In This Issue
Why You Gain Weight on Your Period
Rapid Fertility Preservation Critical to Breast Cancer Survival
Foods to Avoid During Pregnancy
8 Reasons You Can't Stop Eating
6 Things You Can Thank Your Hormones For

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Why You Gain Weight on Your Periodperiod 

You've been exercising and eating healthy, but the scale just threw you a curve ball, clocking in at five more pounds than last week. Don't worry-if your shocking weigh-in lands the week before your period, you can chalk it up to water weight, reassures Raquel Dardik, M.D., gynecologist at NYU Langone Medical Center.

"Weight gain happens five days before your period, but you'll be back to normal once you start," she explains.

Pre-period water weight can range from half of a pound to 10 pounds, usually averaging around five for most women, Dardik explains. Why? The hormone progesterone-essential in the early stages of pregnancy-is to blame: when there's no baby (aka when you get your period), these levels fall. As a side effect, each cell in your body retains an extra microscopic drop of water, Dardik explains.
While it doesn't lead to weight change, bloating caused by gas can magnify the situation by making you feel a size bigger.

Before you ask, yes, you can figure out exactly how much weight gain is to blame on your monthly visitor, but it's better to not focus on numbers. Instead, maintain a healthy scale schedule to keep yourself in check: weigh yourself once a week, on the same day, at the same time, using the same scale.

"The main thing is not to overdo it, because fluctuations in weight are common," Dardik says.

Combat these side effects the way you battle all bulge: with exercise. And drink a lot of water to help get rid of water retention, says Dardik. Also try and avoid fatty foods, alcohol, and salt, which triggers your body to hold onto water, says Dardik.

That extra weight that doesn't disappear after your period, though? This could be caused by pre-period cravings that make you hungry for salty, greasy foods, and sweets-and that kind of weight will not come off after your period, Dardik warns. So before you indulge simply because you're PMSing, think about whether you want to be carrying that extra weight post-period.

Moral of the story: check your weight, but don't be paranoid about it. And keep your chin up: Your best days are ahead of you, explains Dardik, as women usually feel at their peak in the first 7-10 days after their period.

Source: Shape

Rapid Fertility Preservation Critical to Breast Cancer Survivalfertility 

By Art Castelbaum, MD; RMA at Jefferson

Breast cancer in young women receives considerable attention. While cure rates are high, only a small fraction of survivors treated with chemotherapy will conceive, making fertility preservation before treatment critical.

Recent Breast Cancer Research
Two important studies published this week demonstrate that women with breast cancer have improved survival rates if they start cancer treatment within thirty to ninety days of diagnosis (Timeliness in Breast Cancer Treatment-The Sooner, the Better). It is well-known that many forms of cancer treatment can impair fertility. The need for rapid fertility preservation for cancer patients has never been clearer.

Fertility Preservation at RMA
The fertility preservation team at RMA at Jefferson has significant expertise helping women newly diagnosed with cancer.

Fertility Preservation Procedure:
Patients are evaluated by a fertility specialist physician within 24 to 48 hours of referral.
Injectable medications, which typically cost thousands of dollars, can be obtained free of charge.

Fertility treatment can start at any point in a woman's menstrual cycle - usually within 3 days of initial evaluation.

Eggs can be retrieved within 2 and 1/2 weeks.
Women without a partner can freeze eggs, while those with a partner typically freeze fertilized embryos.

Frozen embryos likely produce even healthier children than with fresh embryos. We have had successful pregnancies using embryos frozen for almost a decade. There is less known about how long frozen embryos can remain viable, but with newer freezing technologies we suspect they will also do well after thawing.
Our team of IVF nurses, embryologists and finance professionals take genuine satisfaction helping women who face life-threatening cancer keep their dreams of family building alive. Many cancer survivors have told us years later that freezing their eggs and embryos gave them hope during their cancer treatment and improved their outlook.

Dr. Castelbaum is currently seeing patients at the Yardley office of Lawrence OB/GYN. Please call 267-852-0780 or visit RMA Specialists to learn more about Dr. Castelbaum and RMA at Jefferson.

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April 2016  

Welcome Spring!

