Not as often as you think, even though Medicare may be willing to pay for it every two years. Via Science Daily:
Now a new study led by Margaret L. Gourlay, MD, MPH of the University of North Carolina at Chapel Hill School of Medicine finds that women aged 67 years and older with normal bone mineral density scores may not need screening again for 10 years.
“If a woman’s bone density at age 67 is very good, then she doesn’t need to be re-screened in two years or three years, because we’re not likely to see much change,” Gourlay said. “Our study found it would take about 16 years for 10 percent of women in the highest bone density ranges to develop osteoporosis. That was longer than we expected, and it’s great news for this group of women,” Gourlay said.
The researchers suggest that for T scores > -1.5, repeat testing needn’t be done for 10 years. Women with T scores between -1.5 and -2.0 can be re-screened in 5 years, and those with T scores below -2.0 can have every other year testing as is done now.
To be honest, I’ve been spacing out bone density testing in woman with good baseline scores for some time, but not knowing how long I can go. This is great information for me and for my patients.
*This blog post was originally published at tbtam*
Oocyte preservation, or egg freezing as it’s popularly called, is now being offered by over half of U.S. fertility clinics, and half of those not offering it now plan to do so in the future. This according to a national survey conducted in mid 2009 and reported this week in Fertility and Sterility.
Over two-thirds of the 143 centers offering oocyte cryopreservation will do it electively, as opposed to those that offer it only to women undergoing cancer treatments that threaten their natural fertility.
Go West, But Be Prepared To Pay
Centers located in the Western part of the U.S. are more likely to offer elective egg freezing than those in the East. Not surprisingly, centers that only accept out of pocket (as opposed to insurance) payments were more likely to offer the procedure, reflecting the history of infertility advancement, which, unlike almost any other area of medicine, has largely been financed by private individual dollars. Read more »
*This blog post was originally published at tbtam*
Dr. Steve Brule (aka John C. Reilly) makes medical history by solving America’s obesity epidemic with a groundbreaking new operation. Dr. Oz, step aside — Brules rules!
*This blog post was originally published at tbtam*
Ask any third-year medical student how hormonal contraception prevents pregnancy, and they’ll probably tell you it prevents ovulation. What they won’t tell you is that this effect is variable and dose-dependent, and if we depended on it alone, hormonal contraception would be much less effective.
That’s because of the very important, and in my opinion, much under-appreciated effect of hormonal contraception on cervical mucus.
A Cervical Mucus Primer
Fertile cervical mucus— which forms under the influence of rising estrogen levels in the first half of the menstrual cycle and is maximal around ovulation –- is thin, watery, clear and easy for sperm to traverse.
Non-fertile mucus — which forms after ovulation and also in pregnancy under the influence of progesterone –- is the exact opposite: Thick,tacky, non-distensible and impossible for sperm to penetrate. (It’s not called the mucus plug for nothing.) Read more »
*This blog post was originally published at tbtam*
A new analysis of long-term data from the Women’s Health Initiative confirms what we already knew the first time around: Use of combination hormone replacement (HRT*) is associated with a small, but real, risk of breast cancer. This new 11-year followup data carries that knowledge out to its not unexpected conclusion — namely, that some (although not most) breast cancers can be fatal, and therefore the the use of HRT can increase breast cancer mortality.
While it may seem a bit of a “duh,” this study was, in fact, necessary to quell the WHI critics who continued to argue that the breast cancers caused by HRT were somehow less aggressive than those occurring off HRT (which they are not.) It was also a wake-up call for many women who were continuing to use HRT and thinking that somehow its risks did not apply to them. A fair number of these women appear to be coming off of HRT, at least in my practice. Others are staying the course and accepting the risks as they have been defined. Either of which is fine with me.
The spin going on around this study — both for and against HRT use — is tremendous and ultimately confusing to women. The pro-HRT crowd (some of whom have relationships to Pharma) is using language like: “The increased risk from using HRT for five years is the same as if your menopause occurred five years later,” which is technically true, but so what? The bioidentical hormone crowd (usually also selling the same) are using the study to further hype how their regimens are safer than the evil Big Pharma products — based on no data. Which leaves the rest of us to try to find ways to help our patients understand the risks, place them into perspective for themselves, and make a decision about how and if to treat their menopausal symptoms. Read more »
*This blog post was originally published at tbtam*
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