- You Asked: What Does My Period Say About Me?
- There’s a Startling Increase in Major Depression Among Teens in the U.S.
- D.C. Council Approves ‘Death With Dignity’ Bill for Terminally Ill Patients
- This Kind of Dieting Is Unhealthy for Women
Posted: 16 Nov 2016 05:00 AM PST
According to some forms of ancient Chinese medicine, a woman’s menstrual discharge is interwoven with her qi, or life force. If her qi is disrupted—by stress or disease or internal discord—those issues may manifest as irregularities in her menstrual bleeding.
While Western doctors don’t talk a lot about their patient’s “life force,” they agree some attributes of a woman’s menses could be a tip-off to underlying health conditions—both good and bad.
“The average woman has 400 to 500 periods in her lifetime, and most go off without a hitch,” says Dr. Linda Bradley, an OB/GYN and surgeon with Cleveland Clinic. While there’s a lot of woman-to-woman variation in terms of timing and volume, Bradley says normal menstrual bleeding lasts three to seven days, and comes on every 24 to 35 days. And “bleeding” is not exclusively blood; it’s a mixture of mucous, blood and tissue from the lining of your uterus.
The color and consistency of a woman’s menses can vary, so in most cases, those characteristics aren’t reliable indicators of any specific health issue, says Dr. Nanette Santoro, chair of obstetrics and gynecology at the University of Colorado School of Medicine and a member of the Endocrine Society.
One textural exception: “Clots are not supposed to form in menstrual blood,” Santoro says. Your uterus contains enzymes that should break up any clots. If some are showing up in your menses—especially if they’re large, about quarter-sized—that’s a sign of an unusually heavy bleed, which is something you should tell your doctor about, she says.
Some other signs of a heavy menstrual bleed include having to change pads more than twice an hour for four hours, or a period that lasts longer than eight days, Santoro says. “If you’re changing your pad every 20 minutes, or you can’t go to work, or you’re waking up in the middle of the night to change your pad, that’s aberrant,” Bradley adds. She says that kind of heavy bleeding could be nothing—or a sign of benign uterine polyps or fibroids, disorders of the muscle wall or lining of the uterus, hormone imbalances or even cancer.
Returning to color, a brownish or rust-colored tint can result from taking birth control pills or using an IUD, and neither is concerning, she says. But any kind of noticeable odor is. “An offensive smell could signal vaginal infection or a sexually transmitted disease,” she says. Experiencing pain or fatigue with your period are also reasons to talk with your doc. Ditto light periods or going several months without a period. Bradley says pain or period absences could signal unhealthy weight gain or malnourishment. “Anorexia, bulimia, or very heavy exercise without proper nutrition can all cause dysfunction,” she says.
In some cases, hormonal imbalances—whether caused by pregnancy, menopause or a thyroid condition—could also lead to period hiccups. That’s also true of diabetes, liver disease, or chronic diseases, Bradley explains. “It’s good to remember that regular cycles happen because your body is making an egg,” she says. If something’s up with your health, your body may decide making that egg isn’t such a hot idea, and so you might experience a wide range of menstrual abnormalities.
Rather than scrutinize your period blood for any unusual characteristics, she recommends keeping an eye out for deviations from your normal flow or schedule. “You know your body, and you know its pattern,” she says. Like a random headache, one particularly heavy or light period isn’t something to freak out about. “But if you notice a change that lasts more than one cycle, see your doctor,” she says.
Posted: 15 Nov 2016 05:53 PM PST
Describing teens as moody and angsty is an old cliche. That stage of life is loaded with drama and intense feelings. And it was ever thus—just go back read your high school diary for evidence. But while anxiety and sadness aren’t new phenomena among adolescents, there’s been a significant increase in the percentage of young people aged 12-20 who have reported having a major depressive episode (MDE).
A study of national trends in depression among adolescents and young adults published in the journal Pediatrics on November 14 found that the prevalence of teens who reported an MDE in the previous 12 months jumped from 8.7% in 2005 to 11.5% in 2014. That’s a 37 percent increase. (An MDE is defined as a period of at least two weeks of low mood that is present in most situations. Symptoms include low self-esteem, loss of interest in normally enjoyable activities, and problems with sleep, energy and concentration.)
