Approximately 80% of reproductive-aged women develop uterine fibroids —non-cancerous tumors that grow in the uterus — yet it’s often unclear what causes them.
Scientists have long suspected that genetics play a role, as do hormones, diet and major life stressors. New research from scientists at Northwestern University suggests that chemicals we’re exposed to in everyday life may also contribute to the development of uterine fibroids in many women.
According to the report, these chemicals — which are found in plastics used in food packaging, medical products (like IV bags, for example), and cosmetics — disrupt endocrine function and can lead to the growth of hormone-sensitive tumors like uterine fibroids. Even though these chemicals are toxic and can directly harm human tissue when ingested or inhaled, they are permitted in the United States and used commonly and frequently.
Past research has identified a link between endocrine-disrupting chemicals and uterine fibroids and other hormone-sensitive health conditions like breast cancer and endometriosis. But this report, published on Monday in the Proceedings of the National Academy of Sciences, is one of the first to identify how these chemicals impair hormone function.
“Currently unbanned environmental pollutants, called phthalates, cause significant reproductive problems including the growth of uterine fibroids using stimulating distinct molecular pathways in these tumors,” corresponding study author Dr. Serdar Bulun, chair of the department of obstetrics and gynecology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician told HuffPost.
For the study, the researchers measured the amount of DEHP – the most commonly used endocrine-disrupting phthalate — in the urine of 712 participants. According to the report, we are constantly exposed to DEHP through medical products, food, drinks and dust that hangs in the air.
The team found that those with higher levels of DEHP traces in their urine had a greater risk of having a symptomatic uterine fibroid. Every 10% increase in phthalate concentration was associated with a 6% higher risk of fibroid development.
The researchers also explored why phthalates affect fibroid growth by exposing cells from some of the patients’ fibroid tumors to various types of phthalate metabolites or the substances that are leftover after phthalates are metabolized in the body.
They found that high doses of phthalates activated a hormone pathway that helped fibroid cells survive and expand. “We detected the phthalate DEHP and its breakdown products in much higher quantities in the urine of women who also have symptomatic uterine fibroid tumors. Then we asked the question of whether this association was causal. And the answer was yes,” Bulun said.
What we know about endocrine-disrupting chemicals and our health
Past research has associated endocrine-disrupting chemicals with uterine fibroids, suggesting that the higher the phthalate concentration in the body is, the greater the risk of uterine fibroids. Evidence has also linked these types of chemicals to breast cancer, endometriosis, ovarian aging, and decreased sperm production and function, Bulun said.
Scientists have suspected that phthalates facilitate fibroid cell growth by mimicking or blocking estrogen and progesterone production — two hormones that stimulate fibroid growth in people’s reproductive years — but the evidence has been limited. According to Shannon Whirledge, an associate term professor of Obstetrics, Gynecology and Reproductive Sciences at Yale School of Medicine, our understanding of how endocrine-disrupting chemicals can impact our health is in its infancy.
But these new findings shed some light on how toxins in our environment change some of our hormonal processes and contribute to the development of uterine fibroids and other reproductive health conditions. “Because the way uterine fibroids develop and grow is not well-understood, this new study is certainly important to uncovering the potential mechanisms by which a woman’s environmental exposures may increase her risk for uterine fibroids,” Whirledge said.
Unfortunately, though commonly-used chemicals are tested for toxicity, their ability to mess with endocrine function is not closely examined, mainly because the health effects can be tricky to evaluate. “The effects aren’t always related to dose, and sometimes big effects are seen at low or high doses, and the effects of endocrine disruptors are not always immediately apparent,” Whirledge said, adding that it’s clear they can significantly alter our health throughout our lifespan.
“This new study is certainly important to uncovering the potential mechanisms by which a woman’s environmental exposures may increase her risk for uterine fibroids.”
– Shannon Whirledge, associate term professor of Obstetrics, Gynecology & Reproductive Sciences
Should we avoid certain products?
It’s worth considering, according to Bulun. He recommends avoiding plastic bottles and plastic food packaging — opt for glass containers when possible and avoid polyvinyl chloride (PVC)-containing products packed with phthalates.
It’s a bit harder to completely dodge phthalates since they’re everywhere. “These chemicals are included in hundreds of different products, and in most cases, they won’t be listed on the product packaging labels,” Whirledge said. Bulun recommends carefully checking the ingredients in any foods, makeup or household products that you use. Look for microwave-safe containers, toys and consumer products that are labeled phthalate-free. Because so many medical products contain high levels of phthalates, it may be worth asking your healthcare provider if they have any phthalate-free options.
