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WOMEN’S HEALTH

A newsletter from El Camino Women’s Medical Group

Though it feels like 2024 just started, it also feels like the rain will never end.  I guess this is the new spring in California. May it be full of growth and happiness for all of you.

April this year also marks the end of the new masking requirements in Santa Clara County for the “Designated Winter Respiratory Virus Period,” which runs from November 1st to March 31st every year. El Camino Hospital has also loosened its visitor policies starting April 1^st, returning to pre-COVID visitor limitations.

This newsletter is full of fantastic articles, from an integrative approach to menopause, the allergen “of the year,” and treatment for the vasomotor symptoms of menopause to treating “tongue-tie” and considering hereditary cancer screening.   However, our Practice Updates section is probably the most important to read.   In the spirit of Spring, we have much to share about changes at the office, including saying goodbye to Dr. Lam, wishing Dr. Balassiano a wonderful sabbatical, welcoming Dr. Dorismond to the team, and introducing new part-time support from Drs. Achari and Yogam.   We are also launching an amazing new pregnancy support program in the coming months.

Best wishes to all of you and your loved ones,

Sarah Azad, MD

In this issue:

Practice Updates

Online Prenatal Classes

Research at El Camino Women’s Medical Group

Welcome Dr. Dorismond

From Discomfort to Balance: Easing Menopause with Integrative Medicine

The 2024 Skin Allergen of the Year Is…

“Tongue-Tied”

Beyond the Baby Blues: Understanding and Overcoming Perinatal Depression

The Impact of Marijuana Use During Pregnancy on the Neurodevelopmental Health of Children

Latest Guidelines on MonaLisa Touch Laser for Genitourinary Syndrome Menopause

Veozah: Revolutionizing Menopausal Relief

The Evolution of Hereditary Cancer Screening: Empowering Women

Take Charge of Your Healing Journey: Empowered Healing Masterclass!

El Camino Hospital Visitor Policy Updates

Highlights from our Women’s Health Blog

Practice Updates

A farewell to Dr. Christina Lam

We are sad to share that Dr. Christina Lam has decided to pursue other opportunities. During her two-and-a-half years with us, she built a wonderful practice, and she will be greatly missed by her patients and by all of us here in the office.

Her last day at El Camino Women’s Medical Group was March 25th. Her patients were all notified in early February.  Office staff have been working with all patients for follow-up visits.

The physicians at ECWMG will continue to be available to accept her patients. Everyone’s health records will remain with us at ECWMG and available through the patient portal or healow app. For patients wanting a transfer of records, a release form can be found here.

A message from Dr. Balassiano on her upcoming sabbatical

For the past eight years, I feel fortunate to have had the opportunity to work at El Camino Women’s Medical Group and especially to be able to care for you. It has been truly an honor to have you trust my medical care over the years. However, “home is where the heart is,” and I have decided to take a sabbatical year. I will be moving back to Brazil to spend quality time with my family.

It was not an easy decision, but I feel confident your healthcare needs will be placed in the very caring hands of my partners. All your records will remain within the group, and your care will continue uninterrupted.

Thank you for letting me be a part of your family’s lives. I truly enjoyed our time together, and I hope to care for you again once I return to the country in the summer of 2025. If there is anything you want to discuss before I leave, please call and make an appointment with me. My last day in the office will be June 28th.

It has been such a privilege to be your Obstetrician and Gynecologist. Although I cannot give medical advice after moving, I would love to stay in touch with you.

Hope to see you soon!

**********************

Esses ultimos 8 anos trabalhando na clinica El Camino Women’s Medical Group foram maravilhosos. O suporte de toda a equipe e excelente e, mais importante, tive a grande oportunidade de cuidar um pouquinho da nossa comunidade brasileira, o que enche meu coracao de alegria.

Com tudo isso, foi uma decisao dificil, mas resolvi voltar ao Brasil temporariamente para passar mais tempo com meus pais e para que minhas filhas se sintam mais brasileiras, mais conectadas com nossas raizes e cultura.

Muito obrigada por permitir que eu fizesse parte da sua vida e da sua familia. Eu prezo bastante sua confianca em mim e nos meus cuidados medicos. Eu espero poder continuar tendo o privilegio de cuidar de voce quando eu retornar para a California em Agosto de 2025.

Seu prontuario medico continuara com a clinica El Camino Women Medical Group que mantera seu acompanhamento, todos os exames e cuidados medicos pertinentes. Em meados de abril, a clinica estara enviando por email o boletim com suas atualizacoes e novas formas de agendamento.

Meu ultimo dia na clinica sera dia 28 de junho, 2024. Se eu puder ajudar ate la, nao hesite em ligar e marcar sua consulta. Estarei fazendo o melhor para acomodar a todas.

Nao vou poder fazer consultas medicas a distancia, mas adoraria manter o contato neste ano que estarei longe.

Espero que possamos nos ver em breve!

New Members of our Team!

We have been fortunate to find Dr. Vanessa Dorismond, who will join us full-time this summer. You can read more about her below. We also have two amazing physicians supporting us through the end of the year: Drs. Kris Yogam and Aroti Achari.

Dr. Kris Yogam is a board-certified OBGYN who joins us with over 35 years of obstetric and gynecologic experience.  She has an impressive career in women’s health and is committed to high-quality support for patients during labor, delivery, and postpartum.   She will be supporting El Camino Women’s Medical Group in the hospital several days of each month during the rest of the year.