Despite the rise in teen depression, the study, which analyzed data from the National Surveys on Drug Use and Health, reported that there hasn’t a corresponding increase in mental health treatment for adolescents and young adults. Researchers said this is an indication that there is a growing number of young people who are under-treated or not treated at all for their symptoms. Meanwhile, among those who did get help, treatment tended to be more intense, often involving specialized care by in-patient and outpatient providers and including prescription medications. (This may be due in part to increased mental health coverage in the wake of new health care parity laws.)
This information won’t come as a surprise to school counselors and clinicians who’ve seen a rise in depression, anxiety and related incidents of self-harm first hand, as reported in TIME’s Nov. 7th cover story “The Kids Are Not All Right.” The number of kids who are struggling with these issues is staggering. According to the Department of Health and Human Services, more than three million adolescents aged 12-17 reported at least one major depressive episode in the past year, and more than two million reported severe depression that impeded their daily functioning.
Ellen Chance, co-president of the Palm Beach School Counselor Association, says that in her region “anxiety and depression are affecting kids’ behavior and their ability to learn which can lead to dropping out or home school.” Getting resources to these students is essential for them to function in school. She’s working with the National Alliance for Mental Illness to get more counselors trained to identify mental health disorders, but it’s not easy. Counselors are often responsible for more than 500 kids and have other duties as well, often including administering state tests.
In Montana, where major depressive episodes have also spiked, there’s a dearth of trained counselors that can get to all the schools in the sparsely populated state so officials are trying implement tele-counselling programs.
And California’s largest school district, Los Angeles Unified, tallied more than 5,000 incidents of suicidal behavior last year. That’s huge increase since they began tracking these issues in the 2010-2011 school year, when just 255 incidents were reported. These incidents ranged from expressions of openness to suicide and self-harm, and acts of self-harm. Specific incidents of self-harm, like superficial cutting and burning the skin are usually not attempts at suicide, but the behavior does correlate with a higher risk of suicidal behavior. Studies of self harm are consistent in showing that people who injure themselves do so to cope with anxiety or depression.
Some of the increase in depression in Los Angeles schools may be due to more awareness and improved data collection, but with more than 30 percent of high school students there reporting prolonged feelings of hopelessness and sadness lasting more than two weeks, and 9.1% of middle schoolers and 8.4% of high schoolers in the district actually attempting suicide, the data highlights the need for more mental health resources for young people.
Pia Escudero, L.A. Unified’s director of school mental health crisis counseling and intervention services, reported that kids in her district are at increased risk of depression when faced with adverse conditions such as single parent homes, community violence, sexual violence, economic hardship or cyber bullying. She and her team released a Blueprint for Wellness earlier this year detailing the district’s plan to increase resilience particularly among those at-risk students.
However, depression isn’t just affecting kids facing conditions that have long been associated with poor mental health outcomes. The Pediatrics study whose lead author was Ramin Mojtabai, MD, a professor at Johns Hopkins Bloomberg School of Public Health, adjusted for those socio-demographic and household factors and concluded that they could not account for the big increase in depression trends. Nor was there a correlation with substance abuse. In fact, there has been little change in rates of substance abuse among teens.
Perhaps the most common risk for depression is being female. According to the department of Health and Human Services, rates of depression among girls ages 12-17 in 2015 were more than double that of boys. (In the U.S., 19.5% of girls experienced at least one major depressive episode in the last year, while only 5.8% of boys did.) The Pediatrics study researchers suggested that adolescent girls may be more exposed to risk factors. They point to research that indicates that cyber-bullying is far more prevalent among girls than boys. Some studies show that girls use mobile phones with texting applications more frequently and intensively. And, problematic mobile phone use in this age group has been linked to depressed mood.
Counselors like Ellen Chance in Palm Beach say they see evidence that technology and online bullying are affecting kids’ mental health as young as fifth grade, particularly girls. “I couldn’t tell you how many students are being malicious to each other over Instagram. “I’ve had cases where girls don’t to come to school and they are cutting themselves and becoming severely depressed because they feel outcasted and targeted.” She says she now sees cutting incidents pretty much weekly at her elementary school, and while they vary in severity, it’s a signal that not all is right.
