Endometriosis: Facts for Every Woman

Approximately 5 million women in North America have endometriosis. Symptoms can range from mild to severe and commonly include painful menstrual cramps (dysmenorrhea), pelvic pain, heavy menstrual bleeding, pain during intercourse or bowel movements and infertility.

Although endometriosis is common, it’s also widely misunderstood and often misdiagnosed. Education is important to increasing awareness. We recently joined Dr. Christine Metz, Investigator at the Feinstein Institute for Medical Research and Professor at the Hofstra Northwell School of Medicine, for a Q&A session on the topic of endometriosis. Dr. Metz shared some valuable information and insights.

What is endometriosis?

Endometriosis is characterized by the growth of endometrial tissue or lesions outside of the uterus. These lesions can grow on the lining of the pelvis, internal organs (e.g. the outside of the uterus, ovaries, Fallopian tubes and rectum). In some women, lesions can grow on more distant areas of the body, including the diaphragm, lungs, kidneys and brain.

What causes endometriosis?

The cause of endometriosis is not completely understood. However, many researchers believe that it arises after abnormal menstrual flow where menstrual blood is carried through the fallopian tubes into the pelvic cavity instead of exiting through the vagina. Like the endometrium, which sheds monthly, endometriosis lesions bleed in response to monthly hormone fluctuations. Other factors that may influence endometriosis are genetics and environmental and immune system factors.

How is endometriosis diagnosed?

One of the most frustrating problems for patients with endometriosis is delayed diagnosis, which can take up to 10 years. The diagnosis of endometriosis requires laparoscopic surgery with pathology confirmation of the biopsy specimens. Early diagnosis by a doctor who specializes in treating endometriosis patients is important because early treatment can dramatically improve patient outcomes.

Do pain and other symptoms correlate with the severity of endometriosis?

No. Pain and other symptoms do NOT always correlate with the severity of the disease.

What are the treatments for endometriosis?

While there is no cure for endometriosis, treatments include non-steroidal anti-inflammatory (NSAID) drugs and other pain relievers, hormonal contraceptives (e.g. birth control pills or vaginal rings), other hormonal agents (e.g. gonadotropin-releasing hormone (GnRH) agonists and antagonists, androgenic agents, progestins and Danazol) and surgery to remove the lesions or the uterus (in severe cases only).

What can women do?

Researchers at the Feinstein Institute for Medical Research at Northwell Health are looking for women with and without endometriosis to participate in the ROSE (Research OutSmarts Endometriosis) research study. Our goal is to investigate the causes of endometriosis and develop non-invasive diagnostic methods and new treatments for women suffering with endometriosis. For additional information, please contact us at ROSE@northwell.edu or call 516-562-ENDO (3636).

Katz Institute for Women’s Health is also here to answer your questions about endometriosis. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

The Importance of Gender-Specific Research

The Importance of Gender-Specific Research

While there has been considerable publicity about the gender pay gap, it’s by no means the only inequality that women face on a widespread basis. We’ve learned that gender differences matter in all aspects of health and disease and we should not assume that study results for men are the same as for women. Historically, there has been a lack of gender-specific research which has had an impact on the ability of women to obtain accurate diagnosis and treatment. Because females have been generally excluded from research participation, they unfortunately have been overlooked in research findings.

Encouraging Researchers to Enroll More Women in Studies

There have been significant strides to encourage more gender-specific research which is enabling healthcare professionals to provide more specialized, effective care for women. More than 20 years ago, the National Institutes of Health (NIH) made a ruling that every study they funded had to state whether women and minorities were included and in what proportions. If women were not included, an explanation was required. In 2016, the Food and Drug Administration (FDA) Office of Women’s Health, in partnership with the NIH Office of Research on Women’s Health, launched the Diverse Women in Clinical Trials Campaign to further raise awareness about the importance of diverse women participating in clinical trials. The NIH, the FDA and the Centers for Disease Control and Prevention (CDC) continue to develop new policies, programs and procedures to mandate and implement the inclusion of more women, as well as racial and ethnic minorities, in research.

The Challenge of Gender Disparity in Medical Research

Despite efforts to enroll more women in studies, there continues to be an under representation of female participants. According to the NIH, only one-third of cardiovascular clinical trial participants are female. Yet, cardiovascular disease is the number one killer of both men and women, and their presenting symptoms and response to treatments are different.