Aroti Achari, MD, is a board-certified OB/GYN. After completing her residency at Albert Einstein Medical, she joined a private practice in South Jersey, where she met her husband, and they moved to California. She enjoys all aspects of obstetrics & gynecology and minimally invasive surgery. She believes in a tailored approach for every patient by being detail-oriented, compassionate, and empathetic. Women’s health is not just a career; it’s her passion.  In her spare time, she likes spending time with her family, reading, biking, running, dancing, practicing yoga, and traveling. Someday, she hopes to (own or live) on a farm!  She will support El Camino Women’s Medical Group in the office a few days a month and occasionally in the hospital.

Transitioning from BabyScripts to e-Lōvu

It’s been almost three years since we first introduced the BabyScripts app for expecting mothers at our office. This app’s role in pregnancy education and providing access to all our office support materials has been helpful to many patients.

To build on this idea of continuous support for our pregnant patients, we are moving to a new, extraordinary program called e-Lōvu.  e-Lōvu is a new digital maternal health platform that brings together best-in-class technology-enabled care for mother and baby from pre-pregnancy through two years post-pregnancy.  Co-founded by Dr. Santosh Pandipati, who we’ve worked with for years in his role as a Maternal-Fetal Medicine expert, we have been so impressed by the extent of what e-Lōvu has to offer our pregnant and postpartum patients, from nutrition to mental health support, we are hoping to launch before the end of this month.

Office Visitor Policy Updates

The Designated Respiratory Virus Season has ended in Santa Clara County.   Masking is no longer required in our building or at El Camino Hospital.  We continue to ask that you avoid coming to the office if you have symptoms of infection and that you try to minimize visitors.

Bill Payment

We have completely transitioned to our new payment processing system, which requires you to be logged into your healow app or the patient portal to pay bills. However, payment at the time of check-in for outstanding balances will remain an option.  Our staff is available to support you if you encounter difficulties.

Don’t forget to follow us on social media to stay updated on office information and women’s health topics.  You can follow us on Facebook,  LinkedIn, or Instagram.  Your feedback on our office practices and physician and staff communication is always welcome. 

Online Prenatal and Women’s Health Classes

Prenatal Classes

We are now offering four virtual prenatal classes a month online.    These classes cover preparing for childbirth, breastfeeding, and newborn care.   These classes have been very popular, and we plan to have them every month.  They are also available for women interested in signing up, though we prioritize our patients.

Virtual Breastfeeding Class

This is a 2-hour class presented by Nadia, RN, our lactation educator.  The class is a virtual, in-depth review of breastfeeding.  Learn how to get the best start, avoid pain, make sure your baby is getting enough, and when to ask for help!

 Virtual Newborn Care & Safety Class

2.5-hour class presented by Nadia, RN

Practical tips for caring for a newborn

• Appearance of newborn
• Normal skin conditions
• bathing & diaper changing
• safe sleeping
• Newborn safety:
  • Car seat safety
  • Choking hazards
  • Poison control
  • Childproofing your home

Childbirth Preparation Part One

2.5-hour class presented by Nadia, RN:

• The last month of pregnancy
• Preparing for the hospital
• Laboring at home, when to call and when to come in
• Admission to the hospital
• Active labor
• Pain management

Childbirth Preparation Part Two

2.5-hour class presented by Nadia, RN:

• The last stage of labor: pushing
• Vaginal delivery
• Cesarean delivery
• Initial recovery in the hospital
• The postpartum period

You can learn more about these classes or register here.

Research at ECWMG

Sunbeam Study

Stanford University is interested in cord blood samples obtained during delivery.  You can learn more about the Sunbeam Study, which aims to learn how environmental and genetic factors play a role in food allergy and eczema development.   You can register here.

Welcome Dr. Dorismond

We are thrilled to welcome Vanessa Dorismond, MD, MA, MAS, to our hospital team, where she will bring a wealth of expertise and dedication. Dr. Dorismond is a distinguished specialist with a remarkable background in women’s health and advanced research.

After completing her residency at Howard University Hospital, Dr. Dorismond first pursued an Advanced Pelvic Surgery fellowship at Emory University Hospital in Atlanta, GA, and is now completing an Advanced Women’s Health Research fellowship at the San Francisco Veterans Affairs Medical Center (SFVAMC) while also earning her master’s in clinical research at the University of California, San Francisco (UCSF). Her focus areas encompass minimally invasive surgery, cervical cancer, and HPV screening, prevention, and management, demonstrating a profound commitment to enhancing women’s healthcare.

Remaining in the Bay Area, Dr. Dorismond is set to make significant contributions to our community through her clinical practice and research endeavors. Outside of her professional pursuits, she has cultivated a successful art business, showcasing her creative talents through various mediums online and at local markets.

Notably, Dr. Dorismond is proficient in English, French, and Spanish; she is a former professional volleyball player and holds a master’s in creative writing alongside her medical qualifications. She also passionately shares her medical expertise with startups in maternal health, cervical cancer screening, and AI healthcare, reflecting her dedication to innovation and progress in healthcare delivery.

Join us in welcoming Dr. Dorismond as she continues her exceptional journey of empowering patients and advancing medical knowledge in our community.

From Discomfort to Balance: Easing Menopause with Integrative Medicine

Dr. Malathi Acharya

Board Certified Internal Medicine

Board Certified Integrated Medicine

From Discomfort to Balance: Easing Menopause with Integrative Medicine

Menopause is a natural, normal part of aging in many women, except when it’s brought about by illness or treatments like surgery or medications.

Some women have an easier time with menopause, with only a few mild symptoms, while others face more difficult symptoms. The common symptoms of menopause are hot flashes and night sweats (vasomotor symptoms), sleep disruption, mood changes, and vaginal dryness.