The best way to effectuate change — build public awareness. Think back to the case of BPA: growing evidence and public pressure eventually pushed legislators to ban the substance from being used in certain products like baby bottles.
The same can, hopefully, happen with phthalates, according to Whirledge. “The study from Dr. Bulun’s group is a great step towards building that foundation of research needed to understand how phthalate exposure can impact health and disease risk so that women can advocate for safer products,” Whirledge said.
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5 Benefits Of Listening To Music While Working Out
Music is a lot of things: It’s restorative, motivational, moving and educational. There are endless ways we use music to get through our days, whether listening to a sad song on repeat or hitting play on an upbeat tune.
According to Ronna Kaplan, a clinical supervisor and adjunct music therapy faculty at Cleveland State University, “music is positive in many ways for mental health, it can be used across the lifespan” for many different situations.
One of those ways is during exercise. It can be a crucial element in enhancing your workout. Here’s how:
Your body’s movement naturally matches a song’s rhythm, which can help you stick to a specific pace.
There’s a reason your foot starts tapping or your shoulders start moving as soon as a song comes on. According to Joy Allen, the chair of music therapy and director of the music and health institute at Berklee College of Music in Boston, this is because of rhythmic entrainment, which is an “unconscious reaction — that’s what we call the entrainment.”
“Our body’s going to [move] in time with that sound or that rhythm,” she said.
So, when it comes to exercise, your body automatically falls in line with the tempo of the music “because of the way that our brains are connected with rhythm,” Allen said.
When picking music for a workout, like when going for a walk or run, for example, you’ll want to choose a tempo that is close to your natural stride. “Go [with] what seems comfortable for you and play around with different songs,” she said.
You can use music to increase your pace, too.
If you’re looking for an added challenge, pick a song with a pace that is a little quicker than your average running or walking stride, this should help you move faster throughout your workout.
You can start with a song with a slower tempo and gradually increase your speed by picking songs with faster beats, which is ideal if you’re looking to improve your walking or running pace, according to Kaplan.
“It primes the person to an outside cue,” she said. It “helps your muscles activate in their walking pattern.”
How often has someone walked into the gym, realized they forgot their headphones, and then had a not-so-great workout — or even left the gym altogether? Allen pointed out this is a common occurrence: There is a major reason why music is integral to so many people’s workouts.
The music you listen to during a workout helps with motivation, and there are several things behind that motivation.
First, you probably want to hear your favorite song on your exercise playlist, which may keep you going for longer. Second, if you put on music that’s unexpected (like if you put on reggaeton instead of your regular pop soundtrack), you will be interested in hearing what comes next in the song, which may also keep you moving longer than usual.
“If you’re always listening to the same stuff, sometimes that’s great [but] sometimes we have fatigue from it — we know what to expect and what’s coming, so it can be a little less motivating,” Allen said.
And music is distracting.
No one wants to focus on their tough workout as they’re in it. If anything, they want to not think about it. As you sing along to lyrics or are reminded of music-induced memories, songs let your mind wander throughout an exercise regimen, so you don’t have to stand (or sit) there and think about how hard your workout is.
Music keeps you from getting bored during a workout, too, which can happen when you’re doing something kind of mundane like walking on a treadmill, Allen noted. Music activates the brain by giving your mind something else to think about.
“It captures your attention… ‘oh, here’s something I’m listening to,’ so I’m not attending to what could be an uncomfortable experience with the exercise, it gives me something else to focus on,” Allen said.
You’ll reap even more benefits when you pick your music.
According to Kaplan, when someone chooses the music they’re listening to, they’ll have better results, whether working out or doing something like meditation.
A recent study led by the Department of Kinesiology at Samford University in Alabama stated, “if the music played over the speakers is not preferred by the individual giving effort, performance may suffer. Thus, coaches and athletes should consider individual music preferences when attempting to optimize performance and training.”
This further speaks to the motivation you feel when working out to music you enjoy.
Additionally, Kaplan said you might notice you’re in a better mood when working out to music you select, which may make you feel like you enjoyed your workout more. And that’s a win-win.
This may mean you’ll be more likely to work out again that week, which is a great way to hit your fitness goals.
6 Everyday Activities That Naturally Release Dopamine In Your Brain
Dopamine is a feel-good chemical that’s produced in your brain. Essentially, it makes you happy. And your brain releases it with certain activities and behaviors ― many of which you already do every single day.
