Category: California

Treatment for Male Partners Cut Bacterial Vaginosis Recurrence Nearly in Half

For the study, researchers wanted to see whether standard treatment — a week of antibiotics just for women — might work better by also giving their male partners a week of oral antibiotics and topical antibiotics applied to the penis.

Scientists randomly assigned 83 monogamous couples to standard treatment for only the women, then gave another 81 couples treatment for both partners.

After 12 weeks, 35 percent of the women whose partners also received antibiotics got bacterial vaginosis again — compared with 63 percent of the women whose male partners were not treated, according to study findings reported in the New England Journal of Medicine.

Bacterial Vaginosis May Actually Be an STI

These results suggest that bacterial vaginosis, which isn’t currently categorized as a sexually transmitted infection, might actually be spread through sex, says the lead study author, Lenka Vodstrcil, PhD, a researcher at Monash University and the Melbourne Sexual Health Centre in Australia.

“Our study has shown that reinfection from an untreated sexual partner is a significant driver of BV-recurrence,” Dr. Vodstrcil says. “This simple intervention will reduce a woman’s risk of reinfection and increase her probability of being cured.”

There also seemed to be little risk to treating men. A majority of them experienced no side effects, and those who did most often reported mild issues like nausea and headaches, the study found.

What Causes Bacterial Vaginosis?

While bacterial vaginosis can happen to anyone with a vagina, it’s more common in people who have naturally low levels of lactobacilli and in individuals who reduce levels of these healthy bacteria by douching or cleansing the vagina too much, Mayo Clinic says.

Another risk factor for bacterial vaginosis is sexual activity and a new partner or a variety of partners, according to Mayo Clinic.

Tips for Preventing Bacterial Vaginosis and Recurrence

• Avoid scented products. Wash the genitals only with warm water, and steer clear of scented soaps, tampons, or maxi pads.
• Don’t douche. Douching isn’t necessary, and it can alter the vaginal flora and make you more prone to bacterial vaginosis.
• Practice safe sex. You can help prevent unhealthy bacteria in the vagina by using condoms and keeping sex toys clean.

The new study offers fresh evidence that safe sex can also make it easier to get rid of bacterial vaginosis once you have it, says Christina Muzny, MD, a professor of epidemiology and obstetrics and gynecology at the University of Alabama in Birmingham, who wasn’t involved in the new study.

“We recommend consistent condom use in women, avoidance of douching, and now treatment of male sexual partners if they get a bacterial vaginosis infection,” Dr. Muzny says.

With a doctorate in English (rhetoric and composition), Dr. Cherney focuses her academic scholarship on the intersection between disability and literacy. She also holds a Master of Arts in English and a Bachelor of Arts in communication.

Cherney has contributed to the books The Wiley Handbook on Violence in Education: Forms, Factors, and Preventions, Composing in Four Acts: Readings for Writers, and Georgia State University’s Guide to First-Year Writing, as well as to scholarly journals like Praxis, the Journal of Teaching Writing, and the Journal of Dracula Studies.

Cherney enjoys running, meditating, hiking, and paddleboarding.

Most of the time, a person’s senses of taste and smell will come back on their own soon after recovering from a COVID infection. When they don’t, there’s no guaranteed way to treat this condition. Here’s what we know so far.

Medical Treatments and Therapies

Research is still in the early stages, but the following therapies are being investigated:

• Medications: These include steroid nasal drops, sprays, and large-volume irrigation.

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• Stellate ganglion block: In this procedure, anesthesia is injected into nerves in the neck.

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• Neuromodulation: This treatment uses either magnetic pulses or electrical currents to stimulate specific nerves or areas of the brain.

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• Platelet-rich plasma: In this treatment, a concentrated solution of your own blood cells is injected around the olfactory nerves.

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There is not enough evidence yet to show how effective these treatments are or who might benefit.

Olfactory Training

While taste and smell are two distinct senses, they work together to give flavor to what you eat and drink. So, restoring your sense of taste may start with your nose.

