Healthy Pregnancy - Healthy Baby

Healthy pregnancy is a much longed for condition among women who are pregnant. Mere knowledge of the fact that a baby is about to arrive in the family makes one joyous. The most promising way to have a healthy baby is to have a healthy pregnancy. One can do so by adopting a healthy lifestyle. If would-be parents happen to be pursuing a healthy lifestyle even before conception, then the fetus becomes safer during early weeks of pregnancy, when a woman might not be aware of her pregnancy.

Preparing For A Healthy Baby

Husband as well as wife should be nutrition conscious before deciding to have a baby. This ensures that they are in good health right from day one and provide the baby a healthier beginning of life. Although most of the childbearing age group women are healthy and most pregnancies are considered low risk, it is desirable to take a few steps to have a healthy pregnancy:

# Access to proper health care before getting pregnant

# Have a balanced diet plan

# Regular exercises after consulting the doctor

# Say No to alcohol, caffeine, drugs and nicotine

# Avoid medications, x-rays, hot tub baths and saunas

# Protect oneself from infections

source : www.americanchronicle.com

Brazil to subsidize contraception for poor

Brazil will subsidize birth control pills for the poor, Health Minister Jose Temporao said on Monday, a decision that may stoke a simmering conflict between the state and Catholic Church over contraception and abortion.

Birth control pills will be discounted up to 90 percent at a network of 3,500 government-authorized pharmacies across Brazil. That number will rise to 10,000 drugstores by the end of the year, Temporao said.

A pack of pills designed to last a month will cost the equivalent of 20 U.S. cents. The government hopes to boost the supply of pills to 50 million per year from the current 20 million.

It also wants more men to take advantage of the free vasectomies offered by the public health service.

Temporao said the measures were needed after the government failed to reduce newborn child and maternal deaths by 15 percent.

He also suggested the government should present a proposal on the legalization of abortion to Congress, despite the church's opposition.

source : health.yahoo.com

Asthma doesn't usually increase pregnancy risks

Adverse obstetric or pediatric complications are not generally increased in women with asthma, according to a report in the May 15th American Journal of Respiratory and Critical Care Medicine.

Previous studies have suggested the possibility of increased risks of pregnancy complications in women with asthma, the authors explain, but these studies have had various statistical shortcomings.

To further investigate, Dr. Laila J. Tata from University of Nottingham in the UK and colleagues used data from more than 280,000 pregnancies to compare the risks of obstetric complications and adverse pregnancy outcomes in women with asthma and those without asthma.

Asthma did not significantly increase the risk of high blood pressure, diabetes, thyroid disorders, the need for assisted delivery, placental separation from the uterine wall (placental abruption), placenta blocks the opening to the birth canal (placental previa), pre-eclampsia (a condition affecting multiple body systems characterized by high blood pressure and kidney failure), or eclampsia (progression of pre-eclampsia to a life-threatening severity).

However, when compared with women without asthma, women with asthma did have a 20-percent increased risk of hemorrhaging during delivery, a 38-percent risk of hemorrhaging after delivery, a 6-percent risk of anemia, and a 57-percent increase risk of depression. They were also 11-percent more likely to deliver by cesarean section.

Women with more severe asthma and a history of asthma exacerbations had an increased risk of miscarriage and depression, the researchers note, but increased risk of hemorrhage after delivery was restricted to women with milder asthma and no exacerbations.

"Our results provide reassuring evidence that the risks of most adverse pregnancy outcomes and obstetric complications are similar to those in women without asthma," the investigators conclude.

"With the possible exception of increased vigilance in monitoring certain complications in pregnant women with asthma, our findings do not indicate a necessity to alter current practice of optimal (asthma drug therapy) in women of child-bearing age in the general population," the authors add.

source : health.yahoo.com

Cities Ranked for Sun Savvy

People in Washington, DC, know more about sun safety than residents of other US cities, according to a new survey by the American Academy of Dermatology. The professional group polled adults in 32 US cities and regions to see just how savvy Americans are when it comes to sun protection and lowering their risk for skin cancer.

"Based on our initial review of what people are currently doing, know, and believe about sun protection, 35% of the national public score above average, with grades of A or B," says Diane R. Baker, MD, FAAD, president of the American Academy of Dermatology.

The goal, she added, is to have 45%-50% of Americans in the above-average range.

The "RAYS: Your Grade" survey, which was conducted online, included more than 3,000 men and women. Some of the questions focused on attitudes, asking participants to agree or disagree with statements like: "People look more attractive with a tan," "Sun exposure is good for your health," and "I am concerned about skin cancer and feel it's important to protect myself."
Other questions focused on habits like when people apply sunscreen, where they use it, and how often they check their skin for suspicious moles. The survey also asked participants to judge the accuracy of statements like: "You can get sunburned on cloudy days" (true); "Tanning beds are safer than the sun" (false); and "You don't need to use sunscreen if you have dark skin or already have a tan" (false).
Skin Cancer a Risk Even in Cloudy Climates

Forty-seven percent of survey respondents in Washington, DC, scored an A or B on the survey, putting the city at the top of the sun-savvy list. Rounding out the top 5 (in descending order): New York City, Miami, Tampa, and Los Angeles.

Chicago, where only 21% of respondents got an A or B, came in last. Nearly half of respondents there said they don't worry too much about sun exposure because of their skin type, and 41% said they prefer to enjoy sunshine and not worry about protecting themselves from it. But sun protection is important for people of all skin types. While it's true that people with fair skin are more susceptible to skin cancer, this disease can strike people with any skin tone.

Forty percent of Chicago respondents said their city's climate was a key reason they didn't worry about skin cancer.

Yet people in all parts of the country are at risk, experts say. Damaging ultraviolet rays from the sun can penetrate through clouds and fog, and be reflected off water, snow, and sand.

"The notion that only people living in year-round sunny climates are prone to developing skin cancer is completely untrue," says Baker. "The bottom line is that everyone needs to be concerned about protecting themselves from skin cancer, no matter where you live."
Use Sunscreen, Cover Up

Here are some simple steps you can take to protect yourself from sun damage:

* Before you go outside, even if you're only staying out briefly, generously apply sunscreen with a sun protection factor (SPF) of 15 or more. Choose a product that protects against both UVA and UVB rays, and be sure to apply it correctly: cover all exposed skin and don't be stingy with the amount you use.


* Wear protective clothing -- long sleeves, pants, and hats -- when you're in the sun. And don't forget sunglasses that block UV rays. Your eyes need protection from the sun, too.


* Stick to the shade when you're outside. Limit your outdoor time between the hours of 10 a.m. and 4 p.m., when sunlight is most intense.


* Stay away from tanning beds and sunlamps. The light from these devices can harm your skin, too, and put you at risk of developing skin cancer.

Even if you follow all the recommendations for protecting your skin, it's still important to check your skin regularly for signs of skin cancer.

* Look for any new growths, spots, bumps, patches, or sores that don't heal after 2 or 3 months.


* Check for melanoma using the ABCD rule.


* Watch for any changes to existing moles or freckles: redness, swelling, itching, tenderness, bleeding, oozing, scaliness, or bumps.

If you find anything suspicious, show it to your doctor. Also, get your doctor to check your skin as part of your routine cancer-related check-ups.

source : health.yahoo.com

Scientists Find Clues to AIDS-Linked Cancer

FRIDAY, May 11 (HealthDay News) -- U.S. researchers say they've identified specific human genes targeted by the virus behind Kaposi's sarcoma, a rare cancer often found in AIDS patients.

Kaposi's sarcoma is typically seen in people with weakened immune systems, such as those with AIDS and organ transplant patients. It can also affect elderly men of Jewish or Mediterranean heritage. Patients with the disease develop patches of red or purple tissue under their skin.

The virus believed to cause Kaposi's sarcoma has "mini-molecules" called microRNAs that silence genes that suppress tumor cells and limit vascular growth. The silencing of these genes results in the unchecked blood vessel growth typical of Kaposi's sarcoma, said at team at the University of Florida.

The findings are published in the May 11 issue of Public Library of Science Pathogens.

"The hallmarks of Kaposi's sarcoma are red spots full of blood vessels on the necks, arms and legs of patients. We think that the tumor virus is using microRNAs to make sure infected cells are well-nourished and protected from the human immune system," Rolf Renne, an associate professor of molecular genetics and microbiology at the College of Medicine and a member of the UF Shands Cancer Center and the UF Genetics Institute, said in a prepared statement.

The findings may help in the development of new treatments for Kaposi's sarcoma, the researchers said.

source : health.yahoo.com

Scientists Find Clues to AIDS-Linked Cancer

FRIDAY, May 11 (HealthDay News) -- U.S. researchers say they've identified specific human genes targeted by the virus behind Kaposi's sarcoma, a rare cancer often found in AIDS patients.

Kaposi's sarcoma is typically seen in people with weakened immune systems, such as those with AIDS and organ transplant patients. It can also affect elderly men of Jewish or Mediterranean heritage. Patients with the disease develop patches of red or purple tissue under their skin.

The virus believed to cause Kaposi's sarcoma has "mini-molecules" called microRNAs that silence genes that suppress tumor cells and limit vascular growth. The silencing of these genes results in the unchecked blood vessel growth typical of Kaposi's sarcoma, said at team at the University of Florida.

The findings are published in the May 11 issue of Public Library of Science Pathogens.

"The hallmarks of Kaposi's sarcoma are red spots full of blood vessels on the necks, arms and legs of patients. We think that the tumor virus is using microRNAs to make sure infected cells are well-nourished and protected from the human immune system," Rolf Renne, an associate professor of molecular genetics and microbiology at the College of Medicine and a member of the UF Shands Cancer Center and the UF Genetics Institute, said in a prepared statement.