Every woman experiences menopause differently, needing a unique approach to feel comfortable and well. While hormone replacement therapy (HRT) stands as a well-known option for managing menopause symptoms, it is just one of many paths. This blog explores the rich landscape of integrative treatments for menopause, focusing on dietary adjustments, supplements/herbal medications, and complementary therapies.

Dietary interventions

Eating well is an important aspect within integrative medicine. As an integrative medicine doctor, I strongly advise embracing a diet filled with whole and natural foods—vegetables, whole grains, beans, seeds, nuts, fruits, lean proteins, and healthy fats. Minimizing fried foods, simple carbs, alcohol, sugar, and salt is also important.

Some foods can help with menopause symptoms, like hot flashes. For example, soy and flaxseed are good choices. However, some foods and drinks  like caffeine, alcohol, spicy foods, and hot (temperature) foods or drinks can make hot flashes worse and are best avoided.

Soy

Soy has compounds called isoflavones, which can act like estrogen in the body and may be useful for hot flashes, bone, cholesterol, blood pressure and coronary artery disease. Eating foods with soy does not increase the risk of breast or uterine cancer.

Flaxseed

Including flaxseed in your diet can be beneficial due to its high content of plant omega-3s and phytoestrogens. While it may not significantly ease menopause symptoms such as hot flashes, studies suggest it could potentially lower breast cancer risk and offer health benefits in heart disease and diabetes, making it a healthy addition to your dietary choices during menopause.

Supplements

Moving beyond diet, let’s explore how certain supplements and herbal medications can further support women navigating through menopause.

Fish Oil

Fish oil can help with hot flashes, dry skin, and dry eyes as the prominent symptoms that menopausal women experience.

Herbal Medications

Black Cohosh has shown potential in easing hot flashes, mood disturbances, sleep disorders, and body aches associated with menopause. Valerian root may offer relief from sleep disturbances, while hops have been noted to improve hot flashes, night sweats, and insomnia symptoms.

While these herbal supplements offer potential benefits, it’s important to exercise caution as certain herbs may not be suitable for individuals with liver disease and should be avoided. For personalized advice and to ensure safety, consult your integrative doctor or holistic medical doctor before starting any new supplement regimen.

Other Complementary Therapies

With a foundation in nutrition and supplements, complementary therapies offer additional avenues to manage menopause symptoms effectively.

Mind-body Treatments like MBSR
Mindfulness-based stress reduction (MBSR) helps with the overall quality of life for women going through menopause. It doesn’t reduce how often hot flashes happen, but it makes them less bothersome and improves how women feel about their symptoms. The positive effects can last up to three months after the treatment ends.

Cognitive Behavior Therapy (CBT)
The North American Menopause Society (NAMS) recommends cognitive behavioral therapy for menopause symptoms. CBT helps manage the symptoms by changing the way you think and behave, offering a practical approach to easing menopause challenges.

Clinical Hypnosis

NAMS also supports using clinical hypnosis. This method has been proven to greatly reduce hot flashes, as well as improve sleep, reduce anxiety, enhance sexual function, and increase satisfaction with treatment among postmenopausal women.

Massage

Research shows that therapeutic massage can help reduce stress. Studies also indicate that using aromatherapy and massage can make menopause symptoms less severe and improve overall quality of life.

Acupuncture

Acupuncture helps lessen hot flashes in women going through menopause, women treated for breast cancer. It not only decreases the frequency and intensity of hot flashes but also improves overall quality of life and well-being.

About Dr. Malathi and Ayur Integrative Medicine

Dr. Malathi Acharya is the founder and Chief Medical Officer of Ayur® Integrative Medicine one of the premier practices for integrative medicine in California.  Ayur is dedicated to providing integrative medicine for cancer patients to support and empower you and your family throughout the healing journey. More info at Ayur Integrative Medicine

The 2024 Skin Allergen of the Year Is…

Lillian Soohoo, MD

Board Certified Dermatologist

Golden State Dermatology

Sulfites were recently named the “2024 Allergen of the Year” by the American Contact Dermatitis Society.  Also known as sodium disulfite, bisulfite or sodium metabisulfite,  these inorganic compounds are commonly used as preservatives in foods, drinks, medications, and personal care products. Exposure to sulfites may cause an itchy, red rash in susceptible individuals.

The American Contact Dermatitis Society (ACDS), founded in 1989, is an international professional organization comprised of dermatologists, allergists and occupational medicine physicians who seek to educate the public about under-recognized allergens that may trigger skin reactions.  Their mission is “dedicated to understanding and investigating the interplay among all forms of dermatitis, including contact, atopic, occupational, environmental, photo and drug.”  Their consensus selection of Sulfites as the 2024 Allergen of the Year puts a lens on this common ingredient and highlights its potential as a culprit for itchy skin rashes of unknown cause.

What are Sulfites?

Sulfites function as antioxidants and preservatives in a range of products including food and beverages, personal care products, and medications.

Patients who are allergic to sulfites typically present with itchy, red, scaly skin patches which may include small blisters or vesicles. Sulfites can also cause hives and anaphylactic reactions in allergic persons, so correct labeling of food and beverages is important.

Where do you find Sulfites?

Some common sulfite sources include hair coloring and bleach products, hairspray, tanning lotions, makeup, sunscreens, and deodorants. Medications, including topical steroid creams, topical antifungal creams, prescription eyedrops, and nasal solutions, can also contain sulfites. Even swimming pool water may contain sulfites when added to adjust chlorine levels.

