Current women's health reports
-
Curr Womens Health Rep · Oct 2003
ReviewEndometriosis and infertility: what do we do for each stage?
Endometriosis and infertility have been linked in the discipline of gynecology for more than a century. There is evidence that endometriosis can and does decrease fertility. However, our ability to determine fertility prognosis based on a staging system is severely limited. ⋯ Our suggestions for the treatment of early-stage endometriosis are surgery and/or superovulation with intrauterine insemination as first-line treatments. For more advanced disease, with tubal damage, surgery or in vitro fertilization are options. For the most advanced cases, in vitro fertilization preceded by 3 months of medical treatment of the endometriosis is advised.
-
The financial, emotional, and personal costs of dealing with urinary tract infections are tremendous. However, these expenditures are multiplied when the infections become recurrent. ⋯ Clearly, those with recurrent urinary tract infections have differences at the cell surface level that render them more susceptible. Treatment is changing direction from combatting bacteria with antimicrobials to bolstering host defenses.
-
Curr Womens Health Rep · Jun 2003
ReviewBones and nutrition: common sense supplementation for osteoporosis.
Osteoporosis is a serious public health concern. Skeletal fragility, leading to spine and hip fractures, is a major source of morbidity and mortality. Adequate calcium intake from childhood to the end of life is critical for the formation and retention of a healthy skeleton. ⋯ Among these, diet is believed to be one of the most important, especially the roles of calcium and vitamin D. Deficiency in other dietary factors--eg, protein, vitamin K, vitamin A, phytoestrogens, and other nutrients--might also contribute to the risk for osteoporosis. In this article, the roles of diet and nutritional supplementation in preventing and treating osteoporosis are reviewed.
-
Eating disorders are prevalent in the young adult female population. Given the serious medical, nutritional, and psychological risks associated with eating disorders, it is advisable that patients be seen within the framework of a multidisciplinary team. Psychotherapy is the most effective treatment modality for eating disorders and constitutes the core of mental health treatment. ⋯ Active weight management is also a key component of treatment for anorexia nervosa. Psychotropic medication therapy is not generally useful for the primary symptoms of anorexia nervosa, whereas it is moderately effective in the treatment of both bulimia nervosa and binge-eating disorder. Given the patient population at Massachusetts General Hospital, to which patients often present with serious and chronic symptoms, comorbid medical and psychiatric illness, and history of poor response to treatment, we have found a flexible and eclectic treatment approach most useful clinically.
-
Curr Womens Health Rep · Apr 2003
ReviewLong QT syndrome: a preventable cause of sudden death in women.
Long QT syndrome is a hereditary disorder of cardiac ion channels causing abnormal electrical activation of the heart and leading to life-threatening ventricular tachycardia. Syncope, ventricular tachycardia, or sudden cardiac death in the absence of structural heart disease is the typical presentation, often starting in childhood. ⋯ Several mutations in six genes encoding subunits of cardiac potassium and sodium channels have so far been identified, and gene-specific epidemiology, risk stratification, and management are emerging. beta-blockers are the mainstay of therapy for primary prevention of cardiac events and implantable defibrillators for secondary prevention. Patient education, screening of family members, and increasing awareness of this disorder among physicians are important steps toward prevention of sudden death in these otherwise healthy young individuals.