The findings may help in the development of new treatments for Kaposi's sarcoma, the researchers said.

source : health.yahoo.com

Immune System Dysfunction Pinpointed in Melanoma

(HealthDay News) -- U.S. researchers say they've spotted a key immune system dysfunction in patients with melanoma skin cancer.

A team at Stanford University School of Medicine, in California, found that the immune cells in most melanoma patients fail to respond properly to a molecule called interferon, which normally activates the immune system. This failure to respond to interferon means that the immune cells don't fight off melanoma.

The findings, published in the May issue of the journal Public Library of Science-Medicine, could help in the development of new treatments for melanoma.

Melanoma will kill about 16 percent of the 47,700 people in the United States expected to be diagnosed with this form of skin cancer this year.

These findings help explain why a common melanoma treatment involving prolonged exposure to interferon sometimes helps melanoma patients, said senior author Dr. Peter Lee, associate professor of medicine.

"Doctors knew it worked in some people but didn't know why," Lee said in a prepared statement. This study suggests that prolonged interferon treatment may work by overcoming the immune system's inability to respond to interferon.

Previous research has found that cancer patients often have immune system problems, but, until now, scientists didn't know which genes or pathways were at the root of the trouble. Identification of this interferon response disruption may boost efforts to develop vaccines for different types of cancer, the Stanford researchers said.

"We think this is a dominant way that immune dysfunction occurs in people with cancer," Lee said.

source : health.yahoo.com

Could Viagra Put the Brakes on Jet Lag?

(HealthDay News) -- Worried about jet lag? Researchers think they might have just the ticket to perk you up: Viagra.

While it's too early to know if it will work in humans, Argentinean researchers are reporting that the drug sildenafil -- better known by the brand name Viagra -- appears to reduce symptoms of jet lag in hamsters.

Viagra does come with potential side effects, and some men might not appreciate experiencing a temporary respite from erectile dysfunction at 30,000 feet. Still, a sleep specialist called the research promising.

"We do need more effective therapies for jet lag and for sleep difficulties that occur as a consequence of shift work," said Dr. Robert Vorona, an associate professor at Eastern Virginia Medical School who's familiar with the study findings.

In the study, researchers administered small doses of sildenafil to hamsters before adjusting the cycles of light and dark they lived in. This reset their body clocks as if they'd taken a six-hour plane trip to the east.

The hamsters recovered 25 percent to 50 percent more quickly from the equivalent of human jet lag, needing less time to synchronize themselves to the new schedule, said Dr. Diego Golombek, a researcher with the Universidad Nacional de Quilmes in Buenos Aires. He said sildenafil worked at least as well as melatonin, a jet-lag treatment.

But the drug didn't help hamsters who underwent a simulation of westward jet travel.

The findings were published in this week's Proceedings of the National Academy of Sciences.

The drug, originally developed to treat high blood pressure and angina, might alleviate jet lag by interfering with a molecule that sends signals to the hamster brain's body clock mechanism, Golombek said.

But the potential impact on humans isn't clear, and Golombek said people shouldn't rush out to prevent jet lag with doses of Viagra. For one thing, Viagra can cause side effects such as low blood pressure.

As for the next step, Golombek said "a full-scale clinical trial has to be performed in humans, which is indeed quite expensive and time-consuming. Jet-lag trials might involve laboratory simulations, but we also need 'the real thing,' which means testing pharmacological treatments on long-haul air travel."

And that, he added, will take even more time.

source : health.yahoo.com

Sleep Apnea Could Raise Obstetric Risks

(HealthDay News) -- Sleep apnea greatly increases the risk of diabetes and high blood pressure during pregnancy, according to a U.S. study that looked at nationwide data on millions of pregnancies in 2003.

Sleep apnea is a nighttime breathing disorder that disrupts sleep, causing multiple awakenings. Obesity is a major risk factor for sleep apnea.

Out of almost 4 million deliveries, 452 women had sleep apnea. Of the almost 168,000 women with gestational diabetes, 67 had sleep apnea. Of the almost 201,000 women with pregnancy-induced high blood pressure, 166 had sleep apnea.

The researchers concluded that sleep apnea was associated with a twofold increase in the risk of gestational diabetes and a fourfold increase in the risk of pregnancy-induced high blood pressure.

The findings were to be presented Tuesday at the American Thoracic Society's international conference in San Francisco.

"The repetitive decrease in oxygen that occurs during the night in someone with sleep apnea heightens the body's 'fight or flight' state, which can raise blood pressure," researcher Hatim Youssef of the Robert Wood Johnson Medical School at the University of Medicine & Dentistry of New Jersey, said in a prepared statement.

"The body also secretes more hormones such as cortisol and epinephrine, and the body responds by producing more glucose coupled with a decreased sensitivity to insulin, which can lead to diabetes," Youssef explained.

He noted that pregnancy can worsen sleep apnea, particularly during the third trimester when weight gain is the greatest.

"When a mother's oxygen level drops at night, it may also affect the oxygen level of the fetus, and we don't know what the long-term effects are," Youssef said. "That's why it's important for a pregnant woman with sleep apnea to be treated with CPAP (continuous positive airway pressure) during her pregnancy."

CPAP delivers air through a mask while a person sleeps.

source : health.yahoo.com

Health Tip: Signs of Hyperthyroidism

(HealthDay News) -- Hyperthyroidism occurs when the thyroid overproduces hormones that control the body's metabolism.

The American Academy of Family Physicians lists these common warning signs of hyperthyroidism:

* Sudden, unexplained weight loss.
* Weakened muscles and fatigue.
* Feelings of nervousness and anxiousness.
* Excessive sweating.
* Rapid heartbeat.
* Tremors.
* Eyes that are red, wide, or swollen.

The academy says other diseases and conditions can mimic these symptoms, so your doctor may run some tests to confirm a suspected diagnosis.

source : health.yahoo.com

New Treatment for Common Genital Infection

(HealthDay News) -- The U.S. Food and Drug Administration has approved Tindamax (tinidazole) to treat bacterial vaginosis (BV), the most common vaginal infection among women of childbearing age, drug maker Mission Pharmacal said Thursday.

It's the first new oral therapy in a decade to treat BV, which affects almost one-third of women in the United States, the company said. Caused by an overgrowth of certain bacteria, BV often does not have symptoms. When they are present, symptoms may include vaginal discharge, burning during urination, and itching.

Tindamax treats the entire reproductive tract, including the upper tract where the bacteria have been shown to migrate. Left untreated, BV can increase a woman's risk of acquiring sexually transmitted diseases including chlamydia, gonorrhea and HIV, the drug maker said. Among pregnant women, BV can increase a woman's risk of early pregnancy loss and premature delivery.

During clinical testing, side effects of Tindamax included metallic taste and nausea. First FDA approved in 2004, the drug was previously sanctioned for trichomoniasis, giardiasis, and amebic liver abscess.

source : health.yahoo.com

Drinking While Pregnant Boosts Preemie Birth Risk

THURSDAY, May 24 (HealthDay News) -- Drinking alcohol during pregnancy increases the risk of having an extremely premature baby (less than 32 weeks of gestation), especially among women aged 30 and older, U.S. researchers warn.

They studied 3,130 pregnant women and collected information on their use of alcohol, cocaine and cigarettes.

Of the babies born to the women, 66 were extremely premature, 462 were mildly premature, and 2,602 were full-term deliveries.

The study found that alcohol and cocaine, but not cigarettes, were associated with an increased risk of having an extremely premature baby. Alcohol was a much greater risk factor than cocaine and the impact was greater in women over age 30.

"Although we found smoking to be associated with mild preterm, but not extreme preterm delivery, smoking remains a recognized risk for preterm delivery and should still be considered a problem from a fetal perspective," Robert J. Sokol, distinguished professor of obstetrics and gynecology, and director of the C.S. Mott Center for Human Growth and Development at Wayne State University, said in a prepared statement.

He noted that 92 percent of the women in the study were black, and the findings need to be confirmed in other studies.

"The baseline risk for preterm delivery is higher among African Americans than whites in the United States. There are known ethnicity effects for prenatal alcohol exposure, so studying pregnancies among white s would be sensible, yet if I had to guess, I think we would see changes in the same direction," Sokol said.

The bottom line: drinking alcohol during pregnancy increases the risk of extreme preterm delivery and it "would be best for women to just not drink during pregnancy," Sokol said.

The findings are published in the June issue of Alcoholism: Clinical & Experimental Research.

source: health.yahoo.com

FDA Approves 'No-Period' Contraceptive Pill

Lybrel, a birth-control pill that does away with a woman's monthly period, was approved Tuesday by the U.S. Food and Drug Administration.

The estrogen-progestin hormonal pill differs from traditional birth-control pills in that it does not include the "week off" of placebo pills that leads to a cessation of artificial hormones and bleeding.

Lybrel is described as "continual contraception" but it "works the same way as the 21-days on, seven-days off [pill] cycle -- it stops the body's monthly preparation for pregnancy by lowering the production of hormones that make pregnancy possible," Dr. Daniel Shames, deputy director of the FDA's Office of Drug Evaluation III, at the Center for Drug Evaluation and Research, explained at a press conference late Tuesday.

A majority of women who decide to take Lybrel will encounter unscheduled bleeding, or spotting, that in most cases tapers off over the first year of use, Shames said. In the primary clinical trial leading up to approval, 59 percent of women who took Lybrel for one year reported no bleeding or spotting during the last month of the trial.

In terms of safety, two one-year clinical trials involving more than 2,400 18-to-49-year-old women showed no increased risk of endometrial cancer among those taking Lybrel. The risks of other side effects linked to the birth-control pill -- primarily blood clots -- were similar to those seen in other contraception regimens, Shames said.

"We don't expect any surprises in terms of long-term use of this product," he added, although he noted that the FDA has requested that the drug's maker, Wyeth Pharmaceuticals, conduct post-marketing studies to keep tabs on Lybrel's long-term safety.

