Let’s Talk Sex, Let’s Talk O-Shot®!

It is estimated that up to 15% of married couples either have no sex or have sex less than 10 times per year. While some couples claim to still have a close, fulfilling relationship without sex, the majority of one or both partners in a couple are unhappy with the state of affairs.

There are many reasons why sex can decline in a relationship. The demands of being a parent, financial stresses, medications, illness and declining hormone levels resulting in a decrease in desire and increase in painful intercourse, are a few causes of declining sexual activity.

Now, a new treatment is available at our clinic called the O-Shot® that uses Platelet Rich Plasma (PRP) to revitalize tissue so sex can be more enjoyable.

What are the benefits of the O-Shot® for women?

Women who have received the O-Shot® injection report an increase in vaginal sensitivity and enhanced orgasm, as well as more frequent and more intense orgasms! Other benefits include improvements in vaginal dryness, painful intercourse, and urinary control.
O-Shot® Benefits:

  • Increased sensitivity and sexual desire
    The O-Shot® can increase your desire and sensitivity for sexual activity, helping you restore the intimacy that you and your partner have missed out on.
  • Enhanced orgasm 
    After receiving the O-Shot® women report improved ability and stronger, more frequent orgasms.
  • Improved lubrication and urinary control
    By stimulating tissue growth, natural lubrication is improved which in turn makes intercourse less painful. Rejuvenation of your genital tissue also results in improvements in urinary control.
  • A safe, effective, non-surgical and drug-free procedure with no recovery time
    The O-Shot® injection is a safe, effective, drug-free and non-surgical procedure. What’s even better is that there is NO recovery time and results can last a year or more!

What is Platelet Rich Plasma and what does it have to do with sex?

Platelet Rich Plasma is a substance in your own blood that contains a tremendous amount of growth factors. It has been used for years in the orthopedic world to repair cartilage, ligaments, and tendons and now it is available for many other uses, including improving vaginal and sexual health.

What can I expect from the O-Shot® procedure?

After a blood draw, the patient’s own PRP is separated from white blood cells. After receiving a local anesthetic, the PRP is then injected to the genital tissue and the natural growth factors in the PRP begin to work right away, stimulating tissue repair and rejuvenation. The O-Shot® is a safe and relatively painless procedure, even though the thought of a needle down there can seem scary!

How can the O-Shot® change my life?

If one or both partners want a change, starting with communication is key. Expressing one’s desire to be more intimate can begin to improve the relationship right away. Planning date time together without distractions is also essential, resulting in the space to talk and share feelings.

The O-Shot® procedure has helped countless women strengthen their sexual relationships while boosting confidence and self-esteem. Being proactive in your sexual and urinary health is a big step, but well worth the effort.

If the desire to change and be more intimate is there but there are physical issues, working with a doctor to test hormones and to rule out other conditions like diabetes and cardiovascular disease is important.

If you are interested in learning more about the O-Shot®, please contact us for more information.

Lisa Lilienfield, M.D.
Certified provider of the O-Shot®

Call Today: 703-532-4892, ext. 2

Minimizing Breast Cancer Risk

According to the American Cancer Society, over 1.7 million people are expected to be newly diagnosed with some form of cancer this year alone. The causes of cancer are complex; genetics and our environment can play a large role. So while there is no sure way to prevent it, the tests, supplements, and lifestyle recommendations outlined below, along with the guidance of a trusted physician, can help minimize your risk.

Rick Assesment Tests

There are currently many tests available to assess the risk of breast cancer – for the purpose of this article I have chosen 2 to mention:

1) Estrogen-Metabolism Assessment: This valuable tool evaluates how your body metabolizes and processes estrogen. Certain types of estrogen metabolites may increase the risk and worsen the prognosis of breast cancer. Testing the levels of these metabolites in your blood or urine can help determine whether lifestyle changes, such as diet and exercise, are warranted in reducing the level of unhealthy estrogens in the body.

2) BRCA-Gene Testing for Women with a Strong Family History of Cancer. Certain gene mutations can indicate that some women have a higher risk of developing breast and ovarian cancers. Women who have inherited the harmful BRCA-gene mutation are about five times more likely to develop breast cancer in their lifetimes than women without it. Also, certain ethnic and geographic populations, such as Ashkenazi Jews, Norwegians, Dutch and Icelandic people have a higher prevalence of BRCA 1 and 2 mutations. Knowing whether or not you carry the mutation can help you understand your personal risk of developing breast or ovarian cancer.

Cancer-risk testing, although not yet perfect, is highly recommended, especially if you have a family history of the disease. Taking these tests can also help your doctor proactively tailor your care, depending on any medical predispositions.

The Importance of Lifestyle Choices in Minimizing Cancer Risk

Lifestyle can also play a very important role in minimizing your risk of cancer. I highly recommend the book, Keeping aBreast, by Dr. Khalid Mahmud, which offers the following suggestions for maintaining an optimal lifestyle (some of these also appear in well-regarded studies).