“Whenever we participate in activities that are considered essential from our body’s point of view, our brain releases a large amount of dopamine,” which is meant to encourage you to do this activity more, according to Dr. Kiran F. Rajneesh, the director of the neurological pain division and associate professor of neurology at the Ohio State University Wexner Medical Center.
Throughout evolution, dopamine’s task was to “sense reward, learn the place and activity that leads to reward and also motivate you to go to those places to obtain [a] reward,” said Dr. Hitoshi Morikawa, an associate professor in the departments of neuroscience and psychiatry at the University of Texas at Austin. And that is still the case today. In essence, “dopamine is a reward sensor,” Morikawa said.
While this reward sensor was and is essential to human survival, evolution has made it so maladaptive behaviors also result in the release of dopamine in humans, both experts said.
“Generally, when neuroscientists talk about dopamine, we think about addiction because it is an addiction driver,” Morikawa explained.
The hormone makes you want to repeat certain behaviors, turning them into habits ― whether they are healthy or not. (Like substance misuse or smoking, for example.)
However, that’s not always the case. The release of this hormone is also part of your body’s daily function. While this is not a cure for any disease or condition, it can be helpful to know when dopamine is released — and when you can expect to feel a little mood boost as a result. Here are a few times when your body releases dopamine:
Our prehistoric ancestors knew that food was necessary for survival, in part because of the reward sensor that dopamine activated. This is still true today.
In fact, Rajneesh said that any activity that is “evolutionarily protective and essential for our well-being and survival” releases dopamine. Being able to find food and eat that food certainly falls into this category.
Some studies even say that eating results in a dopamine release twice: first when the food is eaten and again when the food is in the stomach.
Think about it: When you’re parched, a glass of water certainly feels like a reward, so it’s no wonder it also triggers the release of dopamine in your brain.
But not all sips of water will release dopamine, Morikawa noted. Instead, you have to really want or need the water — like after a tough workout or on a hot day.
“In the middle of summer in Austin, and you’re really thirsty, then drinking water should increase dopamine levels in the brain — that should be one of the most effective ways to increase them,” he said.
One really common way that dopamine is released is when praising children for good behaviors, Rajneesh said. Praise triggers a release of dopamine in kids’ brains — and the same goes for praising pets. In these situations, their good behaviors are reinforced by the feel-good nature of that dopamine release, he said.
The same is true when adults receive praise, Rajneesh added. So sending a congratulatory email to your colleague or a celebratory text to a friend is actually doing more good than you think.
This is especially important for people with certain conditions that are a result of low dopamine levels, like ADHD, according to ADDitude Magazine, an ADHD-focused publication.
Playing Video Games
Many studies have measured and found that playing video games results in the release of dopamine in the brain for some people, Morikawa noted.
While this in itself is not a bad thing, it can become negative if the feeling of playing video games is too positive or too fun, he added. When “elevating dopamine levels, sometimes you get really hooked [onto] certain activities,” Morikawa said.
In this case, that activity can be video games, which can lead to problems for people who aren’t professional gamers, he added. (For example, students who should be doing homework instead of playing.)
Sex causes a release of endorphins, as Dr. Elizabeth C. Gardner, an orthopedics sports medicine surgeon at Yale Medicine, previously told HuffPost. And studies show it also causes a release of dopamine.
During evolution, the dopaminergic system developed to promote the “survival and maintenance of our species,” Morikawa said. In other words, there’s an instinctual reason sex feels so enticing. Our brains are wired to know that sex is important for survival, and the neurons that release dopamine do so when they sense the reward associated with the act.
Activities That Enhance Your Well-Being
Meditating and other activities can also lead to a release of dopamine, Rajneesh said.
“Engaging in activities that enhance your well-being such as yoga, exercise, hobbies [and] games … can help release dopamine in the brain and further enhance your sense of well-being and health as nature intended it to be,” Rajneesh said.
‘Better Off Hibernating’: What It’s Really Like To Live With Seasonal Depression
While many of us may catch a case of the winter blues as the days get shorter, an estimated 10 million adults in the United States live with seasonal affective disorder.
This mental health condition, also known as seasonal depression, lasts around four to five months on average. “The appropriately named SAD, or seasonal affective disorder, is considered a type of depression characterized by its seasonal nature,” Jeff Temple, a professor at University of Texas Medical Branch and a licensed psychologist, told HuffPost.
Unsurprisingly, people living farther north in states with less sunlight and earlier sunsets are more likely to experience SAD, likely due to the lack of sunlight and much shorter days. However, that doesn’t mean people in warmer, sunnier climates aren’t affected. While seasonal depression is much more common during the winter months, some people may experience seasonal depression during summer or during the colder season because of the fewer daylight hours. Women experience it more frequently than men.