High-sulfite food products to be aware of include dried fruit (raisins and prunes are exceptions), bottled lemon or lime juice (but not frozen products), wine, molasses, grape juice, and pickled cocktail onions.

In occupational settings, sulfites may be present not only in food and drink products but also in the compounds used in their production, such as those used for sterilization during beer and wine fermentation. Other potential occupational sources of sulfite exposure include healthcare settings and textile, chemical, rubber, and pharmaceutical manufacturing.

It should be noted that Sulfites are distinct from sulfates, and the groups do not cross-react with each other. They are two separate allergies. Both sulfates (such as sodium lauryl sulfate) and sulfites are sulfur-based compounds. Sulfa drugs such as some antibiotics (Bactrim, Dapsone), diuretics (Lasix, HCTZ), and other medicines that contain a sulfonamide molecule are also not the same as sulfites. Therefore, an individual can be allergic to sulfites and not to sulfates or sulfa medications.

What does Sulfite contact dermatitis look like?

Patients with sulfite allergies can present with facial dermatitis related to cosmetics and medications used on the face, as well as products, such as shampoo used on the scalp, that have dripped onto the face. Interestingly, the scalp itself may not be involved since this area of the body is more resistant to contact allergy than the face.

In general, most cases of allergic contact dermatitis occur at the site of application of the allergen.  For example, a new rash developing on the hands is commonly due to use of soap containing the offending allergen. Or an eyelid rash may occur after applying a new eye-makeup remover.  An itchy rash on the lips is also common in sulfite allergic individuals who ingest sulfite-containing foods.

Common body areas for sulfite-induced rashes besides the face include hands, lips, and a generalized body rash.

What does this mean for you?

Sulfites are generally harmless to those without an allergy. Despite the widespread use of sulfites, reactions are uncommon and typically present on the face or hands. If you develop an itchy rash but don’t know the cause, consult a dermatologist to begin investigating the source of your discomfort. It’s possible that sulfites or another contact allergen could be the root cause of your skin rash.

1. Sulfites Selected as ACDS Allergen of the Year – Medscape – March 08, 2024. 
2. Warshaw, et al. (2021). Patch testing with sodium disulfite: North Am Contact Derm Group experience, 2017-18. Contact Dermatitis,85, 285-96.

Dr. Lillian Soohoo 

555 Knowles Drive; Suite 220

Los Gatos, CA  95032

Office: 408.317.3688

“Tongue-Tied”

By Katrina Chaung, M.D.

Board Certified ENT

Ankyloglossia, colloquially known as a “ tongue-tie” is a condition present at birth where the thin piece of tissue that connects the underside of the tongue to the bottom of the mouth, called the lingual frenulum, is shorter/thicker/tighter than usual or attaches more anteriorly (more towards the tip) of the tongue, limiting the movement of the tongue.  While there can be a range of variability in everyone’s anatomy, if the anatomy restricts the range of motion of the tongue enough, it can lead to difficulties with breast or bottle feeding in infants or with speech articulation in young children.  These symptoms can range from mild to severe.

Because tongue positioning and movement are crucial to being able to appropriately latch onto the breast and transfer milk into the mouth, infants with a tongue-tie may have trouble breast or even bottle feeding.  In severe cases, it can cause or contribute to inadequate nutrition and weight gain.  Ankyloglossia can also lead to significant pain for the mother and trauma to the breast, prolonged feeding sessions, and clicking sounds during nursing.

Tongue-tie can also impact accurate pronunciation and clarity of speech in older children and even adults.  The movement of the tongue is crucial for creating different sounds.  With limited tongue movement, certain sounds may be more difficult to pronounce.  Specifically, sounds such as “l”, “r”, “s” and “t”; require precise tongue placement and can be difficult to pronounce in the setting of ankyloglossia.  This may lead some children to compensate by substituting other sounds that are easier to produce or modifying their tongue positioning.  Over time, this can lead to persistent and habitual speech patterns.  Speech difficulties can subsequently impact self-esteem, social interactions, and academic performance.

A tongue-tie can be diagnosed on a physical exam.  Pediatricians, otolaryngologists, oral surgeons, and dentists are usually comfortable assessing the oral cavity and tongue.  Further testing is usually not necessary.

The treatment for tongue-tie is a small procedure where the lingual frenulum is cut or divided to allow for increased mobility of the tongue.  In infants, this procedure can usually be done comfortably in the office with local anesthesia if needed.  In older children or adults, depending on the level of cooperation and comfort level, the procedure can be performed under local or general anesthesia.  Subsequently speech or swallowing/feeding therapy may be recommended.

It is important to realize that not all individuals with the appearance of a tongue-tie will have associated issues.  In these cases, no intervention is necessary.  Early recognition of potential issues can significantly improve quality of life and contribute to appropriate speech development.

Katrina Chaung, M.D.

Board-certified, Otolaryngology-Head and Neck Surgery

Camino Ear, Nose & Throat

(408) 227-6300

Beyond the Baby Blues: Understanding and Overcoming Perinatal Depression

Dr. Sanjana Karim

Board Certified Psychiatrist

The arrival of a newborn is often celebrated as a joyous occasion. For many new mothers, however, the postpartum period can be a time of unexpected emotional turmoil. Often overshadowed by the “baby blues,” the more serious condition called peripartum depression can cast a long shadow on this supposedly happy time.

More Than Just the Baby Blues: Defining Peripartum Depression

The “baby blues” are a common experience affecting up to 80% of new mothers. Characterized by mild sadness, fatigue, and anxiety, these feelings typically peak within the first week after delivery and resolve on their own within a few days.