  • Nutrition: Good nutrition and targeted supplementation can help to reduce cancer risk. A low-glycemic diet that includes lean protein and more than 5 daily servings of vegetables is recommended. (See below for some of the best cancer-fighting foods and supplements.)
  • Exercise: Exercise programs emphasizing an increase in lean muscle mass offer benefits twofold by decreasing inflammation which in turn lowers cancer risk. On the other hand, an excess of fat in the body can increase levels of estrogen which increases the risk of breast cancer. One should aim for a BMI (body mass index) of 25.
  • Red Wine: Drinking red wine in moderation (less then 3 small glasses, 5 ounces each, per week) can reduce free radicals that damage DNA. Drinking in excess and smoking have the opposite effect of increasing free radicals, interfering with the body’s ability to repair potential cancer cells.
Consider Seeking an Integrative Medical Practitioner

A board-certified physician with experience in functional medicine can work with you to safely tailor a vitamin and supplement plan based on your personal test results and health concerns.

Eat More Cancer-Fighting Foods

Here are a few scientifically well regarded, cancer-fighting foods and supplements that a doctor may include in a personalized care plan:

Indole-3 Carbinol (I3C) – I3C enables the body to metabolize estrogen in a positive way; this is especially important if tests indicate high risk or a family history of breast cancer.[1] Good sources of I3C are cruciferous vegetables such as broccoli, cabbage, brussels sprouts, turnips, kale, and cauliflower. Those with a high-risk profile can take a supplement of I3C and should aim for 200-400 mg per day.
Omega-3 EPA-DHA Fatty Acids – Omega-3 has been shown to have a positive impact on preventing several forms of cancer, including breast and prostate cancer. You can increase your intake of Omega-3 fatty acids by eating fatty fish such as wild salmon. 1,500-3,000 mg of EPA-DHA Omega-3’s combined per day is considered optimal for most individuals.[2]
Vitamin-E Gamma-Tocopherol – “Whole” vitamin E is a potent anti-inflammatory vitamin and antioxidant. Most vitamin E is sold in the “alpha-tocopherol” form so make sure you are supplementing with whole vitamin E with “gamma-tocopherol.” Vitamin E is found in nuts, seeds, greens, and avocados. Suggested supplementation is 50-200 mg per day.[3]
Vitamin D – Your vitamin D levels should be checked regularly. Our practice regards an ideal vitamin D 25-hydroxy blood level to be between 40-80 ng/ml. Though Vitamin D can be obtained naturally from the sun, if you don’t spend enough time in the sun, or if your body has trouble absorbing it, you may need to supplement. The suggested dosage is 5,000 IU a day, with levels checked a few times a year by your doctor.[4]
Fiber – Research has linked a high-fiber diet to a reduced risk of colon cancer. 35 grams a day should be the goal. If dietary fiber levels are inadequate, supplementing with over-the-counter fiber is recommended.
Magnesium –Magnesium plays a role in enabling the body’s synthesis and repair of DNA, and research has linked low levels of magnesium to elevated cancer risk. Foods containing magnesium include leafy greens, nuts, fish, and avocados. 200-600 mg at the end of the day can also calm nerves and help with any sleep issues. Magnesium Glycinate is one form of magnesium supplement that absorbs particularly well to the body.[5]
Folic Acid – Folate, a B-complex vitamin, is helpful in building red blood cells and also can help regulate estrogen. Dietary folate is preferred, but supplementation may also be needed, especially for women who drink more than one alcoholic beverage per day. The ideal level of folic acid thought to be protective against breast cancer is 400 mcg per day. Folate is found in leafy greens, asparagus, beans and lentils, and avocado.[6]

If you are concerned about breast cancer, our doctors at the Kaplan Center for Integrative Medicine can work with you to tailor a scientifically-based program designed to lower the risk of cancer, while also helping you enjoy a healthy and active life.

[1] Brew, C.T., Aronchik, I., et al. 2009. “Indole-3-carbinol inhibits MDA-MB-231 breast cancer cell motility and induces stress fibers and focal adhesion formation by activation of Rho kinase activity.” International Journal of Cancer, May 15;124(10):2294-302.
[2] Simonpoulos, A.P. 2002. “The importance of the ratio of omega-6/omega-3 essential fatty acids.” Biomed Pharmacother, Oct; 56(8):365-79.
[3] Dietrich, M., Traber, M.G., et al. 2006. “Does gamma-tocopherol play a role in the primary prevention of heart disease and cancer? A review.” Journal of the American College of Nutrition, Aug;25(4):292-9.
[4] Garland, C.F., Gorham, E.D., et al. 2009. “Vitamin D for cancer prevention; global perspective.” Annals of Epidemiology, Jul;19(7):468-83
[5] Rosanoff, A., Weaver, C.M., et al. 2012. “Suboptimal magnesium status in the United States: Are the health consequences underestimated?” Nutrition Review, Mar; 70(3): 153-64.
[6] Chen, P., Li, C., Li, X., Li, J., Chu, R., and Wang, H. 2014. “Higher dietary folate reduces breast cancer risk.” British Journal of Cancer, 110(9):2327-38.

