welcome to ask the doc I'm Kathy buio and today it's all about women's health and self-care we have Dr meline kameo Chief Pharmacy officer for Baptist Health and Dr Marissa Macio clinical pharmacy specialist at Baptist Health and they're standing by ready to answer any question that you may have so get those questions ready on this episode of as to do send in your questions to questions allhealth tv.com or allhealth go on Facebook or YouTube or visit the ask the doc page on our website allhealth tv.com welcome to ask the do the show where we encourage our viewers to send in their health questions so let's kick things off with a question from one of our viewers today's first question comes from Tandy who just reached out to us through our website allhealth tv.com now Tandy ask hi Dr Kaho I read an article recently that suggested that birth control pills could have an adverse effect on a woman's card cardiovascular health I've been on the pill for a number of years and now I'm a little concerned about my heart health I'd love to know your thoughts on this hi Tandy we appreciate you sharing your concerns with us so what's the deal Dr C can birth control pills cause heart problems well Tandy it all depends on your overall health you are more prone to uh have heart problems on birth control if you are over the age of 35 you're a smoker you have high blood pressure you're diabetic or have ever had a heart attack so birth control contains estrogens which increases blood pressure so women who have high blood pressure on birth control do have a risk of stroke or heart attack compared with women who don't have high blood pressure so keeping tabs on your blood pressure while you're on birth control is really essential and that way you can monitor yourself but also hormonal birth controls can also affect your cholesterol so sometimes it'll lead to a plaque of accumulation in your arteries and it also leads to a heart attack or stroke Marissa what are you things that you're seeing your patients what other factors would you consider yeah as you mentioned there are many things for women to consider in regards to birth control and their cardiovascular health one of the major risks with birth control is the increased risk of blood clots especially in smokers and women over the age of 35 there are also some non-modifiable risks or essentially risks that you cannot change such as your gender your age family history and race so according to the American Heart Association 80% of people who die from cardiovascular disease are 65 years old or greater and while many people consider cardiovascular disease to be primarily a men's disease it's the leading cause of death and women in the United States the risk for developing heart disease increases if you have a relative who developed heart disease at an early age and after African-Americans are at a greater risk of developing cardiovascular disease so while there are some things that you can't control there are other lifestyle choices like birth control or smoking which could enhance your risk thank you so much doctors okay heads up we have another question this is a YouTube question it's coming in hot it's from Mickey and her question is Dr Kaho I'm 52 and I've gained a little weight recently I've also had what I can only assume are hot flashes does this mean I'm close to menopause and what are the most common symptoms of menopause and how can they be managed effectively what a great question what do you think doc well hi Mickey I have a few thoughts but let's check out this video from our friends at the National Institute of Health [Music] First Maria is 45 and is having night sweats and trouble sleeping she wonders are these changes related to menopause what are the signs and symptoms of menopause women begin experiencing changes in midlife that could be related to aging the transition to menopause or a combination of both often changes happen to the menstrual cycle the body's internal thermostat sleep vaginal Health sex drive bladder health and mood a woman has reached menopause when she hasn't had a period for a full year changes in your period might be the first thing you notice periods may be inconsistent shorter longer or lighter or heavier than usual many women experience hot flashes a sudden feeling of heat during the transition and for many years after menopause women may start having difficulties falling and staying asleep hot flashes at night or night sweats can make this worse the vagina may become drier which can make sexual intercourse uncomfortable your feelings about an interest in sex may also change some women start to have bladder control issues they may have a sudden urge to urinate or be unable to hold their urine you might feel moodier or more irritable many women experience mild menopausal symptoms but for others symptoms can be severe not everyone's experience is the same but remember menopause is a normal part of aging and not a disease that must be treated if your symptoms are bothering you talk with the doctor learn more at www.nih.gov menopause so as mentioned in the video the common symptoms are hot flashes night sweat sleeping problems and vaginal dryness now you can talk to your provider about hormonal replacement therapy to see if that's right for you but there are other ways to help manage your symptoms that are over the- counter mostly common used is black kohos is often used to help manage hot flashes and another good one is Mecca powder Mecca comes from the root plant in the Andes mountains and Studies have shown that this nutritions had had an impact on hormone levels as women's reported improvements in their in their symptoms so for vaginal dryness you can use vaginal um moisturizers or lubricants which are often recommended to provide