Anthony Del Signore, MD, director of rhinology and skull base surgery at Mount Sinai Beth Israel in New York City, has seen promising results in patients using olfactory training, or “smell therapy.”

“We’ve been using essential oils, basically as smelling rehab,” Dr. Del Signore says. “We typically use lemon, cloves, and around three or four different oils.” Rose and eucalyptus are common scents to try. “We tell patients to breathe it in and out and try to remember what it smelled like. It can help to get neural pathways reestablished. It does take a little bit of time, around three to six months, but we’ve seen a good response with that,” he says.

Even though smell therapy has not been rigorously studied in COVID-19 patients, Del Signore says, “We recommend patients at least try it. It’s not going to hurt anything.”

1. Choose four distinct scents.
2. Sniff each scent gently for about 20 seconds, concentrating on what you’re trying to smell.
3. Repeat this process twice a day.
4. Continue for at least 12 weeks or until you notice improvement.

Home Remedies

While you can find all kinds of purported home remedies on social media — like eating foods with a particularly strong flavor — nothing has been found to be as effective as olfactory training, says Dr. Dalton. “Many people do begin to enjoy spicy food because that sensation is often preserved when smell or taste is lost. So, there’s no harm in [eating] spicy food, but there have been no randomized controlled trials to show that it’s effective.”

1. Wake Up at the Same Time Every Day

You may be tempted to “catch up” on your sleep over the weekend, but Michael Breus, PhD, a clinical psychologist and sleep medicine expert based in Manhattan Beach, California, recommends waking up at the same time every day, even on the weekends.

However, when you don’t get enough sleep during the workweek (experts recommend that adults get at least seven hours per night), getting one to two extra hours on non-workdays may be beneficial, the panel added.

2. Get Out of Bed Right Away

For better sleep at night, don’t prolong getting out of bed in the morning. “When I wake up, the first thing I do is get out of my bed,” Polos says. “The bed should be reserved for sleep and sex, and when you spend too much time relaxing in bed in the morning, it prevents your mind and body from associating sleep with the bed.”

3. Open Your Blinds

After getting out of bed, Polos lets the light in. “The next thing I do [after waking up] is open my blinds,” he says. Why? “Experiencing daylight first thing in the morning triggers your mind to know it’s time to be awake.”

In other words, for optimal sleep, you want your sleep-wake cycle to align with your body’s natural circadian rhythms.

4. Meditate First Thing in the Morning

Breus likes to start his day by meditating, and recommends the Muse headband, which includes several meditation practices and tracks some brain activity while you use it.

5. Do Breathwork

6. Exercise on the Early Side

Polos’s morning routine includes exercise on most days. He does a cardio rowing and weight-training combination workout (usually for about 45 to 60 minutes) three to four times a week, and swims one day per week.

But it’s important to point out that exercise, particularly higher-intensity exercise, raises your body’s core body temperature, and may actually make it tougher to fall asleep.

“If you can fit in a workout in your morning routine, I’d recommend doing it then rather than at night for that very reason,” Polos says.

But Polos adds that the extent to which various types of exercise affect your sleep also depends in large part on the individual. You might find that choosing a lower-impact workout like yoga, stretching, or brisk walking doesn’t impact your sleep at all, he says.

7. Eat a Balanced Breakfast

Polos says he doesn’t skip breakfast. He chooses a balanced meal that usually includes protein, some fat, and some carbohydrates within two hours of waking up. “Prior to the gym, I usually have a banana, yogurt, or some lightly buttered toast and water. Then when I come home, I have breakfast.” Breakfast might include cereal and milk, eggs, or oatmeal, as well as fruit and coffee.

“The morning fuel we take in can have a major impact on how we function during the day,” Polos adds.