Posted: Oct 26, 2015. Updated: September 24, 2018.

Hormone Levels and Risk of Alzheimer’s

Last month at the Alzheimer’s Association International Conference in Chicago, studies were presented in relation to lower hormone levels contributing to possible risk of dementia.
One study, Women’s Reproductive History and Dementia Risk, which looked at 15,000 women in California, showed that women were less likely to develop dementia later in life if they started menstruating earlier and went through menopause later. Menopause at age 45 or younger increased risk by 28%. Also the risk of Alzheimer’s for women who had 3 or more children were 12% lower than those women who had one child.
Another study out of the U.K., Women’s Pregnancy History May Influence Alzheimer’s Risk through Alterations in Immune Function, of 133 elderly women, supported these findings. They looked at the number of months of pregnancy in their lives and found the higher the number, the lower the rate of Alzheimer’s.
One presenter remarked that the intense fluctuations of hormones related to menopause may be associated with increased risk of Alzheimer’s.
While it’s not clear if estrogen replacement protects against dementia after menopause, there is supportive evidence that if given to women in their early 50’s, estrogen and progesterone prevent the hormonal fluctuations, hot flashes and sleep disturbance that could be associated with dementia. The benefits of giving hormones after 65 is murky, in that there may be an increase risk in dementia, heart disease and breast cancer. In this age group, it is recommended to look at each case individually, depending on other medical conditions and to use the lowest possible dose with a safer delivery system, like transdermal estrogen and natural micronized progesterone. Some conditions that could benefit from hormone replacement later in life include multiple sclerosis, chronic pain syndromes, osteoporosis, or continuation of severe hot flashes.

5 Steps For Better Health If You Have a Chronic Illness or Pain

Today, medical care is a highly specialized and compartmentalized business, and many physicians are pressured by significant time constraints. When your health problems are complex, it can be difficult and frustrating to find answers. Be your own advocate, don’t be afraid to ask questions and seize control of your health.


5 Important Steps For Better Health When You Have a Chronic Illness or Pain

  1. Find an expert. Chronic pain can undermine every aspect of your life – your work, relationships, recreational activities, self-esteem and hope for the future. You want – and need – a pain specialist who is going to investigate the causes of your particular pain problem, strive to understand exactly how it has affected your life, and work with you to create and implement a personalized and comprehensive treatment strategy that fits the context of your life. You don’t have to just live with it. Chronic pain or illness should not define who you are and what you do.
  2. Understand Your Diagnosis. A diagnosis is not just a label; expect your doctor to provide you with resources to help you better understand your own condition; and expect him or her to lay out clear recommendations for your short and long-term treatment, including steps that you can take to assist with your own healing process.
  3. Understand the Value of Non-invasive Manual Therapies to Your Recovery. Seek out a physician who is knowledgeable about non-invasive manual therapies that will support your recovery. Ideally, you want a doctor who can recommend highly skilled manual practitioners who will communicate with your doctor about your progress and the need for adjustments in your ongoing medical care.
  4. Be Careful about Using Pain MedicationWhile medications may help pain, some also have the potential to cause other problems with your health and quality of life. Be confident that the medication your doctor has prescribed for you is truly the most effective and least invasive way of treating your chronic pain problem.
  5. Understand All the Factors that May Be Contributing to Your Condition. Many times there are underlying, undiagnosed factors that may be contributing to your pain. Nutrition, emotional issues, hormone imbalances, biotoxicity or neurotoxicity, and sleep disorders can all cause inflammatory reactions in the body which can lead to a cascade of painful symptoms. Chronic pain is a multi-faceted problem that requires a multi-disciplinary approach to diagnosing and treating your pain.

Hormones, The Great Communicators

A look at some of the causes of hormonal imbalance.

Somewhere in the middle of the brain is a control center called the limbic system, or old mammalian brain. Here, amongst a host of structures are two glands of the endocrine system: the hypothalamus and pituitary glands. These glands act as a hub for the body’s chemical messengers called hormones.

Hormones travel from one endocrine gland to the next to communicate messages from the brain that control a number of biological functions. For example, the hypothalamus tells the pituitary to produce thyroid stimulating hormone (TSH), which tells the thyroid to produce thyroid hormone, which feeds back to turn down the hypothalamus and pituitary. This is called a feedback loop. The pituitary produces a hormone that travels down to the gonads (ovary and testes) to tell them to produce estrogen or testosterone. The hypothalamus and pituitary tell the adrenals to produce cortisol, which is needed in times of an acute stressor, to increase blood pressure, glucose production and suppress the immune system. This whole structure is called the Hypothalamic Pituitary Adrenal Thyroid Gonadal Access, or HPATGA.