A common misconception is that SAD is less serious than major depressive disorder because it doesn’t last all year round. However, people with this mental health condition explained to HuffPost that the symptoms of SAD are very real, and can even be debilitating.
Here’s what they want you to know:
People with seasonal depression may struggle to do daily activities.
Like those with major depressive disorder, people with SAD may experience a lack of motivation and a loss of interest in day-to-day activities.
“I have had SAD for about 12 years, but I didn’t recognize the pattern or be diagnosed until about five years ago,” Claire, an optometrist, told HuffPost. (Claire, along with some others in this story, asked to keep her last name private so she could freely talk about her mental health condition.) “I am typically an early riser and consider myself a productive person. However, when SAD hits, I struggle to do even the smallest daily chores like doing the dishes or making dinner.”
Similarly, Rebecca, a grad student, said that she has a “difficult time keeping up with [her] self-care and workout routine during the winter months,” and finds it nearly impossible to “function at full capacity.”
People with SAD may also feel more isolated during the darker months.
Moreover, staying socially and emotionally connected to loved ones can require much more effort when coping with seasonal depression.
“The most prominent SAD symptoms I experience are loneliness and apathy. I tend to become quite numb in the winter months, and feel emotionally separated from the people around me,” said Vera, a freelance illustrator. “During regular depressive episodes, I may be able to ‘mask’ for most basic social interactions, whereas in winter seasons it’s not even an option. I’m too wiped out to even show up or pretend.”
Seasonal depression can interrupt normal sleep cycles and lead to extreme fatigue.
SAD and sleep disturbances go hand in hand. Chloé Perrin, a bartender, has found that her symptoms of seasonal depression often manifest as constant exhaustion, leading to hypersomnia. Simply put, hypersomnia is characterized by recurring episodes of sleepiness during the day, difficulty waking up in the morning, and feeling tired despite oversleeping.
“My family used to joke that every winter I’d hibernate, whereas my sleep is otherwise normal-to-low the rest of the year and during other episodes,” she said.
Bella Sutter, a dancer with seasonal depression, explained that “getting out of bed feels impossible and my mornings normally start late.”
“I feel as if I would be better off hibernating through the winter because seasonal depression makes me feel like I’m half asleep anyway,” she added.
People with seasonal depression may experience changes related to appetite and eating habits.
Not only does seasonal depression impact sleep, but this mental health condition can have a negative impact on a person’s eating habits. Researchers have found a marked correlation between SAD and higher rates of disordered eating, including behaviors such as binging, purging and restricting food intake.
For Anna Samanamú, a high school paraprofessional and graphic designer, symptoms of SAD began when she was a teenager. “My appetite becomes affected [with SAD], and I would prefer to sleep rather than eat,” she said. “Unfortunately, that led me to have issues such as anemia and Vitamin D deficiency.”
Seasonal depression may worsen symptoms of other mental health conditions.
According to Temple, “seasonal affective disorder has a bi-directional relationship with other mood disorders like depression and bipolar disorder — meaning that people with one form are much more likely to develop or worsen the other.” Notably, SAD affects up to 20% of people with major depressive disorder, and 25% of people with bipolar disorder.
Rhiannon Bellia, who works in social services, has found that seasonal depression tends to exacerbate symptoms of other mental health conditions.
“My OCD gets a lot worse in the winter, it’s harder for me to focus and gauge time with my ADHD. With having autism, it’s also a bit harder for me to regulate sensory overwhelm,” Bellia said.
There are treatments for SAD.
Temple explained that if symptoms such as losing interest in activities or feeling sad last “longer than a couple of weeks or [start] to interfere with your work, family, or relationships, then that’s a good sign that you may need some extra help.”
Fortunately, light therapy and cognitive behavioral therapy are proven to be effective treatments for people with SAD. The most beneficial at-home light therapy boxes provide light at 10,000 lux.
SAD is not simply feeling a little gloomy when the sun goes down; it is a serious mental health condition that can greatly impact every aspect of someone’s life.
“Please be kind to everyone who struggles with seasonal depression,” Samanamú said. “We are not lazy — sometimes there is just a disconnect from our minds and bodies. Many of us just need to take a little bit of time to become whole once again.”
The 6 Most Common Issues Introverts Bring Up In Therapy
As someone who spends a lot of time alone, I’d call myself an introvert. Not only do I enjoy my own company, but also I need that time alone to recharge myself even if it was just from a tiny social interaction. However, on the other hand, extroverts get energized by being around people and receiving lots of stimulation.