Despite some women's reticence to do away completely with their monthly period, gynecologic experts agreed that there was no physiological "downside" to a period-free life. In fact, one expert noted that, for decades, many American women have been pharmaceutically ending their periods with more traditional birth-control pills with no resulting problems.

"There were other products, such as the long-acting progestin, Depo-Provera, that was given by injection," said Dr. Michael Petriella, vice chairman of obstetrics and gynecology at Hackensack University Medical Center, in Hackensack, N.J. "Women who were using that for contraception wouldn't get their period at all while on that product."

And for years, "some physicians have been allowing some women to take the Pill off-label -- allowing them to take two packages continuously, for example," Petriella said.

Another expert noted that the "period" women get while on conventional birth-control pills isn't connected to a natural cycle of egg production, anyway.

"It's not a natural period. It's an artificially induced period that happens because she stops taking the hormones for seven days. So, she gets some vaginal bleeding," explained Dr. Camelia Davtyan, an internist specializing in women's health and an associate professor of medicine at the University of California, Los Angeles.

In fact, a no-period pill like Lybrel could have been a contraceptive norm for women from the get-go, Davtyan said. However, the doctors and pharmaceutical companies who developed the birth-control pill back in the 1960s assumed that women would want a regimen that mimicked the monthly cycle.

"I guess they were trying to make it seem as 'real' as possible and cause as little change as possible in a woman's life," Davtyan said.

But times have changed, and newer contraceptive products such as Seasonale -- a contraceptive pill that cuts the number of periods to just four a year -- have already been readily embraced by some American women over the past decade.

Davtyan said she has recently noticed a big shift in her patients' attitudes toward their period.

"They want convenience, and they tell me that they'd just rather not have the bleeding altogether so that they don't have any limitations with sports, with having to use pads, tampons," she said. "And the younger the woman, the more likely that she will want her periods stopped. It's very possible that this will be the wave of the future."

But Petriella said many women still feel a strong psychological attachment to their period and do not want to give it up, however inconvenient it may be.

"Sometimes [ending periods] is just emotionally uncomfortable for women," he said. "They don't feel right about not having their period. For those women, obviously Lybrel and other such products are not good products for them."

Petriella believes that, at least in the short-term, Lybrel will appeal to only a minority of women. They include those with menstruation-linked conditions such as endometriosis and menstrual migraine, or those who have already tried -- and liked -- period-limiting products such as Seasonale, he said.

As with any pharmaceutical contraceptives, women who decide to go on Lybrel may experience random breakthrough bleeding, Davtyan said.

So, for the 59 percent of women who have no bleeding or spotting after one year, "I think Lybrel is a great deal," Davtyan said. "For the remainder, if they have the patience to hang in there for a few months, the spotting might abate. There will be an occasional patient that will continue to spot, and then, clearly, it's a better deal to have a scheduled period than to start spotting at an unknown time and maybe in an uncomfortable circumstance."

Women who decide to resume their monthly cycle -- for example, those who wish to become pregnant -- can typically expect to resume their normal cycle within days of stopping Lybrel, Shames said. He said that short timespan to resumption of ovulation could leave women who skip or miss pills open to unplanned pregnancy, so the FDA is advising that women consider a second form of birth control while on Lybrel, as a safeguard.

Both Davtyan and Petriella stressed that young women who are considering a pharmaceutical end to their period should not be concerned that doing so will harm their health.

"Remember, there's no real physiological value to hold on to the period that a woman has while she is taking the Pill, unless it is a psychological value, which I respect," Davtyan said.

source : health.yahoo.com

Gene Findings Boost Breast Cancer Research

Four new studies released Thursday are shedding new light on the genetics of breast cancer, especially for one of the best-known breast cancer genes, BRCA1.

"The more we can understand the underlying mechanism for BRCA1, the better shot we have at developing chemoprevention" for women who carry the DNA mutation, said one expert, Kathleen Malone, a cancer epidemiologist at the Fred Hutchinson Cancer Research Center in Seattle.

She was not involved in the studies, which were all published in the May 25 issue of Science.

In one article, scientists who track how the body repairs its DNA (the "DNA damage response") when it is exposed to chemicals or other carcinogens say they've found a possible new breast cancer gene.

The new candidate gene is called Rap80, according to a partnership of scientists at the Abramson Family Cancer Research Institute, University of Pennsylvania, Philadelphia, and the Dana-Farber Cancer Institute, Boston.

Rap80 is a protein that is crucial for BRCA1 to do its repair work properly, they found.

It has long been known that certain mutations in the BRCA1 and BRCA2 gene prevent it from doing normal repair work. This puts carriers of the gene defect at dramatically higher risk of breast and ovarian cancers.

Yet, mutations in these genes explain less than 50 percent of inherited cancers, the scientists from Penn and Dana-Farber said.

Rap80 deficits may help explain many other cancer cases, the scientists said. If BRCA1 is mutated, it can't bind to the RAP80 protein, the scientists found. If this DNA damage is not identified and fixed, the mutations can lead to malignancy.

Other researchers found that the list of proteins involved in the DNA damage response is much longer than believed.

"A lot more proteins are called into action than we ever guessed," said Stephen Elledge, the Gregor Mendel Professor of Genetics and of Medicine at Harvard Medical School and an author on two of the four papers.

"The list of proteins totals 700," Elledge said. "Before, we knew about 20 proteins." The discoveries, he said, "will give us a higher-resolution picture of what the BRCA1 gene is doing inside the cells."

"Cells constantly have a problem with DNA, with cells breaking down," explained Elledge. "Cells have a built in sensory network to find out if there is a problem. If you can't fix the problem, it could lead to mutation and cancer."

"The hope is that as we learn enough about BRCA1, we can figure out what it isn't doing and try to fix that," Elledge added. The list of proteins gives scientists a large database to hunt for other potential cancer genes.

Malone called the host of papers "an amazing convergence" of new findings from different laboratories.

With the identification of the role of Rap80, Malone agreed that "we could be talking about another breast cancer candidate gene."

In a Science perspective accompanying the papers, John H. J. Petrini, a researcher at Memorial Sloan-Kettering Cancer Center, noted that the new research "brings fundamental new information to the table, while at the same time reminding us that the more we know, the more complicated things get."

source : health.yahoo.com

Health Tip: Breast Cysts

(HealthDay News) -- Breast cysts are fluid-filled sacs that are formed when milk-producing glands become enlarged.

The California Pacific Medical Center says the cause of these cysts isn't fully understood, although it is believed that they are related to an irregular balance between fluid production and absorption.

Breast cysts are particularly common in women between the ages of 40 and 60. They are sometimes felt as lumps in the breast, but others are small enough to be detected only by a mammogram.

Most cysts in the breasts are benign, and usually do not mean an increased risk of breast cancer, the hospital says. But all cysts should be evaluated by a doctor without delay.

source : health.yahoo.com

Tips to Keeping the Barbecue Cancer-Free

SATURDAY, May 26 (HealthDay News) -- The Memorial Day holiday is the traditional kick-off of the summer barbecue season in the United States, but research has shown that grilling can create cancer-causing compounds in meat, experts say.

Among the compounds are heterocyclic amines (HCAs), which are created when heat acts on amino acids, and creatinine in animal muscle.

The longer the cooking time and the higher the heat, the more HCAs, say experts at the University of California, Davis, Cancer Center. That means that barbecuing produces the most HCAs, followed by pan-frying and broiling. Baking, poaching, stir-frying and stewing produce the least HCAs.

The UC Davis experts offer the following advice for limiting HCAs:

* Before you barbecue meat, partially cook it in the microwave and then throw out the juices that collect in the cooking dish. Finish cooking the meat on the grill. Precooking a hamburger for a few minutes in the microwave reduces HCAs by up to 95 percent.
* Flip hamburgers often. Doing so every minute reduces HCAs by up to 100 percent. This is likely because constant flipping keeps internal meat temperatures lower.
* Marinate meat before grilling. This can greatly reduce HCAs. For example, one study found that chicken marinated for 40 minutes in a mixture of brown sugar, olive oil, cider vinegar, garlic, mustard, lemon juice and salt cut HCAs by 92 percent to 99 percent.
* Don't cook meat to "well done." Use a meat thermometer and cook poultry to an internal temperature of 165-180 degrees F, ground beef, pork and lamb to 160-170 degrees F, and beef steaks and roasts to 145-160 degrees F.
* One or two days before you barbecue, eat cruciferous vegetables such as broccoli, cabbage, cauliflower, kale and brussels sprouts. These vegetables contain compounds that activate enzymes in the body that detoxify HCAs.


source : health.yahoo.com

Breast Cancer Genetics Takes Big Leap Forward

SUNDAY, May 27 (HealthDay News) -- Researchers say they've moved much closer to untangling the genetic threads that raise a woman's chance for breast cancer.

A set of studies published Sunday in the journals Nature and Nature Genetics identified four new breast cancer susceptibility genes, as well as several genetic markers, that are associated with the risk for the disease and that deserve further investigation.

The findings may be the most important genetic discoveries relating to breast cancer genetics since the identification of the BRCA1 and BRCA 2 susceptibility mutations in 1994, experts say.

"With these three reports, we've doubled or more the number of genes in which inherited variations are known to be associated with an increased risk of breast cancer. It's a big quantum of new knowledge," said David Hunter, lead author of one of the papers and co-author on another.

"What we hope will happen is that each of those genes or gene regions will lead us to better understand the mechanisms and biology behind breast cancer," he said. "And that with that better understanding, we'll be able to develop improved means of prevention and treatment."

Hunter is professor of cancer prevention at the Harvard School of Public Health and an epidemiologist with Brigham & Women's Hospital, both in Boston.

Other experts echoed those sentiments. Because the research involved such a large team of international researchers, it was difficult to identify experts who had not been involved with the odyssey in one way or another.