The Takeaway

• What you do first thing in the morning can help prep your body for a good night’s sleep in the evening.
• Exercising, meditating, and eating a balanced breakfast early in the day are just some of the healthy habits that can set you up for better sleep at the end of the day.
• Having a regular sleep schedule, avoiding the bed when it’s not bedtime, and making sure you are exposed to natural light every day can also help you sleep better at night.

If you think everything is better with butter, you might want to think again. A new study suggests that people who eat lots of butter have an increased risk of premature death.

The study included about 221,000 adults who were typically in their midfifties and had no history of major health issues such as heart disease, diabetes, cancer, or neurodegenerative diseases like Alzheimer’s or multiple sclerosis.

Over a follow-up period of up to more than three decades, participants completed dietary questionnaires every four years that included information on their consumption of butter, safflower oil, soybean oil, corn oil, canola oil, and olive oil.

People who ate the most butter were 15 percent more likely to die of all causes during the study period.

But plant-based oils appeared to have the opposite effect. People who ate the most plant-based oils were 16 percent less likely to die during the study.

Researchers controlled for confounding factors including age, body mass index (BMI), physical activity, smoking and alcohol consumption, and history of high blood pressure or high cholesterol.

Fat Type Makes a Difference in Early Death Risk

The different impact of butter and plant-based oils on longevity is likely due to differences in the types of fats they contain, says Yikyung Park, ScD, a professor at the Washington University School of Medicine in St. Louis, who wasn’t involved in the new study.

“The fat in butter is mostly saturated fat, which is considered unhealthy because it increases bad cholesterol in the blood, which is linked to a higher risk of heart disease,” Dr. Park says.

“But plant oils mostly contain unsaturated fat, which is the healthy type,” Park says. “Unsaturated fats can improve your blood lipid profile and help fight inflammation in the body.”

Just 1 Daily Tablespoon of Butter Was Harmful

It didn’t take a lot of butter to increase the risk of premature death, the study found. People who consumed the highest amount of butter ate about 13 to 14 grams (g) daily, or about 1 tablespoon (tbsp). There are typically 8 tbsp in a stick of butter. People with the lowest butter consumption took in, at most, about 0.2 g daily.

The negative impact of butter on longevity appeared tied to how much butter people put on their bread, the study found. The amount of butter people used for baking and frying food didn’t make a meaningful difference in the risk of premature death.

Canola, Soybean, and Olive Oil Were Tied to Lower Early Death Risk

People who ate the highest amount of plant-based oils (tied to the biggest longevity boost) consumed about 5 teaspoons (tsp) per day. Low consumption was about 1 tsp per day.

Three types of oil did the most to reduce the risk of premature death: canola, soybean, and olive. Corn oil and safflower oil, two seed oils, didn’t appear to significantly affect longevity, the study found.

Each additional 10 g (about 2 tsp) a day of plant-based oils was associated with an 11 percent lower risk of premature death from cancer and a 6 percent lower risk of fatalities from heart disease, the study also found.

In contrast, each additional 10 g of butter a day was tied to 12 percent higher risk of premature death from cancer, but didn’t appear to alter the risk of heart disease fatalities.

A Healthy Diet for Longevity

The study wasn’t designed to prove whether or how eating more butter might cause early deaths or how consuming more plant oils might prevent premature fatalities.

One limitation of the study is that it relied on people to accurately recall and report on how much butter and oil they consumed, leaving room for human error. Another is that most study participants were white healthcare workers, so the findings may not be generalizable to other groups.

Finally, it’s possible that other eating habits influenced the connections between longevity, butter, and plant-based oils.

“The lower mortality with plant-based oils is most likely related to people using these as part of a healthier diet,” says Penny M. Kris-Etherton, PhD, RD, an emeritus professor of nutritional sciences at Pennsylvania State University in University Park who wasn’t involved in the new study. “They would have a higher diet quality, which decreases the risk of cardiovascular disease and cancer.”

The health benefits of adding plant-based oils to your diet depend a lot on how you do it, Dr. Kris-Etherton says.