With age, both women and men undergo natural changes that interrupt this communication system and produce hormonal imbalances; but most of the time it’s external factors, like environment, diet, and lifestyle, that are to blame.

Symptoms that individuals experience vary greatly; among the more common symptoms are sleep disruptions, unexplained weight gain or loss, changes in mood, sex drive, and energy levels. When left unchecked these imbalances can contribute to more serious clinical conditions.

Causes of hormonal imbalances

Let’s start with the diet. First and foremost, the gut and its entire bacterial flora are intricately connected to our immune system. We know that 1% of the U.S. population has Celiac disease, a condition where the gluten in wheat barley and rye cause inflammation in the gut and destroys the natural barrier in the small intestine to large proteins and toxins. This has been associated with autoimmune disorders like rheumatoid arthritis, lupus, multiple sclerosis, Type 1 diabetes and autoimmune thyroid disease.

Similar issues are observed in people who are gluten intolerant, which by some estimates account for over 6% of the population. There has also been identified a non-gluten protein in wheat called ATI (amylase trypsin inhibitor) that has been associated with autoimmune disorders[1].

For example, in autoimmune thyroiditis, the thyroid gland is attacked and becomes inflamed. As a result, it can produce too much thyroid hormone (Graves’ disease), or stop producing thyroid hormone leading to hypothyroidism (Hashimoto’s disease). A leaky, inflamed gut from gluten and other wheat proteins can be the cause or further aggregate these conditions.

What about lifestyle? A busy, high-stressed lifestyle can cause the overproduction of cortisol from the adrenal gland which can results in an increased risk of diabetes, inflammatory diseases like heart disease and cancer, disruption of sleep, and an increase in anxiety and fatigue. Since cortisol suppresses the immune system, those who are chronically stressed get sick more easily. Cortisol also suppresses estrogen and testosterone, and interferes with the conversion of T4 thyroid hormone to the more active T3, resulting in fatigue, weight gain, irregular menses, chronic pain, and depression.

How does the environment affect hormones? There are environmental toxins called endocrine disruptors that actually bind to hormone receptors and increase or decrease these hormones unnaturally.

Examples of endocrine disruptors include pesticides like DDT, plastics that contain phthalate and bisphenol A (BPA), and industrial chemicals like PCBs. There are also glyphosate-based weed killers (like Roundup®) that are used in agriculture and end up in our food. These herbicides damage DNA and act as an antibiotic killing off our good digestive bacteria and disrupt the proper functioning of the immune system.

How to support hormonal balance

1. Evaluate Diet and Medications. What we eat and the medicines we take make a difference. Food is code, meaning food turns genes on and off. If someone carries genes for Celiac disease, diabetes, or cancer, these genes can be turned on – or off – by specific types of food. Eat to minimize inflammation in the gut and promote the growth of highly diverse, good bacteria, which research shows is associated with good health.

There is evidence that over the past several decades, the newer wheat strains like dwarf wheat which are so loaded with gluten and other proteins, are causing more and more people to develop Celiac and non-Celiac gluten wheat intolerance, leading to leaky gut and autoimmune disorders[2]. Anyone with an autoimmune thyroid condition, or other autoimmune, disorder should eliminate gluten.

In addition, the overuse of antibiotics and other pharmaceuticals reduce the beneficial bacteria in the gut. Minimizing the use of medications, and eating fermented foods, probiotics, and dietary fiber that feeds our good bacteria, promotes good gut health and decreases the likelihood of autoimmune disorders.

2. Assess stress levels. Stress can lead to chronically elevated cortisol. How can we lower cortisol levels and restore the natural cortisol pattern? We need to take the time to assess our stress levels. Are we working too many hours, sitting too long, staying up too late, worrying about yesterday and tomorrow, and coming up with excuses for not exercising and eating poorly? All of these practices increase cortisol which increases the risk of diabetes, hypertension, and heart disease, and affect our hormones. It is imperative that we slow down, prioritize, take time to move, eat well, sleep, seek help and support when needed, and get connected with the community and loved ones. Yoga, Tai Chi, meditation, weight training and aerobics help tremendously with stress and lower cortisol. Research is now showing that sitting too long can be as bad as smoking!

3. Eliminate toxins. Environmental toxins are tougher to deal with, but minimizing the toxins we are exposed to, and eating foods that naturally detoxify like deeply colored and cruciferous vegetables, foods with omega 3 fatty acids (i.e. fish oil or other sources), and supplementing with magnesium, vitamins B and C, are just a few ways to support the liver’s detoxification process.

