Heavy Women May Be More Likely to See Breast Cancer Recur

2014-01-28

Overweight and obese women may have a tougher battle in store when it comes to breast cancer: a new study published in the journal Cancer finds that carrying extra pounds is linked with a higher risk of cancer recurrence and death.

Previous studies have linked obesity with breast cancer recurrence, but the new study is among the first to find the same trend even among women who are overweight but not obese. The researchers found that having higher body mass index increased women’s risk of breast cancer recurrence and death, even if they had state-of-the-art treatment like chemotherapy and hormonal therapy.

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“We found that obesity at diagnosis of breast cancer is associated with about a 30 percent higher risk of recurrence and a nearly 50 percent higher risk of death despite optimal treatment,” said lead study author Dr. Joseph Sparano of the Montefiore Einstein Center for Cancer Care, in New York City, in a statement.

(MORE: Good News for Women With Dense Breasts: No Higher Risk of Breast Cancer Death)

For the study, researchers analyzed data on 6,885 patients with stage 1, 2 or 3 breast cancer who were enrolled in three National Cancer Institute–sponsored treatment trials. The researchers compared outcomes of obese and overweight women with those of normal-weight participants. Aside from their weight differences, all the women in the new study had normal heart, kidney, liver, and bone marrow function and were considered healthy overall.

Over eight years of follow-up, about 1 in 4 women saw their cancer come back and 891 died (including 695 women who died from breast cancer). The researchers found that the association between excess weight and cancer recurrence and death was strongest among women with estrogen receptor positive breast cancer, which is the most common type of breast cancer, affecting about two-thirds of all patients, according to the study authors.

The study wasn’t designed to identify the underlying factors connecting weight and breast cancer recurrence, but the hormone estrogen may play a role, the authors surmise. People with more fat stores produce more estrogen, which may fuel the growth of hormone receptor positive tumors.

(MORE: Study: For Some Women in their 40s, Routine Mammograms May Be Worth the Risks)

Another theory is that heavier people are more likely to be insulin-resistant and therefore to have more insulin, another hormone that is thought to trigger the growth of breast cancer cells. Having excess body fat may also cause more inflammation in the body, which could drive breast cancer cells to spread or cancer to recur. “There are several possibilities and it could be any one of these factors or a combination of a few,” says Sparano.

The authors say obese women may do better with breast cancer treatment strategies aimed at such hormonal changes and inflammation. Perhaps these women need to be treated longer, or would benefit from lifestyle changes that would encourage weight loss — and improve health overall — after breast cancer diagnosis.

The authors call for more research into whether lifestyle modification could lead to positive long-term outcomes in obese breast cancer patients. “It’s possible that changes in diet could complement chemotherapy successfully,” says Sparano.

Read more: http://healthland.time.com/2012/08/27/heavy-women-may-be-more-likely-to-see-their-breast-cancer-come-back/?iid=hl-main-lede#ixzz24okdbvM7

(No) Condom Culture: Why Teens Aren’t Practicing Safe Sex

2013-12-04

By Katy Steinmetz

There were certain things that the 1990s just did better — including getting the word out about the dangers of unprotected sex.

According to the Centers for Disease Control and Prevention (CDC), the percentage of American students using condoms hit its peak at around 60% a decade ago, and has stalled since then, even declining among some demographics. A recent study released by the Sex Information and Education Council of Canada found that nearly 50% of sexually active college students aren’t using condoms. Other reports have found that while teenagers are likely to use a condom the first time they have sex, their behavior becomes inconsistent after that.

Health officials from Oregon to Georgia are ringing alarm bells about rising rates of sexually transmitted diseases, worried that kids aren’t getting the message. Sex education is more robust than it was for previous generations, but a 2012 Guttmacher Institute report revealed that while nearly 90% of high schools are teaching students about abstinence and STDs, fewer than 60% are providing lessons about contraception methods.

The CDC estimates that half of new STD infections occur among young people. Americans ages 15 to 24 contract chlamydia and gonorrhea at four times the rate of the general population, and those in their early 20s have the highest reported cases of syphilis and HIV. Young men and women are more likely than older people to report having no sex in the past year, yet those who are having sex are more likely to have multiple partners, which increases the risk of STDs.

