Our Bodies, Our Lives is a column focusing on issues surrounding women’s sexual, gynecological and emotional health, currently published in the Galveston County Daily News. Dr. Tristi Muir is a gynecologists at UTMB. See more writings on the Working Wonders blog.
Galveston County Daily News, April 29, 2014
Menarche is the time when a girl has her first period. The normal age range of menarche is 9-15. As the average weight of people — including children — in our country has increased during the past four decades, the age of the onset of puberty and menarche has decreased. Periods are usually light and irregular in the beginning. Within two years of menarche, two out of three girls will progress to regular, predictable periods occurring about monthly — anywhere between 21 and 45 days — and lasting from three to seven days.
Galveston County Daily News, March 18, 2014
The change of life sounds so dramatic. Life is always changing. Hormonally, we have menarche (starting periods), cyclic changes (including premenstrual syndrome), pregnancy and postpartum hormonal changes, and alas — menopause. It should probably be called meno‘stop’ rather than meno‘pause,’ because the ovaries have sputtered out and are not likely to get going again.
Houston Chronicle, March 10, 2014
Violence against women is a pervasive and widespread plague on our society - one that crosses geographic, economic and racial lines. In the United States alone, the U.S. Centers for Disease Control and Prevention estimates that 1.3 million women each year are victims of physical violence at the hands of their partners; one in four will be physically assaulted by a boyfriend or husband in her lifetime. Texas is no exception to this problem.
Galveston County Daily News, March 4, 2014
Just as I started writing this column on stress relief, I had an unexpected stressful event. My mother had a subdural hematoma and emergency neurosurgery in California — with no other family around her. I felt my adrenal glands squeeze and the stress hormones bathe my body as I sat by her intensive care bed. What I realized at that moment was the thought of starting stress relieving measures at such a stressful time was overwhelming. The only way for stress relief to be there when we need it is if stress-relieving measures are part of our daily routine.
Galveston County Daily News, February 18, 2014
A fire races toward your house. This is definitely a stressful situation, but how you handle it may be programmed in your sex genes. Fight or flight is typically a male response to this type of situation — sticking around to fight the fire or running as fast as you can away from it. Women have a tend and befriend response to sudden stress. Estrogen blunts the fight or flight response, and we engage in nurturing activities to protect ourselves and our children.
Galveston County Daily News, December 10, 2013
The weight gain around the middle that accompanies midlife can creep up on you and then hang on for dear life. Loss of muscle mass that accompanies aging and decreased physical activity are the primary contributors to a slower metabolism; however, there are other potential contributors to the midlife spread. Eating out, alcohol, sleep deprivation, stress, medical problems and family genetics can all pack pounds around our waistlines. With the scale creeping up an average of one pound a year, how can you fight back?
Galveston County Daily News, November 26, 2013
You look in the mirror and see gray hair sprouting on your head and wrinkles streaming across your face. As you glance further down, chins are forming and a muffin top spills over your jeans. The average weight gain during midlife is 10 to 15 pounds. Is aging a battle that we must lay down our weapons against and accept as an eventuality?
Galveston County Daily News, Oct. 29, 2013
Breast cancer has affected all of our lives. One in 8 women will be diagnosed with invasive breast cancer in our lifetimes. While men can develop breast cancer, it is 100 times more common in women. The American Cancer Society estimates that in the year 2013, there will be 232,340 new diagnoses of invasive breast cancer.
Galveston County Daily News, Oct. 8, 2013
Fear of ridicule can lead many women to avoid activities that may cause bladder leakage. First you stop jumping on the trampoline with your kids and soon you’re avoiding many activities you once enjoyed. Urinary incontinence is actually quite common — affecting 45 percent of women.
Galveston County Daily News, Aug. 13, 2013
In 2010, approximately 368,000 U.S. teenagers 15-19 gave birth. Sixty percent of sexually experienced teens reported using a highly effective birth control like an IUD or hormonal method.
Galveston County Daily News, July 23, 2013
While we blame pregnancy for a momentary lapse of memory, sleep deprivation may actually be the cause of forgetfulness. During pregnancy, sleep becomes interrupted. Women have to wake up to roll over or their bladder sends them running to the bathroom. In the first year after the baby’s birth, a woman accumulates up to 700 hours of sleep debt.
Galveston County Daily News, July 9, 2013
A decade ago when the Women’s Health Initiative famously announced that menopausal women who took hormones had higher rates of coronary heart disease, stroke, blood clot formation and breast cancer, women abandoned their hormones in droves. But now, newer research has shown that wholesale elimination of hormone therapy for all menopausal women may not make sense.
