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Women’s Health

Vaccine hesitancy, S-equol, and women’s health in rural Africa



Michael Krychman, MD, is a sexual health specialist and survival medicine expert at the Southern California Center for Sexual Health and Survivorship Medicine.

Barb Dehn, NP, is a Women’s Health Nurse for El Camino Women’s Group and a nationally recognized health professional specializing in pregnancy, breastfeeding, fertility, menopause, and sexual health.

MK: Hello i’m dr Michael Krychman here with Contemporary OB / GYN®. We’re at the North American Menopause Society’s annual meeting in Washington [D.C.], and I’m so excited to have Sister Barb Dehn here. She’s a regular medical reporter, she’s on NBC California Live, she wears a million different hats. We’re going to try to pick out your brain a little for the next little while.

Tell us what’s wrong? What did you do on your show?

Address vaccine hesitation

BD: We talked a lot about COVID. We talked about how to get people from being hesitant to vaccinate to being ready to vaccinate. And guess what? Trusted Ob-Gyn are some of the people that make the most difference in people’s lives because women love Ob-Gyn. They gave birth to their babies, they are always there for them. So women have a lot more influence than they might think when it comes to helping people make decisions about getting vaccinated.

MK: It’s a very sensitive subject. I know where I am in Orange County, it’s a very sensitive issue where people get their information or their misinformation. We need really good resources and how to communicate with our patients. Because I agree with you, we have influence and now we are all asking, ‘Did you get the vaccine?’ And if not, what are you hesitating about? Where do you get information from? How can we educate you to make informed decisions based on fact, not fiction, right?

BD: Exactly. And we don’t want to shame or blame. What I always say is that we have two ears and one mouth so we can listen twice as much as we can talk. By listening you can really go deeper into the real reasons, and sometimes it really comes as a surprise. And then, if possible, you can break myths, but not shame or blame them because people already feel anchored in their positions.

MK: I have to tell you the truth I have children. Your teams and I use this line all the time: ‘Two ears, one mouth, make me listen more than speak.’ And I think this is a really good clinical bead for almost everything we do, right?

BD: Especially for sex. And you are an expert in sexual medicine. No matter who I talk to about sex with, especially teenagers, I always say, ‘It’s not about the birds and the bees. It’s really about listening and asking open-ended questions. Sometimes just what-if questions, right, when you’re talking to a teenager? Or, ‘When do you think people want to have sex and you know what needs to happen in a relationship before you make that decision?’ So I like to ask a lot of questions.

Myths and Misconceptions About Soy

MK: I know you have been very busy here and I was lucky enough to only attend one session today that you presented at 1. Tell me what are the highlights and the take-home messages, because I find it really exciting and new.

Even for someone seasoned like me, I’ve brought a lot of clinical gems with me and I’m really excited about new innovations that come on the market so I know you are on the cutting edge. So tell us what’s going on.

S-Equol and Estrogen Receptors

BD: I’ve always been interested in soy because it’s a phytoestrogen. There is so much conflicting data on this, and we talk about myths and misconceptions when it comes to soy. So many people fear it because rodent studies have shown hyperplasia in the chest, but it turns out that some people metabolize soy for its natural metabolite, S-equol. But S-Equal – take this – it only works on estrogen receptor beta.

It has a 13-fold higher affinity for the estrogen receptor beta than alpha, which means that sometimes it acts like an estrogen and sometimes like a sirmaur, an antagonist, or an antagonist.

MK: Back to the basics, a lot of clinicians don’t even know. All you think about is estrogen receptors, don’t you? And you are [thinking]”All estrogen receptors are the same and they do the same thing.” We know it now and they [inaudible] really taught us that cells are sometimes turned on, sometimes turned off, and this adds another layer.

I find the alpha and beta receptors really exciting and I think it’s important to remember that not all soybeans are created equal. There are different qualities. It’s really exciting because you gave us some statistics about women and what they want, and it really opened my eyes.