Every year since 2004 the Environmental Working Group assesses the sampling of pesticides in our food source from the U.S. Department of Agriculture and the Food & Drug Administration, and makes a recommendation as to which fruits and vegetables should be consumed as organic and which are safe as non-organic (EWG Guide to Pesticides in Produce). As previously mentioned, herbicides like Roundup® are showing up in wheat, corn, soybeans and a host of other foods. Shopping wisely for foods like grass-fed beef (not grain-fed), free-range chicken and eggs (organic may not be enough), wild-caught fish (rather than farm-raised), dairy products without hormones, and buying organic produce from the list put out by EWG, are ways to minimize your exposure to toxins.

Household cleaners, personal care products, and plastic bottles can also have endocrine-disrupting chemicals, so using glass instead of plastic, and minimizing exposures to these chemicals is recommended.

As we age, there is a natural decline of our gonadal hormones (estrogen, progesterone and testosterone) and in some cases replacement hormones are beneficial. There are ways that we can minimize the risk associated with hormone replacement by using bio-identical hormones, which are closest to natural hormones, and by supporting the metabolic process with diet to reduce any harmful metabolites of hormones that could increase risk of disease.

To support you in your journey to good hormonal health, I recommend hormonal testing, functional digestive testing when indicated (stool, urine, and breath tests), a dietary consultation to plan a healthy low-inflammation diet, meditation, yoga, a regular exercise plan, adequate sleep, and a look at any potential toxic exposures that could disrupt your hormones, the Great Communicators!

1 Consumption of wheat amylase trypsin inhibitors enhances autoimmune encephalitis in mice. Oral presentation, 16th International Celiac Disease Symposium, 2015, Zevallos

2 Akil Palanisamy, MD, The Paleovedic Diet

Pelvic Floor Dysfunction: 6 Myths Busted!

Pelvic Floor Dysfunction (PFD) is a highly personal topic, so it is rarely discussed among family, friends, and sometimes even doctors, leaving many individuals to suffer in silence. Consequently, there are common misconceptions surrounding the condition – which we’re here to “bust!”

MYTH 1: Pelvic floor dysfunction is always associated with pelvic pain.

FACT: Pelvic Floor Dysfunction (PFD) is an umbrella term — encompassing problems with pelvic floor muscles, ligaments and connective tissue that support the pelvic organs. Sometimes, but not always, PFD is associated with pelvic pain. The pelvic organs include the rectum and bladder, and in women, the uterus and vagina. With PFD, the pelvic muscles may be tight, damaged or weak, which can lead to lack of bladder and bowel control (urinary or fecal incontinence). In women, “pelvic-organ prolapse” can occur, a condition where the pelvic organs drop, causing a bulge in the vaginal canal, which can lead to incontinence or pain during intercourse.

MYTH 2 – Incontinence, a typical symptom of Pelvic Floor Dysfunction (PFD), is rare.

Fact: These disorders are actually quite common. In fact, according to a National Institutes of Health (NIH) study, those suffering from a pelvic floor disorder include:

  • 10 percent of women from 20 to 39 years of age,
  • 27 percent of women ages 40 to 59,
  • 37 percent of women ages 60 to 79, and
  • Almost half of all women 80 or older.

There are few studies that have investigated pelvic floor dysfunction in men, however, in 2006 the National Health and Nutrition Examination Survey (NHANES) reported that incontinence, one of the most common symptoms of pelvic floor dysfunction, affected approximately 17% of men overall.
Another study, conducted by Harris Interactive (a market research firm) and published in Urologic Nursing, reported that 32% of Americans ages 30-70 have experienced some episode of urinary incontinence. Only 1 in 8 of those people, however, have reported being diagnosed by a medical professional.
The most startling statistic may be that women suffer with incontinence for an average of 6.5 years, and men for 4.2 years, before they finally seek treatment. Obviously, many people are living with chronic symptoms that undermine their day-to-day quality of life — a fact made more tragic because help is readily available.

MYTH 3: Incontinence is a normal part of aging.

FACT: In the same study conducted by Harris Interactive, it was reported that as many as 38% of those surveyed believe that incontinence is a normal part of aging. Although age is contributing factor in pelvic floor dysfunction, the truth is that incontinence is NOT a normal OR an inevitable part of growing older. In fact, there are many factors that can contribute to the onset of incontinence, including a poor diet, years of being sedentary, hormonal changes, and being overweight. In women, pregnancy and childbirth also can increase the risk.

MYTH 4: PFD is strictly a woman’s disorder.

FACT: Although it is true that women are more often diagnosed with pelvic floor dysfunction, it does occur in men too. Men can experience urinary or fecal incontinence due to weak pelvic floor muscles, just as women do. And like women, men also can exhibit coccydynia — pain in the tailbone — if their pelvic floor muscles are too tight.

MYTH 5: Your medical provider will be embarrassed if you bring up any issues you be experiencing with incontinence, pelvic pain, or sexual dysfunction.