With that said, sometimes society isn’t made to fit the needs of introverts, and it can be difficult to socialize and communicate. That’s where therapy comes in handy: It can help you navigate these situations and assist you in exploring your own inner life, making you more comfortable with your quieter nature and your needs that come with it.
Below, we asked therapists to share the most common topics introverts frequently bring up in therapy and why they usually come up. If you relate, you’re not alone.
Finding space to recharge their social battery
Everyone needs a bit of alone time every now and then. However, some need it more than others ― and it can be hard to achieve that when loved ones may not understand how important it is or if you don’t have the physical space to just be isolated.
“Many introverts may feel drained after socializing with friends, and it’s important for them to create space to recharge. This can be difficult if they live with a partner or roommate,” said Kristen Casey, a telehealth clinical psychologist and insomnia specialist. “In therapy, we usually discuss how to communicate their needs effectively to ensure their friends or family understand that the creation of space from others is not personal.”
Kristen Gingrich, a therapist and certified alcohol and drug counselor, said that she usually tells her clients to go into a bathroom for five to seven minutes to ground themselves and recoup since it’s the place where you’re least likely to be bothered.
Setting boundaries with friends and loved ones
Many people find it difficult to set boundaries, but it can be even harder for introverts to speak up for themselves and communicate their needs.
“A lot of times, introverts talk about how they struggle to set boundaries because it can require more extroverted energy than they are comfortable with,” Gingrich said.
She added that when an introverted client is struggling with this, they may discuss ways to set boundaries that are clear and to the point, as sometimes it can be easy to get caught up in the discussion aspect as opposed to actually setting them.
Additionally, coping skills and distress tolerance skills are usually talked about because uncomfortable feelings and emotions will likely arise when setting boundaries, and it’s important for clients to know how to manage those in a healthy way when they come up.
Managing communication with friends
This isn’t a topic only introverts bring up in therapy, but it comes up often because it can be overwhelming to respond to texts and calls sometimes when your social battery is running low.
“The concept of answering phone calls or text messages may feel overwhelming for some introverts, and they may struggle with coaching their loved ones on their preferences for communication,” Casey said.
In these instances, the client might raise concerns around friends and family members taking their delay in response personally or viewing it as a sign that they don’t value the relationship, as opposed to it simply being a result of their needs.
“In therapy, we explore ways to coach friends and family on their preferences or how to answer briefly to maintain the relationship,” Casey said.
Managing overstimulation and irritability
After a while of socializing in a group setting, introverts will need that alone time to recharge their battery. When they can’t get that or have trouble communicating that need, it can sometimes lead to irritability ― a topic that introverts tend to bring up in therapy as they are looking for better ways to manage it.
“This is a thing I see with introverts and that is when they are overstimulated or their social battery runs empty, that they either shut down or it turns into irritability, which is really common,” Gingrich said.
In session, the therapist and client will together to discuss and build mindfulness skills and coping techniques to help prepare them for situations when they are highly irritable or overstimulated.
“We also talk about how to take accountability for the times where their irritability may get the best of them and come out towards other people,” Gingrich said.
Although it may be difficult, it’s important to take accountability and move forward in a more healthy and productive manner.
Wanting to find a romantic relationship
Dating is hard for just about anybody ― this includes introverts, who get easily drained by social interactions. Going on many dates can feel overwhelming for an introvert who needs frequent alone time to recharge.
“Clients often bring this up often because the idea of internet dating seems daunting with meeting lots of people and going out on different occasions,” said Heather Kent, a registered psychotherapist and trauma recovery specialist in Canada.
It’s not that introverts don’t want romantic relationships, but it can be hard to find the balance necessary to suit the needs of both people.
Dealing with societal pressure
Society places a lot of pressure on people to maintain the status quo in just about everything. However, introverts tend to find this hard when the extroverted personality is the default.
“Introverts often bring up how they worry about how others feel about them and that they feel a constant societal pressure to be involved in activities and engaged with friends,” Casey said. “They may also sometimes think that something is wrong with them, or that they aren’t living up to societal standards because of this.”
During sessions, she works with her clients to explore the need to adjust their own expectations with societal standards to ensure they feel seen and heard and live a life of their choosing. It’s more advantageous than trying to be someone you’re not.