BD: As a result, 2 million women go through menopause each year – and yet – only one in four uses some type of treatment, whether it is over-the-counter or prescription. But 50% – and I actually think that’s a little low – 50% of women want to use some type of dietary supplement or natural product.

Now they come to us with a lot of crazy ideas that they hear from an online influencer. It’s really up to us to look at the data and say, ‘Look, is that evidence-based?’ And: “Does it hold up against placebos?” And as it turns out, S-Equol has great data and it has great security, great security profile.

MK: I think that’s really important. Because there are many snake oil remedies out there. We see it all the time. Every day they put some strange thing in their vagina or they take this strange product that comes in a brown paper bag and we don’t know what it is. Then they have complications.

It’s really exciting that some of these companies are taking the extra step to do this research. It is very reassuring for us as clinicians to implement this. Where do you see the future of that?

Increasing knowledge of receptors for tailor-made care

BD: I am very excited. I just did a literature review of ovarian cancer cells inhibited by beta activation of the estrogen receptor, and it was recent research from the University of Texas.

I think as clinicians we will not only pay more attention to whether like breast cancer are estrogen receptor positive or negative, but if it is an alpha receptor if they are estrogen receptor positive? Is It a Beta Receptor? And how do we use this knowledge about receptors to better tailor or individualize the treatment options we have for women? You and I both know that one size never fits all. That is why we are always looking for a tool in our menopause toolbox to offer patients different things, because every woman wants different things.

MK: Or sometimes even stratify. Very often I will be doing behavioral things and I will incorporate a nutraceutical or dietary supplement. Even with estrogen, people want to stick to a lower dose, but they still want an extra boost. So sometimes you have to layer it. And I think your concept is right, precision medicine. Are you doing any other events here? Any posters, other exciting things?

Foundation for African Medical Education (FAME)

I know you genuinely care about health and health inequalities. I cannot have you interviewed without talking about your commitment to FAME. I find it really amazing so I think people want to know about it. Tell us about fame and how you started, where we are and where we need to be.

BD: That’s very nice of you, because I’ve been going to Karatu, Tanzania, that’s sub-Saharan Africa for about six years – very close to the Serengeti, very close to the wildebeest migration. I became a board member, but here I am challenged [and] loaded with.

I built our Global Fellowship program specifically for ob-gyn.

FAME is a non-denominational hospital. There is no religion involved. It’s sustainable. Really sustainable. They are all Tanzanian doctors, all Tanzanian nurses and experts like you. We’re getting the Penn neuroteam that’s coming, and we had a global colleague. I am actually recruiting post-residency fellows who come to FAME for at least three months. Our last mate liked it so much that he stayed for nine months.

We are looking for people who would like to complete their training or do a scholarship with us at FAME. It’s an amazing, amazing process and you can see a whole different part of the world. That’s why I was charged.

We have anesthesia fellows from Stanford, we have the neuro team from Penn, we had a surgeon from Creighton [University], University of Arizona for our Ob Scholar, and I would like to welcome everyone else. You can find me at if you are interested. I think I’m trying to get you to come over, right?

MK: I think I have to do this trip. What about clinicians? How can you help?

BD: If a doctor wants to come, we want you to come for at least three weeks. You would come in, you would look after your Tanzanian colleagues, you would act like a visitor. You would learn a lot about infectious diseases. We learn from each other.

There is a volunteer house and it is a safe area. We learn from each other, we work together and there is a great need for women’s health. Because – obviously – everything is created, right? You are going to see this kind of crazy stuff that you would never see in the United States. It’s an amazing experience, but we expect people to give something back. You have to pay yourself, but after that you can go on safari!

MK: Barb, I really want to thank you today for your time. It was wonderful to see you in person. I know we have been challenged by Zoom meetings and everything else. I am sure the future will be on Zoom again and in person. I know you are very busy here at the conference, but I really want to thank you for your time and insight, especially for your commitment to women’s health.

BD: Oh thank you. What a pleasure. Thank you very much.