FACT: This is the silliest myth of all!! Your physicians and physical therapists have heard and seen it all. They deal with these issues often. Your provider will ask questions to help you describe your symptoms and will be happy to answer any questions you may about the issues that may be contributing to your particular set of symptoms.

MYTH 6: PFD cannot be treated.

FACT: PFD most definitely CAN be treated. In some cases surgery is necessary, but usually there are non-invasive treatments that can help you reclaim control of your bodily functions and your life. Treatments include combination of physical therapy, relaxation techniques and sometimes with hormones.
The muscles of the pelvic floor are just that — muscles. As with any muscle, there are strengthening exercises and ways to reeducate the muscles so that that they regain strength and functionality.
Remember, your medical providers are there to help you. If you are experiencing urinary or fecal incontinence, pelvic or tailbone pain/pressure, we urge you to talk to your physician. At the Kaplan Center, we assess possible musculoskeletal and postural problems, as well as hormonal or dietary issues that may be contributing to symptoms. When appropriate, we also use biofeedback to help assess the health of the pelvic floor muscles. A typical course of treatment is likely to include physical therapy, and may include modification to posture, diet, and physical exercise routines.

Now that we’ve busted the myths about pelvic floor dysfunction, it’s up to you. Talk with your medical provider, and get on the path toward resolution.


As a part of Kaplan’s free Community Health Lecture Series, physical therapist Jeanne Scheele explained the urological system (UG system) and the factors that influence bladder urgency & frequency, stress incontinence, and normal/abnormal behaviors of the UG system. Jeanne also discussed several ways to manage symptoms in order to regain control and lessen the stress and anxiety that incontinence issues cause for so many women.

Part I: Understanding the Urogenital System, Bladder Control: Urinary Urgency & Frequency

Natural Solutions For Women's Common Aches & Pains

4 Ways Women Can Fight Chronic Pain

By Julia Westbrook
Article reprinted from www.RodaleNews.com
You don’t have to live with the pain any more. Here are 4 natural solutions for common painful problems for women.
Men may have a reputation for sucking it up and soldiering on, but it’s women who are the ones suffering in silence from chronic pain, according to a research review by the American Society of Anesthesiologists (ASA). To add insult to already-painful injury, the study revealed that most of this pain is unnecessary and treatment is often ineffective or, worse, harmful.
“I can’t tell you the number of women I see who have been told they just have to live with the pain,” said Donna-Ann Thomas, MD, a member of the ASA’s committee on pain medicine. “It’s just heartbreaking because many of these women have been suffering a long time. Women, especially older women, are less likely to speak up and seek treatment for their pain.”
And when women do report pain, the medical solutions can do more damage than the original cause. For instance, the researchers found that 1 in 7 expecting mothers were prescribed opioids for pregnancy pains—a practice that is unhealthy for both the mom and baby.
Even seemingly safe over-the-counter painkillers often harbor unpleasant side effects. “People take nonsteroidal anti-inflammatory drugs (NSAIDs) like breath mints and think nothing of it,” says Gary Kaplan, DO, author of Total Recovery: Solving the Mystery of Chronic Pain and Depression. “In fact, there are more than 32,000 hospitalizations each year as a result of complications from taking NSAIDs and more than 3,200 deaths a year. These are not benign drugs.”
Instead of ignoring the pain or reaching for painkillers, try these natural solutions for women’s common aches and pains:
#1. Fix magnesium deficiencies. “Because of the blood loss during their menstrual cycles, women are more prone to magnesium deficiencies than men,” says Dr. Kaplan, and deficiency can lead to a whole host of painful issues, from migraines to muscle pain. He recommends adding foods high in magnesium to your diet. Indulge in leafy greens, dried apricots, avocados, almonds, cashews, and bananas, as well as other magnesium-rich foods.
#2. Opt for a rose oil massage for cramps. Rose oil doesn’t just smell nice; it can also ease menstrual pain. Research has found that rubbing rose oil on your abdomen relieves menstrual pain, whereas using unscented almond oil was found to be ineffective.
#3. Say “om” to eradicate back pain. It sounds counter-intuitive: Twist and bend your spine to reduce pain? Research says yes. In a 12-week yoga program, those who completed the program had less back pain, while those who didn’t do any yoga said their back pain worsened.
#4. Bring your playlist into the delivery room. Welcome your baby into the world with a fanfare of music. A study of 156 women found that those who listened to music during labor reported less pain and anxiety during labor and needed less pain relief afterward.
Published on www.RodaleNews.com on January 21, 2015

Dr. Lisa Lilienfield on Female Athletes & Iron Deficiency

What Female Athletes Need to Know About Iron Deficiency

by Gabriella Boston
Article reprinted from www.WashingtonPost.com, October 14, 2014
A year ago, local running coach and veteran marathoner Kathy Pugh was preparing for the Marine Corps Marathon. But despite a tried-and-true training program, it wasn’t going well.
“I just didn’t have the energy,” Pugh says. “I was struggling and felt like I never wanted to do a marathon again.”
What had happened?
As Pugh found out through a blood test, she was iron-deficient, something that’s not all that unusual for premenopausal women, particularly athletes.
“It’s quite common for female athletes to have iron deficiency,” says Nancy Clark, a Boston-based sports nutritionist and author of the “Sports Nutrition Guidebook.”