“Large gender gaps in research participation limit our findings on the difference between men’s and women’s health,” says Dr. Christina Brennan, MD, MBA, Vice-President, Clinical Research, Northwell Health. “Even when women are enrolled, the data is not analyzed and reported separately which can limit our understanding of findings.”

More recently, in the cases of heart disease, as well as lung cancer, there has been increased inclusion of women in research and clinical trials. This has led to greater knowledge and better tools for clinicians to provide optimal care for women.

Participating in a Clinical Trial

Although many women participate in clinical trials, there is still the need for greater involvement. Women from all ages, racial and ethnic groups can participate in trials, including those with disabilities or chronic health conditions. Through participation, women can make a difference by helping doctors learn more about women’s health.

Want to learn more about gender-specific research? At Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

Integrative Medicine: A Holistic Approach to Healthcare

Integrative Medicine: A Holistic Approach to Healthcare

What Are the Benefits of Integrative Medicine?

Integrative medicine is about teaching healthier habits and treating the whole person and not just specific symptoms. The benefits are often far-reaching and long-lasting for patients. Integrative medicine can be an excellent tool for sustaining good health, as well as for treating chronic issues and painful or debilitating diseases and injuries.

Key Principles of Integrative Medicine

Unlike alternative medicine which refers to an approach to healing that is used in place of conventional medical therapies, integrative medicine uses all appropriate therapeutic approaches to achieve optimal health and healing. The following are some of the key principles of integrative medicine:

  • A strong partnership between patient and physician
  • Use of both conventional and alternative medicines and modalities
  • A focus on non-invasive treatments when possible
  • A clear emphasis on promoting health and illness prevention through ongoing healthy living

Combining Therapies

Over the last several decades, the popularity of combining conventional treatments with complementary therapies has grown tremendously. Patients and healthcare providers who were once skeptical of alternative treatments have become believers in the benefits of an integrative approach.

Increasingly, healthcare professionals who specialize in modern medicine are incorporating integrative medicine to promote health and wellness. By combining these approaches with conventional therapies, integrative practitioners can partner with patients and their primary healthcare providers to help relieve pain, reduce stress and support overall well-being.

And, many healthcare providers themselves use integrative approaches for their own personal healthcare because of the distinct health and wellness benefits.

“All medicine is integrative,” says Lucy P. Gade, MD, MPH, Medical Director, Center for Wellness and Integrative Medicine, Northwell Health. “By shifting from being disease-oriented to health-oriented, we can identify risks and minimize them as part of a whole person approach to healthcare. This can enable individuals to live healthier and happier lives.”

Common Integrative Health Approaches Used in Integrative Medicine

  • Deep breathing
  • Yoga
  • Tai chi or qi gong
  • Meditation
  • Massage
  • Functional nutrition
  • Homeopathy
  • Guided imagery

Want to learn more about integrative medicine? At Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

colorectal cancer

Take Action to Prevent Colorectal Cancer

Colorectal cancer doesn’t get the same amount of attention as some high-profile cancers, but it should. Many women are surprised to learn that colorectal cancer is the fourth most common cancer in the United States and the second leading cause of death from cancer. Found most often in individuals who are 50 and older, this common form of cancer is highly preventable. In fact, six out of 10 deaths from colorectal cancer could be prevented with regular screening.

Colorectal Cancer Screening Saves Lives

Screening for colorectal cancer can help find cancer at an early stage and decrease your chance of dying from it. The U.S. Preventive Services Task Force (USPSTF) recommends screening colonoscopy beginning at age 50 and continuing until age 75 years. Women who are at a higher risk of developing this form of cancer should be screened at a younger age and may need more frequent screening.

The colonoscopy procedure is painless with a low risk of complications. Written instructions, provided by your doctor, prescribe a solution required to cleanse the colon. Fortunately, colonoscopy prep has improved over the years and the days of consuming large amounts of an unpleasant tasting laxative prior to the procedure are over. During the colonoscopy, your physician looks at the interior walls of the rectum and colon with a flexible, lighted tube called a colonoscope. If polyps are discovered, samples of tissue may be collected for closer examination and polyps can be removed.

