obstetricians can elect to monitor the baby and mother with weekly tests to insure the safety of both.  This management will allow more time so that the baby’s lungs will mature and at birth, the infant can breathe on its own without assistance.  Nevertheless, once there is evidence that the mother or baby is in danger, delivery–either by the vaginal route or by a Caesarean section–is the next step.  In this situation and if there is time, the mother may be given steroids to help strengthen the lungs of a premature baby before he/she is brought into the world.  During this brief period, medication to prevent seizures and to control blood pressure may be given to the mother.  Sometimes babies have to be delivered early in order to save their lives and that of the mother.

I bring this topic to you because many women forgo their prenatal appointments.  The only way to spot preeclampsia is by monitoring your blood pressure and urine each time you go to the doctor.  So make the time ladies (and dads-to-be), keep your appointments!

There it is, now spread the word!

Fact: At age 18, your chances of getting pregnant during ovulation is about 40%, by the time you are 40 that number drops to 10%.  It doesn’t matter if you have a six pack and look fabulous–fertility declines with age, period.  In addition, as American women get older we tend to develop health problems that further impact our fertility in a negative way…obesity, hypertension, addiction to nicotine, diabetes, abdominal surgery (which can scar the fallopian tubes), etc.  A blood test done at a specific time during the menstrual cycle, with/without an accompanying ultrasound (done by an infertility specialist), can assess one’s fertility.

There it is, now spread the word!

Keep in mind, men suffer from some of the same ailments that women do, namely emotional and relationship problems that get them down…no pun intended.

But, I wanted to alert you about the fact that erectile dysfunction can be a sign of serious medical problems like coronary heart disease, hypertension and diabetes.  Diabetes can affect the penile nerves and atherosclerosis (build up of fatty material like cholesterol in the arteries) also affects the penis!

More than one third of men between the ages of 40 and 70 suffer from moderate to severe ED.  That’s a lot…probably includes someone you know.  Seventy four per cent of men are too embarrassed to discuss erectile dysfunction with their physicians, but since it is often a result of disease, it can also alert physicians that an undiagnosed problem is at the root cause.

Of course, we have all heard about Viagra, Levitra, and Cialis.  I want to remind you that some men cannot use these medications because of heart problems.  For those who cannot use these medications however, there is a wide range of other therapies that a urologist or primary care physician can offer.  There is something available for every man.

There it is, now spread the word!

In general, this procedure is reserved for patients who want to keep their uterus for future childbearing. Incisions are made in the uterus itself and the fibroids are “shelled out”.  Because the uterus has such a vibrant blood supply and because the technique involves multiple cuts into the uterus, there can be a fair amount of bleeding.  Sometimes, 1/1000, the uterus cannot be saved because it has been completely ‘taken over’ by the fibroids and the patient will need a full hysterectomy.

With respect to having children, women are advised to get pregnant within six months to a year of having the surgery because fibroids do grow back!  Also, If you are planning pregnancy, it’s a good idea to consult with a fertility specialists before electing this procedure.  Scarring can occur around the fallopian tubes or ovaries after a myomectomy; this can damage the tubes and make it difficult to conceive.  Studies have shown, however, that when fibroids are the cause of infertility, this surgery can significantly improve your chances of having a baby.

There you have it!  Now spread the word!

Most women are terrified of Human papillomavirus (HPV).  But, once you enter the world of sex, an infection with HPV is almost inevitable.  If you have one lifetime partner, who in turn, has only had sexual relations with you, you might have a shot.  Keep in mind that HPV is transmitted even without penile penetration. Contact with the genitalia is enough!  The good news is that a healthy immune system, one not weakened by chronic disease, smoking or certain medications, will usually clear the virus in a matter of months.  It’s true that some women continue to harbor the virus and these women are most at risk for abnormal pap smears that signal worrisome changes on the cervix (also referred to as dysplasia or ‘pre-cancerous changes’).  Don’t have a melt down!  It takes many years to progress from an abnormal pap smear to cervical cancer.  For most, close monitoring is all that is needed.  For others, a simple procedure to remove the abnormal area on the cervix can be done in about ten minutes.

Testing for HPV helps us to target those women who need to be followed closely.  It’s up to you to remember to keep your annual gynecological visits.

There you have it, now spread the word!