Peripartum depression, however, is a much more significant and persistent mood disorder. It encompasses a wider range of symptoms with a greater intensity and duration than the baby blues. Here’s a breakdown of the key differences:

Baby Blues

• Onset: Within a few days after delivery
• Duration: Less than 2 weeks
• Symptoms: Mild sadness, tearfulness, irritability, fatigue, difficulty sleeping
• Impact: Minor disruption to daily functioning

Peripartum Depression

• Onset: Can occur anytime during pregnancy or within the first year postpartum
• Duration: More than 2 weeks, often lasting months if untreated
• Symptoms: Intense sadness, anxiety, hopelessness, loss of interest in activities once enjoyed, difficulty concentrating, changes in appetite and sleep patterns, feelings of guilt or worthlessness, thoughts of harming oneself or the baby
• Impact: Significant impairment in daily functioning, affecting relationships, self-care, and ability to bond with the baby

Unveiling the Causes: Why Does Peripartum Depression Occur?

The exact cause of peripartum depression is still being researched, but it’s likely a combination of biological, psychological, and social factors:

• Hormonal fluctuations: Dramatic shifts in estrogen and progesterone levels after childbirth can contribute to mood swings and emotional instability.
• Sleep deprivation: Newborn care often involves frequent nighttime awakenings, leading to sleep deprivation, a known trigger for depression.
• Physical changes: The physical demands of recovering from childbirth and caring for a newborn can be overwhelming, leading to stress and exhaustion.
• Psychological factors: A history of depression, anxiety, or other mental health conditions can increase the risk of peripartum depression.
• Social factors: Lack of social support, feelings of isolation, and unrealistic expectations about motherhood can exacerbate existing vulnerabilities.

These factors create a perfect storm, impacting a new mother’s emotional well-being and making her susceptible to depression.

The Mask of Motherhood: Recognizing the Signs of Peripartum Depression

Peripartum depression can be remarkably good at hiding in plain sight.  New mothers, often overwhelmed and sleep-deprived, may downplay their symptoms, believing these feelings are normal or a sign of weakness.  However, recognizing the warning signs is crucial for seeking help:

• Emotional symptoms: Persistent sadness, tearfulness, irritability, anxiety, hopelessness, feelings of worthlessness, guilt, or shame about not being a good mother.
• Behavioral changes: Loss of interest in activities once enjoyed, social withdrawal, neglecting self-care, difficulty concentrating, changes in appetite or sleep patterns.
• Cognitive symptoms: Negative thoughts about oneself or the baby, difficulty making decisions, thoughts of harming oneself or the baby.
• Physical symptoms: Changes in appetite or sleep patterns, fatigue, headaches, body aches.

It’s important to note that not everyone will experience all these symptoms.  However, if you’re struggling with several of these for more than two weeks, it’s crucial to reach out for help.

Beyond “Just Get Over It”: Dispelling Myths and Seeking Support

Many myths and misconceptions surround peripartum depression. Here are some common ones to dispel:

• Myth: Peripartum depression is a sign of weakness or a failure as a mother.
• Fact: It’s a medical condition just like any other, and it’s not your fault.
• Myth: You should just “get over it” and be happy because you have a baby.
• Fact: You deserve to feel good and get the help you need.
• Myth: Only women with a history of mental illness experience peripartum depression.
• Fact: Anyone can develop peripartum depression, regardless of mental health history.

If you suspect you might be struggling with peripartum depression, here are some steps to take:

1. Acknowledge Your Feelings: The first step is acknowledging your struggles.  Don’t dismiss your emotions as “just the baby blues” or a sign of weakness.  Recognize that these feelings are valid and deserve attention.
2. Educate Yourself: Knowledge is power. Learn more about peripartum depression, its symptoms, and treatment options. Reputable sources like the National Institute of Mental Health (https://www.nimh.nih.gov/sites/default/files/documents/health/publications/perinatal-depression/20-mh-8116-perinataldepression.pdf) or Postpartum Support International (https://www.postpartum.net/) offer valuable information.
3. Talk to Your Doctor: Don’t hesitate to reach out to your healthcare provider. They can screen you for peripartum depression and discuss treatment options. Be honest and open about your symptoms and concerns.
4. Seek Support From Loved Ones: Isolation can worsen depression.  Talk to your partner, family, or close friends about how you’re feeling. Asking for help with childcare, household chores, or simply a listening ear can make a big difference.
5. Consider Therapy: Talking to a therapist can provide valuable coping mechanisms and emotional support.  Cognitive Behavioral Therapy (CBT) is particularly effective in treating peripartum depression.
6. Join a Support Group: Connecting with other mothers who understand what you’re going through can be incredibly helpful. Support groups can provide a safe space to share your experiences and receive encouragement.
7. Prioritize Self-Care: Taking care of yourself is essential for recovery.  Despite the demands of a newborn, try to get enough sleep, eat healthy meals, and engage in activities you enjoy, even if it’s just for a short while. Don’t feel guilty about prioritizing your own well-being.
8. Remember, It’s Not Your Fault: Peripartum depression is a medical condition, and you are not to blame for experiencing it. Don’t let feelings of shame or guilt hold you back from seeking help.
9. Be Patient with Yourself: Recovery takes time and effort. There will be good and bad days. Celebrate small victories and be patient with yourself throughout the process.
10. If You Have Thoughts of Harming Yourself or Your Baby, Seek Immediate Help: Reach out to your doctor, emergency services, or a crisis hotline.