What You Need To Know About Getting Pregnant With Polycystic Ovary Syndrome
Perhaps you already have a polycystic ovary syndrome (PCOS) diagnosis and a doctor has told you that you’ll likely have a hard time getting pregnant. Or maybe you’ve been trying to get pregnant for a while and are beginning to wonder if an underlying condition like PCOS is the reason it hasn’t happened yet.
PCOS is “a complex disorder that is very common — impacting [approximately] 10% of people with ovaries,” Dr. Lucky Sekhon, a reproductive endocrinologist and OB-GYN at Reproductive Medicine Associates of New York, told HuffPost.
“It is one of the most common causes of female infertility,” Dr. Christina Mitchell, an OB-GYN fertility specialist at the University of North Carolina School of Medicine, told HuffPost.
PCOS is a hormonal imbalance that prevents regular ovulation, but it manifests differently from one person to the next, and there are different criteria for diagnosis.
Sekhon explained that her clinic uses the Rotterdam criteria, meaning a person can be diagnosed with PCOS when they present with at least two of the three main symptoms: many cysts on the ovaries, which can hinder ovulation; irregular or absent periods; and/or signs of excess androgens, which are hormones like testosterone that can affect menstruation.
Obesity and insulin resistance ― a condition in which your body does not respond well to insulin, potentially leading to Type 2 diabetes ― are also common in people with PCOS. It is important to note, however, that not all obese people with ovaries have PCOS, and people who aren’t obese or overweight can develop PCOS, too.
Whether you’re trying to get pregnant or not, it’s important for a doctor to tailor a treatment plan to your individual needs.
How does PCOS affect fertility?
You can’t get pregnant without ovulating, or releasing an egg. If you’re not ovulating at all, pregnancy won’t happen without some intervention. If you’re ovulating irregularly, you might get pregnant, but it can be a challenge to figure out when you’re nearing ovulation in time for intercourse or insemination.
“PCOS results in few or no ovulatory events and thus infrequent opportunities to conceive,” Mitchell said.
In addition to a lack of cycle regularity making it difficult to know when ovulation will occur, “ovulation predictor kits can be less accurate in people with PCOS,” Sekhon said. “The ovulation predictor kits detect a rise in luteinizing hormone levels in the urine ― these levels tend to run high throughout the menstrual cycle in people with PCOS and can lead to confusing false-positive results that are all over the map.”
Infrequent ovulation means fewer attempts to conceive, explaining why many people with PCOS have a hard time getting pregnant. That said, you still can get pregnant even if your ovulation is irregular, and you should use birth control when you want to avoid a pregnancy.
What fertility treatments are available for people with PCOS?
The good news is that many people with PCOS are able to get pregnant with lifestyle modifications, medications or fertility treatments.
Some people improve their odds of pregnancy by losing weight — and the weight loss often doesn’t need to be huge. “Losing only about 5-10% of their body weight can restore normal ovulatory patterns, improving the chance of conception without any medical intervention,” Mitchell said.
However, a catch with this is that it’s often extremely challenging for people with PCOS to lose weight. The condition can sometimes even lead to weight gain.
Metformin, a Type 2 diabetes drug that sensitizes the body to insulin, can also be effective in regulating the menstrual cycles of people with PCOS.
In addition, there are drugs that induce ovulation. The two most commonly used are Clomid (clomiphene citrate) and Femara (letrozole). The medication is taken for five consecutive days at the beginning of your cycle, and then your doctor will do an ultrasound to see if your body is responding to treatment by preparing an egg for ovulation.
This ultrasound can also determine if the medication has worked too well. It’s important “to make sure you will not ovulate too many eggs if you have an overly robust response, which could increase the risk of twins,” Sekhon said.
Your doctor may also prescribe an injection of HCG (human chorionic gonadotropin — the hormone detected by pregnancy tests) to trigger your ovary to release the egg. This can help you more precisely time intercourse or insemination.
Injectable fertility medications, like the ones used in IVF cycles, can also be used to induce ovulation, “but this is now viewed as very aggressive, as it often leads to many follicles releasing eggs and leading to a higher risk of twins or triplets,” Sekhon said.
IVF offers the highest odds of success, although it is expensive and may not be fully covered by your insurance. It is also a more involved process, requiring many visits to the fertility clinic for monitoring via ultrasounds and blood tests.
What are my chances of success with these treatments?
“I tend to think of patients with PCOS as having a good prognosis, as irregular ovulation can most often be directly addressed with medication and lifestyle changes,” Sekhon said.
If weight loss, metformin, Clomid or Femara works and you ovulate, then you have the same chances of getting pregnant as any other ovulating person your age.