“We need to do better as a nation,” says Laura Kann, an expert in youth risk behaviors at the CDC. “Far too many kids in this country continue to be infected with HIV and continue to be at risk.”

When condom-usage rates were on the upswing in the ’90s, America was in the midst of an AIDS epidemic that was claiming young lives daily. The fear of the disease gave heft to safe-sex campaigns. Today, public-health officials are partly a victim of their own success; contemporary teenagers grew up after the terror had subsided, thanks to antiviral drugs and those messages that helped bring infection rates down. “The young people today know HIV as a manageable, chronic disease,” Kann says. “It’s not something that can kill you in their eyes. So that leads, most likely, to an attitude that it’s not something that they have to protect themselves from.”

In Oregon’s Lane County, senior health official Patrick Luedtke is in the midst of confronting an ongoing gonorrhea outbreak, with rates jumping as much as 40% in recent years. Like Kann, he believes complacency is a large part of the problem. “People don’t have the fear of death from sex like they had 15 years ago,” he says. “For the teenagers, that fear is gone, and people are not practicing safe sex as much as they used to.”

Other research collected by the CDC shows that some schools aren’t hammering away at the safe-sex lessons like they once did. In Alabama, Alaska and Florida, for instance, fewer public schools are teaching teenagers how to obtain condoms and why it’s important to use condoms. “Schools have competing health issues that they’re asked to deal with, things like tobacco use, bullying, the obesity epidemic. It’s been hard to keep attention focused on HIV and STD prevention,” Kann says. “This complacency issue [is not] unique to just youth themselves.” Last week, the American Academy of Pediatrics issued a policy statement supporting better access to condoms for teenagers, saying schools are still hesitant to provide them because of an enduring fear that access to condoms will make kids have more sex.

Public institutions beyond schools have had setbacks too. Budget cuts in Oregon meant that Luedtke’s county closed its STD clinic. “People don’t stop having sex because of the bad economy,” he says. “Where are the resources?”

Even in places where there’s money and free condoms to go around, health departments haven’t necessarily seen safe sex go viral. New York City health officials are reporting that only 1 in 3 adult residents uses protection, despite years of PSAs and prophylactic handouts under Mayor Michael Bloomberg. While condom use among young people in New York City is slightly up since 2009, that puts it on par with the stagnant nationwide average.

Kann says there are broader societal factors at work too, ones that disproportionately affect African-American youth. Compared with the population as a whole, their parents are less educated and have lower incomes, both factors that have been linked to sexually risky behaviors, including having unprotected sex. Adolescents who postpone sex have parents who are more educated. Lower incomes, meanwhile, are associated with factors like parents working multiple jobs, which can mean kids are left home alone without a watchful eye to factor into their decisionmaking.

Some research has suggested that sexually active Americans simply assume their partner is free of STDs, and an infected partner may be unaware, given that diseases like “silent” chlamydia often don’t have obvious symptoms. And there is a perception — if not a diehard belief — that using condoms makes sex less pleasurable. That’s why Bill Gates challenged designers earlier this year to create a better-feeling condom that sexually active people might be more likely to use.

While it’s hardly a sexy, revolutionary proposition like remaking the condom, Kann says the key to driving condom use higher is more education. Canada’s survey, for instance, was revealing about how relatively unimportant the students considered STDs. Those who used condoms were much more likely to cite pregnancy than STDs as their main concern; 54% said their single motivation for using protection was birth control, while just 6% cited STDs as their sole reason.

“It’s really critical for kids to know about their risk,” Kann says. “They need to know how to get tested. They need to know how to prevent infection. And we can’t do that alone here at CDC. We’re going to need action not only by this agency but also by parents, by schools and communities.”

No Satisfaction: Woman Are Less Likely to Orgasm During Casual Sex Read more: Study Shows Women Don’t Always Orgasm During Hook-Ups

2013-11-12

The hookups may be exciting, but they’re ultimately anti-climactic for many women

How much sex is considered exercise?