It goes without saying that food cravings and pregnancy go hand-in-hand. But if you've been thinking about whipping up a ham and Brie sandwich with a tall glass of juice to help wash it down, then listen up: if you're eating for two, that's not a good idea. Read on to find out which foods to avoid during pregnancy.

Speaking of food cravings, ever wonder why you can't stop eating, even though you just ate lunch a half an hour ago? Are you always wondering, "Why am I always hungry?" Figure out what's causing your never-ending snacking by checking out these 8 Reasons You Can't Stop Eating.

When it's that "time of month," it's not at all uncommon to feel as though you've actually gained weight. But is that skyrocketing scale just water weight? Find out how your period affects your number.

You're probably familiar with three of your major sex hormones: estrogen, progesterone, and testosterone. (Even though testosterone is usually associated with men, women have a small amount of it, too.) And you likely know that this hormone play a major role in boosting your libido - a surge in estrogen before ovulation triggers the release of the egg, and is associated with increased sexual feelings. But that's not where the benefits end. 6 Weird Things You Can Thank Your Hormones For explains how your hormones are partly responsible for mood enhancement, preventing the flu, helping you sleep, and more.

When diagnosed with breast cancer, many emotions arise and there are so many decisions to make. It can be overwhelming. And if you want to get pregnant and have children in the future, the medical decisions become even more complex. Many women diagnosed with breast cancer have fertility concerns. If having children is important to you, one of the most important things you can do as you're planning your treatment is talk to your doctor about your fertility options. Dr. Art Castelbaum of Reproductive Medical Associates (RMA) explains why fertility preservation before treatment is critical.

With warm regards,
The Practitioners and Staff of Lawrence OB/GYN 
Foods to Avoid During Pregnancyavoidfoods 
Before you give in to weird pregnancy cravings, take a look at which nibbles are off limits:

Soft cheese
AVOID: Any cheese made from unpasteurized milk, including Brie, feta, Camembert, Roquefort, queso blanco, and queso fresco.
REASON: May contain E. coli or Listeria.
EAT THIS INSTEAD: Hard cheeses, such as cheddar or Swiss. Or, check the label and make sure that the cheese is made from pasteurized milk.

Raw Cookie Dough or Cake Batter
AVOID: Any unbaked sweets.
REASON: May contain Salmonella.
EAT THIS INSTEAD: Any baked treats.

Certain Kinds of Fish
AVOID: Shark, swordfish, king mackerel, and tilefish.
REASON: Contains high levels of mercury.
EAT THIS INSTRAD: Eat up to 12 ounces a week of fish and shellfish that are lower in mercury, such as shrimp, salmon, pollock, and catfish. Limit consumption of albacore tuna to 6 ounces per week.

AVOID: Sushi rolls that contain raw fish.
REASON: May contain parasites or bacteria.
EAT THIS INSTEAD: Sushi rolls that have either cooked fish or no fish.

Unpasteurized Juice, Cider, or Milk
AVOID: Fresh squeezed juices from your local farm and milk right from the udder.
REASON: May contain E. coli.
DRINK THIS INSTEAD: Pasteurized juice, cider, or milk. Bring unpasteurized drinks to a rolling boil and boil for at least 1 minute before drinking.

Store-Bought Salads
AVOID: Salads made in a store, such as ham salad, chicken salad, and seafood salad.
REASON: May contain Listeria.
EAT THIS INSTEAD: Make salads at home, following the food safety basics: clean, separate, cook, and chill.

Raw Shellfish
AVOID: Raw oysters and clams.
REASON: May contain Vibrio bacteria.
EAT THIS INSTEAD: Cooked shellfish.

AVOID: Raw alfalfa, clover, mung bean, and radish.
REASON: May contain E. coli or Salmonella.
EAT THIS INSTEAD: Cooked sprouts.

Cold Cuts
AVOID: Hot dogs, luncheon meats, cold cuts, fermented or dry sausage, and other deli-style meat and poultry.
REASON: May contain Listeria.
EAT THIS INSTEAD: Even if the label says that the meat is precooked, reheat these meats to steaming hot or 165 F before eating.