"These findings are really very exciting. Ever since BRCA 1 and BRCA 2, we have been looking for genes associated with breast cancer, and there haven't been many identified," said Heather Spencer Feigelson, a co-author on one of the papers and strategic director of genetic epidemiology at the American Cancer Society in Atlanta. "These are three independent, genome-wide association studies coming out simultaneously that give us some new clues."

"It means a tremendous amount. It's very exciting," added Dr. Stephen Chanock, who was involved in two of the papers and is a senior investigator at the U.S. National Cancer Institute. "This opens a whole series of new doors for therapy and, when we can start to explain it better, prevention."

Mutations in the BRCA1 and BRCA2 genes, the best-known susceptibility genes identified thus far, increase a woman's risk of developing both breast and ovarian cancer. But these genes account for only a small proportion of total breast cancer cases, because the frequency of the mutations is so low in the general population.

"The BRCA1 and 2 genes were milestones in cancer research, but they are rare mutations," Chanock said. "If you have one of those, you have a particularly higher risk of developing breast or ovarian cancer, but 95 percent of the population is not affected by these rare but very significant genes."

Other genes have also been implicated in breast cancer susceptibility but, again, most of these are rare.

"Then the question is, well, maybe it's a conglomeration of things, and what does that complex conglomeration look like?" Chanock continued. "We are just at the dawn of pulling out the major pieces of that."

The first study, appearing in Nature, involved several stages of analysis. That, in turn, led to an analysis of 30 single nucleotide polymorphisms ("SNPs") in 21,860 breast cancer patients and 22,578 controls.

Out of that analysis, the investigators, based in Cambridge, U.K., identified four genes linked with genetic susceptibility to breast cancer (FGFR2, TNRC9, MAP3K1 and LSP1).

The researchers also found five regions of DNA that were present more often in breast cancer patients, suggesting that elements in these regions might raise a woman's risk.

A second study, this one appearing in Nature Genetics, was carried out as part of a collaboration -- called The Cancer Genetic Markers of Susceptibility or CGEMS project -- between Harvard and the NCI. It found that variations of the gene FGFR2 were associated with a heightened risk of breast cancer.

Women of European ancestry who inherited one copy of the FGFR2 mutation increased their breast cancer risk by about 20 percent and by 60 percent if they had two copies.

This same association was found by the Cambridge researchers as well.

These FGFR2 variants, which appear to be involved in cell growth or division, are thought to be present in more than 60 percent of U.S. female adults.

The final paper, also appearing in Nature Genetics, found genetic variants on chromosome 2 and on chromosome 16 that increase the risk of estrogen-receptor-positive breast cancer. One of these variants is located near TNRC9, which was identified in the U.K. study.

Researchers are not advocating that each gene be tested, because the risk from each is relatively small. One day, however, a test for gene combinations may be useful.

"We wouldn't ask to test each of them but, certainly, as we learn more about this, it will give us more clues about the etiology and biology and may lead to differences in treatment," Feigelson said. "This tells us what genes and where to look, and that's the important first step."

"These are all markers. They don't tell you why someone gets breast cancer. They tell us that parts of the genome are very, very important," Chanock added. "We have to figure out what they are."

The technology used in the research only became available last year and is now being applied to a wide variety of diseases, including diabetes and prostate cancer. It will also continue to be applied to the genetics of breast cancer.

"This is sort of the middle of the story," Hunter said. "It is by no means the end of the story."


source : health.yahoo.com

Hair Follicles May Regrow After Head Wounds

WEDNESDAY, May 16 (HealthDay News) -- A chance finding in wounded lab mice could point the way to reversing hair loss, scientists say.

While studying the healing of wounds in mice, a team at the University of Pennsylvania noticed that the animals developed new hair follicles after their skin was scraped.

This is very unusual, because "the dogma was that when you're born, you're stuck with the number of hair follicles that you have," said study co-author Dr. George Cotsarelis, director of the university's Hair and Scalp Clinic. And, if the follicles die -- as occurs during aging -- they can't be revived.

No one knows if new follicle growth occurs in wounded humans or if researchers can find a way to harness the hair-growing effect without having to actually hurt people.

But scientists are hopeful, especially considering that current treatments for baldness do not create new follicles to replace ones that have died.

"We're amazed that we're getting follicles to form," Cotsarelis said. He believes the findings could even "lead to a better understanding of regeneration that might be important for treating wounds and larger sorts of injuries down the road."

Apparently, something in the mice's healing process reprograms stem cells in the skin to start making new follicles, Cotsarelis said. Essentially, he said, the process is like rebooting a computer and sending out a new command through a gene. "You're getting the clock to go back to where it was at birth," he explained.

The result is new follicles that seem to act just like follicles should -- they sprout hair.

The study is published in the May 17 issue of the journal Nature.

The wounds that appear to cause the hair regrowth in the mice are similar to a common dermatological treatment known as dermabrasion, Cotsarelis said. In dermabrasion, layers of skin are scraped off and healing begins.

So, why not start treating balding people with dermabrasion on their heads? Cotsarelis -- who is forming a company to explore ways to develop the treatment for human use -- cautioned that it's not quite that easy. Scientists may have to expand upon the treatment and work with genes to make hair grow properly, he said.

Besides hair growth, the research could have other benefits. "The follicle is a small organ, a mini-organ," Cotsarelis said. "If you can figure out how to regenerate the follicle, you also have a better idea about how to regenerate a finger or a limb."

Dr. Andrzej A. Dlugosz, a professor of dermatology at the University of Michigan who's familiar with the study, said the research is "very elegant" and especially unique since it involves mice that have not been genetically altered.

As to the scientific study of hair loss, he said that hair growth problems are hardly trivial. "There are many types of hair loss, and some of these can be emotionally devastating. Developing effective ways to restore hair can do a lot of good for patients in terms of their general well-being," Dlugosz said.

Indeed, he said, the research might also help produce skin grafts that look and function more like normal skin in burn victims.

Experts Debate Giving HPV Vaccine to Boys

FRIDAY, May 18 (HealthDay News) -- Amid the controversy around mandated vaccination of young girls against the human papillomavirus (HPV), some experts are beginning to wonder whether the shot should also be given to boys.

While males cannot get HPV-linked cervical cancer, they make up half of the equation when it comes to spreading the sexually transmitted virus. And a new study released last week shows that the virus is also a leading cause of throat cancer, which affects both sexes.

"This is a viral infectious process, and the majority of the time it is passed through heterosexual contact. And I think it's important to consider boys as equal players in that process," said Dr. Michael Bookman, director of medical gynecologic oncology at Fox Chase Cancer Center in Philadelphia.

"Boys are not as prone to [HPV-linked] cancer as girls, but they are obviously involved in the transmission, and there is some risk of cancer in boys, as well," he added.

No one is debating the effectiveness of the vaccine, called Gardasil. The shot is targeted against the four strains (out of 15) of HPV that are thought to trigger 70 percent of cervical cancers.

Since its approval for use in girls and women between the ages of 9 and 26 by the U.S. Food and Drug Administration last June, several states have moved to mandate Gardasil's inclusion into routine school vaccination programs. That's because vaccinating before the onset of sexual activity is most effective in preventing HPV infection.

Those efforts have met with strong opposition, however. Some conservative groups worry the vaccine will encourage sex among young people, while other critics view the mandates as an intrusion on parental rights. Most state measures do give parents the right to opt out of the program, however.

So far, those debates have centered on young girls. But, in more rare instances, boys and men can fall prey to HPV as well. Reporting last week in the New England Journal of Medicine, a team of researchers at Johns Hopkins University confirmed that infection with HPV via oral sex is by far the leading cause of throat cancer, which strikes 11,000 American men and women each year. HPV is also a major cause of anal cancer and genital warts, both of which affect either sex.

The threat of throat cancer is especially troubling, Bookman said, because doctors traditionally only look for these malignancies in long-time smokers and drinkers. "Head and neck exams are more associated with smoking and alcohol and less associated with HPV, although that's changing," he said.

And while girls and women typically see a gynecologist for their Pap smear to look for cervical cancer, "how many boys and men are going to go to a doctor and ask them to look at their throat? It's just not that common," Bookman said.

Debbie Saslow is director of breast and gynecological cancers at the American Cancer Society. She agreed that HPV also poses a threat to males, but she's not yet convinced that Gardasil would help protect them.

"We have been considering vaccination for boys since day one, but the problem is that there is just no data yet -- everything is holding until we get data that the vaccine actually works in boys," she said.

Gardasil's maker, Merck & Co., is largely responsible for pulling that data together. However, according to Bookman, "they took a more conservative stance when they approached the FDA for licensure, registration and vaccine recommendations -- their safety data base was stronger for girls than boys."

Saslow also is doubtful whether Gardasil -- which costs $360 per three-shot regimen -- would prove to be cost-effective if provided to boys as well, at least in terms of preventing the biggest threat, cervical cancer.

"It may be cost-effective to vaccinate boys if not that many girls get vaccinated," she said. "But if most of the female population ends up getting vaccinated, then vaccinating boys won't add very much."

But what about the vaccine's cost-effectiveness in preventing anal and throat cancers, plus genital warts, among boys? Saslow said that since Gardasil has not yet been proven to be effective in boys, or to be effective against cancers outside the cervix, those points remain up in the air. "We still have all these questions that we need to look at," she said.

Another expert, Dr. Robert Frenck, a professor of pediatrics at Cincinnati Children's Hospital, was equally noncommittal. Frenck, who sits on the American Academy of Pediatrics' committee on infectious diseases, said his group is "in the process of developing the recommendations for HPV vaccine use." He said the AAP recommendations would focus only on the vaccine's "currently [FDA] licensed usage," which is exclusively for females.

Still, Bookman believes that, should Gardasil prove effective in boys, widening its use to both sexes "is the correct way to try and do things."