2013-09-18

By Jay Williams, upwave.com

Editor’s note: upwave is Turner Broadcasting’s new lifestyle brand designed to entertain the health into you! Visit upwave.com for more information and follow upwave on Twitter, Facebook, YouTube, Pinterest and Instagram @upwaveofficial.

(upwave.com) — When I think of the ultimate sex workout, I picture the scene from “Mr. and Mrs. Smith” where Brad Pitt and Angelina Jolie throw each other around their kitchen for an hour. Unfortunately, not every sexual experience is quite that… well, high-intensity. But how many calories do we really burn in the act?

The rumor: A bout of sexual activity can burn between 100 and 300 calories

Continue reading How much sex is considered exercise? →

Erectile dysfunction? Try losing weight

2013-09-16

By Anne Harding, Health.com

Viagra gets the job done, but it’s a quick fix. For many men, weaning themselves off the little blue pill and finding a longer-lasting solution to their sexual dysfunction may require hitting the gym and putting down the doughnuts.

A new Australian study, published Friday in the “Journal of Sexual Medicine,” found that losing just 5% to 10% of body weight over a two-month period improved the erectile function — and revved up the sex drives — of obese men with diabetes.

The study was very small (it included just 31 men), so the results should be taken with a grain of salt. But the findings are yet another reminder that obesity and erectile dysfunction (ED) often go hand in hand.

Excess weight — especially excess belly fat — can affect sexual function in many ways; it can interfere with the body’s ability to supply blood to the penis, for instance, and it can cause testosterone production to plummet.

And though the research on weight loss and sexual dysfunction is still emerging, there’s growing evidence that men who get active, eat healthier foods, and pare a few pounds will see their sex lives improve — not to mention their overall health.

In fact, doctors express hope that the promise of an improved sex life will finally get through to all the overweight and obese men who haven’t responded to dire warnings about heart disease, diabetes and stroke.

“You talk all the prevention you want,” says Kevin Billups, M.D., an associate professor of urology at the University of Minnesota, in Minneapolis. “When I talk about restoring penile health, I have their attention.”

When a patient comes to see him about ED, one of the first things Billups tells him to do is to stand up and look at his belly. “If you can’t see your penis,” he says, “that’s a problem.”

How obesity hits below the belt

The most important way that excess weight drags down a man’s sex life is by affecting the health of his blood vessels.

An erection occurs when the blood vessels leading to the penis dilate, causing it to fill with blood. This process begins when the inner lining of the vessels (known as the endothelium) releases nitric oxide, a molecule that signals the surrounding muscles to relax. (Viagra and similar drugs work by increasing the amount of nitric oxide in the endothelium.)

Although experts aren’t exactly sure why, obesity appears to damage the endothelium. And when the endothelium doesn’t work properly, the penis may not get enough blood to produce or sustain an erection.

“An erection is basically a cardiovascular event,” says Robert A. Kloner, M.D., a cardiologist and professor of medicine at the University of Southern California’s Keck School of Medicine, in Los Angeles. “If blood flow cannot increase because the blood vessels can’t dilate normally, then there’s a decrease in erectile function.”

Sure enough, in the new study, endothelial function improved in the men who lost weight. (Function was measured using two different laboratory tests.)

Poor heart health can cause ED in another way. The fatty foods and lack of exercise that cause weight gain also contribute to the narrowing and hardening of arteries (atherosclerosis), in which cholesterol and other substances build up in the artery wall.

Atherosclerosis, which can lead to heart attacks if it occurs in major arteries near the heart, can happen just as easily in the small blood vessels leading to the penis.

In fact, atherosclerosis may hit those small blood vessels first, which is why ED is increasingly seen as an early warning sign of heart disease, Kloner says.

The role of testosterone

Blood vessel problems are responsible for the vast majority of ED cases in obese men over 40, experts say, but another common culprit is low testosterone, which is also linked to obesity. Adequate levels of this male sex hormone are necessary to maintain sex drive and get erections.