Galveston County Daily News, June 25, 2013
It is a popular idea these days that bio-identical, custom-compounded hormone replacement therapy is safer and more natural than other alternatives. The word “natural,” however, applies to any product produced directly from an animal, plant or mineral source. Natural does not automatically mean safe or resembling anything found in the human body.
Galveston County Daily News, June 11, 2013
Not all women realize they are menopausal. Many women go through midlife changes without needing to seek medical advice or noting any problems at all. If you are in this category, don’t worry about your lack of symptoms and don’t go looking for answers to questions you don’t have. There is no need to test your hormones or start any medications. But some of the following advice might help to maximize your preventive health strategies as you negotiate menopause gracefully.
Galveston County Daily News, May 28, 2013
One in two women has pelvic floor dysfunction — problems related to the support and function of the pelvic floor. The life event that affects the pelvic floor most significantly is childbirth. Pelvic floor dysfunction is common, but it doesn’t have to be a normal part of aging. There are solutions.
Galveston County Daily News, April 2, 2013
Bringing a new life into the world is truly a miracle. Yet in the aftermath of the birth and all the excitement surrounding bringing the baby home, many women find themselves noticing something not so miraculous — their body is not the same. The uterus, vagina, pelvic muscles and nerves undergo tremendous change during pregnancy, delivery and postpartum. The uterus shrinks back to approximately its pre-pregnancy size within six weeks. Bleeding can persist throughout this time, but resumption of an actual period is variable and often significantly delayed if a woman decides to breast-feed.
Dr. Joseph Sonstein recently wrote in the Galveston County Daily News: "In the United States, urinary incontinence affects an estimated 17 million men and women and costs an estimated $30 billion to manage. Despite the uncomfortable nature of the problem, an open discussion with your doctor about it is important for two reasons: One, the problem may be treatable, and, two, the leakage might actually be a result of a more dangerous problem. Underlying diseases or conditions that might lead to urinary leakage include infection, damage to the nervous system, diabetes, heart disease, constipation, side effects from medications, obstruction from the prostate in men or prolapse (hernia) of the female organs in women and even cancer. Often, if these underlying conditions can be treated, the incontinence will improve or disappear completely."
Recently, the Institute of Medicine (IOM) released a report suggesting that contraceptives, sterilization and reproductive education should be covered by health insurance plans under the health care reform law -- at no cost to patients. UTMB Health's Dr. Tristi Muir was interviewed as part of a report on the proposed changes, on the Self.com health blog written by Amy Paturel. Read the post online...
Dr. Muir also was interviewed by Paturel on the pros and cons of blood tests that reveal a baby's gender as early as seven weeks into pregnancy. Read more...
Dr. Tristi Muir, UTMB’s director of urogynecology, offers tips on how to avoid urinary tract infections during the summer. Promptly changing out of a wet swimsuit, drying off thoroughly, and drinking lots of water can all help, she says. Enhanced or more frequent intimacy can also increase the chance of a UTI. She was quoted as part of a Cosmo Health Report feature in the August 2011 issue of Cosmopolitan.
Dr. Tristi Muir was interviewed on Dr. Joe Galati’s “Your Health First” radio show on Sunday, Feb. 13. Dr. Muir, an associate professor of obstetrics and gynecology and the director of urogynecology at UTMB Health, discussed pelvic health and incontinence issues, new treatments, and services offered at the Pelvic Health and Continence Center at Victory Lakes. She is passionate about broadening the scope of options available to treat urinary and fecal incontinence and pelvic organ prolapse, and equally excited about educating women about their gynecologic health and providing them with options. The radio show, which is broadcast from 7 to 8 p.m., airs on KTRH 740 AM.
You can hear a webcast of Dr. Muir's interview online; her section begins at the 21:30 minute mark.
Dr. Jeff Temple, an assistant professor in the department of obstetrics and gynecology and a member of the Pelvic Health and Continence Center team, will study the impact of teen dating violence on mental health with the help of a research grant from the Hogg Foundation for Mental Health. His proposal was selected from a pool of 47 applicants from 19 universities across Texas. The foundation awarded 10 grants totaling nearly $150,000. Temple will expand an ongoing study of the effects of teen dating violence on mental health and dropout rates among low-income and ethnically diverse youth. According to his proposal, an estimated 25 percent of teens are physically or sexually abused by dating partners each year. Many more are victims of severe emotional and verbal abuse.
Weakened Pelvic Muscles May Result In Incontinence, Discomfort, Activity Limitation
Nearly 24 percent of U.S. women are affected with one or more pelvic floor disorders, report researchers funded by the National Institutes of Health. Their analysis is the first to document in a nationally representative sample the extent of pelvic floor disorders, a cluster of health problems that causes physical discomfort and limits activity.
