Women’s Health Update AUGUST 2019
Women’s Health Update AUGUST 2019
FERTILITY
The Impact of Preconceptional Multiple-Micronutrient Supplementation on Female Fertility.
Schaefer E, et al Clin Med Insights Womens Health. 2019 Apr 23
ABSTRACT: In industrialized countries, fertility has declined in recent years to the lowest recorded levels. Identifying modifiable factors that influence human fertility, such as diet, is therefore of major clinical and public health relevance. Micronutrient status is a modifiable risk factor that may have an impact on female fertility, as essential vitamins and minerals have important roles in the physiological processes that are involved. Adequate levels are important for oocyte quality, maturation, fertilization, and implantation, whereas antioxidants are vital to reduce oxidative stress, a process known to impair fertility. In women who are diagnosed as infertile, lower than recommended levels of certain micronutrients have been reported. A similar scenario has been found in a proportion of women of childbearing age in general, some of whom may be struggling to conceive. The literature suggests that supplementation before conception can help restore micronutrient status to recommended levels and reduce oxidative stress when antioxidants are included. Overall, supplementation has a beneficial effect on fertility in healthy and infertile women, including a shorter time to pregnancy and an increased chance of becoming pregnant.
Association of Maternal Prenatal Vitamin Use With Risk for Autism Spectrum Disorder (ASD) Recurrence in Young Siblings.
Schmidt RJet al. JAMA Psychiatry. 2019 Apr 1;76(4):391-398
ABSTRACT: Maternal prenatal vitamin intake during the first month of pregnancy may reduce ASD recurrence in siblings of children with ASD in high-risk families. Additional research is needed to confirm these results; to investigate dose thresholds, contributing nutrients, and biologic mechanisms of prenatal vitamins; and to inform public health recommendations for ASD prevention in affected families.
ANALYSIS: A simple prenatal vitamin has so many protective benefits, from neural tube defects, and autism spectrum disorders, and now we see that these same nutrients can be so important for fertility. Simple blood testing can confirm that you are getting adequate amounts of the most important nutrients and whether you would benefit from additional supplementation above and beyond a typical prenatal vitamin and mineral formula. Ideally supplementation should begin at least 1 month, but preferably one year prior to conception and be combined with healthy diet & lifestyle changes in both partners to improve outcomes.
Acupuncture for infertile women without undergoing assisted reproductive techniques (ART): A systematic review and meta-analysis.
Yun L. Medicine (Baltimore). 2019 Jul;98(29)
ABSTRACT: This study looked at the effectiveness of acupuncture and related therapies in the treatment of infertility in those who are not pursuing ART. The pregnancy rate was significantly improved with treatment this approach compared with pure western medicine intervention; no matter intervention with acupuncture alone, with acupuncture plus western medicine, with acupuncture plus Chinese medicine, or acupuncture plus Chinese medicine and western medicine, all of these subgroups exhibited significant improvement. The subgroup according to different types of infertility showed a significant improvement in infertility caused by polycystic ovary syndrome, tubal infertility, ovulatory disorder, and other factors. In addition, the ovulation rate and endometrial thickness were significantly increased. Moreover, with acupuncture, less adverse effects occurred. Acupuncture and its combined therapy may be effective for treating female infertility, with or without the addition of ART.
ANALYSIS: This study demonstrates that acupuncture and its related therapies, electro-acupuncture & supplements/herbal treatments, are worth a try for patients prior to and in conjunction with ART.
PERINATAL
Poor sleep quality is associated with perinatal depression. A systematic review of last decade scientific literature and meta-analysis.
González-Mesa E. J Perinat Med. 2019 Aug 6.
ABSTRACT Although pregnancy is frequently associated with mental states of happiness, hope and well-being, some physical and psychological changes can contribute to increased sleep disturbances and worsened sleep quality. Sleep quality has been linked to negative emotions, anxiety and depression. Poor sleep quality was associated with perinatal mood disturbances.
ANALYSIS: This should come as no surprise, the impact on sleep & perinatal mood, but frequently this aspect is under appreciated in postpartum planning. Local companies like Matrescence 4thTrimester Planning and Support can help to prepare expectant moms for the realisties of postpartum life, and the motherhood co. has several postpartum doulas that can assist new moms in getting the care they need to prevent many postpartum issues. Follow this link for these and more resources for new moms: https://arcadiawomenswellness.com/resources
The Role of Allopregnanolone in Pregnancy in Predicting Postpartum Anxiety Symptoms.
