Mayo Clinic Women s HealthSource: Highlights from the February issue

ROCHESTER, Minn.-- (BUSINESS WIRE) -- Here are highlights from the February issue of Mayo Clinic Women’s HealthSource. You may cite this publication as often as you wish. Mayo Clinic Women’s HealthSource attribution is required. Reprinting is allowed for a fee. Include the following subscription information as your editorial policies permit: Visit www.bookstore.mayoclinic.com or call toll-free for subscription information, 800-876-8633, extension 9751.

Treatment Options Available for Women’s Pelvic Health Concerns

ROCHESTER, Minn. -- Pelvic health concerns in women are common -- yet how the issues impact sexuality and childbearing is not often discussed, according to Mayo Clinic Women’s HealthSource.

The February issue features an overview of pelvic health problems, risk factors, causes and treatment options. The key recommendation is that women should talk to their doctors about pelvic health concerns because several treatment options, including physical therapy, can help.

The pelvic floor holds in place the uterus, bladder and rectum. Over time, the pelvic floor may stretch, weaken or become excessively tense. The tension or loss of support can lead to pain, bladder and bowel problems, pain during sexual intercourse and other symptoms.

Factors that may contribute to pelvic floor concerns include childbirth, obesity, menopause, stress, straining during bowel movements and older age. Half of women over age 50 experience pelvic floor weakening.

Several types of treatment can provide relief for pelvic floor disorders.

Physical therapy: Most women can benefit from physical therapy that’s designed to relax or train pelvic floor muscles. When pelvic floor muscles are tight and painful (pelvic floor tension myalgia), exercise to improve the strength and stability of the spine can be helpful. In addition, massage techniques to release tight muscles can ease pain.

To treat urinary incontinence, Kegel exercises -- contractions of the muscles used to stop the flow of urine -- combined with bladder training can help resolve incontinence.

Biofeedback: A biofeedback specialist uses monitoring equipment that provides feedback -- visual cues, sound or verbal guidance -- to the patient about body functions that usually aren’t under conscious control. Biofeedback can help improve pelvic floor muscle coordination and rectal and bladder sensation.

Medical treatment: Various medical therapies may be helpful for pelvic floor tension myalgia, including estrogen, pain relievers, nerve pain medications, antidepressants, numbing agents or Botox injections.

Surgery: Many different surgical procedures, including minimally invasive techniques, can be used.

Acupuncture: This may relieve muscle pain, but more research is needed to determine whether it specifically helps with pelvic floor problems.

C-reactive Protein: Not a Routine Test for Heart Disease

ROCHESTER, Minn. -- For women concerned about heart disease, routine testing of high-sensitivity C-reactive protein (hs-CRP) is controversial, says Thomas Behrenbeck, M.D., Ph.D., a Mayo Clinic cardiologist, in an interview in the February issue of Mayo Clinic Women’s HealthSource.

CRP is a marker for inflammation within the body and has been promoted as a screening test for coronary artery disease. Inflammation can play an important role in atherosclerosis, the process in which fatty deposits build up in coronary arteries. Interest in hs-CRP originated when studies found that patients with unstable angina or chest pain had high levels of this marker. Researchers found that hs-CRP could be used to predict who would go on to have a heart attack. But other studies have shown that hs-CRP isn’t a predictor of heart attack risk in people without symptoms of heart disease.

“If hs-CRP is elevated, it is worrisome because it tells you there is inflammation in the body,” says Dr. Behrenbeck. “But it doesn’t mean the inflammation is related to coronary artery disease.” Inflammation can be a response to any type of injury or infection. People who have rheumatoid arthritis have very high levels of hs-CRP. Elevated levels also can be caused by a bruise or a minor surgical procedure such as a tooth extraction.

For now, says Dr. Behrenheck, there’s no good role for hs-CRP screening in patients without symptoms of coronary artery disease. “We’ve been unable to determine if knowing your hs-CRP level is helpful beyond all of the other traditional risk factors -- such as high blood pressure, diabetes, smoking and high cholesterol,” he says.

He advises women to continue to focus on the traditional risk factors. Controlling these risk factors is especially important postmenopause, when a woman’s risk of coronary heart disease increases.

Mediterranean Diet: Ingredients for a Heart-Healthy Eating Approach

ROCHESTER, Minn. -- In countries bordering the Mediterranean Sea, heart disease is less common than in the United States. Researchers believe that foods common to Greece and southern Italy are a major reason for this difference.

The February issue of Mayo Clinic Women’s HealthSource covers key components of the Mediterranean diet as well as reasons why this approach is beneficial to heart health. Key components include:

Eating generous amounts of fruits and vegetables and whole grains. In most Mediterranean countries, fruits and vegetables are part of every meal. They are naturally low in fat and sodium and have no cholesterol. Many are loaded with antioxidants, which may help prevent cholesterol buildup in the arteries.

Breads, pastas and rice are typically made from whole grains instead of grains that have been refined and lost some nutritional value. Whole grains provide an excellent source of fiber and contain a variety of vitamins and minerals. Certain types of dietary fiber also can help reduce blood cholesterol levels and may lower the overall risk of heart disease.

Getting most fats from healthy sources. Olive oil is the primary fat used in Mediterranean cooking. This type of monounsaturated fat can help reduce low-density lipoprotein (LDL, or “bad”) cholesterol levels when used in place of unhealthy saturated fats or trans fats. Other healthy fats in the Mediterranean diet include polyunsaturated fats and omega-3 fatty acids, which can be found in vegetable oils, nuts and fish. Omega-3 fatty acids are considered especially beneficial because they can lower triglycerides, a type of blood fat; improve the health of blood vessels; and protect against death from sudden heart attack.

Consuming very little red meat and eating generous amounts of legumes. Red meat isn’t a big part of the Mediterranean diet. Legumes, a class of vegetables that includes beans, peas and lentils -- offer a source of protein that’s typically low in fat and contains no cholesterol.

Drink wine, in moderation. Some research has shown that a light intake of alcohol is associated with a reduced risk of heart disease. In the Mediterranean, the alcoholic beverage consumed most is wine, which may offer slightly greater heart health benefits than other forms of alcohol. For women (and men over age 65), the recommendation is no more than one glass, or 5 ounces, of wine daily. For men under age 65, it’s no more than two glasses, or 10 ounces, daily.

Other aspects of the Mediterranean diet include dining on fish or shellfish as least twice a week; lesser amounts of dairy products, such as cheese and yogurt; incorporating small portions of nuts and seeds daily; eating sweets only on occasion; using herbs and spices instead of salt to flavor food; getting plenty of physical activity; and eating meals with family and friends.

The Mediterranean diet may be best known as a heart-healthy eating plan, but some studies suggest that it may also reduce the risk of diabetes, certain cancers, obesity and Alzheimer’s disease.

Mayo Clinic Women’s HealthSource is published monthly to help women enjoy healthier, more productive lives. Revenue from subscriptions is used to support medical research at Mayo Clinic. To subscribe, please call 800-876-8633, extension 9751, (toll-free) or visit www.bookstore.mayoclinic.com.

Mayo Clinic

Ginger Plumbo

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