In This Issue
Decreasing Twin Pregnancies
Can Fiber Help Me Lose Weight?
6 Things to Know About Menopause
Medical Tests for Women in Their 40's
Can Physical Therapy Improve Fertility?
Is it OK to Miss a Period?

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Decreasing Twin Pregnanciestwin
Dr. Art Castelbaum, a world-class fertility specialist from Reproductive Medical Associates (RMA) who is currently seeing patients in our Yardley office once a month, has written a blog about the goal of decreasing twin pregnancies.

Click here to read the full article and learn why RMA at Jefferson (Dr. Castelbaum's practice that has four Philadelphia area locations) concentrates on one healthy baby at a time.
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Can Fiber Help Me Lose Weight? fiber
blonde girl on scale

Two important lifestyle factors can affect your body weight more than any others.  The first is work-related physical activity. Individuals who walk and stay mobile as part of their jobs are less likely to be overweight.  The second factor is dietary fiber.  If you are mostly stationary during your work day, it's a good idea to look at how much fiber you are getting in your diet.


Fiber serves two main purposes that affect your health. Soluble fiber -- in foods like oat bran, nuts, beans, and some fruits and vegetables -- helps prevent your body from reabsorbing bile acids in your gastrointestinal tract, which can help lower your cholesterol without medication.    


Insoluble fiber -- found in wheat bran, whole wheat bread, and many vegetables -- absorbs water in your colon and can help keep you regular. Because fiber absorbs water, it can also help you feel fuller after taking in fewer calories.  


Most of us get less than the 25 grams of daily fiber recommended by the American Heart Association.   Consuming this recommended amount can help you lose weight while improving your heart health.  You can bulk up on fiber pretty easily by increasing your intake of fruits and vegetables, and making a point of trying higher-fiber breads, cereals, and rice. In some cases, you can meet your fiber goals with the use of a fiber supplement, but talk to your health care provider first about that.    

Making some simple changes in your shopping patterns can help you reach the recommended amount of daily fiber and reduce your risk of heart disease ... and stay regular.  


Source: WebMD

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Hot flashes. Sleepless nights. Weight gain. Intense crabbiness. You don't have to struggle through symptoms. Here are 8 things you need to know so you can be prepared.


You no longer need birth control

You no longer need birth control once menopause is complete, but you most certainly need to use birth control until you have missed your menstrual cycle for 12 consecutive months.  It is not unusual for women to miss several menstrual cycles only to have a period and then have to start counting missed cycles again.  You can get pregnant during these "start and stop" moments, so only give up birth control after the 12th consecutive missed cycle.


Not all women get hot flashes

Not all women get hot flashes as they move into their menopausal stage.  Most women will experience some hot flashes (and sweats), particularly at night.  Experiencing hot flashes can continue up until five years post menopause.


Weight gain around your mid-section is typical

Weight gain around your mid-section is typical and is often due to the fact that you may need to adjust your daily total calories downward in response to a slightly slower metabolic rate (and loss of muscle mass).


You may experience vulvar and vaginal atrophy

You may experience vulvar and vaginal atrophy (vaginal shrinking and narrowing) which can result in dryness and painful intercourse.  Talk to your gynecologist about treatment options.


Hormone therapy a treatment option only for severe hot flashes

Hormone therapy is currently considered a medical treatment option only for severe, unrelenting hot flashes, due to the increased risk of breast cancer associated with HT. Other menopause symptoms need to be addressed with other treatment options. A maximum of 2 years of HT is currently considered the "safest time frame" for hormone use.


Sleep difficulties, anxiety among common complaints

Sleep difficulties, anxiety, depression, forgetfulness, irritability are common complaints made by women who have experienced menopause.


Source: Women's Magazine





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August 2015 

Make the Last Month of Summer a Healthy One


woman eating salad Judging by the commercials on TV, food companies have finally realized that fiber is a healthy addition to a good diet. While it is no miracle food, failure to get enough in your food can lead to a number of health problems. Among the health benefits of are: relieving constipation and hemorrhoids; preventing certain diseases and keeping weight under control. This begs the question: Can fiber help me lose weight? Find out how increasing fiber in your diet could help you shed some extra pounds.


When women reach their 40s, some may go through a "midlife crisis," but there are plenty of ways you can stay healthy and happy regardless of your age. Your diet, sleep habits, and exercise have a huge impact on how healthy you will be at middle age. (Staying current on your wellness exams, OB checkups and vaccines will help, too!) How healthy are you? This is a great time to assess the current state of your health by reading Medical Tests for Women in their 40's so you can best prepare your body for the future.