8 Reasons You Can't Stop Eatingeating 
woman_icecream.jpg Hunger is your body telling you it needs sustenance so it can operate efficiently. Yet sometimes, it can feel like all our hunger is a little...excessive.

It is normal to experience an increase in appetite after going hard in the gym or during your menstrual cycle, pregnancy, or breastfeeding. But if you feel like a bottomless pit, something might be up.

Luckily, tweaking some of your daily habits can help keep your appetite in check so you'll keep all that eating to when you're truly, really, actually hungry.

1. You're not eating often enough.
It might sound counter-intuitive if you're trying to curb your eating, but spacing out your meals too far can make you constantly hungry. When your stomach is empty for too long, your body will release more ghrelin, an appetite-stimulating hormone, leaving you feeling famished; over time, that can lead to overeating. Try eating a meal or snack every three to four hours, or keep an emergency snack on you, like a piece of fruit, for when you're tight on time.

2. You're not getting the right balance of nutrients.
Satisfying snacks have three components: fiber, protein, and a little healthy fat. All three can help slow digestion, which keeps blood sugar stable and keeps you full for longer. Some suggestions: a serving of plain popcorn (fiber) with roasted almonds (protein and healthy fat); vegetable sticks (fiber) with hummus (protein and healthy fat); or cherry tomatoes (fiber), avocado (healthy fat) and part-skim cottage cheese (protein).

3. You're eating too many simple carbs and sugars.
On the other hand, eating lots of simple carbohydrates (think: white bread, pasta, bagels, pastries) and sugar will make it impossible to feel satisfied. Your glucose will rise at first giving you a burst of energy, and then crash rapidly causing your body to crave more fuel. This can become a vicious cycle, where you never feel satisfied no matter how much you keep eating.

4. You're dehydrated and confusing thirst for hunger.
Our thirst and hunger cues both come from the same part of the brain, the hypothalamus, making it difficult for our bodies to know the difference. Keep a water bottle at your desk so you remember to sip throughout the day. You'll know you're drinking enough water when your pee is light yellow or clear.

5. You're stressed.
Simply put, stress increases the body's production of the hormone cortisol, which boosts appetite, since your body thinks it needs to prepare to fight. According to the Harvard School of Public Health, many studies have found that stress can increase cravings for sugary, fatty foods. These foods may actually comfort you on a physiological level-they seem to inhibit parts of your brain that produce stress emotions. This may make you feel better temporarily, but it ends up increasing snack cravings.

6. You're not paying attention to what you're eating.
Eating mindfully-that means actually paying attention to what you're eating instead of shoveling it in your mouth as you're running off to do something else-is important for your body to register when it's hungry or not. When you don't fully experience a meal, you may still feel hungry even when your body is full, because you essentially forget you already ate.
In addition to sensing when you're hungry and full, mindful eating can help you decide if food is even satisfying, or if your hunger is something else entirely, like dehydration or stress.

7. You're not getting enough sleep.
Sleep is very closely linked with two hunger hormones, leptin and ghrelin. Leptin reduces appetite, and ghrelin stimulates it. When you're sleep-deprived, leptin levels drop and ghrelin soars-no wonder you're hungry! Plus, when you're exhausted, your body craves a quick fuel source, glucose, which gets you reaching for those sugar-laden foods. These 'comfort carbs' set you off on a hunger rollercoaster, since they give you a quick (but fleeting) energy boost, followed by a sugar crash that makes you crave more.

8. You have an underlying medical condition that's messing with your appetite.
If you've checked all the other potential causes, and you're still eating nonstop, it may be worth seeing a doctor to rule out any real health concerns. Diabetes, hyperthyroidism, depression, and anxiety (along with some medications) can all amp up your appetite.

Source: Self

6 Things You Can Thank Your Hormones Forhormones 
They're a major part of your life, responsible for bone health and muscle building, among other things, but what exactly are hormones, anyway? They're chemical couriers that help get messages from one part of the body to the other. We really couldn't survive without them. Hormones are also the chemistry of our emotions. Our hormone balance can influence how we feel and even help prevent disease. How? Read on below.