“Simply put, screening colonoscopy saves lives,” says Dr. David Rivadeneira, Director of Colon and Rectal Surgery at Huntington Hospital. “Colorectal cancer is extremely prevalent, yet screening is fast and very safe with a very low complication rate.”

Colorectal Screening Tests

While colonoscopy remains the gold standard screening test for colorectal cancer, there are new tests now being introduced that use advanced DNA technology to find elevated levels of altered DNA which could be associated with cancer or pre-cancer. These tests include Cologuard, which is a single stool sample kit that patients can use at home.

Other colorectal cancer screening tests that are currently available include:

  • High-sensitivity fecal occult blood test – Checks for hidden blood in stool samples.
  • Flexible sigmoidoscopy – Looks at the interior walls of the rectum and part of the colon.

It’s important to discuss with your doctor which test is best for your specific needs.

What Else Can You Do to Prevent Colorectal Cancer?

Along with getting regular screenings for colorectal cancer, there are also lifestyle decisions you can make to lower your risk.

  • Don’t smoke
  • Maintain a healthy weight
  • Get regular exercise
  • Drink alcohol only moderately, if not at all
  • Limit red meat, especially processed meat
  • Get the daily recommended amount of calcium and vitamin D in your diet
  • Take a multivitamin with folate

Want to learn more about colorectal cancer prevention? At Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist. For questions about colorectal cancer and screenings, please contact Dr. David Rivadeneira at 631-470-1450.


Simple Tips for Everyday Healthy Eating

While it’s a given that we all need balanced nutrition for good health, it can sometimes be challenging to put this into daily practice. For many women, the hectic daily routine of work and family means that optimal food choices are put on the back burner. It can be overwhelming to think about making sweeping changes to your diet. The reality is that even small improvements can make a big difference. It’s also true that changes that turn into healthy eating habits are developed over time.

March is National Nutrition Month, and this year’s theme is Put Your Best Fork Forward – a reminder that every bite counts. With every meal or snack, you can choose a nutritious option. The following are some simple ideas that can help you eat better each day.

Choose a color a day for fruits and vegetables

With many healthy eating options to select from, one way to narrow down your choices is to focus on one color of produce for each day. For example, on Monday, choose from the bounty of red options, including peppers, apples, berries and potatoes. When you begin to make choices based on the amazing spectrum of colorful fruits and vegetables, you can enjoy old favorites and experiment with new options, too.

Choose more whole grains

Eating grains, particularly whole grains, is an important part of healthy eating. Grains provide important nutrients, including fiber, several B vitamins and minerals, such as iron, magnesium and selenium. By swapping out white bread, biscuits, and pasta for whole grain alternatives, you may also help reduce blood cholesterol levels and your chance of developing heart disease, obesity and type 2 diabetes.

Include low-fat dairy products or dairy alternatives

When possible, choose fat-free or low-fat milk, yogurt and cheese. For those who are lactose intolerant, there are lactose-free products available, as well as calcium-fortified, plant-based milk substitutes. Other beneficial sources of calcium to consider include sardines, leafy greens, and some types of beans.

Watch your portions

How much we eat is as important as what we eat. Americans are eating larger portions than ever, and this is a big contributor to the growing epidemic of obesity in the United States. Not sure how many calories you’re taking in each day? Check out the USDA’s SuperTracker. This tool can help you evaluate the foods you eat and compare them to your nutrition targets.

Keep healthy snacks on hand

You’ll reduce your risk of grabbing for a candy bar or other less-than-healthy snack if you have more nutritious options available. Easy options include nuts, protein bars and plain yogurt.

Find activities you enjoy

You don’t have to be training for a marathon to get sufficient physical activity. The key is finding activities that you like to do on a regular basis. A simple walk each day is a great place to start. Consider partnering with a buddy who can keep you “on track.”

Avoid fast weight loss diets

Fad diets may help you take off a few pounds, but it’s unlikely that the weight loss will last.

“Fad diets just don’t work,” says Marissa Licata, MS, RD, CDN, Registered Dietitian, Katz Institute for Women’s Health. “If it seems too good to be true, it probably is. Choose a weight loss plan that teaches you how to make long-term positive changes. Changes to behavior and the type of food you choose is where you’ll find long-term success.”

Get Expert Advice and Guidance

A licensed dietitian can help you improve your health and manage diseases. By working with you to create personalized meal planning, you gain the tools you need to make sound nutritional choices.