For example, consuming salad dressings with plant-based oils or using these oils to roast vegetables or sauté lean proteins like poultry or seafood will likely help you achieve the longevity benefits seen in the study, Kris-Etherton says.

By contrast, eating lots of ultra-processed foods like potato chips or sweets like cakes and cookies that contain plant-based oils is less likely to provide the same longevity benefits, she says.

Moderation is also key, even when it comes to healthier plant-based oils, Park says. You should aim to get no more than 20 to 35 percent of your daily calories from fats, including plant-based oils, Park says.

“While plant-based oils are a healthier choice than butter, eating too much of any oil can increase your calorie intake and potentially lead to weight gain,” Park says. “So, it’s important to use them in moderation.”

“It’s important to think about the optimal timeline for family planning,” says Rozenblit. Even if you’re not thinking about having kids soon, you may want to consider procedures like egg harvesting to protect your ability to grow your future family.

Young people with BRCA variants often feel pressure to have kids earlier than they’d like to so they can have their ovaries removed preventively, says Raimonda Goldman, DO, the chief of medical oncology at Holy Name health system in New Jersey. Luckily, alternatives exist thanks to fertility preservation (more on this below).

For those with a cancer diagnosis, Goldman refers all her young patients to a fertility specialist before they start chemotherapy so they can also discuss fertility preservation strategies.

Consider Preventive Surgery and Fertility Preservation

Some women with BRCA mutations choose to have preventive surgery to lower their risk of cancer. Two common surgeries include:

• Salpingo-oophorectomy: Removal of the ovaries and fallopian tubes reduces the risk of ovarian cancer by 80 to 90 percent.

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• Bilateral mastectomy: Removal of both breasts reduces the risk of breast cancer by about 90 percent.

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Experts recommend ovary removal between ages 35 and 40 for BRCA1 carriers, says Rozenblit, and between 40 and 45 in BRCA2 carriers. If you’re considering an oophorectomy, Rozenblit recommends fertility preservation, which involves stimulating the ovaries and removing eggs.

These eggs are then cryogenically frozen and saved until you need them. What’s more, when a provider chooses eggs to implant in the future, they can test for the BRCA mutations and choose eggs with no variants, so you won’t pass on your BRCA gene variants to your kids, says Rosenblit.

Ask About Preimplantation Genetic Testing

Get Frequent Screenings

It’s because of this variability in cases, goals, and treatment paths that you’ll be empowered to help guide your own treatment.

Here are some factors to consider when you and your healthcare providers are deciding on hormone therapy for metastatic prostate cancer:

Side Effects of Hormone Therapy

• Diarrhea
• Erectile dysfunction
• Fatigue
• Gynecomastia (breast tissue growth)
• Hot flashes
• Insulin resistance
• Nausea and vomiting
• Low libido
• Osteopenia and osteoporosis (weakened bones)
• Sarcopenia (loss of muscle mass)

Armstrong points out that androgen synthesis inhibitors are taken with corticosteroids, which come with their own side effects, such as mood swings, weight gain, headaches, and osteoporosis.

Treatment Goals

Your own goals — and what you want from treatment — will inform just about all of your treatment decisions. “It’s not so much that some treatments are good and some are bad, it’s more like each has advantages and disadvantages,” says Dawson.

“Some patients will say, ‘I want the best quality of life, the treatment that interferes with my life the least.’ Others say, ‘Anything to extend life.'” says Dawson. “Some people will want pills; some say they take enough pills already and want injections. Some are willing to do chemo with hormone therapy, while others think it will interfere too much with quality of life.”

And the burning question: “Patients want to know how long they’ll live,” says Dawson. “I expect they’d respond to treatment for years. I don’t like to get pinned down with an average because people hone in on that and it’s not in their best interest. In a person with aggressive disease, they may stop responding within six months. In others, it could be 10 to 15 years.”

