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Women’s Health – DrPullen.com – Medical and Health Blog

Category Archives: Women’s Health

AFP Pearls

I read the American Family Physician journal, sent to all members of the American Academy of Family Physicians and anyone else who subscribes, and sometimes an issue comes out with a few pearls that I want to pass on. The Oct 15, 2016 edition was one of them and here are a few of the tidbits of wisdom I’m sharing from this issue today:

     –TRAVELERS DIARRHEA UPDATE:  Traveler’s diarrhea is the most common infection in international travelers.  It can occur in 30-70% of travelers in some areas.  Despite the universal advice to avoid food from street vendors, don’t drink tap water, avoid raw foods and ice there is evidence that these precautions have not been shown to reduce the incidence of travelers diarrhea.  Although a short course of ciprofloxacin has been the usual recommendation (500 mg initial dose followed by 500 mg 12 hours later) there are reasons that this may no longer be optimal.  First resistance to this class of antibiotics is high in some areas, especially in Campylobacter infections in SE Asia.  Second is the FDA warning to limit fluoroquinolone use due to side effects risk. Azithromycin is also effective at a dose of 500 mg daily for 1-3 days, or as a single 1000 mg dose. It may now be the best recommendation worldwide. 

     -TWO GOOD PLACES TO FIND MALARIA PROPHYLAXIS INDORMATION:  Advice for Malaria prophylaxis is available on the CDC site or from the WHO Malaria information web page.

     -SPECIFIC GENERIC INEXPENSIVE BIRTH CONTROL PILLS ARE SAFER THAN SOME NEW EXPENSIVE BRAND NAME OPTIONS:   In a huge French study of the use of ischemic stroke, heart attack and pulmonary embolism with birth control pill use came good news.  First as has been previously shown the risks are very low, roughly 6 per 10,000 women.  Not just that but the risks are lowest with the lowest dose estrogen pills, i.e. 20 mcg.  Not only that but the specific progestin used makes a difference, and the older, generally less expensive oral contraceptive ingredient levonorgestrel is associated with the lowest risk.  Newer progestins used in the considerably more expensive branded birth control pills specifically desogestrel (in Desogen and Mircette) and gestodene (in Gynera, Femogen, and others).  The lowest risk was in  pills using 20 mcg estrogen and levonorgestrel.   Examples are Alesse, Aviane, Lessina, Levlite, and Lutera all of which have 20 mcg. of ethinyl estradiol and 0.1 mg of levonorgestrel.  Although some women may have breakthrough bleeding on these fixed dose birth control pills, they seem like the optimal first choice option for many women who choose a daily use pill for contraception.  (A caveat to this report is that some types of birth control pills were not looked at because they were not used in the French national health formulary.)

The Mammograms or Not in Women 40-49 Controversy

As usual Dr. Kenny Lin, a former USPSTF member and prolific writer of “common sense” articles writes on how emotions rule rather than evidence and data when it comes to how people feel about breast cancer Check out his article: Countering the too neat narrative on screening mammography. Here are a couple of snippets for… Continue Reading

Pros and Cons of Planned Parenthood E-visits for Birth Control Pills

Planned Parenthood has announced that it is launching a program to allow women to obtain hormonal contraception, primarily birth control pills but also contraceptive patches and vaginal hormonal rings via an e-visit online.  This is an attempt to try to reduce the incidence of unplanned and undesired pregnancies that often occur because of women delaying… Continue Reading

Cancer Care: Redefining the Best We Can Do

Sometimes it seems like in cancer care the lag between bench science breakthroughs and clinical care is painfully long.  In addition information on the latest therapeutic modalities is fragmented and proprietary between competing research and clinical centers of excellence.  It can seem nearly impossible for a patient or a practicing oncologist to both be informed… Continue Reading

Another Endangered Species Due to Habitat Loss: Crab Lice

I’m a birder and have seen the populations of many species I’ve watched over the last 30+ years decline.  Many of these declines are felt to be due to the loss of breeding, wintering or migration stop-over habitats required by these species.  In the late 1980’s a trip to Grays Harbor, WA at the time… Continue Reading

Preventing Death After a Heart Attack

Cardiovascular disease remains the leading cause of mortality in the U.S.  It causes leading to of every six deaths. On hospital discharge many patients are dismayed at the number of pills they are asked to take every day.  Often they had felt perfectly healthy prior to the sudden cardiac event, and may have taken pride… Continue Reading

Still Taking Turmeric Extract Curcumin C3 Complex

I posted a little over 3 months ago in a post called First Hand Anecdotal Evidence about the hopeful improvement in the level of CA-125, the tumor marker for my wife Kay’s ovarian cancer tumor marker, after she had started taking Turmeric Extract Curcumon C3.   She decided to start taking this at the recommendation of… Continue Reading

Bendectin resururected as Diclegis

Finally a Canadian pharmaceutical company has received FDA approval to market Diclegis, a medication for treatment of morning sickness that has been commonly used in the U.S. for over 40 years.  This is only newsworthy because finally a company has chosen to take on the risk of lawsuits that led to the removal of Bendectin… Continue Reading

Downton Abbey: Eclampsia. Lady Sybil’s Death. What Fans Ought to Know

Would Dr. Clarkson’s Recommended C-Section Have Saved Sybil On Downton Abbey?  Did Dr. Clarkson breech medical ethics by reassuring the family that the decisions of Earl Robert did not doom Sybil to an otherwise preventable death?  These and other questions will be addressed in this post. It took my wife’s questions about the death of… Continue Reading