resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
October, 2010, Vol. 10, Issue 10
Premature Ovarian Failure (POF)
By Elaine Stillerman, LMT
The New York Times recently cited a 2008 report which showed that birth rates for women over 40 years of age rose 4 percent over the previous year and a 2009 survey indicated that 14 percent of people in their prime childbearing years decided to delay becoming pregnant due to the economic recession. For some of these women, this decision may have dire consequences on future pregnancies.
For nearly 1 in 1,000 women (1 percent to 4 percent, or 250,000 to 1 million) between ages 15-29 years old who delay pregnancy, it may already be too late. These women may have a condition called premature ovarian failure (POF). It is also referred to as primary ovarian insufficiency, premature menopause, or hypergonadotropic amenorrhea.
When girls are born, we generally have enough eggs in our ovaries to menstruate monthly from puberty until the supply is depleted and menopause ensues. But in women with POF, there either aren't enough eggs at birth or there is something genetically wrong or dysfunctional with the ones they have. (There is also a possibility of surgical intervention, such as removal of the ovaries, and radiation or chemotherapy that can bring on early menopause.)
When this occurs at an early age, it is considered a natural, yet premature menopause and the symptoms are the same as in older women: cessation of menstruation, hot flashes, night sweats, decrease in breast size (or lack of breast development in puberty), vaginal dryness, mood swings, loss of energy, dry eyes, low sex drive, painful sex, bladder control problems, and insomnia. While these symptoms usually accompany POF, some women with the condition have periods and hot flashes, or no periods and no other symptoms.
A simple blood test to check the levels of FSH (follicle-stimulating hormone) can indicate the presence of POF. High levels of FSH usually confirm the diagnosis. However, that same blood sample can be used to test for other genetic causes of POF, and these should not be overlooked. A positive result for any genetic causes may have a significant effect on the carrier's long-term health, if not her immediate fertility.
Genetic or chromosomal causes of POF may include: Turner syndrome (the absence of two functioning X chromosomes affecting 1 in 2,500 women), Swyer syndrome (a condition also called XY gonadal dysgenesis or the lack of functioning gonads), Androgen Insensitivity syndrome, or premutation of Fragile X (the most common inherited cause of cognitive impairment, global developmental delays, seizure disorders, carried by 1 in 259 women worldwide [and 1 in 800 men]. Approximately 20 percent of women who carry the defective gene have POF).
There may be a family history of early menopause or some enzymatic or metabolic defects such as galactosemia (when the body is unable to metabolize galactose), thalassemia major (an inherited blood disorder where the body makes an abnormal form of hemoglobin), or hemochromatosis (wherein the body cannot break down iron and blood levels escalate).
Autoimmune diseases may also be causative for POF: thyroid dysfunction, rheumatoid arthritis, polyglandular failure I and II, diabetes, pernicious anemia, adrenal insufficiency, vitiligo, and lupus erythematosus.
But missing a period and its fertility sequelae are only part of the concern with POF. Women with POF are at higher risk for osteoporosis and heart disease. And of course, infertility, although 6 percent to 8 percent of women with POF can become pregnant.
The current medical treatment for POF is hormone replacement therapy (HRT). The dose generally starts out low to give the woman's body a chance to acclimate itself. Then the dose is gradually increased to a level higher than menopausal women. Sometimes birth control pills are prescribed in lieu of hormone replacement therapy. About 1-2 months after the start of HRT, a menstrual cycle may begin, accompanied by increased breast size, cramps, and even PMS.
Acupuncture and massage can have palliative effects on the symptoms of POF, helping reduce the discomforts associated with this condition. Points that support the reproductive system and hormone production are very useful.
Having a baby is still not out of the question, however. IVF with donor eggs may work for some women, while adoption may be the better choice for others. And while there is no current cure, support groups can be a great help and benefit. With so many young women experiencing this dramatic change in their lives, it's wonderful to know you are not alone.
Click here for previous articles by Elaine Stillerman, LMT.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.