To my Patients,
What lurks beneath the surface
In a recent study published in the journal Human Reproduction, it was found that early life exposure to certain chemicals commonly found in cosmetics and other household products was linked to early puberty in girls. These chemicals—called endocrine disruptors (EDCs)– are widely used in everyday products such as fragrances, soaps and toothpaste and have previously been found to affect hormonal pathways in developing children and adolescents. This recent study helps to clarify some of the impacts these chemicals can have. Specific EDCs and their effects were highlighted in the study:
- Monoethyl phthalate: 1.3 months earlier pubarche (onset of puberty) in girls
- Triclosan: 0.7 month earlier onset of menarche (menstruation)
- 2,4-dichlorophenol: 0.8 month earlier menarche
The researchers found a twofold increase in EDC levels in mothers’ urine during pregnancy. Exposure to EDCs after birth was also associated with early pubarche and menarche in girls.
According to one researcher, “this is important because we know that the age at which puberty starts in girls has been getting earlier in the last few decades — one hypothesis is that chemicals in the environment might be playing a role, and our findings support this idea. Earlier puberty in girls increases their risk of mental health problems and risk-taking behavior as teenagers and increases their risk of breast and ovarian cancer over the long-term, so this is an important issue to address.”
I urge you to read labels before buying household products in order to ascertain that they are free of these EDCs. Other resources are also available… check out the Environmental Working Group’s “Healthy Living smartphone app, which enables consumers to scan UPC labels to determine products’ contents and safety ratings.
The deadly “anti-vax” movement
Reported cases of measles have increased more than 30% globally over the last couple of years, according to the World Health Organization (WHO). Most of these increases have occurred in the Americas, the Eastern Mediterranean, and Europe. According to the report, measles was responsible for 110,000 deaths in 2017. The spike is blamed largely on the decrease in vaccination rates as a result of fake news about the dangers of vaccines. Please don’t believe the hype! Vaccines are safe and effective. I encourage everyone to get all of the standard vaccines for which they are eligible based on their age or level of health. And it’s still not too late to get the flu shot this season! Find it, get it. Do it for yourself and for your community.
Better not hike up your pants on that next hike
Another nasty tick has made its mark (pardon the pun). According to a recent announcement in the Morbidity and Mortality Weekly Report (MMWR) from the Centers for Disease Control (CDC), the Asian longhorned tick (Haemaphysalis longicornis)—originally native to eastern Asia—has gained a foothold in nine states, including Connecticut, New Jersey, New York, Pennsylvania, Virginia, West Virginia, North Carolina, Maryland and Arkansas. This particular tick has been found to carry numerous disease-causing organisms (including Rickettsia, Borrelia (which causes Lyme disease), Ehrlichia, and Anaplasma). It has also been linked to a particular virus which causes fever and hemorrhage. So far in the US, however, no associated human illnesses have been reported. According to the authors of this report, the presence of this tick in the US “represents a new and emerging disease threat.” More research will be needed as related to the tick’s biology and ecology, disease surveillance and approaches to testing. In the meantime, as always, please make every effort to consistently employ good tick bite prevention measures. More to come on this.
A mammography update
According to researchers at New York University’s Langone Health in New York City, annual screening with mammography is beneficial in women ages 30-39 at high risk for breast cancer. Based on this research, screening mammograms are recommended for the following groups of high-risk women in their 30s:
- Women with a personal history of breast cancer (this may seem obvious)
- Women with a family history of breast cancer (in a mother, daughter, or sister), particularly if the cancer arose prior to menopause
- Women with dense breast tissue as seen on a previous mammogram
These data support previous recommendations by the American College of Radiology that every woman by age 30 should be assessed for risk of breast cancer by their primary care doctor or gynecologist, and if risk factors are present, mammography should be considered.
And in a related study from the University of Rochester, it was found that enough women age 75 and over undergoing screening mammography were found to have breast tumors to justify screening mammography for healthy women in this age group. Previous (somewhat controversial) guidelines from the United States Preventive Services Task Force (USPSTF) had indicated that there was “not enough evidence to assess benefits and harms of screening mammography in women at or above age 75. So if you happen to fall into this category, I recommend that you have an informed discussion about breast cancer screening with your physician.
That’s all for now. Happy Holidays to you all… enjoy your families, stay well and get your flu shots!