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Women’s Health

Ellen Noble: Fostering inclusivity, opportunity and health awareness in cycling



Ellen Noble is stepping down from professional cycling indefinitely to make her health a priority, but she will continue her mission of promoting inclusivity, opportunity and health awareness in the sport.

In an interview with Cyclingnews, Noble said she wanted to provide opportunities for girls and young women through ENCXQuest and Noble Racing Mentorship Program Grant initiatives.

“It is possible to still be inclusive and create community, be it in person or remotely. I love this connection. I didn’t always fit in when I was in school, so it really means having a group of people we can all fit into. ”A lot to me, and I want to keep finding ways to do that. I don’t want to stop doing my initiatives outside of racing and I hope I can do more of them now that I have more time. I intend to stay in the sport even if it’s not on the track, “said Noble.

Noble has ongoing health problems after being diagnosed with Hashimoto’s disease in 2018, an autoimmune disease that affects thyroid function.

Noble told Cyclingnews that it took some time to find ways to relieve her symptoms through visits to different doctors, but that she was slowly putting together treatments and lifestyle adjustments that work for her.

“In the last two years since my diagnosis, I’ve had a lot of small wins. Every time you work with someone new, you learn a little and I take small pieces from each practitioner and I slowly build a solid foundation for health, which is my goal, ”said Noble, who uses acupuncture to provide symptom relief has found .

“Practitioners in many circles believe that autoimmune diseases and chronic diseases can be hibernated, they can never be cured, but they can be let dormant. The ultimate goal for me is to put it into hibernation and not struggle with flare-ups. “

Noble said her health was in delicate but good shape when she suffered a fall earlier this year that broke her spine in three places. Although she was now almost completely healed, the injury opened a void in her health that was difficult to fill.

“I still have back pain, my back is healed, but it didn’t just go away. I don’t think injuries, be it a broken bone or illness, aren’t always linear, ”she said.

“I think this is how my autoimmune disease changed after I broke my back. When I broke my back in April, I was doing pretty well. I felt healthy, my symptoms were regulated, and I felt pretty good. I just wasn’t in my best shape and my results weren’t great, but I felt good.

“That was a bridge too far for me. My health was still fragile and the physical trauma of breaking my back shook my health as we were in a delicate balancing act. I came back and rode and worked at the gym and then hit a wall in August. Physically I couldn’t anymore and my nervous system was at its limit. “

Noble hasn’t ruled out the possibility of a return to professional racing; However, she has not set a schedule for her sabbatical. Instead, it focuses on other goals within the sport that offer rewards beyond performance and results.

“I’m still trying to find out everything. I take my time and I feel like this is a great opportunity for me and I feel grateful in this room where I can do something new. I still want to be involved in the sport because I love cycling, I love bikes and most of all I love what bikes can do for people, from racing to commuting to rides around your neighborhood with friends of kids. I want to pass this message on. I also think bikes are a great platform to talk about physical and mental health, ”said Noble.

Connection and acceptance

Noble launched ENCXQuest in 2017, which accommodates 12 to 18 girls and young women ages 15 to 23 to experience an all-women cycling camp that includes training, technique building, yoga, and education on nutrition, sponsorship, and the sport in general.

“The camp started as an answer to my question: What did I want and need in sports when I was 15? When I was in high school, sport opportunities were lacking for women my age. There were many junior camps and, despite my requests, I was never admitted. When there weren’t any options for the next generation, I decided to do it myself, “said Noble.

Camp has been postponed in 2020 and 2021 due to Covid-19, but Noble is preparing to host its fourth edition in 2022. Noble stated that ENCXQuest relies on donations and industry partners. It’s also an application-based program that offers places for women of all backgrounds, whether they can afford it or not.

“We want to make sure that the athletes who are eligible for the camp regardless of their financial status can participate. I’m delighted that space has been created for these athletes that might otherwise not have been created, ”said Noble.