Unless you're trying for a baby, getting your period regularly is both a blessing and a curse. On the one hand, you have to deal with cramps, bloating, and mood swings. Suddenly missing your period when babies aren't on the agenda can be a real freak-out moment, but there are a few other factors that may be to blame. Is it OK to miss a period? offers potential reasons your period is late that have nothing to do with a bouncing bundle of joy.


Infertility can be one of the most heartbreaking medical issues for a woman to deal with. It's hard physically, with so many possible causes and relatively few solutions, but it's also devastating emotionally, as you usually don't discover it until you have set your hopes on having a baby.   

The medical community has made great strides, but even advanced technologies like IVF only have a 20 to 30 percent success rate despite the hefty price tag. But a new study shows promise in helping to treat infertility using a special physical therapy technique that's not only cheaper, but also less invasive and easier than most traditional practices.  

Find out the role physical therapy may play in improving fertility.


It's been called the change of life, the beginning of the end, a renewal time, the start of the next half of your life. However you think of menopause, there are plenty of questions women have about this female milestone. Here are 6 Things You Should Know About Menopause.


With warm regards,


The Practitioners and Staff of Lawrence OB/GYN 

Medical Tests for Women in their 40's  testing

woman dr with stethoscope

Whether each morning starts with a frantic hunt for your keys or you're so organized that you have automated reminders to send birthday cards, one thing is for's hard to keep tabs on your health when every medical test and screening has its own guidelines. To help you out, here are a few that need your attention.  Take a look and then start scheduling your appointments.


  • Blood sugar. Decades of eating the wrong food (think chocolate, hot dogs, fries -- you get the picture) plus weight gain (often due to hormone changes) may have overworked your poor pancreas. It can't keep up and that can lead to diabetes. Starting at age 45, be sure to get a fasting blood sugar test, and then at least once every three years.
  • Breast exam and mammogram. You're probably checking your breasts at home regularly and your doctor does an exam annually, but most experts recommend adding a mammogram to the mix somewhere after age 40 or 50. Not all breast cancer experts agree. When to start? Work with your doctor to decide.
  • Blood pressure. Don't be surprised if your blood pressure starts rising now -- that's common. Fortunately, you can lower your blood pressure through diet, exercise, and medication. It's worth the effort. Lower blood pressure is a key factor in longevity.
  • Cholesterol profile. Take heart: this simple blood test can save your life. One in five Americans has high cholesterol, a condition that leads to heart attacks or strokes - diseases that claim a life every 33 seconds! If you have high cholesterol, protect yourself by changing your diet and taking medications such as statins.
  • Stepping on the scales. You blissfully enjoyed chips and hamburgers while ignoring your expanding waistline, but the scale doesn't lie. Pay attention to the results: being overweight puts you at high risk for developing a number of diseases, including diabetes and heart disease.
  • Pelvic exam and pap. Yes, you still need these -- especially if you're sexually active. Ten minutes of mild discomfort pays big dividends in protecting you from cancer and sexually transmitted diseases.
  • Looking for moles. Those years of getting "a healthy tan" can lead to something not so healthy -- skin cancer. Luckily, most skin cancers are curable. So don't forget to ask your doctor to check your skin for unusual moles or skin changes once a year.
  • Protecting your eyes. Having trouble reading or working at the computer? It's not unusual. Be sure to get your eyes examined regularly -- every two years until age 60 -- to check for common problems like presbyopia, glaucoma, and macular degeneration. Go more often if you have vision problems or risk factors for eye problems.
  • Checking your immunizations. Ask your doctor if you need a tetanus booster shot, and whether you should consider a flu shot.

Schedule a visit to your dentist, and call your doctor to see if there are important tests you should take. By investing an hour or so with the doctor now, you may be able to add years to your life.   


Source:  WebMD 


Can Physical Therapy Improve Fertility?fertility

pregnant woman in shadow If you feel like you've tried just about everything imaginable to put a bun in the oven with no positive pregnancy test results in sight, here's some new hope: A recent study published in Alternative Therapies in Health and Medicine found that physical therapy may seriously impact the pregnancy rates of women with fertility issues.


This is big news considering 11 percent of women currently struggle with infertility and 7.4 million have tried expensive treatments like in vitro fertilization (IVF).  

The 1,392 female patients in the study underwent whole-body, patient-centered manual therapies over a period of 10 years. Researchers worked with women who suffered from a variety of causes of infertility, including endometriosis, blocked fallopian tubes, and polycystic ovary syndrome. In addition to inhibiting fertility, these issues can also cause serious sexual pain. For the purposes of the study, the researchers defined infertile women as those under 35 who've been trying to get pregnant for at least 12 months and those over 35 who've been trying to get pregnant for at least six months (this definition comes from the Centers for Disease Control and Prevention's guidelines).