Low testosterone is “very much underdiagnosed,” says Ronald Tamler, M.D., co-director of the men’s health program at the Mount Sinai Medical Center, in New York. “And as we are all getting fatter, it’s becoming an increasing problem.”

Those big bellies Billups warns his patients about are especially worrisome when it comes to testosterone. Belly fat, a strong predictor of heart risk, seems to have a greater effect on the hormone than excess fat distributed in other parts of the body.

“That’s the bad actor that causes all sorts of inflammatory mediators and different substances to be emitted into the body that will lower testosterone,” says Billups, who studies the relationship between heart health and sexual dysfunction.

Losing even a little weight can improve blood vessel function (as the new study shows), but the effect of weight loss on testosterone levels may not be as rapid or as direct. Men who have persistently low testosterone levels and ED despite losing weight may need to consider testosterone gels, shots or patches, Tamler says.

Weight loss can turn things around

Being overweight doesn’t seem to affect a man’s self-esteem as much as it does a woman’s, says Joel Block, Ph.D., a psychologist on Long Island who specializes in couples therapy and sex therapy. ED, on the other hand, can trigger a cycle of shame and doubt in even the most confident men.

“Once [ED] happens it becomes self-perpetuating,” says Block, an assistant clinical professor at the Albert Einstein College of Medicine, in New York City. “The more he fails, the more difficulty he has.”

Eventually, Block says, a man will begin to avoid sex. And his condition may plunge him into depression.

“Even if you have clear cut medical reasons — diabetes, obesity — when you’re having erectile dysfunction…it is depressing,” Billups says. “A lot of these men [are] down in the dumps.”

Losing weight can help with the plumbing aspect of ED, but it can also provide an ego boost that carries over into the bedroom, says Stephen Josephson, Ph.D., a psychologist at New York-Presbyterian Hospital.

“People need to feel good about themselves [to] overcome performance anxiety and other things in the sex arena, and sometimes it’s as simple as getting into shape,” Josephson says.

Some men who have relied on pills like Viagra or Cialis to get erections can toss them once they start exercising, eating right and losing weight, Billups says.

These men may see their morning erections return, he adds, and their wives have been known to say they’re acting “friskier.”

“They’ll come in and tell me, ‘Wow, doc, things are really turned around,'” he says.

Study: More Breast Cancer Deaths Occuring in Younger, Unscreened Women

2013-09-12

By Alexandra Sifferlin

The latest data questions the most recent recommendation for breast cancer screening by the U.S. Preventive Services Task Force (USPSTF), which advised women to get mammograms every other year starting at age 50.

But the new study from Harvard University researchers found that half of 600 women they studied who died of breast cancer were under age 50. The women were diagnosed between 1990 and 1999 at two Boston hospitals and followed until 2007; 71% of those who died had never had a mammogram before their diagnosis.

That suggests that mammograms may be helping to save lives, particularly among younger women, whose denser breasts may make smaller lesions more difficult to detect — and therefore require more vigilant monitoring. While the USPSTF recommendations are followed by many doctors and physician organizations, the American Cancer Society continues to advise women to get annual mammogram screenings once they reach age 40.

The USPSTF’s recommendation was based on data suggesting that widespread mammogram screening was not providing sufficient benefits in preventing cancers and saving lives when compared to the risks associated with the screenings, which include false positive results that require additional, invasive procedures such as biopsies and treatments, and overdiagnosis.

Sexless Marriage: How To Deal With A Decrease In Sex

2013-09-10

Sex is one of those topics we’re all constantly thinking about, reading about, and even acting out… but not necessarily talking about. Sure, you’ll dish to your friends about the steamy sex session you had with your new man last night, but you won’t necessarily be so eager to share when your sex life goes from consistent to non-existent. And yet, several studies have been revealing for the last decade that a dry spell in the bedroom is actually common among couples. Is a lack of sex the one thing our conversations are lacking?

“It is very common for couples to go through sexual dry spells,” says Rabbi Ed Weinsberg, EdD. “It’s estimated that this process begins for most couples anywhere from two to ten years after they get married.”