“Typically, for the average patient, we say there is approximately a 15% chance of conceiving with each ovulated egg,” Sekhon explained, adding that a person in their 20s has about a 20% chance of getting pregnant each cycle but that this drops to less than 5% for people over 40.
Injectable fertility drugs increase the number of eggs you ovulate, which in turn increases your odds of pregnancy — but also of having twins or higher-order multiples, which brings significant risks both to the pregnant person and the babies.
The likelihood of success with IVF depends both on your age and how many eggs you produce in response to the medications. People with PCOS often produce a high “egg count” on IVF drugs, leading to more chances for conception to occur.
Doctors can then fertilize all the mature eggs you produce to see which ones produce healthy embryos. An embryo that has been tested and proven to be genetically normal has a 50% to 70% chance of resulting in pregnancy. Doctors now generally transfer only one healthy embryo into the uterus at a time, virtually eliminating the risk of twins. If a cycle produces more than one healthy embryo, they can be frozen and thawed for later use.
That said, not every IVF cycle will produce any genetically normal embryos, and the odds of this outcome increase with age. Odds of success for fertility treatments are also lower if you or your partner has other fertility issues.
Why is it important to know that I have PCOS, even if I’m not trying to get pregnant?
If infertility is the symptom that brought you to your PCOS diagnosis, you may wonder why else it would matter. But PCOS affects more that just your reproductive system.
“Specifically, it increases the risk of metabolic disease, including high blood pressure, diabetes and high cholesterol — even in women who are not obese. Women with PCOS should have regular health screening for these conditions in order to prevent and/or treat them,” Mitchell said.
Because PCOS prevents the regular shedding of the uterine lining (aka your period), it can increase a person’s odds for pre-cancer or cancer of the uterus. There are treatments, such as birth control, to resolve this issue.
In addition, “many women with PCOS suffer from various bothersome symptoms, such as heavy or unpredictable vaginal bleeding, abnormal hair growth on their face or chin, and cystic acne. These can be treated very effectively with hormonal therapies, such as birth control pills, if the underlying cause is diagnosed,” Mitchell said.
And it isn’t just your physical health that matters, of course.
“Mental health issues — depression and anxiety — have been shown to be more common in women with PCOS,” Sekhon said. So it’s also important to be regularly screened for these, too.
What Experts Really Think About Powdered Greens
It’s hard to go on social media without seeing a fitness influencer or health-conscious celebrity touting powdered greens.
Popular brands like Athletic Greens, Ora, Bloom and 1st Phorm have unique powdered green mixes that you can easily combine with water to create a beverage that helps you hit your daily vitamin needs while consuming powerful superfoods, too — or so they say.
Essentially, these powdered greens are dried fruits or vegetables that are blended up into a powdered form, according to Carlie Saint-Laurent Beaucejour, a registered dietitian and owner of Crave With Carlie, a virtual nutrition practice.
Since fruits and vegetables are known to promote gut health, boost immunity and build antioxidant levels, these powdered greens claim to do the same, Saint-Laurent Beaucejour said.
Gina Milano, a clinical dietitian at Stanford Health Care in California, said, although the reported perks vary from blend to blend, most products also promise to help you maintain energy levels throughout the day and are said to alleviate bloating and support liver function.
In other words, the claims say one scoop of these powdered greens can do a lot.
Here, experts share if these powdered greens deliver on their promises — and what to know about the blends you’re drinking.
First, know that many of these powders are not FDA-regulated.
According to Milano, though the makers of powdered greens seem to boast all kinds of eye-catching benefits, most of these powders are not regulated by the Food and Drug Administration, meaning they have not gone through a process that proves they fully achieve the promises.
“A lot of … these different products will say something like ‘these statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease,’” Milano said. “So, even though they’re touting all these great claims, they’re still saying, in very small print, of course, ‘Hey, just so you know, this isn’t FDA-regulated.’”
For the powders that are not FDA-regulated, any claims around the prevention of disease or treatment of a health condition are not vetted. And the exact makeup of the disease-preventing superfood complexes are unknown, Milano added.
While these mixes claim to have superfood ingredients, like spirulina or green tea powder, it’s unknown exactly how much.
“There isn’t a ton of research on superfood products or green blends, which I guess is not surprising as a lot of these products vary from blend to blend based on the brand [and] manufacturing,” Milano said.
These green powders are made of proprietary blends — so while the components of the powders are listed on the label (such as spirulina, alfalfa powder, wheat grass juice powder), what’s missing is how much of each is in the product.