“People are very supportive and so we can operate through donations from very generous people who also have the mission to get more girls and young women on bikes and to create a space for young women to have fellowship. Yes, it’s about bikes, but it’s also about 12 to 18 girls who spend the week together and find that having more women in your circle is pretty cool. “

While the ENCXQuest took a break due to Covid-19, Noble launched a virtual platform in 2021 to create opportunities for women in cycling. The Noble Racing Mentorship Program Grant Fundraiser is an attempt to support and mentor the next generation of young women in cycling. It offers seven athletes monthly group and one-on-one meetings, as well as financial grants to cover their entry fees, travel expenses, and coaching.

Noble wants to continue both initiatives while finding new ways to promote inclusion and opportunities for women in cycling.

When asked where she sees herself in the future in sport, especially in terms of her initiatives, Noble said, “I don’t think I’m alone in this, but I hope the sport continues. We see these little advances in different areas. We’re seeing more colored riders in the results, on the start lists and on the podium and it’s amazing. The same goes for transporters. Seeing acceptance grow wider, which is amazing to see, has been my mission since the beginning of the quest to promote that inclusivity.

“I hope more people understand that bikes are powerful and can change lives. The more people from all backgrounds – no matter where you come from or who you are – the more people we can bring on bikes mission. If you have love in your heart and want to ride a bike then you are friends of mine. It’s a great way to connect. “

Noble will take the time it takes to get better and one day we may see her at the highest level of racing again, but even if we don’t she’s sure she has a place in cycling .

“My comeback to cycling is not guaranteed. I won’t be racing again if I don’t fix my health, but my goal is to fix that and if I can I’ll be back at the track. Anyway, I’m not done with cycling yet, “said Noble.

Today’s best cyclocross bike deals

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Women’s Health

New York electeds rally around Planned Parenthood, assure NYC as safe haven for abortion seekers



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As the right to abortion is threatened in states across the country, elected officials from New York gathered in Lower Manhattan on Monday to discuss planned parenting.

With abortion fast becoming one of the most controversial issues of the year and fear of losing the right to vote, a bevy of city and state officials assure New Yorkers that they will not lose access to these health services.

While touring Planned Parenthood at 26 Bleecker Street, Congressman Carolyn Maloney, Senator Brian Kavanagh, councilor Carlina Rivera, famous journalist and activist Gloria Steinem, and more brought the facility’s importance to the fore today more than ever. Maloney said the site is already seeing an influx of patients from overseas.

Congressman Carolyn Maloney. Photo by Dean Moses

“We just visited Planned Parenthood and they are already telling us that people are flying in from Texas for treatment. I am so proud that Planned Parenthood is in the district I represent and that it does such a good and wonderful job helping women and girls, ”said Maloney.

“Reproduction rights are no longer chopped off. They were thrown away the entire time I was in Congress. Vote here and vote there. They no longer scratch our rights. They ram them into the ground, ”she added.

That influx coincides with the case of the Dobbs Supreme Court over the 15-week abortion ban in Mississippi, the ongoing litigation over the six-week abortion ban in Texas, and efforts to escalate denials of health care, including abortion and contraception. In the Dobbs v Jackson case, the state of Mississippi argues that the power to regulate abortions should be a state issue, not a state issue. As the court battle continues with a verdict due by the summer of this year, 21 states are on the verge of making abortions illegal or extremely difficult due to strict guidelines such as the “Heartbeat Laws”.

Chair of the Oversight and Reform Committee alongside her work in Congress, Maloney is pushing for a five-part plan to tackle the attack on women’s rights. Citing discussions she had with incestants aged 10 and over who became pregnant, she called abortion abolition “cruel” and “inhuman”.

Maloney’s initiative sees the constitutional change in equality through the passage of the Women’s Health Protection Act, which would establish a legal right to abortion across the country while cracking down on contraceptive restrictions.

Gloria Steinem is all too familiar with this fight. Steinem, who fought for women’s rights for decades, called this latest controversy an attack on democracy.