Want to learn more about resources to support your nutritional needs? At the Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

cervical cancer screening

What’s New in Cervical Cancer Screening and Prevention?

Recently, sports journalist Erin Andrews confirmed that she had undergone surgery for cervical cancer. By making her diagnosis and treatment public, Andrews provided an important reminder to all women that cervical cancer screenings save lives. Once a common cause of death among women, the cervical cancer death rate has decreased substantially over the past 40 years, primarily because of Pap tests which detect cervical cancer in its earliest and most preventable stage.

Although Pap tests have been used to screen for cervical cancer for decades, the guidelines for when women should be screened have changed in recent years. It was once considered a healthcare necessity for women to undergo an annual Pap test. These guidelines have been revised due to new research and advances in preventive care. The American Cancer Society and the US Preventive Services Task Force now recommend that healthy women begin cervical cancer screenings at age 21 with Pap tests every three years. At age 30, women should have a Pap test combined with an HPV test every five years. Women over the age of 65 may not need to continue screening if there has not been a history of significant cervical pre-cancer and her screening has been adequate. Of course, these guidelines do not apply to all women. Depending on specific circumstances, a woman may require other testing or continued screening. This is why it’s important to discuss your specific screening needs with your healthcare provider.

Understanding the Link between HPV and Cervical Cancer

Certain types of human papillomavirus (HPV) cause nearly all cases of cervical cancer. HPV is the most common sexually transmitted infection in the United States. In fact, it’s so common that the vast majority of sexually active men and women acquire it at some point in their lives. There are many types of the HPV virus. Yet, only some cause cervical cancer, as well as other cancers, including cancer of the vulva, vagina, anus, throat and tonsils. Cancer caused by HPV is generally slow-growing and can take years and even decades to develop.

The best way to reduce the spread of HPV infection is through vaccination. The HPV vaccine is highly effective in protecting females, as well as males against HPV when given in the recommended age group. Currently, the Centers for Disease Control (CDC) recommend 11 to 12-year-olds receive two doses of HPV vaccine to protect against developing cancers caused by HPV. Catch-up vaccines are recommended for males through age 21 and for females through age 26 if they haven’t been previously vaccinated.

“Cervical cancer screening and HPV vaccinations have the potential to virtually eliminate cervical cancer,” say Dr. Andrew Menzin, Chief of Gynecologic Oncology for Northwell Physician Partners, Central Region. “It’s essential for healthcare providers to help their patients understand what they can do to proactively mitigate their risk of this highly preventable form of cancer.”

Cervical Cancer Treatment

For the over 11,000 women in the United States who develop cervical cancer each year, there is also good news. Those who are diagnosed with cervical cancer in its earliest and most preventable stage have a very high survival rate. In other words, be an advocate in your health by ensuring you’re staying current with life-saving cervical cancer screenings.

Learn more about cervical cancer prevention. At Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

Go Red

Go Red in February!

Heart disease is the number one killer of women. In fact, more women die of cardiovascular disease than the next three most common causes of death combined, including all forms of cancer. And, 90 percent of women have one or more risk factors for developing heart disease. While these statistics may seem downright scary, there’s also good news. We all have the power to fight the battle against heart disease by making a few simple lifestyle changes and educating ourselves and others.

The Go Red for Women Movement launched by the American Heart Association in 2004 is making giant strides in raising awareness about heart disease in women. Since the start of the campaign, awareness levels have risen from 34 percent to 54 percent of women who know that heart disease is their number one killer. Millions of dollars have also been raised to fund heart disease research with the specific aim to save lives. Northwell Health is a Cities Go Red Sponsor for the American Heart Association’s Go Red for Women movement.

What You Can Do

On February 3rd, join women throughout New York and across the United States who will be wearing red as a statement to help prevent heart disease and stroke. Encourage your friends and family to do so, too! Participate in one or more of the many events Northwell Health will be hosting throughout the month of February to learn more about heart health.

Are you ready to lower your risk of heart disease? We encourage you to check out the American Heart Association’s “Life’s Simple 7.” This list of steps you can take can make a big difference in improving your health and helping you to live a long, healthy life!