Osborne LM, et al. Front Psychol. 2019 Jul 16;10:1033
Postpartum depression & anxiety are serious illnesses affecting up to 20% of women worldwide after childbirth, and our understanding of its biology is limited. Prior studies indicate that pregnanolone, a metabolite of progesterone, may play a role in reproductive mood disorders, including postpartum depression, but the exact nature of that role is unclear, but psychiatrically ill women often have low pregnanolone levels in the second trimester and postpartum and this predicts mood and anxiety disorders. Both concurrent sleep and prior histories of mood and anxiety disorders contributed to the variance in mood and anxiety scores at 6 weeks postpartum. These findings confirm the importance of pregnancy pregnanolone in postpartum psychiatric symptoms and point to future directions that may determine other important contributing factors.
ANALYSIS: Lab levels of pregnenalone along with progesterone can inform treatment of postpartum mood & anxiety disorders and replacement, if deficient can be a safe and effective therapy. Before such testing is considered, simple lab tests can rule out nutrients that may be depleted in pregnancy & postpartum, especially over the course of several periods of pregnancy and lactation. Please contact https://arcadiawomenswellness.com/fertilityto get more information on perinatal mood and anxiety disorders and the treatments that are available.
PERIMENOPAUSE
The Effect of Sprint Interval Training on Body Composition of Postmenopausal Women.
Boutcher YN, et al. Med Sci Sports Exerc. 2019 Jul;51(7):1413-1419
ABSTRACT: Menopause is accompanied by body composition changes that include a decrease in lean mass and aerobic fitness and an increase in fat mass. Sprint interval training (SIT) may be able to reverse these changes. This study evaluated an 8-wk SIT program on body composition and aerobic fitness of overweight postmenopausal women consisting of 20 min of alternating 8-s sprints and 12-s of light pedaling and was found to increase total lean mass, decreased fat mass, and increased aerobic fitness of postmenopausal women after only 8 h of actual exercise over 8 wk.
Cardiovascular response of postmenopausal women to 8 weeks of sprint interval training.
Zhang D, et al. Eur J Appl Physiol. 2019 Apr;119(4):981-989.
ABSTRACT: The same training program outlined above was found to improve various measures of cardiovascular functioning & aerobic fitness, including resting stroke volume, diastolic filling time as indicators of
ANALYSIS: This is a great study showing how endurance training, pounding the pavement for hours on end, is not necessary to maintain health, muscle mass, and weight, and even lose weight in perimenopause. This corresponds with what I see clinically, confirming that short periods or cardio, combined with weight training is the most effective exercise for women over forty. For trainers that specialize in working with women, see this page: https://arcadiawomenswellness.com/resources
Clinical trials of treatment of woman menopause insomnia due to disharmony between heart and kidney by body and auricular acupuncture.
Zhang S. Zhen Ci Yan Jiu. 2019 Jul 25;44
ABSTRACT: Both body acupuncture and body acupuncture combined with auricular acupuncture were found to be effective in the treatment of menopausal insomnia due to disharmony between the heart and kidney, and the two combined treatment was evidently better.
ANALYSIS: Insomnia is a common complaint in menopause, affecting up to 40-50% of women. Acupuncture combined with herbal and hormonal therapies can be very effective in helping to alleviate perimenopausal sleep disturbances.
Acupuncture or phy(F)itoestrogens vs. (E)strogen plus progestin on menopausal symptoms. A randomized study.
Palma F. Gynecol Endocrinol. 2019 May 29:1-4.
ABSTRACT: This study evaluated the effects of hormone replacement therapy vs isoflavonids vs acupuncture to control perimenopausal symptoms and found that acupuncture was equivalent to HRT and superior to isoflavonoids on several menopausal sympotoms and that these effects persisted for 3 months post treatment for acupuncture arm.
ANALYSIS: The most of the current information is very reassuring as to the safety of HRT (check out this podcast on the topic https://peterattiamd.com/caroltavris-avrumbluming/), many women choose to try something else before embarking on HRT prescriptions. This study is another that confirm acupuncture is effective and safe.