Defining a sexual dry spell, though, can be as difficult as dealing with the problem itself. One of my favorite scenes from the 1977 film “Annie Hall” features Alvy Singer (Woody Allen) and Annie Hall (Diane Keaton) talking to a therapist about their sex life. When the therapist asks how often they have sex, Alvy answers, “Hardly ever. Maybe three times a week.” Annie, however, answers this way: “Constantly. I’d say three times a week.”

“The disparity is normal,” says Rabbi Weinsberg, author of two books on sexuality after illnesses, including “Conquer Prostate Cancer: How Medicine, Faith, Love and Sex Can Renew Your Life.” “Going through a sexual dry spell is fairly subjective.” Just as we all have different likes and dislikes when it comes to sex, we all have a different take on how often we should be having sex as well. “There is no one ‘right’ amount of sex that a couple should be having,” says Jodi Lipper, co-author of “How to Love Like a Hot Chick”. “For some married couples, normal is having sex every day. For others, it might be having sex once a month.”

Wondering if you and your partner are going through a sexual dry spell? Start by asking if both of your needs are being met. If your answer is no, then you may be facing a sexual drought. “It’s not enough when one or both partners is unsatisfied, or feels that his or her needs aren’t being met,” says Lipper. Her advice to couples in a sexless relationship? Talk it out with an open mind to determine the cause of the problem before you take drastic steps. In other words, share your sexual needs and wants before you demand that you and your partner either get it on, or get divorced!

“Sometimes a decrease in sexual activity in a relationship represents a manifestation of other problems,” explains Dr. Alexis Conason, a clinical psychologist in New York City. “It is important to understand why the couple has stopped, or decreased, having sex before we can diagnose a sexless period as problematic or not.” In other words, talking about your lack of sex could turn up a simple cause for what seems like a major problem. Before you give up on your sex life, Dr. Conason suggests asking yourself the following questions:

• Have you stopped having sex because one partner is furious at the other?
• Is one partner having an affair?
• Are there medical issues that interfere with sexual functioning or desire?
• Is one or both partners overwhelmed with childcare responsibilities?
• Is one or both partners overwhelmed with career stress?
• Was there ever a time when you were having more sex with your partner? Or has the relationship always been sexless?

Discussing these questions may seem like a daunting task, but it’s vital to the health of your relationship. “That hot and heavy sex that may have brought you together is not what is going to sustain the relationship,” explains Dr. Lisa Bahar, a licensed marriage and family therapist in Dana Point, Calif. “Now is the time to build intimacy on a deeper level, which requires awareness and a willingness to be curious about your partner in new ways that create spontaneous intimacy.” And spontaneous intimacy, my friends, is what leads to sexual intimacy… i.e. the opposite of a sexual dry spell!

The bottom line is that a lack of sex is an indicator of a greater problem. If you can’t remember the last time you had sex, make a list of all the obstacles holding you back from doing the deed –- like work stress, a lack of time, etc. –- and then work to find solutions to those obstacles, like trading massages with your partner to help relieve work stress, or planning a Saturday “staycation” in your bedroom to make time for an all-day shag. However, the most important step to finding your happy ending (pun intended) is to open up and talk to your partner about what’s really going on. You’ll hopefully go from “We need to talk” to “Less talk, more action!” in no time at all.

My Name is John and I Am a Sex Addict. (Or Maybe Not)

2013-07-24

By Maia Szalavitz

Is it or isn’t it? A new study undermines the theory that sex addiction is a brain-based disorder similar to other addictions.

For most of the public, the concept of addiction is pretty straightforward— it involves taking something, or doing something, that brings you pleasure and that you can’t control. But scientifically, addiction means something much more specific, if not precisely quantifiable.

For much of the 20^th century, psychiatrists and lay people defined addictions as use of substances or behaviors that required ever-increasing doses to maintain a satisfying “high.” These addictions also conspired to form some type of physiologic dependence, which led to physical symptoms such as vomiting and diarrhea when the addictive substance or activity was stopped.

Continue reading My Name is John and I Am a Sex Addict. (Or Maybe Not) →

Does your relationship need a ‘love drug’?