Here are some additional resources that can be helpful:

• Postpartum Support International Helpline: 1-800-944-4773
• National Suicide Prevention Lifeline: 988 (or 1-800-273-8255)
• Crisis Text Line: Text HOME to 741741

Remember, peripartum depression is treatable. By taking these steps and seeking professional help, you can overcome this challenge and find joy in motherhood.

Ready to take control of your emotional well-being? 

Dr. Sanjana Karim at Peace Tree Mental Health specializes in women’s mental health, offering compassionate care for peripartum depression and other challenges.

Sanjana Karim, MD ABPN ABPM

Psychiatrist & Psychotherapist

2211 Post St, Suite 300    |    San Francisco, CA 94115

moc.h1787920388tlaeH1787920388latne1787920388MeerT1787920388ecaeP1787920388@tcat1787920388noC1787920388

Phone (415) 841-2850

www.peacetreementalhealth.com

About Dr. Karim and Peace Tree Mental Health 

Dr. Sanjana Karim is a Bay Area psychotherapist and psychiatrist specializing in women’s mental health, offering compassionate care for peripartum depression and other challenges. She also specializes in psycho-oncology, providing therapy and psychiatry support to women with cancer. Her office is located in San Francisco, CA and she treats women all over the state of California via telehealth/video. To learn more about Dr. Karim, please visit www.peacetreementalhealth.com.

The Impact of Marijuana Use During Pregnancy on the Neurodevelopmental Health of Children

Recent studies have unveiled concerning associations between maternal marijuana use during pregnancy and adverse neurodevelopmental outcomes in children. Amidst debates surrounding the legalization and societal acceptance of cannabis, understanding its effects on fetal and childhood development remains crucial. The latest research, presented at the European Psychiatric Association annual meeting, underscores the heightened risks of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) among offspring exposed to marijuana in utero. Delving into the implications of these findings is essential for informed decision-making and safeguarding maternal and child health.

 The Link Between Maternal Marijuana Use and Neurodevelopmental Issues

The study referenced highlights a significant correlation between prenatal cannabis exposure and an increased likelihood of neurodevelopmental disorders in children. Specifically, findings reveal a striking 98% higher odds for ADHD and a 94% higher risk for ASD among offspring of mothers who consumed marijuana during pregnancy. Such statistics underscore the intricate interplay between maternal behavior and fetal development, raising concerns regarding the potential long-term consequences of prenatal cannabis exposure.

Understanding the Mechanisms at Play

To comprehend the impact of maternal marijuana use on fetal neurodevelopment, it’s imperative to explore the underlying mechanisms. Tetrahydrocannabinol (THC), the psychoactive component of cannabis, readily crosses the placental barrier, exposing the developing fetus to its effects. THC interferes with crucial neurotransmitter systems involved in fetal brain development, potentially disrupting the intricate processes of neuronal proliferation, migration, and synaptogenesis. Moreover, cannabis exposure during pregnancy may perturb endocannabinoid signaling, which plays a pivotal role in modulating neuronal connectivity and synaptic plasticity. These disruptions could manifest as aberrations in neurobehavioral functioning, contributing to the heightened risk of ASD and ADHD observed in offspring.

The Role of Epigenetics

Emerging evidence suggests that prenatal cannabis exposure may exert epigenetic alterations, influencing gene expression patterns in the developing brain. Epigenetic modifications, such as DNA methylation and histone acetylation, can modulate the activity of genes involved in neurodevelopmental pathways. Consequently, maternal marijuana use during pregnancy could induce epigenetic changes that predispose offspring to neurodevelopmental disorders. Unraveling the epigenetic underpinnings of prenatal cannabis exposure represents a burgeoning area of research with profound implications for understanding the developmental origins of ASD and ADHD.

Addressing Confounding Factors

While the association between maternal marijuana use and neurodevelopmental issues is compelling, it’s essential to acknowledge potential confounding variables that may influence study outcomes. Factors such as maternal age, socioeconomic status, concomitant substance use, and access to healthcare services can significantly impact child neurodevelopmental outcomes. Disentangling the effects of cannabis exposure from these confounders necessitates rigorous methodological approaches, including prospective cohort studies with meticulous control for covariates. By elucidating the nuanced interplay between maternal cannabis use and child neurodevelopment, researchers can refine our understanding of this complex relationship.

Implications for Clinical Practice and Public Health

The findings underscored by the latest research have profound implications for clinical practice and public health initiatives. Healthcare providers play a pivotal role in educating expectant mothers about the potential risks associated with cannabis use during pregnancy. Incorporating routine screening for substance use into prenatal care protocols enables early identification of at-risk individuals, facilitating targeted interventions and support services. Furthermore, public health campaigns aimed at raising awareness about the adverse effects of prenatal cannabis exposure are essential for promoting informed decision-making among pregnant women and their families.

Navigating the Complexities of Policy and Advocacy

As policymakers grapple with the regulatory landscape surrounding cannabis legalization, addressing the potential impact on maternal and child health remains paramount. Balancing individual autonomy with public health imperatives necessitates evidence-based policy interventions prioritizing maternal and child well-being. Implementing comprehensive prenatal education programs and maternal support services can empower expectant mothers to make informed choices regarding substance use during pregnancy. Moreover, fostering multidisciplinary collaborations between healthcare providers, researchers, policymakers, and advocacy groups is essential for advancing evidence-based strategies to mitigate the adverse effects of prenatal cannabis exposure.