Journalist and activist Gloria Steinem. Photo by Dean Moses

“If we cannot control ourselves, there is no democracy. When Hitler was elected and he was elected, the first thing he did the very next day was padlock the family planning clinics and declare abortion a crime against the state. Mussolini did the same. Dictators know that they have to control reproduction, ”Steinem said.

While this is extremely worrying for those living in the affected states, many in attendance reassured New Yorkers as well.

“New Yorkers need to know that their right to abortion is safe here in this state. Regardless of what happens in the Supreme Court, ”said Sonia Ossorio, President of NOW-NYC.

Tiffany Caban. Photo by Dean Moses

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Women’s Health

Gynaecologist busts some common PCOS myths



Polycystic Ovarian Syndrome (PCOS) has become one of the most common hormonal problems in women today. Recent data shows that at least three in ten women are diagnosed with it, and six in ten women diagnosed are teenagers, said Dr. Vaishali Joshi, Senior Obstetrician and Gynecologist at Kokilaben Ambani Hospital.

“PCOS is a disease of civilization that has problems like irregular periods, scant menstrual flow, acne, excessive body hair, weight gain, darkening of the skin, along with polycystic bulky ovaries (PCOD) on sonography and hormonal imbalance including high insulin resistance and excess male hormones, “she said.

The following should be noted with PCOS (Photo: Getty / Thinkstock)

“Many young women are mistakenly diagnosed with PCOD instead of PCOS because some symptoms are similar. Hence, there are many myths and facts surrounding PCOS too, ”she added.

* PCOS only occurs in young women in their early twenties or thirties: PCOS can occur at any time between the ages of 18 and the age of perimenopause.

* All women with PCOS have PCOD: Polycystic Ovaries found in 20 percent of healthy women. At the same time, not all women with PCOS necessarily have PCOD ovaries on sonography.

* PCOD ovaries cause abdominal pain: PCOD ovaries are small (<10 mm) large water sacs (cysts) and are arranged around the periphery of the ovary in a pearl necklace pattern. They don't cause pain or discomfort. The ovarian cysts that cause pain are at least 3 cm in size and are not found in PCOD.

* Irregular periods and poor period flow lead to weight gain and PCOS: Culturally, menstruation has been viewed as a process by which unhealthy blood is thrown from a woman’s body. Skipping periods or decreased flow is believed to prevent this process and lead to the accumulation of fat and obesity. Unfortunately it’s the other way around. The weight gain leads to a hormonal imbalance and therefore an irregularity in the periods and development of PCOSsaid Dr. Joshi.

* PCOS only occurs in overweight women: women with acquired PCOS gain weight from poor lifestyle choices. Almost 80-85 percent of PCOS women are overweight. However, PCOS can occur in women of normal body weight, especially those with a family history.

* All women with irregular periods have PCOS: Period irregularities can also occur with thyroid diseases, hyperprolactinemia, eating disorders, low hormonal levels induced by overuse, especially in long distance runners.

* Acne is always due to PCOS: acne or pimples on the face can have several causes. PCOS is one of them. The most common are skin problems, allergies, or dandruff.

* Women with PCOS have difficulty getting pregnant: PCOS causes anovulation, which means stopping an egg from being released every month, but does not stop it completely. Women with PCOS have inconsistent and delayed ovulation but can get pregnant naturally. Most of the time, having missed periods makes them unaware that they are pregnant, said Dr. Joshi.

* Drugs Can Cure PCOS: Drugs are usually used to treat the symptoms of PCOS, depending on the treatment needed, such as infertility or regular menstruation. These treatments do not address the cause and therefore are not curative drugs. PCOS is a disease of civilization and the cure is achieved through regular exercise, diet changes and weight loss.

* Losing weight can cure PCOS completely: Unfortunately, PCOS is a lifelong disease. A Weight loss of at least 10 percent leads to an improvement in symptoms by reducing hyperinsulinemia and excess male hormones. One has to continue with lifestyle measures and weight loss should be maintained.

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