By using manual techniques (predominately the Wurn Technique, which is similar to a massage and done at the site of endometrial tissue), doctors went after three primary causes of infertility: pain during sex, hormonal imbalances, and adhesions (scar tissue in the body that can develop if you have endometriosis). The results? Pretty amazing. Depending on the underlying cause, patients experienced anywhere between a 20 and 60 percent success rate and went on to have a healthy pregnancy.  


"The Wurn Technique is designed to deform and detach the bonds of these tiny but powerful adhesions and return the body to normal, pain-free function," says Larry Wurn, a licensed massage therapist and co-author of the study, who developed this particular technique with his wife, Belinda, a physical therapist who also co-authored the study. Doctors also used elements of myofascial manipulation, a soft-tissue therapy that involves placing gentle pressure on an area to alleviate pain.  


"This is the largest study of its kind ever conducted," says Wurn, who explains that prior research on this subject has been pretty scarce. So it's important to note that this is a relatively new area that experts are still exploring. As the researchers point out in the study, "some causes of infertility are straightforward...whereas others are quite complex," so there's not a one-size-fits-all solution for every woman.  


But experts say that for a growing number of women, physical therapy could work hand-in-hand with other types of fertility treatments.


And physical therapy is especially beneficial for women who haven't been able to get pregnant because sex is too painful, says Sallie Sarrel, a doctor of physical therapy who specializes in internal and external pelvic mobilization. "Physical therapy can help so much with painful sex so that women are able to actually have sex and get pregnant," she says.


What's more, experts say they are seeing more and more women turning to physical therapy for a variety of sexual health issues, including experiencing trouble conceiving. Isa Herrera, clinical director of Renew Physical Therapy, a center focused on treating women with fertility issues, says other alternative fertility treatments she's seen patients try are abdominal massages, Reiki, accupuncture, and chiropractic care.  


The bottom line: If you're struggling to get pregnant, physical therapy could be worth trying.  


Source: Women's Health


Is it OK to Miss a Period?period2 

Calendar The only thing worse than getting your period is not getting your period. The anxiety, the trip to the drugstore for a pregnancy test, and the confusion that sets in when the test comes back negative is worse than any case of cramps.   


And while a lot of women don't talk about it, almost all of us have been there. Missing a period is very common, And luckily, most of the time, it's harmless and only your body's way of showing you some TLC.     


When you undergo a lot of stress, your body may not ovulate and have a period.  That stress could come from your job, your boyfriend, or even your workout. Excessive exercise-and the stress it causes on your body-can lead to missed periods. In one study, a quarter of elite female athletes reported a history of missing periods, and runners led the pack.   


What's more, menstrual cycles can go MIA even if you're on a medication that's supposed to regulate them. Birth control pills and the Mirena IUD can make your endometrial lining so thin that sometimes there's nothing to shed. That's also true for 28-day packs of birth control complete with placebos and some oral contraceptives with placebo pills spaced further apart that are designed to make you only get your period every few months. And it's fine, as your body isn't ovulating when you're on hormonal contraceptives anyway. If you discontinue use of BC, remember it may take six or more months for your periods to get back on schedule.  


When to Worry

If the above doesn't describe you and your missed periods hit the three-month mark (when missed periods are officially dubbed amenorrhea), visit your gyno. Several missed periods in a row can be a sign of decreased estrogen levels, which can spur bone loss, according to research in the Journal of Obstetrics and Gynecology. To your body, it's like going through menopause right now (but without all those calcium chews).  


Even more concerning is that serious health conditions could be behind your MIA menstrual cycle. Among the most common is polycystic ovary syndrome (PCOS), a hormonal imbalance that makes ovulation infrequent or stops it altogether and that can increase the risk of endometrial cancer. The uterine lining builds up every month but is not shed. Over time it can thicken and cancerous changes can occur. PCOS is the most common cause of female infertility in the United States, and while its exact cause is unknown, early diagnosis and treatment can help reduce the risk any long-term complications such as type 2 diabetes and heart disease.   


Eating disorders and too-low BMIs can also cause missed periods.  

According to the National Institutes of Health, having a body fat percentage lower than 15 to 17 percent increases your chances of missing periods for an extended period of time. The body isn't in the shape to carry a pregnancy, so the brain tells your ovaries to shut it down. And even if your BMI doesn't get too low, super-speedy weight loss can send your periods on hiatus.


If you do visit your gyno about a case of the missing period, it's important to go armed with a calendar of any menstrual cycles you have had, as well as a list of any other symptoms as well as health and lifestyle changes that have occurred recently.  And whatever you do, don't stress about it. It won't make your period come back any faster.   


Source: Shape Magazine


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