The link between maternal marijuana use during pregnancy and neurodevelopmental issues in children underscores the need for heightened awareness, research, and intervention efforts. Researchers can refine our understanding of the complex interplay between maternal behavior and child neurodevelopment by elucidating the mechanisms underlying this association and addressing confounding factors. Integrating these insights into clinical practice, public health initiatives, and policy frameworks is essential for safeguarding maternal and child health in an era of evolving cannabis legislation. Ultimately, prioritizing evidence-based approaches is paramount for mitigating the potential long-term consequences of prenatal cannabis exposure on the neurodevelopmental health of future generations.

Latest Guidelines on MonaLisa Touch Laser for Genitourinary Syndrome Menopause

The MonaLisa Touch laser has emerged as a promising treatment for the genitourinary syndrome of menopause (GSM), offering relief to millions of women worldwide experiencing symptoms such as vaginal dryness, burning, itching, and painful intercourse due to decreased estrogen levels.

Here are the most recent guidelines from leading medical societies shed light on its efficacy, safety, and optimal usage:

American College of Obstetricians and Gynecologists (ACOG):

ACOG recognizes the MonaLisa Touch laser as a viable option for treating GSM. In their updated guidelines, they highlight that the treatment has shown significant improvement in vaginal health, leading to decreased symptoms and improved quality of life for menopausal women.

International Society for the Study of Women’s Sexual Health (ISSWSH):

ISSWSH emphasizes the importance of MonaLisa Touch laser therapy in managing GSM-related symptoms, particularly for women who cannot or prefer not to use hormonal treatments. They recommend a comprehensive evaluation by a qualified healthcare provider before initiating treatment.

European Menopause and Andropause Society (EMAS):

EMAS endorses the use of MonaLisa Touch laser therapy as a non-hormonal option for alleviating GSM symptoms. They stress the need for ongoing research to establish its long-term safety and efficacy.

Society of Obstetricians and Gynaecologists of Canada (SOGC):

SOGC acknowledges MonaLisa Touch laser therapy as an effective treatment for GSM, particularly in cases where traditional therapies have been unsuccessful or contraindicated. They advocate for individualized treatment plans tailored to each patient’s needs.

European Society of Gynaecological Oncology (ESGO):

ESGO recognizes MonaLisa Touch laser therapy as a valuable tool in managing GSM symptoms in cancer survivors, emphasizing its potential to improve sexual function and overall quality of life post-treatment.

Key Takeaways:

• The MonaLisa Touch laser therapy is gaining widespread acceptance as a safe and effective treatment for GSM.
• It offers a non-hormonal option for women who cannot or prefer not to use hormonal therapies.
• Patients should have a thorough assessment with a gynecologist before deciding on treatment.

These latest guidelines from prominent medical societies underscore the role of MonaLisa Touch laser therapy as a valuable addition to the armamentarium for managing GSM, providing relief, and improving the quality of life for women experiencing GSM.

If this is a treatment you are interested in, please schedule a consultation with any of our physicians at El Camino Women’s Medical Group.   If you are ready to schedule the procedure, contact our office manager, moc.n1787920388emowo1787920388nimac1787920388le@ra1787920388hS1787920388.

Veozah: Revolutionizing Menopausal Relief

Menopause is a natural biological process that every woman experiences as she ages. However, the symptoms associated with menopause, particularly vasomotor symptoms (VMS) like hot flashes and night sweats, can significantly impact a woman’s quality of life. Veozah, a novel medication developed to alleviate these symptoms, has emerged as a promising solution, offering relief and restoring comfort to women navigating this transitional phase of life.

Development of Veozah:

Veozah was developed through extensive research and clinical trials by dedicated scientists and medical professionals. The primary goal was to create a safe and effective treatment explicitly targeting menopausal vasomotor symptoms. The development process involved rigorous testing to ensure the medication’s efficacy and safety.

The key breakthrough in Veozah’s development lies in its unique formulation: an innovative neurokinin 3 (NK3) receptor antagonist that targets the disrupted thermoregulation underlying VMS. It modulates neural activity within the thermoregulatory center by crossing the blood‐brain barrier, offering relief from hot flashes and night sweats

How Veozah Works:

Veozah targets the underlying cause of VMS during menopause. The receptor antagonist directly blocks one of the sources of hot flashes. It works in the hypothalamus, the area of the brain that controls body temperature.

Clinical studies have demonstrated the significant benefits of Veozah in alleviating menopausal vasomotor symptoms, including hot flashes, night sweats, and mood fluctuations. Women who have incorporated Veozah into their treatment regimen report a notable reduction in the frequency and severity of these symptoms, leading to improved quality of life and overall well-being.

One of the most significant advantages of Veozah is its rapid onset of action, with many women experiencing relief within one to two weeks of starting treatment. This quick response is particularly valuable for women struggling with severe and debilitating symptoms, allowing them to regain control and confidence in their daily lives.

Uptake in the Market:

Since its release, Veozah has garnered significant attention in the medical community and among menopausal women seeking alternative treatment options. Data showing it to be an effective, non-hormonal option for VMS has filled a much-needed gap in current treatment options for menopausal women.

The FDA approval of Veozah represents a groundbreaking advancement in the management of menopausal vasomotor symptoms, offering women a safe, effective, and natural alternative to traditional hormone replacement therapies. Its innovative formulation, rapid onset of action, and favorable safety profile have positioned it as a leading choice for women seeking relief from the discomfort and disruption caused by menopause.

The Evolution of Hereditary Cancer Screening: Empowering Women

In the healthcare landscape, few advancements have been as pivotal and empowering as the advent of hereditary cancer screening. This revolutionary tool has fundamentally transformed the way we understand and manage cancer risk, particularly in women, who often bear the brunt of its impact. From those with a familial history of cancer to those without, hereditary cancer screening has emerged as a critical part of knowing who needs earlier and additional testing.  Fortunately, these advances have also resulted in impoved accessibility through affordability.