relief and also consider eating foods that are high in phytoestrogen and have antioxidant properties that can show some benefits like soy uh with edamami soy milk tofu legumes kidney beans chickpeas seeds are also good sunflower flax seeds or even sesame seeds and even fruits fruits like strawberry cranberries peaches nuts like cashews and almonds and teas like black or green teas are also good but remember if you're going to take any supplements like Maca talk to your doctor or pharmacist first to make sure that they're not interacting with any of your current medications thank you Dr gel okay we got a terrific Facebook question here but I'm gonna take a pregnant pause before I share Brandy's question okay pause over Dr gameo I just found out that I'm pregnant it not me Brandy it wasn't something we planned for but there you go as a result of this unexpected blessing I have a million questions for you but I'll limit myself to one what medications can I take during my pregnancy congrats Brandy okay Dr kameho Dr micio what are some of the medications that you can take and I'm sure there are many that you absolutely cannot take am I right Kathy you are right first always consult your doctor prior to starting any prescriptions or overthe counter medications during pregnancy I can't state that enough but there are several medic medications to avoid that you need to find Alternatives and work with your physician such as ineds or ACE inhibitors beta blockers or even calcium Cho blockers which are used for blood pressure so the choice depends on the individual health factors Marissa what are some of the recommendations you're giv to your patients in clinic yeah some some medications that I often see in the clinic which need to be stopped during pregnancy are retinoids these are often used for acne um some examples are Accutane tretinoin or adapalene I also see benzodiazapines like Xanax or clopin which are medications used to treat anxiety and these have been linked to miscarriages low birth weights and premature births so these medications are not recommended to be used during pregnancy there's also inets like Dr kameho had mentioned for example ibuprofen nepro or diclophenac which should be avoided in pregnancy due to the increased risk of life-threatening kidney problems in the baby Statin medications these are used for cholesterol as well as the ACE inhibitors which are used for blood pressure and these have been shown to be unsafe in pregnancy as well so it's important to discuss your options with your doctor and consider the overall risks of both the mom and the baby's Health when taking medications while pregnant thank you Dr Mario now in case you missed it the first time here's another opportunity to find out where to send in your questions send in your questions to questions allhealth tv.com or allhealth go on Facebook or YouTube or visit the askthe do page on our website allhealth tv.com finally someone reaching out to us through the gram this question comes from Natalie and she wants to know hi doctor my mother and my aunt both went on hormone replacement therapy my aunt had some complications and died a few years later of breast cancer but my mom never had a problem I want to know what the risks and benefits are of hormone replacement therapy HRT this is a really good question who wants to take it first so that's a great question Natalie and every great question does deserve a great answer so I would say that the benefits and risk of taking HRT really depends on your age and your menopause symptoms and any risk factors that you have so if you're under the age of 60 and have menopausal systems and you're not at risk for like breast cancer or blood clots the benefits of HRT are likely to outweigh the risk and so the men benefits of HRT is that it you does relieve most of the premenopause and menopause symptoms such as mentioned in the video um like hot flashes night sweat sleeping uh vaginal dryness those are all great but it also helps prevent osteoporosis by increasing your level of estrogen which is really in Need for health bone but the most important thing is to talk to your provider to see if he can help you decide if HRT is right for you and the next question comes to us from Matilda who reached out through YouTube she asked Dr Kaho I'm a postman ofus woman and I want to know how I can reduce my risk of developing osteoporosis I'm not postmenopausal yet Dr Goo but I love the 411 and osteoporosis what can you tell us so Matilda that's a good question but before I I give you and Kathy the 411 on osteoporosis let's check out a video from our good Folks at the Mayo Clinic osteoporosis is often called Soft bones osteoporosis is thinning of the bone to the point where the bones can break Dr Bart Clark a male clinic endocrinologist says common breaks from thinning bones occur in the spine wrist shoulder and hip women in general past menopause past the mid-50s are at high risk for this because of the degree of bone loss they have due to the lack of estrogen the standard screening procedure for osteoporosis is a bone density test treatment is a combination of medication adequate calcium and vitamin D intake and physical activity so the perception is sometimes we can't fix it if it's a problem it's just the opposite these days Dr Clark says if you have osteoporosis you need to be careful not to overexert your body which can lead to fractures but in general simply walking for 30 minutes 3 to 4 days a week is the right amount of physical activity for the mail Clinic News Network I'm Jason Howland so osteoporosis is more common in women than men but men do get it so um you have to look at that as well but the primary risk factors for Osteo is advancing age but there are other few risks that also increase