1. Preventing the flu 
A study led by researchers at Johns Hopkins Bloomberg School of Public Health, published in American Journal of Physiology: Lung Cellular and Molecular Physiology, found that estrogen helps protect against the flu virus.

Since estrogen levels fluctuate during each month in premenopausal women-usually becoming more dominant around week 2 of the menstrual cycle, before ovulation-it's possible that premenopausal women are more protected from flu around week 2 of their menstrual cycles. It's also possible that women who are taking certain kinds of birth control, fertility treatments, or hormone therapy may be more protected from flu.

2. Warding off osteoporosis
Estrogen is essential for bone strength. The bones do not incorporate calcium optimally without a little bit of estrogen around. Testosterone also plays a role in building bones.

You might think of your bones as static body parts that just sit there and do nothing. But, technically, bone is constantly building up and breaking down. When you're young and you have a higher level of estrogen, the estrogen stimulates what's called osteoblastic activity, which builds up bone. When your estrogen level dips after menopause, osteoclastic activity-the kind that breaks down bone-starts to exceed osteoblastic activity.

This is why after menopause you're at higher risk of developing osteoporosis, a disease that makes your bones weaker and easier to break. You lose the most bone in the first 5 years after menopause. After menopause, it's important to get adequate calcium and vitamin D in your diet and to do weight-bearing exercises to keep your bones strong.

3. Keeping you lubricated
Estrogen is a big reason that you feel slippery during sex, and that's because it improves blood flow to the vagina. As much as we all think lubrication comes out of a gland, it doesn't. It's actually a filtered portion of our blood that makes us wet.

You can also thank estrogen for keeping your vagina plump and pinkish-red in color. After menopause, the vagina can become paler, almost white. And, believe it or not, the canal itself can become smaller. As you lose estrogen-this is the wildest thing that nobody ever tells you-your vaginal cells actually atrophy and shrink. This reduction in size, coupled with vaginal dryness, can make sex more painful later in life.

4. Building muscle
Testosterone is a huge help when it comes to building muscle, and it can also help maintain skin thickness so that it doesn't wrinkle, sag, and easily bruise or tear. Regarding testosterone, we have only a tenth of what men have, but it's really important to us. We need that little bit.

If you're annoyed that your husband can build muscle more easily and, therefore, boost his metabolism more quickly and burn calories at a faster rate, blame it on testosterone. Testosterone's influence on muscle is one of the reasons that, generally speaking, men have an easier time with their weight than women do.

5. Improving your mood
Testosterone is known for increasing your level of dopamine, a neurotransmitter that makes you feel pleasure and improves your focus. 
Women who cry very easily seem to experience a great stabilization of their moods when they take testosterone. And women with higher testosterone levels tend to have a better sense of well-being and more self-esteem, and they tend to be more decisive.

6. Helping you sleep
There's one more major sex hormone that hasn't yet been mentioned, and that's progesterone, which is often called the "calming and soothing hormone."

Levels start to go down in our 30s, and that really picks up steam in our late 40s. Low progesterone can lead to not sleeping well at night, feeling more anxious, having irregular cycles, and experiencing worse PMS. 
These symptoms are more likely to occur during the second half of your cycle. During that stretch, progesterone is supposed to be higher than usual, so if and when it isn't, you tend to feel the effects.

Should You Try Hormone Therapy?
If you're worried that you might be particularly low on certain hormones, or if you feel that your levels may be fluctuating, talk to your ob-gyn. Each woman has different levels and can experience different symptoms in varying degrees of intensity. Your doctor may be able to test your hormone levels and discuss possible treatments with you.

There are a variety of ways to treat your symptoms, and each treatment comes with its own array of risks and benefits. There is no 'one size fits all' treatment that broadly addresses the problem. It's really a matter of assessing a woman's health status, her inherent risks of disease, and then factoring in just how much inconvenience her symptoms are causing her.

When hormones aren't an option [it's contraindicated in women with breast cancer, for example], there are now a few FDA-approved alternatives to hormones, and there is a decent arsenal of well-studied treatments that aren't FDA approved that can be tried.

Source: Prevention

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