The authors of the teen depression trends study concluded that “the growing number of depressed adolescents and young adults who do not receive any mental health treatment of their symptoms calls for renewed outreach efforts, especially in school and college health and counseling services and pediatric practices where many of the untreated adolescents and young adults with depression may be detected and managed.”
For budget-crunched schools and municipalities, it’s difficult to fund and deploy more mental health resources. But quantifying the problem is a significant step. To that end, the American Academy of Pediatrics is now recommending depression screening for all young people ages 11 through 21. Because symptoms of depression are often not recognizable by teachers, parents or even physicians, this move may be key to better identifying kids who are suffering and getting them treatment.
Posted: 15 Nov 2016 02:21 PM PST
The D.C. Council overwhelmingly approved a “Death With Dignity” bill Tuesday that allows terminally ill patients the ability to obtain medication to end their own lives.
The council passed the measure 11-2 after approving the bill by the same margin in an initial vote two weeks ago. The bill will now go to Mayor Muriel Bowser, who has pledged not to veto the legislation, which would make D.C. the first jurisdiction with a predominantly African-American population to approve a so-called right to die.
The bill is modeled after the nation’s first “Death With Dignity Act” in Oregon and would let terminally ill patients 18 years or older and with six months or less to live the ability to obtain life-ending, physician-prescribed medicine. Two witnesses have to verify that the patient’s decision is voluntary, and the medication must be self-administered.
Some African-Americans in D.C. opposed the bill claiming it could be used to target elderly black residents. Other groups like disability rights advocates and medical associations have historically opposed a so-called right-to-die, saying it unnecessarily devalues life and violates doctors’ Hippocratic Oath to do no harm.
The vote makes D.C. the seventh jurisdiction to allow aid in dying and comes after Colorado approved a ballot referendum last week legalizing the practice. Five other states—Oregon, Washington, Vermont, Montana and California—have also authorized it.
Posted: 15 Nov 2016 01:52 PM PST
Losing 10 pounds now and then and gaining it back may be bad for your heart, according to research presented at the American Heart Association’s Scientific Sessions.
Particularly if you’re a normal-weight woman: “We found that those with normal weight were the highest at risk for both sudden cardiac death and coronary heart disease death,” says Dr. Somwail Rasla, study lead author and internal medicine resident at Memorial Hospital of Rhode Island at Brown University.
In the study, Rasla and his colleagues looked at data from 158,000 women over age 50, who had self-reported their weight history and were categorized as normal weight, overweight or obese. During an 11-year followup, they were tracked for sudden cardiac death and coronary heart disease death.
Women who were normal weight at the study’s start but who reported a history of weight cycling—dropping more than 10 pounds and regaining it while not sick or pregnant, more than four times—had a 3.5 times greater risk for sudden cardiac death than those with stable weights. They also had a 66% increased risk of dying from coronary heart disease. However, weight cycling didn’t increase these risks for overweight or obese people.
That weight fluctuations are linked to such dire consequences makes some sense, and there are several different theories as to why. One is that every time weight is gained and lost, risk variables like heart rate, blood pressure, cholesterol and blood glucose fluctuate; repeat this cycle enough, and they’ll be less likely to return to baseline levels, Rasla says. Gaining and losing weight repeatedly may also cause insulin resistance, which increases the risk for coronary heart disease death, he says.
Why do these health problems appear to disproportionately affect women of healthy weight? Other research has shown that normal-weight women are more likely to die from with heart failure than obese women, Rasla says. “Obese people have higher blood pressure, high diabetes but over a long period of time, and it’s been found that their bodies develop a compensatory adaptive mechanism to different diseases,” he says. Thinner women, though they don’t get sick as often, may therefore be more vulnerable.
The preliminary research needs to be replicated in men and different age groups before researchers can make conclusions and recommendations. It’s also important to keep in mind that self-reports are sometimes inaccurate and that the study was merely observational, so the link could be due to a number of factors.
Rasla says the research shouldn’t discourage obese and overweight people from trying to lose weight because they fear the potential consequences of weight cycling. “However, the study adds to the literature that weight cycling in normal weight people may have adverse effects on their health,” he says, “and this should be taken with caution. The better way is to keep your weight still.”
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