“And it really affects performance.”

Exactly how prevalent iron deficiency is among female athletes isn’t known, but Clark says it could be as high as 50 percent. In the general premenopausal female population, the prevalence is roughly 9 percent. A 2011 study of female collegiate rowers in New York state found 10 percent were anemic and 30 percent had low iron stores.
(Anemic refers to low hemoglobin, for which the most common reason is low iron. But you can be iron-deficient without being anemic — as was true for Pugh.)
Clark attributes iron deficiency among female athletes to monthly blood loss (true for most premenopausal women) and an added demand on iron stores through high-intensity training as well as a focus on lean, vegetarian and natural foods.
But wouldn’t “lean, vegetarian and natural” be a good thing?
“Absolutely, but if you are vegan, especially as an athlete, you have to make sure you are getting what you need nutritionally,” says Lisa Lilienfield, a doctor with the Kaplan Center for Integrative Medicine in McLean, whose expertise includes women’s health and sports medicine.
Iron can be taken as a supplement but is readily available in our food — especially in red meat and seafood (in particular, clams). It is also abundant in green-leafy vegetables such as spinach and in beans and fortified cereals.

And so, Clark says, the trend among female athletes and other health-conscious consumers to move away from red meat and to give up fortified foods in favor of natural foods creates a “perfect storm” for iron deficiency.

“Female athletes tend to be very health- and weight-conscious,” she says. “And when they want to lose weight, they’ll give up things like hamburgers and steaks,” as well as processed food, she says.
For example, good ol’ Grape Nuts – a fortified (“processed”) cereal has 90 percent of the recommended daily allowance for iron, while the natural Kashi Go Lean Crunch has 8 percent.
The recommendation for the general female premenopausal population is 18 mg of iron per day. Lilienfield suggests that should be higher — in the range of 20 mg or higher — for female athletes.
“I would recommend that female endurance athletes get screened so they can see if they need iron supplementation,” Clark said. Note: Too much iron is not healthful, either, so it’s important to know the right level before taking any iron supplementation.
Pugh says she can relate to both parts of Clark’s perfect storm: She moved away from red meat and tried eating all-natural foods for the year leading up to the 2013 Marine Corps Marathon.
“I was doing my green smoothies and eating nutritional yeast — I felt like I was the picture of perfect health, and yet I felt tired,” Pugh says.
For women who want to get more of their iron from plants, one possibility is to consume greens or beans together with vitamin C, which improves iron absorption, Lilienfield says.
For example, says Pugh, who is now also a trained health coach with the Institute for Integrative Nutrition: “You could have your salad with a lemon vinaigrette.”
It’s also worth limiting consumption of foods that inhibit the uptake of iron, she says, including calcium and coffee and tea.
So, what are some of the signs — aside from lack of energy — of low iron, and why is iron important in sports?
One is the desire to chew ice, says Clark (the medical term is pacophagia). In addition, “being cold all the time, feeling depressed and feeling tired,” can be signs of iron deficiency.
Iron is essential for successful athletic performance since it helps carry oxygen to cells throughout the body. But when athletes feel overtired from workouts they often assume they need to lose weight — and in doing so they often deplete their iron stores even more.
“Athletes in endurance sports will notice it the most,” Clark says. “But iron deficiency could impact all sports.”
And she adds that iron deficiency is a “needless” problem, “since it’s totally preventable. I see it as an education problem.”
Pugh says she definitely has learned what works better for her these past few months. Her diet still consists of mostly natural foods and lots of greens, but she has added some red meat once a week or so — and says she thinks there is a link to her feeling better.

Dr. Lilienfield Explains How Women Can Proactively Assess Their Risk of Developing Breast Cancer