Learn more about how to take charge of your heart health. At Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

Looking Your Best at Any Age

Tips for Graceful Aging

We all know those fortunate women who don’t seem to age as fast as others. They sustain glowing skin, bright eyes and a youthful smile for decades without having any signs of having “work” done. Have you wondered what their secret is for slowing the aging process? The truth is they are likely taking proactive steps that all of us can use to look and feel young.

Minimize Sun Exposure

According to a 2013 study of sunscreen and prevention of skin aging, sun exposure accounts for up to 80 percent of visible signs of aging on the face. In other words, that “healthy” looking tan in your 20s is the cause of fine lines and wrinkles that begin to appear in your 30s and 40s. To maintain young-looking skin, it’s vital to stay out of the sun as much as possible. Wear hats and clothing to protect your skin and get into the habit of wearing sunscreen when you’re outside. This includes during the winter!

Moisturize, Moisturize, Moisturize

Just peruse the skincare aisle of your local grocery or drug store, and you’ll see a dizzying array of creams, lotions and serums that all promise to make you look younger and wrinkle-free. Of course, there’s a lot of marketing that goes into skincare products. Yet, it’s not all gimmick. In fact, the regular use of a facial moisturizer can help treat dry skin and improve overall skin texture. Consider adopting a daily moisturizing regiment to maintain balance in your skin. For mature skin, look for an exfoliating cream that contains ingredients such as salicylic acid, beta hydroxy acids and antioxidants like vitamin C to promote cell turnover and fight cell damage that cause skin to age.

Embrace a Healthy Lifestyle

While staying out of the sun and getting into the habit of moisturizing can go a long way toward protecting your skin, it’s also important to make some healthy lifestyle decisions. By eating a balanced diet, avoiding smoking and getting regular exercise, you’ll not only be healthier, you’ll look healthier too.

“Maintaining good health is essential to protecting the visible top layer of the face.” says Dr. Lyle Leipziger, M.D., FACS, chief of the Division of Plastic and Reconstructive Surgery at North Shore University Hospital (NSUH) and Long Island Jewish Medical Center (LIJMC). “By making proactive decisions to eat right, exercise and avoid sun exposure, you can greatly reduce many of the signs of aging, such as fine lines and skin discolorations.”

Aging Is Inevitable

It’s a fact of life that, while you may be able to slow down aging, there is simply no way to completely stop its progression. For every woman, there are normal changes that inevitably appear over time. Thinning skin and loss of facial volume can create a droopy appearance that can make some feel less than youthful when they look in the mirror. Advancements in technologies and treatments have made it easier than ever to look younger.

If you feel you’re aging faster than you’d like or simply want to freshen your look, the good news is there are many non-surgical and minimally-invasive procedures that can help. Botox or Dysport injectable treatments can reduce the appearance of facial wrinkles by temporarily paralyzing muscle activity in injected areas. This simple treatment takes about 10 minutes to complete and offers significant improvements in just a few days. Artful placement of dermal fillers, such as Juvederm, Voluma and Restylane, can also offer amazing results by plumping lips, improving contours, filling depressions, lessening wrinkles and replacing lost volume in the face. These non-surgical procedures are cost-effective and effective at reversing many signs of aging.

For longer-lasting results, there are also surgical procedures that can greatly diminish signs of aging. Procedures like eyelid lifts, facelifts and brow lifts can dramatically improve appearance. “Surgery is often the best option for a woman who wants to reset the clock with a one-stage procedure for a more youthful appearance,” says Dr. Leipziger.

If you’re considering cosmetic surgery, first and foremost, it’s important to choose the right surgeon. As you talk to prospective cosmetic surgeons, don’t be shy about asking questions. A few questions to ask include:

  • How long have you been performing cosmetic surgery?
  • Are you certified by the American Board of Plastic Surgery?
  • At which hospitals do you have privileges?
  • Am I a good candidate for this procedure?
  • Can I speak to some of your previous patients about their experience?
  • Can I view before and after photographs of the proposed procedure?
  • What will the cost be and do you offer any financing options?
  • What happens if the results aren’t what we planned?

Choose your surgeon with care to minimize the chance of having complications and unsatisfactory results. Your best bet is always a Board Certified Plastic Surgeon who is skilled, professional and willing to listen closely to find out exactly what you want and need.

Do you want to learn more about how to look your best at any age? At Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist. For questions about cosmetic enhancements, please contact Dr. Lyle Leipziger at 516-465-8787.