"What about everything that we know about controlling any other type of infectious process? Where we wouldn't discriminate on the basis of sex, we would vaccinate universally," he said. "Yes, in women cervical cancer is a more serious risk statistically than other cancers in men. But I think that the best way of controlling it with a vaccine is to use it broadly."

Katrina Victims 10 Times More Prone to Post-Traumatic Stress

FRIDAY, May 18 (HealthDay News) -- Following Hurricane Katrina, New Orleans residents suffered post-traumatic stress disorder (PTSD) at a rate that was 10 times that of the general population, a new study finds.

The study, to be presented Friday at the annual meeting of the Society for Academic Emergency Medicine, in Chicago, found that PTSD was diagnosed in more than 38 percent of people arriving at an interim emergency department facility in New Orleans following Katrina. The rate in the general U.S. population is just 3.6 percent.

People who lost loved ones and remained in New Orleans during the hurricane were most likely to be affected by PTSD symptoms, the researchers said.

The scope and duration of this one mental health issue after Katrina shows that long-term, coordinated mental health response must be included in disaster relief, the researchers said.

"The incidence of PTSD in our population post-Katrina reported in this research study is noteworthy and worth following as recovery efforts move forward. The prevalence cited in this study is not alarming to those professionals caring for patients who have been traumatized by the storm and challenged by the recovery efforts," Dr. Peter DeBlieux, director of emergency services at Louisiana State University in New Orleans, said in a prepared statement.

Gardasil Guards Against Vaginal, Vulval Cancers

THURSDAY, May 17 (HealthDay News) -- An international study shows that the cervical cancer vaccine that received government approval in the United States last year also protects women against vulval and vaginal cancers.

The findings seem to confirm that human papillomavirus (HPV), which is responsible for virtually all cases of cervical cancer, is also responsible for many cases of vulval and vaginal cancer. HPV is present in 80 percent of the 6,000 cases of vulval and vaginal cancers diagnosed in the United States each year.

"We've spent a lot of time over the last 20 years trying to show that HPV was associated with vulval and vaginal cancers, so that's very exciting," said Dr. Leo Twiggs, professor and chairman of the department of obstetrics and gynecology at the University of Miami Miller School of Medicine. "It's the answer to whether the cause is HPV."

The findings appear in the May 19 issue of The Lancet; initial data was first presented at the American Society of Clinical Oncology meeting last year.

Although less common than cervical cancer, vulval and vaginal cancers are becoming more widespread in young women. The incidence of in situ vulval carcinoma increased more than 400 percent in the United States between 1973 and 2000. Invasive vulval cancer increased by 20 percent during the same period.

The Gardasil vaccine was developed to target four strains of HPV, two of which (HPV 16 and 18) are linked to cervical cancer and to vulval cancer, and two (HPV 6 and 11) which cause anogenital warts.

Unlike cervical cancer, there are no screening programs for vaginal or vulval cancer.

Recent research also found that HPV is probably the number one cause of throat cancer, which affects about 11,000 Americans each year.

The HPV vaccine has already been shown to be almost 100 percent effective in preventing HPV 16-related or HPV 18-related cervical lesions, which are precursors to cancer.

Here, the authors did a combined analysis of three randomized clinical trials involving, collectively, more than 18,000 women aged 16 to 26 in 24 countries around the world. The research was funded by Merck, which makes Gardasil.

Participants had been randomly assigned to receive either the vaccine or a placebo.

After three years of follow-up, the vaccine proved to be 100 percent effective against vulval and vaginal lesions related to HPV 16 or HPV 18 in women never previously exposed to the HPV virus. The vaccine was 71 percent effective in women previously exposed to HPV.

The vaccine reduced the risk of high-grade vaginal and vulval lesions by 49 percent, regardless of whether HPV was detected in the lesion.

"This is very impressive," said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. "We're having a paradigm shift. It's very hard for a lot of people to recognize that we can actually prevent cancer, and it's very hard for people to recognize that certain types of cancer are sexually transmitted. The vaccine is very good. It is not perfect. It does not protect against every viral infection from HPV, but it protects against the ones that are the most common."

According to the Finnish study authors, the maximum effect of the vaccine would be expected in girls who are vaccinated in early adolescence, before any exposure to HPV.

"I would recommend it for my daughters and anybody else's daughters," Brooks said.

"I've been practicing medicine for 30 years and have seen patients die of cervical cancer and oftentimes younger patients who have kids at home," Twiggs added. "It's great that we can actually prevent it. It's very important for us to get the word out there about how this could prevent cancer."

Health Tip: Symptoms of Yeast Infection

(HealthDay News) -- Vaginal yeast infections occur when the yeast that is found naturally in and around the vagina grow in large numbers.

The normal acidic environment of the vagina should keep yeast growth in check. But if this environment becomes less acidic, too many yeast can trigger an infection.

The American Academy of Family Physicians offers these common symptoms of yeast infections:

* Itching or burning.
* Vaginal discharge that is white and thick.
* Painful intercourse.
* Swollen vulva.

Health Tip: Prenatal Checkups
(HealthDay News) -- If you've just learned you're pregnant, don't hesitate to schedule a doctor's appointment.

Regular doctor visits during pregnancy are important to ensure that you and your baby stay healthy, according to the University of Arkansas for Medical Sciences.

At some point, you can expect to undergo:

* A physical exam, including a pelvic and breast exam, checking your heart, lungs, eyes, ears, nose and throat, and measuring your height and weight.
* Blood, urine and blood pressure tests, and a Pap smear to check for disease that could affect your health during pregnancy.
* Checks for several harmful conditions, including anemia, bladder infections, syphilis, gonorrhea, HIV, cervical cancer, hepatitis B, vaginal infections and other problems.
* Questioning about the state of your health and that of the baby's father.

Health Tip: Symptoms of Yeast Infection

(HealthDay News) -- Vaginal yeast infections occur when the yeast that is found naturally in and around the vagina grow in large numbers.

The normal acidic environment of the vagina should keep yeast growth in check. But if this environment becomes less acidic, too many yeast can trigger an infection.

The American Academy of Family Physicians offers these common symptoms of yeast infections:

* Itching or burning.
* Vaginal discharge that is white and thick.
* Painful intercourse.
* Swollen vulva.

Race Plays Role in Women's Folic Acid Intake

THURSDAY, May 10 (HealthDay News) -- There are racial and ethnic differences among U.S. women of childbearing age in the intake of folic acid, which can prevent serious neural tube defects that affect the brain and spinal cord.

That finding is published in the May issue of the American Journal of Clinical Nutrition.

Even though the U.S. Food and Drug Administration requires moderate folic acid (folate) supplementation of enriched cereal-grain products, most women of childbearing age don't get the recommended 400 micrograms of folic acid a day, the study noted.

Researchers analyzed data on 1,685 women, ages 15 to 49, who took part in the 2001-2002 National Health and Nutrition Examination Survey. Of those women, 69.9 percent were non-Hispanic white, 13.5 percent were non-Hispanic black, and 17 percent were Hispanic.

Overall, the women consumed an average of 221 micrograms of folic acid a day from fortified foods and diet supplements, and an additional 151 micrograms a day from naturally occurring folic acid in foods, such as dark, leafy vegetables.

The study found that 40.5 percent of non-Hispanic white women, 21 percent of Hispanic women, and 19.1 percent of non-Hispanic black women got 400 micrograms or more of folic acid a day from all sources.

Among the women who did get the recommended amount of folic acid, 76 percent consumed folic acid supplements. Supplement use was lower among non-Hispanic black women and Hispanic women than among non-Hispanic white women.

These findings may help explain why non-Hispanic black women have a higher risk of having babies with neural tube defects, the study authors said.

Race Plays Role in Women's Folic Acid Intake

THURSDAY, May 10 (HealthDay News) -- There are racial and ethnic differences among U.S. women of childbearing age in the intake of folic acid, which can prevent serious neural tube defects that affect the brain and spinal cord.

That finding is published in the May issue of the American Journal of Clinical Nutrition.

Even though the U.S. Food and Drug Administration requires moderate folic acid (folate) supplementation of enriched cereal-grain products, most women of childbearing age don't get the recommended 400 micrograms of folic acid a day, the study noted.

Researchers analyzed data on 1,685 women, ages 15 to 49, who took part in the 2001-2002 National Health and Nutrition Examination Survey. Of those women, 69.9 percent were non-Hispanic white, 13.5 percent were non-Hispanic black, and 17 percent were Hispanic.

Overall, the women consumed an average of 221 micrograms of folic acid a day from fortified foods and diet supplements, and an additional 151 micrograms a day from naturally occurring folic acid in foods, such as dark, leafy vegetables.

The study found that 40.5 percent of non-Hispanic white women, 21 percent of Hispanic women, and 19.1 percent of non-Hispanic black women got 400 micrograms or more of folic acid a day from all sources.

Among the women who did get the recommended amount of folic acid, 76 percent consumed folic acid supplements. Supplement use was lower among non-Hispanic black women and Hispanic women than among non-Hispanic white women.

These findings may help explain why non-Hispanic black women have a higher risk of having babies with neural tube defects, the study authors said.

Standard Infertility Treatment Best for Hormone Disorder

WEDNESDAY, Feb. 7 (HealthDay News) -- Women with polycystic ovary syndrome who want to have a baby will probably have better luck if they take the fertility drug clomiphene instead of metformin, an insulin-sensitizing medication that helps induce ovulation in women with the disorder.

That's the conclusion of new research that found the live birth rate was 22.5 percent for women taking clomiphene, compared to just 7.2 percent for those on metformin.

"Many people thought that metformin would be more effective, but it failed on two counts -- either alone or in combination with clomiphene," said the study's lead author, Dr. Richard Legro, professor of obstetrics and gynecology at Penn State College of Medicine.

"Clomiphene alone is the gold-standard way for women with PCOS to achie ve pregnancy," he added.