The study also revealed that the frequency of pelvic floor disorders increases with age, affecting more than 40 percent of women from 60 to 79 years of age, and about 50 percent of women 80 and older.
Pelvic floor disorders result when the muscles and connective tissue within the pelvic cavity weaken or are injured. These muscles and ligaments form a sling across the opening of a woman’s pelvis, holding the bladder, uterus, bowel, and rectum in place. The three main pelvic floor disorders are urinary incontinence, fecal incontinence, and pelvic organ prolapse. Pelvic organ prolapse results when pelvic organs such as the uterus, bladder and bowel, collapse onto the vagina. The resulting pressure may cause a bulge or protrusion through the vaginal canal. This protrusion may be uncomfortable, may make physical activity difficult, and may interfere with sexual functioning.
The study results appear in the September 17, 2008 Journal of the American Medical Association.
“The study results underscore the need to identify the causes of pelvic floor disorders and the means to prevent and treat them.” said Duane Alexander, M.D., director of the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). “The NIH Pelvic Floor Disorders Network is conducting studies to provide much needed answers.”
Funding was provided by the NICHD, the National Institute of Diabetes and Digestive and Kidney Diseases and the Office of Research on Women’s Health (ORWH), all at the NIH, and by the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention.
The study’s first author was Ingrid Nygaard, M.D., M.S., of the University of Utah School of Medicine, Salt Lake City. The study was conducted by researchers in NIH’s Pelvic Floor Disorders Network, which seeks to improve diagnosis, treatment, and prevention of pelvic floor disorders in women.
To conduct the study, the researchers submitted questions on pelvic floor disorders for inclusion in the 2005-2006 National Health and Nutrition Examination Survey (NHANES), a periodic survey of the U.S. population conducted by the NCHS
“Before our study, there were no comprehensive national prevalence estimates for pelvic floor disorders,” said Susan Meikle, M.D., M.S.P.H, Project Scientist for the NIH Pelvic Floor Disorders Network.
The 1961 women who participated in the survey answered questions about symptoms of pelvic floor disorders. The women were age 20 and older and were not pregnant. Overall, 23.7 percent of the women had symptoms of at least one pelvic floor disorder: 15.7 percent had urinary incontinence, 9.0 percent had fecal incontinence, and 2.9 had symptoms of pelvic organ prolapse.
The proportion of women who reported at least one pelvic floor disorder increased with age: 9.7 percent of women aged 20 to 39 years, 26.5 percent of women aged 40 to 59 years, 36.8 percent of women aged 60 to 79 years, and 49.7 percent of women 80 or older.
Underweight and normal weight women were less likely to have a pelvic floor disorder (15.1 percent) than were overweight women (26.3 percent) and obese women (30.4 percent).
The prevalence of pelvic floor disorders also varied with the number of times a woman had given birth: 12.8 percent for women who had never given birth, 18.4 percent of women who had one child, 24.6 percent of women who had two children, and 32.4 percent for women who had three or more children.
The researchers did not find any differences in pelvic floor disorders based on race, ethnicity, or level of education achieved.
The researchers noted that their study focused on moderate to severe forms of pelvic floor disorders, and so did not include women with mild symptoms.
Treatment for pelvic floor disorders varies with the severity of symptoms. Treatment may involve behavioral therapies, exercises to strengthen muscles, vaginal devices to hold up the bladder or other pelvic organs, medications, or surgery.
In 2006, researchers in the Pelvic Floor Disorders Network published study results describing a successful surgery to reduce the urinary incontinence caused by pelvic organ prolapse: http://www.nichd.nih.gov/news/releases/Pages/surgery_reduces_incontinence.aspx
Additional information on pelvic floor disorders is available at http://www.nichd.nih.gov/health/topics/pelvicfloor/Pages/default.aspx
Friday, January 22, 2010
We’ve come a long way since women’s pelvic conditions were dismissed with a blush as “female troubles.” Or have we? A recent study in the Journal of the American Medical Association (JAMA) found that pelvic problems plague nearly one in four women older than age 20. But all too often women put off calling their doctors for these conditions, often out of embarrassment.
The women in the JAMA study complained of incontinence—leaking urine, and, less commonly, feces—and pelvic organ prolapse. Prolapse is the falling of pelvic organs into the vagina. Women may also suffer pelvic pain. Treatments exist for all of these problems, and the team at UTMB’s Pelvic Health and Continence Center can help end the suffering and discomfort.
Pelvic Health and Continence Center
Urology-Gynecology, Urology, Geriatrics, Psychology, Colon-Rectal Surgery, Physical Therapy
2240 Gulf Freeway South
League City, TX 77573