Identifying And Confronting Breast Cancer Risks
Thanks in part to government projects such as the Women’s Health Initiative and outreach by celebrities like Angelina Jolie, the risks associated with breast cancer are commonly discussed in the national media. Still, many women may wonder where to begin after determining the need to assess their own risk of developing breast cancer.
Lisa Lilienfield, M.D., of the Kaplan Center for Integrative Medicine in McLean, says that many good things have resulted from the increased focus on breast cancer over the past few decades, yet there is still a need for more discussion regarding individual symptoms and preventive lifestyle changes for those battling breast cancer.
A great starting point for those investigating their own risk for breast cancer is to first take stock of the family medical history. “Talk to a primary care physician or nurse practitioner about your concerns. It’s important to choose a healthcare provider who will block off a significant amount of time to listen to their patients—30 minutes or more is ideal. The patient should not feel rushed,” Lilienfield says.
Several tests are used to determine a person’s risk of developing breast cancer, provide an assessment of estrogen levels and how the hormones are being metabolized. Lifestyle changes may help to metabolize hormones in a way that minimizes the risk of developing breast cancer.
“Various dietary and lifestyle habits may affect the way your body is metabolizing the estrogen, so people who are overweight, do not exercise, or are diagnosed with endocrine disorders like hypothyroidism may have an increased risk.” Lilienfield suggests eating a number of foods that may improve the way estrogen is metabolized in a person’s body: broccoli, cauliflower and flax seed.
Women living in Northern Virginia are at an advantage when it comes to seeking advice and treatment for breast cancer and other health concerns, Lilienfield says. “I do believe that women in this area have access to quality screening facilities and health education. This area is known for having a fairly well education population, which means many people are aware of many risk factors associated with breast cancer.”
As with any medical condition, being able to identify common misconceptions is also important. When it comes to breast cancer, a common misconception is that hormone replacement therapy should always be avoided in menopause, due to an associated risk of developing breast cancer. Lilienfield says that while certain hormone replacement therapies do in fact carry an increased risk for breast cancer, there are others on the market that have a much lower risk, as they closely mimic the body’s own estrogen. It is important for patients to explore these concerns with health care providers, in order to find safe solutions that will also improve quality of life.
By Lexi Gray Steacy
Northern Virginia Magazine OCT 2013

Identifying Your Risk of Breast Cancer

In 2013, Angelina Jolie announced that she had undergone a double mastectomy and reconstructive surgery as a way of minimizing her risk of developing breast cancer and ovarian cancer. She generously shared her story with the public, explaining that her mother had died of breast cancer at the age of 56; that she, Angelina, had inherited a “faulty” BRCA-1 gene; and that her doctors said she had a very high risk of developing breast cancer (about 87%).
The news, though shocking, focused our attention on the subject of BRCA gene mutation and its strong correlation with cancers in women. By sharing her story she offered each of us an excellent opportunity to reflect upon our own health situation and options.
One test that can help identify a women’s risk of developing breast cancer is the Estrogen-Metabolism Assessment. It evaluates how well your body metabolizes and processes estrogen. Certain types of estrogen metabolites can increase one’s risk of developing breast cancer and worsen your prognosis if you do develop cancer. By proactively measuring the levels of these metabolites in a person’s blood or urine, we can determine whether medication changes or lifestyle modifications, such as diet and exercise, are warranted. This is a test that can be ordered through the Kaplan Center so that you can discuss the results with your physician.
There are many other things that you do to improve your health and lower your cancer risks – such as reducing your stress level, getting sufficient exercise, sleep and balanced nutrition, including the nutritional supplementation that you may need. These factors are explained in more detail in this article about the steps you can take to improve your breast health. I encourage you to review it and forward it to a loved one.
If you have a strong history of breast cancer in your immediate family (mother, grandmother, sisters, etc.) and are concerned about your own genetic risk of developing breast or ovarian cancer, you may want to seek genetic counseling with a specialist. Coming to this decision is a journey often fraught with emotion for patients and their partners; consequently, I usually recommend patients who may want to pursue genetic testing to the Inova Breast Care Institute. According to Inova’s guidelines, the women who can benefit from genetic counseling for breast cancer will have one or more of the following characteristics:

  • Strong family history of early-onset breast cancer, diagnosed before age 50
  • Breast cancer in two or more first-degree relatives on the same side of the family
  • Multiple primary tumors (for example, a woman with two primary breast cancers)
  • Bilateral or multiple cancers
  • Ashkenazi (Eastern European) Jewish ancestry with significant personal and/or family history of breast or ovarian cancer

BRCA-Gene Testing, which is conducted at Inova, can identify gene mutations that indicate an increased risk of developing certain breast and ovarian cancers. On average, women who have inherited the harmful BRCA-gene mutation have a 65 percent higher chance of developing breast cancer during their lifetimes than women without it. Knowing whether or not you carry the mutation can help you understand your personal risk of developing breast or ovarian cancer.
After prevention, detection is the next most powerful step in fighting breast cancer. Women now have access to 3-D Mammography, a new technology that allows radiologists to view the tissue inside the breast layer by layer and from different angles. Although the 3-D mammography takes a little longer than an ordinary mammography (approximately 4 seconds longer per compression), it is much more accurate in detecting breast cancer.
Most importantly, I urge you to not shy away from facing up to what can be emotionally difficult health topics. Take charge of your health. Talk with your doctor about the medical testing and lifestyle changes that can help you increase your chances of living a long, healthy life!