The study, funded by the National Institutes of Health, is published in the Feb. 8 issue of the New England Journal of Medicine. Bristol-Myers Squibb provided the metformin and the placebos used in the study.

Polycystic ovary syndrome (PCOS) is a common endocrinological disorder. It affects as many as 8 percent of American women and may be the cause of most infertility, according to background information in the article. Women with PCOS are often overweight, have excess body and facial hair, reduced insulin sensitivity and irregular menstrual cycles. The root of many of these symptoms is an excess of androgens, or male hormones.

Many women with PCOS are treated with metformin (brand name, Glucophage), a diabetes drug that helps increase the body's response to insulin. This, in turn, reduces the levels of circulating insulin, which reduces the levels of androgens. This often helps restore ovulation and normal menstruation, and possibly helps some women lose weight. Many also believe that metformin could help with PCOS-related infertility, according to the article.

Dr. David Guzick is dean of the School of Medicine at the University of Rochester School of Medicine and Dentistry, in Rochester, N.Y. The author of an accompanying editorial in the journal, he said: "Metformin took hold as a generally accepted treatment. The belief was that because you're addressing the underlying abnormality, you're restoring the system back to normal.

"Clomiphene was viewed as old-fashioned and not reflecting the physiology of PCOS. However, this study found the reverse is true, the old-fashioned way is shown to be preferable," he added.

Guzick said clomiphene works more directly than metformin when it comes to fertility. Clomiphene causes the body to release follicle-stimulating hormone, which stimulates the ovaries to release an egg.

For the new study, the researchers recruited 626 women with PCOS who were infertile. The average duration of infertility, according to Legro, was three years.

The women were randomly assigned to receive clomiphene plus a placebo, metformin plus a placebo, or both metformin and clomiphene for as long as six months.

The combination group had the highest live-birth rate with 26.8 percent. The live-birth rate for the clomiphene group was 22.5 percent, while the metformin group's live-birth rate was just 7.2 percent. The difference between the combination group and the clomiphene group was not statistically significant, the researchers said.

While metformin and clomiphene both caused women to ovulate more, Legro said another interesting finding from this study was that "all ovulations are not alike" and that studies like this one can't stop at looking at the ovulation rate but need to follow through to see how many women actually achieve a pregnancy.

Another concern, Legro said, was that more women on metformin experienced first-trimester pregnancy loss. While the numbers weren't statistically significant in the study, Legro said the finding was troubling, and he would recommend that women stop metformin as soon as they know they're pregnant.

The biggest concern with clomiphene is the increased risk of multiple births, according to Legro. In this study, the rate of multiple births in the clomiphene group was 6 percent, compared to zero percent in the metformin group.

The bottom line, said Legro, is that women with PCOS who want to conceive should get clomiphene as their first-line therapy. "Metformin is not as good as it was hyped to be, but this is not the first time a newcomer has been dethroned," he added.

Guzick said that, aside from medication, one of the most important things women with PCOS can do, both to get pregnant and improve overall health, is to lose weight.

"Even losing just five to 10 pounds can lead to a 50 percent increase in ovulation," said Guzick. And, losing weight prior to conception can also help women lower the risk of some pregnancy complications, he said.

Smoking's Effects on Uterus Harm Fertility

THURSDAY, Nov. 9 (HealthDay News) -- If you thought all the risks of cigarette smoking were already known, think again.

New research finds that heavy smoking impairs women's fertility by reducing the odds that a fetus will implant in the uterus.

Previously, experts had thought that heavy smoking reduced fertility because of its effect on the ovaries. The new finding suggests tobacco deals women a double blow.

"Tobacco consumption reduces your pregnancy probability, not only due to the already known ovarian effects but also due to impaired uterine receptiveness," said Dr. Sergio R. Soares, lead author of the study and director of the IVI Clinic in Lisbon, Portugal.

"This is the first study that shows the clinical impact of cigarette smoking on uterine receptiveness," added Soares, whose study is published in the Nov. 9 online edition of Human Reproduction.

The take-home message remains the same: "A healthy pregnancy starts with a healthy mother," said Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City. "Quit smoking before you become pregnant."

The effect of cigarette smoking on the ovaries has been known for a while, she said. "There's often ovulatory dysfunction in heavy smokers, and they tend to have menopause at an earlier stage," Wu noted.

The authors of the study looked retrospectively at 741 non-heavy smokers (under 10 cigarettes a day) and 44 heavy smokers (over 10 cigarettes a day). All of the women had received oocyte donations as part of in vitro fertilization (IVF) between January 2002 and June 2005.

None of the women's partners smoked and none of the oocyte donors were heavy smokers.

According to the study, the lighter smokers had a significantly higher pregnancy rate (52.2 percent) than the heavy smokers (34.1 percent).

The fact that the oocytes were donated means the problem lies with the uterus, not the ovaries, the researchers noted.

Previous research had also shown that light smoking had no significant effect on IVF cycles.

Oddly, heavy smokers had about double the rate of multiple pregnancies (60 percent) than non-heavy smokers (31 percent). Although this may be a glitch in the findings, it's also possible that different women respond differently to cigarette smoking, Soares said.

Soares and his team are now looking at the genetics behind the phenomenon.

"We are beginning a study of gene expression in the endometrium of heavy smoking oocyte recipients to see which might be the key molecules involved in the implantation process that are altered in these patients," he said.

Boosting Iron May Boost Female Fertility

TUESDAY, Oct. 31 (HealthDay News) -- Women who took extra iron dramatically reduced their risk of developing ovulatory infertility compared with women who did not take extra iron, researchers report.

"It's actually a very simple problem to correct with iron supplements and probably a multivitamin," added Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City. "It would be a very easy fix for infertility if iron plays a role in ovulatory dysfunction."

But even such a simple solution may not yet be ready for widespread use, she said.

"This is just one study," Wu said. "We need more studies with larger numbers to indicate what exact level of iron supplement is ideal for women attempting conception."

She was not involved with the study, which is published in the November issue of Obstetrics & Gynecology.

According to the study, iron deficiency is the most common nutritional deficiency in the world. Women of childbearing age are at increased risk for the condition, since menstruation, pregnancy and lactation take their toll on the body's iron supplies.

For this trial, Harvard researchers looked at data on more than 18,500 married, premenopausal women who were participating in the Nurses' Health Study II. None of the women had a history of infertility and all attempted or actually became pregnant between 1991 and 1999. Diet was assessed twice and then correlated to the incidence of infertility.

The researchers looked specifically at the use of iron supplements, intake of iron in the diet (supplements plus food) and whether there was a difference between "heme" iron (from animal sources) and nonheme iron (from vegetables sources and supplements).

During an eight-year follow-up, "women who consumed nonheme iron had a significantly lower risk of infertility due to ovulation when compared to women who were consuming low iron or heme iron," said study author Dr. Jorge E. Chavarro, a research fellow in the department of nutrition at Harvard School of Public Health. Women should also inform their physician if they plan to boost their iron intake, he added.

The higher the nonheme intake, the lower the risk of infertility. In fact, women consuming iron supplements with 41 mg of iron or more had a 62 percent lower risk of infertility, the lowest in the study. Women consuming high amounts of iron from other non-animal sources also had a significantly lower risk of ovulatory infertility compared with women who consumed little iron.

"It's important that the results are reproduced, but the results suggest that women who are trying to get pregnant should consider having greater amounts of iron in their diet from non-animal sources including multivitamin supplements," Chavarro said.

The findings do seem to make some biological sense, said the study authors and others.

"You assume that you need certain building blocks in order to ovulate and have conception and fertilization and all that, so it does make sense that you'd want to have good nutrition overall," Wu explained. "What the exact mix of nutrients is, no one knows."

Ovary Removal Raises Young Women's Death Risk

FRIDAY, Sept. 15 (HealthDay News) -- Younger women who have had their ovaries removed should consider estrogen therapy if they are under the age of 45, a new study suggests.

Mayo Clinic researchers found that those who said no to hormone therapy faced a higher death risk than those who said yes.

Many women with high-risk family histories have their ovaries removed, a procedure known as an oophorectomy, to help them avoid cancer or other diseases. However, experts said this new data should give them pause when deciding whether to use hormone replacement therapy afterwards.

According to one specialist, the study suggests that estrogen may have different risks and benefits, depending on a woman's age: protecting health at a younger age, seemingly neutral at menopause, but harmful at an older age.

"The study tells us that estrogen for women under 45 is very important to maintain health. Estrogen is a complex hormone in its interactions in the body, and has importance far beyond the reproductive tract," said Dr. Bobbie Gostout, a Mayo Clinic gynecologic surgeon who was not involved in the research.

The findings are published in the Oct. 1 issue of Lancet Oncology.

In their study, the researchers developed a statistical model of death due to ovarian cancer, breast cancer, coronary heart disease, hip fracture and stroke. Risks for all of these illnesses have been tied to estrogen levels.

"We aimed to investigate survival patterns in a population-based sample of women who had received an oophorectomy, and compare these with women who had not received an oophorectomy," the researchers wrote.

Women who had oophorectomies for reasons other than cancer before menopause were compared with age-matched women in the same population who did not have oophorectomies.

There were nearly 1,300 women with unilateral oophorectomy (one ovary removed), nearly 1,100 with bilateral oophorectomy (both ovaries removed), and close to 2,400 controls in the study.

The team found that certain younger women who have prophylactic bilateral oophorectomy -- surgical removal of both ovaries -- were at an increased risk of death from all causes.

Overall, mortality was not increased in women who had both ovaries removed, but that changed when the researchers broke down the findings by age.

For example, mortality was significantly higher in women who had both ovaries removed before the age of 45 years than women with intact ovaries. Furthermore, this increased mortality was seen mainly in women who had not received estrogen supplementation to the age of 45 years.