the likelihood of that and race is one of them so white and Asian women are more at risk for Osteo body size so people with small frames family history of osteoporosis hormones that are low levels of estrogen or testosterone and certain medications like long-term use of anti-depressants can also lead to Osteo and also look at your lifestyle factors like excessive alcohol drinking or low levels of physical activity and smoking can also lead to Osteo but take steps to limit some of these risks but there are other things you can do to maintain bone strength and prevent Osteo one thing for women definitely take calcium and supplements women over 50 need at least 12200 milligrams a day exercise regularly so that it impacts bone strength and muscle strengthening is one of your best defenses add more Lan proteins to your diet more protein intake creates higher bone density for you uh remember to get enough vitamin D that's always great which a lot of sun um but limit your alcohol consumption because it does affect the balance of calcium in your body and it impairs your body ability to actually produce vitamin D when you're exposed to too much sunlight so heavy dinking can create hormone deficiencies and maintain a healthy weight so people overweight also have an increase and if you smoke quit because Studies have found a direct correlation between tobacco use and Osteo fantastic information Dr kameho now let's see what we got here this is a great question for parents especially this one came from Facebook from Nala and she ask hey doctors it's almost time for me to have the conversation with my young daughter I'm obviously talking about sex and birth control my husband had a vasectomy so it's been a while since I've given much thought to protection can you tell me about the different types of birth control and their effectiveness but seriously doctor what should men I have to say men and women know about birth control these days so Nala I appreciate the Outreach and I'm happy to hear you're gonna have that important conversation with your daughter I remember having those conversations long ago so I'm going to let Marissa practice and answer this one so there are many different forms of birth control to consider one of the most common forms is the birth control pill there are two types one that has a combination of both estrogen and progestin and the other one is proges only fun fact recently the FDA approved the first over-the-counter birth control pill it's called the opil which does not require a prescription the perfect with perfect use birth control pills are typically about 99% effective the most effective non-pill birth control options are going to be longacting contraceptives so this includes implants which are in placed into the arm or the intrauterine device also known as the IUD and these are over 99% effective and they can be used for many years at a time for those who aren't afraid of needles there is a contraceptive injection and these provide birth control for several weeks and they have about a 94% Effectiveness rate there are also vaginal ringings which last several weeks and weekly birth control patches which could be considered these are about 91% effective and another common option are single-use condoms which can also be used to protect from STDs or sexually transmitted diseases and when these are used perfectly every single time condoms can be about 98% effective so as you can see there are many different options to consider for birth control depending on the effectiveness to how long you have to take each of these how long they last how invasive they can be I always recommend talking about these options with your doctor to get the most information and to understand what would work best for you thank you Dr Mario okay Dr Kam looks like we got another question from the gram this time it's from Kang and she asked Dr kameho my husband and I just found out that we're pregnant with our first child are there certain vitamins or supplements that I should be taking during my pregnancy now uh Dr kameho before we jump into answer carman's question which is is great I I would love to also because we all we know that prenatal vitamins are a a must um when you find out you're pregnant but I want to find out to about medications that you actually can take as well not just vitamins and supplements but medications that you can take while you're pregnant so many of medications there there are medications you could take but I think it really depends on the condition to list on all the types of medications you can take it would be a long list but depending on your condition that's why I always say talk to your doctor because there are meds you can take that while while you're pregnant but the most important thing is really for pregnancy is to please check what prematal vitamins lists contain on because not all prematal vitamins are the same so the most the most important minerals that you need to take are like folic acid very important it plays an integral role in DNA synthesis red blood cells production and Fetal growth and and and development so folic acid at least uh that is really an important one that you must take iron you need iron because iron increases significantly during pregnancy especially as you're as babies growing magnesium is another one that plays an important role in immune and muscle and nerve function the other thing that you should look at is also fish oils that contain DHA and EPA these are two essential fatty acids that are important for the B brain's development but and also choline choline plays a vital role in the baby's uh brain development and helps uh prevent abnormalities in in spine and brain but I would also look at vitamins that you should not take don't take vitamin