Friday, January 29, 2010

Does obesity in adolescent girls lead to urinary incontinence?

We know, from the news and medical reports, that American kids are fat, and fatter than they have ever been. Whether due to video games or junk food, obesity in children and adolescents has doubled in the past three decades. A survey in 2004 on nutrition and health done in the USD showed that 17% of children and adolescents in the US are obese (BMI >95% percentile for age and sex). Unfortunately, obese children and adolescents suffer from the same health issues as obese adults: diabetes, high blood pressure, high lipids/cholesterol, sleep apnea, joint problems and psychological issues.

It is well known that obesity is a risk factor for urinary incontinence and that weight loss can significantly improve both stress and urge incontinence, and that diabetes has been correlated to urinary incontinence. Constipation and stool soiling is also more common in obese children, and constipation can also lead to urinary incontinence in both adults and children. Therefore the logical question is: are obesity girls (children and adolescents) at higher risk for urinary incontinence?

A recent study from Minnesota looked at this very question. 40 obese girls and 20 non-obese girls between the ages of 12 and 17 were recruited to answer a questionnaire. The kids were examined and weighed. Incontinence of urine was defined as leaking once or more per week. Questions regarding stress and urge incontinence were asked.

Among the obese girls, 12.5% reported incontinence at least about once a week. None of non-obese girls reported any incontinence meeting this definition. Infrequent leakage (less than once a month) with low volume occurred in both 45% of the obese and non-obese girls. The impact of incontinence was more severe in the obese girls in terms of degree of “bother”. Children with daytime wetting have been reported to have lower self-esteem. This is all the more relevant, as the authors state, that obese children and adolescents may be reluctant to report it, are embarrassed about it, and may not know there is treatment. On the basis of this, pediatricians, and other health care providers should gently ask their patients about such topics in order to offer assistance. First line remedies that are safe include weight loss (non-surgical), Kegel exercises, and even medications that aide bedwetters.

Thursday, January 21, 2010

Can Yogurt Help Vaginal Health?

The consensus seems to be Yes. Fermented milk products contain so-called “probiotic,” or “good” bacteria, including lactobacillus, acidophilus , and bifidobacterium , that compete with Candida in the vagina. Candida is a common yeast found in our colon and in women's vaginas. It can overgrow if healthy bacteria are killed (when taking antibiotics) and lead to a yeast infection. The probiotics found in yogurt are thought to counter the growth of Candida. That is considered a desirable effect.

In a Finnish study conducted of 320 women, researchers found that those who ate three or more servings per week of yogurt–or in some cases, cheeses made from fermented milk–had far fewer UTIs than those who didn’t eat yogurt or ate it only infrequently.
Several studies have found that to cause a significant reduction in the occurrence of yeast infections, people need to consume at least one serving of yogurt per day. In these studies, the yogurt contained acidophilus bacteria, which is generally noted on food labels as containing “live” or “active” cultures.

Half of all women will experience a yeast infection in their lifetime. Women who suffer from repeated infections may want to add yogurt to their regular diets, and have at least one serving daily. Because yeast feeds on sugar, most researchers recommend choosing low sugar or unsweetened yogurts.

P.S. once you have a yeast infection or UTI, you must take antibiotics to treat them- yogurt will do nothing for an active infection, but it can help prevent them.

Friday, January 15, 2010

Lateral episiotomy protects from obstetric anal sphincter rupture only with the first child

Tearing through the perineal tissue (from the vagina to anus) during labor is a serious complication of childbirth and even if repaired can lead to fecal incontinence. Some studies have shown that risk factors for anal sphincter rupture during delivery include vacuum assisted delivery, forceps delivery, high birth weight, and prolonged 2nd stage of delivery, and midline (straight downward) episiotomy. Some reports don’t see a difference between routine use of episiotomy and very restrictive use of it in terms of anal rupture.

A recent HUGE study of over 500,000 women from Finland looked at risk factors for anal rupture during delivery and whether episiotomy had any bearing on it. It was found that episiotomy decreased the likelihood of anal rupture only in women delivery their first child, but not for any subsequent delivery. The strongest risk factors for anal rupture in first time births was forceps delivery, birth weight over 4 kg (approximately 9 lbs), vacuum assisted delivery, and prolonged 2nd stage delivery), reinforcing previously held concepts, which were also risk factors for women delivering their second child or more. Episiotomy appeared to be protective only in vacuum assisted delivery in women delivering their first child, but nothing else. Ultimately, the study concludes that episiotomy should be used sparingly as it takes nearly 900 episiotomies to spare one anal rupture. Cutting sideways away from the anus appears to be protective only in first time deliveries using vaccum.

Monday, January 4, 2010

Can Certain Foods Kill Your Sex Drive?

Most of us know that oysters are commonly known as aphrodisiacs, whether in truth in myth, and yohimbine has been used as an aphrodisiac for hundreds of years, however, are there foods that can kill your libido? There may be truth to these, or merely myth as well, but some brief researching came up with the following short list:

Soy- Soy is well known to be heart healthy, and an ingredient in many foods, however, soy contains phytoestrogens, which may be good for the cardiovascular or inhibit prostate growth but it can throw the Testosterone/Estrogen ratio off, whether male or female. Estrogen may be the “female hormone”, but libido in men and women are driven by testosterone. Anything that upsets this imbalance may drive the libido down. What else can offset this ratio in women?- Oral contraceptives and oral hormone replacement therapy. Again, good for your heart, and may prevent a baby, but may be bad for sex drive.

Licorice- huge quantities of black licorice which contains glycyrrhizin has been shown in studies to lower testosterone in men and women. Red licorice usually does not contain glycyrrhizin.

Tonic water- Used as a home remedy for leg cramps because it contains quinine. (Quinine has also been used to treat malaria.) However quinine has been shown to lower testosterone levels and testosterone production in rat studies.