Understanding Hereditary Cancer Screening

Hereditary cancer screening involves analyzing an individual’s genetic makeup to identify mutations or alterations that predispose them to certain types of cancer. By detecting these genetic anomalies, physicians can assess an individual’s risk profile and devise personalized strategies for prevention, early detection, and treatment.

The Role of Hereditary Cancer Screening in Women with a Family History of Cancer

For women with a familial history of cancer, hereditary cancer screening can be a helpful, empowering tool.  It provides women with insights into their genetic predispositions, enabling proactive measures to mitigate their cancer risk. By identifying inherited mutations associated with breast, ovarian, uterine, and other cancers, women can make informed decisions regarding preventive measures such as increased surveillance, risk-reducing surgeries, or lifestyle modifications.

Furthermore, hereditary cancer screening facilitates early detection efforts, allowing for timely interventions that can significantly improve treatment outcomes. Regular screenings and surveillance protocols tailored to an individual’s genetic profile empower women to take charge of their health and adopt a proactive stance against cancer, potentially saving lives in the process.

Hereditary Cancer Screening for Women Without a Family History of Cancer

While hereditary cancer screening has traditionally been associated with individuals with a familial predisposition to cancer, its relevance extends far beyond this demographic. Surprisingly, a significant proportion of cancer cases occur in individuals with no prior family history of the disease. In such cases, hereditary cancer screening plays a crucial role in uncovering underlying genetic factors that might otherwise go undetected.

By identifying inherited mutations in women without a familial history of cancer, hereditary cancer screening offers a preemptive strike against the disease. It allows healthcare providers to implement proactive measures tailored to an individual’s genetic risk profile, thereby averting potential cancer diagnoses or detecting them at an early, more treatable stage. This proactive approach not only enhances individual health outcomes but also contributes to the broader effort of reducing the societal burden of cancer.

The Accessibility Revolution: How Newer Technologies Have Democratized Hereditary Cancer Screening

Historically, its cost is one of the most significant barriers to the widespread adoption of hereditary cancer screening. Traditional genetic testing methods were often prohibitively expensive, placing them out of reach for many individuals, particularly those from underserved communities. However, the landscape has undergone a profound transformation with the advent of newer technologies.

Advancements in genetic sequencing technologies, such as next-generation sequencing (NGS), have revolutionized hereditary cancer screening, making it more accessible and affordable than ever before. NGS techniques allow for the simultaneous analysis of multiple genes associated with various cancer types, significantly reducing the cost per test. Moreover, automation and streamlining of laboratory processes have further enhanced efficiency, driving down overall costs and turnaround times.

As a result of these advancements, hereditary cancer screening has transitioned from being a niche service to a standard component of preventive healthcare. Women from diverse socioeconomic backgrounds now have access to this invaluable tool, empowering them to proactively manage their cancer risk and make informed decisions about their health.

In the realm of women’s health, hereditary cancer screening stands as a testament to the power of knowledge and proactivity. By unlocking the mysteries of our genetic code, this revolutionary tool empowers women to take control of their health destinies, whether they have a familial history of cancer or not. From personalized prevention strategies to early detection and intervention, hereditary cancer screening offers a multifaceted approach to combating this pervasive disease.

Moreover, the democratization of hereditary cancer screening through newer technologies ensures that its benefits are not confined to a privileged few but are accessible to all women, regardless of their socioeconomic status. As we continue to harness the potential of genetic insights in healthcare, the role of hereditary cancer screening in women’s health will only continue to grow, ushering in a future where cancer is not just treated but prevented altogether. In this future, empowered by knowledge and equipped with proactive tools, women can stand strong in the face of cancer, united in their pursuit of a healthier, cancer-free world.

Take Charge of Your Healing Journey: Empowered Healing Masterclass!

El Camino Hospital Visitor Policy Updates

General information on visitor’s policy

Last updated visitor guidelines from April 1, 2024

All visitors to the hospital must be healthy and without symptoms of infection.  Please read more here.

Since April 1^st, 2024, masking is no longer required of staff, patients, or visitors anywhere in the hospital, though it is encouraged and masks remain available.

As we all know, this pandemic has been through several phases with changing recommendations, so these visitor policies may change.  At no point during the pandemic has El Camino Hospital prevented laboring or postpartum women from having at least one visitor with her that met requirements.

Highlights from our Women’s Health Blog

Our Women’s Health Blog continues to be a very popular part of our website, attracting over five thousand readers a month worldwide.  We find our blog a helpful vehicle to provide up-to-date information on relevant women’s health issues.  Last quarter an article on paternal age and its relationship to childbearing was again the most-read article on our blog.  Almost 6,000 people read up on paternal age!  An article by guest author Dr. Shyamali Singhal on avoiding cancer-causing chemicals in cosmetics was read by over 1500 people.  It’s been the most commonly read article in our blog for almost a year.     An older article on the science behind couples trying to conceive a baby of a certain gender, also with over 1,500 people wanting to see if they can influence the gender they conceive was our third most-read article this last quarter.

We update our blog a few times monthly with information on various women’s health issues.  Recent posts have been on the struggle of mental health challenges in women with PCOS, a discussion on mental health as a major contributor to perinatal mortality, and treatment options for perimenopausal and menopausal women with vaginal dryness.

Follow us on Facebook, LinkedIn, or Instagram to be informed when we post new articles and stay updated on women’s health news.

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