Among the most common and sometimes most challenging menopausal experiences many women face are the changes that occur on the external genital tissue and intravaginal tissue that can affect urinary function. This is called genitourinary atrophy, most recently coined genitourinary syndrome of menopause. Symptoms can include one or more of the following: vulvovaginal discomfort, itching, burning, tingling, dryness, thinning of tissue, pain, pain with vaginal penetration related to dryness and/or tightness of vaginal opening, postcoital bleeding, vaginal discharge, bladder leakage, and...Read more
Over the past six years, there have been published trials raising concerns regarding calcium supplementation and excess risk for myocardial infarction and stroke. While the findings have not been consistent, a recent updated systematic review and meta-analysis on the effects of calcium intake from diet and supplements, either alone or with vitamin D, on the risk for cardiovascular disease in generally healthy adults, provides some clarification.1
The researchers analyzed four randomized trials and 27 observational studies. Calcium supplementation ranged from 400 mg/day to...Read more
Vitamin D3 and K2 are two essential, fat-soluble vitamins that together have a broad and intertwined impact on health.1-3 We all know that vitamin D3 (cholecalciferol) is light transformed and that it is technically not a vitamin because the skin synthesizes it on exposure to UV light. Vitamin D3 is the precursor to a class of D3-related hormones that have many functions in the body beyond calcium homeostasis. Receptors for this vitamin are ubiquitous throughout the body as they are found in more than 36 cell types.4 Recent research has shown the action of vitamin D...Read more
New York State finally got on board with offering another alternative to the chronic pain dilemma. Chronic pain is now a qualifying condition for the New York State medical cannabis program. New York’s program1 began in 2016 and has been grossly underutilized largely due to the glaring omission of one of the most prevalent conditions, chronic pain.
When the program was first announced, optimism loomed large as initial estimates for the number of people who would benefit from the program were somewhere between 200,000 and 400,000. To date only 15,000 patients and 911...Read more
Heavy menstrual bleeding is one of the more common gynecological reasons why women see their healthcare provider. The experience and results of heavy menstrual bleeding can greatly impact quality of life. There can also be blood loss that leads to iron deficiency anemia, which can result in mild to severe fatigue as well as changes in cognition, exercise tolerance, dyspnea and heart palpitations.
In addition to effectively treating this condition, it’s important to determine the underlying cause of the heavy menstrual bleeding (defined as greater than 80 mL per menstrual cycle)....Read more
While in Maui recently, we drove to the Haleakala Summit at 10,000 feet to watch the sunrise. We miscalculated driving times and reached the top three hours before the sun was supposed to rise. Yet we all agreed our mistake was worth it because we got to see the brightest star-studded sky any of us could remember. There wasn’t a cloud in the sky when we arrived, but by sunrise the summit was enveloped in a whiteout fog so that we never did see the sun come up or any color in the sky. I was reminded of this experience recently as I worked with Heather Wright to...Read more
Current physical activity guidelines recommend moderate intensity exercise for 30 minutes most days of the week for a total of 150 minutes/week, or vigorous exercise for 75 minutes per week, spread out over at least 3 sessions per week. In a report published in January 2017, researchers evaluated more than 63,000 men and women over age 40, inquiring about their moderate to vigorous physical activity.1 The research participants were classified into four groups:
- individuals who did no moderate or vigorous physical activity
- those who met the guidelines of 150...
My office is rife this month with patients exhibiting anticipation anxieties about what college accepted them or rejected them (their hopes are dashed forever!), what classes they failed, how well they performed, and how they are positioned for future success.
The sea of despair, the self-accusations, the diminution of inherent self-worth hangs in the balance of the student’s final report card. It appears that the cultivation of innate self-worth through other means has not been deemed worthy in our culture. The price tag on education is a functional reality and a concomitant...Read more
How we experience and interpret events in our lives is critically dependent on the context in which we frame them. This framing can be shaped by previous experiences, expectations, beliefs, social context, emotions and many other variables (see previous blog post). The experience of pain is not an exception.
As clinicians, we have numerous assessment scales for pain: the Wong-Baker Faces, 0-10 Numeric Rating Scale, Visual Analog Scale, Verbal Pain Intensity Scale, the McGill (where is your...Read more
The use of bitters as a therapeutic tool can be traced back to ancient Egypt. Eventually, around the 1800s, these combinations of medicinal herbs became a popular cocktail. Today, there is a resurgence of interest in bitters as both a custom cocktail addition and as a powerful supportive aid to digestive health.
When it comes to digestive health, ingestion of bitter herbs acts along two proposed pathways:1
- Binding of receptors that act reflexively to increase saliva and vagal tone of digestive organs.
- Stimulation of local receptors to increase...