You’ll find this information on the full ingredient list, next to or below the amount of vitamins and minerals in the product. For example, when it comes to Athletic Greens, these superfood ingredients are bucketed under blends like “Alkaline, Nutrient-Dense Raw Superfood Complex” and “Nutrient Dense Extracts, Herbs & Antioxidants.” For Ora, you can find them under “Organic Alkalizing Grass Blend” and “Organic Alkalizing Greens Blend.”
The ingredients listed in this area are buzzwords that you probably associate with healthfulness, and you’re not wrong: Studies show that consuming specific amounts of these items can be beneficial, especially spirulina and matcha, Milano noted. But since it’s unknown how much of these products are actually in these blends, it’s also unknown if there’s enough to do your body any good.
“We don’t know how much is actually included, so the effectiveness is really hard to determine,” she said, “I think just as a whole it’s hard to promise all these health claims that they typically recommend.”
The vitamin and mineral contents are more known, though.
Though some of the information on the makeup of the superfood complexes or proprietary blends is murky, Milano said she’s confident that the vitamin and mineral promises on the label are more straightforward.
These powdered greens are an easy way to get your vitamins, she explained, so you can kind of look at them as a well-rounded daily vitamin.
It’s easier to measure vitamin and mineral content. “That, to me, is much more believable that they’ve measured and done the data collection on that piece of the puzzle,” Milano added.
Also, since most Americans are not getting the recommended amount of fruits and vegetables (which is 1.5 to 2 cups of fruit and 2 to 3 cups of veggies, according to the Centers for Disease Control and Prevention), Saint-Laurent Beaucejour added that these green blends overall could help people meet their nutrient requirements.
If these greens help you focus on your health, there is probably nothing wrong with consuming them.
Both Milano and Saint-Laurent Beaucejour said that, though these powdered greens are not necessary for a healthy diet ― and, at a time of high inflation, they’re an expensive investment at that ― they can usually be helpful for people who use these greens as a catalyst for a healthful change.
“I think if this helps the average person take one step to just putting vegetables on their plate or thinking about doing that, then, sure, these powders can be helpful,” Milano said. “If this is something they enjoy and it encourages them to make healthier choices, that’s a positive.”
Plus, most of these blends need to be mixed with water, so if you are drinking these powders you’re also boosting your hydration, which is key to good health — and most Americans aren’t drinking enough water as it is, Saint-Laurent Beaucejour noted.
When combined with other healthy activities, like eating a balanced diet, drinking water and exercising, these greens powders aren’t bad. But “there’s plenty of other things we can do to help our guts feel healthier, our brains function better and to live longer and healthier lives,” Milano said.
If you’re going to drink these powder blends, do your prep and research.
“These greens are juiced, pressed and made into powders, which extracts the fiber,” Milano said. “So the fiber content in a lot of these aren’t great.” For something that is so fruit- and veggie-rich, you’d think there would be more fiber, so that is a downside, she added.
“It’s not giving you that same fiber that a whole food approach would,” Milano said.
If you are going to drink these blends, make sure you’re eating full meals with your beverage. Milano suggested having two hard-boiled eggs or a piece of wheat toast with nut butter with your glass of greens.
Lastly, before picking out a blend, do your research to make sure the mixture is safe and has been through the necessary health checks.
“You do want to make sure that these brands are NSF third-party verified … this basically just confirms that what is said to be in the bottle, like the vitamin content and the extracts that they are using, are there,” Milano said. (Even though, as mentioned above, the exact amount of each ingredient is not measured.)
Milano added that you can also see if the product you want to buy is reviewed by Informed Choice, which checks for contaminants and heavy metal content, or check Consumer Lab, which is a good safety resource for health products.
Some people may have adverse reactions, so check with health care providers before taking something new.
Since everyone’s genetics are different, these powdered greens may work for some people and not for others, Saint-Laurent Beaucejour noted. What’s more, they may be safe for some folks but not others.
“I think that’s why it’s important to work with your health care professional [and] work with a dietitian,” she said.
According to Saint-Laurent Beaucejour, you should inform your doctor of any supplements you’re taking or want to start taking. This is because some of the ingredients in these powdered blends could negatively interact with medications you’re taking or with medical conditions you have.
“These supplements are not FDA-approved, meaning they’re not regulated,” she said, adding that the sellers could make claims that are not true and could withhold information about possible side effects.
Though very rare, there is a chance of toxicity in these concentrated powers, she added.
“When it comes to any supplements, I would just be cautious,” Saint-Laurent Beaucejour said.
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