A there are high doses of vitamin can cause birth defects V you know high dose of vitamin E can also increase risk of bleeding you know other supplements like black kohos can cause early labor and miscarriage so that's why it's really important before you add any other supplements always check with your gyno and uh make sure you go over what you would like to have very helpful Dr kameho thank you now if you got questions we've got answers and just in case you missed it the first couple of times I'm going to remind you again here's yet another chance to find out where to send in your questions send in your questions to questions allhealth tv.com or allhealth go on Facebook or YouTube or visit the askthe do page on our website allhealth tv.com okay here's a question that gets straight to the point it comes from Mariana through our YouTube page Dr kameho Are there specific medications for managing high blood pressure in women now Marissa that's a great question I know there are lots of medications out there for managing blood pressure and that's why we have you on here today but there are some there are specifically for women so Marissa can you break that down for us absolutely well Kathy when treating blood pressure there are no specific medications developed specifically for women typically medications prescribed uh for blood pressure are based on how elevated a person's blood pressure is and potentially other health conditions that they may have so as we briefly mentioned before so we talked about ACE inhibitors which is an Angiotensin um medication that helps with controlling the blood pressure some examples would be captopril or lysil there's also Angiotensin receptor blockers like Kar or lartin and these are considered harmful during the the second and the third trimesters of pregnancy so if a woman is of childbearing age or she's to get pregnant you would want to discuss an alternative blood pressure option with your doctor to keep make to make sure that your blood pressure is staying under control um and reducing that potential risk thank you for that okay this next question comes from Miranda who asks can you discuss the symptoms and treatment options for endometriosis very important question docs what are your thoughts so the most common symptom for endometriosis may include like pain in your lower tummy your legs pelvic areaa or even your back that usually worsens during your period abnormal and heavy irregular periods um period pain that stops you from doing anything or any normal activity pain during sex or after sex and feeling six constant patient diarrhea bloating all during your periods it's really bad but in order to really determine if you have endometriosis your doctor will have to do a physical exam and this may include an exam of your pelvis or your Ultrasound with an MRI and in some cases a referral to a surgeon which may be placed to perform a laparoscopy to check the tissue inside your atom um Marissa any other thoughts on this yeah well there's no cure for endometriosis there are treatments to help with the symptoms of this condition such as pain medicine uh hormone replacement therapy like we talked about earlier HRT uh contraceptives progestin therapy as well as potentially surgery or in severe cases potentially a hysterctomy thank you doctors we have time for one more question this one comes to us from Fila what are the potential health effects of chronic stress on women and how can it be managed who wants to take that one so Marissa you're G to take that one yeah of course of course so when it comes to stress um this is mainly due to an activation of the hormone called cortisol and other uh stress hormones in the body which can disrupt almost all of the body's processes so long-term activation of the stress hormone puts you at risk for uh many different health problems including anxiety depression digestive problems headaches um muscle tension and pain as well and so some ways that you can manage stress really include um getting regular physical activity on most days of the week practicing relaxation techniques so trying deep breathing meditation yoga Tai Chi or even massage um keeping that sense of humor It's Great To Laugh um on a daily basis many times a day spending time with your friends and your family and then also setting aside some time for your hobbies so like reading a book listening to music music going for a walk those types of things scheduling time for your passions is important um writing in a journal is great for stress relief as well as getting enough sleep throughout the night that's very important eating a healthy well-balanced diet and then staying away from tobacco and alcohol use and especially the use of illegal substances thank you so much Dr maricio anything to add Dr kameho before we go no I think uh you know I like to go to spas that is one that's not a bad way that's not a bad I definitely want to go you know we all have stress Kathy you do too uh especially managing family as well as her children and even work uh women have a lot on their plate all the time and it's usually a lot of we don't always take care of ourselves which is right but you know really taking care of that that's important and going to a Spa enjoying yourself every once in a while it if you can't take care of you it's GNA be very hard for you to take care of your family absolutely we put ourselves first and I'm joining you at that SP Dr Kaho please face for me there so that's all the time that we have for today I want to thank Dr kjo and Dr Modio for joining us today on aad do I'm Kathy buo and I'll see you next time send in your questions to questions at allhealth tv.com or allhealth go on Facebook or YouTube or visit the ask the do page on on our website allhealth tv.com e