As variable as cases and treatments are, many people with metastatic prostate cancer are living with it for a long time, so treatments are tailored to their goals and lifestyle. “People [taking hormone therapy] usually feel pretty good, so they’re traveling and spending time with their families,” says Dawson. “People on hormone therapy are out there living their lives. You wouldn’t know who’s on hormone therapy.”

Do talk to a dermatologist. Make an appointment with a dermatologist who specializes in treating psoriasis — he or she will be aware of the latest developments regarding treatment plans. Be prepared to discuss the details of your condition with your doctor, including when you first noticed it, what your symptoms are, any situations that seem to make your symptoms worse, and what treatments have and have not worked for you in the past.

If over-the-counter products don’t help, your doctor may prescribe a moisturizing cream that contains medication.

Be especially diligent about moisturizing during the winter months, when cold outdoor weather and overheated buildings are a particularly drying combination. “In psoriasis, the epidermis builds up rapidly, producing a thick scale,” says James W. Swan, MD, former professor of medicine in the division of dermatology at Loyola University Medical Center in La Grange Park, Illinois.

When the skin is hydrated, the scales soften and fall away, alleviating itch and dryness. “But not using anything on the skin for three days will allow the scale to get very thick,” says Dr. Swan.

Do take a soak. Soaking in a warm (not hot) bath for 15 minutes can help loosen scales and help reduce the itching and inflammation caused by psoriasis. Adding sea salt, oatmeal, bath oil, or a bath gel containing coal tar to the water can further soothe and moisturize your skin. If you live or vacation in an area with mineral or salt baths, take a dip in one. Both are associated with relieving psoriasis.

Do get some sun. For reasons experts still don’t fully understand, psoriasis lesions often diminish when exposed to ultraviolet light. So while sunbathing is discouraged for most people because of the risk of skin cancer, it can be helpful for those with psoriasis. The trick is to make sure that only the areas affected by psoriasis are exposed.

Cover unaffected skin with clothing or a sunscreen with an SPF (sun protection factor) of at least 30. Limit sun exposure to 15 minutes, and be careful to avoid sunburn, which will only make matters worse. It may take several weeks to see an improvement. Avoid tanning beds, which don’t produce the same healing effect and may actually be harmful.

“Ultraviolet B light reduces the inflammatory cells from the skin that is causing psoriasis,” says Swan. “It also slows the cell proliferation that results in the scaling.”

Discuss your feelings about the disease with your family, friends, and doctor. In-person and online support groups for those with psoriasis can also provide support and help you remember that you’re not alone. Psoriasis organizations, such as the National Psoriasis Foundation, can connect you with others who are living with psoriasis, as well as keep you informed about research developments and opportunities to get involved in fundraising walks and other events.

Other health conditions may increase your risk of developing PsA. Research suggests that people with psoriasis who have one or more of the other health conditions below are more likely to develop PsA.

Obesity

According to Eric Ruderman, MD, a rheumatologist and a professor of medicine in the division of rheumatology at Northwestern University Feinberg School of Medicine in Chicago, “There is no question there is a link between obesity and psoriasis, and that there is a higher risk in those with obesity of developing psoriatic arthritis on top of psoriasis.”

Dr. Ruderman adds that “diet is not one-size-fits-all” but recommends limiting processed foods and excess sugar and aiming for a balanced diet with lots of vegetables.

“If you believe that specific foods may trigger your psoriatic arthritis symptoms, it may be reasonable to avoid those foods for two to four weeks to see if your symptoms improve, but there are no particular foods that we generally recommend avoiding if you have psoriatic arthritis,” Ruderman says.

Musculoskeletal Conditions

People with psoriasis who have nonspecific musculoskeletal symptoms, such as joint pain, fatigue, and stiffness, often go on to develop PsA. The link is unclear. Rather than being a cause, these could be early symptoms of PsA.

If you have psoriasis, taking measures to avoid traumatic injuries and overuse could help delay or prevent PsA.

Depression and Anxiety

Seeking treatment for depression, anxiety, and other mood disorders may improve your quality of life with psoriasis and lower your PsA risk.