Although having both ovaries removed before age 45 years is associated with increased death risk, it is uncertain whether it helps cause death, or is merely a marker of some other underlying risk, the authors wrote.

No increased mortality was recorded in women who had just one ovary removed, regardless of their age, the study found.

In the United States, prophylactic oophorectomy prevents about 1,000 cases of ovarian cancer each year. Over the last three decades doctors have been gradually increasing their recommendations that women have ovaries removed at time of hysterectomy to avoid the risk of cancer, "but that wonderful prevention has been at the cost of removing ovaries in 300,000 women per year," Gostout said.

"This 25-year study showed a decreased incidence in ovarian cancer, however that was countered by adverse health impact in other areas," said Gostout. The increased death risk did not show up for at least a decade, and was 1.7 times greater than normal, the study found.

The work is exciting because it fills in part of the information deficit for women in this age bracket, she added.

Before this study, people were applying lessons from Women's Health Initiative -- a study that focused on women 60 years and older -- to much younger women, recommending that estrogen not be used any longer than five years.

"This study shows that could be an error -- that women under the age of 50 face a different risk/benefit scenario than older women," Gostout said.

But whether all women who've had bilateral oophorectomy should receive estrogen therapy isn't yet proven, another expert said.

The researchers looked at associations in this study, "but don't prove cause and effect," noted Dr. Andrew Berchuck, director of gynecologic oncology at Duke University, and president-elect of the Society of Gynecologic Oncologists. Estrogen replacement after menopause is a "patient-by-patient decision, and physicians and patients must look at individual risk factors and symptoms," he said.

There's a long-running debate about what age to remove ovaries, "but there's very little science because these studies require long-term follow-up, and that's hard to do," Berchuck said. "This study adds some ammunition to the argument that says 'leave the ovaries in closer to the natural age of menopause' -- about 50 years -- but it's by no means conclusive," he said.

Gostout agreed these decisions are tough, and best left to an individual woman and her doctor. "If a woman is considering hysterectomy, she will probably be invited to make a decision about her ovaries. That decision should be highly individualized," Gostout cautioned. "No woman should be told that because she's having a hysterectomy her ovaries must removed as well." Rather, the decision is based on age and family risk for breast and ovarian cancer, she said.

If a woman needs her ovaries removed because of disease or elects to have them removed, estrogen replacement is recommended until the average age of menopause, age 50, Gostout said.

"Don't be scared away from estrogen-replacement therapy in the premenopausal age because there are some concerns in the postmenopausal age," Berchuck added.

In the meantime, women who have had their ovaries removed in the past should not be "alarmed or frightened," Gostout said, since "the increased risk [of illness] for any single woman is very tiny." She said it might also be reasonable for these women to ask their physicians about "estrogen-replacement therapy if they're not already taking it and they're less than 50 years of age."

Mother's Beef Consumption May Affect Son's Fertility

TUESDAY, March 27 (HealthDay News) -- Pregnant women who eat beef seven or more times a week may be producing sons with low sperm counts.

The exact reason for the association isn't clear. But hormones, pesticides or other chemicals in beef might affect the development of the testes of the still developing fetus, speculated the authors of a study in the March 28 issue of Human Reproduction.

But expectant mothers and others should weigh the findings judiciously against other evidence, the researchers added.

"We're not saying that people should stop eating beef, and it's particularly important in pregnancy that women get enough protein," said study lead author Shanna Swan, associate chairwoman for research and professor of obstetrics and gynecology at the University of Rochester (N.Y.) School of Medicine and Dentistry.

"Women have to eat protein, although they don't necessarily have to eat meat," she said. "If women want to take action, they could try hormone-free beef or organic beef, although it's not proven, or reduce their consumption of beef or find some other protein."

Dr. George R. Attia, associate professor and director of the Division of Reproductive Endocrinology & Infertility at the University of Miami Miller School of Medicine, added: "It's very hard to draw conclusions from a single study like this. They used historical data, so the mom had to remember what she was eating at the time. That also makes it difficult to get a conclusion."

Six different anabolic hormones are used in cattle in the United States and Canada to stimulate growth. Three are natural hormones -- estradiol, progesterone and testosterone -- and three are synthetic hormones -- zeranol (an estrogen), trenbolone acetate (a steroid with androgen effects) and melengestrol acetate (a progestin), the study authors said.

The use of these hormones has been banned in Europe since 1988. In the United States, use is regulated through measurable levels of the hormones present in muscle, fat, liver, kidney and other organs found in meat products.

According to background information in the study, developing fetuses and pre-pubescent children are most sensitive to exposure to sex steroids, so meat consumption by pregnant women and young children needs to be watched.

For this study, the first to look at beef consumption and semen quality, researchers analyzed semen samples and questionnaires from 387 male partners of pregnant women. The men, born between 1949 and 1983, had reported (with the mothers' input, if possible) on their own mothers' diet during pregnancy.

Sperm concentration was inversely related to how much beef the mother had consumed each week. Sons of women who ate more than seven beef meals a week had sperm concentrations 24.3 percent lower. And the proportion of men with low sperm concentrations was three times higher (17.7 percent vs. 5.7 percent) among sons of women who consumed more than seven meals of beef a week, compared with men whose mothers ate less beef while pregnant.

Sperm concentration was not related to a mother's consumption of other meat, including veal and pork, as well as fish and chicken, the researchers said.

Although none of the men in the study was infertile, 18 percent of those whose mothers ate the most beef had sperm counts classified as "sub-fertile" by the World Health Organization, the researchers said.

"While they (men whose mothers ate high quantities of beef) were fertile, they may have taken a longer time to conceive or, if we had asked them a year before, they might have been having trouble conceiving," Swan said. "They were twice as likely to have visited a doctor because they thought there were problems, so it's not to say there's no effect on fertility."

The study authors don't yet know if anabolic hormones in beef can explain the findings. Most American beef consumed while these women were pregnant was fortified with these hormones, however. Beef also contains residues of pesticides and other industrial chemicals, the study authors said.

Next, Swan and her colleagues hope to repeat this study with men born in Europe after 1988, when such hormones were banned.

"If we did the same study, and there was an association, it couldn't be due to the hormones, because there aren't any," Swan said. "But if we do not see an association, that would actually point to the hormones. That's our plan."

Obese Women Face Greater Risk for Polycystic Ovary Syndrome

FRIDAY, Oct. 27 (HealthDay News) -- Overweight and obese women are five times more likely than lean women to have polycystic ovary syndrome, a new Spanish study finds.

Polycystic ovary syndrome, which decreases fertility, occurs when the ovaries malfunction and levels of the hormone androgen in the body are unusually high. Symptoms include acne, excess hair growth, and irregular or no menstrual periods.

The condition is associated with sleep apnea, poor quality of life, and an increased risk for diabetes and heart disease. More than half of women with polycystic ovary syndrome are obese, but the actual prevalence of the condition in overweight or obese women was not known, according to the study authors.

This study of 113 overweight or obese women found that 28.3 percent had polycystic ovary syndrome, compared to established rates of 6.5 percent among all women and 5.5 percent among lean women.

Women in the study with polycystic ovary syndrome tended to be younger and were more likely to also have insulin resistance, the study found.

"We conclude that physicians treating overweight and obese patients should be aware of the high prevalence of polycystic ovary syndrome among these women and that screening for polycystic ovary syndrome, at least by obtaining a detailed menstrual history and a careful clinical evaluation of hyperandrogenic symptoms, should be conducted routinely to diagnose polycystic ovary syndrome and ameliorate the health burden distinctly associated with this prevalent disorder," the study authors wrote.

Health Tip: Female Infertility

(HealthDay News) -- About 12 percent of women in the United States aged 15-44 have difficulty getting pregnant or carrying a baby to term, the U.S. government says.

Here is a list of risk factors for infertility, courtesy of the U.S. Department of Health and Human Services:

* Age, usually 35 or older.
* Stress.
* An unhealthy diet and/or body weight.
* Excessive exercise or training.
* Alcohol and tobacco use.
* Sexually transmitted disease.
* Any health condition that causes hormone levels to change.

source : www.yahoo.com/news/rss/pregnancy

Uterine Cancer Survival Worse for Black Women

MONDAY, Sept. 25 (HealthDay News) -- Despite similar treatments, black women with uterine cancer have higher death rates and shorter survival times than white women, new U.S. research shows.

Black women lived an average of 10.6 months compared to 12.2 months for white women with stage III, IV, or recurrent endometrial cancer, which is cancer of the uterine lining.

"African-American women with advanced endometrial cancer have worse outcomes than Caucasians even when they receive equal treatment," said Dr. G. Larry Maxwell, director of the Gynecologic Disease Center at Walter Reed Army Medical Center in Washington, D.C.

The study findings are published in the November issue of the journal Cancer.

Maxwell and his co-investigators performed a retrospective analysis of 1,151 patients -- 169 were black, 982 were white -- enrolled in one of four randomized treatment trials for advanced or recurrent endometrial cancer.

The analysis showed that black women had a 26 percent greater risk of death, compared to white women -- even if the stages of disease and treatments were similar. Blacks appeared to have lower tumor response to each of the chemotherapy regimens used in the trials, according to the study.

The study researchers looked at chemotherapy, surgery and postoperative radiation treatments. "Treatment in the general population may be a factor leading to differences in outcomes, but our findings suggested other factors need to be explored," Maxwell said. Those factors could include socioeconomic and cultural influences, he said.

The study is important because it "examines whether racial differences play a role in responses to chemotherapy and, most importantly, looks at survival in patients at high risk for recurrent endometrial cancer," said Dr. Robert Morgan, section head of medical gynecologic oncology at City of Hope cancer center, in Duarte, Calif.

The study authors looked at patients in clinical trials who received the same treatment. "This is the ideal setting to see differences in outcome with equal treatment. African-Americans have much worse survival even when we controlled for many prognostic variables that ultimately can affect survival," Maxwell said.