2013-07-12

By Ian Kerner, CNN Contributor

It’s a Saturday night. You get the kids to bed, wash the dishes and plop down on the couch for a marathon of reality TV. Across the room, your partner is engrossed in his or her iPad.

Later, you give each other a chaste kiss good night, roll over and go to sleep.

On one hand, you wish the magic of your heady early days would return. On the other, you’re not sure if you really care that much anymore.

It’s a scene so typical in many marriages and long-term relationships that it’s no wonder only an estimated 37% of couples say they’re still very happy together.

But what are your options? Divorce? Therapy? How about a “love drug” guaranteed to keep you both content?

That’s the premise of a recent report in Current Opinion in Psychiatry that examined the implications of a potential pharmaceutical drug aimed at keeping couples happy and in love.

Surveys suggest that humans may not be meant to stay in lifelong, monogamous relationships: Roughly half of all marriages end in divorce, while up to 72% of husbands and 52% of wives cop to cheating on their spouses.

Yet many couples want to remain married, despite the potential problems. Based on this concept, researchers at the University of Oxford considered what might happen if couples had access to an intranasal spray containing oxytocin.

Oxytocin is the “cuddle hormone” that’s released during childbirth, nursing and orgasm, resulting in feelings of closeness, bonding and connection. Could a spritz of liquid oxytocin have the same effects on your romantic relationship? Some research suggests that it might.

For example, one study published last year in the journal Social Cognitive and Affective Neuroscience found that, of 47 couples, those who sniffed oxytocin before discussing a disagreement were more likely to react positively toward each other than those who used a placebo spray. Such a product, say the authors of the more recent report, could be used under the direction of therapists and other clinicians to “enhance marital well-being.”

Yet other evidence suggests that the effects of this hormone may not always be so beneficial: In some research, oxytocin was found to amplify negative memories, while studies of the prairie vole — one of few animals that remain in lifelong relationships, presumably because of its high levels of oxytocin — show that this critter is also prone to infidelity. When it comes to supplemental oxytocin, there are ethical issues to consider, too.

“Pharmaceutical companies are pushing the medical approach because it’s profitable, while doctors and patients are increasingly demanding medications because taking a pill or using a spray is cheaper and ‘easier’ than therapy,” said social psychologist Justin Lehmiller. “I’m uncomfortable with the notion that the key to solving relationship problems is taking a drug.”

Of course, that hasn’t stopped manufacturers from jumping on the bandwagon: Safe or not, a slew of oxytocin-based products are for sale, no prescription necessary. Aimed at improving relationships between partners and supposedly increasing attraction among strangers, these products are pricey — and unproven.

Instead, I recommend boosting oxytocin naturally. It could be as easy as simply giving each other a nice long squeeze. In her book “The Female Brain,” Dr. Louann Brizendine says that hugging your partner for 20 seconds or more has been shown to trigger the release of oxytocin.

Added Lehmiller, “If couples make an active effort to be more intimate and touch each other more often, they can likely boost their oxytocin levels without the aid of a drug. It’s also likely that enhancing intimacy in this way will do more good for your relationship in the long run than any pill ever could.”

You’ll save your money — and maybe your relationship, too.

Relationship, sex issues: What would you do?

2013-06-28

By Ian Kerner, CNN Contributor

Your buddy’s wife decides to “friend” her ex on Facebook. Your local politician gets busted sending pictures of his private parts to his campaign workers. Your sister tells you her boyfriend wants her to watch pornography with him.

It’s easy to offer your two cents in these situations — but what would you do if they happened in your relationship?

That’s the premise of a new survey I developed with my colleague Kristen Mark, director of the Sexual Health Promotion Lab at the University of Kentucky.

We asked nearly 5,000 men and women how they thought they would react in 50 different sex and relationship scenarios to get a sense of how the average person would respond when faced with their own fun, adventurous — and sometimes, anxiety-provoking — situations. Their answers (and your own feelings on these subjects) might surprise you.

Continue reading Relationship, sex issues: What would you do? →