resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
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.
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