Morgan said the study findings "suggest that the difference in survival is biologic and that is consistent with what's reported with multiple other cancers."

There may be specific genes that mutate at different rates in tumors in blacks compared to whites, suggesting that biology -- not socioeconomic or cultural factors -- may explain the difference, Maxwell speculated. "Our group is looking at broader analyses of the entire genome," he said.

Morgan said the study findings suggest genetic causes for the differences between the races. "Although the authors hypothesize socioeconomic or cultural differences, in these well-controlled trials in which the populations are the same, I would be more inclined to believe there are biological differences," he added.

He said other studies have found differences in survival rates between races for other cancers, including breast, prostate and "a number of other" malignancies.

"This study looked at uterine cancer and shows more evidence for potential biologic differences between the races. We need to look for a scientific viewpoint focusing on genomic differences between racial groups," Morgan said.

Maxwell's group plans to do just that. It will be designing a prospective trial to determine whether genetic differences explain the disparity in survival.

In the end, however, another crucial message is clear, Morgan stressed. "The answer to patients is that early detection of endometrial cancer is almost always curative. Women of all races should know that if they have postmenopausal bleeding, they should see a gynecologist immediately. There is no normal postmenopausal bleeding," he said.

source : www.health.yahoo.com/news/rss/cancer

Conjugated estrogen and medroxyprogesterone combinations

What is the most important information I should know about conjugated estrogens and medroxyprogesterone?

Conjugated estrogens increase the risk of developing endometrial hyperplasia, a condition that may lead to cancer of the lining of the uterus. Taking a progestin, such as medroxyprogesterone, with conjugated estrogens lowers the risk of developing this condition. Visit your doctor regularly and report any unusual vaginal bleeding right away.

The Women's Health Initiative (WHI) study found an increased risk of breast cancer, heart disease, nonfatal heart attacks, and blood clots in women taking estrogen and medroxyprogesterone combinations long-term. You should contact your doctor or healthcare provider to discuss your individual risks and benefits before taking a conjugated estrogen and medroxyprogesterone combination long-term. You should also talk to your doctor or healthcare provider on a regular basis (for example, every 3-6 months) about whether you should continue this treatment.

Have yearly physical exams and examine your breasts for lumps on a monthly basis while taking conjugated estrogen and medroxyprogesterone combinations.
nopreg Do not take conjugated estrogen and medroxyprogesterone combinations if you are pregnant or planning to become pregnant. It could affect the development of the baby.
What is conjugated estrogens and medroxyprogesterone?

Conjugated estrogens are naturally occurring female sex hormones that are involved in the development and maintenance of the female reproductive system.

Medroxyprogesterone is a female hormone, usually called "progesterone." It is important for the regulation of ovulation and menstruation.

Together, conjugated estrogen and progesterone are used to treat the symptoms of menopause such as feelings of warmth in the face, neck and chest, or sudden intense spells of heat and sweating ("hot flashes" or "hot flushes"); to treat vulvar and vaginal changes caused by menopause (itching, burning, dryness in or around the vagina, difficulty or burning with urination); and to prevent thinning of the bones (osteoporosis).

Conjugated estrogen and medroxyprogesterone combinations may also be used for purposes other than those listed in this medication guide.
What should I discuss with my healthcare provider before taking conjugated estrogens and medroxyprogesterone?
donot Do not take conjugated estrogen and medroxyprogesterone combinations without first talking to your doctor if you have

* had an allergic reaction to another estrogen or progesterone product;
* a circulation, bleeding, or blood-clotting disorder;
* a history of blood clots in the leg or lung;
* liver disease;
* undiagnosed, abnormal vaginal bleeding; or
* any type of breast, uterine, or hormone-dependent cancer.

Taking conjugated estrogen and medroxyprogesterone combinations may be dangerous in some cases if you have any of the conditions listed above.

Before taking conjugated estrogen and medroxyprogesterone combinations, tell your doctor if you have

* high blood pressure, angina, or heart disease;
* a history of heart attack or stroke;
* high levels of cholesterol or triglycerides in the blood;
* kidney disease;
* thyroid problems;
* asthma;
* epilepsy;
* migraines;
* depression;
* diabetes;
* gallbladder disease;
* uterine fibroids; or
* had a hysterectomy (uterus removed).

You may not be able to take conjugated estrogen and medroxyprogesterone combinations, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

The Women's Health Initiative (WHI) study found an increased risk of breast cancer, heart disease, nonfatal heart attacks, and blood clots in women taking estrogen and medroxyprogesterone combinations long-term. You should contact your doctor or healthcare provider to discuss your individual risks and benefits before taking a conjugated estrogen and medroxyprogesterone combination long-term. You should also talk to your doctor or healthcare provider on a regular basis (for example, every 3-6 months) about whether you should continue this treatment.
nopreg Conjugated estrogen and medroxyprogesterone combinations are in the FDA pregnancy category X. This means that these medications are known cause birth defects in an unborn baby. Do not take conjugated estrogen and medroxyprogesterone combinations if you are pregnant or if you could become pregnant during treatment.
nobrfeed Conjugated estrogen and medroxyprogesterone combinations pass into breast milk, and the effects on a nursing infant are unknown. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.
How should I take conjugated estrogens and medroxyprogesterone?

Take conjugated estrogen and medroxyprogesterone combinations exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
water Take each dose with a full glass of water.
food Take conjugated estrogen and medroxyprogesterone combinations with food or milk to lessen stomach upset. Try to take doses at the same time each day. You may be taking the medication on a cycle, such as every day for 3 weeks with 1 week off each month to mimic the body's natural cycle. Follow the directions on the prescription label.

Have yearly physical exams and examine your breasts for lumps on a monthly basis while taking a conjugated estrogen and medroxyprogesterone combination.

It is important to take conjugated estrogen and medroxyprogesterone combinations regularly to get the most benefit.

Your doctor may want you to have blood tests or other medical evaluations during treatment with a conjugated estrogen and medroxyprogesterone combination to monitor progress and side effects.
rt Store conjugated estrogen and medroxyprogesterone combinations at room temperature away from moisture and heat.
What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and return to the regular dosing schedule. Do not take a double dose of this medication unless otherwise directed by your doctor.
What happens if I overdose?
emt An overdose of a conjugated estrogen and medroxyprogesterone combination is unlikely to threaten life. Call an emergency room or poison control center for advice if an overdose is suspected.

Symptoms of a conjugated estrogen and medroxyprogesterone combination overdose might include nausea, vomiting, and vaginal bleeding.
What should I avoid while taking conjugated estrogens and medroxyprogesterone?

There are no restrictions on food, beverages, or activity while taking a conjugated estrogen and medroxyprogesterone combination unless your doctor directs otherwise.
What are the possible side effects of conjugated estrogens and medroxyprogesterone?

Conjugated estrogens increase the risk of developing endometrial hyperplasia, a condition that may lead to cancer of the lining of the uterus. Taking a progestin, such as medroxyprogesterone, with conjugated estrogens lowers the risk of developing this condition. Visit your doctor regularly and report any unusual vaginal bleeding right away.

The Women's Health Initiative (WHI) study found an increased risk of breast cancer, heart disease, nonfatal heart attacks, and blood clots in women taking estrogen and medroxyprogesterone combinations long-term. You should contact your doctor or healthcare provider to discuss your individual risks and benefits before taking a conjugated estrogen and medroxyprogesterone combination long-term. You should also talk to your doctor or healthcare provider on a regular basis (for example, every 3-6 months) about whether you should continue this treatment.
emt Stop taking the conjugated estrogen and medroxyprogesterone combination and seek emergency medical attention or call your doctor immediately if you experience any of the following serious side effects:

* an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
* a blood clot (pain, redness, and swelling in an arm or leg; shortness of breath; coughing blood; chest pain; headache; blurred vision; confusion; loss of speech, or dizziness);
* unusual or abnormal vaginal bleeding;
* gallbladder disease (pain, swelling, or tenderness in the abdomen);
* liver damage (yellowing of the skin or eyes, nausea, abdominal pain or discomfort, unusual bleeding or bruising, severe fatigue); or
* a lump in a breast.

Other, less serious side effects may be more likely to occur. Continue to take conjugated estrogen and medroxyprogesterone combinations and talk to your doctor if you experience

* changes in appetite or weight,
* changes in blood sugar levels;
* swelling of the hands or feet,
* tiredness or weakness,
* irregular bleeding or spotting,
* depression,
* an increase in body or facial hair or hair loss,
* swollen or tender breasts,
* nausea,
* headache or insomnia,
* changes in your voice, or
* areas of darker skin.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect conjugated estrogens and medroxyprogesterone?

Before taking a conjugated estrogen and medroxyprogesterone combination, tell your doctor if you are taking any of the following medicines:

* an anticoagulant (blood thinner) such as warfarin (Coumadin);
* insulin or an oral diabetes medicine such as glipizide (Glucotrol), glyburide (Diabeta, Micronase), and others; or
* tamoxifen (Nolvadex);

A dosage adjustment or special monitoring may be required during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with conjugated estrogen and medroxyprogesterone combinations. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.
Where can I get more information?

Your pharmacist has additional information about conjugated estrogen and medroxyprogesterone combinations written for health professionals that you may read.
What does my medication look like?

Conjugated estrogen and medroxyprogesterone combinations are available with a prescription under the brand names Prempro and Premphase. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

* Prempro 0.625 mg of conjugated estrogens and 2.5 mg of medroxyprogesterone--two blister cards, each containing 14 oval, peach-colored tablets
* Premphase--one blister card of 14 oval, maroon tablets, each containing 0.625 mg of conjugated estrogens, to be taken on days 1 through 14; and a second blister card of 14 oval, light-blue tablets, each containing 0.625 mg of conjugated estrogens and 5 mg of medroxyprogesterone, to be taken on days 15 through 28.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.